Senate File 505 - Reprinted SENATE FILE 505 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO SSB 1288) (As Amended and Passed by the Senate May 6, 2015 ) A BILL FOR An Act relating to appropriations for health and human services 1 and veterans and including other related provisions and 2 appropriations, and including effective date and retroactive 3 and other applicability date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 SF 505 (3) 86 pf/rj
S.F. 505 DIVISION I 1 DEPARTMENT ON AGING —— FY 2015-2016 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, 2015, and ending June 30, 5 2016, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,436,066 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 31.00 20 1. Funds appropriated in this section may be used to 21 supplement federal funds under federal regulations. To 22 receive funds appropriated in this section, a local area 23 agency on aging shall match the funds with moneys from other 24 sources according to rules adopted by the department. Funds 25 appropriated in this section may be used for elderly services 26 not specifically enumerated in this section only if approved 27 by an area agency on aging for provision of the service within 28 the area. 29 2. Of the funds appropriated in this section, $279,946 is 30 transferred to the economic development authority for the Iowa 31 commission on volunteer services to be used for the retired and 32 senior volunteer program. 33 3. a. The department on aging shall establish and enforce 34 procedures relating to expenditure of state and federal funds 35 -1- SF 505 (3) 86 pf/rj 1/ 195
S.F. 505 by area agencies on aging that require compliance with both 1 state and federal laws, rules, and regulations, including but 2 not limited to all of the following: 3 (1) Requiring that expenditures are incurred only for goods 4 or services received or performed prior to the end of the 5 fiscal period designated for use of the funds. 6 (2) Prohibiting prepayment for goods or services not 7 received or performed prior to the end of the fiscal period 8 designated for use of the funds. 9 (3) Prohibiting the prepayment for goods or services 10 not defined specifically by good or service, time period, or 11 recipient. 12 (4) Prohibiting the establishment of accounts from which 13 future goods or services which are not defined specifically by 14 good or service, time period, or recipient, may be purchased. 15 b. The procedures shall provide that if any funds are 16 expended in a manner that is not in compliance with the 17 procedures and applicable federal and state laws, rules, and 18 regulations, and are subsequently subject to repayment, the 19 area agency on aging expending such funds in contravention of 20 such procedures, laws, rules and regulations, not the state, 21 shall be liable for such repayment. 22 4. Of the funds appropriated in this section, at least 23 $250,000 shall be used to fund the unmet needs identified 24 through Iowa’s aging and disability resource center network. 25 5. Of the funds appropriated in this section, at least 26 $600,000 shall be used to fund home and community-based 27 services through the area agencies on aging that enable older 28 individuals to avoid more costly utilization of residential or 29 institutional services and remain in their own homes. 30 6. Of the funds appropriated in this section, $850,000 31 shall be used for the purposes of chapter 231E and section 32 231.56A, of which $325,000 shall be used for the office of 33 substitute decision maker pursuant to chapter 231E, and the 34 remainder shall be distributed equally to the area agencies on 35 -2- SF 505 (3) 86 pf/rj 2/ 195
S.F. 505 aging to administer the prevention of elder abuse, neglect, and 1 exploitation program pursuant to section 231.56A, in accordance 2 with the requirements of the federal Older Americans Act of 3 1965, 42 U.S.C. §3001 et seq., as amended. 4 DIVISION II 5 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2015-2016 6 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. 7 1. There is appropriated from the general fund of the state 8 to the office of long-term care ombudsman for the fiscal year 9 beginning July 1, 2015, and ending June 30, 2016, the following 10 amount, or so much thereof as is necessary, to be used for the 11 purposes designated: 12 For salaries, support, administration, maintenance, and 13 miscellaneous purposes, and for not more than the following 14 full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,506,783 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 21.00 17 2. Of the funds appropriated in this section, $450,000 shall 18 be used to provide additional local long-term care ombudsmen. 19 3. The office of long-term care ombudsman and the department 20 of human services shall collaborate to develop a Medicaid 21 state plan amendment to provide for the claiming of federal 22 financial participation for office of long-term care ombudsman 23 activities that are performed to assist with administration of 24 the Medicaid program. The Medicaid state plan amendment shall 25 be submitted to the centers for Medicare and Medicaid services 26 of the United States department of health and human services in 27 a timely manner to allow for such claiming of federal financial 28 participation beginning January 1, 2016. 29 DIVISION III 30 DEPARTMENT OF PUBLIC HEALTH —— FY 2015-2016 31 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 32 from the general fund of the state to the department of public 33 health for the fiscal year beginning July 1, 2015, and ending 34 June 30, 2016, the following amounts, or so much thereof as is 35 -3- SF 505 (3) 86 pf/rj 3/ 195
S.F. 505 necessary, to be used for the purposes designated: 1 1. ADDICTIVE DISORDERS 2 For reducing the prevalence of the use of tobacco, alcohol, 3 and other drugs, and treating individuals affected by addictive 4 behaviors, including gambling, and for not more than the 5 following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 27,263,690 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 8 a. (1) Of the funds appropriated in this subsection, 9 $5,248,361 shall be used for the tobacco use prevention 10 and control initiative, including efforts at the state and 11 local levels, as provided in chapter 142A . The commission 12 on tobacco use prevention and control established pursuant 13 to section 142A.3 shall advise the director of public health 14 in prioritizing funding needs and the allocation of moneys 15 appropriated for the programs and initiatives. Activities 16 of the programs and initiatives shall be in alignment with 17 the United States centers for disease control and prevention 18 best practices for comprehensive tobacco control programs that 19 include the goals of preventing youth initiation of tobacco 20 usage, reducing exposure to secondhand smoke, and promotion of 21 tobacco cessation. 22 (2) (a) Of the funds allocated in this paragraph “a”, 23 $453,067 is transferred to the alcoholic beverages division of 24 the department of commerce for enforcement of tobacco laws, 25 regulations, and ordinances and to engage in tobacco control 26 activities approved by the division of tobacco use prevention 27 and control of the department of public health as specified 28 in the memorandum of understanding entered into between the 29 divisions. 30 (b) For the fiscal year beginning July 1, 2015, and ending 31 June 30, 2016, the terms of the memorandum of understanding, 32 entered into between the division of tobacco use prevention 33 and control of the department of public health and the 34 alcoholic beverages division of the department of commerce, 35 -4- SF 505 (3) 86 pf/rj 4/ 195
S.F. 505 governing compliance checks conducted to ensure licensed retail 1 tobacco outlet conformity with tobacco laws, regulations, and 2 ordinances relating to persons under eighteen years of age, 3 shall continue to restrict the number of such checks to one 4 check per retail outlet, and one additional check for any 5 retail outlet found to be in violation during the first check. 6 b. Of the funds appropriated in this subsection, 7 $22,015,329 shall be used for problem gambling and 8 substance-related disorder prevention, treatment, and recovery 9 services, including a 24-hour helpline, public information 10 resources, professional training, and program evaluation. 11 (1) Of the funds allocated in this paragraph “b”, 12 $18,903,715 shall be used for substance-related disorder 13 prevention and treatment. 14 (a) Of the funds allocated in this subparagraph (1), 15 $899,300 shall be used for the public purpose of a grant 16 program to provide substance-related disorder prevention 17 programming for children. 18 (i) Of the funds allocated in this subparagraph division 19 (a), $427,539 shall be used for grant funding for organizations 20 that provide programming for children by utilizing mentors. 21 Programs approved for such grants shall be certified or must 22 be certified within six months of receiving the grant award 23 by the Iowa commission on volunteer services as utilizing the 24 standards for effective practice for mentoring programs. 25 (ii) Of the funds allocated in this subparagraph division 26 (a), $426,839 shall be used for grant funding for organizations 27 providing programming that includes youth development and 28 leadership services. The programs shall also be recognized as 29 being programs that are scientifically based with evidence of 30 their effectiveness in reducing substance-related disorders in 31 children. 32 (iii) The department of public health shall utilize a 33 request for proposals process to implement the grant program. 34 (iv) All grant recipients shall participate in a program 35 -5- SF 505 (3) 86 pf/rj 5/ 195
S.F. 505 evaluation as a requirement for receiving grant funds. 1 (v) Of the funds allocated in this subparagraph division 2 (a), up to $44,922 may be used to administer substance-related 3 disorder prevention grants and for program evaluations. 4 (b) Of the funds allocated in this subparagraph 5 (1), $272,603 shall be used for culturally competent 6 substance-related disorder treatment pilot projects. 7 (i) The department shall utilize the amount allocated 8 in this subparagraph division (b) for at least three pilot 9 projects to provide culturally competent substance-related 10 disorder treatment in various areas of the state. Each pilot 11 project shall target a particular ethnic minority population. 12 The populations targeted shall include but are not limited to 13 African American, Asian, and Latino. 14 (ii) The pilot project requirements shall provide for 15 documentation or other means to ensure access to the cultural 16 competence approach used by a pilot project so that such 17 approach can be replicated and improved upon in successor 18 programs. 19 (2) Of the funds allocated in this paragraph “b”, up 20 to $3,111,614 may be used for problem gambling prevention, 21 treatment, and recovery services. 22 (a) Of the funds allocated in this subparagraph (2), 23 $2,573,762 shall be used for problem gambling prevention and 24 treatment. 25 (b) Of the funds allocated in this subparagraph (2), up to 26 $437,852 may be used for a 24-hour helpline, public information 27 resources, professional training, and program evaluation. 28 (c) Of the funds allocated in this subparagraph (2), up 29 to $100,000 may be used for the licensing of problem gambling 30 treatment programs. 31 (3) It is the intent of the general assembly that from the 32 moneys allocated in this paragraph “b”, persons with a dual 33 diagnosis of substance-related disorder and gambling addiction 34 shall be given priority in treatment services. 35 -6- SF 505 (3) 86 pf/rj 6/ 195
S.F. 505 c. Notwithstanding any provision of law to the contrary, 1 to standardize the availability, delivery, cost of delivery, 2 and accountability of problem gambling and substance-related 3 disorder treatment services statewide, the department shall 4 continue implementation of a process to create a system 5 for delivery of treatment services in accordance with the 6 requirements specified in 2008 Iowa Acts, chapter 1187, section 7 3, subsection 4. To ensure the system provides a continuum 8 of treatment services that best meets the needs of Iowans, 9 the problem gambling and substance-related disorder treatment 10 services in any area may be provided either by a single agency 11 or by separate agencies submitting a joint proposal. 12 (1) The system for delivery of substance-related disorder 13 and problem gambling treatment shall include problem gambling 14 prevention. 15 (2) The system for delivery of substance-related disorder 16 and problem gambling treatment shall include substance-related 17 disorder prevention by July 1, 2016. 18 (3) Of the funds allocated in paragraph “b”, the department 19 may use up to $100,000 for administrative costs to continue 20 developing and implementing the process in accordance with this 21 paragraph “c”. 22 d. The requirement of section 123.53, subsection 5 , is met 23 by the appropriations and allocations made in this division of 24 this Act for purposes of substance-related disorder treatment 25 and addictive disorders for the fiscal year beginning July 1, 26 2015. 27 e. The department of public health shall work with all 28 other departments that fund substance-related disorder 29 prevention and treatment services and all such departments 30 shall, to the extent necessary, collectively meet the state 31 maintenance of effort requirements for expenditures for 32 substance-related disorder services as required under the 33 federal substance-related disorder prevention and treatment 34 block grant. 35 -7- SF 505 (3) 86 pf/rj 7/ 195
S.F. 505 2. HEALTHY CHILDREN AND FAMILIES 1 For promoting the optimum health status for children, 2 adolescents from birth through 21 years of age, and families, 3 and for not more than the following full-time equivalent 4 positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,331,602 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 7 a. Of the funds appropriated in this subsection, not more 8 than $734,841 shall be used for the healthy opportunities for 9 parents to experience success (HOPES)-healthy families Iowa 10 (HFI) program established pursuant to section 135.106 . The 11 funding shall be distributed to renew the grants that were 12 provided to the grantees that operated the program during the 13 fiscal year ending June 30, 2015. 14 b. In order to implement the legislative intent stated in 15 sections 135.106 and 256I.9 , that priority for home visitation 16 program funding be given to programs using evidence-based or 17 promising models for home visitation, it is the intent of the 18 general assembly to phase in the funding priority in accordance 19 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, 20 paragraph 0b. 21 c. Of the funds appropriated in this subsection, $4,912,887 22 shall be used to expand statewide the department’s initiative 23 to provide for adequate developmental surveillance and 24 screening during a child’s first five years. The funds shall 25 be used first to fully fund the current sites to ensure that 26 the sites are fully operational, with the remaining funds 27 to be used for expansion to additional sites. The full 28 implementation and expansion shall include enhancing the scope 29 of the program through collaboration with the child health 30 specialty clinics to promote healthy child development through 31 early identification and response to both biomedical and social 32 determinants of healthy development; by monitoring child 33 health metrics to inform practice, document long-term health 34 impacts and savings, and provide for continuous improvement 35 -8- SF 505 (3) 86 pf/rj 8/ 195
S.F. 505 through training, education, and evaluation; and by providing 1 for practitioner consultation particularly for children with 2 behavioral conditions and needs. The department of public 3 health shall also collaborate with the Iowa Medicaid enterprise 4 and the child health specialty clinics to integrate the 5 activities of the first five initiative into the establishment 6 of patient-centered medical homes, community utilities, 7 accountable care organizations, and other integrated care 8 models developed to improve health quality and population 9 health while reducing health care costs. To the maximum extent 10 possible, funding allocated in this paragraph shall be utilized 11 as matching funds for medical assistance program reimbursement. 12 d. Of the funds appropriated in this subsection, $74,640 13 shall be distributed to a statewide dental carrier to provide 14 funds to continue the donated dental services program patterned 15 after the projects developed by the lifeline network to provide 16 dental services to indigent individuals who are elderly or with 17 disabilities. 18 e. Of the funds appropriated in this subsection, $111,995 19 shall be used for childhood obesity prevention. 20 f. Of the funds appropriated in this subsection, $162,768 21 shall be used to provide audiological services and hearing 22 aids for children. The department may enter into a contract 23 to administer this paragraph. 24 g. Of the funds appropriated in this subsection, $25,000 is 25 transferred to the university of Iowa college of dentistry for 26 provision of primary dental services to children. State funds 27 shall be matched on a dollar-for-dollar basis. The university 28 of Iowa college of dentistry shall coordinate efforts with the 29 department of public health, bureau of oral and health delivery 30 systems, to provide dental care to underserved populations 31 throughout the state. 32 h. Of the funds appropriated in this subsection, $50,000 33 shall be used to address youth suicide prevention. 34 i. Of the funds appropriated in this subsection, $50,000 35 -9- SF 505 (3) 86 pf/rj 9/ 195
S.F. 505 shall be used to support the Iowa effort to address the survey 1 of children who experience adverse childhood experiences known 2 as ACEs. 3 3. CHRONIC CONDITIONS 4 For serving individuals identified as having chronic 5 conditions or special health care needs, and for not more than 6 the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,105,861 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 9 a. Of the funds appropriated in this subsection, $159,932 10 shall be used for grants to individual patients who have an 11 inherited metabolic disorder to assist with the costs of 12 medically necessary foods and formula. 13 b. Of the funds appropriated in this subsection, $891,644 14 shall be used for the brain injury services program pursuant to 15 section 135.22B , including for continuation of the contracts 16 for resource facilitator services in accordance with section 17 135.22B, subsection 9 , and to enhance brain injury training and 18 recruitment of service providers on a statewide basis. Of the 19 amount allocated in this paragraph, $95,000 shall be used to 20 fund one full-time equivalent position to serve as the state 21 brain injury services program manager. 22 c. Of the funds appropriated in this subsection, $547,982 23 shall be used as additional funding to leverage federal funding 24 through the federal Ryan White Care Act, Tit. II, AIDS drug 25 assistance program supplemental drug treatment grants. 26 d. Of the funds appropriated in this subsection, $149,823 27 shall be used for the public purpose of continuing to contract 28 with an existing national-affiliated organization to provide 29 education, client-centered programs, and client and family 30 support for people living with epilepsy and their families. 31 The amount allocated in this paragraph in excess of $100,000 32 shall be matched dollar-for-dollar by the organization 33 specified. 34 e. Of the funds appropriated in this subsection, $785,114 35 -10- SF 505 (3) 86 pf/rj 10/ 195
S.F. 505 shall be used for child health specialty clinics. 1 f. Of the funds appropriated in this subsection, $400,000 2 shall be used by the regional autism assistance program 3 established pursuant to section 256.35 , and administered by 4 the child health specialty clinic located at the university of 5 Iowa hospitals and clinics. The funds shall be used to enhance 6 interagency collaboration and coordination of educational, 7 medical, and other human services for persons with autism, 8 their families, and providers of services, including delivering 9 regionalized services of care coordination, family navigation, 10 and integration of services through the statewide system of 11 regional child health specialty clinics and fulfilling other 12 requirements as specified in chapter 225D . The university of 13 Iowa shall not receive funds allocated under this paragraph for 14 indirect costs associated with the regional autism assistance 15 program. 16 g. Of the funds appropriated in this subsection, $570,993 17 shall be used for the comprehensive cancer control program to 18 reduce the burden of cancer in Iowa through prevention, early 19 detection, effective treatment, and ensuring quality of life. 20 Of the funds allocated in this paragraph “g”, $150,000 shall 21 be used to support a melanoma research symposium, a melanoma 22 biorepository and registry, basic and translational melanoma 23 research, and clinical trials. 24 h. Of the funds appropriated in this subsection, $126,450 25 shall be used for cervical and colon cancer screening, and 26 $300,000 shall be used to enhance the capacity of the cervical 27 cancer screening program to include provision of recommended 28 prevention and early detection measures to a broader range of 29 low-income women. 30 i. Of the funds appropriated in this subsection, $676,864 31 shall be used for the center for congenital and inherited 32 disorders including to provide for surveillance of stillbirths 33 as defined in section 136A.2. 34 j. Of the funds appropriated in this subsection, $129,411 35 -11- SF 505 (3) 86 pf/rj 11/ 195
S.F. 505 shall be used for the prescription drug donation repository 1 program created in chapter 135M . 2 k. Of the funds appropriated in this subsection, 3 $215,263 shall be used by the department of public health 4 for reform-related activities, including but not limited to 5 facilitation of communication to stakeholders at the state and 6 local level, administering the patient-centered health advisory 7 council pursuant to section 135.159, and involvement in health 8 care system innovation activities occurring across the state. 9 l. Of the funds appropriated in this subsection, $25,000 10 shall be used for administration of chapter 124D, the medical 11 cannabidiol Act, or other Code provisions authorizing the 12 compassionate medical use of cannabis, if enacted by the 2015 13 regular session of the Eighty-sixth General Assembly. 14 4. COMMUNITY CAPACITY 15 For strengthening the health care delivery system at the 16 local level, and for not more than the following full-time 17 equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,719,716 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 11.00 20 a. Of the funds appropriated in this subsection, $99,414 21 is allocated for continuation of the child vision screening 22 program implemented through the university of Iowa hospitals 23 and clinics in collaboration with early childhood Iowa areas. 24 The program shall submit a report to the individuals identified 25 in this Act for submission of reports regarding the use of 26 funds allocated under this paragraph “a”. The report shall 27 include the objectives and results for the program year 28 including the target population and how the funds allocated 29 assisted the program in meeting the objectives; the number, 30 age, and location within the state of individuals served; 31 the type of services provided to the individuals served; the 32 distribution of funds based on service provided; and the 33 continuing needs of the program. 34 b. Of the funds appropriated in this subsection, $110,656 is 35 -12- SF 505 (3) 86 pf/rj 12/ 195
S.F. 505 allocated for continuation of an initiative implemented at the 1 university of Iowa and $99,904 is allocated for continuation of 2 an initiative at the state mental health institute at Cherokee 3 to expand and improve the workforce engaged in mental health 4 treatment and services. The initiatives shall receive input 5 from the university of Iowa, the department of human services, 6 the department of public health, and the mental health and 7 disability services commission to address the focus of the 8 initiatives. 9 c. Of the funds appropriated in this subsection, $1,164,628 10 shall be used for essential public health services that promote 11 healthy aging throughout one’s 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, $99,286 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, $105,448 19 shall be used to continue to address the shortage of mental 20 health professionals in the state. 21 f. Of the funds appropriated in this subsection, 22 $50,000 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 135.180 . 28 g. (1) Of the funds appropriated in this subsection, 29 $2,882,969 shall be allocated as a grant to the Iowa primary 30 care association to be used pursuant to section 135.153 for 31 the statewide coordination of the Iowa collaborative safety 32 net provider network. Coordination of the network shall 33 focus on increasing access by underserved populations to 34 health care services, increasing integration of the health 35 -13- SF 505 (3) 86 pf/rj 13/ 195
S.F. 505 system and collaboration across the continuum of care with 1 a focus on safety net services, and enhancing the Iowa 2 collaborative safety net provider network’s communication and 3 education efforts. The amount allocated as a grant under this 4 subparagraph (1) shall be used as follows to support the Iowa 5 collaborative safety net provider network goals of increased 6 access, health system integration, and engagement: 7 (a) For distribution to safety net partners in the state 8 that work to increase access of the underserved population to 9 health services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,025,485 11 (i) Of the amount allocated in this subparagraph division 12 (a), not less than $413,415 shall be distributed to the 13 Iowa prescription drug corporation for continuation of the 14 pharmaceutical infrastructure for safety net providers as 15 described in 2007 Iowa Acts, chapter 218, section 108. 16 (ii) Of the amount allocated in this subparagraph division 17 (a), not less than $348,322 shall be distributed to free 18 clinics and free clinics of Iowa for necessary infrastructure, 19 statewide coordination, provider recruitment, service delivery, 20 and provision of assistance to patients in securing a medical 21 home inclusive of oral health care. 22 (iii) Of the amount allocated in this subparagraph division 23 (a), not less than $50,000 shall be distributed to the Iowa 24 coalition against sexual assault to continue a training 25 program for sexual assault response team (SART) members, 26 including representatives of law enforcement, victim advocates, 27 prosecutors, and certified medical personnel. 28 (iv) Of the amount allocated in this subparagraph division 29 (a), not less than $213,748 shall be distributed to the Polk 30 county medical society for continuation of the safety net 31 provider patient access to a specialty health care initiative 32 as described in 2007 Iowa Acts, chapter 218, section 109. 33 (b) For distribution to safety net partners in the 34 state that work to increase health system integration, care 35 -14- SF 505 (3) 86 pf/rj 14/ 195
S.F. 505 coordination, and collaboration across the continuum of care 1 with a focus on safety net services. Such efforts shall 2 include but not be limited to community care coordination team 3 development and integration of medical and behavioral health 4 services. Efforts shall also include working, in conjunction 5 with the department of human services and the department 6 of public health, to support Medicaid managed care efforts 7 inclusive of the state innovation model through the continued 8 development and implementation of community care coordination 9 teams. Implementation of the community care coordination 10 teams shall be accomplished through a statewide regionally 11 based network that provides an integrated approach to health 12 care delivery through care coordination that supports primary 13 care providers and links patients with community resources 14 necessary to empower patients in addressing biomedical and 15 social determinants of health to improve health outcomes: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,672,199 17 (c) For distribution to safety net partners in the state 18 that work to serve as a resource for credible, accurate 19 information on health care-related needs and services 20 for vulnerable populations in the state including the 21 Iowa association of rural health clinics for necessary 22 infrastructure and service delivery transformation and the Iowa 23 primary care association to support partner engagement, program 24 management, and statewide coordination of the network: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 185,285 26 (2) The amount allocated under this paragraph “g” shall 27 not be reduced for administrative or other costs prior to 28 distribution. The Iowa collaborative safety net provider 29 network may continue to distribute funds allocated pursuant to 30 this paragraph “g” through existing contracts or renewal of 31 existing contracts. 32 (3) For each goal of the Iowa collaborative safety net 33 provider network, the Iowa primary care association shall 34 submit a progress report to the individuals designated in this 35 -15- SF 505 (3) 86 pf/rj 15/ 195
S.F. 505 Act for submission of reports by December 15, 2015, including 1 progress in developing and implementing the network, how the 2 funds were distributed and used in developing and implementing 3 the network, and the remaining needs identified to fully 4 develop and implement the network. 5 h. Of the funds appropriated in this subsection, $213,400 6 shall be used for continuation of the work of the direct care 7 worker advisory council established pursuant to 2008 Iowa Acts, 8 chapter 1188, section 69, in implementing the recommendations 9 in the final report submitted by the advisory council to the 10 governor and the general assembly in March 2012, including 11 by continuing to develop, promote, and make available on a 12 statewide basis the prepare-to-care core curriculum and its 13 associated modules and specialties through various formats 14 including online access, community colleges, and other venues; 15 exploring new and maintaining existing specialties including 16 but not limited to oral health and dementia care; supporting 17 instructor training; and assessing and making recommendations 18 concerning the Iowa care book and information technology 19 systems and infrastructure uses and needs. 20 i. (1) Of the funds appropriated in this subsection, 21 $216,375 shall be used for allocation to an independent 22 statewide direct care worker organization under continuation 23 of the contract in effect during the fiscal year ending June 24 30, 2015. 25 (2) Of the funds appropriated in this subsection, 26 $105,000 shall be used to provide scholarships or other 27 forms of subsidization for direct care worker educational 28 conferences, training, or outreach activities, and for the 29 mouth-care-matters oral health care project. 30 j. Of the funds appropriated in this subsection, the 31 department may use up to $58,175 for up to one full-time 32 equivalent position to administer the volunteer health care 33 provider program pursuant to section 135.24 . 34 k. Of the funds appropriated in this subsection, $100,000 35 -16- SF 505 (3) 86 pf/rj 16/ 195
S.F. 505 shall be used for a matching dental education loan repayment 1 program to be allocated to a dental nonprofit health service 2 corporation to continue to develop the criteria and implement 3 the loan repayment program. 4 l. Of the funds appropriated in this subsection, $105,823 is 5 transferred to the college student aid commission for deposit 6 in the rural Iowa primary care trust fund created in section 7 261.113 to be used for the purposes of the fund. 8 m. Of the funds appropriated in this subsection, $250,000 9 shall be used for the purposes of the Iowa donor registry as 10 specified in section 142C.18 . 11 n. Of the funds appropriated in this subsection, $100,000 12 shall be used for continuation of a grant to a nationally 13 affiliated volunteer eye organization that has an established 14 program for children and adults and that is solely dedicated to 15 preserving sight and preventing blindness through education, 16 nationally certified vision screening and training, and 17 community and patient service programs. The organization 18 shall submit a report to the individuals identified in this 19 Act for submission of reports regarding the use of funds 20 allocated under this paragraph “n”. The report shall include 21 the objectives and results for the program year including 22 the target population and how the funds allocated assisted 23 the program in meeting the objectives; the number, age, and 24 location within the state of individuals served; the type of 25 services provided to the individuals served; the distribution 26 of funds based on services provided; and the continuing needs 27 of the program. 28 o. Of the funds appropriated in this subsection, $25,000 29 shall be used for the continuation of a wellness council under 30 the direction of the director of public health to increase 31 support for wellness activities in the state. 32 p. Of the funds appropriated in this subsection, $2,000,000 33 shall be deposited in the medical residency training account 34 created in section 135.175, subsection 5, paragraph “a” , and 35 -17- SF 505 (3) 86 pf/rj 17/ 195
S.F. 505 is appropriated from the account to the department of public 1 health to be used for the purposes of the medical residency 2 training state matching grants program as specified in section 3 135.176 . However, notwithstanding any provision to the 4 contrary in section 135.176, priority in the awarding of grants 5 shall be given to sponsors that propose preference in the use 6 of the grant funds for psychiatric residency positions and 7 family practice residency positions. 8 5. HEALTHY AGING 9 To provide public health services that reduce risks and 10 invest in promoting and protecting good health over the 11 course of a lifetime with a priority given to older Iowans and 12 vulnerable populations: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,297,142 14 6. INFECTIOUS DISEASES 15 For reducing the incidence and prevalence of communicable 16 diseases, and for not more than the following full-time 17 equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,335,155 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 20 7. PUBLIC PROTECTION 21 For protecting the health and safety of the public through 22 establishing standards and enforcing regulations, and for not 23 more than the following full-time equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,339,191 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 135.50 26 a. Of the funds appropriated in this subsection, not more 27 than $454,700 shall be credited to the emergency medical 28 services fund created in section 135.25 . Moneys in the 29 emergency medical services fund are appropriated to the 30 department to be used for the purposes of the fund. 31 b. Of the funds appropriated in this subsection, $203,032 32 shall be used for sexual violence prevention programming 33 through a statewide organization representing programs 34 serving victims of sexual violence through the department’s 35 -18- SF 505 (3) 86 pf/rj 18/ 195
S.F. 505 sexual violence prevention program. The amount allocated 1 in this paragraph “b” shall not be used to supplant funding 2 administered for other sexual violence prevention or victims 3 assistance programs. 4 c. Of the funds appropriated in this subsection, $598,751 5 shall be used for the state poison control center. Pursuant 6 to the directive under 2014 Iowa Acts, chapter 1140, section 7 102, the federal matching funds available to the state poison 8 control center from the department of human services under the 9 federal Children’s Health Insurance Program Reauthorization Act 10 allotment shall be subject to the federal administrative cap 11 rule of 10 percent applicable to funding provided under Tit. 12 XXI of the federal Social Security Act and included within the 13 department’s calculations of the cap. 14 d. Of the funds appropriated in this subsection, $537,750 15 shall be used for childhood lead poisoning provisions. 16 8. RESOURCE MANAGEMENT 17 For establishing and sustaining the overall ability of the 18 department to deliver services to the public, and for not more 19 than the following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 855,072 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 22 The university of Iowa hospitals and clinics under the 23 control of the state board of regents shall not receive 24 indirect costs from the funds appropriated in this section. 25 The university of Iowa hospitals and clinics billings to the 26 department shall be on at least a quarterly basis. 27 DIVISION IV 28 DEPARTMENT OF VETERANS AFFAIRS —— FY 2015-2016 29 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is 30 appropriated from the general fund of the state to the 31 department of veterans affairs for the fiscal year beginning 32 July 1, 2015, and ending June 30, 2016, the following amounts, 33 or so much thereof as is necessary, to be used for the purposes 34 designated: 35 -19- SF 505 (3) 86 pf/rj 19/ 195
S.F. 505 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 1 For salaries, support, maintenance, and miscellaneous 2 purposes, and for not more than the following full-time 3 equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,200,546 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 6 2. IOWA VETERANS HOME 7 For salaries, support, maintenance, and miscellaneous 8 purposes: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,594,996 10 a. The Iowa veterans home billings involving the department 11 of human services shall be submitted to the department on at 12 least a monthly basis. 13 b. If there is a change in the employer of employees 14 providing services at the Iowa veterans home under a collective 15 bargaining agreement, such employees and the agreement shall 16 be continued by the successor employer as though there had not 17 been a change in employer. 18 c. Within available resources and in conformance with 19 associated state and federal program eligibility requirements, 20 the Iowa veterans home may implement measures to provide 21 financial assistance to or on behalf of veterans or their 22 spouses who are participating in the community reentry program. 23 d. The Iowa veterans home expenditure report shall be 24 submitted monthly to the legislative services agency. 25 3. HOME OWNERSHIP ASSISTANCE PROGRAM 26 For transfer to the Iowa finance authority for the 27 continuation of the home ownership assistance program for 28 persons who are or were eligible members of the armed forces of 29 the United States, pursuant to section 16.54 : 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,500,000 31 Sec. 5. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 32 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 33 appropriation in section 35A.16 for the fiscal year beginning 34 July 1, 2015, and ending June 30, 2016, the amount appropriated 35 -20- SF 505 (3) 86 pf/rj 20/ 195
S.F. 505 from the general fund of the state pursuant to that section 1 for the following designated purposes shall not exceed the 2 following amount: 3 For the county commissions of veteran affairs fund under 4 section 35A.16 : 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 6 DIVISION V 7 DEPARTMENT OF HUMAN SERVICES —— FY 2015-2016 8 Sec. 6. 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, 2015, and ending June 30, 2016, 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, the following 16 amounts, or so much thereof as is necessary, to be used for the 17 purposes designated: 18 1. To be credited to the family investment program account 19 and used for assistance under the family investment program 20 under chapter 239B : 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,136,995 22 2. To be credited to the family investment program account 23 and used for the job opportunities and basic skills (JOBS) 24 program and implementing family investment agreements in 25 accordance with chapter 239B : 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,138,178 27 3. To be used for the family development and 28 self-sufficiency grant program in accordance with section 29 216A.107 : 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 31 Notwithstanding section 8.33 , moneys appropriated in this 32 subsection that remain unencumbered or unobligated at the close 33 of the fiscal year shall not revert but shall remain available 34 for expenditure for the purposes designated until the close of 35 -21- SF 505 (3) 86 pf/rj 21/ 195
S.F. 505 the succeeding fiscal year. However, unless such moneys are 1 encumbered or obligated on or before September 30, 2016, the 2 moneys shall revert. 3 4. For field operations: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 5 5. For general administration: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 7 6. For state child care assistance: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 35,047,110 9 a. Of the funds appropriated in this subsection, 10 $26,328,097 is transferred to the child care and development 11 block grant appropriation made by the Eighty-sixth General 12 Assembly, 2015 Session, for the federal fiscal year beginning 13 October 1, 2015, and ending September 30, 2016. Of this 14 amount, $200,000 shall be used for provision of educational 15 opportunities to registered child care home providers in order 16 to improve services and programs offered by this category 17 of providers and to increase the number of providers. The 18 department may contract with institutions of higher education 19 or child care resource and referral centers to provide 20 the educational opportunities. Allowable administrative 21 costs under the contracts shall not exceed 5 percent. The 22 application for a grant shall not exceed two pages in length. 23 b. Any funds appropriated in this subsection remaining 24 unallocated shall be used for state child care assistance 25 payments for families who are employed including but not 26 limited to individuals enrolled in the family investment 27 program. 28 7. For distribution to counties and regions through the 29 property tax relief fund for mental health and disability 30 services as provided in an appropriation made for this purpose: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,894,052 32 8. For child and family services: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,084,430 34 9. For child abuse prevention grants: 35 -22- SF 505 (3) 86 pf/rj 22/ 195
S.F. 505 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 1 10. For pregnancy prevention grants on the condition that 2 family planning services are funded: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,930,067 4 Pregnancy prevention grants shall be awarded to programs 5 in existence on or before July 1, 2015, if the programs have 6 demonstrated positive outcomes. Grants shall be awarded to 7 pregnancy prevention programs which are developed after July 8 1, 2015, if the programs are based on existing models that 9 have demonstrated positive outcomes. Grants shall comply with 10 the requirements provided in 1997 Iowa Acts, chapter 208, 11 section 14, subsections 1 and 2, including the requirement that 12 grant programs must emphasize sexual abstinence. Priority in 13 the awarding of grants shall be given to programs that serve 14 areas of the state which demonstrate the highest percentage of 15 unplanned pregnancies of females of childbearing age within the 16 geographic area to be served by the grant. 17 11. For technology needs and other resources necessary 18 to meet federal welfare reform reporting, tracking, and case 19 management requirements: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 21 12. For the family investment program share of the costs to 22 continue to develop and maintain a new, integrated eligibility 23 determination system: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,654,880 25 13. a. Notwithstanding any provision to the contrary, 26 including but not limited to requirements in section 8.41 or 27 provisions in 2014 or 2015 Iowa Acts regarding the receipt and 28 appropriation of federal block grants, federal funds from the 29 temporary assistance for needy families block grant received by 30 the state and not otherwise appropriated in this section and 31 remaining available for the fiscal year beginning July 1, 2015, 32 are appropriated to the department of human services to the 33 extent as may be necessary to be used in the following priority 34 order: the family investment program, for state child care 35 -23- SF 505 (3) 86 pf/rj 23/ 195
S.F. 505 assistance program payments for families who are employed, and 1 for the family investment program share of costs to develop and 2 maintain a new, integrated eligibility determination system. 3 The federal funds appropriated in this paragraph “a” shall be 4 expended only after all other funds appropriated in subsection 5 1 for the assistance under the family investment program, 6 in subsection 6 for child care assistance, or in subsection 7 12 for the family investment program share of the costs to 8 continue to develop and maintain a new, integrated eligibility 9 determination system, as applicable, have been expended. For 10 the purposes of this subsection, the funds appropriated in 11 subsection 6, paragraph “a”, for transfer to the child care 12 and development block grant appropriation are considered fully 13 expended when the full amount has been transferred. 14 b. The department shall, on a quarterly basis, advise the 15 legislative services agency and department of management of 16 the amount of funds appropriated in this subsection that was 17 expended in the prior quarter. 18 14. Of the amounts appropriated in this section, 19 $12,962,008 for the fiscal year beginning July 1, 2015, is 20 transferred to the appropriation of the federal social services 21 block grant made to the department of human services for that 22 fiscal year. 23 15. For continuation of the program providing categorical 24 eligibility for the food assistance program as specified for 25 the program in the section of this division of this 2015 Act 26 relating to the family investment program account: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,000 28 16. The department may transfer funds allocated in this 29 section to the appropriations made in this division of this Act 30 for the same fiscal year for general administration and field 31 operations for resources necessary to implement and operate the 32 services referred to in this section and those funded in the 33 appropriation made in this division of this Act for the same 34 fiscal year for the family investment program from the general 35 -24- SF 505 (3) 86 pf/rj 24/ 195
