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Senate Study Bill 1266 - IntroducedA Bill ForAn Act 1relating to appropriations for health and human services
2and veterans and including other related provisions and
3appropriations, providing penalties, and including effective
4date provisions.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2021-2022
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, 2021, and ending June 30,
62022, 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
10years of age and older with case management, Iowa’s aging and
11disabilities resource center, and other services which may
12include but are not limited to adult day, respite care, chore,
13information and assistance, and material aid, for information
14and options counseling for persons with disabilities who
15are 18 years of age or older, and for salaries, support,
16administration, maintenance, and miscellaneous purposes:
.................................................. $1711,164,382
181. Funds appropriated in this section may be used to
19supplement federal funds under federal regulations. To
20receive funds appropriated in this section, a local area
21agency on aging shall match the funds with moneys from other
22sources according to rules adopted by the department. Funds
23appropriated in this section may be used for elderly services
24not specifically enumerated in this section only if approved
25by an area agency on aging for provision of the service within
26the area.
272. Of the funds appropriated in this section, $279,000 is
28transferred to the economic development authority for the Iowa
29commission on volunteer services to be used for the retired and
30senior volunteer program.
313. a. The department on aging shall establish and enforce
32procedures relating to expenditure of state and federal funds
33by area agencies on aging that require compliance with both
34state and federal laws, rules, and regulations, including but
35not limited to all of the following:
-1- 1(1) Requiring that expenditures are incurred only for goods
2or services received or performed prior to the end of the
3fiscal period designated for use of the funds.
4(2) Prohibiting prepayment for goods or services not
5received or performed prior to the end of the fiscal period
6designated for use of the funds.
7(3) Prohibiting prepayment for goods or services not
8defined specifically by good or service, time period, or
9recipient.
10(4) Prohibiting the establishment of accounts from which
11future goods or services which are not defined specifically by
12good or service, time period, or recipient, may be purchased.
13b. The procedures shall provide that if any funds are
14expended in a manner that is not in compliance with the
15procedures and applicable federal and state laws, rules, and
16regulations, and are subsequently subject to repayment, the
17area agency on aging expending such funds in contravention of
18such procedures, laws, rules and regulations, not the state,
19shall be liable for such repayment.
204. Of the funds appropriated in this section, at least
21$600,000 shall be used to fund home and community-based
22services through the area agencies on aging that enable older
23individuals to avoid more costly utilization of residential or
24institutional services and remain in their own homes.
255. Of the funds appropriated in this section, $812,000 shall
26be used for the purposes of chapter 231E and to administer
27the prevention of elder abuse, neglect, and exploitation
28program pursuant to section 231.56A, in accordance with the
29requirements of the federal Older Americans Act of 1965, 42
30U.S.C.§3001 et seq., as amended.
316. Of the funds appropriated in this section, $1,000,000
32shall be used to fund continuation of the aging and disability
33resource center lifelong links to provide individuals and
34caregivers with information and services to plan for and
35maintain independence.
-2- 17. Of the funds appropriated in this section, $250,000
2shall be used by the department on aging, in collaboration with
3the department of human services and affected stakeholders,
4to continue to expand the pilot initiative to provide
5long-term care options counseling utilizing support planning
6protocols, to assist non-Medicaid eligible consumers who
7indicate a preference to return to the community and are
8deemed appropriate for discharge, to return to their community
9following a nursing facility stay. The department on aging
10shall submit a report regarding the outcomes of the pilot
11initiative to the governor and the general assembly by December
1215, 2021.
13DIVISION II
14OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2021-2022
15 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
16appropriated from the general fund of the state to the office
17of long-term care ombudsman for the fiscal year beginning July
181, 2021, and ending June 30, 2022, the following amount, or
19so much thereof as is necessary, to be used for the purposes
20designated:
21For salaries, support, administration, maintenance, and
22miscellaneous purposes:
.................................................. $231,149,821
24DIVISION III
25DEPARTMENT OF PUBLIC HEALTH — FY 2021-2022
26 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
27from the general fund of the state to the department of public
28health for the fiscal year beginning July 1, 2021, and ending
29June 30, 2022, the following amounts, or so much thereof as is
30necessary, to be used for the purposes designated:
311. ADDICTIVE DISORDERS
32For reducing the prevalence of the use of tobacco, alcohol,
33and other drugs, and treating individuals affected by addictive
34behaviors, including gambling:
.................................................. $3523,659,379
-3- 1a. Of the funds appropriated in this subsection, $4,020,894
2shall be used for the tobacco use prevention and control
3initiative, including efforts at the state and local levels,
4as provided in chapter 142A. The commission on tobacco use
5prevention and control established pursuant to section 142A.3
6shall advise the director of public health in prioritizing
7funding needs and the allocation of moneys appropriated for
8the programs and initiatives. Activities of the programs
9and initiatives shall be in alignment with the United States
10centers for disease control and prevention best practices
11for comprehensive tobacco control programs that include
12the goals of preventing youth initiation of tobacco usage,
13reducing exposure to secondhand smoke, and promotion of tobacco
14cessation.
15b. (1) Of the funds appropriated in this subsection,
16$19,638,485 shall be used for problem gambling and
17substance-related disorder prevention, treatment, and recovery
18services, including a 24-hour helpline, public information
19resources, professional training, youth prevention, and program
20evaluation.
21(2) Of the amount allocated under this paragraph, $306,000
22shall be utilized by the department of public health, in
23collaboration with the department of human services, to
24maintain a single statewide 24-hour crisis hotline for the Iowa
25children’s behavioral health system that incorporates warmline
26services which may be provided through expansion of existing
27capabilities maintained by the department of public health as
28required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
29c. The requirement of section 123.17, subsection 5, is met
30by the appropriations and allocations made in this division of
31this Act for purposes of substance-related disorder treatment
32and addictive disorders for the fiscal year beginning July 1,
332021.
342. HEALTHY CHILDREN AND FAMILIES
35For promoting the optimum health status for children and
-4-1adolescents from birth through 21 years of age, and families:
.................................................. $25,816,681
33. CHRONIC CONDITIONS
4For serving individuals identified as having chronic
5conditions or special health care needs:
.................................................. $64,223,373
74. COMMUNITY CAPACITY
8For strengthening the health care delivery system at the
9local level:
.................................................. $106,794,306
11a. Of the funds appropriated in this subsection, $2,000,000
12shall be deposited in the medical residency training account
13created in section 135.175, subsection 5, paragraph “a”, and
14is appropriated from the account to the department of public
15health to be used for the purposes of the medical residency
16training state matching grants program as specified in section
17135.176.
18b. Of the funds appropriated in this subsection, $250,000
19shall be used for the public purpose of providing funding to
20Des Moines university to continue a provider education project
21to provide primary care physicians with the training and skills
22necessary to recognize the signs of mental illness in patients.
23c. Of the funds appropriated in this subsection, $600,000
24shall be used for rural psychiatric residencies to support the
25annual creation and training of four psychiatric residents who
26will provide mental health services in underserved areas of
27the state. Notwithstanding section 8.33, moneys that remain
28unencumbered or unobligated at the close of the fiscal year
29shall not revert but shall remain available for expenditure for
30the purposes designated for subsequent fiscal years.
31d. Of the funds appropriated in this subsection, $1,000,000
32shall be used for the creation of two centers of excellence
33programs to encourage innovation and collaboration among
34regional health care providers to transform health care
35delivery in order to provide quality, sustainable care that
-5-1meets the needs of local communities.
25. ESSENTIAL PUBLIC HEALTH SERVICES
3To provide public health services that reduce risks and
4invest in promoting and protecting good health over the
5course of a lifetime with a priority given to older Iowans and
6vulnerable populations:
.................................................. $77,662,464
86. INFECTIOUS DISEASES
9For reducing the incidence and prevalence of communicable
10diseases:
.................................................. $111,796,206
127. PUBLIC PROTECTION
13For protecting the health and safety of the public through
14establishing standards and enforcing regulations:
.................................................. $154,466,601
16Of the funds appropriated in this subsection, not more than
17$304,000 shall be credited to the emergency medical services
18fund created in section 135.25. Moneys in the emergency
19medical services fund are appropriated to the department to be
20used for the purposes of the fund.
218. RESOURCE MANAGEMENT
22For establishing and sustaining the overall ability of the
23department to deliver services to the public:
.................................................. $24933,871
259. MISCELLANEOUS PROVISIONS
26The university of Iowa hospitals and clinics under the
27control of the state board of regents shall not receive
28indirect costs from the funds appropriated in this section.
29The university of Iowa hospitals and clinics billings to the
30department shall be on at least a quarterly basis.
31 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
32RECEIPTS FUND. There is appropriated from the sports wagering
33receipts fund created in section 8.57, subsection 6, to the
34department of public health for the fiscal year beginning July
351, 2021, and ending June 30, 2022, the following amount, or
-6-1so much thereof as is necessary, to be used for the purposes
2designated:
3For problem gambling and substance-related disorder
4prevention, treatment, and recovery services, including a
524-hour helpline, public information resources, professional
6training, youth prevention, and program evaluation:
.................................................. $71,750,000
8DIVISION IV
9DEPARTMENT OF VETERANS AFFAIRS — FY 2021-2022
10 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
11appropriated from the general fund of the state to the
12department of veterans affairs for the fiscal year beginning
13July 1, 2021, and ending June 30, 2022, the following amounts,
14or so much thereof as is necessary, to be used for the purposes
15designated:
161. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
17For salaries, support, maintenance, and miscellaneous
18purposes:
.................................................. $191,229,763
202. IOWA VETERANS HOME
21For salaries, support, maintenance, and miscellaneous
22purposes:
.................................................. $237,131,552
24a. The Iowa veterans home billings involving the department
25of human services shall be submitted to the department on at
26least a monthly basis.
27b. The Iowa veterans home expenditure report shall be
28submitted monthly to the general assembly.
29c. The Iowa veterans home shall continue to include in the
30annual discharge report applicant information to provide for
31the collection of demographic information including but not
32limited to the number of individuals applying for admission and
33admitted or denied admittance and the basis for the admission
34or denial; the age, gender, and race of such individuals;
35and the level of care for which such individuals applied for
-7-1admission including residential or nursing level of care.
23. HOME OWNERSHIP ASSISTANCE PROGRAM
3For transfer to the Iowa finance authority for the
4continuation of the home ownership assistance program for
5persons who are or were eligible members of the armed forces of
6the United States, pursuant to section 16.54:
.................................................. $72,000,000
8 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
9FUND STANDING APPROPRIATIONS. Notwithstanding the standing
10appropriation in section 35A.16 for the fiscal year beginning
11July 1, 2021, and ending June 30, 2022, the amount appropriated
12from the general fund of the state pursuant to that section
13for the following designated purposes shall not exceed the
14following amount:
15For the county commissions of veteran affairs fund under
16section 35A.16:
.................................................. $17990,000
18DIVISION V
19DEPARTMENT OF HUMAN SERVICES — FY 2021-2022
20 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
21GRANT. There is appropriated from the fund created in section
228.41 to the department of human services for the fiscal year
23beginning July 1, 2021, and ending June 30, 2022, from moneys
24received under the federal temporary assistance for needy
25families (TANF) block grant pursuant to the federal Personal
26Responsibility and Work Opportunity Reconciliation Act of 1996,
27Pub.L.No.104-193, and successor legislation, the following
28amounts, or so much thereof as is necessary, to be used for the
29purposes designated:
301. To be credited to the family investment program account
31and used for assistance under the family investment program
32under chapter 239B:
.................................................. $335,002,006
342. To be credited to the family investment program account
35and used for the job opportunities and basic skills (JOBS)
-8-1program and implementing family investment agreements in
2accordance with chapter 239B:
.................................................. $35,412,060
43. To be used for the family development and
5self-sufficiency grant program in accordance with section
6216A.107:
.................................................. $72,888,980
8Notwithstanding section 8.33, moneys appropriated in this
9subsection that remain unencumbered or unobligated at the close
10of the fiscal year shall not revert but shall remain available
11for expenditure for the purposes designated until the close of
12the succeeding fiscal year. However, unless such moneys are
13encumbered or obligated on or before September 30, 2022, the
14moneys shall revert.
154. For field operations:
.................................................. $1631,296,232
175. For general administration:
.................................................. $183,744,000
196. For state child care assistance:
.................................................. $2047,166,826
21a. Of the funds appropriated in this subsection,
22$26,205,412 is transferred to the child care and development
23block grant appropriation made by the Eighty-ninth General
24Assembly, 2021 session, for the federal fiscal year beginning
25October 1, 2021, and ending September 30, 2022. Of this
26amount, $200,000 shall be used for provision of educational
27opportunities to registered child care home providers in order
28to improve services and programs offered by this category
29of providers and to increase the number of providers. The
30department may contract with institutions of higher education
31or child care resource and referral centers to provide
32the educational opportunities. Allowable administrative
33costs under the contracts shall not exceed 5 percent. The
34application for a grant shall not exceed two pages in length.
35b. Any funds appropriated in this subsection remaining
-9-1unallocated shall be used for state child care assistance
2payments for families who are employed including but not
3limited to individuals enrolled in the family investment
4program.
57. For child and family services:
.................................................. $632,380,654
78. For child abuse prevention grants:
.................................................. $8125,000
99. For pregnancy prevention grants on the condition that
10family planning services are funded:
.................................................. $111,913,203
12Pregnancy prevention grants shall be awarded to programs
13in existence on or before July 1, 2021, if the programs have
14demonstrated positive outcomes. Grants shall be awarded to
15pregnancy prevention programs which are developed after July
161, 2021, if the programs are based on existing models that
17have demonstrated positive outcomes. Grants shall comply with
18the requirements provided in 1997 Iowa Acts, chapter 208,
19section 14, subsections 1 and 2, including the requirement that
20grant programs must emphasize sexual abstinence. Priority in
21the awarding of grants shall be given to programs that serve
22areas of the state which demonstrate the highest percentage of
23unplanned pregnancies of females of childbearing age within the
24geographic area to be served by the grant.
2510. For technology needs and other resources necessary to
26meet federal, state, and welfare reform reporting, tracking,
27and case management requirements and other departmental needs:
.................................................. $281,037,186
2911. a. Notwithstanding any provision to the contrary,
30including but not limited to requirements in section 8.41 or
31provisions in 2020 Iowa Acts or 2021 Iowa Acts regarding the
32receipt and appropriation of federal block grants, federal
33funds from the temporary assistance for needy families block
34grant received by the state and not otherwise appropriated
35in this section and remaining available for the fiscal year
-10-1beginning July 1, 2021, are appropriated to the department of
2human services to the extent as may be necessary to be used in
3the following priority order: the family investment program,
4for state child care assistance program payments for families
5who are employed, and for the family investment program share
6of system costs for eligibility determination and related
7functions. The federal funds appropriated in this paragraph
8“a” shall be expended only after all other funds appropriated
9in subsection 1 for assistance under the family investment
10program, in subsection 6 for state child care assistance, or
11in subsection 10 for technology costs related to the family
12investment program, as applicable, have been expended. For
13the purposes of this subsection, the funds appropriated in
14subsection 6, paragraph “a”, for transfer to the child care
15and development block grant appropriation are considered fully
16expended when the full amount has been transferred.
17b. The department shall, on a quarterly basis, advise the
18legislative services agency and department of management of
19the amount of funds appropriated in this subsection that was
20expended in the prior quarter.
2112. Of the amounts appropriated in this section,
22$12,962,008 for the fiscal year beginning July 1, 2021, is
23transferred to the appropriation of the federal social services
24block grant made to the department of human services for that
25fiscal year.
2613. For continuation of the program providing categorical
27eligibility for the food assistance program as specified
28for the program in the section of this division of this Act
29relating to the family investment program account:
.................................................. $3014,236
3114. The department may transfer funds allocated in this
32section to the appropriations made in this division of this Act
33for the same fiscal year for general administration and field
34operations for resources necessary to implement and operate the
35services referred to in this section and those funded in the
-11-1appropriation made in this division of this Act for the same
2fiscal year for the family investment program from the general
3fund of the state.
415. With the exception of moneys allocated under this
5section for the family development and self-sufficiency grant
6program, to the extent moneys allocated in this section are
7deemed by the department not to be necessary to support the
8purposes for which they are allocated, such moneys may be
9used in the same fiscal year for any other purpose for which
10funds are allocated in this section or in section 8 of this
11division for the family investment program account. If there
12are conflicting needs, priority shall first be given to the
13family investment program account as specified under subsection
141 of this section and used for the purposes of assistance under
15the family investment program in accordance with chapter 239B,
16followed by state child care assistance program payments for
17families who are employed, followed by other priorities as
18specified by the department.
19 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
201. Moneys credited to the family investment program (FIP)
21account for the fiscal year beginning July 1, 2021, and
22ending June 30, 2022, shall be used to provide assistance in
23accordance with chapter 239B.
242. The department may use a portion of the moneys credited
25to the FIP account under this section as necessary for
26salaries, support, maintenance, and miscellaneous purposes.
273. The department may transfer funds allocated in
28subsection 4, excluding the allocation under subsection 4,
29paragraph “b”, to the appropriations made in this division of
30this Act for the same fiscal year for general administration
31and field operations for resources necessary to implement
32and operate the services referred to in this section and
33those funded in the appropriations made in section 7 for the
34temporary assistance for needy families block grant and in
35section 9 for the family investment program from the general
-12-1fund of the state in this division of this Act for the same
2fiscal year.
34. Moneys appropriated in this division of this Act and
4credited to the FIP account for the fiscal year beginning July
51, 2021, and ending June 30, 2022, are allocated as follows:
6a. To be retained by the department of human services to
7be used for coordinating with the department of human rights
8to more effectively serve participants in FIP and other shared
9clients and to meet federal reporting requirements under the
10federal temporary assistance for needy families block grant:
.................................................. $1110,000
12b. To the department of human rights for staffing,
13administration, and implementation of the family development
14and self-sufficiency grant program in accordance with section
15216A.107:
.................................................. $166,192,834
17(1) Of the funds allocated for the family development
18and self-sufficiency grant program in this paragraph “b”,
19not more than 5 percent of the funds shall be used for the
20administration of the grant program.
21(2) The department of human rights may continue to implement
22the family development and self-sufficiency grant program
23statewide during fiscal year 2021-2022.
24(3) The department of human rights may engage in activities
25to strengthen and improve family outcomes measures and
26data collection systems under the family development and
27self-sufficiency grant program.
28c. For the diversion subaccount of the FIP account:
.................................................. $291,293,000
30A portion of the moneys allocated for the diversion
31subaccount may be used for field operations, salaries, data
32management system development, and implementation costs and
33support deemed necessary by the director of human services
34in order to administer the FIP diversion program. To the
35extent moneys allocated in this paragraph “c” are deemed by the
-13-1department not to be necessary to support diversion activities,
2such moneys may be used for other efforts intended to increase
3engagement by family investment program participants in work,
4education, or training activities, or for the purposes of
5assistance under the family investment program in accordance
6with chapter 239B.
7d. For the food assistance employment and training program:
.................................................. $866,588
9(1) The department shall apply the federal supplemental
10nutrition assistance program (SNAP) employment and training
11state plan in order to maximize to the fullest extent permitted
12by federal law the use of the 50 percent federal reimbursement
13provisions for the claiming of allowable federal reimbursement
14funds from the United States department of agriculture
15pursuant to the federal SNAP employment and training program
16for providing education, employment, and training services
17for eligible food assistance program participants, including
18but not limited to related dependent care and transportation
19expenses.
20(2) The department shall continue the categorical federal
21food assistance program eligibility at 160 percent of the
22federal poverty level and continue to eliminate the asset test
23from eligibility requirements, consistent with federal food
24assistance program requirements. The department shall include
25as many food assistance households as is allowed by federal
26law. The eligibility provisions shall conform to all federal
27requirements including requirements addressing individuals who
28are incarcerated or otherwise ineligible.
29e. For the JOBS program, not more than:
.................................................. $3012,018,258
315. Of the child support collections assigned under FIP,
32an amount equal to the federal share of support collections
33shall be credited to the child support recovery appropriation
34made in this division of this Act. Of the remainder of the
35assigned child support collections received by the child
-14-1support recovery unit, a portion shall be credited to the FIP
2account, a portion may be used to increase recoveries, and a
3portion may be used to sustain cash flow in the child support
4payments account. If as a consequence of the appropriations
5and allocations made in this section the resulting amounts
6are insufficient to sustain cash assistance payments and meet
7federal maintenance of effort requirements, the department
8shall seek supplemental funding. If child support collections
9assigned under FIP are greater than estimated or are otherwise
10determined not to be required for maintenance of effort, the
11state share of either amount may be transferred to or retained
12in the child support payments account.
13 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
14is appropriated from the general fund of the state to the
15department of human services for the fiscal year beginning July
161, 2021, and ending June 30, 2022, the following amount, or
17so much thereof as is necessary, to be used for the purpose
18designated:
19To be credited to the family investment program (FIP)
20account and used for family investment program assistance
21under chapter 239B and other costs associated with providing
22needs-based benefits or assistance:
.................................................. $2340,003,978
241. Of the funds appropriated in this section, $6,606,198 is
25allocated for the JOBS program.
262. Of the funds appropriated in this section, $3,313,854 is
27allocated for the family development and self-sufficiency grant
28program.
293. a. Notwithstanding section 8.39, for the fiscal
30year beginning July 1, 2021, if necessary to meet federal
31maintenance of effort requirements or to transfer federal
32temporary assistance for needy families block grant funding
33to be used for purposes of the federal social services block
34grant or to meet cash flow needs resulting from delays in
35receiving federal funding or to implement, in accordance with
-15-1this division of this Act, activities currently funded with
2juvenile court services, county, or community moneys and state
3moneys used in combination with such moneys; to comply with
4federal requirements; or to maximize the use of federal funds;
5the department of human services may transfer funds within or
6between any of the appropriations made in this division of this
7Act and appropriations in law for the federal social services
8block grant to the department for the following purposes,
9provided that the combined amount of state and federal
10temporary assistance for needy families block grant funding
11for each appropriation remains the same before and after the
12transfer:
13(1) For the family investment program.
14(2) For state child care assistance.
15(3) For child and family services.
16(4) For field operations.
17(5) For general administration.
18b. This subsection shall not be construed to prohibit the
19use of existing state transfer authority for other purposes.
20The department shall report any transfers made pursuant to this
21subsection to the general assembly.
224. Of the funds appropriated in this section, $195,000
23shall be used for a contract for tax preparation assistance
24to low-income Iowans to expand the usage of the earned income
25tax credit. The purpose of the contract is to supply this
26assistance to underserved areas of the state. The department
27shall not retain any portion of the allocation under this
28subsection for administrative costs.
295. Of the funds appropriated in this section, $70,000 shall
30be used for the continuation of the parenting program, as
31specified in 441 IAC ch.100, relating to parental obligations,
32in which the child support recovery unit participates, to
33support the efforts of a nonprofit organization committed
34to strengthening the community through youth development,
35healthy living, and social responsibility headquartered in
-16-1a county with a population over 350,000 according to the
2latest certified federal census. The funds allocated in this
3subsection shall be used by the recipient organization to
4develop a larger community effort, through public and private
5partnerships, to support a broad-based multi-county parenthood
6initiative that promotes payment of child support obligations,
7improved family relationships, and full-time employment.
86. The department may transfer funds appropriated in this
9section, excluding the allocation in subsection 2 for the
10family development and self-sufficiency grant program, to the
11appropriations made in this division of this Act for general
12administration and field operations as necessary to administer
13this section, section 7 for the temporary assistance for needy
14families block grant, and section 8 for the family investment
15program account.
16 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
17from the general fund of the state to the department of human
18services for the fiscal year beginning July 1, 2021, and ending
19June 30, 2022, the following amount, or so much thereof as is
20necessary, to be used for the purposes designated:
21For child support recovery, including salaries, support,
22maintenance, and miscellaneous purposes:
.................................................. $2315,942,885
241. The department shall expend up to $24,000, including
25federal financial participation, for the fiscal year beginning
26July 1, 2021, for a child support public awareness campaign.
27The department and the office of the attorney general shall
28cooperate in continuation of the campaign. The public
29awareness campaign shall emphasize, through a variety of
30media activities, the importance of maximum involvement of
31both parents in the lives of their children as well as the
32importance of payment of child support obligations.
332. Federal access and visitation grant moneys shall be
34issued directly to private not-for-profit agencies that provide
35services designed to increase compliance with the child access
-17-1provisions of court orders, including but not limited to
2neutral visitation sites and mediation services.
33. The appropriation made to the department for child
4support recovery may be used throughout the fiscal year in the
5manner necessary for purposes of cash flow management, and for
6cash flow management purposes the department may temporarily
7draw more than the amount appropriated, provided the amount
8appropriated is not exceeded at the close of the fiscal year.
9 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
10FY 2021-2022. Any funds remaining in the health care trust
11fund created in section 453A.35A for the fiscal year beginning
12July 1, 2021, and ending June 30, 2022, are appropriated to
13the department of human services to supplement the medical
14assistance program appropriations made in this division of this
15Act, for medical assistance reimbursement and associated costs,
16including program administration and costs associated with
17program implementation.
18 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
192021-2022. Any funds remaining in the Medicaid fraud fund
20created in section 249A.50 for the fiscal year beginning
21July 1, 2021, and ending June 30, 2022, are appropriated to
22the department of human services to supplement the medical
23assistance appropriations made in this division of this Act,
24for medical assistance reimbursement and associated costs,
25including program administration and costs associated with
26program implementation.
27 Sec. 13. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES
28FUND — FY 2021-2022. There is appropriated from the general
29fund of the state to the department of human services for the
30fiscal year beginning July 1, 2021, and ending June 30, 2022,
31the following amount, or so much thereof as is necessary, to be
32used for the purpose designated:
33For transfer to the mental health and disability regional
34services fund created in section 225C.7A, or a successor fund:
.................................................. $3515,000,000
-18- 1Moneys transferred to the mental health and disability
2regional services fund under this section are appropriated to
3the department of human services for distribution to regions
4for funding of mental health and disability services in
5accordance with section 225C.7A.
6 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the
7general fund of the state to the department of human services
8for the fiscal year beginning July 1, 2021, and ending June 30,
92022, the following amount, or so much thereof as is necessary,
10to be used for the purpose designated:
11For medical assistance program reimbursement and associated
12costs as specifically provided in the reimbursement
13methodologies in effect on June 30, 2021, except as otherwise
14expressly authorized by law, consistent with options under
15federal law and regulations, and contingent upon receipt of
16approval from the office of the governor of reimbursement for
17each abortion performed under the program:
.................................................. $181,481,499,409
191. Iowans support reducing the number of abortions
20performed in our state. Funds appropriated under this section
21shall not be used for abortions, unless otherwise authorized
22under this section.
232. The provisions of this section relating to abortions
24shall also apply to the Iowa health and wellness plan created
25pursuant to chapter 249N.
263. The department shall utilize not more than $60,000 of
27the funds appropriated in this section to continue the AIDS/HIV
28health insurance premium payment program as established in 1992
29Iowa Acts, Second Extraordinary Session, chapter 1001, section
30409, subsection 6. Of the funds allocated in this subsection,
31not more than $5,000 may be expended for administrative
32purposes.
334. Of the funds appropriated in this Act to the department
34of public health for addictive disorders, $950,000 for
35the fiscal year beginning July 1, 2021, is transferred
-19-1to the department of human services for an integrated
2substance-related disorder managed care system. The
3departments of human services and public health shall
4work together to maintain the level of mental health and
5substance-related disorder treatment services provided by the
6managed care contractors. Each department shall take the steps
7necessary to continue the federal waivers as necessary to
8maintain the level of services.
95. The department shall aggressively pursue options for
10providing medical assistance or other assistance to individuals
11with special needs who become ineligible to continue receiving
12services under the early and periodic screening, diagnostic,
13and treatment program under the medical assistance program
14due to becoming 21 years of age who have been approved for
15additional assistance through the department’s exception to
16policy provisions, but who have health care needs in excess
17of the funding available through the exception to policy
18provisions.
196. Of the funds appropriated in this section, up to
20$3,050,082 may be transferred to the field operations or
21general administration appropriations in this division of this
22Act for operational costs associated with Part D of the federal
23Medicare Prescription Drug Improvement and Modernization Act
24of 2003, Pub.L.No.108-173.
257. Of the funds appropriated in this section, up to $442,100
26may be transferred to the appropriation in this division of
27this Act for health program operations to be used for clinical
28assessment services and prior authorization of services.
298. A portion of the funds appropriated in this section may
30be transferred to the appropriations in this division of this
31Act for general administration, health program operations, the
32children’s health insurance program, or field operations to be
33used for the state match cost to comply with the payment error
34rate measurement (PERM) program for both the medical assistance
35and children’s health insurance programs as developed by the
-20-1centers for Medicare and Medicaid services of the United States
2department of health and human services to comply with the
3federal Improper Payments Information Act of 2002, Pub.L.
4No.107-300, and to support other reviews and quality control
5activities to improve the integrity of these programs.
69. Of the funds appropriated in this section, a sufficient
7amount is allocated to supplement the incomes of residents of
8nursing facilities, intermediate care facilities for persons
9with mental illness, and intermediate care facilities for
10persons with an intellectual disability, with incomes of less
11than $50 in the amount necessary for the residents to receive a
12personal needs allowance of $50 per month pursuant to section
13249A.30A.
1410. a. Hospitals that meet the conditions specified
15in subparagraphs (1) and (2) shall either certify public
16expenditures or transfer to the medical assistance program
17an amount equal to provide the nonfederal share for a
18disproportionate share hospital payment in an amount up to the
19hospital-specific limit as approved in the Medicaid state plan.
20The hospitals that meet the conditions specified shall receive
21and retain 100 percent of the total disproportionate share
22hospital payment in an amount up to the hospital-specific limit
23as approved in the Medicaid state plan.
24(1) The hospital qualifies for disproportionate share and
25graduate medical education payments.
26(2) The hospital is an Iowa state-owned hospital with more
27than 500 beds and eight or more distinct residency specialty
28or subspecialty programs recognized by the American college of
29graduate medical education.
30b. Distribution of the disproportionate share payments
31shall be made on a monthly basis. The total amount of
32disproportionate share payments including graduate medical
33education, enhanced disproportionate share, and Iowa
34state-owned teaching hospital payments shall not exceed the
35amount of the state’s allotment under Pub.L.No.102-234.
-21-1In addition, the total amount of all disproportionate
2share payments shall not exceed the hospital-specific
3disproportionate share limits under Pub.L.No.103-66.
411. One hundred percent of the nonfederal share of payments
5to area education agencies that are medical assistance
6providers for medical assistance-covered services provided to
7medical assistance-covered children, shall be made from the
8appropriation made in this section.
912. A portion of the funds appropriated in this section may
10be transferred to the appropriation in this division of this
11Act for health program operations to be used for administrative
12activities associated with the money follows the person
13demonstration project.
1413. Of the funds appropriated in this section, $349,011
15shall be used for the administration of the health insurance
16premium payment program, including salaries, support,
17maintenance, and miscellaneous purposes.
1814. a. The department may increase the amounts allocated
19for salaries, support, maintenance, and miscellaneous purposes
20associated with the medical assistance program, as necessary,
21to sustain cost management efforts. The department shall
22report any such increase to the general assembly and the
23department of management.
24b. If the savings to the medical assistance program from
25ongoing cost management efforts exceed the associated cost
26for the fiscal year beginning July 1, 2021, the department
27may transfer any savings generated for the fiscal year due
28to medical assistance program cost management efforts to the
29appropriation made in this division of this Act for health
30program operations or general administration to defray the
31costs associated with implementing the efforts.
3215. For the fiscal year beginning July 1, 2021, and ending
33June 30, 2022, the replacement generation tax revenues required
34to be deposited in the property tax relief fund pursuant to
35section 437A.8, subsection 4, paragraph “d”, and section
-22-1437A.15, subsection 3, paragraph “f”, shall instead be credited
2to and supplement the appropriation made in this section and
3used for the allocations made in this section.
416. a. Of the funds appropriated in this section, up
5to $50,000 may be transferred by the department to the
6appropriation made in this division of this Act to the
7department for the same fiscal year for general administration
8to be used for associated administrative expenses.
9b. Of the funds appropriated in this section, up to $400,000
10may be transferred by the department to the appropriation made
11to the department in this division of this Act for the same
12fiscal year for Medicaid program-related general administration
13planning and implementation activities. The funds may be used
14for contracts or for personnel in addition to the amounts
15appropriated for general administration for the fiscal year.
16c. Of the funds appropriated in this section, up to
17$3,000,000 may be transferred by the department to the
18appropriations made in this division of this Act for the
19same fiscal year for general administration or health
20program operations to be used to support the development
21and implementation of standardized assessment tools for
22persons with mental illness, an intellectual disability, a
23developmental disability, or a brain injury.
2417. Of the funds appropriated in this section, $150,000
25shall be used for lodging expenses associated with care
26provided at the university of Iowa hospitals and clinics for
27patients with cancer whose travel distance is 30 miles or more
28and whose income is at or below 200 percent of the federal
29poverty level as defined by the most recently revised poverty
30income guidelines published by the United States department of
31health and human services. The department of human services
32shall establish the maximum number of overnight stays and the
33maximum rate reimbursed for overnight lodging, which may be
34based on the state employee rate established by the department
35of administrative services. The funds allocated in this
-23-1subsection shall not be used as nonfederal share matching
2funds.
318. Of the funds appropriated in this section, up to
4$3,383,880 shall be used for administration of the state family
5planning services program pursuant to section 217.41B, and
6of this amount, the department may use up to $200,000 for
7administrative expenses.
819. Of the funds appropriated in this section, $1,545,530
9shall be used and may be transferred to other appropriations
10in this division of this Act as necessary to administer the
11provisions in the division of this Act relating to Medicaid
12program administration.
13 Sec. 15. HEALTH PROGRAM OPERATIONS. There is appropriated
14from the general fund of the state to the department of human
15services for the fiscal year beginning July 1, 2021, and ending
16June 30, 2022, the following amount, or so much thereof as is
17necessary, to be used for the purpose designated:
18For health program operations:
.................................................. $1917,831,343
201. The department of inspections and appeals shall
21provide all state matching funds for survey and certification
22activities performed by the department of inspections
23and appeals. The department of human services is solely
24responsible for distributing the federal matching funds for
25such activities.
262. Of the funds appropriated in this section, $50,000 shall
27be used for continuation of home and community-based services
28waiver quality assurance programs, including the review and
29streamlining of processes and policies related to oversight and
30quality management to meet state and federal requirements.
313. Of the amount appropriated in this section, up to
32$200,000 may be transferred to the appropriation for general
33administration in this division of this Act to be used for the
34development of key health initiatives such as development and
35oversight of managed care programs and development of health
-24-1strategies targeted toward improved quality and reduced costs
2in the Medicaid program.
34. Of the funds appropriated in this section, $1,000,000
4shall be used for planning and development, in cooperation with
5the department of public health, of a phased-in program to
6provide a dental home for children.
75. a. Of the funds appropriated in this section, $573,000
8shall be credited to the autism support program fund created
9in section 225D.2 to be used for the autism support program
10created in chapter 225D, with the exception of the following
11amount of this allocation which shall be used as follows:
12b. Of the funds allocated in this subsection, $25,000 shall
13be used for the public purpose of continuation of a grant to a
14nonprofit provider of child welfare services that has been in
15existence for more than 115 years, is located in a county with
16a population between 200,000 and 220,000 according to the most
17recent federal decennial census, is licensed as a psychiatric
18medical institution for children, and provides school-based
19programming, to be used for support services for children with
20autism spectrum disorder and their families.
21 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2021, and ending June 30, 2022, the following
25amount, or so much thereof as is necessary, to be used for the
26purpose designated:
27For the state supplementary assistance program:
.................................................. $287,349,002
292. The department shall increase the personal needs
30allowance for residents of residential care facilities by the
31same percentage and at the same time as federal supplemental
32security income and federal social security benefits are
33increased due to a recognized increase in the cost of living.
34The department may adopt emergency rules to implement this
35subsection.
-25- 13. If during the fiscal year beginning July 1, 2021,
2the department projects that state supplementary assistance
3expenditures for a calendar year will not meet the federal
4pass-through requirement specified in Tit.XVI of the federal
5Social Security Act, section 1618, as codified in 42 U.S.C.
6§1382g, the department may take actions including but not
7limited to increasing the personal needs allowance for
8residential care facility residents and making programmatic
9adjustments or upward adjustments of the residential care
10facility or in-home health-related care reimbursement rates
11prescribed in this division of this Act to ensure that federal
12requirements are met. In addition, the department may make
13other programmatic and rate adjustments necessary to remain
14within the amount appropriated in this section while ensuring
15compliance with federal requirements. The department may adopt
16emergency rules to implement the provisions of this subsection.
174. Notwithstanding section 8.33, moneys appropriated
18in this section that remain unencumbered or unobligated
19at the close of the fiscal year shall not revert but
20shall remain available for expenditure for the purposes
21designated, including for liability amounts associated with the
22supplemental nutrition assistance program payment error rate,
23until the close of the succeeding fiscal year.
24 Sec. 17. CHILDREN’S HEALTH INSURANCE PROGRAM.
251. There is appropriated from the general fund of the
26state to the department of human services for the fiscal year
27beginning July 1, 2021, and ending June 30, 2022, the following
28amount, or so much thereof as is necessary, to be used for the
29purpose designated:
30For maintenance of the healthy and well kids in Iowa (hawk-i)
31program pursuant to chapter 514I, including supplemental dental
32services, for receipt of federal financial participation under
33Tit.XXI of the federal Social Security Act, which creates the
34children’s health insurance program:
.................................................. $3540,460,555
-26- 12. Of the funds appropriated in this section, $149,189 is
2allocated for continuation of the contract for outreach with
3the department of public health.
43. A portion of the funds appropriated in this section may
5be transferred to the appropriations made in this division of
6this Act for field operations or health program operations to
7be used for the integration of hawk-i program eligibility,
8payment, and administrative functions under the purview of
9the department of human services, including for the Medicaid
10management information system upgrade.
11 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated
12from the general fund of the state to the department of human
13services for the fiscal year beginning July 1, 2021, and ending
14June 30, 2022, the following amount, or so much thereof as is
15necessary, to be used for the purpose designated:
16For child care programs:
.................................................. $1740,816,931
181. Of the funds appropriated in this section, $34,966,931
19shall be used for state child care assistance in accordance
20with section 237A.13.
212. Nothing in this section shall be construed or is
22intended as or shall imply a grant of entitlement for services
23to persons who are eligible for assistance due to an income
24level consistent with the waiting list requirements of section
25237A.13. Any state obligation to provide services pursuant to
26this section is limited to the extent of the funds appropriated
27in this section.
283. A list of the registered and licensed child care
29facilities operating in the area served by a child care
30resource and referral service shall be made available to the
31families receiving state child care assistance in that area.
324. Of the funds appropriated in this section, $5,850,000
33shall be credited to the early childhood programs grants
34account in the early childhood Iowa fund created in section
35256I.11. The moneys shall be distributed for funding of
-27-1community-based early childhood programs targeted to children
2from birth through five years of age developed by early
3childhood Iowa areas in accordance with approved community
4plans as provided in section 256I.8.
55. The department may use any of the funds appropriated
6in this section as a match to obtain federal funds for use in
7expanding child care assistance and related programs. For
8the purpose of expenditures of state and federal child care
9funding, funds shall be considered obligated at the time
10expenditures are projected or are allocated to the department’s
11service areas. Projections shall be based on current and
12projected caseload growth, current and projected provider
13rates, staffing requirements for eligibility determination
14and management of program requirements including data systems
15management, staffing requirements for administration of the
16program, contractual and grant obligations and any transfers
17to other state agencies, and obligations for decategorization
18or innovation projects.
196. A portion of the state match for the federal child care
20and development block grant shall be provided as necessary to
21meet federal matching funds requirements through the state
22general fund appropriation made for child development grants
23and other programs for at-risk children in section 279.51.
247. If a uniform reduction ordered by the governor under
25section 8.31 or other operation of law, transfer, or federal
26funding reduction reduces the appropriation made in this
27section for the fiscal year, the percentage reduction in the
28amount paid out to or on behalf of the families participating
29in the state child care assistance program shall be equal to or
30less than the percentage reduction made for any other purpose
31payable from the appropriation made in this section and the
32federal funding relating to it. The percentage reduction to
33the other allocations made in this section shall be the same as
34the uniform reduction ordered by the governor or the percentage
35change of the federal funding reduction, as applicable. If
-28-1there is an unanticipated increase in federal funding provided
2for state child care services, the entire amount of the
3increase, except as necessary to meet federal requirements
4including quality set asides, shall be used for state child
5care assistance payments. If the appropriations made for
6purposes of the state child care assistance program for the
7fiscal year are determined to be insufficient, it is the intent
8of the general assembly to appropriate sufficient funding for
9the fiscal year in order to avoid establishment of waiting list
10requirements.
118. Notwithstanding section 8.33, moneys advanced for
12purposes of the programs developed by early childhood Iowa
13areas, advanced for purposes of wraparound child care, or
14received from the federal appropriations made for the purposes
15of this section that remain unencumbered or unobligated at the
16close of the fiscal year shall not revert to any fund but shall
17remain available for expenditure for the purposes designated
18until the close of the succeeding fiscal year.
19 Sec. 19. JUVENILE INSTITUTION. There is appropriated
20from the general fund of the state to the department of human
21services for the fiscal year beginning July 1, 2021, and ending
22June 30, 2022, the following amounts, or so much thereof as is
23necessary, to be used for the purposes designated:
241. a. For operation of the state training school at Eldora
25and for salaries, support, maintenance, and miscellaneous
26purposes:
.................................................. $2717,397,068
28b. Of the funds appropriated in this subsection, $91,000
29shall be used for distribution to licensed classroom teachers
30at this and other institutions under the control of the
31department of human services based upon the average student
32yearly enrollment at each institution as determined by the
33department.
342. A portion of the moneys appropriated in this section
35shall be used by the state training school at Eldora for
-29-1grants for adolescent pregnancy prevention activities at the
2institution in the fiscal year beginning July 1, 2021.
33. Of the funds appropriated in this subsection, $212,000
4shall be used by the state training school at Eldora for a
5substance use disorder treatment program at the institution for
6the fiscal year beginning July 1, 2021.
74. Notwithstanding section 8.33, moneys appropriated in
8this section that remain unencumbered or unobligated at the
9close of the fiscal year shall not revert but shall remain
10available for expenditure for the purposes designated until the
11close of the succeeding fiscal year.
12 Sec. 20. CHILD AND FAMILY SERVICES.
131. There is appropriated from the general fund of the
14state to the department of human services for the fiscal year
15beginning July 1, 2021, and ending June 30, 2022, the following
16amount, or so much thereof as is necessary, to be used for the
17purpose designated:
18For child and family services:
.................................................. $1989,071,930
202. The department may transfer funds appropriated in this
21section as necessary to pay the nonfederal costs of services
22reimbursed under the medical assistance program, state child
23care assistance program, or the family investment program which
24are provided to children who would otherwise receive services
25paid under the appropriation in this section. The department
26may transfer funds appropriated in this section to the
27appropriations made in this division of this Act for general
28administration and for field operations for resources necessary
29to implement and operate the services funded in this section.
303. a. Of the funds appropriated in this section, up to
31$31,500,000 is allocated as the statewide expenditure target
32under section 232.143 for group foster care maintenance and
33services. If the department projects that such expenditures
34for the fiscal year will be less than the target amount
35allocated in this paragraph “a”, the department may reallocate
-30-1the excess to provide additional funding for family foster
2care, independent living, family-centered services, shelter
3care, or the child welfare emergency services addressed with
4the allocation for shelter care.
5b. If at any time after September 30, 2021, annualization
6of a service area’s current expenditures indicates a service
7area is at risk of exceeding its group foster care expenditure
8target under section 232.143 by more than 5 percent, the
9department and juvenile court services shall examine all
10group foster care placements in that service area in order to
11identify those which might be appropriate for termination.
12In addition, any aftercare services believed to be needed
13for the children whose placements may be terminated shall be
14identified. The department and juvenile court services shall
15initiate action to set dispositional review hearings for the
16placements identified. In such a dispositional review hearing,
17the juvenile court shall determine whether needed aftercare
18services are available and whether termination of the placement
19is in the best interest of the child and the community.
204. In accordance with the provisions of section 232.188,
21the department shall continue the child welfare and juvenile
22justice funding initiative during fiscal year 2021-2022. Of
23the funds appropriated in this section, $1,717,000 is allocated
24specifically for expenditure for fiscal year 2021-2022 through
25the decategorization services funding pools and governance
26boards established pursuant to section 232.188.
275. A portion of the funds appropriated in this section
28may be used for emergency family assistance to provide other
29resources required for a family participating in a family
30preservation or reunification project or successor project to
31stay together or to be reunified.
326. Of the funds appropriated in this section, a sufficient
33amount is allocated for shelter care and the child welfare
34emergency services contracting implemented to provide for or
35prevent the need for shelter care.
-31- 17. Federal funds received by the state during the fiscal
2year beginning July 1, 2021, as the result of the expenditure
3of state funds appropriated during a previous state fiscal
4year for a service or activity funded under this section are
5appropriated to the department to be used as additional funding
6for services and purposes provided for under this section.
7Notwithstanding section 8.33, moneys received in accordance
8with this subsection that remain unencumbered or unobligated at
9the close of the fiscal year shall not revert to any fund but
10shall remain available for the purposes designated until the
11close of the succeeding fiscal year.
