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Senate Study Bill 3158 - IntroducedA Bill ForAn Act 1relating to appropriations for health and human
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2022-2023
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, 2022, and ending June 30,
62023, 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:
.................................................. $1711,804,082
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, $418,700 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, 2022.
13DIVISION II
14OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2022-2023
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, 2022, and ending June 30, 2023, 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 2022-2023
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, 2022, and ending
29June 30, 2023, 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,
332022.
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:
.................................................. $64,258,373
74. COMMUNITY CAPACITY
8For strengthening the health care delivery system at the
9local level:
.................................................. $106,519,306
11a. Of the funds appropriated in this subsection, $2,100,000
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, $800,000
19shall be used for rural psychiatric residencies to support the
20annual creation and training of six psychiatric residents who
21will provide mental health services in underserved areas of
22the state. Notwithstanding section 8.33, moneys that remain
23unencumbered or unobligated at the close of the fiscal year
24shall not revert but shall remain available for expenditure for
25the purposes designated for subsequent fiscal years.
26c. Of the funds appropriated in this subsection, $425,000
27shall be used for the creation or continuation of a center of
28excellence program to encourage innovation and collaboration
29among regional health care providers in a rural area based
30upon the results of a regional community needs assessment to
31transform health care delivery in order to provide quality,
32sustainable care that meets the needs of the local communities.
33An applicant for the funds shall specify how the funds will
34be expended to accomplish the goals of the program and shall
35provide a detailed five-year sustainability plan prior to
-5-1being awarded any funding. Following the receipt of funding,
2a recipient shall submit periodic reports as specified by the
3department to the governor and the general assembly regarding
4the recipient’s expenditure of the funds and progress in
5accomplishing the program goals.
65. ESSENTIAL PUBLIC HEALTH SERVICES
7To provide public health services that reduce risks and
8invest in promoting and protecting good health over the
9course of a lifetime with a priority given to older Iowans and
10vulnerable populations:
.................................................. $117,662,464
126. INFECTIOUS DISEASES
13For reducing the incidence and prevalence of communicable
14diseases:
.................................................. $151,796,206
167. PUBLIC PROTECTION
17a. For protecting the health and safety of the public
18through establishing standards and enforcing regulations:
.................................................. $194,706,601
20b. Of the funds appropriated in this subsection, not more
21than $304,000 shall be credited to the emergency medical
22services fund created in section 135.25. Moneys in the
23emergency medical services fund are appropriated to the
24department to be used for the purposes of the fund.
258. RESOURCE MANAGEMENT
26For establishing and sustaining the overall ability of the
27department to deliver services to the public:
.................................................. $28933,871
299. MISCELLANEOUS PROVISIONS
30The university of Iowa hospitals and clinics under the
31control of the state board of regents shall not receive
32indirect costs from the funds appropriated in this section.
33The university of Iowa hospitals and clinics billings to the
34department shall be on at least a quarterly basis.
35 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
-6-1RECEIPTS FUND. There is appropriated from the sports wagering
2receipts fund created in section 8.57, subsection 6, to the
3department of public health for the fiscal year beginning July
41, 2022, and ending June 30, 2023, the following amount, or
5so much thereof as is necessary, to be used for the purposes
6designated:
7For problem gambling and substance-related disorder
8prevention, treatment, and recovery services, including a
924-hour helpline, public information resources, professional
10training, youth prevention, and program evaluation:
.................................................. $111,750,000
12DIVISION IV
13DEPARTMENT OF VETERANS AFFAIRS — FY 2022-2023
14 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
15appropriated from the general fund of the state to the
16department of veterans affairs for the fiscal year beginning
17July 1, 2022, and ending June 30, 2023, the following amounts,
18or so much thereof as is necessary, to be used for the purposes
19designated:
201. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
21For salaries, support, maintenance, and miscellaneous
22purposes:
.................................................. $231,415,288
242. IOWA VETERANS HOME
25For salaries, support, maintenance, and miscellaneous
26purposes:
.................................................. $277,131,552
28a. The Iowa veterans home billings involving the department
29of human services shall be submitted to the department on at
30least a monthly basis.
31b. The Iowa veterans home expenditure report shall be
32submitted monthly to the general assembly.
33c. The Iowa veterans home shall continue to include in the
34annual discharge report applicant information to provide for
35the collection of demographic information including but not
-7-1limited to the number of individuals applying for admission and
2admitted or denied admittance and the basis for the admission
3or denial; the age, gender, and race of such individuals;
4and the level of care for which such individuals applied for
5admission including residential or nursing level of care.
63. HOME OWNERSHIP ASSISTANCE PROGRAM
7For transfer to the Iowa finance authority for the
8continuation of the home ownership assistance program for
9persons who are or were eligible members of the armed forces of
10the United States, pursuant to section 16.54:
.................................................. $112,000,000
12 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
13FUND STANDING APPROPRIATIONS. Notwithstanding the standing
14appropriation in section 35A.16 for the fiscal year beginning
15July 1, 2022, and ending June 30, 2023, the amount appropriated
16from the general fund of the state pursuant to that section
17for the following designated purposes shall not exceed the
18following amount:
19For the county commissions of veteran affairs fund under
20section 35A.16:
.................................................. $21990,000
22DIVISION V
23DEPARTMENT OF HUMAN SERVICES — FY 2022-2023
24 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
25GRANT. There is appropriated from the fund created in section
268.41 to the department of human services for the fiscal year
27beginning July 1, 2022, and ending June 30, 2023, from moneys
28received under the federal temporary assistance for needy
29families (TANF) block grant pursuant to the federal Personal
30Responsibility and Work Opportunity Reconciliation Act of 1996,
31Pub.L.No.104-193, and successor legislation, the following
32amounts, or so much thereof as is necessary, to be used for the
33purposes designated:
341. To be credited to the family investment program account
35and used for assistance under the family investment program
-8-1under chapter 239B:
.................................................. $25,002,006
32. To be credited to the family investment program account
4and used for the job opportunities and basic skills (JOBS)
5program and implementing family investment agreements in
6accordance with chapter 239B:
.................................................. $75,412,060
83. To be used for the family development and
9self-sufficiency grant program in accordance with section
10216A.107:
.................................................. $112,888,980
12Notwithstanding section 8.33, moneys appropriated in this
13subsection that remain unencumbered or unobligated at the close
14of the fiscal year shall not revert but shall remain available
15for expenditure for the purposes designated until the close of
16the succeeding fiscal year. However, unless such moneys are
17encumbered or obligated on or before September 30, 2023, the
18moneys shall revert.
194. For field operations:
.................................................. $2031,296,232
215. For general administration:
.................................................. $223,744,000
236. For state child care assistance:
.................................................. $2447,166,826
25a. Of the funds appropriated in this subsection,
26$26,205,412 is transferred to the child care and development
27block grant appropriation made by the Eighty-ninth General
28Assembly, 2022 session, for the federal fiscal year beginning
29October 1, 2022, and ending September 30, 2023. Of this
30amount, $200,000 shall be used for provision of educational
31opportunities to registered child care home providers in order
32to improve services and programs offered by this category
33of providers and to increase the number of providers. The
34department may contract with institutions of higher education
35or child care resource and referral centers to provide
-9-1the educational opportunities. Allowable administrative
2costs under the contracts shall not exceed 5 percent. The
3application for a grant shall not exceed two pages in length.
4b. Any funds appropriated in this subsection remaining
5unallocated shall be used for state child care assistance
6payments for families who are employed including but not
7limited to individuals enrolled in the family investment
8program.
97. For child and family services:
.................................................. $1032,380,654
118. For child abuse prevention grants:
.................................................. $12125,000
139. For pregnancy prevention grants on the condition that
14family planning services are funded:
.................................................. $151,913,203
16Pregnancy prevention grants shall be awarded to programs
17in existence on or before July 1, 2022, if the programs have
18demonstrated positive outcomes. Grants shall be awarded to
19pregnancy prevention programs which are developed after July
201, 2022, if the programs are based on existing models that
21have demonstrated positive outcomes. Grants shall comply with
22the requirements provided in 1997 Iowa Acts, chapter 208,
23section 14, subsections 1 and 2, including the requirement that
24grant programs must emphasize sexual abstinence. Priority in
25the awarding of grants shall be given to programs that serve
26areas of the state which demonstrate the highest percentage of
27unplanned pregnancies of females of childbearing age within the
28geographic area to be served by the grant.
2910. For technology needs and other resources necessary to
30meet federal and state reporting, tracking, and case management
31requirements and other departmental needs:
.................................................. $321,037,186
3311. a. Notwithstanding any provision to the contrary,
34including but not limited to requirements in section 8.41 or
35provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the
-10-1receipt and appropriation of federal block grants, federal
2funds from the temporary assistance for needy families block
3grant received by the state and not otherwise appropriated
4in this section and remaining available for the fiscal year
5beginning July 1, 2022, are appropriated to the department of
6human services to the extent as may be necessary to be used in
7the following priority order: the family investment program,
8for state child care assistance program payments for families
9who are employed, and for the family investment program share
10of system costs for eligibility determination and related
11functions. The federal funds appropriated in this paragraph
12“a” shall be expended only after all other funds appropriated
13in subsection 1 for assistance under the family investment
14program, in subsection 6 for state child care assistance, or
15in subsection 10 for technology costs related to the family
16investment program, as applicable, have been expended. For
17the purposes of this subsection, the funds appropriated in
18subsection 6, paragraph “a”, for transfer to the child care
19and development block grant appropriation are considered fully
20expended when the full amount has been transferred.
21b. The department shall, on a quarterly basis, advise the
22general assembly and department of management of the amount of
23funds appropriated in this subsection that was expended in the
24prior quarter.
2512. Of the amounts appropriated in this section,
26$12,962,008 for the fiscal year beginning July 1, 2022, is
27transferred to the appropriation of the federal social services
28block grant made to the department of human services for that
29fiscal year.
3013. For continuation of the program providing categorical
31eligibility for the supplemental nutrition assistance program
32(SNAP) as specified for the program in the section of this
33division of this Act relating to the family investment program
34account:
.................................................. $3514,236
-11- 114. The department may transfer funds allocated in this
2section to the appropriations made in this division of this Act
3for the same fiscal year for general administration and field
4operations for resources necessary to implement and operate the
5services referred to in this section and those funded in the
6appropriation made in this division of this Act for the same
7fiscal year for the family investment program from the general
8fund of the state.
915. With the exception of moneys allocated under this
10section for the family development and self-sufficiency grant
11program, to the extent moneys allocated in this section are
12deemed by the department not to be necessary to support the
13purposes for which they are allocated, such moneys may be used
14in the same fiscal year for any other purpose for which funds
15are allocated in this section or in section 8 of this division
16of this Act for the family investment program account. If
17there are conflicting needs, priority shall first be given
18to the family investment program account as specified under
19subsection 1 of this section and used for the purposes of
20assistance under the family investment program in accordance
21with chapter 239B, followed by state child care assistance
22program payments for families who are employed, followed by
23other priorities as specified by the department.
24 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
251. Moneys credited to the family investment program (FIP)
26account for the fiscal year beginning July 1, 2022, and
27ending June 30, 2023, shall be used to provide assistance in
28accordance with chapter 239B.
292. The department may use a portion of the moneys credited
30to the FIP account under this section as necessary for
31salaries, support, maintenance, and miscellaneous purposes,
32including administrative and information technology costs
33associated with rent reimbursement and other income assistance
34programs administered by the department.
353. The department may transfer funds allocated in
-12-1subsection 4, excluding the allocation under subsection 4,
2paragraph “b”, to the appropriations made in this division of
3this Act for the same fiscal year for general administration
4and field operations for resources necessary to implement
5and operate the services referred to in this section and
6those funded in the appropriations made in section 7 for the
7temporary assistance for needy families block grant and in
8section 9 for the family investment program from the general
9fund of the state in this division of this Act for the same
10fiscal year.
114. Moneys appropriated in this division of this Act and
12credited to the FIP account for the fiscal year beginning July
131, 2022, and ending June 30, 2023, are allocated as follows:
14a. To be retained by the department of human services to
15be used for coordinating with the department of human rights
16to more effectively serve participants in FIP and other shared
17clients and to meet federal reporting requirements under the
18federal temporary assistance for needy families block grant:
.................................................. $1910,000
20b. To the department of human rights for staffing,
21administration, and implementation of the family development
22and self-sufficiency grant program in accordance with section
23216A.107:
.................................................. $247,192,834
25(1) Of the funds allocated for the family development
26and self-sufficiency grant program in this paragraph “b”,
27not more than 5 percent of the funds shall be used for the
28administration of the grant program.
29(2) The department of human rights may continue to implement
30the family development and self-sufficiency grant program
31statewide during fiscal year 2022-2023.
32(3) The department of human rights may engage in activities
33to strengthen and improve family outcomes measures and
34data collection systems under the family development and
35self-sufficiency grant program.
-13- 1c. For the diversion subaccount of the FIP account:
.................................................. $21,293,000
3A portion of the moneys allocated for the diversion
4subaccount may be used for field operations, salaries, data
5management system development, and implementation costs and
6support deemed necessary by the director of human services
7in order to administer the FIP diversion program. To the
8extent moneys allocated in this paragraph “c” are deemed by the
9department not to be necessary to support diversion activities,
10such moneys may be used for other efforts intended to increase
11engagement by family investment program participants in work,
12education, or training activities, or for the purposes of
13assistance under the family investment program in accordance
14with chapter 239B.
15d. For the SNAP employment and training program:
.................................................. $1666,588
17(1) The department shall apply the federal SNAP employment
18and training state plan in order to maximize to the fullest
19extent permitted by federal law the use of the 50 percent
20federal reimbursement provisions for the claiming of allowable
21federal reimbursement funds from the United States department
22of agriculture pursuant to the federal SNAP employment and
23training program for providing education, employment, and
24training services for eligible SNAP participants, including
25but not limited to related dependent care and transportation
26expenses.
27(2) The department shall continue the categorical federal
28SNAP eligibility at 160 percent of the federal poverty level
29and continue to eliminate the asset test from eligibility
30requirements, consistent with federal SNAP requirements. The
31department shall include as many SNAP households as is allowed
32by federal law. The eligibility provisions shall conform to
33all federal requirements including requirements addressing
34individuals who are incarcerated or otherwise ineligible.
35e. For the JOBS program, not more than:
-14-.................................................. $111,710,593
25. Of the child support collections assigned under FIP,
3an amount equal to the federal share of support collections
4shall be credited to the child support recovery appropriation
5made in this division of this Act. Of the remainder of the
6assigned child support collections received by the child
7support recovery unit, a portion shall be credited to the FIP
8account, a portion may be used to increase recoveries, and a
9portion may be used to sustain cash flow in the child support
10payments account. If as a consequence of the appropriations
11and allocations made in this section the resulting amounts
12are insufficient to sustain cash assistance payments and meet
13federal maintenance of effort requirements, the department
14shall seek supplemental funding. If child support collections
15assigned under FIP are greater than estimated or are otherwise
16determined not to be required for maintenance of effort, the
17state share of either amount may be transferred to or retained
18in the child support payments account.
19 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
20is appropriated from the general fund of the state to the
21department of human services for the fiscal year beginning July
221, 2022, and ending June 30, 2023, the following amount, or
23so much thereof as is necessary, to be used for the purpose
24designated:
25To be credited to the family investment program (FIP)
26account and used for family investment program assistance
27under chapter 239B and other costs associated with providing
28needs-based benefits or assistance:
.................................................. $2941,003,978
301. Of the funds appropriated in this section, $6,606,198 is
31allocated for the JOBS program.
322. Of the funds appropriated in this section, $4,313,854 is
33allocated for the family development and self-sufficiency grant
34program.
353. a. Notwithstanding section 8.39, for the fiscal
-15-1year beginning July 1, 2022, if necessary to meet federal
2maintenance of effort requirements or to transfer federal
3temporary assistance for needy families block grant funding
4to be used for purposes of the federal social services block
5grant or to meet cash flow needs resulting from delays in
6receiving federal funding or to implement, in accordance with
7this division of this Act, activities currently funded with
8juvenile court services, county, or community moneys and state
9moneys used in combination with such moneys; to comply with
10federal requirements; or to maximize the use of federal funds;
11the department of human services may transfer funds within or
12between any of the appropriations made in this division of this
13Act and appropriations in law for the federal social services
14block grant to the department for the following purposes,
15provided that the combined amount of state and federal
16temporary assistance for needy families block grant funding
17for each appropriation remains the same before and after the
18transfer:
19(1) For the family investment program.
20(2) For state child care assistance.
21(3) For child and family services.
22(4) For field operations.
23(5) For general administration.
24b. This subsection shall not be construed to prohibit the
25use of existing state transfer authority for other purposes.
26The department shall report any transfers made pursuant to this
27subsection to the general assembly.
284. Of the funds appropriated in this section, $195,000
29shall be used for a contract for tax preparation assistance
30to low-income Iowans to expand the usage of the earned income
31tax credit. The purpose of the contract is to supply this
32assistance to underserved areas of the state. The department
33shall not retain any portion of the allocation under this
34subsection for administrative costs.
355. Of the funds appropriated in this section, $70,000 shall
-16-1be used for the continuation of the parenting program, as
2specified in 441 IAC ch.100, relating to parental obligations,
3in which the child support recovery unit participates, to
4support the efforts of a nonprofit organization committed to
5strengthening the community through youth development, healthy
6living, and social responsibility headquartered in a county
7with a population over 450,000 according to the 2020 certified
8federal census. The funds allocated in this subsection shall
9be used by the recipient organization to develop a larger
10community effort, through public and private partnerships, to
11support a broad-based multi-county parenthood initiative that
12promotes payment of child support obligations, improved family
13relationships, and full-time employment.
146. The department may transfer funds appropriated in this
15section, excluding the allocation in subsection 2 for the
16family development and self-sufficiency grant program, to the
17appropriations made in this division of this Act for general
18administration and field operations as necessary to administer
19this section, section 7 for the temporary assistance for needy
20families block grant, and section 8 for the family investment
21program account.
22 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
23from the general fund of the state to the department of human
24services for the fiscal year beginning July 1, 2022, and ending
25June 30, 2023, the following amount, or so much thereof as is
26necessary, to be used for the purposes designated:
27For child support recovery, including salaries, support,
28maintenance, and miscellaneous purposes:
.................................................. $2915,942,885
301. The department shall expend up to $24,000, including
31federal financial participation, for the fiscal year beginning
32July 1, 2022, for a child support public awareness campaign.
33The department and the office of the attorney general shall
34cooperate in continuation of the campaign. The public
35awareness campaign shall emphasize, through a variety of
-17-1media activities, the importance of maximum involvement of
2both parents in the lives of their children as well as the
3importance of payment of child support obligations.
42. Federal access and visitation grant moneys shall be
5issued directly to private not-for-profit agencies that provide
6services designed to increase compliance with the child access
7provisions of court orders, including but not limited to
8neutral visitation sites and mediation services.
93. The appropriation made to the department for child
10support recovery may be used throughout the fiscal year in the
11manner necessary for purposes of cash flow management, and for
12cash flow management purposes the department may temporarily
13draw more than the amount appropriated, provided the amount
14appropriated is not exceeded at the close of the fiscal year.
15 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
16FY 2022-2023. Any funds remaining in the health care trust
17fund created in section 453A.35A for the fiscal year beginning
18July 1, 2022, and ending June 30, 2023, are appropriated to
19the department of human services to supplement the medical
20assistance program appropriations made in this division of this
21Act, for medical assistance reimbursement and associated costs,
22including program administration and costs associated with
23program implementation.
24 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
252022-2023. Any funds remaining in the Medicaid fraud fund
26created in section 249A.50 for the fiscal year beginning
27July 1, 2022, and ending June 30, 2023, are appropriated to
28the department of human services to supplement the medical
29assistance appropriations made in this division of this Act,
30for medical assistance reimbursement and associated costs,
31including program administration and costs associated with
32program implementation.
33 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
34general fund of the state to the department of human services
35for the fiscal year beginning July 1, 2022, and ending June 30,
-18-12023, the following amount, or so much thereof as is necessary,
2to be used for the purpose designated:
3For medical assistance program reimbursement and associated
4costs as specifically provided in the reimbursement
5methodologies in effect on June 30, 2022, except as otherwise
6expressly authorized by law, consistent with options under
7federal law and regulations, and contingent upon receipt of
8approval from the office of the governor of reimbursement for
9each abortion performed under the program:
.................................................. $101,503,848,253
111. Iowans support reducing the number of abortions
12performed in our state. Funds appropriated under this section
13shall not be used for abortions, unless otherwise authorized
14under this section.
152. The provisions of this section relating to abortions
16shall also apply to the Iowa health and wellness plan created
17pursuant to chapter 249N.
183. The department shall utilize not more than $60,000 of
19the funds appropriated in this section to continue the AIDS/HIV
20health insurance premium payment program as established in 1992
21Iowa Acts, Second Extraordinary Session, chapter 1001, section
22409, subsection 6. Of the funds allocated in this subsection,
23not more than $5,000 may be expended for administrative
24purposes.
254. Of the funds appropriated in this Act to the department
26of public health for addictive disorders, $950,000 for
27the fiscal year beginning July 1, 2022, is transferred
28to the department of human services for an integrated
29substance-related disorder managed care system. The
30departments of human services and public health shall
31work together to maintain the level of mental health and
32substance-related disorder treatment services provided by the
33managed care contractors. Each department shall take the steps
34necessary to continue the federal waivers as necessary to
35maintain the level of services.
-19- 15. The department shall aggressively pursue options for
2providing medical assistance or other assistance to individuals
3with special needs who become ineligible to continue receiving
4services under the early and periodic screening, diagnostic,
5and treatment program under the medical assistance program
6due to becoming 21 years of age who have been approved for
7additional assistance through the department’s exception to
8policy provisions, but who have health care needs in excess
9of the funding available through the exception to policy
10provisions.
116. Of the funds appropriated in this section, up to
12$3,050,082 may be transferred to the field operations or
13general administration appropriations in this division of this
14Act for operational costs associated with Part D of the federal
15Medicare Prescription Drug Improvement and Modernization Act
16of 2003, Pub.L.No.108-173.
177. Of the funds appropriated in this section, up to $442,100
18may be transferred to the appropriation in this division of
19this Act for health program operations to be used for clinical
20assessment services and prior authorization of services.
