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House File 766 - ReprintedA Bill ForAn Act 1relating to appropriations for health and human
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE 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, and for not more than the following
18full-time equivalent positions:
.................................................. $1911,191,441
............................................... FTEs2027.00
211. Funds appropriated in this section may be used to
22supplement federal funds under federal regulations. To
23receive funds appropriated in this section, a local area
24agency on aging shall match the funds with moneys from other
25sources according to rules adopted by the department. Funds
26appropriated in this section may be used for elderly services
27not specifically enumerated in this section only if approved
28by an area agency on aging for provision of the service within
29the area.
302. Of the funds appropriated in this section, $279,000 is
31transferred to the economic development authority for the Iowa
32commission on volunteer services to be used for the retired and
33senior volunteer program.
343. a. The department on aging shall establish and enforce
35procedures relating to expenditure of state and federal funds
-1-1by area agencies on aging that require compliance with both
2state and federal laws, rules, and regulations, including but
3not limited to all of the following:
4(1) Requiring that expenditures are incurred only for goods
5or services received or performed prior to the end of the
6fiscal period designated for use of the funds.
7(2) Prohibiting prepayment for goods or services not
8received or performed prior to the end of the fiscal period
9designated for use of the funds.
10(3) Prohibiting prepayment for goods or services not
11defined specifically by good or service, time period, or
12recipient.
13(4) Prohibiting the establishment of accounts from which
14future goods or services which are not defined specifically by
15good or service, time period, or recipient, may be purchased.
16b. The procedures shall provide that if any funds are
17expended in a manner that is not in compliance with the
18procedures and applicable federal and state laws, rules, and
19regulations, and are subsequently subject to repayment, the
20area agency on aging expending such funds in contravention of
21such procedures, laws, rules and regulations, not the state,
22shall be liable for such repayment.
234. Of the funds appropriated in this section, at least
24$600,000 shall be used to fund home and community-based
25services through the area agencies on aging that enable older
26individuals to avoid more costly utilization of residential or
27institutional services and remain in their own homes.
285. Of the funds appropriated in this section, $812,000 shall
29be used for the purposes of chapter 231E and to administer
30the prevention of elder abuse, neglect, and exploitation
31program pursuant to section 231.56A, in accordance with the
32requirements of the federal Older Americans Act of 1965, 42
33U.S.C.§3001 et seq., as amended.
346. Of the funds appropriated in this section, $1,000,000
35shall be used to fund continuation of the aging and disability
-2-1resource center lifelong links to provide individuals and
2caregivers with information and services to plan for and
3maintain independence.
47. Of the funds appropriated in this section, $250,000
5shall be used by the department on aging, in collaboration with
6the department of human services and affected stakeholders, to
7expand the pilot initiative to provide long-term care options
8counseling utilizing support planning protocols, to assist
9non-Medicaid eligible consumers who indicate a preference
10to return to the community and are deemed appropriate for
11discharge, to return to their community following a nursing
12facility stay. The department on aging shall submit a report
13regarding the outcomes of the pilot initiative to the governor
14and the general assembly by December 15, 2019.
15DIVISION II
16OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2019-2020
17 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
18appropriated from the general fund of the state to the office
19of long-term care ombudsman for the fiscal year beginning July
201, 2019, and ending June 30, 2020, the following amount, or
21so much thereof as is necessary, to be used for the purposes
22designated:
23For salaries, support, administration, maintenance, and
24miscellaneous purposes, and for not more than the following
25full-time equivalent positions:
.................................................. $261,149,821
............................................... FTEs2716.00
28DIVISION III
29DEPARTMENT OF PUBLIC HEALTH — FY 2019-2020
30 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
31from the general fund of the state to the department of public
32health for the fiscal year beginning July 1, 2019, and ending
33June 30, 2020, the following amounts, or so much thereof as is
34necessary, to be used for the purposes designated:
351. ADDICTIVE DISORDERS
-3- 1For reducing the prevalence of the use of tobacco, alcohol,
2and other drugs, and treating individuals affected by addictive
3behaviors, including gambling, and for not more than the
4following full-time equivalent positions:
.................................................. $525,110,000
............................................... FTEs611.00
7a. (1) Of the funds appropriated in this subsection,
8$4,021,000 shall be used for the tobacco use prevention
9and control initiative, including efforts at the state and
10local levels, as provided in chapter 142A. The commission
11on tobacco use prevention and control established pursuant
12to section 142A.3 shall advise the director of public health
13in prioritizing funding needs and the allocation of moneys
14appropriated for the programs and initiatives. Activities
15of the programs and initiatives shall be in alignment with
16the United States centers for disease control and prevention
17best practices for comprehensive tobacco control programs that
18include the goals of preventing youth initiation of tobacco
19usage, reducing exposure to secondhand smoke, and promotion
20of tobacco cessation. To maximize resources, the department
21shall determine if third-party sources are available to
22instead provide nicotine replacement products to an applicant
23prior to provision of such products to an applicant under
24the initiative. The department shall track and report to
25the individuals specified in this Act, any reduction in
26the provision of nicotine replacement products realized by
27the initiative through implementation of the prerequisite
28screening.
29(2) (a) The department shall collaborate with the
30alcoholic beverages division of the department of commerce for
31enforcement of tobacco laws, regulations, and ordinances and to
32engage in tobacco control activities approved by the division
33of tobacco use prevention and control of the department of
34public health as specified in the memorandum of understanding
35entered into between the divisions.
-4- 1(b) For the fiscal year beginning July 1, 2019, and ending
2June 30, 2020, the terms of the memorandum of understanding,
3entered into between the division of tobacco use prevention
4and control of the department of public health and the
5alcoholic beverages division of the department of commerce,
6governing compliance checks conducted to ensure licensed retail
7tobacco outlet conformity with tobacco laws, regulations, and
8ordinances relating to persons under 18 years of age, shall
9continue to restrict the number of such checks to one check per
10retail outlet, and one additional check for any retail outlet
11found to be in violation during the first check.
12b. (1) Of the funds appropriated in this subsection,
13$21,089,000 shall be used for problem gambling and
14substance-related disorder prevention, treatment, and recovery
15services, including a 24-hour helpline, public information
16resources, professional training, youth prevention, and program
17evaluation.
18(2) Of the amount allocated under this paragraph, $306,000
19shall be utilized by the department of public health, in
20collaboration with the department of human services, to support
21establishment and maintenance of a single statewide 24-hour
22crisis hotline for the Iowa children’s behavioral health system
23that incorporates warmline services which may be provided
24through expansion of existing capabilities maintained by the
25department of public health as required pursuant to 2018 Iowa
26Acts, chapter 1056, section 16.
27c. The requirement of section 123.17, subsection 5, is met
28by the appropriations and allocations made in this division of
29this Act for purposes of substance-related disorder treatment
30and addictive disorders for the fiscal year beginning July 1,
312019.
322. HEALTHY CHILDREN AND FAMILIES
33For promoting the optimum health status for children and
34adolescents from birth through 21 years of age, and families,
35and for not more than the following full-time equivalent
-5-1positions:
.................................................. $25,817,057
............................................... FTEs313.00
4a. Of the funds appropriated in this subsection, not more
5than $734,000 shall be used for the healthy opportunities for
6parents to experience success (HOPES)-healthy families Iowa
7(HFI) program established pursuant to section 135.106. The
8funding shall be distributed to renew the grants that were
9provided to the grantees that operated the program during the
10fiscal year ending June 30, 2018. However, the department
11shall issue a request for proposals and distribute grants to
12the grantees selected to operate the program no later than
13January 1, 2020. The department shall not retain any portion
14of the allocation under this paragraph for administrative
15costs.
16b. In order to implement the legislative intent stated
17in sections 135.106 and 256I.9, priority for home visitation
18program funding shall be given to programs using evidence-based
19or promising models for home visitation.
20c. Of the funds appropriated in this subsection, $3,075,000
21shall be used for continuation of the department’s initiative
22to provide for adequate developmental surveillance and
23screening during a child’s first five years. The funds shall
24be used first to fully fund the current sites to ensure that
25the sites are fully operational, with the remaining funds
26to be used for expansion to additional sites. The full
27implementation and expansion shall include enhancing the scope
28of the initiative through collaboration with the child health
29specialty clinics to promote healthy child development through
30early identification and response to both biomedical and social
31determinants of healthy development; by monitoring child
32health metrics to inform practice, document long-term health
33impacts and savings, and provide for continuous improvement
34through training, education, and evaluation; and by providing
35for practitioner consultation particularly for children with
-6-1behavioral conditions and needs. The department of public
2health shall also collaborate with the Iowa Medicaid enterprise
3and the child health specialty clinics to integrate the
4activities of the first five initiative into the establishment
5of patient-centered medical homes, community utilities,
6accountable care organizations, and other integrated care
7models developed to improve health quality and population
8health while reducing health care costs. To the maximum extent
9possible, funding allocated in this paragraph shall be utilized
10as matching funds for medical assistance program reimbursement.
11d. Of the funds appropriated in this subsection, $64,000
12shall be distributed to a statewide dental carrier to provide
13funds to continue the donated dental services program patterned
14after the projects developed by the lifeline network to provide
15dental services to indigent individuals who are elderly or with
16disabilities.
17e. Of the funds appropriated in this subsection, $156,000
18shall be used to provide audiological services and hearing aids
19for children.
20f. Of the funds appropriated in this subsection, $23,000 is
21transferred to the university of Iowa college of dentistry for
22provision of primary dental services to children. State funds
23shall be matched on a dollar-for-dollar basis. The university
24of Iowa college of dentistry shall coordinate efforts with the
25department of public health, oral and health delivery system
26bureau, to provide dental care to underserved populations
27throughout the state.
28g. Of the funds appropriated in this subsection, $50,000
29shall be used to address youth suicide prevention.
30h. Of the funds appropriated in this subsection, $40,000
31shall be used to support the Iowa effort to address the survey
32of children who experience adverse childhood experiences known
33as ACEs.
34i. Of the funds appropriated in this subsection, up to
35$494,000 shall be used for childhood obesity prevention.
-7- 13. CHRONIC CONDITIONS
2For serving individuals identified as having chronic
3conditions or special health care needs, and for not more than
4the following full-time equivalent positions:
.................................................. $54,223,519
............................................... FTEs69.00
7a. Of the funds appropriated in this subsection, $153,000
8shall be used for grants to individual patients who have an
9inherited metabolic disorder to assist with the costs of
10medically necessary foods and formula.
11b. Of the funds appropriated in this subsection, $1,055,000
12shall be used for the brain injury services program pursuant
13to section 135.22B, including for contracting with an existing
14nationally affiliated and statewide organization whose purpose
15is to educate, serve, and support Iowans with brain injury and
16their families, for resource facilitator services in accordance
17with section 135.22B, subsection 9, and for contracting to
18enhance brain injury training and recruitment of service
19providers on a statewide basis. Of the amount allocated in
20this paragraph, $95,000 shall be used to fund one full-time
21equivalent position to serve as the state brain injury services
22program manager.
23c. Of the funds appropriated in this subsection, $144,000
24shall be used for the public purpose of continuing to contract
25with an existing national-affiliated organization to provide
26education, client-centered programs, and client and family
27support for people living with epilepsy and their families.
28The amount allocated in this paragraph shall be matched
29dollar-for-dollar by the organization specified.
30d. Of the funds appropriated in this subsection, $809,000
31shall be used for child health specialty clinics.
32e. Of the funds appropriated in this subsection, $384,000
33shall be used by the regional autism assistance program
34established pursuant to section 256.35, and administered by
35the child health specialty clinic located at the university of
-8-1Iowa hospitals and clinics. The funds shall be used to enhance
2interagency collaboration and coordination of educational,
3medical, and other human services for persons with autism,
4their families, and providers of services, including delivering
5regionalized services of care coordination, family navigation,
6and integration of services through the statewide system of
7regional child health specialty clinics and fulfilling other
8requirements as specified in chapter 225D. The university of
9Iowa shall not receive funds allocated under this paragraph for
10indirect costs associated with the regional autism assistance
11program.
12f. Of the funds appropriated in this subsection, $577,000
13shall be used for the comprehensive cancer control program to
14reduce the burden of cancer in Iowa through prevention, early
15detection, effective treatment, and ensuring quality of life.
16Of the funds allocated in this paragraph “f”, $150,000 shall
17be used to support a melanoma research symposium, a melanoma
18biorepository and registry, basic and translational melanoma
19research, and clinical trials.
20g. Of the funds appropriated in this subsection, $97,000
21shall be used for cervical and colon cancer screening, and
22$177,000 shall be used to enhance the capacity of the cervical
23cancer screening program to include provision of recommended
24prevention and early detection measures to a broader range of
25low-income women.
26h. Of the funds appropriated in this subsection, $506,000
27shall be used for the center for congenital and inherited
28disorders.
294. COMMUNITY CAPACITY
30For strengthening the health care delivery system at the
31local level, and for not more than the following full-time
32equivalent positions:
.................................................. $335,516,677
............................................... FTEs3413.00
35a. Of the funds appropriated in this subsection, $95,000
-9-1is allocated for continuation of the child vision screening
2program implemented through the university of Iowa hospitals
3and clinics in collaboration with early childhood Iowa areas.
4The program shall submit a report to the department regarding
5the use of funds allocated under this paragraph “a”. The
6report shall include the objectives and results for the
7program year including the target population and how the funds
8allocated assisted the program in meeting the objectives; the
9number, age, and location within the state of individuals
10served; the type of services provided to the individuals
11served; the distribution of funds based on service provided;
12and the continuing needs of the program.
13b. Of the funds appropriated in this subsection,
14$48,000 shall be used for a grant to a statewide association
15of psychologists, that is affiliated with the American
16psychological association, to be used for continuation of a
17program to rotate intern psychologists in placements in urban
18and rural mental health professional shortage areas. For the
19purposes of this paragraph “b”, “mental health professional
20shortage area” means a geographic area in this state that has
21been designated by the United States department of health and
22human services, health resources and services administration,
23bureau of health professionals, as having a shortage of mental
24health professionals.
25c. Of the funds appropriated in this subsection, the
26following amounts are allocated to be used as follows
27to support the goals of increased access, health system
28integration, and engagement:
29(1) Not less than $542,000 is allocated to the Iowa
30prescription drug corporation for continuation of the
31pharmaceutical infrastructure for safety net providers as
32described in 2007 Iowa Acts, chapter 218, section 108, and for
33the prescription drug donation repository program created in
34chapter 135M.
35(2) (a) Not less than $334,000 is allocated to free
-10-1clinics and free clinics of Iowa for necessary infrastructure,
2statewide coordination, provider recruitment, service delivery,
3and provision of assistance to patients in securing a medical
4home inclusive of oral health care. However, the department
5shall issue a request for proposals and execute a contract
6with the contractor selected, to perform the activities under
7this subparagraph division no later than January 1, 2020. The
8department shall not retain any portion of the allocation under
9this subparagraph division for administrative costs.
10(b) Not less than $25,000 is allocated to the Iowa
11association of rural health clinics for necessary
12infrastructure and service delivery transformation. However,
13the department shall issue a request for proposals and
14execute a contract with the contractor selected to perform
15the activities under this subparagraph division no later
16than January 1, 2020. The department shall not retain any
17portion of the allocation under this subparagraph division for
18administrative costs.
19(c) Not less than $205,000 is allocated to the Polk county
20medical society for continuation of the safety net provider
21patient access to specialty health care initiative as described
22in 2007 Iowa Acts, chapter 218, section 109. However, the
23department shall issue a request for proposals and execute a
24contract with the contractor selected to operate the initiative
25under this subparagraph division no later than January 1, 2020.
26The department shall not retain any portion of the allocation
27under this subparagraph division for administrative costs.
28(3) The department may combine the allocations and
29activities specified in subparagraph (2) for the purposes of
30issuing a request for proposals.
31d. Of the funds appropriated in this subsection, $191,000
32is allocated for the purposes of health care and public health
33workforce initiatives.
34e. Of the funds appropriated in this subsection, $96,000
35shall be used for a matching dental education loan repayment
-11-1program to be allocated to a dental nonprofit health service
2corporation to continue to develop the criteria and implement
3the loan repayment program.
4f. Of the funds appropriated in this subsection, $100,000
5shall be used for the purposes of the Iowa donor registry as
6specified in section 142C.18.
7g. Of the funds appropriated in this subsection, $96,000
8shall be used for continuation of a grant to a nationally
9affiliated volunteer eye organization that has an established
10program for children and adults and that is solely dedicated to
11preserving sight and preventing blindness through education,
12nationally certified vision screening and training, and
13community and patient service programs. The contractor
14shall submit a report to the individuals identified in this
15Act for submission of reports regarding the use of funds
16allocated under this paragraph “g”. The report shall include
17the objectives and results for the program year including
18the target population and how the funds allocated assisted
19the program in meeting the objectives; the number, age, and
20location within the state of individuals served; the type of
21services provided to the individuals served; the distribution
22of funds based on services provided; and the continuing needs
23of the program.
24h. Of the funds appropriated in this subsection, $2,000,000
25shall be deposited in the medical residency training account
26created in section 135.175, subsection 5, paragraph “a”, and
27is appropriated from the account to the department of public
28health to be used for the purposes of the medical residency
29training state matching grants program as specified in section
30135.176.
31i. Of the funds appropriated in this subsection, $250,000
32shall be used for the public purpose of providing funding to
33Des Moines university to continue a provider education project
34to provide primary care physicians with the training and skills
35necessary to recognize the signs of mental illness in patients.
-12- 1j. Of the funds appropriated in this subsection, $400,000
2shall be used for rural psychiatric residencies to support the
3annual creation and training of four psychiatric residents who
4will provide mental health services in underserved areas of the
5state.
6k. Of the funds appropriated in this subsection, $150,000
7shall be used for psychiatric training to increase access to
8mental health care services by expanding the mental health
9workforce via training of additional physician assistants and
10nurse practitioners.
115. ESSENTIAL PUBLIC HEALTH SERVICES
12To provide public health services that reduce risks and
13invest in promoting and protecting good health over the
14course of a lifetime with a priority given to older Iowans and
15vulnerable populations:
.................................................. $167,662,464
176. INFECTIOUS DISEASES
18For reducing the incidence and prevalence of communicable
19diseases, and for not more than the following full-time
20equivalent positions:
.................................................. $211,796,426
............................................... FTEs224.00
237. PUBLIC PROTECTION
24For protecting the health and safety of the public through
25establishing standards and enforcing regulations, and for not
26more than the following full-time equivalent positions:
.................................................. $274,093,383
............................................... FTEs28142.00
29a. Of the funds appropriated in this subsection, not more
30than $304,000 shall be credited to the emergency medical
31services fund created in section 135.25. Moneys in the
32emergency medical services fund are appropriated to the
33department to be used for the purposes of the fund.
34b. Of the funds appropriated in this subsection, up
35to $243,000 shall be used for sexual violence prevention
-13-1programming through a statewide organization representing
2programs serving victims of sexual violence through the
3department’s sexual violence prevention program, and for
4continuation of a training program for sexual assault
5response team (SART) members, including representatives of
6law enforcement, victim advocates, prosecutors, and certified
7medical personnel. However, the department shall issue
8a request for proposals and execute a contract with the
9contractor selected to provide the programming and training
10as specified in this paragraph no later than January 1, 2020.
11The amount allocated in this paragraph “b” shall not be used
12to supplant funding administered for other sexual violence
13prevention or victims assistance programs. The department
14shall not retain any portion of the allocation under this
15paragraph for administrative costs.
16c. Of the funds appropriated in this subsection, up to
17$500,000 shall be used for the state poison control center.
18Pursuant to the directive under 2014 Iowa Acts, chapter
191140, section 102, the federal matching funds available to
20the state poison control center from the department of human
21services under the federal Children’s Health Insurance Program
22Reauthorization Act allotment shall be subject to the federal
23administrative cap rule of 10 percent applicable to funding
24provided under Tit.XXI of the federal Social Security Act and
25included within the department’s calculations of the cap.
26d. Of the funds appropriated in this subsection, up to
27$504,000 shall be used for childhood lead poisoning provisions.
288. RESOURCE MANAGEMENT
29For establishing and sustaining the overall ability of the
30department to deliver services to the public, and for not more
31than the following full-time equivalent positions:
.................................................. $32971,215
............................................... FTEs334.00
349. MISCELLANEOUS PROVISIONS
35a. The university of Iowa hospitals and clinics under
-14-1the control of the state board of regents shall not receive
2indirect costs from the funds appropriated in this section.
3The university of Iowa hospitals and clinics billings to the
4department shall be on at least a quarterly basis.
5b. The department of public health shall collaborate
6with applicable stakeholders to review the allocations,
7grants, and other distributions of funds appropriated under
8this division of this Act and shall submit a report to the
9individuals identified in this Act for submission of reports by
10December 15, 2019, regarding a proposal for the distribution
11of funds that more clearly reflects the department’s stated
12priorities and goals, provides increased flexibility in the
13distribution of funds to meet these priorities and goals, and
14ensures stakeholder accountability and a discernable return on
15investment.
16 Sec. 4. CONTRACTED SERVICES — PROHIBITED USE OF GENERAL
17FUND MONEYS FOR LOBBYING.
181. The department shall submit a report to the individuals
19identified in this Act for submission of reports by January 1,
202020, regarding the outcomes of any program or activity for
21which funding is appropriated or allocated from the general
22fund of the state to the department under this division of
23this Act, and for which a request for proposals process is
24specifically required.
252. The department shall incorporate into the general
26conditions applicable to all award documents involving funding
27appropriated or allocated from the general fund of the state to
28the department under this division of this Act, a prohibition
29against the use of such funding for the compensation of a
30lobbyist. For the purposes of this section, “lobbyist” means
31the same as defined in section 68B.2; however, “lobbyist”
32does not include a person employed by a state agency of the
33executive branch of state government who represents the agency
34relative to the passage, defeat, approval, or modification of
35legislation that is being considered by the general assembly.
-15-1DIVISION IV
2DEPARTMENT OF VETERANS AFFAIRS — FY 2019-2020
3 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
4appropriated from the general fund of the state to the
5department of veterans affairs for the fiscal year beginning
6July 1, 2019, and ending June 30, 2020, the following amounts,
7or so much thereof as is necessary, to be used for the purposes
8designated:
91. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
10For salaries, support, maintenance, and miscellaneous
11purposes, and for not more than the following full-time
12equivalent positions:
.................................................. $131,225,500
............................................... FTEs1415.00
152. IOWA VETERANS HOME
16For salaries, support, maintenance, and miscellaneous
17purposes:
.................................................. $187,162,976
19a. The Iowa veterans home billings involving the department
20of human services shall be submitted to the department on at
21least a monthly basis.
22b. Within available resources and in conformance with
23associated state and federal program eligibility requirements,
24the Iowa veterans home may implement measures to provide
25financial assistance to or on behalf of veterans or their
26spouses who are participating in the community reentry program.
27c. The Iowa veterans home expenditure report shall be
28submitted monthly to the legislative services agency.
29d. The Iowa veterans home shall continue to include in the
30annual discharge report applicant information to provide for
31the collection of demographic information including but not
32limited to the number of individuals applying for admission and
33admitted or denied admittance and the basis for the admission
34or denial; the age, gender, and race of such individuals;
35and the level of care for which such individuals applied for
-16-1admission including residential or nursing level of care.
23. HOME OWNERSHIP ASSISTANCE PROGRAM
3For transfer to the Iowa finance authority for the
4continuation of the home ownership assistance program for
5persons who are or were eligible members of the armed forces of
6the United States, pursuant to section 16.54:
.................................................. $72,000,000
8 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
9FUND STANDING APPROPRIATIONS. Notwithstanding the standing
10appropriation in section 35A.16 for the fiscal year beginning
11July 1, 2019, and ending June 30, 2020, the amount appropriated
12from the general fund of the state pursuant to that section
13for the following designated purposes shall not exceed the
14following amount:
15For the county commissions of veteran affairs fund under
16section 35A.16:
.................................................. $17990,000
18DIVISION V
19DEPARTMENT OF HUMAN SERVICES — FY 2019-2020
20 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
21GRANT. There is appropriated from the fund created in section
228.41 to the department of human services for the fiscal year
23beginning July 1, 2019, and ending June 30, 2020, from moneys
24received under the federal temporary assistance for needy
25families (TANF) block grant pursuant to the federal Personal
26Responsibility and Work Opportunity Reconciliation Act of 1996,
27Pub.L.No.104-193, and successor legislation, the following
28amounts, or so much thereof as is necessary, to be used for the
29purposes designated:
301. To be credited to the family investment program account
31and used for assistance under the family investment program
32under chapter 239B:
.................................................. $334,524,006
342. To be credited to the family investment program account
35and used for the job opportunities and basic skills (JOBS)
-17-1program and implementing family investment agreements in
2accordance with chapter 239B:
.................................................. $35,412,060
43. To be used for the family development and
5self-sufficiency grant program in accordance with section
6216A.107:
.................................................. $72,898,980
8Notwithstanding section 8.33, moneys appropriated in this
9subsection that remain unencumbered or unobligated at the close
10of the fiscal year shall not revert but shall remain available
11for expenditure for the purposes designated until the close of
12the succeeding fiscal year. However, unless such moneys are
13encumbered or obligated on or before September 30, 2020, the
14moneys shall revert.
154. For field operations:
.................................................. $1631,296,232
175. For general administration:
.................................................. $183,744,000
196. For state child care assistance:
.................................................. $2047,166,826
21a. Of the funds appropriated in this subsection,
22$26,205,412 is transferred to the child care and development
23block grant appropriation made by the Eighty-eighth General
24Assembly, 2019 session, for the federal fiscal year beginning
25October 1, 2019, and ending September 30, 2020. Of this
26amount, $200,000 shall be used for provision of educational
27opportunities to registered child care home providers in order
28to improve services and programs offered by this category
29of providers and to increase the number of providers. The
30department may contract with institutions of higher education
31or child care resource and referral centers to provide
32the educational opportunities. Allowable administrative
33costs under the contracts shall not exceed 5 percent. The
34application for a grant shall not exceed two pages in length.
35b. Any funds appropriated in this subsection remaining
-18-1unallocated shall be used for state child care assistance
2payments for families who are employed including but not
3limited to individuals enrolled in the family investment
4program.
57. For child and family services:
.................................................. $632,380,654
78. For child abuse prevention grants:
.................................................. $8125,000
99. For pregnancy prevention grants on the condition that
10family planning services are funded:
.................................................. $111,913,203
12Pregnancy prevention grants shall be awarded to programs
13in existence on or before July 1, 2019, if the programs have
14demonstrated positive outcomes. Grants shall be awarded to
15pregnancy prevention programs which are developed after July
161, 2019, if the programs are based on existing models that
17have demonstrated positive outcomes. Grants shall comply with
18the requirements provided in 1997 Iowa Acts, chapter 208,
19section 14, subsections 1 and 2, including the requirement that
20grant programs must emphasize sexual abstinence. Priority in
21the awarding of grants shall be given to programs that serve
22areas of the state which demonstrate the highest percentage of
23unplanned pregnancies of females of childbearing age within the
24geographic area to be served by the grant.
2510. For technology needs and other resources necessary
26to meet federal welfare reform reporting, tracking, and case
27management requirements:
.................................................. $281,037,186
2911. a. Notwithstanding any provision to the contrary,
30including but not limited to requirements in section 8.41 or
31provisions in 2018 Iowa Acts or 2019 Iowa Acts regarding the
32receipt and appropriation of federal block grants, federal
33funds from the temporary assistance for needy families block
34grant received by the state and not otherwise appropriated
35in this section and remaining available for the fiscal year
-19-1beginning July 1, 2019, are appropriated to the department of
2human services to the extent as may be necessary to be used in
3the following priority order: the family investment program,
4for state child care assistance program payments for families
5who are employed, and for the family investment program share
6of system costs for eligibility determination and related
7functions. The federal funds appropriated in this paragraph
8“a” shall be expended only after all other funds appropriated
9in subsection 1 for assistance under the family investment
10program, in subsection 6 for state child care assistance, or
11in subsection 10 for technology costs related to the family
12investment program, as applicable, have been expended. For
13the purposes of this subsection, the funds appropriated in
14subsection 6, paragraph “a”, for transfer to the child care
15and development block grant appropriation are considered fully
16expended when the full amount has been transferred.
17b. The department shall, on a quarterly basis, advise the
18legislative services agency and department of management of
19the amount of funds appropriated in this subsection that was
20expended in the prior quarter.
2112. Of the amounts appropriated in this section,
22$12,962,008 for the fiscal year beginning July 1, 2019, is
23transferred to the appropriation of the federal social services
24block grant made to the department of human services for that
25fiscal year.
2613. For continuation of the program providing categorical
27eligibility for the food assistance program as specified
28for the program in the section of this division of this Act
29relating to the family investment program account:
.................................................. $3014,236
3114. The department may transfer funds allocated in this
32section to the appropriations made in this division of this Act
33for the same fiscal year for general administration and field
34operations for resources necessary to implement and operate the
35services referred to in this section and those funded in the
-20-1appropriation made in this division of this Act for the same
2fiscal year for the family investment program from the general
3fund of the state.
415. With the exception of moneys allocated under this
5section for the family development and self-sufficiency grant
6program, to the extent moneys allocated in this section are
7deemed by the department not to be necessary to support the
8purposes for which they are allocated, such moneys may be
9used in the same fiscal year for any other purpose for which
10funds are allocated in this section or in section 8 of this
11division for the family investment program account. If there
12are conflicting needs, priority shall first be given to the
13family investment program account as specified under subsection
141 of this section and used for the purposes of assistance under
15the family investment program in accordance with chapter 239B,
16followed by state child care assistance program payments for
17families who are employed, followed by other priorities as
18specified by the department.
19 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
201. Moneys credited to the family investment program (FIP)
21account for the fiscal year beginning July 1, 2019, and
22ending June 30, 2020, shall be used to provide assistance in
23accordance with chapter 239B.
242. The department may use a portion of the moneys credited
25to the FIP account under this section as necessary for
26salaries, support, maintenance, and miscellaneous purposes.
273. The department may transfer funds allocated in
28subsection 4, excluding the allocation under subsection 4,
29paragraph “b”, to the appropriations made in this division of
30this Act for the same fiscal year for general administration
31and field operations for resources necessary to implement
32and operate the services referred to in this section and
33those funded in the appropriations made in section 7 for the
34temporary assistance for needy families block grant and in
35section 9 for the family investment program from the general
-21-1fund of the state in this division of this Act for the same
2fiscal year.
34. Moneys appropriated in this division of this Act and
4credited to the FIP account for the fiscal year beginning July
51, 2019, and ending June 30, 2020, are allocated as follows:
6a. To be retained by the department of human services to
7be used for coordinating with the department of human rights
8to more effectively serve participants in FIP and other shared
9clients and to meet federal reporting requirements under the
10federal temporary assistance for needy families block grant:
.................................................. $1120,000
12b. To the department of human rights for staffing,
13administration, and implementation of the family development
14and self-sufficiency grant program in accordance with section
15216A.107:
.................................................. $166,192,834
17(1) Of the funds allocated for the family development
18and self-sufficiency grant program in this paragraph “b”,
19not more than 5 percent of the funds shall be used for the
20administration of the grant program.
21(2) The department of human rights may continue to implement
22the family development and self-sufficiency grant program
23statewide during fiscal year 2019-2020.
24(3) The department of human rights may engage in activities
25to strengthen and improve family outcomes measures and
26data collection systems under the family development and
27self-sufficiency grant program.
28c. For the diversion subaccount of the FIP account:
.................................................. $29815,000
30A portion of the moneys allocated for the diversion
31subaccount may be used for field operations, salaries, data
32management system development, and implementation costs and
33support deemed necessary by the director of human services
34in order to administer the FIP diversion program. To the
35extent moneys allocated in this paragraph “c” are deemed by the
-22-1department not to be necessary to support diversion activities,
2such moneys may be used for other efforts intended to increase
3engagement by family investment program participants in work,
4education, or training activities, or for the purposes of
5assistance under the family investment program in accordance
6with chapter 239B.
7d. For the food assistance employment and training program:
.................................................. $866,588
9(1) The department shall apply the federal supplemental
10nutrition assistance program (SNAP) employment and training
11state plan in order to maximize to the fullest extent permitted
12by federal law the use of the 50 percent federal reimbursement
13provisions for the claiming of allowable federal reimbursement
14funds from the United States department of agriculture
15pursuant to the federal SNAP employment and training program
16for providing education, employment, and training services
17for eligible food assistance program participants, including
18but not limited to related dependent care and transportation
19expenses.
20(2) The department shall continue the categorical federal
21food assistance program eligibility at 160 percent of the
22federal poverty level and continue to eliminate the asset test
23from eligibility requirements, consistent with federal food
24assistance program requirements. The department shall include
25as many food assistance households as is allowed by federal
26law. The eligibility provisions shall conform to all federal
27requirements including requirements addressing individuals who
28are incarcerated or otherwise ineligible.
