Senate File 2418 - Reprinted SENATE FILE 2418 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO SSB 3222) (As Amended and Passed by the Senate May 4, 2018 ) A BILL FOR An Act relating to appropriations for health and human 1 services and veterans and including other related provisions 2 and appropriations, providing penalties, and including 3 effective date and retroactive and other applicability date 4 provisions. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 SF 2418 (2) 87 pf/rn/jh

S.F. 2418 DIVISION I 1 DEPARTMENT ON AGING —— FY 2018-2019 2 Section 1. 2017 Iowa Acts, chapter 174, section 40, 3 unnumbered paragraphs 1 and 2, are amended to read as follows: 4 There is appropriated from the general fund of the state 5 to the department on aging for the fiscal year beginning July 6 1, 2018, and ending June 30, 2019, the following amount, or 7 so much thereof as is necessary, to be used for the purposes 8 designated: 9 For aging programs for the department on aging and area 10 agencies on aging to provide citizens of Iowa who are 60 years 11 of age and older with case management for frail elders, Iowa’s 12 aging and disabilities resource center, and other services 13 which may include but are not limited to adult day services, 14 respite care, chore services, information and assistance, 15 and material aid, for information and options counseling for 16 persons with disabilities who are 18 years of age or older, 17 and for salaries, support, administration, maintenance, and 18 miscellaneous purposes, and for not more than the following 19 full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,521,238 21 11,042,924 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 23 Sec. 2. 2017 Iowa Acts, chapter 174, section 40, subsections 24 2, 4, 5, 6, and 7, are amended to read as follows: 25 2. Of the funds appropriated in this section, $139,973 26 $279,946 is transferred to the economic development authority 27 for the Iowa commission on volunteer services to be used for 28 the retired and senior volunteer program. 29 4. Of the funds appropriated in this section, at least 30 $125,000 shall be used to fund the unmet needs identified 31 through Iowa’s aging and disability resource center network. 32 5. Of the funds appropriated in this section, at 33 least $300,000 $600,000 shall be used to fund home and 34 community-based services through the area agencies on aging 35 -1- SF 2418 (2) 87 pf/rn/jh 1/ 112

S.F. 2418 that enable older individuals to avoid more costly utilization 1 of residential or institutional services and remain in their 2 own homes. 3 6. Of the funds appropriated in this section, $406,268 4 $812,537 shall be used for the purposes of chapter 231E and 5 section 231.56A , of which $175,000 shall be used for the office 6 of substitute decision maker pursuant to chapter 231E , and the 7 remainder shall be distributed equally to the area agencies on 8 aging to administer the prevention of elder abuse, neglect, and 9 exploitation program pursuant to section 231.56A , in accordance 10 with the requirements of the federal Older Americans Act of 11 1965, 42 U.S.C. §3001 et seq., as amended. 12 7. Of the funds appropriated in this section, $375,000 13 $1,000,000 shall be used to fund continuation of the aging 14 and disability resource center lifelong links to provide 15 individuals and caregivers with information and services to 16 plan for and maintain independence. 17 Sec. 3. 2017 Iowa Acts, chapter 174, section 40, subsection 18 8, is amended by striking the subsection. 19 Sec. 4. 2017 Iowa Acts, chapter 174, section 40, is amended 20 by adding the following new subsection: 21 NEW SUBSECTION . 9. Of the funds appropriated in this 22 section, $100,000 shall be used by the department on aging, 23 in collaboration with the department of human services and 24 affected stakeholders, to design a pilot initiative to provide 25 long-term care options counseling utilizing support planning 26 protocols, to assist non-Medicaid eligible consumers who 27 indicate a preference to return to the community and are 28 deemed appropriate for discharge, to return to their community 29 following a nursing facility stay. The department on aging 30 shall submit the design plan as well as recommendations for 31 legislation necessary to administer the initiative, including 32 but not limited to legislation to allow the exchange of contact 33 information for nursing facility residents appropriate for 34 discharge planning, to the governor and the general assembly by 35 -2- SF 2418 (2) 87 pf/rn/jh 2/ 112

