Print
Senate Study Bill 3194 - IntroducedA 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 2020-2021
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, 2020, and ending June 30,
62021, the following amount, or so much thereof as is necessary,
7to be used for the purposes designated:
8For aging programs for the department on aging and area
9agencies on aging to provide citizens of Iowa who are 60 years
10of age and older with case management for frail elders, Iowa’s
11aging and disabilities resource center, and other services
12which may include but are not limited to adult day services,
13respite care, chore services, information and assistance,
14and material aid, for information and options counseling for
15persons with disabilities who are 18 years of age or older,
16and for salaries, support, administration, maintenance, and
17miscellaneous purposes:
.................................................. $1811,202,196
191. Funds appropriated in this section may be used to
20supplement federal funds under federal regulations. To
21receive funds appropriated in this section, a local area
22agency on aging shall match the funds with moneys from other
23sources according to rules adopted by the department. Funds
24appropriated in this section may be used for elderly services
25not specifically enumerated in this section only if approved
26by an area agency on aging for provision of the service within
27the area.
282. Of the funds appropriated in this section, $279,000 is
29transferred to the economic development authority for the Iowa
30commission on volunteer services to be used for the retired and
31senior volunteer program.
323. a. The department on aging shall establish and enforce
33procedures relating to expenditure of state and federal funds
34by area agencies on aging that require compliance with both
35state and federal laws, rules, and regulations, including but
-1-1not limited to all of the following:
2(1) Requiring that expenditures are incurred only for goods
3or services received or performed prior to the end of the
4fiscal period designated for use of the funds.
5(2) Prohibiting prepayment for goods or services not
6received or performed prior to the end of the fiscal period
7designated for use of the funds.
8(3) Prohibiting prepayment for goods or services not
9defined specifically by good or service, time period, or
10recipient.
11(4) Prohibiting the establishment of accounts from which
12future goods or services which are not defined specifically by
13good or service, time period, or recipient, may be purchased.
14b. The procedures shall provide that if any funds are
15expended in a manner that is not in compliance with the
16procedures and applicable federal and state laws, rules, and
17regulations, and are subsequently subject to repayment, the
18area agency on aging expending such funds in contravention of
19such procedures, laws, rules and regulations, not the state,
20shall be liable for such repayment.
214. Of the funds appropriated in this section, at least
22$600,000 shall be used to fund home and community-based
23services through the area agencies on aging that enable older
24individuals to avoid more costly utilization of residential or
25institutional services and remain in their own homes.
265. Of the funds appropriated in this section, $812,000 shall
27be used for the purposes of chapter 231E and to administer
28the prevention of elder abuse, neglect, and exploitation
29program pursuant to section 231.56A, in accordance with the
30requirements of the federal Older Americans Act of 1965, 42
31U.S.C.§3001 et seq., as amended.
326. Of the funds appropriated in this section, $1,000,000
33shall be used to fund continuation of the aging and disability
34resource center lifelong links to provide individuals and
35caregivers with information and services to plan for and
-2-1maintain independence.
27. Of the funds appropriated in this section, $250,000
3shall be used by the department on aging, in collaboration with
4the department of human services and affected stakeholders,
5to continue to expand the pilot initiative to provide
6long-term care options counseling utilizing support planning
7protocols, to assist non-Medicaid eligible consumers who
8indicate a preference to return to the community and are
9deemed appropriate for discharge, to return to their community
10following a nursing facility stay. The department on aging
11shall submit a report regarding the outcomes of the pilot
12initiative to the governor and the general assembly by December
1315, 2020.
14DIVISION II
15OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2020-2021
16 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
17appropriated from the general fund of the state to the office
18of long-term care ombudsman for the fiscal year beginning July
191, 2020, and ending June 30, 2021, the following amount, or
20so much thereof as is necessary, to be used for the purposes
21designated:
22For salaries, support, administration, maintenance, and
23miscellaneous purposes:
.................................................. $241,168,936
25DIVISION III
26DEPARTMENT OF PUBLIC HEALTH — FY 2020-2021
27 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
28from the general fund of the state to the department of public
29health for the fiscal year beginning July 1, 2020, and ending
30June 30, 2021, the following amounts, or so much thereof as is
31necessary, to be used for the purposes designated:
321. ADDICTIVE DISORDERS
33For reducing the prevalence of the use of tobacco, alcohol,
34and other drugs, and treating individuals affected by addictive
35behaviors, including gambling:
-3-.................................................. $125,129,012
2a. Of the funds appropriated in this subsection, $4,020,852
3shall be used for the tobacco use prevention and control
4initiative, including efforts at the state and local levels,
5as provided in chapter 142A. The commission on tobacco use
6prevention and control established pursuant to section 142A.3
7shall advise the director of public health in prioritizing
8funding needs and the allocation of moneys appropriated for
9the programs and initiatives. Activities of the programs
10and initiatives shall be in alignment with the United States
11centers for disease control and prevention best practices
12for comprehensive tobacco control programs that include
13the goals of preventing youth initiation of tobacco usage,
14reducing exposure to secondhand smoke, and promotion of tobacco
15cessation.
16b. (1) Of the funds appropriated in this subsection,
17$21,088,527 shall be used for problem gambling and
18substance-related disorder prevention, treatment, and recovery
19services, including a 24-hour helpline, public information
20resources, professional training, youth prevention, and program
21evaluation.
22(2) Of the amount allocated under this paragraph, $306,000
23shall be utilized by the department of public health, in
24collaboration with the department of human services, to
25maintain a single statewide 24-hour crisis hotline for the Iowa
26children’s behavioral health system that incorporates warmline
27services which may be provided through expansion of existing
28capabilities maintained by the department of public health as
29required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
30c. The requirement of section 123.17, subsection 5, is met
31by the appropriations and allocations made in this division of
32this Act for purposes of substance-related disorder treatment
33and addictive disorders for the fiscal year beginning July 1,
342020.
352. HEALTHY CHILDREN AND FAMILIES
-4- 1For promoting the optimum health status for children and
2adolescents from birth through 21 years of age, and families:
.................................................. $35,824,387
43. CHRONIC CONDITIONS
5For serving individuals identified as having chronic
6conditions or special health care needs:
.................................................. $74,237,927
84. COMMUNITY CAPACITY
9For strengthening the health care delivery system at the
10local level:
.................................................. $117,004,757
12a. Of the funds appropriated in this subsection, $2,000,000
13shall be deposited in the medical residency training account
14created in section 135.175, subsection 5, paragraph “a”, and
15is appropriated from the account to the department of public
16health to be used for the purposes of the medical residency
17training state matching grants program as specified in section
18135.176.
19b. Of the funds appropriated in this subsection, $250,000
20shall be used for the public purpose of providing funding to
21Des Moines university to continue a provider education project
22to provide primary care physicians with the training and skills
23necessary to recognize the signs of mental illness in patients.
24c. Of the funds appropriated in this subsection, $800,000
25shall be used for rural psychiatric residencies to support the
26annual creation and training of four psychiatric residents who
27will provide mental health services in underserved areas of
28the state. Notwithstanding section 8.33, moneys allocated in
29this paragraph “c” that remain unencumbered or unobligated at
30the close of the fiscal year shall not revert but shall remain
31available for expenditure for the purposes designated for
32subsequent fiscal years.
33d. Of the funds appropriated in this subsection,
34$400,000 shall be used for a family medicine obstetrics and
35gynecology fellowship program to offer four physician fellows
-5-1a one-year period of specialized obstetrics and gynecology
2training following a three-year family medicine residency.
3Notwithstanding section 8.33, moneys allocated in this
4paragraph “d” that remain unencumbered or unobligated at the
5close of the fiscal year shall not revert but shall remain
6available for expenditure for the purposes designated for
7subsequent fiscal years.
8e. Of the funds appropriated in this subsection, $100,000
9shall be used to expand access to telementoring technology to
10enable specialty conferences between obstetrician/gynecologists
11and family medicine physicians.
12f. Of the funds appropriated in this subsection, $500,000
13shall be used for a centers of excellence pilot program to
14encourage innovation and collaboration among regional health
15care providers in order to transform health care delivery to
16provide quality, sustainable care that meets the needs of local
17communities.
185. ESSENTIAL PUBLIC HEALTH SERVICES
19To provide public health services that reduce risks and
20invest in promoting and protecting good health over the
21course of a lifetime with a priority given to older Iowans and
22vulnerable populations:
.................................................. $237,662,464
246. INFECTIOUS DISEASES
25For reducing the incidence and prevalence of communicable
26diseases:
.................................................. $271,803,212
287. PUBLIC PROTECTION
29For protecting the health and safety of the public through
30establishing standards and enforcing regulations:
.................................................. $314,314,883
32Of the funds appropriated in this subsection, not more than
33$304,000 shall be credited to the emergency medical services
34fund created in section 135.25. Moneys in the emergency
35medical services fund are appropriated to the department to be
-6-1used for the purposes of the fund.
28. RESOURCE MANAGEMENT
3For establishing and sustaining the overall ability of the
4department to deliver services to the public:
.................................................. $5936,139
69. MISCELLANEOUS PROVISIONS
7The university of Iowa hospitals and clinics under the
8control of the state board of regents shall not receive
9indirect costs from the funds appropriated in this section.
10The university of Iowa hospitals and clinics billings to the
11department shall be on at least a quarterly basis.
12 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — GAMBLING TREATMENT
13PROGRAM. There is appropriated from the sports wagering
14receipts fund created in section 8.57, subsection 6, to the
15department of public health for the fiscal year beginning July
161, 2020, and ending June 30, 2021, the following amount or
17so much thereof as is necessary, to be used for the purposes
18designated:
19For the purposes of the gambling treatment program
20established pursuant to section 135.150:
.................................................. $21300,000
22DIVISION IV
23DEPARTMENT OF VETERANS AFFAIRS — FY 2020-2021
24 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
25appropriated from the general fund of the state to the
26department of veterans affairs for the fiscal year beginning
27July 1, 2020, and ending June 30, 2021, the following amounts,
28or so much thereof as is necessary, to be used for the purposes
29designated:
301. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
31For salaries, support, maintenance, and miscellaneous
32purposes:
.................................................. $331,249,946
342. IOWA VETERANS HOME
35For salaries, support, maintenance, and miscellaneous
-7-1purposes:
.................................................. $27,131,552
3a. The Iowa veterans home billings involving the department
4of human services shall be submitted to the department on at
5least a monthly basis.
6b. Within available resources and in conformance with
7associated state and federal program eligibility requirements,
8the Iowa veterans home may implement measures to provide
9financial assistance to or on behalf of veterans or their
10spouses who are participating in the community reentry program.
11c. The Iowa veterans home expenditure report shall be
12submitted monthly to the legislative services agency.
13d. The Iowa veterans home shall continue to include in the
14annual discharge report applicant information to provide for
15the collection of demographic information including but not
16limited to the number of individuals applying for admission and
17admitted or denied admittance and the basis for the admission
18or denial; the age, gender, and race of such individuals;
19and the level of care for which such individuals applied for
20admission including residential or nursing level of care.
213. HOME OWNERSHIP ASSISTANCE PROGRAM
22For transfer to the Iowa finance authority for the
23continuation of the home ownership assistance program for
24persons who are or were eligible members of the armed forces of
25the United States, pursuant to section 16.54:
.................................................. $262,000,000
27 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
28FUND STANDING APPROPRIATIONS. Notwithstanding the standing
29appropriation in section 35A.16 for the fiscal year beginning
30July 1, 2020, and ending June 30, 2021, the amount appropriated
31from the general fund of the state pursuant to that section
32for the following designated purposes shall not exceed the
33following amount:
34For the county commissions of veteran affairs fund under
35section 35A.16:
-8-.................................................. $1990,000
2DIVISION V
3DEPARTMENT OF HUMAN SERVICES — FY 2020-2021
4 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
5GRANT. There is appropriated from the fund created in section
68.41 to the department of human services for the fiscal year
7beginning July 1, 2020, and ending June 30, 2021, from moneys
8received under the federal temporary assistance for needy
9families (TANF) block grant pursuant to the federal Personal
10Responsibility and Work Opportunity Reconciliation Act of 1996,
11Pub.L.No.104-193, and successor legislation, the following
12amounts, or so much thereof as is necessary, to be used for the
13purposes designated:
141. To be credited to the family investment program account
15and used for assistance under the family investment program
16under chapter 239B:
.................................................. $175,002,006
182. To be credited to the family investment program account
19and used for the job opportunities and basic skills (JOBS)
20program and implementing family investment agreements in
21accordance with chapter 239B:
.................................................. $225,412,060
233. To be used for the family development and
24self-sufficiency grant program in accordance with section
25216A.107:
.................................................. $262,888,980
27Notwithstanding section 8.33, moneys appropriated in this
28subsection that remain unencumbered or unobligated at the close
29of the fiscal year shall not revert but shall remain available
30for expenditure for the purposes designated until the close of
31the succeeding fiscal year. However, unless such moneys are
32encumbered or obligated on or before September 30, 2020, the
33moneys shall revert.
344. For field operations:
.................................................. $3531,296,232
-9- 15. For general administration:
.................................................. $23,744,000
36. For state child care assistance:
.................................................. $447,166,826
5a. Of the funds appropriated in this subsection,
6$26,205,412 is transferred to the child care and development
7block grant appropriation made by the Eighty-ninth General
8Assembly, 2020 session, for the federal fiscal year beginning
9October 1, 2020, and ending September 30, 2021. Of this
10amount, $200,000 shall be used for provision of educational
11opportunities to registered child care home providers in order
12to improve services and programs offered by this category
13of providers and to increase the number of providers. The
14department may contract with institutions of higher education
15or child care resource and referral centers to provide
16the educational opportunities. Allowable administrative
17costs under the contracts shall not exceed 5 percent. The
18application for a grant shall not exceed two pages in length.
19b. Any funds appropriated in this subsection remaining
20unallocated shall be used for state child care assistance
21payments for families who are employed including but not
22limited to individuals enrolled in the family investment
23program.
247. For child and family services:
.................................................. $2532,380,654
268. For child abuse prevention grants:
.................................................. $27125,000
289. For pregnancy prevention grants on the condition that
29family planning services are funded:
.................................................. $301,913,203
31Pregnancy prevention grants shall be awarded to programs
32in existence on or before July 1, 2020, if the programs have
33demonstrated positive outcomes. Grants shall be awarded to
34pregnancy prevention programs which are developed after July
351, 2020, if the programs are based on existing models that
-10-1have 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 to
10meet federal and state reporting, tracking, and case management
11requirements and other departmental needs:
.................................................. $121,037,186
1311. a. Notwithstanding any provision to the contrary,
14including but not limited to requirements in section 8.41 or
15provisions in 2019 Iowa Acts or 2020 Iowa Acts regarding the
16receipt and appropriation of federal block grants, federal
17funds from the temporary assistance for needy families block
18grant received by the state and not otherwise appropriated
19in this section and remaining available for the fiscal year
20beginning July 1, 2020, are appropriated to the department of
21human services to the extent as may be necessary to be used in
22the following priority order: the family investment program,
23for state child care assistance program payments for families
24who are employed, and for the family investment program share
25of system costs for eligibility determination and related
26functions. The federal funds appropriated in this paragraph
27shall be expended only after all other funds appropriated
28in subsection 1 for assistance under the family investment
29program, in subsection 6 for state child care assistance, or
30in subsection 10 for technology costs related to the family
31investment program, as applicable, have been expended. For
32the purposes of this subsection, the funds appropriated in
33subsection 6, paragraph “a”, for transfer to the child care
34and development block grant appropriation are considered fully
35expended when the full amount has been transferred.
-11- 1b. The department shall, on a quarterly basis, advise the
2legislative services agency and department of management of
3the amount of funds appropriated in this subsection that was
4expended in the prior quarter.
512. Of the amounts appropriated in this section,
6$12,962,008 for the fiscal year beginning July 1, 2020, is
7transferred to the appropriation of the federal social services
8block grant made to the department of human services for that
9fiscal year.
1013. For continuation of the program providing categorical
11eligibility for the food assistance program as specified
12for the program in the section of this division of this Act
13relating to the family investment program account:
.................................................. $1414,236
1514. The department may transfer funds allocated in this
16section to the appropriations made in this division of this Act
17for the same fiscal year for general administration and field
18operations for resources necessary to implement and operate the
19services referred to in this section and those funded in the
20appropriation made in this division of this Act for the same
21fiscal year for the family investment program from the general
22fund of the state.
2315. With the exception of moneys allocated under this
24section for the family development and self-sufficiency grant
25program, to the extent moneys allocated in this section are
26deemed by the department not to be necessary to support the
27purposes for which they are allocated, such moneys may be
28used in the same fiscal year for any other purpose for which
29funds are allocated in this section or in section 8 of this
30division for the family investment program account. If there
31are conflicting needs, priority shall first be given to the
32family investment program account as specified under subsection
331 of this section and used for the purposes of assistance under
34the family investment program in accordance with chapter 239B,
35followed by state child care assistance program payments for
-12-1families who are employed, followed by other priorities as
2specified by the department.
3 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
41. Moneys credited to the family investment program (FIP)
5account for the fiscal year beginning July 1, 2020, and
6ending June 30, 2021, shall be used to provide assistance in
7accordance with chapter 239B.
82. The department may use a portion of the moneys credited
9to the FIP account under this section as necessary for
10salaries, support, maintenance, and miscellaneous purposes.
113. The department may transfer funds allocated in
12subsection 4, excluding the allocation under subsection 4,
13paragraph “b”, to the appropriations made in this division of
14this Act for the same fiscal year for general administration
15and field operations for resources necessary to implement
16and operate the services referred to in this section and
17those funded in the appropriations made in section 7 for the
18temporary assistance for needy families block grant and in
19section 9 for the family investment program from the general
20fund of the state in this division of this Act for the same
21fiscal year.
224. Moneys appropriated in this division of this Act and
23credited to the FIP account for the fiscal year beginning July
241, 2020, and ending June 30, 2021, are allocated as follows:
25a. To be retained by the department of human services to
26be used for coordinating with the department of human rights
27to more effectively serve participants in FIP and other shared
28clients and to meet federal reporting requirements under the
29federal temporary assistance for needy families block grant:
.................................................. $3010,000
31b. To the department of human rights for staffing,
32administration, and implementation of the family development
33and self-sufficiency grant program in accordance with section
34216A.107:
.................................................. $356,192,834
-13- 1(1) Of the funds allocated for the family development
2and self-sufficiency grant program in this paragraph “b”,
3not more than 5 percent of the funds shall be used for the
4administration of the grant program.
5(2) The department of human rights may continue to implement
6the family development and self-sufficiency grant program
7statewide during fiscal year 2020-2021.
8(3) The department of human rights may engage in activities
9to strengthen and improve family outcomes measures and
10data collection systems under the family development and
11self-sufficiency grant program.
12c. For the diversion subaccount of the FIP account:
.................................................. $131,293,000
14A portion of the moneys allocated for the diversion
15subaccount may be used for field operations, salaries, data
16management system development, and implementation costs and
17support deemed necessary by the director of human services
18in order to administer the FIP diversion program. To the
19extent moneys allocated in this paragraph are deemed by the
20department not to be necessary to support diversion activities,
21such moneys may be used for other efforts intended to increase
22engagement by family investment program participants in work,
23education, or training activities, or for the purposes of
24assistance under the family investment program in accordance
25with chapter 239B.
26d. For the food assistance employment and training program:
.................................................. $2766,588
28(1) The department shall apply the federal supplemental
29nutrition assistance program (SNAP) employment and training
30state plan in order to maximize to the fullest extent permitted
31by federal law the use of the 50 percent federal reimbursement
32provisions for the claiming of allowable federal reimbursement
33funds from the United States department of agriculture
34pursuant to the federal SNAP employment and training program
35for providing education, employment, and training services
-14-1for eligible food assistance program participants, including
2but not limited to related dependent care and transportation
3expenses.
4(2) The department shall continue the categorical federal
5food assistance program eligibility at 160 percent of the
6federal poverty level and continue to eliminate the asset test
7from eligibility requirements, consistent with federal food
8assistance program requirements. The department shall include
9as many food assistance households as is allowed by federal
10law. The eligibility provisions shall conform to all federal
11requirements including requirements addressing individuals who
12are incarcerated or otherwise ineligible.
13e. For the JOBS program:
.................................................. $1411,837,505
155. Of the child support collections assigned under FIP,
16an amount equal to the federal share of support collections
17shall be credited to the child support recovery appropriation
18made in this division of this Act. Of the remainder of the
19assigned child support collections received by the child
20support recovery unit, a portion shall be credited to the FIP
21account, a portion may be used to increase recoveries, and a
22portion may be used to sustain cash flow in the child support
23payments account. If as a consequence of the appropriations
24and allocations made in this section the resulting amounts
25are insufficient to sustain cash assistance payments and meet
26federal maintenance of effort requirements, the department
27shall seek supplemental funding. If child support collections
28assigned under FIP are greater than estimated or are otherwise
29determined not to be required for maintenance of effort, the
30state share of either amount may be transferred to or retained
31in the child support payments account.
326. The department may adopt emergency rules for the family
33investment, JOBS, food assistance, and medical assistance
34programs if necessary to comply with federal requirements.
35 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
-15-1is appropriated from the general fund of the state to the
2department of human services for the fiscal year beginning July
31, 2020, and ending June 30, 2021, the following amount, or
4so much thereof as is necessary, to be used for the purpose
5designated:
6To be credited to the family investment program (FIP)
7account and used for family investment program assistance under
8chapter 239B:
.................................................. $939,793,542
101. Of the funds appropriated in this section, $6,425,445 is
11allocated for the JOBS program.
