House File 2578 - Reprinted HOUSE FILE 2578 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO LSB 5004HB) (As Amended and Passed by the House April 5, 2022 ) 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 2578 (3) 89 pf/rn/md
H.F. 2578 DIVISION I 1 DEPARTMENT ON AGING —— FY 2022-2023 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, 2022, and ending June 30, 5 2023, 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 9 years of age and older with case management, Iowa’s aging and 10 disabilities resource center, and other services which may 11 include but are not limited to adult day, respite care, chore, 12 information and assistance, and material aid, for information 13 and options counseling for persons with disabilities who 14 are 18 years of age or older, and for salaries, support, 15 administration, maintenance, and miscellaneous purposes, and 16 for not more than the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,804,082 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 28.00 19 1. Funds appropriated in this section may be used to 20 supplement federal funds under federal regulations. To 21 receive funds appropriated in this section, a local area 22 agency on aging shall match the funds with moneys from other 23 sources according to rules adopted by the department. Funds 24 appropriated in this section may be used for elderly services 25 not specifically enumerated in this section only if approved 26 by an area agency on aging for provision of the service within 27 the area. 28 2. Of the funds appropriated in this section, $418,700 is 29 transferred to the economic development authority for the Iowa 30 commission on volunteer services to be used for the retired and 31 senior volunteer program. 32 3. a. The department on aging shall establish and enforce 33 procedures relating to expenditure of state and federal funds 34 by area agencies on aging that require compliance with both 35 -1- HF 2578 (3) 89 pf/rn/md 1/ 79
H.F. 2578 state and federal laws, rules, and regulations, including but 1 not limited to all of the following: 2 (1) Requiring that expenditures are incurred only for goods 3 or services received or performed prior to the end of the 4 fiscal period designated for use of the funds. 5 (2) Prohibiting prepayment for goods or services not 6 received or performed prior to the end of the fiscal period 7 designated for use of the funds. 8 (3) Prohibiting prepayment for goods or services not 9 defined specifically by good or service, time period, or 10 recipient. 11 (4) Prohibiting the establishment of accounts from which 12 future goods or services which are not defined specifically by 13 good or service, time period, or recipient, may be purchased. 14 b. The procedures shall provide that if any funds are 15 expended in a manner that is not in compliance with the 16 procedures and applicable federal and state laws, rules, and 17 regulations, and are subsequently subject to repayment, the 18 area agency on aging expending such funds in contravention of 19 such procedures, laws, rules and regulations, not the state, 20 shall be liable for such repayment. 21 4. Of the funds appropriated in this section, $1,312,000 22 shall be used for the purposes of chapter 231E and to 23 administer the prevention of elder abuse, neglect, and 24 exploitation program pursuant to section 231.56A , in accordance 25 with the requirements of the federal Older Americans Act of 26 1965, 42 U.S.C. §3001 et seq., as amended. 27 5. Of the funds appropriated in this section, $1,000,000 28 shall be used to fund continuation of the aging and disability 29 resource center lifelong links to provide individuals and 30 caregivers with information and services to plan for and 31 maintain independence. 32 6. Of the funds appropriated in this section, $850,000 33 shall be used by the department on aging, in collaboration with 34 the department of human services and affected stakeholders, 35 -2- HF 2578 (3) 89 pf/rn/md 2/ 79
H.F. 2578 to continue to expand the pilot initiative to provide 1 long-term care options counseling utilizing support planning 2 protocols, to assist non-Medicaid eligible consumers who 3 indicate a preference to return to the community and are 4 deemed appropriate for discharge, to return to their community 5 following a nursing facility stay; and shall be used by the 6 department on aging to fund home and community-based services 7 to enable older individuals to avoid more costly utilization 8 of residential or institutional services and remain in their 9 homes. The department on aging shall submit a report regarding 10 the outcomes of the pilot initiative to the governor and the 11 general assembly by December 15, 2022. 12 DIVISION II 13 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2022-2023 14 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 15 appropriated from the general fund of the state to the office 16 of long-term care ombudsman for the fiscal year beginning July 17 1, 2022, and ending June 30, 2023, the following amount, or 18 so much thereof as is necessary, to be used for the purposes 19 designated: 20 For salaries, support, administration, maintenance, and 21 miscellaneous purposes, and for not more than the following 22 full-time equivalent positions: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,449,821 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 25 DIVISION III 26 DEPARTMENT OF PUBLIC HEALTH —— FY 2022-2023 27 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 28 from the general fund of the state to the department of public 29 health for the fiscal year beginning July 1, 2022, and ending 30 June 30, 2023, the following amounts, or so much thereof as is 31 necessary, to be used for the purposes designated: 32 1. ADDICTIVE DISORDERS 33 For reducing the prevalence of the use of tobacco, alcohol, 34 and other drugs, and treating individuals affected by addictive 35 -3- HF 2578 (3) 89 pf/rn/md 3/ 79
H.F. 2578 behaviors, including gambling, and for not more than the 1 following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,659,379 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 4 a. Of the funds appropriated in this subsection, $4,020,894 5 shall be used for the tobacco use prevention and control 6 initiative, including efforts at the state and local levels, 7 as provided in chapter 142A . The commission on tobacco use 8 prevention and control established pursuant to section 142A.3 9 shall advise the director of public health in prioritizing 10 funding needs and the allocation of moneys appropriated for 11 the programs and initiatives. Activities of the programs 12 and initiatives shall be in alignment with the United States 13 centers for disease control and prevention best practices 14 for comprehensive tobacco control programs that include 15 the goals of preventing youth initiation of tobacco usage, 16 reducing exposure to secondhand smoke, and promotion of tobacco 17 cessation. 18 b. (1) Of the funds appropriated in this subsection, 19 $19,638,485 shall be used for problem gambling and 20 substance-related disorder prevention, treatment, and recovery 21 services, including a 24-hour helpline, public information 22 resources, professional training, youth prevention, and program 23 evaluation. 24 (2) Of the amount allocated under this paragraph, $306,000 25 shall be utilized by the department of public health, in 26 collaboration with the department of human services, to 27 maintain a single statewide 24-hour crisis hotline for the Iowa 28 children’s behavioral health system that incorporates warmline 29 services which may be provided through expansion of existing 30 capabilities maintained by the department of public health as 31 required pursuant to 2018 Iowa Acts, chapter 1056, section 16 . 32 c. The requirement of section 123.17, subsection 5 , is met 33 by the appropriations and allocations made in this division of 34 this Act for purposes of substance-related disorder treatment 35 -4- HF 2578 (3) 89 pf/rn/md 4/ 79
H.F. 2578 and addictive disorders for the fiscal year beginning July 1, 1 2022. 2 2. HEALTHY CHILDREN AND FAMILIES 3 For promoting the optimum health status for children and 4 adolescents from birth through 21 years of age, and families, 5 and for not more than the following full-time equivalent 6 positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,816,681 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 9 3. CHRONIC CONDITIONS 10 For serving individuals identified as having chronic 11 conditions or special health care needs, and for not more than 12 the following full-time equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,258,373 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 15 4. COMMUNITY CAPACITY 16 For strengthening the health care delivery system at the 17 local level, and for not more than the following full-time 18 equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,519,306 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 21 a. Of the funds appropriated in this subsection, $2,100,000 22 shall be deposited in the medical residency training account 23 created in section 135.175, subsection 5 , paragraph “a”, and 24 is appropriated from the account to the department of public 25 health to be used for the purposes of the medical residency 26 training state matching grants program as specified in section 27 135.176 . 28 b. Of the funds appropriated in this subsection, $800,000 29 shall be used for rural psychiatric residencies to support the 30 annual creation and training of six psychiatric residents who 31 will provide mental health services in underserved areas of 32 the state. Notwithstanding section 8.33, moneys that remain 33 unencumbered or unobligated at the close of the fiscal year 34 shall not revert but shall remain available for expenditure for 35 -5- HF 2578 (3) 89 pf/rn/md 5/ 79
H.F. 2578 the purposes designated for subsequent fiscal years. 1 c. Of the funds appropriated in this subsection, $425,000 2 shall be used for the creation or continuation of a center of 3 excellence program to encourage innovation and collaboration 4 among regional health care providers in a rural area based 5 upon the results of a regional community needs assessment to 6 transform health care delivery in order to provide quality, 7 sustainable care that meets the needs of the local communities. 8 An applicant for the funds shall specify how the funds will 9 be expended to accomplish the goals of the program and shall 10 provide a detailed five-year sustainability plan prior to 11 being awarded any funding. Following the receipt of funding, 12 a recipient shall submit periodic reports as specified by the 13 department to the governor and the general assembly regarding 14 the recipient’s expenditure of the funds and progress in 15 accomplishing the program goals. 16 5. ESSENTIAL PUBLIC HEALTH SERVICES 17 To provide public health services that reduce risks and 18 invest in promoting and protecting good health over the 19 course of a lifetime with a priority given to older Iowans and 20 vulnerable populations: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 22 6. INFECTIOUS DISEASES 23 For reducing the incidence and prevalence of communicable 24 diseases, and for not more than the following full-time 25 equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,206 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 6.00 28 7. PUBLIC PROTECTION 29 a. For protecting the health and safety of the public 30 through establishing standards and enforcing regulations, and 31 for not more than the following full-time equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,466,601 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 34 b. Of the funds appropriated in this subsection, not more 35 -6- HF 2578 (3) 89 pf/rn/md 6/ 79
H.F. 2578 than $304,000 shall be credited to the emergency medical 1 services fund created in section 135.25 . Moneys in the 2 emergency medical services fund are appropriated to the 3 department to be used for the purposes of the fund. 4 8. RESOURCE MANAGEMENT 5 For establishing and sustaining the overall ability of the 6 department to deliver services to the public, and for not more 7 than the following full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,871 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 10 9. MISCELLANEOUS PROVISIONS 11 The university of Iowa hospitals and clinics under the 12 control of the state board of regents shall not receive 13 indirect costs from the funds appropriated in this section. 14 The university of Iowa hospitals and clinics billings to the 15 department shall be on at least a quarterly basis. 16 Sec. 4. DEPARTMENT OF PUBLIC HEALTH —— SPORTS WAGERING 17 RECEIPTS FUND. There is appropriated from the sports wagering 18 receipts fund created in section 8.57, subsection 6, to the 19 department of public health for the fiscal year beginning July 20 1, 2022, and ending June 30, 2023, the following amount, or 21 so much thereof as is necessary, to be used for the purposes 22 designated: 23 For problem gambling and substance-related disorder 24 prevention, treatment, and recovery services, including a 25 24-hour helpline, public information resources, professional 26 training, youth prevention, and program evaluation: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 28 DIVISION IV 29 DEPARTMENT OF VETERANS AFFAIRS —— FY 2022-2023 30 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 31 appropriated from the general fund of the state to the 32 department of veterans affairs for the fiscal year beginning 33 July 1, 2022, and ending June 30, 2023, the following amounts, 34 or so much thereof as is necessary, to be used for the purposes 35 -7- HF 2578 (3) 89 pf/rn/md 7/ 79
H.F. 2578 designated: 1 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 2 For salaries, support, maintenance, and miscellaneous 3 purposes, and for not more than the following full-time 4 equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,229,763 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 7 2. IOWA VETERANS HOME 8 For salaries, support, maintenance, and miscellaneous 9 purposes: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,131,552 11 a. The Iowa veterans home billings involving the department 12 of human services shall be submitted to the department on at 13 least a monthly basis. 14 b. The Iowa veterans home expenditure report shall be 15 submitted monthly to the general assembly. 16 c. The Iowa veterans home shall continue to include in the 17 annual discharge report applicant information to provide for 18 the collection of demographic information including but not 19 limited to the number of individuals applying for admission and 20 admitted or denied admittance and the basis for the admission 21 or denial; the age, gender, and race of such individuals; 22 and the level of care for which such individuals applied for 23 admission including residential or nursing level of care. 24 3. HOME OWNERSHIP ASSISTANCE PROGRAM 25 For transfer to the Iowa finance authority for the 26 continuation of the home ownership assistance program for 27 persons who are or were eligible members of the armed forces of 28 the United States, pursuant to section 16.54 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 30 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 31 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 32 appropriation in section 35A.16 for the fiscal year beginning 33 July 1, 2022, and ending June 30, 2023, the amount appropriated 34 from the general fund of the state pursuant to that section 35 -8- HF 2578 (3) 89 pf/rn/md 8/ 79
H.F. 2578 for the following designated purposes shall not exceed the 1 following amount: 2 For the county commissions of veteran affairs fund under 3 section 35A.16 : 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 5 DIVISION V 6 DEPARTMENT OF HUMAN SERVICES —— FY 2022-2023 7 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 8 GRANT. There is appropriated from the fund created in section 9 8.41 to the department of human services for the fiscal year 10 beginning July 1, 2022, and ending June 30, 2023, from moneys 11 received under the federal temporary assistance for needy 12 families (TANF) block grant pursuant to the federal Personal 13 Responsibility and Work Opportunity Reconciliation Act of 1996, 14 Pub. L. No. 104-193, and successor legislation, the following 15 amounts, or so much thereof as is necessary, to be used for the 16 purposes designated: 17 1. To be credited to the family investment program account 18 and used for assistance under the family investment program 19 under chapter 239B : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 21 2. To be credited to the family investment program account 22 and used for the job opportunities and basic skills (JOBS) 23 program and implementing family investment agreements in 24 accordance with chapter 239B : 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 26 3. To be used for the family development and 27 self-sufficiency grant program in accordance with section 28 216A.107 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 30 Notwithstanding section 8.33 , moneys appropriated in this 31 subsection that remain unencumbered or unobligated at the close 32 of the fiscal year shall not revert but shall remain available 33 for expenditure for the purposes designated until the close of 34 the succeeding fiscal year. However, unless such moneys are 35 -9- HF 2578 (3) 89 pf/rn/md 9/ 79
H.F. 2578 encumbered or obligated on or before September 30, 2023, the 1 moneys shall revert. 2 4. For field operations: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 4 5. For general administration: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 6 6. For state child care assistance: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 8 a. Of the funds appropriated in this subsection, 9 $26,205,412 is transferred to the child care and development 10 block grant appropriation made by the Eighty-ninth General 11 Assembly, 2022 session, for the federal fiscal year beginning 12 October 1, 2022, and ending September 30, 2023. Of this 13 amount, $200,000 shall be used for provision of educational 14 opportunities to registered child care home providers in order 15 to improve services and programs offered by this category 16 of providers and to increase the number of providers. The 17 department may contract with institutions of higher education 18 or child care resource and referral centers to provide 19 the educational opportunities. Allowable administrative 20 costs under the contracts shall not exceed 5 percent. The 21 application for a grant shall not exceed two pages in length. 22 b. Any funds appropriated in this subsection remaining 23 unallocated shall be used for state child care assistance 24 payments for families who are employed including but not 25 limited to individuals enrolled in the family investment 26 program. 27 7. For child and family services: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 29 8. For child abuse prevention grants: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 31 9. For pregnancy prevention grants on the condition that 32 family planning services are funded: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 34 Pregnancy prevention grants shall be awarded to programs 35 -10- HF 2578 (3) 89 pf/rn/md 10/ 79
