Print
House File 2578 - ReprintedA Bill ForAn Act 1relating to appropriations for health and human
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 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, and
17for not more than the following full-time equivalent positions:
.................................................. $1811,804,082
............................................... FTEs1928.00
201. Funds appropriated in this section may be used to
21supplement federal funds under federal regulations. To
22receive funds appropriated in this section, a local area
23agency on aging shall match the funds with moneys from other
24sources according to rules adopted by the department. Funds
25appropriated in this section may be used for elderly services
26not specifically enumerated in this section only if approved
27by an area agency on aging for provision of the service within
28the area.
292. Of the funds appropriated in this section, $418,700 is
30transferred to the economic development authority for the Iowa
31commission on volunteer services to be used for the retired and
32senior volunteer program.
333. a. The department on aging shall establish and enforce
34procedures relating to expenditure of state and federal funds
35by area agencies on aging that require compliance with both
-1-1state and federal laws, rules, and regulations, including but
2not limited to all of the following:
3(1) Requiring that expenditures are incurred only for goods
4or services received or performed prior to the end of the
5fiscal period designated for use of the funds.
6(2) Prohibiting prepayment for goods or services not
7received or performed prior to the end of the fiscal period
8designated for use of the funds.
9(3) Prohibiting prepayment for goods or services not
10defined specifically by good or service, time period, or
11recipient.
12(4) Prohibiting the establishment of accounts from which
13future goods or services which are not defined specifically by
14good or service, time period, or recipient, may be purchased.
15b. The procedures shall provide that if any funds are
16expended in a manner that is not in compliance with the
17procedures and applicable federal and state laws, rules, and
18regulations, and are subsequently subject to repayment, the
19area agency on aging expending such funds in contravention of
20such procedures, laws, rules and regulations, not the state,
21shall be liable for such repayment.
224. Of the funds appropriated in this section, $1,312,000
23shall be used for the purposes of chapter 231E and to
24administer the prevention of elder abuse, neglect, and
25exploitation program pursuant to section 231.56A, in accordance
26with the requirements of the federal Older Americans Act of
271965, 42 U.S.C.§3001 et seq., as amended.
285. Of the funds appropriated in this section, $1,000,000
29shall be used to fund continuation of the aging and disability
30resource center lifelong links to provide individuals and
31caregivers with information and services to plan for and
32maintain independence.
336. Of the funds appropriated in this section, $850,000
34shall be used by the department on aging, in collaboration with
35the department of human services and affected stakeholders,
-2-1to continue to expand the pilot initiative to provide
2long-term care options counseling utilizing support planning
3protocols, to assist non-Medicaid eligible consumers who
4indicate a preference to return to the community and are
5deemed appropriate for discharge, to return to their community
6following a nursing facility stay; and shall be used by the
7department on aging to fund home and community-based services
8to enable older individuals to avoid more costly utilization
9of residential or institutional services and remain in their
10homes. The department on aging shall submit a report regarding
11the outcomes of the pilot initiative to the governor and the
12general assembly by December 15, 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, and for not more than the following
23full-time equivalent positions:
.................................................. $241,449,821
............................................... FTEs2516.00
26DIVISION III
27DEPARTMENT OF PUBLIC HEALTH — FY 2022-2023
28 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
29from the general fund of the state to the department of public
30health for the fiscal year beginning July 1, 2022, and ending
31June 30, 2023, the following amounts, or so much thereof as is
32necessary, to be used for the purposes designated:
331. ADDICTIVE DISORDERS
34For reducing the prevalence of the use of tobacco, alcohol,
35and other drugs, and treating individuals affected by addictive
-3-1behaviors, including gambling, and for not more than the
2following full-time equivalent positions:
.................................................. $323,659,379
............................................... FTEs412.00
5a. Of the funds appropriated in this subsection, $4,020,894
6shall be used for the tobacco use prevention and control
7initiative, including efforts at the state and local levels,
8as provided in chapter 142A. The commission on tobacco use
9prevention and control established pursuant to section 142A.3
10shall advise the director of public health in prioritizing
11funding needs and the allocation of moneys appropriated for
12the programs and initiatives. Activities of the programs
13and initiatives shall be in alignment with the United States
14centers for disease control and prevention best practices
15for comprehensive tobacco control programs that include
16the goals of preventing youth initiation of tobacco usage,
17reducing exposure to secondhand smoke, and promotion of tobacco
18cessation.
19b. (1) Of the funds appropriated in this subsection,
20$19,638,485 shall be used for problem gambling and
21substance-related disorder prevention, treatment, and recovery
22services, including a 24-hour helpline, public information
23resources, professional training, youth prevention, and program
24evaluation.
25(2) Of the amount allocated under this paragraph, $306,000
26shall be utilized by the department of public health, in
27collaboration with the department of human services, to
28maintain a single statewide 24-hour crisis hotline for the Iowa
29children’s behavioral health system that incorporates warmline
30services which may be provided through expansion of existing
31capabilities maintained by the department of public health as
32required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
33c. The requirement of section 123.17, subsection 5, is met
34by the appropriations and allocations made in this division of
35this Act for purposes of substance-related disorder treatment
-4-1and addictive disorders for the fiscal year beginning July 1,
22022.
32. HEALTHY CHILDREN AND FAMILIES
4For promoting the optimum health status for children and
5adolescents from birth through 21 years of age, and families,
6and for not more than the following full-time equivalent
7positions:
.................................................. $85,816,681
............................................... FTEs914.00
103. CHRONIC CONDITIONS
11For serving individuals identified as having chronic
12conditions or special health care needs, and for not more than
13the following full-time equivalent positions:
.................................................. $144,258,373
............................................... FTEs1510.00
164. COMMUNITY CAPACITY
17For strengthening the health care delivery system at the
18local level, and for not more than the following full-time
19equivalent positions:
.................................................. $206,519,306
............................................... FTEs2113.00
22a. Of the funds appropriated in this subsection, $2,100,000
23shall be deposited in the medical residency training account
24created in section 135.175, subsection 5, paragraph “a”, and
25is appropriated from the account to the department of public
26health to be used for the purposes of the medical residency
27training state matching grants program as specified in section
28135.176.
29b. Of the funds appropriated in this subsection, $800,000
30shall be used for rural psychiatric residencies to support the
31annual creation and training of six psychiatric residents who
32will provide mental health services in underserved areas of
33the state. Notwithstanding section 8.33, moneys that remain
34unencumbered or unobligated at the close of the fiscal year
35shall not revert but shall remain available for expenditure for
-5-1the purposes designated for subsequent fiscal years.
2c. Of the funds appropriated in this subsection, $425,000
3shall be used for the creation or continuation of a center of
4excellence program to encourage innovation and collaboration
5among regional health care providers in a rural area based
6upon the results of a regional community needs assessment to
7transform health care delivery in order to provide quality,
8sustainable care that meets the needs of the local communities.
9An applicant for the funds shall specify how the funds will
10be expended to accomplish the goals of the program and shall
11provide a detailed five-year sustainability plan prior to
12being awarded any funding. Following the receipt of funding,
13a recipient shall submit periodic reports as specified by the
14department to the governor and the general assembly regarding
15the recipient’s expenditure of the funds and progress in
16accomplishing the program goals.
175. ESSENTIAL PUBLIC HEALTH SERVICES
18To provide public health services that reduce risks and
19invest in promoting and protecting good health over the
20course of a lifetime with a priority given to older Iowans and
21vulnerable populations:
.................................................. $227,662,464
236. INFECTIOUS DISEASES
24For reducing the incidence and prevalence of communicable
25diseases, and for not more than the following full-time
26equivalent positions:
.................................................. $271,796,206
............................................... FTEs286.00
297. PUBLIC PROTECTION
30a. For protecting the health and safety of the public
31through establishing standards and enforcing regulations, and
32for not more than the following full-time equivalent positions:
.................................................. $334,466,601
............................................... FTEs34142.00
35b. Of the funds appropriated in this subsection, not more
-6-1than $304,000 shall be credited to the emergency medical
2services fund created in section 135.25. Moneys in the
3emergency medical services fund are appropriated to the
4department to be used for the purposes of the fund.
58. RESOURCE MANAGEMENT
6For establishing and sustaining the overall ability of the
7department to deliver services to the public, and for not more
8than the following full-time equivalent positions:
.................................................. $9933,871
............................................... FTEs104.00
119. MISCELLANEOUS PROVISIONS
12The university of Iowa hospitals and clinics under the
13control of the state board of regents shall not receive
14indirect costs from the funds appropriated in this section.
15The university of Iowa hospitals and clinics billings to the
16department shall be on at least a quarterly basis.
17 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
18RECEIPTS FUND. There is appropriated from the sports wagering
19receipts fund created in section 8.57, subsection 6, to the
20department of public health for the fiscal year beginning July
211, 2022, and ending June 30, 2023, the following amount, or
22so much thereof as is necessary, to be used for the purposes
23designated:
24For problem gambling and substance-related disorder
25prevention, treatment, and recovery services, including a
2624-hour helpline, public information resources, professional
27training, youth prevention, and program evaluation:
.................................................. $281,750,000
29DIVISION IV
30DEPARTMENT OF VETERANS AFFAIRS — FY 2022-2023
31 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
32appropriated from the general fund of the state to the
33department of veterans affairs for the fiscal year beginning
34July 1, 2022, and ending June 30, 2023, the following amounts,
35or so much thereof as is necessary, to be used for the purposes
-7-1designated:
21. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
3For salaries, support, maintenance, and miscellaneous
4purposes, and for not more than the following full-time
5equivalent positions:
.................................................. $61,229,763
............................................... FTEs715.00
82. IOWA VETERANS HOME
9For salaries, support, maintenance, and miscellaneous
10purposes:
.................................................. $117,131,552
12a. The Iowa veterans home billings involving the department
13of human services shall be submitted to the department on at
14least a monthly basis.
15b. The Iowa veterans home expenditure report shall be
16submitted monthly to the general assembly.
17c. The Iowa veterans home shall continue to include in the
18annual discharge report applicant information to provide for
19the collection of demographic information including but not
20limited to the number of individuals applying for admission and
21admitted or denied admittance and the basis for the admission
22or denial; the age, gender, and race of such individuals;
23and the level of care for which such individuals applied for
24admission including residential or nursing level of care.
253. HOME OWNERSHIP ASSISTANCE PROGRAM
26For transfer to the Iowa finance authority for the
27continuation of the home ownership assistance program for
28persons who are or were eligible members of the armed forces of
29the United States, pursuant to section 16.54:
.................................................. $302,000,000
31 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
32FUND STANDING APPROPRIATIONS. Notwithstanding the standing
33appropriation in section 35A.16 for the fiscal year beginning
34July 1, 2022, and ending June 30, 2023, the amount appropriated
35from the general fund of the state pursuant to that section
-8-1for the following designated purposes shall not exceed the
2following amount:
3For the county commissions of veteran affairs fund under
4section 35A.16:
.................................................. $5990,000
6DIVISION V
7DEPARTMENT OF HUMAN SERVICES — FY 2022-2023
8 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
9GRANT. There is appropriated from the fund created in section
108.41 to the department of human services for the fiscal year
11beginning July 1, 2022, and ending June 30, 2023, from moneys
12received under the federal temporary assistance for needy
13families (TANF) block grant pursuant to the federal Personal
14Responsibility and Work Opportunity Reconciliation Act of 1996,
15Pub.L.No.104-193, and successor legislation, the following
16amounts, or so much thereof as is necessary, to be used for the
17purposes designated:
181. To be credited to the family investment program account
19and used for assistance under the family investment program
20under chapter 239B:
.................................................. $215,002,006
222. To be credited to the family investment program account
23and used for the job opportunities and basic skills (JOBS)
24program and implementing family investment agreements in
25accordance with chapter 239B:
.................................................. $265,412,060
273. To be used for the family development and
28self-sufficiency grant program in accordance with section
29216A.107:
.................................................. $302,888,980
31Notwithstanding section 8.33, moneys appropriated in this
32subsection that remain unencumbered or unobligated at the close
33of the fiscal year shall not revert but shall remain available
34for expenditure for the purposes designated until the close of
35the succeeding fiscal year. However, unless such moneys are
-9-1encumbered or obligated on or before September 30, 2023, the
2moneys shall revert.
34. For field operations:
.................................................. $431,296,232
55. For general administration:
.................................................. $63,744,000
76. For state child care assistance:
.................................................. $847,166,826
9a. Of the funds appropriated in this subsection,
10$26,205,412 is transferred to the child care and development
11block grant appropriation made by the Eighty-ninth General
12Assembly, 2022 session, for the federal fiscal year beginning
13October 1, 2022, and ending September 30, 2023. Of this
14amount, $200,000 shall be used for provision of educational
15opportunities to registered child care home providers in order
16to improve services and programs offered by this category
17of providers and to increase the number of providers. The
18department may contract with institutions of higher education
19or child care resource and referral centers to provide
20the educational opportunities. Allowable administrative
21costs under the contracts shall not exceed 5 percent. The
22application for a grant shall not exceed two pages in length.
23b. Any funds appropriated in this subsection remaining
24unallocated shall be used for state child care assistance
25payments for families who are employed including but not
26limited to individuals enrolled in the family investment
27program.
287. For child and family services:
.................................................. $2932,380,654
308. For child abuse prevention grants:
.................................................. $31125,000
329. For pregnancy prevention grants on the condition that
33family planning services are funded:
.................................................. $341,913,203
35Pregnancy prevention grants shall be awarded to programs
-10-1in existence on or before July 1, 2022, if the programs have
2demonstrated positive outcomes. Grants shall be awarded to
3pregnancy prevention programs which are developed after July
41, 2022, if the programs are based on existing models that
5have demonstrated positive outcomes. Grants shall comply with
6the requirements provided in 1997 Iowa Acts, chapter 208,
7section 14, subsections 1 and 2, including the requirement that
8grant programs must emphasize sexual abstinence. Priority in
9the awarding of grants shall be given to programs that serve
10areas of the state which demonstrate the highest percentage of
11unplanned pregnancies of females of childbearing age within the
12geographic area to be served by the grant.
1310. For technology needs and other resources necessary to
14meet federal and state reporting, tracking, and case management
15requirements and other departmental needs:
.................................................. $161,037,186
1711. a. Notwithstanding any provision to the contrary,
18including but not limited to requirements in section 8.41 or
19provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the
20receipt and appropriation of federal block grants, federal
21funds from the temporary assistance for needy families block
22grant received by the state and not otherwise appropriated
23in this section and remaining available for the fiscal year
24beginning July 1, 2022, are appropriated to the department of
25human services to the extent as may be necessary to be used in
26the following priority order: the family investment program,
27for state child care assistance program payments for families
28who are employed, and for the family investment program share
29of system costs for eligibility determination and related
30functions. The federal funds appropriated in this paragraph
31“a” shall be expended only after all other funds appropriated
32in subsection 1 for assistance under the family investment
33program, in subsection 6 for state child care assistance, or
34in subsection 10 for technology needs and other resources
35necessary to meet departmental needs, as applicable, have been
-11-1expended. For the purposes of this subsection, the funds
2appropriated in subsection 6, paragraph “a”, for transfer
3to the child care and development block grant appropriation
4are considered fully expended when the full amount has been
5transferred.
6b. The department shall, on a quarterly basis, advise the
7general assembly and department of management of the amount of
8funds appropriated in this subsection that was expended in the
9prior quarter.
1012. Of the amounts appropriated in this section,
11$12,962,008 for the fiscal year beginning July 1, 2022, is
12transferred to the appropriation of the federal social services
13block grant made to the department of human services for that
14fiscal year.
1513. For continuation of the program providing categorical
16eligibility for the supplemental nutrition assistance program
17(SNAP) as specified for the program in the section of this
18division of this Act relating to the family investment program
19account:
.................................................. $2014,236
2114. The department may transfer funds allocated in this
22section to the appropriations made in this division of this Act
23for the same fiscal year for general administration and field
24operations for resources necessary to implement and operate the
25services referred to in this section and those funded in the
26appropriation made in this division of this Act for the same
27fiscal year for the family investment program from the general
28fund of the state.
2915. With the exception of moneys allocated under this
30section for the family development and self-sufficiency grant
31program, to the extent moneys allocated in this section are
32deemed by the department not to be necessary to support the
33purposes for which they are allocated, such moneys may be used
34in the same fiscal year for any other purpose for which funds
35are allocated in this section or in section 8 of this division
-12-1of this Act for the family investment program account. If
2there are conflicting needs, priority shall first be given
3to the family investment program account as specified under
4subsection 1 of this section and used for the purposes of
5assistance under the family investment program in accordance
6with chapter 239B, followed by state child care assistance
7program payments for families who are employed, followed by
8other priorities as specified by the department.
9 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
101. Moneys credited to the family investment program (FIP)
11account for the fiscal year beginning July 1, 2022, and
12ending June 30, 2023, shall be used to provide assistance in
13accordance with chapter 239B.
142. The department may use a portion of the moneys credited
15to the FIP account under this section as necessary for
16salaries, support, maintenance, and miscellaneous purposes,
17including administrative and information technology costs
18associated with rent reimbursement and other income assistance
19programs administered by the department.
203. The department may transfer funds allocated in
21subsection 4, excluding the allocation under subsection 4,
22paragraph “b”, to the appropriations made in this division of
23this Act for the same fiscal year for general administration
24and field operations for resources necessary to implement
25and operate the services referred to in this section and
26those funded in the appropriations made in section 7 for the
27temporary assistance for needy families block grant and in
28section 9 for the family investment program from the general
29fund of the state in this division of this Act for the same
30fiscal year.
314. Moneys appropriated in this division of this Act and
32credited to the FIP account for the fiscal year beginning July
331, 2022, and ending June 30, 2023, are allocated as follows:
34a. To be retained by the department of human services to
35be used for coordinating with the department of human rights
-13-1to more effectively serve participants in FIP and other shared
2clients and to meet federal reporting requirements under the
3federal temporary assistance for needy families block grant:
.................................................. $410,000
5b. To the department of human rights for staffing,
6administration, and implementation of the family development
7and self-sufficiency grant program in accordance with section
8216A.107:
.................................................. $97,192,834
10(1) Of the funds allocated for the family development
11and self-sufficiency grant program in this paragraph “b”,
12not more than 5 percent of the funds shall be used for the
13administration of the grant program.
14(2) The department of human rights may continue to implement
15the family development and self-sufficiency grant program
16statewide during fiscal year 2022-2023.
17(3) The department of human rights may engage in activities
18to strengthen and improve family outcomes measures and
19data collection systems under the family development and
20self-sufficiency grant program.
21c. For the diversion subaccount of the FIP account:
.................................................. $221,293,000
23A portion of the moneys allocated for the diversion
24subaccount may be used for field operations, salaries, data
25management system development, and implementation costs and
26support deemed necessary by the director of human services
27in order to administer the FIP diversion program. To the
28extent moneys allocated in this paragraph “c” are deemed by the
29department not to be necessary to support diversion activities,
30such moneys may be used for other efforts intended to increase
31engagement by family investment program participants in work,
32education, or training activities, or for the purposes of
33assistance under the family investment program in accordance
34with chapter 239B.
35d. For the SNAP employment and training program:
-14-.................................................. $166,588
2(1) The department shall apply the federal SNAP employment
3and training state plan in order to maximize to the fullest
4extent permitted by federal law the use of the 50 percent
5federal reimbursement provisions for the claiming of allowable
6federal reimbursement funds from the United States department
7of agriculture pursuant to the federal SNAP employment and
8training program for providing education, employment, and
9training services for eligible SNAP participants, including
10but not limited to related dependent care and transportation
11expenses.
12(2) The department shall continue the categorical
13federal SNAP eligibility at 160 percent of the federal
14poverty level and continue to eliminate the asset test from
15eligibility requirements, consistent with federal SNAP program
16requirements. The department shall include as many SNAP
17households as is allowed by federal law. The eligibility
18provisions shall conform to all federal requirements including
19requirements addressing individuals who are disqualified for
20committing an intentional program violation or are otherwise
21ineligible.
22e. For the JOBS program, not more than:
.................................................. $2312,018,258
245. Of the child support collections assigned under FIP,
25an amount equal to the federal share of support collections
26shall be credited to the child support recovery appropriation
27made in this division of this Act. Of the remainder of the
28assigned child support collections received by the child
29support recovery unit, a portion shall be credited to the FIP
30account, a portion may be used to increase recoveries, and a
31portion may be used to sustain cash flow in the child support
32payments account. If as a consequence of the appropriations
33and allocations made in this section the resulting amounts
34are insufficient to sustain cash assistance payments and meet
35federal maintenance of effort requirements, the department
-15-1shall seek supplemental funding. If child support collections
2assigned under FIP are greater than estimated or are otherwise
3determined not to be required for maintenance of effort, the
4state share of either amount may be transferred to or retained
5in the child support payments account.
6 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
7is appropriated from the general fund of the state to the
8department of human services for the fiscal year beginning July
91, 2022, and ending June 30, 2023, the following amount, or
10so much thereof as is necessary, to be used for the purpose
11designated:
12To be credited to the family investment program (FIP)
13account and used for family investment program assistance
14under chapter 239B and other costs associated with providing
15needs-based benefits or assistance:
.................................................. $1641,003,978
171. Of the funds appropriated in this section, $6,606,198 is
18allocated for the JOBS program.
192. Of the funds appropriated in this section, $4,313,854 is
20allocated for the family development and self-sufficiency grant
21program.
223. a. Notwithstanding section 8.39, for the fiscal
23year beginning July 1, 2022, if necessary to meet federal
24maintenance of effort requirements or to transfer federal
25temporary assistance for needy families block grant funding
26to be used for purposes of the federal social services block
27grant or to meet cash flow needs resulting from delays in
28receiving federal funding or to implement, in accordance with
29this division of this Act, activities currently funded with
30juvenile court services, county, or community moneys and state
31moneys used in combination with such moneys; to comply with
32federal requirements; or to maximize the use of federal funds;
33the department of human services may transfer funds within or
34between any of the appropriations made in this division of this
35Act and appropriations in law for the federal social services
-16-1block grant to the department for the following purposes,
2provided that the combined amount of state and federal
3temporary assistance for needy families block grant funding
4for each appropriation remains the same before and after the
5transfer:
6(1) For the family investment program.
7(2) For state child care assistance.
8(3) For child and family services.
9(4) For field operations.
10(5) For general administration.
11b. This subsection shall not be construed to prohibit the
12use of existing state transfer authority for other purposes.
13The department shall report any transfers made pursuant to this
14subsection to the general assembly.
154. Of the funds appropriated in this section, $195,000
16shall be used for a contract for tax preparation assistance
17to low-income Iowans to expand the usage of the earned income
18tax credit. The purpose of the contract is to supply this
19assistance to underserved areas of the state. The department
20shall not retain any portion of the allocation under this
21subsection for administrative costs.
225. Of the funds appropriated in this section, $70,000 shall
23be used for the continuation of the parenting program, as
24specified in 441 IAC ch.100, relating to parental obligations,
25in which the child support recovery unit participates, to
26support the efforts of a nonprofit organization committed to
27strengthening the community through youth development, healthy
28living, and social responsibility headquartered in a county
29with a population over 450,000 according to the 2020 certified
30federal census. The funds allocated in this subsection shall
31be used by the recipient organization to develop a larger
32community effort, through public and private partnerships, to
33support a broad-based multi-county parenthood initiative that
34promotes payment of child support obligations, improved family
35relationships, and full-time employment.
-17- 16. The department may transfer funds appropriated in this
2section, excluding the allocation in subsection 2 for the
3family development and self-sufficiency grant program, to the
4appropriations made in this division of this Act for general
5administration and field operations as necessary to administer
6this section, section 7 for the temporary assistance for needy
7families block grant, and section 8 for the family investment
8program account.
9 Sec. 10. CHILD SUPPORT RECOVERY. 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 amount, or so much thereof as is
13necessary, to be used for the purposes designated:
14For child support recovery, including salaries, support,
15maintenance, and miscellaneous purposes, and for not more than
16the following full-time equivalent positions:
.................................................. $1715,942,885
............................................... FTEs18459.00
191. The department shall expend up to $24,000, including
20federal financial participation, for the fiscal year beginning
21July 1, 2022, for a child support public awareness campaign.
22The department and the office of the attorney general shall
23cooperate in continuation of the campaign. The public
24awareness campaign shall emphasize, through a variety of
25media activities, the importance of maximum involvement of
26both parents in the lives of their children as well as the
27importance of payment of child support obligations.
282. Federal access and visitation grant moneys shall be
29issued directly to private not-for-profit agencies that provide
30services designed to increase compliance with the child access
31provisions of court orders, including but not limited to
32neutral visitation sites and mediation services.
