Print
Senate Study Bill 1253 - IntroducedA Bill ForAn Act 1relating to appropriations for health and human services
2and veterans, including other related appropriations and
3provisions and including effective date and retroactive and
4other applicability date provisions.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2019-2020
3 Section 1. DEPARTMENT ON AGING. There is appropriated from
4the general fund of the state to the department on aging for
5the fiscal year beginning July 1, 2019, and ending June 30,
62020, the following amount, or so much thereof as is necessary,
7to be used for the purposes designated:
8For aging programs for the department on aging and area
9agencies on aging to provide citizens of Iowa who are 60 years
10of age and older with case management for frail elders, Iowa’s
11aging and disabilities resource center, and other services
12which may include but are not limited to adult day services,
13respite care, chore services, information and assistance,
14and material aid, for information and options counseling for
15persons with disabilities who are 18 years of age or older,
16and for salaries, support, administration, maintenance, and
17miscellaneous purposes:
.................................................. $1811,042,924
191. Funds appropriated in this section may be used to
20supplement federal funds under federal regulations. To
21receive funds appropriated in this section, a local area
22agency on aging shall match the funds with moneys from other
23sources according to rules adopted by the department. Funds
24appropriated in this section may be used for elderly services
25not specifically enumerated in this section only if approved
26by an area agency on aging for provision of the service within
27the area.
282. Of the funds appropriated in this section, $279,946 is
29transferred to the economic development authority for the Iowa
30commission on volunteer services to be used for the retired and
31senior volunteer program.
323. a. The department on aging shall establish and enforce
33procedures relating to expenditure of state and federal funds
34by area agencies on aging that require compliance with both
35state and federal laws, rules, and regulations, including but
-1-1not limited to all of the following:
2(1) Requiring that expenditures are incurred only for goods
3or services received or performed prior to the end of the
4fiscal period designated for use of the funds.
5(2) Prohibiting prepayment for goods or services not
6received or performed prior to the end of the fiscal period
7designated for use of the funds.
8(3) Prohibiting the prepayment for goods or services
9not defined specifically by good or service, time period, or
10recipient.
11(4) Prohibiting the establishment of accounts from which
12future goods or services which are not defined specifically by
13good or service, time period, or recipient, may be purchased.
14b. The procedures shall provide that if any funds are
15expended in a manner that is not in compliance with the
16procedures and applicable federal and state laws, rules, and
17regulations, and are subsequently subject to repayment, the
18area agency on aging expending such funds in contravention of
19such procedures, laws, rules and regulations, not the state,
20shall be liable for such repayment.
214. Of the funds appropriated in this section, at least
22$600,000 shall be used to fund home and community-based
23services through the area agencies on aging that enable older
24individuals to avoid more costly utilization of residential or
25institutional services and remain in their own homes.
265. Of the funds appropriated in this section, $812,537 shall
27be used for the purposes of chapter 231E and to administer
28the prevention of elder abuse, neglect, and exploitation
29program pursuant to section 231.56A, in accordance with the
30requirements of the federal Older Americans Act of 1965, 42
31U.S.C.§3001 et seq., as amended.
326. Of the funds appropriated in this section, $1,000,000
33shall be used to fund continuation of the aging and disability
34resource center lifelong links to provide individuals and
35caregivers with information and services to plan for and
-2-1maintain independence.
27. Of the funds appropriated in this section, $100,000
3shall be used by the department on aging, in collaboration with
4the department of human services and affected stakeholders, to
5continue the pilot initiative to provide long-term care options
6counseling utilizing support planning protocols, to assist
7non-Medicaid eligible consumers who indicate a preference
8to return to the community and are deemed appropriate for
9discharge, to return to their community following a nursing
10facility stay.
11DIVISION II
12OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2019-2020
13 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
14appropriated from the general fund of the state to the office
15of long-term care ombudsman for the fiscal year beginning July
161, 2019, and ending June 30, 2020, the following amount, or
17so much thereof as is necessary, to be used for the purposes
18designated:
19For salaries, support, administration, maintenance, and
20miscellaneous purposes:
.................................................. $211,149,821
22DIVISION III
23DEPARTMENT OF PUBLIC HEALTH — FY 2019-2020
24 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
25from the general fund of the state to the department of public
26health for the fiscal year beginning July 1, 2019, and ending
27June 30, 2020, the following amounts, or so much thereof as is
28necessary, to be used for the purposes designated:
291. ADDICTIVE DISORDERS
30For reducing the prevalence of the use of tobacco, alcohol,
31and other drugs, and treating individuals affected by addictive
32behaviors, including gambling:
.................................................. $3325,110,594
34a. Of the funds appropriated in this subsection, $4,021,225
35shall be used for the tobacco use prevention and control
-3-1initiative, including efforts at the state and local levels,
2as provided in chapter 142A. The commission on tobacco use
3prevention and control established pursuant to section 142A.3
4shall advise the director of public health in prioritizing
5funding needs and the allocation of moneys appropriated for
6the programs and initiatives. Activities of the programs
7and initiatives shall be in alignment with the United States
8centers for disease control and prevention best practices
9for comprehensive tobacco control programs that include
10the goals of preventing youth initiation of tobacco usage,
11reducing exposure to secondhand smoke, and promotion of tobacco
12cessation.
13b. (1) Of the funds appropriated in this subsection,
14$21,089,369 shall be used for problem gambling and
15substance-related disorder prevention, treatment, and recovery
16services, including a 24-hour helpline, public information
17resources, professional training, youth prevention, and program
18evaluation.
19(2) Of the amount allocated under this paragraph, not
20more than $306,250 shall be utilized by the department of
21public health, in collaboration with the department of human
22services, to support establishment and maintenance of a single
23statewide 24-hour crisis hotline for the Iowa children’s mental
24health system that incorporates warmline services which may be
25provided through expansion of existing capabilities maintained
26by the department of public health as required pursuant to 2018
27Iowa Acts, chapter 1056, section 16.
28c. The requirement of section 123.17, subsection 5, is met
29by the appropriations and allocations made in this division of
30this Act for purposes of substance-related disorder treatment
31and addictive disorders for the fiscal year beginning July 1,
322019.
332. HEALTHY CHILDREN AND FAMILIES
34For promoting the optimum health status for children,
35adolescents from birth through 21 years of age, and families:
-4-.................................................. $15,820,625
23. CHRONIC CONDITIONS
3For serving individuals identified as having chronic
4conditions or special health care needs:
.................................................. $54,228,109
64. COMMUNITY CAPACITY
7For strengthening the health care delivery system at the
8local level:
.................................................. $94,970,152
10a. Of the funds appropriated in this subsection, $2,000,000
11shall be deposited in the medical residency training account
12created in section 135.175, subsection 5, paragraph “a”, and
13is appropriated from the account to the department of public
14health to be used for the purposes of the medical residency
15training state matching grants program as specified in section
16135.176.
17b. Of the funds appropriated in this subsection, $799,454
18is allocated for the purposes of health care and public health
19workforce initiatives, and of this amount, $250,000 shall be
20used for the public purpose of providing funding to Des Moines
21university to continue a provider education project to provide
22primary care physicians with the training and skills necessary
23to recognize the signs of mental illness in patients.
245. ESSENTIAL PUBLIC HEALTH SERVICES
25a. To provide public health services that reduce risks
26and invest in promoting and protecting good health over the
27course of a lifetime with a priority given to older Iowans and
28vulnerable populations:
.................................................. $297,962,464
30b. Of the funds appropriated in this subsection, $300,000 is
31allocated for performance improvement activities.
326. INFECTIOUS DISEASES
33For reducing the incidence and prevalence of communicable
34diseases:
.................................................. $351,796,426
-5- 17. PUBLIC PROTECTION
2a. For protecting the health and safety of the public
3through establishing standards and enforcing regulations:
.................................................. $44,095,139
5b. Of the funds appropriated in this subsection, not more
6than $304,700 shall be credited to the emergency medical
7services fund created in section 135.25. Moneys in the
8emergency medical services fund are appropriated to the
9department to be used for the purposes of the fund.
108. RESOURCE MANAGEMENT
11For establishing and sustaining the overall ability of the
12department to deliver services to the public:
.................................................. $13971,215
149. MISCELLANEOUS PROVISIONS
15The university of Iowa hospitals and clinics under the
16control of the state board of regents shall not receive
17indirect costs from the funds appropriated in this section.
18The university of Iowa hospitals and clinics billings to the
19department shall be on at least a quarterly basis.
20DIVISION IV
21DEPARTMENT OF VETERANS AFFAIRS — FY 2019-2020
22 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is
23appropriated from the general fund of the state to the
24department of veterans affairs for the fiscal year beginning
25July 1, 2019, and ending June 30, 2020, the following amounts,
26or so much thereof as is necessary, to be used for the purposes
27designated:
281. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
29For salaries, support, maintenance, and miscellaneous
30purposes:
.................................................. $311,225,500
322. IOWA VETERANS HOME
33For salaries, support, maintenance, and miscellaneous
34purposes:
.................................................. $357,162,976
-6- 1a. The Iowa veterans home billings involving the department
2of human services shall be submitted to the department on at
3least a monthly basis.
4b. Within available resources and in conformance with
5associated state and federal program eligibility requirements,
6the Iowa veterans home may implement measures to provide
7financial assistance to or on behalf of veterans or their
8spouses who are participating in the community reentry program.
9c. The Iowa veterans home expenditure report shall be
10submitted monthly to the legislative services agency.
11d. The Iowa veterans home shall continue to include in the
12annual discharge report applicant information to provide for
13the collection of demographic information including but not
14limited to the number of individuals applying for admission and
15admitted or denied admittance and the basis for the admission
16or denial; the age, gender, and race of such individuals;
17and the level of care for which such individuals applied for
18admission including residential or nursing level of care.
193. HOME OWNERSHIP ASSISTANCE PROGRAM
20For transfer to the Iowa finance authority for the
21continuation of the home ownership assistance program for
22persons who are or were eligible members of the armed forces of
23the United States, pursuant to section 16.54:
.................................................. $242,000,000
25 Sec. 5. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
26FUND STANDING APPROPRIATIONS. Notwithstanding the standing
27appropriation in section 35A.16 for the fiscal year beginning
28July 1, 2019, and ending June 30, 2020, the amount appropriated
29from the general fund of the state pursuant to that section
30for the following designated purposes shall not exceed the
31following amount:
32For the county commissions of veteran affairs fund under
33section 35A.16:
.................................................. $34990,000
35DIVISION V
-7-1DEPARTMENT OF HUMAN SERVICES — FY 2019-2020
2 Sec. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
3GRANT. There is appropriated from the fund created in section
48.41 to the department of human services for the fiscal year
5beginning July 1, 2019, and ending June 30, 2020, from moneys
6received under the federal temporary assistance for needy
7families (TANF) block grant pursuant to the federal Personal
8Responsibility and Work Opportunity Reconciliation Act of 1996,
9Pub.L.No.104-193, and successor legislation, the following
10amounts, or so much thereof as is necessary, to be used for the
11purposes designated:
121. To be credited to the family investment program account
13and used for assistance under the family investment program
14under chapter 239B:
.................................................. $154,524,006
162. To be credited to the family investment program account
17and used for the job opportunities and basic skills (JOBS)
18program and implementing family investment agreements in
19accordance with chapter 239B:
.................................................. $205,412,060
213. To be used for the family development and
22self-sufficiency grant program in accordance with section
23216A.107:
.................................................. $242,898,980
25Notwithstanding section 8.33, moneys appropriated in this
26subsection that remain unencumbered or unobligated at the close
27of the fiscal year shall not revert but shall remain available
28for expenditure for the purposes designated until the close of
29the succeeding fiscal year. However, unless such moneys are
30encumbered or obligated on or before September 30, 2020, the
31moneys shall revert.
324. For field operations:
.................................................. $3331,296,232
345. For general administration:
.................................................. $353,744,000
-8- 16. For state child care assistance:
.................................................. $247,166,826
3a. Of the funds appropriated in this subsection,
4$26,205,412 is transferred to the child care and development
5block grant appropriation made by the Eighty-eighth General
6Assembly, 2019 session, for the federal fiscal year beginning
7October 1, 2019, and ending September 30, 2020. Of this
8amount, $200,000 shall be used for provision of educational
9opportunities to registered child care home providers in order
10to improve services and programs offered by this category
11of providers and to increase the number of providers. The
12department may contract with institutions of higher education
13or child care resource and referral centers to provide
14the educational opportunities. Allowable administrative
15costs under the contracts shall not exceed 5 percent. The
16application for a grant shall not exceed two pages in length.
17b. Any funds appropriated in this subsection remaining
18unallocated shall be used for state child care assistance
19payments for families who are employed including but not
20limited to individuals enrolled in the family investment
21program.
227. For child and family services:
.................................................. $2332,380,654
248. For child abuse prevention grants:
.................................................. $25125,000
269. For pregnancy prevention grants on the condition that
27family planning services are funded:
.................................................. $281,913,203
29Pregnancy prevention grants shall be awarded to programs
30in existence on or before July 1, 2019, if the programs have
31demonstrated positive outcomes. Grants shall be awarded to
32pregnancy prevention programs which are developed after July
331, 2019, if the programs are based on existing models that
34have demonstrated positive outcomes. Grants shall comply with
35the requirements provided in 1997 Iowa Acts, chapter 208,
-9-1section 14, subsections 1 and 2, including the requirement that
2grant programs must emphasize sexual abstinence. Priority in
3the awarding of grants shall be given to programs that serve
4areas of the state which demonstrate the highest percentage of
5unplanned pregnancies of females of childbearing age within the
6geographic area to be served by the grant.
710. For technology needs and other resources necessary
8to meet federal welfare reform reporting, tracking, and case
9management requirements:
.................................................. $101,037,186
1111. a. Notwithstanding any provision to the contrary,
12including but not limited to requirements in section 8.41 or
13provisions in 2018 or 2019 Iowa Acts regarding the receipt and
14appropriation of federal block grants, federal funds from the
15temporary assistance for needy families block grant received by
16the state and not otherwise appropriated in this section and
17remaining available for the fiscal year beginning July 1, 2019,
18are appropriated to the department of human services to the
19extent as may be necessary to be used in the following priority
20order: the family investment program, for state child care
21assistance program payments for families who are employed, and
22for the family investment program share of system costs for
23eligibility determination and related functions. The federal
24funds appropriated in this paragraph “a” shall be expended
25only after all other funds appropriated in subsection 1 for
26assistance under the family investment program, in subsection
276 for state child care assistance, or in subsection 10 for
28technology costs related to the family investment program,
29as applicable, have been expended. For the purposes of this
30subsection, the funds appropriated in subsection 6, paragraph
31“a”, for transfer to the child care and development block grant
32appropriation are considered fully expended when the full
33amount has been transferred.
34b. The department shall, on a quarterly basis, advise the
35legislative services agency and department of management of
-10-1the amount of funds appropriated in this subsection that was
2expended in the prior quarter.
312. Of the amounts appropriated in this section,
4$12,962,008 for the fiscal year beginning July 1, 2019, is
5transferred to the appropriation of the federal social services
6block grant made to the department of human services for that
7fiscal year.
813. For continuation of the program providing categorical
9eligibility for the food assistance program as specified
10for the program in the section of this division of this Act
11relating to the family investment program account:
.................................................. $1214,236
1314. The department may transfer funds allocated in this
14section to the appropriations made in this division of this Act
15for the same fiscal year for general administration and field
16operations for resources necessary to implement and operate the
17services referred to in this section and those funded in the
18appropriation made in this division of this Act for the same
19fiscal year for the family investment program from the general
20fund of the state.
2115. With the exception of moneys allocated under this
22section for the family development and self-sufficiency grant
23program, to the extent moneys allocated in this section are
24deemed by the department not to be necessary to support the
25purposes for which they are allocated, such moneys may be
26used in the same fiscal year for any other purpose for which
27funds are allocated in this section or in section 7 of this
28division for the family investment program account. If there
29are conflicting needs, priority shall first be given to the
30family investment program account as specified under subsection
311 of this section and used for the purposes of assistance under
32the family investment program in accordance with chapter 239B,
33followed by state child care assistance program payments for
34families who are employed, followed by other priorities as
35specified by the department.
-11-1 Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT.
21. Moneys credited to the family investment program (FIP)
3account for the fiscal year beginning July 1, 2019, and
4ending June 30, 2020, shall be used to provide assistance in
5accordance with chapter 239B.
62. The department may use a portion of the moneys credited
7to the FIP account under this section as necessary for
8salaries, support, maintenance, and miscellaneous purposes.
93. The department may transfer funds allocated in
10subsection 4, excluding the allocation under subsection 4,
11paragraph “b”, to the appropriations made in this division of
12this Act for the same fiscal year for general administration
13and field operations for resources necessary to implement
14and operate the services referred to in this section and
15those funded in the appropriations made in section 6 for the
16temporary assistance for needy families block grant and in
17section 8 for the family investment program from the general
18fund of the state in this division of this Act for the same
19fiscal year.
204. Moneys appropriated in this division of this Act and
21credited to the FIP account for the fiscal year beginning July
221, 2019, and ending June 30, 2020, are allocated as follows:
23a. To be retained by the department of human services to
24be used for coordinating with the department of human rights
25to more effectively serve participants in FIP and other shared
26clients and to meet federal reporting requirements under the
27federal temporary assistance for needy families block grant:
.................................................. $2820,000
29b. To the department of human rights for staffing,
30administration, and implementation of the family development
31and self-sufficiency grant program in accordance with section
32216A.107:
.................................................. $336,192,834
34(1) Of the funds allocated for the family development
35and self-sufficiency grant program in this paragraph “b”,
-12-1not more than 5 percent of the funds shall be used for the
2administration of the grant program.
3(2) The department of human rights may continue to implement
4the family development and self-sufficiency grant program
5statewide during fiscal year 2019-2020.
6(3) The department of human rights may engage in activities
7to strengthen and improve family outcomes measures and
8data collection systems under the family development and
9self-sufficiency grant program.
10c. For the diversion subaccount of the FIP account:
.................................................. $11815,000
12A portion of the moneys allocated for the subaccount may
13be used for field operations, salaries, data management
14system development, and implementation costs and support
15deemed necessary by the director of human services in order to
16administer the FIP diversion program. To the extent moneys
17allocated in this paragraph “c” are deemed by the department
18not to be necessary to support diversion activities, such
19moneys may be used for other efforts intended to increase
20engagement by family investment program participants in work,
21education, or training activities, or for the purposes of
22assistance under the family investment program in accordance
23with chapter 239B.
24d. For the food assistance employment and training program:
.................................................. $2566,588
26(1) The department shall apply the federal supplemental
27nutrition assistance program (SNAP) employment and training
28state plan in order to maximize to the fullest extent permitted
29by federal law the use of the 50 percent federal reimbursement
30provisions for the claiming of allowable federal reimbursement
31funds from the United States department of agriculture
32pursuant to the federal SNAP employment and training program
33for providing education, employment, and training services
34for eligible food assistance program participants, including
35but not limited to related dependent care and transportation
-13-1expenses.
2(2) The department shall continue the categorical federal
3food assistance program eligibility at 160 percent of the
4federal poverty level and continue to eliminate the asset test
5from eligibility requirements, consistent with federal food
6assistance program requirements. The department shall include
7as many food assistance households as is allowed by federal
8law. The eligibility provisions shall conform to all federal
9requirements including requirements addressing individuals who
10are incarcerated or otherwise ineligible.
11e. For the JOBS program:
.................................................. $1212,018,258
135. Of the child support collections assigned under FIP,
14an amount equal to the federal share of support collections
15shall be credited to the child support recovery appropriation
16made in this division of this Act. Of the remainder of the
17assigned child support collections received by the child
18support recovery unit, a portion shall be credited to the FIP
19account, a portion may be used to increase recoveries, and a
20portion may be used to sustain cash flow in the child support
21payments account. If as a consequence of the appropriations
22and allocations made in this section the resulting amounts
23are insufficient to sustain cash assistance payments and meet
24federal maintenance of effort requirements, the department
25shall seek supplemental funding. If child support collections
26assigned under FIP are greater than estimated or are otherwise
27determined not to be required for maintenance of effort, the
28state share of either amount may be transferred to or retained
29in the child support payments account.
306. The department may adopt emergency rules for the family
31investment, JOBS, food assistance, and medical assistance
32programs if necessary to comply with federal requirements.
33 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
34is appropriated from the general fund of the state to the
35department of human services for the fiscal year beginning July
-14-11, 2019, and ending June 30, 2020, the following amount, or
2so much thereof as is necessary, to be used for the purpose
3designated:
4To be credited to the family investment program (FIP)
5account and used for family investment program assistance under
6chapter 239B:
.................................................. $740,365,715
81. Of the funds appropriated in this section, $6,606,198 is
9allocated for the JOBS program.
102. Of the funds appropriated in this section, $3,313,854 is
11allocated for the family development and self-sufficiency grant
12program.
133. Notwithstanding section 8.39, for the fiscal year
14beginning July 1, 2019, if necessary to meet federal
15maintenance of effort requirements or to transfer federal
16temporary assistance for needy families block grant funding
17to be used for purposes of the federal social services block
18grant or to meet cash flow needs resulting from delays in
19receiving federal funding or to implement, in accordance with
20this division of this Act, activities currently funded with
21juvenile court services, county, or community moneys and state
22moneys used in combination with such moneys; to comply with
23federal requirements; or to maximize the use of federal funds,
24the department of human services may transfer funds within or
25between any of the appropriations made in this division of this
26Act and appropriations in law for the federal social services
27block grant to the department for the following purposes,
28provided that the combined amount of state and federal
29temporary assistance for needy families block grant funding
30for each appropriation remains the same before and after the
31transfer:
32a. For the family investment program.
33b. For state child care assistance.
34c. For child and family services.
35d. For field operations.
-15- 1e. For general administration.
2This subsection shall not be construed to prohibit the use
3of existing state transfer authority for other purposes. The
4department shall report any transfers made pursuant to this
5subsection to the legislative services agency.
64. Of the funds appropriated in this section, $195,678 shall
7be used for continuation of a grant to an Iowa-based nonprofit
8organization with a history of providing tax preparation
9assistance to low-income Iowans in order to expand the usage of
10the earned income tax credit. The purpose of the grant is to
11supply this assistance to underserved areas of the state.
125. Of the funds appropriated in this section, $70,000
13shall be used for the continuation of the parenting program as
14specified in 441 IACch.100, relating to parental obligations,
15in which the child support recovery unit participates, to
16support the efforts of a nonprofit organization committed
17to strengthening the community through youth development,
18healthy living, and social responsibility headquartered in
19a county with a population over 350,000 according to the
20latest certified federal census. The funds allocated in this
21subsection shall be used by the recipient organization to
22develop a larger community effort, through public and private
23partnerships, to support a broad-based multi-county parenthood
24initiative that promotes payment of child support obligations,
25improved family relationships, and full-time employment.
266. The department may transfer funds appropriated in this
27section, excluding the allocation in subsection 2 for the
28family development and self-sufficiency grant program, to the
29appropriations made in this division of this Act for general
30administration and field operations as necessary to administer
31this section, section 6 for the temporary assistance for needy
32families block grant, and section 7 for the family investment
33program account.
34 Sec. 9. CHILD SUPPORT RECOVERY. There is appropriated
35from the general fund of the state to the department of human
-16-1services for the fiscal year beginning July 1, 2019, and ending
2June 30, 2020, the following amount, or so much thereof as is
3necessary, to be used for the purposes designated:
4For child support recovery, including salaries, support,
5maintenance, and miscellaneous purposes:
.................................................. $614,749,697
71. The department shall expend up to $24,329, including
8federal financial participation, for the fiscal year beginning
9July 1, 2019, for a child support public awareness campaign.
10The department and the office of the attorney general shall
11cooperate in continuation of the campaign. The public
12awareness campaign shall emphasize, through a variety of
13media activities, the importance of maximum involvement of
14both parents in the lives of their children as well as the
15importance of payment of child support obligations.
162. Federal access and visitation grant moneys shall be
17issued directly to private not-for-profit agencies that provide
18services designed to increase compliance with the child access
19provisions of court orders, including but not limited to
20neutral visitation sites and mediation services.
213. The appropriation made to the department for child
22support recovery may be used throughout the fiscal year in the
23manner necessary for purposes of cash flow management, and for
24cash flow management purposes the department may temporarily
25draw more than the amount appropriated, provided the amount
26appropriated is not exceeded at the close of the fiscal year.
27 Sec. 10. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
28FY 2019-2020. Any funds remaining in the health care trust
29fund created in section 453A.35A for the fiscal year beginning
30July 1, 2019, and ending June 30, 2020, are appropriated to
31the department of human services to supplement the medical
32assistance program appropriations made in this division of this
33Act, for medical assistance reimbursement and associated costs,
34including program administration and costs associated with
35program implementation.
-17-1 Sec. 11. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
22019-2020. Any funds remaining in the Medicaid fraud fund
3created in section 249A.50 for the fiscal year beginning
4July 1, 2019, and ending June 30, 2020, are appropriated to
5the department of human services to supplement the medical
6assistance appropriations made in this division of this Act,
7for medical assistance reimbursement and associated costs,
8including program administration and costs associated with
9program implementation.
10 Sec. 12. MEDICAL ASSISTANCE. There is appropriated from the
11general fund of the state to the department of human services
12for the fiscal year beginning July 1, 2019, and ending June 30,
132020, the following amount, or so much thereof as is necessary,
14to be used for the purpose designated:
15For medical assistance program reimbursement and associated
16costs as specifically provided in the reimbursement
17methodologies in effect on June 30, 2019, except as otherwise
18expressly authorized by law, consistent with options under
19federal law and regulations, and contingent upon receipt of
20approval from the office of the governor of reimbursement for
21each abortion performed under the program:
.................................................. $221,409,929,895
231. Iowans support reducing the number of abortions
24performed in our state. Funds appropriated under this section
25shall not be used for abortions, unless otherwise authorized
26under this section.
272. The provisions of this section relating to abortions
28shall also apply to the Iowa health and wellness plan created
29pursuant to chapter 249N.
303. The department shall utilize not more than $60,000 of
31the funds appropriated in this section to continue the AIDS/HIV
32health insurance premium payment program as established in 1992
33Iowa Acts, Second Extraordinary Session, chapter 1001, section
34409, subsection 6. Of the funds allocated in this subsection,
35not more than $5,000 may be expended for administrative
-18-1purposes.
24. Of the funds appropriated in this Act to the department
3of public health for addictive disorders, $950,000 for
4the fiscal year beginning July 1, 2019, is transferred
5to the department of human services for an integrated
6substance-related disorder managed care system. The
7departments of human services and public health shall
8work together to maintain the level of mental health and
9substance-related disorder treatment services provided by the
10managed care contractors. Each department shall take the steps
11necessary to continue the federal waivers as necessary to
12maintain the level of services.
135. a. The department shall aggressively pursue options for
14providing medical assistance or other assistance to individuals
15with special needs who become ineligible to continue receiving
16services under the early and periodic screening, diagnostic,
17and treatment program under the medical assistance program
18due to becoming 21 years of age who have been approved for
19additional assistance through the department’s exception to
20policy provisions, but who have health care needs in excess
21of the funding available through the exception to policy
22provisions.
23b. Of the funds appropriated in this section, $100,000
24shall be used for participation in one or more pilot projects
25operated by a private provider to allow the individual or
26individuals to receive service in the community in accordance
27with principles established in Olmstead v.L.C., 527 U.S.581
28(1999), for the purpose of providing medical assistance or
29other assistance to individuals with special needs who become
30ineligible to continue receiving services under the early and
31periodic screening, diagnostic, and treatment program under
32the medical assistance program due to becoming 21 years of
33age who have been approved for additional assistance through
34the department’s exception to policy provisions, but who have
35health care needs in excess of the funding available through
-19-1the exception to the policy provisions.
26. Of the funds appropriated in this section, up to
3$3,050,082 may be transferred to the field operations or
4general administration appropriations in this division of this
5Act for operational costs associated with Part D of the federal
6Medicare Prescription Drug Improvement and Modernization Act
7of 2003, Pub.L.No.108-173.
87. Of the funds appropriated in this section, up to $442,100
9may be transferred to the appropriation in this division
10of this Act for medical contracts to be used for clinical
11assessment services and prior authorization of services.
128. A portion of the funds appropriated in this section
13may be transferred to the appropriations in this division of
14this Act for general administration, medical contracts, the
15children’s health insurance program, or field operations to be
16used for the state match cost to comply with the payment error
17rate measurement (PERM) program for both the medical assistance
18and children’s health insurance programs as developed by the
19centers for Medicare and Medicaid services of the United States
20department of health and human services to comply with the
21federal Improper Payments Information Act of 2002, Pub.L.
22No.107-300, and to support other reviews and quality control
23activities to improve the integrity of these programs.
249. The department shall continue to implement the
25recommendations of the assuring better child health and
26development initiative II (ABCDII) clinical panel to the
27Iowa early and periodic screening, diagnostic, and treatment
28services healthy mental development collaborative board
29regarding changes to billing procedures, codes, and eligible
30service providers.
3110. Of the funds appropriated in this section, a sufficient
32amount is allocated to supplement the incomes of residents of
33nursing facilities, intermediate care facilities for persons
34with mental illness, and intermediate care facilities for
35persons with an intellectual disability, with incomes of less
-20-1than $50 in the amount necessary for the residents to receive a
2personal needs allowance of $50 per month pursuant to section
3249A.30A.
411. a. Hospitals that meet the conditions specified
5in subparagraphs (1) and (2) shall either certify public
6expenditures or transfer to the medical assistance program
7an amount equal to provide the nonfederal share for a
8disproportionate share hospital payment in an amount up to the
9hospital-specific limit as approved in the Medicaid state plan.
10The hospitals that meet the conditions specified shall receive
11and retain 100 percent of the total disproportionate share
12hospital payment in an amount up to the hospital-specific limit
13as approved in the Medicaid state plan.
14(1) The hospital qualifies for disproportionate share and
15graduate medical education payments.
16(2) The hospital is an Iowa state-owned hospital with more
17than 500 beds and eight or more distinct residency specialty
18or subspecialty programs recognized by the American college of
19graduate medical education.
20b. Distribution of the disproportionate share payments
21shall be made on a monthly basis. The total amount of
22disproportionate share payments including graduate medical
23education, enhanced disproportionate share, and Iowa
24state-owned teaching hospital payments shall not exceed the
25amount of the state’s allotment under Pub.L.No.102-234.
26In addition, the total amount of all disproportionate
27share payments shall not exceed the hospital-specific
28disproportionate share limits under Pub.L.No.103-66.
2912. One hundred percent of the nonfederal share of payments
30to area education agencies that are medical assistance
31providers for medical assistance-covered services provided to
32medical assistance-covered children, shall be made from the
33appropriation made in this section.
3413. A portion of the funds appropriated in this section
35may be transferred to the appropriation in this division of
-21-1this Act for medical contracts to be used for administrative
2activities associated with the money follows the person
3demonstration project.
414. Of the funds appropriated in this section, $349,011
5shall be used for the administration of the health insurance
6premium payment program, including salaries, support,
7maintenance, and miscellaneous purposes.
815. a. The department may increase the amounts allocated
9for salaries, support, maintenance, and miscellaneous purposes
10associated with the medical assistance program, as necessary,
11to implement cost containment strategies. The department shall
12report any such increase to the legislative services agency and
13the department of management.
14b. If the savings to the medical assistance program from
15cost containment efforts exceed the cost for the fiscal
16year beginning July 1, 2019, the department may transfer any
17savings generated for the fiscal year due to medical assistance
18program cost containment efforts to the appropriation
19made in this division of this Act for medical contracts or
20general administration to defray the increased contract costs
21associated with implementing such efforts.
2216. For the fiscal year beginning July 1, 2019, and ending
23June 30, 2020, the replacement generation tax revenues required
24to be deposited in the property tax relief fund pursuant to
25section 437A.8, subsection 4, paragraph “d”, and section
26437A.15, subsection 3, paragraph “f”, shall instead be credited
27to and supplement the appropriation made in this section and
28used for the allocations made in this section.
2917. a. Of the funds appropriated in this section, up
30to $50,000 may be transferred by the department to the
31appropriation made in this division of this Act to the
32department for the same fiscal year for general administration
33to be used for associated administrative expenses and for not
34more than one full-time equivalent position, in addition to
35those authorized for the same fiscal year, to be assigned to
-22-1implementing the children’s mental health home project.
2b. Of the funds appropriated in this section, up to $400,000
3may be transferred by the department to the appropriation made
4to the department in this division of this Act for the same
5fiscal year for Medicaid program-related general administration
6planning and implementation activities. The funds may be used
7for contracts or for personnel in addition to the amounts
8appropriated for and the positions authorized for general
9administration for the fiscal year.
10c. Of the funds appropriated in this section, up to
11$3,000,000 may be transferred by the department to the
12appropriations made in this division of this Act for the same
13fiscal year for general administration or medical contracts
14to be used to support the development and implementation of
15standardized assessment tools for persons with mental illness,
16an intellectual disability, a developmental disability, or a
17brain injury.
1818. Of the funds appropriated in this section, $150,000
19shall be used for lodging expenses associated with care
20provided at the university of Iowa hospitals and clinics for
21patients with cancer whose travel distance is 30 miles or more
22and whose income is at or below 200 percent of the federal
23poverty level as defined by the most recently revised poverty
24income guidelines published by the United States department of
25health and human services. The department of human services
26shall establish the maximum number of overnight stays and the
27maximum rate reimbursed for overnight lodging, which may be
28based on the state employee rate established by the department
29of administrative services. The funds allocated in this
30subsection shall not be used as nonfederal share matching
31funds.
3219. Of the funds appropriated in this section, up to
33$3,383,880 shall be used for administration of the state family
34planning services program pursuant to section 217.41B, and
35of this amount, the department may use up to $200,000 for
-23-1administrative expenses.
220. The department shall report the implementation of
3any cost containment strategies to the individuals specified
4in this division of this Act for submission of reports upon
5implementation.
621. The department shall report the implementation of any
7process improvement changes and any related cost reductions
8to the individuals specified in this division of this Act for
9submission of reports upon implementation.
1022. Of the funds appropriated in this section, $1,545,530
11shall be used and may be transferred to other appropriations
12in this division of this Act as necessary to administer the
13provisions in the division of this Act relating to Medicaid
14program administration.
1523. The department shall continue to implement and
16administer the provisions of 2018 Iowa Acts, chapter 1056. Of
17the funds appropriated in this section, up to $39,069 may be
18transferred to the department of inspections and appeals for
19inspection costs.
2024. Of the funds appropriated in this section, up to
21$1,200,000 shall be used to implement reductions in the waiting
22list for the children’s mental health home and community-based
23services waiver.
24 Sec. 13. MEDICAL CONTRACTS. There is appropriated from the
25general fund of the state to the department of human services
26for the fiscal year beginning July 1, 2019, and ending June 30,
272020, the following amount, or so much thereof as is necessary,
28to be used for the purpose designated:
29For medical contracts:
.................................................. $3017,992,530
311. The department of inspections and appeals shall
32provide all state matching funds for survey and certification
33activities performed by the department of inspections
34and appeals. The department of human services is solely
35responsible for distributing the federal matching funds for
-24-1such activities.
22. Of the funds appropriated in this section, $50,000 shall
3be used for continuation of home and community-based services
4waiver quality assurance programs, including the review and
5streamlining of processes and policies related to oversight and
6quality management to meet state and federal requirements.
73. Of the amount appropriated in this section, up to
8$200,000 may be transferred to the appropriation for general
9administration in this division of this Act to be used for
10additional full-time equivalent positions in the development of
11key health initiatives such as cost containment, development
12and oversight of managed care programs, and development of
13health strategies targeted toward improved quality and reduced
14costs in the Medicaid program.
154. Of the funds appropriated in this section, $1,000,000
16shall be used for planning and development, in cooperation with
17the department of public health, of a phased-in program to
18provide a dental home for children.
195. a. Of the funds appropriated in this section, $573,000
20shall be credited to the autism support program fund created
21in section 225D.2 to be used for the autism support program
22created in chapter 225D, with the exception of the following
23amounts of this allocation which shall be used as follows:
24b. Of the funds allocated in this subsection, $25,000
25shall be used for the public purpose of continuation of a
26grant to a nonprofit provider of child welfare services that
27has been in existence for more than 115 years, is located in
28a county with a population between 200,000 and 220,000 in the
29latest certified federal census, is licensed as a psychiatric
30medical institution for children, and provides school-based
31programming, to be used for support services for children with
32autism spectrum disorder and their families.
33 Sec. 14. STATE SUPPLEMENTARY ASSISTANCE.
341. There is appropriated from the general fund of the
35state to the department of human services for the fiscal year
-25-1beginning July 1, 2019, and ending June 30, 2020, the following
2amount, or so much thereof as is necessary, to be used for the
3purpose designated:
4For the state supplementary assistance program:
.................................................. $57,812,909
62. The department shall increase the personal needs
7allowance for residents of residential care facilities by the
8same percentage and at the same time as federal supplemental
9security income and federal social security benefits are
10increased due to a recognized increase in the cost of living.
11The department may adopt emergency rules to implement this
12subsection.
133. If during the fiscal year beginning July 1, 2019,
14the department projects that state supplementary assistance
15expenditures for a calendar year will not meet the federal
16pass-through requirement specified in Tit.XVI of the federal
17Social Security Act, section 1618, as codified in 42 U.S.C.
18§1382g, the department may take actions including but not
19limited to increasing the personal needs allowance for
20residential care facility residents and making programmatic
21adjustments or upward adjustments of the residential care
22facility or in-home health-related care reimbursement rates
23prescribed in this division of this Act to ensure that federal
24requirements are met. In addition, the department may make
25other programmatic and rate adjustments necessary to remain
26within the amount appropriated in this section while ensuring
27compliance with federal requirements. The department may adopt
28emergency rules to implement the provisions of this subsection.
294. Notwithstanding section 8.33, moneys appropriated in
30this section that remain unencumbered or unobligated at the
31close of the fiscal year shall not revert but shall remain
32available for expenditure for the purposes designated until the
33close of the succeeding fiscal year.
34 Sec. 15. CHILDREN’S HEALTH INSURANCE PROGRAM.
351. There is appropriated from the general fund of the
-26-1state to the department of human services for the fiscal year
2beginning July 1, 2019, and ending June 30, 2020, the following
3amount, or so much thereof as is necessary, to be used for the
4purpose designated:
5For maintenance of the healthy and well kids in Iowa (hawk-i)
6program pursuant to chapter 514I, including supplemental dental
7services, for receipt of federal financial participation under
8Tit.XXI of the federal Social Security Act, which creates the
9children’s health insurance program:
.................................................. $1019,361,112
112. Of the funds appropriated in this section, up to $79,486
12is allocated for continuation of the contract for outreach with
13the department of public health.
143. A portion of the funds appropriated in this section may
15be transferred to the appropriations made in this division of
16this Act for field operations or medical contracts to be used
17for the integration of hawk-i program eligibility, payment, and
18administrative functions under the purview of the department
19of human services, including for the Medicaid management
20information system upgrade.
21 Sec. 16. CHILD CARE ASSISTANCE. There is appropriated
22from the general fund of the state to the department of human
23services for the fiscal year beginning July 1, 2019, and ending
24June 30, 2020, the following amount, or so much thereof as is
25necessary, to be used for the purpose designated:
26For child care programs:
.................................................. $2740,816,931
281. Of the funds appropriated in this section, $34,966,931
29shall be used for state child care assistance in accordance
30with section 237A.13.
312. Nothing in this section shall be construed or is
32intended as or shall imply a grant of entitlement for services
33to persons who are eligible for assistance due to an income
34level consistent with the waiting list requirements of section
35237A.13. Any state obligation to provide services pursuant to
-27-1this section is limited to the extent of the funds appropriated
2in this section.
33. A list of the registered and licensed child care
4facilities operating in the area served by a child care
5resource and referral service shall be made available to the
6families receiving state child care assistance in that area.
74. Of the funds appropriated in this section, $5,850,000
8shall be credited to the early childhood programs grants
9account in the early childhood Iowa fund created in section
10256I.11. The moneys shall be distributed for funding of
11community-based early childhood programs targeted to children
12from birth through five years of age developed by early
13childhood Iowa areas in accordance with approved community
14plans as provided in section 256I.8.
155. The department may use any of the funds appropriated
16in this section as a match to obtain federal funds for use in
17expanding child care assistance and related programs. For
18the purpose of expenditures of state and federal child care
19funding, funds shall be considered obligated at the time
20expenditures are projected or are allocated to the department’s
21service areas. Projections shall be based on current and
22projected caseload growth, current and projected provider
23rates, staffing requirements for eligibility determination
24and management of program requirements including data systems
25management, staffing requirements for administration of the
26program, contractual and grant obligations and any transfers
27to other state agencies, and obligations for decategorization
28or innovation projects.
296. A portion of the state match for the federal child care
30and development block grant shall be provided as necessary to
31meet federal matching funds requirements through the state
32general fund appropriation made for child development grants
33and other programs for at-risk children in section 279.51.
347. If a uniform reduction ordered by the governor under
35section 8.31 or other operation of law, transfer, or federal
-28-1funding reduction reduces the appropriation made in this
2section for the fiscal year, the percentage reduction in the
3amount paid out to or on behalf of the families participating
4in the state child care assistance program shall be equal to or
5less than the percentage reduction made for any other purpose
6payable from the appropriation made in this section and the
7federal funding relating to it. The percentage reduction to
8the other allocations made in this section shall be the same as
9the uniform reduction ordered by the governor or the percentage
10change of the federal funding reduction, as applicable. If
11there is an unanticipated increase in federal funding provided
12for state child care services, the entire amount of the
13increase, except as necessary to meet federal requirements
14including quality set asides, shall be used for state child
15care assistance payments. If the appropriations made for
16purposes of the state child care assistance program for the
17fiscal year are determined to be insufficient, it is the intent
18of the general assembly to appropriate sufficient funding for
19the fiscal year in order to avoid establishment of waiting list
20requirements.
218. Notwithstanding section 8.33, moneys advanced for
22purposes of the programs developed by early childhood Iowa
23areas, advanced for purposes of wraparound child care, or
24received from the federal appropriations made for the purposes
25of this section that remain unencumbered or unobligated at the
26close of the fiscal year shall not revert to any fund but shall
27remain available for expenditure for the purposes designated
28until the close of the succeeding fiscal year.
29 Sec. 17. JUVENILE INSTITUTION. There is appropriated
30from the general fund of the state to the department of human
31services for the fiscal year beginning July 1, 2019, and ending
32June 30, 2020, the following amounts, or so much thereof as is
33necessary, to be used for the purposes designated:
341. For operation of the state training school at Eldora and
35for salaries, support, maintenance, and miscellaneous purposes:
-29-.................................................. $113,920,907
2Of the funds appropriated in this subsection, $91,150 shall
3be used for distribution to licensed classroom teachers at this
4and other institutions under the control of the department of
5human services based upon the average student yearly enrollment
6at each institution as determined by the department.
72. A portion of the moneys appropriated in this section
8shall be used by the state training school at Eldora for
9grants for adolescent pregnancy prevention activities at the
10institution in the fiscal year beginning July 1, 2019.
113. Of the funds appropriated in this subsection, $212,000
12shall be used by the state training school at Eldora for a
13substance use disorder training program at the institution for
14the fiscal year beginning July 1, 2019.
15 Sec. 18. CHILD AND FAMILY SERVICES.
161. There is appropriated from the general fund of the
17state to the department of human services for the fiscal year
18beginning July 1, 2019, and ending June 30, 2020, the following
19amount, or so much thereof as is necessary, to be used for the
20purpose designated:
21For child and family services:
.................................................. $2289,078,185
232. The department may transfer funds appropriated in this
24section as necessary to pay the nonfederal costs of services
25reimbursed under the medical assistance program, state child
26care assistance program, or the family investment program which
27are provided to children who would otherwise receive services
28paid under the appropriation in this section. The department
29may transfer funds appropriated in this section to the
30appropriations made in this division of this Act for general
31administration and for field operations for resources necessary
32to implement and operate the services funded in this section.
333. a. Of the funds appropriated in this section, up to
34$34,536,648 is allocated as the statewide expenditure target
35under section 232.143 for group foster care maintenance and
-30-1services. If the department projects that such expenditures
2for the fiscal year will be less than the target amount
3allocated in this paragraph “a”, the department may reallocate
4the excess to provide additional funding for family foster
5care, independent living, family safety, risk and permanency
6services, shelter care, or the child welfare emergency services
7addressed with the allocation for shelter care.