H.F. 2578 in existence on or before July 1, 2022, if the programs have 1 demonstrated positive outcomes. Grants shall be awarded to 2 pregnancy prevention programs which are developed after July 3 1, 2022, if the programs are based on existing models that 4 have demonstrated positive outcomes. Grants shall comply with 5 the requirements provided in 1997 Iowa Acts, chapter 208, 6 section 14, subsections 1 and 2 , including the requirement that 7 grant programs must emphasize sexual abstinence. Priority in 8 the awarding of grants shall be given to programs that serve 9 areas of the state which demonstrate the highest percentage of 10 unplanned pregnancies of females of childbearing age within the 11 geographic area to be served by the grant. 12 10. For technology needs and other resources necessary to 13 meet federal and state reporting, tracking, and case management 14 requirements and other departmental needs: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 16 11. a. Notwithstanding any provision to the contrary, 17 including but not limited to requirements in section 8.41 or 18 provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the 19 receipt and appropriation of federal block grants, federal 20 funds from the temporary assistance for needy families block 21 grant received by the state and not otherwise appropriated 22 in this section and remaining available for the fiscal year 23 beginning July 1, 2022, are appropriated to the department of 24 human services to the extent as may be necessary to be used in 25 the following priority order: the family investment program, 26 for state child care assistance program payments for families 27 who are employed, and for the family investment program share 28 of system costs for eligibility determination and related 29 functions. The federal funds appropriated in this paragraph 30 “a” shall be expended only after all other funds appropriated 31 in subsection 1 for assistance under the family investment 32 program, in subsection 6 for state child care assistance, or 33 in subsection 10 for technology needs and other resources 34 necessary to meet departmental needs, as applicable, have been 35 -11- HF 2578 (3) 89 pf/rn/md 11/ 79
H.F. 2578 expended. For the purposes of this subsection, the funds 1 appropriated in subsection 6, paragraph “a”, for transfer 2 to the child care and development block grant appropriation 3 are considered fully expended when the full amount has been 4 transferred. 5 b. The department shall, on a quarterly basis, advise the 6 general assembly and department of management of the amount of 7 funds appropriated in this subsection that was expended in the 8 prior quarter. 9 12. Of the amounts appropriated in this section, 10 $12,962,008 for the fiscal year beginning July 1, 2022, is 11 transferred to the appropriation of the federal social services 12 block grant made to the department of human services for that 13 fiscal year. 14 13. For continuation of the program providing categorical 15 eligibility for the supplemental nutrition assistance program 16 (SNAP) as specified for the program in the section of this 17 division of this Act relating to the family investment program 18 account: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 20 14. The department may transfer funds allocated in this 21 section to the appropriations made in this division of this Act 22 for the same fiscal year for general administration and field 23 operations for resources necessary to implement and operate the 24 services referred to in this section and those funded in the 25 appropriation made in this division of this Act for the same 26 fiscal year for the family investment program from the general 27 fund of the state. 28 15. With the exception of moneys allocated under this 29 section for the family development and self-sufficiency grant 30 program, to the extent moneys allocated in this section are 31 deemed by the department not to be necessary to support the 32 purposes for which they are allocated, such moneys may be used 33 in the same fiscal year for any other purpose for which funds 34 are allocated in this section or in section 8 of this division 35 -12- HF 2578 (3) 89 pf/rn/md 12/ 79
H.F. 2578 of this Act for the family investment program account. If 1 there are conflicting needs, priority shall first be given 2 to the family investment program account as specified under 3 subsection 1 of this section and used for the purposes of 4 assistance under the family investment program in accordance 5 with chapter 239B , followed by state child care assistance 6 program payments for families who are employed, followed by 7 other priorities as specified by the department. 8 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 9 1. Moneys credited to the family investment program (FIP) 10 account for the fiscal year beginning July 1, 2022, and 11 ending June 30, 2023, shall be used to provide assistance in 12 accordance with chapter 239B . 13 2. The department may use a portion of the moneys credited 14 to the FIP account under this section as necessary for 15 salaries, support, maintenance, and miscellaneous purposes, 16 including administrative and information technology costs 17 associated with rent reimbursement and other income assistance 18 programs administered by the department. 19 3. The department may transfer funds allocated in 20 subsection 4, excluding the allocation under subsection 4, 21 paragraph “b”, to the appropriations made in this division of 22 this Act for the same fiscal year for general administration 23 and field operations for resources necessary to implement 24 and operate the services referred to in this section and 25 those funded in the appropriations made in section 7 for the 26 temporary assistance for needy families block grant and in 27 section 9 for the family investment program from the general 28 fund of the state in this division of this Act for the same 29 fiscal year. 30 4. Moneys appropriated in this division of this Act and 31 credited to the FIP account for the fiscal year beginning July 32 1, 2022, and ending June 30, 2023, are allocated as follows: 33 a. To be retained by the department of human services to 34 be used for coordinating with the department of human rights 35 -13- HF 2578 (3) 89 pf/rn/md 13/ 79
H.F. 2578 to more effectively serve participants in FIP and other shared 1 clients and to meet federal reporting requirements under the 2 federal temporary assistance for needy families block grant: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 4 b. To the department of human rights for staffing, 5 administration, and implementation of the family development 6 and self-sufficiency grant program in accordance with section 7 216A.107 : 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,192,834 9 (1) Of the funds allocated for the family development 10 and self-sufficiency grant program in this paragraph “b”, 11 not more than 5 percent of the funds shall be used for the 12 administration of the grant program. 13 (2) The department of human rights may continue to implement 14 the family development and self-sufficiency grant program 15 statewide during fiscal year 2022-2023. 16 (3) The department of human rights may engage in activities 17 to strengthen and improve family outcomes measures and 18 data collection systems under the family development and 19 self-sufficiency grant program. 20 c. For the diversion subaccount of the FIP account: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 22 A portion of the moneys allocated for the diversion 23 subaccount may be used for field operations, salaries, data 24 management system development, and implementation costs and 25 support deemed necessary by the director of human services 26 in order to administer the FIP diversion program. To the 27 extent moneys allocated in this paragraph “c” are deemed by the 28 department not to be necessary to support diversion activities, 29 such moneys may be used for other efforts intended to increase 30 engagement by family investment program participants in work, 31 education, or training activities, or for the purposes of 32 assistance under the family investment program in accordance 33 with chapter 239B . 34 d. For the SNAP employment and training program: 35 -14- HF 2578 (3) 89 pf/rn/md 14/ 79
H.F. 2578 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 1 (1) The department shall apply the federal SNAP employment 2 and training state plan in order to maximize to the fullest 3 extent permitted by federal law the use of the 50 percent 4 federal reimbursement provisions for the claiming of allowable 5 federal reimbursement funds from the United States department 6 of agriculture pursuant to the federal SNAP employment and 7 training program for providing education, employment, and 8 training services for eligible SNAP participants, including 9 but not limited to related dependent care and transportation 10 expenses. 11 (2) The department shall continue the categorical 12 federal SNAP eligibility at 160 percent of the federal 13 poverty level and continue to eliminate the asset test from 14 eligibility requirements, consistent with federal SNAP program 15 requirements. The department shall include as many SNAP 16 households as is allowed by federal law. The eligibility 17 provisions shall conform to all federal requirements including 18 requirements addressing individuals who are disqualified for 19 committing an intentional program violation or are otherwise 20 ineligible. 21 e. For the JOBS program, not more than: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 23 5. Of the child support collections assigned under FIP, 24 an amount equal to the federal share of support collections 25 shall be credited to the child support recovery appropriation 26 made in this division of this Act. Of the remainder of the 27 assigned child support collections received by the child 28 support recovery unit, a portion shall be credited to the FIP 29 account, a portion may be used to increase recoveries, and a 30 portion may be used to sustain cash flow in the child support 31 payments account. If as a consequence of the appropriations 32 and allocations made in this section the resulting amounts 33 are insufficient to sustain cash assistance payments and meet 34 federal maintenance of effort requirements, the department 35 -15- HF 2578 (3) 89 pf/rn/md 15/ 79
H.F. 2578 shall seek supplemental funding. If child support collections 1 assigned under FIP are greater than estimated or are otherwise 2 determined not to be required for maintenance of effort, the 3 state share of either amount may be transferred to or retained 4 in the child support payments account. 5 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 6 is appropriated from the general fund of the state to the 7 department of human services for the fiscal year beginning July 8 1, 2022, and ending June 30, 2023, the following amount, or 9 so much thereof as is necessary, to be used for the purpose 10 designated: 11 To be credited to the family investment program (FIP) 12 account and used for family investment program assistance 13 under chapter 239B and other costs associated with providing 14 needs-based benefits or assistance: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,003,978 16 1. Of the funds appropriated in this section, $6,606,198 is 17 allocated for the JOBS program. 18 2. Of the funds appropriated in this section, $4,313,854 is 19 allocated for the family development and self-sufficiency grant 20 program. 21 3. a. Notwithstanding section 8.39 , for the fiscal 22 year beginning July 1, 2022, if necessary to meet federal 23 maintenance of effort requirements or to transfer federal 24 temporary assistance for needy families block grant funding 25 to be used for purposes of the federal social services block 26 grant or to meet cash flow needs resulting from delays in 27 receiving federal funding or to implement, in accordance with 28 this division of this Act, activities currently funded with 29 juvenile court services, county, or community moneys and state 30 moneys used in combination with such moneys; to comply with 31 federal requirements; or to maximize the use of federal funds; 32 the department of human services may transfer funds within or 33 between any of the appropriations made in this division of this 34 Act and appropriations in law for the federal social services 35 -16- HF 2578 (3) 89 pf/rn/md 16/ 79
H.F. 2578 block grant to the department for the following purposes, 1 provided that the combined amount of state and federal 2 temporary assistance for needy families block grant funding 3 for each appropriation remains the same before and after the 4 transfer: 5 (1) For the family investment program. 6 (2) For state child care assistance. 7 (3) For child and family services. 8 (4) For field operations. 9 (5) For general administration. 10 b. This subsection shall not be construed to prohibit the 11 use of existing state transfer authority for other purposes. 12 The department shall report any transfers made pursuant to this 13 subsection to the general assembly. 14 4. Of the funds appropriated in this section, $195,000 15 shall be used for a contract for tax preparation assistance 16 to low-income Iowans to expand the usage of the earned income 17 tax credit. The purpose of the contract is to supply this 18 assistance to underserved areas of the state. The department 19 shall not retain any portion of the allocation under this 20 subsection for administrative costs. 21 5. Of the funds appropriated in this section, $70,000 shall 22 be used for the continuation of the parenting program, as 23 specified in 441 IAC ch. 100 , relating to parental obligations, 24 in which the child support recovery unit participates, to 25 support the efforts of a nonprofit organization committed to 26 strengthening the community through youth development, healthy 27 living, and social responsibility headquartered in a county 28 with a population over 450,000 according to the 2020 certified 29 federal census. The funds allocated in this subsection shall 30 be used by the recipient organization to develop a larger 31 community effort, through public and private partnerships, to 32 support a broad-based multi-county parenthood initiative that 33 promotes payment of child support obligations, improved family 34 relationships, and full-time employment. 35 -17- HF 2578 (3) 89 pf/rn/md 17/ 79
H.F. 2578 6. The department may transfer funds appropriated in this 1 section, excluding the allocation in subsection 2 for the 2 family development and self-sufficiency grant program, to the 3 appropriations made in this division of this Act for general 4 administration and field operations as necessary to administer 5 this section, section 7 for the temporary assistance for needy 6 families block grant, and section 8 for the family investment 7 program account. 8 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 9 from the general fund of the state to the department of human 10 services for the fiscal year beginning July 1, 2022, and ending 11 June 30, 2023, the following amount, or so much thereof as is 12 necessary, to be used for the purposes designated: 13 For child support recovery, including salaries, support, 14 maintenance, and miscellaneous purposes, and for not more than 15 the following full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,942,885 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 18 1. The department shall expend up to $24,000, including 19 federal financial participation, for the fiscal year beginning 20 July 1, 2022, for a child support public awareness campaign. 21 The department and the office of the attorney general shall 22 cooperate in continuation of the campaign. The public 23 awareness campaign shall emphasize, through a variety of 24 media activities, the importance of maximum involvement of 25 both parents in the lives of their children as well as the 26 importance of payment of child support obligations. 27 2. Federal access and visitation grant moneys shall be 28 issued directly to private not-for-profit agencies that provide 29 services designed to increase compliance with the child access 30 provisions of court orders, including but not limited to 31 neutral visitation sites and mediation services. 32 3. The appropriation made to the department for child 33 support recovery may be used throughout the fiscal year in the 34 manner necessary for purposes of cash flow management, and for 35 -18- HF 2578 (3) 89 pf/rn/md 18/ 79
H.F. 2578 cash flow management purposes the department may temporarily 1 draw more than the amount appropriated, provided the amount 2 appropriated is not exceeded at the close of the fiscal year. 3 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 4 FY 2022-2023. Any funds remaining in the health care trust 5 fund created in section 453A.35A for the fiscal year beginning 6 July 1, 2022, and ending June 30, 2023, are appropriated to 7 the department of human services to supplement the medical 8 assistance program appropriations made in this division of this 9 Act, for medical assistance reimbursement and associated costs, 10 including program administration and costs associated with 11 program implementation. 12 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 13 2022-2023. Any funds remaining in the Medicaid fraud fund 14 created in section 249A.50 for the fiscal year beginning 15 July 1, 2022, and ending June 30, 2023, are appropriated to 16 the department of human services to supplement the medical 17 assistance appropriations made in this division of this Act, 18 for medical assistance reimbursement and associated costs, 19 including program administration and costs associated with 20 program implementation. 21 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 22 general fund of the state to the department of human services 23 for the fiscal year beginning July 1, 2022, and ending June 30, 24 2023, the following amount, or so much thereof as is necessary, 25 to be used for the purpose designated: 26 For medical assistance program reimbursement and associated 27 costs as specifically provided in the reimbursement 28 methodologies in effect on June 30, 2022, except as otherwise 29 expressly authorized by law, consistent with options under 30 federal law and regulations, and contingent upon receipt of 31 approval from the office of the governor of reimbursement for 32 each abortion performed under the program: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,539,659,031 34 1. Iowans support reducing the number of abortions 35 -19- HF 2578 (3) 89 pf/rn/md 19/ 79
H.F. 2578 performed in our state. Funds appropriated under this section 1 shall not be used for abortions, unless otherwise authorized 2 under this section. 3 2. The provisions of this section relating to abortions 4 shall also apply to the Iowa health and wellness plan created 5 pursuant to chapter 249N . 6 3. The department shall utilize not more than $60,000 of 7 the funds appropriated in this section to continue the AIDS/HIV 8 health insurance premium payment program as established in 1992 9 Iowa Acts, Second Extraordinary Session, chapter 1001, section 10 409, subsection 6 . Of the funds allocated in this subsection, 11 not more than $5,000 may be expended for administrative 12 purposes. 13 4. Of the funds appropriated in this Act to the department 14 of public health for addictive disorders, $950,000 for 15 the fiscal year beginning July 1, 2022, is transferred 16 to the department of human services for an integrated 17 substance-related disorder managed care system. The 18 departments of human services and public health shall 19 work together to maintain the level of mental health and 20 substance-related disorder treatment services provided by the 21 managed care contractors. Each department shall take the steps 22 necessary to continue the federal waivers as necessary to 23 maintain the level of services. 24 5. The department shall aggressively pursue options for 25 providing medical assistance or other assistance to individuals 26 with special needs who become ineligible to continue receiving 27 services under the early and periodic screening, diagnostic, 28 and treatment program under the medical assistance program 29 due to becoming 21 years of age who have been approved for 30 additional assistance through the department’s exception to 31 policy provisions, but who have health care needs in excess 32 of the funding available through the exception to policy 33 provisions. 34 6. Of the funds appropriated in this section, up to 35 -20- HF 2578 (3) 89 pf/rn/md 20/ 79