29e. For the JOBS program:
.................................................. $3012,018,258
315. Of the child support collections assigned under FIP,
32an amount equal to the federal share of support collections
33shall be credited to the child support recovery appropriation
34made in this division of this Act. Of the remainder of the
35assigned child support collections received by the child
-23-1support recovery unit, a portion shall be credited to the FIP
2account, a portion may be used to increase recoveries, and a
3portion may be used to sustain cash flow in the child support
4payments account. If as a consequence of the appropriations
5and allocations made in this section the resulting amounts
6are insufficient to sustain cash assistance payments and meet
7federal maintenance of effort requirements, the department
8shall seek supplemental funding. If child support collections
9assigned under FIP are greater than estimated or are otherwise
10determined not to be required for maintenance of effort, the
11state share of either amount may be transferred to or retained
12in the child support payments account.
136. The department may adopt emergency rules for the family
14investment, JOBS, food assistance, and medical assistance
15programs if necessary to comply with federal requirements.
16 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
17is appropriated from the general fund of the state to the
18department of human services for the fiscal year beginning July
191, 2019, and ending June 30, 2020, the following amount, or
20so much thereof as is necessary, to be used for the purpose
21designated:
22To be credited to the family investment program (FIP)
23account and used for family investment program assistance under
24chapter 239B:
.................................................. $2540,365,037
261. Of the funds appropriated in this section, $6,606,198 is
27allocated for the JOBS program.
282. Of the funds appropriated in this section, $3,313,854 is
29allocated for the family development and self-sufficiency grant
30program.
313. a. Notwithstanding section 8.39, for the fiscal
32year beginning July 1, 2019, if necessary to meet federal
33maintenance of effort requirements or to transfer federal
34temporary assistance for needy families block grant funding
35to be used for purposes of the federal social services block
-24-1grant or to meet cash flow needs resulting from delays in
2receiving federal funding or to implement, in accordance with
3this division of this Act, activities currently funded with
4juvenile court services, county, or community moneys and state
5moneys used in combination with such moneys; to comply with
6federal requirements; or to maximize the use of federal funds;
7the department of human services may transfer funds within or
8between any of the appropriations made in this division of this
9Act and appropriations in law for the federal social services
10block grant to the department for the following purposes,
11provided that the combined amount of state and federal
12temporary assistance for needy families block grant funding
13for each appropriation remains the same before and after the
14transfer:
15(1) For the family investment program.
16(2) For state child care assistance.
17(3) For child and family services.
18(4) For field operations.
19(5) For general administration.
20b. This subsection shall not be construed to prohibit the
21use of existing state transfer authority for other purposes.
22The department shall report any transfers made pursuant to this
23subsection to the legislative services agency.
244. Of the funds appropriated in this section, $195,000 shall
25be used for continuation of a grant to an Iowa-based nonprofit
26organization with a history of providing tax preparation
27assistance to low-income Iowans in order to expand the usage
28of the earned income tax credit. The purpose of the grant is
29to supply this assistance to underserved areas of the state.
30However, the department shall issue a request for proposals and
31execute a contract with the contractor selected to administer
32the program no later than January 1, 2020. The department
33shall not retain any portion of the allocation under this
34subsection for administrative costs.
355. Of the funds appropriated in this section, $70,000 shall
-25-1be used for the continuation of the parenting program, as
2specified in 441 IAC ch.100, relating to parental obligations,
3in which the child support recovery unit participates, to
4support the efforts of a nonprofit organization committed
5to strengthening the community through youth development,
6healthy living, and social responsibility headquartered in
7a county with a population over 350,000 according to the
8latest certified federal census. The funds allocated in this
9subsection shall be used by the recipient organization to
10develop a larger community effort, through public and private
11partnerships, to support a broad-based multi-county fatherhood
12parenthood initiative that promotes payment of child support
13obligations, improved family relationships, and full-time
14employment. However, the department shall issue a request for
15proposals and execute a contract with the contractor selected
16to administer the program no later than January 1, 2020. The
17department shall not retain any portion of the allocation under
18this subsection for administrative costs.
196. The department may transfer funds appropriated in this
20section, excluding the allocation in subsection 2 for the
21family development and self-sufficiency grant program, to the
22appropriations made in this division of this Act for general
23administration and field operations as necessary to administer
24this section, section 7 for the temporary assistance for needy
25families block grant, and section 8 for the family investment
26program account.
27 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
28from the general fund of the state to the department of human
29services for the fiscal year beginning July 1, 2019, and ending
30June 30, 2020, the following amount, or so much thereof as is
31necessary, to be used for the purposes designated:
32For child support recovery, including salaries, support,
33maintenance, and miscellaneous purposes, and for not more than
34the following full-time equivalent positions:
.................................................. $3514,749,368
-26-............................................... FTEs1459.00
21. The department shall expend up to $24,000, including
3federal financial participation, for the fiscal year beginning
4July 1, 2019, for a child support public awareness campaign.
5The department and the office of the attorney general shall
6cooperate in continuation of the campaign. The public
7awareness campaign shall emphasize, through a variety of
8media activities, the importance of maximum involvement of
9both parents in the lives of their children as well as the
10importance of payment of child support obligations.
112. Federal access and visitation grant moneys shall be
12issued directly to private not-for-profit agencies that provide
13services designed to increase compliance with the child access
14provisions of court orders, including but not limited to
15neutral visitation sites and mediation services.
163. The appropriation made to the department for child
17support recovery may be used throughout the fiscal year in the
18manner necessary for purposes of cash flow management, and for
19cash flow management purposes the department may temporarily
20draw more than the amount appropriated, provided the amount
21appropriated is not exceeded at the close of the fiscal year.
22 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
23FY 2019-2020. Any funds remaining in the health care trust
24fund created in section 453A.35A for the fiscal year beginning
25July 1, 2019, and ending June 30, 2020, are appropriated to
26the department of human services to supplement the medical
27assistance program appropriations made in this division of this
28Act, for medical assistance reimbursement and associated costs,
29including program administration and costs associated with
30program implementation.
31 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
322019-2020. Any funds remaining in the Medicaid fraud fund
33created in section 249A.50 for the fiscal year beginning
34July 1, 2019, and ending June 30, 2020, are appropriated to
35the department of human services to supplement the medical
-27-1assistance appropriations made in this division of this Act,
2for medical assistance reimbursement and associated costs,
3including program administration and costs associated with
4program implementation.
5 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
6general fund of the state to the department of human services
7for the fiscal year beginning July 1, 2019, and ending June 30,
82020, the following amount, or so much thereof as is necessary,
9to be used for the purpose designated:
10For medical assistance program reimbursement and associated
11costs as specifically provided in the reimbursement
12methodologies in effect on June 30, 2019, except as otherwise
13expressly authorized by law, consistent with options under
14federal law and regulations, and contingent upon receipt of
15approval from the office of the governor of reimbursement for
16each abortion performed under the program:
.................................................. $171,431,334,812
181. Iowans support reducing the number of abortions
19performed in our state. Funds appropriated under this section
20shall not be used for abortions, unless otherwise authorized
21under this section.
222. The provisions of this section relating to abortions
23shall also apply to the Iowa health and wellness plan created
24pursuant to chapter 249N.
253. The department shall utilize not more than $60,000 of
26the funds appropriated in this section to continue the AIDS/HIV
27health insurance premium payment program as established in 1992
28Iowa Acts, Second Extraordinary Session, chapter 1001, section
29409, subsection 6. Of the funds allocated in this subsection,
30not more than $5,000 may be expended for administrative
31purposes.
324. Of the funds appropriated in this Act to the department
33of public health for addictive disorders, $950,000 for
34the fiscal year beginning July 1, 2019, is transferred
35to the department of human services for an integrated
-28-1substance-related disorder managed care system. The
2departments of human services and public health shall
3work together to maintain the level of mental health and
4substance-related disorder treatment services provided by the
5managed care contractors. Each department shall take the steps
6necessary to continue the federal waivers as necessary to
7maintain the level of services.
85. a. The department shall aggressively pursue options for
9providing medical assistance or other assistance to individuals
10with special needs who become ineligible to continue receiving
11services under the early and periodic screening, diagnostic,
12and treatment program under the medical assistance program
13due to becoming 21 years of age who have been approved for
14additional assistance through the department’s exception to
15policy provisions, but who have health care needs in excess
16of the funding available through the exception to policy
17provisions.
18b. Of the funds appropriated in this section, $100,000
19shall be used for participation in one or more pilot projects
20operated by a private provider to allow the individual or
21individuals to receive service in the community in accordance
22with principles established in Olmstead v.L.C., 527 U.S.581
23(1999), for the purpose of providing medical assistance or
24other assistance to individuals with special needs who become
25ineligible to continue receiving services under the early and
26periodic screening, diagnostic, and treatment program under
27the medical assistance program due to becoming 21 years of
28age who have been approved for additional assistance through
29the department’s exception to policy provisions, but who have
30health care needs in excess of the funding available through
31the exception to the policy provisions.
326. Of the funds appropriated in this section, up to
33$3,050,082 may be transferred to the field operations or
34general administration appropriations in this division of this
35Act for operational costs associated with Part D of the federal
-29-1Medicare Prescription Drug Improvement and Modernization Act
2of 2003, Pub.L.No.108-173.
37. Of the funds appropriated in this section, up to $442,100
4may be transferred to the appropriation in this division
5of this Act for medical contracts to be used for clinical
6assessment services and prior authorization of services.
78. A portion of the funds appropriated in this section
8may be transferred to the appropriations in this division of
9this Act for general administration, medical contracts, the
10children’s health insurance program, or field operations to be
11used for the state match cost to comply with the payment error
12rate measurement (PERM) program for both the medical assistance
13and children’s health insurance programs as developed by the
14centers for Medicare and Medicaid services of the United States
15department of health and human services to comply with the
16federal Improper Payments Information Act of 2002, Pub.L.
17No.107-300, and to support other reviews and quality control
18activities to improve the integrity of these programs.
199. The department shall continue to implement the
20recommendations of the assuring better child health and
21development initiative II (ABCDII) clinical panel to the
22Iowa early and periodic screening, diagnostic, and treatment
23services healthy mental development collaborative board
24regarding changes to billing procedures, codes, and eligible
25service providers.
2610. Of the funds appropriated in this section, a sufficient
27amount is allocated to supplement the incomes of residents of
28nursing facilities, intermediate care facilities for persons
29with mental illness, and intermediate care facilities for
30persons with an intellectual disability, with incomes of less
31than $50 in the amount necessary for the residents to receive a
32personal needs allowance of $50 per month pursuant to section
33249A.30A.
3411. a. Hospitals that meet the conditions specified
35in subparagraphs (1) and (2) shall either certify public
-30-1expenditures or transfer to the medical assistance program
2an amount equal to provide the nonfederal share for a
3disproportionate share hospital payment in an amount up to the
4hospital-specific limit as approved in the Medicaid state plan.
5The hospitals that meet the conditions specified shall receive
6and retain 100 percent of the total disproportionate share
7hospital payment in an amount up to the hospital-specific limit
8as approved in the Medicaid state plan.
9(1) The hospital qualifies for disproportionate share and
10graduate medical education payments.
11(2) The hospital is an Iowa state-owned hospital with more
12than 500 beds and eight or more distinct residency specialty
13or subspecialty programs recognized by the American college of
14graduate medical education.
15b. Distribution of the disproportionate share payments
16shall be made on a monthly basis. The total amount of
17disproportionate share payments including graduate medical
18education, enhanced disproportionate share, and Iowa
19state-owned teaching hospital payments shall not exceed the
20amount of the state’s allotment under Pub.L.No.102-234.
21In addition, the total amount of all disproportionate
22share payments shall not exceed the hospital-specific
23disproportionate share limits under Pub.L.No.103-66.
2412. One hundred percent of the nonfederal share of payments
25to area education agencies that are medical assistance
26providers for medical assistance-covered services provided to
27medical assistance-covered children, shall be made from the
28appropriation made in this section.
2913. A portion of the funds appropriated in this section
30may be transferred to the appropriation in this division of
31this Act for medical contracts to be used for administrative
32activities associated with the money follows the person
33demonstration project.
3414. Of the funds appropriated in this section, $349,011
35shall be used for the administration of the health insurance
-31-1premium payment program, including salaries, support,
2maintenance, and miscellaneous purposes.
315. a. The department may increase the amounts allocated
4for salaries, support, maintenance, and miscellaneous purposes
5associated with the medical assistance program, as necessary,
6to sustain cost management efforts. The department shall
7report any such increase to the legislative services agency and
8the department of management.
9b. If the savings to the medical assistance program from
10ongoing cost management efforts exceed the associated cost
11for the fiscal year beginning July 1, 2019, the department
12may transfer any savings generated for the fiscal year due
13to medical assistance program cost management efforts to the
14appropriation made in this division of this Act for medical
15contracts or general administration to defray the costs
16associated with implementing the efforts.
1716. For the fiscal year beginning July 1, 2019, and ending
18June 30, 2020, the replacement generation tax revenues required
19to be deposited in the property tax relief fund pursuant to
20section 437A.8, subsection 4, paragraph “d”, and section
21437A.15, subsection 3, paragraph “f”, shall instead be credited
22to and supplement the appropriation made in this section and
23used for the allocations made in this section.
2417. a. Of the funds appropriated in this section, up
25to $50,000 may be transferred by the department to the
26appropriation made in this division of this Act to the
27department for the same fiscal year for general administration
28to be used for associated administrative expenses and for not
29more than one full-time equivalent position, in addition to
30those authorized for the same fiscal year, to be assigned to
31implementing the children’s mental health home project.
32b. Of the funds appropriated in this section, up to $400,000
33may be transferred by the department to the appropriation made
34to the department in this division of this Act for the same
35fiscal year for Medicaid program-related general administration
-32-1planning and implementation activities. The funds may be used
2for contracts or for personnel in addition to the amounts
3appropriated for and the positions authorized for general
4administration for the fiscal year.
5c. Of the funds appropriated in this section, up to
6$3,000,000 may be transferred by the department to the
7appropriations made in this division of this Act for the same
8fiscal year for general administration or medical contracts
9to be used to support the development and implementation of
10standardized assessment tools for persons with mental illness,
11an intellectual disability, a developmental disability, or a
12brain injury.
1318. Of the funds appropriated in this section, $150,000
14shall be used for lodging expenses associated with care
15provided at the university of Iowa hospitals and clinics for
16patients with cancer whose travel distance is 30 miles or more
17and whose income is at or below 200 percent of the federal
18poverty level as defined by the most recently revised poverty
19income guidelines published by the United States department of
20health and human services. The department of human services
21shall establish the maximum number of overnight stays and the
22maximum rate reimbursed for overnight lodging, which may be
23based on the state employee rate established by the department
24of administrative services. The funds allocated in this
25subsection shall not be used as nonfederal share matching
26funds.
2719. Of the funds appropriated in this section, up to
28$3,383,880 shall be used for administration of the state family
29planning services program pursuant to section 217.41B, and
30of this amount, the department may use up to $200,000 for
31administrative expenses.
3220. Of the funds appropriated in this section, $1,545,530
33shall be used and may be transferred to other appropriations
34in this division of this Act as necessary to administer the
35provisions in the division of this Act relating to Medicaid
-33-1program administration.
221. The department shall continue to implement and
3administer the provisions of 2018 Iowa Acts, chapter 1056.
4Of the funds appropriated in this section, up to $39,069 may
5be transferred to the department of inspections and appeals
6for inspection costs related to such implementation and
7administration.
822. Of the funds appropriated in this section, up to
9$1,200,000 shall be used to implement reductions in the waiting
10list for the children’s mental health home and community-based
11services waiver.
1223. Of the funds appropriated in this section, a sufficient
13amount shall be used to reinstate cost-based reimbursement and
14the settlement process under both fee-for-service and managed
15care administration of the Medicaid program for critical access
16hospitals in the state, as designated pursuant to 42 U.S.C.
17§1395i-4, to provide reimbursement at the rate provided for
18such hospitals under the federal Medicare program.
1924. Of the funds appropriated in this section, the
20department shall use a sufficient amount to audit all
21prescription drug benefit claims managed by a pharmacy
22benefit manager under the Medicaid program. The audit shall
23address issues including but not limited to transparency of
24data on pharmacy services, the relationship between pharmacy
25reimbursement and overall costs to the Medicaid program or
26spread pricing, any potential conflicts of interest related
27to a retail pharmacy chain that is affiliated with a pharmacy
28benefit manager and any reported reductions in pharmacy
29reimbursements, and the impact of reduction in pharmacy
30reimbursement on access to care, especially in rural areas.
31The department shall report the findings and recommendations of
32the audit to the governor and the general assembly by December
3315, 2019.
34 Sec. 14. MEDICAL CONTRACTS. There is appropriated from the
35general fund of the state to the department of human services
-34-1for the fiscal year beginning July 1, 2019, and ending June 30,
22020, the following amount, or so much thereof as is necessary,
3to be used for the purpose designated:
4For medical contracts:
.................................................. $517,992,530
61. The department of inspections and appeals shall
7provide all state matching funds for survey and certification
8activities performed by the department of inspections
9and appeals. The department of human services is solely
10responsible for distributing the federal matching funds for
11such activities.
122. Of the funds appropriated in this section, $50,000 shall
13be used for continuation of home and community-based services
14waiver quality assurance programs, including the review and
15streamlining of processes and policies related to oversight and
16quality management to meet state and federal requirements.
173. Of the amount appropriated in this section, up to
18$200,000 may be transferred to the appropriation for general
19administration in this division of this Act to be used for
20additional full-time equivalent positions in the development
21of key health initiatives such as development and oversight
22of managed care programs and development of health strategies
23targeted toward improved quality and reduced costs in the
24Medicaid program.
254. Of the funds appropriated in this section, $1,000,000
26shall be used for planning and development, in cooperation with
27the department of public health, of a phased-in program to
28provide a dental home for children.
295. a. Of the funds appropriated in this section, $573,000
30shall be credited to the autism support program fund created
31in section 225D.2 to be used for the autism support program
32created in chapter 225D, with the exception of the following
33amount of this allocation which shall be used as follows:
34b. Of the funds allocated in this subsection, $25,000 shall
35be used for the public purpose of continuation of a grant to a
-35-1nonprofit provider of child welfare services that has been in
2existence for more than 115 years, is located in a county with
3a population between 200,000 and 220,000 according to the most
4recent federal decennial census, is licensed as a psychiatric
5medical institution for children, and provides school-based
6programming, to be used for support services for children with
7autism spectrum disorder and their families.
8 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
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:
14For the state supplementary assistance program:
.................................................. $157,812,909
162. The department shall increase the personal needs
17allowance for residents of residential care facilities by the
18same percentage and at the same time as federal supplemental
19security income and federal social security benefits are
20increased due to a recognized increase in the cost of living.
21The department may adopt emergency rules to implement this
22subsection.
233. If during the fiscal year beginning July 1, 2019,
24the department projects that state supplementary assistance
25expenditures for a calendar year will not meet the federal
26pass-through requirement specified in Tit.XVI of the federal
27Social Security Act, section 1618, as codified in 42 U.S.C.
28§1382g, the department may take actions including but not
29limited to increasing the personal needs allowance for
30residential care facility residents and making programmatic
31adjustments or upward adjustments of the residential care
32facility or in-home health-related care reimbursement rates
33prescribed in this division of this Act to ensure that federal
34requirements are met. In addition, the department may make
35other programmatic and rate adjustments necessary to remain
-36-1within the amount appropriated in this section while ensuring
2compliance with federal requirements. The department may adopt
3emergency rules to implement the provisions of this subsection.
44. Notwithstanding section 8.33, moneys appropriated in
5this section that remain unencumbered or unobligated at the
6close of the fiscal year shall not revert but shall remain
7available for expenditure for the purposes designated until the
8close of the succeeding fiscal year.
9 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
101. There is appropriated from the general fund of the
11state to the department of human services for the fiscal year
12beginning July 1, 2019, and ending June 30, 2020, the following
13amount, or so much thereof as is necessary, to be used for the
14purpose designated:
15For maintenance of the healthy and well kids in Iowa (hawk-i)
16program pursuant to chapter 514I, including supplemental dental
17services, for receipt of federal financial participation under
18Tit.XXI of the federal Social Security Act, which creates the
19children’s health insurance program:
.................................................. $2019,361,112
212. Of the funds appropriated in this section, $79,486 is
22allocated for continuation of the contract for outreach with
23the department of public health.
243. A portion of the funds appropriated in this section may
25be transferred to the appropriations made in this division of
26this Act for field operations or medical contracts to be used
27for the integration of hawk-i program eligibility, payment, and
28administrative functions under the purview of the department
29of human services, including for the Medicaid management
30information system upgrade.
31 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated
32from the general fund of the state to the department of human
33services for the fiscal year beginning July 1, 2019, and ending
34June 30, 2020, the following amount, or so much thereof as is
35necessary, to be used for the purpose designated:
-37- 1For child care programs:
.................................................. $240,816,931
31. Of the funds appropriated in this section, $34,966,931
4shall be used for state child care assistance in accordance
5with section 237A.13.
62. Nothing in this section shall be construed or is
7intended as or shall imply a grant of entitlement for services
8to persons who are eligible for assistance due to an income
9level consistent with the waiting list requirements of section
10237A.13. Any state obligation to provide services pursuant to
11this section is limited to the extent of the funds appropriated
12in this section.
133. A list of the registered and licensed child care
14facilities operating in the area served by a child care
15resource and referral service shall be made available to the
16families receiving state child care assistance in that area.
174. Of the funds appropriated in this section, $5,850,000
18shall be credited to the early childhood programs grants
19account in the early childhood Iowa fund created in section
20256I.11. The moneys shall be distributed for funding of
21community-based early childhood programs targeted to children
22from birth through five years of age developed by early
23childhood Iowa areas in accordance with approved community
24plans as provided in section 256I.8.
255. The department may use any of the funds appropriated
26in this section as a match to obtain federal funds for use in
27expanding child care assistance and related programs. For
28the purpose of expenditures of state and federal child care
29funding, funds shall be considered obligated at the time
30expenditures are projected or are allocated to the department’s
31service areas. Projections shall be based on current and
32projected caseload growth, current and projected provider
33rates, staffing requirements for eligibility determination
34and management of program requirements including data systems
35management, staffing requirements for administration of the
-38-1program, contractual and grant obligations and any transfers
2to other state agencies, and obligations for decategorization
3or innovation projects.
46. A portion of the state match for the federal child care
5and development block grant shall be provided as necessary to
6meet federal matching funds requirements through the state
7general fund appropriation made for child development grants
8and other programs for at-risk children in section 279.51.
97. If a uniform reduction ordered by the governor under
10section 8.31 or other operation of law, transfer, or federal
11funding reduction reduces the appropriation made in this
12section for the fiscal year, the percentage reduction in the
13amount paid out to or on behalf of the families participating
14in the state child care assistance program shall be equal to or
15less than the percentage reduction made for any other purpose
16payable from the appropriation made in this section and the
17federal funding relating to it. The percentage reduction to
18the other allocations made in this section shall be the same as
19the uniform reduction ordered by the governor or the percentage
20change of the federal funding reduction, as applicable. If
21there is an unanticipated increase in federal funding provided
22for state child care services, the entire amount of the
23increase, except as necessary to meet federal requirements
24including quality set asides, shall be used for state child
25care assistance payments. If the appropriations made for
26purposes of the state child care assistance program for the
27fiscal year are determined to be insufficient, it is the intent
28of the general assembly to appropriate sufficient funding for
29the fiscal year in order to avoid establishment of waiting list
30requirements.
318. Notwithstanding section 8.33, moneys advanced for
32purposes of the programs developed by early childhood Iowa
33areas, advanced for purposes of wraparound child care, or
34received from the federal appropriations made for the purposes
35of this section that remain unencumbered or unobligated at the
-39-1close of the fiscal year shall not revert to any fund but shall
2remain available for expenditure for the purposes designated
3until the close of the succeeding fiscal year.
4 Sec. 18. JUVENILE INSTITUTION. There is appropriated
5from the general fund of the state to the department of human
6services for the fiscal year beginning July 1, 2019, and ending
7June 30, 2020, the following amounts, or so much thereof as is
8necessary, to be used for the purposes designated:
91. a. For operation of the state training school at Eldora
10and for salaries, support, maintenance, and miscellaneous
11purposes, and for not more than the following full-time
12equivalent positions:
.................................................. $1313,920,757
............................................... FTEs14207.00
15b. Of the funds appropriated in this subsection, $91,000
16shall be used for distribution to licensed classroom teachers
17at this and other institutions under the control of the
18department of human services based upon the average student
19yearly enrollment at each institution as determined by the
20department.
21c. The additional full-time equivalent positions authorized
22in paragraph “a” shall include 1.00 youth services technician,
231.00 clinical supervisor, and 1.00 registered nurse, or
24comparable additional, full-time equivalent positions.
252. A portion of the moneys appropriated in this section
26shall be used by the state training school at Eldora for
27grants for adolescent pregnancy prevention activities at the
28institution in the fiscal year beginning July 1, 2019.
293. Of the funds appropriated in this subsection, $212,000
30shall be used by the state training school at Eldora for a
31substance use disorder treatment program at the institution for
32the fiscal year beginning July 1, 2019.
334. Notwithstanding section 8.33, moneys appropriated in
34this section that remain unencumbered or unobligated at the
35close of the fiscal year shall not revert but shall remain
-40-1available for expenditure for the purposes designated until the
2close of the succeeding fiscal year.
3 Sec. 19. CHILD AND FAMILY SERVICES.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2019, and ending June 30, 2020, the following
7amount, or so much thereof as is necessary, to be used for the
8purpose designated:
9For child and family services:
.................................................. $1089,071,761
112. The department may transfer funds appropriated in this
12section as necessary to pay the nonfederal costs of services
13reimbursed under the medical assistance program, state child
14care assistance program, or the family investment program which
15are provided to children who would otherwise receive services
16paid under the appropriation in this section. The department
17may transfer funds appropriated in this section to the
18appropriations made in this division of this Act for general
19administration and for field operations for resources necessary
20to implement and operate the services funded in this section.
213. a. Of the funds appropriated in this section, up to
22$34,536,000 is allocated as the statewide expenditure target
23under section 232.143 for group foster care maintenance and
24services. If the department projects that such expenditures
25for the fiscal year will be less than the target amount
26allocated in this paragraph “a”, the department may reallocate
27the excess to provide additional funding for family foster
28care, independent living, family safety, risk and permanency
29services, shelter care, or the child welfare emergency services
30addressed with the allocation for shelter care.
31b. If at any time after September 30, 2019, annualization
32of a service area’s current expenditures indicates a service
33area is at risk of exceeding its group foster care expenditure
34target under section 232.143 by more than 5 percent, the
35department and juvenile court services shall examine all
-41-1group foster care placements in that service area in order to
2identify those which might be appropriate for termination.
3In addition, any aftercare services believed to be needed
4for the children whose placements may be terminated shall be
5identified. The department and juvenile court services shall
6initiate action to set dispositional review hearings for the
7placements identified. In such a dispositional review hearing,
8the juvenile court shall determine whether needed aftercare
9services are available and whether termination of the placement
10is in the best interest of the child and the community.
114. In accordance with the provisions of section 232.188,
12the department shall continue the child welfare and juvenile
13justice funding initiative during fiscal year 2019-2020. Of
14the funds appropriated in this section, $1,717,000 is allocated
15specifically for expenditure for fiscal year 2019-2020 through
16the decategorization services funding pools and governance
17boards established pursuant to section 232.188.
185. A portion of the funds appropriated in this section
19may be used for emergency family assistance to provide other
20resources required for a family participating in a family
21preservation or reunification project or successor project to
22stay together or to be reunified.
236. Of the funds appropriated in this section, a sufficient
24amount is allocated for shelter care and the child welfare
25emergency services contracting implemented to provide for or
26prevent the need for shelter care.
277. Federal funds received by the state during the fiscal
28year beginning July 1, 2019, as the result of the expenditure
29of state funds appropriated during a previous state fiscal
30year for a service or activity funded under this section are
31appropriated to the department to be used as additional funding
32for services and purposes provided for under this section.
33Notwithstanding section 8.33, moneys received in accordance
34with this subsection that remain unencumbered or unobligated at
35the close of the fiscal year shall not revert to any fund but
-42-1shall remain available for the purposes designated until the
2close of the succeeding fiscal year.
38. a. Of the funds appropriated in this section, up to
4$3,290,000 is allocated for the payment of the expenses of
5court-ordered services provided to juveniles who are under the
6supervision of juvenile court services, which expenses are a
7charge upon the state pursuant to section 232.141, subsection
84. Of the amount allocated in this paragraph “a”, up to
9$1,556,000 shall be made available to provide school-based
10supervision of children adjudicated under chapter 232, of which
11not more than $15,000 may be used for the purpose of training.
12A portion of the cost of each school-based liaison officer
13shall be paid by the school district or other funding source as
14approved by the chief juvenile court officer.
15b. Of the funds appropriated in this section, up to $748,000
16is allocated for the payment of the expenses of court-ordered
17services provided to children who are under the supervision
18of the department, which expenses are a charge upon the state
19pursuant to section 232.141, subsection 4.
20c. Notwithstanding section 232.141 or any other provision
21of law to the contrary, the amounts allocated in this
22subsection shall be distributed to the judicial districts
23as determined by the state court administrator and to the
24department’s service areas as determined by the administrator
25of the department of human services’ division of child and
26family services. The state court administrator and the
27division administrator shall make the determination of the
28distribution amounts on or before June 15, 2019.
29d. Notwithstanding chapter 232 or any other provision of
30law to the contrary, a district or juvenile court shall not
31order any service which is a charge upon the state pursuant
32to section 232.141 if there are insufficient court-ordered
33services funds available in the district court or departmental
34service area distribution amounts to pay for the service. The
35chief juvenile court officer and the departmental service area
-43-1manager shall encourage use of the funds allocated in this
2subsection such that there are sufficient funds to pay for
3all court-related services during the entire year. The chief
4juvenile court officers and departmental service area managers
5shall attempt to anticipate potential surpluses and shortfalls
6in the distribution amounts and shall cooperatively request the
7state court administrator or division administrator to transfer
8funds between the judicial districts’ or departmental service
9areas’ distribution amounts as prudent.
10e. Notwithstanding any provision of law to the contrary,
11a district or juvenile court shall not order a county to pay
12for any service provided to a juvenile pursuant to an order
13entered under chapter 232 which is a charge upon the state
14under section 232.141, subsection 4.
15f. Of the funds allocated in this subsection, not more than
16$83,000 may be used by the judicial branch for administration
17of the requirements under this subsection.
18g. Of the funds allocated in this subsection, $17,000
19shall be used by the department of human services to support
20the interstate commission for juveniles in accordance with
21the interstate compact for juveniles as provided in section
22232.173.
239. Of the funds appropriated in this section, $12,253,000 is
24allocated for juvenile delinquent graduated sanctions services.
25Any state funds saved as a result of efforts by juvenile court
26services to earn a federal Tit.IV-E match for juvenile court
27services administration may be used for the juvenile delinquent
28graduated sanctions services.
2910. Of the funds appropriated in this section, $1,658,000 is
30transferred to the department of public health to be used for
31the child protection center grant program for child protection
32centers located in Iowa in accordance with section 135.118.
33The grant amounts under the program shall be equalized so that
34each center receives a uniform base amount of $245,000, and so
35that the remaining funds are awarded through a funding formula
-44-1based upon the volume of children served. To increase access
2to child protection center services for children in rural
3areas, the funding formula for the awarding of the remaining
4funds shall provide for the awarding of an enhanced amount to
5eligible grantees to develop and maintain satellite centers in
6underserved regions of the state.
711. Of the funds appropriated in this section, $4,025,000 is
8allocated for the preparation for adult living program pursuant
9to section 234.46.
1012. Of the funds appropriated in this section, $227,000
11shall be used for the public purpose of continuing a grant to a
12nonprofit human services organization, providing services to
13individuals and families in multiple locations in southwest
14Iowa and Nebraska for support of a project providing immediate,
15sensitive support and forensic interviews, medical exams, needs
16assessments, and referrals for victims of child abuse and their
17nonoffending family members.
1813. Of the funds appropriated in this section, $300,000
19is allocated for the foster care youth council approach of
20providing a support network to children placed in foster care.
2114. Of the funds appropriated in this section, $202,000 is
22allocated for use pursuant to section 235A.1 for continuation
23of the initiative to address child sexual abuse implemented
24pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
2521.
2615. Of the funds appropriated in this section, $630,000 is
27allocated for the community partnership for child protection
28sites.
2916. Of the funds appropriated in this section, $371,000
30is allocated for the department’s minority youth and family
31projects under the redesign of the child welfare system.
3217. Of the funds appropriated in this section, $851,000
33is allocated for funding of the community circle of care
34collaboration for children and youth in northeast Iowa.
3518. Of the funds appropriated in this section, at least
-45-1$147,000 shall be used for the continuation of the child
2welfare provider training academy, a collaboration between the
3coalition for family and children’s services in Iowa and the
4department.
519. Of the funds appropriated in this section, $211,000
6shall be used for continuation of the central Iowa system of
7care program grant through June 30, 2020.
820. Of the funds appropriated in this section, $235,000
9shall be used for the public purpose of the continuation
10and expansion of a system of care program grant implemented
11in Cerro Gordo and Linn counties to utilize a comprehensive
12and long-term approach for helping children and families by
13addressing the key areas in a child’s life of childhood basic
14needs, education and work, family, and community.
1521. Of the funds appropriated in this section, at least
16$25,000 shall be used to continue and to expand the foster
17care respite pilot program in which postsecondary students in
18social work and other human services-related programs receive
19experience by assisting family foster care providers with
20respite and other support.
