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
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$
11,304,082
18
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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
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-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,
$250,000
3
shall
be
used
by
the
department
on
aging,
in
collaboration
with
4
the
department
of
human
services
and
affected
stakeholders,
5
to
continue
to
expand
the
pilot
initiative
to
provide
6
long-term
care
options
counseling
utilizing
support
planning
7
protocols,
to
assist
non-Medicaid
eligible
consumers
who
8
indicate
a
preference
to
return
to
the
community
and
are
9
deemed
appropriate
for
discharge,
to
return
to
their
community
10
following
a
nursing
facility
stay.
The
department
on
aging
11
shall
submit
a
report
regarding
the
outcomes
of
the
pilot
12
initiative
to
the
governor
and
the
general
assembly
by
December
13
15,
2021.
14
DIVISION
II
15
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN
——
FY
2021-2022
16
Sec.
2.
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN.
There
is
17
appropriated
from
the
general
fund
of
the
state
to
the
office
18
of
long-term
care
ombudsman
for
the
fiscal
year
beginning
July
19
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
20
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
21
designated:
22
For
salaries,
support,
administration,
maintenance,
and
23
miscellaneous
purposes,
and
for
not
more
than
the
following
24
full-time
equivalent
positions:
25
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$
1,149,821
26
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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
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$
23,659,379
5
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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,
$306,000
18
shall
be
utilized
by
the
department
of
public
health,
in
19
collaboration
with
the
department
of
human
services,
to
20
maintain
a
single
statewide
24-hour
crisis
hotline
for
the
Iowa
21
children’s
behavioral
health
system
that
incorporates
warmline
22
services
which
may
be
provided
through
expansion
of
existing
23
capabilities
maintained
by
the
department
of
public
health
as
24
required
pursuant
to
2018
Iowa
Acts,
chapter
1056,
section
16
.
25
c.
The
requirement
of
section
123.17,
subsection
5
,
is
met
26
by
the
appropriations
and
allocations
made
in
this
division
of
27
this
Act
for
purposes
of
substance-related
disorder
treatment
28
and
addictive
disorders
for
the
fiscal
year
beginning
July
1,
29
2021.
30
2.
HEALTHY
CHILDREN
AND
FAMILIES
31
For
promoting
the
optimum
health
status
for
children
and
32
adolescents
from
birth
through
21
years
of
age,
and
families,
33
and
for
not
more
than
the
following
full-time
equivalent
34
positions:
35
-5-
HF
891
(3)
89
pf/rn/md
5/
74
H.F.
891
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$
5,816,681
1
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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
mental
health
institute
at
Cherokee
or
the
23
state
mental
health
institute
at
Independence
may
be
retained
24
and
expended
by
the
mental
health
institute.
25
3.
Notwithstanding
any
provision
of
law
to
the
contrary,
26
a
Medicaid
member
residing
at
the
state
mental
health
27
institute
at
Cherokee
or
the
state
mental
health
institute
28
at
Independence
shall
retain
Medicaid
eligibility
during
29
the
period
of
the
Medicaid
member’s
stay
for
which
federal
30
financial
participation
is
available.
31
4.
Notwithstanding
section
8.33
,
moneys
appropriated
in
32
this
section
that
remain
unencumbered
or
unobligated
at
the
33
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
34
available
for
expenditure
for
the
purposes
designated
until
the
35
-48-
HF
891
(3)
89
pf/rn/md
48/
74
H.F.
891
close
of
the
succeeding
fiscal
year.
1
Sec.
25.
STATE
RESOURCE
CENTERS.
2
1.
There
is
appropriated
from
the
general
fund
of
the
3
state
to
the
department
of
human
services
for
the
fiscal
year
4
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
5
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
6
purposes
designated:
7
a.
For
the
state
resource
center
at
Glenwood
for
salaries,
8
support,
maintenance,
and
miscellaneous
purposes:
9
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,802,873
10
b.
For
the
state
resource
center
at
Woodward
for
salaries,
11
support,
maintenance,
and
miscellaneous
purposes:
12
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,237,937
13
2.
The
department
may
continue
to
bill
for
state
resource
14
center
services
utilizing
a
scope
of
services
approach
used
for
15
private
providers
of
intermediate
care
facilities
for
persons
16
with
an
intellectual
disability
services,
in
a
manner
which
17
does
not
shift
costs
between
the
medical
assistance
program,
18
counties,
or
other
sources
of
funding
for
the
state
resource
19
centers.
20
3.
The
state
resource
centers
may
expand
the
time-limited
21
assessment
and
respite
services
during
the
fiscal
year.
22
4.
If
the
department’s
administration
and
the
department
23
of
management
concur
with
a
finding
by
a
state
resource
24
center’s
superintendent
that
projected
revenues
can
reasonably
25
be
expected
to
pay
the
salary
and
support
costs
for
a
new
26
employee
position,
or
that
such
costs
for
adding
a
particular
27
number
of
new
positions
for
the
fiscal
year
would
be
less
28
than
the
overtime
costs
if
new
positions
would
not
be
added,
29
the
superintendent
may
add
the
new
position
or
positions.
If
30
the
vacant
positions
available
to
a
resource
center
do
not
31
include
the
position
classification
desired
to
be
filled,
the
32
state
resource
center’s
superintendent
may
reclassify
any
33
vacant
position
as
necessary
to
fill
the
desired
position.
The
34
superintendents
of
the
state
resource
centers
may,
by
mutual
35
-49-
HF
891
(3)
89
pf/rn/md
49/
74
H.F.
891
agreement,
pool
vacant
positions
and
position
classifications
1
during
the
course
of
the
fiscal
year
in
order
to
assist
one
2
another
in
filling
necessary
positions.
3
5.
If
existing
capacity
limitations
are
reached
in
4
operating
units,
a
waiting
list
is
in
effect
for
a
service
or
5
a
special
need
for
which
a
payment
source
or
other
funding
6
is
available
for
the
service
or
to
address
the
special
need,
7
and
facilities
for
the
service
or
to
address
the
special
need
8
can
be
provided
within
the
available
payment
source
or
other
9
funding,
the
superintendent
of
a
state
resource
center
may
10
authorize
opening
not
more
than
two
units
or
other
facilities
11
and
begin
implementing
the
service
or
addressing
the
special
12
need
during
fiscal
year
2021-2022.
13
6.
Notwithstanding
section
8.33
,
and
notwithstanding
14
the
amount
limitation
specified
in
section
222.92
,
moneys
15
appropriated
in
this
section
that
remain
unencumbered
or
16
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
17
but
shall
remain
available
for
expenditure
for
the
purposes
18
designated
until
the
close
of
the
succeeding
fiscal
year.
19
Sec.
26.
SEXUALLY
VIOLENT
PREDATORS.
20
1.
There
is
appropriated
from
the
general
fund
of
the
21
state
to
the
department
of
human
services
for
the
fiscal
year
22
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
23
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
24
purpose
designated:
25
For
costs
associated
with
the
commitment
and
treatment
of
26
sexually
violent
predators
in
the
unit
located
at
the
state
27
mental
health
institute
at
Cherokee,
including
costs
of
legal
28
services
and
other
associated
costs,
including
salaries,
29
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
30
more
than
the
following
full-time
equivalent
positions:
31
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
13,643,727
32
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
139.00
33
2.
Unless
specifically
prohibited
by
law,
if
the
amount
34
charged
provides
for
recoupment
of
at
least
the
entire
amount
35
-50-
HF
891
(3)
89
pf/rn/md
50/
74
H.F.
891
of
direct
and
indirect
costs,
the
department
of
human
services
1
may
contract
with
other
states
to
provide
care
and
treatment
2
of
persons
placed
by
the
other
states
at
the
unit
for
sexually
3
violent
predators
at
Cherokee.
The
moneys
received
under
4
such
a
contract
shall
be
considered
to
be
repayment
receipts
5
and
used
for
the
purposes
of
the
appropriation
made
in
this
6
section.