218. A portion of the funds appropriated in this section may
22be transferred to the appropriations in this division of this
23Act for general administration, health program operations, the
24children’s health insurance program, or field operations to be
25used for the state match cost to comply with the payment error
26rate measurement (PERM) program for both the medical assistance
27and children’s health insurance programs as developed by the
28centers for Medicare and Medicaid services of the United States
29department of health and human services to comply with the
30federal Improper Payments Information Act of 2002, Pub.L.
31No.107-300, and to support other reviews and quality control
32activities to improve the integrity of these programs.
339. Of the funds appropriated in this section, a sufficient
34amount is allocated to supplement the incomes of residents of
35nursing facilities, intermediate care facilities for persons
-20-1with mental illness, and intermediate care facilities for
2persons with an intellectual disability, with incomes of less
3than $50 in the amount necessary for the residents to receive a
4personal needs allowance of $50 per month pursuant to section
5249A.30A.
610. One hundred percent of the nonfederal share of payments
7to area education agencies that are medical assistance
8providers for medical assistance-covered services provided to
9medical assistance-covered children, shall be made from the
10appropriation made in this section.
1111. A portion of the funds appropriated in this section may
12be transferred to the appropriation in this division of this
13Act for health program operations to be used for administrative
14activities associated with the money follows the person
15demonstration project.
1612. Of the funds appropriated in this section, $349,011
17shall be used for the administration of the health insurance
18premium payment program, including salaries, support,
19maintenance, and miscellaneous purposes.
2013. a. The department may increase the amounts allocated
21for salaries, support, maintenance, and miscellaneous purposes
22associated with the medical assistance program, as necessary,
23to sustain cost management efforts. The department shall
24report any such increase to the general assembly and the
25department of management.
26b. If the savings to the medical assistance program from
27ongoing cost management efforts exceed the associated cost
28for the fiscal year beginning July 1, 2022, the department
29may transfer any savings generated for the fiscal year due
30to medical assistance program cost management efforts to the
31appropriation made in this division of this Act for health
32program operations or general administration to defray the
33costs associated with implementing the efforts.
3414. For the fiscal year beginning July 1, 2022, and ending
35June 30, 2023, the replacement generation tax revenues required
-21-1to be deposited in the property tax relief fund pursuant to
2section 437A.8, subsection 4, paragraph “d”, and section
3437A.15, subsection 3, paragraph “f”, shall instead be credited
4to and supplement the appropriation made in this section and
5used for the allocations made in this section.
615. a. Of the funds appropriated in this section, up
7to $50,000 may be transferred by the department to the
8appropriation made in this division of this Act to the
9department for the same fiscal year for general administration
10to be used for associated administrative expenses and for not
11more than 1.00 full-time equivalent position, in addition to
12those authorized for the same fiscal year, to be assigned to
13implementing the children’s mental health home project.
14b. Of the funds appropriated in this section, up to $400,000
15may be transferred by the department to the appropriation made
16to the department in this division of this Act for the same
17fiscal year for Medicaid program-related general administration
18planning and implementation activities. The funds may be used
19for contracts or for personnel in addition to the amounts
20appropriated for and the positions authorized for general
21administration for the fiscal year.
22c. Of the funds appropriated in this section, up to
23$3,000,000 may be transferred by the department to the
24appropriations made in this division of this Act for the
25same fiscal year for general administration or health
26program operations to be used to support the development
27and implementation of standardized assessment tools for
28persons with mental illness, an intellectual disability, a
29developmental disability, or a brain injury.
3016. Of the funds appropriated in this section, $150,000
31shall be used for lodging expenses associated with care
32provided at the university of Iowa hospitals and clinics for
33patients with cancer whose travel distance is 30 miles or more
34and whose income is at or below 200 percent of the federal
35poverty level as defined by the most recently revised poverty
-22-1income guidelines published by the United States department of
2health and human services. The department of human services
3shall establish the maximum number of overnight stays and the
4maximum rate reimbursed for overnight lodging, which may be
5based on the state employee rate established by the department
6of administrative services. The funds allocated in this
7subsection shall not be used as nonfederal share matching
8funds.
917. Of the funds appropriated in this section, up to
10$3,383,880 shall be used for administration of the state family
11planning services program pursuant to section 217.41B, and
12of this amount, the department may use up to $200,000 for
13administrative expenses.
1418. Of the funds appropriated in this section, $1,545,530
15shall be used and may be transferred to other appropriations
16in this division of this Act as necessary to administer the
17provisions in the division of this Act relating to Medicaid
18program administration.
1919. The department shall comply with the centers for
20Medicare and Medicaid services’ guidance related to Medicaid
21program and children’s health insurance program maintenance
22of effort provisions, including eligibility standards,
23methodologies, procedures, and continuous enrollment, to
24receive the enhanced federal medical assistance percentage
25under section 6008(b) of the federal Families First Coronavirus
26Response Act, Pub.L. No.116-127. The department shall
27utilize and implement all tools, processes, and resources
28available to expediently return to normal eligibility and
29enrollment operations in compliance with federal guidance and
30expectations.
3120. A portion of the funds appropriated in this section
32may be transferred to the appropriation in this division
33of this Act for the children’s health insurance program
34if the children’s health insurance program appropriation
35is not sufficient to cover the designated purposes of that
-23-1appropriation.
2 Sec. 14. HEALTH PROGRAM OPERATIONS. 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 purpose designated:
7For health program operations:
.................................................. $817,831,343
91. The department of inspections and appeals shall
10provide all state matching funds for survey and certification
11activities performed by the department of inspections
12and appeals. The department of human services is solely
13responsible for distributing the federal matching funds for
14such activities.
152. Of the funds appropriated in this section, $50,000 shall
16be used for continuation of home and community-based services
17waiver quality assurance programs, including the review and
18streamlining of processes and policies related to oversight and
19quality management to meet state and federal requirements.
203. Of the amount appropriated in this section, up to
21$200,000 may be transferred to the appropriation for general
22administration in this division of this Act to be used for
23additional full-time equivalent positions in the development
24of key health initiatives such as development and oversight
25of managed care programs and development of health strategies
26targeted toward improved quality and reduced costs in the
27Medicaid program.
284. Of the funds appropriated in this section, $1,000,000
29shall be used for planning and development, in cooperation with
30the department of public health, of a phased-in program to
31provide a dental home for children.
325. a. Of the funds appropriated in this section, $573,000
33shall be credited to the autism support program fund created
34in section 225D.2 to be used for the autism support program
35created in chapter 225D, with the exception of the following
-24-1amount of this allocation which shall be used as follows:
2b. Of the funds allocated in this subsection, $25,000 shall
3be used for the public purpose of continuation of a grant to
4a nonprofit provider of child welfare services that has been
5in existence for more than 115 years, is located in a county
6with a population between 220,000 and 250,000 according to the
72020 federal decennial census, is licensed as a psychiatric
8medical institution for children, and provides school-based
9programming, to be used for support services for children with
10autism spectrum disorder and their families.
11 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
121. There is appropriated from the general fund of the
13state to the department of human services for the fiscal year
14beginning July 1, 2022, and ending June 30, 2023, the following
15amount, or so much thereof as is necessary, to be used for the
16purpose designated:
17For the state supplementary assistance program:
.................................................. $187,349,002
192. The department shall increase the personal needs
20allowance for residents of residential care facilities by the
21same percentage and at the same time as federal supplemental
22security income and federal social security benefits are
23increased due to a recognized increase in the cost of living.
24The department may adopt emergency rules to implement this
25subsection.
263. If during the fiscal year beginning July 1, 2022,
27the department projects that state supplementary assistance
28expenditures for a calendar year will not meet the federal
29pass-through requirement specified in Tit.XVI of the federal
30Social Security Act, section 1618, as codified in 42 U.S.C.
31§1382g, the department may take actions including but not
32limited to increasing the personal needs allowance for
33residential care facility residents and making programmatic
34adjustments or upward adjustments of the residential care
35facility or in-home health-related care reimbursement rates
-25-1prescribed in this division of this Act to ensure that federal
2requirements are met. In addition, the department may make
3other programmatic and rate adjustments necessary to remain
4within the amount appropriated in this section while ensuring
5compliance with federal requirements. The department may adopt
6emergency rules to implement the provisions of this subsection.
74. Notwithstanding section 8.33, moneys appropriated
8in this section that remain unencumbered or unobligated
9at the close of the fiscal year shall not revert but
10shall remain available for expenditure for the purposes
11designated, including for liability amounts associated with the
12supplemental nutrition assistance program payment error rate,
13until the close of the succeeding fiscal year.
14 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
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:
20For maintenance of the healthy and well kids in Iowa (hawk-i)
21program pursuant to chapter 514I, including supplemental dental
22services, for receipt of federal financial participation under
23Tit.XXI of the federal Social Security Act, which creates the
24children’s health insurance program:
.................................................. $2541,713,403
262. Of the funds appropriated in this section, $158,850 is
27allocated for continuation of the contract for outreach with
28the department of public health.
293. A portion of the funds appropriated in this section may
30be transferred to the appropriations made in this division of
31this Act for field operations or health program operations to
32be used for the integration of hawk-i program eligibility,
33payment, and administrative functions under the purview of
34the department of human services, including for the Medicaid
35management information system upgrade.
-26-1 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated
2from the general fund of the state to the department of human
3services for the fiscal year beginning July 1, 2022, and ending
4June 30, 2023, the following amount, or so much thereof as is
5necessary, to be used for the purpose designated:
6For child care programs:
.................................................. $740,816,931
81. Of the funds appropriated in this section, $34,966,931
9shall be used for state child care assistance in accordance
10with section 237A.13.
112. Nothing in this section shall be construed or is
12intended as or shall imply a grant of entitlement for services
13to persons who are eligible for assistance due to an income
14level consistent with the waiting list requirements of section
15237A.13. Any state obligation to provide services pursuant to
16this section is limited to the extent of the funds appropriated
17in this section.
183. A list of the registered and licensed child care
19facilities operating in the area served by a child care
20resource and referral service shall be made available to the
21families receiving state child care assistance in that area.
224. Of the funds appropriated in this section, $5,850,000
23shall be credited to the early childhood programs grants
24account in the early childhood Iowa fund created in section
25256I.11. The moneys shall be distributed for funding of
26community-based early childhood programs targeted to children
27from birth through five years of age developed by early
28childhood Iowa areas in accordance with approved community
29plans as provided in section 256I.8.
305. The department may use any of the funds appropriated
31in this section as a match to obtain federal funds for use in
32expanding child care assistance and related programs. For
33the purpose of expenditures of state and federal child care
34funding, funds shall be considered obligated at the time
35expenditures are projected or are allocated to the department’s
-27-1service areas. Projections shall be based on current and
2projected caseload growth, current and projected provider
3rates, staffing requirements for eligibility determination
4and management of program requirements including data systems
5management, staffing requirements for administration of the
6program, contractual and grant obligations and any transfers
7to other state agencies, and obligations for decategorization
8or innovation projects.
96. A portion of the state match for the federal child care
10and development block grant shall be provided as necessary to
11meet federal matching funds requirements through the state
12general fund appropriation made for child development grants
13and other programs for at-risk children in section 279.51.
147. If a uniform reduction ordered by the governor under
15section 8.31 or other operation of law, transfer, or federal
16funding reduction reduces the appropriation made in this
17section for the fiscal year, the percentage reduction in the
18amount paid out to or on behalf of the families participating
19in the state child care assistance program shall be equal to or
20less than the percentage reduction made for any other purpose
21payable from the appropriation made in this section and the
22federal funding relating to it. The percentage reduction to
23the other allocations made in this section shall be the same as
24the uniform reduction ordered by the governor or the percentage
25change of the federal funding reduction, as applicable. If
26there is an unanticipated increase in federal funding provided
27for state child care services, the entire amount of the
28increase, except as necessary to meet federal requirements
29including quality set asides, shall be used for state child
30care assistance payments. If the appropriations made for
31purposes of the state child care assistance program for the
32fiscal year are determined to be insufficient, it is the intent
33of the general assembly to appropriate sufficient funding for
34the fiscal year in order to avoid establishment of waiting list
35requirements.
-28- 18. Notwithstanding section 8.33, moneys advanced for
2purposes of the programs developed by early childhood Iowa
3areas, advanced for purposes of wraparound child care, or
4received from the federal appropriations made for the purposes
5of this section that remain unencumbered or unobligated at the
6close of the fiscal year shall not revert to any fund but shall
7remain available for expenditure for the purposes designated
8until the close of the succeeding fiscal year.
9 Sec. 18. JUVENILE INSTITUTION. There is appropriated
10from the general fund of the state to the department of human
11services for the fiscal year beginning July 1, 2022, and ending
12June 30, 2023, the following amounts, or so much thereof as is
13necessary, to be used for the purposes designated:
141. a. For operation of the state training school at Eldora
15and for salaries, support, maintenance, and miscellaneous
16purposes:
.................................................. $1717,606,871
18b. Of the funds appropriated in this subsection, $91,000
19shall be used for distribution to licensed classroom teachers
20at this and other institutions under the control of the
21department of human services based upon the average student
22yearly enrollment at each institution as determined by the
23department.
242. A portion of the moneys appropriated in this section
25shall be used by the state training school at Eldora for
26grants for adolescent pregnancy prevention activities at the
27institution in the fiscal year beginning July 1, 2022.
283. Of the funds appropriated in this subsection, $212,000
29shall be used by the state training school at Eldora for a
30substance use disorder treatment program at the institution for
31the fiscal year beginning July 1, 2022.
324. Notwithstanding section 8.33, moneys appropriated in
33this section that remain unencumbered or unobligated at the
34close of the fiscal year shall not revert but shall remain
35available for expenditure for the purposes designated until the
-29-1close of the succeeding fiscal year.
2 Sec. 19. CHILD AND FAMILY SERVICES.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2022, and ending June 30, 2023, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8For child and family services:
.................................................. $989,371,930
102. The department may transfer funds appropriated in this
11section as necessary to pay the nonfederal costs of services
12reimbursed under the medical assistance program, state child
13care assistance program, or the family investment program which
14are provided to children who would otherwise receive services
15paid under the appropriation in this section. The department
16may transfer funds appropriated in this section to the
17appropriations made in this division of this Act for general
18administration and for field operations for resources necessary
19to implement and operate the services funded in this section.
203. a. Of the funds appropriated in this section, up to
21$36,500,000 is allocated as the statewide expenditure target
22under section 232.143 for group foster care maintenance and
23services. If the department projects that such expenditures
24for the fiscal year will be less than the target amount
25allocated in this paragraph “a”, the department may reallocate
26the excess to provide additional funding for family foster
27care, independent living, family-centered services, shelter
28care, or the child welfare emergency services addressed with
29the allocation for shelter care.
30b. If at any time after September 30, 2022, annualization
31of a service area’s current expenditures indicates a service
32area is at risk of exceeding its group foster care expenditure
33target under section 232.143 by more than 5 percent, the
34department and juvenile court services shall examine all
35group foster care placements in that service area in order to
-30-1identify those which might be appropriate for termination.
2In addition, any aftercare services believed to be needed
3for the children whose placements may be terminated shall be
4identified. The department and juvenile court services shall
5initiate action to set dispositional review hearings for the
6placements identified. In such a dispositional review hearing,
7the juvenile court shall determine whether needed aftercare
8services are available and whether termination of the placement
9is in the best interest of the child and the community.
104. In accordance with the provisions of section 232.188,
11the department shall continue the child welfare and juvenile
12justice funding initiative during fiscal year 2022-2023. Of
13the funds appropriated in this section, $1,717,000 is allocated
14specifically for expenditure for fiscal year 2022-2023 through
15the decategorization services funding pools and governance
16boards established pursuant to section 232.188.
175. A portion of the funds appropriated in this section
18may be used for emergency family assistance to provide other
19resources required for a family participating in a family
20preservation or reunification project or successor project to
21stay together or to be reunified.
226. Of the funds appropriated in this section, a sufficient
23amount is allocated for shelter care and the child welfare
24emergency services contracting implemented to provide for or
25prevent the need for shelter care.
267. Federal funds received by the state during the fiscal
27year beginning July 1, 2022, as the result of the expenditure
28of state funds appropriated during a previous state fiscal
29year for a service or activity funded under this section are
30appropriated to the department to be used as additional funding
31for services and purposes provided for under this section.
32Notwithstanding section 8.33, moneys received in accordance
33with this subsection that remain unencumbered or unobligated at
34the close of the fiscal year shall not revert to any fund but
35shall remain available for the purposes designated until the
-31-1close of the succeeding fiscal year.
28. a. Of the funds appropriated in this section, up to
3$3,290,000 is allocated for the payment of the expenses of
4court-ordered services provided to juveniles who are under the
5supervision of juvenile court services, which expenses are a
6charge upon the state pursuant to section 232.141, subsection
74. Of the amount allocated in this paragraph “a”, up to
8$1,556,000 shall be made available to provide school-based
9supervision of children adjudicated under chapter 232, of which
10not more than $15,000 may be used for the purpose of training.
11A portion of the cost of each school-based liaison officer
12shall be paid by the school district or other funding source as
13approved by the chief juvenile court officer.
14b. Of the funds appropriated in this section, up to $748,000
15is allocated for the payment of the expenses of court-ordered
16services provided to children who are under the supervision
17of the department, which expenses are a charge upon the state
18pursuant to section 232.141, subsection 4.
19c. Notwithstanding section 232.141 or any other provision
20of law to the contrary, the amounts allocated in this
21subsection shall be distributed to the judicial districts
22as determined by the state court administrator and to the
23department’s service areas as determined by the administrator
24of the department of human services’ division of child and
25family services. The state court administrator and the
26division administrator shall make the determination of the
27distribution amounts on or before June 15, 2022.
28d. Notwithstanding chapter 232 or any other provision of
29law to the contrary, a district or juvenile court shall not
30order any service which is a charge upon the state pursuant
31to section 232.141 if there are insufficient court-ordered
32services funds available in the district court or departmental
33service area distribution amounts to pay for the service. The
34chief juvenile court officer and the departmental service area
35manager shall encourage use of the funds allocated in this
-32-1subsection such that there are sufficient funds to pay for
2all court-related services during the entire year. The chief
3juvenile court officers and departmental service area managers
4shall attempt to anticipate potential surpluses and shortfalls
5in the distribution amounts and shall cooperatively request the
6state court administrator or division administrator to transfer
7funds between the judicial districts’ or departmental service
8areas’ distribution amounts as prudent.
9e. Notwithstanding any provision of law to the contrary,
10a district or juvenile court shall not order a county to pay
11for any service provided to a juvenile pursuant to an order
12entered under chapter 232 which is a charge upon the state
13under section 232.141, subsection 4.
14f. Of the funds allocated in this subsection, not more than
15$83,000 may be used by the judicial branch for administration
16of the requirements under this subsection.
17g. Of the funds allocated in this subsection, $17,000
18shall be used by the department of human services to support
19the interstate commission for juveniles in accordance with
20the interstate compact for juveniles as provided in section
21232.173.
229. Of the funds appropriated in this section, $12,253,000 is
23allocated for juvenile delinquent graduated sanctions services.
24Any state funds saved as a result of efforts by juvenile court
25services to earn a federal Tit.IV-E match for juvenile court
26services administration may be used for the juvenile delinquent
27graduated sanctions services.
2810. Of the funds appropriated in this section, $1,658,000 is
29transferred to the department of public health to be used for
30the child protection center grant program for child protection
31centers located in Iowa in accordance with section 135.118.
32The grant amounts under the program shall be equalized so that
33each center receives a uniform base amount of $245,000, and so
34that the remaining funds are awarded through a funding formula
35based upon the volume of children served. To increase access
-33-1to child protection center services for children in rural
2areas, the funding formula for the awarding of the remaining
3funds shall provide for the awarding of an enhanced amount to
4eligible grantees to develop and maintain satellite centers in
5underserved regions of the state.
611. Of the funds appropriated in this section, $4,025,000 is
7allocated for the preparation for adult living program pursuant
8to section 234.46.
912. Of the funds appropriated in this section, $227,000
10shall be used for the public purpose of continuing a grant to a
11nonprofit human services organization, providing services to
12individuals and families in multiple locations in southwest
13Iowa and Nebraska for support of a project providing immediate,
14sensitive support and forensic interviews, medical exams, needs
15assessments, and referrals for victims of child abuse and their
16nonoffending family members.
1713. Of the funds appropriated in this section, $300,000
18is allocated for the foster care youth council approach of
19providing a support network to children placed in foster care.
2014. Of the funds appropriated in this section, $202,000 is
21allocated for use pursuant to section 235A.1 for continuation
22of the initiative to address child sexual abuse implemented
23pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
2421.
2515. Of the funds appropriated in this section, $630,000 is
26allocated for the community partnership for child protection
27sites.
2816. Of the funds appropriated in this section, $371,000
29is allocated for the department’s minority youth and family
30projects under the redesign of the child welfare system.
3117. Of the funds appropriated in this section, $851,000
32is allocated for funding of the community circle of care
33collaboration for children and youth in northeast Iowa.
3418. Of the funds appropriated in this section, at least
35$147,000 shall be used for the continuation of the child
-34-1welfare provider training program.
219. Of the funds appropriated in this section, $211,000
3shall be used for continuation of the central Iowa system of
4care program grant for the purposes of funding community-based
5services and other supports with a system of care approach for
6children with serious emotional disturbance and their families
7through a nonprofit provider that is located in a county
8with a population of more than 450,000 according to the 2020
9certified federal census, is licensed as a psychiatric medical
10institution for children, and was a system of care grantee
11prior to July 1, 2022.
1220. Of the funds appropriated in this section, $235,000
13shall be used for the public purpose of the continuation
14and expansion of a system of care program grant implemented
15in Cerro Gordo and Linn counties to utilize a comprehensive
16and long-term approach for helping children and families by
17addressing the key areas in a child’s life of childhood basic
18needs, education and work, family, and community.
1921. Of the funds appropriated in this section, $110,000
20shall be used for the public purpose of funding community-based
21services and other supports with a system of care approach
22for children with a serious emotional disturbance and their
23families through a nonprofit provider of child welfare services
24that has been in existence for more than 115 years, is located
25in a county with a population of more than 230,000 according to
26the 2020 certified federal census, is licensed as a psychiatric
27medical institution for children, and was a system of care
28grantee prior to July 1, 2022.