H.F. 2578 $3,050,082 may be transferred to the field operations or 1 general administration appropriations in this division of this 2 Act for operational costs associated with Part D of the federal 3 Medicare Prescription Drug Improvement and Modernization Act 4 of 2003, Pub. L. No. 108-173. 5 7. Of the funds appropriated in this section, up to $442,100 6 may be transferred to the appropriation in this division of 7 this Act for health program operations to be used for clinical 8 assessment services and prior authorization of services. 9 8. A portion of the funds appropriated in this section may 10 be transferred to the appropriations in this division of this 11 Act for general administration, health program operations, the 12 children’s health insurance program, or field operations to be 13 used for the state match cost to comply with the payment error 14 rate measurement (PERM) program for both the medical assistance 15 and children’s health insurance programs as developed by the 16 centers for Medicare and Medicaid services of the United States 17 department of health and human services to comply with the 18 federal Improper Payments Information Act of 2002, Pub. L. 19 No. 107-300, and to support other reviews and quality control 20 activities to improve the integrity of these programs. 21 9. Of the funds appropriated in this section, a sufficient 22 amount is allocated to supplement the incomes of residents of 23 nursing facilities, intermediate care facilities for persons 24 with mental illness, and intermediate care facilities for 25 persons with an intellectual disability, with incomes of less 26 than $50 in the amount necessary for the residents to receive a 27 personal needs allowance of $50 per month pursuant to section 28 249A.30A . 29 10. One hundred percent of the nonfederal share of payments 30 to area education agencies that are medical assistance 31 providers for medical assistance-covered services provided to 32 medical assistance-covered children, shall be made from the 33 appropriation made in this section. 34 11. A portion of the funds appropriated in this section may 35 -21- HF 2578 (3) 89 pf/rn/md 21/ 79
H.F. 2578 be transferred to the appropriation in this division of this 1 Act for health program operations to be used for administrative 2 activities associated with the money follows the person 3 demonstration project. 4 12. Of the funds appropriated in this section, $349,011 5 shall be used for the administration of the health insurance 6 premium payment program, including salaries, support, 7 maintenance, and miscellaneous purposes. 8 13. a. The department may increase the amounts allocated 9 for salaries, support, maintenance, and miscellaneous purposes 10 associated with the medical assistance program, as necessary, 11 to sustain cost management efforts. The department shall 12 report any such increase to the general assembly and the 13 department of management. 14 b. If the savings to the medical assistance program from 15 ongoing cost management efforts exceed the associated cost 16 for the fiscal year beginning July 1, 2022, the department 17 may transfer any savings generated for the fiscal year due 18 to medical assistance program cost management efforts to the 19 appropriation made in this division of this Act for health 20 program operations or general administration to defray the 21 costs associated with implementing the efforts. 22 14. For the fiscal year beginning July 1, 2022, and ending 23 June 30, 2023, the replacement generation tax revenues required 24 to be deposited in the property tax relief fund pursuant to 25 section 437A.8, subsection 4 , paragraph “d”, and section 26 437A.15, subsection 3 , paragraph “f”, shall instead be credited 27 to and supplement the appropriation made in this section and 28 used for the allocations made in this section. 29 15. a. Of the funds appropriated in this section, up 30 to $50,000 may be transferred by the department to the 31 appropriation made in this division of this Act to the 32 department for the same fiscal year for general administration 33 to be used for associated administrative expenses and for not 34 more than 1.00 full-time equivalent position, in addition to 35 -22- HF 2578 (3) 89 pf/rn/md 22/ 79
H.F. 2578 those authorized for the same fiscal year, to be assigned to 1 implementing the children’s mental health home project. 2 b. Of the funds appropriated in this section, up to $400,000 3 may be transferred by the department to the appropriation made 4 to the department in this division of this Act for the same 5 fiscal year for Medicaid program-related general administration 6 planning and implementation activities. The funds may be used 7 for contracts or for personnel in addition to the amounts 8 appropriated for and the positions authorized for general 9 administration for the fiscal year. 10 c. Of the funds appropriated in this section, up to 11 $3,000,000 may be transferred by the department to the 12 appropriations made in this division of this Act for the 13 same fiscal year for general administration or health 14 program operations to be used to support the development 15 and implementation of standardized assessment tools for 16 persons with mental illness, an intellectual disability, a 17 developmental disability, or a brain injury. 18 16. Of the funds appropriated in this section, $150,000 19 shall be used for lodging expenses associated with care 20 provided at the university of Iowa hospitals and clinics for 21 patients with cancer whose travel distance is 30 miles or more 22 and whose income is at or below 200 percent of the federal 23 poverty level as defined by the most recently revised poverty 24 income guidelines published by the United States department of 25 health and human services. The department of human services 26 shall establish the maximum number of overnight stays and the 27 maximum rate reimbursed for overnight lodging, which may be 28 based on the state employee rate established by the department 29 of administrative services. The funds allocated in this 30 subsection shall not be used as nonfederal share matching 31 funds. 32 17. Of the funds appropriated in this section, up to 33 $3,383,880 shall be used for administration of the state family 34 planning services program pursuant to section 217.41B , and 35 -23- HF 2578 (3) 89 pf/rn/md 23/ 79
H.F. 2578 of this amount, the department may use up to $200,000 for 1 administrative expenses. 2 18. Of the funds appropriated in this section, $1,545,530 3 shall be used and may be transferred to other appropriations 4 in this division of this Act as necessary to administer the 5 provisions in the division of this Act relating to Medicaid 6 program administration. 7 19. The department shall comply with the centers for 8 Medicare and Medicaid services’ guidance related to Medicaid 9 program and children’s health insurance program maintenance 10 of effort provisions, including eligibility standards, 11 methodologies, procedures, and continuous enrollment, to 12 receive the enhanced federal medical assistance percentage 13 under section 6008(b) of the federal Families First Coronavirus 14 Response Act, Pub. L. No. 116-127. The department shall 15 utilize and implement all tools, processes, and resources 16 available to expediently return to normal eligibility and 17 enrollment operations in compliance with federal guidance and 18 expectations. 19 20. A portion of the funds appropriated in this section 20 may be transferred to the appropriation made in this division 21 of this Act for the children’s health insurance program, 22 if the children’s health insurance program appropriation 23 is insufficient to cover the designated purposes of that 24 appropriation. 25 21. No later than January 1, 2023, the department of 26 human services shall implement a tiered rate reimbursement 27 methodology for psychiatric intensive inpatient care under the 28 Medicaid program based on the level of patient acuity and other 29 factors as recommended in the inpatient bed tracking study 30 committee report submitted to the governor and the general 31 assembly on December 1, 2021. 32 22. The department of human services shall submit a Medicaid 33 state plan amendment to the centers for Medicare and Medicaid 34 services to request the addition of functional family therapy 35 -24- HF 2578 (3) 89 pf/rn/md 24/ 79
H.F. 2578 and multisystemic therapy for youth as covered services under 1 the Medicaid program. The department shall include functional 2 family therapy and multisystemic therapy under the Medicaid 3 program as covered services upon receipt of federal approval. 4 23. Of the funds appropriated in this section, $7,400,000 5 shall be used to implement reductions in the waiting list for 6 the home and community-based services waiver for persons with 7 an intellectual disability. 8 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated 9 from the general fund of the state to the department of human 10 services for the fiscal year beginning July 1, 2022, and ending 11 June 30, 2023, the following amount, or so much thereof as is 12 necessary, to be used for the purpose designated: 13 For health program operations: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,446,343 15 1. The department of inspections and appeals shall 16 provide all state matching funds for survey and certification 17 activities performed by the department of inspections 18 and appeals. The department of human services is solely 19 responsible for distributing the federal matching funds for 20 such activities. 21 2. Of the funds appropriated in this section, $50,000 shall 22 be used for continuation of home and community-based services 23 waiver quality assurance programs, including the review and 24 streamlining of processes and policies related to oversight and 25 quality management to meet state and federal requirements. 26 3. Of the amount appropriated in this section, up to 27 $200,000 may be transferred to the appropriation for general 28 administration in this division of this Act to be used for 29 additional full-time equivalent positions in the development 30 of key health initiatives such as development and oversight 31 of managed care programs and development of health strategies 32 targeted toward improved quality and reduced costs in the 33 Medicaid program. 34 4. Of the funds appropriated in this section, $1,000,000 35 -25- HF 2578 (3) 89 pf/rn/md 25/ 79
H.F. 2578 shall be used for planning and development, in cooperation with 1 the department of public health, of a phased-in program to 2 provide a dental home for children. 3 5. a. Of the funds appropriated in this section, $188,000 4 shall be credited to the autism support program fund created 5 in section 225D.2 to be used for the autism support program 6 created in chapter 225D , with the exception of the following 7 amount of this allocation which shall be used as follows: 8 b. Of the funds allocated in this subsection, $25,000 shall 9 be used for the public purpose of continuation of a grant to 10 a nonprofit provider of child welfare services that has been 11 in existence for more than 115 years, is located in a county 12 with a population between 220,000 and 250,000 according to the 13 2020 federal decennial census, is licensed as a psychiatric 14 medical institution for children, and provides school-based 15 programming, to be used for support services for children with 16 autism spectrum disorder and their families. 17 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 18 1. There is appropriated from the general fund of the 19 state to the department of human services for the fiscal year 20 beginning July 1, 2022, and ending June 30, 2023, the following 21 amount, or so much thereof as is necessary, to be used for the 22 purpose designated: 23 For the state supplementary assistance program: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,349,002 25 2. The department shall increase the personal needs 26 allowance for residents of residential care facilities by the 27 same percentage and at the same time as federal supplemental 28 security income and federal social security benefits are 29 increased due to a recognized increase in the cost of living. 30 The department may adopt emergency rules to implement this 31 subsection. 32 3. If during the fiscal year beginning July 1, 2022, 33 the department projects that state supplementary assistance 34 expenditures for a calendar year will not meet the federal 35 -26- HF 2578 (3) 89 pf/rn/md 26/ 79
H.F. 2578 pass-through requirement specified in Tit. XVI of the federal 1 Social Security Act, section 1618, as codified in 42 U.S.C. 2 §1382g, the department may take actions including but not 3 limited to increasing the personal needs allowance for 4 residential care facility residents and making programmatic 5 adjustments or upward adjustments of the residential care 6 facility or in-home health-related care reimbursement rates 7 prescribed in this division of this Act to ensure that federal 8 requirements are met. In addition, the department may make 9 other programmatic and rate adjustments necessary to remain 10 within the amount appropriated in this section while ensuring 11 compliance with federal requirements. The department may adopt 12 emergency rules to implement the provisions of this subsection. 13 4. Notwithstanding section 8.33 , moneys appropriated 14 in this section that remain unencumbered or unobligated 15 at the close of the fiscal year shall not revert but 16 shall remain available for expenditure for the purposes 17 designated, including for liability amounts associated with the 18 supplemental nutrition assistance program payment error rate, 19 until the close of the succeeding fiscal year. 20 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 21 1. There is appropriated from the general fund of the 22 state to the department of human services for the fiscal year 23 beginning July 1, 2022, and ending June 30, 2023, the following 24 amount, or so much thereof as is necessary, to be used for the 25 purpose designated: 26 For maintenance of the healthy and well kids in Iowa (hawk-i) 27 program pursuant to chapter 514I , including supplemental dental 28 services, for receipt of federal financial participation under 29 Tit. XXI of the federal Social Security Act, which creates the 30 children’s health insurance program: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 38,661,688 32 2. Of the funds appropriated in this section, $158,850 is 33 allocated for continuation of the contract for outreach with 34 the department of public health. 35 -27- HF 2578 (3) 89 pf/rn/md 27/ 79
H.F. 2578 3. A portion of the funds appropriated in this section may 1 be transferred to the appropriations made in this division of 2 this Act for field operations or health program operations to 3 be used for the integration of hawk-i program eligibility, 4 payment, and administrative functions under the purview of 5 the department of human services, including for the Medicaid 6 management information system upgrade. 7 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 8 from the general fund of the state to the department of human 9 services for the fiscal year beginning July 1, 2022, and ending 10 June 30, 2023, the following amount, or so much thereof as is 11 necessary, to be used for the purpose designated: 12 For child care programs: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 14 1. Of the funds appropriated in this section, $34,966,931 15 shall be used for state child care assistance in accordance 16 with section 237A.13 . 17 2. Nothing in this section shall be construed or is 18 intended as or shall imply a grant of entitlement for services 19 to persons who are eligible for assistance due to an income 20 level consistent with the waiting list requirements of section 21 237A.13 . Any state obligation to provide services pursuant to 22 this section is limited to the extent of the funds appropriated 23 in this section. 24 3. A list of the registered and licensed child care 25 facilities operating in the area served by a child care 26 resource and referral service shall be made available to the 27 families receiving state child care assistance in that area. 28 4. Of the funds appropriated in this section, $5,850,000 29 shall be credited to the early childhood programs grants 30 account in the early childhood Iowa fund created in section 31 256I.11 . The moneys shall be distributed for funding of 32 community-based early childhood programs targeted to children 33 from birth through five years of age developed by early 34 childhood Iowa areas in accordance with approved community 35 -28- HF 2578 (3) 89 pf/rn/md 28/ 79
H.F. 2578 plans as provided in section 256I.8 . 1 5. The department may use any of the funds appropriated 2 in this section as a match to obtain federal funds for use in 3 expanding child care assistance and related programs. For 4 the purpose of expenditures of state and federal child care 5 funding, funds shall be considered obligated at the time 6 expenditures are projected or are allocated to the department’s 7 service areas. Projections shall be based on current and 8 projected caseload growth, current and projected provider 9 rates, staffing requirements for eligibility determination 10 and management of program requirements including data systems 11 management, staffing requirements for administration of the 12 program, contractual and grant obligations and any transfers 13 to other state agencies, and obligations for decategorization 14 or innovation projects. 15 6. A portion of the state match for the federal child care 16 and development block grant shall be provided as necessary to 17 meet federal matching funds requirements through the state 18 general fund appropriation made for child development grants 19 and other programs for at-risk children in section 279.51 . 20 7. If a uniform reduction ordered by the governor under 21 section 8.31 or other operation of law, transfer, or federal 22 funding reduction reduces the appropriation made in this 23 section for the fiscal year, the percentage reduction in the 24 amount paid out to or on behalf of the families participating 25 in the state child care assistance program shall be equal to or 26 less than the percentage reduction made for any other purpose 27 payable from the appropriation made in this section and the 28 federal funding relating to it. The percentage reduction to 29 the other allocations made in this section shall be the same as 30 the uniform reduction ordered by the governor or the percentage 31 change of the federal funding reduction, as applicable. If 32 there is an unanticipated increase in federal funding provided 33 for state child care services, the entire amount of the 34 increase, except as necessary to meet federal requirements 35 -29- HF 2578 (3) 89 pf/rn/md 29/ 79
