House File 766 - Reprinted HOUSE FILE 766 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO HSB 253) (As Amended and Passed by the House April 11, 2019 ) 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 HF 766 (3) 88 pf/rn/md
H.F. 766 DIVISION I 1 DEPARTMENT ON AGING —— FY 2019-2020 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, 2019, and ending June 30, 5 2020, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,191,441 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 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, $279,000 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- HF 766 (3) 88 pf/rn/md 1/ 92
H.F. 766 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 prepayment for goods or services not 10 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 $600,000 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 5. Of the funds appropriated in this section, $812,000 shall 28 be used for the purposes of chapter 231E and to administer 29 the prevention of elder abuse, neglect, and exploitation 30 program pursuant to section 231.56A , in accordance with the 31 requirements of the federal Older Americans Act of 1965, 42 32 U.S.C. §3001 et seq., as amended. 33 6. Of the funds appropriated in this section, $1,000,000 34 shall be used to fund continuation of the aging and disability 35 -2- HF 766 (3) 88 pf/rn/md 2/ 92
H.F. 766 resource center lifelong links to provide individuals and 1 caregivers with information and services to plan for and 2 maintain independence. 3 7. Of the funds appropriated in this section, $250,000 4 shall be used by the department on aging, in collaboration with 5 the department of human services and affected stakeholders, to 6 expand the pilot initiative to provide long-term care options 7 counseling utilizing support planning protocols, to assist 8 non-Medicaid eligible consumers who indicate a preference 9 to return to the community and are deemed appropriate for 10 discharge, to return to their community following a nursing 11 facility stay. The department on aging shall submit a report 12 regarding the outcomes of the pilot initiative to the governor 13 and the general assembly by December 15, 2019. 14 DIVISION II 15 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2019-2020 16 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 17 appropriated from the general fund of the state to the office 18 of long-term care ombudsman for the fiscal year beginning July 19 1, 2019, and ending June 30, 2020, the following amount, or 20 so much thereof as is necessary, to be used for the purposes 21 designated: 22 For salaries, support, administration, maintenance, and 23 miscellaneous purposes, and for not more than the following 24 full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 27 DIVISION III 28 DEPARTMENT OF PUBLIC HEALTH —— FY 2019-2020 29 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 30 from the general fund of the state to the department of public 31 health for the fiscal year beginning July 1, 2019, and ending 32 June 30, 2020, the following amounts, or so much thereof as is 33 necessary, to be used for the purposes designated: 34 1. ADDICTIVE DISORDERS 35 -3- HF 766 (3) 88 pf/rn/md 3/ 92
H.F. 766 For reducing the prevalence of the use of tobacco, alcohol, 1 and other drugs, and treating individuals affected by addictive 2 behaviors, including gambling, and for not more than the 3 following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,110,000 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 11.00 6 a. (1) Of the funds appropriated in this subsection, 7 $4,021,000 shall be used for the tobacco use prevention 8 and control initiative, including efforts at the state and 9 local levels, as provided in chapter 142A . The commission 10 on tobacco use prevention and control established pursuant 11 to section 142A.3 shall advise the director of public health 12 in prioritizing funding needs and the allocation of moneys 13 appropriated for the programs and initiatives. Activities 14 of the programs and initiatives shall be in alignment with 15 the United States centers for disease control and prevention 16 best practices for comprehensive tobacco control programs that 17 include the goals of preventing youth initiation of tobacco 18 usage, reducing exposure to secondhand smoke, and promotion 19 of tobacco cessation. To maximize resources, the department 20 shall determine if third-party sources are available to 21 instead provide nicotine replacement products to an applicant 22 prior to provision of such products to an applicant under 23 the initiative. The department shall track and report to 24 the individuals specified in this Act, any reduction in 25 the provision of nicotine replacement products realized by 26 the initiative through implementation of the prerequisite 27 screening. 28 (2) (a) The department shall collaborate with the 29 alcoholic beverages division of the department of commerce for 30 enforcement of tobacco laws, regulations, and ordinances and to 31 engage in tobacco control activities approved by the division 32 of tobacco use prevention and control of the department of 33 public health as specified in the memorandum of understanding 34 entered into between the divisions. 35 -4- HF 766 (3) 88 pf/rn/md 4/ 92
H.F. 766 (b) For the fiscal year beginning July 1, 2019, and ending 1 June 30, 2020, the terms of the memorandum of understanding, 2 entered into between the division of tobacco use prevention 3 and control of the department of public health and the 4 alcoholic beverages division of the department of commerce, 5 governing compliance checks conducted to ensure licensed retail 6 tobacco outlet conformity with tobacco laws, regulations, and 7 ordinances relating to persons under 18 years of age, shall 8 continue to restrict the number of such checks to one check per 9 retail outlet, and one additional check for any retail outlet 10 found to be in violation during the first check. 11 b. (1) Of the funds appropriated in this subsection, 12 $21,089,000 shall be used for problem gambling and 13 substance-related disorder prevention, treatment, and recovery 14 services, including a 24-hour helpline, public information 15 resources, professional training, youth prevention, and program 16 evaluation. 17 (2) Of the amount allocated under this paragraph, $306,000 18 shall be utilized by the department of public health, in 19 collaboration with the department of human services, to support 20 establishment and maintenance of a single statewide 24-hour 21 crisis hotline for the Iowa children’s behavioral health system 22 that incorporates warmline services which may be provided 23 through expansion of existing capabilities maintained by the 24 department of public health as required pursuant to 2018 Iowa 25 Acts, chapter 1056, section 16. 26 c. The requirement of section 123.17, subsection 5 , is met 27 by the appropriations and allocations made in this division of 28 this Act for purposes of substance-related disorder treatment 29 and addictive disorders for the fiscal year beginning July 1, 30 2019. 31 2. HEALTHY CHILDREN AND FAMILIES 32 For promoting the optimum health status for children and 33 adolescents from birth through 21 years of age, and families, 34 and for not more than the following full-time equivalent 35 -5- HF 766 (3) 88 pf/rn/md 5/ 92
H.F. 766 positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,817,057 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 3 a. Of the funds appropriated in this subsection, not more 4 than $734,000 shall be used for the healthy opportunities for 5 parents to experience success (HOPES)-healthy families Iowa 6 (HFI) program established pursuant to section 135.106. The 7 funding shall be distributed to renew the grants that were 8 provided to the grantees that operated the program during the 9 fiscal year ending June 30, 2018. However, the department 10 shall issue a request for proposals and distribute grants to 11 the grantees selected to operate the program no later than 12 January 1, 2020. The department shall not retain any portion 13 of the allocation under this paragraph for administrative 14 costs. 15 b. In order to implement the legislative intent stated 16 in sections 135.106 and 256I.9 , priority for home visitation 17 program funding shall be given to programs using evidence-based 18 or promising models for home visitation. 19 c. Of the funds appropriated in this subsection, $3,075,000 20 shall be used for continuation of the department’s initiative 21 to provide for adequate developmental surveillance and 22 screening during a child’s first five years. The funds shall 23 be used first to fully fund the current sites to ensure that 24 the sites are fully operational, with the remaining funds 25 to be used for expansion to additional sites. The full 26 implementation and expansion shall include enhancing the scope 27 of the initiative through collaboration with the child health 28 specialty clinics to promote healthy child development through 29 early identification and response to both biomedical and social 30 determinants of healthy development; by monitoring child 31 health metrics to inform practice, document long-term health 32 impacts and savings, and provide for continuous improvement 33 through training, education, and evaluation; and by providing 34 for practitioner consultation particularly for children with 35 -6- HF 766 (3) 88 pf/rn/md 6/ 92
H.F. 766 behavioral conditions and needs. The department of public 1 health shall also collaborate with the Iowa Medicaid enterprise 2 and the child health specialty clinics to integrate the 3 activities of the first five initiative into the establishment 4 of patient-centered medical homes, community utilities, 5 accountable care organizations, and other integrated care 6 models developed to improve health quality and population 7 health while reducing health care costs. To the maximum extent 8 possible, funding allocated in this paragraph shall be utilized 9 as matching funds for medical assistance program reimbursement. 10 d. Of the funds appropriated in this subsection, $64,000 11 shall be distributed to a statewide dental carrier to provide 12 funds to continue the donated dental services program patterned 13 after the projects developed by the lifeline network to provide 14 dental services to indigent individuals who are elderly or with 15 disabilities. 16 e. Of the funds appropriated in this subsection, $156,000 17 shall be used to provide audiological services and hearing aids 18 for children. 19 f. Of the funds appropriated in this subsection, $23,000 is 20 transferred to the university of Iowa college of dentistry for 21 provision of primary dental services to children. State funds 22 shall be matched on a dollar-for-dollar basis. The university 23 of Iowa college of dentistry shall coordinate efforts with the 24 department of public health, oral and health delivery system 25 bureau, to provide dental care to underserved populations 26 throughout the state. 27 g. Of the funds appropriated in this subsection, $50,000 28 shall be used to address youth suicide prevention. 29 h. Of the funds appropriated in this subsection, $40,000 30 shall be used to support the Iowa effort to address the survey 31 of children who experience adverse childhood experiences known 32 as ACEs. 33 i. Of the funds appropriated in this subsection, up to 34 $494,000 shall be used for childhood obesity prevention. 35 -7- HF 766 (3) 88 pf/rn/md 7/ 92