S.F. 2418 December 15, 2018. 1 DIVISION II 2 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2018-2019 3 Sec. 5. 2017 Iowa Acts, chapter 174, section 41, is amended 4 to read as follows: 5 SEC. 41. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 6 appropriated from the general fund of the state to the office 7 of long-term care ombudsman for the fiscal year beginning July 8 1, 2018, and ending June 30, 2019, the following amount, or 9 so much thereof as is necessary, to be used for the purposes 10 designated: 11 For salaries, support, administration, maintenance, and 12 miscellaneous purposes, and for not more than the following 13 full-time equivalent positions: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 580,140 15 1,149,821 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 17 DIVISION III 18 DEPARTMENT OF PUBLIC HEALTH —— FY 2018-2019 19 Sec. 6. 2017 Iowa Acts, chapter 174, section 42, subsections 20 1, 2, 3, 4, 5, 6, 7, and 8, are amended to read as follows: 21 1. ADDICTIVE DISORDERS 22 For reducing the prevalence of the use of tobacco, alcohol, 23 and other drugs, and treating individuals affected by addictive 24 behaviors, including gambling, and for not more than the 25 following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,492,915 27 24,804,344 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 29 11.00 30 a. (1) Of the funds appropriated in this subsection, 31 $2,010,612 $4,021,225 shall be used for the tobacco use 32 prevention and control initiative, including efforts at the 33 state and local levels, as provided in chapter 142A . The 34 commission on tobacco use prevention and control established 35 -3- SF 2418 (2) 87 pf/rn/jh 3/ 112

S.F. 2418 pursuant to section 142A.3 shall advise the director of 1 public health in prioritizing funding needs and the allocation 2 of moneys appropriated for the programs and initiatives. 3 Activities of the programs and initiatives shall be in 4 alignment with the United States centers for disease control 5 and prevention best practices for comprehensive tobacco control 6 programs that include the goals of preventing youth initiation 7 of tobacco usage, reducing exposure to secondhand smoke, 8 and promotion of tobacco cessation. To maximize resources, 9 the department shall determine if third-party sources are 10 available to instead provide nicotine replacement products 11 to an applicant prior to provision of such products to an 12 applicant under the initiative. The department shall track and 13 report to the individuals specified in this Act, any reduction 14 in the provision of nicotine replacement products realized 15 by the initiative through implementation of the prerequisite 16 screening. 17 (2) (a) The department shall collaborate with the 18 alcoholic beverages division of the department of commerce for 19 enforcement of tobacco laws, regulations, and ordinances and to 20 engage in tobacco control activities approved by the division 21 of tobacco use prevention and control of the department of 22 public health as specified in the memorandum of understanding 23 entered into between the divisions. 24 (b) For the fiscal year beginning July 1, 2018, and ending 25 June 30, 2019, the terms of the memorandum of understanding, 26 entered into between the division of tobacco use prevention 27 and control of the department of public health and the 28 alcoholic beverages division of the department of commerce, 29 governing compliance checks conducted to ensure licensed retail 30 tobacco outlet conformity with tobacco laws, regulations, and 31 ordinances relating to persons under 18 years of age, shall 32 continue to restrict the number of such checks to one check per 33 retail outlet, and one additional check for any retail outlet 34 found to be in violation during the first check. 35 -4- SF 2418 (2) 87 pf/rn/jh 4/ 112

S.F. 2418 b. Of the funds appropriated in this subsection, 1 $10,482,303 $20,783,119 shall be used for problem gambling and 2 substance-related disorder prevention, treatment, and recovery 3 services, including a 24-hour helpline, public information 4 resources, professional training, youth prevention, and program 5 evaluation. 6 c. The requirement of section 123.17, subsection 5 , is met 7 by the appropriations and allocations made in this division of 8 this Act for purposes of substance-related disorder treatment 9 and addictive disorders for the fiscal year beginning July 1, 10 2018. 11 d. The department of public health, in collaboration with 12 the department of human services, shall engage a stakeholder 13 workgroup to review reimbursement provisions applicable 14 to substance use disorder services providers. The issues 15 considered by the workgroup shall include but are not limited 16 to the adequacy of reimbursement provisions including for 17 both outpatient and residential treatment, whether it is 18 appropriate to rebase reimbursement, whether there is equity in 19 reimbursement compared to the reimbursement methodologies used 20 for providers of similar behavioral health services, and access 21 to substance use disorder services providers including whether 22 the designated number of community mental health centers in the 23 state is sufficient. The workgroup shall review the reports 24 of previous workgroups including those authorized in 2014 Iowa 25 Acts, chapter 1140, section 3, subsection 1, and shall report 26 the workgroup’s findings and recommendations to the general 27 assembly on or before December 15, 2018. 28 2. HEALTHY CHILDREN AND FAMILIES 29 For promoting the optimum health status for children, 30 adolescents from birth through 21 years of age, and families, 31 and for not more than the following full-time equivalent 32 positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,662,816 34 5,820,625 35 -5- SF 2418 (2) 87 pf/rn/jh 5/ 112