7
3.
Notwithstanding
section
8.33
,
moneys
appropriated
in
8
this
section
that
remain
unencumbered
or
unobligated
at
the
9
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
10
available
for
expenditure
for
the
purposes
designated
until
the
11
close
of
the
succeeding
fiscal
year.
12
Sec.
27.
FIELD
OPERATIONS.
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
purposes
designated:
18
For
field
operations,
including
salaries,
support,
19
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
20
the
following
full-time
equivalent
positions:
21
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
60,596,667
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
1,539.00
23
2.
Priority
in
filling
full-time
equivalent
positions
24
shall
be
given
to
those
positions
related
to
child
protection
25
services
and
eligibility
determination
for
low-income
families.
26
Sec.
28.
GENERAL
ADMINISTRATION.
There
is
appropriated
27
from
the
general
fund
of
the
state
to
the
department
of
human
28
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
29
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
30
necessary,
to
be
used
for
the
purpose
designated:
31
For
general
administration,
including
salaries,
support,
32
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
33
the
following
full-time
equivalent
positions:
34
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
15,342,189
35
-51-
HF
891
(3)
89
pf/rn/md
51/
74
H.F.
891
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
294.00
1
1.
The
department
shall
report
at
least
monthly
to
the
2
general
assembly
concerning
the
department’s
operational
and
3
program
expenditures.
4
2.
Of
the
funds
appropriated
in
this
section,
$150,000
shall
5
be
used
for
the
provision
of
a
program
to
provide
technical
6
assistance,
support,
and
consultation
to
providers
of
home
and
7
community-based
services
under
the
medical
assistance
program.
8
3.
Of
the
funds
appropriated
in
this
section,
$50,000
9
is
transferred
to
the
Iowa
finance
authority
to
be
used
10
for
administrative
support
of
the
council
on
homelessness
11
established
in
section
16.2D
and
for
the
council
to
fulfill
its
12
duties
in
addressing
and
reducing
homelessness
in
the
state.
13
4.
Of
the
funds
appropriated
in
this
section,
$200,000
shall
14
be
transferred
to
and
deposited
in
the
administrative
fund
of
15
the
Iowa
ABLE
savings
plan
trust
created
in
section
12I.4
,
to
16
be
used
for
implementation
and
administration
activities
of
the
17
Iowa
ABLE
savings
plan
trust.
18
5.
Of
the
funds
appropriated
in
this
section,
$200,000
is
19
transferred
to
the
economic
development
authority
for
the
Iowa
20
commission
on
volunteer
services
to
continue
to
be
used
for
the
21
RefugeeRISE
AmeriCorps
program
established
under
section
15H.8
22
for
member
recruitment
and
training
to
improve
the
economic
23
well-being
and
health
of
economically
disadvantaged
refugees
in
24
local
communities
across
Iowa.
Funds
transferred
may
be
used
25
to
supplement
federal
funds
under
federal
regulations.
26
6.
Of
the
funds
appropriated
in
this
section,
up
to
$300,000
27
shall
be
used
as
follows:
28
a.
To
fund
not
more
than
one
full-time
equivalent
position
29
to
address
the
department’s
responsibility
to
support
the
work
30
of
the
children’s
behavioral
health
system
state
board
and
31
implementation
of
the
services
required
pursuant
to
section
32
331.397.
33
b.
To
support
the
cost
of
establishing
and
implementing
new
34
or
additional
services
required
pursuant
to
sections
331.397
35
-52-
HF
891
(3)
89
pf/rn/md
52/
74
H.F.
891
and
331.397A.
1
c.
Of
the
amount
allocated,
$32,000
shall
be
transferred
2
to
the
department
of
public
health
to
support
the
costs
of
3
establishing
and
implementing
new
or
additional
services
4
required
pursuant
to
sections
331.397
and
331.397A.
5
7.
Of
the
funds
appropriated
in
this
section,
$800,000
shall
6
be
used
for
the
renovation
and
construction
of
certain
nursing
7
facilities,
consistent
with
the
provisions
of
chapter
249K.
8
Sec.
29.
DEPARTMENT-WIDE
DUTIES.
There
is
appropriated
9
from
the
general
fund
of
the
state
to
the
department
of
human
10
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
11
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
12
necessary,
to
be
used
for
the
purposes
designated:
13
For
salaries,
support,
maintenance,
and
miscellaneous
14
purposes
at
facilities
under
the
purview
of
the
department
of
15
human
services:
16
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,879,274
17
Sec.
30.
VOLUNTEERS.
There
is
appropriated
from
the
general
18
fund
of
the
state
to
the
department
of
human
services
for
the
19
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
20
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
21
used
for
the
purpose
designated:
22
For
development
and
coordination
of
volunteer
services:
23
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
84,686
24
Sec.
31.
MEDICAL
ASSISTANCE,
STATE
SUPPLEMENTARY
25
ASSISTANCE,
AND
SOCIAL
SERVICE
PROVIDERS
REIMBURSED
UNDER
THE
26
DEPARTMENT
OF
HUMAN
SERVICES.
27
1.
a.
(1)
(a)
Notwithstanding
any
provision
of
law
to
28
the
contrary,
for
the
fiscal
year
beginning
July
1,
2021,
the
29
department
shall
not
rebase
case-mix
nursing
facility
rates,
30
but
shall
instead
reimburse
case-mix
nursing
facilities
by
31
adjusting
the
nursing
facility
case-mix
adjusted
rates
that
32
were
effective
July
1,
2019,
using
the
mid-points
of
each
of
33
the
most
recent
cost
reports
submitted
by
the
nursing
facility
34
for
the
period
ending
on
or
before
December
31,
2018,
and
35
-53-
HF
891
(3)
89
pf/rn/md
53/
74
H.F.
891
inflating
these
costs
forward
applying
the
inflation
factor
as
1
determined
using
the
latest
available
quarterly
publication
of
2
the
HCFA/SNF
index,
to
the
extent
possible
within
the
state
3
funding,
including
the
$19,080,860
provided
for
this
purpose.
4
(b)
For
the
fiscal
year
beginning
July
1,
2021,
non-case-mix
5
and
special
population
nursing
facilities
shall
be
reimbursed
6
in
accordance
with
the
methodology
in
effect
on
June
30
of
the
7
prior
fiscal
year.
8
(c)
For
managed
care
claims,
the
department
of
human
9
services
shall
adjust
the
payment
rate
floor
for
nursing
10
facilities,
annually,
to
maintain
a
rate
floor
that
is
no
11
lower
than
the
Medicaid
fee-for-service
case-mix
adjusted
rate
12
calculated
in
accordance
with
subparagraph
division
(a)
and
13
441
IAC
81.6.
The
department
shall
then
calculate
adjusted
14
reimbursement
rates,
including
but
not
limited
to
add-on
15
payments,
annually,
and
shall
notify
Medicaid
managed
care
16
organizations
of
the
adjusted
reimbursement
rates
within
30
17
days
of
determining
the
adjusted
reimbursement
rates.
Any
18
adjustment
of
reimbursement
rates
under
this
subparagraph
19
division
shall
be
budget
neutral
to
the
state
budget.
20
(d)
For
the
fiscal
year
beginning
July
1,
2021,
Medicaid
21
managed
care
long-term
services
and
supports
capitation
rates
22
shall
be
adjusted
to
reflect
the
case-mix
adjusted
rates
23
specified
pursuant
to
subparagraph
division
(a)
for
the
patient
24
populations
residing
in
Medicaid-certified
nursing
facilities.
25
(2)
Medicaid
managed
care
organizations
shall
adjust
26
facility-specific
rates
based
upon
payment
rate
listings
issued
27
by
the
department.
The
rate
adjustments
shall
be
applied
28
prospectively
from
the
effective
date
of
the
rate
letter
issued
29
by
the
department.