H.F. 766 3. CHRONIC CONDITIONS 1 For serving individuals identified as having chronic 2 conditions or special health care needs, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,223,519 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 9.00 6 a. Of the funds appropriated in this subsection, $153,000 7 shall be used for grants to individual patients who have an 8 inherited metabolic disorder to assist with the costs of 9 medically necessary foods and formula. 10 b. Of the funds appropriated in this subsection, $1,055,000 11 shall be used for the brain injury services program pursuant 12 to section 135.22B, including for contracting with an existing 13 nationally affiliated and statewide organization whose purpose 14 is to educate, serve, and support Iowans with brain injury and 15 their families, for resource facilitator services in accordance 16 with section 135.22B, subsection 9, and for contracting to 17 enhance brain injury training and recruitment of service 18 providers on a statewide basis. Of the amount allocated in 19 this paragraph, $95,000 shall be used to fund one full-time 20 equivalent position to serve as the state brain injury services 21 program manager. 22 c. Of the funds appropriated in this subsection, $144,000 23 shall be used for the public purpose of continuing to contract 24 with an existing national-affiliated organization to provide 25 education, client-centered programs, and client and family 26 support for people living with epilepsy and their families. 27 The amount allocated in this paragraph shall be matched 28 dollar-for-dollar by the organization specified. 29 d. Of the funds appropriated in this subsection, $809,000 30 shall be used for child health specialty clinics. 31 e. Of the funds appropriated in this subsection, $384,000 32 shall be used by the regional autism assistance program 33 established pursuant to section 256.35 , and administered by 34 the child health specialty clinic located at the university of 35 -8- HF 766 (3) 88 pf/rn/md 8/ 92
H.F. 766 Iowa hospitals and clinics. The funds shall be used to enhance 1 interagency collaboration and coordination of educational, 2 medical, and other human services for persons with autism, 3 their families, and providers of services, including delivering 4 regionalized services of care coordination, family navigation, 5 and integration of services through the statewide system of 6 regional child health specialty clinics and fulfilling other 7 requirements as specified in chapter 225D . The university of 8 Iowa shall not receive funds allocated under this paragraph for 9 indirect costs associated with the regional autism assistance 10 program. 11 f. Of the funds appropriated in this subsection, $577,000 12 shall be used for the comprehensive cancer control program to 13 reduce the burden of cancer in Iowa through prevention, early 14 detection, effective treatment, and ensuring quality of life. 15 Of the funds allocated in this paragraph “f”, $150,000 shall 16 be used to support a melanoma research symposium, a melanoma 17 biorepository and registry, basic and translational melanoma 18 research, and clinical trials. 19 g. Of the funds appropriated in this subsection, $97,000 20 shall be used for cervical and colon cancer screening, and 21 $177,000 shall be used to enhance the capacity of the cervical 22 cancer screening program to include provision of recommended 23 prevention and early detection measures to a broader range of 24 low-income women. 25 h. Of the funds appropriated in this subsection, $506,000 26 shall be used for the center for congenital and inherited 27 disorders. 28 4. COMMUNITY CAPACITY 29 For strengthening the health care delivery system at the 30 local level, and for not more than the following full-time 31 equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,516,677 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 34 a. Of the funds appropriated in this subsection, $95,000 35 -9- HF 766 (3) 88 pf/rn/md 9/ 92
H.F. 766 is allocated for continuation of the child vision screening 1 program implemented through the university of Iowa hospitals 2 and clinics in collaboration with early childhood Iowa areas. 3 The program shall submit a report to the department regarding 4 the use of funds allocated under this paragraph “a”. The 5 report shall include the objectives and results for the 6 program year including the target population and how the funds 7 allocated assisted the program in meeting the objectives; the 8 number, age, and location within the state of individuals 9 served; the type of services provided to the individuals 10 served; the distribution of funds based on service provided; 11 and the continuing needs of the program. 12 b. Of the funds appropriated in this subsection, 13 $48,000 shall be used for a grant to a statewide association 14 of psychologists, that is affiliated with the American 15 psychological association, to be used for continuation of a 16 program to rotate intern psychologists in placements in urban 17 and rural mental health professional shortage areas. For the 18 purposes of this paragraph “b”, “mental health professional 19 shortage area” means a geographic area in this state that has 20 been designated by the United States department of health and 21 human services, health resources and services administration, 22 bureau of health professionals, as having a shortage of mental 23 health professionals. 24 c. Of the funds appropriated in this subsection, the 25 following amounts are allocated to be used as follows 26 to support the goals of increased access, health system 27 integration, and engagement: 28 (1) Not less than $542,000 is allocated to the Iowa 29 prescription drug corporation for continuation of the 30 pharmaceutical infrastructure for safety net providers as 31 described in 2007 Iowa Acts, chapter 218, section 108, and for 32 the prescription drug donation repository program created in 33 chapter 135M. 34 (2) (a) Not less than $334,000 is allocated to free 35 -10- HF 766 (3) 88 pf/rn/md 10/ 92
H.F. 766 clinics and free clinics of Iowa for necessary infrastructure, 1 statewide coordination, provider recruitment, service delivery, 2 and provision of assistance to patients in securing a medical 3 home inclusive of oral health care. However, the department 4 shall issue a request for proposals and execute a contract 5 with the contractor selected, to perform the activities under 6 this subparagraph division no later than January 1, 2020. The 7 department shall not retain any portion of the allocation under 8 this subparagraph division for administrative costs. 9 (b) Not less than $25,000 is allocated to the Iowa 10 association of rural health clinics for necessary 11 infrastructure and service delivery transformation. However, 12 the department shall issue a request for proposals and 13 execute a contract with the contractor selected to perform 14 the activities under this subparagraph division no later 15 than January 1, 2020. The department shall not retain any 16 portion of the allocation under this subparagraph division for 17 administrative costs. 18 (c) Not less than $205,000 is allocated to the Polk county 19 medical society for continuation of the safety net provider 20 patient access to specialty health care initiative as described 21 in 2007 Iowa Acts, chapter 218, section 109. However, the 22 department shall issue a request for proposals and execute a 23 contract with the contractor selected to operate the initiative 24 under this subparagraph division no later than January 1, 2020. 25 The department shall not retain any portion of the allocation 26 under this subparagraph division for administrative costs. 27 (3) The department may combine the allocations and 28 activities specified in subparagraph (2) for the purposes of 29 issuing a request for proposals. 30 d. Of the funds appropriated in this subsection, $191,000 31 is allocated for the purposes of health care and public health 32 workforce initiatives. 33 e. Of the funds appropriated in this subsection, $96,000 34 shall be used for a matching dental education loan repayment 35 -11- HF 766 (3) 88 pf/rn/md 11/ 92
H.F. 766 program to be allocated to a dental nonprofit health service 1 corporation to continue to develop the criteria and implement 2 the loan repayment program. 3 f. Of the funds appropriated in this subsection, $100,000 4 shall be used for the purposes of the Iowa donor registry as 5 specified in section 142C.18 . 6 g. Of the funds appropriated in this subsection, $96,000 7 shall be used for continuation of a grant to a nationally 8 affiliated volunteer eye organization that has an established 9 program for children and adults and that is solely dedicated to 10 preserving sight and preventing blindness through education, 11 nationally certified vision screening and training, and 12 community and patient service programs. The contractor 13 shall submit a report to the individuals identified in this 14 Act for submission of reports regarding the use of funds 15 allocated under this paragraph “g”. The report shall include 16 the objectives and results for the program year including 17 the target population and how the funds allocated assisted 18 the program in meeting the objectives; the number, age, and 19 location within the state of individuals served; the type of 20 services provided to the individuals served; the distribution 21 of funds based on services provided; and the continuing needs 22 of the program. 23 h. Of the funds appropriated in this subsection, $2,000,000 24 shall be deposited in the medical residency training account 25 created in section 135.175, subsection 5, paragraph “a”, and 26 is appropriated from the account to the department of public 27 health to be used for the purposes of the medical residency 28 training state matching grants program as specified in section 29 135.176. 30 i. Of the funds appropriated in this subsection, $250,000 31 shall be used for the public purpose of providing funding to 32 Des Moines university to continue a provider education project 33 to provide primary care physicians with the training and skills 34 necessary to recognize the signs of mental illness in patients. 35 -12- HF 766 (3) 88 pf/rn/md 12/ 92
H.F. 766 j. Of the funds appropriated in this subsection, $400,000 1 shall be used for rural psychiatric residencies to support the 2 annual creation and training of four psychiatric residents who 3 will provide mental health services in underserved areas of the 4 state. 5 k. Of the funds appropriated in this subsection, $150,000 6 shall be used for psychiatric training to increase access to 7 mental health care services by expanding the mental health 8 workforce via training of additional physician assistants and 9 nurse practitioners. 10 5. ESSENTIAL PUBLIC HEALTH SERVICES 11 To provide public health services that reduce risks and 12 invest in promoting and protecting good health over the 13 course of a lifetime with a priority given to older Iowans and 14 vulnerable populations: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 16 6. INFECTIOUS DISEASES 17 For reducing the incidence and prevalence of communicable 18 diseases, and for not more than the following full-time 19 equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,426 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 22 7. PUBLIC PROTECTION 23 For protecting the health and safety of the public through 24 establishing standards and enforcing regulations, and for not 25 more than the following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,093,383 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 28 a. Of the funds appropriated in this subsection, not more 29 than $304,000 shall be credited to the emergency medical 30 services fund created in section 135.25 . Moneys in the 31 emergency medical services fund are appropriated to the 32 department to be used for the purposes of the fund. 33 b. Of the funds appropriated in this subsection, up 34 to $243,000 shall be used for sexual violence prevention 35 -13- HF 766 (3) 88 pf/rn/md 13/ 92