2122. Of the funds appropriated in this section, $110,000
22shall be used for the public purpose of funding community-based
23services and other supports with a system of care approach
24for children with a serious emotional disturbance and their
25families through a nonprofit provider of child welfare services
26that has been in existence for more than 115 years, is located
27in a county with a population of more than 200,000 but less
28than 220,000 according to the latest certified federal census,
29is licensed as a psychiatric medical institution for children,
30and was a system of care grantee prior to July 1, 2019.
3123. If a separate funding source is identified that reduces
32the need for state funds within an allocation under this
33section, the allocated state funds may be redistributed to
34other allocations under this section for the same fiscal year.
35 Sec. 20. ADOPTION SUBSIDY.
-46- 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:
6a. For adoption subsidy payments and services:
.................................................. $740,596,007
8b. (1) The funds appropriated in this section shall be used
9as authorized or allowed by federal law or regulation for any
10of the following purposes:
11(a) For adoption subsidy payments and related costs.
12(b) For post-adoption services and for other purposes under
13Tit.IV-B or Tit.IV-E of the federal Social Security Act.
14(2) The department of human services may transfer funds
15appropriated in this subsection to the appropriation for
16child and family services in this Act for the purposes of
17post-adoption services as specified in this paragraph “b”.
18c. Notwithstanding section 8.33, moneys corresponding to
19the state savings resulting from implementation of the federal
20Fostering Connections to Success and Increasing Adoptions Act
21of 2008, Pub.L. No.110-351, and successor legislation, as
22determined in accordance with 42 U.S.C. §673(a)(8), that remain
23unencumbered or unobligated at the close of the fiscal year,
24shall not revert to any fund but shall remain available for the
25purposes designated in this subsection until expended. The
26amount of such savings and any corresponding funds remaining
27at the close of the fiscal year shall be determined separately
28and any changes in either amount between fiscal years shall not
29result in an unfunded need.
302. The department may transfer funds appropriated in
31this section to the appropriation made in this division of
32this Act for general administration for costs paid from the
33appropriation relating to adoption subsidy.
343. Federal funds received by the state during the
35fiscal year beginning July 1, 2019, as the result of the
-47-1expenditure of state funds during a previous state fiscal
2year for a service or activity funded under this section are
3appropriated to the department to be used as additional funding
4for the services and activities funded under this section.
5Notwithstanding section 8.33, moneys received in accordance
6with this subsection that remain unencumbered or unobligated
7at the close of the fiscal year shall not revert to any fund
8but shall remain available for expenditure for the purposes
9designated until the close of the succeeding fiscal year.
10 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited
11in the juvenile detention home fund created in section 232.142
12during the fiscal year beginning July 1, 2019, and ending June
1330, 2020, are appropriated to the department of human services
14for the fiscal year beginning July 1, 2019, and ending June 30,
152020, for distribution of an amount equal to a percentage of
16the costs of the establishment, improvement, operation, and
17maintenance of county or multicounty juvenile detention homes
18in the fiscal year beginning July 1, 2018. Moneys appropriated
19for distribution in accordance with this section shall be
20allocated among eligible detention homes, prorated on the basis
21of an eligible detention home’s proportion of the costs of all
22eligible detention homes in the fiscal year beginning July
231, 2018. The percentage figure shall be determined by the
24department based on the amount available for distribution for
25the fund. Notwithstanding section 232.142, subsection 3, the
26financial aid payable by the state under that provision for the
27fiscal year beginning July 1, 2019, shall be limited to the
28amount appropriated for the purposes of this section.
29 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM.
301. There is appropriated from the general fund of the
31state to the department of human services for the fiscal year
32beginning July 1, 2019, and ending June 30, 2020, the following
33amount, or so much thereof as is necessary, to be used for the
34purpose designated:
35For the family support subsidy program subject to the
-48-1enrollment restrictions in section 225C.37, subsection 3:
.................................................. $2949,282
32. At least $819,275 of the moneys appropriated in this
4section is transferred to the department of public health for
5the family support center component of the comprehensive family
6support program under chapter 225C, subchapter V.
73. If at any time during the fiscal year, the amount of
8funding available for the family support subsidy program
9is reduced from the amount initially used to establish the
10figure for the number of family members for whom a subsidy
11is to be provided at any one time during the fiscal year,
12notwithstanding section 225C.38, subsection 2, the department
13shall revise the figure as necessary to conform to the amount
14of funding available.
15 Sec. 23. CONNER DECREE. There is appropriated from the
16general fund of the state to the department of human services
17for the fiscal year beginning July 1, 2019, and ending June 30,
182020, the following amount, or so much thereof as is necessary,
19to be used for the purpose designated:
20For building community capacity through the coordination
21and provision of training opportunities in accordance with the
22consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
23Iowa, July 14, 1994):
.................................................. $2433,632
25 Sec. 24. MENTAL HEALTH INSTITUTES.
261. There is appropriated from the general fund of the
27state to the department of human services for the fiscal year
28beginning July 1, 2019, and ending June 30, 2020, the following
29amounts, or so much thereof as is necessary, to be used for the
30purposes designated:
31a. (1) For operation of the state mental health institute
32at Cherokee as required by chapters 218 and 226 for salaries,
33support, maintenance, and miscellaneous purposes, and for not
34more than the following full-time equivalent positions:
.................................................. $3514,216,149
-49-............................................... FTEs1169.00
2(2) The additional full-time equivalent positions
3authorized in this paragraph “a” shall include 3.50 security
4staff and 3.00 support staff, or comparable additional,
5full-time equivalent positions.
6b. (1) For operation of the state mental health institute
7at Independence as required by chapters 218 and 226 for
8salaries, support, maintenance, and miscellaneous purposes, and
9for not more than the following full-time equivalent positions:
.................................................. $1019,165,110
............................................... FTEs11208.00
12(2) The additional full-time equivalent positions
13authorized in this paragraph “b” shall include 3.50 security
14staff, or comparable additional, full-time equivalent
15positions.
162. Notwithstanding sections 218.78 and 249A.11, any revenue
17received from the state mental health institute at Cherokee or
18the state mental health institute at Independence pursuant to
1942 C.F.R §438.6(e) may be retained and expended by the mental
20health institute.
213. Notwithstanding any provision of law to the contrary,
22a Medicaid member residing at the state mental health
23institute at Cherokee or the state mental health institute
24at Independence shall retain Medicaid eligibility during
25the period of the Medicaid member’s stay for which federal
26financial participation is available.
274. Notwithstanding section 8.33, moneys appropriated in
28this section that remain unencumbered or unobligated at the
29close of the fiscal year shall not revert but shall remain
30available for expenditure for the purposes designated until the
31close of the succeeding fiscal year.
32 Sec. 25. STATE RESOURCE CENTERS.
331. There is appropriated from the general fund of the
34state to the department of human services for the fiscal year
35beginning July 1, 2019, and ending June 30, 2020, the following
-50-1amounts, or so much thereof as is necessary, to be used for the
2purposes designated:
3a. For the state resource center at Glenwood for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $516,048,348
6b. For the state resource center at Woodward for salaries,
7support, maintenance, and miscellaneous purposes:
.................................................. $810,872,356
92. The department may continue to bill for state resource
10center services utilizing a scope of services approach used for
11private providers of intermediate care facilities for persons
12with an intellectual disability services, in a manner which
13does not shift costs between the medical assistance program,
14counties, or other sources of funding for the state resource
15centers.
163. The state resource centers may expand the time-limited
17assessment and respite services during the fiscal year.
184. If the department’s administration and the department
19of management concur with a finding by a state resource
20center’s superintendent that projected revenues can reasonably
21be expected to pay the salary and support costs for a new
22employee position, or that such costs for adding a particular
23number of new positions for the fiscal year would be less
24than the overtime costs if new positions would not be added,
25the superintendent may add the new position or positions. If
26the vacant positions available to a resource center do not
27include the position classification desired to be filled, the
28state resource center’s superintendent may reclassify any
29vacant position as necessary to fill the desired position. The
30superintendents of the state resource centers may, by mutual
31agreement, pool vacant positions and position classifications
32during the course of the fiscal year in order to assist one
33another in filling necessary positions.
345. If existing capacity limitations are reached in
35operating units, a waiting list is in effect for a service or
-51-1a special need for which a payment source or other funding
2is available for the service or to address the special need,
3and facilities for the service or to address the special need
4can be provided within the available payment source or other
5funding, the superintendent of a state resource center may
6authorize opening not more than two units or other facilities
7and begin implementing the service or addressing the special
8need during fiscal year 2019-2020.
96. Notwithstanding section 8.33, and notwithstanding
10the amount limitation specified in section 222.92, moneys
11appropriated in this section that remain unencumbered or
12unobligated at the close of the fiscal year shall not revert
13but shall remain available for expenditure for the purposes
14designated until the close of the succeeding fiscal year.
15 Sec. 26. SEXUALLY VIOLENT PREDATORS.
161. a. 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 costs associated with the commitment and treatment of
22sexually violent predators in the unit located at the state
23mental health institute at Cherokee, including costs of legal
24services and other associated costs, including salaries,
25support, maintenance, and miscellaneous purposes, and for not
26more than the following full-time equivalent positions:
.................................................. $2712,053,093
............................................... FTEs28139.00
29b. The additional full-time equivalent positions authorized
30in paragraph “a” shall include 7.00 clinical and support staff,
31or comparable additional, full-time equivalent positions.
322. Unless specifically prohibited by law, if the amount
33charged provides for recoupment of at least the entire amount
34of direct and indirect costs, the department of human services
35may contract with other states to provide care and treatment
-52-1of persons placed by the other states at the unit for sexually
2violent predators at Cherokee. The moneys received under
3such a contract shall be considered to be repayment receipts
4and used for the purposes of the appropriation made in this
5section.
63. Notwithstanding section 8.33, moneys appropriated in
7this section that remain unencumbered or unobligated at the
8close of the fiscal year shall not revert but shall remain
9available for expenditure for the purposes designated until the
10close of the succeeding fiscal year.
11 Sec. 27. FIELD OPERATIONS.
121. There is appropriated from the general fund of the
13state to the department of human services for the fiscal year
14beginning July 1, 2019, and ending June 30, 2020, the following
15amount, or so much thereof as is necessary, to be used for the
16purposes designated:
17For field operations, including salaries, support,
18maintenance, and miscellaneous purposes, and for not more than
19the following full-time equivalent positions:
.................................................. $2055,396,906
............................................... FTEs211,539.00
222. The additional full-time equivalent positions authorized
23in subsection 1 shall include 29.00 full-time equivalent staff
24positions to relieve caseloads and 6.00 full-time equivalent
25positions related to the eligibility integrated application
26solution (ELIAS) system.
273. Priority in filling full-time equivalent positions
28shall be given to those positions related to child protection
29services and eligibility determination for low-income families.
30 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
31from the general fund of the state to the department of human
32services for the fiscal year beginning July 1, 2019, and ending
33June 30, 2020, the following amount, or so much thereof as is
34necessary, to be used for the purpose designated:
35For general administration, including salaries, support,
-53-1maintenance, and miscellaneous purposes, and for not more than
2the following full-time equivalent positions:
.................................................. $313,833,040
............................................... FTEs4294.00
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
-54-1of 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 behavioral health system.
8c. Of the amount allocated, $32,000 shall be transferred
9to the 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 behavioral health system.
14 Sec. 29. 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. 30. VOLUNTEERS. There is appropriated from the general
24fund of the state 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:
28For development and coordination of volunteer services:
.................................................. $2984,686
30 Sec. 31. CORPORATE TECHNOLOGY. There is appropriated
31from the general fund of the state to the department of human
32services for the fiscal year beginning July 1, 2019, and ending
33June 30, 2020, the following amount, or so much thereof as is
34necessary, to be used for the purposes designated:
35For the purchase of department-wide technology and software
-55-1update needs:
.................................................. $2824,832
3 Sec. 32. 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 $27,479,942, 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
35prospectively from the effective date of the rate letter issued
-56-1by the department.
2b. (1) For the fiscal year beginning July 1, 2019,
3the department shall establish the pharmacy dispensing fee
4reimbursement at $10.07 per prescription, until a cost of
5dispensing survey is completed. The actual dispensing fee
6shall be determined by a cost of dispensing survey performed
7by the department and required to be completed by all medical
8assistance program participating pharmacies every two years,
9adjusted as necessary to maintain expenditures within the
10amount appropriated to the department for this purpose for the
11fiscal year.
12(2) The department shall utilize an average acquisition
13cost reimbursement methodology for all drugs covered under the
14medical assistance program in accordance with 2012 Iowa Acts,
15chapter 1133, section 33.
16c. (1) For the fiscal year beginning July 1, 2019,
17reimbursement rates for outpatient hospital services shall
18remain at the rates in effect on June 30, 2019, subject to
19Medicaid program upper payment limit rules, and adjusted
20as necessary to maintain expenditures within the amount
21appropriated to the department for this purpose for the fiscal
22year.
23(2) For the fiscal year beginning July 1, 2019,
24reimbursement rates for inpatient hospital services shall
25remain at the rates in effect on June 30, 2019, subject to
26Medicaid program upper payment limit rules, and adjusted
27as necessary to maintain expenditures within the amount
28appropriated to the department for this purpose for the fiscal
29year.
30(3) For the fiscal year beginning July 1, 2019, under
31both fee-for-service and managed care administration of the
32Medicaid program, critical access hospitals in the state,
33as designated pursuant to 42 U.S.C. §1395i-4, shall receive
34cost-based reimbursement utilizing a settlement process to
35provide reimbursement at the rate provided such hospitals under
-57-1the federal Medicare program.
2(4) For the fiscal year beginning July 1, 2019, the graduate
3medical education and disproportionate share hospital fund
4shall remain at the amount in effect on June 30, 2019, except
5that the portion of the fund attributable to graduate medical
6education shall be reduced in an amount that reflects the
7elimination of graduate medical education payments made to
8out-of-state hospitals.
9(5) In order to ensure the efficient use of limited state
10funds in procuring health care services for low-income Iowans,
11funds appropriated in this Act for hospital services shall
12not be used for activities which would be excluded from a
13determination of reasonable costs under the federal Medicare
14program pursuant to 42 U.S.C.§1395x(v)(1)(N).
15d. For the fiscal year beginning July 1, 2019, reimbursement
16rates for hospices and acute psychiatric hospitals shall be
17increased in accordance with increases under the federal
18Medicare program or as supported by their Medicare audited
19costs.
20e. For the fiscal year beginning July 1, 2019, independent
21laboratories and rehabilitation agencies shall be reimbursed
22using the same methodology in effect on June 30, 2019.
23f. (1) For the fiscal year beginning July 1, 2019,
24reimbursement rates for home health agencies shall be rebased,
25to the extent possible, within the state funding appropriated
26for this purpose, and shall continue to be based on the
27Medicare low utilization payment adjustment (LUPA) methodology
28with state geographic wage adjustments to reflect the most
29recent Medicare LUPA rates to the extent possible within the
30state funding appropriated for this purpose.
31(2) For the fiscal year beginning July 1, 2019, rates for
32private duty nursing and personal care services under the early
33and periodic screening, diagnostic, and treatment program
34benefit shall be calculated based on the methodology in effect
35on June 30, 2019.
-58- 1g. For the fiscal year beginning July 1, 2019, federally
2qualified health centers and rural health clinics shall receive
3cost-based reimbursement for 100 percent of the reasonable
4costs for the provision of services to recipients of medical
5assistance.
6h. For the fiscal year beginning July 1, 2019, the
7reimbursement rates for dental services shall remain at the
8rates in effect on June 30, 2019.
9i. (1) For the fiscal year beginning July 1, 2019,
10reimbursement rates for non-state-owned psychiatric medical
11institutions for children shall be based on the reimbursement
12methodology in effect on June 30, 2019.
13(2) As a condition of participation in the medical
14assistance program, enrolled providers shall accept the medical
15assistance reimbursement rate for any covered goods or services
16provided to recipients of medical assistance who are children
17under the custody of a psychiatric medical institution for
18children.
19j. For the fiscal year beginning July 1, 2019, unless
20otherwise specified in this Act, all noninstitutional medical
21assistance provider reimbursement rates shall remain at the
22rates in effect on June 30, 2019, except for area education
23agencies, local education agencies, infant and toddler
24services providers, home and community-based services providers
25including consumer-directed attendant care providers under a
26section 1915(c) or 1915(i) waiver, targeted case management
27providers, and those providers whose rates are required to be
28determined pursuant to section 249A.20, or to meet federal
29mental health parity requirements.
30k. Notwithstanding any provision to the contrary, for the
31fiscal year beginning July 1, 2019, the reimbursement rate for
32anesthesiologists shall remain at the rates in effect on June
3330, 2019, and updated on January 1, 2020, to align with the
34most current Iowa Medicare anesthesia rate.
35l. Notwithstanding section 249A.20, for the fiscal year
-59-1beginning July 1, 2019, the average reimbursement rate for
2health care providers eligible for use of the federal Medicare
3resource-based relative value scale reimbursement methodology
4under section 249A.20 shall remain at the rate in effect on
5June 30, 2019; however, this rate shall not exceed the maximum
6level authorized by the federal government.
7m. For the fiscal year beginning July 1, 2019, the
8reimbursement rate for residential care facilities shall not
9be less than the minimum payment level as established by the
10federal government to meet the federally mandated maintenance
11of effort requirement. The flat reimbursement rate for
12facilities electing not to file annual cost reports shall not
13be less than the minimum payment level as established by the
14federal government to meet the federally mandated maintenance
15of effort requirement.
16n. For the fiscal year beginning July 1, 2019, the
17reimbursement rates for inpatient mental health services
18provided at hospitals shall remain at the rates in effect on
19June 30, 2019, subject to Medicaid program upper payment limit
20rules; and psychiatrists shall be reimbursed at the medical
21assistance program fee-for-service rate in effect on June 30,
222019.
23o. For the fiscal year beginning July 1, 2019, community
24mental health centers may choose to be reimbursed for the
25services provided to recipients of medical assistance through
26either of the following options:
27(1) For 100 percent of the reasonable costs of the services.
28(2) In accordance with the alternative reimbursement rate
29methodology approved by the department of human services in
30effect on June 30, 2019.
31p. For the fiscal year beginning July 1, 2019, the
32reimbursement rate for providers of family planning services
33that are eligible to receive a 90 percent federal match shall
34remain at the rates in effect on June 30, 2019.
35q. Unless otherwise subject to a tiered rate methodology,
-60-1for the fiscal year beginning July 1, 2019, the upper
2limits and reimbursement rates for providers of home and
3community-based services waiver services shall be reimbursed
4using the reimbursement methodology in effect on June 30, 2019.
5r. For the fiscal year beginning July 1, 2019, the
6reimbursement rates for emergency medical service providers
7shall remain at the rates in effect on June 30, 2019.
8s. For the fiscal year beginning July 1, 2019, reimbursement
9rates for substance-related disorder treatment programs
10licensed under section 125.13 shall remain at the rates in
11effect on June 30, 2019.
12t. For the fiscal year beginning July 1, 2019, assertive
13community treatment per diem rates shall be adjusted to
14reflect an actual average per diem cost within the additional
15$1,088,437 appropriated for this purpose.
162. For the fiscal year beginning July 1, 2019, the
17reimbursement rate for providers reimbursed under the
18in-home-related care program shall not be less than the minimum
19payment level as established by the federal government to meet
20the federally mandated maintenance of effort requirement.
213. Unless otherwise directed in this section, when the
22department’s reimbursement methodology for any provider
23reimbursed in accordance with this section includes an
24inflation factor, this factor shall not exceed the amount
25by which the consumer price index for all urban consumers
26increased during the calendar year ending December 31, 2002.
274. Notwithstanding section 234.38, for the fiscal
28year beginning July 1, 2019, the foster family basic daily
29maintenance rate and the maximum adoption subsidy rate for
30children ages 0 through 5 years shall be $16.78, the rate for
31children ages 6 through 11 years shall be $17.45, the rate for
32children ages 12 through 15 years shall be $19.10, and the
33rate for children and young adults ages 16 and older shall
34be $19.35. For youth ages 18 to 21 who have exited foster
35care, the preparation for adult living program maintenance rate
-61-1shall be $602.70 per month. The maximum payment for adoption
2subsidy nonrecurring expenses shall be limited to $500 and the
3disallowance of additional amounts for court costs and other
4related legal expenses implemented pursuant to 2010 Iowa Acts,
5chapter 1031, section 408, shall be continued.
65. For the fiscal year beginning July 1, 2019, the maximum
7reimbursement rates for social services providers under
8contract shall remain at the rates in effect on June 30, 2019,
9or the provider’s actual and allowable cost plus inflation for
10each service, whichever is less. However, if a new service
11or service provider is added after June 30, 2019, the initial
12reimbursement rate for the service or provider shall be based
13upon a weighted average of provider rates for similar services.
146. a. For the fiscal year beginning July 1, 2019, the
15reimbursement rates for resource family recruitment and
16retention contractors shall be established by contract.
17b. For the fiscal year beginning July 1, 2019, the
18reimbursement rates for supervised apartment living foster care
19providers shall be established by contract.
207. For the fiscal year beginning July 1, 2019, the
21reimbursement rate for group foster care providers shall be the
22combined service and maintenance reimbursement rate established
23by contract.
248. The group foster care reimbursement rates paid for
25placement of children out of state shall be calculated
26according to the same rate-setting principles as those used for
27in-state providers, unless the director of human services or
28the director’s designee determines that appropriate care cannot
29be provided within the state. The payment of the daily rate
30shall be based on the number of days in the calendar month in
31which service is provided.
329. a. For the fiscal year beginning July 1, 2019, the
33reimbursement rate paid for shelter care and the child welfare
34emergency services implemented to provide or prevent the need
35for shelter care shall be established by contract.
-62- 1b. For the fiscal year beginning July 1, 2019, the combined
2service and maintenance components of the reimbursement rate
3paid for shelter care services shall be based on the financial
4and statistical report submitted to the department. The
5maximum reimbursement rate shall be $101.83 per day. The
6department shall reimburse a shelter care provider at the
7provider’s actual and allowable unit cost, plus inflation, not
8to exceed the maximum reimbursement rate.
9c. Notwithstanding section 232.141, subsection 8, for the
10fiscal year beginning July 1, 2019, the amount of the statewide
11average of the actual and allowable rates for reimbursement of
12juvenile shelter care homes that is utilized for the limitation
13on recovery of unpaid costs shall remain at the amount in
14effect for this purpose in the fiscal year beginning July 1,
152018.
1610. For the fiscal year beginning July 1, 2019, the
17department shall calculate reimbursement rates for intermediate
18care facilities for persons with an intellectual disability
19at the 80th percentile. Beginning July 1, 2019, the rate
20calculation methodology shall utilize the consumer price index
21inflation factor applicable to the fiscal year beginning July
221, 2019.
2311. Effective July 1, 2019, the child care provider
24reimbursement rates shall remain at the rates in effect on June
2530, 2019. The department shall set rates in a manner so as
26to provide incentives for a nonregistered provider to become
27registered by applying any increase only to registered and
28licensed providers.
2912. The department may adopt emergency rules to implement
30this section.
31 Sec. 33. CONTRACTED SERVICES — PROHIBITED USE OF STATE
32FUNDING FOR LOBBYING.
331. The department shall submit a report to the individuals
34identified in this Act for submission of reports by December
3515, 2019, regarding the outcomes of any program or activity for
-63-1which funding is appropriated or allocated from the general
2fund of the state to the department under this division of this
3Act, and for which a request for proposals process is required.
42. The department shall incorporate into the general
5conditions applicable to all award documents involving funding
6appropriated or allocated from the general fund of the state to
7the department under this division of this Act, a prohibition
8against the use of such funding for the compensation of a
9lobbyist. For the purposes of this section, “lobbyist” means
10the same as defined in section 68B.2; however, “lobbyist”
11does not include a person employed by a state agency of the
12executive branch of state government who represents the agency
13relative to the passage, defeat, approval, or modification of
14legislation that is being considered by the general assembly.
15 Sec. 34. LEGISLATIVE INTERIM COMMITTEE — HEALTH DATA
16COLLECTION. The legislative council shall establish a
17legislative interim committee to review the collection,
18maintaining, and disseminating of hospital inpatient,
19outpatient, and ambulatory data pursuant to section 135.166.
20The committee shall report findings and recommendations to the
21general assembly by December 15, 2019.
22 Sec. 35. EMERGENCY RULES.
231. If specifically authorized by a provision of this
24division of this Act, the department of human services or
25the mental health and disability services commission may
26adopt administrative rules under section 17A.4, subsection
273, and section 17A.5, subsection 2, paragraph “b”, to
28implement the provisions of this division of this Act and
29the rules shall become effective immediately upon filing or
30on a later effective date specified in the rules, unless the
31effective date of the rules is delayed or the applicability
32of the rules is suspended by the administrative rules review
33committee. Any rules adopted in accordance with this section
34shall not take effect before the rules are reviewed by the
35administrative rules review committee. The delay authority
-64-1provided to the administrative rules review committee under
2section 17A.4, subsection 7, and section 17A.8, subsection 9,
3shall be applicable to a delay imposed under this section,
4notwithstanding a provision in those sections making them
5inapplicable to section 17A.5, subsection 2, paragraph “b”.
6Any rules adopted in accordance with the provisions of this
7section shall also be published as a notice of intended action
8as provided in section 17A.4.
92. If during a fiscal year, the department of human
10services is adopting rules in accordance with this section
11or as otherwise directed or authorized by state law, and the
12rules will result in an expenditure increase beyond the amount
13anticipated in the budget process or if the expenditure was
14not addressed in the budget process for the fiscal year, the
15department shall notify the persons designated by this division
16of this Act for submission of reports, the chairpersons and
17ranking members of the committees on appropriations, and
18the department of management concerning the rules and the
19expenditure increase. The notification shall be provided at
20least 30 calendar days prior to the date notice of the rules
21is submitted to the administrative rules coordinator and the
22administrative code editor.
23 Sec. 36. REPORTS. Any reports or other information
24required to be compiled and submitted under this Act during the
25fiscal year beginning July 1, 2019, shall be submitted to the
26chairpersons and ranking members of the joint appropriations
27subcommittee on health and human services, the legislative
28services agency, and the legislative caucus staffs on or
29before the dates specified for submission of the reports or
30information.
31 Sec. 37. EFFECTIVE UPON ENACTMENT. The following
32provisions of this division of this Act, being deemed of
33immediate importance, take effect upon enactment:
341. The provision relating to section 232.141 and directing
35the state court administrator and the division administrator of
-65-1the department of human services division of child and family
2services to make the determination, by June 15, 2019, of the
3distribution of funds allocated for the payment of the expenses
4of court-ordered services provided to juveniles which are a
5charge upon the state.
6DIVISION VI
7HEALTH CARE ACCOUNTS AND FUNDS — FY 2019-2020
8 Sec. 38. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
9appropriated from the pharmaceutical settlement account created
10in section 249A.33 to the department of human services for the
11fiscal year beginning July 1, 2019, and ending June 30, 2020,
12the following amount, or so much thereof as is necessary, to be
13used for the purpose designated:
14Notwithstanding any provision of law to the contrary, to
15supplement the appropriations made in this Act for medical
16contracts under the medical assistance program for the fiscal
17year beginning July 1, 2019, and ending June 30, 2020:
.................................................. $18234,193
19 Sec. 39. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
20SERVICES. Notwithstanding any provision to the contrary and
21subject to the availability of funds, there is appropriated
22from the quality assurance trust fund created in section
23249L.4 to the department of human services for the fiscal year
24beginning July 1, 2019, and ending June 30, 2020, the following
25amounts, or so much thereof as is necessary, for the purposes
26designated:
27To supplement the appropriation made in this Act from the
28general fund of the state to the department of human services
29for medical assistance for the same fiscal year:
.................................................. $3058,570,397
31 Sec. 40. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
32DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
33the contrary and subject to the availability of funds, there is
34appropriated from the hospital health care access trust fund
35created in section 249M.4 to the department of human services
-66-1for the fiscal year beginning July 1, 2019, and ending June
230, 2020, the following amounts, or so much thereof as is
3necessary, for the purposes designated:
4To supplement the appropriation made in this Act from the
5general fund of the state to the department of human services
6for medical assistance for the same fiscal year:
.................................................. $733,920,554
8 Sec. 41. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
9FOR FY 2019-2020. Notwithstanding section 8.33, if moneys
10appropriated for purposes of the medical assistance program for
11the fiscal year beginning July 1, 2019, and ending June 30,
122020, from the general fund of the state, the quality assurance
13trust fund and the hospital health care access trust fund, are
14in excess of actual expenditures for the medical assistance
15program and remain unencumbered or unobligated at the close
16of the fiscal year, the excess moneys shall not revert but
17shall remain available for expenditure for the purposes of the
18medical assistance program until the close of the succeeding
19fiscal year.
20DIVISION VII
21GRADUATED SANCTION, COURT-ORDERED, AND GROUP FOSTER CARE
22SERVICES AND FUNDING WORK GROUP
23 Sec. 42. GRADUATED SANCTION, COURT-ORDERED, AND GROUP
24FOSTER CARE SERVICES AND FUNDING WORK GROUP.
251. As used in this section, unless the context otherwise
26requires:
27a. “Court-ordered services” means the defined or specific
28care and treatment that is ordered by the court for an eligible
29child and for which no other payment source is available to
30cover the cost.
31b. “Department” means the department of human services.
32c. “Eligible child” means a child who has been adjudicated
33delinquent, is at risk, or has been certified by the chief
34juvenile court officer as eligible for court-ordered services.
35d. “Graduated sanction services” includes community-based
-67-1interventions, school-based supervision, and supportive
2enhancements provided in community-based settings to an
3eligible child who is adjudicated delinquent or who is at risk
4of adjudication.
52. The division of criminal and juvenile justice planning
6of the department of human rights shall convene and provide
7administrative support to a work group to review and develop
8a plan to transfer the administration of graduated sanctions
9and court-ordered services and funding and the oversight of
10group foster care placements for eligible children from the
11department to the office of the state court administrator.
12The plan shall ensure that the office of the state court
13administrator has the capacity, resources, and expertise to
14manage the funding and services effectively.
153. a. In addition to a representative of the division of
16criminal and juvenile justice planning of the department of
17human rights, the membership of the work group shall include
18but is not limited to representatives of all of the following:
19(1) The judicial branch, including the state court
20administrator or the state court administrator’s designee,
21a juvenile court judge, at least one chief juvenile court
22officer, and a representative with fiscal and contract
23experience.
24(2) The department of human services, including
25representatives with experience managing graduated sanctions
26funding and group foster care placements.
27(3) The department of justice.
28(4) The juvenile justice advisory committee.
29(5) Member and nonmember agencies of the coalition for
30family and children’s services in Iowa.
31(6) Providers of community-based services for eligible
32children.
33(7) Providers of group foster care.
34(8) Attorneys who represent children in juvenile justice
35proceedings.
-68- 1(9) County attorneys.
2(10) Federal Title IV-E funding and services subject matter
3experts.
4(11) Individuals who formerly received services as eligible
5children or their parents.
6b. In addition, the work group membership shall include
7four members of the general assembly. The legislative members
8shall serve as ex officio, nonvoting members of the work group,
9with one member to be appointed by each of the following: the
10majority leader of the senate, the minority leader of the
11senate, the speaker of the house of representatives, and the
12minority leader of the house of representatives.
13c. In addition to the members specified, the division
14of criminal and juvenile justice planning may include other
15stakeholders with interest or expertise on the work group.
16d. Any expenses incurred by a member of the work group
17shall be the responsibility of the individual member or the
18respective entity represented by the member.
194. The work group shall do all of the following:
20a. Develop an action plan to transfer the administration
21of juvenile court graduated sanction services, court-ordered
22services, and associated funding from the department to the
23office of the state court administrator.
24b. Develop an action plan to transfer the oversight of
25group foster care services for eligible children from the
26department to the office of the state court administrator or
27other appropriate state entity with the necessary expertise to
28provide such services.
29c. Develop an action plan to transfer administration of the
30juvenile detention home fund created in section 232.142 from
31the department to the office of the state court administrator
32or other appropriate state entity.
33d. Evaluate current resources to determine the most
34efficient means of suitably equipping the office of the state
35court administrator with the policies and legal authority;
-69-1staffing; contracting, procurement, data, and quality assurance
2capabilities; and other resources necessary to manage such
3funds and associated services effectively. The evaluation
4shall require collaboration with the department to manage
5transition activities.
6e. Recommend statutory and administrative policies and
7court rules to promote collaborative case planning and quality
8assurance between the department and juvenile court services
9for youth who may be involved in both the child welfare and
10juvenile justice systems or who may utilize the same providers
11or services.
12f. Determine the impact and role of the federal Family
13First Prevention Services Act relative to the various funding
14streams and services under the purview of the work group, and
15recommend statutory and administrative policies and rules to
16coordinate the duties of the work group with implementation and
17administration of the federal Act.
18g. Determine the role of the decategorization of child
19welfare and juvenile justice funding initiative pursuant
20to section 232.188 relative to the other funding streams
21and services under the purview of the work group, and make
22recommendations regarding the future of the initiative
23including the potential transfer of administration of the
24initiative from the department to the office of the state court
25administrator.
26h. Consult with other state juvenile court systems and
27subject matter experts to review administration of similar
28programs, to glean information on lessons learned and best
29practices, and to determine the types of community and
30residential services that have demonstrated effectiveness for
31eligible children.