S.F. 505 fund of the state. 1 Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT. 2 1. Moneys credited to the family investment program (FIP) 3 account for the fiscal year beginning July 1, 2015, and 4 ending June 30, 2016, shall be used to provide assistance in 5 accordance with chapter 239B . 6 2. The department may use a portion of the moneys credited 7 to the FIP account under this section as necessary for 8 salaries, support, maintenance, and miscellaneous purposes. 9 3. The department may transfer funds allocated in 10 subsection 4 to the appropriations made in this division of 11 this Act for the same fiscal year for general administration 12 and field operations for resources necessary to implement and 13 operate the family investment program services referred to in 14 this section and those funded in the appropriation made in this 15 division of this Act for the same fiscal year for the family 16 investment program from the general 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, 2015, and ending June 30, 2016, 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 FIP and other shared 23 clients and to meet federal reporting requirements under the 24 federal temporary assistance for needy families block grant: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 26 b. To the department of human rights for staffing, 27 administration, and implementation of the family development 28 and self-sufficiency grant program in accordance with section 29 216A.107 : 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,392,834 31 (1) Of the funds allocated for the family development 32 and self-sufficiency grant program in this paragraph “b”, 33 not more than 5 percent of the funds shall be used for the 34 administration of the grant program. 35 -25- SF 505 (3) 86 pf/rj 25/ 195
S.F. 505 (2) The department of human rights may continue to implement 1 the family development and self-sufficiency grant program 2 statewide during fiscal year 2015-2016. 3 (3) The department of human rights may engage in activities 4 to strengthen and improve family outcomes measures and 5 data collection systems under the family development and 6 self-sufficiency grant program. 7 c. For the diversion subaccount of the FIP account: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 9 A portion of the moneys allocated for the subaccount may 10 be used for field operations, salaries, data management 11 system development, and implementation costs and support 12 deemed necessary by the director of human services in order 13 to administer the FIP diversion program. To the extent 14 moneys allocated in this paragraph “c” are not deemed by the 15 department to be necessary to support diversion activities, 16 such moneys may be used for other efforts intended to increase 17 engagement by family investment program participants in work, 18 education, or training activities. 19 d. For the food assistance employment and training program: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 21 (1) The department shall apply the federal supplemental 22 nutrition assistance program (SNAP) employment and training 23 state plan in order to maximize to the fullest extent permitted 24 by federal law the use of the 50 percent federal reimbursement 25 provisions for the claiming of allowable federal reimbursement 26 funds from the United States department of agriculture 27 pursuant to the federal SNAP employment and training program 28 for providing education, employment, and training services 29 for eligible food assistance program participants, including 30 but not limited to related dependent care and transportation 31 expenses. 32 (2) The department shall continue the categorical federal 33 food assistance program eligibility at 160 percent of the 34 federal poverty level and continue to eliminate the asset test 35 -26- SF 505 (3) 86 pf/rj 26/ 195
S.F. 505 from eligibility requirements, consistent with federal food 1 assistance program requirements. The department shall include 2 as many food assistance households as is allowed by federal 3 law. The eligibility provisions shall conform to all federal 4 requirements including requirements addressing individuals who 5 are incarcerated or otherwise ineligible. 6 e. For the JOBS program: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,540,398 8 5. Of the child support collections assigned under FIP, 9 an amount equal to the federal share of support collections 10 shall be credited to the child support recovery appropriation 11 made in this division of this Act. Of the remainder of the 12 assigned child support collections received by the child 13 support recovery unit, a portion shall be credited to the FIP 14 account, a portion may be used to increase recoveries, and a 15 portion may be used to sustain cash flow in the child support 16 payments account. If as a consequence of the appropriations 17 and allocations made in this section the resulting amounts 18 are insufficient to sustain cash assistance payments and meet 19 federal maintenance of effort requirements, the department 20 shall seek supplemental funding. If child support collections 21 assigned under FIP are greater than estimated or are otherwise 22 determined not to be required for maintenance of effort, the 23 state share of either amount may be transferred to or retained 24 in the child support payments account. 25 6. The department may adopt emergency rules for the family 26 investment, JOBS, food assistance, and medical assistance 27 programs if necessary to comply with federal requirements. 28 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 29 is appropriated from the general fund of the state to the 30 department of human services for the fiscal year beginning July 31 1, 2015, and ending June 30, 2016, the following amount, or 32 so much thereof as is necessary, to be used for the purpose 33 designated: 34 To be credited to the family investment program (FIP) 35 -27- SF 505 (3) 86 pf/rj 27/ 195
S.F. 505 account and used for family investment program assistance under 1 chapter 239B : 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 49,093,875 3 1. Of the funds appropriated in this section, $7,402,220 is 4 allocated for the JOBS program. 5 2. Of the funds appropriated in this section, $3,513,854 is 6 allocated for the family development and self-sufficiency grant 7 program. 8 3. Notwithstanding section 8.39 , for the fiscal year 9 beginning July 1, 2015, if necessary to meet federal 10 maintenance of effort requirements or to transfer federal 11 temporary assistance for needy families block grant funding 12 to be used for purposes of the federal social services block 13 grant or to meet cash flow needs resulting from delays in 14 receiving federal funding or to implement, in accordance with 15 this division of this Act, activities currently funded with 16 juvenile court services, county, or community moneys and state 17 moneys used in combination with such moneys, the department 18 of human services may transfer funds within or between any 19 of the appropriations made in this division of this Act and 20 appropriations in law for the federal social services block 21 grant to the department for the following purposes, provided 22 that the combined amount of state and federal temporary 23 assistance for needy families block grant funding for each 24 appropriation remains the same before and after the transfer: 25 a. For the family investment program. 26 b. For child care assistance. 27 c. For child and family services. 28 d. For field operations. 29 e. For general administration. 30 f. For distribution to counties or regions through the 31 property tax relief fund for mental health and disability 32 services as provided in an appropriation for this purpose. 33 This subsection shall not be construed to prohibit the use 34 of existing state transfer authority for other purposes. The 35 -28- SF 505 (3) 86 pf/rj 28/ 195
S.F. 505 department shall report any transfers made pursuant to this 1 subsection to the legislative services agency. 2 4. Of the funds appropriated in this section, $195,678 shall 3 be used for continuation of a grant to an Iowa-based nonprofit 4 organization with a history of providing tax preparation 5 assistance to low-income Iowans in order to expand the usage of 6 the earned income tax credit. The purpose of the grant is to 7 supply this assistance to underserved areas of the state. 8 5. Of the funds appropriated in this section, $80,000 shall 9 be used for the continuation of an unfunded pilot project, as 10 defined in 441 IAC 100.1, relating to parental obligations, 11 in which the child support recovery unit participates, to 12 support the efforts of a nonprofit organization committed to 13 strengthening the community through youth development, healthy 14 living, and social responsibility headquartered in a county 15 with a population over 350,000. The funds allocated in this 16 subsection shall be used by the recipient organization to 17 develop a larger community effort, through public and private 18 partnerships, to support a broad-based multi-county fatherhood 19 initiative that promotes payment of child support obligations, 20 improved family relationships, and full-time employment. 21 6. Of the funds appropriated in this section, $200,000 shall 22 be used as a grant to a nonprofit organization organized under 23 section 501(c)(4) of the Internal Revenue Code to implement a 24 youth development strategy through after-school programming 25 that promotes academic success, healthy lifestyles, good 26 character, and citizenship. The organization shall meet all of 27 the following criteria: 28 a. Operate statewide and provide services through more than 29 one location. 30 b. Provide the after-school programming for students ages 31 five through eighteen years of age who are members of families 32 eligible for the federal temporary assistance for needy 33 families program. 34 c. Provide evidence, based on measurable outcomes, that the 35 -29- SF 505 (3) 86 pf/rj 29/ 195
S.F. 505 after-school programming provided results in increased student 1 achievement. 2 7. The department may transfer funds appropriated in this 3 section to the appropriations made in this division of this Act 4 for general administration and field operations as necessary 5 to administer this section and the overall family investment 6 program. 7 Sec. 9. CHILD SUPPORT RECOVERY. There is appropriated 8 from the general fund of the state to the department of human 9 services for the fiscal year beginning July 1, 2015, and ending 10 June 30, 2016, the following amount, or so much thereof as is 11 necessary, to be used for the purposes designated: 12 For child support recovery, including salaries, support, 13 maintenance, and miscellaneous purposes, and for not more than 14 the following full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,663,373 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00 17 1. The department shall expend up to $24,329, including 18 federal financial participation, for the fiscal year beginning 19 July 1, 2015, for a child support public awareness campaign. 20 The department and the office of the attorney general shall 21 cooperate in continuation of the campaign. The public 22 awareness campaign shall emphasize, through a variety of 23 media activities, the importance of maximum involvement of 24 both parents in the lives of their children as well as the 25 importance of payment of child support obligations. 26 2. Federal access and visitation grant moneys shall be 27 issued directly to private not-for-profit agencies that provide 28 services designed to increase compliance with the child access 29 provisions of court orders, including but not limited to 30 neutral visitation sites and mediation services. 31 3. The appropriation made to the department for child 32 support recovery may be used throughout the fiscal year in the 33 manner necessary for purposes of cash flow management, and for 34 cash flow management purposes the department may temporarily 35 -30- SF 505 (3) 86 pf/rj 30/ 195
S.F. 505 draw more than the amount appropriated, provided the amount 1 appropriated is not exceeded at the close of the fiscal year. 2 4. With the exception of the funding amount specified, the 3 requirements established under 2001 Iowa Acts, chapter 191, 4 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 5 be applicable to parental obligation pilot projects for the 6 fiscal year beginning July 1, 2015, and ending June 30, 2016. 7 Notwithstanding 441 IAC 100.8, providing for termination of 8 rules relating to the pilot projects, the rules shall remain 9 in effect until June 30, 2016. 10 Sec. 10. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 11 FY 2015-2016. Any funds remaining in the health care trust 12 fund created in section 453A.35A for the fiscal year beginning 13 July 1, 2015, and ending June 30, 2016, are appropriated to 14 the department of human services to supplement the medical 15 assistance program appropriations made in this division of this 16 Act, for medical assistance reimbursement and associated costs, 17 including program administration and costs associated with 18 program implementation. 19 Sec. 11. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 20 2015-2016. Any funds remaining in the Medicaid fraud fund 21 created in section 249A.50 for the fiscal year beginning 22 July 1, 2015, and ending June 30, 2016, are appropriated to 23 the department of human services to supplement the medical 24 assistance appropriations made in this division of this Act, 25 for medical assistance reimbursement and associated costs, 26 including program administration and costs associated with 27 program implementation. 28 Sec. 12. MEDICAL ASSISTANCE. 29 1. There is appropriated from the general fund of the 30 state to the department of human services for the fiscal year 31 beginning July 1, 2015, and ending June 30, 2016, the following 32 amount, or so much thereof as is necessary, to be used for the 33 purpose designated: 34 For medical assistance program reimbursement and associated 35 -31- SF 505 (3) 86 pf/rj 31/ 195
S.F. 505 costs as specifically provided in the reimbursement 1 methodologies in effect on June 30, 2015, except as otherwise 2 expressly authorized by law, including reimbursement for 3 abortion services which shall be available under the medical 4 assistance program only for those abortions which are medically 5 necessary: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,346,353,640 7 2. Medically necessary abortions are those performed under 8 any of the following conditions: 9 a. The attending physician certifies that continuing the 10 pregnancy would endanger the life of the pregnant woman. 11 b. The attending physician certifies that the fetus is 12 physically deformed, mentally deficient, or afflicted with a 13 congenital illness. 14 c. The pregnancy is the result of a rape which is reported 15 within 45 days of the incident to a law enforcement agency or 16 public or private health agency which may include a family 17 physician. 18 d. The pregnancy is the result of incest which is reported 19 within 150 days of the incident to a law enforcement agency 20 or public or private health agency which may include a family 21 physician. 22 e. Any spontaneous abortion, commonly known as a 23 miscarriage, if not all of the products of conception are 24 expelled. 25 3. a. Iowans support reducing the number of abortions 26 performed in our state. For an abortion covered under the 27 program, except in the case of a medical emergency, as defined 28 in section 135L.1 , for any woman, the physician shall certify 29 both of the following: 30 (1) That the woman has been given the opportunity to view an 31 ultrasound image of the fetus as part of the standard of care 32 before an abortion is performed. 33 (2) That the woman has been provided information regarding 34 the options relative to a pregnancy, including continuing the 35 -32- SF 505 (3) 86 pf/rj 32/ 195
S.F. 505 pregnancy to term and retaining parental rights following the 1 child’s birth, continuing the pregnancy to term and placing the 2 child for adoption, and terminating the pregnancy. 3 b. The provisions of this section relating to abortions 4 shall also apply to the Iowa health and wellness plan created 5 pursuant to chapter 249N . 6 4. The department shall utilize not more than $60,000 of 7 the funds appropriated in this section to continue the AIDS/HIV 8 health insurance premium payment program as established in 1992 9 Iowa Acts, Second Extraordinary Session, chapter 1001, section 10 409, subsection 6. Of the funds allocated in this subsection, 11 not more than $5,000 may be expended for administrative 12 purposes. 13 5. Of the funds appropriated in this Act to the department 14 of public health for addictive disorders, $950,000 for 15 the fiscal year beginning July 1, 2015, is transferred 16 to the department of human services for an integrated 17 substance-related disorder managed care system. The department 18 shall not assume management of the substance-related disorder 19 system in place of the managed care contractor unless such 20 a change in approach is specifically authorized in law. 21 The departments of human services and public health shall 22 work together to maintain the level of mental health and 23 substance-related disorder treatment services provided by the 24 managed care contractor through the Iowa plan for behavioral 25 health. Each department shall take the steps necessary to 26 continue the federal waivers as necessary to maintain the level 27 of services. 28 6. a. The department shall aggressively pursue options for 29 providing medical assistance or other assistance to individuals 30 with special needs who become ineligible to continue receiving 31 services under the early and periodic screening, diagnostic, 32 and treatment program under the medical assistance program 33 due to becoming 21 years of age who have been approved for 34 additional assistance through the department’s exception to 35 -33- SF 505 (3) 86 pf/rj 33/ 195
S.F. 505 policy provisions, but who have health care needs in excess 1 of the funding available through the exception to policy 2 provisions. 3 b. Of the funds appropriated in this section, $100,000 4 shall be used for participation in one or more pilot projects 5 operated by a private provider to allow the individual or 6 individuals to receive service in the community in accordance 7 with principles established in Olmstead v. L.C., 527 U.S. 581 8 (1999), for the purpose of providing medical assistance or 9 other assistance to individuals with special needs who become 10 ineligible to continue receiving services under the early and 11 periodic screening, diagnostic, and treatment program under 12 the medical assistance program due to becoming 21 years of 13 age who have been approved for additional assistance through 14 the department’s exception to policy provisions, but who have 15 health care needs in excess of the funding available through 16 the exception to the policy provisions. 17 7. Of the funds appropriated in this section, up to 18 $3,050,082 may be transferred to the field operations or 19 general administration appropriations in this division of this 20 Act for operational costs associated with Part D of the federal 21 Medicare Prescription Drug Improvement and Modernization Act 22 of 2003, Pub. L. No. 108-173. 23 8. Of the funds appropriated in this section, up to $442,100 24 may be transferred to the appropriation in this division 25 of this Act for medical contracts to be used for clinical 26 assessment services and prior authorization of services. 27 9. A portion of the funds appropriated in this section 28 may be transferred to the appropriations in this division of 29 this Act for general administration, medical contracts, the 30 children’s health insurance program, or field operations to be 31 used for the state match cost to comply with the payment error 32 rate measurement (PERM) program for both the medical assistance 33 and children’s health insurance programs as developed by the 34 centers for Medicare and Medicaid services of the United States 35 -34- SF 505 (3) 86 pf/rj 34/ 195
S.F. 505 department of health and human services to comply with the 1 federal Improper Payments Information Act of 2002, Pub. L. No. 2 107-300. 3 10. The department shall continue to implement the 4 recommendations of the assuring better child health and 5 development initiative II (ABCDII) clinical panel to the 6 Iowa early and periodic screening, diagnostic, and treatment 7 services healthy mental development collaborative board 8 regarding changes to billing procedures, codes, and eligible 9 service providers. 10 11. Of the funds appropriated in this section, a sufficient 11 amount is allocated to supplement the incomes of residents of 12 nursing facilities, intermediate care facilities for persons 13 with mental illness, and intermediate care facilities for 14 persons with an intellectual disability, with incomes of less 15 than $50 in the amount necessary for the residents to receive a 16 personal needs allowance of $50 per month pursuant to section 17 249A.30A . 18 12. Of the funds appropriated in this section, the following 19 amounts are transferred to the appropriations made in this 20 division of this Act for the state mental health institutes: 21 a. Cherokee mental health institute . . . . . . . . . . . $ 9,098,425 22 b. Clarinda mental health institute . . . . . . . . . . . $ 1,977,305 23 c. Independence mental health institute . . . . . . . $ 9,045,894 24 13. a. Of the funds appropriated in this section, 25 $8,596,650 is allocated for the state match for a 26 disproportionate share hospital payment of $19,133,430 to 27 hospitals that meet both of the conditions specified in 28 subparagraphs (1) and (2). In addition, the hospitals that 29 meet the conditions specified shall either certify public 30 expenditures or transfer to the medical assistance program 31 an amount equal to provide the nonfederal share for a 32 disproportionate share hospital payment of $7,500,000. The 33 hospitals that meet the conditions specified shall receive and 34 retain 100 percent of the total disproportionate share hospital 35 -35- SF 505 (3) 86 pf/rj 35/ 195
S.F. 505 payment of $26,633,430. 1 (1) The hospital qualifies for disproportionate share and 2 graduate medical education payments. 3 (2) The hospital is an Iowa state-owned hospital with more 4 than 500 beds and eight or more distinct residency specialty 5 or subspecialty programs recognized by the American college of 6 graduate medical education. 7 b. Distribution of the disproportionate share payments 8 shall be made on a monthly basis. The total amount of 9 disproportionate share payments including graduate medical 10 education, enhanced disproportionate share, and Iowa 11 state-owned teaching hospital payments shall not exceed the 12 amount of the state’s allotment under Pub. L. No. 102-234. 13 In addition, the total amount of all disproportionate 14 share payments shall not exceed the hospital-specific 15 disproportionate share limits under Pub. L. No. 103-66. 16 c. The university of Iowa hospitals and clinics shall either 17 certify public expenditures or transfer to the appropriations 18 made in this division of this Act for medical assistance an 19 amount equal to provide the nonfederal share for increased 20 medical assistance payments for inpatient and outpatient 21 hospital services of $9,900,000. The university of Iowa 22 hospitals and clinics shall receive and retain 100 percent of 23 the total increase in medical assistance payments. 24 d. Program payments for disproportionate share hospitals 25 and graduate medical education, and the upper payment limits 26 applicable to these programs shall be held harmless from the 27 impacts of Medicaid managed care and the governor’s Medicaid 28 modernization initiative. Payment methodologies utilized 29 for these programs may be adjusted or converted to other 30 methodologies or payment types in order to comply with this 31 hold harmless requirement. 32 14. One hundred percent of the nonfederal share of payments 33 to area education agencies that are medical assistance 34 providers for medical assistance-covered services provided to 35 -36- SF 505 (3) 86 pf/rj 36/ 195
S.F. 505 medical assistance-covered children, shall be made from the 1 appropriation made in this section. 2 15. Any new or renewed contract entered into by the 3 department with a third party to administer behavioral health 4 services under the medical assistance program shall provide 5 that any interest earned on payments from the state during 6 the state fiscal year shall be remitted to the department 7 and treated as recoveries to offset the costs of the medical 8 assistance program. 9 16. 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 17. 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. 18 18. a. The department may increase the amounts allocated 19 for salaries, support, maintenance, and miscellaneous purposes 20 associated with the medical assistance program, as necessary, 21 to implement cost containment strategies. The department shall 22 report any such increase to the legislative services agency and 23 the department of management. 24 b. If the savings to the medical assistance program from 25 cost containment efforts exceed the cost for the fiscal 26 year beginning July 1, 2015, the department may transfer any 27 savings generated for the fiscal year due to medical assistance 28 program cost containment efforts to the appropriation 29 made in this division of this Act for medical contracts or 30 general administration to defray the increased contract costs 31 associated with implementing such efforts. 32 c. The department of human services shall not implement 33 the following cost containment measures as recommended by the 34 governor for the fiscal year beginning July 1, 2015: 35 -37- SF 505 (3) 86 pf/rj 37/ 195
S.F. 505 (1) A measure to provide uniform rates of $.575 per mile 1 based on the 2015 Internal Revenue Service mileage rate and 2 of $9.29, the current statewide average, per one-way trip for 3 Medicaid program home and community-based services waivers. 4 (2) A measure to cap the total costs of all services 5 received by a recipient of the home and community-based 6 services waiver for individuals with an intellectual disability 7 at the daily intermediate care facility for persons with an 8 intellectual disability (ICF/ID) per diem rate of $346.39 per 9 day based on the 80th percentile of all ICF/ID rates. 10 (3) A measure to align individual requests for exceptions to 11 policy with the capped total cost of services for a recipient 12 of the home and community-based services waiver for individuals 13 with an intellectual disability as computed under subparagraph 14 (2). 15 (4) A measure to utilize the supports intensity scale 16 to determine payment amounts and a tiered payment system 17 for the services provided to adults served under the home 18 and community-based services waiver for individuals with an 19 intellectual disability. 20 (5) A measure to accelerate implementation of the provision 21 that beginning July 1, 2015, rather than July 1, 2016, the 22 department of human services requires services through the 23 consumer-directed attendant care option to be provided through 24 an agency or consumer choices option. 25 (6) A measure to reallocate funding for community-based 26 systems of care to instead support integrated health homes. 27 (7) A measure to increase the university of Iowa hospitals 28 and clinics state share responsibility for the supplemental 29 disproportionate share hospital payment to the university of 30 Iowa hospitals and clinics for the fiscal year beginning July 31 1, 2015. 32 d. The department shall report the implementation of 33 any cost containment strategies under this subsection to 34 the individuals specified in this division of this Act for 35 -38- SF 505 (3) 86 pf/rj 38/ 195
S.F. 505 submission of reports on a quarterly basis. 1 19. For the fiscal year beginning July 1, 2015, and ending 2 June 30, 2016, the replacement generation tax revenues required 3 to be deposited in the property tax relief fund pursuant to 4 section 437A.8, subsection 4, paragraph “d” , and section 5 437A.15, subsection 3, paragraph “f” , shall instead be credited 6 to and supplement the appropriation made in this section and 7 used for the allocations made in this section. 8 20. The department shall continue to administer the state 9 balancing incentive payments program as specified in 2012 Iowa 10 Acts, chapter 1133, section 14. 11 21. a. Of the funds appropriated in this section, $900,000 12 shall be used for continued implementation of the children’s 13 mental health home project proposed by the department of human 14 services and reported to the general assembly’s mental health 15 and disability services study committee in December 2011. Of 16 this amount, up to $50,000 may be transferred by the department 17 to the appropriation made in this division of this Act to the 18 department for the same fiscal year for general administration 19 to be used for associated administrative expenses and for not 20 more than one full-time equivalent position, in addition to 21 those authorized for the same fiscal year, to be assigned to 22 implementing the project. 23 b. Of the funds appropriated in this section, up to $400,000 24 may be transferred by the department to the appropriation made 25 to the department in this division of this Act for the same 26 fiscal year for Medicaid program-related general administration 27 planning and implementation activities. The funds may be used 28 for contracts or for personnel in addition to the amounts 29 appropriated for and the positions authorized for general 30 administration for the fiscal year. 31 c. Of the funds appropriated in this section, up to 32 $3,000,000 may be transferred by the department to the 33 appropriations made in this division of this Act for the same 34 fiscal year for general administration or medical contracts 35 -39- SF 505 (3) 86 pf/rj 39/ 195
S.F. 505 to be used to support the development and implementation of 1 standardized assessment tools for persons with mental illness, 2 an intellectual disability, a developmental disability, or a 3 brain injury. 4 22. Of the funds appropriated in this section, $250,000 5 shall be used for lodging expenses associated with care 6 provided at the university of Iowa hospitals and clinics for 7 patients with cancer whose travel distance is 30 miles or more 8 and whose income is at or below 200 percent of the federal 9 poverty level as defined by the most recently revised poverty 10 income guidelines published by the United States department of 11 health and human services. The department of human services 12 shall establish the maximum number of overnight stays and the 13 maximum rate reimbursed for overnight lodging, which may be 14 based on the state employee rate established by the department 15 of administrative services. The funds allocated in this 16 subsection shall not be used as nonfederal share matching 17 funds. 18 23. The department of human services shall adopt rules to 19 provide for coverage of telehealth under the Medicaid program. 20 The rules shall provide that in-person contact between a 21 health care professional and a patient is not required as a 22 prerequisite for payment for services appropriately provided 23 through telehealth in accordance with generally accepted health 24 care practices and standards prevailing in the applicable 25 professional community at the time the services are provided. 26 Health care services provided through in-person consultations 27 or through telehealth shall be treated as equivalent services 28 for the purposes of reimbursement. 29 24. a. For inpatient and outpatient services provided 30 by hospitals on or after July 1, 2015, the department of 31 human services shall recalculate and prospectively apply an 32 updated cost-to-charge ratio upon the request of a hospital to 33 implement price or charge reductions, if all of the following 34 criteria are met: 35 -40- SF 505 (3) 86 pf/rj 40/ 195
S.F. 505 (1) The recalculation of an updated cost-to-charge ratio is 1 budget neutral to the state funding amount appropriated for the 2 respective fiscal year and maintains budget neutral payments or 3 revenue to all hospitals. 4 (2) The hospital requesting the price or charge reduction 5 submits a proforma cost report and charge master that reflects 6 the anticipated cost-to-charge reduction. 7 b. Based upon the proforma cost report submitted by the 8 requesting hospital, the department of human services shall 9 prospectively apply the recalculated cost-to-charge ratio as 10 appropriate to submitted claims for health care services. 11 25. The department of human services shall not adopt 12 emergency rules to implement Medicaid managed care or the 13 governor’s Medicaid modernization initiative. 14 26. The number of home and community-based services waiver 15 slots available during the fiscal year beginning July 1, 2015, 16 shall not be reduced below the number of such slots available 17 on January 1, 2015. 18 Sec. 13. MEDICAL CONTRACTS. 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, 2015, and ending June 30, 21 2016, the following amount, or so much thereof as is necessary, 22 to be used for the purpose designated: 23 For medical contracts: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 22,153,584 25 1. The department of inspections and appeals shall 26 provide all state matching funds for survey and certification 27 activities performed by the department of inspections 28 and appeals. The department of human services is solely 29 responsible for distributing the federal matching funds for 30 such activities. 31 2. Of the funds appropriated in this section, $50,000 shall 32 be used for continuation of home and community-based services 33 waiver quality assurance programs, including the review and 34 streamlining of processes and policies related to oversight and 35 -41- SF 505 (3) 86 pf/rj 41/ 195
S.F. 505 quality management to meet state and federal requirements. 1 3. Of the amount appropriated in this section, up to 2 $200,000 may be transferred to the appropriation for general 3 administration in this division of this Act to be used for 4 additional full-time equivalent positions in the development of 5 key health initiatives such as cost containment, development 6 and oversight of managed care programs, and development of 7 health strategies targeted toward improved quality and reduced 8 costs in the Medicaid program. 9 4. Of the funds appropriated in this section, $1,000,000 10 shall be used for planning and development, in cooperation with 11 the department of public health, of a phased-in program to 12 provide a dental home for children. 13 5. Of the funds appropriated in this section, $2,000,000 14 shall be used for the autism support program created in chapter 15 225D . 16 Sec. 14. STATE SUPPLEMENTARY ASSISTANCE. 17 1. There is appropriated from the general fund of the 18 state to the department of human services for the fiscal year 19 beginning July 1, 2015, and ending June 30, 2016, the following 20 amount, or so much thereof as is necessary, to be used for the 21 purpose designated: 22 For the state supplementary assistance program: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $12,997,187 24 2. The department shall increase the personal needs 25 allowance for residents of residential care facilities by the 26 same percentage and at the same time as federal supplemental 27 security income and federal social security benefits are 28 increased due to a recognized increase in the cost of living. 29 The department may adopt emergency rules to implement this 30 subsection. 31 3. If during the fiscal year beginning July 1, 2015, 32 the department projects that state supplementary assistance 33 expenditures for a calendar year will not meet the federal 34 pass-through requirement specified in Tit. XVI of the federal 35 -42- SF 505 (3) 86 pf/rj 42/ 195
S.F. 505 Social Security Act, section 1618, as codified in 42 U.S.C. 1 §1382g, the department may take actions including but not 2 limited to increasing the personal needs allowance for 3 residential care facility residents and making programmatic 4 adjustments or upward adjustments of the residential care 5 facility or in-home health-related care reimbursement rates 6 prescribed in this division of this Act to ensure that federal 7 requirements are met. In addition, the department may make 8 other programmatic and rate adjustments necessary to remain 9 within the amount appropriated in this section while ensuring 10 compliance with federal requirements. The department may adopt 11 emergency rules to implement the provisions of this subsection. 12 Sec. 15. CHILDREN’S HEALTH INSURANCE 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, 2015, and ending June 30, 2016, the following 16 amount, or so much thereof as is necessary, to be used for the 17 purpose designated: 18 For maintenance of the healthy and well kids in Iowa (hawk-i) 19 program pursuant to chapter 514I , including supplemental dental 20 services, for receipt of federal financial participation under 21 Tit. XXI of the federal Social Security Act, which creates the 22 children’s health insurance program: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,163,844 24 2. Of the funds appropriated in this section, $42,800 is 25 allocated for continuation of the contract for outreach with 26 the department of public health. 27 Sec. 16. CHILD CARE ASSISTANCE. There is appropriated 28 from the general fund of the state to the department of human 29 services for the fiscal year beginning July 1, 2015, and ending 30 June 30, 2016, the following amount, or so much thereof as is 31 necessary, to be used for the purpose designated: 32 For child care programs: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 56,638,030 34 1. Of the funds appropriated in this section, $48,818,603 35 -43- SF 505 (3) 86 pf/rj 43/ 195
S.F. 505 shall be used for state child care assistance in accordance 1 with section 237A.13 . 2 2. Nothing in this section shall be construed or is 3 intended as or shall imply a grant of entitlement for services 4 to persons who are eligible for assistance due to an income 5 level consistent with the waiting list requirements of section 6 237A.13 . Any state obligation to provide services pursuant to 7 this section is limited to the extent of the funds appropriated 8 in this section. 9 3. Of the funds appropriated in this section, $432,453 10 is allocated for the statewide grant program for child care 11 resource and referral services under section 237A.26 . A list 12 of the registered and licensed child care facilities operating 13 in the area served by a child care resource and referral 14 service shall be made available to the families receiving state 15 child care assistance in that area. 16 4. Of the funds appropriated in this section, $936,974 17 is allocated for child care quality improvement initiatives 18 including but not limited to the voluntary quality rating 19 system in accordance with section 237A.30 . 20 5. Of the funds appropriated in this section, $6,350,000 21 shall be credited to the early childhood programs grants 22 account in the early childhood Iowa fund created in section 23 256I.11 . The moneys shall be distributed for funding of 24 community-based early childhood programs targeted to children 25 from birth through five years of age developed by early 26 childhood Iowa areas in accordance with approved community 27 plans as provided in section 256I.8 . 28 6. The department may use any of the funds appropriated 29 in this section as a match to obtain federal funds for use in 30 expanding child care assistance and related programs. For 31 the purpose of expenditures of state and federal child care 32 funding, funds shall be considered obligated at the time 33 expenditures are projected or are allocated to the department’s 34 service areas. Projections shall be based on current and 35 -44- SF 505 (3) 86 pf/rj 44/ 195
S.F. 505 projected caseload growth, current and projected provider 1 rates, staffing requirements for eligibility determination 2 and management of program requirements including data systems 3 management, staffing requirements for administration of the 4 program, contractual and grant obligations and any transfers 5 to other state agencies, and obligations for decategorization 6 or innovation projects. 7 7. A portion of the state match for the federal child care 8 and development block grant shall be provided as necessary to 9 meet federal matching funds requirements through the state 10 general fund appropriation made for child development grants 11 and other programs for at-risk children in section 279.51 . 12 8. If a uniform reduction ordered by the governor under 13 section 8.31 or other operation of law, transfer, or federal 14 funding reduction reduces the appropriation made in this 15 section for the fiscal year, the percentage reduction in the 16 amount paid out to or on behalf of the families participating 17 in the state child care assistance program shall be equal to or 18 less than the percentage reduction made for any other purpose 19 payable from the appropriation made in this section and the 20 federal funding relating to it. The percentage reduction to 21 the other allocations made in this section shall be the same as 22 the uniform reduction ordered by the governor or the percentage 23 change of the federal funding reduction, as applicable. 24 If there is an unanticipated increase in federal funding 25 provided for state child care assistance, the entire amount 26 of the increase shall be used for state child care assistance 27 payments. If the appropriations made for purposes of the 28 state child care assistance program for the fiscal year are 29 determined to be insufficient, it is the intent of the general 30 assembly to appropriate sufficient funding for the fiscal year 31 in order to avoid establishment of waiting list requirements. 32 9. Notwithstanding section 8.33 , moneys advanced for 33 purposes of the programs developed by early childhood Iowa 34 areas, advanced for purposes of wraparound child care, or 35 -45- SF 505 (3) 86 pf/rj 45/ 195
S.F. 505 received from the federal appropriations made for the purposes 1 of this section that remain unencumbered or unobligated at the 2 close of the fiscal year shall not revert to any fund but shall 3 remain available for expenditure for the purposes designated 4 until the close of the succeeding fiscal year. 5 10. Of the funds appropriated in this section, $100,000 6 is transferred to the department of public health to be used 7 to continue a program to assist parents in this state with 8 costs resulting from the death of a child in accordance with 9 this subsection. If it is less costly than administering the 10 program directly, the department shall issue a request for 11 proposals and issue a grant to an appropriate organization to 12 administer the program. 13 a. The program funding shall be used to assist parents who 14 reside in this state with costs incurred for a funeral, burial 15 or cremation, cemetery costs, or grave marker costs associated 16 with the unintended death of a child of the parent or a child 17 under the care of a guardian or custodian. The department 18 shall consider the following eligibility factors in developing 19 program requirements: 20 (1) The child was a stillborn infant or was less than age 21 eighteen at the time of death. 22 (2) The request for assistance was approved by the local 23 board or department of health or the county general assistance 24 director and may have been referred by a local funeral home. 25 (3) To be eligible, the parent, guardian, or custodian must 26 have an annual household income that is less than 145 percent 27 of the federal poverty level based on the number of people 28 in the applicant’s household as defined by the most recently 29 revised poverty income guidelines published by the United 30 States department of health and human services. 31 (4) The maximum amount of grant assistance provided to a 32 parent, guardian, or custodian associated with the death of 33 a child is $2,000. If the death is a multiple death and the 34 infants or children are being cremated, or buried together, the 35 -46- SF 505 (3) 86 pf/rj 46/ 195
S.F. 505 same limitation applies. 1 (5) To the extent the overall amount of assistance received 2 by a recipient for the costs addressed under this subsection 3 does not exceed the overall total of the costs, the recipient 4 may receive other public or private assistance in addition to 5 grant assistance under this section. 6 b. Notwithstanding section 8.33, moneys transferred by this 7 subsection that remain unencumbered or unobligated at the close 8 of the fiscal year shall not revert but shall remain available 9 for expenditure for the purposes designated until expended. 10 Sec. 17. JUVENILE INSTITUTIONS. There is appropriated 11 from the general fund of the state to the department of human 12 services for the fiscal year beginning July 1, 2015, and ending 13 June 30, 2016, the following amounts, or so much thereof as is 14 necessary, to be used for the purposes designated: 15 1. For the costs of security, building and grounds 16 maintenance, utilities, salary, and support for the facilities 17 located at the Iowa juvenile home at Toledo and for salaries, 18 support, maintenance, and miscellaneous purposes, and for not 19 more than the following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 372,766 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 2.00 22 2. For operation of the state training school at Eldora and 23 for salaries, support, maintenance, and miscellaneous purposes, 24 and for not more than the following full-time equivalent 25 positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,445,552 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.30 28 Of the funds appropriated in this subsection, $91,150 shall 29 be used for distribution to licensed classroom teachers at this 30 and other institutions under the control of the department of 31 human services based upon the average student yearly enrollment 32 at each institution as determined by the department. 33 Sec. 18. CHILD AND FAMILY SERVICES. 34 1. There is appropriated from the general fund of the 35 -47- SF 505 (3) 86 pf/rj 47/ 195
S.F. 505 state to the department of human services for the fiscal year 1 beginning July 1, 2015, and ending June 30, 2016, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 98,182,179 6 2. Up to $5,200,000 of the amount of federal temporary 7 assistance for needy families block grant funding appropriated 8 in this division of this Act for child and family services 9 shall be made available for purposes of juvenile delinquent 10 graduated sanction services. 11 3. The department may transfer funds appropriated in this 12 section as necessary to pay the nonfederal costs of services 13 reimbursed under the medical assistance program, state child 14 care assistance program, or the family investment program which 15 are provided to children who would otherwise receive services 16 paid under the appropriation in this section. The department 17 may transfer funds appropriated in this section to the 18 appropriations made in this division of this Act for general 19 administration and for field operations for resources necessary 20 to implement and operate the services funded in this section. 21 4. a. Of the funds appropriated in this section, up to 22 $35,821,786 is allocated as the statewide expenditure target 23 under section 232.143 for group foster care maintenance and 24 services. If the department projects that such expenditures 25 for the fiscal year will be less than the target amount 26 allocated in this paragraph “a”, the department may reallocate 27 the excess to provide additional funding for shelter care 28 or the child welfare emergency services addressed with the 29 allocation for shelter care. 30 b. If at any time after September 30, 2015, annualization 31 of a service area’s current expenditures indicates a service 32 area is at risk of exceeding its group foster care expenditure 33 target under section 232.143 by more than 5 percent, the 34 department and juvenile court services shall examine all 35 -48- SF 505 (3) 86 pf/rj 48/ 195