128. a. Of the funds appropriated in this section, up to
13$3,290,000 is allocated for the payment of the expenses of
14court-ordered services provided to juveniles who are under the
15supervision of juvenile court services, which expenses are a
16charge upon the state pursuant to section 232.141, subsection
174. Of the amount allocated in this paragraph “a”, up to
18$1,556,000 shall be made available to provide school-based
19supervision of children adjudicated under chapter 232, of which
20not more than $15,000 may be used for the purpose of training.
21A portion of the cost of each school-based liaison officer
22shall be paid by the school district or other funding source as
23approved by the chief juvenile court officer.
24b. Of the funds appropriated in this section, up to $748,000
25is allocated for the payment of the expenses of court-ordered
26services provided to children who are under the supervision
27of the department, which expenses are a charge upon the state
28pursuant to section 232.141, subsection 4.
29c. Notwithstanding section 232.141 or any other provision
30of law to the contrary, the amounts allocated in this
31subsection shall be distributed to the judicial districts
32as determined by the state court administrator and to the
33department’s service areas as determined by the administrator
34of the department of human services’ division of child and
35family services. The state court administrator and the
-32-1division administrator shall make the determination of the
2distribution amounts on or before June 15, 2021.
3d. Notwithstanding chapter 232 or any other provision of
4law to the contrary, a district or juvenile court shall not
5order any service which is a charge upon the state pursuant
6to section 232.141 if there are insufficient court-ordered
7services funds available in the district court or departmental
8service area distribution amounts to pay for the service. The
9chief juvenile court officer and the departmental service area
10manager shall encourage use of the funds allocated in this
11subsection such that there are sufficient funds to pay for
12all court-related services during the entire year. The chief
13juvenile court officers and departmental service area managers
14shall attempt to anticipate potential surpluses and shortfalls
15in the distribution amounts and shall cooperatively request the
16state court administrator or division administrator to transfer
17funds between the judicial districts’ or departmental service
18areas’ distribution amounts as prudent.
19e. Notwithstanding any provision of law to the contrary,
20a district or juvenile court shall not order a county to pay
21for any service provided to a juvenile pursuant to an order
22entered under chapter 232 which is a charge upon the state
23under section 232.141, subsection 4.
24f. Of the funds allocated in this subsection, not more than
25$83,000 may be used by the judicial branch for administration
26of the requirements under this subsection.
27g. Of the funds allocated in this subsection, $17,000
28shall be used by the department of human services to support
29the interstate commission for juveniles in accordance with
30the interstate compact for juveniles as provided in section
31232.173.
329. Of the funds appropriated in this section, $12,253,000 is
33allocated for juvenile delinquent graduated sanctions services.
34Any state funds saved as a result of efforts by juvenile court
35services to earn a federal Tit.IV-E match for juvenile court
-33-1services administration may be used for the juvenile delinquent
2graduated sanctions services.
310. Of the funds appropriated in this section, $1,658,000 is
4transferred to the department of public health to be used for
5the child protection center grant program for child protection
6centers located in Iowa in accordance with section 135.118.
7The grant amounts under the program shall be equalized so that
8each center receives a uniform base amount of $245,000, and so
9that the remaining funds are awarded through a funding formula
10based upon the volume of children served. To increase access
11to child protection center services for children in rural
12areas, the funding formula for the awarding of the remaining
13funds shall provide for the awarding of an enhanced amount to
14eligible grantees to develop and maintain satellite centers in
15underserved regions of the state.
1611. Of the funds appropriated in this section, $4,025,000 is
17allocated for the preparation for adult living program pursuant
18to section 234.46.
1912. Of the funds appropriated in this section, $227,000
20shall be used for the public purpose of continuing a grant to a
21nonprofit human services organization, providing services to
22individuals and families in multiple locations in southwest
23Iowa and Nebraska for support of a project providing immediate,
24sensitive support and forensic interviews, medical exams, needs
25assessments, and referrals for victims of child abuse and their
26nonoffending family members.
2713. Of the funds appropriated in this section, $300,000
28is allocated for the foster care youth council approach of
29providing a support network to children placed in foster care.
3014. Of the funds appropriated in this section, $202,000 is
31allocated for use pursuant to section 235A.1 for continuation
32of the initiative to address child sexual abuse implemented
33pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
3421.
3515. Of the funds appropriated in this section, $630,000 is
-34-1allocated for the community partnership for child protection
2sites.
316. Of the funds appropriated in this section, $371,000
4is allocated for the department’s minority youth and family
5projects under the redesign of the child welfare system.
617. Of the funds appropriated in this section, $851,000
7is allocated for funding of the community circle of care
8collaboration for children and youth in northeast Iowa.
918. Of the funds appropriated in this section, at least
10$147,000 shall be used for the continuation of the child
11welfare provider training academy, a collaboration between the
12coalition for family and children’s services in Iowa and the
13department.
1419. Of the funds appropriated in this section, $211,000
15shall be used for continuation of the central Iowa system of
16care program grant through June 30, 2022.
1720. Of the funds appropriated in this section, $235,000
18shall be used for the public purpose of the continuation
19and expansion of a system of care program grant implemented
20in Cerro Gordo and Linn counties to utilize a comprehensive
21and long-term approach for helping children and families by
22addressing the key areas in a child’s life of childhood basic
23needs, education and work, family, and community.
2421. Of the funds appropriated in this section, $110,000
25shall be used for the public purpose of funding community-based
26services and other supports with a system of care approach
27for children with a serious emotional disturbance and their
28families through a nonprofit provider of child welfare services
29that has been in existence for more than 115 years, is located
30in a county with a population of more than 200,000 but less
31than 235,000 according to the latest certified federal census,
32is licensed as a psychiatric medical institution for children,
33and was a system of care grantee prior to July 1, 2021.
3422. If a separate funding source is identified that reduces
35the need for state funds within an allocation under this
-35-1section, the allocated state funds may be redistributed to
2other allocations under this section for the same fiscal year.
323. Of the funds appropriated in this section, a portion may
4be used for family-centered services for purposes of complying
5with the federal Family First Prevention Services Act of 2018,
6Pub.L. No.115-123, and successor legislation.
7 Sec. 21. ADOPTION SUBSIDY.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2021, and ending June 30, 2022, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13a. For adoption subsidy payments and related costs and for
14other services provided for under paragraph “b”, subparagraph
15(2):
.................................................. $1640,596,007
17b. (1) Of the funds appropriated in this section, a
18sufficient amount is allocated for adoption subsidy payments
19and related costs.
20(2) Any funds appropriated in this section remaining after
21the allocation under subparagraph (1) are designated and
22allocated as state savings resulting from implementation of
23the federal Fostering Connections to Success and Increasing
24Adoptions Act of 2008, Pub.L. No.110-351, and successor
25legislation, as determined in accordance with 42 U.S.C.
26§673(a)(8), and shall be used for post-adoption services and
27for other purposes allowed under these federal laws, Tit.IV-B
28or Tit.IV-E of the federal Social Security Act.
29(a) The department of human services may transfer funds
30allocated in this subparagraph (2) to the appropriation for
31child and family services in this division of this Act for the
32purposes designated in this subparagraph (2).
33(b) Notwithstanding section 8.33, moneys allocated
34under this subparagraph (2) shall not revert to any fund but
35shall remain available for the purposes designated in this
-36-1subparagraph (2) until expended.
22. The department may transfer funds appropriated in
3this section to the appropriation made in this division of
4this Act for general administration for costs paid from the
5appropriation relating to adoption subsidy.
63. Federal funds received by the state during the
7fiscal year beginning July 1, 2021, as the result of the
8expenditure of state funds during a previous state fiscal
9year for a service or activity funded under this section are
10appropriated to the department to be used as additional funding
11for the services and activities funded under this section.
12Notwithstanding section 8.33, moneys received in accordance
13with this subsection that remain unencumbered or unobligated
14at the close of the fiscal year shall not revert to any fund
15but shall remain available for expenditure for the purposes
16designated until the close of the succeeding fiscal year.
17 Sec. 22. JUVENILE DETENTION HOME FUND. Moneys deposited
18in the juvenile detention home fund created in section 232.142
19during the fiscal year beginning July 1, 2021, and ending June
2030, 2022, are appropriated to the department of human services
21for the fiscal year beginning July 1, 2021, and ending June 30,
222022, for distribution of an amount equal to a percentage of
23the costs of the establishment, improvement, operation, and
24maintenance of county or multicounty juvenile detention homes
25in the fiscal year beginning July 1, 2020. Moneys appropriated
26for distribution in accordance with this section shall be
27allocated among eligible detention homes, prorated on the basis
28of an eligible detention home’s proportion of the costs of all
29eligible detention homes in the fiscal year beginning July
301, 2020. The percentage figure shall be determined by the
31department based on the amount available for distribution for
32the fund. Notwithstanding section 232.142, subsection 3, the
33financial aid payable by the state under that provision for the
34fiscal year beginning July 1, 2021, shall be limited to the
35amount appropriated for the purposes of this section.
-37-1 Sec. 23. FAMILY SUPPORT SUBSIDY PROGRAM.
21. There is appropriated from the general fund of the
3state to the department of human services for the fiscal year
4beginning July 1, 2021, and ending June 30, 2022, the following
5amount, or so much thereof as is necessary, to be used for the
6purpose designated:
7For the family support subsidy program subject to the
8enrollment restrictions in section 225C.37, subsection 3:
.................................................. $9949,282
102. At least $899,291 of the moneys appropriated in this
11section is transferred to the department of public health for
12the family support center component of the comprehensive family
13support program under chapter 225C, subchapter V.
143. If at any time during the fiscal year, the amount of
15funding available for the family support subsidy program
16is reduced from the amount initially used to establish the
17figure for the number of family members for whom a subsidy
18is to be provided at any one time during the fiscal year,
19notwithstanding section 225C.38, subsection 2, the department
20shall revise the figure as necessary to conform to the amount
21of funding available.
22 Sec. 24. CONNER DECREE. There is appropriated from the
23general fund of the state to the department of human services
24for the fiscal year beginning July 1, 2021, and ending June 30,
252022, the following amount, or so much thereof as is necessary,
26to be used for the purpose designated:
27For building community capacity through the coordination
28and provision of training opportunities in accordance with the
29consent decree of Conner v.Branstad, No.4-86-CV-30871 (S.D.
30Iowa, July 14, 1994):
.................................................. $3133,632
32 Sec. 25. MENTAL HEALTH INSTITUTES.
331. There is appropriated from the general fund of the
34state to the department of human services for the fiscal year
35beginning July 1, 2021, and ending June 30, 2022, the following
-38-1amounts, or so much thereof as is necessary, to be used for the
2purposes designated:
3a. For operation of the state mental health institute at
4Cherokee as required by chapters 218 and 226 for salaries,
5support, maintenance, and miscellaneous purposes:
.................................................. $616,058,356
7b. For operation of the state mental health institute at
8Independence as required by chapters 218 and 226 for salaries,
9support, maintenance, and miscellaneous purposes:
.................................................. $1020,628,077
112. a. Notwithstanding sections 218.78 and 249A.11, any
12revenue received from the state mental health institute at
13Cherokee or the state mental health institute at Independence
14pursuant to 42 C.F.R§438.6(e) may be retained and expended by
15the mental health institute.
16b. Notwithstanding sections 218.78 and 249A.11, any
17COVID-19 related funding received through federal funding
18sources by the state mental health institute at Cherokee or the
19state mental health institute at Independence may be retained
20and expended by the mental health institute.
213. Notwithstanding any provision of law to the contrary,
22a Medicaid member residing at the state mental health
23institute at Cherokee or the state mental health institute
24at Independence shall retain Medicaid eligibility during
25the period of the Medicaid member’s stay for which federal
26financial participation is available.
274. Notwithstanding section 8.33, moneys appropriated in
28this section that remain unencumbered or unobligated at the
29close of the fiscal year shall not revert but shall remain
30available for expenditure for the purposes designated until the
31close of the succeeding fiscal year.
32 Sec. 26. STATE RESOURCE CENTERS.
331. There is appropriated from the general fund of the
34state to the department of human services for the fiscal year
35beginning July 1, 2021, and ending June 30, 2022, the following
-39-1amounts, or so much thereof as is necessary, to be used for the
2purposes designated:
3a. For the state resource center at Glenwood for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $514,802,873
6b. For the state resource center at Woodward for salaries,
7support, maintenance, and miscellaneous purposes:
.................................................. $813,698,094
92. The department may continue to bill for state resource
10center services utilizing a scope of services approach used for
11private providers of intermediate care facilities for persons
12with an intellectual disability services, in a manner which
13does not shift costs between the medical assistance program,
14counties, or other sources of funding for the state resource
15centers.
163. The state resource centers may expand the time-limited
17assessment and respite services during the fiscal year.
184. If the department’s administration and the department
19of management concur with a finding by a state resource
20center’s superintendent that projected revenues can reasonably
21be expected to pay the salary and support costs for a new
22employee position, or that such costs for adding a particular
23number of new positions for the fiscal year would be less
24than the overtime costs if new positions would not be added,
25the superintendent may add the new position or positions. If
26the vacant positions available to a resource center do not
27include the position classification desired to be filled, the
28state resource center’s superintendent may reclassify any
29vacant position as necessary to fill the desired position. The
30superintendents of the state resource centers may, by mutual
31agreement, pool vacant positions and position classifications
32during the course of the fiscal year in order to assist one
33another in filling necessary positions.
345. If existing capacity limitations are reached in
35operating units, a waiting list is in effect for a service or
-40-1a special need for which a payment source or other funding
2is available for the service or to address the special need,
3and facilities for the service or to address the special need
4can be provided within the available payment source or other
5funding, the superintendent of a state resource center may
6authorize opening not more than two units or other facilities
7and begin implementing the service or addressing the special
8need during fiscal year 2021-2022.
96. Notwithstanding section 8.33, and notwithstanding
10the amount limitation specified in section 222.92, moneys
11appropriated in this section that remain unencumbered or
12unobligated at the close of the fiscal year shall not revert
13but shall remain available for expenditure for the purposes
14designated until the close of the succeeding fiscal year.
15 Sec. 27. SEXUALLY VIOLENT PREDATORS.
161. There is appropriated from the general fund of the
17state to the department of human services for the fiscal year
18beginning July 1, 2021, and ending June 30, 2022, the following
19amount, or so much thereof as is necessary, to be used for the
20purpose designated:
21For costs associated with the commitment and treatment of
22sexually violent predators in the unit located at the state
23mental health institute at Cherokee, including costs of legal
24services and other associated costs, including salaries,
25support, maintenance, and miscellaneous purposes:
.................................................. $2613,643,727
272. Unless specifically prohibited by law, if the amount
28charged provides for recoupment of at least the entire amount
29of direct and indirect costs, the department of human services
30may contract with other states to provide care and treatment
31of persons placed by the other states at the unit for sexually
32violent predators at Cherokee. The moneys received under
33such a contract shall be considered to be repayment receipts
34and used for the purposes of the appropriation made in this
35section.
-41- 13. Notwithstanding section 8.33, moneys appropriated in
2this section that remain unencumbered or unobligated at the
3close of the fiscal year shall not revert but shall remain
4available for expenditure for the purposes designated until the
5close of the succeeding fiscal year.
6 Sec. 28. FIELD OPERATIONS.
71. There is appropriated from the general fund of the
8state to the department of human services for the fiscal year
9beginning July 1, 2021, and ending June 30, 2022, the following
10amount, or so much thereof as is necessary, to be used for the
11purposes designated:
12For field operations, including salaries, support,
13maintenance, and miscellaneous purposes:
.................................................. $1460,596,667
152. Priority in filling full-time equivalent positions
16shall be given to those positions related to child protection
17services and eligibility determination for low-income families.
18 Sec. 29. GENERAL ADMINISTRATION. There is appropriated
19from the general fund of the state to the department of human
20services for the fiscal year beginning July 1, 2021, and ending
21June 30, 2022, the following amount, or so much thereof as is
22necessary, to be used for the purpose designated:
23For general administration, including salaries, support,
24maintenance, and miscellaneous purposes:
.................................................. $2514,542,189
261. The department shall report at least monthly to the
27general assembly concerning the department’s operational and
28program expenditures.
292. Of the funds appropriated in this section, $150,000
30shall be used for the provision of a program to provide
31technical assistance, support, and consultation to providers
32of habilitation services and home and community-based services
33waiver services for adults with disabilities under the medical
34assistance program.
353. Of the funds appropriated in this section, $50,000
-42-1is transferred to the Iowa finance authority to be used
2for administrative support of the council on homelessness
3established in section 16.2D and for the council to fulfill its
4duties in addressing and reducing homelessness in the state.
54. Of the funds appropriated in this section, $200,000 shall
6be transferred to and deposited in the administrative fund of
7the Iowa ABLE savings plan trust created in section 12I.4, to
8be used for implementation and administration activities of the
9Iowa ABLE savings plan trust.
105. Of the funds appropriated in this section, $200,000 is
11transferred to the economic development authority for the Iowa
12commission on volunteer services to continue to be used for the
13RefugeeRISE AmeriCorps program established under section 15H.8
14for member recruitment and training to improve the economic
15well-being and health of economically disadvantaged refugees in
16local communities across Iowa. Funds transferred may be used
17to supplement federal funds under federal regulations.
186. Of the funds appropriated in this section, up to $300,000
19shall be used as follows:
20a. To address the department’s responsibility to support
21the work of the children’s behavioral health system state board
22and implementation of the services required pursuant to section
23331.397.
24b. To support the cost of establishing and implementing new
25or additional services required pursuant to sections 331.397
26and 331.397A.
27c. Of the amount allocated, $32,000 shall be transferred
28to the department of public health to support the costs of
29establishing and implementing new or additional services
30required pursuant to sections 331.397 and 331.397A.
31 Sec. 30. DEPARTMENT-WIDE DUTIES. There is appropriated
32from the general fund of the state to the department of human
33services for the fiscal year beginning July 1, 2021, and ending
34June 30, 2022, the following amount, or so much thereof as is
35necessary, to be used for the purposes designated:
-43- 1For salaries, support, maintenance, and miscellaneous
2purposes at facilities under the purview of the department of
3human services:
.................................................. $42,879,274
5 Sec. 31. VOLUNTEERS. There is appropriated from the general
6fund of the state to the department of human services for the
7fiscal year beginning July 1, 2021, and ending June 30, 2022,
8the following amount, or so much thereof as is necessary, to be
9used for the purpose designated:
10For development and coordination of volunteer services:
.................................................. $1184,686
12 Sec. 32. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
13ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
14DEPARTMENT OF HUMAN SERVICES.
151. a. (1) (a) For the fiscal year beginning July 1,
162021, the department shall rebase case-mix nursing facility
17rates effective July 1, 2021, to the extent possible within the
18state funding, including the $10,000,000 appropriated for this
19purpose.
20(b) For the fiscal year beginning July 1, 2021, non-case-mix
21and special population nursing facilities shall be reimbursed
22in accordance with the methodology in effect on June 30 of the
23prior fiscal year.
24(c) For managed care claims, the department of human
25services shall adjust the payment rate floor for nursing
26facilities, annually, to maintain a rate floor that is no
27lower than the Medicaid fee-for-service case-mix adjusted rate
28calculated in accordance with subparagraph division (a) and
29441 IAC 81.6. The department shall then calculate adjusted
30reimbursement rates, including but not limited to add-on
31payments, annually, and shall notify Medicaid managed care
32organizations of the adjusted reimbursement rates within 30
33days of determining the adjusted reimbursement rates. Any
34adjustment of reimbursement rates under this subparagraph
35division shall be budget neutral to the state budget.
-44- 1(d) For the fiscal year beginning July 1, 2021, Medicaid
2managed care long-term services and supports capitation
3rates shall be adjusted to reflect the rebasing pursuant to
4subparagraph division (a) for the patient populations residing
5in Medicaid-certified nursing facilities.
6(2) 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, 2021,
12the department 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
20the fiscal year. A change in the dispensing fee shall become
21effective following federal approval of the Medicaid state
22plan.
23(2) The department shall utilize an average acquisition
24cost reimbursement methodology for all drugs covered under the
25medical assistance program in accordance with 2012 Iowa Acts,
26chapter 1133, section 33.
27c. (1) For the fiscal year beginning July 1, 2021,
28reimbursement rates for outpatient hospital services shall
29remain at the rates in effect on June 30, 2021, subject to
30Medicaid program upper payment limit rules, and adjusted
31as necessary to maintain expenditures within the amount
32appropriated to the department for this purpose for the fiscal
33year.
34(2) For the fiscal year beginning July 1, 2021,
35reimbursement rates for inpatient hospital services shall
-45-1be rebased effective October 1, 2021, subject to Medicaid
2program upper payment limit rules, and adjusted as necessary
3to maintain expenditures within the amount appropriated to the
4department for this purpose for the fiscal year.
5(3) For the fiscal year beginning July 1, 2021, under
6both fee-for-service and managed care administration of
7the Medicaid program, critical access hospitals shall be
8reimbursed for inpatient and outpatient services based on the
9hospital-specific critical access hospital cost adjustment
10factor methodology utilizing the most recent and complete cost
11reporting period as applied prospectively within the funds
12appropriated for such purpose for the fiscal year.
13(4) For the fiscal year beginning July 1, 2021, the graduate
14medical education and disproportionate share hospital fund
15shall remain at the amount in effect on June 30, 2021, except
16that the portion of the fund attributable to graduate medical
17education shall be reduced in an amount that reflects the
18elimination of graduate medical education payments made to
19out-of-state hospitals.
20(5) In order to ensure the efficient use of limited state
21funds in procuring health care services for low-income Iowans,
22funds appropriated in this Act for hospital services shall
23not be used for activities which would be excluded from a
24determination of reasonable costs under the federal Medicare
25program pursuant to 42 U.S.C.§1395x(v)(1)(N).
26d. For the fiscal year beginning July 1, 2021, reimbursement
27rates for hospices and acute psychiatric hospitals shall be
28increased in accordance with increases under the federal
29Medicare program or as supported by their Medicare audited
30costs.
31e. For the fiscal year beginning July 1, 2021, independent
32laboratories and rehabilitation agencies shall be reimbursed
33using the same methodology in effect on June 30, 2021.
34f. (1) For the fiscal year beginning July 1, 2021,
35reimbursement rates for home health agencies shall continue to
-46-1be based on the Medicare low utilization payment adjustment
2(LUPA) methodology with state geographic wage adjustments.
3The department shall continue to update the rates every two
4years to reflect the most recent Medicare LUPA rates to the
5extent possible within the state funding appropriated for this
6purpose.
7(2) For the fiscal year beginning July 1, 2021, rates for
8private duty nursing and personal care services under the early
9and periodic screening, diagnostic, and treatment program
10benefit shall be calculated based on the methodology in effect
11on June 30, 2021.
12g. For the fiscal year beginning July 1, 2021, federally
13qualified health centers and rural health clinics shall receive
14cost-based reimbursement for 100 percent of the reasonable
15costs for the provision of services to recipients of medical
16assistance.
17h. For the fiscal year beginning July 1, 2021, the
18reimbursement rates for dental services shall remain at the
19rates in effect on June 30, 2021.
20i. (1) For the fiscal year beginning July 1, 2021,
21reimbursement rates for non-state-owned psychiatric medical
22institutions for children shall be increased to the extent
23possible within the $3,900,000 appropriated for this purpose.
24(2) As a condition of participation in the medical
25assistance program, enrolled providers shall accept the medical
26assistance reimbursement rate for any covered goods or services
27provided to recipients of medical assistance who are children
28under the custody of a psychiatric medical institution for
29children.
30j. For the fiscal year beginning July 1, 2021, unless
31otherwise specified in this Act, all noninstitutional medical
32assistance provider reimbursement rates shall remain at the
33rates in effect on June 30, 2021, except for area education
34agencies, local education agencies, infant and toddler
35services providers, home and community-based services providers
-47-1including consumer-directed attendant care providers under a
2section 1915(c) or 1915(i) waiver, targeted case management
3providers, and those providers whose rates are required to be
4determined pursuant to section 249A.20, or to meet federal
5mental health parity requirements.
6k. Notwithstanding any provision to the contrary, for the
7fiscal year beginning July 1, 2021, the reimbursement rate for
8anesthesiologists shall remain at the rates in effect on June
930, 2021, and updated on January 1, 2022, to align with the
10most current Iowa Medicare anesthesia rate.
11l. Notwithstanding section 249A.20, for the fiscal year
12beginning July 1, 2021, the average reimbursement rate for
13health care providers eligible for use of the federal Medicare
14resource-based relative value scale reimbursement methodology
15under section 249A.20 shall remain at the rate in effect on
16June 30, 2021; however, this rate shall not exceed the maximum
17level authorized by the federal government.
18m. For the fiscal year beginning July 1, 2021, the
19reimbursement rate for residential care facilities shall not
20be less than the minimum payment level as established by the
21federal government to meet the federally mandated maintenance
22of effort requirement. The flat reimbursement rate for
23facilities electing not to file annual cost reports shall not
24be less than the minimum payment level as established by the
25federal government to meet the federally mandated maintenance
26of effort requirement.
27n. For the fiscal year beginning July 1, 2021, the
28reimbursement rates for inpatient mental health services
29provided at hospitals shall be rebased effective October 1,
302021, subject to Medicaid program upper payment limit rules
31and adjusted as necessary to maintain expenditures within the
32amount appropriated to the department for this purpose for
33the fiscal year; and psychiatrists shall be reimbursed at the
34medical assistance program fee-for-service rate in effect on
35June 30, 2021.
-48- 1o. For the fiscal year beginning July 1, 2021, community
2mental health centers may choose to be reimbursed for the
3services provided to recipients of medical assistance through
4either of the following options:
5(1) For 100 percent of the reasonable costs of the services.
6(2) In accordance with the alternative reimbursement rate
7methodology approved by the department of human services in
8effect on June 30, 2021.
9p. For the fiscal year beginning July 1, 2021, the
10reimbursement rate for providers of family planning services
11that are eligible to receive a 90 percent federal match shall
12remain at the rates in effect on June 30, 2021.
13q. For the fiscal year beginning July 1, 2021, the upper
14limits and reimbursement rates for providers of home and
15community-based services waiver services and habilitation
16services shall be increased to the extent possible within the
17$8,000,000 appropriated for this purpose.
18r. For the fiscal year beginning July 1, 2021, the
19reimbursement rates for emergency medical service providers
20shall remain at the rates in effect on June 30, 2021, or as
21approved by the centers for Medicare and Medicaid services of
22the United States department of health and human services.
23s. For the fiscal year beginning July 1, 2021, reimbursement
24rates for substance-related disorder treatment programs
25licensed under section 125.13 shall remain at the rates in
26effect on June 30, 2021.
27t. For the fiscal year beginning July 1, 2021, assertive
28community treatment per diem rates shall remain at the rates in
29effect on June 30, 2021.
30u. For the fiscal year beginning July 1, 2021, the
31reimbursement rate for family-centered services providers shall
32be established by contract.
332. For the fiscal year beginning July 1, 2021, the
34reimbursement rate for providers reimbursed under the
35in-home-related care program shall not be less than the minimum
-49-1payment level as established by the federal government to meet
2the federally mandated maintenance of effort requirement.
33. Unless otherwise directed in this section, when the
4department’s reimbursement methodology for any provider
5reimbursed in accordance with this section includes an
6inflation factor, this factor shall not exceed the amount
7by which the consumer price index for all urban consumers
8increased during the calendar year ending December 31, 2002.
94. Notwithstanding section 234.38, for the fiscal
10year beginning July 1, 2021, the foster family basic daily
11maintenance rate and the maximum adoption subsidy rate for
12children ages 0 through 5 years shall be $16.78, the rate for
13children ages 6 through 11 years shall be $17.45, the rate for
14children ages 12 through 15 years shall be $19.10, and the
15rate for children and young adults ages 16 and older shall
16be $19.35. For youth ages 18 to 23 who have exited foster
17care, the preparation for adult living program maintenance
18rate shall be up to $602.70 per month as calculated based on
19the age of the participant. The maximum payment for adoption
20subsidy nonrecurring expenses shall be limited to $500 and the
21disallowance of additional amounts for court costs and other
22related legal expenses implemented pursuant to 2010 Iowa Acts,
23chapter 1031, section 408, shall be continued.
245. For the fiscal year beginning July 1, 2021, the maximum
25reimbursement rates for social services providers under
26contract shall remain at the rates in effect on June 30, 2021,
27or the provider’s actual and allowable cost plus inflation for
28each service, whichever is less. However, if a new service
29or service provider is added after June 30, 2021, the initial
30reimbursement rate for the service or provider shall be based
31upon a weighted average of provider rates for similar services.
326. a. For the fiscal year beginning July 1, 2021, the
33reimbursement rates for resource family recruitment and
34retention contractors shall be established by contract.
35b. For the fiscal year beginning July 1, 2021, the
-50-1reimbursement rates for supervised apartment living foster care
2providers shall be established by contract.
37. For the fiscal year beginning July 1, 2021, the
4reimbursement rate for group foster care providers shall be the
5combined service and maintenance reimbursement rate established
6by contract.
78. The group foster care reimbursement rates paid for
8placement of children out of state shall be calculated
9according to the same rate-setting principles as those used for
10in-state providers, unless the director of human services or
11the director’s designee determines that appropriate care cannot
12be provided within the state. The payment of the daily rate
13shall be based on the number of days in the calendar month in
14which service is provided.
159. a. For the fiscal year beginning July 1, 2021, the
16reimbursement rate paid for shelter care and the child welfare
17emergency services implemented to provide or prevent the need
18for shelter care shall be established by contract.
19b. For the fiscal year beginning July 1, 2021, the combined
20service and maintenance components of the reimbursement rate
21paid for shelter care services shall be based on the financial
22and statistical report submitted to the department. The
23maximum reimbursement rate shall be $101.83 per day. The
24department shall reimburse a shelter care provider at the
25provider’s actual and allowable unit cost, plus inflation, not
26to exceed the maximum reimbursement rate.
27c. Notwithstanding section 232.141, subsection 8, for the
28fiscal year beginning July 1, 2021, the amount of the statewide
29average of the actual and allowable rates for reimbursement of
30juvenile shelter care homes that is utilized for the limitation
31on recovery of unpaid costs shall remain at the amount in
32effect for this purpose in the fiscal year beginning July 1,
332020.
3410. For the fiscal year beginning July 1, 2021, the
35department shall calculate reimbursement rates for intermediate
-51-1care facilities for persons with an intellectual disability
2at the 80th percentile. Beginning July 1, 2021, the rate
3calculation methodology shall utilize the consumer price index
4inflation factor applicable to the fiscal year beginning July
51, 2021.
611. Effective July 1, 2021, the child care provider
7reimbursement rates shall remain at the rates in effect on June
830, 2021. The department shall set rates in a manner so as
9to provide incentives for a nonregistered provider to become
10registered by applying any increase only to registered and
11licensed providers.
1212. The department may adopt emergency rules to implement
13this section.
14 Sec. 33. EMERGENCY RULES.
151. If necessary to comply with federal requirements
16including time frames, or if specifically authorized by a
17provision of this division of this Act, the department of
18human services or the mental health and disability services
19commission may adopt administrative rules under section 17A.4,
20subsection 3, and section 17A.5, subsection 2, paragraph “b”,
21to implement the provisions of this division of this Act and
22the rules shall become effective immediately upon filing or
23on a later effective date specified in the rules, unless the
24effective date of the rules is delayed or the applicability
25of the rules is suspended by the administrative rules review
26committee. Any rules adopted in accordance with this section
27shall not take effect before the rules are reviewed by the
28administrative rules review committee. The delay authority
29provided to the administrative rules review committee under
30section 17A.4, subsection 7, and section 17A.8, subsection 9,
31shall be applicable to a delay imposed under this section,
32notwithstanding a provision in those sections making them
33inapplicable to section 17A.5, subsection 2, paragraph “b”.
34Any rules adopted in accordance with the provisions of this
35section shall also be published as a notice of intended action
-52-1as provided in section 17A.4.
22. If during a fiscal year, the department of human
3services is adopting rules in accordance with this section
4or as otherwise directed or authorized by state law, and the
5rules will result in an expenditure increase beyond the amount
6anticipated in the budget process or if the expenditure was
7not addressed in the budget process for the fiscal year, the
8department shall notify the legislative services agency and
9the department of management concerning the rules and the
10expenditure increase. The notification shall be provided at
11least 30 calendar days prior to the date notice of the rules
12is submitted to the administrative rules coordinator and the
13administrative code editor.
14 Sec. 34. REPORTS. Any reports or other information required
15to be compiled and submitted under this Act during the fiscal
16year beginning July 1, 2021, shall be submitted to the general
17assembly on or before the dates specified for submission of the
18reports or information.
19 Sec. 35. EFFECTIVE UPON ENACTMENT. The following
20provisions of this division of this Act, being deemed of
21immediate importance, take effect upon enactment:
221. The provision relating to section 232.141 and directing
23the state court administrator and the division administrator of
24the department of human services division of child and family
25services to make the determination, by June 15, 2021, of the
26distribution of funds allocated for the payment of the expenses
27of court-ordered services provided to juveniles which are a
28charge upon the state.
29DIVISION VI
30HEALTH CARE ACCOUNTS AND FUNDS — FY 2021-2022
31 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
32appropriated from the pharmaceutical settlement account created
33in section 249A.33 to the department of human services for the
34fiscal year beginning July 1, 2021, and ending June 30, 2022,
35the following amount, or so much thereof as is necessary, to be
-53-1used for the purpose designated:
2Notwithstanding any provision of law to the contrary, to
3supplement the appropriations made in this Act for health
4program operations under the medical assistance program for the
5fiscal year beginning July 1, 2021, and ending June 30, 2022:
.................................................. $6234,193
7 Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
8SERVICES. Notwithstanding any provision to the contrary and
9subject to the availability of funds, there is appropriated
10from the quality assurance trust fund created in section
11249L.4 to the department of human services for the fiscal year
12beginning July 1, 2021, and ending June 30, 2022, the following
13amounts, or so much thereof as is necessary, for the purposes
14designated:
15To supplement the appropriation made in this Act from the
16general fund of the state to the department of human services
17for medical assistance for the same fiscal year:
.................................................. $1856,305,139
19 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
20DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
21the contrary and subject to the availability of funds, there is
22appropriated from the hospital health care access trust fund
23created in section 249M.4 to the department of human services
24for the fiscal year beginning July 1, 2021, and ending June
2530, 2022, the following amounts, or so much thereof as is
26necessary, for the purposes designated:
27To supplement the appropriation made in this Act from the
28general fund of the state to the department of human services
29for medical assistance for the same fiscal year:
.................................................. $3033,920,554
31 Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
32FOR FY 2021-2022. Notwithstanding section 8.33, if moneys
33appropriated for purposes of the medical assistance program for
34the fiscal year beginning July 1, 2021, and ending June 30,
352022, from the general fund of the state, the quality assurance
-54-1trust fund, and the hospital health care access trust fund, are
2in excess of actual expenditures for the medical assistance
3program and remain unencumbered or unobligated at the close
4of the fiscal year, the excess moneys shall not revert but
5shall remain available for expenditure for the purposes of the
6medical assistance program until the close of the succeeding
7fiscal year.
8DIVISION VII
9DEPARTMENT ON AGING — FY 2022-2023
10 Sec. 40. DEPARTMENT ON AGING. There is appropriated from
11the general fund of the state to the department on aging for
12the fiscal year beginning July 1, 2022, and ending June 30,
132023, the following amount, or so much thereof as is necessary,
14to be used for the purposes designated:
15For aging programs for the department on aging and area
16agencies on aging to provide citizens of Iowa who are 60
17years of age and older with case management, Iowa’s aging and
18disabilities resource center, and other services which may
19include but are not limited to adult day, respite care, chore,
20information and assistance, and material aid, for information
21and options counseling for persons with disabilities who
22are 18 years of age or older, and for salaries, support,
23administration, maintenance, and miscellaneous purposes:
.................................................. $2411,164,382
251. Funds appropriated in this section may be used to
26supplement federal funds under federal regulations. To
27receive funds appropriated in this section, a local area
28agency on aging shall match the funds with moneys from other
29sources according to rules adopted by the department. Funds
30appropriated in this section may be used for elderly services
31not specifically enumerated in this section only if approved
32by an area agency on aging for provision of the service within
33the area.
342. Of the funds appropriated in this section, $279,000 is
35transferred to the economic development authority for the Iowa
-55-1commission on volunteer services to be used for the retired and
2senior volunteer program.
33. a. The department on aging shall establish and enforce
4procedures relating to expenditure of state and federal funds
5by area agencies on aging that require compliance with both
6state and federal laws, rules, and regulations, including but
7not limited to all of the following:
8(1) Requiring that expenditures are incurred only for goods
9or services received or performed prior to the end of the
10fiscal period designated for use of the funds.
11(2) Prohibiting prepayment for goods or services not
12received or performed prior to the end of the fiscal period
13designated for use of the funds.
14(3) Prohibiting prepayment for goods or services not
15defined specifically by good or service, time period, or
16recipient.
17(4) Prohibiting the establishment of accounts from which
18future goods or services which are not defined specifically by
19good or service, time period, or recipient, may be purchased.
20b. The procedures shall provide that if any funds are
21expended in a manner that is not in compliance with the
22procedures and applicable federal and state laws, rules, and
23regulations, and are subsequently subject to repayment, the
24area agency on aging expending such funds in contravention of
25such procedures, laws, rules and regulations, not the state,
26shall be liable for such repayment.
274. Of the funds appropriated in this section, at least
28$600,000 shall be used to fund home and community-based
29services through the area agencies on aging that enable older
30individuals to avoid more costly utilization of residential or
31institutional services and remain in their own homes.
325. Of the funds appropriated in this section, $812,000 shall
33be used for the purposes of chapter 231E and to administer
34the prevention of elder abuse, neglect, and exploitation
35program pursuant to section 231.56A, in accordance with the
-56-1requirements of the federal Older Americans Act of 1965, 42
2U.S.C.§3001 et seq., as amended.
36. Of the funds appropriated in this section, $1,000,000
4shall be used to fund continuation of the aging and disability
5resource center lifelong links to provide individuals and
6caregivers with information and services to plan for and
7maintain independence.
87. Of the funds appropriated in this section, $250,000
9shall be used by the department on aging, in collaboration with
10the department of human services and affected stakeholders,
11to continue to expand the pilot initiative to provide
12long-term care options counseling utilizing support planning
13protocols, to assist non-Medicaid eligible consumers who
14indicate a preference to return to the community and are
15deemed appropriate for discharge, to return to their community
16following a nursing facility stay. The department on aging
17shall submit a report regarding the outcomes of the pilot
18initiative to the governor and the general assembly by December
1915, 2022.
20DIVISION VIII
21OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2022-2023
22 Sec. 41. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
23appropriated from the general fund of the state to the office
24of long-term care ombudsman for the fiscal year beginning July
251, 2022, and ending June 30, 2023, the following amount, or
26so much thereof as is necessary, to be used for the purposes
27designated:
28For salaries, support, administration, maintenance, and
29miscellaneous purposes:
.................................................. $301,149,821
31DIVISION IX
32DEPARTMENT OF PUBLIC HEALTH — FY 2022-2023
33 Sec. 42. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
34from the general fund of the state to the department of public
35health for the fiscal year beginning July 1, 2022, and ending
-57-1June 30, 2023, the following amounts, or so much thereof as is
2necessary, to be used for the purposes designated:
31. ADDICTIVE DISORDERS
4For reducing the prevalence of the use of tobacco, alcohol,
5and other drugs, and treating individuals affected by addictive
6behaviors, including gambling:
.................................................. $723,659,379
8a. Of the funds appropriated in this subsection, $4,020,894
9shall be used for the tobacco use prevention and control
10initiative, including efforts at the state and local levels,
11as provided in chapter 142A. The commission on tobacco use
12prevention and control established pursuant to section 142A.3
13shall advise the director of public health in prioritizing
14funding needs and the allocation of moneys appropriated for
15the programs and initiatives. Activities of the programs
16and initiatives shall be in alignment with the United States
17centers for disease control and prevention best practices
18for comprehensive tobacco control programs that include
19the goals of preventing youth initiation of tobacco usage,
20reducing exposure to secondhand smoke, and promotion of tobacco
21cessation.
22b. (1) Of the funds appropriated in this subsection,
23$19,638,485 shall be used for problem gambling and
24substance-related disorder prevention, treatment, and recovery
25services, including a 24-hour helpline, public information
26resources, professional training, youth prevention, and program
27evaluation.
28(2) Of the amount allocated under this paragraph, $306,000
29shall be utilized by the department of public health, in
30collaboration with the department of human services, to
31maintain a single statewide 24-hour crisis hotline for the Iowa
32children’s behavioral health system that incorporates warmline
33services which may be provided through expansion of existing
34capabilities maintained by the department of public health as
35required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
-58- 1c. The requirement of section 123.17, subsection 5, is met
2by the appropriations and allocations made in this division of
3this Act for purposes of substance-related disorder treatment
4and addictive disorders for the fiscal year beginning July 1,
52022.
62. HEALTHY CHILDREN AND FAMILIES
7For promoting the optimum health status for children and
8adolescents from birth through 21 years of age, and families:
.................................................. $95,816,681
103. CHRONIC CONDITIONS
11For serving individuals identified as having chronic
12conditions or special health care needs:
.................................................. $134,223,373
144. COMMUNITY CAPACITY
15For strengthening the health care delivery system at the
16local level:
.................................................. $176,794,306
18a. Of the funds appropriated in this subsection, $2,000,000
19shall be deposited in the medical residency training account
20created in section 135.175, subsection 5, paragraph “a”, and
21is appropriated from the account to the department of public
22health to be used for the purposes of the medical residency
23training state matching grants program as specified in section
24135.176.
25b. Of the funds appropriated in this subsection, $250,000
26shall be used for the public purpose of providing funding to
27Des Moines university to continue a provider education project
28to provide primary care physicians with the training and skills
29necessary to recognize the signs of mental illness in patients.
30c. Of the funds appropriated in this subsection, $600,000
31shall be used for rural psychiatric residencies to support the
32annual creation and training of four psychiatric residents who
33will provide mental health services in underserved areas of
34the state. Notwithstanding section 8.33, moneys that remain
35unencumbered or unobligated at the close of the fiscal year
-59-1shall not revert but shall remain available for expenditure for
2the purposes designated for subsequent fiscal years.
3d. Of the funds appropriated in this subsection, $1,000,000
4shall be used for the creation of two centers of excellence
5programs to encourage innovation and collaboration among
6regional health care providers to transform health care
7delivery in order to provide quality, sustainable care that
8meets the needs of local communities.
95. ESSENTIAL PUBLIC HEALTH SERVICES
10To provide public health services that reduce risks and
11invest in promoting and protecting good health over the
12course of a lifetime with a priority given to older Iowans and
13vulnerable populations:
.................................................. $147,662,464
156. INFECTIOUS DISEASES
16For reducing the incidence and prevalence of communicable
17diseases:
.................................................. $181,796,206
197. PUBLIC PROTECTION
20For protecting the health and safety of the public through
21establishing standards and enforcing regulations:
.................................................. $224,466,601
23Of the funds appropriated in this subsection, not more than
24$304,000 shall be credited to the emergency medical services
25fund created in section 135.25. Moneys in the emergency
26medical services fund are appropriated to the department to be
27used for the purposes of the fund.
288. RESOURCE MANAGEMENT
29For establishing and sustaining the overall ability of the
30department to deliver services to the public:
.................................................. $31933,871
329. MISCELLANEOUS PROVISIONS
33The university of Iowa hospitals and clinics under the
34control of the state board of regents shall not receive
35indirect costs from the funds appropriated in this section.
-60-1The university of Iowa hospitals and clinics billings to the
2department shall be on at least a quarterly basis.
3 Sec. 43. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
4RECEIPTS FUND. There is appropriated from the sports wagering
5receipts fund created in section 8.57, subsection 6, to the
6department of public health for the fiscal year beginning July
71, 2022, and ending June 30, 2023, the following amount, or
8so much thereof as is necessary, to be used for the purposes
9designated:
10For problem gambling and substance-related disorder
11prevention, treatment, and recovery services, including a
1224-hour helpline, public information resources, professional
13training, youth prevention, and program evaluation:
.................................................. $141,750,000
15DIVISION X
16DEPARTMENT OF VETERANS AFFAIRS — FY 2022-2023
17 Sec. 44. DEPARTMENT OF VETERANS AFFAIRS. There is
18appropriated from the general fund of the state to the
19department of veterans affairs for the fiscal year beginning
20July 1, 2022, and ending June 30, 2023, the following amounts,
21or so much thereof as is necessary, to be used for the purposes
22designated:
231. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
24For salaries, support, maintenance, and miscellaneous
25purposes:
.................................................. $261,229,763
272. IOWA VETERANS HOME
28For salaries, support, maintenance, and miscellaneous
29purposes:
.................................................. $307,131,552
31a. The Iowa veterans home billings involving the department
32of human services shall be submitted to the department on at
33least a monthly basis.
34b. The Iowa veterans home expenditure report shall be
35submitted monthly to the general assembly.
-61- 1c. The Iowa veterans home shall continue to include in the
2annual discharge report applicant information to provide for
3the collection of demographic information including but not
4limited to the number of individuals applying for admission and
5admitted or denied admittance and the basis for the admission
6or denial; the age, gender, and race of such individuals;
7and the level of care for which such individuals applied for
8admission including residential or nursing level of care.