H.F. 2578 including quality set asides, shall be used for state child 1 care assistance payments. If the appropriations made for 2 purposes of the state child care assistance program for the 3 fiscal year are determined to be insufficient, it is the intent 4 of the general assembly to appropriate sufficient funding for 5 the fiscal year in order to avoid establishment of waiting list 6 requirements. 7 8. Notwithstanding section 8.33 , moneys advanced for 8 purposes of the programs developed by early childhood Iowa 9 areas, advanced for purposes of wraparound child care, or 10 received from the federal appropriations made for the purposes 11 of this section that remain unencumbered or unobligated at the 12 close of the fiscal year shall not revert to any fund but shall 13 remain available for expenditure for the purposes designated 14 until the close of the succeeding fiscal year. 15 Sec. 18. JUVENILE INSTITUTION. There is appropriated 16 from the general fund of the state to the department of human 17 services for the fiscal year beginning July 1, 2022, and ending 18 June 30, 2023, the following amounts, or so much thereof as is 19 necessary, to be used for the purposes designated: 20 1. a. For operation of the state training school at Eldora 21 and for salaries, support, maintenance, and miscellaneous 22 purposes, and for not more than the following full-time 23 equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,606,871 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 26 b. Of the funds appropriated in this subsection, $91,000 27 shall be used for distribution to licensed classroom teachers 28 at this and other institutions under the control of the 29 department of human services based upon the average student 30 yearly enrollment at each institution as determined by the 31 department. 32 2. A portion of the moneys appropriated in this section 33 shall be used by the state training school at Eldora for 34 grants for adolescent pregnancy prevention activities at the 35 -30- HF 2578 (3) 89 pf/rn/md 30/ 79
H.F. 2578 institution in the fiscal year beginning July 1, 2022. 1 3. Of the funds appropriated in this subsection, $212,000 2 shall be used by the state training school at Eldora for a 3 substance use disorder treatment program at the institution for 4 the fiscal year beginning July 1, 2022. 5 4. Notwithstanding section 8.33 , moneys appropriated in 6 this section that remain unencumbered or unobligated at the 7 close of the fiscal year shall not revert but shall remain 8 available for expenditure for the purposes designated until the 9 close of the succeeding fiscal year. 10 Sec. 19. CHILD AND FAMILY SERVICES. 11 1. There is appropriated from the general fund of the 12 state to the department of human services for the fiscal year 13 beginning July 1, 2022, and ending June 30, 2023, the following 14 amount, or so much thereof as is necessary, to be used for the 15 purpose designated: 16 For child and family services: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 93,571,677 18 2. The department may transfer funds appropriated in this 19 section as necessary to pay the nonfederal costs of services 20 reimbursed under the medical assistance program, state child 21 care assistance program, or the family investment program which 22 are provided to children who would otherwise receive services 23 paid under the appropriation in this section. The department 24 may transfer funds appropriated in this section to the 25 appropriations made in this division of this Act for general 26 administration and for field operations for resources necessary 27 to implement and operate the services funded in this section. 28 3. a. (1) Of the funds appropriated in this section, up to 29 $40,500,000 is allocated as the statewide expenditure target 30 under section 232.143 for group foster care maintenance and 31 services. If the department projects that such expenditures 32 for the fiscal year will be less than the target amount 33 allocated in this paragraph “a”, the department may reallocate 34 the excess to provide additional funding for family foster 35 -31- HF 2578 (3) 89 pf/rn/md 31/ 79
H.F. 2578 care, supervised apartment living, family-centered services, 1 shelter care, or the child welfare emergency services addressed 2 with the allocation for shelter care. 3 (2) If 2022 Iowa Acts, House File 2507, amending section 4 232.143, is enacted, notwithstanding subparagraph (1), of 5 the funds appropriated in this section, up to $40,500,000 is 6 allocated for group foster care maintenance and services to 7 be expended in accordance with the applicable provisions of 8 2022 Iowa Acts, House File 2507. If the department projects 9 that such expenditures for the fiscal year will be less than 10 the target amount in this paragraph “a”, the department may 11 reallocate the excess to provide additional funding for family 12 foster care, supervised apartment living, family-centered 13 services, shelter care, or the child welfare emergency services 14 addresses with the allocation for shelter care. 15 b. Unless 2022 Iowa Acts, House File 2507, is enacted, 16 if at any time after September 30, 2022, annualization of a 17 service area’s current expenditures indicates a service area 18 is at risk of exceeding its group foster care expenditure 19 target under section 232.143 by more than 5 percent, the 20 department and juvenile court services shall examine all 21 group foster care placements in that service area in order to 22 identify those which might be appropriate for termination. 23 In addition, any aftercare services believed to be needed 24 for the children whose placements may be terminated shall be 25 identified. The department and juvenile court services shall 26 initiate action to set dispositional review hearings for the 27 placements identified. In such a dispositional review hearing, 28 the juvenile court shall determine whether needed aftercare 29 services are available and whether termination of the placement 30 is in the best interest of the child and the community. If 31 2022 Iowa Acts, House File 2507, is enacted, the applicable 32 provisions of House File 2507 shall supersede the provisions 33 of this paragraph “b”. 34 4. In accordance with the provisions of section 232.188 , 35 -32- HF 2578 (3) 89 pf/rn/md 32/ 79
H.F. 2578 the department shall continue the child welfare and juvenile 1 justice funding initiative during fiscal year 2022-2023. Of 2 the funds appropriated in this section, $1,717,000 is allocated 3 specifically for expenditure for fiscal year 2022-2023 through 4 the decategorization services funding pools and governance 5 boards established pursuant to section 232.188 . 6 5. A portion of the funds appropriated in this section 7 may be used for emergency family assistance to provide other 8 resources required for a family participating in a family 9 preservation or reunification project or successor project to 10 stay together or to be reunified. 11 6. Of the funds appropriated in this section, a sufficient 12 amount is allocated for shelter care and the child welfare 13 emergency services contracting implemented to provide for or 14 prevent the need for shelter care. 15 7. Federal funds received by the state during the fiscal 16 year beginning July 1, 2022, as the result of the expenditure 17 of state funds appropriated during a previous state fiscal 18 year for a service or activity funded under this section are 19 appropriated to the department to be used as additional funding 20 for services and purposes provided for under this section. 21 Notwithstanding section 8.33 , moneys received in accordance 22 with this subsection that remain unencumbered or unobligated at 23 the close of the fiscal year shall not revert to any fund but 24 shall remain available for the purposes designated until the 25 close of the succeeding fiscal year. 26 8. a. Of the funds appropriated in this section, up to 27 $3,290,000 is allocated for the payment of the expenses of 28 court-ordered services provided to juveniles who are under the 29 supervision of juvenile court services, which expenses are a 30 charge upon the state pursuant to section 232.141, subsection 31 4 . Of the amount allocated in this paragraph “a”, up to 32 $1,556,000 shall be made available to provide school-based 33 supervision of children adjudicated under chapter 232 , of which 34 not more than $15,000 may be used for the purpose of training. 35 -33- HF 2578 (3) 89 pf/rn/md 33/ 79
H.F. 2578 A portion of the cost of each school-based liaison officer 1 shall be paid by the school district or other funding source as 2 approved by the chief juvenile court officer. 3 b. Of the funds appropriated in this section, up to $748,000 4 is allocated for the payment of the expenses of court-ordered 5 services provided to children who are under the supervision 6 of the department, which expenses are a charge upon the state 7 pursuant to section 232.141, subsection 4 . 8 c. Notwithstanding section 232.141 or any other provision 9 of law to the contrary, the amounts allocated in this 10 subsection shall be distributed to the judicial districts 11 as determined by the state court administrator and to the 12 department’s service areas as determined by the administrator 13 of the department of human services’ division of child and 14 family services. The state court administrator and the 15 division administrator shall make the determination of the 16 distribution amounts on or before June 15, 2022. 17 d. Notwithstanding chapter 232 or any other provision of 18 law to the contrary, a district or juvenile court shall not 19 order any service which is a charge upon the state pursuant 20 to section 232.141 if there are insufficient court-ordered 21 services funds available in the district court or departmental 22 service area distribution amounts to pay for the service. The 23 chief juvenile court officer and the departmental service area 24 manager shall encourage use of the funds allocated in this 25 subsection such that there are sufficient funds to pay for 26 all court-related services during the entire year. The chief 27 juvenile court officers and departmental service area managers 28 shall attempt to anticipate potential surpluses and shortfalls 29 in the distribution amounts and shall cooperatively request the 30 state court administrator or division administrator to transfer 31 funds between the judicial districts’ or departmental service 32 areas’ distribution amounts as prudent. 33 e. Notwithstanding any provision of law to the contrary, 34 a district or juvenile court shall not order a county to pay 35 -34- HF 2578 (3) 89 pf/rn/md 34/ 79
H.F. 2578 for any service provided to a juvenile pursuant to an order 1 entered under chapter 232 which is a charge upon the state 2 under section 232.141, subsection 4 . 3 f. Of the funds allocated in this subsection, not more than 4 $83,000 may be used by the judicial branch for administration 5 of the requirements under this subsection. 6 g. Of the funds allocated in this subsection, $17,000 7 shall be used by the department of human services to support 8 the interstate commission for juveniles in accordance with 9 the interstate compact for juveniles as provided in section 10 232.173 . 11 9. Of the funds appropriated in this section, $12,253,000 is 12 allocated for juvenile delinquent graduated sanctions services. 13 Any state funds saved as a result of efforts by juvenile court 14 services to earn a federal Tit. IV-E match for juvenile court 15 services administration may be used for the juvenile delinquent 16 graduated sanctions services. 17 10. Of the funds appropriated in this section, $1,658,000 is 18 transferred to the department of public health to be used for 19 the child protection center grant program for child protection 20 centers located in Iowa in accordance with section 135.118 . 21 The grant amounts under the program shall be equalized so that 22 each center receives a uniform base amount of $245,000, and so 23 that the remaining funds are awarded through a funding formula 24 based upon the volume of children served. To increase access 25 to child protection center services for children in rural 26 areas, the funding formula for the awarding of the remaining 27 funds shall provide for the awarding of an enhanced amount to 28 eligible grantees to develop and maintain satellite centers in 29 underserved regions of the state. 30 11. Of the funds appropriated in this section, $4,025,000 is 31 allocated for the preparation for adult living program pursuant 32 to section 234.46 . 33 12. Of the funds appropriated in this section, $227,000 34 shall be used for the public purpose of continuing a grant to a 35 -35- HF 2578 (3) 89 pf/rn/md 35/ 79
H.F. 2578 nonprofit human services organization, providing services to 1 individuals and families in multiple locations in southwest 2 Iowa and Nebraska for support of a project providing immediate, 3 sensitive support and forensic interviews, medical exams, needs 4 assessments, and referrals for victims of child abuse and their 5 nonoffending family members. 6 13. Of the funds appropriated in this section, $300,000 7 is allocated for the foster care youth council approach of 8 providing a support network to children placed in foster care. 9 14. Of the funds appropriated in this section, $202,000 is 10 allocated for use pursuant to section 235A.1 for continuation 11 of the initiative to address child sexual abuse implemented 12 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 13 21 . 14 15. Of the funds appropriated in this section, $630,000 is 15 allocated for the community partnership for child protection 16 sites. 17 16. Of the funds appropriated in this section, $371,000 18 is allocated for the department’s minority youth and family 19 projects under the redesign of the child welfare system. 20 17. Of the funds appropriated in this section, $851,000 21 is allocated for funding of the community circle of care 22 collaboration for children and youth in northeast Iowa. 23 18. Of the funds appropriated in this section, at least 24 $147,000 shall be used for the continuation of the child 25 welfare provider training program. 26 19. Of the funds appropriated in this section, $211,000 27 shall be used for continuation of the central Iowa system of 28 care program grant for the purposes of funding community-based 29 services and other supports with a system of care approach for 30 children with serious emotional disturbance and their families 31 through a nonprofit provider that is located in a county with a 32 population of over 420,000 but less than 450,000 according to 33 the 2010 certified federal census, is licensed as a psychiatric 34 medical institution for children, and was a system of care 35 -36- HF 2578 (3) 89 pf/rn/md 36/ 79
H.F. 2578 grantee prior to July 1, 2022. 1 20. Of the funds appropriated in this section, $235,000 2 shall be used for the public purpose of the continuation 3 and expansion of a system of care program grant implemented 4 in Cerro Gordo and Linn counties to utilize a comprehensive 5 and long-term approach for helping children and families by 6 addressing the key areas in a child’s life of childhood basic 7 needs, education and work, family, and community. 8 21. Of the funds appropriated in this section, $110,000 9 shall be used for the public purpose of funding community-based 10 services and other supports with a system of care approach 11 for children with a serious emotional disturbance and their 12 families through a nonprofit provider of child welfare services 13 that has been in existence for more than 115 years, is located 14 in a county with a population of more than 230,000 according to 15 the 2020 certified federal census, is licensed as a psychiatric 16 medical institution for children, and was a system of care 17 grantee prior to July 1, 2022. 18 22. If a separate funding source is identified that reduces 19 the need for state funds within an allocation under this 20 section, the allocated state funds may be redistributed to 21 other allocations under this section for the same fiscal year. 22 23. Of the funds appropriated in this section, a portion may 23 be used for family-centered services for purposes of complying 24 with the federal Family First Prevention Services Act of 2018, 25 Pub. L. No. 115-123, and successor legislation. 26 24. Of the funds appropriated in this section, $3,850,718 27 shall be used to support placements in qualified residential 28 treatment programs. 29 Sec. 20. ADOPTION SUBSIDY. 30 1. There is appropriated from the general fund of the 31 state to the department of human services for the fiscal year 32 beginning July 1, 2022, and ending June 30, 2023, the following 33 amount, or so much thereof as is necessary, to be used for the 34 purpose designated: 35 -37- HF 2578 (3) 89 pf/rn/md 37/ 79
H.F. 2578 a. For adoption subsidy payments and related costs and for 1 other services provided for under paragraph “b”, subparagraph 2 (2): 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 4 b. (1) Of the funds appropriated in this section, a 5 sufficient amount is allocated for adoption subsidy payments 6 and related costs. 7 (2) Any funds appropriated in this section remaining after 8 the allocation under subparagraph (1) are designated and 9 allocated as state savings resulting from implementation of 10 the federal Fostering Connections to Success and Increasing 11 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 12 legislation, as determined in accordance with 42 U.S.C. 13 §673(a)(8), and shall be used for post-adoption services and 14 for other purposes allowed under these federal laws, Tit. IV-B 15 or Tit. IV-E of the federal Social Security Act. 16 (a) The department of human services may transfer funds 17 allocated in this subparagraph (2) to the appropriation for 18 child and family services in this division of this Act for the 19 purposes designated in this subparagraph (2). 20 (b) Notwithstanding section 8.33, moneys allocated 21 under this subparagraph (2) shall not revert to any fund but 22 shall remain available for the purposes designated in this 23 subparagraph (2) until expended. 24 2. The department may transfer funds appropriated in 25 this section to the appropriation made in this division of 26 this Act for general administration for costs paid from the 27 appropriation relating to adoption subsidy. 28 3. Federal funds received by the state during the 29 fiscal year beginning July 1, 2022, as the result of the 30 expenditure of state funds during a previous state fiscal 31 year for a service or activity funded under this section are 32 appropriated to the department to be used as additional funding 33 for the services and activities funded under this section. 34 Notwithstanding section 8.33 , moneys received in accordance 35 -38- HF 2578 (3) 89 pf/rn/md 38/ 79
H.F. 2578 with this subsection that remain unencumbered or unobligated 1 at the close of the fiscal year shall not revert to any fund 2 but shall remain available for expenditure for the purposes 3 designated until the close of the succeeding fiscal year. 4 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 5 in the juvenile detention home fund created in section 232.142 6 during the fiscal year beginning July 1, 2022, and ending June 7 30, 2023, are appropriated to the department of human services 8 for the fiscal year beginning July 1, 2022, and ending June 30, 9 2023, for distribution of an amount equal to a percentage of 10 the costs of the establishment, improvement, operation, and 11 maintenance of county or multicounty juvenile detention homes 12 in the fiscal year beginning July 1, 2021. Moneys appropriated 13 for distribution in accordance with this section shall be 14 allocated among eligible detention homes, prorated on the basis 15 of an eligible detention home’s proportion of the costs of all 16 eligible detention homes in the fiscal year beginning July 17 1, 2021. The percentage figure shall be determined by the 18 department based on the amount available for distribution for 19 the fund. Notwithstanding section 232.142, subsection 3 , the 20 financial aid payable by the state under that provision for the 21 fiscal year beginning July 1, 2022, shall be limited to the 22 amount appropriated for the purposes of this section. 23 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 24 1. There is appropriated from the general fund of the 25 state to the department of human services for the fiscal year 26 beginning July 1, 2022, and ending June 30, 2023, the following 27 amount, or so much thereof as is necessary, to be used for the 28 purpose designated: 29 For the family support subsidy program subject to the 30 enrollment restrictions in section 225C.37, subsection 3 : 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 32 2. At least $931,536 of the moneys appropriated in this 33 section is transferred to the department of public health for 34 the family support center component of the comprehensive family 35 -39- HF 2578 (3) 89 pf/rn/md 39/ 79