2922. If a separate funding source is identified that reduces
30the need for state funds within an allocation under this
31section, the allocated state funds may be redistributed to
32other allocations under this section for the same fiscal year.
3323. Of the funds appropriated in this section, a portion may
34be used for family-centered services for purposes of complying
35with the federal Family First Prevention Services Act of 2018,
-35-1Pub.L. No.115-123, and successor legislation.
2 Sec. 20. ADOPTION SUBSIDY.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2022, and ending June 30, 2023, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8a. For adoption subsidy payments and related costs and for
9other services provided for under paragraph “b”, subparagraph
10(2):
.................................................. $1140,596,007
12b. (1) Of the funds appropriated in this section, a
13sufficient amount is allocated for adoption subsidy payments
14and related costs.
15(2) Any funds appropriated in this section remaining after
16the allocation under subparagraph (1) are designated and
17allocated as state savings resulting from implementation of
18the federal Fostering Connections to Success and Increasing
19Adoptions Act of 2008, Pub.L. No.110-351, and successor
20legislation, as determined in accordance with 42 U.S.C.
21§673(a)(8), and shall be used for post-adoption services and
22for other purposes allowed under these federal laws, Tit.IV-B
23or Tit.IV-E of the federal Social Security Act.
24(a) The department of human services may transfer funds
25allocated in this subparagraph (2) to the appropriation for
26child and family services in this division of this Act for the
27purposes designated in this subparagraph (2).
28(b) Notwithstanding section 8.33, moneys allocated
29under this subparagraph (2) shall not revert to any fund but
30shall remain available for the purposes designated in this
31subparagraph (2) until expended.
322. The department may transfer funds appropriated in
33this section to the appropriation made in this division of
34this Act for general administration for costs paid from the
35appropriation relating to adoption subsidy.
-36- 13. Federal funds received by the state during the
2fiscal year beginning July 1, 2022, as the result of the
3expenditure of state funds during a previous state fiscal
4year for a service or activity funded under this section are
5appropriated to the department to be used as additional funding
6for the services and activities funded under this section.
7Notwithstanding section 8.33, moneys received in accordance
8with this subsection that remain unencumbered or unobligated
9at the close of the fiscal year shall not revert to any fund
10but shall remain available for expenditure for the purposes
11designated until the close of the succeeding fiscal year.
12 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited
13in the juvenile detention home fund created in section 232.142
14during the fiscal year beginning July 1, 2022, and ending June
1530, 2023, are appropriated to the department of human services
16for the fiscal year beginning July 1, 2022, and ending June 30,
172023, for distribution of an amount equal to a percentage of
18the costs of the establishment, improvement, operation, and
19maintenance of county or multicounty juvenile detention homes
20in the fiscal year beginning July 1, 2021. Moneys appropriated
21for distribution in accordance with this section shall be
22allocated among eligible detention homes, prorated on the basis
23of an eligible detention home’s proportion of the costs of all
24eligible detention homes in the fiscal year beginning July
251, 2021. The percentage figure shall be determined by the
26department based on the amount available for distribution for
27the fund. Notwithstanding section 232.142, subsection 3, the
28financial aid payable by the state under that provision for the
29fiscal year beginning July 1, 2022, shall be limited to the
30amount appropriated for the purposes of this section.
31 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM.
321. There is appropriated from the general fund of the
33state to the department of human services for the fiscal year
34beginning July 1, 2022, and ending June 30, 2023, the following
35amount, or so much thereof as is necessary, to be used for the
-37-1purpose designated:
2For the family support subsidy program subject to the
3enrollment restrictions in section 225C.37, subsection 3:
.................................................. $4949,282
52. At least $931,536 of the moneys appropriated in this
6section is transferred to the department of public health for
7the family support center component of the comprehensive family
8support program under chapter 225C, subchapter V.
93. If at any time during the fiscal year, the amount of
10funding available for the family support subsidy program
11is reduced from the amount initially used to establish the
12figure for the number of family members for whom a subsidy
13is to be provided at any one time during the fiscal year,
14notwithstanding section 225C.38, subsection 2, the department
15shall revise the figure as necessary to conform to the amount
16of funding available.
17 Sec. 23. CONNER DECREE. There is appropriated from the
18general fund of the state to the department of human services
19for the fiscal year beginning July 1, 2022, and ending June 30,
202023, the following amount, or so much thereof as is necessary,
21to be used for the purpose designated:
22For building community capacity through the coordination
23and provision of training opportunities in accordance with the
24consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
25Iowa, July 14, 1994):
.................................................. $2633,632
27 Sec. 24. MENTAL HEALTH INSTITUTES.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2022, and ending June 30, 2023, the following
31amounts, or so much thereof as is necessary, to be used for the
32purposes designated:
33a. For operation of the state mental health institute at
34Cherokee as required by chapters 218 and 226 for salaries,
35support, maintenance, and miscellaneous purposes:
-38-.................................................. $115,613,624
2b. For operation of the state mental health institute at
3Independence as required by chapters 218 and 226 for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $519,688,928
62. a. Notwithstanding sections 218.78 and 249A.11, any
7revenue received from the state mental health institute at
8Cherokee or the state mental health institute at Independence
9pursuant to 42 C.F.R§438.6(e) may be retained and expended by
10the mental health institute.
11b. Notwithstanding sections 218.78 and 249A.11, any
12COVID-19 related funding received through federal funding
13sources by the state mental health institute at Cherokee or the
14state mental health institute at Independence may be retained
15and expended by the mental health institute.
163. Notwithstanding any provision of law to the contrary,
17a Medicaid member residing at the state mental health
18institute at Cherokee or the state mental health institute
19at Independence shall retain Medicaid eligibility during
20the period of the Medicaid member’s stay for which federal
21financial participation is available.
224. Notwithstanding section 8.33, moneys appropriated in
23this section that remain unencumbered or unobligated at the
24close of the fiscal year shall not revert but shall remain
25available for expenditure for the purposes designated until the
26close of the succeeding fiscal year.
27 Sec. 25. STATE RESOURCE CENTERS.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2022, and ending June 30, 2023, the following
31amounts, or so much thereof as is necessary, to be used for the
32purposes designated:
33a. For the state resource center at Glenwood for salaries,
34support, maintenance, and miscellaneous purposes:
.................................................. $3516,288,739
-39- 1b. For the state resource center at Woodward for salaries,
2support, maintenance, and miscellaneous purposes:
.................................................. $313,409,294
42. The department may continue to bill for state resource
5center services utilizing a scope of services approach used for
6private providers of intermediate care facilities for persons
7with an intellectual disability services, in a manner which
8does not shift costs between the medical assistance program,
9mental health and disability services regions, or other sources
10of funding for the state resource centers.
113. The state resource centers may expand the time-limited
12assessment and respite services during the fiscal year.
134. If the department’s administration and the department
14of management concur with a finding by a state resource
15center’s superintendent that projected revenues can reasonably
16be expected to pay the salary and support costs for a new
17employee position, or that such costs for adding a particular
18number of new positions for the fiscal year would be less
19than the overtime costs if new positions would not be added,
20the superintendent may add the new position or positions. If
21the vacant positions available to a resource center do not
22include the position classification desired to be filled, the
23state resource center’s superintendent may reclassify any
24vacant position as necessary to fill the desired position. The
25superintendents of the state resource centers may, by mutual
26agreement, pool vacant positions and position classifications
27during the course of the fiscal year in order to assist one
28another in filling necessary positions.
295. If existing capacity limitations are reached in
30operating units, a waiting list is in effect for a service or
31a special need for which a payment source or other funding
32is available for the service or to address the special need,
33and facilities for the service or to address the special need
34can be provided within the available payment source or other
35funding, the superintendent of a state resource center may
-40-1authorize opening not more than two units or other facilities
2and begin implementing the service or addressing the special
3need during fiscal year 2022-2023.
46. Notwithstanding section 8.33, and notwithstanding
5the amount limitation specified in section 222.92, moneys
6appropriated in this section that remain unencumbered or
7unobligated at the close of the fiscal year shall not revert
8but shall remain available for expenditure for the purposes
9designated until the close of the succeeding fiscal year.
10 Sec. 26. SEXUALLY VIOLENT PREDATORS.
111. There is appropriated from the general fund of the
12state to the department of human services for the fiscal year
13beginning July 1, 2022, and ending June 30, 2023, the following
14amount, or so much thereof as is necessary, to be used for the
15purpose designated:
16For costs associated with the commitment and treatment of
17sexually violent predators in the unit located at the state
18mental health institute at Cherokee, including costs of legal
19services and other associated costs, including salaries,
20support, maintenance, and miscellaneous purposes:
.................................................. $2113,891,276
222. Unless specifically prohibited by law, if the amount
23charged provides for recoupment of at least the entire amount
24of direct and indirect costs, the department of human services
25may contract with other states to provide care and treatment
26of persons placed by the other states at the unit for sexually
27violent predators at Cherokee. The moneys received under
28such a contract shall be considered to be repayment receipts
29and used for the purposes of the appropriation made in this
30section.
313. Notwithstanding section 8.33, moneys appropriated in
32this section that remain unencumbered or unobligated at the
33close of the fiscal year shall not revert but shall remain
34available for expenditure for the purposes designated until the
35close of the succeeding fiscal year.
-41-1 Sec. 27. FIELD OPERATIONS.
21. There is appropriated from the general fund of the
3state to the department of human services for the fiscal year
4beginning July 1, 2022, and ending June 30, 2023, the following
5amount, or so much thereof as is necessary, to be used for the
6purposes designated:
7For field operations, including salaries, support,
8maintenance, and miscellaneous purposes:
.................................................. $965,894,438
102. Priority in filling full-time equivalent positions
11shall be given to those positions related to child protection
12services and eligibility determination for low-income families.
13 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
14from the general fund of the state to the department of human
15services for the fiscal year beginning July 1, 2022, and ending
16June 30, 2023, the following amount, or so much thereof as is
17necessary, to be used for the purpose designated:
18For general administration, including salaries, support,
19maintenance, and miscellaneous purposes:
.................................................. $2015,342,189
211. The department shall report at least monthly to the
22general assembly concerning the department’s operational and
23program expenditures.
242. Of the funds appropriated in this section, $150,000 shall
25be used for the provision of a program to provide technical
26assistance, support, and consultation to providers of home and
27community-based services under the medical assistance program.
283. Of the funds appropriated in this section, $50,000
29is transferred to the Iowa finance authority to be used
30for administrative support of the council on homelessness
31established in section 16.2D and for the council to fulfill its
32duties in addressing and reducing homelessness in the state.
334. Of the funds appropriated in this section, $200,000 shall
34be transferred to and deposited in the administrative fund of
35the Iowa ABLE savings plan trust created in section 12I.4, to
-42-1be used for implementation and administration activities of the
2Iowa ABLE savings plan trust.
35. Of the funds appropriated in this section, $200,000 is
4transferred to the economic development authority for the Iowa
5commission on volunteer services to continue to be used for the
6RefugeeRISE AmeriCorps program established under section 15H.8
7for member recruitment and training to improve the economic
8well-being and health of economically disadvantaged refugees in
9local communities across Iowa. Funds transferred may be used
10to supplement federal funds under federal regulations.
116. Of the funds appropriated in this section, up to $300,000
12shall be used as follows:
13a. To fund not more than 1.00 full-time equivalent position
14to address the department’s responsibility to support the work
15of the children’s behavioral health system state board and
16implementation of the services required pursuant to section
17331.397.
18b. To support the cost of establishing and implementing new
19or additional services required pursuant to sections 331.397
20and 331.397A.
21c. Of the amount allocated, $32,000 shall be transferred
22to the department of public health to support the costs of
23establishing and implementing new or additional services
24required pursuant to sections 331.397 and 331.397A.
257. Of the funds appropriated in this section, $800,000 shall
26be used for the renovation and construction of certain nursing
27facilities, consistent with the provisions of chapter 249K.
28 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated
29from the general fund of the state to the department of human
30services for the fiscal year beginning July 1, 2022, and ending
31June 30, 2023, the following amount, or so much thereof as is
32necessary, to be used for the purposes designated:
33For salaries, support, maintenance, and miscellaneous
34purposes at facilities under the purview of the department of
35human services:
-43-.................................................. $14,172,123
2 Sec. 30. VOLUNTEERS. There is appropriated from the general
3fund of the state to the department of human services for the
4fiscal year beginning July 1, 2022, and ending June 30, 2023,
5the following amount, or so much thereof as is necessary, to be
6used for the purpose designated:
7For development and coordination of volunteer services:
.................................................. $884,686
9 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
10ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
11DEPARTMENT OF HUMAN SERVICES.
121. a. (1) (a) Notwithstanding any provision of law to the
13contrary, for the fiscal year beginning July 1, 2022, case-mix
14nursing facilities shall be reimbursed in accordance with the
15methodology in effect on June 30, 2022.
16(b) For the fiscal year beginning July 1, 2022, non-case-mix
17and special population nursing facilities shall be reimbursed
18in accordance with the methodology in effect on June 30, 2022.
19(c) For managed care claims, the department of human
20services shall adjust the payment rate floor for nursing
21facilities, annually, to maintain a rate floor that is no
22lower than the Medicaid fee-for-service case-mix adjusted rate
23calculated in accordance with subparagraph division (a) and
24441 IAC 81.6. The department shall then calculate adjusted
25reimbursement rates, including but not limited to add-on
26payments, annually, and shall notify Medicaid managed care
27organizations of the adjusted reimbursement rates within 30
28days of determining the adjusted reimbursement rates. Any
29adjustment of reimbursement rates under this subparagraph
30division shall be budget neutral to the state budget.
31(d) For the fiscal year beginning July 1, 2022, Medicaid
32managed care long-term services and supports capitation rates
33shall be adjusted to reflect the case-mix adjusted rates
34specified pursuant to subparagraph division (a) for the patient
35populations residing in Medicaid-certified nursing facilities.
-44- 1(2) Medicaid managed care organizations shall adjust
2facility-specific rates based upon payment rate listings issued
3by the department. The rate adjustments shall be applied
4prospectively from the effective date of the rate letter issued
5by the department.
6b. (1) For the fiscal year beginning July 1, 2022, the
7department shall establish the fee-for-service pharmacy
8dispensing fee reimbursement at $10.38 per prescription,
9until a cost of dispensing survey is completed. The actual
10dispensing fee shall be determined by a cost of dispensing
11survey performed by the department and required to be completed
12by all medical assistance program participating pharmacies
13every two years, adjusted as necessary to maintain expenditures
14within the amount appropriated to the department for this
15purpose for the fiscal year. A change in the dispensing
16fee shall become effective following federal approval of the
17Medicaid state plan.
18(2) The department shall utilize an average acquisition
19cost reimbursement methodology for all drugs covered under the
20medical assistance program in accordance with 2012 Iowa Acts,
21chapter 1133, section 33.
22c. (1) For the fiscal year beginning July 1, 2022,
23reimbursement rates for outpatient hospital services shall
24remain at the rates in effect on June 30, 2022, subject to
25Medicaid program upper payment limit rules, and adjusted
26as necessary to maintain expenditures within the amount
27appropriated to the department for this purpose for the fiscal
28year.
29(2) For the fiscal year beginning July 1, 2022,
30reimbursement rates for inpatient hospital services shall
31remain at the rates in effect on June 30, 2022, subject to
32Medicaid program upper payment limit rules, and adjusted
33as necessary to maintain expenditures within the amount
34appropriated to the department for this purpose for the fiscal
35year.
-45- 1(3) For the fiscal year beginning July 1, 2022, under
2both fee-for-service and managed care administration of
3the Medicaid program, critical access hospitals shall be
4reimbursed for inpatient and outpatient services based on the
5hospital-specific critical access hospital cost adjustment
6factor methodology utilizing the most recent and complete cost
7reporting period as applied prospectively within the funds
8appropriated for such purpose for the fiscal year.
9(4) For the fiscal year beginning July 1, 2022, the graduate
10medical education and disproportionate share hospital fund
11shall remain at the amount in effect on June 30, 2022, except
12that the portion of the fund attributable to graduate medical
13education shall be reduced in an amount that reflects the
14elimination of graduate medical education payments made to
15out-of-state hospitals.
16(5) In order to ensure the efficient use of limited state
17funds in procuring health care services for low-income Iowans,
18funds appropriated in this Act for hospital services shall
19not be used for activities which would be excluded from a
20determination of reasonable costs under the federal Medicare
21program pursuant to 42 U.S.C.§1395x(v)(1)(N).
22d. For the fiscal year beginning July 1, 2022, reimbursement
23rates for hospices and acute psychiatric hospitals shall be
24increased in accordance with increases under the federal
25Medicare program or as supported by their Medicare audited
26costs.
27e. For the fiscal year beginning July 1, 2022, independent
28laboratories and rehabilitation agencies shall be reimbursed
29using the same methodology in effect on June 30, 2022.
30f. (1) For the fiscal year beginning July 1, 2022,
31reimbursement rates for home health agencies shall continue to
32be based on the Medicare low utilization payment adjustment
33(LUPA) methodology with state geographic wage adjustments. The
34department shall continue to update the rates every two years
35to reflect the most recent Medicare LUPA rates.
-46- 1(2) For the fiscal year beginning July 1, 2022, rates for
2private duty nursing and personal care services under the early
3and periodic screening, diagnostic, and treatment program
4benefit shall be calculated based on the methodology in effect
5on June 30, 2022.
6g. For the fiscal year beginning July 1, 2022, federally
7qualified health centers and rural health clinics shall receive
8cost-based reimbursement for 100 percent of the reasonable
9costs for the provision of services to recipients of medical
10assistance.
11h. For the fiscal year beginning July 1, 2022, the
12reimbursement rates for dental services shall remain at the
13rates in effect on June 30, 2022.
14i. (1) For the fiscal year beginning July 1, 2022,
15reimbursement rates for non-state-owned psychiatric medical
16institutions for children shall be based on the reimbursement
17methodology in effect on June 30, 2022.
18(2) As a condition of participation in the medical
19assistance program, enrolled providers shall accept the medical
20assistance reimbursement rate for any covered goods or services
21provided to recipients of medical assistance who are children
22under the custody of a psychiatric medical institution for
23children.
24j. For the fiscal year beginning July 1, 2022, unless
25otherwise specified in this Act, all noninstitutional medical
26assistance provider reimbursement rates shall remain at the
27rates in effect on June 30, 2022, except for area education
28agencies, local education agencies, infant and toddler
29services providers, home and community-based services providers
30including consumer-directed attendant care providers under a
31section 1915(c) or 1915(i) waiver, targeted case management
32providers, and those providers whose rates are required to be
33determined pursuant to section 249A.20, or to meet federal
34mental health parity requirements.
35k. Notwithstanding any provision to the contrary, for the
-47-1fiscal year beginning July 1, 2022, the reimbursement rate for
2anesthesiologists shall remain at the rates in effect on June
330, 2022, and updated on January 1, 2023, to align with the
4most current Iowa Medicare anesthesia rate.
5l. Notwithstanding section 249A.20, for the fiscal year
6beginning July 1, 2022, the average reimbursement rate for
7health care providers eligible for use of the federal Medicare
8resource-based relative value scale reimbursement methodology
9under section 249A.20 shall remain at the rate in effect on
10June 30, 2022; however, this rate shall not exceed the maximum
11level authorized by the federal government.
12m. For the fiscal year beginning July 1, 2022, the
13reimbursement rate for residential care facilities shall not
14be less than the minimum payment level as established by the
15federal government to meet the federally mandated maintenance
16of effort requirement. The flat reimbursement rate for
17facilities electing not to file annual cost reports shall not
18be less than the minimum payment level as established by the
19federal government to meet the federally mandated maintenance
20of effort requirement.
21n. For the fiscal year beginning July 1, 2022, the
22reimbursement rates for inpatient mental health services
23provided at hospitals shall remain at the rates in effect on
24June 30, 2022, subject to Medicaid program upper payment limit
25rules and adjusted as necessary to maintain expenditures within
26the amount appropriated to the department for this purpose for
27the fiscal year; and psychiatrists shall be reimbursed at the
28medical assistance program fee-for-service rate in effect on
29June 30, 2022.
30o. For the fiscal year beginning July 1, 2022, community
31mental health centers may choose to be reimbursed for the
32services provided to recipients of medical assistance through
33either of the following options:
34(1) For 100 percent of the reasonable costs of the services.
35(2) In accordance with the alternative reimbursement rate
-48-1methodology approved by the department of human services in
2effect on June 30, 2022.
3p. For the fiscal year beginning July 1, 2022, the
4reimbursement rate for providers of family planning services
5that are eligible to receive a 90 percent federal match shall
6remain at the rates in effect on June 30, 2022.
7q. (1) For the fiscal year beginning July 1, 2022,
8reimbursement rates for providers of home and community-based
9services waiver and habilitation services shall remain at the
10rates in effect on June 30, 2022.
11(2) For the fiscal year beginning July 1, 2022,
12reimbursement rates for providers of state plan home and
13community-based services home-based habilitation services
14shall remain at the rates in effect on June 30, 2022. The
15reimbursement rates for home-based habilitation services shall
16be based on a fee schedule that incorporates the acuity-based
17tiers.
18r. For the fiscal year beginning July 1, 2022, the
19reimbursement rates for emergency medical service providers
20shall remain at the rates in effect on June 30, 2022, 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, 2022, reimbursement
24rates for substance-related disorder treatment programs
25licensed under section 125.13 shall remain at the rates in
26effect on June 30, 2022.
27t. For the fiscal year beginning July 1, 2022, assertive
28community treatment per diem rates shall remain at the rates in
29effect on June 30, 2022.
30u. For the fiscal year beginning July 1, 2022, the
31reimbursement rate for family-centered services providers shall
32be established by contract.
33v. For the fiscal year beginning July 1, 2022, the
34reimbursement rate for air ambulance services shall remain at
35the rate in effect on June 30, 2022.
-49- 12. For the fiscal year beginning July 1, 2022, the
2reimbursement rate for providers reimbursed under the
3in-home-related care program shall not be less than the minimum
4payment level as established by the federal government to meet
5the federally mandated maintenance of effort requirement.