S.F. 505 group foster care placements in that service area in order to 1 identify those which might be appropriate for termination. 2 In addition, any aftercare services believed to be needed 3 for the children whose placements may be terminated shall be 4 identified. The department and juvenile court services shall 5 initiate action to set dispositional review hearings for the 6 placements identified. In such a dispositional review hearing, 7 the juvenile court shall determine whether needed aftercare 8 services are available and whether termination of the placement 9 is in the best interest of the child and the community. 10 5. In accordance with the provisions of section 232.188 , 11 the department shall continue the child welfare and juvenile 12 justice funding initiative during fiscal year 2015-2016. Of 13 the funds appropriated in this section, $1,717,753 is allocated 14 specifically for expenditure for fiscal year 2015-2016 through 15 the decategorization services funding pools and governance 16 boards established pursuant to section 232.188 . 17 6. A portion of the funds appropriated in this section 18 may be used for emergency family assistance to provide other 19 resources required for a family participating in a family 20 preservation or reunification project or successor project to 21 stay together or to be reunified. 22 7. Notwithstanding section 234.35 or any other provision 23 of law to the contrary, state funding for shelter care and 24 the child welfare emergency services contracting implemented 25 to provide for or prevent the need for shelter care shall be 26 limited to $8,068,474. 27 8. Federal funds received by the state during the fiscal 28 year beginning July 1, 2015, as the result of the expenditure 29 of state funds appropriated during a previous state fiscal 30 year for a service or activity funded under this section are 31 appropriated to the department to be used as additional funding 32 for services and purposes provided for under this section. 33 Notwithstanding section 8.33 , moneys received in accordance 34 with this subsection that remain unencumbered or unobligated at 35 -49- SF 505 (3) 86 pf/rj 49/ 195
S.F. 505 the close of the fiscal year shall not revert to any fund but 1 shall remain available for the purposes designated until the 2 close of the succeeding fiscal year. 3 9. a. Of the funds appropriated in this section, up to 4 $3,290,000 is allocated for the payment of the expenses of 5 court-ordered services provided to juveniles who are under the 6 supervision of juvenile court services, which expenses are a 7 charge upon the state pursuant to section 232.141, subsection 8 4 . Of the amount allocated in this paragraph “a”, up to 9 $1,556,287 shall be made available to provide school-based 10 supervision of children adjudicated under chapter 232 , of which 11 not more than $15,000 may be used for the purpose of training. 12 A portion of the cost of each school-based liaison officer 13 shall be paid by the school district or other funding source as 14 approved by the chief juvenile court officer. 15 b. Of the funds appropriated in this section, up to $748,985 16 is allocated for the payment of the expenses of court-ordered 17 services provided to children who are under the supervision 18 of the department, which expenses are a charge upon the state 19 pursuant to section 232.141, subsection 4 . 20 c. Notwithstanding section 232.141 or any other provision 21 of law to the contrary, the amounts allocated in this 22 subsection shall be distributed to the judicial districts 23 as determined by the state court administrator and to the 24 department’s service areas as determined by the administrator 25 of the department of human services’ division of child and 26 family services. The state court administrator and the 27 division administrator shall make the determination of the 28 distribution amounts on or before June 15, 2015. 29 d. Notwithstanding chapter 232 or any other provision of 30 law to the contrary, a district or juvenile court shall not 31 order any service which is a charge upon the state pursuant 32 to section 232.141 if there are insufficient court-ordered 33 services funds available in the district court or departmental 34 service area distribution amounts to pay for the service. The 35 -50- SF 505 (3) 86 pf/rj 50/ 195
S.F. 505 chief juvenile court officer and the departmental service area 1 manager shall encourage use of the funds allocated in this 2 subsection such that there are sufficient funds to pay for 3 all court-related services during the entire year. The chief 4 juvenile court officers and departmental service area managers 5 shall attempt to anticipate potential surpluses and shortfalls 6 in the distribution amounts and shall cooperatively request the 7 state court administrator or division administrator to transfer 8 funds between the judicial districts’ or departmental service 9 areas’ distribution amounts as prudent. 10 e. Notwithstanding any provision of law to the contrary, 11 a district or juvenile court shall not order a county to pay 12 for any service provided to a juvenile pursuant to an order 13 entered under chapter 232 which is a charge upon the state 14 under section 232.141, subsection 4 . 15 f. Of the funds allocated in this subsection, not more than 16 $83,000 may be used by the judicial branch for administration 17 of the requirements under this subsection. 18 g. Of the funds allocated in this subsection, $17,000 19 shall be used by the department of human services to support 20 the interstate commission for juveniles in accordance with 21 the interstate compact for juveniles as provided in section 22 232.173 . 23 10. Of the funds appropriated in this section, $8,053,227 is 24 allocated for juvenile delinquent graduated sanctions services. 25 Any state funds saved as a result of efforts by juvenile court 26 services to earn a federal Tit. IV-E match for juvenile court 27 services administration may be used for the juvenile delinquent 28 graduated sanctions services. 29 11. Of the funds appropriated in this section, $1,608,285 is 30 transferred to the department of public health to be used for 31 the child protection center grant program for child protection 32 centers located in Iowa in accordance with section 135.118 . 33 The grant amounts under the program shall be equalized so that 34 each center receives a uniform base amount of $245,000, and 35 -51- SF 505 (3) 86 pf/rj 51/ 195
S.F. 505 the remaining funds shall be awarded through a funding formula 1 based upon the volume of children served. 2 12. If the department receives federal approval to 3 implement a waiver under Tit. IV-E of the federal Social 4 Security Act to enable providers to serve children who remain 5 in the children’s families and communities, for purposes of 6 eligibility under the medical assistance program through 25 7 years of age, children who participate in the waiver shall be 8 considered to be placed in foster care. 9 13. Of the funds appropriated in this section, $4,025,167 is 10 allocated for the preparation for adult living program pursuant 11 to section 234.46 . 12 14. Of the funds appropriated in this section, $520,150 13 shall be used for juvenile drug courts. The amount allocated 14 in this subsection shall be distributed as follows: 15 To the judicial branch for salaries to assist with the 16 operation of juvenile drug court programs operated in the 17 following jurisdictions: 18 a. Marshall county: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,708 20 b. Woodbury county: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,682 22 c. Polk county: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 195,892 24 d. The third judicial district: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 26 e. The eighth judicial district: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 28 15. Of the funds appropriated in this section, $227,337 29 shall be used for the public purpose of continuing a grant to 30 a nonprofit human services organization providing services to 31 individuals and families in multiple locations in southwest 32 Iowa and Nebraska for support of a project providing immediate, 33 sensitive support and forensic interviews, medical exams, needs 34 assessments, and referrals for victims of child abuse and their 35 -52- SF 505 (3) 86 pf/rj 52/ 195
S.F. 505 nonoffending family members. 1 16. Of the funds appropriated in this section, $300,620 2 is allocated for the foster care youth council approach of 3 providing a support network to children placed in foster care. 4 17. Of the funds appropriated in this section, $202,000 is 5 allocated for use pursuant to section 235A.1 for continuation 6 of the initiative to address child sexual abuse implemented 7 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 8 21. 9 18. Of the funds appropriated in this section, $630,240 is 10 allocated for the community partnership for child protection 11 sites. 12 19. Of the funds appropriated in this section, $371,250 13 is allocated for the department’s minority youth and family 14 projects under the redesign of the child welfare system. 15 20. Of the funds appropriated in this section, $1,186,595 16 is allocated for funding of the community circle of care 17 collaboration for children and youth in northeast Iowa. 18 21. Of the funds appropriated in this section, at least 19 $147,158 shall be used for the continuation of the child 20 welfare provider training academy, a collaboration between the 21 coalition for family and children’s services in Iowa and the 22 department. 23 22. Of the funds appropriated in this section, $25,000 24 shall be used for the public purpose of continuation of a 25 grant to a child welfare services provider headquartered in a 26 county with a population between 205,000 and 215,000 in the 27 latest certified federal census that provides multiple services 28 including but not limited to a psychiatric medical institution 29 for children, shelter, residential treatment, after school 30 programs, school-based programming, and an Asperger’s syndrome 31 program, to be used for support services for children with 32 autism spectrum disorder and their families. 33 23. Of the funds appropriated in this section, $25,000 34 shall be used for the public purpose of continuing a grant to 35 -53- SF 505 (3) 86 pf/rj 53/ 195
S.F. 505 a hospital-based provider headquartered in a county with a 1 population between 90,000 and 95,000 in the latest certified 2 federal census that provides multiple services including 3 but not limited to diagnostic, therapeutic, and behavioral 4 services to individuals with autism spectrum disorder across 5 one’s lifespan. The grant recipient shall utilize the funds 6 to continue the pilot project to determine the necessary 7 support services for children with autism spectrum disorder and 8 their families to be included in the children’s disabilities 9 services system. The grant recipient shall submit findings and 10 recommendations based upon the results of the pilot project 11 to the individuals specified in this division of this Act for 12 submission of reports by December 31, 2015. 13 24. Of the funds appropriated in this section, $211,872 14 shall be used for continuation of the central Iowa system of 15 care program grant through June 30, 2016. 16 25. Of the funds appropriated in this section, $250,000 17 shall be used for the public purpose of the continuation 18 and expansion of a system of care program grant implemented 19 in Cerro Gordo and Linn counties to utilize a comprehensive 20 and long-term approach for helping children and families by 21 addressing the key areas in a child’s life of childhood basic 22 needs, education and work, family, and community. 23 26. Of the funds appropriated in this section, at least 24 $25,000 shall be used to continue and to expand the foster 25 care respite pilot program in which postsecondary students in 26 social work and other human services-related programs receive 27 experience by assisting family foster care providers with 28 respite and other support. 29 27. Of the funds appropriated in this section, $110,000 30 shall be used for the public purpose of funding community-based 31 services and other supports with a system of care approach 32 for children with a serious emotional disturbance and their 33 families through a nonprofit provider of child welfare services 34 that has been in existence for more than 115 years, is located 35 -54- SF 505 (3) 86 pf/rj 54/ 195
S.F. 505 in a county with a population of more than 200,000 but less 1 than 220,000 according to the latest census information 2 issued by the United States census bureau, is licensed as a 3 psychiatric medical institution for children, and was a system 4 of care grantee prior to July 1, 2015. 5 Sec. 19. 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, 2015, and ending June 30, 2016, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,998,286 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, 2015, 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. 20. 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, 2015, and ending June 31 30, 2016, are appropriated to the department of human services 32 for the fiscal year beginning July 1, 2015, and ending June 30, 33 2016, for distribution of an amount equal to a percentage of 34 the costs of the establishment, improvement, operation, and 35 -55- SF 505 (3) 86 pf/rj 55/ 195
S.F. 505 maintenance of county or multicounty juvenile detention homes 1 in the fiscal year beginning July 1, 2014. 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, 2014. 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, 2015, shall be limited to the 11 amount appropriated for the purposes of this section. 12 Sec. 21. 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, 2015, and ending June 30, 2016, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,073,932 21 2. The department shall use at least $641,500 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 $25,000 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. 22. CONNER DECREE. There is appropriated from the 35 -56- SF 505 (3) 86 pf/rj 56/ 195
S.F. 505 general fund of the state to the department of human services 1 for the fiscal year beginning July 1, 2015, and ending June 30, 2 2016, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 9 Sec. 23. 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, 2015, and ending 12 June 30, 2016, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,545,616 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.20 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,812,899 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,390,773 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 29 Sec. 24. STATE RESOURCE CENTERS. 30 1. There is appropriated from the general fund of the 31 state to the department of human services for the fiscal year 32 beginning July 1, 2015, and ending June 30, 2016, the following 33 amounts, or so much thereof as is necessary, to be used for the 34 purposes designated: 35 -57- SF 505 (3) 86 pf/rj 57/ 195
S.F. 505 a. For the state resource center at Glenwood for salaries, 1 support, maintenance, and miscellaneous purposes: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 22,024,482 3 b. For the state resource center at Woodward for salaries, 4 support, maintenance, and miscellaneous purposes: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,933,806 6 2. The department may continue to bill for state resource 7 center services utilizing a scope of services approach used for 8 private providers of intermediate care facilities for persons 9 with an intellectual disability services, in a manner which 10 does not shift costs between the medical assistance program, 11 counties, or other sources of funding for the state resource 12 centers. 13 3. The state resource centers may expand the time-limited 14 assessment and respite services during the fiscal year. 15 4. If the department’s administration and the department 16 of management concur with a finding by a state resource 17 center’s superintendent that projected revenues can reasonably 18 be expected to pay the salary and support costs for a new 19 employee position, or that such costs for adding a particular 20 number of new positions for the fiscal year would be less 21 than the overtime costs if new positions would not be added, 22 the superintendent may add the new position or positions. If 23 the vacant positions available to a resource center do not 24 include the position classification desired to be filled, the 25 state resource center’s superintendent may reclassify any 26 vacant position as necessary to fill the desired position. The 27 superintendents of the state resource centers may, by mutual 28 agreement, pool vacant positions and position classifications 29 during the course of the fiscal year in order to assist one 30 another in filling necessary positions. 31 5. If existing capacity limitations are reached in 32 operating units, a waiting list is in effect for a service or 33 a special need for which a payment source or other funding 34 is available for the service or to address the special need, 35 -58- SF 505 (3) 86 pf/rj 58/ 195
S.F. 505 and facilities for the service or to address the special need 1 can be provided within the available payment source or other 2 funding, the superintendent of a state resource center may 3 authorize opening not more than two units or other facilities 4 and begin implementing the service or addressing the special 5 need during fiscal year 2015-2016. 6 Sec. 25. SEXUALLY VIOLENT PREDATORS. 7 1. There is appropriated from the general fund of the 8 state to the department of human services for the fiscal year 9 beginning July 1, 2015, and ending June 30, 2016, the following 10 amount, or so much thereof as is necessary, to be used for the 11 purpose designated: 12 For costs associated with the commitment and treatment of 13 sexually violent predators in the unit located at the state 14 mental health institute at Cherokee, including costs of legal 15 services and other associated costs, including salaries, 16 support, maintenance, and miscellaneous purposes, and for not 17 more than the following full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,893,079 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 132.50 20 2. Unless specifically prohibited by law, if the amount 21 charged provides for recoupment of at least the entire amount 22 of direct and indirect costs, the department of human services 23 may contract with other states to provide care and treatment 24 of persons placed by the other states at the unit for sexually 25 violent predators at Cherokee. The moneys received under 26 such a contract shall be considered to be repayment receipts 27 and used for the purposes of the appropriation made in this 28 section. 29 Sec. 26. FIELD OPERATIONS. There is appropriated from the 30 general fund of the state to the department of human services 31 for the fiscal year beginning July 1, 2015, and ending June 30, 32 2016, the following amount, or so much thereof as is necessary, 33 to be used for the purposes designated: 34 For field operations, including salaries, support, 35 -59- SF 505 (3) 86 pf/rj 59/ 195
S.F. 505 maintenance, and miscellaneous purposes, and for not more than 1 the following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 58,920,976 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,837.00 4 1. As a condition of this appropriation, the department 5 shall make every possible effort to fill the entire number of 6 positions authorized by this section and, unless specifically 7 provided otherwise by an applicable collective bargaining 8 agreement, the department is not subject to any approval 9 requirement external to the department to fill a field 10 operations vacancy within the number of full-time equivalent 11 positions authorized by this section. The department shall 12 report on the first of each month to the chairpersons and 13 ranking members of the appropriations committees of the senate 14 and house of representatives, and the persons designated by 15 this Act for submission of reports concerning the status of 16 filling the positions. 17 2. Priority in filling full-time equivalent positions 18 shall be given to those positions related to child protection 19 services and eligibility determination for low-income families. 20 Sec. 27. GENERAL ADMINISTRATION. There is appropriated 21 from the general fund of the state to the department of human 22 services for the fiscal year beginning July 1, 2015, and ending 23 June 30, 2016, the following amount, or so much thereof as is 24 necessary, to be used for the purpose designated: 25 For general administration, including salaries, support, 26 maintenance, and miscellaneous purposes, and for not more than 27 the following full-time equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,161,741 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 309.00 30 1. Of the funds appropriated in this section, $38,543 is 31 allocated for the prevention of disabilities policy council 32 created in section 225B.103, if enacted in this Act. 33 2. The department shall report at least monthly to the 34 legislative services agency concerning the department’s 35 -60- SF 505 (3) 86 pf/rj 60/ 195
S.F. 505 operational and program expenditures. 1 3. Of the funds appropriated in this section, $150,000 shall 2 be used to continue the contract for the provision of a program 3 to provide technical assistance, support, and consultation to 4 providers of habilitation services and home and community-based 5 services waiver services for adults with disabilities under the 6 medical assistance program. 7 4. Of the funds appropriated in this section, $50,000 8 is transferred to the Iowa finance authority to be used 9 for administrative support of the council on homelessness 10 established in section 16.2D and for the council to fulfill its 11 duties in addressing and reducing homelessness in the state. 12 5. Of the funds appropriated in this section, $250,000 13 is allocated to an Iowa food bank association selected by 14 the department for the purchase of food on behalf of an Iowa 15 emergency feeding organization or for the distribution of 16 moneys to the Iowa emergency feeding organization for the 17 purchase of food. The moneys allocated in this subsection 18 shall be allocated only to the extent that the allocated moneys 19 are matched on a dollar-for-dollar basis. Notwithstanding 20 section 8.33, moneys allocated in this subsection that remain 21 unencumbered or unobligated at the close of the fiscal year 22 shall not revert but shall remain available for expenditure for 23 the purposes designated until the close of the following fiscal 24 year. 25 6. Of the funds appropriated in this section, $250,000 26 shall be transferred to and deposited in the administrative 27 fund of the Iowa ABLE savings plan trust created in section 28 12I.4, if enacted in this Act, to be used for implementation 29 and administration activities of the Iowa ABLE savings plan 30 trust. Such activities may include the funding of a program 31 manager position, the issuance of a request for proposals, 32 and creation of an informational internet site, but shall not 33 include funding for marketing. The appropriation made in this 34 section is deemed to meet the requirement in the section of 35 -61- SF 505 (3) 86 pf/rj 61/ 195
S.F. 505 the division of this Act, if enacted, relating to contingent 1 implementation of chapter 12I. 2 Sec. 28. VOLUNTEERS. There is appropriated from the general 3 fund of the state to the department of human services for the 4 fiscal year beginning July 1, 2015, and ending June 30, 2016, 5 the following amount, or so much thereof as is necessary, to be 6 used for the purpose designated: 7 For development and coordination of volunteer services: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 9 Sec. 29. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 10 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 11 DEPARTMENT OF HUMAN SERVICES. 12 1. a. (1) For the fiscal year beginning July 1, 2015, 13 the total state funding amount for the nursing facility budget 14 shall not exceed $321,900,006. 15 (2) For the fiscal year beginning July 1, 2015, the 16 department shall rebase case-mix nursing facility rates 17 effective July 1, 2015. However, total nursing facility budget 18 expenditures, including both case-mix and noncase-mix, shall 19 not exceed the amount specified in subparagraph (1). When 20 calculating case-mix per diem cost and the patient-day-weighted 21 medians used in rate-setting for nursing facilities effective 22 July 1, 2015, the inflation factor applied from the midpoint 23 of the cost report period to the first day of the state fiscal 24 year rate period shall be adjusted to maintain state funding 25 within the amount specified in subparagraph (1). 26 (3) The department, in cooperation with nursing facility 27 representatives, shall review projections for state funding 28 expenditures for reimbursement of nursing facilities on a 29 quarterly basis and the department shall determine if an 30 adjustment to the medical assistance reimbursement rate is 31 necessary in order to provide reimbursement within the state 32 funding amount for the fiscal year. Notwithstanding 2001 33 Iowa Acts, chapter 192, section 4, subsection 2, paragraph 34 “c”, and subsection 3, paragraph “a”, subparagraph (2), 35 -62- SF 505 (3) 86 pf/rj 62/ 195
S.F. 505 if the state funding expenditures for the nursing facility 1 budget for the fiscal year are projected to exceed the amount 2 specified in subparagraph (1), the department shall adjust 3 the reimbursement for nursing facilities reimbursed under the 4 case-mix reimbursement system to maintain expenditures of the 5 nursing facility budget within the specified amount for the 6 fiscal year. 7 (4) For the fiscal year beginning July 1, 2015, special 8 population nursing facilities shall be reimbursed in accordance 9 with the methodology in effect on June 30, 2015. 10 (5) For any open or unsettled nursing facility cost report 11 for a fiscal year prior to and including the fiscal year 12 beginning July 1, 2014, including any cost report remanded on 13 judicial review for inclusion of prescription drug, laboratory, 14 or x-ray costs, the department shall offset all reported 15 prescription drug, laboratory, and x-ray costs with any revenue 16 received from Medicare or other revenue source for any purpose. 17 For purposes of this subparagraph, a nursing facility cost 18 report is not considered open or unsettled if the facility did 19 not initiate an administrative appeal under chapter 17A or if 20 any appeal rights initiated have been exhausted. 21 b. (1) For the fiscal year beginning July 1, 2015, 22 the department shall establish the pharmacy dispensing fee 23 reimbursement at $11.73 per prescription as determined by the 24 June 2014 cost of dispensing fee survey. 25 (2) The department shall utilize an average acquisition 26 cost reimbursement methodology for all drugs covered under the 27 medical assistance program in accordance with 2012 Iowa Acts, 28 chapter 1133, section 33. 29 (3) Notwithstanding subparagraph (2), if the centers for 30 Medicare and Medicaid services of the United States department 31 of health and human services (CMS) requires, as a condition 32 of federal Medicaid funding, that the department implement an 33 aggregate federal upper limit (FUL) for drug reimbursement 34 based on the average manufacturer’s price (AMP), the department 35 -63- SF 505 (3) 86 pf/rj 63/ 195
S.F. 505 may utilize a reimbursement methodology for all drugs covered 1 under the Medicaid program based on the national average drug 2 acquisition cost (NADAC) methodology published by CMS, in order 3 to assure compliance with the aggregate FUL, minimize outcomes 4 of drug reimbursements below pharmacy acquisition costs, limit 5 administrative costs, and minimize any change in the aggregate 6 reimbursement for drugs. The department may adopt emergency 7 rules to implement this subparagraph. 8 c. (1) For the fiscal year beginning July 1, 2015, 9 reimbursement rates for outpatient hospital services shall 10 remain at the rates in effect on June 30, 2015, subject 11 to Medicaid program upper payment limit rules and adjusted 12 as necessary to maintain expenditures within the amount 13 appropriated to the department for this purpose for the fiscal 14 year. 15 (2) For the fiscal year beginning July 1, 2015, 16 reimbursement rates for inpatient hospital services shall be 17 rebased effective October 1, 2015, subject to Medicaid program 18 upper payment limit rules and adjusted as necessary to maintain 19 expenditures within the amount appropriated to the department 20 for this purpose for the fiscal year. 21 (3) For the fiscal year beginning July 1, 2015, the graduate 22 medical education and disproportionate share hospital fund 23 shall remain at the amount in effect on June 30, 2015, except 24 that the portion of the fund attributable to graduate medical 25 education shall be reduced in an amount that reflects the 26 elimination of graduate medical education payments made to 27 out-of-state hospitals. 28 (4) In order to ensure the efficient use of limited state 29 funds in procuring health care services for low-income Iowans, 30 funds appropriated in this Act for hospital services shall 31 not be used for activities which would be excluded from a 32 determination of reasonable costs under the federal Medicare 33 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 34 d. For the fiscal year beginning July 1, 2015, reimbursement 35 -64- SF 505 (3) 86 pf/rj 64/ 195
S.F. 505 rates for rural health clinics, hospices, and acute mental 1 hospitals shall be increased in accordance with increases under 2 the federal Medicare program or as supported by their Medicare 3 audited costs. 4 e. For the fiscal year beginning July 1, 2015, independent 5 laboratories and rehabilitation agencies shall be reimbursed 6 using the same methodology in effect on June 30, 2015. 7 f. (1) For the fiscal year beginning July 1, 2015, 8 reimbursement rates for home health agencies shall continue to 9 be based on the Medicare low utilization payment adjustment 10 (LUPA) methodology with state geographic wage adjustments, and 11 updated to reflect the most recent Medicare LUPA rates. 12 (2) For the fiscal year beginning July 1, 2015, rates for 13 private duty nursing and personal care services under the early 14 and periodic screening, diagnostic, and treatment program 15 benefit shall be calculated based on the methodology in effect 16 on June 30, 2015. 17 g. For the fiscal year beginning July 1, 2015, federally 18 qualified health centers shall receive cost-based reimbursement 19 for 100 percent of the reasonable costs for the provision of 20 services to recipients of medical assistance. 21 h. For the fiscal year beginning July 1, 2015, the 22 reimbursement rates for dental services shall remain at the 23 rates in effect on June 30, 2015. 24 i. (1) For the fiscal year beginning July 1, 2015, 25 state-owned psychiatric medical institutions for children shall 26 receive cost-based reimbursement for 100 percent of the actual 27 and allowable costs for the provision of services to recipients 28 of medical assistance. 29 (2) For the nonstate-owned psychiatric medical institutions 30 for children, reimbursement rates shall be based on the 31 reimbursement methodology developed by the department as 32 required for federal compliance. 33 (3) As a condition of participation in the medical 34 assistance program, enrolled providers shall accept the medical 35 -65- SF 505 (3) 86 pf/rj 65/ 195
S.F. 505 assistance reimbursement rate for any covered goods or services 1 provided to recipients of medical assistance who are children 2 under the custody of a psychiatric medical institution for 3 children. 4 j. For the fiscal year beginning July 1, 2015, unless 5 otherwise specified in this Act, all noninstitutional medical 6 assistance provider reimbursement rates shall remain at the 7 rates in effect on June 30, 2015, except for area education 8 agencies, local education agencies, infant and toddler 9 services providers, home and community-based services providers 10 including consumer-directed attendant care providers under a 11 section 1915(c) or 1915(i) waiver, targeted case management 12 providers, and those providers whose rates are required to be 13 determined pursuant to section 249A.20 . 14 k. Notwithstanding any provision to the contrary, for the 15 fiscal year beginning July 1, 2015, the reimbursement rate for 16 anesthesiologists shall remain at the rate in effect on June 17 30, 2015. 18 l. Notwithstanding section 249A.20, for the fiscal year 19 beginning July 1, 2015, the average reimbursement rate for 20 health care providers eligible for use of the federal Medicare 21 resource-based relative value scale reimbursement methodology 22 under section 249A.20 shall remain at the rate in effect on 23 June 30, 2015; however, this rate shall not exceed the maximum 24 level authorized by the federal government. 25 m. For the fiscal year beginning July 1, 2015, the 26 reimbursement rate for residential care facilities shall not 27 be less than the minimum payment level as established by the 28 federal government to meet the federally mandated maintenance 29 of effort requirement. The flat reimbursement rate for 30 facilities electing not to file annual cost reports shall not 31 be less than the minimum payment level as established by the 32 federal government to meet the federally mandated maintenance 33 of effort requirement. 34 n. For the fiscal year beginning July 1, 2015, the 35 -66- SF 505 (3) 86 pf/rj 66/ 195
S.F. 505 reimbursement rates for inpatient mental health services 1 provided at hospitals shall be rebased effective October 1, 2 2015, subject to Medicaid program upper payment limit rules; 3 and psychiatrists shall be reimbursed at the medical assistance 4 program fee-for-service rate in effect on June 30, 2015. 5 o. For the fiscal year beginning July 1, 2015, community 6 mental health centers may choose to be reimbursed for the 7 services provided to recipients of medical assistance through 8 either of the following options: 9 (1) For 100 percent of the reasonable costs of the services. 10 (2) In accordance with the alternative reimbursement rate 11 methodology established by the medical assistance program’s 12 managed care contractor for mental health services and approved 13 by the department of human services. 14 p. For the fiscal year beginning July 1, 2015, the 15 reimbursement rate for providers of family planning services 16 that are eligible to receive a 90 percent federal match shall 17 remain at the rates in effect on June 30, 2015. 18 q. For the fiscal year beginning July 1, 2015, the upper 19 limits on reimbursement rates for providers of home and 20 community-based services waiver services shall be increased by 21 1.5 percent over the limits in effect on June 30, 2015. 22 r. For the fiscal year beginning July 1, 2015, the 23 reimbursement rates for emergency medical service providers 24 shall remain at the rates in effect on June 30, 2015. 25 s. For the fiscal year beginning July 1, 2015, reimbursement 26 rates for substance-related disorder treatment programs 27 licensed under section 125.13 shall be increased by 3 percent 28 over the rates in effect on June 30, 2015. 29 2. For the fiscal year beginning July 1, 2015, the 30 reimbursement rate for providers reimbursed under the 31 in-home-related care program shall not be less than the minimum 32 payment level as established by the federal government to meet 33 the federally mandated maintenance of effort requirement. 34 3. Unless otherwise directed in this section, when the 35 -67- SF 505 (3) 86 pf/rj 67/ 195
S.F. 505 department’s reimbursement methodology for any provider 1 reimbursed in accordance with this section includes an 2 inflation factor, this factor shall not exceed the amount 3 by which the consumer price index for all urban consumers 4 increased during the calendar year ending December 31, 2002. 5 4. For the fiscal year beginning July 1, 2015, the foster 6 family basic daily maintenance rate and the maximum adoption 7 subsidy rate for children ages 0 through 5 years shall be 8 $16.78, the rate for children ages 6 through 11 years shall be 9 $17.45, the rate for children ages 12 through 15 years shall 10 be $19.10, and the rate for children and young adults ages 16 11 and older shall be $19.35. For youth ages 18 to 21 who have 12 exited foster care, the preparation for adult living program 13 maintenance rate shall be $602.70 per month. The maximum 14 payment for adoption subsidy nonrecurring expenses shall be 15 limited to $500 and the disallowance of additional amounts 16 for court costs and other related legal expenses implemented 17 pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall 18 be continued. 19 5. For the fiscal year beginning July 1, 2015, the maximum 20 reimbursement rates for social services providers under 21 contract shall remain at the rates in effect on June 30, 2015, 22 or the provider’s actual and allowable cost plus inflation for 23 each service, whichever is less. However, if a new service 24 or service provider is added after June 30, 2015, the initial 25 reimbursement rate for the service or provider shall be based 26 upon a weighted average of provider rates for similar services. 27 6. For the fiscal year beginning July 1, 2015, the 28 reimbursement rates for resource family recruitment and 29 retention contractors, child welfare emergency services 30 contractors, and supervised apartment living foster care 31 providers shall be increased by 5 percent over the rates in 32 effect on June 30, 2015. 33 7. For the fiscal year beginning July 1, 2015, the 34 reimbursement rate for safety plan services and family safety, 35 -68- SF 505 (3) 86 pf/rj 68/ 195
S.F. 505 risk, and permanency services (family-centered) shall be 1 increased as follows: 2 a. The statewide base monthly payment amount for all 3 family safety, risk, and permanency services (family-centered) 4 contractors shall be increased by $25.22 per month over the 5 rate in effect on June 30, 2015. 6 (1) Family safety, risk, and permanency services 7 Performance Measure 1 payments shall be increased by $5.25 per 8 case over the rate in effect on June 30, 2015. 9 (2) Family safety, risk, and permanency services 10 Performance Measure 2 payments shall be increased by $13.15 per 11 case over the rate in effect on June 30, 2015. 12 (3) Family safety, risk, and permanency services 13 Performance Measure 3 payments shall be increased by $26.25 per 14 case over the rate in effect on June 30, 2015. 15 (4) Family safety, risk, and permanency services 16 Performance Measure 4 payments shall be increased by $26.25 per 17 case over the rate in effect on June 30, 2015. 18 b. The maximum reimbursement unit rate for safety plan 19 services shall be increased by $27.61 over the rate in effect 20 on June 30, 2015. 21 (1) Safety plan services Performance Measure 1 payments 22 shall be increased by $5.25 per case over the rate in effect on 23 June 30, 2015. 24 (2) Safety plan services Performance Measure 2 payments 25 shall be increased by $5.25 per case over the rate in effect on 26 June 30, 2015. 27 8. a. For the purposes of this subsection, “combined 28 reimbursement rate” means the combined service and maintenance 29 reimbursement rate for a service level under the department’s 30 reimbursement methodology. Effective July 1, 2015, the 31 combined reimbursement rate for a group foster care service 32 level shall be the amount designated in this subsection. 33 However, if a group foster care provider’s reimbursement rate 34 for a service level as of June 30, 2015, is more than the rate 35 -69- SF 505 (3) 86 pf/rj 69/ 195
S.F. 505 designated in this subsection, the provider’s reimbursement 1 shall remain at the higher rate. 2 b. Unless a group foster care provider is subject to the 3 exception provided in paragraph “a”, effective July 1, 2015, 4 the combined reimbursement rates for the service levels under 5 the department’s reimbursement methodology shall be as follows: 6 (1) For service level, community - D1, the daily rate shall 7 be at least $84.17. 8 (2) For service level, comprehensive - D2, the daily rate 9 shall be at least $119.09. 10 (3) For service level, enhanced - D3, the daily rate shall 11 be at least $131.09. 12 9. The group foster care reimbursement rates paid for 13 placement of children out of state shall be calculated 14 according to the same rate-setting principles as those used for 15 in-state providers, unless the director of human services or 16 the director’s designee determines that appropriate care cannot 17 be provided within the state. The payment of the daily rate 18 shall be based on the number of days in the calendar month in 19 which service is provided. 20 10. a. For the fiscal year beginning July 1, 2015, the 21 reimbursement rate paid for shelter care and the child welfare 22 emergency services implemented to provide or prevent the need 23 for shelter care shall be established by contract. 24 b. For the fiscal year beginning July 1, 2015, the combined 25 service and maintenance components of the reimbursement rate 26 paid for shelter care services shall be based on the financial 27 and statistical report submitted to the department. The 28 maximum reimbursement rate shall be $101.83 per day. The 29 department shall reimburse a shelter care provider at the 30 provider’s actual and allowable unit cost, plus inflation, not 31 to exceed the maximum reimbursement rate. 32 c. Notwithstanding section 232.141, subsection 8 , for the 33 fiscal year beginning July 1, 2015, the amount of the statewide 34 average of the actual and allowable rates for reimbursement of 35 -70- SF 505 (3) 86 pf/rj 70/ 195
S.F. 505 juvenile shelter care homes that is utilized for the limitation 1 on recovery of unpaid costs shall remain at the amount in 2 effect for this purpose in the fiscal year beginning July 1, 3 2014. 4 11. For the fiscal year beginning July 1, 2015, the 5 department shall calculate reimbursement rates for intermediate 6 care facilities for persons with an intellectual disability 7 at the 80th percentile. Beginning July 1, 2015, the rate 8 calculation methodology shall utilize the consumer price index 9 inflation factor applicable to the fiscal year beginning July 10 1, 2015. 11 12. For the fiscal year beginning July 1, 2015, for child 12 care providers reimbursed under the state child care assistance 13 program, the department shall set provider reimbursement 14 rates based on the rate reimbursement survey completed in 15 December 2004. Effective July 1, 2015, the child care provider 16 reimbursement rates shall remain at the rates in effect on June 17 30, 2015. The department shall set rates in a manner so as 18 to provide incentives for a nonregistered provider to become 19 registered by applying the increase only to registered and 20 licensed providers. 21 13. For the fiscal year beginning July 1, 2015, if the 22 centers for Medicare and Medicaid services of the United 23 States department of health and human services approves the 24 waivers necessary to implement medical assistance program 25 managed care applicable to any providers or services subject to 26 reimbursement under this section, notwithstanding any provision 27 to the contrary under this section, affected providers or 28 services shall instead be reimbursed as follows: 29 a. For fee-for-service claims, reimbursement rates shall 30 be calculated based on the methodology otherwise specified in 31 this section for the fiscal year beginning July 1, 2015, for 32 the respective provider or service. 33 b. For claims subject to a managed care contract, 34 reimbursement shall be based on the actuarially sound 35 -71- SF 505 (3) 86 pf/rj 71/ 195
S.F. 505 capitation rates established under the contract. However, 1 any reimbursement established under such contract shall not 2 be lower than the reimbursement otherwise specified in this 3 section for the fiscal year beginning July 1, 2015, for the 4 respective provider or service. 5 14. The department may adopt emergency rules to implement 6 this section. 7 Sec. 30. EMERGENCY RULES. 8 1. If specifically authorized by a provision of this 9 division of this Act, the department of human services or 10 the mental health and disability services commission may 11 adopt administrative rules under section 17A.4, subsection 12 3, and section 17A.5, subsection 2, paragraph “b”, to 13 implement the provisions of this division of this Act and 14 the rules shall become effective immediately upon filing or 15 on a later effective date specified in the rules, unless the 16 effective date of the rules is delayed or the applicability 17 of the rules is suspended by the administrative rules review 18 committee. Any rules adopted in accordance with this section 19 shall not take effect before the rules are reviewed by the 20 administrative rules review committee. The delay authority 21 provided to the administrative rules review committee under 22 section 17A.4, subsection 7, and section 17A.8, subsection 9, 23 shall be applicable to a delay imposed under this section, 24 notwithstanding a provision in those sections making them 25 inapplicable to section 17A.5, subsection 2, paragraph “b”. 26 Any rules adopted in accordance with the provisions of this 27 section shall also be published as a notice of intended action 28 as provided in section 17A.4. 29 2. If during a fiscal year, the department of human 30 services is adopting rules in accordance with this section 31 or as otherwise directed or authorized by state law, and the 32 rules will result in an expenditure increase beyond the amount 33 anticipated in the budget process or if the expenditure was 34 not addressed in the budget process for the fiscal year, the 35 -72- SF 505 (3) 86 pf/rj 72/ 195
S.F. 505 department shall notify the persons designated by this division 1 of this Act for submission of reports, the chairpersons and 2 ranking members of the committees on appropriations, and 3 the department of management concerning the rules and the 4 expenditure increase. The notification shall be provided at 5 least 30 calendar days prior to the date notice of the rules 6 is submitted to the administrative rules coordinator and the 7 administrative code editor. 8 Sec. 31. REPORTS. Any reports or other information 9 required to be compiled and submitted under this Act during the 10 fiscal year beginning July 1, 2015, shall be submitted to the 11 chairpersons and ranking members of the joint appropriations 12 subcommittee on health and human services, the legislative 13 services agency, and the legislative caucus staffs on or 14 before the dates specified for submission of the reports or 15 information. 16 Sec. 32. EFFECTIVE UPON ENACTMENT. The following 17 provisions of this division of this Act, being deemed of 18 immediate importance, take effect upon enactment: 19 1. The provision relating to section 232.141 and directing 20 the state court administrator and the division administrator of 21 the department of human services division of child and family 22 services to make the determination, by June 15, 2015, of the 23 distribution of funds allocated for the payment of the expenses 24 of court-ordered services provided to juveniles which are a 25 charge upon the state. 26 2. The provision prohibiting the department of human 27 services from adopting emergency rules to implement Medicaid 28 managed care or the governor’s Medicaid modernization 29 initiative. 30 DIVISION VI 31 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2015-2016 32 Sec. 33. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 33 appropriated from the pharmaceutical settlement account created 34 in section 249A.33 to the department of human services for the 35 -73- SF 505 (3) 86 pf/rj 73/ 195
