House File 891 - Reprinted HOUSE FILE 891 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO LSB 1004YC) (As Amended and Passed by the House May 17, 2021 ) 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 891 (3) 89 pf/rn/md
H.F. 891 DIVISION I 1 DEPARTMENT ON AGING —— FY 2021-2022 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, 2021, and ending June 30, 5 2022, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,304,082 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 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 891 (3) 89 pf/rn/md 1/ 74
H.F. 891 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, at least 22 $600,000 shall be used to fund home and community-based 23 services through the area agencies on aging that enable older 24 individuals to avoid more costly utilization of residential or 25 institutional services and remain in their own homes. 26 5. Of the funds appropriated in this section, $812,000 shall 27 be used for the purposes of chapter 231E and to administer 28 the prevention of elder abuse, neglect, and exploitation 29 program pursuant to section 231.56A , in accordance with the 30 requirements of the federal Older Americans Act of 1965, 42 31 U.S.C. §3001 et seq., as amended. 32 6. Of the funds appropriated in this section, $1,000,000 33 shall be used to fund continuation of the aging and disability 34 resource center lifelong links to provide individuals and 35 -2- HF 891 (3) 89 pf/rn/md 2/ 74
H.F. 891 caregivers with information and services to plan for and 1 maintain independence. 2 7. Of the funds appropriated in this section, $250,000 3 shall be used by the department on aging, in collaboration with 4 the department of human services and affected stakeholders, 5 to continue to expand the pilot initiative to provide 6 long-term care options counseling utilizing support planning 7 protocols, to assist non-Medicaid eligible consumers who 8 indicate a preference to return to the community and are 9 deemed appropriate for discharge, to return to their community 10 following a nursing facility stay. The department on aging 11 shall submit a report regarding the outcomes of the pilot 12 initiative to the governor and the general assembly by December 13 15, 2021. 14 DIVISION II 15 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2021-2022 16 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 17 appropriated from the general fund of the state to the office 18 of long-term care ombudsman for the fiscal year beginning July 19 1, 2021, and ending June 30, 2022, the following amount, or 20 so much thereof as is necessary, to be used for the purposes 21 designated: 22 For salaries, support, administration, maintenance, and 23 miscellaneous purposes, and for not more than the following 24 full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 27 DIVISION III 28 DEPARTMENT OF PUBLIC HEALTH —— FY 2021-2022 29 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 30 from the general fund of the state to the department of public 31 health for the fiscal year beginning July 1, 2021, and ending 32 June 30, 2022, the following amounts, or so much thereof as is 33 necessary, to be used for the purposes designated: 34 1. ADDICTIVE DISORDERS 35 -3- HF 891 (3) 89 pf/rn/md 3/ 74
H.F. 891 For reducing the prevalence of the use of tobacco, alcohol, 1 and other drugs, and treating individuals affected by addictive 2 behaviors, including gambling, and for not more than the 3 following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,659,379 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 6 a. (1) Of the funds appropriated in this subsection, 7 $4,020,894 shall be used for the tobacco use prevention 8 and control initiative, including efforts at the state and 9 local levels, as provided in chapter 142A . The commission 10 on tobacco use prevention and control established pursuant 11 to section 142A.3 shall advise the director of public health 12 in prioritizing funding needs and the allocation of moneys 13 appropriated for the programs and initiatives. Activities 14 of the programs and initiatives shall be in alignment with 15 the United States centers for disease control and prevention 16 best practices for comprehensive tobacco control programs 17 that include the goals of preventing youth initiation of 18 tobacco usage, reducing exposure to secondhand smoke, and 19 promotion of tobacco cessation. To maximize resources, 20 the department shall determine if third-party sources are 21 available to instead provide nicotine replacement products 22 to an applicant prior to provision of such products to an 23 applicant under the initiative. The department shall track and 24 report to the governor and the general assembly any reduction 25 in the provision of nicotine replacement products realized 26 by the initiative through implementation of the prerequisite 27 screening. 28 (2) (a) The department shall collaborate with the 29 alcoholic beverages division of the department of commerce for 30 enforcement of tobacco laws, regulations, and ordinances and to 31 engage in tobacco control activities approved by the division 32 of tobacco use prevention and control of the department of 33 public health as specified in the memorandum of understanding 34 entered into between the divisions. 35 -4- HF 891 (3) 89 pf/rn/md 4/ 74
H.F. 891 (b) For the fiscal year beginning July 1, 2021, and ending 1 June 30, 2022, the terms of the memorandum of understanding, 2 entered into between the division of tobacco use prevention 3 and control of the department of public health and the 4 alcoholic beverages division of the department of commerce, 5 governing compliance checks conducted to ensure licensed retail 6 tobacco outlet conformity with tobacco laws, regulations, and 7 ordinances relating to persons under 21 years of age, shall 8 continue to restrict the number of such checks to one check per 9 retail outlet, and one additional check for any retail outlet 10 found to be in violation during the first check. 11 b. (1) Of the funds appropriated in this subsection, 12 $19,638,485 shall be used for problem gambling and 13 substance-related disorder prevention, treatment, and recovery 14 services, including a 24-hour helpline, public information 15 resources, professional training, youth prevention, and program 16 evaluation. 17 (2) Of the amount allocated under this paragraph, $306,000 18 shall be utilized by the department of public health, in 19 collaboration with the department of human services, to 20 maintain a single statewide 24-hour crisis hotline for the Iowa 21 children’s behavioral health system that incorporates warmline 22 services which may be provided through expansion of existing 23 capabilities maintained by the department of public health as 24 required pursuant to 2018 Iowa Acts, chapter 1056, section 16 . 25 c. The requirement of section 123.17, subsection 5 , is met 26 by the appropriations and allocations made in this division of 27 this Act for purposes of substance-related disorder treatment 28 and addictive disorders for the fiscal year beginning July 1, 29 2021. 30 2. HEALTHY CHILDREN AND FAMILIES 31 For promoting the optimum health status for children and 32 adolescents from birth through 21 years of age, and families, 33 and for not more than the following full-time equivalent 34 positions: 35 -5- HF 891 (3) 89 pf/rn/md 5/ 74
H.F. 891 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,816,681 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 2 a. Of the funds appropriated in this subsection, not more 3 than $734,000 shall be used for the healthy opportunities for 4 parents to experience success (HOPES)-healthy families Iowa 5 (HFI) program established pursuant to section 135.106 . 6 b. In order to implement the legislative intent stated 7 in sections 135.106 and 256I.9 , priority for home visitation 8 program funding shall be given to programs using evidence-based 9 or promising models for home visitation. 10 c. Of the funds appropriated in this subsection, $3,075,000 11 shall be used for continuation of the department’s initiative 12 to provide for adequate developmental surveillance and 13 screening during a child’s first five years. The funds shall 14 be used first to fully fund the current sites to ensure that 15 the sites are fully operational, with the remaining funds 16 to be used for expansion to additional sites. The full 17 implementation and expansion shall include enhancing the scope 18 of the initiative through collaboration with the child health 19 specialty clinics to promote healthy child development through 20 early identification and response to both biomedical and social 21 determinants of healthy development; by monitoring child 22 health metrics to inform practice, document long-term health 23 impacts and savings, and provide for continuous improvement 24 through training, education, and evaluation; and by providing 25 for practitioner consultation particularly for children with 26 behavioral conditions and needs. The department of public 27 health shall also collaborate with the Iowa Medicaid enterprise 28 and the child health specialty clinics to integrate the 29 activities of the first five initiative into the establishment 30 of patient-centered medical homes, community utilities, 31 accountable care organizations, and other integrated care 32 models developed to improve health quality and population 33 health while reducing health care costs. To the maximum extent 34 possible, funding allocated in this paragraph shall be utilized 35 -6- HF 891 (3) 89 pf/rn/md 6/ 74
H.F. 891 as matching funds for medical assistance program reimbursement. 1 d. Of the funds appropriated in this subsection, $64,000 2 shall be distributed to a statewide dental carrier to provide 3 funds to continue the donated dental services program patterned 4 after the projects developed by the dental lifeline network to 5 provide dental services to indigent individuals who are elderly 6 or with disabilities. 7 e. Of the funds appropriated in this subsection, $156,000 8 shall be used to provide audiological services and hearing aids 9 for children. 10 f. Of the funds appropriated in this subsection, $23,000 is 11 transferred to the university of Iowa college of dentistry for 12 provision of primary dental services to children. State funds 13 shall be matched on a dollar-for-dollar basis. The university 14 of Iowa college of dentistry shall coordinate efforts with the 15 department of public health, oral and health delivery system 16 bureau, to provide dental care to underserved populations 17 throughout the state. 18 g. Of the funds appropriated in this subsection, $50,000 19 shall be used to address youth suicide prevention. 20 h. Of the funds appropriated in this subsection, $40,000 21 shall be used to support the Iowa effort to address the survey 22 of children who experience adverse childhood experiences known 23 as ACEs. 24 i. Of the funds appropriated in this subsection, up to 25 $494,000 shall be used for childhood obesity prevention. 26 3. CHRONIC CONDITIONS 27 For serving individuals identified as having chronic 28 conditions or special health care needs, and for not more than 29 the following full-time equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,258,373 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 32 a. Of the funds appropriated in this subsection, $188,000 33 shall be used for grants to individual patients who have an 34 inherited metabolic disorder to assist with the costs of 35 -7- HF 891 (3) 89 pf/rn/md 7/ 74