S.F. 2418 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 13.00 1 a. Of the funds appropriated in this subsection, not 2 more than $367,420 $734,841 shall be used for the healthy 3 opportunities for parents to experience success (HOPES)-healthy 4 families Iowa (HFI) program established pursuant to section 5 135.106 . The funding shall be distributed to renew the grants 6 that were provided to the grantees that operated the program 7 during the fiscal year ending June 30, 2018. 8 b. In order to implement the legislative intent stated in 9 sections 135.106 and 256I.9 , that priority for home visitation 10 program funding be given to programs using evidence-based or 11 promising models for home visitation, it is the intent of the 12 general assembly to phase in the funding priority in accordance 13 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, 14 paragraph “0b” . 15 c. Of the funds appropriated in this subsection, $1,537,550 16 $3,075,101 shall be used for continuation of the department’s 17 initiative to provide for adequate developmental surveillance 18 and screening during a child’s first five years. The funds 19 shall be used first to fully fund the current sites to ensure 20 that the sites are fully operational, with the remaining 21 funds to be used for expansion to additional sites. The full 22 implementation and expansion shall include enhancing the scope 23 of the initiative through collaboration with the child health 24 specialty clinics to promote healthy child development through 25 early identification and response to both biomedical and social 26 determinants of healthy development; by monitoring child 27 health metrics to inform practice, document long-term health 28 impacts and savings, and provide for continuous improvement 29 through training, education, and evaluation; and by providing 30 for practitioner consultation particularly for children with 31 behavioral conditions and needs. The department of public 32 health shall also collaborate with the Iowa Medicaid enterprise 33 and the child health specialty clinics to integrate the 34 activities of the first five initiative into the establishment 35 -6- SF 2418 (2) 87 pf/rn/jh 6/ 112

S.F. 2418 of patient-centered medical homes, community utilities, 1 accountable care organizations, and other integrated care 2 models developed to improve health quality and population 3 health while reducing health care costs. To the maximum extent 4 possible, funding allocated in this paragraph shall be utilized 5 as matching funds for medical assistance program reimbursement. 6 d. Of the funds appropriated in this subsection, $32,320 7 $64,640 shall be distributed to a statewide dental carrier to 8 provide funds to continue the donated dental services program 9 patterned after the projects developed by the lifeline network 10 to provide dental services to indigent individuals who are 11 elderly or with disabilities. 12 e. Of the funds appropriated in this subsection, $78,241 13 $156,482 shall be used to provide audiological services and 14 hearing aids for children. The department may enter into a 15 contract to administer this paragraph. 16 f. Of the funds appropriated in this subsection, $11,500 17 $23,000 is transferred to the university of Iowa college of 18 dentistry for provision of primary dental services to children. 19 State funds shall be matched on a dollar-for-dollar basis. 20 The university of Iowa college of dentistry shall coordinate 21 efforts with the department of public health, bureau of 22 oral and health delivery systems, to provide dental care to 23 underserved populations throughout the state. 24 g. Of the funds appropriated in this subsection, $25,000 25 $50,000 shall be used to address youth suicide prevention. 26 h. Of the funds appropriated in this subsection, $20,255 27 $40,511 shall be used to support the Iowa effort to address the 28 survey of children who experience adverse childhood experiences 29 known as ACEs. 30 i. The department of public health shall continue to 31 administer the program to assist parents in this state with 32 costs resulting from the death of a child in accordance with 33 the provisions of 2014 Iowa Acts, chapter 1140, section 22, 34 subsection 12 . 35 -7- SF 2418 (2) 87 pf/rn/jh 7/ 112