30
b.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
31
contingent
upon
implementation
of
the
contractual
agreements
32
with
Medicaid
managed
care
organizations
as
described
pursuant
33
to
subparagraph
(2),
the
department
shall
establish
the
34
fee-for-service
pharmacy
dispensing
fee
reimbursement
at
35
-54-
HF
891
(3)
89
pf/rn/md
54/
74
H.F.
891
$10.38
per
prescription,
until
a
cost
of
dispensing
survey
is
1
completed.
The
actual
dispensing
fee
shall
be
determined
by
2
a
cost
of
dispensing
survey
performed
by
the
department
and
3
required
to
be
completed
by
all
medical
assistance
program
4
participating
pharmacies
every
two
years.
A
change
in
the
5
dispensing
fee
shall
become
effective
following
federal
6
approval
of
the
Medicaid
state
plan.
7
(2)
The
department
shall
amend
Medicaid
managed
care
8
organization
contracts
to
authorize
establishment
of
a
managed
9
care
pharmacy
dispensing
fee
reimbursement
in
accordance
with
10
either
of
the
following:
11
(a)
The
established
fee-for-service
pharmacy
dispensing
12
fee
reimbursement
per
prescription
as
specified
pursuant
to
13
subparagraph
(1).
14
(b)
A
dispensing
fee
determined
contractually
by
mutual
15
agreement
between
the
managed
care
organization
and
a
16
participating
pharmacy
with
more
than
thirty
locations
in
17
the
state
and
headquarters
located
outside
the
state,
not
to
18
exceed
the
established
fee-for-service
pharmacy
dispensing
19
fee
reimbursement
per
prescription
as
specified
pursuant
to
20
subparagraph
(1).
21
(3)
The
department
shall
utilize
an
average
acquisition
22
cost
reimbursement
methodology
for
all
drugs
covered
under
the
23
medical
assistance
program
in
accordance
with
2012
Iowa
Acts,
24
chapter
1133,
section
33.
25
c.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
26
reimbursement
rates
for
outpatient
hospital
services
shall
27
remain
at
the
rates
in
effect
on
June
30,
2021,
subject
to
28
Medicaid
program
upper
payment
limit
rules,
and
adjusted
29
as
necessary
to
maintain
expenditures
within
the
amount
30
appropriated
to
the
department
for
this
purpose
for
the
fiscal
31
year.
32
(2)
For
the
fiscal
year
beginning
July
1,
2021,
33
reimbursement
rates
for
inpatient
hospital
services
shall
34
be
rebased
effective
October
1,
2021,
subject
to
Medicaid
35
-55-
HF
891
(3)
89
pf/rn/md
55/
74
H.F.
891
program
upper
payment
limit
rules,
and
adjusted
as
necessary
1
to
maintain
expenditures
within
the
amount
appropriated
to
the
2
department
for
this
purpose
for
the
fiscal
year.
3
(3)
For
the
fiscal
year
beginning
July
1,
2021,
under
4
both
fee-for-service
and
managed
care
administration
of
5
the
Medicaid
program,
critical
access
hospitals
shall
be
6
reimbursed
for
inpatient
and
outpatient
services
based
on
the
7
hospital-specific
critical
access
hospital
cost
adjustment
8
factor
methodology
utilizing
the
most
recent
and
complete
cost
9
reporting
period
as
applied
prospectively
within
the
funds
10
appropriated
for
such
purpose
for
the
fiscal
year.
11
(4)
For
the
fiscal
year
beginning
July
1,
2021,
the
graduate
12
medical
education
and
disproportionate
share
hospital
fund
13
shall
remain
at
the
amount
in
effect
on
June
30,
2021,
except
14
that
the
portion
of
the
fund
attributable
to
graduate
medical
15
education
shall
be
reduced
in
an
amount
that
reflects
the
16
elimination
of
graduate
medical
education
payments
made
to
17
out-of-state
hospitals.
18
(5)
In
order
to
ensure
the
efficient
use
of
limited
state
19
funds
in
procuring
health
care
services
for
low-income
Iowans,
20
funds
appropriated
in
this
Act
for
hospital
services
shall
21
not
be
used
for
activities
which
would
be
excluded
from
a
22
determination
of
reasonable
costs
under
the
federal
Medicare
23
program
pursuant
to
42
U.S.C.
§1395x(v)(1)(N).
24
d.
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
25
rates
for
hospices
and
acute
psychiatric
hospitals
shall
be
26
increased
in
accordance
with
increases
under
the
federal
27
Medicare
program
or
as
supported
by
their
Medicare
audited
28
costs.
29
e.
For
the
fiscal
year
beginning
July
1,
2021,
independent
30
laboratories
and
rehabilitation
agencies
shall
be
reimbursed
31
using
the
same
methodology
in
effect
on
June
30,
2021.
32
f.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
33
reimbursement
rates
for
home
health
agencies
shall
continue
to
34
be
based
on
the
Medicare
low
utilization
payment
adjustment
35
-56-
HF
891
(3)
89
pf/rn/md
56/
74
H.F.
891
(LUPA)
methodology
with
state
geographic
wage
adjustments
and
1
shall
be
adjusted
to
increase
the
rates
to
the
extent
possible
2
within
the
state
funding,
including
the
$2,000,000
appropriated
3
for
this
purpose.
The
department
shall
continue
to
update
the
4
rates
every
two
years
to
reflect
the
most
recent
Medicare
LUPA
5
rates.
6
(2)
For
the
fiscal
year
beginning
July
1,
2021,
rates
for
7
private
duty
nursing
and
personal
care
services
under
the
early
8
and
periodic
screening,
diagnostic,
and
treatment
program
9
benefit
shall
be
calculated
based
on
the
methodology
in
effect
10
on
June
30,
2021.
11
g.
For
the
fiscal
year
beginning
July
1,
2021,
federally
12
qualified
health
centers
and
rural
health
clinics
shall
receive
13
cost-based
reimbursement
for
100
percent
of
the
reasonable
14
costs
for
the
provision
of
services
to
recipients
of
medical
15
assistance.
16
h.
For
the
fiscal
year
beginning
July
1,
2021,
the
17
reimbursement
rates
for
dental
services
shall
remain
at
the
18
rates
in
effect
on
June
30,
2021.
19
i.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
20
reimbursement
rates
for
non-state-owned
psychiatric
medical
21
institutions
for
children
shall
be
increased
to
the
extent
22
possible
within
the
$3,900,000
appropriated
for
this
purpose.
23
(2)
As
a
condition
of
participation
in
the
medical
24
assistance
program,
enrolled
providers
shall
accept
the
medical
25
assistance
reimbursement
rate
for
any
covered
goods
or
services
26
provided
to
recipients
of
medical
assistance
who
are
children
27
under
the
custody
of
a
psychiatric
medical
institution
for
28
children.
29
j.
For
the
fiscal
year
beginning
July
1,
2021,
unless
30
otherwise
specified
in
this
Act,
all
noninstitutional
medical
31
assistance
provider
reimbursement
rates
shall
remain
at
the
32
rates
in
effect
on
June
30,
2021,
except
for
area
education
33
agencies,
local
education
agencies,
infant
and
toddler
34
services
providers,
home
and
community-based
services
providers
35
-57-
HF
891
(3)
89
pf/rn/md
57/
74
H.F.
891
including
consumer-directed
attendant
care
providers
under
a
1
section
1915(c)
or
1915(i)
waiver,
targeted
case
management
2
providers,
and
those
providers
whose
rates
are
required
to
be
3
determined
pursuant
to
section
249A.20
,
or
to
meet
federal
4
mental
health
parity
requirements.
5
k.
Notwithstanding
any
provision
to
the
contrary,
for
the
6
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rate
for
7
anesthesiologists
shall
remain
at
the
rates
in
effect
on
June
8
30,
2021,
and
updated
on
January
1,
2022,
to
align
with
the
9
most
current
Iowa
Medicare
anesthesia
rate.