H.F. 891 medically necessary foods and formula. 1 b. Of the funds appropriated in this subsection, $1,055,000 2 shall be used for the brain injury services program pursuant 3 to section 135.22B , including $861,000 for contracting with an 4 existing nationally affiliated and statewide organization whose 5 purpose is to educate, serve, and support Iowans with brain 6 injury and their families, for resource facilitator services 7 in accordance with section 135.22B, subsection 9 , and for 8 contracting to enhance brain injury training and recruitment 9 of service providers on a statewide basis. Of the amount 10 allocated in this paragraph, $95,000 shall be used to fund 11 1.00 full-time equivalent position to serve as the state brain 12 injury services program manager. 13 c. Of the funds appropriated in this subsection, $144,000 14 shall be used for the public purpose of continuing to contract 15 with an existing nationally affiliated organization to provide 16 education, client-centered programs, and client and family 17 support for people living with epilepsy and their families. 18 The amount allocated in this paragraph in excess of $50,000 19 shall be matched dollar-for-dollar by the organization 20 specified. Funds allocated under this paragraph shall be 21 distributed in their entirety for the purpose specified on July 22 1, 2021. 23 d. Of the funds appropriated in this subsection, $809,000 24 shall be used for child health specialty clinics. 25 e. Of the funds appropriated in this subsection, $384,000 26 shall be used by the regional autism assistance program 27 established pursuant to section 256.35 , and administered by 28 the child health specialty clinic located at the university of 29 Iowa hospitals and clinics. The funds shall be used to enhance 30 interagency collaboration and coordination of educational, 31 medical, and other human services for persons with autism, 32 their families, and providers of services, including delivering 33 regionalized services of care coordination, family navigation, 34 and integration of services through the statewide system of 35 -8- HF 891 (3) 89 pf/rn/md 8/ 74
H.F. 891 regional child health specialty clinics and fulfilling other 1 requirements as specified in chapter 225D . The university of 2 Iowa shall not receive funds allocated under this paragraph for 3 indirect costs associated with the regional autism assistance 4 program. 5 f. Of the funds appropriated in this subsection, $577,000 6 shall be used for the comprehensive cancer control program to 7 reduce the burden of cancer in Iowa through prevention, early 8 detection, effective treatment, and ensuring quality of life. 9 Of the funds allocated in this paragraph “f”, $150,000 shall 10 be used to support a melanoma research symposium, a melanoma 11 biorepository and registry, basic and translational melanoma 12 research, and clinical trials. 13 g. Of the funds appropriated in this subsection, $97,000 14 shall be used for cervical and colon cancer screening, and 15 $177,000 shall be used to enhance the capacity of the cervical 16 cancer screening program to include provision of recommended 17 prevention and early detection measures to a broader range of 18 low-income women. 19 h. Of the funds appropriated in this subsection, $506,000 20 shall be used for the center for congenital and inherited 21 disorders. 22 4. COMMUNITY CAPACITY 23 For strengthening the health care delivery system at the 24 local level, and for not more than the following full-time 25 equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,319,306 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 28 a. Of the funds appropriated in this subsection, $95,000 29 is allocated for continuation of the child vision screening 30 program implemented through the university of Iowa hospitals 31 and clinics in collaboration with early childhood Iowa areas. 32 The program shall submit a report to the department regarding 33 the use of funds allocated under this paragraph “a”. The 34 report shall include the objectives and results for the 35 -9- HF 891 (3) 89 pf/rn/md 9/ 74
H.F. 891 program year including the target population and how the funds 1 allocated assisted the program in meeting the objectives; the 2 number, age, and location within the state of individuals 3 served; the type of services provided to the individuals 4 served; the distribution of funds based on service provided; 5 and the continuing needs of the program. 6 b. Of the funds appropriated in this subsection, 7 $48,000 shall be used for a grant to a statewide association 8 of psychologists, that is affiliated with the American 9 psychological association, to be used for continuation of a 10 program to rotate intern psychologists in placements that 11 serve urban and rural mental health professional shortage 12 areas. Once an intern psychologist begins service, the intern 13 psychologist may continue serving in the location of the intern 14 psychologist’s placement, notwithstanding any change in the 15 mental health professional shortage area designation of such 16 location. The intern psychologist may also provide services 17 via telehealth, to underserved populations, and to Medicaid 18 members. For the purposes of this paragraph “b”, “mental 19 health professional shortage area” means a geographic area 20 in this state that has been designated by the United States 21 department of health and human services, health resources and 22 services administration, bureau of health professionals, as 23 having a shortage of mental health professionals. 24 c. Of the funds appropriated in this subsection, the 25 following amounts are allocated to be used as follows 26 to support the goals of increased access, health system 27 integration, and engagement: 28 (1) Not less than $1,600,000 is allocated to the Iowa 29 prescription drug corporation for continuation of the 30 pharmaceutical infrastructure for safety net providers as 31 described in 2007 Iowa Acts, chapter 218, section 108 , and for 32 the prescription drug donation repository program created in 33 chapter 135M . Of the amount allocated in this subparagraph, 34 $1,000,000 shall be used as one-time funding to support 35 -10- HF 891 (3) 89 pf/rn/md 10/ 74
H.F. 891 program expansion and to implement an automated multi-dose 1 prescription packaging system. Funds allocated under this 2 subparagraph shall be distributed in their entirety for the 3 purpose specified on July 1, 2021. 4 (2) Not less than $334,000 is allocated to free clinics and 5 free clinics of Iowa for necessary infrastructure, statewide 6 coordination, provider recruitment, service delivery, and 7 provision of assistance to patients in securing a medical home 8 inclusive of oral health care. Funds allocated under this 9 subparagraph shall be distributed in their entirety for the 10 purpose specified on July 1, 2021. 11 (3) Not less than $25,000 is allocated to the Iowa 12 association of rural health clinics for necessary 13 infrastructure and service delivery transformation. Funds 14 allocated under this subparagraph shall be distributed in their 15 entirety for the purpose specified on July 1, 2021. 16 (4) Not less than $225,000 is allocated to the Polk county 17 medical society for continuation of the safety net provider 18 patient access to specialty health care initiative as described 19 in 2007 Iowa Acts, chapter 218, section 109 . Funds allocated 20 under this subparagraph shall be distributed in their entirety 21 for the purpose specified on July 1, 2021. 22 d. Of the funds appropriated in this subsection, $191,000 23 is allocated for the purposes of health care and public health 24 workforce initiatives. 25 e. Of the funds appropriated in this subsection, $96,000 26 shall be used for a matching dental education loan repayment 27 program to be allocated to a dental nonprofit health service 28 corporation to continue to develop the criteria and implement 29 the loan repayment program. 30 f. Of the funds appropriated in this subsection, $100,000 31 shall be used for the purposes of the Iowa donor registry as 32 specified in section 142C.18 . 33 g. Of the funds appropriated in this subsection, $96,000 34 shall be used for continuation of a grant to a nationally 35 -11- HF 891 (3) 89 pf/rn/md 11/ 74
H.F. 891 affiliated volunteer eye organization that has an established 1 program for children and adults and that is solely dedicated to 2 preserving sight and preventing blindness through education, 3 nationally certified vision screening and training, and 4 community and patient service programs. The contractor shall 5 submit a report to the general assembly regarding the use 6 of funds allocated under this paragraph “g”. The report 7 shall include the objectives and results for the program year 8 including the target population and how the funds allocated 9 assisted the program in meeting the objectives; the number, 10 age, grade level if appropriate, and location within the state 11 of individuals served; the type of services provided to the 12 individuals served; the distribution of funds based on services 13 provided; and the continuing needs of the program. 14 h. Of the funds appropriated in this subsection, $2,100,000 15 shall be deposited in the medical residency training account 16 created in section 135.175, subsection 5 , paragraph “a”, and 17 is appropriated from the account to the department of public 18 health to be used for the purposes of the medical residency 19 training state matching grants program as specified in section 20 135.176 . 21 i. Of the funds appropriated in this subsection, $250,000 22 shall be used for the public purpose of providing funding to 23 Des Moines university to continue a provider education project 24 to provide primary care physicians with the training and skills 25 necessary to recognize the signs of mental illness in patients. 26 j. Of the funds appropriated in this subsection, $600,000 27 shall be used for rural psychiatric residencies to support the 28 annual creation and training of four psychiatric residents who 29 will provide mental health services in underserved areas of 30 the state. Notwithstanding section 8.33, moneys that remain 31 unencumbered or unobligated at the close of the fiscal year 32 shall not revert but shall remain available for expenditure for 33 the purposes designated for subsequent fiscal years. 34 k. Of the funds appropriated in this subsection, $150,000 35 -12- HF 891 (3) 89 pf/rn/md 12/ 74
H.F. 891 shall be used for psychiatric training to increase access to 1 mental health care services by expanding the mental health 2 workforce via training of additional physician assistants and 3 nurse practitioners. 4 1. Of the funds appropriated in this subsection, $425,000 5 shall be used for the creation of a center of excellence 6 program to encourage innovation and collaboration among 7 regional health care providers in a rural area based upon the 8 results of a regional community needs assessment to transform 9 health care delivery in order to provide quality, sustainable 10 care that meets the needs of the local communities. An 11 applicant for the funds shall specify how the funds will be 12 expended to accomplish the goals of the program and shall 13 provide a detailed five-year sustainability plan prior to 14 being awarded any funding. Following the receipt of funding, 15 a recipient shall submit periodic reports as specified by the 16 department to the governor and the general assembly regarding 17 the recipient’s expenditure of the funds and progress in 18 accomplishing the program goals. 19 5. ESSENTIAL PUBLIC HEALTH SERVICES 20 To provide public health services that reduce risks and 21 invest in promoting and protecting good health over the 22 course of a lifetime with a priority given to older Iowans and 23 vulnerable populations: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 25 6. INFECTIOUS DISEASES 26 For reducing the incidence and prevalence of communicable 27 diseases, and for not more than the following full-time 28 equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,206 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 6.00 31 7. PUBLIC PROTECTION 32 For protecting the health and safety of the public through 33 establishing standards and enforcing regulations, and for not 34 more than the following full-time equivalent positions: 35 -13- HF 891 (3) 89 pf/rn/md 13/ 74