325. The division of criminal and juvenile justice planning
33of the department of human rights shall submit a report of the
34findings and recommendations of the work group to the governor
35and the general assembly by December 15, 2019.
-70-1DIVISION VIII
2CO-OCCURRING CONDITIONS — ENHANCED DELIVERY OF SERVICES REVIEW
3 Sec. 43. REVIEW TO PROVIDE ENHANCED DELIVERY OF SERVICES
4FOR CO-OCCURRING CONDITIONS. The director of the department
5of public health and the director of the department of human
6services shall develop recommendations for the enhanced
7delivery of co-occurring conditions services. The directors
8shall examine the current service delivery system to identify
9opportunities for reducing the administrative burden on the
10departments and providers, evaluate the use of an integrated
11helpline and website and improvements in data collection
12and sharing of outcomes, and create a structure for ongoing
13collaboration. The directors shall submit a report including
14findings, a five-year plan to address co-occurring conditions
15across provider types and payors, and other recommendations to
16the governor and general assembly by December 15, 2019.
17DIVISION IX
18MEDICAID MANAGED CARE CONTRACTS
19 Sec. 44. MEDICAID MANAGED CARE CONTRACTS — NOTIFICATION
20TO GENERAL ASSEMBLY. The department of human services shall
21notify the chairpersons and ranking members of the joint
22appropriations subcommittee on health and human services, the
23legislative services agency, and the legislative caucus staffs
24as follows:
251. Within thirty days of the execution of a Medicaid managed
26care contract or amendment to a Medicaid managed care contract.
272. Within thirty days of the determination by the
28department during each measurement year whether to return the
29incentive payment withhold amount to the Medicaid managed care
30organization based upon performance and the criteria used in
31making the determination.
32DIVISION X
33IOWA DEPARTMENT ON AGING — MEDICAID CLAIMING
34 Sec. 45. IOWA DEPARTMENT ON AGING — MEDICAID CLAIMING. The
35department on aging and the department of human services shall
-71-1continue to collaborate to develop a cost allocation plan
2requesting Medicaid administrative funding to provide for the
3claiming of federal financial participation for aging and
4disability resource center activities that are performed to
5assist with administration of the Medicaid program. By January
61, 2021, the department of human services shall submit to
7the centers for Medicare and Medicaid services of the United
8States department of health and human services any Medicaid
9state plan amendment as necessary and shall enter into any
10interagency agreement with the department on aging to implement
11this section.
12DIVISION XI
13DECATEGORIZATION FY 2017 CARRYOVER FUNDING
14 Sec. 46. DECATEGORIZATION CARRYOVER FUNDING FY 2017 —
15TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
16subsection 5, paragraph “b”, any state-appropriated moneys in
17the funding pool that remained unencumbered or unobligated
18at the close of the fiscal year beginning July 1, 2016, and
19were deemed carryover funding to remain available for the two
20succeeding fiscal years that still remain unencumbered or
21unobligated at the close of the fiscal year beginning July 1,
222018, shall not revert but shall be transferred to the medical
23assistance program for the fiscal year beginning July 1, 2019.
24 Sec. 47. EFFECTIVE DATE. This division of this Act, being
25deemed of immediate importance, takes effect upon enactment.
26 Sec. 48. RETROACTIVE APPLICABILITY. This division of this
27Act applies retroactively to July 1, 2018.
28DIVISION XII
29PRIOR APPROPRIATIONS AND OTHER PROVISIONS
30TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF)
31 Sec. 49. 2017 Iowa Acts, chapter 174, section 45, as amended
32by 2018 Iowa Acts, chapter 1165, section 10, is amended to read
33as follows:
34SEC. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
35GRANT. There is appropriated from the fund created in section
-72-18.41 to the department of human services for the fiscal year
2beginning July 1, 2018, and ending June 30, 2019, from moneys
3received under the federal temporary assistance for needy
4families (TANF) block grant pursuant to the federal Personal
5Responsibility and Work Opportunity Reconciliation Act of 1996,
6Pub.L.No.104-193, and successor legislation, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
91. To be credited to the family investment program account
10and used for assistance under the family investment program
11under chapter 239B:
.................................................. $124,539,006
134,025,108
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
195,192,060
203. To be used for the family development and
21self-sufficiency grant program in accordance with section
22216A.107:
.................................................. $232,883,980
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, 2019, the
31moneys shall revert.
324. For field operations:
.................................................. $3331,296,232
3432,465,681
355. For general administration:
-73-.................................................. $13,744,000
26. For state child care assistance:
.................................................. $347,166,826
4a. Of the funds appropriated in this subsection,
5$26,205,412 is transferred to the child care and development
6block grant appropriation made by the Eighty-seventh General
7Assembly, 2018 session, for the federal fiscal year beginning
8October 1, 2018, and ending September 30, 2019. Of this
9amount, $200,000 shall be used for provision of educational
10opportunities to registered child care home providers in order
11to improve services and programs offered by this category
12of providers and to increase the number of providers. The
13department may contract with institutions of higher education
14or child care resource and referral centers to provide
15the educational opportunities. Allowable administrative
16costs under the contracts shall not exceed 5 percent. The
17application for a grant shall not exceed two pages in length.
18b. Any funds appropriated in this subsection remaining
19unallocated shall be used for state child care assistance
20payments for families who are employed including but not
21limited to individuals enrolled in the family investment
22program.
237. For child and family services:
.................................................. $2432,380,654
258. For child abuse prevention grants:
.................................................. $26125,000
279. For pregnancy prevention grants on the condition that
28family planning services are funded:
.................................................. $291,913,203
301,890,203
31Pregnancy prevention grants shall be awarded to programs
32in existence on or before July 1, 2018, if the programs have
33demonstrated positive outcomes. Grants shall be awarded to
34pregnancy prevention programs which are developed after July
351, 2018, if the programs are based on existing models that
-74-1have demonstrated positive outcomes. Grants shall comply with
2the requirements provided in 1997 Iowa Acts, chapter 208,
3section 14, subsections 1 and 2, including the requirement that
4grant programs must emphasize sexual abstinence. Priority in
5the awarding of grants shall be given to programs that serve
6areas of the state which demonstrate the highest percentage of
7unplanned pregnancies of females of childbearing age within the
8geographic area to be served by the grant.
910. For technology needs and other resources necessary
10to meet federal welfare reform reporting, tracking, and case
11management requirements:
.................................................. $121,037,186
13862,186
1411. a. Notwithstanding any provision to the contrary,
15including but not limited to requirements in section 8.41 or
16provisions in 2017 or 2018 Iowa Acts regarding the receipt and
17appropriation of federal block grants, federal funds from the
18temporary assistance for needy families block grant received by
19the state and not otherwise appropriated in this section and
20remaining available for the fiscal year beginning July 1, 2018,
21are appropriated to the department of human services to the
22extent as may be necessary to be used in the following priority
23order: the family investment program, for state child care
24assistance program payments for families who are employed, and
25for the family investment program share of system costs for
26eligibility determination and related functions. The federal
27funds appropriated in this paragraph “a” shall be expended
28only after all other funds appropriated in subsection 1 for
29assistance under the family investment program, in subsection 6
30for child care assistance, or in subsection 10 for technology
31costs related to the family investment program, as applicable,
32have been expended. For the purposes of this subsection, the
33funds appropriated in subsection 6, paragraph “a”, for transfer
34to the child care and development block grant appropriation
35are considered fully expended when the full amount has been
-75-1transferred.
2b. The department shall, on a quarterly basis, advise the
3legislative services agency and department of management of
4the amount of funds appropriated in this subsection that was
5expended in the prior quarter.
612. Of the amounts appropriated in this section,
7$12,962,008 for the fiscal year beginning July 1, 2018, is
8transferred to the appropriation of the federal social services
9block grant made to the department of human services for that
10fiscal year.
1113. For continuation of the program providing categorical
12eligibility for the food assistance program as specified
13for the program in the section of this division of this Act
14relating to the family investment program account:
.................................................. $1514,236
1613,000
1714. The department may transfer funds allocated in this
18section to the appropriations made in this division of this Act
19for the same fiscal year for general administration and field
20operations for resources necessary to implement and operate the
21services referred to in this section and those funded in the
22appropriation made in this division of this Act for the same
23fiscal year for the family investment program from the general
24fund of the state.
2515. With the exception of moneys allocated under this
26section for the family development and self-sufficiency grant
27program, to the extent moneys allocated in this section are
28deemed by the department not to be necessary to support the
29purposes for which they are allocated, such moneys may be
30used in the same fiscal year for any other purpose for which
31funds are allocated in this section or in section 7 of this
32division for the family investment program account. If there
33are conflicting needs, priority shall first be given to the
34family investment program account as specified under subsection
351 of this section and used for the purposes of assistance under
-76-1the family investment program under chapter 239B, followed by
2state child care assistance program payments for families who
3are employed, followed by other priorities as specified by the
4department.
5FAMILY INVESTMENT PROGRAM ADJUSTMENTS
6 Sec. 50. 2017 Iowa Acts, chapter 174, section 46, subsection
74, as amended by 2018 Iowa Acts, chapter 1165, section 11, is
8amended to read as follows:
94. Moneys appropriated in this division of this Act and
10credited to the FIP account for the fiscal year beginning July
111, 2018, and ending June 30, 2019, are allocated as follows:
12a. To be retained by the department of human services to
13be used for coordinating with the department of human rights
14to more effectively serve participants in FIP and other shared
15clients and to meet federal reporting requirements under the
16federal temporary assistance for needy families block grant:
.................................................. $175,000
1820,000
19b. To the department of human rights for staffing,
20administration, and implementation of the family development
21and self-sufficiency grant program in accordance with section
22216A.107:
.................................................. $236,192,834
24(1) Of the funds allocated for the family development
25and self-sufficiency grant program in this paragraph “b”,
26not more than 5 percent of the funds shall be used for the
27administration of the grant program.
28(2) The department of human rights may continue to implement
29the family development and self-sufficiency grant program
30statewide during fiscal year 2018-2019.
31(3) The department of human rights may engage in activities
32to strengthen and improve family outcomes measures and
33data collection systems under the family development and
34self-sufficiency grant program.
35c. For the diversion subaccount of the FIP account:
-77-.................................................. $1749,694
2815,000
3A portion of the moneys allocated for the subaccount may
4be used for field operations, salaries, data management
5system development, and implementation costs and support
6deemed necessary by the director of human services in order to
7administer the FIP diversion program. To the extent moneys
8allocated in this paragraph “c” are deemed by the department
9not to be necessary to support diversion activities, such
10moneys may be used for other efforts intended to increase
11engagement by family investment program participants in work,
12education, or training activities, or for the purposes of
13assistance under the family investment program in accordance
14with chapter 239B.
15d. For the food assistance employment and training program:
.................................................. $1666,588
17(1) The department shall apply the federal supplemental
18nutrition assistance program (SNAP) employment and training
19state plan in order to maximize to the fullest extent permitted
20by federal law the use of the 50 percent federal reimbursement
21provisions for the claiming of allowable federal reimbursement
22funds from the United States department of agriculture
23pursuant to the federal SNAP employment and training program
24for providing education, employment, and training services
25for eligible food assistance program participants, including
26but not limited to related dependent care and transportation
27expenses.
28(2) The department shall continue the categorical federal
29food assistance program eligibility at 160 percent of the
30federal poverty level and continue to eliminate the asset test
31from eligibility requirements, consistent with federal food
32assistance program requirements. The department shall include
33as many food assistance households as is allowed by federal
34law. The eligibility provisions shall conform to all federal
35requirements including requirements addressing individuals who
-78-1are incarcerated or otherwise ineligible.
2e. For the JOBS program:
.................................................. $312,139,821
411,919,821
5MEDICAL ASSISTANCE PROGRAM ADJUSTMENT
6 Sec. 51. 2017 Iowa Acts, chapter 174, section 51, unnumbered
7paragraph 2, as amended by 2018 Iowa Acts, chapter 1165,
8section 18, is amended to read as follows:
9For medical assistance program reimbursement and associated
10costs as specifically provided in the reimbursement
11methodologies in effect on June 30, 2018, except as otherwise
12expressly authorized by law, consistent with options under
13federal law and regulations, and contingent upon receipt of
14approval from the office of the governor of reimbursement for
15each abortion performed under the program:
.................................................. $161,337,841,375
171,488,141,375
18GROUP FOSTER CARE REALLOCATION
19 Sec. 52. 2017 Iowa Acts, chapter 174, section 57, subsection
203, paragraph a, as amended by 2018 Iowa Acts, chapter 1165,
21section 28, is amended to read as follows:
22a. Of the funds appropriated in this section, up to
23$34,536,648 is allocated as the statewide expenditure target
24under section 232.143 for group foster care maintenance and
25services. If the department projects that such expenditures
26for the fiscal year will be less than the target amount
27allocated in this paragraph “a”, the department may reallocate
28the excess to provide additional funding for family foster
29care, independent living, family safety, risk and permanency
30services, shelter care, or the child welfare emergency services
31addressed with the allocation for shelter care.
32SHELTER CARE ALLOCATION
33 Sec. 53. 2017 Iowa Acts, chapter 174, section 57, subsection
346, as amended by 2018 Iowa Acts, chapter 1165, section 28, is
35amended to read as follows:
-79- 16. Notwithstanding section 234.35 or any other provision of
2law to the contrary, state funding Of the funds appropriated
3in this section, a sufficient amount is allocated for shelter
4care and the child welfare emergency services contracting
5implemented to provide for or prevent the need for shelter care
6shall be limited to $8,096,158.
7OTHER FUNDING FOR CHILD WELFARE SERVICES
8 Sec. 54. 2017 Iowa Acts, chapter 174, section 57, subsection
96, as amended by 2018 Iowa Acts, chapter 1165, section 28, is
10amended by adding the following new subsection:
11 NEW SUBSECTION. 24. If a separate funding source is
12identified that reduces the need for state funds within an
13allocation under this section, the allocated state funds may be
14redistributed to other allocations under this section for the
15same fiscal year.
16 Sec. 55. EFFECTIVE DATE. This division of this Act, being
17deemed of immediate importance, takes effect upon enactment.
18 Sec. 56. RETROACTIVE APPLICABILITY. This division of this
19Act applies retroactively to July 1, 2018.
20DIVISION XIII
21HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM FUTURE REPEAL
22 Sec. 57. Section 249M.5, Code 2019, is amended to read as
23follows:
24249M.5 Future repeal.
25This chapter is repealed July 1, 2019 2021.
26 Sec. 58. EFFECTIVE DATE. This division of this Act, being
27deemed of immediate importance, takes effect upon enactment.
28DIVISION XIV
29MENTAL HEALTH AND DISABILITY SERVICES — TRANSFER OF FUNDS
30 Sec. 59. MENTAL HEALTH AND DISABILITY SERVICES — TRANSFER
31OF FUNDS. Notwithstanding section 331.432, a county with a
32population of over 300,000 based on the most recent federal
33decennial census, may transfer funds from any other fund of the
34county to the mental health and disability regional services
35fund for the purposes of providing mental health and disability
-80-1services for the fiscal year beginning July 1, 2019, and
2ending June 30, 2020. The county shall submit a report to
3the governor and the general assembly by September 1, 2020,
4including the source of any funds transferred, the amount of
5the funds transferred, and the mental health and disability
6services provided with the transferred funds.
7DIVISION XV
8OPERATION OF BOARD OF MEDICINE, BOARD OF NURSING, BOARD OF
9PHARMACY, AND THE DENTAL BOARD
10 Sec. 60. Section 135.11A, subsection 1, Code 2019, is
11amended to read as follows:
121. There shall be a professional licensure division within
13the department of public health. Each board under chapter 147
14or under the administrative authority of the department, except
15the board of nursing, board of medicine, dental board, and
16board of pharmacy, shall receive administrative and clerical
17support from the division and may not employ its own support
18staff for administrative and clerical duties. The executive
19director of the board of nursing, board of medicine, dental
20board, and board of pharmacy shall be appointed pursuant to
21section 135.11B.
22 Sec. 61. NEW SECTION. 135.11B Appointment of certain
23executive directors.
241. The director shall appoint and supervise a full-time
25executive director for each of the following boards:
26a. The board of medicine.
27b. The board of nursing.
28c. The dental board.
29d. The board of pharmacy.
302. Each board listed in subsection 1 shall advise the
31director in evaluating potential candidates for the position of
32executive director, consult with the director in the hiring of
33the executive director, and review and advise the director on
34the performance of the executive director in the discharge of
35the executive director’s duties.
-81- 13. Each board listed in subsection 1 shall retain sole
2discretion and authority to execute the core functions of the
3board including but not limited to policymaking, advocating
4for and against legislation, rulemaking, licensing, licensee
5investigations, licensee disciplinary proceedings, and
6oversight of professional health programs. The director’s
7supervision of the executive director shall not interfere with
8the board’s discretion and authority in executing the core
9functions of the board.
10 Sec. 62. Section 147.80, subsection 3, Code 2019, is amended
11to read as follows:
123. The board of medicine, the board of pharmacy, the
13dental board, and the board of nursing shall retain individual
14executive officers pursuant to section 135.11B, but shall
15make every effort to share administrative, clerical, and
16investigative staff to the greatest extent possible.
17 Sec. 63. Section 152.2, Code 2019, is amended to read as
18follows:
19152.2 Executive director.
20The board shall appoint retain a full-time executive
21director, who shall be appointed pursuant to section 135B.11.
22The executive director shall be a registered nurse and shall
23not be a member of the board. The governor, with the approval
24of the executive council pursuant to section 8A.413, subsection
253, under the pay plan for exempt positions in the executive
26branch of government, shall set the salary of the executive
27director.
28 Sec. 64. Section 153.33, subsection 2, Code 2019, is amended
29to read as follows:
302. All employees needed to administer this chapter except
31the executive director shall be appointed pursuant to the merit
32system. The executive director shall serve at the pleasure of
33the board be appointed pursuant to section 135.11B and shall
34be exempt from the merit system provisions of chapter 8A,
35subchapter IV.
-82-1DIVISION XVI
2MEDICAID PRIOR AUTHORIZATION — UNIFORM PROCESS — CENTRAL
3PORTAL
4 Sec. 65. MEDICAID — PRIOR AUTHORIZATION UNIFORM
5PROCESS. The department of human services shall adopt rules
6pursuant to chapter 17A to require, and shall contractually
7require, that both managed care and fee-for-service payment
8and delivery systems utilize a uniform process, including but
9not limited to uniform forms, information requirements, and
10time frames, to request prior authorization under the Medicaid
11program no later than October 1, 2019.
12 Sec. 66. MEDICAID MANAGEMENT INFORMATION SYSTEM — CENTRAL
13PORTAL — REVIEW. The department shall review the costs
14associated with expanding the medical assistance management
15information system to integrate a single, statewide system
16to serve as a central portal for submission of all prior
17authorization requests for the Medicaid program. The portal
18shall not be designed to make or review final determinations
19of managed care organization prior authorization requests, but
20shall only serve as a conduit to deliver prior authorization
21requests to the appropriate managed care organization. The
22results of the study shall be submitted to the governor and the
23general assembly no later than March 31, 2020.
24 Sec. 67. EFFECTIVE DATE. This division of this Act, being
25deemed of immediate importance, takes effect upon enactment.
26DIVISION XVII
27HEALTH AND HUMAN SERVICES EXECUTIVE BRANCH ENTITIES — REFORM
28Iowa collaborative safety net provider network
29 Sec. 68. Section 135.24, subsection 7, paragraph e, Code
302019, is amended to read as follows:
31e. “Specialty health care provider office” means the
32private office or clinic of an individual specialty health
33care provider or group of specialty health care providers as
34referred by the Iowa collaborative safety net provider network
35established in section 135.153, but does not include a field
-83-1dental clinic, a free clinic, or a hospital.
2 Sec. 69. Section 135.159, subsection 1, paragraph h, Code
32019, is amended by striking the paragraph.
4 Sec. 70. REPEAL. Section 135.153, Code 2019, is repealed.
5Hospital health care access trust fund board
6 Sec. 71. Section 249M.4, Code 2019, is amended to read as
7follows:
8249M.4 Hospital health care access trust fund — board.
91. A hospital health care access trust fund is created
10in the state treasury under the authority of the department.
11Moneys received through the collection of the hospital health
12care access assessment imposed under this chapter and any
13other moneys specified for deposit in the trust fund shall be
14deposited in the trust fund.
152. Moneys in the trust fund shall be used, subject to
16their appropriation by the general assembly, by the department
17to reimburse participating hospitals the medical assistance
18program upper payment limit for inpatient and outpatient
19hospital services as calculated in this section. Following
20payment of such upper payment limit to participating hospitals,
21any remaining funds in the trust fund on an annual basis may be
22used for any of the following purposes:
23a. To support medical assistance program utilization
24shortfalls.
25b. To maintain the state’s capacity to provide access to and
26delivery of services for vulnerable Iowans.
27c. To fund the health care workforce support initiative
28created pursuant to section 135.175.
29d. To support access to health care services for uninsured
30Iowans.
31e. To support Iowa hospital programs and services which
32expand access to health care services for Iowans.
333. The trust fund shall be separate from the general fund
34of the state and shall not be considered part of the general
35fund. The moneys in the trust fund shall not be considered
-84-1revenue of the state, but rather shall be funds of the hospital
2health care access assessment program. The moneys deposited
3in the trust fund are not subject to section 8.33 and shall not
4be transferred, used, obligated, appropriated, or otherwise
5encumbered, except to provide for the purposes of this chapter.
6Notwithstanding section 12C.7, subsection 2, interest or
7earnings on moneys deposited in the trust fund shall be
8credited to the trust fund.
94. The department shall adopt rules pursuant to chapter
1017A to administer the trust fund and reimbursements and
11expenditures as specified in this chapter made from the trust
12fund.
135. a. Beginning July 1, 2010, or the implementation date
14of the hospital health care access assessment program as
15determined by receipt of approval from the centers for Medicare
16and Medicaid services of the United States department of health
17and human services, whichever is later, the department shall
18increase the diagnostic related groups and ambulatory patient
19classifications base rates to provide payments to participating
20hospitals at the Medicare upper payment limit for the fiscal
21year beginning July 1, 2010, calculated as of July 31, 2010.
22Each participating hospital shall receive the same percentage
23increase, but the percentage may differ depending on whether
24the basis for the base rate increase is the diagnostic related
25groups or ambulatory patient classifications.
26b. The percentage increase shall be calculated by dividing
27the amount calculated under subparagraph (1) by the amount
28calculated under subparagraph (2) as follows:
29(1) The amount under the Medicare upper payment limit for
30the fiscal year beginning July 1, 2010, for participating
31hospitals.
32(2) The projected expenditures for participating hospitals
33for the fiscal year beginning July 1, 2010, as determined by
34the fiscal management division of the department, plus the
35amount calculated under subparagraph (1).
-85- 16. For the fiscal year beginning July 1, 2011, and for
2each fiscal year beginning July 1, thereafter, the payments to
3participating hospitals shall continue to be calculated based
4on the upper payment limit as calculated for the fiscal year
5beginning July 1, 2010.
67. Reimbursement of participating hospitals shall
7incorporate the rebasing process for inpatient and outpatient
8services for state fiscal year 2012. However, the total amount
9of increased funding available for reimbursement attributable
10to rebasing shall not exceed four million five hundred thousand
11dollars for state fiscal year 2012 and six million dollars for
12state fiscal year 2013.
138. Any payments to participating hospitals under this
14section shall result in budget neutrality to the general fund
15of the state.
169. a. A hospital health care access trust fund board is
17established consisting of the following members:
18(1) The co-chairpersons and the ranking members of the joint
19appropriations subcommittee on health and human services.
20(2) The Iowa medical assistance program director.
21(3) Two hospital executives representing the two largest
22private health care systems in the state.
23(4) The president of the Iowa hospital association.
24(5) A representative of a consumer advocacy group, involved
25in both state and national initiatives, that provides data on
26key indicators of well-being for children and families in order
27to inform policymakers to help children and families succeed.
28b. The board shall do all of the following:
29(1) Provide oversight of the trust fund.
30(2) Make recommendations regarding the hospital health care
31access assessment program, including recommendations regarding
32the assessment calculation, assessment amounts, payments to
33participating hospitals, and use of the moneys in the trust
34fund.
35(3) Submit an annual report to the governor and the general
-86-1assembly regarding the use and expenditure of moneys deposited
2in the trust fund.
3c. The department shall provide administrative assistance
4to the board.
5Advisory COMMITTEE TO THE CENTER for rural health and primary
6care
7 Sec. 72. Section 135.107, subsection 5, Code 2019, is
8amended by striking the subsection.
9 Sec. 73. Section 262.78, subsection 3, Code 2019, is amended
10to read as follows:
113. The president of the university of Iowa, in consultation
12with the president of Iowa state university of science and
13technology, shall employ a full-time director of the center.
14The center may employ staff to carry out the center’s purpose.
15The director shall coordinate the agricultural health and
16safety programs of the center. The director shall regularly
17meet and consult with the advisory committee to the center for
18rural health and primary care. The director shall provide
19the board of regents with relevant information regarding the
20center.
21Governmental public health advisory council
22 Sec. 74. Section 135A.2, subsection 2, Code 2019, is amended
23by striking the subsection.
24 Sec. 75. Section 135A.9, subsection 1, Code 2019, is amended
25by striking the subsection.
26 Sec. 76. REPEAL. Section 135A.4, Code 2019, is repealed.
27Patient-centered health advisory council
28 Sec. 77. REPEAL. Section 135.159, Code 2019, is repealed.
29Combining state medical examiner advisory council with the
30interagency coordinating council
31 Sec. 78. Section 691.6B, Code 2019, is amended to read as
32follows:
33691.6B Interagency coordinating council.
341. An interagency coordinating council is created to advise
35 do all of the following:
-87- 1a. Advise and consult withthe state medical examiner on a
2range of issues affecting the organization and functions of the
3office of the state medical examiner and the effectiveness of
4the medical examiner system in the state.
5b. Advise the state medical examinerconcerning the
6assurance of effective coordination of the functions and
7operations of the office of the state medical examiner with the
8needs and interests of the departments of public safety and
9public health.
102. Members of the interagency coordinating council shall
11include the all of the following:
12a. Thestate medical examiner, or when the state medical
13examiner is not available, the deputy state medical examiner;
14the.
15b. Thecommissioner of public safety or the commissioner’s
16designee; the.
17c. Thedirector of public health or the director’s designee;
18and the.
19d. Thegovernor or the governor’s designee.
20e. Representatives from the office of the attorney
21general, the Iowa county attorneys association, the Iowa
22medical society, the Iowa association of pathologists, the
23Iowa association of county medical examiners, the statewide
24emergency medical system, and the Iowa funeral directors
25association.
263. The interagency coordinating council shall meet on
27a regular basis, and shall be organized and function as
28established by the state medical examiner by rule.
29 Sec. 79. REPEAL. Section 691.6C, Code 2019, is repealed.
30Tobacco use prevention and control commission — MEMBERSHIP —
31MEETINGS — EXPENSES
32 Sec. 80. Section 142A.3, subsection 6, Code 2019, is amended
33to read as follows:
346. Citizen members shall be reimbursed for actual and
35necessary expenses incurred in performance of their duties.
-88-1Citizen members shall be paid a per diem as specified in
2section 7E.6. Legislative members are eligible for per diem
3and expenses as provided in section 2.10.
4 Sec. 81. Section 142A.3, subsection 9, Code 2019, is amended
5to read as follows:
69. The commission shall elect a chairperson from among its
7voting members and may select other officers from among its
8voting members, as determined necessary by the commission.
9The commission shall meet regularly no more than quarterly as
10determined by the commission, upon the call of the chairperson,
11or upon the call of a majority of the voting members.
12 Sec. 82. TOBACCO USE PREVENTION AND CONTROL COMMISSION —
13MEMBERSHIP REDUCTION. The tobacco use prevention and control
14commission shall evaluate the membership of the commission
15and shall submit to the department of public health the
16commission’s recommendation, to be submitted by the director
17of public health as proposed legislation in compliance with
18section 2.16 for consideration by the general assembly during
19the 2020 legislative session, to reduce the number of voting
20members from nine to seven members.
21Trauma system advisory council
22 Sec. 83. Section 147A.24, subsection 2, Code 2019, is
23amended to read as follows:
242. The council shall consist of seven members to be
25appointed by the director from the recommendations of
26the organizations in subsection 1 for terms of two years.
27Vacancies on the council shall be filled for the remainder of
28the term of the original appointment. Members whose terms
29expire may be reappointed.
30 Sec. 84. TRANSITION PROVISIONS. Notwithstanding any
31provision of section 147A.24, subsection 2, to the contrary, a
32member of the trauma system advisory council on July 1, 2019,
33shall continue serving until the expiration of that member’s
34term or until a vacancy occurs prior to the expiration of the
35applicable term, and such vacancy shall only be filled to the
-89-1extent consistent with and necessary to maintain the total
2number of members of the council specified in section 147A.24,
3subsection 2, as amended in this Act.
4Teleconference option for state entities
5 Sec. 85. NEW SECTION. 135.11B Statutory board, commission,
6committee, or council of committee — teleconference option.
7Any statutorily established board, commission, committee, or
8council established under the purview of the department shall
9provide for a teleconference option for board, commission,
10committee, or council members to participate in official
11meetings.
12Elimination of payment of expenses for public members of
13certain state entities
14 Sec. 86. Section 105.3, subsection 6, Code 2019, is amended
15by striking the subsection.
16 Sec. 87. Section 135.43, subsection 2, unnumbered paragraph
171, Code 2019, is amended to read as follows:
18The membership of the review team is subject to the
19provisions of sections 69.16 and 69.16A, relating to political
20affiliation and gender balance. Review team members who
21are not designated by another appointing authority shall be
22appointed by the state medical examiner. Membership terms
23shall be for three years. A membership vacancy shall be filled
24in the same manner as the original appointment. The review
25team shall elect a chairperson and other officers as deemed
26necessary by the review team. The review team shall meet upon
27the call of the state medical examiner or as determined by
28the review team. The members of the team are eligible for
29reimbursement of actual and necessary expenses incurred in the
30performance of their official duties. The review team shall
31include the following:
32 Sec. 88. Section 135.62, subsection 2, paragraph e, Code
332019, is amended by striking the paragraph.
34 Sec. 89. Section 147A.3, Code 2019, is amended to read as
35follows:
-90- 1147A.3 Meetings of the council — quorum — expenses.
2Membership, terms of office, and quorum, and expenses shall
3be determined by the director pursuant to chapter 135.
4 Sec. 90. Section 256I.3, subsection 3, Code 2019, is amended
5by striking the subsection.
6Elimination of CHILD WELFARE ADVISORY COMMITTEE, CHILD
7SUPPORT ADVISORY COMMITTEE, CHILDREN’S MENTAL HEALTH WAIVER
8IMPLEMENTATION COMMITTEE, AND PROPERTY TAX RELIEF FUND RISK
9POOL
10 Sec. 91. Section 217.3A, subsection 1, Code 2019, is amended
11to read as follows:
121. General. The council on human services shall establish
13and utilize the advisory committees committee identified in
14this section and may establish and utilize other advisory
15committees. The council shall establish appointment
16provisions, membership terms, operating guidelines, and other
17operational requirements for committees established pursuant to
18this section.
19 Sec. 92. Section 217.3A, subsections 3 and 4, Code 2019, are
20amended by striking the subsections.
21 Sec. 93. Section 426B.5, subsection 1, Code 2019, is amended
22by striking the subsection.
23 Sec. 94. 2005 Iowa Acts, chapter 117, section 4, subsection
243, is amended by striking the subsection.
25MEDICAL ASSISTANCE ADVISORY COUNCIL
26 Sec. 95. MEDICAL ASSISTANCE ADVISORY COUNCIL — VOTING
27MEMBER SUSPENSION. Notwithstanding any provision of law to the
28contrary, if a representative of a professional or business
29entity, a public member, or a member of the hawk-i board who
30is a voting member of the medical assistance advisory council
31pursuant to section 249A.4B, subsection 2, is absent for
32two consecutive meetings of the medical assistance advisory
33council, the member shall be suspended from participation in
34the deliberations of the advisory council for a period of
35twelve months from the date of the member’s second absence.
-91-1During the member’s suspension period, the voting rights of the
2professional or business entity, consumer group or consumer
3organization, or the hawk-i board shall not be exercised, but
4the vacancy in voting membership shall not prohibit the medical
5assistance advisory council from achieving a quorum.
6DIVISION XVIII
7MEDICAID MANAGED CARE TERMINATION — EXPEDITED claims dispute
8PROCESS
9 Sec. 96. MEDICAID MANAGED CARE TERMINATION — EXPEDITED
10CLAIMS DISPUTE PROCESS. No later than July 1, 2019, the
11department of human services shall require an expedited claims
12dispute process for all outstanding claims to be applicable
13if a managed care organization terminates coverage under the
14Medicaid program. Such an expedited claims dispute process
15shall, beginning on the date a managed care organization
16terminates coverage, allow a provider, a member, or a member’s
17authorized representative the option to dispute the managed
18care organization’s claim adjudication within the required time
19frames and consistent with this section. The managed care
20organization shall report all disputed claims being processed
21and the outcomes of such disputed claims to the department on a
22monthly basis for at least two years following termination of
23the managed care organization’s contract with the state.
pf/rn/md
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE 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, and for not more than the following
18full-time equivalent positions:
.................................................. $1911,191,441
............................................... FTEs2027.00
211. Funds appropriated in this section may be used to
22supplement federal funds under federal regulations. To
23receive funds appropriated in this section, a local area
24agency on aging shall match the funds with moneys from other
25sources according to rules adopted by the department. Funds
26appropriated in this section may be used for elderly services
27not specifically enumerated in this section only if approved
28by an area agency on aging for provision of the service within
29the area.
