Senate File 542 - Reprinted SENATE FILE 542 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO SSB 1218) (As Amended and Passed by the Senate June 22, 2011 ) A BILL FOR An Act relating to and making appropriations for health and 1 human services and including other related provisions, 2 providing penalties, and including effective, retroactive, 3 and applicability date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 SF 542 (3) 84 pf/jp
S.F. 542 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,302,577 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. The amount appropriated in this section includes 30 additional funding of $450,000 for delivery of long-term care 31 services to seniors with low or moderate incomes. 32 3. Of the funds appropriated in this section, $179,946 shall 33 be transferred to the department of economic development for 34 the Iowa commission on volunteer services to be used for the 35 -1- SF 542 (3) 84 pf/jp 1/ 209
S.F. 542 retired and senior volunteer program. 1 4. a. The department on aging shall establish and enforce 2 procedures relating to expenditure of state and federal funds 3 by area agencies on aging that require compliance with both 4 state and federal laws, rules, and regulations, including but 5 not limited to all of the following: 6 (1) Requiring that expenditures are incurred only for goods 7 or services received or performed prior to the end of the 8 fiscal period designated for use of the funds. 9 (2) Prohibiting prepayment for goods or services not 10 received or performed prior to the end of the fiscal period 11 designated for use of the funds. 12 (3) Prohibiting the prepayment for goods or services 13 not defined specifically by good or service, time period, or 14 recipient. 15 (4) Prohibiting the establishment of accounts from which 16 future goods or services which are not defined specifically by 17 good or service, time period, or recipient, may be purchased. 18 b. The procedures shall provide that if any funds are 19 expended in a manner that is not in compliance with the 20 procedures and applicable federal and state laws, rules, and 21 regulations, and are subsequently subject to repayment, the 22 area agency on aging expending such funds in contravention of 23 such procedures, laws, rules and regulations, not the state, 24 shall be liable for such repayment. 25 DIVISION II 26 DEPARTMENT OF PUBLIC HEALTH —— FY 2011-2012 27 Sec. 2. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 28 from the general fund of the state to the department of public 29 health for the fiscal year beginning July 1, 2011, and ending 30 June 30, 2012, the following amounts, or so much thereof as is 31 necessary, to be used for the purposes designated: 32 1. ADDICTIVE DISORDERS 33 For reducing the prevalence of use of tobacco, alcohol, and 34 other drugs, and treating individuals affected by addictive 35 -2- SF 542 (3) 84 pf/jp 2/ 209
S.F. 542 behaviors, including gambling, and for not more than the 1 following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,603,190 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 4 a. (1) Of the funds appropriated in this subsection, 5 $4,353,830 shall be used for the tobacco use prevention and 6 control initiative, including efforts at the state and local 7 levels, as provided in chapter 142A. 8 (2) Of the funds allocated in this paragraph “a”, $453,830 9 shall be transferred to the alcoholic beverages division of 10 the department of commerce for enforcement of tobacco laws, 11 regulations, and ordinances in accordance with 2011 Iowa Acts, 12 House File 467, as enacted. 13 b. Of the funds appropriated in this subsection, 14 $20,249,360 shall be used for problem gambling and substance 15 abuse prevention, treatment, and recovery services, including a 16 24-hour helpline, public information resources, professional 17 training, and program evaluation. 18 (1) Of the funds allocated in this paragraph “b”, 19 $17,132,508 shall be used for substance abuse prevention and 20 treatment. 21 (a) Of the funds allocated in this subparagraph (1), 22 $899,300 shall be used for the public purpose of a grant 23 program to provide substance abuse prevention programming for 24 children. 25 (i) Of the funds allocated in this subparagraph division 26 (a), $427,539 shall be used for grant funding for organizations 27 that provide programming for children by utilizing mentors. 28 Programs approved for such grants shall be certified or will 29 be certified within six months of receiving the grant award 30 by the Iowa commission on volunteer services as utilizing the 31 standards for effective practice for mentoring programs. 32 (ii) Of the funds allocated in this subparagraph division 33 (a), $426,839 shall be used for grant funding for organizations 34 that provide programming that includes youth development and 35 -3- SF 542 (3) 84 pf/jp 3/ 209
S.F. 542 leadership. The programs shall also be recognized as being 1 programs that are scientifically based with evidence of their 2 effectiveness in reducing substance abuse in children. 3 (iii) The department of public health shall utilize a 4 request for proposals process to implement the grant program. 5 (iv) All grant recipients shall participate in a program 6 evaluation as a requirement for receiving grant funds. 7 (v) Of the funds allocated in this subparagraph division 8 (a), up to $44,922 may be used to administer substance abuse 9 prevention grants and for program evaluations. 10 (b) Of the funds allocated in this subparagraph (1), 11 $273,062 shall be used for culturally competent substance abuse 12 treatment pilot projects. 13 (i) The department shall utilize the amount allocated 14 in this subparagraph division (b) for at least three pilot 15 projects to provide culturally competent substance abuse 16 treatment in various areas of the state. Each pilot project 17 shall target a particular ethnic minority population. The 18 populations targeted shall include but are not limited to 19 African American, Asian, and Latino. 20 (ii) The pilot project requirements shall provide for 21 documentation or other means to ensure access to the cultural 22 competence approach used by a pilot project so that such 23 approach can be replicated and improved upon in successor 24 programs. 25 (2) Of the funds allocated in this paragraph “b”, up 26 to $3,116,852 may be used for problem gambling prevention, 27 treatment, and recovery services. 28 (a) Of the funds allocated in this subparagraph (2), 29 $2,579,000 shall be used for problem gambling prevention and 30 treatment. 31 (b) Of the funds allocated in this subparagraph (2), up to 32 $437,852 may be used for a 24-hour helpline, public information 33 resources, professional training, and program evaluation. 34 (c) Of the funds allocated in this subparagraph (2), up 35 -4- SF 542 (3) 84 pf/jp 4/ 209
S.F. 542 to $100,000 may be used for the licensing of problem gambling 1 treatment programs. 2 (3) It is the intent of the general assembly that from the 3 moneys allocated in this paragraph “b”, persons with a dual 4 diagnosis of substance abuse and gambling addictions shall be 5 given priority in treatment services. 6 c. Notwithstanding any provision of law to the contrary, 7 to standardize the availability, delivery, cost of delivery, 8 and accountability of problem gambling and substance abuse 9 treatment services statewide, the department shall continue 10 implementation of a process to create a system for delivery 11 of treatment services in accordance with the requirements 12 specified in 2008 Iowa Acts, chapter 1187, section 3, 13 subsection 4. To ensure the system provides a continuum of 14 treatment services that best meets the needs of Iowans, the 15 problem gambling and substance abuse treatment services in any 16 area may be provided either by a single agency or by separate 17 agencies submitting a joint proposal. 18 (1) The system for delivery of substance abuse and 19 problem gambling treatment shall include problem gambling 20 prevention by July 1, 2012. The department shall submit a 21 proposed legislative bill in accordance with section 2.16, for 22 consideration during the 2012 legislative session, addressing 23 any statutory revisions necessary for full implementation of 24 the system. 25 (2) The system for delivery of substance abuse and problem 26 gambling treatment shall include substance abuse prevention by 27 July 1, 2014. 28 (3) Of the funds allocated in paragraph “b”, the department 29 may use up to $100,000 for administrative costs to continue 30 developing and implementing the process in accordance with this 31 paragraph “c”. 32 d. The requirement of section 123.53, subsection 5, is met 33 by the appropriations and allocations made in this Act for 34 purposes of substance abuse treatment and addictive disorders 35 -5- SF 542 (3) 84 pf/jp 5/ 209
S.F. 542 for the fiscal year beginning July 1, 2011. 1 e. The department of public health shall work with all other 2 departments that fund substance abuse prevention and treatment 3 services and all such departments shall, to the extent 4 necessary, collectively meet the state maintenance of effort 5 requirements for expenditures for substance abuse services 6 as required under the federal substance abuse prevention and 7 treatment block grant. 8 f. The department shall amend or otherwise revise 9 departmental policies and contract provisions in order to 10 eliminate free t-shirt distribution, banner production, and 11 other unnecessary promotional expenditures. 12 2. HEALTHY CHILDREN AND FAMILIES 13 For promoting the optimum health status for children, 14 adolescents from birth through 21 years of age, and families, 15 and for not more than the following full-time equivalent 16 positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,594,270 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 11.00 19 a. Of the funds appropriated in this subsection, not more 20 than $739,318 shall be used for the healthy opportunities to 21 experience success (HOPES)-healthy families Iowa (HFI) program 22 established pursuant to section 135.106. The funding shall 23 be distributed to renew the grants that were provided to the 24 grantees that operated the program during the fiscal year 25 ending June 30, 2011. 26 b. Of the funds appropriated in this subsection, $329,885 27 shall be used to continue to address the healthy mental 28 development of children from birth through five years of age 29 through local evidence-based strategies that engage both the 30 public and private sectors in promoting healthy development, 31 prevention, and treatment for children. A portion of the 32 funds allocated in this lettered paragraph may be used for a 33 full-time equivalent position to coordinate the activities 34 under this paragraph. 35 -6- SF 542 (3) 84 pf/jp 6/ 209
S.F. 542 c. Of the funds appropriated in this subsection, $31,597 1 shall be distributed to a statewide dental carrier to provide 2 funds to continue the donated dental services program patterned 3 after the projects developed by the dental lifeline network 4 to provide dental services to indigent elderly and disabled 5 individuals. 6 d. Of the funds appropriated in this subsection, $112,677 7 shall be used for childhood obesity prevention. 8 e. Of the funds appropriated in this subsection, $163,760 9 shall be used to provide audiological services and hearing 10 aids for children. The department may enter into a contract 11 to administer this paragraph. 12 3. CHRONIC CONDITIONS 13 For serving individuals identified as having chronic 14 conditions or special health care needs, and for not more than 15 the following full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,399,156 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 18 a. Of the funds appropriated in this subsection, $160,582 19 shall be used for grants to individual patients who have 20 phenylketonuria (PKU) to assist with the costs of necessary 21 special foods. 22 b. Of the funds appropriated in this subsection, $483,600 23 is allocated for continuation of the contracts for resource 24 facilitator services in accordance with section 135.22B, 25 subsection 9, and for brain injury training services and 26 recruiting of service providers to increase the capacity within 27 this state to address the needs of individuals with brain 28 injuries and such individuals’ families. 29 c. Of the funds appropriated in this subsection, $498,874 30 shall be used as additional funding to leverage federal funding 31 through the federal Ryan White Care Act, Tit. II, AIDS drug 32 assistance program supplemental drug treatment grants. 33 d. Of the funds appropriated in this subsection, $31,254 34 shall be used for the public purpose of providing a grant to an 35 -7- SF 542 (3) 84 pf/jp 7/ 209
S.F. 542 existing national-affiliated organization to provide education, 1 client-centered programs, and client and family support for 2 people living with epilepsy and their families. 3 e. Of the funds appropriated in this subsection, $788,303 4 shall be used for child health specialty clinics. 5 f. Of the funds appropriated in this subsection, $547,065 6 shall be used for the comprehensive cancer control program to 7 reduce the burden of cancer in Iowa through prevention, early 8 detection, effective treatment, and ensuring quality of life. 9 Of the funds allocated in this lettered paragraph, $200,000 10 shall be used to support a melanoma research symposium, a 11 melanoma biorepository and registry, basic and translational 12 melanoma research, and clinical trials. 13 g. Of the funds appropriated in this subsection, $126,450 14 shall be used for cervical and colon cancer screening. 15 h. Of the funds appropriated in this subsection, $528,834 16 shall be used for the center for congenital and inherited 17 disorders. A portion of the funds allocated in this paragraph 18 may be used for one full-time equivalent position for 19 administration of the center. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,826,699 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- SF 542 (3) 84 pf/jp 8/ 209
S.F. 542 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, $144,542 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. The following 32 amounts allocated under this lettered paragraph shall be 33 distributed to the specified provider and shall not be reduced 34 for administrative or other costs prior to distribution: 35 -9- SF 542 (3) 84 pf/jp 9/ 209
S.F. 542 (1) For distribution to the Iowa primary care association 1 for statewide coordination of the Iowa collaborative safety net 2 provider network: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 132,580 4 (2) For distribution to the Iowa family planning network 5 agencies for necessary infrastructure, statewide coordination, 6 provider recruitment, service delivery, and provision of 7 assistance to patients in determining an appropriate medical 8 home: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 74,517 10 (3) For distribution to the local boards of health that 11 provide direct services for pilot programs in three counties to 12 assist patients in determining an appropriate medical home: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 74,517 14 (4) For distribution to maternal and child health centers 15 for pilot programs in three counties to assist patients in 16 determining an appropriate medical home: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 74,517 18 (5) For distribution to free clinics for necessary 19 infrastructure, statewide coordination, provider recruitment, 20 service delivery, and provision of assistance to patients in 21 determining an appropriate medical home: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 124,050 23 (6) For distribution to rural health clinics for necessary 24 infrastructure, statewide coordination, provider recruitment, 25 service delivery, and provision of assistance to patients in 26 determining an appropriate medical home: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 110,430 28 (7) For continuation of the safety net provider patient 29 access to specialty health care initiative as described in 2007 30 Iowa Acts, chapter 218, section 109: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 260,000 32 (8) For continuation of the pharmaceutical infrastructure 33 for safety net providers as described in 2007 Iowa Acts, 34 chapter 218, section 108: 35 -10- SF 542 (3) 84 pf/jp 10/ 209
S.F. 542 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 270,000 1 The Iowa collaborative safety net provider network may 2 continue to distribute funds allocated pursuant to this 3 lettered paragraph through existing contracts or renewal of 4 existing contracts. 5 h. (1) Of the funds appropriated in this subsection, 6 $149,000 shall be used for continued implementation of 7 the recommendations of the direct care worker task force 8 established pursuant to 2005 Iowa Acts, chapter 88, based upon 9 the report submitted to the governor and the general assembly 10 in December 2006. The department may use a portion of the 11 funds allocated in this lettered paragraph for an additional 12 position to assist in the continued implementation. 13 (2) It is the intent of the general assembly that a 14 board of direct care workers shall be established within the 15 department of public health by July 1, 2014, contingent upon 16 the availability of funds to establish and maintain the board. 17 (3) The direct care worker advisory council shall submit 18 a final report no later than March 1, 2012, to the governor 19 and the general assembly, in accordance with 2010 Iowa 20 Acts, chapter 1192, section 2, subsection 4, paragraph “h”, 21 subparagraph (3). 22 (4) The department of public health shall report to the 23 persons designated in this Act for submission of reports 24 regarding use of the funds allocated in this lettered 25 paragraph, on or before January 15, 2012. 26 i. (1) Of the funds appropriated in this subsection, 27 $130,100 shall be used for allocation to an independent 28 statewide direct care worker association for education, 29 outreach, leadership development, mentoring, and other 30 initiatives intended to enhance the recruitment and retention 31 of direct care workers in health care and long-term care 32 settings. 33 (2) Of the funds appropriated in this subsection, $58,000 34 shall be used to provide scholarships or other forms of 35 -11- SF 542 (3) 84 pf/jp 11/ 209
S.F. 542 subsidization for direct care worker educational conferences, 1 training, or outreach activities. 2 j. The department may utilize one of the full-time 3 equivalent positions authorized in this subsection for 4 administration of the activities related to the Iowa 5 collaborative safety net provider network. 6 k. Of the funds appropriated in this subsection, the 7 department may use up to $58,518 for up to one full-time 8 equivalent position to administer the volunteer health care 9 provider program pursuant to section 135.24. 10 l. Of the funds appropriated in this subsection, $50,000 11 shall be used for a matching dental education loan repayment 12 program to be allocated to a dental nonprofit health service 13 corporation to develop the criteria and implement the loan 14 repayment program. 15 m. Of the funds appropriated in this subsection, up to 16 $134,214 shall be used to support the department’s activities 17 relating to health and long-term care access as specified 18 pursuant to chapter 135, division XXIV. 19 n. Of the funds appropriated in this subsection, 20 $363,987 shall be used as state matching funds for the health 21 information network as enacted by this Act. 22 o. Of the funds appropriated in this subsection, $25,000 23 shall be used for a pilot program established through a 24 grant to an organization that has an existing program for 25 children and adults and that is solely dedicated to preserving 26 sight and preventing blindness to provide vision screening 27 to elementary school children in one urban and one rural 28 school district in the state, on a voluntary basis, over a 29 multiyear period. The grantee organization shall develop 30 protocol for participating schools including the grade level 31 of the children to be screened, the training and certification 32 necessary for individuals conducting the vision screening, 33 vision screening equipment requirements, and documentation and 34 tracking requirements. Following the conclusion of the pilot 35 -12- SF 542 (3) 84 pf/jp 12/ 209
S.F. 542 program, the grantee organization shall report findings and 1 recommendations for statewide implementation of the vision 2 screening program to the department of public health. 3 5. HEALTHY AGING 4 To provide public health services that reduce risks and 5 invest in promoting and protecting good health over the 6 course of a lifetime with a priority given to older Iowans and 7 vulnerable populations: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,336,142 9 a. Of the funds appropriated in this subsection, $2,009,187 10 shall be used for local public health nursing services. 11 b. Of the funds appropriated in this subsection, $5,326,955 12 shall be used for home care aide services. 13 6. ENVIRONMENTAL HAZARDS 14 For reducing the public’s exposure to hazards in the 15 environment, primarily chemical hazards, and for not more than 16 the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 813,777 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 19 Of the funds appropriated in this subsection, $544,377 shall 20 be used for childhood lead poisoning provisions. 21 7. INFECTIOUS DISEASES 22 For reducing the incidence and prevalence of communicable 23 diseases, and for not more than the following full-time 24 equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,345,847 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 27 8. PUBLIC PROTECTION 28 For protecting the health and safety of the public through 29 establishing standards and enforcing regulations, and for not 30 more than the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,778,688 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 125.00 33 a. Of the funds appropriated in this subsection, not more 34 than $424,146 shall be credited to the emergency medical 35 -13- SF 542 (3) 84 pf/jp 13/ 209
S.F. 542 services fund created in section 135.25. Moneys in the 1 emergency medical services fund are appropriated to the 2 department to be used for the purposes of the fund. 3 b. Of the funds appropriated in this subsection, $210,619 4 shall be used for sexual violence prevention programming 5 through a statewide organization representing programs serving 6 victims of sexual violence through the department’s sexual 7 violence prevention program. The amount allocated in this 8 lettered paragraph shall not be used to supplant funding 9 administered for other sexual violence prevention or victims 10 assistance programs. 11 c. Of the funds appropriated in this subsection, not more 12 than $436,582 shall be used for the state poison control 13 center. 14 d. Of the funds appropriated in this subsection, $50,000 15 shall be used for education, testing, training, and other costs 16 to conform the requirements for certification of emergency 17 medical care providers with national standards. 18 9. RESOURCE MANAGEMENT 19 For establishing and sustaining the overall ability of the 20 department to deliver services to the public, and for not more 21 than the following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 819,554 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 7.00 24 The university of Iowa hospitals and clinics under the 25 control of the state board of regents shall not receive 26 indirect costs from the funds appropriated in this section. 27 The university of Iowa hospitals and clinics billings to the 28 department shall be on at least a quarterly basis. 29 DIVISION III 30 DEPARTMENT OF VETERANS AFFAIRS —— FY 2011-2012 31 Sec. 3. DEPARTMENT OF VETERANS AFFAIRS. There is 32 appropriated from the general fund of the state to the 33 department of veterans affairs for the fiscal year beginning 34 July 1, 2011, and ending June 30, 2012, the following amounts, 35 -14- SF 542 (3) 84 pf/jp 14/ 209
S.F. 542 or so much thereof as is necessary, to be used for the purposes 1 designated: 2 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 3 For salaries, support, maintenance, and miscellaneous 4 purposes, including the war orphans educational assistance fund 5 created in section 35.8, and for not more than the following 6 full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 998,832 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.34 9 2. IOWA VETERANS HOME 10 For salaries, support, maintenance, and miscellaneous 11 purposes: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,952,151 13 a. The Iowa veterans home billings involving the department 14 of human services shall be submitted to the department on at 15 least a monthly basis. 16 b. If there is a change in the employer of employees 17 providing services at the Iowa veterans home under a collective 18 bargaining agreement, such employees and the agreement shall 19 be continued by the successor employer as though there had not 20 been a change in employer. 21 c. Within available resources and in conformance with 22 associated state and federal program eligibility requirements, 23 the Iowa veterans home may implement measures to provide 24 financial assistance to or on behalf of veterans or their 25 spouses participating in the community reentry program. 26 3. STATE EDUCATIONAL ASSISTANCE —— CHILDREN OF DECEASED 27 VETERANS 28 For provision of educational assistance pursuant to section 29 35.9: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,416 31 Sec. 4. LIMITATION OF COUNTY COMMISSION OF VETERANS AFFAIRS 32 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 33 appropriation in the following designated section for the 34 fiscal year beginning July 1, 2011, and ending June 30, 2012, 35 -15- SF 542 (3) 84 pf/jp 15/ 209
S.F. 542 the amounts appropriated from the general fund of the state 1 pursuant to that section for the following designated purposes 2 shall not exceed the following amount: 3 For the county commissions of veterans affairs fund under 4 section 35A.16: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 6 DIVISION IV 7 DEPARTMENT OF HUMAN SERVICES —— FY 2011-2012 8 Sec. 5. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 9 GRANT. There is appropriated from the fund created in section 10 8.41 to the department of human services for the fiscal year 11 beginning July 1, 2011, and ending June 30, 2012, from moneys 12 received under the federal temporary assistance for needy 13 families (TANF) block grant pursuant to the federal Personal 14 Responsibility and Work Opportunity Reconciliation Act of 1996, 15 Pub. L. No. 104-193, and successor legislation, and from moneys 16 received under the emergency contingency fund for temporary 17 assistance for needy families state program established 18 pursuant to the federal American Recovery and Reinvestment Act 19 of 2009, Pub. L. No. 111-5 § 2101, and successor legislation, 20 the following amounts, or so much thereof as is necessary, to 21 be used for the purposes designated: 22 1. To be credited to the family investment program account 23 and used for assistance under the family investment program 24 under chapter 239B: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,500,738 26 2. To be credited to the family investment program account 27 and used for the job opportunities and basic skills (JOBS) 28 program and implementing family investment agreements in 29 accordance with chapter 239B: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,411,528 31 3. To be used for the family development and 32 self-sufficiency grant program in accordance with section 33 216A.107: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 35 -16- SF 542 (3) 84 pf/jp 16/ 209
S.F. 542 Notwithstanding section 8.33, moneys appropriated in this 1 subsection that remain unencumbered or unobligated at the close 2 of the fiscal year shall not revert but shall remain available 3 for expenditure for the purposes designated until the close of 4 the succeeding fiscal year. However, unless such moneys are 5 encumbered or obligated on or before September 30, 2012, the 6 moneys shall revert. 7 4. For field operations: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 9 5. For general administration: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 11 6. For state child care assistance: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,382,687 13 The funds appropriated in this subsection shall be 14 transferred to the child care and development block grant 15 appropriation made by the Eighty-fourth General Assembly, 2011 16 Session, for the federal fiscal year beginning October 1, 17 2011, and ending September 30, 2012. Of this amount, $200,000 18 shall be used for provision of educational opportunities to 19 registered child care home providers in order to improve 20 services and programs offered by this category of providers 21 and to increase the number of providers. The department may 22 contract with institutions of higher education or child care 23 resource and referral centers to provide the educational 24 opportunities. Allowable administrative costs under the 25 contracts shall not exceed 5 percent. The application for a 26 grant shall not exceed two pages in length. 27 7. For mental health and developmental disabilities 28 community services: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,894,052 30 8. For child and family services: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,084,430 32 9. For child abuse prevention grants: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 34 10. For pregnancy prevention grants on the condition that 35 -17- SF 542 (3) 84 pf/jp 17/ 209
S.F. 542 family planning services are funded: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,930,067 2 Pregnancy prevention grants shall be awarded to programs 3 in existence on or before July 1, 2011, if the programs are 4 comprehensive in scope and have demonstrated positive outcomes. 5 Grants shall be awarded to pregnancy prevention programs 6 which are developed after July 1, 2011, if the programs are 7 comprehensive in scope and are based on existing models that 8 have demonstrated positive outcomes. Grants shall comply with 9 the requirements provided in 1997 Iowa Acts, chapter 208, 10 section 14, subsections 1 and 2, including the requirement that 11 grant programs must emphasize sexual abstinence. Priority in 12 the awarding of grants shall be given to programs that serve 13 areas of the state which demonstrate the highest percentage of 14 unplanned pregnancies of females of childbearing age within the 15 geographic area to be served by the grant. 16 11. For technology needs and other resources necessary 17 to meet federal welfare reform reporting, tracking, and case 18 management requirements: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 20 12. To be credited to the state child care assistance 21 appropriation made in this section to be used for funding of 22 community-based early childhood programs targeted to children 23 from birth through five years of age developed by early 24 childhood Iowa areas as provided in section 256I.11: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,350,000 26 The department shall transfer TANF block grant funding 27 appropriated and allocated in this subsection to the child care 28 and development block grant appropriation in accordance with 29 federal law as necessary to comply with the provisions of this 30 subsection. 31 13. a. Notwithstanding any provision to the contrary, 32 including but not limited to requirements in section 8.41 or 33 provisions in 2010 or 2011 Iowa Acts regarding the receipt 34 and appropriation of federal block grants, federal funds 35 -18- SF 542 (3) 84 pf/jp 18/ 209
S.F. 542 from the emergency contingency fund for temporary assistance 1 for needy families state program established pursuant to the 2 federal American Recovery and Reinvestment Act of 2009, Pub. 3 L. No. 111-5 § 2101, received by the state during the fiscal 4 year beginning July 1, 2010, and ending June 30, 2011, not 5 otherwise appropriated in this section and remaining available 6 as of July 1, 2011, and received by the state during the fiscal 7 year beginning July 1, 2011, and ending June 30, 2012, are 8 appropriated to the extent as may be necessary to be used in 9 the following priority order: the family investment program 10 for the fiscal year and for state child care assistance program 11 payments for individuals enrolled in the family investment 12 program who are employed. The federal funds appropriated in 13 this paragraph “a” shall be expended only after all other 14 funds appropriated in subsection 1 for the assistance under 15 the family investment program under chapter 239B have been 16 expended. 17 b. The department shall, on a quarterly basis, advise the 18 legislative services agency and department of management of 19 the amount of funds appropriated in this subsection that was 20 expended in the prior quarter. 21 14. Of the amounts appropriated in this section, 22 $12,962,008 for the fiscal year beginning July 1, 2011, shall 23 be transferred to the appropriation of the federal social 24 services block grant made for that fiscal year. 25 15. For continuation of the program allowing the department 26 to maintain categorical eligibility for the food assistance 27 program as required under the section of this division relating 28 to the family investment account: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 146,072 30 16. The department may transfer funds allocated in this 31 section to the appropriations made in this division of this Act 32 for general administration and field operations for resources 33 necessary to implement and operate the services referred to in 34 this section and those funded in the appropriation made in this 35 -19- SF 542 (3) 84 pf/jp 19/ 209
S.F. 542 division of this Act for the family investment program from the 1 general fund of the state. 2 Sec. 6. FAMILY INVESTMENT PROGRAM ACCOUNT. 3 1. Moneys credited to the family investment program (FIP) 4 account for the fiscal year beginning July 1, 2011, and 5 ending June 30, 2012, shall be used to provide assistance in 6 accordance with chapter 239B. 7 2. The department may use a portion of the moneys credited 8 to the FIP account under this section as necessary for 9 salaries, support, maintenance, and miscellaneous purposes. 10 3. The department may transfer funds allocated in 11 this section to the appropriations in this Act for general 12 administration and field operations for resources necessary to 13 implement and operate the services referred to in this section 14 and those funded in the appropriation made in this division of 15 this Act for the family investment program from the general 16 fund of the state. 17 4. Moneys appropriated in this division of this Act and 18 credited to the FIP account for the fiscal year beginning July 19 1, 2011, and ending June 30, 2012, are allocated as follows: 20 a. To be retained by the department of human services to 21 be used for coordinating with the department of human rights 22 to more effectively serve participants in the FIP program and 23 other shared clients and to meet federal reporting requirements 24 under the federal temporary assistance for needy families block 25 grant: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 27 b. To the department of human rights for staffing, 28 administration, and implementation of the family development 29 and self-sufficiency grant program in accordance with section 30 216A.107: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,342,834 32 (1) Of the funds allocated for the family development and 33 self-sufficiency grant program in this lettered paragraph, 34 not more than 5 percent of the funds shall be used for the 35 -20- SF 542 (3) 84 pf/jp 20/ 209
S.F. 542 administration of the grant program. 1 (2) The department of human rights may continue to implement 2 the family development and self-sufficiency grant program 3 statewide during fiscal year 2011-2012. 4 c. For the diversion subaccount of the FIP account: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,698,400 6 A portion of the moneys allocated for the subaccount may 7 be used for field operations salaries, data management system 8 development, and implementation costs and support deemed 9 necessary by the director of human services in order to 10 administer the FIP diversion program. 11 d. For the food stamp employment and training program: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 13 (1) The department shall amend the food stamp employment and 14 training state plan in order to maximize to the fullest extent 15 permitted by federal law the use of the 50-50 match provisions 16 for the claiming of allowable federal matching funds from the 17 United States department of agriculture pursuant to the federal 18 food stamp employment and training program for providing 19 education, employment, and training services for eligible food 20 assistance program participants, including but not limited to 21 related dependent care and transportation expenses. 22 (2) The department shall continue the categorical federal 23 food assistance program eligibility at 160 percent of the 24 federal poverty level and continue to eliminate the asset test 25 from eligibility requirements, consistent with federal food 26 assistance program requirements. The department shall include 27 as many food assistance households as is allowed by federal 28 law. The eligibility provisions shall conform to all federal 29 requirements including requirements addressing individuals who 30 are incarcerated or otherwise ineligible. 31 e. For the JOBS program: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,235,905 33 5. Of the child support collections assigned under FIP, 34 an amount equal to the federal share of support collections 35 -21- SF 542 (3) 84 pf/jp 21/ 209
S.F. 542 shall be credited to the child support recovery appropriation 1 made in this division of this Act. Of the remainder of the 2 assigned child support collections received by the child 3 support recovery unit, a portion shall be credited to the FIP 4 account, a portion may be used to increase recoveries, and a 5 portion may be used to sustain cash flow in the child support 6 payments account. If as a consequence of the appropriations 7 and allocations made in this section the resulting amounts 8 are insufficient to sustain cash assistance payments and meet 9 federal maintenance of effort requirements, the department 10 shall seek supplemental funding. If child support collections 11 assigned under FIP are greater than estimated or are otherwise 12 determined not to be required for maintenance of effort, the 13 state share of either amount may be transferred to or retained 14 in the child support payment account. 15 6. The department may adopt emergency rules for the family 16 investment, JOBS, food stamp, and medical assistance programs 17 if necessary to comply with federal requirements. 18 Sec. 7. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 19 is appropriated from the general fund of the state to the 20 department of human services for the fiscal year beginning July 21 1, 2011, and ending June 30, 2012, the following amount, or 22 so much thereof as is necessary, to be used for the purpose 23 designated: 24 To be credited to the family investment program (FIP) 25 account and used for family investment program assistance under 26 chapter 239B: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,171,027 28 1. Of the funds appropriated in this section, $7,824,377 is 29 allocated for the JOBS program. 30 2. Of the funds appropriated in this section, $2,463,854 is 31 allocated for the family development and self-sufficiency grant 32 program. 33 3. Notwithstanding section 8.39, for the fiscal year 34 beginning July 1, 2011, if necessary to meet federal 35 -22- SF 542 (3) 84 pf/jp 22/ 209
S.F. 542 maintenance of effort requirements or to transfer federal 1 temporary assistance for needy families block grant funding 2 to be used for purposes of the federal social services block 3 grant or to meet cash flow needs resulting from delays in 4 receiving federal funding or to implement, in accordance with 5 this division of this Act, activities currently funded with 6 juvenile court services, county, or community moneys and state 7 moneys used in combination with such moneys, the department 8 of human services may transfer funds within or between any 9 of the appropriations made in this division of this Act and 10 appropriations in law for the federal social services block 11 grant to the department for the following purposes, provided 12 that the combined amount of state and federal temporary 13 assistance for needy families block grant funding for each 14 appropriation remains the same before and after the transfer: 15 a. For the family investment program. 16 b. For child care assistance. 17 c. For child and family services. 18 d. For field operations. 19 e. For general administration. 20 f. MH/MR/DD/BI community services (local purchase). 21 This subsection shall not be construed to prohibit the use 22 of existing state transfer authority for other purposes. The 23 department shall report any transfers made pursuant to this 24 subsection to the legislative services agency. 25 4. Of the funds appropriated in this section, $195,678 shall 26 be used for continuation of a grant to an Iowa-based nonprofit 27 organization with a history of providing tax preparation 28 assistance to low-income Iowans in order to expand the usage of 29 the earned income tax credit. The purpose of the grant is to 30 supply this assistance to underserved areas of the state. 31 Sec. 8. CHILD SUPPORT RECOVERY. There is appropriated 32 from the general fund of the state to the department of human 33 services for the fiscal year beginning July 1, 2011, and ending 34 June 30, 2012, the following amount, or so much thereof as is 35 -23- SF 542 (3) 84 pf/jp 23/ 209
S.F. 542 necessary, to be used for the purposes designated: 1 For child support recovery, including salaries, support, 2 maintenance, and miscellaneous purposes, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,119,255 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 475.00 6 1. The department shall expend up to $24,329, including 7 federal financial participation, for the fiscal year beginning 8 July 1, 2011, for a child support public awareness campaign. 9 The department and the office of the attorney general shall 10 cooperate in continuation of the campaign. The public 11 awareness campaign shall emphasize, through a variety of 12 media activities, the importance of maximum involvement of 13 both parents in the lives of their children as well as the 14 importance of payment of child support obligations. 15 2. Federal access and visitation grant moneys shall be 16 issued directly to private not-for-profit agencies that provide 17 services designed to increase compliance with the child access 18 provisions of court orders, including but not limited to 19 neutral visitation sites and mediation services. 20 3. The appropriation made to the department for child 21 support recovery may be used throughout the fiscal year in the 22 manner necessary for purposes of cash flow management, and for 23 cash flow management purposes the department may temporarily 24 draw more than the amount appropriated, provided the amount 25 appropriated is not exceeded at the close of the fiscal year. 26 4. With the exception of the funding amount specified, the 27 requirements established under 2001 Iowa Acts, chapter 191, 28 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 29 be applicable to parental obligation pilot projects for the 30 fiscal year beginning July 1, 2011, and ending June 30, 2012. 31 Notwithstanding 441 IAC 100.8, providing for termination of 32 rules relating to the pilot projects, the rules shall remain 33 in effect until June 30, 2012. 34 Sec. 9. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE. Any 35 -24- SF 542 (3) 84 pf/jp 24/ 209
S.F. 542 funds remaining in the health care trust fund created in 1 section 453A.35A for the fiscal year beginning July 1, 2011, 2 and ending June 30, 2012, are appropriated to the department 3 of human services to supplement the medical assistance program 4 appropriations made in this Act, for medical assistance 5 reimbursement and associated costs, including program 6 administration and costs associated with implementation. 7 Sec. 10. MEDICAL ASSISTANCE. 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 medical assistance reimbursement and associated costs 13 as specifically provided in the reimbursement methodologies 14 in effect on June 30, 2011, except as otherwise expressly 15 authorized by law, including reimbursement for abortion 16 services which shall be available under the medical assistance 17 program only for those abortions which are medically necessary: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $897,816,915 19 1. Medically necessary abortions are those performed under 20 any of the following conditions: 21 a. The attending physician certifies that continuing the 22 pregnancy would endanger the life of the pregnant woman. 23 b. The attending physician certifies that the fetus is 24 physically deformed, mentally deficient, or afflicted with a 25 congenital illness. 26 c. The pregnancy is the result of a rape which is reported 27 within 45 days of the incident to a law enforcement agency or 28 public or private health agency which may include a family 29 physician. 30 d. The pregnancy is the result of incest which is reported 31 within 150 days of the incident to a law enforcement agency 32 or public or private health agency which may include a family 33 physician. 34 e. Any spontaneous abortion, commonly known as a 35 -25- SF 542 (3) 84 pf/jp 25/ 209
S.F. 542 miscarriage, if not all of the products of conception are 1 expelled. 2 2. The department shall utilize not more than $60,000 of 3 the funds appropriated in this section to continue the AIDS/HIV 4 health insurance premium payment program as established in 1992 5 Iowa Acts, Second Extraordinary Session, chapter 1001, section 6 409, subsection 6. Of the funds allocated in this subsection, 7 not more than $5,000 may be expended for administrative 8 purposes. 9 3. Of the funds appropriated in this Act to the department 10 of public health for addictive disorders, $950,000 for the 11 fiscal year beginning July 1, 2011, shall be transferred to 12 the department of human services for an integrated substance 13 abuse managed care system. The department shall not assume 14 management of the substance abuse system in place of the 15 managed care contractor unless such a change in approach is 16 specifically authorized in law. The departments of human 17 services and public health shall work together to maintain 18 the level of mental health and substance abuse services 19 provided by the managed care contractor through the Iowa plan 20 for behavioral health. Each department shall take the steps 21 necessary to continue the federal waivers as necessary to 22 maintain the level of services. 23 4. a. The department shall aggressively pursue options for 24 providing medical assistance or other assistance to individuals 25 with special needs who become ineligible to continue receiving 26 services under the early and periodic screening, diagnostic, 27 and treatment program under the medical assistance program 28 due to becoming 21 years of age who have been approved for 29 additional assistance through the department’s exception to 30 policy provisions, but who have health care needs in excess 31 of the funding available through the exception to policy 32 provisions. 33 b. Of the funds appropriated in this section, $100,000 34 shall be used for participation in one or more pilot projects 35 -26- SF 542 (3) 84 pf/jp 26/ 209
S.F. 542 operated by a private provider to allow the individual or 1 individuals to receive service in the community in accordance 2 with principles established in Olmstead v. L.C., 527 U.S. 581 3 (1999), for the purpose of providing medical assistance or 4 other assistance to individuals with special needs who become 5 ineligible to continue receiving services under the early and 6 periodic screening, diagnosis, and treatment program under 7 the medical assistance program due to becoming 21 years of 8 age who have been approved for additional assistance through 9 the department’s exception to policy provisions, but who have 10 health care needs in excess of the funding available through 11 the exception to the policy provisions. 12 5. Of the funds appropriated in this section, up to 13 $3,050,082 may be transferred to the field operations 14 or general administration appropriations in this Act for 15 operational costs associated with Part D of the federal 16 Medicare Prescription Drug Improvement and Modernization Act 17 of 2003, Pub. L. No. 108-173. 18 6. Of the funds appropriated in this section, up to $442,100 19 may be transferred to the appropriation in this division 20 of this Act for medical contracts to be used for clinical 21 assessment services and prior authorization of services. 22 7. A portion of the funds appropriated in this section 23 may be transferred to the appropriations in this division of 24 this Act for general administration, medical contracts, the 25 children’s health insurance program, or field operations to be 26 used for the state match cost to comply with the payment error 27 rate measurement (PERM) program for both the medical assistance 28 and children’s health insurance programs as developed by the 29 centers for Medicare and Medicaid services of the United States 30 department of health and human services to comply with the 31 federal Improper Payments Information Act of 2002, Pub. L. No. 32 107-300. 33 8. It is the intent of the general assembly that the 34 department continue to implement the recommendations of 35 -27- SF 542 (3) 84 pf/jp 27/ 209
S.F. 542 the assuring better child health and development initiative 1 II (ABCDII) clinical panel to the Iowa early and periodic 2 screening, diagnostic, and treatment services healthy mental 3 development collaborative board regarding changes to billing 4 procedures, codes, and eligible service providers. 5 9. Of the funds appropriated in this section, a sufficient 6 amount is allocated to supplement the incomes of residents of 7 nursing facilities, intermediate care facilities for persons 8 with mental illness, and intermediate care facilities for 9 persons with mental retardation, with incomes of less than $50 10 in the amount necessary for the residents to receive a personal 11 needs allowance of $50 per month pursuant to section 249A.30A. 12 10. Of the funds appropriated in this section, the following 13 amounts shall be transferred to the appropriations made in this 14 division of this Act for the state mental health institutes: 15 a. Cherokee mental health institute .......... $ 9,098,425 16 b. Clarinda mental health institute .......... $ 1,977,305 17 c. Independence mental health institute ...... $ 9,045,894 18 d. Mount Pleasant mental health institute .... $ 5,752,587 19 11. a. Of the funds appropriated in this section, 20 $7,425,684 is allocated for the state match for a 21 disproportionate share hospital payment of $19,133,430 to 22 hospitals that meet both of the conditions specified in 23 subparagraphs (1) and (2). In addition, the hospitals that 24 meet the conditions specified shall either certify public 25 expenditures or transfer to the medical assistance program 26 an amount equal to provide the nonfederal share for a 27 disproportionate share hospital payment of $7,500,000. The 28 hospitals that meet the conditions specified shall receive and 29 retain 100 percent of the total disproportionate share hospital 30 payment of $26,633,430. 31 (1) The hospital qualifies for disproportionate share and 32 graduate medical education payments. 33 (2) The hospital is an Iowa state-owned hospital with more 34 than 500 beds and eight or more distinct residency specialty 35 -28- SF 542 (3) 84 pf/jp 28/ 209