H.F. 766 programming through a statewide organization representing 1 programs serving victims of sexual violence through the 2 department’s sexual violence prevention program, and for 3 continuation of a training program for sexual assault 4 response team (SART) members, including representatives of 5 law enforcement, victim advocates, prosecutors, and certified 6 medical personnel. However, the department shall issue 7 a request for proposals and execute a contract with the 8 contractor selected to provide the programming and training 9 as specified in this paragraph no later than January 1, 2020. 10 The amount allocated in this paragraph “b” shall not be used 11 to supplant funding administered for other sexual violence 12 prevention or victims assistance programs. The department 13 shall not retain any portion of the allocation under this 14 paragraph for administrative costs. 15 c. Of the funds appropriated in this subsection, up to 16 $500,000 shall be used for the state poison control center. 17 Pursuant to the directive under 2014 Iowa Acts, chapter 18 1140, section 102 , the federal matching funds available to 19 the state poison control center from the department of human 20 services under the federal Children’s Health Insurance Program 21 Reauthorization Act allotment shall be subject to the federal 22 administrative cap rule of 10 percent applicable to funding 23 provided under Tit. XXI of the federal Social Security Act and 24 included within the department’s calculations of the cap. 25 d. Of the funds appropriated in this subsection, up to 26 $504,000 shall be used for childhood lead poisoning provisions. 27 8. RESOURCE MANAGEMENT 28 For establishing and sustaining the overall ability of the 29 department to deliver services to the public, and for not more 30 than the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 971,215 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 33 9. MISCELLANEOUS PROVISIONS 34 a. The university of Iowa hospitals and clinics under 35 -14- HF 766 (3) 88 pf/rn/md 14/ 92
H.F. 766 the control of the state board of regents shall not receive 1 indirect costs from the funds appropriated in this section. 2 The university of Iowa hospitals and clinics billings to the 3 department shall be on at least a quarterly basis. 4 b. The department of public health shall collaborate 5 with applicable stakeholders to review the allocations, 6 grants, and other distributions of funds appropriated under 7 this division of this Act and shall submit a report to the 8 individuals identified in this Act for submission of reports by 9 December 15, 2019, regarding a proposal for the distribution 10 of funds that more clearly reflects the department’s stated 11 priorities and goals, provides increased flexibility in the 12 distribution of funds to meet these priorities and goals, and 13 ensures stakeholder accountability and a discernable return on 14 investment. 15 Sec. 4. CONTRACTED SERVICES —— PROHIBITED USE OF GENERAL 16 FUND MONEYS FOR LOBBYING. 17 1. The department shall submit a report to the individuals 18 identified in this Act for submission of reports by January 1, 19 2020, regarding the outcomes of any program or activity for 20 which funding is appropriated or allocated from the general 21 fund of the state to the department under this division of 22 this Act, and for which a request for proposals process is 23 specifically required. 24 2. The department shall incorporate into the general 25 conditions applicable to all award documents involving funding 26 appropriated or allocated from the general fund of the state to 27 the department under this division of this Act, a prohibition 28 against the use of such funding for the compensation of a 29 lobbyist. For the purposes of this section, “lobbyist” means 30 the same as defined in section 68B.2; however, “lobbyist” 31 does not include a person employed by a state agency of the 32 executive branch of state government who represents the agency 33 relative to the passage, defeat, approval, or modification of 34 legislation that is being considered by the general assembly. 35 -15- HF 766 (3) 88 pf/rn/md 15/ 92
H.F. 766 DIVISION IV 1 DEPARTMENT OF VETERANS AFFAIRS —— FY 2019-2020 2 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 3 appropriated from the general fund of the state to the 4 department of veterans affairs for the fiscal year beginning 5 July 1, 2019, and ending June 30, 2020, the following amounts, 6 or so much thereof as is necessary, to be used for the purposes 7 designated: 8 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 9 For salaries, support, maintenance, and miscellaneous 10 purposes, and for not more than the following full-time 11 equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,225,500 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 14 2. IOWA VETERANS HOME 15 For salaries, support, maintenance, and miscellaneous 16 purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,162,976 18 a. The Iowa veterans home billings involving the department 19 of human services shall be submitted to the department on at 20 least a monthly basis. 21 b. Within available resources and in conformance with 22 associated state and federal program eligibility requirements, 23 the Iowa veterans home may implement measures to provide 24 financial assistance to or on behalf of veterans or their 25 spouses who are participating in the community reentry program. 26 c. The Iowa veterans home expenditure report shall be 27 submitted monthly to the legislative services agency. 28 d. The Iowa veterans home shall continue to include in the 29 annual discharge report applicant information to provide for 30 the collection of demographic information including but not 31 limited to the number of individuals applying for admission and 32 admitted or denied admittance and the basis for the admission 33 or denial; the age, gender, and race of such individuals; 34 and the level of care for which such individuals applied for 35 -16- HF 766 (3) 88 pf/rn/md 16/ 92
H.F. 766 admission including residential or nursing level of care. 1 3. HOME OWNERSHIP ASSISTANCE PROGRAM 2 For transfer to the Iowa finance authority for the 3 continuation of the home ownership assistance program for 4 persons who are or were eligible members of the armed forces of 5 the United States, pursuant to section 16.54 : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 7 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 8 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 9 appropriation in section 35A.16 for the fiscal year beginning 10 July 1, 2019, and ending June 30, 2020, the amount appropriated 11 from the general fund of the state pursuant to that section 12 for the following designated purposes shall not exceed the 13 following amount: 14 For the county commissions of veteran affairs fund under 15 section 35A.16 : 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 17 DIVISION V 18 DEPARTMENT OF HUMAN SERVICES —— FY 2019-2020 19 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 20 GRANT. There is appropriated from the fund created in section 21 8.41 to the department of human services for the fiscal year 22 beginning July 1, 2019, and ending June 30, 2020, from moneys 23 received under the federal temporary assistance for needy 24 families (TANF) block grant pursuant to the federal Personal 25 Responsibility and Work Opportunity Reconciliation Act of 1996, 26 Pub. L. No. 104-193, and successor legislation, the following 27 amounts, or so much thereof as is necessary, to be used for the 28 purposes designated: 29 1. To be credited to the family investment program account 30 and used for assistance under the family investment program 31 under chapter 239B : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,524,006 33 2. To be credited to the family investment program account 34 and used for the job opportunities and basic skills (JOBS) 35 -17- HF 766 (3) 88 pf/rn/md 17/ 92
H.F. 766 program and implementing family investment agreements in 1 accordance with chapter 239B : 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 3 3. To be used for the family development and 4 self-sufficiency grant program in accordance with section 5 216A.107 : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 7 Notwithstanding section 8.33 , moneys appropriated in this 8 subsection that remain unencumbered or unobligated at the close 9 of the fiscal year shall not revert but shall remain available 10 for expenditure for the purposes designated until the close of 11 the succeeding fiscal year. However, unless such moneys are 12 encumbered or obligated on or before September 30, 2020, the 13 moneys shall revert. 14 4. For field operations: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 16 5. For general administration: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 18 6. For state child care assistance: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 20 a. Of the funds appropriated in this subsection, 21 $26,205,412 is transferred to the child care and development 22 block grant appropriation made by the Eighty-eighth General 23 Assembly, 2019 session, for the federal fiscal year beginning 24 October 1, 2019, and ending September 30, 2020. Of this 25 amount, $200,000 shall be used for provision of educational 26 opportunities to registered child care home providers in order 27 to improve services and programs offered by this category 28 of providers and to increase the number of providers. The 29 department may contract with institutions of higher education 30 or child care resource and referral centers to provide 31 the educational opportunities. Allowable administrative 32 costs under the contracts shall not exceed 5 percent. The 33 application for a grant shall not exceed two pages in length. 34 b. Any funds appropriated in this subsection remaining 35 -18- HF 766 (3) 88 pf/rn/md 18/ 92
H.F. 766 unallocated shall be used for state child care assistance 1 payments for families who are employed including but not 2 limited to individuals enrolled in the family investment 3 program. 4 7. For child and family services: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 6 8. For child abuse prevention grants: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 8 9. For pregnancy prevention grants on the condition that 9 family planning services are funded: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 11 Pregnancy prevention grants shall be awarded to programs 12 in existence on or before July 1, 2019, if the programs have 13 demonstrated positive outcomes. Grants shall be awarded to 14 pregnancy prevention programs which are developed after July 15 1, 2019, if the programs are based on existing models that 16 have demonstrated positive outcomes. Grants shall comply with 17 the requirements provided in 1997 Iowa Acts, chapter 208, 18 section 14, subsections 1 and 2 , including the requirement that 19 grant programs must emphasize sexual abstinence. Priority in 20 the awarding of grants shall be given to programs that serve 21 areas of the state which demonstrate the highest percentage of 22 unplanned pregnancies of females of childbearing age within the 23 geographic area to be served by the grant. 24 10. For technology needs and other resources necessary 25 to meet federal welfare reform reporting, tracking, and case 26 management requirements: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 28 11. a. Notwithstanding any provision to the contrary, 29 including but not limited to requirements in section 8.41 or 30 provisions in 2018 Iowa Acts or 2019 Iowa Acts regarding the 31 receipt and appropriation of federal block grants, federal 32 funds from the temporary assistance for needy families block 33 grant received by the state and not otherwise appropriated 34 in this section and remaining available for the fiscal year 35 -19- HF 766 (3) 88 pf/rn/md 19/ 92