10
l.
Notwithstanding
section
249A.20
,
for
the
fiscal
year
11
beginning
July
1,
2021,
the
average
reimbursement
rate
for
12
health
care
providers
eligible
for
use
of
the
federal
Medicare
13
resource-based
relative
value
scale
reimbursement
methodology
14
under
section
249A.20
shall
remain
at
the
rate
in
effect
on
15
June
30,
2021;
however,
this
rate
shall
not
exceed
the
maximum
16
level
authorized
by
the
federal
government.
17
m.
For
the
fiscal
year
beginning
July
1,
2021,
the
18
reimbursement
rate
for
residential
care
facilities
shall
not
19
be
less
than
the
minimum
payment
level
as
established
by
the
20
federal
government
to
meet
the
federally
mandated
maintenance
21
of
effort
requirement.
The
flat
reimbursement
rate
for
22
facilities
electing
not
to
file
annual
cost
reports
shall
not
23
be
less
than
the
minimum
payment
level
as
established
by
the
24
federal
government
to
meet
the
federally
mandated
maintenance
25
of
effort
requirement.
26
n.
For
the
fiscal
year
beginning
July
1,
2021,
the
27
reimbursement
rates
for
inpatient
mental
health
services
28
provided
at
hospitals
shall
be
rebased
effective
October
1,
29
2021,
subject
to
Medicaid
program
upper
payment
limit
rules
30
and
adjusted
as
necessary
to
maintain
expenditures
within
the
31
amount
appropriated
to
the
department
for
this
purpose
for
32
the
fiscal
year;
and
psychiatrists
shall
be
reimbursed
at
the
33
medical
assistance
program
fee-for-service
rate
in
effect
on
34
June
30,
2021.
35
-58-
HF
891
(3)
89
pf/rn/md
58/
74
H.F.
891
o.
For
the
fiscal
year
beginning
July
1,
2021,
community
1
mental
health
centers
may
choose
to
be
reimbursed
for
the
2
services
provided
to
recipients
of
medical
assistance
through
3
either
of
the
following
options:
4
(1)
For
100
percent
of
the
reasonable
costs
of
the
services.
5
(2)
In
accordance
with
the
alternative
reimbursement
rate
6
methodology
approved
by
the
department
of
human
services
in
7
effect
on
June
30,
2021.
8
p.
For
the
fiscal
year
beginning
July
1,
2021,
the
9
reimbursement
rate
for
providers
of
family
planning
services
10
that
are
eligible
to
receive
a
90
percent
federal
match
shall
11
remain
at
the
rates
in
effect
on
June
30,
2021.
12
q.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
13
reimbursement
rates
for
providers
of
home
and
community-based
14
services
waiver
and
habilitation
services
shall
be
increased
15
to
the
extent
possible
within
the
$11,002,240
appropriated
for
16
this
purpose.
17
(2)
For
the
fiscal
year
beginning
July
1,
2021,
18
reimbursement
rates
for
providers
of
state
plan
home
and
19
community-based
services
home-based
habilitation
services
20
shall
be
increased
with
the
$7,134,214
appropriated
for
this
21
purpose.
The
reimbursement
rates
for
home-based
habilitation
22
services
shall
be
based
on
a
fee
schedule
that
incorporates
the
23
acuity-based
tiers.
24
r.
For
the
fiscal
year
beginning
July
1,
2021,
the
25
reimbursement
rates
for
emergency
medical
service
providers
26
shall
remain
at
the
rates
in
effect
on
June
30,
2021,
or
as
27
approved
by
the
centers
for
Medicare
and
Medicaid
services
of
28
the
United
States
department
of
health
and
human
services.
29
s.
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
30
rates
for
substance-related
disorder
treatment
programs
31
licensed
under
section
125.13
shall
remain
at
the
rates
in
32
effect
on
June
30,
2021.
33
t.
For
the
fiscal
year
beginning
July
1,
2021,
assertive
34
community
treatment
per
diem
rates
shall
remain
at
the
rates
in
35
-59-
HF
891
(3)
89
pf/rn/md
59/
74
H.F.
891
effect
on
June
30,
2021.
1
u.
For
the
fiscal
year
beginning
July
1,
2021,
the
2
reimbursement
rate
for
family-centered
services
providers
shall
3
be
established
by
contract.
4
v.
For
the
fiscal
year
beginning
July
1,
2021,
the
5
reimbursement
rate
for
air
ambulance
services
shall
be
6
increased
to
the
extent
possible
within
the
additional
$100,000
7
appropriated
for
this
purpose.
8
2.
For
the
fiscal
year
beginning
July
1,
2021,
the
9
reimbursement
rate
for
providers
reimbursed
under
the
10
in-home-related
care
program
shall
not
be
less
than
the
minimum
11
payment
level
as
established
by
the
federal
government
to
meet
12
the
federally
mandated
maintenance
of
effort
requirement.
13
3.
Unless
otherwise
directed
in
this
section,
when
the
14
department’s
reimbursement
methodology
for
any
provider
15
reimbursed
in
accordance
with
this
section
includes
an
16
inflation
factor,
this
factor
shall
not
exceed
the
amount
17
by
which
the
consumer
price
index
for
all
urban
consumers
18
increased
during
the
calendar
year
ending
December
31,
2002.
19
4.
Notwithstanding
section
234.38
,
for
the
fiscal
20
year
beginning
July
1,
2021,
the
foster
family
basic
daily
21
maintenance
rate
and
the
maximum
adoption
subsidy
rate
for
22
children
ages
0
through
5
years
shall
be
$16.78,
the
rate
for
23
children
ages
6
through
11
years
shall
be
$17.45,
the
rate
for
24
children
ages
12
through
15
years
shall
be
$19.10,
and
the
25
rate
for
children
and
young
adults
ages
16
and
older
shall
26
be
$19.35.
For
youth
ages
18
to
23
who
have
exited
foster
27
care,
the
preparation
for
adult
living
program
maintenance
28
rate
shall
be
up
to
$602.70
per
month
as
calculated
based
on
29
the
age
of
the
participant.
The
maximum
payment
for
adoption
30
subsidy
nonrecurring
expenses
shall
be
limited
to
$500
and
the
31
disallowance
of
additional
amounts
for
court
costs
and
other
32
related
legal
expenses
implemented
pursuant
to
2010
Iowa
Acts,
33
chapter
1031,
section
408
,
shall
be
continued.
34
5.
For
the
fiscal
year
beginning
July
1,
2021,
the
maximum
35
-60-
HF
891
(3)
89
pf/rn/md
60/
74
H.F.
891
reimbursement
rates
for
social
services
providers
under
1
contract
shall
remain
at
the
rates
in
effect
on
June
30,
2021,
2
or
the
provider’s
actual
and
allowable
cost
plus
inflation
for
3
each
service,
whichever
is
less.
However,
if
a
new
service
4
or
service
provider
is
added
after
June
30,
2021,
the
initial
5
reimbursement
rate
for
the
service
or
provider
shall
be
based
6
upon
a
weighted
average
of
provider
rates
for
similar
services.
7
6.
a.
For
the
fiscal
year
beginning
July
1,
2021,
the
8
reimbursement
rates
for
resource
family
recruitment
and
9
retention
contractors
shall
be
established
by
contract.
10
b.
For
the
fiscal
year
beginning
July
1,
2021,
the
11
reimbursement
rates
for
supervised
apartment
living
foster
care
12
providers
shall
be
established
by
contract.
13
7.
For
the
fiscal
year
beginning
July
1,
2021,
the
14
reimbursement
rate
for
group
foster
care
providers
shall
be
the
15
combined
service
and
maintenance
reimbursement
rate
established
16
by
contract.
17
8.