S.F. 542 or subspecialty programs recognized by the American college of 1 graduate medical education. 2 b. Distribution of the disproportionate share payments 3 shall be made on a monthly basis. The total amount of 4 disproportionate share payments including graduate medical 5 education, enhanced disproportionate share, and Iowa 6 state-owned teaching hospital payments shall not exceed the 7 amount of the state’s allotment under Pub. L. No. 102-234. 8 In addition, the total amount of all disproportionate 9 share payments shall not exceed the hospital-specific 10 disproportionate share limits under Pub. L. No. 103-66. 11 12. The university of Iowa hospitals and clinics shall 12 either certify public expenditures or transfer to the medical 13 assistance appropriation an amount equal to provide the 14 nonfederal share for increased medical assistance payments for 15 inpatient and outpatient hospital services of $9,900,000. The 16 university of Iowa hospitals and clinics shall receive and 17 retain 100 percent of the total increase in medical assistance 18 payments. 19 13. Of the funds appropriated in this section, up to 20 $4,480,304 may be transferred to the IowaCare account created 21 in section 249J.24. 22 14. Of the funds appropriated in this section, $200,000 23 shall be used for the Iowa chronic care consortium pursuant to 24 2003 Iowa Acts, chapter 112, section 12, as amended by 2003 25 Iowa Acts, chapter 179, sections 166 and 167. 26 15. One hundred percent of the nonfederal share of payments 27 to area education agencies that are medical assistance 28 providers for medical assistance-covered services provided to 29 medical assistance-covered children, shall be made from the 30 appropriation made in this section. 31 16. Any new or renewed contract entered into by the 32 department with a third party to administer behavioral health 33 services under the medical assistance program shall provide 34 that any interest earned on payments from the state during 35 -29- SF 542 (3) 84 pf/jp 29/ 209
S.F. 542 the state fiscal year shall be remitted to the department 1 and treated as recoveries to offset the costs of the medical 2 assistance program. 3 17. The department shall continue to implement the 4 provisions in 2007 Iowa Acts, chapter 218, section 124 and 5 section 126, as amended by 2008 Iowa Acts, chapter 1188, 6 section 55, relating to eligibility for certain persons with 7 disabilities under the medical assistance program in accordance 8 with the federal family opportunity Act. 9 18. A portion of the funds appropriated in this section 10 may be transferred to the appropriation in this division of 11 this Act for medical contracts to be used for administrative 12 activities associated with the money follows the person 13 demonstration project. 14 19. Of the funds appropriated in this section, $349,011 15 shall be used for the administration of the health insurance 16 premium payment program, including salaries, support, 17 maintenance, and miscellaneous purposes for the fiscal year 18 beginning July 1, 2011. 19 20. a. The department may implement cost containment 20 strategies recommended by the governor, and may adopt emergency 21 rules for such implementation. 22 b. The department shall not implement the cost containment 23 strategy to require a primary care referral for the provision 24 of chiropractic services. 25 c. The department may increase the amounts allocated for 26 salaries, support, maintenance, and miscellaneous purposes 27 associated with the medical assistance program, as necessary, 28 to implement the cost containment strategies. The department 29 shall report any such increase to the legislative services 30 agency and the department of management. 31 d. If the savings to the medical assistance program exceed 32 the cost, the department may transfer any savings generated 33 for the fiscal year due to medical assistance program cost 34 containment efforts initiated pursuant to 2010 Iowa Acts, 35 -30- SF 542 (3) 84 pf/jp 30/ 209
S.F. 542 chapter 1031, Executive Order No. 20, issued December 16, 2009, 1 or cost containment strategies initiated pursuant to this 2 subsection, to the appropriation made in this division of this 3 Act for medical contracts or general administration to defray 4 the increased contract costs associated with implementing such 5 efforts. 6 e. The department shall report the implementation of 7 any cost containment strategies under this subsection to 8 the individuals specified in this division of this Act for 9 submission of reports on a quarterly basis. 10 21. Notwithstanding any provision of law to the contrary, 11 the department of human services shall amend the section 12 1915(b) waiver and Iowa plan contract to include remedial 13 services under the Iowa plan contract effective July 1, 2011. 14 22. Of the funds appropriated in this section, $5,000,000 15 shall be used to reduce the waiting lists of the medical 16 assistance home and community-based services waivers, including 17 the waiver for persons with intellectual disabilities for 18 which the nonfederal share is paid as state case services and 19 other support pursuant to section 331.440. The department 20 shall distribute the funding allocated under this subsection 21 proportionately among all home and community-based services 22 waivers. 23 23. a. The department may submit medical assistance program 24 state plan amendments to the centers for Medicare and Medicaid 25 services of the United States department of health and human 26 services, and may adopt administrative rules pursuant to 27 chapter 17A to implement any of the following if the respective 28 state plan amendment is approved: 29 (1) Health homes pursuant to section 2703 of the federal 30 Patient Protection and Affordable Care Act, Pub. L. No. 31 111-148. The department shall collaborate with the medical 32 home system advisory council created pursuant to section 33 135.159 in developing such health homes. 34 (2) Accountable care organization pilot programs, if such 35 -31- SF 542 (3) 84 pf/jp 31/ 209
S.F. 542 programs are advantageous to the medical assistance program. 1 b. Any health home or accountable care organization 2 pilot program implemented pursuant to this subsection shall 3 demonstrate value to the state with a positive return on 4 investment within two years of implementation, and may utilize 5 care coordination fees, pay-for-performance fees, or shared 6 saving strategies if approved as part of the state plan 7 amendment. 8 24. The department, in consultation with the Iowa pharmacy 9 association and other appropriate entities, shall develop 10 recommendations to replace the reimbursement methodology of 11 average wholesale price minus 12 percent for covered brand-name 12 prescription drugs, generic drugs, and over-the-counter drugs. 13 The department shall report the recommendations to the persons 14 designated in this division of this Act for submission of 15 reports by December 15, 2011. 16 Sec. 11. MEDICAL CONTRACTS. There is appropriated from the 17 general fund of the state to the department of human services 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 purpose designated: 21 For medical contracts: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,893,844 23 1. The department of inspections and appeals shall 24 provide all state matching funds for survey and certification 25 activities performed by the department of inspections 26 and appeals. The department of human services is solely 27 responsible for distributing the federal matching funds for 28 such activities. 29 2. Of the funds appropriated in this section, $150,000 shall 30 be used for implementation of a uniform cost report to be used 31 in the development of specified Medicaid reimbursement rates 32 over a multiyear timeframe. The department of human services, 33 in collaboration with affected providers, shall finalize a 34 uniform cost report that includes provider type-specific cost 35 -32- SF 542 (3) 84 pf/jp 32/ 209
S.F. 542 schedules by December 15, 2011. The uniform cost report shall 1 be applied to providers of home and community-based services 2 waiver services, habilitation services, case management 3 services and community mental health centers, residential care 4 facilities, psychiatric medical institutions for children, and 5 intermediate care facilities for the mentally retarded in the 6 development of Medicaid reimbursement rates. The department 7 shall collaborate with affected Medicaid providers to test 8 the effectiveness of the cost report and determine the fiscal 9 impact of implementing the uniform cost report during the 10 fiscal year beginning July 1, 2012. A report of the findings 11 and fiscal impact shall be submitted to the governor and the 12 general assembly by December 31, 2013. The rates paid in the 13 fiscal year beginning July 1, 2014, shall be established using 14 uniform cost reports submitted in the fiscal year beginning 15 July 1, 2012. Implementation of the uniform cost report shall 16 be limited to the extent of the funding available. 17 3. a. Of the funds appropriated in this section, $100,000 18 shall be used for implementation of an electronic medical 19 records system, including system purchase or development, for 20 home and community-based services providers and mental health 21 services providers that comply with the requirements of federal 22 and state laws and regulation by the fiscal year beginning July 23 1, 2013. 24 b. The department shall analyze the costs and benefits of 25 providing an electronic medical records and billing system for 26 home and community-based services providers and mental health 27 services providers that comply with the requirements of federal 28 and state laws and regulation. The analysis shall include a 29 review of all of the following: including the capability for 30 an electronic medical records and billing system within the 31 procurement for the Medicaid management information system, 32 developing the system, and utilizing capacity within the health 33 information network established by the department of public 34 health as enacted in this Act. If the analysis demonstrates 35 -33- SF 542 (3) 84 pf/jp 33/ 209
S.F. 542 that a program may be implemented in a cost-effective manner 1 and within available funds, the department may take steps to 2 implement such a system. The department shall report the 3 results of the analysis, activities, and recommendations to the 4 persons designated in this division of this Act for submission 5 of reports by December 15, 2011. 6 c. Notwithstanding section 8.33, funds allocated in this 7 subsection that remain unencumbered or unobligated at the close 8 of the fiscal year shall not revert but shall remain available 9 in succeeding fiscal years to be used for the purposes 10 designated. 11 4. Of the amount appropriated in this section, $3,500,000 12 shall be used for technology upgrades necessary to support 13 Medicaid claims and other health operations, worldwide federal 14 Health Insurance Portability and Accountability Act of 1996 15 (HIPAA) claims, transactions, and coding requirements, and the 16 Iowa automated benefits calculation system. Notwithstanding 17 section 8.33, funds allocated in this subsection that remain 18 unencumbered or unobligated at the close of the fiscal year 19 shall not revert but shall remain available in succeeding 20 fiscal years to be used for the purposes designated. 21 5. Of the funds appropriated in this section, $100,000 shall 22 be used for an accountable care organization pilot project 23 as specified in the division of this Act relating to prior 24 appropriations and related changes. 25 6. Of the funds appropriated in this section, $200,000 shall 26 be used for the development of a provider payment system plan 27 to provide recommendations to reform the health care provider 28 payment system as an effective way to promote coordination of 29 care, lower costs, and improve quality as specified in the 30 division of this Act relating to cost containment. 31 7. Of the funds appropriated in this section, $20,000 shall 32 be used for the development of a plan to establish an all-payer 33 claims database to provide for the collection and analysis of 34 claims data from multiple payers of health care as specified in 35 -34- SF 542 (3) 84 pf/jp 34/ 209
S.F. 542 the division of this Act relating to cost containment. 1 8. The department shall amend the state Medicaid health 2 information technology plan to include costs related to the 3 one-time development costs of the health information network 4 as enacted in this Act. 5 9. Of the amount appropriated in this section, up to 6 $250,000 may be transferred to the appropriation for general 7 administration in this division of this Act to be used for 8 additional full-time equivalent positions in the development of 9 key health initiatives such as cost containment, development 10 and oversight of managed care programs, and development of 11 health strategies targeted toward improved quality and reduced 12 costs in the Medicaid program. 13 10. Of the funds appropriated in this section, $50,000 shall 14 be used for home and community-based services waiver quality 15 assurance programs, including the review and streamlining 16 of processes and policies related to oversight and quality 17 management to meet state and federal requirements. The 18 department shall submit a report to the persons designated by 19 this division of this Act for submission of reports by December 20 15, 2011, regarding the modifications to the quality assurance 21 programs. 22 Sec. 12. STATE SUPPLEMENTARY ASSISTANCE. 23 1. There is appropriated from the general fund of the 24 state to the department of human services for the fiscal year 25 beginning July 1, 2011, and ending June 30, 2012, the following 26 amount, or so much thereof as is necessary, to be used for the 27 purpose designated: 28 For the state supplementary assistance program: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,850,747 30 2. The department shall increase the personal needs 31 allowance for residents of residential care facilities by the 32 same percentage and at the same time as federal supplemental 33 security income and federal social security benefits are 34 increased due to a recognized increase in the cost of living. 35 -35- SF 542 (3) 84 pf/jp 35/ 209
S.F. 542 The department may adopt emergency rules to implement this 1 subsection. 2 3. If during the fiscal year beginning July 1, 2011, 3 the department projects that state supplementary assistance 4 expenditures for a calendar year will not meet the federal 5 pass-through requirement specified in Tit. XVI of the federal 6 Social Security Act, section 1618, as codified in 42 U.S.C. 7 § 1382g, the department may take actions including but not 8 limited to increasing the personal needs allowance for 9 residential care facility residents and making programmatic 10 adjustments or upward adjustments of the residential care 11 facility or in-home health-related care reimbursement rates 12 prescribed in this division of this Act to ensure that federal 13 requirements are met. In addition, the department may make 14 other programmatic and rate adjustments necessary to remain 15 within the amount appropriated in this section while ensuring 16 compliance with federal requirements. The department may adopt 17 emergency rules to implement the provisions of this subsection. 18 Sec. 13. CHILDREN’S HEALTH INSURANCE PROGRAM. 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, 2011, and ending June 30, 2012, the following 22 amount, or so much thereof as is necessary, to be used for the 23 purpose designated: 24 For maintenance of the healthy and well kids in Iowa (hawk-i) 25 program pursuant to chapter 514I, including supplemental dental 26 services, for receipt of federal financial participation under 27 Tit. XXI of the federal Social Security Act, which creates the 28 children’s health insurance program: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,806,102 30 2. Of the funds appropriated in this section, $128,950 is 31 allocated for continuation of the contract for advertising and 32 outreach with the department of public health. 33 Sec. 14. CHILD CARE ASSISTANCE. There is appropriated 34 from the general fund of the state to the department of human 35 -36- SF 542 (3) 84 pf/jp 36/ 209
S.F. 542 services for the fiscal year beginning July 1, 2011, and ending 1 June 30, 2012, the following amount, or so much thereof as is 2 necessary, to be used for the purpose designated: 3 For child care programs: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 55,265,509 5 1. Of the funds appropriated in this section, $53,896,082 6 shall be used for state child care assistance in accordance 7 with section 237A.13. 8 2. Nothing in this section shall be construed or is 9 intended as or shall imply a grant of entitlement for services 10 to persons who are eligible for assistance due to an income 11 level consistent with the waiting list requirements of section 12 237A.13. Any state obligation to provide services pursuant to 13 this section is limited to the extent of the funds appropriated 14 in this section. 15 3. Of the funds appropriated in this section, $432,453 is 16 allocated for the statewide program for child care resource 17 and referral services under section 237A.26. A list of the 18 registered and licensed child care facilities operating in the 19 area served by a child care resource and referral service shall 20 be made available to the families receiving state child care 21 assistance in that area. 22 4. Of the funds appropriated in this section, $936,974 23 is allocated for child care quality improvement initiatives 24 including but not limited to the voluntary quality rating 25 system in accordance with section 237A.30. 26 5. The department may use any of the funds appropriated 27 in this section as a match to obtain federal funds for use in 28 expanding child care assistance and related programs. For 29 the purpose of expenditures of state and federal child care 30 funding, funds shall be considered obligated at the time 31 expenditures are projected or are allocated to the department’s 32 service areas. Projections shall be based on current and 33 projected caseload growth, current and projected provider 34 rates, staffing requirements for eligibility determination 35 -37- SF 542 (3) 84 pf/jp 37/ 209
S.F. 542 and management of program requirements including data systems 1 management, staffing requirements for administration of the 2 program, contractual and grant obligations and any transfers 3 to other state agencies, and obligations for decategorization 4 or innovation projects. 5 6. A portion of the state match for the federal child care 6 and development block grant shall be provided as necessary to 7 meet federal matching funds requirements through the state 8 general fund appropriation made for child development grants 9 and other programs for at-risk children in section 279.51. 10 7. If a uniform reduction ordered by the governor under 11 section 8.31 or other operation of law, transfer, or federal 12 funding reduction reduces the appropriation made in this 13 section for the fiscal year, the percentage reduction in the 14 amount paid out to or on behalf of the families participating 15 in the state child care assistance program shall be equal to or 16 less than the percentage reduction made for any other purpose 17 payable from the appropriation made in this section and the 18 federal funding relating to it. The percentage reduction to 19 the other allocations made in this section shall be the same as 20 the uniform reduction ordered by the governor or the percentage 21 change of the federal funding reduction, as applicable. 22 If there is an unanticipated increase in federal funding 23 provided for state child care assistance, the entire amount 24 of the increase shall be used for state child care assistance 25 payments. If the appropriations made for purposes of the 26 state child care assistance program for the fiscal year are 27 determined to be insufficient, it is the intent of the general 28 assembly to appropriate sufficient funding for the fiscal year 29 in order to avoid establishment of waiting list requirements. 30 8. Notwithstanding section 8.33, moneys appropriated in 31 this section or received from the federal appropriations made 32 for the purposes of this section that remain unencumbered or 33 unobligated at the close of the fiscal year shall not revert 34 to any fund but shall remain available for expenditure for the 35 -38- SF 542 (3) 84 pf/jp 38/ 209
S.F. 542 purposes designated until the close of the succeeding fiscal 1 year. 2 Sec. 15. JUVENILE INSTITUTIONS. There is appropriated 3 from the general fund of the state to the department of human 4 services for the fiscal year beginning July 1, 2011, and ending 5 June 30, 2012, the following amounts, or so much thereof as is 6 necessary, to be used for the purposes designated: 7 1. For operation of the Iowa juvenile home at Toledo and for 8 salaries, support, maintenance, and miscellaneous purposes, and 9 for not more than the following full-time equivalent positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,258,251 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 114.00 12 2. For operation of the state training school at Eldora and 13 for salaries, support, maintenance, and miscellaneous purposes, 14 and for not more than the following full-time equivalent 15 positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,638,677 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 164.30 18 Of the funds appropriated in this subsection, $91,150 shall 19 be used for distribution to licensed classroom teachers at this 20 and other institutions under the control of the department of 21 human services based upon the average student yearly enrollment 22 at each institution as determined by the department. 23 3. A portion of the moneys appropriated in this section 24 shall be used by the state training school and by the Iowa 25 juvenile home for grants for adolescent pregnancy prevention 26 activities at the institutions in the fiscal year beginning 27 July 1, 2011. 28 4. For the fiscal year beginning July 1, 2011, 29 notwithstanding section 232.52, subsection 2, and section 30 907.3A, subsection 1, the court shall not order the placement 31 of a child at the Iowa juvenile home or the state training 32 school under section 232.52, if that placement is not in 33 accordance with the population guidelines for the respective 34 juvenile institution established pursuant to section 233A.1 or 35 -39- SF 542 (3) 84 pf/jp 39/ 209
S.F. 542 233B.1. 1 Sec. 16. CHILD AND FAMILY SERVICES. 2 1. There is appropriated from the general fund of the 3 state to the department of human services for the fiscal year 4 beginning July 1, 2011, and ending June 30, 2012, the following 5 amount, or so much thereof as is necessary, to be used for the 6 purpose designated: 7 For child and family services: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 83,077,336 9 2. In order to address a reduction of $5,200,000 from the 10 amount allocated under the appropriation made for the purposes 11 of this section in prior years for purposes of juvenile 12 delinquent graduated sanction services, up to $5,200,000 of the 13 amount of federal temporary assistance for needy families block 14 grant funding appropriated in this division of this Act for 15 child and family services shall be made available for purposes 16 of juvenile delinquent graduated sanction services. 17 3. The department may transfer funds appropriated in this 18 section as necessary to pay the nonfederal costs of services 19 reimbursed under the medical assistance program, state child 20 care assistance program, or the family investment program which 21 are provided to children who would otherwise receive services 22 paid under the appropriation in this section. The department 23 may transfer funds appropriated in this section to the 24 appropriations made in this division of this Act for general 25 administration and for field operations for resources necessary 26 to implement and operate the services funded in this section. 27 4. a. Of the funds appropriated in this section, up to 28 $30,169,129 is allocated as the statewide expenditure target 29 under section 232.143 for group foster care maintenance and 30 services. If the department projects that such expenditures 31 for the fiscal year will be less than the target amount 32 allocated in this lettered paragraph, the department may 33 reallocate the excess to provide additional funding for shelter 34 care or the child welfare emergency services addressed with the 35 -40- SF 542 (3) 84 pf/jp 40/ 209
S.F. 542 allocation for shelter care. 1 b. If at any time after September 30, 2011, annualization 2 of a service area’s current expenditures indicates a service 3 area is at risk of exceeding its group foster care expenditure 4 target under section 232.143 by more than 5 percent, the 5 department and juvenile court services shall examine all 6 group foster care placements in that service area in order to 7 identify those which might be appropriate for termination. 8 In addition, any aftercare services believed to be needed 9 for the children whose placements may be terminated shall be 10 identified. The department and juvenile court services shall 11 initiate action to set dispositional review hearings for the 12 placements identified. In such a dispositional review hearing, 13 the juvenile court shall determine whether needed aftercare 14 services are available and whether termination of the placement 15 is in the best interest of the child and the community. 16 5. In accordance with the provisions of section 232.188, 17 the department shall continue the child welfare and juvenile 18 justice funding initiative during fiscal year 2011-2012. Of 19 the funds appropriated in this section, $1,717,753 is allocated 20 specifically for expenditure for fiscal year 2011-2012 through 21 the decategorization service funding pools and governance 22 boards established pursuant to section 232.188. 23 6. A portion of the funds appropriated in this section 24 may be used for emergency family assistance to provide other 25 resources required for a family participating in a family 26 preservation or reunification project or successor project to 27 stay together or to be reunified. 28 7. Notwithstanding section 234.35 or any other provision 29 of law to the contrary, state funding for shelter care and 30 the child welfare emergency services contracting implemented 31 to provide for or prevent the need for shelter care shall be 32 limited to $7,570,116. The department may execute contracts 33 that result from the department’s request for proposal, bid 34 number ACFS-11-114, to provide the range of child welfare 35 -41- SF 542 (3) 84 pf/jp 41/ 209
S.F. 542 emergency services described in the request for proposals, and 1 any subsequent amendments to the request for proposals. 2 8. Federal funds received by the state during the fiscal 3 year beginning July 1, 2011, as the result of the expenditure 4 of state funds appropriated during a previous state fiscal 5 year for a service or activity funded under this section are 6 appropriated to the department to be used as additional funding 7 for services and purposes provided for under this section. 8 Notwithstanding section 8.33, moneys received in accordance 9 with this subsection that remain unencumbered or unobligated at 10 the close of the fiscal year shall not revert to any fund but 11 shall remain available for the purposes designated until the 12 close of the succeeding fiscal year. 13 9. Of the funds appropriated in this section, at least 14 $3,696,285 shall be used for protective child care assistance. 15 10. a. Of the funds appropriated in this section, up to 16 $2,062,488 is allocated for the payment of the expenses of 17 court-ordered services provided to juveniles who are under the 18 supervision of juvenile court services, which expenses are a 19 charge upon the state pursuant to section 232.141, subsection 20 4. Of the amount allocated in this lettered paragraph, up to 21 $1,556,287 shall be made available to provide school-based 22 supervision of children adjudicated under chapter 232, of which 23 not more than $15,000 may be used for the purpose of training. 24 A portion of the cost of each school-based liaison officer 25 shall be paid by the school district or other funding source as 26 approved by the chief juvenile court officer. 27 b. Of the funds appropriated in this section, up to $748,985 28 is allocated for the payment of the expenses of court-ordered 29 services provided to children who are under the supervision 30 of the department, which expenses are a charge upon the state 31 pursuant to section 232.141, subsection 4. 32 c. Notwithstanding section 232.141 or any other provision 33 of law to the contrary, the amounts allocated in this 34 subsection shall be distributed to the judicial districts 35 -42- SF 542 (3) 84 pf/jp 42/ 209
S.F. 542 as determined by the state court administrator and to the 1 department’s service areas as determined by the administrator 2 of the department’s division of child and family services. 3 The state court administrator and the division administrator 4 shall make the determination of the distribution amounts on or 5 before June 15, 2011. However, if this subsection is enacted 6 on or after June 15, 2011, the determination shall be made not 7 later than 10 calendar days after the effective date of this 8 subsection. 9 d. Notwithstanding chapter 232 or any other provision of 10 law to the contrary, a district or juvenile court shall not 11 order any service which is a charge upon the state pursuant 12 to section 232.141 if there are insufficient court-ordered 13 services funds available in the district court or departmental 14 service area distribution amounts to pay for the service. The 15 chief juvenile court officer and the departmental service area 16 manager shall encourage use of the funds allocated in this 17 subsection such that there are sufficient funds to pay for 18 all court-related services during the entire year. The chief 19 juvenile court officers and departmental service area managers 20 shall attempt to anticipate potential surpluses and shortfalls 21 in the distribution amounts and shall cooperatively request the 22 state court administrator or division administrator to transfer 23 funds between the judicial districts’ or departmental service 24 areas’ distribution amounts as prudent. 25 e. Notwithstanding any provision of law to the contrary, 26 a district or juvenile court shall not order a county to pay 27 for any service provided to a juvenile pursuant to an order 28 entered under chapter 232 which is a charge upon the state 29 under section 232.141, subsection 4. 30 f. Of the funds allocated in this subsection, not more than 31 $83,000 may be used by the judicial branch for administration 32 of the requirements under this subsection. 33 g. Of the funds allocated in this subsection, $17,000 34 shall be used by the department of human services to support 35 -43- SF 542 (3) 84 pf/jp 43/ 209
S.F. 542 the interstate commission for juveniles in accordance with 1 the interstate compact for juveniles as provided in section 2 232.173. 3 11. Of the funds appropriated in this section, $5,922,602 is 4 allocated for juvenile delinquent graduated sanctions services. 5 Any state funds saved as a result of efforts by juvenile court 6 services to earn federal Tit. IV-E match for juvenile court 7 services administration may be used for the juvenile delinquent 8 graduated sanctions services. 9 12. Of the funds appropriated in this section, $988,285 10 shall be transferred to the department of public health to 11 be used for the child protection center grant program in 12 accordance with section 135.118. 13 13. If the department receives federal approval to 14 implement a waiver under Tit. IV-E of the federal Social 15 Security Act to enable providers to serve children who remain 16 in the children’s families and communities, for purposes of 17 eligibility under the medical assistance program, children who 18 participate in the waiver shall be considered to be placed in 19 foster care. 20 14. Of the funds appropriated in this section, $3,069,832 is 21 allocated for the preparation for adult living program pursuant 22 to section 234.46. 23 15. Of the funds appropriated in this section, $520,150 24 shall be used for juvenile drug courts. The amount allocated 25 in this subsection shall be distributed as follows: 26 To the judicial branch for salaries to assist with the 27 operation of juvenile drug court programs operated in the 28 following jurisdictions: 29 a. Marshall county: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,708 31 b. Woodbury county: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,682 33 c. Polk county: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 195,892 35 -44- SF 542 (3) 84 pf/jp 44/ 209
S.F. 542 d. The third judicial district: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 2 e. The eighth judicial district: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 4 16. Of the funds appropriated in this section, $227,337 5 shall be used for the public purpose of providing a grant to 6 a nonprofit human services organization providing services to 7 individuals and families in multiple locations in southwest 8 Iowa and Nebraska for support of a project providing immediate, 9 sensitive support and forensic interviews, medical exams, needs 10 assessments, and referrals for victims of child abuse and their 11 nonoffending family members. 12 17. Of the funds appropriated in this section, $125,590 13 is allocated for the elevate approach of providing a support 14 network to children placed in foster care. 15 18. Of the funds appropriated in this section, $202,000 is 16 allocated for use pursuant to section 235A.1 for continuation 17 of the initiative to address child sexual abuse implemented 18 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 19 21. 20 19. Of the funds appropriated in this section, $630,240 is 21 allocated for the community partnership for child protection 22 sites. 23 20. Of the funds appropriated in this section, $371,250 24 is allocated for the department’s minority youth and family 25 projects under the redesign of the child welfare system. 26 21. Of the funds appropriated in this section, $1,200,495 27 is allocated for funding of the state match for the federal 28 substance abuse and mental health services administration 29 (SAMHSA) system of care grant. 30 22. Of the funds appropriated in this section, at least 31 $147,158 shall be used for the child welfare training academy. 32 23. Of the funds appropriated in this section, $25,000 33 shall be used for the public purpose of providing a grant to 34 a child welfare services provider headquartered in a county 35 -45- SF 542 (3) 84 pf/jp 45/ 209
S.F. 542 with a population between 205,000 and 215,000 in the latest 1 certified federal census that provides multiple services 2 including but not limited to a psychiatric medical institution 3 for children, shelter, residential treatment, after school 4 programs, school-based programming, and an Asperger’s syndrome 5 program, to be used for support services for children with 6 autism spectrum disorder and their families. 7 24. Of the funds appropriated in this section, $257,173 8 shall be used for continuation of the central Iowa system of 9 care program grant through June 30, 2012. 10 Sec. 17. ADOPTION SUBSIDY. 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, 2011, and ending June 30, 2012, the following 14 amount, or so much thereof as is necessary, to be used for the 15 purpose designated: 16 For adoption subsidy payments and services: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 34,466,591 18 2. The department may transfer funds appropriated in 19 this section to the appropriation made in this division of 20 this Act for general administration for costs paid from the 21 appropriation relating to adoption subsidy. 22 3. Federal funds received by the state during the 23 fiscal year beginning July 1, 2011, as the result of the 24 expenditure of state funds during a previous state fiscal 25 year for a service or activity funded under this section are 26 appropriated to the department to be used as additional funding 27 for the services and activities funded under this section. 28 Notwithstanding section 8.33, moneys received in accordance 29 with this subsection that remain unencumbered or unobligated 30 at the close of the fiscal year shall not revert to any fund 31 but shall remain available for expenditure for the purposes 32 designated until the close of the succeeding fiscal year. 33 Sec. 18. JUVENILE DETENTION HOME FUND. 34 1. Moneys deposited in the juvenile detention home fund 35 -46- SF 542 (3) 84 pf/jp 46/ 209
S.F. 542 created in section 232.142 during the fiscal year beginning 1 July 1, 2011, and ending June 30, 2012, are appropriated to 2 the department of human services for the fiscal year beginning 3 July 1, 2011, and ending June 30, 2012, for distribution of an 4 amount equal to a percentage of the costs of the establishment, 5 improvement, operation, and maintenance of county or 6 multicounty juvenile detention homes in the fiscal year 7 beginning July 1, 2010. Moneys appropriated for distribution 8 in accordance with this section shall be allocated among 9 eligible detention homes, prorated on the basis of an eligible 10 detention home’s proportion of the costs of all eligible 11 detention homes in the fiscal year beginning July 1, 2010. 12 The percentage figure shall be determined by the department 13 based on the amount available for distribution for the fund. 14 Notwithstanding section 232.142, subsection 3, the financial 15 aid payable by the state under that provision for the fiscal 16 year beginning July 1, 2011, shall be limited to the amount 17 appropriated for the purposes of this section. 18 2. Representatives of chief juvenile court officers, 19 the department of human rights, and the department of human 20 services shall work with juvenile detention centers and other 21 stakeholders to review the current methodology for distribution 22 of moneys from the juvenile detention home fund, consider 23 alternative distribution methodologies, and report findings 24 and recommendations to the persons designated by this division 25 of this Act for the submission of reports by December 15, 26 2011. It is the intent of the general assembly to shift 27 responsibility for administering the fund from the department 28 of human services to the division of criminal and juvenile 29 justice planning of the department of human rights, effective 30 with the fiscal year beginning July 1, 2012. 31 Sec. 19. FAMILY SUPPORT SUBSIDY PROGRAM. 32 1. There is appropriated from the general fund of the 33 state to the department of human services for the fiscal year 34 beginning July 1, 2011, and ending June 30, 2012, the following 35 -47- SF 542 (3) 84 pf/jp 47/ 209
S.F. 542 amount, or so much thereof as is necessary, to be used for the 1 purpose designated: 2 For the family support subsidy program subject to the 3 enrollment restrictions in section 225C.37, subsection 3: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,167,998 5 2. The department shall use at least $385,500 of the moneys 6 appropriated in this section for the family support center 7 component of the comprehensive family support program under 8 section 225C.47. Not more than $25,000 of the amount allocated 9 in this subsection shall be used for administrative costs. 10 3. If at any time during the fiscal year, the amount of 11 funding available for the family support subsidy program 12 is reduced from the amount initially used to establish the 13 figure for the number of family members for whom a subsidy 14 is to be provided at any one time during the fiscal year, 15 notwithstanding section 225C.38, subsection 2, the department 16 shall revise the figure as necessary to conform to the amount 17 of funding available. 18 Sec. 20. CONNER DECREE. There is appropriated from the 19 general fund of the state to the department of human services 20 for the fiscal year beginning July 1, 2011, and ending June 30, 21 2012, the following amount, or so much thereof as is necessary, 22 to be used for the purpose designated: 23 For building community capacity through the coordination 24 and provision of training opportunities in accordance with the 25 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 26 Iowa, July 14, 1994): 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,622 28 Sec. 21. MENTAL HEALTH INSTITUTES. 29 There is appropriated from the general fund of the state to 30 the department of human services for the fiscal year beginning 31 July 1, 2011, and ending June 30, 2012, the following amounts, 32 or so much thereof as is necessary, to be used for the purposes 33 designated: 34 1. For the state mental health institute at Cherokee for 35 -48- SF 542 (3) 84 pf/jp 48/ 209
S.F. 542 salaries, support, maintenance, and miscellaneous purposes, and 1 for not more than the following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,877,308 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 168.50 4 2. For the state mental health institute at Clarinda for 5 salaries, support, maintenance, and miscellaneous purposes, and 6 for not more than the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,411,734 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 86.10 9 3. For the state mental health institute at Independence for 10 salaries, support, maintenance, and miscellaneous purposes, and 11 for not more than the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,275,685 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 14 4. For the state mental health institute at Mount Pleasant 15 for salaries, support, maintenance, and miscellaneous purposes, 16 and for not more than the following full-time equivalent 17 positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 944,323 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 91.72 20 Sec. 22. STATE RESOURCE CENTERS. 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 amounts, or so much thereof as is necessary, to be used for the 25 purposes designated: 26 a. For the state resource center at Glenwood for salaries, 27 support, maintenance, and miscellaneous purposes: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,607,801 29 b. For the state resource center at Woodward for salaries, 30 support, maintenance, and miscellaneous purposes: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,885,658 32 2. The department may continue to bill for state resource 33 center services utilizing a scope of services approach used for 34 private providers of ICFMR services, in a manner which does not 35 -49- SF 542 (3) 84 pf/jp 49/ 209
S.F. 542 shift costs between the medical assistance program, counties, 1 or other sources of funding for the state resource centers. 2 3. The state resource centers may expand the time-limited 3 assessment and respite services during the fiscal year. 4 4. If the department’s administration and the department 5 of management concur with a finding by a state resource 6 center’s superintendent that projected revenues can reasonably 7 be expected to pay the salary and support costs for a new 8 employee position, or that such costs for adding a particular 9 number of new positions for the fiscal year would be less 10 than the overtime costs if new positions would not be added, 11 the superintendent may add the new position or positions. If 12 the vacant positions available to a resource center do not 13 include the position classification desired to be filled, the 14 state resource center’s superintendent may reclassify any 15 vacant position as necessary to fill the desired position. The 16 superintendents of the state resource centers may, by mutual 17 agreement, pool vacant positions and position classifications 18 during the course of the fiscal year in order to assist one 19 another in filling necessary positions. 20 5. If existing capacity limitations are reached in 21 operating units, a waiting list is in effect for a service or 22 a special need for which a payment source or other funding 23 is available for the service or to address the special need, 24 and facilities for the service or to address the special need 25 can be provided within the available payment source or other 26 funding, the superintendent of a state resource center may 27 authorize opening not more than two units or other facilities 28 and begin implementing the service or addressing the special 29 need during fiscal year 2011-2012. 30 Sec. 23. MI/MR/DD STATE CASES. 31 1. There is appropriated from the general fund of the 32 state to the department of human services for the fiscal year 33 beginning July 1, 2011, and ending June 30, 2012, the following 34 amount, or so much thereof as is necessary, to be used for the 35 -50- SF 542 (3) 84 pf/jp 50/ 209
S.F. 542 purpose designated: 1 For distribution to counties for state case services 2 for persons with mental illness, mental retardation, and 3 developmental disabilities in accordance with section 331.440: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,169,482 5 2. For the fiscal year beginning July 1, 2011, and ending 6 June 30, 2012, $200,000 is allocated for state case services 7 from the amounts appropriated from the fund created in section 8 8.41 to the department of human services from the funds 9 received from the federal government under 42 U.S.C. ch. 6A, 10 subch. XVII, relating to the community mental health center 11 block grant, for the federal fiscal years beginning October 12 1, 2009, and ending September 30, 2010, beginning October 1, 13 2010, and ending September 30, 2011, and beginning October 1, 14 2011, and ending September 30, 2012. The allocation made in 15 this subsection shall be made prior to any other distribution 16 allocation of the appropriated federal funds. 17 3. Notwithstanding section 8.33, moneys appropriated in 18 this section that remain unencumbered or unobligated at the 19 close of the fiscal year shall not revert but shall remain 20 available for expenditure for the purposes designated until the 21 close of the succeeding fiscal year. 22 Sec. 24. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES 23 —— COMMUNITY SERVICES FUND. There is appropriated from 24 the general fund of the state to the mental health and 25 developmental disabilities community services fund created in 26 section 225C.7 for the fiscal year beginning July 1, 2011, and 27 ending June 30, 2012, the following amount, or so much thereof 28 as is necessary, to be used for the purpose designated: 29 For mental health and developmental disabilities community 30 services in accordance with this division of this Act: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,211,100 32 1. Of the funds appropriated in this section, $14,187,556 33 shall be allocated to counties for funding of community-based 34 mental health and developmental disabilities services. The 35 -51- SF 542 (3) 84 pf/jp 51/ 209
S.F. 542 moneys shall be allocated to a county as follows: 1 a. Fifty percent based upon the county’s proportion of the 2 state’s population of persons with an annual income which is 3 equal to or less than the poverty guideline established by the 4 federal office of management and budget. 5 b. Fifty percent based upon the county’s proportion of the 6 state’s general population. 7 2. a. A county shall utilize the funding the county 8 receives pursuant to subsection 1 for services provided to 9 persons with a disability, as defined in section 225C.2. 10 However, no more than 50 percent of the funding shall be used 11 for services provided to any one of the service populations. 12 b. A county shall use at least 50 percent of the funding the 13 county receives under subsection 1 for contemporary services 14 provided to persons with a disability, as described in rules 15 adopted by the department. 16 3. Of the funds appropriated in this section, $23,544 17 shall be used to support the Iowa compass program providing 18 computerized information and referral services for Iowans with 19 disabilities and their families. 20 4. a. Funding appropriated for purposes of the federal 21 social services block grant is allocated for distribution 22 to counties for local purchase of services for persons with 23 mental illness or mental retardation or other developmental 24 disability. 25 b. The funds allocated in this subsection shall be expended 26 by counties in accordance with the county’s county management 27 plan approved by the board of supervisors. A county without 28 an approved county management plan shall not receive allocated 29 funds until the county’s management plan is approved. 30 c. The funds provided by this subsection shall be allocated 31 to each county as follows: 32 (1) Fifty percent based upon the county’s proportion of the 33 state’s population of persons with an annual income which is 34 equal to or less than the poverty guideline established by the 35 -52- SF 542 (3) 84 pf/jp 52/ 209
S.F. 542 federal office of management and budget. 1 (2) Fifty percent based upon the amount provided to the 2 county for local purchase of services in the preceding fiscal 3 year. 4 5. A county is eligible for funds under this section if the 5 county qualifies for a state payment as described in section 6 331.439. 7 6. The latest certified census issued by the United States 8 bureau of the census shall be applied for the population 9 factors utilized in this section. 10 Sec. 25. SEXUALLY VIOLENT PREDATORS. 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, 2011, and ending June 30, 2012, the following 14 amount, or so much thereof as is necessary, to be used for the 15 purpose designated: 16 For costs associated with the commitment and treatment of 17 sexually violent predators in the unit located at the state 18 mental health institute at Cherokee, including costs of legal 19 services and other associated costs, including salaries, 20 support, maintenance, and miscellaneous purposes, and for not 21 more than the following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,550,727 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 89.50 24 2. Unless specifically prohibited by law, if the amount 25 charged provides for recoupment of at least the entire amount 26 of direct and indirect costs, the department of human services 27 may contract with other states to provide care and treatment 28 of persons placed by the other states at the unit for sexually 29 violent predators at Cherokee. The moneys received under 30 such a contract shall be considered to be repayment receipts 31 and used for the purposes of the appropriation made in this 32 section. 33 Sec. 26. FIELD OPERATIONS. There is appropriated from the 34 general fund of the state to the department of human services 35 -53- SF 542 (3) 84 pf/jp 53/ 209