S.F. 505 fiscal year beginning July 1, 2015, and ending June 30, 2016, 1 the following amount, or so much thereof as is necessary, to be 2 used for the purpose designated: 3 Notwithstanding any provision of law to the contrary, to 4 supplement the appropriations made in this Act for medical 5 contracts under the medical assistance program for the fiscal 6 year beginning July 1, 2015, and ending June 30, 2016: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 8 Sec. 34. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 9 SERVICES. Notwithstanding any provision to the contrary and 10 subject to the availability of funds, there is appropriated 11 from the quality assurance trust fund created in section 12 249L.4 to the department of human services for the fiscal year 13 beginning July 1, 2015, and ending June 30, 2016, the following 14 amounts, or so much thereof as is necessary, for the purposes 15 designated: 16 To supplement the appropriation made in this Act from the 17 general fund of the state to the department of human services 18 for medical assistance for the same fiscal year: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,705,208 20 Sec. 35. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 21 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 22 the contrary and subject to the availability of funds, there is 23 appropriated from the hospital health care access trust fund 24 created in section 249M.4 to the department of human services 25 for the fiscal year beginning July 1, 2015, and ending June 26 30, 2016, the following amounts, or so much thereof as is 27 necessary, for the purposes designated: 28 To supplement the appropriation made in this Act from the 29 general fund of the state to the department of human services 30 for medical assistance for the same fiscal year: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 34,700,000 32 Sec. 36. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 33 FOR FY 2015-2016. Notwithstanding section 8.33 , if moneys 34 appropriated for purposes of the medical assistance program for 35 -74- SF 505 (3) 86 pf/rj 74/ 195
S.F. 505 the fiscal year beginning July 1, 2015, and ending June 30, 1 2016, from the general fund of the state, the quality assurance 2 trust fund and the hospital health care access trust fund, are 3 in excess of actual expenditures for the medical assistance 4 program and remain unencumbered or unobligated at the close 5 of the fiscal year, the excess moneys shall not revert but 6 shall remain available for expenditure for the purposes of the 7 medical assistance program until the close of the succeeding 8 fiscal year. 9 DIVISION VII 10 PATIENT-CENTERED HEALTH ADVISORY COUNCIL 11 Sec. 37. Section 135.159, subsection 2, paragraph a, 12 unnumbered paragraph 1, Code 2015, is amended to read as 13 follows: 14 The department shall establish an a patient-centered health 15 advisory council which shall include but is not limited to 16 all of the following members, selected by their respective 17 organizations, and any other members the department determines 18 necessary to assist in the department’s duties at various 19 stages of development of the medical home system: 20 Sec. 38. Section 135.159, subsection 2, paragraph b, Code 21 2015, is amended to read as follows: 22 b. Public members of the patient-centered health advisory 23 council shall receive reimbursement for actual expenses 24 incurred while serving in their official capacity only if they 25 are not eligible for reimbursement by the organization that 26 they represent. 27 Sec. 39. Section 135.159, subsection 10, Code 2015, is 28 amended to read as follows: 29 10. The department shall integrate the recommendations and 30 policies developed pursuant to section 135.161 , Code 2011, into 31 the medical home system and shall incorporate the development 32 and implementation of the state initiative for prevention 33 and chronic care management as developed pursuant to section 34 135.161 , Code 2011, into the duties of the medical home system 35 -75- SF 505 (3) 86 pf/rj 75/ 195
S.F. 505 patient-centered health advisory council beginning January 1, 1 2012. 2 Sec. 40. CODE EDITOR DIRECTIVE. The Code editor shall amend 3 the headnote of section 135.159, Code 2015, to read Medical home 4 system —— patient-centered health advisory council —— development 5 and implementation . 6 DIVISION VIII 7 PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS 8 DECATEGORIZATION 9 Sec. 41. DECATEGORIZATION CARRYOVER FUNDING —— TRANSFER TO 10 MEDICAID PROGRAM. Notwithstanding section 232.188, subsection 11 5, paragraph “b”, any state appropriated moneys in the funding 12 pool that remained unencumbered or unobligated at the close 13 of the fiscal year beginning July 1, 2012, and were deemed 14 carryover funding to remain available for the two succeeding 15 fiscal years that still remain unencumbered or unobligated at 16 the close of the fiscal year beginning July 1, 2014, shall 17 not revert but shall be transferred to the medical assistance 18 program for the fiscal year beginning July 1, 2014. 19 COMMUNITY MENTAL HEALTH SERVICES APPROPRIATION 20 Sec. 42. 2013 Iowa Acts, chapter 136, section 2, subsection 21 1, paragraph c, is amended to read as follows: 22 c. The department shall allocate not less than 95 percent 23 of the amount of the block grant each federal fiscal year 24 to eligible community mental health services providers for 25 carrying out the plan submitted to and approved by the federal 26 substance abuse and mental health services administration 27 for the fiscal year involved , except that for federal fiscal 28 year 2014-2015, $1,643,467 of such federal block grant funds 29 shall be used for child and family services pursuant to 2013 30 Iowa Acts, chapter 138, section 148, as amended by 2014 Iowa 31 Acts, chapter 1140, section 25, for the purposes of 2014 Iowa 32 Acts, chapter 1140, section 25, subsection 20, relating to 33 the community circle of care collaboration for children and 34 youth in northeast Iowa, subsection 24 relating to the central 35 -76- SF 505 (3) 86 pf/rj 76/ 195
S.F. 505 Iowa system of care program grant, subsection 25 relating 1 to the system of care grant implemented in Cerro Gordo and 2 Linn counties, and subsection 27 relating to a system of care 3 approach for children with a serious emotional disturbance and 4 their families through a nonprofit provider of child welfare 5 services licensed as a psychiatric medical institution for 6 children . 7 TEMPORARY ASSISTANCE FOR NEEDY FAMILIES 8 Sec. 43. 2013 Iowa Acts, chapter 138, section 136, 9 subsections 1, 2, 6, and 13, as amended by 2014 Iowa Acts, 10 chapter 1140, section 9, are amended to read as follows: 11 1. To be credited to the family investment program account 12 and used for assistance under the family investment program 13 under chapter 239B : 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,879,488 15 6,281,222 16 2. To be credited to the family investment program account 17 and used for the job opportunities and basic skills (JOBS) 18 program and implementing family investment agreements in 19 accordance with chapter 239B : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,091,911 21 10,232,340 22 6. For state child care assistance: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 35,047,110 24 41,210,239 25 a. Of the funds appropriated in this subsection, 26 $26,347,110 $26,332,712 is transferred to the child care and 27 development block grant appropriation made by the Eighty-fifth 28 General Assembly, 2013 Session, in 2013 Iowa Acts, chapter 136, 29 section 14 for the federal fiscal year beginning October 1, 30 2014, and ending September 30, 2015. Of this amount, $200,000 31 shall be used for provision of educational opportunities to 32 registered child care home providers in order to improve 33 services and programs offered by this category of providers 34 and to increase the number of providers. The department may 35 -77- SF 505 (3) 86 pf/rj 77/ 195
S.F. 505 contract with institutions of higher education or child care 1 resource and referral centers to provide the educational 2 opportunities. Allowable administrative costs under the 3 contracts shall not exceed 5 percent. The application for a 4 grant shall not exceed two pages in length. 5 b. Any funds appropriated in this subsection remaining 6 unallocated shall be used for state child care assistance 7 payments for families who are employed, including but not 8 limited to individuals enrolled in the family investment 9 program who are employed . 10 13. a. Notwithstanding any provision to the contrary, 11 including but not limited to requirements in section 8.41 or 12 provisions in 2013 or 2014 Iowa Acts regarding the receipt and 13 appropriation of federal block grants, federal funds from the 14 temporary assistance for needy families block grant received 15 by the state not otherwise appropriated in this section and 16 remaining available for the fiscal year beginning July 1, 2014, 17 are appropriated to the department of human services to the 18 extent as may be necessary to be used in the following priority 19 order: the family investment program, for state child care 20 assistance program payments for individuals enrolled in the 21 family investment program families who are employed, and for 22 the family investment program share of costs to develop and 23 maintain a new, integrated eligibility determination system. 24 The federal funds appropriated in this paragraph “a” shall be 25 expended only after all other funds appropriated in subsection 26 1 for the assistance under the family investment program, 27 in subsection 6 for child care assistance, or in subsection 28 12 for the family investment program share of the costs to 29 continue to develop and maintain a new, integrated eligibility 30 determination system, as applicable, have been expended. For 31 the purposes of this subsection, the funds appropriated in 32 subsection 6, paragraph “a”, for transfer to the child care and 33 development block grant are considered fully expended when the 34 full amount has been transferred. 35 -78- SF 505 (3) 86 pf/rj 78/ 195
S.F. 505 b. The department shall, on a quarterly basis, advise the 1 legislative services agency and department of management of 2 the amount of funds appropriated in this subsection that was 3 expended in the prior quarter. 4 CHILD SUPPORT RECOVERY UNIT 5 Sec. 44. 2013 Iowa Acts, chapter 138, section 139, 6 unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter 7 1140, section 12, is amended to read as follows: 8 For child support recovery, including salaries, support, 9 maintenance, and miscellaneous purposes, and for not more than 10 the following full-time equivalent positions: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,911,230 12 14,771,230 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00 14 MEDICAL ASSISTANCE 15 Sec. 45. 2013 Iowa Acts, chapter 139, section 142, 16 unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter 17 1140, section 14, is amended to read as follows: 18 For medical assistance program reimbursement and associated 19 costs as specifically provided in the reimbursement 20 methodologies in effect on June 30, 2014, except as otherwise 21 expressly authorized by law, consistent with options under 22 federal law and regulations, and contingent upon receipt of 23 approval from the office of the governor of reimbursement for 24 each abortion performed under the program: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,250,658,393 26 1,310,299,250 27 MEDICAL CONTRACTS 28 Sec. 46. 2013 Iowa Acts, chapter 138, section 143, 29 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, 30 chapter 1140, section 19, are amended to read as follows: 31 There is appropriated from the general fund of the state to 32 the department of human services for the fiscal year beginning 33 July 1, 2014, and ending June 30, 2015, the following amount, 34 or so much thereof as is necessary, to be used for the purpose 35 -79- SF 505 (3) 86 pf/rj 79/ 195
S.F. 505 designated: 1 For medical contracts: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,148,576 3 12,896,400 4 STATE SUPPLEMENTARY ASSISTANCE 5 Sec. 47. 2013 Iowa Acts, chapter 138, section 144, 6 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 7 section 20, is amended to read as follows: 8 1. There is appropriated from the general fund of the 9 state to the department of human services for the fiscal year 10 beginning July 1, 2014, and ending June 30, 2015, the following 11 amount, or so much thereof as is necessary, to be used for the 12 purpose designated: 13 For the state supplementary assistance program: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,121,154 15 12,965,318 16 CHILDREN’S HEALTH INSURANCE PROGRAM/ 17 HEALTHY AND WELL KIDS IN IOWA PROGRAM 18 Sec. 48. 2013 Iowa Acts, chapter 138, section 145, 19 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 20 section 21, is amended to read as follows: 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, 2014, and ending June 30, 2015, the following 24 amount, or so much thereof as is necessary, to be used for the 25 purpose designated: 26 For maintenance of the healthy and well kids in Iowa (hawk-i) 27 program pursuant to chapter 514I , including supplemental dental 28 services, for receipt of federal financial participation under 29 Tit. XXI of the federal Social Security Act, which creates the 30 children’s health insurance program: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 45,877,998 32 45,097,085 33 CHILD CARE ASSISTANCE 34 Sec. 49. 2013 Iowa Acts, chapter 138, section 146, 35 -80- SF 505 (3) 86 pf/rj 80/ 195
S.F. 505 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, 1 chapter 1140, section 22, are amended to read as follows: 2 There is appropriated from the general fund of the state to 3 the department of human services for the fiscal year beginning 4 July 1, 2014, and ending June 30, 2015, the following amount, 5 or so much thereof as is necessary, to be used for the purpose 6 designated: 7 For child care programs: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,132,080 9 36,303,944 10 CHILDREN ADJUDICATED AS DELINQUENT AND CHILD IN NEED OF 11 ASSISTANCE PLACEMENTS 12 Sec. 50. 2013 Iowa Acts, chapter 138, unnumbered paragraphs 13 1 and 2, as amended by 2014 Iowa Acts, chapter 1140, section 14 24, are amended to read as follows: 15 There is appropriated from the general fund of the state to 16 the department of human services for the fiscal year beginning 17 July 1, 2014, and ending June 30, 2015, the following amount, 18 or so much thereof as is necessary, to be used for the purposes 19 designated: 20 For the placement costs of female children adjudicated as 21 delinquent and male and female children adjudicated as a child 22 in need of assistance: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 24 1,400,000 25 CHILD AND FAMILY SERVICES 26 Sec. 51. 2013 Iowa Acts, chapter 138, section 148, 27 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 28 section 25, is amended to read as follows: 29 1. There is appropriated from the general fund of the 30 state to the department of human services for the fiscal year 31 beginning July 1, 2014, and ending June 30, 2015, the following 32 amount, or so much thereof as is necessary, to be used for the 33 purpose designated: 34 For child and family services: 35 -81- SF 505 (3) 86 pf/rj 81/ 195
S.F. 505 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 94,857,554 1 91,364,087 2 ADOPTION SUBSIDY 3 Sec. 52. 2013 Iowa Acts, chapter 138, section 149, 4 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 5 section 26, is amended to read as follows: 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, 2014, and ending June 30, 2015, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,580,749 13 41,744,149 14 FAMILY SUPPORT SUBSIDY 15 Sec. 53. 2013 Iowa Acts, chapter 138, section 151, 16 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 17 section 27, is amended to read as follows: 18 1. There is appropriated from the general fund of the 19 state to the department of human services for the fiscal year 20 beginning July 1, 2014, and ending June 30, 2015, the following 21 amount, or so much thereof as is necessary, to be used for the 22 purpose designated: 23 For the family support subsidy program subject to the 24 enrollment restrictions in section 225C.37, subsection 3 : 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,079,739 26 579,739 27 FIELD OPERATIONS 28 Sec. 54. 2013 Iowa Acts, chapter 138, section 156, 29 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, 30 chapter 1140, section 32, are amended to read as follows: 31 There is appropriated from the general fund of the state to 32 the department of human services for the fiscal year beginning 33 July 1, 2014, and ending June 30, 2015, the following amount, 34 or so much thereof as is necessary, to be used for the purposes 35 -82- SF 505 (3) 86 pf/rj 82/ 195
S.F. 505 designated: 1 For field operations, including salaries, support, 2 maintenance, and miscellaneous purposes, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,170,976 5 61,170,976 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,837.00 7 GENERAL ADMINISTRATION 8 Sec. 55. 2013 Iowa Acts, chapter 138, section 157, 9 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, 10 chapter 1140, section 33, are amended to read as follows: 11 There is appropriated from the general fund of the state to 12 the department of human services for the fiscal year beginning 13 July 1, 2014, and ending June 30, 2015, the following amount, 14 or so much thereof as is necessary, to be used for the purpose 15 designated: 16 For general administration, including salaries, support, 17 maintenance, and miscellaneous purposes, and for not more than 18 the following full-time equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,072,302 20 15,072,302 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 309.00 22 PHARMACEUTICAL SETTLEMENT ACCOUNT 23 Sec. 56. 2013 Iowa Acts, chapter 138, section 162, as 24 amended by 2014 Iowa Acts, chapter 1140, section 47, is amended 25 to read as follows: 26 SEC. 162. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 27 appropriated from the pharmaceutical settlement account created 28 in section 249A.33 to the department of human services for the 29 fiscal year beginning July 1, 2014, and ending June 30, 2015, 30 the following amount, or so much thereof as is necessary, to be 31 used for the purpose designated: 32 Notwithstanding any provision of law to the contrary, to 33 supplement the appropriations made in this Act for medical 34 contracts under the medical assistance program for the fiscal 35 -83- SF 505 (3) 86 pf/rj 83/ 195
S.F. 505 year beginning July 1, 2014, and ending June 30, 2015: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,467,564 2 6,969,740 3 QUALITY ASSURANCE TRUST FUND 4 Sec. 57. 2013 Iowa Acts, chapter 138, section 163, as 5 amended by 2014 Iowa Acts, chapter 1140, section 48, is amended 6 to read as follows: 7 SEC. 163. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 8 HUMAN SERVICES. Notwithstanding any provision to the contrary 9 and subject to the availability of funds, there is appropriated 10 from the quality assurance trust fund created in section 11 249L.4 to the department of human services for the fiscal year 12 beginning July 1, 2014, and ending June 30, 2015, the following 13 amounts, or so much thereof as is necessary, for the purposes 14 designated: 15 To supplement the appropriation made in this Act from the 16 general fund of the state to the department of human services 17 for medical assistance for the same fiscal year: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,195,653 19 29,695,653 20 Sec. 58. EFFECTIVE UPON ENACTMENT. This division of this 21 Act, being deemed of immediate importance, takes effect upon 22 enactment. 23 Sec. 59. RETROACTIVE APPLICABILITY. This division of this 24 Act is retroactively applicable to July 1, 2014. 25 DIVISION IX 26 QUALITY ASSURANCE ASSESSMENT 27 Sec. 60. Section 249L.3, subsection 1, paragraph d, Code 28 2015, is amended to read as follows: 29 d. The aggregate quality assurance assessments imposed 30 under this chapter shall not exceed the lower of be established 31 at three percent of the aggregate non-Medicare revenues of a 32 nursing facility or the maximum amount that may be assessed 33 pursuant to the indirect guarantee threshold as established 34 pursuant to 42 C.F.R. §433.68(f)(3)(i), and shall be stated on 35 -84- SF 505 (3) 86 pf/rj 84/ 195
S.F. 505 a per-patient-day basis. 1 DIVISION X 2 HEALTH POLICY —— OVERSIGHT 3 Sec. 61. NEW SECTION . 2.70 Legislative health policy 4 oversight committee. 5 1. A legislative health policy oversight committee 6 is created to provide a formal venue for oversight of 7 and stakeholder engagement in, the design, development, 8 implementation, administration, and funding associated 9 with general state health care policy, with a particular 10 focus on the Medicaid program. The overall purpose of the 11 committee is to ensure that health care policy in this state 12 is consumer-focused and provides for accessible, accountable, 13 efficient, cost-effective, and quality health care. The goal 14 of the committee is to continue to further health policy that 15 improves health care, improves population health, reduces 16 health care costs, and integrates medical and social services 17 and supports into a holistic health system. 18 2. a. The committee shall include all of the following 19 members: 20 (1) The co-chairpersons and ranking members of the 21 legislative joint appropriations subcommittee on health 22 and human services, or members of the joint appropriations 23 subcommittee designated by the respective co-chairpersons or 24 ranking members. 25 (2) The chairpersons and ranking members of the 26 human resources committees of the senate and house of 27 representatives, or members of the respective committees 28 designated by the respective chairpersons or ranking members. 29 (3) The chairpersons and ranking members of the 30 appropriations committees of the senate and house of 31 representatives, or members of the respective committees 32 designated by the respective chairpersons or ranking members. 33 b. The members of the committee shall receive a per diem as 34 provided in section 2.10. 35 -85- SF 505 (3) 86 pf/rj 85/ 195
S.F. 505 c. The committee shall meet at least quarterly, but may meet 1 as often as necessary. The committee may request information 2 from sources as deemed appropriate, and the department of human 3 services and other agencies of state government shall provide 4 information to the committee as requested. The legislative 5 services agency shall provide staff support to the committee. 6 d. The committee shall select co-chairpersons, one 7 representing the senate and one representing the house of 8 representatives, annually, from its membership. A majority of 9 the members of the committee shall constitute a quorum. 10 e. The committee may contract for the services of persons 11 who are qualified by education, expertise, or experience to 12 advise, consult with, or otherwise assist the committee in the 13 performance of its duties. 14 3. The committee shall submit a report to the governor and 15 the general assembly by December 15, annually. 16 Sec. 62. NEW SECTION . 231.44 Utilization of resources 17 —— assistance and advocacy related to long-term services and 18 supports under the Medicaid program. 19 1. The office of long-term care ombudsman may utilize its 20 available resources to provide assistance and advocacy services 21 to potential or actual recipients, or the families or legal 22 representatives of such potential or actual recipients, of 23 long-term services and supports provided through the Medicaid 24 program. Such assistance and advocacy shall include but is not 25 limited to all of the following: 26 a. Providing information, education, consultation, and 27 assistance regarding eligibility for, enrollment in, and the 28 obtaining of long-term services and supports through the 29 Medicaid program. 30 b. Identifying and referring individuals who may be eligible 31 for and in need of long-term services and supports to the 32 Medicaid program. 33 c. Developing procedures for tracking and reporting 34 individual requests for assistance with the obtaining of 35 -86- SF 505 (3) 86 pf/rj 86/ 195
S.F. 505 necessary services and supports. 1 d. Providing consultation for individuals transitioning into 2 or out of an institutional setting or across levels of care. 3 e. Identifying gaps in or duplication of services provided 4 to older individuals and persons with disabilities and 5 developing strategies to improve the delivery and coordination 6 of these services for these individuals. 7 f. Providing advice, assistance, and negotiation relating 8 to the preparation and filing of complaints, grievances, and 9 appeals of complaints or grievances relating to long-term 10 services and supports under the Medicaid program. 11 g. Providing individual case advocacy services in 12 administrative hearings and legal representation for judicial 13 proceedings related to long-term services and supports under 14 the Medicaid program. 15 2. A representative of the office of long-term care 16 ombudsman providing assistance and advocacy services authorized 17 under this section for an individual, shall be provided 18 access to the individual, and shall be provided access to 19 the individual’s medical and social records as authorized by 20 the individual or the individual’s legal representative, as 21 necessary to carry out the duties specified in this section. 22 3. A representative of the office of long-term care 23 ombudsman providing assistance and advocacy services authorized 24 under this section for an individual, shall be provided access 25 to administrative records related to the provision of the 26 long-term services and supports to the individual, as necessary 27 to carry out the duties specified in this section. 28 4. For the purposes of this section: 29 a. “Institutional setting” includes a long-term care 30 facility, an elder group home, or an assisted living program. 31 b. “Long-term services and supports” means the broad range of 32 health, health-related, and personal care assistance services 33 and supports, provided in both institutional settings and home 34 and community-based settings, necessary for older individuals 35 -87- SF 505 (3) 86 pf/rj 87/ 195
S.F. 505 and persons with disabilities who experience limitations in 1 their capacity for self-care due to a physical, cognitive, or 2 mental disability or condition. 3 Sec. 63. MEDICAID MANAGED CARE ORGANIZATIONS —— UTILIZATION 4 OF CAPITATED PAYMENTS. 5 1. All of the following shall apply to Medicaid managed care 6 contracts entered into on or after July 1, 2015: 7 a. Two percent of the Medicaid capitation payment amount 8 specified under the contract shall be withheld by the state to 9 be used to provide for Medicaid program oversight, including 10 for a health consumer ombudsman function, and for quality 11 improvement. 12 b. The minimum medical loss ratio applicable to Medicaid 13 managed care shall be established at no less than 85 14 percent. The portion of the Medicaid capitation payment paid 15 to a Medicaid managed care contractor that is required to be 16 dedicated to meeting the minimum medical loss ratio shall be 17 allocated to a Medicaid claims fund. Expenditures of moneys 18 in the Medicaid claims fund shall comply with all of the 19 following: 20 (1) Only expenditures for medical claims shall be 21 considered in computing the minimum medical loss ratio 22 as specified in the contract. For the purposes of the 23 computation, “medical claims” means only the costs of claims 24 for direct delivery of covered benefits incurred during the 25 applicable minimum medical loss ratio reporting period, not 26 otherwise defined or designated as administrative costs, 27 population health benefits or quality improvement, or profit in 28 this section. 29 (2) If a Medicaid managed care contractor does not meet 30 the minimum medical loss ratio established under the contract 31 for the reporting period specified, the Medicaid managed 32 care contractor shall remit the excess amount, multiplied 33 by the total contract revenue, to the state for community 34 reinvestment, oversight, and quality improvement. 35 -88- SF 505 (3) 86 pf/rj 88/ 195
S.F. 505 c. The portion of the Medicaid capitation payment that is 1 not required to be dedicated to meeting the minimum medical 2 loss ratio, shall be allocated to an administrative fund. 3 Expenditure or use of moneys in the administrative fund shall 4 comply with all of the following: 5 (1) Funds in the administrative fund may be used for 6 population health and quality improvement activities 7 including conflict or reinvestment free case management, care 8 coordination, community benefit expenditures, nontraditional 9 consumer-centered services that address social determinants 10 of health, health information technology, data collection and 11 analysis, and other population health and quality improvement 12 activities as specified by rule of the department of human 13 services. 14 (2) Administrative costs shall not exceed the percentage 15 applicable to the Medicaid program for administrative costs for 16 FY 2015 of a maximum of 4 percent calculated as a percentage of 17 the Medicaid capitation payment during the applicable minimum 18 medical loss ratio reporting period. Administrative functions 19 and costs shall not be shifted to providers or other entities 20 as a means of administrative cost avoidance. 21 (3) Profit, including reserves and earnings on reserves 22 such as investment income and earned interest, as a percentage 23 of the Medicaid capitated payment, shall be limited to a 24 maximum of 3 percent during the applicable minimum medical loss 25 ratio reporting period. 26 (4) Any funds remaining in the administrative fund 27 following allowable expenditures or uses specified in 28 subparagraphs (1), (2), and (3) shall be remitted to the state 29 for community reinvestment, oversight, and quality improvement. 30 2. The department of human services shall specify by rule 31 reporting requirements for Medicaid managed care contractors 32 under this section. 33 Sec. 64. PROPOSAL FOR A HEALTH CONSUMER OMBUDSMAN 34 ALLIANCE. The office of long-term care ombudsman shall 35 -89- SF 505 (3) 86 pf/rj 89/ 195
S.F. 505 collaborate with the department on aging, the office of 1 substitute decision maker, the department of veterans affairs, 2 the department of human services, the department of public 3 health, the department of inspections and appeals, the 4 designated protection and advocacy agency as provided in 5 section 135C.2, subsection 4, the civil rights commission, the 6 senior health insurance information program, the Iowa insurance 7 consumer advocate, Iowa legal aid, and other consumer advocates 8 and consumer assistance programs, to develop a proposal for the 9 establishment of a health consumer ombudsman alliance. The 10 purpose of the alliance is to provide a permanent coordinated 11 system of independent consumer supports to ensure that 12 consumers, including consumers covered under Medicaid managed 13 care, obtain and maintain essential health care, are provided 14 unbiased information in understanding coverage models, and are 15 assisted in resolving problems regarding health care services, 16 coverage, access, and rights. The proposal developed shall 17 include annual budget projections and shall be submitted to the 18 governor and the general assembly no later than December 15, 19 2015. 20 Sec. 65. FUNCTIONAL, LEVEL OF CARE, AND NEEDS-BASED 21 ASSESSMENTS —— CASE MANAGEMENT. 22 1. The department of human services shall contract 23 with a conflict free third party to conduct initial and 24 subsequent functional, level of care, and needs assessments and 25 reassessments of consumers who may be eligible for long-term 26 services and supports and are subject to a Medicaid managed 27 care contract. Such assessments and reassessments shall not 28 be completed by a Medicaid managed care organization under 29 contract with the state or by any entity that is not deemed 30 conflict free. If a managed care contractor becomes aware that 31 an applicant may require long-term services and supports or 32 that an enrolled consumer’s functional level of care, support 33 needs, or medical status has changed, the Medicaid managed care 34 contractor shall notify the department and the conflict free 35 -90- SF 505 (3) 86 pf/rj 90/ 195
S.F. 505 third party shall administer any assessment or reassessment 1 in response to the notification. A case manager or Medicaid 2 managed care contractor shall not alter a consumer’s service 3 plan independent of the prior administration of an assessment 4 or reassessment conducted by the conflict free third party. 5 The department of human services shall retain authority to 6 determine or redetermine a consumer’s categorical, financial, 7 level of care or needs-based eligibility based on the conflict 8 free third party assessment or reassessment. 9 2. The department of human services shall provide for 10 administration of non-biased, community-based, in-person 11 options counseling by a conflict free third party for 12 applicants for a Medicaid managed care plan. 13 3. Case management under a Medicaid managed care contract 14 shall be administered in a conflict free manner. 15 4. For the purposes of this section, “conflict free” means 16 conflict free pursuant to specifications of the balancing 17 incentive program requirements. 18 DIVISION XI 19 AUTISM 20 Sec. 66. Section 225D.1, subsections 3 and 8, Code 2015, are 21 amended to read as follows: 22 3. “Autism service provider” means a person providing 23 applied behavioral analysis, who meets all of the following 24 criteria: 25 a. Is any of the following: 26 (1) Is certified as a behavior analyst by the behavior 27 analyst certification board or is a health professional 28 licensed under chapter 147 . 29 (2) Is a board-certified assistant behavior analyst who 30 performs duties, identified by and based on the standards of 31 the behavior analyst certification board, under the supervision 32 of a board-certified behavior analyst. 33 b. Is approved as a member of the provider network by the 34 department. 35 -91- SF 505 (3) 86 pf/rj 91/ 195
S.F. 505 8. “Eligible individual” means a child less than nine 1 fifteen years of age who has been diagnosed with autism based 2 on a diagnostic assessment of autism, is not otherwise eligible 3 for coverage for applied behavioral analysis treatment under 4 the medical assistance program, section 514C.28 , or private 5 insurance coverage, and whose household income does not exceed 6 four hundred percent of the federal poverty level. 7 Sec. 67. Section 225D.2, subsection 2, paragraph c, Code 8 2015, is amended to read as follows: 9 c. Notwithstanding the age limitation for an eligible 10 individual, a provision that if an eligible individual reaches 11 nine fifteen years of age prior to completion of the maximum 12 applied behavioral analysis treatment period specified in 13 paragraph “b” , the individual may complete such treatment in 14 accordance with the individual’s treatment plan, not to exceed 15 the maximum treatment period. 16 Sec. 68. Section 225D.2, subsection 2, Code 2015, is amended 17 by adding the following new paragraph: 18 NEW PARAGRAPH . l. Proof of eligibility for the autism 19 support program that includes a written denial for coverage or 20 a benefits summary indicating that applied behavioral analysis 21 treatment is not a covered benefit for which the applicant 22 is eligible, under the Medicaid program, section 514C.28, or 23 private insurance coverage. 24 DIVISION XII 25 OFFICE OF SUBSTITUTE DECISION MAKER 26 Sec. 69. Section 231E.4, subsection 3, paragraph a, Code 27 2015, is amended to read as follows: 28 a. Select persons through a request for proposals process to 29 establish local offices of substitute decision maker in each 30 of the planning and service areas. Local offices shall be 31 established statewide on or before July 1, 2015 2017 . 32 DIVISION XIII 33 DEMENTIA WORKFORCE 34 Sec. 70. INTERAGENCY DEMENTIA PROFICIENT WORKFORCE TASK 35 -92- SF 505 (3) 86 pf/rj 92/ 195
S.F. 505 FORCE. The department on aging shall convene an interagency 1 task force, in collaboration with the office of long-term 2 care ombudsman, the office of substitute decision maker, the 3 departments of public health, human services, and inspections 4 and appeals, and the Alzheimer’s association, to review the 5 recommendations for a standard curriculum model for dementia 6 education submitted by the Alzheimer’s association dementia 7 education task force to the department on aging in June 2010, 8 in the Iowa dementia education project final report, and the 9 curricula-related recommendations submitted by the direct care 10 worker task force and the direct care worker advisory council; 11 identify staff, in settings in which individuals with dementia 12 may seek services and care, who should have some level of 13 dementia proficiency and analyze gaps in existing training 14 and educational requirements; and develop an implementation 15 plan to transition toward competency-based dementia curricula 16 and training that achieves dementia proficiency across a 17 broader care continuum. To the greatest extent possible, 18 the plan shall address training strategies for different 19 settings, levels of skill, and licensure. The plan shall 20 include a timeline for implementation, fiscal implications of 21 recommendations, and identification of key decision points 22 for the general assembly. The task force shall provide 23 opportunities for stakeholder input from affected industry, 24 education, professional, employee, and consumer organizations. 25 The task force shall submit its recommendations to the governor 26 and the general assembly no later than December 15, 2015. 27 DIVISION XIV 28 PHARMACEUTICAL COLLECTION AND DISPOSAL PROGRAM 29 Sec. 71. Section 155A.43, Code 2015, is amended to read as 30 follows: 31 155A.43 Pharmaceutical collection and disposal program —— 32 annual allocation. 33 Of the fees collected pursuant to sections 124.301 and 34 147.80 and chapter 155A by the board of pharmacy, and retained 35 -93- SF 505 (3) 86 pf/rj 93/ 195
S.F. 505 by the board pursuant to section 147.82 , not more than 1 one hundred twenty-five seventy-five thousand dollars may 2 be allocated annually by the board for administering the 3 pharmaceutical collection and disposal program originally 4 established pursuant to 2009 Iowa Acts, ch. 175, §9. The 5 program shall provide for the management and disposal of 6 unused, excess, and expired pharmaceuticals. The board of 7 pharmacy may cooperate with the Iowa pharmacy association and 8 may consult with the department and sanitary landfill operators 9 in administering the program. 10 DIVISION XV 11 MEDICAID STATE PLAN —— FAMILY PLANNING 12 Sec. 72. MEDICAID STATE PLAN AMENDMENT —— FAMILY 13 PLANNING. The department of human services shall amend the 14 medical assistance state plan to include, effective no later 15 than January 1, 2016, the eligibility provisions of the Iowa 16 family planning network section 1115 demonstration waiver in 17 effect on January 1, 2015. The department shall implement 18 the state plan amendment upon receipt of approval by the 19 centers for Medicare and Medicaid services of the United States 20 department of health and human services. 21 Sec. 73. EFFECTIVE DATE. This division of this Act, being 22 deemed of immediate importance, takes effect upon enactment. 23 DIVISION XVI 24 IOWA ABLE SAVINGS PLAN TRUST 25 Sec. 74. NEW SECTION . 12I.1 Purpose and definitions. 26 1. The general assembly finds that the general welfare 27 and well-being of the state are directly related to the 28 health, maintenance, independence, and quality of life of its 29 disabled residents, and that a vital and valid public purpose 30 is served by the creation and implementation of programs that 31 encourage and make possible savings to secure funding for 32 disability-related expenses on behalf of individuals with 33 disabilities that will supplement, but not supplant, other 34 benefits provided by various federal, state, and private 35 -94- SF 505 (3) 86 pf/rj 94/ 195
S.F. 505 sources. The creation of the means of encouragement for 1 citizens to invest in such a program represents the carrying 2 out of a vital and valid public purpose. In order to make 3 available to the citizens of the state an opportunity to fund 4 future disability-related expenses of individuals, it is 5 necessary that a public trust be established in which moneys 6 may be invested for payment of future disability-related 7 expenses of an individual. 8 2. As used in this chapter, unless the context otherwise 9 requires: 10 a. “Account balance limit” means the maximum allowable 11 aggregate balance of an account established for a designated 12 beneficiary. Account earnings, if any, are included in the 13 account balance limit. 14 b. “Account owner” means an individual who enters into a 15 participation agreement under this chapter for the payment 16 of qualified disability expenses on behalf of a designated 17 beneficiary. 18 c. “Contracting state” means the same as defined in section 19 529A of the Internal Revenue Code. 20 d. “Designated beneficiary” means an individual who is a 21 resident of this state or a resident of a contracting state and 22 who meets the definition of “eligible individual” in section 23 529A of the Internal Revenue Code. 24 e. “Internal Revenue Code” means the Internal Revenue Code 25 of 1986, as amended, and regulations promulgated thereunder. 26 f. “Iowa ABLE savings plan trust” or “trust” means the trust 27 created under section 12I.2. 28 g. “Participation agreement” means an agreement between the 29 account owner and the trust entered into under this chapter. 30 h. “Qualified ABLE program means the same as defined in 31 section 529A of the Internal Revenue Code. 32 i. “Qualified disability expenses” means the same as defined 33 in section 529A of the Internal Revenue Code. 34 j. “Resident” shall be defined by rules adopted by the 35 -95- SF 505 (3) 86 pf/rj 95/ 195
S.F. 505 treasurer of state. The rules shall determine residency in 1 such manner as may be required or permitted under section 2 529A of the Internal Revenue Code, or, in the absence of any 3 guidance under federal law, as the treasurer of state deems 4 advisable for the purpose of satisfying the requirements of 5 section 529A of the Internal Revenue Code. 6 Sec. 75. NEW SECTION . 12I.2 Creation of Iowa ABLE savings 7 plan trust. 8 An Iowa ABLE savings plan trust is created. The treasurer of 9 state is the trustee of the trust, and has all powers necessary 10 to carry out and effectuate the purposes, objectives, and 11 provisions of this chapter pertaining to the trust, including 12 the power to do all of the following: 13 1. Make and enter into contracts necessary for the 14 administration of the trust created under this chapter. 15 2. Enter into agreements with this state or any other 16 state, or any federal or other state agency, or other entity as 17 required to implement this chapter. 18 3. Carry out the duties and obligations of the trust 19 pursuant to this chapter. 20 4. Accept any grants, gifts, legislative appropriations, 21 and other moneys from the state, any unit of federal, state, or 22 local government, or any other person, firm, partnership, or 23 corporation which the treasurer of state shall deposit into the 24 administrative fund or program fund. 25 5. Participate in any federal, state, or local governmental 26 program for the benefit of the trust. 27 6. Procure insurance against any loss in connection with the 28 property, assets, or activities of the trust. 29 7. Enter into participation agreements with account owners. 30 8. Make payments to designated beneficiaries pursuant to 31 participation agreements. 32 9. Make refunds to account owners upon the termination 33 of participation agreements, and partial nonqualified 34 distributions to account owners, pursuant to this chapter and 35 -96- SF 505 (3) 86 pf/rj 96/ 195
S.F. 505 the limitations and restrictions set forth in this chapter. 1 10. Invest moneys from the program fund in any investments 2 that are determined by the treasurer of state to be 3 appropriate. 4 11. Engage investment advisors, if necessary, to assist in 5 the investment of trust assets. 6 12. Contract for goods and services and engage personnel 7 as necessary, including consultants, actuaries, managers, 8 legal counsel, and auditors for the purpose of rendering 9 professional, managerial, and technical assistance and advice 10 to the treasurer of state regarding trust administration and 11 operation. 12 13. Establish, impose, and collect administrative fees 13 and charges in connection with transactions of the trust, and 14 provide for reasonable service charges, including penalties for 15 cancellations and late payments with respect to participation 16 agreements. 17 14. Administer the funds of the trust. 18 15. Prepare and file reports and notices. 19 16. Enter into agreements with contracting states to permit 20 residents of the contracting state to participate in the Iowa 21 ABLE savings plan trust. 22 17. Adopt rules pursuant to chapter 17A for the 23 administration of this chapter. 24 Sec. 76. NEW SECTION . 12I.3 Participation agreements for 25 trust. 26 On or after July 1, 2016, the trust may enter into 27 participation agreements with account owners pursuant to the 28 following terms and agreements: 29 1. a. Unless otherwise permitted under section 529A of the 30 Internal Revenue Code, the treasurer of state shall allow only 31 one participation agreement per designated beneficiary. 32 b. Unless otherwise permitted under section 529A of the 33 Internal Revenue Code, the account owner must also be the 34 designated beneficiary of the account. However, a trustee or 35 -97- SF 505 (3) 86 pf/rj 97/ 195
S.F. 505 legal guardian may be designated as custodian of an account for 1 a designated beneficiary who is a minor or who lacks capacity 2 to enter into a participation agreement if such designation is 3 not prohibited under section 529A of the Internal Revenue Code. 4 c. The treasurer of state shall set an annual contribution 5 limit and account balance limit to maintain compliance with 6 section 529A of the Internal Revenue Code. A contribution 7 shall not be permitted to the extent it exceeds the annual 8 contribution limit or causes the aggregate balance of the 9 account established for the designated beneficiary to exceed 10 the applicable account balance limit. 11 d. The maximum amount that may be deducted per year for 12 Iowa income tax purposes by an individual for contributions on 13 behalf of any one designated beneficiary that is a resident 14 of this state shall not exceed the maximum deductible amount 15 determined for the year pursuant to section 12D.3, subsection 16 1, paragraph “a” . 17 e. Participation agreements may be amended to provide 18 for adjusted levels of contributions based upon changed 19 circumstances or changes in disability-related expenses. 20 f. Any person may make contributions pursuant to a 21 participation agreement on behalf of a designated beneficiary 22 under rules adopted by the treasurer of state. 23 2. The execution of a participation agreement by the trust 24 shall not guarantee in any way that future disability-related 25 expenses will be equal to projections and estimates provided by 26 the trust or that the account owner or designated beneficiary 27 is guaranteed any of the following: 28 a. A return of principal. 29 b. A rate of interest or other return from the trust. 30 c. Payment of interest or other return from the trust. 31 3. a. A designated beneficiary under a participation 32 agreement may be changed as permitted under rules adopted by 33 the treasurer of state upon written request of the account 34 owner as long as such change would be permitted by section 529A 35 -98- SF 505 (3) 86 pf/rj 98/ 195