H.F. 891 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,466,601 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 2 a. Of the funds appropriated in this subsection, not more 3 than $304,000 shall be credited to the emergency medical 4 services fund created in section 135.25 . Moneys in the 5 emergency medical services fund are appropriated to the 6 department to be used for the purposes of the fund. 7 b. Of the funds appropriated in this subsection, up 8 to $243,000 shall be used for sexual violence prevention 9 programming through a statewide organization representing 10 programs serving victims of sexual violence through the 11 department’s sexual violence prevention program, and for 12 continuation of a training program for sexual assault 13 response team (SART) members, including representatives of 14 law enforcement, victim advocates, prosecutors, and certified 15 medical personnel. The amount allocated in this paragraph “b” 16 shall not be used to supplant funding administered for other 17 sexual violence prevention or victims assistance programs. 18 c. Of the funds appropriated in this subsection, up to 19 $500,000 shall be used for the state poison control center. 20 Pursuant to the directive under 2014 Iowa Acts, chapter 21 1140, section 102 , the federal matching funds available to 22 the state poison control center from the department of human 23 services under the federal Children’s Health Insurance Program 24 Reauthorization Act allotment shall be subject to the federal 25 administrative cap rule of 10 percent applicable to funding 26 provided under Tit. XXI of the federal Social Security Act and 27 included within the department’s calculations of the cap. 28 d. Of the funds appropriated in this subsection, up to 29 $504,000 shall be used for childhood lead poisoning provisions. 30 8. RESOURCE MANAGEMENT 31 For establishing and sustaining the overall ability of the 32 department to deliver services to the public, and for not more 33 than the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,871 35 -14- HF 891 (3) 89 pf/rn/md 14/ 74
H.F. 891 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 1 9. MISCELLANEOUS PROVISIONS 2 The university of Iowa hospitals and clinics under the 3 control of the state board of regents shall not receive 4 indirect costs from the funds appropriated in this section. 5 The university of Iowa hospitals and clinics billings to the 6 department shall be on at least a quarterly basis. 7 Sec. 4. DEPARTMENT OF PUBLIC HEALTH —— SPORTS WAGERING 8 RECEIPTS FUND. There is appropriated from the sports wagering 9 receipts fund created in section 8.57, subsection 6, to the 10 department of public health for the fiscal year beginning July 11 1, 2021, and ending June 30, 2022, the following amount, or 12 so much thereof as is necessary, to be used for the purposes 13 designated: 14 For problem gambling and substance-related disorder 15 prevention, treatment, and recovery services, including a 16 24-hour helpline, public information resources, professional 17 training, youth prevention, and program evaluation: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 19 DIVISION IV 20 DEPARTMENT OF VETERANS AFFAIRS —— FY 2021-2022 21 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 22 appropriated from the general fund of the state to the 23 department of veterans affairs for the fiscal year beginning 24 July 1, 2021, and ending June 30, 2022, the following amounts, 25 or so much thereof as is necessary, to be used for the purposes 26 designated: 27 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 28 For salaries, support, maintenance, and miscellaneous 29 purposes, and for not more than the following full-time 30 equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,229,763 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 33 2. IOWA VETERANS HOME 34 For salaries, support, maintenance, and miscellaneous 35 -15- HF 891 (3) 89 pf/rn/md 15/ 74
H.F. 891 purposes: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,131,552 2 a. The Iowa veterans home billings involving the department 3 of human services shall be submitted to the department on at 4 least a monthly basis. 5 b. The Iowa veterans home expenditure report shall be 6 submitted monthly to the general assembly. 7 c. The Iowa veterans home shall continue to include in the 8 annual discharge report applicant information to provide for 9 the collection of demographic information including but not 10 limited to the number of individuals applying for admission and 11 admitted or denied admittance and the basis for the admission 12 or denial; the age, gender, and race of such individuals; 13 and the level of care for which such individuals applied for 14 admission including residential or nursing level of care. 15 3. HOME OWNERSHIP ASSISTANCE PROGRAM 16 For transfer to the Iowa finance authority for the 17 continuation of the home ownership assistance program for 18 persons who are or were eligible members of the armed forces of 19 the United States, pursuant to section 16.54 : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 21 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 22 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 23 appropriation in section 35A.16 for the fiscal year beginning 24 July 1, 2021, and ending June 30, 2022, the amount appropriated 25 from the general fund of the state pursuant to that section 26 for the following designated purposes shall not exceed the 27 following amount: 28 For the county commissions of veteran affairs fund under 29 section 35A.16 : 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 31 DIVISION V 32 DEPARTMENT OF HUMAN SERVICES —— FY 2021-2022 33 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 34 GRANT. There is appropriated from the fund created in section 35 -16- HF 891 (3) 89 pf/rn/md 16/ 74
H.F. 891 8.41 to the department of human services for the fiscal year 1 beginning July 1, 2021, and ending June 30, 2022, from moneys 2 received under the federal temporary assistance for needy 3 families (TANF) block grant pursuant to the federal Personal 4 Responsibility and Work Opportunity Reconciliation Act of 1996, 5 Pub. L. No. 104-193, and successor legislation, the following 6 amounts, or so much thereof as is necessary, to be used for the 7 purposes designated: 8 1. To be credited to the family investment program account 9 and used for assistance under the family investment program 10 under chapter 239B : 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 12 2. To be credited to the family investment program account 13 and used for the job opportunities and basic skills (JOBS) 14 program and implementing family investment agreements in 15 accordance with chapter 239B : 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 17 3. To be used for the family development and 18 self-sufficiency grant program in accordance with section 19 216A.107 : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 21 Notwithstanding section 8.33 , moneys appropriated in this 22 subsection that remain unencumbered or unobligated at the close 23 of the fiscal year shall not revert but shall remain available 24 for expenditure for the purposes designated until the close of 25 the succeeding fiscal year. However, unless such moneys are 26 encumbered or obligated on or before September 30, 2022, the 27 moneys shall revert. 28 4. For field operations: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 30 5. For general administration: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 32 6. For state child care assistance: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 34 a. Of the funds appropriated in this subsection, 35 -17- HF 891 (3) 89 pf/rn/md 17/ 74
H.F. 891 $26,205,412 is transferred to the child care and development 1 block grant appropriation made by the Eighty-ninth General 2 Assembly, 2021 session, for the federal fiscal year beginning 3 October 1, 2021, and ending September 30, 2022. Of this 4 amount, $200,000 shall be used for provision of educational 5 opportunities to registered child care home providers in order 6 to improve services and programs offered by this category 7 of providers and to increase the number of providers. The 8 department may contract with institutions of higher education 9 or child care resource and referral centers to provide 10 the educational opportunities. Allowable administrative 11 costs under the contracts shall not exceed 5 percent. The 12 application for a grant shall not exceed two pages in length. 13 b. Any funds appropriated in this subsection remaining 14 unallocated shall be used for state child care assistance 15 payments for families who are employed including but not 16 limited to individuals enrolled in the family investment 17 program. 18 7. For child and family services: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 20 8. For child abuse prevention grants: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 22 9. For pregnancy prevention grants on the condition that 23 family planning services are funded: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 25 Pregnancy prevention grants shall be awarded to programs 26 in existence on or before July 1, 2021, if the programs have 27 demonstrated positive outcomes. Grants shall be awarded to 28 pregnancy prevention programs which are developed after July 29 1, 2021, if the programs are based on existing models that 30 have demonstrated positive outcomes. Grants shall comply with 31 the requirements provided in 1997 Iowa Acts, chapter 208, 32 section 14, subsections 1 and 2 , including the requirement that 33 grant programs must emphasize sexual abstinence. Priority in 34 the awarding of grants shall be given to programs that serve 35 -18- HF 891 (3) 89 pf/rn/md 18/ 74
H.F. 891 areas of the state which demonstrate the highest percentage of 1 unplanned pregnancies of females of childbearing age within the 2 geographic area to be served by the grant. 3 10. For technology needs and other resources necessary to 4 meet federal, state, and welfare reform reporting, tracking, 5 and case management requirements and other departmental needs: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 7 11. a. Notwithstanding any provision to the contrary, 8 including but not limited to requirements in section 8.41 or 9 provisions in 2020 Iowa Acts or 2021 Iowa Acts regarding the 10 receipt and appropriation of federal block grants, federal 11 funds from the temporary assistance for needy families block 12 grant received by the state and not otherwise appropriated 13 in this section and remaining available for the fiscal year 14 beginning July 1, 2021, are appropriated to the department of 15 human services to the extent as may be necessary to be used in 16 the following priority order: the family investment program, 17 for state child care assistance program payments for families 18 who are employed, and for the family investment program share 19 of system costs for eligibility determination and related 20 functions. The federal funds appropriated in this paragraph 21 “a” shall be expended only after all other funds appropriated 22 in subsection 1 for assistance under the family investment 23 program, in subsection 6 for state child care assistance, or 24 in subsection 10 for technology costs related to the family 25 investment program, as applicable, have been expended. For 26 the purposes of this subsection, the funds appropriated in 27 subsection 6, paragraph “a”, for transfer to the child care 28 and development block grant appropriation are considered fully 29 expended when the full amount has been transferred. 30 b. The department shall, on a quarterly basis, advise the 31 general assembly and department of management of the amount of 32 funds appropriated in this subsection that was expended in the 33 prior quarter. 34 12. Of the amounts appropriated in this section, 35 -19- HF 891 (3) 89 pf/rn/md 19/ 74