The
group
foster
care
reimbursement
rates
paid
for
18
placement
of
children
out
of
state
shall
be
calculated
19
according
to
the
same
rate-setting
principles
as
those
used
for
20
in-state
providers,
unless
the
director
of
human
services
or
21
the
director’s
designee
determines
that
appropriate
care
cannot
22
be
provided
within
the
state.
The
payment
of
the
daily
rate
23
shall
be
based
on
the
number
of
days
in
the
calendar
month
in
24
which
service
is
provided.
25
9.
a.
For
the
fiscal
year
beginning
July
1,
2021,
the
26
reimbursement
rate
paid
for
shelter
care
and
the
child
welfare
27
emergency
services
implemented
to
provide
or
prevent
the
need
28
for
shelter
care
shall
be
established
by
contract.
29
b.
For
the
fiscal
year
beginning
July
1,
2021,
the
combined
30
service
and
maintenance
components
of
the
reimbursement
rate
31
paid
for
shelter
care
services
shall
be
based
on
the
financial
32
and
statistical
report
submitted
to
the
department.
The
33
maximum
reimbursement
rate
shall
be
$101.83
per
day.
The
34
department
shall
reimburse
a
shelter
care
provider
at
the
35
-61-
HF
891
(3)
89
pf/rn/md
61/
74
H.F.
891
provider’s
actual
and
allowable
unit
cost,
plus
inflation,
not
1
to
exceed
the
maximum
reimbursement
rate.
2
c.
Notwithstanding
section
232.141,
subsection
8
,
for
the
3
fiscal
year
beginning
July
1,
2021,
the
amount
of
the
statewide
4
average
of
the
actual
and
allowable
rates
for
reimbursement
of
5
juvenile
shelter
care
homes
that
is
utilized
for
the
limitation
6
on
recovery
of
unpaid
costs
shall
remain
at
the
amount
in
7
effect
for
this
purpose
in
the
fiscal
year
beginning
July
1,
8
2020.
9
10.
For
the
fiscal
year
beginning
July
1,
2021,
the
10
department
shall
calculate
reimbursement
rates
for
intermediate
11
care
facilities
for
persons
with
an
intellectual
disability
12
at
the
80th
percentile.
Beginning
July
1,
2021,
the
rate
13
calculation
methodology
shall
utilize
the
consumer
price
index
14
inflation
factor
applicable
to
the
fiscal
year
beginning
July
15
1,
2021.
16
11.
Effective
July
1,
2021,
the
department
of
human
services
17
shall
set
the
reimbursement
rate
of
child
care
providers
whose
18
reimbursement
rates
are
below
the
fiftieth
percentile
of
the
19
most
recent
market
rate
survey
at
the
fiftieth
percentile
of
20
the
most
recent
market
rate
survey.
Reimbursement
rates
of
21
child
care
providers
whose
reimbursement
rates
are
at
or
above
22
the
fiftieth
percentile
of
the
most
recent
market
rate
survey
23
shall
remain
at
the
rates
in
effect
on
June
30,
2021.
The
24
department
shall
also
adjust
quality
rating
system
bonuses
to
25
reflect
increased
child
care
provider
reimbursement
rates
as
26
appropriate.
The
department
shall
set
rates
in
a
manner
so
as
27
to
provide
incentives
for
a
nonregistered
provider
to
become
28
registered
by
applying
any
increase
only
to
registered
and
29
licensed
providers.
30
12.
The
department
may
adopt
emergency
rules
to
implement
31
this
section.
32
Sec.
32.
EMERGENCY
RULES.
33
1.
If
necessary
to
comply
with
federal
requirements
34
including
time
frames,
or
if
specifically
authorized
by
a
35
-62-
HF
891
(3)
89
pf/rn/md
62/
74
H.F.
891
provision
of
this
division
of
this
Act,
the
department
of
1
human
services
or
the
mental
health
and
disability
services
2
commission
may
adopt
administrative
rules
under
section
17A.4,
3
subsection
3,
and
section
17A.5,
subsection
2,
paragraph
“b”,
4
to
implement
the
provisions
of
this
division
of
this
Act
and
5
the
rules
shall
become
effective
immediately
upon
filing
or
6
on
a
later
effective
date
specified
in
the
rules,
unless
the
7
effective
date
of
the
rules
is
delayed
or
the
applicability
8
of
the
rules
is
suspended
by
the
administrative
rules
review
9
committee.
Any
rules
adopted
in
accordance
with
this
section
10
shall
not
take
effect
before
the
rules
are
reviewed
by
the
11
administrative
rules
review
committee.
The
delay
authority
12
provided
to
the
administrative
rules
review
committee
under
13
section
17A.4,
subsection
7,
and
section
17A.8,
subsections
14
9
and
10,
shall
be
applicable
to
a
delay
imposed
under
this
15
section,
notwithstanding
a
provision
in
those
subsections
16
making
them
inapplicable
to
section
17A.5,
subsection
2,
17
paragraph
“b”.
Any
rules
adopted
in
accordance
with
the
18
provisions
of
this
section
shall
also
be
published
as
a
notice
19
of
intended
action
as
provided
in
section
17A.4.
20
2.
If
during
a
fiscal
year,
the
department
of
human
21
services
is
adopting
rules
in
accordance
with
this
section
22
or
as
otherwise
directed
or
authorized
by
state
law,
and
23
the
rules
will
result
in
an
expenditure
increase
beyond
the
24
amount
anticipated
in
the
budget
process
or
if
the
expenditure
25
was
not
addressed
in
the
budget
process
for
the
fiscal
26
year,
the
department
shall
notify
the
general
assembly
and
27
the
department
of
management
concerning
the
rules
and
the
28
expenditure
increase.
The
notification
shall
be
provided
at
29
least
30
calendar
days
prior
to
the
date
notice
of
the
rules
30
is
submitted
to
the
administrative
rules
coordinator
and
the
31
administrative
code
editor.
32
Sec.
33.
REPORTS.
Unless
otherwise
provided,
any
reports
or
33
other
information
required
to
be
compiled
and
submitted
under
34
this
Act
during
the
fiscal
year
beginning
July
1,
2021,
shall
35
-63-
HF
891
(3)
89
pf/rn/md
63/
74
H.F.
891
be
submitted
on
or
before
the
dates
specified
for
submission
1
of
the
reports
or
information.
2
Sec.
34.
EFFECTIVE
UPON
ENACTMENT.
The
following
provision
3
of
this
division
of
this
Act,
being
deemed
of
immediate
4
importance,
takes
effect
upon
enactment:
5
1.
The
provision
relating
to
section
232.141
and
directing
6
the
state
court
administrator
and
the
division
administrator
of
7
the
department
of
human
services
division
of
child
and
family
8
services
to
make
the
determination,
by
June
15,
2021,
of
the
9
distribution
of
funds
allocated
for
the
payment
of
the
expenses
10
of
court-ordered
services
provided
to
juveniles
which
are
a
11
charge
upon
the
state.
12
DIVISION
VI
13
HEALTH
CARE
ACCOUNTS
AND
FUNDS
——
FY
2021-2022
14
Sec.
35.
PHARMACEUTICAL
SETTLEMENT
ACCOUNT.
There
is
15
appropriated
from
the
pharmaceutical
settlement
account
created
16
in
section
249A.33
to
the
department
of
human
services
for
the
17
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
18
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
19
used
for
the
purpose
designated:
20
Notwithstanding
any
provision
of
law
to
the
contrary,
to
21
supplement
the
appropriations
made
in
this
Act
for
health
22
program
operations
under
the
medical
assistance
program
for
the
23
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022:
24
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
234,193
25
Sec.
36.
QUALITY
ASSURANCE
TRUST
FUND
——
DEPARTMENT
OF
HUMAN
26
SERVICES.