63. Unless otherwise directed in this section, when the
7department’s reimbursement methodology for any provider
8reimbursed in accordance with this section includes an
9inflation factor, this factor shall not exceed the amount
10by which the consumer price index for all urban consumers
11increased during the calendar year ending December 31, 2002.
124. Notwithstanding section 234.38, for the fiscal
13year beginning July 1, 2022, the foster family basic daily
14maintenance rate and the maximum adoption subsidy rate for
15children ages 0 through 5 years shall be $16.78, the rate for
16children ages 6 through 11 years shall be $17.45, the rate for
17children ages 12 through 15 years shall be $19.10, and the
18rate for children and young adults ages 16 and older shall
19be $19.35. For youth ages 18 to 23 who have exited foster
20care, the preparation for adult living program maintenance
21rate shall be up to $602.70 per month as calculated based on
22the age of the participant. The maximum payment for adoption
23subsidy nonrecurring expenses shall be limited to $500 and the
24disallowance of additional amounts for court costs and other
25related legal expenses implemented pursuant to 2010 Iowa Acts,
26chapter 1031, section 408, shall be continued.
275. For the fiscal year beginning July 1, 2022, the maximum
28reimbursement rates for social services providers under
29contract shall remain at the rates in effect on June 30, 2022,
30or the provider’s actual and allowable cost plus inflation for
31each service, whichever is less. However, if a new service
32or service provider is added after June 30, 2022, the initial
33reimbursement rate for the service or provider shall be based
34upon a weighted average of provider rates for similar services.
356. a. For the fiscal year beginning July 1, 2022, the
-50-1reimbursement rates for resource family recruitment and
2retention contractors shall be established by contract.
3b. For the fiscal year beginning July 1, 2022, the
4reimbursement rates for supervised apartment living foster care
5providers shall be established by contract.
67. For the fiscal year beginning July 1, 2022, the
7reimbursement rate for group foster care providers shall be the
8combined service and maintenance reimbursement rate established
9by contract.
108. The group foster care reimbursement rates paid for
11placement of children out of state shall be calculated
12according to the same rate-setting principles as those used for
13in-state providers, unless the director of human services or
14the director’s designee determines that appropriate care cannot
15be provided within the state. The payment of the daily rate
16shall be based on the number of days in the calendar month in
17which service is provided.
189. a. For the fiscal year beginning July 1, 2022, the
19reimbursement rate paid for shelter care and the child welfare
20emergency services implemented to provide or prevent the need
21for shelter care shall be the combined service and maintenance
22rate established by contract.
23b. For the fiscal year beginning July 1, 2022, the combined
24service and maintenance components of the reimbursement rate
25paid for shelter care services shall be based on the financial
26and statistical report submitted to the department.
2710. For the fiscal year beginning July 1, 2022, the
28department shall calculate reimbursement rates for intermediate
29care facilities for persons with an intellectual disability
30at the 80th percentile. Beginning July 1, 2022, the rate
31calculation methodology shall utilize the consumer price index
32inflation factor applicable to the fiscal year beginning July
331, 2022.
3411. Effective July 1, 2022, child care provider
35reimbursement rates shall remain at the rates in effect on June
-51-130, 2022. The department shall set rates in a manner so as
2to provide incentives for a nonregistered provider to become
3registered by applying any increase only to registered and
4licensed providers.
512. The department may adopt emergency rules to implement
6this section.
7 Sec. 32. EMERGENCY RULES.
81. If necessary to comply with federal requirements
9including time frames, or if specifically authorized by a
10provision of this division of this Act, the department of
11human services or the mental health and disability services
12commission may adopt administrative rules under section 17A.4,
13subsection 3, and section 17A.5, subsection 2, paragraph “b”,
14to implement the provisions of this division of this Act and
15the rules shall become effective immediately upon filing or
16on a later effective date specified in the rules, unless the
17effective date of the rules is delayed or the applicability
18of the rules is suspended by the administrative rules review
19committee. Any rules adopted in accordance with this section
20shall not take effect before the rules are reviewed by the
21administrative rules review committee. The delay authority
22provided to the administrative rules review committee under
23section 17A.4, subsection 7, and section 17A.8, subsections
249 and 10, shall be applicable to a delay imposed under this
25section, notwithstanding a provision in those subsections
26making them inapplicable to section 17A.5, subsection 2,
27paragraph “b”. Any rules adopted in accordance with the
28provisions of this section shall also be published as a notice
29of intended action as provided in section 17A.4.
302. If during a fiscal year, the department of human
31services is adopting rules in accordance with this section
32or as otherwise directed or authorized by state law, and
33the rules will result in an expenditure increase beyond the
34amount anticipated in the budget process or if the expenditure
35was not addressed in the budget process for the fiscal
-52-1year, the department shall notify the general assembly and
2the department of management concerning the rules and the
3expenditure increase. The notification shall be provided at
4least 30 calendar days prior to the date notice of the rules
5is submitted to the administrative rules coordinator and the
6administrative code editor.
7 Sec. 33. REPORTS. Unless otherwise provided, any reports or
8other information required to be compiled and submitted under
9this Act during the fiscal year beginning July 1, 2022, shall
10be submitted on or before the dates specified for submission
11of the reports or information.
12 Sec. 34. EFFECTIVE UPON ENACTMENT. The following provision
13of this division of this Act, being deemed of immediate
14importance, takes effect upon enactment:
15The provision relating to section 232.141 and directing the
16state court administrator and the division administrator of
17the department of human services division of child and family
18services to make the determination, by June 15, 2022, of the
19distribution of funds allocated for the payment of the expenses
20of court-ordered services provided to juveniles which are a
21charge upon the state.
22DIVISION VI
23HEALTH CARE ACCOUNTS AND FUNDS — FY 2022-2023
24 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
25appropriated from the pharmaceutical settlement account created
26in section 249A.33 to the department of human services for the
27fiscal year beginning July 1, 2022, and ending June 30, 2023,
28the following amount, or so much thereof as is necessary, to be
29used for the purpose designated:
30Notwithstanding any provision of law to the contrary, to
31supplement the appropriations made in this Act for health
32program operations under the medical assistance program for the
33fiscal year beginning July 1, 2022, and ending June 30, 2023:
.................................................. $34234,193
35 Sec. 36. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
-53-1SERVICES. Notwithstanding any provision to the contrary and
2subject to the availability of funds, there is appropriated
3from the quality assurance trust fund created in section
4249L.4 to the department of human services for the fiscal year
5beginning July 1, 2022, and ending June 30, 2023, the following
6amounts, or so much thereof as is necessary, for the purposes
7designated:
8To supplement the appropriation made in this Act from the
9general fund of the state to the department of human services
10for medical assistance for the same fiscal year:
.................................................. $1156,305,139
12 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
13DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
14the contrary and subject to the availability of funds, there is
15appropriated from the hospital health care access trust fund
16created in section 249M.4 to the department of human services
17for the fiscal year beginning July 1, 2022, and ending June
1830, 2023, the following amounts, or so much thereof as is
19necessary, for the purposes designated:
20To supplement the appropriation made in this Act from the
21general fund of the state to the department of human services
22for medical assistance for the same fiscal year:
.................................................. $2333,920,554
24 Sec. 38. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
25FOR FY 2022-2023. Notwithstanding section 8.33, if moneys
26appropriated for purposes of the medical assistance program for
27the fiscal year beginning July 1, 2022, and ending June 30,
282023, from the general fund of the state, the quality assurance
29trust fund, and the hospital health care access trust fund, are
30in excess of actual expenditures for the medical assistance
31program and remain unencumbered or unobligated at the close
32of the fiscal year, the excess moneys shall not revert but
33shall remain available for expenditure for the purposes of the
34medical assistance program until the close of the succeeding
35fiscal year.
-54-1DIVISION VII
2DECATEGORIZATION CARRYOVER FUNDING
3 Sec. 39. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —
4TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
5subsection 5, paragraph “b”, any state-appropriated moneys in
6the funding pool that remained unencumbered or unobligated
7at the close of the fiscal year beginning July 1, 2019, and
8were deemed carryover funding to remain available for the two
9succeeding fiscal years that still remain unencumbered or
10unobligated at the close of the fiscal year beginning July 1,
112021, shall not revert but shall be transferred to the medical
12assistance program for the fiscal year beginning July 1, 2022.
13 Sec. 40. EFFECTIVE DATE. This division of this Act, being
14deemed of immediate importance, takes effect upon enactment.
15 Sec. 41. RETROACTIVE APPLICABILITY. This division of this
16Act applies retroactively to July 1, 2021.
17DIVISION VIII
18TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE
19 Sec. 42. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —
20FY2021-2022. Notwithstanding any provision to the contrary,
21any funds remaining in the property tax relief fund created
22in section 426B.1 at the close of the fiscal year beginning
23July 1, 2021, shall be transferred to the region incentive fund
24created in the mental health and disability services regional
25service fund pursuant to section 225C.7A.
26 Sec. 43. EFFECTIVE DATE. This division of this Act, being
27deemed of immediate importance, takes effect upon enactment.
28DIVISION IX
29PRIOR APPROPRIATIONS AND OTHER PROVISIONS
30FAMILY INVESTMENT PROGRAM GENERAL FUND
31 Sec. 44. 2021 Iowa Acts, chapter 182, section 9, is amended
32by adding the following new subsection:
33 NEW SUBSECTION. 7. Notwithstanding section 8.33, moneys
34appropriated in this section that remain unencumbered or
35unobligated at the close of the fiscal year shall not revert
-55-1but shall remain available for one-time expenditure purposes,
2and may be transferred to the appropriation in this division of
3this Act for general administration for technology purposes,
4until the close of the succeeding fiscal year.
5CHILD AND FAMILY SERVICES
6 Sec. 45. 2021 Iowa Acts, chapter 182, section 19, is amended
7by adding the following new subsection:
8 NEW SUBSECTION. 24. Notwithstanding section 8.33, moneys
9appropriated in this section that remain unencumbered or
10unobligated at the close of the fiscal year shall not revert
11but shall remain available for the purposes designated until
12the close of the succeeding fiscal year.
13GENERAL ADMINISTRATION
14 Sec. 46. 2021 Iowa Acts, chapter 182, section 28, is amended
15by adding the following new subsection:
16 NEW SUBSECTION. 8. Notwithstanding section 8.33, 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 one-time expenditure purposes
20until the close of the succeeding fiscal year.
21 Sec. 47. EFFECTIVE DATE. This division of this Act, being
22deemed of immediate importance, takes effect upon enactment.
23DIVISION X
24PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS
25 Sec. 48. COVID-19 FEDERAL REGULATIONS. For the time
26period beginning on the effective date of this division of
27this Act, and ending June 30, 2023, notwithstanding state
28administrative rules to the contrary, to the extent federal
29regulations relating to the COVID-19 pandemic differ from state
30administrative rules, including applicable federal waivers,
31the federal regulations are controlling during the pendency of
32the federally declared state of emergency and for such period
33of time following the end of the federally declared state of
34emergency applicable to the respective federal regulations.
35DIVISION XI
-56-1HEALTH AND HUMAN SERVICES REALIGNMENT
2 Sec. 49. TRANSITION OF DEPARTMENT OF HUMAN SERVICES AND
3DEPARTMENT OF PUBLIC HEALTH INTO DEPARTMENT OF HEALTH AND HUMAN
4SERVICES.
51. Definitions. For the purposes of this section:
6a. “Department of health and human services” or
7“department” means the department of health and human services
8created under this section.
9b. “Transition department” means the department of human
10services or the department of public health.
11c. “Transition departments” means the department of human
12services and the department of public health.
13d. “Transition period” means the period beginning July 1,
142022, and ending June 30, 2023.
152. Creation of department of health and human services
16— transition period — powers and duties. Notwithstanding
17any conflicting provision of law to the contrary, there is
18created a department of health and human services. During
19the transition period, the department of health and human
20services shall have and may exercise all of the policymaking
21functions, regulatory and enforcement powers, rights, duties,
22and responsibilities of the department of human services and
23the department of public health as prescribed by law or rule
24in effect on July 1, 2022, including but not limited to those
25relating to:
26a. All obligations and contracts of a transition
27department, including obligations and contracts related to a
28grant program.
29b. All property and records in the custody of a transition
30department.
31c. All funds appropriated to a transition department by the
32general assembly and all state, federal, and other funds for
33which expenditure by a transition department is authorized.
34d. Complaints, investigations, contested cases, causes of
35action, and statutes of limitations involving a transition
-57-1department.
2(1) All complaints, investigations, contested cases, or
3a remand of an action by a reviewing court pending before a
4transition department or an authorized person of a transition
5department shall continue without change in status before
6the department and shall be governed by the laws and rules
7applicable to the complaint, investigation, contested case, or
8remand action or proceeding in effect on July 1, 2022.
9(2) Any cause of action or statute of limitation relating
10to a transition department shall not be affected as a result
11of the transition and such cause of action or statute of
12limitation shall apply to the department.
13e. Rules, policies, and forms. All rules, policies, and
14forms adopted by or on behalf of a transition department shall
15become rules, policies, and forms of the department and shall
16remain in effect unless altered by the department.
17f. Licenses, permits, and certifications. All licenses,
18permits, and certifications issued by a transition department
19shall continue in effect as a license, permit, or certification
20of the department in accordance with the law or rule governing
21the license, permit, or certification in effect on July 1,
222022, until the license, permit, or certification expires, is
23suspended or revoked, or otherwise becomes invalid by the terms
24of such law or rule.
25g. References to a department or director. All references
26to the department of public health or the department of human
27services in law or in rule shall be interpreted to mean the
28department of health and human services, and all references to
29the director of public health or the director of human services
30shall be interpreted to mean the director of the department of
31health and human services.
32h. Departmental structure.
33(1) Any transition department, transition department
34subunit, or transition department body created or established
35by law and in existence on July 1, 2022, shall continue in
-58-1full force and effect and shall not be permanently abolished,
2merged, or otherwise altered until amended, repealed, or
3supplemented by action of the general assembly.
4(2) This paragraph shall not prohibit a transition
5department, transition department subunit, or transition
6department body created or established by law in existence on
7July 1, 2022, from sharing or coordinating responsibilities
8or functions under their respective purviews nor prohibit
9the director from temporarily integrating such departments,
10subunits, or bodies or the responsibilities or functions under
11their respective purviews in furtherance of the transition plan
12during the transition period.
133. Transition period leadership. During the transition
14period, the director of human services shall continue to act
15as the director of human services, shall assume the duties of
16the director of public health, shall act as the director of
17the department of health and human services, and may thereby
18exercise any policymaking functions, regulatory and enforcement
19powers, rights, duties, and responsibilities of the director
20of human services and the director of public health including
21those duties prescribed by law for the department of human
22services or the department of public health in effect on July
231, 2022.
244. Federal authorization and effective date of
25authorizations. If a transition department or the department
26determines that a waiver or authorization from the federal
27government is necessary to administer any provision of
28this section, the department shall request the waiver or
29authorization, and notwithstanding any other effective date to
30the contrary, the provision shall take effect only upon receipt
31of federal approval.
325. Initial written transition plan.
33a. On or before September 30, 2022, the transition
34departments or department shall publish on their respective
35internet sites an initial written transition plan for merging
-59-1the functions of the transition departments into the department
2of health and human services effective July 1, 2023, in order
3to do all of the following:
4(1) More efficiently and effectively manage health and
5human services programs that are the responsibility of the
6state.
7(2) Establish a health and human services policy for the
8state.
9(3) Promote health and the quality of life in the health and
10human services field.
11b. The transition plan shall describe, at a minimum, all of
12the following:
13(1) The tasks that require completion before July 1, 2023,
14including a description of how the transition departments shall
15solicit comment from stakeholders, including employees of the
16transition departments, clients and partners of the transition
17departments, members of the public, and members of the general
18assembly.
19(2) The proposed organizational structure of the
20department, at a minimum, including the division level of
21the table of organization. Any personnel in the state merit
22system of employment who are mandatorily transferred due to the
23transition shall be so transferred without any loss in salary,
24benefits, or accrued years of service.
25(3) Proposed changes to any transition department boards,
26commissions, committees, councils, or other bodies and their
27functions.
28(4) Office space and infrastructure requirements related
29to the transition.
30(5) Any work site location changes for transitioning
31employees.
32(6) The transition of service delivery sites.
33(7) Procedures for the transfer and reconciliation of
34budgeting and funding between the transition departments and
35the department.
-60- 1(8) The transition of technology services of the transition
2departments to the department.
3(9) Any additional known tasks that may require completion
4after the transition on July 1, 2023.
5c. The written transition plan published under paragraph
6“b” shall:
7(1) Include a detailed timeline for the completion of the
8tasks described.
9(2) Be updated quarterly during the remainder of the
10transition period.
11(3) Describe how information will be provided to clients
12of the transition departments and the department regarding any
13changes in service delivery.
14(4) Describe how the transition to the department will be
15funded, including how expenses associated with the transition
16will be managed; how funding for services provided by the
17transition departments will be managed to ensure provision
18of services by the transition departments and the department
19without interruption; and how federal funds will be used by
20or transferred between the transition departments and the
21department to ensure provision of services by the transition
22departments and the department without interruption.
236. Statutory and administrative rule updates.
24a. Legislative changes required to implement the
25transition. Additional legislation is necessary to fully
26implement the transition. The director of the department
27of health and human services shall, in compliance with
28section 2.16, prepare draft legislation for submission to the
29legislative services agency, as necessary, for consideration
30by the general assembly during the 2023 legislative
31session, to implement the transition effective July 1, 2023.
32Notwithstanding any provision to the contrary in section 2.16,
33the draft legislation shall be submitted to the legislative
34services agency by October 1, 2022.
35b. Update of administrative code required by the
-61-1transition. In updating references and the format in the
2Iowa administrative code, in order to correspond to the
3transferring of duties of the transition departments, the
4administrative rules coordinator and the administrative rules
5review committee, in consultation with the administrative code
6editor, shall collectively develop a schedule for the necessary
7updating of the Iowa administrative code.
8DIVISION XII
9NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY
10OF CARE RATE ADD-ON PROGRAM
11 Sec. 50. Section 249L.2, subsections 6 and 7, Code 2022, are
12amended by striking the subsections.
13 Sec. 51. Section 249L.2, subsection 8, Code 2022, is amended
14to read as follows:
158. “Nursing facility” means a licensed nursing facility as
16defined in section 135C.1 that is a freestanding facility or
17a nursing facility operated by a hospital licensed pursuant
18to chapter 135B, but does not include a distinct-part skilled
19nursing unit or a swing-bed unit operated by a hospital, or
20a nursing facility owned by the state or federal government
21or other governmental unit.“Nursing facility” includes a
22non-state government-owned nursing facility if the nursing
23facility participates in the non-state government-owned nursing
24facility quality of care rate add-on program.
25 Sec. 52. REPEAL. 2019 Iowa Acts, chapter 85, sections 103,
26104, and 108, are repealed.
27 Sec. 53. REPEAL. 2020 Iowa Acts, chapter 1063, section 390,
28is repealed.
29EXPLANATION
30The inclusion of this explanation does not constitute agreement with
31the explanation’s substance by the members of the general assembly.
32This bill relates to appropriations for health and human
33services for fiscal year 2022-2023 to the department of
34veterans affairs, Iowa veterans home, department on aging
35(IDA), office of long-term care ombudsman, department of public
-62-1health (DPH), Iowa finance authority, department of human
2rights, and department of human services (DHS). The bill is
3organized into divisions for each fiscal year.
4DEPARTMENT ON AGING. This division makes appropriations
5from the general fund of the state to the department on aging.
6OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
7appropriations from the general fund of the state to the office
8of long-term care ombudsman.
9DEPARTMENT OF PUBLIC HEALTH. This division makes
10appropriations from the general fund of the state and from
11the sports wagering receipts fund to the department of public
12health.
13DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
14division makes appropriations from the general fund of the
15state to the department of veterans affairs for administration,
16the Iowa veterans home, for transfer to the Iowa finance
17authority for the home ownership assistance program and for the
18county commissions of veteran affairs.
19DEPARTMENT OF HUMAN SERVICES. This division makes
20appropriations from the general fund of the state and the
21federal temporary assistance for needy families block
22grant to DHS. The allocation for the family development
23and self-sufficiency grant program is made directly to
24the department of human rights. The reimbursement section
25addresses reimbursement for providers reimbursed by the
26department of human services.
27HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
28health-related appropriations. A number of the appropriations
29are made for purposes of the Medicaid program in addition to
30the general fund appropriations made for this purpose for the
31same fiscal year.
32DECATEGORIZATION CARRYOVER FUNDING. This division provides
33for the transfer of carryover decategorization funds that
34remained unencumbered or unobligated at the close of the fiscal
35year beginning July 1, 2021, to the Medicaid program for
-63-1FY 2022-2023. The division takes effect upon enactment and is
2retroactively applicable to July 1, 2021.
3TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE. This division
4transfers any funds remaining in the property tax relief fund
5created in Code section 426B.1 at the close of FY 2021-2022 to
6the region incentive fund created in the mental health and
7disability services regional service fund pursuant to Code
8section 225C.7A. The division takes effect upon enactment.
9PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division
10provides that moneys appropriated for the family investment
11program general fund, child and family services and general
12administration for FY 2021-2022 shall not revert but shall
13remain available for one-time expenditure or for the purposes
14designated, or may be transferred, as specified, until the
15close of the succeeding fiscal year.
16PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS.
17 This division provides that for FY 2022-2023, notwithstanding
18state administrative rules to the contrary, to the extent
19federal regulations relating to the COVID-19 pandemic differ
20from state administrative rules, including applicable federal
21waivers, the federal regulations are controlling during the
22pendency of the federally declared state of emergency and for
23such period of time following the end of the federally declared
24state of emergency applicable to the respective federal
25regulations.
26HEALTH AND HUMAN SERVICES REALIGNMENT. This division
27provides a process during a transition period beginning July
281, 2022, and ending June 30, 2023, for the realignment of
29the department of public health and the department of human
30services into the department of health and human services
31effective July 1, 2023.
32NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY OF CARE
33RATE ADD-ON PROGRAM. This division eliminates the non-state
34government-owned nursing facility quality of care rate add-on
35program, and makes conforming changes in the Iowa Acts and the
-64-1Code.