S.F. 542 for the fiscal year beginning July 1, 2011, and ending June 30, 1 2012, the following amount, or so much thereof as is necessary, 2 to be used for the purposes designated: 3 For field operations, including salaries, support, 4 maintenance, and miscellaneous purposes, and for not more than 5 the following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 54,789,921 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,781.00 8 Priority in filling full-time equivalent positions shall be 9 given to those positions related to child protection services 10 and eligibility determination for low-income families. 11 Notwithstanding section 8.33, moneys appropriated in this 12 section that remain unencumbered or unobligated at the close of 13 the fiscal year shall not revert but shall remain available for 14 expenditure for the purposes designated until the close of the 15 succeeding fiscal year. 16 Sec. 27. GENERAL ADMINISTRATION. There is appropriated 17 from the general fund of the state to the department of human 18 services for the fiscal year beginning July 1, 2011, and ending 19 June 30, 2012, the following amount, or so much thereof as is 20 necessary, to be used for the purpose designated: 21 For general administration, including salaries, support, 22 maintenance, and miscellaneous purposes, and for not more than 23 the following full-time equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,596,745 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 290.00 26 1. Of the funds appropriated in this section, $38,543 27 allocated for the prevention of disabilities policy council 28 established in section 225B.3. 29 2. The department shall report at least monthly to the 30 legislative services agency concerning the department’s 31 operational and program expenditures. 32 3. Of the funds appropriated in this section, $132,300 shall 33 be used to contract with a statewide association representing 34 community providers of mental health, mental retardation and 35 -54- SF 542 (3) 84 pf/jp 54/ 209
S.F. 542 brain injury services programs to provide technical assistance, 1 support, and consultation to providers of habilitation 2 services and home and community-based waiver services for 3 adults with disabilities under the medical assistance program. 4 Notwithstanding section 8.47 or any other provision of law to 5 the contrary, the department may utilize a sole source approach 6 to contract with the association. 7 4. Of the funds appropriated in this section, $176,400 8 shall be used to contract with an appropriate entity to 9 expand the provision of nationally accredited and recognized 10 internet-based training to include mental health and disability 11 services providers. Notwithstanding section 8.47 or any other 12 provision of law to the contrary, the department may utilize a 13 sole source approach to enter into such contract. 14 5. Of the funds appropriated in this section, $500,000 15 shall be used for implementation of child protection system 16 improvements addressed in 2011 Iowa Acts, House File 562, as 17 enacted. 18 6. Notwithstanding section 8.33, moneys appropriated in 19 this section that remain unencumbered or unobligated at the 20 close of the fiscal year shall not revert but shall remain 21 available for expenditure for the purposes designated until the 22 close of the succeeding fiscal year. 23 Sec. 28. VOLUNTEERS. There is appropriated from the general 24 fund of the state to the department of human services for the 25 fiscal year beginning July 1, 2011, and ending June 30, 2012, 26 the following amount, or so much thereof as is necessary, to be 27 used for the purpose designated: 28 For development and coordination of volunteer services: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,660 30 Sec. 29. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 31 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 32 DEPARTMENT OF HUMAN SERVICES. 33 1. a. (1) For the fiscal year beginning July 1, 2011, 34 the total state funding amount for the nursing facility budget 35 -55- SF 542 (3) 84 pf/jp 55/ 209
S.F. 542 shall not exceed $223,202,551. 1 (2) For the fiscal year beginning July 1, 2011, the 2 department shall rebase case-mix nursing facility rates 3 effective July 1, 2011. However, total nursing facility budget 4 expenditures, including both case-mix and noncase-mix shall 5 not exceed the amount specified in subparagraph (1). When 6 calculating case-mix per diem cost and the patient-day-weighted 7 medians used in rate-setting for nursing facilities effective 8 July 1, 2011, the inflation factor applied from the midpoint 9 of the cost report period to the first day of the state fiscal 10 year rate period shall be adjusted to maintain state funding 11 within the amount specified in subparagraph (1). 12 (3) The department, in cooperation with nursing facility 13 representatives, shall review projections for state funding 14 expenditures for reimbursement of nursing facilities on a 15 quarterly basis and the department shall determine if an 16 adjustment to the medical assistance reimbursement rate is 17 necessary in order to provide reimbursement within the state 18 funding amount for the fiscal year. Notwithstanding 2001 19 Iowa Acts, chapter 192, section 4, subsection 2, paragraph 20 “c”, and subsection 3, paragraph “a”, subparagraph (2), 21 if the state funding expenditures for the nursing facility 22 budget for the fiscal year is projected to exceed the amount 23 specified in subparagraph (1), the department shall adjust 24 the reimbursement for nursing facilities reimbursed under the 25 case-mix reimbursement system to maintain expenditures of the 26 nursing facility budget within the specified amount for the 27 fiscal year. 28 (4) For the fiscal year beginning July 1, 2011, special 29 population nursing facilities shall be reimbursed in accordance 30 with the methodology in effect on June 30, 2011. 31 b. For the fiscal year beginning July 1, 2011, the 32 department shall reimburse pharmacy dispensing fees using a 33 single rate of $4.34 per prescription or the pharmacy’s usual 34 and customary fee, whichever is lower. However, the department 35 -56- SF 542 (3) 84 pf/jp 56/ 209
S.F. 542 shall adjust the dispensing fee specified in this paragraph 1 to distribute an additional $2,400,000 in reimbursements for 2 pharmacy dispensing fees under this paragraph for the fiscal 3 year. 4 c. (1) For the fiscal year beginning July 1, 2011, 5 reimbursement rates for outpatient hospital services shall be 6 rebased effective January 1, 2012. 7 (2) For the fiscal year beginning July 1, 2011, 8 reimbursement rates for inpatient hospital services shall be 9 rebased effective October 1, 2011. 10 (3) The total amount of increased funding available for 11 reimbursement attributable to rebasing under this paragraph 12 for the fiscal year beginning July 1, 2011, shall not exceed 13 $4,500,000. 14 (4) For the fiscal year beginning July 1, 2011, the graduate 15 medical education and disproportionate share hospital fund 16 shall remain at the amount in effect on June 30, 2011, except 17 that the portion of the fund attributable to graduate medical 18 education shall be reduced in an amount that reflects the 19 elimination of graduate medical education payments made to 20 out-of-state hospitals. 21 (5) In order to ensure the efficient use of limited state 22 funds in procuring health care services for low-income Iowans, 23 funds appropriated in this Act for hospital services shall 24 not be used for activities which would be excluded from a 25 determination of reasonable costs under the federal Medicare 26 program pursuant to 42 U.S.C. § 1395X(v)(1)(N). 27 d. For the fiscal year beginning July 1, 2011, reimbursement 28 rates for rural health clinics, hospices, and acute mental 29 hospitals shall be increased in accordance with increases under 30 the federal Medicare program or as supported by their Medicare 31 audited costs. 32 e. For the fiscal year beginning July 1, 2011, independent 33 laboratories and rehabilitation agencies shall be reimbursed 34 using the same methodology in effect on June 30, 2011. 35 -57- SF 542 (3) 84 pf/jp 57/ 209
S.F. 542 f. For the fiscal year beginning July 1, 2011, reimbursement 1 rates for home health agencies shall remain at the rates in 2 effect on June 30, 2011, not to exceed a home health agency’s 3 actual allowable cost. 4 g. For the fiscal year beginning July 1, 2011, federally 5 qualified health centers shall receive cost-based reimbursement 6 for 100 percent of the reasonable costs for the provision of 7 services to recipients of medical assistance. 8 h. For the fiscal year beginning July 1, 2011, the 9 reimbursement rates for dental services shall remain at the 10 rates in effect on June 30, 2011. 11 i. (1) For the fiscal year beginning July 1, 2011, 12 state-owned psychiatric medical institutions for children shall 13 receive cost-based reimbursement for 100 percent of the actual 14 and allowable costs for the provision of services to recipients 15 of medical assistance. 16 (2) For the nonstate-owned psychiatric medical institutions 17 for children, reimbursement rates shall remain at the rates 18 in effect on June 30, 2011. The department, in consultation 19 with representatives of the nonstate-owned psychiatric medical 20 institutions for children, shall develop a reimbursement 21 methodology to include all ancillary medical services costs 22 and any other changes required for federal compliance, to be 23 implemented on July 1, 2012. To the extent possible, the 24 reimbursement methodology shall be developed in a manner so as 25 to be budget neutral to the institutions and cost effective for 26 the state. 27 j. For the fiscal year beginning July 1, 2011, unless 28 otherwise specified in this Act, all noninstitutional medical 29 assistance provider reimbursement rates shall remain at the 30 rates in effect on June 30, 2011, except for area education 31 agencies, local education agencies, infant and toddler services 32 providers, and those providers whose rates are required to be 33 determined pursuant to section 249A.20. 34 k. Notwithstanding any provision to the contrary, for the 35 -58- SF 542 (3) 84 pf/jp 58/ 209
S.F. 542 fiscal year beginning July 1, 2011, the reimbursement rate for 1 anesthesiologists shall remain at the rate in effect on June 2 30, 2011. 3 l. Notwithstanding section 249A.20, for the fiscal year 4 beginning July 1, 2011, the average reimbursement rate for 5 health care providers eligible for use of the federal Medicare 6 resource-based relative value scale reimbursement methodology 7 under that section shall remain at the rate in effect on June 8 30, 2011; however, this rate shall not exceed the maximum level 9 authorized by the federal government. 10 m. For the fiscal year beginning July 1, 2011, the 11 reimbursement rate for residential care facilities shall not 12 be less than the minimum payment level as established by the 13 federal government to meet the federally mandated maintenance 14 of effort requirement. The flat reimbursement rate for 15 facilities electing not to file annual cost reports shall not 16 be less than the minimum payment level as established by the 17 federal government to meet the federally mandated maintenance 18 of effort requirement. 19 n. For the fiscal year beginning July 1, 2011, inpatient 20 mental health services provided at hospitals shall be rebased 21 effective October 1, 2011, subject to Medicaid program upper 22 payment limit rules; community mental health centers and 23 providers of mental health services to county residents 24 pursuant to a waiver approved under section 225C.7, subsection 25 3, shall be reimbursed at 100 percent of the reasonable 26 costs for the provision of services to recipients of medical 27 assistance; and psychiatrists shall be reimbursed at the 28 medical assistance program fee for service rate. 29 o. For the fiscal year beginning July 1, 2011, the 30 reimbursement rate for consumer-directed attendant care shall 31 remain at the rates in effect on June 30, 2011. 32 p. For the fiscal year beginning July 1, 2011, the 33 reimbursement rate for providers of family planning services 34 that are eligible to receive a 90 percent federal match shall 35 -59- SF 542 (3) 84 pf/jp 59/ 209
S.F. 542 remain at the rates in effect on June 30, 2011. 1 q. For the fiscal year beginning July 1, 2011, the 2 department shall adjust the rates in effect on June 30, 3 2011, for providers of home and community-based services 4 waiver services to distribute an additional $1,500,000 in 5 reimbursements to such providers for the fiscal year. 6 2. For the fiscal year beginning July 1, 2011, the 7 reimbursement rate for providers reimbursed under the 8 in-home-related care program shall not be less than the minimum 9 payment level as established by the federal government to meet 10 the federally mandated maintenance of effort requirement. 11 3. Unless otherwise directed in this section, when the 12 department’s reimbursement methodology for any provider 13 reimbursed in accordance with this section includes an 14 inflation factor, this factor shall not exceed the amount 15 by which the consumer price index for all urban consumers 16 increased during the calendar year ending December 31, 2002. 17 4. For the fiscal year beginning July 1, 2011, 18 notwithstanding section 234.38, the foster family basic daily 19 maintenance rate and the maximum adoption subsidy rate for 20 children ages 0 through 5 years shall be $15.74, the rate for 21 children ages 6 through 11 years shall be $16.37, the rate for 22 children ages 12 through 15 years shall be $17.92, and the 23 rate for children and young adults ages 16 and older shall be 24 $18.16. The maximum supervised apartment living foster care 25 reimbursement rate shall be $25.00 per day. For youth ages 26 18 to 21 who have exited foster care, the maximum preparation 27 for adult living program maintenance rate shall be $574.00 per 28 month. The maximum payment for adoption subsidy nonrecurring 29 expenses shall be limited to $500 and the disallowance of 30 additional amounts for court costs and other related legal 31 expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, 32 section 408 shall be continued. 33 5. For the fiscal year beginning July 1, 2011, the maximum 34 reimbursement rates under the supervised apartment living 35 -60- SF 542 (3) 84 pf/jp 60/ 209
S.F. 542 program and for social services providers under contract 1 shall remain at the rates in effect on June 30, 2011, or the 2 provider’s actual and allowable cost plus inflation for each 3 service, whichever is less. However, if a new service or 4 service provider is added after June 30, 2011, the initial 5 reimbursement rate for the service or provider shall be 6 based upon actual and allowable costs. Providers may also 7 be eligible for an additional amount as specified under the 8 department’s request for proposal, bid number ACFS-11-115. 9 6. For the fiscal year beginning July 1, 2011, the 10 reimbursement rates for family-centered service providers, 11 family foster care service providers, group foster care service 12 providers, and the resource family recruitment and retention 13 contractor shall remain at the rates in effect on June 30, 14 2011. 15 7. The group foster care reimbursement rates paid for 16 placement of children out of state shall be calculated 17 according to the same rate-setting principles as those used for 18 in-state providers, unless the director of human services or 19 the director’s designee determines that appropriate care cannot 20 be provided within the state. The payment of the daily rate 21 shall be based on the number of days in the calendar month in 22 which service is provided. 23 8. a. For the fiscal year beginning July 1, 2011, the 24 reimbursement rate paid for shelter care and the child welfare 25 emergency services implemented to provide or prevent the need 26 for shelter care shall be established in a contract based on 27 the requirements of the department’s request for proposal, bid 28 number ACFS-11-114. 29 b. For the fiscal year beginning July 1, 2011, the combined 30 service and maintenance components of the reimbursement rate 31 paid for shelter care services shall be based on the financial 32 and statistical report submitted to the department. The 33 maximum reimbursement rate shall be $92.36 per day. The 34 department shall reimburse a shelter care provider at the 35 -61- SF 542 (3) 84 pf/jp 61/ 209
S.F. 542 provider’s actual and allowable unit cost, plus inflation, not 1 to exceed the maximum reimbursement rate. 2 c. Notwithstanding section 232.141, subsection 8, for the 3 fiscal year beginning July 1, 2011, the amount of the statewide 4 average of the actual and allowable rates for reimbursement of 5 juvenile shelter care homes that is utilized for the limitation 6 on recovery of unpaid costs shall remain at the amount in 7 effect for this purpose in the fiscal year beginning July 1, 8 2010. 9 9. For the fiscal year beginning July 1, 2011, the 10 department shall calculate reimbursement rates for intermediate 11 care facilities for persons with mental retardation at the 12 80th percentile. Beginning July 1, 2011, the rate calculation 13 methodology shall utilize the consumer price index inflation 14 factor applicable to the fiscal year beginning July 1, 2011. 15 10. For the fiscal year beginning July 1, 2011, for child 16 care providers reimbursed under the state child care assistance 17 program, the department shall set provider reimbursement 18 rates based on the rate reimbursement survey completed in 19 December 2004. Effective July 1, 2011, the child care provider 20 reimbursement rates shall remain at the rates in effect on June 21 30, 2011. The department shall set rates in a manner so as 22 to provide incentives for a nonregistered provider to become 23 registered by applying the increase only to registered and 24 licensed providers. 25 11. The department may adopt emergency rules to implement 26 this section. 27 Sec. 30. EMERGENCY RULES. 28 1. If specifically authorized by a provision of this 29 division of this Act, the department of human services or 30 the mental health, and disability services commission may 31 adopt administrative rules under section 17A.4, subsection 32 3, and section 17A.5, subsection 2, paragraph “b”, to 33 implement the provisions and the rules shall become effective 34 immediately upon filing or on a later effective date specified 35 -62- SF 542 (3) 84 pf/jp 62/ 209
S.F. 542 in the rules, unless the effective date is delayed by the 1 administrative rules review committee. Any rules adopted in 2 accordance with this section shall not take effect before 3 the rules are reviewed by the administrative rules review 4 committee. The delay authority provided to the administrative 5 rules review committee under section 17A.4, subsection 7, and 6 section 17A.8, subsection 9, shall be applicable to a delay 7 imposed under this section, notwithstanding a provision in 8 those sections making them inapplicable to section 17A.5, 9 subsection 2, paragraph “b”. Any rules adopted in accordance 10 with the provisions of this section shall also be published as 11 notice of intended action as provided in section 17A.4. 12 2. If during the fiscal year beginning July 1, 2011, the 13 department of human services is adopting rules in accordance 14 with this section or as otherwise directed or authorized by 15 state law, and the rules will result in an expenditure increase 16 beyond the amount anticipated in the budget process or if the 17 expenditure was not addressed in the budget process for the 18 fiscal year, the department shall notify the persons designated 19 by this division of this Act for submission of reports, 20 the chairpersons and ranking members of the committees on 21 appropriations, and the department of management concerning the 22 rules and the expenditure increase. The notification shall be 23 provided at least 30 calendar days prior to the date notice of 24 the rules is submitted to the administrative rules coordinator 25 and the administrative code editor. 26 Sec. 31. CIVIL MONETARY PENALTIES —— DIRECT CARE WORKER 27 INITIATIVES PROPOSAL. The department of human services shall 28 develop a proposal, in collaboration with the department of 29 public health, requesting federal approval for the use of 30 a portion of the funds received by the department of human 31 services as civil monetary penalties from nursing facilities 32 to support direct care worker initiatives that enhance the 33 quality of care in nursing facilities. The proposal shall 34 request use of the funds for direct care worker initiatives 35 -63- SF 542 (3) 84 pf/jp 63/ 209
S.F. 542 based on recommendations of the direct care worker task force 1 established pursuant to 2005 Iowa Acts, chapter 88, as included 2 in the report submitted to the governor and the general 3 assembly in December 2006. Upon completion of the proposal, 4 the department of human services shall submit the proposal to 5 the centers for Medicare and Medicaid services of the United 6 States department of health and human services for approval. 7 The department of human services shall notify the persons 8 designated in this division of this Act for submission of 9 reports upon receipt of approval of the proposal. 10 Sec. 32. 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. 33. 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. 34. EFFECTIVE UPON ENACTMENT AND RETROACTIVE 29 APPLICABILITY. The following provisions of this division of 30 this Act, being deemed of immediate importance, take effect 31 upon enactment and if approved by the governor on or after July 32 1, 2011, apply retroactively to June 30, 2011: 33 The provision under the appropriation for child and family 34 services, relating to requirements of section 232.143 for 35 -64- SF 542 (3) 84 pf/jp 64/ 209
S.F. 542 representatives of the department of human services and 1 juvenile court services to establish a plan for continuing 2 group foster care expenditures for fiscal year 2011-2012. 3 DIVISION V 4 PHARMACEUTICAL SETTLEMENT ACCOUNT, 5 IOWACARE ACCOUNT, NONPARTICIPATING PROVIDER REIMBURSEMENT FUND, 6 HEALTH CARE 7 TRANSFORMATION ACCOUNT, MEDICAID FRAUD ACCOUNT, 8 QUALITY ASSURANCE TRUST FUND, AND 9 HOSPITAL HEALTH CARE ACCESS TRUST FUND —— FY 2011-2012 10 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 11 appropriated from the pharmaceutical settlement account created 12 in section 249A.33 to the department of human services for the 13 fiscal year beginning July 1, 2011, and ending June 30, 2012, 14 the following amount, or so much thereof as is necessary, to be 15 used for the purpose designated: 16 Notwithstanding any provision of law to the contrary, to 17 supplement the appropriations made in this Act for medical 18 contracts under the medical assistance program: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,433,613 20 Sec. 36. APPROPRIATIONS FROM IOWACARE ACCOUNT. 21 1. There is appropriated from the IowaCare account 22 created in section 249J.24 to the state board of regents for 23 distribution to the university of Iowa hospitals and clinics 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 salaries, support, maintenance, equipment, and 28 miscellaneous purposes, for the provision of medical and 29 surgical treatment of indigent patients, for provision of 30 services to members of the expansion population pursuant to 31 chapter 249J, and for medical education: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 27,284,584 33 a. Funds appropriated in this subsection shall not be used 34 to perform abortions except medically necessary abortions, and 35 -65- SF 542 (3) 84 pf/jp 65/ 209
S.F. 542 shall not be used to operate the early termination of pregnancy 1 clinic except for the performance of medically necessary 2 abortions. For the purpose of this subsection, an abortion is 3 the purposeful interruption of pregnancy with the intention 4 other than to produce a live-born infant or to remove a dead 5 fetus, and a medically necessary abortion is one performed 6 under one of the following conditions: 7 (1) The attending physician certifies that continuing the 8 pregnancy would endanger the life of the pregnant woman. 9 (2) The attending physician certifies that the fetus is 10 physically deformed, mentally deficient, or afflicted with a 11 congenital illness. 12 (3) The pregnancy is the result of a rape which is reported 13 within 45 days of the incident to a law enforcement agency or 14 public or private health agency which may include a family 15 physician. 16 (4) The pregnancy is the result of incest which is reported 17 within 150 days of the incident to a law enforcement agency 18 or public or private health agency which may include a family 19 physician. 20 (5) The abortion is a spontaneous abortion, commonly known 21 as a miscarriage, wherein not all of the products of conception 22 are expelled. 23 b. Notwithstanding any provision of law to the contrary, 24 the amount appropriated in this subsection shall be distributed 25 based on claims submitted, adjudicated, and paid by the Iowa 26 Medicaid enterprise. 27 c. The university of Iowa hospitals and clinics shall 28 certify public expenditures in an amount equal to provide 29 the nonfederal share on total expenditures not to exceed 30 $20,000,000. 31 2. There is appropriated from the IowaCare account 32 created in section 249J.24 to the state board of regents for 33 distribution to the university of Iowa hospitals and clinics 34 for the fiscal year beginning July 1, 2011, and ending June 30, 35 -66- SF 542 (3) 84 pf/jp 66/ 209
S.F. 542 2012, the following amount, or so much thereof as is necessary, 1 to be used 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 44,226,279 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. 12 3. There is appropriated from the IowaCare account 13 created in section 249J.24, to the state board of regents for 14 distribution to university of Iowa physicians for the fiscal 15 year beginning July 1, 2011, and ending June 30, 2012, the 16 following amount, or so much thereof as is necessary to be used 17 for the purposes designated: 18 For salaries, support, maintenance, equipment, and 19 miscellaneous purposes for the provision of medical and 20 surgical treatment of indigent patients, for provision of 21 services to members of the expansion population pursuant to 22 chapter 249J, and for medical education: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,277,753 24 Notwithstanding any provision of law to the contrary, the 25 amount appropriated in this subsection shall be distributed 26 based on claims submitted, adjudicated, and paid by the Iowa 27 Medicaid enterprise. Once the entire amount appropriated in 28 this subsection has been distributed, claims shall continue to 29 be submitted and adjudicated by the Iowa Medicaid enterprise; 30 however, no payment shall be made based upon such claims. 31 4. There is appropriated from the IowaCare account created 32 in section 249J.24 to the department of human services for the 33 fiscal year beginning July 1, 2011, and ending June 30, 2012, 34 the following amount, or so much thereof as is necessary, to be 35 -67- SF 542 (3) 84 pf/jp 67/ 209
S.F. 542 used for the purposes designated: 1 For distribution to a publicly owned acute care teaching 2 hospital located in a county with a population over 350,000 for 3 the provision of medical and surgical treatment of indigent 4 patients, for provision of services to members of the expansion 5 population pursuant to chapter 249J, and for medical education: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,000,000 7 a. 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 plus a monthly disproportionate share 11 hospital payment. Any amount appropriated in this subsection 12 in excess of $60,000,000 shall be distributed only if the sum 13 of the expansion population claims adjudicated and paid by the 14 Iowa Medicaid enterprise plus the estimated disproportionate 15 share hospital payments exceeds $60,000,000. The amount paid 16 in excess of $60,000,000 shall not adjust the original monthly 17 payment amount but shall be distributed monthly based on actual 18 claims adjudicated and paid by the Iowa Medicaid enterprise 19 plus the estimated disproportionate share hospital amount. Any 20 amount appropriated in this subsection in excess of $60,000,000 21 shall be allocated only if federal funds are available to match 22 the amount allocated. Pursuant to paragraph “b”, of the amount 23 appropriated in this subsection, not more than $4,000,000 shall 24 be distributed for prescription drugs and podiatry services. 25 b. Notwithstanding any provision of law to the contrary, the 26 hospital identified in this subsection, shall be reimbursed for 27 outpatient prescription drugs and podiatry services provided to 28 members of the expansion population pursuant to all applicable 29 medical assistance program rules, in an amount not to exceed 30 $4,000,000. 31 c. Notwithstanding the total amount of proceeds distributed 32 pursuant to section 249J.24, subsection 4, paragraph “a”, 33 unnumbered paragraph 1, for the fiscal year beginning July 34 1, 2011, and ending June 30, 2012, the county treasurer of a 35 -68- SF 542 (3) 84 pf/jp 68/ 209
S.F. 542 county with a population of over 350,000 in which a publicly 1 owned acute care teaching hospital is located shall distribute 2 the proceeds collected pursuant to section 347.7 in a total 3 amount of $38,000,000, which would otherwise be distributed to 4 the county hospital, to the treasurer of state for deposit in 5 the IowaCare account. 6 d. (1) Notwithstanding the amount collected and 7 distributed for deposit in the IowaCare account pursuant to 8 section 249J.24, subsection 4, paragraph “a”, subparagraph 9 (1), the first $19,000,000 in proceeds collected pursuant to 10 section 347.7 between July 1, 2011, and December 31, 2011, 11 shall be distributed to the treasurer of state for deposit in 12 the IowaCare account and collections during this time period 13 in excess of $19,000,000 shall be distributed to the acute 14 care teaching hospital identified in this subsection. Of the 15 collections in excess of the $19,000,000 received by the acute 16 care teaching hospital under this subparagraph (1), $2,000,000 17 shall be distributed by the acute care teaching hospital to the 18 treasurer of state for deposit in the IowaCare account in the 19 month of January 2012, following the July 1 through December 20 31, 2011, period. 21 (2) Notwithstanding the amount collected and distributed 22 for deposit in the IowaCare account pursuant to section 23 249J.24, subsection 4, paragraph “a”, subparagraph (2), 24 the first $19,000,000 in collections pursuant to section 25 347.7 between January 1, 2012, and June 30, 2012, shall be 26 distributed to the treasurer of state for deposit in the 27 IowaCare account and collections during this time period in 28 excess of $19,000,000 shall be distributed to the acute care 29 teaching hospital identified in this subsection. Of the 30 collections in excess of the $19,000,000 received by the acute 31 care teaching hospital under this subparagraph (2), $2,000,000 32 shall be distributed by the acute care teaching hospital to the 33 treasurer of state for deposit in the IowaCare account in the 34 month of July 2012, following the January 1 through June 30, 35 -69- SF 542 (3) 84 pf/jp 69/ 209
S.F. 542 2012, period. 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, 2011, and ending June 30, 2012, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,472,176 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, 2011, and ending June 30, 2012, 21 the following amount, or so much thereof as is necessary to be 22 used for the purposes designated: 23 For a care coordination pool to pay the expansion population 24 providers consisting of the university of Iowa hospitals and 25 clinics, the publicly owned acute care teaching hospital as 26 specified in section 249J.7, and current medical assistance 27 program providers that are not expansion population network 28 providers pursuant to section 249J.7, for services covered by 29 the full benefit medical assistance program but not under the 30 IowaCare program pursuant to section 249J.6, that are provided 31 to expansion population members: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,500,000 33 a. Notwithstanding sections 249J.6 and 249J.7, the amount 34 appropriated in this subsection is intended to provide 35 -70- SF 542 (3) 84 pf/jp 70/ 209
S.F. 542 payment for medically necessary services provided to expansion 1 population members for continuation of care provided by the 2 university of Iowa hospitals and clinics or the publicly owned 3 acute care teaching hospital as specified in section 249J.7. 4 Payment may only be made for services that are not otherwise 5 covered under section 249J.6, and which are follow-up services 6 to covered services provided by the hospitals specified in this 7 paragraph “a”. 8 b. The funds appropriated in this subsection are intended 9 to provide limited payment for continuity of care services for 10 an expansion population member, and are intended to cover the 11 costs of services to expansion population members, regardless 12 of the member’s county of residence or medical home assignment, 13 if the care is related to specialty or hospital services 14 provided by the hospitals specified in paragraph “a”. 15 c. The funds appropriated in this subsection are 16 not intended to provide for expanded coverage under the 17 IowaCare program, and shall not be used to cover emergency 18 transportation services. 19 d. The department shall adopt administrative rules pursuant 20 to chapter 17A to establish a prior authorization process and 21 to identify covered services for reimbursement under this 22 subsection. 23 7. There is appropriated from the IowaCare account created 24 in section 249J.24 to the department of human services for the 25 fiscal year beginning July 1, 2011, and ending June 30, 2012, 26 the following amount or so much thereof as is necessary to be 27 used for the purposes designated: 28 For a laboratory test and radiology pool for services 29 authorized by a federally qualified health center designated 30 by the department as part of the IowaCare regional provider 31 network that does not have the capability to provide these 32 services on site: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 34 Notwithstanding sections 249J.6 and 249J.7, the amount 35 -71- SF 542 (3) 84 pf/jp 71/ 209
S.F. 542 appropriated in this subsection is intended to provide 1 reimbursement for services provided to expansion population 2 members that have previously been paid for through expenditure 3 by designated regional provider network providers of their 4 own funds, not to expand coverage under the IowaCare program 5 or to expand the expansion population provider network. The 6 department shall designate the laboratory and radiology 7 provider associated with each designated regional provider 8 network provider that may receive reimbursement. The 9 department shall adopt administrative rules pursuant to chapter 10 17A to establish a prior authorization process and to identify 11 covered services for reimbursement under this subsection. 12 All other medical assistance program payment policies and 13 rules for laboratory and radiology services shall apply to 14 services provided under this subsection. If the entire amount 15 appropriated under this subsection is expended, laboratory 16 tests and radiology services ordered by a designated regional 17 provider network provider shall be the financial responsibility 18 of the regional provider network provider. 19 Sec. 37. APPROPRIATIONS FROM NONPARTICIPATING 20 PROVIDER REIMBURSEMENT FUND —— DEPARTMENT OF HUMAN 21 SERVICES. Notwithstanding any provision to the contrary, and 22 subject to the availability of funds, there is appropriated 23 from the nonparticipating provider reimbursement fund created 24 in section 249J.24A to the department of human services for the 25 fiscal year beginning July 1, 2011, and ending June 30, 2012, 26 the following amount or so much thereof as is necessary for the 27 purposes designated: 28 To reimburse nonparticipating providers in accordance with 29 section 249J.24A: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 31 Sec. 38. APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE 32 TRANSFORMATION —— DEPARTMENT OF HUMAN SERVICES. 33 Notwithstanding any provision to the contrary, there is 34 appropriated from the account for health care transformation 35 -72- SF 542 (3) 84 pf/jp 72/ 209
S.F. 542 created in section 249J.23 to the department of human services 1 for the fiscal year beginning July 1, 2011, and ending June 2 30, 2012, the following amounts, or so much thereof as is 3 necessary, to be used for the purposes designated: 4 1. For the provision of an IowaCare nurse helpline for the 5 expansion population as provided in section 249J.6: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 7 2. For other health promotion partnership activities 8 pursuant to section 249J.14: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 600,000 10 3. For the costs related to audits, performance 11 evaluations, and studies required pursuant to chapter 249J: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 13 4. For administrative costs associated with chapter 249J: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,132,412 15 5. For planning and development, in cooperation with the 16 department of public health, of a phased-in program to provide 17 a dental home for children in accordance with section 249J.14: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 19 6. For continuation of the establishment of the tuition 20 assistance for individuals serving individuals with 21 disabilities pilot program, as enacted in 2008 Iowa Acts, 22 chapter 1187, section 130: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,000 24 7. For medical contracts: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 26 8. For payment to the publicly owned acute care teaching 27 hospital located in a county with a population of over 350,000 28 that is a participating provider pursuant to chapter 249J: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 290,000 30 Disbursements under this subsection shall be made monthly. 31 The hospital shall submit a report following the close of the 32 fiscal year regarding use of the funds appropriated in this 33 subsection to the persons specified in this Act to receive 34 reports. 35 -73- SF 542 (3) 84 pf/jp 73/ 209
S.F. 542 9. For transfer to the department of public health to be 1 used for the costs of medical home system advisory council 2 established pursuant to section 135.159, including for the 3 incorporation of the work and duties of the prevention and 4 chronic care management advisory council pursuant to section 5 135.161, as amended by this Act: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 233,357 7 Notwithstanding section 8.39, subsection 1, without the 8 prior written consent and approval of the governor and the 9 director of the department of management, the director of human 10 services may transfer funds among the appropriations made in 11 this section as necessary to carry out the purposes of the 12 account for health care transformation. The department shall 13 report any transfers made pursuant to this section to the 14 legislative services agency. 15 Sec. 39. MEDICAID FRAUD ACCOUNT —— DEPARTMENT OF 16 INSPECTIONS AND APPEALS. There is appropriated from the 17 Medicaid fraud account created in section 249A.7 to the 18 department of inspections and appeals for the fiscal year 19 beginning July 1, 2011, and ending June 30, 2012, the following 20 amount, or so much thereof as is necessary, to be used for the 21 purposes designated: 22 For the inspection and certification of assisted living 23 programs and adult day care services, including program 24 administration and costs associated with implementation: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,339,527 26 Sec. 40. MEDICAID FRAUD ACCOUNT —— DEPARTMENT OF HUMAN 27 SERVICES. There is appropriated from the Medicaid fraud 28 account created in section 249A.7 to the department of human 29 services for the fiscal year beginning July 1, 2011, and ending 30 June 30, 2012, the following amount, or so much thereof as is 31 necessary, to be used for the purposes designated: 32 To supplement the appropriation made in this Act from the 33 general fund of the state to the department of human services 34 for medical assistance: 35 -74- SF 542 (3) 84 pf/jp 74/ 209
S.F. 542 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 1 Sec. 41. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 2 SERVICES. Notwithstanding any provision to the contrary and 3 subject to the availability of funds, there is appropriated 4 from the quality assurance trust fund created in section 5 249L.4 to the department of human services for the fiscal year 6 beginning July 1, 2011, and ending June 30, 2012, the following 7 amounts, or so much thereof as is necessary for the purposes 8 designated: 9 To supplement the appropriation made in this Act from the 10 general fund of the state to the department of human services 11 for medical assistance: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,000,000 13 Sec. 42. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 14 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 15 the contrary and subject to the availability of funds, there is 16 appropriated from the hospital health care access trust fund 17 created in section 249M.4 to the department of human services 18 for the fiscal year beginning July 1, 2011, and ending June 19 30, 2012, the following amounts, or so much thereof as is 20 necessary, for the purposes designated: 21 1. To supplement the appropriation made in this Act from the 22 general fund of the state to the department of human services 23 for medical assistance: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,223,800 25 2. For deposit in the nonparticipating provider 26 reimbursement fund created in section 249J.24A to be used for 27 the purposes of the fund: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 776,200 29 Sec. 43. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 30 FOR FY 2011-2012. Notwithstanding section 8.33, if moneys 31 appropriated for purposes of the medical assistance program 32 for the fiscal year beginning July 1, 2011, and ending June 33 30, 2012, from the general fund of the state, the Medicaid 34 fraud account, the quality assurance trust fund, and the 35 -75- SF 542 (3) 84 pf/jp 75/ 209
S.F. 542 hospital health care access trust fund, are in excess of actual 1 expenditures for the medical assistance program and remain 2 unencumbered or unobligated at the close of the fiscal year, 3 the excess moneys shall not revert but shall remain available 4 for expenditure for the purposes of the medical assistance 5 program until the close of the succeeding fiscal year. 6 DIVISION VI 7 MH/MR/DD SERVICES ALLOWED GROWTH FUNDING FOR FISCAL YEAR 8 2011-2012 9 Sec. 44. MENTAL HEALTH, MENTAL RETARDATION, AND 10 DEVELOPMENTAL DISABILITIES SERVICES PROPERTY TAX 11 RELIEF. Notwithstanding the standing appropriation in section 12 426B.1, subsection 2, for the fiscal year beginning July 1, 13 2011, and ending June 30, 2012, the amount appropriated from 14 the general fund of the state pursuant to that provision shall 15 not exceed the following amount: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 81,199,911 17 Sec. 45. 2010 Iowa Acts, chapter 1193, section 1, is amended 18 to read as follows: 19 SECTION 1. ADULT MH/MR/DD SERVICES ALLOWED GROWTH FUNDING 20 —— FY 2011-2012. 21 1. Notwithstanding section 331.439, subsection 3 , the 22 allowed growth factor adjustment for county mental health, 23 mental retardation, and developmental disabilities service 24 expenditures for the fiscal year beginning July 1, 2011, shall 25 be established by statute which shall be enacted within thirty 26 calendar days of the convening of the Eighty-fourth General 27 Assembly, 2011 Session, on January 10, 2011. The governor 28 shall submit to the general assembly a recommendation for such 29 allowed growth factor adjustment and the amounts of related 30 appropriations to the general assembly on or before January 11, 31 2011. 32 2. The appropriation and allocations made in this section 33 fulfill the requirements of the governor and general assembly 34 under subsection 1. 35 -76- SF 542 (3) 84 pf/jp 76/ 209
S.F. 542 3. 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 distribution to counties of the county mental health, 6 mental retardation, and developmental disabilities allowed 7 growth factor adjustment for fiscal year 2011-2012 as provided 8 in this section in lieu of the allowed growth factor provisions 9 of section 331.438, subsection 2, and section 331.439, 10 subsection 3, and chapter 426B: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 48,697,893 12 Sec. 46. 2010 Iowa Acts, chapter 1193, section 1, as 13 amended by this division of this Act, is amended by adding the 14 following new subsections: 15 NEW SUBSECTION . 4. Of the amount appropriated in this 16 section, $12,000,000 shall be distributed as provided in this 17 subsection. 18 a. To be eligible to receive a distribution under this 19 subsection, a county must meet the following requirements: 20 (1) The county is levying for the maximum amount allowed 21 for the county’s mental health, mental retardation, and 22 developmental disabilities services fund under section 331.424A 23 for taxes due and payable in the fiscal year beginning July 1, 24 2011, or the county is levying for at least 90 percent of the 25 maximum amount allowed for the county’s services fund and that 26 levy rate is more than $2 per $1,000 of the assessed value of 27 all taxable property in the county. 28 (2) In the fiscal year beginning July 1, 2009, the 29 county’s mental health, mental retardation, and developmental 30 disabilities services fund ending balance under generally 31 accepted accounting principles was equal to or less than 15 32 percent of the county’s actual gross expenditures for that 33 fiscal year. 34 b. The amount of a county’s distribution from the allocation 35 -77- SF 542 (3) 84 pf/jp 77/ 209
S.F. 542 made in this subsection shall be determined based upon the 1 county’s proportion of the general population of the counties 2 eligible to receive a distribution under this subsection. The 3 latest certified federal census issued by the United States 4 bureau of the census shall be applied in determining population 5 for the purposes of this paragraph. 6 c. The distributions made pursuant to this subsection 7 are subject to the distribution provisions and withholding 8 requirements established in this section for the county mental 9 health, mental retardation, and developmental disabilities 10 allowed growth factor adjustment for the fiscal year beginning 11 July 1, 2011. 12 NEW SUBSECTION . 5. The following amount of the funding 13 appropriated in this section is the allowed growth factor 14 adjustment for fiscal year 2011-2012, and shall be credited to 15 the allowed growth funding pool created in the property tax 16 relief fund and for distribution in accordance with section 17 426B.5, subsection 1: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,697,893 19 For the distribution made for the fiscal year beginning 20 July 1, 2011, a county that is levying at least 92 percent of 21 the maximum amount allowed for the county’s mental health, 22 mental retardation, and developmental disabilities services 23 fund under section 331.424A for the fiscal year and that had a 24 negative services fund balance for the fiscal year beginning 25 July 1, 2009, after disregarding the temporary funding increase 26 provided to counties for the fiscal year beginning July 1, 27 2009, through the federal American Recovery and Reinvestment 28 Act of 2009, Pub. L. No. 111-5, shall be deemed to have met 29 the allocation eligibility requirement under section 426B.5, 30 subsection 1, paragraph “d”, subparagraph (1), subparagraph 31 division (a). 32 NEW SUBSECTION . 6. The following formula amounts shall be 33 utilized only to calculate preliminary distribution amounts for 34 the allowed growth factor adjustment for fiscal year 2011-2012 35 -78- SF 542 (3) 84 pf/jp 78/ 209
S.F. 542 under this section by applying the indicated formula provisions 1 to the formula amounts and producing a preliminary distribution 2 total for each county: 3 a. For calculation of a distribution amount for eligible 4 counties from the allowed growth funding pool created in the 5 property tax relief fund in accordance with the requirements 6 in section 426B.5, subsection 1, and including the allocation 7 eligibility provision authorized in subsection 5 of this 8 section: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 49,773,346 10 b. For calculation of a distribution amount for counties 11 from the mental health and developmental disabilities (MH/DD) 12 community services fund in accordance with the formula provided 13 in the appropriation made for the MH/DD community services fund 14 for the fiscal year beginning July 1, 2011: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,187,556 16 NEW SUBSECTION . 7. a. After applying the applicable 17 statutory distribution formulas to the amounts indicated in 18 subsection 6 for purposes of producing preliminary distribution 19 totals, the department of human services shall apply a 20 withholding factor to adjust an eligible individual county’s 21 preliminary distribution total. In order to be eligible for 22 a distribution under this section, a county must be levying 23 90 percent or more of the maximum amount allowed for the 24 county’s mental health, mental retardation, and developmental 25 disabilities services fund under section 331.424A for taxes due 26 and payable in the fiscal year for which the distribution is 27 payable. 28 b. An ending balance percentage for each county shall 29 be determined by expressing the county’s ending balance on a 30 modified accrual basis under generally accepted accounting 31 principles for the fiscal year beginning July 1, 2009, in the 32 county’s mental health, mental retardation, and developmental 33 disabilities services fund created under section 331.424A, as a 34 percentage of the county’s gross expenditures from that fund 35 -79- SF 542 (3) 84 pf/jp 79/ 209