H.F. 2578 support program under chapter 225C, subchapter V . 1 3. If at any time during the fiscal year, the amount of 2 funding available for the family support subsidy program 3 is reduced from the amount initially used to establish the 4 figure for the number of family members for whom a subsidy 5 is to be provided at any one time during the fiscal year, 6 notwithstanding section 225C.38, subsection 2 , the department 7 shall revise the figure as necessary to conform to the amount 8 of funding available. 9 Sec. 23. CONNER DECREE. There is appropriated from the 10 general fund of the state to the department of human services 11 for the fiscal year beginning July 1, 2022, and ending June 30, 12 2023, the following amount, or so much thereof as is necessary, 13 to be used for the purpose designated: 14 For building community capacity through the coordination 15 and provision of training opportunities in accordance with the 16 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 17 Iowa, July 14, 1994): 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 19 Sec. 24. MENTAL HEALTH INSTITUTES. 20 1. There is appropriated from the general fund of the 21 state to the department of human services for the fiscal year 22 beginning July 1, 2022, and ending June 30, 2023, the following 23 amounts, or so much thereof as is necessary, to be used for the 24 purposes designated: 25 a. For operation of the state mental health institute at 26 Cherokee as required by chapters 218 and 226 for salaries, 27 support, maintenance, and miscellaneous purposes, and for not 28 more than the following full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,613,624 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.00 31 b. For operation of the state mental health institute at 32 Independence as required by chapters 218 and 226 for salaries, 33 support, maintenance, and miscellaneous purposes, and for not 34 more than the following full-time equivalent positions: 35 -40- HF 2578 (3) 89 pf/rn/md 40/ 79
H.F. 2578 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,688,928 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 208.00 2 2. a. Notwithstanding sections 218.78 and 249A.11 , any 3 revenue received from the state mental health institute at 4 Cherokee or the state mental health institute at Independence 5 pursuant to 42 C.F.R §438.6(e) may be retained and expended by 6 the mental health institute. 7 b. Notwithstanding sections 218.78 and 249A.11, any 8 COVID-19 related funding received through federal funding 9 sources by the state mental health institute at Cherokee or the 10 state mental health institute at Independence may be retained 11 and expended by the mental health institute. 12 3. Notwithstanding any provision of law to the contrary, 13 a Medicaid member residing at the state mental health 14 institute at Cherokee or the state mental health institute 15 at Independence shall retain Medicaid eligibility during 16 the period of the Medicaid member’s stay for which federal 17 financial participation is available. 18 4. Notwithstanding section 8.33 , moneys appropriated in 19 this section that remain unencumbered or unobligated at the 20 close of the fiscal year shall not revert but shall remain 21 available for expenditure for the purposes designated until the 22 close of the succeeding fiscal year. 23 Sec. 25. STATE RESOURCE CENTERS. 24 1. There is appropriated from the general fund of the 25 state to the department of human services for the fiscal year 26 beginning July 1, 2022, and ending June 30, 2023, the following 27 amounts, or so much thereof as is necessary, to be used for the 28 purposes designated: 29 a. For the state resource center at Glenwood for salaries, 30 support, maintenance, and miscellaneous purposes: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,288,739 32 b. For the state resource center at Woodward for salaries, 33 support, maintenance, and miscellaneous purposes: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,409,294 35 -41- HF 2578 (3) 89 pf/rn/md 41/ 79
H.F. 2578 2. The department may continue to bill for state resource 1 center services utilizing a scope of services approach used for 2 private providers of intermediate care facilities for persons 3 with an intellectual disability services, in a manner which 4 does not shift costs between the medical assistance program, 5 mental health and disability services regions, or other sources 6 of funding for the state resource centers. 7 3. The state resource centers may expand the time-limited 8 assessment and respite services during the fiscal year. 9 4. If the department’s administration and the department 10 of management concur with a finding by a state resource 11 center’s superintendent that projected revenues can reasonably 12 be expected to pay the salary and support costs for a new 13 employee position, or that such costs for adding a particular 14 number of new positions for the fiscal year would be less 15 than the overtime costs if new positions would not be added, 16 the superintendent may add the new position or positions. If 17 the vacant positions available to a resource center do not 18 include the position classification desired to be filled, the 19 state resource center’s superintendent may reclassify any 20 vacant position as necessary to fill the desired position. The 21 superintendents of the state resource centers may, by mutual 22 agreement, pool vacant positions and position classifications 23 during the course of the fiscal year in order to assist one 24 another in filling necessary positions. 25 5. If existing capacity limitations are reached in 26 operating units, a waiting list is in effect for a service or 27 a special need for which a payment source or other funding 28 is available for the service or to address the special need, 29 and facilities for the service or to address the special need 30 can be provided within the available payment source or other 31 funding, the superintendent of a state resource center may 32 authorize opening not more than two units or other facilities 33 and begin implementing the service or addressing the special 34 need during fiscal year 2022-2023. 35 -42- HF 2578 (3) 89 pf/rn/md 42/ 79
H.F. 2578 6. Notwithstanding section 8.33 , and notwithstanding 1 the amount limitation specified in section 222.92 , moneys 2 appropriated in this section that remain unencumbered or 3 unobligated at the close of the fiscal year shall not revert 4 but shall remain available for expenditure for the purposes 5 designated until the close of the succeeding fiscal year. 6 Sec. 26. SEXUALLY VIOLENT PREDATORS. 7 1. There is appropriated from the general fund of the 8 state to the department of human services for the fiscal year 9 beginning July 1, 2022, and ending June 30, 2023, the following 10 amount, or so much thereof as is necessary, to be used for the 11 purpose designated: 12 For costs associated with the commitment and treatment of 13 sexually violent predators in the unit located at the state 14 mental health institute at Cherokee, including costs of legal 15 services and other associated costs, including salaries, 16 support, maintenance, and miscellaneous purposes, and for not 17 more than the following full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,891,276 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 140.00 20 2. Unless specifically prohibited by law, if the amount 21 charged provides for recoupment of at least the entire amount 22 of direct and indirect costs, the department of human services 23 may contract with other states to provide care and treatment 24 of persons placed by the other states at the unit for sexually 25 violent predators at Cherokee. The moneys received under 26 such a contract shall be considered to be repayment receipts 27 and used for the purposes of the appropriation made in this 28 section. 29 3. Notwithstanding section 8.33 , moneys appropriated in 30 this section that remain unencumbered or unobligated at the 31 close of the fiscal year shall not revert but shall remain 32 available for expenditure for the purposes designated until the 33 close of the succeeding fiscal year. 34 Sec. 27. FIELD OPERATIONS. 35 -43- HF 2578 (3) 89 pf/rn/md 43/ 79
H.F. 2578 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, 2022, and ending June 30, 2023, the following 3 amount, or so much thereof as is necessary, to be used for the 4 purposes designated: 5 For field operations, including salaries, support, 6 maintenance, and miscellaneous purposes, and for not more than 7 the following full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,894,438 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,589.00 10 2. Priority in filling full-time equivalent positions 11 shall be given to those positions related to child protection 12 services and eligibility determination for low-income families. 13 Sec. 28. GENERAL ADMINISTRATION. There is appropriated 14 from the general fund of the state to the department of human 15 services for the fiscal year beginning July 1, 2022, and ending 16 June 30, 2023, the following amount, or so much thereof as is 17 necessary, to be used for the purpose designated: 18 For general administration, including salaries, support, 19 maintenance, and miscellaneous purposes, and for not more than 20 the following full-time equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,342,189 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 294.00 23 1. The department shall report at least monthly to the 24 general assembly concerning the department’s operational and 25 program expenditures. 26 2. Of the funds appropriated in this section, $150,000 shall 27 be used for the provision of a program to provide technical 28 assistance, support, and consultation to providers of home and 29 community-based services under the medical assistance program. 30 3. Of the funds appropriated in this section, $50,000 31 is transferred to the Iowa finance authority to be used 32 for administrative support of the council on homelessness 33 established in section 16.2D and for the council to fulfill its 34 duties in addressing and reducing homelessness in the state. 35 -44- HF 2578 (3) 89 pf/rn/md 44/ 79
H.F. 2578 4. Of the funds appropriated in this section, $200,000 shall 1 be transferred to and deposited in the administrative fund of 2 the Iowa ABLE savings plan trust created in section 12I.4 , to 3 be used for implementation and administration activities of the 4 Iowa ABLE savings plan trust. 5 5. Of the funds appropriated in this section, $200,000 is 6 transferred to the economic development authority for the Iowa 7 commission on volunteer services to continue to be used for the 8 RefugeeRISE AmeriCorps program established under section 15H.8 9 for member recruitment and training to improve the economic 10 well-being and health of economically disadvantaged refugees in 11 local communities across Iowa. Funds transferred may be used 12 to supplement federal funds under federal regulations. 13 6. Of the funds appropriated in this section, up to $300,000 14 shall be used as follows: 15 a. To fund not more than 1.00 full-time equivalent position 16 to address the department’s responsibility to support the work 17 of the children’s behavioral health system state board and 18 implementation of the services required pursuant to section 19 331.397. 20 b. To support the cost of establishing and implementing new 21 or additional services required pursuant to sections 331.397 22 and 331.397A. 23 c. Of the amount allocated, $32,000 shall be transferred 24 to the department of public health to support the costs of 25 establishing and implementing new or additional services 26 required pursuant to sections 331.397 and 331.397A. 27 7. Of the funds appropriated in this section, $800,000 shall 28 be used for the renovation and construction of certain nursing 29 facilities, consistent with the provisions of chapter 249K. 30 Sec. 29. DEPARTMENT-WIDE DUTIES. 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, 2022, and ending 33 June 30, 2023, the following amount, or so much thereof as is 34 necessary, to be used for the purposes designated: 35 -45- HF 2578 (3) 89 pf/rn/md 45/ 79
H.F. 2578 For salaries, support, maintenance, and miscellaneous 1 purposes at facilities under the purview of the department of 2 human services: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,172,123 4 Sec. 30. VOLUNTEERS. There is appropriated from the general 5 fund of the state to the department of human services for the 6 fiscal year beginning July 1, 2022, and ending June 30, 2023, 7 the following amount, or so much thereof as is necessary, to be 8 used for the purpose designated: 9 For development and coordination of volunteer services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 11 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 12 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 13 DEPARTMENT OF HUMAN SERVICES. 14 1. a. (1) (a) Notwithstanding any provision of law to the 15 contrary, for the fiscal year beginning July 1, 2022, case-mix 16 nursing facilities shall be reimbursed in accordance with the 17 methodology in effect on June 30, 2022. 18 (b) For the fiscal year beginning July 1, 2022, non-case-mix 19 and special population nursing facilities shall be reimbursed 20 in accordance with the methodology in effect on June 30, 2022. 21 (c) For managed care claims, the department of human 22 services shall adjust the payment rate floor for nursing 23 facilities, annually, to maintain a rate floor that is no 24 lower than the Medicaid fee-for-service case-mix adjusted rate 25 calculated in accordance with subparagraph division (a) and 26 441 IAC 81.6. The department shall then calculate adjusted 27 reimbursement rates, including but not limited to add-on 28 payments, annually, and shall notify Medicaid managed care 29 organizations of the adjusted reimbursement rates within 30 30 days of determining the adjusted reimbursement rates. Any 31 adjustment of reimbursement rates under this subparagraph 32 division shall be budget neutral to the state budget. 33 (d) For the fiscal year beginning July 1, 2022, Medicaid 34 managed care long-term services and supports capitation rates 35 -46- HF 2578 (3) 89 pf/rn/md 46/ 79
H.F. 2578 shall be adjusted to reflect the case-mix adjusted rates 1 specified pursuant to subparagraph division (a) for the patient 2 populations residing in Medicaid-certified nursing facilities. 3 (2) Medicaid managed care organizations shall adjust 4 facility-specific rates based upon payment rate listings issued 5 by the department. The rate adjustments shall be applied 6 prospectively from the effective date of the rate letter issued 7 by the department. 8 b. (1) For the fiscal year beginning July 1, 2022, the 9 department shall establish the fee-for-service pharmacy 10 dispensing fee reimbursement at $10.38 per prescription, 11 until a cost of dispensing survey is completed. The actual 12 dispensing fee shall be determined by a cost of dispensing 13 survey performed by the department and required to be completed 14 by all medical assistance program participating pharmacies 15 every two years, adjusted as necessary to maintain expenditures 16 within the amount appropriated to the department for this 17 purpose for the fiscal year. A change in the dispensing 18 fee shall become effective following federal approval of the 19 Medicaid state plan. 20 (2) The department shall utilize an average acquisition 21 cost reimbursement methodology for all drugs covered under the 22 medical assistance program in accordance with 2012 Iowa Acts, 23 chapter 1133, section 33. 24 c. (1) For the fiscal year beginning July 1, 2022, 25 reimbursement rates for outpatient hospital services shall 26 remain at the rates in effect on June 30, 2022, subject to 27 Medicaid program upper payment limit rules, and adjusted 28 as necessary to maintain expenditures within the amount 29 appropriated to the department for this purpose for the fiscal 30 year. 31 (2) For the fiscal year beginning July 1, 2022, 32 reimbursement rates for inpatient hospital services shall 33 remain at the rates in effect on June 30, 2022, subject to 34 Medicaid program upper payment limit rules, and adjusted 35 -47- HF 2578 (3) 89 pf/rn/md 47/ 79
H.F. 2578 as necessary to maintain expenditures within the amount 1 appropriated to the department for this purpose for the fiscal 2 year. 3 (3) For the fiscal year beginning July 1, 2022, under 4 both fee-for-service and managed care administration of 5 the Medicaid program, critical access hospitals shall be 6 reimbursed for inpatient and outpatient services based on the 7 hospital-specific critical access hospital cost adjustment 8 factor methodology utilizing the most recent and complete cost 9 reporting period as applied prospectively within the funds 10 appropriated for such purpose for the fiscal year. 11 (4) For the fiscal year beginning July 1, 2022, the graduate 12 medical education and disproportionate share hospital fund 13 shall remain at the amount in effect on June 30, 2022, except 14 that the portion of the fund attributable to graduate medical 15 education shall be reduced in an amount that reflects the 16 elimination of graduate medical education payments made to 17 out-of-state hospitals. 18 (5) In order to ensure the efficient use of limited state 19 funds in procuring health care services for low-income Iowans, 20 funds appropriated in this Act for hospital services shall 21 not be used for activities which would be excluded from a 22 determination of reasonable costs under the federal Medicare 23 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 24 d. For the fiscal year beginning July 1, 2022, reimbursement 25 rates for hospices and acute psychiatric hospitals shall be 26 increased in accordance with increases under the federal 27 Medicare program or as supported by their Medicare audited 28 costs. 29 e. For the fiscal year beginning July 1, 2022, independent 30 laboratories and rehabilitation agencies shall be reimbursed 31 using the same methodology in effect on June 30, 2022. 32 f. (1) For the fiscal year beginning July 1, 2022, 33 reimbursement rates for home health agencies shall continue to 34 be based on the Medicare low utilization payment adjustment 35 -48- HF 2578 (3) 89 pf/rn/md 48/ 79