93. HOME OWNERSHIP ASSISTANCE PROGRAM
10For transfer to the Iowa finance authority for the
11continuation of the home ownership assistance program for
12persons who are or were eligible members of the armed forces of
13the United States, pursuant to section 16.54:
.................................................. $142,000,000
15 Sec. 45. LIMITATION OF COUNTY COMMISSIONS OF VETERAN
16AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the
17standing appropriation in section 35A.16 for the fiscal year
18beginning July 1, 2022, and ending June 30, 2023, the amount
19appropriated from the general fund of the state pursuant to
20that section for the following designated purposes shall not
21exceed the following amount:
22For the county commissions of veteran affairs fund under
23section 35A.16:
.................................................. $24990,000
25DIVISION XI
26DEPARTMENT OF HUMAN SERVICES — FY 2022-2023
27 Sec. 46. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
28GRANT. There is appropriated from the fund created in section
298.41 to the department of human services for the fiscal year
30beginning July 1, 2022, and ending June 30, 2023, from moneys
31received under the federal temporary assistance for needy
32families (TANF) block grant pursuant to the federal Personal
33Responsibility and Work Opportunity Reconciliation Act of 1996,
34Pub.L.No.104-193, and successor legislation, the following
35amounts, or so much thereof as is necessary, to be used for the
-62-1purposes designated:
21. To be credited to the family investment program account
3and used for assistance under the family investment program
4under chapter 239B:
.................................................. $55,002,006
62. To be credited to the family investment program account
7and used for the job opportunities and basic skills (JOBS)
8program and implementing family investment agreements in
9accordance with chapter 239B:
.................................................. $105,412,060
113. To be used for the family development and
12self-sufficiency grant program in accordance with section
13216A.107:
.................................................. $142,888,980
15Notwithstanding section 8.33, moneys appropriated in this
16subsection that remain unencumbered or unobligated at the close
17of the fiscal year shall not revert but shall remain available
18for expenditure for the purposes designated until the close of
19the succeeding fiscal year. However, unless such moneys are
20encumbered or obligated on or before September 30, 2023, the
21moneys shall revert.
224. For field operations:
.................................................. $2331,296,232
245. For general administration:
.................................................. $253,744,000
266. For state child care assistance:
.................................................. $2747,166,826
28a. Of the funds appropriated in this subsection,
29$26,205,412 is transferred to the child care and development
30block grant appropriation made by the Eighty-ninth General
31Assembly, 2021 session, for the federal fiscal year beginning
32October 1, 2022, and ending September 30, 2023. Of this
33amount, $200,000 shall be used for provision of educational
34opportunities to registered child care home providers in order
35to improve services and programs offered by this category
-63-1of providers and to increase the number of providers. The
2department may contract with institutions of higher education
3or child care resource and referral centers to provide
4the educational opportunities. Allowable administrative
5costs under the contracts shall not exceed 5 percent. The
6application for a grant shall not exceed two pages in length.
7b. Any funds appropriated in this subsection remaining
8unallocated shall be used for state child care assistance
9payments for families who are employed including but not
10limited to individuals enrolled in the family investment
11program.
127. For child and family services:
.................................................. $1332,380,654
148. For child abuse prevention grants:
.................................................. $15125,000
169. For pregnancy prevention grants on the condition that
17family planning services are funded:
.................................................. $181,913,203
19Pregnancy prevention grants shall be awarded to programs
20in existence on or before July 1, 2022, if the programs have
21demonstrated positive outcomes. Grants shall be awarded to
22pregnancy prevention programs which are developed after July
231, 2022, if the programs are based on existing models that
24have demonstrated positive outcomes. Grants shall comply with
25the requirements provided in 1997 Iowa Acts, chapter 208,
26section 14, subsections 1 and 2, including the requirement that
27grant programs must emphasize sexual abstinence. Priority in
28the awarding of grants shall be given to programs that serve
29areas of the state which demonstrate the highest percentage of
30unplanned pregnancies of females of childbearing age within the
31geographic area to be served by the grant.
3210. For technology needs and other resources necessary to
33meet federal, state, and welfare reform reporting, tracking,
34and case management requirements and other departmental needs:
.................................................. $351,037,186
-64- 111. a. Notwithstanding any provision to the contrary,
2including but not limited to requirements in section 8.41 or
3provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the
4receipt and appropriation of federal block grants, federal
5funds from the temporary assistance for needy families block
6grant received by the state and not otherwise appropriated
7in this section and remaining available for the fiscal year
8beginning July 1, 2022, are appropriated to the department of
9human services to the extent as may be necessary to be used in
10the following priority order: the family investment program,
11for state child care assistance program payments for families
12who are employed, and for the family investment program share
13of system costs for eligibility determination and related
14functions. The federal funds appropriated in this paragraph
15“a” shall be expended only after all other funds appropriated
16in subsection 1 for assistance under the family investment
17program, in subsection 6 for state child care assistance, or
18in subsection 10 for technology costs related to the family
19investment program, as applicable, have been expended. For
20the purposes of this subsection, the funds appropriated in
21subsection 6, paragraph “a”, for transfer to the child care
22and development block grant appropriation are considered fully
23expended when the full amount has been transferred.
24b. The department shall, on a quarterly basis, advise the
25legislative services agency and department of management of
26the amount of funds appropriated in this subsection that was
27expended in the prior quarter.
2812. Of the amounts appropriated in this section,
29$12,962,008 for the fiscal year beginning July 1, 2022, is
30transferred to the appropriation of the federal social services
31block grant made to the department of human services for that
32fiscal year.
3313. For continuation of the program providing categorical
34eligibility for the food assistance program as specified
35for the program in the section of this division of this Act
-65-1relating to the family investment program account:
.................................................. $214,236
314. The department may transfer funds allocated in this
4section to the appropriations made in this division of this Act
5for the same fiscal year for general administration and field
6operations for resources necessary to implement and operate the
7services referred to in this section and those funded in the
8appropriation made in this division of this Act for the same
9fiscal year for the family investment program from the general
10fund of the state.
1115. With the exception of moneys allocated under this
12section for the family development and self-sufficiency grant
13program, to the extent moneys allocated in this section are
14deemed by the department not to be necessary to support the
15purposes for which they are allocated, such moneys may be
16used in the same fiscal year for any other purpose for which
17funds are allocated in this section or in section 46 of this
18division for the family investment program account. If there
19are conflicting needs, priority shall first be given to the
20family investment program account as specified under subsection
211 of this section and used for the purposes of assistance under
22the family investment program in accordance with chapter 239B,
23followed by state child care assistance program payments for
24families who are employed, followed by other priorities as
25specified by the department.
26 Sec. 47. FAMILY INVESTMENT PROGRAM ACCOUNT.
271. Moneys credited to the family investment program (FIP)
28account for the fiscal year beginning July 1, 2022, and
29ending June 30, 2023, shall be used to provide assistance in
30accordance with chapter 239B.
312. The department may use a portion of the moneys credited
32to the FIP account under this section as necessary for
33salaries, support, maintenance, and miscellaneous purposes.
343. The department may transfer funds allocated in
35subsection 4, excluding the allocation under subsection 4,
-66-1paragraph “b”, to the appropriations made in this division of
2this Act for the same fiscal year for general administration
3and field operations for resources necessary to implement
4and operate the services referred to in this section and
5those funded in the appropriations made in section 45 for the
6temporary assistance for needy families block grant and in
7section 47 for the family investment program from the general
8fund of the state in this division of this Act for the same
9fiscal year.
104. Moneys appropriated in this division of this Act and
11credited to the FIP account for the fiscal year beginning July
121, 2022, and ending June 30, 2023, are allocated as follows:
13a. To be retained by the department of human services to
14be used for coordinating with the department of human rights
15to more effectively serve participants in FIP and other shared
16clients and to meet federal reporting requirements under the
17federal temporary assistance for needy families block grant:
.................................................. $1810,000
19b. To the department of human rights for staffing,
20administration, and implementation of the family development
21and self-sufficiency grant program in accordance with section
22216A.107:
.................................................. $236,192,834
24(1) Of the funds allocated for the family development
25and self-sufficiency grant program in this paragraph “b”,
26not more than 5 percent of the funds shall be used for the
27administration of the grant program.
28(2) The department of human rights may continue to implement
29the family development and self-sufficiency grant program
30statewide during fiscal year 2022-2023.
31(3) The department of human rights may engage in activities
32to strengthen and improve family outcomes measures and
33data collection systems under the family development and
34self-sufficiency grant program.
35c. For the diversion subaccount of the FIP account:
-67-.................................................. $11,293,000
2A portion of the moneys allocated for the diversion
3subaccount may be used for field operations, salaries, data
4management system development, and implementation costs and
5support deemed necessary by the director of human services
6in order to administer the FIP diversion program. To the
7extent moneys allocated in this paragraph “c” are deemed by the
8department not to be necessary to support diversion activities,
9such moneys may be used for other efforts intended to increase
10engagement by family investment program participants in work,
11education, or training activities, or for the purposes of
12assistance under the family investment program in accordance
13with chapter 239B.
14d. For the food assistance employment and training program:
.................................................. $1566,588
16(1) The department shall apply the federal supplemental
17nutrition assistance program (SNAP) employment and training
18state plan in order to maximize to the fullest extent permitted
19by federal law the use of the 50 percent federal reimbursement
20provisions for the claiming of allowable federal reimbursement
21funds from the United States department of agriculture
22pursuant to the federal SNAP employment and training program
23for providing education, employment, and training services
24for eligible food assistance program participants, including
25but not limited to related dependent care and transportation
26expenses.
27(2) The department shall continue the categorical federal
28food assistance program eligibility at 160 percent of the
29federal poverty level and continue to eliminate the asset test
30from eligibility requirements, consistent with federal food
31assistance program requirements. The department shall include
32as many food assistance households as is allowed by federal
33law. The eligibility provisions shall conform to all federal
34requirements including requirements addressing individuals who
35are incarcerated or otherwise ineligible.
-68- 1e. For the JOBS program, not more than:
.................................................. $212,018,258
35. Of the child support collections assigned under FIP,
4an amount equal to the federal share of support collections
5shall be credited to the child support recovery appropriation
6made in this division of this Act. Of the remainder of the
7assigned child support collections received by the child
8support recovery unit, a portion shall be credited to the FIP
9account, a portion may be used to increase recoveries, and a
10portion may be used to sustain cash flow in the child support
11payments account. If as a consequence of the appropriations
12and allocations made in this section the resulting amounts
13are insufficient to sustain cash assistance payments and meet
14federal maintenance of effort requirements, the department
15shall seek supplemental funding. If child support collections
16assigned under FIP are greater than estimated or are otherwise
17determined not to be required for maintenance of effort, the
18state share of either amount may be transferred to or retained
19in the child support payments account.
20 Sec. 48. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
21is appropriated from the general fund of the state to the
22department of human services for the fiscal year beginning July
231, 2022, and ending June 30, 2023, the following amount, or
24so much thereof as is necessary, to be used for the purpose
25designated:
26To be credited to the family investment program (FIP)
27account and used for family investment program assistance
28under chapter 239B and other costs associated with providing
29needs-based benefits or assistance:
.................................................. $3040,003,978
311. Of the funds appropriated in this section, $6,606,198 is
32allocated for the JOBS program.
332. Of the funds appropriated in this section, $3,313,854 is
34allocated for the family development and self-sufficiency grant
35program.
-69- 13. a. Notwithstanding section 8.39, for the fiscal
2year beginning July 1, 2022, if necessary to meet federal
3maintenance of effort requirements or to transfer federal
4temporary assistance for needy families block grant funding
5to be used for purposes of the federal social services block
6grant or to meet cash flow needs resulting from delays in
7receiving federal funding or to implement, in accordance with
8this division of this Act, activities currently funded with
9juvenile court services, county, or community moneys and state
10moneys used in combination with such moneys; to comply with
11federal requirements; or to maximize the use of federal funds;
12the department of human services may transfer funds within or
13between any of the appropriations made in this division of this
14Act and appropriations in law for the federal social services
15block grant to the department for the following purposes,
16provided that the combined amount of state and federal
17temporary assistance for needy families block grant funding
18for each appropriation remains the same before and after the
19transfer:
20(1) For the family investment program.
21(2) For state child care assistance.
22(3) For child and family services.
23(4) For field operations.
24(5) For general administration.
25b. This subsection shall not be construed to prohibit the
26use of existing state transfer authority for other purposes.
27The department shall report any transfers made pursuant to this
28subsection to the general assembly.
294. Of the funds appropriated in this section, $195,000
30shall be used for a contract for tax preparation assistance
31to low-income Iowans in order to expand the usage of the
32earned income tax credit. The purpose of the contract is to
33supply this assistance to underserved areas of the state. The
34department shall not retain any portion of the allocation under
35this subsection for administrative costs.
-70- 15. Of the funds appropriated in this section, $70,000 shall
2be used for the continuation of the parenting program, as
3specified in 441 IAC ch.100, relating to parental obligations,
4in which the child support recovery unit participates, to
5support the efforts of a nonprofit organization committed
6to strengthening the community through youth development,
7healthy living, and social responsibility headquartered in
8a county with a population over 350,000 according to the
9latest certified federal census. The funds allocated in this
10subsection shall be used by the recipient organization to
11develop a larger community effort, through public and private
12partnerships, to support a broad-based multi-county parenthood
13initiative that promotes payment of child support obligations,
14improved family relationships, and full-time employment.
156. The department may transfer funds appropriated in this
16section, excluding the allocation in subsection 2 for the
17family development and self-sufficiency grant program, to the
18appropriations made in this division of this Act for general
19administration and field operations as necessary to administer
20this section, section 45 for the temporary assistance for needy
21families block grant, and section 46 for the family investment
22program account.
23 Sec. 49. CHILD SUPPORT RECOVERY. There is appropriated
24from the general fund of the state to the department of human
25services for the fiscal year beginning July 1, 2022, and ending
26June 30, 2023, the following amount, or so much thereof as is
27necessary, to be used for the purposes designated:
28For child support recovery, including salaries, support,
29maintenance, and miscellaneous purposes:
.................................................. $3015,942,885
311. The department shall expend up to $24,000, including
32federal financial participation, for the fiscal year beginning
33July 1, 2022, for a child support public awareness campaign.
34The department and the office of the attorney general shall
35cooperate in continuation of the campaign. The public
-71-1awareness campaign shall emphasize, through a variety of
2media activities, the importance of maximum involvement of
3both parents in the lives of their children as well as the
4importance of payment of child support obligations.
52. Federal access and visitation grant moneys shall be
6issued directly to private not-for-profit agencies that provide
7services designed to increase compliance with the child access
8provisions of court orders, including but not limited to
9neutral visitation sites and mediation services.
103. The appropriation made to the department for child
11support recovery may be used throughout the fiscal year in the
12manner necessary for purposes of cash flow management, and for
13cash flow management purposes the department may temporarily
14draw more than the amount appropriated, provided the amount
15appropriated is not exceeded at the close of the fiscal year.
16 Sec. 50. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
17FY 2022-2023. Any funds remaining in the health care trust
18fund created in section 453A.35A for the fiscal year beginning
19July 1, 2022, and ending June 30, 2023, are appropriated to
20the department of human services to supplement the medical
21assistance program appropriations made in this division of this
22Act, for medical assistance reimbursement and associated costs,
23including program administration and costs associated with
24program implementation.
25 Sec. 51. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
262022-2023. Any funds remaining in the Medicaid fraud fund
27created in section 249A.50 for the fiscal year beginning
28July 1, 2022, and ending June 30, 2023, are appropriated to
29the department of human services to supplement the medical
30assistance appropriations made in this division of this Act,
31for medical assistance reimbursement and associated costs,
32including program administration and costs associated with
33program implementation.
34 Sec. 52. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES
35FUND — FY 2022-2023. There is appropriated from the general
-72-1fund of the state to the department of human services for the
2fiscal year beginning July 1, 2022, and ending June 30, 2023,
3the following amount, or so much thereof as is necessary, to be
4used for the purpose designated:
5For transfer to the mental health and disability regional
6services fund created in section 225C.7A, or a successor fund:
.................................................. $730,000,000
8Moneys transferred to the mental health and disability
9regional services fund under this section are appropriated to
10the department of human services for distribution to regions
11for funding of mental health and disability services in
12accordance with section 225C.7A.
13 Sec. 53. MEDICAL ASSISTANCE. There is appropriated from the
14general fund of the state to the department of human services
15for the fiscal year beginning July 1, 2022, and ending June 30,
162023, the following amount, or so much thereof as is necessary,
17to be used for the purpose designated:
18For medical assistance program reimbursement and associated
19costs as specifically provided in the reimbursement
20methodologies in effect on June 30, 2022, except as otherwise
21expressly authorized by law, consistent with options under
22federal law and regulations, and contingent upon receipt of
23approval from the office of the governor of reimbursement for
24each abortion performed under the program:
.................................................. $251,491,499,409
261. Iowans support reducing the number of abortions
27performed in our state. Funds appropriated under this section
28shall not be used for abortions, unless otherwise authorized
29under this section.
302. The provisions of this section relating to abortions
31shall also apply to the Iowa health and wellness plan created
32pursuant to chapter 249N.
333. The department shall utilize not more than $60,000 of
34the funds appropriated in this section to continue the AIDS/HIV
35health insurance premium payment program as established in 1992
-73-1Iowa Acts, Second Extraordinary Session, chapter 1001, section
2409, subsection 6. Of the funds allocated in this subsection,
3not more than $5,000 may be expended for administrative
4purposes.
54. Of the funds appropriated in this Act to the department
6of public health for addictive disorders, $950,000 for
7the fiscal year beginning July 1, 2022, is transferred
8to the department of human services for an integrated
9substance-related disorder managed care system. The
10departments of human services and public health shall
11work together to maintain the level of mental health and
12substance-related disorder treatment services provided by the
13managed care contractors. Each department shall take the steps
14necessary to continue the federal waivers as necessary to
15maintain the level of services.
165. The department shall aggressively pursue options for
17providing medical assistance or other assistance to individuals
18with special needs who become ineligible to continue receiving
19services under the early and periodic screening, diagnostic,
20and treatment program under the medical assistance program
21due to becoming 21 years of age who have been approved for
22additional assistance through the department’s exception to
23policy provisions, but who have health care needs in excess
24of the funding available through the exception to policy
25provisions.
266. Of the funds appropriated in this section, up to
27$3,050,082 may be transferred to the field operations or
28general administration appropriations in this division of this
29Act for operational costs associated with Part D of the federal
30Medicare Prescription Drug Improvement and Modernization Act
31of 2003, Pub.L.No.108-173.
327. Of the funds appropriated in this section, up to $442,100
33may be transferred to the appropriation in this division of
34this Act for health program operations to be used for clinical
35assessment services and prior authorization of services.
-74- 18. A portion of the funds appropriated in this section may
2be transferred to the appropriations in this division of this
3Act for general administration, health program operations, the
4children’s health insurance program, or field operations to be
5used for the state match cost to comply with the payment error
6rate measurement (PERM) program for both the medical assistance
7and children’s health insurance programs as developed by the
8centers for Medicare and Medicaid services of the United States
9department of health and human services to comply with the
10federal Improper Payments Information Act of 2002, Pub.L.
11No.107-300, and to support other reviews and quality control
12activities to improve the integrity of these programs.
139. Of the funds appropriated in this section, a sufficient
14amount is allocated to supplement the incomes of residents of
15nursing facilities, intermediate care facilities for persons
16with mental illness, and intermediate care facilities for
17persons with an intellectual disability, with incomes of less
18than $50 in the amount necessary for the residents to receive a
19personal needs allowance of $50 per month pursuant to section
20249A.30A.
2110. a. Hospitals that meet the conditions specified
22in subparagraphs (1) and (2) shall either certify public
23expenditures or transfer to the medical assistance program
24an amount equal to provide the nonfederal share for a
25disproportionate share hospital payment in an amount up to the
26hospital-specific limit as approved in the Medicaid state plan.
27The hospitals that meet the conditions specified shall receive
28and retain 100 percent of the total disproportionate share
29hospital payment in an amount up to the hospital-specific limit
30as approved in the Medicaid state plan.
31(1) The hospital qualifies for disproportionate share and
32graduate medical education payments.
33(2) The hospital is an Iowa state-owned hospital with more
34than 500 beds and eight or more distinct residency specialty
35or subspecialty programs recognized by the American college of
-75-1graduate medical education.
2b. Distribution of the disproportionate share payments
3shall be made on a monthly basis. The total amount of
4disproportionate share payments including graduate medical
5education, enhanced disproportionate share, and Iowa
6state-owned teaching hospital payments shall not exceed the
7amount of the state’s allotment under Pub.L.No.102-234.
8In addition, the total amount of all disproportionate
9share payments shall not exceed the hospital-specific
10disproportionate share limits under Pub.L.No.103-66.
1111. One hundred percent of the nonfederal share of payments
12to area education agencies that are medical assistance
13providers for medical assistance-covered services provided to
14medical assistance-covered children, shall be made from the
15appropriation made in this section.
1612. A portion of the funds appropriated in this section may
17be transferred to the appropriation in this division of this
18Act for health program operations to be used for administrative
19activities associated with the money follows the person
20demonstration project.
2113. Of the funds appropriated in this section, $349,011
22shall be used for the administration of the health insurance
23premium payment program, including salaries, support,
24maintenance, and miscellaneous purposes.
2514. a. The department may increase the amounts allocated
26for salaries, support, maintenance, and miscellaneous purposes
27associated with the medical assistance program, as necessary,
28to sustain cost management efforts. The department shall
29report any such increase to the general assembly and the
30department of management.
31b. If the savings to the medical assistance program from
32ongoing cost management efforts exceed the associated cost
33for the fiscal year beginning July 1, 2022, the department
34may transfer any savings generated for the fiscal year due
35to medical assistance program cost management efforts to the
-76-1appropriation made in this division of this Act for health
2program operations or general administration to defray the
3costs associated with implementing the efforts.
415. For the fiscal year beginning July 1, 2022, and ending
5June 30, 2023, the replacement generation tax revenues required
6to be deposited in the property tax relief fund pursuant to
7section 437A.8, subsection 4, paragraph “d”, and section
8437A.15, subsection 3, paragraph “f”, shall instead be credited
9to and supplement the appropriation made in this section and
10used for the allocations made in this section.
1116. a. Of the funds appropriated in this section, up
12to $50,000 may be transferred by the department to the
13appropriation made in this division of this Act to the
14department for the same fiscal year for general administration
15to be used for associated administrative expenses.
16b. Of the funds appropriated in this section, up to $400,000
17may be transferred by the department to the appropriation made
18to the department in this division of this Act for the same
19fiscal year for Medicaid program-related general administration
20planning and implementation activities. The funds may be used
21for contracts or for personnel in addition to the amounts
22appropriated for general administration for the fiscal year.
23c. Of the funds appropriated in this section, up to
24$3,000,000 may be transferred by the department to the
25appropriations made in this division of this Act for the
26same fiscal year for general administration or health
27program operations to be used to support the development
28and implementation of standardized assessment tools for
29persons with mental illness, an intellectual disability, a
30developmental disability, or a brain injury.
3117. Of the funds appropriated in this section, $150,000
32shall be used for lodging expenses associated with care
33provided at the university of Iowa hospitals and clinics for
34patients with cancer whose travel distance is 30 miles or more
35and whose income is at or below 200 percent of the federal
-77-1poverty level as defined by the most recently revised poverty
2income guidelines published by the United States department of
3health and human services. The department of human services
4shall establish the maximum number of overnight stays and the
5maximum rate reimbursed for overnight lodging, which may be
6based on the state employee rate established by the department
7of administrative services. The funds allocated in this
8subsection shall not be used as nonfederal share matching
9funds.
1018. Of the funds appropriated in this section, up to
11$3,383,880 shall be used for administration of the state family
12planning services program pursuant to section 217.41B, and
13of this amount, the department may use up to $200,000 for
14administrative expenses.
1519. Of the funds appropriated in this section, $1,545,530
16shall be used and may be transferred to other appropriations
17in this division of this Act as necessary to administer the
18provisions in the division of this Act relating to Medicaid
19program administration.
20 Sec. 54. HEALTH PROGRAM OPERATIONS. There is appropriated
21from the general fund of the state to the department of human
22services for the fiscal year beginning July 1, 2022, and ending
23June 30, 2023, the following amount, or so much thereof as is
24necessary, to be used for the purpose designated:
25For health program operations:
.................................................. $2617,831,343
271. The department of inspections and appeals shall
28provide all state matching funds for survey and certification
29activities performed by the department of inspections
30and appeals. The department of human services is solely
31responsible for distributing the federal matching funds for
32such activities.
332. Of the funds appropriated in this section, $50,000 shall
34be used for continuation of home and community-based services
35waiver quality assurance programs, including the review and
-78-1streamlining of processes and policies related to oversight and
2quality management to meet state and federal requirements.
33. Of the amount appropriated in this section, up to
4$200,000 may be transferred to the appropriation for general
5administration in this division of this Act to be used for the
6development of key health initiatives such as development and
7oversight of managed care programs and development of health
8strategies targeted toward improved quality and reduced costs
9in the Medicaid program.
104. Of the funds appropriated in this section, $1,000,000
11shall be used for planning and development, in cooperation with
12the department of public health, of a phased-in program to
13provide a dental home for children.
145. a. Of the funds appropriated in this section, $573,000
15shall be credited to the autism support program fund created
16in section 225D.2 to be used for the autism support program
17created in chapter 225D, with the exception of the following
18amount of this allocation which shall be used as follows:
19b. Of the funds allocated in this subsection, $25,000 shall
20be used for the public purpose of continuation of a grant to a
21nonprofit provider of child welfare services that has been in
22existence for more than 115 years, is located in a county with
23a population between 200,000 and 220,000 according to the most
24recent federal decennial census, is licensed as a psychiatric
25medical institution for children, and provides school-based
26programming, to be used for support services for children with
27autism spectrum disorder and their families.
28 Sec. 55. STATE SUPPLEMENTARY ASSISTANCE.
291. There is appropriated from the general fund of the
30state to the department of human services for the fiscal year
31beginning July 1, 2022, and ending June 30, 2023, the following
32amount, or so much thereof as is necessary, to be used for the
33purpose designated:
34For the state supplementary assistance program:
.................................................. $357,349,002
-79- 12. The department shall increase the personal needs
2allowance for residents of residential care facilities by the
3same percentage and at the same time as federal supplemental
4security income and federal social security benefits are
5increased due to a recognized increase in the cost of living.
6The department may adopt emergency rules to implement this
7subsection.
83. If during the fiscal year beginning July 1, 2022,
9the department projects that state supplementary assistance
10expenditures for a calendar year will not meet the federal
11pass-through requirement specified in Tit.XVI of the federal
12Social Security Act, section 1618, as codified in 42 U.S.C.
13§1382g, the department may take actions including but not
14limited to increasing the personal needs allowance for
15residential care facility residents and making programmatic
16adjustments or upward adjustments of the residential care
17facility or in-home health-related care reimbursement rates
18prescribed in this division of this Act to ensure that federal
19requirements are met. In addition, the department may make
20other programmatic and rate adjustments necessary to remain
21within the amount appropriated in this section while ensuring
22compliance with federal requirements. The department may adopt
23emergency rules to implement the provisions of this subsection.
244. Notwithstanding section 8.33, moneys appropriated
25in this section that remain unencumbered or unobligated
26at the close of the fiscal year shall not revert but
27shall remain available for expenditure for the purposes
28designated, including for liability amounts associated with the
29supplemental nutrition assistance program payment error rate,
30until the close of the succeeding fiscal year.
31 Sec. 56. CHILDREN’S HEALTH INSURANCE PROGRAM.
321. There is appropriated from the general fund of the
33state to the department of human services for the fiscal year
34beginning July 1, 2022, and ending June 30, 2023, the following
35amount, or so much thereof as is necessary, to be used for the
-80-1purpose designated:
2For maintenance of the healthy and well kids in Iowa (hawk-i)
3program pursuant to chapter 514I, including supplemental dental
4services, for receipt of federal financial participation under
5Tit.XXI of the federal Social Security Act, which creates the
6children’s health insurance program:
.................................................. $748,326,863
82. Of the funds appropriated in this section, $162,029 is
9allocated for continuation of the contract for outreach with
10the department of public health.
113. A portion of the funds appropriated in this section may
12be transferred to the appropriations made in this division of
13this Act for field operations or health program operations to
14be used for the integration of hawk-i program eligibility,
15payment, and administrative functions under the purview of
16the department of human services, including for the Medicaid
17management information system upgrade.
18 Sec. 57. CHILD CARE ASSISTANCE. There is appropriated
19from the general fund of the state to the department of human
20services for the fiscal year beginning July 1, 2022, and ending
21June 30, 2023, the following amount, or so much thereof as is
22necessary, to be used for the purpose designated:
23For child care programs:
.................................................. $2440,816,931
251. Of the funds appropriated in this section, $34,966,931
26shall be used for state child care assistance in accordance
27with section 237A.13.
282. Nothing in this section shall be construed or is
29intended as or shall imply a grant of entitlement for services
30to persons who are eligible for assistance due to an income
31level consistent with the waiting list requirements of section
32237A.13. Any state obligation to provide services pursuant to
33this section is limited to the extent of the funds appropriated
34in this section.
353. A list of the registered and licensed child care
-81-1facilities operating in the area served by a child care
2resource and referral service shall be made available to the
3families receiving state child care assistance in that area.
44. Of the funds appropriated in this section, $5,850,000
5shall be credited to the early childhood programs grants
6account in the early childhood Iowa fund created in section
7256I.11. The moneys shall be distributed for funding of
8community-based early childhood programs targeted to children
9from birth through five years of age developed by early
10childhood Iowa areas in accordance with approved community
11plans as provided in section 256I.8.
125. The department may use any of the funds appropriated
13in this section as a match to obtain federal funds for use in
14expanding child care assistance and related programs. For
15the purpose of expenditures of state and federal child care
16funding, funds shall be considered obligated at the time
17expenditures are projected or are allocated to the department’s
18service areas. Projections shall be based on current and
19projected caseload growth, current and projected provider
20rates, staffing requirements for eligibility determination
21and management of program requirements including data systems
22management, staffing requirements for administration of the
23program, contractual and grant obligations and any transfers
24to other state agencies, and obligations for decategorization
25or innovation projects.
266. A portion of the state match for the federal child care
27and development block grant shall be provided as necessary to
28meet federal matching funds requirements through the state
29general fund appropriation made for child development grants
30and other programs for at-risk children in section 279.51.
317. If a uniform reduction ordered by the governor under
32section 8.31 or other operation of law, transfer, or federal
33funding reduction reduces the appropriation made in this
34section for the fiscal year, the percentage reduction in the
35amount paid out to or on behalf of the families participating
-82-1in the state child care assistance program shall be equal to or
2less than the percentage reduction made for any other purpose
3payable from the appropriation made in this section and the
4federal funding relating to it. The percentage reduction to
5the other allocations made in this section shall be the same as
6the uniform reduction ordered by the governor or the percentage
7change of the federal funding reduction, as applicable. If
8there is an unanticipated increase in federal funding provided
9for state child care services, the entire amount of the
10increase, except as necessary to meet federal requirements
11including quality set asides, shall be used for state child
12care assistance payments. If the appropriations made for
13purposes of the state child care assistance program for the
14fiscal year are determined to be insufficient, it is the intent
15of the general assembly to appropriate sufficient funding for
16the fiscal year in order to avoid establishment of waiting list
17requirements.
188. Notwithstanding section 8.33, moneys advanced for
19purposes of the programs developed by early childhood Iowa
20areas, advanced for purposes of wraparound child care, or
21received from the federal appropriations made for the purposes
22of this section that remain unencumbered or unobligated at the
23close of the fiscal year shall not revert to any fund but shall
24remain available for expenditure for the purposes designated
25until the close of the succeeding fiscal year.
26 Sec. 58. JUVENILE INSTITUTION. There is appropriated
27from the general fund of the state to the department of human
28services for the fiscal year beginning July 1, 2022, and ending
29June 30, 2023, the following amounts, or so much thereof as is
30necessary, to be used for the purposes designated:
311. a. For operation of the state training school at Eldora
32and for salaries, support, maintenance, and miscellaneous
33purposes:
.................................................. $3417,397,068
35b. Of the funds appropriated in this subsection, $91,000
-83-1shall be used for distribution to licensed classroom teachers
2at this and other institutions under the control of the
3department of human services based upon the average student
4yearly enrollment at each institution as determined by the
5department.
62. A portion of the moneys appropriated in this section
7shall be used by the state training school at Eldora for
8grants for adolescent pregnancy prevention activities at the
9institution in the fiscal year beginning July 1, 2022.
103. Of the funds appropriated in this subsection, $212,000
11shall be used by the state training school at Eldora for a
12substance use disorder treatment program at the institution for
13the fiscal year beginning July 1, 2022.
144. Notwithstanding section 8.33, moneys appropriated in
15this section that remain unencumbered or unobligated at the
16close of the fiscal year shall not revert but shall remain
17available for expenditure for the purposes designated until the
18close of the succeeding fiscal year.
19 Sec. 59. CHILD AND FAMILY SERVICES.
201. There is appropriated from the general fund of the
21state to the department of human services for the fiscal year
22beginning July 1, 2022, and ending June 30, 2023, the following
23amount, or so much thereof as is necessary, to be used for the
24purpose designated:
25For child and family services:
.................................................. $2689,071,930
272. The department may transfer funds appropriated in this
28section as necessary to pay the nonfederal costs of services
29reimbursed under the medical assistance program, state child
30care assistance program, or the family investment program which
31are provided to children who would otherwise receive services
32paid under the appropriation in this section. The department
33may transfer funds appropriated in this section to the
34appropriations made in this division of this Act for general
35administration and for field operations for resources necessary
-84-1to implement and operate the services funded in this section.
23. a. Of the funds appropriated in this section, up to
3$31,500,000 is allocated as the statewide expenditure target
4under section 232.143 for group foster care maintenance and
5services. If the department projects that such expenditures
6for the fiscal year will be less than the target amount
7allocated in this paragraph “a”, the department may reallocate
8the excess to provide additional funding for family foster
9care, independent living, family-centered services, shelter
10care, or the child welfare emergency services addressed with
11the allocation for shelter care.
12b. If at any time after September 30, 2022, annualization
13of a service area’s current expenditures indicates a service
14area is at risk of exceeding its group foster care expenditure
15target under section 232.143 by more than 5 percent, the
16department and juvenile court services shall examine all
17group foster care placements in that service area in order to
18identify those which might be appropriate for termination.
19In addition, any aftercare services believed to be needed
20for the children whose placements may be terminated shall be
21identified. The department and juvenile court services shall
22initiate action to set dispositional review hearings for the
23placements identified. In such a dispositional review hearing,
24the juvenile court shall determine whether needed aftercare
25services are available and whether termination of the placement
26is in the best interest of the child and the community.
274. In accordance with the provisions of section 232.188,
28the department shall continue the child welfare and juvenile
29justice funding initiative during fiscal year 2022-2023. Of
30the funds appropriated in this section, $1,717,000 is allocated
31specifically for expenditure for fiscal year 2022-2023 through
32the decategorization services funding pools and governance
33boards established pursuant to section 232.188.
345. A portion of the funds appropriated in this section
35may be used for emergency family assistance to provide other
-85-1resources required for a family participating in a family
2preservation or reunification project or successor project to
3stay together or to be reunified.
46. Of the funds appropriated in this section, a sufficient
5amount is allocated for shelter care and the child welfare
6emergency services contracting implemented to provide for or
7prevent the need for shelter care.
87. Federal funds received by the state during the fiscal
9year beginning July 1, 2022, as the result of the expenditure
10of state funds appropriated during a previous state fiscal
11year for a service or activity funded under this section are
12appropriated to the department to be used as additional funding
13for services and purposes provided for under this section.
14Notwithstanding section 8.33, moneys received in accordance
15with this subsection that remain unencumbered or unobligated at
16the close of the fiscal year shall not revert to any fund but
17shall remain available for the purposes designated until the
18close of the succeeding fiscal year.
198. a. Of the funds appropriated in this section, up to
20$3,290,000 is allocated for the payment of the expenses of
21court-ordered services provided to juveniles who are under the
22supervision of juvenile court services, which expenses are a
23charge upon the state pursuant to section 232.141, subsection
244. Of the amount allocated in this paragraph “a”, up to
25$1,556,000 shall be made available to provide school-based
26supervision of children adjudicated under chapter 232, of which
27not more than $15,000 may be used for the purpose of training.
28A portion of the cost of each school-based liaison officer
29shall be paid by the school district or other funding source as
30approved by the chief juvenile court officer.
31b. Of the funds appropriated in this section, up to $748,000
32is allocated for the payment of the expenses of court-ordered
33services provided to children who are under the supervision
34of the department, which expenses are a charge upon the state
35pursuant to section 232.141, subsection 4.
-86- 1c. Notwithstanding section 232.141 or any other provision
2of law to the contrary, the amounts allocated in this
3subsection shall be distributed to the judicial districts
4as determined by the state court administrator and to the
5department’s service areas as determined by the administrator
6of the department of human services’ division of child and
7family services. The state court administrator and the
8division administrator shall make the determination of the
9distribution amounts on or before June 15, 2022.
10d. Notwithstanding chapter 232 or any other provision of
11law to the contrary, a district or juvenile court shall not
12order any service which is a charge upon the state pursuant
13to section 232.141 if there are insufficient court-ordered
14services funds available in the district court or departmental
15service area distribution amounts to pay for the service. The
16chief juvenile court officer and the departmental service area
17manager shall encourage use of the funds allocated in this
18subsection such that there are sufficient funds to pay for
19all court-related services during the entire year. The chief
20juvenile court officers and departmental service area managers
21shall attempt to anticipate potential surpluses and shortfalls
22in the distribution amounts and shall cooperatively request the
23state court administrator or division administrator to transfer
24funds between the judicial districts’ or departmental service
25areas’ distribution amounts as prudent.
26e. Notwithstanding any provision of law to the contrary,
27a district or juvenile court shall not order a county to pay
28for any service provided to a juvenile pursuant to an order
29entered under chapter 232 which is a charge upon the state
30under section 232.141, subsection 4.
31f. Of the funds allocated in this subsection, not more than
32$83,000 may be used by the judicial branch for administration
33of the requirements under this subsection.
34g. Of the funds allocated in this subsection, $17,000
35shall be used by the department of human services to support
-87-1the interstate commission for juveniles in accordance with
2the interstate compact for juveniles as provided in section
3232.173.
49. Of the funds appropriated in this section, $12,253,000 is
5allocated for juvenile delinquent graduated sanctions services.
6Any state funds saved as a result of efforts by juvenile court
7services to earn a federal Tit.IV-E match for juvenile court
8services administration may be used for the juvenile delinquent
9graduated sanctions services.
1010. Of the funds appropriated in this section, $1,658,000 is
11transferred to the department of public health to be used for
12the child protection center grant program for child protection
13centers located in Iowa in accordance with section 135.118.
14The grant amounts under the program shall be equalized so that
15each center receives a uniform base amount of $245,000, and so
16that the remaining funds are awarded through a funding formula
17based upon the volume of children served. To increase access
18to child protection center services for children in rural
19areas, the funding formula for the awarding of the remaining
20funds shall provide for the awarding of an enhanced amount to
21eligible grantees to develop and maintain satellite centers in
22underserved regions of the state.
2311. Of the funds appropriated in this section, $4,025,000 is
24allocated for the preparation for adult living program pursuant
25to section 234.46.
2612. Of the funds appropriated in this section, $227,000
27shall be used for the public purpose of continuing a grant to a
28nonprofit human services organization, providing services to
29individuals and families in multiple locations in southwest
30Iowa and Nebraska for support of a project providing immediate,
31sensitive support and forensic interviews, medical exams, needs
32assessments, and referrals for victims of child abuse and their
33nonoffending family members.
3413. Of the funds appropriated in this section, $300,000
35is allocated for the foster care youth council approach of
-88-1providing a support network to children placed in foster care.
214. Of the funds appropriated in this section, $202,000 is
3allocated for use pursuant to section 235A.1 for continuation
4of the initiative to address child sexual abuse implemented
5pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
621.
715. Of the funds appropriated in this section, $630,000 is
8allocated for the community partnership for child protection
9sites.
1016. Of the funds appropriated in this section, $371,000
11is allocated for the department’s minority youth and family
12projects under the redesign of the child welfare system.
1317. Of the funds appropriated in this section, $851,000
14is allocated for funding of the community circle of care
15collaboration for children and youth in northeast Iowa.
1618. Of the funds appropriated in this section, at least
17$147,000 shall be used for the continuation of the child
18welfare provider training academy, a collaboration between the
19coalition for family and children’s services in Iowa and the
20department.
2119. Of the funds appropriated in this section, $211,000
22shall be used for continuation of the central Iowa system of
23care program grant through June 30, 2023.
2420. Of the funds appropriated in this section, $235,000
25shall be used for the public purpose of the continuation
26and expansion of a system of care program grant implemented
27in Cerro Gordo and Linn counties to utilize a comprehensive
28and long-term approach for helping children and families by
29addressing the key areas in a child’s life of childhood basic
30needs, education and work, family, and community.
3121. Of the funds appropriated in this section, $110,000
32shall be used for the public purpose of funding community-based
33services and other supports with a system of care approach
34for children with a serious emotional disturbance and their
35families through a nonprofit provider of child welfare services
-89-1that has been in existence for more than 115 years, is located
2in a county with a population of more than 200,000 but less
3than 235,000 according to the latest certified federal census,
4is licensed as a psychiatric medical institution for children,
5and was a system of care grantee prior to July 1, 2022.
622. If a separate funding source is identified that reduces
7the need for state funds within an allocation under this
8section, the allocated state funds may be redistributed to
9other allocations under this section for the same fiscal year.
1023. Of the funds appropriated in this section, a portion may
11be used for family-centered services for purposes of complying
12with the federal Family First Prevention Services Act of 2018,
13Pub.L. No.115-123, and successor legislation.
14 Sec. 60. ADOPTION SUBSIDY.
151. There is appropriated from the general fund of the
16state to the department of human services for the fiscal year
17beginning July 1, 2022, and ending June 30, 2023, the following
18amount, or so much thereof as is necessary, to be used for the
19purpose designated:
20a. For adoption subsidy payments and related costs and for
21other services provided under paragraph “b”, subparagraph (2):
.................................................. $2240,596,007
23b. (1) Of the funds appropriated in this section, a
24sufficient amount is allocated for adoption subsidy payments
25and related costs.
26(2) Any funds appropriated in this section remaining after
27the allocation under subparagraph (1) are designated and
28allocated as state savings resulting from implementation of
29the federal Fostering Connections to Success and Increasing
30Adoptions Act of 2008, Pub.L. No.110-351, and successor
31legislation, as determined in accordance with 42 U.S.C.
32§673(a)(8), and shall be used for post-adoption services and
33for other purposes allowed under these federal laws, Tit.IV-B
34or Tit.IV-E of the federal Social Security Act.
35(a) The department of human services may transfer funds
-90-1allocated in this subparagraph (2) to the appropriation for
2child and family services in this division of this Act for the
3purposes designated in this subparagraph (2).
4(b) Notwithstanding section 8.33, moneys allocated
5under this subparagraph (2) shall not revert to any fund but
6shall remain available for the purposes designated in this
7subparagraph (2) until expended.
82. The department may transfer funds appropriated in
9this section to the appropriation made in this division of
10this Act for general administration for costs paid from the
11appropriation relating to adoption subsidy.
123. Federal funds received by the state during the
13fiscal year beginning July 1, 2022, as the result of the
14expenditure of state funds during a previous state fiscal
15year for a service or activity funded under this section are
16appropriated to the department to be used as additional funding
17for the services and activities funded under this section.
18Notwithstanding section 8.33, moneys received in accordance
19with this subsection that remain unencumbered or unobligated
20at the close of the fiscal year shall not revert to any fund
21but shall remain available for expenditure for the purposes
22designated until the close of the succeeding fiscal year.
23 Sec. 61. JUVENILE DETENTION HOME FUND. Moneys deposited
24in the juvenile detention home fund created in section 232.142
25during the fiscal year beginning July 1, 2022, and ending June
2630, 2023, are appropriated to the department of human services
27for the fiscal year beginning July 1, 2022, and ending June 30,
282023, for distribution of an amount equal to a percentage of
29the costs of the establishment, improvement, operation, and
30maintenance of county or multicounty juvenile detention homes
31in the fiscal year beginning July 1, 2021. Moneys appropriated
32for distribution in accordance with this section shall be
33allocated among eligible detention homes, prorated on the basis
34of an eligible detention home’s proportion of the costs of all
35eligible detention homes in the fiscal year beginning July
-91-11, 2021. The percentage figure shall be determined by the
2department based on the amount available for distribution for
3the fund. Notwithstanding section 232.142, subsection 3, the
4financial aid payable by the state under that provision for the
5fiscal year beginning July 1, 2022, shall be limited to the
6amount appropriated for the purposes of this section.
7 Sec. 62. FAMILY SUPPORT SUBSIDY PROGRAM.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2022, and ending June 30, 2023, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13For the family support subsidy program subject to the
14enrollment restrictions in section 225C.37, subsection 3:
.................................................. $15949,282
162. At least $922,735 of the moneys appropriated in this
17section is transferred to the department of public health for
18the family support center component of the comprehensive family
19support program under chapter 225C, subchapter V.
203. If at any time during the fiscal year, the amount of
21funding available for the family support subsidy program
22is reduced from the amount initially used to establish the
23figure for the number of family members for whom a subsidy
24is to be provided at any one time during the fiscal year,
25notwithstanding section 225C.38, subsection 2, the department
26shall revise the figure as necessary to conform to the amount
27of funding available.
28 Sec. 63. CONNER DECREE. There is appropriated from the
29general fund of the state to the department of human services
30for the fiscal year beginning July 1, 2022, and ending June 30,
312023, the following amount, or so much thereof as is necessary,
32to be used for the purpose designated:
33For building community capacity through the coordination
34and provision of training opportunities in accordance with the
35consent decree of Conner v.Branstad, No.4-86-CV-30871 (S.D.