H.F. 766 beginning July 1, 2019, are appropriated to the department of 1 human services to the extent as may be necessary to be used in 2 the following priority order: the family investment program, 3 for state child care assistance program payments for families 4 who are employed, and for the family investment program share 5 of system costs for eligibility determination and related 6 functions. The federal funds appropriated in this paragraph 7 “a” shall be expended only after all other funds appropriated 8 in subsection 1 for assistance under the family investment 9 program, in subsection 6 for state child care assistance, or 10 in subsection 10 for technology costs related to the family 11 investment program, as applicable, have been expended. For 12 the purposes of this subsection, the funds appropriated in 13 subsection 6, paragraph “a”, for transfer to the child care 14 and development block grant appropriation are considered fully 15 expended when the full amount has been transferred. 16 b. The department shall, on a quarterly basis, advise the 17 legislative services agency and department of management of 18 the amount of funds appropriated in this subsection that was 19 expended in the prior quarter. 20 12. Of the amounts appropriated in this section, 21 $12,962,008 for the fiscal year beginning July 1, 2019, is 22 transferred to the appropriation of the federal social services 23 block grant made to the department of human services for that 24 fiscal year. 25 13. For continuation of the program providing categorical 26 eligibility for the food assistance program as specified 27 for the program in the section of this division of this Act 28 relating to the family investment program account: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 30 14. The department may transfer funds allocated in this 31 section to the appropriations made in this division of this Act 32 for the same fiscal year for general administration and field 33 operations for resources necessary to implement and operate the 34 services referred to in this section and those funded in the 35 -20- HF 766 (3) 88 pf/rn/md 20/ 92
H.F. 766 appropriation made in this division of this Act for the same 1 fiscal year for the family investment program from the general 2 fund of the state. 3 15. With the exception of moneys allocated under this 4 section for the family development and self-sufficiency grant 5 program, to the extent moneys allocated in this section are 6 deemed by the department not to be necessary to support the 7 purposes for which they are allocated, such moneys may be 8 used in the same fiscal year for any other purpose for which 9 funds are allocated in this section or in section 8 of this 10 division for the family investment program account. If there 11 are conflicting needs, priority shall first be given to the 12 family investment program account as specified under subsection 13 1 of this section and used for the purposes of assistance under 14 the family investment program in accordance with chapter 239B , 15 followed by state child care assistance program payments for 16 families who are employed, followed by other priorities as 17 specified by the department. 18 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 19 1. Moneys credited to the family investment program (FIP) 20 account for the fiscal year beginning July 1, 2019, and 21 ending June 30, 2020, shall be used to provide assistance in 22 accordance with chapter 239B . 23 2. The department may use a portion of the moneys credited 24 to the FIP account under this section as necessary for 25 salaries, support, maintenance, and miscellaneous purposes. 26 3. The department may transfer funds allocated in 27 subsection 4, excluding the allocation under subsection 4, 28 paragraph “b”, to the appropriations made in this division of 29 this Act for the same fiscal year for general administration 30 and field operations for resources necessary to implement 31 and operate the services referred to in this section and 32 those funded in the appropriations made in section 7 for the 33 temporary assistance for needy families block grant and in 34 section 9 for the family investment program from the general 35 -21- HF 766 (3) 88 pf/rn/md 21/ 92
H.F. 766 fund of the state in this division of this Act for the same 1 fiscal year. 2 4. Moneys appropriated in this division of this Act and 3 credited to the FIP account for the fiscal year beginning July 4 1, 2019, and ending June 30, 2020, are allocated as follows: 5 a. To be retained by the department of human services to 6 be used for coordinating with the department of human rights 7 to more effectively serve participants in FIP and other shared 8 clients and to meet federal reporting requirements under the 9 federal temporary assistance for needy families block grant: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 11 b. To the department of human rights for staffing, 12 administration, and implementation of the family development 13 and self-sufficiency grant program in accordance with section 14 216A.107 : 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 16 (1) Of the funds allocated for the family development 17 and self-sufficiency grant program in this paragraph “b”, 18 not more than 5 percent of the funds shall be used for the 19 administration of the grant program. 20 (2) The department of human rights may continue to implement 21 the family development and self-sufficiency grant program 22 statewide during fiscal year 2019-2020. 23 (3) The department of human rights may engage in activities 24 to strengthen and improve family outcomes measures and 25 data collection systems under the family development and 26 self-sufficiency grant program. 27 c. For the diversion subaccount of the FIP account: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 29 A portion of the moneys allocated for the diversion 30 subaccount may be used for field operations, salaries, data 31 management system development, and implementation costs and 32 support deemed necessary by the director of human services 33 in order to administer the FIP diversion program. To the 34 extent moneys allocated in this paragraph “c” are deemed by the 35 -22- HF 766 (3) 88 pf/rn/md 22/ 92
H.F. 766 department not to be necessary to support diversion activities, 1 such moneys may be used for other efforts intended to increase 2 engagement by family investment program participants in work, 3 education, or training activities, or for the purposes of 4 assistance under the family investment program in accordance 5 with chapter 239B . 6 d. For the food assistance employment and training program: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 8 (1) The department shall apply the federal supplemental 9 nutrition assistance program (SNAP) employment and training 10 state plan in order to maximize to the fullest extent permitted 11 by federal law the use of the 50 percent federal reimbursement 12 provisions for the claiming of allowable federal reimbursement 13 funds from the United States department of agriculture 14 pursuant to the federal SNAP employment and training program 15 for providing education, employment, and training services 16 for eligible food assistance program participants, including 17 but not limited to related dependent care and transportation 18 expenses. 19 (2) The department shall continue the categorical federal 20 food assistance program eligibility at 160 percent of the 21 federal poverty level and continue to eliminate the asset test 22 from eligibility requirements, consistent with federal food 23 assistance program requirements. The department shall include 24 as many food assistance households as is allowed by federal 25 law. The eligibility provisions shall conform to all federal 26 requirements including requirements addressing individuals who 27 are incarcerated or otherwise ineligible. 28 e. For the JOBS program: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 30 5. Of the child support collections assigned under FIP, 31 an amount equal to the federal share of support collections 32 shall be credited to the child support recovery appropriation 33 made in this division of this Act. Of the remainder of the 34 assigned child support collections received by the child 35 -23- HF 766 (3) 88 pf/rn/md 23/ 92
H.F. 766 support recovery unit, a portion shall be credited to the FIP 1 account, a portion may be used to increase recoveries, and a 2 portion may be used to sustain cash flow in the child support 3 payments account. If as a consequence of the appropriations 4 and allocations made in this section the resulting amounts 5 are insufficient to sustain cash assistance payments and meet 6 federal maintenance of effort requirements, the department 7 shall seek supplemental funding. If child support collections 8 assigned under FIP are greater than estimated or are otherwise 9 determined not to be required for maintenance of effort, the 10 state share of either amount may be transferred to or retained 11 in the child support payments account. 12 6. The department may adopt emergency rules for the family 13 investment, JOBS, food assistance, and medical assistance 14 programs if necessary to comply with federal requirements. 15 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 16 is appropriated from the general fund of the state to the 17 department of human services for the fiscal year beginning July 18 1, 2019, and ending June 30, 2020, the following amount, or 19 so much thereof as is necessary, to be used for the purpose 20 designated: 21 To be credited to the family investment program (FIP) 22 account and used for family investment program assistance under 23 chapter 239B : 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,365,037 25 1. Of the funds appropriated in this section, $6,606,198 is 26 allocated for the JOBS program. 27 2. Of the funds appropriated in this section, $3,313,854 is 28 allocated for the family development and self-sufficiency grant 29 program. 30 3. a. Notwithstanding section 8.39 , for the fiscal 31 year beginning July 1, 2019, if necessary to meet federal 32 maintenance of effort requirements or to transfer federal 33 temporary assistance for needy families block grant funding 34 to be used for purposes of the federal social services block 35 -24- HF 766 (3) 88 pf/rn/md 24/ 92
H.F. 766 grant or to meet cash flow needs resulting from delays in 1 receiving federal funding or to implement, in accordance with 2 this division of this Act, activities currently funded with 3 juvenile court services, county, or community moneys and state 4 moneys used in combination with such moneys; to comply with 5 federal requirements; or to maximize the use of federal funds; 6 the department of human services may transfer funds within or 7 between any of the appropriations made in this division of this 8 Act and appropriations in law for the federal social services 9 block grant to the department for the following purposes, 10 provided that the combined amount of state and federal 11 temporary assistance for needy families block grant funding 12 for each appropriation remains the same before and after the 13 transfer: 14 (1) For the family investment program. 15 (2) For state child care assistance. 16 (3) For child and family services. 17 (4) For field operations. 18 (5) For general administration. 19 b. This subsection shall not be construed to prohibit the 20 use of existing state transfer authority for other purposes. 21 The department shall report any transfers made pursuant to this 22 subsection to the legislative services agency. 23 4. Of the funds appropriated in this section, $195,000 shall 24 be used for continuation of a grant to an Iowa-based nonprofit 25 organization with a history of providing tax preparation 26 assistance to low-income Iowans in order to expand the usage 27 of the earned income tax credit. The purpose of the grant is 28 to supply this assistance to underserved areas of the state. 29 However, the department shall issue a request for proposals and 30 execute a contract with the contractor selected to administer 31 the program no later than January 1, 2020. The department 32 shall not retain any portion of the allocation under this 33 subsection for administrative costs. 34 5. Of the funds appropriated in this section, $70,000 shall 35 -25- HF 766 (3) 88 pf/rn/md 25/ 92