302. Of the funds appropriated in this section, $279,000 is
31transferred to the economic development authority for the Iowa
32commission on volunteer services to be used for the retired and
33senior volunteer program.
343. a. The department on aging shall establish and enforce
35procedures relating to expenditure of state and federal funds
-1-1by area agencies on aging that require compliance with both
2state and federal laws, rules, and regulations, including but
3not limited to all of the following:
4(1) Requiring that expenditures are incurred only for goods
5or services received or performed prior to the end of the
6fiscal period designated for use of the funds.
7(2) Prohibiting prepayment for goods or services not
8received or performed prior to the end of the fiscal period
9designated for use of the funds.
10(3) Prohibiting prepayment for goods or services not
11defined specifically by good or service, time period, or
12recipient.
13(4) Prohibiting the establishment of accounts from which
14future goods or services which are not defined specifically by
15good or service, time period, or recipient, may be purchased.
16b. The procedures shall provide that if any funds are
17expended in a manner that is not in compliance with the
18procedures and applicable federal and state laws, rules, and
19regulations, and are subsequently subject to repayment, the
20area agency on aging expending such funds in contravention of
21such procedures, laws, rules and regulations, not the state,
22shall be liable for such repayment.
234. Of the funds appropriated in this section, at least
24$600,000 shall be used to fund home and community-based
25services through the area agencies on aging that enable older
26individuals to avoid more costly utilization of residential or
27institutional services and remain in their own homes.
285. Of the funds appropriated in this section, $812,000 shall
29be used for the purposes of chapter 231E and to administer
30the prevention of elder abuse, neglect, and exploitation
31program pursuant to section 231.56A, in accordance with the
32requirements of the federal Older Americans Act of 1965, 42
33U.S.C.§3001 et seq., as amended.
346. Of the funds appropriated in this section, $1,000,000
35shall be used to fund continuation of the aging and disability
-2-1resource center lifelong links to provide individuals and
2caregivers with information and services to plan for and
3maintain independence.
47. Of the funds appropriated in this section, $250,000
5shall be used by the department on aging, in collaboration with
6the department of human services and affected stakeholders, to
7expand the pilot initiative to provide long-term care options
8counseling utilizing support planning protocols, to assist
9non-Medicaid eligible consumers who indicate a preference
10to return to the community and are deemed appropriate for
11discharge, to return to their community following a nursing
12facility stay. The department on aging shall submit a report
13regarding the outcomes of the pilot initiative to the governor
14and the general assembly by December 15, 2019.
15DIVISION II
16OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2019-2020
17 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
18appropriated from the general fund of the state to the office
19of long-term care ombudsman for the fiscal year beginning July
201, 2019, and ending June 30, 2020, the following amount, or
21so much thereof as is necessary, to be used for the purposes
22designated:
23For salaries, support, administration, maintenance, and
24miscellaneous purposes, and for not more than the following
25full-time equivalent positions:
.................................................. $261,149,821
............................................... FTEs2716.00
28DIVISION III
29DEPARTMENT OF PUBLIC HEALTH — FY 2019-2020
30 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
31from the general fund of the state to the department of public
32health for the fiscal year beginning July 1, 2019, and ending
33June 30, 2020, the following amounts, or so much thereof as is
34necessary, to be used for the purposes designated:
351. ADDICTIVE DISORDERS
-3- 1For reducing the prevalence of the use of tobacco, alcohol,
2and other drugs, and treating individuals affected by addictive
3behaviors, including gambling, and for not more than the
4following full-time equivalent positions:
.................................................. $525,110,000
............................................... FTEs611.00
7a. (1) Of the funds appropriated in this subsection,
8$4,021,000 shall be used for the tobacco use prevention
9and control initiative, including efforts at the state and
10local levels, as provided in chapter 142A. The commission
11on tobacco use prevention and control established pursuant
12to section 142A.3 shall advise the director of public health
13in prioritizing funding needs and the allocation of moneys
14appropriated for the programs and initiatives. Activities
15of the programs and initiatives shall be in alignment with
16the United States centers for disease control and prevention
17best practices for comprehensive tobacco control programs that
18include the goals of preventing youth initiation of tobacco
19usage, reducing exposure to secondhand smoke, and promotion
20of tobacco cessation. To maximize resources, the department
21shall determine if third-party sources are available to
22instead provide nicotine replacement products to an applicant
23prior to provision of such products to an applicant under
24the initiative. The department shall track and report to
25the individuals specified in this Act, any reduction in
26the provision of nicotine replacement products realized by
27the initiative through implementation of the prerequisite
28screening.
29(2) (a) The department shall collaborate with the
30alcoholic beverages division of the department of commerce for
31enforcement of tobacco laws, regulations, and ordinances and to
32engage in tobacco control activities approved by the division
33of tobacco use prevention and control of the department of
34public health as specified in the memorandum of understanding
35entered into between the divisions.
-4- 1(b) For the fiscal year beginning July 1, 2019, and ending
2June 30, 2020, the terms of the memorandum of understanding,
3entered into between the division of tobacco use prevention
4and control of the department of public health and the
5alcoholic beverages division of the department of commerce,
6governing compliance checks conducted to ensure licensed retail
7tobacco outlet conformity with tobacco laws, regulations, and
8ordinances relating to persons under 18 years of age, shall
9continue to restrict the number of such checks to one check per
10retail outlet, and one additional check for any retail outlet
11found to be in violation during the first check.
12b. (1) Of the funds appropriated in this subsection,
13$21,089,000 shall be used for problem gambling and
14substance-related disorder prevention, treatment, and recovery
15services, including a 24-hour helpline, public information
16resources, professional training, youth prevention, and program
17evaluation.
18(2) Of the amount allocated under this paragraph, $306,000
19shall be utilized by the department of public health, in
20collaboration with the department of human services, to support
21establishment and maintenance of a single statewide 24-hour
22crisis hotline for the Iowa children’s behavioral health system
23that incorporates warmline services which may be provided
24through expansion of existing capabilities maintained by the
25department of public health as required pursuant to 2018 Iowa
26Acts, chapter 1056, section 16.
27c. The requirement of section 123.17, subsection 5, is met
28by the appropriations and allocations made in this division of
29this Act for purposes of substance-related disorder treatment
30and addictive disorders for the fiscal year beginning July 1,
312019.
322. HEALTHY CHILDREN AND FAMILIES
33For promoting the optimum health status for children and
34adolescents from birth through 21 years of age, and families,
35and for not more than the following full-time equivalent
-5-1positions:
.................................................. $25,817,057
............................................... FTEs313.00
4a. Of the funds appropriated in this subsection, not more
5than $734,000 shall be used for the healthy opportunities for
6parents to experience success (HOPES)-healthy families Iowa
7(HFI) program established pursuant to section 135.106. The
8funding shall be distributed to renew the grants that were
9provided to the grantees that operated the program during the
10fiscal year ending June 30, 2018. However, the department
11shall issue a request for proposals and distribute grants to
12the grantees selected to operate the program no later than
13January 1, 2020. The department shall not retain any portion
14of the allocation under this paragraph for administrative
15costs.
16b. In order to implement the legislative intent stated
17in sections 135.106 and 256I.9, priority for home visitation
18program funding shall be given to programs using evidence-based
19or promising models for home visitation.
20c. Of the funds appropriated in this subsection, $3,075,000
21shall be used for continuation of the department’s initiative
22to provide for adequate developmental surveillance and
23screening during a child’s first five years. The funds shall
24be used first to fully fund the current sites to ensure that
25the sites are fully operational, with the remaining funds
26to be used for expansion to additional sites. The full
27implementation and expansion shall include enhancing the scope
28of the initiative through collaboration with the child health
29specialty clinics to promote healthy child development through
30early identification and response to both biomedical and social
31determinants of healthy development; by monitoring child
32health metrics to inform practice, document long-term health
33impacts and savings, and provide for continuous improvement
34through training, education, and evaluation; and by providing
35for practitioner consultation particularly for children with
-6-1behavioral conditions and needs. The department of public
2health shall also collaborate with the Iowa Medicaid enterprise
3and the child health specialty clinics to integrate the
4activities of the first five initiative into the establishment
5of patient-centered medical homes, community utilities,
6accountable care organizations, and other integrated care
7models developed to improve health quality and population
8health while reducing health care costs. To the maximum extent
9possible, funding allocated in this paragraph shall be utilized
10as matching funds for medical assistance program reimbursement.
11d. Of the funds appropriated in this subsection, $64,000
12shall be distributed to a statewide dental carrier to provide
13funds to continue the donated dental services program patterned
14after the projects developed by the lifeline network to provide
15dental services to indigent individuals who are elderly or with
16disabilities.
17e. Of the funds appropriated in this subsection, $156,000
18shall be used to provide audiological services and hearing aids
19for children.
20f. Of the funds appropriated in this subsection, $23,000 is
21transferred to the university of Iowa college of dentistry for
22provision of primary dental services to children. State funds
23shall be matched on a dollar-for-dollar basis. The university
24of Iowa college of dentistry shall coordinate efforts with the
25department of public health, oral and health delivery system
26bureau, to provide dental care to underserved populations
27throughout the state.
28g. Of the funds appropriated in this subsection, $50,000
29shall be used to address youth suicide prevention.
30h. Of the funds appropriated in this subsection, $40,000
31shall be used to support the Iowa effort to address the survey
32of children who experience adverse childhood experiences known
33as ACEs.
34i. Of the funds appropriated in this subsection, up to
35$494,000 shall be used for childhood obesity prevention.
-7- 13. CHRONIC CONDITIONS
2For serving individuals identified as having chronic
3conditions or special health care needs, and for not more than
4the following full-time equivalent positions:
.................................................. $54,223,519
............................................... FTEs69.00
7a. Of the funds appropriated in this subsection, $153,000
8shall be used for grants to individual patients who have an
9inherited metabolic disorder to assist with the costs of
10medically necessary foods and formula.
11b. Of the funds appropriated in this subsection, $1,055,000
12shall be used for the brain injury services program pursuant
13to section 135.22B, including for contracting with an existing
14nationally affiliated and statewide organization whose purpose
15is to educate, serve, and support Iowans with brain injury and
16their families, for resource facilitator services in accordance
17with section 135.22B, subsection 9, and for contracting to
18enhance brain injury training and recruitment of service
19providers on a statewide basis. Of the amount allocated in
20this paragraph, $95,000 shall be used to fund one full-time
21equivalent position to serve as the state brain injury services
22program manager.
23c. Of the funds appropriated in this subsection, $144,000
24shall be used for the public purpose of continuing to contract
25with an existing national-affiliated organization to provide
26education, client-centered programs, and client and family
27support for people living with epilepsy and their families.
28The amount allocated in this paragraph shall be matched
29dollar-for-dollar by the organization specified.
30d. Of the funds appropriated in this subsection, $809,000
31shall be used for child health specialty clinics.
32e. Of the funds appropriated in this subsection, $384,000
33shall be used by the regional autism assistance program
34established pursuant to section 256.35, and administered by
35the child health specialty clinic located at the university of
-8-1Iowa hospitals and clinics. The funds shall be used to enhance
2interagency collaboration and coordination of educational,
3medical, and other human services for persons with autism,
4their families, and providers of services, including delivering
5regionalized services of care coordination, family navigation,
6and integration of services through the statewide system of
7regional child health specialty clinics and fulfilling other
8requirements as specified in chapter 225D. The university of
9Iowa shall not receive funds allocated under this paragraph for
10indirect costs associated with the regional autism assistance
11program.
12f. Of the funds appropriated in this subsection, $577,000
13shall be used for the comprehensive cancer control program to
14reduce the burden of cancer in Iowa through prevention, early
15detection, effective treatment, and ensuring quality of life.
16Of the funds allocated in this paragraph “f”, $150,000 shall
17be used to support a melanoma research symposium, a melanoma
18biorepository and registry, basic and translational melanoma
19research, and clinical trials.
20g. Of the funds appropriated in this subsection, $97,000
21shall be used for cervical and colon cancer screening, and
22$177,000 shall be used to enhance the capacity of the cervical
23cancer screening program to include provision of recommended
24prevention and early detection measures to a broader range of
25low-income women.
26h. Of the funds appropriated in this subsection, $506,000
27shall be used for the center for congenital and inherited
28disorders.
294. COMMUNITY CAPACITY
30For strengthening the health care delivery system at the
31local level, and for not more than the following full-time
32equivalent positions:
.................................................. $335,516,677
............................................... FTEs3413.00
35a. Of the funds appropriated in this subsection, $95,000
-9-1is allocated for continuation of the child vision screening
2program implemented through the university of Iowa hospitals
3and clinics in collaboration with early childhood Iowa areas.
4The program shall submit a report to the department regarding
5the use of funds allocated under this paragraph “a”. The
6report shall include the objectives and results for the
7program year including the target population and how the funds
8allocated assisted the program in meeting the objectives; the
9number, age, and location within the state of individuals
10served; the type of services provided to the individuals
11served; the distribution of funds based on service provided;
12and the continuing needs of the program.
13b. Of the funds appropriated in this subsection,
14$48,000 shall be used for a grant to a statewide association
15of psychologists, that is affiliated with the American
16psychological association, to be used for continuation of a
17program to rotate intern psychologists in placements in urban
18and rural mental health professional shortage areas. For the
19purposes of this paragraph “b”, “mental health professional
20shortage area” means a geographic area in this state that has
21been designated by the United States department of health and
22human services, health resources and services administration,
23bureau of health professionals, as having a shortage of mental
24health professionals.
25c. Of the funds appropriated in this subsection, the
26following amounts are allocated to be used as follows
27to support the goals of increased access, health system
28integration, and engagement:
29(1) Not less than $542,000 is allocated to the Iowa
30prescription drug corporation for continuation of the
31pharmaceutical infrastructure for safety net providers as
32described in 2007 Iowa Acts, chapter 218, section 108, and for
33the prescription drug donation repository program created in
34chapter 135M.
35(2) (a) Not less than $334,000 is allocated to free
-10-1clinics and free clinics of Iowa for necessary infrastructure,
2statewide coordination, provider recruitment, service delivery,
3and provision of assistance to patients in securing a medical
4home inclusive of oral health care. However, the department
5shall issue a request for proposals and execute a contract
6with the contractor selected, to perform the activities under
7this subparagraph division no later than January 1, 2020. The
8department shall not retain any portion of the allocation under
9this subparagraph division for administrative costs.
10(b) Not less than $25,000 is allocated to the Iowa
11association of rural health clinics for necessary
12infrastructure and service delivery transformation. However,
13the department shall issue a request for proposals and
14execute a contract with the contractor selected to perform
15the activities under this subparagraph division no later
16than January 1, 2020. The department shall not retain any
17portion of the allocation under this subparagraph division for
18administrative costs.
19(c) Not less than $205,000 is allocated to the Polk county
20medical society for continuation of the safety net provider
21patient access to specialty health care initiative as described
22in 2007 Iowa Acts, chapter 218, section 109. However, the
23department shall issue a request for proposals and execute a
24contract with the contractor selected to operate the initiative
25under this subparagraph division no later than January 1, 2020.
26The department shall not retain any portion of the allocation
27under this subparagraph division for administrative costs.
28(3) The department may combine the allocations and
29activities specified in subparagraph (2) for the purposes of
30issuing a request for proposals.
31d. Of the funds appropriated in this subsection, $191,000
32is allocated for the purposes of health care and public health
33workforce initiatives.
34e. Of the funds appropriated in this subsection, $96,000
35shall be used for a matching dental education loan repayment
-11-1program to be allocated to a dental nonprofit health service
2corporation to continue to develop the criteria and implement
3the loan repayment program.
4f. Of the funds appropriated in this subsection, $100,000
5shall be used for the purposes of the Iowa donor registry as
6specified in section 142C.18.
7g. Of the funds appropriated in this subsection, $96,000
8shall be used for continuation of a grant to a nationally
9affiliated volunteer eye organization that has an established
10program for children and adults and that is solely dedicated to
11preserving sight and preventing blindness through education,
12nationally certified vision screening and training, and
13community and patient service programs. The contractor
14shall submit a report to the individuals identified in this
15Act for submission of reports regarding the use of funds
16allocated under this paragraph “g”. The report shall include
17the objectives and results for the program year including
18the target population and how the funds allocated assisted
19the program in meeting the objectives; the number, age, and
20location within the state of individuals served; the type of
21services provided to the individuals served; the distribution
22of funds based on services provided; and the continuing needs
23of the program.
24h. Of the funds appropriated in this subsection, $2,000,000
25shall be deposited in the medical residency training account
26created in section 135.175, subsection 5, paragraph “a”, and
27is appropriated from the account to the department of public
28health to be used for the purposes of the medical residency
29training state matching grants program as specified in section
30135.176.
31i. Of the funds appropriated in this subsection, $250,000
32shall be used for the public purpose of providing funding to
33Des Moines university to continue a provider education project
34to provide primary care physicians with the training and skills
35necessary to recognize the signs of mental illness in patients.
-12- 1j. Of the funds appropriated in this subsection, $400,000
2shall be used for rural psychiatric residencies to support the
3annual creation and training of four psychiatric residents who
4will provide mental health services in underserved areas of the
5state.
6k. Of the funds appropriated in this subsection, $150,000
7shall be used for psychiatric training to increase access to
8mental health care services by expanding the mental health
9workforce via training of additional physician assistants and
10nurse practitioners.
115. ESSENTIAL PUBLIC HEALTH SERVICES
12To provide public health services that reduce risks and
13invest in promoting and protecting good health over the
14course of a lifetime with a priority given to older Iowans and
15vulnerable populations:
.................................................. $167,662,464
176. INFECTIOUS DISEASES
18For reducing the incidence and prevalence of communicable
19diseases, and for not more than the following full-time
20equivalent positions:
.................................................. $211,796,426
............................................... FTEs224.00
237. PUBLIC PROTECTION
24For protecting the health and safety of the public through
25establishing standards and enforcing regulations, and for not
26more than the following full-time equivalent positions:
.................................................. $274,093,383
............................................... FTEs28142.00
29a. Of the funds appropriated in this subsection, not more
30than $304,000 shall be credited to the emergency medical
31services fund created in section 135.25. Moneys in the
32emergency medical services fund are appropriated to the
33department to be used for the purposes of the fund.
34b. Of the funds appropriated in this subsection, up
35to $243,000 shall be used for sexual violence prevention
-13-1programming through a statewide organization representing
2programs serving victims of sexual violence through the
3department’s sexual violence prevention program, and for
4continuation of a training program for sexual assault
5response team (SART) members, including representatives of
6law enforcement, victim advocates, prosecutors, and certified
7medical personnel. However, the department shall issue
8a request for proposals and execute a contract with the
9contractor selected to provide the programming and training
10as specified in this paragraph no later than January 1, 2020.
11The amount allocated in this paragraph “b” shall not be used
12to supplant funding administered for other sexual violence
13prevention or victims assistance programs. The department
14shall not retain any portion of the allocation under this
15paragraph for administrative costs.
16c. Of the funds appropriated in this subsection, up to
17$500,000 shall be used for the state poison control center.
18Pursuant to the directive under 2014 Iowa Acts, chapter
191140, section 102, the federal matching funds available to
20the state poison control center from the department of human
21services under the federal Children’s Health Insurance Program
22Reauthorization Act allotment shall be subject to the federal
23administrative cap rule of 10 percent applicable to funding
24provided under Tit.XXI of the federal Social Security Act and
25included within the department’s calculations of the cap.
26d. Of the funds appropriated in this subsection, up to
27$504,000 shall be used for childhood lead poisoning provisions.
288. RESOURCE MANAGEMENT
29For establishing and sustaining the overall ability of the
30department to deliver services to the public, and for not more
31than the following full-time equivalent positions:
.................................................. $32971,215
............................................... FTEs334.00
349. MISCELLANEOUS PROVISIONS
35a. The university of Iowa hospitals and clinics under
-14-1the control of the state board of regents shall not receive
2indirect costs from the funds appropriated in this section.
3The university of Iowa hospitals and clinics billings to the
4department shall be on at least a quarterly basis.
5b. The department of public health shall collaborate
6with applicable stakeholders to review the allocations,
7grants, and other distributions of funds appropriated under
8this division of this Act and shall submit a report to the
9individuals identified in this Act for submission of reports by
10December 15, 2019, regarding a proposal for the distribution
11of funds that more clearly reflects the department’s stated
12priorities and goals, provides increased flexibility in the
13distribution of funds to meet these priorities and goals, and
14ensures stakeholder accountability and a discernable return on
15investment.
16 Sec. 4. CONTRACTED SERVICES — PROHIBITED USE OF GENERAL
17FUND MONEYS FOR LOBBYING.
181. The department shall submit a report to the individuals
19identified in this Act for submission of reports by January 1,
202020, regarding the outcomes of any program or activity for
21which funding is appropriated or allocated from the general
22fund of the state to the department under this division of
23this Act, and for which a request for proposals process is
24specifically required.
252. The department shall incorporate into the general
26conditions applicable to all award documents involving funding
27appropriated or allocated from the general fund of the state to
28the department under this division of this Act, a prohibition
29against the use of such funding for the compensation of a
30lobbyist. For the purposes of this section, “lobbyist” means
31the same as defined in section 68B.2; however, “lobbyist”
32does not include a person employed by a state agency of the
33executive branch of state government who represents the agency
34relative to the passage, defeat, approval, or modification of
35legislation that is being considered by the general assembly.
-15-1DIVISION IV
2DEPARTMENT OF VETERANS AFFAIRS — FY 2019-2020
3 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
4appropriated from the general fund of the state to the
5department of veterans affairs for the fiscal year beginning
6July 1, 2019, and ending June 30, 2020, the following amounts,
7or so much thereof as is necessary, to be used for the purposes
8designated:
91. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
10For salaries, support, maintenance, and miscellaneous
11purposes, and for not more than the following full-time
12equivalent positions:
.................................................. $131,225,500
............................................... FTEs1415.00
152. IOWA VETERANS HOME
16For salaries, support, maintenance, and miscellaneous
17purposes:
.................................................. $187,162,976
19a. The Iowa veterans home billings involving the department
20of human services shall be submitted to the department on at
21least a monthly basis.
22b. Within available resources and in conformance with
23associated state and federal program eligibility requirements,
24the Iowa veterans home may implement measures to provide
25financial assistance to or on behalf of veterans or their
26spouses who are participating in the community reentry program.
27c. The Iowa veterans home expenditure report shall be
28submitted monthly to the legislative services agency.
29d. The Iowa veterans home shall continue to include in the
30annual discharge report applicant information to provide for
31the collection of demographic information including but not
32limited to the number of individuals applying for admission and
33admitted or denied admittance and the basis for the admission
34or denial; the age, gender, and race of such individuals;
35and the level of care for which such individuals applied for
-16-1admission including residential or nursing level of care.
23. HOME OWNERSHIP ASSISTANCE PROGRAM
3For transfer to the Iowa finance authority for the
4continuation of the home ownership assistance program for
5persons who are or were eligible members of the armed forces of
6the United States, pursuant to section 16.54:
.................................................. $72,000,000
8 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
9FUND STANDING APPROPRIATIONS. Notwithstanding the standing
10appropriation in section 35A.16 for the fiscal year beginning
11July 1, 2019, and ending June 30, 2020, the amount appropriated
12from the general fund of the state pursuant to that section
13for the following designated purposes shall not exceed the
14following amount:
15For the county commissions of veteran affairs fund under
16section 35A.16:
.................................................. $17990,000
18DIVISION V
19DEPARTMENT OF HUMAN SERVICES — FY 2019-2020
20 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
21GRANT. There is appropriated from the fund created in section
228.41 to the department of human services for the fiscal year
23beginning July 1, 2019, and ending June 30, 2020, from moneys
24received under the federal temporary assistance for needy
25families (TANF) block grant pursuant to the federal Personal
26Responsibility and Work Opportunity Reconciliation Act of 1996,
27Pub.L.No.104-193, and successor legislation, the following
28amounts, or so much thereof as is necessary, to be used for the
29purposes designated:
301. To be credited to the family investment program account
31and used for assistance under the family investment program
32under chapter 239B:
.................................................. $334,524,006
342. To be credited to the family investment program account
35and used for the job opportunities and basic skills (JOBS)
-17-1program and implementing family investment agreements in
2accordance with chapter 239B:
.................................................. $35,412,060
43. To be used for the family development and
5self-sufficiency grant program in accordance with section
6216A.107:
.................................................. $72,898,980
8Notwithstanding section 8.33, moneys appropriated in this
9subsection that remain unencumbered or unobligated at the close
10of the fiscal year shall not revert but shall remain available
11for expenditure for the purposes designated until the close of
12the succeeding fiscal year. However, unless such moneys are
13encumbered or obligated on or before September 30, 2020, the
14moneys shall revert.
154. For field operations:
.................................................. $1631,296,232
175. For general administration:
.................................................. $183,744,000
196. For state child care assistance:
.................................................. $2047,166,826
21a. Of the funds appropriated in this subsection,
22$26,205,412 is transferred to the child care and development
23block grant appropriation made by the Eighty-eighth General
24Assembly, 2019 session, for the federal fiscal year beginning
25October 1, 2019, and ending September 30, 2020. Of this
26amount, $200,000 shall be used for provision of educational
27opportunities to registered child care home providers in order
28to improve services and programs offered by this category
29of providers and to increase the number of providers. The
30department may contract with institutions of higher education
31or child care resource and referral centers to provide
32the educational opportunities. Allowable administrative
33costs under the contracts shall not exceed 5 percent. The
34application for a grant shall not exceed two pages in length.
35b. Any funds appropriated in this subsection remaining
-18-1unallocated shall be used for state child care assistance
2payments for families who are employed including but not
3limited to individuals enrolled in the family investment
4program.
57. For child and family services:
.................................................. $632,380,654
78. For child abuse prevention grants:
.................................................. $8125,000
99. For pregnancy prevention grants on the condition that
10family planning services are funded:
.................................................. $111,913,203
12Pregnancy prevention grants shall be awarded to programs
13in existence on or before July 1, 2019, if the programs have
14demonstrated positive outcomes. Grants shall be awarded to
15pregnancy prevention programs which are developed after July
161, 2019, if the programs are based on existing models that
17have demonstrated positive outcomes. Grants shall comply with
18the requirements provided in 1997 Iowa Acts, chapter 208,
19section 14, subsections 1 and 2, including the requirement that
20grant programs must emphasize sexual abstinence. Priority in
21the awarding of grants shall be given to programs that serve
22areas of the state which demonstrate the highest percentage of
23unplanned pregnancies of females of childbearing age within the
24geographic area to be served by the grant.
2510. For technology needs and other resources necessary
26to meet federal welfare reform reporting, tracking, and case
27management requirements:
.................................................. $281,037,186
2911. a. Notwithstanding any provision to the contrary,
30including but not limited to requirements in section 8.41 or
31provisions in 2018 Iowa Acts or 2019 Iowa Acts regarding the
32receipt and appropriation of federal block grants, federal
33funds from the temporary assistance for needy families block
34grant received by the state and not otherwise appropriated
35in this section and remaining available for the fiscal year
-19-1beginning July 1, 2019, are appropriated to the department of
2human services to the extent as may be necessary to be used in
3the following priority order: the family investment program,
4for state child care assistance program payments for families
5who are employed, and for the family investment program share
6of system costs for eligibility determination and related
7functions. The federal funds appropriated in this paragraph
8“a” shall be expended only after all other funds appropriated
9in subsection 1 for assistance under the family investment
10program, in subsection 6 for state child care assistance, or
11in subsection 10 for technology costs related to the family
12investment program, as applicable, have been expended. For
13the purposes of this subsection, the funds appropriated in
14subsection 6, paragraph “a”, for transfer to the child care
15and development block grant appropriation are considered fully
16expended when the full amount has been transferred.
17b. The department shall, on a quarterly basis, advise the
18legislative services agency and department of management of
19the amount of funds appropriated in this subsection that was
20expended in the prior quarter.
2112. Of the amounts appropriated in this section,
22$12,962,008 for the fiscal year beginning July 1, 2019, is
23transferred to the appropriation of the federal social services
24block grant made to the department of human services for that
25fiscal year.
2613. For continuation of the program providing categorical
27eligibility for the food assistance program as specified
28for the program in the section of this division of this Act
29relating to the family investment program account:
.................................................. $3014,236
3114. The department may transfer funds allocated in this
32section to the appropriations made in this division of this Act
33for the same fiscal year for general administration and field
34operations for resources necessary to implement and operate the
35services referred to in this section and those funded in the
-20-1appropriation made in this division of this Act for the same
2fiscal year for the family investment program from the general
3fund of the state.
415. With the exception of moneys allocated under this
5section for the family development and self-sufficiency grant
6program, to the extent moneys allocated in this section are
7deemed by the department not to be necessary to support the
8purposes for which they are allocated, such moneys may be
9used in the same fiscal year for any other purpose for which
10funds are allocated in this section or in section 8 of this
11division for the family investment program account. If there
12are conflicting needs, priority shall first be given to the
13family investment program account as specified under subsection
141 of this section and used for the purposes of assistance under
15the family investment program in accordance with chapter 239B,
16followed by state child care assistance program payments for
17families who are employed, followed by other priorities as
18specified by the department.
19 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
201. Moneys credited to the family investment program (FIP)
21account for the fiscal year beginning July 1, 2019, and
22ending June 30, 2020, shall be used to provide assistance in
23accordance with chapter 239B.
242. The department may use a portion of the moneys credited
25to the FIP account under this section as necessary for
26salaries, support, maintenance, and miscellaneous purposes.
273. The department may transfer funds allocated in
28subsection 4, excluding the allocation under subsection 4,
29paragraph “b”, to the appropriations made in this division of
30this Act for the same fiscal year for general administration
31and field operations for resources necessary to implement
32and operate the services referred to in this section and
33those funded in the appropriations made in section 7 for the
34temporary assistance for needy families block grant and in
35section 9 for the family investment program from the general
-21-1fund of the state in this division of this Act for the same
2fiscal year.
34. Moneys appropriated in this division of this Act and
4credited to the FIP account for the fiscal year beginning July
51, 2019, and ending June 30, 2020, are allocated as follows:
6a. To be retained by the department of human services to
7be used for coordinating with the department of human rights
8to more effectively serve participants in FIP and other shared
9clients and to meet federal reporting requirements under the
10federal temporary assistance for needy families block grant:
.................................................. $1120,000
12b. To the department of human rights for staffing,
13administration, and implementation of the family development
14and self-sufficiency grant program in accordance with section
15216A.107:
.................................................. $166,192,834
17(1) Of the funds allocated for the family development
18and self-sufficiency grant program in this paragraph “b”,
19not more than 5 percent of the funds shall be used for the
20administration of the grant program.
21(2) The department of human rights may continue to implement
22the family development and self-sufficiency grant program
23statewide during fiscal year 2019-2020.
24(3) The department of human rights may engage in activities
25to strengthen and improve family outcomes measures and
26data collection systems under the family development and
27self-sufficiency grant program.
28c. For the diversion subaccount of the FIP account:
.................................................. $29815,000
30A portion of the moneys allocated for the diversion
31subaccount may be used for field operations, salaries, data
32management system development, and implementation costs and
33support deemed necessary by the director of human services
34in order to administer the FIP diversion program. To the
35extent moneys allocated in this paragraph “c” are deemed by the
-22-1department not to be necessary to support diversion activities,
2such moneys may be used for other efforts intended to increase
3engagement by family investment program participants in work,
4education, or training activities, or for the purposes of
5assistance under the family investment program in accordance
6with chapter 239B.
7d. For the food assistance employment and training program:
.................................................. $866,588
9(1) The department shall apply the federal supplemental
10nutrition assistance program (SNAP) employment and training
11state plan in order to maximize to the fullest extent permitted
12by federal law the use of the 50 percent federal reimbursement
13provisions for the claiming of allowable federal reimbursement
14funds from the United States department of agriculture
15pursuant to the federal SNAP employment and training program
16for providing education, employment, and training services
17for eligible food assistance program participants, including
18but not limited to related dependent care and transportation
19expenses.
20(2) The department shall continue the categorical federal
21food assistance program eligibility at 160 percent of the
22federal poverty level and continue to eliminate the asset test
23from eligibility requirements, consistent with federal food
24assistance program requirements. The department shall include
25as many food assistance households as is allowed by federal
26law. The eligibility provisions shall conform to all federal
27requirements including requirements addressing individuals who
28are incarcerated or otherwise ineligible.
29e. For the JOBS program:
.................................................. $3012,018,258
315. Of the child support collections assigned under FIP,
32an amount equal to the federal share of support collections
33shall be credited to the child support recovery appropriation
34made in this division of this Act. Of the remainder of the
35assigned child support collections received by the child
-23-1support recovery unit, a portion shall be credited to the FIP
2account, a portion may be used to increase recoveries, and a
3portion may be used to sustain cash flow in the child support
4payments account. If as a consequence of the appropriations
5and allocations made in this section the resulting amounts
6are insufficient to sustain cash assistance payments and meet
7federal maintenance of effort requirements, the department
8shall seek supplemental funding. If child support collections
9assigned under FIP are greater than estimated or are otherwise
10determined not to be required for maintenance of effort, the
11state share of either amount may be transferred to or retained
12in the child support payments account.