-92-1Iowa, July 14, 1994):
.................................................. $233,632
3 Sec. 64. MENTAL HEALTH INSTITUTES.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2022, and ending June 30, 2023, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
9a. For operation of the state mental health institute at
10Cherokee as required by chapters 218 and 226 for salaries,
11support, maintenance, and miscellaneous purposes:
.................................................. $1216,058,356
13b. For operation of the state mental health institute at
14Independence as required by chapters 218 and 226 for salaries,
15support, maintenance, and miscellaneous purposes:
.................................................. $1620,628,077
172. a. Notwithstanding sections 218.78 and 249A.11, any
18revenue received from the state mental health institute at
19Cherokee or the state mental health institute at Independence
20pursuant to 42 C.F.R§438.6(e) may be retained and expended by
21the mental health institute.
22b. Notwithstanding sections 218.78 and 249A.11, any
23COVID-19 related funding received through federal funding
24sources by the state mental health institute at Cherokee or the
25state mental health institute at Independence may be retained
26and expended by the mental health institute.
273. Notwithstanding any provision of law to the contrary,
28a Medicaid member residing at the state mental health
29institute at Cherokee or the state mental health institute
30at Independence shall retain Medicaid eligibility during
31the period of the Medicaid member’s stay for which federal
32financial participation is available.
334. Notwithstanding section 8.33, moneys appropriated in
34this section that remain unencumbered or unobligated at the
35close of the fiscal year shall not revert but shall remain
-93-1available for expenditure for the purposes designated until the
2close of the succeeding fiscal year.
3 Sec. 65. STATE RESOURCE CENTERS.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2022, and ending June 30, 2023, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
9a. For the state resource center at Glenwood for salaries,
10support, maintenance, and miscellaneous purposes:
.................................................. $1114,802,873
12b. For the state resource center at Woodward for salaries,
13support, maintenance, and miscellaneous purposes:
.................................................. $1413,698,094
152. The department may continue to bill for state resource
16center services utilizing a scope of services approach used for
17private providers of intermediate care facilities for persons
18with an intellectual disability services, in a manner which
19does not shift costs between the medical assistance program,
20counties, or other sources of funding for the state resource
21centers.
223. The state resource centers may expand the time-limited
23assessment and respite services during the fiscal year.
244. If the department’s administration and the department
25of management concur with a finding by a state resource
26center’s superintendent that projected revenues can reasonably
27be expected to pay the salary and support costs for a new
28employee position, or that such costs for adding a particular
29number of new positions for the fiscal year would be less
30than the overtime costs if new positions would not be added,
31the superintendent may add the new position or positions. If
32the vacant positions available to a resource center do not
33include the position classification desired to be filled, the
34state resource center’s superintendent may reclassify any
35vacant position as necessary to fill the desired position. The
-94-1superintendents of the state resource centers may, by mutual
2agreement, pool vacant positions and position classifications
3during the course of the fiscal year in order to assist one
4another in filling necessary positions.
55. If existing capacity limitations are reached in
6operating units, a waiting list is in effect for a service or
7a special need for which a payment source or other funding
8is available for the service or to address the special need,
9and facilities for the service or to address the special need
10can be provided within the available payment source or other
11funding, the superintendent of a state resource center may
12authorize opening not more than two units or other facilities
13and begin implementing the service or addressing the special
14need during fiscal year 2022-2023.
156. Notwithstanding section 8.33, and notwithstanding
16the amount limitation specified in section 222.92, moneys
17appropriated in this section that remain unencumbered or
18unobligated at the close of the fiscal year shall not revert
19but shall remain available for expenditure for the purposes
20designated until the close of the succeeding fiscal year.
21 Sec. 66. SEXUALLY VIOLENT PREDATORS.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2022, and ending June 30, 2023, the following
25amount, or so much thereof as is necessary, to be used for the
26purpose designated:
27For costs associated with the commitment and treatment of
28sexually violent predators in the unit located at the state
29mental health institute at Cherokee, including costs of legal
30services and other associated costs, including salaries,
31support, maintenance, and miscellaneous purposes:
.................................................. $3213,643,727
332. Unless specifically prohibited by law, if the amount
34charged provides for recoupment of at least the entire amount
35of direct and indirect costs, the department of human services
-95-1may contract with other states to provide care and treatment
2of persons placed by the other states at the unit for sexually
3violent predators at Cherokee. The moneys received under
4such a contract shall be considered to be repayment receipts
5and used for the purposes of the appropriation made in this
6section.
73. Notwithstanding section 8.33, moneys appropriated in
8this section that remain unencumbered or unobligated at the
9close of the fiscal year shall not revert but shall remain
10available for expenditure for the purposes designated until the
11close of the succeeding fiscal year.
12 Sec. 67. FIELD OPERATIONS.
131. There is appropriated from the general fund of the
14state to the department of human services for the fiscal year
15beginning July 1, 2022, and ending June 30, 2023, the following
16amount, or so much thereof as is necessary, to be used for the
17purposes designated:
18For field operations, including salaries, support,
19maintenance, and miscellaneous purposes:
.................................................. $2061,362,351
212. Priority in filling full-time equivalent positions
22shall be given to those positions related to child protection
23services and eligibility determination for low-income families.
24 Sec. 68. GENERAL ADMINISTRATION. There is appropriated
25from the general fund of the state to the department of human
26services for the fiscal year beginning July 1, 2022, and ending
27June 30, 2023, the following amount, or so much thereof as is
28necessary, to be used for the purpose designated:
29For general administration, including salaries, support,
30maintenance, and miscellaneous purposes:
.................................................. $3114,542,189
321. The department shall report at least monthly to the
33general assembly concerning the department’s operational and
34program expenditures.
352. Of the funds appropriated in this section, $150,000 shall
-96-1be used to contract for the provision of a program to provide
2technical assistance, support, and consultation to providers
3of habilitation services and home and community-based services
4waiver services for adults with disabilities under the medical
5assistance program.
63. Of the funds appropriated in this section, $50,000
7is transferred to the Iowa finance authority to be used
8for administrative support of the council on homelessness
9established in section 16.2D and for the council to fulfill its
10duties in addressing and reducing homelessness in the state.
114. Of the funds appropriated in this section, $200,000 shall
12be transferred to and deposited in the administrative fund of
13the Iowa ABLE savings plan trust created in section 12I.4, to
14be used for implementation and administration activities of the
15Iowa ABLE savings plan trust.
165. Of the funds appropriated in this section, $200,000 is
17transferred to the economic development authority for the Iowa
18commission on volunteer services to continue to be used for the
19RefugeeRISE AmeriCorps program established under section 15H.8
20for member recruitment and training to improve the economic
21well-being and health of economically disadvantaged refugees in
22local communities across Iowa. Funds transferred may be used
23to supplement federal funds under federal regulations.
246. Of the funds appropriated in this section, up to $300,000
25shall be used as follows:
26a. To address the department’s responsibility to support
27the work of the children’s behavioral health system state board
28and implementation of the services required pursuant to section
29331.397.
30b. To support the cost of establishing and implementing new
31or additional services required pursuant to sections 331.397
32and 331.397A.
33c. Of the amount allocated, $32,000 shall be transferred
34to the department of public health to support the costs of
35establishing and implementing new or additional services
-97-1required pursuant to sections 331.397 and 331.397A.
2 Sec. 69. DEPARTMENT-WIDE DUTIES. There is appropriated
3from the general fund of the state to the department of human
4services for the fiscal year beginning July 1, 2022, and ending
5June 30, 2023, the following amount, or so much thereof as is
6necessary, to be used for the purposes designated:
7For salaries, support, maintenance, and miscellaneous
8purposes at facilities under the purview of the department of
9human services:
.................................................. $102,879,274
11 Sec. 70. VOLUNTEERS. There is appropriated from the general
12fund of the state to the department of human services for the
13fiscal year beginning July 1, 2022, and ending June 30, 2023,
14the following amount, or so much thereof as is necessary, to be
15used for the purpose designated:
16For development and coordination of volunteer services:
.................................................. $1784,686
18 Sec. 71. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
19ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
20DEPARTMENT OF HUMAN SERVICES.
211. a. (1) (a) For the fiscal year beginning July 1,
222022, the department shall rebase case-mix nursing facility
23rates effective July 1, 2022, to the extent possible within the
24state funding, including the $20,000,000 appropriated for this
25purpose.
26(b) For the fiscal year beginning July 1, 2022, non-case-mix
27and special population nursing facilities shall be reimbursed
28in accordance with the methodology in effect on June 30 of the
29prior fiscal year.
30(c) For managed care claims, the department of human
31services shall adjust the payment rate floor for nursing
32facilities, annually, to maintain a rate floor that is no
33lower than the Medicaid fee-for-service case-mix adjusted rate
34calculated in accordance with subparagraph division (a) and
35441 IAC 81.6. The department shall then calculate adjusted
-98-1reimbursement rates, including but not limited to add-on
2payments, annually, and shall notify Medicaid managed care
3organizations of the adjusted reimbursement rates within 30
4days of determining the adjusted reimbursement rates. Any
5adjustment of reimbursement rates under this subparagraph
6division shall be budget neutral to the state budget.
7(d) For the fiscal year beginning July 1, 2022, Medicaid
8managed care long-term services and supports capitation
9rates shall be adjusted to reflect the rebasing pursuant to
10subparagraph division (a) for the patient populations residing
11in Medicaid-certified nursing facilities.
12(2) Medicaid managed care organizations shall adjust
13facility-specific rates based upon payment rate listings issued
14by the department. The rate adjustments shall be applied
15prospectively from the effective date of the rate letter issued
16by the department.
17b. (1) For the fiscal year beginning July 1, 2022,
18the department shall establish the pharmacy dispensing fee
19reimbursement at $10.07 per prescription, until a cost of
20dispensing survey is completed. The actual dispensing fee
21shall be determined by a cost of dispensing survey performed
22by the department and required to be completed by all medical
23assistance program participating pharmacies every two years,
24adjusted as necessary to maintain expenditures within the
25amount appropriated to the department for this purpose for
26the fiscal year. A change in the dispensing fee shall become
27effective following federal approval of the Medicaid state
28plan.
29(2) The department shall utilize an average acquisition
30cost reimbursement methodology for all drugs covered under the
31medical assistance program in accordance with 2012 Iowa Acts,
32chapter 1133, section 33.
33c. (1) For the fiscal year beginning July 1, 2022,
34reimbursement rates for outpatient hospital services shall
35remain at the rates in effect on June 30, 2022, subject to
-99-1Medicaid program upper payment limit rules, and adjusted
2as necessary to maintain expenditures within the amount
3appropriated to the department for this purpose for the fiscal
4year.
5(2) For the fiscal year beginning July 1, 2022,
6reimbursement rates for inpatient hospital services shall
7remain at the rates in effect on June 30, 2022, subject to
8Medicaid program upper payment limit rules, and adjusted
9as necessary to maintain expenditures within the amount
10appropriated to the department for this purpose for the fiscal
11year.
12(3) For the fiscal year beginning July 1, 2022, under
13both fee-for-service and managed care administration of
14the Medicaid program, critical access hospitals shall be
15reimbursed for inpatient and outpatient services based on the
16hospital-specific critical access hospital cost adjustment
17factor methodology utilizing the most recent and complete cost
18reporting period as applied prospectively within the funds
19appropriated for such purpose for the fiscal year.
20(4) For the fiscal year beginning July 1, 2022, the graduate
21medical education and disproportionate share hospital fund
22shall remain at the amount in effect on June 30, 2022, except
23that the portion of the fund attributable to graduate medical
24education shall be reduced in an amount that reflects the
25elimination of graduate medical education payments made to
26out-of-state hospitals.
27(5) In order to ensure the efficient use of limited state
28funds in procuring health care services for low-income Iowans,
29funds appropriated in this Act for hospital services shall
30not be used for activities which would be excluded from a
31determination of reasonable costs under the federal Medicare
32program pursuant to 42 U.S.C.§1395x(v)(1)(N).
33d. For the fiscal year beginning July 1, 2022, reimbursement
34rates for hospices and acute psychiatric hospitals shall be
35increased in accordance with increases under the federal
-100-1Medicare program or as supported by their Medicare audited
2costs.
3e. For the fiscal year beginning July 1, 2022, independent
4laboratories and rehabilitation agencies shall be reimbursed
5using the same methodology in effect on June 30, 2022.
6f. (1) For the fiscal year beginning July 1, 2022,
7reimbursement rates for home health agencies shall continue to
8be based on the Medicare low utilization payment adjustment
9(LUPA) methodology with state geographic wage adjustments.
10The department shall continue to update the rates every two
11years to reflect the most recent Medicare LUPA rates to the
12extent possible within the state funding appropriated for this
13purpose.
14(2) For the fiscal year beginning July 1, 2022, rates for
15private duty nursing and personal care services under the early
16and periodic screening, diagnostic, and treatment program
17benefit shall be calculated based on the methodology in effect
18on June 30, 2022.
19g. For the fiscal year beginning July 1, 2022, federally
20qualified health centers and rural health clinics shall receive
21cost-based reimbursement for 100 percent of the reasonable
22costs for the provision of services to recipients of medical
23assistance.
24h. For the fiscal year beginning July 1, 2022, the
25reimbursement rates for dental services shall remain at the
26rates in effect on June 30, 2022.
27i. (1) For the fiscal year beginning July 1, 2022,
28reimbursement rates for non-state-owned psychiatric medical
29institutions for children shall be based on the reimbursement
30methodology in effect on June 30, 2022.
31(2) As a condition of participation in the medical
32assistance program, enrolled providers shall accept the medical
33assistance reimbursement rate for any covered goods or services
34provided to recipients of medical assistance who are children
35under the custody of a psychiatric medical institution for
-101-1children.
2j. For the fiscal year beginning July 1, 2022, unless
3otherwise specified in this Act, all noninstitutional medical
4assistance provider reimbursement rates shall remain at the
5rates in effect on June 30, 2022, except for area education
6agencies, local education agencies, infant and toddler
7services providers, home and community-based services providers
8including consumer-directed attendant care providers under a
9section 1915(c) or 1915(i) waiver, targeted case management
10providers, and those providers whose rates are required to be
11determined pursuant to section 249A.20, or to meet federal
12mental health parity requirements.
13k. Notwithstanding any provision to the contrary, for the
14fiscal year beginning July 1, 2022, the reimbursement rate for
15anesthesiologists shall remain at the rates in effect on June
1630, 2022, and updated on January 1, 2023, to align with the
17most current Iowa Medicare anesthesia rate.
18l. Notwithstanding section 249A.20, for the fiscal year
19beginning July 1, 2022, the average reimbursement rate for
20health care providers eligible for use of the federal Medicare
21resource-based relative value scale reimbursement methodology
22under section 249A.20 shall remain at the rate in effect on
23June 30, 2022; however, this rate shall not exceed the maximum
24level authorized by the federal government.
25m. For the fiscal year beginning July 1, 2022, the
26reimbursement rate for residential care facilities shall not
27be less than the minimum payment level as established by the
28federal government to meet the federally mandated maintenance
29of effort requirement. The flat reimbursement rate for
30facilities electing not to file annual cost reports shall not
31be less than the minimum payment level as established by the
32federal government to meet the federally mandated maintenance
33of effort requirement.
34n. For the fiscal year beginning July 1, 2022, the
35reimbursement rates for inpatient mental health services
-102-1provided at hospitals shall remain at the rates in effect on
2June 30, 2022, subject to Medicaid program upper payment limit
3rules; and psychiatrists shall be reimbursed at the medical
4assistance program fee-for-service rate in effect on June 30,
52022.
6o. For the fiscal year beginning July 1, 2022, community
7mental health centers may choose to be reimbursed for the
8services provided to recipients of medical assistance through
9either of the following options:
10(1) For 100 percent of the reasonable costs of the services.
11(2) In accordance with the alternative reimbursement rate
12methodology approved by the department of human services in
13effect on June 30, 2022.
14p. For the fiscal year beginning July 1, 2022, the
15reimbursement rate for providers of family planning services
16that are eligible to receive a 90 percent federal match shall
17remain at the rates in effect on June 30, 2022.
18q. For the fiscal year beginning July 1, 2022, the upper
19limits and reimbursement rates for providers of home and
20community-based services waiver services and habilitation
21services shall be reimbursed using the reimbursement
22methodology in effect on June 30, 2022.
23r. For the fiscal year beginning July 1, 2022, the
24reimbursement rates for emergency medical service providers
25shall remain at the rates in effect on June 30, 2022, or as
26approved by the centers for Medicare and Medicaid services of
27the United States department of health and human services.
28s. For the fiscal year beginning July 1, 2022, reimbursement
29rates for substance-related disorder treatment programs
30licensed under section 125.13 shall remain at the rates in
31effect on June 30, 2022.
32t. For the fiscal year beginning July 1, 2022, assertive
33community treatment per diem rates shall remain at the rates in
34effect on June 30, 2022.
35u. For the fiscal year beginning July 1, 2022, the
-103-1reimbursement rate for family-centered services providers shall
2be established by contract.
32. For the fiscal year beginning July 1, 2022, the
4reimbursement rate for providers reimbursed under the
5in-home-related care program shall not be less than the minimum
6payment level as established by the federal government to meet
7the federally mandated maintenance of effort requirement.
83. Unless otherwise directed in this section, when the
9department’s reimbursement methodology for any provider
10reimbursed in accordance with this section includes an
11inflation factor, this factor shall not exceed the amount
12by which the consumer price index for all urban consumers
13increased during the calendar year ending December 31, 2002.
144. Notwithstanding section 234.38, for the fiscal
15year beginning July 1, 2022, the foster family basic daily
16maintenance rate and the maximum adoption subsidy rate for
17children ages 0 through 5 years shall be $16.78, the rate for
18children ages 6 through 11 years shall be $17.45, the rate for
19children ages 12 through 15 years shall be $19.10, and the
20rate for children and young adults ages 16 and older shall
21be $19.35. For youth ages 18 to 23 who have exited foster
22care, the preparation for adult living program maintenance
23rate shall be up to $602.70 per month as calculated based on
24the age of the participant. The maximum payment for adoption
25subsidy nonrecurring expenses shall be limited to $500 and the
26disallowance of additional amounts for court costs and other
27related legal expenses implemented pursuant to 2010 Iowa Acts,
28chapter 1031, section 408, shall be continued.
295. For the fiscal year beginning July 1, 2022, the maximum
30reimbursement rates for social services providers under
31contract shall remain at the rates in effect on June 30, 2022,
32or the provider’s actual and allowable cost plus inflation for
33each service, whichever is less. However, if a new service
34or service provider is added after June 30, 2022, the initial
35reimbursement rate for the service or provider shall be based
-104-1upon a weighted average of provider rates for similar services.
26. a. For the fiscal year beginning July 1, 2022, the
3reimbursement rates for resource family recruitment and
4retention contractors shall be established by contract.
5b. For the fiscal year beginning July 1, 2022, the
6reimbursement rates for supervised apartment living foster care
7providers shall be established by contract.
87. For the fiscal year beginning July 1, 2022, the
9reimbursement rate for group foster care providers shall be the
10combined service and maintenance reimbursement rate established
11by contract.
128. The group foster care reimbursement rates paid for
13placement of children out of state shall be calculated
14according to the same rate-setting principles as those used for
15in-state providers, unless the director of human services or
16the director’s designee determines that appropriate care cannot
17be provided within the state. The payment of the daily rate
18shall be based on the number of days in the calendar month in
19which service is provided.
209. a. For the fiscal year beginning July 1, 2022, the
21reimbursement rate paid for shelter care and the child welfare
22emergency services implemented to provide or prevent the need
23for shelter care shall be established by contract.
24b. For the fiscal year beginning July 1, 2022, the combined
25service and maintenance components of the reimbursement rate
26paid for shelter care services shall be based on the financial
27and statistical report submitted to the department. The
28maximum reimbursement rate shall be $101.83 per day. The
29department shall reimburse a shelter care provider at the
30provider’s actual and allowable unit cost, plus inflation, not
31to exceed the maximum reimbursement rate.
32c. Notwithstanding section 232.141, subsection 8, for the
33fiscal year beginning July 1, 2022, the amount of the statewide
34average of the actual and allowable rates for reimbursement of
35juvenile shelter care homes that is utilized for the limitation
-105-1on recovery of unpaid costs shall remain at the amount in
2effect for this purpose in the fiscal year beginning July 1,
32021.
410. For the fiscal year beginning July 1, 2022, the
5department shall calculate reimbursement rates for intermediate
6care facilities for persons with an intellectual disability
7at the 80th percentile. Beginning July 1, 2022, the rate
8calculation methodology shall utilize the consumer price index
9inflation factor applicable to the fiscal year beginning July
101, 2022.
1111. Effective July 1, 2022, the child care provider
12reimbursement rates shall remain at the rates in effect on June
1330, 2022. The department shall set rates in a manner so as
14to provide incentives for a nonregistered provider to become
15registered by applying any increase only to registered and
16licensed providers.
1712. The department may adopt emergency rules to implement
18this section.
19 Sec. 72. EMERGENCY RULES.
201. If specifically authorized by a provision of this
21division of this Act, the department of human services or
22the mental health and disabilities services commission may
23adopt administrative rules under section 17A.4, subsection 3,
24and section 17A.5, subsection 2, paragraph “b”, to implement
25provisions of this division of this Act and the rules shall
26become effective immediately upon filing or on a later
27effective date specified in the rules, unless the effective
28date of the rules is delayed or the applicability of the rules
29is suspended by the administrative rules review committee. Any
30rules adopted in accordance with this section shall not take
31effect before the rules are reviewed by the administrative
32rules review committee. The delay authority provided to
33the administrative rules review committee under section
3417A.8, subsections 9 and 10, shall be applicable to a delay
35imposed under this section, notwithstanding a provision in
-106-1those subsections making them inapplicable to section 17A.5,
2subsection 2, paragraph “b”. Any rules adopted in accordance
3with the provisions of this section shall also be published as
4a notice of intended action as provided in section 17A.4.
52. If during a fiscal year, the department of human
6services is adopting rules in accordance with this section
7or as otherwise directed or authorized by state law, and the
8rules will result in an expenditure increase beyond the amount
9anticipated in the budget process or if the expenditure was
10not addressed in the budget process for the fiscal year, the
11department shall notify the legislative services agency 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. 73. REPORTS. Any reports or other information required
18to be compiled and submitted under this Act during the fiscal
19year beginning July 1, 2022, shall be submitted to the general
20assembly on or before the dates specified for submission of the
21reports or information.
22 Sec. 74. EFFECTIVE UPON ENACTMENT. The following
23provisions of this division of this Act, being deemed of
24immediate importance, take effect upon enactment:
25The provision relating to section 232.141 and directing the
26state court administrator and the division administrator of
27the department of human services division of child and family
28services to make the determination, by June 15, 2022, of the
29distribution of funds allocated for the payment of the expenses
30of court-ordered services provided to juveniles which are a
31charge upon the state.
32DIVISION XII
33HEALTH CARE ACCOUNTS AND FUNDS — FY 2022-2023
34 Sec. 75. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
35appropriated from the pharmaceutical settlement account created
-107-1in section 249A.33 to the department of human services for the
2fiscal year beginning July 1, 2022, and ending June 30, 2023,
3the following amount, or so much thereof as is necessary, to be
4used for the purpose designated:
5Notwithstanding any provision of law to the contrary, to
6supplement the appropriations made in this Act for health
7program operations under the medical assistance program for the
8fiscal year beginning July 1, 2022, and ending June 30, 2023:
.................................................. $9234,193
10 Sec. 76. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
11SERVICES. Notwithstanding any provision to the contrary and
12subject to the availability of funds, there is appropriated
13from the quality assurance trust fund created in section
14249L.4 to the department of human services for the fiscal year
15beginning July 1, 2022, and ending June 30, 2023, the following
16amounts, or so much thereof as is necessary, for the purposes
17designated:
18To supplement the appropriation made in this Act from the
19general fund of the state to the department of human services
20for medical assistance for the same fiscal year:
.................................................. $2156,305,139
22 Sec. 77. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
23DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
24the contrary and subject to the availability of funds, there is
25appropriated from the hospital health care access trust fund
26created in section 249M.4 to the department of human services
27for the fiscal year beginning July 1, 2022, and ending June
2830, 2023, the following amounts, or so much thereof as is
29necessary, for the purposes designated:
30To supplement the appropriation made in this Act from the
31general fund of the state to the department of human services
32for medical assistance for the same fiscal year:
.................................................. $3333,920,554
34 Sec. 78. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
35FOR FY 2022-2023. Notwithstanding section 8.33, if moneys
-108-1appropriated for purposes of the medical assistance program for
2the fiscal year beginning July 1, 2022, and ending June 30,
32023, from the general fund of the state, the quality assurance
4trust fund, and the hospital health care access trust fund, are
5in excess of actual expenditures for the medical assistance
6program and remain unencumbered or unobligated at the close
7of the fiscal year, the excess moneys shall not revert but
8shall remain available for expenditure for the purposes of the
9medical assistance program until the close of the succeeding
10fiscal year.
11DIVISION XIII
12DECATEGORIZATION CARRYOVER FUNDING
13 Sec. 79. DECATEGORIZATION CARRYOVER FUNDING FY 2019 —
14TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
15subsection 5, paragraph “b”, any state-appropriated moneys in
16the funding pool that remained unencumbered or unobligated
17at the close of the fiscal year beginning July 1, 2018, and
18were deemed carryover funding to remain available for the two
19succeeding fiscal years that still remain unencumbered or
20unobligated at the close of the fiscal year beginning July 1,
212020, shall not revert but shall be transferred to the medical
22assistance program for the fiscal year beginning July 1, 2021.
23 Sec. 80. EFFECTIVE DATE. This division of this Act, being
24deemed of immediate importance, takes effect upon enactment.
25 Sec. 81. RETROACTIVE APPLICABILITY. This division of this
26Act applies retroactively to July 1, 2020.
27DIVISION XIV
28PRIOR APPROPRIATIONS AND OTHER PROVISIONS
29FAMILY INVESTMENT PROGRAM ACCOUNT
30 Sec. 82. 2019 Iowa Acts, chapter 85, section 9, as amended
31by 2020 Iowa Acts, chapter 1121, section 20, is amended by
32adding the following new subsection:
33 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
34appropriated in this section that remain unencumbered or
35unobligated at the close of the fiscal year shall not revert
-109-1but shall remain available for expenditure for the purposes
2designated, and may be transferred to other appropriations made
3in this division of this Act as necessary to carry out the
4initiatives included in the report submitted on nonreversion
5of funds required pursuant to 2020 Iowa Acts, chapter 1121,
6section 43, until the close of the succeeding fiscal year.
7Child and family services
8 Sec. 83. 2019 Iowa Acts, chapter 85, section 19, as amended
9by 2020 Iowa Acts, chapter 1121, section 23, is amended by
10adding the following new subsection:
11 NEW SUBSECTION. 25. Notwithstanding section 8.33, moneys
12appropriated in this section that remain unencumbered or
13unobligated at the close of the fiscal year shall not revert
14but shall remain available for expenditure for the purpose of
15the redesign of the child welfare system, until the close of
16the succeeding fiscal year.
17 Sec. 84. EFFECTIVE DATE. This division of this Act, being
18deemed of immediate importance, takes effect upon enactment.
19DIVISION XV
20EXTENSION OF FUTURE REPEAL — HOSPITAL HEALTH CARE ACCESS
21ASSESSMENT PROGRAM
22 Sec. 85. Section 249M.5, Code 2021, is amended to read as
23follows:
24249M.5 Future repeal.
25This chapter is repealed July 1, 2021 2023.
26 Sec. 86. EFFECTIVE DATE. This division of this Act, being
27deemed of immediate importance, takes effect upon enactment.
28DIVISION XVI
29PUBLIC ASSISTANCE PROGRAM OVERSIGHT
30 Sec. 87. NEW SECTION. 239.1 Definitions.
31As used in this chapter, unless the context otherwise
32requires:
331. “Applicant” means an individual who is applying for
34public assistance benefits in the state.
352. “Asset” or “asset test” means all assets of the members
-110-1of the applicant’s household, including all of the following:
2a. All bank accounts, excluding retirement accounts of
3members of the household.
4b. All cash, excluding the first two thousand dollars of
5members of the household.
6c. All lottery and gambling income of the household whether
7received as a lump sum or installment payments.
8d. All real estate, excluding the primary household
9residence and surrounding lot.
10e. All other personal property excluding personal
11belongings, household goods, and one vehicle.
123. “Department” means the department of human services.
134. “Public assistance” means SNAP (the supplemental
14nutrition assistance program), the Medicaid program, FIP (the
15family investment program), and CHIP (the children’s health
16insurance program).
175. “Real-time system” means real-time electronic access
18to a system that allows verification of all applicable public
19assistance program eligibility information based on the
20most recent information available to the department through
21nonmodeled earned and unearned income, such as commercially
22available wage data.
236. “Recipient” means an individual who is receiving public
24assistance benefits in the state.
25 Sec. 88. NEW SECTION. 239.2 Asset test for supplemental
26nutrition assistance program.
271. For the purposes of determining eligibility for receipt
28of SNAP benefits, the department shall conduct an asset test
29on all members of the applicant’s household. The allowable
30financial resources to be included in or excluded from a
31determination of eligibility for SNAP shall be those specified
32in 7 U.S.C.§2014(g)(1).
332. Prior to determining eligibility for SNAP benefits,
34the department shall access, at a minimum, for every member
35of the applicant’s household, the following information from
-111-1the following federal, state, and miscellaneous sources, or
2successor sources:
3a. Federal sources and information:
4(1) Earned and unearned income information maintained by
5the internal revenue service.
6(2) The following sources and information maintained by the
7United States social security administration:
8(a) Earned income information.
9(b) Death register information.
10(c) Prisoner or incarceration status information.
11(d) Supplemental security income information maintained in
12the state data exchange database.
13(e) Beneficiary records and earnings information maintained
14in the beneficiary and earnings data exchange database.
15(f) Earnings and pension information maintained in the
16beneficiary earnings exchange record system database.
17(3) The following sources and information maintained by the
18United States department of health and human services:
19(a) Income and employment information maintained in the
20national directory of new hires database by the office of child
21support enforcement of the administration for children and
22families.
23(b) Other federal data sources maintained by the office of
24child support enforcement of the administration for children
25and families.
26b. State sources and information:
27(1) The department’s sources and information including but
28not limited to all of the following:
29(a) Income and employment information maintained by the
30child support recovery unit.
31(b) Child care assistance information maintained by the
32division of child and family services.
33(c) Enrollment status in other public assistance programs.
34(2) The department of workforce development sources and
35information including all of the following:
-112- 1(a) Employment information.
2(b) Employer weekly, monthly, and quarterly reports of
3income and unemployment insurance payments.
4(3) The Iowa public employees’ retirement system for
5earnings and pension information.
6c. Miscellaneous sources:
7(1) Any existing real-time database of persons currently
8receiving benefits in other states, such as the national
9accuracy clearinghouse.
10(2) Any databases maintained by the Iowa lottery
11commission.
12(3) Any existing real-time eligibility system that includes
13employment and income information maintained by a consumer
14reporting agency, as defined by the federal Fair Credit
15Reporting Act, 15 U.S.C. §1681a, for the purpose of obtaining
16real-time employment and income information.
173. Prior to determining eligibility for SNAP benefits, the
18department shall access information for every member of the
19applicant’s household from the following public records:
20a. A nationwide public records data source of physical asset
21ownership. The data source may include but is not limited to
22real property, automobiles, watercraft, aircraft, and luxury
23vehicles, or any other vehicle owned by the applicant.
24b. National and state financial institutions in order
25to locate undisclosed depository accounts or verify account
26balances of disclosed accounts.
274. The department shall enter into a memorandum of
28understanding with any department, division, bureau, section,
29unit, or any other subunit of a department to obtain the
30information specified in this section.
315. The provisions of this section shall not apply if every
32member of the applicant’s household receives supplemental
33security income.
34 Sec. 89. NEW SECTION. 239.3 Verification and authentication
35systems — public assistance programs.
-113- 11. By July 1, 2023, the department shall redesign an
2existing system; establish a new computerized income, asset,
3and identity eligibility verification system; or contract with
4a third-party vendor to provide for identity verification,
5identity authentication, asset verification, and dual
6enrollment prevention in order to deter waste, fraud, and
7abuse in each public assistance program administered by the
8department.
92. The department may contract with a third-party vendor
10to develop or provide a service for a real-time eligibility
11system that allows the department to verify or authenticate
12income, assets, and identity eligibility of applicants and
13recipients to prevent fraud, misrepresentation, and inadequate
14documentation when determining eligibility for public
15assistance programs. The system shall be accessed prior to
16determining eligibility, periodically between eligibility
17redeterminations, and during eligibility redeterminations
18and reviews. The department may also contract with a
19third-party vendor to provide information to facilitate
20reviews of recipient eligibility conducted by the department.
21Specifically, the department may contract with a third-party
22consumer reporting agency, as defined by the federal Fair
23Credit Reporting Act, 15 U.S.C. §1681a, for the purpose of
24obtaining real-time employment and income information.
253. A contract entered into under this section shall provide,
26at a minimum, for all of the following:
27a. The establishment of the annual savings amount from
28utilization of the system or service, and a provision that the
29contract may be terminated contingent upon the savings not
30exceeding the total yearly cost to the state for utilization of
31the system or service.
32b. That the contract shall not preclude the department
33from continuing to conduct additional eligibility verification
34or authentication processes, to receive, review, or verify
35additional information related to the eligibility of an
-114-1individual, or from contracting with a third-party vendor to
2provide additional eligibility authentication or verification
3information.
44. The department shall seek federal approval as necessary
5to implement and administer this section.
6 Sec. 90. NEW SECTION. 239.4 Public assistance programs —
7applicant and recipient eligibility verification.
81. All applications for initial public assistance
9program benefits and all determinations of ongoing recipient
10eligibility shall be processed through a system as specified
11in this section. Complete initial applications shall be
12processed within the minimum period required by federal law.
13Prior to determining initial eligibility of an applicant for,
14or ongoing eligibility of a recipient of, public assistance,
15the department shall access information for every applicant or
16recipient from the following federal, state, and other sources:
17a. Federal sources and information:
18(1) Earned and unearned income information maintained by
19the internal revenue service.
20(2) The following sources and information maintained by the
21United States social security administration:
22(a) Earned income information.
23(b) Death register information.
24(c) Prisoner or incarceration status information.
25(d) Supplemental security income information maintained in
26the state data exchange database.
27(e) Beneficiary records and earnings information maintained
28in the beneficiary and earnings data exchange database.
29(f) Earnings and pension information maintained in the
30beneficiary earnings exchange record system database.
31(3) The following sources and information maintained by the
32United States department of health and human services:
33(a) Income and employment information maintained in the
34national directory of new hires database by the office of child
35support enforcement of the administration for children and
-115-1families.
2(b) Other federal data sources maintained by the office of
3child support enforcement of the administration for children
4and families.
5(4) Information maintained by the United States citizenship
6and immigration services of the United States department of
7homeland security.
8(5) Payment information for public housing and section 8
9housing assistance guidelines maintained by the United States
10department of housing and urban development.
11(6) National fleeing felon information maintained by the
12United States federal bureau of investigation.
13b. State sources and information:
14(1) The department’s sources and information including but
15not limited to all of the following:
16(a) Income and employment information maintained by the
17child support recovery unit.
18(b) Child care assistance information maintained by the
19division of child and family services.
20(c) Enrollment status in other public assistance programs.
21(2) The department of workforce development sources and
22information including all of the following:
23(a) Employment information.
24(b) Employer weekly, monthly, and quarterly reports of
25income and unemployment insurance payments.
26(3) The Iowa public employees’ retirement system for
27earnings and pension information.
28c. Other sources including all of the following:
29(1) Any existing real-time database of persons currently
30receiving benefits in other states, such as the national
31accuracy clearinghouse.
32(2) An available database of persons who currently hold a
33license, permit, or certificate from any state agency, the cost
34of which exceeds five hundred dollars.
35(3) Wage reporting and similar information maintained by
-116-1states contiguous to Iowa.
2(4) A third-party consumer reporting agency, as defined
3by the federal Fair Credit Reporting Act, 15 U.S.C. §1681a,
4for the purpose of obtaining real-time employment and income
5information.
62. Prior to determining the initial eligibility of an
7applicant for, or the ongoing eligibility of a recipient
8of, public assistance benefits, the department shall access
9information for every applicant or recipient from, at a
10minimum, the following public records:
11a. A nationwide public records data source of physical asset
12ownership. The data source may include but is not limited to
13real property, automobiles, watercraft, aircraft, and luxury
14vehicles, or any other vehicle owned by the applicant for or
15recipient of assistance.
16b. A nationwide public records data source of incarcerated
17individuals.
18c. A nationwide best address and driver’s license data
19source to verify that individuals are residents of the state.
20d. A comprehensive public records database from which the
21department may identify potential identity fraud or identity
22theft that is capable of closely associating name, social
23security number, date of birth, phone, and address information.
24e. National and local financial institutions in order
25to locate undisclosed depository accounts or verify account
26balances of disclosed accounts.
27f. Outstanding default or arrest warrant information.
283. The state may contract with a third-party consumer
29reporting agency, as defined by the federal Fair Credit
30Reporting Act, 15 U.S.C. §1681a, for the purpose of obtaining
31real-time employment and income information under this section.
32 Sec. 91. NEW SECTION. 239.5 Identity authentication.
33Unless otherwise prohibited by federal law or regulation,
34prior to the department awarding public assistance benefits, an
35applicant shall complete a computerized identity authentication
-117-1process to confirm the identity of the applicant. Identity
2authentication shall be accomplished through a knowledge-based
3questionnaire consisting of financial and personal questions.
4The questionnaire shall contain questions tailored to assist
5persons without a bank account or those who have poor access
6to financial and banking services or who do not have an
7established credit history. The questionnaire may be submitted
8by the applicant online, in person, or via telephone.
9 Sec. 92. NEW SECTION. 239.6 Case review of applicant and
10recipient information.
111. If the information obtained from a review of an
12applicant’s or recipient’s information under this chapter does
13not result in the department finding a discrepancy or change
14in an individual’s circumstances affecting eligibility, the
15department shall take no further action.
162. If the information obtained from a review of the
17applicant’s or recipient’s information under this chapter
18results in the department finding a discrepancy or change in
19the individual’s circumstances affecting eligibility, the
20department shall respond in accordance with the provisions of
21section 239.8.
22 Sec. 93. NEW SECTION. 239.7 Notice and right to be heard.
231. An applicant for, or recipient of, public assistance
24shall be provided written notice and the opportunity to explain
25any issues identified in a review performed under this chapter
26for initial eligibility or redetermination of eligibility.
27Unless otherwise prohibited by federal law or regulation,
28a self-declaration by an applicant or recipient shall not
29be accepted as verification of categorical and financial
30eligibility during such review.
312. The notice provided to the applicant or recipient shall
32describe in sufficient detail the circumstances of the issue
33identified, the manner in which the applicant or recipient
34may respond, and the consequences of failing to respond to
35the notice or resolve the issue identified. The applicant or
-118-1recipient shall be provided ten days to respond to the notice.
2The department may request additional information as necessary
3to reach a decision.
43. An applicant or recipient may respond to the notice as
5follows:
6a. By disagreeing with the findings of the department. If
7the applicant or recipient responds in a timely manner and
8disagrees with the findings of the department, the department
9shall reevaluate the circumstances to determine if the
10applicant’s or recipient’s position is valid. If, through
11reevaluation, the department finds that the department is in
12error, the department shall take immediate action to correct
13the error. If, through reevaluation, the department affirms
14that the applicant’s or recipient’s position is invalid, the
15department shall determine the effect on the applicant’s or
16recipient’s eligibility and take appropriate action. Written
17notice of the department’s determination and the actions taken
18shall be provided to the applicant or recipient.
19b. By agreeing with the findings of the department. If
20the applicant or recipient responds in a timely manner and
21agrees with the findings of the department, the department
22shall determine the effect on the applicant’s or recipient’s
23eligibility and take appropriate action. Written notice of the
24department’s determination and actions taken shall be provided
25to the applicant or recipient.
264. If the applicant or recipient fails to respond to the
27notice in a timely manner, the department shall provide notice
28to terminate the applicant’s application or to discontinue
29the recipient’s enrollment for failure to cooperate, and
30shall terminate the applicant’s application or discontinue
31the recipient’s enrollment. The applicant’s or recipient’s
32eligibility for such public assistance shall not be established
33or reestablished until the issue has been resolved.
34 Sec. 94. NEW SECTION. 239.8 Referrals for fraud,
35misrepresentation, or inadequate documentation.
-119- 11. Following a review of an applicant’s or recipient’s
2eligibility under this chapter, the department may refer cases
3of suspected fraud along with any supportive information to the
4department of inspections and appeals for review.
52. In cases of substantiated fraud, upon conviction, the
6state shall review all appropriate legal options including
7but not limited to removal of a recipient from other public
8assistance programs and garnishment of wages or state income
9tax refunds until the department recovers an equal amount of
10benefits fraudulently claimed.
113. The department may refer suspected cases of fraud,
12misrepresentation, or inadequate documentation relating to
13initial or continued eligibility to appropriate state agencies,
14divisions, or departments for review of eligibility issues in
15programs providing public benefits other than those as defined
16in this chapter.
17 Sec. 95. NEW SECTION. 239.9 Administration — rules —
18reporting.
191. The department of human services shall adopt rules
20pursuant to chapter 17A to administer this chapter.
212. The department shall submit a report to the governor
22and the general assembly by January 15, 2024, and by January
2315 annually thereafter through January 15, 2028, detailing the
24impact of the verification and authentication measures taken
25under this chapter. The report shall include data for all
26affected public assistance programs including the number of
27cases reviewed, the number of cases closed, the number of fraud
28investigation referrals made, and the amount of savings and
29cost avoidance realized from the provisions of this chapter.
30 Sec. 96. IMPLEMENTATION.
311. The department of human services shall request federal
32approval including for any state plan amendment or waiver
33necessary to administer this Act.
342. The provisions of this Act requiring federal approval
35shall be implemented upon receipt of such federal approval.
-120- 13. The provisions of this Act not requiring federal approval
2shall be implemented as specified in this Act, or if not
3specified in this Act, no later than July 1, 2023.
44. The department may contract with multiple third-party
5vendors to administer this Act.
6EXPLANATION
7The inclusion of this explanation does not constitute agreement with
8the explanation’s substance by the members of the general assembly.
9This bill relates to appropriations for health and human
10services for fiscal years 2021-2022 and 2022-2023 to the
11department of veterans affairs, Iowa veterans home, department
12on aging (IDA), office of long-term care ombudsman, department
13of public health (DPH), Iowa finance authority, department of
14human rights, and department of human services (DHS). The bill
15is organized into divisions for each fiscal year.
16DEPARTMENT ON AGING. This division makes appropriations
17from the general fund of the state to the department on aging.
18OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
19appropriations from the general fund of the state to the office
20of long-term care ombudsman.
21DEPARTMENT OF PUBLIC HEALTH. This division makes
22appropriations from the general fund of the state and from
23the sports wagering receipts fund to the department of public
24health.
25DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
26division makes appropriations from the general fund of the
27state to the department of veterans affairs for administration,
28the Iowa veterans home, for transfer to the Iowa finance
29authority for the home ownership assistance program and for the
30county commissions of veteran affairs.
31DEPARTMENT OF HUMAN SERVICES. This division makes
32appropriations from the general fund of the state and the
33federal temporary assistance for needy families block
34grant to DHS. The allocation for the family development
35and self-sufficiency grant program is made directly to
-121-1the department of human rights. The reimbursement section
2addresses reimbursement for providers reimbursed by the
3department of human services.
4HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
5health-related appropriations. A number of the appropriations
6are made for purposes of the Medicaid program in addition to
7the general fund appropriations made for this purpose for the
8same fiscal year.
9DECATEGORIZATION CARRYOVER FUNDING. This division provides
10for the transfer of carryover decategorization funds that
11remained unencumbered or unobligated at the close of the fiscal
12year beginning July 1, 2020, to the Medicaid program for
13FY 2021-2022. The division takes effect upon enactment and is
14retroactively applicable to July 1, 2020.
15PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division
16provides that funds appropriated to the department of human
17services and credited to the family investment program account
18that remain unencumbered or unobligated at the close of
19FY 2020-2021 shall not revert but shall remain available for
20expenditure for the purposes designated, and may be transferred
21to other appropriations as necessary to carry out the
22initiatives included in the report submitted on nonreversion
23of funds required pursuant to 2020 Iowa Acts, chapter 1121,
24section 43, until the close of the succeeding fiscal year.
25The division also provides that funds appropriated to the
26department of human services for child and family services that
27remain unencumbered or unobligated at the close of FY 2020-2021
28shall not revert but shall remain available for expenditure for
29the purpose of the redesign of the child welfare system, until
30the close of the succeeding fiscal year.
31The division takes effect upon enactment.
32EXTENSION OF REPEAL FOR HOSPITAL HEALTH CARE ACCESS
33ASSESSMENT PROGRAM. This division extends the repeal of
34the hospital health care access assessment program chapter,
35Code chapter 249M, from July 1, 2021, to July 1, 2023. This
-122-1provision takes effect upon enactment.
2PUBLIC ASSISTANCE PROGRAM OVERSIGHT. This division relates
3to public assistance program oversight, including various
4eligibility verification and authentication measures under
5new Code chapter 239 relating to the supplemental nutrition
6assistance program (SNAP), the Medicaid program, the family
7investment program (FIP), and the children’s health insurance
8program (CHIP).