122. Of the funds appropriated in this section, $3,313,854 is
13allocated for the family development and self-sufficiency grant
14program.
153. a. Notwithstanding section 8.39, for the fiscal
16year beginning July 1, 2020, if necessary to meet federal
17maintenance of effort requirements or to transfer federal
18temporary assistance for needy families block grant funding
19to be used for purposes of the federal social services block
20grant or to meet cash flow needs resulting from delays in
21receiving federal funding or to implement, in accordance with
22this division of this Act, activities currently funded with
23juvenile court services, county, or community moneys and state
24moneys used in combination with such moneys; to comply with
25federal requirements; or to maximize the use of federal funds;
26the department of human services may transfer funds within or
27between any of the appropriations made in this division of this
28Act and appropriations in law for the federal social services
29block grant to the department for the following purposes,
30provided that the combined amount of state and federal
31temporary assistance for needy families block grant funding
32for each appropriation remains the same before and after the
33transfer:
34(1) For the family investment program.
35(2) For state child care assistance.
-16- 1(3) For child and family services.
2(4) For field operations.
3(5) For general administration.
4b. This subsection shall not be construed to prohibit the
5use of existing state transfer authority for other purposes.
6The department shall report any transfers made pursuant to this
7subsection to the legislative services agency.
84. Of the funds appropriated in this section, $195,000
9shall be used for a contract with an Iowa-based nonprofit
10organization with a history of providing tax preparation
11assistance to low-income Iowans in order to expand the usage of
12the earned income tax credit. The purpose of the contract is
13to supply this assistance to underserved areas of the state.
14The department shall not retain any portion of the allocation
15under this subsection for administrative costs.
165. Of the funds appropriated in this section, $70,000 shall
17be used for the continuation of the parenting program, as
18specified in 441 IAC ch.100, relating to parental obligations,
19in which the child support recovery unit participates, to
20support the efforts of a nonprofit organization committed
21to strengthening the community through youth development,
22healthy living, and social responsibility headquartered in
23a county with a population over 350,000 according to the
24latest certified federal census. The funds allocated in this
25subsection shall be used by the recipient organization to
26develop a larger community effort, through public and private
27partnerships, to support a broad-based multi-county parenthood
28initiative that promotes payment of child support obligations,
29improved family relationships, and full-time employment.
306. The department may transfer funds appropriated in this
31section, excluding the allocation in subsection 2 for the
32family development and self-sufficiency grant program, to the
33appropriations made in this division of this Act for general
34administration and field operations as necessary to administer
35this section, section 7 for the temporary assistance for needy
-17-1families block grant, and section 8 for the family investment
2program account.
3 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
4from the general fund of the state to the department of human
5services for the fiscal year beginning July 1, 2020, and ending
6June 30, 2021, the following amount, or so much thereof as is
7necessary, to be used for the purposes designated:
8For child support recovery, including salaries, support,
9maintenance, and miscellaneous purposes:
.................................................. $1015,247,977
111. The department shall expend up to $24,000, including
12federal financial participation, for the fiscal year beginning
13July 1, 2020, for a child support public awareness campaign.
14The department and the office of the attorney general shall
15cooperate in continuation of the campaign. The public
16awareness campaign shall emphasize, through a variety of
17media activities, the importance of maximum involvement of
18both parents in the lives of their children as well as the
19importance of payment of child support obligations.
202. Federal access and visitation grant moneys shall be
21issued directly to private not-for-profit agencies that provide
22services designed to increase compliance with the child access
23provisions of court orders, including but not limited to
24neutral visitation sites and mediation services.
253. The appropriation made to the department for child
26support recovery may be used throughout the fiscal year in the
27manner necessary for purposes of cash flow management, and for
28cash flow management purposes the department may temporarily
29draw more than the amount appropriated, provided the amount
30appropriated is not exceeded at the close of the fiscal year.
31 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
32FY 2020-2021. Any funds remaining in the health care trust
33fund created in section 453A.35A for the fiscal year beginning
34July 1, 2020, and ending June 30, 2021, are appropriated to
35the department of human services to supplement the medical
-18-1assistance program appropriations made in this division of this
2Act, for medical assistance reimbursement and associated costs,
3including program administration and costs associated with
4program implementation.
5 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
62020-2021. Any funds remaining in the Medicaid fraud fund
7created in section 249A.50 for the fiscal year beginning
8July 1, 2020, and ending June 30, 2021, are appropriated to
9the department of human services to supplement the medical
10assistance appropriations made in this division of this Act,
11for medical assistance reimbursement and associated costs,
12including program administration and costs associated with
13program implementation.
14 Sec. 13. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES
15FUND — FY 2020-2021. There is appropriated from the general
16fund of the state to the department of human services for the
17fiscal year beginning July 1, 2020, and ending June 30, 2021,
18the following amount, or so much thereof as is necessary, to be
19used for the purpose designated:
20For transfer to the mental health and disability regional
21services fund created in section 225C.7A, or a successor fund:
.................................................. $2280,600,000
23Moneys transferred to the mental health and disability
24regional services fund under this section are appropriated to
25the department of human services for distribution to counties
26for funding of mental health and disability services in
27accordance with section 225C.7A.
28 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the
29general fund of the state to the department of human services
30for the fiscal year beginning July 1, 2020, and ending June 30,
312021, the following amount, or so much thereof as is necessary,
32to be used for the purpose designated:
33For medical assistance program reimbursement and associated
34costs as specifically provided in the reimbursement
35methodologies in effect on June 30, 2019, except as otherwise
-19-1expressly authorized by law, consistent with options under
2federal law and regulations, and contingent upon receipt of
3approval from the office of the governor of reimbursement for
4each abortion performed under the program:
.................................................. $51,594,425,375
61. Iowans support reducing the number of abortions
7performed in our state. Funds appropriated under this section
8shall not be used for abortions, unless otherwise authorized
9under this section.
102. The provisions of this section relating to abortions
11shall also apply to the Iowa health and wellness plan created
12pursuant to chapter 249N.
133. The department shall utilize not more than $60,000 of
14the funds appropriated in this section to continue the AIDS/HIV
15health insurance premium payment program as established in 1992
16Iowa Acts, Second Extraordinary Session, chapter 1001, section
17409, subsection 6. Of the funds allocated in this subsection,
18not more than $5,000 may be expended for administrative
19purposes.
204. Of the funds appropriated in this Act to the department
21of public health for addictive disorders, $950,000 for
22the fiscal year beginning July 1, 2020, is transferred
23to the department of human services for an integrated
24substance-related disorder managed care system. The
25departments of human services and public health shall
26work together to maintain the level of mental health and
27substance-related disorder treatment services provided by the
28managed care contractors. Each department shall take the steps
29necessary to continue the federal waivers as necessary to
30maintain the level of services.
315. The department shall aggressively pursue options for
32providing medical assistance or other assistance to individuals
33with special needs who become ineligible to continue receiving
34services under the early and periodic screening, diagnostic,
35and treatment program under the medical assistance program
-20-1due to becoming 21 years of age who have been approved for
2additional assistance through the department’s exception to
3policy provisions, but who have health care needs in excess
4of the funding available through the exception to policy
5provisions.
66. Of the funds appropriated in this section, up to
7$3,050,082 may be transferred to the field operations or
8general administration appropriations in this division of this
9Act for operational costs associated with Part D of the federal
10Medicare Prescription Drug Improvement and Modernization Act
11of 2003, Pub.L.No.108-173.
127. Of the funds appropriated in this section, up to $442,100
13may be transferred to the appropriation in this division
14of this Act for medical contracts to be used for clinical
15assessment services and prior authorization of services.
168. A portion of the funds appropriated in this section
17may be transferred to the appropriations in this division of
18this Act for general administration, medical contracts, the
19children’s health insurance program, or field operations to be
20used for the state match cost to comply with the payment error
21rate measurement (PERM) program for both the medical assistance
22and children’s health insurance programs as developed by the
23centers for Medicare and Medicaid services of the United States
24department of health and human services to comply with the
25federal Improper Payments Information Act of 2002, Pub.L.
26No.107-300, and to support other reviews and quality control
27activities to improve the integrity of these programs.
289. Of the funds appropriated in this section, a sufficient
29amount is allocated to supplement the incomes of residents of
30nursing facilities, intermediate care facilities for persons
31with mental illness, and intermediate care facilities for
32persons with an intellectual disability, with incomes of less
33than $50 in the amount necessary for the residents to receive a
34personal needs allowance of $50 per month pursuant to section
35249A.30A.
-21- 110. a. Hospitals that meet the conditions specified
2in subparagraphs (1) and (2) shall either certify public
3expenditures or transfer to the medical assistance program
4an amount equal to provide the nonfederal share for a
5disproportionate share hospital payment in an amount up to the
6hospital-specific limit as approved in the Medicaid state plan.
7The hospitals that meet the conditions specified shall receive
8and retain 100 percent of the total disproportionate share
9hospital payment in an amount up to the hospital-specific limit
10as approved in the Medicaid state plan.
11(1) The hospital qualifies for disproportionate share and
12graduate medical education payments.
13(2) The hospital is an Iowa state-owned hospital with more
14than 500 beds and eight or more distinct residency specialty
15or subspecialty programs recognized by the American college of
16graduate medical education.
17b. Distribution of the disproportionate share payments
18shall be made on a monthly basis. The total amount of
19disproportionate share payments including graduate medical
20education, enhanced disproportionate share, and Iowa
21state-owned teaching hospital payments shall not exceed the
22amount of the state’s allotment under Pub.L.No.102-234.
23In addition, the total amount of all disproportionate
24share payments shall not exceed the hospital-specific
25disproportionate share limits under Pub.L.No.103-66.
2611. One hundred percent of the nonfederal share of payments
27to area education agencies that are medical assistance
28providers for medical assistance-covered services provided to
29medical assistance-covered children, shall be made from the
30appropriation made in this section.
3112. A portion of the funds appropriated in this section
32may be transferred to the appropriation in this division of
33this Act for medical contracts to be used for administrative
34activities associated with the money follows the person
35demonstration project.
-22- 113. Of the funds appropriated in this section, $349,011
2shall be used for the administration of the health insurance
3premium payment program, including salaries, support,
4maintenance, and miscellaneous purposes.
514. a. The department may increase the amounts allocated
6for salaries, support, maintenance, and miscellaneous purposes
7associated with the medical assistance program, as necessary,
8to sustain cost management efforts. The department shall
9report any such increase to the legislative services agency and
10the department of management.
11b. If the savings to the medical assistance program from
12ongoing cost management efforts exceed the associated cost
13for the fiscal year beginning July 1, 2020, the department
14may transfer any savings generated for the fiscal year due
15to medical assistance program cost management efforts to the
16appropriation made in this division of this Act for medical
17contracts or general administration to defray the costs
18associated with implementing the efforts.
1915. For the fiscal year beginning July 1, 2020, and ending
20June 30, 2021, the replacement generation tax revenues required
21to be deposited in the property tax relief fund pursuant to
22section 437A.8, subsection 4, paragraph “d”, and section
23437A.15, subsection 3, paragraph “f”, shall instead be credited
24to and supplement the appropriation made in this section and
25used for the allocations made in this section.
2616. a. Of the funds appropriated in this section, up
27to $50,000 may be transferred by the department to the
28appropriation made in this division of this Act to the
29department for the same fiscal year for general administration
30to be used for associated administrative expenses and for not
31more than 1.00 full-time equivalent position, in addition to
32those authorized for the same fiscal year, to be assigned to
33implementing the children’s mental health home project.
34b. Of the funds appropriated in this section, up to $400,000
35may be transferred by the department to the appropriation made
-23-1to the department in this division of this Act for the same
2fiscal year for Medicaid program-related general administration
3planning and implementation activities. The funds may be used
4for contracts or for personnel in addition to the amounts
5appropriated for and the positions authorized for general
6administration for the fiscal year.
7c. Of the funds appropriated in this section, up to
8$3,000,000 may be transferred by the department to the
9appropriations made in this division of this Act for the same
10fiscal year for general administration or medical contracts
11to be used to support the development and implementation of
12standardized assessment tools for persons with mental illness,
13an intellectual disability, a developmental disability, or a
14brain injury.
1517. Of the funds appropriated in this section, $150,000
16shall be used for lodging expenses associated with care
17provided at the university of Iowa hospitals and clinics for
18patients with cancer whose travel distance is 30 miles or more
19and whose income is at or below 200 percent of the federal
20poverty level as defined by the most recently revised poverty
21income guidelines published by the United States department of
22health and human services. The department of human services
23shall establish the maximum number of overnight stays and the
24maximum rate reimbursed for overnight lodging, which may be
25based on the state employee rate established by the department
26of administrative services. The funds allocated in this
27subsection shall not be used as nonfederal share matching
28funds.
2918. Of the funds appropriated in this section, up to
30$3,383,880 shall be used for administration of the state family
31planning services program pursuant to section 217.41B, and
32of this amount, the department may use up to $200,000 for
33administrative expenses.
3419. Of the funds appropriated in this section, $1,545,530
35shall be used and may be transferred to other appropriations
-24-1in this division of this Act as necessary to administer the
2provisions in the division of this Act relating to Medicaid
3program administration.
420. Of the funds appropriated in this section, $5,000,000
5shall be used to increase the availability of telehealth
6providers and sites of service.
7 Sec. 15. MEDICAL CONTRACTS. There is appropriated from the
8general fund of the state to the department of human services
9for the fiscal year beginning July 1, 2020, and ending June 30,
102021, the following amount, or so much thereof as is necessary,
11to be used for the purpose designated:
12For medical contracts:
.................................................. $1317,832,301
141. The department of inspections and appeals shall
15provide all state matching funds for survey and certification
16activities performed by the department of inspections
17and appeals. The department of human services is solely
18responsible for distributing the federal matching funds for
19such activities.
202. Of the funds appropriated in this section, $50,000 shall
21be used for continuation of home and community-based services
22waiver quality assurance programs, including the review and
23streamlining of processes and policies related to oversight and
24quality management to meet state and federal requirements.
253. Of the amount appropriated in this section, up to
26$200,000 may be transferred to the appropriation for general
27administration in this division of this Act to be used for
28additional full-time equivalent positions in the development
29of key health initiatives such as development and oversight
30of managed care programs and development of health strategies
31targeted toward improved quality and reduced costs in the
32Medicaid program.
334. Of the funds appropriated in this section, $1,000,000
34shall be used for planning and development, in cooperation with
35the department of public health, of a phased-in program to
-25-1provide a dental home for children.
25. a. Of the funds appropriated in this section, $573,000
3shall be credited to the autism support program fund created
4in section 225D.2 to be used for the autism support program
5created in chapter 225D, with the exception of the following
6amount of this allocation which shall be used as follows:
7b. Of the funds allocated in this subsection, $25,000 shall
8be used for the public purpose of continuation of a grant to a
9nonprofit provider of child welfare services that has been in
10existence for more than 115 years, is located in a county with
11a population between 200,000 and 220,000 according to the most
12recent federal decennial census, is licensed as a psychiatric
13medical institution for children, and provides school-based
14programming, to be used for support services for children with
15autism spectrum disorder and their families.
16 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE.
171. There is appropriated from the general fund of the
18state to the department of human services for the fiscal year
19beginning July 1, 2020, and ending June 30, 2021, the following
20amount, or so much thereof as is necessary, to be used for the
21purpose designated:
22For the state supplementary assistance program:
.................................................. $237,349,002
242. The department shall increase the personal needs
25allowance for residents of residential care facilities by the
26same percentage and at the same time as federal supplemental
27security income and federal social security benefits are
28increased due to a recognized increase in the cost of living.
29The department may adopt emergency rules to implement this
30subsection.
313. If during the fiscal year beginning July 1, 2020,
32the department projects that state supplementary assistance
33expenditures for a calendar year will not meet the federal
34pass-through requirement specified in Tit.XVI of the federal
35Social Security Act, section 1618, as codified in 42 U.S.C.
-26-1§1382g, the department may take actions including but not
2limited to increasing the personal needs allowance for
3residential care facility residents and making programmatic
4adjustments or upward adjustments of the residential care
5facility or in-home health-related care reimbursement rates
6prescribed in this division of this Act to ensure that federal
7requirements are met. In addition, the department may make
8other programmatic and rate adjustments necessary to remain
9within the amount appropriated in this section while ensuring
10compliance with federal requirements. The department may adopt
11emergency rules to implement the provisions of this subsection.
124. Notwithstanding section 8.33, moneys appropriated in
13this section that remain unencumbered or unobligated at the
14close of the fiscal year shall not revert but shall remain
15available for expenditure for the purposes designated until the
16close of the succeeding fiscal year.
17 Sec. 17. CHILDREN’S HEALTH INSURANCE PROGRAM.
181. There is appropriated from the general fund of the
19state to the department of human services for the fiscal year
20beginning July 1, 2020, and ending June 30, 2021, the following
21amount, or so much thereof as is necessary, to be used for the
22purpose designated:
23For maintenance of the healthy and well kids in Iowa (hawk-i)
24program pursuant to chapter 514I, including supplemental dental
25services, for receipt of federal financial participation under
26Tit.XXI of the federal Social Security Act, which creates the
27children’s health insurance program:
.................................................. $2841,132,725
292. Of the funds appropriated in this section, $146,682 is
30allocated for continuation of the contract for outreach with
31the department of public health.
323. A portion of the funds appropriated in this section may
33be transferred to the appropriations made in this division of
34this Act for field operations or medical contracts to be used
35for the integration of hawk-i program eligibility, payment, and
-27-1administrative functions under the purview of the department
2of human services, including for the Medicaid management
3information system upgrade.
4 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated
5from the general fund of the state to the department of human
6services for the fiscal year beginning July 1, 2020, and ending
7June 30, 2021, the following amount, or so much thereof as is
8necessary, to be used for the purpose designated:
9For child care programs:
.................................................. $1040,817,751
111. Of the funds appropriated in this section, $34,967,751
12shall be used for state child care assistance in accordance
13with section 237A.13.
142. Nothing in this section shall be construed or is
15intended as or shall imply a grant of entitlement for services
16to persons who are eligible for assistance due to an income
17level consistent with the waiting list requirements of section
18237A.13. Any state obligation to provide services pursuant to
19this section is limited to the extent of the funds appropriated
20in this section.
213. A list of the registered and licensed child care
22facilities operating in the area served by a child care
23resource and referral service shall be made available to the
24families receiving state child care assistance in that area.
254. Of the funds appropriated in this section, $5,850,000
26shall be credited to the early childhood programs grants
27account in the early childhood Iowa fund created in section
28256I.11. The moneys shall be distributed for funding of
29community-based early childhood programs targeted to children
30from birth through five years of age developed by early
31childhood Iowa areas in accordance with approved community
32plans as provided in section 256I.8.
335. The department may use any of the funds appropriated
34in this section as a match to obtain federal funds for use in
35expanding child care assistance and related programs. For
-28-1the purpose of expenditures of state and federal child care
2funding, funds shall be considered obligated at the time
3expenditures are projected or are allocated to the department’s
4service areas. Projections shall be based on current and
5projected caseload growth, current and projected provider
6rates, staffing requirements for eligibility determination
7and management of program requirements including data systems
8management, staffing requirements for administration of the
9program, contractual and grant obligations and any transfers
10to other state agencies, and obligations for decategorization
11or innovation projects.
126. A portion of the state match for the federal child care
13and development block grant shall be provided as necessary to
14meet federal matching funds requirements through the state
15general fund appropriation made for child development grants
16and other programs for at-risk children in section 279.51.
177. If a uniform reduction ordered by the governor under
18section 8.31 or other operation of law, transfer, or federal
19funding reduction reduces the appropriation made in this
20section for the fiscal year, the percentage reduction in the
21amount paid out to or on behalf of the families participating
22in the state child care assistance program shall be equal to or
23less than the percentage reduction made for any other purpose
24payable from the appropriation made in this section and the
25federal funding relating to it. The percentage reduction to
26the other allocations made in this section shall be the same as
27the uniform reduction ordered by the governor or the percentage
28change of the federal funding reduction, as applicable. If
29there is an unanticipated increase in federal funding provided
30for state child care services, the entire amount of the
31increase, except as necessary to meet federal requirements
32including quality set asides, shall be used for state child
33care assistance payments. If the appropriations made for
34purposes of the state child care assistance program for the
35fiscal year are determined to be insufficient, it is the intent
-29-1of the general assembly to appropriate sufficient funding for
2the fiscal year in order to avoid establishment of waiting list
3requirements.
48. Notwithstanding section 8.33, moneys advanced for
5purposes of the programs developed by early childhood Iowa
6areas, advanced for purposes of wraparound child care, or
7received from the federal appropriations made for the purposes
8of this section that remain unencumbered or unobligated at the
9close of the fiscal year shall not revert to any fund but shall
10remain available for expenditure for the purposes designated
11until the close of the succeeding fiscal year.
12 Sec. 19. JUVENILE INSTITUTION. There is appropriated
13from the general fund of the state to the department of human
14services for the fiscal year beginning July 1, 2020, and ending
15June 30, 2021, the following amounts, or so much thereof as is
16necessary, to be used for the purposes designated:
171. a. For operation of the state training school at Eldora
18and for salaries, support, maintenance, and miscellaneous
19purposes:
.................................................. $2016,333,688
21b. Of the funds appropriated in this subsection, $91,000
22shall be used for distribution to licensed classroom teachers
23at this and other institutions under the control of the
24department of human services based upon the average student
25yearly enrollment at each institution as determined by the
26department.
272. A portion of the moneys appropriated in this section
28shall be used by the state training school at Eldora for
29grants for adolescent pregnancy prevention activities at the
30institution in the fiscal year beginning July 1, 2020.