-65-pf/rn
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2022-2023
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, 2022, and ending June 30,
62023, 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:
.................................................. $1711,804,082
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, $418,700 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, 2022.
13DIVISION II
14OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2022-2023
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, 2022, and ending June 30, 2023, 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 2022-2023
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, 2022, and ending
29June 30, 2023, 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,
332022.
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:
.................................................. $64,258,373
74. COMMUNITY CAPACITY
8For strengthening the health care delivery system at the
9local level:
.................................................. $106,519,306
11a. Of the funds appropriated in this subsection, $2,100,000
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, $800,000
19shall be used for rural psychiatric residencies to support the
20annual creation and training of six psychiatric residents who
21will provide mental health services in underserved areas of
22the state. Notwithstanding section 8.33, moneys that remain
23unencumbered or unobligated at the close of the fiscal year
24shall not revert but shall remain available for expenditure for
25the purposes designated for subsequent fiscal years.
26c. Of the funds appropriated in this subsection, $425,000
27shall be used for the creation or continuation of a center of
28excellence program to encourage innovation and collaboration
29among regional health care providers in a rural area based
30upon the results of a regional community needs assessment to
31transform health care delivery in order to provide quality,
32sustainable care that meets the needs of the local communities.
33An applicant for the funds shall specify how the funds will
34be expended to accomplish the goals of the program and shall
35provide a detailed five-year sustainability plan prior to
-5-1being awarded any funding. Following the receipt of funding,
2a recipient shall submit periodic reports as specified by the
3department to the governor and the general assembly regarding
4the recipient’s expenditure of the funds and progress in
5accomplishing the program goals.
65. ESSENTIAL PUBLIC HEALTH SERVICES
7To provide public health services that reduce risks and
8invest in promoting and protecting good health over the
9course of a lifetime with a priority given to older Iowans and
10vulnerable populations:
.................................................. $117,662,464
126. INFECTIOUS DISEASES
13For reducing the incidence and prevalence of communicable
14diseases:
.................................................. $151,796,206
167. PUBLIC PROTECTION
17a. For protecting the health and safety of the public
18through establishing standards and enforcing regulations:
.................................................. $194,706,601
20b. Of the funds appropriated in this subsection, not more
21than $304,000 shall be credited to the emergency medical
22services fund created in section 135.25. Moneys in the
23emergency medical services fund are appropriated to the
24department to be used for the purposes of the fund.
258. RESOURCE MANAGEMENT
26For establishing and sustaining the overall ability of the
27department to deliver services to the public:
.................................................. $28933,871
299. MISCELLANEOUS PROVISIONS
30The university of Iowa hospitals and clinics under the
31control of the state board of regents shall not receive
32indirect costs from the funds appropriated in this section.
33The university of Iowa hospitals and clinics billings to the
34department shall be on at least a quarterly basis.
35 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
-6-1RECEIPTS FUND. There is appropriated from the sports wagering
2receipts fund created in section 8.57, subsection 6, to the
3department of public health for the fiscal year beginning July
41, 2022, and ending June 30, 2023, the following amount, or
5so much thereof as is necessary, to be used for the purposes
6designated:
7For problem gambling and substance-related disorder
8prevention, treatment, and recovery services, including a
924-hour helpline, public information resources, professional
10training, youth prevention, and program evaluation:
.................................................. $111,750,000
12DIVISION IV
13DEPARTMENT OF VETERANS AFFAIRS — FY 2022-2023
14 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
15appropriated from the general fund of the state to the
16department of veterans affairs for the fiscal year beginning
17July 1, 2022, and ending June 30, 2023, the following amounts,
18or so much thereof as is necessary, to be used for the purposes
19designated:
201. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
21For salaries, support, maintenance, and miscellaneous
22purposes:
.................................................. $231,415,288
242. IOWA VETERANS HOME
25For salaries, support, maintenance, and miscellaneous
26purposes:
.................................................. $277,131,552
28a. The Iowa veterans home billings involving the department
29of human services shall be submitted to the department on at
30least a monthly basis.
31b. The Iowa veterans home expenditure report shall be
32submitted monthly to the general assembly.
33c. The Iowa veterans home shall continue to include in the
34annual discharge report applicant information to provide for
35the collection of demographic information including but not
-7-1limited to the number of individuals applying for admission and
2admitted or denied admittance and the basis for the admission
3or denial; the age, gender, and race of such individuals;
4and the level of care for which such individuals applied for
5admission including residential or nursing level of care.
63. HOME OWNERSHIP ASSISTANCE PROGRAM
7For transfer to the Iowa finance authority for the
8continuation of the home ownership assistance program for
9persons who are or were eligible members of the armed forces of
10the United States, pursuant to section 16.54:
.................................................. $112,000,000
12 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
13FUND STANDING APPROPRIATIONS. Notwithstanding the standing
14appropriation in section 35A.16 for the fiscal year beginning
15July 1, 2022, and ending June 30, 2023, the amount appropriated
16from the general fund of the state pursuant to that section
17for the following designated purposes shall not exceed the
18following amount:
19For the county commissions of veteran affairs fund under
20section 35A.16:
.................................................. $21990,000
22DIVISION V
23DEPARTMENT OF HUMAN SERVICES — FY 2022-2023
24 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
25GRANT. There is appropriated from the fund created in section
268.41 to the department of human services for the fiscal year
27beginning July 1, 2022, and ending June 30, 2023, from moneys
28received under the federal temporary assistance for needy
29families (TANF) block grant pursuant to the federal Personal
30Responsibility and Work Opportunity Reconciliation Act of 1996,
31Pub.L.No.104-193, and successor legislation, the following
32amounts, or so much thereof as is necessary, to be used for the
33purposes designated:
341. To be credited to the family investment program account
35and used for assistance under the family investment program
-8-1under chapter 239B:
.................................................. $25,002,006
32. To be credited to the family investment program account
4and used for the job opportunities and basic skills (JOBS)
5program and implementing family investment agreements in
6accordance with chapter 239B:
.................................................. $75,412,060
83. To be used for the family development and
9self-sufficiency grant program in accordance with section
10216A.107:
.................................................. $112,888,980
12Notwithstanding section 8.33, moneys appropriated in this
13subsection that remain unencumbered or unobligated at the close
14of the fiscal year shall not revert but shall remain available
15for expenditure for the purposes designated until the close of
16the succeeding fiscal year. However, unless such moneys are
17encumbered or obligated on or before September 30, 2023, the
18moneys shall revert.
194. For field operations:
.................................................. $2031,296,232
215. For general administration:
.................................................. $223,744,000
236. For state child care assistance:
.................................................. $2447,166,826
25a. Of the funds appropriated in this subsection,
26$26,205,412 is transferred to the child care and development
27block grant appropriation made by the Eighty-ninth General
28Assembly, 2022 session, for the federal fiscal year beginning
29October 1, 2022, and ending September 30, 2023. Of this
30amount, $200,000 shall be used for provision of educational
31opportunities to registered child care home providers in order
32to improve services and programs offered by this category
33of providers and to increase the number of providers. The
34department may contract with institutions of higher education
35or child care resource and referral centers to provide
-9-1the educational opportunities. Allowable administrative
2costs under the contracts shall not exceed 5 percent. The
3application for a grant shall not exceed two pages in length.
4b. Any funds appropriated in this subsection remaining
5unallocated shall be used for state child care assistance
6payments for families who are employed including but not
7limited to individuals enrolled in the family investment
8program.
97. For child and family services:
.................................................. $1032,380,654
118. For child abuse prevention grants:
.................................................. $12125,000
139. For pregnancy prevention grants on the condition that
14family planning services are funded:
.................................................. $151,913,203
16Pregnancy prevention grants shall be awarded to programs
17in existence on or before July 1, 2022, if the programs have
18demonstrated positive outcomes. Grants shall be awarded to
19pregnancy prevention programs which are developed after July
201, 2022, if the programs are based on existing models that
21have demonstrated positive outcomes. Grants shall comply with
22the requirements provided in 1997 Iowa Acts, chapter 208,
23section 14, subsections 1 and 2, including the requirement that
24grant programs must emphasize sexual abstinence. Priority in
25the awarding of grants shall be given to programs that serve
26areas of the state which demonstrate the highest percentage of
27unplanned pregnancies of females of childbearing age within the
28geographic area to be served by the grant.
2910. For technology needs and other resources necessary to
30meet federal and state reporting, tracking, and case management
31requirements and other departmental needs:
.................................................. $321,037,186
3311. a. Notwithstanding any provision to the contrary,
34including but not limited to requirements in section 8.41 or
35provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the
-10-1receipt and appropriation of federal block grants, federal
2funds from the temporary assistance for needy families block
3grant received by the state and not otherwise appropriated
4in this section and remaining available for the fiscal year
5beginning July 1, 2022, are appropriated to the department of
6human services to the extent as may be necessary to be used in
7the following priority order: the family investment program,
8for state child care assistance program payments for families
9who are employed, and for the family investment program share
10of system costs for eligibility determination and related
11functions. The federal funds appropriated in this paragraph
12“a” shall be expended only after all other funds appropriated
13in subsection 1 for assistance under the family investment
14program, in subsection 6 for state child care assistance, or
15in subsection 10 for technology costs related to the family
16investment program, as applicable, have been expended. For
17the purposes of this subsection, the funds appropriated in
18subsection 6, paragraph “a”, for transfer to the child care
19and development block grant appropriation are considered fully
20expended when the full amount has been transferred.
21b. The department shall, on a quarterly basis, advise the
22general assembly and department of management of the amount of
23funds appropriated in this subsection that was expended in the
24prior quarter.
2512. Of the amounts appropriated in this section,
26$12,962,008 for the fiscal year beginning July 1, 2022, is
27transferred to the appropriation of the federal social services
28block grant made to the department of human services for that
29fiscal year.
3013. For continuation of the program providing categorical
31eligibility for the supplemental nutrition assistance program
32(SNAP) as specified for the program in the section of this
33division of this Act relating to the family investment program
34account:
.................................................. $3514,236
-11- 114. The department may transfer funds allocated in this
2section to the appropriations made in this division of this Act
3for the same fiscal year for general administration and field
4operations for resources necessary to implement and operate the
5services referred to in this section and those funded in the
6appropriation made in this division of this Act for the same
7fiscal year for the family investment program from the general
8fund of the state.
915. With the exception of moneys allocated under this
10section for the family development and self-sufficiency grant
11program, to the extent moneys allocated in this section are
12deemed by the department not to be necessary to support the
13purposes for which they are allocated, such moneys may be used
14in the same fiscal year for any other purpose for which funds
15are allocated in this section or in section 8 of this division
16of this Act for the family investment program account. If
17there are conflicting needs, priority shall first be given
18to the family investment program account as specified under
19subsection 1 of this section and used for the purposes of
20assistance under the family investment program in accordance
21with chapter 239B, followed by state child care assistance
22program payments for families who are employed, followed by
23other priorities as specified by the department.
24 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
251. Moneys credited to the family investment program (FIP)
26account for the fiscal year beginning July 1, 2022, and
27ending June 30, 2023, shall be used to provide assistance in
28accordance with chapter 239B.
292. The department may use a portion of the moneys credited
30to the FIP account under this section as necessary for
31salaries, support, maintenance, and miscellaneous purposes,
32including administrative and information technology costs
33associated with rent reimbursement and other income assistance
34programs administered by the department.
353. The department may transfer funds allocated in
-12-1subsection 4, excluding the allocation under subsection 4,
2paragraph “b”, to the appropriations made in this division of
3this Act for the same fiscal year for general administration
4and field operations for resources necessary to implement
5and operate the services referred to in this section and
6those funded in the appropriations made in section 7 for the
7temporary assistance for needy families block grant and in
8section 9 for the family investment program from the general
9fund of the state in this division of this Act for the same
10fiscal year.
114. Moneys appropriated in this division of this Act and
12credited to the FIP account for the fiscal year beginning July
131, 2022, and ending June 30, 2023, are allocated as follows:
14a. To be retained by the department of human services to
15be used for coordinating with the department of human rights
16to more effectively serve participants in FIP and other shared
17clients and to meet federal reporting requirements under the
18federal temporary assistance for needy families block grant:
.................................................. $1910,000
20b. To the department of human rights for staffing,
21administration, and implementation of the family development
22and self-sufficiency grant program in accordance with section
23216A.107:
.................................................. $247,192,834
25(1) Of the funds allocated for the family development
26and self-sufficiency grant program in this paragraph “b”,
27not more than 5 percent of the funds shall be used for the
28administration of the grant program.
29(2) The department of human rights may continue to implement
30the family development and self-sufficiency grant program
31statewide during fiscal year 2022-2023.
32(3) The department of human rights may engage in activities
33to strengthen and improve family outcomes measures and
34data collection systems under the family development and
35self-sufficiency grant program.
-13- 1c. For the diversion subaccount of the FIP account:
.................................................. $21,293,000
3A portion of the moneys allocated for the diversion
4subaccount may be used for field operations, salaries, data
5management system development, and implementation costs and
6support deemed necessary by the director of human services
7in order to administer the FIP diversion program. To the
8extent moneys allocated in this paragraph “c” are deemed by the
9department not to be necessary to support diversion activities,
10such moneys may be used for other efforts intended to increase
11engagement by family investment program participants in work,
12education, or training activities, or for the purposes of
13assistance under the family investment program in accordance
14with chapter 239B.
15d. For the SNAP employment and training program:
.................................................. $1666,588
17(1) The department shall apply the federal SNAP employment
18and training state plan in order to maximize to the fullest
19extent permitted by federal law the use of the 50 percent
20federal reimbursement provisions for the claiming of allowable
21federal reimbursement funds from the United States department
22of agriculture pursuant to the federal SNAP employment and
23training program for providing education, employment, and
24training services for eligible SNAP participants, including
25but not limited to related dependent care and transportation
26expenses.
27(2) The department shall continue the categorical federal
28SNAP eligibility at 160 percent of the federal poverty level
29and continue to eliminate the asset test from eligibility
30requirements, consistent with federal SNAP requirements. The
31department shall include as many SNAP households as is allowed
32by federal law. The eligibility provisions shall conform to
33all federal requirements including requirements addressing
34individuals who are incarcerated or otherwise ineligible.
35e. For the JOBS program, not more than:
-14-.................................................. $111,710,593
25. Of the child support collections assigned under FIP,
3an amount equal to the federal share of support collections
4shall be credited to the child support recovery appropriation
5made in this division of this Act. Of the remainder of the
6assigned child support collections received by the child
7support recovery unit, a portion shall be credited to the FIP
8account, a portion may be used to increase recoveries, and a
9portion may be used to sustain cash flow in the child support
10payments account. If as a consequence of the appropriations
11and allocations made in this section the resulting amounts
12are insufficient to sustain cash assistance payments and meet
13federal maintenance of effort requirements, the department
14shall seek supplemental funding. If child support collections
15assigned under FIP are greater than estimated or are otherwise
16determined not to be required for maintenance of effort, the
17state share of either amount may be transferred to or retained
18in the child support payments account.
19 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
20is appropriated from the general fund of the state to the
21department of human services for the fiscal year beginning July
221, 2022, and ending June 30, 2023, the following amount, or
23so much thereof as is necessary, to be used for the purpose
24designated:
25To be credited to the family investment program (FIP)
26account and used for family investment program assistance
27under chapter 239B and other costs associated with providing
28needs-based benefits or assistance:
.................................................. $2941,003,978
301. Of the funds appropriated in this section, $6,606,198 is
31allocated for the JOBS program.
322. Of the funds appropriated in this section, $4,313,854 is
33allocated for the family development and self-sufficiency grant
34program.
353. a. Notwithstanding section 8.39, for the fiscal
-15-1year beginning July 1, 2022, if necessary to meet federal
2maintenance of effort requirements or to transfer federal
3temporary assistance for needy families block grant funding
4to be used for purposes of the federal social services block
5grant or to meet cash flow needs resulting from delays in
6receiving federal funding or to implement, in accordance with
7this division of this Act, activities currently funded with
8juvenile court services, county, or community moneys and state
9moneys used in combination with such moneys; to comply with
10federal requirements; or to maximize the use of federal funds;
11the department of human services may transfer funds within or
12between any of the appropriations made in this division of this
13Act and appropriations in law for the federal social services
14block grant to the department for the following purposes,
15provided that the combined amount of state and federal
16temporary assistance for needy families block grant funding
17for each appropriation remains the same before and after the
18transfer:
19(1) For the family investment program.
20(2) For state child care assistance.
21(3) For child and family services.
22(4) For field operations.
23(5) For general administration.
24b. This subsection shall not be construed to prohibit the
25use of existing state transfer authority for other purposes.
26The department shall report any transfers made pursuant to this
27subsection to the general assembly.
284. Of the funds appropriated in this section, $195,000
29shall be used for a contract for tax preparation assistance
30to low-income Iowans to expand the usage of the earned income
31tax credit. The purpose of the contract is to supply this
32assistance to underserved areas of the state. The department
33shall not retain any portion of the allocation under this
34subsection for administrative costs.
355. Of the funds appropriated in this section, $70,000 shall
-16-1be used for the continuation of the parenting program, as
2specified in 441 IAC ch.100, relating to parental obligations,
3in which the child support recovery unit participates, to
4support the efforts of a nonprofit organization committed to
5strengthening the community through youth development, healthy
6living, and social responsibility headquartered in a county
7with a population over 450,000 according to the 2020 certified
8federal census. The funds allocated in this subsection shall
9be used by the recipient organization to develop a larger
10community effort, through public and private partnerships, to
11support a broad-based multi-county parenthood initiative that
12promotes payment of child support obligations, improved family
13relationships, and full-time employment.
146. The department may transfer funds appropriated in this
15section, excluding the allocation in subsection 2 for the
16family development and self-sufficiency grant program, to the
17appropriations made in this division of this Act for general
18administration and field operations as necessary to administer
19this section, section 7 for the temporary assistance for needy
20families block grant, and section 8 for the family investment
21program account.
22 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
23from the general fund of the state to the department of human
24services for the fiscal year beginning July 1, 2022, and ending
25June 30, 2023, the following amount, or so much thereof as is
26necessary, to be used for the purposes designated:
27For child support recovery, including salaries, support,
28maintenance, and miscellaneous purposes:
.................................................. $2915,942,885
301. The department shall expend up to $24,000, including
31federal financial participation, for the fiscal year beginning
32July 1, 2022, for a child support public awareness campaign.
33The department and the office of the attorney general shall
34cooperate in continuation of the campaign. The public
35awareness campaign shall emphasize, through a variety of
-17-1media activities, the importance of maximum involvement of
2both parents in the lives of their children as well as the
3importance of payment of child support obligations.
42. Federal access and visitation grant moneys shall be
5issued directly to private not-for-profit agencies that provide
6services designed to increase compliance with the child access
7provisions of court orders, including but not limited to
8neutral visitation sites and mediation services.
93. The appropriation made to the department for child
10support recovery may be used throughout the fiscal year in the
11manner necessary for purposes of cash flow management, and for
12cash flow management purposes the department may temporarily
13draw more than the amount appropriated, provided the amount
14appropriated is not exceeded at the close of the fiscal year.
15 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
16FY 2022-2023. Any funds remaining in the health care trust
17fund created in section 453A.35A for the fiscal year beginning
18July 1, 2022, and ending June 30, 2023, are appropriated to
19the department of human services to supplement the medical
20assistance program appropriations made in this division of this
21Act, for medical assistance reimbursement and associated costs,
22including program administration and costs associated with
23program implementation.
24 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
252022-2023. Any funds remaining in the Medicaid fraud fund
26created in section 249A.50 for the fiscal year beginning
27July 1, 2022, and ending June 30, 2023, are appropriated to
28the department of human services to supplement the medical
29assistance appropriations made in this division of this Act,
30for medical assistance reimbursement and associated costs,
31including program administration and costs associated with
32program implementation.
33 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
34general fund of the state to the department of human services
35for the fiscal year beginning July 1, 2022, and ending June 30,
-18-12023, the following amount, or so much thereof as is necessary,
2to be used for the purpose designated:
3For medical assistance program reimbursement and associated
4costs as specifically provided in the reimbursement
5methodologies in effect on June 30, 2022, except as otherwise
6expressly authorized by law, consistent with options under
7federal law and regulations, and contingent upon receipt of
8approval from the office of the governor of reimbursement for
9each abortion performed under the program:
.................................................. $101,503,848,253
111. Iowans support reducing the number of abortions
12performed in our state. Funds appropriated under this section
13shall not be used for abortions, unless otherwise authorized
14under this section.
152. The provisions of this section relating to abortions
16shall also apply to the Iowa health and wellness plan created
17pursuant to chapter 249N.
183. The department shall utilize not more than $60,000 of
19the funds appropriated in this section to continue the AIDS/HIV
20health insurance premium payment program as established in 1992
21Iowa Acts, Second Extraordinary Session, chapter 1001, section
22409, subsection 6. Of the funds allocated in this subsection,
23not more than $5,000 may be expended for administrative
24purposes.
254. Of the funds appropriated in this Act to the department
26of public health for addictive disorders, $950,000 for
27the fiscal year beginning July 1, 2022, is transferred
28to the department of human services for an integrated
29substance-related disorder managed care system. The
30departments of human services and public health shall
31work together to maintain the level of mental health and
32substance-related disorder treatment services provided by the
33managed care contractors. Each department shall take the steps
34necessary to continue the federal waivers as necessary to
35maintain the level of services.
-19- 15. The department shall aggressively pursue options for
2providing medical assistance or other assistance to individuals
3with special needs who become ineligible to continue receiving
4services under the early and periodic screening, diagnostic,
5and treatment program under the medical assistance program
6due to becoming 21 years of age who have been approved for
7additional assistance through the department’s exception to
8policy provisions, but who have health care needs in excess
9of the funding available through the exception to policy
10provisions.
116. Of the funds appropriated in this section, up to
12$3,050,082 may be transferred to the field operations or
13general administration appropriations in this division of this
14Act for operational costs associated with Part D of the federal
15Medicare Prescription Drug Improvement and Modernization Act
16of 2003, Pub.L.No.108-173.
177. Of the funds appropriated in this section, up to $442,100
18may be transferred to the appropriation in this division of
19this Act for health program operations to be used for clinical
20assessment services and prior authorization of services.