S.F. 2418 j. Of the funds appropriated in this subsection, up to 1 $494,993 shall be used for childhood obesity prevention. 2 3. CHRONIC CONDITIONS 3 For serving individuals identified as having chronic 4 conditions or special health care needs, and for not more than 5 the following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,085,375 7 4,528,109 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 9 9.00 10 a. Of the funds appropriated in this subsection, $76,877 11 $153,755 shall be used for grants to individual patients who 12 have an inherited metabolic disorder to assist with the costs 13 of medically necessary foods and formula. 14 b. Of the funds appropriated in this subsection, $510,397 15 $1,055,291 shall be used for the brain injury services program 16 pursuant to section 135.22B , including for contracting with an 17 existing nationally affiliated and statewide organization whose 18 purpose is to educate, serve, and support Iowans with brain 19 injury and their families for resource facilitator services 20 in accordance with section 135.22B, subsection 9 , and for 21 contracting to enhance brain injury training and recruitment 22 of service providers on a statewide basis. Of the amount 23 allocated in this paragraph, $47,500 $95,000 shall be used to 24 fund one full-time equivalent position to serve as the state 25 brain injury services program manager. 26 c. Of the funds appropriated in this subsection, $72,048 27 $144,097 shall be used for the public purpose of continuing 28 to contract with an existing national-affiliated organization 29 to provide education, client-centered programs, and client 30 and family support for people living with epilepsy and their 31 families. The amount allocated in this paragraph in excess 32 of $50,000 $100,000 shall be matched dollar-for-dollar by the 33 organization specified. 34 d. Of the funds appropriated in this subsection, $404,775 35 -8- SF 2418 (2) 87 pf/rn/jh 8/ 112

S.F. 2418 $809,550 shall be used for child health specialty clinics. 1 e. Of the funds appropriated in this subsection, 2 $192,276 $384,552 shall be used by the regional autism 3 assistance program established pursuant to section 256.35 , 4 and administered by the child health specialty clinic located 5 at the university of Iowa hospitals and clinics. The funds 6 shall be used to enhance interagency collaboration and 7 coordination of educational, medical, and other human services 8 for persons with autism, their families, and providers of 9 services, including delivering regionalized services of care 10 coordination, family navigation, and integration of services 11 through the statewide system of regional child health specialty 12 clinics and fulfilling other requirements as specified in 13 chapter 225D . The university of Iowa shall not receive funds 14 allocated under this paragraph for indirect costs associated 15 with the regional autism assistance program. 16 f. Of the funds appropriated in this subsection, $288,687 17 $577,375 shall be used for the comprehensive cancer control 18 program to reduce the burden of cancer in Iowa through 19 prevention, early detection, effective treatment, and ensuring 20 quality of life. Of the funds allocated in this paragraph “f”, 21 $75,000 $150,000 shall be used to support a melanoma research 22 symposium, a melanoma biorepository and registry, basic and 23 translational melanoma research, and clinical trials. 24 g. Of the funds appropriated in this subsection, $48,766 25 $97,532 shall be used for cervical and colon cancer screening, 26 and $88,860 $177,720 shall be used to enhance the capacity of 27 the cervical cancer screening program to include provision 28 of recommended prevention and early detection measures to a 29 broader range of low-income women. 30 h. Of the funds appropriated in this subsection, $253,177 31 $506,355 shall be used for the center for congenital and 32 inherited disorders. 33 i. Of the funds appropriated in this subsection, $107,631 34 $225,263 shall be used by the department of public health 35 -9- SF 2418 (2) 87 pf/rn/jh 9/ 112