313. Of the funds appropriated in this section, $212,000 shall
32be used by the state training school at Eldora for a substance
33use disorder treatment program at the institution for the
34fiscal year beginning July 1, 2020.
35 Sec. 20. CHILD AND FAMILY SERVICES.
-30- 11. There is appropriated from the general fund of the
2state to the department of human services for the fiscal year
3beginning July 1, 2020, and ending June 30, 2021, the following
4amount, or so much thereof as is necessary, to be used for the
5purpose designated:
6For child and family services:
.................................................. $789,077,415
82. The department may transfer funds appropriated in this
9section as necessary to pay the nonfederal costs of services
10reimbursed under the medical assistance program, state child
11care assistance program, or the family investment program which
12are provided to children who would otherwise receive services
13paid under the appropriation in this section. The department
14may transfer funds appropriated in this section to the
15appropriations made in this division of this Act for general
16administration and for field operations for resources necessary
17to implement and operate the services funded in this section.
183. a. Of the funds appropriated in this section, up to
19$26,025,000 is allocated as the statewide expenditure target
20under section 232.143 for group foster care maintenance and
21services. If the department projects that such expenditures
22for the fiscal year will be less than the target amount
23allocated in this paragraph, the department may reallocate the
24excess to provide additional funding for family foster care,
25independent living, family-centered services, shelter care,
26or the child welfare emergency services addressed with the
27allocation for shelter care.
28b. If at any time after September 30, 2020, annualization
29of a service area’s current expenditures indicates a service
30area is at risk of exceeding its group foster care expenditure
31target under section 232.143 by more than 5 percent, the
32department and juvenile court services shall examine all
33group foster care placements in that service area in order to
34identify those which might be appropriate for termination.
35In addition, any aftercare services believed to be needed
-31-1for the children whose placements may be terminated shall be
2identified. The department and juvenile court services shall
3initiate action to set dispositional review hearings for the
4placements identified. In such a dispositional review hearing,
5the juvenile court shall determine whether needed aftercare
6services are available and whether termination of the placement
7is in the best interest of the child and the community.
84. In accordance with the provisions of section 232.188,
9the department shall continue the child welfare and juvenile
10justice funding initiative during fiscal year 2020-2021. Of
11the funds appropriated in this section, $1,717,000 is allocated
12specifically for expenditure for fiscal year 2020-2021 through
13the decategorization services funding pools and governance
14boards established pursuant to section 232.188.
155. A portion of the funds appropriated in this section
16may be used for emergency family assistance to provide other
17resources required for a family participating in a family
18preservation or reunification project or successor project to
19stay together or to be reunified.
206. Of the funds appropriated in this section, a sufficient
21amount is allocated for shelter care and the child welfare
22emergency services contracting implemented to provide for or
23prevent the need for shelter care.
247. Federal funds received by the state during the fiscal
25year beginning July 1, 2020, as the result of the expenditure
26of state funds appropriated during a previous state fiscal
27year for a service or activity funded under this section are
28appropriated to the department to be used as additional funding
29for services and purposes provided for under this section.
30Notwithstanding section 8.33, moneys received in accordance
31with this subsection that remain unencumbered or unobligated at
32the close of the fiscal year shall not revert to any fund but
33shall remain available for the purposes designated until the
34close of the succeeding fiscal year.
358. a. Of the funds appropriated in this section, up to
-32-1$3,290,000 is allocated for the payment of the expenses of
2court-ordered services provided to juveniles who are under the
3supervision of juvenile court services, which expenses are a
4charge upon the state pursuant to section 232.141, subsection
54. Of the amount allocated in this paragraph, up to $1,556,000
6shall be made available to provide school-based supervision of
7children adjudicated under chapter 232, of which not more than
8$15,000 may be used for the purpose of training. A portion of
9the cost of each school-based liaison officer shall be paid by
10the school district or other funding source as approved by the
11chief juvenile court officer.
12b. Of the funds appropriated in this section, up to $748,000
13is allocated for the payment of the expenses of court-ordered
14services provided to children who are under the supervision
15of the department, which expenses are a charge upon the state
16pursuant to section 232.141, subsection 4.
17c. Notwithstanding section 232.141 or any other provision
18of law to the contrary, the amounts allocated in this
19subsection shall be distributed to the judicial districts
20as determined by the state court administrator and to the
21department’s service areas as determined by the administrator
22of the department of human services’ division of child and
23family services. The state court administrator and the
24division administrator shall make the determination of the
25distribution amounts on or before June 15, 2020.
26d. Notwithstanding chapter 232 or any other provision of
27law to the contrary, a district or juvenile court shall not
28order any service which is a charge upon the state pursuant
29to section 232.141 if there are insufficient court-ordered
30services funds available in the district court or departmental
31service area distribution amounts to pay for the service. The
32chief juvenile court officer and the departmental service area
33manager shall encourage use of the funds allocated in this
34subsection such that there are sufficient funds to pay for
35all court-related services during the entire year. The chief
-33-1juvenile court officers and departmental service area managers
2shall attempt to anticipate potential surpluses and shortfalls
3in the distribution amounts and shall cooperatively request the
4state court administrator or division administrator to transfer
5funds between the judicial districts’ or departmental service
6areas’ distribution amounts as prudent.
7e. Notwithstanding any provision of law to the contrary,
8a district or juvenile court shall not order a county to pay
9for any service provided to a juvenile pursuant to an order
10entered under chapter 232 which is a charge upon the state
11under section 232.141, subsection 4.
12f. Of the funds allocated in this subsection, not more than
13$83,000 may be used by the judicial branch for administration
14of the requirements under this subsection.
15g. Of the funds allocated in this subsection, $17,000
16shall be used by the department of human services to support
17the interstate commission for juveniles in accordance with
18the interstate compact for juveniles as provided in section
19232.173.
209. Of the funds appropriated in this section, $12,253,000 is
21allocated for juvenile delinquent graduated sanctions services.
22Any state funds saved as a result of efforts by juvenile court
23services to earn a federal Tit.IV-E match for juvenile court
24services administration may be used for the juvenile delinquent
25graduated sanctions services.
2610. Of the funds appropriated in this section, $1,658,000 is
27transferred to the department of public health to be used for
28the child protection center grant program for child protection
29centers located in Iowa in accordance with section 135.118.
30The grant amounts under the program shall be equalized so that
31each center receives a uniform base amount of $245,000, and so
32that the remaining funds are awarded through a funding formula
33based upon the volume of children served. To increase access
34to child protection center services for children in rural
35areas, the funding formula for the awarding of the remaining
-34-1funds shall provide for the awarding of an enhanced amount to
2eligible grantees to develop and maintain satellite centers in
3underserved regions of the state.
411. Of the funds appropriated in this section, $4,025,000 is
5allocated for the preparation for adult living program pursuant
6to section 234.46.
712. Of the funds appropriated in this section, $227,000
8shall be used for the public purpose of continuing a grant to a
9nonprofit human services organization, providing services to
10individuals and families in multiple locations in southwest
11Iowa and Nebraska for support of a project providing immediate,
12sensitive support and forensic interviews, medical exams, needs
13assessments, and referrals for victims of child abuse and their
14nonoffending family members.
1513. Of the funds appropriated in this section, $300,000
16is allocated for the foster care youth council approach of
17providing a support network to children placed in foster care.
1814. Of the funds appropriated in this section, $202,000 is
19allocated for use pursuant to section 235A.1 for continuation
20of the initiative to address child sexual abuse implemented
21pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
2221.
2315. Of the funds appropriated in this section, $630,000 is
24allocated for the community partnership for child protection
25sites.
2616. Of the funds appropriated in this section, $371,000
27is allocated for the department’s minority youth and family
28projects under the redesign of the child welfare system.
2917. Of the funds appropriated in this section, $851,000
30is allocated for funding of the community circle of care
31collaboration for children and youth in northeast Iowa.
3218. Of the funds appropriated in this section, at least
33$147,000 shall be used for the continuation of the child
34welfare provider training academy, a collaboration between the
35coalition for family and children’s services in Iowa and the
-35-1department.
219. Of the funds appropriated in this section, $211,000
3shall be used for continuation of the central Iowa system of
4care program grant through June 30, 2021.
520. Of the funds appropriated in this section, $235,000
6shall be used for the public purpose of the continuation
7and expansion of a system of care program grant implemented
8in Cerro Gordo and Linn counties to utilize a comprehensive
9and long-term approach for helping children and families by
10addressing the key areas in a child’s life of childhood basic
11needs, education and work, family, and community.
1221. Of the funds appropriated in this section, $110,000
13shall be used for the public purpose of funding community-based
14services and other supports with a system of care approach
15for children with a serious emotional disturbance and their
16families through a nonprofit provider of child welfare services
17that has been in existence for more than 115 years, is located
18in a county with a population of more than 200,000 but less
19than 220,000 according to the latest certified federal census,
20is licensed as a psychiatric medical institution for children,
21and was a system of care grantee prior to July 1, 2020.
2222. If a separate funding source is identified that reduces
23the need for state funds within an allocation under this
24section, the allocated state funds may be redistributed to
25other allocations under this section for the same fiscal year.
2623. A portion of the funds appropriated in this section
27may be used for family-centered services for the purposes of
28complying with the federal family first prevention and services
29Act of 2018, Pub.L.No.115-123, and successor legislation.
30 Sec. 21. ADOPTION SUBSIDY.
311. There is appropriated from the general fund of the
32state to the department of human services for the fiscal year
33beginning July 1, 2020, and ending June 30, 2021, the following
34amount, or so much thereof as is necessary, to be used for the
35purpose designated:
-36- 1a. For adoption subsidy payments and services:
.................................................. $241,588,378
3b. (1) The funds appropriated in this section shall be used
4as authorized or allowed by federal law or regulation for any
5of the following purposes:
6(a) For adoption subsidy payments and related costs.
7(b) For post-adoption services and for other purposes under
8Tit.IV-B or Tit.IV-E of the federal Social Security Act.
9(2) The department of human services may transfer funds
10appropriated in this subsection to the appropriation for
11child and family services in this Act for the purposes of
12post-adoption services and for other purposes under Tit.IV-B
13or Tit.IV-E of the federal Social Security Act.
14c. Notwithstanding section 8.33, moneys corresponding to
15the state savings resulting from implementation of the federal
16Fostering Connections to Success and Increasing Adoptions Act
17of 2008, Pub.L. No.110-351, and successor legislation, as
18determined in accordance with 42 U.S.C.§673(a)(8), that remain
19unencumbered or unobligated at the close of the fiscal year,
20shall not revert to any fund but shall remain available for the
21purposes designated in this subsection until expended. The
22amount of such savings and any corresponding funds remaining
23at the close of the fiscal year shall be determined separately
24and any changes in either amount between fiscal years shall not
25result in an unfunded need.
262. The department may transfer funds appropriated in
27this section to the appropriation made in this division of
28this Act for general administration for costs paid from the
29appropriation relating to adoption subsidy.
303. Federal funds received by the state during the
31fiscal year beginning July 1, 2020, as the result of the
32expenditure of state funds during a previous state fiscal
33year for a service or activity funded under this section are
34appropriated to the department to be used as additional funding
35for the services and activities funded under this section.
-37-1Notwithstanding section 8.33, moneys received in accordance
2with this subsection that remain unencumbered or unobligated
3at the close of the fiscal year shall not revert to any fund
4but shall remain available for expenditure for the purposes
5designated until the close of the succeeding fiscal year.
6 Sec. 22. JUVENILE DETENTION HOME FUND. Moneys deposited
7in the juvenile detention home fund created in section 232.142
8during the fiscal year beginning July 1, 2020, and ending June
930, 2021, are appropriated to the department of human services
10for the fiscal year beginning July 1, 2020, and ending June 30,
112021, for distribution of an amount equal to a percentage of
12the costs of the establishment, improvement, operation, and
13maintenance of county or multicounty juvenile detention homes
14in the fiscal year beginning July 1, 2019. Moneys appropriated
15for distribution in accordance with this section shall be
16allocated among eligible detention homes, prorated on the basis
17of an eligible detention home’s proportion of the costs of all
18eligible detention homes in the fiscal year beginning July
191, 2019. The percentage figure shall be determined by the
20department based on the amount available for distribution for
21the fund. Notwithstanding section 232.142, subsection 3, the
22financial aid payable by the state under that provision for the
23fiscal year beginning July 1, 2020, shall be limited to the
24amount appropriated for the purposes of this section.
25 Sec. 23. FAMILY SUPPORT SUBSIDY PROGRAM.
261. There is appropriated from the general fund of the
27state to the department of human services for the fiscal year
28beginning July 1, 2020, and ending June 30, 2021, the following
29amount, or so much thereof as is necessary, to be used for the
30purpose designated:
31For the family support subsidy program subject to the
32enrollment restrictions in section 225C.37, subsection 3:
.................................................. $33949,282
342. At least $875,195 of the moneys appropriated in this
35section is transferred to the department of public health for
-38-1the family support center component of the comprehensive family
2support program under chapter 225C, subchapter V.
33. If at any time during the fiscal year, the amount of
4funding available for the family support subsidy program
5is reduced from the amount initially used to establish the
6figure for the number of family members for whom a subsidy
7is to be provided at any one time during the fiscal year,
8notwithstanding section 225C.38, subsection 2, the department
9shall revise the figure as necessary to conform to the amount
10of funding available.
11 Sec. 24. CONNER DECREE. There is appropriated from the
12general fund of the state to the department of human services
13for the fiscal year beginning July 1, 2020, and ending June 30,
142021, the following amount, or so much thereof as is necessary,
15to be used for the purpose designated:
16For building community capacity through the coordination
17and provision of training opportunities in accordance with the
18consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
19Iowa, July 14, 1994):
.................................................. $2033,632
21 Sec. 25. MENTAL HEALTH INSTITUTES.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2020, and ending June 30, 2021, the following
25amounts, or so much thereof as is necessary, to be used for the
26purposes designated:
27a. For operation of the state mental health institute at
28Cherokee as required by chapters 218 and 226 for salaries,
29support, maintenance, and miscellaneous purposes:
.................................................. $3014,826,075
31b. For operation of the state mental health institute at
32Independence as required by chapters 218 and 226 for salaries,
33support, maintenance, and miscellaneous purposes:
.................................................. $3419,710,614
352. Notwithstanding sections 218.78 and 249A.11, any revenue
-39-1received from the state mental health institute at Cherokee or
2the state mental health institute at Independence pursuant to
342 C.F.R§438.6(e) may be retained and expended by the mental
4health institute.
53. Notwithstanding any provision of law to the contrary,
6a Medicaid member residing at the state mental health
7institute at Cherokee or the state mental health institute
8at Independence shall retain Medicaid eligibility during
9the period of the Medicaid member’s stay for which federal
10financial participation is available.
11 Sec. 26. STATE RESOURCE CENTERS.
121. There is appropriated from the general fund of the
13state to the department of human services for the fiscal year
14beginning July 1, 2020, and ending June 30, 2021, the following
15amounts, or so much thereof as is necessary, to be used for the
16purposes designated:
17a. For the state resource center at Glenwood for salaries,
18support, maintenance, and miscellaneous purposes:
.................................................. $1916,536,391
20b. For the state resource center at Woodward for salaries,
21support, maintenance, and miscellaneous purposes:
.................................................. $2211,452,986
232. The department may continue to bill for state resource
24center services utilizing a scope of services approach used for
25private providers of intermediate care facilities for persons
26with an intellectual disability services, in a manner which
27does not shift costs between the medical assistance program,
28counties, or other sources of funding for the state resource
29centers.
303. The state resource centers may expand the time-limited
31assessment and respite services during the fiscal year.
324. If the department’s administration and the department
33of management concur with a finding by a state resource
34center’s superintendent that projected revenues can reasonably
35be expected to pay the salary and support costs for a new
-40-1employee position, or that such costs for adding a particular
2number of new positions for the fiscal year would be less
3than the overtime costs if new positions would not be added,
4the superintendent may add the new position or positions. If
5the vacant positions available to a resource center do not
6include the position classification desired to be filled, the
7state resource center’s superintendent may reclassify any
8vacant position as necessary to fill the desired position. The
9superintendents of the state resource centers may, by mutual
10agreement, pool vacant positions and position classifications
11during the course of the fiscal year in order to assist one
12another in filling necessary positions.
135. If existing capacity limitations are reached in
14operating units, a waiting list is in effect for a service or
15a special need for which a payment source or other funding
16is available for the service or to address the special need,
17and facilities for the service or to address the special need
18can be provided within the available payment source or other
19funding, the superintendent of a state resource center may
20authorize opening not more than two units or other facilities
21and begin implementing the service or addressing the special
22need during fiscal year 2020-2021.
236. Notwithstanding section 8.33, and notwithstanding
24the amount limitation specified in section 222.92, moneys
25appropriated in this section that remain unencumbered or
26unobligated at the close of the fiscal year shall not revert
27but shall remain available for expenditure for the purposes
28designated until the close of the succeeding fiscal year.
29 Sec. 27. SEXUALLY VIOLENT PREDATORS.
301. There is appropriated from the general fund of the
31state to the department of human services for the fiscal year
32beginning July 1, 2020, and ending June 30, 2021, the following
33amount, or so much thereof as is necessary, to be used for the
34purpose designated:
35For costs associated with the commitment and treatment of
-41-1sexually violent predators in the unit located at the state
2mental health institute at Cherokee, including costs of legal
3services and other associated costs, including salaries,
4support, maintenance, and miscellaneous purposes, and for not
5more than the following full-time equivalent positions:
.................................................. $612,452,572
72. Unless specifically prohibited by law, if the amount
8charged provides for recoupment of at least the entire amount
9of direct and indirect costs, the department of human services
10may contract with other states to provide care and treatment
11of persons placed by the other states at the unit for sexually
12violent predators at Cherokee. The moneys received under
13such a contract shall be considered to be repayment receipts
14and used for the purposes of the appropriation made in this
15section.
16 Sec. 28. FIELD OPERATIONS.
171. There is appropriated from the general fund of the
18state to the department of human services for the fiscal year
19beginning July 1, 2020, and ending June 30, 2021, the following
20amount, or so much thereof as is necessary, to be used for the
21purposes designated:
22For field operations, including salaries, support,
23maintenance, and miscellaneous purposes:
.................................................. $2460,341,204
252. Priority in filling full-time equivalent positions
26shall be given to those positions related to child protection
27services and eligibility determination for low-income families.
28 Sec. 29. GENERAL ADMINISTRATION. There is appropriated
29from the general fund of the state to the department of human
30services for the fiscal year beginning July 1, 2020, and ending
31June 30, 2021, the following amount, or so much thereof as is
32necessary, to be used for the purpose designated:
33For general administration, including salaries, support,
34maintenance, and miscellaneous purposes:
.................................................. $3514,264,728
-42- 11. The department shall report at least monthly to the
2legislative services agency concerning the department’s
3operational and program expenditures.
42. Of the funds appropriated in this section, $150,000
5shall be used for the provision of a program to provide
6technical assistance, support, and consultation to providers
7of habilitation services and home and community-based services
8waiver services for adults with disabilities under the medical
9assistance program.
103. Of the funds appropriated in this section, $50,000
11is transferred to the Iowa finance authority to be used
12for administrative support of the council on homelessness
13established in section 16.2D and for the council to fulfill its
14duties in addressing and reducing homelessness in the state.
154. Of the funds appropriated in this section, $200,000 shall
16be transferred to and deposited in the administrative fund of
17the Iowa ABLE savings plan trust created in section 12I.4, to
18be used for implementation and administration activities of the
19Iowa ABLE savings plan trust.
205. Of the funds appropriated in this section, $200,000 is
21transferred to the economic development authority for the Iowa
22commission on volunteer services to continue to be used for the
23RefugeeRISE AmeriCorps program established under section 15H.8
24for member recruitment and training to improve the economic
25well-being and health of economically disadvantaged refugees in
26local communities across Iowa. Funds transferred may be used
27to supplement federal funds under federal regulations.
286. Of the funds appropriated in this section, up to $300,000
29shall be used to support the work of the children’s behavioral
30health system state board created in section 225C.51 and the
31children’s behavioral health system as defined in section
32225C.2. Of the amount allocated in this subsection, $32,000
33shall be transferred to the department of public health to
34support the costs related to the children’s behavioral health
35system.
-43-1 Sec. 30. DEPARTMENT-WIDE DUTIES. There is appropriated
2from the general fund of the state to the department of human
3services for the fiscal year beginning July 1, 2020, and ending
4June 30, 2021, the following amount, or so much thereof as is
5necessary, to be used for the purposes designated:
6For salaries, support, maintenance, and miscellaneous
7purposes at facilities under the purview of the department of
8human services:
.................................................. $92,879,274
10 Sec. 31. VOLUNTEERS. There is appropriated from the general
11fund of the state to the department of human services for the
12fiscal year beginning July 1, 2020, and ending June 30, 2021,
13the following amount, or so much thereof as is necessary, to be
14used for the purpose designated:
15For development and coordination of volunteer services:
.................................................. $1684,686
17 Sec. 32. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
18ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
19DEPARTMENT OF HUMAN SERVICES.
201. a. (1) (a) For the fiscal year beginning July 1,
212020, the department shall rebase case-mix nursing facility
22rates effective July 1, 2020, to the extent possible within the
23state funding, including the $8,000,000, appropriated for this
24purpose.
25(b) For the fiscal year beginning July 1, 2020, non-case-mix
26and special population nursing facilities shall be reimbursed
27in accordance with the methodology in effect on June 30 of the
28prior fiscal year.