333. The appropriation made to the department for child
34support recovery may be used throughout the fiscal year in the
35manner necessary for purposes of cash flow management, and for
-18-1cash flow management purposes the department may temporarily
2draw more than the amount appropriated, provided the amount
3appropriated is not exceeded at the close of the fiscal year.
4 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
5FY 2022-2023. Any funds remaining in the health care trust
6fund created in section 453A.35A for the fiscal year beginning
7July 1, 2022, and ending June 30, 2023, are appropriated to
8the department of human services to supplement the medical
9assistance program appropriations made in this division of this
10Act, for medical assistance reimbursement and associated costs,
11including program administration and costs associated with
12program implementation.
13 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
142022-2023. Any funds remaining in the Medicaid fraud fund
15created in section 249A.50 for the fiscal year beginning
16July 1, 2022, and ending June 30, 2023, are appropriated to
17the department of human services to supplement the medical
18assistance appropriations made in this division of this Act,
19for medical assistance reimbursement and associated costs,
20including program administration and costs associated with
21program implementation.
22 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
23general fund of the state to the department of human services
24for the fiscal year beginning July 1, 2022, and ending June 30,
252023, the following amount, or so much thereof as is necessary,
26to be used for the purpose designated:
27For medical assistance program reimbursement and associated
28costs as specifically provided in the reimbursement
29methodologies in effect on June 30, 2022, except as otherwise
30expressly authorized by law, consistent with options under
31federal law and regulations, and contingent upon receipt of
32approval from the office of the governor of reimbursement for
33each abortion performed under the program:
.................................................. $341,539,659,031
351. Iowans support reducing the number of abortions
-19-1performed in our state. Funds appropriated under this section
2shall not be used for abortions, unless otherwise authorized
3under this section.
42. The provisions of this section relating to abortions
5shall also apply to the Iowa health and wellness plan created
6pursuant to chapter 249N.
73. The department shall utilize not more than $60,000 of
8the funds appropriated in this section to continue the AIDS/HIV
9health insurance premium payment program as established in 1992
10Iowa Acts, Second Extraordinary Session, chapter 1001, section
11409, subsection 6. Of the funds allocated in this subsection,
12not more than $5,000 may be expended for administrative
13purposes.
144. Of the funds appropriated in this Act to the department
15of public health for addictive disorders, $950,000 for
16the fiscal year beginning July 1, 2022, is transferred
17to the department of human services for an integrated
18substance-related disorder managed care system. The
19departments of human services and public health shall
20work together to maintain the level of mental health and
21substance-related disorder treatment services provided by the
22managed care contractors. Each department shall take the steps
23necessary to continue the federal waivers as necessary to
24maintain the level of services.
255. The department shall aggressively pursue options for
26providing medical assistance or other assistance to individuals
27with special needs who become ineligible to continue receiving
28services under the early and periodic screening, diagnostic,
29and treatment program under the medical assistance program
30due to becoming 21 years of age who have been approved for
31additional assistance through the department’s exception to
32policy provisions, but who have health care needs in excess
33of the funding available through the exception to policy
34provisions.
356. Of the funds appropriated in this section, up to
-20-1$3,050,082 may be transferred to the field operations or
2general administration appropriations in this division of this
3Act for operational costs associated with Part D of the federal
4Medicare Prescription Drug Improvement and Modernization Act
5of 2003, Pub.L.No.108-173.
67. Of the funds appropriated in this section, up to $442,100
7may be transferred to the appropriation in this division of
8this Act for health program operations to be used for clinical
9assessment services and prior authorization of services.
108. A portion of the funds appropriated in this section may
11be transferred to the appropriations in this division of this
12Act for general administration, health program operations, the
13children’s health insurance program, or field operations to be
14used for the state match cost to comply with the payment error
15rate measurement (PERM) program for both the medical assistance
16and children’s health insurance programs as developed by the
17centers for Medicare and Medicaid services of the United States
18department of health and human services to comply with the
19federal Improper Payments Information Act of 2002, Pub.L.
20No.107-300, and to support other reviews and quality control
21activities to improve the integrity of these programs.
229. Of the funds appropriated in this section, a sufficient
23amount is allocated to supplement the incomes of residents of
24nursing facilities, intermediate care facilities for persons
25with mental illness, and intermediate care facilities for
26persons with an intellectual disability, with incomes of less
27than $50 in the amount necessary for the residents to receive a
28personal needs allowance of $50 per month pursuant to section
29249A.30A.
3010. One hundred percent of the nonfederal share of payments
31to area education agencies that are medical assistance
32providers for medical assistance-covered services provided to
33medical assistance-covered children, shall be made from the
34appropriation made in this section.
3511. A portion of the funds appropriated in this section may
-21-1be transferred to the appropriation in this division of this
2Act for health program operations to be used for administrative
3activities associated with the money follows the person
4demonstration project.
512. Of the funds appropriated in this section, $349,011
6shall be used for the administration of the health insurance
7premium payment program, including salaries, support,
8maintenance, and miscellaneous purposes.
913. a. The department may increase the amounts allocated
10for salaries, support, maintenance, and miscellaneous purposes
11associated with the medical assistance program, as necessary,
12to sustain cost management efforts. The department shall
13report any such increase to the general assembly and the
14department of management.
15b. If the savings to the medical assistance program from
16ongoing cost management efforts exceed the associated cost
17for the fiscal year beginning July 1, 2022, the department
18may transfer any savings generated for the fiscal year due
19to medical assistance program cost management efforts to the
20appropriation made in this division of this Act for health
21program operations or general administration to defray the
22costs associated with implementing the efforts.
2314. For the fiscal year beginning July 1, 2022, and ending
24June 30, 2023, the replacement generation tax revenues required
25to be deposited in the property tax relief fund pursuant to
26section 437A.8, subsection 4, paragraph “d”, and section
27437A.15, subsection 3, paragraph “f”, shall instead be credited
28to and supplement the appropriation made in this section and
29used for the allocations made in this section.
3015. a. Of the funds appropriated in this section, up
31to $50,000 may be transferred by the department to the
32appropriation made in this division of this Act to the
33department for the same fiscal year for general administration
34to be used for associated administrative expenses and for not
35more than 1.00 full-time equivalent position, in addition to
-22-1those authorized for the same fiscal year, to be assigned to
2implementing the children’s mental health home project.
3b. Of the funds appropriated in this section, up to $400,000
4may be transferred by the department to the appropriation made
5to the department in this division of this Act for the same
6fiscal year for Medicaid program-related general administration
7planning and implementation activities. The funds may be used
8for contracts or for personnel in addition to the amounts
9appropriated for and the positions authorized for general
10administration for the fiscal year.
11c. Of the funds appropriated in this section, up to
12$3,000,000 may be transferred by the department to the
13appropriations made in this division of this Act for the
14same fiscal year for general administration or health
15program operations to be used to support the development
16and implementation of standardized assessment tools for
17persons with mental illness, an intellectual disability, a
18developmental disability, or a brain injury.
1916. Of the funds appropriated in this section, $150,000
20shall be used for lodging expenses associated with care
21provided at the university of Iowa hospitals and clinics for
22patients with cancer whose travel distance is 30 miles or more
23and whose income is at or below 200 percent of the federal
24poverty level as defined by the most recently revised poverty
25income guidelines published by the United States department of
26health and human services. The department of human services
27shall establish the maximum number of overnight stays and the
28maximum rate reimbursed for overnight lodging, which may be
29based on the state employee rate established by the department
30of administrative services. The funds allocated in this
31subsection shall not be used as nonfederal share matching
32funds.
3317. Of the funds appropriated in this section, up to
34$3,383,880 shall be used for administration of the state family
35planning services program pursuant to section 217.41B, and
-23-1of this amount, the department may use up to $200,000 for
2administrative expenses.
318. Of the funds appropriated in this section, $1,545,530
4shall be used and may be transferred to other appropriations
5in this division of this Act as necessary to administer the
6provisions in the division of this Act relating to Medicaid
7program administration.
819. The department shall comply with the centers for
9Medicare and Medicaid services’ guidance related to Medicaid
10program and children’s health insurance program maintenance
11of effort provisions, including eligibility standards,
12methodologies, procedures, and continuous enrollment, to
13receive the enhanced federal medical assistance percentage
14under section 6008(b) of the federal Families First Coronavirus
15Response Act, Pub.L. No.116-127. The department shall
16utilize and implement all tools, processes, and resources
17available to expediently return to normal eligibility and
18enrollment operations in compliance with federal guidance and
19expectations.
2020. A portion of the funds appropriated in this section
21may be transferred to the appropriation made in this division
22of this Act for the children’s health insurance program,
23if the children’s health insurance program appropriation
24is insufficient to cover the designated purposes of that
25appropriation.
2621. No later than January 1, 2023, the department of
27human services shall implement a tiered rate reimbursement
28methodology for psychiatric intensive inpatient care under the
29Medicaid program based on the level of patient acuity and other
30factors as recommended in the inpatient bed tracking study
31committee report submitted to the governor and the general
32assembly on December 1, 2021.
3322. The department of human services shall submit a Medicaid
34state plan amendment to the centers for Medicare and Medicaid
35services to request the addition of functional family therapy
-24-1and multisystemic therapy for youth as covered services under
2the Medicaid program. The department shall include functional
3family therapy and multisystemic therapy under the Medicaid
4program as covered services upon receipt of federal approval.
523. Of the funds appropriated in this section, $7,400,000
6shall be used to implement reductions in the waiting list for
7the home and community-based services waiver for persons with
8an intellectual disability.
9 Sec. 14. HEALTH PROGRAM OPERATIONS. 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 amount, or so much thereof as is
13necessary, to be used for the purpose designated:
14For health program operations:
.................................................. $1517,446,343
161. The department of inspections and appeals shall
17provide all state matching funds for survey and certification
18activities performed by the department of inspections
19and appeals. The department of human services is solely
20responsible for distributing the federal matching funds for
21such activities.
222. Of the funds appropriated in this section, $50,000 shall
23be used for continuation of home and community-based services
24waiver quality assurance programs, including the review and
25streamlining of processes and policies related to oversight and
26quality management to meet state and federal requirements.
273. Of the amount appropriated in this section, up to
28$200,000 may be transferred to the appropriation for general
29administration in this division of this Act to be used for
30additional full-time equivalent positions in the development
31of key health initiatives such as development and oversight
32of managed care programs and development of health strategies
33targeted toward improved quality and reduced costs in the
34Medicaid program.
354. Of the funds appropriated in this section, $1,000,000
-25-1shall be used for planning and development, in cooperation with
2the department of public health, of a phased-in program to
3provide a dental home for children.
45. a. Of the funds appropriated in this section, $188,000
5shall be credited to the autism support program fund created
6in section 225D.2 to be used for the autism support program
7created in chapter 225D, with the exception of the following
8amount of this allocation which shall be used as follows:
9b. Of the funds allocated in this subsection, $25,000 shall
10be used for the public purpose of continuation of a grant to
11a nonprofit provider of child welfare services that has been
12in existence for more than 115 years, is located in a county
13with a population between 220,000 and 250,000 according to the
142020 federal decennial census, is licensed as a psychiatric
15medical institution for children, and provides school-based
16programming, to be used for support services for children with
17autism spectrum disorder and their families.
18 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
191. There is appropriated from the general fund of the
20state to the department of human services for the fiscal year
21beginning July 1, 2022, and ending June 30, 2023, the following
22amount, or so much thereof as is necessary, to be used for the
23purpose designated:
24For the state supplementary assistance program:
.................................................. $257,349,002
262. The department shall increase the personal needs
27allowance for residents of residential care facilities by the
28same percentage and at the same time as federal supplemental
29security income and federal social security benefits are
30increased due to a recognized increase in the cost of living.
31The department may adopt emergency rules to implement this
32subsection.
333. If during the fiscal year beginning July 1, 2022,
34the department projects that state supplementary assistance
35expenditures for a calendar year will not meet the federal
-26-1pass-through requirement specified in Tit.XVI of the federal
2Social Security Act, section 1618, as codified in 42 U.S.C.
3§1382g, the department may take actions including but not
4limited to increasing the personal needs allowance for
5residential care facility residents and making programmatic
6adjustments or upward adjustments of the residential care
7facility or in-home health-related care reimbursement rates
8prescribed in this division of this Act to ensure that federal
9requirements are met. In addition, the department may make
10other programmatic and rate adjustments necessary to remain
11within the amount appropriated in this section while ensuring
12compliance with federal requirements. The department may adopt
13emergency rules to implement the provisions of this subsection.
144. Notwithstanding section 8.33, moneys appropriated
15in this section that remain unencumbered or unobligated
16at the close of the fiscal year shall not revert but
17shall remain available for expenditure for the purposes
18designated, including for liability amounts associated with the
19supplemental nutrition assistance program payment error rate,
20until the close of the succeeding fiscal year.
21 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2022, and ending June 30, 2023, the following
25amount, or so much thereof as is necessary, to be used for the
26purpose designated:
27For maintenance of the healthy and well kids in Iowa (hawk-i)
28program pursuant to chapter 514I, including supplemental dental
29services, for receipt of federal financial participation under
30Tit.XXI of the federal Social Security Act, which creates the
31children’s health insurance program:
.................................................. $3238,661,688
332. Of the funds appropriated in this section, $158,850 is
34allocated for continuation of the contract for outreach with
35the department of public health.
-27- 13. A portion of the funds appropriated in this section may
2be transferred to the appropriations made in this division of
3this Act for field operations or health program operations to
4be used for the integration of hawk-i program eligibility,
5payment, and administrative functions under the purview of
6the department of human services, including for the Medicaid
7management information system upgrade.
8 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated
9from the general fund of the state to the department of human
10services for the fiscal year beginning July 1, 2022, and ending
11June 30, 2023, the following amount, or so much thereof as is
12necessary, to be used for the purpose designated:
13For child care programs:
.................................................. $1440,816,931
151. Of the funds appropriated in this section, $34,966,931
16shall be used for state child care assistance in accordance
17with section 237A.13.
182. Nothing in this section shall be construed or is
19intended as or shall imply a grant of entitlement for services
20to persons who are eligible for assistance due to an income
21level consistent with the waiting list requirements of section
22237A.13. Any state obligation to provide services pursuant to
23this section is limited to the extent of the funds appropriated
24in this section.
253. A list of the registered and licensed child care
26facilities operating in the area served by a child care
27resource and referral service shall be made available to the
28families receiving state child care assistance in that area.
294. Of the funds appropriated in this section, $5,850,000
30shall be credited to the early childhood programs grants
31account in the early childhood Iowa fund created in section
32256I.11. The moneys shall be distributed for funding of
33community-based early childhood programs targeted to children
34from birth through five years of age developed by early
35childhood Iowa areas in accordance with approved community
-28-1plans as provided in section 256I.8.
25. The department may use any of the funds appropriated
3in this section as a match to obtain federal funds for use in
4expanding child care assistance and related programs. For
5the purpose of expenditures of state and federal child care
6funding, funds shall be considered obligated at the time
7expenditures are projected or are allocated to the department’s
8service areas. Projections shall be based on current and
9projected caseload growth, current and projected provider
10rates, staffing requirements for eligibility determination
11and management of program requirements including data systems
12management, staffing requirements for administration of the
13program, contractual and grant obligations and any transfers
14to other state agencies, and obligations for decategorization
15or innovation projects.
166. A portion of the state match for the federal child care
17and development block grant shall be provided as necessary to
18meet federal matching funds requirements through the state
19general fund appropriation made for child development grants
20and other programs for at-risk children in section 279.51.
217. If a uniform reduction ordered by the governor under
22section 8.31 or other operation of law, transfer, or federal
23funding reduction reduces the appropriation made in this
24section for the fiscal year, the percentage reduction in the
25amount paid out to or on behalf of the families participating
26in the state child care assistance program shall be equal to or
27less than the percentage reduction made for any other purpose
28payable from the appropriation made in this section and the
29federal funding relating to it. The percentage reduction to
30the other allocations made in this section shall be the same as
31the uniform reduction ordered by the governor or the percentage
32change of the federal funding reduction, as applicable. If
33there is an unanticipated increase in federal funding provided
34for state child care services, the entire amount of the
35increase, except as necessary to meet federal requirements
-29-1including quality set asides, shall be used for state child
2care assistance payments. If the appropriations made for
3purposes of the state child care assistance program for the
4fiscal year are determined to be insufficient, it is the intent
5of the general assembly to appropriate sufficient funding for
6the fiscal year in order to avoid establishment of waiting list
7requirements.
88. Notwithstanding section 8.33, moneys advanced for
9purposes of the programs developed by early childhood Iowa
10areas, advanced for purposes of wraparound child care, or
11received from the federal appropriations made for the purposes
12of this section that remain unencumbered or unobligated at the
13close of the fiscal year shall not revert to any fund but shall
14remain available for expenditure for the purposes designated
15until the close of the succeeding fiscal year.
16 Sec. 18. JUVENILE INSTITUTION. There is appropriated
17from the general fund of the state to the department of human
18services for the fiscal year beginning July 1, 2022, and ending
19June 30, 2023, the following amounts, or so much thereof as is
20necessary, to be used for the purposes designated:
211. a. For operation of the state training school at Eldora
22and for salaries, support, maintenance, and miscellaneous
23purposes, and for not more than the following full-time
24equivalent positions:
.................................................. $2517,606,871
............................................... FTEs26207.00
27b. Of the funds appropriated in this subsection, $91,000
28shall be used for distribution to licensed classroom teachers
29at this and other institutions under the control of the
30department of human services based upon the average student
31yearly enrollment at each institution as determined by the
32department.
332. A portion of the moneys appropriated in this section
34shall be used by the state training school at Eldora for
35grants for adolescent pregnancy prevention activities at the
-30-1institution in the fiscal year beginning July 1, 2022.
23. Of the funds appropriated in this subsection, $212,000
3shall be used by the state training school at Eldora for a
4substance use disorder treatment program at the institution for
5the fiscal year beginning July 1, 2022.
64. Notwithstanding section 8.33, moneys appropriated in
7this section that remain unencumbered or unobligated at the
8close of the fiscal year shall not revert but shall remain
9available for expenditure for the purposes designated until the
10close of the succeeding fiscal year.
11 Sec. 19. CHILD AND FAMILY SERVICES.
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 child and family services:
.................................................. $1893,571,677
192. The department may transfer funds appropriated in this
20section as necessary to pay the nonfederal costs of services
21reimbursed under the medical assistance program, state child
22care assistance program, or the family investment program which
23are provided to children who would otherwise receive services
24paid under the appropriation in this section. The department
25may transfer funds appropriated in this section to the
26appropriations made in this division of this Act for general
27administration and for field operations for resources necessary
28to implement and operate the services funded in this section.
293. a. (1) Of the funds appropriated in this section, up to
30$40,500,000 is allocated as the statewide expenditure target
31under section 232.143 for group foster care maintenance and
32services. If the department projects that such expenditures
33for the fiscal year will be less than the target amount
34allocated in this paragraph “a”, the department may reallocate
35the excess to provide additional funding for family foster
-31-1care, supervised apartment living, family-centered services,
2shelter care, or the child welfare emergency services addressed
3with the allocation for shelter care.
4(2) If 2022 Iowa Acts, House File 2507, amending section
5232.143, is enacted, notwithstanding subparagraph (1), of
6the funds appropriated in this section, up to $40,500,000 is
7allocated for group foster care maintenance and services to
8be expended in accordance with the applicable provisions of
92022 Iowa Acts, House File 2507. If the department projects
10that such expenditures for the fiscal year will be less than
11the target amount in this paragraph “a”, the department may
12reallocate the excess to provide additional funding for family
13foster care, supervised apartment living, family-centered
14services, shelter care, or the child welfare emergency services
15addresses with the allocation for shelter care.
16b. Unless 2022 Iowa Acts, House File 2507, is enacted,
17if at any time after September 30, 2022, annualization of a
18service area’s current expenditures indicates a service area
19is at risk of exceeding its group foster care expenditure
20target under section 232.143 by more than 5 percent, the
21department and juvenile court services shall examine all
22group foster care placements in that service area in order to
23identify those which might be appropriate for termination.
24In addition, any aftercare services believed to be needed
25for the children whose placements may be terminated shall be
26identified. The department and juvenile court services shall
27initiate action to set dispositional review hearings for the
28placements identified. In such a dispositional review hearing,
29the juvenile court shall determine whether needed aftercare
30services are available and whether termination of the placement
31is in the best interest of the child and the community. If
322022 Iowa Acts, House File 2507, is enacted, the applicable
33provisions of House File 2507 shall supersede the provisions
34of this paragraph “b”.
354. In accordance with the provisions of section 232.188,
-32-1the department shall continue the child welfare and juvenile
2justice funding initiative during fiscal year 2022-2023. Of
3the funds appropriated in this section, $1,717,000 is allocated
4specifically for expenditure for fiscal year 2022-2023 through
5the decategorization services funding pools and governance
6boards established pursuant to section 232.188.
75. A portion of the funds appropriated in this section
8may be used for emergency family assistance to provide other
9resources required for a family participating in a family
10preservation or reunification project or successor project to
11stay together or to be reunified.
126. Of the funds appropriated in this section, a sufficient
13amount is allocated for shelter care and the child welfare
14emergency services contracting implemented to provide for or
15prevent the need for shelter care.
167. Federal funds received by the state during the fiscal
17year beginning July 1, 2022, as the result of the expenditure
18of state funds appropriated during a previous state fiscal
19year for a service or activity funded under this section are
20appropriated to the department to be used as additional funding
21for services and purposes provided for under this section.
22Notwithstanding section 8.33, moneys received in accordance
23with this subsection that remain unencumbered or unobligated at
24the close of the fiscal year shall not revert to any fund but
25shall remain available for the purposes designated until the
26close of the succeeding fiscal year.
278. a. Of the funds appropriated in this section, up to
28$3,290,000 is allocated for the payment of the expenses of
29court-ordered services provided to juveniles who are under the
30supervision of juvenile court services, which expenses are a
31charge upon the state pursuant to section 232.141, subsection
324. Of the amount allocated in this paragraph “a”, up to
33$1,556,000 shall be made available to provide school-based
34supervision of children adjudicated under chapter 232, of which
35not more than $15,000 may be used for the purpose of training.
-33-1A portion of the cost of each school-based liaison officer
2shall be paid by the school district or other funding source as
3approved by the chief juvenile court officer.
4b. Of the funds appropriated in this section, up to $748,000
5is allocated for the payment of the expenses of court-ordered
6services provided to children who are under the supervision
7of the department, which expenses are a charge upon the state
8pursuant to section 232.141, subsection 4.
9c. Notwithstanding section 232.141 or any other provision
10of law to the contrary, the amounts allocated in this
11subsection shall be distributed to the judicial districts
12as determined by the state court administrator and to the
13department’s service areas as determined by the administrator
14of the department of human services’ division of child and
15family services. The state court administrator and the
16division administrator shall make the determination of the
17distribution amounts on or before June 15, 2022.
18d. Notwithstanding chapter 232 or any other provision of
19law to the contrary, a district or juvenile court shall not
20order any service which is a charge upon the state pursuant
21to section 232.141 if there are insufficient court-ordered
22services funds available in the district court or departmental
23service area distribution amounts to pay for the service. The
24chief juvenile court officer and the departmental service area
25manager shall encourage use of the funds allocated in this
26subsection such that there are sufficient funds to pay for
27all court-related services during the entire year. The chief
28juvenile court officers and departmental service area managers
29shall attempt to anticipate potential surpluses and shortfalls
30in the distribution amounts and shall cooperatively request the
31state court administrator or division administrator to transfer
32funds between the judicial districts’ or departmental service
33areas’ distribution amounts as prudent.
34e. Notwithstanding any provision of law to the contrary,
35a district or juvenile court shall not order a county to pay
-34-1for any service provided to a juvenile pursuant to an order
2entered under chapter 232 which is a charge upon the state
3under section 232.141, subsection 4.
4f. Of the funds allocated in this subsection, not more than
5$83,000 may be used by the judicial branch for administration
6of the requirements under this subsection.
7g. Of the funds allocated in this subsection, $17,000
8shall be used by the department of human services to support
9the interstate commission for juveniles in accordance with
10the interstate compact for juveniles as provided in section
11232.173.
129. Of the funds appropriated in this section, $12,253,000 is
13allocated for juvenile delinquent graduated sanctions services.
14Any state funds saved as a result of efforts by juvenile court
15services to earn a federal Tit.IV-E match for juvenile court
16services administration may be used for the juvenile delinquent
17graduated sanctions services.
1810. Of the funds appropriated in this section, $1,658,000 is
19transferred to the department of public health to be used for
20the child protection center grant program for child protection
21centers located in Iowa in accordance with section 135.118.