H.F. 891 $12,962,008 for the fiscal year beginning July 1, 2021, is 1 transferred to the appropriation of the federal social services 2 block grant made to the department of human services for that 3 fiscal year. 4 13. For continuation of the program providing categorical 5 eligibility for the food assistance program as specified 6 for the program in the section of this division of this Act 7 relating to the family investment program account: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 9 14. The department may transfer funds allocated in this 10 section to the appropriations made in this division of this Act 11 for the same fiscal year for general administration and field 12 operations for resources necessary to implement and operate the 13 services referred to in this section and those funded in the 14 appropriation made in this division of this Act for the same 15 fiscal year for the family investment program from the general 16 fund of the state. 17 15. With the exception of moneys allocated under this 18 section for the family development and self-sufficiency grant 19 program, to the extent moneys allocated in this section are 20 deemed by the department not to be necessary to support the 21 purposes for which they are allocated, such moneys may be used 22 in the same fiscal year for any other purpose for which funds 23 are allocated in this section or in section 8 of this division 24 of this Act for the family investment program account. If 25 there are conflicting needs, priority shall first be given 26 to the family investment program account as specified under 27 subsection 1 of this section and used for the purposes of 28 assistance under the family investment program in accordance 29 with chapter 239B , followed by state child care assistance 30 program payments for families who are employed, followed by 31 other priorities as specified by the department. 32 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 33 1. Moneys credited to the family investment program (FIP) 34 account for the fiscal year beginning July 1, 2021, and 35 -20- HF 891 (3) 89 pf/rn/md 20/ 74
H.F. 891 ending June 30, 2022, shall be used to provide assistance in 1 accordance with chapter 239B . 2 2. The department may use a portion of the moneys credited 3 to the FIP account under this section as necessary for 4 salaries, support, maintenance, and miscellaneous purposes. 5 3. The department may transfer funds allocated in 6 subsection 4, excluding the allocation under subsection 4, 7 paragraph “b”, to the appropriations made in this division of 8 this Act for the same fiscal year for general administration 9 and field operations for resources necessary to implement 10 and operate the services referred to in this section and 11 those funded in the appropriations made in section 7 for the 12 temporary assistance for needy families block grant and in 13 section 9 for the family investment program from the general 14 fund of the state in this division of this Act for the same 15 fiscal year. 16 4. Moneys appropriated in this division of this Act and 17 credited to the FIP account for the fiscal year beginning July 18 1, 2021, and ending June 30, 2022, are allocated as follows: 19 a. To be retained by the department of human services to 20 be used for coordinating with the department of human rights 21 to more effectively serve participants in FIP and other shared 22 clients and to meet federal reporting requirements under the 23 federal temporary assistance for needy families block grant: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 25 b. To the department of human rights for staffing, 26 administration, and implementation of the family development 27 and self-sufficiency grant program in accordance with section 28 216A.107 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,192,834 30 (1) Of the funds allocated for the family development 31 and self-sufficiency grant program in this paragraph “b”, 32 not more than 5 percent of the funds shall be used for the 33 administration of the grant program. 34 (2) The department of human rights may continue to implement 35 -21- HF 891 (3) 89 pf/rn/md 21/ 74
H.F. 891 the family development and self-sufficiency grant program 1 statewide during fiscal year 2021-2022. 2 (3) The department of human rights may engage in activities 3 to strengthen and improve family outcomes measures and 4 data collection systems under the family development and 5 self-sufficiency grant program. 6 c. For the diversion subaccount of the FIP account: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 8 A portion of the moneys allocated for the diversion 9 subaccount may be used for field operations, salaries, data 10 management system development, and implementation costs and 11 support deemed necessary by the director of human services 12 in order to administer the FIP diversion program. To the 13 extent moneys allocated in this paragraph “c” are deemed by the 14 department not to be necessary to support diversion activities, 15 such moneys may be used for other efforts intended to increase 16 engagement by family investment program participants in work, 17 education, or training activities, or for the purposes of 18 assistance under the family investment program in accordance 19 with chapter 239B . 20 d. For the food assistance employment and training program: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 22 (1) The department shall apply the federal supplemental 23 nutrition assistance program (SNAP) employment and training 24 state plan in order to maximize to the fullest extent permitted 25 by federal law the use of the 50 percent federal reimbursement 26 provisions for the claiming of allowable federal reimbursement 27 funds from the United States department of agriculture 28 pursuant to the federal SNAP employment and training program 29 for providing education, employment, and training services 30 for eligible food assistance program participants, including 31 but not limited to related dependent care and transportation 32 expenses. 33 (2) The department shall continue the categorical federal 34 food assistance program eligibility at 160 percent of the 35 -22- HF 891 (3) 89 pf/rn/md 22/ 74
H.F. 891 federal poverty level and continue to eliminate the asset test 1 from eligibility requirements, consistent with federal food 2 assistance program requirements. The department shall include 3 as many food assistance households as is allowed by federal 4 law. The eligibility provisions shall conform to all federal 5 requirements including requirements addressing individuals who 6 are incarcerated or otherwise ineligible. 7 e. For the JOBS program, not more than: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 9 5. Of the child support collections assigned under FIP, 10 an amount equal to the federal share of support collections 11 shall be credited to the child support recovery appropriation 12 made in this division of this Act. Of the remainder of the 13 assigned child support collections received by the child 14 support recovery unit, a portion shall be credited to the FIP 15 account, a portion may be used to increase recoveries, and a 16 portion may be used to sustain cash flow in the child support 17 payments account. If as a consequence of the appropriations 18 and allocations made in this section the resulting amounts 19 are insufficient to sustain cash assistance payments and meet 20 federal maintenance of effort requirements, the department 21 shall seek supplemental funding. If child support collections 22 assigned under FIP are greater than estimated or are otherwise 23 determined not to be required for maintenance of effort, the 24 state share of either amount may be transferred to or retained 25 in the child support payments account. 26 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 27 is appropriated from the general fund of the state to the 28 department of human services for the fiscal year beginning July 29 1, 2021, and ending June 30, 2022, the following amount, or 30 so much thereof as is necessary, to be used for the purpose 31 designated: 32 To be credited to the family investment program (FIP) 33 account and used for family investment program assistance 34 under chapter 239B and other costs associated with providing 35 -23- HF 891 (3) 89 pf/rn/md 23/ 74
H.F. 891 needs-based benefits or assistance: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,003,978 2 1. Of the funds appropriated in this section, $6,606,198 is 3 allocated for the JOBS program. 4 2. Of the funds appropriated in this section, $4,313,854 is 5 allocated for the family development and self-sufficiency grant 6 program. 7 3. a. Notwithstanding section 8.39 , for the fiscal 8 year beginning July 1, 2021, if necessary to meet federal 9 maintenance of effort requirements or to transfer federal 10 temporary assistance for needy families block grant funding 11 to be used for purposes of the federal social services block 12 grant or to meet cash flow needs resulting from delays in 13 receiving federal funding or to implement, in accordance with 14 this division of this Act, activities currently funded with 15 juvenile court services, county, or community moneys and state 16 moneys used in combination with such moneys; to comply with 17 federal requirements; or to maximize the use of federal funds; 18 the department of human services may transfer funds within or 19 between any of the appropriations made in this division of this 20 Act and appropriations in law for the federal social services 21 block grant to the department for the following purposes, 22 provided that the combined amount of state and federal 23 temporary assistance for needy families block grant funding 24 for each appropriation remains the same before and after the 25 transfer: 26 (1) For the family investment program. 27 (2) For state child care assistance. 28 (3) For child and family services. 29 (4) For field operations. 30 (5) For general administration. 31 b. This subsection shall not be construed to prohibit the 32 use of existing state transfer authority for other purposes. 33 The department shall report any transfers made pursuant to this 34 subsection to the general assembly. 35 -24- HF 891 (3) 89 pf/rn/md 24/ 74
H.F. 891 4. Of the funds appropriated in this section, $195,000 1 shall be used for a contract for tax preparation assistance 2 to low-income Iowans to expand the usage of the earned income 3 tax credit. The purpose of the contract is to supply this 4 assistance to underserved areas of the state. The department 5 shall not retain any portion of the allocation under this 6 subsection for administrative costs. 7 5. Of the funds appropriated in this section, $70,000 shall 8 be used for the continuation of the parenting program, as 9 specified in 441 IAC ch. 100 , relating to parental obligations, 10 in which the child support recovery unit participates, to 11 support the efforts of a nonprofit organization committed to 12 strengthening the community through youth development, healthy 13 living, and social responsibility headquartered in a county 14 with a population over 350,000 according to the 2010 certified 15 federal census. The funds allocated in this subsection shall 16 be used by the recipient organization to develop a larger 17 community effort, through public and private partnerships, to 18 support a broad-based multi-county parenthood initiative that 19 promotes payment of child support obligations, improved family 20 relationships, and full-time employment. 21 6. The department may transfer funds appropriated in this 22 section, excluding the allocation in subsection 2 for the 23 family development and self-sufficiency grant program, to the 24 appropriations made in this division of this Act for general 25 administration and field operations as necessary to administer 26 this section, section 7 for the temporary assistance for needy 27 families block grant, and section 8 for the family investment 28 program account. 29 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 30 from the general fund of the state to the department of human 31 services for the fiscal year beginning July 1, 2021, and ending 32 June 30, 2022, the following amount, or so much thereof as is 33 necessary, to be used for the purposes designated: 34 For child support recovery, including salaries, support, 35 -25- HF 891 (3) 89 pf/rn/md 25/ 74