8b. If at any time after September 30, 2019, annualization
9of a service area’s current expenditures indicates a service
10area is at risk of exceeding its group foster care expenditure
11target under section 232.143 by more than 5 percent, the
12department and juvenile court services shall examine all
13group foster care placements in that service area in order to
14identify those which might be appropriate for termination.
15In addition, any aftercare services believed to be needed
16for the children whose placements may be terminated shall be
17identified. The department and juvenile court services shall
18initiate action to set dispositional review hearings for the
19placements identified. In such a dispositional review hearing,
20the juvenile court shall determine whether needed aftercare
21services are available and whether termination of the placement
22is in the best interest of the child and the community.
234. In accordance with the provisions of section 232.188,
24the department shall continue the child welfare and juvenile
25justice funding initiative during fiscal year 2019-2020. Of
26the funds appropriated in this section, $1,717,753 is allocated
27specifically for expenditure for fiscal year 2019-2020 through
28the decategorization services funding pools and governance
29boards established pursuant to section 232.188.
305. A portion of the funds appropriated in this section
31may be used for emergency family assistance to provide other
32resources required for a family participating in a family
33preservation or reunification project or successor project to
34stay together or to be reunified.
356. Of the funds appropriated in this section, a sufficient
-31-1amount is allocated for shelter care and the child welfare
2emergency services contracting implemented to provide for or
3prevent the need for shelter care.
47. Federal funds received by the state during the fiscal
5year beginning July 1, 2019, as the result of the expenditure
6of state funds appropriated during a previous state fiscal
7year for a service or activity funded under this section are
8appropriated to the department to be used as additional funding
9for services and purposes provided for under this section.
10Notwithstanding section 8.33, moneys received in accordance
11with this subsection that remain unencumbered or unobligated at
12the close of the fiscal year shall not revert to any fund but
13shall remain available for the purposes designated until the
14close of the succeeding fiscal year.
158. a. Of the funds appropriated in this section, up to
16$3,290,000 is allocated for the payment of the expenses of
17court-ordered services provided to juveniles who are under the
18supervision of juvenile court services, which expenses are a
19charge upon the state pursuant to section 232.141, subsection
204. Of the amount allocated in this paragraph “a”, up to
21$1,556,287 shall be made available to provide school-based
22supervision of children adjudicated under chapter 232, of which
23not more than $15,000 may be used for the purpose of training.
24A portion of the cost of each school-based liaison officer
25shall be paid by the school district or other funding source as
26approved by the chief juvenile court officer.
27b. Of the funds appropriated in this section, up to $748,985
28is allocated for the payment of the expenses of court-ordered
29services provided to children who are under the supervision
30of the department, which expenses are a charge upon the state
31pursuant to section 232.141, subsection 4.
32c. Notwithstanding section 232.141 or any other provision
33of law to the contrary, the amounts allocated in this
34subsection shall be distributed to the judicial districts
35as determined by the state court administrator and to the
-32-1department’s service areas as determined by the administrator
2of the department of human services’ division of child and
3family services. The state court administrator and the
4division administrator shall make the determination of the
5distribution amounts on or before June 15, 2019.
6d. Notwithstanding chapter 232 or any other provision of
7law to the contrary, a district or juvenile court shall not
8order any service which is a charge upon the state pursuant
9to section 232.141 if there are insufficient court-ordered
10services funds available in the district court or departmental
11service area distribution amounts to pay for the service. The
12chief juvenile court officer and the departmental service area
13manager shall encourage use of the funds allocated in this
14subsection such that there are sufficient funds to pay for
15all court-related services during the entire year. The chief
16juvenile court officers and departmental service area managers
17shall attempt to anticipate potential surpluses and shortfalls
18in the distribution amounts and shall cooperatively request the
19state court administrator or division administrator to transfer
20funds between the judicial districts’ or departmental service
21areas’ distribution amounts as prudent.
22e. Notwithstanding any provision of law to the contrary,
23a district or juvenile court shall not order a county to pay
24for any service provided to a juvenile pursuant to an order
25entered under chapter 232 which is a charge upon the state
26under section 232.141, subsection 4.
27f. Of the funds allocated in this subsection, not more than
28$83,000 may be used by the judicial branch for administration
29of the requirements under this subsection.
30g. Of the funds allocated in this subsection, $17,000
31shall be used by the department of human services to support
32the interstate commission for juveniles in accordance with
33the interstate compact for juveniles as provided in section
34232.173.
359. Of the funds appropriated in this section, $12,253,227 is
-33-1allocated for juvenile delinquent graduated sanctions services.
2Any state funds saved as a result of efforts by juvenile court
3services to earn a federal Tit.IV-E match for juvenile court
4services administration may be used for the juvenile delinquent
5graduated sanctions services.
610. Of the funds appropriated in this section, $1,658,285 is
7transferred to the department of public health to be used for
8the child protection center grant program for child protection
9centers located in Iowa in accordance with section 135.118.
10The grant amounts under the program shall be equalized so that
11each center receives a uniform base amount of $245,000, and so
12that the remaining funds are awarded through a funding formula
13based upon the volume of children served.
1411. If the department receives federal approval to
15implement a waiver under Tit.IV-E of the federal Social
16Security Act to enable providers to serve children who remain
17in the children’s families and communities, for purposes of
18eligibility under the medical assistance program through 25
19years of age, children who participate in the waiver shall be
20considered to be placed in foster care.
2112. Of the funds appropriated in this section, $4,025,167 is
22allocated for the preparation for adult living program pursuant
23to section 234.46.
2413. Of the funds appropriated in this section, $227,337
25shall be used for the public purpose of continuing a grant to
26a nonprofit human services organization providing services to
27individuals and families in multiple locations in southwest
28Iowa and Nebraska for support of a project providing immediate,
29sensitive support and forensic interviews, medical exams, needs
30assessments, and referrals for victims of child abuse and their
31nonoffending family members.
3214. Of the funds appropriated in this section, $300,620
33is allocated for the foster care youth council approach of
34providing a support network to children placed in foster care.
3515. Of the funds appropriated in this section, $202,000 is
-34-1allocated for use pursuant to section 235A.1 for continuation
2of the initiative to address child sexual abuse implemented
3pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
421.
516. Of the funds appropriated in this section, $630,240 is
6allocated for the community partnership for child protection
7sites.
817. Of the funds appropriated in this section, $371,250
9is allocated for the department’s minority youth and family
10projects under the redesign of the child welfare system.
1118. Of the funds appropriated in this section, $851,595
12is allocated for funding of the community circle of care
13collaboration for children and youth in northeast Iowa.
1419. Of the funds appropriated in this section, at least
15$147,158 shall be used for the continuation of the child
16welfare provider training academy, a collaboration between the
17coalition for family and children’s services in Iowa and the
18department.
1920. Of the funds appropriated in this section, $211,872
20shall be used for continuation of the central Iowa system of
21care program grant through June 30, 2020.
2221. Of the funds appropriated in this section, $235,000
23shall be used for the public purpose of the continuation
24and expansion of a system of care program grant implemented
25in Cerro Gordo and Linn counties to utilize a comprehensive
26and long-term approach for helping children and families by
27addressing the key areas in a child’s life of childhood basic
28needs, education and work, family, and community.
2922. Of the funds appropriated in this section, $110,000
30shall be used for the public purpose of funding community-based
31services and other supports with a system of care approach
32for children with a serious emotional disturbance and their
33families through a nonprofit provider of child welfare services
34that has been in existence for more than 115 years, is located
35in a county with a population of more than 200,000 but less
-35-1than 220,000 according to the latest certified federal census,
2is licensed as a psychiatric medical institution for children,
3and was a system of care grantee prior to July 1, 2019.
423. If a separate funding source is identified that reduces
5the need for state funds within an allocation under this
6section, the allocated state funds may be redistributed to
7other allocations under this section for the same fiscal year.
8 Sec. 19. ADOPTION SUBSIDY.
91. There is appropriated from the general fund of the
10state to the department of human services for the fiscal year
11beginning July 1, 2019, and ending June 30, 2020, the following
12amount, or so much thereof as is necessary, to be used for the
13purpose designated:
14a. For adoption subsidy payments and services:
.................................................. $1540,596,007
16b. (1) The funds appropriated in this section shall be used
17as authorized or allowed by federal law or regulation for any
18of the following purposes:
19(a) For adoption subsidy payments and related costs.
20(b) For post-adoption services and for other purposes under
21Tit.IV-B or Tit.IV-E of the federal Social Security Act.
22(2) The department of human services may transfer funds
23appropriated in this subsection to the appropriation for
24child and family services in this Act for the purposes of
25post-adoption services as specified in this paragraph “b”.
26c. Notwithstanding section 8.33, moneys corresponding to
27the state savings resulting from implementation of the federal
28Fostering Connections to Success and Increasing Adoptions Act
29of 2008, Pub.L. No.110-351, and successor legislation, as
30determined in accordance with 42 U.S.C.§673(a)(8), that remain
31unencumbered or unobligated at the close of the fiscal year,
32shall not revert to any fund but shall remain available for the
33purposes designated in this subsection until expended. The
34amount of such savings and any corresponding funds remaining
35at the close of the fiscal year shall be determined separately
-36-1and any changes in either amount between fiscal years shall not
2result in an unfunded need.
32. The department may transfer funds appropriated in
4this section to the appropriation made in this division of
5this Act for general administration for costs paid from the
6appropriation relating to adoption subsidy.
73. Federal funds received by the state during the
8fiscal year beginning July 1, 2019, as the result of the
9expenditure of state funds during a previous state fiscal
10year for a service or activity funded under this section are
11appropriated to the department to be used as additional funding
12for the services and activities funded under this section.
13Notwithstanding section 8.33, moneys received in accordance
14with this subsection that remain unencumbered or unobligated
15at the close of the fiscal year shall not revert to any fund
16but shall remain available for expenditure for the purposes
17designated until the close of the succeeding fiscal year.
18 Sec. 20. JUVENILE DETENTION HOME FUND. Moneys deposited
19in the juvenile detention home fund created in section 232.142
20during the fiscal year beginning July 1, 2019, and ending June
2130, 2020, are appropriated to the department of human services
22for the fiscal year beginning July 1, 2019, and ending June 30,
232020, for distribution of an amount equal to a percentage of
24the costs of the establishment, improvement, operation, and
25maintenance of county or multicounty juvenile detention homes
26in the fiscal year beginning July 1, 2018. Moneys appropriated
27for distribution in accordance with this section shall be
28allocated among eligible detention homes, prorated on the basis
29of an eligible detention home’s proportion of the costs of all
30eligible detention homes in the fiscal year beginning July
311, 2018. The percentage figure shall be determined by the
32department based on the amount available for distribution for
33the fund. Notwithstanding section 232.142, subsection 3, the
34financial aid payable by the state under that provision for the
35fiscal year beginning July 1, 2019, shall be limited to the
-37-1amount appropriated for the purposes of this section.
2 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2019, and ending June 30, 2020, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8For the family support subsidy program subject to the
9enrollment restrictions in section 225C.37, subsection 3:
.................................................. $10949,282
112. At least $819,275 of the moneys appropriated in this
12section is transferred to the department of public health for
13the family support center component of the comprehensive family
14support program under chapter 225C, subchapter V.
153. If at any time during the fiscal year, the amount of
16funding available for the family support subsidy program
17is reduced from the amount initially used to establish the
18figure for the number of family members for whom a subsidy
19is to be provided at any one time during the fiscal year,
20notwithstanding section 225C.38, subsection 2, the department
21shall revise the figure as necessary to conform to the amount
22of funding available.
23 Sec. 22. CONNER DECREE. There is appropriated from the
24general fund of the state to the department of human services
25for the fiscal year beginning July 1, 2019, and ending June 30,
262020, the following amount, or so much thereof as is necessary,
27to be used for the purpose designated:
28For building community capacity through the coordination
29and provision of training opportunities in accordance with the
30consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
31Iowa, July 14, 1994):
.................................................. $3233,632
33 Sec. 23. MENTAL HEALTH INSTITUTES.
341. There is appropriated from the general fund of the
35state to the department of human services for the fiscal year
-38-1beginning July 1, 2019, and ending June 30, 2020, the following
2amounts, or so much thereof as is necessary, to be used for the
3purposes designated:
4a. For operation of the state mental health institute at
5Cherokee as required by chapters 218 and 226 for salaries,
6support, maintenance, and miscellaneous purposes:
.................................................. $714,216,149
8b. For operation of the state mental health institute at
9Independence as required by chapters 218 and 226 for salaries,
10support, maintenance, and miscellaneous purposes:
.................................................. $1119,165,110
122. Notwithstanding sections 218.78 and 249A.11, any revenue
13received from the state mental health institute at Cherokee or
14the state mental health institute at Independence pursuant to
1542 C.F.R§438.6(e) may be retained and expended by the mental
16health institute.
173. Notwithstanding any provision of law to the contrary,
18a Medicaid member residing at the state mental health
19institute at Cherokee or the state mental health institute
20at Independence shall retain Medicaid eligibility during
21the period of the Medicaid member’s stay for which federal
22financial participation is available.
23 Sec. 24. STATE RESOURCE CENTERS.
241. There is appropriated from the general fund of the
25state to the department of human services for the fiscal year
26beginning July 1, 2019, and ending June 30, 2020, the following
27amounts, or so much thereof as is necessary, to be used for the
28purposes designated:
29a. For the state resource center at Glenwood for salaries,
30support, maintenance, and miscellaneous purposes:
.................................................. $3116,048,348
32b. For the state resource center at Woodward for salaries,
33support, maintenance, and miscellaneous purposes:
.................................................. $3410,872,356
352. The department may continue to bill for state resource
-39-1center services utilizing a scope of services approach used for
2private providers of intermediate care facilities for persons
3with an intellectual disability services, in a manner which
4does not shift costs between the medical assistance program,
5counties, or other sources of funding for the state resource
6centers.
73. The state resource centers may expand the time-limited
8assessment and respite services during the fiscal year.
94. If the department’s administration and the department
10of management concur with a finding by a state resource
11center’s superintendent that projected revenues can reasonably
12be expected to pay the salary and support costs for a new
13employee position, or that such costs for adding a particular
14number of new positions for the fiscal year would be less
15than the overtime costs if new positions would not be added,
16the superintendent may add the new position or positions. If
17the vacant positions available to a resource center do not
18include the position classification desired to be filled, the
19state resource center’s superintendent may reclassify any
20vacant position as necessary to fill the desired position. The
21superintendents of the state resource centers may, by mutual
22agreement, pool vacant positions and position classifications
23during the course of the fiscal year in order to assist one
24another in filling necessary positions.
255. If existing capacity limitations are reached in
26operating units, a waiting list is in effect for a service or
27a special need for which a payment source or other funding
28is available for the service or to address the special need,
29and facilities for the service or to address the special need
30can be provided within the available payment source or other
31funding, the superintendent of a state resource center may
32authorize opening not more than two units or other facilities
33and begin implementing the service or addressing the special
34need during fiscal year 2019-2020.
35 Sec. 25. SEXUALLY VIOLENT PREDATORS.
-40- 11. There is appropriated from the general fund of the
2state to the department of human services for the fiscal year
3beginning July 1, 2019, and ending June 30, 2020, the following
4amount, or so much thereof as is necessary, to be used for the
5purpose designated:
6For costs associated with the commitment and treatment of
7sexually violent predators in the unit located at the state
8mental health institute at Cherokee, including costs of legal
9services and other associated costs, including salaries,
10support, maintenance, and miscellaneous purposes:
.................................................. $1112,053,093
122. Unless specifically prohibited by law, if the amount
13charged provides for recoupment of at least the entire amount
14of direct and indirect costs, the department of human services
15may contract with other states to provide care and treatment
16of persons placed by the other states at the unit for sexually
17violent predators at Cherokee. The moneys received under
18such a contract shall be considered to be repayment receipts
19and used for the purposes of the appropriation made in this
20section.
21 Sec. 26. FIELD OPERATIONS. There is appropriated from the
22general fund of the state to the department of human services
23for the fiscal year beginning July 1, 2019, and ending June 30,
242020, the following amount, or so much thereof as is necessary,
25to be used for the purposes designated:
26For field operations, including salaries, support,
27maintenance, and miscellaneous purposes:
.................................................. $2853,923,195
29Priority in filling full-time equivalent positions shall be
30given to those positions related to child protection services
31and eligibility determination for low-income families.
32 Sec. 27. GENERAL ADMINISTRATION. There is appropriated
33from the general fund of the state to the department of human
34services for the fiscal year beginning July 1, 2019, and ending
35June 30, 2020, the following amount, or so much thereof as is
-41-1necessary, to be used for the purpose designated:
2For general administration, including salaries, support,
3maintenance, and miscellaneous purposes:
.................................................. $413,833,040
51. The department shall report at least monthly to the
6legislative services agency concerning the department’s
7operational and program expenditures.
82. Of the funds appropriated in this section, $150,000 shall
9be used to continue the contract for the provision of a program
10to provide technical assistance, support, and consultation to
11providers of habilitation services and home and community-based
12services waiver services for adults with disabilities under the
13medical assistance program.
143. Of the funds appropriated in this section, $50,000
15is transferred to the Iowa finance authority to be used
16for administrative support of the council on homelessness
17established in section 16.2D and for the council to fulfill its
18duties in addressing and reducing homelessness in the state.
194. Of the funds appropriated in this section, $200,000 shall
20be transferred to and deposited in the administrative fund of
21the Iowa ABLE savings plan trust created in section 12I.4, to
22be used for implementation and administration activities of the
23Iowa ABLE savings plan trust.
245. Of the funds appropriated in this section, $200,000 is
25transferred to the economic development authority for the Iowa
26commission on volunteer services to continue to be used for
27RefugeeRISE AmeriCorps program established under section 15H.8
28for member recruitment and training to improve the economic
29well-being and health of economically disadvantaged refugees in
30local communities across Iowa. Funds transferred may be used
31to supplement federal funds under federal regulations.
326. Of the funds appropriated in this section, up to $300,000
33shall be used as follows:
34a. To fund not more than one full-time equivalent position
35to address the department’s responsibility to support the work
-42-1of the children’s system state board and implementation of the
2services required pursuant to 2018 Iowa Acts, chapter 1056,
3section 13.
4b. To support the cost of establishing and implementing new
5or additional services required pursuant to 2018 Iowa Acts,
6chapter 1056, and any legislation enacted by the 2019 general
7assembly establishing a children’s mental health system.
8c. Of the amount, $32,000 shall be transferred to
9the department of public health to support the costs of
10establishing and implementing new or additional services
11required pursuant to 2018 Iowa Acts, chapter 1056, and any
12legislation enacted by the 2019 general assembly establishing a
13children’s mental health system.
14 Sec. 28. DEPARTMENT-WIDE DUTIES. There is appropriated
15from the general fund of the state to the department of human
16services for the fiscal year beginning July 1, 2019, and ending
17June 30, 2020, the following amount, or so much thereof as is
18necessary, to be used for the purposes designated:
19For salaries, support, maintenance, and miscellaneous
20purposes at facilities under the purview of the department of
21human services:
.................................................. $222,879,274
23 Sec. 29. CORPORATE TECHNOLOGY. There is appropriated
24from the general fund of the state to the department of human
25services for the fiscal year beginning July 1, 2019, and ending
26June 30, 2020, the following amount, or so much thereof as is
27necessary, to be used for the purposes designated:
28For the purchase of department-wide technology and software
29update needs:
.................................................. $302,530,413
31 Sec. 30. VOLUNTEERS. There is appropriated from the general
32fund of the state to the department of human services for the
33fiscal year beginning July 1, 2019, and ending June 30, 2020,
34the following amount, or so much thereof as is necessary, to be
35used for the purpose designated:
-43- 1For development and coordination of volunteer services:
.................................................. $284,686
3 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
4ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
5DEPARTMENT OF HUMAN SERVICES.
61. a. (1) (a) For the fiscal year beginning July 1,
72019, the department shall rebase case-mix nursing facility
8rates effective July 1, 2019, to the extent possible within the
9state funding, including the $8,479,942, appropriated for this
10purpose.
11(b) For the fiscal year beginning July 1, 2019, non-case-mix
12and special population nursing facilities shall be reimbursed
13in accordance with the methodology in effect on June 30 of the
14prior fiscal year.
15(c) For managed care claims, the department of human
16services shall adjust the payment rate floor for nursing
17facilities, annually, to maintain a rate floor that is no
18lower than the Medicaid fee-for-service case-mix adjusted
19rate calculated in accordance with subparagraph division
20(a) and 441 IAC 81.6. The department shall then calculate
21adjusted reimbursement rates, including but not limited to
22add-on-payments, annually, and shall notify Medicaid managed
23care organizations of the adjusted reimbursement rates within
2430 days of determining the adjusted reimbursement rates. Any
25adjustment of reimbursement rates under this subparagraph
26division shall be budget neutral to the state budget.
27(d) For the fiscal year beginning July 1, 2019, Medicaid
28managed care long-term services and supports capitation
29rates shall be adjusted to reflect the rebasing pursuant to
30subparagraph division (a) for the patient populations residing
31in Medicaid-certified nursing facilities.
32(2) Medicaid managed care organizations shall adjust
33facility-specific rates based upon payment rate listings issued
34by the department. The rate adjustments shall be applied
35retroactively based upon the effective date of the rate letter
-44-1issued by the department. A Medicaid managed care organization
2shall honor all retroactive rate adjustments including when
3specific provider rates are delayed or amended.
4b. (1) For the fiscal year beginning July 1, 2019,
5the department shall establish the pharmacy dispensing fee
6reimbursement at $10.07 per prescription, until a cost of
7dispensing survey is completed. The actual dispensing fee
8shall be determined by a cost of dispensing survey performed
9by the department and required to be completed by all medical
10assistance program participating pharmacies every two years,
11adjusted as necessary to maintain expenditures within the
12amount appropriated to the department for this purpose for the
13fiscal year.
14(2) The department shall utilize an average acquisition
15cost reimbursement methodology for all drugs covered under the
16medical assistance program in accordance with 2012 Iowa Acts,
17chapter 1133, section 33.
18c. (1) For the fiscal year beginning July 1, 2019,
19reimbursement rates for outpatient hospital services shall
20remain at the rates in effect on June 30, 2019, subject to
21Medicaid program upper payment limit rules, and adjusted
22as necessary to maintain expenditures within the amount
23appropriated to the department for this purpose for the fiscal
24year.
25(2) For the fiscal year beginning July 1, 2019,
26reimbursement rates for inpatient hospital services shall
27remain at the rates in effect on June 30, 2019, subject to
28Medicaid program upper payment limit rules, and adjusted
29as necessary to maintain expenditures within the amount
30appropriated to the department for this purpose for the fiscal
31year.
32(3) For the fiscal year beginning July 1, 2019, the graduate
33medical education and disproportionate share hospital fund
34shall remain at the amount in effect on June 30, 2019, except
35that the portion of the fund attributable to graduate medical
-45-1education shall be reduced in an amount that reflects the
2elimination of graduate medical education payments made to
3out-of-state hospitals.
4(4) In order to ensure the efficient use of limited state
5funds in procuring health care services for low-income Iowans,
6funds appropriated in this Act for hospital services shall
7not be used for activities which would be excluded from a
8determination of reasonable costs under the federal Medicare
9program pursuant to 42 U.S.C.§1395x(v)(1)(N).
10d. For the fiscal year beginning July 1, 2019, reimbursement
11rates for hospices and acute mental hospitals shall be
12increased in accordance with increases under the federal
13Medicare program or as supported by their Medicare audited
14costs.
15e. For the fiscal year beginning July 1, 2019, independent
16laboratories and rehabilitation agencies shall be reimbursed
17using the same methodology in effect on June 30, 2019.
18f. (1) For the fiscal year beginning July 1, 2019,
19reimbursement rates for home health agencies shall be rebased,
20to the extent possible, within the state funding appropriated
21for this purpose, and shall continue to be based on the
22Medicare low utilization payment adjustment (LUPA) methodology
23with state geographic wage adjustments to reflect the most
24recent Medicare LUPA rates to the extent possible within the
25state funding appropriated for this purpose.
26(2) For the fiscal year beginning July 1, 2019, rates for
27private duty nursing and personal care services under the early
28and periodic screening, diagnostic, and treatment program
29benefit shall be calculated based on the methodology in effect
30on June 30, 2019.
31g. For the fiscal year beginning July 1, 2019, federally
32qualified health centers and rural health clinics shall receive
33cost-based reimbursement for 100 percent of the reasonable
34costs for the provision of services to recipients of medical
35assistance.
-46- 1h. For the fiscal year beginning July 1, 2019, the
2reimbursement rates for dental services shall remain at the
3rates in effect on June 30, 2019.
4i. (1) For the fiscal year beginning July 1, 2019,
5reimbursement rates for non-state-owned psychiatric medical
6institutions for children shall be based on the reimbursement
7methodology in effect on June 30, 2019.
8(2) As a condition of participation in the medical
9assistance program, enrolled providers shall accept the medical
10assistance reimbursement rate for any covered goods or services
11provided to recipients of medical assistance who are children
12under the custody of a psychiatric medical institution for
13children.
14j. For the fiscal year beginning July 1, 2019, unless
15otherwise specified in this Act, all noninstitutional medical
16assistance provider reimbursement rates shall remain at the
17rates in effect on June 30, 2019, except for area education
18agencies, local education agencies, infant and toddler
19services providers, home and community-based services providers
20including consumer-directed attendant care providers under a
21section 1915(c) or 1915(i) waiver, targeted case management
22providers, and those providers whose rates are required to be
23determined pursuant to section 249A.20, or to meet federal
24mental health parity requirements.
25k. Notwithstanding any provision to the contrary, for the
26fiscal year beginning July 1, 2019, the reimbursement rate for
27anesthesiologists shall remain at the rates in effect on June
2830, 2019, and updated on January 1, 2020, to align with the
29most current Iowa Medicare anesthesia rate.
30l. Notwithstanding section 249A.20, for the fiscal year
31beginning July 1, 2019, the average reimbursement rate for
32health care providers eligible for use of the federal Medicare
33resource-based relative value scale reimbursement methodology
34under section 249A.20 shall remain at the rate in effect on
35June 30, 2019; however, this rate shall not exceed the maximum
-47-1level authorized by the federal government.
2m. For the fiscal year beginning July 1, 2019, the
3reimbursement rate for residential care facilities shall not
4be less than the minimum payment level as established by the
5federal government to meet the federally mandated maintenance
6of effort requirement. The flat reimbursement rate for
7facilities electing not to file annual cost reports shall not
8be less than the minimum payment level as established by the
9federal government to meet the federally mandated maintenance
10of effort requirement.
11n. For the fiscal year beginning July 1, 2019, the
12reimbursement rates for inpatient mental health services
13provided at hospitals shall remain at the rates in effect on
14June 30, 2019, subject to Medicaid program upper payment limit
15rules; and psychiatrists shall be reimbursed at the medical
16assistance program fee-for-service rate in effect on June 30,
172019.
18o. For the fiscal year beginning July 1, 2019, community
19mental health centers may choose to be reimbursed for the
20services provided to recipients of medical assistance through
21either of the following options:
22(1) For 100 percent of the reasonable costs of the services.
23(2) In accordance with the alternative reimbursement rate
24methodology approved by the department of human services in
25effect on June 30, 2019.
26p. For the fiscal year beginning July 1, 2019, the
27reimbursement rate for providers of family planning services
28that are eligible to receive a 90 percent federal match shall
29remain at the rates in effect on June 30, 2019.
30q. Unless otherwise subject to a tiered rate methodology,
31for the fiscal year beginning July 1, 2019, the upper
32limits and reimbursement rates for providers of home and
33community-based services waiver services shall be reimbursed
34using the reimbursement methodology in effect on June 30, 2019.
35r. For the fiscal year beginning July 1, 2019, the
-48-1reimbursement rates for emergency medical service providers
2shall remain at the rates in effect on June 30, 2019.
3s. For the fiscal year beginning July 1, 2019, reimbursement
4rates for substance-related disorder treatment programs
5licensed under section 125.13 shall remain at the rates in
6effect on June 30, 2019.
72. For the fiscal year beginning July 1, 2019, the
8reimbursement rate for providers reimbursed under the
9in-home-related care program shall not be less than the minimum
10payment level as established by the federal government to meet
11the federally mandated maintenance of effort requirement.
123. Unless otherwise directed in this section, when the
13department’s reimbursement methodology for any provider
14reimbursed in accordance with this section includes an
15inflation factor, this factor shall not exceed the amount
16by which the consumer price index for all urban consumers
17increased during the calendar year ending December 31, 2002.
184. Notwithstanding section 234.38, for the fiscal
19year beginning July 1, 2019, the foster family basic daily
20maintenance rate and the maximum adoption subsidy rate for
21children ages 0 through 5 years shall be $16.78, the rate for
22children ages 6 through 11 years shall be $17.45, the rate for
23children ages 12 through 15 years shall be $19.10, and the
24rate for children and young adults ages 16 and older shall
25be $19.35. For youth ages 18 to 21 who have exited foster
26care, the preparation for adult living program maintenance rate
27shall be $602.70 per month. The maximum payment for adoption
28subsidy nonrecurring expenses shall be limited to $500 and the
29disallowance of additional amounts for court costs and other
30related legal expenses implemented pursuant to 2010 Iowa Acts,
31chapter 1031, section 408, shall be continued.
325. For the fiscal year beginning July 1, 2019, the maximum
33reimbursement rates for social services providers under
34contract shall remain at the rates in effect on June 30, 2019,
35or the provider’s actual and allowable cost plus inflation for
-49-1each service, whichever is less. However, if a new service
2or service provider is added after June 30, 2019, the initial
3reimbursement rate for the service or provider shall be based
4upon a weighted average of provider rates for similar services.
56. a. For the fiscal year beginning July 1, 2019, the
6reimbursement rates for resource family recruitment and
7retention contractors shall be established by contract.
8b. For the fiscal year beginning July 1, 2019, the
9reimbursement rates for supervised apartment living foster care
10providers shall be established by contract.
117. For the fiscal year beginning July 1, 2019, the
12reimbursement rate for group foster care providers shall be the
13combined service and maintenance reimbursement rate established
14by contract.
158. The group foster care reimbursement rates paid for
16placement of children out of state shall be calculated
17according to the same rate-setting principles as those used for
18in-state providers, unless the director of human services or
19the director’s designee determines that appropriate care cannot
20be provided within the state. The payment of the daily rate
21shall be based on the number of days in the calendar month in
22which service is provided.
239. a. For the fiscal year beginning July 1, 2019, the
24reimbursement rate paid for shelter care and the child welfare
25emergency services implemented to provide or prevent the need
26for shelter care shall be established by contract.
27b. For the fiscal year beginning July 1, 2019, the combined
28service and maintenance components of the reimbursement rate
29paid for shelter care services shall be based on the financial
30and statistical report submitted to the department. The
31maximum reimbursement rate shall be $101.83 per day. The
32department shall reimburse a shelter care provider at the
33provider’s actual and allowable unit cost, plus inflation, not
34to exceed the maximum reimbursement rate.
35c. Notwithstanding section 232.141, subsection 8, for the
-50-1fiscal year beginning July 1, 2019, the amount of the statewide
2average of the actual and allowable rates for reimbursement of
3juvenile shelter care homes that is utilized for the limitation
4on recovery of unpaid costs shall remain at the amount in
5effect for this purpose in the fiscal year beginning July 1,
62018.
710. For the fiscal year beginning July 1, 2019, the
8department shall calculate reimbursement rates for intermediate
9care facilities for persons with an intellectual disability
10at the 80th percentile. Beginning July 1, 2019, the rate
11calculation methodology shall utilize the consumer price index
12inflation factor applicable to the fiscal year beginning July
131, 2019.
1411. Effective July 1, 2019, the child care provider
15reimbursement rates shall remain at the rates in effect on June
1630, 2019. The department shall set rates in a manner so as
17to provide incentives for a nonregistered provider to become
18registered by applying any increase only to registered and
19licensed providers.
2012. The department may adopt emergency rules to implement
21this section.
22 Sec. 32. TRANSFER OF MEDICAID MANAGED CARE SAVINGS BETWEEN
23APPROPRIATIONS — FY 2019-2020. Notwithstanding section 8.39,
24subsection 1, for the fiscal year beginning July 1, 2019,
25and ending June 30, 2020, if savings resulting from Medicaid
26managed care initiatives accrue to the medical contracts or
27children’s health insurance program appropriation from the
28general fund of the state and not to the medical assistance
29appropriation from the general fund of the state under this
30division of this Act, such savings may be transferred to such
31medical assistance appropriation for the same fiscal year
32without prior written consent and approval of the governor and
33the director of the department of management. The department
34of human services shall report any transfers made pursuant to
35this section to the legislative services agency.
-51-1 Sec. 33. EMERGENCY RULES.
21. If specifically authorized by a provision of this
3division of this Act, the department of human services or
4the mental health and disability services commission may
5adopt administrative rules under section 17A.4, subsection
63, and section 17A.5, subsection 2, paragraph “b”, to
7implement the provisions of this division of this Act and
8the rules shall become effective immediately upon filing or
9on a later effective date specified in the rules, unless the
10effective date of the rules is delayed or the applicability
11of the rules is suspended by the administrative rules review
12committee. Any rules adopted in accordance with this section
13shall not take effect before the rules are reviewed by the
14administrative rules review committee. The delay authority
15provided to the administrative rules review committee under
16section 17A.4, subsection 7, and section 17A.8, subsection 9,
17shall be applicable to a delay imposed under this section,
18notwithstanding a provision in those sections making them
19inapplicable to section 17A.5, subsection 2, paragraph “b”.
20Any rules adopted in accordance with the provisions of this
21section shall also be published as a notice of intended action
22as provided in section 17A.4.
232. If during a fiscal year, the department of human
24services is adopting rules in accordance with this section
25or as otherwise directed or authorized by state law, and the
26rules will result in an expenditure increase beyond the amount
27anticipated in the budget process or if the expenditure was
28not addressed in the budget process for the fiscal year, the
29department shall notify the persons designated by this division
30of this Act for submission of reports, the chairpersons and
31ranking members of the committees on appropriations, and
32the department of management concerning the rules and the
33expenditure increase. The notification shall be provided at
34least 30 calendar days prior to the date notice of the rules
35is submitted to the administrative rules coordinator and the
-52-1administrative code editor.
2 Sec. 34. REPORTS. Any reports or other information
3required to be compiled and submitted under this Act during the
4fiscal year beginning July 1, 2019, shall be submitted to the
5chairpersons and ranking members of the joint appropriations
6subcommittee on health and human services, the legislative
7services agency, and the legislative caucus staffs on or
8before the dates specified for submission of the reports or
9information.
10 Sec. 35. EFFECTIVE UPON ENACTMENT. The following
11provisions of this division of this Act, being deemed of
12immediate importance, take effect upon enactment:
131. The provision relating to section 232.141 and directing
14the state court administrator and the division administrator of
15the department of human services division of child and family
16services to make the determination, by June 15, 2019, of the
17distribution of funds allocated for the payment of the expenses
18of court-ordered services provided to juveniles which are a
19charge upon the state.
20DIVISION VI
21HEALTH CARE ACCOUNTS AND FUNDS — FY 2019-2020
22 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
23appropriated from the pharmaceutical settlement account created
24in section 249A.33 to the department of human services for the
25fiscal year beginning July 1, 2019, and ending June 30, 2020,
26the following amount, or so much thereof as is necessary, to be
27used for the purpose designated:
28Notwithstanding any provision of law to the contrary, to
29supplement the appropriations made in this Act for medical
30contracts under the medical assistance program for the fiscal
31year beginning July 1, 2019, and ending June 30, 2020:
.................................................. $32234,193
33 Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
34SERVICES. Notwithstanding any provision to the contrary and
35subject to the availability of funds, there is appropriated
-53-1from the quality assurance trust fund created in section
2249L.4 to the department of human services for the fiscal year
3beginning July 1, 2019, and ending June 30, 2020, the following
4amounts, or so much thereof as is necessary, for the purposes
5designated:
6To supplement the appropriation made in this Act from the
7general fund of the state to the department of human services
8for medical assistance for the same fiscal year:
.................................................. $958,570,397
10 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
11DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
12the contrary and subject to the availability of funds, there is
13appropriated from the hospital health care access trust fund
14created in section 249M.4 to the department of human services
15for the fiscal year beginning July 1, 2019, and ending June
1630, 2020, the following amounts, or so much thereof as is
17necessary, for the purposes designated:
18To supplement the appropriation made in this Act from the
19general fund of the state to the department of human services
20for medical assistance for the same fiscal year:
.................................................. $2133,920,554
22 Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
23FOR FY 2019-2020. Notwithstanding section 8.33, if moneys
24appropriated for purposes of the medical assistance program for
25the fiscal year beginning July 1, 2019, and ending June 30,
262020, from the general fund of the state, the quality assurance
27trust fund and the hospital health care access trust fund, are
28in excess of actual expenditures for the medical assistance
29program and remain unencumbered or unobligated at the close
30of the fiscal year, the excess moneys shall not revert but
31shall remain available for expenditure for the purposes of the
32medical assistance program until the close of the succeeding
33fiscal year.
34DIVISION VII
35DEPARTMENT ON AGING — FY 2020-2021
-54-1 Sec. 40. DEPARTMENT ON AGING. There is appropriated from
2the general fund of the state to the department on aging for
3the fiscal year beginning July 1, 2020, and ending June 30,
42021, the following amount, or so much thereof as is necessary,
5to be used for the purposes designated:
6For aging programs for the department on aging and area
7agencies on aging to provide citizens of Iowa who are 60 years
8of age and older with case management for frail elders, Iowa’s
9aging and disabilities resource center, and other services
10which may include but are not limited to adult day services,
11respite care, chore services, information and assistance,
12and material aid, for information and options counseling for
13persons with disabilities who are 18 years of age or older,
14and for salaries, support, administration, maintenance, and
15miscellaneous purposes:
.................................................. $1611,042,924
171. Funds appropriated in this section may be used to
18supplement federal funds under federal regulations. To
19receive funds appropriated in this section, a local area
20agency on aging shall match the funds with moneys from other
21sources according to rules adopted by the department. Funds
22appropriated in this section may be used for elderly services
23not specifically enumerated in this section only if approved
24by an area agency on aging for provision of the service within
25the area.
262. Of the funds appropriated in this section, $279,946 is
27transferred to the economic development authority for the Iowa
28commission on volunteer services to be used for the retired and
29senior volunteer program.
303. a. The department on aging shall establish and enforce
31procedures relating to expenditure of state and federal funds
32by area agencies on aging that require compliance with both
33state and federal laws, rules, and regulations, including but
34not limited to all of the following:
35(1) Requiring that expenditures are incurred only for goods
-55-1or services received or performed prior to the end of the
2fiscal period designated for use of the funds.
3(2) Prohibiting prepayment for goods or services not
4received or performed prior to the end of the fiscal period
5designated for use of the funds.
6(3) Prohibiting the prepayment for goods or services
7not defined specifically by good or service, time period, or
8recipient.
9(4) Prohibiting the establishment of accounts from which
10future goods or services which are not defined specifically by
11good or service, time period, or recipient, may be purchased.
12b. The procedures shall provide that if any funds are
13expended in a manner that is not in compliance with the
14procedures and applicable federal and state laws, rules, and
15regulations, and are subsequently subject to repayment, the
16area agency on aging expending such funds in contravention of
17such procedures, laws, rules and regulations, not the state,
18shall be liable for such repayment.
194. Of the funds appropriated in this section, at least
20$600,000 shall be used to fund home and community-based
21services through the area agencies on aging that enable older
22individuals to avoid more costly utilization of residential or
23institutional services and remain in their own homes.
245. Of the funds appropriated in this section, $812,537 shall
25be used for the purposes of chapter 231E and to administer
26the prevention of elder abuse, neglect, and exploitation
27program pursuant to section 231.56A, in accordance with the
28requirements of the federal Older Americans Act of 1965, 42
29U.S.C. §3001 et seq., as amended.
306. Of the funds appropriated in this section, $1,000,000
31shall be used to fund continuation of the aging and disability
32resource center lifelong links to provide individuals and
33caregivers with information and services to plan for and
34maintain independence.
357. Of the funds appropriated in this section, $100,000
-56-1shall be used by the department on aging, in collaboration with
2the department of human services and affected stakeholders, to
3continue the pilot initiative to provide long-term care options
4counseling utilizing support planning protocols, to assist
5non-Medicaid eligible consumers who indicate a preference
6to return to the community and are deemed appropriate for
7discharge, to return to their community following a nursing
8facility stay.
9DIVISION VIII
10OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2020-2021
11 Sec. 41. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
12appropriated from the general fund of the state to the office
13of long-term care ombudsman for the fiscal year beginning July
141, 2020, and ending June 30, 2021, the following amount, or
15so much thereof as is necessary, to be used for the purposes
16designated:
17For salaries, support, administration, maintenance, and
18miscellaneous purposes:
.................................................. $191,149,821
20DIVISION IX
21DEPARTMENT OF PUBLIC HEALTH — FY 2020-2021
22 Sec. 42. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
23from the general fund of the state to the department of public
24health for the fiscal year beginning July 1, 2020, and ending
25June 30, 2021, the following amounts, or so much thereof as is
26necessary, to be used for the purposes designated:
271. ADDICTIVE DISORDERS
28For reducing the prevalence of the use of tobacco, alcohol,
29and other drugs, and treating individuals affected by addictive
30behaviors, including gambling:
.................................................. $3125,049,544
32a. Of the funds appropriated in this subsection, $4,021,225
33shall be used for the tobacco use prevention and control
34initiative, including efforts at the state and local levels,
35as provided in chapter 142A. The commission on tobacco use
-57-1prevention and control established pursuant to section 142A.3
2shall advise the director of public health in prioritizing
3funding needs and the allocation of moneys appropriated for
4the programs and initiatives. Activities of the programs
5and initiatives shall be in alignment with the United States
6centers for disease control and prevention best practices
7for comprehensive tobacco control programs that include
8the goals of preventing youth initiation of tobacco usage,
9reducing exposure to secondhand smoke, and promotion of tobacco
10cessation.
11b. (1) Of the funds appropriated in this subsection,
12$21,028,319 shall be used for problem gambling and
13substance-related disorder prevention, treatment, and recovery
14services, including a 24-hour helpline, public information
15resources, professional training, youth prevention, and program
16evaluation.
17(2) Of the amount allocated under this paragraph, not
18more than $245,200 shall be utilized by the department of
19public health, in collaboration with the department of human
20services, to support establishment and maintenance of a single
21statewide 24-hour crisis hotline for the Iowa children’s mental
22health system that incorporates warmline services which may be
23provided through expansion of existing capabilities maintained
24by the department of public health as required pursuant to 2018
25Iowa Acts, chapter 1056, section 16.
26c. The requirement of section 123.17, subsection 5, is met
27by the appropriations and allocations made in this division of
28this Act for purposes of substance-related disorder treatment
29and addictive disorders for the fiscal year beginning July 1,
302020.
312. HEALTHY CHILDREN AND FAMILIES
32For promoting the optimum health status for children,
33adolescents from birth through 21 years of age, and families:
.................................................. $345,820,625
353. CHRONIC CONDITIONS
-58- 1For serving individuals identified as having chronic
2conditions or special health care needs:
.................................................. $34,228,109
44. COMMUNITY CAPACITY
5For strengthening the health care delivery system at the
6local level:
.................................................. $74,970,152
8a. Of the funds appropriated in this subsection, $2,000,000
9shall be deposited in the medical residency training account
10created in section 135.175, subsection 5, paragraph “a”, and
11is appropriated from the account to the department of public
12health to be used for the purposes of the medical residency
13training state matching grants program as specified in section
14135.176.
15b. Of the funds appropriated in this subsection, $799,454
16is allocated for the purposes of health care and public health
17workforce initiatives, and of this amount, $250,000 shall be
18used for the public purpose of providing funding to Des Moines
19university to continue a provider education project to provide
20primary care physicians with the training and skills necessary
21to recognize the signs of mental illness in patients.
225. ESSENTIAL PUBLIC HEALTH SERVICES
23a. To provide public health services that reduce risks
24and invest in promoting and protecting good health over the
25course of a lifetime with a priority given to older Iowans and
26vulnerable populations:
.................................................. $277,962,464
28b. Of the funds appropriated in this subsection, $300,000 is
29allocated for performance improvement activities.