S.F. 542 for that fiscal year. If a county borrowed moneys for purposes 1 of providing services from the county’s services fund on or 2 before July 1, 2009, and the county’s services fund ending 3 balance for that fiscal year includes the loan proceeds or an 4 amount designated in the county budget to service the loan for 5 the borrowed moneys, those amounts shall not be considered 6 to be part of the county’s ending balance for purposes of 7 calculating an ending balance percentage under this subsection. 8 c. For purposes of calculating withholding factors and 9 for ending balance amounts used for other purposes under law, 10 the county ending balances shall be adjusted, using forms 11 developed for this purpose by the county finance committee, 12 to disregard the temporary funding increase provided to the 13 counties for the fiscal year through the federal American 14 Recovery and Reinvestment Act of 2009, Pub. L. No. 111-5. In 15 addition, a county may adjust the ending balance amount by 16 rebating to the department all or a portion of the allowed 17 growth and MH/DD services fund moneys the county received for 18 the fiscal year beginning July 1, 2010, in accordance with 19 2009 Iowa Acts, chapter 179, section 1, as amended by 2009 20 Iowa Acts, chapter 1192, sections 47 and 48, or from any other 21 services fund moneys available to the county. The rebate must 22 be remitted to the department on or before June 1, 2011, in 23 order to be counted. However, if this division of this Act 24 is enacted after June 1, 2011, the rebate must be remitted no 25 later than 10 calendar days after the date of the governor’s 26 approval of this Act. The amount rebated by a county shall be 27 subtracted dollar-for-dollar from the county’s ending balance 28 amount for the fiscal year beginning July 1, 2009, for purposes 29 of calculating the withholding factor and for other ending 30 balance purposes for the fiscal year beginning July 1, 2011. 31 The rebates received by the department shall be credited to the 32 property tax relief fund and distributed as additional funding 33 for the fiscal year beginning July 1, 2011, in accordance with 34 the formula provisions in this section. 35 -80- SF 542 (3) 84 pf/jp 80/ 209
S.F. 542 d. The withholding factor for a county shall be the 1 following applicable percent: 2 (1) For an ending balance percentage of less than 5 3 percent, a withholding factor of 0 percent. In addition, 4 a county that is subject to this lettered paragraph shall 5 receive an inflation adjustment equal to 3 percent of the gross 6 expenditures reported for the county’s services fund for the 7 fiscal year. 8 (2) For an ending balance percentage of 5 percent or more 9 but less than 10 percent, a withholding factor of 0 percent. 10 In addition, a county that is subject to this lettered 11 paragraph shall receive an inflation adjustment equal to 2 12 percent of the gross expenditures reported for the county’s 13 services fund for the fiscal year. 14 (3) For an ending balance percentage of 10 percent or more 15 but less than 25 percent, a withholding factor of 25 percent. 16 However, for counties with an ending balance percentage of 10 17 percent or more but less than 15 percent, the amount withheld 18 shall be limited to the amount by which the county’s ending 19 balance was in excess of the ending balance percentage of 10 20 percent. 21 (4) For an ending balance percentage of 25 percent or more, 22 a withholding percentage of 100 percent. 23 NEW SUBSECTION . 8. The total withholding amounts applied 24 pursuant to subsection 7 shall be equal to a withholding target 25 amount of $13,075,453. If the department of human services 26 determines that the amount appropriated is insufficient or 27 the amount to be withheld in accordance with subsection 7 is 28 not equal to the target withholding amount, the department 29 shall adjust the withholding factors listed in subsection 7 as 30 necessary to achieve the target withholding amount. However, 31 in making such adjustments to the withholding factors, the 32 department shall strive to minimize changes to the withholding 33 factors for those ending balance percentage ranges that are 34 lower than others and shall only adjust the zero withholding 35 -81- SF 542 (3) 84 pf/jp 81/ 209
S.F. 542 factor or the inflation adjustment percentages specified in 1 subsection 7, paragraph “d”, when the amount appropriated is 2 insufficient. 3 Sec. 47. 2010 Iowa Acts, chapter 1193, section 99, is 4 amended to read as follows: 5 SEC. 99. MH/MR/DD SERVICES FUND TRANSFER. Notwithstanding 6 section 331.424A, subsection 5 , and section 331.432, subsection 7 3 , for the fiscal year beginning July 1, 2010, and ending June 8 30, 2011, a county may transfer moneys from other funds of the 9 county to the county’s mental health, mental retardation, and 10 developmental disabilities services fund created in section 11 331.424A . A county transferring moneys from other funds of the 12 county to the county’s services fund pursuant to this section 13 shall submit a report detailing the transfers made and funds 14 affected. The county shall submit the report along with the 15 county expenditure and information report submitted by December 16 1, 2010 2011 , in accordance with section 331.439 . 17 Sec. 48. EFFECTIVE UPON ENACTMENT AND RETROACTIVE 18 APPLICABILITY. The section of this division of this Act 19 amending 2010 Iowa Acts, chapter 1193, section 99, being deemed 20 of immediate importance, takes effect upon enactment and is 21 retroactively applicable to December 1, 2010. 22 DIVISION VII 23 PRIOR APPROPRIATIONS AND RELATED CHANGES 24 COMMUNITY HOUSING AND SERVICES REVOLVING LOAN PROGRAM 25 Sec. 49. NEW SECTION . 16.185 Community housing and services 26 for persons with disabilities revolving loan program fund. 27 1. A community housing and services for persons with 28 disabilities revolving loan program fund is created within the 29 authority to further the availability of affordable housing and 30 supportive services for Medicaid waiver-eligible individuals 31 with behaviors that provide significant barriers to accessing 32 traditional rental and supportive services opportunities. The 33 moneys in the fund are annually appropriated to the authority 34 to be used for the development and operation of a revolving 35 -82- SF 542 (3) 84 pf/jp 82/ 209
S.F. 542 loan program to provide financing to construct affordable 1 permanent supportive housing or develop infrastructure in 2 which to provide supportive services, including through new 3 construction, acquisition and rehabilitation of existing 4 housing or infrastructure, or conversion or adaptive reuse. 5 2. Moneys transferred by the authority for deposit in the 6 community housing and services for persons with disabilities 7 revolving loan program fund, moneys appropriated to the 8 community housing and services for persons with disabilities 9 revolving loan program, and any other moneys available to and 10 obtained or accepted by the authority for placement in the 11 fund shall be credited to the fund. Additionally, payment of 12 interest, recaptures of awards, and other repayments to the 13 community housing and services for persons with disabilities 14 revolving loan program fund shall be credited to the fund. 15 Notwithstanding section 12C.7, subsection 2, interest or 16 earnings on moneys in the fund shall be credited to the fund. 17 Notwithstanding section 8.33, moneys credited to the fund from 18 any other fund that remain unencumbered or unobligated at the 19 close of the fiscal year shall not revert to the other fund. 20 3. a. The authority shall annually allocate moneys 21 available in the fund for the development of permanent 22 supportive housing for Medicaid waiver-eligible individuals. 23 The authority shall develop a joint application process for the 24 allocation of United States housing and urban development HOME 25 investment partnerships program funding and the funds available 26 under this section. Moneys allocated to such projects may be 27 in the form of loans, forgivable loans, or a combination of 28 loans and forgivable loans. 29 b. The authority shall annually allocate moneys available 30 in the fund for the development of infrastructure in which 31 to provide supportive services for Medicaid waiver-eligible 32 individuals who meet the psychiatric medical institution for 33 children level of care. Moneys allocated to such projects may 34 be in the form of loans, forgivable loans, or a combination of 35 -83- SF 542 (3) 84 pf/jp 83/ 209
S.F. 542 loans and forgivable loans. 1 4. a. A project shall demonstrate written approval of the 2 project by the department of human services to the authority 3 prior to application for funding under this section. 4 b. In order to be approved by the department of human 5 services for application for funding for development of 6 permanent supportive housing under this section, a project 7 shall include all of the following components: 8 (1) Provision of services to any of the following Medicaid 9 waiver-eligible individuals: 10 (a) Individuals who are currently underserved in community 11 placements, including individuals who are physically aggressive 12 or have behaviors that are difficult to manage or individuals 13 who meet the psychiatric medical institution for children level 14 of care. 15 (b) Individuals who are currently residing in out-of-state 16 facilities. 17 (c) Individuals who are currently receiving care in a 18 licensed health care facility. 19 (2) A plan to provide each individual with crisis 20 stabilization services to ensure that the individual’s 21 behavioral issues are appropriately addressed by the provider. 22 (3) Policies and procedures that prohibit discharge of the 23 individual from the waiver services provided by the project 24 provider unless an alternative placement that is acceptable to 25 the client or the client’s guardian is identified. 26 c. In order to be approved by the department of human 27 services for application for funding for development of 28 infrastructure in which to provide supportive services under 29 this section, a project shall include all of the following 30 components: 31 (1) Provision of services to Medicaid waiver-eligible 32 individuals who meet the psychiatric medical institution for 33 children level of care. 34 (2) Policies and procedures that prohibit discharge of the 35 -84- SF 542 (3) 84 pf/jp 84/ 209
S.F. 542 individual from the waiver services provided by the project 1 provider unless an alternative placement that is acceptable to 2 the client or the client’s guardian is identified. 3 d. Housing provided through a project under this section is 4 exempt from the requirements of chapter 135O. 5 5. The authority, in collaboration with the department of 6 human services, shall adopt rules pursuant to chapter 17A to 7 administer this section. 8 VIETNAM CONFLICT VETERANS BONUS 9 Sec. 50. Section 35A.8A, subsection 2, paragraph d, Code 10 2011, is amended to read as follows: 11 d. The person files an application for compensation under 12 this section , in a manner determined by the department of 13 veterans affairs , by July 1, 2010 May 1, 2011 . 14 VIETNAM CONFLICT VETERANS 15 BONUS FUND 16 Sec. 51. 2008 Iowa Acts, chapter 1187, section 68, as 17 amended by 2009 Iowa Acts, chapter 182, section 82, and 2010 18 Iowa Acts, chapter 1192, section 55, is amended to read as 19 follows: 20 Notwithstanding section 8.33 , moneys appropriated in this 21 section that remain unencumbered or unobligated at the close of 22 the fiscal year shall not revert but shall remain available for 23 expenditure for the purposes designated until the close of the 24 fiscal year beginning July 1, 2010 repeal of section 35A.8A . 25 Upon such repeal, the remaining moneys shall be transferred to 26 the veterans trust fund and, notwithstanding section 35A.13, 27 subsection 3, shall only be expended in accordance with an 28 appropriation for purposes of a bonus enacted for veterans of 29 the conflicts in Panama, Grenada, Lebanon, or the Persian Gulf. 30 INJURED VETERANS GRANT PROGRAM 31 Sec. 52. 2008 Iowa Acts, chapter 1187, section 69, 32 unnumbered paragraph 1, as amended by 2009 Iowa Acts, chapter 33 182, section 83, and 2010 Iowa Acts, chapter 1192, section 56, 34 is amended to read as follows: 35 -85- SF 542 (3) 84 pf/jp 85/ 209
S.F. 542 Notwithstanding section 8.33 , moneys appropriated in this 1 subsection that remain unencumbered or unobligated at the close 2 of the fiscal year shall not revert but shall remain available 3 for expenditure for the purposes designated until the close of 4 the fiscal year beginning July 1, 2010 2011 . 5 BEHAVIORAL HEALTH SERVICES 6 ACCOUNT —— MEDICAL ASSISTANCE 7 Sec. 53. 2009 Iowa Acts, chapter 182, section 9, subsection 8 16, paragraph b, as amended by 2010 Iowa Acts, chapter 1192, 9 section 63, is amended to read as follows: 10 b. The department shall continue to maintain a separate 11 account within the medical assistance budget for the deposit 12 of all funds remitted pursuant to a contract with a third 13 party to administer behavioral health services under the 14 medical assistance program established pursuant to 2008 Iowa 15 Acts, chapter 1187, section 9, subsection 20. Notwithstanding 16 section 8.33 , other than funds remaining from the appropriation 17 allocations made for implementation of the emergency mental 18 health crisis services and system, for implementation of the 19 mental health services system for children and youth, and 20 for training of child welfare services providers in 2008 21 Iowa Acts, chapter 1187, section 9, subsection 20, paragraph 22 “c”, subparagraphs (1), (2), and (6), as authorized in 2009 23 Iowa Acts, chapter 182, section 72, shall not revert but 24 shall remain available in succeeding fiscal years to be used 25 for the purposes designated until expended and any other 26 funds remaining in the account that remain unencumbered or 27 unobligated at the end of the fiscal year shall not revert 28 but shall remain available in succeeding fiscal years 29 and are appropriated to the department to be used for the 30 medical assistance program to be used for purposes of crisis 31 stabilization and other mental and behavioral health service 32 improvements . 33 CHILD WELFARE DECATEGORIZATION 34 FY 2009-2010 NONREVERSION 35 -86- SF 542 (3) 84 pf/jp 86/ 209
S.F. 542 Sec. 54. 2009 Iowa Acts, chapter 182, section 14, subsection 1 5, is amended by adding the following new unnumbered paragraph: 2 NEW UNNUMBERED PARAGRAPH . Notwithstanding section 3 232.188, subsection 5, moneys from the allocations made 4 in this subsection or made from any other source for the 5 decategorization of child welfare and juvenile justice funding 6 initiative under section 232.188 for the fiscal year beginning 7 July 1, 2009, that are designated as carryover funding that 8 remain unencumbered or unobligated at the close of the fiscal 9 year beginning July 1, 2010, shall not revert but shall be 10 transferred to the community housing and services for persons 11 with disabilities revolving loan program fund created in 12 section 16.185, as enacted by this division of this Act. 13 AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 —— ALLOCATION 14 FOR INFANT AND TODDLER CARE QUALITY 15 Sec. 55. 2009 Iowa Acts, chapter 183, section 62, subsection 16 3, is amended to read as follows: 17 3. For the purposes of this subsection, “federal poverty 18 level” means the poverty level defined by the most recently 19 revised poverty income guidelines published by the United 20 States department of health and human services. The program 21 shall provide financial assistance to families with infants 22 and toddlers less than thirty-six months of age two that have 23 a family income of more than 145 percent but not more than 185 24 percent of the federal poverty level. However, the department 25 may adjust the qualifying criteria or the financial assistance 26 purpose provisions specified in this subsection or make other 27 changes as necessary for implementation to conform with federal 28 requirements for the funding. Outcome reporting and other 29 grant requirements shall be developed by the department in 30 cooperation with the Iowa empowerment board. 31 Sec. 56. 2009 Iowa Acts, chapter 183, section 62, subsection 32 4, is amended to read as follows: 33 4. The financial assistance shall be for any of the 34 following purposes: 35 -87- SF 542 (3) 84 pf/jp 87/ 209
S.F. 542 a. For making temporary payments to qualifying families 1 whose members are recently unemployed and seeking work to use 2 in meeting immediate family needs. 3 b. For providing sliding scale subsidies for qualifying 4 families for child care provided to the families’ infants 5 and toddlers by providers who are accredited by the national 6 association for the education of young children or the national 7 association for family child care, or who have a rating at 8 level 3 2 or higher under the child care quality rating system 9 implemented pursuant to section 237A.30. 10 c. For expanding training and other support for infant care 11 providers in the community and this state. 12 d. For ensuring child care environments are healthy and 13 safe. 14 e. For promoting positive relationships between parents 15 and providers in their mutual efforts to care for very young 16 children. 17 f. For ensuring that parents have the information and 18 resources needed to choose quality child care. 19 IOWA DEPARTMENT ON AGING CASE MANAGEMENT REVIEW 20 Sec. 57. 2010 Iowa Acts, chapter 1192, section 1, subsection 21 2, is amended to read as follows: 22 2. a. Of the funds appropriated in this section, $1,246,514 23 shall be transferred to the department of human services in 24 equal amounts on a quarterly basis for reimbursement of case 25 management services provided under the medical assistance 26 elderly waiver. The department of human services shall adopt 27 rules for case management services provided under the medical 28 assistance elderly waiver in consultation with the department 29 on aging. 30 b. The department of human services shall review 31 projections for state funding expenditures for reimbursement 32 of case management services under the medical assistance 33 elderly waiver on a quarterly basis and shall determine if an 34 adjustment to the medical assistance reimbursement rates are 35 -88- SF 542 (3) 84 pf/jp 88/ 209
S.F. 542 necessary to provide reimbursement within the state funding 1 amounts budgeted under the appropriations made for the fiscal 2 year for the medical assistance program. Any temporary 3 enhanced federal financial participation that may become 4 available for the medical assistance program during the fiscal 5 year shall not be used in projecting the medical assistance 6 elderly waiver case management budget. The department of human 7 services shall revise such reimbursement rates as necessary to 8 maintain expenditures for medical assistance elderly waiver 9 case management services within the state funding amounts 10 budgeted under the appropriations made for the fiscal year for 11 the medical assistance program. 12 IOWA VETERANS HOME 13 Sec. 58. 2010 Iowa Acts, chapter 1192, section 3, subsection 14 2, is amended by adding the following new paragraph: 15 NEW PARAGRAPH . d. The funds appropriated in this subsection 16 to the Iowa veterans home that remain available for expenditure 17 for the succeeding fiscal year pursuant to section 35D.18, 18 subsection 5, shall be distributed to be used in the succeeding 19 fiscal year in accordance with this lettered paragraph. The 20 first $500,000 shall remain available to be used for the 21 purposes of the Iowa veterans home. On or before October 15, 22 2011, the department of management shall transfer the remaining 23 balance to the appropriation to the department of human 24 services for medical assistance. 25 MEDICAL ASSISTANCE PROGRAM 26 Sec. 59. 2010 Iowa Acts, chapter 1192, section 11, is 27 amended by adding the following new subsection: 28 NEW SUBSECTION . 25. The department may increase the amounts 29 allocated for salaries, support, maintenance, and miscellaneous 30 purposes associated with the medical assistance program as 31 necessary to implement cost containment efforts in order to 32 accomplish medical assistance program savings. These amounts 33 may be transferred to the appropriation made in this division 34 of this Act for the health insurance premium payment program. 35 -89- SF 542 (3) 84 pf/jp 89/ 209
S.F. 542 STATE SUPPLEMENTARY ASSISTANCE PROGRAM 1 Sec. 60. 2010 Iowa Acts, chapter 1192, section 14, is 2 amended by adding the following new subsection: 3 NEW SUBSECTION . 4. Notwithstanding section 8.33, moneys 4 appropriated in this section that remain unencumbered or 5 unobligated at the close of the fiscal year shall remain 6 available for expenditure for the purposes designated until the 7 close of the succeeding fiscal year. 8 CHILD WELFARE TRAINING ACADEMY 9 Sec. 61. 2010 Iowa Acts, chapter 1192, section 19, 10 subsection 22, is amended to read as follows: 11 22. Of the funds appropriated in this section, at least 12 $47,158 shall be used for the child welfare training academy. 13 Notwithstanding section 8.33, moneys allocated in this 14 subsection that remain unencumbered or unobligated at the close 15 of the fiscal year shall not revert but shall remain available 16 for expenditure for the purposes designated until the close of 17 the succeeding fiscal year. 18 ADOPTION SUBSIDY TRANSFER AND NONREVERSION 19 Sec. 62. 2010 Iowa Acts, chapter 1192, section 20, is 20 amended by adding the following new subsections: 21 NEW SUBSECTION . 4. Of the funds appropriated in this 22 section, $60,000 shall be transferred to the appropriation 23 made in this division of this Act for the state mental health 24 institute at Cherokee to be used for childrens’ beds at the 25 institute. 26 NEW SUBSECTION . 5. Notwithstanding section 8.33, moneys 27 appropriated in this section that remain unencumbered or 28 unobligated at the close of the fiscal year shall not revert 29 but shall remain available for expenditure for the purposes 30 designated until the close of the succeeding fiscal year. 31 DEPARTMENT OF HUMAN SERVICES —— FIELD OPERATIONS 32 Sec. 63. 2010 Iowa Acts, chapter 1192, section 29, is 33 amended by adding the following new unnumbered paragraph: 34 NEW UNNUMBERED PARAGRAPH . Notwithstanding section 8.33, 35 -90- SF 542 (3) 84 pf/jp 90/ 209
S.F. 542 moneys appropriated in this section that remain unencumbered or 1 unobligated at the close of the fiscal year shall not revert 2 but shall remain available for expenditure for the purposes 3 designated until the close of the succeeding fiscal year. 4 DEPARTMENT OF HUMAN SERVICES —— GENERAL ADMINISTRATION 5 Sec. 64. 2010 Iowa Acts, chapter 1192, section 30, is 6 amended by adding the following new subsection: 7 NEW SUBSECTION . 5. Notwithstanding section 8.33, moneys 8 appropriated in this section and the designated allocations 9 that remain unencumbered or unobligated at the close of the 10 fiscal year shall not revert but shall remain available for 11 expenditure for the purposes designated until the close of the 12 succeeding fiscal year. 13 IOWA DEPARTMENT ON AGING CASE MANAGEMENT REVIEW 14 Sec. 65. 2010 Iowa Acts, chapter 1192, section 37, 15 subsection 1, is amended to read as follows: 16 1. a. Of the funds appropriated in this section, $1,010,000 17 shall be transferred to the department of human services in 18 equal amounts on a quarterly basis for reimbursement of case 19 management services provided under the medical assistance 20 elderly waiver. 21 b. The department of human services shall review 22 projections for state funding expenditures for reimbursement 23 of case management services under the medical assistance 24 elderly waiver on a quarterly basis and shall determine if an 25 adjustment to the medical assistance reimbursement rates are 26 necessary to provide reimbursement within the state funding 27 amounts budgeted under the appropriations made for the fiscal 28 year for the medical assistance program. Any temporary 29 enhanced federal financial participation that may become 30 available for the medical assistance program during the fiscal 31 year shall not be used in projecting the medical assistance 32 elderly waiver case management budget. The department of human 33 services shall revise such reimbursement rates as necessary to 34 maintain expenditures for medical assistance elderly waiver 35 -91- SF 542 (3) 84 pf/jp 91/ 209
S.F. 542 case management services within the state funding amounts 1 budgeted under the appropriations made for the fiscal year for 2 the medical assistance program. 3 QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN SERVICES 4 Sec. 66. 2010 Iowa Acts, chapter 1192, section 44, is 5 amended to read as follows: 6 SEC. 44. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 7 SERVICES. Notwithstanding any provision to the contrary and 8 subject to the availability of funds, there is appropriated 9 from the quality assurance trust fund created in section 10 249L.4 to the department of human services for the fiscal year 11 beginning July 1, 2010, and ending June 30, 2011, the following 12 amounts, or so much thereof as is necessary for the purposes 13 designated: 14 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,900,000 18 33,708,458 19 1. Of the funds appropriated in this section, $7,500,000 20 shall be used for nursing facility reimbursement under the 21 medical assistance program in accordance with the nursing 22 facility reimbursement provisions of division IV of this 23 Act, to continue application of the administrative rules 24 changes relating to nursing facility reimbursement and payment 25 procedures made pursuant to 2010 Iowa Acts, Senate File 2366, 26 if enacted, for the fiscal year beginning July 1, 2010, and 27 ending June 30, 2011, and to restore the 5 percent reduction 28 made in nursing facility reimbursement in accordance with 29 executive order number 19 issued October 8, 2009. 30 2. The costs associated with the implementation of this 31 section shall be funded exclusively through moneys appropriated 32 from the quality assurance trust fund, and shall result in 33 budget neutrality to the general fund of the state for the 34 fiscal year beginning July 1, 2010, and ending June 30, 2011. 35 -92- SF 542 (3) 84 pf/jp 92/ 209
S.F. 542 INJURED VETERANS TRUST FUND 1 Sec. 67. INJURED VETERANS TRUST FUND. There is appropriated 2 from the general fund of the state to the department of 3 veterans affairs for the fiscal year beginning July 1, 4 2010, and ending June 30, 2011, the following amount, or so 5 much thereof as is necessary, to be used for the purposes 6 designated: 7 To be credited to the injured veterans trust fund created 8 pursuant to section 35A.14 to be used for the injured veterans 9 grant program: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 11 The department shall review the rules and statutory 12 provisions pertaining to the injured veterans grant program and 13 propose amendments to improve the program. Notwithstanding 14 section 8.33, moneys appropriated in this section that remain 15 unencumbered or unobligated at the close of the fiscal year 16 shall not revert but shall remain available for expenditure for 17 the purposes designated until expended. 18 MERCHANT MARINE BONUS FUND TRANSFER 19 Sec. 68. DEPARTMENT OF CULTURAL AFFAIRS —— MERCHANT MARINE 20 BONUS FUND. 21 1. The appropriation made from the merchant marine bonus 22 fund to the department of cultural affairs for the fiscal year 23 beginning July 1, 2010, and ending June 30, 2011, in 2010 Iowa 24 Acts, chapter 1193, section 82, shall be transferred on the 25 effective date of this section to the department of veterans 26 affairs to be used for departmental costs. 27 2. Moneys transferred pursuant to this section that remain 28 unencumbered or unobligated at the close of the fiscal year 29 shall be credited to the veterans trust fund created in section 30 35A.13. 31 Sec. 69. DECATEGORIZATION PROJECT FUNDING. For the 32 period beginning June 1, 2010, and ending June 30, 2012, a 33 child welfare and juvenile justice funding decategorization 34 initiative project that is incorporated and owns real property 35 -93- SF 542 (3) 84 pf/jp 93/ 209
S.F. 542 may utilize project funding to purchase liability insurance. 1 STATE INSTITUTION —— APPROPRIATION TRANSFERS 2 Sec. 70. DEPARTMENT OF HUMAN SERVICES. There is transferred 3 between the following designated appropriations made to the 4 department of human services for the fiscal year beginning July 5 1, 2010, and ending June 30, 2011, not more than the following 6 amounts: 7 1. From the appropriation made for purposes of the state 8 resource center at Glenwood in 2010 Iowa Acts, chapter 1192, 9 section 25, subsection 1, paragraph “a”, to the appropriation 10 made for purposes of the Iowa juvenile home at Toledo in 2010 11 Iowa Acts, chapter 1192, section 17, subsection 1: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 13 2. From the appropriation made for purposes of the state 14 resource center at Woodward in 2010 Iowa Acts, chapter 1192, 15 section 25, subsection 1, paragraph “b”, to the appropriation 16 made for purposes of the state mental health institute at 17 Independence in 2010 Iowa Acts, chapter 1192, section 24, 18 subsection 1, paragraph “c”: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 20 Sec. 71. ACCOUNTABLE CARE ORGANIZATION —— PILOT. 21 1. a. If an entity applies for certification from the 22 secretary of the United States department of health and 23 human services prior to January 1, 2012, and is subsequently 24 certified to administer an accountable care organization 25 pilot project, pursuant to the federal Patient Protection and 26 Accountability Act, Pub. L. No. 111-148, the department of 27 human services shall work with the entity to provide access to 28 the complete deidentified claims data of the medical assistance 29 recipients receiving health care services through the pilot 30 project for the purposes of identifying areas of utilization, 31 need, and potential cost savings to the medical assistance 32 program subject to all applicable state and federal laws and 33 regulations. The department may also employ new payment 34 models, information technology, and data analytics provisions 35 -94- SF 542 (3) 84 pf/jp 94/ 209
S.F. 542 necessary to the administration of the pilot project. 1 b. The department of human services shall work with an 2 entity to administer an accountable care organization pilot 3 project, only if the centers for Medicare and Medicaid services 4 of the United States department of health and human services 5 approves participation of the medical assistance program in 6 the pilot project and the entity meets all of the following 7 requirements: 8 (1) At a minimum, includes the participation of a 9 prospective payment system hospital, ten primary care 10 physicians, a home health care practice, a palliative care 11 services, a hospice service, and a community mental health 12 center, all of which agree to be paid under a partial or global 13 payment for identified services. 14 (2) Requires all participating providers to utilize 15 electronic health records. 16 (3) Includes delivery of mental health services to 17 recipients of medical assistance through collaboration with 18 the regional community mental health center, a federally 19 qualified health center, and at least one nursing facility as 20 consistent with any other law enacted by the Eighty-fourth 21 general assembly, 2011 session, that redesigns the mental 22 health delivery system in the state. 23 c. The entity certified to implement the pilot project shall 24 report to the joint appropriations subcommittee for health and 25 human services during the 2012 legislative session detailing 26 the progress and expected outcomes of the pilot project. 27 Sec. 72. EMERGENCY RULES. For purposes of the initial 28 rules to implement the provisions of section 16.185, as enacted 29 by this division of this Act, the Iowa finance authority may 30 adopt administrative rules under section 17A.4, subsection 31 3, and section 17A.5, subsection 2, paragraph “b”, to 32 implement the provisions and the rules shall become effective 33 immediately upon filing or on a later effective date specified 34 in the rules, unless the effective date is delayed by the 35 -95- SF 542 (3) 84 pf/jp 95/ 209
S.F. 542 administrative rules review committee. Any rules adopted in 1 accordance with this section shall not take effect before 2 the rules are reviewed by the administrative rules review 3 committee. The delay authority provided to the administrative 4 rules review committee under section 17A.4, subsection 7, and 5 section 17A.8, subsection 9, shall be applicable to a delay 6 imposed under this section, notwithstanding a provision in 7 those sections making them inapplicable to section 17A.5, 8 subsection 2, paragraph “b”. Any rules adopted in accordance 9 with the provisions of this section shall also be published as 10 a notice of intended action as provided in section 17A.4. 11 Sec. 73. EFFECTIVE UPON ENACTMENT AND RETROACTIVE 12 APPLICABILITY. Except as otherwise provided by this division 13 of this Act, this division of this Act, being deemed of 14 immediate importance, takes effect upon enactment and if 15 approved by the governor on or after July 1, 2011, applies 16 retroactively to June 30, 2011. 17 Sec. 74. RETROACTIVE APPLICABILITY. The section of this 18 division of this Act addressing child welfare and juvenile 19 justice funding decategorization initiative project funding for 20 the period beginning June 1, 2010, and ending June 30, 2012, 21 applies retroactively to June 1, 2010. 22 Sec. 75. RETROACTIVE APPLICABILITY. The section of 23 this division of this Act amending section 35A.8A, applies 24 retroactively to July 1, 2010. 25 Sec. 76. RETROACTIVE APPLICABILITY. The section of this 26 division of this Act making transfers between appropriations 27 made to the department of human services for state institutions 28 in 2010 Iowa Acts, chapter 1192, applies retroactively to 29 January 1, 2011. 30 DIVISION VIII 31 PREVENTION AND CHRONIC CARE MANAGEMENT 32 Sec. 77. Section 135.159, subsection 10, Code 2011, is 33 amended to read as follows: 34 10. The department shall integrate the recommendations 35 -96- SF 542 (3) 84 pf/jp 96/ 209
S.F. 542 and policies developed by the prevention and chronic care 1 management advisory council pursuant to section 135.161, Code 2 2011, into the medical home system and shall incorporate the 3 development and implementation of the state initiative for 4 prevention and chronic care management as developed pursuant to 5 section 135.161, Code 2011, into the duties of the medical home 6 system advisory council beginning January 1, 2012 . 7 Sec. 78. Section 135.162, subsections 1 and 3, Code 2011, 8 are amended to read as follows: 9 1. The director shall convene a clinicians advisory panel to 10 advise and recommend to the department clinically appropriate, 11 evidence-based best practices regarding the implementation 12 of the medical home as defined in section 135.157 and the 13 prevention and chronic care management initiative pursuant to 14 section 135.161 . The director shall act as chairperson of the 15 advisory panel. 16 3. The clinicians advisory panel shall meet on a quarterly 17 basis to receive updates from the director regarding strategic 18 planning and implementation progress on the medical home and 19 the prevention and chronic care management initiative and shall 20 provide clinical consultation to the department regarding the 21 medical home and the initiative . 22 Sec. 79. Section 136.3, subsection 14, Code 2011, is amended 23 to read as follows: 24 14. Perform those duties authorized pursuant to sections 25 135.156 , and 135.159 , and 135.161 , and other provisions of law. 26 Sec. 80. REPEAL. Section 135.161, Code 2011, is repealed. 27 Sec. 81. EFFECTIVE DATE. This division of this Act takes 28 effect December 31, 2011. 29 DIVISION IX 30 MISCELLANEOUS 31 Sec. 82. Section 29C.20B, Code 2011, is amended to read as 32 follows: 33 29C.20B Disaster case management. 34 1. The rebuild Iowa office homeland security and emergency 35 -97- SF 542 (3) 84 pf/jp 97/ 209
S.F. 542 management division shall work with the department of 1 human services and nonprofit, voluntary, and faith-based 2 organizations active in disaster recovery and response 3 in coordination with the homeland security and emergency 4 management division the department of human services to 5 establish a statewide system of disaster case management 6 to be activated following the governor’s proclamation of a 7 disaster emergency or the declaration of a major disaster by 8 the president of the United States for individual assistance 9 purposes. Under the system, the department of human services 10 homeland security and emergency management division shall 11 coordinate case management services locally through local 12 committees as established in each local emergency management 13 commission’s emergency plan. Beginning July 1, 2011, the 14 department of human services shall assume the duties of the 15 rebuild Iowa office under this subsection . 16 2. The department of human services homeland security 17 and emergency management division , in conjunction with the 18 rebuild Iowa office, the homeland security and emergency 19 management division department of human services , and an 20 Iowa representative to the national voluntary organizations 21 active in disaster, shall adopt rules pursuant to chapter 22 17A to create coordination mechanisms and standards for the 23 establishment and implementation of a statewide system of 24 disaster case management which shall include at least all of 25 the following: 26 a. Disaster case management standards. 27 b. Disaster case management policies. 28 c. Reporting requirements. 29 d. Eligibility criteria. 30 e. Coordination mechanisms necessary to carry out the 31 services provided. 32 f. Develop formal working relationships with agencies and 33 create interagency agreements for those considered to provide 34 disaster case management services. 35 -98- SF 542 (3) 84 pf/jp 98/ 209
S.F. 542 g. Coordination of all available services for individuals 1 from multiple agencies. 2 Sec. 83. Section 135.106, Code 2011, is amended by adding 3 the following new subsection: 4 NEW SUBSECTION . 4. It is the intent of the general 5 assembly that priority for home visitation funding be given to 6 approaches using evidence-based or promising models for home 7 visitation. 8 Sec. 84. Section 135C.4, Code 2011, is amended to read as 9 follows: 10 135C.4 Residential care facilities. 11 1. Each facility licensed as a residential care facility 12 shall provide an organized continuous twenty-four-hour program 13 of care commensurate with the needs of the residents of the 14 home and under the immediate direction of a person approved 15 and certified by the department whose combined training 16 and supervised experience is such as to ensure adequate and 17 competent care. 18 2. All admissions to residential care facilities shall be 19 based on an order written by a physician certifying that the 20 individual being admitted does not require nursing services or 21 that the individual’s need for nursing services can be avoided 22 if home and community-based services, other than nursing care, 23 as defined by this chapter and departmental rule, are provided. 24 3. For the purposes of this section , the home and 25 community-based services to be provided shall be limited to the 26 type included under the medical assistance program provided 27 pursuant to chapter 249A , shall be subject to cost limitations 28 established by the department of human services under the 29 medical assistance program, and except as otherwise provided by 30 the department of inspections and appeals with the concurrence 31 of the department of human services, shall be limited in 32 capacity to the number of licensed residential care facilities 33 and the number of licensed residential care facility beds in 34 the state as of December 1, 2003. 35 -99- SF 542 (3) 84 pf/jp 99/ 209
S.F. 542 4. A residential care facility is not required to admit 1 an individual through court order, referral, or other means 2 if the individual has been arrested, charged, or convicted 3 of a forcible felony, arson, or an offense that requires 4 registration as a sex offender under chapter 692A. The court 5 order, referral, or other documentation for admission of 6 an individual to a residential care facility shall contain 7 sufficient information relating to the criminal history of 8 the individual in order for the facility to make an informed 9 decision about the admittance of the individual. The court 10 order, referral, or other documentation shall be provided to 11 the facility prior to the facility determining whether to admit 12 the individual. 13 Sec. 85. Section 135H.6, subsection 8, Code 2011, is amended 14 to read as follows: 15 8. The department of human services may give approval to 16 conversion of beds approved under subsection 6 , to beds which 17 are specialized to provide substance abuse treatment. However, 18 the total number of beds approved under subsection 6 and this 19 subsection shall not exceed four hundred thirty. Conversion 20 of beds under this subsection shall not require a revision of 21 the certificate of need issued for the psychiatric institution 22 making the conversion. Beds for children who do not reside 23 in this state and whose service costs are not paid by public 24 funds in this state are not subject to the limitations on the 25 number of beds and certificate of need requirements otherwise 26 applicable under this section. 27 Sec. 86. Section 147.136, Code 2011, is amended to read as 28 follows: 29 147.136 Scope of recovery. 30 1. In Except as otherwise provided in subsection 2, in an 31 action for damages for personal injury against a physician and 32 surgeon, osteopathic physician and surgeon, dentist, podiatric 33 physician, optometrist, pharmacist, chiropractor, or nurse 34 licensed to practice that profession in this state, or against 35 -100- SF 542 (3) 84 pf/jp 100/ 209
S.F. 542 a hospital licensed for operation in this state, based on the 1 alleged negligence of the practitioner in the practice of the 2 profession or occupation, or upon the alleged negligence of 3 the hospital in patient care, in which liability is admitted 4 or established, the damages awarded shall not include actual 5 economic losses incurred or to be incurred in the future by the 6 claimant by reason of the personal injury, including but not 7 limited to, the cost of reasonable and necessary medical care, 8 rehabilitation services, and custodial care, and the loss of 9 services and loss of earned income, to the extent that those 10 losses are replaced or are indemnified by insurance, or by 11 governmental, employment, or service benefit programs or from 12 any other source except the assets of the claimant or of the 13 members of the claimant’s immediate family . 14 2. This section shall not bar recovery of economic losses 15 replaced or indemnified by any of the following: 16 a. Benefits received under the medical assistance program 17 under chapter 249A. 18 b. The assets of the claimant or of the members of the 19 claimant’s immediate family. 20 Sec. 87. Section 153.14, subsection 1, Code 2011, is amended 21 to read as follows: 22 1. Students of dentistry who practice dentistry upon 23 patients at clinics in connection with their regular course 24 of instruction at the state an accredited dental college, 25 students of dental hygiene who practice upon patients at 26 clinics in connection with their regular course of instruction 27 at state-approved schools, and students of dental assisting 28 who practice upon patients at clinics in connection with a 29 regular course of instruction determined by the board pursuant 30 to section 153.39 . 31 Sec. 88. Section 154A.24, subsection 3, paragraph s, Code 32 2011, is amended by striking the paragraph. 33 Sec. 89. NEW SECTION . 155A.43 Pharmaceutical collection and 34 disposal program —— annual allocation. 35 -101- SF 542 (3) 84 pf/jp 101/ 209
S.F. 542 Of the fees collected pursuant to sections 124.301 and 1 147.80 and chapter 155A by the board of pharmacy, and retained 2 by the board pursuant to section 147.82, not more than one 3 hundred twenty-five thousand dollars, may be allocated annually 4 by the board for administering the pharmaceutical collection 5 and disposal program originally established pursuant to 2009 6 Iowa Acts, chapter 175, section 9. The program shall provide 7 for the management and disposal of unused, excess, and expired 8 pharmaceuticals. The board of pharmacy may cooperate with the 9 Iowa pharmacy association and may consult with the department 10 and sanitary landfill operators in administering the program. 11 Sec. 90. Section 225B.8, Code 2011, is amended to read as 12 follows: 13 225B.8 Repeal. 14 This chapter is repealed July 1, 2011 2012 . 15 Sec. 91. Section 232.188, subsection 5, paragraph b, 16 unnumbered paragraph 1, Code 2011, is amended to read as 17 follows: 18 Notwithstanding section 8.33 , moneys designated for a 19 project’s decategorization services funding pool that remain 20 unencumbered or unobligated at the close of the fiscal year 21 shall not revert but shall remain available for expenditure as 22 directed by the project’s governance board for child welfare 23 and juvenile justice systems enhancements and other purposes of 24 the project until the close of the succeeding fiscal year and 25 for the next two succeeding fiscal years. Such moneys shall be 26 known as “carryover funding” . Moneys may be made available to a 27 funding pool from one or more of the following sources: 28 Sec. 92. Section 235B.19, Code 2011, is amended by adding 29 the following new subsection: 30 NEW SUBSECTION . 2A. a. The department shall serve a copy 31 of the petition and any order authorizing protective services, 32 if issued, on the dependent adult and on persons who are 33 competent adults and reasonably ascertainable at the time the 34 petition is filed in accordance with the following priority: 35 -102- SF 542 (3) 84 pf/jp 102/ 209
S.F. 542 (1) An attorney in fact named by the dependent adult in a 1 durable power of attorney for health care pursuant to chapter 2 144B. 3 (2) The dependent adult’s spouse. 4 (3) The dependent adult’s children. 5 (4) The dependent adult’s grandchildren. 6 (5) The dependent adult’s siblings. 7 (6) The dependent adult’s aunts and uncles. 8 (7) The dependent adult’s nieces and nephews. 9 (8) The dependent adult’s cousins. 10 b. When the department has served a person in one of the 11 categories specified in paragraph “a” , the department shall not 12 be required to serve a person in any other category. 13 c. The department shall serve the dependent adult’s copy 14 of the petition and order personally upon the dependent 15 adult. Service of the petition and all other orders and 16 notices shall be in a sealed envelope with the proper postage 17 on the envelope, addressed to the person being served at the 18 person’s last known post office address, and deposited in a 19 mail receptacle provided by the United States postal service. 20 The department shall serve such copies of emergency orders 21 authorizing protective services and notices within three days 22 after filing the petition and receiving such orders. 23 d. The department and all persons served by the department 24 with notices under this subsection shall be prohibited from 25 all of the following without prior court approval after the 26 department’s petition has been filed: 27 (1) Selling, removing, or otherwise disposing of the 28 dependent adult’s personal property. 29 (2) Withdrawing funds from any bank, savings and loan 30 association, credit union, or other financial institution, or 31 from an account containing securities in which the dependent 32 adult has an interest. 33 Sec. 93. Section 237A.1, subsection 3, paragraph n, Code 34 2011, is amended to read as follows: 35 -103- SF 542 (3) 84 pf/jp 103/ 209
S.F. 542 n. A program offered to a child whose parent, guardian, 1 or custodian is engaged solely in a recreational or social 2 activity, remains immediately available and accessible on the 3 physical premises on which the child’s care is provided, and 4 does not engage in employment while the care is provided. 5 However, if the recreational or social activity is provided in 6 a fitness center or on the premises of a nonprofit organization 7 the parent, guardian, or custodian of the child may be employed 8 to teach or lead the activity. 9 Sec. 94. Section 249A.4B, subsection 2, paragraph a, 10 subparagraph (18), Code 2011, is amended to read as follows: 11 (18) The Iowa/Nebraska Iowa primary care association. 12 Sec. 95. REPEAL. Section 135.27A, Code 2011, is repealed 13 December 31, 2011. 14 DIVISION X 15 MEDICAID PRESCRIPTION DRUGS 16 Sec. 96. Section 249A.20A, subsection 4, Code 2011, is 17 amended to read as follows: 18 4. With the exception of drugs prescribed for the treatment 19 of human immunodeficiency virus or acquired immune deficiency 20 syndrome, transplantation, or cancer and drugs prescribed 21 for mental illness with the exception of drugs and drug 22 compounds that do not have a significant variation in a 23 therapeutic profile or side effect profile within a therapeutic 24 class, prescribing and dispensing of prescription drugs not 25 included on the preferred drug list shall be subject to prior 26 authorization. 27 Sec. 97. 2010 Iowa Acts, chapter 1031, section 348, is 28 amended to read as follows: 29 SEC. 348. MEDICAID NONPREFERRED DRUG LIST PRESCRIBING. 30 1. The department shall adopt rules pursuant to chapter 17A 31 to restrict physicians and other prescribers to prescribing 32 not more than a 72-hour or three-day supply of a prescription 33 drug not included on the medical assistance preferred drug list 34 while seeking approval to continue prescribing the medication. 35 -104- SF 542 (3) 84 pf/jp 104/ 209
S.F. 542 2. Notwithstanding subsection 1, the department shall 1 adopt rules pursuant to chapter 17A to restrict a physician or 2 other prescriber prescribing a chemically unique mental health 3 prescription drug to prescribing not more than a seven-day 4 supply of the prescription drug while requesting approval to 5 continue to prescribe the medication. The rules shall provide 6 that if an approval or disapproval is not received by the 7 physician or other prescriber within 48 hours of the request, 8 the request is deemed approved. 9 Sec. 98. REPEAL. 2010 Iowa Acts, chapter 1031, section 349, 10 is repealed. 11 Sec. 99. RESCINDING AND ADOPTION OF RULES. The department 12 of human services shall rescind the rules adopted pursuant 13 to 2010 Iowa Acts, chapter 1031, section 347, chapter 1031, 14 section 348, subsection 2, and chapter 1031, section 349, 15 and shall instead adopt emergency rules under section 17A.4, 16 subsection 3, and section 17A.5, subsection 2, paragraph “b”, 17 to implement section 249A.20A, as amended in this division of 18 this Act, and the rules shall be effective immediately upon 19 filing and retroactively applicable to January 1, 2011, unless 20 a later date is specified in the rules. Any rules adopted 21 in accordance with this section shall also be published as a 22 notice of intended action as provided in section 17A.4. 23 Sec. 100. EFFECTIVE UPON ENACTMENT AND RETROACTIVE 24 APPLICABILITY. This division of this Act, being deemed of 25 immediate importance, takes effect upon enactment and applies 26 retroactively to January 1, 2011. 27 DIVISION XI 28 IOWA FALSE CLAIMS ACT 29 Sec. 101. Section 685.1, subsection 11, Code 2011, is 30 amended to read as follows: 31 11. “Original source” means an individual who has direct and 32 independent prior to a public disclosure under section 685.3, 33 subsection 5, paragraph “c” , has voluntarily disclosed to the 34 state the information on which the allegations or transactions 35 -105- SF 542 (3) 84 pf/jp 105/ 209