22The grant amounts under the program shall be equalized so that
23each center receives a uniform base amount of $245,000, and so
24that the remaining funds are awarded through a funding formula
25based upon the volume of children served. To increase access
26to child protection center services for children in rural
27areas, the funding formula for the awarding of the remaining
28funds shall provide for the awarding of an enhanced amount to
29eligible grantees to develop and maintain satellite centers in
30underserved regions of the state.
3111. Of the funds appropriated in this section, $4,025,000 is
32allocated for the preparation for adult living program pursuant
33to section 234.46.
3412. Of the funds appropriated in this section, $227,000
35shall be used for the public purpose of continuing a grant to a
-35-1nonprofit human services organization, providing services to
2individuals and families in multiple locations in southwest
3Iowa and Nebraska for support of a project providing immediate,
4sensitive support and forensic interviews, medical exams, needs
5assessments, and referrals for victims of child abuse and their
6nonoffending family members.
713. Of the funds appropriated in this section, $300,000
8is allocated for the foster care youth council approach of
9providing a support network to children placed in foster care.
1014. Of the funds appropriated in this section, $202,000 is
11allocated for use pursuant to section 235A.1 for continuation
12of the initiative to address child sexual abuse implemented
13pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
1421.
1515. Of the funds appropriated in this section, $630,000 is
16allocated for the community partnership for child protection
17sites.
1816. Of the funds appropriated in this section, $371,000
19is allocated for the department’s minority youth and family
20projects under the redesign of the child welfare system.
2117. Of the funds appropriated in this section, $851,000
22is allocated for funding of the community circle of care
23collaboration for children and youth in northeast Iowa.
2418. Of the funds appropriated in this section, at least
25$147,000 shall be used for the continuation of the child
26welfare provider training program.
2719. Of the funds appropriated in this section, $211,000
28shall be used for continuation of the central Iowa system of
29care program grant for the purposes of funding community-based
30services and other supports with a system of care approach for
31children with serious emotional disturbance and their families
32through a nonprofit provider that is located in a county with a
33population of over 420,000 but less than 450,000 according to
34the 2010 certified federal census, is licensed as a psychiatric
35medical institution for children, and was a system of care
-36-1grantee prior to July 1, 2022.
220. Of the funds appropriated in this section, $235,000
3shall be used for the public purpose of the continuation
4and expansion of a system of care program grant implemented
5in Cerro Gordo and Linn counties to utilize a comprehensive
6and long-term approach for helping children and families by
7addressing the key areas in a child’s life of childhood basic
8needs, education and work, family, and community.
921. Of the funds appropriated in this section, $110,000
10shall be used for the public purpose of funding community-based
11services and other supports with a system of care approach
12for children with a serious emotional disturbance and their
13families through a nonprofit provider of child welfare services
14that has been in existence for more than 115 years, is located
15in a county with a population of more than 230,000 according to
16the 2020 certified federal census, is licensed as a psychiatric
17medical institution for children, and was a system of care
18grantee prior to July 1, 2022.
1922. If a separate funding source is identified that reduces
20the need for state funds within an allocation under this
21section, the allocated state funds may be redistributed to
22other allocations under this section for the same fiscal year.
2323. Of the funds appropriated in this section, a portion may
24be used for family-centered services for purposes of complying
25with the federal Family First Prevention Services Act of 2018,
26Pub.L. No.115-123, and successor legislation.
2724. Of the funds appropriated in this section, $3,850,718
28shall be used to support placements in qualified residential
29treatment programs.
30 Sec. 20. ADOPTION SUBSIDY.
311. There is appropriated from the general fund of the
32state to the department of human services for the fiscal year
33beginning July 1, 2022, and ending June 30, 2023, the following
34amount, or so much thereof as is necessary, to be used for the
35purpose designated:
-37- 1a. For adoption subsidy payments and related costs and for
2other services provided for under paragraph “b”, subparagraph
3(2):
.................................................. $440,596,007
5b. (1) Of the funds appropriated in this section, a
6sufficient amount is allocated for adoption subsidy payments
7and related costs.
8(2) Any funds appropriated in this section remaining after
9the allocation under subparagraph (1) are designated and
10allocated as state savings resulting from implementation of
11the federal Fostering Connections to Success and Increasing
12Adoptions Act of 2008, Pub.L. No.110-351, and successor
13legislation, as determined in accordance with 42 U.S.C.
14§673(a)(8), and shall be used for post-adoption services and
15for other purposes allowed under these federal laws, Tit.IV-B
16or Tit.IV-E of the federal Social Security Act.
17(a) The department of human services may transfer funds
18allocated in this subparagraph (2) to the appropriation for
19child and family services in this division of this Act for the
20purposes designated in this subparagraph (2).
21(b) Notwithstanding section 8.33, moneys allocated
22under this subparagraph (2) shall not revert to any fund but
23shall remain available for the purposes designated in this
24subparagraph (2) until expended.
252. The department may transfer funds appropriated in
26this section to the appropriation made in this division of
27this Act for general administration for costs paid from the
28appropriation relating to adoption subsidy.
293. Federal funds received by the state during the
30fiscal year beginning July 1, 2022, as the result of the
31expenditure of state funds during a previous state fiscal
32year for a service or activity funded under this section are
33appropriated to the department to be used as additional funding
34for the services and activities funded under this section.
35Notwithstanding section 8.33, moneys received in accordance
-38-1with this subsection that remain unencumbered or unobligated
2at the close of the fiscal year shall not revert to any fund
3but shall remain available for expenditure for the purposes
4designated until the close of the succeeding fiscal year.
5 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited
6in the juvenile detention home fund created in section 232.142
7during the fiscal year beginning July 1, 2022, and ending June
830, 2023, are appropriated to the department of human services
9for the fiscal year beginning July 1, 2022, and ending June 30,
102023, for distribution of an amount equal to a percentage of
11the costs of the establishment, improvement, operation, and
12maintenance of county or multicounty juvenile detention homes
13in the fiscal year beginning July 1, 2021. Moneys appropriated
14for distribution in accordance with this section shall be
15allocated among eligible detention homes, prorated on the basis
16of an eligible detention home’s proportion of the costs of all
17eligible detention homes in the fiscal year beginning July
181, 2021. The percentage figure shall be determined by the
19department based on the amount available for distribution for
20the fund. Notwithstanding section 232.142, subsection 3, the
21financial aid payable by the state under that provision for the
22fiscal year beginning July 1, 2022, shall be limited to the
23amount appropriated for the purposes of this section.
24 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM.
251. There is appropriated from the general fund of the
26state to the department of human services for the fiscal year
27beginning July 1, 2022, and ending June 30, 2023, the following
28amount, or so much thereof as is necessary, to be used for the
29purpose designated:
30For the family support subsidy program subject to the
31enrollment restrictions in section 225C.37, subsection 3:
.................................................. $32949,282
332. At least $931,536 of the moneys appropriated in this
34section is transferred to the department of public health for
35the family support center component of the comprehensive family
-39-1support program under chapter 225C, subchapter V.
23. If at any time during the fiscal year, the amount of
3funding available for the family support subsidy program
4is reduced from the amount initially used to establish the
5figure for the number of family members for whom a subsidy
6is to be provided at any one time during the fiscal year,
7notwithstanding section 225C.38, subsection 2, the department
8shall revise the figure as necessary to conform to the amount
9of funding available.
10 Sec. 23. CONNER DECREE. There is appropriated from the
11general fund of the state to the department of human services
12for the fiscal year beginning July 1, 2022, and ending June 30,
132023, the following amount, or so much thereof as is necessary,
14to be used for the purpose designated:
15For building community capacity through the coordination
16and provision of training opportunities in accordance with the
17consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
18Iowa, July 14, 1994):
.................................................. $1933,632
20 Sec. 24. MENTAL HEALTH INSTITUTES.
211. There is appropriated from the general fund of the
22state to the department of human services for the fiscal year
23beginning July 1, 2022, and ending June 30, 2023, the following
24amounts, or so much thereof as is necessary, to be used for the
25purposes designated:
26a. For operation of the state mental health institute at
27Cherokee as required by chapters 218 and 226 for salaries,
28support, maintenance, and miscellaneous purposes, and for not
29more than the following full-time equivalent positions:
.................................................. $3015,613,624
............................................... FTEs31169.00
32b. For operation of the state mental health institute at
33Independence as required by chapters 218 and 226 for salaries,
34support, maintenance, and miscellaneous purposes, and for not
35more than the following full-time equivalent positions:
-40-.................................................. $119,688,928
............................................... FTEs2208.00
32. a. Notwithstanding sections 218.78 and 249A.11, any
4revenue received from the state mental health institute at
5Cherokee or the state mental health institute at Independence
6pursuant to 42 C.F.R§438.6(e) may be retained and expended by
7the mental health institute.
8b. Notwithstanding sections 218.78 and 249A.11, any
9COVID-19 related funding received through federal funding
10sources by the state mental health institute at Cherokee or the
11state mental health institute at Independence may be retained
12and expended by the mental health institute.
133. Notwithstanding any provision of law to the contrary,
14a Medicaid member residing at the state mental health
15institute at Cherokee or the state mental health institute
16at Independence shall retain Medicaid eligibility during
17the period of the Medicaid member’s stay for which federal
18financial participation is available.
194. Notwithstanding section 8.33, moneys appropriated in
20this section that remain unencumbered or unobligated at the
21close of the fiscal year shall not revert but shall remain
22available for expenditure for the purposes designated until the
23close of the succeeding fiscal year.
24 Sec. 25. STATE RESOURCE CENTERS.
251. There is appropriated from the general fund of the
26state to the department of human services for the fiscal year
27beginning July 1, 2022, and ending June 30, 2023, the following
28amounts, or so much thereof as is necessary, to be used for the
29purposes designated:
30a. For the state resource center at Glenwood for salaries,
31support, maintenance, and miscellaneous purposes:
.................................................. $3216,288,739
33b. For the state resource center at Woodward for salaries,
34support, maintenance, and miscellaneous purposes:
.................................................. $3513,409,294
-41- 12. The department may continue to bill for state resource
2center services utilizing a scope of services approach used for
3private providers of intermediate care facilities for persons
4with an intellectual disability services, in a manner which
5does not shift costs between the medical assistance program,
6mental health and disability services regions, or other sources
7of funding for the state resource centers.
83. The state resource centers may expand the time-limited
9assessment and respite services during the fiscal year.
104. If the department’s administration and the department
11of management concur with a finding by a state resource
12center’s superintendent that projected revenues can reasonably
13be expected to pay the salary and support costs for a new
14employee position, or that such costs for adding a particular
15number of new positions for the fiscal year would be less
16than the overtime costs if new positions would not be added,
17the superintendent may add the new position or positions. If
18the vacant positions available to a resource center do not
19include the position classification desired to be filled, the
20state resource center’s superintendent may reclassify any
21vacant position as necessary to fill the desired position. The
22superintendents of the state resource centers may, by mutual
23agreement, pool vacant positions and position classifications
24during the course of the fiscal year in order to assist one
25another in filling necessary positions.
265. If existing capacity limitations are reached in
27operating units, a waiting list is in effect for a service or
28a special need for which a payment source or other funding
29is available for the service or to address the special need,
30and facilities for the service or to address the special need
31can be provided within the available payment source or other
32funding, the superintendent of a state resource center may
33authorize opening not more than two units or other facilities
34and begin implementing the service or addressing the special
35need during fiscal year 2022-2023.
-42- 16. Notwithstanding section 8.33, and notwithstanding
2the amount limitation specified in section 222.92, moneys
3appropriated in this section that remain unencumbered or
4unobligated at the close of the fiscal year shall not revert
5but shall remain available for expenditure for the purposes
6designated until the close of the succeeding fiscal year.
7 Sec. 26. SEXUALLY VIOLENT PREDATORS.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2022, and ending June 30, 2023, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13For costs associated with the commitment and treatment of
14sexually violent predators in the unit located at the state
15mental health institute at Cherokee, including costs of legal
16services and other associated costs, including salaries,
17support, maintenance, and miscellaneous purposes, and for not
18more than the following full-time equivalent positions:
.................................................. $1913,891,276
............................................... FTEs20140.00
212. Unless specifically prohibited by law, if the amount
22charged provides for recoupment of at least the entire amount
23of direct and indirect costs, the department of human services
24may contract with other states to provide care and treatment
25of persons placed by the other states at the unit for sexually
26violent predators at Cherokee. The moneys received under
27such a contract shall be considered to be repayment receipts
28and used for the purposes of the appropriation made in this
29section.
303. Notwithstanding section 8.33, moneys appropriated in
31this section that remain unencumbered or unobligated at the
32close of the fiscal year shall not revert but shall remain
33available for expenditure for the purposes designated until the
34close of the succeeding fiscal year.
35 Sec. 27. FIELD OPERATIONS.
-43- 11. There is appropriated from the general fund of the
2state to the department of human services for the fiscal year
3beginning July 1, 2022, and ending June 30, 2023, the following
4amount, or so much thereof as is necessary, to be used for the
5purposes designated:
6For field operations, including salaries, support,
7maintenance, and miscellaneous purposes, and for not more than
8the following full-time equivalent positions:
.................................................. $965,894,438
............................................... FTEs101,589.00
112. Priority in filling full-time equivalent positions
12shall be given to those positions related to child protection
13services and eligibility determination for low-income families.
14 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
15from the general fund of the state to the department of human
16services for the fiscal year beginning July 1, 2022, and ending
17June 30, 2023, the following amount, or so much thereof as is
18necessary, to be used for the purpose designated:
19For general administration, including salaries, support,
20maintenance, and miscellaneous purposes, and for not more than
21the following full-time equivalent positions:
.................................................. $2215,342,189
............................................... FTEs23294.00
241. The department shall report at least monthly to the
25general assembly concerning the department’s operational and
26program expenditures.
272. Of the funds appropriated in this section, $150,000 shall
28be used for the provision of a program to provide technical
29assistance, support, and consultation to providers of home and
30community-based services under the medical assistance program.
313. Of the funds appropriated in this section, $50,000
32is transferred to the Iowa finance authority to be used
33for administrative support of the council on homelessness
34established in section 16.2D and for the council to fulfill its
35duties in addressing and reducing homelessness in the state.
-44- 14. Of the funds appropriated in this section, $200,000 shall
2be transferred to and deposited in the administrative fund of
3the Iowa ABLE savings plan trust created in section 12I.4, to
4be used for implementation and administration activities of the
5Iowa ABLE savings plan trust.
65. Of the funds appropriated in this section, $200,000 is
7transferred to the economic development authority for the Iowa
8commission on volunteer services to continue to be used for the
9RefugeeRISE AmeriCorps program established under section 15H.8
10for member recruitment and training to improve the economic
11well-being and health of economically disadvantaged refugees in
12local communities across Iowa. Funds transferred may be used
13to supplement federal funds under federal regulations.
146. Of the funds appropriated in this section, up to $300,000
15shall be used as follows:
16a. To fund not more than 1.00 full-time equivalent position
17to address the department’s responsibility to support the work
18of the children’s behavioral health system state board and
19implementation of the services required pursuant to section
20331.397.
21b. To support the cost of establishing and implementing new
22or additional services required pursuant to sections 331.397
23and 331.397A.
24c. Of the amount allocated, $32,000 shall be transferred
25to the department of public health to support the costs of
26establishing and implementing new or additional services
27required pursuant to sections 331.397 and 331.397A.
287. Of the funds appropriated in this section, $800,000 shall
29be used for the renovation and construction of certain nursing
30facilities, consistent with the provisions of chapter 249K.
31 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated
32from the general fund of the state to the department of human
33services for the fiscal year beginning July 1, 2022, and ending
34June 30, 2023, the following amount, or so much thereof as is
35necessary, to be used for the purposes designated:
-45- 1For salaries, support, maintenance, and miscellaneous
2purposes at facilities under the purview of the department of
3human services:
.................................................. $44,172,123
5 Sec. 30. VOLUNTEERS. There is appropriated from the general
6fund of the state to the department of human services for the
7fiscal year beginning July 1, 2022, and ending June 30, 2023,
8the following amount, or so much thereof as is necessary, to be
9used for the purpose designated:
10For development and coordination of volunteer services:
.................................................. $1184,686
12 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
13ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
14DEPARTMENT OF HUMAN SERVICES.
151. a. (1) (a) Notwithstanding any provision of law to the
16contrary, for the fiscal year beginning July 1, 2022, case-mix
17nursing facilities shall be reimbursed in accordance with the
18methodology in effect on June 30, 2022.
19(b) For the fiscal year beginning July 1, 2022, non-case-mix
20and special population nursing facilities shall be reimbursed
21in accordance with the methodology in effect on June 30, 2022.
22(c) For managed care claims, the department of human
23services shall adjust the payment rate floor for nursing
24facilities, annually, to maintain a rate floor that is no
25lower than the Medicaid fee-for-service case-mix adjusted rate
26calculated in accordance with subparagraph division (a) and
27441 IAC 81.6. The department shall then calculate adjusted
28reimbursement rates, including but not limited to add-on
29payments, annually, and shall notify Medicaid managed care
30organizations of the adjusted reimbursement rates within 30
31days of determining the adjusted reimbursement rates. Any
32adjustment of reimbursement rates under this subparagraph
33division shall be budget neutral to the state budget.
34(d) For the fiscal year beginning July 1, 2022, Medicaid
35managed care long-term services and supports capitation rates
-46-1shall be adjusted to reflect the case-mix adjusted rates
2specified pursuant to subparagraph division (a) for the patient
3populations residing in Medicaid-certified nursing facilities.
4(2) Medicaid managed care organizations shall adjust
5facility-specific rates based upon payment rate listings issued
6by the department. The rate adjustments shall be applied
7prospectively from the effective date of the rate letter issued
8by the department.
9b. (1) For the fiscal year beginning July 1, 2022, the
10department shall establish the fee-for-service pharmacy
11dispensing fee reimbursement at $10.38 per prescription,
12until a cost of dispensing survey is completed. The actual
13dispensing fee shall be determined by a cost of dispensing
14survey performed by the department and required to be completed
15by all medical assistance program participating pharmacies
16every two years, adjusted as necessary to maintain expenditures
17within the amount appropriated to the department for this
18purpose for the fiscal year. A change in the dispensing
19fee shall become effective following federal approval of the
20Medicaid state plan.
21(2) The department shall utilize an average acquisition
22cost reimbursement methodology for all drugs covered under the
23medical assistance program in accordance with 2012 Iowa Acts,
24chapter 1133, section 33.
25c. (1) For the fiscal year beginning July 1, 2022,
26reimbursement rates for outpatient hospital services shall
27remain at the rates in effect on June 30, 2022, subject to
28Medicaid program upper payment limit rules, and adjusted
29as necessary to maintain expenditures within the amount
30appropriated to the department for this purpose for the fiscal
31year.
32(2) For the fiscal year beginning July 1, 2022,
33reimbursement rates for inpatient hospital services shall
34remain at the rates in effect on June 30, 2022, subject to
35Medicaid program upper payment limit rules, and adjusted
-47-1as necessary to maintain expenditures within the amount
2appropriated to the department for this purpose for the fiscal
3year.
4(3) For the fiscal year beginning July 1, 2022, under
5both fee-for-service and managed care administration of
6the Medicaid program, critical access hospitals shall be
7reimbursed for inpatient and outpatient services based on the
8hospital-specific critical access hospital cost adjustment
9factor methodology utilizing the most recent and complete cost
10reporting period as applied prospectively within the funds
11appropriated for such purpose for the fiscal year.
12(4) For the fiscal year beginning July 1, 2022, the graduate
13medical education and disproportionate share hospital fund
14shall remain at the amount in effect on June 30, 2022, except
15that the portion of the fund attributable to graduate medical
16education shall be reduced in an amount that reflects the
17elimination of graduate medical education payments made to
18out-of-state hospitals.
19(5) In order to ensure the efficient use of limited state
20funds in procuring health care services for low-income Iowans,
21funds appropriated in this Act for hospital services shall
22not be used for activities which would be excluded from a
23determination of reasonable costs under the federal Medicare
24program pursuant to 42 U.S.C.§1395x(v)(1)(N).
25d. For the fiscal year beginning July 1, 2022, reimbursement
26rates for hospices and acute psychiatric hospitals shall be
27increased in accordance with increases under the federal
28Medicare program or as supported by their Medicare audited
29costs.
30e. For the fiscal year beginning July 1, 2022, independent
31laboratories and rehabilitation agencies shall be reimbursed
32using the same methodology in effect on June 30, 2022.
33f. (1) For the fiscal year beginning July 1, 2022,
34reimbursement rates for home health agencies shall continue to
35be based on the Medicare low utilization payment adjustment
-48-1(LUPA) methodology with state geographic wage adjustments. The
2department shall continue to update the rates every two years
3to reflect the most recent Medicare LUPA rates.
4(2) For the fiscal year beginning July 1, 2022, the
5department shall create a reimbursement rate structure that
6provides incentives to home health care providers located in
7rural areas and providing home health care to Medicaid members,
8within the $4,000,000 appropriated for this purpose. The rate
9structure shall include a telehealth component to incentivize
10the provision of necessary supervision for skilled care without
11requiring travel time. For the purposes of this subparagraph
12(2), “rural area” means an area that is not an Iowa core based
13statistical area as defined by the federal office of management
14and budget.
15(3) For the fiscal year beginning July 1, 2022, rates for
16private duty nursing and personal care services under the early
17and periodic screening, diagnostic, and treatment program
18benefit shall be calculated based on the methodology in effect
19on June 30, 2022.
20g. For the fiscal year beginning July 1, 2022, federally
21qualified health centers and rural health clinics shall receive
22cost-based reimbursement for 100 percent of the reasonable
23costs for the provision of services to recipients of medical
24assistance.
25h. For the fiscal year beginning July 1, 2022, the
26reimbursement rates for dental services shall remain at the
27rates in effect on June 30, 2022.
28i. (1) For the fiscal year beginning July 1, 2022,
29reimbursement rates for non-state-owned psychiatric medical
30institutions for children shall be based on the reimbursement
31methodology in effect on June 30, 2022.
32(2) As a condition of participation in the medical
33assistance program, enrolled providers shall accept the medical
34assistance reimbursement rate for any covered goods or services
35provided to recipients of medical assistance who are children
-49-1under the custody of a psychiatric medical institution for
2children.
3j. For the fiscal year beginning July 1, 2022, unless
4otherwise specified in this Act, all noninstitutional medical
5assistance provider reimbursement rates shall remain at the
6rates in effect on June 30, 2022, except for area education
7agencies, local education agencies, infant and toddler
8services providers, home and community-based services providers
9including consumer-directed attendant care providers under a
10section 1915(c) or 1915(i) waiver, targeted case management
11providers, and those providers whose rates are required to be
12determined pursuant to section 249A.20, or to meet federal
13mental health parity requirements.
14k. Notwithstanding any provision to the contrary, for the
15fiscal year beginning July 1, 2022, the reimbursement rate for
16anesthesiologists shall remain at the rates in effect on June
1730, 2022, and updated on January 1, 2023, to align with the
18most current Iowa Medicare anesthesia rate.
19l. Notwithstanding section 249A.20, for the fiscal year
20beginning July 1, 2022, the average reimbursement rate for
21health care providers eligible for use of the federal Medicare
22resource-based relative value scale reimbursement methodology
23under section 249A.20 shall remain at the rate in effect on
24June 30, 2022; however, this rate shall not exceed the maximum
25level authorized by the federal government.
26m. For the fiscal year beginning July 1, 2022, the
27reimbursement rate for residential care facilities shall not
28be less than the minimum payment level as established by the
29federal government to meet the federally mandated maintenance
30of effort requirement. The flat reimbursement rate for
31facilities electing not to file annual cost reports shall not
32be less than the minimum payment level as established by the
33federal government to meet the federally mandated maintenance
34of effort requirement.
35n. For the fiscal year beginning July 1, 2022, the
-50-1reimbursement rates for inpatient mental health services
2provided at hospitals shall remain at the rates in effect on
3June 30, 2022, subject to Medicaid program upper payment limit
4rules and adjusted as necessary to maintain expenditures within
5the amount appropriated to the department for this purpose for
6the fiscal year; and psychiatrists shall be reimbursed at the
7medical assistance program fee-for-service rate in effect on
8June 30, 2022.
9o. For the fiscal year beginning July 1, 2022, community
10mental health centers may choose to be reimbursed for the
11services provided to recipients of medical assistance through
12either of the following options:
13(1) For 100 percent of the reasonable costs of the services.
14(2) In accordance with the alternative reimbursement rate
15methodology approved by the department of human services in
16effect on June 30, 2022.
17p. For the fiscal year beginning July 1, 2022, the
18reimbursement rate for providers of family planning services
19that are eligible to receive a 90 percent federal match shall
20remain at the rates in effect on June 30, 2022.