S.F. 505 of the Internal Revenue Code. 1 b. Participation agreements may otherwise be freely amended 2 throughout their terms in order to enable account owners to 3 increase or decrease the level of participation, change the 4 designated beneficiary, and carry out similar matters as 5 authorized by rule. 6 4. Each participation agreement shall provide that the 7 participation agreement may be canceled upon the terms and 8 conditions, and upon payment of applicable fees and costs set 9 forth and contained in the rules adopted by the treasurer of 10 state. 11 Sec. 77. NEW SECTION . 12I.4 Program and administrative 12 funds —— investment and payment. 13 1. a. The treasurer of state shall segregate moneys 14 received by the trust into two funds: the program fund and the 15 administrative fund. 16 b. All moneys paid by account owners or other persons 17 on behalf of a designated beneficiary in connection with 18 participation agreements shall be deposited as received into 19 separate accounts for each designated beneficiary within the 20 program fund. 21 c. Contributions to the trust made on behalf of designated 22 beneficiaries may only be made in the form of cash. 23 d. An account owner or designated beneficiary is 24 not permitted to provide investment direction regarding 25 contributions or earnings held by the trust. 26 2. Moneys accrued by account owners in the program fund 27 of the trust may be used for payments of qualified disability 28 expenses. 29 3. Moneys in the account of a designated beneficiary may 30 be claimed by the Iowa Medicaid program as provided in section 31 529A(f) of the Internal Revenue Code and subject to limitations 32 imposed by the treasurer of state. 33 4. The trust shall comply with Pub. L. No. 113-295, §103, 34 regarding treatment of ABLE accounts under certain federal 35 -99- SF 505 (3) 86 pf/rj 99/ 195
S.F. 505 programs. 1 5. Moneys in the funds are not subject to section 8.33. 2 Notwithstanding section 12C.7, interest or earnings on moneys 3 in the funds shall be credited to the funds. 4 Sec. 78. NEW SECTION . 12I.5 Cancellation of agreements. 5 An account owner may cancel a participation agreement at 6 will. Upon cancellation of a participation agreement, an 7 account owner shall be entitled to the return of the account 8 owner’s account balance. 9 Sec. 79. NEW SECTION . 12I.6 Repayment and ownership of 10 payments and investment income —— transfer of ownership rights. 11 1. a. An account owner retains ownership of all 12 contributions made on behalf of a designated beneficiary under 13 a participation agreement up to the date of utilization for 14 payment of qualified disability expenses of the designated 15 beneficiary. 16 b. All income derived from the investment of the 17 contributions made on behalf of a designated beneficiary shall 18 be considered to be held in trust for the benefit of the 19 designated beneficiary. 20 2. In the event the trust is terminated prior to payment of 21 qualified disability expenses for the designated beneficiary, 22 the account owner is entitled to a refund of the account 23 owner’s account balance. 24 3. Any amounts which may be paid to any person or persons 25 pursuant to the Iowa ABLE savings plan trust but which are not 26 listed in this section are owned by the trust. 27 4. An account owner may transfer ownership rights to 28 another designated beneficiary, including a gift of the 29 ownership rights to a designated beneficiary who is a minor, in 30 accordance with rules adopted by the treasurer of state and the 31 terms of the participation agreement, so long as the transfer 32 would be permitted by section 529A of the Internal Revenue 33 Code. 34 5. An account owner or designated beneficiary shall not be 35 -100- SF 505 (3) 86 pf/rj 100/ 195
S.F. 505 entitled to utilize any interest in the trust as security for 1 a loan. 2 Sec. 80. NEW SECTION . 12I.7 Reports —— annual audited 3 financial report —— reports under federal law. 4 1. a. The treasurer of state shall submit an annual 5 audited financial report, prepared in accordance with generally 6 accepted accounting principles, on the operations of the trust 7 by November 1 to the governor and the general assembly. 8 b. The annual audit shall be made either by the auditor 9 of state or by an independent certified public accountant 10 designated by the auditor of state and shall include direct and 11 indirect costs attributable to the use of outside consultants, 12 independent contractors, and any other persons who are not 13 state employees. 14 2. The annual audit shall be supplemented by all of the 15 following information prepared by the treasurer of state: 16 a. Any related studies or evaluations prepared in the 17 preceding year. 18 b. A summary of the benefits provided by the trust, 19 including the number of account owners and designated 20 beneficiaries in the trust, or, if the trust has caused this 21 state to become a contracting state pursuant to section 12I.10, 22 a summary of the benefits provided to Iowa residents by the 23 contracted qualified ABLE program, including the number of 24 account owners and designated beneficiaries in the contracted 25 qualified ABLE program who are Iowa residents. 26 c. Any other information deemed relevant by the treasurer of 27 state in order to make a full, fair, and effective disclosure 28 of the operations of the trust or the contracted qualified ABLE 29 program if applicable. 30 3. The treasurer of state shall prepare and submit to the 31 secretary of the United States treasury or other required party 32 any reports, notices, or statements required under section 529A 33 of the Internal Revenue Code. 34 Sec. 81. NEW SECTION . 12I.8 Tax considerations. 35 -101- SF 505 (3) 86 pf/rj 101/ 195
S.F. 505 1. For federal income tax purposes, the Iowa ABLE savings 1 plan trust shall be considered a qualified ABLE program exempt 2 from taxation pursuant to section 529A of the Internal Revenue 3 Code and shall be operated so that it meets the requirements of 4 section 529A of the Internal Revenue Code. 5 2. State income tax treatment of the Iowa ABLE savings plan 6 trust shall be as provided in section 422.7, subsections 34 and 7 34A. 8 3. State inheritance tax treatment of interests in Iowa ABLE 9 savings plans shall be as provided in section 450.4, subsection 10 9. 11 Sec. 82. NEW SECTION . 12I.9 Property rights to assets in 12 trust. 13 1. The assets of the trust shall at all times be preserved, 14 invested, and expended solely and only for the purposes of the 15 trust and shall be held in trust for the account owners and 16 designated beneficiaries. 17 2. Except as provided in section 12I.4, subsection 3, no 18 property rights in the trust shall exist in favor of the state. 19 3. Except as provided in section 12I.4, subsection 3, the 20 assets of the trust shall not be transferred or used by the 21 state for any purposes other than the purposes of the trust. 22 Sec. 83. NEW SECTION . 12I.10 Implementation as a 23 contracting state —— tax considerations. 24 1. The general assembly acknowledges that section 529A of 25 the Internal Revenue Code permits access to qualified ABLE 26 programs by residents of a state without such a program. The 27 general assembly finds that becoming a contracting state may 28 accomplish the public purpose set forth in section 12I.1, 29 subsection 1, in the same manner as if the qualified ABLE 30 program under the Iowa ABLE savings plan trust were to be 31 implemented and administered by this state. To that end, 32 the treasurer of state, as trustee of the trust, may defer 33 implementation of the qualified ABLE program under the trust 34 and alternatively cause this state to become a contracting 35 -102- SF 505 (3) 86 pf/rj 102/ 195
S.F. 505 state by entering into an agreement with another state with a 1 qualified ABLE program to provide Iowa residents access to that 2 state’s qualified ABLE program. The trust shall not enter into 3 an agreement pursuant to this section unless the treasurer, 4 as trustee of the trust, determines that all of the following 5 requirements are satisfied: 6 a. The program is a qualified ABLE program. 7 b. The qualified ABLE program provides comparable benefits 8 and protections to Iowa residents as would be provided under 9 the Iowa ABLE savings plan trust. 10 c. That entering into an agreement for access to the 11 qualified ABLE program would not result in increased costs to 12 the state or to account owners and designated beneficiaries as 13 compared to the costs of implementing and administering the 14 qualified ABLE program under the Iowa ABLE savings plan trust. 15 d. The qualified ABLE program will be audited annually by 16 an independent certified public accountant or by the state 17 auditor, or similar public official, of the state that has 18 implemented the qualified ABLE program. 19 e. The qualified ABLE program will provide information to 20 the treasurer of state as trustee of the trust so as to allow 21 the trustee to fulfill the reporting requirements in section 22 12I.7. 23 2. a. The maximum amount that may be deducted per year for 24 Iowa income tax purposes by an individual for contributions on 25 behalf of any one designated beneficiary that is a resident of 26 this state to the qualified ABLE program with which the state 27 has contracted pursuant to this section shall not exceed the 28 maximum deductible amount determined for the year pursuant to 29 section 12D.3, subsection 1, paragraph “a” . 30 b. State income tax treatment of the qualified ABLE program 31 with which the state has contracted pursuant to this section 32 shall be as provided in section 422.7, subsections 34 and 34A. 33 3. State inheritance tax treatment of interests in the 34 qualified ABLE program with which the state has contracted 35 -103- SF 505 (3) 86 pf/rj 103/ 195
S.F. 505 pursuant to this section shall be as provided in section 450.4, 1 subsection 9. 2 Sec. 84. NEW SECTION . 12I.11 Construction. 3 This chapter shall be construed liberally in order to 4 effectuate its purpose. 5 Sec. 85. Section 422.7, Code 2015, is amended by adding the 6 following new subsections: 7 NEW SUBSECTION . 34. a. Subtract the amount contributed 8 during the tax year on behalf of a designated beneficiary 9 that is a resident of this state to the Iowa ABLE savings 10 plan trust or to the qualified ABLE program with which the 11 state has contracted pursuant to section 12I.10, not to exceed 12 the maximum contribution level established in section 12I.3, 13 subsection 1, paragraph “d” , or section 12I.10, subsection 2, 14 paragraph “a” , as applicable. 15 b. Add the amount resulting from the cancellation of a 16 participation agreement refunded to the taxpayer as an account 17 owner in the Iowa ABLE savings plan trust or the qualified 18 ABLE program with which the state has contracted pursuant to 19 section 12I.10 to the extent previously deducted pursuant 20 to this subsection by the taxpayer or any other person as a 21 contribution to the trust or qualified ABLE program. 22 c. Add the amount resulting from a withdrawal made by a 23 taxpayer from the Iowa ABLE savings plan trust or the qualified 24 ABLE program with which the state has contracted pursuant to 25 section 12I.10 for purposes other than the payment of qualified 26 disability expenses to the extent previously deducted pursuant 27 to this subsection by the taxpayer or any other person as a 28 contribution to the trust or qualified ABLE program. 29 NEW SUBSECTION . 34A. Subtract, to the extent included, 30 income from interest and earnings received from the Iowa ABLE 31 savings plan trust created in chapter 12I, or received by a 32 resident account owner from a qualified ABLE program with which 33 the state has contracted pursuant to section 12I.10. 34 Sec. 86. Section 450.4, Code 2015, is amended by adding the 35 -104- SF 505 (3) 86 pf/rj 104/ 195
S.F. 505 following new subsection: 1 NEW SUBSECTION . 9. On the value of any interest in the Iowa 2 ABLE savings plan trust created in chapter 12I, or any interest 3 held by a resident account owner in a qualified ABLE program 4 with which the state has contracted pursuant to section 12I.10. 5 Sec. 87. CONTINGENT IMPLEMENTATION. The implementation of 6 chapter 12I as enacted in this division of this Act is subject 7 to an appropriation with the stated purpose of the Iowa ABLE 8 Savings Plan Trust. 9 Sec. 88. APPLICABILITY. The section of this division of 10 this Act amending section 450.4 applies to estates of decedents 11 dying on or after January 1, 2016. 12 Sec. 89. APPLICABILITY. The section of this division of 13 this Act amending section 422.7 applies to tax years beginning 14 on or after January 1, 2016. 15 DIVISION XVII 16 STATE CHILD CARE ASSISTANCE —— INCOME ELIGIBILITY 17 Sec. 90. Section 237A.13, subsection 7, paragraph c, Code 18 2015, is amended to read as follows: 19 c. Families with an income of more than one hundred 20 percent but not more than one hundred forty-five sixty percent 21 of the federal poverty level whose members, for at least 22 twenty-eight hours per week in the aggregate, are employed 23 or are participating at a satisfactory level in an approved 24 training program or educational program. 25 Sec. 91. DIRECTIVE TO DEPARTMENT OF HUMAN SERVICES ON 26 CHILD CARE ASSISTANCE. The department of human services shall 27 amend its administrative rules relating to income eligibility 28 for state child care assistance, according to family size for 29 children needing basic care, to families whose nonexempt gross 30 monthly income does not exceed 160 percent of the federal 31 poverty level. 32 DIVISION XVIII 33 COUNTY MENTAL HEALTH AND DISABILITIES SERVICES FUNDING —— 34 EQUALIZATION AND MEDICAID OFFSET 35 -105- SF 505 (3) 86 pf/rj 105/ 195
S.F. 505 Sec. 92. Section 331.424A, subsection 8, unnumbered 1 paragraph 1, Code 2015, is amended to read as follows: 2 Notwithstanding subsection 6 , for the fiscal years beginning 3 July 1, 2013, July 1, 2014, and July 1, 2015, and July 1, 2016, 4 county revenues from taxes levied by the county and credited 5 to the county services fund shall not exceed the lower of the 6 following amounts: 7 Sec. 93. Section 426B.3, subsection 1, Code 2015, is amended 8 to read as follows: 9 1. For the fiscal years beginning July 1, 2013, July 10 1, 2014, and July 1, 2015, and July 1, 2016, the state and 11 county funding for the mental health and disability services 12 administered or paid for by counties shall be provided based on 13 a statewide per capita expenditure target amount computed in 14 accordance with this section and section 331.424A . 15 Sec. 94. Section 426B.3, subsection 4, paragraph a, Code 16 2015, is amended to read as follows: 17 a. For the fiscal years beginning July 1, 2013, July 1, 18 2014, and July 1, 2015, and July 1, 2016, a county with a county 19 population expenditure target amount that exceeds the amount 20 of the county’s base year expenditures for mental health and 21 disabilities services shall receive an equalization payment for 22 the difference. 23 Sec. 95. Section 426B.3, subsection 5, Code 2015, is amended 24 by striking the subsection. 25 DIVISION XIX 26 MEDICAID OFFSET PAYMENTS —— PROPERTY TAX RELIEF FUND 27 APPROPRIATIONS 28 Sec. 96. MEDICAID OFFSET PAYMENTS —— PROPERTY TAX RELIEF 29 FUND APPROPRIATION. 30 1. Of the moneys credited to the property tax relief fund 31 pursuant to section 426B.3, subsection 5, paragraph “e”, 32 subparagraph (1), Code 2015, in the fiscal year beginning July 33 1, 2014, and ending June 30, 2015, there is appropriated to the 34 department of human services for the fiscal year beginning July 35 -106- SF 505 (3) 86 pf/rj 106/ 195
S.F. 505 1, 2015, and ending June 30, 2016, the following amounts, to be 1 used for the purposes designated, notwithstanding any contrary 2 provision of chapter 426B: 3 a. For reductions in the waiting lists of all medical 4 assistance home and community-based services waivers: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,092,000 6 b. For allocation to the department on aging for a grant 7 to a nationally affiliated organization providing support and 8 education to people living with Alzheimer’s disease and other 9 related dementias to be used for a statewide public awareness 10 campaign regarding the signs of Alzheimer’s disease and other 11 related dementias and the resources available to such people: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 13 c. For development of an application for a planning 14 grant through the substance abuse and mental health services 15 administration of the United States department of health and 16 human services to participate in a two-year pilot project for 17 certified community behavioral health clinics under the federal 18 Protecting Access to Medicare Act of 2014, Pub. L. No. 113-93: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 240,000 20 The department may use the funds allocated pursuant to this 21 paragraph to contract for necessary support to develop and 22 submit the application for the planning grant. The department 23 shall submit the application for the planning grant to the 24 centers for Medicare and Medicaid services of the United States 25 department of health and human services upon completion of the 26 application. 27 2. Of the moneys credited to the property tax relief 28 fund pursuant to section 426B.3, subsection 5, paragraph e, 29 subparagraph (1), Code 2015, in the fiscal year beginning July 30 1, 2014, and ending June 30, 2015, there is appropriated to 31 the department of human services for the fiscal year beginning 32 July 1, 2015, and ending June 30, 2016, the following amount, 33 or so much thereof as is necessary, to be used for the purpose 34 designated: 35 -107- SF 505 (3) 86 pf/rj 107/ 195
S.F. 505 a. For distribution to a mental health and disability 1 services region where 25 percent of a region’s projected 2 expenditures exceeds the region’s projected fund balance: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,554,651 4 b. For purposes of this section: 5 (1) “Available funds” means a county mental health and 6 services fund balance on June 30, 2015, plus the maximum amount 7 a county was allowed to levy for the fiscal year beginning July 8 1, 2015. 9 (2) “Projected expenditures” means the actual expenditures 10 of a mental health and disability services region as of June 11 30, 2015, multiplied by an annual inflation rate equal to 12 2 percent plus the projected costs for core services and 13 additional core services administered by the region as provided 14 in a region’s regional service system management plan approved 15 pursuant to section 331.393 for the fiscal year beginning July 16 1, 2015. 17 (3) “Projected fund balance” means the difference between a 18 mental health and disability services region’s available funds 19 and projected expenditures. 20 c. If sufficient funds are not available to implement this 21 subsection, the department of human services shall distribute 22 funds to a region in proportion to the availability of funds. 23 DIVISION XX 24 PROPERTY TAX RELIEF FUND —— BLOCK GRANT MONEYS —— MENTAL HEALTH 25 INSTITUTES 26 Sec. 97. MENTAL HEALTH INSTITUTES. The moneys transferred 27 to the property tax relief fund for the fiscal year beginning 28 July 1, 2015, from the federal social services block grant 29 pursuant to 2015 Iowa Acts, House File 630, if enacted, and 30 from the federal temporary assistance for needy families block 31 grant, totaling at least $11,774,275, are appropriated to the 32 department of human services for the fiscal year beginning July 33 1, 2015, and ending June 30, 2016, to be used for the purposes 34 designated: 35 -108- SF 505 (3) 86 pf/rj 108/ 195
S.F. 505 1. For the state mental health institute at Clarinda for 1 salaries, support, maintenance, and miscellaneous purposes: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,836,507 3 2. For the state mental health institute at Mount Pleasant 4 for salaries, support, maintenance, and miscellaneous purposes, 5 and for not more than the following full-time equivalent 6 positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,937,768 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 97.68 9 DIVISION XXI 10 STUDY —— CHILD WELFARE ADVISORY COMMITTEE 11 Sec. 98. STUDY —— CHILD WELFARE ADVISORY COMMITTEE. The 12 child welfare advisory committee of the council on human 13 services established pursuant to section 217.3A shall study 14 procedures in the department of human services for receiving 15 complaints from families involved in guardianship, placement, 16 and custody proceedings; the specificity and clarity of court 17 orders issued in foster care placements pursuant to the State 18 of Iowa Primary Review of Tit. IV-E Foster Care Eligibility 19 Report of Findings for October 1, 2012, through March 31, 2013; 20 and caseload trends of social workers, including an analysis 21 of how Iowa compares nationally and with best practices as 22 utilized by other states. The study shall also identify 23 methods for decreasing social worker caseloads. The committee 24 shall submit a report with findings and recommendations to the 25 governor and general assembly on or before December 15, 2015. 26 DIVISION XXII 27 COVERAGE OF SERVICES PROVIDED BY A PHYSICAL THERAPIST, 28 OCCUPATIONAL THERAPIST, OR SPEECH PATHOLOGIST 29 Sec. 99. NEW SECTION . 514C.30 Services provided by 30 a physical therapist, occupational therapist, or speech 31 pathologist. 32 1. Notwithstanding the uniformity of treatment requirements 33 of section 514C.6, a policy, contract, or plan providing 34 for third-party payment or prepayment of health or medical 35 -109- SF 505 (3) 86 pf/rj 109/ 195
S.F. 505 expenses shall not impose a copayment or coinsurance amount 1 on an insured for services provided by a physical therapist 2 licensed pursuant to chapter 148A, by an occupational therapist 3 licensed pursuant to chapter 148B, or by a speech pathologist 4 licensed pursuant to 154F that is greater than the copayment or 5 coinsurance amount imposed on the insured for services provided 6 by a person engaged in the practice of medicine and surgery 7 or osteopathic medicine and surgery under chapter 148 for the 8 same or a similar diagnosed condition even if a different 9 nomenclature is used to describe the condition for which the 10 services are provided. 11 2. This section applies to the following classes of 12 third-party payment provider policies, contracts, or plans 13 delivered, issued for delivery, continued, or renewed in this 14 state on or after July 1, 2015: 15 a. Individual or group accident and sickness insurance 16 providing coverage on an expense-incurred basis. 17 b. An individual or group hospital or medical service 18 contract issued pursuant to chapter 509, 514, or 514A. 19 c. An individual or group health maintenance organization 20 contract regulated under chapter 514B. 21 d. A plan established pursuant to chapter 509A for public 22 employees. 23 e. An organized delivery system licensed by the director of 24 public health. 25 3. This section shall not apply to accident-only, 26 specified disease, short-term hospital or medical, hospital 27 confinement indemnity, credit, dental, vision, Medicare 28 supplement, long-term care, basic hospital and medical-surgical 29 expense coverage as defined by the commissioner, disability 30 income insurance coverage, coverage issued as a supplement 31 to liability insurance, workers’ compensation or similar 32 insurance, or automobile medical payment insurance. 33 DIVISION XXIII 34 CHILDREN’S MENTAL HEALTH AND WELL-BEING WORKGROUP 35 -110- SF 505 (3) 86 pf/rj 110/ 195
S.F. 505 Sec. 100. CHILDREN’S MENTAL HEALTH AND WELL-BEING 1 WORKGROUP. The department of human services, in cooperation 2 with the departments of education and public health, shall 3 facilitate a workgroup of stakeholders to study and make 4 recommendations relating to children’s mental health and 5 well-being in this state. The issues that may be considered 6 by the workgroup include developing a strategic plan for 7 data systems to provide for a comprehensive analysis of 8 the mental health and well-being of children in this state; 9 creating a comprehensive system of care for children that 10 incorporates a coordinated response to mental health issues 11 across many disciplines including education, public health, 12 mental health, child welfare, and child welfare systems 13 and services and that specifically addresses the effects of 14 adverse childhood experiences and extreme child poverty and 15 homelessness; and building interdepartmental awareness of 16 issues relating to child mental health and well-being and 17 creating interdepartmental strategies for helping improve 18 child mental health and well-being and understanding impacts 19 on education and employment outcomes; examining child care 20 quality and affordability; and determining how government can 21 create community partnerships to help address issues of child 22 mental health and well-being. In carrying out the charge 23 of the workgroup, the workgroup shall review a 2014 report 24 by the children’s defense fund on the state of America’s 25 children containing the most recent and reliable national and 26 state-by-state data on many complex issues affecting children’s 27 health and well-being, including data on more than 7,000 28 homeless public school students in Iowa. The workgroup shall 29 develop and recommend proactive strategies across state systems 30 to address these most complex needs impacting children’s mental 31 health and well-being which will also aid different populations 32 of children with fewer challenges. The workgroup shall submit 33 a report on the study and make recommendations to the governor 34 and the general assembly on or before December 15, 2015. 35 -111- SF 505 (3) 86 pf/rj 111/ 195
S.F. 505 DIVISION XXIV 1 PREVENTION OF DISABILITIES POLICY COUNCIL 2 Sec. 101. NEW SECTION . 225B.101 Findings and intent. 3 1. The general assembly finds that: 4 a. Between ten and twenty percent of Iowans have a 5 disability that affects their ability to learn, work, 6 communicate, perform activities of daily living, and 7 participate in everyday community life. These disabilities 8 are the result of genetics, environmental factors, injury, or 9 illness; may occur at any point in life; may be mild, severe, 10 or intermittent; and are often very costly for the individuals 11 affected, their families, and government both in terms of 12 quality of life and financial expenditures. 13 b. Most disabilities are due to conditions that can be 14 prevented, can be minimized if recognized and treated early, or 15 can be reduced through appropriate accommodation. 16 c. A need exists to optimize the use of cost-effective 17 prevention of disability strategies in state policies and 18 programs in order to reduce the cost of disabilities to Iowa’s 19 citizens and government. 20 2. It is the intent of the general assembly to establish 21 a structure and process to identify opportunities to enhance 22 prevention of disability efforts in Iowa, design cross-agency 23 strategies to address the prevention of disabilities, integrate 24 and coordinate proven prevention of disability strategies 25 within state programs, and inform the general assembly about 26 priority prevention of disability policies and programs. 27 Sec. 102. NEW SECTION . 225B.102 Definitions. 28 As used in this chapter, unless the context otherwise 29 requires: 30 1. “Council” means the prevention of disabilities policy 31 council. 32 2. “Disability” means an individual who meets the definition 33 in 42 U.S.C. §12102. 34 3. “Prevention” activities include policies, programs, and 35 -112- SF 505 (3) 86 pf/rj 112/ 195
S.F. 505 practices that do any of the following: 1 a. Prevent a disability or a condition that leads to a 2 disability from occurring. 3 b. Identify a disability or a condition that leads to a 4 disability early on so that intervention can eliminate the risk 5 of a disability or minimize the disability’s effect. 6 c. Reduce the effects of a disability on an individual’s 7 health and independence. 8 Sec. 103. NEW SECTION . 225B.103 Prevention of disabilities 9 policy council established —— membership —— duties. 10 1. A prevention of disabilities policy council is 11 established to focus state prevention of disability efforts 12 and provide oversight in the development and operation of a 13 coordinated prevention of disabilities system. The council 14 shall consist of the following members: 15 a. Three providers of disability prevention services 16 appointed by the governor and confirmed by the senate. The 17 governor may consider recommendations from the prevention of 18 disabilities policy council in making appointments. 19 b. Three persons with expertise in priority prevention areas 20 appointed by the governor and confirmed by the senate. The 21 governor may consider recommendations from the prevention of 22 disabilities policy council in making appointments. 23 c. Three persons with disabilities or family members 24 of a person with disabilities appointed by the governor, 25 and confirmed by the senate. The governor may consider 26 recommendations from the prevention of disabilities policy 27 council in making appointments. 28 d. One representative each from the department on aging, 29 department of education, department of human services, and 30 department of public health appointed by the directors of the 31 respective agencies. 32 e. Two members of the senate appointed by the senate 33 majority leader and minority leader and two members of the 34 house of representatives appointed by the speaker of the house 35 -113- SF 505 (3) 86 pf/rj 113/ 195
S.F. 505 and the house minority leader. 1 2. Members of the council appointed by the governor shall 2 serve three-year staggered terms for terms beginning and ending 3 as provided in section 69.19. Members representing the state 4 departments shall serve one-year terms and shall serve as ex 5 officio, nonvoting members. Members of the general assembly 6 appointed to the council shall serve two-year terms as provided 7 in section 69.16B and shall serve as ex officio, nonvoting 8 members. Vacancies on the council shall be filled in the same 9 manner as original appointments. Members are entitled to 10 reimbursement of actual expenses incurred in performance of 11 their official duties. 12 3. The council shall do all of the following: 13 a. Review the prevention of disabilities activities of 14 public and private entities and provide recommendations to 15 optimize the planning, implementation, and evaluation of 16 prevention of disabilities efforts. 17 b. Promote cooperative and complementary planning among the 18 public, nonpublic, and volunteer sectors involved in prevention 19 of disabilities activities. 20 c. Facilitate coordination of prevention of disabilities 21 activities among state departments to develop an integrated 22 system of care. 23 d. Provide support and technical assistance to public 24 or nonpublic entities to identify, seek, implement, and 25 evaluate state, federal, and private grants for prevention of 26 disabilities activities. 27 e. Encourage research into the causes and prevention of 28 disabilities, including methods to evaluate the effectiveness 29 of prevention efforts. 30 f. Promote professional and provider training in 31 evidence-based prevention of disabilities measures and assure 32 adequate dissemination of such to appropriate entities. 33 g. Submit to the governor and general assembly annually by 34 November 1 a report that includes all of the following: 35 -114- SF 505 (3) 86 pf/rj 114/ 195
S.F. 505 (1) A summary of all disabilities prevention activities 1 conducted since the preceding annual report. 2 (2) Recommendations for policy and priorities for the 3 prevention of disabilities. 4 4. The council shall meet at least six times during the 5 year. A majority of the members of the council constitutes a 6 quorum and a quorum is necessary to act on matters within the 7 purview of the council. 8 Sec. 104. NEW SECTION . 225B.104 Rules. 9 The department of human services shall adopt and update 10 administrative rules as necessary to implement the provisions 11 of this chapter. All rules adopted by the department of human 12 services pursuant to this section are subject to approval by 13 the council. 14 Sec. 105. NEW SECTION . 225B.105 Coordination with state 15 agencies. 16 1. The directors or deputy directors of the state 17 departments on aging, and of education, human services, and 18 public health shall meet at least annually with the council and 19 shall do all of the following: 20 a. Provide an update to the council regarding the status 21 of prevention of disabilities policies and programs with 22 each respective department and provide recommendations about 23 priorities the council should consider in the next year. 24 b. Receive new policy and program recommendations from the 25 council regarding the prevention of disabilities. 26 2. The council may seek and receive data from state 27 departments that will aid in developing, implementing, and 28 evaluating prevention of disabilities efforts and systems in 29 Iowa. 30 Sec. 106. NEW SECTION . 225B.106 Coordination with 31 disability groups. 32 The chairpersons and designated staff of chairpersons of 33 public and private state disabilities prevention groups shall 34 meet with the council at least annually to do all of the 35 -115- SF 505 (3) 86 pf/rj 115/ 195
S.F. 505 following: 1 1. Identify ways to incorporate prevention of disabilities 2 activities within Iowa’s disabilities services system. 3 2. Assist in developing a policy agenda for prevention of 4 disabilities services system improvements. 5 Sec. 107. NEW SECTION . 225B.107 Evaluation. 6 The state’s prevention of disability effort and the council 7 are subject to review and evaluation by the governor and the 8 general assembly. 9 DIVISION XXV 10 FACILITY FOR PERSONS WITH AGGRESSIVE OR PSYCHIATRIC BEHAVIORS 11 —— INTERIM COMMITTEE 12 Sec. 108. FACILITY FOR PERSONS WITH AGGRESSIVE OR 13 PSYCHIATRIC BEHAVIORS —— INTERIM COMMITTEE —— REPORT. 14 1. The legislative council is requested to establish an 15 interim study committee relating to the establishment of one 16 or more facilities to provide care and treatment for persons 17 who are sexually aggressive, combative, or who have unmet 18 geropsychiatric needs. 19 2. The study committee shall be composed of ten members 20 of the general assembly. Five members shall be members of 21 the senate, three of whom shall be appointed by the majority 22 leader of the senate, and two of whom shall be appointed by 23 the minority leader of the senate. Five members shall be 24 members of the house of representatives, three of whom shall 25 be appointed by the speaker of the house of representatives, 26 and two of whom shall be appointed by the minority leader of 27 the house of representatives. 28 3. The study committee shall receive testimony from 29 stakeholders with an interest or expertise relating to the 30 care and treatment of persons who are sexually aggressive, 31 combative, or who have unmet geropsychiatric needs including 32 health care providers, long-term care facilities, hospitals, 33 health systems, and other entities; consumers and families of 34 consumers; individuals involved in the delivery and financing 35 -116- SF 505 (3) 86 pf/rj 116/ 195
S.F. 505 of related services and supports; and representatives of 1 agencies responsible for oversight, funding, and regulation of 2 such services and supports. 3 4. The study committee shall specifically address and 4 make recommendations relating to the characteristics of the 5 residents for such a facility and the size of the resident 6 populations to be served; options for creating a new facility 7 or expanding an existing facility; workforce recruitment, 8 training, and compensation issues; requirements that the 9 facility or facilities must meet in order to qualify for 10 Medicaid reimbursement; and any other information deemed 11 appropriate by the committee. 12 5. The study committee shall meet during the 2015 13 legislative interim and shall submit a report and 14 recommendations to the general assembly by January 1, 2016. 15 DIVISION XXVI 16 ANATOMICAL GIFT PUBLIC AWARENESS AND TRANSPLANTATION FUND 17 Sec. 109. Section 142C.15, subsection 4, paragraph c, 18 unnumbered paragraph 1, Code 2015, is amended to read as 19 follows: 20 Not more than fifty percent of the Any unobligated moneys 21 in the fund annually may be expended in the form of grants to 22 transplant recipients, transplant candidates, living organ 23 donors, or to legal representatives on behalf of transplant 24 recipients, transplant candidates, or living organ donors. 25 Transplant recipients, transplant candidates, living organ 26 donors, or the legal representatives of transplant recipients, 27 transplant candidates, or living organ donors shall submit 28 grant applications with supporting documentation provided 29 by a hospital that performs transplants, verifying that the 30 person by or for whom the application is submitted requires a 31 transplant or is a living organ donor and specifying the amount 32 of the costs associated with the following, if funds are not 33 available from any other third-party payor: 34 DIVISION XXVII 35 -117- SF 505 (3) 86 pf/rj 117/ 195
S.F. 505 HOSPITAL AND LONG-TERM CARE PHARMACY PRACTICE —— 1 PNEUMOCOCCAL VACCINES —— BOARD OF PHARMACY RULES 2 Sec. 110. HOSPITAL AND LONG-TERM CARE PHARMACY PRACTICE —— 3 PNEUMOCOCCAL VACCINES —— BOARD OF PHARMACY RULES. The board 4 of pharmacy shall adopt rules pursuant to chapter 17A relating 5 to hospital and long-term care pharmacy practices that allow, 6 as authorized by federal law, in addition to influenza and 7 pneumococcal polysaccharide vaccines, that a written or verbal 8 patient-specific medication administration order shall not 9 be required prior to administration to an adult patient of 10 pneumococcal conjugate vaccine pursuant to physician-approved 11 hospital or facility policy and after the patient has been 12 assessed for contraindications. 13 DIVISION XXVIII 14 HEALTHY AND WELL KIDS IN IOWA PROGRAM —— CONTINUED ENROLLMENT 15 Sec. 111. Section 514I.8, subsection 3, Code 2015, is 16 amended to read as follows: 17 3. In accordance with the rules adopted by the board, a 18 child may be determined to be presumptively eligible for the 19 program pending a final eligibility determination. Following 20 final determination of eligibility, a child shall be eligible 21 for a twelve-month period. At the end of the twelve-month 22 period, a review of the circumstances of the child’s family 23 shall be conducted to establish eligibility and cost sharing 24 for the subsequent twelve-month period. Pending such review 25 of the circumstances of the child’s family, the child shall 26 continue to be eligible for and remain enrolled in the same 27 plan if the family complies with requirements to provide 28 information and verification of income, otherwise cooperates 29 in the annual review process, and submits the completed 30 review form and any information necessary to establish 31 continued eligibility in a timely manner in accordance with 32 administrative rules. 33 DIVISION XXIX 34 PERSONNEL SETTLEMENT AGREEMENT PAYMENTS 35 -118- SF 505 (3) 86 pf/rj 118/ 195
S.F. 505 Sec. 112. PERSONNEL SETTLEMENT AGREEMENT PAYMENTS. As a 1 condition of the appropriations in this 2015 Act, the moneys 2 appropriated and any other moneys available shall not be used 3 for payment of a personnel settlement agreement that contains a 4 confidentiality provision intended to prevent public disclosure 5 of the agreement or any terms of the agreement. 6 DIVISION XXX 7 MEDICAID REIMBURSEMENT —— PSYCHOLOGISTS 8 Sec. 113. Section 249A.15, Code 2015, is amended to read as 9 follows: 10 249A.15 Licensed psychologists eligible for payment. 11 The department shall adopt rules pursuant to chapter 17A 12 entitling psychologists who are licensed pursuant to chapter 13 154B and psychologists who are licensed in the state where 14 the services are provided and have a doctorate degree in 15 psychology, have had at least two years of clinical experience 16 in a recognized health setting, or have met the standards of a 17 national register of health service providers in psychology, 18 to payment for services provided to recipients of medical 19 assistance, subject to limitations and exclusions the 20 department finds necessary on the basis of federal laws and 21 regulations and of funds available for the medical assistance 22 program. 23 DIVISION XXXI 24 HOME MODIFICATION ASSISTANCE PROGRAM PLAN 25 Sec. 114. HOME MODIFICATION ASSISTANCE PROGRAM PLAN. 26 1. The aging and disability resource center and the mental 27 health and disability services commission shall jointly 28 develop a plan for a home modification assistance program to 29 provide grants and individual income tax credits to assist with 30 expenses related to the making of permanent home modifications 31 that permit individuals with a disability in this state to 32 remain in their homes and age in place. The plan shall include 33 the following components: 34 a. The plan shall develop criteria and procedures for 35 -119- SF 505 (3) 86 pf/rj 119/ 195
S.F. 505 establishing eligibility of individuals with a disability 1 under the program, and in doing so the plan shall utilize the 2 definition of disability found in 42 U.S.C. §12102 and shall 3 require appropriate certifications from the primary health care 4 providers of individuals with a disability. 5 b. The plan shall establish criteria for determining the 6 type of home modification expenses that will be eligible for a 7 grant or tax credit award under the program. 8 c. The plan shall develop criteria and procedures for 9 receiving grants and tax credits under the program, and shall 10 determine the maximum amount of grants and tax credits that 11 may be provided to an individual with a disability under the 12 program. 13 d. The plan shall provide that individuals with a disability 14 shall utilize any funding for home modification under the 15 Medicaid program to the fullest extent possible before becoming 16 eligible to participate in the home modification assistance 17 program to ensure that the program’s grants and tax credits do 18 not supplant available Medicaid program resources. 19 e. The plan shall provide that grants under the program 20 shall be available to individuals with a disability with annual 21 incomes that do not exceed 250 percent of the federal poverty 22 level, and that individual income tax credits under the program 23 shall be available to individuals with a disability with annual 24 incomes exceeding 250 percent but not exceeding 450 percent of 25 the federal poverty level. 26 f. The plan shall avoid placing unrealistic expectations 27 and overly burdensome requirements on individuals with a 28 disability and their families, particularly those living in 29 rural areas. 30 2. In developing the plan for the home modification 31 assistance program, the aging and disability resource center 32 and the mental health and disability services commission shall 33 seek input from and consult with the department on aging, the 34 department of human services, the department of revenue, and 35 -120- SF 505 (3) 86 pf/rj 120/ 195
S.F. 505 other interested public and private stakeholders. 1 3. The aging and disability resource center and the mental 2 health and disability services commission shall submit the plan 3 on or before December 15, 2015, to the chairpersons and ranking 4 members of the joint appropriations subcommittee on health and 5 human services, to the chairpersons and ranking members of the 6 senate and house standing committees on human resources, to 7 the chairpersons and ranking members of the senate and house 8 standing committees on ways and means, and to the governor. 9 DIVISION XXXII 10 MEDICAID PROGRAM ELIGIBILITY VERIFICATION 11 Sec. 115. MEDICAID PROGRAM-ELIGIBILITY VERIFICATION. The 12 department of human services shall establish an electronic 13 asset, income, and identity eligibility verification system 14 for the purposes of compliance with 42 U.S.C. §1396w requiring 15 determination or redetermination of the eligibility of an 16 individual who is an applicant for or recipient of medical 17 assistance under the Medicaid state plan on the basis of 18 being aged, blind, or disabled in accordance with 42 U.S.C. 19 §1396w. The department may issue a request for proposals to 20 select a third-party vendor to administer such an eligibility 21 verification system. If a third-party vendor is selected, 22 such vendor must be able to demonstrate in writing its current 23 relationships or contracts with financial institutions in the 24 state and nationally. Participation by financial institutions 25 in providing account balances for asset verification 26 shall remain voluntary. This section shall not result in 27 the displacement of existing asset, income, or identity 28 verification workers. 29 Sec. 116. EFFECTIVE UPON ENACTMENT. This division of this 30 Act, being deemed of immediate importance, takes effect upon 31 enactment. 32 DIVISION XXXIII 33 DEPARTMENT ON AGING —— FY 2016-2017 34 Sec. 117. DEPARTMENT ON AGING. There is appropriated from 35 -121- SF 505 (3) 86 pf/rj 121/ 195
S.F. 505 the general fund of the state to the department on aging for 1 the fiscal year beginning July 1, 2016, and ending June 30, 2 2017, the following amount, or so much thereof as is necessary, 3 to be used for the purposes designated: 4 For aging programs for the department on aging and area 5 agencies on aging to provide citizens of Iowa who are 60 years 6 of age and older with case management for frail elders, Iowa’s 7 aging and disabilities resource center, and other services 8 which may include but are not limited to adult day services, 9 respite care, chore services, information and assistance, 10 and material aid, for information and options counseling for 11 persons with disabilities who are 18 years of age or older, 12 and for salaries, support, administration, maintenance, and 13 miscellaneous purposes, and for not more than the following 14 full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,718,033 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 31.00 17 1. Funds appropriated in this section may be used to 18 supplement federal funds under federal regulations. To 19 receive funds appropriated in this section, a local area 20 agency on aging shall match the funds with moneys from other 21 sources according to rules adopted by the department. Funds 22 appropriated in this section may be used for elderly services 23 not specifically enumerated in this section only if approved 24 by an area agency on aging for provision of the service within 25 the area. 26 2. Of the funds appropriated in this section, $139,973 is 27 transferred to the economic development authority for the Iowa 28 commission on volunteer services to be used for the retired and 29 senior volunteer program. 30 3. a. The department on aging shall establish and enforce 31 procedures relating to expenditure of state and federal funds 32 by area agencies on aging that require compliance with both 33 state and federal laws, rules, and regulations, including but 34 not limited to all of the following: 35 -122- SF 505 (3) 86 pf/rj 122/ 195
S.F. 505 (1) Requiring that expenditures are incurred only for goods 1 or services received or performed prior to the end of the 2 fiscal period designated for use of the funds. 3 (2) Prohibiting prepayment for goods or services not 4 received or performed prior to the end of the fiscal period 5 designated for use of the funds. 6 (3) Prohibiting the prepayment for goods or services 7 not defined specifically by good or service, time period, or 8 recipient. 9 (4) Prohibiting the establishment of accounts from which 10 future goods or services which are not defined specifically by 11 good or service, time period, or recipient, may be purchased. 12 b. The procedures shall provide that if any funds are 13 expended in a manner that is not in compliance with the 14 procedures and applicable federal and state laws, rules, and 15 regulations, and are subsequently subject to repayment, the 16 area agency on aging expending such funds in contravention of 17 such procedures, laws, rules and regulations, not the state, 18 shall be liable for such repayment. 19 4. Of the funds appropriated in this section, at least 20 $125,000 shall be used to fund the unmet needs identified 21 through Iowa’s aging and disability resource center network. 22 5. Of the funds appropriated in this section, at least 23 $300,000 shall be used to fund home and community-based 24 services through the area agencies on aging that enable older 25 individuals to avoid more costly utilization of residential or 26 institutional services and remain in their own homes. 27 6. Of the funds appropriated in this section, $425,000 28 shall be used for the purposes of chapter 231E and section 29 231.56A, of which $162,500 shall be used for the office of 30 substitute decision maker pursuant to chapter 231E, and the 31 remainder shall be distributed equally to the area agencies on 32 aging to administer the prevention of elder abuse, neglect, and 33 exploitation program pursuant to section 231.56A, in accordance 34 with the requirements of the federal Older Americans Act of 35 -123- SF 505 (3) 86 pf/rj 123/ 195