H.F. 891 maintenance, and miscellaneous purposes, and for not more than 1 the following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,942,885 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 4 1. The department shall expend up to $24,000, including 5 federal financial participation, for the fiscal year beginning 6 July 1, 2021, for a child support public awareness campaign. 7 The department and the office of the attorney general shall 8 cooperate in continuation of the campaign. The public 9 awareness campaign shall emphasize, through a variety of 10 media activities, the importance of maximum involvement of 11 both parents in the lives of their children as well as the 12 importance of payment of child support obligations. 13 2. Federal access and visitation grant moneys shall be 14 issued directly to private not-for-profit agencies that provide 15 services designed to increase compliance with the child access 16 provisions of court orders, including but not limited to 17 neutral visitation sites and mediation services. 18 3. The appropriation made to the department for child 19 support recovery may be used throughout the fiscal year in the 20 manner necessary for purposes of cash flow management, and for 21 cash flow management purposes the department may temporarily 22 draw more than the amount appropriated, provided the amount 23 appropriated is not exceeded at the close of the fiscal year. 24 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 25 FY 2021-2022. Any funds remaining in the health care trust 26 fund created in section 453A.35A for the fiscal year beginning 27 July 1, 2021, and ending June 30, 2022, are appropriated to 28 the department of human services to supplement the medical 29 assistance program appropriations made in this division of this 30 Act, for medical assistance reimbursement and associated costs, 31 including program administration and costs associated with 32 program implementation. 33 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 34 2021-2022. Any funds remaining in the Medicaid fraud fund 35 -26- HF 891 (3) 89 pf/rn/md 26/ 74
H.F. 891 created in section 249A.50 for the fiscal year beginning 1 July 1, 2021, and ending June 30, 2022, are appropriated to 2 the department of human services to supplement the medical 3 assistance appropriations made in this division of this Act, 4 for medical assistance reimbursement and associated costs, 5 including program administration and costs associated with 6 program implementation. 7 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 8 general fund of the state to the department of human services 9 for the fiscal year beginning July 1, 2021, and ending June 30, 10 2022, the following amount, or so much thereof as is necessary, 11 to be used for the purpose designated: 12 For medical assistance program reimbursement and associated 13 costs as specifically provided in the reimbursement 14 methodologies in effect on June 30, 2021, except as otherwise 15 expressly authorized by law, consistent with options under 16 federal law and regulations, and contingent upon receipt of 17 approval from the office of the governor of reimbursement for 18 each abortion performed under the program: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,503,848,253 20 1. Iowans support reducing the number of abortions 21 performed in our state. Funds appropriated under this section 22 shall not be used for abortions, unless otherwise authorized 23 under this section. 24 2. The provisions of this section relating to abortions 25 shall also apply to the Iowa health and wellness plan created 26 pursuant to chapter 249N . 27 3. The department shall utilize not more than $60,000 of 28 the funds appropriated in this section to continue the AIDS/HIV 29 health insurance premium payment program as established in 1992 30 Iowa Acts, Second Extraordinary Session, chapter 1001, section 31 409, subsection 6 . Of the funds allocated in this subsection, 32 not more than $5,000 may be expended for administrative 33 purposes. 34 4. Of the funds appropriated in this Act to the department 35 -27- HF 891 (3) 89 pf/rn/md 27/ 74
H.F. 891 of public health for addictive disorders, $950,000 for 1 the fiscal year beginning July 1, 2021, is transferred 2 to the department of human services for an integrated 3 substance-related disorder managed care system. The 4 departments of human services and public health shall 5 work together to maintain the level of mental health and 6 substance-related disorder treatment services provided by the 7 managed care contractors. Each department shall take the steps 8 necessary to continue the federal waivers as necessary to 9 maintain the level of services. 10 5. The department shall aggressively pursue options for 11 providing medical assistance or other assistance to individuals 12 with special needs who become ineligible to continue receiving 13 services under the early and periodic screening, diagnostic, 14 and treatment program under the medical assistance program 15 due to becoming 21 years of age who have been approved for 16 additional assistance through the department’s exception to 17 policy provisions, but who have health care needs in excess 18 of the funding available through the exception to policy 19 provisions. 20 6. Of the funds appropriated in this section, up to 21 $3,050,082 may be transferred to the field operations or 22 general administration appropriations in this division of this 23 Act for operational costs associated with Part D of the federal 24 Medicare Prescription Drug Improvement and Modernization Act 25 of 2003, Pub. L. No. 108-173. 26 7. Of the funds appropriated in this section, up to $442,100 27 may be transferred to the appropriation in this division of 28 this Act for health program operations to be used for clinical 29 assessment services and prior authorization of services. 30 8. A portion of the funds appropriated in this section may 31 be transferred to the appropriations in this division of this 32 Act for general administration, health program operations, the 33 children’s health insurance program, or field operations to be 34 used for the state match cost to comply with the payment error 35 -28- HF 891 (3) 89 pf/rn/md 28/ 74
H.F. 891 rate measurement (PERM) program for both the medical assistance 1 and children’s health insurance programs as developed by the 2 centers for Medicare and Medicaid services of the United States 3 department of health and human services to comply with the 4 federal Improper Payments Information Act of 2002, Pub. L. 5 No. 107-300, and to support other reviews and quality control 6 activities to improve the integrity of these programs. 7 9. Of the funds appropriated in this section, a sufficient 8 amount is allocated to supplement the incomes of residents of 9 nursing facilities, intermediate care facilities for persons 10 with mental illness, and intermediate care facilities for 11 persons with an intellectual disability, with incomes of less 12 than $50 in the amount necessary for the residents to receive a 13 personal needs allowance of $50 per month pursuant to section 14 249A.30A . 15 10. a. Hospitals that meet the conditions specified 16 in subparagraphs (1) and (2) shall either certify public 17 expenditures or transfer to the medical assistance program 18 an amount equal to provide the nonfederal share for a 19 disproportionate share hospital payment in an amount up to the 20 hospital-specific limit as approved in the Medicaid state plan. 21 The hospitals that meet the conditions specified shall receive 22 and retain 100 percent of the total disproportionate share 23 hospital payment in an amount up to the hospital-specific limit 24 as approved in the Medicaid state plan. 25 (1) The hospital qualifies for disproportionate share and 26 graduate medical education payments. 27 (2) The hospital is an Iowa state-owned hospital with more 28 than 500 beds and eight or more distinct residency specialty 29 or subspecialty programs recognized by the American college of 30 graduate medical education. 31 b. Distribution of the disproportionate share payments 32 shall be made on a monthly basis. The total amount of 33 disproportionate share payments including graduate medical 34 education, enhanced disproportionate share, and Iowa 35 -29- HF 891 (3) 89 pf/rn/md 29/ 74
H.F. 891 state-owned teaching hospital payments shall not exceed the 1 amount of the state’s allotment under Pub. L. No. 102-234. 2 In addition, the total amount of all disproportionate 3 share payments shall not exceed the hospital-specific 4 disproportionate share limits under Pub. L. No. 103-66. 5 11. One hundred percent of the nonfederal share of payments 6 to area education agencies that are medical assistance 7 providers for medical assistance-covered services provided to 8 medical assistance-covered children, shall be made from the 9 appropriation made in this section. 10 12. A portion of the funds appropriated in this section may 11 be transferred to the appropriation in this division of this 12 Act for health program operations to be used for administrative 13 activities associated with the money follows the person 14 demonstration project. 15 13. Of the funds appropriated in this section, $349,011 16 shall be used for the administration of the health insurance 17 premium payment program, including salaries, support, 18 maintenance, and miscellaneous purposes. 19 14. a. The department may increase the amounts allocated 20 for salaries, support, maintenance, and miscellaneous purposes 21 associated with the medical assistance program, as necessary, 22 to sustain cost management efforts. The department shall 23 report any such increase to the general assembly and the 24 department of management. 25 b. If the savings to the medical assistance program from 26 ongoing cost management efforts exceed the associated cost 27 for the fiscal year beginning July 1, 2021, the department 28 may transfer any savings generated for the fiscal year due 29 to medical assistance program cost management efforts to the 30 appropriation made in this division of this Act for health 31 program operations or general administration to defray the 32 costs associated with implementing the efforts. 33 15. For the fiscal year beginning July 1, 2021, and ending 34 June 30, 2022, the replacement generation tax revenues required 35 -30- HF 891 (3) 89 pf/rn/md 30/ 74