306. INFECTIOUS DISEASES
31For reducing the incidence and prevalence of communicable
32diseases:
.................................................. $331,796,426
347. PUBLIC PROTECTION
35a. For protecting the health and safety of the public
-59-1through establishing standards and enforcing regulations:
.................................................. $24,095,139
3b. Of the funds appropriated in this subsection, not more
4than $304,700 shall be credited to the emergency medical
5services fund created in section 135.25. Moneys in the
6emergency medical services fund are appropriated to the
7department to be used for the purposes of the fund.
88. RESOURCE MANAGEMENT
9For establishing and sustaining the overall ability of the
10department to deliver services to the public:
.................................................. $11971,215
129. MISCELLANEOUS PROVISIONS
13The university of Iowa hospitals and clinics under the
14control of the state board of regents shall not receive
15indirect costs from the funds appropriated in this section.
16The university of Iowa hospitals and clinics billings to the
17department shall be on at least a quarterly basis.
18DIVISION X
19DEPARTMENT OF VETERANS AFFAIRS — FY 2020-2021
20 Sec. 43. DEPARTMENT OF VETERANS AFFAIRS. There is
21appropriated from the general fund of the state to the
22department of veterans affairs for the fiscal year beginning
23July 1, 2020, and ending June 30, 2021, the following amounts,
24or so much thereof as is necessary, to be used for the purposes
25designated:
261. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
27For salaries, support, maintenance, and miscellaneous
28purposes:
.................................................. $291,225,500
302. IOWA VETERANS HOME
31For salaries, support, maintenance, and miscellaneous
32purposes:
.................................................. $337,162,976
34a. The Iowa veterans home billings involving the department
35of human services shall be submitted to the department on at
-60-1least a monthly basis.
2b. Within available resources and in conformance with
3associated state and federal program eligibility requirements,
4the Iowa veterans home may implement measures to provide
5financial assistance to or on behalf of veterans or their
6spouses who are participating in the community reentry program.
7c. The Iowa veterans home expenditure report shall be
8submitted monthly to the legislative services agency.
9d. The Iowa veterans home shall continue to include in the
10annual discharge report applicant information and to provide
11for the collection of demographic information including but not
12limited to the number of individuals applying for admission and
13admitted or denied admittance and the basis for the admission
14or denial; the age, gender, and race of such individuals;
15and the level of care for which such individuals applied for
16admission including residential or nursing level of care.
173. HOME OWNERSHIP ASSISTANCE PROGRAM
18For transfer to the Iowa finance authority for the
19continuation of the home ownership assistance program for
20persons who are or were eligible members of the armed forces of
21the United States, pursuant to section 16.54:
.................................................. $222,000,000
23 Sec. 44. LIMITATION OF COUNTY COMMISSIONS OF VETERAN
24AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the
25standing appropriation in section 35A.16 for the fiscal year
26beginning July 1, 2020, and ending June 30, 2021, the amount
27appropriated from the general fund of the state pursuant to
28that section for the following designated purposes shall not
29exceed the following amount:
30For the county commissions of veteran affairs fund under
31section 35A.16:
.................................................. $32990,000
33DIVISION XI
34DEPARTMENT OF HUMAN SERVICES — FY 2020-2021
35 Sec. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
-61-1GRANT. There is appropriated from the fund created in section
28.41 to the department of human services for the fiscal year
3beginning July 1, 2020, and ending June 30, 2021, from moneys
4received under the federal temporary assistance for needy
5families (TANF) block grant pursuant to the federal Personal
6Responsibility and Work Opportunity Reconciliation Act of 1996,
7Pub.L.No.104-193, and successor legislation, the following
8amounts, or so much thereof as is necessary, to be used for the
9purposes designated:
101. To be credited to the family investment program account
11and used for assistance under the family investment program
12under chapter 239B:
.................................................. $134,524,006
142. To be credited to the family investment program account
15and used for the job opportunities and basic skills (JOBS)
16program and implementing family investment agreements in
17accordance with chapter 239B:
.................................................. $185,412,060
193. To be used for the family development and
20self-sufficiency grant program in accordance with section
21216A.107:
.................................................. $222,898,980
23Notwithstanding section 8.33, moneys appropriated in this
24subsection that remain unencumbered or unobligated at the close
25of the fiscal year shall not revert but shall remain available
26for expenditure for the purposes designated until the close of
27the succeeding fiscal year. However, unless such moneys are
28encumbered or obligated on or before September 30, 2021, the
29moneys shall revert.
304. For field operations:
.................................................. $3131,296,232
325. For general administration:
.................................................. $333,744,000
346. For state child care assistance:
.................................................. $3547,166,826
-62- 1a. Of the funds appropriated in this subsection,
2$26,205,412 is transferred to the child care and development
3block grant appropriation made by the Eighty-eighth General
4Assembly, 2020 session, for the federal fiscal year beginning
5October 1, 2020, and ending September 30, 2021. Of this
6amount, $200,000 shall be used for provision of educational
7opportunities to registered child care home providers in order
8to improve services and programs offered by this category
9of providers and to increase the number of providers. The
10department may contract with institutions of higher education
11or child care resource and referral centers to provide
12the educational opportunities. Allowable administrative
13costs under the contracts shall not exceed 5 percent. The
14application for a grant shall not exceed two pages in length.
15b. Any funds appropriated in this subsection remaining
16unallocated shall be used for state child care assistance
17payments for families who are employed including but not
18limited to individuals enrolled in the family investment
19program.
207. For child and family services:
.................................................. $2132,380,654
228. For child abuse prevention grants:
.................................................. $23125,000
249. For pregnancy prevention grants on the condition that
25family planning services are funded:
.................................................. $261,913,203
27Pregnancy prevention grants shall be awarded to programs
28in existence on or before July 1, 2020, if the programs have
29demonstrated positive outcomes. Grants shall be awarded to
30pregnancy prevention programs which are developed after July
311, 2020, if the programs are based on existing models that
32have demonstrated positive outcomes. Grants shall comply with
33the requirements provided in 1997 Iowa Acts, chapter 208,
34section 14, subsections 1 and 2, including the requirement that
35grant programs must emphasize sexual abstinence. Priority in
-63-1the awarding of grants shall be given to programs that serve
2areas of the state which demonstrate the highest percentage of
3unplanned pregnancies of females of childbearing age within the
4geographic area to be served by the grant.
510. For technology needs and other resources necessary
6to meet federal welfare reform reporting, tracking, and case
7management requirements:
.................................................. $81,037,186
911. a. Notwithstanding any provision to the contrary,
10including but not limited to requirements in section 8.41 or
11provisions in 2019 or 2020 Iowa Acts regarding the receipt and
12appropriation of federal block grants, federal funds from the
13temporary assistance for needy families block grant received by
14the state and not otherwise appropriated in this section and
15remaining available for the fiscal year beginning July 1, 2020,
16are appropriated to the department of human services to the
17extent as may be necessary to be used in the following priority
18order: the family investment program, for state child care
19assistance program payments for families who are employed, and
20for the family investment program share of system costs for
21eligibility determination and related functions. The federal
22funds appropriated in this paragraph “a” shall be expended
23only after all other funds appropriated in subsection 1 for
24assistance under the family investment program, in subsection
256 for state child care assistance, or in subsection 10 for
26technology costs related to the family investment program,
27as applicable, have been expended. For the purposes of this
28subsection, the funds appropriated in subsection 6, paragraph
29“a”, for transfer to the child care and development block grant
30appropriation are considered fully expended when the full
31amount has been transferred.
32b. The department shall, on a quarterly basis, advise the
33legislative services agency and department of management of
34the amount of funds appropriated in this subsection that was
35expended in the prior quarter.
-64- 112. Of the amounts appropriated in this section,
2$12,962,008 for the fiscal year beginning July 1, 2020, is
3transferred to the appropriation of the federal social services
4block grant made to the department of human services for that
5fiscal year.
613. For continuation of the program providing categorical
7eligibility for the food assistance program as specified
8for the program in the section of this division of this Act
9relating to the family investment program account:
.................................................. $1014,236
1114. The department may transfer funds allocated in this
12section to the appropriations made in this division of this Act
13for the same fiscal year for general administration and field
14operations for resources necessary to implement and operate the
15services referred to in this section and those funded in the
16appropriation made in this division of this Act for the same
17fiscal year for the family investment program from the general
18fund of the state.
1915. With the exception of moneys allocated under this
20section for the family development and self-sufficiency grant
21program, to the extent moneys allocated in this section are
22deemed by the department not to be necessary to support the
23purposes for which they are allocated, such moneys may be
24used in the same fiscal year for any other purpose for which
25funds are allocated in this section or in section 46 of this
26division for the family investment program account. If there
27are conflicting needs, priority shall first be given to the
28family investment program account as specified under subsection
291 of this section and used for the purposes of assistance under
30the family investment program under chapter 239B, followed by
31state child care assistance program payments for families who
32are employed, followed by other priorities as specified by the
33department.
34 Sec. 46. FAMILY INVESTMENT PROGRAM ACCOUNT.
351. Moneys credited to the family investment program (FIP)
-65-1account for the fiscal year beginning July 1, 2020, and
2ending June 30, 2021, shall be used to provide assistance in
3accordance with chapter 239B.
42. The department may use a portion of the moneys credited
5to the FIP account under this section as necessary for
6salaries, support, maintenance, and miscellaneous purposes.
73. The department may transfer funds allocated in
8subsection 4, excluding the allocation under subsection 4,
9paragraph “b”, to the appropriations made in this division of
10this Act for the same fiscal year for general administration
11and field operations for resources necessary to implement
12and operate the services referred to in this section and
13those funded in the appropriations made in section 45 for the
14temporary assistance for needy families block grant and in
15section 47 for the family investment program from the general
16fund of the state in this division of this Act for the same
17fiscal year.
184. Moneys appropriated in this division of this Act and
19credited to the FIP account for the fiscal year beginning July
201, 2020, and ending June 30, 2021, are allocated as follows:
21a. To be retained by the department of human services to
22be used for coordinating with the department of human rights
23to more effectively serve participants in FIP and other shared
24clients and to meet federal reporting requirements under the
25federal temporary assistance for needy families block grant:
.................................................. $2620,000
27b. To the department of human rights for staffing,
28administration, and implementation of the family development
29and self-sufficiency grant program in accordance with section
30216A.107:
.................................................. $316,192,834
32(1) Of the funds allocated for the family development
33and self-sufficiency grant program in this paragraph “b”,
34not more than 5 percent of the funds shall be used for the
35administration of the grant program.
-66- 1(2) The department of human rights may continue to implement
2the family development and self-sufficiency grant program
3statewide during fiscal year 2020-2021.
4(3) The department of human rights may engage in activities
5to strengthen and improve family outcomes measures and
6data collection systems under the family development and
7self-sufficiency grant program.
8c. For the diversion subaccount of the FIP account:
.................................................. $9815,000
10A portion of the moneys allocated for the subaccount may
11be used for field operations, salaries, data management
12system development, and implementation costs and support
13deemed necessary by the director of human services in order to
14administer the FIP diversion program. To the extent moneys
15allocated in this paragraph “c” are deemed by the department
16not to be necessary to support diversion activities, such
17moneys may be used for other efforts intended to increase
18engagement by family investment program participants in work,
19education, or training activities, or for the purposes of
20assistance under the family investment program in accordance
21with chapter 239B.
22d. For the food assistance employment and training program:
.................................................. $2366,588
24(1) The department shall apply the federal supplemental
25nutrition assistance program (SNAP) employment and training
26state plan in order to maximize to the fullest extent permitted
27by federal law the use of the 50 percent federal reimbursement
28provisions for the claiming of allowable federal reimbursement
29funds from the United States department of agriculture
30pursuant to the federal SNAP employment and training program
31for providing education, employment, and training services
32for eligible food assistance program participants, including
33but not limited to related dependent care and transportation
34expenses.
35(2) The department shall continue the categorical federal
-67-1food assistance program eligibility at 160 percent of the
2federal poverty level and continue to eliminate the asset test
3from eligibility requirements, consistent with federal food
4assistance program requirements. The department shall include
5as many food assistance households as is allowed by federal
6law. The eligibility provisions shall conform to all federal
7requirements including requirements addressing individuals who
8are incarcerated or otherwise ineligible.
9e. For the JOBS program:
.................................................. $1012,005,109
115. Of the child support collections assigned under FIP,
12an amount equal to the federal share of support collections
13shall be credited to the child support recovery appropriation
14made in this division of this Act. Of the remainder of the
15assigned child support collections received by the child
16support recovery unit, a portion shall be credited to the FIP
17account, a portion may be used to increase recoveries, and a
18portion may be used to sustain cash flow in the child support
19payments account. If as a consequence of the appropriations
20and allocations made in this section the resulting amounts
21are insufficient to sustain cash assistance payments and meet
22federal maintenance of effort requirements, the department
23shall seek supplemental funding. If child support collections
24assigned under FIP are greater than estimated or are otherwise
25determined not to be required for maintenance of effort, the
26state share of either amount may be transferred to or retained
27in the child support payments account.
286. The department may adopt emergency rules for the family
29investment, JOBS, food assistance, and medical assistance
30programs if necessary to comply with federal requirements.
31 Sec. 47. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
32is appropriated from the general fund of the state to the
33department of human services for the fiscal year beginning July
341, 2020, and ending June 30, 2021, the following amount, or
35so much thereof as is necessary, to be used for the purpose
-68-1designated:
2To be credited to the family investment program (FIP)
3account and used for family investment program assistance under
4chapter 239B:
.................................................. $540,365,715
61. Of the funds appropriated in this section, $6,593,049 is
7allocated for the JOBS program.
82. Of the funds appropriated in this section, $3,313,854 is
9allocated for the family development and self-sufficiency grant
10program.
113. Notwithstanding section 8.39, for the fiscal year
12beginning July 1, 2020, if necessary to meet federal
13maintenance of effort requirements or to transfer federal
14temporary assistance for needy families block grant funding
15to be used for purposes of the federal social services block
16grant or to meet cash flow needs resulting from delays in
17receiving federal funding or to implement, in accordance with
18this division of this Act, activities currently funded with
19juvenile court services, county, or community moneys and state
20moneys used in combination with such moneys; to comply with
21federal requirements; or to maximize the use of federal funds,
22the department of human services may transfer funds within or
23between any of the appropriations made in this division of this
24Act and appropriations in law for the federal social services
25block grant to the department for the following purposes,
26provided that the combined amount of state and federal
27temporary assistance for needy families block grant funding
28for each appropriation remains the same before and after the
29transfer:
30a. For the family investment program.
31b. For state child care assistance.
32c. For child and family services.
33d. For field operations.
34e. For general administration.
35This subsection shall not be construed to prohibit the use
-69-1of existing state transfer authority for other purposes. The
2department shall report any transfers made pursuant to this
3subsection to the legislative services agency.
44. Of the funds appropriated in this section, $195,678 shall
5be used for continuation of a grant to an Iowa-based nonprofit
6organization with a history of providing tax preparation
7assistance to low-income Iowans in order to expand the usage of
8the earned income tax credit. The purpose of the grant is to
9supply this assistance to underserved areas of the state.
105. Of the funds appropriated in this section, $70,000 shall
11be used for the continuation of the parenting program, as
12specified in 441 IAC ch.100, relating to parental obligations,
13in which the child support recovery unit participates, to
14support the efforts of a nonprofit organization committed
15to strengthening the community through youth development,
16healthy living, and social responsibility headquartered in
17a county with a population over 350,000 according to the
18latest certified federal census. The funds allocated in this
19subsection shall be used by the recipient organization to
20develop a larger community effort, through public and private
21partnerships, to support a broad-based multi-county parenthood
22initiative that promotes payment of child support obligations,
23improved family relationships, and full-time employment.
246. The department may transfer funds appropriated in this
25section, excluding the allocation in subsection 2 for the
26family development and self-sufficiency grant program, to the
27appropriations made in this division of this Act for general
28administration and field operations as necessary to administer
29this section, section 45 for the temporary assistance for needy
30families block grant, and section 46 for the family investment
31program account.
32 Sec. 48. CHILD SUPPORT RECOVERY. There is appropriated
33from the general fund of the state to the department of human
34services for the fiscal year beginning July 1, 2020, and ending
35June 30, 2021, the following amount, or so much thereof as is
-70-1necessary, to be used for the purposes designated:
2For child support recovery, including salaries, support,
3maintenance, and miscellaneous purposes:
.................................................. $414,943,998
51. The department shall expend up to $24,329, including
6federal financial participation, for the fiscal year beginning
7July 1, 2020, for a child support public awareness campaign.
8The department and the office of the attorney general shall
9cooperate in continuation of the campaign. The public
10awareness campaign shall emphasize, through a variety of
11media activities, the importance of maximum involvement of
12both parents in the lives of their children as well as the
13importance of payment of child support obligations.
142. Federal access and visitation grant moneys shall be
15issued directly to private not-for-profit agencies that provide
16services designed to increase compliance with the child access
17provisions of court orders, including but not limited to
18neutral visitation sites and mediation services.
193. The appropriation made to the department for child
20support recovery may be used throughout the fiscal year in the
21manner necessary for purposes of cash flow management, and for
22cash flow management purposes the department may temporarily
23draw more than the amount appropriated, provided the amount
24appropriated is not exceeded at the close of the fiscal year.
25 Sec. 49. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
26FY 2020-2021. Any funds remaining in the health care trust
27fund created in section 453A.35A for the fiscal year beginning
28July 1, 2020, and ending June 30, 2021, are appropriated to
29the department of human services to supplement the medical
30assistance program appropriations made in this division of this
31Act, for medical assistance reimbursement and associated costs,
32including program administration and costs associated with
33program implementation.
34 Sec. 50. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
352020-2021. Any funds remaining in the Medicaid fraud fund
-71-1created in section 249A.50 for the fiscal year beginning
2July 1, 2020, and ending June 30, 2021, are appropriated to
3the department of human services to supplement the medical
4assistance appropriations made in this division of this Act,
5for medical assistance reimbursement and associated costs,
6including program administration and costs associated with
7program implementation.
8 Sec. 51. MEDICAL ASSISTANCE. There is appropriated from the
9general fund of the state to the department of human services
10for the fiscal year beginning July 1, 2020, and ending June 30,
112021, the following amount, or so much thereof as is necessary,
12to be used for the purpose designated:
13For medical assistance program reimbursement and associated
14costs as specifically provided in the reimbursement
15methodologies in effect on June 30, 2020, except as otherwise
16expressly authorized by law, consistent with options under
17federal law and regulations, and contingent upon receipt of
18approval from the office of the governor of reimbursement for
19each abortion performed under the program:
.................................................. $201,456,223,889
211. Iowans support reducing the number of abortions
22performed in our state. Funds appropriated under this section
23shall not be used for abortions, unless otherwise authorized
24under this section.
252. The provisions of this section relating to abortions
26shall also apply to the Iowa health and wellness plan created
27pursuant to chapter 249N.
283. The department shall utilize not more than $60,000 of
29the funds appropriated in this section to continue the AIDS/HIV
30health insurance premium payment program as established in 1992
31Iowa Acts, Second Extraordinary Session, chapter 1001, section
32409, subsection 6. Of the funds allocated in this subsection,
33not more than $5,000 may be expended for administrative
34purposes.
354. Of the funds appropriated in this Act to the department
-72-1of public health for addictive disorders, $950,000 for
2the fiscal year beginning July 1, 2020, is transferred
3to the department of human services for an integrated
4substance-related disorder managed care system. The
5departments of human services and public health shall
6work together to maintain the level of mental health and
7substance-related disorder treatment services provided by the
8managed care contractors. Each department shall take the steps
9necessary to continue the federal waivers as necessary to
10maintain the level of services.
115. a. The department shall aggressively pursue options for
12providing medical assistance or other assistance to individuals
13with special needs who become ineligible to continue receiving
14services under the early and periodic screening, diagnostic,
15and treatment program under the medical assistance program
16due to becoming 21 years of age who have been approved for
17additional assistance through the department’s exception to
18policy provisions, but who have health care needs in excess
19of the funding available through the exception to policy
20provisions.
21b. Of the funds appropriated in this section, $100,000
22shall be used for participation in one or more pilot projects
23operated by a private provider to allow the individual or
24individuals to receive service in the community in accordance
25with principles established in Olmstead v.L.C., 527 U.S.581
26(1999), for the purpose of providing medical assistance or
27other assistance to individuals with special needs who become
28ineligible to continue receiving services under the early and
29periodic screening, diagnostic, and treatment program under
30the medical assistance program due to becoming 21 years of
31age who have been approved for additional assistance through
32the department’s exception to policy provisions, but who have
33health care needs in excess of the funding available through
34the exception to the policy provisions.
356. Of the funds appropriated in this section, up to
-73-1$3,050,082 may be transferred to the field operations or
2general administration appropriations in this division of this
3Act for operational costs associated with Part D of the federal
4Medicare Prescription Drug Improvement and Modernization Act
5of 2003, Pub.L.No.108-173.
67. Of the funds appropriated in this section, up to $442,100
7may be transferred to the appropriation in this division
8of this Act for medical contracts to be used for clinical
9assessment services and prior authorization of services.
108. A portion of the funds appropriated in this section
11may be transferred to the appropriations in this division of
12this Act for general administration, medical contracts, the
13children’s health insurance program, or field operations to be
14used for the state match cost to comply with the payment error
15rate measurement (PERM) program for both the medical assistance
16and children’s health insurance programs as developed by the
17centers for Medicare and Medicaid services of the United States
18department of health and human services to comply with the
19federal Improper Payments Information Act of 2002, Pub.L.
20No.107-300, and to support other reviews and quality control
21activities to improve the integrity of these programs.
229. The department shall continue to implement the
23recommendations of the assuring better child health and
24development initiative II (ABCDII) clinical panel to the
25Iowa early and periodic screening, diagnostic, and treatment
26services healthy mental development collaborative board
27regarding changes to billing procedures, codes, and eligible
28service providers.
2910. Of the funds appropriated in this section, a sufficient
30amount is allocated to supplement the incomes of residents of
31nursing facilities, intermediate care facilities for persons
32with mental illness, and intermediate care facilities for
33persons with an intellectual disability, with incomes of less
34than $50 in the amount necessary for the residents to receive a
35personal needs allowance of $50 per month pursuant to section
-74-1249A.30A.
211. a. Hospitals that meet the conditions specified
3in subparagraphs (1) and (2) shall either certify public
4expenditures or transfer to the medical assistance program
5an amount equal to provide the nonfederal share for a
6disproportionate share hospital payment in an amount up to the
7hospital-specific limit as approved in the Medicaid state plan.
8The hospitals that meet the conditions specified shall receive
9and retain 100 percent of the total disproportionate share
10hospital payment in an amount up to the hospital-specific limit
11as approved in the Medicaid state plan.
12(1) The hospital qualifies for disproportionate share and
13graduate medical education payments.
14(2) The hospital is an Iowa state-owned hospital with more
15than 500 beds and eight or more distinct residency specialty
16or subspecialty programs recognized by the American college of
17graduate medical education.
18b. Distribution of the disproportionate share payments
19shall be made on a monthly basis. The total amount of
20disproportionate share payments including graduate medical
21education, enhanced disproportionate share, and Iowa
22state-owned teaching hospital payments shall not exceed the
23amount of the state’s allotment under Pub.L.No.102-234.
24In addition, the total amount of all disproportionate
25share payments shall not exceed the hospital-specific
26disproportionate share limits under Pub.L.No.103-66.
2712. One hundred percent of the nonfederal share of payments
28to area education agencies that are medical assistance
29providers for medical assistance-covered services provided to
30medical assistance-covered children, shall be made from the
31appropriation made in this section.
3213. A portion of the funds appropriated in this section
33may be transferred to the appropriation in this division of
34this Act for medical contracts to be used for administrative
35activities associated with the money follows the person
-75-1demonstration project.
214. Of the funds appropriated in this section, $349,011
3shall be used for the administration of the health insurance
4premium payment program, including salaries, support,
5maintenance, and miscellaneous purposes.
615. a. The department may increase the amounts allocated
7for salaries, support, maintenance, and miscellaneous purposes
8associated with the medical assistance program, as necessary,
9to implement cost containment strategies. The department shall
10report any such increase to the legislative services agency and
11the department of management.
12b. If the savings to the medical assistance program from
13cost containment efforts exceed the cost for the fiscal
14year beginning July 1, 2020, the department may transfer any
15savings generated for the fiscal year due to medical assistance
16program cost containment efforts to the appropriation
17made in this division of this Act for medical contracts or
18general administration to defray the increased contract costs
19associated with implementing such efforts.
2016. For the fiscal year beginning July 1, 2020, and ending
21June 30, 2021, the replacement generation tax revenues required
22to be deposited in the property tax relief fund pursuant to
23section 437A.8, subsection 4, paragraph “d”, and section
24437A.15, subsection 3, paragraph “f”, shall instead be credited
25to and supplement the appropriation made in this section and
26used for the allocations made in this section.
2717. a. Of the funds appropriated in this section, up
28to $50,000 may be transferred by the department to the
29appropriation made in this division of this Act to the
30department for the same fiscal year for general administration
31to be used for associated administrative expenses and for not
32more than one full-time equivalent position, in addition to
33those authorized for the same fiscal year, to be assigned to
34implementing the children’s mental health home project.
35b. Of the funds appropriated in this section, up to $400,000
-76-1may be transferred by the department to the appropriation made
2to the department in this division of this Act for the same
3fiscal year for Medicaid program-related general administration
4planning and implementation activities. The funds may be used
5for contracts or for personnel in addition to the amounts
6appropriated for and the positions authorized for general
7administration for the fiscal year.
8c. Of the funds appropriated in this section, up to
9$3,000,000 may be transferred by the department to the
10appropriations made in this division of this Act for the same
11fiscal year for general administration or medical contracts
12to be used to support the development and implementation of
13standardized assessment tools for persons with mental illness,
14an intellectual disability, a developmental disability, or a
15brain injury.
1618. Of the funds appropriated in this section, $150,000
17shall be used for lodging expenses associated with care
18provided at the university of Iowa hospitals and clinics for
19patients with cancer whose travel distance is 30 miles or more
20and whose income is at or below 200 percent of the federal
21poverty level as defined by the most recently revised poverty
22income guidelines published by the United States department of
23health and human services. The department of human services
24shall establish the maximum number of overnight stays and the
25maximum rate reimbursed for overnight lodging, which may be
26based on the state employee rate established by the department
27of administrative services. The funds allocated in this
28subsection shall not be used as nonfederal share matching
29funds.
3019. Of the funds appropriated in this section, up to
31$3,383,880 shall be used for administration of the state
32family planning services program pursuant to section 217.41B,
33and of this amount the department may use up to $200,000 for
34administrative expenses.
3520. The department shall report the implementation of
-77-1any cost containment strategies to the individuals specified
2in this division of this Act for submission of reports upon
3implementation.
421. The department shall report the implementation of any
5process improvement changes and any related cost reductions
6to the individuals specified in this division of this Act for
7submission of reports upon implementation.
822. Of the funds appropriated in this section, $1,545,530
9shall be used and may be transferred to other appropriations
10in this division of this Act as necessary to administer the
11provisions in the division of this Act relating to Medicaid
12program administration.
1323. The department shall continue to implement and
14administer the provisions of 2018 Iowa Acts, chapter 1056. Of
15the funds appropriated in this section, up to $39,069 may be
16transferred to the department of inspections and appeals for
17inspection costs.
18 Sec. 52. MEDICAL CONTRACTS. There is appropriated from the
19general fund of the state to the department of human services
20for the fiscal year beginning July 1, 2020, and ending June 30,
212021, the following amount, or so much thereof as is necessary,
22to be used for the purpose designated:
23For medical contracts:
.................................................. $2418,264,987
251. The department of inspections and appeals shall
26provide all state matching funds for survey and certification
27activities performed by the department of inspections
28and appeals. The department of human services is solely
29responsible for distributing the federal matching funds for
30such activities.
312. Of the funds appropriated in this section, $50,000 shall
32be used for continuation of home and community-based services
33waiver quality assurance programs, including the review and
34streamlining of processes and policies related to oversight and
35quality management to meet state and federal requirements.
-78- 13. Of the amount appropriated in this section, up to
2$200,000 may be transferred to the appropriation for general
3administration in this division of this Act to be used for
4additional full-time equivalent positions in the development of
5key health initiatives such as cost containment, development
6and oversight of managed care programs, and development of
7health strategies targeted toward improved quality and reduced
8costs in the Medicaid program.
94. Of the funds appropriated in this section, $1,000,000
10shall be used for planning and development, in cooperation with
11the department of public health, of a phased-in program to
12provide a dental home for children.
135. a. Of the funds appropriated in this section, $573,000
14shall be credited to the autism support program fund created
15in section 225D.2 to be used for the autism support program
16created in chapter 225D, with the exception of the following
17amounts of this allocation which shall be used as follows:
18b. Of the funds allocated in this subsection, $25,000 shall
19be used for the public purpose of continuation of a grant to
20a non profit provider of child welfare services that has been
21in existence for more than 115 years, is located in a county
22with a population between 200,000 and 220,000 according to the
23latest certified federal census, is licensed as a psychiatric
24medical institution for children, and provides school-based
25programming, to be used for support services for children with
26autism spectrum disorder and their families.
27 Sec. 53. STATE SUPPLEMENTARY ASSISTANCE.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2020, and ending June 30, 2021, the following
31amount, or so much thereof as is necessary, to be used for the
32purpose designated:
33For the state supplementary assistance program:
.................................................. $347,176,606
352. The department shall increase the personal needs
-79-1allowance for residents of residential care facilities by the
2same percentage and at the same time as federal supplemental
3security income and federal social security benefits are
4increased due to a recognized increase in the cost of living.
5The department may adopt emergency rules to implement this
6subsection.
73. If during the fiscal year beginning July 1, 2020,
8the department projects that state supplementary assistance
9expenditures for a calendar year will not meet the federal
10pass-through requirement specified in Tit.XVI of the federal
11Social Security Act, section 1618, as codified in 42 U.S.C.
12§1382g, the department may take actions including but not
13limited to increasing the personal needs allowance for
14residential care facility residents and making programmatic
15adjustments or upward adjustments of the residential care
16facility or in-home health-related care reimbursement rates
17prescribed in this division of this Act to ensure that federal
18requirements are met. In addition, the department may make
19other programmatic and rate adjustments necessary to remain
20within the amount appropriated in this section while ensuring
21compliance with federal requirements. The department may adopt
22emergency rules to implement the provisions of this subsection.
234. Notwithstanding section 8.33, moneys appropriated in
24this section that remain unencumbered or unobligated at the
25close of the fiscal year shall not revert but shall remain
26available for expenditure for the purposes designated until the
27close of the succeeding fiscal year.
28 Sec. 54. CHILDREN’S HEALTH INSURANCE PROGRAM.
291. There is appropriated from the general fund of the
30state to the department of human services for the fiscal year
31beginning July 1, 2020, and ending June 30, 2021, the following
32amount, or so much thereof as is necessary, to be used for the
33purpose designated:
34For maintenance of the healthy and well kids in Iowa (hawk-i)
35program pursuant to chapter 514I, including supplemental dental
-80-1services, for receipt of federal financial participation under
2Tit.XXI of the federal Social Security Act, which creates the
3children’s health insurance program:
.................................................. $438,267,453
52. Of the funds appropriated in this section, up to $148,455
6is allocated for continuation of the contract for outreach with
7the department of public health.
83. A portion of the funds appropriated in this section may
9be transferred to the appropriations made in this division of
10this Act for field operations or medical contracts to be used
11for the integration of hawk-i program eligibility, payment, and
12administrative functions under the purview of the department
13of human services, including for the Medicaid management
14information system upgrade.
15 Sec. 55. CHILD CARE ASSISTANCE. There is appropriated
16from the general fund of the state to the department of human
17services for the fiscal year beginning July 1, 2020, and ending
18June 30, 2021, the following amount, or so much thereof as is
19necessary, to be used for the purpose designated:
20For child care programs:
.................................................. $2140,816,931
221. Of the funds appropriated in this section, $34,966,931
23shall be used for state child care assistance in accordance
24with section 237A.13.
252. Nothing in this section shall be construed or is
26intended as or shall imply a grant of entitlement for services
27to persons who are eligible for assistance due to an income
28level consistent with the waiting list requirements of section
29237A.13. Any state obligation to provide services pursuant to
30this section is limited to the extent of the funds appropriated
31in this section.
323. A list of the registered and licensed child care
33facilities operating in the area served by a child care
34resource and referral service shall be made available to the
35families receiving state child care assistance in that area.
-81- 14. Of the funds appropriated in this section, $5,850,000
2shall be credited to the early childhood programs grants
3account in the early childhood Iowa fund created in section
4256I.11. The moneys shall be distributed for funding of
5community-based early childhood programs targeted to children
6from birth through five years of age developed by early
7childhood Iowa areas in accordance with approved community
8plans as provided in section 256I.8.
95. The department may use any of the funds appropriated
10in this section as a match to obtain federal funds for use in
11expanding child care assistance and related programs. For
12the purpose of expenditures of state and federal child care
13funding, funds shall be considered obligated at the time
14expenditures are projected or are allocated to the department’s
15service areas. Projections shall be based on current and
16projected caseload growth, current and projected provider
17rates, staffing requirements for eligibility determination
18and management of program requirements including data systems
19management, staffing requirements for administration of the
20program, contractual and grant obligations and any transfers
21to other state agencies, and obligations for decategorization
22or innovation projects.
236. A portion of the state match for the federal child care
24and development block grant shall be provided as necessary to
25meet federal matching funds requirements through the state
26general fund appropriation made for child development grants
27and other programs for at-risk children in section 279.51.
287. If a uniform reduction ordered by the governor under
29section 8.31 or other operation of law, transfer, or federal
30funding reduction reduces the appropriation made in this
31section for the fiscal year, the percentage reduction in the
32amount paid out to or on behalf of the families participating
33in the state child care assistance program shall be equal to or
34less than the percentage reduction made for any other purpose
35payable from the appropriation made in this section and the
-82-1federal funding relating to it. The percentage reduction to
2the other allocations made in this section shall be the same as
3the uniform reduction ordered by the governor or the percentage
4change of the federal funding reduction, as applicable. If
5there is an unanticipated increase in federal funding provided
6for state child care services, the entire amount of the
7increase, except as necessary to meet federal requirements
8including quality set asides, shall be used for state child
9care assistance payments. If the appropriations made for
10purposes of the state child care assistance program for the
11fiscal year are determined to be insufficient, it is the intent
12of the general assembly to appropriate sufficient funding for
13the fiscal year in order to avoid establishment of waiting list
14requirements.
158. Notwithstanding section 8.33, moneys advanced for
16purposes of the programs developed by early childhood Iowa
17areas, advanced for purposes of wraparound child care, or
18received from the federal appropriations made for the purposes
19of this section that remain unencumbered or unobligated at the
20close of the fiscal year shall not revert to any fund but shall
21remain available for expenditure for the purposes designated
22until the close of the succeeding fiscal year.
23 Sec. 56. JUVENILE INSTITUTION. There is appropriated
24from the general fund of the state to the department of human
25services for the fiscal year beginning July 1, 2020, and ending
26June 30, 2021, the following amounts, or so much thereof as is
27necessary, to be used for the purposes designated:
281. For operation of the state training school at Eldora and
29for salaries, support, maintenance, and miscellaneous purposes:
.................................................. $3013,965,806
31Of the funds appropriated in this subsection, $91,150 shall
32be used for distribution to licensed classroom teachers at this
33and other institutions under the control of the department of
34human services based upon the average student yearly enrollment
35at each institution as determined by the department.
-83- 12. A portion of the moneys appropriated in this section
2shall be used by the state training school at Eldora for
3grants for adolescent pregnancy prevention activities at the
4institution in the fiscal year beginning July 1, 2020.
53. Of the funds appropriated in this subsection, $212,000
6shall be used by the state training school at Eldora for a
7substance use disorder treatment program at the institution in
8the fiscal year beginning July 1, 2020.
9 Sec. 57. CHILD AND FAMILY SERVICES.
101. There is appropriated from the general fund of the
11state to the department of human services for the fiscal year
12beginning July 1, 2020, and ending June 30, 2021, the following
13amount, or so much thereof as is necessary, to be used for the
14purpose designated:
15For child and family services:
.................................................. $1689,078,185
172. The department may transfer funds appropriated in this
18section as necessary to pay the nonfederal costs of services
19reimbursed under the medical assistance program, state child
20care assistance program, or the family investment program which
21are provided to children who would otherwise receive services
22paid under the appropriation in this section. The department
23may transfer funds appropriated in this section to the
24appropriations made in this division of this Act for general
25administration and for field operations for resources necessary
26to implement and operate the services funded in this section.
273. a. Of the funds appropriated in this section, up to
28$34,536,648 is allocated as the statewide expenditure target
29under section 232.143 for group foster care maintenance and
30services. If the department projects that such expenditures
31for the fiscal year will be less than the target amount
32allocated in this paragraph “a”, the department may reallocate
33the excess to provide additional funding for family foster
34care, independent living, family safety, risk and permanency
35services, shelter care, or the child welfare emergency services
-84-1addressed with the allocation for shelter care.
2b. If at any time after September 30, 2020, annualization
3of a service area’s current expenditures indicates a service
4area is at risk of exceeding its group foster care expenditure
5target under section 232.143 by more than 5 percent, the
6department and juvenile court services shall examine all
7group foster care placements in that service area in order to
8identify those which might be appropriate for termination.
9In addition, any aftercare services believed to be needed
10for the children whose placements may be terminated shall be
11identified. The department and juvenile court services shall
12initiate action to set dispositional review hearings for the
13placements identified. In such a dispositional review hearing,
14the juvenile court shall determine whether needed aftercare
15services are available and whether termination of the placement
16is in the best interest of the child and the community.
174. In accordance with the provisions of section 232.188,
18the department shall continue the child welfare and juvenile
19justice funding initiative during fiscal year 2020-2021. Of
20the funds appropriated in this section, $1,717,753 is allocated
21specifically for expenditure for fiscal year 2020-2021 through
22the decategorization services funding pools and governance
23boards established pursuant to section 232.188.
245. A portion of the funds appropriated in this section
25may be used for emergency family assistance to provide other
26resources required for a family participating in a family
27preservation or reunification project or successor project to
28stay together or to be reunified.
296. Of the funds appropriated in this section, a sufficient
30amount is allocated for shelter care and the child welfare
31emergency services contracting implemented to provide for or
32prevent the need for shelter care.
337. Federal funds received by the state during the fiscal
34year beginning July 1, 2020, as the result of the expenditure
35of state funds appropriated during a previous state fiscal
-85-1year for a service or activity funded under this section are
2appropriated to the department to be used as additional funding
3for services and purposes provided for under this section.
4Notwithstanding section 8.33, moneys received in accordance
5with this subsection that remain unencumbered or unobligated at
6the close of the fiscal year shall not revert to any fund but
7shall remain available for the purposes designated until the
8close of the succeeding fiscal year.
98. a. Of the funds appropriated in this section, up to
10$3,290,000 is allocated for the payment of the expenses of
11court-ordered services provided to juveniles who are under the
12supervision of juvenile court services, which expenses are a
13charge upon the state pursuant to section 232.141, subsection
144. Of the amount allocated in this paragraph “a”, up to
15$1,556,287 shall be made available to provide school-based
16supervision of children adjudicated under chapter 232, of which
17not more than $15,000 may be used for the purpose of training.
18A portion of the cost of each school-based liaison officer
19shall be paid by the school district or other funding source as
20approved by the chief juvenile court officer.
21b. Of the funds appropriated in this section, up to $748,985
22is allocated for the payment of the expenses of court-ordered
23services provided to children who are under the supervision
24of the department, which expenses are a charge upon the state
25pursuant to section 232.141, subsection 4.
26c. Notwithstanding section 232.141 or any other provision
27of law to the contrary, the amounts allocated in this
28subsection shall be distributed to the judicial districts
29as determined by the state court administrator and to the
30department’s service areas as determined by the administrator
31of the department of human services’ division of child and
32family services. The state court administrator and the
33division administrator shall make the determination of the
34distribution amounts on or before June 15, 2020.
35d. Notwithstanding chapter 232 or any other provision of
-86-1law to the contrary, a district or juvenile court shall not
2order any service which is a charge upon the state pursuant
3to section 232.141 if there are insufficient court-ordered
4services funds available in the district court or departmental
5service area distribution amounts to pay for the service. The
6chief juvenile court officer and the departmental service area
7manager shall encourage use of the funds allocated in this
8subsection such that there are sufficient funds to pay for
9all court-related services during the entire year. The chief
10juvenile court officers and departmental service area managers
11shall attempt to anticipate potential surpluses and shortfalls
12in the distribution amounts and shall cooperatively request the
13state court administrator or division administrator to transfer
14funds between the judicial districts’ or departmental service
15areas’ distribution amounts as prudent.
16e. Notwithstanding any provision of law to the contrary,
17a district or juvenile court shall not order a county to pay
18for any service provided to a juvenile pursuant to an order
19entered under chapter 232 which is a charge upon the state
20under section 232.141, subsection 4.
21f. Of the funds allocated in this subsection, not more than
22$83,000 may be used by the judicial branch for administration
23of the requirements under this subsection.
24g. Of the funds allocated in this subsection, $17,000
25shall be used by the department of human services to support
26the interstate commission for juveniles in accordance with
27the interstate compact for juveniles as provided in section
28232.173.
299. Of the funds appropriated in this section, $12,253,227 is
30allocated for juvenile delinquent graduated sanctions services.
31Any state funds saved as a result of efforts by juvenile court
32services to earn a federal Tit.IV-E match for juvenile court
33services administration may be used for the juvenile delinquent
34graduated sanctions services.
3510. Of the funds appropriated in this section, $1,658,285 is
-87-1transferred to the department of public health to be used for
2the child protection center grant program for child protection
3centers located in Iowa in accordance with section 135.118.
4The grant amounts under the program shall be equalized so that
5each center receives a uniform base amount of $245,000, and so
6that the remaining funds are awarded through a funding formula
7based upon the volume of children served.
811. If the department receives federal approval to
9implement a waiver under Tit.IV-E of the federal Social
10Security Act to enable providers to serve children who remain
11in the children’s families and communities, for purposes of
12eligibility under the medical assistance program through 25
13years of age, children who participate in the waiver shall be
14considered to be placed in foster care.
1512. Of the funds appropriated in this section, $4,025,167 is
16allocated for the preparation for adult living program pursuant
17to section 234.46.
1813. Of the funds appropriated in this section, $227,337
19shall be used for the public purpose of continuing a grant to
20a nonprofit human services organization providing services to
21individuals and families in multiple locations in southwest
22Iowa and Nebraska for support of a project providing immediate,
23sensitive support and forensic interviews, medical exams, needs
24assessments, and referrals for victims of child abuse and their
25nonoffending family members.
2614. Of the funds appropriated in this section, $300,620
27is allocated for the foster care youth council approach of
28providing a support network to children placed in foster care.
2915. Of the funds appropriated in this section, $202,000 is
30allocated for use pursuant to section 235A.1 for continuation
31of the initiative to address child sexual abuse implemented
32pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
3321.
3416. Of the funds appropriated in this section, $630,240 is
35allocated for the community partnership for child protection
-88-1sites.
217. Of the funds appropriated in this section, $371,250
3is allocated for the department’s minority youth and family
4projects under the redesign of the child welfare system.
518. Of the funds appropriated in this section, $851,595
6is allocated for funding of the community circle of care
7collaboration for children and youth in northeast Iowa.
819. Of the funds appropriated in this section, at least
9$147,158 shall be used for the continuation of the child
10welfare provider training academy, a collaboration between the
11coalition for family and children’s services in Iowa and the
12department.
1320. Of the funds appropriated in this section, $211,872
14shall be used for continuation of the central Iowa system of
15care program grant through June 30, 2021.
1621. Of the funds appropriated in this section, $235,000
17shall be used for the public purpose of the continuation
18and expansion of a system of care program grant implemented
19in Cerro Gordo and Linn counties to utilize a comprehensive
20and long-term approach for helping children and families by
21addressing the key areas in a child’s life of childhood basic
22needs, education and work, family, and community.