H.F. 2578 (LUPA) methodology with state geographic wage adjustments. The 1 department shall continue to update the rates every two years 2 to reflect the most recent Medicare LUPA rates. 3 (2) For the fiscal year beginning July 1, 2022, the 4 department shall create a reimbursement rate structure that 5 provides incentives to home health care providers located in 6 rural areas and providing home health care to Medicaid members, 7 within the $4,000,000 appropriated for this purpose. The rate 8 structure shall include a telehealth component to incentivize 9 the provision of necessary supervision for skilled care without 10 requiring travel time. For the purposes of this subparagraph 11 (2), “rural area” means an area that is not an Iowa core based 12 statistical area as defined by the federal office of management 13 and budget. 14 (3) For the fiscal year beginning July 1, 2022, rates for 15 private duty nursing and personal care services under the early 16 and periodic screening, diagnostic, and treatment program 17 benefit shall be calculated based on the methodology in effect 18 on June 30, 2022. 19 g. For the fiscal year beginning July 1, 2022, federally 20 qualified health centers and rural health clinics shall receive 21 cost-based reimbursement for 100 percent of the reasonable 22 costs for the provision of services to recipients of medical 23 assistance. 24 h. For the fiscal year beginning July 1, 2022, the 25 reimbursement rates for dental services shall remain at the 26 rates in effect on June 30, 2022. 27 i. (1) For the fiscal year beginning July 1, 2022, 28 reimbursement rates for non-state-owned psychiatric medical 29 institutions for children shall be based on the reimbursement 30 methodology in effect on June 30, 2022. 31 (2) As a condition of participation in the medical 32 assistance program, enrolled providers shall accept the medical 33 assistance reimbursement rate for any covered goods or services 34 provided to recipients of medical assistance who are children 35 -49- HF 2578 (3) 89 pf/rn/md 49/ 79
H.F. 2578 under the custody of a psychiatric medical institution for 1 children. 2 j. For the fiscal year beginning July 1, 2022, unless 3 otherwise specified in this Act, all noninstitutional medical 4 assistance provider reimbursement rates shall remain at the 5 rates in effect on June 30, 2022, except for area education 6 agencies, local education agencies, infant and toddler 7 services providers, home and community-based services providers 8 including consumer-directed attendant care providers under a 9 section 1915(c) or 1915(i) waiver, targeted case management 10 providers, and those providers whose rates are required to be 11 determined pursuant to section 249A.20 , or to meet federal 12 mental health parity requirements. 13 k. Notwithstanding any provision to the contrary, for the 14 fiscal year beginning July 1, 2022, the reimbursement rate for 15 anesthesiologists shall remain at the rates in effect on June 16 30, 2022, and updated on January 1, 2023, to align with the 17 most current Iowa Medicare anesthesia rate. 18 l. Notwithstanding section 249A.20 , for the fiscal year 19 beginning July 1, 2022, the average reimbursement rate for 20 health care providers eligible for use of the federal Medicare 21 resource-based relative value scale reimbursement methodology 22 under section 249A.20 shall remain at the rate in effect on 23 June 30, 2022; however, this rate shall not exceed the maximum 24 level authorized by the federal government. 25 m. For the fiscal year beginning July 1, 2022, the 26 reimbursement rate for residential care facilities shall not 27 be less than the minimum payment level as established by the 28 federal government to meet the federally mandated maintenance 29 of effort requirement. The flat reimbursement rate for 30 facilities electing not to file annual cost reports shall not 31 be less than the minimum payment level as established by the 32 federal government to meet the federally mandated maintenance 33 of effort requirement. 34 n. For the fiscal year beginning July 1, 2022, the 35 -50- HF 2578 (3) 89 pf/rn/md 50/ 79
H.F. 2578 reimbursement rates for inpatient mental health services 1 provided at hospitals shall remain at the rates in effect on 2 June 30, 2022, subject to Medicaid program upper payment limit 3 rules and adjusted as necessary to maintain expenditures within 4 the amount appropriated to the department for this purpose for 5 the fiscal year; and psychiatrists shall be reimbursed at the 6 medical assistance program fee-for-service rate in effect on 7 June 30, 2022. 8 o. For the fiscal year beginning July 1, 2022, community 9 mental health centers may choose to be reimbursed for the 10 services provided to recipients of medical assistance through 11 either of the following options: 12 (1) For 100 percent of the reasonable costs of the services. 13 (2) In accordance with the alternative reimbursement rate 14 methodology approved by the department of human services in 15 effect on June 30, 2022. 16 p. For the fiscal year beginning July 1, 2022, the 17 reimbursement rate for providers of family planning services 18 that are eligible to receive a 90 percent federal match shall 19 remain at the rates in effect on June 30, 2022. 20 q. (1) For the fiscal year beginning July 1, 2022, 21 reimbursement rates for providers of home and community-based 22 services waiver and habilitation services shall be increased 23 to the extent possible within the $14,600,000 appropriated for 24 this purpose. The entire rate increase shall be used for wages 25 and associated costs specific to wages, benefits, and required 26 withholding of direct support professionals and frontline 27 management, including consumer choices option employees. 28 (2) For the fiscal year beginning July 1, 2022, 29 reimbursement rates for intermediate care facility for 30 persons with an intellectual disability providers shall be 31 increased over the rates in effect on June 30, 2022, within 32 the $3,125,778 appropriated for this purpose. The entire rate 33 increase shall be used for wages and associated costs specific 34 to wages, benefits, and required withholding of direct support 35 -51- HF 2578 (3) 89 pf/rn/md 51/ 79
H.F. 2578 professionals and frontline management. 1 (3) For the fiscal year beginning July 1, 2022, 2 reimbursement rates for providers of state plan home and 3 community-based services home-based habilitation services 4 shall remain at the rates in effect on June 30, 2022. The 5 reimbursement rates for home-based habilitation services shall 6 be based on a fee schedule that incorporates the acuity-based 7 tiers. 8 r. For the fiscal year beginning July 1, 2022, the 9 reimbursement rates for emergency medical service providers 10 shall remain at the rates in effect on June 30, 2022, or as 11 approved by the centers for Medicare and Medicaid services of 12 the United States department of health and human services. 13 s. (1) For the fiscal year beginning July 1, 2022, 14 reimbursement rates for substance-related disorder treatment 15 programs licensed under section 125.13 shall remain at the 16 rates in effect on June 30, 2022. 17 (2) For the fiscal year beginning July 1, 2022, the 18 department shall establish a fee schedule or provider-specific 19 rate structure to increase reimbursement rates for residential 20 substance use treatment providers within the $1,100,000 21 appropriated for this purpose. 22 t. For the fiscal year beginning July 1, 2022, assertive 23 community treatment per diem rates shall remain at the rates in 24 effect on June 30, 2022. 25 u. For the fiscal year beginning July 1, 2022, the 26 reimbursement rate for family-centered services providers shall 27 be established by contract. 28 v. For the fiscal year beginning July 1, 2022, the 29 reimbursement rate for air ambulance services shall remain at 30 the rate in effect on June 30, 2022. 31 w. For the fiscal year beginning July 1, 2022, all 32 behavioral health intervention services reimbursement rates 33 shall be increased over the rates in effect on June 30, 2022, 34 within the $3,000,000 appropriated for this purpose. The 35 -52- HF 2578 (3) 89 pf/rn/md 52/ 79
H.F. 2578 entire rate increase shall be used for wages and associated 1 costs specific to wages, benefits, and required withholding of 2 direct support professionals and frontline management. 3 x. For the fiscal year beginning July 1, 2022, all applied 4 behavioral analysis services reimbursement rates shall be 5 increased over the rates in effect on June 30, 2022, within the 6 $385,000 appropriated for this purpose. 7 2. For the fiscal year beginning July 1, 2022, the 8 reimbursement rate for providers reimbursed under the 9 in-home-related care program shall not be less than the minimum 10 payment level as established by the federal government to meet 11 the federally mandated maintenance of effort requirement. 12 3. Unless otherwise directed in this section, when the 13 department’s reimbursement methodology for any provider 14 reimbursed in accordance with this section includes an 15 inflation factor, this factor shall not exceed the amount 16 by which the consumer price index for all urban consumers 17 increased during the most recently ended calendar year. 18 4. Notwithstanding section 234.38 , for the fiscal 19 year beginning July 1, 2022, the foster family basic daily 20 maintenance rate and the maximum adoption subsidy rate for 21 children ages 0 through 5 years shall be $16.78, the rate for 22 children ages 6 through 11 years shall be $17.45, the rate for 23 children ages 12 through 15 years shall be $19.10, and the 24 rate for children and young adults ages 16 and older shall 25 be $19.35. For youth ages 18 to 23 who have exited foster 26 care, the preparation for adult living program maintenance 27 rate shall be up to $602.70 per month as calculated based on 28 the age of the participant. The maximum payment for adoption 29 subsidy nonrecurring expenses shall be limited to $500 and the 30 disallowance of additional amounts for court costs and other 31 related legal expenses implemented pursuant to 2010 Iowa Acts, 32 chapter 1031, section 408 , shall be continued. 33 5. For the fiscal year beginning July 1, 2022, the maximum 34 reimbursement rates for social services providers under 35 -53- HF 2578 (3) 89 pf/rn/md 53/ 79
H.F. 2578 contract shall remain at the rates in effect on June 30, 2022, 1 or the provider’s actual and allowable cost plus inflation for 2 each service, whichever is less. However, if a new service 3 or service provider is added after June 30, 2022, the initial 4 reimbursement rate for the service or provider shall be based 5 upon a weighted average of provider rates for similar services. 6 6. a. For the fiscal year beginning July 1, 2022, the 7 reimbursement rates for resource family recruitment and 8 retention contractors shall be established by contract. 9 b. For the fiscal year beginning July 1, 2022, the 10 reimbursement rates for supervised apartment living foster care 11 providers shall be established by contract. 12 7. For the fiscal year beginning July 1, 2022, the 13 reimbursement rate for group foster care providers shall be the 14 combined service and maintenance reimbursement rate established 15 by contract. 16 8. The group foster care reimbursement rates paid for 17 placement of children out of state shall be calculated 18 according to the same rate-setting principles as those used for 19 in-state providers, unless the director of human services or 20 the director’s designee determines that appropriate care cannot 21 be provided within the state. The payment of the daily rate 22 shall be based on the number of days in the calendar month in 23 which service is provided. 24 9. a. For the fiscal year beginning July 1, 2022, the 25 reimbursement rate paid for shelter care and the child welfare 26 emergency services implemented to provide or prevent the need 27 for shelter care shall be established by contract. 28 b. For the fiscal year beginning July 1, 2022, the combined 29 service and maintenance components of the per day reimbursement 30 rate paid for shelter care services shall be based on the 31 financial and statistical report submitted to the department. 32 The maximum per day reimbursement rate shall be the maximum 33 per day reimbursement rate in effect on June 30, 2022, as 34 increased within the $649,029 appropriated for this purpose. 35 -54- HF 2578 (3) 89 pf/rn/md 54/ 79
H.F. 2578 The department shall reimburse a shelter care provider at the 1 provider’s actual and allowable unit cost, plus inflation, not 2 to exceed the maximum reimbursement rate. 3 c. Unless 2022 Iowa Acts, House File 2507, is enacted, 4 notwithstanding section 232.141, subsection 8 , for the fiscal 5 year beginning July 1, 2022, the amount of the statewide 6 average of the actual and allowable rates for reimbursement of 7 juvenile shelter care homes that is utilized for the limitation 8 on recovery of unpaid costs shall remain at the amount in 9 effect for this purpose in the fiscal year beginning July 1, 10 2021. If 2022 Iowa Acts, House File 2507, is enacted, the 11 applicable provisions of House File 2507 shall supersede the 12 provisions of this paragraph “c”. 13 10. For the fiscal year beginning July 1, 2022, the 14 department shall calculate reimbursement rates for intermediate 15 care facilities for persons with an intellectual disability 16 at the 80th percentile. Beginning July 1, 2022, the rate 17 calculation methodology shall utilize the consumer price index 18 inflation factor applicable to the fiscal year beginning July 19 1, 2022. 20 11. Effective July 1, 2022, child care provider 21 reimbursement rates shall remain at the rates in effect on June 22 30, 2022. The department shall set rates in a manner so as 23 to provide incentives for a nonregistered provider to become 24 registered by applying any increase only to registered and 25 licensed providers. 26 12. The department may adopt emergency rules to implement 27 this section. 28 Sec. 32. EMERGENCY RULES. 29 1. If necessary to comply with federal requirements 30 including time frames, or if specifically authorized by a 31 provision of this division of this Act, the department of 32 human services or the mental health and disability services 33 commission may adopt administrative rules under section 17A.4, 34 subsection 3, and section 17A.5, subsection 2, paragraph “b”, 35 -55- HF 2578 (3) 89 pf/rn/md 55/ 79
H.F. 2578 to implement the provisions of this division of this Act and 1 the rules shall become effective immediately upon filing or 2 on a later effective date specified in the rules, unless the 3 effective date of the rules is delayed or the applicability 4 of the rules is suspended by the administrative rules review 5 committee. Any rules adopted in accordance with this section 6 shall not take effect before the rules are reviewed by the 7 administrative rules review committee. The delay authority 8 provided to the administrative rules review committee under 9 section 17A.8, subsections 9 and 10, shall be applicable to a 10 delay imposed under this section, notwithstanding a provision 11 in those subsections making them inapplicable to section 17A.5, 12 subsection 2, paragraph “b”. Any rules adopted in accordance 13 with the provisions of this section shall also be published as 14 a notice of intended action as provided in section 17A.4. 15 2. If during a fiscal year, the department of human 16 services is adopting rules in accordance with this section 17 or as otherwise directed or authorized by state law, and 18 the rules will result in an expenditure increase beyond the 19 amount anticipated in the budget process or if the expenditure 20 was not addressed in the budget process for the fiscal 21 year, the department shall notify the general assembly and 22 the department of management concerning the rules and the 23 expenditure increase. The notification shall be provided at 24 least 30 calendar days prior to the date notice of the rules 25 is submitted to the administrative rules coordinator and the 26 administrative code editor. 27 Sec. 33. REPORTS. Unless otherwise provided, any reports or 28 other information required to be compiled and submitted under 29 this Act during the fiscal year beginning July 1, 2022, shall 30 be submitted on or before the dates specified for submission 31 of the reports or information. 32 Sec. 34. EFFECTIVE UPON ENACTMENT. The following provision 33 of this division of this Act, being deemed of immediate 34 importance, takes effect upon enactment: 35 -56- HF 2578 (3) 89 pf/rn/md 56/ 79
H.F. 2578 The provision relating to section 232.141 and directing the 1 state court administrator and the division administrator of 2 the department of human services division of child and family 3 services to make the determination, by June 15, 2022, of the 4 distribution of funds allocated for the payment of the expenses 5 of court-ordered services provided to juveniles which are a 6 charge upon the state. 7 DIVISION VI 8 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2022-2023 9 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 10 appropriated from the pharmaceutical settlement account created 11 in section 249A.33 to the department of human services for the 12 fiscal year beginning July 1, 2022, and ending June 30, 2023, 13 the following amount, or so much thereof as is necessary, to be 14 used for the purpose designated: 15 Notwithstanding any provision of law to the contrary, to 16 supplement the appropriations made in this Act for health 17 program operations under the medical assistance program for the 18 fiscal year beginning July 1, 2022, and ending June 30, 2023: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 20 Sec. 36. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 21 SERVICES. Notwithstanding any provision to the contrary and 22 subject to the availability of funds, there is appropriated 23 from the quality assurance trust fund created in section 24 249L.4 to the department of human services for the fiscal year 25 beginning July 1, 2022, and ending June 30, 2023, the following 26 amounts, or so much thereof as is necessary, for the purposes 27 designated: 28 To supplement the appropriation made in this Act from the 29 general fund of the state to the department of human services 30 for medical assistance for the same fiscal year: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 56,305,139 32 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 33 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 34 the contrary and subject to the availability of funds, there is 35 -57- HF 2578 (3) 89 pf/rn/md 57/ 79
H.F. 2578 appropriated from the hospital health care access trust fund 1 created in section 249M.4 to the department of human services 2 for the fiscal year beginning July 1, 2022, and ending June 3 30, 2023, the following amounts, or so much thereof as is 4 necessary, for the purposes designated: 5 To supplement the appropriation made in this Act from the 6 general fund of the state to the department of human services 7 for medical assistance for the same fiscal year: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 9 Sec. 38. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 10 FOR FY 2022-2023. Notwithstanding section 8.33 , if moneys 11 appropriated for purposes of the medical assistance program for 12 the fiscal year beginning July 1, 2022, and ending June 30, 13 2023, from the general fund of the state, the quality assurance 14 trust fund, and the hospital health care access trust fund, are 15 in excess of actual expenditures for the medical assistance 16 program and remain unencumbered or unobligated at the close 17 of the fiscal year, the excess moneys shall not revert but 18 shall remain available for expenditure for the purposes of the 19 medical assistance program until the close of the succeeding 20 fiscal year. 21 DIVISION VII 22 DECATEGORIZATION CARRYOVER FUNDING 23 Sec. 39. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —— 24 TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188, 25 subsection 5, paragraph “b”, any state-appropriated moneys in 26 the funding pool that remained unencumbered or unobligated 27 at the close of the fiscal year beginning July 1, 2019, and 28 were deemed carryover funding to remain available for the two 29 succeeding fiscal years that still remain unencumbered or 30 unobligated at the close of the fiscal year beginning July 1, 31 2021, shall not revert but shall be transferred to the medical 32 assistance program for the fiscal year beginning July 1, 2022. 33 Sec. 40. EFFECTIVE DATE. This division of this Act, being 34 deemed of immediate importance, takes effect upon enactment. 35 -58- HF 2578 (3) 89 pf/rn/md 58/ 79