H.F. 891 to be deposited in the property tax relief fund pursuant to 1 section 437A.8, subsection 4 , paragraph “d”, and section 2 437A.15, subsection 3 , paragraph “f”, shall instead be credited 3 to and supplement the appropriation made in this section and 4 used for the allocations made in this section. 5 16. a. Of the funds appropriated in this section, up 6 to $50,000 may be transferred by the department to the 7 appropriation made in this division of this Act to the 8 department for the same fiscal year for general administration 9 to be used for associated administrative expenses and for not 10 more than 1.00 full-time equivalent position, in addition to 11 those authorized for the same fiscal year, to be assigned to 12 implementing the children’s mental health home project. 13 b. Of the funds appropriated in this section, up to $400,000 14 may be transferred by the department to the appropriation made 15 to the department in this division of this Act for the same 16 fiscal year for Medicaid program-related general administration 17 planning and implementation activities. The funds may be used 18 for contracts or for personnel in addition to the amounts 19 appropriated for and the positions authorized for general 20 administration for the fiscal year. 21 c. Of the funds appropriated in this section, up to 22 $3,000,000 may be transferred by the department to the 23 appropriations made in this division of this Act for the 24 same fiscal year for general administration or health 25 program operations to be used to support the development 26 and implementation of standardized assessment tools for 27 persons with mental illness, an intellectual disability, a 28 developmental disability, or a brain injury. 29 17. Of the funds appropriated in this section, $150,000 30 shall be used for lodging expenses associated with care 31 provided at the university of Iowa hospitals and clinics for 32 patients with cancer whose travel distance is 30 miles or more 33 and whose income is at or below 200 percent of the federal 34 poverty level as defined by the most recently revised poverty 35 -31- HF 891 (3) 89 pf/rn/md 31/ 74
H.F. 891 income guidelines published by the United States department of 1 health and human services. The department of human services 2 shall establish the maximum number of overnight stays and the 3 maximum rate reimbursed for overnight lodging, which may be 4 based on the state employee rate established by the department 5 of administrative services. The funds allocated in this 6 subsection shall not be used as nonfederal share matching 7 funds. 8 18. Of the funds appropriated in this section, up to 9 $3,383,880 shall be used for administration of the state family 10 planning services program pursuant to section 217.41B , and 11 of this amount, the department may use up to $200,000 for 12 administrative expenses. 13 19. Of the funds appropriated in this section, $1,545,530 14 shall be used and may be transferred to other appropriations 15 in this division of this Act as necessary to administer the 16 provisions in the division of this Act relating to Medicaid 17 program administration. 18 20. The department shall comply with the centers for 19 Medicare and Medicaid services’ guidance related to Medicaid 20 program and children’s health insurance program maintenance 21 of effort provisions, including eligibility standards, 22 methodologies, procedures, and continuous enrollment, to 23 receive the enhanced federal medical assistance percentage 24 under section 6008(b) of the federal Families First Coronavirus 25 Response Act, Pub. L. No. 116-127. The department shall 26 utilize and implement all tools, processes, and resources 27 available to expediently return to normal eligibility and 28 enrollment operations in compliance with federal guidance and 29 expectations. 30 21. Of the funds appropriated in this section, up to 31 $1,031,530 shall be used to implement reductions in the waiting 32 list for the children’s mental health home and community-based 33 services waiver. 34 22. Of the funds appropriated in this section, a sufficient 35 -32- HF 891 (3) 89 pf/rn/md 32/ 74
H.F. 891 amount is allocated to fund up to three full-time equivalent 1 positions to support the administrative work associated with 2 existing and potential supplemental payment programs. 3 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated 4 from the general fund of the state to the department of human 5 services for the fiscal year beginning July 1, 2021, and ending 6 June 30, 2022, the following amount, or so much thereof as is 7 necessary, to be used for the purpose designated: 8 For health program operations: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,831,343 10 1. The department of inspections and appeals shall 11 provide all state matching funds for survey and certification 12 activities performed by the department of inspections 13 and appeals. The department of human services is solely 14 responsible for distributing the federal matching funds for 15 such activities. 16 2. Of the funds appropriated in this section, $50,000 shall 17 be used for continuation of home and community-based services 18 waiver quality assurance programs, including the review and 19 streamlining of processes and policies related to oversight and 20 quality management to meet state and federal requirements. 21 3. Of the amount appropriated in this section, up to 22 $200,000 may be transferred to the appropriation for general 23 administration in this division of this Act to be used for 24 additional full-time equivalent positions in the development 25 of key health initiatives such as development and oversight 26 of managed care programs and development of health strategies 27 targeted toward improved quality and reduced costs in the 28 Medicaid program. 29 4. Of the funds appropriated in this section, $1,000,000 30 shall be used for planning and development, in cooperation with 31 the department of public health, of a phased-in program to 32 provide a dental home for children. 33 5. a. Of the funds appropriated in this section, $573,000 34 shall be credited to the autism support program fund created 35 -33- HF 891 (3) 89 pf/rn/md 33/ 74
H.F. 891 in section 225D.2 to be used for the autism support program 1 created in chapter 225D , with the exception of the following 2 amount of this allocation which shall be used as follows: 3 b. Of the funds allocated in this subsection, $25,000 shall 4 be used for the public purpose of continuation of a grant to 5 a nonprofit provider of child welfare services that has been 6 in existence for more than 115 years, is located in a county 7 with a population between 200,000 and 220,000 according to the 8 2010 federal decennial census, is licensed as a psychiatric 9 medical institution for children, and provides school-based 10 programming, to be used for support services for children with 11 autism spectrum disorder and their families. 12 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 13 1. There is appropriated from the general fund of the 14 state to the department of human services for the fiscal year 15 beginning July 1, 2021, and ending June 30, 2022, the following 16 amount, or so much thereof as is necessary, to be used for the 17 purpose designated: 18 For the state supplementary assistance program: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,349,002 20 2. The department shall increase the personal needs 21 allowance for residents of residential care facilities by the 22 same percentage and at the same time as federal supplemental 23 security income and federal social security benefits are 24 increased due to a recognized increase in the cost of living. 25 The department may adopt emergency rules to implement this 26 subsection. 27 3. If during the fiscal year beginning July 1, 2021, 28 the department projects that state supplementary assistance 29 expenditures for a calendar year will not meet the federal 30 pass-through requirement specified in Tit. XVI of the federal 31 Social Security Act, section 1618, as codified in 42 U.S.C. 32 §1382g, the department may take actions including but not 33 limited to increasing the personal needs allowance for 34 residential care facility residents and making programmatic 35 -34- HF 891 (3) 89 pf/rn/md 34/ 74
H.F. 891 adjustments or upward adjustments of the residential care 1 facility or in-home health-related care reimbursement rates 2 prescribed in this division of this Act to ensure that federal 3 requirements are met. In addition, the department may make 4 other programmatic and rate adjustments necessary to remain 5 within the amount appropriated in this section while ensuring 6 compliance with federal requirements. The department may adopt 7 emergency rules to implement the provisions of this subsection. 8 4. Notwithstanding section 8.33 , moneys appropriated 9 in this section that remain unencumbered or unobligated 10 at the close of the fiscal year shall not revert but 11 shall remain available for expenditure for the purposes 12 designated, including for liability amounts associated with the 13 supplemental nutrition assistance program payment error rate, 14 until the close of the succeeding fiscal year. 15 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 16 1. There is appropriated from the general fund of the 17 state to the department of human services for the fiscal year 18 beginning July 1, 2021, and ending June 30, 2022, the following 19 amount, or so much thereof as is necessary, to be used for the 20 purpose designated: 21 For maintenance of the healthy and well kids in Iowa (hawk-i) 22 program pursuant to chapter 514I , including supplemental dental 23 services, for receipt of federal financial participation under 24 Tit. XXI of the federal Social Security Act, which creates the 25 children’s health insurance program: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 37,957,643 27 2. Of the funds appropriated in this section, $149,189 is 28 allocated for continuation of the contract for outreach with 29 the department of public health. 30 3. A portion of the funds appropriated in this section may 31 be transferred to the appropriations made in this division of 32 this Act for field operations or health program operations to 33 be used for the integration of hawk-i program eligibility, 34 payment, and administrative functions under the purview of 35 -35- HF 891 (3) 89 pf/rn/md 35/ 74
H.F. 891 the department of human services, including for the Medicaid 1 management information system upgrade. 2 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 3 from the general fund of the state to the department of human 4 services for the fiscal year beginning July 1, 2021, and ending 5 June 30, 2022, the following amount, or so much thereof as is 6 necessary, to be used for the purpose designated: 7 For child care programs: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 9 1. Of the funds appropriated in this section, $34,966,931 10 shall be used for state child care assistance in accordance 11 with section 237A.13 . 12 2. Nothing in this section shall be construed or is 13 intended as or shall imply a grant of entitlement for services 14 to persons who are eligible for assistance due to an income 15 level consistent with the waiting list requirements of section 16 237A.13 . Any state obligation to provide services pursuant to 17 this section is limited to the extent of the funds appropriated 18 in this section. 19 3. A list of the registered and licensed child care 20 facilities operating in the area served by a child care 21 resource and referral service shall be made available to the 22 families receiving state child care assistance in that area. 23 4. Of the funds appropriated in this section, $5,850,000 24 shall be credited to the early childhood programs grants 25 account in the early childhood Iowa fund created in section 26 256I.11 . The moneys shall be distributed for funding of 27 community-based early childhood programs targeted to children 28 from birth through five years of age developed by early 29 childhood Iowa areas in accordance with approved community 30 plans as provided in section 256I.8 . 31 5. The department may use any of the funds appropriated 32 in this section as a match to obtain federal funds for use in 33 expanding child care assistance and related programs. For 34 the purpose of expenditures of state and federal child care 35 -36- HF 891 (3) 89 pf/rn/md 36/ 74