29(2) For managed care claims, the department of human
30services shall adjust the payment rate floor for nursing
31facilities, annually, to maintain a rate floor that is no
32lower than the Medicaid fee-for-service case-mix adjusted
33rate calculated in accordance with subparagraph division
34(a) and 441 IAC 81.6. The department shall then calculate
35adjusted reimbursement rates, including but not limited to
-44-1add-on-payments, annually, and shall notify Medicaid managed
2care organizations of the adjusted reimbursement rates within
330 days of determining the adjusted reimbursement rates. Any
4adjustment of reimbursement rates under this subparagraph
5division shall be budget neutral to the state budget.
6(3) Medicaid managed care organizations shall adjust
7facility-specific rates based upon payment rate listings issued
8by the department. The rate adjustments shall be applied
9prospectively from the effective date of the rate letter issued
10by the department.
11b. (1) For the fiscal year beginning July 1,2020, the
12department shall establish the pharmacy dispensing fee
13reimbursement at $10.07 per prescription, until a cost of
14dispensing survey is completed. The actual dispensing fee
15shall be determined by a cost of dispensing survey performed
16by the department and required to be completed by all medical
17assistance program participating pharmacies every two years,
18adjusted as necessary to maintain expenditures within the
19amount appropriated to the department for this purpose for the
20fiscal year.
21(2) The department shall utilize an average acquisition
22cost reimbursement methodology for all drugs covered under the
23medical assistance program in accordance with 2012 Iowa Acts,
24chapter 1133, section 33.
25c. (1) For the fiscal year beginning July 1, 2020,
26reimbursement rates for outpatient hospital services shall
27remain at the rates in effect on June 30, 2020, subject to
28Medicaid program upper payment limit rules, and adjusted
29as necessary to maintain expenditures within the amount
30appropriated to the department for this purpose for the fiscal
31year.
32(2) For the fiscal year beginning July 1, 2020,
33reimbursement rates for inpatient hospital services shall
34be rebased effective October 1, 2020, subject to Medicaid
35program upper payment limit rules, and adjusted as necessary
-45-1to maintain expenditures within the amount appropriated to the
2department for this purpose for the fiscal year.
3(3) For the fiscal year beginning July 1, 2020, under
4both fee-for-service and managed care administration of
5the Medicaid program, critical access hospitals shall be
6reimbursed for inpatient and outpatient services based on the
7hospital-specific critical access hospital cost adjustment
8factor methodology utilizing the most recent and complete cost
9reporting period as applied prospectively within the funds
10appropriated for such purpose for the fiscal year.
11(4) For the fiscal year beginning July 1, 2020, the graduate
12medical education and disproportionate share hospital fund
13shall remain at the amount in effect on June 30, 2020, except
14that the portion of the fund attributable to graduate medical
15education shall be reduced in an amount that reflects the
16elimination of graduate medical education payments made to
17out-of-state hospitals.
18(5) In order to ensure the efficient use of limited state
19funds in procuring health care services for low-income Iowans,
20funds appropriated in this Act for hospital services shall
21not be used for activities which would be excluded from a
22determination of reasonable costs under the federal Medicare
23program pursuant to 42 U.S.C.§1395x(v)(1)(N).
24d. For the fiscal year beginning July 1, 2020, reimbursement
25rates for hospices and acute psychiatric hospitals shall be
26increased in accordance with increases under the federal
27Medicare program or as supported by their Medicare audited
28costs.
29e. For the fiscal year beginning July 1, 2020, independent
30laboratories and rehabilitation agencies shall be reimbursed
31using the same methodology in effect on June 30, 2020.
32f. (1) For the fiscal year beginning July 1, 2020,
33reimbursement rates for home health agencies shall continue to
34be based on the Medicare low utilization payment adjustment
35(LUPA) methodology with state geographic wage adjustments.
-46-1The department shall continue to update the rates every two
2years to reflect the most recent Medicare LUPA rates to the
3extent possible within the state funding appropriated for this
4purpose.
5(2) For the fiscal year beginning July 1, 2020, rates for
6private duty nursing and personal care services under the early
7and periodic screening, diagnostic, and treatment program
8benefit shall be calculated based on the methodology in effect
9on June 30, 2020.
10g. For the fiscal year beginning July 1, 2020, federally
11qualified health centers and rural health clinics shall receive
12cost-based reimbursement for 100 percent of the reasonable
13costs for the provision of services to recipients of medical
14assistance.
15h. For the fiscal year beginning July 1, 2020, the
16reimbursement rates for dental services shall remain at the
17rates in effect on June 30, 2020.
18i. (1) For the fiscal year beginning July 1, 2020,
19reimbursement rates for non-state-owned psychiatric medical
20institutions for children shall be based on the reimbursement
21methodology in effect on June 30, 2020.
22(2) As a condition of participation in the medical
23assistance program, enrolled providers shall accept the medical
24assistance reimbursement rate for any covered goods or services
25provided to recipients of medical assistance who are children
26under the custody of a psychiatric medical institution for
27children.
28j. For the fiscal year beginning July 1, 2020, unless
29otherwise specified in this Act, all noninstitutional medical
30assistance provider reimbursement rates shall remain at the
31rates in effect on June 30, 2020, except for area education
32agencies, local education agencies, infant and toddler
33services providers, home and community-based services providers
34including consumer-directed attendant care providers under a
35section 1915(c) or 1915(i) waiver, targeted case management
-47-1providers, and those providers whose rates are required to be
2determined pursuant to section 249A.20, or to meet federal
3mental health parity requirements.
4k. Notwithstanding any provision to the contrary, for the
5fiscal year beginning July 1, 2020, the reimbursement rate for
6anesthesiologists shall remain at the rates in effect on June
730, 2020, and updated on January 1, 2021, to align with the
8most current Iowa Medicare anesthesia rate.
9l. Notwithstanding section 249A.20, for the fiscal year
10beginning July 1, 2020, the average reimbursement rate for
11health care providers eligible for use of the federal Medicare
12resource-based relative value scale reimbursement methodology
13under section 249A.20 shall remain at the rate in effect on
14June 30, 2020; however, this rate shall not exceed the maximum
15level authorized by the federal government.
16m. For the fiscal year beginning July 1, 2020, the
17reimbursement rate for residential care facilities shall not
18be less than the minimum payment level as established by the
19federal government to meet the federally mandated maintenance
20of effort requirement. The flat reimbursement rate for
21facilities electing not to file annual cost reports shall not
22be less than the minimum payment level as established by the
23federal government to meet the federally mandated maintenance
24of effort requirement.
25n. For the fiscal year beginning July 1, 2020, the
26reimbursement rates for inpatient mental health services
27provided at hospitals shall be rebased effective October 1,
282020, subject to Medicaid program upper payment limit rules;
29and psychiatrists shall be reimbursed at the medical assistance
30program fee-for-service rate in effect on June 30, 2020.
31o. For the fiscal year beginning July 1, 2020, community
32mental health centers may choose to be reimbursed for the
33services provided to recipients of medical assistance through
34either of the following options:
35(1) For 100 percent of the reasonable costs of the services.
-48- 1(2) In accordance with the alternative reimbursement rate
2methodology approved by the department of human services in
3effect on June 30, 2020.
4p. For the fiscal year beginning July 1, 2020, the
5reimbursement rate for providers of family planning services
6that are eligible to receive a 90 percent federal match shall
7remain at the rates in effect on June 30, 2020.
8q. For the fiscal year beginning July 1, 2020, the upper
9limits and reimbursement rates for providers of home and
10community-based services waiver services and habilitation
11services shall be increased across-the-board within the
12$3,300,000 of state funding appropriated for this purpose.
13r. For the fiscal year beginning July 1, 2020, the
14reimbursement rates for emergency medical service providers
15shall remain at the rates in effect on June 30, 2020, or as
16approved by the centers for Medicare and Medicaid services of
17the United States department of health and human services.
18s. (1) For the fiscal year beginning July 1, 2020,
19reimbursement rates provided under managed care administration
20of the Medicaid program for substance-related disorder
21residential treatment programs licensed under section 125.13,
22shall be increased to the extent possible within the $2,725,690
23of state funding appropriated for this purpose.
24(2) For the fiscal year beginning July 1, 2020,
25reimbursement rates for substance-related disorder outpatient
26treatment programs licensed under section 125.13, shall be
27increased to the extent possible within the $3,339,930 of state
28funding appropriated for this purpose.
29t. For the fiscal year beginning July 1, 2020, assertive
30community treatment per diem rates shall remain at the rates in
31effect on June 30, 2020.
322. For the fiscal year beginning July 1, 2020, the
33reimbursement rate for providers reimbursed under the
34in-home-related care program shall not be less than the minimum
35payment level as established by the federal government to meet
-49-1the federally mandated maintenance of effort requirement.
23. Unless otherwise directed in this section, when the
3department’s reimbursement methodology for any provider
4reimbursed in accordance with this section includes an
5inflation factor, this factor shall not exceed the amount
6by which the consumer price index for all urban consumers
7increased during the calendar year ending December 31, 2002.
84. Notwithstanding section 234.38, for the fiscal
9year beginning July 1, 2020, the foster family basic daily
10maintenance rate and the maximum adoption subsidy rate for
11children ages 0 through 5 years shall be $16.78, the rate for
12children ages 6 through 11 years shall be $17.45, the rate for
13children ages 12 through 15 years shall be $19.10, and the
14rate for children and young adults ages 16 and older shall
15be $19.35. For youth ages 18 to 23 who have exited foster
16care, the preparation for adult living program maintenance rate
17shall be $602.70 per month. The maximum payment for adoption
18subsidy nonrecurring expenses shall be limited to $500 and the
19disallowance of additional amounts for court costs and other
20related legal expenses implemented pursuant to 2010 Iowa Acts,
21chapter 1031, section 408, shall be continued.
225. For the fiscal year beginning July 1, 2020, the maximum
23reimbursement rates for social services providers under
24contract shall remain at the rates in effect on June 30, 2020,
25or the provider’s actual and allowable cost plus inflation for
26each service, whichever is less. However, if a new service
27or service provider is added after June 30, 2020, the initial
28reimbursement rate for the service or provider shall be based
29upon a weighted average of provider rates for similar services.
306. a. For the fiscal year beginning July 1, 2020, the
31reimbursement rates for resource family recruitment and
32retention contractors shall be established by contract.
33b. For the fiscal year beginning July 1, 2020, the
34reimbursement rates for supervised apartment living foster care
35providers shall be established by contract.
-50- 17. For the fiscal year beginning July 1, 2020, the
2reimbursement rate for group foster care providers shall be the
3combined service and maintenance reimbursement rate established
4by contract.
58. The group foster care reimbursement rates paid for
6placement of children out of state shall be calculated
7according to the same rate-setting principles as those used for
8in-state providers, unless the director of human services or
9the director’s designee determines that appropriate care cannot
10be provided within the state. The payment of the daily rate
11shall be based on the number of days in the calendar month in
12which service is provided.
139. a. For the fiscal year beginning July 1, 2020, the
14reimbursement rate paid for shelter care and the child welfare
15emergency services implemented to provide or prevent the need
16for shelter care shall be established by contract.
17b. For the fiscal year beginning July 1, 2020, the combined
18service and maintenance components of the reimbursement rate
19paid for shelter care services shall be based on the financial
20and statistical report submitted to the department. The
21maximum reimbursement rate shall be $101.83 per day. The
22department shall reimburse a shelter care provider at the
23provider’s actual and allowable unit cost, plus inflation, not
24to exceed the maximum reimbursement rate.
25c. Notwithstanding section 232.141, subsection 8, for the
26fiscal year beginning July 1, 2020, the amount of the statewide
27average of the actual and allowable rates for reimbursement of
28juvenile shelter care homes that is utilized for the limitation
29on recovery of unpaid costs shall remain at the amount in
30effect for this purpose in the fiscal year beginning July 1,
312020.
3210. For the fiscal year beginning July 1, 2020, the
33department shall calculate reimbursement rates for intermediate
34care facilities for persons with an intellectual disability
35at the 80th percentile. Beginning July 1, 2020, the rate
-51-1calculation methodology shall utilize the consumer price index
2inflation factor applicable to the fiscal year beginning July
31, 2020.
411. Effective July 1, 2020, the child care provider
5reimbursement rates shall remain at the rates in effect on June
630, 2020. The department shall set rates in a manner so as
7to provide incentives for a nonregistered provider to become
8registered by applying any increase only to registered and
9licensed providers.
1012. For the fiscal year beginning July 1, 2020, the
11reimbursement rate for family-centered services providers shall
12be established by contract.
1313. The department may adopt emergency rules to implement
14this section.
15 Sec. 33. EMERGENCY RULES.
161. If necessary to comply with federal requirements,
17including time frames, or if specifically authorized by a
18provision of this division of this Act, the department of
19human services or the mental health and disability services
20commission may adopt administrative rules under section 17A.4,
21subsection 3, and section 17A.5, subsection 2, paragraph “b”,
22to implement the provisions of this division of this Act and
23the rules shall become effective immediately upon filing or
24on a later effective date specified in the rules, unless the
25effective date of the rules is delayed or the applicability
26of the rules is suspended by the administrative rules review
27committee. Any rules adopted in accordance with this section
28shall not take effect before the rules are reviewed by the
29administrative rules review committee. The delay authority
30provided to the administrative rules review committee under
31section 17A.4, subsection 7, and section 17A.8, subsection 9,
32shall be applicable to a delay imposed under this section,
33notwithstanding a provision in those sections making them
34inapplicable to section 17A.5, subsection 2, paragraph “b”.
35Any rules adopted in accordance with the provisions of this
-52-1section shall also be published as a notice of intended action
2as provided in section 17A.4.
32. If during a fiscal year, the department of human
4services is adopting rules in accordance with this section
5or as otherwise directed or authorized by state law, and the
6rules will result in an expenditure increase beyond the amount
7anticipated in the budget process or if the expenditure was
8not addressed in the budget process for the fiscal year, the
9department shall notify the persons designated by this division
10of this Act for submission of reports, the chairpersons and
11ranking members of the committees on appropriations, and
12the department of management concerning the rules and the
13expenditure increase. The notification shall be provided at
14least 30 calendar days prior to the date notice of the rules
15is submitted to the administrative rules coordinator and the
16administrative code editor.
17 Sec. 34. REPORTS. Any reports or other information
18required to be compiled and submitted under this Act during the
19fiscal year beginning July 1, 2020, shall be submitted to the
20chairpersons and ranking members of the joint appropriations
21subcommittee on health and human services, the legislative
22services agency, and the legislative caucus staffs on or
23before the dates specified for submission of the reports or
24information.
25 Sec. 35. EFFECTIVE UPON ENACTMENT. The following
26provisions of this division of this Act, being deemed of
27immediate importance, take effect upon enactment:
281. The provision relating to section 232.141 and directing
29the state court administrator and the division administrator of
30the department of human services division of child and family
31services to make the determination, by June 15, 2020, of the
32distribution of funds allocated for the payment of the expenses
33of court-ordered services provided to juveniles which are a
34charge upon the state.
35DIVISION VI
-53-1HEALTH CARE ACCOUNTS AND FUNDS — FY 2020-2021
2 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
3appropriated from the pharmaceutical settlement account created
4in section 249A.33 to the department of human services for the
5fiscal year beginning July 1, 2020, and ending June 30, 2021,
6the following amount, or so much thereof as is necessary, to be
7used for the purpose designated:
8Notwithstanding any provision of law to the contrary, to
9supplement the appropriations made in this Act for medical
10contracts under the medical assistance program for the fiscal
11year beginning July 1, 2020, and ending June 30, 2021:
.................................................. $12234,193
13 Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
14SERVICES. Notwithstanding any provision to the contrary and
15subject to the availability of funds, there is appropriated
16from the quality assurance trust fund created in section
17249L.4 to the department of human services for the fiscal year
18beginning July 1, 2020, and ending June 30, 2021, the following
19amounts, or so much thereof as is necessary, for the purposes
20designated:
21To supplement the appropriation made in this Act from the
22general fund of the state to the department of human services
23for medical assistance for the same fiscal year:
.................................................. $2458,570,397
25 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
26DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
27the contrary and subject to the availability of funds, there is
28appropriated from the hospital health care access trust fund
29created in section 249M.4 to the department of human services
30for the fiscal year beginning July 1, 2020, and ending June
3130, 2021, the following amounts, or so much thereof as is
32necessary, for the purposes designated:
33To supplement the appropriation made in this Act from the
34general fund of the state to the department of human services
35for medical assistance for the same fiscal year:
-54-.................................................. $133,920,554
2 Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
3FOR FY 2020-2021. Notwithstanding section 8.33, if moneys
4appropriated for purposes of the medical assistance program for
5the fiscal year beginning July 1, 2020, and ending June 30,
62021, from the general fund of the state, the quality assurance
7trust fund, and the hospital health care access trust fund, are
8in excess of actual expenditures for the medical assistance
9program and remain unencumbered or unobligated at the close
10of the fiscal year, the excess moneys shall not revert but
11shall remain available for expenditure for the purposes of the
12medical assistance program until the close of the succeeding
13fiscal year.
14DIVISION VII
15PRIOR APPROPRIATIONS AND OTHER PROVISIONS
16MEDICAL ASSISTANCE
17 Sec. 40. 2019 Iowa Acts, chapter 85, section 13, unnumbered
18paragraph 2, is amended to read as follows:
19For medical assistance program reimbursement and associated
20costs as specifically provided in the reimbursement
21methodologies in effect on June 30, 2019, except as otherwise
22expressly authorized by law, consistent with options under
23federal law and regulations, and contingent upon receipt of
24approval from the office of the governor of reimbursement for
25each abortion performed under the program:
.................................................. $261,427,379,707
271,516,364,409
28CHILDREN’S HEALTH INSURANCE PROGRAM
29 Sec. 41. 2019 Iowa Acts, chapter 85, section 16, subsection
301, unnumbered paragraph 2, is amended to read as follows:
31For maintenance of the healthy and well kids in Iowa (hawk-i)
32program pursuant to chapter 514I, including supplemental dental
33services, for receipt of federal financial participation under
34Tit.XXI of the federal Social Security Act, which creates the
35children’s health insurance program:
-55-.................................................. $119,361,112
221,098,426
3STATE RESOURCE CENTERS
4 Sec. 42. 2019 Iowa Acts, chapter 85, section 25, subsection
51, paragraph a, is amended to read as follows:
6a. For the state resource center at Glenwood for salaries,
7support, maintenance, and miscellaneous purposes:
.................................................. $816,048,348
916,438,259
10Of the funds appropriated in this paragraph “a”, $333,000
11shall be used for expert consultation at the state resource
12center at Glenwood.
13 Sec. 43. EFFECTIVE DATE. This division of this Act, being
14deemed of immediate importance, takes effect upon enactment.
15 Sec. 44. RETROACTIVE APPLICABILITY. This division of this
16Act applies retroactively to July 1, 2019.
17DIVISION VIII
18DECATEGORIZATION FY 2018 CARRYOVER FUNDING
19 Sec. 45. DECATEGORIZATION CARRYOVER FUNDING FY 2018 —
20TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
21subsection 5, paragraph “b”, any state-appropriated moneys in
22the funding pool that remained unencumbered or unobligated
23at the close of the fiscal year beginning July 1, 2017, and
24were deemed carryover funding to remain available for the two
25succeeding fiscal years that still remain unencumbered or
26unobligated at the close of the fiscal year beginning July 1,
272019, shall not revert but shall be transferred to the medical
28assistance program for the fiscal year beginning July 1, 2020.
29 Sec. 46. EFFECTIVE DATE. This division of this Act, being
30deemed of immediate importance, takes effect upon enactment.
31 Sec. 47. RETROACTIVE APPLICABILITY. This division of this
32Act applies retroactively to July 1, 2019.
33EXPLANATION
34The inclusion of this explanation does not constitute agreement with
35the explanation’s substance by the members of the general assembly.
-56- 1This bill relates to appropriations for health and human
2services for fiscal year 2020-2021 to the department of
3veterans affairs, Iowa veterans home, department on aging
4(IDA), office of long-term care ombudsman, department of public
5health (DPH), Iowa finance authority, department of human
6rights, and department of human services (DHS). The bill is
7organized into divisions.
8DEPARTMENT ON AGING. This division makes appropriations
9from the general fund of the state to the department on aging.
10OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
11appropriations from the general fund of the state to the office
12of long-term care ombudsman.
13DEPARTMENT OF PUBLIC HEALTH. This division makes
14appropriations from the general fund of the state to the
15department of public health.
16DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
17division makes appropriations from the general fund of the
18state to the department of veterans affairs for administration,
19the Iowa veterans home, for transfer to the Iowa finance
20authority for the home ownership assistance program, and for
21the county commissions of veteran affairs.
22DEPARTMENT OF HUMAN SERVICES. This division makes
23appropriations from the general fund of the state and the
24federal temporary assistance for needy families block
25grant to DHS. The allocation for the family development
26and self-sufficiency grant program is made directly to
27the department of human rights. The reimbursement section
28addresses reimbursement for providers reimbursed by the
29department of human services.
30HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
31health-related appropriations. A number of the appropriations
32are made for purposes of the Medicaid program in addition to
33the general fund appropriations made for this purpose for the
34same fiscal year.
35PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division
-57-1provides for adjustments of appropriations for FY 2019-2020
2relating to the Medicaid program, the state children’s health
3insurance program, and the state resource center at Glenwood.
4DECATEGORIZATION FY 2018 CARRYOVER FUNDING. This division
5provides for the transfer of decategorization carryover funding
6that remains unencumbered or unobligated at the close of FY
72019-2020 to the Medicaid program for FY 2020-2021.