H.F. 766 be used for the continuation of the parenting program, as 1 specified in 441 IAC ch. 100, relating to parental obligations, 2 in which the child support recovery unit participates, to 3 support the efforts of a nonprofit organization committed 4 to strengthening the community through youth development, 5 healthy living, and social responsibility headquartered in 6 a county with a population over 350,000 according to the 7 latest certified federal census. The funds allocated in this 8 subsection shall be used by the recipient organization to 9 develop a larger community effort, through public and private 10 partnerships, to support a broad-based multi-county fatherhood 11 parenthood initiative that promotes payment of child support 12 obligations, improved family relationships, and full-time 13 employment. However, the department shall issue a request for 14 proposals and execute a contract with the contractor selected 15 to administer the program no later than January 1, 2020. The 16 department shall not retain any portion of the allocation under 17 this subsection for administrative costs. 18 6. The department may transfer funds appropriated in this 19 section, excluding the allocation in subsection 2 for the 20 family development and self-sufficiency grant program, to the 21 appropriations made in this division of this Act for general 22 administration and field operations as necessary to administer 23 this section, section 7 for the temporary assistance for needy 24 families block grant, and section 8 for the family investment 25 program account. 26 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 27 from the general fund of the state to the department of human 28 services for the fiscal year beginning July 1, 2019, and ending 29 June 30, 2020, the following amount, or so much thereof as is 30 necessary, to be used for the purposes designated: 31 For child support recovery, including salaries, support, 32 maintenance, and miscellaneous purposes, and for not more than 33 the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,749,368 35 -26- HF 766 (3) 88 pf/rn/md 26/ 92
H.F. 766 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 1 1. The department shall expend up to $24,000, including 2 federal financial participation, for the fiscal year beginning 3 July 1, 2019, for a child support public awareness campaign. 4 The department and the office of the attorney general shall 5 cooperate in continuation of the campaign. The public 6 awareness campaign shall emphasize, through a variety of 7 media activities, the importance of maximum involvement of 8 both parents in the lives of their children as well as the 9 importance of payment of child support obligations. 10 2. Federal access and visitation grant moneys shall be 11 issued directly to private not-for-profit agencies that provide 12 services designed to increase compliance with the child access 13 provisions of court orders, including but not limited to 14 neutral visitation sites and mediation services. 15 3. The appropriation made to the department for child 16 support recovery may be used throughout the fiscal year in the 17 manner necessary for purposes of cash flow management, and for 18 cash flow management purposes the department may temporarily 19 draw more than the amount appropriated, provided the amount 20 appropriated is not exceeded at the close of the fiscal year. 21 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 22 FY 2019-2020. Any funds remaining in the health care trust 23 fund created in section 453A.35A for the fiscal year beginning 24 July 1, 2019, and ending June 30, 2020, are appropriated to 25 the department of human services to supplement the medical 26 assistance program appropriations made in this division of this 27 Act, for medical assistance reimbursement and associated costs, 28 including program administration and costs associated with 29 program implementation. 30 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 31 2019-2020. Any funds remaining in the Medicaid fraud fund 32 created in section 249A.50 for the fiscal year beginning 33 July 1, 2019, and ending June 30, 2020, are appropriated to 34 the department of human services to supplement the medical 35 -27- HF 766 (3) 88 pf/rn/md 27/ 92
H.F. 766 assistance appropriations made in this division of this Act, 1 for medical assistance reimbursement and associated costs, 2 including program administration and costs associated with 3 program implementation. 4 Sec. 13. MEDICAL ASSISTANCE. 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, 2019, and ending June 30, 7 2020, the following amount, or so much thereof as is necessary, 8 to be used for the purpose designated: 9 For medical assistance program reimbursement and associated 10 costs as specifically provided in the reimbursement 11 methodologies in effect on June 30, 2019, except as otherwise 12 expressly authorized by law, consistent with options under 13 federal law and regulations, and contingent upon receipt of 14 approval from the office of the governor of reimbursement for 15 each abortion performed under the program: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,431,334,812 17 1. Iowans support reducing the number of abortions 18 performed in our state. Funds appropriated under this section 19 shall not be used for abortions, unless otherwise authorized 20 under this section. 21 2. The provisions of this section relating to abortions 22 shall also apply to the Iowa health and wellness plan created 23 pursuant to chapter 249N . 24 3. The department shall utilize not more than $60,000 of 25 the funds appropriated in this section to continue the AIDS/HIV 26 health insurance premium payment program as established in 1992 27 Iowa Acts, Second Extraordinary Session, chapter 1001, section 28 409, subsection 6 . Of the funds allocated in this subsection, 29 not more than $5,000 may be expended for administrative 30 purposes. 31 4. Of the funds appropriated in this Act to the department 32 of public health for addictive disorders, $950,000 for 33 the fiscal year beginning July 1, 2019, is transferred 34 to the department of human services for an integrated 35 -28- HF 766 (3) 88 pf/rn/md 28/ 92
H.F. 766 substance-related disorder managed care system. The 1 departments of human services and public health shall 2 work together to maintain the level of mental health and 3 substance-related disorder treatment services provided by the 4 managed care contractors. Each department shall take the steps 5 necessary to continue the federal waivers as necessary to 6 maintain the level of services. 7 5. a. The department shall aggressively pursue options for 8 providing medical assistance or other assistance to individuals 9 with special needs who become ineligible to continue receiving 10 services under the early and periodic screening, diagnostic, 11 and treatment program under the medical assistance program 12 due to becoming 21 years of age who have been approved for 13 additional assistance through the department’s exception to 14 policy provisions, but who have health care needs in excess 15 of the funding available through the exception to policy 16 provisions. 17 b. Of the funds appropriated in this section, $100,000 18 shall be used for participation in one or more pilot projects 19 operated by a private provider to allow the individual or 20 individuals to receive service in the community in accordance 21 with principles established in Olmstead v. L.C., 527 U.S. 581 22 (1999), for the purpose of providing medical assistance or 23 other assistance to individuals with special needs who become 24 ineligible to continue receiving services under the early and 25 periodic screening, diagnostic, and treatment program under 26 the medical assistance program due to becoming 21 years of 27 age who have been approved for additional assistance through 28 the department’s exception to policy provisions, but who have 29 health care needs in excess of the funding available through 30 the exception to the policy provisions. 31 6. Of the funds appropriated in this section, up to 32 $3,050,082 may be transferred to the field operations or 33 general administration appropriations in this division of this 34 Act for operational costs associated with Part D of the federal 35 -29- HF 766 (3) 88 pf/rn/md 29/ 92
H.F. 766 Medicare Prescription Drug Improvement and Modernization Act 1 of 2003, Pub. L. No. 108-173. 2 7. Of the funds appropriated in this section, up to $442,100 3 may be transferred to the appropriation in this division 4 of this Act for medical contracts to be used for clinical 5 assessment services and prior authorization of services. 6 8. A portion of the funds appropriated in this section 7 may be transferred to the appropriations in this division of 8 this Act for general administration, medical contracts, the 9 children’s health insurance program, or field operations to be 10 used for the state match cost to comply with the payment error 11 rate measurement (PERM) program for both the medical assistance 12 and children’s health insurance programs as developed by the 13 centers for Medicare and Medicaid services of the United States 14 department of health and human services to comply with the 15 federal Improper Payments Information Act of 2002, Pub. L. 16 No. 107-300, and to support other reviews and quality control 17 activities to improve the integrity of these programs. 18 9. The department shall continue to implement the 19 recommendations of the assuring better child health and 20 development initiative II (ABCDII) clinical panel to the 21 Iowa early and periodic screening, diagnostic, and treatment 22 services healthy mental development collaborative board 23 regarding changes to billing procedures, codes, and eligible 24 service providers. 25 10. Of the funds appropriated in this section, a sufficient 26 amount is allocated to supplement the incomes of residents of 27 nursing facilities, intermediate care facilities for persons 28 with mental illness, and intermediate care facilities for 29 persons with an intellectual disability, with incomes of less 30 than $50 in the amount necessary for the residents to receive a 31 personal needs allowance of $50 per month pursuant to section 32 249A.30A . 33 11. a. Hospitals that meet the conditions specified 34 in subparagraphs (1) and (2) shall either certify public 35 -30- HF 766 (3) 88 pf/rn/md 30/ 92
H.F. 766 expenditures or transfer to the medical assistance program 1 an amount equal to provide the nonfederal share for a 2 disproportionate share hospital payment in an amount up to the 3 hospital-specific limit as approved in the Medicaid state plan. 4 The hospitals that meet the conditions specified shall receive 5 and retain 100 percent of the total disproportionate share 6 hospital payment in an amount up to the hospital-specific limit 7 as approved in the Medicaid state plan. 8 (1) The hospital qualifies for disproportionate share and 9 graduate medical education payments. 10 (2) The hospital is an Iowa state-owned hospital with more 11 than 500 beds and eight or more distinct residency specialty 12 or subspecialty programs recognized by the American college of 13 graduate medical education. 14 b. Distribution of the disproportionate share payments 15 shall be made on a monthly basis. The total amount of 16 disproportionate share payments including graduate medical 17 education, enhanced disproportionate share, and Iowa 18 state-owned teaching hospital payments shall not exceed the 19 amount of the state’s allotment under Pub. L. No. 102-234. 20 In addition, the total amount of all disproportionate 21 share payments shall not exceed the hospital-specific 22 disproportionate share limits under Pub. L. No. 103-66. 23 12. One hundred percent of the nonfederal share of payments 24 to area education agencies that are medical assistance 25 providers for medical assistance-covered services provided to 26 medical assistance-covered children, shall be made from the 27 appropriation made in this section. 28 13. A portion of the funds appropriated in this section 29 may be transferred to the appropriation in this division of 30 this Act for medical contracts to be used for administrative 31 activities associated with the money follows the person 32 demonstration project. 33 14. Of the funds appropriated in this section, $349,011 34 shall be used for the administration of the health insurance 35 -31- HF 766 (3) 88 pf/rn/md 31/ 92