21q. (1) For the fiscal year beginning July 1, 2022,
22reimbursement rates for providers of home and community-based
23services waiver and habilitation services shall be increased
24to the extent possible within the $14,600,000 appropriated for
25this purpose. The entire rate increase shall be used for wages
26and associated costs specific to wages, benefits, and required
27withholding of direct support professionals and frontline
28management, including consumer choices option employees.
29(2) For the fiscal year beginning July 1, 2022,
30reimbursement rates for intermediate care facility for
31persons with an intellectual disability providers shall be
32increased over the rates in effect on June 30, 2022, within
33the $3,125,778 appropriated for this purpose. The entire rate
34increase shall be used for wages and associated costs specific
35to wages, benefits, and required withholding of direct support
-51-1professionals and frontline management.
2(3) For the fiscal year beginning July 1, 2022,
3reimbursement rates for providers of state plan home and
4community-based services home-based habilitation services
5shall remain at the rates in effect on June 30, 2022. The
6reimbursement rates for home-based habilitation services shall
7be based on a fee schedule that incorporates the acuity-based
8tiers.
9r. For the fiscal year beginning July 1, 2022, the
10reimbursement rates for emergency medical service providers
11shall remain at the rates in effect on June 30, 2022, or as
12approved by the centers for Medicare and Medicaid services of
13the United States department of health and human services.
14s. (1) For the fiscal year beginning July 1, 2022,
15reimbursement rates for substance-related disorder treatment
16programs licensed under section 125.13 shall remain at the
17rates in effect on June 30, 2022.
18(2) For the fiscal year beginning July 1, 2022, the
19department shall establish a fee schedule or provider-specific
20rate structure to increase reimbursement rates for residential
21substance use treatment providers within the $1,100,000
22appropriated for this purpose.
23t. For the fiscal year beginning July 1, 2022, assertive
24community treatment per diem rates shall remain at the rates in
25effect on June 30, 2022.
26u. For the fiscal year beginning July 1, 2022, the
27reimbursement rate for family-centered services providers shall
28be established by contract.
29v. For the fiscal year beginning July 1, 2022, the
30reimbursement rate for air ambulance services shall remain at
31the rate in effect on June 30, 2022.
32w. For the fiscal year beginning July 1, 2022, all
33behavioral health intervention services reimbursement rates
34shall be increased over the rates in effect on June 30, 2022,
35within the $3,000,000 appropriated for this purpose. The
-52-1entire rate increase shall be used for wages and associated
2costs specific to wages, benefits, and required withholding of
3direct support professionals and frontline management.
4x. For the fiscal year beginning July 1, 2022, all applied
5behavioral analysis services reimbursement rates shall be
6increased over the rates in effect on June 30, 2022, within the
7$385,000 appropriated for this purpose.
82. For the fiscal year beginning July 1, 2022, the
9reimbursement rate for providers reimbursed under the
10in-home-related care program shall not be less than the minimum
11payment level as established by the federal government to meet
12the federally mandated maintenance of effort requirement.
133. Unless otherwise directed in this section, when the
14department’s reimbursement methodology for any provider
15reimbursed in accordance with this section includes an
16inflation factor, this factor shall not exceed the amount
17by which the consumer price index for all urban consumers
18increased during the most recently ended calendar year.
194. Notwithstanding section 234.38, for the fiscal
20year beginning July 1, 2022, the foster family basic daily
21maintenance rate and the maximum adoption subsidy rate for
22children ages 0 through 5 years shall be $16.78, the rate for
23children ages 6 through 11 years shall be $17.45, the rate for
24children ages 12 through 15 years shall be $19.10, and the
25rate for children and young adults ages 16 and older shall
26be $19.35. For youth ages 18 to 23 who have exited foster
27care, the preparation for adult living program maintenance
28rate shall be up to $602.70 per month as calculated based on
29the age of the participant. The maximum payment for adoption
30subsidy nonrecurring expenses shall be limited to $500 and the
31disallowance of additional amounts for court costs and other
32related legal expenses implemented pursuant to 2010 Iowa Acts,
33chapter 1031, section 408, shall be continued.
345. For the fiscal year beginning July 1, 2022, the maximum
35reimbursement rates for social services providers under
-53-1contract shall remain at the rates in effect on June 30, 2022,
2or the provider’s actual and allowable cost plus inflation for
3each service, whichever is less. However, if a new service
4or service provider is added after June 30, 2022, the initial
5reimbursement rate for the service or provider shall be based
6upon a weighted average of provider rates for similar services.
76. a. For the fiscal year beginning July 1, 2022, the
8reimbursement rates for resource family recruitment and
9retention contractors shall be established by contract.
10b. For the fiscal year beginning July 1, 2022, the
11reimbursement rates for supervised apartment living foster care
12providers shall be established by contract.
137. For the fiscal year beginning July 1, 2022, the
14reimbursement rate for group foster care providers shall be the
15combined service and maintenance reimbursement rate established
16by contract.
178. The group foster care reimbursement rates paid for
18placement of children out of state shall be calculated
19according to the same rate-setting principles as those used for
20in-state providers, unless the director of human services or
21the director’s designee determines that appropriate care cannot
22be provided within the state. The payment of the daily rate
23shall be based on the number of days in the calendar month in
24which service is provided.
259. a. For the fiscal year beginning July 1, 2022, the
26reimbursement rate paid for shelter care and the child welfare
27emergency services implemented to provide or prevent the need
28for shelter care shall be established by contract.
29b. For the fiscal year beginning July 1, 2022, the combined
30service and maintenance components of the per day reimbursement
31rate paid for shelter care services shall be based on the
32financial and statistical report submitted to the department.
33The maximum per day reimbursement rate shall be the maximum
34per day reimbursement rate in effect on June 30, 2022, as
35increased within the $649,029 appropriated for this purpose.
-54-1The department shall reimburse a shelter care provider at the
2provider’s actual and allowable unit cost, plus inflation, not
3to exceed the maximum reimbursement rate.
4c. Unless 2022 Iowa Acts, House File 2507, is enacted,
5notwithstanding section 232.141, subsection 8, for the fiscal
6year beginning July 1, 2022, the amount of the statewide
7average of the actual and allowable rates for reimbursement of
8juvenile shelter care homes that is utilized for the limitation
9on recovery of unpaid costs shall remain at the amount in
10effect for this purpose in the fiscal year beginning July 1,
112021. If 2022 Iowa Acts, House File 2507, is enacted, the
12applicable provisions of House File 2507 shall supersede the
13provisions of this paragraph “c”.
1410. For the fiscal year beginning July 1, 2022, the
15department shall calculate reimbursement rates for intermediate
16care facilities for persons with an intellectual disability
17at the 80th percentile. Beginning July 1, 2022, the rate
18calculation methodology shall utilize the consumer price index
19inflation factor applicable to the fiscal year beginning July
201, 2022.
2111. Effective July 1, 2022, child care provider
22reimbursement rates shall remain at the rates in effect on June
2330, 2022. The department shall set rates in a manner so as
24to provide incentives for a nonregistered provider to become
25registered by applying any increase only to registered and
26licensed providers.
2712. The department may adopt emergency rules to implement
28this section.
29 Sec. 32. EMERGENCY RULES.
301. If necessary to comply with federal requirements
31including time frames, or if specifically authorized by a
32provision of this division of this Act, the department of
33human services or the mental health and disability services
34commission may adopt administrative rules under section 17A.4,
35subsection 3, and section 17A.5, subsection 2, paragraph “b”,
-55-1to implement the provisions of this division of this Act and
2the rules shall become effective immediately upon filing or
3on a later effective date specified in the rules, unless the
4effective date of the rules is delayed or the applicability
5of the rules is suspended by the administrative rules review
6committee. Any rules adopted in accordance with this section
7shall not take effect before the rules are reviewed by the
8administrative rules review committee. The delay authority
9provided to the administrative rules review committee under
10section 17A.8, subsections 9 and 10, shall be applicable to a
11delay imposed under this section, notwithstanding a provision
12in those subsections making them inapplicable to section 17A.5,
13subsection 2, paragraph “b”. Any rules adopted in accordance
14with the provisions of this section shall also be published as
15a notice of intended action as provided in section 17A.4.
162. If during a fiscal year, the department of human
17services is adopting rules in accordance with this section
18or as otherwise directed or authorized by state law, and
19the rules will result in an expenditure increase beyond the
20amount anticipated in the budget process or if the expenditure
21was not addressed in the budget process for the fiscal
22year, the department shall notify the general assembly and
23the department of management concerning the rules and the
24expenditure increase. The notification shall be provided at
25least 30 calendar days prior to the date notice of the rules
26is submitted to the administrative rules coordinator and the
27administrative code editor.
28 Sec. 33. REPORTS. Unless otherwise provided, any reports or
29other information required to be compiled and submitted under
30this Act during the fiscal year beginning July 1, 2022, shall
31be submitted on or before the dates specified for submission
32of the reports or information.
33 Sec. 34. EFFECTIVE UPON ENACTMENT. The following provision
34of this division of this Act, being deemed of immediate
35importance, takes effect upon enactment:
-56- 1The provision relating to section 232.141 and directing the
2state court administrator and the division administrator of
3the department of human services division of child and family
4services to make the determination, by June 15, 2022, of the
5distribution of funds allocated for the payment of the expenses
6of court-ordered services provided to juveniles which are a
7charge upon the state.
8DIVISION VI
9HEALTH CARE ACCOUNTS AND FUNDS — FY 2022-2023
10 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
11appropriated from the pharmaceutical settlement account created
12in section 249A.33 to the department of human services for the
13fiscal year beginning July 1, 2022, and ending June 30, 2023,
14the following amount, or so much thereof as is necessary, to be
15used for the purpose designated:
16Notwithstanding any provision of law to the contrary, to
17supplement the appropriations made in this Act for health
18program operations under the medical assistance program for the
19fiscal year beginning July 1, 2022, and ending June 30, 2023:
.................................................. $20234,193
21 Sec. 36. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
22SERVICES. Notwithstanding any provision to the contrary and
23subject to the availability of funds, there is appropriated
24from the quality assurance trust fund created in section
25249L.4 to the department of human services for the fiscal year
26beginning July 1, 2022, and ending June 30, 2023, the following
27amounts, or so much thereof as is necessary, for the purposes
28designated:
29To supplement the appropriation made in this Act from the
30general fund of the state to the department of human services
31for medical assistance for the same fiscal year:
.................................................. $3256,305,139
33 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
34DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
35the contrary and subject to the availability of funds, there is
-57-1appropriated from the hospital health care access trust fund
2created in section 249M.4 to the department of human services
3for the fiscal year beginning July 1, 2022, and ending June
430, 2023, the following amounts, or so much thereof as is
5necessary, for the purposes designated:
6To supplement the appropriation made in this Act from the
7general fund of the state to the department of human services
8for medical assistance for the same fiscal year:
.................................................. $933,920,554
10 Sec. 38. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
11FOR FY 2022-2023. Notwithstanding section 8.33, if moneys
12appropriated for purposes of the medical assistance program for
13the fiscal year beginning July 1, 2022, and ending June 30,
142023, from the general fund of the state, the quality assurance
15trust fund, and the hospital health care access trust fund, are
16in excess of actual expenditures for the medical assistance
17program and remain unencumbered or unobligated at the close
18of the fiscal year, the excess moneys shall not revert but
19shall remain available for expenditure for the purposes of the
20medical assistance program until the close of the succeeding
21fiscal year.
22DIVISION VII
23DECATEGORIZATION CARRYOVER FUNDING
24 Sec. 39. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —
25TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
26subsection 5, paragraph “b”, any state-appropriated moneys in
27the funding pool that remained unencumbered or unobligated
28at the close of the fiscal year beginning July 1, 2019, and
29were deemed carryover funding to remain available for the two
30succeeding fiscal years that still remain unencumbered or
31unobligated at the close of the fiscal year beginning July 1,
322021, shall not revert but shall be transferred to the medical
33assistance program for the fiscal year beginning July 1, 2022.
34 Sec. 40. EFFECTIVE DATE. This division of this Act, being
35deemed of immediate importance, takes effect upon enactment.
-58-1 Sec. 41. RETROACTIVE APPLICABILITY. This division of this
2Act applies retroactively to July 1, 2021.
3DIVISION VIII
4TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE
5 Sec. 42. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —
6FY 2021-2022. Notwithstanding any provision to the contrary,
7any funds remaining in the property tax relief fund created
8in section 426B.1 at the close of the fiscal year beginning
9July 1, 2021, shall be transferred to the region incentive fund
10created in the mental health and disability services regional
11service fund pursuant to section 225C.7A.
12 Sec. 43. EFFECTIVE DATE. This division of this Act, being
13deemed of immediate importance, takes effect upon enactment.
14DIVISION IX
15PRIOR APPROPRIATIONS AND OTHER PROVISIONS
16FAMILY INVESTMENT PROGRAM GENERAL FUND
17 Sec. 44. 2021 Iowa Acts, chapter 182, section 9, is amended
18by adding the following new subsection:
19 NEW SUBSECTION. 7. Notwithstanding section 8.33, moneys
20appropriated in this section that remain unencumbered or
21unobligated at the close of the fiscal year shall not revert
22but shall remain available for one-time purposes, and may be
23transferred to the appropriation in this division of this Act
24for general administration for technology purposes, until the
25close of the succeeding fiscal year.
26CHILD AND FAMILY SERVICES
27 Sec. 45. 2021 Iowa Acts, chapter 182, section 19, is amended
28by adding the following new subsection:
29 NEW SUBSECTION. 24. Notwithstanding section 8.33, moneys
30appropriated in this section that remain unencumbered or
31unobligated at the close of the fiscal year shall not revert
32but shall remain available for the purposes designated until
33the close of the succeeding fiscal year.
34FIELD OPERATIONS
35 Sec. 46. 2021 Iowa Acts, chapter 182, section 27, is amended
-59-1by adding the following new subsection:
2 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
3appropriated in this section that remain unencumbered or
4unobligated at the close of the fiscal year shall not revert
5but shall remain available for one-time expenditure purposes
6until the close of the succeeding fiscal year.
7GENERAL ADMINISTRATION
8 Sec. 47. 2021 Iowa Acts, chapter 182, section 28, is amended
9by adding the following new subsection:
10 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
11appropriated in this section that remain unencumbered or
12unobligated at the close of the fiscal year shall not revert
13but shall remain available for one-time expenditure purposes
14until the close of the succeeding fiscal year.
15 Sec. 48. EFFECTIVE DATE. This division of this Act, being
16deemed of immediate importance, takes effect upon enactment.
17DIVISION X
18PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS
19 Sec. 49. COVID-19 FEDERAL REGULATIONS. For the time
20period beginning on the effective date of this division of
21this Act, and ending June 30, 2023, notwithstanding state
22administrative rules to the contrary, to the extent federal
23regulations relating to the COVID-19 pandemic differ from state
24administrative rules, including applicable federal waivers,
25the federal regulations are controlling during the pendency of
26the federally declared state of emergency and for such period
27of time following the end of the federally declared state of
28emergency applicable to the respective federal regulations.
29DIVISION XI
30HEALTH AND HUMAN SERVICES REALIGNMENT
31 Sec. 50. TRANSITION OF DEPARTMENT OF HUMAN SERVICES AND
32DEPARTMENT OF PUBLIC HEALTH INTO DEPARTMENT OF HEALTH AND HUMAN
33SERVICES.
341. Definitions. For the purposes of this section:
35a. “Department of health and human services” or
-60-1“department” means the department of health and human services
2created under this section.
3b. “Transition department” means the department of human
4services or the department of public health.
5c. “Transition departments” means the department of human
6services and the department of public health.
7d. “Transition period” means the period beginning July 1,
82022, and ending June 30, 2023.
92. Creation of department of health and human services
10— transition period — powers and duties. Notwithstanding
11any conflicting provision of law to the contrary, there is
12created a department of health and human services. During
13the transition period, the department of health and human
14services shall have and may exercise all of the policymaking
15functions, regulatory and enforcement powers, rights, duties,
16and responsibilities of the department of human services and
17the department of public health as prescribed by law or rule
18in effect on July 1, 2022, including but not limited to those
19relating to:
20a. All obligations and contracts of a transition
21department, including obligations and contracts related to a
22grant program.
23b. All property and records in the custody of a transition
24department.
25c. All funds appropriated to a transition department by the
26general assembly and all state, federal, and other funds for
27which expenditure by a transition department is authorized.
28d. Complaints, investigations, contested cases, causes of
29action, and statutes of limitations involving a transition
30department.
31(1) All complaints, investigations, contested cases, or
32a remand of an action by a reviewing court pending before a
33transition department or an authorized person of a transition
34department shall continue without change in status before
35the department and shall be governed by the laws and rules
-61-1applicable to the complaint, investigation, contested case, or
2remand action or proceeding in effect on July 1, 2022.
3(2) Any cause of action or statute of limitation relating
4to a transition department shall not be affected as a result
5of the transition and such cause of action or statute of
6limitation shall apply to the department.
7e. Rules, policies, and forms. All rules, policies, and
8forms adopted by or on behalf of a transition department shall
9become rules, policies, and forms of the department and shall
10remain in effect unless altered by the department.
11f. Licenses, permits, and certifications. All licenses,
12permits, and certifications issued by a transition department
13shall continue in effect as a license, permit, or certification
14of the department in accordance with the law or rule governing
15the license, permit, or certification in effect on July 1,
162022, until the license, permit, or certification expires, is
17suspended or revoked, or otherwise becomes invalid by the terms
18of such law or rule.
19g. References to a department or director. All references
20to the department of public health or the department of human
21services in law or in rule shall be interpreted to mean the
22department of health and human services, and all references to
23the director of public health or the director of human services
24shall be interpreted to mean the director of the department of
25health and human services.
26h. Departmental structure.
27(1) Any transition department, transition department
28subunit, or transition department body created or established
29by law and in existence on July 1, 2022, shall continue in
30full force and effect and shall not be permanently abolished,
31merged, or otherwise altered until amended, repealed, or
32supplemented by action of the general assembly.
33(2) This paragraph shall not prohibit a transition
34department, transition department subunit, or transition
35department body created or established by law in existence on
-62-1July 1, 2022, from sharing or coordinating responsibilities
2or functions under their respective purviews nor prohibit
3the director from temporarily integrating such departments,
4subunits, or bodies or the responsibilities or functions under
5their respective purviews in furtherance of the transition plan
6during the transition period.
73. Transition period leadership. During the transition
8period, the director of human services shall continue to act
9as the director of human services, shall assume the duties of
10the director of public health, shall act as the director of
11the department of health and human services, and may thereby
12exercise any policymaking functions, regulatory and enforcement
13powers, rights, duties, and responsibilities of the director
14of human services and the director of public health including
15those duties prescribed by law for the department of human
16services or the department of public health in effect on July
171, 2022.
184. Federal authorization and effective date of
19authorizations. If a transition department or the department
20determines that a waiver or authorization from the federal
21government is necessary to administer any provision of
22this section, the department shall request the waiver or
23authorization, and notwithstanding any other effective date to
24the contrary, the provision shall take effect only upon receipt
25of federal approval.
265. Initial written transition plan.
27a. On or before September 30, 2022, the transition
28departments or department shall publish on their respective
29internet sites an initial written transition plan for merging
30the functions of the transition departments into the department
31of health and human services effective July 1, 2023, in order
32to do all of the following:
33(1) More efficiently and effectively manage health and
34human services programs that are the responsibility of the
35state.
-63- 1(2) Establish a health and human services policy for the
2state.
3(3) Promote health and the quality of life in the health and
4human services field.
5b. The transition plan shall describe, at a minimum, all of
6the following:
7(1) The tasks that require completion before July 1, 2023,
8including a description of how the transition departments shall
9solicit comment from stakeholders, including employees of the
10transition departments, clients and partners of the transition
11departments, members of the public, and members of the general
12assembly.
13(2) The proposed organizational structure of the
14department, at a minimum, including the division level of
15the table of organization. Any personnel in the state merit
16system of employment who are mandatorily transferred due to the
17transition shall be so transferred without any loss in salary,
18benefits, or accrued years of service.
19(3) Proposed changes to any transition department boards,
20commissions, committees, councils, or other bodies and their
21functions.
22(4) Office space and infrastructure requirements related
23to the transition.
24(5) Any work site location changes for transitioning
25employees.
26(6) The transition of service delivery sites.
27(7) Procedures for the transfer and reconciliation of
28budgeting and funding between the transition departments and
29the department.
30(8) The transition of technology services of the transition
31departments to the department.
32(9) Any additional known tasks that may require completion
33after the transition on July 1, 2023.
34c. The written transition plan published under paragraph
35“b” shall:
-64- 1(1) Include a detailed timeline for the completion of the
2tasks described.
3(2) Be updated quarterly during the remainder of the
4transition period.
5(3) Describe how information will be provided to clients
6of the transition departments and the department regarding any
7changes in service delivery.
8(4) Describe how the transition to the department will be
9funded, including how expenses associated with the transition
10will be managed; how funding for services provided by the
11transition departments will be managed to ensure provision
12of services by the transition departments and the department
13without interruption; and how federal funds will be used by
14or transferred between the transition departments and the
15department to ensure provision of services by the transition
16departments and the department without interruption.
176. Statutory and administrative rule updates.
18a. Legislative changes required to implement the
19transition. Additional legislation is necessary to fully
20implement the transition. The director of the department
21of health and human services shall, in compliance with
22section 2.16, prepare draft legislation for submission to the
23legislative services agency, as necessary, for consideration
24by the general assembly during the 2023 legislative
25session, to implement the transition effective July 1, 2023.
26Notwithstanding any provision to the contrary in section 2.16,
27the draft legislation shall be submitted to the legislative
28services agency by October 1, 2022.
29b. Update of administrative code required by the
30transition. In updating references and the format in the
31Iowa administrative code, in order to correspond to the
32transferring of duties of the transition departments, the
33administrative rules coordinator and the administrative rules
34review committee, in consultation with the administrative code
35editor, shall collectively develop a schedule for the necessary
-65-1updating of the Iowa administrative code.
2DIVISION XII
3NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY
4OF CARE RATE ADD-ON PROGRAM
5 Sec. 51. Section 249L.2, subsections 6 and 7, Code 2022, are
6amended by striking the subsections.
7 Sec. 52. Section 249L.2, subsection 8, Code 2022, is amended
8to read as follows:
98. “Nursing facility” means a licensed nursing facility as
10defined in section 135C.1 that is a freestanding facility or
11a nursing facility operated by a hospital licensed pursuant
12to chapter 135B, but does not include a distinct-part skilled
13nursing unit or a swing-bed unit operated by a hospital, or
14a nursing facility owned by the state or federal government
15or other governmental unit.“Nursing facility” includes a
16non-state government-owned nursing facility if the nursing
17facility participates in the non-state government-owned nursing
18facility quality of care rate add-on program.
19 Sec. 53. REPEAL. 2019 Iowa Acts, chapter 85, sections 103,
20104, and 108, are repealed.
21 Sec. 54. REPEAL. 2020 Iowa Acts, chapter 1063, section 390,
22is repealed.
23DIVISION XIII
24HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —
25ADMINISTRATION
26 Sec. 55. HEARING AID AND AUDIOLOGIC SERVICES FUNDING
27PROGRAM ADMINISTRATION. The Iowa department of public
28health shall not enter into a contract with a third party to
29administer the hearing aids and audiologic services funding
30program and shall adopt rules pursuant to chapter 17A to
31administer the program within the department, including but not
32limited to the administration of the application process, the
33determination of applicants’ eligibility, the enrollment of
34eligible applicants into the program, the maintenance of the
35hearing aids and audiologic services funding waitlist, and the
-66-1reimbursement of providers.
2DIVISION XIV
3HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —
4FY 2021-2022 NONREVERSION
5 Sec. 56. 2021 Iowa Acts, chapter 182, section 3, subsection
62, paragraph e, is amended to read as follows:
7e. Of the funds appropriated in this subsection, $156,000
8shall be used to provide audiological services and hearing
9aids for children. Notwithstanding section 8.33, moneys
10appropriated in this paragraph that remain unencumbered or
11unobligated at the close of the fiscal year shall not revert
12but shall remain available for expenditure for the purposes
13designated until the close of the succeeding fiscal year. The
14amount that does not revert shall be reported by the department
15to the general assembly.
16 Sec. 57. EFFECTIVE DATE. This division of this Act, being
17deemed of immediate importance, takes effect upon enactment.