H.F. 891 funding, funds shall be considered obligated at the time 1 expenditures are projected or are allocated to the department’s 2 service areas. Projections shall be based on current and 3 projected caseload growth, current and projected provider 4 rates, staffing requirements for eligibility determination 5 and management of program requirements including data systems 6 management, staffing requirements for administration of the 7 program, contractual and grant obligations and any transfers 8 to other state agencies, and obligations for decategorization 9 or innovation projects. 10 6. A portion of the state match for the federal child care 11 and development block grant shall be provided as necessary to 12 meet federal matching funds requirements through the state 13 general fund appropriation made for child development grants 14 and other programs for at-risk children in section 279.51 . 15 7. If a uniform reduction ordered by the governor under 16 section 8.31 or other operation of law, transfer, or federal 17 funding reduction reduces the appropriation made in this 18 section for the fiscal year, the percentage reduction in the 19 amount paid out to or on behalf of the families participating 20 in the state child care assistance program shall be equal to or 21 less than the percentage reduction made for any other purpose 22 payable from the appropriation made in this section and the 23 federal funding relating to it. The percentage reduction to 24 the other allocations made in this section shall be the same as 25 the uniform reduction ordered by the governor or the percentage 26 change of the federal funding reduction, as applicable. If 27 there is an unanticipated increase in federal funding provided 28 for state child care services, the entire amount of the 29 increase, except as necessary to meet federal requirements 30 including quality set asides, shall be used for state child 31 care assistance payments. If the appropriations made for 32 purposes of the state child care assistance program for the 33 fiscal year are determined to be insufficient, it is the intent 34 of the general assembly to appropriate sufficient funding for 35 -37- HF 891 (3) 89 pf/rn/md 37/ 74
H.F. 891 the fiscal year in order to avoid establishment of waiting list 1 requirements. 2 8. Notwithstanding section 8.33 , moneys advanced for 3 purposes of the programs developed by early childhood Iowa 4 areas, advanced for purposes of wraparound child care, or 5 received from the federal appropriations made for the purposes 6 of this section that remain unencumbered or unobligated at the 7 close of the fiscal year shall not revert to any fund but shall 8 remain available for expenditure for the purposes designated 9 until the close of the succeeding fiscal year. 10 Sec. 18. JUVENILE INSTITUTION. There is appropriated 11 from the general fund of the state to the department of human 12 services for the fiscal year beginning July 1, 2021, and ending 13 June 30, 2022, the following amounts, or so much thereof as is 14 necessary, to be used for the purposes designated: 15 1. a. For operation of the state training school at Eldora 16 and for salaries, support, maintenance, and miscellaneous 17 purposes, and for not more than the following full-time 18 equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,397,068 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 21 b. Of the funds appropriated in this subsection, $91,000 22 shall be used for distribution to licensed classroom teachers 23 at this and other institutions under the control of the 24 department of human services based upon the average student 25 yearly enrollment at each institution as determined by the 26 department. 27 2. A portion of the moneys appropriated in this section 28 shall be used by the state training school at Eldora for 29 grants for adolescent pregnancy prevention activities at the 30 institution in the fiscal year beginning July 1, 2021. 31 3. Of the funds appropriated in this subsection, $212,000 32 shall be used by the state training school at Eldora for a 33 substance use disorder treatment program at the institution for 34 the fiscal year beginning July 1, 2021. 35 -38- HF 891 (3) 89 pf/rn/md 38/ 74
H.F. 891 4. Notwithstanding section 8.33 , moneys appropriated in 1 this section that remain unencumbered or unobligated at the 2 close of the fiscal year shall not revert but shall remain 3 available for expenditure for the purposes designated until the 4 close of the succeeding fiscal year. 5 Sec. 19. CHILD AND FAMILY SERVICES. 6 1. There is appropriated from the general fund of the 7 state to the department of human services for the fiscal year 8 beginning July 1, 2021, and ending June 30, 2022, the following 9 amount, or so much thereof as is necessary, to be used for the 10 purpose designated: 11 For child and family services: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,071,930 13 2. The department may transfer funds appropriated in this 14 section as necessary to pay the nonfederal costs of services 15 reimbursed under the medical assistance program, state child 16 care assistance program, or the family investment program which 17 are provided to children who would otherwise receive services 18 paid under the appropriation in this section. The department 19 may transfer funds appropriated in this section to the 20 appropriations made in this division of this Act for general 21 administration and for field operations for resources necessary 22 to implement and operate the services funded in this section. 23 3. a. Of the funds appropriated in this section, up to 24 $31,500,000 is allocated as the statewide expenditure target 25 under section 232.143 for group foster care maintenance and 26 services. If the department projects that such expenditures 27 for the fiscal year will be less than the target amount 28 allocated in this paragraph “a”, the department may reallocate 29 the excess to provide additional funding for family foster 30 care, independent living, family-centered services, shelter 31 care, or the child welfare emergency services addressed with 32 the allocation for shelter care. 33 b. If at any time after September 30, 2021, annualization 34 of a service area’s current expenditures indicates a service 35 -39- HF 891 (3) 89 pf/rn/md 39/ 74
H.F. 891 area is at risk of exceeding its group foster care expenditure 1 target under section 232.143 by more than 5 percent, the 2 department and juvenile court services shall examine all 3 group foster care placements in that service area in order to 4 identify those which might be appropriate for termination. 5 In addition, any aftercare services believed to be needed 6 for the children whose placements may be terminated shall be 7 identified. The department and juvenile court services shall 8 initiate action to set dispositional review hearings for the 9 placements identified. In such a dispositional review hearing, 10 the juvenile court shall determine whether needed aftercare 11 services are available and whether termination of the placement 12 is in the best interest of the child and the community. 13 4. In accordance with the provisions of section 232.188 , 14 the department shall continue the child welfare and juvenile 15 justice funding initiative during fiscal year 2021-2022. Of 16 the funds appropriated in this section, $1,717,000 is allocated 17 specifically for expenditure for fiscal year 2021-2022 through 18 the decategorization services funding pools and governance 19 boards established pursuant to section 232.188 . 20 5. A portion of the funds appropriated in this section 21 may be used for emergency family assistance to provide other 22 resources required for a family participating in a family 23 preservation or reunification project or successor project to 24 stay together or to be reunified. 25 6. Of the funds appropriated in this section, a sufficient 26 amount is allocated for shelter care and the child welfare 27 emergency services contracting implemented to provide for or 28 prevent the need for shelter care. 29 7. Federal funds received by the state during the fiscal 30 year beginning July 1, 2021, as the result of the expenditure 31 of state funds appropriated during a previous state fiscal 32 year for a service or activity funded under this section are 33 appropriated to the department to be used as additional funding 34 for services and purposes provided for under this section. 35 -40- HF 891 (3) 89 pf/rn/md 40/ 74
H.F. 891 Notwithstanding section 8.33 , moneys received in accordance 1 with this subsection that remain unencumbered or unobligated at 2 the close of the fiscal year shall not revert to any fund but 3 shall remain available for the purposes designated until the 4 close of the succeeding fiscal year. 5 8. a. Of the funds appropriated in this section, up to 6 $3,290,000 is allocated for the payment of the expenses of 7 court-ordered services provided to juveniles who are under the 8 supervision of juvenile court services, which expenses are a 9 charge upon the state pursuant to section 232.141, subsection 10 4 . Of the amount allocated in this paragraph “a”, up to 11 $1,556,000 shall be made available to provide school-based 12 supervision of children adjudicated under chapter 232 , of which 13 not more than $15,000 may be used for the purpose of training. 14 A portion of the cost of each school-based liaison officer 15 shall be paid by the school district or other funding source as 16 approved by the chief juvenile court officer. 17 b. Of the funds appropriated in this section, up to $748,000 18 is allocated for the payment of the expenses of court-ordered 19 services provided to children who are under the supervision 20 of the department, which expenses are a charge upon the state 21 pursuant to section 232.141, subsection 4 . 22 c. Notwithstanding section 232.141 or any other provision 23 of law to the contrary, the amounts allocated in this 24 subsection shall be distributed to the judicial districts 25 as determined by the state court administrator and to the 26 department’s service areas as determined by the administrator 27 of the department of human services’ division of child and 28 family services. The state court administrator and the 29 division administrator shall make the determination of the 30 distribution amounts on or before June 15, 2021. 31 d. Notwithstanding chapter 232 or any other provision of 32 law to the contrary, a district or juvenile court shall not 33 order any service which is a charge upon the state pursuant 34 to section 232.141 if there are insufficient court-ordered 35 -41- HF 891 (3) 89 pf/rn/md 41/ 74
H.F. 891 services funds available in the district court or departmental 1 service area distribution amounts to pay for the service. The 2 chief juvenile court officer and the departmental service area 3 manager shall encourage use of the funds allocated in this 4 subsection such that there are sufficient funds to pay for 5 all court-related services during the entire year. The chief 6 juvenile court officers and departmental service area managers 7 shall attempt to anticipate potential surpluses and shortfalls 8 in the distribution amounts and shall cooperatively request the 9 state court administrator or division administrator to transfer 10 funds between the judicial districts’ or departmental service 11 areas’ distribution amounts as prudent. 12 e. Notwithstanding any provision of law to the contrary, 13 a district or juvenile court shall not order a county to pay 14 for any service provided to a juvenile pursuant to an order 15 entered under chapter 232 which is a charge upon the state 16 under section 232.141, subsection 4 . 17 f. Of the funds allocated in this subsection, not more than 18 $83,000 may be used by the judicial branch for administration 19 of the requirements under this subsection. 20 g. Of the funds allocated in this subsection, $17,000 21 shall be used by the department of human services to support 22 the interstate commission for juveniles in accordance with 23 the interstate compact for juveniles as provided in section 24 232.173 . 25 9. Of the funds appropriated in this section, $12,253,000 is 26 allocated for juvenile delinquent graduated sanctions services. 27 Any state funds saved as a result of efforts by juvenile court 28 services to earn a federal Tit. IV-E match for juvenile court 29 services administration may be used for the juvenile delinquent 30 graduated sanctions services. 31 10. Of the funds appropriated in this section, $1,658,000 is 32 transferred to the department of public health to be used for 33 the child protection center grant program for child protection 34 centers located in Iowa in accordance with section 135.118 . 35 -42- HF 891 (3) 89 pf/rn/md 42/ 74