2322. Of the funds appropriated in this section, $110,000
24shall be used for the public purpose of funding community-based
25services and other supports with a system of care approach
26for children with a serious emotional disturbance and their
27families through a nonprofit provider of child welfare services
28that has been in existence for more than 115 years, is located
29in a county with a population of more than 200,000 but less
30than 220,000 according to the latest certified federal census,
31is licensed as a psychiatric medical institution for children,
32and was a system of care grantee prior to July 1, 2020.
3323. If a separate funding source is identified that reduces
34the need for state funds within an allocation under this
35section, the allocated state funds may be redistributed to
-89-1other allocations under this section for the same fiscal year.
2 Sec. 58. ADOPTION SUBSIDY.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2020, and ending June 30, 2021, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8a. For adoption subsidy payments and services:
.................................................. $940,752,396
10b. (1) The funds appropriated in this section shall be used
11as authorized or allowed by federal law or regulation for any
12of the following purposes:
13(a) For adoption subsidy payments and related costs.
14(b) For post-adoption services and for other purposes under
15Tit.IV-B or Tit.IV-E of the federal Social Security Act.
16(2) The department of human services may transfer funds
17appropriated in this subsection to the appropriation for
18child and family services in this Act for the purposes of
19post-adoption services as specified in this paragraph “b”.
20c. Notwithstanding section 8.33, moneys corresponding to
21the state savings resulting from implementation of the federal
22Fostering Connections to Success and Increasing Adoptions Act
23of 2008, Pub.L. No.110-351, and successor legislation, as
24determined in accordance with 42 U.S.C. §673(a)(8), that remain
25unencumbered or unobligated at the close of the fiscal year,
26shall not revert to any fund but shall remain available for the
27purposes designated in this subsection until expended. The
28amount of such savings and any corresponding funds remaining
29at the close of the fiscal year shall be determined separately
30and any changes in either amount between fiscal years shall not
31result in an unfunded need.
322. The department may transfer funds appropriated in
33this section to the appropriation made in this division of
34this Act for general administration for costs paid from the
35appropriation relating to adoption subsidy.
-90- 13. Federal funds received by the state during the
2fiscal year beginning July 1, 2020, as the result of the
3expenditure of state funds during a previous state fiscal
4year for a service or activity funded under this section are
5appropriated to the department to be used as additional funding
6for the services and activities funded under this section.
7Notwithstanding section 8.33, moneys received in accordance
8with this subsection that remain unencumbered or unobligated
9at the close of the fiscal year shall not revert to any fund
10but shall remain available for expenditure for the purposes
11designated until the close of the succeeding fiscal year.
12 Sec. 59. JUVENILE DETENTION HOME FUND. Moneys deposited
13in the juvenile detention home fund created in section 232.142
14during the fiscal year beginning July 1, 2020, and ending June
1530, 2021, are appropriated to the department of human services
16for the fiscal year beginning July 1, 2020, and ending June 30,
172021, for distribution of an amount equal to a percentage of
18the costs of the establishment, improvement, operation, and
19maintenance of county or multicounty juvenile detention homes
20in the fiscal year beginning July 1, 2019. Moneys appropriated
21for distribution in accordance with this section shall be
22allocated among eligible detention homes, prorated on the basis
23of an eligible detention home’s proportion of the costs of all
24eligible detention homes in the fiscal year beginning July
251, 2019. The percentage figure shall be determined by the
26department based on the amount available for distribution for
27the fund. Notwithstanding section 232.142, subsection 3, the
28financial aid payable by the state under that provision for the
29fiscal year beginning July 1, 2020, shall be limited to the
30amount appropriated for the purposes of this section.
31 Sec. 60. FAMILY SUPPORT SUBSIDY PROGRAM.
321. There is appropriated from the general fund of the
33state to the department of human services for the fiscal year
34beginning July 1, 2020, and ending June 30, 2021, the following
35amount, or so much thereof as is necessary, to be used for the
-91-1purpose designated:
2For the family support subsidy program subject to the
3enrollment restrictions in section 225C.37, subsection 3:
.................................................. $4949,282
52. At least $859,364 of the moneys appropriated in this
6section is transferred to the department of public health for
7the family support center component of the comprehensive family
8support program under chapter 225C, subchapter V.
93. If at any time during the fiscal year, the amount of
10funding available for the family support subsidy program
11is reduced from the amount initially used to establish the
12figure for the number of family members for whom a subsidy
13is to be provided at any one time during the fiscal year,
14notwithstanding section 225C.38, subsection 2, the department
15shall revise the figure as necessary to conform to the amount
16of funding available.
17 Sec. 61. CONNER DECREE. There is appropriated from the
18general fund of the state to the department of human services
19for the fiscal year beginning July 1, 2020, and ending June 30,
202021, the following amount, or so much thereof as is necessary,
21to be used for the purpose designated:
22For building community capacity through the coordination
23and provision of training opportunities in accordance with the
24consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
25Iowa, July 14, 1994):
.................................................. $2633,632
27 Sec. 62. MENTAL HEALTH INSTITUTES.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2020, and ending June 30, 2021, the following
31amounts, or so much thereof as is necessary, to be used for the
32purposes designated:
33a. For operation of the state mental health institute at
34Cherokee as required by chapters 218 and 226 for salaries,
35support, maintenance, and miscellaneous purposes:
-92-.................................................. $114,293,758
2b. For operation of the state mental health institute at
3Independence as required by chapters 218 and 226 for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $519,262,041
62. Notwithstanding sections 218.78 and 249A.11, any revenue
7received from the state mental health institute at Cherokee or
8the state mental health institute at Independence pursuant to
942 C.F.R§438.6(e) may be retained and expended by the mental
10health institute.
113. Notwithstanding any provision of law to the contrary,
12a Medicaid member residing at the state mental health
13institute at Cherokee or the state mental health institute
14at Independence shall retain Medicaid eligibility during
15the period of the Medicaid member’s stay for which federal
16financial participation is available.
17 Sec. 63. STATE RESOURCE CENTERS.
181. There is appropriated from the general fund of the
19state to the department of human services for the fiscal year
20beginning July 1, 2020, and ending June 30, 2021, the following
21amounts, or so much thereof as is necessary, to be used for the
22purposes designated:
23a. For the state resource center at Glenwood for salaries,
24support, maintenance, and miscellaneous purposes:
.................................................. $2516,105,964
26b. For the state resource center at Woodward for salaries,
27support, maintenance, and miscellaneous purposes:
.................................................. $2810,912,712
292. The department may continue to bill for state resource
30center services utilizing a scope of services approach used for
31private providers of intermediate care facilities for persons
32with an intellectual disability services, in a manner which
33does not shift costs between the medical assistance program,
34counties, or other sources of funding for the state resource
35centers.
-93- 13. The state resource centers may expand the time-limited
2assessment and respite services during the fiscal year.
34. If the department’s administration and the department
4of management concur with a finding by a state resource
5center’s superintendent that projected revenues can reasonably
6be expected to pay the salary and support costs for a new
7employee position, or that such costs for adding a particular
8number of new positions for the fiscal year would be less
9than the overtime costs if new positions would not be added,
10the superintendent may add the new position or positions. If
11the vacant positions available to a resource center do not
12include the position classification desired to be filled, the
13state resource center’s superintendent may reclassify any
14vacant position as necessary to fill the desired position. The
15superintendents of the state resource centers may, by mutual
16agreement, pool vacant positions and position classifications
17during the course of the fiscal year in order to assist one
18another in filling necessary positions.
195. If existing capacity limitations are reached in
20operating units, a waiting list is in effect for a service or
21a special need for which a payment source or other funding
22is available for the service or to address the special need,
23and facilities for the service or to address the special need
24can be provided within the available payment source or other
25funding, the superintendent of a state resource center may
26authorize opening not more than two units or other facilities
27and begin implementing the service or addressing the special
28need during fiscal year 2020-2021.
29 Sec. 64. SEXUALLY VIOLENT PREDATORS.
301. There is appropriated from the general fund of the
31state to the department of human services for the fiscal year
32beginning July 1, 2020, and ending June 30, 2021, the following
33amount, or so much thereof as is necessary, to be used for the
34purpose designated:
35For costs associated with the commitment and treatment of
-94-1sexually violent predators in the unit located at the state
2mental health institute at Cherokee, including costs of legal
3services and other associated costs, including salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $512,313,977
62. Unless specifically prohibited by law, if the amount
7charged provides for recoupment of at least the entire amount
8of direct and indirect costs, the department of human services
9may contract with other states to provide care and treatment
10of persons placed by the other states at the unit for sexually
11violent predators at Cherokee. The moneys received under
12such a contract shall be considered to be repayment receipts
13and used for the purposes of the appropriation made in this
14section.
15 Sec. 65. FIELD OPERATIONS. There is appropriated from the
16general fund of the state to the department of human services
17for the fiscal year beginning July 1, 2020, and ending June 30,
182021, the following amount, or so much thereof as is necessary,
19to be used for the purposes designated:
20For field operations, including salaries, support,
21maintenance, and miscellaneous purposes:
.................................................. $2253,923,195
23Priority in filling full-time equivalent positions shall be
24given to those positions related to child protection services
25and eligibility determination for low-income families.
26 Sec. 66. GENERAL ADMINISTRATION. There is appropriated
27from the general fund of the state to the department of human
28services for the fiscal year beginning July 1, 2020, and ending
29June 30, 2021, the following amount, or so much thereof as is
30necessary, to be used for the purpose designated:
31For general administration, including salaries, support,
32maintenance, and miscellaneous purposes:
.................................................. $3313,833,040
341. The department shall report at least monthly to the
35legislative services agency concerning the department’s
-95-1operational and program expenditures.
22. Of the funds appropriated in this section, $150,000 shall
3be used to continue the contract for the provision of a program
4to provide technical assistance, support, and consultation to
5providers of habilitation services and home and community-based
6services waiver services for adults with disabilities under the
7medical assistance program.
83. Of the funds appropriated in this section, $50,000
9is transferred to the Iowa finance authority to be used
10for administrative support of the council on homelessness
11established in section 16.2D and for the council to fulfill its
12duties in addressing and reducing homelessness in the state.
134. Of the funds appropriated in this section, $200,000 shall
14be transferred to and deposited in the administrative fund of
15the Iowa ABLE savings plan trust created in section 12I.4, to
16be used for implementation and administration activities of the
17Iowa ABLE savings plan trust.
185. Of the funds appropriated in this section, $200,000 is
19transferred to the economic development authority for the Iowa
20commission on volunteer services to continue to be used for
21RefugeeRISE AmeriCorps program established under section 15H.8
22for member recruitment and training to improve the economic
23well-being and health of economically disadvantaged refugees in
24local communities across Iowa. Funds transferred may be used
25to supplement federal funds under federal regulations.
266. Of the funds appropriated in this section, up to $300,000
27shall be used as follows:
28a. To fund not more than one full-time equivalent position
29to address the department’s responsibility to support the work
30of the children’s system state board and implementation of the
31services required pursuant to 2018 Iowa Acts, chapter 1056,
32section 13.
33b. To support the cost of establishing and implementing
34new or additional services required pursuant to 2018 Iowa
35Acts, chapter 1056, and any legislation enacted by the 2019 or
-96-12020 general assembly establishing a children’s mental health
2system.
3c. Of the amount, $32,000 shall be transferred to
4the department of public health to support the costs of
5establishing and implementing new or additional services
6required pursuant to 2018 Iowa Acts, chapter 1056, and any
7legislation enacted by the 2019 or 2020 general assembly
8establishing a children’s mental health system.
9 Sec. 67. DEPARTMENT-WIDE DUTIES. There is appropriated
10from the general fund of the state to the department of human
11services for the fiscal year beginning July 1, 2020, and ending
12June 30, 2021, the following amount, or so much thereof as is
13necessary, to be used for the purposes designated:
14For salaries, support, maintenance, and miscellaneous
15purposes at facilities under the purview of the department of
16human services:
.................................................. $172,879,274
18 Sec. 68. CORPORATE TECHNOLOGY. There is appropriated
19from the general fund of the state to the department of human
20services for the fiscal year beginning July 1, 2020, and ending
21June 30, 2021, the following amount, or so much thereof as is
22necessary, to be used for the purposes designated:
23For the purchase of department-wide technology and software
24update needs:
.................................................. $252,530,413
26 Sec. 69. VOLUNTEERS. There is appropriated from the general
27fund of the state to the department of human services for the
28fiscal year beginning July 1, 2020, and ending June 30, 2021,
29the following amount, or so much thereof as is necessary, to be
30used for the purpose designated:
31For development and coordination of volunteer services:
.................................................. $3284,686
33 Sec. 70. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
34ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
35DEPARTMENT OF HUMAN SERVICES.
-97- 11. a. (1) For the fiscal year beginning July 1, 2020,
2case-mix, non-case mix, and special population nursing
3facilities shall be reimbursed in accordance with the
4methodology in effect on June 30, 2020.
5(2) For managed care claims, the department of human
6services shall adjust the payment rate floor for nursing
7facilities, annually, to maintain a rate floor that is no
8lower than the Medicaid fee-for-service case-mix adjusted rate
9calculated in accordance with 441 IAC 81.6. The department
10shall then calculate adjusted reimbursement rates, including
11but not limited to add-on-payments, annually, and shall
12notify Medicaid managed care organizations of the adjusted
13reimbursement rates within 30 days of determining the adjusted
14reimbursement rates. Any adjustment of reimbursement rates
15under this subparagraph division shall be budget neutral to the
16state budget.
17b. (1) For the fiscal year beginning July 1, 2020,
18the department shall establish the pharmacy dispensing fee
19reimbursement at $10.07 per prescription, until a cost of
20dispensing survey is completed. The actual dispensing fee
21shall be determined by a cost of dispensing survey performed
22by the department and required to be completed by all medical
23assistance program participating pharmacies every two years,
24adjusted as necessary to maintain expenditures within the
25amount appropriated to the department for this purpose for the
26fiscal year.
27(2) The department shall utilize an average acquisition
28cost reimbursement methodology for all drugs covered under the
29medical assistance program in accordance with 2012 Iowa Acts,
30chapter 1133, section 33.
31c. (1) For the fiscal year beginning July 1, 2020,
32reimbursement rates for outpatient hospital services shall
33be rebased effective January 1, 2021, subject to Medicaid
34program upper payment limit rules, and adjusted as necessary
35to maintain expenditures within the amount appropriated to the
-98-1department for this purpose for the fiscal year.
2(2) For the fiscal year beginning July 1, 2020,
3reimbursement rates for inpatient hospital services shall
4remain at the rates in effect on June 30, 2020, subject to
5Medicaid program upper payment limit rules, and adjusted
6as necessary to maintain expenditures within the amount
7appropriated to the department for this purpose for the fiscal
8year.
9(3) For the fiscal year beginning July 1, 2020, the graduate
10medical education and disproportionate share hospital fund
11shall remain at the amount in effect on June 30, 2020, except
12that the portion of the fund attributable to graduate medical
13education shall be reduced in an amount that reflects the
14elimination of graduate medical education payments made to
15out-of-state hospitals.
16(4) In order to ensure the efficient use of limited state
17funds in procuring health care services for low-income Iowans,
18funds appropriated in this Act for hospital services shall
19not be used for activities which would be excluded from a
20determination of reasonable costs under the federal Medicare
21program pursuant to 42 U.S.C.§1395x(v)(1)(N).
22d. For the fiscal year beginning July 1, 2020, reimbursement
23rates for hospices and acute mental hospitals shall be
24increased in accordance with increases under the federal
25Medicare program or as supported by their Medicare audited
26costs.
27e. For the fiscal year beginning July 1, 2020, independent
28laboratories and rehabilitation agencies shall be reimbursed
29using the same methodology in effect on June 30, 2020.
30f. (1) For the fiscal year beginning July 1, 2020,
31reimbursement rates for home health agencies shall continue to
32be based on the Medicare low utilization payment adjustment
33(LUPA) methodology with state geographic wage adjustments.
34(2) For the fiscal year beginning July 1, 2020, rates for
35private duty nursing and personal care services under the early
-99-1and periodic screening, diagnostic, and treatment program
2benefit shall be calculated based on the methodology in effect
3on June 30, 2020.
4g. For the fiscal year beginning July 1, 2020, federally
5qualified health centers and rural health clinics shall receive
6cost-based reimbursement for 100 percent of the reasonable
7costs for the provision of services to recipients of medical
8assistance.
9h. For the fiscal year beginning July 1, 2020, the
10reimbursement rates for dental services shall remain at the
11rates in effect on June 30, 2020.
12i. (1) For the fiscal year beginning July 1, 2020,
13reimbursement rates for the non-state-owned psychiatric medical
14institution for children shall be based on the methodology in
15effect on June 30, 2020.
16(2) As a condition of participation in the medical
17assistance program, enrolled providers shall accept the medical
18assistance reimbursement rate for any covered goods or services
19provided to recipients of medical assistance who are children
20under the custody of a psychiatric medical institution for
21children.
22j. For the fiscal year beginning July 1, 2020, unless
23otherwise specified in this Act, all noninstitutional medical
24assistance provider reimbursement rates shall remain at the
25rates in effect on June 30, 2020, except for area education
26agencies, local education agencies, infant and toddler
27services providers, home and community-based services providers
28including consumer-directed attendant care providers under a
29section 1915(c) or 1915(i) waiver, targeted case management
30providers, those providers whose rates are required to be
31determined pursuant to section 249A.20, or to meet federal
32mental health parity requirements.
33k. Notwithstanding any provision to the contrary, for the
34fiscal year beginning July 1, 2020, the reimbursement rate for
35anesthesiologists shall remain at the rate in effect on June
-100-130, 2020, and updated on January 1, 2021, to align with the
2most current Iowa Medicare anesthesia base rate.
3l. Notwithstanding section 249A.20, for the fiscal year
4beginning July 1, 2020, the average reimbursement rate for
5health care providers eligible for use of the federal Medicare
6resource-based relative value scale reimbursement methodology
7under section 249A.20 shall remain at the rate in effect on
8June 30, 2020; however, this rate shall not exceed the maximum
9level authorized by the federal government.
10m. For the fiscal year beginning July 1, 2020, the
11reimbursement rate for residential care facilities shall not
12be less than the minimum payment level as established by the
13federal government to meet the federally mandated maintenance
14of effort requirement. The flat reimbursement rate for
15facilities electing not to file annual cost reports shall not
16be less than the minimum payment level as established by the
17federal government to meet the federally mandated maintenance
18of effort requirement.
19n. For the fiscal year beginning July 1, 2020, the
20reimbursement rates for inpatient mental health services
21provided at hospitals shall remain at the rates in effect on
22June 30, 2020, subject to Medicaid program upper payment limit
23rules; and psychiatrists shall be reimbursed at the medical
24assistance program fee-for-service rate in effect on June 30,
252020.
26o. For the fiscal year beginning July 1, 2020, community
27mental health centers may choose to be reimbursed for the
28services provided to recipients of medical assistance through
29either of the following options:
30(1) For 100 percent of the reasonable costs of the services.
31(2) In accordance with the alternative reimbursement rate
32methodology approved by the department of human services in
33effect on June 30, 2020.
34p. For the fiscal year beginning July 1, 2020, the
35reimbursement rate for providers of family planning services
-101-1that are eligible to receive a 90 percent federal match shall
2remain at the rates in effect on June 30, 2020.
3q. Unless otherwise subject to a tiered rate methodology,
4for the fiscal year beginning July 1, 2020, the upper
5limits and reimbursement rates for providers of home and
6community-based services waiver services shall be reimbursed
7using the reimbursement methodology in effect on June 30, 2020.
8r. For the fiscal year beginning July 1, 2020, the
9reimbursement rates for emergency medical service providers
10shall remain at the rates in effect on June 30, 2020.
11s. For the fiscal year beginning July 1, 2020, reimbursement
12rates for substance-related disorder treatment programs
13licensed under section 125.13 shall remain at the rates in
14effect on June 30, 2020.
152. For the fiscal year beginning July 1, 2020, the
16reimbursement rate for providers reimbursed under the
17in-home-related care program shall not be less than the minimum
18payment level as established by the federal government to meet
19the federally mandated maintenance of effort requirement.
203. Unless otherwise directed in this section, when the
21department’s reimbursement methodology for any provider
22reimbursed in accordance with this section includes an
23inflation factor, this factor shall not exceed the amount
24by which the consumer price index for all urban consumers
25increased during the calendar year ending December 31, 2002.
264. Notwithstanding section 234.38, for the fiscal
27year beginning July 1, 2020, the foster family basic daily
28maintenance rate and the maximum adoption subsidy rate for
29children ages 0 through 5 years shall be $16.78, the rate for
30children ages 6 through 11 years shall be $17.45, the rate for
31children ages 12 through 15 years shall be $19.10, and the
32rate for children and young adults ages 16 and older shall
33be $19.35. For youth ages 18 to 21 who have exited foster
34care, the preparation for adult living program maintenance rate
35shall be $602.70 per month. The maximum payment for adoption
-102-1subsidy nonrecurring expenses shall be limited to $500 and the
2disallowance of additional amounts for court costs and other
3related legal expenses implemented pursuant to 2010 Iowa Acts,
4chapter 1031, section 408, shall be continued.
55. For the fiscal year beginning July 1, 2020, the maximum
6reimbursement rates for social services providers under
7contract shall remain at the rates in effect on June 30, 2020,
8or the provider’s actual and allowable cost plus inflation for
9each service, whichever is less. However, if a new service
10or service provider is added after June 30, 2020, the initial
11reimbursement rate for the service or provider shall be based
12upon a weighted average of provider rates for similar services.
136. a. For the fiscal year beginning July 1, 2020, the
14reimbursement rates for resource family recruitment and
15retention contractors shall be established by contract.
16b. For the fiscal year beginning July 1, 2020, the
17reimbursement rates for supervised apartment living foster care
18providers shall be established by contract.
197. For the fiscal year beginning July 1, 2019, the
20reimbursement rate for group foster care providers shall be the
21combined service and maintenance reimbursement rate established
22by contract.
238. The group foster care reimbursement rates paid for
24placement of children out of state shall be calculated
25according to the same rate-setting principles as those used for
26in-state providers, unless the director of human services or
27the director’s designee determines that appropriate care cannot
28be provided within the state. The payment of the daily rate
29shall be based on the number of days in the calendar month in
30which service is provided.
319. a. For the fiscal year beginning July 1, 2020, the
32reimbursement rate paid for shelter care and the child welfare
33emergency services implemented to provide or prevent the need
34for shelter care shall be established by contract.
35b. For the fiscal year beginning July 1, 2020, the combined
-103-1service and maintenance components of the reimbursement rate
2paid for shelter care services shall be based on the financial
3and statistical report submitted to the department. The
4maximum reimbursement rate shall be $101.83 per day. The
5department shall reimburse a shelter care provider at the
6provider’s actual and allowable unit cost, plus inflation, not
7to exceed the maximum reimbursement rate.
8c. Notwithstanding section 232.141, subsection 8, for the
9fiscal year beginning July 1, 2020, the amount of the statewide
10average of the actual and allowable rates for reimbursement of
11juvenile shelter care homes that is utilized for the limitation
12on recovery of unpaid costs shall remain at the amount in
13effect for this purpose in the fiscal year beginning July 1,
142019.
1510. For the fiscal year beginning July 1, 2020, the
16department shall calculate reimbursement rates for intermediate
17care facilities for persons with an intellectual disability
18at the 80th percentile. Beginning July 1, 2020, the rate
19calculation methodology shall utilize the consumer price index
20inflation factor applicable to the fiscal year beginning July
211, 2020.
2211. Effective July 1, 2020, the child care provider
23reimbursement rates shall remain at the rates in effect on June
2430, 2020. The department shall set rates in a manner so as
25to provide incentives for a nonregistered provider to become
26registered by applying any increase only to registered and
27licensed providers.
2812. The department may adopt emergency rules to implement
29this section.
30 Sec. 71. TRANSFER OF MEDICAID MANAGED CARE SAVINGS BETWEEN
31APPROPRIATIONS — FY 2020-2021. Notwithstanding section 8.39,
32subsection 1, for the fiscal year beginning July 1, 2020,
33and ending June 30, 2021, if savings resulting from Medicaid
34managed care initiatives accrue to the medical contracts or
35children’s health insurance program appropriation from the
-104-1general fund of the state and not to the medical assistance
2appropriation from the general fund of the state under this
3division of this Act, such savings may be transferred to such
4medical assistance appropriation for the same fiscal year
5without prior written consent and approval of the governor and
6the director of the department of management. The department
7of human services shall report any transfers made pursuant to
8this section to the legislative services agency.
9 Sec. 72. EMERGENCY RULES.
101. If specifically authorized by a provision of this
11division of this Act, the department of human services or
12the mental health and disability services commission may
13adopt administrative rules under section 17A.4, subsection
143, and section 17A.5, subsection 2, paragraph “b”, to
15implement the provisions of this division of this Act and
16the rules shall become effective immediately upon filing or
17on a later effective date specified in the rules, unless the
18effective date of the rules is delayed or the applicability
19of the rules is suspended by the administrative rules review
20committee. Any rules adopted in accordance with this section
21shall not take effect before the rules are reviewed by the
22administrative rules review committee. The delay authority
23provided to the administrative rules review committee under
24section 17A.4, subsection 7, and section 17A.8, subsection 9,
25shall be applicable to a delay imposed under this section,
26notwithstanding a provision in those sections making them
27inapplicable to section 17A.5, subsection 2, paragraph “b”.
28Any rules adopted in accordance with the provisions of this
29section shall also be published as a notice of intended action
30as provided in section 17A.4.
312. If during a fiscal year, the department of human
32services is adopting rules in accordance with this section
33or as otherwise directed or authorized by state law, and the
34rules will result in an expenditure increase beyond the amount
35anticipated in the budget process or if the expenditure was
-105-1not addressed in the budget process for the fiscal year, the
2department shall notify the persons designated by this division
3of this Act for submission of reports, the chairpersons and
4ranking members of the committees on appropriations, and
5the department of management concerning the rules and the
6expenditure increase. The notification shall be provided at
7least 30 calendar days prior to the date notice of the rules
8is submitted to the administrative rules coordinator and the
9administrative code editor.
10 Sec. 73. REPORTS. Any reports or other information
11required to be compiled and submitted under this Act during the
12fiscal year beginning July 1, 2020, shall be submitted to the
13chairpersons and ranking members of the joint appropriations
14subcommittee on health and human services, the legislative
15services agency, and the legislative caucus staffs on or
16before the dates specified for submission of the reports or
17information.
18 Sec. 74. EFFECTIVE UPON ENACTMENT. The following
19provisions of this division of this Act, being deemed of
20immediate importance, take effect upon enactment:
211. The provision relating to section 232.141 and directing
22the state court administrator and the division administrator of
23the department of human services division of child and family
24services to make the determination, by June 15, 2020, of the
25distribution of funds allocated for the payment of the expenses
26of court-ordered services provided to juveniles which are a
27charge upon the state.
28DIVISION XII
29HEALTH CARE ACCOUNTS AND FUNDS — FY 2020-2021
30 Sec. 75. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
31appropriated from the pharmaceutical settlement account created
32in section 249A.33 to the department of human services for the
33fiscal year beginning July 1, 2020, and ending June 30, 2021,
34the following amount, or so much thereof as is necessary, to be
35used for the purpose designated:
-106- 1Notwithstanding any provision of law to the contrary, to
2supplement the appropriations made in this Act for medical
3contracts under the medical assistance program for the fiscal
4year beginning July 1, 2020, and ending June 30, 2021:
.................................................. $5234,193
6 Sec. 76. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
7SERVICES. Notwithstanding any provision to the contrary and
8subject to the availability of funds, there is appropriated
9from the quality assurance trust fund created in section
10249L.4 to the department of human services for the fiscal year
11beginning July 1, 2020, and ending June 30, 2021, the following
12amounts, or so much thereof as is necessary, for the purposes
13designated:
14To supplement the appropriation made in this Act from the
15general fund of the state to the department of human services
16for medical assistance for the same fiscal year:
.................................................. $1758,570,397
18 Sec. 77. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
19DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
20the contrary and subject to the availability of funds, there is
21appropriated from the hospital health care access trust fund
22created in section 249M.4 to the department of human services
23for the fiscal year beginning July 1, 2020, and ending June
2430, 2021, the following amounts, or so much thereof as is
25necessary, for the purposes designated:
26To supplement the appropriation made in this Act from the
27general fund of the state to the department of human services
28for medical assistance for the same fiscal year:
.................................................. $2933,920,554
30 Sec. 78. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
31FOR FY 2020-2021. Notwithstanding section 8.33, if moneys
32appropriated for purposes of the medical assistance program for
33the fiscal year beginning July 1, 2020, and ending June 30,
342021, from the general fund of the state, the quality assurance
35trust fund and the hospital health care access trust fund, are
-107-1in excess of actual expenditures for the medical assistance
2program and remain unencumbered or unobligated at the close
3of the fiscal year, the excess moneys shall not revert but
4shall remain available for expenditure for the purposes of the
5medical assistance program until the close of the succeeding
6fiscal year.
7DIVISION XIII
8IOWA DEPARTMENT ON AGING — MEDICAID CLAIMING
9 Sec. 79. IOWA DEPARTMENT ON AGING — MEDICAID CLAIMING. The
10department on aging and the department of human services shall
11continue to collaborate to develop a cost allocation plan
12requesting Medicaid administrative funding to provide for the
13claiming of federal financial participation for aging and
14disability resource center activities that are performed to
15assist with administration of the Medicaid program. By January
161, 2021, the department of human services shall submit to
17the centers for Medicare and Medicaid services of the United
18States department of health and human services any Medicaid
19state plan amendment as necessary and shall enter into any
20interagency agreement with the department on aging to implement
21this section.
22DIVISION XIV
23DECATEGORIZATION
24 Sec. 80. DECATEGORIZATION CARRYOVER FUNDING FY 2017 —
25TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
26subsection 5, paragraph “b”, any state-appropriated moneys in
27the funding pool that remained unencumbered or unobligated
28at the close of the fiscal year beginning July 1, 2016, and
29were deemed carryover funding to remain available for the two
30succeeding fiscal years that still remain unencumbered or
31unobligated at the close of the fiscal year beginning July 1,
322018, shall not revert but shall be transferred to the medical
33assistance program for the fiscal year beginning July 1, 2019.
34 Sec. 81. EFFECTIVE DATE. This division of this Act, being
35deemed of immediate importance, takes effect upon enactment.
-108-1 Sec. 82. RETROACTIVE APPLICABILITY. This division of this
2Act applies retroactively to July 1, 2018.
3DIVISION XV
4Decategorization
5 Sec. 83. DECATEGORIZATION CARRYOVER FUNDING FY 2018 —
6TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
7subsection 5, paragraph “b”, any state-appropriated moneys in
8the funding pool that remained unencumbered or unobligated
9at the close of the fiscal year beginning July 1, 2017, and
10were deemed carryover funding to remain available for the two
11succeeding fiscal years that still remain unencumbered or
12unobligated at the close of the fiscal year beginning July 1,
132019, shall not revert but shall be transferred to the medical
14assistance program for the fiscal year beginning July 1, 2020.
15 Sec. 84. EFFECTIVE DATE. This division of this Act, being
16deemed of immediate importance, takes effect upon enactment.
17 Sec. 85. RETROACTIVE APPLICABILITY. This division of this
18Act applies retroactively to July 1, 2019.
19DIVISION XVI
20PRIOR APPROPRIATIONS AND OTHER PROVISIONS
21TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF)
22 Sec. 86. 2017 Iowa Acts, chapter 174, section 45, as amended
23by 2018 Iowa Acts, chapter 1165, section 10, is amended to read
24as follows:
25SEC. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
26GRANT. There is appropriated from the fund created in section
278.41 to the department of human services for the fiscal year
28beginning July 1, 2018, and ending June 30, 2019, from moneys
29received under the federal temporary assistance for needy
30families (TANF) block grant pursuant to the federal Personal
31Responsibility and Work Opportunity Reconciliation Act of 1996,
32Pub.L.No.104-193, and successor legislation, the following
33amounts, or so much thereof as is necessary, to be used for the
34purposes designated:
351. To be credited to the family investment program account
-109-1and used for assistance under the family investment program
2under chapter 239B:
.................................................. $34,539,006
44,025,108
52. To be credited to the family investment program account
6and used for the job opportunities and basic skills (JOBS)
7program and implementing family investment agreements in
8accordance with chapter 239B:
.................................................. $95,412,060
105,192,060
113. To be used for the family development and
12self-sufficiency grant program in accordance with section
13216A.107:
.................................................. $142,883,980
152,898,980
16Notwithstanding section 8.33, moneys appropriated in this
17subsection that remain unencumbered or unobligated at the close
18of the fiscal year shall not revert but shall remain available
19for expenditure for the purposes designated until the close of
20the succeeding fiscal year. However, unless such moneys are
21encumbered or obligated on or before September 30, 2019, the
22moneys shall revert.
234. For field operations:
.................................................. $2431,296,232
2532,465,681
265. For general administration:
.................................................. $273,744,000
286. For state child care assistance:
.................................................. $2947,166,826
30a. Of the funds appropriated in this subsection,
31$26,205,412 is transferred to the child care and development
32block grant appropriation made by the Eighty-seventh General
33Assembly, 2018 session, for the federal fiscal year beginning
34October 1, 2018, and ending September 30, 2019. Of this
35amount, $200,000 shall be used for provision of educational
-110-1opportunities to registered child care home providers in order
2to improve services and programs offered by this category
3of providers and to increase the number of providers. The
4department may contract with institutions of higher education
5or child care resource and referral centers to provide
6the educational opportunities. Allowable administrative
7costs under the contracts shall not exceed 5 percent. The
8application for a grant shall not exceed two pages in length.
9b. Any funds appropriated in this subsection remaining
10unallocated shall be used for state child care assistance
11payments for families who are employed including but not
12limited to individuals enrolled in the family investment
13program.
147. For child and family services:
.................................................. $1532,380,654
168. For child abuse prevention grants:
.................................................. $17125,000
189. For pregnancy prevention grants on the condition that
19family planning services are funded:
.................................................. $201,913,203
211,890,203
22Pregnancy prevention grants shall be awarded to programs
23in existence on or before July 1, 2018, if the programs have
24demonstrated positive outcomes. Grants shall be awarded to
25pregnancy prevention programs which are developed after July
261, 2018, if the programs are based on existing models that
27have demonstrated positive outcomes. Grants shall comply with
28the requirements provided in 1997 Iowa Acts, chapter 208,
29section 14, subsections 1 and 2, including the requirement that
30grant programs must emphasize sexual abstinence. Priority in
31the awarding of grants shall be given to programs that serve
32areas of the state which demonstrate the highest percentage of
33unplanned pregnancies of females of childbearing age within the
34geographic area to be served by the grant.
3510. For technology needs and other resources necessary
-111-1to meet federal welfare reform reporting, tracking, and case
2management requirements:
.................................................. $31,037,186
4862,186
511. a. Notwithstanding any provision to the contrary,
6including but not limited to requirements in section 8.41 or
7provisions in 2017 or 2018 Iowa Acts regarding the receipt and
8appropriation of federal block grants, federal funds from the
9temporary assistance for needy families block grant received by
10the state and not otherwise appropriated in this section and
11remaining available for the fiscal year beginning July 1, 2018,
12are appropriated to the department of human services to the
13extent as may be necessary to be used in the following priority
14order: the family investment program, for state child care
15assistance program payments for families who are employed, and
16for the family investment program share of system costs for
17eligibility determination and related functions. The federal
18funds appropriated in this paragraph “a” shall be expended
19only after all other funds appropriated in subsection 1 for
20assistance under the family investment program, in subsection 6
21for child care assistance, or in subsection 10 for technology
22costs related to the family investment program, as applicable,
23have been expended. For the purposes of this subsection, the
24funds appropriated in subsection 6, paragraph “a”, for transfer
25to the child care and development block grant appropriation
26are considered fully expended when the full amount has been
27transferred.
28b. The department shall, on a quarterly basis, advise the
29legislative services agency and department of management of
30the amount of funds appropriated in this subsection that was
31expended in the prior quarter.
3212. Of the amounts appropriated in this section,
33$12,962,008 for the fiscal year beginning July 1, 2018, is
34transferred to the appropriation of the federal social services
35block grant made to the department of human services for that
-112-1fiscal year.
213. For continuation of the program providing categorical
3eligibility for the food assistance program as specified
4for the program in the section of this division of this Act
5relating to the family investment program account:
.................................................. $614,236
713,000
814. The department may transfer funds allocated in this
9section to the appropriations made in this division of this Act
10for the same fiscal year for general administration and field
11operations for resources necessary to implement and operate the
12services referred to in this section and those funded in the
13appropriation made in this division of this Act for the same
14fiscal year for the family investment program from the general
15fund of the state.
1615. With the exception of moneys allocated under this
17section for the family development and self-sufficiency grant
18program, to the extent moneys allocated in this section are
19deemed by the department not to be necessary to support the
20purposes for which they are allocated, such moneys may be
21used in the same fiscal year for any other purpose for which
22funds are allocated in this section or in section 7 of this
23division for the family investment program account. If there
24are conflicting needs, priority shall first be given to the
25family investment program account as specified under subsection
261 of this section and used for the purposes of assistance under
27the family investment program under chapter 239B, followed by
28state child care assistance program payments for families who
29are employed, followed by other priorities as specified by the
30department.
31FAMILY INVESTMENT PROGRAM ADJUSTMENTS
32 Sec. 87. 2017 Iowa Acts, chapter 174, section 46, subsection
334, as amended by 2018 Iowa Acts, chapter 1165, section 11, is
34amended to read as follows:
354. Moneys appropriated in this division of this Act and
-113-1credited to the FIP account for the fiscal year beginning July
21, 2018, and ending June 30, 2019, are allocated as follows:
3a. To be retained by the department of human services to
4be used for coordinating with the department of human rights
5to more effectively serve participants in FIP and other shared
6clients and to meet federal reporting requirements under the
7federal temporary assistance for needy families block grant:
.................................................. $85,000
920,000
10b. To the department of human rights for staffing,
11administration, and implementation of the family development
12and self-sufficiency grant program in accordance with section
13216A.107:
.................................................. $146,192,834
15(1) Of the funds allocated for the family development
16and self-sufficiency grant program in this paragraph “b”,
17not more than 5 percent of the funds shall be used for the
18administration of the grant program.
19(2) The department of human rights may continue to implement
20the family development and self-sufficiency grant program
21statewide during fiscal year 2018-2019.
22(3) The department of human rights may engage in activities
23to strengthen and improve family outcomes measures and
24data collection systems under the family development and
25self-sufficiency grant program.
26c. For the diversion subaccount of the FIP account:
.................................................. $27749,694
28815,000
29A portion of the moneys allocated for the subaccount may
30be used for field operations, salaries, data management
31system development, and implementation costs and support
32deemed necessary by the director of human services in order to
33administer the FIP diversion program. To the extent moneys
34allocated in this paragraph “c” are deemed by the department
35not to be necessary to support diversion activities, such
-114-1moneys may be used for other efforts intended to increase
2engagement by family investment program participants in work,
3education, or training activities, or for the purposes of
4assistance under the family investment program in accordance
5with chapter 239B.
6d. For the food assistance employment and training program:
.................................................. $766,588
8(1) The department shall apply the federal supplemental
9nutrition assistance program (SNAP) employment and training
10state plan in order to maximize to the fullest extent permitted
11by federal law the use of the 50 percent federal reimbursement
12provisions for the claiming of allowable federal reimbursement
13funds from the United States department of agriculture
14pursuant to the federal SNAP employment and training program
15for providing education, employment, and training services
16for eligible food assistance program participants, including
17but not limited to related dependent care and transportation
18expenses.
19(2) The department shall continue the categorical federal
20food assistance program eligibility at 160 percent of the
21federal poverty level and continue to eliminate the asset test
22from eligibility requirements, consistent with federal food
23assistance program requirements. The department shall include
24as many food assistance households as is allowed by federal
25law. The eligibility provisions shall conform to all federal
26requirements including requirements addressing individuals who
27are incarcerated or otherwise ineligible.
28e. For the JOBS program:
.................................................. $2912,139,821
3011,919,821
31MEDICAL ASSISTANCE PROGRAM ADJUSTMENT
32 Sec. 88. 2017 Iowa Acts, chapter 174, section 51, unnumbered
33paragraph 2, as amended by 2018 Iowa Acts, chapter 1165,
34section 18, unnumbered paragraph 2, is amended to read as
35follows:
-115- 1For medical assistance program reimbursement and associated
2costs as specifically provided in the reimbursement
3methodologies in effect on June 30, 2018, except as otherwise
4expressly authorized by law, consistent with options under
5federal law and regulations, and contingent upon receipt of
6approval from the office of the governor of reimbursement for
7each abortion performed under the program:
.................................................. $81,337,841,375
91,478,966,820
10GROUP FOSTER CARE REALLOCATION
11 Sec. 89. 2017 Iowa Acts, chapter 174, section 57, subsection
123, paragraph a, as amended by 2018 Iowa Acts, chapter 1165,
13section 28, is amended to read as follows:
143. a. Of the funds appropriated in this section, up to
15$34,536,648 is allocated as the statewide expenditure target
16under section 232.143 for group foster care maintenance and
17services. If the department projects that such expenditures
18for the fiscal year will be less than the target amount
19allocated in this paragraph “a”, the department may reallocate
20the excess to provide additional funding for family foster
21care, independent living, family safety, risk and permanency
22services, shelter care, or the child welfare emergency services
23addressed with the allocation for shelter care.
24SHELTER CARE ALLOCATION
25 Sec. 90. 2017 Iowa Acts, chapter 174, section 57, subsection
266, as amended by 2018 Iowa Acts, chapter 1165, section 28, is
27amended to read as follows:
286. Notwithstanding section 234.35 or any other provision of
29law to the contrary, state funding Of the funds appropriated
30in this section, a sufficient amount is allocated for shelter
31care and the child welfare emergency services contracting
32implemented to provide for or prevent the need for shelter care
33shall be limited to $8,096,158.
34OTHER FUNDING FOR CHILD WELFARE SERVICES
35 Sec. 91. 2017 Iowa Acts, chapter 174, section 57, subsection
-116-16, as amended by 2018 Iowa Acts, chapter 1165, section 28, is
2amended by adding the following new subsection:
3 NEW SUBSECTION. 24. If a separate funding source is
4identified that reduces the need for state funds within an
5allocation under this section, the allocated state funds may be
6redistributed to other allocations under this section for the
7same fiscal year.
8 Sec. 92. EFFECTIVE DATE. This division of this Act, being
9deemed of immediate importance, takes effect upon enactment.
10 Sec. 93. RETROACTIVE APPLICABILITY. This division of this
11Act applies retroactively to July 1, 2018.
12DIVISION XVII
13HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM FUTURE REPEAL
14 Sec. 94. Section 249M.5, Code 2019, is amended to read as
15follows:
16249M.5 Future repeal.
17This chapter is repealed July 1, 2019 2021.
18 Sec. 95. EFFECTIVE DATE. This division of this Act, being
19deemed of immediate importance, takes effect upon enactment.
20EXPLANATION
21The inclusion of this explanation does not constitute agreement with
22the explanation’s substance by the members of the general assembly.
23This bill relates to appropriations for health and human
24services for fiscal years 2019-2020 and 2020-2021 to the
25department of veterans affairs, Iowa veterans home, department
26on aging (IDA), office of long-term care ombudsman, department
27of public health (DPH), Iowa finance authority, department of
28human rights, and department of human services (DHS). The bill
29is organized into divisions for each fiscal year.
30DEPARTMENT ON AGING. This division makes appropriations
31from the general fund of the state to the department on aging.
32OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
33appropriations from the general fund of the state to the office
34of long-term care ombudsman.
35DEPARTMENT OF PUBLIC HEALTH. This division makes
-117-1appropriations from the general fund of the state to the
2department of public health.
3DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
4division makes appropriations from the general fund of the
5state to the department of veterans affairs for administration,
6the Iowa veterans home, for transfer to the Iowa finance
7authority for the home ownership assistance program, and for
8the county commissions of veteran affairs.
9DEPARTMENT OF HUMAN SERVICES. This division makes
10appropriations from the general fund of the state and the
11federal temporary assistance for needy families block
12grant to DHS. The allocation for the family development
13and self-sufficiency grant program is made directly to
14the department of human rights. The reimbursement section
15addresses reimbursement for providers reimbursed by the
16department of human services.
17HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
18health-related appropriations. A number of the appropriations
19are made for purposes of the Medicaid program in addition to
20the general fund appropriations made for this purpose for the
21same fiscal year.