S.F. 542 in a claim are based; or who has knowledge of the information 1 on which the allegations are based that is independent of 2 and materially adds to the publicly disclosed allegations or 3 transactions, and has voluntarily provided the information to 4 the state before filing an action under section 685.3 which is 5 based on the information this chapter . 6 Sec. 102. Section 685.1, Code 2011, is amended by adding the 7 following new subsection: 8 NEW SUBSECTION . 15. “State” means the state of Iowa. 9 Sec. 103. Section 685.2, subsection 1, unnumbered paragraph 10 1, Code 2011, is amended to read as follows: 11 A person who commits any of the following acts is jointly 12 and severally liable to the state for a civil penalty of not 13 less than five thousand dollars and not more than ten thousand 14 dollars the civil penalty allowed under the federal False 15 Claims Act, as codified in 31 U.S.C. § 3729 et seq., as may be 16 adjusted in accordance with the inflation adjustment procedures 17 prescribed in the federal Civil Penalties Inflation Adjustment 18 Act of 1990, Pub. L. No. 101-410, for each false or fraudulent 19 claim , plus three times the amount of damages which the state 20 sustains because of the act of that person : 21 Sec. 104. Section 685.3, subsection 5, paragraph c, Code 22 2011, is amended by striking the paragraph and inserting in 23 lieu thereof the following: 24 c. A court shall dismiss an action or claim under this 25 section, unless opposed by the state, if substantially the 26 same allegations or transactions as alleged in the action or 27 claim were publicly disclosed in a state criminal, civil, or 28 administrative hearing in which the state or an agent of the 29 state is a party; in a state legislative, state auditor, or 30 other state report, hearing, audit, or investigation; or by 31 the news media, unless the action is brought by the attorney 32 general or the qui tam plaintiff is an original source of the 33 information. 34 Sec. 105. Section 685.3, subsection 6, Code 2011, is amended 35 -106- SF 542 (3) 84 pf/jp 106/ 209
S.F. 542 to read as follows: 1 6. a. Any employee, contractor, or agent who shall be 2 entitled to all relief necessary to make that employee, 3 contractor, or agent whole, if that employee, contractor, or 4 agent is discharged, demoted, suspended, threatened, harassed, 5 or in any other manner discriminated against in the terms and 6 conditions of employment because of lawful acts performed 7 done by the employee, contractor, or agent on behalf of 8 the employee, contractor, or agent or associated others in 9 furtherance of an action under this section or other efforts 10 to stop a violation one or more violations of this chapter , 11 shall be entitled to all relief necessary to make the employee, 12 contractor, or agent whole . Such relief 13 b. Relief under paragraph “a” shall include reinstatement 14 with the same seniority status such that employee, contractor, 15 or agent would have had but for the discrimination, two 16 times the amount of back pay, interest on the back pay, and 17 compensation for any special damages sustained as a result of 18 the discrimination, including litigation costs and reasonable 19 attorney fees. An employee, contractor, or agent may bring an 20 action under this subsection may be brought in the appropriate 21 district court of the state for the relief provided in this 22 subsection . 23 c. A civil action under this subsection shall not be brought 24 more than three years after the date when the retaliation 25 occurred. 26 DIVISION XII 27 VOLUNTEER HEALTH CARE PROVIDER PROGRAM 28 Sec. 106. Section 135.24, subsection 2, paragraphs b and c, 29 Code 2011, are amended to read as follows: 30 b. Procedures for registration of hospitals, free clinics, 31 field dental clinics, and specialty health care provider 32 offices. 33 c. Criteria for and identification of hospitals, clinics, 34 free clinics, field dental clinics, specialty health care 35 -107- SF 542 (3) 84 pf/jp 107/ 209
S.F. 542 provider offices, or other health care facilities, health 1 care referral programs, or charitable organizations, 2 eligible to participate in the provision of free medical, 3 dental, chiropractic, pharmaceutical, nursing, optometric, 4 psychological, social work, behavioral science, podiatric, 5 physical therapy, occupational therapy, respiratory therapy, 6 or emergency medical care services through the volunteer 7 health care provider program. A hospital, a clinic, a 8 free clinic, a field dental clinic, a specialty health care 9 provider office, a health care facility, a health care referral 10 program, a charitable organization, or a health care provider 11 participating in the program shall not bill or charge a 12 patient for any health care provider service provided under the 13 volunteer health care provider program. 14 Sec. 107. Section 135.24, Code 2011, is amended by adding 15 the following new subsection: 16 NEW SUBSECTION . 6A. A hospital providing free care under 17 this section shall be considered a state agency solely for 18 the purposes of this section and chapter 669 and shall be 19 afforded protection under chapter 669 as a state agency for 20 all claims arising from the provision of free care by a health 21 care provider registered under subsection 3 who is providing 22 services at the hospital in accordance with this section, if 23 the hospital has registered with the department pursuant to 24 subsection 1. 25 Sec. 108. Section 135.24, subsection 7, Code 2011, is 26 amended by adding the following new paragraph: 27 NEW PARAGRAPH . 0e. “Hospital” means hospital as defined in 28 section 135B.1. 29 DIVISION XIII 30 HEALTH CARE COST CONTAINMENT 31 Sec. 109. ALL-PAYER CLAIMS DATABASE PLAN. The department of 32 human services shall develop a plan to establish an all-payer 33 claims database to provide for the collection and analysis of 34 claims data from multiple payers of health care. The plan 35 -108- SF 542 (3) 84 pf/jp 108/ 209
S.F. 542 shall establish the goals of the database which may include 1 but are not limited to determining health care utilization 2 patterns and rates; identifying gaps in prevention and health 3 promotion services; evaluating access to care; assisting with 4 benefit design and planning; analyzing statewide and local 5 health care expenditures by provider, employer, and geography; 6 informing the development of payment systems for providers; and 7 establishing clinical guidelines related to quality, safety, 8 and continuity of care. The plan shall identify a standard 9 means of data collection, statutory changes necessary to the 10 collection and use of the data, and the types of claims for 11 which collection of data is required which may include but are 12 not limited to eligibility data; provider information; medical 13 data; private and public medical, pharmacy, and dental claims 14 data; and other appropriate data. The plan shall also include 15 an implementation and maintenance schedule including a proposed 16 budget and funding plan and vision for the future. 17 Sec. 110. PROVIDER PAYMENT SYSTEM PLAN —— PILOT 18 PROJECT. The department of human services shall develop a 19 provider payment system plan to provide recommendations to 20 reform the health care provider payment system as an effective 21 way to promote coordination of care, lower costs, and improve 22 quality. The plan shall provide analysis and recommendations 23 regarding but not limited to accountable care organizations, a 24 global payment system, or an episode of care payment system. 25 Sec. 111. EFFECTIVE UPON ENACTMENT. This division of this 26 Act, being deemed of immediate importance, takes effect upon 27 enactment. 28 DIVISION XIV 29 HEALTH INFORMATION TECHNOLOGY 30 Sec. 112. NEW SECTION . 135D.1 Findings and intent. 31 1. The general assembly finds all of the following: 32 a. Technology used to support health-related functions is 33 widely known as health information technology. Electronic 34 health records are used to collect and store relevant patient 35 -109- SF 542 (3) 84 pf/jp 109/ 209
S.F. 542 health information. Electronic health records serve as a means 1 of bringing evidence-based knowledge resources and patient 2 information to the point of care to support better decision 3 making and more efficient care processes. 4 b. Health information technology allows for comprehensive 5 management of health information and its secure electronic 6 exchange between providers, public health agencies, payers, 7 and consumers. Broad use of health information technology 8 should improve health care quality and the overall health of 9 the population, increase efficiencies in administrative health 10 care, reduce unnecessary health care costs, and help prevent 11 medical errors. 12 c. Health information technology provides a mechanism to 13 transform the delivery of health and medical care in Iowa and 14 across the nation. 15 2. It is the intent of the general assembly to use health 16 information technology as a catalyst to achieve a healthier 17 Iowa through the electronic sharing of health information. A 18 health information network involves sharing health information 19 across the boundaries of individual practice and institutional 20 health settings and with consumers. The result is a public 21 good that will contribute to improved clinical outcomes and 22 patient safety, population health, access to and quality of 23 health care, and efficiency in health care delivery. 24 3. It is the intent of the general assembly that the health 25 information network shall not constitute a health benefit 26 exchange or a health insurance exchange. 27 Sec. 113. NEW SECTION . 135D.2 Definitions. 28 For the purposes of this chapter, unless the context 29 otherwise requires: 30 1. “Authorized” means having met the requirements as a 31 participant for access to the health information network. 32 2. “Board” means the board of directors of Iowa e-health. 33 3. “Consumers” means people who acquire and use goods and 34 services for personal need. 35 -110- SF 542 (3) 84 pf/jp 110/ 209
S.F. 542 4. “Continuity of care document” means a summary of a 1 patient’s health information for each visit to a provider to be 2 delivered through the health information network. 3 5. “Department” means the department of public health. 4 6. “Deputy director” means the deputy director of public 5 health. 6 7. “Director” means the director of public health. 7 8. “Exchange” means the authorized electronic sharing 8 of health information between providers, payers, consumers, 9 public health agencies, the department, and other authorized 10 participants utilizing the health information network and 11 health information network services. 12 9. “Executive director” means the executive director of the 13 office of health information technology. 14 10. “Health information” means any information, in any 15 form or medium, that is created, transmitted, or received 16 by a provider, payer, consumer, public health agency, the 17 department, or other authorized participant, which relates 18 to the past, present, or future physical or mental health or 19 condition of an individual; the provision of health care to an 20 individual; or the past, present, or future payment for the 21 provision of health care to an individual. 22 11. “Health information network” means the exclusive 23 statewide electronic health information network. 24 12. “Health information network services” means the 25 exchanging of health information via the health information 26 network; education and outreach to support connection and 27 access to and use of the health information network; and all 28 other activities related to the electronic exchange of health 29 information. 30 13. “Health Insurance Portability and Accountability 31 Act” means the federal Health Insurance Portability and 32 Accountability Act of 1996, Pub. L. No. 104-191, including 33 amendments thereto and regulations promulgated thereunder. 34 14. “Infrastructure” means technology including 35 -111- SF 542 (3) 84 pf/jp 111/ 209
S.F. 542 architecture, hardware, software, networks, terminology and 1 standards, and policies and procedures governing the electronic 2 exchange of health information. 3 15. “Iowa e-health” means the collaboration between the 4 department and other public and private stakeholders to 5 establish, operate, and sustain an exclusive statewide health 6 information network. 7 16. “Iowa Medicaid enterprise” means Iowa medicaid 8 enterprise as defined in section 249J.3. 9 17. “Local board of health” means a city, county, or 10 district board of health. 11 18. “Office” means the office of health information 12 technology within the department. 13 19. “Participant” means an authorized provider, payer, 14 patient, public health agency, the department, or other 15 authorized person that has voluntarily agreed to authorize, 16 submit, access, and disclose health information through the 17 health information network in accordance with this chapter 18 and all applicable laws, rules, agreements, policies, and 19 procedures. 20 20. “Participation and data sharing agreement” means 21 the agreement outlining the terms of access and use for 22 participation in the health information network. 23 21. “Patient” means a person who has received or is 24 receiving health services from a provider. 25 22. “Payer” means a person who makes payments for health 26 services, including but not limited to an insurance company, 27 self-insured employer, government program, individual, or other 28 purchaser that makes such payments. 29 23. “Protected health information” means individually 30 identifiable patient information, including demographic 31 information, related to the past, present, or future health 32 or condition of a person; the provision of health care to 33 a person; or the past, present, or future payment for such 34 health care; which is created, transmitted, or received by a 35 -112- SF 542 (3) 84 pf/jp 112/ 209
S.F. 542 participant. “Protected health information” does not include 1 education and other records that are covered under the federal 2 Family Educational Rights and Privacy Act of 1974, as codified 3 at 20 U.S.C. 1232g, as amended; or any employment records 4 maintained by a covered entity, as defined under the Health 5 Insurance Portability and Accountability Act, in its role as 6 an employer. 7 24. “Provider” means a hospital, physician clinic, pharmacy, 8 laboratory, health service provider, or other person that is 9 licensed, certified, or otherwise authorized or permitted 10 by law to administer health care in the ordinary course of 11 business or in the practice of a profession, or any other 12 person or organization that furnishes, bills, or is paid for 13 health care in the normal course of business. 14 25. “Public health agency” means an entity that is governed 15 by or contractually responsible to a local board of health or 16 the department to provide services focused on the health status 17 of population groups and their environments. 18 26. “Purchaser” means any individual, employer, or 19 organization that purchases health insurance or services and 20 includes intermediaries. 21 27. “Vendor” means a person or organization that provides 22 or proposes to provide goods or services to the department 23 pursuant to a contract, but does not include an employee of the 24 state, a retailer, or a state agency or instrumentality. 25 Sec. 114. NEW SECTION . 135D.3 Iowa e-health established —— 26 guiding principles, goals, domains. 27 1. Iowa e-health is established as a public-private, 28 multi-stakeholder collaborative. The purpose of Iowa e-health 29 is to develop, administer, and sustain the health information 30 network to improve the quality, safety, and efficiency of 31 health care available to Iowans. 32 2. Iowa e-health shall manage and operate the health 33 information network. Nothing in this chapter shall be 34 interpreted to impede or preclude the formation and operation 35 -113- SF 542 (3) 84 pf/jp 113/ 209
S.F. 542 of regional, population-specific, or local health information 1 networks or their participation in the health information 2 network. 3 3. Iowa e-health shall facilitate the exchange of health 4 information for prevention and treatment purposes to help 5 providers make the best health care decisions for patients and 6 to provide patients with continuity of care regardless of the 7 provider the patient visits. 8 4. The guiding principles of Iowa e-health include all of 9 the following: 10 a. To engage in a collaborative, public-private, 11 multi-stakeholder effort including providers, payers, 12 purchasers, governmental entities, educational institutions, 13 and consumers. 14 b. To create a sustainable health information network which 15 makes information available when and where it is needed. 16 c. To ensure the health information network incorporates 17 provider priorities and appropriate participant education. 18 d. To instill confidence in consumers that their health 19 information is secure, private, and accessed appropriately. 20 e. To build on smart practices and align with federal 21 standards to ensure interoperability within and beyond the 22 state. 23 5. The goals of Iowa e-health include all of the following: 24 a. To build awareness and trust of health information 25 technology through communication and outreach to providers and 26 consumers. 27 b. To safeguard privacy and security of health information 28 shared electronically between participants through the health 29 information network so that the health information is secure, 30 private, and accessed only by authorized individuals and 31 entities. 32 c. To promote statewide deployment and use of electronic 33 health records. 34 d. To enable the electronic exchange of health information. 35 -114- SF 542 (3) 84 pf/jp 114/ 209
S.F. 542 e. To advance coordination of activities across state and 1 federal governments. 2 f. To establish a governance model for the health 3 information network. 4 g. To establish sustainable business and technical 5 operations for the health information exchange. 6 h. To secure financial resources to develop and sustain the 7 health information network. 8 i. To monitor and evaluate health information technology 9 progress and outcomes. 10 6. Iowa e-health shall include the following five domains: 11 a. Governance. Iowa e-health shall be governed by a board 12 of directors whose members represent stakeholders such as 13 provider organizations and associations, providers, payers, 14 purchasers, governmental entities, business, and consumers. 15 Iowa e-health shall be supported by the department’s office of 16 health information technology. The board shall set direction, 17 goals, and policies for Iowa e-health and provide oversight of 18 the business and technical operations of the health information 19 network and health information network services. 20 b. Business and technical operations. The office of health 21 information technology shall perform day-to-day operations 22 to support and advance Iowa e-health, the health information 23 network, and health information network services. 24 c. Finance. Iowa e-health shall identify and manage 25 financial resources to achieve short-term and long-term 26 sustainability of the health information network. The health 27 information network shall be financed by participants based on 28 a business model and financial sustainability plan approved by 29 the board no later than December 31, 2011, and submitted to 30 the governor and the general assembly. The model and plan may 31 contemplate participant fees based on value-based principles. 32 Fees shall not be assessed to participants prior to approval by 33 the board and an enactment of the general assembly establishing 34 such fees. 35 -115- SF 542 (3) 84 pf/jp 115/ 209
S.F. 542 d. Technical infrastructure. Iowa e-health shall implement 1 and manage the core infrastructure and standards to enable the 2 safe and secure delivery of health information to providers and 3 consumers through the health information network. 4 e. Legal and policy. Iowa e-health shall establish privacy 5 and security policies and guidelines, and participation and 6 data sharing agreements, to protect consumers and enforce rules 7 for utilization of the health information network. 8 Sec. 115. NEW SECTION . 135D.4 Governance —— board of 9 directors —— advisory council. 10 1. Iowa e-health shall be governed by a board of directors. 11 Board members shall be residents of the state of Iowa. The 12 membership of the board shall comply with sections 69.16 and 13 69.16A. 14 2. The board of directors shall be comprised of the 15 following members: 16 a. The board shall include all of the following as voting 17 members: 18 (1) Two members who represent the Iowa collaborative safety 19 net provider network created in section 135.153, designated by 20 the network. 21 (2) Four members who represent hospitals, two of whom are 22 designated by the two largest health care systems in the state, 23 one of whom is designated by the university of Iowa hospitals 24 and clinics, and one of whom is designated by the Iowa hospital 25 association to represent critical access hospitals. 26 (3) Two members who represent two different private health 27 insurance carriers, designated by the federation of Iowa 28 insurers, one of which has the largest health market share in 29 Iowa. 30 (4) One member who is a licensed physician, designated by 31 the Iowa medical society. 32 (5) One member representing the department who is 33 designated by the department. 34 (6) One member representing the Iowa Medicaid enterprise 35 -116- SF 542 (3) 84 pf/jp 116/ 209
S.F. 542 who is the Iowa Medicaid director, or the director’s designee. 1 b. The board shall include as ex officio, nonvoting members 2 four members of the general assembly, one appointed by the 3 speaker of the house of representatives, one appointed by the 4 minority leader of the house of representatives, one appointed 5 by the majority leader of the senate, and one appointed by the 6 minority leader of the senate. 7 3. A person shall not serve on the board in any capacity if 8 the person is required to register as a lobbyist under section 9 68B.36 because of the person’s activities for compensation 10 on behalf of a profession or an entity that is engaged in 11 providing health care, reviewing or analyzing health care, 12 paying for health care services or procedures, or providing 13 health information technology or health information network 14 services. 15 4. a. Board members shall serve four-year terms but shall 16 not serve more than two consecutive four-year terms. However, 17 the board members who represent state agencies are not subject 18 to term limits. 19 b. At the end of any term, a member of the board may 20 continue to serve until the appointing or designating authority 21 names a successor. 22 c. A vacancy on the board shall be filled for the remainder 23 of the term in the manner of the original appointment. A 24 vacancy in the membership of the board shall not impair the 25 right of the remaining members to exercise all the powers and 26 perform all the duties of the board. 27 d. A board member may be removed by the board for cause 28 including but not limited to malfeasance in office, failure 29 to attend board meetings, misconduct, or violation of ethical 30 rules and standards. Nonattendance of the board members 31 appointed by the governor shall be governed by the provisions 32 of section 69.15. A board member may be removed by a vote of 33 the board if, based on the criteria provided in section 69.15, 34 subsection 1, paragraphs “a” and “b” , the board member would be 35 -117- SF 542 (3) 84 pf/jp 117/ 209
S.F. 542 deemed to have submitted a resignation from the board. 1 e. The board members shall elect a chairperson from their 2 membership. The department’s designee shall serve as vice 3 chairperson. 4 5. Meetings of the board shall be governed by the provisions 5 of chapter 21. 6 a. The board shall meet upon the call of the chairperson 7 or the vice chairperson. Notice of the time and place of each 8 board meeting shall be given to each member. The board shall 9 keep accurate and complete records of all of its meetings. 10 b. A simple majority of the members shall constitute a 11 quorum to enable the transaction of any business and for the 12 exercise of any power or function of the board. Action may be 13 taken and motions and resolutions adopted by the affirmative 14 vote of a majority of the members attending the meeting whether 15 in person, by telephone, web conference, or other means. A 16 board member shall not vote by proxy or through a delegate. 17 c. Public members of the board shall receive reimbursement 18 for actual expenses incurred while serving in their official 19 capacity, only if they are not eligible for reimbursement by 20 the organization that they represent. A person who serves as a 21 member of the board shall not by reason of such membership be 22 entitled to membership in the Iowa public employees’ retirement 23 system or service credit for any public retirement system. 24 6. The board may exercise its powers, duties, and functions 25 as provided in this chapter and as prescribed by law. The 26 director and the board shall ensure that matters under the 27 purview of the board are carried out in a manner that does not 28 violate or risk violation of applicable state or federal laws 29 or regulations, and that supports overriding public policy and 30 public safety concerns, fiscal compliance, and compliance with 31 the office of the national coordinator for health information 32 technology state health information exchange cooperative 33 agreement program or any other cooperative agreement programs 34 or grants supporting Iowa e-health. The board shall do all of 35 -118- SF 542 (3) 84 pf/jp 118/ 209
S.F. 542 the following: 1 a. Participate in the selection of the executive director 2 and assist in the development of performance standards and 3 evaluations of the executive director. 4 b. Establish priorities among health information network 5 services based on the needs of the population of this state. 6 c. Oversee the handling and accounting of assets and moneys 7 received for or generated by the health information network. 8 d. Establish committees and workgroups as needed. 9 e. Review and approve or disapprove all of the following, 10 as proposed by the department: 11 (1) Strategic, operational, and financial sustainability 12 plans for Iowa e-health, the health information network, and 13 health information network services. 14 (2) Standards, requirements, policies, and procedures for 15 access, use, secondary use, and privacy and security of health 16 information network through the health information exchange, 17 consistent with applicable federal and state standards and 18 laws. 19 (3) Policies and procedures for administering the 20 infrastructure, technology, and associated professional 21 services necessary for the business and technical operation of 22 the health information network and health information network 23 services. 24 (4) Policies and procedures for evaluation of the health 25 information network and health information network services. 26 (5) Mechanisms for periodic review and update of policies 27 and procedures. 28 (6) An annual budget and fiscal report for the operations of 29 the health information network and an annual report for Iowa 30 e-health and health information network services. 31 (7) Major purchases of goods and services. 32 f. Adopt administrative rules pursuant to chapter 17A 33 to implement this chapter and relating to the management 34 and operation of the health information network and health 35 -119- SF 542 (3) 84 pf/jp 119/ 209
S.F. 542 information network services. 1 g. Adopt rules for monitoring access to and use of 2 the health information network and enforcement of health 3 information network rules, standards, requirements, policies, 4 and procedures. The board may suspend, limit, or terminate a 5 participant’s utilization of the health information network for 6 violation of such rules, standards, requirements, policies, 7 or procedures, and shall establish, by rule, a process for 8 notification, right to respond, and appeal relative to such 9 violations. 10 h. Have all remedies allowed by law to address any violation 11 of the terms of the participation and data sharing agreement. 12 i. Perform any and all other activities in furtherance of 13 its purpose. 14 7. a. A board member is subject to chapter 68B, the rules 15 adopted by the Iowa ethics and campaign disclosure board, and 16 the ethics rules and requirements that apply to the executive 17 branch of state government. 18 b. A board member shall not participate in any matter 19 before the board in which the board member has a direct or 20 indirect interest in an undertaking that places the board 21 member’s personal or business interests in conflict with those 22 of Iowa e-health, including but not limited to an interest in 23 a procurement contract, or that may create the appearance of 24 impropriety. 25 8. Advisory council. 26 a. An advisory council to the board is established 27 to provide an additional mechanism for obtaining broader 28 stakeholder advice and input regarding health information 29 technology, the health information network, and health 30 information network services. 31 b. The advisory council shall be comprised of the following 32 members who shall serve two-year staggered terms: 33 (1) The following members designated as specified: 34 (a) One member who is a licensed practicing nurse in 35 -120- SF 542 (3) 84 pf/jp 120/ 209
S.F. 542 an office or clinic setting, designated by the Iowa nurses 1 association. 2 (b) One member representing licensed pharmacists, 3 designated by the Iowa pharmacy association. 4 (c) One member representing the Iowa healthcare 5 collaborative, designated by the collaborative. 6 (d) One member representing substance abuse programs, 7 designated by the Iowa behavioral health association. 8 (e) One member representing community mental health 9 centers, designated by the Iowa association of community 10 providers. 11 (f) One member representing long-term care providers, 12 designated by the Iowa health care association/Iowa center for 13 assisted living and the Iowa association of homes and services 14 for the aging. 15 (g) One member representing licensed physicians, designated 16 by the Iowa academy of family physicians. 17 (h) One member representing chiropractors, designated by 18 the Iowa chiropractic society. 19 (i) One member who is a practicing physician in an office 20 or clinic setting, designated by the Iowa osteopathic medical 21 association. 22 (j) One member representing business interests, designated 23 by the Iowa association of business and industry. 24 (2) The following members appointed by the board: 25 (a) One member representing the state board of health. 26 (b) One member representing academics. 27 (c) One member representing the Iowa Medicare quality 28 improvement organization. 29 (d) One member who is the state chief information officer. 30 (e) One member representing the private telecommunications 31 industry. 32 (f) One member representing Des Moines university. 33 (g) One member representing home health care providers. 34 (h) One member representing the department of veterans 35 -121- SF 542 (3) 84 pf/jp 121/ 209
S.F. 542 affairs. 1 c. The board may change the membership and the composition 2 of the advisory council, by rule, to accommodate changes in 3 stakeholder interests and the evolution of health information 4 technology, the health information network, and health 5 information network services. An advisory council member may 6 be removed by a vote of the board if, based on the criteria 7 provided in section 69.15, subsection 1, paragraphs “a” and “b” , 8 the advisory council member would be deemed to have submitted a 9 resignation from the advisory council. 10 Sec. 116. NEW SECTION . 135D.5 Business and technical 11 operations —— office of health information technology. 12 1. The office of health information technology is 13 established within the department and shall be responsible for 14 the day-to-day business and operations of Iowa e-health, the 15 health information network, and health information network 16 services. The office shall be under the direction of the 17 director and under the supervision of the deputy director. 18 2. a. The department shall employ an executive director to 19 manage the office and the executive director shall report to 20 the deputy director. 21 b. The executive director shall manage the planning and 22 implementation of Iowa e-health, the health information 23 network, and health information network services, and shall 24 provide high-level coordination across public and private 25 sector stakeholders. 26 c. The executive director shall serve as Iowa’s health 27 information technology coordinator and primary point of 28 contact for the office of the national coordinator for health 29 information technology, other federal and state agencies 30 involved in health information technology, and state health 31 information technology coordinators from other states. 32 3. a. The executive director and all other employees of 33 the office shall be employees of the state, classified and 34 compensated in accordance with chapter 8A, subchapter IV, and 35 -122- SF 542 (3) 84 pf/jp 122/ 209
S.F. 542 chapter 20. 1 b. Subject to approval of the board, the director shall 2 have the sole power to determine the number of full-time and 3 part-time equivalent positions necessary to carry out the 4 provisions of this chapter. 5 c. An employee of the office shall not have a financial 6 interest in any vendor doing business or proposing to do 7 business with Iowa e-health. 8 4. The department shall do all of the following: 9 a. Develop, implement, and enforce the following, as 10 approved by the board: 11 (1) Strategic, operational, and financial sustainability 12 plans for the health information network, Iowa e-health, and 13 health information network services. 14 (2) Standards, requirements, policies, and procedures for 15 access, use, secondary use, and privacy and security of health 16 information exchanged through the health information network, 17 consistent with applicable federal and state standards and 18 laws. 19 (3) Policies and procedures for monitoring participant 20 usage of the health information network and health information 21 network services; enforcing noncompliance with health 22 information network standards, requirements, policies, rules, 23 and procedures. 24 (4) Policies and procedures for administering the 25 infrastructure, technology, and associated professional 26 services required for operation of the health information 27 network and health information network services. 28 (5) Policies and procedures for evaluation of the health 29 information network and health information network services. 30 (6) A mechanism for periodic review and update of policies 31 and procedures. 32 (7) An annual budget and fiscal report for the business 33 and technical operations of the health information network and 34 an annual report for Iowa e-health, the health information 35 -123- SF 542 (3) 84 pf/jp 123/ 209
S.F. 542 network, and health information network services. The 1 department shall submit all such reports to the general 2 assembly. 3 b. Convene and facilitate board, advisory council, 4 workgroup, committee, and other stakeholder meetings. 5 c. Provide technical and operational assistance for 6 planning and implementing Iowa e-health activities, the health 7 information network, and health information network services. 8 d. Provide human resource, budgeting, project and 9 activity coordination, and related management functions to 10 Iowa e-health, the health information network, and health 11 information network services. 12 e. Develop educational materials and educate the general 13 public on the benefits of electronic health records, the health 14 information network, and the safeguards available to prevent 15 unauthorized disclosure of health information. 16 f. Enter into participation and data sharing agreements with 17 participants of the health information network. 18 g. Record receipts and approval of payments, and file 19 required financial reports. 20 h. Apply for, acquire by gift or purchase, and hold, 21 dispense, or dispose of funds and real or personal property 22 from any person, governmental entity, or organization in 23 the exercise of its powers and performance of its duties in 24 accordance with this chapter. 25 i. Administer grant funds in accordance with the terms of 26 the grant and all applicable state and federal laws, rules, and 27 regulations. 28 j. Select and contract with vendors in compliance with 29 applicable state and federal procurement laws and regulations. 30 k. Coordinate with other health information technology and 31 health information network programs and activities. 32 l. Work to align interstate and intrastate interoperability 33 and standards in accordance with national health information 34 exchange standards. 35 -124- SF 542 (3) 84 pf/jp 124/ 209
S.F. 542 m. Execute all instruments necessary or incidental to the 1 performance of its duties and the execution of its powers. 2 Sec. 117. NEW SECTION . 135D.6 Iowa e-health finance fund. 3 1. The Iowa e-health finance fund is created as a separate 4 fund within the state treasury under the control of the board. 5 Revenues, donations, gifts, interest, or other moneys received 6 or generated relative to the operation and administration of 7 the health information network and health information network 8 services, shall be deposited in the fund. 9 2. Moneys in the fund shall be expended by the department 10 only on activities and operations suitable to the performance 11 of the department’s duties on behalf of the board and Iowa 12 e-health as specified in this chapter, subject to board 13 approval. Disbursements may be made from the fund for purposes 14 related to the administration, management, operations, 15 functions, activities, and sustainability of the health 16 information network and health information network services. 17 3. Notwithstanding section 12C.7, subsection 2, earnings or 18 interest on moneys deposited in the fund shall be credited to 19 the fund. Notwithstanding section 8.33, any unexpended balance 20 in the fund at the end of each fiscal year shall be retained in 21 the fund and shall not be transferred to the general fund of 22 the state. 23 4. The moneys in the fund shall be subject to financial and 24 compliance audits by the auditor of state. 25 5. The general assembly may appropriate moneys in the fund 26 to the department on behalf of Iowa e-health for the health 27 information network and health information network services. 28 Sec. 118. NEW SECTION . 135D.7 Technical infrastructure. 29 1. The health information network shall provide a mechanism 30 to facilitate and support the secure electronic exchange 31 of health information between participants. The health 32 information network shall not function as a central repository 33 of all health information. 34 2. The health information network shall provide a mechanism 35 -125- SF 542 (3) 84 pf/jp 125/ 209
S.F. 542 for participants without an electronic health record system to 1 access health information from the health information network. 2 3. The technical infrastructure of the health information 3 network shall be designed to facilitate the secure electronic 4 exchange of health information using functions including but 5 not limited to all of the following: 6 a. A master patient index, in the absence of a single, 7 standardized patient identifier, to exchange secure health 8 information among participants. 9 b. A record locator service to locate and exchange secure 10 health information among participants. 11 c. Authorization, authentication, access, and auditing 12 processes for security controls to protect the privacy of 13 consumers and participants and the confidentiality of health 14 information by limiting access to the health information 15 network and health information to participants whose identity 16 has been authenticated, and whose access to health information 17 is limited by their role and recorded through an audit trail. 18 d. Electronic transmission procedures and software necessary 19 to facilitate the electronic exchange of various types of 20 health information through the health information network. 21 e. Telecommunications through coordination of public 22 and private networks to provide the backbone infrastructure 23 to connect participants exchanging health information. The 24 networks may include but are not limited to the state-owned 25 communications network, other fiber optic networks, and private 26 telecommunications service providers. 27 4. The state shall own or possess the rights to use all 28 processes and software developed, and hardware installed, 29 leased, designed, or purchased for the health information 30 network, and shall permit participants to use the health 31 information network and health information network services in 32 accordance with the standards, policies, procedures, rules, 33 and regulations approved by the board, and the terms of the 34 participation and data sharing agreement. 35 -126- SF 542 (3) 84 pf/jp 126/ 209
S.F. 542 Sec. 119. NEW SECTION . 135D.8 Legal and policy. 1 1. Upon approval from the board, the office of health 2 information technology shall establish appropriate security 3 standards, policies, and procedures to protect the transmission 4 and receipt of individually identifiable health information 5 exchanged through the health information network. The security 6 standards, policies, and procedures shall, at a minimum, comply 7 with the Health Insurance Portability and Accountability Act 8 security rule pursuant to 45 C.F.R. pt. 164, subpt. C, and 9 shall reflect all of the following: 10 a. Include authorization controls, including the 11 responsibility to authorize, maintain, and terminate a 12 participant’s use of the health information network. 13 b. Require authentication controls to verify the identity 14 and role of the participant using the health information 15 network. 16 c. Include role-based access controls to restrict 17 functionality and information available through the health 18 information network. 19 d. Include a secure and traceable electronic audit system 20 to document and monitor the sender and the recipient of health 21 information exchanged through the health information network. 22 e. Require standard participation and data sharing 23 agreements which define the minimum privacy and security 24 obligations of all participants using the health information 25 network and health information network services. 26 f. Include controls over access to and the collection, 27 organization, and maintenance of records and data for 28 purposes of research or population health that protect the 29 confidentiality of consumers who are the subject of the health 30 information. 31 2. a. A patient shall have the opportunity to decline 32 exchange of their health information through the health 33 information network. The board shall provide by rule the means 34 and process by which patients may decline participation. A 35 -127- SF 542 (3) 84 pf/jp 127/ 209
S.F. 542 patient shall not be denied care or treatment for declining 1 to exchange their health information, in whole or in part, 2 through the health information network. The means and process 3 utilized under the rules shall minimize the burden on patients 4 and providers. 5 b. Unless otherwise authorized by law or rule, a patient’s 6 decision to decline participation means that none of the 7 patient’s health information shall be exchanged through the 8 health information network. If a patient does not decline 9 participation, the patient’s health information may be 10 exchanged through the health information network except as 11 follows: 12 (1) If health information associated with a patient 13 visit with a provider is protected by state law that is 14 more restrictive than the Health Insurance Portability and 15 Accountability Act, a patient shall have the right to decline 16 sharing of health information through the health information 17 network from such visit as provided by rule. 18 (2) With the consent of the patient, a provider may 19 limit health information associated with a patient visit 20 from being shared through the health information network if 21 such limitation is reasonably determined by the provider, in 22 consultation with the patient, to be in the best interest of 23 the patient as provided by rule. 24 c. A patient who declines participation in the health 25 information network may later decide to have health information 26 shared through the health information network. A patient who 27 is participating in the health information network may later 28 decline participation in the health information network. 29 3. The office shall develop and distribute educational 30 tools and information for consumers, patients, and providers to 31 inform them about the health information network, including but 32 not limited to the safeguards available to prevent unauthorized 33 disclosure of health information and a patient’s right to 34 decline participation in the health information network. 35 -128- SF 542 (3) 84 pf/jp 128/ 209
S.F. 542 4. a. A participant shall not release or use protected 1 health information exchanged through the health information 2 network for purposes unrelated to prevention, treatment, 3 payment, or health care operations unless otherwise authorized 4 or required by law. Participants shall limit the use and 5 disclosure of protected health information to the minimum 6 amount required to accomplish the intended purpose of the use 7 or request, in compliance with the Health Insurance Portability 8 and Accountability Act and other applicable federal law. Use 9 or distribution of the information for a marketing purpose, as 10 defined by the Health Insurance Portability and Accountability 11 Act, is strictly prohibited. 12 b. The department, the office, and all persons using the 13 health information network shall be individually responsible 14 for following breach notification policies as provided by the 15 Health Insurance Portability and Accountability Act. 16 c. A participant shall not be compelled by subpoena, court 17 order, or other process of law to access health information 18 through the health information network in order to gather 19 records or information not created by the participant. 20 5. a. If a patient has declined participation in the health 21 information network, the patient’s health information may be 22 released to a provider through the health information network 23 if all of the following circumstances exist: 24 (1) The patient is unable to provide consent due to 25 incapacitation. 26 (2) The requesting provider believes, in good faith, that 27 the information is necessary to prevent imminent serious injury 28 to the patient. Imminent serious injury includes but it not 29 limited to death, injury or disease that creates a substantial 30 risk of death, or injury or disease that causes protracted loss 31 or impairment of any organ or body system. 32 (3) Such information cannot otherwise be readily obtained. 33 b. The department shall provide by rule for the reporting of 34 emergency access and use by a provider. 35 -129- SF 542 (3) 84 pf/jp 129/ 209
S.F. 542 6. All participants exchanging health information and 1 data through the health information network shall grant to 2 participants of the health information network a nonexclusive 3 license to retrieve and use that information or data in 4 accordance with applicable state and federal laws, and the 5 policies, procedures, and rules established by the board. 6 7. The department shall establish by rule the procedures for 7 a patient who is the subject of health information to do all of 8 the following: 9 a. Receive notice of a violation of the confidentiality 10 provisions required under this chapter. 11 b. Upon request to the department, view an audit report 12 created under this chapter for the purpose of monitoring access 13 to the patient’s records. 14 8. a. A provider who relies reasonably and in good faith 15 upon any health information provided through the health 16 information network in treatment of a patient shall be immune 17 from criminal or civil liability arising from any damages 18 caused by such reasonable, good faith reliance. Such immunity 19 shall not apply to acts or omissions constituting negligence, 20 recklessness, or intentional misconduct. 21 b. A participant that has disclosed health information 22 through the health information network in compliance with 23 applicable law and the standards, requirements, policies, 24 procedures, and agreements of the health information network 25 shall not be subject to criminal or civil liability for the use 26 or disclosure of the health information by another participant. 27 9. a. Notwithstanding chapter 22, the following records 28 shall be kept confidential, unless otherwise ordered by a court 29 or consented to by the patient or by a person duly authorized 30 to release such information: 31 (1) The protected health information contained in, stored 32 in, submitted to, transferred or exchanged by, or released from 33 the health information network. 34 (2) Any protected health information in the possession of 35 -130- SF 542 (3) 84 pf/jp 130/ 209
S.F. 542 Iowa e-health or the department due to its administration of 1 the health information network. 2 b. Unless otherwise provided in this chapter, when using 3 the health information network for the purpose of patient 4 treatment, a provider is exempt from any other state law that 5 is more restrictive than the Health Insurance Portability and 6 Accountability Act that would otherwise prevent or hinder the 7 exchange of patient information by the patient’s providers. 8 Sec. 120. NEW SECTION . 135D.9 Iowa e-health —— health 9 information network services. 10 Iowa e-health shall facilitate services through the health 11 information network or through other marketplace mechanisms 12 to improve the quality, safety, and efficiency of health care 13 available to consumers. These services shall include but are 14 not limited to all of the following: 15 1. Patient summary records such as continuity of care 16 documents. 17 2. A provider directory and provider messaging. 18 3. Clinical orders and results. 19 4. Public health reporting such as electronic reporting to 20 the statewide immunization registry and reportable diseases. 21 5. Medication history. 22 Sec. 121. NEW SECTION . 135D.10 Governance review and 23 transition. 24 1. a. The Iowa e-health governance structure shall continue 25 during the first two years of the term of the state health 26 information exchange cooperative agreement with the office of 27 the national coordinator for health information technology 28 to address the development of policies and procedures; 29 dissemination of interoperability standards; the initiation, 30 testing, and operation of the health information network 31 infrastructure; and the evolution of health information network 32 services to improve patient care for the population. 33 b. Following the end of the first two years of the term 34 of the cooperative agreement, the board and the department 35 -131- SF 542 (3) 84 pf/jp 131/ 209