H.F. 2578 Sec. 41. RETROACTIVE APPLICABILITY. This division of this 1 Act applies retroactively to July 1, 2021. 2 DIVISION VIII 3 TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE 4 Sec. 42. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —— 5 FY 2021-2022. Notwithstanding any provision to the contrary, 6 any funds remaining in the property tax relief fund created 7 in section 426B.1 at the close of the fiscal year beginning 8 July 1, 2021, shall be transferred to the region incentive fund 9 created in the mental health and disability services regional 10 service fund pursuant to section 225C.7A. 11 Sec. 43. EFFECTIVE DATE. This division of this Act, being 12 deemed of immediate importance, takes effect upon enactment. 13 DIVISION IX 14 PRIOR APPROPRIATIONS AND OTHER PROVISIONS 15 FAMILY INVESTMENT PROGRAM GENERAL FUND 16 Sec. 44. 2021 Iowa Acts, chapter 182, section 9, is amended 17 by adding the following new subsection: 18 NEW SUBSECTION . 7. Notwithstanding section 8.33, moneys 19 appropriated in this section that remain unencumbered or 20 unobligated at the close of the fiscal year shall not revert 21 but shall remain available for one-time purposes, and may be 22 transferred to the appropriation in this division of this Act 23 for general administration for technology purposes, until the 24 close of the succeeding fiscal year. 25 CHILD AND FAMILY SERVICES 26 Sec. 45. 2021 Iowa Acts, chapter 182, section 19, is amended 27 by adding the following new subsection: 28 NEW SUBSECTION . 24. Notwithstanding section 8.33, moneys 29 appropriated in this section that remain unencumbered or 30 unobligated at the close of the fiscal year shall not revert 31 but shall remain available for the purposes designated until 32 the close of the succeeding fiscal year. 33 FIELD OPERATIONS 34 Sec. 46. 2021 Iowa Acts, chapter 182, section 27, is amended 35 -59- HF 2578 (3) 89 pf/rn/md 59/ 79
H.F. 2578 by adding the following new subsection: 1 NEW SUBSECTION . 3. Notwithstanding section 8.33, moneys 2 appropriated in this section that remain unencumbered or 3 unobligated at the close of the fiscal year shall not revert 4 but shall remain available for one-time expenditure purposes 5 until the close of the succeeding fiscal year. 6 GENERAL ADMINISTRATION 7 Sec. 47. 2021 Iowa Acts, chapter 182, section 28, is amended 8 by adding the following new subsection: 9 NEW SUBSECTION . 8. Notwithstanding section 8.33, moneys 10 appropriated in this section that remain unencumbered or 11 unobligated at the close of the fiscal year shall not revert 12 but shall remain available for one-time expenditure purposes 13 until the close of the succeeding fiscal year. 14 Sec. 48. EFFECTIVE DATE. This division of this Act, being 15 deemed of immediate importance, takes effect upon enactment. 16 DIVISION X 17 PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS 18 Sec. 49. COVID-19 FEDERAL REGULATIONS. For the time 19 period beginning on the effective date of this division of 20 this Act, and ending June 30, 2023, notwithstanding state 21 administrative rules to the contrary, to the extent federal 22 regulations relating to the COVID-19 pandemic differ from state 23 administrative rules, including applicable federal waivers, 24 the federal regulations are controlling during the pendency of 25 the federally declared state of emergency and for such period 26 of time following the end of the federally declared state of 27 emergency applicable to the respective federal regulations. 28 DIVISION XI 29 HEALTH AND HUMAN SERVICES REALIGNMENT 30 Sec. 50. TRANSITION OF DEPARTMENT OF HUMAN SERVICES AND 31 DEPARTMENT OF PUBLIC HEALTH INTO DEPARTMENT OF HEALTH AND HUMAN 32 SERVICES. 33 1. Definitions. For the purposes of this section: 34 a. “Department of health and human services” or 35 -60- HF 2578 (3) 89 pf/rn/md 60/ 79
H.F. 2578 “department” means the department of health and human services 1 created under this section. 2 b. “Transition department” means the department of human 3 services or the department of public health. 4 c. “Transition departments” means the department of human 5 services and the department of public health. 6 d. “Transition period” means the period beginning July 1, 7 2022, and ending June 30, 2023. 8 2. Creation of department of health and human services 9 —— transition period —— powers and duties. Notwithstanding 10 any conflicting provision of law to the contrary, there is 11 created a department of health and human services. During 12 the transition period, the department of health and human 13 services shall have and may exercise all of the policymaking 14 functions, regulatory and enforcement powers, rights, duties, 15 and responsibilities of the department of human services and 16 the department of public health as prescribed by law or rule 17 in effect on July 1, 2022, including but not limited to those 18 relating to: 19 a. All obligations and contracts of a transition 20 department, including obligations and contracts related to a 21 grant program. 22 b. All property and records in the custody of a transition 23 department. 24 c. All funds appropriated to a transition department by the 25 general assembly and all state, federal, and other funds for 26 which expenditure by a transition department is authorized. 27 d. Complaints, investigations, contested cases, causes of 28 action, and statutes of limitations involving a transition 29 department. 30 (1) All complaints, investigations, contested cases, or 31 a remand of an action by a reviewing court pending before a 32 transition department or an authorized person of a transition 33 department shall continue without change in status before 34 the department and shall be governed by the laws and rules 35 -61- HF 2578 (3) 89 pf/rn/md 61/ 79
H.F. 2578 applicable to the complaint, investigation, contested case, or 1 remand action or proceeding in effect on July 1, 2022. 2 (2) Any cause of action or statute of limitation relating 3 to a transition department shall not be affected as a result 4 of the transition and such cause of action or statute of 5 limitation shall apply to the department. 6 e. Rules, policies, and forms. All rules, policies, and 7 forms adopted by or on behalf of a transition department shall 8 become rules, policies, and forms of the department and shall 9 remain in effect unless altered by the department. 10 f. Licenses, permits, and certifications. All licenses, 11 permits, and certifications issued by a transition department 12 shall continue in effect as a license, permit, or certification 13 of the department in accordance with the law or rule governing 14 the license, permit, or certification in effect on July 1, 15 2022, until the license, permit, or certification expires, is 16 suspended or revoked, or otherwise becomes invalid by the terms 17 of such law or rule. 18 g. References to a department or director. All references 19 to the department of public health or the department of human 20 services in law or in rule shall be interpreted to mean the 21 department of health and human services, and all references to 22 the director of public health or the director of human services 23 shall be interpreted to mean the director of the department of 24 health and human services. 25 h. Departmental structure. 26 (1) Any transition department, transition department 27 subunit, or transition department body created or established 28 by law and in existence on July 1, 2022, shall continue in 29 full force and effect and shall not be permanently abolished, 30 merged, or otherwise altered until amended, repealed, or 31 supplemented by action of the general assembly. 32 (2) This paragraph shall not prohibit a transition 33 department, transition department subunit, or transition 34 department body created or established by law in existence on 35 -62- HF 2578 (3) 89 pf/rn/md 62/ 79
H.F. 2578 July 1, 2022, from sharing or coordinating responsibilities 1 or functions under their respective purviews nor prohibit 2 the director from temporarily integrating such departments, 3 subunits, or bodies or the responsibilities or functions under 4 their respective purviews in furtherance of the transition plan 5 during the transition period. 6 3. Transition period leadership. During the transition 7 period, the director of human services shall continue to act 8 as the director of human services, shall assume the duties of 9 the director of public health, shall act as the director of 10 the department of health and human services, and may thereby 11 exercise any policymaking functions, regulatory and enforcement 12 powers, rights, duties, and responsibilities of the director 13 of human services and the director of public health including 14 those duties prescribed by law for the department of human 15 services or the department of public health in effect on July 16 1, 2022. 17 4. Federal authorization and effective date of 18 authorizations. If a transition department or the department 19 determines that a waiver or authorization from the federal 20 government is necessary to administer any provision of 21 this section, the department shall request the waiver or 22 authorization, and notwithstanding any other effective date to 23 the contrary, the provision shall take effect only upon receipt 24 of federal approval. 25 5. Initial written transition plan. 26 a. On or before September 30, 2022, the transition 27 departments or department shall publish on their respective 28 internet sites an initial written transition plan for merging 29 the functions of the transition departments into the department 30 of health and human services effective July 1, 2023, in order 31 to do all of the following: 32 (1) More efficiently and effectively manage health and 33 human services programs that are the responsibility of the 34 state. 35 -63- HF 2578 (3) 89 pf/rn/md 63/ 79
H.F. 2578 (2) Establish a health and human services policy for the 1 state. 2 (3) Promote health and the quality of life in the health and 3 human services field. 4 b. The transition plan shall describe, at a minimum, all of 5 the following: 6 (1) The tasks that require completion before July 1, 2023, 7 including a description of how the transition departments shall 8 solicit comment from stakeholders, including employees of the 9 transition departments, clients and partners of the transition 10 departments, members of the public, and members of the general 11 assembly. 12 (2) The proposed organizational structure of the 13 department, at a minimum, including the division level of 14 the table of organization. Any personnel in the state merit 15 system of employment who are mandatorily transferred due to the 16 transition shall be so transferred without any loss in salary, 17 benefits, or accrued years of service. 18 (3) Proposed changes to any transition department boards, 19 commissions, committees, councils, or other bodies and their 20 functions. 21 (4) Office space and infrastructure requirements related 22 to the transition. 23 (5) Any work site location changes for transitioning 24 employees. 25 (6) The transition of service delivery sites. 26 (7) Procedures for the transfer and reconciliation of 27 budgeting and funding between the transition departments and 28 the department. 29 (8) The transition of technology services of the transition 30 departments to the department. 31 (9) Any additional known tasks that may require completion 32 after the transition on July 1, 2023. 33 c. The written transition plan published under paragraph 34 “b” shall: 35 -64- HF 2578 (3) 89 pf/rn/md 64/ 79
H.F. 2578 (1) Include a detailed timeline for the completion of the 1 tasks described. 2 (2) Be updated quarterly during the remainder of the 3 transition period. 4 (3) Describe how information will be provided to clients 5 of the transition departments and the department regarding any 6 changes in service delivery. 7 (4) Describe how the transition to the department will be 8 funded, including how expenses associated with the transition 9 will be managed; how funding for services provided by the 10 transition departments will be managed to ensure provision 11 of services by the transition departments and the department 12 without interruption; and how federal funds will be used by 13 or transferred between the transition departments and the 14 department to ensure provision of services by the transition 15 departments and the department without interruption. 16 6. Statutory and administrative rule updates. 17 a. Legislative changes required to implement the 18 transition. Additional legislation is necessary to fully 19 implement the transition. The director of the department 20 of health and human services shall, in compliance with 21 section 2.16, prepare draft legislation for submission to the 22 legislative services agency, as necessary, for consideration 23 by the general assembly during the 2023 legislative 24 session, to implement the transition effective July 1, 2023. 25 Notwithstanding any provision to the contrary in section 2.16, 26 the draft legislation shall be submitted to the legislative 27 services agency by October 1, 2022. 28 b. Update of administrative code required by the 29 transition. In updating references and the format in the 30 Iowa administrative code, in order to correspond to the 31 transferring of duties of the transition departments, the 32 administrative rules coordinator and the administrative rules 33 review committee, in consultation with the administrative code 34 editor, shall collectively develop a schedule for the necessary 35 -65- HF 2578 (3) 89 pf/rn/md 65/ 79
H.F. 2578 updating of the Iowa administrative code. 1 DIVISION XII 2 NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY 3 OF CARE RATE ADD-ON PROGRAM 4 Sec. 51. Section 249L.2, subsections 6 and 7, Code 2022, are 5 amended by striking the subsections. 6 Sec. 52. Section 249L.2, subsection 8, Code 2022, is amended 7 to read as follows: 8 8. “Nursing facility” means a licensed nursing facility as 9 defined in section 135C.1 that is a freestanding facility or 10 a nursing facility operated by a hospital licensed pursuant 11 to chapter 135B , but does not include a distinct-part skilled 12 nursing unit or a swing-bed unit operated by a hospital, or 13 a nursing facility owned by the state or federal government 14 or other governmental unit. “Nursing facility” includes a 15 non-state government-owned nursing facility if the nursing 16 facility participates in the non-state government-owned nursing 17 facility quality of care rate add-on program. 18 Sec. 53. REPEAL. 2019 Iowa Acts, chapter 85, sections 103, 19 104, and 108, are repealed. 20 Sec. 54. REPEAL. 2020 Iowa Acts, chapter 1063, section 390, 21 is repealed. 22 DIVISION XIII 23 HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —— 24 ADMINISTRATION 25 Sec. 55. HEARING AID AND AUDIOLOGIC SERVICES FUNDING 26 PROGRAM ADMINISTRATION. The Iowa department of public 27 health shall not enter into a contract with a third party to 28 administer the hearing aids and audiologic services funding 29 program and shall adopt rules pursuant to chapter 17A to 30 administer the program within the department, including but not 31 limited to the administration of the application process, the 32 determination of applicants’ eligibility, the enrollment of 33 eligible applicants into the program, the maintenance of the 34 hearing aids and audiologic services funding waitlist, and the 35 -66- HF 2578 (3) 89 pf/rn/md 66/ 79
H.F. 2578 reimbursement of providers. 1 DIVISION XIV 2 HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —— 3 FY 2021-2022 NONREVERSION 4 Sec. 56. 2021 Iowa Acts, chapter 182, section 3, subsection 5 2, paragraph e, is amended to read as follows: 6 e. Of the funds appropriated in this subsection, $156,000 7 shall be used to provide audiological services and hearing 8 aids for children. Notwithstanding section 8.33, moneys 9 appropriated in this paragraph that remain unencumbered or 10 unobligated at the close of the fiscal year shall not revert 11 but shall remain available for expenditure for the purposes 12 designated until the close of the succeeding fiscal year. The 13 amount that does not revert shall be reported by the department 14 to the general assembly. 15 Sec. 57. EFFECTIVE DATE. This division of this Act, being 16 deemed of immediate importance, takes effect upon enactment. 17 DIVISION XV 18 ADMISSION OR TRANSFER OF PERSONS WITH A DIAGNOSIS OF AN 19 INTELLECTUAL DISABILITY TO A STATE MENTAL HEALTH INSTITUTE 20 Sec. 58. Section 4.1, subsection 9A, Code 2022, is amended 21 by striking the subsection and inserting in lieu thereof the 22 following: 23 9A. “Intellectual disability” means a diagnosis of 24 intellectual disability or intellectual developmental disorder, 25 global developmental delay, or unspecified intellectual 26 disability or intellectual developmental disorder which 27 diagnosis shall be made only when the onset of the person’s 28 condition was during the developmental period and based on an 29 assessment of the person’s intellectual functioning and level 30 of adaptive skills. A diagnosis of intellectual disability 31 shall be made by a licensed psychologist or psychiatrist who 32 is professionally trained to administer the tests required to 33 assess intellectual functioning and to evaluate a person’s 34 adaptive skills and shall be made in accordance with the 35 -67- HF 2578 (3) 89 pf/rn/md 67/ 79
H.F. 2578 criteria provided in the current version of the diagnostic 1 and statistical manual of mental disorders published by the 2 American psychiatric association. 3 Sec. 59. Section 226.8, Code 2022, is amended to read as 4 follows: 5 226.8 Persons with a diagnosis of an intellectual disability 6 not receivable —— exception —— admission or transfer to state 7 mental health institute . 8 1. A Admission or transfer pursuant to section 222.7 to 9 a state mental health institute of a person who has with a 10 diagnosis of an intellectual disability, as defined in section 11 4.1 , shall not be admitted, or transferred pursuant to section 12 222.7 , to a state mental health institute unless a professional 13 diagnostic evaluation indicates that such only occur under the 14 following conditions: 15 a. If all of the following requirements are met: 16 (1) The person has been determined by the state mental 17 health institute to meet admission criteria for inpatient 18 psychiatric care. 19 (2) The state mental health institute has determined the 20 person will benefit from psychiatric treatment or from some 21 other specific program available at the state mental health 22 institute to which it is proposed to admit or transfer the 23 person . 24 (3) There is sufficient capacity available at the state 25 mental health institute to support the needs of the person. 26 b. If determined appropriate for the person at the 27 sole discretion of the director of human services, the 28 administrator, or the director’s or administrator’s designee. 29 2. Charges for the care of any person with a diagnosis of 30 an intellectual disability admitted to a state mental health 31 institute shall be made by the institute in the manner provided 32 by chapter 230 , but the liability of any other person to any 33 county mental health and disability services region for the 34 cost of care of such person with a diagnosis of an intellectual 35 -68- HF 2578 (3) 89 pf/rn/md 68/ 79