-118-pf/tm
2and veterans, including other related appropriations and
3provisions and including effective date and retroactive and
4other applicability date provisions.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2019-2020
3 Section 1. DEPARTMENT ON AGING. There is appropriated from
4the general fund of the state to the department on aging for
5the fiscal year beginning July 1, 2019, and ending June 30,
62020, the following amount, or so much thereof as is necessary,
7to be used for the purposes designated:
8For aging programs for the department on aging and area
9agencies on aging to provide citizens of Iowa who are 60 years
10of age and older with case management for frail elders, Iowa’s
11aging and disabilities resource center, and other services
12which may include but are not limited to adult day services,
13respite care, chore services, information and assistance,
14and material aid, for information and options counseling for
15persons with disabilities who are 18 years of age or older,
16and for salaries, support, administration, maintenance, and
17miscellaneous purposes:
.................................................. $1811,042,924
191. Funds appropriated in this section may be used to
20supplement federal funds under federal regulations. To
21receive funds appropriated in this section, a local area
22agency on aging shall match the funds with moneys from other
23sources according to rules adopted by the department. Funds
24appropriated in this section may be used for elderly services
25not specifically enumerated in this section only if approved
26by an area agency on aging for provision of the service within
27the area.
282. Of the funds appropriated in this section, $279,946 is
29transferred to the economic development authority for the Iowa
30commission on volunteer services to be used for the retired and
31senior volunteer program.
323. a. The department on aging shall establish and enforce
33procedures relating to expenditure of state and federal funds
34by area agencies on aging that require compliance with both
35state and federal laws, rules, and regulations, including but
-1-1not limited to all of the following:
2(1) Requiring that expenditures are incurred only for goods
3or services received or performed prior to the end of the
4fiscal period designated for use of the funds.
5(2) Prohibiting prepayment for goods or services not
6received or performed prior to the end of the fiscal period
7designated for use of the funds.
8(3) Prohibiting the prepayment for goods or services
9not defined specifically by good or service, time period, or
10recipient.
11(4) Prohibiting the establishment of accounts from which
12future goods or services which are not defined specifically by
13good or service, time period, or recipient, may be purchased.
14b. The procedures shall provide that if any funds are
15expended in a manner that is not in compliance with the
16procedures and applicable federal and state laws, rules, and
17regulations, and are subsequently subject to repayment, the
18area agency on aging expending such funds in contravention of
19such procedures, laws, rules and regulations, not the state,
20shall be liable for such repayment.
214. Of the funds appropriated in this section, at least
22$600,000 shall be used to fund home and community-based
23services through the area agencies on aging that enable older
24individuals to avoid more costly utilization of residential or
25institutional services and remain in their own homes.
265. Of the funds appropriated in this section, $812,537 shall
27be used for the purposes of chapter 231E and to administer
28the prevention of elder abuse, neglect, and exploitation
29program pursuant to section 231.56A, in accordance with the
30requirements of the federal Older Americans Act of 1965, 42
31U.S.C.§3001 et seq., as amended.
326. Of the funds appropriated in this section, $1,000,000
33shall be used to fund continuation of the aging and disability
34resource center lifelong links to provide individuals and
35caregivers with information and services to plan for and
-2-1maintain independence.
27. Of the funds appropriated in this section, $100,000
3shall be used by the department on aging, in collaboration with
4the department of human services and affected stakeholders, to
5continue the pilot initiative to provide long-term care options
6counseling utilizing support planning protocols, to assist
7non-Medicaid eligible consumers who indicate a preference
8to return to the community and are deemed appropriate for
9discharge, to return to their community following a nursing
10facility stay.
11DIVISION II
12OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2019-2020
13 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
14appropriated from the general fund of the state to the office
15of long-term care ombudsman for the fiscal year beginning July
161, 2019, and ending June 30, 2020, the following amount, or
17so much thereof as is necessary, to be used for the purposes
18designated:
19For salaries, support, administration, maintenance, and
20miscellaneous purposes:
.................................................. $211,149,821
22DIVISION III
23DEPARTMENT OF PUBLIC HEALTH — FY 2019-2020
24 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
25from the general fund of the state to the department of public
26health for the fiscal year beginning July 1, 2019, and ending
27June 30, 2020, the following amounts, or so much thereof as is
28necessary, to be used for the purposes designated:
291. ADDICTIVE DISORDERS
30For reducing the prevalence of the use of tobacco, alcohol,
31and other drugs, and treating individuals affected by addictive
32behaviors, including gambling:
.................................................. $3325,110,594
34a. Of the funds appropriated in this subsection, $4,021,225
35shall be used for the tobacco use prevention and control
-3-1initiative, including efforts at the state and local levels,
2as provided in chapter 142A. The commission on tobacco use
3prevention and control established pursuant to section 142A.3
4shall advise the director of public health in prioritizing
5funding needs and the allocation of moneys appropriated for
6the programs and initiatives. Activities of the programs
7and initiatives shall be in alignment with the United States
8centers for disease control and prevention best practices
9for comprehensive tobacco control programs that include
10the goals of preventing youth initiation of tobacco usage,
11reducing exposure to secondhand smoke, and promotion of tobacco
12cessation.
13b. (1) Of the funds appropriated in this subsection,
14$21,089,369 shall be used for problem gambling and
15substance-related disorder prevention, treatment, and recovery
16services, including a 24-hour helpline, public information
17resources, professional training, youth prevention, and program
18evaluation.
19(2) Of the amount allocated under this paragraph, not
20more than $306,250 shall be utilized by the department of
21public health, in collaboration with the department of human
22services, to support establishment and maintenance of a single
23statewide 24-hour crisis hotline for the Iowa children’s mental
24health system that incorporates warmline services which may be
25provided through expansion of existing capabilities maintained
26by the department of public health as required pursuant to 2018
27Iowa Acts, chapter 1056, section 16.
28c. The requirement of section 123.17, subsection 5, is met
29by the appropriations and allocations made in this division of
30this Act for purposes of substance-related disorder treatment
31and addictive disorders for the fiscal year beginning July 1,
322019.
332. HEALTHY CHILDREN AND FAMILIES
34For promoting the optimum health status for children,
35adolescents from birth through 21 years of age, and families:
-4-.................................................. $15,820,625
23. CHRONIC CONDITIONS
3For serving individuals identified as having chronic
4conditions or special health care needs:
.................................................. $54,228,109
64. COMMUNITY CAPACITY
7For strengthening the health care delivery system at the
8local level:
.................................................. $94,970,152
10a. Of the funds appropriated in this subsection, $2,000,000
11shall be deposited in the medical residency training account
12created in section 135.175, subsection 5, paragraph “a”, and
13is appropriated from the account to the department of public
14health to be used for the purposes of the medical residency
15training state matching grants program as specified in section
16135.176.
17b. Of the funds appropriated in this subsection, $799,454
18is allocated for the purposes of health care and public health
19workforce initiatives, and of this amount, $250,000 shall be
20used for the public purpose of providing funding to Des Moines
21university to continue a provider education project to provide
22primary care physicians with the training and skills necessary
23to recognize the signs of mental illness in patients.
245. ESSENTIAL PUBLIC HEALTH SERVICES
25a. To provide public health services that reduce risks
26and invest in promoting and protecting good health over the
27course of a lifetime with a priority given to older Iowans and
28vulnerable populations:
.................................................. $297,962,464
30b. Of the funds appropriated in this subsection, $300,000 is
31allocated for performance improvement activities.
326. INFECTIOUS DISEASES
33For reducing the incidence and prevalence of communicable
34diseases:
.................................................. $351,796,426
-5- 17. PUBLIC PROTECTION
2a. For protecting the health and safety of the public
3through establishing standards and enforcing regulations:
.................................................. $44,095,139
5b. Of the funds appropriated in this subsection, not more
6than $304,700 shall be credited to the emergency medical
7services fund created in section 135.25. Moneys in the
8emergency medical services fund are appropriated to the
9department to be used for the purposes of the fund.
108. RESOURCE MANAGEMENT
11For establishing and sustaining the overall ability of the
12department to deliver services to the public:
.................................................. $13971,215
149. MISCELLANEOUS PROVISIONS
15The university of Iowa hospitals and clinics under the
16control of the state board of regents shall not receive
17indirect costs from the funds appropriated in this section.
18The university of Iowa hospitals and clinics billings to the
19department shall be on at least a quarterly basis.
20DIVISION IV
21DEPARTMENT OF VETERANS AFFAIRS — FY 2019-2020
22 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is
23appropriated from the general fund of the state to the
24department of veterans affairs for the fiscal year beginning
25July 1, 2019, and ending June 30, 2020, the following amounts,
26or so much thereof as is necessary, to be used for the purposes
27designated:
281. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
29For salaries, support, maintenance, and miscellaneous
30purposes:
.................................................. $311,225,500
322. IOWA VETERANS HOME
33For salaries, support, maintenance, and miscellaneous
34purposes:
.................................................. $357,162,976
-6- 1a. The Iowa veterans home billings involving the department
2of human services shall be submitted to the department on at
3least a monthly basis.
4b. Within available resources and in conformance with
5associated state and federal program eligibility requirements,
6the Iowa veterans home may implement measures to provide
7financial assistance to or on behalf of veterans or their
8spouses who are participating in the community reentry program.
9c. The Iowa veterans home expenditure report shall be
10submitted monthly to the legislative services agency.
11d. The Iowa veterans home shall continue to include in the
12annual discharge report applicant information to provide for
13the collection of demographic information including but not
14limited to the number of individuals applying for admission and
15admitted or denied admittance and the basis for the admission
16or denial; the age, gender, and race of such individuals;
17and the level of care for which such individuals applied for
18admission including residential or nursing level of care.
193. HOME OWNERSHIP ASSISTANCE PROGRAM
20For transfer to the Iowa finance authority for the
21continuation of the home ownership assistance program for
22persons who are or were eligible members of the armed forces of
23the United States, pursuant to section 16.54:
.................................................. $242,000,000
25 Sec. 5. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
26FUND STANDING APPROPRIATIONS. Notwithstanding the standing
27appropriation in section 35A.16 for the fiscal year beginning
28July 1, 2019, and ending June 30, 2020, the amount appropriated
29from the general fund of the state pursuant to that section
30for the following designated purposes shall not exceed the
31following amount:
32For the county commissions of veteran affairs fund under
33section 35A.16:
.................................................. $34990,000
35DIVISION V
-7-1DEPARTMENT OF HUMAN SERVICES — FY 2019-2020
2 Sec. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
3GRANT. There is appropriated from the fund created in section
48.41 to the department of human services for the fiscal year
5beginning July 1, 2019, and ending June 30, 2020, from moneys
6received under the federal temporary assistance for needy
7families (TANF) block grant pursuant to the federal Personal
8Responsibility and Work Opportunity Reconciliation Act of 1996,
9Pub.L.No.104-193, and successor legislation, the following
10amounts, or so much thereof as is necessary, to be used for the
11purposes designated:
121. To be credited to the family investment program account
13and used for assistance under the family investment program
14under chapter 239B:
.................................................. $154,524,006
162. To be credited to the family investment program account
17and used for the job opportunities and basic skills (JOBS)
18program and implementing family investment agreements in
19accordance with chapter 239B:
.................................................. $205,412,060
213. To be used for the family development and
22self-sufficiency grant program in accordance with section
23216A.107:
.................................................. $242,898,980
25Notwithstanding section 8.33, moneys appropriated in this
26subsection that remain unencumbered or unobligated at the close
27of the fiscal year shall not revert but shall remain available
28for expenditure for the purposes designated until the close of
29the succeeding fiscal year. However, unless such moneys are
30encumbered or obligated on or before September 30, 2020, the
31moneys shall revert.
324. For field operations:
.................................................. $3331,296,232
345. For general administration:
.................................................. $353,744,000
-8- 16. For state child care assistance:
.................................................. $247,166,826
3a. Of the funds appropriated in this subsection,
4$26,205,412 is transferred to the child care and development
5block grant appropriation made by the Eighty-eighth General
6Assembly, 2019 session, for the federal fiscal year beginning
7October 1, 2019, and ending September 30, 2020. Of this
8amount, $200,000 shall be used for provision of educational
9opportunities to registered child care home providers in order
10to improve services and programs offered by this category
11of providers and to increase the number of providers. The
12department may contract with institutions of higher education
13or child care resource and referral centers to provide
14the educational opportunities. Allowable administrative
15costs under the contracts shall not exceed 5 percent. The
16application for a grant shall not exceed two pages in length.
17b. Any funds appropriated in this subsection remaining
18unallocated shall be used for state child care assistance
19payments for families who are employed including but not
20limited to individuals enrolled in the family investment
21program.
227. For child and family services:
.................................................. $2332,380,654
248. For child abuse prevention grants:
.................................................. $25125,000
269. For pregnancy prevention grants on the condition that
27family planning services are funded:
.................................................. $281,913,203
29Pregnancy prevention grants shall be awarded to programs
30in existence on or before July 1, 2019, if the programs have
31demonstrated positive outcomes. Grants shall be awarded to
32pregnancy prevention programs which are developed after July
331, 2019, if the programs are based on existing models that
34have demonstrated positive outcomes. Grants shall comply with
35the requirements provided in 1997 Iowa Acts, chapter 208,
-9-1section 14, subsections 1 and 2, including the requirement that
2grant programs must emphasize sexual abstinence. Priority in
3the awarding of grants shall be given to programs that serve
4areas of the state which demonstrate the highest percentage of
5unplanned pregnancies of females of childbearing age within the
6geographic area to be served by the grant.
710. For technology needs and other resources necessary
8to meet federal welfare reform reporting, tracking, and case
9management requirements:
.................................................. $101,037,186
1111. a. Notwithstanding any provision to the contrary,
12including but not limited to requirements in section 8.41 or
13provisions in 2018 or 2019 Iowa Acts regarding the receipt and
14appropriation of federal block grants, federal funds from the
15temporary assistance for needy families block grant received by
16the state and not otherwise appropriated in this section and
17remaining available for the fiscal year beginning July 1, 2019,
18are appropriated to the department of human services to the
19extent as may be necessary to be used in the following priority
20order: the family investment program, for state child care
21assistance program payments for families who are employed, and
22for the family investment program share of system costs for
23eligibility determination and related functions. The federal
24funds appropriated in this paragraph “a” shall be expended
25only after all other funds appropriated in subsection 1 for
26assistance under the family investment program, in subsection
276 for state child care assistance, or in subsection 10 for
28technology costs related to the family investment program,
29as applicable, have been expended. For the purposes of this
30subsection, the funds appropriated in subsection 6, paragraph
31“a”, for transfer to the child care and development block grant
32appropriation are considered fully expended when the full
33amount has been transferred.
34b. The department shall, on a quarterly basis, advise the
35legislative services agency and department of management of
-10-1the amount of funds appropriated in this subsection that was
2expended in the prior quarter.
312. Of the amounts appropriated in this section,
4$12,962,008 for the fiscal year beginning July 1, 2019, is
5transferred to the appropriation of the federal social services
6block grant made to the department of human services for that
7fiscal year.
813. For continuation of the program providing categorical
9eligibility for the food assistance program as specified
10for the program in the section of this division of this Act
11relating to the family investment program account:
.................................................. $1214,236
1314. The department may transfer funds allocated in this
14section to the appropriations made in this division of this Act
15for the same fiscal year for general administration and field
16operations for resources necessary to implement and operate the
17services referred to in this section and those funded in the
18appropriation made in this division of this Act for the same
19fiscal year for the family investment program from the general
20fund of the state.
2115. With the exception of moneys allocated under this
22section for the family development and self-sufficiency grant
23program, to the extent moneys allocated in this section are
24deemed by the department not to be necessary to support the
25purposes for which they are allocated, such moneys may be
26used in the same fiscal year for any other purpose for which
27funds are allocated in this section or in section 7 of this
28division for the family investment program account. If there
29are conflicting needs, priority shall first be given to the
30family investment program account as specified under subsection
311 of this section and used for the purposes of assistance under
32the family investment program in accordance with chapter 239B,
33followed by state child care assistance program payments for
34families who are employed, followed by other priorities as
35specified by the department.
-11-1 Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT.
21. Moneys credited to the family investment program (FIP)
3account for the fiscal year beginning July 1, 2019, and
4ending June 30, 2020, shall be used to provide assistance in
5accordance with chapter 239B.
62. The department may use a portion of the moneys credited
7to the FIP account under this section as necessary for
8salaries, support, maintenance, and miscellaneous purposes.
93. The department may transfer funds allocated in
10subsection 4, excluding the allocation under subsection 4,
11paragraph “b”, to the appropriations made in this division of
12this Act for the same fiscal year for general administration
13and field operations for resources necessary to implement
14and operate the services referred to in this section and
15those funded in the appropriations made in section 6 for the
16temporary assistance for needy families block grant and in
17section 8 for the family investment program from the general
18fund of the state in this division of this Act for the same
19fiscal year.
204. Moneys appropriated in this division of this Act and
21credited to the FIP account for the fiscal year beginning July
221, 2019, and ending June 30, 2020, are allocated as follows:
23a. To be retained by the department of human services to
24be used for coordinating with the department of human rights
25to more effectively serve participants in FIP and other shared
26clients and to meet federal reporting requirements under the
27federal temporary assistance for needy families block grant:
.................................................. $2820,000
29b. To the department of human rights for staffing,
30administration, and implementation of the family development
31and self-sufficiency grant program in accordance with section
32216A.107:
.................................................. $336,192,834
34(1) Of the funds allocated for the family development
35and self-sufficiency grant program in this paragraph “b”,
-12-1not more than 5 percent of the funds shall be used for the
2administration of the grant program.
3(2) The department of human rights may continue to implement
4the family development and self-sufficiency grant program
5statewide during fiscal year 2019-2020.
6(3) The department of human rights may engage in activities
7to strengthen and improve family outcomes measures and
8data collection systems under the family development and
9self-sufficiency grant program.
10c. For the diversion subaccount of the FIP account:
.................................................. $11815,000
12A portion of the moneys allocated for the subaccount may
13be used for field operations, salaries, data management
14system development, and implementation costs and support
15deemed necessary by the director of human services in order to
16administer the FIP diversion program. To the extent moneys
17allocated in this paragraph “c” are deemed by the department
18not to be necessary to support diversion activities, such
19moneys may be used for other efforts intended to increase
20engagement by family investment program participants in work,
21education, or training activities, or for the purposes of
22assistance under the family investment program in accordance
23with chapter 239B.
24d. For the food assistance employment and training program:
.................................................. $2566,588
26(1) The department shall apply the federal supplemental
27nutrition assistance program (SNAP) employment and training
28state plan in order to maximize to the fullest extent permitted
29by federal law the use of the 50 percent federal reimbursement
30provisions for the claiming of allowable federal reimbursement
31funds from the United States department of agriculture
32pursuant to the federal SNAP employment and training program
33for providing education, employment, and training services
34for eligible food assistance program participants, including
35but not limited to related dependent care and transportation
-13-1expenses.
2(2) The department shall continue the categorical federal
3food assistance program eligibility at 160 percent of the
4federal poverty level and continue to eliminate the asset test
5from eligibility requirements, consistent with federal food
6assistance program requirements. The department shall include
7as many food assistance households as is allowed by federal
8law. The eligibility provisions shall conform to all federal
9requirements including requirements addressing individuals who
10are incarcerated or otherwise ineligible.
11e. For the JOBS program:
.................................................. $1212,018,258
135. Of the child support collections assigned under FIP,
14an amount equal to the federal share of support collections
15shall be credited to the child support recovery appropriation
16made in this division of this Act. Of the remainder of the
17assigned child support collections received by the child
18support recovery unit, a portion shall be credited to the FIP
19account, a portion may be used to increase recoveries, and a
20portion may be used to sustain cash flow in the child support
21payments account. If as a consequence of the appropriations
22and allocations made in this section the resulting amounts
23are insufficient to sustain cash assistance payments and meet
24federal maintenance of effort requirements, the department
25shall seek supplemental funding. If child support collections
26assigned under FIP are greater than estimated or are otherwise
27determined not to be required for maintenance of effort, the
28state share of either amount may be transferred to or retained
29in the child support payments account.
306. The department may adopt emergency rules for the family
31investment, JOBS, food assistance, and medical assistance
32programs if necessary to comply with federal requirements.
33 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
34is appropriated from the general fund of the state to the
35department of human services for the fiscal year beginning July
-14-11, 2019, and ending June 30, 2020, the following amount, or
2so much thereof as is necessary, to be used for the purpose
3designated:
4To be credited to the family investment program (FIP)
5account and used for family investment program assistance under
6chapter 239B:
.................................................. $740,365,715
81. Of the funds appropriated in this section, $6,606,198 is
9allocated for the JOBS program.
102. Of the funds appropriated in this section, $3,313,854 is
11allocated for the family development and self-sufficiency grant
12program.
133. Notwithstanding section 8.39, for the fiscal year
14beginning July 1, 2019, if necessary to meet federal
15maintenance of effort requirements or to transfer federal
16temporary assistance for needy families block grant funding
17to be used for purposes of the federal social services block
18grant or to meet cash flow needs resulting from delays in
19receiving federal funding or to implement, in accordance with
20this division of this Act, activities currently funded with
21juvenile court services, county, or community moneys and state
22moneys used in combination with such moneys; to comply with
23federal requirements; or to maximize the use of federal funds,
24the department of human services may transfer funds within or
25between any of the appropriations made in this division of this
26Act and appropriations in law for the federal social services
27block grant to the department for the following purposes,
28provided that the combined amount of state and federal
29temporary assistance for needy families block grant funding
30for each appropriation remains the same before and after the
31transfer:
32a. For the family investment program.
33b. For state child care assistance.
34c. For child and family services.
35d. For field operations.
-15- 1e. For general administration.
2This subsection shall not be construed to prohibit the use
3of existing state transfer authority for other purposes. The
4department shall report any transfers made pursuant to this
5subsection to the legislative services agency.
64. Of the funds appropriated in this section, $195,678 shall
7be used for continuation of a grant to an Iowa-based nonprofit
8organization with a history of providing tax preparation
9assistance to low-income Iowans in order to expand the usage of
10the earned income tax credit. The purpose of the grant is to
11supply this assistance to underserved areas of the state.
125. Of the funds appropriated in this section, $70,000
13shall be used for the continuation of the parenting program as
14specified in 441 IACch.100, relating to parental obligations,
15in which the child support recovery unit participates, to
16support the efforts of a nonprofit organization committed
17to strengthening the community through youth development,
18healthy living, and social responsibility headquartered in
19a county with a population over 350,000 according to the
20latest certified federal census. The funds allocated in this
21subsection shall be used by the recipient organization to
22develop a larger community effort, through public and private
23partnerships, to support a broad-based multi-county parenthood
24initiative that promotes payment of child support obligations,
25improved family relationships, and full-time employment.
266. The department may transfer funds appropriated in this
27section, excluding the allocation in subsection 2 for the
28family development and self-sufficiency grant program, to the
29appropriations made in this division of this Act for general
30administration and field operations as necessary to administer
31this section, section 6 for the temporary assistance for needy
32families block grant, and section 7 for the family investment
33program account.
34 Sec. 9. CHILD SUPPORT RECOVERY. There is appropriated
35from the general fund of the state to the department of human
-16-1services for the fiscal year beginning July 1, 2019, and ending
2June 30, 2020, the following amount, or so much thereof as is
3necessary, to be used for the purposes designated:
4For child support recovery, including salaries, support,
5maintenance, and miscellaneous purposes:
.................................................. $614,749,697
71. The department shall expend up to $24,329, including
8federal financial participation, for the fiscal year beginning
9July 1, 2019, for a child support public awareness campaign.
10The department and the office of the attorney general shall
11cooperate in continuation of the campaign. The public
12awareness campaign shall emphasize, through a variety of
13media activities, the importance of maximum involvement of
14both parents in the lives of their children as well as the
15importance of payment of child support obligations.
162. Federal access and visitation grant moneys shall be
17issued directly to private not-for-profit agencies that provide
18services designed to increase compliance with the child access
19provisions of court orders, including but not limited to
20neutral visitation sites and mediation services.
213. The appropriation made to the department for child
22support recovery may be used throughout the fiscal year in the
23manner necessary for purposes of cash flow management, and for
24cash flow management purposes the department may temporarily
25draw more than the amount appropriated, provided the amount
26appropriated is not exceeded at the close of the fiscal year.
27 Sec. 10. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
28FY 2019-2020. Any funds remaining in the health care trust
29fund created in section 453A.35A for the fiscal year beginning
30July 1, 2019, and ending June 30, 2020, are appropriated to
31the department of human services to supplement the medical
32assistance program appropriations made in this division of this
33Act, for medical assistance reimbursement and associated costs,
34including program administration and costs associated with
35program implementation.
-17-1 Sec. 11. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
22019-2020. Any funds remaining in the Medicaid fraud fund
3created in section 249A.50 for the fiscal year beginning
4July 1, 2019, and ending June 30, 2020, are appropriated to
5the department of human services to supplement the medical
6assistance appropriations made in this division of this Act,
7for medical assistance reimbursement and associated costs,
8including program administration and costs associated with
9program implementation.
10 Sec. 12. MEDICAL ASSISTANCE. There is appropriated from the
11general fund of the state to the department of human services
12for the fiscal year beginning July 1, 2019, and ending June 30,
132020, the following amount, or so much thereof as is necessary,
14to be used for the purpose designated:
15For medical assistance program reimbursement and associated
16costs as specifically provided in the reimbursement
17methodologies in effect on June 30, 2019, except as otherwise
18expressly authorized by law, consistent with options under
19federal law and regulations, and contingent upon receipt of
20approval from the office of the governor of reimbursement for
21each abortion performed under the program:
.................................................. $221,409,929,895
231. Iowans support reducing the number of abortions
24performed in our state. Funds appropriated under this section
25shall not be used for abortions, unless otherwise authorized
26under this section.
272. The provisions of this section relating to abortions
28shall also apply to the Iowa health and wellness plan created
29pursuant to chapter 249N.
303. The department shall utilize not more than $60,000 of
31the funds appropriated in this section to continue the AIDS/HIV
32health insurance premium payment program as established in 1992
33Iowa Acts, Second Extraordinary Session, chapter 1001, section
34409, subsection 6. Of the funds allocated in this subsection,
35not more than $5,000 may be expended for administrative
-18-1purposes.
24. Of the funds appropriated in this Act to the department
3of public health for addictive disorders, $950,000 for
4the fiscal year beginning July 1, 2019, is transferred
5to the department of human services for an integrated
6substance-related disorder managed care system. The
7departments of human services and public health shall
8work together to maintain the level of mental health and
9substance-related disorder treatment services provided by the
10managed care contractors. Each department shall take the steps
11necessary to continue the federal waivers as necessary to
12maintain the level of services.
135. a. The department shall aggressively pursue options for
14providing medical assistance or other assistance to individuals
15with special needs who become ineligible to continue receiving
16services under the early and periodic screening, diagnostic,
17and treatment program under the medical assistance program
18due to becoming 21 years of age who have been approved for
19additional assistance through the department’s exception to
20policy provisions, but who have health care needs in excess
21of the funding available through the exception to policy
22provisions.
23b. Of the funds appropriated in this section, $100,000
24shall be used for participation in one or more pilot projects
25operated by a private provider to allow the individual or
26individuals to receive service in the community in accordance
27with principles established in Olmstead v.L.C., 527 U.S.581
28(1999), for the purpose of providing medical assistance or
29other assistance to individuals with special needs who become
30ineligible to continue receiving services under the early and
31periodic screening, diagnostic, and treatment program under
32the medical assistance program due to becoming 21 years of
33age who have been approved for additional assistance through
34the department’s exception to policy provisions, but who have
35health care needs in excess of the funding available through
-19-1the exception to the policy provisions.
26. Of the funds appropriated in this section, up to
3$3,050,082 may be transferred to the field operations or
4general administration appropriations in this division of this
5Act for operational costs associated with Part D of the federal
6Medicare Prescription Drug Improvement and Modernization Act
7of 2003, Pub.L.No.108-173.
87. Of the funds appropriated in this section, up to $442,100
9may be transferred to the appropriation in this division
10of this Act for medical contracts to be used for clinical
11assessment services and prior authorization of services.
128. A portion of the funds appropriated in this section
13may be transferred to the appropriations in this division of
14this Act for general administration, medical contracts, the
15children’s health insurance program, or field operations to be
16used for the state match cost to comply with the payment error
17rate measurement (PERM) program for both the medical assistance
18and children’s health insurance programs as developed by the
19centers for Medicare and Medicaid services of the United States
20department of health and human services to comply with the
21federal Improper Payments Information Act of 2002, Pub.L.
22No.107-300, and to support other reviews and quality control
23activities to improve the integrity of these programs.
249. The department shall continue to implement the
25recommendations of the assuring better child health and
26development initiative II (ABCDII) clinical panel to the
27Iowa early and periodic screening, diagnostic, and treatment
28services healthy mental development collaborative board
29regarding changes to billing procedures, codes, and eligible
30service providers.
3110. Of the funds appropriated in this section, a sufficient
32amount is allocated to supplement the incomes of residents of
33nursing facilities, intermediate care facilities for persons
34with mental illness, and intermediate care facilities for
35persons with an intellectual disability, with incomes of less
-20-1than $50 in the amount necessary for the residents to receive a
2personal needs allowance of $50 per month pursuant to section
3249A.30A.
411. a. Hospitals that meet the conditions specified
5in subparagraphs (1) and (2) shall either certify public
6expenditures or transfer to the medical assistance program
7an amount equal to provide the nonfederal share for a
8disproportionate share hospital payment in an amount up to the
9hospital-specific limit as approved in the Medicaid state plan.
10The hospitals that meet the conditions specified shall receive
11and retain 100 percent of the total disproportionate share
12hospital payment in an amount up to the hospital-specific limit
13as approved in the Medicaid state plan.
14(1) The hospital qualifies for disproportionate share and
15graduate medical education payments.
16(2) The hospital is an Iowa state-owned hospital with more
17than 500 beds and eight or more distinct residency specialty
18or subspecialty programs recognized by the American college of
19graduate medical education.
20b. Distribution of the disproportionate share payments
21shall be made on a monthly basis. The total amount of
22disproportionate share payments including graduate medical
23education, enhanced disproportionate share, and Iowa
24state-owned teaching hospital payments shall not exceed the
25amount of the state’s allotment under Pub.L.No.102-234.
26In addition, the total amount of all disproportionate
27share payments shall not exceed the hospital-specific
28disproportionate share limits under Pub.L.No.103-66.
2912. One hundred percent of the nonfederal share of payments
30to area education agencies that are medical assistance
31providers for medical assistance-covered services provided to
32medical assistance-covered children, shall be made from the
33appropriation made in this section.
3413. A portion of the funds appropriated in this section
35may be transferred to the appropriation in this division of
-21-1this Act for medical contracts to be used for administrative
2activities associated with the money follows the person
3demonstration project.
414. Of the funds appropriated in this section, $349,011
5shall be used for the administration of the health insurance
6premium payment program, including salaries, support,
7maintenance, and miscellaneous purposes.
815. a. The department may increase the amounts allocated
9for salaries, support, maintenance, and miscellaneous purposes
10associated with the medical assistance program, as necessary,
11to implement cost containment strategies. The department shall
12report any such increase to the legislative services agency and
13the department of management.
14b. If the savings to the medical assistance program from
15cost containment efforts exceed the cost for the fiscal
16year beginning July 1, 2019, the department may transfer any
17savings generated for the fiscal year due to medical assistance
18program cost containment efforts to the appropriation
19made in this division of this Act for medical contracts or
20general administration to defray the increased contract costs
21associated with implementing such efforts.
2216. For the fiscal year beginning July 1, 2019, and ending
23June 30, 2020, the replacement generation tax revenues required
24to be deposited in the property tax relief fund pursuant to
25section 437A.8, subsection 4, paragraph “d”, and section
26437A.15, subsection 3, paragraph “f”, shall instead be credited
27to and supplement the appropriation made in this section and
28used for the allocations made in this section.
2917. a. Of the funds appropriated in this section, up
30to $50,000 may be transferred by the department to the
31appropriation made in this division of this Act to the
32department for the same fiscal year for general administration
33to be used for associated administrative expenses and for not
34more than one full-time equivalent position, in addition to
35those authorized for the same fiscal year, to be assigned to
-22-1implementing the children’s mental health home project.
2b. Of the funds appropriated in this section, up to $400,000
3may be transferred by the department to the appropriation made
4to the department in this division of this Act for the same
5fiscal year for Medicaid program-related general administration
6planning and implementation activities. The funds may be used
7for contracts or for personnel in addition to the amounts
8appropriated for and the positions authorized for general
9administration for the fiscal year.
10c. Of the funds appropriated in this section, up to
11$3,000,000 may be transferred by the department to the
12appropriations made in this division of this Act for the same
13fiscal year for general administration or medical contracts
14to be used to support the development and implementation of
15standardized assessment tools for persons with mental illness,
16an intellectual disability, a developmental disability, or a
17brain injury.
1818. Of the funds appropriated in this section, $150,000
19shall be used for lodging expenses associated with care
20provided at the university of Iowa hospitals and clinics for
21patients with cancer whose travel distance is 30 miles or more
22and whose income is at or below 200 percent of the federal
23poverty level as defined by the most recently revised poverty
24income guidelines published by the United States department of
25health and human services. The department of human services
26shall establish the maximum number of overnight stays and the
27maximum rate reimbursed for overnight lodging, which may be
28based on the state employee rate established by the department
29of administrative services. The funds allocated in this
30subsection shall not be used as nonfederal share matching
31funds.
3219. Of the funds appropriated in this section, up to
33$3,383,880 shall be used for administration of the state family
34planning services program pursuant to section 217.41B, and
35of this amount, the department may use up to $200,000 for
-23-1administrative expenses.
220. The department shall report the implementation of
3any cost containment strategies to the individuals specified
4in this division of this Act for submission of reports upon
5implementation.
621. The department shall report the implementation of any
7process improvement changes and any related cost reductions
8to the individuals specified in this division of this Act for
9submission of reports upon implementation.
1022. Of the funds appropriated in this section, $1,545,530
11shall be used and may be transferred to other appropriations
12in this division of this Act as necessary to administer the
13provisions in the division of this Act relating to Medicaid
14program administration.
1523. The department shall continue to implement and
16administer the provisions of 2018 Iowa Acts, chapter 1056. Of
17the funds appropriated in this section, up to $39,069 may be
18transferred to the department of inspections and appeals for
19inspection costs.
2024. Of the funds appropriated in this section, up to
21$1,200,000 shall be used to implement reductions in the waiting
22list for the children’s mental health home and community-based
23services waiver.
24 Sec. 13. MEDICAL CONTRACTS. There is appropriated from the
25general fund of the state to the department of human services
26for the fiscal year beginning July 1, 2019, and ending June 30,
272020, the following amount, or so much thereof as is necessary,
28to be used for the purpose designated:
29For medical contracts:
.................................................. $3017,992,530
311. The department of inspections and appeals shall
32provide all state matching funds for survey and certification
33activities performed by the department of inspections
34and appeals. The department of human services is solely
35responsible for distributing the federal matching funds for
-24-1such activities.
22. Of the funds appropriated in this section, $50,000 shall
3be used for continuation of home and community-based services
4waiver quality assurance programs, including the review and
5streamlining of processes and policies related to oversight and
6quality management to meet state and federal requirements.
73. Of the amount appropriated in this section, up to
8$200,000 may be transferred to the appropriation for general
9administration in this division of this Act to be used for
10additional full-time equivalent positions in the development of
11key health initiatives such as cost containment, development
12and oversight of managed care programs, and development of
13health strategies targeted toward improved quality and reduced
14costs in the Medicaid program.
154. Of the funds appropriated in this section, $1,000,000
16shall be used for planning and development, in cooperation with
17the department of public health, of a phased-in program to
18provide a dental home for children.
195. a. Of the funds appropriated in this section, $573,000
20shall be credited to the autism support program fund created
21in section 225D.2 to be used for the autism support program
22created in chapter 225D, with the exception of the following
23amounts of this allocation which shall be used as follows:
24b. Of the funds allocated in this subsection, $25,000
25shall be used for the public purpose of continuation of a
26grant to a nonprofit provider of child welfare services that
27has been in existence for more than 115 years, is located in
28a county with a population between 200,000 and 220,000 in the
29latest certified federal census, is licensed as a psychiatric
30medical institution for children, and provides school-based
31programming, to be used for support services for children with
32autism spectrum disorder and their families.
33 Sec. 14. STATE SUPPLEMENTARY ASSISTANCE.
341. There is appropriated from the general fund of the
35state to the department of human services for the fiscal year
-25-1beginning July 1, 2019, and ending June 30, 2020, the following
2amount, or so much thereof as is necessary, to be used for the
3purpose designated:
4For the state supplementary assistance program:
.................................................. $57,812,909
62. The department shall increase the personal needs
7allowance for residents of residential care facilities by the
8same percentage and at the same time as federal supplemental
9security income and federal social security benefits are
10increased due to a recognized increase in the cost of living.
11The department may adopt emergency rules to implement this
12subsection.
133. If during the fiscal year beginning July 1, 2019,
14the department projects that state supplementary assistance
15expenditures for a calendar year will not meet the federal
16pass-through requirement specified in Tit.XVI of the federal
17Social Security Act, section 1618, as codified in 42 U.S.C.
18§1382g, the department may take actions including but not
19limited to increasing the personal needs allowance for
20residential care facility residents and making programmatic
21adjustments or upward adjustments of the residential care
22facility or in-home health-related care reimbursement rates
23prescribed in this division of this Act to ensure that federal
24requirements are met. In addition, the department may make
25other programmatic and rate adjustments necessary to remain
26within the amount appropriated in this section while ensuring
27compliance with federal requirements. The department may adopt
28emergency rules to implement the provisions of this subsection.
294. Notwithstanding section 8.33, moneys appropriated in
30this section that remain unencumbered or unobligated at the
31close of the fiscal year shall not revert but shall remain
32available for expenditure for the purposes designated until the
33close of the succeeding fiscal year.
34 Sec. 15. CHILDREN’S HEALTH INSURANCE PROGRAM.
351. There is appropriated from the general fund of the
-26-1state to the department of human services for the fiscal year
2beginning July 1, 2019, and ending June 30, 2020, the following
3amount, or so much thereof as is necessary, to be used for the
4purpose designated:
5For maintenance of the healthy and well kids in Iowa (hawk-i)
6program pursuant to chapter 514I, including supplemental dental
7services, for receipt of federal financial participation under
8Tit.XXI of the federal Social Security Act, which creates the
9children’s health insurance program:
.................................................. $1019,361,112
112. Of the funds appropriated in this section, up to $79,486
12is allocated for continuation of the contract for outreach with
13the department of public health.
143. A portion of the funds appropriated in this section may
15be transferred to the appropriations made in this division of
16this Act for field operations or medical contracts to be used
17for the integration of hawk-i program eligibility, payment, and
18administrative functions under the purview of the department
19of human services, including for the Medicaid management
20information system upgrade.
21 Sec. 16. CHILD CARE ASSISTANCE. There is appropriated
22from the general fund of the state to the department of human
23services for the fiscal year beginning July 1, 2019, and ending
24June 30, 2020, the following amount, or so much thereof as is
25necessary, to be used for the purpose designated:
26For child care programs:
.................................................. $2740,816,931
281. Of the funds appropriated in this section, $34,966,931
29shall be used for state child care assistance in accordance
30with section 237A.13.
312. Nothing in this section shall be construed or is
32intended as or shall imply a grant of entitlement for services
33to persons who are eligible for assistance due to an income
34level consistent with the waiting list requirements of section
35237A.13. Any state obligation to provide services pursuant to
-27-1this section is limited to the extent of the funds appropriated
2in this section.
33. A list of the registered and licensed child care
4facilities operating in the area served by a child care
5resource and referral service shall be made available to the
6families receiving state child care assistance in that area.
74. Of the funds appropriated in this section, $5,850,000
8shall be credited to the early childhood programs grants
9account in the early childhood Iowa fund created in section
10256I.11. The moneys shall be distributed for funding of
11community-based early childhood programs targeted to children
12from birth through five years of age developed by early
13childhood Iowa areas in accordance with approved community
14plans as provided in section 256I.8.
155. The department may use any of the funds appropriated
16in this section as a match to obtain federal funds for use in
17expanding child care assistance and related programs. For
18the purpose of expenditures of state and federal child care
19funding, funds shall be considered obligated at the time
20expenditures are projected or are allocated to the department’s
21service areas. Projections shall be based on current and
22projected caseload growth, current and projected provider
23rates, staffing requirements for eligibility determination
24and management of program requirements including data systems
25management, staffing requirements for administration of the
26program, contractual and grant obligations and any transfers
27to other state agencies, and obligations for decategorization
28or innovation projects.
296. A portion of the state match for the federal child care
30and development block grant shall be provided as necessary to
31meet federal matching funds requirements through the state
32general fund appropriation made for child development grants
33and other programs for at-risk children in section 279.51.
347. If a uniform reduction ordered by the governor under
35section 8.31 or other operation of law, transfer, or federal
-28-1funding reduction reduces the appropriation made in this
2section for the fiscal year, the percentage reduction in the
3amount paid out to or on behalf of the families participating
4in the state child care assistance program shall be equal to or
5less than the percentage reduction made for any other purpose
6payable from the appropriation made in this section and the
7federal funding relating to it. The percentage reduction to
8the other allocations made in this section shall be the same as
9the uniform reduction ordered by the governor or the percentage
10change of the federal funding reduction, as applicable. If
11there is an unanticipated increase in federal funding provided
12for state child care services, the entire amount of the
13increase, except as necessary to meet federal requirements
14including quality set asides, shall be used for state child
15care assistance payments. If the appropriations made for
16purposes of the state child care assistance program for the
17fiscal year are determined to be insufficient, it is the intent
18of the general assembly to appropriate sufficient funding for
19the fiscal year in order to avoid establishment of waiting list
20requirements.
218. Notwithstanding section 8.33, moneys advanced for
22purposes of the programs developed by early childhood Iowa
23areas, advanced for purposes of wraparound child care, or
24received from the federal appropriations made for the purposes
25of this section that remain unencumbered or unobligated at the
26close of the fiscal year shall not revert to any fund but shall
27remain available for expenditure for the purposes designated
28until the close of the succeeding fiscal year.
29 Sec. 17. JUVENILE INSTITUTION. There is appropriated
30from the general fund of the state to the department of human
31services for the fiscal year beginning July 1, 2019, and ending
32June 30, 2020, the following amounts, or so much thereof as is
33necessary, to be used for the purposes designated:
341. For operation of the state training school at Eldora and
35for salaries, support, maintenance, and miscellaneous purposes:
-29-.................................................. $113,920,907
2Of the funds appropriated in this subsection, $91,150 shall
3be used for distribution to licensed classroom teachers at this
4and other institutions under the control of the department of
5human services based upon the average student yearly enrollment
6at each institution as determined by the department.
72. A portion of the moneys appropriated in this section
8shall be used by the state training school at Eldora for
9grants for adolescent pregnancy prevention activities at the
10institution in the fiscal year beginning July 1, 2019.
113. Of the funds appropriated in this subsection, $212,000
12shall be used by the state training school at Eldora for a
13substance use disorder training program at the institution for
14the fiscal year beginning July 1, 2019.
15 Sec. 18. CHILD AND FAMILY SERVICES.
161. There is appropriated from the general fund of the
17state to the department of human services for the fiscal year
18beginning July 1, 2019, and ending June 30, 2020, the following
19amount, or so much thereof as is necessary, to be used for the
20purpose designated:
21For child and family services:
.................................................. $2289,078,185
232. The department may transfer funds appropriated in this
24section as necessary to pay the nonfederal costs of services
25reimbursed under the medical assistance program, state child
26care assistance program, or the family investment program which
27are provided to children who would otherwise receive services
28paid under the appropriation in this section. The department
29may transfer funds appropriated in this section to the
30appropriations made in this division of this Act for general
31administration and for field operations for resources necessary
32to implement and operate the services funded in this section.
333. a. Of the funds appropriated in this section, up to
34$34,536,648 is allocated as the statewide expenditure target
35under section 232.143 for group foster care maintenance and
-30-1services. If the department projects that such expenditures
2for the fiscal year will be less than the target amount
3allocated in this paragraph “a”, the department may reallocate
4the excess to provide additional funding for family foster
5care, independent living, family safety, risk and permanency
6services, shelter care, or the child welfare emergency services
7addressed with the allocation for shelter care.