218. A portion of the funds appropriated in this section may
22be transferred to the appropriations in this division of this
23Act for general administration, health program operations, the
24children’s health insurance program, or field operations to be
25used for the state match cost to comply with the payment error
26rate measurement (PERM) program for both the medical assistance
27and children’s health insurance programs as developed by the
28centers for Medicare and Medicaid services of the United States
29department of health and human services to comply with the
30federal Improper Payments Information Act of 2002, Pub.L.
31No.107-300, and to support other reviews and quality control
32activities to improve the integrity of these programs.
339. Of the funds appropriated in this section, a sufficient
34amount is allocated to supplement the incomes of residents of
35nursing facilities, intermediate care facilities for persons
-20-1with mental illness, and intermediate care facilities for
2persons with an intellectual disability, with incomes of less
3than $50 in the amount necessary for the residents to receive a
4personal needs allowance of $50 per month pursuant to section
5249A.30A.
610. One hundred percent of the nonfederal share of payments
7to area education agencies that are medical assistance
8providers for medical assistance-covered services provided to
9medical assistance-covered children, shall be made from the
10appropriation made in this section.
1111. A portion of the funds appropriated in this section may
12be transferred to the appropriation in this division of this
13Act for health program operations to be used for administrative
14activities associated with the money follows the person
15demonstration project.
1612. Of the funds appropriated in this section, $349,011
17shall be used for the administration of the health insurance
18premium payment program, including salaries, support,
19maintenance, and miscellaneous purposes.
2013. a. The department may increase the amounts allocated
21for salaries, support, maintenance, and miscellaneous purposes
22associated with the medical assistance program, as necessary,
23to sustain cost management efforts. The department shall
24report any such increase to the general assembly and the
25department of management.
26b. If the savings to the medical assistance program from
27ongoing cost management efforts exceed the associated cost
28for the fiscal year beginning July 1, 2022, the department
29may transfer any savings generated for the fiscal year due
30to medical assistance program cost management efforts to the
31appropriation made in this division of this Act for health
32program operations or general administration to defray the
33costs associated with implementing the efforts.
3414. For the fiscal year beginning July 1, 2022, and ending
35June 30, 2023, the replacement generation tax revenues required
-21-1to be deposited in the property tax relief fund pursuant to
2section 437A.8, subsection 4, paragraph “d”, and section
3437A.15, subsection 3, paragraph “f”, shall instead be credited
4to and supplement the appropriation made in this section and
5used for the allocations made in this section.
615. a. Of the funds appropriated in this section, up
7to $50,000 may be transferred by the department to the
8appropriation made in this division of this Act to the
9department for the same fiscal year for general administration
10to be used for associated administrative expenses and for not
11more than 1.00 full-time equivalent position, in addition to
12those authorized for the same fiscal year, to be assigned to
13implementing the children’s mental health home project.
14b. Of the funds appropriated in this section, up to $400,000
15may be transferred by the department to the appropriation made
16to the department in this division of this Act for the same
17fiscal year for Medicaid program-related general administration
18planning and implementation activities. The funds may be used
19for contracts or for personnel in addition to the amounts
20appropriated for and the positions authorized for general
21administration for the fiscal year.
22c. Of the funds appropriated in this section, up to
23$3,000,000 may be transferred by the department to the
24appropriations made in this division of this Act for the
25same fiscal year for general administration or health
26program operations to be used to support the development
27and implementation of standardized assessment tools for
28persons with mental illness, an intellectual disability, a
29developmental disability, or a brain injury.
3016. Of the funds appropriated in this section, $150,000
31shall be used for lodging expenses associated with care
32provided at the university of Iowa hospitals and clinics for
33patients with cancer whose travel distance is 30 miles or more
34and whose income is at or below 200 percent of the federal
35poverty level as defined by the most recently revised poverty
-22-1income guidelines published by the United States department of
2health and human services. The department of human services
3shall establish the maximum number of overnight stays and the
4maximum rate reimbursed for overnight lodging, which may be
5based on the state employee rate established by the department
6of administrative services. The funds allocated in this
7subsection shall not be used as nonfederal share matching
8funds.
917. Of the funds appropriated in this section, up to
10$3,383,880 shall be used for administration of the state family
11planning services program pursuant to section 217.41B, and
12of this amount, the department may use up to $200,000 for
13administrative expenses.
1418. Of the funds appropriated in this section, $1,545,530
15shall be used and may be transferred to other appropriations
16in this division of this Act as necessary to administer the
17provisions in the division of this Act relating to Medicaid
18program administration.
1919. The department shall comply with the centers for
20Medicare and Medicaid services’ guidance related to Medicaid
21program and children’s health insurance program maintenance
22of effort provisions, including eligibility standards,
23methodologies, procedures, and continuous enrollment, to
24receive the enhanced federal medical assistance percentage
25under section 6008(b) of the federal Families First Coronavirus
26Response Act, Pub.L. No.116-127. The department shall
27utilize and implement all tools, processes, and resources
28available to expediently return to normal eligibility and
29enrollment operations in compliance with federal guidance and
30expectations.
3120. A portion of the funds appropriated in this section
32may be transferred to the appropriation in this division
33of this Act for the children’s health insurance program
34if the children’s health insurance program appropriation
35is not sufficient to cover the designated purposes of that
-23-1appropriation.
2 Sec. 14. HEALTH PROGRAM OPERATIONS. 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 purpose designated:
7For health program operations:
.................................................. $817,831,343
91. The department of inspections and appeals shall
10provide all state matching funds for survey and certification
11activities performed by the department of inspections
12and appeals. The department of human services is solely
13responsible for distributing the federal matching funds for
14such activities.
152. Of the funds appropriated in this section, $50,000 shall
16be used for continuation of home and community-based services
17waiver quality assurance programs, including the review and
18streamlining of processes and policies related to oversight and
19quality management to meet state and federal requirements.
203. Of the amount appropriated in this section, up to
21$200,000 may be transferred to the appropriation for general
22administration in this division of this Act to be used for
23additional full-time equivalent positions in the development
24of key health initiatives such as development and oversight
25of managed care programs and development of health strategies
26targeted toward improved quality and reduced costs in the
27Medicaid program.
284. Of the funds appropriated in this section, $1,000,000
29shall be used for planning and development, in cooperation with
30the department of public health, of a phased-in program to
31provide a dental home for children.
325. a. Of the funds appropriated in this section, $573,000
33shall be credited to the autism support program fund created
34in section 225D.2 to be used for the autism support program
35created in chapter 225D, with the exception of the following
-24-1amount of this allocation which shall be used as follows:
2b. Of the funds allocated in this subsection, $25,000 shall
3be used for the public purpose of continuation of a grant to
4a nonprofit provider of child welfare services that has been
5in existence for more than 115 years, is located in a county
6with a population between 220,000 and 250,000 according to the
72020 federal decennial census, is licensed as a psychiatric
8medical institution for children, and provides school-based
9programming, to be used for support services for children with
10autism spectrum disorder and their families.
11 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
121. There is appropriated from the general fund of the
13state to the department of human services for the fiscal year
14beginning July 1, 2022, and ending June 30, 2023, the following
15amount, or so much thereof as is necessary, to be used for the
16purpose designated:
17For the state supplementary assistance program:
.................................................. $187,349,002
192. The department shall increase the personal needs
20allowance for residents of residential care facilities by the
21same percentage and at the same time as federal supplemental
22security income and federal social security benefits are
23increased due to a recognized increase in the cost of living.
24The department may adopt emergency rules to implement this
25subsection.
263. If during the fiscal year beginning July 1, 2022,
27the department projects that state supplementary assistance
28expenditures for a calendar year will not meet the federal
29pass-through requirement specified in Tit.XVI of the federal
30Social Security Act, section 1618, as codified in 42 U.S.C.
31§1382g, the department may take actions including but not
32limited to increasing the personal needs allowance for
33residential care facility residents and making programmatic
34adjustments or upward adjustments of the residential care
35facility or in-home health-related care reimbursement rates
-25-1prescribed in this division of this Act to ensure that federal
2requirements are met. In addition, the department may make
3other programmatic and rate adjustments necessary to remain
4within the amount appropriated in this section while ensuring
5compliance with federal requirements. The department may adopt
6emergency rules to implement the provisions of this subsection.
74. Notwithstanding section 8.33, moneys appropriated
8in this section that remain unencumbered or unobligated
9at the close of the fiscal year shall not revert but
10shall remain available for expenditure for the purposes
11designated, including for liability amounts associated with the
12supplemental nutrition assistance program payment error rate,
13until the close of the succeeding fiscal year.
14 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
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:
20For maintenance of the healthy and well kids in Iowa (hawk-i)
21program pursuant to chapter 514I, including supplemental dental
22services, for receipt of federal financial participation under
23Tit.XXI of the federal Social Security Act, which creates the
24children’s health insurance program:
.................................................. $2541,713,403
262. Of the funds appropriated in this section, $158,850 is
27allocated for continuation of the contract for outreach with
28the department of public health.
293. A portion of the funds appropriated in this section may
30be transferred to the appropriations made in this division of
31this Act for field operations or health program operations to
32be used for the integration of hawk-i program eligibility,
33payment, and administrative functions under the purview of
34the department of human services, including for the Medicaid
35management information system upgrade.
-26-1 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated
2from the general fund of the state to the department of human
3services for the fiscal year beginning July 1, 2022, and ending
4June 30, 2023, the following amount, or so much thereof as is
5necessary, to be used for the purpose designated:
6For child care programs:
.................................................. $740,816,931
81. Of the funds appropriated in this section, $34,966,931
9shall be used for state child care assistance in accordance
10with section 237A.13.
112. Nothing in this section shall be construed or is
12intended as or shall imply a grant of entitlement for services
13to persons who are eligible for assistance due to an income
14level consistent with the waiting list requirements of section
15237A.13. Any state obligation to provide services pursuant to
16this section is limited to the extent of the funds appropriated
17in this section.
183. A list of the registered and licensed child care
19facilities operating in the area served by a child care
20resource and referral service shall be made available to the
21families receiving state child care assistance in that area.
224. Of the funds appropriated in this section, $5,850,000
23shall be credited to the early childhood programs grants
24account in the early childhood Iowa fund created in section
25256I.11. The moneys shall be distributed for funding of
26community-based early childhood programs targeted to children
27from birth through five years of age developed by early
28childhood Iowa areas in accordance with approved community
29plans as provided in section 256I.8.
305. The department may use any of the funds appropriated
31in this section as a match to obtain federal funds for use in
32expanding child care assistance and related programs. For
33the purpose of expenditures of state and federal child care
34funding, funds shall be considered obligated at the time
35expenditures are projected or are allocated to the department’s
-27-1service areas. Projections shall be based on current and
2projected caseload growth, current and projected provider
3rates, staffing requirements for eligibility determination
4and management of program requirements including data systems
5management, staffing requirements for administration of the
6program, contractual and grant obligations and any transfers
7to other state agencies, and obligations for decategorization
8or innovation projects.
96. A portion of the state match for the federal child care
10and development block grant shall be provided as necessary to
11meet federal matching funds requirements through the state
12general fund appropriation made for child development grants
13and other programs for at-risk children in section 279.51.
147. If a uniform reduction ordered by the governor under
15section 8.31 or other operation of law, transfer, or federal
16funding reduction reduces the appropriation made in this
17section for the fiscal year, the percentage reduction in the
18amount paid out to or on behalf of the families participating
19in the state child care assistance program shall be equal to or
20less than the percentage reduction made for any other purpose
21payable from the appropriation made in this section and the
22federal funding relating to it. The percentage reduction to
23the other allocations made in this section shall be the same as
24the uniform reduction ordered by the governor or the percentage
25change of the federal funding reduction, as applicable. If
26there is an unanticipated increase in federal funding provided
27for state child care services, the entire amount of the
28increase, except as necessary to meet federal requirements
29including quality set asides, shall be used for state child
30care assistance payments. If the appropriations made for
31purposes of the state child care assistance program for the
32fiscal year are determined to be insufficient, it is the intent
33of the general assembly to appropriate sufficient funding for
34the fiscal year in order to avoid establishment of waiting list
35requirements.
-28- 18. Notwithstanding section 8.33, moneys advanced for
2purposes of the programs developed by early childhood Iowa
3areas, advanced for purposes of wraparound child care, or
4received from the federal appropriations made for the purposes
5of this section that remain unencumbered or unobligated at the
6close of the fiscal year shall not revert to any fund but shall
7remain available for expenditure for the purposes designated
8until the close of the succeeding fiscal year.
9 Sec. 18. JUVENILE INSTITUTION. There is appropriated
10from the general fund of the state to the department of human
11services for the fiscal year beginning July 1, 2022, and ending
12June 30, 2023, the following amounts, or so much thereof as is
13necessary, to be used for the purposes designated:
141. a. For operation of the state training school at Eldora
15and for salaries, support, maintenance, and miscellaneous
16purposes:
.................................................. $1717,606,871
18b. Of the funds appropriated in this subsection, $91,000
19shall be used for distribution to licensed classroom teachers
20at this and other institutions under the control of the
21department of human services based upon the average student
22yearly enrollment at each institution as determined by the
23department.
242. A portion of the moneys appropriated in this section
25shall be used by the state training school at Eldora for
26grants for adolescent pregnancy prevention activities at the
27institution in the fiscal year beginning July 1, 2022.
283. Of the funds appropriated in this subsection, $212,000
29shall be used by the state training school at Eldora for a
30substance use disorder treatment program at the institution for
31the fiscal year beginning July 1, 2022.
324. Notwithstanding section 8.33, moneys appropriated in
33this section that remain unencumbered or unobligated at the
34close of the fiscal year shall not revert but shall remain
35available for expenditure for the purposes designated until the
-29-1close of the succeeding fiscal year.
2 Sec. 19. CHILD AND FAMILY SERVICES.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2022, and ending June 30, 2023, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8For child and family services:
.................................................. $989,371,930
102. The department may transfer funds appropriated in this
11section as necessary to pay the nonfederal costs of services
12reimbursed under the medical assistance program, state child
13care assistance program, or the family investment program which
14are provided to children who would otherwise receive services
15paid under the appropriation in this section. The department
16may transfer funds appropriated in this section to the
17appropriations made in this division of this Act for general
18administration and for field operations for resources necessary
19to implement and operate the services funded in this section.
203. a. Of the funds appropriated in this section, up to
21$36,500,000 is allocated as the statewide expenditure target
22under section 232.143 for group foster care maintenance and
23services. If the department projects that such expenditures
24for the fiscal year will be less than the target amount
25allocated in this paragraph “a”, the department may reallocate
26the excess to provide additional funding for family foster
27care, independent living, family-centered services, shelter
28care, or the child welfare emergency services addressed with
29the allocation for shelter care.
30b. If at any time after September 30, 2022, annualization
31of a service area’s current expenditures indicates a service
32area is at risk of exceeding its group foster care expenditure
33target under section 232.143 by more than 5 percent, the
34department and juvenile court services shall examine all
35group foster care placements in that service area in order to
-30-1identify those which might be appropriate for termination.
2In addition, any aftercare services believed to be needed
3for the children whose placements may be terminated shall be
4identified. The department and juvenile court services shall
5initiate action to set dispositional review hearings for the
6placements identified. In such a dispositional review hearing,
7the juvenile court shall determine whether needed aftercare
8services are available and whether termination of the placement
9is in the best interest of the child and the community.
104. In accordance with the provisions of section 232.188,
11the department shall continue the child welfare and juvenile
12justice funding initiative during fiscal year 2022-2023. Of
13the funds appropriated in this section, $1,717,000 is allocated
14specifically for expenditure for fiscal year 2022-2023 through
15the decategorization services funding pools and governance
16boards established pursuant to section 232.188.
175. A portion of the funds appropriated in this section
18may be used for emergency family assistance to provide other
19resources required for a family participating in a family
20preservation or reunification project or successor project to
21stay together or to be reunified.
226. Of the funds appropriated in this section, a sufficient
23amount is allocated for shelter care and the child welfare
24emergency services contracting implemented to provide for or
25prevent the need for shelter care.
267. Federal funds received by the state during the fiscal
27year beginning July 1, 2022, as the result of the expenditure
28of state funds appropriated during a previous state fiscal
29year for a service or activity funded under this section are
30appropriated to the department to be used as additional funding
31for services and purposes provided for under this section.
32Notwithstanding section 8.33, moneys received in accordance
33with this subsection that remain unencumbered or unobligated at
34the close of the fiscal year shall not revert to any fund but
35shall remain available for the purposes designated until the
-31-1close of the succeeding fiscal year.
28. a. Of the funds appropriated in this section, up to
3$3,290,000 is allocated for the payment of the expenses of
4court-ordered services provided to juveniles who are under the
5supervision of juvenile court services, which expenses are a
6charge upon the state pursuant to section 232.141, subsection
74. Of the amount allocated in this paragraph “a”, up to
8$1,556,000 shall be made available to provide school-based
9supervision of children adjudicated under chapter 232, of which
10not more than $15,000 may be used for the purpose of training.
11A portion of the cost of each school-based liaison officer
12shall be paid by the school district or other funding source as
13approved by the chief juvenile court officer.
14b. Of the funds appropriated in this section, up to $748,000
15is allocated for the payment of the expenses of court-ordered
16services provided to children who are under the supervision
17of the department, which expenses are a charge upon the state
18pursuant to section 232.141, subsection 4.
19c. Notwithstanding section 232.141 or any other provision
20of law to the contrary, the amounts allocated in this
21subsection shall be distributed to the judicial districts
22as determined by the state court administrator and to the
23department’s service areas as determined by the administrator
24of the department of human services’ division of child and
25family services. The state court administrator and the
26division administrator shall make the determination of the
27distribution amounts on or before June 15, 2022.
28d. Notwithstanding chapter 232 or any other provision of
29law to the contrary, a district or juvenile court shall not
30order any service which is a charge upon the state pursuant
31to section 232.141 if there are insufficient court-ordered
32services funds available in the district court or departmental
33service area distribution amounts to pay for the service. The
34chief juvenile court officer and the departmental service area
35manager shall encourage use of the funds allocated in this
-32-1subsection such that there are sufficient funds to pay for
2all court-related services during the entire year. The chief
3juvenile court officers and departmental service area managers
4shall attempt to anticipate potential surpluses and shortfalls
5in the distribution amounts and shall cooperatively request the
6state court administrator or division administrator to transfer
7funds between the judicial districts’ or departmental service
8areas’ distribution amounts as prudent.
9e. Notwithstanding any provision of law to the contrary,
10a district or juvenile court shall not order a county to pay
11for any service provided to a juvenile pursuant to an order
12entered under chapter 232 which is a charge upon the state
13under section 232.141, subsection 4.
14f. Of the funds allocated in this subsection, not more than
15$83,000 may be used by the judicial branch for administration
16of the requirements under this subsection.
17g. Of the funds allocated in this subsection, $17,000
18shall be used by the department of human services to support
19the interstate commission for juveniles in accordance with
20the interstate compact for juveniles as provided in section
21232.173.
229. Of the funds appropriated in this section, $12,253,000 is
23allocated for juvenile delinquent graduated sanctions services.
24Any state funds saved as a result of efforts by juvenile court
25services to earn a federal Tit.IV-E match for juvenile court
26services administration may be used for the juvenile delinquent
27graduated sanctions services.
2810. Of the funds appropriated in this section, $1,658,000 is
29transferred to the department of public health to be used for
30the child protection center grant program for child protection
31centers located in Iowa in accordance with section 135.118.
32The grant amounts under the program shall be equalized so that
33each center receives a uniform base amount of $245,000, and so
34that the remaining funds are awarded through a funding formula
35based upon the volume of children served. To increase access
-33-1to child protection center services for children in rural
2areas, the funding formula for the awarding of the remaining
3funds shall provide for the awarding of an enhanced amount to
4eligible grantees to develop and maintain satellite centers in
5underserved regions of the state.
611. Of the funds appropriated in this section, $4,025,000 is
7allocated for the preparation for adult living program pursuant
8to section 234.46.
912. Of the funds appropriated in this section, $227,000
10shall be used for the public purpose of continuing a grant to a
11nonprofit human services organization, providing services to
12individuals and families in multiple locations in southwest
13Iowa and Nebraska for support of a project providing immediate,
14sensitive support and forensic interviews, medical exams, needs
15assessments, and referrals for victims of child abuse and their
16nonoffending family members.
1713. Of the funds appropriated in this section, $300,000
18is allocated for the foster care youth council approach of
19providing a support network to children placed in foster care.
2014. Of the funds appropriated in this section, $202,000 is
21allocated for use pursuant to section 235A.1 for continuation
22of the initiative to address child sexual abuse implemented
23pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
2421.
2515. Of the funds appropriated in this section, $630,000 is
26allocated for the community partnership for child protection
27sites.
2816. Of the funds appropriated in this section, $371,000
29is allocated for the department’s minority youth and family
30projects under the redesign of the child welfare system.
3117. Of the funds appropriated in this section, $851,000
32is allocated for funding of the community circle of care
33collaboration for children and youth in northeast Iowa.
3418. Of the funds appropriated in this section, at least
35$147,000 shall be used for the continuation of the child
-34-1welfare provider training program.
219. Of the funds appropriated in this section, $211,000
3shall be used for continuation of the central Iowa system of
4care program grant for the purposes of funding community-based
5services and other supports with a system of care approach for
6children with serious emotional disturbance and their families
7through a nonprofit provider that is located in a county
8with a population of more than 450,000 according to the 2020
9certified federal census, is licensed as a psychiatric medical
10institution for children, and was a system of care grantee
11prior to July 1, 2022.
1220. Of the funds appropriated in this section, $235,000
13shall be used for the public purpose of the continuation
14and expansion of a system of care program grant implemented
15in Cerro Gordo and Linn counties to utilize a comprehensive
16and long-term approach for helping children and families by
17addressing the key areas in a child’s life of childhood basic
18needs, education and work, family, and community.
1921. Of the funds appropriated in this section, $110,000
20shall be used for the public purpose of funding community-based
21services and other supports with a system of care approach
22for children with a serious emotional disturbance and their
23families through a nonprofit provider of child welfare services
24that has been in existence for more than 115 years, is located
25in a county with a population of more than 230,000 according to
26the 2020 certified federal census, is licensed as a psychiatric
27medical institution for children, and was a system of care
28grantee prior to July 1, 2022.