-123-pf/rn
2and veterans and including other related provisions and
3appropriations, providing penalties, and including effective
4date provisions.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2021-2022
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, 2021, and ending June 30,
62022, 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
10years of age and older with case management, Iowa’s aging and
11disabilities resource center, and other services which may
12include but are not limited to adult day, respite care, chore,
13information and assistance, and material aid, for information
14and options counseling for persons with disabilities who
15are 18 years of age or older, and for salaries, support,
16administration, maintenance, and miscellaneous purposes:
.................................................. $1711,164,382
181. Funds appropriated in this section may be used to
19supplement federal funds under federal regulations. To
20receive funds appropriated in this section, a local area
21agency on aging shall match the funds with moneys from other
22sources according to rules adopted by the department. Funds
23appropriated in this section may be used for elderly services
24not specifically enumerated in this section only if approved
25by an area agency on aging for provision of the service within
26the area.
272. Of the funds appropriated in this section, $279,000 is
28transferred to the economic development authority for the Iowa
29commission on volunteer services to be used for the retired and
30senior volunteer program.
313. a. The department on aging shall establish and enforce
32procedures relating to expenditure of state and federal funds
33by area agencies on aging that require compliance with both
34state and federal laws, rules, and regulations, including but
35not limited to all of the following:
-1- 1(1) Requiring that expenditures are incurred only for goods
2or services received or performed prior to the end of the
3fiscal period designated for use of the funds.
4(2) Prohibiting prepayment for goods or services not
5received or performed prior to the end of the fiscal period
6designated for use of the funds.
7(3) Prohibiting prepayment for goods or services not
8defined specifically by good or service, time period, or
9recipient.
10(4) Prohibiting the establishment of accounts from which
11future goods or services which are not defined specifically by
12good or service, time period, or recipient, may be purchased.
13b. The procedures shall provide that if any funds are
14expended in a manner that is not in compliance with the
15procedures and applicable federal and state laws, rules, and
16regulations, and are subsequently subject to repayment, the
17area agency on aging expending such funds in contravention of
18such procedures, laws, rules and regulations, not the state,
19shall be liable for such repayment.
204. Of the funds appropriated in this section, at least
21$600,000 shall be used to fund home and community-based
22services through the area agencies on aging that enable older
23individuals to avoid more costly utilization of residential or
24institutional services and remain in their own homes.
255. Of the funds appropriated in this section, $812,000 shall
26be used for the purposes of chapter 231E and to administer
27the prevention of elder abuse, neglect, and exploitation
28program pursuant to section 231.56A, in accordance with the
29requirements of the federal Older Americans Act of 1965, 42
30U.S.C.§3001 et seq., as amended.
316. Of the funds appropriated in this section, $1,000,000
32shall be used to fund continuation of the aging and disability
33resource center lifelong links to provide individuals and
34caregivers with information and services to plan for and
35maintain independence.
-2- 17. Of the funds appropriated in this section, $250,000
2shall be used by the department on aging, in collaboration with
3the department of human services and affected stakeholders,
4to continue to expand the pilot initiative to provide
5long-term care options counseling utilizing support planning
6protocols, to assist non-Medicaid eligible consumers who
7indicate a preference to return to the community and are
8deemed appropriate for discharge, to return to their community
9following a nursing facility stay. The department on aging
10shall submit a report regarding the outcomes of the pilot
11initiative to the governor and the general assembly by December
1215, 2021.
13DIVISION II
14OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2021-2022
15 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
16appropriated from the general fund of the state to the office
17of long-term care ombudsman for the fiscal year beginning July
181, 2021, and ending June 30, 2022, the following amount, or
19so much thereof as is necessary, to be used for the purposes
20designated:
21For salaries, support, administration, maintenance, and
22miscellaneous purposes:
.................................................. $231,149,821
24DIVISION III
25DEPARTMENT OF PUBLIC HEALTH — FY 2021-2022
26 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
27from the general fund of the state to the department of public
28health for the fiscal year beginning July 1, 2021, and ending
29June 30, 2022, the following amounts, or so much thereof as is
30necessary, to be used for the purposes designated:
311. ADDICTIVE DISORDERS
32For reducing the prevalence of the use of tobacco, alcohol,
33and other drugs, and treating individuals affected by addictive
34behaviors, including gambling:
.................................................. $3523,659,379
-3- 1a. Of the funds appropriated in this subsection, $4,020,894
2shall be used for the tobacco use prevention and control
3initiative, including efforts at the state and local levels,
4as provided in chapter 142A. The commission on tobacco use
5prevention and control established pursuant to section 142A.3
6shall advise the director of public health in prioritizing
7funding needs and the allocation of moneys appropriated for
8the programs and initiatives. Activities of the programs
9and initiatives shall be in alignment with the United States
10centers for disease control and prevention best practices
11for comprehensive tobacco control programs that include
12the goals of preventing youth initiation of tobacco usage,
13reducing exposure to secondhand smoke, and promotion of tobacco
14cessation.
15b. (1) Of the funds appropriated in this subsection,
16$19,638,485 shall be used for problem gambling and
17substance-related disorder prevention, treatment, and recovery
18services, including a 24-hour helpline, public information
19resources, professional training, youth prevention, and program
20evaluation.
21(2) Of the amount allocated under this paragraph, $306,000
22shall be utilized by the department of public health, in
23collaboration with the department of human services, to
24maintain a single statewide 24-hour crisis hotline for the Iowa
25children’s behavioral health system that incorporates warmline
26services which may be provided through expansion of existing
27capabilities maintained by the department of public health as
28required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
29c. The requirement of section 123.17, subsection 5, is met
30by the appropriations and allocations made in this division of
31this Act for purposes of substance-related disorder treatment
32and addictive disorders for the fiscal year beginning July 1,
332021.
342. HEALTHY CHILDREN AND FAMILIES
35For promoting the optimum health status for children and
-4-1adolescents from birth through 21 years of age, and families:
.................................................. $25,816,681
33. CHRONIC CONDITIONS
4For serving individuals identified as having chronic
5conditions or special health care needs:
.................................................. $64,223,373
74. COMMUNITY CAPACITY
8For strengthening the health care delivery system at the
9local level:
.................................................. $106,794,306
11a. Of the funds appropriated in this subsection, $2,000,000
12shall be deposited in the medical residency training account
13created in section 135.175, subsection 5, paragraph “a”, and
14is appropriated from the account to the department of public
15health to be used for the purposes of the medical residency
16training state matching grants program as specified in section
17135.176.
18b. Of the funds appropriated in this subsection, $250,000
19shall be used for the public purpose of providing funding to
20Des Moines university to continue a provider education project
21to provide primary care physicians with the training and skills
22necessary to recognize the signs of mental illness in patients.
23c. Of the funds appropriated in this subsection, $600,000
24shall be used for rural psychiatric residencies to support the
25annual creation and training of four psychiatric residents who
26will provide mental health services in underserved areas of
27the state. Notwithstanding section 8.33, moneys that remain
28unencumbered or unobligated at the close of the fiscal year
29shall not revert but shall remain available for expenditure for
30the purposes designated for subsequent fiscal years.
31d. Of the funds appropriated in this subsection, $1,000,000
32shall be used for the creation of two centers of excellence
33programs to encourage innovation and collaboration among
34regional health care providers to transform health care
35delivery in order to provide quality, sustainable care that
-5-1meets the needs of local communities.
25. ESSENTIAL PUBLIC HEALTH SERVICES
3To provide public health services that reduce risks and
4invest in promoting and protecting good health over the
5course of a lifetime with a priority given to older Iowans and
6vulnerable populations:
.................................................. $77,662,464
86. INFECTIOUS DISEASES
9For reducing the incidence and prevalence of communicable
10diseases:
.................................................. $111,796,206
127. PUBLIC PROTECTION
13For protecting the health and safety of the public through
14establishing standards and enforcing regulations:
.................................................. $154,466,601
16Of the funds appropriated in this subsection, not more than
17$304,000 shall be credited to the emergency medical services
18fund created in section 135.25. Moneys in the emergency
19medical services fund are appropriated to the department to be
20used for the purposes of the fund.
218. RESOURCE MANAGEMENT
22For establishing and sustaining the overall ability of the
23department to deliver services to the public:
.................................................. $24933,871
259. MISCELLANEOUS PROVISIONS
26The university of Iowa hospitals and clinics under the
27control of the state board of regents shall not receive
28indirect costs from the funds appropriated in this section.
29The university of Iowa hospitals and clinics billings to the
30department shall be on at least a quarterly basis.
31 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
32RECEIPTS FUND. There is appropriated from the sports wagering
33receipts fund created in section 8.57, subsection 6, to the
34department of public health for the fiscal year beginning July
351, 2021, and ending June 30, 2022, the following amount, or
-6-1so much thereof as is necessary, to be used for the purposes
2designated:
3For problem gambling and substance-related disorder
4prevention, treatment, and recovery services, including a
524-hour helpline, public information resources, professional
6training, youth prevention, and program evaluation:
.................................................. $71,750,000
8DIVISION IV
9DEPARTMENT OF VETERANS AFFAIRS — FY 2021-2022
10 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
11appropriated from the general fund of the state to the
12department of veterans affairs for the fiscal year beginning
13July 1, 2021, and ending June 30, 2022, the following amounts,
14or so much thereof as is necessary, to be used for the purposes
15designated:
161. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
17For salaries, support, maintenance, and miscellaneous
18purposes:
.................................................. $191,229,763
202. IOWA VETERANS HOME
21For salaries, support, maintenance, and miscellaneous
22purposes:
.................................................. $237,131,552
24a. The Iowa veterans home billings involving the department
25of human services shall be submitted to the department on at
26least a monthly basis.
27b. The Iowa veterans home expenditure report shall be
28submitted monthly to the general assembly.
29c. The Iowa veterans home shall continue to include in the
30annual discharge report applicant information to provide for
31the collection of demographic information including but not
32limited to the number of individuals applying for admission and
33admitted or denied admittance and the basis for the admission
34or denial; the age, gender, and race of such individuals;
35and the level of care for which such individuals applied for
-7-1admission including residential or nursing level of care.
23. HOME OWNERSHIP ASSISTANCE PROGRAM
3For transfer to the Iowa finance authority for the
4continuation of the home ownership assistance program for
5persons who are or were eligible members of the armed forces of
6the United States, pursuant to section 16.54:
.................................................. $72,000,000
8 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
9FUND STANDING APPROPRIATIONS. Notwithstanding the standing
10appropriation in section 35A.16 for the fiscal year beginning
11July 1, 2021, and ending June 30, 2022, the amount appropriated
12from the general fund of the state pursuant to that section
13for the following designated purposes shall not exceed the
14following amount:
15For the county commissions of veteran affairs fund under
16section 35A.16:
.................................................. $17990,000
18DIVISION V
19DEPARTMENT OF HUMAN SERVICES — FY 2021-2022
20 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
21GRANT. There is appropriated from the fund created in section
228.41 to the department of human services for the fiscal year
23beginning July 1, 2021, and ending June 30, 2022, from moneys
24received under the federal temporary assistance for needy
25families (TANF) block grant pursuant to the federal Personal
26Responsibility and Work Opportunity Reconciliation Act of 1996,
27Pub.L.No.104-193, and successor legislation, the following
28amounts, or so much thereof as is necessary, to be used for the
29purposes designated:
301. To be credited to the family investment program account
31and used for assistance under the family investment program
32under chapter 239B:
.................................................. $335,002,006
342. To be credited to the family investment program account
35and used for the job opportunities and basic skills (JOBS)
-8-1program and implementing family investment agreements in
2accordance with chapter 239B:
.................................................. $35,412,060
43. To be used for the family development and
5self-sufficiency grant program in accordance with section
6216A.107:
.................................................. $72,888,980
8Notwithstanding section 8.33, moneys appropriated in this
9subsection that remain unencumbered or unobligated at the close
10of the fiscal year shall not revert but shall remain available
11for expenditure for the purposes designated until the close of
12the succeeding fiscal year. However, unless such moneys are
13encumbered or obligated on or before September 30, 2022, the
14moneys shall revert.
154. For field operations:
.................................................. $1631,296,232
175. For general administration:
.................................................. $183,744,000
196. For state child care assistance:
.................................................. $2047,166,826
21a. Of the funds appropriated in this subsection,
22$26,205,412 is transferred to the child care and development
23block grant appropriation made by the Eighty-ninth General
24Assembly, 2021 session, for the federal fiscal year beginning
25October 1, 2021, and ending September 30, 2022. Of this
26amount, $200,000 shall be used for provision of educational
27opportunities to registered child care home providers in order
28to improve services and programs offered by this category
29of providers and to increase the number of providers. The
30department may contract with institutions of higher education
31or child care resource and referral centers to provide
32the educational opportunities. Allowable administrative
33costs under the contracts shall not exceed 5 percent. The
34application for a grant shall not exceed two pages in length.
35b. Any funds appropriated in this subsection remaining
-9-1unallocated shall be used for state child care assistance
2payments for families who are employed including but not
3limited to individuals enrolled in the family investment
4program.
57. For child and family services:
.................................................. $632,380,654
78. For child abuse prevention grants:
.................................................. $8125,000
99. For pregnancy prevention grants on the condition that
10family planning services are funded:
.................................................. $111,913,203
12Pregnancy prevention grants shall be awarded to programs
13in existence on or before July 1, 2021, if the programs have
14demonstrated positive outcomes. Grants shall be awarded to
15pregnancy prevention programs which are developed after July
161, 2021, if the programs are based on existing models that
17have demonstrated positive outcomes. Grants shall comply with
18the requirements provided in 1997 Iowa Acts, chapter 208,
19section 14, subsections 1 and 2, including the requirement that
20grant programs must emphasize sexual abstinence. Priority in
21the awarding of grants shall be given to programs that serve
22areas of the state which demonstrate the highest percentage of
23unplanned pregnancies of females of childbearing age within the
24geographic area to be served by the grant.
2510. For technology needs and other resources necessary to
26meet federal, state, and welfare reform reporting, tracking,
27and case management requirements and other departmental needs:
.................................................. $281,037,186
2911. a. Notwithstanding any provision to the contrary,
30including but not limited to requirements in section 8.41 or
31provisions in 2020 Iowa Acts or 2021 Iowa Acts regarding the
32receipt and appropriation of federal block grants, federal
33funds from the temporary assistance for needy families block
34grant received by the state and not otherwise appropriated
35in this section and remaining available for the fiscal year
-10-1beginning July 1, 2021, are appropriated to the department of
2human services to the extent as may be necessary to be used in
3the following priority order: the family investment program,
4for state child care assistance program payments for families
5who are employed, and for the family investment program share
6of system costs for eligibility determination and related
7functions. The federal funds appropriated in this paragraph
8“a” shall be expended only after all other funds appropriated
9in subsection 1 for assistance under the family investment
10program, in subsection 6 for state child care assistance, or
11in subsection 10 for technology costs related to the family
12investment program, as applicable, have been expended. For
13the purposes of this subsection, the funds appropriated in
14subsection 6, paragraph “a”, for transfer to the child care
15and development block grant appropriation are considered fully
16expended when the full amount has been transferred.
17b. The department shall, on a quarterly basis, advise the
18legislative services agency and department of management of
19the amount of funds appropriated in this subsection that was
20expended in the prior quarter.
2112. Of the amounts appropriated in this section,
22$12,962,008 for the fiscal year beginning July 1, 2021, is
23transferred to the appropriation of the federal social services
24block grant made to the department of human services for that
25fiscal year.
2613. For continuation of the program providing categorical
27eligibility for the food assistance program as specified
28for the program in the section of this division of this Act
29relating to the family investment program account:
.................................................. $3014,236
3114. The department may transfer funds allocated in this
32section to the appropriations made in this division of this Act
33for the same fiscal year for general administration and field
34operations for resources necessary to implement and operate the
35services referred to in this section and those funded in the
-11-1appropriation made in this division of this Act for the same
2fiscal year for the family investment program from the general
3fund of the state.
415. With the exception of moneys allocated under this
5section for the family development and self-sufficiency grant
6program, to the extent moneys allocated in this section are
7deemed by the department not to be necessary to support the
8purposes for which they are allocated, such moneys may be
9used in the same fiscal year for any other purpose for which
10funds are allocated in this section or in section 8 of this
11division for the family investment program account. If there
12are conflicting needs, priority shall first be given to the
13family investment program account as specified under subsection
141 of this section and used for the purposes of assistance under
15the family investment program in accordance with chapter 239B,
16followed by state child care assistance program payments for
17families who are employed, followed by other priorities as
18specified by the department.
19 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
201. Moneys credited to the family investment program (FIP)
21account for the fiscal year beginning July 1, 2021, and
22ending June 30, 2022, shall be used to provide assistance in
23accordance with chapter 239B.
242. The department may use a portion of the moneys credited
25to the FIP account under this section as necessary for
26salaries, support, maintenance, and miscellaneous purposes.
273. The department may transfer funds allocated in
28subsection 4, excluding the allocation under subsection 4,
29paragraph “b”, to the appropriations made in this division of
30this Act for the same fiscal year for general administration
31and field operations for resources necessary to implement
32and operate the services referred to in this section and
33those funded in the appropriations made in section 7 for the
34temporary assistance for needy families block grant and in
35section 9 for the family investment program from the general
-12-1fund of the state in this division of this Act for the same
2fiscal year.
34. Moneys appropriated in this division of this Act and
4credited to the FIP account for the fiscal year beginning July
51, 2021, and ending June 30, 2022, are allocated as follows:
6a. To be retained by the department of human services to
7be used for coordinating with the department of human rights
8to more effectively serve participants in FIP and other shared
9clients and to meet federal reporting requirements under the
10federal temporary assistance for needy families block grant:
.................................................. $1110,000
12b. To the department of human rights for staffing,
13administration, and implementation of the family development
14and self-sufficiency grant program in accordance with section
15216A.107:
.................................................. $166,192,834
17(1) Of the funds allocated for the family development
18and self-sufficiency grant program in this paragraph “b”,
19not more than 5 percent of the funds shall be used for the
20administration of the grant program.
21(2) The department of human rights may continue to implement
22the family development and self-sufficiency grant program
23statewide during fiscal year 2021-2022.
24(3) The department of human rights may engage in activities
25to strengthen and improve family outcomes measures and
26data collection systems under the family development and
27self-sufficiency grant program.
28c. For the diversion subaccount of the FIP account:
.................................................. $291,293,000
30A portion of the moneys allocated for the diversion
31subaccount may be used for field operations, salaries, data
32management system development, and implementation costs and
33support deemed necessary by the director of human services
34in order to administer the FIP diversion program. To the
35extent moneys allocated in this paragraph “c” are deemed by the
-13-1department not to be necessary to support diversion activities,
2such moneys may be used for other efforts intended to increase
3engagement by family investment program participants in work,
4education, or training activities, or for the purposes of
5assistance under the family investment program in accordance
6with chapter 239B.
7d. For the food assistance employment and training program:
.................................................. $866,588
9(1) The department shall apply the federal supplemental
10nutrition assistance program (SNAP) employment and training
11state plan in order to maximize to the fullest extent permitted
12by federal law the use of the 50 percent federal reimbursement
13provisions for the claiming of allowable federal reimbursement
14funds from the United States department of agriculture
15pursuant to the federal SNAP employment and training program
16for providing education, employment, and training services
17for eligible food assistance program participants, including
18but not limited to related dependent care and transportation
19expenses.
20(2) The department shall continue the categorical federal
21food assistance program eligibility at 160 percent of the
22federal poverty level and continue to eliminate the asset test
23from eligibility requirements, consistent with federal food
24assistance program requirements. The department shall include
25as many food assistance households as is allowed by federal
26law. The eligibility provisions shall conform to all federal
27requirements including requirements addressing individuals who
28are incarcerated or otherwise ineligible.
29e. For the JOBS program, not more than:
.................................................. $3012,018,258
315. Of the child support collections assigned under FIP,
32an amount equal to the federal share of support collections
33shall be credited to the child support recovery appropriation
34made in this division of this Act. Of the remainder of the
35assigned child support collections received by the child
-14-1support recovery unit, a portion shall be credited to the FIP
2account, a portion may be used to increase recoveries, and a
3portion may be used to sustain cash flow in the child support
4payments account. If as a consequence of the appropriations
5and allocations made in this section the resulting amounts
6are insufficient to sustain cash assistance payments and meet
7federal maintenance of effort requirements, the department
8shall seek supplemental funding. If child support collections
9assigned under FIP are greater than estimated or are otherwise
10determined not to be required for maintenance of effort, the
11state share of either amount may be transferred to or retained
12in the child support payments account.
13 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
14is appropriated from the general fund of the state to the
15department of human services for the fiscal year beginning July
161, 2021, and ending June 30, 2022, the following amount, or
17so much thereof as is necessary, to be used for the purpose
18designated:
19To be credited to the family investment program (FIP)
20account and used for family investment program assistance
21under chapter 239B and other costs associated with providing
22needs-based benefits or assistance:
.................................................. $2340,003,978
241. Of the funds appropriated in this section, $6,606,198 is
25allocated for the JOBS program.
262. Of the funds appropriated in this section, $3,313,854 is
27allocated for the family development and self-sufficiency grant
28program.
293. a. Notwithstanding section 8.39, for the fiscal
30year beginning July 1, 2021, if necessary to meet federal
31maintenance of effort requirements or to transfer federal
32temporary assistance for needy families block grant funding
33to be used for purposes of the federal social services block
34grant or to meet cash flow needs resulting from delays in
35receiving federal funding or to implement, in accordance with
-15-1this division of this Act, activities currently funded with
2juvenile court services, county, or community moneys and state
3moneys used in combination with such moneys; to comply with
4federal requirements; or to maximize the use of federal funds;
5the department of human services may transfer funds within or
6between any of the appropriations made in this division of this
7Act and appropriations in law for the federal social services
8block grant to the department for the following purposes,
9provided that the combined amount of state and federal
10temporary assistance for needy families block grant funding
11for each appropriation remains the same before and after the
12transfer:
13(1) For the family investment program.
14(2) For state child care assistance.
15(3) For child and family services.
16(4) For field operations.
17(5) For general administration.
18b. This subsection shall not be construed to prohibit the
19use of existing state transfer authority for other purposes.
20The department shall report any transfers made pursuant to this
21subsection to the general assembly.
224. Of the funds appropriated in this section, $195,000
23shall be used for a contract for tax preparation assistance
24to low-income Iowans to expand the usage of the earned income
25tax credit. The purpose of the contract is to supply this
26assistance to underserved areas of the state. The department
27shall not retain any portion of the allocation under this
28subsection for administrative costs.
295. Of the funds appropriated in this section, $70,000 shall
30be used for the continuation of the parenting program, as
31specified in 441 IAC ch.100, relating to parental obligations,
32in which the child support recovery unit participates, to
33support the efforts of a nonprofit organization committed
34to strengthening the community through youth development,
35healthy living, and social responsibility headquartered in
-16-1a county with a population over 350,000 according to the
2latest certified federal census. The funds allocated in this
3subsection shall be used by the recipient organization to
4develop a larger community effort, through public and private
5partnerships, to support a broad-based multi-county parenthood
6initiative that promotes payment of child support obligations,
7improved family relationships, and full-time employment.
86. The department may transfer funds appropriated in this
9section, excluding the allocation in subsection 2 for the
10family development and self-sufficiency grant program, to the
11appropriations made in this division of this Act for general
12administration and field operations as necessary to administer
13this section, section 7 for the temporary assistance for needy
14families block grant, and section 8 for the family investment
15program account.
16 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
17from the general fund of the state to the department of human
18services for the fiscal year beginning July 1, 2021, and ending
19June 30, 2022, the following amount, or so much thereof as is
20necessary, to be used for the purposes designated:
21For child support recovery, including salaries, support,
22maintenance, and miscellaneous purposes:
.................................................. $2315,942,885
241. The department shall expend up to $24,000, including
25federal financial participation, for the fiscal year beginning
26July 1, 2021, for a child support public awareness campaign.
27The department and the office of the attorney general shall
28cooperate in continuation of the campaign. The public
29awareness campaign shall emphasize, through a variety of
30media activities, the importance of maximum involvement of
31both parents in the lives of their children as well as the
32importance of payment of child support obligations.
332. Federal access and visitation grant moneys shall be
34issued directly to private not-for-profit agencies that provide
35services designed to increase compliance with the child access
-17-1provisions of court orders, including but not limited to
2neutral visitation sites and mediation services.
33. The appropriation made to the department for child
4support recovery may be used throughout the fiscal year in the
5manner necessary for purposes of cash flow management, and for
6cash flow management purposes the department may temporarily
7draw more than the amount appropriated, provided the amount
8appropriated is not exceeded at the close of the fiscal year.
9 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
10FY 2021-2022. Any funds remaining in the health care trust
11fund created in section 453A.35A for the fiscal year beginning
12July 1, 2021, and ending June 30, 2022, are appropriated to
13the department of human services to supplement the medical
14assistance program appropriations made in this division of this
15Act, for medical assistance reimbursement and associated costs,
16including program administration and costs associated with
17program implementation.
18 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
192021-2022. Any funds remaining in the Medicaid fraud fund
20created in section 249A.50 for the fiscal year beginning
21July 1, 2021, and ending June 30, 2022, are appropriated to
22the department of human services to supplement the medical
23assistance appropriations made in this division of this Act,
24for medical assistance reimbursement and associated costs,
25including program administration and costs associated with
26program implementation.
27 Sec. 13. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES
28FUND — FY 2021-2022. There is appropriated from the general
29fund of the state to the department of human services for the
30fiscal year beginning July 1, 2021, and ending June 30, 2022,
31the following amount, or so much thereof as is necessary, to be
32used for the purpose designated:
33For transfer to the mental health and disability regional
34services fund created in section 225C.7A, or a successor fund:
.................................................. $3515,000,000
-18- 1Moneys transferred to the mental health and disability
2regional services fund under this section are appropriated to
3the department of human services for distribution to regions
4for funding of mental health and disability services in
5accordance with section 225C.7A.
6 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the
7general fund of the state to the department of human services
8for the fiscal year beginning July 1, 2021, and ending June 30,
92022, the following amount, or so much thereof as is necessary,
10to be used for the purpose designated:
11For medical assistance program reimbursement and associated
12costs as specifically provided in the reimbursement
13methodologies in effect on June 30, 2021, except as otherwise
14expressly authorized by law, consistent with options under
15federal law and regulations, and contingent upon receipt of
16approval from the office of the governor of reimbursement for
17each abortion performed under the program:
.................................................. $181,481,499,409
191. Iowans support reducing the number of abortions
20performed in our state. Funds appropriated under this section
21shall not be used for abortions, unless otherwise authorized
22under this section.
232. The provisions of this section relating to abortions
24shall also apply to the Iowa health and wellness plan created
25pursuant to chapter 249N.
263. The department shall utilize not more than $60,000 of
27the funds appropriated in this section to continue the AIDS/HIV
28health insurance premium payment program as established in 1992
29Iowa Acts, Second Extraordinary Session, chapter 1001, section
30409, subsection 6. Of the funds allocated in this subsection,
31not more than $5,000 may be expended for administrative
32purposes.
334. Of the funds appropriated in this Act to the department
34of public health for addictive disorders, $950,000 for
35the fiscal year beginning July 1, 2021, is transferred
-19-1to the department of human services for an integrated
2substance-related disorder managed care system. The
3departments of human services and public health shall
4work together to maintain the level of mental health and
5substance-related disorder treatment services provided by the
6managed care contractors. Each department shall take the steps
7necessary to continue the federal waivers as necessary to
8maintain the level of services.
95. The department shall aggressively pursue options for
10providing medical assistance or other assistance to individuals
11with special needs who become ineligible to continue receiving
12services under the early and periodic screening, diagnostic,
13and treatment program under the medical assistance program
14due to becoming 21 years of age who have been approved for
15additional assistance through the department’s exception to
16policy provisions, but who have health care needs in excess
17of the funding available through the exception to policy
18provisions.
196. Of the funds appropriated in this section, up to
20$3,050,082 may be transferred to the field operations or
21general administration appropriations in this division of this
22Act for operational costs associated with Part D of the federal
23Medicare Prescription Drug Improvement and Modernization Act
24of 2003, Pub.L.No.108-173.
257. Of the funds appropriated in this section, up to $442,100
26may be transferred to the appropriation in this division of
27this Act for health program operations to be used for clinical
28assessment services and prior authorization of services.
298. A portion of the funds appropriated in this section may
30be transferred to the appropriations in this division of this
31Act for general administration, health program operations, the
32children’s health insurance program, or field operations to be
33used for the state match cost to comply with the payment error
34rate measurement (PERM) program for both the medical assistance
35and children’s health insurance programs as developed by the
-20-1centers for Medicare and Medicaid services of the United States
2department of health and human services to comply with the
3federal Improper Payments Information Act of 2002, Pub.L.
4No.107-300, and to support other reviews and quality control
5activities to improve the integrity of these programs.
69. Of the funds appropriated in this section, a sufficient
7amount is allocated to supplement the incomes of residents of
8nursing facilities, intermediate care facilities for persons
9with mental illness, and intermediate care facilities for
10persons with an intellectual disability, with incomes of less
11than $50 in the amount necessary for the residents to receive a
12personal needs allowance of $50 per month pursuant to section
13249A.30A.
1410. a. Hospitals that meet the conditions specified
15in subparagraphs (1) and (2) shall either certify public
16expenditures or transfer to the medical assistance program
17an amount equal to provide the nonfederal share for a
18disproportionate share hospital payment in an amount up to the
19hospital-specific limit as approved in the Medicaid state plan.
20The hospitals that meet the conditions specified shall receive
21and retain 100 percent of the total disproportionate share
22hospital payment in an amount up to the hospital-specific limit
23as approved in the Medicaid state plan.
24(1) The hospital qualifies for disproportionate share and
25graduate medical education payments.
26(2) The hospital is an Iowa state-owned hospital with more
27than 500 beds and eight or more distinct residency specialty
28or subspecialty programs recognized by the American college of
29graduate medical education.
30b. Distribution of the disproportionate share payments
31shall be made on a monthly basis. The total amount of
32disproportionate share payments including graduate medical
33education, enhanced disproportionate share, and Iowa
34state-owned teaching hospital payments shall not exceed the
35amount of the state’s allotment under Pub.L.No.102-234.
-21-1In addition, the total amount of all disproportionate
2share payments shall not exceed the hospital-specific
3disproportionate share limits under Pub.L.No.103-66.
411. One hundred percent of the nonfederal share of payments
5to area education agencies that are medical assistance
6providers for medical assistance-covered services provided to
7medical assistance-covered children, shall be made from the
8appropriation made in this section.
912. A portion of the funds appropriated in this section may
10be transferred to the appropriation in this division of this
11Act for health program operations to be used for administrative
12activities associated with the money follows the person
13demonstration project.
1413. Of the funds appropriated in this section, $349,011
15shall be used for the administration of the health insurance
16premium payment program, including salaries, support,
17maintenance, and miscellaneous purposes.
1814. a. The department may increase the amounts allocated
19for salaries, support, maintenance, and miscellaneous purposes
20associated with the medical assistance program, as necessary,
21to sustain cost management efforts. The department shall
22report any such increase to the general assembly and the
23department of management.
24b. If the savings to the medical assistance program from
25ongoing cost management efforts exceed the associated cost
26for the fiscal year beginning July 1, 2021, the department
27may transfer any savings generated for the fiscal year due
28to medical assistance program cost management efforts to the
29appropriation made in this division of this Act for health
30program operations or general administration to defray the
31costs associated with implementing the efforts.
3215. For the fiscal year beginning July 1, 2021, and ending
33June 30, 2022, the replacement generation tax revenues required
34to be deposited in the property tax relief fund pursuant to
35section 437A.8, subsection 4, paragraph “d”, and section
-22-1437A.15, subsection 3, paragraph “f”, shall instead be credited
2to and supplement the appropriation made in this section and
3used for the allocations made in this section.
416. a. Of the funds appropriated in this section, up
5to $50,000 may be transferred by the department to the
6appropriation made in this division of this Act to the
7department for the same fiscal year for general administration
8to be used for associated administrative expenses.
9b. Of the funds appropriated in this section, up to $400,000
10may be transferred by the department to the appropriation made
11to the department in this division of this Act for the same
12fiscal year for Medicaid program-related general administration
13planning and implementation activities. The funds may be used
14for contracts or for personnel in addition to the amounts
15appropriated for general administration for the fiscal year.
16c. Of the funds appropriated in this section, up to
17$3,000,000 may be transferred by the department to the
18appropriations made in this division of this Act for the
19same fiscal year for general administration or health
20program operations to be used to support the development
21and implementation of standardized assessment tools for
22persons with mental illness, an intellectual disability, a
23developmental disability, or a brain injury.
2417. Of the funds appropriated in this section, $150,000
25shall be used for lodging expenses associated with care
26provided at the university of Iowa hospitals and clinics for
27patients with cancer whose travel distance is 30 miles or more
28and whose income is at or below 200 percent of the federal
29poverty level as defined by the most recently revised poverty
30income guidelines published by the United States department of
31health and human services. The department of human services
32shall establish the maximum number of overnight stays and the
33maximum rate reimbursed for overnight lodging, which may be
34based on the state employee rate established by the department
35of administrative services. The funds allocated in this
-23-1subsection shall not be used as nonfederal share matching
2funds.
318. Of the funds appropriated in this section, up to
4$3,383,880 shall be used for administration of the state family
5planning services program pursuant to section 217.41B, and
6of this amount, the department may use up to $200,000 for
7administrative expenses.
819. Of the funds appropriated in this section, $1,545,530
9shall be used and may be transferred to other appropriations
10in this division of this Act as necessary to administer the
11provisions in the division of this Act relating to Medicaid
12program administration.
13 Sec. 15. HEALTH PROGRAM OPERATIONS. There is appropriated
14from the general fund of the state to the department of human
15services for the fiscal year beginning July 1, 2021, and ending
16June 30, 2022, the following amount, or so much thereof as is
17necessary, to be used for the purpose designated:
18For health program operations:
.................................................. $1917,831,343
201. The department of inspections and appeals shall
21provide all state matching funds for survey and certification
22activities performed by the department of inspections
23and appeals. The department of human services is solely
24responsible for distributing the federal matching funds for
25such activities.
262. Of the funds appropriated in this section, $50,000 shall
27be used for continuation of home and community-based services
28waiver quality assurance programs, including the review and
29streamlining of processes and policies related to oversight and
30quality management to meet state and federal requirements.
313. Of the amount appropriated in this section, up to
32$200,000 may be transferred to the appropriation for general
33administration in this division of this Act to be used for the
34development of key health initiatives such as development and
35oversight of managed care programs and development of health
-24-1strategies targeted toward improved quality and reduced costs
2in the Medicaid program.
34. Of the funds appropriated in this section, $1,000,000
4shall be used for planning and development, in cooperation with
5the department of public health, of a phased-in program to
6provide a dental home for children.
75. a. Of the funds appropriated in this section, $573,000
8shall be credited to the autism support program fund created
9in section 225D.2 to be used for the autism support program
10created in chapter 225D, with the exception of the following
11amount of this allocation which shall be used as follows:
12b. Of the funds allocated in this subsection, $25,000 shall
13be used for the public purpose of continuation of a grant to a
14nonprofit provider of child welfare services that has been in
15existence for more than 115 years, is located in a county with
16a population between 200,000 and 220,000 according to the most
17recent federal decennial census, is licensed as a psychiatric
18medical institution for children, and provides school-based
19programming, to be used for support services for children with
20autism spectrum disorder and their families.
21 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2021, and ending June 30, 2022, the following
25amount, or so much thereof as is necessary, to be used for the
26purpose designated:
27For the state supplementary assistance program:
.................................................. $287,349,002
292. The department shall increase the personal needs
30allowance for residents of residential care facilities by the
31same percentage and at the same time as federal supplemental
32security income and federal social security benefits are
33increased due to a recognized increase in the cost of living.
34The department may adopt emergency rules to implement this
35subsection.
-25- 13. If during the fiscal year beginning July 1, 2021,
2the department projects that state supplementary assistance
3expenditures for a calendar year will not meet the federal
4pass-through requirement specified in Tit.XVI of the federal
5Social Security Act, section 1618, as codified in 42 U.S.C.
6§1382g, the department may take actions including but not
7limited to increasing the personal needs allowance for
8residential care facility residents and making programmatic
9adjustments or upward adjustments of the residential care
10facility or in-home health-related care reimbursement rates
11prescribed in this division of this Act to ensure that federal
12requirements are met. In addition, the department may make
13other programmatic and rate adjustments necessary to remain
14within the amount appropriated in this section while ensuring
15compliance with federal requirements. The department may adopt
16emergency rules to implement the provisions of this subsection.
174. Notwithstanding section 8.33, moneys appropriated
18in this section that remain unencumbered or unobligated
19at the close of the fiscal year shall not revert but
20shall remain available for expenditure for the purposes
21designated, including for liability amounts associated with the
22supplemental nutrition assistance program payment error rate,
23until the close of the succeeding fiscal year.
24 Sec. 17. CHILDREN’S HEALTH INSURANCE PROGRAM.
251. There is appropriated from the general fund of the
26state to the department of human services for the fiscal year
27beginning July 1, 2021, and ending June 30, 2022, the following
28amount, or so much thereof as is necessary, to be used for the
29purpose designated:
30For maintenance of the healthy and well kids in Iowa (hawk-i)
31program pursuant to chapter 514I, including supplemental dental
32services, for receipt of federal financial participation under
33Tit.XXI of the federal Social Security Act, which creates the
34children’s health insurance program:
.................................................. $3540,460,555
-26- 12. Of the funds appropriated in this section, $149,189 is
2allocated for continuation of the contract for outreach with
3the department of public health.
43. A portion of the funds appropriated in this section may
5be transferred to the appropriations made in this division of
6this Act for field operations or health program operations to
7be used for the integration of hawk-i program eligibility,
8payment, and administrative functions under the purview of
9the department of human services, including for the Medicaid
10management information system upgrade.
11 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated
12from the general fund of the state to the department of human
13services for the fiscal year beginning July 1, 2021, and ending
14June 30, 2022, the following amount, or so much thereof as is
15necessary, to be used for the purpose designated:
16For child care programs:
.................................................. $1740,816,931
181. Of the funds appropriated in this section, $34,966,931
19shall be used for state child care assistance in accordance
20with section 237A.13.
212. Nothing in this section shall be construed or is
22intended as or shall imply a grant of entitlement for services
23to persons who are eligible for assistance due to an income
24level consistent with the waiting list requirements of section
25237A.13. Any state obligation to provide services pursuant to
26this section is limited to the extent of the funds appropriated
27in this section.
283. A list of the registered and licensed child care
29facilities operating in the area served by a child care
30resource and referral service shall be made available to the
31families receiving state child care assistance in that area.
324. Of the funds appropriated in this section, $5,850,000
33shall be credited to the early childhood programs grants
34account in the early childhood Iowa fund created in section
35256I.11. The moneys shall be distributed for funding of
-27-1community-based early childhood programs targeted to children
2from birth through five years of age developed by early
3childhood Iowa areas in accordance with approved community
4plans as provided in section 256I.8.
55. The department may use any of the funds appropriated
6in this section as a match to obtain federal funds for use in
7expanding child care assistance and related programs. For
8the purpose of expenditures of state and federal child care
9funding, funds shall be considered obligated at the time
10expenditures are projected or are allocated to the department’s
11service areas. Projections shall be based on current and
12projected caseload growth, current and projected provider
13rates, staffing requirements for eligibility determination
14and management of program requirements including data systems
15management, staffing requirements for administration of the
16program, contractual and grant obligations and any transfers
17to other state agencies, and obligations for decategorization
18or innovation projects.
196. A portion of the state match for the federal child care
20and development block grant shall be provided as necessary to
21meet federal matching funds requirements through the state
22general fund appropriation made for child development grants
23and other programs for at-risk children in section 279.51.
247. If a uniform reduction ordered by the governor under
25section 8.31 or other operation of law, transfer, or federal
26funding reduction reduces the appropriation made in this
27section for the fiscal year, the percentage reduction in the
28amount paid out to or on behalf of the families participating
29in the state child care assistance program shall be equal to or
30less than the percentage reduction made for any other purpose
31payable from the appropriation made in this section and the
32federal funding relating to it. The percentage reduction to
33the other allocations made in this section shall be the same as
34the uniform reduction ordered by the governor or the percentage
35change of the federal funding reduction, as applicable. If
-28-1there is an unanticipated increase in federal funding provided
2for state child care services, the entire amount of the
3increase, except as necessary to meet federal requirements
4including quality set asides, shall be used for state child
5care assistance payments. If the appropriations made for
6purposes of the state child care assistance program for the
7fiscal year are determined to be insufficient, it is the intent
8of the general assembly to appropriate sufficient funding for
9the fiscal year in order to avoid establishment of waiting list
10requirements.
118. Notwithstanding section 8.33, moneys advanced for
12purposes of the programs developed by early childhood Iowa
13areas, advanced for purposes of wraparound child care, or
14received from the federal appropriations made for the purposes
15of this section that remain unencumbered or unobligated at the
16close of the fiscal year shall not revert to any fund but shall
17remain available for expenditure for the purposes designated
18until the close of the succeeding fiscal year.
19 Sec. 19. JUVENILE INSTITUTION. There is appropriated
20from the general fund of the state to the department of human
21services for the fiscal year beginning July 1, 2021, and ending
22June 30, 2022, the following amounts, or so much thereof as is
23necessary, to be used for the purposes designated:
241. a. For operation of the state training school at Eldora
25and for salaries, support, maintenance, and miscellaneous
26purposes:
.................................................. $2717,397,068
28b. Of the funds appropriated in this subsection, $91,000
29shall be used for distribution to licensed classroom teachers
30at this and other institutions under the control of the
31department of human services based upon the average student
32yearly enrollment at each institution as determined by the
33department.
342. A portion of the moneys appropriated in this section
35shall be used by the state training school at Eldora for
-29-1grants for adolescent pregnancy prevention activities at the
2institution in the fiscal year beginning July 1, 2021.
33. Of the funds appropriated in this subsection, $212,000
4shall be used by the state training school at Eldora for a
5substance use disorder treatment program at the institution for
6the fiscal year beginning July 1, 2021.
74. Notwithstanding section 8.33, moneys appropriated in
8this section that remain unencumbered or unobligated at the
9close of the fiscal year shall not revert but shall remain
10available for expenditure for the purposes designated until the
11close of the succeeding fiscal year.
12 Sec. 20. CHILD AND FAMILY SERVICES.
131. There is appropriated from the general fund of the
14state to the department of human services for the fiscal year
15beginning July 1, 2021, and ending June 30, 2022, the following
16amount, or so much thereof as is necessary, to be used for the
17purpose designated:
18For child and family services:
.................................................. $1989,071,930
202. The department may transfer funds appropriated in this
21section as necessary to pay the nonfederal costs of services
22reimbursed under the medical assistance program, state child
23care assistance program, or the family investment program which
24are provided to children who would otherwise receive services
25paid under the appropriation in this section. The department
26may transfer funds appropriated in this section to the
27appropriations made in this division of this Act for general
28administration and for field operations for resources necessary
29to implement and operate the services funded in this section.
303. a. Of the funds appropriated in this section, up to
31$31,500,000 is allocated as the statewide expenditure target
32under section 232.143 for group foster care maintenance and
33services. If the department projects that such expenditures
34for the fiscal year will be less than the target amount
35allocated in this paragraph “a”, the department may reallocate
-30-1the excess to provide additional funding for family foster
2care, independent living, family-centered services, shelter
3care, or the child welfare emergency services addressed with
4the allocation for shelter care.
5b. If at any time after September 30, 2021, annualization
6of a service area’s current expenditures indicates a service
7area is at risk of exceeding its group foster care expenditure
8target under section 232.143 by more than 5 percent, the
9department and juvenile court services shall examine all
10group foster care placements in that service area in order to
11identify those which might be appropriate for termination.
12In addition, any aftercare services believed to be needed
13for the children whose placements may be terminated shall be
14identified. The department and juvenile court services shall
15initiate action to set dispositional review hearings for the
16placements identified. In such a dispositional review hearing,
17the juvenile court shall determine whether needed aftercare
18services are available and whether termination of the placement
19is in the best interest of the child and the community.
204. In accordance with the provisions of section 232.188,
21the department shall continue the child welfare and juvenile
22justice funding initiative during fiscal year 2021-2022. Of
23the funds appropriated in this section, $1,717,000 is allocated
24specifically for expenditure for fiscal year 2021-2022 through
25the decategorization services funding pools and governance
26boards established pursuant to section 232.188.
275. A portion of the funds appropriated in this section
28may be used for emergency family assistance to provide other
29resources required for a family participating in a family
30preservation or reunification project or successor project to
31stay together or to be reunified.
326. Of the funds appropriated in this section, a sufficient
33amount is allocated for shelter care and the child welfare
34emergency services contracting implemented to provide for or
35prevent the need for shelter care.
-31- 17. Federal funds received by the state during the fiscal
2year beginning July 1, 2021, as the result of the expenditure
3of state funds appropriated during a previous state fiscal
4year for a service or activity funded under this section are
5appropriated to the department to be used as additional funding
6for services and purposes provided for under this section.
7Notwithstanding section 8.33, moneys received in accordance
8with this subsection that remain unencumbered or unobligated at
9the close of the fiscal year shall not revert to any fund but
10shall remain available for the purposes designated until the
11close of the succeeding fiscal year.