18DIVISION XV
19ADMISSION OR TRANSFER OF PERSONS WITH A DIAGNOSIS OF AN
20INTELLECTUAL DISABILITY TO A STATE MENTAL HEALTH INSTITUTE
21 Sec. 58. Section 4.1, subsection 9A, Code 2022, is amended
22by striking the subsection and inserting in lieu thereof the
23following:
249A. “Intellectual disability” means a diagnosis of
25intellectual disability or intellectual developmental disorder,
26global developmental delay, or unspecified intellectual
27disability or intellectual developmental disorder which
28diagnosis shall be made only when the onset of the person’s
29condition was during the developmental period and based on an
30assessment of the person’s intellectual functioning and level
31of adaptive skills. A diagnosis of intellectual disability
32shall be made by a licensed psychologist or psychiatrist who
33is professionally trained to administer the tests required to
34assess intellectual functioning and to evaluate a person’s
35adaptive skills and shall be made in accordance with the
-67-1criteria provided in the current version of the diagnostic
2and statistical manual of mental disorders published by the
3American psychiatric association.
4 Sec. 59. Section 226.8, Code 2022, is amended to read as
5follows:
6226.8 Persons with a diagnosis of an intellectual disability
7not receivable — exception — admission or transfer to state
8mental health institute.
91. A Admission or transfer pursuant to section 222.7 to
10a state mental health institute of a person who has with a
11diagnosis of an intellectual disability, as defined in section
124.1, shall not be admitted, or transferred pursuant to section
13222.7, to a state mental health institute unless a professional
14diagnostic evaluation indicates that such only occur under the
15following conditions:
16a. If all of the following requirements are met:
17(1) The person has been determined by the state mental
18health institute to meet admission criteria for inpatient
19psychiatric care.
20(2) The state mental health institute has determined the
21person will benefit from psychiatric treatment or from some
22other specific program available at the state mental health
23institute to which it is proposed to admit or transfer the
24person.
25(3) There is sufficient capacity available at the state
26mental health institute to support the needs of the person.
27b. If determined appropriate for the person at the
28sole discretion of the director of human services, the
29administrator, or the director’s or administrator’s designee.
302. Charges for the care of any person with a diagnosis of
31 an intellectual disability admitted to a state mental health
32institute shall be made by the institute in the manner provided
33by chapter 230, but the liability of any other person to any
34county mental health and disability services region for the
35cost of care of such person with a diagnosis of an intellectual
-68-1disability shall be as prescribed by section 222.78.
2DIVISION XVI
3Colleges OF medicine and dentistry — residency — reports
4 Sec. 60. Section 262.9, Code 2022, is amended by adding the
5following new subsection:
6 NEW SUBSECTION. 39. Adopt a policy requiring that not less
7than seventy-five percent of the students who are accepted
8at the college of medicine in the doctor of medicine program
9and who are accepted at the college of dentistry at the state
10university of Iowa be residents of Iowa or persons who were,
11prior to applying to such college, enrolled in an eligible
12postsecondary institution as defined in section 261E.2.
13 Sec. 61. Section 263.2, Code 2022, is amended to read as
14follows:
15263.2 Degrees — reports.
161. A person shall not be admitted to courses of instruction
17in the university if the person has not completed the
18elementary instruction in such branches as are taught in the
19public or accredited nonpublic schools throughout the state.
202. Graduates of the university shall receive degrees or
21diplomas, or other evidences of distinction such as are usually
22conferred and granted by universities and are authorized by the
23state board of regents.
243. The state university of Iowa, in collaboration with the
25university hospitals and clinics, shall submit an annual report
26to the general assembly providing the following information:
27a. The states in which members of each graduating class
28from the college of dentistry and the college of medicine’s
29doctor of medicine program reside during the year immediately
30following graduation. The information shall be categorized
31by either residents of Iowa at the time of application to the
32college or nonresidents at the time of application to the
33college.
34b. The states in which the university of Iowa hospitals and
35clinics primary care and specialty residents reside in the year
-69-1following completion of medical residency and whether following
2residency such residents accepted fellowships. The information
3shall be categorized by primary care and the various areas of
4specialty, and shall specify whether the medical residents
5were residents of Iowa prior to applying for admission at an
6undergraduate college or university, received a baccalaureate
7degree from a postsecondary institution in Iowa, or graduated
8from a medical school in Iowa, whether or not the medical
9residents were residents of the state at the time of acceptance
10into the university of Iowa hospitals and clinics’ residency
11programs and, if any residents accepted fellowships following
12residency, the states in which the fellowships are offered and
13the areas of specialty under the fellowships.
14DIVISION XVII
15MEDICAL RESIDENCY POSITIONS AND AUDITION cLINICALS
16 Sec. 62. MEDICAL RESIDENCY POSITIONS AND AUDITION CLINICALS
17— MEDICAL STUDENTS AND APPLICANTS MEETING CERTAIN CRITERIA —
18ANNUAL REPORT.
191. The university of Iowa hospitals and clinics shall offer
20an interview for an available medical residency position to
21any applicant who has a residency specialty in obstetrics and
22gynecology, psychiatry, general surgery, emergency medicine,
23cardiology, neurology, or primary care and who also is a
24resident of Iowa, attended and earned an undergraduate degree
25from an Iowa college or university, or attended and earned a
26medical degree from a medical school in Iowa.
272. The university of Iowa hospitals and clinics shall
28provide the opportunity to a medical student attending a
29medical school in Iowa to participate in an audition clinical
30in the medical residency specialty for which the medical
31student applies to allow the university to constructively
32review the student in a clinical setting.
333. The university of Iowa hospitals and clinics shall submit
34a report to the governor and the general assembly by January
3515, annually, regarding the interviews and audition clinicals
-70-1as specified in this section during the prior fiscal year.
2Specifically, the report shall include for each interview or
3audition clinical the name of the student’s or applicant’s
4medical school, whether an applicant was offered and
5participated in an interview, whether the student was offered
6and participated in an audition clinical, whether the applicant
7was accepted for one of the residency program positions, and
8the total number of available residency positions filled by an
9applicant meeting the criteria under this section.
10DIVISION XVIII
11HEALTH CARRIERS — TELEHEALTH
12 Sec. 63. Section 514C.34, subsection 3, Code 2022, is
13amended to read as follows:
143. a. Health care services that are delivered by telehealth
15must be appropriate and delivered in accordance with applicable
16law and generally accepted health care practices and standards
17prevailing at the time the health care services are provided,
18including all rules adopted by the appropriate professional
19licensing board, pursuant to chapter 147, having oversight
20of the health care professional providing the health care
21services.
22b. A health carrier shall not exclude a health care
23professional who provides services for mental health
24conditions, illnesses, injuries, or diseases and who is
25physically located out-of-state from participating as a
26provider, via telehealth, under a policy, plan, or contract
27offered by the health carrier in the state if all of the
28following requirements are met:
29(1) The health care professional is licensed in this state
30by the appropriate professional licensing board and is able
31to deliver health care services for mental health conditions,
32illnesses, injuries, or diseases via telehealth in compliance
33with paragraph “a”.
34(2) The health care professional is able to satisfy the same
35criteria that the health carrier uses to qualify a health care
-71-1professional who is located in the state, and who holds the
2same license as the out-of-state professional, to participate
3as a provider, via telehealth, under a policy, plan, or
4contract offered by the health carrier in the state.
5 Sec. 64. EFFECTIVE DATE. This division of this Act, being
6deemed of immediate importance, takes effect upon enactment.
7 Sec. 65. APPLICABILITY. This division of this Act applies
8to health carriers that deliver, issue for delivery, continue,
9or renew a policy, contract, or plan in this state on or after
10the effective date of this Act.
11DIVISION XIX
12NURSING FACILITY CONSTRUCTION OR EXPANSION RELIEF
13 Sec. 66. Section 249K.2, subsection 4, Code 2022, is amended
14to read as follows:
154. “Major renovations” means construction or facility
16improvements to a nursing facility in which the total amount
17expended exceeds one million five seven hundred fifty thousand
18dollars.
19 Sec. 67. Section 249K.5, subsection 2, Code 2022, is amended
20by adding the following new paragraph:
21 NEW PARAGRAPH. c. The nursing facility for which relief
22or an exception is requested is proposing replacement or
23enhancement of an HVAC, as defined in section 105.2, system for
24improved infection control.
25 Sec. 68. ADMINISTRATIVE RULES — ADOPTION AND
26AMENDMENT. The department of human services shall adopt or
27amend rules pursuant to chapter 17A to administer this division
28of this Act. Specifically, the department shall amend rules
29relating to nursing facility additional requirements for all
30requests for the capital cost per diem instant relief add-on
31and enhanced nondirect care rate component limit to provide
32that with regard to the additional requirements a nursing
33facility must meet, the facility has Medicaid utilization at
34or above forty percent for the two-month period before the
35request for additional reimbursement is submitted. Medicaid
-72-1utilization for this purpose is calculated as total nursing
2facility Medicaid patient days divided by total in-house
3patient days as reported on the facility’s most current
4financial and statistical report.
5DIVISION XX
6Health Care providers — covid-19 and experimental treatments
7 Sec. 69. Section 144E.2, subsection 1, paragraphs a, c, and
8e, Code 2022, are amended to read as follows:
9a. Has a terminal illness, attested to by the patient’s a
10 treating physician, or is receiving mechanical ventilation to
11prolong life.
12c. Has received a recommendation from the individual’s a
13 physician for an investigational drug, biological product, or
14device.
15e. Has documentation from the individual’s a physician that
16the individual meets the requirements of this subsection.
17 Sec. 70. Section 144E.2, subsection 2, Code 2022, is amended
18to read as follows:
192. “Investigational drug, biological product, or device”
20means a any of the following:
21a. Adrug, biological product, or device that has
22successfully completed phase 1 of a United States food and drug
23administration-approved clinical trial but has not yet been
24approved for general use by the United States food and drug
25administration and remains under investigation in a United
26States food and drug administration-approved clinical trial.
27b. An off-label use of a drug.
28 Sec. 71. Section 144E.2, Code 2022, is amended by adding the
29following new subsection:
30 NEW SUBSECTION. 2A. “Off-label use of a drug” means
31the legal, prescribed use of a drug in a manner different
32from that described on the United States food and drug
33administration-approved drug label, including the use of a
34drug for a different disease or medical condition or giving
35a drug at a different dose or through a different route of
-73-1administration other than that approved by the United States
2food and drug administration.
3 Sec. 72. Section 144E.2, subsection 4, unnumbered paragraph
41, Code 2022, is amended to read as follows:
5“Written informed consent” means a written document that
6is signed by the patient, a parent of a minor patient, or a
7legal guardian or other legal representative of the patient and
8attested to by the patient’s a treating physician and a witness
9and that includes all of the following:
10 Sec. 73. Section 144E.2, subsection 4, paragraphs b and d,
11Code 2022, are amended to read as follows:
12b. An attestation that the patient concurs with the
13patient’s a treating physician in believing that all products
14and treatments approved by the United States food and drug
15administration are unlikely to prolong the patient’s life.
16d. A description of the best and worst potential outcomes
17of using the investigational drug, biological product, or
18device and a realistic description of the most likely outcome.
19The description shall include the possibility that new,
20unanticipated, different, or worse symptoms might result
21and that death could be hastened by use of the proposed
22investigational drug, biological product, or device. The
23description shall be based on the a treating physician’s
24knowledge of the proposed investigational drug, biological
25product, or device in conjunction with an awareness of the
26patient’s condition.
27 Sec. 74. Section 144E.4, Code 2022, is amended by adding the
28following new subsection:
29 NEW SUBSECTION. 5. This chapter does not create a duty
30for a hospital licensed under chapter 135B to credential any
31physician.
32 Sec. 75. Section 144E.8, subsection 1, Code 2022, is amended
33to read as follows:
341. This chapter shall not create a private cause of
35action against a manufacturer of an investigational drug,
-74-1biological product, or device, against a physician, health care
2practitioner, or facility that provides necessary follow-up
3care, or against any other person or entity involved in the
4care of an eligible patient using the investigational drug,
5biological product, or device for any harm done to the eligible
6patient resulting from the investigational drug, biological
7product, or device, if the manufacturer or other person or
8entity is complying in good faith with the terms of this
9chapter and has exercised reasonable care.
10 Sec. 76. Section 144E.9, Code 2022, is amended to read as
11follows:
12144E.9 Assisting suicide.
13This chapter shall not be construed to allow a patient’s
14treating physician to assist the a patient in committing or
15attempting to commit suicide as prohibited in section 707A.2.
16 Sec. 77. Section 686D.6, Code 2022, is amended to read as
17follows:
18686D.6 Liability of and disciplinary actions against health
19care providers.
201. A health care provider shall not be liable for civil
21damages or subject to disciplinary action by the health
22care provider’s licensing board for causing or contributing,
23directly or indirectly, to the death or injury of an individual
24as a result of the health care provider’s acts or omissions
25while providing or arranging health care in support of the
26state’s response to COVID-19. This subsection shall apply to
27all of the following:
28a. Injury or death resulting from screening, assessing,
29diagnosing, caring for, or treating individuals with a
30suspected or confirmed case of COVID-19.
31b. Prescribing, administering, or dispensing a
32pharmaceutical for off-label use to treat a patient with a
33suspected or confirmed case of COVID-19.
34c. Acts or omissions while providing health care to
35individuals unrelated to COVID-19 when those acts or omissions
-75-1support the state’s response to COVID-19, including any of the
2following:
3(1) Delaying or canceling nonurgent or elective dental,
4medical, or surgical procedures, or altering the diagnosis or
5treatment of an individual in response to any federal or state
6statute, regulation, order, or public health guidance.
7(2) Diagnosing or treating patients outside the normal
8scope of the health care provider’s license or practice.
9(3) Using medical devices, equipment, or supplies outside
10of their normal use for the provision of health care, including
11using or modifying medical devices, equipment, or supplies for
12an unapproved use.
13(4) Conducting tests or providing treatment to any
14individual outside the premises of a health care facility.
15(5) Acts or omissions undertaken by a health care provider
16because of a lack of staffing, facilities, medical devices,
17equipment, supplies, or other resources attributable to
18COVID-19 that renders the health care provider unable to
19provide the level or manner of care to any person that
20otherwise would have been required in the absence of COVID-19.
21(6) Acts or omissions undertaken by a health care provider
22relating to use or nonuse of personal protective equipment.
232. This section shall not relieve any person of liability
24for civil damages or a health care provider from disciplinary
25action by the health care provider’s licensing board for any
26act or omission which constitutes recklessness or willful
27misconduct.
28 Sec. 78. EFFECTIVE DATE. This division of this Act, being
29deemed of immediate importance, takes effect upon enactment.
30DIVISION XXI
31Health-related data
32 Sec. 79. Section 11.41, subsection 3, Code 2022, is amended
33to read as follows:
343. If the information, records, instrumentalities, and
35properties sought by the auditor of state are required by law
-76-1to be kept confidential, the auditor of state shall have access
2to the information, records, instrumentalities, and properties,
3but shall maintain the confidentiality of all such information
4and is subject to the same penalties as the lawful custodian
5of the information for dissemination of the information.
6However, the auditor of state shall not have access to the
7income tax returns of individuals or to an individual’s name
8or residential address from a reportable disease report under
9section 139A.3.
10 Sec. 80. Section 135.166, subsection 2, Code 2022, is
11amended to read as follows:
122. Unless otherwise authorized or required by state or
13federal law, data collected under this section shall not
14include the social security number or name of the individual
15subject of the data.
16 Sec. 81. Section 139A.3, Code 2022, is amended by adding the
17following new subsection:
18 NEW SUBSECTION. 1A. A state or local agency employee
19or agent shall not have access to personally identifiable
20information included in a reportable disease report provided
21to or maintained by the department, a local board, or a local
22department, unless the employee or agent has completed data
23confidentiality training.
24DIVISION XXII
25Psychiatry residency program
26 Sec. 82. NEW SECTION. 135.180 State-funded psychiatry
27residency program — fund — appropriations.
281. The university of Iowa hospitals and clinics shall
29administer a state-funded psychiatry residency program
30in cooperation with the state mental health institutes at
31Independence and Cherokee, the state resource centers at
32Glenwood and Woodward, the state training school at Eldora,
33and the Iowa medical and classification center at Oakdale.
34The university of Iowa hospitals and clinics shall expand the
35psychiatry residency program to provide additional residency
-77-1positions by providing financial support for residency
2positions which are in excess of the federal residency cap
3established by the federal Balanced Budget Act of 1997, Pub.L.
4No.105-33. Participating residents shall complete a portion
5of their psychiatry training at one of the state mental health
6institutes, the state resource centers, the state training
7school, or the Iowa medical and classification center at
8Oakdale. For accreditation-required clinical experiences not
9available at the state mental health institutes, the state
10resource centers, the state training school, or the Iowa
11medical and classification center at Oakdale, the psychiatry
12residency program and its residents may utilize clinical
13rotations at the university of Iowa hospitals and clinics and
14its affiliates across the state.
152. The residency program shall provide for the awarding
16of twelve residency positions for each class of residents.
17Preference in the awarding of residency positions shall
18be given to candidates who are residents of Iowa, attended
19and earned an undergraduate degree from an Iowa college or
20university, or attended and earned a medical degree from a
21medical school in Iowa.
223. A psychiatry residency program fund is created in
23the state treasury consisting of the moneys appropriated or
24credited to the fund by law. Notwithstanding section 8.33,
25moneys in the fund at the end of each fiscal year shall not
26revert to any other fund but shall remain in the psychiatry
27residency program fund for use in subsequent fiscal years.
28Moneys in the fund are appropriated to the university of Iowa
29hospitals and clinics to be used for the purposes of the
30program. For fiscal years beginning on or after July 1, 2023,
31there is appropriated from the general fund of the state to the
32psychiatry residency program fund the following amounts to be
33used for the purposes of the program:
34a. For the fiscal year beginning July 1, 2023, one million
35two hundred thousand dollars.
-78- 1b. For the fiscal year beginning July 1, 2024, two million
2four hundred thousand dollars.
3c. For the fiscal year beginning July 1, 2025, three million
4six hundred thousand dollars.
5d. For the fiscal year beginning July 1, 2026, and each
6fiscal year thereafter, four million eight hundred thousand
7dollars.
pf/rn/md
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 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, and
17for not more than the following full-time equivalent positions:
.................................................. $1811,804,082
............................................... FTEs1928.00
201. Funds appropriated in this section may be used to
21supplement federal funds under federal regulations. To
22receive funds appropriated in this section, a local area
23agency on aging shall match the funds with moneys from other
24sources according to rules adopted by the department. Funds
25appropriated in this section may be used for elderly services
26not specifically enumerated in this section only if approved
27by an area agency on aging for provision of the service within
28the area.
292. Of the funds appropriated in this section, $418,700 is
30transferred to the economic development authority for the Iowa
31commission on volunteer services to be used for the retired and
32senior volunteer program.
333. a. The department on aging shall establish and enforce
34procedures relating to expenditure of state and federal funds
35by area agencies on aging that require compliance with both
-1-1state and federal laws, rules, and regulations, including but
2not limited to all of the following:
3(1) Requiring that expenditures are incurred only for goods
4or services received or performed prior to the end of the
5fiscal period designated for use of the funds.
6(2) Prohibiting prepayment for goods or services not
7received or performed prior to the end of the fiscal period
8designated for use of the funds.
9(3) Prohibiting prepayment for goods or services not
10defined specifically by good or service, time period, or
11recipient.
12(4) Prohibiting the establishment of accounts from which
13future goods or services which are not defined specifically by
14good or service, time period, or recipient, may be purchased.
15b. The procedures shall provide that if any funds are
16expended in a manner that is not in compliance with the
17procedures and applicable federal and state laws, rules, and
18regulations, and are subsequently subject to repayment, the
19area agency on aging expending such funds in contravention of
20such procedures, laws, rules and regulations, not the state,
21shall be liable for such repayment.
224. Of the funds appropriated in this section, $1,312,000
23shall be used for the purposes of chapter 231E and to
24administer the prevention of elder abuse, neglect, and
25exploitation program pursuant to section 231.56A, in accordance
26with the requirements of the federal Older Americans Act of
271965, 42 U.S.C.§3001 et seq., as amended.
285. Of the funds appropriated in this section, $1,000,000
29shall be used to fund continuation of the aging and disability
30resource center lifelong links to provide individuals and
31caregivers with information and services to plan for and
32maintain independence.
336. Of the funds appropriated in this section, $850,000
34shall be used by the department on aging, in collaboration with
35the department of human services and affected stakeholders,
-2-1to continue to expand the pilot initiative to provide
2long-term care options counseling utilizing support planning
3protocols, to assist non-Medicaid eligible consumers who
4indicate a preference to return to the community and are
5deemed appropriate for discharge, to return to their community
6following a nursing facility stay; and shall be used by the
7department on aging to fund home and community-based services
8to enable older individuals to avoid more costly utilization
9of residential or institutional services and remain in their
10homes. The department on aging shall submit a report regarding
11the outcomes of the pilot initiative to the governor and the
12general assembly by December 15, 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, and for not more than the following
23full-time equivalent positions:
.................................................. $241,449,821
............................................... FTEs2516.00
26DIVISION III
27DEPARTMENT OF PUBLIC HEALTH — FY 2022-2023
28 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
29from the general fund of the state to the department of public
30health for the fiscal year beginning July 1, 2022, and ending
31June 30, 2023, the following amounts, or so much thereof as is
32necessary, to be used for the purposes designated:
331. ADDICTIVE DISORDERS
34For reducing the prevalence of the use of tobacco, alcohol,
35and other drugs, and treating individuals affected by addictive
-3-1behaviors, including gambling, and for not more than the
2following full-time equivalent positions:
.................................................. $323,659,379
............................................... FTEs412.00
5a. Of the funds appropriated in this subsection, $4,020,894
6shall be used for the tobacco use prevention and control
7initiative, including efforts at the state and local levels,
8as provided in chapter 142A. The commission on tobacco use
9prevention and control established pursuant to section 142A.3
10shall advise the director of public health in prioritizing
11funding needs and the allocation of moneys appropriated for
12the programs and initiatives. Activities of the programs
13and initiatives shall be in alignment with the United States
14centers for disease control and prevention best practices
15for comprehensive tobacco control programs that include
16the goals of preventing youth initiation of tobacco usage,
17reducing exposure to secondhand smoke, and promotion of tobacco
18cessation.
19b. (1) Of the funds appropriated in this subsection,
20$19,638,485 shall be used for problem gambling and
21substance-related disorder prevention, treatment, and recovery
22services, including a 24-hour helpline, public information
23resources, professional training, youth prevention, and program
24evaluation.
25(2) Of the amount allocated under this paragraph, $306,000
26shall be utilized by the department of public health, in
27collaboration with the department of human services, to
28maintain a single statewide 24-hour crisis hotline for the Iowa
29children’s behavioral health system that incorporates warmline
30services which may be provided through expansion of existing
31capabilities maintained by the department of public health as
32required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
33c. The requirement of section 123.17, subsection 5, is met
34by the appropriations and allocations made in this division of
35this Act for purposes of substance-related disorder treatment
-4-1and addictive disorders for the fiscal year beginning July 1,
22022.
32. HEALTHY CHILDREN AND FAMILIES
4For promoting the optimum health status for children and
5adolescents from birth through 21 years of age, and families,
6and for not more than the following full-time equivalent
7positions:
.................................................. $85,816,681
............................................... FTEs914.00
103. CHRONIC CONDITIONS
11For serving individuals identified as having chronic
12conditions or special health care needs, and for not more than
13the following full-time equivalent positions:
.................................................. $144,258,373
............................................... FTEs1510.00
164. COMMUNITY CAPACITY
17For strengthening the health care delivery system at the
18local level, and for not more than the following full-time
19equivalent positions:
.................................................. $206,519,306
............................................... FTEs2113.00
22a. Of the funds appropriated in this subsection, $2,100,000
23shall be deposited in the medical residency training account
24created in section 135.175, subsection 5, paragraph “a”, and
25is appropriated from the account to the department of public
26health to be used for the purposes of the medical residency
27training state matching grants program as specified in section
28135.176.
29b. Of the funds appropriated in this subsection, $800,000
30shall be used for rural psychiatric residencies to support the
31annual creation and training of six psychiatric residents who
32will provide mental health services in underserved areas of
33the state. Notwithstanding section 8.33, moneys that remain
34unencumbered or unobligated at the close of the fiscal year
35shall not revert but shall remain available for expenditure for
-5-1the purposes designated for subsequent fiscal years.
2c. Of the funds appropriated in this subsection, $425,000
3shall be used for the creation or continuation of a center of
4excellence program to encourage innovation and collaboration
5among regional health care providers in a rural area based
6upon the results of a regional community needs assessment to
7transform health care delivery in order to provide quality,
8sustainable care that meets the needs of the local communities.
9An applicant for the funds shall specify how the funds will
10be expended to accomplish the goals of the program and shall
11provide a detailed five-year sustainability plan prior to
12being awarded any funding. Following the receipt of funding,
13a recipient shall submit periodic reports as specified by the
14department to the governor and the general assembly regarding
15the recipient’s expenditure of the funds and progress in
16accomplishing the program goals.