2922. If a separate funding source is identified that reduces
30the need for state funds within an allocation under this
31section, the allocated state funds may be redistributed to
32other allocations under this section for the same fiscal year.
3323. Of the funds appropriated in this section, a portion may
34be used for family-centered services for purposes of complying
35with the federal Family First Prevention Services Act of 2018,
-35-1Pub.L. No.115-123, and successor legislation.
2 Sec. 20. ADOPTION SUBSIDY.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2022, and ending June 30, 2023, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8a. For adoption subsidy payments and related costs and for
9other services provided for under paragraph “b”, subparagraph
10(2):
.................................................. $1140,596,007
12b. (1) Of the funds appropriated in this section, a
13sufficient amount is allocated for adoption subsidy payments
14and related costs.
15(2) Any funds appropriated in this section remaining after
16the allocation under subparagraph (1) are designated and
17allocated as state savings resulting from implementation of
18the federal Fostering Connections to Success and Increasing
19Adoptions Act of 2008, Pub.L. No.110-351, and successor
20legislation, as determined in accordance with 42 U.S.C.
21§673(a)(8), and shall be used for post-adoption services and
22for other purposes allowed under these federal laws, Tit.IV-B
23or Tit.IV-E of the federal Social Security Act.
24(a) The department of human services may transfer funds
25allocated in this subparagraph (2) to the appropriation for
26child and family services in this division of this Act for the
27purposes designated in this subparagraph (2).
28(b) Notwithstanding section 8.33, moneys allocated
29under this subparagraph (2) shall not revert to any fund but
30shall remain available for the purposes designated in this
31subparagraph (2) until expended.
322. The department may transfer funds appropriated in
33this section to the appropriation made in this division of
34this Act for general administration for costs paid from the
35appropriation relating to adoption subsidy.
-36- 13. Federal funds received by the state during the
2fiscal year beginning July 1, 2022, as the result of the
3expenditure of state funds during a previous state fiscal
4year for a service or activity funded under this section are
5appropriated to the department to be used as additional funding
6for the services and activities funded under this section.
7Notwithstanding section 8.33, moneys received in accordance
8with this subsection that remain unencumbered or unobligated
9at the close of the fiscal year shall not revert to any fund
10but shall remain available for expenditure for the purposes
11designated until the close of the succeeding fiscal year.
12 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited
13in the juvenile detention home fund created in section 232.142
14during the fiscal year beginning July 1, 2022, and ending June
1530, 2023, are appropriated to the department of human services
16for the fiscal year beginning July 1, 2022, and ending June 30,
172023, for distribution of an amount equal to a percentage of
18the costs of the establishment, improvement, operation, and
19maintenance of county or multicounty juvenile detention homes
20in the fiscal year beginning July 1, 2021. Moneys appropriated
21for distribution in accordance with this section shall be
22allocated among eligible detention homes, prorated on the basis
23of an eligible detention home’s proportion of the costs of all
24eligible detention homes in the fiscal year beginning July
251, 2021. The percentage figure shall be determined by the
26department based on the amount available for distribution for
27the fund. Notwithstanding section 232.142, subsection 3, the
28financial aid payable by the state under that provision for the
29fiscal year beginning July 1, 2022, shall be limited to the
30amount appropriated for the purposes of this section.
31 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM.
321. There is appropriated from the general fund of the
33state to the department of human services for the fiscal year
34beginning July 1, 2022, and ending June 30, 2023, the following
35amount, or so much thereof as is necessary, to be used for the
-37-1purpose designated:
2For the family support subsidy program subject to the
3enrollment restrictions in section 225C.37, subsection 3:
.................................................. $4949,282
52. At least $931,536 of the moneys appropriated in this
6section is transferred to the department of public health for
7the family support center component of the comprehensive family
8support program under chapter 225C, subchapter V.
93. If at any time during the fiscal year, the amount of
10funding available for the family support subsidy program
11is reduced from the amount initially used to establish the
12figure for the number of family members for whom a subsidy
13is to be provided at any one time during the fiscal year,
14notwithstanding section 225C.38, subsection 2, the department
15shall revise the figure as necessary to conform to the amount
16of funding available.
17 Sec. 23. CONNER DECREE. There is appropriated from the
18general fund of the state to the department of human services
19for the fiscal year beginning July 1, 2022, and ending June 30,
202023, the following amount, or so much thereof as is necessary,
21to be used for the purpose designated:
22For building community capacity through the coordination
23and provision of training opportunities in accordance with the
24consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
25Iowa, July 14, 1994):
.................................................. $2633,632
27 Sec. 24. MENTAL HEALTH INSTITUTES.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2022, and ending June 30, 2023, the following
31amounts, or so much thereof as is necessary, to be used for the
32purposes designated:
33a. For operation of the state mental health institute at
34Cherokee as required by chapters 218 and 226 for salaries,
35support, maintenance, and miscellaneous purposes:
-38-.................................................. $115,613,624
2b. For operation of the state mental health institute at
3Independence as required by chapters 218 and 226 for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $519,688,928
62. a. Notwithstanding sections 218.78 and 249A.11, any
7revenue received from the state mental health institute at
8Cherokee or the state mental health institute at Independence
9pursuant to 42 C.F.R§438.6(e) may be retained and expended by
10the mental health institute.
11b. Notwithstanding sections 218.78 and 249A.11, any
12COVID-19 related funding received through federal funding
13sources by the state mental health institute at Cherokee or the
14state mental health institute at Independence may be retained
15and expended by the mental health institute.
163. Notwithstanding any provision of law to the contrary,
17a Medicaid member residing at the state mental health
18institute at Cherokee or the state mental health institute
19at Independence shall retain Medicaid eligibility during
20the period of the Medicaid member’s stay for which federal
21financial participation is available.
224. Notwithstanding section 8.33, moneys appropriated in
23this section that remain unencumbered or unobligated at the
24close of the fiscal year shall not revert but shall remain
25available for expenditure for the purposes designated until the
26close of the succeeding fiscal year.
27 Sec. 25. STATE RESOURCE CENTERS.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2022, and ending June 30, 2023, the following
31amounts, or so much thereof as is necessary, to be used for the
32purposes designated:
33a. For the state resource center at Glenwood for salaries,
34support, maintenance, and miscellaneous purposes:
.................................................. $3516,288,739
-39- 1b. For the state resource center at Woodward for salaries,
2support, maintenance, and miscellaneous purposes:
.................................................. $313,409,294
42. The department may continue to bill for state resource
5center services utilizing a scope of services approach used for
6private providers of intermediate care facilities for persons
7with an intellectual disability services, in a manner which
8does not shift costs between the medical assistance program,
9mental health and disability services regions, or other sources
10of funding for the state resource centers.
113. The state resource centers may expand the time-limited
12assessment and respite services during the fiscal year.
134. If the department’s administration and the department
14of management concur with a finding by a state resource
15center’s superintendent that projected revenues can reasonably
16be expected to pay the salary and support costs for a new
17employee position, or that such costs for adding a particular
18number of new positions for the fiscal year would be less
19than the overtime costs if new positions would not be added,
20the superintendent may add the new position or positions. If
21the vacant positions available to a resource center do not
22include the position classification desired to be filled, the
23state resource center’s superintendent may reclassify any
24vacant position as necessary to fill the desired position. The
25superintendents of the state resource centers may, by mutual
26agreement, pool vacant positions and position classifications
27during the course of the fiscal year in order to assist one
28another in filling necessary positions.
295. If existing capacity limitations are reached in
30operating units, a waiting list is in effect for a service or
31a special need for which a payment source or other funding
32is available for the service or to address the special need,
33and facilities for the service or to address the special need
34can be provided within the available payment source or other
35funding, the superintendent of a state resource center may
-40-1authorize opening not more than two units or other facilities
2and begin implementing the service or addressing the special
3need during fiscal year 2022-2023.
46. Notwithstanding section 8.33, and notwithstanding
5the amount limitation specified in section 222.92, moneys
6appropriated in this section that remain unencumbered or
7unobligated at the close of the fiscal year shall not revert
8but shall remain available for expenditure for the purposes
9designated until the close of the succeeding fiscal year.
10 Sec. 26. SEXUALLY VIOLENT PREDATORS.
111. There is appropriated from the general fund of the
12state to the department of human services for the fiscal year
13beginning July 1, 2022, and ending June 30, 2023, the following
14amount, or so much thereof as is necessary, to be used for the
15purpose designated:
16For costs associated with the commitment and treatment of
17sexually violent predators in the unit located at the state
18mental health institute at Cherokee, including costs of legal
19services and other associated costs, including salaries,
20support, maintenance, and miscellaneous purposes:
.................................................. $2113,891,276
222. Unless specifically prohibited by law, if the amount
23charged provides for recoupment of at least the entire amount
24of direct and indirect costs, the department of human services
25may contract with other states to provide care and treatment
26of persons placed by the other states at the unit for sexually
27violent predators at Cherokee. The moneys received under
28such a contract shall be considered to be repayment receipts
29and used for the purposes of the appropriation made in this
30section.
313. Notwithstanding section 8.33, moneys appropriated in
32this section that remain unencumbered or unobligated at the
33close of the fiscal year shall not revert but shall remain
34available for expenditure for the purposes designated until the
35close of the succeeding fiscal year.
-41-1 Sec. 27. FIELD OPERATIONS.
21. There is appropriated from the general fund of the
3state to the department of human services for the fiscal year
4beginning July 1, 2022, and ending June 30, 2023, the following
5amount, or so much thereof as is necessary, to be used for the
6purposes designated:
7For field operations, including salaries, support,
8maintenance, and miscellaneous purposes:
.................................................. $965,894,438
102. Priority in filling full-time equivalent positions
11shall be given to those positions related to child protection
12services and eligibility determination for low-income families.
13 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
14from the general fund of the state to the department of human
15services for the fiscal year beginning July 1, 2022, and ending
16June 30, 2023, the following amount, or so much thereof as is
17necessary, to be used for the purpose designated:
18For general administration, including salaries, support,
19maintenance, and miscellaneous purposes:
.................................................. $2015,342,189
211. The department shall report at least monthly to the
22general assembly concerning the department’s operational and
23program expenditures.
242. Of the funds appropriated in this section, $150,000 shall
25be used for the provision of a program to provide technical
26assistance, support, and consultation to providers of home and
27community-based services under the medical assistance program.
283. Of the funds appropriated in this section, $50,000
29is transferred to the Iowa finance authority to be used
30for administrative support of the council on homelessness
31established in section 16.2D and for the council to fulfill its
32duties in addressing and reducing homelessness in the state.
334. Of the funds appropriated in this section, $200,000 shall
34be transferred to and deposited in the administrative fund of
35the Iowa ABLE savings plan trust created in section 12I.4, to
-42-1be used for implementation and administration activities of the
2Iowa ABLE savings plan trust.
35. Of the funds appropriated in this section, $200,000 is
4transferred to the economic development authority for the Iowa
5commission on volunteer services to continue to be used for the
6RefugeeRISE AmeriCorps program established under section 15H.8
7for member recruitment and training to improve the economic
8well-being and health of economically disadvantaged refugees in
9local communities across Iowa. Funds transferred may be used
10to supplement federal funds under federal regulations.
116. Of the funds appropriated in this section, up to $300,000
12shall be used as follows:
13a. To fund not more than 1.00 full-time equivalent position
14to address the department’s responsibility to support the work
15of the children’s behavioral health system state board and
16implementation of the services required pursuant to section
17331.397.
18b. To support the cost of establishing and implementing new
19or additional services required pursuant to sections 331.397
20and 331.397A.
21c. Of the amount allocated, $32,000 shall be transferred
22to the department of public health to support the costs of
23establishing and implementing new or additional services
24required pursuant to sections 331.397 and 331.397A.
257. Of the funds appropriated in this section, $800,000 shall
26be used for the renovation and construction of certain nursing
27facilities, consistent with the provisions of chapter 249K.
28 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated
29from the general fund of the state to the department of human
30services for the fiscal year beginning July 1, 2022, and ending
31June 30, 2023, the following amount, or so much thereof as is
32necessary, to be used for the purposes designated:
33For salaries, support, maintenance, and miscellaneous
34purposes at facilities under the purview of the department of
35human services:
-43-.................................................. $14,172,123
2 Sec. 30. VOLUNTEERS. There is appropriated from the general
3fund of the state to the department of human services for the
4fiscal year beginning July 1, 2022, and ending June 30, 2023,
5the following amount, or so much thereof as is necessary, to be
6used for the purpose designated:
7For development and coordination of volunteer services:
.................................................. $884,686
9 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
10ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
11DEPARTMENT OF HUMAN SERVICES.
121. a. (1) (a) Notwithstanding any provision of law to the
13contrary, for the fiscal year beginning July 1, 2022, case-mix
14nursing facilities shall be reimbursed in accordance with the
15methodology in effect on June 30, 2022.
16(b) For the fiscal year beginning July 1, 2022, non-case-mix
17and special population nursing facilities shall be reimbursed
18in accordance with the methodology in effect on June 30, 2022.
19(c) For managed care claims, the department of human
20services shall adjust the payment rate floor for nursing
21facilities, annually, to maintain a rate floor that is no
22lower than the Medicaid fee-for-service case-mix adjusted rate
23calculated in accordance with subparagraph division (a) and
24441 IAC 81.6. The department shall then calculate adjusted
25reimbursement rates, including but not limited to add-on
26payments, annually, and shall notify Medicaid managed care
27organizations of the adjusted reimbursement rates within 30
28days of determining the adjusted reimbursement rates. Any
29adjustment of reimbursement rates under this subparagraph
30division shall be budget neutral to the state budget.
31(d) For the fiscal year beginning July 1, 2022, Medicaid
32managed care long-term services and supports capitation rates
33shall be adjusted to reflect the case-mix adjusted rates
34specified pursuant to subparagraph division (a) for the patient
35populations residing in Medicaid-certified nursing facilities.
-44- 1(2) Medicaid managed care organizations shall adjust
2facility-specific rates based upon payment rate listings issued
3by the department. The rate adjustments shall be applied
4prospectively from the effective date of the rate letter issued
5by the department.
6b. (1) For the fiscal year beginning July 1, 2022, the
7department shall establish the fee-for-service pharmacy
8dispensing fee reimbursement at $10.38 per prescription,
9until a cost of dispensing survey is completed. The actual
10dispensing fee shall be determined by a cost of dispensing
11survey performed by the department and required to be completed
12by all medical assistance program participating pharmacies
13every two years, adjusted as necessary to maintain expenditures
14within the amount appropriated to the department for this
15purpose for the fiscal year. A change in the dispensing
16fee shall become effective following federal approval of the
17Medicaid state plan.
18(2) The department shall utilize an average acquisition
19cost reimbursement methodology for all drugs covered under the
20medical assistance program in accordance with 2012 Iowa Acts,
21chapter 1133, section 33.
22c. (1) For the fiscal year beginning July 1, 2022,
23reimbursement rates for outpatient hospital services shall
24remain at the rates in effect on June 30, 2022, subject to
25Medicaid program upper payment limit rules, and adjusted
26as necessary to maintain expenditures within the amount
27appropriated to the department for this purpose for the fiscal
28year.
29(2) For the fiscal year beginning July 1, 2022,
30reimbursement rates for inpatient hospital services shall
31remain at the rates in effect on June 30, 2022, subject to
32Medicaid program upper payment limit rules, and adjusted
33as necessary to maintain expenditures within the amount
34appropriated to the department for this purpose for the fiscal
35year.
-45- 1(3) For the fiscal year beginning July 1, 2022, under
2both fee-for-service and managed care administration of
3the Medicaid program, critical access hospitals shall be
4reimbursed for inpatient and outpatient services based on the
5hospital-specific critical access hospital cost adjustment
6factor methodology utilizing the most recent and complete cost
7reporting period as applied prospectively within the funds
8appropriated for such purpose for the fiscal year.
9(4) For the fiscal year beginning July 1, 2022, the graduate
10medical education and disproportionate share hospital fund
11shall remain at the amount in effect on June 30, 2022, except
12that the portion of the fund attributable to graduate medical
13education shall be reduced in an amount that reflects the
14elimination of graduate medical education payments made to
15out-of-state hospitals.
16(5) In order to ensure the efficient use of limited state
17funds in procuring health care services for low-income Iowans,
18funds appropriated in this Act for hospital services shall
19not be used for activities which would be excluded from a
20determination of reasonable costs under the federal Medicare
21program pursuant to 42 U.S.C.§1395x(v)(1)(N).
22d. For the fiscal year beginning July 1, 2022, reimbursement
23rates for hospices and acute psychiatric hospitals shall be
24increased in accordance with increases under the federal
25Medicare program or as supported by their Medicare audited
26costs.
27e. For the fiscal year beginning July 1, 2022, independent
28laboratories and rehabilitation agencies shall be reimbursed
29using the same methodology in effect on June 30, 2022.
30f. (1) For the fiscal year beginning July 1, 2022,
31reimbursement rates for home health agencies shall continue to
32be based on the Medicare low utilization payment adjustment
33(LUPA) methodology with state geographic wage adjustments. The
34department shall continue to update the rates every two years
35to reflect the most recent Medicare LUPA rates.
-46- 1(2) For the fiscal year beginning July 1, 2022, rates for
2private duty nursing and personal care services under the early
3and periodic screening, diagnostic, and treatment program
4benefit shall be calculated based on the methodology in effect
5on June 30, 2022.
6g. For the fiscal year beginning July 1, 2022, federally
7qualified health centers and rural health clinics shall receive
8cost-based reimbursement for 100 percent of the reasonable
9costs for the provision of services to recipients of medical
10assistance.
11h. For the fiscal year beginning July 1, 2022, the
12reimbursement rates for dental services shall remain at the
13rates in effect on June 30, 2022.
14i. (1) For the fiscal year beginning July 1, 2022,
15reimbursement rates for non-state-owned psychiatric medical
16institutions for children shall be based on the reimbursement
17methodology in effect on June 30, 2022.
18(2) As a condition of participation in the medical
19assistance program, enrolled providers shall accept the medical
20assistance reimbursement rate for any covered goods or services
21provided to recipients of medical assistance who are children
22under the custody of a psychiatric medical institution for
23children.
24j. For the fiscal year beginning July 1, 2022, unless
25otherwise specified in this Act, all noninstitutional medical
26assistance provider reimbursement rates shall remain at the
27rates in effect on June 30, 2022, except for area education
28agencies, local education agencies, infant and toddler
29services providers, home and community-based services providers
30including consumer-directed attendant care providers under a
31section 1915(c) or 1915(i) waiver, targeted case management
32providers, and those providers whose rates are required to be
33determined pursuant to section 249A.20, or to meet federal
34mental health parity requirements.
35k. Notwithstanding any provision to the contrary, for the
-47-1fiscal year beginning July 1, 2022, the reimbursement rate for
2anesthesiologists shall remain at the rates in effect on June
330, 2022, and updated on January 1, 2023, to align with the
4most current Iowa Medicare anesthesia rate.
5l. Notwithstanding section 249A.20, for the fiscal year
6beginning July 1, 2022, the average reimbursement rate for
7health care providers eligible for use of the federal Medicare
8resource-based relative value scale reimbursement methodology
9under section 249A.20 shall remain at the rate in effect on
10June 30, 2022; however, this rate shall not exceed the maximum
11level authorized by the federal government.
12m. For the fiscal year beginning July 1, 2022, the
13reimbursement rate for residential care facilities shall not
14be less than the minimum payment level as established by the
15federal government to meet the federally mandated maintenance
16of effort requirement. The flat reimbursement rate for
17facilities electing not to file annual cost reports shall not
18be less than the minimum payment level as established by the
19federal government to meet the federally mandated maintenance
20of effort requirement.
21n. For the fiscal year beginning July 1, 2022, the
22reimbursement rates for inpatient mental health services
23provided at hospitals shall remain at the rates in effect on
24June 30, 2022, subject to Medicaid program upper payment limit
25rules and adjusted as necessary to maintain expenditures within
26the amount appropriated to the department for this purpose for
27the fiscal year; and psychiatrists shall be reimbursed at the
28medical assistance program fee-for-service rate in effect on
29June 30, 2022.
30o. For the fiscal year beginning July 1, 2022, community
31mental health centers may choose to be reimbursed for the
32services provided to recipients of medical assistance through
33either of the following options:
34(1) For 100 percent of the reasonable costs of the services.
35(2) In accordance with the alternative reimbursement rate
-48-1methodology approved by the department of human services in
2effect on June 30, 2022.
3p. For the fiscal year beginning July 1, 2022, the
4reimbursement rate for providers of family planning services
5that are eligible to receive a 90 percent federal match shall
6remain at the rates in effect on June 30, 2022.
7q. (1) For the fiscal year beginning July 1, 2022,
8reimbursement rates for providers of home and community-based
9services waiver and habilitation services shall remain at the
10rates in effect on June 30, 2022.
11(2) For the fiscal year beginning July 1, 2022,
12reimbursement rates for providers of state plan home and
13community-based services home-based habilitation services
14shall remain at the rates in effect on June 30, 2022. The
15reimbursement rates for home-based habilitation services shall
16be based on a fee schedule that incorporates the acuity-based
17tiers.
18r. For the fiscal year beginning July 1, 2022, the
19reimbursement rates for emergency medical service providers
20shall remain at the rates in effect on June 30, 2022, 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, 2022, reimbursement
24rates for substance-related disorder treatment programs
25licensed under section 125.13 shall remain at the rates in
26effect on June 30, 2022.
27t. For the fiscal year beginning July 1, 2022, assertive
28community treatment per diem rates shall remain at the rates in
29effect on June 30, 2022.
30u. For the fiscal year beginning July 1, 2022, the
31reimbursement rate for family-centered services providers shall
32be established by contract.
33v. For the fiscal year beginning July 1, 2022, the
34reimbursement rate for air ambulance services shall remain at
35the rate in effect on June 30, 2022.
-49- 12. For the fiscal year beginning July 1, 2022, the
2reimbursement rate for providers reimbursed under the
3in-home-related care program shall not be less than the minimum
4payment level as established by the federal government to meet
5the federally mandated maintenance of effort requirement.