S.F. 2418 for reform-related activities, including but not limited to 1 facilitation of communication to stakeholders at the state and 2 local level, administering the patient-centered health advisory 3 council pursuant to section 135.159 , and involvement in health 4 care system innovation activities occurring across the state. 5 j. Of the funds appropriated in this subsection, $11,050 6 $322,100 shall be used for administration of chapter 124D 124E , 7 the medical cannabidiol Act. 8 4. COMMUNITY CAPACITY 9 For strengthening the health care delivery system at the 10 local level, and for not more than the following full-time 11 equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,453,888 13 4,970,152 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 15 a. Of the funds appropriated in this subsection, $47,787 16 $95,575 is allocated for continuation of the child vision 17 screening program implemented through the university of Iowa 18 hospitals and clinics in collaboration with early childhood 19 Iowa areas. The program shall submit a report to the 20 individuals identified in this Act for submission of reports 21 regarding the use of funds allocated under this paragraph 22 “a”. The report shall include the objectives and results for 23 the program year including the target population and how the 24 funds allocated assisted the program in meeting the objectives; 25 the number, age, and location within the state of individuals 26 served; the type of services provided to the individuals 27 served; the distribution of funds based on service provided; 28 and the continuing needs of the program. 29 b. Of the funds appropriated in this subsection, $52,828 is 30 allocated for continuation of an initiative implemented at the 31 university of Iowa to expand and improve the workforce engaged 32 in mental health treatment and services. The initiative shall 33 receive input from the university of Iowa, the department of 34 human services, the department of public health, and the mental 35 -10- SF 2418 (2) 87 pf/rn/jh 10/ 112

S.F. 2418 health and disability services commission to address the focus 1 of the initiative. 2 c. Of the funds appropriated in this section, $41,657 shall 3 be deposited in the governmental public health system fund 4 created in section 135A.8 to be used for the purposes of the 5 fund. 6 d. Of the funds appropriated in this subsection, $24,034 7 $48,069 shall be used for a grant to a statewide association 8 of psychologists that is affiliated with the American 9 psychological association to be used for continuation of a 10 program to rotate intern psychologists in placements in urban 11 and rural mental health professional shortage areas, as defined 12 in section 135.180 . 13 e. Of the funds appropriated in this subsection, the 14 following amounts are allocated to be used as follows to 15 support the Iowa collaborative safety net provider network 16 goals of increased access, health system integration, and 17 engagement. 18 (1) Not less than $260,931 $542,829 is allocated to the 19 Iowa prescription drug corporation for continuation of the 20 pharmaceutical infrastructure for safety net providers as 21 described in 2007 Iowa Acts, chapter 218, section 108 , and for 22 the prescription drug donation repository program created in 23 chapter 135M . 24 (2) Not less than $167,435 $334,870 is allocated to free 25 clinics and free clinics of Iowa for necessary infrastructure, 26 statewide coordination, provider recruitment, service delivery, 27 and provision of assistance to patients in securing a medical 28 home inclusive of oral health care. 29 (3) Not less than $12,500 $25,000 is allocated to the 30 Iowa association of rural health clinics for necessary 31 infrastructure and service delivery transformation. 32 (4) Not less than $50,000 $205,493 is allocated to the 33 Polk county medical society for continuation of the safety net 34 provider patient access to a specialty health care initiative 35 -11- SF 2418 (2) 87 pf/rn/jh 11/ 112

S.F. 2418 as described in 2007 Iowa Acts, chapter 218, section 109 . 1 f. Of the funds appropriated in this subsection, $38,115 2 $15,000 shall be used by the department in implementing 3 the recommendations in the final report submitted by the 4 direct care worker advisory council to the governor and the 5 general assembly in March 2012, including by continuing to 6 develop, promote, and make available on a statewide basis the 7 prepare-to-care core curriculum and its associated modules 8 and specialties through various formats including online 9 access, community colleges, and other venues; exploring new and 10 maintaining existing specialties including but not limited to 11 oral health and dementia care; supporting instructor training; 12 and assessing and making recommendations concerning the Iowa 13 care book and information technology systems and infrastructure 14 uses and needs. 15 g. Of the funds appropriated in this subsection, $95,594 16 $176,188 shall be allocated for continuation of the contract 17 with an independent statewide direct care worker organization 18 previously selected through a request for proposals process. 19 The contract shall continue to include performance and outcomes 20 measures, and shall continue to allow the contractor to use a 21 portion of the funds received under the contract to collect 22 data to determine results based on the performance and outcomes 23 measures. 24 h. Of the funds appropriated in this subsection, the 25 department may use up to $29,087 $58,175 for up to one 26 full-time equivalent position to administer the volunteer 27 health care provider program pursuant to section 135.24 . 28 i. Of the funds appropriated in this subsection, $48,069 29 $96,138 shall be used for a matching dental education loan 30 repayment program to be allocated to a dental nonprofit health 31 service corporation to continue to develop the criteria and 32 implement the loan repayment program. 33 j. Of the funds appropriated in this subsection, $26,455 is 34 transferred to the college student aid commission for deposit 35 -12- SF 2418 (2) 87 pf/rn/jh 12/ 112