H.F. 2578 disability shall be as prescribed by section 222.78 . 1 DIVISION XVI 2 COLLEGES OF MEDICINE AND DENTISTRY —— RESIDENCY —— REPORTS 3 Sec. 60. Section 262.9, Code 2022, is amended by adding the 4 following new subsection: 5 NEW SUBSECTION . 39. Adopt a policy requiring that not less 6 than seventy-five percent of the students who are accepted 7 at the college of medicine in the doctor of medicine program 8 and who are accepted at the college of dentistry at the state 9 university of Iowa be residents of Iowa or persons who were, 10 prior to applying to such college, enrolled in an eligible 11 postsecondary institution as defined in section 261E.2. 12 Sec. 61. Section 263.2, Code 2022, is amended to read as 13 follows: 14 263.2 Degrees —— reports . 15 1. A person shall not be admitted to courses of instruction 16 in the university if the person has not completed the 17 elementary instruction in such branches as are taught in the 18 public or accredited nonpublic schools throughout the state. 19 2. Graduates of the university shall receive degrees or 20 diplomas, or other evidences of distinction such as are usually 21 conferred and granted by universities and are authorized by the 22 state board of regents. 23 3. The state university of Iowa, in collaboration with the 24 university hospitals and clinics, shall submit an annual report 25 to the general assembly providing the following information: 26 a. The states in which members of each graduating class 27 from the college of dentistry and the college of medicine’s 28 doctor of medicine program reside during the year immediately 29 following graduation. The information shall be categorized 30 by either residents of Iowa at the time of application to the 31 college or nonresidents at the time of application to the 32 college. 33 b. The states in which the university of Iowa hospitals and 34 clinics primary care and specialty residents reside in the year 35 -69- HF 2578 (3) 89 pf/rn/md 69/ 79
H.F. 2578 following completion of medical residency and whether following 1 residency such residents accepted fellowships. The information 2 shall be categorized by primary care and the various areas of 3 specialty, and shall specify whether the medical residents 4 were residents of Iowa prior to applying for admission at an 5 undergraduate college or university, received a baccalaureate 6 degree from a postsecondary institution in Iowa, or graduated 7 from a medical school in Iowa, whether or not the medical 8 residents were residents of the state at the time of acceptance 9 into the university of Iowa hospitals and clinics’ residency 10 programs and, if any residents accepted fellowships following 11 residency, the states in which the fellowships are offered and 12 the areas of specialty under the fellowships. 13 DIVISION XVII 14 MEDICAL RESIDENCY POSITIONS AND AUDITION CLINICALS 15 Sec. 62. MEDICAL RESIDENCY POSITIONS AND AUDITION CLINICALS 16 —— MEDICAL STUDENTS AND APPLICANTS MEETING CERTAIN CRITERIA —— 17 ANNUAL REPORT. 18 1. The university of Iowa hospitals and clinics shall offer 19 an interview for an available medical residency position to 20 any applicant who has a residency specialty in obstetrics and 21 gynecology, psychiatry, general surgery, emergency medicine, 22 cardiology, neurology, or primary care and who also is a 23 resident of Iowa, attended and earned an undergraduate degree 24 from an Iowa college or university, or attended and earned a 25 medical degree from a medical school in Iowa. 26 2. The university of Iowa hospitals and clinics shall 27 provide the opportunity to a medical student attending a 28 medical school in Iowa to participate in an audition clinical 29 in the medical residency specialty for which the medical 30 student applies to allow the university to constructively 31 review the student in a clinical setting. 32 3. The university of Iowa hospitals and clinics shall submit 33 a report to the governor and the general assembly by January 34 15, annually, regarding the interviews and audition clinicals 35 -70- HF 2578 (3) 89 pf/rn/md 70/ 79
H.F. 2578 as specified in this section during the prior fiscal year. 1 Specifically, the report shall include for each interview or 2 audition clinical the name of the student’s or applicant’s 3 medical school, whether an applicant was offered and 4 participated in an interview, whether the student was offered 5 and participated in an audition clinical, whether the applicant 6 was accepted for one of the residency program positions, and 7 the total number of available residency positions filled by an 8 applicant meeting the criteria under this section. 9 DIVISION XVIII 10 HEALTH CARRIERS —— TELEHEALTH 11 Sec. 63. Section 514C.34, subsection 3, Code 2022, is 12 amended to read as follows: 13 3. a. Health care services that are delivered by telehealth 14 must be appropriate and delivered in accordance with applicable 15 law and generally accepted health care practices and standards 16 prevailing at the time the health care services are provided, 17 including all rules adopted by the appropriate professional 18 licensing board, pursuant to chapter 147 , having oversight 19 of the health care professional providing the health care 20 services. 21 b. A health carrier shall not exclude a health care 22 professional who provides services for mental health 23 conditions, illnesses, injuries, or diseases and who is 24 physically located out-of-state from participating as a 25 provider, via telehealth, under a policy, plan, or contract 26 offered by the health carrier in the state if all of the 27 following requirements are met: 28 (1) The health care professional is licensed in this state 29 by the appropriate professional licensing board and is able 30 to deliver health care services for mental health conditions, 31 illnesses, injuries, or diseases via telehealth in compliance 32 with paragraph “a” . 33 (2) The health care professional is able to satisfy the same 34 criteria that the health carrier uses to qualify a health care 35 -71- HF 2578 (3) 89 pf/rn/md 71/ 79
H.F. 2578 professional who is located in the state, and who holds the 1 same license as the out-of-state professional, to participate 2 as a provider, via telehealth, under a policy, plan, or 3 contract offered by the health carrier in the state. 4 Sec. 64. EFFECTIVE DATE. This division of this Act, being 5 deemed of immediate importance, takes effect upon enactment. 6 Sec. 65. APPLICABILITY. This division of this Act applies 7 to health carriers that deliver, issue for delivery, continue, 8 or renew a policy, contract, or plan in this state on or after 9 the effective date of this Act. 10 DIVISION XIX 11 NURSING FACILITY CONSTRUCTION OR EXPANSION RELIEF 12 Sec. 66. Section 249K.2, subsection 4, Code 2022, is amended 13 to read as follows: 14 4. “Major renovations” means construction or facility 15 improvements to a nursing facility in which the total amount 16 expended exceeds one million five seven hundred fifty thousand 17 dollars. 18 Sec. 67. Section 249K.5, subsection 2, Code 2022, is amended 19 by adding the following new paragraph: 20 NEW PARAGRAPH . c. The nursing facility for which relief 21 or an exception is requested is proposing replacement or 22 enhancement of an HVAC, as defined in section 105.2, system for 23 improved infection control. 24 Sec. 68. ADMINISTRATIVE RULES —— ADOPTION AND 25 AMENDMENT. The department of human services shall adopt or 26 amend rules pursuant to chapter 17A to administer this division 27 of this Act. Specifically, the department shall amend rules 28 relating to nursing facility additional requirements for all 29 requests for the capital cost per diem instant relief add-on 30 and enhanced nondirect care rate component limit to provide 31 that with regard to the additional requirements a nursing 32 facility must meet, the facility has Medicaid utilization at 33 or above forty percent for the two-month period before the 34 request for additional reimbursement is submitted. Medicaid 35 -72- HF 2578 (3) 89 pf/rn/md 72/ 79
H.F. 2578 utilization for this purpose is calculated as total nursing 1 facility Medicaid patient days divided by total in-house 2 patient days as reported on the facility’s most current 3 financial and statistical report. 4 DIVISION XX 5 HEALTH CARE PROVIDERS —— COVID-19 AND EXPERIMENTAL TREATMENTS 6 Sec. 69. Section 144E.2, subsection 1, paragraphs a, c, and 7 e, Code 2022, are amended to read as follows: 8 a. Has a terminal illness, attested to by the patient’s a 9 treating physician , or is receiving mechanical ventilation to 10 prolong life . 11 c. Has received a recommendation from the individual’s a 12 physician for an investigational drug, biological product, or 13 device. 14 e. Has documentation from the individual’s a physician that 15 the individual meets the requirements of this subsection . 16 Sec. 70. Section 144E.2, subsection 2, Code 2022, is amended 17 to read as follows: 18 2. “Investigational drug, biological product, or device” 19 means a any of the following: 20 a. A drug, biological product, or device that has 21 successfully completed phase 1 of a United States food and drug 22 administration-approved clinical trial but has not yet been 23 approved for general use by the United States food and drug 24 administration and remains under investigation in a United 25 States food and drug administration-approved clinical trial. 26 b. An off-label use of a drug. 27 Sec. 71. Section 144E.2, Code 2022, is amended by adding the 28 following new subsection: 29 NEW SUBSECTION . 2A. “Off-label use of a drug” means 30 the legal, prescribed use of a drug in a manner different 31 from that described on the United States food and drug 32 administration-approved drug label, including the use of a 33 drug for a different disease or medical condition or giving 34 a drug at a different dose or through a different route of 35 -73- HF 2578 (3) 89 pf/rn/md 73/ 79
H.F. 2578 administration other than that approved by the United States 1 food and drug administration. 2 Sec. 72. Section 144E.2, subsection 4, unnumbered paragraph 3 1, Code 2022, is amended to read as follows: 4 “Written informed consent” means a written document that 5 is signed by the patient, a parent of a minor patient, or a 6 legal guardian or other legal representative of the patient and 7 attested to by the patient’s a treating physician and a witness 8 and that includes all of the following: 9 Sec. 73. Section 144E.2, subsection 4, paragraphs b and d, 10 Code 2022, are amended to read as follows: 11 b. An attestation that the patient concurs with the 12 patient’s a treating physician in believing that all products 13 and treatments approved by the United States food and drug 14 administration are unlikely to prolong the patient’s life. 15 d. A description of the best and worst potential outcomes 16 of using the investigational drug, biological product, or 17 device and a realistic description of the most likely outcome. 18 The description shall include the possibility that new, 19 unanticipated, different, or worse symptoms might result 20 and that death could be hastened by use of the proposed 21 investigational drug, biological product, or device. The 22 description shall be based on the a treating physician’s 23 knowledge of the proposed investigational drug, biological 24 product, or device in conjunction with an awareness of the 25 patient’s condition. 26 Sec. 74. Section 144E.4, Code 2022, is amended by adding the 27 following new subsection: 28 NEW SUBSECTION . 5. This chapter does not create a duty 29 for a hospital licensed under chapter 135B to credential any 30 physician. 31 Sec. 75. Section 144E.8, subsection 1, Code 2022, is amended 32 to read as follows: 33 1. This chapter shall not create a private cause of 34 action against a manufacturer of an investigational drug, 35 -74- HF 2578 (3) 89 pf/rn/md 74/ 79
H.F. 2578 biological product, or device , against a physician, health care 1 practitioner, or facility that provides necessary follow-up 2 care, or against any other person or entity involved in the 3 care of an eligible patient using the investigational drug, 4 biological product, or device for any harm done to the eligible 5 patient resulting from the investigational drug, biological 6 product, or device, if the manufacturer or other person or 7 entity is complying in good faith with the terms of this 8 chapter and has exercised reasonable care. 9 Sec. 76. Section 144E.9, Code 2022, is amended to read as 10 follows: 11 144E.9 Assisting suicide. 12 This chapter shall not be construed to allow a patient’s 13 treating physician to assist the a patient in committing or 14 attempting to commit suicide as prohibited in section 707A.2 . 15 Sec. 77. Section 686D.6, Code 2022, is amended to read as 16 follows: 17 686D.6 Liability of and disciplinary actions against health 18 care providers. 19 1. A health care provider shall not be liable for civil 20 damages or subject to disciplinary action by the health 21 care provider’s licensing board for causing or contributing, 22 directly or indirectly, to the death or injury of an individual 23 as a result of the health care provider’s acts or omissions 24 while providing or arranging health care in support of the 25 state’s response to COVID-19. This subsection shall apply to 26 all of the following: 27 a. Injury or death resulting from screening, assessing, 28 diagnosing, caring for, or treating individuals with a 29 suspected or confirmed case of COVID-19. 30 b. Prescribing, administering, or dispensing a 31 pharmaceutical for off-label use to treat a patient with a 32 suspected or confirmed case of COVID-19. 33 c. Acts or omissions while providing health care to 34 individuals unrelated to COVID-19 when those acts or omissions 35 -75- HF 2578 (3) 89 pf/rn/md 75/ 79
H.F. 2578 support the state’s response to COVID-19, including any of the 1 following: 2 (1) Delaying or canceling nonurgent or elective dental, 3 medical, or surgical procedures, or altering the diagnosis or 4 treatment of an individual in response to any federal or state 5 statute, regulation, order, or public health guidance. 6 (2) Diagnosing or treating patients outside the normal 7 scope of the health care provider’s license or practice. 8 (3) Using medical devices, equipment, or supplies outside 9 of their normal use for the provision of health care, including 10 using or modifying medical devices, equipment, or supplies for 11 an unapproved use. 12 (4) Conducting tests or providing treatment to any 13 individual outside the premises of a health care facility. 14 (5) Acts or omissions undertaken by a health care provider 15 because of a lack of staffing, facilities, medical devices, 16 equipment, supplies, or other resources attributable to 17 COVID-19 that renders the health care provider unable to 18 provide the level or manner of care to any person that 19 otherwise would have been required in the absence of COVID-19. 20 (6) Acts or omissions undertaken by a health care provider 21 relating to use or nonuse of personal protective equipment. 22 2. This section shall not relieve any person of liability 23 for civil damages or a health care provider from disciplinary 24 action by the health care provider’s licensing board for any 25 act or omission which constitutes recklessness or willful 26 misconduct. 27 Sec. 78. EFFECTIVE DATE. This division of this Act, being 28 deemed of immediate importance, takes effect upon enactment. 29 DIVISION XXI 30 HEALTH-RELATED DATA 31 Sec. 79. Section 11.41, subsection 3, Code 2022, is amended 32 to read as follows: 33 3. If the information, records, instrumentalities, and 34 properties sought by the auditor of state are required by law 35 -76- HF 2578 (3) 89 pf/rn/md 76/ 79
H.F. 2578 to be kept confidential, the auditor of state shall have access 1 to the information, records, instrumentalities, and properties, 2 but shall maintain the confidentiality of all such information 3 and is subject to the same penalties as the lawful custodian 4 of the information for dissemination of the information. 5 However, the auditor of state shall not have access to the 6 income tax returns of individuals or to an individual’s name 7 or residential address from a reportable disease report under 8 section 139A.3 . 9 Sec. 80. Section 135.166, subsection 2, Code 2022, is 10 amended to read as follows: 11 2. Unless otherwise authorized or required by state or 12 federal law, data collected under this section shall not 13 include the social security number or name of the individual 14 subject of the data. 15 Sec. 81. Section 139A.3, Code 2022, is amended by adding the 16 following new subsection: 17 NEW SUBSECTION . 1A. A state or local agency employee 18 or agent shall not have access to personally identifiable 19 information included in a reportable disease report provided 20 to or maintained by the department, a local board, or a local 21 department, unless the employee or agent has completed data 22 confidentiality training. 23 DIVISION XXII 24 PSYCHIATRY RESIDENCY PROGRAM 25 Sec. 82. NEW SECTION . 135.180 State-funded psychiatry 26 residency program —— fund —— appropriations. 27 1. The university of Iowa hospitals and clinics shall 28 administer a state-funded psychiatry residency program 29 in cooperation with the state mental health institutes at 30 Independence and Cherokee, the state resource centers at 31 Glenwood and Woodward, the state training school at Eldora, 32 and the Iowa medical and classification center at Oakdale. 33 The university of Iowa hospitals and clinics shall expand the 34 psychiatry residency program to provide additional residency 35 -77- HF 2578 (3) 89 pf/rn/md 77/ 79
H.F. 2578 positions by providing financial support for residency 1 positions which are in excess of the federal residency cap 2 established by the federal Balanced Budget Act of 1997, Pub. L. 3 No. 105-33. Participating residents shall complete a portion 4 of their psychiatry training at one of the state mental health 5 institutes, the state resource centers, the state training 6 school, or the Iowa medical and classification center at 7 Oakdale. For accreditation-required clinical experiences not 8 available at the state mental health institutes, the state 9 resource centers, the state training school, or the Iowa 10 medical and classification center at Oakdale, the psychiatry 11 residency program and its residents may utilize clinical 12 rotations at the university of Iowa hospitals and clinics and 13 its affiliates across the state. 14 2. The residency program shall provide for the awarding 15 of twelve residency positions for each class of residents. 16 Preference in the awarding of residency positions shall 17 be given to candidates who are residents of Iowa, attended 18 and earned an undergraduate degree from an Iowa college or 19 university, or attended and earned a medical degree from a 20 medical school in Iowa. 21 3. A psychiatry residency program fund is created in 22 the state treasury consisting of the moneys appropriated or 23 credited to the fund by law. Notwithstanding section 8.33, 24 moneys in the fund at the end of each fiscal year shall not 25 revert to any other fund but shall remain in the psychiatry 26 residency program fund for use in subsequent fiscal years. 27 Moneys in the fund are appropriated to the university of Iowa 28 hospitals and clinics to be used for the purposes of the 29 program. For fiscal years beginning on or after July 1, 2023, 30 there is appropriated from the general fund of the state to the 31 psychiatry residency program fund the following amounts to be 32 used for the purposes of the program: 33 a. For the fiscal year beginning July 1, 2023, one million 34 two hundred thousand dollars. 35 -78- HF 2578 (3) 89 pf/rn/md 78/ 79
H.F. 2578 b. For the fiscal year beginning July 1, 2024, two million 1 four hundred thousand dollars. 2 c. For the fiscal year beginning July 1, 2025, three million 3 six hundred thousand dollars. 4 d. For the fiscal year beginning July 1, 2026, and each 5 fiscal year thereafter, four million eight hundred thousand 6 dollars. 7 -79- HF 2578 (3) 89 pf/rn/md 79/ 79