S.F. 505 1965, 42 U.S.C. §3001 et seq., as amended. 1 DIVISION XXXIV 2 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2016-2017 3 Sec. 118. OFFICE OF LONG-TERM CARE OMBUDSMAN. 4 1. There is appropriated from the general fund of the state 5 to the office of long-term care ombudsman for the fiscal year 6 beginning July 1, 2016, and ending June 30, 2017, the following 7 amount, or so much thereof as is necessary, to be used for the 8 purposes designated: 9 For salaries, support, administration, maintenance, and 10 miscellaneous purposes, and for not more than the following 11 full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 753,392 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 21.00 14 2. Of the funds appropriated in this section, $225,000 shall 15 be used to continue to provide for additional local long-term 16 care ombudsmen. 17 DIVISION XXXV 18 DEPARTMENT OF PUBLIC HEALTH —— FY 2016-2017 19 Sec. 119. DEPARTMENT OF PUBLIC HEALTH. There is 20 appropriated from the general fund of the state to the 21 department of public health for the fiscal year beginning July 22 1, 2016, and ending June 30, 2017, the following amounts, or 23 so much thereof as is necessary, to be used for the purposes 24 designated: 25 1. ADDICTIVE DISORDERS 26 For reducing the prevalence of the use of tobacco, alcohol, 27 and other drugs, and treating individuals affected by addictive 28 behaviors, including gambling, and for not more than the 29 following full-time equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,631,845 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 32 a. (1) Of the funds appropriated in this subsection, 33 $2,624,181 shall be used for the tobacco use prevention 34 and control initiative, including efforts at the state and 35 -124- SF 505 (3) 86 pf/rj 124/ 195
S.F. 505 local levels, as provided in chapter 142A . The commission 1 on tobacco use prevention and control established pursuant 2 to section 142A.3 shall advise the director of public health 3 in prioritizing funding needs and the allocation of moneys 4 appropriated for the programs and initiatives. Activities 5 of the programs and initiatives shall be in alignment with 6 the United States centers for disease control and prevention 7 best practices for comprehensive tobacco control programs that 8 include the goals of preventing youth initiation of tobacco 9 usage, reducing exposure to secondhand smoke, and promotion of 10 tobacco cessation. 11 (2) (a) Of the funds allocated in this paragraph “a”, 12 $226,534 is transferred to the alcoholic beverages division of 13 the department of commerce for enforcement of tobacco laws, 14 regulations, and ordinances and to engage in tobacco control 15 activities approved by the division of tobacco use prevention 16 and control of the department of public health as specified 17 in the memorandum of understanding entered into between the 18 divisions. 19 (b) For the fiscal year beginning July 1, 2016, and ending 20 June 30, 2017, the terms of the memorandum of understanding, 21 entered into between the division of tobacco use prevention 22 and control of the department of public health and the 23 alcoholic beverages division of the department of commerce, 24 governing compliance checks conducted to ensure licensed retail 25 tobacco outlet conformity with tobacco laws, regulations, and 26 ordinances relating to persons under eighteen years of age, 27 shall continue to restrict the number of such checks to one 28 check per retail outlet, and one additional check for any 29 retail outlet found to be in violation during the first check. 30 b. Of the funds appropriated in this subsection, 31 $11,007,664 shall be used for problem gambling and 32 substance-related disorder prevention, treatment, and recovery 33 services, including a 24-hour helpline, public information 34 resources, professional training, and program evaluation. 35 -125- SF 505 (3) 86 pf/rj 125/ 195
S.F. 505 (1) Of the funds allocated in this paragraph “b”, $9,451,857 1 shall be used for substance-related disorder prevention and 2 treatment. 3 (a) Of the funds allocated in this subparagraph (1), 4 $449,650 shall be used for the public purpose of a grant 5 program to provide substance-related disorder prevention 6 programming for children. 7 (i) Of the funds allocated in this subparagraph division 8 (a), $213,770 shall be used for grant funding for organizations 9 that provide programming for children by utilizing mentors. 10 Programs approved for such grants shall be certified or must 11 be certified within six months of receiving the grant award 12 by the Iowa commission on volunteer services as utilizing the 13 standards for effective practice for mentoring programs. 14 (ii) Of the funds allocated in this subparagraph division 15 (a), $213,420 shall be used for grant funding for organizations 16 providing programming that includes youth development and 17 leadership services. The programs shall also be recognized as 18 being programs that are scientifically based with evidence of 19 their effectiveness in reducing substance-related disorders in 20 children. 21 (iii) The department of public health shall utilize a 22 request for proposals process to implement the grant program. 23 (iv) All grant recipients shall participate in a program 24 evaluation as a requirement for receiving grant funds. 25 (v) Of the funds allocated in this subparagraph division 26 (a), up to $22,461 may be used to administer substance-related 27 disorder prevention grants and for program evaluations. 28 (b) Of the funds allocated in this subparagraph 29 (1), $136,302 shall be used for culturally competent 30 substance-related disorder treatment pilot projects. 31 (i) The department shall utilize the amount allocated 32 in this subparagraph division (b) for at least three pilot 33 projects to provide culturally competent substance-related 34 disorder treatment in various areas of the state. Each pilot 35 -126- SF 505 (3) 86 pf/rj 126/ 195
S.F. 505 project shall target a particular ethnic minority population. 1 The populations targeted shall include but are not limited to 2 African American, Asian, and Latino. 3 (ii) The pilot project requirements shall provide for 4 documentation or other means to ensure access to the cultural 5 competence approach used by a pilot project so that such 6 approach can be replicated and improved upon in successor 7 programs. 8 (2) Of the funds allocated in this paragraph “b”, up 9 to $1,555,807 may be used for problem gambling prevention, 10 treatment, and recovery services. 11 (a) Of the funds allocated in this subparagraph (2), 12 $1,286,881 shall be used for problem gambling prevention and 13 treatment. 14 (b) Of the funds allocated in this subparagraph (2), up to 15 $218,926 may be used for a 24-hour helpline, public information 16 resources, professional training, and program evaluation. 17 (c) Of the funds allocated in this subparagraph (2), up 18 to $50,000 may be used for the licensing of problem gambling 19 treatment programs. 20 (3) It is the intent of the general assembly that from the 21 moneys allocated in this paragraph “b”, persons with a dual 22 diagnosis of substance-related disorder and gambling addiction 23 shall be given priority in treatment services. 24 c. Notwithstanding any provision of law to the contrary, 25 to standardize the availability, delivery, cost of delivery, 26 and accountability of problem gambling and substance-related 27 disorder treatment services statewide, the department shall 28 continue implementation of a process to create a system 29 for delivery of treatment services in accordance with the 30 requirements specified in 2008 Iowa Acts, chapter 1187, section 31 3, subsection 4. To ensure the system provides a continuum 32 of treatment services that best meets the needs of Iowans, 33 the problem gambling and substance-related disorder treatment 34 services in any area may be provided either by a single agency 35 -127- SF 505 (3) 86 pf/rj 127/ 195
S.F. 505 or by separate agencies submitting a joint proposal. 1 (1) The system for delivery of substance-related disorder 2 and problem gambling treatment shall include problem gambling 3 prevention. 4 (2) The system for delivery of substance-related disorder 5 and problem gambling treatment shall include substance-related 6 disorder prevention by July 1, 2017. 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 division of 13 this Act for purposes of substance-related disorder treatment 14 and addictive disorders for the fiscal year beginning July 1, 15 2016. 16 e. The department of public health shall work with all 17 other departments that fund substance-related disorder 18 prevention and treatment services and all such departments 19 shall, to the extent necessary, collectively meet the state 20 maintenance of effort requirements for expenditures for 21 substance-related disorder services as required under the 22 federal substance-related disorder prevention and treatment 23 block grant. 24 2. HEALTHY CHILDREN AND FAMILIES 25 For promoting the optimum health status for children, 26 adolescents from birth through 21 years of age, and families, 27 and for not more than the following full-time equivalent 28 positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,665,801 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 31 a. Of the funds appropriated in this subsection, not more 32 than $367,421 shall be used for the healthy opportunities for 33 parents to experience success (HOPES)-healthy families Iowa 34 (HFI) program established pursuant to section 135.106 . The 35 -128- SF 505 (3) 86 pf/rj 128/ 195
S.F. 505 funding shall be distributed to renew the grants that were 1 provided to the grantees that operated the program during the 2 fiscal year ending June 30, 2016. 3 b. In order to implement the legislative intent stated in 4 sections 135.106 and 256I.9 , that priority for home visitation 5 program funding be given to programs using evidence-based or 6 promising models for home visitation, it is the intent of the 7 general assembly to phase in the funding priority in accordance 8 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, 9 paragraph 0b. 10 c. Of the funds appropriated in this subsection, $2,456,444 11 shall be used to continue to expand statewide the department’s 12 initiative to provide for adequate developmental surveillance 13 and screening during a child’s first five years. The funds 14 shall be used first to fully fund the current sites to ensure 15 that the sites are fully operational, with the remaining 16 funds to be used for expansion to additional sites. The full 17 implementation and expansion shall include enhancing the scope 18 of the program through collaboration with the child health 19 specialty clinics to promote healthy child development through 20 early identification and response to both biomedical and social 21 determinants of healthy development; by monitoring child 22 health metrics to inform practice, document long-term health 23 impacts and savings, and provide for continuous improvement 24 through training, education, and evaluation; and by providing 25 for practitioner consultation particularly for children with 26 behavioral conditions and needs. The department of public 27 health shall also collaborate with the Iowa Medicaid enterprise 28 and the child health specialty clinics to integrate the 29 activities of the first five initiative into the establishment 30 of patient-centered medical homes, community utilities, 31 accountable care organizations, and other integrated care 32 models developed to improve health quality and population 33 health while reducing health care costs. To the maximum extent 34 possible, funding allocated in this paragraph shall be utilized 35 -129- SF 505 (3) 86 pf/rj 129/ 195
S.F. 505 as matching funds for medical assistance program reimbursement. 1 d. Of the funds appropriated in this subsection, $37,320 2 shall be distributed to a statewide dental carrier to provide 3 funds to continue the donated dental services program patterned 4 after the projects developed by the lifeline network to provide 5 dental services to indigent individuals who are elderly or with 6 disabilities. 7 e. Of the funds appropriated in this subsection, $55,998 8 shall be used for childhood obesity prevention. 9 f. Of the funds appropriated in this subsection, $81,384 10 shall be used to provide audiological services and hearing 11 aids for children. The department may enter into a contract 12 to administer this paragraph. 13 g. Of the funds appropriated in this subsection, $12,500 is 14 transferred to the university of Iowa college of dentistry for 15 provision of primary dental services to children. State funds 16 shall be matched on a dollar-for-dollar basis. The university 17 of Iowa college of dentistry shall coordinate efforts with the 18 department of public health, bureau of oral and health delivery 19 systems, to provide dental care to underserved populations 20 throughout the state. 21 h. Of the funds appropriated in this subsection, $25,000 22 shall be used to address youth suicide prevention. 23 i. Of the funds appropriated in this subsection, $25,000 24 shall be used to support the Iowa effort to address the survey 25 of children who experience adverse childhood experiences known 26 as ACEs. 27 3. CHRONIC CONDITIONS 28 For serving individuals identified as having chronic 29 conditions or special health care needs, and for not more than 30 the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,552,931 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 33 a. Of the funds appropriated in this subsection, $79,966 34 shall be used for grants to individual patients who have an 35 -130- SF 505 (3) 86 pf/rj 130/ 195
S.F. 505 inherited metabolic disorder to assist with the costs of 1 medically necessary foods and formula. 2 b. Of the funds appropriated in this subsection, $445,822 3 shall be used for the brain injury services program pursuant to 4 section 135.22B , including for continuation of the contracts 5 for resource facilitator services in accordance with section 6 135.22B, subsection 9 , and to enhance brain injury training and 7 recruitment of service providers on a statewide basis. Of the 8 amount allocated in this paragraph, $47,500 shall be used to 9 fund one full-time equivalent position to serve as the state 10 brain injury services program manager. 11 c. Of the funds appropriated in this subsection, $273,991 12 shall be used as additional funding to leverage federal funding 13 through the federal Ryan White Care Act, Tit. II, AIDS drug 14 assistance program supplemental drug treatment grants. 15 d. Of the funds appropriated in this subsection, $74,912 16 shall be used for the public purpose of continuing to contract 17 with an existing national-affiliated organization to provide 18 education, client-centered programs, and client and family 19 support for people living with epilepsy and their families. 20 The amount allocated in this paragraph in excess of $50,000 21 shall be matched dollar-for-dollar by the organization 22 specified. 23 e. Of the funds appropriated in this subsection, $392,557 24 shall be used for child health specialty clinics. 25 f. Of the funds appropriated in this subsection, $200,000 26 shall be used by the regional autism assistance program 27 established pursuant to section 256.35 , and administered by 28 the child health specialty clinic located at the university of 29 Iowa hospitals and clinics. The funds shall be used to enhance 30 interagency collaboration and coordination of educational, 31 medical, and other human services for persons with autism, 32 their families, and providers of services, including delivering 33 regionalized services of care coordination, family navigation, 34 and integration of services through the statewide system of 35 -131- SF 505 (3) 86 pf/rj 131/ 195
S.F. 505 regional child health specialty clinics and fulfilling other 1 requirements as specified in chapter 225D . The university of 2 Iowa shall not receive funds allocated under this paragraph for 3 indirect costs associated with the regional autism assistance 4 program. 5 g. Of the funds appropriated in this subsection, $285,497 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 paragraph “g”, $75,000 shall 10 be used to support a melanoma research symposium, a melanoma 11 biorepository and registry, basic and translational melanoma 12 research, and clinical trials. 13 h. Of the funds appropriated in this subsection, $63,225 14 shall be used for cervical and colon cancer screening, and 15 $150,000 shall be used to enhance the capacity of the cervical 16 cancer screening program to include provision of recommended 17 prevention and early detection measures to a broader range of 18 low-income women. 19 i. Of the funds appropriated in this subsection, $338,432 20 shall be used for the center for congenital and inherited 21 disorders including to provide for surveillance of stillbirths 22 as defined in section 136A.2. 23 j. Of the funds appropriated in this subsection, $64,706 24 shall be used for the prescription drug donation repository 25 program created in chapter 135M . 26 k. Of the funds appropriated in this subsection, 27 $107,632 shall be used by the department of public health 28 for reform-related activities, including but not limited to 29 facilitation of communication to stakeholders at the state and 30 local level, administering the patient-centered health advisory 31 council pursuant to section 135.159, and involvement in health 32 care system innovation activities occurring across the state. 33 l. Of the funds appropriated in this subsection, $12,500 34 shall be used for administration of chapter 124D, the medical 35 -132- SF 505 (3) 86 pf/rj 132/ 195
S.F. 505 cannabidiol Act, or other Code provisions authorizing the 1 compassionate medical use of cannabis, if enacted by the 2016 2 regular session of the Eighty-sixth General Assembly. 3 4. COMMUNITY CAPACITY 4 For strengthening the health care delivery system at the 5 local level, and for not more than the following full-time 6 equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,359,858 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 11.00 9 a. Of the funds appropriated in this subsection, $49,707 10 is allocated for continuation of the child vision screening 11 program implemented through the university of Iowa hospitals 12 and clinics in collaboration with early childhood Iowa areas. 13 The program shall submit a report to the individuals identified 14 in this Act for submission of reports regarding the use of 15 funds allocated under this paragraph “a”. The report shall 16 include the objectives and results for the program year 17 including the target population and how the funds allocated 18 assisted the program in meeting the objectives; the number, 19 age, and location within the state of individuals served; 20 the type of services provided to the individuals served; the 21 distribution of funds based on service provided; and the 22 continuing needs of the program. 23 b. Of the funds appropriated in this subsection, $55,328 is 24 allocated for continuation of an initiative implemented at the 25 university of Iowa and $49,952 is allocated for continuation of 26 an initiative at the state mental health institute at Cherokee 27 to expand and improve the workforce engaged in mental health 28 treatment and services. The initiatives shall receive input 29 from the university of Iowa, the department of human services, 30 the department of public health, and the mental health and 31 disability services commission to address the focus of the 32 initiatives. 33 c. Of the funds appropriated in this subsection, $582,314 34 shall be used for essential public health services that promote 35 -133- SF 505 (3) 86 pf/rj 133/ 195
S.F. 505 healthy aging throughout one’s lifespan, contracted through a 1 formula for local boards of health, to enhance health promotion 2 and disease prevention services. 3 d. Of the funds appropriated in this section, $49,643 shall 4 be deposited in the governmental public health system fund 5 created in section 135A.8 to be used for the purposes of the 6 fund. 7 e. Of the funds appropriated in this subsection, $52,724 8 shall be used to continue to address the shortage of mental 9 health professionals in the state. 10 f. Of the funds appropriated in this subsection, 11 $25,000 shall be used for a grant to a statewide association 12 of psychologists that is affiliated with the American 13 psychological association to be used for continuation of a 14 program to rotate intern psychologists in placements in urban 15 and rural mental health professional shortage areas, as defined 16 in section 135.180 . 17 g. (1) Of the funds appropriated in this subsection, 18 $1,441,485 shall be allocated as a grant to the Iowa primary 19 care association to be used pursuant to section 135.153 for 20 the statewide coordination of the Iowa collaborative safety 21 net provider network. Coordination of the network shall 22 focus on increasing access by underserved populations to 23 health care services, increasing integration of the health 24 system and collaboration across the continuum of care with 25 a focus on safety net services, and enhancing the Iowa 26 collaborative safety net provider network’s communication and 27 education efforts. The amount allocated as a grant under this 28 subparagraph (1) shall be used as follows to support the Iowa 29 collaborative safety net provider network goals of increased 30 access, health system integration, and engagement: 31 (a) For distribution to safety net partners in the state 32 that work to increase access of the underserved population to 33 health services: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 512,743 35 -134- SF 505 (3) 86 pf/rj 134/ 195
S.F. 505 (i) Of the amount allocated in this subparagraph 1 division (a), up to $206,708 shall be distributed to the 2 Iowa prescription drug corporation for continuation of the 3 pharmaceutical infrastructure for safety net providers as 4 described in 2007 Iowa Acts, chapter 218, section 108. 5 (ii) Of the amount allocated in this subparagraph division 6 (a), up to $174,161 shall be distributed to free clinics and 7 free clinics of Iowa for necessary infrastructure, statewide 8 coordination, provider recruitment, service delivery, and 9 provision of assistance to patients in securing a medical home 10 inclusive of oral health care. 11 (iii) Of the amount allocated in this subparagraph 12 division (a), up to $25,000 shall be distributed to the 13 Iowa coalition against sexual assault to continue a training 14 program for sexual assault response team (SART) members, 15 including representatives of law enforcement, victim advocates, 16 prosecutors, and certified medical personnel. 17 (iv) Of the amount allocated in this subparagraph division 18 (a), up to $106,874 shall be distributed to the Polk county 19 medical society for continuation of the safety net provider 20 patient access to a specialty health care initiative as 21 described in 2007 Iowa Acts, chapter 218, section 109. 22 (b) For distribution to safety net partners in the 23 state that work to increase health system integration, care 24 coordination, and collaboration across the continuum of care 25 with a focus on safety net services. Such efforts shall 26 include but not be limited to community care coordination team 27 development and integration of medical and behavioral health 28 services. Efforts shall also include working, in conjunction 29 with the department of human services and the department 30 of public health, to support Medicaid managed care efforts 31 inclusive of the state innovation model through the continued 32 development and implementation of community care coordination 33 teams. Implementation of the community care coordination 34 teams shall be accomplished through a statewide regionally 35 -135- SF 505 (3) 86 pf/rj 135/ 195
S.F. 505 based network that provides an integrated approach to health 1 care delivery through care coordination that supports primary 2 care providers and links patients with community resources 3 necessary to empower patients in addressing biomedical and 4 social determinants of health to improve health outcomes: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 836,100 6 (c) For distribution to safety net partners in the state 7 that work to serve as a resource for credible, accurate 8 information on health care-related needs and services 9 for vulnerable populations in the state including the 10 Iowa association of rural health clinics for necessary 11 infrastructure and service delivery transformation and the Iowa 12 primary care association to support partner engagement, program 13 management, and statewide coordination of the network: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 92,643 15 (2) The amount allocated under this paragraph “g” shall 16 not be reduced for administrative or other costs prior to 17 distribution. The Iowa collaborative safety net provider 18 network may continue to distribute funds allocated pursuant to 19 this paragraph “g” through existing contracts or renewal of 20 existing contracts. 21 (3) For each goal of the Iowa collaborative safety net 22 provider network, the Iowa primary care association shall 23 submit a progress report to the individuals designated in this 24 Act for submission of reports by December 15, 2016, including 25 progress in developing and implementing the network, how the 26 funds were distributed and used in developing and implementing 27 the network, and the remaining needs identified to fully 28 develop and implement the network. 29 h. Of the funds appropriated in this subsection, $106,700 30 shall be used for continuation of the work of the direct care 31 worker advisory council established pursuant to 2008 Iowa Acts, 32 chapter 1188, section 69, in implementing the recommendations 33 in the final report submitted by the advisory council to the 34 governor and the general assembly in March 2012, including 35 -136- SF 505 (3) 86 pf/rj 136/ 195
S.F. 505 by continuing to develop, promote, and make available on a 1 statewide basis the prepare-to-care core curriculum and its 2 associated modules and specialties through various formats 3 including online access, community colleges, and other venues; 4 exploring new and maintaining existing specialties including 5 but not limited to oral health and dementia care; supporting 6 instructor training; and assessing and making recommendations 7 concerning the Iowa care book and information technology 8 systems and infrastructure uses and needs. 9 i. (1) Of the funds appropriated in this subsection, 10 $108,188 shall be used for allocation to an independent 11 statewide direct care worker organization under continuation 12 of the contract in effect during the fiscal year ending June 13 30, 2016. 14 (2) Of the funds appropriated in this subsection, 15 $52,500 shall be used to provide scholarships or other 16 forms of subsidization for direct care worker educational 17 conferences, training, or outreach activities, and for the 18 mouth-care-matters oral health care project. 19 j. Of the funds appropriated in this subsection, the 20 department may use up to $29,088 for up to one full-time 21 equivalent position to administer the volunteer health care 22 provider program pursuant to section 135.24 . 23 k. Of the funds appropriated in this subsection, $50,000 24 shall be used for a matching dental education loan repayment 25 program to be allocated to a dental nonprofit health service 26 corporation to continue to develop the criteria and implement 27 the loan repayment program. 28 l. Of the funds appropriated in this subsection, $52,912 is 29 transferred to the college student aid commission for deposit 30 in the rural Iowa primary care trust fund created in section 31 261.113 to be used for the purposes of the fund. 32 m. Of the funds appropriated in this subsection, $125,000 33 shall be used for the purposes of the Iowa donor registry as 34 specified in section 142C.18 . 35 -137- SF 505 (3) 86 pf/rj 137/ 195
S.F. 505 n. Of the funds appropriated in this subsection, $50,000 1 shall be used for continuation of a grant to a nationally 2 affiliated volunteer eye organization that has an established 3 program for children and adults and that is solely dedicated to 4 preserving sight and preventing blindness through education, 5 nationally certified vision screening and training, and 6 community and patient service programs. The organization 7 shall submit a report to the individuals identified in this 8 Act for submission of reports regarding the use of funds 9 allocated under this paragraph “n”. The report shall include 10 the objectives and results for the program year including 11 the target population and how the funds allocated assisted 12 the program in meeting the objectives; the number, age, and 13 location within the state of individuals served; the type of 14 services provided to the individuals served; the distribution 15 of funds based on services provided; and the continuing needs 16 of the program. 17 o. Of the funds appropriated in this subsection, $12,500 18 shall be used for the continuation of a wellness council under 19 the direction of the director of public health to increase 20 support for wellness activities in the state. 21 p. Of the funds appropriated in this subsection, $1,000,000 22 shall be deposited in the medical residency training account 23 created in section 135.175, subsection 5, paragraph “a” , and 24 is appropriated from the account to the department of public 25 health to be used for the purposes of the medical residency 26 training state matching grants program as specified in section 27 135.176 . However, notwithstanding any provision to the 28 contrary in section 135.176, priority in the awarding of grants 29 shall be given to sponsors that propose preference in the use 30 of the grant funds for psychiatric residency positions and 31 family practice residency positions. 32 5. HEALTHY AGING 33 To provide public health services that reduce risks and 34 invest in promoting and protecting good health over the 35 -138- SF 505 (3) 86 pf/rj 138/ 195
S.F. 505 course of a lifetime with a priority given to older Iowans and 1 vulnerable populations: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,648,571 3 6. INFECTIOUS DISEASES 4 For reducing the incidence and prevalence of communicable 5 diseases, and for not more than the following full-time 6 equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 667,578 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 9 7. PUBLIC PROTECTION 10 For protecting the health and safety of the public through 11 establishing standards and enforcing regulations, and for not 12 more than the following full-time equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,169,596 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 135.50 15 a. Of the funds appropriated in this subsection, not more 16 than $227,350 shall be credited to the emergency medical 17 services fund created in section 135.25 . Moneys in the 18 emergency medical services fund are appropriated to the 19 department to be used for the purposes of the fund. 20 b. Of the funds appropriated in this subsection, $101,516 21 shall be used for sexual violence prevention programming 22 through a statewide organization representing programs 23 serving victims of sexual violence through the department’s 24 sexual violence prevention program. The amount allocated 25 in this paragraph “b” shall not be used to supplant funding 26 administered for other sexual violence prevention or victims 27 assistance programs. 28 c. Of the funds appropriated in this subsection, $299,376 29 shall be used for the state poison control center. Pursuant 30 to the directive under 2014 Iowa Acts, chapter 1140, section 31 102, the federal matching funds available to the state poison 32 control center from the department of human services under the 33 federal Children’s Health Insurance Program Reauthorization Act 34 allotment shall be subject to the federal administrative cap 35 -139- SF 505 (3) 86 pf/rj 139/ 195
S.F. 505 rule of 10 percent applicable to funding provided under Tit. 1 XXI of the federal Social Security Act and included within the 2 department’s calculations of the cap. 3 d. Of the funds appropriated in this subsection, $268,875 4 shall be used for childhood lead poisoning provisions. 5 8. RESOURCE MANAGEMENT 6 For establishing and sustaining the overall ability of the 7 department to deliver services to the public, and for not more 8 than the following full-time equivalent positions: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 427,536 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 11 The university of Iowa hospitals and clinics under the 12 control of the state board of regents shall not receive 13 indirect costs from the funds appropriated in this section. 14 The university of Iowa hospitals and clinics billings to the 15 department shall be on at least a quarterly basis. 16 DIVISION XXXVI 17 DEPARTMENT OF VETERANS AFFAIRS —— FY 2016-2017 18 Sec. 120. DEPARTMENT OF VETERANS AFFAIRS. There is 19 appropriated from the general fund of the state to the 20 department of veterans affairs for the fiscal year beginning 21 July 1, 2016, and ending June 30, 2017, the following amounts, 22 or so much thereof as is necessary, to be used for the purposes 23 designated: 24 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 25 For salaries, support, maintenance, and miscellaneous 26 purposes, and for not more than the following full-time 27 equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 600,273 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 30 2. IOWA VETERANS HOME 31 For salaries, support, maintenance, and miscellaneous 32 purposes: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,797,498 34 a. The Iowa veterans home billings involving the department 35 -140- SF 505 (3) 86 pf/rj 140/ 195
S.F. 505 of human services shall be submitted to the department on at 1 least a monthly basis. 2 b. If there is a change in the employer of employees 3 providing services at the Iowa veterans home under a collective 4 bargaining agreement, such employees and the agreement shall 5 be continued by the successor employer as though there had not 6 been a change in employer. 7 c. Within available resources and in conformance with 8 associated state and federal program eligibility requirements, 9 the Iowa veterans home may implement measures to provide 10 financial assistance to or on behalf of veterans or their 11 spouses who are participating in the community reentry program. 12 d. The Iowa veterans home expenditure report shall be 13 submitted monthly to the legislative services agency. 14 3. HOME OWNERSHIP ASSISTANCE PROGRAM 15 For transfer to the Iowa finance authority for the 16 continuation of the home ownership assistance program for 17 persons who are or were eligible members of the armed forces of 18 the United States, pursuant to section 16.54 : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,250,000 20 Sec. 121. LIMITATION OF COUNTY COMMISSIONS OF VETERAN 21 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 22 standing appropriation in section 35A.16 for the fiscal year 23 beginning July 1, 2016, and ending June 30, 2017, the amount 24 appropriated from the general fund of the state pursuant to 25 that section for the following designated purposes shall not 26 exceed the following amount: 27 For the county commissions of veteran affairs fund under 28 section 35A.16 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 495,000 30 DIVISION XXXVII 31 DEPARTMENT OF HUMAN SERVICES —— FY 2016-2017 32 Sec. 122. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 33 GRANT. There is appropriated from the fund created in section 34 8.41 to the department of human services for the fiscal year 35 -141- SF 505 (3) 86 pf/rj 141/ 195
S.F. 505 beginning July 1, 2016, and ending June 30, 2017, from moneys 1 received under the federal temporary assistance for needy 2 families (TANF) block grant pursuant to the federal Personal 3 Responsibility and Work Opportunity Reconciliation Act of 1996, 4 Pub. L. No. 104-193, and successor legislation, the following 5 amounts, or so much thereof as is necessary, to be used for the 6 purposes designated: 7 1. To be credited to the family investment program account 8 and used for assistance under the family investment program 9 under chapter 239B : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,568,498 11 2. To be credited to the family investment program account 12 and used for the job opportunities and basic skills (JOBS) 13 program and implementing family investment agreements in 14 accordance with chapter 239B : 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,069,089 16 3. To be used for the family development and 17 self-sufficiency grant program in accordance with section 18 216A.107 : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,449,490 20 Notwithstanding section 8.33 , moneys appropriated in this 21 subsection that remain unencumbered or unobligated at the close 22 of the fiscal year shall not revert but shall remain available 23 for expenditure for the purposes designated until the close of 24 the succeeding fiscal year. However, unless such moneys are 25 encumbered or obligated on or before September 30, 2016, the 26 moneys shall revert. 27 4. For field operations: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,648,116 29 5. For general administration: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,872,000 31 6. For state child care assistance: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,523,555 33 a. Of the funds appropriated in this subsection, 34 $13,164,049 is transferred to the child care and development 35 -142- SF 505 (3) 86 pf/rj 142/ 195
S.F. 505 block grant appropriation made by the Eighty-sixth General 1 Assembly, 2016 Session, for the federal fiscal year beginning 2 October 1, 2016, and ending September 30, 2017. Of this 3 amount, $100,000 shall be used for provision of educational 4 opportunities to registered child care home providers in order 5 to improve services and programs offered by this category 6 of providers and to increase the number of providers. The 7 department may contract with institutions of higher education 8 or child care resource and referral centers to provide 9 the educational opportunities. Allowable administrative 10 costs under the contracts shall not exceed 5 percent. The 11 application for a grant shall not exceed two pages in length. 12 b. Any funds appropriated in this subsection remaining 13 unallocated shall be used for state child care assistance 14 payments for families who are employed including but not 15 limited to individuals enrolled in the family investment 16 program. 17 7. For distribution to counties and regions through the 18 property tax relief fund for mental health and disability 19 services as provided in an appropriation made for this purpose: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,447,026 21 8. For child and family services: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,042,215 23 9. For child abuse prevention grants: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,500 25 10. For pregnancy prevention grants on the condition that 26 family planning services are funded: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 965,034 28 Pregnancy prevention grants shall be awarded to programs 29 in existence on or before July 1, 2016, if the programs have 30 demonstrated positive outcomes. Grants shall be awarded to 31 pregnancy prevention programs which are developed after July 32 1, 2016, if the programs are based on existing models that 33 have demonstrated positive outcomes. Grants shall comply with 34 the requirements provided in 1997 Iowa Acts, chapter 208, 35 -143- SF 505 (3) 86 pf/rj 143/ 195
S.F. 505 section 14, subsections 1 and 2, including the requirement that 1 grant programs must emphasize sexual abstinence. Priority in 2 the awarding of grants shall be given to programs that serve 3 areas of the state which demonstrate the highest percentage of 4 unplanned pregnancies of females of childbearing age within the 5 geographic area to be served by the grant. 6 11. For technology needs and other resources necessary 7 to meet federal welfare reform reporting, tracking, and case 8 management requirements: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 518,593 10 12. For the family investment program share of the costs to 11 continue to develop and maintain a new, integrated eligibility 12 determination system: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,327,440 14 13. a. Notwithstanding any provision to the contrary, 15 including but not limited to requirements in section 8.41 or 16 provisions in 2015 or 2016 Iowa Acts regarding the receipt and 17 appropriation of federal block grants, federal funds from the 18 temporary assistance for needy families block grant received by 19 the state and not otherwise appropriated in this section and 20 remaining available for the fiscal year beginning July 1, 2016, 21 are appropriated to the department of human services to the 22 extent as may be necessary to be used in the following priority 23 order: the family investment program, for state child care 24 assistance program payments for families who are employed, and 25 for the family investment program share of costs to develop and 26 maintain a new, integrated eligibility determination system. 27 The federal funds appropriated in this paragraph “a” shall be 28 expended only after all other funds appropriated in subsection 29 1 for the assistance under the family investment program, 30 in subsection 6 for child care assistance, or in subsection 31 12 for the family investment program share of the costs to 32 continue to develop and maintain a new, integrated eligibility 33 determination system, as applicable, have been expended. For 34 the purposes of this subsection, the funds appropriated in 35 -144- SF 505 (3) 86 pf/rj 144/ 195
S.F. 505 subsection 6, paragraph “a”, for transfer to the child care 1 and development block grant appropriation are considered fully 2 expended when the full amount has been transferred. 3 b. The department shall, on a quarterly basis, advise the 4 legislative services agency and department of management of 5 the amount of funds appropriated in this subsection that was 6 expended in the prior quarter. 7 14. Of the amounts appropriated in this section, $6,481,004 8 for the fiscal year beginning July 1, 2016, is transferred to 9 the appropriation of the federal social services block grant 10 made to the department of human services for that fiscal year. 11 15. For continuation of the program providing categorical 12 eligibility for the food assistance program as specified for 13 the program in the section of this division of this 2016 Act 14 relating to the family investment program account: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,500 16 16. The department may transfer funds allocated in this 17 section to the appropriations made in this division of this Act 18 for the same fiscal year for general administration and field 19 operations for resources necessary to implement and operate the 20 services referred to in this section and those funded in the 21 appropriation made in this division of this Act for the same 22 fiscal year for the family investment program from the general 23 fund of the state. 24 Sec. 123. FAMILY INVESTMENT PROGRAM ACCOUNT. 25 1. Moneys credited to the family investment program (FIP) 26 account for the fiscal year beginning July 1, 2016, and 27 ending June 30, 2017, shall be used to provide assistance in 28 accordance with chapter 239B . 29 2. The department may use a portion of the moneys credited 30 to the FIP account under this section as necessary for 31 salaries, support, maintenance, and miscellaneous purposes. 32 3. The department may transfer funds allocated in 33 subsection 4 to the appropriations made in this division of 34 this Act for the same fiscal year for general administration 35 -145- SF 505 (3) 86 pf/rj 145/ 195
S.F. 505 and field operations for resources necessary to implement and 1 operate the family investment program services referred to in 2 this section and those funded in the appropriation made in this 3 division of this Act for the same fiscal year for the family 4 investment program from the general fund of the state. 5 4. Moneys appropriated in this division of this Act and 6 credited to the FIP account for the fiscal year beginning July 7 1, 2016, and ending June 30, 2017, are allocated as follows: 8 a. To be retained by the department of human services to 9 be used for coordinating with the department of human rights 10 to more effectively serve participants in FIP and other shared 11 clients and to meet federal reporting requirements under the 12 federal temporary assistance for needy families block grant: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 14 b. To the department of human rights for staffing, 15 administration, and implementation of the family development 16 and self-sufficiency grant program in accordance with section 17 216A.107 : 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,196,417 19 (1) Of the funds allocated for the family development 20 and self-sufficiency grant program in this paragraph “b”, 21 not more than 5 percent of the funds shall be used for the 22 administration of the grant program. 23 (2) The department of human rights may continue to implement 24 the family development and self-sufficiency grant program 25 statewide during fiscal year 2016-2017. 26 (3) The department of human rights may engage in activities 27 to strengthen and improve family outcomes measures and 28 data collection systems under the family development and 29 self-sufficiency grant program. 30 c. For the diversion subaccount of the FIP account: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 407,500 32 A portion of the moneys allocated for the subaccount may 33 be used for field operations, salaries, data management 34 system development, and implementation costs and support 35 -146- SF 505 (3) 86 pf/rj 146/ 195
S.F. 505 deemed necessary by the director of human services in order 1 to administer the FIP diversion program. To the extent 2 moneys allocated in this paragraph “c” are not deemed by the 3 department to be necessary to support diversion activities, 4 such moneys may be used for other efforts intended to increase 5 engagement by family investment program participants in work, 6 education, or training activities. 7 d. For the food assistance employment and training program: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,294 9 (1) The department shall apply the federal supplemental 10 nutrition assistance program (SNAP) employment and training 11 state plan in order to maximize to the fullest extent permitted 12 by federal law the use of the 50 percent federal reimbursement 13 provisions for the claiming of allowable federal reimbursement 14 funds from the United States department of agriculture 15 pursuant to the federal SNAP employment and training program 16 for providing education, employment, and training services 17 for eligible food assistance program participants, including 18 but not limited to related dependent care and transportation 19 expenses. 20 (2) The department shall continue the categorical federal 21 food assistance program eligibility at 160 percent of the 22 federal poverty level and continue to eliminate the asset test 23 from eligibility requirements, consistent with federal food 24 assistance program requirements. The department shall include 25 as many food assistance households as is allowed by federal 26 law. The eligibility provisions shall conform to all federal 27 requirements including requirements addressing individuals who 28 are incarcerated or otherwise ineligible. 29 e. For the JOBS program: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,770,199 31 5. Of the child support collections assigned under FIP, 32 an amount equal to the federal share of support collections 33 shall be credited to the child support recovery appropriation 34 made in this division of this Act. Of the remainder of the 35 -147- SF 505 (3) 86 pf/rj 147/ 195