128. a. Of the funds appropriated in this section, up to
13$3,290,000 is allocated for the payment of the expenses of
14court-ordered services provided to juveniles who are under the
15supervision of juvenile court services, which expenses are a
16charge upon the state pursuant to section 232.141, subsection
174. Of the amount allocated in this paragraph “a”, up to
18$1,556,000 shall be made available to provide school-based
19supervision of children adjudicated under chapter 232, of which
20not more than $15,000 may be used for the purpose of training.
21A portion of the cost of each school-based liaison officer
22shall be paid by the school district or other funding source as
23approved by the chief juvenile court officer.
24b. Of the funds appropriated in this section, up to $748,000
25is allocated for the payment of the expenses of court-ordered
26services provided to children who are under the supervision
27of the department, which expenses are a charge upon the state
28pursuant to section 232.141, subsection 4.
29c. Notwithstanding section 232.141 or any other provision
30of law to the contrary, the amounts allocated in this
31subsection shall be distributed to the judicial districts
32as determined by the state court administrator and to the
33department’s service areas as determined by the administrator
34of the department of human services’ division of child and
35family services. The state court administrator and the
-32-1division administrator shall make the determination of the
2distribution amounts on or before June 15, 2021.
3d. Notwithstanding chapter 232 or any other provision of
4law to the contrary, a district or juvenile court shall not
5order any service which is a charge upon the state pursuant
6to section 232.141 if there are insufficient court-ordered
7services funds available in the district court or departmental
8service area distribution amounts to pay for the service. The
9chief juvenile court officer and the departmental service area
10manager shall encourage use of the funds allocated in this
11subsection such that there are sufficient funds to pay for
12all court-related services during the entire year. The chief
13juvenile court officers and departmental service area managers
14shall attempt to anticipate potential surpluses and shortfalls
15in the distribution amounts and shall cooperatively request the
16state court administrator or division administrator to transfer
17funds between the judicial districts’ or departmental service
18areas’ distribution amounts as prudent.
19e. Notwithstanding any provision of law to the contrary,
20a district or juvenile court shall not order a county to pay
21for any service provided to a juvenile pursuant to an order
22entered under chapter 232 which is a charge upon the state
23under section 232.141, subsection 4.
24f. Of the funds allocated in this subsection, not more than
25$83,000 may be used by the judicial branch for administration
26of the requirements under this subsection.
27g. Of the funds allocated in this subsection, $17,000
28shall be used by the department of human services to support
29the interstate commission for juveniles in accordance with
30the interstate compact for juveniles as provided in section
31232.173.
329. Of the funds appropriated in this section, $12,253,000 is
33allocated for juvenile delinquent graduated sanctions services.
34Any state funds saved as a result of efforts by juvenile court
35services to earn a federal Tit.IV-E match for juvenile court
-33-1services administration may be used for the juvenile delinquent
2graduated sanctions services.
310. Of the funds appropriated in this section, $1,658,000 is
4transferred to the department of public health to be used for
5the child protection center grant program for child protection
6centers located in Iowa in accordance with section 135.118.
7The grant amounts under the program shall be equalized so that
8each center receives a uniform base amount of $245,000, and so
9that the remaining funds are awarded through a funding formula
10based upon the volume of children served. To increase access
11to child protection center services for children in rural
12areas, the funding formula for the awarding of the remaining
13funds shall provide for the awarding of an enhanced amount to
14eligible grantees to develop and maintain satellite centers in
15underserved regions of the state.
1611. Of the funds appropriated in this section, $4,025,000 is
17allocated for the preparation for adult living program pursuant
18to section 234.46.
1912. Of the funds appropriated in this section, $227,000
20shall be used for the public purpose of continuing a grant to a
21nonprofit human services organization, providing services to
22individuals and families in multiple locations in southwest
23Iowa and Nebraska for support of a project providing immediate,
24sensitive support and forensic interviews, medical exams, needs
25assessments, and referrals for victims of child abuse and their
26nonoffending family members.
2713. Of the funds appropriated in this section, $300,000
28is allocated for the foster care youth council approach of
29providing a support network to children placed in foster care.
3014. Of the funds appropriated in this section, $202,000 is
31allocated for use pursuant to section 235A.1 for continuation
32of the initiative to address child sexual abuse implemented
33pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
3421.
3515. Of the funds appropriated in this section, $630,000 is
-34-1allocated for the community partnership for child protection
2sites.
316. Of the funds appropriated in this section, $371,000
4is allocated for the department’s minority youth and family
5projects under the redesign of the child welfare system.
617. Of the funds appropriated in this section, $851,000
7is allocated for funding of the community circle of care
8collaboration for children and youth in northeast Iowa.
918. Of the funds appropriated in this section, at least
10$147,000 shall be used for the continuation of the child
11welfare provider training academy, a collaboration between the
12coalition for family and children’s services in Iowa and the
13department.
1419. Of the funds appropriated in this section, $211,000
15shall be used for continuation of the central Iowa system of
16care program grant through June 30, 2022.
1720. Of the funds appropriated in this section, $235,000
18shall be used for the public purpose of the continuation
19and expansion of a system of care program grant implemented
20in Cerro Gordo and Linn counties to utilize a comprehensive
21and long-term approach for helping children and families by
22addressing the key areas in a child’s life of childhood basic
23needs, education and work, family, and community.
2421. Of the funds appropriated in this section, $110,000
25shall be used for the public purpose of funding community-based
26services and other supports with a system of care approach
27for children with a serious emotional disturbance and their
28families through a nonprofit provider of child welfare services
29that has been in existence for more than 115 years, is located
30in a county with a population of more than 200,000 but less
31than 235,000 according to the latest certified federal census,
32is licensed as a psychiatric medical institution for children,
33and was a system of care grantee prior to July 1, 2021.
3422. If a separate funding source is identified that reduces
35the need for state funds within an allocation under this
-35-1section, the allocated state funds may be redistributed to
2other allocations under this section for the same fiscal year.
323. Of the funds appropriated in this section, a portion may
4be used for family-centered services for purposes of complying
5with the federal Family First Prevention Services Act of 2018,
6Pub.L. No.115-123, and successor legislation.
7 Sec. 21. ADOPTION SUBSIDY.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2021, and ending June 30, 2022, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13a. For adoption subsidy payments and related costs and for
14other services provided for under paragraph “b”, subparagraph
15(2):
.................................................. $1640,596,007
17b. (1) Of the funds appropriated in this section, a
18sufficient amount is allocated for adoption subsidy payments
19and related costs.
20(2) Any funds appropriated in this section remaining after
21the allocation under subparagraph (1) are designated and
22allocated as state savings resulting from implementation of
23the federal Fostering Connections to Success and Increasing
24Adoptions Act of 2008, Pub.L. No.110-351, and successor
25legislation, as determined in accordance with 42 U.S.C.
26§673(a)(8), and shall be used for post-adoption services and
27for other purposes allowed under these federal laws, Tit.IV-B
28or Tit.IV-E of the federal Social Security Act.
29(a) The department of human services may transfer funds
30allocated in this subparagraph (2) to the appropriation for
31child and family services in this division of this Act for the
32purposes designated in this subparagraph (2).
33(b) Notwithstanding section 8.33, moneys allocated
34under this subparagraph (2) shall not revert to any fund but
35shall remain available for the purposes designated in this
-36-1subparagraph (2) until expended.
22. The department may transfer funds appropriated in
3this section to the appropriation made in this division of
4this Act for general administration for costs paid from the
5appropriation relating to adoption subsidy.
63. Federal funds received by the state during the
7fiscal year beginning July 1, 2021, as the result of the
8expenditure of state funds during a previous state fiscal
9year for a service or activity funded under this section are
10appropriated to the department to be used as additional funding
11for the services and activities funded under this section.
12Notwithstanding section 8.33, moneys received in accordance
13with this subsection that remain unencumbered or unobligated
14at the close of the fiscal year shall not revert to any fund
15but shall remain available for expenditure for the purposes
16designated until the close of the succeeding fiscal year.
17 Sec. 22. JUVENILE DETENTION HOME FUND. Moneys deposited
18in the juvenile detention home fund created in section 232.142
19during the fiscal year beginning July 1, 2021, and ending June
2030, 2022, are appropriated to the department of human services
21for the fiscal year beginning July 1, 2021, and ending June 30,
222022, for distribution of an amount equal to a percentage of
23the costs of the establishment, improvement, operation, and
24maintenance of county or multicounty juvenile detention homes
25in the fiscal year beginning July 1, 2020. Moneys appropriated
26for distribution in accordance with this section shall be
27allocated among eligible detention homes, prorated on the basis
28of an eligible detention home’s proportion of the costs of all
29eligible detention homes in the fiscal year beginning July
301, 2020. The percentage figure shall be determined by the
31department based on the amount available for distribution for
32the fund. Notwithstanding section 232.142, subsection 3, the
33financial aid payable by the state under that provision for the
34fiscal year beginning July 1, 2021, shall be limited to the
35amount appropriated for the purposes of this section.
-37-1 Sec. 23. FAMILY SUPPORT SUBSIDY PROGRAM.
21. There is appropriated from the general fund of the
3state to the department of human services for the fiscal year
4beginning July 1, 2021, and ending June 30, 2022, the following
5amount, or so much thereof as is necessary, to be used for the
6purpose designated:
7For the family support subsidy program subject to the
8enrollment restrictions in section 225C.37, subsection 3:
.................................................. $9949,282
102. At least $899,291 of the moneys appropriated in this
11section is transferred to the department of public health for
12the family support center component of the comprehensive family
13support program under chapter 225C, subchapter V.
143. If at any time during the fiscal year, the amount of
15funding available for the family support subsidy program
16is reduced from the amount initially used to establish the
17figure for the number of family members for whom a subsidy
18is to be provided at any one time during the fiscal year,
19notwithstanding section 225C.38, subsection 2, the department
20shall revise the figure as necessary to conform to the amount
21of funding available.
22 Sec. 24. CONNER DECREE. There is appropriated from the
23general fund of the state to the department of human services
24for the fiscal year beginning July 1, 2021, and ending June 30,
252022, the following amount, or so much thereof as is necessary,
26to be used for the purpose designated:
27For building community capacity through the coordination
28and provision of training opportunities in accordance with the
29consent decree of Conner v.Branstad, No.4-86-CV-30871 (S.D.
30Iowa, July 14, 1994):
.................................................. $3133,632
32 Sec. 25. MENTAL HEALTH INSTITUTES.
331. There is appropriated from the general fund of the
34state to the department of human services for the fiscal year
35beginning July 1, 2021, and ending June 30, 2022, the following
-38-1amounts, or so much thereof as is necessary, to be used for the
2purposes designated:
3a. For operation of the state mental health institute at
4Cherokee as required by chapters 218 and 226 for salaries,
5support, maintenance, and miscellaneous purposes:
.................................................. $616,058,356
7b. For operation of the state mental health institute at
8Independence as required by chapters 218 and 226 for salaries,
9support, maintenance, and miscellaneous purposes:
.................................................. $1020,628,077
112. a. Notwithstanding sections 218.78 and 249A.11, any
12revenue received from the state mental health institute at
13Cherokee or the state mental health institute at Independence
14pursuant to 42 C.F.R§438.6(e) may be retained and expended by
15the mental health institute.
16b. Notwithstanding sections 218.78 and 249A.11, any
17COVID-19 related funding received through federal funding
18sources by the state mental health institute at Cherokee or the
19state mental health institute at Independence may be retained
20and expended by the mental health institute.
213. Notwithstanding any provision of law to the contrary,
22a Medicaid member residing at the state mental health
23institute at Cherokee or the state mental health institute
24at Independence shall retain Medicaid eligibility during
25the period of the Medicaid member’s stay for which federal
26financial participation is available.
274. Notwithstanding section 8.33, moneys appropriated in
28this section that remain unencumbered or unobligated at the
29close of the fiscal year shall not revert but shall remain
30available for expenditure for the purposes designated until the
31close of the succeeding fiscal year.
32 Sec. 26. STATE RESOURCE CENTERS.
331. There is appropriated from the general fund of the
34state to the department of human services for the fiscal year
35beginning July 1, 2021, and ending June 30, 2022, the following
-39-1amounts, or so much thereof as is necessary, to be used for the
2purposes designated:
3a. For the state resource center at Glenwood for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $514,802,873
6b. For the state resource center at Woodward for salaries,
7support, maintenance, and miscellaneous purposes:
.................................................. $813,698,094
92. The department may continue to bill for state resource
10center services utilizing a scope of services approach used for
11private providers of intermediate care facilities for persons
12with an intellectual disability services, in a manner which
13does not shift costs between the medical assistance program,
14counties, or other sources of funding for the state resource
15centers.
163. The state resource centers may expand the time-limited
17assessment and respite services during the fiscal year.
184. If the department’s administration and the department
19of management concur with a finding by a state resource
20center’s superintendent that projected revenues can reasonably
21be expected to pay the salary and support costs for a new
22employee position, or that such costs for adding a particular
23number of new positions for the fiscal year would be less
24than the overtime costs if new positions would not be added,
25the superintendent may add the new position or positions. If
26the vacant positions available to a resource center do not
27include the position classification desired to be filled, the
28state resource center’s superintendent may reclassify any
29vacant position as necessary to fill the desired position. The
30superintendents of the state resource centers may, by mutual
31agreement, pool vacant positions and position classifications
32during the course of the fiscal year in order to assist one
33another in filling necessary positions.
345. If existing capacity limitations are reached in
35operating units, a waiting list is in effect for a service or
-40-1a special need for which a payment source or other funding
2is available for the service or to address the special need,
3and facilities for the service or to address the special need
4can be provided within the available payment source or other
5funding, the superintendent of a state resource center may
6authorize opening not more than two units or other facilities
7and begin implementing the service or addressing the special
8need during fiscal year 2021-2022.
96. Notwithstanding section 8.33, and notwithstanding
10the amount limitation specified in section 222.92, moneys
11appropriated in this section that remain unencumbered or
12unobligated at the close of the fiscal year shall not revert
13but shall remain available for expenditure for the purposes
14designated until the close of the succeeding fiscal year.
15 Sec. 27. SEXUALLY VIOLENT PREDATORS.
161. There is appropriated from the general fund of the
17state to the department of human services for the fiscal year
18beginning July 1, 2021, and ending June 30, 2022, the following
19amount, or so much thereof as is necessary, to be used for the
20purpose designated:
21For costs associated with the commitment and treatment of
22sexually violent predators in the unit located at the state
23mental health institute at Cherokee, including costs of legal
24services and other associated costs, including salaries,
25support, maintenance, and miscellaneous purposes:
.................................................. $2613,643,727
272. Unless specifically prohibited by law, if the amount
28charged provides for recoupment of at least the entire amount
29of direct and indirect costs, the department of human services
30may contract with other states to provide care and treatment
31of persons placed by the other states at the unit for sexually
32violent predators at Cherokee. The moneys received under
33such a contract shall be considered to be repayment receipts
34and used for the purposes of the appropriation made in this
35section.
-41- 13. Notwithstanding section 8.33, moneys appropriated in
2this section that remain unencumbered or unobligated at the
3close of the fiscal year shall not revert but shall remain
4available for expenditure for the purposes designated until the
5close of the succeeding fiscal year.
6 Sec. 28. FIELD OPERATIONS.
71. There is appropriated from the general fund of the
8state to the department of human services for the fiscal year
9beginning July 1, 2021, and ending June 30, 2022, the following
10amount, or so much thereof as is necessary, to be used for the
11purposes designated:
12For field operations, including salaries, support,
13maintenance, and miscellaneous purposes:
.................................................. $1460,596,667
152. Priority in filling full-time equivalent positions
16shall be given to those positions related to child protection
17services and eligibility determination for low-income families.
18 Sec. 29. GENERAL ADMINISTRATION. There is appropriated
19from the general fund of the state to the department of human
20services for the fiscal year beginning July 1, 2021, and ending
21June 30, 2022, the following amount, or so much thereof as is
22necessary, to be used for the purpose designated:
23For general administration, including salaries, support,
24maintenance, and miscellaneous purposes:
.................................................. $2514,542,189
261. The department shall report at least monthly to the
27general assembly concerning the department’s operational and
28program expenditures.
292. Of the funds appropriated in this section, $150,000
30shall be used for the provision of a program to provide
31technical assistance, support, and consultation to providers
32of habilitation services and home and community-based services
33waiver services for adults with disabilities under the medical
34assistance program.
353. Of the funds appropriated in this section, $50,000
-42-1is transferred to the Iowa finance authority to be used
2for administrative support of the council on homelessness
3established in section 16.2D and for the council to fulfill its
4duties in addressing and reducing homelessness in the state.
54. Of the funds appropriated in this section, $200,000 shall
6be transferred to and deposited in the administrative fund of
7the Iowa ABLE savings plan trust created in section 12I.4, to
8be used for implementation and administration activities of the
9Iowa ABLE savings plan trust.
105. Of the funds appropriated in this section, $200,000 is
11transferred to the economic development authority for the Iowa
12commission on volunteer services to continue to be used for the
13RefugeeRISE AmeriCorps program established under section 15H.8
14for member recruitment and training to improve the economic
15well-being and health of economically disadvantaged refugees in
16local communities across Iowa. Funds transferred may be used
17to supplement federal funds under federal regulations.
186. Of the funds appropriated in this section, up to $300,000
19shall be used as follows:
20a. To address the department’s responsibility to support
21the work of the children’s behavioral health system state board
22and implementation of the services required pursuant to section
23331.397.
24b. To support the cost of establishing and implementing new
25or additional services required pursuant to sections 331.397
26and 331.397A.
27c. Of the amount allocated, $32,000 shall be transferred
28to the department of public health to support the costs of
29establishing and implementing new or additional services
30required pursuant to sections 331.397 and 331.397A.
31 Sec. 30. DEPARTMENT-WIDE DUTIES. There is appropriated
32from the general fund of the state to the department of human
33services for the fiscal year beginning July 1, 2021, and ending
34June 30, 2022, the following amount, or so much thereof as is
35necessary, to be used for the purposes designated:
-43- 1For salaries, support, maintenance, and miscellaneous
2purposes at facilities under the purview of the department of
3human services:
.................................................. $42,879,274
5 Sec. 31. VOLUNTEERS. There is appropriated from the general
6fund of the state to the department of human services for the
7fiscal year beginning July 1, 2021, and ending June 30, 2022,
8the following amount, or so much thereof as is necessary, to be
9used for the purpose designated:
10For development and coordination of volunteer services:
.................................................. $1184,686
12 Sec. 32. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
13ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
14DEPARTMENT OF HUMAN SERVICES.
151. a. (1) (a) For the fiscal year beginning July 1,
162021, the department shall rebase case-mix nursing facility
17rates effective July 1, 2021, to the extent possible within the
18state funding, including the $10,000,000 appropriated for this
19purpose.
20(b) For the fiscal year beginning July 1, 2021, non-case-mix
21and special population nursing facilities shall be reimbursed
22in accordance with the methodology in effect on June 30 of the
23prior fiscal year.
24(c) For managed care claims, the department of human
25services shall adjust the payment rate floor for nursing
26facilities, annually, to maintain a rate floor that is no
27lower than the Medicaid fee-for-service case-mix adjusted rate
28calculated in accordance with subparagraph division (a) and
29441 IAC 81.6. The department shall then calculate adjusted
30reimbursement rates, including but not limited to add-on
31payments, annually, and shall notify Medicaid managed care
32organizations of the adjusted reimbursement rates within 30
33days of determining the adjusted reimbursement rates. Any
34adjustment of reimbursement rates under this subparagraph
35division shall be budget neutral to the state budget.
-44- 1(d) For the fiscal year beginning July 1, 2021, Medicaid
2managed care long-term services and supports capitation
3rates shall be adjusted to reflect the rebasing pursuant to
4subparagraph division (a) for the patient populations residing
5in Medicaid-certified nursing facilities.
6(2) 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, 2021,
12the department 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
20the fiscal year. A change in the dispensing fee shall become
21effective following federal approval of the Medicaid state
22plan.
23(2) The department shall utilize an average acquisition
24cost reimbursement methodology for all drugs covered under the
25medical assistance program in accordance with 2012 Iowa Acts,
26chapter 1133, section 33.
27c. (1) For the fiscal year beginning July 1, 2021,
28reimbursement rates for outpatient hospital services shall
29remain at the rates in effect on June 30, 2021, subject to
30Medicaid program upper payment limit rules, and adjusted
31as necessary to maintain expenditures within the amount
32appropriated to the department for this purpose for the fiscal
33year.
34(2) For the fiscal year beginning July 1, 2021,
35reimbursement rates for inpatient hospital services shall
-45-1be rebased effective October 1, 2021, subject to Medicaid
2program upper payment limit rules, and adjusted as necessary
3to maintain expenditures within the amount appropriated to the
4department for this purpose for the fiscal year.
5(3) For the fiscal year beginning July 1, 2021, under
6both fee-for-service and managed care administration of
7the Medicaid program, critical access hospitals shall be
8reimbursed for inpatient and outpatient services based on the
9hospital-specific critical access hospital cost adjustment
10factor methodology utilizing the most recent and complete cost
11reporting period as applied prospectively within the funds
12appropriated for such purpose for the fiscal year.
13(4) For the fiscal year beginning July 1, 2021, the graduate
14medical education and disproportionate share hospital fund
15shall remain at the amount in effect on June 30, 2021, except
16that the portion of the fund attributable to graduate medical
17education shall be reduced in an amount that reflects the
18elimination of graduate medical education payments made to
19out-of-state hospitals.
20(5) In order to ensure the efficient use of limited state
21funds in procuring health care services for low-income Iowans,
22funds appropriated in this Act for hospital services shall
23not be used for activities which would be excluded from a
24determination of reasonable costs under the federal Medicare
25program pursuant to 42 U.S.C.§1395x(v)(1)(N).
26d. For the fiscal year beginning July 1, 2021, reimbursement
27rates for hospices and acute psychiatric hospitals shall be
28increased in accordance with increases under the federal
29Medicare program or as supported by their Medicare audited
30costs.
31e. For the fiscal year beginning July 1, 2021, independent
32laboratories and rehabilitation agencies shall be reimbursed
33using the same methodology in effect on June 30, 2021.
34f. (1) For the fiscal year beginning July 1, 2021,
35reimbursement rates for home health agencies shall continue to
-46-1be based on the Medicare low utilization payment adjustment
2(LUPA) methodology with state geographic wage adjustments.
3The department shall continue to update the rates every two
4years to reflect the most recent Medicare LUPA rates to the
5extent possible within the state funding appropriated for this
6purpose.
7(2) For the fiscal year beginning July 1, 2021, rates for
8private duty nursing and personal care services under the early
9and periodic screening, diagnostic, and treatment program
10benefit shall be calculated based on the methodology in effect
11on June 30, 2021.
12g. For the fiscal year beginning July 1, 2021, federally
13qualified health centers and rural health clinics shall receive
14cost-based reimbursement for 100 percent of the reasonable
15costs for the provision of services to recipients of medical
16assistance.
17h. For the fiscal year beginning July 1, 2021, the
18reimbursement rates for dental services shall remain at the
19rates in effect on June 30, 2021.
20i. (1) For the fiscal year beginning July 1, 2021,
21reimbursement rates for non-state-owned psychiatric medical
22institutions for children shall be increased to the extent
23possible within the $3,900,000 appropriated for this purpose.
24(2) As a condition of participation in the medical
25assistance program, enrolled providers shall accept the medical
26assistance reimbursement rate for any covered goods or services
27provided to recipients of medical assistance who are children
28under the custody of a psychiatric medical institution for
29children.
30j. For the fiscal year beginning July 1, 2021, unless
31otherwise specified in this Act, all noninstitutional medical
32assistance provider reimbursement rates shall remain at the
33rates in effect on June 30, 2021, except for area education
34agencies, local education agencies, infant and toddler
35services providers, home and community-based services providers
-47-1including consumer-directed attendant care providers under a
2section 1915(c) or 1915(i) waiver, targeted case management
3providers, and those providers whose rates are required to be
4determined pursuant to section 249A.20, or to meet federal
5mental health parity requirements.
6k. Notwithstanding any provision to the contrary, for the
7fiscal year beginning July 1, 2021, the reimbursement rate for
8anesthesiologists shall remain at the rates in effect on June
930, 2021, and updated on January 1, 2022, to align with the
10most current Iowa Medicare anesthesia rate.
11l. Notwithstanding section 249A.20, for the fiscal year
12beginning July 1, 2021, the average reimbursement rate for
13health care providers eligible for use of the federal Medicare
14resource-based relative value scale reimbursement methodology
15under section 249A.20 shall remain at the rate in effect on
16June 30, 2021; however, this rate shall not exceed the maximum
17level authorized by the federal government.
18m. For the fiscal year beginning July 1, 2021, the
19reimbursement rate for residential care facilities shall not
20be less than the minimum payment level as established by the
21federal government to meet the federally mandated maintenance
22of effort requirement. The flat reimbursement rate for
23facilities electing not to file annual cost reports shall not
24be less than the minimum payment level as established by the
25federal government to meet the federally mandated maintenance
26of effort requirement.
27n. For the fiscal year beginning July 1, 2021, the
28reimbursement rates for inpatient mental health services
29provided at hospitals shall be rebased effective October 1,
302021, subject to Medicaid program upper payment limit rules
31and adjusted as necessary to maintain expenditures within the
32amount appropriated to the department for this purpose for
33the fiscal year; and psychiatrists shall be reimbursed at the
34medical assistance program fee-for-service rate in effect on
35June 30, 2021.
-48- 1o. For the fiscal year beginning July 1, 2021, community
2mental health centers may choose to be reimbursed for the
3services provided to recipients of medical assistance through
4either of the following options:
5(1) For 100 percent of the reasonable costs of the services.
6(2) In accordance with the alternative reimbursement rate
7methodology approved by the department of human services in
8effect on June 30, 2021.
9p. For the fiscal year beginning July 1, 2021, the
10reimbursement rate for providers of family planning services
11that are eligible to receive a 90 percent federal match shall
12remain at the rates in effect on June 30, 2021.
13q. For the fiscal year beginning July 1, 2021, the upper
14limits and reimbursement rates for providers of home and
15community-based services waiver services and habilitation
16services shall be increased to the extent possible within the
17$8,000,000 appropriated for this purpose.
18r. For the fiscal year beginning July 1, 2021, the
19reimbursement rates for emergency medical service providers
20shall remain at the rates in effect on June 30, 2021, or as
21approved by the centers for Medicare and Medicaid services of
22the United States department of health and human services.
23s. For the fiscal year beginning July 1, 2021, reimbursement
24rates for substance-related disorder treatment programs
25licensed under section 125.13 shall remain at the rates in
26effect on June 30, 2021.
27t. For the fiscal year beginning July 1, 2021, assertive
28community treatment per diem rates shall remain at the rates in
29effect on June 30, 2021.
30u. For the fiscal year beginning July 1, 2021, the
31reimbursement rate for family-centered services providers shall
32be established by contract.
332. For the fiscal year beginning July 1, 2021, the
34reimbursement rate for providers reimbursed under the
35in-home-related care program shall not be less than the minimum
-49-1payment level as established by the federal government to meet
2the federally mandated maintenance of effort requirement.
33. Unless otherwise directed in this section, when the
4department’s reimbursement methodology for any provider
5reimbursed in accordance with this section includes an
6inflation factor, this factor shall not exceed the amount
7by which the consumer price index for all urban consumers
8increased during the calendar year ending December 31, 2002.
94. Notwithstanding section 234.38, for the fiscal
10year beginning July 1, 2021, the foster family basic daily
11maintenance rate and the maximum adoption subsidy rate for
12children ages 0 through 5 years shall be $16.78, the rate for
13children ages 6 through 11 years shall be $17.45, the rate for
14children ages 12 through 15 years shall be $19.10, and the
15rate for children and young adults ages 16 and older shall
16be $19.35. For youth ages 18 to 23 who have exited foster
17care, the preparation for adult living program maintenance
18rate shall be up to $602.70 per month as calculated based on
19the age of the participant. The maximum payment for adoption
20subsidy nonrecurring expenses shall be limited to $500 and the
21disallowance of additional amounts for court costs and other
22related legal expenses implemented pursuant to 2010 Iowa Acts,
23chapter 1031, section 408, shall be continued.
245. For the fiscal year beginning July 1, 2021, the maximum
25reimbursement rates for social services providers under
26contract shall remain at the rates in effect on June 30, 2021,
27or the provider’s actual and allowable cost plus inflation for
28each service, whichever is less. However, if a new service
29or service provider is added after June 30, 2021, the initial
30reimbursement rate for the service or provider shall be based
31upon a weighted average of provider rates for similar services.
326. a. For the fiscal year beginning July 1, 2021, the
33reimbursement rates for resource family recruitment and
34retention contractors shall be established by contract.
35b. For the fiscal year beginning July 1, 2021, the
-50-1reimbursement rates for supervised apartment living foster care
2providers shall be established by contract.
37. For the fiscal year beginning July 1, 2021, the
4reimbursement rate for group foster care providers shall be the
5combined service and maintenance reimbursement rate established
6by contract.
78. The group foster care reimbursement rates paid for
8placement of children out of state shall be calculated
9according to the same rate-setting principles as those used for
10in-state providers, unless the director of human services or
11the director’s designee determines that appropriate care cannot
12be provided within the state. The payment of the daily rate
13shall be based on the number of days in the calendar month in
14which service is provided.
159. a. For the fiscal year beginning July 1, 2021, the
16reimbursement rate paid for shelter care and the child welfare
17emergency services implemented to provide or prevent the need
18for shelter care shall be established by contract.
19b. For the fiscal year beginning July 1, 2021, the combined
20service and maintenance components of the reimbursement rate
21paid for shelter care services shall be based on the financial
22and statistical report submitted to the department. The
23maximum reimbursement rate shall be $101.83 per day. The
24department shall reimburse a shelter care provider at the
25provider’s actual and allowable unit cost, plus inflation, not
26to exceed the maximum reimbursement rate.
27c. Notwithstanding section 232.141, subsection 8, for the
28fiscal year beginning July 1, 2021, the amount of the statewide
29average of the actual and allowable rates for reimbursement of
30juvenile shelter care homes that is utilized for the limitation
31on recovery of unpaid costs shall remain at the amount in
32effect for this purpose in the fiscal year beginning July 1,
332020.
3410. For the fiscal year beginning July 1, 2021, the
35department shall calculate reimbursement rates for intermediate
-51-1care facilities for persons with an intellectual disability
2at the 80th percentile. Beginning July 1, 2021, the rate
3calculation methodology shall utilize the consumer price index
4inflation factor applicable to the fiscal year beginning July
51, 2021.
611. Effective July 1, 2021, the child care provider
7reimbursement rates shall remain at the rates in effect on June
830, 2021. The department shall set rates in a manner so as
9to provide incentives for a nonregistered provider to become
10registered by applying any increase only to registered and
11licensed providers.
1212. The department may adopt emergency rules to implement
13this section.
14 Sec. 33. EMERGENCY RULES.
151. If necessary to comply with federal requirements
16including time frames, or if specifically authorized by a
17provision of this division of this Act, the department of
18human services or the mental health and disability services
19commission may adopt administrative rules under section 17A.4,
20subsection 3, and section 17A.5, subsection 2, paragraph “b”,
21to implement the provisions of this division of this Act and
22the rules shall become effective immediately upon filing or
23on a later effective date specified in the rules, unless the
24effective date of the rules is delayed or the applicability
25of the rules is suspended by the administrative rules review
26committee. Any rules adopted in accordance with this section
27shall not take effect before the rules are reviewed by the
28administrative rules review committee. The delay authority
29provided to the administrative rules review committee under
30section 17A.4, subsection 7, and section 17A.8, subsection 9,
31shall be applicable to a delay imposed under this section,
32notwithstanding a provision in those sections making them
33inapplicable to section 17A.5, subsection 2, paragraph “b”.
34Any rules adopted in accordance with the provisions of this
35section shall also be published as a notice of intended action
-52-1as provided in section 17A.4.
22. If during a fiscal year, the department of human
3services is adopting rules in accordance with this section
4or as otherwise directed or authorized by state law, and the
5rules will result in an expenditure increase beyond the amount
6anticipated in the budget process or if the expenditure was
7not addressed in the budget process for the fiscal year, the
8department shall notify the legislative services agency and
9the department of management concerning the rules and the
10expenditure increase. The notification shall be provided at
11least 30 calendar days prior to the date notice of the rules
12is submitted to the administrative rules coordinator and the
13administrative code editor.
14 Sec. 34. REPORTS. Any reports or other information required
15to be compiled and submitted under this Act during the fiscal
16year beginning July 1, 2021, shall be submitted to the general
17assembly on or before the dates specified for submission of the
18reports or information.
19 Sec. 35. EFFECTIVE UPON ENACTMENT. The following
20provisions of this division of this Act, being deemed of
21immediate importance, take effect upon enactment:
221. The provision relating to section 232.141 and directing
23the state court administrator and the division administrator of
24the department of human services division of child and family
25services to make the determination, by June 15, 2021, of the
26distribution of funds allocated for the payment of the expenses
27of court-ordered services provided to juveniles which are a
28charge upon the state.
29DIVISION VI
30HEALTH CARE ACCOUNTS AND FUNDS — FY 2021-2022
31 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
32appropriated from the pharmaceutical settlement account created
33in section 249A.33 to the department of human services for the
34fiscal year beginning July 1, 2021, and ending June 30, 2022,
35the following amount, or so much thereof as is necessary, to be
-53-1used for the purpose designated:
2Notwithstanding any provision of law to the contrary, to
3supplement the appropriations made in this Act for health
4program operations under the medical assistance program for the
5fiscal year beginning July 1, 2021, and ending June 30, 2022:
.................................................. $6234,193
7 Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
8SERVICES. Notwithstanding any provision to the contrary and
9subject to the availability of funds, there is appropriated
10from the quality assurance trust fund created in section
11249L.4 to the department of human services for the fiscal year
12beginning July 1, 2021, and ending June 30, 2022, the following
13amounts, or so much thereof as is necessary, for the purposes
14designated:
15To supplement the appropriation made in this Act from the
16general fund of the state to the department of human services
17for medical assistance for the same fiscal year:
.................................................. $1856,305,139
19 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
20DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
21the contrary and subject to the availability of funds, there is
22appropriated from the hospital health care access trust fund
23created in section 249M.4 to the department of human services
24for the fiscal year beginning July 1, 2021, and ending June
2530, 2022, the following amounts, or so much thereof as is
26necessary, for the purposes designated:
27To supplement the appropriation made in this Act from the
28general fund of the state to the department of human services
29for medical assistance for the same fiscal year:
.................................................. $3033,920,554
31 Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
32FOR FY 2021-2022. Notwithstanding section 8.33, if moneys
33appropriated for purposes of the medical assistance program for
34the fiscal year beginning July 1, 2021, and ending June 30,
352022, from the general fund of the state, the quality assurance
-54-1trust fund, and the hospital health care access trust fund, are
2in excess of actual expenditures for the medical assistance
3program and remain unencumbered or unobligated at the close
4of the fiscal year, the excess moneys shall not revert but
5shall remain available for expenditure for the purposes of the
6medical assistance program until the close of the succeeding
7fiscal year.
8DIVISION VII
9DEPARTMENT ON AGING — FY 2022-2023
10 Sec. 40. DEPARTMENT ON AGING. There is appropriated from
11the general fund of the state to the department on aging for
12the fiscal year beginning July 1, 2022, and ending June 30,
132023, the following amount, or so much thereof as is necessary,
14to be used for the purposes designated:
15For aging programs for the department on aging and area
16agencies on aging to provide citizens of Iowa who are 60
17years of age and older with case management, Iowa’s aging and
18disabilities resource center, and other services which may
19include but are not limited to adult day, respite care, chore,
20information and assistance, and material aid, for information
21and options counseling for persons with disabilities who
22are 18 years of age or older, and for salaries, support,
23administration, maintenance, and miscellaneous purposes:
.................................................. $2411,164,382
251. Funds appropriated in this section may be used to
26supplement federal funds under federal regulations. To
27receive funds appropriated in this section, a local area
28agency on aging shall match the funds with moneys from other
29sources according to rules adopted by the department. Funds
30appropriated in this section may be used for elderly services
31not specifically enumerated in this section only if approved
32by an area agency on aging for provision of the service within
33the area.
342. Of the funds appropriated in this section, $279,000 is
35transferred to the economic development authority for the Iowa
-55-1commission on volunteer services to be used for the retired and
2senior volunteer program.
33. a. The department on aging shall establish and enforce
4procedures relating to expenditure of state and federal funds
5by area agencies on aging that require compliance with both
6state and federal laws, rules, and regulations, including but
7not limited to all of the following:
8(1) Requiring that expenditures are incurred only for goods
9or services received or performed prior to the end of the
10fiscal period designated for use of the funds.
11(2) Prohibiting prepayment for goods or services not
12received or performed prior to the end of the fiscal period
13designated for use of the funds.
14(3) Prohibiting prepayment for goods or services not
15defined specifically by good or service, time period, or
16recipient.
17(4) Prohibiting the establishment of accounts from which
18future goods or services which are not defined specifically by
19good or service, time period, or recipient, may be purchased.
20b. The procedures shall provide that if any funds are
21expended in a manner that is not in compliance with the
22procedures and applicable federal and state laws, rules, and
23regulations, and are subsequently subject to repayment, the
24area agency on aging expending such funds in contravention of
25such procedures, laws, rules and regulations, not the state,
26shall be liable for such repayment.
274. Of the funds appropriated in this section, at least
28$600,000 shall be used to fund home and community-based
29services through the area agencies on aging that enable older
30individuals to avoid more costly utilization of residential or
31institutional services and remain in their own homes.
325. Of the funds appropriated in this section, $812,000 shall
33be used for the purposes of chapter 231E and to administer
34the prevention of elder abuse, neglect, and exploitation
35program pursuant to section 231.56A, in accordance with the
-56-1requirements of the federal Older Americans Act of 1965, 42
2U.S.C.§3001 et seq., as amended.
36. Of the funds appropriated in this section, $1,000,000
4shall be used to fund continuation of the aging and disability
5resource center lifelong links to provide individuals and
6caregivers with information and services to plan for and
7maintain independence.
87. Of the funds appropriated in this section, $250,000
9shall be used by the department on aging, in collaboration with
10the department of human services and affected stakeholders,
11to continue to expand the pilot initiative to provide
12long-term care options counseling utilizing support planning
13protocols, to assist non-Medicaid eligible consumers who
14indicate a preference to return to the community and are
15deemed appropriate for discharge, to return to their community
16following a nursing facility stay. The department on aging
17shall submit a report regarding the outcomes of the pilot
18initiative to the governor and the general assembly by December
1915, 2022.
20DIVISION VIII
21OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2022-2023
22 Sec. 41. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
23appropriated from the general fund of the state to the office
24of long-term care ombudsman for the fiscal year beginning July
251, 2022, and ending June 30, 2023, the following amount, or
26so much thereof as is necessary, to be used for the purposes
27designated:
28For salaries, support, administration, maintenance, and
29miscellaneous purposes:
.................................................. $301,149,821
31DIVISION IX
32DEPARTMENT OF PUBLIC HEALTH — FY 2022-2023
33 Sec. 42. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
34from the general fund of the state to the department of public
35health for the fiscal year beginning July 1, 2022, and ending
-57-1June 30, 2023, the following amounts, or so much thereof as is
2necessary, to be used for the purposes designated:
31. ADDICTIVE DISORDERS
4For reducing the prevalence of the use of tobacco, alcohol,
5and other drugs, and treating individuals affected by addictive
6behaviors, including gambling:
.................................................. $723,659,379
8a. Of the funds appropriated in this subsection, $4,020,894
9shall be used for the tobacco use prevention and control
10initiative, including efforts at the state and local levels,
11as provided in chapter 142A. The commission on tobacco use
12prevention and control established pursuant to section 142A.3
13shall advise the director of public health in prioritizing
14funding needs and the allocation of moneys appropriated for
15the programs and initiatives. Activities of the programs
16and initiatives shall be in alignment with the United States
17centers for disease control and prevention best practices
18for comprehensive tobacco control programs that include
19the goals of preventing youth initiation of tobacco usage,
20reducing exposure to secondhand smoke, and promotion of tobacco
21cessation.
22b. (1) Of the funds appropriated in this subsection,
23$19,638,485 shall be used for problem gambling and
24substance-related disorder prevention, treatment, and recovery
25services, including a 24-hour helpline, public information
26resources, professional training, youth prevention, and program
27evaluation.
28(2) Of the amount allocated under this paragraph, $306,000
29shall be utilized by the department of public health, in
30collaboration with the department of human services, to
31maintain a single statewide 24-hour crisis hotline for the Iowa
32children’s behavioral health system that incorporates warmline
33services which may be provided through expansion of existing
34capabilities maintained by the department of public health as
35required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
-58- 1c. The requirement of section 123.17, subsection 5, is met
2by the appropriations and allocations made in this division of
3this Act for purposes of substance-related disorder treatment
4and addictive disorders for the fiscal year beginning July 1,
52022.
62. HEALTHY CHILDREN AND FAMILIES
7For promoting the optimum health status for children and
8adolescents from birth through 21 years of age, and families:
.................................................. $95,816,681
103. CHRONIC CONDITIONS
11For serving individuals identified as having chronic
12conditions or special health care needs:
.................................................. $134,223,373
144. COMMUNITY CAPACITY
15For strengthening the health care delivery system at the
16local level:
.................................................. $176,794,306
18a. Of the funds appropriated in this subsection, $2,000,000
19shall be deposited in the medical residency training account
20created in section 135.175, subsection 5, paragraph “a”, and
21is appropriated from the account to the department of public
22health to be used for the purposes of the medical residency
23training state matching grants program as specified in section
24135.176.
25b. Of the funds appropriated in this subsection, $250,000
26shall be used for the public purpose of providing funding to
27Des Moines university to continue a provider education project
28to provide primary care physicians with the training and skills
29necessary to recognize the signs of mental illness in patients.
30c. Of the funds appropriated in this subsection, $600,000
31shall be used for rural psychiatric residencies to support the
32annual creation and training of four psychiatric residents who
33will provide mental health services in underserved areas of
34the state. Notwithstanding section 8.33, moneys that remain
35unencumbered or unobligated at the close of the fiscal year
-59-1shall not revert but shall remain available for expenditure for
2the purposes designated for subsequent fiscal years.
3d. Of the funds appropriated in this subsection, $1,000,000
4shall be used for the creation of two centers of excellence
5programs to encourage innovation and collaboration among
6regional health care providers to transform health care
7delivery in order to provide quality, sustainable care that
8meets the needs of local communities.
95. ESSENTIAL PUBLIC HEALTH SERVICES
10To provide public health services that reduce risks and
11invest in promoting and protecting good health over the
12course of a lifetime with a priority given to older Iowans and
13vulnerable populations:
.................................................. $147,662,464
156. INFECTIOUS DISEASES
16For reducing the incidence and prevalence of communicable
17diseases:
.................................................. $181,796,206
197. PUBLIC PROTECTION
20For protecting the health and safety of the public through
21establishing standards and enforcing regulations:
.................................................. $224,466,601
23Of the funds appropriated in this subsection, not more than
24$304,000 shall be credited to the emergency medical services
25fund created in section 135.25. Moneys in the emergency
26medical services fund are appropriated to the department to be
27used for the purposes of the fund.
288. RESOURCE MANAGEMENT
29For establishing and sustaining the overall ability of the
30department to deliver services to the public:
.................................................. $31933,871
329. MISCELLANEOUS PROVISIONS
33The university of Iowa hospitals and clinics under the
34control of the state board of regents shall not receive
35indirect costs from the funds appropriated in this section.
-60-1The university of Iowa hospitals and clinics billings to the
2department shall be on at least a quarterly basis.
3 Sec. 43. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
4RECEIPTS FUND. There is appropriated from the sports wagering
5receipts fund created in section 8.57, subsection 6, to the
6department of public health for the fiscal year beginning July
71, 2022, and ending June 30, 2023, the following amount, or
8so much thereof as is necessary, to be used for the purposes
9designated:
10For problem gambling and substance-related disorder
11prevention, treatment, and recovery services, including a
1224-hour helpline, public information resources, professional
13training, youth prevention, and program evaluation:
.................................................. $141,750,000
15DIVISION X
16DEPARTMENT OF VETERANS AFFAIRS — FY 2022-2023
17 Sec. 44. DEPARTMENT OF VETERANS AFFAIRS. There is
18appropriated from the general fund of the state to the
19department of veterans affairs for the fiscal year beginning
20July 1, 2022, and ending June 30, 2023, the following amounts,
21or so much thereof as is necessary, to be used for the purposes
22designated:
231. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
24For salaries, support, maintenance, and miscellaneous
25purposes:
.................................................. $261,229,763
272. IOWA VETERANS HOME
28For salaries, support, maintenance, and miscellaneous
29purposes:
.................................................. $307,131,552
31a. The Iowa veterans home billings involving the department
32of human services shall be submitted to the department on at
33least a monthly basis.
34b. The Iowa veterans home expenditure report shall be
35submitted monthly to the general assembly.
-61- 1c. The Iowa veterans home shall continue to include in the
2annual discharge report applicant information to provide for
3the collection of demographic information including but not
4limited to the number of individuals applying for admission and
5admitted or denied admittance and the basis for the admission
6or denial; the age, gender, and race of such individuals;
7and the level of care for which such individuals applied for
8admission including residential or nursing level of care.