136. The department may adopt emergency rules for the family
14investment, JOBS, food assistance, and medical assistance
15programs if necessary to comply with federal requirements.
16 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
17is appropriated from the general fund of the state to the
18department of human services for the fiscal year beginning July
191, 2019, and ending June 30, 2020, the following amount, or
20so much thereof as is necessary, to be used for the purpose
21designated:
22To be credited to the family investment program (FIP)
23account and used for family investment program assistance under
24chapter 239B:
.................................................. $2540,365,037
261. Of the funds appropriated in this section, $6,606,198 is
27allocated for the JOBS program.
282. Of the funds appropriated in this section, $3,313,854 is
29allocated for the family development and self-sufficiency grant
30program.
313. a. Notwithstanding section 8.39, for the fiscal
32year beginning July 1, 2019, if necessary to meet federal
33maintenance of effort requirements or to transfer federal
34temporary assistance for needy families block grant funding
35to be used for purposes of the federal social services block
-24-1grant or to meet cash flow needs resulting from delays in
2receiving federal funding or to implement, in accordance with
3this division of this Act, activities currently funded with
4juvenile court services, county, or community moneys and state
5moneys used in combination with such moneys; to comply with
6federal requirements; or to maximize the use of federal funds;
7the department of human services may transfer funds within or
8between any of the appropriations made in this division of this
9Act and appropriations in law for the federal social services
10block grant to the department for the following purposes,
11provided that the combined amount of state and federal
12temporary assistance for needy families block grant funding
13for each appropriation remains the same before and after the
14transfer:
15(1) For the family investment program.
16(2) For state child care assistance.
17(3) For child and family services.
18(4) For field operations.
19(5) For general administration.
20b. This subsection shall not be construed to prohibit the
21use of existing state transfer authority for other purposes.
22The department shall report any transfers made pursuant to this
23subsection to the legislative services agency.
244. Of the funds appropriated in this section, $195,000 shall
25be used for continuation of a grant to an Iowa-based nonprofit
26organization with a history of providing tax preparation
27assistance to low-income Iowans in order to expand the usage
28of the earned income tax credit. The purpose of the grant is
29to supply this assistance to underserved areas of the state.
30However, the department shall issue a request for proposals and
31execute a contract with the contractor selected to administer
32the program no later than January 1, 2020. The department
33shall not retain any portion of the allocation under this
34subsection for administrative costs.
355. Of the funds appropriated in this section, $70,000 shall
-25-1be used for the continuation of the parenting program, as
2specified in 441 IAC ch.100, relating to parental obligations,
3in which the child support recovery unit participates, to
4support the efforts of a nonprofit organization committed
5to strengthening the community through youth development,
6healthy living, and social responsibility headquartered in
7a county with a population over 350,000 according to the
8latest certified federal census. The funds allocated in this
9subsection shall be used by the recipient organization to
10develop a larger community effort, through public and private
11partnerships, to support a broad-based multi-county fatherhood
12parenthood initiative that promotes payment of child support
13obligations, improved family relationships, and full-time
14employment. However, the department shall issue a request for
15proposals and execute a contract with the contractor selected
16to administer the program no later than January 1, 2020. The
17department shall not retain any portion of the allocation under
18this subsection for administrative costs.
196. The department may transfer funds appropriated in this
20section, excluding the allocation in subsection 2 for the
21family development and self-sufficiency grant program, to the
22appropriations made in this division of this Act for general
23administration and field operations as necessary to administer
24this section, section 7 for the temporary assistance for needy
25families block grant, and section 8 for the family investment
26program account.
27 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
28from the general fund of the state to the department of human
29services for the fiscal year beginning July 1, 2019, and ending
30June 30, 2020, the following amount, or so much thereof as is
31necessary, to be used for the purposes designated:
32For child support recovery, including salaries, support,
33maintenance, and miscellaneous purposes, and for not more than
34the following full-time equivalent positions:
.................................................. $3514,749,368
-26-............................................... FTEs1459.00
21. The department shall expend up to $24,000, including
3federal financial participation, for the fiscal year beginning
4July 1, 2019, for a child support public awareness campaign.
5The department and the office of the attorney general shall
6cooperate in continuation of the campaign. The public
7awareness campaign shall emphasize, through a variety of
8media activities, the importance of maximum involvement of
9both parents in the lives of their children as well as the
10importance of payment of child support obligations.
112. Federal access and visitation grant moneys shall be
12issued directly to private not-for-profit agencies that provide
13services designed to increase compliance with the child access
14provisions of court orders, including but not limited to
15neutral visitation sites and mediation services.
163. The appropriation made to the department for child
17support recovery may be used throughout the fiscal year in the
18manner necessary for purposes of cash flow management, and for
19cash flow management purposes the department may temporarily
20draw more than the amount appropriated, provided the amount
21appropriated is not exceeded at the close of the fiscal year.
22 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
23FY 2019-2020. Any funds remaining in the health care trust
24fund created in section 453A.35A for the fiscal year beginning
25July 1, 2019, and ending June 30, 2020, are appropriated to
26the department of human services to supplement the medical
27assistance program appropriations made in this division of this
28Act, for medical assistance reimbursement and associated costs,
29including program administration and costs associated with
30program implementation.
31 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
322019-2020. Any funds remaining in the Medicaid fraud fund
33created in section 249A.50 for the fiscal year beginning
34July 1, 2019, and ending June 30, 2020, are appropriated to
35the department of human services to supplement the medical
-27-1assistance appropriations made in this division of this Act,
2for medical assistance reimbursement and associated costs,
3including program administration and costs associated with
4program implementation.
5 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
6general fund of the state to the department of human services
7for the fiscal year beginning July 1, 2019, and ending June 30,
82020, the following amount, or so much thereof as is necessary,
9to be used for the purpose designated:
10For medical assistance program reimbursement and associated
11costs as specifically provided in the reimbursement
12methodologies in effect on June 30, 2019, except as otherwise
13expressly authorized by law, consistent with options under
14federal law and regulations, and contingent upon receipt of
15approval from the office of the governor of reimbursement for
16each abortion performed under the program:
.................................................. $171,431,334,812
181. Iowans support reducing the number of abortions
19performed in our state. Funds appropriated under this section
20shall not be used for abortions, unless otherwise authorized
21under this section.
222. The provisions of this section relating to abortions
23shall also apply to the Iowa health and wellness plan created
24pursuant to chapter 249N.
253. The department shall utilize not more than $60,000 of
26the funds appropriated in this section to continue the AIDS/HIV
27health insurance premium payment program as established in 1992
28Iowa Acts, Second Extraordinary Session, chapter 1001, section
29409, subsection 6. Of the funds allocated in this subsection,
30not more than $5,000 may be expended for administrative
31purposes.
324. Of the funds appropriated in this Act to the department
33of public health for addictive disorders, $950,000 for
34the fiscal year beginning July 1, 2019, is transferred
35to the department of human services for an integrated
-28-1substance-related disorder managed care system. The
2departments of human services and public health shall
3work together to maintain the level of mental health and
4substance-related disorder treatment services provided by the
5managed care contractors. Each department shall take the steps
6necessary to continue the federal waivers as necessary to
7maintain the level of services.
85. a. The department shall aggressively pursue options for
9providing medical assistance or other assistance to individuals
10with special needs who become ineligible to continue receiving
11services under the early and periodic screening, diagnostic,
12and treatment program under the medical assistance program
13due to becoming 21 years of age who have been approved for
14additional assistance through the department’s exception to
15policy provisions, but who have health care needs in excess
16of the funding available through the exception to policy
17provisions.
18b. Of the funds appropriated in this section, $100,000
19shall be used for participation in one or more pilot projects
20operated by a private provider to allow the individual or
21individuals to receive service in the community in accordance
22with principles established in Olmstead v.L.C., 527 U.S.581
23(1999), for the purpose of providing medical assistance or
24other assistance to individuals with special needs who become
25ineligible to continue receiving services under the early and
26periodic screening, diagnostic, and treatment program under
27the medical assistance program due to becoming 21 years of
28age who have been approved for additional assistance through
29the department’s exception to policy provisions, but who have
30health care needs in excess of the funding available through
31the exception to the policy provisions.
326. Of the funds appropriated in this section, up to
33$3,050,082 may be transferred to the field operations or
34general administration appropriations in this division of this
35Act for operational costs associated with Part D of the federal
-29-1Medicare Prescription Drug Improvement and Modernization Act
2of 2003, Pub.L.No.108-173.
37. Of the funds appropriated in this section, up to $442,100
4may be transferred to the appropriation in this division
5of this Act for medical contracts to be used for clinical
6assessment services and prior authorization of services.
78. A portion of the funds appropriated in this section
8may be transferred to the appropriations in this division of
9this Act for general administration, medical contracts, the
10children’s health insurance program, or field operations to be
11used for the state match cost to comply with the payment error
12rate measurement (PERM) program for both the medical assistance
13and children’s health insurance programs as developed by the
14centers for Medicare and Medicaid services of the United States
15department of health and human services to comply with the
16federal Improper Payments Information Act of 2002, Pub.L.
17No.107-300, and to support other reviews and quality control
18activities to improve the integrity of these programs.
199. The department shall continue to implement the
20recommendations of the assuring better child health and
21development initiative II (ABCDII) clinical panel to the
22Iowa early and periodic screening, diagnostic, and treatment
23services healthy mental development collaborative board
24regarding changes to billing procedures, codes, and eligible
25service providers.
2610. Of the funds appropriated in this section, a sufficient
27amount is allocated to supplement the incomes of residents of
28nursing facilities, intermediate care facilities for persons
29with mental illness, and intermediate care facilities for
30persons with an intellectual disability, with incomes of less
31than $50 in the amount necessary for the residents to receive a
32personal needs allowance of $50 per month pursuant to section
33249A.30A.
3411. a. Hospitals that meet the conditions specified
35in subparagraphs (1) and (2) shall either certify public
-30-1expenditures or transfer to the medical assistance program
2an amount equal to provide the nonfederal share for a
3disproportionate share hospital payment in an amount up to the
4hospital-specific limit as approved in the Medicaid state plan.
5The hospitals that meet the conditions specified shall receive
6and retain 100 percent of the total disproportionate share
7hospital payment in an amount up to the hospital-specific limit
8as approved in the Medicaid state plan.
9(1) The hospital qualifies for disproportionate share and
10graduate medical education payments.
11(2) The hospital is an Iowa state-owned hospital with more
12than 500 beds and eight or more distinct residency specialty
13or subspecialty programs recognized by the American college of
14graduate medical education.
15b. Distribution of the disproportionate share payments
16shall be made on a monthly basis. The total amount of
17disproportionate share payments including graduate medical
18education, enhanced disproportionate share, and Iowa
19state-owned teaching hospital payments shall not exceed the
20amount of the state’s allotment under Pub.L.No.102-234.
21In addition, the total amount of all disproportionate
22share payments shall not exceed the hospital-specific
23disproportionate share limits under Pub.L.No.103-66.
2412. One hundred percent of the nonfederal share of payments
25to area education agencies that are medical assistance
26providers for medical assistance-covered services provided to
27medical assistance-covered children, shall be made from the
28appropriation made in this section.
2913. A portion of the funds appropriated in this section
30may be transferred to the appropriation in this division of
31this Act for medical contracts to be used for administrative
32activities associated with the money follows the person
33demonstration project.
3414. Of the funds appropriated in this section, $349,011
35shall be used for the administration of the health insurance
-31-1premium payment program, including salaries, support,
2maintenance, and miscellaneous purposes.
315. a. The department may increase the amounts allocated
4for salaries, support, maintenance, and miscellaneous purposes
5associated with the medical assistance program, as necessary,
6to sustain cost management efforts. The department shall
7report any such increase to the legislative services agency and
8the department of management.
9b. If the savings to the medical assistance program from
10ongoing cost management efforts exceed the associated cost
11for the fiscal year beginning July 1, 2019, the department
12may transfer any savings generated for the fiscal year due
13to medical assistance program cost management efforts to the
14appropriation made in this division of this Act for medical
15contracts or general administration to defray the costs
16associated with implementing the efforts.
1716. For the fiscal year beginning July 1, 2019, and ending
18June 30, 2020, the replacement generation tax revenues required
19to be deposited in the property tax relief fund pursuant to
20section 437A.8, subsection 4, paragraph “d”, and section
21437A.15, subsection 3, paragraph “f”, shall instead be credited
22to and supplement the appropriation made in this section and
23used for the allocations made in this section.
2417. a. Of the funds appropriated in this section, up
25to $50,000 may be transferred by the department to the
26appropriation made in this division of this Act to the
27department for the same fiscal year for general administration
28to be used for associated administrative expenses and for not
29more than one full-time equivalent position, in addition to
30those authorized for the same fiscal year, to be assigned to
31implementing the children’s mental health home project.
32b. Of the funds appropriated in this section, up to $400,000
33may be transferred by the department to the appropriation made
34to the department in this division of this Act for the same
35fiscal year for Medicaid program-related general administration
-32-1planning and implementation activities. The funds may be used
2for contracts or for personnel in addition to the amounts
3appropriated for and the positions authorized for general
4administration for the fiscal year.
5c. Of the funds appropriated in this section, up to
6$3,000,000 may be transferred by the department to the
7appropriations made in this division of this Act for the same
8fiscal year for general administration or medical contracts
9to be used to support the development and implementation of
10standardized assessment tools for persons with mental illness,
11an intellectual disability, a developmental disability, or a
12brain injury.
1318. Of the funds appropriated in this section, $150,000
14shall be used for lodging expenses associated with care
15provided at the university of Iowa hospitals and clinics for
16patients with cancer whose travel distance is 30 miles or more
17and whose income is at or below 200 percent of the federal
18poverty level as defined by the most recently revised poverty
19income guidelines published by the United States department of
20health and human services. The department of human services
21shall establish the maximum number of overnight stays and the
22maximum rate reimbursed for overnight lodging, which may be
23based on the state employee rate established by the department
24of administrative services. The funds allocated in this
25subsection shall not be used as nonfederal share matching
26funds.
2719. Of the funds appropriated in this section, up to
28$3,383,880 shall be used for administration of the state family
29planning services program pursuant to section 217.41B, and
30of this amount, the department may use up to $200,000 for
31administrative expenses.
3220. Of the funds appropriated in this section, $1,545,530
33shall be used and may be transferred to other appropriations
34in this division of this Act as necessary to administer the
35provisions in the division of this Act relating to Medicaid
-33-1program administration.
221. The department shall continue to implement and
3administer the provisions of 2018 Iowa Acts, chapter 1056.
4Of the funds appropriated in this section, up to $39,069 may
5be transferred to the department of inspections and appeals
6for inspection costs related to such implementation and
7administration.
822. Of the funds appropriated in this section, up to
9$1,200,000 shall be used to implement reductions in the waiting
10list for the children’s mental health home and community-based
11services waiver.
1223. Of the funds appropriated in this section, a sufficient
13amount shall be used to reinstate cost-based reimbursement and
14the settlement process under both fee-for-service and managed
15care administration of the Medicaid program for critical access
16hospitals in the state, as designated pursuant to 42 U.S.C.
17§1395i-4, to provide reimbursement at the rate provided for
18such hospitals under the federal Medicare program.
1924. Of the funds appropriated in this section, the
20department shall use a sufficient amount to audit all
21prescription drug benefit claims managed by a pharmacy
22benefit manager under the Medicaid program. The audit shall
23address issues including but not limited to transparency of
24data on pharmacy services, the relationship between pharmacy
25reimbursement and overall costs to the Medicaid program or
26spread pricing, any potential conflicts of interest related
27to a retail pharmacy chain that is affiliated with a pharmacy
28benefit manager and any reported reductions in pharmacy
29reimbursements, and the impact of reduction in pharmacy
30reimbursement on access to care, especially in rural areas.
31The department shall report the findings and recommendations of
32the audit to the governor and the general assembly by December
3315, 2019.
34 Sec. 14. MEDICAL CONTRACTS. There is appropriated from the
35general fund of the state to the department of human services
-34-1for the fiscal year beginning July 1, 2019, and ending June 30,
22020, the following amount, or so much thereof as is necessary,
3to be used for the purpose designated:
4For medical contracts:
.................................................. $517,992,530
61. The department of inspections and appeals shall
7provide all state matching funds for survey and certification
8activities performed by the department of inspections
9and appeals. The department of human services is solely
10responsible for distributing the federal matching funds for
11such activities.
122. Of the funds appropriated in this section, $50,000 shall
13be used for continuation of home and community-based services
14waiver quality assurance programs, including the review and
15streamlining of processes and policies related to oversight and
16quality management to meet state and federal requirements.
173. Of the amount appropriated in this section, up to
18$200,000 may be transferred to the appropriation for general
19administration in this division of this Act to be used for
20additional full-time equivalent positions in the development
21of key health initiatives such as development and oversight
22of managed care programs and development of health strategies
23targeted toward improved quality and reduced costs in the
24Medicaid program.
254. Of the funds appropriated in this section, $1,000,000
26shall be used for planning and development, in cooperation with
27the department of public health, of a phased-in program to
28provide a dental home for children.
295. a. Of the funds appropriated in this section, $573,000
30shall be credited to the autism support program fund created
31in section 225D.2 to be used for the autism support program
32created in chapter 225D, with the exception of the following
33amount of this allocation which shall be used as follows:
34b. Of the funds allocated in this subsection, $25,000 shall
35be used for the public purpose of continuation of a grant to a
-35-1nonprofit provider of child welfare services that has been in
2existence for more than 115 years, is located in a county with
3a population between 200,000 and 220,000 according to the most
4recent federal decennial census, is licensed as a psychiatric
5medical institution for children, and provides school-based
6programming, to be used for support services for children with
7autism spectrum disorder and their families.
8 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
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:
14For the state supplementary assistance program:
.................................................. $157,812,909
162. The department shall increase the personal needs
17allowance for residents of residential care facilities by the
18same percentage and at the same time as federal supplemental
19security income and federal social security benefits are
20increased due to a recognized increase in the cost of living.
21The department may adopt emergency rules to implement this
22subsection.
233. If during the fiscal year beginning July 1, 2019,
24the department projects that state supplementary assistance
25expenditures for a calendar year will not meet the federal
26pass-through requirement specified in Tit.XVI of the federal
27Social Security Act, section 1618, as codified in 42 U.S.C.
28§1382g, the department may take actions including but not
29limited to increasing the personal needs allowance for
30residential care facility residents and making programmatic
31adjustments or upward adjustments of the residential care
32facility or in-home health-related care reimbursement rates
33prescribed in this division of this Act to ensure that federal
34requirements are met. In addition, the department may make
35other programmatic and rate adjustments necessary to remain
-36-1within the amount appropriated in this section while ensuring
2compliance with federal requirements. The department may adopt
3emergency rules to implement the provisions of this subsection.
44. Notwithstanding section 8.33, moneys appropriated in
5this section that remain unencumbered or unobligated at the
6close of the fiscal year shall not revert but shall remain
7available for expenditure for the purposes designated until the
8close of the succeeding fiscal year.
9 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
101. There is appropriated from the general fund of the
11state to the department of human services for the fiscal year
12beginning July 1, 2019, and ending June 30, 2020, the following
13amount, or so much thereof as is necessary, to be used for the
14purpose designated:
15For maintenance of the healthy and well kids in Iowa (hawk-i)
16program pursuant to chapter 514I, including supplemental dental
17services, for receipt of federal financial participation under
18Tit.XXI of the federal Social Security Act, which creates the
19children’s health insurance program:
.................................................. $2019,361,112
212. Of the funds appropriated in this section, $79,486 is
22allocated for continuation of the contract for outreach with
23the department of public health.
243. A portion of the funds appropriated in this section may
25be transferred to the appropriations made in this division of
26this Act for field operations or medical contracts to be used
27for the integration of hawk-i program eligibility, payment, and
28administrative functions under the purview of the department
29of human services, including for the Medicaid management
30information system upgrade.
31 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated
32from the general fund of the state to the department of human
33services for the fiscal year beginning July 1, 2019, and ending
34June 30, 2020, the following amount, or so much thereof as is
35necessary, to be used for the purpose designated:
-37- 1For child care programs:
.................................................. $240,816,931
31. Of the funds appropriated in this section, $34,966,931
4shall be used for state child care assistance in accordance
5with section 237A.13.
62. Nothing in this section shall be construed or is
7intended as or shall imply a grant of entitlement for services
8to persons who are eligible for assistance due to an income
9level consistent with the waiting list requirements of section
10237A.13. Any state obligation to provide services pursuant to
11this section is limited to the extent of the funds appropriated
12in this section.
133. A list of the registered and licensed child care
14facilities operating in the area served by a child care
15resource and referral service shall be made available to the
16families receiving state child care assistance in that area.
174. Of the funds appropriated in this section, $5,850,000
18shall be credited to the early childhood programs grants
19account in the early childhood Iowa fund created in section
20256I.11. The moneys shall be distributed for funding of
21community-based early childhood programs targeted to children
22from birth through five years of age developed by early
23childhood Iowa areas in accordance with approved community
24plans as provided in section 256I.8.
255. The department may use any of the funds appropriated
26in this section as a match to obtain federal funds for use in
27expanding child care assistance and related programs. For
28the purpose of expenditures of state and federal child care
29funding, funds shall be considered obligated at the time
30expenditures are projected or are allocated to the department’s
31service areas. Projections shall be based on current and
32projected caseload growth, current and projected provider
33rates, staffing requirements for eligibility determination
34and management of program requirements including data systems
35management, staffing requirements for administration of the
-38-1program, contractual and grant obligations and any transfers
2to other state agencies, and obligations for decategorization
3or innovation projects.
46. A portion of the state match for the federal child care
5and development block grant shall be provided as necessary to
6meet federal matching funds requirements through the state
7general fund appropriation made for child development grants
8and other programs for at-risk children in section 279.51.
97. If a uniform reduction ordered by the governor under
10section 8.31 or other operation of law, transfer, or federal
11funding reduction reduces the appropriation made in this
12section for the fiscal year, the percentage reduction in the
13amount paid out to or on behalf of the families participating
14in the state child care assistance program shall be equal to or
15less than the percentage reduction made for any other purpose
16payable from the appropriation made in this section and the
17federal funding relating to it. The percentage reduction to
18the other allocations made in this section shall be the same as
19the uniform reduction ordered by the governor or the percentage
20change of the federal funding reduction, as applicable. If
21there is an unanticipated increase in federal funding provided
22for state child care services, the entire amount of the
23increase, except as necessary to meet federal requirements
24including quality set asides, shall be used for state child
25care assistance payments. If the appropriations made for
26purposes of the state child care assistance program for the
27fiscal year are determined to be insufficient, it is the intent
28of the general assembly to appropriate sufficient funding for
29the fiscal year in order to avoid establishment of waiting list
30requirements.
318. Notwithstanding section 8.33, moneys advanced for
32purposes of the programs developed by early childhood Iowa
33areas, advanced for purposes of wraparound child care, or
34received from the federal appropriations made for the purposes
35of this section that remain unencumbered or unobligated at the
-39-1close of the fiscal year shall not revert to any fund but shall
2remain available for expenditure for the purposes designated
3until the close of the succeeding fiscal year.
4 Sec. 18. JUVENILE INSTITUTION. There is appropriated
5from the general fund of the state to the department of human
6services for the fiscal year beginning July 1, 2019, and ending
7June 30, 2020, the following amounts, or so much thereof as is
8necessary, to be used for the purposes designated:
91. a. For operation of the state training school at Eldora
10and for salaries, support, maintenance, and miscellaneous
11purposes, and for not more than the following full-time
12equivalent positions:
.................................................. $1313,920,757
............................................... FTEs14207.00
15b. Of the funds appropriated in this subsection, $91,000
16shall be used for distribution to licensed classroom teachers
17at this and other institutions under the control of the
18department of human services based upon the average student
19yearly enrollment at each institution as determined by the
20department.
21c. The additional full-time equivalent positions authorized
22in paragraph “a” shall include 1.00 youth services technician,
231.00 clinical supervisor, and 1.00 registered nurse, or
24comparable additional, full-time equivalent positions.
252. A portion of the moneys appropriated in this section
26shall be used by the state training school at Eldora for
27grants for adolescent pregnancy prevention activities at the
28institution in the fiscal year beginning July 1, 2019.
293. Of the funds appropriated in this subsection, $212,000
30shall be used by the state training school at Eldora for a
31substance use disorder treatment program at the institution for
32the fiscal year beginning July 1, 2019.
334. Notwithstanding section 8.33, moneys appropriated in
34this section that remain unencumbered or unobligated at the
35close of the fiscal year shall not revert but shall remain
-40-1available for expenditure for the purposes designated until the
2close of the succeeding fiscal year.
3 Sec. 19. CHILD AND FAMILY SERVICES.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2019, and ending June 30, 2020, the following
7amount, or so much thereof as is necessary, to be used for the
8purpose designated:
9For child and family services:
.................................................. $1089,071,761
112. The department may transfer funds appropriated in this
12section as necessary to pay the nonfederal costs of services
13reimbursed under the medical assistance program, state child
14care assistance program, or the family investment program which
15are provided to children who would otherwise receive services
16paid under the appropriation in this section. The department
17may transfer funds appropriated in this section to the
18appropriations made in this division of this Act for general
19administration and for field operations for resources necessary
20to implement and operate the services funded in this section.
213. a. Of the funds appropriated in this section, up to
22$34,536,000 is allocated as the statewide expenditure target
23under section 232.143 for group foster care maintenance and
24services. If the department projects that such expenditures
25for the fiscal year will be less than the target amount
26allocated in this paragraph “a”, the department may reallocate
27the excess to provide additional funding for family foster
28care, independent living, family safety, risk and permanency
29services, shelter care, or the child welfare emergency services
30addressed with the allocation for shelter care.
31b. If at any time after September 30, 2019, annualization
32of a service area’s current expenditures indicates a service
33area is at risk of exceeding its group foster care expenditure
34target under section 232.143 by more than 5 percent, the
35department and juvenile court services shall examine all
-41-1group foster care placements in that service area in order to
2identify those which might be appropriate for termination.
3In addition, any aftercare services believed to be needed
4for the children whose placements may be terminated shall be
5identified. The department and juvenile court services shall
6initiate action to set dispositional review hearings for the
7placements identified. In such a dispositional review hearing,
8the juvenile court shall determine whether needed aftercare
9services are available and whether termination of the placement
10is in the best interest of the child and the community.
114. In accordance with the provisions of section 232.188,
12the department shall continue the child welfare and juvenile
13justice funding initiative during fiscal year 2019-2020. Of
14the funds appropriated in this section, $1,717,000 is allocated
15specifically for expenditure for fiscal year 2019-2020 through
16the decategorization services funding pools and governance
17boards established pursuant to section 232.188.
185. A portion of the funds appropriated in this section
19may be used for emergency family assistance to provide other
20resources required for a family participating in a family
21preservation or reunification project or successor project to
22stay together or to be reunified.
236. Of the funds appropriated in this section, a sufficient
24amount is allocated for shelter care and the child welfare
25emergency services contracting implemented to provide for or
26prevent the need for shelter care.
277. Federal funds received by the state during the fiscal
28year beginning July 1, 2019, as the result of the expenditure
29of state funds appropriated during a previous state fiscal
30year for a service or activity funded under this section are
31appropriated to the department to be used as additional funding
32for services and purposes provided for under this section.
33Notwithstanding section 8.33, moneys received in accordance
34with this subsection that remain unencumbered or unobligated at
35the close of the fiscal year shall not revert to any fund but
-42-1shall remain available for the purposes designated until the
2close of the succeeding fiscal year.
38. a. Of the funds appropriated in this section, up to
4$3,290,000 is allocated for the payment of the expenses of
5court-ordered services provided to juveniles who are under the
6supervision of juvenile court services, which expenses are a
7charge upon the state pursuant to section 232.141, subsection
84. Of the amount allocated in this paragraph “a”, up to
9$1,556,000 shall be made available to provide school-based
10supervision of children adjudicated under chapter 232, of which
11not more than $15,000 may be used for the purpose of training.
12A portion of the cost of each school-based liaison officer
13shall be paid by the school district or other funding source as
14approved by the chief juvenile court officer.
15b. Of the funds appropriated in this section, up to $748,000
16is allocated for the payment of the expenses of court-ordered
17services provided to children who are under the supervision
18of the department, which expenses are a charge upon the state
19pursuant to section 232.141, subsection 4.
20c. Notwithstanding section 232.141 or any other provision
21of law to the contrary, the amounts allocated in this
22subsection shall be distributed to the judicial districts
23as determined by the state court administrator and to the
24department’s service areas as determined by the administrator
25of the department of human services’ division of child and
26family services. The state court administrator and the
27division administrator shall make the determination of the
28distribution amounts on or before June 15, 2019.
29d. Notwithstanding chapter 232 or any other provision of
30law to the contrary, a district or juvenile court shall not
31order any service which is a charge upon the state pursuant
32to section 232.141 if there are insufficient court-ordered
33services funds available in the district court or departmental
34service area distribution amounts to pay for the service. The
35chief juvenile court officer and the departmental service area
-43-1manager shall encourage use of the funds allocated in this
2subsection such that there are sufficient funds to pay for
3all court-related services during the entire year. The chief
4juvenile court officers and departmental service area managers
5shall attempt to anticipate potential surpluses and shortfalls
6in the distribution amounts and shall cooperatively request the
7state court administrator or division administrator to transfer
8funds between the judicial districts’ or departmental service
9areas’ distribution amounts as prudent.
10e. Notwithstanding any provision of law to the contrary,
11a district or juvenile court shall not order a county to pay
12for any service provided to a juvenile pursuant to an order
13entered under chapter 232 which is a charge upon the state
14under section 232.141, subsection 4.
15f. Of the funds allocated in this subsection, not more than
16$83,000 may be used by the judicial branch for administration
17of the requirements under this subsection.
18g. Of the funds allocated in this subsection, $17,000
19shall be used by the department of human services to support
20the interstate commission for juveniles in accordance with
21the interstate compact for juveniles as provided in section
22232.173.
239. Of the funds appropriated in this section, $12,253,000 is
24allocated for juvenile delinquent graduated sanctions services.
25Any state funds saved as a result of efforts by juvenile court
26services to earn a federal Tit.IV-E match for juvenile court
27services administration may be used for the juvenile delinquent
28graduated sanctions services.
2910. Of the funds appropriated in this section, $1,658,000 is
30transferred to the department of public health to be used for
31the child protection center grant program for child protection
32centers located in Iowa in accordance with section 135.118.
33The grant amounts under the program shall be equalized so that
34each center receives a uniform base amount of $245,000, and so
35that the remaining funds are awarded through a funding formula
-44-1based upon the volume of children served. To increase access
2to child protection center services for children in rural
3areas, the funding formula for the awarding of the remaining
4funds shall provide for the awarding of an enhanced amount to
5eligible grantees to develop and maintain satellite centers in
6underserved regions of the state.
711. Of the funds appropriated in this section, $4,025,000 is
8allocated for the preparation for adult living program pursuant
9to section 234.46.
1012. Of the funds appropriated in this section, $227,000
11shall be used for the public purpose of continuing a grant to a
12nonprofit human services organization, providing services to
13individuals and families in multiple locations in southwest
14Iowa and Nebraska for support of a project providing immediate,
15sensitive support and forensic interviews, medical exams, needs
16assessments, and referrals for victims of child abuse and their
17nonoffending family members.
1813. Of the funds appropriated in this section, $300,000
19is allocated for the foster care youth council approach of
20providing a support network to children placed in foster care.
2114. Of the funds appropriated in this section, $202,000 is
22allocated for use pursuant to section 235A.1 for continuation
23of the initiative to address child sexual abuse implemented
24pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
2521.
2615. Of the funds appropriated in this section, $630,000 is
27allocated for the community partnership for child protection
28sites.
2916. Of the funds appropriated in this section, $371,000
30is allocated for the department’s minority youth and family
31projects under the redesign of the child welfare system.
3217. Of the funds appropriated in this section, $851,000
33is allocated for funding of the community circle of care
34collaboration for children and youth in northeast Iowa.
3518. Of the funds appropriated in this section, at least
-45-1$147,000 shall be used for the continuation of the child
2welfare provider training academy, a collaboration between the
3coalition for family and children’s services in Iowa and the
4department.
519. Of the funds appropriated in this section, $211,000
6shall be used for continuation of the central Iowa system of
7care program grant through June 30, 2020.
820. Of the funds appropriated in this section, $235,000
9shall be used for the public purpose of the continuation
10and expansion of a system of care program grant implemented
11in Cerro Gordo and Linn counties to utilize a comprehensive
12and long-term approach for helping children and families by
13addressing the key areas in a child’s life of childhood basic
14needs, education and work, family, and community.
1521. Of the funds appropriated in this section, at least
16$25,000 shall be used to continue and to expand the foster
17care respite pilot program in which postsecondary students in
18social work and other human services-related programs receive
19experience by assisting family foster care providers with
20respite and other support.