S.F. 2418 in the rural Iowa primary care trust fund created in section 1 261.113 to be used for the purposes of the fund. 2 k. Of the funds appropriated in this subsection, $75,000 3 $100,000 shall be used for the purposes of the Iowa donor 4 registry as specified in section 142C.18 . 5 l. Of the funds appropriated in this subsection, $48,069 6 $96,138 shall be used for continuation of a grant to a 7 nationally affiliated volunteer eye organization that has an 8 established program for children and adults and that is solely 9 dedicated to preserving sight and preventing blindness through 10 education, nationally certified vision screening and training, 11 and community and patient service programs. The organization 12 shall submit a report to the individuals identified in this 13 Act for submission of reports regarding the use of funds 14 allocated under this paragraph “l”. The report shall include 15 the objectives and results for the program year including 16 the target population and how the funds allocated assisted 17 the program in meeting the objectives; the number, age, and 18 location within the state of individuals served; the type of 19 services provided to the individuals served; the distribution 20 of funds based on services provided; and the continuing needs 21 of the program. 22 m. Of the funds appropriated in this subsection, $436,327 23 $2,000,000 shall be deposited in the medical residency training 24 account created in section 135.175, subsection 5 , paragraph 25 “a”, and is appropriated from the account to the department 26 of public health to be used for the purposes of the medical 27 residency training state matching grants program as specified 28 in section 135.176 . 29 n. Of the funds appropriated in this subsection, $250,000 30 shall be used for the public purpose of providing funding to 31 Des Moines university to establish a provider education project 32 to provide primary care physicians with the training and skills 33 necessary to recognize signs of mental illness in patients. 34 5. ESSENTIAL PUBLIC HEALTH SERVICES 35 -13- SF 2418 (2) 87 pf/rn/jh 13/ 112

S.F. 2418 To provide public health services that reduce risks and 1 invest in promoting and protecting good health over the 2 course of a lifetime with a priority given to older Iowans and 3 vulnerable populations: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,098,939 5 7,662,464 6 6. INFECTIOUS DISEASES 7 For reducing the incidence and prevalence of communicable 8 diseases, and for not more than the following full-time 9 equivalent positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 823,213 11 1,796,426 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 13 7. PUBLIC PROTECTION 14 For protecting the health and safety of the public through 15 establishing standards and enforcing regulations, and for not 16 more than the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,097,569 18 4,095,139 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 138.00 20 141.00 21 a. Of the funds appropriated in this subsection, not more 22 than $152,350 $304,700 shall be credited to the emergency 23 medical services fund created in section 135.25 . Moneys in 24 the emergency medical services fund are appropriated to the 25 department to be used for the purposes of the fund. 26 b. Of the funds appropriated in this subsection, up 27 to $121,630 $243,260 shall be used for sexual violence 28 prevention programming through a statewide organization 29 representing programs serving victims of sexual violence 30 through the department’s sexual violence prevention program, 31 and for continuation of a training program for sexual assault 32 response team (SART) members, including representatives of 33 law enforcement, victim advocates, prosecutors, and certified 34 medical personnel. The amount allocated in this paragraph “b” 35 -14- SF 2418 (2) 87 pf/rn/jh 14/ 112