93. HOME OWNERSHIP ASSISTANCE PROGRAM
10For transfer to the Iowa finance authority for the
11continuation of the home ownership assistance program for
12persons who are or were eligible members of the armed forces of
13the United States, pursuant to section 16.54:
.................................................. $142,000,000
15 Sec. 45. LIMITATION OF COUNTY COMMISSIONS OF VETERAN
16AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the
17standing appropriation in section 35A.16 for the fiscal year
18beginning July 1, 2022, and ending June 30, 2023, the amount
19appropriated from the general fund of the state pursuant to
20that section for the following designated purposes shall not
21exceed the following amount:
22For the county commissions of veteran affairs fund under
23section 35A.16:
.................................................. $24990,000
25DIVISION XI
26DEPARTMENT OF HUMAN SERVICES — FY 2022-2023
27 Sec. 46. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
28GRANT. There is appropriated from the fund created in section
298.41 to the department of human services for the fiscal year
30beginning July 1, 2022, and ending June 30, 2023, from moneys
31received under the federal temporary assistance for needy
32families (TANF) block grant pursuant to the federal Personal
33Responsibility and Work Opportunity Reconciliation Act of 1996,
34Pub.L.No.104-193, and successor legislation, the following
35amounts, or so much thereof as is necessary, to be used for the
-62-1purposes designated:
21. To be credited to the family investment program account
3and used for assistance under the family investment program
4under chapter 239B:
.................................................. $55,002,006
62. To be credited to the family investment program account
7and used for the job opportunities and basic skills (JOBS)
8program and implementing family investment agreements in
9accordance with chapter 239B:
.................................................. $105,412,060
113. To be used for the family development and
12self-sufficiency grant program in accordance with section
13216A.107:
.................................................. $142,888,980
15Notwithstanding section 8.33, moneys appropriated in this
16subsection that remain unencumbered or unobligated at the close
17of the fiscal year shall not revert but shall remain available
18for expenditure for the purposes designated until the close of
19the succeeding fiscal year. However, unless such moneys are
20encumbered or obligated on or before September 30, 2023, the
21moneys shall revert.
224. For field operations:
.................................................. $2331,296,232
245. For general administration:
.................................................. $253,744,000
266. For state child care assistance:
.................................................. $2747,166,826
28a. Of the funds appropriated in this subsection,
29$26,205,412 is transferred to the child care and development
30block grant appropriation made by the Eighty-ninth General
31Assembly, 2021 session, for the federal fiscal year beginning
32October 1, 2022, and ending September 30, 2023. Of this
33amount, $200,000 shall be used for provision of educational
34opportunities to registered child care home providers in order
35to improve services and programs offered by this category
-63-1of providers and to increase the number of providers. The
2department may contract with institutions of higher education
3or child care resource and referral centers to provide
4the educational opportunities. Allowable administrative
5costs under the contracts shall not exceed 5 percent. The
6application for a grant shall not exceed two pages in length.
7b. Any funds appropriated in this subsection remaining
8unallocated shall be used for state child care assistance
9payments for families who are employed including but not
10limited to individuals enrolled in the family investment
11program.
127. For child and family services:
.................................................. $1332,380,654
148. For child abuse prevention grants:
.................................................. $15125,000
169. For pregnancy prevention grants on the condition that
17family planning services are funded:
.................................................. $181,913,203
19Pregnancy prevention grants shall be awarded to programs
20in existence on or before July 1, 2022, if the programs have
21demonstrated positive outcomes. Grants shall be awarded to
22pregnancy prevention programs which are developed after July
231, 2022, if the programs are based on existing models that
24have demonstrated positive outcomes. Grants shall comply with
25the requirements provided in 1997 Iowa Acts, chapter 208,
26section 14, subsections 1 and 2, including the requirement that
27grant programs must emphasize sexual abstinence. Priority in
28the awarding of grants shall be given to programs that serve
29areas of the state which demonstrate the highest percentage of
30unplanned pregnancies of females of childbearing age within the
31geographic area to be served by the grant.
3210. For technology needs and other resources necessary to
33meet federal, state, and welfare reform reporting, tracking,
34and case management requirements and other departmental needs:
.................................................. $351,037,186
-64- 111. a. Notwithstanding any provision to the contrary,
2including but not limited to requirements in section 8.41 or
3provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the
4receipt and appropriation of federal block grants, federal
5funds from the temporary assistance for needy families block
6grant received by the state and not otherwise appropriated
7in this section and remaining available for the fiscal year
8beginning July 1, 2022, are appropriated to the department of
9human services to the extent as may be necessary to be used in
10the following priority order: the family investment program,
11for state child care assistance program payments for families
12who are employed, and for the family investment program share
13of system costs for eligibility determination and related
14functions. The federal funds appropriated in this paragraph
15“a” shall be expended only after all other funds appropriated
16in subsection 1 for assistance under the family investment
17program, in subsection 6 for state child care assistance, or
18in subsection 10 for technology costs related to the family
19investment program, as applicable, have been expended. For
20the purposes of this subsection, the funds appropriated in
21subsection 6, paragraph “a”, for transfer to the child care
22and development block grant appropriation are considered fully
23expended when the full amount has been transferred.
24b. The department shall, on a quarterly basis, advise the
25legislative services agency and department of management of
26the amount of funds appropriated in this subsection that was
27expended in the prior quarter.
2812. Of the amounts appropriated in this section,
29$12,962,008 for the fiscal year beginning July 1, 2022, is
30transferred to the appropriation of the federal social services
31block grant made to the department of human services for that
32fiscal year.
3313. For continuation of the program providing categorical
34eligibility for the food assistance program as specified
35for the program in the section of this division of this Act
-65-1relating to the family investment program account:
.................................................. $214,236
314. The department may transfer funds allocated in this
4section to the appropriations made in this division of this Act
5for the same fiscal year for general administration and field
6operations for resources necessary to implement and operate the
7services referred to in this section and those funded in the
8appropriation made in this division of this Act for the same
9fiscal year for the family investment program from the general
10fund of the state.
1115. With the exception of moneys allocated under this
12section for the family development and self-sufficiency grant
13program, to the extent moneys allocated in this section are
14deemed by the department not to be necessary to support the
15purposes for which they are allocated, such moneys may be
16used in the same fiscal year for any other purpose for which
17funds are allocated in this section or in section 46 of this
18division for the family investment program account. If there
19are conflicting needs, priority shall first be given to the
20family investment program account as specified under subsection
211 of this section and used for the purposes of assistance under
22the family investment program in accordance with chapter 239B,
23followed by state child care assistance program payments for
24families who are employed, followed by other priorities as
25specified by the department.
26 Sec. 47. FAMILY INVESTMENT PROGRAM ACCOUNT.
271. Moneys credited to the family investment program (FIP)
28account for the fiscal year beginning July 1, 2022, and
29ending June 30, 2023, shall be used to provide assistance in
30accordance with chapter 239B.
312. The department may use a portion of the moneys credited
32to the FIP account under this section as necessary for
33salaries, support, maintenance, and miscellaneous purposes.
343. The department may transfer funds allocated in
35subsection 4, excluding the allocation under subsection 4,
-66-1paragraph “b”, to the appropriations made in this division of
2this Act for the same fiscal year for general administration
3and field operations for resources necessary to implement
4and operate the services referred to in this section and
5those funded in the appropriations made in section 45 for the
6temporary assistance for needy families block grant and in
7section 47 for the family investment program from the general
8fund of the state in this division of this Act for the same
9fiscal year.
104. Moneys appropriated in this division of this Act and
11credited to the FIP account for the fiscal year beginning July
121, 2022, and ending June 30, 2023, are allocated as follows:
13a. To be retained by the department of human services to
14be used for coordinating with the department of human rights
15to more effectively serve participants in FIP and other shared
16clients and to meet federal reporting requirements under the
17federal temporary assistance for needy families block grant:
.................................................. $1810,000
19b. To the department of human rights for staffing,
20administration, and implementation of the family development
21and self-sufficiency grant program in accordance with section
22216A.107:
.................................................. $236,192,834
24(1) Of the funds allocated for the family development
25and self-sufficiency grant program in this paragraph “b”,
26not more than 5 percent of the funds shall be used for the
27administration of the grant program.
28(2) The department of human rights may continue to implement
29the family development and self-sufficiency grant program
30statewide during fiscal year 2022-2023.
31(3) The department of human rights may engage in activities
32to strengthen and improve family outcomes measures and
33data collection systems under the family development and
34self-sufficiency grant program.
35c. For the diversion subaccount of the FIP account:
-67-.................................................. $11,293,000
2A portion of the moneys allocated for the diversion
3subaccount may be used for field operations, salaries, data
4management system development, and implementation costs and
5support deemed necessary by the director of human services
6in order to administer the FIP diversion program. To the
7extent moneys allocated in this paragraph “c” are deemed by the
8department not to be necessary to support diversion activities,
9such moneys may be used for other efforts intended to increase
10engagement by family investment program participants in work,
11education, or training activities, or for the purposes of
12assistance under the family investment program in accordance
13with chapter 239B.
14d. For the food assistance employment and training program:
.................................................. $1566,588
16(1) The department shall apply the federal supplemental
17nutrition assistance program (SNAP) employment and training
18state plan in order to maximize to the fullest extent permitted
19by federal law the use of the 50 percent federal reimbursement
20provisions for the claiming of allowable federal reimbursement
21funds from the United States department of agriculture
22pursuant to the federal SNAP employment and training program
23for providing education, employment, and training services
24for eligible food assistance program participants, including
25but not limited to related dependent care and transportation
26expenses.
27(2) The department shall continue the categorical federal
28food assistance program eligibility at 160 percent of the
29federal poverty level and continue to eliminate the asset test
30from eligibility requirements, consistent with federal food
31assistance program requirements. The department shall include
32as many food assistance households as is allowed by federal
33law. The eligibility provisions shall conform to all federal
34requirements including requirements addressing individuals who
35are incarcerated or otherwise ineligible.
-68- 1e. For the JOBS program, not more than:
.................................................. $212,018,258
35. Of the child support collections assigned under FIP,
4an amount equal to the federal share of support collections
5shall be credited to the child support recovery appropriation
6made in this division of this Act. Of the remainder of the
7assigned child support collections received by the child
8support recovery unit, a portion shall be credited to the FIP
9account, a portion may be used to increase recoveries, and a
10portion may be used to sustain cash flow in the child support
11payments account. If as a consequence of the appropriations
12and allocations made in this section the resulting amounts
13are insufficient to sustain cash assistance payments and meet
14federal maintenance of effort requirements, the department
15shall seek supplemental funding. If child support collections
16assigned under FIP are greater than estimated or are otherwise
17determined not to be required for maintenance of effort, the
18state share of either amount may be transferred to or retained
19in the child support payments account.
20 Sec. 48. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
21is appropriated from the general fund of the state to the
22department of human services for the fiscal year beginning July
231, 2022, and ending June 30, 2023, the following amount, or
24so much thereof as is necessary, to be used for the purpose
25designated:
26To be credited to the family investment program (FIP)
27account and used for family investment program assistance
28under chapter 239B and other costs associated with providing
29needs-based benefits or assistance:
.................................................. $3040,003,978
311. Of the funds appropriated in this section, $6,606,198 is
32allocated for the JOBS program.
332. Of the funds appropriated in this section, $3,313,854 is
34allocated for the family development and self-sufficiency grant
35program.
-69- 13. a. Notwithstanding section 8.39, for the fiscal
2year beginning July 1, 2022, if necessary to meet federal
3maintenance of effort requirements or to transfer federal
4temporary assistance for needy families block grant funding
5to be used for purposes of the federal social services block
6grant or to meet cash flow needs resulting from delays in
7receiving federal funding or to implement, in accordance with
8this division of this Act, activities currently funded with
9juvenile court services, county, or community moneys and state
10moneys used in combination with such moneys; to comply with
11federal requirements; or to maximize the use of federal funds;
12the department of human services may transfer funds within or
13between any of the appropriations made in this division of this
14Act and appropriations in law for the federal social services
15block grant to the department for the following purposes,
16provided that the combined amount of state and federal
17temporary assistance for needy families block grant funding
18for each appropriation remains the same before and after the
19transfer:
20(1) For the family investment program.
21(2) For state child care assistance.
22(3) For child and family services.
23(4) For field operations.
24(5) For general administration.
25b. This subsection shall not be construed to prohibit the
26use of existing state transfer authority for other purposes.
27The department shall report any transfers made pursuant to this
28subsection to the general assembly.
294. Of the funds appropriated in this section, $195,000
30shall be used for a contract for tax preparation assistance
31to low-income Iowans in order to expand the usage of the
32earned income tax credit. The purpose of the contract is to
33supply this assistance to underserved areas of the state. The
34department shall not retain any portion of the allocation under
35this subsection for administrative costs.
-70- 15. Of the funds appropriated in this section, $70,000 shall
2be used for the continuation of the parenting program, as
3specified in 441 IAC ch.100, relating to parental obligations,
4in which the child support recovery unit participates, to
5support the efforts of a nonprofit organization committed
6to strengthening the community through youth development,
7healthy living, and social responsibility headquartered in
8a county with a population over 350,000 according to the
9latest certified federal census. The funds allocated in this
10subsection shall be used by the recipient organization to
11develop a larger community effort, through public and private
12partnerships, to support a broad-based multi-county parenthood
13initiative that promotes payment of child support obligations,
14improved family relationships, and full-time employment.
156. The department may transfer funds appropriated in this
16section, excluding the allocation in subsection 2 for the
17family development and self-sufficiency grant program, to the
18appropriations made in this division of this Act for general
19administration and field operations as necessary to administer
20this section, section 45 for the temporary assistance for needy
21families block grant, and section 46 for the family investment
22program account.
23 Sec. 49. CHILD SUPPORT RECOVERY. There is appropriated
24from the general fund of the state to the department of human
25services for the fiscal year beginning July 1, 2022, and ending
26June 30, 2023, the following amount, or so much thereof as is
27necessary, to be used for the purposes designated:
28For child support recovery, including salaries, support,
29maintenance, and miscellaneous purposes:
.................................................. $3015,942,885
311. The department shall expend up to $24,000, including
32federal financial participation, for the fiscal year beginning
33July 1, 2022, for a child support public awareness campaign.
34The department and the office of the attorney general shall
35cooperate in continuation of the campaign. The public
-71-1awareness campaign shall emphasize, through a variety of
2media activities, the importance of maximum involvement of
3both parents in the lives of their children as well as the
4importance of payment of child support obligations.
52. Federal access and visitation grant moneys shall be
6issued directly to private not-for-profit agencies that provide
7services designed to increase compliance with the child access
8provisions of court orders, including but not limited to
9neutral visitation sites and mediation services.
103. The appropriation made to the department for child
11support recovery may be used throughout the fiscal year in the
12manner necessary for purposes of cash flow management, and for
13cash flow management purposes the department may temporarily
14draw more than the amount appropriated, provided the amount
15appropriated is not exceeded at the close of the fiscal year.
16 Sec. 50. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
17FY 2022-2023. Any funds remaining in the health care trust
18fund created in section 453A.35A for the fiscal year beginning
19July 1, 2022, and ending June 30, 2023, are appropriated to
20the department of human services to supplement the medical
21assistance program appropriations made in this division of this
22Act, for medical assistance reimbursement and associated costs,
23including program administration and costs associated with
24program implementation.
25 Sec. 51. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
262022-2023. Any funds remaining in the Medicaid fraud fund
27created in section 249A.50 for the fiscal year beginning
28July 1, 2022, and ending June 30, 2023, are appropriated to
29the department of human services to supplement the medical
30assistance appropriations made in this division of this Act,
31for medical assistance reimbursement and associated costs,
32including program administration and costs associated with
33program implementation.
34 Sec. 52. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES
35FUND — FY 2022-2023. There is appropriated from the general
-72-1fund of the state to the department of human services for the
2fiscal year beginning July 1, 2022, and ending June 30, 2023,
3the following amount, or so much thereof as is necessary, to be
4used for the purpose designated:
5For transfer to the mental health and disability regional
6services fund created in section 225C.7A, or a successor fund:
.................................................. $730,000,000
8Moneys transferred to the mental health and disability
9regional services fund under this section are appropriated to
10the department of human services for distribution to regions
11for funding of mental health and disability services in
12accordance with section 225C.7A.
13 Sec. 53. MEDICAL ASSISTANCE. There is appropriated from the
14general fund of the state to the department of human services
15for the fiscal year beginning July 1, 2022, and ending June 30,
162023, the following amount, or so much thereof as is necessary,
17to be used for the purpose designated:
18For medical assistance program reimbursement and associated
19costs as specifically provided in the reimbursement
20methodologies in effect on June 30, 2022, except as otherwise
21expressly authorized by law, consistent with options under
22federal law and regulations, and contingent upon receipt of
23approval from the office of the governor of reimbursement for
24each abortion performed under the program:
.................................................. $251,491,499,409
261. Iowans support reducing the number of abortions
27performed in our state. Funds appropriated under this section
28shall not be used for abortions, unless otherwise authorized
29under this section.
302. The provisions of this section relating to abortions
31shall also apply to the Iowa health and wellness plan created
32pursuant to chapter 249N.
333. The department shall utilize not more than $60,000 of
34the funds appropriated in this section to continue the AIDS/HIV
35health insurance premium payment program as established in 1992
-73-1Iowa Acts, Second Extraordinary Session, chapter 1001, section
2409, subsection 6. Of the funds allocated in this subsection,
3not more than $5,000 may be expended for administrative
4purposes.
54. Of the funds appropriated in this Act to the department
6of public health for addictive disorders, $950,000 for
7the fiscal year beginning July 1, 2022, is transferred
8to the department of human services for an integrated
9substance-related disorder managed care system. The
10departments of human services and public health shall
11work together to maintain the level of mental health and
12substance-related disorder treatment services provided by the
13managed care contractors. Each department shall take the steps
14necessary to continue the federal waivers as necessary to
15maintain the level of services.
165. The department shall aggressively pursue options for
17providing medical assistance or other assistance to individuals
18with special needs who become ineligible to continue receiving
19services under the early and periodic screening, diagnostic,
20and treatment program under the medical assistance program
21due to becoming 21 years of age who have been approved for
22additional assistance through the department’s exception to
23policy provisions, but who have health care needs in excess
24of the funding available through the exception to policy
25provisions.
266. Of the funds appropriated in this section, up to
27$3,050,082 may be transferred to the field operations or
28general administration appropriations in this division of this
29Act for operational costs associated with Part D of the federal
30Medicare Prescription Drug Improvement and Modernization Act
31of 2003, Pub.L.No.108-173.
327. Of the funds appropriated in this section, up to $442,100
33may be transferred to the appropriation in this division of
34this Act for health program operations to be used for clinical
35assessment services and prior authorization of services.
-74- 18. A portion of the funds appropriated in this section may
2be transferred to the appropriations in this division of this
3Act for general administration, health program operations, the
4children’s health insurance program, or field operations to be
5used for the state match cost to comply with the payment error
6rate measurement (PERM) program for both the medical assistance
7and children’s health insurance programs as developed by the
8centers for Medicare and Medicaid services of the United States
9department of health and human services to comply with the
10federal Improper Payments Information Act of 2002, Pub.L.
11No.107-300, and to support other reviews and quality control
12activities to improve the integrity of these programs.
139. Of the funds appropriated in this section, a sufficient
14amount is allocated to supplement the incomes of residents of
15nursing facilities, intermediate care facilities for persons
16with mental illness, and intermediate care facilities for
17persons with an intellectual disability, with incomes of less
18than $50 in the amount necessary for the residents to receive a
19personal needs allowance of $50 per month pursuant to section
20249A.30A.
2110. a. Hospitals that meet the conditions specified
22in subparagraphs (1) and (2) shall either certify public
23expenditures or transfer to the medical assistance program
24an amount equal to provide the nonfederal share for a
25disproportionate share hospital payment in an amount up to the
26hospital-specific limit as approved in the Medicaid state plan.
27The hospitals that meet the conditions specified shall receive
28and retain 100 percent of the total disproportionate share
29hospital payment in an amount up to the hospital-specific limit
30as approved in the Medicaid state plan.
31(1) The hospital qualifies for disproportionate share and
32graduate medical education payments.
33(2) The hospital is an Iowa state-owned hospital with more
34than 500 beds and eight or more distinct residency specialty
35or subspecialty programs recognized by the American college of
-75-1graduate medical education.
2b. Distribution of the disproportionate share payments
3shall be made on a monthly basis. The total amount of
4disproportionate share payments including graduate medical
5education, enhanced disproportionate share, and Iowa
6state-owned teaching hospital payments shall not exceed the
7amount of the state’s allotment under Pub.L.No.102-234.
8In addition, the total amount of all disproportionate
9share payments shall not exceed the hospital-specific
10disproportionate share limits under Pub.L.No.103-66.
1111. One hundred percent of the nonfederal share of payments
12to area education agencies that are medical assistance
13providers for medical assistance-covered services provided to
14medical assistance-covered children, shall be made from the
15appropriation made in this section.
1612. A portion of the funds appropriated in this section may
17be transferred to the appropriation in this division of this
18Act for health program operations to be used for administrative
19activities associated with the money follows the person
20demonstration project.
2113. Of the funds appropriated in this section, $349,011
22shall be used for the administration of the health insurance
23premium payment program, including salaries, support,
24maintenance, and miscellaneous purposes.
2514. a. The department may increase the amounts allocated
26for salaries, support, maintenance, and miscellaneous purposes
27associated with the medical assistance program, as necessary,
28to sustain cost management efforts. The department shall
29report any such increase to the general assembly and the
30department of management.
31b. If the savings to the medical assistance program from
32ongoing cost management efforts exceed the associated cost
33for the fiscal year beginning July 1, 2022, the department
34may transfer any savings generated for the fiscal year due
35to medical assistance program cost management efforts to the
-76-1appropriation made in this division of this Act for health
2program operations or general administration to defray the
3costs associated with implementing the efforts.
415. For the fiscal year beginning July 1, 2022, and ending
5June 30, 2023, the replacement generation tax revenues required
6to be deposited in the property tax relief fund pursuant to
7section 437A.8, subsection 4, paragraph “d”, and section
8437A.15, subsection 3, paragraph “f”, shall instead be credited
9to and supplement the appropriation made in this section and
10used for the allocations made in this section.
1116. a. Of the funds appropriated in this section, up
12to $50,000 may be transferred by the department to the
13appropriation made in this division of this Act to the
14department for the same fiscal year for general administration
15to be used for associated administrative expenses.
16b. Of the funds appropriated in this section, up to $400,000
17may be transferred by the department to the appropriation made
18to the department in this division of this Act for the same
19fiscal year for Medicaid program-related general administration
20planning and implementation activities. The funds may be used
21for contracts or for personnel in addition to the amounts
22appropriated for general administration for the fiscal year.
23c. Of the funds appropriated in this section, up to
24$3,000,000 may be transferred by the department to the
25appropriations made in this division of this Act for the
26same fiscal year for general administration or health
27program operations to be used to support the development
28and implementation of standardized assessment tools for
29persons with mental illness, an intellectual disability, a
30developmental disability, or a brain injury.
3117. Of the funds appropriated in this section, $150,000
32shall be used for lodging expenses associated with care
33provided at the university of Iowa hospitals and clinics for
34patients with cancer whose travel distance is 30 miles or more
35and whose income is at or below 200 percent of the federal
-77-1poverty level as defined by the most recently revised poverty
2income guidelines published by the United States department of
3health and human services. The department of human services
4shall establish the maximum number of overnight stays and the
5maximum rate reimbursed for overnight lodging, which may be
6based on the state employee rate established by the department
7of administrative services. The funds allocated in this
8subsection shall not be used as nonfederal share matching
9funds.
1018. Of the funds appropriated in this section, up to
11$3,383,880 shall be used for administration of the state family
12planning services program pursuant to section 217.41B, and
13of this amount, the department may use up to $200,000 for
14administrative expenses.
1519. Of the funds appropriated in this section, $1,545,530
16shall be used and may be transferred to other appropriations
17in this division of this Act as necessary to administer the
18provisions in the division of this Act relating to Medicaid
19program administration.
20 Sec. 54. HEALTH PROGRAM OPERATIONS. There is appropriated
21from the general fund of the state to the department of human
22services for the fiscal year beginning July 1, 2022, and ending
23June 30, 2023, the following amount, or so much thereof as is
24necessary, to be used for the purpose designated:
25For health program operations:
.................................................. $2617,831,343
271. The department of inspections and appeals shall
28provide all state matching funds for survey and certification
29activities performed by the department of inspections
30and appeals. The department of human services is solely
31responsible for distributing the federal matching funds for
32such activities.
332. Of the funds appropriated in this section, $50,000 shall
34be used for continuation of home and community-based services
35waiver quality assurance programs, including the review and
-78-1streamlining of processes and policies related to oversight and
2quality management to meet state and federal requirements.
33. Of the amount appropriated in this section, up to
4$200,000 may be transferred to the appropriation for general
5administration in this division of this Act to be used for the
6development of key health initiatives such as development and
7oversight of managed care programs and development of health
8strategies targeted toward improved quality and reduced costs
9in the Medicaid program.
104. Of the funds appropriated in this section, $1,000,000
11shall be used for planning and development, in cooperation with
12the department of public health, of a phased-in program to
13provide a dental home for children.
145. a. Of the funds appropriated in this section, $573,000
15shall be credited to the autism support program fund created
16in section 225D.2 to be used for the autism support program
17created in chapter 225D, with the exception of the following
18amount of this allocation which shall be used as follows:
19b. Of the funds allocated in this subsection, $25,000 shall
20be used for the public purpose of continuation of a grant to a
21nonprofit provider of child welfare services that has been in
22existence for more than 115 years, is located in a county with
23a population between 200,000 and 220,000 according to the most
24recent federal decennial census, is licensed as a psychiatric
25medical institution for children, and provides school-based
26programming, to be used for support services for children with
27autism spectrum disorder and their families.
28 Sec. 55. STATE SUPPLEMENTARY ASSISTANCE.
291. There is appropriated from the general fund of the
30state to the department of human services for the fiscal year
31beginning July 1, 2022, and ending June 30, 2023, the following
32amount, or so much thereof as is necessary, to be used for the
33purpose designated:
34For the state supplementary assistance program:
.................................................. $357,349,002
-79- 12. The department shall increase the personal needs
2allowance for residents of residential care facilities by the
3same percentage and at the same time as federal supplemental
4security income and federal social security benefits are
5increased due to a recognized increase in the cost of living.
6The department may adopt emergency rules to implement this
7subsection.
83. If during the fiscal year beginning July 1, 2022,
9the department projects that state supplementary assistance
10expenditures for a calendar year will not meet the federal
11pass-through requirement specified in Tit.XVI of the federal
12Social Security Act, section 1618, as codified in 42 U.S.C.
13§1382g, the department may take actions including but not
14limited to increasing the personal needs allowance for
15residential care facility residents and making programmatic
16adjustments or upward adjustments of the residential care
17facility or in-home health-related care reimbursement rates
18prescribed in this division of this Act to ensure that federal
19requirements are met. In addition, the department may make
20other programmatic and rate adjustments necessary to remain
21within the amount appropriated in this section while ensuring
22compliance with federal requirements. The department may adopt
23emergency rules to implement the provisions of this subsection.
244. Notwithstanding section 8.33, moneys appropriated
25in this section that remain unencumbered or unobligated
26at the close of the fiscal year shall not revert but
27shall remain available for expenditure for the purposes
28designated, including for liability amounts associated with the
29supplemental nutrition assistance program payment error rate,
30until the close of the succeeding fiscal year.
31 Sec. 56. CHILDREN’S HEALTH INSURANCE PROGRAM.
321. There is appropriated from the general fund of the
33state to the department of human services for the fiscal year
34beginning July 1, 2022, and ending June 30, 2023, the following
35amount, or so much thereof as is necessary, to be used for the
-80-1purpose designated:
2For maintenance of the healthy and well kids in Iowa (hawk-i)
3program pursuant to chapter 514I, including supplemental dental
4services, for receipt of federal financial participation under
5Tit.XXI of the federal Social Security Act, which creates the
6children’s health insurance program:
.................................................. $748,326,863
82. Of the funds appropriated in this section, $162,029 is
9allocated for continuation of the contract for outreach with
10the department of public health.
113. A portion of the funds appropriated in this section may
12be transferred to the appropriations made in this division of
13this Act for field operations or health program operations to
14be used for the integration of hawk-i program eligibility,
15payment, and administrative functions under the purview of
16the department of human services, including for the Medicaid
17management information system upgrade.
18 Sec. 57. CHILD CARE ASSISTANCE. There is appropriated
19from the general fund of the state to the department of human
20services for the fiscal year beginning July 1, 2022, and ending
21June 30, 2023, the following amount, or so much thereof as is
22necessary, to be used for the purpose designated:
23For child care programs:
.................................................. $2440,816,931
251. Of the funds appropriated in this section, $34,966,931
26shall be used for state child care assistance in accordance
27with section 237A.13.
282. Nothing in this section shall be construed or is
29intended as or shall imply a grant of entitlement for services
30to persons who are eligible for assistance due to an income
31level consistent with the waiting list requirements of section
32237A.13. Any state obligation to provide services pursuant to
33this section is limited to the extent of the funds appropriated
34in this section.
353. A list of the registered and licensed child care
-81-1facilities operating in the area served by a child care
2resource and referral service shall be made available to the
3families receiving state child care assistance in that area.
44. Of the funds appropriated in this section, $5,850,000
5shall be credited to the early childhood programs grants
6account in the early childhood Iowa fund created in section
7256I.11. The moneys shall be distributed for funding of
8community-based early childhood programs targeted to children
9from birth through five years of age developed by early
10childhood Iowa areas in accordance with approved community
11plans as provided in section 256I.8.
125. The department may use any of the funds appropriated
13in this section as a match to obtain federal funds for use in
14expanding child care assistance and related programs. For
15the purpose of expenditures of state and federal child care
16funding, funds shall be considered obligated at the time
17expenditures are projected or are allocated to the department’s
18service areas. Projections shall be based on current and
19projected caseload growth, current and projected provider
20rates, staffing requirements for eligibility determination
21and management of program requirements including data systems
22management, staffing requirements for administration of the
23program, contractual and grant obligations and any transfers
24to other state agencies, and obligations for decategorization
25or innovation projects.
266. A portion of the state match for the federal child care
27and development block grant shall be provided as necessary to
28meet federal matching funds requirements through the state
29general fund appropriation made for child development grants
30and other programs for at-risk children in section 279.51.
317. If a uniform reduction ordered by the governor under
32section 8.31 or other operation of law, transfer, or federal
33funding reduction reduces the appropriation made in this
34section for the fiscal year, the percentage reduction in the
35amount paid out to or on behalf of the families participating
-82-1in the state child care assistance program shall be equal to or
2less than the percentage reduction made for any other purpose
3payable from the appropriation made in this section and the
4federal funding relating to it. The percentage reduction to
5the other allocations made in this section shall be the same as
6the uniform reduction ordered by the governor or the percentage
7change of the federal funding reduction, as applicable. If
8there is an unanticipated increase in federal funding provided
9for state child care services, the entire amount of the
10increase, except as necessary to meet federal requirements
11including quality set asides, shall be used for state child
12care assistance payments. If the appropriations made for
13purposes of the state child care assistance program for the
14fiscal year are determined to be insufficient, it is the intent
15of the general assembly to appropriate sufficient funding for
16the fiscal year in order to avoid establishment of waiting list
17requirements.
188. Notwithstanding section 8.33, moneys advanced for
19purposes of the programs developed by early childhood Iowa
20areas, advanced for purposes of wraparound child care, or
21received from the federal appropriations made for the purposes
22of this section that remain unencumbered or unobligated at the
23close of the fiscal year shall not revert to any fund but shall
24remain available for expenditure for the purposes designated
25until the close of the succeeding fiscal year.
26 Sec. 58. JUVENILE INSTITUTION. There is appropriated
27from the general fund of the state to the department of human
28services for the fiscal year beginning July 1, 2022, and ending
29June 30, 2023, the following amounts, or so much thereof as is
30necessary, to be used for the purposes designated:
311. a. For operation of the state training school at Eldora
32and for salaries, support, maintenance, and miscellaneous
33purposes:
.................................................. $3417,397,068
35b. Of the funds appropriated in this subsection, $91,000
-83-1shall be used for distribution to licensed classroom teachers
2at this and other institutions under the control of the
3department of human services based upon the average student
4yearly enrollment at each institution as determined by the
5department.
62. A portion of the moneys appropriated in this section
7shall be used by the state training school at Eldora for
8grants for adolescent pregnancy prevention activities at the
9institution in the fiscal year beginning July 1, 2022.
103. Of the funds appropriated in this subsection, $212,000
11shall be used by the state training school at Eldora for a
12substance use disorder treatment program at the institution for
13the fiscal year beginning July 1, 2022.
144. Notwithstanding section 8.33, moneys appropriated in
15this section that remain unencumbered or unobligated at the
16close of the fiscal year shall not revert but shall remain
17available for expenditure for the purposes designated until the
18close of the succeeding fiscal year.
19 Sec. 59. CHILD AND FAMILY SERVICES.
201. There is appropriated from the general fund of the
21state to the department of human services for the fiscal year
22beginning July 1, 2022, and ending June 30, 2023, the following
23amount, or so much thereof as is necessary, to be used for the
24purpose designated:
25For child and family services:
.................................................. $2689,071,930
272. The department may transfer funds appropriated in this
28section as necessary to pay the nonfederal costs of services
29reimbursed under the medical assistance program, state child
30care assistance program, or the family investment program which
31are provided to children who would otherwise receive services
32paid under the appropriation in this section. The department
33may transfer funds appropriated in this section to the
34appropriations made in this division of this Act for general
35administration and for field operations for resources necessary
-84-1to implement and operate the services funded in this section.
23. a. Of the funds appropriated in this section, up to
3$31,500,000 is allocated as the statewide expenditure target
4under section 232.143 for group foster care maintenance and
5services. If the department projects that such expenditures
6for the fiscal year will be less than the target amount
7allocated in this paragraph “a”, the department may reallocate
8the excess to provide additional funding for family foster
9care, independent living, family-centered services, shelter
10care, or the child welfare emergency services addressed with
11the allocation for shelter care.
12b. If at any time after September 30, 2022, annualization
13of a service area’s current expenditures indicates a service
14area is at risk of exceeding its group foster care expenditure
15target under section 232.143 by more than 5 percent, the
16department and juvenile court services shall examine all
17group foster care placements in that service area in order to
18identify those which might be appropriate for termination.
19In addition, any aftercare services believed to be needed
20for the children whose placements may be terminated shall be
21identified. The department and juvenile court services shall
22initiate action to set dispositional review hearings for the
23placements identified. In such a dispositional review hearing,
24the juvenile court shall determine whether needed aftercare
25services are available and whether termination of the placement
26is in the best interest of the child and the community.
274. In accordance with the provisions of section 232.188,
28the department shall continue the child welfare and juvenile
29justice funding initiative during fiscal year 2022-2023. Of
30the funds appropriated in this section, $1,717,000 is allocated
31specifically for expenditure for fiscal year 2022-2023 through
32the decategorization services funding pools and governance
33boards established pursuant to section 232.188.
345. A portion of the funds appropriated in this section
35may be used for emergency family assistance to provide other
-85-1resources required for a family participating in a family
2preservation or reunification project or successor project to
3stay together or to be reunified.
46. Of the funds appropriated in this section, a sufficient
5amount is allocated for shelter care and the child welfare
6emergency services contracting implemented to provide for or
7prevent the need for shelter care.
87. Federal funds received by the state during the fiscal
9year beginning July 1, 2022, as the result of the expenditure
10of state funds appropriated during a previous state fiscal
11year for a service or activity funded under this section are
12appropriated to the department to be used as additional funding
13for services and purposes provided for under this section.
14Notwithstanding section 8.33, moneys received in accordance
15with this subsection that remain unencumbered or unobligated at
16the close of the fiscal year shall not revert to any fund but
17shall remain available for the purposes designated until the
18close of the succeeding fiscal year.
198. a. Of the funds appropriated in this section, up to
20$3,290,000 is allocated for the payment of the expenses of
21court-ordered services provided to juveniles who are under the
22supervision of juvenile court services, which expenses are a
23charge upon the state pursuant to section 232.141, subsection
244. Of the amount allocated in this paragraph “a”, up to
25$1,556,000 shall be made available to provide school-based
26supervision of children adjudicated under chapter 232, of which
27not more than $15,000 may be used for the purpose of training.
28A portion of the cost of each school-based liaison officer
29shall be paid by the school district or other funding source as
30approved by the chief juvenile court officer.
31b. Of the funds appropriated in this section, up to $748,000
32is allocated for the payment of the expenses of court-ordered
33services provided to children who are under the supervision
34of the department, which expenses are a charge upon the state
35pursuant to section 232.141, subsection 4.
-86- 1c. Notwithstanding section 232.141 or any other provision
2of law to the contrary, the amounts allocated in this
3subsection shall be distributed to the judicial districts
4as determined by the state court administrator and to the
5department’s service areas as determined by the administrator
6of the department of human services’ division of child and
7family services. The state court administrator and the
8division administrator shall make the determination of the
9distribution amounts on or before June 15, 2022.
10d. Notwithstanding chapter 232 or any other provision of
11law to the contrary, a district or juvenile court shall not
12order any service which is a charge upon the state pursuant
13to section 232.141 if there are insufficient court-ordered
14services funds available in the district court or departmental
15service area distribution amounts to pay for the service. The
16chief juvenile court officer and the departmental service area
17manager shall encourage use of the funds allocated in this
18subsection such that there are sufficient funds to pay for
19all court-related services during the entire year. The chief
20juvenile court officers and departmental service area managers
21shall attempt to anticipate potential surpluses and shortfalls
22in the distribution amounts and shall cooperatively request the
23state court administrator or division administrator to transfer
24funds between the judicial districts’ or departmental service
25areas’ distribution amounts as prudent.
26e. Notwithstanding any provision of law to the contrary,
27a district or juvenile court shall not order a county to pay
28for any service provided to a juvenile pursuant to an order
29entered under chapter 232 which is a charge upon the state
30under section 232.141, subsection 4.
31f. Of the funds allocated in this subsection, not more than
32$83,000 may be used by the judicial branch for administration
33of the requirements under this subsection.
34g. Of the funds allocated in this subsection, $17,000
35shall be used by the department of human services to support
-87-1the interstate commission for juveniles in accordance with
2the interstate compact for juveniles as provided in section
3232.173.
49. Of the funds appropriated in this section, $12,253,000 is
5allocated for juvenile delinquent graduated sanctions services.
6Any state funds saved as a result of efforts by juvenile court
7services to earn a federal Tit.IV-E match for juvenile court
8services administration may be used for the juvenile delinquent
9graduated sanctions services.
1010. Of the funds appropriated in this section, $1,658,000 is
11transferred to the department of public health to be used for
12the child protection center grant program for child protection
13centers located in Iowa in accordance with section 135.118.
14The grant amounts under the program shall be equalized so that
15each center receives a uniform base amount of $245,000, and so
16that the remaining funds are awarded through a funding formula
17based upon the volume of children served. To increase access
18to child protection center services for children in rural
19areas, the funding formula for the awarding of the remaining
20funds shall provide for the awarding of an enhanced amount to
21eligible grantees to develop and maintain satellite centers in
22underserved regions of the state.
2311. Of the funds appropriated in this section, $4,025,000 is
24allocated for the preparation for adult living program pursuant
25to section 234.46.
2612. Of the funds appropriated in this section, $227,000
27shall be used for the public purpose of continuing a grant to a
28nonprofit human services organization, providing services to
29individuals and families in multiple locations in southwest
30Iowa and Nebraska for support of a project providing immediate,
31sensitive support and forensic interviews, medical exams, needs
32assessments, and referrals for victims of child abuse and their
33nonoffending family members.
3413. Of the funds appropriated in this section, $300,000
35is allocated for the foster care youth council approach of
-88-1providing a support network to children placed in foster care.
214. Of the funds appropriated in this section, $202,000 is
3allocated for use pursuant to section 235A.1 for continuation
4of the initiative to address child sexual abuse implemented
5pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
621.
715. Of the funds appropriated in this section, $630,000 is
8allocated for the community partnership for child protection
9sites.
1016. Of the funds appropriated in this section, $371,000
11is allocated for the department’s minority youth and family
12projects under the redesign of the child welfare system.
1317. Of the funds appropriated in this section, $851,000
14is allocated for funding of the community circle of care
15collaboration for children and youth in northeast Iowa.
1618. Of the funds appropriated in this section, at least
17$147,000 shall be used for the continuation of the child
18welfare provider training academy, a collaboration between the
19coalition for family and children’s services in Iowa and the
20department.
2119. Of the funds appropriated in this section, $211,000
22shall be used for continuation of the central Iowa system of
23care program grant through June 30, 2023.
2420. Of the funds appropriated in this section, $235,000
25shall be used for the public purpose of the continuation
26and expansion of a system of care program grant implemented
27in Cerro Gordo and Linn counties to utilize a comprehensive
28and long-term approach for helping children and families by
29addressing the key areas in a child’s life of childhood basic
30needs, education and work, family, and community.
3121. Of the funds appropriated in this section, $110,000
32shall be used for the public purpose of funding community-based
33services and other supports with a system of care approach
34for children with a serious emotional disturbance and their
35families through a nonprofit provider of child welfare services
-89-1that has been in existence for more than 115 years, is located
2in a county with a population of more than 200,000 but less
3than 235,000 according to the latest certified federal census,
4is licensed as a psychiatric medical institution for children,
5and was a system of care grantee prior to July 1, 2022.
622. If a separate funding source is identified that reduces
7the need for state funds within an allocation under this
8section, the allocated state funds may be redistributed to
9other allocations under this section for the same fiscal year.
1023. Of the funds appropriated in this section, a portion may
11be used for family-centered services for purposes of complying
12with the federal Family First Prevention Services Act of 2018,
13Pub.L. No.115-123, and successor legislation.
14 Sec. 60. ADOPTION SUBSIDY.
151. There is appropriated from the general fund of the
16state to the department of human services for the fiscal year
17beginning July 1, 2022, and ending June 30, 2023, the following
18amount, or so much thereof as is necessary, to be used for the
19purpose designated:
20a. For adoption subsidy payments and related costs and for
21other services provided under paragraph “b”, subparagraph (2):
.................................................. $2240,596,007
23b. (1) Of the funds appropriated in this section, a
24sufficient amount is allocated for adoption subsidy payments
25and related costs.
26(2) Any funds appropriated in this section remaining after
27the allocation under subparagraph (1) are designated and
28allocated as state savings resulting from implementation of
29the federal Fostering Connections to Success and Increasing
30Adoptions Act of 2008, Pub.L. No.110-351, and successor
31legislation, as determined in accordance with 42 U.S.C.
32§673(a)(8), and shall be used for post-adoption services and
33for other purposes allowed under these federal laws, Tit.IV-B
34or Tit.IV-E of the federal Social Security Act.
35(a) The department of human services may transfer funds
-90-1allocated in this subparagraph (2) to the appropriation for
2child and family services in this division of this Act for the
3purposes designated in this subparagraph (2).
4(b) Notwithstanding section 8.33, moneys allocated
5under this subparagraph (2) shall not revert to any fund but
6shall remain available for the purposes designated in this
7subparagraph (2) until expended.
82. The department may transfer funds appropriated in
9this section to the appropriation made in this division of
10this Act for general administration for costs paid from the
11appropriation relating to adoption subsidy.
123. Federal funds received by the state during the
13fiscal year beginning July 1, 2022, as the result of the
14expenditure of state funds during a previous state fiscal
15year for a service or activity funded under this section are
16appropriated to the department to be used as additional funding
17for the services and activities funded under this section.
18Notwithstanding section 8.33, moneys received in accordance
19with this subsection that remain unencumbered or unobligated
20at the close of the fiscal year shall not revert to any fund
21but shall remain available for expenditure for the purposes
22designated until the close of the succeeding fiscal year.
23 Sec. 61. JUVENILE DETENTION HOME FUND. Moneys deposited
24in the juvenile detention home fund created in section 232.142
25during the fiscal year beginning July 1, 2022, and ending June
2630, 2023, are appropriated to the department of human services
27for the fiscal year beginning July 1, 2022, and ending June 30,
282023, for distribution of an amount equal to a percentage of
29the costs of the establishment, improvement, operation, and
30maintenance of county or multicounty juvenile detention homes
31in the fiscal year beginning July 1, 2021. Moneys appropriated
32for distribution in accordance with this section shall be
33allocated among eligible detention homes, prorated on the basis
34of an eligible detention home’s proportion of the costs of all
35eligible detention homes in the fiscal year beginning July
-91-11, 2021. The percentage figure shall be determined by the
2department based on the amount available for distribution for
3the fund. Notwithstanding section 232.142, subsection 3, the
4financial aid payable by the state under that provision for the
5fiscal year beginning July 1, 2022, shall be limited to the
6amount appropriated for the purposes of this section.
7 Sec. 62. FAMILY SUPPORT SUBSIDY PROGRAM.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2022, and ending June 30, 2023, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13For the family support subsidy program subject to the
14enrollment restrictions in section 225C.37, subsection 3:
.................................................. $15949,282
162. At least $922,735 of the moneys appropriated in this
17section is transferred to the department of public health for
18the family support center component of the comprehensive family
19support program under chapter 225C, subchapter V.
203. If at any time during the fiscal year, the amount of
21funding available for the family support subsidy program
22is reduced from the amount initially used to establish the
23figure for the number of family members for whom a subsidy
24is to be provided at any one time during the fiscal year,
25notwithstanding section 225C.38, subsection 2, the department
26shall revise the figure as necessary to conform to the amount
27of funding available.
28 Sec. 63. CONNER DECREE. There is appropriated from the
29general fund of the state to the department of human services
30for the fiscal year beginning July 1, 2022, and ending June 30,
312023, the following amount, or so much thereof as is necessary,
32to be used for the purpose designated:
33For building community capacity through the coordination
34and provision of training opportunities in accordance with the
35consent decree of Conner v.Branstad, No.4-86-CV-30871 (S.D.