2122. Of the funds appropriated in this section, $110,000
22shall be used for the public purpose of funding community-based
23services and other supports with a system of care approach
24for children with a serious emotional disturbance and their
25families through a nonprofit provider of child welfare services
26that has been in existence for more than 115 years, is located
27in a county with a population of more than 200,000 but less
28than 220,000 according to the latest certified federal census,
29is licensed as a psychiatric medical institution for children,
30and was a system of care grantee prior to July 1, 2019.
3123. If a separate funding source is identified that reduces
32the need for state funds within an allocation under this
33section, the allocated state funds may be redistributed to
34other allocations under this section for the same fiscal year.
35 Sec. 20. ADOPTION SUBSIDY.
-46- 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:
6a. For adoption subsidy payments and services:
.................................................. $740,596,007
8b. (1) The funds appropriated in this section shall be used
9as authorized or allowed by federal law or regulation for any
10of the following purposes:
11(a) For adoption subsidy payments and related costs.
12(b) For post-adoption services and for other purposes under
13Tit.IV-B or Tit.IV-E of the federal Social Security Act.
14(2) The department of human services may transfer funds
15appropriated in this subsection to the appropriation for
16child and family services in this Act for the purposes of
17post-adoption services as specified in this paragraph “b”.
18c. Notwithstanding section 8.33, moneys corresponding to
19the state savings resulting from implementation of the federal
20Fostering Connections to Success and Increasing Adoptions Act
21of 2008, Pub.L. No.110-351, and successor legislation, as
22determined in accordance with 42 U.S.C. §673(a)(8), that remain
23unencumbered or unobligated at the close of the fiscal year,
24shall not revert to any fund but shall remain available for the
25purposes designated in this subsection until expended. The
26amount of such savings and any corresponding funds remaining
27at the close of the fiscal year shall be determined separately
28and any changes in either amount between fiscal years shall not
29result in an unfunded need.
302. The department may transfer funds appropriated in
31this section to the appropriation made in this division of
32this Act for general administration for costs paid from the
33appropriation relating to adoption subsidy.
343. Federal funds received by the state during the
35fiscal year beginning July 1, 2019, as the result of the
-47-1expenditure of state funds during a previous state fiscal
2year for a service or activity funded under this section are
3appropriated to the department to be used as additional funding
4for the services and activities funded under this section.
5Notwithstanding section 8.33, moneys received in accordance
6with this subsection that remain unencumbered or unobligated
7at the close of the fiscal year shall not revert to any fund
8but shall remain available for expenditure for the purposes
9designated until the close of the succeeding fiscal year.
10 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited
11in the juvenile detention home fund created in section 232.142
12during the fiscal year beginning July 1, 2019, and ending June
1330, 2020, are appropriated to the department of human services
14for the fiscal year beginning July 1, 2019, and ending June 30,
152020, for distribution of an amount equal to a percentage of
16the costs of the establishment, improvement, operation, and
17maintenance of county or multicounty juvenile detention homes
18in the fiscal year beginning July 1, 2018. Moneys appropriated
19for distribution in accordance with this section shall be
20allocated among eligible detention homes, prorated on the basis
21of an eligible detention home’s proportion of the costs of all
22eligible detention homes in the fiscal year beginning July
231, 2018. The percentage figure shall be determined by the
24department based on the amount available for distribution for
25the fund. Notwithstanding section 232.142, subsection 3, the
26financial aid payable by the state under that provision for the
27fiscal year beginning July 1, 2019, shall be limited to the
28amount appropriated for the purposes of this section.
29 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM.
301. There is appropriated from the general fund of the
31state to the department of human services for the fiscal year
32beginning July 1, 2019, and ending June 30, 2020, the following
33amount, or so much thereof as is necessary, to be used for the
34purpose designated:
35For the family support subsidy program subject to the
-48-1enrollment restrictions in section 225C.37, subsection 3:
.................................................. $2949,282
32. At least $819,275 of the moneys appropriated in this
4section is transferred to the department of public health for
5the family support center component of the comprehensive family
6support program under chapter 225C, subchapter V.
73. If at any time during the fiscal year, the amount of
8funding available for the family support subsidy program
9is reduced from the amount initially used to establish the
10figure for the number of family members for whom a subsidy
11is to be provided at any one time during the fiscal year,
12notwithstanding section 225C.38, subsection 2, the department
13shall revise the figure as necessary to conform to the amount
14of funding available.
15 Sec. 23. CONNER DECREE. There is appropriated from the
16general fund of the state to the department of human services
17for the fiscal year beginning July 1, 2019, and ending June 30,
182020, the following amount, or so much thereof as is necessary,
19to be used for the purpose designated:
20For building community capacity through the coordination
21and provision of training opportunities in accordance with the
22consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
23Iowa, July 14, 1994):
.................................................. $2433,632
25 Sec. 24. MENTAL HEALTH INSTITUTES.
261. There is appropriated from the general fund of the
27state to the department of human services for the fiscal year
28beginning July 1, 2019, and ending June 30, 2020, the following
29amounts, or so much thereof as is necessary, to be used for the
30purposes designated:
31a. (1) For operation of the state mental health institute
32at Cherokee as required by chapters 218 and 226 for salaries,
33support, maintenance, and miscellaneous purposes, and for not
34more than the following full-time equivalent positions:
.................................................. $3514,216,149
-49-............................................... FTEs1169.00
2(2) The additional full-time equivalent positions
3authorized in this paragraph “a” shall include 3.50 security
4staff and 3.00 support staff, or comparable additional,
5full-time equivalent positions.
6b. (1) For operation of the state mental health institute
7at Independence as required by chapters 218 and 226 for
8salaries, support, maintenance, and miscellaneous purposes, and
9for not more than the following full-time equivalent positions:
.................................................. $1019,165,110
............................................... FTEs11208.00
12(2) The additional full-time equivalent positions
13authorized in this paragraph “b” shall include 3.50 security
14staff, or comparable additional, full-time equivalent
15positions.
162. Notwithstanding sections 218.78 and 249A.11, any revenue
17received from the state mental health institute at Cherokee or
18the state mental health institute at Independence pursuant to
1942 C.F.R §438.6(e) may be retained and expended by the mental
20health institute.
213. Notwithstanding any provision of law to the contrary,
22a Medicaid member residing at the state mental health
23institute at Cherokee or the state mental health institute
24at Independence shall retain Medicaid eligibility during
25the period of the Medicaid member’s stay for which federal
26financial participation is available.
274. Notwithstanding section 8.33, moneys appropriated in
28this section that remain unencumbered or unobligated at the
29close of the fiscal year shall not revert but shall remain
30available for expenditure for the purposes designated until the
31close of the succeeding fiscal year.
32 Sec. 25. STATE RESOURCE CENTERS.
331. There is appropriated from the general fund of the
34state to the department of human services for the fiscal year
35beginning July 1, 2019, and ending June 30, 2020, the following
-50-1amounts, or so much thereof as is necessary, to be used for the
2purposes designated:
3a. For the state resource center at Glenwood for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $516,048,348
6b. For the state resource center at Woodward for salaries,
7support, maintenance, and miscellaneous purposes:
.................................................. $810,872,356
92. The department may continue to bill for state resource
10center services utilizing a scope of services approach used for
11private providers of intermediate care facilities for persons
12with an intellectual disability services, in a manner which
13does not shift costs between the medical assistance program,
14counties, or other sources of funding for the state resource
15centers.
163. The state resource centers may expand the time-limited
17assessment and respite services during the fiscal year.
184. If the department’s administration and the department
19of management concur with a finding by a state resource
20center’s superintendent that projected revenues can reasonably
21be expected to pay the salary and support costs for a new
22employee position, or that such costs for adding a particular
23number of new positions for the fiscal year would be less
24than the overtime costs if new positions would not be added,
25the superintendent may add the new position or positions. If
26the vacant positions available to a resource center do not
27include the position classification desired to be filled, the
28state resource center’s superintendent may reclassify any
29vacant position as necessary to fill the desired position. The
30superintendents of the state resource centers may, by mutual
31agreement, pool vacant positions and position classifications
32during the course of the fiscal year in order to assist one
33another in filling necessary positions.
345. If existing capacity limitations are reached in
35operating units, a waiting list is in effect for a service or
-51-1a special need for which a payment source or other funding
2is available for the service or to address the special need,
3and facilities for the service or to address the special need
4can be provided within the available payment source or other
5funding, the superintendent of a state resource center may
6authorize opening not more than two units or other facilities
7and begin implementing the service or addressing the special
8need during fiscal year 2019-2020.
96. Notwithstanding section 8.33, and notwithstanding
10the amount limitation specified in section 222.92, moneys
11appropriated in this section that remain unencumbered or
12unobligated at the close of the fiscal year shall not revert
13but shall remain available for expenditure for the purposes
14designated until the close of the succeeding fiscal year.
15 Sec. 26. SEXUALLY VIOLENT PREDATORS.
161. a. 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 costs associated with the commitment and treatment of
22sexually violent predators in the unit located at the state
23mental health institute at Cherokee, including costs of legal
24services and other associated costs, including salaries,
25support, maintenance, and miscellaneous purposes, and for not
26more than the following full-time equivalent positions:
.................................................. $2712,053,093
............................................... FTEs28139.00
29b. The additional full-time equivalent positions authorized
30in paragraph “a” shall include 7.00 clinical and support staff,
31or comparable additional, full-time equivalent positions.
322. Unless specifically prohibited by law, if the amount
33charged provides for recoupment of at least the entire amount
34of direct and indirect costs, the department of human services
35may contract with other states to provide care and treatment
-52-1of persons placed by the other states at the unit for sexually
2violent predators at Cherokee. The moneys received under
3such a contract shall be considered to be repayment receipts
4and used for the purposes of the appropriation made in this
5section.
63. Notwithstanding section 8.33, moneys appropriated in
7this section that remain unencumbered or unobligated at the
8close of the fiscal year shall not revert but shall remain
9available for expenditure for the purposes designated until the
10close of the succeeding fiscal year.
11 Sec. 27. FIELD OPERATIONS.
121. There is appropriated from the general fund of the
13state to the department of human services for the fiscal year
14beginning July 1, 2019, and ending June 30, 2020, the following
15amount, or so much thereof as is necessary, to be used for the
16purposes designated:
17For field operations, including salaries, support,
18maintenance, and miscellaneous purposes, and for not more than
19the following full-time equivalent positions:
.................................................. $2055,396,906
............................................... FTEs211,539.00
222. The additional full-time equivalent positions authorized
23in subsection 1 shall include 29.00 full-time equivalent staff
24positions to relieve caseloads and 6.00 full-time equivalent
25positions related to the eligibility integrated application
26solution (ELIAS) system.
273. Priority in filling full-time equivalent positions
28shall be given to those positions related to child protection
29services and eligibility determination for low-income families.
30 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
31from the general fund of the state to the department of human
32services for the fiscal year beginning July 1, 2019, and ending
33June 30, 2020, the following amount, or so much thereof as is
34necessary, to be used for the purpose designated:
35For general administration, including salaries, support,
-53-1maintenance, and miscellaneous purposes, and for not more than
2the following full-time equivalent positions:
.................................................. $313,833,040
............................................... FTEs4294.00
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
-54-1of 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 behavioral health system.
8c. Of the amount allocated, $32,000 shall be transferred
9to the 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 behavioral health system.
14 Sec. 29. 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. 30. VOLUNTEERS. There is appropriated from the general
24fund of the state 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:
28For development and coordination of volunteer services:
.................................................. $2984,686
30 Sec. 31. CORPORATE TECHNOLOGY. There is appropriated
31from the general fund of the state to the department of human
32services for the fiscal year beginning July 1, 2019, and ending
33June 30, 2020, the following amount, or so much thereof as is
34necessary, to be used for the purposes designated:
35For the purchase of department-wide technology and software
-55-1update needs:
.................................................. $2824,832
3 Sec. 32. 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 $27,479,942, 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
35prospectively from the effective date of the rate letter issued
-56-1by the department.
2b. (1) For the fiscal year beginning July 1, 2019,
3the department shall establish the pharmacy dispensing fee
4reimbursement at $10.07 per prescription, until a cost of
5dispensing survey is completed. The actual dispensing fee
6shall be determined by a cost of dispensing survey performed
7by the department and required to be completed by all medical
8assistance program participating pharmacies every two years,
9adjusted as necessary to maintain expenditures within the
10amount appropriated to the department for this purpose for the
11fiscal year.
12(2) The department shall utilize an average acquisition
13cost reimbursement methodology for all drugs covered under the
14medical assistance program in accordance with 2012 Iowa Acts,
15chapter 1133, section 33.
16c. (1) For the fiscal year beginning July 1, 2019,
17reimbursement rates for outpatient hospital services shall
18remain at the rates in effect on June 30, 2019, subject to
19Medicaid program upper payment limit rules, and adjusted
20as necessary to maintain expenditures within the amount
21appropriated to the department for this purpose for the fiscal
22year.
23(2) For the fiscal year beginning July 1, 2019,
24reimbursement rates for inpatient hospital services shall
25remain at the rates in effect on June 30, 2019, subject to
26Medicaid program upper payment limit rules, and adjusted
27as necessary to maintain expenditures within the amount
28appropriated to the department for this purpose for the fiscal
29year.
30(3) For the fiscal year beginning July 1, 2019, under
31both fee-for-service and managed care administration of the
32Medicaid program, critical access hospitals in the state,
33as designated pursuant to 42 U.S.C. §1395i-4, shall receive
34cost-based reimbursement utilizing a settlement process to
35provide reimbursement at the rate provided such hospitals under
-57-1the federal Medicare program.
2(4) For the fiscal year beginning July 1, 2019, the graduate
3medical education and disproportionate share hospital fund
4shall remain at the amount in effect on June 30, 2019, except
5that the portion of the fund attributable to graduate medical
6education shall be reduced in an amount that reflects the
7elimination of graduate medical education payments made to
8out-of-state hospitals.
9(5) In order to ensure the efficient use of limited state
10funds in procuring health care services for low-income Iowans,
11funds appropriated in this Act for hospital services shall
12not be used for activities which would be excluded from a
13determination of reasonable costs under the federal Medicare
14program pursuant to 42 U.S.C.§1395x(v)(1)(N).
15d. For the fiscal year beginning July 1, 2019, reimbursement
16rates for hospices and acute psychiatric hospitals shall be
17increased in accordance with increases under the federal
18Medicare program or as supported by their Medicare audited
19costs.
20e. For the fiscal year beginning July 1, 2019, independent
21laboratories and rehabilitation agencies shall be reimbursed
22using the same methodology in effect on June 30, 2019.
23f. (1) For the fiscal year beginning July 1, 2019,
24reimbursement rates for home health agencies shall be rebased,
25to the extent possible, within the state funding appropriated
26for this purpose, and shall continue to be based on the
27Medicare low utilization payment adjustment (LUPA) methodology
28with state geographic wage adjustments to reflect the most
29recent Medicare LUPA rates to the extent possible within the
30state funding appropriated for this purpose.
31(2) For the fiscal year beginning July 1, 2019, rates for
32private duty nursing and personal care services under the early
33and periodic screening, diagnostic, and treatment program
34benefit shall be calculated based on the methodology in effect
35on June 30, 2019.
-58- 1g. For the fiscal year beginning July 1, 2019, federally
2qualified health centers and rural health clinics shall receive
3cost-based reimbursement for 100 percent of the reasonable
4costs for the provision of services to recipients of medical
5assistance.
6h. For the fiscal year beginning July 1, 2019, the
7reimbursement rates for dental services shall remain at the
8rates in effect on June 30, 2019.
9i. (1) For the fiscal year beginning July 1, 2019,
10reimbursement rates for non-state-owned psychiatric medical
11institutions for children shall be based on the reimbursement
12methodology in effect on June 30, 2019.
13(2) As a condition of participation in the medical
14assistance program, enrolled providers shall accept the medical
15assistance reimbursement rate for any covered goods or services
16provided to recipients of medical assistance who are children
17under the custody of a psychiatric medical institution for
18children.
19j. For the fiscal year beginning July 1, 2019, unless
20otherwise specified in this Act, all noninstitutional medical
21assistance provider reimbursement rates shall remain at the
22rates in effect on June 30, 2019, except for area education
23agencies, local education agencies, infant and toddler
24services providers, home and community-based services providers
25including consumer-directed attendant care providers under a
26section 1915(c) or 1915(i) waiver, targeted case management
27providers, and those providers whose rates are required to be
28determined pursuant to section 249A.20, or to meet federal
29mental health parity requirements.
30k. Notwithstanding any provision to the contrary, for the
31fiscal year beginning July 1, 2019, the reimbursement rate for
32anesthesiologists shall remain at the rates in effect on June
3330, 2019, and updated on January 1, 2020, to align with the
34most current Iowa Medicare anesthesia rate.
35l. Notwithstanding section 249A.20, for the fiscal year
-59-1beginning July 1, 2019, the average reimbursement rate for
2health care providers eligible for use of the federal Medicare
3resource-based relative value scale reimbursement methodology
4under section 249A.20 shall remain at the rate in effect on
5June 30, 2019; however, this rate shall not exceed the maximum
6level authorized by the federal government.
7m. For the fiscal year beginning July 1, 2019, the
8reimbursement rate for residential care facilities shall not
9be less than the minimum payment level as established by the
10federal government to meet the federally mandated maintenance
11of effort requirement. The flat reimbursement rate for
12facilities electing not to file annual cost reports shall not
13be less than the minimum payment level as established by the
14federal government to meet the federally mandated maintenance
15of effort requirement.
16n. For the fiscal year beginning July 1, 2019, the
17reimbursement rates for inpatient mental health services
18provided at hospitals shall remain at the rates in effect on
19June 30, 2019, subject to Medicaid program upper payment limit
20rules; and psychiatrists shall be reimbursed at the medical
21assistance program fee-for-service rate in effect on June 30,
222019.
23o. For the fiscal year beginning July 1, 2019, community
24mental health centers may choose to be reimbursed for the
25services provided to recipients of medical assistance through
26either of the following options:
27(1) For 100 percent of the reasonable costs of the services.
28(2) In accordance with the alternative reimbursement rate
29methodology approved by the department of human services in
30effect on June 30, 2019.
31p. For the fiscal year beginning July 1, 2019, the
32reimbursement rate for providers of family planning services
33that are eligible to receive a 90 percent federal match shall
34remain at the rates in effect on June 30, 2019.
35q. Unless otherwise subject to a tiered rate methodology,
-60-1for the fiscal year beginning July 1, 2019, the upper
2limits and reimbursement rates for providers of home and
3community-based services waiver services shall be reimbursed
4using the reimbursement methodology in effect on June 30, 2019.
5r. For the fiscal year beginning July 1, 2019, the
6reimbursement rates for emergency medical service providers
7shall remain at the rates in effect on June 30, 2019.
8s. For the fiscal year beginning July 1, 2019, reimbursement
9rates for substance-related disorder treatment programs
10licensed under section 125.13 shall remain at the rates in
11effect on June 30, 2019.
12t. For the fiscal year beginning July 1, 2019, assertive
13community treatment per diem rates shall be adjusted to
14reflect an actual average per diem cost within the additional
15$1,088,437 appropriated for this purpose.
162. For the fiscal year beginning July 1, 2019, the
17reimbursement rate for providers reimbursed under the
18in-home-related care program shall not be less than the minimum
19payment level as established by the federal government to meet
20the federally mandated maintenance of effort requirement.
213. Unless otherwise directed in this section, when the
22department’s reimbursement methodology for any provider
23reimbursed in accordance with this section includes an
24inflation factor, this factor shall not exceed the amount
25by which the consumer price index for all urban consumers
26increased during the calendar year ending December 31, 2002.
274. Notwithstanding section 234.38, for the fiscal
28year beginning July 1, 2019, the foster family basic daily
29maintenance rate and the maximum adoption subsidy rate for
30children ages 0 through 5 years shall be $16.78, the rate for
31children ages 6 through 11 years shall be $17.45, the rate for
32children ages 12 through 15 years shall be $19.10, and the
33rate for children and young adults ages 16 and older shall
34be $19.35. For youth ages 18 to 21 who have exited foster
35care, the preparation for adult living program maintenance rate
-61-1shall be $602.70 per month. The maximum payment for adoption
2subsidy nonrecurring expenses shall be limited to $500 and the
3disallowance of additional amounts for court costs and other
4related legal expenses implemented pursuant to 2010 Iowa Acts,
5chapter 1031, section 408, shall be continued.
65. For the fiscal year beginning July 1, 2019, the maximum
7reimbursement rates for social services providers under
8contract shall remain at the rates in effect on June 30, 2019,
9or the provider’s actual and allowable cost plus inflation for
10each service, whichever is less. However, if a new service
11or service provider is added after June 30, 2019, the initial
12reimbursement rate for the service or provider shall be based
13upon a weighted average of provider rates for similar services.
146. a. For the fiscal year beginning July 1, 2019, the
15reimbursement rates for resource family recruitment and
16retention contractors shall be established by contract.
17b. For the fiscal year beginning July 1, 2019, the
18reimbursement rates for supervised apartment living foster care
19providers shall be established by contract.
207. For the fiscal year beginning July 1, 2019, the
21reimbursement rate for group foster care providers shall be the
22combined service and maintenance reimbursement rate established
23by contract.
248. The group foster care reimbursement rates paid for
25placement of children out of state shall be calculated
26according to the same rate-setting principles as those used for
27in-state providers, unless the director of human services or
28the director’s designee determines that appropriate care cannot
29be provided within the state. The payment of the daily rate
30shall be based on the number of days in the calendar month in
31which service is provided.
329. a. For the fiscal year beginning July 1, 2019, the
33reimbursement rate paid for shelter care and the child welfare
34emergency services implemented to provide or prevent the need
35for shelter care shall be established by contract.
-62- 1b. For the fiscal year beginning July 1, 2019, the combined
2service and maintenance components of the reimbursement rate
3paid for shelter care services shall be based on the financial
4and statistical report submitted to the department. The
5maximum reimbursement rate shall be $101.83 per day. The
6department shall reimburse a shelter care provider at the
7provider’s actual and allowable unit cost, plus inflation, not
8to exceed the maximum reimbursement rate.
9c. Notwithstanding section 232.141, subsection 8, for the
10fiscal year beginning July 1, 2019, the amount of the statewide
11average of the actual and allowable rates for reimbursement of
12juvenile shelter care homes that is utilized for the limitation
13on recovery of unpaid costs shall remain at the amount in
14effect for this purpose in the fiscal year beginning July 1,
152018.
1610. For the fiscal year beginning July 1, 2019, the
17department shall calculate reimbursement rates for intermediate
18care facilities for persons with an intellectual disability
19at the 80th percentile. Beginning July 1, 2019, the rate
20calculation methodology shall utilize the consumer price index
21inflation factor applicable to the fiscal year beginning July
221, 2019.
2311. Effective July 1, 2019, the child care provider
24reimbursement rates shall remain at the rates in effect on June
2530, 2019. The department shall set rates in a manner so as
26to provide incentives for a nonregistered provider to become
27registered by applying any increase only to registered and
28licensed providers.
2912. The department may adopt emergency rules to implement
30this section.
31 Sec. 33. CONTRACTED SERVICES — PROHIBITED USE OF STATE
32FUNDING FOR LOBBYING.
331. The department shall submit a report to the individuals
34identified in this Act for submission of reports by December
3515, 2019, regarding the outcomes of any program or activity for
-63-1which funding is appropriated or allocated from the general
2fund of the state to the department under this division of this
3Act, and for which a request for proposals process is required.
42. The department shall incorporate into the general
5conditions applicable to all award documents involving funding
6appropriated or allocated from the general fund of the state to
7the department under this division of this Act, a prohibition
8against the use of such funding for the compensation of a
9lobbyist. For the purposes of this section, “lobbyist” means
10the same as defined in section 68B.2; however, “lobbyist”
11does not include a person employed by a state agency of the
12executive branch of state government who represents the agency
13relative to the passage, defeat, approval, or modification of
14legislation that is being considered by the general assembly.
15 Sec. 34. LEGISLATIVE INTERIM COMMITTEE — HEALTH DATA
16COLLECTION. The legislative council shall establish a
17legislative interim committee to review the collection,
18maintaining, and disseminating of hospital inpatient,
19outpatient, and ambulatory data pursuant to section 135.166.
20The committee shall report findings and recommendations to the
21general assembly by December 15, 2019.
22 Sec. 35. EMERGENCY RULES.
231. If specifically authorized by a provision of this
24division of this Act, the department of human services or
25the mental health and disability services commission may
26adopt administrative rules under section 17A.4, subsection
273, and section 17A.5, subsection 2, paragraph “b”, to
28implement the provisions of this division of this Act and
29the rules shall become effective immediately upon filing or
30on a later effective date specified in the rules, unless the
31effective date of the rules is delayed or the applicability
32of the rules is suspended by the administrative rules review
33committee. Any rules adopted in accordance with this section
34shall not take effect before the rules are reviewed by the
35administrative rules review committee. The delay authority
-64-1provided to the administrative rules review committee under
2section 17A.4, subsection 7, and section 17A.8, subsection 9,
3shall be applicable to a delay imposed under this section,
4notwithstanding a provision in those sections making them
5inapplicable to section 17A.5, subsection 2, paragraph “b”.
6Any rules adopted in accordance with the provisions of this
7section shall also be published as a notice of intended action
8as provided in section 17A.4.
92. If during a fiscal year, the department of human
10services is adopting rules in accordance with this section
11or as otherwise directed or authorized by state law, and the
12rules will result in an expenditure increase beyond the amount
13anticipated in the budget process or if the expenditure was
14not addressed in the budget process for the fiscal year, the
15department shall notify the persons designated by this division
16of this Act for submission of reports, the chairpersons and
17ranking members of the committees on appropriations, and
18the department of management concerning the rules and the
19expenditure increase. The notification shall be provided at
20least 30 calendar days prior to the date notice of the rules
21is submitted to the administrative rules coordinator and the
22administrative code editor.
23 Sec. 36. REPORTS. Any reports or other information
24required to be compiled and submitted under this Act during the
25fiscal year beginning July 1, 2019, shall be submitted to the
26chairpersons and ranking members of the joint appropriations
27subcommittee on health and human services, the legislative
28services agency, and the legislative caucus staffs on or
29before the dates specified for submission of the reports or
30information.
31 Sec. 37. EFFECTIVE UPON ENACTMENT. The following
32provisions of this division of this Act, being deemed of
33immediate importance, take effect upon enactment:
341. The provision relating to section 232.141 and directing
35the state court administrator and the division administrator of
-65-1the department of human services division of child and family
2services to make the determination, by June 15, 2019, of the
3distribution of funds allocated for the payment of the expenses
4of court-ordered services provided to juveniles which are a
5charge upon the state.
6DIVISION VI
7HEALTH CARE ACCOUNTS AND FUNDS — FY 2019-2020
8 Sec. 38. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
9appropriated from the pharmaceutical settlement account created
10in section 249A.33 to the department of human services for the
11fiscal year beginning July 1, 2019, and ending June 30, 2020,
12the following amount, or so much thereof as is necessary, to be
13used for the purpose designated:
14Notwithstanding any provision of law to the contrary, to
15supplement the appropriations made in this Act for medical
16contracts under the medical assistance program for the fiscal
17year beginning July 1, 2019, and ending June 30, 2020:
.................................................. $18234,193
19 Sec. 39. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
20SERVICES. Notwithstanding any provision to the contrary and
21subject to the availability of funds, there is appropriated
22from the quality assurance trust fund created in section
23249L.4 to the department of human services for the fiscal year
24beginning July 1, 2019, and ending June 30, 2020, the following
25amounts, or so much thereof as is necessary, for the purposes
26designated:
27To supplement the appropriation made in this Act from the
28general fund of the state to the department of human services
29for medical assistance for the same fiscal year:
.................................................. $3058,570,397
31 Sec. 40. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
32DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
33the contrary and subject to the availability of funds, there is
34appropriated from the hospital health care access trust fund
35created in section 249M.4 to the department of human services
-66-1for the fiscal year beginning July 1, 2019, and ending June
230, 2020, the following amounts, or so much thereof as is
3necessary, for the purposes designated:
4To supplement the appropriation made in this Act from the
5general fund of the state to the department of human services
6for medical assistance for the same fiscal year:
.................................................. $733,920,554
8 Sec. 41. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
9FOR FY 2019-2020. Notwithstanding section 8.33, if moneys
10appropriated for purposes of the medical assistance program for
11the fiscal year beginning July 1, 2019, and ending June 30,
122020, from the general fund of the state, the quality assurance
13trust fund and the hospital health care access trust fund, are
14in excess of actual expenditures for the medical assistance
15program and remain unencumbered or unobligated at the close
16of the fiscal year, the excess moneys shall not revert but
17shall remain available for expenditure for the purposes of the
18medical assistance program until the close of the succeeding
19fiscal year.
20DIVISION VII
21GRADUATED SANCTION, COURT-ORDERED, AND GROUP FOSTER CARE
22SERVICES AND FUNDING WORK GROUP
23 Sec. 42. GRADUATED SANCTION, COURT-ORDERED, AND GROUP
24FOSTER CARE SERVICES AND FUNDING WORK GROUP.
251. As used in this section, unless the context otherwise
26requires:
27a. “Court-ordered services” means the defined or specific
28care and treatment that is ordered by the court for an eligible
29child and for which no other payment source is available to
30cover the cost.
31b. “Department” means the department of human services.
32c. “Eligible child” means a child who has been adjudicated
33delinquent, is at risk, or has been certified by the chief
34juvenile court officer as eligible for court-ordered services.
35d. “Graduated sanction services” includes community-based
-67-1interventions, school-based supervision, and supportive
2enhancements provided in community-based settings to an
3eligible child who is adjudicated delinquent or who is at risk
4of adjudication.
52. The division of criminal and juvenile justice planning
6of the department of human rights shall convene and provide
7administrative support to a work group to review and develop
8a plan to transfer the administration of graduated sanctions
9and court-ordered services and funding and the oversight of
10group foster care placements for eligible children from the
11department to the office of the state court administrator.
12The plan shall ensure that the office of the state court
13administrator has the capacity, resources, and expertise to
14manage the funding and services effectively.
153. a. In addition to a representative of the division of
16criminal and juvenile justice planning of the department of
17human rights, the membership of the work group shall include
18but is not limited to representatives of all of the following:
19(1) The judicial branch, including the state court
20administrator or the state court administrator’s designee,
21a juvenile court judge, at least one chief juvenile court
22officer, and a representative with fiscal and contract
23experience.
24(2) The department of human services, including
25representatives with experience managing graduated sanctions
26funding and group foster care placements.
27(3) The department of justice.
28(4) The juvenile justice advisory committee.
29(5) Member and nonmember agencies of the coalition for
30family and children’s services in Iowa.
31(6) Providers of community-based services for eligible
32children.
33(7) Providers of group foster care.
34(8) Attorneys who represent children in juvenile justice
35proceedings.
-68- 1(9) County attorneys.
2(10) Federal Title IV-E funding and services subject matter
3experts.
4(11) Individuals who formerly received services as eligible
5children or their parents.
6b. In addition, the work group membership shall include
7four members of the general assembly. The legislative members
8shall serve as ex officio, nonvoting members of the work group,
9with one member to be appointed by each of the following: the
10majority leader of the senate, the minority leader of the
11senate, the speaker of the house of representatives, and the
12minority leader of the house of representatives.
13c. In addition to the members specified, the division
14of criminal and juvenile justice planning may include other
15stakeholders with interest or expertise on the work group.
16d. Any expenses incurred by a member of the work group
17shall be the responsibility of the individual member or the
18respective entity represented by the member.
194. The work group shall do all of the following:
20a. Develop an action plan to transfer the administration
21of juvenile court graduated sanction services, court-ordered
22services, and associated funding from the department to the
23office of the state court administrator.
24b. Develop an action plan to transfer the oversight of
25group foster care services for eligible children from the
26department to the office of the state court administrator or
27other appropriate state entity with the necessary expertise to
28provide such services.
29c. Develop an action plan to transfer administration of the
30juvenile detention home fund created in section 232.142 from
31the department to the office of the state court administrator
32or other appropriate state entity.
33d. Evaluate current resources to determine the most
34efficient means of suitably equipping the office of the state
35court administrator with the policies and legal authority;
-69-1staffing; contracting, procurement, data, and quality assurance
2capabilities; and other resources necessary to manage such
3funds and associated services effectively. The evaluation
4shall require collaboration with the department to manage
5transition activities.
6e. Recommend statutory and administrative policies and
7court rules to promote collaborative case planning and quality
8assurance between the department and juvenile court services
9for youth who may be involved in both the child welfare and
10juvenile justice systems or who may utilize the same providers
11or services.
12f. Determine the impact and role of the federal Family
13First Prevention Services Act relative to the various funding
14streams and services under the purview of the work group, and
15recommend statutory and administrative policies and rules to
16coordinate the duties of the work group with implementation and
17administration of the federal Act.
18g. Determine the role of the decategorization of child
19welfare and juvenile justice funding initiative pursuant
20to section 232.188 relative to the other funding streams
21and services under the purview of the work group, and make
22recommendations regarding the future of the initiative
23including the potential transfer of administration of the
24initiative from the department to the office of the state court
25administrator.
26h. Consult with other state juvenile court systems and
27subject matter experts to review administration of similar
28programs, to glean information on lessons learned and best
29practices, and to determine the types of community and
30residential services that have demonstrated effectiveness for
31eligible children.