Notwithstanding
any
provision
to
the
contrary
and
27
subject
to
the
availability
of
funds,
there
is
appropriated
28
from
the
quality
assurance
trust
fund
created
in
section
29
249L.4
to
the
department
of
human
services
for
the
fiscal
year
30
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
31
amounts,
or
so
much
thereof
as
is
necessary,
for
the
purposes
32
designated:
33
To
supplement
the
appropriation
made
in
this
Act
from
the
34
general
fund
of
the
state
to
the
department
of
human
services
35
-64-
HF
891
(3)
89
pf/rn/md
64/
74
H.F.
891
for
medical
assistance
for
the
same
fiscal
year:
1
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
56,305,139
2
Sec.
37.
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND
——
3
DEPARTMENT
OF
HUMAN
SERVICES.
Notwithstanding
any
provision
to
4
the
contrary
and
subject
to
the
availability
of
funds,
there
is
5
appropriated
from
the
hospital
health
care
access
trust
fund
6
created
in
section
249M.4
to
the
department
of
human
services
7
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
8
30,
2022,
the
following
amounts,
or
so
much
thereof
as
is
9
necessary,
for
the
purposes
designated:
10
To
supplement
the
appropriation
made
in
this
Act
from
the
11
general
fund
of
the
state
to
the
department
of
human
services
12
for
medical
assistance
for
the
same
fiscal
year:
13
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,920,554
14
Sec.
38.
MEDICAL
ASSISTANCE
PROGRAM
——
NONREVERSION
15
FOR
FY
2021-2022.
Notwithstanding
section
8.33
,
if
moneys
16
appropriated
for
purposes
of
the
medical
assistance
program
for
17
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
18
2022,
from
the
general
fund
of
the
state,
the
quality
assurance
19
trust
fund,
and
the
hospital
health
care
access
trust
fund,
are
20
in
excess
of
actual
expenditures
for
the
medical
assistance
21
program
and
remain
unencumbered
or
unobligated
at
the
close
22
of
the
fiscal
year,
the
excess
moneys
shall
not
revert
but
23
shall
remain
available
for
expenditure
for
the
purposes
of
the
24
medical
assistance
program
until
the
close
of
the
succeeding
25
fiscal
year.
26
DIVISION
VII
27
NURSING
FACILITY
REIMBURSEMENT
METHODOLOGY
——
FISCAL
PERIOD
28
JULY
1,
2023,
THROUGH
JUNE
30,
2025
29
Sec.
39.
NURSING
FACILITY
REIMBURSEMENT
METHODOLOGY
——
30
FISCAL
PERIOD
JULY
1,
2023,
THROUGH
JUNE
30,
2025.
31
Notwithstanding
any
provision
of
law
to
the
contrary,
for
the
32
fiscal
period
beginning
July
1,
2023,
and
ending
June
30,
2025,
33
the
department
of
human
services
shall
rebase
case-mix
nursing
34
facility
rates
beginning
July
1,
2023,
using
the
Medicaid
cost
35
-65-
HF
891
(3)
89
pf/rn/md
65/
74
H.F.
891
reports
on
file
for
the
period
ending
December
31,
2022,
and
1
applying
a
minimum
occupancy
factor
of
70
percent.
2
DIVISION
VIII
3
NURSING
FACILITY
REIMBURSEMENT
STUDY
4
Sec.
40.
NURSING
FACILITY
CASE-MIX
REIMBURSEMENT
——
STUDY
5
AND
RECOMMENDATIONS.
The
department
of
human
services
shall
6
convene
a
workgroup
including
representatives
of
nursing
7
facilities,
managed
care
organizations,
and
other
appropriate
8
stakeholders
to
review
the
case-mix
reimbursement
methodology
9
and
process
for
nursing
facilities,
including
but
not
limited
10
to
rebasing,
the
use
of
cost
reports,
and
the
application
11
of
quarterly
case-mix
index
adjustments,
and
shall
submit
12
recommendations
to
the
governor
and
the
general
assembly
by
13
December
1,
2021,
for
improvements
including
those
related
to
14
the
methodology,
the
process,
the
use
of
prospective
payments,
15
and
the
applicable
time
frames
to
increase
efficiencies
16
and
accuracy
in
the
determination
of
reimbursements,
reduce
17
duplication
of
effort,
more
adequately
reflect
the
actual
costs
18
of
care,
address
changes
in
patient
acuity
levels
without
19
reliance
on
retroactive
rate
adjustments,
and
incentivize
20
quality
outcomes.
21
DIVISION
IX
22
MEDICAID-ELIGIBLE
CHILDREN
——
PEDIATRIC
HEALTH
CARE
SERVICES
23
Sec.
41.
MEDICAID-ELIGIBLE
CHILDREN
——
PROVISION
OF
24
PEDIATRIC
HEALTH
CARE
SERVICES
——
REVIEW
AND
REPORT.
The
25
department
of
human
services
shall
review
federal
Medicare
26
and
state
law
and
administrative
rule
restrictions
related
27
to
the
provision
of
physical
therapy,
occupational
therapy,
28
speech-language
pathology,
applied
behavior
analysis,
and
other
29
pediatric
health
care
services
to
Medicaid-eligible
children
30
to
determine
necessary
changes
in
law
and
policy
to
ensure
31
that
these
services
are
provided
consistent
with
the
early
and
32
periodic
screening,
diagnostic,
and
treatment
program.
The
33
department
shall
submit
a
report
including
the
findings
of
the
34
review
and
recommendations
to
the
governor
and
the
general
35
-66-
HF
891
(3)
89
pf/rn/md
66/
74
H.F.
891
assembly
by
October
1,
2021.
1
DIVISION
X
2
DECATEGORIZATION
CARRYOVER
FUNDING
3
Sec.
42.
DECATEGORIZATION
CARRYOVER
FUNDING
FY
2019
——
4
TRANSFER
TO
MEDICAID
PROGRAM.
Notwithstanding
section
232.188,
5
subsection
5,
paragraph
“b”,
any
state-appropriated
moneys
in
6
the
funding
pool
that
remained
unencumbered
or
unobligated
7
at
the
close
of
the
fiscal
year
beginning
July
1,
2018,
and
8
were
deemed
carryover
funding
to
remain
available
for
the
two
9
succeeding
fiscal
years
that
still
remain
unencumbered
or
10
unobligated
at
the
close
of
the
fiscal
year
beginning
July
1,
11
2020,
shall
not
revert
but
shall
be
transferred
to
the
medical
12
assistance
program
for
the
fiscal
year
beginning
July
1,
2021.
13
Sec.
43.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
14
deemed
of
immediate
importance,
takes
effect
upon
enactment.
15
Sec.
44.
RETROACTIVE
APPLICABILITY.
This
division
of
this
16
Act
applies
retroactively
to
July
1,
2020.
17
DIVISION
XI
18
PRIOR
APPROPRIATIONS
AND
OTHER
PROVISIONS
19
COURT-ORDERED
SERVICES
REIMBURSEMENT
BY
MANAGED
CARE
20
ORGANIZATIONS
21
Sec.
45.
2018
Iowa
Acts,
chapter
1165,
section
128,
22
subsection
2,
paragraph
a,
is
amended
to
read
as
follows:
23
a.
If
a
Medicaid
member
is
receiving
court-ordered
services
24
or
treatment
for
a
substance-related
disorder
pursuant
to
25
chapter
125
or
for
a
mental
illness
pursuant
to
chapter
229
,
26
such
services
or
treatment
shall
be
provided
and
reimbursed
27
for
an
initial
period
of
three
days
before
a
managed
care
28
organization
may
apply
medical
necessity
criteria
to
determine
29
the
most
appropriate
services
,
treatment,
or
placement
for
the
30
Medicaid
member.
31
FAMILY
INVESTMENT
PROGRAM
ACCOUNT
32
Sec.
46.
2019
Iowa
Acts,
chapter
85,
section
9,
as
amended
33
by
2020
Iowa
Acts,
chapter
1121,
section
20,
is
amended
by
34
adding
the
following
new
subsection:
35
-67-
HF
891
(3)
89
pf/rn/md
67/
74
H.F.
891
NEW
SUBSECTION
.