-58-pf/rn
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 2020-2021
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, 2020, and ending June 30,
62021, the following amount, or so much thereof as is necessary,
7to be used for the purposes designated:
8For aging programs for the department on aging and area
9agencies on aging to provide citizens of Iowa who are 60 years
10of age and older with case management for frail elders, Iowa’s
11aging and disabilities resource center, and other services
12which may include but are not limited to adult day services,
13respite care, chore services, information and assistance,
14and material aid, for information and options counseling for
15persons with disabilities who are 18 years of age or older,
16and for salaries, support, administration, maintenance, and
17miscellaneous purposes:
.................................................. $1811,202,196
191. Funds appropriated in this section may be used to
20supplement federal funds under federal regulations. To
21receive funds appropriated in this section, a local area
22agency on aging shall match the funds with moneys from other
23sources according to rules adopted by the department. Funds
24appropriated in this section may be used for elderly services
25not specifically enumerated in this section only if approved
26by an area agency on aging for provision of the service within
27the area.
282. Of the funds appropriated in this section, $279,000 is
29transferred to the economic development authority for the Iowa
30commission on volunteer services to be used for the retired and
31senior volunteer program.
323. a. The department on aging shall establish and enforce
33procedures relating to expenditure of state and federal funds
34by area agencies on aging that require compliance with both
35state and federal laws, rules, and regulations, including but
-1-1not limited to all of the following:
2(1) Requiring that expenditures are incurred only for goods
3or services received or performed prior to the end of the
4fiscal period designated for use of the funds.
5(2) Prohibiting prepayment for goods or services not
6received or performed prior to the end of the fiscal period
7designated for use of the funds.
8(3) Prohibiting prepayment for goods or services not
9defined specifically by good or service, time period, or
10recipient.
11(4) Prohibiting the establishment of accounts from which
12future goods or services which are not defined specifically by
13good or service, time period, or recipient, may be purchased.
14b. The procedures shall provide that if any funds are
15expended in a manner that is not in compliance with the
16procedures and applicable federal and state laws, rules, and
17regulations, and are subsequently subject to repayment, the
18area agency on aging expending such funds in contravention of
19such procedures, laws, rules and regulations, not the state,
20shall be liable for such repayment.
214. Of the funds appropriated in this section, at least
22$600,000 shall be used to fund home and community-based
23services through the area agencies on aging that enable older
24individuals to avoid more costly utilization of residential or
25institutional services and remain in their own homes.
265. Of the funds appropriated in this section, $812,000 shall
27be used for the purposes of chapter 231E and to administer
28the prevention of elder abuse, neglect, and exploitation
29program pursuant to section 231.56A, in accordance with the
30requirements of the federal Older Americans Act of 1965, 42
31U.S.C.§3001 et seq., as amended.
326. Of the funds appropriated in this section, $1,000,000
33shall be used to fund continuation of the aging and disability
34resource center lifelong links to provide individuals and
35caregivers with information and services to plan for and
-2-1maintain independence.
27. Of the funds appropriated in this section, $250,000
3shall be used by the department on aging, in collaboration with
4the department of human services and affected stakeholders,
5to continue to expand the pilot initiative to provide
6long-term care options counseling utilizing support planning
7protocols, to assist non-Medicaid eligible consumers who
8indicate a preference to return to the community and are
9deemed appropriate for discharge, to return to their community
10following a nursing facility stay. The department on aging
11shall submit a report regarding the outcomes of the pilot
12initiative to the governor and the general assembly by December
1315, 2020.
14DIVISION II
15OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2020-2021
16 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
17appropriated from the general fund of the state to the office
18of long-term care ombudsman for the fiscal year beginning July
191, 2020, and ending June 30, 2021, the following amount, or
20so much thereof as is necessary, to be used for the purposes
21designated:
22For salaries, support, administration, maintenance, and
23miscellaneous purposes:
.................................................. $241,168,936
25DIVISION III
26DEPARTMENT OF PUBLIC HEALTH — FY 2020-2021
27 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
28from the general fund of the state to the department of public
29health for the fiscal year beginning July 1, 2020, and ending
30June 30, 2021, the following amounts, or so much thereof as is
31necessary, to be used for the purposes designated:
321. ADDICTIVE DISORDERS
33For reducing the prevalence of the use of tobacco, alcohol,
34and other drugs, and treating individuals affected by addictive
35behaviors, including gambling:
-3-.................................................. $125,129,012
2a. Of the funds appropriated in this subsection, $4,020,852
3shall be used for the tobacco use prevention and control
4initiative, including efforts at the state and local levels,
5as provided in chapter 142A. The commission on tobacco use
6prevention and control established pursuant to section 142A.3
7shall advise the director of public health in prioritizing
8funding needs and the allocation of moneys appropriated for
9the programs and initiatives. Activities of the programs
10and initiatives shall be in alignment with the United States
11centers for disease control and prevention best practices
12for comprehensive tobacco control programs that include
13the goals of preventing youth initiation of tobacco usage,
14reducing exposure to secondhand smoke, and promotion of tobacco
15cessation.
16b. (1) Of the funds appropriated in this subsection,
17$21,088,527 shall be used for problem gambling and
18substance-related disorder prevention, treatment, and recovery
19services, including a 24-hour helpline, public information
20resources, professional training, youth prevention, and program
21evaluation.
22(2) Of the amount allocated under this paragraph, $306,000
23shall be utilized by the department of public health, in
24collaboration with the department of human services, to
25maintain a single statewide 24-hour crisis hotline for the Iowa
26children’s behavioral health system that incorporates warmline
27services which may be provided through expansion of existing
28capabilities maintained by the department of public health as
29required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
30c. The requirement of section 123.17, subsection 5, is met
31by the appropriations and allocations made in this division of
32this Act for purposes of substance-related disorder treatment
33and addictive disorders for the fiscal year beginning July 1,
342020.
352. HEALTHY CHILDREN AND FAMILIES
-4- 1For promoting the optimum health status for children and
2adolescents from birth through 21 years of age, and families:
.................................................. $35,824,387
43. CHRONIC CONDITIONS
5For serving individuals identified as having chronic
6conditions or special health care needs:
.................................................. $74,237,927
84. COMMUNITY CAPACITY
9For strengthening the health care delivery system at the
10local level:
.................................................. $117,004,757
12a. Of the funds appropriated in this subsection, $2,000,000
13shall be deposited in the medical residency training account
14created in section 135.175, subsection 5, paragraph “a”, and
15is appropriated from the account to the department of public
16health to be used for the purposes of the medical residency
17training state matching grants program as specified in section
18135.176.
19b. Of the funds appropriated in this subsection, $250,000
20shall be used for the public purpose of providing funding to
21Des Moines university to continue a provider education project
22to provide primary care physicians with the training and skills
23necessary to recognize the signs of mental illness in patients.
24c. Of the funds appropriated in this subsection, $800,000
25shall be used for rural psychiatric residencies to support the
26annual creation and training of four psychiatric residents who
27will provide mental health services in underserved areas of
28the state. Notwithstanding section 8.33, moneys allocated in
29this paragraph “c” that remain unencumbered or unobligated at
30the close of the fiscal year shall not revert but shall remain
31available for expenditure for the purposes designated for
32subsequent fiscal years.
33d. Of the funds appropriated in this subsection,
34$400,000 shall be used for a family medicine obstetrics and
35gynecology fellowship program to offer four physician fellows
-5-1a one-year period of specialized obstetrics and gynecology
2training following a three-year family medicine residency.
3Notwithstanding section 8.33, moneys allocated in this
4paragraph “d” that remain unencumbered or unobligated at the
5close of the fiscal year shall not revert but shall remain
6available for expenditure for the purposes designated for
7subsequent fiscal years.
8e. Of the funds appropriated in this subsection, $100,000
9shall be used to expand access to telementoring technology to
10enable specialty conferences between obstetrician/gynecologists
11and family medicine physicians.
12f. Of the funds appropriated in this subsection, $500,000
13shall be used for a centers of excellence pilot program to
14encourage innovation and collaboration among regional health
15care providers in order to transform health care delivery to
16provide quality, sustainable care that meets the needs of local
17communities.
185. ESSENTIAL PUBLIC HEALTH SERVICES
19To provide public health services that reduce risks and
20invest in promoting and protecting good health over the
21course of a lifetime with a priority given to older Iowans and
22vulnerable populations:
.................................................. $237,662,464
246. INFECTIOUS DISEASES
25For reducing the incidence and prevalence of communicable
26diseases:
.................................................. $271,803,212
287. PUBLIC PROTECTION
29For protecting the health and safety of the public through
30establishing standards and enforcing regulations:
.................................................. $314,314,883
32Of the funds appropriated in this subsection, not more than
33$304,000 shall be credited to the emergency medical services
34fund created in section 135.25. Moneys in the emergency
35medical services fund are appropriated to the department to be
-6-1used for the purposes of the fund.
28. RESOURCE MANAGEMENT
3For establishing and sustaining the overall ability of the
4department to deliver services to the public:
.................................................. $5936,139
69. MISCELLANEOUS PROVISIONS
7The university of Iowa hospitals and clinics under the
8control of the state board of regents shall not receive
9indirect costs from the funds appropriated in this section.
10The university of Iowa hospitals and clinics billings to the
11department shall be on at least a quarterly basis.
12 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — GAMBLING TREATMENT
13PROGRAM. There is appropriated from the sports wagering
14receipts fund created in section 8.57, subsection 6, to the
15department of public health for the fiscal year beginning July
161, 2020, and ending June 30, 2021, the following amount or
17so much thereof as is necessary, to be used for the purposes
18designated:
19For the purposes of the gambling treatment program
20established pursuant to section 135.150:
.................................................. $21300,000
22DIVISION IV
23DEPARTMENT OF VETERANS AFFAIRS — FY 2020-2021
24 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
25appropriated from the general fund of the state to the
26department of veterans affairs for the fiscal year beginning
27July 1, 2020, and ending June 30, 2021, the following amounts,
28or so much thereof as is necessary, to be used for the purposes
29designated:
301. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
31For salaries, support, maintenance, and miscellaneous
32purposes:
.................................................. $331,249,946
342. IOWA VETERANS HOME
35For salaries, support, maintenance, and miscellaneous
-7-1purposes:
.................................................. $27,131,552
3a. The Iowa veterans home billings involving the department
4of human services shall be submitted to the department on at
5least a monthly basis.
6b. Within available resources and in conformance with
7associated state and federal program eligibility requirements,
8the Iowa veterans home may implement measures to provide
9financial assistance to or on behalf of veterans or their
10spouses who are participating in the community reentry program.
11c. The Iowa veterans home expenditure report shall be
12submitted monthly to the legislative services agency.
13d. The Iowa veterans home shall continue to include in the
14annual discharge report applicant information to provide for
15the collection of demographic information including but not
16limited to the number of individuals applying for admission and
17admitted or denied admittance and the basis for the admission
18or denial; the age, gender, and race of such individuals;
19and the level of care for which such individuals applied for
20admission including residential or nursing level of care.
213. HOME OWNERSHIP ASSISTANCE PROGRAM
22For transfer to the Iowa finance authority for the
23continuation of the home ownership assistance program for
24persons who are or were eligible members of the armed forces of
25the United States, pursuant to section 16.54:
.................................................. $262,000,000
27 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
28FUND STANDING APPROPRIATIONS. Notwithstanding the standing
29appropriation in section 35A.16 for the fiscal year beginning
30July 1, 2020, and ending June 30, 2021, the amount appropriated
31from the general fund of the state pursuant to that section
32for the following designated purposes shall not exceed the
33following amount:
34For the county commissions of veteran affairs fund under
35section 35A.16:
-8-.................................................. $1990,000
2DIVISION V
3DEPARTMENT OF HUMAN SERVICES — FY 2020-2021
4 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
5GRANT. There is appropriated from the fund created in section
68.41 to the department of human services for the fiscal year
7beginning July 1, 2020, and ending June 30, 2021, from moneys
8received under the federal temporary assistance for needy
9families (TANF) block grant pursuant to the federal Personal
10Responsibility and Work Opportunity Reconciliation Act of 1996,
11Pub.L.No.104-193, and successor legislation, the following
12amounts, or so much thereof as is necessary, to be used for the
13purposes designated:
141. To be credited to the family investment program account
15and used for assistance under the family investment program
16under chapter 239B:
.................................................. $175,002,006
182. To be credited to the family investment program account
19and used for the job opportunities and basic skills (JOBS)
20program and implementing family investment agreements in
21accordance with chapter 239B:
.................................................. $225,412,060
233. To be used for the family development and
24self-sufficiency grant program in accordance with section
25216A.107:
.................................................. $262,888,980
27Notwithstanding section 8.33, moneys appropriated in this
28subsection that remain unencumbered or unobligated at the close
29of the fiscal year shall not revert but shall remain available
30for expenditure for the purposes designated until the close of
31the succeeding fiscal year. However, unless such moneys are
32encumbered or obligated on or before September 30, 2020, the
33moneys shall revert.
344. For field operations:
.................................................. $3531,296,232
-9- 15. For general administration:
.................................................. $23,744,000
36. For state child care assistance:
.................................................. $447,166,826
5a. Of the funds appropriated in this subsection,
6$26,205,412 is transferred to the child care and development
7block grant appropriation made by the Eighty-ninth General
8Assembly, 2020 session, for the federal fiscal year beginning
9October 1, 2020, and ending September 30, 2021. Of this
10amount, $200,000 shall be used for provision of educational
11opportunities to registered child care home providers in order
12to improve services and programs offered by this category
13of providers and to increase the number of providers. The
14department may contract with institutions of higher education
15or child care resource and referral centers to provide
16the educational opportunities. Allowable administrative
17costs under the contracts shall not exceed 5 percent. The
18application for a grant shall not exceed two pages in length.
19b. Any funds appropriated in this subsection remaining
20unallocated shall be used for state child care assistance
21payments for families who are employed including but not
22limited to individuals enrolled in the family investment
23program.
247. For child and family services:
.................................................. $2532,380,654
268. For child abuse prevention grants:
.................................................. $27125,000
289. For pregnancy prevention grants on the condition that
29family planning services are funded:
.................................................. $301,913,203
31Pregnancy prevention grants shall be awarded to programs
32in existence on or before July 1, 2020, if the programs have
33demonstrated positive outcomes. Grants shall be awarded to
34pregnancy prevention programs which are developed after July
351, 2020, if the programs are based on existing models that
-10-1have 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 to
10meet federal and state reporting, tracking, and case management
11requirements and other departmental needs:
.................................................. $121,037,186
1311. a. Notwithstanding any provision to the contrary,
14including but not limited to requirements in section 8.41 or
15provisions in 2019 Iowa Acts or 2020 Iowa Acts regarding the
16receipt and appropriation of federal block grants, federal
17funds from the temporary assistance for needy families block
18grant received by the state and not otherwise appropriated
19in this section and remaining available for the fiscal year
20beginning July 1, 2020, are appropriated to the department of
21human services to the extent as may be necessary to be used in
22the following priority order: the family investment program,
23for state child care assistance program payments for families
24who are employed, and for the family investment program share
25of system costs for eligibility determination and related
26functions. The federal funds appropriated in this paragraph
27shall be expended only after all other funds appropriated
28in subsection 1 for assistance under the family investment
29program, in subsection 6 for state child care assistance, or
30in subsection 10 for technology costs related to the family
31investment program, as applicable, have been expended. For
32the purposes of this subsection, the funds appropriated in
33subsection 6, paragraph “a”, for transfer to the child care
34and development block grant appropriation are considered fully
35expended when the full amount has been transferred.
-11- 1b. The department shall, on a quarterly basis, advise the
2legislative services agency and department of management of
3the amount of funds appropriated in this subsection that was
4expended in the prior quarter.
512. Of the amounts appropriated in this section,
6$12,962,008 for the fiscal year beginning July 1, 2020, is
7transferred to the appropriation of the federal social services
8block grant made to the department of human services for that
9fiscal year.
1013. For continuation of the program providing categorical
11eligibility for the food assistance program as specified
12for the program in the section of this division of this Act
13relating to the family investment program account:
.................................................. $1414,236
1514. The department may transfer funds allocated in this
16section to the appropriations made in this division of this Act
17for the same fiscal year for general administration and field
18operations for resources necessary to implement and operate the
19services referred to in this section and those funded in the
20appropriation made in this division of this Act for the same
21fiscal year for the family investment program from the general
22fund of the state.
2315. With the exception of moneys allocated under this
24section for the family development and self-sufficiency grant
25program, to the extent moneys allocated in this section are
26deemed by the department not to be necessary to support the
27purposes for which they are allocated, such moneys may be
28used in the same fiscal year for any other purpose for which
29funds are allocated in this section or in section 8 of this
30division for the family investment program account. If there
31are conflicting needs, priority shall first be given to the
32family investment program account as specified under subsection
331 of this section and used for the purposes of assistance under
34the family investment program in accordance with chapter 239B,
35followed by state child care assistance program payments for
-12-1families who are employed, followed by other priorities as
2specified by the department.
3 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
41. Moneys credited to the family investment program (FIP)
5account for the fiscal year beginning July 1, 2020, and
6ending June 30, 2021, shall be used to provide assistance in
7accordance with chapter 239B.
82. The department may use a portion of the moneys credited
9to the FIP account under this section as necessary for
10salaries, support, maintenance, and miscellaneous purposes.
113. The department may transfer funds allocated in
12subsection 4, excluding the allocation under subsection 4,
13paragraph “b”, to the appropriations made in this division of
14this Act for the same fiscal year for general administration
15and field operations for resources necessary to implement
16and operate the services referred to in this section and
17those funded in the appropriations made in section 7 for the
18temporary assistance for needy families block grant and in
19section 9 for the family investment program from the general
20fund of the state in this division of this Act for the same
21fiscal year.
224. Moneys appropriated in this division of this Act and
23credited to the FIP account for the fiscal year beginning July
241, 2020, and ending June 30, 2021, are allocated as follows:
25a. To be retained by the department of human services to
26be used for coordinating with the department of human rights
27to more effectively serve participants in FIP and other shared
28clients and to meet federal reporting requirements under the
29federal temporary assistance for needy families block grant:
.................................................. $3010,000
31b. To the department of human rights for staffing,
32administration, and implementation of the family development
33and self-sufficiency grant program in accordance with section
34216A.107:
.................................................. $356,192,834
-13- 1(1) Of the funds allocated for the family development
2and self-sufficiency grant program in this paragraph “b”,
3not more than 5 percent of the funds shall be used for the
4administration of the grant program.
5(2) The department of human rights may continue to implement
6the family development and self-sufficiency grant program
7statewide during fiscal year 2020-2021.
8(3) The department of human rights may engage in activities
9to strengthen and improve family outcomes measures and
10data collection systems under the family development and
11self-sufficiency grant program.
12c. For the diversion subaccount of the FIP account:
.................................................. $131,293,000
14A portion of the moneys allocated for the diversion
15subaccount may be used for field operations, salaries, data
16management system development, and implementation costs and
17support deemed necessary by the director of human services
18in order to administer the FIP diversion program. To the
19extent moneys allocated in this paragraph are deemed by the
20department not to be necessary to support diversion activities,
21such moneys may be used for other efforts intended to increase
22engagement by family investment program participants in work,
23education, or training activities, or for the purposes of
24assistance under the family investment program in accordance
25with chapter 239B.
26d. For the food assistance employment and training program:
.................................................. $2766,588
28(1) The department shall apply the federal supplemental
29nutrition assistance program (SNAP) employment and training
30state plan in order to maximize to the fullest extent permitted
31by federal law the use of the 50 percent federal reimbursement
32provisions for the claiming of allowable federal reimbursement
33funds from the United States department of agriculture
34pursuant to the federal SNAP employment and training program
35for providing education, employment, and training services
-14-1for eligible food assistance program participants, including
2but not limited to related dependent care and transportation
3expenses.
4(2) The department shall continue the categorical federal
5food assistance program eligibility at 160 percent of the
6federal poverty level and continue to eliminate the asset test
7from eligibility requirements, consistent with federal food
8assistance program requirements. The department shall include
9as many food assistance households as is allowed by federal
10law. The eligibility provisions shall conform to all federal
11requirements including requirements addressing individuals who
12are incarcerated or otherwise ineligible.
13e. For the JOBS program:
.................................................. $1411,837,505
155. Of the child support collections assigned under FIP,
16an amount equal to the federal share of support collections
17shall be credited to the child support recovery appropriation
18made in this division of this Act. Of the remainder of the
19assigned child support collections received by the child
20support recovery unit, a portion shall be credited to the FIP
21account, a portion may be used to increase recoveries, and a
22portion may be used to sustain cash flow in the child support
23payments account. If as a consequence of the appropriations
24and allocations made in this section the resulting amounts
25are insufficient to sustain cash assistance payments and meet
26federal maintenance of effort requirements, the department
27shall seek supplemental funding. If child support collections
28assigned under FIP are greater than estimated or are otherwise
29determined not to be required for maintenance of effort, the
30state share of either amount may be transferred to or retained
31in the child support payments account.
326. The department may adopt emergency rules for the family
33investment, JOBS, food assistance, and medical assistance
34programs if necessary to comply with federal requirements.
35 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
-15-1is appropriated from the general fund of the state to the
2department of human services for the fiscal year beginning July
31, 2020, and ending June 30, 2021, the following amount, or
4so much thereof as is necessary, to be used for the purpose
5designated:
6To be credited to the family investment program (FIP)
7account and used for family investment program assistance under
8chapter 239B:
.................................................. $939,793,542
101. Of the funds appropriated in this section, $6,425,445 is
11allocated for the JOBS program.