-92-1Iowa, July 14, 1994):
.................................................. $233,632
3 Sec. 64. MENTAL HEALTH INSTITUTES.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2022, and ending June 30, 2023, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
9a. For operation of the state mental health institute at
10Cherokee as required by chapters 218 and 226 for salaries,
11support, maintenance, and miscellaneous purposes:
.................................................. $1216,058,356
13b. For operation of the state mental health institute at
14Independence as required by chapters 218 and 226 for salaries,
15support, maintenance, and miscellaneous purposes:
.................................................. $1620,628,077
172. a. Notwithstanding sections 218.78 and 249A.11, any
18revenue received from the state mental health institute at
19Cherokee or the state mental health institute at Independence
20pursuant to 42 C.F.R§438.6(e) may be retained and expended by
21the mental health institute.
22b. Notwithstanding sections 218.78 and 249A.11, any
23COVID-19 related funding received through federal funding
24sources by the state mental health institute at Cherokee or the
25state mental health institute at Independence may be retained
26and expended by the mental health institute.
273. Notwithstanding any provision of law to the contrary,
28a Medicaid member residing at the state mental health
29institute at Cherokee or the state mental health institute
30at Independence shall retain Medicaid eligibility during
31the period of the Medicaid member’s stay for which federal
32financial participation is available.
334. Notwithstanding section 8.33, moneys appropriated in
34this section that remain unencumbered or unobligated at the
35close of the fiscal year shall not revert but shall remain
-93-1available for expenditure for the purposes designated until the
2close of the succeeding fiscal year.
3 Sec. 65. STATE RESOURCE CENTERS.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2022, and ending June 30, 2023, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
9a. For the state resource center at Glenwood for salaries,
10support, maintenance, and miscellaneous purposes:
.................................................. $1114,802,873
12b. For the state resource center at Woodward for salaries,
13support, maintenance, and miscellaneous purposes:
.................................................. $1413,698,094
152. The department may continue to bill for state resource
16center services utilizing a scope of services approach used for
17private providers of intermediate care facilities for persons
18with an intellectual disability services, in a manner which
19does not shift costs between the medical assistance program,
20counties, or other sources of funding for the state resource
21centers.
223. The state resource centers may expand the time-limited
23assessment and respite services during the fiscal year.
244. If the department’s administration and the department
25of management concur with a finding by a state resource
26center’s superintendent that projected revenues can reasonably
27be expected to pay the salary and support costs for a new
28employee position, or that such costs for adding a particular
29number of new positions for the fiscal year would be less
30than the overtime costs if new positions would not be added,
31the superintendent may add the new position or positions. If
32the vacant positions available to a resource center do not
33include the position classification desired to be filled, the
34state resource center’s superintendent may reclassify any
35vacant position as necessary to fill the desired position. The
-94-1superintendents of the state resource centers may, by mutual
2agreement, pool vacant positions and position classifications
3during the course of the fiscal year in order to assist one
4another in filling necessary positions.
55. If existing capacity limitations are reached in
6operating units, a waiting list is in effect for a service or
7a special need for which a payment source or other funding
8is available for the service or to address the special need,
9and facilities for the service or to address the special need
10can be provided within the available payment source or other
11funding, the superintendent of a state resource center may
12authorize opening not more than two units or other facilities
13and begin implementing the service or addressing the special
14need during fiscal year 2022-2023.
156. Notwithstanding section 8.33, and notwithstanding
16the amount limitation specified in section 222.92, moneys
17appropriated in this section that remain unencumbered or
18unobligated at the close of the fiscal year shall not revert
19but shall remain available for expenditure for the purposes
20designated until the close of the succeeding fiscal year.
21 Sec. 66. SEXUALLY VIOLENT PREDATORS.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2022, and ending June 30, 2023, the following
25amount, or so much thereof as is necessary, to be used for the
26purpose designated:
27For costs associated with the commitment and treatment of
28sexually violent predators in the unit located at the state
29mental health institute at Cherokee, including costs of legal
30services and other associated costs, including salaries,
31support, maintenance, and miscellaneous purposes:
.................................................. $3213,643,727
332. Unless specifically prohibited by law, if the amount
34charged provides for recoupment of at least the entire amount
35of direct and indirect costs, the department of human services
-95-1may contract with other states to provide care and treatment
2of persons placed by the other states at the unit for sexually
3violent predators at Cherokee. The moneys received under
4such a contract shall be considered to be repayment receipts
5and used for the purposes of the appropriation made in this
6section.
73. Notwithstanding section 8.33, moneys appropriated in
8this section that remain unencumbered or unobligated at the
9close of the fiscal year shall not revert but shall remain
10available for expenditure for the purposes designated until the
11close of the succeeding fiscal year.
12 Sec. 67. FIELD OPERATIONS.
131. There is appropriated from the general fund of the
14state to the department of human services for the fiscal year
15beginning July 1, 2022, and ending June 30, 2023, the following
16amount, or so much thereof as is necessary, to be used for the
17purposes designated:
18For field operations, including salaries, support,
19maintenance, and miscellaneous purposes:
.................................................. $2061,362,351
212. Priority in filling full-time equivalent positions
22shall be given to those positions related to child protection
23services and eligibility determination for low-income families.
24 Sec. 68. GENERAL ADMINISTRATION. There is appropriated
25from the general fund of the state to the department of human
26services for the fiscal year beginning July 1, 2022, and ending
27June 30, 2023, the following amount, or so much thereof as is
28necessary, to be used for the purpose designated:
29For general administration, including salaries, support,
30maintenance, and miscellaneous purposes:
.................................................. $3114,542,189
321. The department shall report at least monthly to the
33general assembly concerning the department’s operational and
34program expenditures.
352. Of the funds appropriated in this section, $150,000 shall
-96-1be used to contract for the provision of a program to provide
2technical assistance, support, and consultation to providers
3of habilitation services and home and community-based services
4waiver services for adults with disabilities under the medical
5assistance program.
63. Of the funds appropriated in this section, $50,000
7is transferred to the Iowa finance authority to be used
8for administrative support of the council on homelessness
9established in section 16.2D and for the council to fulfill its
10duties in addressing and reducing homelessness in the state.
114. Of the funds appropriated in this section, $200,000 shall
12be transferred to and deposited in the administrative fund of
13the Iowa ABLE savings plan trust created in section 12I.4, to
14be used for implementation and administration activities of the
15Iowa ABLE savings plan trust.
165. Of the funds appropriated in this section, $200,000 is
17transferred to the economic development authority for the Iowa
18commission on volunteer services to continue to be used for the
19RefugeeRISE AmeriCorps program established under section 15H.8
20for member recruitment and training to improve the economic
21well-being and health of economically disadvantaged refugees in
22local communities across Iowa. Funds transferred may be used
23to supplement federal funds under federal regulations.
246. Of the funds appropriated in this section, up to $300,000
25shall be used as follows:
26a. To address the department’s responsibility to support
27the work of the children’s behavioral health system state board
28and implementation of the services required pursuant to section
29331.397.
30b. To support the cost of establishing and implementing new
31or additional services required pursuant to sections 331.397
32and 331.397A.
33c. Of the amount allocated, $32,000 shall be transferred
34to the department of public health to support the costs of
35establishing and implementing new or additional services
-97-1required pursuant to sections 331.397 and 331.397A.
2 Sec. 69. DEPARTMENT-WIDE DUTIES. There is appropriated
3from the general fund of the state to the department of human
4services for the fiscal year beginning July 1, 2022, and ending
5June 30, 2023, the following amount, or so much thereof as is
6necessary, to be used for the purposes designated:
7For salaries, support, maintenance, and miscellaneous
8purposes at facilities under the purview of the department of
9human services:
.................................................. $102,879,274
11 Sec. 70. VOLUNTEERS. There is appropriated from the general
12fund of the state to the department of human services for the
13fiscal year beginning July 1, 2022, and ending June 30, 2023,
14the following amount, or so much thereof as is necessary, to be
15used for the purpose designated:
16For development and coordination of volunteer services:
.................................................. $1784,686
18 Sec. 71. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
19ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
20DEPARTMENT OF HUMAN SERVICES.
211. a. (1) (a) For the fiscal year beginning July 1,
222022, the department shall rebase case-mix nursing facility
23rates effective July 1, 2022, to the extent possible within the
24state funding, including the $20,000,000 appropriated for this
25purpose.
26(b) For the fiscal year beginning July 1, 2022, non-case-mix
27and special population nursing facilities shall be reimbursed
28in accordance with the methodology in effect on June 30 of the
29prior fiscal year.
30(c) For managed care claims, the department of human
31services shall adjust the payment rate floor for nursing
32facilities, annually, to maintain a rate floor that is no
33lower than the Medicaid fee-for-service case-mix adjusted rate
34calculated in accordance with subparagraph division (a) and
35441 IAC 81.6. The department shall then calculate adjusted
-98-1reimbursement rates, including but not limited to add-on
2payments, annually, and shall notify Medicaid managed care
3organizations of the adjusted reimbursement rates within 30
4days of determining the adjusted reimbursement rates. Any
5adjustment of reimbursement rates under this subparagraph
6division shall be budget neutral to the state budget.
7(d) For the fiscal year beginning July 1, 2022, Medicaid
8managed care long-term services and supports capitation
9rates shall be adjusted to reflect the rebasing pursuant to
10subparagraph division (a) for the patient populations residing
11in Medicaid-certified nursing facilities.
12(2) Medicaid managed care organizations shall adjust
13facility-specific rates based upon payment rate listings issued
14by the department. The rate adjustments shall be applied
15prospectively from the effective date of the rate letter issued
16by the department.
17b. (1) For the fiscal year beginning July 1, 2022,
18the department shall establish the pharmacy dispensing fee
19reimbursement at $10.07 per prescription, until a cost of
20dispensing survey is completed. The actual dispensing fee
21shall be determined by a cost of dispensing survey performed
22by the department and required to be completed by all medical
23assistance program participating pharmacies every two years,
24adjusted as necessary to maintain expenditures within the
25amount appropriated to the department for this purpose for
26the fiscal year. A change in the dispensing fee shall become
27effective following federal approval of the Medicaid state
28plan.
29(2) The department shall utilize an average acquisition
30cost reimbursement methodology for all drugs covered under the
31medical assistance program in accordance with 2012 Iowa Acts,
32chapter 1133, section 33.
33c. (1) For the fiscal year beginning July 1, 2022,
34reimbursement rates for outpatient hospital services shall
35remain at the rates in effect on June 30, 2022, subject to
-99-1Medicaid program upper payment limit rules, and adjusted
2as necessary to maintain expenditures within the amount
3appropriated to the department for this purpose for the fiscal
4year.
5(2) For the fiscal year beginning July 1, 2022,
6reimbursement rates for inpatient hospital services shall
7remain at the rates in effect on June 30, 2022, subject to
8Medicaid program upper payment limit rules, and adjusted
9as necessary to maintain expenditures within the amount
10appropriated to the department for this purpose for the fiscal
11year.
12(3) For the fiscal year beginning July 1, 2022, under
13both fee-for-service and managed care administration of
14the Medicaid program, critical access hospitals shall be
15reimbursed for inpatient and outpatient services based on the
16hospital-specific critical access hospital cost adjustment
17factor methodology utilizing the most recent and complete cost
18reporting period as applied prospectively within the funds
19appropriated for such purpose for the fiscal year.
20(4) For the fiscal year beginning July 1, 2022, the graduate
21medical education and disproportionate share hospital fund
22shall remain at the amount in effect on June 30, 2022, except
23that the portion of the fund attributable to graduate medical
24education shall be reduced in an amount that reflects the
25elimination of graduate medical education payments made to
26out-of-state hospitals.
27(5) In order to ensure the efficient use of limited state
28funds in procuring health care services for low-income Iowans,
29funds appropriated in this Act for hospital services shall
30not be used for activities which would be excluded from a
31determination of reasonable costs under the federal Medicare
32program pursuant to 42 U.S.C.§1395x(v)(1)(N).
33d. For the fiscal year beginning July 1, 2022, reimbursement
34rates for hospices and acute psychiatric hospitals shall be
35increased in accordance with increases under the federal
-100-1Medicare program or as supported by their Medicare audited
2costs.
3e. For the fiscal year beginning July 1, 2022, independent
4laboratories and rehabilitation agencies shall be reimbursed
5using the same methodology in effect on June 30, 2022.
6f. (1) For the fiscal year beginning July 1, 2022,
7reimbursement rates for home health agencies shall continue to
8be based on the Medicare low utilization payment adjustment
9(LUPA) methodology with state geographic wage adjustments.
10The department shall continue to update the rates every two
11years to reflect the most recent Medicare LUPA rates to the
12extent possible within the state funding appropriated for this
13purpose.
14(2) For the fiscal year beginning July 1, 2022, rates for
15private duty nursing and personal care services under the early
16and periodic screening, diagnostic, and treatment program
17benefit shall be calculated based on the methodology in effect
18on June 30, 2022.
19g. For the fiscal year beginning July 1, 2022, federally
20qualified health centers and rural health clinics shall receive
21cost-based reimbursement for 100 percent of the reasonable
22costs for the provision of services to recipients of medical
23assistance.
24h. For the fiscal year beginning July 1, 2022, the
25reimbursement rates for dental services shall remain at the
26rates in effect on June 30, 2022.
27i. (1) For the fiscal year beginning July 1, 2022,
28reimbursement rates for non-state-owned psychiatric medical
29institutions for children shall be based on the reimbursement
30methodology in effect on June 30, 2022.
31(2) As a condition of participation in the medical
32assistance program, enrolled providers shall accept the medical
33assistance reimbursement rate for any covered goods or services
34provided to recipients of medical assistance who are children
35under the custody of a psychiatric medical institution for
-101-1children.
2j. For the fiscal year beginning July 1, 2022, unless
3otherwise specified in this Act, all noninstitutional medical
4assistance provider reimbursement rates shall remain at the
5rates in effect on June 30, 2022, except for area education
6agencies, local education agencies, infant and toddler
7services providers, home and community-based services providers
8including consumer-directed attendant care providers under a
9section 1915(c) or 1915(i) waiver, targeted case management
10providers, and those providers whose rates are required to be
11determined pursuant to section 249A.20, or to meet federal
12mental health parity requirements.
13k. Notwithstanding any provision to the contrary, for the
14fiscal year beginning July 1, 2022, the reimbursement rate for
15anesthesiologists shall remain at the rates in effect on June
1630, 2022, and updated on January 1, 2023, to align with the
17most current Iowa Medicare anesthesia rate.
18l. Notwithstanding section 249A.20, for the fiscal year
19beginning July 1, 2022, the average reimbursement rate for
20health care providers eligible for use of the federal Medicare
21resource-based relative value scale reimbursement methodology
22under section 249A.20 shall remain at the rate in effect on
23June 30, 2022; however, this rate shall not exceed the maximum
24level authorized by the federal government.
25m. For the fiscal year beginning July 1, 2022, the
26reimbursement rate for residential care facilities shall not
27be less than the minimum payment level as established by the
28federal government to meet the federally mandated maintenance
29of effort requirement. The flat reimbursement rate for
30facilities electing not to file annual cost reports shall not
31be less than the minimum payment level as established by the
32federal government to meet the federally mandated maintenance
33of effort requirement.
34n. For the fiscal year beginning July 1, 2022, the
35reimbursement rates for inpatient mental health services
-102-1provided at hospitals shall remain at the rates in effect on
2June 30, 2022, subject to Medicaid program upper payment limit
3rules; and psychiatrists shall be reimbursed at the medical
4assistance program fee-for-service rate in effect on June 30,
52022.
6o. For the fiscal year beginning July 1, 2022, community
7mental health centers may choose to be reimbursed for the
8services provided to recipients of medical assistance through
9either of the following options:
10(1) For 100 percent of the reasonable costs of the services.
11(2) In accordance with the alternative reimbursement rate
12methodology approved by the department of human services in
13effect on June 30, 2022.
14p. For the fiscal year beginning July 1, 2022, the
15reimbursement rate for providers of family planning services
16that are eligible to receive a 90 percent federal match shall
17remain at the rates in effect on June 30, 2022.
18q. For the fiscal year beginning July 1, 2022, the upper
19limits and reimbursement rates for providers of home and
20community-based services waiver services and habilitation
21services shall be reimbursed using the reimbursement
22methodology in effect on June 30, 2022.
23r. For the fiscal year beginning July 1, 2022, the
24reimbursement rates for emergency medical service providers
25shall remain at the rates in effect on June 30, 2022, or as
26approved by the centers for Medicare and Medicaid services of
27the United States department of health and human services.
28s. For the fiscal year beginning July 1, 2022, reimbursement
29rates for substance-related disorder treatment programs
30licensed under section 125.13 shall remain at the rates in
31effect on June 30, 2022.
32t. For the fiscal year beginning July 1, 2022, assertive
33community treatment per diem rates shall remain at the rates in
34effect on June 30, 2022.
35u. For the fiscal year beginning July 1, 2022, the
-103-1reimbursement rate for family-centered services providers shall
2be established by contract.
32. For the fiscal year beginning July 1, 2022, the
4reimbursement rate for providers reimbursed under the
5in-home-related care program shall not be less than the minimum
6payment level as established by the federal government to meet
7the federally mandated maintenance of effort requirement.
83. Unless otherwise directed in this section, when the
9department’s reimbursement methodology for any provider
10reimbursed in accordance with this section includes an
11inflation factor, this factor shall not exceed the amount
12by which the consumer price index for all urban consumers
13increased during the calendar year ending December 31, 2002.
144. Notwithstanding section 234.38, for the fiscal
15year beginning July 1, 2022, the foster family basic daily
16maintenance rate and the maximum adoption subsidy rate for
17children ages 0 through 5 years shall be $16.78, the rate for
18children ages 6 through 11 years shall be $17.45, the rate for
19children ages 12 through 15 years shall be $19.10, and the
20rate for children and young adults ages 16 and older shall
21be $19.35. For youth ages 18 to 23 who have exited foster
22care, the preparation for adult living program maintenance
23rate shall be up to $602.70 per month as calculated based on
24the age of the participant. The maximum payment for adoption
25subsidy nonrecurring expenses shall be limited to $500 and the
26disallowance of additional amounts for court costs and other
27related legal expenses implemented pursuant to 2010 Iowa Acts,
28chapter 1031, section 408, shall be continued.
295. For the fiscal year beginning July 1, 2022, the maximum
30reimbursement rates for social services providers under
31contract shall remain at the rates in effect on June 30, 2022,
32or the provider’s actual and allowable cost plus inflation for
33each service, whichever is less. However, if a new service
34or service provider is added after June 30, 2022, the initial
35reimbursement rate for the service or provider shall be based
-104-1upon a weighted average of provider rates for similar services.
26. a. For the fiscal year beginning July 1, 2022, the
3reimbursement rates for resource family recruitment and
4retention contractors shall be established by contract.
5b. For the fiscal year beginning July 1, 2022, the
6reimbursement rates for supervised apartment living foster care
7providers shall be established by contract.
87. For the fiscal year beginning July 1, 2022, the
9reimbursement rate for group foster care providers shall be the
10combined service and maintenance reimbursement rate established
11by contract.
128. The group foster care reimbursement rates paid for
13placement of children out of state shall be calculated
14according to the same rate-setting principles as those used for
15in-state providers, unless the director of human services or
16the director’s designee determines that appropriate care cannot
17be provided within the state. The payment of the daily rate
18shall be based on the number of days in the calendar month in
19which service is provided.
209. a. For the fiscal year beginning July 1, 2022, the
21reimbursement rate paid for shelter care and the child welfare
22emergency services implemented to provide or prevent the need
23for shelter care shall be established by contract.
24b. For the fiscal year beginning July 1, 2022, the combined
25service and maintenance components of the reimbursement rate
26paid for shelter care services shall be based on the financial
27and statistical report submitted to the department. The
28maximum reimbursement rate shall be $101.83 per day. The
29department shall reimburse a shelter care provider at the
30provider’s actual and allowable unit cost, plus inflation, not
31to exceed the maximum reimbursement rate.
32c. Notwithstanding section 232.141, subsection 8, for the
33fiscal year beginning July 1, 2022, the amount of the statewide
34average of the actual and allowable rates for reimbursement of
35juvenile shelter care homes that is utilized for the limitation
-105-1on recovery of unpaid costs shall remain at the amount in
2effect for this purpose in the fiscal year beginning July 1,
32021.
410. For the fiscal year beginning July 1, 2022, the
5department shall calculate reimbursement rates for intermediate
6care facilities for persons with an intellectual disability
7at the 80th percentile. Beginning July 1, 2022, the rate
8calculation methodology shall utilize the consumer price index
9inflation factor applicable to the fiscal year beginning July
101, 2022.
1111. Effective July 1, 2022, the child care provider
12reimbursement rates shall remain at the rates in effect on June
1330, 2022. The department shall set rates in a manner so as
14to provide incentives for a nonregistered provider to become
15registered by applying any increase only to registered and
16licensed providers.
1712. The department may adopt emergency rules to implement
18this section.
19 Sec. 72. EMERGENCY RULES.
201. If specifically authorized by a provision of this
21division of this Act, the department of human services or
22the mental health and disabilities services commission may
23adopt administrative rules under section 17A.4, subsection 3,
24and section 17A.5, subsection 2, paragraph “b”, to implement
25provisions of this division of this Act and the rules shall
26become effective immediately upon filing or on a later
27effective date specified in the rules, unless the effective
28date of the rules is delayed or the applicability of the rules
29is suspended by the administrative rules review committee. Any
30rules adopted in accordance with this section shall not take
31effect before the rules are reviewed by the administrative
32rules review committee. The delay authority provided to
33the administrative rules review committee under section
3417A.8, subsections 9 and 10, shall be applicable to a delay
35imposed under this section, notwithstanding a provision in
-106-1those subsections making them inapplicable to section 17A.5,
2subsection 2, paragraph “b”. Any rules adopted in accordance
3with the provisions of this section shall also be published as
4a notice of intended action as provided in section 17A.4.
52. If during a fiscal year, the department of human
6services is adopting rules in accordance with this section
7or as otherwise directed or authorized by state law, and the
8rules will result in an expenditure increase beyond the amount
9anticipated in the budget process or if the expenditure was
10not addressed in the budget process for the fiscal year, the
11department shall notify the legislative services agency 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. 73. REPORTS. Any reports or other information required
18to be compiled and submitted under this Act during the fiscal
19year beginning July 1, 2022, shall be submitted to the general
20assembly on or before the dates specified for submission of the
21reports or information.
22 Sec. 74. EFFECTIVE UPON ENACTMENT. The following
23provisions of this division of this Act, being deemed of
24immediate importance, take effect upon enactment:
25The provision relating to section 232.141 and directing the
26state court administrator and the division administrator of
27the department of human services division of child and family
28services to make the determination, by June 15, 2022, of the
29distribution of funds allocated for the payment of the expenses
30of court-ordered services provided to juveniles which are a
31charge upon the state.
32DIVISION XII
33HEALTH CARE ACCOUNTS AND FUNDS — FY 2022-2023
34 Sec. 75. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
35appropriated from the pharmaceutical settlement account created
-107-1in section 249A.33 to the department of human services for the
2fiscal year beginning July 1, 2022, and ending June 30, 2023,
3the following amount, or so much thereof as is necessary, to be
4used for the purpose designated:
5Notwithstanding any provision of law to the contrary, to
6supplement the appropriations made in this Act for health
7program operations under the medical assistance program for the
8fiscal year beginning July 1, 2022, and ending June 30, 2023:
.................................................. $9234,193
10 Sec. 76. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
11SERVICES. Notwithstanding any provision to the contrary and
12subject to the availability of funds, there is appropriated
13from the quality assurance trust fund created in section
14249L.4 to the department of human services for the fiscal year
15beginning July 1, 2022, and ending June 30, 2023, the following
16amounts, or so much thereof as is necessary, for the purposes
17designated:
18To supplement the appropriation made in this Act from the
19general fund of the state to the department of human services
20for medical assistance for the same fiscal year:
.................................................. $2156,305,139
22 Sec. 77. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
23DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
24the contrary and subject to the availability of funds, there is
25appropriated from the hospital health care access trust fund
26created in section 249M.4 to the department of human services
27for the fiscal year beginning July 1, 2022, and ending June
2830, 2023, the following amounts, or so much thereof as is
29necessary, for the purposes designated:
30To supplement the appropriation made in this Act from the
31general fund of the state to the department of human services
32for medical assistance for the same fiscal year:
.................................................. $3333,920,554
34 Sec. 78. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
35FOR FY 2022-2023. Notwithstanding section 8.33, if moneys
-108-1appropriated for purposes of the medical assistance program for
2the fiscal year beginning July 1, 2022, and ending June 30,
32023, from the general fund of the state, the quality assurance
4trust fund, and the hospital health care access trust fund, are
5in excess of actual expenditures for the medical assistance
6program and remain unencumbered or unobligated at the close
7of the fiscal year, the excess moneys shall not revert but
8shall remain available for expenditure for the purposes of the
9medical assistance program until the close of the succeeding
10fiscal year.
11DIVISION XIII
12DECATEGORIZATION CARRYOVER FUNDING
13 Sec. 79. DECATEGORIZATION CARRYOVER FUNDING FY 2019 —
14TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
15subsection 5, paragraph “b”, any state-appropriated moneys in
16the funding pool that remained unencumbered or unobligated
17at the close of the fiscal year beginning July 1, 2018, and
18were deemed carryover funding to remain available for the two
19succeeding fiscal years that still remain unencumbered or
20unobligated at the close of the fiscal year beginning July 1,
212020, shall not revert but shall be transferred to the medical
22assistance program for the fiscal year beginning July 1, 2021.
23 Sec. 80. EFFECTIVE DATE. This division of this Act, being
24deemed of immediate importance, takes effect upon enactment.
25 Sec. 81. RETROACTIVE APPLICABILITY. This division of this
26Act applies retroactively to July 1, 2020.
27DIVISION XIV
28PRIOR APPROPRIATIONS AND OTHER PROVISIONS
29FAMILY INVESTMENT PROGRAM ACCOUNT
30 Sec. 82. 2019 Iowa Acts, chapter 85, section 9, as amended
31by 2020 Iowa Acts, chapter 1121, section 20, is amended by
32adding the following new subsection:
33 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
34appropriated in this section that remain unencumbered or
35unobligated at the close of the fiscal year shall not revert
-109-1but shall remain available for expenditure for the purposes
2designated, and may be transferred to other appropriations made
3in this division of this Act as necessary to carry out the
4initiatives included in the report submitted on nonreversion
5of funds required pursuant to 2020 Iowa Acts, chapter 1121,
6section 43, until the close of the succeeding fiscal year.
7Child and family services
8 Sec. 83. 2019 Iowa Acts, chapter 85, section 19, as amended
9by 2020 Iowa Acts, chapter 1121, section 23, is amended by
10adding the following new subsection:
11 NEW SUBSECTION. 25. Notwithstanding section 8.33, moneys
12appropriated in this section that remain unencumbered or
13unobligated at the close of the fiscal year shall not revert
14but shall remain available for expenditure for the purpose of
15the redesign of the child welfare system, until the close of
16the succeeding fiscal year.
17 Sec. 84. EFFECTIVE DATE. This division of this Act, being
18deemed of immediate importance, takes effect upon enactment.
19DIVISION XV
20EXTENSION OF FUTURE REPEAL — HOSPITAL HEALTH CARE ACCESS
21ASSESSMENT PROGRAM
22 Sec. 85. Section 249M.5, Code 2021, is amended to read as
23follows:
24249M.5 Future repeal.
25This chapter is repealed July 1, 2021 2023.
26 Sec. 86. EFFECTIVE DATE. This division of this Act, being
27deemed of immediate importance, takes effect upon enactment.
28DIVISION XVI
29PUBLIC ASSISTANCE PROGRAM OVERSIGHT
30 Sec. 87. NEW SECTION. 239.1 Definitions.
31As used in this chapter, unless the context otherwise
32requires:
331. “Applicant” means an individual who is applying for
34public assistance benefits in the state.
352. “Asset” or “asset test” means all assets of the members
-110-1of the applicant’s household, including all of the following:
2a. All bank accounts, excluding retirement accounts of
3members of the household.
4b. All cash, excluding the first two thousand dollars of
5members of the household.
6c. All lottery and gambling income of the household whether
7received as a lump sum or installment payments.
8d. All real estate, excluding the primary household
9residence and surrounding lot.
10e. All other personal property excluding personal
11belongings, household goods, and one vehicle.
123. “Department” means the department of human services.
134. “Public assistance” means SNAP (the supplemental
14nutrition assistance program), the Medicaid program, FIP (the
15family investment program), and CHIP (the children’s health
16insurance program).
175. “Real-time system” means real-time electronic access
18to a system that allows verification of all applicable public
19assistance program eligibility information based on the
20most recent information available to the department through
21nonmodeled earned and unearned income, such as commercially
22available wage data.
236. “Recipient” means an individual who is receiving public
24assistance benefits in the state.
25 Sec. 88. NEW SECTION. 239.2 Asset test for supplemental
26nutrition assistance program.
271. For the purposes of determining eligibility for receipt
28of SNAP benefits, the department shall conduct an asset test
29on all members of the applicant’s household. The allowable
30financial resources to be included in or excluded from a
31determination of eligibility for SNAP shall be those specified
32in 7 U.S.C.§2014(g)(1).
332. Prior to determining eligibility for SNAP benefits,
34the department shall access, at a minimum, for every member
35of the applicant’s household, the following information from
-111-1the following federal, state, and miscellaneous sources, or
2successor sources:
3a. Federal sources and information:
4(1) Earned and unearned income information maintained by
5the internal revenue service.
6(2) The following sources and information maintained by the
7United States social security administration:
8(a) Earned income information.
9(b) Death register information.
10(c) Prisoner or incarceration status information.
11(d) Supplemental security income information maintained in
12the state data exchange database.
13(e) Beneficiary records and earnings information maintained
14in the beneficiary and earnings data exchange database.
15(f) Earnings and pension information maintained in the
16beneficiary earnings exchange record system database.
17(3) The following sources and information maintained by the
18United States department of health and human services:
19(a) Income and employment information maintained in the
20national directory of new hires database by the office of child
21support enforcement of the administration for children and
22families.
23(b) Other federal data sources maintained by the office of
24child support enforcement of the administration for children
25and families.
26b. State sources and information:
27(1) The department’s sources and information including but
28not limited to all of the following:
29(a) Income and employment information maintained by the
30child support recovery unit.
31(b) Child care assistance information maintained by the
32division of child and family services.
33(c) Enrollment status in other public assistance programs.
34(2) The department of workforce development sources and
35information including all of the following:
-112- 1(a) Employment information.
2(b) Employer weekly, monthly, and quarterly reports of
3income and unemployment insurance payments.
4(3) The Iowa public employees’ retirement system for
5earnings and pension information.
6c. Miscellaneous sources:
7(1) Any existing real-time database of persons currently
8receiving benefits in other states, such as the national
9accuracy clearinghouse.
10(2) Any databases maintained by the Iowa lottery
11commission.
12(3) Any existing real-time eligibility system that includes
13employment and income information maintained by a consumer
14reporting agency, as defined by the federal Fair Credit
15Reporting Act, 15 U.S.C. §1681a, for the purpose of obtaining
16real-time employment and income information.
173. Prior to determining eligibility for SNAP benefits, the
18department shall access information for every member of the
19applicant’s household from the following public records:
20a. A nationwide public records data source of physical asset
21ownership. The data source may include but is not limited to
22real property, automobiles, watercraft, aircraft, and luxury
23vehicles, or any other vehicle owned by the applicant.
24b. National and state financial institutions in order
25to locate undisclosed depository accounts or verify account
26balances of disclosed accounts.
274. The department shall enter into a memorandum of
28understanding with any department, division, bureau, section,
29unit, or any other subunit of a department to obtain the
30information specified in this section.
315. The provisions of this section shall not apply if every
32member of the applicant’s household receives supplemental
33security income.
34 Sec. 89. NEW SECTION. 239.3 Verification and authentication
35systems — public assistance programs.
-113- 11. By July 1, 2023, the department shall redesign an
2existing system; establish a new computerized income, asset,
3and identity eligibility verification system; or contract with
4a third-party vendor to provide for identity verification,
5identity authentication, asset verification, and dual
6enrollment prevention in order to deter waste, fraud, and
7abuse in each public assistance program administered by the
8department.
92. The department may contract with a third-party vendor
10to develop or provide a service for a real-time eligibility
11system that allows the department to verify or authenticate
12income, assets, and identity eligibility of applicants and
13recipients to prevent fraud, misrepresentation, and inadequate
14documentation when determining eligibility for public
15assistance programs. The system shall be accessed prior to
16determining eligibility, periodically between eligibility
17redeterminations, and during eligibility redeterminations
18and reviews. The department may also contract with a
19third-party vendor to provide information to facilitate
20reviews of recipient eligibility conducted by the department.
21Specifically, the department may contract with a third-party
22consumer reporting agency, as defined by the federal Fair
23Credit Reporting Act, 15 U.S.C. §1681a, for the purpose of
24obtaining real-time employment and income information.
253. A contract entered into under this section shall provide,
26at a minimum, for all of the following:
27a. The establishment of the annual savings amount from
28utilization of the system or service, and a provision that the
29contract may be terminated contingent upon the savings not
30exceeding the total yearly cost to the state for utilization of
31the system or service.
32b. That the contract shall not preclude the department
33from continuing to conduct additional eligibility verification
34or authentication processes, to receive, review, or verify
35additional information related to the eligibility of an
-114-1individual, or from contracting with a third-party vendor to
2provide additional eligibility authentication or verification
3information.
44. The department shall seek federal approval as necessary
5to implement and administer this section.
6 Sec. 90. NEW SECTION. 239.4 Public assistance programs —
7applicant and recipient eligibility verification.
81. All applications for initial public assistance
9program benefits and all determinations of ongoing recipient
10eligibility shall be processed through a system as specified
11in this section. Complete initial applications shall be
12processed within the minimum period required by federal law.
13Prior to determining initial eligibility of an applicant for,
14or ongoing eligibility of a recipient of, public assistance,
15the department shall access information for every applicant or
16recipient from the following federal, state, and other sources:
17a. Federal sources and information:
18(1) Earned and unearned income information maintained by
19the internal revenue service.
20(2) The following sources and information maintained by the
21United States social security administration:
22(a) Earned income information.
23(b) Death register information.
24(c) Prisoner or incarceration status information.
25(d) Supplemental security income information maintained in
26the state data exchange database.
27(e) Beneficiary records and earnings information maintained
28in the beneficiary and earnings data exchange database.
29(f) Earnings and pension information maintained in the
30beneficiary earnings exchange record system database.
31(3) The following sources and information maintained by the
32United States department of health and human services:
33(a) Income and employment information maintained in the
34national directory of new hires database by the office of child
35support enforcement of the administration for children and
-115-1families.
2(b) Other federal data sources maintained by the office of
3child support enforcement of the administration for children
4and families.
5(4) Information maintained by the United States citizenship
6and immigration services of the United States department of
7homeland security.
8(5) Payment information for public housing and section 8
9housing assistance guidelines maintained by the United States
10department of housing and urban development.
11(6) National fleeing felon information maintained by the
12United States federal bureau of investigation.
13b. State sources and information:
14(1) The department’s sources and information including but
15not limited to all of the following:
16(a) Income and employment information maintained by the
17child support recovery unit.
18(b) Child care assistance information maintained by the
19division of child and family services.
20(c) Enrollment status in other public assistance programs.
21(2) The department of workforce development sources and
22information including all of the following:
23(a) Employment information.
24(b) Employer weekly, monthly, and quarterly reports of
25income and unemployment insurance payments.
26(3) The Iowa public employees’ retirement system for
27earnings and pension information.
28c. Other sources including all of the following:
29(1) Any existing real-time database of persons currently
30receiving benefits in other states, such as the national
31accuracy clearinghouse.
32(2) An available database of persons who currently hold a
33license, permit, or certificate from any state agency, the cost
34of which exceeds five hundred dollars.
35(3) Wage reporting and similar information maintained by
-116-1states contiguous to Iowa.
2(4) A third-party consumer reporting agency, as defined
3by the federal Fair Credit Reporting Act, 15 U.S.C. §1681a,
4for the purpose of obtaining real-time employment and income
5information.
62. Prior to determining the initial eligibility of an
7applicant for, or the ongoing eligibility of a recipient
8of, public assistance benefits, the department shall access
9information for every applicant or recipient from, at a
10minimum, the following public records:
11a. A nationwide public records data source of physical asset
12ownership. The data source may include but is not limited to
13real property, automobiles, watercraft, aircraft, and luxury
14vehicles, or any other vehicle owned by the applicant for or
15recipient of assistance.
16b. A nationwide public records data source of incarcerated
17individuals.
18c. A nationwide best address and driver’s license data
19source to verify that individuals are residents of the state.
20d. A comprehensive public records database from which the
21department may identify potential identity fraud or identity
22theft that is capable of closely associating name, social
23security number, date of birth, phone, and address information.
24e. National and local financial institutions in order
25to locate undisclosed depository accounts or verify account
26balances of disclosed accounts.
27f. Outstanding default or arrest warrant information.
283. The state may contract with a third-party consumer
29reporting agency, as defined by the federal Fair Credit
30Reporting Act, 15 U.S.C. §1681a, for the purpose of obtaining
31real-time employment and income information under this section.
32 Sec. 91. NEW SECTION. 239.5 Identity authentication.
33Unless otherwise prohibited by federal law or regulation,
34prior to the department awarding public assistance benefits, an
35applicant shall complete a computerized identity authentication
-117-1process to confirm the identity of the applicant. Identity
2authentication shall be accomplished through a knowledge-based
3questionnaire consisting of financial and personal questions.
4The questionnaire shall contain questions tailored to assist
5persons without a bank account or those who have poor access
6to financial and banking services or who do not have an
7established credit history. The questionnaire may be submitted
8by the applicant online, in person, or via telephone.
9 Sec. 92. NEW SECTION. 239.6 Case review of applicant and
10recipient information.
111. If the information obtained from a review of an
12applicant’s or recipient’s information under this chapter does
13not result in the department finding a discrepancy or change
14in an individual’s circumstances affecting eligibility, the
15department shall take no further action.
162. If the information obtained from a review of the
17applicant’s or recipient’s information under this chapter
18results in the department finding a discrepancy or change in
19the individual’s circumstances affecting eligibility, the
20department shall respond in accordance with the provisions of
21section 239.8.
22 Sec. 93. NEW SECTION. 239.7 Notice and right to be heard.
231. An applicant for, or recipient of, public assistance
24shall be provided written notice and the opportunity to explain
25any issues identified in a review performed under this chapter
26for initial eligibility or redetermination of eligibility.
27Unless otherwise prohibited by federal law or regulation,
28a self-declaration by an applicant or recipient shall not
29be accepted as verification of categorical and financial
30eligibility during such review.
312. The notice provided to the applicant or recipient shall
32describe in sufficient detail the circumstances of the issue
33identified, the manner in which the applicant or recipient
34may respond, and the consequences of failing to respond to
35the notice or resolve the issue identified. The applicant or
-118-1recipient shall be provided ten days to respond to the notice.
2The department may request additional information as necessary
3to reach a decision.
43. An applicant or recipient may respond to the notice as
5follows:
6a. By disagreeing with the findings of the department. If
7the applicant or recipient responds in a timely manner and
8disagrees with the findings of the department, the department
9shall reevaluate the circumstances to determine if the
10applicant’s or recipient’s position is valid. If, through
11reevaluation, the department finds that the department is in
12error, the department shall take immediate action to correct
13the error. If, through reevaluation, the department affirms
14that the applicant’s or recipient’s position is invalid, the
15department shall determine the effect on the applicant’s or
16recipient’s eligibility and take appropriate action. Written
17notice of the department’s determination and the actions taken
18shall be provided to the applicant or recipient.
19b. By agreeing with the findings of the department. If
20the applicant or recipient responds in a timely manner and
21agrees with the findings of the department, the department
22shall determine the effect on the applicant’s or recipient’s
23eligibility and take appropriate action. Written notice of the
24department’s determination and actions taken shall be provided
25to the applicant or recipient.
264. If the applicant or recipient fails to respond to the
27notice in a timely manner, the department shall provide notice
28to terminate the applicant’s application or to discontinue
29the recipient’s enrollment for failure to cooperate, and
30shall terminate the applicant’s application or discontinue
31the recipient’s enrollment. The applicant’s or recipient’s
32eligibility for such public assistance shall not be established
33or reestablished until the issue has been resolved.
34 Sec. 94. NEW SECTION. 239.8 Referrals for fraud,
35misrepresentation, or inadequate documentation.
-119- 11. Following a review of an applicant’s or recipient’s
2eligibility under this chapter, the department may refer cases
3of suspected fraud along with any supportive information to the
4department of inspections and appeals for review.
52. In cases of substantiated fraud, upon conviction, the
6state shall review all appropriate legal options including
7but not limited to removal of a recipient from other public
8assistance programs and garnishment of wages or state income
9tax refunds until the department recovers an equal amount of
10benefits fraudulently claimed.
113. The department may refer suspected cases of fraud,
12misrepresentation, or inadequate documentation relating to
13initial or continued eligibility to appropriate state agencies,
14divisions, or departments for review of eligibility issues in
15programs providing public benefits other than those as defined
16in this chapter.
17 Sec. 95. NEW SECTION. 239.9 Administration — rules —
18reporting.
191. The department of human services shall adopt rules
20pursuant to chapter 17A to administer this chapter.
212. The department shall submit a report to the governor
22and the general assembly by January 15, 2024, and by January
2315 annually thereafter through January 15, 2028, detailing the
24impact of the verification and authentication measures taken
25under this chapter. The report shall include data for all
26affected public assistance programs including the number of
27cases reviewed, the number of cases closed, the number of fraud
28investigation referrals made, and the amount of savings and
29cost avoidance realized from the provisions of this chapter.
30 Sec. 96. IMPLEMENTATION.
311. The department of human services shall request federal
32approval including for any state plan amendment or waiver
33necessary to administer this Act.
342. The provisions of this Act requiring federal approval
35shall be implemented upon receipt of such federal approval.
-120- 13. The provisions of this Act not requiring federal approval
2shall be implemented as specified in this Act, or if not
3specified in this Act, no later than July 1, 2023.
44. The department may contract with multiple third-party
5vendors to administer this Act.
6EXPLANATION
7The inclusion of this explanation does not constitute agreement with
8the explanation’s substance by the members of the general assembly.
9This bill relates to appropriations for health and human
10services for fiscal years 2021-2022 and 2022-2023 to the
11department of veterans affairs, Iowa veterans home, department
12on aging (IDA), office of long-term care ombudsman, department
13of public health (DPH), Iowa finance authority, department of
14human rights, and department of human services (DHS). The bill
15is organized into divisions for each fiscal year.
16DEPARTMENT ON AGING. This division makes appropriations
17from the general fund of the state to the department on aging.
18OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
19appropriations from the general fund of the state to the office
20of long-term care ombudsman.
21DEPARTMENT OF PUBLIC HEALTH. This division makes
22appropriations from the general fund of the state and from
23the sports wagering receipts fund to the department of public
24health.
25DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
26division makes appropriations from the general fund of the
27state to the department of veterans affairs for administration,
28the Iowa veterans home, for transfer to the Iowa finance
29authority for the home ownership assistance program and for the
30county commissions of veteran affairs.
31DEPARTMENT OF HUMAN SERVICES. This division makes
32appropriations from the general fund of the state and the
33federal temporary assistance for needy families block
34grant to DHS. The allocation for the family development
35and self-sufficiency grant program is made directly to
-121-1the department of human rights. The reimbursement section
2addresses reimbursement for providers reimbursed by the
3department of human services.
4HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
5health-related appropriations. A number of the appropriations
6are made for purposes of the Medicaid program in addition to
7the general fund appropriations made for this purpose for the
8same fiscal year.
9DECATEGORIZATION CARRYOVER FUNDING. This division provides
10for the transfer of carryover decategorization funds that
11remained unencumbered or unobligated at the close of the fiscal
12year beginning July 1, 2020, to the Medicaid program for
13FY 2021-2022. The division takes effect upon enactment and is
14retroactively applicable to July 1, 2020.
15PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division
16provides that funds appropriated to the department of human
17services and credited to the family investment program account
18that remain unencumbered or unobligated at the close of
19FY 2020-2021 shall not revert but shall remain available for
20expenditure for the purposes designated, and may be transferred
21to other appropriations as necessary to carry out the
22initiatives included in the report submitted on nonreversion
23of funds required pursuant to 2020 Iowa Acts, chapter 1121,
24section 43, until the close of the succeeding fiscal year.
25The division also provides that funds appropriated to the
26department of human services for child and family services that
27remain unencumbered or unobligated at the close of FY 2020-2021
28shall not revert but shall remain available for expenditure for
29the purpose of the redesign of the child welfare system, until
30the close of the succeeding fiscal year.
31The division takes effect upon enactment.
32EXTENSION OF REPEAL FOR HOSPITAL HEALTH CARE ACCESS
33ASSESSMENT PROGRAM. This division extends the repeal of
34the hospital health care access assessment program chapter,
35Code chapter 249M, from July 1, 2021, to July 1, 2023. This
-122-1provision takes effect upon enactment.
2PUBLIC ASSISTANCE PROGRAM OVERSIGHT. This division relates
3to public assistance program oversight, including various
4eligibility verification and authentication measures under
5new Code chapter 239 relating to the supplemental nutrition
6assistance program (SNAP), the Medicaid program, the family
7investment program (FIP), and the children’s health insurance
8program (CHIP).
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