8.
Notwithstanding
section
8.33,
moneys
1
appropriated
in
this
section
that
remain
unencumbered
or
2
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
3
but
shall
remain
available
for
expenditure
for
the
purposes
4
designated,
and
may
be
transferred
to
other
appropriations
made
5
in
this
division
of
this
Act
as
necessary
to
carry
out
the
6
initiatives
included
in
the
report
submitted
on
nonreversion
7
of
funds
required
pursuant
to
2020
Iowa
Acts,
chapter
1121,
8
section
43,
until
the
close
of
the
succeeding
fiscal
year.
9
CHILD
AND
FAMILY
SERVICES
10
Sec.
47.
2019
Iowa
Acts,
chapter
85,
section
19,
as
amended
11
by
2020
Iowa
Acts,
chapter
1121,
section
23,
is
amended
by
12
adding
the
following
new
subsection:
13
NEW
SUBSECTION
.
25.
Notwithstanding
section
8.33,
moneys
14
appropriated
in
this
section
that
remain
unencumbered
or
15
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
16
but
shall
remain
available
for
expenditure
for
the
purpose
of
17
the
redesign
of
the
child
welfare
system,
until
the
close
of
18
the
succeeding
fiscal
year.
19
FIELD
OPERATIONS
20
Sec.
48.
2019
Iowa
Acts,
chapter
85,
section
27,
as
amended
21
by
2020
Iowa
Acts,
chapter
1121,
section
25,
is
amended
by
22
adding
the
following
new
subsection:
23
NEW
SUBSECTION
.
5.
Notwithstanding
section
8.33,
moneys
24
appropriated
in
this
section
that
remain
unencumbered
or
25
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
26
but
shall
remain
available
for
expenditure
for
the
purposes
27
designated
until
the
close
of
the
succeeding
fiscal
year.
28
GENERAL
ADMINISTRATION
29
Sec.
49.
2019
Iowa
Acts,
chapter
85,
section
28,
as
amended
30
by
2020
Iowa
Acts,
chapter
1121,
section
26,
is
amended
by
31
adding
the
following
new
subsection:
32
NEW
SUBSECTION
.
8.
Notwithstanding
section
8.33,
moneys
33
appropriated
in
this
section
that
remain
unencumbered
or
34
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
35
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891
but
shall
remain
available
for
expenditure
for
the
purposes
1
designated
until
the
close
of
the
succeeding
fiscal
year.
2
Sec.
50.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
3
deemed
of
immediate
importance,
takes
effect
upon
enactment.
4
DIVISION
XII
5
EXTENSION
OF
FUTURE
REPEAL
——
HOSPITAL
HEALTH
CARE
ACCESS
6
ASSESSMENT
PROGRAM
7
Sec.
51.
Section
249M.5,
Code
2021,
is
amended
to
read
as
8
follows:
9
249M.5
Future
repeal.
10
This
chapter
is
repealed
July
1,
2021
2023
.
11
Sec.
52.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
12
deemed
of
immediate
importance,
takes
effect
upon
enactment.
13
DIVISION
XIII
14
PUBLIC
HEALTH
EMERGENCY
PROVISIONS
COVID-19
REGULATIONS
15
Sec.
53.
COVID-19
FEDERAL
REGULATIONS.
For
the
time
16
period
beginning
on
the
effective
date
of
this
division
of
17
this
Act,
and
ending
June
30,
2022,
notwithstanding
state
18
administrative
rules
to
the
contrary,
to
the
extent
federal
19
regulations
relating
to
the
COVID-19
pandemic
differ
from
state
20
administrative
rules,
including
applicable
federal
waivers,
21
the
federal
regulations
are
controlling
during
the
pendency
of
22
the
federally
declared
state
of
emergency
and
for
such
period
23
of
time
following
the
end
of
the
federally
declared
state
of
24
emergency
applicable
to
the
respective
federal
regulations.
25
DIVISION
XIV
26
FOSTER
HOME
INSURANCE
FUND
27
Sec.
54.
Section
237.13,
subsection
2,
Code
2021,
is
amended
28
to
read
as
follows:
29
2.
The
foster
home
insurance
fund
shall
be
administered
by
30
the
department
of
human
services.
The
fund
shall
consist
of
31
all
moneys
appropriated
by
the
general
assembly
for
deposit
32
in
the
fund.
The
department
shall
use
moneys
in
the
fund
to
33
provide
home
and
property
coverage
for
foster
parents
to
cover
34
damages
to
property
resulting
from
the
actions
of
a
foster
35
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child
residing
in
a
foster
home
or
to
reimburse
foster
parents
1
for
the
cost
of
purchasing
foster
care
liability
insurance
and
2
to
perform
the
administrative
functions
necessary
to
carry
out
3
this
section
.
The
department
may
establish
limitations
of
4
liability
for
individual
claims
as
deemed
reasonable
by
the
5
department.
6
DIVISION
XV
7
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
TRANSFER
OF
FUNDS
8
Sec.
55.
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
TRANSFER
9
OF
FUNDS.
Notwithstanding
section
331.432,
a
county
with
a
10
population
of
over
300,000
based
on
the
2010
federal
decennial
11
census
may
transfer
funds
from
any
other
fund
of
the
county
to
12
the
mental
health
and
disability
regional
services
fund
for
the
13
purposes
of
providing
mental
health
and
disability
services
for
14
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
15
2022.
The
county
shall
submit
a
report
to
the
governor
and
the
16
general
assembly
by
September
1,
2022,
including
the
source
of
17
any
funds
transferred,
the
amount
of
the
funds
transferred,
and
18
the
mental
health
and
disability
services
provided
with
the
19
transferred
funds.
The
county
shall
work
with
the
department
20
to
maximize
the
use
of
the
medical
assistance
program
and
other
21
third-party
payment
sources,
including
but
not
limited
to
22
identifying
individuals
enrolled
with
or
eligible
for
Medicaid
23
whose
Medicaid-covered
services
are
being
paid
by
the
county
or
24
could
be
converted
to
Medicaid-covered
services.
25
DIVISION
XVI
26
IN-PERSON
SUPERVISION
REQUIREMENTS
FOR
LICENSURE
——
CERTAIN
27
PROFESSIONALS
28
Sec.
56.
Section
154C.3,
subsection
1,
paragraph
c,
29
subparagraph
(5),
subparagraph
division
(a),
Code
2021,
is
30
amended
by
adding
the
following
new
subparagraph
subdivision:
31
NEW
SUBPARAGRAPH
SUBDIVISION
.
(0ii)
By
a
person
licensed
32
under
section
154D.2
to
practice
marital
and
family
therapy
33
without
supervision
or
mental
health
counseling
without
34
supervision.
35
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(3)
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74
H.F.
891
Sec.
57.
Section
154C.3,
Code
2021,
is
amended
by
adding
the
1
following
new
subsection:
2
NEW
SUBSECTION
.
4.
Supervision.
The
board
shall
not,
by
3
rule
or
other
means,
require
that
supervision
be
completed
in
4
person
as
a
condition
for
an
applicant
to
receive
a
license,
a
5
reciprocal
license,
or
a
renewed
license
under
this
chapter.
6
Sec.
58.
Section
154D.2,
Code
2021,
is
amended
to
read
as
7
follows:
8
154D.2
Licensure
——
marital
and
family
therapy
——
mental
9
health
counseling.
10
1.
An
applicant
for
a
license
to
practice
marital
and
family
11
therapy
or
mental
health
counseling
shall
be
granted
a
license
12
by
the
board
when
the
applicant
satisfies
all
of
the
following
13
requirements:
14
1.
a.
Possesses
a
master’s
degree
in
marital
and
family
15
therapy
or
mental
health
counseling,
as
applicable,
consisting
16
of
at
least
sixty
semester
hours,
or
its
equivalent,
from
a
17
nationally
accredited
institution
or
from
a
program
approved
18
by
the
board.