S.F. 542 shall review the Iowa e-health governance structure, operations 1 of the health information network, and the business and 2 sustainability plan to determine if the existing Iowa e-health 3 governance structure should continue or should be replaced by 4 any of the following: 5 (1) A public authority or similar body with broad 6 stakeholder representation on its governing board. 7 (2) A not-for-profit entity with broad stakeholder 8 representation on its governing board. 9 2. If the board and department determine that the governance 10 structure should be replaced, Iowa e-health shall develop 11 a transition plan to transfer the responsibilities for the 12 domains specified in section 135D.3. 13 Sec. 122. Section 136.3, subsection 14, Code 2011, is 14 amended to read as follows: 15 14. Perform those duties authorized pursuant to sections 16 135.156 , 135.159 , and 135.161 , and other provisions of law. 17 Sec. 123. Section 249J.14, subsection 2, paragraphs a and b, 18 Code 2011, are amended to read as follows: 19 a. Design and implement a program for distribution 20 and monitoring of provider incentive payments, including 21 development of a definition of “meaningful use” for purposes 22 of promoting the use of electronic medical recordkeeping by 23 providers. The department shall develop this program in 24 collaboration with the department of public health and the 25 electronic health information advisory council and executive 26 committee board of directors and the advisory council to the 27 board of Iowa e-health created pursuant to section 135.156 28 135D.4 . 29 b. Develop the medical assistance health information 30 technology plan as required by the centers for Medicare and 31 Medicaid services of the United States department of health and 32 human services. The plan shall provide detailed implementation 33 plans for the medical assistance program for promotion of the 34 adoption and meaningful use of health information technology by 35 -132- SF 542 (3) 84 pf/jp 132/ 209
S.F. 542 medical assistance providers and the Iowa Medicaid enterprise. 1 The plan shall include the integration of health information 2 technology and the health information exchange network with the 3 medical assistance management information system. The plan 4 shall be developed in collaboration with the department of 5 public health and the electronic health information advisory 6 council and executive committee board of directors and the 7 advisory council to the board of Iowa e-health created pursuant 8 to section 135.156 135D.4 . 9 Sec. 124. INITIAL APPOINTMENTS —— BOARD. 10 1. The initial appointments of board member positions 11 described in section 135D.4, as enacted by this division of 12 this Act, shall have staggered terms as follows: 13 a. The board members designated by the Iowa collaborative 14 safety net provider network and the Iowa medical society, shall 15 have initial terms of two years, after which the members shall 16 serve four-year terms. 17 b. The board members designated by the two largest health 18 care systems in the state, the university of Iowa hospitals 19 and clinics, and the Iowa hospital association, shall have 20 initial terms of four years, after which the members shall 21 serve four-year terms. 22 c. The board members designated by the federation of Iowa 23 insurers shall serve initial terms of six years, after which 24 the members shall serve four-year terms. 25 2. With the exception of board members who are 26 representatives of state agencies and not subject to term 27 limits as provided in section 135D.4, board members appointed 28 under this section may serve an additional four-year term, 29 with the exception of those board members initially serving a 30 two-year term, who may serve two consecutive four-year terms 31 following the initial two-year term. 32 Sec. 125. REPEAL. Sections 135.154, 135.155, and 135.156, 33 Code 2011, are repealed. 34 Sec. 126. TRANSITION PROVISIONS. Notwithstanding any 35 -133- SF 542 (3) 84 pf/jp 133/ 209
S.F. 542 other provision of this division of this Act, the department 1 of public health, and the executive committee and the advisory 2 council created pursuant to section 135.156, shall continue to 3 exercise the powers and duties specified under that section 4 until such time as all board members have been appointed as 5 provided in section 135D.4, as enacted by this division of this 6 Act. 7 Sec. 127. EFFECTIVE DATE. The sections of this division of 8 this Act repealing sections 135.154, 135.155, and 135.156, and 9 amending sections 136.3 and 249J.14, take effect on the date 10 all board members are appointed as provided in section 135D.4, 11 as enacted by this division of this Act. The department of 12 public health shall notify the Code editor of such date. 13 Sec. 128. EFFECTIVE UPON ENACTMENT AND RETROACTIVE 14 APPLICABILITY. Except as otherwise provided by this division 15 of this Act, this division of this Act, being deemed of 16 immediate importance, takes effect upon enactment and if 17 approved by the governor on or after July 1, 2011, applies 18 retroactively to June 30, 2011. 19 DIVISION XV 20 DEPARTMENT ON AGING —— FY 2012-2013 21 Sec. 129. DEPARTMENT ON AGING. There is appropriated from 22 the general fund of the state to the department on aging for 23 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 aging programs for the department on aging and area 27 agencies on aging to provide citizens of Iowa who are 60 years 28 of age and older with case management for frail elders, Iowa’s 29 aging and disabilities resource center, and other services 30 which may include but are not limited to adult day services, 31 respite care, chore services, information and assistance, 32 and material aid, for information and options counseling for 33 persons with disabilities who are 18 years of age or older, 34 and for salaries, support, administration, maintenance, and 35 -134- SF 542 (3) 84 pf/jp 134/ 209
S.F. 542 miscellaneous purposes, and for not more than the following 1 full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,151,289 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 35.00 4 1. Funds appropriated in this section may be used to 5 supplement federal funds under federal regulations. To 6 receive funds appropriated in this section, a local area 7 agency on aging shall match the funds with moneys from other 8 sources according to rules adopted by the department. Funds 9 appropriated in this section may be used for elderly services 10 not specifically enumerated in this section only if approved 11 by an area agency on aging for provision of the service within 12 the area. 13 2. The amount appropriated in this section includes 14 additional funding of $225,000 for delivery of long-term care 15 services to seniors with low or moderate incomes. 16 3. Of the funds appropriated in this section, $89,973 shall 17 be transferred to the department of economic development for 18 the Iowa commission on volunteer services to be used for the 19 retired and senior volunteer program. 20 4. a. The department on aging shall establish and enforce 21 procedures relating to expenditure of state and federal funds 22 by area agencies on aging that require compliance with both 23 state and federal laws, rules, and regulations, including but 24 not limited to all of the following: 25 (1) Requiring that expenditures are incurred only for goods 26 or services received or performed prior to the end of the 27 fiscal period designated for use of the funds. 28 (2) Prohibiting prepayment for goods or services not 29 received or performed prior to the end of the fiscal period 30 designated for use of the funds. 31 (3) Prohibiting the prepayment for goods or services 32 not defined specifically by good or service, time period, or 33 recipient. 34 (4) Prohibiting the establishment of accounts from which 35 -135- SF 542 (3) 84 pf/jp 135/ 209
S.F. 542 future goods or services which are not defined specifically by 1 good or service, time period, or recipient, may be purchased. 2 b. The procedures shall provide that if any funds are 3 expended in a manner that is not in compliance with the 4 procedures and applicable federal and state laws, rules, and 5 regulations, and are subsequently subject to repayment, the 6 area agency on aging expending such funds in contravention of 7 such procedures, laws, rules and regulations, not the state, 8 shall be liable for such repayment. 9 DIVISION XVI 10 DEPARTMENT OF PUBLIC HEALTH —— FY 2012-2013 11 Sec. 130. DEPARTMENT OF PUBLIC HEALTH. There is 12 appropriated from the general fund of the state to the 13 department of public health for the fiscal year beginning July 14 1, 2012, and ending June 30, 2013, the following amounts, or 15 so much thereof as is necessary, to be used for the purposes 16 designated: 17 1. ADDICTIVE DISORDERS 18 For reducing the prevalence of use of tobacco, alcohol, and 19 other drugs, and treating individuals affected by addictive 20 behaviors, including gambling, and for not more than the 21 following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,301,595 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 24 a. (1) Of the funds appropriated in this subsection, 25 $2,176,916 shall be used for the tobacco use prevention and 26 control initiative, including efforts at the state and local 27 levels, as provided in chapter 142A. 28 (2) Of the funds allocated in this paragraph “a”, $226,915 29 shall be transferred to the alcoholic beverages division of 30 the department of commerce for enforcement of tobacco laws, 31 regulations, and ordinances in accordance with 2011 Iowa Acts, 32 House File 467, as enacted. 33 b. Of the funds appropriated in this subsection, 34 $10,124,680 shall be used for problem gambling and substance 35 -136- SF 542 (3) 84 pf/jp 136/ 209
S.F. 542 abuse prevention, treatment, and recovery services, including a 1 24-hour helpline, public information resources, professional 2 training, and program evaluation. 3 (1) Of the funds allocated in this paragraph “b”, $8,566,254 4 shall be used for substance abuse prevention and treatment. 5 (a) Of the funds allocated in this subparagraph (1), 6 $449,650 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), $213,770 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), $213,420 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 division 27 (a), up to $22,461 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 $136,531 shall be used for culturally competent substance abuse 31 treatment pilot projects. 32 (i) The department shall utilize the amount allocated 33 in this subparagraph division (b) for at least three pilot 34 projects to provide culturally competent substance abuse 35 -137- SF 542 (3) 84 pf/jp 137/ 209
S.F. 542 treatment in various areas of the state. Each pilot project 1 shall target a particular ethnic minority population. The 2 populations targeted shall include but are not limited to 3 African American, 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 $1,558,426 may be used for problem gambling prevention, 11 treatment, and recovery services. 12 (a) Of the funds allocated in this subparagraph (2), 13 $1,289,500 shall be used for problem gambling prevention and 14 treatment. 15 (b) Of the funds allocated in this subparagraph (2), up to 16 $218,926 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 $50,000 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 -138- SF 542 (3) 84 pf/jp 138/ 209
S.F. 542 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 problem 3 gambling treatment shall include problem gambling prevention. 4 (2) The system for delivery of substance abuse and problem 5 gambling treatment shall include substance abuse prevention by 6 July 1, 2014. 7 (3) Of the funds allocated in paragraph “b”, the department 8 may use up to $50,000 for administrative costs to continue 9 developing and implementing the process in accordance with this 10 paragraph “c”. 11 d. The requirement of section 123.53, subsection 5, is met 12 by the appropriations and allocations made in this Act for 13 purposes of substance abuse treatment and addictive disorders 14 for the fiscal year beginning July 1, 2012. 15 e. The department of public health shall work with all other 16 departments that fund substance abuse prevention and treatment 17 services and all such departments shall, to the extent 18 necessary, collectively meet the state maintenance of effort 19 requirements for expenditures for substance abuse services 20 as required under the federal substance abuse prevention and 21 treatment block grant. 22 f. The department shall amend or otherwise revise 23 departmental policies and contract provisions in order to 24 eliminate free t-shirt distribution, banner production, and 25 other unnecessary promotional expenditures. 26 2. HEALTHY CHILDREN AND FAMILIES 27 For promoting the optimum health status for children, 28 adolescents from birth through 21 years of age, and families, 29 and for not more than the following full-time equivalent 30 positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,297,135 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 33 a. Of the funds appropriated in this subsection, not more 34 than $369,659 shall be used for the healthy opportunities to 35 -139- SF 542 (3) 84 pf/jp 139/ 209
S.F. 542 experience success (HOPES)-healthy families Iowa (HFI) program 1 established pursuant to section 135.106. The funding shall 2 be distributed to renew the grants that were provided to the 3 grantees that operated the program during the fiscal year 4 ending June 30, 2012. 5 b. Of the funds appropriated in this subsection, $164,943 6 shall be used to continue to address the healthy mental 7 development of children from birth through five years of age 8 through local evidence-based strategies that engage both the 9 public and private sectors in promoting healthy development, 10 prevention, and treatment for children. A portion of the 11 funds allocated in this lettered paragraph may be used for a 12 full-time equivalent position to coordinate the activities 13 under this paragraph. 14 c. Of the funds appropriated in this subsection, $15,799 15 shall be distributed to a statewide dental carrier to provide 16 funds to continue the donated dental services program patterned 17 after the projects developed by the lifeline network to provide 18 dental services to indigent elderly and disabled individuals. 19 d. Of the funds appropriated in this subsection, $56,339 20 shall be used for childhood obesity prevention. 21 e. Of the funds appropriated in this subsection, $81,880 22 shall be used to provide audiological services and hearing 23 aids for children. The department may enter into a contract 24 to administer this paragraph. 25 3. CHRONIC CONDITIONS 26 For serving individuals identified as having chronic 27 conditions or special health care needs, and for not more than 28 the following full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,699,578 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 31 a. Of the funds appropriated in this subsection, $80,291 32 shall be used for grants to individual patients who have 33 phenylketonuria (PKU) to assist with the costs of necessary 34 special foods. 35 -140- SF 542 (3) 84 pf/jp 140/ 209
S.F. 542 b. Of the funds appropriated in this subsection, $241,800 1 is allocated for continuation of the contracts for resource 2 facilitator services in accordance with section 135.22B, 3 subsection 9, and for brain injury training services and 4 recruiting of service providers to increase the capacity within 5 this state to address the needs of individuals with brain 6 injuries and such individuals’ families. 7 c. Of the funds appropriated in this subsection, $249,437 8 shall be used as additional funding to leverage federal funding 9 through the federal Ryan White Care Act, Tit. II, AIDS drug 10 assistance program supplemental drug treatment grants. 11 d. Of the funds appropriated in this subsection, $15,627 12 shall be used for the public purpose of providing a grant to an 13 existing national-affiliated organization to provide education, 14 client-centered programs, and client and family support for 15 people living with epilepsy and their families. 16 e. Of the funds appropriated in this subsection, $394,152 17 shall be used for child health specialty clinics. 18 f. Of the funds appropriated in this subsection, $273,533 19 shall be used for the comprehensive cancer control program to 20 reduce the burden of cancer in Iowa through prevention, early 21 detection, effective treatment, and ensuring quality of life. 22 Of the funds allocated in this lettered paragraph, $100,000 23 shall be used to support a melanoma research symposium, a 24 melanoma biorepository and registry, basic and translational 25 melanoma research, and clinical trials. 26 g. Of the funds appropriated in this subsection, $63,225 27 shall be used for cervical and colon cancer screening. 28 h. Of the funds appropriated in this subsection, $264,417 29 shall be used for the center for congenital and inherited 30 disorders. A portion of the funds allocated in this paragraph 31 may be used for one full-time equivalent position for 32 administration of the center. 33 i. Of the funds appropriated in this subsection, $64,969 34 shall be used for the prescription drug donation repository 35 -141- SF 542 (3) 84 pf/jp 141/ 209
S.F. 542 program created in chapter 135M. 1 4. COMMUNITY CAPACITY 2 For strengthening the health care delivery system at the 3 local level, and for not more than the following full-time 4 equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,413,350 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 7 a. Of the funds appropriated in this subsection, $50,000 8 is allocated for a child vision screening program implemented 9 through the university of Iowa hospitals and clinics in 10 collaboration with early childhood Iowa areas. 11 b. Of the funds appropriated in this subsection, $55,654 is 12 allocated for continuation of an initiative implemented at the 13 university of Iowa and $50,247 is allocated for continuation of 14 an initiative at the state mental health institute at Cherokee 15 to expand and improve the workforce engaged in mental health 16 treatment and services. The initiatives shall receive input 17 from the university of Iowa, the department of human services, 18 the department of public health, and the mental health, mental 19 retardation, developmental disabilities, and brain injury 20 commission to address the focus of the initiatives. 21 c. Of the funds appropriated in this subsection, $585,746 22 shall be used for essential public health services that promote 23 healthy aging throughout the lifespan, contracted through a 24 formula for local boards of health, to enhance health promotion 25 and disease prevention services. 26 d. Of the funds appropriated in this section, $60,909 shall 27 be deposited in the governmental public health system fund 28 created in section 135A.8 to be used for the purposes of the 29 fund. 30 e. Of the funds appropriated in this subsection, $72,271 31 shall be used for the mental health professional shortage area 32 program implemented pursuant to section 135.80. 33 f. Of the funds appropriated in this subsection, 34 $19,132 shall be used for a grant to a statewide association 35 -142- SF 542 (3) 84 pf/jp 142/ 209
S.F. 542 of psychologists that is affiliated with the American 1 psychological association to be used for continuation of a 2 program to rotate intern psychologists in placements in urban 3 and rural mental health professional shortage areas, as defined 4 in section 135.80. 5 g. Of the funds appropriated in this subsection, the 6 following amounts shall be allocated to the Iowa collaborative 7 safety net provider network established pursuant to section 8 135.153 to be used for the purposes designated. The following 9 amounts allocated under this lettered paragraph shall be 10 distributed to the specified provider and shall not be reduced 11 for administrative or other costs prior to distribution: 12 (1) For distribution to the Iowa primary care association 13 for statewide coordination of the Iowa collaborative safety net 14 provider network: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,290 16 (2) For distribution to the Iowa family planning network 17 agencies for necessary infrastructure, statewide coordination, 18 provider recruitment, service delivery, and provision of 19 assistance to patients in determining an appropriate medical 20 home: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 37,259 22 (3) For distribution to the local boards of health that 23 provide direct services for pilot programs in three counties to 24 assist patients in determining an appropriate medical home: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 37,259 26 (4) For distribution to maternal and child health centers 27 for pilot programs in three counties to assist patients in 28 determining an appropriate medical home: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 37,259 30 (5) For distribution to free clinics for necessary 31 infrastructure, statewide coordination, provider recruitment, 32 service delivery, and provision of assistance to patients in 33 determining an appropriate medical home: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,025 35 -143- SF 542 (3) 84 pf/jp 143/ 209
S.F. 542 (6) For distribution to rural health clinics for necessary 1 infrastructure, statewide coordination, provider recruitment, 2 service delivery, and provision of assistance to patients in 3 determining an appropriate medical home: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 55,215 5 (7) For continuation of the safety net provider patient 6 access to specialty health care initiative as described in 2007 7 Iowa Acts, chapter 218, section 109: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 130,000 9 (8) For continuation of the pharmaceutical infrastructure 10 for safety net providers as described in 2007 Iowa Acts, 11 chapter 218, section 108: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 135,000 13 The Iowa collaborative safety net provider network may 14 continue to distribute funds allocated pursuant to this 15 lettered paragraph through existing contracts or renewal of 16 existing contracts. 17 h. (1) Of the funds appropriated in this subsection, 18 $74,500 shall be used for continued implementation of 19 the recommendations of the direct care worker task force 20 established pursuant to 2005 Iowa Acts, chapter 88, based upon 21 the report submitted to the governor and the general assembly 22 in December 2006. The department may use a portion of the 23 funds allocated in this lettered paragraph for an additional 24 position to assist in the continued implementation. 25 (2) It is the intent of the general assembly that a 26 board of direct care workers shall be established within the 27 department of public health by July 1, 2014, contingent upon 28 the availability of funds to establish and maintain the board. 29 i. (1) Of the funds appropriated in this subsection, 30 $65,050 shall be used for allocation to an independent 31 statewide direct care worker association for education, 32 outreach, leadership development, mentoring, and other 33 initiatives intended to enhance the recruitment and retention 34 of direct care workers in health care and long-term care 35 -144- SF 542 (3) 84 pf/jp 144/ 209
S.F. 542 settings. 1 (2) Of the funds appropriated in this subsection, $29,000 2 shall be used to provide scholarships or other forms of 3 subsidization for direct care worker educational conferences, 4 training, or outreach activities. 5 j. 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 k. Of the funds appropriated in this subsection, the 10 department may use up to $29,259 for up to one full-time 11 equivalent position to administer the volunteer health care 12 provider program pursuant to section 135.24. 13 l. Of the funds appropriated in this subsection, $25,000 14 shall be used for a matching dental education loan repayment 15 program to be allocated to a dental nonprofit health service 16 corporation to develop the criteria and implement the loan 17 repayment program. 18 m. Of the funds appropriated in this subsection, up to 19 $67,107 shall be used to support the department’s activities 20 relating to health and long-term care access as specified 21 pursuant to chapter 135, division XXIV. 22 n. Of the funds appropriated in this subsection, 23 $181,994 shall be used as state matching funds for the health 24 information network as enacted by this Act. 25 o. Of the funds appropriated in this subsection, $12,500 26 shall be used for continuation of a pilot program established 27 through a grant to an organization that has an existing 28 program for children and adults and that is solely dedicated 29 to preserving sight and preventing blindness to provide vision 30 screening to elementary school children in one urban and one 31 rural school district in the state, on a voluntary basis, over 32 a multiyear period. The grantee organization shall develop 33 protocol for participating schools including the grade level 34 of the children to be screened, the training and certification 35 -145- SF 542 (3) 84 pf/jp 145/ 209
S.F. 542 necessary for individuals conducting the vision screening, 1 vision screening equipment requirements, and documentation and 2 tracking requirements. Following the conclusion of the pilot 3 program, the grantee organization shall report findings and 4 recommendations for statewide implementation of the vision 5 screening program to the department of public health. 6 5. HEALTHY AGING 7 To provide public health services that reduce risks and 8 invest in promoting and protecting good health over the 9 course of a lifetime with a priority given to older Iowans and 10 vulnerable populations: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,668,071 12 a. Of the funds appropriated in this subsection, $1,004,594 13 shall be used for local public health nursing services. 14 b. Of the funds appropriated in this subsection, $2,663,477 15 shall be used for home care aide services. 16 6. ENVIRONMENTAL HAZARDS 17 For reducing the public’s exposure to hazards in the 18 environment, primarily chemical hazards, and for not more than 19 the following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 406,889 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 22 Of the funds appropriated in this subsection, $272,189 shall 23 be used for childhood lead poisoning provisions. 24 7. INFECTIOUS DISEASES 25 For reducing the incidence and prevalence of communicable 26 diseases, and for not more than the following full-time 27 equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 672,924 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 30 8. PUBLIC PROTECTION 31 For protecting the health and safety of the public through 32 establishing standards and enforcing regulations, and for not 33 more than the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,389,344 35 -146- SF 542 (3) 84 pf/jp 146/ 209
S.F. 542 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 125.00 1 a. Of the funds appropriated in this subsection, not more 2 than $212,073 shall be credited to the emergency medical 3 services fund created in section 135.25. Moneys in the 4 emergency medical services fund are appropriated to the 5 department to be used for the purposes of the fund. 6 b. Of the funds appropriated in this subsection, $105,310 7 shall be used for sexual violence prevention programming 8 through a statewide organization representing programs serving 9 victims of sexual violence through the department’s sexual 10 violence prevention program. The amount allocated in this 11 lettered paragraph shall not be used to supplant funding 12 administered for other sexual violence prevention or victims 13 assistance programs. 14 c. Of the funds appropriated in this subsection, not more 15 than $218,291 shall be used for the state poison control 16 center. 17 d. Of the funds appropriated in this subsection, $25,000 18 shall be used for education, testing, training, and other costs 19 to conform the requirements for certification of emergency 20 medical care providers with national standards. 21 9. RESOURCE MANAGEMENT 22 For establishing and sustaining the overall ability of the 23 department to deliver services to the public, and for not more 24 than the following full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 409,777 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 7.00 27 The university of Iowa hospitals and clinics under the 28 control of the state board of regents shall not receive 29 indirect costs from the funds appropriated in this section. 30 The university of Iowa hospitals and clinics billings to the 31 department shall be on at least a quarterly basis. 32 DIVISION XVII 33 DEPARTMENT OF VETERANS AFFAIRS —— FY 2012-2013 34 Sec. 131. DEPARTMENT OF VETERANS AFFAIRS. There is 35 -147- SF 542 (3) 84 pf/jp 147/ 209
S.F. 542 appropriated from the general fund of the state to the 1 department of veterans affairs for the fiscal year beginning 2 July 1, 2012, and ending June 30, 2013, the following amounts, 3 or so much thereof as is necessary, to be used for the purposes 4 designated: 5 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 6 For salaries, support, maintenance, and miscellaneous 7 purposes, including the war orphans educational assistance fund 8 created in section 35.8, and for not more than the following 9 full-time equivalent positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 499,416 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.34 12 2. IOWA VETERANS HOME 13 For salaries, support, maintenance, and miscellaneous 14 purposes: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,476,076 16 a. The Iowa veterans home billings involving the department 17 of human services shall be submitted to the department on at 18 least a monthly basis. 19 b. If there is a change in the employer of employees 20 providing services at the Iowa veterans home under a collective 21 bargaining agreement, such employees and the agreement shall 22 be continued by the successor employer as though there had not 23 been a change in employer. 24 c. Within available resources and in conformance with 25 associated state and federal program eligibility requirements, 26 the Iowa veterans home may implement measures to provide 27 financial assistance to or on behalf of veterans or their 28 spouses participating in the community reentry program. 29 3. STATE EDUCATIONAL ASSISTANCE —— CHILDREN OF DECEASED 30 VETERANS 31 For provision of educational assistance pursuant to section 32 35.9: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,208 34 Sec. 132. LIMITATION OF COUNTY COMMISSION OF VETERANS 35 -148- SF 542 (3) 84 pf/jp 148/ 209
S.F. 542 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 1 standing appropriation in the following designated section for 2 the fiscal year beginning July 1, 2012, and ending June 30, 3 2013, the amounts appropriated from the general fund of the 4 state pursuant to that section for the following designated 5 purposes shall not exceed the following amount: 6 For the county commissions of veterans affairs fund under 7 section 35A.16: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 495,000 9 DIVISION XVIII 10 DEPARTMENT OF HUMAN SERVICES —— FY 2012-2013 11 Sec. 133. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 12 GRANT. There is appropriated from the fund created in section 13 8.41 to the department of human services for the fiscal year 14 beginning July 1, 2012, and ending June 30, 2013, from moneys 15 received under the federal temporary assistance for needy 16 families (TANF) block grant pursuant to the federal Personal 17 Responsibility and Work Opportunity Reconciliation Act of 1996, 18 Pub. L. No. 104-193, and successor legislation, and from moneys 19 received under the emergency contingency fund for temporary 20 assistance for needy families state program established 21 pursuant to the federal American Recovery and Reinvestment Act 22 of 2009, Pub. L. No. 111-5 § 2101, and successor legislation, 23 the following amounts, or so much thereof as is necessary, to 24 be used for the purposes designated: 25 1. To be credited to the family investment program account 26 and used for assistance under the family investment program 27 under chapter 239B: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,750,369 29 2. To be credited to the family investment program account 30 and used for the job opportunities and basic skills (JOBS) 31 program and implementing family investment agreements in 32 accordance with chapter 239B: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,205,764 34 3. To be used for the family development and 35 -149- SF 542 (3) 84 pf/jp 149/ 209
S.F. 542 self-sufficiency grant program in accordance with section 1 216A.107: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,449,490 3 Notwithstanding section 8.33, moneys appropriated in this 4 subsection that remain unencumbered or unobligated at the close 5 of the fiscal year shall not revert but shall remain available 6 for expenditure for the purposes designated until the close of 7 the succeeding fiscal year. However, unless such moneys are 8 encumbered or obligated on or before September 30, 2013, the 9 moneys shall revert. 10 4. For field operations: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,648,116 12 5. For general administration: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,872,000 14 6. For state child care assistance: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,191,344 16 The funds appropriated in this subsection shall be 17 transferred to the child care and development block grant 18 appropriation made by the Eighty-fourth General Assembly, 2012 19 Session, for the federal fiscal year beginning October 1, 20 2012, and ending September 30, 2013. Of this amount, $100,000 21 shall be used for provision of educational opportunities to 22 registered child care home providers in order to improve 23 services and programs offered by this category of providers 24 and to increase the number of providers. The department may 25 contract with institutions of higher education or child care 26 resource and referral centers to provide the educational 27 opportunities. Allowable administrative costs under the 28 contracts shall not exceed 5 percent. The application for a 29 grant shall not exceed two pages in length. 30 7. For mental health and developmental disabilities 31 community services: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,447,026 33 8. For child and family services: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,042,215 35 -150- SF 542 (3) 84 pf/jp 150/ 209
S.F. 542 9. For child abuse prevention grants: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,500 2 10. For pregnancy prevention grants on the condition that 3 family planning services are funded: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 965,034 5 Pregnancy prevention grants shall be awarded to programs 6 in existence on or before July 1, 2012, if the programs are 7 comprehensive in scope and have demonstrated positive outcomes. 8 Grants shall be awarded to pregnancy prevention programs 9 which are developed after July 1, 2012, if the programs are 10 comprehensive in scope and are based on existing models that 11 have demonstrated positive outcomes. Grants shall comply with 12 the requirements provided in 1997 Iowa Acts, chapter 208, 13 section 14, subsections 1 and 2, including the requirement that 14 grant programs must emphasize sexual abstinence. Priority in 15 the awarding of grants shall be given to programs that serve 16 areas of the state which demonstrate the highest percentage of 17 unplanned pregnancies of females of childbearing age within the 18 geographic area to be served by the grant. 19 11. For technology needs and other resources necessary 20 to meet federal welfare reform reporting, tracking, and case 21 management requirements: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 518,593 23 12. To be credited to the state child care assistance 24 appropriation made in this section to be used for funding of 25 community-based early childhood programs targeted to children 26 from birth through five years of age developed by early 27 childhood Iowa areas as provided in section 256I.11: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,175,000 29 The department shall transfer TANF block grant funding 30 appropriated and allocated in this subsection to the child care 31 and development block grant appropriation in accordance with 32 federal law as necessary to comply with the provisions of this 33 subsection. 34 13. a. Notwithstanding any provision to the contrary, 35 -151- SF 542 (3) 84 pf/jp 151/ 209
S.F. 542 including but not limited to requirements in section 8.41 or 1 provisions in 2011 or 2012 Iowa Acts regarding the receipt 2 and appropriation of federal block grants, federal funds 3 from the emergency contingency fund for temporary assistance 4 for needy families state program established pursuant to the 5 federal American Recovery and Reinvestment Act of 2009, Pub. 6 L. No. 111-5 § 2101, received by the state during the fiscal 7 year beginning July 1, 2011, and ending June 30, 2012, not 8 otherwise appropriated in this section and remaining available 9 as of July 1, 2012, and received by the state during the fiscal 10 year beginning July 1, 2012, and ending June 30, 2013, are 11 appropriated to the extent as may be necessary to be used in 12 the following priority order: the family investment program 13 for the fiscal year and for state child care assistance program 14 payments for individuals enrolled in the family investment 15 program who are employed. The federal funds appropriated in 16 this paragraph “a” shall be expended only after all other 17 funds appropriated in subsection 1 for the assistance under 18 the family investment program under chapter 239B have been 19 expended. 20 b. The department shall, on a quarterly basis, advise the 21 legislative services agency and department of management of 22 the amount of funds appropriated in this subsection that was 23 expended in the prior quarter. 24 14. Of the amounts appropriated in this section, 25 $6,481,004 for the fiscal year beginning July 1, 2012, shall be 26 transferred to the appropriation of the federal social services 27 block grant made for that fiscal year. 28 15. For continuation of the program allowing the department 29 to maintain categorical eligibility for the food assistance 30 program as required under the section of this division relating 31 to the family investment account: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 73,036 33 16. The department may transfer funds allocated in this 34 section to the appropriations made in this division of this Act 35 -152- SF 542 (3) 84 pf/jp 152/ 209
S.F. 542 for general administration and field operations for resources 1 necessary to implement and operate the services referred to in 2 this section and those funded in the appropriation made in this 3 division of this Act for the family investment program from the 4 general fund of the state. 5 Sec. 134. FAMILY INVESTMENT PROGRAM ACCOUNT. 6 1. Moneys credited to the family investment program (FIP) 7 account for the fiscal year beginning July 1, 2012, and 8 ending June 30, 2013, shall be used to provide assistance in 9 accordance with chapter 239B. 10 2. The department may use a portion of the moneys credited 11 to the FIP account under this section as necessary for 12 salaries, support, maintenance, and miscellaneous purposes. 13 3. The department may transfer funds allocated in this 14 section to the appropriations in this division of this Act 15 for general administration and field operations for resources 16 necessary to implement and operate the services referred to in 17 this section and those funded in the appropriation made in this 18 division of this Act for the family investment program from the 19 general fund of the state. 20 4. Moneys appropriated in this division of this Act and 21 credited to the FIP account for the fiscal year beginning July 22 1, 2012, and ending June 30, 2013, are allocated as follows: 23 a. To be retained by the department of human services to 24 be used for coordinating with the department of human rights 25 to more effectively serve participants in the FIP program and 26 other shared clients and to meet federal reporting requirements 27 under the federal temporary assistance for needy families block 28 grant: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 30 b. To the department of human rights for staffing, 31 administration, and implementation of the family development 32 and self-sufficiency grant program in accordance with section 33 216A.107: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,671,417 35 -153- SF 542 (3) 84 pf/jp 153/ 209
S.F. 542 (1) Of the funds allocated for the family development and 1 self-sufficiency grant program in this lettered paragraph, 2 not more than 5 percent of the funds shall be used for the 3 administration of the grant program. 4 (2) The department of human rights may continue to implement 5 the family development and self-sufficiency grant program 6 statewide during fiscal year 2012-2013. 7 c. For the diversion subaccount of the FIP account: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 849,200 9 A portion of the moneys allocated for the subaccount may 10 be used for field operations salaries, data management system 11 development, and implementation costs and support deemed 12 necessary by the director of human services in order to 13 administer the FIP diversion program. 14 d. For the food stamp employment and training program: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,294 16 (1) The department shall amend the food stamp employment and 17 training state plan in order to maximize to the fullest extent 18 permitted by federal law the use of the 50-50 match provisions 19 for the claiming of allowable federal matching funds from the 20 United States department of agriculture pursuant to the federal 21 food stamp employment and training program for providing 22 education, employment, and training services for eligible food 23 assistance program participants, including but not limited to 24 related dependent care and transportation expenses. 25 (2) The department shall continue the categorical federal 26 food assistance program eligibility at 160 percent of the 27 federal poverty level and continue to eliminate the asset test 28 from eligibility requirements, consistent with federal food 29 assistance program requirements. The department shall include 30 as many food assistance households as is allowed by federal 31 law. The eligibility provisions shall conform to all federal 32 requirements including requirements addressing individuals who 33 are incarcerated or otherwise ineligible. 34 e. For the JOBS program: 35 -154- SF 542 (3) 84 pf/jp 154/ 209
S.F. 542 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,117,953 1 5. Of the child support collections assigned under FIP, 2 an amount equal to the federal share of support collections 3 shall be credited to the child support recovery appropriation 4 made in this division of this Act. Of the remainder of the 5 assigned child support collections received by the child 6 support recovery unit, a portion shall be credited to the FIP 7 account, a portion may be used to increase recoveries, and a 8 portion may be used to sustain cash flow in the child support 9 payments account. If as a consequence of the appropriations 10 and allocations made in this section the resulting amounts 11 are insufficient to sustain cash assistance payments and meet 12 federal maintenance of effort requirements, the department 13 shall seek supplemental funding. If child support collections 14 assigned under FIP are greater than estimated or are otherwise 15 determined not to be required for maintenance of effort, the 16 state share of either amount may be transferred to or retained 17 in the child support payment account. 18 6. The department may adopt emergency rules for the family 19 investment, JOBS, food stamp, and medical assistance programs 20 if necessary to comply with federal requirements. 21 Sec. 135. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 22 is appropriated from the general fund of the state to the 23 department of human services for the fiscal year beginning July 24 1, 2012, and ending June 30, 2013, the following amount, or 25 so much thereof as is necessary, to be used for the purpose 26 designated: 27 To be credited to the family investment program (FIP) 28 account and used for family investment program assistance under 29 chapter 239B: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,085,514 31 1. Of the funds appropriated in this section, $3,912,189 is 32 allocated for the JOBS program. 33 2. Of the funds appropriated in this section, $1,231,927 is 34 allocated for the family development and self-sufficiency grant 35 -155- SF 542 (3) 84 pf/jp 155/ 209
S.F. 542 program. 1 3. Notwithstanding section 8.39, for the fiscal year 2 beginning July 1, 2012, if necessary to meet federal 3 maintenance of effort requirements or to transfer federal 4 temporary assistance for needy families block grant funding 5 to be used for purposes of the federal social services block 6 grant or to meet cash flow needs resulting from delays in 7 receiving federal funding or to implement, in accordance with 8 this division of this Act, activities currently funded with 9 juvenile court services, county, or community moneys and state 10 moneys used in combination with such moneys, the department 11 of human services may transfer funds within or between any 12 of the appropriations made in this division of this Act and 13 appropriations in law for the federal social services block 14 grant to the department for the following purposes, provided 15 that the combined amount of state and federal temporary 16 assistance for needy families block grant funding for each 17 appropriation remains the same before and after the transfer: 18 a. For the family investment program. 19 b. For child care assistance. 20 c. For child and family services. 21 d. For field operations. 22 e. For general administration. 23 f. MH/MR/DD/BI community services (local purchase). 24 This subsection shall not be construed to prohibit the use 25 of existing state transfer authority for other purposes. The 26 department shall report any transfers made pursuant to this 27 subsection to the legislative services agency. 28 4. Of the funds appropriated in this section, $97,839 shall 29 be used for continuation of a grant to an Iowa-based nonprofit 30 organization with a history of providing tax preparation 31 assistance to low-income Iowans in order to expand the usage of 32 the earned income tax credit. The purpose of the grant is to 33 supply this assistance to underserved areas of the state. 34 Sec. 136. CHILD SUPPORT RECOVERY. There is appropriated 35 -156- SF 542 (3) 84 pf/jp 156/ 209
S.F. 542 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 purposes designated: 4 For child support recovery, including salaries, support, 5 maintenance, and miscellaneous purposes, and for not more than 6 the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,559,628 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 475.00 9 1. The department shall expend up to $12,165, including 10 federal financial participation, for the fiscal year beginning 11 July 1, 2012, for a child support public awareness campaign. 12 The department and the office of the attorney general shall 13 cooperate in continuation of the campaign. The public 14 awareness campaign shall emphasize, through a variety of 15 media activities, the importance of maximum involvement of 16 both parents in the lives of their children as well as the 17 importance of payment of child support obligations. 18 2. Federal access and visitation grant moneys shall be 19 issued directly to private not-for-profit agencies that provide 20 services designed to increase compliance with the child access 21 provisions of court orders, including but not limited to 22 neutral visitation sites and mediation services. 23 3. The appropriation made to the department for child 24 support recovery may be used throughout the fiscal year in the 25 manner necessary for purposes of cash flow management, and for 26 cash flow management purposes the department may temporarily 27 draw more than the amount appropriated, provided the amount 28 appropriated is not exceeded at the close of the fiscal year. 29 4. With the exception of the funding amount specified, the 30 requirements established under 2001 Iowa Acts, chapter 191, 31 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 32 be applicable to parental obligation pilot projects for the 33 fiscal year beginning July 1, 2012, and ending June 30, 2013. 34 Notwithstanding 441 IAC 100.8, providing for termination of 35 -157- SF 542 (3) 84 pf/jp 157/ 209
S.F. 542 rules relating to the pilot projects, the rules shall remain 1 in effect until June 30, 2013. 2 Sec. 137. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE. Any 3 funds remaining in the health care trust fund created in 4 section 453A.35A for the fiscal year beginning July 1, 2012, 5 and ending June 30, 2013, are appropriated to the department 6 of human services to supplement the medical assistance program 7 appropriations made in this Act, for medical assistance 8 reimbursement and associated costs, including program 9 administration and costs associated with implementation. 10 Sec. 138. MEDICAL ASSISTANCE. There is appropriated from 11 the general fund of the state to the department of human 12 services for the fiscal year beginning July 1, 2012, and ending 13 June 30, 2013, the following amount, or so much thereof as is 14 necessary, to be used for the purpose designated: 15 For medical assistance reimbursement and associated costs 16 as specifically provided in the reimbursement methodologies 17 in effect on June 30, 2012, except as otherwise expressly 18 authorized by law, including reimbursement for abortion 19 services which shall be available under the medical assistance 20 program only for those abortions which are medically necessary: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $897,816,915 22 1. Medically necessary abortions are those performed under 23 any of the following conditions: 24 a. The attending physician certifies that continuing the 25 pregnancy would endanger the life of the pregnant woman. 26 b. The attending physician certifies that the fetus is 27 physically deformed, mentally deficient, or afflicted with a 28 congenital illness. 29 c. The pregnancy is the result of a rape which is reported 30 within 45 days of the incident to a law enforcement agency or 31 public or private health agency which may include a family 32 physician. 33 d. The pregnancy is the result of incest which is reported 34 within 150 days of the incident to a law enforcement agency 35 -158- SF 542 (3) 84 pf/jp 158/ 209