175. ESSENTIAL PUBLIC HEALTH SERVICES
18To provide public health services that reduce risks and
19invest in promoting and protecting good health over the
20course of a lifetime with a priority given to older Iowans and
21vulnerable populations:
.................................................. $227,662,464
236. INFECTIOUS DISEASES
24For reducing the incidence and prevalence of communicable
25diseases, and for not more than the following full-time
26equivalent positions:
.................................................. $271,796,206
............................................... FTEs286.00
297. PUBLIC PROTECTION
30a. For protecting the health and safety of the public
31through establishing standards and enforcing regulations, and
32for not more than the following full-time equivalent positions:
.................................................. $334,466,601
............................................... FTEs34142.00
35b. Of the funds appropriated in this subsection, not more
-6-1than $304,000 shall be credited to the emergency medical
2services fund created in section 135.25. Moneys in the
3emergency medical services fund are appropriated to the
4department to be used for the purposes of the fund.
58. RESOURCE MANAGEMENT
6For establishing and sustaining the overall ability of the
7department to deliver services to the public, and for not more
8than the following full-time equivalent positions:
.................................................. $9933,871
............................................... FTEs104.00
119. MISCELLANEOUS PROVISIONS
12The university of Iowa hospitals and clinics under the
13control of the state board of regents shall not receive
14indirect costs from the funds appropriated in this section.
15The university of Iowa hospitals and clinics billings to the
16department shall be on at least a quarterly basis.
17 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
18RECEIPTS FUND. There is appropriated from the sports wagering
19receipts fund created in section 8.57, subsection 6, to the
20department of public health for the fiscal year beginning July
211, 2022, and ending June 30, 2023, the following amount, or
22so much thereof as is necessary, to be used for the purposes
23designated:
24For problem gambling and substance-related disorder
25prevention, treatment, and recovery services, including a
2624-hour helpline, public information resources, professional
27training, youth prevention, and program evaluation:
.................................................. $281,750,000
29DIVISION IV
30DEPARTMENT OF VETERANS AFFAIRS — FY 2022-2023
31 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
32appropriated from the general fund of the state to the
33department of veterans affairs for the fiscal year beginning
34July 1, 2022, and ending June 30, 2023, the following amounts,
35or so much thereof as is necessary, to be used for the purposes
-7-1designated:
21. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
3For salaries, support, maintenance, and miscellaneous
4purposes, and for not more than the following full-time
5equivalent positions:
.................................................. $61,229,763
............................................... FTEs715.00
82. IOWA VETERANS HOME
9For salaries, support, maintenance, and miscellaneous
10purposes:
.................................................. $117,131,552
12a. The Iowa veterans home billings involving the department
13of human services shall be submitted to the department on at
14least a monthly basis.
15b. The Iowa veterans home expenditure report shall be
16submitted monthly to the general assembly.
17c. The Iowa veterans home shall continue to include in the
18annual discharge report applicant information to provide for
19the collection of demographic information including but not
20limited to the number of individuals applying for admission and
21admitted or denied admittance and the basis for the admission
22or denial; the age, gender, and race of such individuals;
23and the level of care for which such individuals applied for
24admission including residential or nursing level of care.
253. HOME OWNERSHIP ASSISTANCE PROGRAM
26For transfer to the Iowa finance authority for the
27continuation of the home ownership assistance program for
28persons who are or were eligible members of the armed forces of
29the United States, pursuant to section 16.54:
.................................................. $302,000,000
31 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
32FUND STANDING APPROPRIATIONS. Notwithstanding the standing
33appropriation in section 35A.16 for the fiscal year beginning
34July 1, 2022, and ending June 30, 2023, the amount appropriated
35from the general fund of the state pursuant to that section
-8-1for the following designated purposes shall not exceed the
2following amount:
3For the county commissions of veteran affairs fund under
4section 35A.16:
.................................................. $5990,000
6DIVISION V
7DEPARTMENT OF HUMAN SERVICES — FY 2022-2023
8 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
9GRANT. There is appropriated from the fund created in section
108.41 to the department of human services for the fiscal year
11beginning July 1, 2022, and ending June 30, 2023, from moneys
12received under the federal temporary assistance for needy
13families (TANF) block grant pursuant to the federal Personal
14Responsibility and Work Opportunity Reconciliation Act of 1996,
15Pub.L.No.104-193, and successor legislation, the following
16amounts, or so much thereof as is necessary, to be used for the
17purposes designated:
181. To be credited to the family investment program account
19and used for assistance under the family investment program
20under chapter 239B:
.................................................. $215,002,006
222. To be credited to the family investment program account
23and used for the job opportunities and basic skills (JOBS)
24program and implementing family investment agreements in
25accordance with chapter 239B:
.................................................. $265,412,060
273. To be used for the family development and
28self-sufficiency grant program in accordance with section
29216A.107:
.................................................. $302,888,980
31Notwithstanding section 8.33, moneys appropriated in this
32subsection that remain unencumbered or unobligated at the close
33of the fiscal year shall not revert but shall remain available
34for expenditure for the purposes designated until the close of
35the succeeding fiscal year. However, unless such moneys are
-9-1encumbered or obligated on or before September 30, 2023, the
2moneys shall revert.
34. For field operations:
.................................................. $431,296,232
55. For general administration:
.................................................. $63,744,000
76. For state child care assistance:
.................................................. $847,166,826
9a. Of the funds appropriated in this subsection,
10$26,205,412 is transferred to the child care and development
11block grant appropriation made by the Eighty-ninth General
12Assembly, 2022 session, for the federal fiscal year beginning
13October 1, 2022, and ending September 30, 2023. Of this
14amount, $200,000 shall be used for provision of educational
15opportunities to registered child care home providers in order
16to improve services and programs offered by this category
17of providers and to increase the number of providers. The
18department may contract with institutions of higher education
19or child care resource and referral centers to provide
20the educational opportunities. Allowable administrative
21costs under the contracts shall not exceed 5 percent. The
22application for a grant shall not exceed two pages in length.
23b. Any funds appropriated in this subsection remaining
24unallocated shall be used for state child care assistance
25payments for families who are employed including but not
26limited to individuals enrolled in the family investment
27program.
287. For child and family services:
.................................................. $2932,380,654
308. For child abuse prevention grants:
.................................................. $31125,000
329. For pregnancy prevention grants on the condition that
33family planning services are funded:
.................................................. $341,913,203
35Pregnancy prevention grants shall be awarded to programs
-10-1in existence on or before July 1, 2022, if the programs have
2demonstrated positive outcomes. Grants shall be awarded to
3pregnancy prevention programs which are developed after July
41, 2022, if the programs are based on existing models that
5have demonstrated positive outcomes. Grants shall comply with
6the requirements provided in 1997 Iowa Acts, chapter 208,
7section 14, subsections 1 and 2, including the requirement that
8grant programs must emphasize sexual abstinence. Priority in
9the awarding of grants shall be given to programs that serve
10areas of the state which demonstrate the highest percentage of
11unplanned pregnancies of females of childbearing age within the
12geographic area to be served by the grant.
1310. For technology needs and other resources necessary to
14meet federal and state reporting, tracking, and case management
15requirements and other departmental needs:
.................................................. $161,037,186
1711. a. Notwithstanding any provision to the contrary,
18including but not limited to requirements in section 8.41 or
19provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the
20receipt and appropriation of federal block grants, federal
21funds from the temporary assistance for needy families block
22grant received by the state and not otherwise appropriated
23in this section and remaining available for the fiscal year
24beginning July 1, 2022, are appropriated to the department of
25human services to the extent as may be necessary to be used in
26the following priority order: the family investment program,
27for state child care assistance program payments for families
28who are employed, and for the family investment program share
29of system costs for eligibility determination and related
30functions. The federal funds appropriated in this paragraph
31“a” shall be expended only after all other funds appropriated
32in subsection 1 for assistance under the family investment
33program, in subsection 6 for state child care assistance, or
34in subsection 10 for technology needs and other resources
35necessary to meet departmental needs, as applicable, have been
-11-1expended. For the purposes of this subsection, the funds
2appropriated in subsection 6, paragraph “a”, for transfer
3to the child care and development block grant appropriation
4are considered fully expended when the full amount has been
5transferred.
6b. The department shall, on a quarterly basis, advise the
7general assembly and department of management of the amount of
8funds appropriated in this subsection that was expended in the
9prior quarter.
1012. Of the amounts appropriated in this section,
11$12,962,008 for the fiscal year beginning July 1, 2022, is
12transferred to the appropriation of the federal social services
13block grant made to the department of human services for that
14fiscal year.
1513. For continuation of the program providing categorical
16eligibility for the supplemental nutrition assistance program
17(SNAP) as specified for the program in the section of this
18division of this Act relating to the family investment program
19account:
.................................................. $2014,236
2114. The department may transfer funds allocated in this
22section to the appropriations made in this division of this Act
23for the same fiscal year for general administration and field
24operations for resources necessary to implement and operate the
25services referred to in this section and those funded in the
26appropriation made in this division of this Act for the same
27fiscal year for the family investment program from the general
28fund of the state.
2915. With the exception of moneys allocated under this
30section for the family development and self-sufficiency grant
31program, to the extent moneys allocated in this section are
32deemed by the department not to be necessary to support the
33purposes for which they are allocated, such moneys may be used
34in the same fiscal year for any other purpose for which funds
35are allocated in this section or in section 8 of this division
-12-1of this Act for the family investment program account. If
2there are conflicting needs, priority shall first be given
3to the family investment program account as specified under
4subsection 1 of this section and used for the purposes of
5assistance under the family investment program in accordance
6with chapter 239B, followed by state child care assistance
7program payments for families who are employed, followed by
8other priorities as specified by the department.
9 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
101. Moneys credited to the family investment program (FIP)
11account for the fiscal year beginning July 1, 2022, and
12ending June 30, 2023, shall be used to provide assistance in
13accordance with chapter 239B.
142. The department may use a portion of the moneys credited
15to the FIP account under this section as necessary for
16salaries, support, maintenance, and miscellaneous purposes,
17including administrative and information technology costs
18associated with rent reimbursement and other income assistance
19programs administered by the department.
203. The department may transfer funds allocated in
21subsection 4, excluding the allocation under subsection 4,
22paragraph “b”, to the appropriations made in this division of
23this Act for the same fiscal year for general administration
24and field operations for resources necessary to implement
25and operate the services referred to in this section and
26those funded in the appropriations made in section 7 for the
27temporary assistance for needy families block grant and in
28section 9 for the family investment program from the general
29fund of the state in this division of this Act for the same
30fiscal year.
314. Moneys appropriated in this division of this Act and
32credited to the FIP account for the fiscal year beginning July
331, 2022, and ending June 30, 2023, are allocated as follows:
34a. To be retained by the department of human services to
35be used for coordinating with the department of human rights
-13-1to more effectively serve participants in FIP and other shared
2clients and to meet federal reporting requirements under the
3federal temporary assistance for needy families block grant:
.................................................. $410,000
5b. To the department of human rights for staffing,
6administration, and implementation of the family development
7and self-sufficiency grant program in accordance with section
8216A.107:
.................................................. $97,192,834
10(1) Of the funds allocated for the family development
11and self-sufficiency grant program in this paragraph “b”,
12not more than 5 percent of the funds shall be used for the
13administration of the grant program.
14(2) The department of human rights may continue to implement
15the family development and self-sufficiency grant program
16statewide during fiscal year 2022-2023.
17(3) The department of human rights may engage in activities
18to strengthen and improve family outcomes measures and
19data collection systems under the family development and
20self-sufficiency grant program.
21c. For the diversion subaccount of the FIP account:
.................................................. $221,293,000
23A portion of the moneys allocated for the diversion
24subaccount may be used for field operations, salaries, data
25management system development, and implementation costs and
26support deemed necessary by the director of human services
27in order to administer the FIP diversion program. To the
28extent moneys allocated in this paragraph “c” are deemed by the
29department not to be necessary to support diversion activities,
30such moneys may be used for other efforts intended to increase
31engagement by family investment program participants in work,
32education, or training activities, or for the purposes of
33assistance under the family investment program in accordance
34with chapter 239B.
35d. For the SNAP employment and training program:
-14-.................................................. $166,588
2(1) The department shall apply the federal SNAP employment
3and training state plan in order to maximize to the fullest
4extent permitted by federal law the use of the 50 percent
5federal reimbursement provisions for the claiming of allowable
6federal reimbursement funds from the United States department
7of agriculture pursuant to the federal SNAP employment and
8training program for providing education, employment, and
9training services for eligible SNAP participants, including
10but not limited to related dependent care and transportation
11expenses.
12(2) The department shall continue the categorical
13federal SNAP eligibility at 160 percent of the federal
14poverty level and continue to eliminate the asset test from
15eligibility requirements, consistent with federal SNAP program
16requirements. The department shall include as many SNAP
17households as is allowed by federal law. The eligibility
18provisions shall conform to all federal requirements including
19requirements addressing individuals who are disqualified for
20committing an intentional program violation or are otherwise
21ineligible.
22e. For the JOBS program, not more than:
.................................................. $2312,018,258
245. Of the child support collections assigned under FIP,
25an amount equal to the federal share of support collections
26shall be credited to the child support recovery appropriation
27made in this division of this Act. Of the remainder of the
28assigned child support collections received by the child
29support recovery unit, a portion shall be credited to the FIP
30account, a portion may be used to increase recoveries, and a
31portion may be used to sustain cash flow in the child support
32payments account. If as a consequence of the appropriations
33and allocations made in this section the resulting amounts
34are insufficient to sustain cash assistance payments and meet
35federal maintenance of effort requirements, the department
-15-1shall seek supplemental funding. If child support collections
2assigned under FIP are greater than estimated or are otherwise
3determined not to be required for maintenance of effort, the
4state share of either amount may be transferred to or retained
5in the child support payments account.
6 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
7is appropriated from the general fund of the state to the
8department of human services for the fiscal year beginning July
91, 2022, and ending June 30, 2023, the following amount, or
10so much thereof as is necessary, to be used for the purpose
11designated:
12To be credited to the family investment program (FIP)
13account and used for family investment program assistance
14under chapter 239B and other costs associated with providing
15needs-based benefits or assistance:
.................................................. $1641,003,978
171. Of the funds appropriated in this section, $6,606,198 is
18allocated for the JOBS program.
192. Of the funds appropriated in this section, $4,313,854 is
20allocated for the family development and self-sufficiency grant
21program.
223. a. Notwithstanding section 8.39, for the fiscal
23year beginning July 1, 2022, if necessary to meet federal
24maintenance of effort requirements or to transfer federal
25temporary assistance for needy families block grant funding
26to be used for purposes of the federal social services block
27grant or to meet cash flow needs resulting from delays in
28receiving federal funding or to implement, in accordance with
29this division of this Act, activities currently funded with
30juvenile court services, county, or community moneys and state
31moneys used in combination with such moneys; to comply with
32federal requirements; or to maximize the use of federal funds;
33the department of human services may transfer funds within or
34between any of the appropriations made in this division of this
35Act and appropriations in law for the federal social services
-16-1block grant to the department for the following purposes,
2provided that the combined amount of state and federal
3temporary assistance for needy families block grant funding
4for each appropriation remains the same before and after the
5transfer:
6(1) For the family investment program.
7(2) For state child care assistance.
8(3) For child and family services.
9(4) For field operations.
10(5) For general administration.
11b. This subsection shall not be construed to prohibit the
12use of existing state transfer authority for other purposes.
13The department shall report any transfers made pursuant to this
14subsection to the general assembly.
154. Of the funds appropriated in this section, $195,000
16shall be used for a contract for tax preparation assistance
17to low-income Iowans to expand the usage of the earned income
18tax credit. The purpose of the contract is to supply this
19assistance to underserved areas of the state. The department
20shall not retain any portion of the allocation under this
21subsection for administrative costs.
225. Of the funds appropriated in this section, $70,000 shall
23be used for the continuation of the parenting program, as
24specified in 441 IAC ch.100, relating to parental obligations,
25in which the child support recovery unit participates, to
26support the efforts of a nonprofit organization committed to
27strengthening the community through youth development, healthy
28living, and social responsibility headquartered in a county
29with a population over 450,000 according to the 2020 certified
30federal census. The funds allocated in this subsection shall
31be used by the recipient organization to develop a larger
32community effort, through public and private partnerships, to
33support a broad-based multi-county parenthood initiative that
34promotes payment of child support obligations, improved family
35relationships, and full-time employment.
-17- 16. The department may transfer funds appropriated in this
2section, excluding the allocation in subsection 2 for the
3family development and self-sufficiency grant program, to the
4appropriations made in this division of this Act for general
5administration and field operations as necessary to administer
6this section, section 7 for the temporary assistance for needy
7families block grant, and section 8 for the family investment
8program account.
9 Sec. 10. CHILD SUPPORT RECOVERY. 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 amount, or so much thereof as is
13necessary, to be used for the purposes designated:
14For child support recovery, including salaries, support,
15maintenance, and miscellaneous purposes, and for not more than
16the following full-time equivalent positions:
.................................................. $1715,942,885
............................................... FTEs18459.00
191. The department shall expend up to $24,000, including
20federal financial participation, for the fiscal year beginning
21July 1, 2022, for a child support public awareness campaign.
22The department and the office of the attorney general shall
23cooperate in continuation of the campaign. The public
24awareness campaign shall emphasize, through a variety of
25media activities, the importance of maximum involvement of
26both parents in the lives of their children as well as the
27importance of payment of child support obligations.
282. Federal access and visitation grant moneys shall be
29issued directly to private not-for-profit agencies that provide
30services designed to increase compliance with the child access
31provisions of court orders, including but not limited to
32neutral visitation sites and mediation services.
333. The appropriation made to the department for child
34support recovery may be used throughout the fiscal year in the
35manner necessary for purposes of cash flow management, and for
-18-1cash flow management purposes the department may temporarily
2draw more than the amount appropriated, provided the amount
3appropriated is not exceeded at the close of the fiscal year.
4 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
5FY 2022-2023. Any funds remaining in the health care trust
6fund created in section 453A.35A for the fiscal year beginning
7July 1, 2022, and ending June 30, 2023, are appropriated to
8the department of human services to supplement the medical
9assistance program appropriations made in this division of this
10Act, for medical assistance reimbursement and associated costs,
11including program administration and costs associated with
12program implementation.
13 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
142022-2023. Any funds remaining in the Medicaid fraud fund
15created in section 249A.50 for the fiscal year beginning
16July 1, 2022, and ending June 30, 2023, are appropriated to
17the department of human services to supplement the medical
18assistance appropriations made in this division of this Act,
19for medical assistance reimbursement and associated costs,
20including program administration and costs associated with
21program implementation.
22 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
23general fund of the state to the department of human services
24for the fiscal year beginning July 1, 2022, and ending June 30,
252023, the following amount, or so much thereof as is necessary,
26to be used for the purpose designated:
27For medical assistance program reimbursement and associated
28costs as specifically provided in the reimbursement
29methodologies in effect on June 30, 2022, except as otherwise
30expressly authorized by law, consistent with options under
31federal law and regulations, and contingent upon receipt of
32approval from the office of the governor of reimbursement for
33each abortion performed under the program:
.................................................. $341,539,659,031
351. Iowans support reducing the number of abortions
-19-1performed in our state. Funds appropriated under this section
2shall not be used for abortions, unless otherwise authorized
3under this section.
42. The provisions of this section relating to abortions
5shall also apply to the Iowa health and wellness plan created
6pursuant to chapter 249N.
73. The department shall utilize not more than $60,000 of
8the funds appropriated in this section to continue the AIDS/HIV
9health insurance premium payment program as established in 1992
10Iowa Acts, Second Extraordinary Session, chapter 1001, section
11409, subsection 6. Of the funds allocated in this subsection,
12not more than $5,000 may be expended for administrative
13purposes.
144. Of the funds appropriated in this Act to the department
15of public health for addictive disorders, $950,000 for
16the fiscal year beginning July 1, 2022, is transferred
17to the department of human services for an integrated
18substance-related disorder managed care system. The
19departments of human services and public health shall
20work together to maintain the level of mental health and
21substance-related disorder treatment services provided by the
22managed care contractors. Each department shall take the steps
23necessary to continue the federal waivers as necessary to
24maintain the level of services.
255. The department shall aggressively pursue options for
26providing medical assistance or other assistance to individuals
27with special needs who become ineligible to continue receiving
28services under the early and periodic screening, diagnostic,
29and treatment program under the medical assistance program
30due to becoming 21 years of age who have been approved for
31additional assistance through the department’s exception to
32policy provisions, but who have health care needs in excess
33of the funding available through the exception to policy
34provisions.
356. Of the funds appropriated in this section, up to
-20-1$3,050,082 may be transferred to the field operations or
2general administration appropriations in this division of this
3Act for operational costs associated with Part D of the federal
4Medicare Prescription Drug Improvement and Modernization Act
5of 2003, Pub.L.No.108-173.
67. Of the funds appropriated in this section, up to $442,100
7may be transferred to the appropriation in this division of
8this Act for health program operations to be used for clinical
9assessment services and prior authorization of services.
108. A portion of the funds appropriated in this section may
11be transferred to the appropriations in this division of this
12Act for general administration, health program operations, the
13children’s health insurance program, or field operations to be
14used for the state match cost to comply with the payment error
15rate measurement (PERM) program for both the medical assistance
16and children’s health insurance programs as developed by the
17centers for Medicare and Medicaid services of the United States
18department of health and human services to comply with the
19federal Improper Payments Information Act of 2002, Pub.L.
20No.107-300, and to support other reviews and quality control
21activities to improve the integrity of these programs.
229. Of the funds appropriated in this section, a sufficient
23amount is allocated to supplement the incomes of residents of
24nursing facilities, intermediate care facilities for persons
25with mental illness, and intermediate care facilities for
26persons with an intellectual disability, with incomes of less
27than $50 in the amount necessary for the residents to receive a
28personal needs allowance of $50 per month pursuant to section
29249A.30A.
3010. One hundred percent of the nonfederal share of payments
31to area education agencies that are medical assistance
32providers for medical assistance-covered services provided to
33medical assistance-covered children, shall be made from the
34appropriation made in this section.
3511. A portion of the funds appropriated in this section may
-21-1be transferred to the appropriation in this division of this
2Act for health program operations to be used for administrative
3activities associated with the money follows the person
4demonstration project.
512. Of the funds appropriated in this section, $349,011
6shall be used for the administration of the health insurance
7premium payment program, including salaries, support,
8maintenance, and miscellaneous purposes.
913. a. The department may increase the amounts allocated
10for salaries, support, maintenance, and miscellaneous purposes
11associated with the medical assistance program, as necessary,
12to sustain cost management efforts. The department shall
13report any such increase to the general assembly and the
14department of management.
15b. If the savings to the medical assistance program from
16ongoing cost management efforts exceed the associated cost
17for the fiscal year beginning July 1, 2022, the department
18may transfer any savings generated for the fiscal year due
19to medical assistance program cost management efforts to the
20appropriation made in this division of this Act for health
21program operations or general administration to defray the
22costs associated with implementing the efforts.
2314. For the fiscal year beginning July 1, 2022, and ending
24June 30, 2023, the replacement generation tax revenues required
25to be deposited in the property tax relief fund pursuant to
26section 437A.8, subsection 4, paragraph “d”, and section
27437A.15, subsection 3, paragraph “f”, shall instead be credited
28to and supplement the appropriation made in this section and
29used for the allocations made in this section.
3015. a. Of the funds appropriated in this section, up
31to $50,000 may be transferred by the department to the
32appropriation made in this division of this Act to the
33department for the same fiscal year for general administration
34to be used for associated administrative expenses and for not
35more than 1.00 full-time equivalent position, in addition to
-22-1those authorized for the same fiscal year, to be assigned to
2implementing the children’s mental health home project.
3b. Of the funds appropriated in this section, up to $400,000
4may be transferred by the department to the appropriation made
5to the department in this division of this Act for the same
6fiscal year for Medicaid program-related general administration
7planning and implementation activities. The funds may be used
8for contracts or for personnel in addition to the amounts
9appropriated for and the positions authorized for general
10administration for the fiscal year.
11c. Of the funds appropriated in this section, up to
12$3,000,000 may be transferred by the department to the
13appropriations made in this division of this Act for the
14same fiscal year for general administration or health
15program operations to be used to support the development
16and implementation of standardized assessment tools for
17persons with mental illness, an intellectual disability, a
18developmental disability, or a brain injury.