325. The division of criminal and juvenile justice planning
33of the department of human rights shall submit a report of the
34findings and recommendations of the work group to the governor
35and the general assembly by December 15, 2019.
-70-1DIVISION VIII
2CO-OCCURRING CONDITIONS — ENHANCED DELIVERY OF SERVICES REVIEW
3 Sec. 43. REVIEW TO PROVIDE ENHANCED DELIVERY OF SERVICES
4FOR CO-OCCURRING CONDITIONS. The director of the department
5of public health and the director of the department of human
6services shall develop recommendations for the enhanced
7delivery of co-occurring conditions services. The directors
8shall examine the current service delivery system to identify
9opportunities for reducing the administrative burden on the
10departments and providers, evaluate the use of an integrated
11helpline and website and improvements in data collection
12and sharing of outcomes, and create a structure for ongoing
13collaboration. The directors shall submit a report including
14findings, a five-year plan to address co-occurring conditions
15across provider types and payors, and other recommendations to
16the governor and general assembly by December 15, 2019.
17DIVISION IX
18MEDICAID MANAGED CARE CONTRACTS
19 Sec. 44. MEDICAID MANAGED CARE CONTRACTS — NOTIFICATION
20TO GENERAL ASSEMBLY. The department of human services shall
21notify the chairpersons and ranking members of the joint
22appropriations subcommittee on health and human services, the
23legislative services agency, and the legislative caucus staffs
24as follows:
251. Within thirty days of the execution of a Medicaid managed
26care contract or amendment to a Medicaid managed care contract.
272. Within thirty days of the determination by the
28department during each measurement year whether to return the
29incentive payment withhold amount to the Medicaid managed care
30organization based upon performance and the criteria used in
31making the determination.
32DIVISION X
33IOWA DEPARTMENT ON AGING — MEDICAID CLAIMING
34 Sec. 45. IOWA DEPARTMENT ON AGING — MEDICAID CLAIMING. The
35department on aging and the department of human services shall
-71-1continue to collaborate to develop a cost allocation plan
2requesting Medicaid administrative funding to provide for the
3claiming of federal financial participation for aging and
4disability resource center activities that are performed to
5assist with administration of the Medicaid program. By January
61, 2021, the department of human services shall submit to
7the centers for Medicare and Medicaid services of the United
8States department of health and human services any Medicaid
9state plan amendment as necessary and shall enter into any
10interagency agreement with the department on aging to implement
11this section.
12DIVISION XI
13DECATEGORIZATION FY 2017 CARRYOVER FUNDING
14 Sec. 46. DECATEGORIZATION CARRYOVER FUNDING FY 2017 —
15TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
16subsection 5, paragraph “b”, any state-appropriated moneys in
17the funding pool that remained unencumbered or unobligated
18at the close of the fiscal year beginning July 1, 2016, and
19were deemed carryover funding to remain available for the two
20succeeding fiscal years that still remain unencumbered or
21unobligated at the close of the fiscal year beginning July 1,
222018, shall not revert but shall be transferred to the medical
23assistance program for the fiscal year beginning July 1, 2019.
24 Sec. 47. EFFECTIVE DATE. This division of this Act, being
25deemed of immediate importance, takes effect upon enactment.
26 Sec. 48. RETROACTIVE APPLICABILITY. This division of this
27Act applies retroactively to July 1, 2018.
28DIVISION XII
29PRIOR APPROPRIATIONS AND OTHER PROVISIONS
30TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF)
31 Sec. 49. 2017 Iowa Acts, chapter 174, section 45, as amended
32by 2018 Iowa Acts, chapter 1165, section 10, is amended to read
33as follows:
34SEC. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
35GRANT. There is appropriated from the fund created in section
-72-18.41 to the department of human services for the fiscal year
2beginning July 1, 2018, and ending June 30, 2019, from moneys
3received under the federal temporary assistance for needy
4families (TANF) block grant pursuant to the federal Personal
5Responsibility and Work Opportunity Reconciliation Act of 1996,
6Pub.L.No.104-193, and successor legislation, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
91. To be credited to the family investment program account
10and used for assistance under the family investment program
11under chapter 239B:
.................................................. $124,539,006
134,025,108
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
195,192,060
203. To be used for the family development and
21self-sufficiency grant program in accordance with section
22216A.107:
.................................................. $232,883,980
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, 2019, the
31moneys shall revert.
324. For field operations:
.................................................. $3331,296,232
3432,465,681
355. For general administration:
-73-.................................................. $13,744,000
26. For state child care assistance:
.................................................. $347,166,826
4a. Of the funds appropriated in this subsection,
5$26,205,412 is transferred to the child care and development
6block grant appropriation made by the Eighty-seventh General
7Assembly, 2018 session, for the federal fiscal year beginning
8October 1, 2018, and ending September 30, 2019. Of this
9amount, $200,000 shall be used for provision of educational
10opportunities to registered child care home providers in order
11to improve services and programs offered by this category
12of providers and to increase the number of providers. The
13department may contract with institutions of higher education
14or child care resource and referral centers to provide
15the educational opportunities. Allowable administrative
16costs under the contracts shall not exceed 5 percent. The
17application for a grant shall not exceed two pages in length.
18b. Any funds appropriated in this subsection remaining
19unallocated shall be used for state child care assistance
20payments for families who are employed including but not
21limited to individuals enrolled in the family investment
22program.
237. For child and family services:
.................................................. $2432,380,654
258. For child abuse prevention grants:
.................................................. $26125,000
279. For pregnancy prevention grants on the condition that
28family planning services are funded:
.................................................. $291,913,203
301,890,203
31Pregnancy prevention grants shall be awarded to programs
32in existence on or before July 1, 2018, if the programs have
33demonstrated positive outcomes. Grants shall be awarded to
34pregnancy prevention programs which are developed after July
351, 2018, if the programs are based on existing models that
-74-1have demonstrated positive outcomes. Grants shall comply with
2the requirements provided in 1997 Iowa Acts, chapter 208,
3section 14, subsections 1 and 2, including the requirement that
4grant programs must emphasize sexual abstinence. Priority in
5the awarding of grants shall be given to programs that serve
6areas of the state which demonstrate the highest percentage of
7unplanned pregnancies of females of childbearing age within the
8geographic area to be served by the grant.
910. For technology needs and other resources necessary
10to meet federal welfare reform reporting, tracking, and case
11management requirements:
.................................................. $121,037,186
13862,186
1411. a. Notwithstanding any provision to the contrary,
15including but not limited to requirements in section 8.41 or
16provisions in 2017 or 2018 Iowa Acts regarding the receipt and
17appropriation of federal block grants, federal funds from the
18temporary assistance for needy families block grant received by
19the state and not otherwise appropriated in this section and
20remaining available for the fiscal year beginning July 1, 2018,
21are appropriated to the department of human services to the
22extent as may be necessary to be used in the following priority
23order: the family investment program, for state child care
24assistance program payments for families who are employed, and
25for the family investment program share of system costs for
26eligibility determination and related functions. The federal
27funds appropriated in this paragraph “a” shall be expended
28only after all other funds appropriated in subsection 1 for
29assistance under the family investment program, in subsection 6
30for child care assistance, or in subsection 10 for technology
31costs related to the family investment program, as applicable,
32have been expended. For the purposes of this subsection, the
33funds appropriated in subsection 6, paragraph “a”, for transfer
34to the child care and development block grant appropriation
35are considered fully expended when the full amount has been
-75-1transferred.
2b. The department shall, on a quarterly basis, advise the
3legislative services agency and department of management of
4the amount of funds appropriated in this subsection that was
5expended in the prior quarter.
612. Of the amounts appropriated in this section,
7$12,962,008 for the fiscal year beginning July 1, 2018, is
8transferred to the appropriation of the federal social services
9block grant made to the department of human services for that
10fiscal year.
1113. For continuation of the program providing categorical
12eligibility for the food assistance program as specified
13for the program in the section of this division of this Act
14relating to the family investment program account:
.................................................. $1514,236
1613,000
1714. The department may transfer funds allocated in this
18section to the appropriations made in this division of this Act
19for the same fiscal year for general administration and field
20operations for resources necessary to implement and operate the
21services referred to in this section and those funded in the
22appropriation made in this division of this Act for the same
23fiscal year for the family investment program from the general
24fund of the state.
2515. With the exception of moneys allocated under this
26section for the family development and self-sufficiency grant
27program, to the extent moneys allocated in this section are
28deemed by the department not to be necessary to support the
29purposes for which they are allocated, such moneys may be
30used in the same fiscal year for any other purpose for which
31funds are allocated in this section or in section 7 of this
32division for the family investment program account. If there
33are conflicting needs, priority shall first be given to the
34family investment program account as specified under subsection
351 of this section and used for the purposes of assistance under
-76-1the family investment program under chapter 239B, followed by
2state child care assistance program payments for families who
3are employed, followed by other priorities as specified by the
4department.
5FAMILY INVESTMENT PROGRAM ADJUSTMENTS
6 Sec. 50. 2017 Iowa Acts, chapter 174, section 46, subsection
74, as amended by 2018 Iowa Acts, chapter 1165, section 11, is
8amended to read as follows:
94. Moneys appropriated in this division of this Act and
10credited to the FIP account for the fiscal year beginning July
111, 2018, and ending June 30, 2019, are allocated as follows:
12a. To be retained by the department of human services to
13be used for coordinating with the department of human rights
14to more effectively serve participants in FIP and other shared
15clients and to meet federal reporting requirements under the
16federal temporary assistance for needy families block grant:
.................................................. $175,000
1820,000
19b. To the department of human rights for staffing,
20administration, and implementation of the family development
21and self-sufficiency grant program in accordance with section
22216A.107:
.................................................. $236,192,834
24(1) Of the funds allocated for the family development
25and self-sufficiency grant program in this paragraph “b”,
26not more than 5 percent of the funds shall be used for the
27administration of the grant program.
28(2) The department of human rights may continue to implement
29the family development and self-sufficiency grant program
30statewide during fiscal year 2018-2019.
31(3) The department of human rights may engage in activities
32to strengthen and improve family outcomes measures and
33data collection systems under the family development and
34self-sufficiency grant program.
35c. For the diversion subaccount of the FIP account:
-77-.................................................. $1749,694
2815,000
3A portion of the moneys allocated for the subaccount may
4be used for field operations, salaries, data management
5system development, and implementation costs and support
6deemed necessary by the director of human services in order to
7administer the FIP diversion program. To the extent moneys
8allocated in this paragraph “c” are deemed by the department
9not to be necessary to support diversion activities, such
10moneys may be used for other efforts intended to increase
11engagement by family investment program participants in work,
12education, or training activities, or for the purposes of
13assistance under the family investment program in accordance
14with chapter 239B.
15d. For the food assistance employment and training program:
.................................................. $1666,588
17(1) The department shall apply the federal supplemental
18nutrition assistance program (SNAP) employment and training
19state plan in order to maximize to the fullest extent permitted
20by federal law the use of the 50 percent federal reimbursement
21provisions for the claiming of allowable federal reimbursement
22funds from the United States department of agriculture
23pursuant to the federal SNAP employment and training program
24for providing education, employment, and training services
25for eligible food assistance program participants, including
26but not limited to related dependent care and transportation
27expenses.
28(2) The department shall continue the categorical federal
29food assistance program eligibility at 160 percent of the
30federal poverty level and continue to eliminate the asset test
31from eligibility requirements, consistent with federal food
32assistance program requirements. The department shall include
33as many food assistance households as is allowed by federal
34law. The eligibility provisions shall conform to all federal
35requirements including requirements addressing individuals who
-78-1are incarcerated or otherwise ineligible.
2e. For the JOBS program:
.................................................. $312,139,821
411,919,821
5MEDICAL ASSISTANCE PROGRAM ADJUSTMENT
6 Sec. 51. 2017 Iowa Acts, chapter 174, section 51, unnumbered
7paragraph 2, as amended by 2018 Iowa Acts, chapter 1165,
8section 18, is amended to read as follows:
9For medical assistance program reimbursement and associated
10costs as specifically provided in the reimbursement
11methodologies in effect on June 30, 2018, except as otherwise
12expressly authorized by law, consistent with options under
13federal law and regulations, and contingent upon receipt of
14approval from the office of the governor of reimbursement for
15each abortion performed under the program:
.................................................. $161,337,841,375
171,488,141,375
18GROUP FOSTER CARE REALLOCATION
19 Sec. 52. 2017 Iowa Acts, chapter 174, section 57, subsection
203, paragraph a, as amended by 2018 Iowa Acts, chapter 1165,
21section 28, is amended to read as follows:
22a. Of the funds appropriated in this section, up to
23$34,536,648 is allocated as the statewide expenditure target
24under section 232.143 for group foster care maintenance and
25services. If the department projects that such expenditures
26for the fiscal year will be less than the target amount
27allocated in this paragraph “a”, the department may reallocate
28the excess to provide additional funding for family foster
29care, independent living, family safety, risk and permanency
30services, shelter care, or the child welfare emergency services
31addressed with the allocation for shelter care.
32SHELTER CARE ALLOCATION
33 Sec. 53. 2017 Iowa Acts, chapter 174, section 57, subsection
346, as amended by 2018 Iowa Acts, chapter 1165, section 28, is
35amended to read as follows:
-79- 16. Notwithstanding section 234.35 or any other provision of
2law to the contrary, state funding Of the funds appropriated
3in this section, a sufficient amount is allocated for shelter
4care and the child welfare emergency services contracting
5implemented to provide for or prevent the need for shelter care
6shall be limited to $8,096,158.
7OTHER FUNDING FOR CHILD WELFARE SERVICES
8 Sec. 54. 2017 Iowa Acts, chapter 174, section 57, subsection
96, as amended by 2018 Iowa Acts, chapter 1165, section 28, is
10amended by adding the following new subsection:
11 NEW SUBSECTION. 24. If a separate funding source is
12identified that reduces the need for state funds within an
13allocation under this section, the allocated state funds may be
14redistributed to other allocations under this section for the
15same fiscal year.
16 Sec. 55. EFFECTIVE DATE. This division of this Act, being
17deemed of immediate importance, takes effect upon enactment.
18 Sec. 56. RETROACTIVE APPLICABILITY. This division of this
19Act applies retroactively to July 1, 2018.
20DIVISION XIII
21HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM FUTURE REPEAL
22 Sec. 57. Section 249M.5, Code 2019, is amended to read as
23follows:
24249M.5 Future repeal.
25This chapter is repealed July 1, 2019 2021.
26 Sec. 58. EFFECTIVE DATE. This division of this Act, being
27deemed of immediate importance, takes effect upon enactment.
28DIVISION XIV
29MENTAL HEALTH AND DISABILITY SERVICES — TRANSFER OF FUNDS
30 Sec. 59. MENTAL HEALTH AND DISABILITY SERVICES — TRANSFER
31OF FUNDS. Notwithstanding section 331.432, a county with a
32population of over 300,000 based on the most recent federal
33decennial census, may transfer funds from any other fund of the
34county to the mental health and disability regional services
35fund for the purposes of providing mental health and disability
-80-1services for the fiscal year beginning July 1, 2019, and
2ending June 30, 2020. The county shall submit a report to
3the governor and the general assembly by September 1, 2020,
4including the source of any funds transferred, the amount of
5the funds transferred, and the mental health and disability
6services provided with the transferred funds.
7DIVISION XV
8OPERATION OF BOARD OF MEDICINE, BOARD OF NURSING, BOARD OF
9PHARMACY, AND THE DENTAL BOARD
10 Sec. 60. Section 135.11A, subsection 1, Code 2019, is
11amended to read as follows:
121. There shall be a professional licensure division within
13the department of public health. Each board under chapter 147
14or under the administrative authority of the department, except
15the board of nursing, board of medicine, dental board, and
16board of pharmacy, shall receive administrative and clerical
17support from the division and may not employ its own support
18staff for administrative and clerical duties. The executive
19director of the board of nursing, board of medicine, dental
20board, and board of pharmacy shall be appointed pursuant to
21section 135.11B.
22 Sec. 61. NEW SECTION. 135.11B Appointment of certain
23executive directors.
241. The director shall appoint and supervise a full-time
25executive director for each of the following boards:
26a. The board of medicine.
27b. The board of nursing.
28c. The dental board.
29d. The board of pharmacy.
302. Each board listed in subsection 1 shall advise the
31director in evaluating potential candidates for the position of
32executive director, consult with the director in the hiring of
33the executive director, and review and advise the director on
34the performance of the executive director in the discharge of
35the executive director’s duties.
-81- 13. Each board listed in subsection 1 shall retain sole
2discretion and authority to execute the core functions of the
3board including but not limited to policymaking, advocating
4for and against legislation, rulemaking, licensing, licensee
5investigations, licensee disciplinary proceedings, and
6oversight of professional health programs. The director’s
7supervision of the executive director shall not interfere with
8the board’s discretion and authority in executing the core
9functions of the board.
10 Sec. 62. Section 147.80, subsection 3, Code 2019, is amended
11to read as follows:
123. The board of medicine, the board of pharmacy, the
13dental board, and the board of nursing shall retain individual
14executive officers pursuant to section 135.11B, but shall
15make every effort to share administrative, clerical, and
16investigative staff to the greatest extent possible.
17 Sec. 63. Section 152.2, Code 2019, is amended to read as
18follows:
19152.2 Executive director.
20The board shall appoint retain a full-time executive
21director, who shall be appointed pursuant to section 135B.11.
22The executive director shall be a registered nurse and shall
23not be a member of the board. The governor, with the approval
24of the executive council pursuant to section 8A.413, subsection
253, under the pay plan for exempt positions in the executive
26branch of government, shall set the salary of the executive
27director.
28 Sec. 64. Section 153.33, subsection 2, Code 2019, is amended
29to read as follows:
302. All employees needed to administer this chapter except
31the executive director shall be appointed pursuant to the merit
32system. The executive director shall serve at the pleasure of
33the board be appointed pursuant to section 135.11B and shall
34be exempt from the merit system provisions of chapter 8A,
35subchapter IV.
-82-1DIVISION XVI
2MEDICAID PRIOR AUTHORIZATION — UNIFORM PROCESS — CENTRAL
3PORTAL
4 Sec. 65. MEDICAID — PRIOR AUTHORIZATION UNIFORM
5PROCESS. The department of human services shall adopt rules
6pursuant to chapter 17A to require, and shall contractually
7require, that both managed care and fee-for-service payment
8and delivery systems utilize a uniform process, including but
9not limited to uniform forms, information requirements, and
10time frames, to request prior authorization under the Medicaid
11program no later than October 1, 2019.
12 Sec. 66. MEDICAID MANAGEMENT INFORMATION SYSTEM — CENTRAL
13PORTAL — REVIEW. The department shall review the costs
14associated with expanding the medical assistance management
15information system to integrate a single, statewide system
16to serve as a central portal for submission of all prior
17authorization requests for the Medicaid program. The portal
18shall not be designed to make or review final determinations
19of managed care organization prior authorization requests, but
20shall only serve as a conduit to deliver prior authorization
21requests to the appropriate managed care organization. The
22results of the study shall be submitted to the governor and the
23general assembly no later than March 31, 2020.
24 Sec. 67. EFFECTIVE DATE. This division of this Act, being
25deemed of immediate importance, takes effect upon enactment.
26DIVISION XVII
27HEALTH AND HUMAN SERVICES EXECUTIVE BRANCH ENTITIES — REFORM
28Iowa collaborative safety net provider network
29 Sec. 68. Section 135.24, subsection 7, paragraph e, Code
302019, is amended to read as follows:
31e. “Specialty health care provider office” means the
32private office or clinic of an individual specialty health
33care provider or group of specialty health care providers as
34referred by the Iowa collaborative safety net provider network
35established in section 135.153, but does not include a field
-83-1dental clinic, a free clinic, or a hospital.
2 Sec. 69. Section 135.159, subsection 1, paragraph h, Code
32019, is amended by striking the paragraph.
4 Sec. 70. REPEAL. Section 135.153, Code 2019, is repealed.
5Hospital health care access trust fund board
6 Sec. 71. Section 249M.4, Code 2019, is amended to read as
7follows:
8249M.4 Hospital health care access trust fund — board.
91. A hospital health care access trust fund is created
10in the state treasury under the authority of the department.
11Moneys received through the collection of the hospital health
12care access assessment imposed under this chapter and any
13other moneys specified for deposit in the trust fund shall be
14deposited in the trust fund.
152. Moneys in the trust fund shall be used, subject to
16their appropriation by the general assembly, by the department
17to reimburse participating hospitals the medical assistance
18program upper payment limit for inpatient and outpatient
19hospital services as calculated in this section. Following
20payment of such upper payment limit to participating hospitals,
21any remaining funds in the trust fund on an annual basis may be
22used for any of the following purposes:
23a. To support medical assistance program utilization
24shortfalls.
25b. To maintain the state’s capacity to provide access to and
26delivery of services for vulnerable Iowans.
27c. To fund the health care workforce support initiative
28created pursuant to section 135.175.
29d. To support access to health care services for uninsured
30Iowans.
31e. To support Iowa hospital programs and services which
32expand access to health care services for Iowans.
333. The trust fund shall be separate from the general fund
34of the state and shall not be considered part of the general
35fund. The moneys in the trust fund shall not be considered
-84-1revenue of the state, but rather shall be funds of the hospital
2health care access assessment program. The moneys deposited
3in the trust fund are not subject to section 8.33 and shall not
4be transferred, used, obligated, appropriated, or otherwise
5encumbered, except to provide for the purposes of this chapter.
6Notwithstanding section 12C.7, subsection 2, interest or
7earnings on moneys deposited in the trust fund shall be
8credited to the trust fund.
94. The department shall adopt rules pursuant to chapter
1017A to administer the trust fund and reimbursements and
11expenditures as specified in this chapter made from the trust
12fund.
135. a. Beginning July 1, 2010, or the implementation date
14of the hospital health care access assessment program as
15determined by receipt of approval from the centers for Medicare
16and Medicaid services of the United States department of health
17and human services, whichever is later, the department shall
18increase the diagnostic related groups and ambulatory patient
19classifications base rates to provide payments to participating
20hospitals at the Medicare upper payment limit for the fiscal
21year beginning July 1, 2010, calculated as of July 31, 2010.
22Each participating hospital shall receive the same percentage
23increase, but the percentage may differ depending on whether
24the basis for the base rate increase is the diagnostic related
25groups or ambulatory patient classifications.
26b. The percentage increase shall be calculated by dividing
27the amount calculated under subparagraph (1) by the amount
28calculated under subparagraph (2) as follows:
29(1) The amount under the Medicare upper payment limit for
30the fiscal year beginning July 1, 2010, for participating
31hospitals.
32(2) The projected expenditures for participating hospitals
33for the fiscal year beginning July 1, 2010, as determined by
34the fiscal management division of the department, plus the
35amount calculated under subparagraph (1).
-85- 16. For the fiscal year beginning July 1, 2011, and for
2each fiscal year beginning July 1, thereafter, the payments to
3participating hospitals shall continue to be calculated based
4on the upper payment limit as calculated for the fiscal year
5beginning July 1, 2010.
67. Reimbursement of participating hospitals shall
7incorporate the rebasing process for inpatient and outpatient
8services for state fiscal year 2012. However, the total amount
9of increased funding available for reimbursement attributable
10to rebasing shall not exceed four million five hundred thousand
11dollars for state fiscal year 2012 and six million dollars for
12state fiscal year 2013.
138. Any payments to participating hospitals under this
14section shall result in budget neutrality to the general fund
15of the state.
169. a. A hospital health care access trust fund board is
17established consisting of the following members:
18(1) The co-chairpersons and the ranking members of the joint
19appropriations subcommittee on health and human services.
20(2) The Iowa medical assistance program director.
21(3) Two hospital executives representing the two largest
22private health care systems in the state.
23(4) The president of the Iowa hospital association.
24(5) A representative of a consumer advocacy group, involved
25in both state and national initiatives, that provides data on
26key indicators of well-being for children and families in order
27to inform policymakers to help children and families succeed.
28b. The board shall do all of the following:
29(1) Provide oversight of the trust fund.
30(2) Make recommendations regarding the hospital health care
31access assessment program, including recommendations regarding
32the assessment calculation, assessment amounts, payments to
33participating hospitals, and use of the moneys in the trust
34fund.
35(3) Submit an annual report to the governor and the general
-86-1assembly regarding the use and expenditure of moneys deposited
2in the trust fund.
3c. The department shall provide administrative assistance
4to the board.
5Advisory COMMITTEE TO THE CENTER for rural health and primary
6care
7 Sec. 72. Section 135.107, subsection 5, Code 2019, is
8amended by striking the subsection.
9 Sec. 73. Section 262.78, subsection 3, Code 2019, is amended
10to read as follows:
113. The president of the university of Iowa, in consultation
12with the president of Iowa state university of science and
13technology, shall employ a full-time director of the center.
14The center may employ staff to carry out the center’s purpose.
15The director shall coordinate the agricultural health and
16safety programs of the center. The director shall regularly
17meet and consult with the advisory committee to the center for
18rural health and primary care. The director shall provide
19the board of regents with relevant information regarding the
20center.
21Governmental public health advisory council
22 Sec. 74. Section 135A.2, subsection 2, Code 2019, is amended
23by striking the subsection.
24 Sec. 75. Section 135A.9, subsection 1, Code 2019, is amended
25by striking the subsection.
26 Sec. 76. REPEAL. Section 135A.4, Code 2019, is repealed.
27Patient-centered health advisory council
28 Sec. 77. REPEAL. Section 135.159, Code 2019, is repealed.
29Combining state medical examiner advisory council with the
30interagency coordinating council
31 Sec. 78. Section 691.6B, Code 2019, is amended to read as
32follows:
33691.6B Interagency coordinating council.
341. An interagency coordinating council is created to advise
35 do all of the following:
-87- 1a. Advise and consult withthe state medical examiner on a
2range of issues affecting the organization and functions of the
3office of the state medical examiner and the effectiveness of
4the medical examiner system in the state.
5b. Advise the state medical examinerconcerning the
6assurance of effective coordination of the functions and
7operations of the office of the state medical examiner with the
8needs and interests of the departments of public safety and
9public health.
102. Members of the interagency coordinating council shall
11include the all of the following:
12a. Thestate medical examiner, or when the state medical
13examiner is not available, the deputy state medical examiner;
14the.
15b. Thecommissioner of public safety or the commissioner’s
16designee; the.
17c. Thedirector of public health or the director’s designee;
18and the.
19d. Thegovernor or the governor’s designee.
20e. Representatives from the office of the attorney
21general, the Iowa county attorneys association, the Iowa
22medical society, the Iowa association of pathologists, the
23Iowa association of county medical examiners, the statewide
24emergency medical system, and the Iowa funeral directors
25association.
263. The interagency coordinating council shall meet on
27a regular basis, and shall be organized and function as
28established by the state medical examiner by rule.
29 Sec. 79. REPEAL. Section 691.6C, Code 2019, is repealed.
30Tobacco use prevention and control commission — MEMBERSHIP —
31MEETINGS — EXPENSES
32 Sec. 80. Section 142A.3, subsection 6, Code 2019, is amended
33to read as follows:
346. Citizen members shall be reimbursed for actual and
35necessary expenses incurred in performance of their duties.
-88-1Citizen members shall be paid a per diem as specified in
2section 7E.6. Legislative members are eligible for per diem
3and expenses as provided in section 2.10.
4 Sec. 81. Section 142A.3, subsection 9, Code 2019, is amended
5to read as follows:
69. The commission shall elect a chairperson from among its
7voting members and may select other officers from among its
8voting members, as determined necessary by the commission.
9The commission shall meet regularly no more than quarterly as
10determined by the commission, upon the call of the chairperson,
11or upon the call of a majority of the voting members.
12 Sec. 82. TOBACCO USE PREVENTION AND CONTROL COMMISSION —
13MEMBERSHIP REDUCTION. The tobacco use prevention and control
14commission shall evaluate the membership of the commission
15and shall submit to the department of public health the
16commission’s recommendation, to be submitted by the director
17of public health as proposed legislation in compliance with
18section 2.16 for consideration by the general assembly during
19the 2020 legislative session, to reduce the number of voting
20members from nine to seven members.
21Trauma system advisory council
22 Sec. 83. Section 147A.24, subsection 2, Code 2019, is
23amended to read as follows:
242. The council shall consist of seven members to be
25appointed by the director from the recommendations of
26the organizations in subsection 1 for terms of two years.
27Vacancies on the council shall be filled for the remainder of
28the term of the original appointment. Members whose terms
29expire may be reappointed.
30 Sec. 84. TRANSITION PROVISIONS. Notwithstanding any
31provision of section 147A.24, subsection 2, to the contrary, a
32member of the trauma system advisory council on July 1, 2019,
33shall continue serving until the expiration of that member’s
34term or until a vacancy occurs prior to the expiration of the
35applicable term, and such vacancy shall only be filled to the
-89-1extent consistent with and necessary to maintain the total
2number of members of the council specified in section 147A.24,
3subsection 2, as amended in this Act.
4Teleconference option for state entities
5 Sec. 85. NEW SECTION. 135.11B Statutory board, commission,
6committee, or council of committee — teleconference option.
7Any statutorily established board, commission, committee, or
8council established under the purview of the department shall
9provide for a teleconference option for board, commission,
10committee, or council members to participate in official
11meetings.
12Elimination of payment of expenses for public members of
13certain state entities
14 Sec. 86. Section 105.3, subsection 6, Code 2019, is amended
15by striking the subsection.
16 Sec. 87. Section 135.43, subsection 2, unnumbered paragraph
171, Code 2019, is amended to read as follows:
18The membership of the review team is subject to the
19provisions of sections 69.16 and 69.16A, relating to political
20affiliation and gender balance. Review team members who
21are not designated by another appointing authority shall be
22appointed by the state medical examiner. Membership terms
23shall be for three years. A membership vacancy shall be filled
24in the same manner as the original appointment. The review
25team shall elect a chairperson and other officers as deemed
26necessary by the review team. The review team shall meet upon
27the call of the state medical examiner or as determined by
28the review team. The members of the team are eligible for
29reimbursement of actual and necessary expenses incurred in the
30performance of their official duties. The review team shall
31include the following:
32 Sec. 88. Section 135.62, subsection 2, paragraph e, Code
332019, is amended by striking the paragraph.
34 Sec. 89. Section 147A.3, Code 2019, is amended to read as
35follows:
-90- 1147A.3 Meetings of the council — quorum — expenses.
2Membership, terms of office, and quorum, and expenses shall
3be determined by the director pursuant to chapter 135.
4 Sec. 90. Section 256I.3, subsection 3, Code 2019, is amended
5by striking the subsection.
6Elimination of CHILD WELFARE ADVISORY COMMITTEE, CHILD
7SUPPORT ADVISORY COMMITTEE, CHILDREN’S MENTAL HEALTH WAIVER
8IMPLEMENTATION COMMITTEE, AND PROPERTY TAX RELIEF FUND RISK
9POOL
10 Sec. 91. Section 217.3A, subsection 1, Code 2019, is amended
11to read as follows:
121. General. The council on human services shall establish
13and utilize the advisory committees committee identified in
14this section and may establish and utilize other advisory
15committees. The council shall establish appointment
16provisions, membership terms, operating guidelines, and other
17operational requirements for committees established pursuant to
18this section.
19 Sec. 92. Section 217.3A, subsections 3 and 4, Code 2019, are
20amended by striking the subsections.
21 Sec. 93. Section 426B.5, subsection 1, Code 2019, is amended
22by striking the subsection.
23 Sec. 94. 2005 Iowa Acts, chapter 117, section 4, subsection
243, is amended by striking the subsection.
25MEDICAL ASSISTANCE ADVISORY COUNCIL
26 Sec. 95. MEDICAL ASSISTANCE ADVISORY COUNCIL — VOTING
27MEMBER SUSPENSION. Notwithstanding any provision of law to the
28contrary, if a representative of a professional or business
29entity, a public member, or a member of the hawk-i board who
30is a voting member of the medical assistance advisory council
31pursuant to section 249A.4B, subsection 2, is absent for
32two consecutive meetings of the medical assistance advisory
33council, the member shall be suspended from participation in
34the deliberations of the advisory council for a period of
35twelve months from the date of the member’s second absence.
-91-1During the member’s suspension period, the voting rights of the
2professional or business entity, consumer group or consumer
3organization, or the hawk-i board shall not be exercised, but
4the vacancy in voting membership shall not prohibit the medical
5assistance advisory council from achieving a quorum.
6DIVISION XVIII
7MEDICAID MANAGED CARE TERMINATION — EXPEDITED claims dispute
8PROCESS
9 Sec. 96. MEDICAID MANAGED CARE TERMINATION — EXPEDITED
10CLAIMS DISPUTE PROCESS. No later than July 1, 2019, the
11department of human services shall require an expedited claims
12dispute process for all outstanding claims to be applicable
13if a managed care organization terminates coverage under the
14Medicaid program. Such an expedited claims dispute process
15shall, beginning on the date a managed care organization
16terminates coverage, allow a provider, a member, or a member’s
17authorized representative the option to dispute the managed
18care organization’s claim adjudication within the required time
19frames and consistent with this section. The managed care
20organization shall report all disputed claims being processed
21and the outcomes of such disputed claims to the department on a
22monthly basis for at least two years following termination of
23the managed care organization’s contract with the state.
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