122. Of the funds appropriated in this section, $3,313,854 is
13allocated for the family development and self-sufficiency grant
14program.
153. a. Notwithstanding section 8.39, for the fiscal
16year beginning July 1, 2020, if necessary to meet federal
17maintenance of effort requirements or to transfer federal
18temporary assistance for needy families block grant funding
19to be used for purposes of the federal social services block
20grant or to meet cash flow needs resulting from delays in
21receiving federal funding or to implement, in accordance with
22this division of this Act, activities currently funded with
23juvenile court services, county, or community moneys and state
24moneys used in combination with such moneys; to comply with
25federal requirements; or to maximize the use of federal funds;
26the department of human services may transfer funds within or
27between any of the appropriations made in this division of this
28Act and appropriations in law for the federal social services
29block grant to the department for the following purposes,
30provided that the combined amount of state and federal
31temporary assistance for needy families block grant funding
32for each appropriation remains the same before and after the
33transfer:
34(1) For the family investment program.
35(2) For state child care assistance.
-16- 1(3) For child and family services.
2(4) For field operations.
3(5) For general administration.
4b. This subsection shall not be construed to prohibit the
5use of existing state transfer authority for other purposes.
6The department shall report any transfers made pursuant to this
7subsection to the legislative services agency.
84. Of the funds appropriated in this section, $195,000
9shall be used for a contract with an Iowa-based nonprofit
10organization with a history of providing tax preparation
11assistance to low-income Iowans in order to expand the usage of
12the earned income tax credit. The purpose of the contract is
13to supply this assistance to underserved areas of the state.
14The department shall not retain any portion of the allocation
15under this subsection for administrative costs.
165. Of the funds appropriated in this section, $70,000 shall
17be used for the continuation of the parenting program, as
18specified in 441 IAC ch.100, relating to parental obligations,
19in which the child support recovery unit participates, to
20support the efforts of a nonprofit organization committed
21to strengthening the community through youth development,
22healthy living, and social responsibility headquartered in
23a county with a population over 350,000 according to the
24latest certified federal census. The funds allocated in this
25subsection shall be used by the recipient organization to
26develop a larger community effort, through public and private
27partnerships, to support a broad-based multi-county parenthood
28initiative that promotes payment of child support obligations,
29improved family relationships, and full-time employment.
306. The department may transfer funds appropriated in this
31section, excluding the allocation in subsection 2 for the
32family development and self-sufficiency grant program, to the
33appropriations made in this division of this Act for general
34administration and field operations as necessary to administer
35this section, section 7 for the temporary assistance for needy
-17-1families block grant, and section 8 for the family investment
2program account.
3 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
4from the general fund of the state to the department of human
5services for the fiscal year beginning July 1, 2020, and ending
6June 30, 2021, the following amount, or so much thereof as is
7necessary, to be used for the purposes designated:
8For child support recovery, including salaries, support,
9maintenance, and miscellaneous purposes:
.................................................. $1015,247,977
111. The department shall expend up to $24,000, including
12federal financial participation, for the fiscal year beginning
13July 1, 2020, for a child support public awareness campaign.
14The department and the office of the attorney general shall
15cooperate in continuation of the campaign. The public
16awareness campaign shall emphasize, through a variety of
17media activities, the importance of maximum involvement of
18both parents in the lives of their children as well as the
19importance of payment of child support obligations.
202. Federal access and visitation grant moneys shall be
21issued directly to private not-for-profit agencies that provide
22services designed to increase compliance with the child access
23provisions of court orders, including but not limited to
24neutral visitation sites and mediation services.
253. The appropriation made to the department for child
26support recovery may be used throughout the fiscal year in the
27manner necessary for purposes of cash flow management, and for
28cash flow management purposes the department may temporarily
29draw more than the amount appropriated, provided the amount
30appropriated is not exceeded at the close of the fiscal year.
31 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
32FY 2020-2021. Any funds remaining in the health care trust
33fund created in section 453A.35A for the fiscal year beginning
34July 1, 2020, and ending June 30, 2021, are appropriated to
35the department of human services to supplement the medical
-18-1assistance program appropriations made in this division of this
2Act, for medical assistance reimbursement and associated costs,
3including program administration and costs associated with
4program implementation.
5 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
62020-2021. Any funds remaining in the Medicaid fraud fund
7created in section 249A.50 for the fiscal year beginning
8July 1, 2020, and ending June 30, 2021, are appropriated to
9the department of human services to supplement the medical
10assistance appropriations made in this division of this Act,
11for medical assistance reimbursement and associated costs,
12including program administration and costs associated with
13program implementation.
14 Sec. 13. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES
15FUND — FY 2020-2021. There is appropriated from the general
16fund of the state to the department of human services for the
17fiscal year beginning July 1, 2020, and ending June 30, 2021,
18the following amount, or so much thereof as is necessary, to be
19used for the purpose designated:
20For transfer to the mental health and disability regional
21services fund created in section 225C.7A, or a successor fund:
.................................................. $2280,600,000
23Moneys transferred to the mental health and disability
24regional services fund under this section are appropriated to
25the department of human services for distribution to counties
26for funding of mental health and disability services in
27accordance with section 225C.7A.
28 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the
29general fund of the state to the department of human services
30for the fiscal year beginning July 1, 2020, and ending June 30,
312021, the following amount, or so much thereof as is necessary,
32to be used for the purpose designated:
33For medical assistance program reimbursement and associated
34costs as specifically provided in the reimbursement
35methodologies in effect on June 30, 2019, except as otherwise
-19-1expressly authorized by law, consistent with options under
2federal law and regulations, and contingent upon receipt of
3approval from the office of the governor of reimbursement for
4each abortion performed under the program:
.................................................. $51,594,425,375
61. Iowans support reducing the number of abortions
7performed in our state. Funds appropriated under this section
8shall not be used for abortions, unless otherwise authorized
9under this section.
102. The provisions of this section relating to abortions
11shall also apply to the Iowa health and wellness plan created
12pursuant to chapter 249N.
133. The department shall utilize not more than $60,000 of
14the funds appropriated in this section to continue the AIDS/HIV
15health insurance premium payment program as established in 1992
16Iowa Acts, Second Extraordinary Session, chapter 1001, section
17409, subsection 6. Of the funds allocated in this subsection,
18not more than $5,000 may be expended for administrative
19purposes.
204. Of the funds appropriated in this Act to the department
21of public health for addictive disorders, $950,000 for
22the fiscal year beginning July 1, 2020, is transferred
23to the department of human services for an integrated
24substance-related disorder managed care system. The
25departments of human services and public health shall
26work together to maintain the level of mental health and
27substance-related disorder treatment services provided by the
28managed care contractors. Each department shall take the steps
29necessary to continue the federal waivers as necessary to
30maintain the level of services.
315. The department shall aggressively pursue options for
32providing medical assistance or other assistance to individuals
33with special needs who become ineligible to continue receiving
34services under the early and periodic screening, diagnostic,
35and treatment program under the medical assistance program
-20-1due to becoming 21 years of age who have been approved for
2additional assistance through the department’s exception to
3policy provisions, but who have health care needs in excess
4of the funding available through the exception to policy
5provisions.
66. Of the funds appropriated in this section, up to
7$3,050,082 may be transferred to the field operations or
8general administration appropriations in this division of this
9Act for operational costs associated with Part D of the federal
10Medicare Prescription Drug Improvement and Modernization Act
11of 2003, Pub.L.No.108-173.
127. Of the funds appropriated in this section, up to $442,100
13may be transferred to the appropriation in this division
14of this Act for medical contracts to be used for clinical
15assessment services and prior authorization of services.
168. A portion of the funds appropriated in this section
17may be transferred to the appropriations in this division of
18this Act for general administration, medical contracts, the
19children’s health insurance program, or field operations to be
20used for the state match cost to comply with the payment error
21rate measurement (PERM) program for both the medical assistance
22and children’s health insurance programs as developed by the
23centers for Medicare and Medicaid services of the United States
24department of health and human services to comply with the
25federal Improper Payments Information Act of 2002, Pub.L.
26No.107-300, and to support other reviews and quality control
27activities to improve the integrity of these programs.
289. Of the funds appropriated in this section, a sufficient
29amount is allocated to supplement the incomes of residents of
30nursing facilities, intermediate care facilities for persons
31with mental illness, and intermediate care facilities for
32persons with an intellectual disability, with incomes of less
33than $50 in the amount necessary for the residents to receive a
34personal needs allowance of $50 per month pursuant to section
35249A.30A.
-21- 110. a. Hospitals that meet the conditions specified
2in subparagraphs (1) and (2) shall either certify public
3expenditures or transfer to the medical assistance program
4an amount equal to provide the nonfederal share for a
5disproportionate share hospital payment in an amount up to the
6hospital-specific limit as approved in the Medicaid state plan.
7The hospitals that meet the conditions specified shall receive
8and retain 100 percent of the total disproportionate share
9hospital payment in an amount up to the hospital-specific limit
10as approved in the Medicaid state plan.
11(1) The hospital qualifies for disproportionate share and
12graduate medical education payments.
13(2) The hospital is an Iowa state-owned hospital with more
14than 500 beds and eight or more distinct residency specialty
15or subspecialty programs recognized by the American college of
16graduate medical education.
17b. Distribution of the disproportionate share payments
18shall be made on a monthly basis. The total amount of
19disproportionate share payments including graduate medical
20education, enhanced disproportionate share, and Iowa
21state-owned teaching hospital payments shall not exceed the
22amount of the state’s allotment under Pub.L.No.102-234.
23In addition, the total amount of all disproportionate
24share payments shall not exceed the hospital-specific
25disproportionate share limits under Pub.L.No.103-66.
2611. One hundred percent of the nonfederal share of payments
27to area education agencies that are medical assistance
28providers for medical assistance-covered services provided to
29medical assistance-covered children, shall be made from the
30appropriation made in this section.
3112. A portion of the funds appropriated in this section
32may be transferred to the appropriation in this division of
33this Act for medical contracts to be used for administrative
34activities associated with the money follows the person
35demonstration project.
-22- 113. Of the funds appropriated in this section, $349,011
2shall be used for the administration of the health insurance
3premium payment program, including salaries, support,
4maintenance, and miscellaneous purposes.
514. a. The department may increase the amounts allocated
6for salaries, support, maintenance, and miscellaneous purposes
7associated with the medical assistance program, as necessary,
8to sustain cost management efforts. The department shall
9report any such increase to the legislative services agency and
10the department of management.
11b. If the savings to the medical assistance program from
12ongoing cost management efforts exceed the associated cost
13for the fiscal year beginning July 1, 2020, the department
14may transfer any savings generated for the fiscal year due
15to medical assistance program cost management efforts to the
16appropriation made in this division of this Act for medical
17contracts or general administration to defray the costs
18associated with implementing the efforts.
1915. For the fiscal year beginning July 1, 2020, and ending
20June 30, 2021, the replacement generation tax revenues required
21to be deposited in the property tax relief fund pursuant to
22section 437A.8, subsection 4, paragraph “d”, and section
23437A.15, subsection 3, paragraph “f”, shall instead be credited
24to and supplement the appropriation made in this section and
25used for the allocations made in this section.
2616. a. Of the funds appropriated in this section, up
27to $50,000 may be transferred by the department to the
28appropriation made in this division of this Act to the
29department for the same fiscal year for general administration
30to be used for associated administrative expenses and for not
31more than 1.00 full-time equivalent position, in addition to
32those authorized for the same fiscal year, to be assigned to
33implementing the children’s mental health home project.
34b. Of the funds appropriated in this section, up to $400,000
35may be transferred by the department to the appropriation made
-23-1to the department in this division of this Act for the same
2fiscal year for Medicaid program-related general administration
3planning and implementation activities. The funds may be used
4for contracts or for personnel in addition to the amounts
5appropriated for and the positions authorized for general
6administration for the fiscal year.
7c. Of the funds appropriated in this section, up to
8$3,000,000 may be transferred by the department to the
9appropriations made in this division of this Act for the same
10fiscal year for general administration or medical contracts
11to be used to support the development and implementation of
12standardized assessment tools for persons with mental illness,
13an intellectual disability, a developmental disability, or a
14brain injury.
1517. Of the funds appropriated in this section, $150,000
16shall be used for lodging expenses associated with care
17provided at the university of Iowa hospitals and clinics for
18patients with cancer whose travel distance is 30 miles or more
19and whose income is at or below 200 percent of the federal
20poverty level as defined by the most recently revised poverty
21income guidelines published by the United States department of
22health and human services. The department of human services
23shall establish the maximum number of overnight stays and the
24maximum rate reimbursed for overnight lodging, which may be
25based on the state employee rate established by the department
26of administrative services. The funds allocated in this
27subsection shall not be used as nonfederal share matching
28funds.
2918. Of the funds appropriated in this section, up to
30$3,383,880 shall be used for administration of the state family
31planning services program pursuant to section 217.41B, and
32of this amount, the department may use up to $200,000 for
33administrative expenses.
3419. Of the funds appropriated in this section, $1,545,530
35shall be used and may be transferred to other appropriations
-24-1in this division of this Act as necessary to administer the
2provisions in the division of this Act relating to Medicaid
3program administration.
420. Of the funds appropriated in this section, $5,000,000
5shall be used to increase the availability of telehealth
6providers and sites of service.
7 Sec. 15. MEDICAL CONTRACTS. There is appropriated from the
8general fund of the state to the department of human services
9for the fiscal year beginning July 1, 2020, and ending June 30,
102021, the following amount, or so much thereof as is necessary,
11to be used for the purpose designated:
12For medical contracts:
.................................................. $1317,832,301
141. The department of inspections and appeals shall
15provide all state matching funds for survey and certification
16activities performed by the department of inspections
17and appeals. The department of human services is solely
18responsible for distributing the federal matching funds for
19such activities.
202. Of the funds appropriated in this section, $50,000 shall
21be used for continuation of home and community-based services
22waiver quality assurance programs, including the review and
23streamlining of processes and policies related to oversight and
24quality management to meet state and federal requirements.
253. Of the amount appropriated in this section, up to
26$200,000 may be transferred to the appropriation for general
27administration in this division of this Act to be used for
28additional full-time equivalent positions in the development
29of key health initiatives such as development and oversight
30of managed care programs and development of health strategies
31targeted toward improved quality and reduced costs in the
32Medicaid program.
334. Of the funds appropriated in this section, $1,000,000
34shall be used for planning and development, in cooperation with
35the department of public health, of a phased-in program to
-25-1provide a dental home for children.
25. a. Of the funds appropriated in this section, $573,000
3shall be credited to the autism support program fund created
4in section 225D.2 to be used for the autism support program
5created in chapter 225D, with the exception of the following
6amount of this allocation which shall be used as follows:
7b. Of the funds allocated in this subsection, $25,000 shall
8be used for the public purpose of continuation of a grant to a
9nonprofit provider of child welfare services that has been in
10existence for more than 115 years, is located in a county with
11a population between 200,000 and 220,000 according to the most
12recent federal decennial census, is licensed as a psychiatric
13medical institution for children, and provides school-based
14programming, to be used for support services for children with
15autism spectrum disorder and their families.
16 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE.
171. There is appropriated from the general fund of the
18state to the department of human services for the fiscal year
19beginning July 1, 2020, and ending June 30, 2021, the following
20amount, or so much thereof as is necessary, to be used for the
21purpose designated:
22For the state supplementary assistance program:
.................................................. $237,349,002
242. The department shall increase the personal needs
25allowance for residents of residential care facilities by the
26same percentage and at the same time as federal supplemental
27security income and federal social security benefits are
28increased due to a recognized increase in the cost of living.
29The department may adopt emergency rules to implement this
30subsection.
313. If during the fiscal year beginning July 1, 2020,
32the department projects that state supplementary assistance
33expenditures for a calendar year will not meet the federal
34pass-through requirement specified in Tit.XVI of the federal
35Social Security Act, section 1618, as codified in 42 U.S.C.
-26-1§1382g, the department may take actions including but not
2limited to increasing the personal needs allowance for
3residential care facility residents and making programmatic
4adjustments or upward adjustments of the residential care
5facility or in-home health-related care reimbursement rates
6prescribed in this division of this Act to ensure that federal
7requirements are met. In addition, the department may make
8other programmatic and rate adjustments necessary to remain
9within the amount appropriated in this section while ensuring
10compliance with federal requirements. The department may adopt
11emergency rules to implement the provisions of this subsection.
124. Notwithstanding section 8.33, moneys appropriated in
13this section that remain unencumbered or unobligated at the
14close of the fiscal year shall not revert but shall remain
15available for expenditure for the purposes designated until the
16close of the succeeding fiscal year.
17 Sec. 17. CHILDREN’S HEALTH INSURANCE PROGRAM.
181. There is appropriated from the general fund of the
19state to the department of human services for the fiscal year
20beginning July 1, 2020, and ending June 30, 2021, the following
21amount, or so much thereof as is necessary, to be used for the
22purpose designated:
23For maintenance of the healthy and well kids in Iowa (hawk-i)
24program pursuant to chapter 514I, including supplemental dental
25services, for receipt of federal financial participation under
26Tit.XXI of the federal Social Security Act, which creates the
27children’s health insurance program:
.................................................. $2841,132,725
292. Of the funds appropriated in this section, $146,682 is
30allocated for continuation of the contract for outreach with
31the department of public health.
323. A portion of the funds appropriated in this section may
33be transferred to the appropriations made in this division of
34this Act for field operations or medical contracts to be used
35for the integration of hawk-i program eligibility, payment, and
-27-1administrative functions under the purview of the department
2of human services, including for the Medicaid management
3information system upgrade.
4 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated
5from the general fund of the state to the department of human
6services for the fiscal year beginning July 1, 2020, and ending
7June 30, 2021, the following amount, or so much thereof as is
8necessary, to be used for the purpose designated:
9For child care programs:
.................................................. $1040,817,751
111. Of the funds appropriated in this section, $34,967,751
12shall be used for state child care assistance in accordance
13with section 237A.13.
142. Nothing in this section shall be construed or is
15intended as or shall imply a grant of entitlement for services
16to persons who are eligible for assistance due to an income
17level consistent with the waiting list requirements of section
18237A.13. Any state obligation to provide services pursuant to
19this section is limited to the extent of the funds appropriated
20in this section.
213. A list of the registered and licensed child care
22facilities operating in the area served by a child care
23resource and referral service shall be made available to the
24families receiving state child care assistance in that area.
254. Of the funds appropriated in this section, $5,850,000
26shall be credited to the early childhood programs grants
27account in the early childhood Iowa fund created in section
28256I.11. The moneys shall be distributed for funding of
29community-based early childhood programs targeted to children
30from birth through five years of age developed by early
31childhood Iowa areas in accordance with approved community
32plans as provided in section 256I.8.
335. The department may use any of the funds appropriated
34in this section as a match to obtain federal funds for use in
35expanding child care assistance and related programs. For
-28-1the purpose of expenditures of state and federal child care
2funding, funds shall be considered obligated at the time
3expenditures are projected or are allocated to the department’s
4service areas. Projections shall be based on current and
5projected caseload growth, current and projected provider
6rates, staffing requirements for eligibility determination
7and management of program requirements including data systems
8management, staffing requirements for administration of the
9program, contractual and grant obligations and any transfers
10to other state agencies, and obligations for decategorization
11or innovation projects.
126. A portion of the state match for the federal child care
13and development block grant shall be provided as necessary to
14meet federal matching funds requirements through the state
15general fund appropriation made for child development grants
16and other programs for at-risk children in section 279.51.
177. If a uniform reduction ordered by the governor under
18section 8.31 or other operation of law, transfer, or federal
19funding reduction reduces the appropriation made in this
20section for the fiscal year, the percentage reduction in the
21amount paid out to or on behalf of the families participating
22in the state child care assistance program shall be equal to or
23less than the percentage reduction made for any other purpose
24payable from the appropriation made in this section and the
25federal funding relating to it. The percentage reduction to
26the other allocations made in this section shall be the same as
27the uniform reduction ordered by the governor or the percentage
28change of the federal funding reduction, as applicable. If
29there is an unanticipated increase in federal funding provided
30for state child care services, the entire amount of the
31increase, except as necessary to meet federal requirements
32including quality set asides, shall be used for state child
33care assistance payments. If the appropriations made for
34purposes of the state child care assistance program for the
35fiscal year are determined to be insufficient, it is the intent
-29-1of the general assembly to appropriate sufficient funding for
2the fiscal year in order to avoid establishment of waiting list
3requirements.
48. Notwithstanding section 8.33, moneys advanced for
5purposes of the programs developed by early childhood Iowa
6areas, advanced for purposes of wraparound child care, or
7received from the federal appropriations made for the purposes
8of this section that remain unencumbered or unobligated at the
9close of the fiscal year shall not revert to any fund but shall
10remain available for expenditure for the purposes designated
11until the close of the succeeding fiscal year.
12 Sec. 19. JUVENILE INSTITUTION. There is appropriated
13from the general fund of the state to the department of human
14services for the fiscal year beginning July 1, 2020, and ending
15June 30, 2021, the following amounts, or so much thereof as is
16necessary, to be used for the purposes designated:
171. a. For operation of the state training school at Eldora
18and for salaries, support, maintenance, and miscellaneous
19purposes:
.................................................. $2016,333,688
21b. Of the funds appropriated in this subsection, $91,000
22shall be used for distribution to licensed classroom teachers
23at this and other institutions under the control of the
24department of human services based upon the average student
25yearly enrollment at each institution as determined by the
26department.
272. A portion of the moneys appropriated in this section
28shall be used by the state training school at Eldora for
29grants for adolescent pregnancy prevention activities at the
30institution in the fiscal year beginning July 1, 2020.