19
2.
b.
Has
at
least
two
years
of
supervised
clinical
20
experience
or
its
equivalent
as
approved
by
the
board.
21
Standards
for
supervision,
including
the
required
22
qualifications
for
supervisors,
shall
be
determined
in
23
accordance
with
subsection
2
and
by
the
board
by
rule
,
provided
24
that
a
supervisor
may
be
a
person
licensed
under
this
section
25
to
practice
marital
and
family
therapy
or
mental
health
26
counseling
without
supervision
or
a
licensed
independent
social
27
worker
licensed
under
chapter
154C
.
28
3.
c.
Passes
an
examination
approved
by
the
board.
29
2.
The
board
shall
not,
by
rule
or
other
means,
require
any
30
in-person
supervised
clinical
experience.
31
Sec.
59.
Section
154D.4,
subsection
2,
paragraph
b,
Code
32
2021,
is
amended
to
read
as
follows:
33
b.
A
person
who
practices
marital
and
family
therapy
or
34
mental
health
counseling
under
the
supervision
of
a
person
35
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891
licensed
under
this
chapter
as
part
of
a
clinical
experience
as
1
described
in
section
154D.2,
subsection
2
1,
paragraph
“b”
.
2
Sec.
60.
BOARD
OF
SOCIAL
WORK
AND
BOARD
OF
BEHAVIORAL
3
SCIENCE
——
RULES.
The
board
of
social
work
and
the
board
4
of
behavioral
science
shall
amend
their
administrative
5
rules
pursuant
to
chapter
17A
to
remove
any
requirement
for
6
supervised
clinical
experience
and
supervised
professional
7
practice
to
be
completed
in
person
as
a
condition
for
the
8
licensure
of
marital
and
family
therapists,
mental
health
9
counselors,
and
social
workers
pursuant
to
chapters
154C
and
10
154D.
The
board
of
social
work
and
the
board
of
behavioral
11
science
shall
replace
all
licensing
requirements
for
in-person
12
supervision
with
the
ability
to
have
supervision
requirements
13
completed
electronically.
14
Sec.
61.
EMERGENCY
RULES.
15
1.
The
board
of
social
work
and
the
board
of
behavioral
16
science
shall
adopt
emergency
rules
under
section
17A.4,
17
subsection
3,
and
section
17A.5,
subsection
2,
to
implement
18
the
sections
of
this
division
of
this
Act
amending
section
19
154C.3
and
section
154D.2,
and
the
rules
shall
be
effective
20
immediately
upon
filing
unless
a
later
date
is
specified
in
the
21
rules.
Any
emergency
rules
adopted
in
accordance
with
this
22
section
shall
also
be
published
as
a
notice
of
intended
action
23
as
provided
in
section
17A.4,
subsection
1.
24
2.
The
board
of
social
work
and
the
board
of
behavioral
25
science
shall
jointly
develop
rules
adopted
pursuant
to
this
26
subsection
through
a
collaborative
process.
The
respective
27
boards
may
establish
subcommittees
or
designate
other
personnel
28
to
facilitate
such
a
process.
Such
rules
shall
consist
of
29
substantively
identical
standards
applicable
to
the
professions
30
regulated
by
the
respective
boards
and
shall,
to
the
greatest
31
extent
possible,
consist
of
substantially
similar
language
32
in
a
substantially
similar
format.
Prior
to
a
vote
to
adopt
33
such
rules
by
either
board,
each
board
shall,
by
a
separate
34
vote,
approve
the
language
to
be
adopted
by
the
other
board.
35
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Neither
board
shall
vote
to
adopt
such
rules
until
the
rules
1
to
be
adopted
by
both
boards
have
been
so
approved.
Such
rules
2
shall
have
the
same
effective
date
and
shall
be
submitted
to
3
the
administrative
rules
coordinator
and
the
administrative
4
code
editor
for
publication
in
the
same
issue
of
the
Iowa
5
administrative
bulletin
pursuant
to
sections
17A.4
and
17A.5.
6
Sec.
62.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
7
deemed
of
immediate
importance,
takes
effect
upon
enactment.
8
DIVISION
XVII
9
MEDICAL
RESIDENCY
LIABILITY
COSTS
10
Sec.
63.
Section
135.176,
subsection
1,
Code
2021,
is
11
amended
by
adding
the
following
new
paragraph:
12
NEW
PARAGRAPH
.
d.
For
the
period
beginning
July
1,
2021,
13
and
ending
June
30,
2026,
the
payment
by
the
sponsor
of
medical
14
residency
program
liability
costs
subject
to
provision
by
the
15
sponsor
of
dollar-for-dollar
matching
funds
used
for
payment
16
of
such
costs.
This
paragraph
shall
not
apply
to
medical
17
residency
programs
to
which
chapter
669
applies.
18
Sec.
64.
Section
135.176,
subsection
2,
paragraphs
e
and
f,
19
Code
2021,
are
amended
to
read
as
follows:
20
e.
The
maximum
award
of
grant
funds
to
a
particular
21
individual
sponsor
per
year.
An
individual
sponsor
that
22
establishes
a
new
or
alternative
campus
accredited
medical
23
residency
training
program
as
defined
in
subsection
1,
24
paragraph
“a”
,
shall
not
receive
more
than
fifty
percent
25
of
the
state
matching
funds
available
each
year
to
support
26
the
program.
An
individual
sponsor
proposing
the
provision
27
of
a
new
residency
position
within
an
existing
accredited
28
medical
residency
or
fellowship
training
program
as
specified
29
in
subsection
1,
paragraph
“b”
,
or
the
funding
of
residency
30
positions
which
are
in
excess
of
the
federal
residency
cap
as
31
defined
in
subsection
1,
paragraph
“c”
,
or
the
funding
of
the
32
payment
by
the
sponsor
of
medical
residency
program
liability
33
costs
subject
to
provision
by
the
sponsor
of
dollar-for-dollar
34
matching
funds
used
for
payment
of
such
costs
as
specified
35
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891
(3)
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pf/rn/md
73/
74
H.F.
891
in
subsection
1,
paragraph
“d”
,
shall
not
receive
more
than
1
twenty-five
percent
of
the
state
matching
funds
available
each
2
year
to
support
the
program.
3
f.
Use
of
the
funds
awarded.
Funds
may
be
used
to
pay
the
4
costs
of
establishing,
expanding,
or
supporting
an
accredited
5
graduate
medical
education
program
as
specified
in
this
6
section
,
including
but
not
limited
to
the
costs
associated
7
with
residency
stipends
and
physician
faculty
stipends.
For
8
the
period
beginning
July
1,
2021,
and
ending
June
30,
2026,
9
use
of
the
funds
awarded
may
include
payment
by
the
sponsor
of
10
medical
residency
program
liability
costs
in
accordance
with
11
subsection
1,
paragraph
“d”
,
and
subject
to
provision
by
the
12
sponsor
of
dollar-for-dollar
matching
funds
used
for
payment
13
of
such
costs.
14
DIVISION
XVIII
15
REPORT
ON
NONREVERSION
OF
FUNDS
16
Sec.
65.
REPORT
ON
NONREVERSION
OF
FUNDS.
The
department
17
of
human
services
shall
report
the
expenditure
of
any
moneys
18
for
which
nonreversion
authorization
was
provided
for
the
19
fiscal
year
beginning
July
1,
2020,
and
ending
June
30,
2021,
20
for
field
operations
or
general
administration
to
the
general
21
assembly
on
a
quarterly
basis
beginning
October
1,
2021.
22
DIVISION
XIX
23
PHYSICIAN
ORDERS
FOR
SCOPE
OF
TREATMENT
24
Sec.
66.
Section
144D.2,
subsection
1,
paragraph
e,
25
subparagraph
(4),
Code
2021,
is
amended
by
striking
the
26
subparagraph.
27
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891
(3)
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pf/rn/md
74/
74