63. Unless otherwise directed in this section, when the
7department’s reimbursement methodology for any provider
8reimbursed in accordance with this section includes an
9inflation factor, this factor shall not exceed the amount
10by which the consumer price index for all urban consumers
11increased during the calendar year ending December 31, 2002.
124. Notwithstanding section 234.38, for the fiscal
13year beginning July 1, 2022, the foster family basic daily
14maintenance rate and the maximum adoption subsidy rate for
15children ages 0 through 5 years shall be $16.78, the rate for
16children ages 6 through 11 years shall be $17.45, the rate for
17children ages 12 through 15 years shall be $19.10, and the
18rate for children and young adults ages 16 and older shall
19be $19.35. For youth ages 18 to 23 who have exited foster
20care, the preparation for adult living program maintenance
21rate shall be up to $602.70 per month as calculated based on
22the age of the participant. The maximum payment for adoption
23subsidy nonrecurring expenses shall be limited to $500 and the
24disallowance of additional amounts for court costs and other
25related legal expenses implemented pursuant to 2010 Iowa Acts,
26chapter 1031, section 408, shall be continued.
275. For the fiscal year beginning July 1, 2022, the maximum
28reimbursement rates for social services providers under
29contract shall remain at the rates in effect on June 30, 2022,
30or the provider’s actual and allowable cost plus inflation for
31each service, whichever is less. However, if a new service
32or service provider is added after June 30, 2022, the initial
33reimbursement rate for the service or provider shall be based
34upon a weighted average of provider rates for similar services.
356. a. For the fiscal year beginning July 1, 2022, the
-50-1reimbursement rates for resource family recruitment and
2retention contractors shall be established by contract.
3b. For the fiscal year beginning July 1, 2022, the
4reimbursement rates for supervised apartment living foster care
5providers shall be established by contract.
67. For the fiscal year beginning July 1, 2022, the
7reimbursement rate for group foster care providers shall be the
8combined service and maintenance reimbursement rate established
9by contract.
108. The group foster care reimbursement rates paid for
11placement of children out of state shall be calculated
12according to the same rate-setting principles as those used for
13in-state providers, unless the director of human services or
14the director’s designee determines that appropriate care cannot
15be provided within the state. The payment of the daily rate
16shall be based on the number of days in the calendar month in
17which service is provided.
189. a. For the fiscal year beginning July 1, 2022, the
19reimbursement rate paid for shelter care and the child welfare
20emergency services implemented to provide or prevent the need
21for shelter care shall be the combined service and maintenance
22rate established by contract.
23b. For the fiscal year beginning July 1, 2022, the combined
24service and maintenance components of the reimbursement rate
25paid for shelter care services shall be based on the financial
26and statistical report submitted to the department.
2710. For the fiscal year beginning July 1, 2022, the
28department shall calculate reimbursement rates for intermediate
29care facilities for persons with an intellectual disability
30at the 80th percentile. Beginning July 1, 2022, the rate
31calculation methodology shall utilize the consumer price index
32inflation factor applicable to the fiscal year beginning July
331, 2022.
3411. Effective July 1, 2022, child care provider
35reimbursement rates shall remain at the rates in effect on June
-51-130, 2022. The department shall set rates in a manner so as
2to provide incentives for a nonregistered provider to become
3registered by applying any increase only to registered and
4licensed providers.
512. The department may adopt emergency rules to implement
6this section.
7 Sec. 32. EMERGENCY RULES.
81. If necessary to comply with federal requirements
9including time frames, or if specifically authorized by a
10provision of this division of this Act, the department of
11human services or the mental health and disability services
12commission may adopt administrative rules under section 17A.4,
13subsection 3, and section 17A.5, subsection 2, paragraph “b”,
14to implement the provisions of this division of this Act and
15the rules shall become effective immediately upon filing or
16on a later effective date specified in the rules, unless the
17effective date of the rules is delayed or the applicability
18of the rules is suspended by the administrative rules review
19committee. Any rules adopted in accordance with this section
20shall not take effect before the rules are reviewed by the
21administrative rules review committee. The delay authority
22provided to the administrative rules review committee under
23section 17A.4, subsection 7, and section 17A.8, subsections
249 and 10, shall be applicable to a delay imposed under this
25section, notwithstanding a provision in those subsections
26making them inapplicable to section 17A.5, subsection 2,
27paragraph “b”. Any rules adopted in accordance with the
28provisions of this section shall also be published as a notice
29of intended action as provided in section 17A.4.
302. If during a fiscal year, the department of human
31services is adopting rules in accordance with this section
32or as otherwise directed or authorized by state law, and
33the rules will result in an expenditure increase beyond the
34amount anticipated in the budget process or if the expenditure
35was not addressed in the budget process for the fiscal
-52-1year, the department shall notify the general assembly and
2the department of management concerning the rules and the
3expenditure increase. The notification shall be provided at
4least 30 calendar days prior to the date notice of the rules
5is submitted to the administrative rules coordinator and the
6administrative code editor.
7 Sec. 33. REPORTS. Unless otherwise provided, any reports or
8other information required to be compiled and submitted under
9this Act during the fiscal year beginning July 1, 2022, shall
10be submitted on or before the dates specified for submission
11of the reports or information.
12 Sec. 34. EFFECTIVE UPON ENACTMENT. The following provision
13of this division of this Act, being deemed of immediate
14importance, takes effect upon enactment:
15The provision relating to section 232.141 and directing the
16state court administrator and the division administrator of
17the department of human services division of child and family
18services to make the determination, by June 15, 2022, of the
19distribution of funds allocated for the payment of the expenses
20of court-ordered services provided to juveniles which are a
21charge upon the state.
22DIVISION VI
23HEALTH CARE ACCOUNTS AND FUNDS — FY 2022-2023
24 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
25appropriated from the pharmaceutical settlement account created
26in section 249A.33 to the department of human services for the
27fiscal year beginning July 1, 2022, and ending June 30, 2023,
28the following amount, or so much thereof as is necessary, to be
29used for the purpose designated:
30Notwithstanding any provision of law to the contrary, to
31supplement the appropriations made in this Act for health
32program operations under the medical assistance program for the
33fiscal year beginning July 1, 2022, and ending June 30, 2023:
.................................................. $34234,193
35 Sec. 36. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
-53-1SERVICES. Notwithstanding any provision to the contrary and
2subject to the availability of funds, there is appropriated
3from the quality assurance trust fund created in section
4249L.4 to the department of human services for the fiscal year
5beginning July 1, 2022, and ending June 30, 2023, the following
6amounts, or so much thereof as is necessary, for the purposes
7designated:
8To supplement the appropriation made in this Act from the
9general fund of the state to the department of human services
10for medical assistance for the same fiscal year:
.................................................. $1156,305,139
12 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
13DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
14the contrary and subject to the availability of funds, there is
15appropriated from the hospital health care access trust fund
16created in section 249M.4 to the department of human services
17for the fiscal year beginning July 1, 2022, and ending June
1830, 2023, the following amounts, or so much thereof as is
19necessary, for the purposes designated:
20To supplement the appropriation made in this Act from the
21general fund of the state to the department of human services
22for medical assistance for the same fiscal year:
.................................................. $2333,920,554
24 Sec. 38. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
25FOR FY 2022-2023. Notwithstanding section 8.33, if moneys
26appropriated for purposes of the medical assistance program for
27the fiscal year beginning July 1, 2022, and ending June 30,
282023, from the general fund of the state, the quality assurance
29trust fund, and the hospital health care access trust fund, are
30in excess of actual expenditures for the medical assistance
31program and remain unencumbered or unobligated at the close
32of the fiscal year, the excess moneys shall not revert but
33shall remain available for expenditure for the purposes of the
34medical assistance program until the close of the succeeding
35fiscal year.
-54-1DIVISION VII
2DECATEGORIZATION CARRYOVER FUNDING
3 Sec. 39. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —
4TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
5subsection 5, paragraph “b”, any state-appropriated moneys in
6the funding pool that remained unencumbered or unobligated
7at the close of the fiscal year beginning July 1, 2019, and
8were deemed carryover funding to remain available for the two
9succeeding fiscal years that still remain unencumbered or
10unobligated at the close of the fiscal year beginning July 1,
112021, shall not revert but shall be transferred to the medical
12assistance program for the fiscal year beginning July 1, 2022.
13 Sec. 40. EFFECTIVE DATE. This division of this Act, being
14deemed of immediate importance, takes effect upon enactment.
15 Sec. 41. RETROACTIVE APPLICABILITY. This division of this
16Act applies retroactively to July 1, 2021.
17DIVISION VIII
18TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE
19 Sec. 42. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —
20FY2021-2022. Notwithstanding any provision to the contrary,
21any funds remaining in the property tax relief fund created
22in section 426B.1 at the close of the fiscal year beginning
23July 1, 2021, shall be transferred to the region incentive fund
24created in the mental health and disability services regional
25service fund pursuant to section 225C.7A.
26 Sec. 43. EFFECTIVE DATE. This division of this Act, being
27deemed of immediate importance, takes effect upon enactment.
28DIVISION IX
29PRIOR APPROPRIATIONS AND OTHER PROVISIONS
30FAMILY INVESTMENT PROGRAM GENERAL FUND
31 Sec. 44. 2021 Iowa Acts, chapter 182, section 9, is amended
32by adding the following new subsection:
33 NEW SUBSECTION. 7. Notwithstanding section 8.33, moneys
34appropriated in this section that remain unencumbered or
35unobligated at the close of the fiscal year shall not revert
-55-1but shall remain available for one-time expenditure purposes,
2and may be transferred to the appropriation in this division of
3this Act for general administration for technology purposes,
4until the close of the succeeding fiscal year.
5CHILD AND FAMILY SERVICES
6 Sec. 45. 2021 Iowa Acts, chapter 182, section 19, is amended
7by adding the following new subsection:
8 NEW SUBSECTION. 24. Notwithstanding section 8.33, moneys
9appropriated in this section that remain unencumbered or
10unobligated at the close of the fiscal year shall not revert
11but shall remain available for the purposes designated until
12the close of the succeeding fiscal year.
13GENERAL ADMINISTRATION
14 Sec. 46. 2021 Iowa Acts, chapter 182, section 28, is amended
15by adding the following new subsection:
16 NEW SUBSECTION. 8. Notwithstanding section 8.33, 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 one-time expenditure purposes
20until the close of the succeeding fiscal year.
21 Sec. 47. EFFECTIVE DATE. This division of this Act, being
22deemed of immediate importance, takes effect upon enactment.
23DIVISION X
24PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS
25 Sec. 48. COVID-19 FEDERAL REGULATIONS. For the time
26period beginning on the effective date of this division of
27this Act, and ending June 30, 2023, notwithstanding state
28administrative rules to the contrary, to the extent federal
29regulations relating to the COVID-19 pandemic differ from state
30administrative rules, including applicable federal waivers,
31the federal regulations are controlling during the pendency of
32the federally declared state of emergency and for such period
33of time following the end of the federally declared state of
34emergency applicable to the respective federal regulations.
35DIVISION XI
-56-1HEALTH AND HUMAN SERVICES REALIGNMENT
2 Sec. 49. TRANSITION OF DEPARTMENT OF HUMAN SERVICES AND
3DEPARTMENT OF PUBLIC HEALTH INTO DEPARTMENT OF HEALTH AND HUMAN
4SERVICES.
51. Definitions. For the purposes of this section:
6a. “Department of health and human services” or
7“department” means the department of health and human services
8created under this section.
9b. “Transition department” means the department of human
10services or the department of public health.
11c. “Transition departments” means the department of human
12services and the department of public health.
13d. “Transition period” means the period beginning July 1,
142022, and ending June 30, 2023.
152. Creation of department of health and human services
16— transition period — powers and duties. Notwithstanding
17any conflicting provision of law to the contrary, there is
18created a department of health and human services. During
19the transition period, the department of health and human
20services shall have and may exercise all of the policymaking
21functions, regulatory and enforcement powers, rights, duties,
22and responsibilities of the department of human services and
23the department of public health as prescribed by law or rule
24in effect on July 1, 2022, including but not limited to those
25relating to:
26a. All obligations and contracts of a transition
27department, including obligations and contracts related to a
28grant program.
29b. All property and records in the custody of a transition
30department.
31c. All funds appropriated to a transition department by the
32general assembly and all state, federal, and other funds for
33which expenditure by a transition department is authorized.
34d. Complaints, investigations, contested cases, causes of
35action, and statutes of limitations involving a transition
-57-1department.
2(1) All complaints, investigations, contested cases, or
3a remand of an action by a reviewing court pending before a
4transition department or an authorized person of a transition
5department shall continue without change in status before
6the department and shall be governed by the laws and rules
7applicable to the complaint, investigation, contested case, or
8remand action or proceeding in effect on July 1, 2022.
9(2) Any cause of action or statute of limitation relating
10to a transition department shall not be affected as a result
11of the transition and such cause of action or statute of
12limitation shall apply to the department.
13e. Rules, policies, and forms. All rules, policies, and
14forms adopted by or on behalf of a transition department shall
15become rules, policies, and forms of the department and shall
16remain in effect unless altered by the department.
17f. Licenses, permits, and certifications. All licenses,
18permits, and certifications issued by a transition department
19shall continue in effect as a license, permit, or certification
20of the department in accordance with the law or rule governing
21the license, permit, or certification in effect on July 1,
222022, until the license, permit, or certification expires, is
23suspended or revoked, or otherwise becomes invalid by the terms
24of such law or rule.
25g. References to a department or director. All references
26to the department of public health or the department of human
27services in law or in rule shall be interpreted to mean the
28department of health and human services, and all references to
29the director of public health or the director of human services
30shall be interpreted to mean the director of the department of
31health and human services.
32h. Departmental structure.
33(1) Any transition department, transition department
34subunit, or transition department body created or established
35by law and in existence on July 1, 2022, shall continue in
-58-1full force and effect and shall not be permanently abolished,
2merged, or otherwise altered until amended, repealed, or
3supplemented by action of the general assembly.
4(2) This paragraph shall not prohibit a transition
5department, transition department subunit, or transition
6department body created or established by law in existence on
7July 1, 2022, from sharing or coordinating responsibilities
8or functions under their respective purviews nor prohibit
9the director from temporarily integrating such departments,
10subunits, or bodies or the responsibilities or functions under
11their respective purviews in furtherance of the transition plan
12during the transition period.
133. Transition period leadership. During the transition
14period, the director of human services shall continue to act
15as the director of human services, shall assume the duties of
16the director of public health, shall act as the director of
17the department of health and human services, and may thereby
18exercise any policymaking functions, regulatory and enforcement
19powers, rights, duties, and responsibilities of the director
20of human services and the director of public health including
21those duties prescribed by law for the department of human
22services or the department of public health in effect on July
231, 2022.
244. Federal authorization and effective date of
25authorizations. If a transition department or the department
26determines that a waiver or authorization from the federal
27government is necessary to administer any provision of
28this section, the department shall request the waiver or
29authorization, and notwithstanding any other effective date to
30the contrary, the provision shall take effect only upon receipt
31of federal approval.
325. Initial written transition plan.
33a. On or before September 30, 2022, the transition
34departments or department shall publish on their respective
35internet sites an initial written transition plan for merging
-59-1the functions of the transition departments into the department
2of health and human services effective July 1, 2023, in order
3to do all of the following:
4(1) More efficiently and effectively manage health and
5human services programs that are the responsibility of the
6state.
7(2) Establish a health and human services policy for the
8state.
9(3) Promote health and the quality of life in the health and
10human services field.
11b. The transition plan shall describe, at a minimum, all of
12the following:
13(1) The tasks that require completion before July 1, 2023,
14including a description of how the transition departments shall
15solicit comment from stakeholders, including employees of the
16transition departments, clients and partners of the transition
17departments, members of the public, and members of the general
18assembly.
19(2) The proposed organizational structure of the
20department, at a minimum, including the division level of
21the table of organization. Any personnel in the state merit
22system of employment who are mandatorily transferred due to the
23transition shall be so transferred without any loss in salary,
24benefits, or accrued years of service.
25(3) Proposed changes to any transition department boards,
26commissions, committees, councils, or other bodies and their
27functions.
28(4) Office space and infrastructure requirements related
29to the transition.
30(5) Any work site location changes for transitioning
31employees.
32(6) The transition of service delivery sites.
33(7) Procedures for the transfer and reconciliation of
34budgeting and funding between the transition departments and
35the department.
-60- 1(8) The transition of technology services of the transition
2departments to the department.
3(9) Any additional known tasks that may require completion
4after the transition on July 1, 2023.
5c. The written transition plan published under paragraph
6“b” shall:
7(1) Include a detailed timeline for the completion of the
8tasks described.
9(2) Be updated quarterly during the remainder of the
10transition period.
11(3) Describe how information will be provided to clients
12of the transition departments and the department regarding any
13changes in service delivery.
14(4) Describe how the transition to the department will be
15funded, including how expenses associated with the transition
16will be managed; how funding for services provided by the
17transition departments will be managed to ensure provision
18of services by the transition departments and the department
19without interruption; and how federal funds will be used by
20or transferred between the transition departments and the
21department to ensure provision of services by the transition
22departments and the department without interruption.
236. Statutory and administrative rule updates.
24a. Legislative changes required to implement the
25transition. Additional legislation is necessary to fully
26implement the transition. The director of the department
27of health and human services shall, in compliance with
28section 2.16, prepare draft legislation for submission to the
29legislative services agency, as necessary, for consideration
30by the general assembly during the 2023 legislative
31session, to implement the transition effective July 1, 2023.
32Notwithstanding any provision to the contrary in section 2.16,
33the draft legislation shall be submitted to the legislative
34services agency by October 1, 2022.
35b. Update of administrative code required by the
-61-1transition. In updating references and the format in the
2Iowa administrative code, in order to correspond to the
3transferring of duties of the transition departments, the
4administrative rules coordinator and the administrative rules
5review committee, in consultation with the administrative code
6editor, shall collectively develop a schedule for the necessary
7updating of the Iowa administrative code.
8DIVISION XII
9NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY
10OF CARE RATE ADD-ON PROGRAM
11 Sec. 50. Section 249L.2, subsections 6 and 7, Code 2022, are
12amended by striking the subsections.
13 Sec. 51. Section 249L.2, subsection 8, Code 2022, is amended
14to read as follows:
158. “Nursing facility” means a licensed nursing facility as
16defined in section 135C.1 that is a freestanding facility or
17a nursing facility operated by a hospital licensed pursuant
18to chapter 135B, but does not include a distinct-part skilled
19nursing unit or a swing-bed unit operated by a hospital, or
20a nursing facility owned by the state or federal government
21or other governmental unit.“Nursing facility” includes a
22non-state government-owned nursing facility if the nursing
23facility participates in the non-state government-owned nursing
24facility quality of care rate add-on program.
25 Sec. 52. REPEAL. 2019 Iowa Acts, chapter 85, sections 103,
26104, and 108, are repealed.
27 Sec. 53. REPEAL. 2020 Iowa Acts, chapter 1063, section 390,
28is repealed.
29EXPLANATION
30The inclusion of this explanation does not constitute agreement with
31the explanation’s substance by the members of the general assembly.
32This bill relates to appropriations for health and human
33services for fiscal year 2022-2023 to the department of
34veterans affairs, Iowa veterans home, department on aging
35(IDA), office of long-term care ombudsman, department of public
-62-1health (DPH), Iowa finance authority, department of human
2rights, and department of human services (DHS). The bill is
3organized into divisions for each fiscal year.
4DEPARTMENT ON AGING. This division makes appropriations
5from the general fund of the state to the department on aging.
6OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
7appropriations from the general fund of the state to the office
8of long-term care ombudsman.
9DEPARTMENT OF PUBLIC HEALTH. This division makes
10appropriations from the general fund of the state and from
11the sports wagering receipts fund to the department of public
12health.
13DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
14division makes appropriations from the general fund of the
15state to the department of veterans affairs for administration,
16the Iowa veterans home, for transfer to the Iowa finance
17authority for the home ownership assistance program and for the
18county commissions of veteran affairs.
19DEPARTMENT OF HUMAN SERVICES. This division makes
20appropriations from the general fund of the state and the
21federal temporary assistance for needy families block
22grant to DHS. The allocation for the family development
23and self-sufficiency grant program is made directly to
24the department of human rights. The reimbursement section
25addresses reimbursement for providers reimbursed by the
26department of human services.
27HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
28health-related appropriations. A number of the appropriations
29are made for purposes of the Medicaid program in addition to
30the general fund appropriations made for this purpose for the
31same fiscal year.
32DECATEGORIZATION CARRYOVER FUNDING. This division provides
33for the transfer of carryover decategorization funds that
34remained unencumbered or unobligated at the close of the fiscal
35year beginning July 1, 2021, to the Medicaid program for
-63-1FY 2022-2023. The division takes effect upon enactment and is
2retroactively applicable to July 1, 2021.
3TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE. This division
4transfers any funds remaining in the property tax relief fund
5created in Code section 426B.1 at the close of FY 2021-2022 to
6the region incentive fund created in the mental health and
7disability services regional service fund pursuant to Code
8section 225C.7A. The division takes effect upon enactment.
9PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division
10provides that moneys appropriated for the family investment
11program general fund, child and family services and general
12administration for FY 2021-2022 shall not revert but shall
13remain available for one-time expenditure or for the purposes
14designated, or may be transferred, as specified, until the
15close of the succeeding fiscal year.
16PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS.
17 This division provides that for FY 2022-2023, notwithstanding
18state administrative rules to the contrary, to the extent
19federal regulations relating to the COVID-19 pandemic differ
20from state administrative rules, including applicable federal
21waivers, the federal regulations are controlling during the
22pendency of the federally declared state of emergency and for
23such period of time following the end of the federally declared
24state of emergency applicable to the respective federal
25regulations.
26HEALTH AND HUMAN SERVICES REALIGNMENT. This division
27provides a process during a transition period beginning July
281, 2022, and ending June 30, 2023, for the realignment of
29the department of public health and the department of human
30services into the department of health and human services
31effective July 1, 2023.
32NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY OF CARE
33RATE ADD-ON PROGRAM. This division eliminates the non-state
34government-owned nursing facility quality of care rate add-on
35program, and makes conforming changes in the Iowa Acts and the
-64-1Code.
-65-pf/rn