S.F. 542 or public or private health agency which may include a family 1 physician. 2 e. Any spontaneous abortion, commonly known as a 3 miscarriage, if not all of the products of conception are 4 expelled. 5 2. The department shall utilize not more than $60,000 of 6 the funds appropriated in this section to continue the AIDS/HIV 7 health insurance premium payment program as established in 1992 8 Iowa Acts, Second Extraordinary Session, chapter 1001, section 9 409, subsection 6. Of the funds allocated in this subsection, 10 not more than $5,000 may be expended for administrative 11 purposes. 12 3. Of the funds appropriated in this Act to the department 13 of public health for addictive disorders, $950,000 for the 14 fiscal year beginning July 1, 2012, shall be transferred to 15 the department of human services for an integrated substance 16 abuse managed care system. The department shall not assume 17 management of the substance abuse system in place of the 18 managed care contractor unless such a change in approach is 19 specifically authorized in law. The departments of human 20 services and public health shall work together to maintain 21 the level of mental health and substance abuse services 22 provided by the managed care contractor through the Iowa plan 23 for behavioral health. Each department shall take the steps 24 necessary to continue the federal waivers as necessary to 25 maintain the level of services. 26 4. a. The department shall aggressively pursue options for 27 providing medical assistance or other assistance to individuals 28 with special needs who become ineligible to continue receiving 29 services under the early and periodic screening, diagnostic, 30 and treatment program under the medical assistance program 31 due to becoming 21 years of age who have been approved for 32 additional assistance through the department’s exception to 33 policy provisions, but who have health care needs in excess 34 of the funding available through the exception to policy 35 -159- SF 542 (3) 84 pf/jp 159/ 209
S.F. 542 provisions. 1 b. Of the funds appropriated in this section, $100,000 2 shall be used for participation in one or more pilot projects 3 operated by a private provider to allow the individual or 4 individuals to receive service in the community in accordance 5 with principles established in Olmstead v. L.C., 527 U.S. 581 6 (1999), for the purpose of providing medical assistance or 7 other assistance to individuals with special needs who become 8 ineligible to continue receiving services under the early and 9 periodic screening, diagnosis, and treatment program under 10 the medical assistance program due to becoming 21 years of 11 age who have been approved for additional assistance through 12 the department’s exception to policy provisions, but who have 13 health care needs in excess of the funding available through 14 the exception to the policy provisions. 15 5. Of the funds appropriated in this section, up to 16 $3,050,082 may be transferred to the field operations 17 or general administration appropriations in this Act for 18 operational costs associated with Part D of the federal 19 Medicare Prescription Drug Improvement and Modernization Act 20 of 2003, Pub. L. No. 108-173. 21 6. Of the funds appropriated in this section, up to $442,100 22 may be transferred to the appropriation in this division 23 of this Act for medical contracts to be used for clinical 24 assessment services and prior authorization of services. 25 7. A portion of the funds appropriated in this section 26 may be transferred to the appropriations in this division of 27 this Act for general administration, medical contracts, the 28 children’s health insurance program, or field operations to be 29 used for the state match cost to comply with the payment error 30 rate measurement (PERM) program for both the medical assistance 31 and children’s health insurance programs as developed by the 32 centers for Medicare and Medicaid services of the United States 33 department of health and human services to comply with the 34 federal Improper Payments Information Act of 2002, Pub. L. No. 35 -160- SF 542 (3) 84 pf/jp 160/ 209
S.F. 542 107-300. 1 8. It is the intent of the general assembly that the 2 department continue to implement the recommendations of 3 the assuring better child health and development initiative 4 II (ABCDII) clinical panel to the Iowa early and periodic 5 screening, diagnostic, and treatment services healthy mental 6 development collaborative board regarding changes to billing 7 procedures, codes, and eligible service providers. 8 9. Of the funds appropriated in this section, a sufficient 9 amount is allocated to supplement the incomes of residents of 10 nursing facilities, intermediate care facilities for persons 11 with mental illness, and intermediate care facilities for 12 persons with mental retardation, with incomes of less than $50 13 in the amount necessary for the residents to receive a personal 14 needs allowance of $50 per month pursuant to section 249A.30A. 15 10. Of the funds appropriated in this section, the following 16 amounts shall be transferred to the appropriations made in this 17 division of this Act for the state mental health institutes: 18 a. Cherokee mental health institute .......... $ 9,098,425 19 b. Clarinda mental health institute .......... $ 1,977,305 20 c. Independence mental health institute ...... $ 9,045,894 21 d. Mount Pleasant mental health institute .... $ 5,752,587 22 11. a. Of the funds appropriated in this section, 23 $7,425,684 is allocated for the state match for a 24 disproportionate share hospital payment of $19,133,430 to 25 hospitals that meet both of the conditions specified in 26 subparagraphs (1) and (2). In addition, the hospitals that 27 meet the conditions specified shall either certify public 28 expenditures or transfer to the medical assistance program 29 an amount equal to provide the nonfederal share for a 30 disproportionate share hospital payment of $7,500,000. The 31 hospitals that meet the conditions specified shall receive and 32 retain 100 percent of the total disproportionate share hospital 33 payment of $26,633,430. 34 (1) The hospital qualifies for disproportionate share and 35 -161- SF 542 (3) 84 pf/jp 161/ 209
S.F. 542 graduate medical education payments. 1 (2) The hospital is an Iowa state-owned hospital with more 2 than 500 beds and eight or more distinct residency specialty 3 or subspecialty programs recognized by the American college of 4 graduate medical education. 5 b. Distribution of the disproportionate share payments 6 shall be made on a monthly basis. The total amount of 7 disproportionate share payments including graduate medical 8 education, enhanced disproportionate share, and Iowa 9 state-owned teaching hospital payments shall not exceed the 10 amount of the state’s allotment under Pub. L. No. 102-234. 11 In addition, the total amount of all disproportionate 12 share payments shall not exceed the hospital-specific 13 disproportionate share limits under Pub. L. No. 103-66. 14 12. The university of Iowa hospitals and clinics shall 15 either certify public expenditures or transfer to the medical 16 assistance appropriation an amount equal to provide the 17 nonfederal share for increased medical assistance payments for 18 inpatient and outpatient hospital services of $9,900,000. The 19 university of Iowa hospitals and clinics shall receive and 20 retain 100 percent of the total increase in medical assistance 21 payments. 22 13. Of the funds appropriated in this section, up to 23 $4,480,304 may be transferred to the IowaCare account created 24 in section 249J.24. 25 14. Of the funds appropriated in this section, $200,000 26 shall be used for the Iowa chronic care consortium pursuant to 27 2003 Iowa Acts, chapter 112, section 12, as amended by 2003 28 Iowa Acts, chapter 179, sections 166 and 167. 29 15. One hundred percent of the nonfederal share of payments 30 to area education agencies that are medical assistance 31 providers for medical assistance-covered services provided to 32 medical assistance-covered children, shall be made from the 33 appropriation made in this section. 34 16. Any new or renewed contract entered into by the 35 -162- SF 542 (3) 84 pf/jp 162/ 209
S.F. 542 department with a third party to administer behavioral health 1 services under the medical assistance program shall provide 2 that any interest earned on payments from the state during 3 the state fiscal year shall be remitted to the department 4 and treated as recoveries to offset the costs of the medical 5 assistance program. 6 17. The department shall continue to implement the 7 provisions in 2007 Iowa Acts, chapter 218, section 124 and 8 section 126, as amended by 2008 Iowa Acts, chapter 1188, 9 section 55, relating to eligibility for certain persons with 10 disabilities under the medical assistance program in accordance 11 with the federal family opportunity Act. 12 18. A portion of the funds appropriated in this section 13 may be transferred to the appropriation in this division of 14 this Act for medical contracts to be used for administrative 15 activities associated with the money follows the person 16 demonstration project. 17 19. Of the funds appropriated in this section, $349,011 18 shall be used for the administration of the health insurance 19 premium payment program, including salaries, support, 20 maintenance, and miscellaneous purposes for the fiscal year 21 beginning July 1, 2012. 22 20. a. The department may continue to implement cost 23 containment strategies recommended by the governor, and may 24 adopt emergency rules for such implementation. 25 b. The department shall not implement the cost containment 26 strategy to require a primary care referral for the provision 27 of chiropractic services. 28 c. The department may increase the amounts allocated for 29 salaries, support, maintenance, and miscellaneous purposes 30 associated with the medical assistance program, as necessary, 31 to implement the cost containment strategies. The department 32 shall report any such increase to the legislative services 33 agency and the department of management. 34 d. If the savings to the medical assistance program exceed 35 -163- SF 542 (3) 84 pf/jp 163/ 209
S.F. 542 the cost, the department may transfer any savings generated 1 for the fiscal year due to medical assistance program cost 2 containment efforts initiated pursuant to 2010 Iowa Acts, 3 chapter 1031, Executive Order No. 20, issued December 16, 2009, 4 or cost containment strategies initiated pursuant to this 5 subsection, to the appropriation made in this division of this 6 Act for medical contracts or general administration to defray 7 the increased contract costs associated with implementing such 8 efforts. 9 e. The department shall report the implementation of 10 any cost containment strategies under this subsection to 11 the individuals specified in this division of this Act for 12 submission of reports on a quarterly basis. 13 21. Notwithstanding any provision of law to the contrary, 14 the department of human services shall continue implementation 15 of the amended section 1915(b) waiver and Iowa plan contract 16 for inclusion of remedial services under the Iowa plan contract 17 for the fiscal year beginning July 1, 2012. 18 22. Of the funds appropriated in this section, $5,000,000 19 shall be used to continue reductions in the waiting lists 20 of the medical assistance home and community-based services 21 waivers, including the waiver for persons with intellectual 22 disabilities for which the nonfederal share is paid as 23 state case services and other support pursuant to section 24 331.440. The department shall distribute the funding allocated 25 under this subsection proportionately among all home and 26 community-based services waivers. 27 Sec. 139. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,946,922 34 1. The department of inspections and appeals shall 35 -164- SF 542 (3) 84 pf/jp 164/ 209
S.F. 542 provide all state matching funds for survey and certification 1 activities performed by the department of inspections 2 and appeals. The department of human services is solely 3 responsible for distributing the federal matching funds for 4 such activities. 5 2. Of the funds appropriated in this section, $75,000 6 shall be used for continued implementation of a uniform cost 7 report to be used in the development of specified Medicaid 8 reimbursement rates over a multiyear timeframe as specified in 9 this Act for FY 2011-2012. 10 3. a. Of the funds appropriated in this section, 11 $50,000 shall be used for continued implementation of an 12 electronic medical records system, including system purchase or 13 development, for home and community-based services providers 14 and mental health services providers that comply with the 15 requirements of federal and state laws and regulation by the 16 fiscal year beginning July 1, 2013. 17 b. Notwithstanding section 8.33, funds allocated in this 18 subsection that remain unencumbered or unobligated at the close 19 of the fiscal year shall not revert but shall remain available 20 in succeeding fiscal years to be used for the purposes 21 designated. 22 4. Of the amount appropriated in this section, $1,750,000 23 shall be used for technology upgrades necessary to support 24 Medicaid claims and other health operations, worldwide federal 25 Health Insurance Portability and Accountability Act of 1996 26 (HIPAA) claims, transactions, and coding requirements, and the 27 Iowa automated benefits calculation system. Notwithstanding 28 section 8.33, funds allocated in this subsection that remain 29 unencumbered or unobligated at the close of the fiscal year 30 shall not revert but shall remain available in succeeding 31 fiscal years to be used for the purposes designated. 32 5. Of the funds appropriated in this section, $50,000 33 shall be used for the continuation of an accountable care 34 organization pilot project as specified in this Act relating to 35 -165- SF 542 (3) 84 pf/jp 165/ 209
S.F. 542 prior appropriations and related changes for FY 2011-2012. 1 6. Of the funds appropriated in this section, $100,000 2 shall be used for the continued development of a provider 3 payment system plan to provide recommendations to reform the 4 health care provider payment system as an effective way to 5 promote coordination of care, lower costs, and improve quality 6 as specified in the division of this Act relating to cost 7 containment for FY 2011-2012. 8 7. Of the funds appropriated in this section, $10,000 shall 9 be used for the continued development of a plan to establish 10 an all-payer claims database to provide for the collection 11 and analysis of claims data from multiple payers of health 12 care as specified in the division of this Act relating to cost 13 containment for FY 2011-2012. 14 8. Of the funds appropriated in this section, $25,000 shall 15 be used for continuation of home and community-based services 16 waiver quality assurance programs, including the review and 17 streamlining of processes and policies related to oversight and 18 quality management to meet state and federal requirements. 19 Sec. 140. STATE SUPPLEMENTARY ASSISTANCE. 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, 2012, and ending June 30, 2013, the following 23 amount, or so much thereof as is necessary, to be used for the 24 purpose designated: 25 For the state supplementary assistance program: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,425,374 27 2. The department shall increase the personal needs 28 allowance for residents of residential care facilities by the 29 same percentage and at the same time as federal supplemental 30 security income and federal social security benefits are 31 increased due to a recognized increase in the cost of living. 32 The department may adopt emergency rules to implement this 33 subsection. 34 3. If during the fiscal year beginning July 1, 2012, 35 -166- SF 542 (3) 84 pf/jp 166/ 209
S.F. 542 the department projects that state supplementary assistance 1 expenditures for a calendar year will not meet the federal 2 pass-through requirement specified in Tit. XVI of the federal 3 Social Security Act, section 1618, as codified in 42 U.S.C. 4 § 1382g, the department may take actions including but not 5 limited to increasing the personal needs allowance for 6 residential care facility residents and making programmatic 7 adjustments or upward adjustments of the residential care 8 facility or in-home health-related care reimbursement rates 9 prescribed in this division of this Act to ensure that federal 10 requirements are met. In addition, the department may make 11 other programmatic and rate adjustments necessary to remain 12 within the amount appropriated in this section while ensuring 13 compliance with federal requirements. The department may adopt 14 emergency rules to implement the provisions of this subsection. 15 Sec. 141. CHILDREN’S HEALTH INSURANCE PROGRAM. 16 1. There is appropriated from the general fund of the 17 state to the department of human services for the fiscal year 18 beginning July 1, 2012, and ending June 30, 2013, the following 19 amount, or so much thereof as is necessary, to be used for the 20 purpose designated: 21 For maintenance of the healthy and well kids in Iowa (hawk-i) 22 program pursuant to chapter 514I, including supplemental dental 23 services, for receipt of federal financial participation under 24 Tit. XXI of the federal Social Security Act, which creates the 25 children’s health insurance program: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,403,051 27 2. Of the funds appropriated in this section, $64,475 is 28 allocated for continuation of the contract for advertising and 29 outreach with the department of public health. 30 Sec. 142. CHILD CARE ASSISTANCE. There is appropriated 31 from the general fund of the state to the department of human 32 services for the fiscal year beginning July 1, 2012, and ending 33 June 30, 2013, the following amount, or so much thereof as is 34 necessary, to be used for the purpose designated: 35 -167- SF 542 (3) 84 pf/jp 167/ 209
S.F. 542 For child care programs: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 27,632,755 2 1. Of the funds appropriated in this section, $26,948,041 3 shall be used for state child care assistance in accordance 4 with section 237A.13. 5 2. Nothing in this section shall be construed or is 6 intended as or shall imply a grant of entitlement for services 7 to persons who are eligible for assistance due to an income 8 level consistent with the waiting list requirements of section 9 237A.13. Any state obligation to provide services pursuant to 10 this section is limited to the extent of the funds appropriated 11 in this section. 12 3. Of the funds appropriated in this section, $216,227 is 13 allocated for the statewide program for child care resource 14 and referral services under section 237A.26. A list of the 15 registered and licensed child care facilities operating in the 16 area served by a child care resource and referral service shall 17 be made available to the families receiving state child care 18 assistance in that area. 19 4. Of the funds appropriated in this section, $468,487 20 is allocated for child care quality improvement initiatives 21 including but not limited to the voluntary quality rating 22 system in accordance with section 237A.30. 23 5. The department may use any of the funds appropriated 24 in this section as a match to obtain federal funds for use in 25 expanding child care assistance and related programs. For 26 the purpose of expenditures of state and federal child care 27 funding, funds shall be considered obligated at the time 28 expenditures are projected or are allocated to the department’s 29 service areas. Projections shall be based on current and 30 projected caseload growth, current and projected provider 31 rates, staffing requirements for eligibility determination 32 and management of program requirements including data systems 33 management, staffing requirements for administration of the 34 program, contractual and grant obligations and any transfers 35 -168- SF 542 (3) 84 pf/jp 168/ 209
S.F. 542 to other state agencies, and obligations for decategorization 1 or innovation projects. 2 6. A portion of the state match for the federal child care 3 and development block grant shall be provided as necessary to 4 meet federal matching funds requirements through the state 5 general fund appropriation made for child development grants 6 and other programs for at-risk children in section 279.51. 7 7. If a uniform reduction ordered by the governor under 8 section 8.31 or other operation of law, transfer, or federal 9 funding reduction reduces the appropriation made in this 10 section for the fiscal year, the percentage reduction in the 11 amount paid out to or on behalf of the families participating 12 in the state child care assistance program shall be equal to or 13 less than the percentage reduction made for any other purpose 14 payable from the appropriation made in this section and the 15 federal funding relating to it. The percentage reduction to 16 the other allocations made in this section shall be the same as 17 the uniform reduction ordered by the governor or the percentage 18 change of the federal funding reduction, as applicable. 19 If there is an unanticipated increase in federal funding 20 provided for state child care assistance, the entire amount 21 of the increase shall be used for state child care assistance 22 payments. If the appropriations made for purposes of the 23 state child care assistance program for the fiscal year are 24 determined to be insufficient, it is the intent of the general 25 assembly to appropriate sufficient funding for the fiscal year 26 in order to avoid establishment of waiting list requirements. 27 8. Notwithstanding section 8.33, moneys appropriated in 28 this section or received from the federal appropriations made 29 for the purposes of this section that remain unencumbered or 30 unobligated at the close of the fiscal year shall not revert 31 to any fund but shall remain available for expenditure for the 32 purposes designated until the close of the succeeding fiscal 33 year. 34 Sec. 143. JUVENILE INSTITUTIONS. There is appropriated 35 -169- SF 542 (3) 84 pf/jp 169/ 209
S.F. 542 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 amounts, or so much thereof as is 3 necessary, to be used for the purposes designated: 4 1. For operation of the Iowa juvenile home at Toledo and for 5 salaries, support, maintenance, and miscellaneous purposes, and 6 for not more than the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,129,126 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 114.00 9 2. For operation of the state training school at Eldora and 10 for salaries, support, maintenance, and miscellaneous purposes, 11 and for not more than the following full-time equivalent 12 positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,319,339 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 164.30 15 Of the funds appropriated in this subsection, $45,575 shall 16 be used for distribution to licensed classroom teachers at this 17 and other institutions under the control of the department of 18 human services based upon the average student yearly enrollment 19 at each institution as determined by the department. 20 3. A portion of the moneys appropriated in this section 21 shall be used by the state training school and by the Iowa 22 juvenile home for grants for adolescent pregnancy prevention 23 activities at the institutions in the fiscal year beginning 24 July 1, 2012. 25 4. For the fiscal year beginning July 1, 2012, 26 notwithstanding section 232.52, subsection 2, and section 27 907.3A, subsection 1, the court shall not order the placement 28 of a child at the Iowa juvenile home or the state training 29 school under section 232.52, if that placement is not in 30 accordance with the population guidelines for the respective 31 juvenile institution established pursuant to section 233A.1 or 32 233B.1. 33 Sec. 144. CHILD AND FAMILY SERVICES. 34 1. There is appropriated from the general fund of the 35 -170- SF 542 (3) 84 pf/jp 170/ 209
S.F. 542 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 child and family services: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,538,668 6 2. In order to address a reduction of $5,200,000 from the 7 amount allocated under the appropriation made for the purposes 8 of this section in prior years for purposes of juvenile 9 delinquent graduated sanction services, up to $2,600,000 of the 10 amount of federal temporary assistance for needy families block 11 grant funding appropriated in this division of this Act for 12 child and family services shall be made available for purposes 13 of juvenile delinquent graduated sanction services. 14 3. The department may transfer funds appropriated in this 15 section as necessary to pay the nonfederal costs of services 16 reimbursed under the medical assistance program, state child 17 care assistance program, or the family investment program which 18 are provided to children who would otherwise receive services 19 paid under the appropriation in this section. The department 20 may transfer funds appropriated in this section to the 21 appropriations made in this division of this Act for general 22 administration and for field operations for resources necessary 23 to implement and operate the services funded in this section. 24 4. a. Of the funds appropriated in this section, up to 25 $15,084,565 is allocated as the statewide expenditure target 26 under section 232.143 for group foster care maintenance and 27 services. If the department projects that such expenditures 28 for the fiscal year will be less than the target amount 29 allocated in this lettered paragraph, the department may 30 reallocate the excess to provide additional funding for shelter 31 care or the child welfare emergency services addressed with the 32 allocation for shelter care. 33 b. If at any time after September 30, 2012, annualization 34 of a service area’s current expenditures indicates a service 35 -171- SF 542 (3) 84 pf/jp 171/ 209
S.F. 542 area is at risk of exceeding its group foster care expenditure 1 target under section 232.143 by more than 5 percent, the 2 department and juvenile court services shall examine all 3 group foster care placements in that service area in order to 4 identify those which might be appropriate for termination. 5 In addition, any aftercare services believed to be needed 6 for the children whose placements may be terminated shall be 7 identified. The department and juvenile court services shall 8 initiate action to set dispositional review hearings for the 9 placements identified. In such a dispositional review hearing, 10 the juvenile court shall determine whether needed aftercare 11 services are available and whether termination of the placement 12 is in the best interest of the child and the community. 13 5. In accordance with the provisions of section 232.188, 14 the department shall continue the child welfare and juvenile 15 justice funding initiative during fiscal year 2012-2013. Of 16 the funds appropriated in this section, $858,877 is allocated 17 specifically for expenditure for fiscal year 2012-2013 through 18 the decategorization service funding pools and governance 19 boards established pursuant to section 232.188. 20 6. A portion of the funds appropriated in this section 21 may be used for emergency family assistance to provide other 22 resources required for a family participating in a family 23 preservation or reunification project or successor project to 24 stay together or to be reunified. 25 7. Notwithstanding section 234.35 or any other provision 26 of law to the contrary, state funding for shelter care and 27 the child welfare emergency services contracting implemented 28 to provide for or prevent the need for shelter care shall 29 be limited to $3,785,058. The department may continue or 30 execute contracts that result from the department’s request 31 for proposal, bid number ACFS-11-114, to provide the range of 32 child welfare emergency services described in the request for 33 proposals, and any subsequent amendments to the request for 34 proposals. 35 -172- SF 542 (3) 84 pf/jp 172/ 209
S.F. 542 8. Federal funds received by the state during the fiscal 1 year beginning July 1, 2012, as the result of the expenditure 2 of state funds appropriated during a previous state fiscal 3 year for a service or activity funded under this section are 4 appropriated to the department to be used as additional funding 5 for services and purposes provided for under this section. 6 Notwithstanding section 8.33, moneys received in accordance 7 with this subsection that remain unencumbered or unobligated at 8 the close of the fiscal year shall not revert to any fund but 9 shall remain available for the purposes designated until the 10 close of the succeeding fiscal year. 11 9. Of the funds appropriated in this section, at least 12 $1,848,143 shall be used for protective child care assistance. 13 10. a. Of the funds appropriated in this section, up to 14 $1,031,244 is allocated for the payment of the expenses of 15 court-ordered services provided to juveniles who are under the 16 supervision of juvenile court services, which expenses are a 17 charge upon the state pursuant to section 232.141, subsection 18 4. Of the amount allocated in this lettered paragraph, up 19 to $778,144 shall be made available to provide school-based 20 supervision of children adjudicated under chapter 232, of which 21 not more than $7,500 may be used for the purpose of training. 22 A portion of the cost of each school-based liaison officer 23 shall be paid by the school district or other funding source as 24 approved by the chief juvenile court officer. 25 b. Of the funds appropriated in this section, up to $374,493 26 is allocated for the payment of the expenses of court-ordered 27 services provided to children who are under the supervision 28 of the department, which expenses are a charge upon the state 29 pursuant to section 232.141, subsection 4. 30 c. Notwithstanding section 232.141 or any other provision 31 of law to the contrary, the amounts allocated in this 32 subsection shall be distributed to the judicial districts 33 as determined by the state court administrator and to the 34 department’s service areas as determined by the administrator 35 -173- SF 542 (3) 84 pf/jp 173/ 209
S.F. 542 of the department’s division of child and family services. The 1 state court administrator and the division administrator shall 2 make the determination of the distribution amounts on or before 3 June 15, 2012. 4 d. Notwithstanding chapter 232 or any other provision of 5 law to the contrary, a district or juvenile court shall not 6 order any service which is a charge upon the state pursuant 7 to section 232.141 if there are insufficient court-ordered 8 services funds available in the district court or departmental 9 service area distribution amounts to pay for the service. The 10 chief juvenile court officer and the departmental service area 11 manager shall encourage use of the funds allocated in this 12 subsection such that there are sufficient funds to pay for 13 all court-related services during the entire year. The chief 14 juvenile court officers and departmental service area managers 15 shall attempt to anticipate potential surpluses and shortfalls 16 in the distribution amounts and shall cooperatively request the 17 state court administrator or division administrator to transfer 18 funds between the judicial districts’ or departmental service 19 areas’ distribution amounts as prudent. 20 e. Notwithstanding any provision of law to the contrary, 21 a district or juvenile court shall not order a county to pay 22 for any service provided to a juvenile pursuant to an order 23 entered under chapter 232 which is a charge upon the state 24 under section 232.141, subsection 4. 25 f. Of the funds allocated in this subsection, not more than 26 $41,500 may be used by the judicial branch for administration 27 of the requirements under this subsection. 28 g. Of the funds allocated in this subsection, $8,500 29 shall be used by the department of human services to support 30 the interstate commission for juveniles in accordance with 31 the interstate compact for juveniles as provided in section 32 232.173. 33 11. Of the funds appropriated in this section, $2,961,301 is 34 allocated for juvenile delinquent graduated sanctions services. 35 -174- SF 542 (3) 84 pf/jp 174/ 209
S.F. 542 Any state funds saved as a result of efforts by juvenile court 1 services to earn federal Tit. IV-E match for juvenile court 2 services administration may be used for the juvenile delinquent 3 graduated sanctions services. 4 12. Of the funds appropriated in this section, $494,143 5 shall be transferred to the department of public health to 6 be used for the child protection center grant program in 7 accordance with section 135.118. 8 13. If the department receives federal approval to 9 implement a waiver under Tit. IV-E of the federal Social 10 Security Act to enable providers to serve children who remain 11 in the children’s families and communities, for purposes of 12 eligibility under the medical assistance program, children who 13 participate in the waiver shall be considered to be placed in 14 foster care. 15 14. Of the funds appropriated in this section, $1,534,916 is 16 allocated for the preparation for adult living program pursuant 17 to section 234.46. 18 15. Of the funds appropriated in this section, $260,075 19 shall be used for juvenile drug courts. The amount allocated 20 in this subsection shall be distributed as follows: 21 To the judicial branch for salaries to assist with the 22 operation of juvenile drug court programs operated in the 23 following jurisdictions: 24 a. Marshall county: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,354 26 b. Woodbury county: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,841 28 c. Polk county: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 97,946 30 d. The third judicial district: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,967 32 e. The eighth judicial district: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,967 34 16. Of the funds appropriated in this section, $113,669 35 -175- SF 542 (3) 84 pf/jp 175/ 209
S.F. 542 shall be used for the public purpose of providing a grant to 1 a nonprofit human services organization providing services to 2 individuals and families in multiple locations in southwest 3 Iowa and Nebraska for support of a project providing immediate, 4 sensitive support and forensic interviews, medical exams, needs 5 assessments, and referrals for victims of child abuse and their 6 nonoffending family members. 7 17. Of the funds appropriated in this section, $62,795 8 is allocated for the elevate approach of providing a support 9 network to children placed in foster care. 10 18. Of the funds appropriated in this section, $101,000 is 11 allocated for use pursuant to section 235A.1 for continuation 12 of the initiative to address child sexual abuse implemented 13 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 14 21. 15 19. Of the funds appropriated in this section, $315,120 is 16 allocated for the community partnership for child protection 17 sites. 18 20. Of the funds appropriated in this section, $185,625 19 is allocated for the department’s minority youth and family 20 projects under the redesign of the child welfare system. 21 21. Of the funds appropriated in this section, $600,248 22 is allocated for funding of the state match for the federal 23 substance abuse and mental health services administration 24 (SAMHSA) system of care grant. 25 22. Of the funds appropriated in this section, at least 26 $73,579 shall be used for the child welfare training academy. 27 23. Of the funds appropriated in this section, $12,500 28 shall be used for the public purpose of providing a grant to 29 a child welfare services provider headquartered in a county 30 with a population between 205,000 and 215,000 in the latest 31 certified federal census that provides multiple services 32 including but not limited to a psychiatric medical institution 33 for children, shelter, residential treatment, after school 34 programs, school-based programming, and an Asperger’s syndrome 35 -176- SF 542 (3) 84 pf/jp 176/ 209
S.F. 542 program, to be used for support services for children with 1 autism spectrum disorder and their families. 2 24. Of the funds appropriated in this section $128,587 shall 3 be used for continuation of the central Iowa system of care 4 program grant through June 30, 2013. 5 Sec. 145. ADOPTION SUBSIDY. 6 1. There is appropriated from the general fund of the 7 state to the department of human services for the fiscal year 8 beginning July 1, 2012, and ending June 30, 2013, the following 9 amount, or so much thereof as is necessary, to be used for the 10 purpose designated: 11 For adoption subsidy payments and services: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,233,296 13 2. The department may transfer funds appropriated in 14 this section to the appropriation made in this division of 15 this Act for general administration for costs paid from the 16 appropriation relating to adoption subsidy. 17 3. Federal funds received by the state during the 18 fiscal year beginning July 1, 2012, as the result of the 19 expenditure of state funds during a previous state fiscal 20 year for a service or activity funded under this section are 21 appropriated to the department to be used as additional funding 22 for the services and activities funded under this section. 23 Notwithstanding section 8.33, moneys received in accordance 24 with this subsection that remain unencumbered or unobligated 25 at the close of the fiscal year shall not revert to any fund 26 but shall remain available for expenditure for the purposes 27 designated until the close of the succeeding fiscal year. 28 Sec. 146. JUVENILE DETENTION HOME FUND. Moneys deposited 29 in the juvenile detention home fund created in section 232.142 30 during the fiscal year beginning July 1, 2012, and ending June 31 30, 2013, are appropriated to the department of human services 32 for the fiscal year beginning July 1, 2012, and ending June 30, 33 2013, for distribution of an amount equal to a percentage of 34 the costs of the establishment, improvement, operation, and 35 -177- SF 542 (3) 84 pf/jp 177/ 209
S.F. 542 maintenance of county or multicounty juvenile detention homes 1 in the fiscal year beginning July 1, 2011. Moneys appropriated 2 for distribution in accordance with this section shall be 3 allocated among eligible detention homes, prorated on the basis 4 of an eligible detention home’s proportion of the costs of all 5 eligible detention homes in the fiscal year beginning July 6 1, 2011. The percentage figure shall be determined by the 7 department based on the amount available for distribution for 8 the fund. Notwithstanding section 232.142, subsection 3, the 9 financial aid payable by the state under that provision for the 10 fiscal year beginning July 1, 2012, shall be limited to the 11 amount appropriated for the purposes of this section. 12 Sec. 147. FAMILY SUPPORT SUBSIDY PROGRAM. 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 the family support subsidy program subject to the 19 enrollment restrictions in section 225C.37, subsection 3: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 583,999 21 2. The department shall use at least $192,750 of the moneys 22 appropriated in this section for the family support center 23 component of the comprehensive family support program under 24 section 225C.47. Not more than $12,500 of the amount allocated 25 in this subsection shall be used for administrative costs. 26 3. If at any time during the fiscal year, the amount of 27 funding available for the family support subsidy program 28 is reduced from the amount initially used to establish the 29 figure for the number of family members for whom a subsidy 30 is to be provided at any one time during the fiscal year, 31 notwithstanding section 225C.38, subsection 2, the department 32 shall revise the figure as necessary to conform to the amount 33 of funding available. 34 Sec. 148. CONNER DECREE. There is appropriated from the 35 -178- SF 542 (3) 84 pf/jp 178/ 209
S.F. 542 general fund of the state to the department of human services 1 for the fiscal year beginning July 1, 2012, and ending June 30, 2 2013, the following amount, or so much thereof as is necessary, 3 to be used for the purpose designated: 4 For building community capacity through the coordination 5 and provision of training opportunities in accordance with the 6 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 7 Iowa, July 14, 1994): 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,811 9 Sec. 149. MENTAL HEALTH INSTITUTES. There is appropriated 10 from the general fund of the state to the department of human 11 services for the fiscal year beginning July 1, 2012, and ending 12 June 30, 2013, the following amounts, or so much thereof as is 13 necessary, to be used for the purposes designated: 14 1. For the state mental health institute at Cherokee for 15 salaries, support, maintenance, and miscellaneous purposes, and 16 for not more than the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,938,654 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 168.50 19 2. For the state mental health institute at Clarinda for 20 salaries, support, maintenance, and miscellaneous purposes, and 21 for not more than the following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,205,867 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 86.10 24 3. For the state mental health institute at Independence for 25 salaries, support, maintenance, and miscellaneous purposes, and 26 for not more than the following full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,137,843 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 29 4. For the state mental health institute at Mount Pleasant 30 for salaries, support, maintenance, and miscellaneous purposes, 31 and for not more than the following full-time equivalent 32 positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 472,162 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 91.72 35 -179- SF 542 (3) 84 pf/jp 179/ 209
S.F. 542 Sec. 150. STATE RESOURCE CENTERS. 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, 2012, and ending June 30, 2013, the following 4 amounts, or so much thereof as is necessary, to be used for the 5 purposes designated: 6 a. For the state resource center at Glenwood for salaries, 7 support, maintenance, and miscellaneous purposes: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,303,901 9 b. For the state resource center at Woodward for salaries, 10 support, maintenance, and miscellaneous purposes: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,442,829 12 2. The department may continue to bill for state resource 13 center services utilizing a scope of services approach used for 14 private providers of ICFMR services, in a manner which does not 15 shift costs between the medical assistance program, counties, 16 or other sources of funding for the state resource centers. 17 3. The state resource centers may expand the time-limited 18 assessment and respite services during the fiscal year. 19 4. If the department’s administration and the department 20 of management concur with a finding by a state resource 21 center’s superintendent that projected revenues can reasonably 22 be expected to pay the salary and support costs for a new 23 employee position, or that such costs for adding a particular 24 number of new positions for the fiscal year would be less 25 than the overtime costs if new positions would not be added, 26 the superintendent may add the new position or positions. If 27 the vacant positions available to a resource center do not 28 include the position classification desired to be filled, the 29 state resource center’s superintendent may reclassify any 30 vacant position as necessary to fill the desired position. The 31 superintendents of the state resource centers may, by mutual 32 agreement, pool vacant positions and position classifications 33 during the course of the fiscal year in order to assist one 34 another in filling necessary positions. 35 -180- SF 542 (3) 84 pf/jp 180/ 209
S.F. 542 5. If existing capacity limitations are reached in 1 operating units, a waiting list is in effect for a service or 2 a special need for which a payment source or other funding 3 is available for the service or to address the special need, 4 and facilities for the service or to address the special need 5 can be provided within the available payment source or other 6 funding, the superintendent of a state resource center may 7 authorize opening not more than two units or other facilities 8 and begin implementing the service or addressing the special 9 need during fiscal year 2012-2013. 10 Sec. 151. MI/MR/DD STATE CASES. 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 distribution to counties for state case services 17 for persons with mental illness, mental retardation, and 18 developmental disabilities in accordance with section 331.440: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,084,741 20 2. For the fiscal year beginning July 1, 2012, and ending 21 June 30, 2013, $100,000 is allocated for state case services 22 from the amounts appropriated from the fund created in section 23 8.41 to the department of human services from the funds 24 received from the federal government under 42 U.S.C. ch. 6A, 25 subch. XVII, relating to the community mental health center 26 block grant, for the federal fiscal years beginning October 27 1, 2010, and ending September 30, 2011, beginning October 1, 28 2011, and ending September 30, 2012, and beginning October 1, 29 2012, and ending September 30, 2013. The allocation made in 30 this subsection shall be made prior to any other distribution 31 allocation of the appropriated federal funds. 32 3. Notwithstanding section 8.33, moneys appropriated in 33 this section that remain unencumbered or unobligated at the 34 close of the fiscal year shall not revert but shall remain 35 -181- SF 542 (3) 84 pf/jp 181/ 209
S.F. 542 available for expenditure for the purposes designated until the 1 close of the succeeding fiscal year. 2 Sec. 152. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES 3 —— COMMUNITY SERVICES FUND. There is appropriated from 4 the general fund of the state to the mental health and 5 developmental disabilities community services fund created in 6 section 225C.7 for the fiscal year beginning July 1, 2012, and 7 ending June 30, 2013, the following amount, or so much thereof 8 as is necessary, to be used for the purpose designated: 9 For mental health and developmental disabilities community 10 services in accordance with this division of this Act: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,211,100 12 1. Of the funds appropriated in this section, $14,187,556 13 shall be allocated to counties for funding of community-based 14 mental health and developmental disabilities services. The 15 moneys shall be allocated to a county as follows: 16 a. Fifty percent based upon the county’s proportion of the 17 state’s population of persons with an annual income which is 18 equal to or less than the poverty guideline established by the 19 federal office of management and budget. 20 b. Fifty percent based upon the county’s proportion of the 21 state’s general population. 22 2. a. A county shall utilize the funding the county 23 receives pursuant to subsection 1 for services provided to 24 persons with a disability, as defined in section 225C.2. 25 However, no more than 50 percent of the funding shall be used 26 for services provided to any one of the service populations. 27 b. A county shall use at least 50 percent of the funding the 28 county receives under subsection 1 for contemporary services 29 provided to persons with a disability, as described in rules 30 adopted by the department. 31 3. Of the funds appropriated in this section, $23,544 32 shall be used to support the Iowa compass program providing 33 computerized information and referral services for Iowans with 34 disabilities and their families. 35 -182- SF 542 (3) 84 pf/jp 182/ 209
S.F. 542 4. a. Funding appropriated for purposes of the federal 1 social services block grant is allocated for distribution 2 to counties for local purchase of services for persons with 3 mental illness or mental retardation or other developmental 4 disability. 5 b. The funds allocated in this subsection shall be expended 6 by counties in accordance with the county’s county management 7 plan approved by the board of supervisors. A county without 8 an approved county management plan shall not receive allocated 9 funds until the county’s management plan is approved. 10 c. The funds provided by this subsection shall be allocated 11 to each county as follows: 12 (1) Fifty percent based upon the county’s proportion of the 13 state’s population of persons with an annual income which is 14 equal to or less than the poverty guideline established by the 15 federal office of management and budget. 16 (2) Fifty percent based upon the amount provided to the 17 county for local purchase of services in the preceding fiscal 18 year. 19 5. A county is eligible for funds under this section if the 20 county qualifies for a state payment as described in section 21 331.439. 22 6. The most recent population estimates issued by the United 23 States bureau of the census shall be applied for the population 24 factors utilized in this section. 25 Sec. 153. SEXUALLY VIOLENT PREDATORS. 26 1. There is appropriated from the general fund of the 27 state to the department of human services for the fiscal year 28 beginning July 1, 2012, and ending June 30, 2013, the following 29 amount, or so much thereof as is necessary, to be used for the 30 purpose designated: 31 For costs associated with the commitment and treatment of 32 sexually violent predators in the unit located at the state 33 mental health institute at Cherokee, including costs of legal 34 services and other associated costs, including salaries, 35 -183- SF 542 (3) 84 pf/jp 183/ 209
S.F. 542 support, maintenance, and miscellaneous purposes, and for not 1 more than the following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,775,364 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 89.50 4 2. Unless specifically prohibited by law, if the amount 5 charged provides for recoupment of at least the entire amount 6 of direct and indirect costs, the department of human services 7 may contract with other states to provide care and treatment 8 of persons placed by the other states at the unit for sexually 9 violent predators at Cherokee. The moneys received under 10 such a contract shall be considered to be repayment receipts 11 and used for the purposes of the appropriation made in this 12 section. 13 Sec. 154. FIELD OPERATIONS. There is appropriated from the 14 general fund of the state to the department of human services 15 for the fiscal year beginning July 1, 2012, and ending June 30, 16 2013, the following amount, or so much thereof as is necessary, 17 to be used for the purposes designated: 18 For field operations, including salaries, support, 19 maintenance, and miscellaneous purposes, and for not more than 20 the following full-time equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 27,394,961 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,781.00 23 Priority in filling full-time equivalent positions shall be 24 given to those positions related to child protection services 25 and eligibility determination for low-income families. 26 Notwithstanding section 8.33, moneys appropriated in this 27 section that remain unencumbered or unobligated at the close of 28 the fiscal year shall not revert but shall remain available for 29 expenditure for the purposes designated until the close of the 30 succeeding fiscal year. 31 Sec. 155. GENERAL ADMINISTRATION. There is appropriated 32 from the general fund of the state to the department of human 33 services for the fiscal year beginning July 1, 2012, and ending 34 June 30, 2013, the following amount, or so much thereof as is 35 -184- SF 542 (3) 84 pf/jp 184/ 209