H.F. 766 premium payment program, including salaries, support, 1 maintenance, and miscellaneous purposes. 2 15. a. The department may increase the amounts allocated 3 for salaries, support, maintenance, and miscellaneous purposes 4 associated with the medical assistance program, as necessary, 5 to sustain cost management efforts. The department shall 6 report any such increase to the legislative services agency and 7 the department of management. 8 b. If the savings to the medical assistance program from 9 ongoing cost management efforts exceed the associated cost 10 for the fiscal year beginning July 1, 2019, the department 11 may transfer any savings generated for the fiscal year due 12 to medical assistance program cost management efforts to the 13 appropriation made in this division of this Act for medical 14 contracts or general administration to defray the costs 15 associated with implementing the efforts. 16 16. For the fiscal year beginning July 1, 2019, and ending 17 June 30, 2020, the replacement generation tax revenues required 18 to be deposited in the property tax relief fund pursuant to 19 section 437A.8, subsection 4 , paragraph “d”, and section 20 437A.15, subsection 3 , paragraph “f”, shall instead be credited 21 to and supplement the appropriation made in this section and 22 used for the allocations made in this section. 23 17. a. Of the funds appropriated in this section, up 24 to $50,000 may be transferred by the department to the 25 appropriation made in this division of this Act to the 26 department for the same fiscal year for general administration 27 to be used for associated administrative expenses and for not 28 more than one full-time equivalent position, in addition to 29 those authorized for the same fiscal year, to be assigned to 30 implementing the children’s mental health home project. 31 b. Of the funds appropriated in this section, up to $400,000 32 may be transferred by the department to the appropriation made 33 to the department in this division of this Act for the same 34 fiscal year for Medicaid program-related general administration 35 -32- HF 766 (3) 88 pf/rn/md 32/ 92
H.F. 766 planning and implementation activities. The funds may be used 1 for contracts or for personnel in addition to the amounts 2 appropriated for and the positions authorized for general 3 administration for the fiscal year. 4 c. Of the funds appropriated in this section, up to 5 $3,000,000 may be transferred by the department to the 6 appropriations made in this division of this Act for the same 7 fiscal year for general administration or medical contracts 8 to be used to support the development and implementation of 9 standardized assessment tools for persons with mental illness, 10 an intellectual disability, a developmental disability, or a 11 brain injury. 12 18. Of the funds appropriated in this section, $150,000 13 shall be used for lodging expenses associated with care 14 provided at the university of Iowa hospitals and clinics for 15 patients with cancer whose travel distance is 30 miles or more 16 and whose income is at or below 200 percent of the federal 17 poverty level as defined by the most recently revised poverty 18 income guidelines published by the United States department of 19 health and human services. The department of human services 20 shall establish the maximum number of overnight stays and the 21 maximum rate reimbursed for overnight lodging, which may be 22 based on the state employee rate established by the department 23 of administrative services. The funds allocated in this 24 subsection shall not be used as nonfederal share matching 25 funds. 26 19. Of the funds appropriated in this section, up to 27 $3,383,880 shall be used for administration of the state family 28 planning services program pursuant to section 217.41B, and 29 of this amount, the department may use up to $200,000 for 30 administrative expenses. 31 20. Of the funds appropriated in this section, $1,545,530 32 shall be used and may be transferred to other appropriations 33 in this division of this Act as necessary to administer the 34 provisions in the division of this Act relating to Medicaid 35 -33- HF 766 (3) 88 pf/rn/md 33/ 92
H.F. 766 program administration. 1 21. The department shall continue to implement and 2 administer the provisions of 2018 Iowa Acts, chapter 1056. 3 Of the funds appropriated in this section, up to $39,069 may 4 be transferred to the department of inspections and appeals 5 for inspection costs related to such implementation and 6 administration. 7 22. Of the funds appropriated in this section, up to 8 $1,200,000 shall be used to implement reductions in the waiting 9 list for the children’s mental health home and community-based 10 services waiver. 11 23. Of the funds appropriated in this section, a sufficient 12 amount shall be used to reinstate cost-based reimbursement and 13 the settlement process under both fee-for-service and managed 14 care administration of the Medicaid program for critical access 15 hospitals in the state, as designated pursuant to 42 U.S.C. 16 §1395i-4, to provide reimbursement at the rate provided for 17 such hospitals under the federal Medicare program. 18 24. Of the funds appropriated in this section, the 19 department shall use a sufficient amount to audit all 20 prescription drug benefit claims managed by a pharmacy 21 benefit manager under the Medicaid program. The audit shall 22 address issues including but not limited to transparency of 23 data on pharmacy services, the relationship between pharmacy 24 reimbursement and overall costs to the Medicaid program or 25 spread pricing, any potential conflicts of interest related 26 to a retail pharmacy chain that is affiliated with a pharmacy 27 benefit manager and any reported reductions in pharmacy 28 reimbursements, and the impact of reduction in pharmacy 29 reimbursement on access to care, especially in rural areas. 30 The department shall report the findings and recommendations of 31 the audit to the governor and the general assembly by December 32 15, 2019. 33 Sec. 14. MEDICAL CONTRACTS. There is appropriated from the 34 general fund of the state to the department of human services 35 -34- HF 766 (3) 88 pf/rn/md 34/ 92
H.F. 766 for the fiscal year beginning July 1, 2019, and ending June 30, 1 2020, the following amount, or so much thereof as is necessary, 2 to be used for the purpose designated: 3 For medical contracts: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,992,530 5 1. The department of inspections and appeals shall 6 provide all state matching funds for survey and certification 7 activities performed by the department of inspections 8 and appeals. The department of human services is solely 9 responsible for distributing the federal matching funds for 10 such activities. 11 2. Of the funds appropriated in this section, $50,000 shall 12 be used for continuation of home and community-based services 13 waiver quality assurance programs, including the review and 14 streamlining of processes and policies related to oversight and 15 quality management to meet state and federal requirements. 16 3. Of the amount appropriated in this section, up to 17 $200,000 may be transferred to the appropriation for general 18 administration in this division of this Act to be used for 19 additional full-time equivalent positions in the development 20 of key health initiatives such as development and oversight 21 of managed care programs and development of health strategies 22 targeted toward improved quality and reduced costs in the 23 Medicaid program. 24 4. Of the funds appropriated in this section, $1,000,000 25 shall be used for planning and development, in cooperation with 26 the department of public health, of a phased-in program to 27 provide a dental home for children. 28 5. a. Of the funds appropriated in this section, $573,000 29 shall be credited to the autism support program fund created 30 in section 225D.2 to be used for the autism support program 31 created in chapter 225D , with the exception of the following 32 amount of this allocation which shall be used as follows: 33 b. Of the funds allocated in this subsection, $25,000 shall 34 be used for the public purpose of continuation of a grant to a 35 -35- HF 766 (3) 88 pf/rn/md 35/ 92
H.F. 766 nonprofit provider of child welfare services that has been in 1 existence for more than 115 years, is located in a county with 2 a population between 200,000 and 220,000 according to the most 3 recent federal decennial census, is licensed as a psychiatric 4 medical institution for children, and provides school-based 5 programming, to be used for support services for children with 6 autism spectrum disorder and their families. 7 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 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, 2019, and ending June 30, 2020, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,812,909 15 2. The department shall increase the personal needs 16 allowance for residents of residential care facilities by the 17 same percentage and at the same time as federal supplemental 18 security income and federal social security benefits are 19 increased due to a recognized increase in the cost of living. 20 The department may adopt emergency rules to implement this 21 subsection. 22 3. If during the fiscal year beginning July 1, 2019, 23 the department projects that state supplementary assistance 24 expenditures for a calendar year will not meet the federal 25 pass-through requirement specified in Tit. XVI of the federal 26 Social Security Act, section 1618, as codified in 42 U.S.C. 27 §1382g, the department may take actions including but not 28 limited to increasing the personal needs allowance for 29 residential care facility residents and making programmatic 30 adjustments or upward adjustments of the residential care 31 facility or in-home health-related care reimbursement rates 32 prescribed in this division of this Act to ensure that federal 33 requirements are met. In addition, the department may make 34 other programmatic and rate adjustments necessary to remain 35 -36- HF 766 (3) 88 pf/rn/md 36/ 92