8b. If at any time after September 30, 2019, annualization
9of a service area’s current expenditures indicates a service
10area is at risk of exceeding its group foster care expenditure
11target under section 232.143 by more than 5 percent, the
12department and juvenile court services shall examine all
13group foster care placements in that service area in order to
14identify those which might be appropriate for termination.
15In addition, any aftercare services believed to be needed
16for the children whose placements may be terminated shall be
17identified. The department and juvenile court services shall
18initiate action to set dispositional review hearings for the
19placements identified. In such a dispositional review hearing,
20the juvenile court shall determine whether needed aftercare
21services are available and whether termination of the placement
22is in the best interest of the child and the community.
234. In accordance with the provisions of section 232.188,
24the department shall continue the child welfare and juvenile
25justice funding initiative during fiscal year 2019-2020. Of
26the funds appropriated in this section, $1,717,753 is allocated
27specifically for expenditure for fiscal year 2019-2020 through
28the decategorization services funding pools and governance
29boards established pursuant to section 232.188.
305. A portion of the funds appropriated in this section
31may be used for emergency family assistance to provide other
32resources required for a family participating in a family
33preservation or reunification project or successor project to
34stay together or to be reunified.
356. Of the funds appropriated in this section, a sufficient
-31-1amount is allocated for shelter care and the child welfare
2emergency services contracting implemented to provide for or
3prevent the need for shelter care.
47. Federal funds received by the state during the fiscal
5year beginning July 1, 2019, as the result of the expenditure
6of state funds appropriated during a previous state fiscal
7year for a service or activity funded under this section are
8appropriated to the department to be used as additional funding
9for services and purposes provided for under this section.
10Notwithstanding section 8.33, moneys received in accordance
11with this subsection that remain unencumbered or unobligated at
12the close of the fiscal year shall not revert to any fund but
13shall remain available for the purposes designated until the
14close of the succeeding fiscal year.
158. a. Of the funds appropriated in this section, up to
16$3,290,000 is allocated for the payment of the expenses of
17court-ordered services provided to juveniles who are under the
18supervision of juvenile court services, which expenses are a
19charge upon the state pursuant to section 232.141, subsection
204. Of the amount allocated in this paragraph “a”, up to
21$1,556,287 shall be made available to provide school-based
22supervision of children adjudicated under chapter 232, of which
23not more than $15,000 may be used for the purpose of training.
24A portion of the cost of each school-based liaison officer
25shall be paid by the school district or other funding source as
26approved by the chief juvenile court officer.
27b. Of the funds appropriated in this section, up to $748,985
28is allocated for the payment of the expenses of court-ordered
29services provided to children who are under the supervision
30of the department, which expenses are a charge upon the state
31pursuant to section 232.141, subsection 4.
32c. Notwithstanding section 232.141 or any other provision
33of law to the contrary, the amounts allocated in this
34subsection shall be distributed to the judicial districts
35as determined by the state court administrator and to the
-32-1department’s service areas as determined by the administrator
2of the department of human services’ division of child and
3family services. The state court administrator and the
4division administrator shall make the determination of the
5distribution amounts on or before June 15, 2019.
6d. Notwithstanding chapter 232 or any other provision of
7law to the contrary, a district or juvenile court shall not
8order any service which is a charge upon the state pursuant
9to section 232.141 if there are insufficient court-ordered
10services funds available in the district court or departmental
11service area distribution amounts to pay for the service. The
12chief juvenile court officer and the departmental service area
13manager shall encourage use of the funds allocated in this
14subsection such that there are sufficient funds to pay for
15all court-related services during the entire year. The chief
16juvenile court officers and departmental service area managers
17shall attempt to anticipate potential surpluses and shortfalls
18in the distribution amounts and shall cooperatively request the
19state court administrator or division administrator to transfer
20funds between the judicial districts’ or departmental service
21areas’ distribution amounts as prudent.
22e. Notwithstanding any provision of law to the contrary,
23a district or juvenile court shall not order a county to pay
24for any service provided to a juvenile pursuant to an order
25entered under chapter 232 which is a charge upon the state
26under section 232.141, subsection 4.
27f. Of the funds allocated in this subsection, not more than
28$83,000 may be used by the judicial branch for administration
29of the requirements under this subsection.
30g. Of the funds allocated in this subsection, $17,000
31shall be used by the department of human services to support
32the interstate commission for juveniles in accordance with
33the interstate compact for juveniles as provided in section
34232.173.
359. Of the funds appropriated in this section, $12,253,227 is
-33-1allocated for juvenile delinquent graduated sanctions services.
2Any state funds saved as a result of efforts by juvenile court
3services to earn a federal Tit.IV-E match for juvenile court
4services administration may be used for the juvenile delinquent
5graduated sanctions services.
610. Of the funds appropriated in this section, $1,658,285 is
7transferred to the department of public health to be used for
8the child protection center grant program for child protection
9centers located in Iowa in accordance with section 135.118.
10The grant amounts under the program shall be equalized so that
11each center receives a uniform base amount of $245,000, and so
12that the remaining funds are awarded through a funding formula
13based upon the volume of children served.
1411. If the department receives federal approval to
15implement a waiver under Tit.IV-E of the federal Social
16Security Act to enable providers to serve children who remain
17in the children’s families and communities, for purposes of
18eligibility under the medical assistance program through 25
19years of age, children who participate in the waiver shall be
20considered to be placed in foster care.
2112. Of the funds appropriated in this section, $4,025,167 is
22allocated for the preparation for adult living program pursuant
23to section 234.46.
2413. Of the funds appropriated in this section, $227,337
25shall be used for the public purpose of continuing a grant to
26a nonprofit human services organization providing services to
27individuals and families in multiple locations in southwest
28Iowa and Nebraska for support of a project providing immediate,
29sensitive support and forensic interviews, medical exams, needs
30assessments, and referrals for victims of child abuse and their
31nonoffending family members.
3214. Of the funds appropriated in this section, $300,620
33is allocated for the foster care youth council approach of
34providing a support network to children placed in foster care.
3515. Of the funds appropriated in this section, $202,000 is
-34-1allocated for use pursuant to section 235A.1 for continuation
2of the initiative to address child sexual abuse implemented
3pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
421.
516. Of the funds appropriated in this section, $630,240 is
6allocated for the community partnership for child protection
7sites.
817. Of the funds appropriated in this section, $371,250
9is allocated for the department’s minority youth and family
10projects under the redesign of the child welfare system.
1118. Of the funds appropriated in this section, $851,595
12is allocated for funding of the community circle of care
13collaboration for children and youth in northeast Iowa.
1419. Of the funds appropriated in this section, at least
15$147,158 shall be used for the continuation of the child
16welfare provider training academy, a collaboration between the
17coalition for family and children’s services in Iowa and the
18department.
1920. Of the funds appropriated in this section, $211,872
20shall be used for continuation of the central Iowa system of
21care program grant through June 30, 2020.
2221. Of the funds appropriated in this section, $235,000
23shall be used for the public purpose of the continuation
24and expansion of a system of care program grant implemented
25in Cerro Gordo and Linn counties to utilize a comprehensive
26and long-term approach for helping children and families by
27addressing the key areas in a child’s life of childhood basic
28needs, education and work, family, and community.
2922. Of the funds appropriated in this section, $110,000
30shall be used for the public purpose of funding community-based
31services and other supports with a system of care approach
32for children with a serious emotional disturbance and their
33families through a nonprofit provider of child welfare services
34that has been in existence for more than 115 years, is located
35in a county with a population of more than 200,000 but less
-35-1than 220,000 according to the latest certified federal census,
2is licensed as a psychiatric medical institution for children,
3and was a system of care grantee prior to July 1, 2019.
423. If a separate funding source is identified that reduces
5the need for state funds within an allocation under this
6section, the allocated state funds may be redistributed to
7other allocations under this section for the same fiscal year.
8 Sec. 19. ADOPTION SUBSIDY.
91. There is appropriated from the general fund of the
10state to the department of human services for the fiscal year
11beginning July 1, 2019, and ending June 30, 2020, the following
12amount, or so much thereof as is necessary, to be used for the
13purpose designated:
14a. For adoption subsidy payments and services:
.................................................. $1540,596,007
16b. (1) The funds appropriated in this section shall be used
17as authorized or allowed by federal law or regulation for any
18of the following purposes:
19(a) For adoption subsidy payments and related costs.
20(b) For post-adoption services and for other purposes under
21Tit.IV-B or Tit.IV-E of the federal Social Security Act.
22(2) The department of human services may transfer funds
23appropriated in this subsection to the appropriation for
24child and family services in this Act for the purposes of
25post-adoption services as specified in this paragraph “b”.
26c. Notwithstanding section 8.33, moneys corresponding to
27the state savings resulting from implementation of the federal
28Fostering Connections to Success and Increasing Adoptions Act
29of 2008, Pub.L. No.110-351, and successor legislation, as
30determined in accordance with 42 U.S.C.§673(a)(8), that remain
31unencumbered or unobligated at the close of the fiscal year,
32shall not revert to any fund but shall remain available for the
33purposes designated in this subsection until expended. The
34amount of such savings and any corresponding funds remaining
35at the close of the fiscal year shall be determined separately
-36-1and any changes in either amount between fiscal years shall not
2result in an unfunded need.
32. The department may transfer funds appropriated in
4this section to the appropriation made in this division of
5this Act for general administration for costs paid from the
6appropriation relating to adoption subsidy.
73. Federal funds received by the state during the
8fiscal year beginning July 1, 2019, as the result of the
9expenditure of state funds during a previous state fiscal
10year for a service or activity funded under this section are
11appropriated to the department to be used as additional funding
12for the services and activities funded under this section.
13Notwithstanding section 8.33, moneys received in accordance
14with this subsection that remain unencumbered or unobligated
15at the close of the fiscal year shall not revert to any fund
16but shall remain available for expenditure for the purposes
17designated until the close of the succeeding fiscal year.
18 Sec. 20. JUVENILE DETENTION HOME FUND. Moneys deposited
19in the juvenile detention home fund created in section 232.142
20during the fiscal year beginning July 1, 2019, and ending June
2130, 2020, are appropriated to the department of human services
22for the fiscal year beginning July 1, 2019, and ending June 30,
232020, for distribution of an amount equal to a percentage of
24the costs of the establishment, improvement, operation, and
25maintenance of county or multicounty juvenile detention homes
26in the fiscal year beginning July 1, 2018. Moneys appropriated
27for distribution in accordance with this section shall be
28allocated among eligible detention homes, prorated on the basis
29of an eligible detention home’s proportion of the costs of all
30eligible detention homes in the fiscal year beginning July
311, 2018. The percentage figure shall be determined by the
32department based on the amount available for distribution for
33the fund. Notwithstanding section 232.142, subsection 3, the
34financial aid payable by the state under that provision for the
35fiscal year beginning July 1, 2019, shall be limited to the
-37-1amount appropriated for the purposes of this section.
2 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2019, and ending June 30, 2020, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8For the family support subsidy program subject to the
9enrollment restrictions in section 225C.37, subsection 3:
.................................................. $10949,282
112. At least $819,275 of the moneys appropriated in this
12section is transferred to the department of public health for
13the family support center component of the comprehensive family
14support program under chapter 225C, subchapter V.
153. If at any time during the fiscal year, the amount of
16funding available for the family support subsidy program
17is reduced from the amount initially used to establish the
18figure for the number of family members for whom a subsidy
19is to be provided at any one time during the fiscal year,
20notwithstanding section 225C.38, subsection 2, the department
21shall revise the figure as necessary to conform to the amount
22of funding available.
23 Sec. 22. CONNER DECREE. There is appropriated from the
24general fund of the state to the department of human services
25for the fiscal year beginning July 1, 2019, and ending June 30,
262020, the following amount, or so much thereof as is necessary,
27to be used for the purpose designated:
28For building community capacity through the coordination
29and provision of training opportunities in accordance with the
30consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
31Iowa, July 14, 1994):
.................................................. $3233,632
33 Sec. 23. MENTAL HEALTH INSTITUTES.
341. There is appropriated from the general fund of the
35state to the department of human services for the fiscal year
-38-1beginning July 1, 2019, and ending June 30, 2020, the following
2amounts, or so much thereof as is necessary, to be used for the
3purposes designated:
4a. For operation of the state mental health institute at
5Cherokee as required by chapters 218 and 226 for salaries,
6support, maintenance, and miscellaneous purposes:
.................................................. $714,216,149
8b. For operation of the state mental health institute at
9Independence as required by chapters 218 and 226 for salaries,
10support, maintenance, and miscellaneous purposes:
.................................................. $1119,165,110
122. Notwithstanding sections 218.78 and 249A.11, any revenue
13received from the state mental health institute at Cherokee or
14the state mental health institute at Independence pursuant to
1542 C.F.R§438.6(e) may be retained and expended by the mental
16health institute.
173. Notwithstanding any provision of law to the contrary,
18a Medicaid member residing at the state mental health
19institute at Cherokee or the state mental health institute
20at Independence shall retain Medicaid eligibility during
21the period of the Medicaid member’s stay for which federal
22financial participation is available.
23 Sec. 24. STATE RESOURCE CENTERS.
241. There is appropriated from the general fund of the
25state to the department of human services for the fiscal year
26beginning July 1, 2019, and ending June 30, 2020, the following
27amounts, or so much thereof as is necessary, to be used for the
28purposes designated:
29a. For the state resource center at Glenwood for salaries,
30support, maintenance, and miscellaneous purposes:
.................................................. $3116,048,348
32b. For the state resource center at Woodward for salaries,
33support, maintenance, and miscellaneous purposes:
.................................................. $3410,872,356
352. The department may continue to bill for state resource
-39-1center services utilizing a scope of services approach used for
2private providers of intermediate care facilities for persons
3with an intellectual disability services, in a manner which
4does not shift costs between the medical assistance program,
5counties, or other sources of funding for the state resource
6centers.
73. The state resource centers may expand the time-limited
8assessment and respite services during the fiscal year.
94. If the department’s administration and the department
10of management concur with a finding by a state resource
11center’s superintendent that projected revenues can reasonably
12be expected to pay the salary and support costs for a new
13employee position, or that such costs for adding a particular
14number of new positions for the fiscal year would be less
15than the overtime costs if new positions would not be added,
16the superintendent may add the new position or positions. If
17the vacant positions available to a resource center do not
18include the position classification desired to be filled, the
19state resource center’s superintendent may reclassify any
20vacant position as necessary to fill the desired position. The
21superintendents of the state resource centers may, by mutual
22agreement, pool vacant positions and position classifications
23during the course of the fiscal year in order to assist one
24another in filling necessary positions.
255. If existing capacity limitations are reached in
26operating units, a waiting list is in effect for a service or
27a special need for which a payment source or other funding
28is available for the service or to address the special need,
29and facilities for the service or to address the special need
30can be provided within the available payment source or other
31funding, the superintendent of a state resource center may
32authorize opening not more than two units or other facilities
33and begin implementing the service or addressing the special
34need during fiscal year 2019-2020.
35 Sec. 25. SEXUALLY VIOLENT PREDATORS.
-40- 11. There is appropriated from the general fund of the
2state to the department of human services for the fiscal year
3beginning July 1, 2019, and ending June 30, 2020, the following
4amount, or so much thereof as is necessary, to be used for the
5purpose designated:
6For costs associated with the commitment and treatment of
7sexually violent predators in the unit located at the state
8mental health institute at Cherokee, including costs of legal
9services and other associated costs, including salaries,
10support, maintenance, and miscellaneous purposes:
.................................................. $1112,053,093
122. Unless specifically prohibited by law, if the amount
13charged provides for recoupment of at least the entire amount
14of direct and indirect costs, the department of human services
15may contract with other states to provide care and treatment
16of persons placed by the other states at the unit for sexually
17violent predators at Cherokee. The moneys received under
18such a contract shall be considered to be repayment receipts
19and used for the purposes of the appropriation made in this
20section.
21 Sec. 26. FIELD OPERATIONS. There is appropriated from the
22general fund of the state to the department of human services
23for the fiscal year beginning July 1, 2019, and ending June 30,
242020, the following amount, or so much thereof as is necessary,
25to be used for the purposes designated:
26For field operations, including salaries, support,
27maintenance, and miscellaneous purposes:
.................................................. $2853,923,195
29Priority in filling full-time equivalent positions shall be
30given to those positions related to child protection services
31and eligibility determination for low-income families.
32 Sec. 27. GENERAL ADMINISTRATION. There is appropriated
33from the general fund of the state to the department of human
34services for the fiscal year beginning July 1, 2019, and ending
35June 30, 2020, the following amount, or so much thereof as is
-41-1necessary, to be used for the purpose designated:
2For general administration, including salaries, support,
3maintenance, and miscellaneous purposes:
.................................................. $413,833,040
51. The department shall report at least monthly to the
6legislative services agency concerning the department’s
7operational and program expenditures.
82. Of the funds appropriated in this section, $150,000 shall
9be used to continue the contract for the provision of a program
10to provide technical assistance, support, and consultation to
11providers of habilitation services and home and community-based
12services waiver services for adults with disabilities under the
13medical assistance program.
143. Of the funds appropriated in this section, $50,000
15is transferred to the Iowa finance authority to be used
16for administrative support of the council on homelessness
17established in section 16.2D and for the council to fulfill its
18duties in addressing and reducing homelessness in the state.
194. Of the funds appropriated in this section, $200,000 shall
20be transferred to and deposited in the administrative fund of
21the Iowa ABLE savings plan trust created in section 12I.4, to
22be used for implementation and administration activities of the
23Iowa ABLE savings plan trust.
245. Of the funds appropriated in this section, $200,000 is
25transferred to the economic development authority for the Iowa
26commission on volunteer services to continue to be used for
27RefugeeRISE AmeriCorps program established under section 15H.8
28for member recruitment and training to improve the economic
29well-being and health of economically disadvantaged refugees in
30local communities across Iowa. Funds transferred may be used
31to supplement federal funds under federal regulations.
326. Of the funds appropriated in this section, up to $300,000
33shall be used as follows:
34a. To fund not more than one full-time equivalent position
35to address the department’s responsibility to support the work
-42-1of the children’s system state board and implementation of the
2services required pursuant to 2018 Iowa Acts, chapter 1056,
3section 13.
4b. To support the cost of establishing and implementing new
5or additional services required pursuant to 2018 Iowa Acts,
6chapter 1056, and any legislation enacted by the 2019 general
7assembly establishing a children’s mental health system.
8c. Of the amount, $32,000 shall be transferred to
9the department of public health to support the costs of
10establishing and implementing new or additional services
11required pursuant to 2018 Iowa Acts, chapter 1056, and any
12legislation enacted by the 2019 general assembly establishing a
13children’s mental health system.
14 Sec. 28. DEPARTMENT-WIDE DUTIES. There is appropriated
15from the general fund of the state to the department of human
16services for the fiscal year beginning July 1, 2019, and ending
17June 30, 2020, the following amount, or so much thereof as is
18necessary, to be used for the purposes designated:
19For salaries, support, maintenance, and miscellaneous
20purposes at facilities under the purview of the department of
21human services:
.................................................. $222,879,274
23 Sec. 29. CORPORATE TECHNOLOGY. There is appropriated
24from the general fund of the state to the department of human
25services for the fiscal year beginning July 1, 2019, and ending
26June 30, 2020, the following amount, or so much thereof as is
27necessary, to be used for the purposes designated:
28For the purchase of department-wide technology and software
29update needs:
.................................................. $302,530,413
31 Sec. 30. VOLUNTEERS. There is appropriated from the general
32fund of the state to the department of human services for the
33fiscal year beginning July 1, 2019, and ending June 30, 2020,
34the following amount, or so much thereof as is necessary, to be
35used for the purpose designated:
-43- 1For development and coordination of volunteer services:
.................................................. $284,686
3 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
4ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
5DEPARTMENT OF HUMAN SERVICES.
61. a. (1) (a) For the fiscal year beginning July 1,
72019, the department shall rebase case-mix nursing facility
8rates effective July 1, 2019, to the extent possible within the
9state funding, including the $8,479,942, appropriated for this
10purpose.
11(b) For the fiscal year beginning July 1, 2019, non-case-mix
12and special population nursing facilities shall be reimbursed
13in accordance with the methodology in effect on June 30 of the
14prior fiscal year.
15(c) For managed care claims, the department of human
16services shall adjust the payment rate floor for nursing
17facilities, annually, to maintain a rate floor that is no
18lower than the Medicaid fee-for-service case-mix adjusted
19rate calculated in accordance with subparagraph division
20(a) and 441 IAC 81.6. The department shall then calculate
21adjusted reimbursement rates, including but not limited to
22add-on-payments, annually, and shall notify Medicaid managed
23care organizations of the adjusted reimbursement rates within
2430 days of determining the adjusted reimbursement rates. Any
25adjustment of reimbursement rates under this subparagraph
26division shall be budget neutral to the state budget.
27(d) For the fiscal year beginning July 1, 2019, Medicaid
28managed care long-term services and supports capitation
29rates shall be adjusted to reflect the rebasing pursuant to
30subparagraph division (a) for the patient populations residing
31in Medicaid-certified nursing facilities.
32(2) Medicaid managed care organizations shall adjust
33facility-specific rates based upon payment rate listings issued
34by the department. The rate adjustments shall be applied
35retroactively based upon the effective date of the rate letter
-44-1issued by the department. A Medicaid managed care organization
2shall honor all retroactive rate adjustments including when
3specific provider rates are delayed or amended.
4b. (1) For the fiscal year beginning July 1, 2019,
5the department shall establish the pharmacy dispensing fee
6reimbursement at $10.07 per prescription, until a cost of
7dispensing survey is completed. The actual dispensing fee
8shall be determined by a cost of dispensing survey performed
9by the department and required to be completed by all medical
10assistance program participating pharmacies every two years,
11adjusted as necessary to maintain expenditures within the
12amount appropriated to the department for this purpose for the
13fiscal year.
14(2) The department shall utilize an average acquisition
15cost reimbursement methodology for all drugs covered under the
16medical assistance program in accordance with 2012 Iowa Acts,
17chapter 1133, section 33.
18c. (1) For the fiscal year beginning July 1, 2019,
19reimbursement rates for outpatient hospital services shall
20remain at the rates in effect on June 30, 2019, subject to
21Medicaid program upper payment limit rules, and adjusted
22as necessary to maintain expenditures within the amount
23appropriated to the department for this purpose for the fiscal
24year.
25(2) For the fiscal year beginning July 1, 2019,
26reimbursement rates for inpatient hospital services shall
27remain at the rates in effect on June 30, 2019, subject to
28Medicaid program upper payment limit rules, and adjusted
29as necessary to maintain expenditures within the amount
30appropriated to the department for this purpose for the fiscal
31year.
32(3) For the fiscal year beginning July 1, 2019, the graduate
33medical education and disproportionate share hospital fund
34shall remain at the amount in effect on June 30, 2019, except
35that the portion of the fund attributable to graduate medical
-45-1education shall be reduced in an amount that reflects the
2elimination of graduate medical education payments made to
3out-of-state hospitals.
4(4) In order to ensure the efficient use of limited state
5funds in procuring health care services for low-income Iowans,
6funds appropriated in this Act for hospital services shall
7not be used for activities which would be excluded from a
8determination of reasonable costs under the federal Medicare
9program pursuant to 42 U.S.C.§1395x(v)(1)(N).
10d. For the fiscal year beginning July 1, 2019, reimbursement
11rates for hospices and acute mental hospitals shall be
12increased in accordance with increases under the federal
13Medicare program or as supported by their Medicare audited
14costs.
15e. For the fiscal year beginning July 1, 2019, independent
16laboratories and rehabilitation agencies shall be reimbursed
17using the same methodology in effect on June 30, 2019.
18f. (1) For the fiscal year beginning July 1, 2019,
19reimbursement rates for home health agencies shall be rebased,
20to the extent possible, within the state funding appropriated
21for this purpose, and shall continue to be based on the
22Medicare low utilization payment adjustment (LUPA) methodology
23with state geographic wage adjustments to reflect the most
24recent Medicare LUPA rates to the extent possible within the
25state funding appropriated for this purpose.
26(2) For the fiscal year beginning July 1, 2019, rates for
27private duty nursing and personal care services under the early
28and periodic screening, diagnostic, and treatment program
29benefit shall be calculated based on the methodology in effect
30on June 30, 2019.
31g. For the fiscal year beginning July 1, 2019, federally
32qualified health centers and rural health clinics shall receive
33cost-based reimbursement for 100 percent of the reasonable
34costs for the provision of services to recipients of medical
35assistance.
-46- 1h. For the fiscal year beginning July 1, 2019, the
2reimbursement rates for dental services shall remain at the
3rates in effect on June 30, 2019.
4i. (1) For the fiscal year beginning July 1, 2019,
5reimbursement rates for non-state-owned psychiatric medical
6institutions for children shall be based on the reimbursement
7methodology in effect on June 30, 2019.
8(2) As a condition of participation in the medical
9assistance program, enrolled providers shall accept the medical
10assistance reimbursement rate for any covered goods or services
11provided to recipients of medical assistance who are children
12under the custody of a psychiatric medical institution for
13children.
14j. For the fiscal year beginning July 1, 2019, unless
15otherwise specified in this Act, all noninstitutional medical
16assistance provider reimbursement rates shall remain at the
17rates in effect on June 30, 2019, except for area education
18agencies, local education agencies, infant and toddler
19services providers, home and community-based services providers
20including consumer-directed attendant care providers under a
21section 1915(c) or 1915(i) waiver, targeted case management
22providers, and those providers whose rates are required to be
23determined pursuant to section 249A.20, or to meet federal
24mental health parity requirements.
25k. Notwithstanding any provision to the contrary, for the
26fiscal year beginning July 1, 2019, the reimbursement rate for
27anesthesiologists shall remain at the rates in effect on June
2830, 2019, and updated on January 1, 2020, to align with the
29most current Iowa Medicare anesthesia rate.
30l. Notwithstanding section 249A.20, for the fiscal year
31beginning July 1, 2019, the average reimbursement rate for
32health care providers eligible for use of the federal Medicare
33resource-based relative value scale reimbursement methodology
34under section 249A.20 shall remain at the rate in effect on
35June 30, 2019; however, this rate shall not exceed the maximum
-47-1level authorized by the federal government.
2m. For the fiscal year beginning July 1, 2019, the
3reimbursement rate for residential care facilities shall not
4be less than the minimum payment level as established by the
5federal government to meet the federally mandated maintenance
6of effort requirement. The flat reimbursement rate for
7facilities electing not to file annual cost reports shall not
8be less than the minimum payment level as established by the
9federal government to meet the federally mandated maintenance
10of effort requirement.
11n. For the fiscal year beginning July 1, 2019, the
12reimbursement rates for inpatient mental health services
13provided at hospitals shall remain at the rates in effect on
14June 30, 2019, subject to Medicaid program upper payment limit
15rules; and psychiatrists shall be reimbursed at the medical
16assistance program fee-for-service rate in effect on June 30,
172019.
18o. For the fiscal year beginning July 1, 2019, community
19mental health centers may choose to be reimbursed for the
20services provided to recipients of medical assistance through
21either of the following options:
22(1) For 100 percent of the reasonable costs of the services.
23(2) In accordance with the alternative reimbursement rate
24methodology approved by the department of human services in
25effect on June 30, 2019.
26p. For the fiscal year beginning July 1, 2019, the
27reimbursement rate for providers of family planning services
28that are eligible to receive a 90 percent federal match shall
29remain at the rates in effect on June 30, 2019.
30q. Unless otherwise subject to a tiered rate methodology,
31for the fiscal year beginning July 1, 2019, the upper
32limits and reimbursement rates for providers of home and
33community-based services waiver services shall be reimbursed
34using the reimbursement methodology in effect on June 30, 2019.
35r. For the fiscal year beginning July 1, 2019, the
-48-1reimbursement rates for emergency medical service providers
2shall remain at the rates in effect on June 30, 2019.
3s. For the fiscal year beginning July 1, 2019, reimbursement
4rates for substance-related disorder treatment programs
5licensed under section 125.13 shall remain at the rates in
6effect on June 30, 2019.
72. For the fiscal year beginning July 1, 2019, the
8reimbursement rate for providers reimbursed under the
9in-home-related care program shall not be less than the minimum
10payment level as established by the federal government to meet
11the federally mandated maintenance of effort requirement.
123. Unless otherwise directed in this section, when the
13department’s reimbursement methodology for any provider
14reimbursed in accordance with this section includes an
15inflation factor, this factor shall not exceed the amount
16by which the consumer price index for all urban consumers
17increased during the calendar year ending December 31, 2002.
184. Notwithstanding section 234.38, for the fiscal
19year beginning July 1, 2019, the foster family basic daily
20maintenance rate and the maximum adoption subsidy rate for
21children ages 0 through 5 years shall be $16.78, the rate for
22children ages 6 through 11 years shall be $17.45, the rate for
23children ages 12 through 15 years shall be $19.10, and the
24rate for children and young adults ages 16 and older shall
25be $19.35. For youth ages 18 to 21 who have exited foster
26care, the preparation for adult living program maintenance rate
27shall be $602.70 per month. The maximum payment for adoption
28subsidy nonrecurring expenses shall be limited to $500 and the
29disallowance of additional amounts for court costs and other
30related legal expenses implemented pursuant to 2010 Iowa Acts,
31chapter 1031, section 408, shall be continued.
325. For the fiscal year beginning July 1, 2019, the maximum
33reimbursement rates for social services providers under
34contract shall remain at the rates in effect on June 30, 2019,
35or the provider’s actual and allowable cost plus inflation for
-49-1each service, whichever is less. However, if a new service
2or service provider is added after June 30, 2019, the initial
3reimbursement rate for the service or provider shall be based
4upon a weighted average of provider rates for similar services.
56. a. For the fiscal year beginning July 1, 2019, the
6reimbursement rates for resource family recruitment and
7retention contractors shall be established by contract.
8b. For the fiscal year beginning July 1, 2019, the
9reimbursement rates for supervised apartment living foster care
10providers shall be established by contract.
117. For the fiscal year beginning July 1, 2019, the
12reimbursement rate for group foster care providers shall be the
13combined service and maintenance reimbursement rate established
14by contract.
158. The group foster care reimbursement rates paid for
16placement of children out of state shall be calculated
17according to the same rate-setting principles as those used for
18in-state providers, unless the director of human services or
19the director’s designee determines that appropriate care cannot
20be provided within the state. The payment of the daily rate
21shall be based on the number of days in the calendar month in
22which service is provided.
239. a. For the fiscal year beginning July 1, 2019, the
24reimbursement rate paid for shelter care and the child welfare
25emergency services implemented to provide or prevent the need
26for shelter care shall be established by contract.
27b. For the fiscal year beginning July 1, 2019, the combined
28service and maintenance components of the reimbursement rate
29paid for shelter care services shall be based on the financial
30and statistical report submitted to the department. The
31maximum reimbursement rate shall be $101.83 per day. The
32department shall reimburse a shelter care provider at the
33provider’s actual and allowable unit cost, plus inflation, not
34to exceed the maximum reimbursement rate.
35c. Notwithstanding section 232.141, subsection 8, for the
-50-1fiscal year beginning July 1, 2019, the amount of the statewide
2average of the actual and allowable rates for reimbursement of
3juvenile shelter care homes that is utilized for the limitation
4on recovery of unpaid costs shall remain at the amount in
5effect for this purpose in the fiscal year beginning July 1,
62018.
710. For the fiscal year beginning July 1, 2019, the
8department shall calculate reimbursement rates for intermediate
9care facilities for persons with an intellectual disability
10at the 80th percentile. Beginning July 1, 2019, the rate
11calculation methodology shall utilize the consumer price index
12inflation factor applicable to the fiscal year beginning July
131, 2019.
1411. Effective July 1, 2019, the child care provider
15reimbursement rates shall remain at the rates in effect on June
1630, 2019. The department shall set rates in a manner so as
17to provide incentives for a nonregistered provider to become
18registered by applying any increase only to registered and
19licensed providers.
2012. The department may adopt emergency rules to implement
21this section.
22 Sec. 32. TRANSFER OF MEDICAID MANAGED CARE SAVINGS BETWEEN
23APPROPRIATIONS — FY 2019-2020. Notwithstanding section 8.39,
24subsection 1, for the fiscal year beginning July 1, 2019,
25and ending June 30, 2020, if savings resulting from Medicaid
26managed care initiatives accrue to the medical contracts or
27children’s health insurance program appropriation from the
28general fund of the state and not to the medical assistance
29appropriation from the general fund of the state under this
30division of this Act, such savings may be transferred to such
31medical assistance appropriation for the same fiscal year
32without prior written consent and approval of the governor and
33the director of the department of management. The department
34of human services shall report any transfers made pursuant to
35this section to the legislative services agency.
-51-1 Sec. 33. EMERGENCY RULES.
21. If specifically authorized by a provision of this
3division of this Act, the department of human services or
4the mental health and disability services commission may
5adopt administrative rules under section 17A.4, subsection
63, and section 17A.5, subsection 2, paragraph “b”, to
7implement the provisions of this division of this Act and
8the rules shall become effective immediately upon filing or
9on a later effective date specified in the rules, unless the
10effective date of the rules is delayed or the applicability
11of the rules is suspended by the administrative rules review
12committee. Any rules adopted in accordance with this section
13shall not take effect before the rules are reviewed by the
14administrative rules review committee. The delay authority
15provided to the administrative rules review committee under
16section 17A.4, subsection 7, and section 17A.8, subsection 9,
17shall be applicable to a delay imposed under this section,
18notwithstanding a provision in those sections making them
19inapplicable to section 17A.5, subsection 2, paragraph “b”.
20Any rules adopted in accordance with the provisions of this
21section shall also be published as a notice of intended action
22as provided in section 17A.4.
232. If during a fiscal year, the department of human
24services is adopting rules in accordance with this section
25or as otherwise directed or authorized by state law, and the
26rules will result in an expenditure increase beyond the amount
27anticipated in the budget process or if the expenditure was
28not addressed in the budget process for the fiscal year, the
29department shall notify the persons designated by this division
30of this Act for submission of reports, the chairpersons and
31ranking members of the committees on appropriations, and
32the department of management concerning the rules and the
33expenditure increase. The notification shall be provided at
34least 30 calendar days prior to the date notice of the rules
35is submitted to the administrative rules coordinator and the
-52-1administrative code editor.
2 Sec. 34. REPORTS. Any reports or other information
3required to be compiled and submitted under this Act during the
4fiscal year beginning July 1, 2019, shall be submitted to the
5chairpersons and ranking members of the joint appropriations
6subcommittee on health and human services, the legislative
7services agency, and the legislative caucus staffs on or
8before the dates specified for submission of the reports or
9information.
10 Sec. 35. EFFECTIVE UPON ENACTMENT. The following
11provisions of this division of this Act, being deemed of
12immediate importance, take effect upon enactment:
131. The provision relating to section 232.141 and directing
14the state court administrator and the division administrator of
15the department of human services division of child and family
16services to make the determination, by June 15, 2019, of the
17distribution of funds allocated for the payment of the expenses
18of court-ordered services provided to juveniles which are a
19charge upon the state.
20DIVISION VI
21HEALTH CARE ACCOUNTS AND FUNDS — FY 2019-2020
22 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
23appropriated from the pharmaceutical settlement account created
24in section 249A.33 to the department of human services for the
25fiscal year beginning July 1, 2019, and ending June 30, 2020,
26the following amount, or so much thereof as is necessary, to be
27used for the purpose designated:
28Notwithstanding any provision of law to the contrary, to
29supplement the appropriations made in this Act for medical
30contracts under the medical assistance program for the fiscal
31year beginning July 1, 2019, and ending June 30, 2020:
.................................................. $32234,193
33 Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
34SERVICES. Notwithstanding any provision to the contrary and
35subject to the availability of funds, there is appropriated
-53-1from the quality assurance trust fund created in section
2249L.4 to the department of human services for the fiscal year
3beginning July 1, 2019, and ending June 30, 2020, the following
4amounts, or so much thereof as is necessary, for the purposes
5designated:
6To supplement the appropriation made in this Act from the
7general fund of the state to the department of human services
8for medical assistance for the same fiscal year:
.................................................. $958,570,397
10 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
11DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
12the contrary and subject to the availability of funds, there is
13appropriated from the hospital health care access trust fund
14created in section 249M.4 to the department of human services
15for the fiscal year beginning July 1, 2019, and ending June
1630, 2020, the following amounts, or so much thereof as is
17necessary, for the purposes designated:
18To supplement the appropriation made in this Act from the
19general fund of the state to the department of human services
20for medical assistance for the same fiscal year:
.................................................. $2133,920,554
22 Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
23FOR FY 2019-2020. Notwithstanding section 8.33, if moneys
24appropriated for purposes of the medical assistance program for
25the fiscal year beginning July 1, 2019, and ending June 30,
262020, from the general fund of the state, the quality assurance
27trust fund and the hospital health care access trust fund, are
28in excess of actual expenditures for the medical assistance
29program and remain unencumbered or unobligated at the close
30of the fiscal year, the excess moneys shall not revert but
31shall remain available for expenditure for the purposes of the
32medical assistance program until the close of the succeeding
33fiscal year.
34DIVISION VII
35DEPARTMENT ON AGING — FY 2020-2021
-54-1 Sec. 40. DEPARTMENT ON AGING. There is appropriated from
2the general fund of the state to the department on aging for
3the fiscal year beginning July 1, 2020, and ending June 30,
42021, the following amount, or so much thereof as is necessary,
5to be used for the purposes designated:
6For aging programs for the department on aging and area
7agencies on aging to provide citizens of Iowa who are 60 years
8of age and older with case management for frail elders, Iowa’s
9aging and disabilities resource center, and other services
10which may include but are not limited to adult day services,
11respite care, chore services, information and assistance,
12and material aid, for information and options counseling for
13persons with disabilities who are 18 years of age or older,
14and for salaries, support, administration, maintenance, and
15miscellaneous purposes:
.................................................. $1611,042,924
171. Funds appropriated in this section may be used to
18supplement federal funds under federal regulations. To
19receive funds appropriated in this section, a local area
20agency on aging shall match the funds with moneys from other
21sources according to rules adopted by the department. Funds
22appropriated in this section may be used for elderly services
23not specifically enumerated in this section only if approved
24by an area agency on aging for provision of the service within
25the area.
262. Of the funds appropriated in this section, $279,946 is
27transferred to the economic development authority for the Iowa
28commission on volunteer services to be used for the retired and
29senior volunteer program.
303. a. The department on aging shall establish and enforce
31procedures relating to expenditure of state and federal funds
32by area agencies on aging that require compliance with both
33state and federal laws, rules, and regulations, including but
34not limited to all of the following:
35(1) Requiring that expenditures are incurred only for goods
-55-1or services received or performed prior to the end of the
2fiscal period designated for use of the funds.
3(2) Prohibiting prepayment for goods or services not
4received or performed prior to the end of the fiscal period
5designated for use of the funds.
6(3) Prohibiting the prepayment for goods or services
7not defined specifically by good or service, time period, or
8recipient.
9(4) Prohibiting the establishment of accounts from which
10future goods or services which are not defined specifically by
11good or service, time period, or recipient, may be purchased.
12b. The procedures shall provide that if any funds are
13expended in a manner that is not in compliance with the
14procedures and applicable federal and state laws, rules, and
15regulations, and are subsequently subject to repayment, the
16area agency on aging expending such funds in contravention of
17such procedures, laws, rules and regulations, not the state,
18shall be liable for such repayment.
194. Of the funds appropriated in this section, at least
20$600,000 shall be used to fund home and community-based
21services through the area agencies on aging that enable older
22individuals to avoid more costly utilization of residential or
23institutional services and remain in their own homes.
245. Of the funds appropriated in this section, $812,537 shall
25be used for the purposes of chapter 231E and to administer
26the prevention of elder abuse, neglect, and exploitation
27program pursuant to section 231.56A, in accordance with the
28requirements of the federal Older Americans Act of 1965, 42
29U.S.C. §3001 et seq., as amended.
306. Of the funds appropriated in this section, $1,000,000
31shall be used to fund continuation of the aging and disability
32resource center lifelong links to provide individuals and
33caregivers with information and services to plan for and
34maintain independence.
357. Of the funds appropriated in this section, $100,000
-56-1shall be used by the department on aging, in collaboration with
2the department of human services and affected stakeholders, to
3continue the pilot initiative to provide long-term care options
4counseling utilizing support planning protocols, to assist
5non-Medicaid eligible consumers who indicate a preference
6to return to the community and are deemed appropriate for
7discharge, to return to their community following a nursing
8facility stay.
9DIVISION VIII
10OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2020-2021
11 Sec. 41. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
12appropriated from the general fund of the state to the office
13of long-term care ombudsman for the fiscal year beginning July
141, 2020, and ending June 30, 2021, the following amount, or
15so much thereof as is necessary, to be used for the purposes
16designated:
17For salaries, support, administration, maintenance, and
18miscellaneous purposes:
.................................................. $191,149,821
20DIVISION IX
21DEPARTMENT OF PUBLIC HEALTH — FY 2020-2021
22 Sec. 42. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
23from the general fund of the state to the department of public
24health for the fiscal year beginning July 1, 2020, and ending
25June 30, 2021, the following amounts, or so much thereof as is
26necessary, to be used for the purposes designated:
271. ADDICTIVE DISORDERS
28For reducing the prevalence of the use of tobacco, alcohol,
29and other drugs, and treating individuals affected by addictive
30behaviors, including gambling:
.................................................. $3125,049,544
32a. Of the funds appropriated in this subsection, $4,021,225
33shall be used for the tobacco use prevention and control
34initiative, including efforts at the state and local levels,
35as provided in chapter 142A. The commission on tobacco use
-57-1prevention and control established pursuant to section 142A.3
2shall advise the director of public health in prioritizing
3funding needs and the allocation of moneys appropriated for
4the programs and initiatives. Activities of the programs
5and initiatives shall be in alignment with the United States
6centers for disease control and prevention best practices
7for comprehensive tobacco control programs that include
8the goals of preventing youth initiation of tobacco usage,
9reducing exposure to secondhand smoke, and promotion of tobacco
10cessation.
11b. (1) Of the funds appropriated in this subsection,
12$21,028,319 shall be used for problem gambling and
13substance-related disorder prevention, treatment, and recovery
14services, including a 24-hour helpline, public information
15resources, professional training, youth prevention, and program
16evaluation.
17(2) Of the amount allocated under this paragraph, not
18more than $245,200 shall be utilized by the department of
19public health, in collaboration with the department of human
20services, to support establishment and maintenance of a single
21statewide 24-hour crisis hotline for the Iowa children’s mental
22health system that incorporates warmline services which may be
23provided through expansion of existing capabilities maintained
24by the department of public health as required pursuant to 2018
25Iowa Acts, chapter 1056, section 16.
26c. The requirement of section 123.17, subsection 5, is met
27by the appropriations and allocations made in this division of
28this Act for purposes of substance-related disorder treatment
29and addictive disorders for the fiscal year beginning July 1,
302020.
312. HEALTHY CHILDREN AND FAMILIES
32For promoting the optimum health status for children,
33adolescents from birth through 21 years of age, and families:
.................................................. $345,820,625
353. CHRONIC CONDITIONS
-58- 1For serving individuals identified as having chronic
2conditions or special health care needs:
.................................................. $34,228,109
44. COMMUNITY CAPACITY
5For strengthening the health care delivery system at the
6local level:
.................................................. $74,970,152
8a. Of the funds appropriated in this subsection, $2,000,000
9shall be deposited in the medical residency training account
10created in section 135.175, subsection 5, paragraph “a”, and
11is appropriated from the account to the department of public
12health to be used for the purposes of the medical residency
13training state matching grants program as specified in section
14135.176.
15b. Of the funds appropriated in this subsection, $799,454
16is allocated for the purposes of health care and public health
17workforce initiatives, and of this amount, $250,000 shall be
18used for the public purpose of providing funding to Des Moines
19university to continue a provider education project to provide
20primary care physicians with the training and skills necessary
21to recognize the signs of mental illness in patients.
225. ESSENTIAL PUBLIC HEALTH SERVICES
23a. To provide public health services that reduce risks
24and invest in promoting and protecting good health over the
25course of a lifetime with a priority given to older Iowans and
26vulnerable populations:
.................................................. $277,962,464
28b. Of the funds appropriated in this subsection, $300,000 is
29allocated for performance improvement activities.