1916. Of the funds appropriated in this section, $150,000
20shall be used for lodging expenses associated with care
21provided at the university of Iowa hospitals and clinics for
22patients with cancer whose travel distance is 30 miles or more
23and whose income is at or below 200 percent of the federal
24poverty level as defined by the most recently revised poverty
25income guidelines published by the United States department of
26health and human services. The department of human services
27shall establish the maximum number of overnight stays and the
28maximum rate reimbursed for overnight lodging, which may be
29based on the state employee rate established by the department
30of administrative services. The funds allocated in this
31subsection shall not be used as nonfederal share matching
32funds.
3317. Of the funds appropriated in this section, up to
34$3,383,880 shall be used for administration of the state family
35planning services program pursuant to section 217.41B, and
-23-1of this amount, the department may use up to $200,000 for
2administrative expenses.
318. Of the funds appropriated in this section, $1,545,530
4shall be used and may be transferred to other appropriations
5in this division of this Act as necessary to administer the
6provisions in the division of this Act relating to Medicaid
7program administration.
819. The department shall comply with the centers for
9Medicare and Medicaid services’ guidance related to Medicaid
10program and children’s health insurance program maintenance
11of effort provisions, including eligibility standards,
12methodologies, procedures, and continuous enrollment, to
13receive the enhanced federal medical assistance percentage
14under section 6008(b) of the federal Families First Coronavirus
15Response Act, Pub.L. No.116-127. The department shall
16utilize and implement all tools, processes, and resources
17available to expediently return to normal eligibility and
18enrollment operations in compliance with federal guidance and
19expectations.
2020. A portion of the funds appropriated in this section
21may be transferred to the appropriation made in this division
22of this Act for the children’s health insurance program,
23if the children’s health insurance program appropriation
24is insufficient to cover the designated purposes of that
25appropriation.
2621. No later than January 1, 2023, the department of
27human services shall implement a tiered rate reimbursement
28methodology for psychiatric intensive inpatient care under the
29Medicaid program based on the level of patient acuity and other
30factors as recommended in the inpatient bed tracking study
31committee report submitted to the governor and the general
32assembly on December 1, 2021.
3322. The department of human services shall submit a Medicaid
34state plan amendment to the centers for Medicare and Medicaid
35services to request the addition of functional family therapy
-24-1and multisystemic therapy for youth as covered services under
2the Medicaid program. The department shall include functional
3family therapy and multisystemic therapy under the Medicaid
4program as covered services upon receipt of federal approval.
523. Of the funds appropriated in this section, $7,400,000
6shall be used to implement reductions in the waiting list for
7the home and community-based services waiver for persons with
8an intellectual disability.
9 Sec. 14. HEALTH PROGRAM OPERATIONS. 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 amount, or so much thereof as is
13necessary, to be used for the purpose designated:
14For health program operations:
.................................................. $1517,446,343
161. The department of inspections and appeals shall
17provide all state matching funds for survey and certification
18activities performed by the department of inspections
19and appeals. The department of human services is solely
20responsible for distributing the federal matching funds for
21such activities.
222. Of the funds appropriated in this section, $50,000 shall
23be used for continuation of home and community-based services
24waiver quality assurance programs, including the review and
25streamlining of processes and policies related to oversight and
26quality management to meet state and federal requirements.
273. Of the amount appropriated in this section, up to
28$200,000 may be transferred to the appropriation for general
29administration in this division of this Act to be used for
30additional full-time equivalent positions in the development
31of key health initiatives such as development and oversight
32of managed care programs and development of health strategies
33targeted toward improved quality and reduced costs in the
34Medicaid program.
354. Of the funds appropriated in this section, $1,000,000
-25-1shall be used for planning and development, in cooperation with
2the department of public health, of a phased-in program to
3provide a dental home for children.
45. a. Of the funds appropriated in this section, $188,000
5shall be credited to the autism support program fund created
6in section 225D.2 to be used for the autism support program
7created in chapter 225D, with the exception of the following
8amount of this allocation which shall be used as follows:
9b. Of the funds allocated in this subsection, $25,000 shall
10be used for the public purpose of continuation of a grant to
11a nonprofit provider of child welfare services that has been
12in existence for more than 115 years, is located in a county
13with a population between 220,000 and 250,000 according to the
142020 federal decennial census, is licensed as a psychiatric
15medical institution for children, and provides school-based
16programming, to be used for support services for children with
17autism spectrum disorder and their families.
18 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
191. There is appropriated from the general fund of the
20state to the department of human services for the fiscal year
21beginning July 1, 2022, and ending June 30, 2023, the following
22amount, or so much thereof as is necessary, to be used for the
23purpose designated:
24For the state supplementary assistance program:
.................................................. $257,349,002
262. The department shall increase the personal needs
27allowance for residents of residential care facilities by the
28same percentage and at the same time as federal supplemental
29security income and federal social security benefits are
30increased due to a recognized increase in the cost of living.
31The department may adopt emergency rules to implement this
32subsection.
333. If during the fiscal year beginning July 1, 2022,
34the department projects that state supplementary assistance
35expenditures for a calendar year will not meet the federal
-26-1pass-through requirement specified in Tit.XVI of the federal
2Social Security Act, section 1618, as codified in 42 U.S.C.
3§1382g, the department may take actions including but not
4limited to increasing the personal needs allowance for
5residential care facility residents and making programmatic
6adjustments or upward adjustments of the residential care
7facility or in-home health-related care reimbursement rates
8prescribed in this division of this Act to ensure that federal
9requirements are met. In addition, the department may make
10other programmatic and rate adjustments necessary to remain
11within the amount appropriated in this section while ensuring
12compliance with federal requirements. The department may adopt
13emergency rules to implement the provisions of this subsection.
144. Notwithstanding section 8.33, moneys appropriated
15in this section that remain unencumbered or unobligated
16at the close of the fiscal year shall not revert but
17shall remain available for expenditure for the purposes
18designated, including for liability amounts associated with the
19supplemental nutrition assistance program payment error rate,
20until the close of the succeeding fiscal year.
21 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2022, and ending June 30, 2023, the following
25amount, or so much thereof as is necessary, to be used for the
26purpose designated:
27For maintenance of the healthy and well kids in Iowa (hawk-i)
28program pursuant to chapter 514I, including supplemental dental
29services, for receipt of federal financial participation under
30Tit.XXI of the federal Social Security Act, which creates the
31children’s health insurance program:
.................................................. $3238,661,688
332. Of the funds appropriated in this section, $158,850 is
34allocated for continuation of the contract for outreach with
35the department of public health.
-27- 13. A portion of the funds appropriated in this section may
2be transferred to the appropriations made in this division of
3this Act for field operations or health program operations to
4be used for the integration of hawk-i program eligibility,
5payment, and administrative functions under the purview of
6the department of human services, including for the Medicaid
7management information system upgrade.
8 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated
9from the general fund of the state to the department of human
10services for the fiscal year beginning July 1, 2022, and ending
11June 30, 2023, the following amount, or so much thereof as is
12necessary, to be used for the purpose designated:
13For child care programs:
.................................................. $1440,816,931
151. Of the funds appropriated in this section, $34,966,931
16shall be used for state child care assistance in accordance
17with section 237A.13.
182. Nothing in this section shall be construed or is
19intended as or shall imply a grant of entitlement for services
20to persons who are eligible for assistance due to an income
21level consistent with the waiting list requirements of section
22237A.13. Any state obligation to provide services pursuant to
23this section is limited to the extent of the funds appropriated
24in this section.
253. A list of the registered and licensed child care
26facilities operating in the area served by a child care
27resource and referral service shall be made available to the
28families receiving state child care assistance in that area.
294. Of the funds appropriated in this section, $5,850,000
30shall be credited to the early childhood programs grants
31account in the early childhood Iowa fund created in section
32256I.11. The moneys shall be distributed for funding of
33community-based early childhood programs targeted to children
34from birth through five years of age developed by early
35childhood Iowa areas in accordance with approved community
-28-1plans as provided in section 256I.8.
25. The department may use any of the funds appropriated
3in this section as a match to obtain federal funds for use in
4expanding child care assistance and related programs. For
5the purpose of expenditures of state and federal child care
6funding, funds shall be considered obligated at the time
7expenditures are projected or are allocated to the department’s
8service areas. Projections shall be based on current and
9projected caseload growth, current and projected provider
10rates, staffing requirements for eligibility determination
11and management of program requirements including data systems
12management, staffing requirements for administration of the
13program, contractual and grant obligations and any transfers
14to other state agencies, and obligations for decategorization
15or innovation projects.
166. A portion of the state match for the federal child care
17and development block grant shall be provided as necessary to
18meet federal matching funds requirements through the state
19general fund appropriation made for child development grants
20and other programs for at-risk children in section 279.51.
217. If a uniform reduction ordered by the governor under
22section 8.31 or other operation of law, transfer, or federal
23funding reduction reduces the appropriation made in this
24section for the fiscal year, the percentage reduction in the
25amount paid out to or on behalf of the families participating
26in the state child care assistance program shall be equal to or
27less than the percentage reduction made for any other purpose
28payable from the appropriation made in this section and the
29federal funding relating to it. The percentage reduction to
30the other allocations made in this section shall be the same as
31the uniform reduction ordered by the governor or the percentage
32change of the federal funding reduction, as applicable. If
33there is an unanticipated increase in federal funding provided
34for state child care services, the entire amount of the
35increase, except as necessary to meet federal requirements
-29-1including quality set asides, shall be used for state child
2care assistance payments. If the appropriations made for
3purposes of the state child care assistance program for the
4fiscal year are determined to be insufficient, it is the intent
5of the general assembly to appropriate sufficient funding for
6the fiscal year in order to avoid establishment of waiting list
7requirements.
88. Notwithstanding section 8.33, moneys advanced for
9purposes of the programs developed by early childhood Iowa
10areas, advanced for purposes of wraparound child care, or
11received from the federal appropriations made for the purposes
12of this section that remain unencumbered or unobligated at the
13close of the fiscal year shall not revert to any fund but shall
14remain available for expenditure for the purposes designated
15until the close of the succeeding fiscal year.
16 Sec. 18. JUVENILE INSTITUTION. There is appropriated
17from the general fund of the state to the department of human
18services for the fiscal year beginning July 1, 2022, and ending
19June 30, 2023, the following amounts, or so much thereof as is
20necessary, to be used for the purposes designated:
211. a. For operation of the state training school at Eldora
22and for salaries, support, maintenance, and miscellaneous
23purposes, and for not more than the following full-time
24equivalent positions:
.................................................. $2517,606,871
............................................... FTEs26207.00
27b. Of the funds appropriated in this subsection, $91,000
28shall be used for distribution to licensed classroom teachers
29at this and other institutions under the control of the
30department of human services based upon the average student
31yearly enrollment at each institution as determined by the
32department.
332. A portion of the moneys appropriated in this section
34shall be used by the state training school at Eldora for
35grants for adolescent pregnancy prevention activities at the
-30-1institution in the fiscal year beginning July 1, 2022.
23. Of the funds appropriated in this subsection, $212,000
3shall be used by the state training school at Eldora for a
4substance use disorder treatment program at the institution for
5the fiscal year beginning July 1, 2022.
64. Notwithstanding section 8.33, moneys appropriated in
7this section that remain unencumbered or unobligated at the
8close of the fiscal year shall not revert but shall remain
9available for expenditure for the purposes designated until the
10close of the succeeding fiscal year.
11 Sec. 19. CHILD AND FAMILY SERVICES.
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 child and family services:
.................................................. $1893,571,677
192. The department may transfer funds appropriated in this
20section as necessary to pay the nonfederal costs of services
21reimbursed under the medical assistance program, state child
22care assistance program, or the family investment program which
23are provided to children who would otherwise receive services
24paid under the appropriation in this section. The department
25may transfer funds appropriated in this section to the
26appropriations made in this division of this Act for general
27administration and for field operations for resources necessary
28to implement and operate the services funded in this section.
293. a. (1) Of the funds appropriated in this section, up to
30$40,500,000 is allocated as the statewide expenditure target
31under section 232.143 for group foster care maintenance and
32services. If the department projects that such expenditures
33for the fiscal year will be less than the target amount
34allocated in this paragraph “a”, the department may reallocate
35the excess to provide additional funding for family foster
-31-1care, supervised apartment living, family-centered services,
2shelter care, or the child welfare emergency services addressed
3with the allocation for shelter care.
4(2) If 2022 Iowa Acts, House File 2507, amending section
5232.143, is enacted, notwithstanding subparagraph (1), of
6the funds appropriated in this section, up to $40,500,000 is
7allocated for group foster care maintenance and services to
8be expended in accordance with the applicable provisions of
92022 Iowa Acts, House File 2507. If the department projects
10that such expenditures for the fiscal year will be less than
11the target amount in this paragraph “a”, the department may
12reallocate the excess to provide additional funding for family
13foster care, supervised apartment living, family-centered
14services, shelter care, or the child welfare emergency services
15addresses with the allocation for shelter care.
16b. Unless 2022 Iowa Acts, House File 2507, is enacted,
17if at any time after September 30, 2022, annualization of a
18service area’s current expenditures indicates a service area
19is at risk of exceeding its group foster care expenditure
20target under section 232.143 by more than 5 percent, the
21department and juvenile court services shall examine all
22group foster care placements in that service area in order to
23identify those which might be appropriate for termination.
24In addition, any aftercare services believed to be needed
25for the children whose placements may be terminated shall be
26identified. The department and juvenile court services shall
27initiate action to set dispositional review hearings for the
28placements identified. In such a dispositional review hearing,
29the juvenile court shall determine whether needed aftercare
30services are available and whether termination of the placement
31is in the best interest of the child and the community. If
322022 Iowa Acts, House File 2507, is enacted, the applicable
33provisions of House File 2507 shall supersede the provisions
34of this paragraph “b”.
354. In accordance with the provisions of section 232.188,
-32-1the department shall continue the child welfare and juvenile
2justice funding initiative during fiscal year 2022-2023. Of
3the funds appropriated in this section, $1,717,000 is allocated
4specifically for expenditure for fiscal year 2022-2023 through
5the decategorization services funding pools and governance
6boards established pursuant to section 232.188.
75. A portion of the funds appropriated in this section
8may be used for emergency family assistance to provide other
9resources required for a family participating in a family
10preservation or reunification project or successor project to
11stay together or to be reunified.
126. Of the funds appropriated in this section, a sufficient
13amount is allocated for shelter care and the child welfare
14emergency services contracting implemented to provide for or
15prevent the need for shelter care.
167. Federal funds received by the state during the fiscal
17year beginning July 1, 2022, as the result of the expenditure
18of state funds appropriated during a previous state fiscal
19year for a service or activity funded under this section are
20appropriated to the department to be used as additional funding
21for services and purposes provided for under this section.
22Notwithstanding section 8.33, moneys received in accordance
23with this subsection that remain unencumbered or unobligated at
24the close of the fiscal year shall not revert to any fund but
25shall remain available for the purposes designated until the
26close of the succeeding fiscal year.
278. a. Of the funds appropriated in this section, up to
28$3,290,000 is allocated for the payment of the expenses of
29court-ordered services provided to juveniles who are under the
30supervision of juvenile court services, which expenses are a
31charge upon the state pursuant to section 232.141, subsection
324. Of the amount allocated in this paragraph “a”, up to
33$1,556,000 shall be made available to provide school-based
34supervision of children adjudicated under chapter 232, of which
35not more than $15,000 may be used for the purpose of training.
-33-1A portion of the cost of each school-based liaison officer
2shall be paid by the school district or other funding source as
3approved by the chief juvenile court officer.
4b. Of the funds appropriated in this section, up to $748,000
5is allocated for the payment of the expenses of court-ordered
6services provided to children who are under the supervision
7of the department, which expenses are a charge upon the state
8pursuant to section 232.141, subsection 4.
9c. Notwithstanding section 232.141 or any other provision
10of law to the contrary, the amounts allocated in this
11subsection shall be distributed to the judicial districts
12as determined by the state court administrator and to the
13department’s service areas as determined by the administrator
14of the department of human services’ division of child and
15family services. The state court administrator and the
16division administrator shall make the determination of the
17distribution amounts on or before June 15, 2022.
18d. Notwithstanding chapter 232 or any other provision of
19law to the contrary, a district or juvenile court shall not
20order any service which is a charge upon the state pursuant
21to section 232.141 if there are insufficient court-ordered
22services funds available in the district court or departmental
23service area distribution amounts to pay for the service. The
24chief juvenile court officer and the departmental service area
25manager shall encourage use of the funds allocated in this
26subsection such that there are sufficient funds to pay for
27all court-related services during the entire year. The chief
28juvenile court officers and departmental service area managers
29shall attempt to anticipate potential surpluses and shortfalls
30in the distribution amounts and shall cooperatively request the
31state court administrator or division administrator to transfer
32funds between the judicial districts’ or departmental service
33areas’ distribution amounts as prudent.
34e. Notwithstanding any provision of law to the contrary,
35a district or juvenile court shall not order a county to pay
-34-1for any service provided to a juvenile pursuant to an order
2entered under chapter 232 which is a charge upon the state
3under section 232.141, subsection 4.
4f. Of the funds allocated in this subsection, not more than
5$83,000 may be used by the judicial branch for administration
6of the requirements under this subsection.
7g. Of the funds allocated in this subsection, $17,000
8shall be used by the department of human services to support
9the interstate commission for juveniles in accordance with
10the interstate compact for juveniles as provided in section
11232.173.
129. Of the funds appropriated in this section, $12,253,000 is
13allocated for juvenile delinquent graduated sanctions services.
14Any state funds saved as a result of efforts by juvenile court
15services to earn a federal Tit.IV-E match for juvenile court
16services administration may be used for the juvenile delinquent
17graduated sanctions services.
1810. Of the funds appropriated in this section, $1,658,000 is
19transferred to the department of public health to be used for
20the child protection center grant program for child protection
21centers located in Iowa in accordance with section 135.118.
22The grant amounts under the program shall be equalized so that
23each center receives a uniform base amount of $245,000, and so
24that the remaining funds are awarded through a funding formula
25based upon the volume of children served. To increase access
26to child protection center services for children in rural
27areas, the funding formula for the awarding of the remaining
28funds shall provide for the awarding of an enhanced amount to
29eligible grantees to develop and maintain satellite centers in
30underserved regions of the state.
3111. Of the funds appropriated in this section, $4,025,000 is
32allocated for the preparation for adult living program pursuant
33to section 234.46.
3412. Of the funds appropriated in this section, $227,000
35shall be used for the public purpose of continuing a grant to a
-35-1nonprofit human services organization, providing services to
2individuals and families in multiple locations in southwest
3Iowa and Nebraska for support of a project providing immediate,
4sensitive support and forensic interviews, medical exams, needs
5assessments, and referrals for victims of child abuse and their
6nonoffending family members.
713. Of the funds appropriated in this section, $300,000
8is allocated for the foster care youth council approach of
9providing a support network to children placed in foster care.
1014. Of the funds appropriated in this section, $202,000 is
11allocated for use pursuant to section 235A.1 for continuation
12of the initiative to address child sexual abuse implemented
13pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
1421.
1515. Of the funds appropriated in this section, $630,000 is
16allocated for the community partnership for child protection
17sites.
1816. Of the funds appropriated in this section, $371,000
19is allocated for the department’s minority youth and family
20projects under the redesign of the child welfare system.
2117. Of the funds appropriated in this section, $851,000
22is allocated for funding of the community circle of care
23collaboration for children and youth in northeast Iowa.
2418. Of the funds appropriated in this section, at least
25$147,000 shall be used for the continuation of the child
26welfare provider training program.
2719. Of the funds appropriated in this section, $211,000
28shall be used for continuation of the central Iowa system of
29care program grant for the purposes of funding community-based
30services and other supports with a system of care approach for
31children with serious emotional disturbance and their families
32through a nonprofit provider that is located in a county with a
33population of over 420,000 but less than 450,000 according to
34the 2010 certified federal census, is licensed as a psychiatric
35medical institution for children, and was a system of care
-36-1grantee prior to July 1, 2022.
220. Of the funds appropriated in this section, $235,000
3shall be used for the public purpose of the continuation
4and expansion of a system of care program grant implemented
5in Cerro Gordo and Linn counties to utilize a comprehensive
6and long-term approach for helping children and families by
7addressing the key areas in a child’s life of childhood basic
8needs, education and work, family, and community.
921. Of the funds appropriated in this section, $110,000
10shall be used for the public purpose of funding community-based
11services and other supports with a system of care approach
12for children with a serious emotional disturbance and their
13families through a nonprofit provider of child welfare services
14that has been in existence for more than 115 years, is located
15in a county with a population of more than 230,000 according to
16the 2020 certified federal census, is licensed as a psychiatric
17medical institution for children, and was a system of care
18grantee prior to July 1, 2022.
1922. If a separate funding source is identified that reduces
20the need for state funds within an allocation under this
21section, the allocated state funds may be redistributed to
22other allocations under this section for the same fiscal year.
2323. Of the funds appropriated in this section, a portion may
24be used for family-centered services for purposes of complying
25with the federal Family First Prevention Services Act of 2018,
26Pub.L. No.115-123, and successor legislation.
2724. Of the funds appropriated in this section, $3,850,718
28shall be used to support placements in qualified residential
29treatment programs.
30 Sec. 20. ADOPTION SUBSIDY.
311. There is appropriated from the general fund of the
32state to the department of human services for the fiscal year
33beginning July 1, 2022, and ending June 30, 2023, the following
34amount, or so much thereof as is necessary, to be used for the
35purpose designated:
-37- 1a. For adoption subsidy payments and related costs and for
2other services provided for under paragraph “b”, subparagraph
3(2):
.................................................. $440,596,007
5b. (1) Of the funds appropriated in this section, a
6sufficient amount is allocated for adoption subsidy payments
7and related costs.
8(2) Any funds appropriated in this section remaining after
9the allocation under subparagraph (1) are designated and
10allocated as state savings resulting from implementation of
11the federal Fostering Connections to Success and Increasing
12Adoptions Act of 2008, Pub.L. No.110-351, and successor
13legislation, as determined in accordance with 42 U.S.C.
14§673(a)(8), and shall be used for post-adoption services and
15for other purposes allowed under these federal laws, Tit.IV-B
16or Tit.IV-E of the federal Social Security Act.
17(a) The department of human services may transfer funds
18allocated in this subparagraph (2) to the appropriation for
19child and family services in this division of this Act for the
20purposes designated in this subparagraph (2).
21(b) Notwithstanding section 8.33, moneys allocated
22under this subparagraph (2) shall not revert to any fund but
23shall remain available for the purposes designated in this
24subparagraph (2) until expended.
252. The department may transfer funds appropriated in
26this section to the appropriation made in this division of
27this Act for general administration for costs paid from the
28appropriation relating to adoption subsidy.
293. Federal funds received by the state during the
30fiscal year beginning July 1, 2022, as the result of the
31expenditure of state funds during a previous state fiscal
32year for a service or activity funded under this section are
33appropriated to the department to be used as additional funding
34for the services and activities funded under this section.
35Notwithstanding section 8.33, moneys received in accordance
-38-1with this subsection that remain unencumbered or unobligated
2at the close of the fiscal year shall not revert to any fund
3but shall remain available for expenditure for the purposes
4designated until the close of the succeeding fiscal year.
5 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited
6in the juvenile detention home fund created in section 232.142
7during the fiscal year beginning July 1, 2022, and ending June
830, 2023, are appropriated to the department of human services
9for the fiscal year beginning July 1, 2022, and ending June 30,
102023, for distribution of an amount equal to a percentage of
11the costs of the establishment, improvement, operation, and
12maintenance of county or multicounty juvenile detention homes
13in the fiscal year beginning July 1, 2021. Moneys appropriated
14for distribution in accordance with this section shall be
15allocated among eligible detention homes, prorated on the basis
16of an eligible detention home’s proportion of the costs of all
17eligible detention homes in the fiscal year beginning July
181, 2021. The percentage figure shall be determined by the
19department based on the amount available for distribution for
20the fund. Notwithstanding section 232.142, subsection 3, the
21financial aid payable by the state under that provision for the
22fiscal year beginning July 1, 2022, shall be limited to the
23amount appropriated for the purposes of this section.
24 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM.
251. There is appropriated from the general fund of the
26state to the department of human services for the fiscal year
27beginning July 1, 2022, and ending June 30, 2023, the following
28amount, or so much thereof as is necessary, to be used for the
29purpose designated:
30For the family support subsidy program subject to the
31enrollment restrictions in section 225C.37, subsection 3:
.................................................. $32949,282
332. At least $931,536 of the moneys appropriated in this
34section is transferred to the department of public health for
35the family support center component of the comprehensive family
-39-1support program under chapter 225C, subchapter V.