313. Of the funds appropriated in this section, $212,000 shall
32be used by the state training school at Eldora for a substance
33use disorder treatment program at the institution for the
34fiscal year beginning July 1, 2020.
35 Sec. 20. CHILD AND FAMILY SERVICES.
-30- 11. There is appropriated from the general fund of the
2state to the department of human services for the fiscal year
3beginning July 1, 2020, and ending June 30, 2021, the following
4amount, or so much thereof as is necessary, to be used for the
5purpose designated:
6For child and family services:
.................................................. $789,077,415
82. The department may transfer funds appropriated in this
9section as necessary to pay the nonfederal costs of services
10reimbursed under the medical assistance program, state child
11care assistance program, or the family investment program which
12are provided to children who would otherwise receive services
13paid under the appropriation in this section. The department
14may transfer funds appropriated in this section to the
15appropriations made in this division of this Act for general
16administration and for field operations for resources necessary
17to implement and operate the services funded in this section.
183. a. Of the funds appropriated in this section, up to
19$26,025,000 is allocated as the statewide expenditure target
20under section 232.143 for group foster care maintenance and
21services. If the department projects that such expenditures
22for the fiscal year will be less than the target amount
23allocated in this paragraph, the department may reallocate the
24excess to provide additional funding for family foster care,
25independent living, family-centered services, shelter care,
26or the child welfare emergency services addressed with the
27allocation for shelter care.
28b. If at any time after September 30, 2020, annualization
29of a service area’s current expenditures indicates a service
30area is at risk of exceeding its group foster care expenditure
31target under section 232.143 by more than 5 percent, the
32department and juvenile court services shall examine all
33group foster care placements in that service area in order to
34identify those which might be appropriate for termination.
35In addition, any aftercare services believed to be needed
-31-1for the children whose placements may be terminated shall be
2identified. The department and juvenile court services shall
3initiate action to set dispositional review hearings for the
4placements identified. In such a dispositional review hearing,
5the juvenile court shall determine whether needed aftercare
6services are available and whether termination of the placement
7is in the best interest of the child and the community.
84. In accordance with the provisions of section 232.188,
9the department shall continue the child welfare and juvenile
10justice funding initiative during fiscal year 2020-2021. Of
11the funds appropriated in this section, $1,717,000 is allocated
12specifically for expenditure for fiscal year 2020-2021 through
13the decategorization services funding pools and governance
14boards established pursuant to section 232.188.
155. A portion of the funds appropriated in this section
16may be used for emergency family assistance to provide other
17resources required for a family participating in a family
18preservation or reunification project or successor project to
19stay together or to be reunified.
206. Of the funds appropriated in this section, a sufficient
21amount is allocated for shelter care and the child welfare
22emergency services contracting implemented to provide for or
23prevent the need for shelter care.
247. Federal funds received by the state during the fiscal
25year beginning July 1, 2020, as the result of the expenditure
26of state funds appropriated during a previous state fiscal
27year for a service or activity funded under this section are
28appropriated to the department to be used as additional funding
29for services and purposes provided for under this section.
30Notwithstanding section 8.33, moneys received in accordance
31with this subsection that remain unencumbered or unobligated at
32the close of the fiscal year shall not revert to any fund but
33shall remain available for the purposes designated until the
34close of the succeeding fiscal year.
358. a. Of the funds appropriated in this section, up to
-32-1$3,290,000 is allocated for the payment of the expenses of
2court-ordered services provided to juveniles who are under the
3supervision of juvenile court services, which expenses are a
4charge upon the state pursuant to section 232.141, subsection
54. Of the amount allocated in this paragraph, up to $1,556,000
6shall be made available to provide school-based supervision of
7children adjudicated under chapter 232, of which not more than
8$15,000 may be used for the purpose of training. A portion of
9the cost of each school-based liaison officer shall be paid by
10the school district or other funding source as approved by the
11chief juvenile court officer.
12b. Of the funds appropriated in this section, up to $748,000
13is allocated for the payment of the expenses of court-ordered
14services provided to children who are under the supervision
15of the department, which expenses are a charge upon the state
16pursuant to section 232.141, subsection 4.
17c. Notwithstanding section 232.141 or any other provision
18of law to the contrary, the amounts allocated in this
19subsection shall be distributed to the judicial districts
20as determined by the state court administrator and to the
21department’s service areas as determined by the administrator
22of the department of human services’ division of child and
23family services. The state court administrator and the
24division administrator shall make the determination of the
25distribution amounts on or before June 15, 2020.
26d. Notwithstanding chapter 232 or any other provision of
27law to the contrary, a district or juvenile court shall not
28order any service which is a charge upon the state pursuant
29to section 232.141 if there are insufficient court-ordered
30services funds available in the district court or departmental
31service area distribution amounts to pay for the service. The
32chief juvenile court officer and the departmental service area
33manager shall encourage use of the funds allocated in this
34subsection such that there are sufficient funds to pay for
35all court-related services during the entire year. The chief
-33-1juvenile court officers and departmental service area managers
2shall attempt to anticipate potential surpluses and shortfalls
3in the distribution amounts and shall cooperatively request the
4state court administrator or division administrator to transfer
5funds between the judicial districts’ or departmental service
6areas’ distribution amounts as prudent.
7e. Notwithstanding any provision of law to the contrary,
8a district or juvenile court shall not order a county to pay
9for any service provided to a juvenile pursuant to an order
10entered under chapter 232 which is a charge upon the state
11under section 232.141, subsection 4.
12f. Of the funds allocated in this subsection, not more than
13$83,000 may be used by the judicial branch for administration
14of the requirements under this subsection.
15g. Of the funds allocated in this subsection, $17,000
16shall be used by the department of human services to support
17the interstate commission for juveniles in accordance with
18the interstate compact for juveniles as provided in section
19232.173.
209. Of the funds appropriated in this section, $12,253,000 is
21allocated for juvenile delinquent graduated sanctions services.
22Any state funds saved as a result of efforts by juvenile court
23services to earn a federal Tit.IV-E match for juvenile court
24services administration may be used for the juvenile delinquent
25graduated sanctions services.
2610. Of the funds appropriated in this section, $1,658,000 is
27transferred to the department of public health to be used for
28the child protection center grant program for child protection
29centers located in Iowa in accordance with section 135.118.
30The grant amounts under the program shall be equalized so that
31each center receives a uniform base amount of $245,000, and so
32that the remaining funds are awarded through a funding formula
33based upon the volume of children served. To increase access
34to child protection center services for children in rural
35areas, the funding formula for the awarding of the remaining
-34-1funds shall provide for the awarding of an enhanced amount to
2eligible grantees to develop and maintain satellite centers in
3underserved regions of the state.
411. Of the funds appropriated in this section, $4,025,000 is
5allocated for the preparation for adult living program pursuant
6to section 234.46.
712. Of the funds appropriated in this section, $227,000
8shall be used for the public purpose of continuing a grant to a
9nonprofit human services organization, providing services to
10individuals and families in multiple locations in southwest
11Iowa and Nebraska for support of a project providing immediate,
12sensitive support and forensic interviews, medical exams, needs
13assessments, and referrals for victims of child abuse and their
14nonoffending family members.
1513. Of the funds appropriated in this section, $300,000
16is allocated for the foster care youth council approach of
17providing a support network to children placed in foster care.
1814. Of the funds appropriated in this section, $202,000 is
19allocated for use pursuant to section 235A.1 for continuation
20of the initiative to address child sexual abuse implemented
21pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
2221.
2315. Of the funds appropriated in this section, $630,000 is
24allocated for the community partnership for child protection
25sites.
2616. Of the funds appropriated in this section, $371,000
27is allocated for the department’s minority youth and family
28projects under the redesign of the child welfare system.
2917. Of the funds appropriated in this section, $851,000
30is allocated for funding of the community circle of care
31collaboration for children and youth in northeast Iowa.
3218. Of the funds appropriated in this section, at least
33$147,000 shall be used for the continuation of the child
34welfare provider training academy, a collaboration between the
35coalition for family and children’s services in Iowa and the
-35-1department.
219. Of the funds appropriated in this section, $211,000
3shall be used for continuation of the central Iowa system of
4care program grant through June 30, 2021.
520. Of the funds appropriated in this section, $235,000
6shall be used for the public purpose of the continuation
7and expansion of a system of care program grant implemented
8in Cerro Gordo and Linn counties to utilize a comprehensive
9and long-term approach for helping children and families by
10addressing the key areas in a child’s life of childhood basic
11needs, education and work, family, and community.
1221. Of the funds appropriated in this section, $110,000
13shall be used for the public purpose of funding community-based
14services and other supports with a system of care approach
15for children with a serious emotional disturbance and their
16families through a nonprofit provider of child welfare services
17that has been in existence for more than 115 years, is located
18in a county with a population of more than 200,000 but less
19than 220,000 according to the latest certified federal census,
20is licensed as a psychiatric medical institution for children,
21and was a system of care grantee prior to July 1, 2020.
2222. If a separate funding source is identified that reduces
23the need for state funds within an allocation under this
24section, the allocated state funds may be redistributed to
25other allocations under this section for the same fiscal year.
2623. A portion of the funds appropriated in this section
27may be used for family-centered services for the purposes of
28complying with the federal family first prevention and services
29Act of 2018, Pub.L.No.115-123, and successor legislation.
30 Sec. 21. ADOPTION SUBSIDY.
311. There is appropriated from the general fund of the
32state to the department of human services for the fiscal year
33beginning July 1, 2020, and ending June 30, 2021, the following
34amount, or so much thereof as is necessary, to be used for the
35purpose designated:
-36- 1a. For adoption subsidy payments and services:
.................................................. $241,588,378
3b. (1) The funds appropriated in this section shall be used
4as authorized or allowed by federal law or regulation for any
5of the following purposes:
6(a) For adoption subsidy payments and related costs.
7(b) For post-adoption services and for other purposes under
8Tit.IV-B or Tit.IV-E of the federal Social Security Act.
9(2) The department of human services may transfer funds
10appropriated in this subsection to the appropriation for
11child and family services in this Act for the purposes of
12post-adoption services and for other purposes under Tit.IV-B
13or Tit.IV-E of the federal Social Security Act.
14c. Notwithstanding section 8.33, moneys corresponding to
15the state savings resulting from implementation of the federal
16Fostering Connections to Success and Increasing Adoptions Act
17of 2008, Pub.L. No.110-351, and successor legislation, as
18determined in accordance with 42 U.S.C.§673(a)(8), that remain
19unencumbered or unobligated at the close of the fiscal year,
20shall not revert to any fund but shall remain available for the
21purposes designated in this subsection until expended. The
22amount of such savings and any corresponding funds remaining
23at the close of the fiscal year shall be determined separately
24and any changes in either amount between fiscal years shall not
25result in an unfunded need.
262. The department may transfer funds appropriated in
27this section to the appropriation made in this division of
28this Act for general administration for costs paid from the
29appropriation relating to adoption subsidy.
303. Federal funds received by the state during the
31fiscal year beginning July 1, 2020, as the result of the
32expenditure of state funds during a previous state fiscal
33year for a service or activity funded under this section are
34appropriated to the department to be used as additional funding
35for the services and activities funded under this section.
-37-1Notwithstanding section 8.33, moneys received in accordance
2with this subsection that remain unencumbered or unobligated
3at the close of the fiscal year shall not revert to any fund
4but shall remain available for expenditure for the purposes
5designated until the close of the succeeding fiscal year.
6 Sec. 22. JUVENILE DETENTION HOME FUND. Moneys deposited
7in the juvenile detention home fund created in section 232.142
8during the fiscal year beginning July 1, 2020, and ending June
930, 2021, are appropriated to the department of human services
10for the fiscal year beginning July 1, 2020, and ending June 30,
112021, for distribution of an amount equal to a percentage of
12the costs of the establishment, improvement, operation, and
13maintenance of county or multicounty juvenile detention homes
14in the fiscal year beginning July 1, 2019. Moneys appropriated
15for distribution in accordance with this section shall be
16allocated among eligible detention homes, prorated on the basis
17of an eligible detention home’s proportion of the costs of all
18eligible detention homes in the fiscal year beginning July
191, 2019. The percentage figure shall be determined by the
20department based on the amount available for distribution for
21the fund. Notwithstanding section 232.142, subsection 3, the
22financial aid payable by the state under that provision for the
23fiscal year beginning July 1, 2020, shall be limited to the
24amount appropriated for the purposes of this section.
25 Sec. 23. FAMILY SUPPORT SUBSIDY PROGRAM.
261. There is appropriated from the general fund of the
27state to the department of human services for the fiscal year
28beginning July 1, 2020, and ending June 30, 2021, the following
29amount, or so much thereof as is necessary, to be used for the
30purpose designated:
31For the family support subsidy program subject to the
32enrollment restrictions in section 225C.37, subsection 3:
.................................................. $33949,282
342. At least $875,195 of the moneys appropriated in this
35section is transferred to the department of public health for
-38-1the family support center component of the comprehensive family
2support program under chapter 225C, subchapter V.
33. If at any time during the fiscal year, the amount of
4funding available for the family support subsidy program
5is reduced from the amount initially used to establish the
6figure for the number of family members for whom a subsidy
7is to be provided at any one time during the fiscal year,
8notwithstanding section 225C.38, subsection 2, the department
9shall revise the figure as necessary to conform to the amount
10of funding available.
11 Sec. 24. CONNER DECREE. There is appropriated from the
12general fund of the state to the department of human services
13for the fiscal year beginning July 1, 2020, and ending June 30,
142021, the following amount, or so much thereof as is necessary,
15to be used for the purpose designated:
16For building community capacity through the coordination
17and provision of training opportunities in accordance with the
18consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
19Iowa, July 14, 1994):
.................................................. $2033,632
21 Sec. 25. MENTAL HEALTH INSTITUTES.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2020, and ending June 30, 2021, the following
25amounts, or so much thereof as is necessary, to be used for the
26purposes designated:
27a. For operation of the state mental health institute at
28Cherokee as required by chapters 218 and 226 for salaries,
29support, maintenance, and miscellaneous purposes:
.................................................. $3014,826,075
31b. For operation of the state mental health institute at
32Independence as required by chapters 218 and 226 for salaries,
33support, maintenance, and miscellaneous purposes:
.................................................. $3419,710,614
352. Notwithstanding sections 218.78 and 249A.11, any revenue
-39-1received from the state mental health institute at Cherokee or
2the state mental health institute at Independence pursuant to
342 C.F.R§438.6(e) may be retained and expended by the mental
4health institute.
53. Notwithstanding any provision of law to the contrary,
6a Medicaid member residing at the state mental health
7institute at Cherokee or the state mental health institute
8at Independence shall retain Medicaid eligibility during
9the period of the Medicaid member’s stay for which federal
10financial participation is available.
11 Sec. 26. STATE RESOURCE CENTERS.
121. There is appropriated from the general fund of the
13state to the department of human services for the fiscal year
14beginning July 1, 2020, and ending June 30, 2021, the following
15amounts, or so much thereof as is necessary, to be used for the
16purposes designated:
17a. For the state resource center at Glenwood for salaries,
18support, maintenance, and miscellaneous purposes:
.................................................. $1916,536,391
20b. For the state resource center at Woodward for salaries,
21support, maintenance, and miscellaneous purposes:
.................................................. $2211,452,986
232. The department may continue to bill for state resource
24center services utilizing a scope of services approach used for
25private providers of intermediate care facilities for persons
26with an intellectual disability services, in a manner which
27does not shift costs between the medical assistance program,
28counties, or other sources of funding for the state resource
29centers.
303. The state resource centers may expand the time-limited
31assessment and respite services during the fiscal year.
324. If the department’s administration and the department
33of management concur with a finding by a state resource
34center’s superintendent that projected revenues can reasonably
35be expected to pay the salary and support costs for a new
-40-1employee position, or that such costs for adding a particular
2number of new positions for the fiscal year would be less
3than the overtime costs if new positions would not be added,
4the superintendent may add the new position or positions. If
5the vacant positions available to a resource center do not
6include the position classification desired to be filled, the
7state resource center’s superintendent may reclassify any
8vacant position as necessary to fill the desired position. The
9superintendents of the state resource centers may, by mutual
10agreement, pool vacant positions and position classifications
11during the course of the fiscal year in order to assist one
12another in filling necessary positions.
135. If existing capacity limitations are reached in
14operating units, a waiting list is in effect for a service or
15a special need for which a payment source or other funding
16is available for the service or to address the special need,
17and facilities for the service or to address the special need
18can be provided within the available payment source or other
19funding, the superintendent of a state resource center may
20authorize opening not more than two units or other facilities
21and begin implementing the service or addressing the special
22need during fiscal year 2020-2021.
236. Notwithstanding section 8.33, and notwithstanding
24the amount limitation specified in section 222.92, moneys
25appropriated in this section that remain unencumbered or
26unobligated at the close of the fiscal year shall not revert
27but shall remain available for expenditure for the purposes
28designated until the close of the succeeding fiscal year.
29 Sec. 27. SEXUALLY VIOLENT PREDATORS.
301. There is appropriated from the general fund of the
31state to the department of human services for the fiscal year
32beginning July 1, 2020, and ending June 30, 2021, the following
33amount, or so much thereof as is necessary, to be used for the
34purpose designated:
35For costs associated with the commitment and treatment of
-41-1sexually violent predators in the unit located at the state
2mental health institute at Cherokee, including costs of legal
3services and other associated costs, including salaries,
4support, maintenance, and miscellaneous purposes, and for not
5more than the following full-time equivalent positions:
.................................................. $612,452,572
72. Unless specifically prohibited by law, if the amount
8charged provides for recoupment of at least the entire amount
9of direct and indirect costs, the department of human services
10may contract with other states to provide care and treatment
11of persons placed by the other states at the unit for sexually
12violent predators at Cherokee. The moneys received under
13such a contract shall be considered to be repayment receipts
14and used for the purposes of the appropriation made in this
15section.
16 Sec. 28. FIELD OPERATIONS.
171. There is appropriated from the general fund of the
18state to the department of human services for the fiscal year
19beginning July 1, 2020, and ending June 30, 2021, the following
20amount, or so much thereof as is necessary, to be used for the
21purposes designated:
22For field operations, including salaries, support,
23maintenance, and miscellaneous purposes:
.................................................. $2460,341,204
252. Priority in filling full-time equivalent positions
26shall be given to those positions related to child protection
27services and eligibility determination for low-income families.
28 Sec. 29. GENERAL ADMINISTRATION. There is appropriated
29from the general fund of the state to the department of human
30services for the fiscal year beginning July 1, 2020, and ending
31June 30, 2021, the following amount, or so much thereof as is
32necessary, to be used for the purpose designated:
33For general administration, including salaries, support,
34maintenance, and miscellaneous purposes:
.................................................. $3514,264,728
-42- 11. The department shall report at least monthly to the
2legislative services agency concerning the department’s
3operational and program expenditures.
42. Of the funds appropriated in this section, $150,000
5shall be used for the provision of a program to provide
6technical assistance, support, and consultation to providers
7of habilitation services and home and community-based services
8waiver services for adults with disabilities under the medical
9assistance program.
103. Of the funds appropriated in this section, $50,000
11is transferred to the Iowa finance authority to be used
12for administrative support of the council on homelessness
13established in section 16.2D and for the council to fulfill its
14duties in addressing and reducing homelessness in the state.
154. Of the funds appropriated in this section, $200,000 shall
16be transferred to and deposited in the administrative fund of
17the Iowa ABLE savings plan trust created in section 12I.4, to
18be used for implementation and administration activities of the
19Iowa ABLE savings plan trust.
205. Of the funds appropriated in this section, $200,000 is
21transferred to the economic development authority for the Iowa
22commission on volunteer services to continue to be used for the
23RefugeeRISE AmeriCorps program established under section 15H.8
24for member recruitment and training to improve the economic
25well-being and health of economically disadvantaged refugees in
26local communities across Iowa. Funds transferred may be used
27to supplement federal funds under federal regulations.
286. Of the funds appropriated in this section, up to $300,000
29shall be used to support the work of the children’s behavioral
30health system state board created in section 225C.51 and the
31children’s behavioral health system as defined in section
32225C.2. Of the amount allocated in this subsection, $32,000
33shall be transferred to the department of public health to
34support the costs related to the children’s behavioral health
35system.
-43-1 Sec. 30. DEPARTMENT-WIDE DUTIES. There is appropriated
2from the general fund of the state to the department of human
3services for the fiscal year beginning July 1, 2020, and ending
4June 30, 2021, the following amount, or so much thereof as is
5necessary, to be used for the purposes designated:
6For salaries, support, maintenance, and miscellaneous
7purposes at facilities under the purview of the department of
8human services:
.................................................. $92,879,274
10 Sec. 31. VOLUNTEERS. There is appropriated from the general
11fund of the state to the department of human services for the
12fiscal year beginning July 1, 2020, and ending June 30, 2021,
13the following amount, or so much thereof as is necessary, to be
14used for the purpose designated:
15For development and coordination of volunteer services:
.................................................. $1684,686
17 Sec. 32. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
18ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
19DEPARTMENT OF HUMAN SERVICES.
201. a. (1) (a) For the fiscal year beginning July 1,
212020, the department shall rebase case-mix nursing facility
22rates effective July 1, 2020, to the extent possible within the
23state funding, including the $8,000,000, appropriated for this
24purpose.
25(b) For the fiscal year beginning July 1, 2020, non-case-mix
26and special population nursing facilities shall be reimbursed
27in accordance with the methodology in effect on June 30 of the
28prior fiscal year.