306. INFECTIOUS DISEASES
31For reducing the incidence and prevalence of communicable
32diseases:
.................................................. $331,796,426
347. PUBLIC PROTECTION
35a. For protecting the health and safety of the public
-59-1through establishing standards and enforcing regulations:
.................................................. $24,095,139
3b. Of the funds appropriated in this subsection, not more
4than $304,700 shall be credited to the emergency medical
5services fund created in section 135.25. Moneys in the
6emergency medical services fund are appropriated to the
7department to be used for the purposes of the fund.
88. RESOURCE MANAGEMENT
9For establishing and sustaining the overall ability of the
10department to deliver services to the public:
.................................................. $11971,215
129. MISCELLANEOUS PROVISIONS
13The university of Iowa hospitals and clinics under the
14control of the state board of regents shall not receive
15indirect costs from the funds appropriated in this section.
16The university of Iowa hospitals and clinics billings to the
17department shall be on at least a quarterly basis.
18DIVISION X
19DEPARTMENT OF VETERANS AFFAIRS — FY 2020-2021
20 Sec. 43. DEPARTMENT OF VETERANS AFFAIRS. There is
21appropriated from the general fund of the state to the
22department of veterans affairs for the fiscal year beginning
23July 1, 2020, and ending June 30, 2021, the following amounts,
24or so much thereof as is necessary, to be used for the purposes
25designated:
261. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
27For salaries, support, maintenance, and miscellaneous
28purposes:
.................................................. $291,225,500
302. IOWA VETERANS HOME
31For salaries, support, maintenance, and miscellaneous
32purposes:
.................................................. $337,162,976
34a. The Iowa veterans home billings involving the department
35of human services shall be submitted to the department on at
-60-1least a monthly basis.
2b. Within available resources and in conformance with
3associated state and federal program eligibility requirements,
4the Iowa veterans home may implement measures to provide
5financial assistance to or on behalf of veterans or their
6spouses who are participating in the community reentry program.
7c. The Iowa veterans home expenditure report shall be
8submitted monthly to the legislative services agency.
9d. The Iowa veterans home shall continue to include in the
10annual discharge report applicant information and to provide
11for the collection of demographic information including but not
12limited to the number of individuals applying for admission and
13admitted or denied admittance and the basis for the admission
14or denial; the age, gender, and race of such individuals;
15and the level of care for which such individuals applied for
16admission including residential or nursing level of care.
173. HOME OWNERSHIP ASSISTANCE PROGRAM
18For transfer to the Iowa finance authority for the
19continuation of the home ownership assistance program for
20persons who are or were eligible members of the armed forces of
21the United States, pursuant to section 16.54:
.................................................. $222,000,000
23 Sec. 44. LIMITATION OF COUNTY COMMISSIONS OF VETERAN
24AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the
25standing appropriation in section 35A.16 for the fiscal year
26beginning July 1, 2020, and ending June 30, 2021, the amount
27appropriated from the general fund of the state pursuant to
28that section for the following designated purposes shall not
29exceed the following amount:
30For the county commissions of veteran affairs fund under
31section 35A.16:
.................................................. $32990,000
33DIVISION XI
34DEPARTMENT OF HUMAN SERVICES — FY 2020-2021
35 Sec. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
-61-1GRANT. There is appropriated from the fund created in section
28.41 to the department of human services for the fiscal year
3beginning July 1, 2020, and ending June 30, 2021, from moneys
4received under the federal temporary assistance for needy
5families (TANF) block grant pursuant to the federal Personal
6Responsibility and Work Opportunity Reconciliation Act of 1996,
7Pub.L.No.104-193, and successor legislation, the following
8amounts, or so much thereof as is necessary, to be used for the
9purposes designated:
101. To be credited to the family investment program account
11and used for assistance under the family investment program
12under chapter 239B:
.................................................. $134,524,006
142. To be credited to the family investment program account
15and used for the job opportunities and basic skills (JOBS)
16program and implementing family investment agreements in
17accordance with chapter 239B:
.................................................. $185,412,060
193. To be used for the family development and
20self-sufficiency grant program in accordance with section
21216A.107:
.................................................. $222,898,980
23Notwithstanding section 8.33, moneys appropriated in this
24subsection that remain unencumbered or unobligated at the close
25of the fiscal year shall not revert but shall remain available
26for expenditure for the purposes designated until the close of
27the succeeding fiscal year. However, unless such moneys are
28encumbered or obligated on or before September 30, 2021, the
29moneys shall revert.
304. For field operations:
.................................................. $3131,296,232
325. For general administration:
.................................................. $333,744,000
346. For state child care assistance:
.................................................. $3547,166,826
-62- 1a. Of the funds appropriated in this subsection,
2$26,205,412 is transferred to the child care and development
3block grant appropriation made by the Eighty-eighth General
4Assembly, 2020 session, for the federal fiscal year beginning
5October 1, 2020, and ending September 30, 2021. Of this
6amount, $200,000 shall be used for provision of educational
7opportunities to registered child care home providers in order
8to improve services and programs offered by this category
9of providers and to increase the number of providers. The
10department may contract with institutions of higher education
11or child care resource and referral centers to provide
12the educational opportunities. Allowable administrative
13costs under the contracts shall not exceed 5 percent. The
14application for a grant shall not exceed two pages in length.
15b. Any funds appropriated in this subsection remaining
16unallocated shall be used for state child care assistance
17payments for families who are employed including but not
18limited to individuals enrolled in the family investment
19program.
207. For child and family services:
.................................................. $2132,380,654
228. For child abuse prevention grants:
.................................................. $23125,000
249. For pregnancy prevention grants on the condition that
25family planning services are funded:
.................................................. $261,913,203
27Pregnancy prevention grants shall be awarded to programs
28in existence on or before July 1, 2020, if the programs have
29demonstrated positive outcomes. Grants shall be awarded to
30pregnancy prevention programs which are developed after July
311, 2020, if the programs are based on existing models that
32have demonstrated positive outcomes. Grants shall comply with
33the requirements provided in 1997 Iowa Acts, chapter 208,
34section 14, subsections 1 and 2, including the requirement that
35grant programs must emphasize sexual abstinence. Priority in
-63-1the awarding of grants shall be given to programs that serve
2areas of the state which demonstrate the highest percentage of
3unplanned pregnancies of females of childbearing age within the
4geographic area to be served by the grant.
510. For technology needs and other resources necessary
6to meet federal welfare reform reporting, tracking, and case
7management requirements:
.................................................. $81,037,186
911. a. Notwithstanding any provision to the contrary,
10including but not limited to requirements in section 8.41 or
11provisions in 2019 or 2020 Iowa Acts regarding the receipt and
12appropriation of federal block grants, federal funds from the
13temporary assistance for needy families block grant received by
14the state and not otherwise appropriated in this section and
15remaining available for the fiscal year beginning July 1, 2020,
16are appropriated to the department of human services to the
17extent as may be necessary to be used in the following priority
18order: the family investment program, for state child care
19assistance program payments for families who are employed, and
20for the family investment program share of system costs for
21eligibility determination and related functions. The federal
22funds appropriated in this paragraph “a” shall be expended
23only after all other funds appropriated in subsection 1 for
24assistance under the family investment program, in subsection
256 for state child care assistance, or in subsection 10 for
26technology costs related to the family investment program,
27as applicable, have been expended. For the purposes of this
28subsection, the funds appropriated in subsection 6, paragraph
29“a”, for transfer to the child care and development block grant
30appropriation are considered fully expended when the full
31amount has been transferred.
32b. The department shall, on a quarterly basis, advise the
33legislative services agency and department of management of
34the amount of funds appropriated in this subsection that was
35expended in the prior quarter.
-64- 112. Of the amounts appropriated in this section,
2$12,962,008 for the fiscal year beginning July 1, 2020, is
3transferred to the appropriation of the federal social services
4block grant made to the department of human services for that
5fiscal year.
613. For continuation of the program providing categorical
7eligibility for the food assistance program as specified
8for the program in the section of this division of this Act
9relating to the family investment program account:
.................................................. $1014,236
1114. The department may transfer funds allocated in this
12section to the appropriations made in this division of this Act
13for the same fiscal year for general administration and field
14operations for resources necessary to implement and operate the
15services referred to in this section and those funded in the
16appropriation made in this division of this Act for the same
17fiscal year for the family investment program from the general
18fund of the state.
1915. With the exception of moneys allocated under this
20section for the family development and self-sufficiency grant
21program, to the extent moneys allocated in this section are
22deemed by the department not to be necessary to support the
23purposes for which they are allocated, such moneys may be
24used in the same fiscal year for any other purpose for which
25funds are allocated in this section or in section 46 of this
26division for the family investment program account. If there
27are conflicting needs, priority shall first be given to the
28family investment program account as specified under subsection
291 of this section and used for the purposes of assistance under
30the family investment program under chapter 239B, followed by
31state child care assistance program payments for families who
32are employed, followed by other priorities as specified by the
33department.
34 Sec. 46. FAMILY INVESTMENT PROGRAM ACCOUNT.
351. Moneys credited to the family investment program (FIP)
-65-1account for the fiscal year beginning July 1, 2020, and
2ending June 30, 2021, shall be used to provide assistance in
3accordance with chapter 239B.
42. The department may use a portion of the moneys credited
5to the FIP account under this section as necessary for
6salaries, support, maintenance, and miscellaneous purposes.
73. The department may transfer funds allocated in
8subsection 4, excluding the allocation under subsection 4,
9paragraph “b”, to the appropriations made in this division of
10this Act for the same fiscal year for general administration
11and field operations for resources necessary to implement
12and operate the services referred to in this section and
13those funded in the appropriations made in section 45 for the
14temporary assistance for needy families block grant and in
15section 47 for the family investment program from the general
16fund of the state in this division of this Act for the same
17fiscal year.
184. Moneys appropriated in this division of this Act and
19credited to the FIP account for the fiscal year beginning July
201, 2020, and ending June 30, 2021, are allocated as follows:
21a. To be retained by the department of human services to
22be used for coordinating with the department of human rights
23to more effectively serve participants in FIP and other shared
24clients and to meet federal reporting requirements under the
25federal temporary assistance for needy families block grant:
.................................................. $2620,000
27b. To the department of human rights for staffing,
28administration, and implementation of the family development
29and self-sufficiency grant program in accordance with section
30216A.107:
.................................................. $316,192,834
32(1) Of the funds allocated for the family development
33and self-sufficiency grant program in this paragraph “b”,
34not more than 5 percent of the funds shall be used for the
35administration of the grant program.
-66- 1(2) The department of human rights may continue to implement
2the family development and self-sufficiency grant program
3statewide during fiscal year 2020-2021.
4(3) The department of human rights may engage in activities
5to strengthen and improve family outcomes measures and
6data collection systems under the family development and
7self-sufficiency grant program.
8c. For the diversion subaccount of the FIP account:
.................................................. $9815,000
10A portion of the moneys allocated for the subaccount may
11be used for field operations, salaries, data management
12system development, and implementation costs and support
13deemed necessary by the director of human services in order to
14administer the FIP diversion program. To the extent moneys
15allocated in this paragraph “c” are deemed by the department
16not to be necessary to support diversion activities, such
17moneys may be used for other efforts intended to increase
18engagement by family investment program participants in work,
19education, or training activities, or for the purposes of
20assistance under the family investment program in accordance
21with chapter 239B.
22d. For the food assistance employment and training program:
.................................................. $2366,588
24(1) The department shall apply the federal supplemental
25nutrition assistance program (SNAP) employment and training
26state plan in order to maximize to the fullest extent permitted
27by federal law the use of the 50 percent federal reimbursement
28provisions for the claiming of allowable federal reimbursement
29funds from the United States department of agriculture
30pursuant to the federal SNAP employment and training program
31for providing education, employment, and training services
32for eligible food assistance program participants, including
33but not limited to related dependent care and transportation
34expenses.
35(2) The department shall continue the categorical federal
-67-1food assistance program eligibility at 160 percent of the
2federal poverty level and continue to eliminate the asset test
3from eligibility requirements, consistent with federal food
4assistance program requirements. The department shall include
5as many food assistance households as is allowed by federal
6law. The eligibility provisions shall conform to all federal
7requirements including requirements addressing individuals who
8are incarcerated or otherwise ineligible.
9e. For the JOBS program:
.................................................. $1012,005,109
115. Of the child support collections assigned under FIP,
12an amount equal to the federal share of support collections
13shall be credited to the child support recovery appropriation
14made in this division of this Act. Of the remainder of the
15assigned child support collections received by the child
16support recovery unit, a portion shall be credited to the FIP
17account, a portion may be used to increase recoveries, and a
18portion may be used to sustain cash flow in the child support
19payments account. If as a consequence of the appropriations
20and allocations made in this section the resulting amounts
21are insufficient to sustain cash assistance payments and meet
22federal maintenance of effort requirements, the department
23shall seek supplemental funding. If child support collections
24assigned under FIP are greater than estimated or are otherwise
25determined not to be required for maintenance of effort, the
26state share of either amount may be transferred to or retained
27in the child support payments account.
286. The department may adopt emergency rules for the family
29investment, JOBS, food assistance, and medical assistance
30programs if necessary to comply with federal requirements.
31 Sec. 47. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
32is appropriated from the general fund of the state to the
33department of human services for the fiscal year beginning July
341, 2020, and ending June 30, 2021, the following amount, or
35so much thereof as is necessary, to be used for the purpose
-68-1designated:
2To be credited to the family investment program (FIP)
3account and used for family investment program assistance under
4chapter 239B:
.................................................. $540,365,715
61. Of the funds appropriated in this section, $6,593,049 is
7allocated for the JOBS program.
82. Of the funds appropriated in this section, $3,313,854 is
9allocated for the family development and self-sufficiency grant
10program.
113. Notwithstanding section 8.39, for the fiscal year
12beginning July 1, 2020, if necessary to meet federal
13maintenance of effort requirements or to transfer federal
14temporary assistance for needy families block grant funding
15to be used for purposes of the federal social services block
16grant or to meet cash flow needs resulting from delays in
17receiving federal funding or to implement, in accordance with
18this division of this Act, activities currently funded with
19juvenile court services, county, or community moneys and state
20moneys used in combination with such moneys; to comply with
21federal requirements; or to maximize the use of federal funds,
22the department of human services may transfer funds within or
23between any of the appropriations made in this division of this
24Act and appropriations in law for the federal social services
25block grant to the department for the following purposes,
26provided that the combined amount of state and federal
27temporary assistance for needy families block grant funding
28for each appropriation remains the same before and after the
29transfer:
30a. For the family investment program.
31b. For state child care assistance.
32c. For child and family services.
33d. For field operations.
34e. For general administration.
35This subsection shall not be construed to prohibit the use
-69-1of existing state transfer authority for other purposes. The
2department shall report any transfers made pursuant to this
3subsection to the legislative services agency.
44. Of the funds appropriated in this section, $195,678 shall
5be used for continuation of a grant to an Iowa-based nonprofit
6organization with a history of providing tax preparation
7assistance to low-income Iowans in order to expand the usage of
8the earned income tax credit. The purpose of the grant is to
9supply this assistance to underserved areas of the state.
105. Of the funds appropriated in this section, $70,000 shall
11be used for the continuation of the parenting program, as
12specified in 441 IAC ch.100, relating to parental obligations,
13in which the child support recovery unit participates, to
14support the efforts of a nonprofit organization committed
15to strengthening the community through youth development,
16healthy living, and social responsibility headquartered in
17a county with a population over 350,000 according to the
18latest certified federal census. The funds allocated in this
19subsection shall be used by the recipient organization to
20develop a larger community effort, through public and private
21partnerships, to support a broad-based multi-county parenthood
22initiative that promotes payment of child support obligations,
23improved family relationships, and full-time employment.
246. The department may transfer funds appropriated in this
25section, excluding the allocation in subsection 2 for the
26family development and self-sufficiency grant program, to the
27appropriations made in this division of this Act for general
28administration and field operations as necessary to administer
29this section, section 45 for the temporary assistance for needy
30families block grant, and section 46 for the family investment
31program account.
32 Sec. 48. CHILD SUPPORT RECOVERY. There is appropriated
33from the general fund of the state to the department of human
34services for the fiscal year beginning July 1, 2020, and ending
35June 30, 2021, the following amount, or so much thereof as is
-70-1necessary, to be used for the purposes designated:
2For child support recovery, including salaries, support,
3maintenance, and miscellaneous purposes:
.................................................. $414,943,998
51. The department shall expend up to $24,329, including
6federal financial participation, for the fiscal year beginning
7July 1, 2020, for a child support public awareness campaign.
8The department and the office of the attorney general shall
9cooperate in continuation of the campaign. The public
10awareness campaign shall emphasize, through a variety of
11media activities, the importance of maximum involvement of
12both parents in the lives of their children as well as the
13importance of payment of child support obligations.
142. Federal access and visitation grant moneys shall be
15issued directly to private not-for-profit agencies that provide
16services designed to increase compliance with the child access
17provisions of court orders, including but not limited to
18neutral visitation sites and mediation services.
193. The appropriation made to the department for child
20support recovery may be used throughout the fiscal year in the
21manner necessary for purposes of cash flow management, and for
22cash flow management purposes the department may temporarily
23draw more than the amount appropriated, provided the amount
24appropriated is not exceeded at the close of the fiscal year.
25 Sec. 49. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
26FY 2020-2021. Any funds remaining in the health care trust
27fund created in section 453A.35A for the fiscal year beginning
28July 1, 2020, and ending June 30, 2021, are appropriated to
29the department of human services to supplement the medical
30assistance program appropriations made in this division of this
31Act, for medical assistance reimbursement and associated costs,
32including program administration and costs associated with
33program implementation.
34 Sec. 50. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
352020-2021. Any funds remaining in the Medicaid fraud fund
-71-1created in section 249A.50 for the fiscal year beginning
2July 1, 2020, and ending June 30, 2021, are appropriated to
3the department of human services to supplement the medical
4assistance appropriations made in this division of this Act,
5for medical assistance reimbursement and associated costs,
6including program administration and costs associated with
7program implementation.
8 Sec. 51. MEDICAL ASSISTANCE. There is appropriated from the
9general fund of the state to the department of human services
10for the fiscal year beginning July 1, 2020, and ending June 30,
112021, the following amount, or so much thereof as is necessary,
12to be used for the purpose designated:
13For medical assistance program reimbursement and associated
14costs as specifically provided in the reimbursement
15methodologies in effect on June 30, 2020, except as otherwise
16expressly authorized by law, consistent with options under
17federal law and regulations, and contingent upon receipt of
18approval from the office of the governor of reimbursement for
19each abortion performed under the program:
.................................................. $201,456,223,889
211. Iowans support reducing the number of abortions
22performed in our state. Funds appropriated under this section
23shall not be used for abortions, unless otherwise authorized
24under this section.
252. The provisions of this section relating to abortions
26shall also apply to the Iowa health and wellness plan created
27pursuant to chapter 249N.
283. The department shall utilize not more than $60,000 of
29the funds appropriated in this section to continue the AIDS/HIV
30health insurance premium payment program as established in 1992
31Iowa Acts, Second Extraordinary Session, chapter 1001, section
32409, subsection 6. Of the funds allocated in this subsection,
33not more than $5,000 may be expended for administrative
34purposes.
354. Of the funds appropriated in this Act to the department
-72-1of public health for addictive disorders, $950,000 for
2the fiscal year beginning July 1, 2020, is transferred
3to the department of human services for an integrated
4substance-related disorder managed care system. The
5departments of human services and public health shall
6work together to maintain the level of mental health and
7substance-related disorder treatment services provided by the
8managed care contractors. Each department shall take the steps
9necessary to continue the federal waivers as necessary to
10maintain the level of services.
115. a. The department shall aggressively pursue options for
12providing medical assistance or other assistance to individuals
13with special needs who become ineligible to continue receiving
14services under the early and periodic screening, diagnostic,
15and treatment program under the medical assistance program
16due to becoming 21 years of age who have been approved for
17additional assistance through the department’s exception to
18policy provisions, but who have health care needs in excess
19of the funding available through the exception to policy
20provisions.
21b. Of the funds appropriated in this section, $100,000
22shall be used for participation in one or more pilot projects
23operated by a private provider to allow the individual or
24individuals to receive service in the community in accordance
25with principles established in Olmstead v.L.C., 527 U.S.581
26(1999), for the purpose of providing medical assistance or
27other assistance to individuals with special needs who become
28ineligible to continue receiving services under the early and
29periodic screening, diagnostic, and treatment program under
30the medical assistance program due to becoming 21 years of
31age who have been approved for additional assistance through
32the department’s exception to policy provisions, but who have
33health care needs in excess of the funding available through
34the exception to the policy provisions.
356. Of the funds appropriated in this section, up to
-73-1$3,050,082 may be transferred to the field operations or
2general administration appropriations in this division of this
3Act for operational costs associated with Part D of the federal
4Medicare Prescription Drug Improvement and Modernization Act
5of 2003, Pub.L.No.108-173.
67. Of the funds appropriated in this section, up to $442,100
7may be transferred to the appropriation in this division
8of this Act for medical contracts to be used for clinical
9assessment services and prior authorization of services.
108. A portion of the funds appropriated in this section
11may be transferred to the appropriations in this division of
12this Act for general administration, medical contracts, the
13children’s health insurance program, or field operations to be
14used for the state match cost to comply with the payment error
15rate measurement (PERM) program for both the medical assistance
16and children’s health insurance programs as developed by the
17centers for Medicare and Medicaid services of the United States
18department of health and human services to comply with the
19federal Improper Payments Information Act of 2002, Pub.L.
20No.107-300, and to support other reviews and quality control
21activities to improve the integrity of these programs.
229. The department shall continue to implement the
23recommendations of the assuring better child health and
24development initiative II (ABCDII) clinical panel to the
25Iowa early and periodic screening, diagnostic, and treatment
26services healthy mental development collaborative board
27regarding changes to billing procedures, codes, and eligible
28service providers.
2910. Of the funds appropriated in this section, a sufficient
30amount is allocated to supplement the incomes of residents of
31nursing facilities, intermediate care facilities for persons
32with mental illness, and intermediate care facilities for
33persons with an intellectual disability, with incomes of less
34than $50 in the amount necessary for the residents to receive a
35personal needs allowance of $50 per month pursuant to section
-74-1249A.30A.
211. a. Hospitals that meet the conditions specified
3in subparagraphs (1) and (2) shall either certify public
4expenditures or transfer to the medical assistance program
5an amount equal to provide the nonfederal share for a
6disproportionate share hospital payment in an amount up to the
7hospital-specific limit as approved in the Medicaid state plan.
8The hospitals that meet the conditions specified shall receive
9and retain 100 percent of the total disproportionate share
10hospital payment in an amount up to the hospital-specific limit
11as approved in the Medicaid state plan.
12(1) The hospital qualifies for disproportionate share and
13graduate medical education payments.
14(2) The hospital is an Iowa state-owned hospital with more
15than 500 beds and eight or more distinct residency specialty
16or subspecialty programs recognized by the American college of
17graduate medical education.
18b. Distribution of the disproportionate share payments
19shall be made on a monthly basis. The total amount of
20disproportionate share payments including graduate medical
21education, enhanced disproportionate share, and Iowa
22state-owned teaching hospital payments shall not exceed the
23amount of the state’s allotment under Pub.L.No.102-234.
24In addition, the total amount of all disproportionate
25share payments shall not exceed the hospital-specific
26disproportionate share limits under Pub.L.No.103-66.
2712. One hundred percent of the nonfederal share of payments
28to area education agencies that are medical assistance
29providers for medical assistance-covered services provided to
30medical assistance-covered children, shall be made from the
31appropriation made in this section.
3213. A portion of the funds appropriated in this section
33may be transferred to the appropriation in this division of
34this Act for medical contracts to be used for administrative
35activities associated with the money follows the person
-75-1demonstration project.
214. Of the funds appropriated in this section, $349,011
3shall be used for the administration of the health insurance
4premium payment program, including salaries, support,
5maintenance, and miscellaneous purposes.
615. a. The department may increase the amounts allocated
7for salaries, support, maintenance, and miscellaneous purposes
8associated with the medical assistance program, as necessary,
9to implement cost containment strategies. The department shall
10report any such increase to the legislative services agency and
11the department of management.
12b. If the savings to the medical assistance program from
13cost containment efforts exceed the cost for the fiscal
14year beginning July 1, 2020, the department may transfer any
15savings generated for the fiscal year due to medical assistance
16program cost containment efforts to the appropriation
17made in this division of this Act for medical contracts or
18general administration to defray the increased contract costs
19associated with implementing such efforts.
2016. For the fiscal year beginning July 1, 2020, and ending
21June 30, 2021, the replacement generation tax revenues required
22to be deposited in the property tax relief fund pursuant to
23section 437A.8, subsection 4, paragraph “d”, and section
24437A.15, subsection 3, paragraph “f”, shall instead be credited
25to and supplement the appropriation made in this section and
26used for the allocations made in this section.
2717. a. Of the funds appropriated in this section, up
28to $50,000 may be transferred by the department to the
29appropriation made in this division of this Act to the
30department for the same fiscal year for general administration
31to be used for associated administrative expenses and for not
32more than one full-time equivalent position, in addition to
33those authorized for the same fiscal year, to be assigned to
34implementing the children’s mental health home project.
35b. Of the funds appropriated in this section, up to $400,000
-76-1may be transferred by the department to the appropriation made
2to the department in this division of this Act for the same
3fiscal year for Medicaid program-related general administration
4planning and implementation activities. The funds may be used
5for contracts or for personnel in addition to the amounts
6appropriated for and the positions authorized for general
7administration for the fiscal year.
8c. Of the funds appropriated in this section, up to
9$3,000,000 may be transferred by the department to the
10appropriations made in this division of this Act for the same
11fiscal year for general administration or medical contracts
12to be used to support the development and implementation of
13standardized assessment tools for persons with mental illness,
14an intellectual disability, a developmental disability, or a
15brain injury.
1618. Of the funds appropriated in this section, $150,000
17shall be used for lodging expenses associated with care
18provided at the university of Iowa hospitals and clinics for
19patients with cancer whose travel distance is 30 miles or more
20and whose income is at or below 200 percent of the federal
21poverty level as defined by the most recently revised poverty
22income guidelines published by the United States department of
23health and human services. The department of human services
24shall establish the maximum number of overnight stays and the
25maximum rate reimbursed for overnight lodging, which may be
26based on the state employee rate established by the department
27of administrative services. The funds allocated in this
28subsection shall not be used as nonfederal share matching
29funds.
3019. Of the funds appropriated in this section, up to
31$3,383,880 shall be used for administration of the state
32family planning services program pursuant to section 217.41B,
33and of this amount the department may use up to $200,000 for
34administrative expenses.
3520. The department shall report the implementation of
-77-1any cost containment strategies to the individuals specified
2in this division of this Act for submission of reports upon
3implementation.
421. The department shall report the implementation of any
5process improvement changes and any related cost reductions
6to the individuals specified in this division of this Act for
7submission of reports upon implementation.
822. Of the funds appropriated in this section, $1,545,530
9shall be used and may be transferred to other appropriations
10in this division of this Act as necessary to administer the
11provisions in the division of this Act relating to Medicaid
12program administration.
1323. The department shall continue to implement and
14administer the provisions of 2018 Iowa Acts, chapter 1056. Of
15the funds appropriated in this section, up to $39,069 may be
16transferred to the department of inspections and appeals for
17inspection costs.
18 Sec. 52. MEDICAL CONTRACTS. There is appropriated from the
19general fund of the state to the department of human services
20for the fiscal year beginning July 1, 2020, and ending June 30,
212021, the following amount, or so much thereof as is necessary,
22to be used for the purpose designated:
23For medical contracts:
.................................................. $2418,264,987
251. The department of inspections and appeals shall
26provide all state matching funds for survey and certification
27activities performed by the department of inspections
28and appeals. The department of human services is solely
29responsible for distributing the federal matching funds for
30such activities.
312. Of the funds appropriated in this section, $50,000 shall
32be used for continuation of home and community-based services
33waiver quality assurance programs, including the review and
34streamlining of processes and policies related to oversight and
35quality management to meet state and federal requirements.
-78- 13. Of the amount appropriated in this section, up to
2$200,000 may be transferred to the appropriation for general
3administration in this division of this Act to be used for
4additional full-time equivalent positions in the development of
5key health initiatives such as cost containment, development
6and oversight of managed care programs, and development of
7health strategies targeted toward improved quality and reduced
8costs in the Medicaid program.
94. Of the funds appropriated in this section, $1,000,000
10shall be used for planning and development, in cooperation with
11the department of public health, of a phased-in program to
12provide a dental home for children.
135. a. Of the funds appropriated in this section, $573,000
14shall be credited to the autism support program fund created
15in section 225D.2 to be used for the autism support program
16created in chapter 225D, with the exception of the following
17amounts of this allocation which shall be used as follows:
18b. Of the funds allocated in this subsection, $25,000 shall
19be used for the public purpose of continuation of a grant to
20a non profit provider of child welfare services that has been
21in existence for more than 115 years, is located in a county
22with a population between 200,000 and 220,000 according to the
23latest certified federal census, is licensed as a psychiatric
24medical institution for children, and provides school-based
25programming, to be used for support services for children with
26autism spectrum disorder and their families.
27 Sec. 53. STATE SUPPLEMENTARY ASSISTANCE.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2020, and ending June 30, 2021, the following
31amount, or so much thereof as is necessary, to be used for the
32purpose designated:
33For the state supplementary assistance program:
.................................................. $347,176,606
352. The department shall increase the personal needs
-79-1allowance for residents of residential care facilities by the
2same percentage and at the same time as federal supplemental
3security income and federal social security benefits are
4increased due to a recognized increase in the cost of living.
5The department may adopt emergency rules to implement this
6subsection.
73. If during the fiscal year beginning July 1, 2020,
8the department projects that state supplementary assistance
9expenditures for a calendar year will not meet the federal
10pass-through requirement specified in Tit.XVI of the federal
11Social Security Act, section 1618, as codified in 42 U.S.C.
12§1382g, the department may take actions including but not
13limited to increasing the personal needs allowance for
14residential care facility residents and making programmatic
15adjustments or upward adjustments of the residential care
16facility or in-home health-related care reimbursement rates
17prescribed in this division of this Act to ensure that federal
18requirements are met. In addition, the department may make
19other programmatic and rate adjustments necessary to remain
20within the amount appropriated in this section while ensuring
21compliance with federal requirements. The department may adopt
22emergency rules to implement the provisions of this subsection.
234. Notwithstanding section 8.33, moneys appropriated in
24this section that remain unencumbered or unobligated at the
25close of the fiscal year shall not revert but shall remain
26available for expenditure for the purposes designated until the
27close of the succeeding fiscal year.
28 Sec. 54. CHILDREN’S HEALTH INSURANCE PROGRAM.
291. There is appropriated from the general fund of the
30state to the department of human services for the fiscal year
31beginning July 1, 2020, and ending June 30, 2021, the following
32amount, or so much thereof as is necessary, to be used for the
33purpose designated:
34For maintenance of the healthy and well kids in Iowa (hawk-i)
35program pursuant to chapter 514I, including supplemental dental
-80-1services, for receipt of federal financial participation under
2Tit.XXI of the federal Social Security Act, which creates the
3children’s health insurance program:
.................................................. $438,267,453
52. Of the funds appropriated in this section, up to $148,455
6is allocated for continuation of the contract for outreach with
7the department of public health.
83. A portion of the funds appropriated in this section may
9be transferred to the appropriations made in this division of
10this Act for field operations or medical contracts to be used
11for the integration of hawk-i program eligibility, payment, and
12administrative functions under the purview of the department
13of human services, including for the Medicaid management
14information system upgrade.
15 Sec. 55. CHILD CARE ASSISTANCE. There is appropriated
16from the general fund of the state to the department of human
17services for the fiscal year beginning July 1, 2020, and ending
18June 30, 2021, the following amount, or so much thereof as is
19necessary, to be used for the purpose designated:
20For child care programs:
.................................................. $2140,816,931
221. Of the funds appropriated in this section, $34,966,931
23shall be used for state child care assistance in accordance
24with section 237A.13.
252. Nothing in this section shall be construed or is
26intended as or shall imply a grant of entitlement for services
27to persons who are eligible for assistance due to an income
28level consistent with the waiting list requirements of section
29237A.13. Any state obligation to provide services pursuant to
30this section is limited to the extent of the funds appropriated
31in this section.
323. A list of the registered and licensed child care
33facilities operating in the area served by a child care
34resource and referral service shall be made available to the
35families receiving state child care assistance in that area.
-81- 14. Of the funds appropriated in this section, $5,850,000
2shall be credited to the early childhood programs grants
3account in the early childhood Iowa fund created in section
4256I.11. The moneys shall be distributed for funding of
5community-based early childhood programs targeted to children
6from birth through five years of age developed by early
7childhood Iowa areas in accordance with approved community
8plans as provided in section 256I.8.
95. The department may use any of the funds appropriated
10in this section as a match to obtain federal funds for use in
11expanding child care assistance and related programs. For
12the purpose of expenditures of state and federal child care
13funding, funds shall be considered obligated at the time
14expenditures are projected or are allocated to the department’s
15service areas. Projections shall be based on current and
16projected caseload growth, current and projected provider
17rates, staffing requirements for eligibility determination
18and management of program requirements including data systems
19management, staffing requirements for administration of the
20program, contractual and grant obligations and any transfers
21to other state agencies, and obligations for decategorization
22or innovation projects.
236. A portion of the state match for the federal child care
24and development block grant shall be provided as necessary to
25meet federal matching funds requirements through the state
26general fund appropriation made for child development grants
27and other programs for at-risk children in section 279.51.
287. If a uniform reduction ordered by the governor under
29section 8.31 or other operation of law, transfer, or federal
30funding reduction reduces the appropriation made in this
31section for the fiscal year, the percentage reduction in the
32amount paid out to or on behalf of the families participating
33in the state child care assistance program shall be equal to or
34less than the percentage reduction made for any other purpose
35payable from the appropriation made in this section and the
-82-1federal funding relating to it. The percentage reduction to
2the other allocations made in this section shall be the same as
3the uniform reduction ordered by the governor or the percentage
4change of the federal funding reduction, as applicable. If
5there is an unanticipated increase in federal funding provided
6for state child care services, the entire amount of the
7increase, except as necessary to meet federal requirements
8including quality set asides, shall be used for state child
9care assistance payments. If the appropriations made for
10purposes of the state child care assistance program for the
11fiscal year are determined to be insufficient, it is the intent
12of the general assembly to appropriate sufficient funding for
13the fiscal year in order to avoid establishment of waiting list
14requirements.
158. Notwithstanding section 8.33, moneys advanced for
16purposes of the programs developed by early childhood Iowa
17areas, advanced for purposes of wraparound child care, or
18received from the federal appropriations made for the purposes
19of this section that remain unencumbered or unobligated at the
20close of the fiscal year shall not revert to any fund but shall
21remain available for expenditure for the purposes designated
22until the close of the succeeding fiscal year.
23 Sec. 56. JUVENILE INSTITUTION. There is appropriated
24from the general fund of the state to the department of human
25services for the fiscal year beginning July 1, 2020, and ending
26June 30, 2021, the following amounts, or so much thereof as is
27necessary, to be used for the purposes designated:
281. For operation of the state training school at Eldora and
29for salaries, support, maintenance, and miscellaneous purposes:
.................................................. $3013,965,806
31Of the funds appropriated in this subsection, $91,150 shall
32be used for distribution to licensed classroom teachers at this
33and other institutions under the control of the department of
34human services based upon the average student yearly enrollment
35at each institution as determined by the department.
-83- 12. A portion of the moneys appropriated in this section
2shall be used by the state training school at Eldora for
3grants for adolescent pregnancy prevention activities at the
4institution in the fiscal year beginning July 1, 2020.
53. Of the funds appropriated in this subsection, $212,000
6shall be used by the state training school at Eldora for a
7substance use disorder treatment program at the institution in
8the fiscal year beginning July 1, 2020.
9 Sec. 57. CHILD AND FAMILY SERVICES.
101. There is appropriated from the general fund of the
11state to the department of human services for the fiscal year
12beginning July 1, 2020, and ending June 30, 2021, the following
13amount, or so much thereof as is necessary, to be used for the
14purpose designated:
15For child and family services:
.................................................. $1689,078,185
172. The department may transfer funds appropriated in this
18section as necessary to pay the nonfederal costs of services
19reimbursed under the medical assistance program, state child
20care assistance program, or the family investment program which
21are provided to children who would otherwise receive services
22paid under the appropriation in this section. The department
23may transfer funds appropriated in this section to the
24appropriations made in this division of this Act for general
25administration and for field operations for resources necessary
26to implement and operate the services funded in this section.
273. a. Of the funds appropriated in this section, up to
28$34,536,648 is allocated as the statewide expenditure target
29under section 232.143 for group foster care maintenance and
30services. If the department projects that such expenditures
31for the fiscal year will be less than the target amount
32allocated in this paragraph “a”, the department may reallocate
33the excess to provide additional funding for family foster
34care, independent living, family safety, risk and permanency
35services, shelter care, or the child welfare emergency services
-84-1addressed with the allocation for shelter care.
2b. If at any time after September 30, 2020, annualization
3of a service area’s current expenditures indicates a service
4area is at risk of exceeding its group foster care expenditure
5target under section 232.143 by more than 5 percent, the
6department and juvenile court services shall examine all
7group foster care placements in that service area in order to
8identify those which might be appropriate for termination.
9In addition, any aftercare services believed to be needed
10for the children whose placements may be terminated shall be
11identified. The department and juvenile court services shall
12initiate action to set dispositional review hearings for the
13placements identified. In such a dispositional review hearing,
14the juvenile court shall determine whether needed aftercare
15services are available and whether termination of the placement
16is in the best interest of the child and the community.
174. In accordance with the provisions of section 232.188,
18the department shall continue the child welfare and juvenile
19justice funding initiative during fiscal year 2020-2021. Of
20the funds appropriated in this section, $1,717,753 is allocated
21specifically for expenditure for fiscal year 2020-2021 through
22the decategorization services funding pools and governance
23boards established pursuant to section 232.188.
245. A portion of the funds appropriated in this section
25may be used for emergency family assistance to provide other
26resources required for a family participating in a family
27preservation or reunification project or successor project to
28stay together or to be reunified.
296. Of the funds appropriated in this section, a sufficient
30amount is allocated for shelter care and the child welfare
31emergency services contracting implemented to provide for or
32prevent the need for shelter care.
337. Federal funds received by the state during the fiscal
34year beginning July 1, 2020, as the result of the expenditure
35of state funds appropriated during a previous state fiscal
-85-1year for a service or activity funded under this section are
2appropriated to the department to be used as additional funding
3for services and purposes provided for under this section.
4Notwithstanding section 8.33, moneys received in accordance
5with this subsection that remain unencumbered or unobligated at
6the close of the fiscal year shall not revert to any fund but
7shall remain available for the purposes designated until the
8close of the succeeding fiscal year.
98. a. Of the funds appropriated in this section, up to
10$3,290,000 is allocated for the payment of the expenses of
11court-ordered services provided to juveniles who are under the
12supervision of juvenile court services, which expenses are a
13charge upon the state pursuant to section 232.141, subsection
144. Of the amount allocated in this paragraph “a”, up to
15$1,556,287 shall be made available to provide school-based
16supervision of children adjudicated under chapter 232, of which
17not more than $15,000 may be used for the purpose of training.
18A portion of the cost of each school-based liaison officer
19shall be paid by the school district or other funding source as
20approved by the chief juvenile court officer.
21b. Of the funds appropriated in this section, up to $748,985
22is allocated for the payment of the expenses of court-ordered
23services provided to children who are under the supervision
24of the department, which expenses are a charge upon the state
25pursuant to section 232.141, subsection 4.
26c. Notwithstanding section 232.141 or any other provision
27of law to the contrary, the amounts allocated in this
28subsection shall be distributed to the judicial districts
29as determined by the state court administrator and to the
30department’s service areas as determined by the administrator
31of the department of human services’ division of child and
32family services. The state court administrator and the
33division administrator shall make the determination of the
34distribution amounts on or before June 15, 2020.
35d. Notwithstanding chapter 232 or any other provision of
-86-1law to the contrary, a district or juvenile court shall not
2order any service which is a charge upon the state pursuant
3to section 232.141 if there are insufficient court-ordered
4services funds available in the district court or departmental
5service area distribution amounts to pay for the service. The
6chief juvenile court officer and the departmental service area
7manager shall encourage use of the funds allocated in this
8subsection such that there are sufficient funds to pay for
9all court-related services during the entire year. The chief
10juvenile court officers and departmental service area managers
11shall attempt to anticipate potential surpluses and shortfalls
12in the distribution amounts and shall cooperatively request the
13state court administrator or division administrator to transfer
14funds between the judicial districts’ or departmental service
15areas’ distribution amounts as prudent.
16e. Notwithstanding any provision of law to the contrary,
17a district or juvenile court shall not order a county to pay
18for any service provided to a juvenile pursuant to an order
19entered under chapter 232 which is a charge upon the state
20under section 232.141, subsection 4.
21f. Of the funds allocated in this subsection, not more than
22$83,000 may be used by the judicial branch for administration
23of the requirements under this subsection.
24g. Of the funds allocated in this subsection, $17,000
25shall be used by the department of human services to support
26the interstate commission for juveniles in accordance with
27the interstate compact for juveniles as provided in section
28232.173.
299. Of the funds appropriated in this section, $12,253,227 is
30allocated for juvenile delinquent graduated sanctions services.
31Any state funds saved as a result of efforts by juvenile court
32services to earn a federal Tit.IV-E match for juvenile court
33services administration may be used for the juvenile delinquent
34graduated sanctions services.
3510. Of the funds appropriated in this section, $1,658,285 is
-87-1transferred to the department of public health to be used for
2the child protection center grant program for child protection
3centers located in Iowa in accordance with section 135.118.
4The grant amounts under the program shall be equalized so that
5each center receives a uniform base amount of $245,000, and so
6that the remaining funds are awarded through a funding formula
7based upon the volume of children served.
811. If the department receives federal approval to
9implement a waiver under Tit.IV-E of the federal Social
10Security Act to enable providers to serve children who remain
11in the children’s families and communities, for purposes of
12eligibility under the medical assistance program through 25
13years of age, children who participate in the waiver shall be
14considered to be placed in foster care.
1512. Of the funds appropriated in this section, $4,025,167 is
16allocated for the preparation for adult living program pursuant
17to section 234.46.
1813. Of the funds appropriated in this section, $227,337
19shall be used for the public purpose of continuing a grant to
20a nonprofit human services organization providing services to
21individuals and families in multiple locations in southwest
22Iowa and Nebraska for support of a project providing immediate,
23sensitive support and forensic interviews, medical exams, needs
24assessments, and referrals for victims of child abuse and their
25nonoffending family members.
2614. Of the funds appropriated in this section, $300,620
27is allocated for the foster care youth council approach of
28providing a support network to children placed in foster care.
2915. Of the funds appropriated in this section, $202,000 is
30allocated for use pursuant to section 235A.1 for continuation
31of the initiative to address child sexual abuse implemented
32pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
3321.
3416. Of the funds appropriated in this section, $630,240 is
35allocated for the community partnership for child protection
-88-1sites.
217. Of the funds appropriated in this section, $371,250
3is allocated for the department’s minority youth and family
4projects under the redesign of the child welfare system.
518. Of the funds appropriated in this section, $851,595
6is allocated for funding of the community circle of care
7collaboration for children and youth in northeast Iowa.
819. Of the funds appropriated in this section, at least
9$147,158 shall be used for the continuation of the child
10welfare provider training academy, a collaboration between the
11coalition for family and children’s services in Iowa and the
12department.
1320. Of the funds appropriated in this section, $211,872
14shall be used for continuation of the central Iowa system of
15care program grant through June 30, 2021.
1621. Of the funds appropriated in this section, $235,000
17shall be used for the public purpose of the continuation
18and expansion of a system of care program grant implemented
19in Cerro Gordo and Linn counties to utilize a comprehensive
20and long-term approach for helping children and families by
21addressing the key areas in a child’s life of childhood basic
22needs, education and work, family, and community.
2322. Of the funds appropriated in this section, $110,000
24shall be used for the public purpose of funding community-based
25services and other supports with a system of care approach
26for children with a serious emotional disturbance and their
27families through a nonprofit provider of child welfare services
28that has been in existence for more than 115 years, is located
29in a county with a population of more than 200,000 but less
30than 220,000 according to the latest certified federal census,
31is licensed as a psychiatric medical institution for children,
32and was a system of care grantee prior to July 1, 2020.