S.F. 542 necessary, to be used for the purpose designated: 1 For general administration, including salaries, support, 2 maintenance, and miscellaneous purposes, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,298,373 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 285.00 6 1. Of the funds appropriated in this section, $19,272 7 allocated for the prevention of disabilities policy council 8 established in section 225B.3. 9 2. The department shall report at least monthly to the 10 legislative services agency concerning the department’s 11 operational and program expenditures. 12 3. Of the funds appropriated in this section, $66,150 shall 13 be used to continue the contract for the provision of a program 14 to provide technical assistance, support, and consultation to 15 providers of habilitation services and home and community-based 16 waiver services for adults with disabilities under the medical 17 assistance program. 18 4. Of the funds appropriated in this section, $88,200 shall 19 be used to continue the contract to expand the provision of 20 nationally accredited and recognized internet-based training to 21 include mental health and disability services providers. 22 5. Of the funds appropriated in this section, $250,000 23 shall be used for continuation of child protection system 24 improvements addressed in 2011 Iowa Acts, House File 562, as 25 enacted. 26 6. Notwithstanding section 8.33, moneys appropriated in 27 this section that remain unencumbered or unobligated at the 28 close of the fiscal year shall not revert but shall remain 29 available for expenditure for the purposes designated until the 30 close of the succeeding fiscal year. 31 Sec. 156. VOLUNTEERS. There is appropriated from the 32 general fund of the state to the department of human services 33 for the fiscal year beginning July 1, 2012, and ending June 30, 34 2013, the following amount, or so much thereof as is necessary, 35 -185- SF 542 (3) 84 pf/jp 185/ 209
S.F. 542 to be used for the purpose designated: 1 For development and coordination of volunteer services: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,330 3 Sec. 157. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 4 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 5 DEPARTMENT OF HUMAN SERVICES. 6 1. a. (1) For the fiscal year beginning July 1, 2012, 7 the total state funding amount for the nursing facility budget 8 shall not exceed $223,202,551. 9 (2) The department, in cooperation with nursing facility 10 representatives, shall review projections for state funding 11 expenditures for reimbursement of nursing facilities on a 12 quarterly basis and the department shall determine if an 13 adjustment to the medical assistance reimbursement rate is 14 necessary in order to provide reimbursement within the state 15 funding amount for the fiscal year. Notwithstanding 2001 16 Iowa Acts, chapter 192, section 4, subsection 2, paragraph 17 “c”, and subsection 3, paragraph “a”, subparagraph (2), 18 if the state funding expenditures for the nursing facility 19 budget for the fiscal year is projected to exceed the amount 20 specified in subparagraph (1), the department shall adjust 21 the reimbursement for nursing facilities reimbursed under the 22 case-mix reimbursement system to maintain expenditures of the 23 nursing facility budget within the specified amount for the 24 fiscal year. 25 (3) For the fiscal year beginning July 1, 2012, special 26 population nursing facilities shall be reimbursed in accordance 27 with the methodology in effect on June 30, 2012. 28 b. For the fiscal year beginning July 1, 2012, the 29 department shall reimburse pharmacy dispensing fees using a 30 single rate of $4.34 per prescription or the pharmacy’s usual 31 and customary fee, whichever is lower. However, the department 32 shall adjust the dispensing fee specified in this paragraph 33 to distribute an additional $2,400,000 in reimbursements for 34 pharmacy dispensing fees under this paragraph for the fiscal 35 -186- SF 542 (3) 84 pf/jp 186/ 209
S.F. 542 year. 1 c. (1) For the fiscal year beginning July 1, 2012, 2 reimbursement rates for outpatient hospital services shall 3 remain at the rates in effect on June 30, 2012. 4 (2) For the fiscal year beginning July 1, 2012, 5 reimbursement rates for inpatient hospital services shall 6 remain at the rates in effect on June 30, 2012. 7 (3) For the fiscal year beginning July 1, 2012, the graduate 8 medical education and disproportionate share hospital fund 9 shall remain at the amount in effect on June 30, 2012, except 10 that the portion of the fund attributable to graduate medical 11 education shall be reduced in an amount that reflects the 12 elimination of graduate medical education payments made to 13 out-of-state hospitals. 14 (4) In order to ensure the efficient use of limited state 15 funds in procuring health care services for low-income Iowans, 16 funds appropriated in this Act for hospital services shall 17 not be used for activities which would be excluded from a 18 determination of reasonable costs under the federal Medicare 19 program pursuant to 42 U.S.C. § 1395X(v)(1)(N). 20 d. For the fiscal year beginning July 1, 2012, reimbursement 21 rates for rural health clinics, hospices, and acute mental 22 hospitals shall be increased in accordance with increases under 23 the federal Medicare program or as supported by their Medicare 24 audited costs. 25 e. For the fiscal year beginning July 1, 2012, independent 26 laboratories and rehabilitation agencies shall be reimbursed 27 using the same methodology in effect on June 30, 2012. 28 f. For the fiscal year beginning July 1, 2012, reimbursement 29 rates for home health agencies shall remain at the rates in 30 effect on June 30, 2012, not to exceed a home health agency’s 31 actual allowable cost. 32 g. For the fiscal year beginning July 1, 2012, federally 33 qualified health centers shall receive cost-based reimbursement 34 for 100 percent of the reasonable costs for the provision of 35 -187- SF 542 (3) 84 pf/jp 187/ 209
S.F. 542 services to recipients of medical assistance. 1 h. For the fiscal year beginning July 1, 2012, the 2 reimbursement rates for dental services shall remain at the 3 rates in effect on June 30, 2012. 4 i. (1) For the fiscal year beginning July 1, 2012, 5 state-owned psychiatric medical institutions for children shall 6 receive cost-based reimbursement for 100 percent of the actual 7 and allowable costs for the provision of services to recipients 8 of medical assistance. 9 (2) For the nonstate-owned psychiatric medical institutions 10 for children, reimbursement rates shall be based on the 11 reimbursement methodology developed by the department to 12 include all ancillary medical services costs and any other 13 changes required for federal compliance. 14 j. For the fiscal year beginning July 1, 2012, unless 15 otherwise specified in this Act, all noninstitutional medical 16 assistance provider reimbursement rates shall remain at the 17 rates in effect on June 30, 2012, except for area education 18 agencies, local education agencies, infant and toddler services 19 providers, and those providers whose rates are required to be 20 determined pursuant to section 249A.20. 21 k. Notwithstanding any provision to the contrary, for the 22 fiscal year beginning July 1, 2012, the reimbursement rate for 23 anesthesiologists shall remain at the rate in effect on June 24 30, 2012. 25 l. Notwithstanding section 249A.20, for the fiscal year 26 beginning July 1, 2012, the average reimbursement rate for 27 health care providers eligible for use of the federal Medicare 28 resource-based relative value scale reimbursement methodology 29 under that section shall remain at the rate in effect on June 30 30, 2012; however, this rate shall not exceed the maximum level 31 authorized by the federal government. 32 m. For the fiscal year beginning July 1, 2012, the 33 reimbursement rate for residential care facilities shall not 34 be less than the minimum payment level as established by the 35 -188- SF 542 (3) 84 pf/jp 188/ 209
S.F. 542 federal government to meet the federally mandated maintenance 1 of effort requirement. The flat reimbursement rate for 2 facilities electing not to file annual cost reports shall not 3 be less than the minimum payment level as established by the 4 federal government to meet the federally mandated maintenance 5 of effort requirement. 6 n. For the fiscal year beginning July 1, 2012, inpatient 7 mental health services provided at hospitals shall remain at 8 the rates in effect on June 30, 2012, subject to Medicaid 9 program upper payment limit rules; community mental health 10 centers and providers of mental health services to county 11 residents pursuant to a waiver approved under section 225C.7, 12 subsection 3, shall be reimbursed at 100 percent of the 13 reasonable costs for the provision of services to recipients of 14 medical assistance; and psychiatrists shall be reimbursed at 15 the medical assistance program fee for service rate. 16 o. For the fiscal year beginning July 1, 2012, the 17 reimbursement rate for consumer-directed attendant care shall 18 remain at the rates in effect on June 30, 2012. 19 p. For the fiscal year beginning July 1, 2012, the 20 reimbursement rate for providers of family planning services 21 that are eligible to receive a 90 percent federal match shall 22 remain at the rates in effect on June 30, 2012. 23 q. For the fiscal year beginning July 1, 2012, the 24 department shall adjust the rates in effect on June 30, 25 2012, for providers of home and community-based services 26 waiver services to distribute an additional $1,500,000 in 27 reimbursements to such providers for the fiscal year. 28 2. For the fiscal year beginning July 1, 2012, the 29 reimbursement rate for providers reimbursed under the 30 in-home-related care program shall not be less than the minimum 31 payment level as established by the federal government to meet 32 the federally mandated maintenance of effort requirement. 33 3. Unless otherwise directed in this section, when the 34 department’s reimbursement methodology for any provider 35 -189- SF 542 (3) 84 pf/jp 189/ 209
S.F. 542 reimbursed in accordance with this section includes an 1 inflation factor, this factor shall not exceed the amount 2 by which the consumer price index for all urban consumers 3 increased during the calendar year ending December 31, 2002. 4 4. For the fiscal year beginning July 1, 2012, 5 notwithstanding section 234.38, the foster family basic daily 6 maintenance rate and the maximum adoption subsidy rate for 7 children ages 0 through 5 years shall be $15.74, the rate for 8 children ages 6 through 11 years shall be $16.37, the rate for 9 children ages 12 through 15 years shall be $17.92, and the 10 rate for children and young adults ages 16 and older shall be 11 $18.16. The maximum supervised apartment living foster care 12 reimbursement rate shall be $25.00 per day. For youth ages 13 18 to 21 who have exited foster care, the maximum preparation 14 for adult living program maintenance rate shall be $574.00 per 15 month. The maximum payment for adoption subsidy nonrecurring 16 expenses shall be limited to $500 and the disallowance of 17 additional amounts for court costs and other related legal 18 expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, 19 section 408 shall be continued. 20 5. For the fiscal year beginning July 1, 2012, the maximum 21 reimbursement rates under the supervised apartment living 22 program and for social services providers under contract 23 shall remain at the rates in effect on June 30, 2012, or the 24 provider’s actual and allowable cost plus inflation for each 25 service, whichever is less. However, if a new service or 26 service provider is added after June 30, 2012, the initial 27 reimbursement rate for the service or provider shall be 28 based upon actual and allowable costs. Providers may also 29 be eligible for an additional amount as specified under the 30 department’s request for proposal, bid number ACFS-11-115. 31 6. For the fiscal year beginning July 1, 2012, the 32 reimbursement rates for family-centered service providers, 33 family foster care service providers, group foster care service 34 providers, and the resource family recruitment and retention 35 -190- SF 542 (3) 84 pf/jp 190/ 209
S.F. 542 contractor shall remain at the rates in effect on June 30, 1 2012. 2 7. The group foster care reimbursement rates paid for 3 placement of children out of state shall be calculated 4 according to the same rate-setting principles as those used for 5 in-state providers, unless the director of human services or 6 the director’s designee determines that appropriate care cannot 7 be provided within the state. The payment of the daily rate 8 shall be based on the number of days in the calendar month in 9 which service is provided. 10 8. a. For the fiscal year beginning July 1, 2012, the 11 reimbursement rate paid for shelter care and the child welfare 12 emergency services implemented to provide or prevent the need 13 for shelter care shall be established in a contract based on 14 the requirements of the department’s request for proposal, bid 15 number ACFS-11-114. 16 b. For the fiscal year beginning July 1, 2012, the combined 17 service and maintenance components of the reimbursement rate 18 paid for shelter care services shall be based on the financial 19 and statistical report submitted to the department. The 20 maximum reimbursement rate shall be $92.36 per day. The 21 department shall reimburse a shelter care provider at the 22 provider’s actual and allowable unit cost, plus inflation, not 23 to exceed the maximum reimbursement rate. 24 c. Notwithstanding section 232.141, subsection 8, for the 25 fiscal year beginning July 1, 2012, the amount of the statewide 26 average of the actual and allowable rates for reimbursement of 27 juvenile shelter care homes that is utilized for the limitation 28 on recovery of unpaid costs shall remain at the amount in 29 effect for this purpose in the fiscal year beginning July 1, 30 2011. 31 9. For the fiscal year beginning July 1, 2012, the 32 department shall calculate reimbursement rates for intermediate 33 care facilities for persons with mental retardation at the 34 80th percentile. Beginning July 1, 2012, the rate calculation 35 -191- SF 542 (3) 84 pf/jp 191/ 209
S.F. 542 methodology shall utilize the consumer price index inflation 1 factor applicable to the fiscal year beginning July 1, 2012. 2 10. For the fiscal year beginning July 1, 2012, for child 3 care providers reimbursed under the state child care assistance 4 program, the department shall set provider reimbursement 5 rates based on the rate reimbursement survey completed in 6 December 2004. Effective July 1, 2012, the child care provider 7 reimbursement rates shall remain at the rates in effect on June 8 30, 2012. The department shall set rates in a manner so as 9 to provide incentives for a nonregistered provider to become 10 registered by applying the increase only to registered and 11 licensed providers. 12 11. The department may adopt emergency rules to implement 13 this section. 14 Sec. 158. EMERGENCY RULES. 15 1. If specifically authorized by a provision of this 16 division of this Act, the department of human services or 17 the mental health, and disability services commission may 18 adopt administrative rules under section 17A.4, subsection 19 3, and section 17A.5, subsection 2, paragraph “b”, to 20 implement the provisions and the rules shall become effective 21 immediately upon filing or on a later effective date specified 22 in the rules, unless the effective date is delayed by the 23 administrative rules review committee. Any rules adopted in 24 accordance with this section shall not take effect before 25 the rules are reviewed by the administrative rules review 26 committee. The delay authority provided to the administrative 27 rules review committee under section 17A.4, subsection 7, and 28 section 17A.8, subsection 9, shall be applicable to a delay 29 imposed under this section, notwithstanding a provision in 30 those sections making them inapplicable to section 17A.5, 31 subsection 2, paragraph “b”. Any rules adopted in accordance 32 with the provisions of this section shall also be published as 33 notice of intended action as provided in section 17A.4. 34 2. If during the fiscal year beginning July 1, 2012, the 35 -192- SF 542 (3) 84 pf/jp 192/ 209
S.F. 542 department of human services is adopting rules in accordance 1 with this section or as otherwise directed or authorized by 2 state law, and the rules will result in an expenditure increase 3 beyond the amount anticipated in the budget process or if the 4 expenditure was not addressed in the budget process for the 5 fiscal year, the department shall notify the persons designated 6 by this division of this Act for submission of reports, 7 the chairpersons and ranking members of the committees on 8 appropriations, and the department of management concerning the 9 rules and the expenditure increase. The notification shall be 10 provided at least 30 calendar days prior to the date notice of 11 the rules is submitted to the administrative rules coordinator 12 and the administrative code editor. 13 Sec. 159. REPORTS. Any reports or information required to 14 be compiled and submitted under this Act shall be submitted 15 to the chairpersons and ranking members of the joint 16 appropriations subcommittee on health and human services, the 17 legislative services agency, and the legislative caucus staffs 18 on or before the dates specified for submission of the reports 19 or information. 20 Sec. 160. EFFECTIVE DATE. The following provision of this 21 division of this Act, being deemed of immediate importance, 22 take effect upon enactment: 23 The provision under the appropriation for child and family 24 services, relating to requirements of section 232.143 for 25 representatives of the department of human services and 26 juvenile court services to establish a plan for continuing 27 group foster care expenditures for fiscal year 2012-2013. 28 DIVISION XIX 29 PHARMACEUTICAL SETTLEMENT ACCOUNT, 30 IOWACARE ACCOUNT, NONPARTICIPATING PROVIDER 31 REIMBURSEMENT FUND, HEALTH CARE TRANSFORMATION ACCOUNT, 32 MEDICAID FRAUD ACCOUNT, QUALITY ASSURANCE TRUST FUND, 33 AND HOSPITAL HEALTH CARE ACCESS TRUST FUND —— FY 2012-2013 34 Sec. 161. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 35 -193- SF 542 (3) 84 pf/jp 193/ 209
S.F. 542 appropriated from the pharmaceutical settlement account created 1 in section 249A.33 to the department of human services for the 2 fiscal year beginning July 1, 2012, and ending June 30, 2013, 3 the following amount, or so much thereof as is necessary, to be 4 used for the purpose designated: 5 Notwithstanding any provision of law to the contrary, to 6 supplement the appropriations made in this Act for medical 7 contracts under the medical assistance program: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,716,807 9 Sec. 162. APPROPRIATIONS FROM IOWACARE ACCOUNT. 10 1. There is appropriated from the IowaCare account 11 created in section 249J.24 to the state board of regents for 12 distribution to the university of Iowa hospitals and clinics 13 for the fiscal year beginning July 1, 2012, and ending June 30, 14 2013, the following amount, or so much thereof as is necessary, 15 to be used for the purposes designated: 16 For salaries, support, maintenance, equipment, and 17 miscellaneous purposes, for the provision of medical and 18 surgical treatment of indigent patients, for provision of 19 services to members of the expansion population pursuant to 20 chapter 249J, and for medical education: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 27,284,584 22 a. Funds appropriated in this subsection shall not be used 23 to perform abortions except medically necessary abortions, and 24 shall not be used to operate the early termination of pregnancy 25 clinic except for the performance of medically necessary 26 abortions. For the purpose of this subsection, an abortion is 27 the purposeful interruption of pregnancy with the intention 28 other than to produce a live-born infant or to remove a dead 29 fetus, and a medically necessary abortion is one performed 30 under one of the following conditions: 31 (1) The attending physician certifies that continuing the 32 pregnancy would endanger the life of the pregnant woman. 33 (2) The attending physician certifies that the fetus is 34 physically deformed, mentally deficient, or afflicted with a 35 -194- SF 542 (3) 84 pf/jp 194/ 209
S.F. 542 congenital illness. 1 (3) The pregnancy is the result of a rape which is reported 2 within 45 days of the incident to a law enforcement agency or 3 public or private health agency which may include a family 4 physician. 5 (4) The pregnancy is the result of incest which is reported 6 within 150 days of the incident to a law enforcement agency 7 or public or private health agency which may include a family 8 physician. 9 (5) The abortion is a spontaneous abortion, commonly known 10 as a miscarriage, wherein not all of the products of conception 11 are expelled. 12 b. Notwithstanding any provision of law to the contrary, 13 the amount appropriated in this subsection shall be distributed 14 based on claims submitted, adjudicated, and paid by the Iowa 15 Medicaid enterprise. 16 c. The university of Iowa hospitals and clinics shall 17 certify public expenditures in an amount equal to provide 18 the nonfederal share on total expenditures not to exceed 19 $20,000,000. 20 2. There is appropriated from the IowaCare account 21 created in section 249J.24 to the state board of regents for 22 distribution to the university of Iowa hospitals and clinics 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 salaries, support, maintenance, equipment, and 27 miscellaneous purposes, for the provision of medical and 28 surgical treatment of indigent patients, for provision of 29 services to members of the expansion population pursuant to 30 chapter 249J, and for medical education: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 44,226,279 32 Notwithstanding any provision of law to the contrary, the 33 amount appropriated in this subsection shall be distributed 34 based on claims submitted, adjudicated, and paid by the Iowa 35 -195- SF 542 (3) 84 pf/jp 195/ 209
S.F. 542 Medicaid enterprise. 1 3. There is appropriated from the IowaCare account 2 created in section 249J.24, to the state board of regents for 3 distribution to university of Iowa physicians for the fiscal 4 year beginning July 1, 2012, and ending June 30, 2013, the 5 following amount, or so much thereof as is necessary to be used 6 for the purposes designated: 7 For salaries, support, maintenance, equipment, and 8 miscellaneous purposes for the provision of medical and 9 surgical treatment of indigent patients, for provision of 10 services to members of the expansion population pursuant to 11 chapter 249J, and for medical education: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,277,753 13 Notwithstanding any provision of law to the contrary, the 14 amount appropriated in this subsection shall be distributed 15 based on claims submitted, adjudicated, and paid by the Iowa 16 Medicaid enterprise. Once the entire amount appropriated in 17 this subsection has been distributed, claims shall continue to 18 be submitted and adjudicated by the Iowa Medicaid enterprise; 19 however, no payment shall be made based upon such claims. 20 4. There is appropriated from the IowaCare account created 21 in section 249J.24 to the department of human services for the 22 fiscal year beginning July 1, 2012, and ending June 30, 2013, 23 the following amount, or so much thereof as is necessary, to be 24 used for the purposes designated: 25 For distribution to a publicly owned acute care teaching 26 hospital located in a county with a population over 350,000 for 27 the provision of medical and surgical treatment of indigent 28 patients, for provision of services to members of the expansion 29 population pursuant to chapter 249J, and for medical education: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,000,000 31 a. Notwithstanding any provision of law to the contrary, 32 the amount appropriated in this subsection shall be distributed 33 based on claims submitted, adjudicated, and paid by the Iowa 34 Medicaid enterprise plus a monthly disproportionate share 35 -196- SF 542 (3) 84 pf/jp 196/ 209
S.F. 542 hospital payment. Any amount appropriated in this subsection 1 in excess of $60,000,000 shall be distributed only if the sum 2 of the expansion population claims adjudicated and paid by the 3 Iowa Medicaid enterprise plus the estimated disproportionate 4 share hospital payments exceeds $60,000,000. The amount paid 5 in excess of $60,000,000 shall not adjust the original monthly 6 payment amount but shall be distributed monthly based on actual 7 claims adjudicated and paid by the Iowa Medicaid enterprise 8 plus the estimated disproportionate share hospital amount. Any 9 amount appropriated in this subsection in excess of $60,000,000 10 shall be allocated only if federal funds are available to match 11 the amount allocated. Pursuant to paragraph “b”, of the amount 12 appropriated in this subsection, not more than $4,000,000 shall 13 be distributed for prescription drugs and podiatry services. 14 b. Notwithstanding any provision of law to the contrary, the 15 hospital identified in this subsection, shall be reimbursed for 16 outpatient prescription drugs and podiatry services provided to 17 members of the expansion population pursuant to all applicable 18 medical assistance program rules, in an amount not to exceed 19 $4,000,000. 20 c. Notwithstanding the total amount of proceeds distributed 21 pursuant to section 249J.24, subsection 4, paragraph “a”, 22 unnumbered paragraph 1, for the fiscal year beginning July 23 1, 2012, and ending June 30, 2013, the county treasurer of a 24 county with a population of over 350,000 in which a publicly 25 owned acute care teaching hospital is located shall distribute 26 the proceeds collected pursuant to section 347.7 in a total 27 amount of $38,000,000, which would otherwise be distributed to 28 the county hospital, to the treasurer of state for deposit in 29 the IowaCare account. 30 d. (1) Notwithstanding the amount collected and 31 distributed for deposit in the IowaCare account pursuant to 32 section 249J.24, subsection 4, paragraph “a”, subparagraph 33 (1), the first $19,000,000 in proceeds collected pursuant to 34 section 347.7 between July 1, 2012, and December 31, 2012, 35 -197- SF 542 (3) 84 pf/jp 197/ 209
S.F. 542 shall be distributed to the treasurer of state for deposit in 1 the IowaCare account and collections during this time period 2 in excess of $19,000,000 shall be distributed to the acute 3 care teaching hospital identified in this subsection. Of the 4 collections in excess of the $19,000,000 received by the acute 5 care teaching hospital under this subparagraph (1), $2,000,000 6 shall be distributed by the acute care teaching hospital to the 7 treasurer of state for deposit in the IowaCare account in the 8 month of January 2013, following the July 1 through December 9 31, 2012, period. 10 (2) Notwithstanding the amount collected and distributed 11 for deposit in the IowaCare account pursuant to section 12 249J.24, subsection 4, paragraph “a”, subparagraph (2), 13 the first $19,000,000 in collections pursuant to section 14 347.7 between January 1, 2013, and June 30, 2013, shall be 15 distributed to the treasurer of state for deposit in the 16 IowaCare account and collections during this time period in 17 excess of $19,000,000 shall be distributed to the acute care 18 teaching hospital identified in this subsection. Of the 19 collections in excess of the $19,000,000 received by the acute 20 care teaching hospital under this subparagraph (2), $2,000,000 21 shall be distributed by the acute care teaching hospital to the 22 treasurer of state for deposit in the IowaCare account in the 23 month of July 2013, following the January 1 through June 30, 24 2013, period. 25 5. There is appropriated from the IowaCare account created 26 in section 249J.24 to the department of human services for the 27 fiscal year beginning July 1, 2012, and ending June 30, 2013, 28 the following amount, or so much thereof as is necessary to be 29 used for the purpose designated: 30 For payment to the regional provider network specified 31 by the department pursuant to section 249J.7 for provision 32 of covered services to members of the expansion population 33 pursuant to chapter 249J: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,472,176 35 -198- SF 542 (3) 84 pf/jp 198/ 209
S.F. 542 Notwithstanding any provision of law to the contrary, the 1 amount appropriated in this subsection shall be distributed 2 based on claims submitted, adjudicated, and paid by the Iowa 3 Medicaid enterprise. Once the entire amount appropriated in 4 this subsection has been distributed, claims shall continue to 5 be submitted and adjudicated by the Iowa Medicaid enterprise; 6 however, no payment shall be made based upon such claims. 7 6. There is appropriated from the IowaCare account created 8 in section 249J.24 to the department of human services for the 9 fiscal year beginning July 1, 2012, and ending June 30, 2013, 10 the following amount, or so much thereof as is necessary to be 11 used for the purposes designated: 12 For a care coordination pool to pay the expansion population 13 providers consisting of the university of Iowa hospitals and 14 clinics, the publicly owned acute care teaching hospital as 15 specified in section 249J.7, and current medical assistance 16 program providers that are not expansion population network 17 providers pursuant to section 249J.7, for services covered by 18 the full benefit medical assistance program but not under the 19 IowaCare program pursuant to section 249J.6, that are provided 20 to expansion population members: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,500,000 22 a. Notwithstanding sections 249J.6 and 249J.7, the amount 23 appropriated in this subsection is intended to provide 24 payment for medically necessary services provided to expansion 25 population members for continuation of care provided by the 26 university of Iowa hospitals and clinics or the publicly owned 27 acute care teaching hospital as specified in section 249J.7. 28 Payment may only be made for services that are not otherwise 29 covered under section 249J.6, and which are follow-up services 30 to covered services provided by the hospitals specified in this 31 paragraph “a”. 32 b. The funds appropriated in this subsection are intended 33 to provide limited payment for continuity of care services for 34 an expansion population member, and are intended to cover the 35 -199- SF 542 (3) 84 pf/jp 199/ 209
S.F. 542 costs of services to expansion population members, regardless 1 of the member’s county of residence or medical home assignment, 2 if the care is related to specialty or hospital services 3 provided by the hospitals specified in paragraph “a”. 4 c. The funds appropriated in this subsection are 5 not intended to provide for expanded coverage under the 6 IowaCare program, and shall not be used to cover emergency 7 transportation services. 8 d. The department shall adopt administrative rules pursuant 9 to chapter 17A to establish a prior authorization process and 10 to identify covered services for reimbursement under this 11 subsection. 12 7. There is appropriated from the IowaCare account created 13 in section 249J.24 to the department of human services for the 14 fiscal year beginning July 1, 2012, and ending June 30, 2013, 15 the following amount or so much thereof as is necessary to be 16 used for the purposes designated: 17 For a laboratory test and radiology pool for services 18 authorized by a federally qualified health center designated 19 by the department as part of the IowaCare regional provider 20 network that does not have the capability to provide these 21 services on site: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 23 Notwithstanding sections 249J.6 and 249J.7, the amount 24 appropriated in this subsection is intended to provide 25 reimbursement for services provided to expansion population 26 members that have previously been paid for through expenditure 27 by designated regional provider network providers of their 28 own funds, not to expand coverage under the IowaCare program 29 or to expand the expansion population provider network. The 30 department shall designate the laboratory and radiology 31 provider associated with each designated regional provider 32 network provider that may receive reimbursement. The 33 department shall adopt administrative rules pursuant to chapter 34 17A to establish a prior authorization process and to identify 35 -200- SF 542 (3) 84 pf/jp 200/ 209
S.F. 542 covered services for reimbursement under this subsection. 1 All other medical assistance program payment policies and 2 rules for laboratory and radiology services shall apply to 3 services provided under this subsection. If the entire amount 4 appropriated under this subsection is expended, laboratory 5 tests and radiology services ordered by a designated regional 6 provider network provider shall be the financial responsibility 7 of the regional provider network provider. 8 Sec. 163. APPROPRIATIONS FROM NONPARTICIPATING 9 PROVIDER REIMBURSEMENT FUND —— DEPARTMENT OF HUMAN 10 SERVICES. Notwithstanding any provision to the contrary, and 11 subject to the availability of funds, there is appropriated 12 from the nonparticipating provider reimbursement fund created 13 in section 249J.24A to the department of human services for the 14 fiscal year beginning July 1, 2012, and ending June 30, 2013, 15 the following amount or so much thereof as is necessary for the 16 purposes designated: 17 To reimburse nonparticipating providers in accordance with 18 section 249J.24A: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 20 Sec. 164. APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE 21 TRANSFORMATION —— DEPARTMENT OF HUMAN SERVICES. 22 Notwithstanding any provision to the contrary, there is 23 appropriated from the account for health care transformation 24 created in section 249J.23 to the department of human services 25 for the fiscal year beginning July 1, 2012, and ending June 26 30, 2013, the following amounts, or so much thereof as is 27 necessary, to be used for the purposes designated: 28 1. For the provision of an IowaCare nurse helpline for the 29 expansion population as provided in section 249J.6: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,000 31 2. For other health promotion partnership activities 32 pursuant to section 249J.14: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 300,000 34 3. For the costs related to audits, performance 35 -201- SF 542 (3) 84 pf/jp 201/ 209
S.F. 542 evaluations, and studies required pursuant to chapter 249J: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,500 2 4. For administrative costs associated with chapter 249J: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 566,206 4 5. For planning and development, in cooperation with the 5 department of public health, of a phased-in program to provide 6 a dental home for children in accordance with section 249J.14: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 8 6. For continuation of the establishment of the tuition 9 assistance for individuals serving individuals with 10 disabilities pilot program, as enacted in 2008 Iowa Acts, 11 chapter 1187, section 130: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,000 13 7. For medical contracts: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 15 8. For payment to the publicly owned acute care teaching 16 hospital located in a county with a population of over 350,000 17 that is a participating provider pursuant to chapter 249J: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 145,000 19 Disbursements under this subsection shall be made monthly. 20 The hospital shall submit a report following the close of the 21 fiscal year regarding use of the funds appropriated in this 22 subsection to the persons specified in this Act to receive 23 reports. 24 9. For transfer to the department of public health to be 25 used for the costs of medical home system advisory council 26 established pursuant to section 135.159: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 116,679 28 Notwithstanding section 8.39, subsection 1, without the 29 prior written consent and approval of the governor and the 30 director of the department of management, the director of human 31 services may transfer funds among the appropriations made in 32 this section as necessary to carry out the purposes of the 33 account for health care transformation. The department shall 34 report any transfers made pursuant to this section to the 35 -202- SF 542 (3) 84 pf/jp 202/ 209
S.F. 542 legislative services agency. 1 Sec. 165. MEDICAID FRAUD ACCOUNT —— DEPARTMENT OF 2 INSPECTIONS AND APPEALS. There is appropriated from the 3 Medicaid fraud account created in section 249A.7 to the 4 department of inspections and appeals for the fiscal year 5 beginning July 1, 2012, and ending June 30, 2013, the following 6 amount, or so much thereof as is necessary, to be used for the 7 purposes designated: 8 For the inspection and certification of assisted living 9 programs and adult day care services, including program 10 administration and costs associated with implementation: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 669,764 12 Sec. 166. MEDICAID FRAUD ACCOUNT —— DEPARTMENT OF HUMAN 13 SERVICES. There is appropriated from the Medicaid fraud 14 account created in section 249A.7 to the department of human 15 services for the fiscal year beginning July 1, 2012, and ending 16 June 30, 2013, the following amount, or so much thereof as is 17 necessary, to be used for the purposes designated: 18 To supplement the appropriation made in this Act from the 19 general fund of the state to the department of human services 20 for medical assistance: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 22 Sec. 167. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 23 HUMAN SERVICES. Notwithstanding any provision to the contrary 24 and subject to the availability of funds, there is appropriated 25 from the quality assurance trust fund created in section 26 249L.4 to the department of human services for the fiscal year 27 beginning July 1, 2012, and ending June 30, 2013, the following 28 amounts, or so much thereof as is necessary for the purposes 29 designated: 30 To supplement the appropriation made in this Act from the 31 general fund of the state to the department of human services 32 for medical assistance: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,000,000 34 Sec. 168. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 35 -203- SF 542 (3) 84 pf/jp 203/ 209
S.F. 542 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 1 the contrary and subject to the availability of funds, there is 2 appropriated from the hospital health care access trust fund 3 created in section 249M.4 to the department of human services 4 for the fiscal year beginning July 1, 2012, and ending June 5 30, 2013, the following amounts, or so much thereof as is 6 necessary, for the purposes designated: 7 1. To supplement the appropriation made in this Act from the 8 general fund of the state to the department of human services 9 for medical assistance: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,223,800 11 2. For deposit in the nonparticipating provider 12 reimbursement fund created in section 249J.24A to be used for 13 the purposes of the fund: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 776,200 15 Sec. 169. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 16 FOR FY 2012-2013. Notwithstanding section 8.33, if moneys 17 appropriated for purposes of the medical assistance program 18 for the fiscal year beginning July 1, 2012, and ending June 19 30, 2013, from the general fund of the state, the Medicaid 20 fraud account, the quality assurance trust fund, and the 21 hospital health care access trust fund, are in excess of actual 22 expenditures for the medical assistance program and remain 23 unencumbered or unobligated at the close of the fiscal year, 24 the excess moneys shall not revert but shall remain available 25 for expenditure for the purposes of the medical assistance 26 program until the close of the succeeding fiscal year. 27 DIVISION XX 28 MH/MR/DD SERVICES ALLOWED GROWTH FUNDING FOR FISCAL YEAR 29 2012-2013 30 Sec. 170. MENTAL HEALTH, MENTAL RETARDATION, AND 31 DEVELOPMENTAL DISABILITIES SERVICES PROPERTY TAX 32 RELIEF. Notwithstanding the standing appropriation in section 33 426B.1, subsection 2, for the fiscal year beginning July 1, 34 2012, and ending June 30, 2013, the amount appropriated from 35 -204- SF 542 (3) 84 pf/jp 204/ 209
S.F. 542 the general fund of the state pursuant to that provision shall 1 not exceed the following amount: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 81,199,911 3 Sec. 171. ADULT MH/MR/DD SERVICES ALLOWED GROWTH FUNDING —— 4 FY 2012-2013. 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 distribution to counties of the county mental health, 11 mental retardation, and developmental disabilities allowed 12 growth factor adjustment for fiscal year 2012-2013 as provided 13 in this section in lieu of the allowed growth factor provisions 14 of section 331.438, subsection 2, and section 331.439, 15 subsection 3, and chapter 426B: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 68,697,893 17 2. Of the amount appropriated in this section, $12,000,000 18 shall be distributed as provided in this subsection. 19 a. To be eligible to receive a distribution under this 20 subsection, a county must meet the following requirements: 21 (1) The county is levying for the maximum amount allowed 22 for the county’s mental health, mental retardation, and 23 developmental disabilities services fund under section 331.424A 24 for taxes due and payable in the fiscal year beginning July 1, 25 2012, or the county is levying for at least 90 percent of the 26 maximum amount allowed for the county’s services fund and that 27 levy rate is more than $2 per $1,000 of the assessed value of 28 all taxable property in the county. 29 (2) In the fiscal year beginning July 1, 2010, the 30 county’s mental health, mental retardation, and developmental 31 disabilities services fund ending balance under generally 32 accepted accounting principles was equal to or less than 15 33 percent of the county’s actual gross expenditures for that 34 fiscal year. 35 -205- SF 542 (3) 84 pf/jp 205/ 209
S.F. 542 b. The amount of a county’s distribution from the allocation 1 made in this subsection shall be determined based upon the 2 county’s proportion of the general population of the counties 3 eligible to receive a distribution under this subsection. The 4 most recent population estimates issued by the United States 5 bureau of the census shall be applied in determining population 6 for the purposes of this paragraph. 7 c. The distributions made pursuant to this subsection 8 are subject to the distribution provisions and withholding 9 requirements established in this section for the county mental 10 health, mental retardation, and developmental disabilities 11 allowed growth factor adjustment for the fiscal year beginning 12 July 1, 2012. 13 3. The following amount of the funding appropriated in this 14 section is the allowed growth factor adjustment for fiscal 15 year 2012-2013, and shall be credited to the allowed growth 16 funding pool created in the property tax relief fund and for 17 distribution in accordance with section 426B.5, subsection 1: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 56,697,893 19 4. The following formula amounts shall be utilized only 20 to calculate preliminary distribution amounts for the allowed 21 growth factor adjustment for fiscal year 2012-2013 under this 22 section by applying the indicated formula provisions to the 23 formula amounts and producing a preliminary distribution total 24 for each county: 25 a. For calculation of a distribution amount for eligible 26 counties from the allowed growth funding pool created in the 27 property tax relief fund in accordance with the requirements in 28 section 426B.5, subsection 1: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 69,773,346 30 b. For calculation of a distribution amount for counties 31 from the mental health and developmental disabilities (MH/DD) 32 community services fund in accordance with the formula provided 33 in the appropriation made for the MH/DD community services fund 34 for the fiscal year beginning July 1, 2012: 35 -206- SF 542 (3) 84 pf/jp 206/ 209
S.F. 542 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,187,556 1 5. a. After applying the applicable statutory distribution 2 formulas to the amounts indicated in subsection 4 for purposes 3 of producing preliminary distribution totals, the department 4 of human services shall apply a withholding factor to adjust 5 an eligible individual county’s preliminary distribution 6 total. In order to be eligible for a distribution under this 7 section, a county must be levying 90 percent or more of the 8 maximum amount allowed for the county’s mental health, mental 9 retardation, and developmental disabilities services fund under 10 section 331.424A for taxes due and payable in the fiscal year 11 for which the distribution is payable. 12 b. An ending balance percentage for each county shall 13 be determined by expressing the county’s ending balance on a 14 modified accrual basis under generally accepted accounting 15 principles for the fiscal year beginning July 1, 2010, in the 16 county’s mental health, mental retardation, and developmental 17 disabilities services fund created under section 331.424A, as a 18 percentage of the county’s gross expenditures from that fund 19 for that fiscal year. If a county borrowed moneys for purposes 20 of providing services from the county’s services fund on or 21 before July 1, 2010, and the county’s services fund ending 22 balance for that fiscal year includes the loan proceeds or an 23 amount designated in the county budget to service the loan for 24 the borrowed moneys, those amounts shall not be considered 25 to be part of the county’s ending balance for purposes of 26 calculating an ending balance percentage under this subsection. 27 c. For purposes of calculating withholding factors and for 28 ending balance amounts used for other purposes under law, the 29 county ending balances shall be adjusted, using forms developed 30 for this purpose by the county finance committee, to disregard 31 the temporary funding increase provided to the counties for 32 the fiscal year through the federal American Recovery and 33 Reinvestment Act of 2009, Pub. L. No. 111-5. In addition, a 34 county may adjust the ending balance amount by rebating to the 35 -207- SF 542 (3) 84 pf/jp 207/ 209
S.F. 542 department all or a portion of the allowed growth and MH/DD 1 services fund moneys the county received for the fiscal year 2 beginning July 1, 2011, in accordance with this Act, or from 3 any other services fund moneys available to the county. The 4 rebate must be remitted to the department on or before June 1, 5 2012, in order to be counted. The amount rebated by a county 6 shall be subtracted dollar-for-dollar from the county’s ending 7 balance amount for the fiscal year beginning July 1, 2010, 8 for purposes of calculating the withholding factor and for 9 other ending balance purposes for the fiscal year beginning 10 July 1, 2012. The rebates received by the department shall be 11 credited to the property tax relief fund and distributed as 12 additional funding for the fiscal year beginning July 1, 2012, 13 in accordance with the formula provisions in this section. 14 d. The withholding factor for a county shall be the 15 following applicable percent: 16 (1) For an ending balance percentage of less than 5 17 percent, a withholding factor of 0 percent. In addition, 18 a county that is subject to this lettered paragraph shall 19 receive an inflation adjustment equal to 3 percent of the gross 20 expenditures reported for the county’s services fund for the 21 fiscal year. 22 (2) For an ending balance percentage of 5 percent or more 23 but less than 10 percent, a withholding factor of 0 percent. 24 In addition, a county that is subject to this lettered 25 paragraph shall receive an inflation adjustment equal to 2 26 percent of the gross expenditures reported for the county’s 27 services fund for the fiscal year. 28 (3) For an ending balance percentage of 10 percent or more 29 but less than 25 percent, a withholding factor of 25 percent. 30 However, for counties with an ending balance of 10 percent or 31 more but less than 15 percent, the amount withheld shall be 32 limited to the amount by which the county’s ending balance was 33 in excess of the ending balance percentage of 10 percent. 34 (4) For an ending balance percentage of 25 percent or more, 35 -208- SF 542 (3) 84 pf/jp 208/ 209
S.F. 542 a withholding percentage of 100 percent. 1 6. The total withholding amounts applied pursuant to 2 subsection 5 shall be equal to a withholding target amount of 3 $13,075,453. If the department of human services determines 4 that the amount appropriated is insufficient or the amount to 5 be withheld in accordance with subsection 5 is not equal to 6 the target withholding amount, the department shall adjust the 7 withholding factors listed in subsection 5 as necessary to 8 achieve the target withholding amount. However, in making such 9 adjustments to the withholding factors, the department shall 10 strive to minimize changes to the withholding factors for those 11 ending balance percentage ranges that are lower than others and 12 shall only adjust the zero withholding factor or the inflation 13 adjustment percentages specified in subsection 5, paragraph 14 “d”, when the amount appropriated is insufficient. 15 DIVISION XXI 16 CONDITIONAL RETROACTIVE APPLICABILITY 17 Sec. 172. EFFECTIVE DATE AND RETROACTIVE 18 APPLICABILITY. Unless otherwise provided, this Act, if 19 approved by the governor on or after July 1, 2011, takes effect 20 upon enactment and applies retroactively to July 1, 2011. 21 -209- SF 542 (3) 84 pf/jp 209/ 209