S.F. 505 assigned child support collections received by the child 1 support recovery unit, a portion shall be credited to the FIP 2 account, a portion may be used to increase recoveries, and a 3 portion may be used to sustain cash flow in the child support 4 payments account. If as a consequence of the appropriations 5 and allocations made in this section the resulting amounts 6 are insufficient to sustain cash assistance payments and meet 7 federal maintenance of effort requirements, the department 8 shall seek supplemental funding. If child support collections 9 assigned under FIP are greater than estimated or are otherwise 10 determined not to be required for maintenance of effort, the 11 state share of either amount may be transferred to or retained 12 in the child support payments account. 13 6. The department may adopt emergency rules for the family 14 investment, JOBS, food assistance, and medical assistance 15 programs if necessary to comply with federal requirements. 16 Sec. 124. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 17 is appropriated from the general fund of the state to the 18 department of human services for the fiscal year beginning July 19 1, 2016, and ending June 30, 2017, the following amount, or 20 so much thereof as is necessary, to be used for the purpose 21 designated: 22 To be credited to the family investment program (FIP) 23 account and used for family investment program assistance under 24 chapter 239B : 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,546,938 26 1. Of the funds appropriated in this section, $3,701,110 is 27 allocated for the JOBS program. 28 2. Of the funds appropriated in this section, $1,756,927 is 29 allocated for the family development and self-sufficiency grant 30 program. 31 3. Notwithstanding section 8.39 , for the fiscal year 32 beginning July 1, 2016, if necessary to meet federal 33 maintenance of effort requirements or to transfer federal 34 temporary assistance for needy families block grant funding 35 -148- SF 505 (3) 86 pf/rj 148/ 195
S.F. 505 to be used for purposes of the federal social services block 1 grant or to meet cash flow needs resulting from delays in 2 receiving federal funding or to implement, in accordance with 3 this division of this Act, activities currently funded with 4 juvenile court services, county, or community moneys and state 5 moneys used in combination with such moneys, the department 6 of human services may transfer funds within or between any 7 of the appropriations made in this division of this Act and 8 appropriations in law for the federal social services block 9 grant to the department for the following purposes, provided 10 that the combined amount of state and federal temporary 11 assistance for needy families block grant funding for each 12 appropriation remains the same before and after the transfer: 13 a. For the family investment program. 14 b. For child care assistance. 15 c. For child and family services. 16 d. For field operations. 17 e. For general administration. 18 f. For distribution to counties or regions through the 19 property tax relief fund for mental health and disability 20 services as provided in an appropriation for this purpose. 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, $97,839 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 5. Of the funds appropriated in this section, $40,000 shall 32 be used for the continuation of an unfunded pilot project, as 33 defined in 441 IAC 100.1, relating to parental obligations, 34 in which the child support recovery unit participates, to 35 -149- SF 505 (3) 86 pf/rj 149/ 195
S.F. 505 support the efforts of a nonprofit organization committed to 1 strengthening the community through youth development, healthy 2 living, and social responsibility headquartered in a county 3 with a population over 350,000. The funds allocated in this 4 subsection shall be used by the recipient organization to 5 develop a larger community effort, through public and private 6 partnerships, to support a broad-based multi-county fatherhood 7 initiative that promotes payment of child support obligations, 8 improved family relationships, and full-time employment. 9 6. Of the funds appropriated in this section, $100,000 10 shall be used to continue a grant to a nonprofit organization 11 organized under section 501(c)(4) of the Internal Revenue Code 12 to continue a youth development strategy through after-school 13 programming that promotes academic success, healthy lifestyles, 14 good character, and citizenship. The organization shall meet 15 all of the following criteria: 16 a. Operate statewide and provide services through more than 17 one location. 18 b. Provide the after-school programming for students ages 19 five through eighteen years of age who are members of families 20 eligible for the federal temporary assistance for needy 21 families program. 22 c. Provide evidence, based on measurable outcomes, that the 23 after-school programming provided results in increased student 24 achievement. 25 7. The department may transfer funds appropriated in this 26 section to the appropriations made in this division of this Act 27 for general administration and field operations as necessary 28 to administer this section and the overall family investment 29 program. 30 Sec. 125. CHILD SUPPORT RECOVERY. 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, 2016, and ending 33 June 30, 2017, the following amount, or so much thereof as is 34 necessary, to be used for the purposes designated: 35 -150- SF 505 (3) 86 pf/rj 150/ 195
S.F. 505 For child support recovery, including salaries, support, 1 maintenance, and miscellaneous purposes, and for not more than 2 the following full-time equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,331,687 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00 5 1. The department shall expend up to $12,165, including 6 federal financial participation, for the fiscal year beginning 7 July 1, 2016, for a child support public awareness campaign. 8 The department and the office of the attorney general shall 9 cooperate in continuation of the campaign. The public 10 awareness campaign shall emphasize, through a variety of 11 media activities, the importance of maximum involvement of 12 both parents in the lives of their children as well as the 13 importance of payment of child support obligations. 14 2. Federal access and visitation grant moneys shall be 15 issued directly to private not-for-profit agencies that provide 16 services designed to increase compliance with the child access 17 provisions of court orders, including but not limited to 18 neutral visitation sites and mediation services. 19 3. The appropriation made to the department for child 20 support recovery may be used throughout the fiscal year in the 21 manner necessary for purposes of cash flow management, and for 22 cash flow management purposes the department may temporarily 23 draw more than the amount appropriated, provided the amount 24 appropriated is not exceeded at the close of the fiscal year. 25 4. With the exception of the funding amount specified, the 26 requirements established under 2001 Iowa Acts, chapter 191, 27 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 28 be applicable to parental obligation pilot projects for the 29 fiscal year beginning July 1, 2016, and ending June 30, 2017. 30 Notwithstanding 441 IAC 100.8, providing for termination of 31 rules relating to the pilot projects, the rules shall remain 32 in effect until June 30, 2017. 33 Sec. 126. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 34 FY 2016-2017. Any funds remaining in the health care trust 35 -151- SF 505 (3) 86 pf/rj 151/ 195
S.F. 505 fund created in section 453A.35A for the fiscal year beginning 1 July 1, 2016, and ending June 30, 2017, are appropriated to 2 the department of human services to supplement the medical 3 assistance program appropriations made in this division of this 4 Act, for medical assistance reimbursement and associated costs, 5 including program administration and costs associated with 6 program implementation. 7 Sec. 127. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 8 2016-2017. Any funds remaining in the Medicaid fraud fund 9 created in section 249A.50 for the fiscal year beginning 10 July 1, 2016, and ending June 30, 2017, are appropriated to 11 the department of human services to supplement the medical 12 assistance appropriations made in this division of this Act, 13 for medical assistance reimbursement and associated costs, 14 including program administration and costs associated with 15 program implementation. 16 Sec. 128. MEDICAL ASSISTANCE. 17 1. There is appropriated from the general fund of the 18 state to the department of human services for the fiscal year 19 beginning July 1, 2016, and ending June 30, 2017, the following 20 amount, or so much thereof as is necessary, to be used for the 21 purpose designated: 22 For medical assistance program reimbursement and associated 23 costs as specifically provided in the reimbursement 24 methodologies in effect on June 30, 2016, except as otherwise 25 expressly authorized by law, including reimbursement for 26 abortion services which shall be available under the medical 27 assistance program only for those abortions which are medically 28 necessary: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $673,176,820 30 2. Medically necessary abortions are those performed under 31 any of the following conditions: 32 a. The attending physician certifies that continuing the 33 pregnancy would endanger the life of the pregnant woman. 34 b. The attending physician certifies that the fetus is 35 -152- SF 505 (3) 86 pf/rj 152/ 195
S.F. 505 physically deformed, mentally deficient, or afflicted with a 1 congenital illness. 2 c. The pregnancy is the result of a rape which is reported 3 within 45 days of the incident to a law enforcement agency or 4 public or private health agency which may include a family 5 physician. 6 d. The pregnancy is the result of incest which is reported 7 within 150 days of the incident to a law enforcement agency 8 or public or private health agency which may include a family 9 physician. 10 e. Any spontaneous abortion, commonly known as a 11 miscarriage, if not all of the products of conception are 12 expelled. 13 3. a. Iowans support reducing the number of abortions 14 performed in our state. For an abortion covered under the 15 program, except in the case of a medical emergency, as defined 16 in section 135L.1 , for any woman, the physician shall certify 17 both of the following: 18 (1) That the woman has been given the opportunity to view an 19 ultrasound image of the fetus as part of the standard of care 20 before an abortion is performed. 21 (2) That the woman has been provided information regarding 22 the options relative to a pregnancy, including continuing the 23 pregnancy to term and retaining parental rights following the 24 child’s birth, continuing the pregnancy to term and placing the 25 child for adoption, and terminating the pregnancy. 26 b. The provisions of this section relating to abortions 27 shall also apply to the Iowa health and wellness plan created 28 pursuant to chapter 249N . 29 4. The department shall utilize not more than $30,000 of 30 the funds appropriated in this section to continue the AIDS/HIV 31 health insurance premium payment program as established in 1992 32 Iowa Acts, Second Extraordinary Session, chapter 1001, section 33 409, subsection 6. Of the funds allocated in this subsection, 34 not more than $2,500 may be expended for administrative 35 -153- SF 505 (3) 86 pf/rj 153/ 195
S.F. 505 purposes. 1 5. Of the funds appropriated in this Act to the department 2 of public health for addictive disorders, $475,000 for 3 the fiscal year beginning July 1, 2016, is transferred 4 to the department of human services for an integrated 5 substance-related disorder managed care system. The department 6 shall not assume management of the substance-related disorder 7 system in place of the managed care contractor unless such 8 a change in approach is specifically authorized in law. 9 The departments of human services and public health shall 10 work together to maintain the level of mental health and 11 substance-related disorder treatment services provided by the 12 managed care contractor through the Iowa plan for behavioral 13 health. Each department shall take the steps necessary to 14 continue the federal waivers as necessary to maintain the level 15 of services. 16 6. a. The department shall aggressively pursue options for 17 providing medical assistance or other assistance to individuals 18 with special needs who become ineligible to continue receiving 19 services under the early and periodic screening, diagnostic, 20 and treatment program under the medical assistance program 21 due to becoming 21 years of age who have been approved for 22 additional assistance through the department’s exception to 23 policy provisions, but who have health care needs in excess 24 of the funding available through the exception to policy 25 provisions. 26 b. Of the funds appropriated in this section, $50,000 27 shall be used for participation in one or more pilot projects 28 operated by a private provider to allow the individual or 29 individuals to receive service in the community in accordance 30 with principles established in Olmstead v. L.C., 527 U.S. 581 31 (1999), for the purpose of providing medical assistance or 32 other assistance to individuals with special needs who become 33 ineligible to continue receiving services under the early and 34 periodic screening, diagnostic, and treatment program under 35 -154- SF 505 (3) 86 pf/rj 154/ 195
S.F. 505 the medical assistance program due to becoming 21 years of 1 age who have been approved for additional assistance through 2 the department’s exception to policy provisions, but who have 3 health care needs in excess of the funding available through 4 the exception to the policy provisions. 5 7. Of the funds appropriated in this section, up to 6 $1,525,041 may be transferred to the field operations or 7 general administration appropriations in this division of this 8 Act for operational costs associated with Part D of the federal 9 Medicare Prescription Drug Improvement and Modernization Act 10 of 2003, Pub. L. No. 108-173. 11 8. Of the funds appropriated in this section, up to $221,050 12 may be transferred to the appropriation in this division 13 of this Act for medical contracts to be used for clinical 14 assessment services and prior authorization of services. 15 9. A portion of the funds appropriated in this section 16 may be transferred to the appropriations in this division of 17 this Act for general administration, medical contracts, the 18 children’s health insurance program, or field operations to be 19 used for the state match cost to comply with the payment error 20 rate measurement (PERM) program for both the medical assistance 21 and children’s health insurance programs as developed by the 22 centers for Medicare and Medicaid services of the United States 23 department of health and human services to comply with the 24 federal Improper Payments Information Act of 2002, Pub. L. No. 25 107-300. 26 10. The department shall continue to implement the 27 recommendations of the assuring better child health and 28 development initiative II (ABCDII) clinical panel to the 29 Iowa early and periodic screening, diagnostic, and treatment 30 services healthy mental development collaborative board 31 regarding changes to billing procedures, codes, and eligible 32 service providers. 33 11. Of the funds appropriated in this section, a sufficient 34 amount is allocated to supplement the incomes of residents of 35 -155- SF 505 (3) 86 pf/rj 155/ 195
S.F. 505 nursing facilities, intermediate care facilities for persons 1 with mental illness, and intermediate care facilities for 2 persons with an intellectual disability, with incomes of less 3 than $50 in the amount necessary for the residents to receive a 4 personal needs allowance of $50 per month pursuant to section 5 249A.30A . 6 12. Of the funds appropriated in this section, the following 7 amounts are transferred to the appropriations made in this 8 division of this Act for the state mental health institutes: 9 a. Cherokee mental health institute . . . . . . . . . . . $ 4,549,213 10 b. Clarinda mental health institute . . . . . . . . . . . $ 988,653 11 c. Independence mental health institute . . . . . . . $ 4,522,947 12 13. a. Of the funds appropriated in this section, 13 $4,298,325 is allocated for the state match for a 14 disproportionate share hospital payment of $9,566,715 to 15 hospitals that meet both of the conditions specified in 16 subparagraphs (1) and (2). In addition, the hospitals that 17 meet the conditions specified shall either certify public 18 expenditures or transfer to the medical assistance program 19 an amount equal to provide the nonfederal share for a 20 disproportionate share hospital payment of $3,750,000. The 21 hospitals that meet the conditions specified shall receive and 22 retain 100 percent of the total disproportionate share hospital 23 payment of $13,316,715. 24 (1) The hospital qualifies for disproportionate share and 25 graduate medical education payments. 26 (2) The hospital is an Iowa state-owned hospital with more 27 than 500 beds and eight or more distinct residency specialty 28 or subspecialty programs recognized by the American college of 29 graduate medical education. 30 b. Distribution of the disproportionate share payments 31 shall be made on a monthly basis. The total amount of 32 disproportionate share payments including graduate medical 33 education, enhanced disproportionate share, and Iowa 34 state-owned teaching hospital payments shall not exceed the 35 -156- SF 505 (3) 86 pf/rj 156/ 195
S.F. 505 amount of the state’s allotment under Pub. L. No. 102-234. 1 In addition, the total amount of all disproportionate 2 share payments shall not exceed the hospital-specific 3 disproportionate share limits under Pub. L. No. 103-66. 4 c. The university of Iowa hospitals and clinics shall either 5 certify public expenditures or transfer to the appropriations 6 made in this division of this Act for medical assistance an 7 amount equal to provide the nonfederal share for increased 8 medical assistance payments for inpatient and outpatient 9 hospital services of $4,950,000. The university of Iowa 10 hospitals and clinics shall receive and retain 100 percent of 11 the total increase in medical assistance payments. 12 d. Program payments for disproportionate share hospitals 13 and graduate medical education, and the upper payment limits 14 applicable to these programs shall be held harmless from the 15 impacts of Medicaid managed care and the governor’s Medicaid 16 modernization initiative. Payment methodologies utilized 17 for these programs may be adjusted or converted to other 18 methodologies or payment types in order to comply with this 19 hold harmless requirement. 20 14. One hundred percent of the nonfederal share of payments 21 to area education agencies that are medical assistance 22 providers for medical assistance-covered services provided to 23 medical assistance-covered children, shall be made from the 24 appropriation made in this section. 25 15. Any new or renewed contract entered into by the 26 department with a third party to administer behavioral health 27 services under the medical assistance program shall provide 28 that any interest earned on payments from the state during 29 the state fiscal year shall be remitted to the department 30 and treated as recoveries to offset the costs of the medical 31 assistance program. 32 16. A portion of the funds appropriated in this section 33 may be transferred to the appropriation in this division of 34 this Act for medical contracts to be used for administrative 35 -157- SF 505 (3) 86 pf/rj 157/ 195
S.F. 505 activities associated with the money follows the person 1 demonstration project. 2 17. Of the funds appropriated in this section, $174,506 3 shall be used for the administration of the health insurance 4 premium payment program, including salaries, support, 5 maintenance, and miscellaneous purposes. 6 18. a. The department may increase the amounts allocated 7 for salaries, support, maintenance, and miscellaneous purposes 8 associated with the medical assistance program, as necessary, 9 to implement cost containment strategies. The department shall 10 report any such increase to the legislative services agency and 11 the department of management. 12 b. If the savings to the medical assistance program from 13 cost containment efforts exceed the cost for the fiscal 14 year beginning July 1, 2016, the department may transfer any 15 savings generated for the fiscal year due to medical assistance 16 program cost containment efforts to the appropriation 17 made in this division of this Act for medical contracts or 18 general administration to defray the increased contract costs 19 associated with implementing such efforts. 20 c. The department of human services shall not implement 21 the following cost containment measures as recommended by the 22 governor for the fiscal year beginning July 1, 2016: 23 (1) A measure to provide uniform rates of $.575 per mile 24 based on the 2015 Internal Revenue Service mileage rate and 25 of $9.29, the current statewide average, per one-way trip for 26 Medicaid program home and community-based services waivers. 27 (2) A measure to cap the total costs of all services 28 received by a recipient of the home and community-based 29 services waiver for individuals with an intellectual disability 30 at the daily intermediate care facility for persons with an 31 intellectual disability (ICF/ID) per diem rate of $346.39 per 32 day based on the 80th percentile of all ICF/ID rates. 33 (3) A measure to align individual requests for exceptions to 34 policy with the capped total cost of services for a recipient 35 -158- SF 505 (3) 86 pf/rj 158/ 195
S.F. 505 of the home and community-based services waiver for individuals 1 with an intellectual disability as computed under subparagraph 2 (2). 3 (4) A measure to utilize the supports intensity scale 4 to determine payment amounts and a tiered payment system 5 for the services provided to adults served under the home 6 and community-based services waiver for individuals with an 7 intellectual disability. 8 (5) A measure to reallocate funding for community-based 9 systems of care to instead support integrated health homes. 10 (6) A measure to increase the university of Iowa hospitals 11 and clinics state share responsibility for the supplemental 12 disproportionate share hospital payment to the university of 13 Iowa hospitals and clinics for the fiscal year beginning July 14 1, 2016. 15 d. The department shall report the implementation of 16 any cost containment strategies under this subsection to 17 the individuals specified in this division of this Act for 18 submission of reports on a quarterly basis. 19 19. For the fiscal year beginning July 1, 2016, and ending 20 June 30, 2017, the replacement generation tax revenues required 21 to be deposited in the property tax relief fund pursuant to 22 section 437A.8, subsection 4, paragraph “d” , and section 23 437A.15, subsection 3, paragraph “f” , shall instead be credited 24 to and supplement the appropriation made in this section and 25 used for the allocations made in this section. 26 20. The department shall continue to administer the state 27 balancing incentive payments program as specified in 2012 Iowa 28 Acts, chapter 1133, section 14. 29 21. a. Of the funds appropriated in this section, $450,000 30 shall be used for continued implementation of the children’s 31 mental health home project proposed by the department of human 32 services and reported to the general assembly’s mental health 33 and disability services study committee in December 2011. Of 34 this amount, up to $25,000 may be transferred by the department 35 -159- SF 505 (3) 86 pf/rj 159/ 195
S.F. 505 to the appropriation made in this division of this Act to the 1 department for the same fiscal year for general administration 2 to be used for associated administrative expenses and for not 3 more than one full-time equivalent position, in addition to 4 those authorized for the same fiscal year, to be assigned to 5 implementing the project. 6 b. Of the funds appropriated in this section, up to $200,000 7 may be transferred by the department to the appropriation made 8 to the department in this division of this Act for the same 9 fiscal year for Medicaid program-related general administration 10 planning and implementation activities. The funds may be used 11 for contracts or for personnel in addition to the amounts 12 appropriated for and the positions authorized for general 13 administration for the fiscal year. 14 c. Of the funds appropriated in this section, up to 15 $1,500,000 may be transferred by the department to the 16 appropriations made in this division of this Act for the same 17 fiscal year for general administration or medical contracts 18 to be used to support the development and implementation of 19 standardized assessment tools for persons with mental illness, 20 an intellectual disability, a developmental disability, or a 21 brain injury. 22 22. Of the funds appropriated in this section, $125,000 23 shall be used for lodging expenses associated with care 24 provided at the university of Iowa hospitals and clinics for 25 patients with cancer whose travel distance is 30 miles or more 26 and whose income is at or below 200 percent of the federal 27 poverty level as defined by the most recently revised poverty 28 income guidelines published by the United States department of 29 health and human services. The department of human services 30 shall establish the maximum number of overnight stays and the 31 maximum rate reimbursed for overnight lodging, which may be 32 based on the state employee rate established by the department 33 of administrative services. The funds allocated in this 34 subsection shall not be used as nonfederal share matching 35 -160- SF 505 (3) 86 pf/rj 160/ 195
S.F. 505 funds. 1 23. a. For inpatient and outpatient services provided by 2 hospitals on or after July 1, 2016, the department of human 3 services shall continue to recalculate and prospectively 4 apply an updated cost-to-charge ratio upon the request of a 5 hospital to implement price or charge reductions, if all of the 6 following criteria are met: 7 (1) The recalculation of an updated cost-to-charge ratio is 8 budget neutral to the state funding amount appropriated for the 9 respective fiscal year and maintains budget neutral payments or 10 revenue to all hospitals. 11 (2) The hospital requesting the price or charge reduction 12 submits a proforma cost report and charge master that reflects 13 the anticipated cost-to-charge reduction. 14 b. Based upon the proforma cost report submitted by the 15 requesting hospital, the department of human services shall 16 prospectively apply the recalculated cost-to-charge ratio as 17 appropriate to submitted claims for health care services. 18 24. The department of human services shall not adopt 19 emergency rules to implement Medicaid managed care or the 20 governor’s Medicaid modernization initiative. 21 25. The number of home and community-based services waiver 22 slots available during the fiscal year beginning July 1, 2016, 23 shall not be reduced below the number of such slots available 24 on January 1, 2015. 25 Sec. 129. MEDICAL CONTRACTS. There is appropriated from the 26 general fund of the state to the department of human services 27 for the fiscal year beginning July 1, 2016, and ending June 30, 28 2017, the following amount, or so much thereof as is necessary, 29 to be used for the purpose designated: 30 For medical contracts: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,076,792 32 1. The department of inspections and appeals shall 33 provide all state matching funds for survey and certification 34 activities performed by the department of inspections 35 -161- SF 505 (3) 86 pf/rj 161/ 195
S.F. 505 and appeals. The department of human services is solely 1 responsible for distributing the federal matching funds for 2 such activities. 3 2. Of the funds appropriated in this section, $25,000 shall 4 be used for continuation of home and community-based services 5 waiver quality assurance programs, including the review and 6 streamlining of processes and policies related to oversight and 7 quality management to meet state and federal requirements. 8 3. Of the amount appropriated in this section, up to 9 $100,000 may be transferred to the appropriation for general 10 administration in this division of this Act to be used for 11 additional full-time equivalent positions in the development of 12 key health initiatives such as cost containment, development 13 and oversight of managed care programs, and development of 14 health strategies targeted toward improved quality and reduced 15 costs in the Medicaid program. 16 4. Of the funds appropriated in this section, $500,000 shall 17 be used for planning and development, in cooperation with the 18 department of public health, of a phased-in program to provide 19 a dental home for children. 20 5. Of the funds appropriated in this section, $1,000,000 21 shall be used for the autism support program created in chapter 22 225D . 23 Sec. 130. STATE SUPPLEMENTARY ASSISTANCE. 24 1. There is appropriated from the general fund of the 25 state to the department of human services for the fiscal year 26 beginning July 1, 2016, and ending June 30, 2017, the following 27 amount, or so much thereof as is necessary, to be used for the 28 purpose designated: 29 For the state supplementary assistance program: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,498,594 31 2. The department shall increase the personal needs 32 allowance for residents of residential care facilities by the 33 same percentage and at the same time as federal supplemental 34 security income and federal social security benefits are 35 -162- SF 505 (3) 86 pf/rj 162/ 195
S.F. 505 increased due to a recognized increase in the cost of living. 1 The department may adopt emergency rules to implement this 2 subsection. 3 3. If during the fiscal year beginning July 1, 2016, 4 the department projects that state supplementary assistance 5 expenditures for a calendar year will not meet the federal 6 pass-through requirement specified in Tit. XVI of the federal 7 Social Security Act, section 1618, as codified in 42 U.S.C. 8 §1382g, the department may take actions including but not 9 limited to increasing the personal needs allowance for 10 residential care facility residents and making programmatic 11 adjustments or upward adjustments of the residential care 12 facility or in-home health-related care reimbursement rates 13 prescribed in this division of this Act to ensure that federal 14 requirements are met. In addition, the department may make 15 other programmatic and rate adjustments necessary to remain 16 within the amount appropriated in this section while ensuring 17 compliance with federal requirements. The department may adopt 18 emergency rules to implement the provisions of this subsection. 19 Sec. 131. CHILDREN’S HEALTH INSURANCE PROGRAM. 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, 2016, and ending June 30, 2017, the following 23 amount, or so much thereof as is necessary, to be used for the 24 purpose designated: 25 For maintenance of the healthy and well kids in Iowa (hawk-i) 26 program pursuant to chapter 514I , including supplemental dental 27 services, for receipt of federal financial participation under 28 Tit. XXI of the federal Social Security Act, which creates the 29 children’s health insurance program: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,581,922 31 2. Of the funds appropriated in this section, $21,400 is 32 allocated for continuation of the contract for outreach with 33 the department of public health. 34 Sec. 132. CHILD CARE ASSISTANCE. There is appropriated 35 -163- SF 505 (3) 86 pf/rj 163/ 195
S.F. 505 from the general fund of the state to the department of human 1 services for the fiscal year beginning July 1, 2016, and ending 2 June 30, 2017, the following amount, or so much thereof as is 3 necessary, to be used for the purpose designated: 4 For child care programs: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 28,319,015 6 1. Of the funds appropriated in this section, $24,409,301 7 shall be used for state child care assistance in accordance 8 with section 237A.13 . 9 2. Nothing in this section shall be construed or is 10 intended as or shall imply a grant of entitlement for services 11 to persons who are eligible for assistance due to an income 12 level consistent with the waiting list requirements of section 13 237A.13 . Any state obligation to provide services pursuant to 14 this section is limited to the extent of the funds appropriated 15 in this section. 16 3. Of the funds appropriated in this section, $216,227 17 is allocated for the statewide grant program for child care 18 resource and referral services under section 237A.26 . A list 19 of the registered and licensed child care facilities operating 20 in the area served by a child care resource and referral 21 service shall be made available to the families receiving state 22 child care assistance in that area. 23 4. Of the funds appropriated in this section, $468,487 24 is allocated for child care quality improvement initiatives 25 including but not limited to the voluntary quality rating 26 system in accordance with section 237A.30 . 27 5. Of the funds appropriated in this section, $3,175,000 28 shall be credited to the early childhood programs grants 29 account in the early childhood Iowa fund created in section 30 256I.11 . The moneys shall be distributed for funding of 31 community-based early childhood programs targeted to children 32 from birth through five years of age developed by early 33 childhood Iowa areas in accordance with approved community 34 plans as provided in section 256I.8 . 35 -164- SF 505 (3) 86 pf/rj 164/ 195
S.F. 505 6. The department may use any of the funds appropriated 1 in this section as a match to obtain federal funds for use in 2 expanding child care assistance and related programs. For 3 the purpose of expenditures of state and federal child care 4 funding, funds shall be considered obligated at the time 5 expenditures are projected or are allocated to the department’s 6 service areas. Projections shall be based on current and 7 projected caseload growth, current and projected provider 8 rates, staffing requirements for eligibility determination 9 and management of program requirements including data systems 10 management, staffing requirements for administration of the 11 program, contractual and grant obligations and any transfers 12 to other state agencies, and obligations for decategorization 13 or innovation projects. 14 7. A portion of the state match for the federal child care 15 and development block grant shall be provided as necessary to 16 meet federal matching funds requirements through the state 17 general fund appropriation made for child development grants 18 and other programs for at-risk children in section 279.51 . 19 8. If a uniform reduction ordered by the governor under 20 section 8.31 or other operation of law, transfer, or federal 21 funding reduction reduces the appropriation made in this 22 section for the fiscal year, the percentage reduction in the 23 amount paid out to or on behalf of the families participating 24 in the state child care assistance program shall be equal to or 25 less than the percentage reduction made for any other purpose 26 payable from the appropriation made in this section and the 27 federal funding relating to it. The percentage reduction to 28 the other allocations made in this section shall be the same as 29 the uniform reduction ordered by the governor or the percentage 30 change of the federal funding reduction, as applicable. 31 If there is an unanticipated increase in federal funding 32 provided for state child care assistance, the entire amount 33 of the increase shall be used for state child care assistance 34 payments. If the appropriations made for purposes of the 35 -165- SF 505 (3) 86 pf/rj 165/ 195
S.F. 505 state child care assistance program for the fiscal year are 1 determined to be insufficient, it is the intent of the general 2 assembly to appropriate sufficient funding for the fiscal year 3 in order to avoid establishment of waiting list requirements. 4 9. Notwithstanding section 8.33 , moneys advanced for 5 purposes of the programs developed by early childhood Iowa 6 areas, advanced for purposes of wraparound child care, or 7 received from the federal appropriations made for the purposes 8 of this section that remain unencumbered or unobligated at the 9 close of the fiscal year shall not revert to any fund but shall 10 remain available for expenditure for the purposes designated 11 until the close of the succeeding fiscal year. 12 10. Of the funds appropriated in this section, $50,000 13 is transferred to the department of public health to be used 14 to continue a program to assist parents in this state with 15 costs resulting from the death of a child in accordance with 16 this subsection. If it is less costly than administering the 17 program directly, the department shall issue a request for 18 proposals and issue a grant to an appropriate organization to 19 administer the program. 20 a. The program funding shall be used to assist parents who 21 reside in this state with costs incurred for a funeral, burial 22 or cremation, cemetery costs, or grave marker costs associated 23 with the unintended death of a child of the parent or a child 24 under the care of a guardian or custodian. The department 25 shall consider the following eligibility factors in developing 26 program requirements: 27 (1) The child was a stillborn infant or was less than age 28 eighteen at the time of death. 29 (2) The request for assistance was approved by the local 30 board or department of health or the county general assistance 31 director and may have been referred by a local funeral home. 32 (3) To be eligible, the parent, guardian, or custodian must 33 have an annual household income that is less than 145 percent 34 of the federal poverty level based on the number of people 35 -166- SF 505 (3) 86 pf/rj 166/ 195
S.F. 505 in the applicant’s household as defined by the most recently 1 revised poverty income guidelines published by the United 2 States department of health and human services. 3 (4) The maximum amount of grant assistance provided to a 4 parent, guardian, or custodian associated with the death of 5 a child is $2,000. If the death is a multiple death and the 6 infants or children are being cremated, or buried together, the 7 same limitation applies. 8 (5) To the extent the overall amount of assistance received 9 by a recipient for the costs addressed under this subsection 10 does not exceed the overall total of the costs, the recipient 11 may receive other public or private assistance in addition to 12 grant assistance under this section. 13 b. Notwithstanding section 8.33, moneys transferred by 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 expended. 17 Sec. 133. JUVENILE INSTITUTIONS. There is appropriated 18 from the general fund of the state to the department of human 19 services for the fiscal year beginning July 1, 2016, and ending 20 June 30, 2017, the following amounts, or so much thereof as is 21 necessary, to be used for the purposes designated: 22 1. For the costs of security, building and grounds 23 maintenance, utilities, salary, and support for the facilities 24 located at the Iowa juvenile home at Toledo and for salaries, 25 support, maintenance, and miscellaneous purposes, and for not 26 more than the following full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 186,383 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 2.00 29 2. For operation of the state training school at Eldora and 30 for salaries, support, maintenance, and miscellaneous purposes, 31 and for not more than the following full-time equivalent 32 positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,222,776 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.30 35 -167- SF 505 (3) 86 pf/rj 167/ 195
S.F. 505 Of the funds appropriated in this subsection, $45,575 shall 1 be used for distribution to licensed classroom teachers at this 2 and other institutions under the control of the department of 3 human services based upon the average student yearly enrollment 4 at each institution as determined by the department. 5 Sec. 134. CHILD AND FAMILY SERVICES. 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, 2016, and ending June 30, 2017, the following 9 amount, or so much thereof as is necessary, to be used for the 10 purpose designated: 11 For child and family services: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 49,091,090 13 2. Up to $2,600,000 of the amount of federal temporary 14 assistance for needy families block grant funding appropriated 15 in this division of this Act for child and family services 16 shall be made available for purposes of juvenile delinquent 17 graduated sanction services. 18 3. The department may transfer funds appropriated in this 19 section as necessary to pay the nonfederal costs of services 20 reimbursed under the medical assistance program, state child 21 care assistance program, or the family investment program which 22 are provided to children who would otherwise receive services 23 paid under the appropriation in this section. The department 24 may transfer funds appropriated in this section to the 25 appropriations made in this division of this Act for general 26 administration and for field operations for resources necessary 27 to implement and operate the services funded in this section. 28 4. a. Of the funds appropriated in this section, up to 29 $17,910,893 is allocated as the statewide expenditure target 30 under section 232.143 for group foster care maintenance and 31 services. If the department projects that such expenditures 32 for the fiscal year will be less than the target amount 33 allocated in this paragraph “a”, the department may reallocate 34 the excess to provide additional funding for shelter care 35 -168- SF 505 (3) 86 pf/rj 168/ 195
S.F. 505 or the child welfare emergency services addressed with the 1 allocation for shelter care. 2 b. If at any time after September 30, 2016, annualization 3 of a service area’s current expenditures indicates a service 4 area is at risk of exceeding its group foster care expenditure 5 target under section 232.143 by more than 5 percent, the 6 department and juvenile court services shall examine all 7 group foster care placements in that service area in order to 8 identify those which might be appropriate for termination. 9 In addition, any aftercare services believed to be needed 10 for the children whose placements may be terminated shall be 11 identified. The department and juvenile court services shall 12 initiate action to set dispositional review hearings for the 13 placements identified. In such a dispositional review hearing, 14 the juvenile court shall determine whether needed aftercare 15 services are available and whether termination of the placement 16 is in the best interest of the child and the community. 17 5. In accordance with the provisions of section 232.188 , 18 the department shall continue the child welfare and juvenile 19 justice funding initiative during fiscal year 2016-2017. Of 20 the funds appropriated in this section, $858,877 is allocated 21 specifically for expenditure for fiscal year 2016-2017 through 22 the decategorization services funding pools and governance 23 boards established pursuant to section 232.188 . 24 6. A portion of the funds appropriated in this section 25 may be used for emergency family assistance to provide other 26 resources required for a family participating in a family 27 preservation or reunification project or successor project to 28 stay together or to be reunified. 29 7. Notwithstanding section 234.35 or any other provision 30 of law to the contrary, state funding for shelter care and 31 the child welfare emergency services contracting implemented 32 to provide for or prevent the need for shelter care shall be 33 limited to $4,034,237. 34 8. Federal funds received by the state during the fiscal 35 -169- SF 505 (3) 86 pf/rj 169/ 195
S.F. 505 year beginning July 1, 2016, as the result of the expenditure 1 of state funds appropriated during a previous state fiscal 2 year for a service or activity funded under this section are 3 appropriated to the department to be used as additional funding 4 for services and purposes provided for under this section. 5 Notwithstanding section 8.33 , moneys received in accordance 6 with this subsection that remain unencumbered or unobligated at 7 the close of the fiscal year shall not revert to any fund but 8 shall remain available for the purposes designated until the 9 close of the succeeding fiscal year. 10 9. a. Of the funds appropriated in this section, up to 11 $1,645,000 is allocated for the payment of the expenses of 12 court-ordered services provided to juveniles who are under 13 the supervision of juvenile court services, which expenses 14 are a charge upon the state pursuant to section 232.141, 15 subsection 4 . Of the amount allocated in this paragraph “a”, 16 up to $778,144 shall be made available to provide school-based 17 supervision of children adjudicated under chapter 232 , of which 18 not more than $7,500 may be used for the purpose of training. 19 A portion of the cost of each school-based liaison officer 20 shall be paid by the school district or other funding source as 21 approved by the chief juvenile court officer. 22 b. Of the funds appropriated in this section, up to $374,493 23 is allocated for the payment of the expenses of court-ordered 24 services provided to children who are under the supervision 25 of the department, which expenses are a charge upon the state 26 pursuant to section 232.141, subsection 4 . 27 c. Notwithstanding section 232.141 or any other provision 28 of law to the contrary, the amounts allocated in this 29 subsection shall be distributed to the judicial districts 30 as determined by the state court administrator and to the 31 department’s service areas as determined by the administrator 32 of the department of human services’ division of child and 33 family services. The state court administrator and the 34 division administrator shall make the determination of the 35 -170- SF 505 (3) 86 pf/rj 170/ 195
S.F. 505 distribution amounts on or before June 15, 2016. 1 d. Notwithstanding chapter 232 or any other provision of 2 law to the contrary, a district or juvenile court shall not 3 order any service which is a charge upon the state pursuant 4 to section 232.141 if there are insufficient court-ordered 5 services funds available in the district court or departmental 6 service area distribution amounts to pay for the service. The 7 chief juvenile court officer and the departmental service area 8 manager shall encourage use of the funds allocated in this 9 subsection such that there are sufficient funds to pay for 10 all court-related services during the entire year. The chief 11 juvenile court officers and departmental service area managers 12 shall attempt to anticipate potential surpluses and shortfalls 13 in the distribution amounts and shall cooperatively request the 14 state court administrator or division administrator to transfer 15 funds between the judicial districts’ or departmental service 16 areas’ distribution amounts as prudent. 17 e. Notwithstanding any provision of law to the contrary, 18 a district or juvenile court shall not order a county to pay 19 for any service provided to a juvenile pursuant to an order 20 entered under chapter 232 which is a charge upon the state 21 under section 232.141, subsection 4 . 22 f. Of the funds allocated in this subsection, not more than 23 $41,500 may be used by the judicial branch for administration 24 of the requirements under this subsection. 25 g. Of the funds allocated in this subsection, $8,500 26 shall be used by the department of human services to support 27 the interstate commission for juveniles in accordance with 28 the interstate compact for juveniles as provided in section 29 232.173 . 30 10. Of the funds appropriated in this section, $4,026,614 is 31 allocated for juvenile delinquent graduated sanctions services. 32 Any state funds saved as a result of efforts by juvenile court 33 services to earn a federal Tit. IV-E match for juvenile court 34 services administration may be used for the juvenile delinquent 35 -171- SF 505 (3) 86 pf/rj 171/ 195