H.F. 766 within the amount appropriated in this section while ensuring 1 compliance with federal requirements. The department may adopt 2 emergency rules to implement the provisions of this subsection. 3 4. Notwithstanding section 8.33 , moneys appropriated in 4 this section that remain unencumbered or unobligated at the 5 close of the fiscal year shall not revert but shall remain 6 available for expenditure for the purposes designated until the 7 close of the succeeding fiscal year. 8 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 9 1. There is appropriated from the general fund of the 10 state to the department of human services for the fiscal year 11 beginning July 1, 2019, and ending June 30, 2020, the following 12 amount, or so much thereof as is necessary, to be used for the 13 purpose designated: 14 For maintenance of the healthy and well kids in Iowa (hawk-i) 15 program pursuant to chapter 514I , including supplemental dental 16 services, for receipt of federal financial participation under 17 Tit. XXI of the federal Social Security Act, which creates the 18 children’s health insurance program: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,361,112 20 2. Of the funds appropriated in this section, $79,486 is 21 allocated for continuation of the contract for outreach with 22 the department of public health. 23 3. A portion of the funds appropriated in this section may 24 be transferred to the appropriations made in this division of 25 this Act for field operations or medical contracts to be used 26 for the integration of hawk-i program eligibility, payment, and 27 administrative functions under the purview of the department 28 of human services, including for the Medicaid management 29 information system upgrade. 30 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 31 from the general fund of the state to the department of human 32 services for the fiscal year beginning July 1, 2019, and ending 33 June 30, 2020, the following amount, or so much thereof as is 34 necessary, to be used for the purpose designated: 35 -37- HF 766 (3) 88 pf/rn/md 37/ 92
H.F. 766 For child care programs: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 2 1. Of the funds appropriated in this section, $34,966,931 3 shall be used for state child care assistance in accordance 4 with section 237A.13 . 5 2. Nothing in this section shall be construed or is 6 intended as or shall imply a grant of entitlement for services 7 to persons who are eligible for assistance due to an income 8 level consistent with the waiting list requirements of section 9 237A.13 . Any state obligation to provide services pursuant to 10 this section is limited to the extent of the funds appropriated 11 in this section. 12 3. A list of the registered and licensed child care 13 facilities operating in the area served by a child care 14 resource and referral service shall be made available to the 15 families receiving state child care assistance in that area. 16 4. Of the funds appropriated in this section, $5,850,000 17 shall be credited to the early childhood programs grants 18 account in the early childhood Iowa fund created in section 19 256I.11 . The moneys shall be distributed for funding of 20 community-based early childhood programs targeted to children 21 from birth through five years of age developed by early 22 childhood Iowa areas in accordance with approved community 23 plans as provided in section 256I.8 . 24 5. The department may use any of the funds appropriated 25 in this section as a match to obtain federal funds for use in 26 expanding child care assistance and related programs. For 27 the purpose of expenditures of state and federal child care 28 funding, funds shall be considered obligated at the time 29 expenditures are projected or are allocated to the department’s 30 service areas. Projections shall be based on current and 31 projected caseload growth, current and projected provider 32 rates, staffing requirements for eligibility determination 33 and management of program requirements including data systems 34 management, staffing requirements for administration of the 35 -38- HF 766 (3) 88 pf/rn/md 38/ 92
H.F. 766 program, contractual and grant obligations and any transfers 1 to other state agencies, and obligations for decategorization 2 or innovation projects. 3 6. A portion of the state match for the federal child care 4 and development block grant shall be provided as necessary to 5 meet federal matching funds requirements through the state 6 general fund appropriation made for child development grants 7 and other programs for at-risk children in section 279.51 . 8 7. If a uniform reduction ordered by the governor under 9 section 8.31 or other operation of law, transfer, or federal 10 funding reduction reduces the appropriation made in this 11 section for the fiscal year, the percentage reduction in the 12 amount paid out to or on behalf of the families participating 13 in the state child care assistance program shall be equal to or 14 less than the percentage reduction made for any other purpose 15 payable from the appropriation made in this section and the 16 federal funding relating to it. The percentage reduction to 17 the other allocations made in this section shall be the same as 18 the uniform reduction ordered by the governor or the percentage 19 change of the federal funding reduction, as applicable. If 20 there is an unanticipated increase in federal funding provided 21 for state child care services, the entire amount of the 22 increase, except as necessary to meet federal requirements 23 including quality set asides, shall be used for state child 24 care assistance payments. If the appropriations made for 25 purposes of the state child care assistance program for the 26 fiscal year are determined to be insufficient, it is the intent 27 of the general assembly to appropriate sufficient funding for 28 the fiscal year in order to avoid establishment of waiting list 29 requirements. 30 8. Notwithstanding section 8.33 , moneys advanced for 31 purposes of the programs developed by early childhood Iowa 32 areas, advanced for purposes of wraparound child care, or 33 received from the federal appropriations made for the purposes 34 of this section that remain unencumbered or unobligated at the 35 -39- HF 766 (3) 88 pf/rn/md 39/ 92
H.F. 766 close of the fiscal year shall not revert to any fund but shall 1 remain available for expenditure for the purposes designated 2 until the close of the succeeding fiscal year. 3 Sec. 18. JUVENILE INSTITUTION. There is appropriated 4 from the general fund of the state to the department of human 5 services for the fiscal year beginning July 1, 2019, and ending 6 June 30, 2020, the following amounts, or so much thereof as is 7 necessary, to be used for the purposes designated: 8 1. a. For operation of the state training school at Eldora 9 and for salaries, support, maintenance, and miscellaneous 10 purposes, and for not more than the following full-time 11 equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,920,757 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 14 b. Of the funds appropriated in this subsection, $91,000 15 shall be used for distribution to licensed classroom teachers 16 at this and other institutions under the control of the 17 department of human services based upon the average student 18 yearly enrollment at each institution as determined by the 19 department. 20 c. The additional full-time equivalent positions authorized 21 in paragraph “a” shall include 1.00 youth services technician, 22 1.00 clinical supervisor, and 1.00 registered nurse, or 23 comparable additional, full-time equivalent positions. 24 2. A portion of the moneys appropriated in this section 25 shall be used by the state training school at Eldora for 26 grants for adolescent pregnancy prevention activities at the 27 institution in the fiscal year beginning July 1, 2019. 28 3. Of the funds appropriated in this subsection, $212,000 29 shall be used by the state training school at Eldora for a 30 substance use disorder treatment program at the institution for 31 the fiscal year beginning July 1, 2019. 32 4. Notwithstanding section 8.33 , moneys appropriated in 33 this section that remain unencumbered or unobligated at the 34 close of the fiscal year shall not revert but shall remain 35 -40- HF 766 (3) 88 pf/rn/md 40/ 92
H.F. 766 available for expenditure for the purposes designated until the 1 close of the succeeding fiscal year. 2 Sec. 19. CHILD AND FAMILY SERVICES. 3 1. There is appropriated from the general fund of the 4 state to the department of human services for the fiscal year 5 beginning July 1, 2019, and ending June 30, 2020, the following 6 amount, or so much thereof as is necessary, to be used for the 7 purpose designated: 8 For child and family services: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,071,761 10 2. The department may transfer funds appropriated in this 11 section as necessary to pay the nonfederal costs of services 12 reimbursed under the medical assistance program, state child 13 care assistance program, or the family investment program which 14 are provided to children who would otherwise receive services 15 paid under the appropriation in this section. The department 16 may transfer funds appropriated in this section to the 17 appropriations made in this division of this Act for general 18 administration and for field operations for resources necessary 19 to implement and operate the services funded in this section. 20 3. a. Of the funds appropriated in this section, up to 21 $34,536,000 is allocated as the statewide expenditure target 22 under section 232.143 for group foster care maintenance and 23 services. If the department projects that such expenditures 24 for the fiscal year will be less than the target amount 25 allocated in this paragraph “a”, the department may reallocate 26 the excess to provide additional funding for family foster 27 care, independent living, family safety, risk and permanency 28 services, shelter care, or the child welfare emergency services 29 addressed with the allocation for shelter care. 30 b. If at any time after September 30, 2019, 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 -41- HF 766 (3) 88 pf/rn/md 41/ 92
H.F. 766 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 4. 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 2019-2020. Of 13 the funds appropriated in this section, $1,717,000 is allocated 14 specifically for expenditure for fiscal year 2019-2020 through 15 the decategorization services funding pools and governance 16 boards established pursuant to section 232.188 . 17 5. 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 6. Of the funds appropriated in this section, a sufficient 23 amount is allocated for shelter care and the child welfare 24 emergency services contracting implemented to provide for or 25 prevent the need for shelter care. 26 7. Federal funds received by the state during the fiscal 27 year beginning July 1, 2019, as the result of the expenditure 28 of state funds appropriated during a previous state fiscal 29 year for a service or activity funded under this section are 30 appropriated to the department to be used as additional funding 31 for services and purposes provided for under this section. 32 Notwithstanding section 8.33 , moneys received in accordance 33 with this subsection that remain unencumbered or unobligated at 34 the close of the fiscal year shall not revert to any fund but 35 -42- HF 766 (3) 88 pf/rn/md 42/ 92
H.F. 766 shall remain available for the purposes designated until the 1 close of the succeeding fiscal year. 2 8. a. Of the funds appropriated in this section, up to 3 $3,290,000 is allocated for the payment of the expenses of 4 court-ordered services provided to juveniles who are under the 5 supervision of juvenile court services, which expenses are a 6 charge upon the state pursuant to section 232.141, subsection 7 4 . Of the amount allocated in this paragraph “a”, up to 8 $1,556,000 shall be made available to provide school-based 9 supervision of children adjudicated under chapter 232 , of which 10 not more than $15,000 may be used for the purpose of training. 11 A portion of the cost of each school-based liaison officer 12 shall be paid by the school district or other funding source as 13 approved by the chief juvenile court officer. 14 b. Of the funds appropriated in this section, up to $748,000 15 is allocated for the payment of the expenses of court-ordered 16 services provided to children who are under the supervision 17 of the department, which expenses are a charge upon the state 18 pursuant to section 232.141, subsection 4 . 19 c. Notwithstanding section 232.141 or any other provision 20 of law to the contrary, the amounts allocated in this 21 subsection shall be distributed to the judicial districts 22 as determined by the state court administrator and to the 23 department’s service areas as determined by the administrator 24 of the department of human services’ division of child and 25 family services. The state court administrator and the 26 division administrator shall make the determination of the 27 distribution amounts on or before June 15, 2019. 28 d. Notwithstanding chapter 232 or any other provision of 29 law to the contrary, a district or juvenile court shall not 30 order any service which is a charge upon the state pursuant 31 to section 232.141 if there are insufficient court-ordered 32 services funds available in the district court or departmental 33 service area distribution amounts to pay for the service. The 34 chief juvenile court officer and the departmental service area 35 -43- HF 766 (3) 88 pf/rn/md 43/ 92