H.F. 891 The grant amounts under the program shall be equalized so that 1 each center receives a uniform base amount of $245,000, and so 2 that the remaining funds are awarded through a funding formula 3 based upon the volume of children served. To increase access 4 to child protection center services for children in rural 5 areas, the funding formula for the awarding of the remaining 6 funds shall provide for the awarding of an enhanced amount to 7 eligible grantees to develop and maintain satellite centers in 8 underserved regions of the state. 9 11. Of the funds appropriated in this section, $4,025,000 is 10 allocated for the preparation for adult living program pursuant 11 to section 234.46 . 12 12. Of the funds appropriated in this section, $227,000 13 shall be used for the public purpose of continuing a grant to a 14 nonprofit human services organization, providing services to 15 individuals and families in multiple locations in southwest 16 Iowa and Nebraska for support of a project providing immediate, 17 sensitive support and forensic interviews, medical exams, needs 18 assessments, and referrals for victims of child abuse and their 19 nonoffending family members. 20 13. Of the funds appropriated in this section, $300,000 21 is allocated for the foster care youth council approach of 22 providing a support network to children placed in foster care. 23 14. Of the funds appropriated in this section, $202,000 is 24 allocated for use pursuant to section 235A.1 for continuation 25 of the initiative to address child sexual abuse implemented 26 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 27 21 . 28 15. Of the funds appropriated in this section, $630,000 is 29 allocated for the community partnership for child protection 30 sites. 31 16. Of the funds appropriated in this section, $371,000 32 is allocated for the department’s minority youth and family 33 projects under the redesign of the child welfare system. 34 17. Of the funds appropriated in this section, $851,000 35 -43- HF 891 (3) 89 pf/rn/md 43/ 74
H.F. 891 is allocated for funding of the community circle of care 1 collaboration for children and youth in northeast Iowa. 2 18. Of the funds appropriated in this section, at least 3 $147,000 shall be used for the continuation of the child 4 welfare provider training academy, a collaboration between the 5 coalition for family and children’s services in Iowa and the 6 department. 7 19. Of the funds appropriated in this section, $211,000 8 shall be used for continuation of the central Iowa system of 9 care program grant for the purposes of funding community-based 10 services and other supports with a system of care approach for 11 children with serious emotional disturbance and their families 12 through a nonprofit provider that is located in a county 13 with a population of more than 420,000 but less than 450,000 14 according to the 2010 certified federal census, is licensed 15 as a psychiatric medical institution for children, and was a 16 system of care grantee prior to July 1, 2021. 17 20. Of the funds appropriated in this section, $235,000 18 shall be used for the public purpose of the continuation 19 and expansion of a system of care program grant implemented 20 in Cerro Gordo and Linn counties to utilize a comprehensive 21 and long-term approach for helping children and families by 22 addressing the key areas in a child’s life of childhood basic 23 needs, education and work, family, and community. 24 21. Of the funds appropriated in this section, $110,000 25 shall be used for the public purpose of funding community-based 26 services and other supports with a system of care approach 27 for children with a serious emotional disturbance and their 28 families through a nonprofit provider of child welfare services 29 that has been in existence for more than 115 years, is located 30 in a county with a population of more than 200,000 but less 31 than 220,000 according to the 2010 certified federal census, is 32 licensed as a psychiatric medical institution for children, and 33 was a system of care grantee prior to July 1, 2021. 34 22. If a separate funding source is identified that reduces 35 -44- HF 891 (3) 89 pf/rn/md 44/ 74
H.F. 891 the need for state funds within an allocation under this 1 section, the allocated state funds may be redistributed to 2 other allocations under this section for the same fiscal year. 3 23. Of the funds appropriated in this section, a portion may 4 be used for family-centered services for purposes of complying 5 with the federal Family First Prevention Services Act of 2018, 6 Pub. L. No. 115-123, and successor legislation. 7 Sec. 20. ADOPTION SUBSIDY. 8 1. There is appropriated from the general fund of the 9 state to the department of human services for the fiscal year 10 beginning July 1, 2021, and ending June 30, 2022, the following 11 amount, or so much thereof as is necessary, to be used for the 12 purpose designated: 13 a. For adoption subsidy payments and related costs and for 14 other services provided for under paragraph “b”, subparagraph 15 (2): 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 17 b. (1) Of the funds appropriated in this section, a 18 sufficient amount is allocated for adoption subsidy payments 19 and related costs. 20 (2) Any funds appropriated in this section remaining after 21 the allocation under subparagraph (1) are designated and 22 allocated as state savings resulting from implementation of 23 the federal Fostering Connections to Success and Increasing 24 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 25 legislation, as determined in accordance with 42 U.S.C. 26 §673(a)(8), and shall be used for post-adoption services and 27 for other purposes allowed under these federal laws, Tit. IV-B 28 or Tit. IV-E of the federal Social Security Act. 29 (a) The department of human services may transfer funds 30 allocated in this subparagraph (2) to the appropriation for 31 child and family services in this division of this Act for the 32 purposes designated in this subparagraph (2). 33 (b) Notwithstanding section 8.33, moneys allocated 34 under this subparagraph (2) shall not revert to any fund but 35 -45- HF 891 (3) 89 pf/rn/md 45/ 74
H.F. 891 shall remain available for the purposes designated in this 1 subparagraph (2) until expended. 2 2. The department may transfer funds appropriated in 3 this section to the appropriation made in this division of 4 this Act for general administration for costs paid from the 5 appropriation relating to adoption subsidy. 6 3. Federal funds received by the state during the 7 fiscal year beginning July 1, 2021, as the result of the 8 expenditure of state funds during a previous state fiscal 9 year for a service or activity funded under this section are 10 appropriated to the department to be used as additional funding 11 for the services and activities funded under this section. 12 Notwithstanding section 8.33 , moneys received in accordance 13 with this subsection that remain unencumbered or unobligated 14 at the close of the fiscal year shall not revert to any fund 15 but shall remain available for expenditure for the purposes 16 designated until the close of the succeeding fiscal year. 17 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 18 in the juvenile detention home fund created in section 232.142 19 during the fiscal year beginning July 1, 2021, and ending June 20 30, 2022, are appropriated to the department of human services 21 for the fiscal year beginning July 1, 2021, and ending June 30, 22 2022, for distribution of an amount equal to a percentage of 23 the costs of the establishment, improvement, operation, and 24 maintenance of county or multicounty juvenile detention homes 25 in the fiscal year beginning July 1, 2020. Moneys appropriated 26 for distribution in accordance with this section shall be 27 allocated among eligible detention homes, prorated on the basis 28 of an eligible detention home’s proportion of the costs of all 29 eligible detention homes in the fiscal year beginning July 30 1, 2020. The percentage figure shall be determined by the 31 department based on the amount available for distribution for 32 the fund. Notwithstanding section 232.142, subsection 3 , the 33 financial aid payable by the state under that provision for the 34 fiscal year beginning July 1, 2021, shall be limited to the 35 -46- HF 891 (3) 89 pf/rn/md 46/ 74
H.F. 891 amount appropriated for the purposes of this section. 1 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 2 1. There is appropriated from the general fund of the 3 state to the department of human services for the fiscal year 4 beginning July 1, 2021, and ending June 30, 2022, the following 5 amount, or so much thereof as is necessary, to be used for the 6 purpose designated: 7 For the family support subsidy program subject to the 8 enrollment restrictions in section 225C.37, subsection 3 : 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 10 2. At least $899,291 of the moneys appropriated in this 11 section is transferred to the department of public health for 12 the family support center component of the comprehensive family 13 support program under chapter 225C, subchapter V . 14 3. If at any time during the fiscal year, the amount of 15 funding available for the family support subsidy program 16 is reduced from the amount initially used to establish the 17 figure for the number of family members for whom a subsidy 18 is to be provided at any one time during the fiscal year, 19 notwithstanding section 225C.38, subsection 2 , the department 20 shall revise the figure as necessary to conform to the amount 21 of funding available. 22 Sec. 23. CONNER DECREE. There is appropriated from the 23 general fund of the state to the department of human services 24 for the fiscal year beginning July 1, 2021, and ending June 30, 25 2022, the following amount, or so much thereof as is necessary, 26 to be used for the purpose designated: 27 For building community capacity through the coordination 28 and provision of training opportunities in accordance with the 29 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 30 Iowa, July 14, 1994): 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 32 Sec. 24. MENTAL HEALTH INSTITUTES. 33 1. There is appropriated from the general fund of the 34 state to the department of human services for the fiscal year 35 -47- HF 891 (3) 89 pf/rn/md 47/ 74
H.F. 891 beginning July 1, 2021, and ending June 30, 2022, the following 1 amounts, or so much thereof as is necessary, to be used for the 2 purposes designated: 3 a. For operation of the state mental health institute at 4 Cherokee as required by chapters 218 and 226 for salaries, 5 support, maintenance, and miscellaneous purposes, and for not 6 more than the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,457,597 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.00 9 b. For operation of the state mental health institute at 10 Independence as required by chapters 218 and 226 for salaries, 11 support, maintenance, and miscellaneous purposes, and for not 12 more than the following full-time equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,652,379 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 208.00 15 2. a. Notwithstanding sections 218.78 and 249A.11 , any 16 revenue received from the state mental health institute at 17 Cherokee or the state mental health institute at Independence 18 pursuant to 42 C.F.R §438.6(e) may be retained and expended by 19 the mental health institute. 20 b. Notwithstanding sections 218.78 and 249A.11, any 21 COVID-19 related funding received through federal funding 22 sources by the state