S.F. 505 graduated sanctions services. 1 11. Of the funds appropriated in this section, $804,143 is 2 transferred to the department of public health to be used for 3 the child protection center grant program for child protection 4 centers located in Iowa in accordance with section 135.118 . 5 The grant amounts under the program shall be equalized so that 6 each center receives a uniform base amount of $122,500, and 7 the remaining funds shall be awarded through a funding formula 8 based upon the volume of children served. 9 12. If the department receives federal approval to 10 implement a waiver under Tit. IV-E of the federal Social 11 Security Act to enable providers to serve children who remain 12 in the children’s families and communities, for purposes of 13 eligibility under the medical assistance program through 25 14 years of age, children who participate in the waiver shall be 15 considered to be placed in foster care. 16 13. Of the funds appropriated in this section, $2,012,584 is 17 allocated for the preparation for adult living program pursuant 18 to section 234.46 . 19 14. Of the funds appropriated in this section, $260,075 20 shall be used for juvenile drug courts. The amount allocated 21 in this subsection shall be distributed as follows: 22 To the judicial branch for salaries to assist with the 23 operation of juvenile drug court programs operated in the 24 following jurisdictions: 25 a. Marshall county: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,354 27 b. Woodbury county: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,841 29 c. Polk county: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 97,946 31 d. The third judicial district: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,967 33 e. The eighth judicial district: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,967 35 -172- SF 505 (3) 86 pf/rj 172/ 195
S.F. 505 15. Of the funds appropriated in this section, $113,669 1 shall be used for the public purpose of continuing a grant to 2 a nonprofit human services organization providing services to 3 individuals and families in multiple locations in southwest 4 Iowa and Nebraska for support of a project providing immediate, 5 sensitive support and forensic interviews, medical exams, needs 6 assessments, and referrals for victims of child abuse and their 7 nonoffending family members. 8 16. Of the funds appropriated in this section, $150,310 9 is allocated for the foster care youth council approach of 10 providing a support network to children placed in foster care. 11 17. Of the funds appropriated in this section, $101,000 is 12 allocated for use pursuant to section 235A.1 for continuation 13 of the initiative to address child sexual abuse implemented 14 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 15 21. 16 18. Of the funds appropriated in this section, $315,120 is 17 allocated for the community partnership for child protection 18 sites. 19 19. Of the funds appropriated in this section, $185,625 20 is allocated for the department’s minority youth and family 21 projects under the redesign of the child welfare system. 22 20. Of the funds appropriated in this section, $593,298 23 is allocated for funding of the community circle of care 24 collaboration for children and youth in northeast Iowa. 25 21. Of the funds appropriated in this section, at least 26 $73,579 shall be used for the continuation of the child 27 welfare provider training academy, a collaboration between the 28 coalition for family and children’s services in Iowa and the 29 department. 30 22. Of the funds appropriated in this section, $12,500 31 shall be used for the public purpose of continuation of a 32 grant to a child welfare services provider headquartered in a 33 county with a population between 205,000 and 215,000 in the 34 latest certified federal census that provides multiple services 35 -173- SF 505 (3) 86 pf/rj 173/ 195
S.F. 505 including but not limited to a psychiatric medical institution 1 for children, shelter, residential treatment, after school 2 programs, school-based programming, and an Asperger’s syndrome 3 program, to be used for support services for children with 4 autism spectrum disorder and their families. 5 23. Of the funds appropriated in this section, $12,500 6 shall be used for the public purpose of continuing a grant to 7 a hospital-based provider headquartered in a county with a 8 population between 90,000 and 95,000 in the latest certified 9 federal census that provides multiple services including 10 but not limited to diagnostic, therapeutic, and behavioral 11 services to individuals with autism spectrum disorder across 12 one’s lifespan. The grant recipient shall utilize the funds 13 to continue the pilot project to determine the necessary 14 support services for children with autism spectrum disorder and 15 their families to be included in the children’s disabilities 16 services system. The grant recipient shall submit findings and 17 recommendations based upon the results of the pilot project 18 to the individuals specified in this division of this Act for 19 submission of reports by December 31, 2016. 20 24. Of the funds appropriated in this section, $105,936 21 shall be used for continuation of the central Iowa system of 22 care program grant through June 30, 2017. 23 25. Of the funds appropriated in this section, $125,000 24 shall be used for the public purpose of the continuation 25 and expansion of a system of care program grant implemented 26 in Cerro Gordo and Linn counties to utilize a comprehensive 27 and long-term approach for helping children and families by 28 addressing the key areas in a child’s life of childhood basic 29 needs, education and work, family, and community. 30 26. Of the funds appropriated in this section, at least 31 $12,500 shall be used to continue and to expand the foster 32 care respite pilot program in which postsecondary students in 33 social work and other human services-related programs receive 34 experience by assisting family foster care providers with 35 -174- SF 505 (3) 86 pf/rj 174/ 195
S.F. 505 respite and other support. 1 27. Of the funds appropriated in this section, $55,000 2 shall be used for the public purpose of funding community-based 3 services and other supports with a system of care approach 4 for children with a serious emotional disturbance and their 5 families through a nonprofit provider of child welfare services 6 that has been in existence for more than 115 years, is located 7 in a county with a population of more than 200,000 but less 8 than 220,000 according to the latest census information 9 issued by the United States census bureau, is licensed as a 10 psychiatric medical institution for children, and was a system 11 of care grantee prior to July 1, 2016. 12 Sec. 135. ADOPTION SUBSIDY. 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, 2016, and ending June 30, 2017, the following 16 amount, or so much thereof as is necessary, to be used for the 17 purpose designated: 18 For adoption subsidy payments and services: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,499,143 20 2. The department may transfer funds appropriated in 21 this section to the appropriation made in this division of 22 this Act for general administration for costs paid from the 23 appropriation relating to adoption subsidy. 24 3. Federal funds received by the state during the 25 fiscal year beginning July 1, 2016, as the result of the 26 expenditure of state funds during a previous state fiscal 27 year for a service or activity funded under this section are 28 appropriated to the department to be used as additional funding 29 for the services and activities funded under this section. 30 Notwithstanding section 8.33 , moneys received in accordance 31 with this subsection that remain unencumbered or unobligated 32 at the close of the fiscal year shall not revert to any fund 33 but shall remain available for expenditure for the purposes 34 designated until the close of the succeeding fiscal year. 35 -175- SF 505 (3) 86 pf/rj 175/ 195
S.F. 505 Sec. 136. JUVENILE DETENTION HOME FUND. Moneys deposited 1 in the juvenile detention home fund created in section 232.142 2 during the fiscal year beginning July 1, 2016, and ending June 3 30, 2017, are appropriated to the department of human services 4 for the fiscal year beginning July 1, 2016, and ending June 30, 5 2017, for distribution of an amount equal to a percentage of 6 the costs of the establishment, improvement, operation, and 7 maintenance of county or multicounty juvenile detention homes 8 in the fiscal year beginning July 1, 2015. Moneys appropriated 9 for distribution in accordance with this section shall be 10 allocated among eligible detention homes, prorated on the basis 11 of an eligible detention home’s proportion of the costs of all 12 eligible detention homes in the fiscal year beginning July 13 1, 2015. The percentage figure shall be determined by the 14 department based on the amount available for distribution for 15 the fund. Notwithstanding section 232.142, subsection 3 , the 16 financial aid payable by the state under that provision for the 17 fiscal year beginning July 1, 2016, shall be limited to the 18 amount appropriated for the purposes of this section. 19 Sec. 137. FAMILY SUPPORT SUBSIDY PROGRAM. 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, 2016, and ending June 30, 2017, the following 23 amount, or so much thereof as is necessary, to be used for the 24 purpose designated: 25 For the family support subsidy program subject to the 26 enrollment restrictions in section 225C.37, subsection 3 : 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 536,966 28 2. The department shall use at least $320,750 of the moneys 29 appropriated in this section for the family support center 30 component of the comprehensive family support program under 31 section 225C.47 . Not more than $12,500 of the amount allocated 32 in this subsection shall be used for administrative costs. 33 3. If at any time during the fiscal year, the amount of 34 funding available for the family support subsidy program 35 -176- SF 505 (3) 86 pf/rj 176/ 195
S.F. 505 is reduced from the amount initially used to establish the 1 figure for the number of family members for whom a subsidy 2 is to be provided at any one time during the fiscal year, 3 notwithstanding section 225C.38, subsection 2 , the department 4 shall revise the figure as necessary to conform to the amount 5 of funding available. 6 Sec. 138. CONNER DECREE. There is appropriated from the 7 general fund of the state to the department of human services 8 for the fiscal year beginning July 1, 2016, and ending June 30, 9 2017, the following amount, or so much thereof as is necessary, 10 to be used for the purpose designated: 11 For building community capacity through the coordination 12 and provision of training opportunities in accordance with the 13 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 14 Iowa, July 14, 1994): 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,816 16 Sec. 139. MENTAL HEALTH INSTITUTES. 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, 2016, and ending 19 June 30, 2017, the following amounts, or so much thereof as is 20 necessary, to be used for the purposes designated: 21 1. For the state mental health institute at Cherokee for 22 salaries, support, maintenance, and miscellaneous purposes, and 23 for not more than the following full-time equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,772,808 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.20 26 2. For the state mental health institute at Clarinda for 27 salaries, support, maintenance, and miscellaneous purposes, and 28 for not more than the following full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 906,450 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 86.10 31 3. For the state mental health institute at Independence for 32 salaries, support, maintenance, and miscellaneous purposes, and 33 for not more than the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,195,387 35 -177- SF 505 (3) 86 pf/rj 177/ 195
S.F. 505 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 1 Sec. 140. STATE RESOURCE CENTERS. 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, 2016, and ending June 30, 2017, the following 5 amounts, or so much thereof as is necessary, to be used for the 6 purposes designated: 7 a. For the state resource center at Glenwood for salaries, 8 support, maintenance, and miscellaneous purposes: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,012,241 10 b. For the state resource center at Woodward for salaries, 11 support, maintenance, and miscellaneous purposes: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,466,903 13 2. The department may continue to bill for state resource 14 center services utilizing a scope of services approach used for 15 private providers of intermediate care facilities for persons 16 with an intellectual disability services, in a manner which 17 does not shift costs between the medical assistance program, 18 counties, or other sources of funding for the state resource 19 centers. 20 3. The state resource centers may expand the time-limited 21 assessment and respite services during the fiscal year. 22 4. If the department’s administration and the department 23 of management concur with a finding by a state resource 24 center’s superintendent that projected revenues can reasonably 25 be expected to pay the salary and support costs for a new 26 employee position, or that such costs for adding a particular 27 number of new positions for the fiscal year would be less 28 than the overtime costs if new positions would not be added, 29 the superintendent may add the new position or positions. If 30 the vacant positions available to a resource center do not 31 include the position classification desired to be filled, the 32 state resource center’s superintendent may reclassify any 33 vacant position as necessary to fill the desired position. The 34 superintendents of the state resource centers may, by mutual 35 -178- SF 505 (3) 86 pf/rj 178/ 195
S.F. 505 agreement, pool vacant positions and position classifications 1 during the course of the fiscal year in order to assist one 2 another in filling necessary positions. 3 5. If existing capacity limitations are reached in 4 operating units, a waiting list is in effect for a service or 5 a special need for which a payment source or other funding 6 is available for the service or to address the special need, 7 and facilities for the service or to address the special need 8 can be provided within the available payment source or other 9 funding, the superintendent of a state resource center may 10 authorize opening not more than two units or other facilities 11 and begin implementing the service or addressing the special 12 need during fiscal year 2016-2017. 13 Sec. 141. SEXUALLY VIOLENT PREDATORS. 14 1. There is appropriated from the general fund of the 15 state to the department of human services for the fiscal year 16 beginning July 1, 2016, and ending June 30, 2017, the following 17 amount, or so much thereof as is necessary, to be used for the 18 purpose designated: 19 For costs associated with the commitment and treatment of 20 sexually violent predators in the unit located at the state 21 mental health institute at Cherokee, including costs of legal 22 services and other associated costs, including salaries, 23 support, maintenance, and miscellaneous purposes, and for not 24 more than the following full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,946,540 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 132.50 27 2. Unless specifically prohibited by law, if the amount 28 charged provides for recoupment of at least the entire amount 29 of direct and indirect costs, the department of human services 30 may contract with other states to provide care and treatment 31 of persons placed by the other states at the unit for sexually 32 violent predators at Cherokee. The moneys received under 33 such a contract shall be considered to be repayment receipts 34 and used for the purposes of the appropriation made in this 35 -179- SF 505 (3) 86 pf/rj 179/ 195
S.F. 505 section. 1 Sec. 142. FIELD OPERATIONS. There is appropriated from the 2 general fund of the state to the department of human services 3 for the fiscal year beginning July 1, 2016, and ending June 30, 4 2017, the following amount, or so much thereof as is necessary, 5 to be used for the purposes designated: 6 For field operations, including salaries, support, 7 maintenance, and miscellaneous purposes, and for not more than 8 the following full-time equivalent positions: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,460,488 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,837.00 11 1. As a condition of this appropriation, the department 12 shall make every possible effort to fill the entire number of 13 positions authorized by this section and, unless specifically 14 provided otherwise by an applicable collective bargaining 15 agreement, the department is not subject to any approval 16 requirement external to the department to fill a field 17 operations vacancy within the number of full-time equivalent 18 positions authorized by this section. The department shall 19 report on the first of each month to the chairpersons and 20 ranking members of the appropriations committees of the senate 21 and house of representatives, and the persons designated by 22 this Act for submission of reports concerning the status of 23 filling the positions. 24 2. Priority in filling full-time equivalent positions 25 shall be given to those positions related to child protection 26 services and eligibility determination for low-income families. 27 Sec. 143. GENERAL ADMINISTRATION. There is appropriated 28 from the general fund of the state to the department of human 29 services for the fiscal year beginning July 1, 2016, and ending 30 June 30, 2017, the following amount, or so much thereof as is 31 necessary, to be used for the purpose designated: 32 For general administration, including salaries, support, 33 maintenance, and miscellaneous purposes, and for not more than 34 the following full-time equivalent positions: 35 -180- SF 505 (3) 86 pf/rj 180/ 195
S.F. 505 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,580,871 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 309.00 2 1. Of the funds appropriated in this section, $19,272 is 3 allocated for the prevention of disabilities policy council 4 created in section 225B.103, if enacted in this or any other 5 Act. 6 2. The department shall report at least monthly to the 7 legislative services agency concerning the department’s 8 operational and program expenditures. 9 3. Of the funds appropriated in this section, $75,000 shall 10 be used to continue the contract for the provision of a program 11 to provide technical assistance, support, and consultation to 12 providers of habilitation services and home and community-based 13 services waiver services for adults with disabilities under the 14 medical assistance program. 15 4. Of the funds appropriated in this section, $25,000 16 is transferred to the Iowa finance authority to be used 17 for administrative support of the council on homelessness 18 established in section 16.2D and for the council to fulfill its 19 duties in addressing and reducing homelessness in the state. 20 5. Of the funds appropriated in this section, $125,000 21 is allocated to an Iowa food bank association selected by 22 the department for the purchase of food on behalf of an Iowa 23 emergency feeding organization or for the distribution of 24 moneys to the Iowa emergency feeding organization for the 25 purchase of food. The moneys allocated in this subsection 26 shall be allocated only to the extent that the allocated moneys 27 are matched on a dollar-for-dollar basis. Notwithstanding 28 section 8.33, moneys 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 for expenditure for 31 the purposes designated until the close of the following fiscal 32 year. 33 6. Of the funds appropriated in this section, $125,000 shall 34 be transferred to and deposited in the administrative fund of 35 -181- SF 505 (3) 86 pf/rj 181/ 195
S.F. 505 the Iowa ABLE savings plan trust created in section 12I.4, if 1 enacted in this or any other Act, to be used for implementation 2 and administration activities of the Iowa ABLE savings plan 3 trust. 4 Sec. 144. VOLUNTEERS. There is appropriated from the 5 general fund of the state to the department of human services 6 for the fiscal year beginning July 1, 2016, and ending June 30, 7 2017, the following amount, or so much thereof as is necessary, 8 to be used for the purpose designated: 9 For development and coordination of volunteer services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,343 11 Sec. 145. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 12 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 13 DEPARTMENT OF HUMAN SERVICES. 14 1. a. (1) For the fiscal year beginning July 1, 2016, 15 the total state funding amount for the nursing facility budget 16 shall not exceed $160,950,003. 17 (2) The department, in cooperation with nursing facility 18 representatives, shall review projections for state funding 19 expenditures for reimbursement of nursing facilities on a 20 quarterly basis and the department shall determine if an 21 adjustment to the medical assistance reimbursement rate is 22 necessary in order to provide reimbursement within the state 23 funding amount for the fiscal year. Notwithstanding 2001 24 Iowa Acts, chapter 192, section 4, subsection 2, paragraph 25 “c”, and subsection 3, paragraph “a”, subparagraph (2), 26 if the state funding expenditures for the nursing facility 27 budget for the fiscal year are projected to exceed the amount 28 specified in subparagraph (1), the department shall adjust 29 the reimbursement for nursing facilities reimbursed under the 30 case-mix reimbursement system to maintain expenditures of the 31 nursing facility budget within the specified amount for the 32 fiscal year. 33 (3) For the fiscal year beginning July 1, 2016, special 34 population nursing facilities shall be reimbursed in accordance 35 -182- SF 505 (3) 86 pf/rj 182/ 195
S.F. 505 with the methodology in effect on June 30, 2016. 1 (4) For any open or unsettled nursing facility cost report 2 for a fiscal year prior to and including the fiscal year 3 beginning July 1, 2015, including any cost report remanded on 4 judicial review for inclusion of prescription drug, laboratory, 5 or x-ray costs, the department shall offset all reported 6 prescription drug, laboratory, and x-ray costs with any revenue 7 received from Medicare or other revenue source for any purpose. 8 For purposes of this subparagraph, a nursing facility cost 9 report is not considered open or unsettled if the facility did 10 not initiate an administrative appeal under chapter 17A or if 11 any appeal rights initiated have been exhausted. 12 b. (1) For the fiscal year beginning July 1, 2016, 13 the department shall establish the pharmacy dispensing fee 14 reimbursement at $11.73 per prescription, until a cost of 15 dispensing survey is completed. The actual dispensing fee 16 shall be determined by a cost of dispensing survey performed 17 by the department and required to be completed by all medical 18 assistance program participating pharmacies every two years, 19 adjusted as necessary to maintain expenditures within the 20 amount appropriated to the department for this purpose for the 21 fiscal year. 22 (2) The department shall utilize an average acquisition 23 cost reimbursement methodology for all drugs covered under the 24 medical assistance program in accordance with 2012 Iowa Acts, 25 chapter 1133, section 33. 26 (3) Notwithstanding subparagraph (2), if the centers for 27 Medicare and Medicaid services of the United States department 28 of health and human services (CMS) requires, as a condition 29 of federal Medicaid funding, that the department implement an 30 aggregate federal upper limit (FUL) for drug reimbursement 31 based on the average manufacturer’s price (AMP), the department 32 may utilize a reimbursement methodology for all drugs covered 33 under the Medicaid program based on the national average drug 34 acquisition cost (NADAC) methodology published by CMS, in order 35 -183- SF 505 (3) 86 pf/rj 183/ 195
S.F. 505 to assure compliance with the aggregate FUL, minimize outcomes 1 of drug reimbursements below pharmacy acquisition costs, limit 2 administrative costs, and minimize any change in the aggregate 3 reimbursement for drugs. The department may adopt emergency 4 rules to implement this subparagraph. 5 c. (1) For the fiscal year beginning July 1, 2016, 6 reimbursement rates for outpatient hospital services shall 7 remain at the rates in effect on June 30, 2016, subject 8 to Medicaid program upper payment limit rules and adjusted 9 as necessary to maintain expenditures within the amount 10 appropriated to the department for this purpose for the fiscal 11 year. 12 (2) For the fiscal year beginning July 1, 2016, 13 reimbursement rates for inpatient hospital services shall 14 remain at the rates in effect on June 30, 2016, subject 15 to Medicaid program upper payment limit rules and adjusted 16 as necessary to maintain expenditures within the amount 17 appropriated to the department for this purpose for the fiscal 18 year. 19 (3) For the fiscal year beginning July 1, 2016, the graduate 20 medical education and disproportionate share hospital fund 21 shall remain at the amount in effect on June 30, 2016, except 22 that the portion of the fund attributable to graduate medical 23 education shall be reduced in an amount that reflects the 24 elimination of graduate medical education payments made to 25 out-of-state hospitals. 26 (4) In order to ensure the efficient use of limited state 27 funds in procuring health care services for low-income Iowans, 28 funds appropriated in this Act for hospital services shall 29 not be used for activities which would be excluded from a 30 determination of reasonable costs under the federal Medicare 31 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 32 d. For the fiscal year beginning July 1, 2016, reimbursement 33 rates for rural health clinics, hospices, and acute mental 34 hospitals shall be increased in accordance with increases under 35 -184- SF 505 (3) 86 pf/rj 184/ 195
S.F. 505 the federal Medicare program or as supported by their Medicare 1 audited costs. 2 e. For the fiscal year beginning July 1, 2016, independent 3 laboratories and rehabilitation agencies shall be reimbursed 4 using the same methodology in effect on June 30, 2016. 5 f. (1) For the fiscal year beginning July 1, 2016, 6 reimbursement rates for home health agencies shall continue to 7 be based on the Medicare low utilization payment adjustment 8 (LUPA) methodology with state geographic wage adjustments, and 9 updated to reflect the most recent Medicare LUPA rates. 10 (2) For the fiscal year beginning July 1, 2016, rates for 11 private duty nursing and personal care services under the early 12 and periodic screening, diagnostic, and treatment program 13 benefit shall be calculated based on the methodology in effect 14 on June 30, 2016. 15 g. For the fiscal year beginning July 1, 2016, federally 16 qualified health centers shall receive cost-based reimbursement 17 for 100 percent of the reasonable costs for the provision of 18 services to recipients of medical assistance. 19 h. For the fiscal year beginning July 1, 2016, the 20 reimbursement rates for dental services shall remain at the 21 rates in effect on June 30, 2016. 22 i. (1) For the fiscal year beginning July 1, 2016, 23 state-owned psychiatric medical institutions for children shall 24 receive cost-based reimbursement for 100 percent of the actual 25 and allowable costs for the provision of services to recipients 26 of medical assistance. 27 (2) For the nonstate-owned psychiatric medical institutions 28 for children, reimbursement rates shall be based on the 29 reimbursement methodology developed by the department as 30 required for federal compliance. 31 (3) As a condition of participation in the medical 32 assistance program, enrolled providers shall accept the medical 33 assistance reimbursement rate for any covered goods or services 34 provided to recipients of medical assistance who are children 35 -185- SF 505 (3) 86 pf/rj 185/ 195
S.F. 505 under the custody of a psychiatric medical institution for 1 children. 2 j. For the fiscal year beginning July 1, 2016, unless 3 otherwise specified in this Act, all noninstitutional medical 4 assistance provider reimbursement rates shall remain at the 5 rates in effect on June 30, 2016, except for area education 6 agencies, local education agencies, infant and toddler 7 services providers, home and community-based services providers 8 including consumer-directed attendant care providers under a 9 section 1915(c) or 1915(i) waiver, targeted case management 10 providers, and those providers whose rates are required to be 11 determined pursuant to section 249A.20 . 12 k. Notwithstanding any provision to the contrary, for the 13 fiscal year beginning July 1, 2016, the reimbursement rate for 14 anesthesiologists shall remain at the rate in effect on June 15 30, 2016. 16 l. Notwithstanding section 249A.20, for the fiscal year 17 beginning July 1, 2016, the average reimbursement rate for 18 health care providers eligible for use of the federal Medicare 19 resource-based relative value scale reimbursement methodology 20 under section 249A.20 shall remain at the rate in effect on 21 June 30, 2016; however, this rate shall not exceed the maximum 22 level authorized by the federal government. 23 m. For the fiscal year beginning July 1, 2016, the 24 reimbursement rate for residential care facilities shall not 25 be less than the minimum payment level as established by the 26 federal government to meet the federally mandated maintenance 27 of effort requirement. The flat reimbursement rate for 28 facilities electing not to file annual cost reports shall not 29 be less than the minimum payment level as established by the 30 federal government to meet the federally mandated maintenance 31 of effort requirement. 32 n. For the fiscal year beginning July 1, 2016, the 33 reimbursement rates for inpatient mental health services 34 provided at hospitals shall remain at the rates in effect on 35 -186- SF 505 (3) 86 pf/rj 186/ 195
S.F. 505 June 30, 2016, subject to Medicaid program upper payment limit 1 rules; and psychiatrists shall be reimbursed at the medical 2 assistance program fee-for-service rate in effect on June 30, 3 2016. 4 o. For the fiscal year beginning July 1, 2016, community 5 mental health centers may choose to be reimbursed for the 6 services provided to recipients of medical assistance through 7 either of the following options: 8 (1) For 100 percent of the reasonable costs of the services. 9 (2) In accordance with the alternative reimbursement rate 10 methodology established by the medical assistance program’s 11 managed care contractor for mental health services and approved 12 by the department of human services. 13 p. For the fiscal year beginning July 1, 2016, the 14 reimbursement rate for providers of family planning services 15 that are eligible to receive a 90 percent federal match shall 16 remain at the rates in effect on June 30, 2016. 17 q. For the fiscal year beginning July 1, 2016, the upper 18 limits on reimbursement rates for providers of home and 19 community-based services waiver services shall remain at the 20 limits in effect on June 30, 2016. 21 r. For the fiscal year beginning July 1, 2016, the 22 reimbursement rates for emergency medical service providers 23 shall remain at the rates in effect on June 30, 2016. 24 s. For the fiscal year beginning July 1, 2016, reimbursement 25 rates for substance-related disorder treatment programs 26 licensed under section 125.13 shall remain at the rates in 27 effect on June 30, 2016. 28 2. For the fiscal year beginning July 1, 2016, 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 -187- SF 505 (3) 86 pf/rj 187/ 195
S.F. 505 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, 2016, the foster 5 family basic daily maintenance rate and the maximum adoption 6 subsidy rate for children ages 0 through 5 years shall be 7 $16.78, the rate for children ages 6 through 11 years shall be 8 $17.45, the rate for children ages 12 through 15 years shall 9 be $19.10, and the rate for children and young adults ages 16 10 and older shall be $19.35. For youth ages 18 to 21 who have 11 exited foster care, the preparation for adult living program 12 maintenance rate shall be $602.70 per month. The maximum 13 payment for adoption subsidy nonrecurring expenses shall be 14 limited to $500 and the disallowance of additional amounts 15 for court costs and other related legal expenses implemented 16 pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall 17 be continued. 18 5. For the fiscal year beginning July 1, 2016, the maximum 19 reimbursement rates for social services providers under 20 contract shall remain at the rates in effect on June 30, 2016, 21 or the provider’s actual and allowable cost plus inflation for 22 each service, whichever is less. However, if a new service 23 or service provider is added after June 30, 2016, the initial 24 reimbursement rate for the service or provider shall be based 25 upon a weighted average of provider rates for similar services. 26 6. For the fiscal year beginning July 1, 2016, the 27 reimbursement rates for resource family recruitment and 28 retention contractors, child welfare emergency services 29 contractors, and supervised apartment living foster care 30 providers shall remain at the rates in effect on June 30, 2016. 31 7. For the fiscal year beginning July 1, 2016, the 32 reimbursement rate for safety plan services and family safety, 33 risk, and permanency services (family-centered) shall be as 34 follows: 35 -188- SF 505 (3) 86 pf/rj 188/ 195
S.F. 505 a. The statewide base monthly payment amount for all 1 family safety, risk, and permanency services (family-centered) 2 contractors shall be the rate in effect on June 30, 2016. 3 (1) Family safety, risk, and permanency services 4 Performance Measure 1 payments shall be the rate in effect on 5 June 30, 2016. 6 (2) Family safety, risk, and permanency services 7 Performance Measure 2 payments shall be the rate in effect on 8 June 30, 2016. 9 (3) Family safety, risk, and permanency services 10 Performance Measure 3 payments shall be the rate in effect on 11 June 30, 2016. 12 (4) Family safety, risk, and permanency services 13 Performance Measure 4 payments shall be the rate in effect on 14 June 30, 2016. 15 b. The maximum reimbursement unit rate for safety plan 16 services shall be the rate in effect on June 30, 2016. 17 (1) Safety plan services Performance Measure 1 payments 18 shall be the rate in effect on June 30, 2016. 19 (2) Safety plan services Performance Measure 2 payments 20 shall be the rate in effect on June 30, 2016. 21 8. a. For the purposes of this subsection, “combined 22 reimbursement rate” means the combined service and maintenance 23 reimbursement rate for a service level under the department’s 24 reimbursement methodology. Effective July 1, 2016, the 25 combined reimbursement rate for a group foster care service 26 level shall be the amount designated in this subsection. 27 However, if a group foster care provider’s reimbursement rate 28 for a service level as of June 30, 2016, is more than the rate 29 designated in this subsection, the provider’s reimbursement 30 shall remain at the higher rate. 31 b. Unless a group foster care provider is subject to the 32 exception provided in paragraph “a”, effective July 1, 2016, 33 the combined reimbursement rates for the service levels under 34 the department’s reimbursement methodology shall be as follows: 35 -189- SF 505 (3) 86 pf/rj 189/ 195
S.F. 505 (1) For service level, community - D1, the daily rate shall 1 be at least $84.17. 2 (2) For service level, comprehensive - D2, the daily rate 3 shall be at least $119.09. 4 (3) For service level, enhanced - D3, the daily rate shall 5 be at least $131.09. 6 9. The group foster care reimbursement rates paid for 7 placement of children out of state shall be calculated 8 according to the same rate-setting principles as those used for 9 in-state providers, unless the director of human services or 10 the director’s designee determines that appropriate care cannot 11 be provided within the state. The payment of the daily rate 12 shall be based on the number of days in the calendar month in 13 which service is provided. 14 10. a. For the fiscal year beginning July 1, 2016, the 15 reimbursement rate paid for shelter care and the child welfare 16 emergency services implemented to provide or prevent the need 17 for shelter care shall be established by contract. 18 b. For the fiscal year beginning July 1, 2016, the combined 19 service and maintenance components of the reimbursement rate 20 paid for shelter care services shall be based on the financial 21 and statistical report submitted to the department. The 22 maximum reimbursement rate shall be $101.83 per day. The 23 department shall reimburse a shelter care provider at the 24 provider’s actual and allowable unit cost, plus inflation, not 25 to exceed the maximum reimbursement rate. 26 c. Notwithstanding section 232.141, subsection 8 , for the 27 fiscal year beginning July 1, 2016, the amount of the statewide 28 average of the actual and allowable rates for reimbursement of 29 juvenile shelter care homes that is utilized for the limitation 30 on recovery of unpaid costs shall remain at the amount in 31 effect for this purpose in the fiscal year beginning July 1, 32 2015. 33 11. For the fiscal year beginning July 1, 2016, the 34 department shall calculate reimbursement rates for intermediate 35 -190- SF 505 (3) 86 pf/rj 190/ 195
S.F. 505 care facilities for persons with an intellectual disability 1 at the 80th percentile. Beginning July 1, 2016, the rate 2 calculation methodology shall utilize the consumer price index 3 inflation factor applicable to the fiscal year beginning July 4 1, 2016. 5 12. For the fiscal year beginning July 1, 2016, for child 6 care providers reimbursed under the state child care assistance 7 program, the department shall set provider reimbursement 8 rates based on the rate reimbursement survey completed in 9 December 2004. Effective July 1, 2016, the child care provider 10 reimbursement rates shall remain at the rates in effect on June 11 30, 2016. The department shall set rates in a manner so as 12 to provide incentives for a nonregistered provider to become 13 registered by applying the increase only to registered and 14 licensed providers. 15 13. For the fiscal year beginning July 1, 2016, if the 16 centers for Medicare and Medicaid services of the United 17 States department of health and human services approves the 18 waivers necessary to implement medical assistance program 19 managed care applicable to any providers or services subject to 20 reimbursement under this section, notwithstanding any provision 21 to the contrary under this section, affected providers or 22 services shall instead be reimbursed as follows: 23 a. For fee-for-service claims, reimbursement rates shall 24 be calculated based on the methodology otherwise specified in 25 this section for the fiscal year beginning July 1, 2016, for 26 the respective provider or service. 27 b. For claims subject to a managed care contract, 28 reimbursement shall be based on the actuarially sound 29 capitation rates established under the contract. However, 30 any reimbursement established under such contract shall not 31 be lower than the reimbursement otherwise specified in this 32 section for the fiscal year beginning July 1, 2016, for the 33 respective provider or service. 34 14. The department may adopt emergency rules to implement 35 -191- SF 505 (3) 86 pf/rj 191/ 195
S.F. 505 this section. 1 Sec. 146. EMERGENCY RULES. 2 1. If specifically authorized by a provision of this 3 division of this Act, the department of human services or 4 the mental health and disability services commission may 5 adopt administrative rules under section 17A.4, subsection 6 3, and section 17A.5, subsection 2, paragraph “b”, to 7 implement the provisions of this division of this Act and 8 the rules shall become effective immediately upon filing or 9 on a later effective date specified in the rules, unless the 10 effective date of the rules is delayed or the applicability 11 of the rules is suspended by the administrative rules review 12 committee. Any rules adopted in accordance with this section 13 shall not take effect before the rules are reviewed by the 14 administrative rules review committee. The delay authority 15 provided to the administrative rules review committee under 16 section 17A.4, subsection 7, and section 17A.8, subsection 9, 17 shall be applicable to a delay imposed under this section, 18 notwithstanding a provision in those sections making them 19 inapplicable to section 17A.5, subsection 2, paragraph “b”. 20 Any rules adopted in accordance with the provisions of this 21 section shall also be published as a notice of intended action 22 as provided in section 17A.4. 23 2. If during a fiscal year, the department of human 24 services is adopting rules in accordance with this section 25 or as otherwise directed or authorized by state law, and the 26 rules will result in an expenditure increase beyond the amount 27 anticipated in the budget process or if the expenditure was 28 not addressed in the budget process for the fiscal year, the 29 department shall notify the persons designated by this division 30 of this Act for submission of reports, the chairpersons and 31 ranking members of the committees on appropriations, and 32 the department of management concerning the rules and the 33 expenditure increase. The notification shall be provided at 34 least 30 calendar days prior to the date notice of the rules 35 -192- SF 505 (3) 86 pf/rj 192/ 195
S.F. 505 is submitted to the administrative rules coordinator and the 1 administrative code editor. 2 Sec. 147. REPORTS. Any reports or other information 3 required to be compiled and submitted under this Act during the 4 fiscal year beginning July 1, 2016, shall be submitted to the 5 chairpersons and ranking members of the joint appropriations 6 subcommittee on health and human services, the legislative 7 services agency, and the legislative caucus staffs on or 8 before the dates specified for submission of the reports or 9 information. 10 Sec. 148. EFFECTIVE UPON ENACTMENT. The following 11 provisions of this division of this Act, being deemed of 12 immediate importance, take effect upon enactment: 13 1. The provision relating to section 232.141 and directing 14 the state court administrator and the division administrator of 15 the department of human services division of child and family 16 services to make the determination, by June 15, 2016, of the 17 distribution of funds allocated for the payment of the expenses 18 of court-ordered services provided to juveniles which are a 19 charge upon the state. 20 DIVISION XXXVIII 21 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2016-2017 22 Sec. 149. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 23 appropriated from the pharmaceutical settlement account created 24 in section 249A.33 to the department of human services for the 25 fiscal year beginning July 1, 2016, and ending June 30, 2017, 26 the following amount, or so much thereof as is necessary, to be 27 used for the purpose designated: 28 Notwithstanding any provision of law to the contrary, to 29 supplement the appropriations made in this Act for medical 30 contracts under the medical assistance program for the fiscal 31 year beginning July 1, 2016, and ending June 30, 2017: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250,000 33 Sec. 150. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 34 HUMAN SERVICES. Notwithstanding any provision to the contrary 35 -193- SF 505 (3) 86 pf/rj 193/ 195
S.F. 505 and subject to the availability of funds, there is appropriated 1 from the quality assurance trust fund created in section 2 249L.4 to the department of human services for the fiscal year 3 beginning July 1, 2016, and ending June 30, 2017, the following 4 amounts, or so much thereof as is necessary, for the purposes 5 designated: 6 To supplement the appropriation made in this Act from the 7 general fund of the state to the department of human services 8 for medical assistance for the same fiscal year: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,352,604 10 Sec. 151. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 11 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 12 the contrary and subject to the availability of funds, there is 13 appropriated from the hospital health care access trust fund 14 created in section 249M.4 to the department of human services 15 for the fiscal year beginning July 1, 2016, and ending June 16 30, 2017, the following amounts, or so much thereof as is 17 necessary, 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 for the same fiscal year: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,350,000 22 Sec. 152. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 23 FOR FY 2016-2017. Notwithstanding section 8.33 , if moneys 24 appropriated for purposes of the medical assistance program for 25 the fiscal year beginning July 1, 2016, and ending June 30, 26 2017, from the general fund of the state, the quality assurance 27 trust fund and the hospital health care access trust fund, are 28 in excess of actual expenditures for the medical assistance 29 program and remain unencumbered or unobligated at the close 30 of the fiscal year, the excess moneys shall not revert but 31 shall remain available for expenditure for the purposes of the 32 medical assistance program until the close of the succeeding 33 fiscal year. 34 DIVISION XXXIX 35 -194- SF 505 (3) 86 pf/rj 194/ 195
S.F. 505 PROPERTY TAX RELIEF FUND —— BLOCK GRANT MONEYS —— MENTAL HEALTH 1 INSTITUTES 2 Sec. 153. MENTAL HEALTH INSTITUTES. The moneys transferred 3 to the property tax relief fund for the fiscal year beginning 4 July 1, 2016, from the federal social services block grant 5 pursuant to 2015 Iowa Acts, House File 630, if enacted, and 6 from the federal temporary assistance for needy families block 7 grant, totaling at least $11,774,275, are appropriated to the 8 department of human services for the fiscal year beginning July 9 1, 2016, and ending June 30, 2017, to be used for the purposes 10 designated: 11 1. For the state mental health institute at Clarinda for 12 salaries, support, maintenance, and miscellaneous purposes: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,418,254 14 2. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,468,884 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 97.68 20 DIVISION XXXX 21 PERSONNEL SETTLEMENT AGREEMENT PAYMENTS 22 Sec. 154. PERSONNEL SETTLEMENT AGREEMENT PAYMENTS. As a 23 condition of the appropriations in this 2016 Act, the moneys 24 appropriated and any other moneys available shall not be used 25 for payment of a personnel settlement agreement that contains a 26 confidentiality provision intended to prevent public disclosure 27 of the agreement or any terms of the agreement. 28 -195- SF 505 (3) 86 pf/rj 195/ 195