3323. If a separate funding source is identified that reduces
34the need for state funds within an allocation under this
35section, the allocated state funds may be redistributed to
-89-1other allocations under this section for the same fiscal year.
2 Sec. 58. ADOPTION SUBSIDY.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2020, and ending June 30, 2021, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8a. For adoption subsidy payments and services:
.................................................. $940,752,396
10b. (1) The funds appropriated in this section shall be used
11as authorized or allowed by federal law or regulation for any
12of the following purposes:
13(a) For adoption subsidy payments and related costs.
14(b) For post-adoption services and for other purposes under
15Tit.IV-B or Tit.IV-E of the federal Social Security Act.
16(2) The department of human services may transfer funds
17appropriated in this subsection to the appropriation for
18child and family services in this Act for the purposes of
19post-adoption services as specified in this paragraph “b”.
20c. Notwithstanding section 8.33, moneys corresponding to
21the state savings resulting from implementation of the federal
22Fostering Connections to Success and Increasing Adoptions Act
23of 2008, Pub.L. No.110-351, and successor legislation, as
24determined in accordance with 42 U.S.C. §673(a)(8), that remain
25unencumbered or unobligated at the close of the fiscal year,
26shall not revert to any fund but shall remain available for the
27purposes designated in this subsection until expended. The
28amount of such savings and any corresponding funds remaining
29at the close of the fiscal year shall be determined separately
30and any changes in either amount between fiscal years shall not
31result in an unfunded need.
322. The department may transfer funds appropriated in
33this section to the appropriation made in this division of
34this Act for general administration for costs paid from the
35appropriation relating to adoption subsidy.
-90- 13. Federal funds received by the state during the
2fiscal year beginning July 1, 2020, as the result of the
3expenditure of state funds during a previous state fiscal
4year for a service or activity funded under this section are
5appropriated to the department to be used as additional funding
6for the services and activities funded under this section.
7Notwithstanding section 8.33, moneys received in accordance
8with this subsection that remain unencumbered or unobligated
9at the close of the fiscal year shall not revert to any fund
10but shall remain available for expenditure for the purposes
11designated until the close of the succeeding fiscal year.
12 Sec. 59. JUVENILE DETENTION HOME FUND. Moneys deposited
13in the juvenile detention home fund created in section 232.142
14during the fiscal year beginning July 1, 2020, and ending June
1530, 2021, are appropriated to the department of human services
16for the fiscal year beginning July 1, 2020, and ending June 30,
172021, for distribution of an amount equal to a percentage of
18the costs of the establishment, improvement, operation, and
19maintenance of county or multicounty juvenile detention homes
20in the fiscal year beginning July 1, 2019. Moneys appropriated
21for distribution in accordance with this section shall be
22allocated among eligible detention homes, prorated on the basis
23of an eligible detention home’s proportion of the costs of all
24eligible detention homes in the fiscal year beginning July
251, 2019. The percentage figure shall be determined by the
26department based on the amount available for distribution for
27the fund. Notwithstanding section 232.142, subsection 3, the
28financial aid payable by the state under that provision for the
29fiscal year beginning July 1, 2020, shall be limited to the
30amount appropriated for the purposes of this section.
31 Sec. 60. FAMILY SUPPORT SUBSIDY PROGRAM.
321. There is appropriated from the general fund of the
33state to the department of human services for the fiscal year
34beginning July 1, 2020, and ending June 30, 2021, the following
35amount, or so much thereof as is necessary, to be used for the
-91-1purpose designated:
2For the family support subsidy program subject to the
3enrollment restrictions in section 225C.37, subsection 3:
.................................................. $4949,282
52. At least $859,364 of the moneys appropriated in this
6section is transferred to the department of public health for
7the family support center component of the comprehensive family
8support program under chapter 225C, subchapter V.
93. If at any time during the fiscal year, the amount of
10funding available for the family support subsidy program
11is reduced from the amount initially used to establish the
12figure for the number of family members for whom a subsidy
13is to be provided at any one time during the fiscal year,
14notwithstanding section 225C.38, subsection 2, the department
15shall revise the figure as necessary to conform to the amount
16of funding available.
17 Sec. 61. CONNER DECREE. There is appropriated from the
18general fund of the state to the department of human services
19for the fiscal year beginning July 1, 2020, and ending June 30,
202021, the following amount, or so much thereof as is necessary,
21to be used for the purpose designated:
22For building community capacity through the coordination
23and provision of training opportunities in accordance with the
24consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
25Iowa, July 14, 1994):
.................................................. $2633,632
27 Sec. 62. MENTAL HEALTH INSTITUTES.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2020, and ending June 30, 2021, the following
31amounts, or so much thereof as is necessary, to be used for the
32purposes designated:
33a. For operation of the state mental health institute at
34Cherokee as required by chapters 218 and 226 for salaries,
35support, maintenance, and miscellaneous purposes:
-92-.................................................. $114,293,758
2b. For operation of the state mental health institute at
3Independence as required by chapters 218 and 226 for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $519,262,041
62. Notwithstanding sections 218.78 and 249A.11, any revenue
7received from the state mental health institute at Cherokee or
8the state mental health institute at Independence pursuant to
942 C.F.R§438.6(e) may be retained and expended by the mental
10health institute.
113. Notwithstanding any provision of law to the contrary,
12a Medicaid member residing at the state mental health
13institute at Cherokee or the state mental health institute
14at Independence shall retain Medicaid eligibility during
15the period of the Medicaid member’s stay for which federal
16financial participation is available.
17 Sec. 63. STATE RESOURCE CENTERS.
181. There is appropriated from the general fund of the
19state to the department of human services for the fiscal year
20beginning July 1, 2020, and ending June 30, 2021, the following
21amounts, or so much thereof as is necessary, to be used for the
22purposes designated:
23a. For the state resource center at Glenwood for salaries,
24support, maintenance, and miscellaneous purposes:
.................................................. $2516,105,964
26b. For the state resource center at Woodward for salaries,
27support, maintenance, and miscellaneous purposes:
.................................................. $2810,912,712
292. The department may continue to bill for state resource
30center services utilizing a scope of services approach used for
31private providers of intermediate care facilities for persons
32with an intellectual disability services, in a manner which
33does not shift costs between the medical assistance program,
34counties, or other sources of funding for the state resource
35centers.
-93- 13. The state resource centers may expand the time-limited
2assessment and respite services during the fiscal year.
34. If the department’s administration and the department
4of management concur with a finding by a state resource
5center’s superintendent that projected revenues can reasonably
6be expected to pay the salary and support costs for a new
7employee position, or that such costs for adding a particular
8number of new positions for the fiscal year would be less
9than the overtime costs if new positions would not be added,
10the superintendent may add the new position or positions. If
11the vacant positions available to a resource center do not
12include the position classification desired to be filled, the
13state resource center’s superintendent may reclassify any
14vacant position as necessary to fill the desired position. The
15superintendents of the state resource centers may, by mutual
16agreement, pool vacant positions and position classifications
17during the course of the fiscal year in order to assist one
18another in filling necessary positions.
195. If existing capacity limitations are reached in
20operating units, a waiting list is in effect for a service or
21a special need for which a payment source or other funding
22is available for the service or to address the special need,
23and facilities for the service or to address the special need
24can be provided within the available payment source or other
25funding, the superintendent of a state resource center may
26authorize opening not more than two units or other facilities
27and begin implementing the service or addressing the special
28need during fiscal year 2020-2021.
29 Sec. 64. SEXUALLY VIOLENT PREDATORS.
301. There is appropriated from the general fund of the
31state to the department of human services for the fiscal year
32beginning July 1, 2020, and ending June 30, 2021, the following
33amount, or so much thereof as is necessary, to be used for the
34purpose designated:
35For costs associated with the commitment and treatment of
-94-1sexually violent predators in the unit located at the state
2mental health institute at Cherokee, including costs of legal
3services and other associated costs, including salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $512,313,977
62. Unless specifically prohibited by law, if the amount
7charged provides for recoupment of at least the entire amount
8of direct and indirect costs, the department of human services
9may contract with other states to provide care and treatment
10of persons placed by the other states at the unit for sexually
11violent predators at Cherokee. The moneys received under
12such a contract shall be considered to be repayment receipts
13and used for the purposes of the appropriation made in this
14section.
15 Sec. 65. FIELD OPERATIONS. There is appropriated from the
16general fund of the state to the department of human services
17for the fiscal year beginning July 1, 2020, and ending June 30,
182021, the following amount, or so much thereof as is necessary,
19to be used for the purposes designated:
20For field operations, including salaries, support,
21maintenance, and miscellaneous purposes:
.................................................. $2253,923,195
23Priority in filling full-time equivalent positions shall be
24given to those positions related to child protection services
25and eligibility determination for low-income families.
26 Sec. 66. GENERAL ADMINISTRATION. There is appropriated
27from the general fund of the state to the department of human
28services for the fiscal year beginning July 1, 2020, and ending
29June 30, 2021, the following amount, or so much thereof as is
30necessary, to be used for the purpose designated:
31For general administration, including salaries, support,
32maintenance, and miscellaneous purposes:
.................................................. $3313,833,040
341. The department shall report at least monthly to the
35legislative services agency concerning the department’s
-95-1operational and program expenditures.
22. Of the funds appropriated in this section, $150,000 shall
3be used to continue the contract for the provision of a program
4to provide technical assistance, support, and consultation to
5providers of habilitation services and home and community-based
6services waiver services for adults with disabilities under the
7medical assistance program.
83. Of the funds appropriated in this section, $50,000
9is transferred to the Iowa finance authority to be used
10for administrative support of the council on homelessness
11established in section 16.2D and for the council to fulfill its
12duties in addressing and reducing homelessness in the state.
134. Of the funds appropriated in this section, $200,000 shall
14be transferred to and deposited in the administrative fund of
15the Iowa ABLE savings plan trust created in section 12I.4, to
16be used for implementation and administration activities of the
17Iowa ABLE savings plan trust.
185. Of the funds appropriated in this section, $200,000 is
19transferred to the economic development authority for the Iowa
20commission on volunteer services to continue to be used for
21RefugeeRISE AmeriCorps program established under section 15H.8
22for member recruitment and training to improve the economic
23well-being and health of economically disadvantaged refugees in
24local communities across Iowa. Funds transferred may be used
25to supplement federal funds under federal regulations.
266. Of the funds appropriated in this section, up to $300,000
27shall be used as follows:
28a. To fund not more than one full-time equivalent position
29to address the department’s responsibility to support the work
30of the children’s system state board and implementation of the
31services required pursuant to 2018 Iowa Acts, chapter 1056,
32section 13.
33b. To support the cost of establishing and implementing
34new or additional services required pursuant to 2018 Iowa
35Acts, chapter 1056, and any legislation enacted by the 2019 or
-96-12020 general assembly establishing a children’s mental health
2system.
3c. Of the amount, $32,000 shall be transferred to
4the department of public health to support the costs of
5establishing and implementing new or additional services
6required pursuant to 2018 Iowa Acts, chapter 1056, and any
7legislation enacted by the 2019 or 2020 general assembly
8establishing a children’s mental health system.
9 Sec. 67. DEPARTMENT-WIDE DUTIES. There is appropriated
10from the general fund of the state to the department of human
11services for the fiscal year beginning July 1, 2020, and ending
12June 30, 2021, the following amount, or so much thereof as is
13necessary, to be used for the purposes designated:
14For salaries, support, maintenance, and miscellaneous
15purposes at facilities under the purview of the department of
16human services:
.................................................. $172,879,274
18 Sec. 68. CORPORATE TECHNOLOGY. There is appropriated
19from the general fund of the state to the department of human
20services for the fiscal year beginning July 1, 2020, and ending
21June 30, 2021, the following amount, or so much thereof as is
22necessary, to be used for the purposes designated:
23For the purchase of department-wide technology and software
24update needs:
.................................................. $252,530,413
26 Sec. 69. VOLUNTEERS. There is appropriated from the general
27fund of the state to the department of human services for the
28fiscal year beginning July 1, 2020, and ending June 30, 2021,
29the following amount, or so much thereof as is necessary, to be
30used for the purpose designated:
31For development and coordination of volunteer services:
.................................................. $3284,686
33 Sec. 70. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
34ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
35DEPARTMENT OF HUMAN SERVICES.
-97- 11. a. (1) For the fiscal year beginning July 1, 2020,
2case-mix, non-case mix, and special population nursing
3facilities shall be reimbursed in accordance with the
4methodology in effect on June 30, 2020.
5(2) For managed care claims, the department of human
6services shall adjust the payment rate floor for nursing
7facilities, annually, to maintain a rate floor that is no
8lower than the Medicaid fee-for-service case-mix adjusted rate
9calculated in accordance with 441 IAC 81.6. The department
10shall then calculate adjusted reimbursement rates, including
11but not limited to add-on-payments, annually, and shall
12notify Medicaid managed care organizations of the adjusted
13reimbursement rates within 30 days of determining the adjusted
14reimbursement rates. Any adjustment of reimbursement rates
15under this subparagraph division shall be budget neutral to the
16state budget.
17b. (1) For the fiscal year beginning July 1, 2020,
18the department shall establish the pharmacy dispensing fee
19reimbursement at $10.07 per prescription, until a cost of
20dispensing survey is completed. The actual dispensing fee
21shall be determined by a cost of dispensing survey performed
22by the department and required to be completed by all medical
23assistance program participating pharmacies every two years,
24adjusted as necessary to maintain expenditures within the
25amount appropriated to the department for this purpose for the
26fiscal year.
27(2) The department shall utilize an average acquisition
28cost reimbursement methodology for all drugs covered under the
29medical assistance program in accordance with 2012 Iowa Acts,
30chapter 1133, section 33.
31c. (1) For the fiscal year beginning July 1, 2020,
32reimbursement rates for outpatient hospital services shall
33be rebased effective January 1, 2021, subject to Medicaid
34program upper payment limit rules, and adjusted as necessary
35to maintain expenditures within the amount appropriated to the
-98-1department for this purpose for the fiscal year.
2(2) For the fiscal year beginning July 1, 2020,
3reimbursement rates for inpatient hospital services shall
4remain at the rates in effect on June 30, 2020, subject to
5Medicaid program upper payment limit rules, and adjusted
6as necessary to maintain expenditures within the amount
7appropriated to the department for this purpose for the fiscal
8year.
9(3) For the fiscal year beginning July 1, 2020, the graduate
10medical education and disproportionate share hospital fund
11shall remain at the amount in effect on June 30, 2020, except
12that the portion of the fund attributable to graduate medical
13education shall be reduced in an amount that reflects the
14elimination of graduate medical education payments made to
15out-of-state hospitals.
16(4) In order to ensure the efficient use of limited state
17funds in procuring health care services for low-income Iowans,
18funds appropriated in this Act for hospital services shall
19not be used for activities which would be excluded from a
20determination of reasonable costs under the federal Medicare
21program pursuant to 42 U.S.C.§1395x(v)(1)(N).
22d. For the fiscal year beginning July 1, 2020, reimbursement
23rates for hospices and acute mental hospitals shall be
24increased in accordance with increases under the federal
25Medicare program or as supported by their Medicare audited
26costs.
27e. For the fiscal year beginning July 1, 2020, independent
28laboratories and rehabilitation agencies shall be reimbursed
29using the same methodology in effect on June 30, 2020.
30f. (1) For the fiscal year beginning July 1, 2020,
31reimbursement rates for home health agencies shall continue to
32be based on the Medicare low utilization payment adjustment
33(LUPA) methodology with state geographic wage adjustments.
34(2) For the fiscal year beginning July 1, 2020, rates for
35private duty nursing and personal care services under the early
-99-1and periodic screening, diagnostic, and treatment program
2benefit shall be calculated based on the methodology in effect
3on June 30, 2020.
4g. For the fiscal year beginning July 1, 2020, federally
5qualified health centers and rural health clinics shall receive
6cost-based reimbursement for 100 percent of the reasonable
7costs for the provision of services to recipients of medical
8assistance.
9h. For the fiscal year beginning July 1, 2020, the
10reimbursement rates for dental services shall remain at the
11rates in effect on June 30, 2020.
12i. (1) For the fiscal year beginning July 1, 2020,
13reimbursement rates for the non-state-owned psychiatric medical
14institution for children shall be based on the methodology in
15effect on June 30, 2020.
16(2) As a condition of participation in the medical
17assistance program, enrolled providers shall accept the medical
18assistance reimbursement rate for any covered goods or services
19provided to recipients of medical assistance who are children
20under the custody of a psychiatric medical institution for
21children.
22j. For the fiscal year beginning July 1, 2020, unless
23otherwise specified in this Act, all noninstitutional medical
24assistance provider reimbursement rates shall remain at the
25rates in effect on June 30, 2020, except for area education
26agencies, local education agencies, infant and toddler
27services providers, home and community-based services providers
28including consumer-directed attendant care providers under a
29section 1915(c) or 1915(i) waiver, targeted case management
30providers, those providers whose rates are required to be
31determined pursuant to section 249A.20, or to meet federal
32mental health parity requirements.
33k. Notwithstanding any provision to the contrary, for the
34fiscal year beginning July 1, 2020, the reimbursement rate for
35anesthesiologists shall remain at the rate in effect on June
-100-130, 2020, and updated on January 1, 2021, to align with the
2most current Iowa Medicare anesthesia base rate.
3l. Notwithstanding section 249A.20, for the fiscal year
4beginning July 1, 2020, the average reimbursement rate for
5health care providers eligible for use of the federal Medicare
6resource-based relative value scale reimbursement methodology
7under section 249A.20 shall remain at the rate in effect on
8June 30, 2020; however, this rate shall not exceed the maximum
9level authorized by the federal government.
10m. For the fiscal year beginning July 1, 2020, the
11reimbursement rate for residential care facilities shall not
12be less than the minimum payment level as established by the
13federal government to meet the federally mandated maintenance
14of effort requirement. The flat reimbursement rate for
15facilities electing not to file annual cost reports shall not
16be less than the minimum payment level as established by the
17federal government to meet the federally mandated maintenance
18of effort requirement.
19n. For the fiscal year beginning July 1, 2020, the
20reimbursement rates for inpatient mental health services
21provided at hospitals shall remain at the rates in effect on
22June 30, 2020, subject to Medicaid program upper payment limit
23rules; and psychiatrists shall be reimbursed at the medical
24assistance program fee-for-service rate in effect on June 30,
252020.
26o. For the fiscal year beginning July 1, 2020, community
27mental health centers may choose to be reimbursed for the
28services provided to recipients of medical assistance through
29either of the following options:
30(1) For 100 percent of the reasonable costs of the services.
31(2) In accordance with the alternative reimbursement rate
32methodology approved by the department of human services in
33effect on June 30, 2020.
34p. For the fiscal year beginning July 1, 2020, the
35reimbursement rate for providers of family planning services
-101-1that are eligible to receive a 90 percent federal match shall
2remain at the rates in effect on June 30, 2020.
3q. Unless otherwise subject to a tiered rate methodology,
4for the fiscal year beginning July 1, 2020, the upper
5limits and reimbursement rates for providers of home and
6community-based services waiver services shall be reimbursed
7using the reimbursement methodology in effect on June 30, 2020.
8r. For the fiscal year beginning July 1, 2020, the
9reimbursement rates for emergency medical service providers
10shall remain at the rates in effect on June 30, 2020.
11s. For the fiscal year beginning July 1, 2020, reimbursement
12rates for substance-related disorder treatment programs
13licensed under section 125.13 shall remain at the rates in
14effect on June 30, 2020.
152. For the fiscal year beginning July 1, 2020, the
16reimbursement rate for providers reimbursed under the
17in-home-related care program shall not be less than the minimum
18payment level as established by the federal government to meet
19the federally mandated maintenance of effort requirement.
203. Unless otherwise directed in this section, when the
21department’s reimbursement methodology for any provider
22reimbursed in accordance with this section includes an
23inflation factor, this factor shall not exceed the amount
24by which the consumer price index for all urban consumers
25increased during the calendar year ending December 31, 2002.
264. Notwithstanding section 234.38, for the fiscal
27year beginning July 1, 2020, the foster family basic daily
28maintenance rate and the maximum adoption subsidy rate for
29children ages 0 through 5 years shall be $16.78, the rate for
30children ages 6 through 11 years shall be $17.45, the rate for
31children ages 12 through 15 years shall be $19.10, and the
32rate for children and young adults ages 16 and older shall
33be $19.35. For youth ages 18 to 21 who have exited foster
34care, the preparation for adult living program maintenance rate
35shall be $602.70 per month. The maximum payment for adoption
-102-1subsidy nonrecurring expenses shall be limited to $500 and the
2disallowance of additional amounts for court costs and other
3related legal expenses implemented pursuant to 2010 Iowa Acts,
4chapter 1031, section 408, shall be continued.
55. For the fiscal year beginning July 1, 2020, the maximum
6reimbursement rates for social services providers under
7contract shall remain at the rates in effect on June 30, 2020,
8or the provider’s actual and allowable cost plus inflation for
9each service, whichever is less. However, if a new service
10or service provider is added after June 30, 2020, the initial
11reimbursement rate for the service or provider shall be based
12upon a weighted average of provider rates for similar services.
136. a. For the fiscal year beginning July 1, 2020, the
14reimbursement rates for resource family recruitment and
15retention contractors shall be established by contract.
16b. For the fiscal year beginning July 1, 2020, the
17reimbursement rates for supervised apartment living foster care
18providers shall be established by contract.
197. For the fiscal year beginning July 1, 2019, the
20reimbursement rate for group foster care providers shall be the
21combined service and maintenance reimbursement rate established
22by contract.
238. The group foster care reimbursement rates paid for
24placement of children out of state shall be calculated
25according to the same rate-setting principles as those used for
26in-state providers, unless the director of human services or
27the director’s designee determines that appropriate care cannot
28be provided within the state. The payment of the daily rate
29shall be based on the number of days in the calendar month in
30which service is provided.
319. a. For the fiscal year beginning July 1, 2020, the
32reimbursement rate paid for shelter care and the child welfare
33emergency services implemented to provide or prevent the need
34for shelter care shall be established by contract.
35b. For the fiscal year beginning July 1, 2020, the combined
-103-1service and maintenance components of the reimbursement rate
2paid for shelter care services shall be based on the financial
3and statistical report submitted to the department. The
4maximum reimbursement rate shall be $101.83 per day. The
5department shall reimburse a shelter care provider at the
6provider’s actual and allowable unit cost, plus inflation, not
7to exceed the maximum reimbursement rate.
8c. Notwithstanding section 232.141, subsection 8, for the
9fiscal year beginning July 1, 2020, the amount of the statewide
10average of the actual and allowable rates for reimbursement of
11juvenile shelter care homes that is utilized for the limitation
12on recovery of unpaid costs shall remain at the amount in
13effect for this purpose in the fiscal year beginning July 1,
142019.
1510. For the fiscal year beginning July 1, 2020, the
16department shall calculate reimbursement rates for intermediate
17care facilities for persons with an intellectual disability
18at the 80th percentile. Beginning July 1, 2020, the rate
19calculation methodology shall utilize the consumer price index
20inflation factor applicable to the fiscal year beginning July
211, 2020.
2211. Effective July 1, 2020, the child care provider
23reimbursement rates shall remain at the rates in effect on June
2430, 2020. The department shall set rates in a manner so as
25to provide incentives for a nonregistered provider to become
26registered by applying any increase only to registered and
27licensed providers.
2812. The department may adopt emergency rules to implement
29this section.
30 Sec. 71. TRANSFER OF MEDICAID MANAGED CARE SAVINGS BETWEEN
31APPROPRIATIONS — FY 2020-2021. Notwithstanding section 8.39,
32subsection 1, for the fiscal year beginning July 1, 2020,
33and ending June 30, 2021, if savings resulting from Medicaid
34managed care initiatives accrue to the medical contracts or
35children’s health insurance program appropriation from the
-104-1general fund of the state and not to the medical assistance
2appropriation from the general fund of the state under this
3division of this Act, such savings may be transferred to such
4medical assistance appropriation for the same fiscal year
5without prior written consent and approval of the governor and
6the director of the department of management. The department
7of human services shall report any transfers made pursuant to
8this section to the legislative services agency.
9 Sec. 72. EMERGENCY RULES.
101. If specifically authorized by a provision of this
11division of this Act, the department of human services or
12the mental health and disability services commission may
13adopt administrative rules under section 17A.4, subsection
143, and section 17A.5, subsection 2, paragraph “b”, to
15implement the provisions of this division of this Act and
16the rules shall become effective immediately upon filing or
17on a later effective date specified in the rules, unless the
18effective date of the rules is delayed or the applicability
19of the rules is suspended by the administrative rules review
20committee. Any rules adopted in accordance with this section
21shall not take effect before the rules are reviewed by the
22administrative rules review committee. The delay authority
23provided to the administrative rules review committee under
24section 17A.4, subsection 7, and section 17A.8, subsection 9,
25shall be applicable to a delay imposed under this section,
26notwithstanding a provision in those sections making them
27inapplicable to section 17A.5, subsection 2, paragraph “b”.
28Any rules adopted in accordance with the provisions of this
29section shall also be published as a notice of intended action
30as provided in section 17A.4.
312. If during a fiscal year, the department of human
32services is adopting rules in accordance with this section
33or as otherwise directed or authorized by state law, and the
34rules will result in an expenditure increase beyond the amount
35anticipated in the budget process or if the expenditure was
-105-1not addressed in the budget process for the fiscal year, the
2department shall notify the persons designated by this division
3of this Act for submission of reports, the chairpersons and
4ranking members of the committees on appropriations, and
5the department of management concerning the rules and the
6expenditure increase. The notification shall be provided at
7least 30 calendar days prior to the date notice of the rules
8is submitted to the administrative rules coordinator and the
9administrative code editor.
10 Sec. 73. REPORTS. Any reports or other information
11required to be compiled and submitted under this Act during the
12fiscal year beginning July 1, 2020, shall be submitted to the
13chairpersons and ranking members of the joint appropriations
14subcommittee on health and human services, the legislative
15services agency, and the legislative caucus staffs on or
16before the dates specified for submission of the reports or
17information.
18 Sec. 74. EFFECTIVE UPON ENACTMENT. The following
19provisions of this division of this Act, being deemed of
20immediate importance, take effect upon enactment:
211. The provision relating to section 232.141 and directing
22the state court administrator and the division administrator of
23the department of human services division of child and family
24services to make the determination, by June 15, 2020, of the
25distribution of funds allocated for the payment of the expenses
26of court-ordered services provided to juveniles which are a
27charge upon the state.
28DIVISION XII
29HEALTH CARE ACCOUNTS AND FUNDS — FY 2020-2021
30 Sec. 75. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
31appropriated from the pharmaceutical settlement account created
32in section 249A.33 to the department of human services for the
33fiscal year beginning July 1, 2020, and ending June 30, 2021,
34the following amount, or so much thereof as is necessary, to be
35used for the purpose designated:
-106- 1Notwithstanding any provision of law to the contrary, to
2supplement the appropriations made in this Act for medical
3contracts under the medical assistance program for the fiscal
4year beginning July 1, 2020, and ending June 30, 2021:
.................................................. $5234,193
6 Sec. 76. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
7SERVICES. Notwithstanding any provision to the contrary and
8subject to the availability of funds, there is appropriated
9from the quality assurance trust fund created in section
10249L.4 to the department of human services for the fiscal year
11beginning July 1, 2020, and ending June 30, 2021, the following
12amounts, or so much thereof as is necessary, for the purposes
13designated:
14To supplement the appropriation made in this Act from the
15general fund of the state to the department of human services
16for medical assistance for the same fiscal year:
.................................................. $1758,570,397
18 Sec. 77. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
19DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
20the contrary and subject to the availability of funds, there is
21appropriated from the hospital health care access trust fund
22created in section 249M.4 to the department of human services
23for the fiscal year beginning July 1, 2020, and ending June
2430, 2021, the following amounts, or so much thereof as is
25necessary, for the purposes designated:
26To supplement the appropriation made in this Act from the
27general fund of the state to the department of human services
28for medical assistance for the same fiscal year:
.................................................. $2933,920,554
30 Sec. 78. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
31FOR FY 2020-2021. Notwithstanding section 8.33, if moneys
32appropriated for purposes of the medical assistance program for
33the fiscal year beginning July 1, 2020, and ending June 30,
342021, from the general fund of the state, the quality assurance
35trust fund and the hospital health care access trust fund, are
-107-1in excess of actual expenditures for the medical assistance
2program and remain unencumbered or unobligated at the close
3of the fiscal year, the excess moneys shall not revert but
4shall remain available for expenditure for the purposes of the
5medical assistance program until the close of the succeeding
6fiscal year.
7DIVISION XIII
8IOWA DEPARTMENT ON AGING — MEDICAID CLAIMING
9 Sec. 79. IOWA DEPARTMENT ON AGING — MEDICAID CLAIMING. The
10department on aging and the department of human services shall
11continue to collaborate to develop a cost allocation plan
12requesting Medicaid administrative funding to provide for the
13claiming of federal financial participation for aging and
14disability resource center activities that are performed to
15assist with administration of the Medicaid program. By January
161, 2021, the department of human services shall submit to
17the centers for Medicare and Medicaid services of the United
18States department of health and human services any Medicaid
19state plan amendment as necessary and shall enter into any
20interagency agreement with the department on aging to implement
21this section.
22DIVISION XIV
23DECATEGORIZATION
24 Sec. 80. DECATEGORIZATION CARRYOVER FUNDING FY 2017 —
25TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
26subsection 5, paragraph “b”, any state-appropriated moneys in
27the funding pool that remained unencumbered or unobligated
28at the close of the fiscal year beginning July 1, 2016, and
29were deemed carryover funding to remain available for the two
30succeeding fiscal years that still remain unencumbered or
31unobligated at the close of the fiscal year beginning July 1,
322018, shall not revert but shall be transferred to the medical
33assistance program for the fiscal year beginning July 1, 2019.
34 Sec. 81. EFFECTIVE DATE. This division of this Act, being
35deemed of immediate importance, takes effect upon enactment.
-108-1 Sec. 82. RETROACTIVE APPLICABILITY. This division of this
2Act applies retroactively to July 1, 2018.
3DIVISION XV
4Decategorization
5 Sec. 83. DECATEGORIZATION CARRYOVER FUNDING FY 2018 —
6TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
7subsection 5, paragraph “b”, any state-appropriated moneys in
8the funding pool that remained unencumbered or unobligated
9at the close of the fiscal year beginning July 1, 2017, and
10were deemed carryover funding to remain available for the two
11succeeding fiscal years that still remain unencumbered or
12unobligated at the close of the fiscal year beginning July 1,
132019, shall not revert but shall be transferred to the medical
14assistance program for the fiscal year beginning July 1, 2020.
15 Sec. 84. EFFECTIVE DATE. This division of this Act, being
16deemed of immediate importance, takes effect upon enactment.
17 Sec. 85. RETROACTIVE APPLICABILITY. This division of this
18Act applies retroactively to July 1, 2019.
19DIVISION XVI
20PRIOR APPROPRIATIONS AND OTHER PROVISIONS
21TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF)
22 Sec. 86. 2017 Iowa Acts, chapter 174, section 45, as amended
23by 2018 Iowa Acts, chapter 1165, section 10, is amended to read
24as follows:
25SEC. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
26GRANT. There is appropriated from the fund created in section
278.41 to the department of human services for the fiscal year
28beginning July 1, 2018, and ending June 30, 2019, from moneys
29received under the federal temporary assistance for needy
30families (TANF) block grant pursuant to the federal Personal
31Responsibility and Work Opportunity Reconciliation Act of 1996,
32Pub.L.No.104-193, and successor legislation, the following
33amounts, or so much thereof as is necessary, to be used for the
34purposes designated:
351. To be credited to the family investment program account
-109-1and used for assistance under the family investment program
2under chapter 239B:
.................................................. $34,539,006
44,025,108
52. To be credited to the family investment program account
6and used for the job opportunities and basic skills (JOBS)
7program and implementing family investment agreements in
8accordance with chapter 239B:
.................................................. $95,412,060
105,192,060
113. To be used for the family development and
12self-sufficiency grant program in accordance with section
13216A.107:
.................................................. $142,883,980
152,898,980
16Notwithstanding section 8.33, moneys appropriated in this
17subsection that remain unencumbered or unobligated at the close
18of the fiscal year shall not revert but shall remain available
19for expenditure for the purposes designated until the close of
20the succeeding fiscal year. However, unless such moneys are
21encumbered or obligated on or before September 30, 2019, the
22moneys shall revert.
234. For field operations:
.................................................. $2431,296,232
2532,465,681
265. For general administration:
.................................................. $273,744,000
286. For state child care assistance:
.................................................. $2947,166,826
30a. Of the funds appropriated in this subsection,
31$26,205,412 is transferred to the child care and development
32block grant appropriation made by the Eighty-seventh General
33Assembly, 2018 session, for the federal fiscal year beginning
34October 1, 2018, and ending September 30, 2019. Of this
35amount, $200,000 shall be used for provision of educational
-110-1opportunities to registered child care home providers in order
2to improve services and programs offered by this category
3of providers and to increase the number of providers. The
4department may contract with institutions of higher education
5or child care resource and referral centers to provide
6the educational opportunities. Allowable administrative
7costs under the contracts shall not exceed 5 percent. The
8application for a grant shall not exceed two pages in length.
9b. Any funds appropriated in this subsection remaining
10unallocated shall be used for state child care assistance
11payments for families who are employed including but not
12limited to individuals enrolled in the family investment
13program.
147. For child and family services:
.................................................. $1532,380,654
168. For child abuse prevention grants:
.................................................. $17125,000
189. For pregnancy prevention grants on the condition that
19family planning services are funded:
.................................................. $201,913,203
211,890,203
22Pregnancy prevention grants shall be awarded to programs
23in existence on or before July 1, 2018, if the programs have
24demonstrated positive outcomes. Grants shall be awarded to
25pregnancy prevention programs which are developed after July
261, 2018, if the programs are based on existing models that
27have demonstrated positive outcomes. Grants shall comply with
28the requirements provided in 1997 Iowa Acts, chapter 208,
29section 14, subsections 1 and 2, including the requirement that
30grant programs must emphasize sexual abstinence. Priority in
31the awarding of grants shall be given to programs that serve
32areas of the state which demonstrate the highest percentage of
33unplanned pregnancies of females of childbearing age within the
34geographic area to be served by the grant.
3510. For technology needs and other resources necessary
-111-1to meet federal welfare reform reporting, tracking, and case
2management requirements:
.................................................. $31,037,186
4862,186
511. a. Notwithstanding any provision to the contrary,
6including but not limited to requirements in section 8.41 or
7provisions in 2017 or 2018 Iowa Acts regarding the receipt and
8appropriation of federal block grants, federal funds from the
9temporary assistance for needy families block grant received by
10the state and not otherwise appropriated in this section and
11remaining available for the fiscal year beginning July 1, 2018,
12are appropriated to the department of human services to the
13extent as may be necessary to be used in the following priority
14order: the family investment program, for state child care
15assistance program payments for families who are employed, and
16for the family investment program share of system costs for
17eligibility determination and related functions. The federal
18funds appropriated in this paragraph “a” shall be expended
19only after all other funds appropriated in subsection 1 for
20assistance under the family investment program, in subsection 6
21for child care assistance, or in subsection 10 for technology
22costs related to the family investment program, as applicable,
23have been expended. For the purposes of this subsection, the
24funds appropriated in subsection 6, paragraph “a”, for transfer
25to the child care and development block grant appropriation
26are considered fully expended when the full amount has been
27transferred.
28b. The department shall, on a quarterly basis, advise the
29legislative services agency and department of management of
30the amount of funds appropriated in this subsection that was
31expended in the prior quarter.
3212. Of the amounts appropriated in this section,
33$12,962,008 for the fiscal year beginning July 1, 2018, is
34transferred to the appropriation of the federal social services
35block grant made to the department of human services for that
-112-1fiscal year.
213. For continuation of the program providing categorical
3eligibility for the food assistance program as specified
4for the program in the section of this division of this Act
5relating to the family investment program account:
.................................................. $614,236
713,000
814. The department may transfer funds allocated in this
9section to the appropriations made in this division of this Act
10for the same fiscal year for general administration and field
11operations for resources necessary to implement and operate the
12services referred to in this section and those funded in the
13appropriation made in this division of this Act for the same
14fiscal year for the family investment program from the general
15fund of the state.
1615. With the exception of moneys allocated under this
17section for the family development and self-sufficiency grant
18program, to the extent moneys allocated in this section are
19deemed by the department not to be necessary to support the
20purposes for which they are allocated, such moneys may be
21used in the same fiscal year for any other purpose for which
22funds are allocated in this section or in section 7 of this
23division for the family investment program account. If there
24are conflicting needs, priority shall first be given to the
25family investment program account as specified under subsection
261 of this section and used for the purposes of assistance under
27the family investment program under chapter 239B, followed by
28state child care assistance program payments for families who
29are employed, followed by other priorities as specified by the
30department.
31FAMILY INVESTMENT PROGRAM ADJUSTMENTS
32 Sec. 87. 2017 Iowa Acts, chapter 174, section 46, subsection
334, as amended by 2018 Iowa Acts, chapter 1165, section 11, is
34amended to read as follows:
354. Moneys appropriated in this division of this Act and
-113-1credited to the FIP account for the fiscal year beginning July
21, 2018, and ending June 30, 2019, are allocated as follows:
3a. To be retained by the department of human services to
4be used for coordinating with the department of human rights
5to more effectively serve participants in FIP and other shared
6clients and to meet federal reporting requirements under the
7federal temporary assistance for needy families block grant:
.................................................. $85,000
920,000
10b. To the department of human rights for staffing,
11administration, and implementation of the family development
12and self-sufficiency grant program in accordance with section
13216A.107:
.................................................. $146,192,834
15(1) Of the funds allocated for the family development
16and self-sufficiency grant program in this paragraph “b”,
17not more than 5 percent of the funds shall be used for the
18administration of the grant program.
19(2) The department of human rights may continue to implement
20the family development and self-sufficiency grant program
21statewide during fiscal year 2018-2019.
22(3) The department of human rights may engage in activities
23to strengthen and improve family outcomes measures and
24data collection systems under the family development and
25self-sufficiency grant program.
26c. For the diversion subaccount of the FIP account:
.................................................. $27749,694
28815,000
29A portion of the moneys allocated for the subaccount may
30be used for field operations, salaries, data management
31system development, and implementation costs and support
32deemed necessary by the director of human services in order to
33administer the FIP diversion program. To the extent moneys
34allocated in this paragraph “c” are deemed by the department
35not to be necessary to support diversion activities, such
-114-1moneys may be used for other efforts intended to increase
2engagement by family investment program participants in work,
3education, or training activities, or for the purposes of
4assistance under the family investment program in accordance
5with chapter 239B.
6d. For the food assistance employment and training program:
.................................................. $766,588
8(1) The department shall apply the federal supplemental
9nutrition assistance program (SNAP) employment and training
10state plan in order to maximize to the fullest extent permitted
11by federal law the use of the 50 percent federal reimbursement
12provisions for the claiming of allowable federal reimbursement
13funds from the United States department of agriculture
14pursuant to the federal SNAP employment and training program
15for providing education, employment, and training services
16for eligible food assistance program participants, including
17but not limited to related dependent care and transportation
18expenses.
19(2) The department shall continue the categorical federal
20food assistance program eligibility at 160 percent of the
21federal poverty level and continue to eliminate the asset test
22from eligibility requirements, consistent with federal food
23assistance program requirements. The department shall include
24as many food assistance households as is allowed by federal
25law. The eligibility provisions shall conform to all federal
26requirements including requirements addressing individuals who
27are incarcerated or otherwise ineligible.
28e. For the JOBS program:
.................................................. $2912,139,821
3011,919,821
31MEDICAL ASSISTANCE PROGRAM ADJUSTMENT
32 Sec. 88. 2017 Iowa Acts, chapter 174, section 51, unnumbered
33paragraph 2, as amended by 2018 Iowa Acts, chapter 1165,
34section 18, unnumbered paragraph 2, is amended to read as
35follows:
-115- 1For medical assistance program reimbursement and associated
2costs as specifically provided in the reimbursement
3methodologies in effect on June 30, 2018, except as otherwise
4expressly authorized by law, consistent with options under
5federal law and regulations, and contingent upon receipt of
6approval from the office of the governor of reimbursement for
7each abortion performed under the program:
.................................................. $81,337,841,375
91,478,966,820
10GROUP FOSTER CARE REALLOCATION
11 Sec. 89. 2017 Iowa Acts, chapter 174, section 57, subsection
123, paragraph a, as amended by 2018 Iowa Acts, chapter 1165,
13section 28, is amended to read as follows:
143. a. Of the funds appropriated in this section, up to
15$34,536,648 is allocated as the statewide expenditure target
16under section 232.143 for group foster care maintenance and
17services. If the department projects that such expenditures
18for the fiscal year will be less than the target amount
19allocated in this paragraph “a”, the department may reallocate
20the excess to provide additional funding for family foster
21care, independent living, family safety, risk and permanency
22services, shelter care, or the child welfare emergency services
23addressed with the allocation for shelter care.
24SHELTER CARE ALLOCATION
25 Sec. 90. 2017 Iowa Acts, chapter 174, section 57, subsection
266, as amended by 2018 Iowa Acts, chapter 1165, section 28, is
27amended to read as follows:
286. Notwithstanding section 234.35 or any other provision of
29law to the contrary, state funding Of the funds appropriated
30in this section, a sufficient amount is allocated for shelter
31care and the child welfare emergency services contracting
32implemented to provide for or prevent the need for shelter care
33shall be limited to $8,096,158.
34OTHER FUNDING FOR CHILD WELFARE SERVICES
35 Sec. 91. 2017 Iowa Acts, chapter 174, section 57, subsection
-116-16, as amended by 2018 Iowa Acts, chapter 1165, section 28, is
2amended by adding the following new subsection:
3 NEW SUBSECTION. 24. If a separate funding source is
4identified that reduces the need for state funds within an
5allocation under this section, the allocated state funds may be
6redistributed to other allocations under this section for the
7same fiscal year.
8 Sec. 92. EFFECTIVE DATE. This division of this Act, being
9deemed of immediate importance, takes effect upon enactment.
10 Sec. 93. RETROACTIVE APPLICABILITY. This division of this
11Act applies retroactively to July 1, 2018.
12DIVISION XVII
13HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM FUTURE REPEAL
14 Sec. 94. Section 249M.5, Code 2019, is amended to read as
15follows:
16249M.5 Future repeal.
17This chapter is repealed July 1, 2019 2021.
18 Sec. 95. EFFECTIVE DATE. This division of this Act, being
19deemed of immediate importance, takes effect upon enactment.
20EXPLANATION
21The inclusion of this explanation does not constitute agreement with
22the explanation’s substance by the members of the general assembly.
23This bill relates to appropriations for health and human
24services for fiscal years 2019-2020 and 2020-2021 to the
25department of veterans affairs, Iowa veterans home, department
26on aging (IDA), office of long-term care ombudsman, department
27of public health (DPH), Iowa finance authority, department of
28human rights, and department of human services (DHS). The bill
29is organized into divisions for each fiscal year.
30DEPARTMENT ON AGING. This division makes appropriations
31from the general fund of the state to the department on aging.
32OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
33appropriations from the general fund of the state to the office
34of long-term care ombudsman.
35DEPARTMENT OF PUBLIC HEALTH. This division makes
-117-1appropriations from the general fund of the state to the
2department of public health.
3DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
4division makes appropriations from the general fund of the
5state to the department of veterans affairs for administration,
6the Iowa veterans home, for transfer to the Iowa finance
7authority for the home ownership assistance program, and for
8the county commissions of veteran affairs.
9DEPARTMENT OF HUMAN SERVICES. This division makes
10appropriations from the general fund of the state and the
11federal temporary assistance for needy families block
12grant to DHS. The allocation for the family development
13and self-sufficiency grant program is made directly to
14the department of human rights. The reimbursement section
15addresses reimbursement for providers reimbursed by the
16department of human services.
17HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
18health-related appropriations. A number of the appropriations
19are made for purposes of the Medicaid program in addition to
20the general fund appropriations made for this purpose for the
21same fiscal year.
-118-pf/tm