29(2) For managed care claims, the department of human
30services shall adjust the payment rate floor for nursing
31facilities, annually, to maintain a rate floor that is no
32lower than the Medicaid fee-for-service case-mix adjusted
33rate calculated in accordance with subparagraph division
34(a) and 441 IAC 81.6. The department shall then calculate
35adjusted reimbursement rates, including but not limited to
-44-1add-on-payments, annually, and shall notify Medicaid managed
2care organizations of the adjusted reimbursement rates within
330 days of determining the adjusted reimbursement rates. Any
4adjustment of reimbursement rates under this subparagraph
5division shall be budget neutral to the state budget.
6(3) Medicaid managed care organizations shall adjust
7facility-specific rates based upon payment rate listings issued
8by the department. The rate adjustments shall be applied
9prospectively from the effective date of the rate letter issued
10by the department.
11b. (1) For the fiscal year beginning July 1,2020, the
12department shall establish the pharmacy dispensing fee
13reimbursement at $10.07 per prescription, until a cost of
14dispensing survey is completed. The actual dispensing fee
15shall be determined by a cost of dispensing survey performed
16by the department and required to be completed by all medical
17assistance program participating pharmacies every two years,
18adjusted as necessary to maintain expenditures within the
19amount appropriated to the department for this purpose for the
20fiscal year.
21(2) The department shall utilize an average acquisition
22cost reimbursement methodology for all drugs covered under the
23medical assistance program in accordance with 2012 Iowa Acts,
24chapter 1133, section 33.
25c. (1) For the fiscal year beginning July 1, 2020,
26reimbursement rates for outpatient hospital services shall
27remain at the rates in effect on June 30, 2020, subject to
28Medicaid program upper payment limit rules, and adjusted
29as necessary to maintain expenditures within the amount
30appropriated to the department for this purpose for the fiscal
31year.
32(2) For the fiscal year beginning July 1, 2020,
33reimbursement rates for inpatient hospital services shall
34be rebased effective October 1, 2020, subject to Medicaid
35program upper payment limit rules, and adjusted as necessary
-45-1to maintain expenditures within the amount appropriated to the
2department for this purpose for the fiscal year.
3(3) For the fiscal year beginning July 1, 2020, under
4both fee-for-service and managed care administration of
5the Medicaid program, critical access hospitals shall be
6reimbursed for inpatient and outpatient services based on the
7hospital-specific critical access hospital cost adjustment
8factor methodology utilizing the most recent and complete cost
9reporting period as applied prospectively within the funds
10appropriated for such purpose for the fiscal year.
11(4) For the fiscal year beginning July 1, 2020, the graduate
12medical education and disproportionate share hospital fund
13shall remain at the amount in effect on June 30, 2020, except
14that the portion of the fund attributable to graduate medical
15education shall be reduced in an amount that reflects the
16elimination of graduate medical education payments made to
17out-of-state hospitals.
18(5) In order to ensure the efficient use of limited state
19funds in procuring health care services for low-income Iowans,
20funds appropriated in this Act for hospital services shall
21not be used for activities which would be excluded from a
22determination of reasonable costs under the federal Medicare
23program pursuant to 42 U.S.C.§1395x(v)(1)(N).
24d. For the fiscal year beginning July 1, 2020, reimbursement
25rates for hospices and acute psychiatric hospitals shall be
26increased in accordance with increases under the federal
27Medicare program or as supported by their Medicare audited
28costs.
29e. For the fiscal year beginning July 1, 2020, independent
30laboratories and rehabilitation agencies shall be reimbursed
31using the same methodology in effect on June 30, 2020.
32f. (1) For the fiscal year beginning July 1, 2020,
33reimbursement rates for home health agencies shall continue to
34be based on the Medicare low utilization payment adjustment
35(LUPA) methodology with state geographic wage adjustments.
-46-1The department shall continue to update the rates every two
2years to reflect the most recent Medicare LUPA rates to the
3extent possible within the state funding appropriated for this
4purpose.
5(2) For the fiscal year beginning July 1, 2020, rates for
6private duty nursing and personal care services under the early
7and periodic screening, diagnostic, and treatment program
8benefit shall be calculated based on the methodology in effect
9on June 30, 2020.
10g. For the fiscal year beginning July 1, 2020, federally
11qualified health centers and rural health clinics shall receive
12cost-based reimbursement for 100 percent of the reasonable
13costs for the provision of services to recipients of medical
14assistance.
15h. For the fiscal year beginning July 1, 2020, the
16reimbursement rates for dental services shall remain at the
17rates in effect on June 30, 2020.
18i. (1) For the fiscal year beginning July 1, 2020,
19reimbursement rates for non-state-owned psychiatric medical
20institutions for children shall be based on the reimbursement
21methodology in effect on June 30, 2020.
22(2) As a condition of participation in the medical
23assistance program, enrolled providers shall accept the medical
24assistance reimbursement rate for any covered goods or services
25provided to recipients of medical assistance who are children
26under the custody of a psychiatric medical institution for
27children.
28j. For the fiscal year beginning July 1, 2020, unless
29otherwise specified in this Act, all noninstitutional medical
30assistance provider reimbursement rates shall remain at the
31rates in effect on June 30, 2020, except for area education
32agencies, local education agencies, infant and toddler
33services providers, home and community-based services providers
34including consumer-directed attendant care providers under a
35section 1915(c) or 1915(i) waiver, targeted case management
-47-1providers, and those providers whose rates are required to be
2determined pursuant to section 249A.20, or to meet federal
3mental health parity requirements.
4k. Notwithstanding any provision to the contrary, for the
5fiscal year beginning July 1, 2020, the reimbursement rate for
6anesthesiologists shall remain at the rates in effect on June
730, 2020, and updated on January 1, 2021, to align with the
8most current Iowa Medicare anesthesia rate.
9l. Notwithstanding section 249A.20, for the fiscal year
10beginning July 1, 2020, the average reimbursement rate for
11health care providers eligible for use of the federal Medicare
12resource-based relative value scale reimbursement methodology
13under section 249A.20 shall remain at the rate in effect on
14June 30, 2020; however, this rate shall not exceed the maximum
15level authorized by the federal government.
16m. For the fiscal year beginning July 1, 2020, the
17reimbursement rate for residential care facilities shall not
18be less than the minimum payment level as established by the
19federal government to meet the federally mandated maintenance
20of effort requirement. The flat reimbursement rate for
21facilities electing not to file annual cost reports shall not
22be less than the minimum payment level as established by the
23federal government to meet the federally mandated maintenance
24of effort requirement.
25n. For the fiscal year beginning July 1, 2020, the
26reimbursement rates for inpatient mental health services
27provided at hospitals shall be rebased effective October 1,
282020, subject to Medicaid program upper payment limit rules;
29and psychiatrists shall be reimbursed at the medical assistance
30program fee-for-service rate in effect on June 30, 2020.
31o. For the fiscal year beginning July 1, 2020, community
32mental health centers may choose to be reimbursed for the
33services provided to recipients of medical assistance through
34either of the following options:
35(1) For 100 percent of the reasonable costs of the services.
-48- 1(2) In accordance with the alternative reimbursement rate
2methodology approved by the department of human services in
3effect on June 30, 2020.
4p. For the fiscal year beginning July 1, 2020, the
5reimbursement rate for providers of family planning services
6that are eligible to receive a 90 percent federal match shall
7remain at the rates in effect on June 30, 2020.
8q. For the fiscal year beginning July 1, 2020, the upper
9limits and reimbursement rates for providers of home and
10community-based services waiver services and habilitation
11services shall be increased across-the-board within the
12$3,300,000 of state funding appropriated for this purpose.
13r. For the fiscal year beginning July 1, 2020, the
14reimbursement rates for emergency medical service providers
15shall remain at the rates in effect on June 30, 2020, or as
16approved by the centers for Medicare and Medicaid services of
17the United States department of health and human services.
18s. (1) For the fiscal year beginning July 1, 2020,
19reimbursement rates provided under managed care administration
20of the Medicaid program for substance-related disorder
21residential treatment programs licensed under section 125.13,
22shall be increased to the extent possible within the $2,725,690
23of state funding appropriated for this purpose.
24(2) For the fiscal year beginning July 1, 2020,
25reimbursement rates for substance-related disorder outpatient
26treatment programs licensed under section 125.13, shall be
27increased to the extent possible within the $3,339,930 of state
28funding appropriated for this purpose.
29t. For the fiscal year beginning July 1, 2020, assertive
30community treatment per diem rates shall remain at the rates in
31effect on June 30, 2020.
322. For the fiscal year beginning July 1, 2020, the
33reimbursement rate for providers reimbursed under the
34in-home-related care program shall not be less than the minimum
35payment level as established by the federal government to meet
-49-1the federally mandated maintenance of effort requirement.
23. Unless otherwise directed in this section, when the
3department’s reimbursement methodology for any provider
4reimbursed in accordance with this section includes an
5inflation factor, this factor shall not exceed the amount
6by which the consumer price index for all urban consumers
7increased during the calendar year ending December 31, 2002.
84. Notwithstanding section 234.38, for the fiscal
9year beginning July 1, 2020, the foster family basic daily
10maintenance rate and the maximum adoption subsidy rate for
11children ages 0 through 5 years shall be $16.78, the rate for
12children ages 6 through 11 years shall be $17.45, the rate for
13children ages 12 through 15 years shall be $19.10, and the
14rate for children and young adults ages 16 and older shall
15be $19.35. For youth ages 18 to 23 who have exited foster
16care, the preparation for adult living program maintenance rate
17shall be $602.70 per month. The maximum payment for adoption
18subsidy nonrecurring expenses shall be limited to $500 and the
19disallowance of additional amounts for court costs and other
20related legal expenses implemented pursuant to 2010 Iowa Acts,
21chapter 1031, section 408, shall be continued.
225. For the fiscal year beginning July 1, 2020, the maximum
23reimbursement rates for social services providers under
24contract shall remain at the rates in effect on June 30, 2020,
25or the provider’s actual and allowable cost plus inflation for
26each service, whichever is less. However, if a new service
27or service provider is added after June 30, 2020, the initial
28reimbursement rate for the service or provider shall be based
29upon a weighted average of provider rates for similar services.
306. a. For the fiscal year beginning July 1, 2020, the
31reimbursement rates for resource family recruitment and
32retention contractors shall be established by contract.
33b. For the fiscal year beginning July 1, 2020, the
34reimbursement rates for supervised apartment living foster care
35providers shall be established by contract.
-50- 17. For the fiscal year beginning July 1, 2020, the
2reimbursement rate for group foster care providers shall be the
3combined service and maintenance reimbursement rate established
4by contract.
58. The group foster care reimbursement rates paid for
6placement of children out of state shall be calculated
7according to the same rate-setting principles as those used for
8in-state providers, unless the director of human services or
9the director’s designee determines that appropriate care cannot
10be provided within the state. The payment of the daily rate
11shall be based on the number of days in the calendar month in
12which service is provided.
139. a. For the fiscal year beginning July 1, 2020, the
14reimbursement rate paid for shelter care and the child welfare
15emergency services implemented to provide or prevent the need
16for shelter care shall be established by contract.
17b. For the fiscal year beginning July 1, 2020, the combined
18service and maintenance components of the reimbursement rate
19paid for shelter care services shall be based on the financial
20and statistical report submitted to the department. The
21maximum reimbursement rate shall be $101.83 per day. The
22department shall reimburse a shelter care provider at the
23provider’s actual and allowable unit cost, plus inflation, not
24to exceed the maximum reimbursement rate.
25c. Notwithstanding section 232.141, subsection 8, for the
26fiscal year beginning July 1, 2020, the amount of the statewide
27average of the actual and allowable rates for reimbursement of
28juvenile shelter care homes that is utilized for the limitation
29on recovery of unpaid costs shall remain at the amount in
30effect for this purpose in the fiscal year beginning July 1,
312020.
3210. For the fiscal year beginning July 1, 2020, the
33department shall calculate reimbursement rates for intermediate
34care facilities for persons with an intellectual disability
35at the 80th percentile. Beginning July 1, 2020, the rate
-51-1calculation methodology shall utilize the consumer price index
2inflation factor applicable to the fiscal year beginning July
31, 2020.
411. Effective July 1, 2020, the child care provider
5reimbursement rates shall remain at the rates in effect on June
630, 2020. The department shall set rates in a manner so as
7to provide incentives for a nonregistered provider to become
8registered by applying any increase only to registered and
9licensed providers.
1012. For the fiscal year beginning July 1, 2020, the
11reimbursement rate for family-centered services providers shall
12be established by contract.
1313. The department may adopt emergency rules to implement
14this section.
15 Sec. 33. EMERGENCY RULES.
161. If necessary to comply with federal requirements,
17including time frames, or if specifically authorized by a
18provision of this division of this Act, the department of
19human services or the mental health and disability services
20commission may adopt administrative rules under section 17A.4,
21subsection 3, and section 17A.5, subsection 2, paragraph “b”,
22to implement the provisions of this division of this Act and
23the rules shall become effective immediately upon filing or
24on a later effective date specified in the rules, unless the
25effective date of the rules is delayed or the applicability
26of the rules is suspended by the administrative rules review
27committee. Any rules adopted in accordance with this section
28shall not take effect before the rules are reviewed by the
29administrative rules review committee. The delay authority
30provided to the administrative rules review committee under
31section 17A.4, subsection 7, and section 17A.8, subsection 9,
32shall be applicable to a delay imposed under this section,
33notwithstanding a provision in those sections making them
34inapplicable to section 17A.5, subsection 2, paragraph “b”.
35Any rules adopted in accordance with the provisions of this
-52-1section shall also be published as a notice of intended action
2as provided in section 17A.4.
32. If during a fiscal year, the department of human
4services is adopting rules in accordance with this section
5or as otherwise directed or authorized by state law, and the
6rules will result in an expenditure increase beyond the amount
7anticipated in the budget process or if the expenditure was
8not addressed in the budget process for the fiscal year, the
9department shall notify the persons designated by this division
10of this Act for submission of reports, the chairpersons and
11ranking members of the committees on appropriations, and
12the department of management concerning the rules and the
13expenditure increase. The notification shall be provided at
14least 30 calendar days prior to the date notice of the rules
15is submitted to the administrative rules coordinator and the
16administrative code editor.
17 Sec. 34. REPORTS. Any reports or other information
18required to be compiled and submitted under this Act during the
19fiscal year beginning July 1, 2020, shall be submitted to the
20chairpersons and ranking members of the joint appropriations
21subcommittee on health and human services, the legislative
22services agency, and the legislative caucus staffs on or
23before the dates specified for submission of the reports or
24information.
25 Sec. 35. EFFECTIVE UPON ENACTMENT. The following
26provisions of this division of this Act, being deemed of
27immediate importance, take effect upon enactment:
281. The provision relating to section 232.141 and directing
29the state court administrator and the division administrator of
30the department of human services division of child and family
31services to make the determination, by June 15, 2020, of the
32distribution of funds allocated for the payment of the expenses
33of court-ordered services provided to juveniles which are a
34charge upon the state.
35DIVISION VI
-53-1HEALTH CARE ACCOUNTS AND FUNDS — FY 2020-2021
2 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
3appropriated from the pharmaceutical settlement account created
4in section 249A.33 to the department of human services for the
5fiscal year beginning July 1, 2020, and ending June 30, 2021,
6the following amount, or so much thereof as is necessary, to be
7used for the purpose designated:
8Notwithstanding any provision of law to the contrary, to
9supplement the appropriations made in this Act for medical
10contracts under the medical assistance program for the fiscal
11year beginning July 1, 2020, and ending June 30, 2021:
.................................................. $12234,193
13 Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
14SERVICES. Notwithstanding any provision to the contrary and
15subject to the availability of funds, there is appropriated
16from the quality assurance trust fund created in section
17249L.4 to the department of human services for the fiscal year
18beginning July 1, 2020, and ending June 30, 2021, the following
19amounts, or so much thereof as is necessary, for the purposes
20designated:
21To supplement the appropriation made in this Act from the
22general fund of the state to the department of human services
23for medical assistance for the same fiscal year:
.................................................. $2458,570,397
25 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
26DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
27the contrary and subject to the availability of funds, there is
28appropriated from the hospital health care access trust fund
29created in section 249M.4 to the department of human services
30for the fiscal year beginning July 1, 2020, and ending June
3130, 2021, the following amounts, or so much thereof as is
32necessary, for the purposes designated:
33To supplement the appropriation made in this Act from the
34general fund of the state to the department of human services
35for medical assistance for the same fiscal year:
-54-.................................................. $133,920,554
2 Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
3FOR FY 2020-2021. Notwithstanding section 8.33, if moneys
4appropriated for purposes of the medical assistance program for
5the fiscal year beginning July 1, 2020, and ending June 30,
62021, from the general fund of the state, the quality assurance
7trust fund, and the hospital health care access trust fund, are
8in excess of actual expenditures for the medical assistance
9program and remain unencumbered or unobligated at the close
10of the fiscal year, the excess moneys shall not revert but
11shall remain available for expenditure for the purposes of the
12medical assistance program until the close of the succeeding
13fiscal year.
14DIVISION VII
15PRIOR APPROPRIATIONS AND OTHER PROVISIONS
16MEDICAL ASSISTANCE
17 Sec. 40. 2019 Iowa Acts, chapter 85, section 13, unnumbered
18paragraph 2, is amended to read as follows:
19For medical assistance program reimbursement and associated
20costs as specifically provided in the reimbursement
21methodologies in effect on June 30, 2019, except as otherwise
22expressly authorized by law, consistent with options under
23federal law and regulations, and contingent upon receipt of
24approval from the office of the governor of reimbursement for
25each abortion performed under the program:
.................................................. $261,427,379,707
271,516,364,409
28CHILDREN’S HEALTH INSURANCE PROGRAM
29 Sec. 41. 2019 Iowa Acts, chapter 85, section 16, subsection
301, unnumbered paragraph 2, is amended to read as follows:
31For maintenance of the healthy and well kids in Iowa (hawk-i)
32program pursuant to chapter 514I, including supplemental dental
33services, for receipt of federal financial participation under
34Tit.XXI of the federal Social Security Act, which creates the
35children’s health insurance program:
-55-.................................................. $119,361,112
221,098,426
3STATE RESOURCE CENTERS
4 Sec. 42. 2019 Iowa Acts, chapter 85, section 25, subsection
51, paragraph a, is amended to read as follows:
6a. For the state resource center at Glenwood for salaries,
7support, maintenance, and miscellaneous purposes:
.................................................. $816,048,348
916,438,259
10Of the funds appropriated in this paragraph “a”, $333,000
11shall be used for expert consultation at the state resource
12center at Glenwood.
13 Sec. 43. EFFECTIVE DATE. This division of this Act, being
14deemed of immediate importance, takes effect upon enactment.
15 Sec. 44. RETROACTIVE APPLICABILITY. This division of this
16Act applies retroactively to July 1, 2019.
17DIVISION VIII
18DECATEGORIZATION FY 2018 CARRYOVER FUNDING
19 Sec. 45. DECATEGORIZATION CARRYOVER FUNDING FY 2018 —
20TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
21subsection 5, paragraph “b”, any state-appropriated moneys in
22the funding pool that remained unencumbered or unobligated
23at the close of the fiscal year beginning July 1, 2017, and
24were deemed carryover funding to remain available for the two
25succeeding fiscal years that still remain unencumbered or
26unobligated at the close of the fiscal year beginning July 1,
272019, shall not revert but shall be transferred to the medical
28assistance program for the fiscal year beginning July 1, 2020.
29 Sec. 46. EFFECTIVE DATE. This division of this Act, being
30deemed of immediate importance, takes effect upon enactment.
31 Sec. 47. RETROACTIVE APPLICABILITY. This division of this
32Act applies retroactively to July 1, 2019.
33EXPLANATION
34The inclusion of this explanation does not constitute agreement with
35the explanation’s substance by the members of the general assembly.
-56- 1This bill relates to appropriations for health and human
2services for fiscal year 2020-2021 to the department of
3veterans affairs, Iowa veterans home, department on aging
4(IDA), office of long-term care ombudsman, department of public
5health (DPH), Iowa finance authority, department of human
6rights, and department of human services (DHS). The bill is
7organized into divisions.
8DEPARTMENT ON AGING. This division makes appropriations
9from the general fund of the state to the department on aging.
10OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
11appropriations from the general fund of the state to the office
12of long-term care ombudsman.
13DEPARTMENT OF PUBLIC HEALTH. This division makes
14appropriations from the general fund of the state to the
15department of public health.
16DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
17division makes appropriations from the general fund of the
18state to the department of veterans affairs for administration,
19the Iowa veterans home, for transfer to the Iowa finance
20authority for the home ownership assistance program, and for
21the county commissions of veteran affairs.
22DEPARTMENT OF HUMAN SERVICES. This division makes
23appropriations from the general fund of the state and the
24federal temporary assistance for needy families block
25grant to DHS. The allocation for the family development
26and self-sufficiency grant program is made directly to
27the department of human rights. The reimbursement section
28addresses reimbursement for providers reimbursed by the
29department of human services.
30HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
31health-related appropriations. A number of the appropriations
32are made for purposes of the Medicaid program in addition to
33the general fund appropriations made for this purpose for the
34same fiscal year.
35PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division
-57-1provides for adjustments of appropriations for FY 2019-2020
2relating to the Medicaid program, the state children’s health
3insurance program, and the state resource center at Glenwood.
4DECATEGORIZATION FY 2018 CARRYOVER FUNDING. This division
5provides for the transfer of decategorization carryover funding
6that remains unencumbered or unobligated at the close of FY
72019-2020 to the Medicaid program for FY 2020-2021.
-58-pf/rn