S.F. 2418 shall not be used to supplant funding administered for other 1 sexual violence prevention or victims assistance programs. 2 c. Of the funds appropriated in this subsection, up to 3 $287,813 $500,000 shall be used for the state poison control 4 center. Pursuant to the directive under 2014 Iowa Acts, 5 chapter 1140, section 102 , the federal matching funds available 6 to the state poison control center from the department of human 7 services under the federal Children’s Health Insurance Program 8 Reauthorization Act allotment shall be subject to the federal 9 administrative cap rule of 10 percent applicable to funding 10 provided under Tit. XXI of the federal Social Security Act and 11 included within the department’s calculations of the cap. 12 d. Of the funds appropriated in this subsection, up to 13 $258,491 $504,796 shall be used for childhood lead poisoning 14 provisions. 15 8. RESOURCE MANAGEMENT 16 For establishing and sustaining the overall ability of the 17 department to deliver services to the public, and for not more 18 than the following full-time equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 485,607 20 971,215 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 22 Sec. 7. 2017 Iowa Acts, chapter 174, section 42, subsections 23 10 and 11, are amended by striking the subsections. 24 DIVISION IV 25 DEPARTMENT OF VETERANS AFFAIRS —— FY 2018-2019 26 Sec. 8. 2017 Iowa Acts, chapter 174, section 43, is amended 27 to read as follows: 28 SEC. 43. DEPARTMENT OF VETERANS AFFAIRS. There is 29 appropriated from the general fund of the state to the 30 department of veterans affairs for the fiscal year beginning 31 July 1, 2018, and ending June 30, 2019, the following amounts, 32 or so much thereof as is necessary, to be used for the purposes 33 designated: 34 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 35 -15- SF 2418 (2) 87 pf/rn/jh 15/ 112

S.F. 2418 For salaries, support, maintenance, and miscellaneous 1 purposes, and for not more than the following full-time 2 equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 571,278 4 1,150,500 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 6 2. IOWA VETERANS HOME 7 For salaries, support, maintenance, and miscellaneous 8 purposes: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,614,070 10 7,162,976 11 a. The Iowa veterans home billings involving the department 12 of human services shall be submitted to the department on at 13 least a monthly basis. 14 b. Within available resources and in conformance with 15 associated state and federal program eligibility requirements, 16 the Iowa veterans home may implement measures to provide 17 financial assistance to or on behalf of veterans or their 18 spouses who are participating in the community reentry program. 19 d. The Iowa veterans home shall continue to include in the 20 annual discharge report applicant information and to provide 21 for the collection of demographic information including but not 22 limited to the number of individuals applying for admission and 23 admitted or denied admittance and the basis for the admission 24 or denial; the age, gender, and race of such individuals; 25 and the level of care for which such individuals applied for 26 admission including residential or nursing level of care. 27 3. HOME OWNERSHIP ASSISTANCE PROGRAM 28 For transfer to the Iowa finance authority for the 29 continuation of the home ownership assistance program for 30 persons who are or were eligible members of the armed forces of 31 the United States, pursuant to section 16.54 : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 33 2,000,000 34 Sec. 9. 2017 Iowa Acts, chapter 174, section 44, is amended 35 -16- SF 2418 (2) 87 pf/rn/jh 16/ 112

S.F. 2418 to read as follows: 1 SEC. 44. LIMITATION OF COUNTY COMMISSIONS OF VETERAN 2 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 3 standing appropriation in section 35A.16 for the fiscal year 4 beginning July 1, 2018, and ending June 30, 2019, the amount 5 appropriated from the general fund of the state pursuant to 6 that section for the following designated purposes shall not 7 exceed the following amount: 8 For the county commissions of veteran affairs fund under 9 section 35A.16 : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 473,962 11 990,000 12 DIVISION V 13 DEPARTMENT OF HUMAN SERVICES —— FY 2018-2019 14 Sec. 10. 2017 Iowa Acts, chapter 174, section 45, is amended 15 to read as follows: 16 SEC. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 17 GRANT. There is appropriated from the fund created in section 18 8.41 to the department of human services for the fiscal year 19 beginning July 1, 2018, and ending June 30, 2019, from moneys 20 received under the federal temporary assistance for needy 21 families (TANF) block grant pursuant to the federal Personal 22 Responsibility and Work Opportunity Reconciliation Act of 1996, 23 Pub. L. No. 104-193, and successor legislation, the following 24 amounts, or so much thereof as is necessary, to be used for the 25 purposes designated: 26 1. To be credited to the family investment program account 27 and used for assistance under the family investment program 28 under chapter 239B : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,556,231 30 4,539,006 31 2. To be credited to the family investment program account 32 and used for the job opportunities and basic skills (JOBS) 33 program and implementing family investment agreements in 34 accordance with chapter 239B : 35 -17- SF 2418 (2) 87 pf/rn/jh 17/ 112