H.F. 766 manager shall encourage use of the funds allocated in this 1 subsection such that there are sufficient funds to pay for 2 all court-related services during the entire year. The chief 3 juvenile court officers and departmental service area managers 4 shall attempt to anticipate potential surpluses and shortfalls 5 in the distribution amounts and shall cooperatively request the 6 state court administrator or division administrator to transfer 7 funds between the judicial districts’ or departmental service 8 areas’ distribution amounts as prudent. 9 e. Notwithstanding any provision of law to the contrary, 10 a district or juvenile court shall not order a county to pay 11 for any service provided to a juvenile pursuant to an order 12 entered under chapter 232 which is a charge upon the state 13 under section 232.141, subsection 4 . 14 f. Of the funds allocated in this subsection, not more than 15 $83,000 may be used by the judicial branch for administration 16 of the requirements under this subsection. 17 g. Of the funds allocated in this subsection, $17,000 18 shall be used by the department of human services to support 19 the interstate commission for juveniles in accordance with 20 the interstate compact for juveniles as provided in section 21 232.173 . 22 9. Of the funds appropriated in this section, $12,253,000 is 23 allocated for juvenile delinquent graduated sanctions services. 24 Any state funds saved as a result of efforts by juvenile court 25 services to earn a federal Tit. IV-E match for juvenile court 26 services administration may be used for the juvenile delinquent 27 graduated sanctions services. 28 10. Of the funds appropriated in this section, $1,658,000 is 29 transferred to the department of public health to be used for 30 the child protection center grant program for child protection 31 centers located in Iowa in accordance with section 135.118 . 32 The grant amounts under the program shall be equalized so that 33 each center receives a uniform base amount of $245,000, and so 34 that the remaining funds are awarded through a funding formula 35 -44- HF 766 (3) 88 pf/rn/md 44/ 92
H.F. 766 based upon the volume of children served. To increase access 1 to child protection center services for children in rural 2 areas, the funding formula for the awarding of the remaining 3 funds shall provide for the awarding of an enhanced amount to 4 eligible grantees to develop and maintain satellite centers in 5 underserved regions of the state. 6 11. Of the funds appropriated in this section, $4,025,000 is 7 allocated for the preparation for adult living program pursuant 8 to section 234.46 . 9 12. Of the funds appropriated in this section, $227,000 10 shall be used for the public purpose of continuing a grant to a 11 nonprofit human services organization, providing services to 12 individuals and families in multiple locations in southwest 13 Iowa and Nebraska for support of a project providing immediate, 14 sensitive support and forensic interviews, medical exams, needs 15 assessments, and referrals for victims of child abuse and their 16 nonoffending family members. 17 13. Of the funds appropriated in this section, $300,000 18 is allocated for the foster care youth council approach of 19 providing a support network to children placed in foster care. 20 14. Of the funds appropriated in this section, $202,000 is 21 allocated for use pursuant to section 235A.1 for continuation 22 of the initiative to address child sexual abuse implemented 23 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 24 21 . 25 15. Of the funds appropriated in this section, $630,000 is 26 allocated for the community partnership for child protection 27 sites. 28 16. Of the funds appropriated in this section, $371,000 29 is allocated for the department’s minority youth and family 30 projects under the redesign of the child welfare system. 31 17. Of the funds appropriated in this section, $851,000 32 is allocated for funding of the community circle of care 33 collaboration for children and youth in northeast Iowa. 34 18. Of the funds appropriated in this section, at least 35 -45- HF 766 (3) 88 pf/rn/md 45/ 92
H.F. 766 $147,000 shall be used for the continuation of the child 1 welfare provider training academy, a collaboration between the 2 coalition for family and children’s services in Iowa and the 3 department. 4 19. Of the funds appropriated in this section, $211,000 5 shall be used for continuation of the central Iowa system of 6 care program grant through June 30, 2020. 7 20. Of the funds appropriated in this section, $235,000 8 shall be used for the public purpose of the continuation 9 and expansion of a system of care program grant implemented 10 in Cerro Gordo and Linn counties to utilize a comprehensive 11 and long-term approach for helping children and families by 12 addressing the key areas in a child’s life of childhood basic 13 needs, education and work, family, and community. 14 21. Of the funds appropriated in this section, at least 15 $25,000 shall be used to continue and to expand the foster 16 care respite pilot program in which postsecondary students in 17 social work and other human services-related programs receive 18 experience by assisting family foster care providers with 19 respite and other support. 20 22. Of the funds appropriated in this section, $110,000 21 shall be used for the public purpose of funding community-based 22 services and other supports with a system of care approach 23 for children with a serious emotional disturbance and their 24 families through a nonprofit provider of child welfare services 25 that has been in existence for more than 115 years, is located 26 in a county with a population of more than 200,000 but less 27 than 220,000 according to the latest certified federal census, 28 is licensed as a psychiatric medical institution for children, 29 and was a system of care grantee prior to July 1, 2019. 30 23. If a separate funding source is identified that reduces 31 the need for state funds within an allocation under this 32 section, the allocated state funds may be redistributed to 33 other allocations under this section for the same fiscal year. 34 Sec. 20. ADOPTION SUBSIDY. 35 -46- HF 766 (3) 88 pf/rn/md 46/ 92
H.F. 766 1. There is appropriated from the general fund of the 1 state to the department of human services for the fiscal year 2 beginning July 1, 2019, and ending June 30, 2020, the following 3 amount, or so much thereof as is necessary, to be used for the 4 purpose designated: 5 a. For adoption subsidy payments and services: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 7 b. (1) The funds appropriated in this section shall be used 8 as authorized or allowed by federal law or regulation for any 9 of the following purposes: 10 (a) For adoption subsidy payments and related costs. 11 (b) For post-adoption services and for other purposes under 12 Tit. IV-B or Tit. IV-E of the federal Social Security Act. 13 (2) The department of human services may transfer funds 14 appropriated in this subsection to the appropriation for 15 child and family services in this Act for the purposes of 16 post-adoption services as specified in this paragraph “b”. 17 c. Notwithstanding section 8.33 , moneys corresponding to 18 the state savings resulting from implementation of the federal 19 Fostering Connections to Success and Increasing Adoptions Act 20 of 2008, Pub. L. No. 110-351, and successor legislation, as 21 determined in accordance with 42 U.S.C. §673(a)(8), that remain 22 unencumbered or unobligated at the close of the fiscal year, 23 shall not revert to any fund but shall remain available for the 24 purposes designated in this subsection until expended. The 25 amount of such savings and any corresponding funds remaining 26 at the close of the fiscal year shall be determined separately 27 and any changes in either amount between fiscal years shall not 28 result in an unfunded need. 29 2. The department may transfer funds appropriated in 30 this section to the appropriation made in this division of 31 this Act for general administration for costs paid from the 32 appropriation relating to adoption subsidy. 33 3. Federal funds received by the state during the 34 fiscal year beginning July 1, 2019, as the result of the 35 -47- HF 766 (3) 88 pf/rn/md 47/ 92
H.F. 766 expenditure of state funds during a previous state fiscal 1 year for a service or activity funded under this section are 2 appropriated to the department to be used as additional funding 3 for the services and activities funded under this section. 4 Notwithstanding section 8.33 , moneys received in accordance 5 with this subsection that remain unencumbered or unobligated 6 at the close of the fiscal year shall not revert to any fund 7 but shall remain available for expenditure for the purposes 8 designated until the close of the succeeding fiscal year. 9 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 10 in the juvenile detention home fund created in section 232.142 11 during the fiscal year beginning July 1, 2019, and ending June 12 30, 2020, are appropriated to the department of human services 13 for the fiscal year beginning July 1, 2019, and ending June 30, 14 2020, for distribution of an amount equal to a percentage of 15 the costs of the establishment, improvement, operation, and 16 maintenance of county or multicounty juvenile detention homes 17 in the fiscal year beginning July 1, 2018. Moneys appropriated 18 for distribution in accordance with this section shall be 19 allocated among eligible detention homes, prorated on the basis 20 of an eligible detention home’s proportion of the costs of all 21 eligible detention homes in the fiscal year beginning July 22 1, 2018. The percentage figure shall be determined by the 23 department based on the amount available for distribution for 24 the fund. Notwithstanding section 232.142, subsection 3 , the 25 financial aid payable by the state under that provision for the 26 fiscal year beginning July 1, 2019, shall be limited to the 27 amount appropriated for the purposes of this section. 28 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 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, 2019, and ending June 30, 2020, the following 32 amount, or so much thereof as is necessary, to be used for the 33 purpose designated: 34 For the family support subsidy program subject to the 35 -48- HF 766 (3) 88 pf/rn/md 48/ 92
H.F. 766 enrollment restrictions in section 225C.37, subsection 3 : 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 2 2. At least $819,275 of the moneys appropriated in this 3 section is transferred to the department of public health for 4 the family support center component of the comprehensive family 5 support program under chapter 225C , subchapter V. 6 3. If at any time during the fiscal year, the amount of 7 funding available for the family support subsidy program 8 is reduced from the amount initially used to establish t