23. If at any time during the fiscal year, the amount of
3funding available for the family support subsidy program
4is reduced from the amount initially used to establish the
5figure for the number of family members for whom a subsidy
6is to be provided at any one time during the fiscal year,
7notwithstanding section 225C.38, subsection 2, the department
8shall revise the figure as necessary to conform to the amount
9of funding available.
10 Sec. 23. CONNER DECREE. There is appropriated from the
11general fund of the state to the department of human services
12for the fiscal year beginning July 1, 2022, and ending June 30,
132023, the following amount, or so much thereof as is necessary,
14to be used for the purpose designated:
15For building community capacity through the coordination
16and provision of training opportunities in accordance with the
17consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
18Iowa, July 14, 1994):
.................................................. $1933,632
20 Sec. 24. MENTAL HEALTH INSTITUTES.
211. There is appropriated from the general fund of the
22state to the department of human services for the fiscal year
23beginning July 1, 2022, and ending June 30, 2023, the following
24amounts, or so much thereof as is necessary, to be used for the
25purposes designated:
26a. For operation of the state mental health institute at
27Cherokee as required by chapters 218 and 226 for salaries,
28support, maintenance, and miscellaneous purposes, and for not
29more than the following full-time equivalent positions:
.................................................. $3015,613,624
............................................... FTEs31169.00
32b. For operation of the state mental health institute at
33Independence as required by chapters 218 and 226 for salaries,
34support, maintenance, and miscellaneous purposes, and for not
35more than the following full-time equivalent positions:
-40-.................................................. $119,688,928
............................................... FTEs2208.00
32. a. Notwithstanding sections 218.78 and 249A.11, any
4revenue received from the state mental health institute at
5Cherokee or the state mental health institute at Independence
6pursuant to 42 C.F.R§438.6(e) may be retained and expended by
7the mental health institute.
8b. Notwithstanding sections 218.78 and 249A.11, any
9COVID-19 related funding received through federal funding
10sources by the state mental health institute at Cherokee or the
11state mental health institute at Independence may be retained
12and expended by the mental health institute.
133. Notwithstanding any provision of law to the contrary,
14a Medicaid member residing at the state mental health
15institute at Cherokee or the state mental health institute
16at Independence shall retain Medicaid eligibility during
17the period of the Medicaid member’s stay for which federal
18financial participation is available.
194. Notwithstanding section 8.33, moneys appropriated in
20this section that remain unencumbered or unobligated at the
21close of the fiscal year shall not revert but shall remain
22available for expenditure for the purposes designated until the
23close of the succeeding fiscal year.
24 Sec. 25. STATE RESOURCE CENTERS.
251. There is appropriated from the general fund of the
26state to the department of human services for the fiscal year
27beginning July 1, 2022, and ending June 30, 2023, the following
28amounts, or so much thereof as is necessary, to be used for the
29purposes designated:
30a. For the state resource center at Glenwood for salaries,
31support, maintenance, and miscellaneous purposes:
.................................................. $3216,288,739
33b. For the state resource center at Woodward for salaries,
34support, maintenance, and miscellaneous purposes:
.................................................. $3513,409,294
-41- 12. The department may continue to bill for state resource
2center services utilizing a scope of services approach used for
3private providers of intermediate care facilities for persons
4with an intellectual disability services, in a manner which
5does not shift costs between the medical assistance program,
6mental health and disability services regions, or other sources
7of funding for the state resource centers.
83. The state resource centers may expand the time-limited
9assessment and respite services during the fiscal year.
104. If the department’s administration and the department
11of management concur with a finding by a state resource
12center’s superintendent that projected revenues can reasonably
13be expected to pay the salary and support costs for a new
14employee position, or that such costs for adding a particular
15number of new positions for the fiscal year would be less
16than the overtime costs if new positions would not be added,
17the superintendent may add the new position or positions. If
18the vacant positions available to a resource center do not
19include the position classification desired to be filled, the
20state resource center’s superintendent may reclassify any
21vacant position as necessary to fill the desired position. The
22superintendents of the state resource centers may, by mutual
23agreement, pool vacant positions and position classifications
24during the course of the fiscal year in order to assist one
25another in filling necessary positions.
265. If existing capacity limitations are reached in
27operating units, a waiting list is in effect for a service or
28a special need for which a payment source or other funding
29is available for the service or to address the special need,
30and facilities for the service or to address the special need
31can be provided within the available payment source or other
32funding, the superintendent of a state resource center may
33authorize opening not more than two units or other facilities
34and begin implementing the service or addressing the special
35need during fiscal year 2022-2023.
-42- 16. Notwithstanding section 8.33, and notwithstanding
2the amount limitation specified in section 222.92, moneys
3appropriated in this section that remain unencumbered or
4unobligated at the close of the fiscal year shall not revert
5but shall remain available for expenditure for the purposes
6designated until the close of the succeeding fiscal year.
7 Sec. 26. SEXUALLY VIOLENT PREDATORS.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2022, and ending June 30, 2023, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13For costs associated with the commitment and treatment of
14sexually violent predators in the unit located at the state
15mental health institute at Cherokee, including costs of legal
16services and other associated costs, including salaries,
17support, maintenance, and miscellaneous purposes, and for not
18more than the following full-time equivalent positions:
.................................................. $1913,891,276
............................................... FTEs20140.00
212. Unless specifically prohibited by law, if the amount
22charged provides for recoupment of at least the entire amount
23of direct and indirect costs, the department of human services
24may contract with other states to provide care and treatment
25of persons placed by the other states at the unit for sexually
26violent predators at Cherokee. The moneys received under
27such a contract shall be considered to be repayment receipts
28and used for the purposes of the appropriation made in this
29section.
303. Notwithstanding section 8.33, moneys appropriated in
31this section that remain unencumbered or unobligated at the
32close of the fiscal year shall not revert but shall remain
33available for expenditure for the purposes designated until the
34close of the succeeding fiscal year.
35 Sec. 27. FIELD OPERATIONS.
-43- 11. There is appropriated from the general fund of the
2state to the department of human services for the fiscal year
3beginning July 1, 2022, and ending June 30, 2023, the following
4amount, or so much thereof as is necessary, to be used for the
5purposes designated:
6For field operations, including salaries, support,
7maintenance, and miscellaneous purposes, and for not more than
8the following full-time equivalent positions:
.................................................. $965,894,438
............................................... FTEs101,589.00
112. Priority in filling full-time equivalent positions
12shall be given to those positions related to child protection
13services and eligibility determination for low-income families.
14 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
15from the general fund of the state to the department of human
16services for the fiscal year beginning July 1, 2022, and ending
17June 30, 2023, the following amount, or so much thereof as is
18necessary, to be used for the purpose designated:
19For general administration, including salaries, support,
20maintenance, and miscellaneous purposes, and for not more than
21the following full-time equivalent positions:
.................................................. $2215,342,189
............................................... FTEs23294.00
241. The department shall report at least monthly to the
25general assembly concerning the department’s operational and
26program expenditures.
272. Of the funds appropriated in this section, $150,000 shall
28be used for the provision of a program to provide technical
29assistance, support, and consultation to providers of home and
30community-based services under the medical assistance program.
313. Of the funds appropriated in this section, $50,000
32is transferred to the Iowa finance authority to be used
33for administrative support of the council on homelessness
34established in section 16.2D and for the council to fulfill its
35duties in addressing and reducing homelessness in the state.
-44- 14. Of the funds appropriated in this section, $200,000 shall
2be transferred to and deposited in the administrative fund of
3the Iowa ABLE savings plan trust created in section 12I.4, to
4be used for implementation and administration activities of the
5Iowa ABLE savings plan trust.
65. Of the funds appropriated in this section, $200,000 is
7transferred to the economic development authority for the Iowa
8commission on volunteer services to continue to be used for the
9RefugeeRISE AmeriCorps program established under section 15H.8
10for member recruitment and training to improve the economic
11well-being and health of economically disadvantaged refugees in
12local communities across Iowa. Funds transferred may be used
13to supplement federal funds under federal regulations.
146. Of the funds appropriated in this section, up to $300,000
15shall be used as follows:
16a. To fund not more than 1.00 full-time equivalent position
17to address the department’s responsibility to support the work
18of the children’s behavioral health system state board and
19implementation of the services required pursuant to section
20331.397.
21b. To support the cost of establishing and implementing new
22or additional services required pursuant to sections 331.397
23and 331.397A.
24c. Of the amount allocated, $32,000 shall be transferred
25to the department of public health to support the costs of
26establishing and implementing new or additional services
27required pursuant to sections 331.397 and 331.397A.
287. Of the funds appropriated in this section, $800,000 shall
29be used for the renovation and construction of certain nursing
30facilities, consistent with the provisions of chapter 249K.
31 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated
32from the general fund of the state to the department of human
33services for the fiscal year beginning July 1, 2022, and ending
34June 30, 2023, the following amount, or so much thereof as is
35necessary, to be used for the purposes designated:
-45- 1For salaries, support, maintenance, and miscellaneous
2purposes at facilities under the purview of the department of
3human services:
.................................................. $44,172,123
5 Sec. 30. VOLUNTEERS. There is appropriated from the general
6fund of the state to the department of human services for the
7fiscal year beginning July 1, 2022, and ending June 30, 2023,
8the following amount, or so much thereof as is necessary, to be
9used for the purpose designated:
10For development and coordination of volunteer services:
.................................................. $1184,686
12 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
13ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
14DEPARTMENT OF HUMAN SERVICES.
151. a. (1) (a) Notwithstanding any provision of law to the
16contrary, for the fiscal year beginning July 1, 2022, case-mix
17nursing facilities shall be reimbursed in accordance with the
18methodology in effect on June 30, 2022.
19(b) For the fiscal year beginning July 1, 2022, non-case-mix
20and special population nursing facilities shall be reimbursed
21in accordance with the methodology in effect on June 30, 2022.
22(c) For managed care claims, the department of human
23services shall adjust the payment rate floor for nursing
24facilities, annually, to maintain a rate floor that is no
25lower than the Medicaid fee-for-service case-mix adjusted rate
26calculated in accordance with subparagraph division (a) and
27441 IAC 81.6. The department shall then calculate adjusted
28reimbursement rates, including but not limited to add-on
29payments, annually, and shall notify Medicaid managed care
30organizations of the adjusted reimbursement rates within 30
31days of determining the adjusted reimbursement rates. Any
32adjustment of reimbursement rates under this subparagraph
33division shall be budget neutral to the state budget.
34(d) For the fiscal year beginning July 1, 2022, Medicaid
35managed care long-term services and supports capitation rates
-46-1shall be adjusted to reflect the case-mix adjusted rates
2specified pursuant to subparagraph division (a) for the patient
3populations residing in Medicaid-certified nursing facilities.
4(2) Medicaid managed care organizations shall adjust
5facility-specific rates based upon payment rate listings issued
6by the department. The rate adjustments shall be applied
7prospectively from the effective date of the rate letter issued
8by the department.
9b. (1) For the fiscal year beginning July 1, 2022, the
10department shall establish the fee-for-service pharmacy
11dispensing fee reimbursement at $10.38 per prescription,
12until a cost of dispensing survey is completed. The actual
13dispensing fee shall be determined by a cost of dispensing
14survey performed by the department and required to be completed
15by all medical assistance program participating pharmacies
16every two years, adjusted as necessary to maintain expenditures
17within the amount appropriated to the department for this
18purpose for the fiscal year. A change in the dispensing
19fee shall become effective following federal approval of the
20Medicaid state plan.
21(2) The department shall utilize an average acquisition
22cost reimbursement methodology for all drugs covered under the
23medical assistance program in accordance with 2012 Iowa Acts,
24chapter 1133, section 33.
25c. (1) For the fiscal year beginning July 1, 2022,
26reimbursement rates for outpatient hospital services shall
27remain at the rates in effect on June 30, 2022, subject to
28Medicaid program upper payment limit rules, and adjusted
29as necessary to maintain expenditures within the amount
30appropriated to the department for this purpose for the fiscal
31year.
32(2) For the fiscal year beginning July 1, 2022,
33reimbursement rates for inpatient hospital services shall
34remain at the rates in effect on June 30, 2022, subject to
35Medicaid program upper payment limit rules, and adjusted
-47-1as necessary to maintain expenditures within the amount
2appropriated to the department for this purpose for the fiscal
3year.
4(3) For the fiscal year beginning July 1, 2022, under
5both fee-for-service and managed care administration of
6the Medicaid program, critical access hospitals shall be
7reimbursed for inpatient and outpatient services based on the
8hospital-specific critical access hospital cost adjustment
9factor methodology utilizing the most recent and complete cost
10reporting period as applied prospectively within the funds
11appropriated for such purpose for the fiscal year.
12(4) For the fiscal year beginning July 1, 2022, the graduate
13medical education and disproportionate share hospital fund
14shall remain at the amount in effect on June 30, 2022, except
15that the portion of the fund attributable to graduate medical
16education shall be reduced in an amount that reflects the
17elimination of graduate medical education payments made to
18out-of-state hospitals.
19(5) In order to ensure the efficient use of limited state
20funds in procuring health care services for low-income Iowans,
21funds appropriated in this Act for hospital services shall
22not be used for activities which would be excluded from a
23determination of reasonable costs under the federal Medicare
24program pursuant to 42 U.S.C.§1395x(v)(1)(N).
25d. For the fiscal year beginning July 1, 2022, reimbursement
26rates for hospices and acute psychiatric hospitals shall be
27increased in accordance with increases under the federal
28Medicare program or as supported by their Medicare audited
29costs.
30e. For the fiscal year beginning July 1, 2022, independent
31laboratories and rehabilitation agencies shall be reimbursed
32using the same methodology in effect on June 30, 2022.
33f. (1) For the fiscal year beginning July 1, 2022,
34reimbursement rates for home health agencies shall continue to
35be based on the Medicare low utilization payment adjustment
-48-1(LUPA) methodology with state geographic wage adjustments. The
2department shall continue to update the rates every two years
3to reflect the most recent Medicare LUPA rates.
4(2) For the fiscal year beginning July 1, 2022, the
5department shall create a reimbursement rate structure that
6provides incentives to home health care providers located in
7rural areas and providing home health care to Medicaid members,
8within the $4,000,000 appropriated for this purpose. The rate
9structure shall include a telehealth component to incentivize
10the provision of necessary supervision for skilled care without
11requiring travel time. For the purposes of this subparagraph
12(2), “rural area” means an area that is not an Iowa core based
13statistical area as defined by the federal office of management
14and budget.
15(3) For the fiscal year beginning July 1, 2022, rates for
16private duty nursing and personal care services under the early
17and periodic screening, diagnostic, and treatment program
18benefit shall be calculated based on the methodology in effect
19on June 30, 2022.
20g. For the fiscal year beginning July 1, 2022, federally
21qualified health centers and rural health clinics shall receive
22cost-based reimbursement for 100 percent of the reasonable
23costs for the provision of services to recipients of medical
24assistance.
25h. For the fiscal year beginning July 1, 2022, the
26reimbursement rates for dental services shall remain at the
27rates in effect on June 30, 2022.
28i. (1) For the fiscal year beginning July 1, 2022,
29reimbursement rates for non-state-owned psychiatric medical
30institutions for children shall be based on the reimbursement
31methodology in effect on June 30, 2022.
32(2) As a condition of participation in the medical
33assistance program, enrolled providers shall accept the medical
34assistance reimbursement rate for any covered goods or services
35provided to recipients of medical assistance who are children
-49-1under the custody of a psychiatric medical institution for
2children.
3j. For the fiscal year beginning July 1, 2022, unless
4otherwise specified in this Act, all noninstitutional medical
5assistance provider reimbursement rates shall remain at the
6rates in effect on June 30, 2022, except for area education
7agencies, local education agencies, infant and toddler
8services providers, home and community-based services providers
9including consumer-directed attendant care providers under a
10section 1915(c) or 1915(i) waiver, targeted case management
11providers, and those providers whose rates are required to be
12determined pursuant to section 249A.20, or to meet federal
13mental health parity requirements.
14k. Notwithstanding any provision to the contrary, for the
15fiscal year beginning July 1, 2022, the reimbursement rate for
16anesthesiologists shall remain at the rates in effect on June
1730, 2022, and updated on January 1, 2023, to align with the
18most current Iowa Medicare anesthesia rate.
19l. Notwithstanding section 249A.20, for the fiscal year
20beginning July 1, 2022, the average reimbursement rate for
21health care providers eligible for use of the federal Medicare
22resource-based relative value scale reimbursement methodology
23under section 249A.20 shall remain at the rate in effect on
24June 30, 2022; however, this rate shall not exceed the maximum
25level authorized by the federal government.
26m. For the fiscal year beginning July 1, 2022, the
27reimbursement rate for residential care facilities shall not
28be less than the minimum payment level as established by the
29federal government to meet the federally mandated maintenance
30of effort requirement. The flat reimbursement rate for
31facilities electing not to file annual cost reports shall not
32be less than the minimum payment level as established by the
33federal government to meet the federally mandated maintenance
34of effort requirement.
35n. For the fiscal year beginning July 1, 2022, the
-50-1reimbursement rates for inpatient mental health services
2provided at hospitals shall remain at the rates in effect on
3June 30, 2022, subject to Medicaid program upper payment limit
4rules and adjusted as necessary to maintain expenditures within
5the amount appropriated to the department for this purpose for
6the fiscal year; and psychiatrists shall be reimbursed at the
7medical assistance program fee-for-service rate in effect on
8June 30, 2022.
9o. For the fiscal year beginning July 1, 2022, community
10mental health centers may choose to be reimbursed for the
11services provided to recipients of medical assistance through
12either of the following options:
13(1) For 100 percent of the reasonable costs of the services.
14(2) In accordance with the alternative reimbursement rate
15methodology approved by the department of human services in
16effect on June 30, 2022.
17p. For the fiscal year beginning July 1, 2022, the
18reimbursement rate for providers of family planning services
19that are eligible to receive a 90 percent federal match shall
20remain at the rates in effect on June 30, 2022.
21q. (1) For the fiscal year beginning July 1, 2022,
22reimbursement rates for providers of home and community-based
23services waiver and habilitation services shall be increased
24to the extent possible within the $14,600,000 appropriated for
25this purpose. The entire rate increase shall be used for wages
26and associated costs specific to wages, benefits, and required
27withholding of direct support professionals and frontline
28management, including consumer choices option employees.
29(2) For the fiscal year beginning July 1, 2022,
30reimbursement rates for intermediate care facility for
31persons with an intellectual disability providers shall be
32increased over the rates in effect on June 30, 2022, within
33the $3,125,778 appropriated for this purpose. The entire rate
34increase shall be used for wages and associated costs specific
35to wages, benefits, and required withholding of direct support
-51-1professionals and frontline management.
2(3) For the fiscal year beginning July 1, 2022,
3reimbursement rates for providers of state plan home and
4community-based services home-based habilitation services
5shall remain at the rates in effect on June 30, 2022. The
6reimbursement rates for home-based habilitation services shall
7be based on a fee schedule that incorporates the acuity-based
8tiers.
9r. For the fiscal year beginning July 1, 2022, the
10reimbursement rates for emergency medical service providers
11shall remain at the rates in effect on June 30, 2022, or as
12approved by the centers for Medicare and Medicaid services of
13the United States department of health and human services.
14s. (1) For the fiscal year beginning July 1, 2022,
15reimbursement rates for substance-related disorder treatment
16programs licensed under section 125.13 shall remain at the
17rates in effect on June 30, 2022.
18(2) For the fiscal year beginning July 1, 2022, the
19department shall establish a fee schedule or provider-specific
20rate structure to increase reimbursement rates for residential
21substance use treatment providers within the $1,100,000
22appropriated for this purpose.
23t. For the fiscal year beginning July 1, 2022, assertive
24community treatment per diem rates shall remain at the rates in
25effect on June 30, 2022.
26u. For the fiscal year beginning July 1, 2022, the
27reimbursement rate for family-centered services providers shall
28be established by contract.
29v. For the fiscal year beginning July 1, 2022, the
30reimbursement rate for air ambulance services shall remain at
31the rate in effect on June 30, 2022.
32w. For the fiscal year beginning July 1, 2022, all
33behavioral health intervention services reimbursement rates
34shall be increased over the rates in effect on June 30, 2022,
35within the $3,000,000 appropriated for this purpose. The
-52-1entire rate increase shall be used for wages and associated
2costs specific to wages, benefits, and required withholding of
3direct support professionals and frontline management.
4x. For the fiscal year beginning July 1, 2022, all applied
5behavioral analysis services reimbursement rates shall be
6increased over the rates in effect on June 30, 2022, within the
7$385,000 appropriated for this purpose.
82. For the fiscal year beginning July 1, 2022, the
9reimbursement rate for providers reimbursed under the
10in-home-related care program shall not be less than the minimum
11payment level as established by the federal government to meet
12the federally mandated maintenance of effort requirement.
133. Unless otherwise directed in this section, when the
14department’s reimbursement methodology for any provider
15reimbursed in accordance with this section includes an
16inflation factor, this factor shall not exceed the amount
17by which the consumer price index for all urban consumers
18increased during the most recently ended calendar year.
194. Notwithstanding section 234.38, for the fiscal
20year beginning July 1, 2022, the foster family basic daily
21maintenance rate and the maximum adoption subsidy rate for
22children ages 0 through 5 years shall be $16.78, the rate for
23children ages 6 through 11 years shall be $17.45, the rate for
24children ages 12 through 15 years shall be $19.10, and the
25rate for children and young adults ages 16 and older shall
26be $19.35. For youth ages 18 to 23 who have exited foster
27care, the preparation for adult living program maintenance
28rate shall be up to $602.70 per month as calculated based on
29the age of the participant. The maximum payment for adoption
30subsidy nonrecurring expenses shall be limited to $500 and the
31disallowance of additional amounts for court costs and other
32related legal expenses implemented pursuant to 2010 Iowa Acts,
33chapter 1031, section 408, shall be continued.
345. For the fiscal year beginning July 1, 2022, the maximum
35reimbursement rates for social services providers under
-53-1contract shall remain at the rates in effect on June 30, 2022,
2or the provider’s actual and allowable cost plus inflation for
3each service, whichever is less. However, if a new service
4or service provider is added after June 30, 2022, the initial
5reimbursement rate for the service or provider shall be based
6upon a weighted average of provider rates for similar services.
76. a. For the fiscal year beginning July 1, 2022, the
8reimbursement rates for resource family recruitment and
9retention contractors shall be established by contract.
10b. For the fiscal year beginning July 1, 2022, the
11reimbursement rates for supervised apartment living foster care
12providers shall be established by contract.
137. For the fiscal year beginning July 1, 2022, the
14reimbursement rate for group foster care providers shall be the
15combined service and maintenance reimbursement rate established
16by contract.
178. The group foster care reimbursement rates paid for
18placement of children out of state shall be calculated
19according to the same rate-setting principles as those used for
20in-state providers, unless the director of human services or
21the director’s designee determines that appropriate care cannot
22be provided within the state. The payment of the daily rate
23shall be based on the number of days in the calendar month in
24which service is provided.
259. a. For the fiscal year beginning July 1, 2022, the
26reimbursement rate paid for shelter care and the child welfare
27emergency services implemented to provide or prevent the need
28for shelter care shall be established by contract.
29b. For the fiscal year beginning July 1, 2022, the combined
30service and maintenance components of the per day reimbursement
31rate paid for shelter care services shall be based on the
32financial and statistical report submitted to the department.
33The maximum per day reimbursement rate shall be the maximum
34per day reimbursement rate in effect on June 30, 2022, as
35increased within the $649,029 appropriated for this purpose.
-54-1The department shall reimburse a shelter care provider at the
2provider’s actual and allowable unit cost, plus inflation, not
3to exceed the maximum reimbursement rate.
4c. Unless 2022 Iowa Acts, House File 2507, is enacted,
5notwithstanding section 232.141, subsection 8, for the fiscal
6year beginning July 1, 2022, the amount of the statewide
7average of the actual and allowable rates for reimbursement of
8juvenile shelter care homes that is utilized for the limitation
9on recovery of unpaid costs shall remain at the amount in
10effect for this purpose in the fiscal year beginning July 1,
112021. If 2022 Iowa Acts, House File 2507, is enacted, the
12applicable provisions of House File 2507 shall supersede the
13provisions of this paragraph “c”.
1410. For the fiscal year beginning July 1, 2022, the
15department shall calculate reimbursement rates for intermediate
16care facilities for persons with an intellectual disability
17at the 80th percentile. Beginning July 1, 2022, the rate
18calculation methodology shall utilize the consumer price index
19inflation factor applicable to the fiscal year beginning July
201, 2022.
2111. Effective July 1, 2022, child care provider
22reimbursement rates shall remain at the rates in effect on June
2330, 2022. The department shall set rates in a manner so as
24to provide incentives for a nonregistered provider to become
25registered by applying any increase only to registered and
26licensed providers.
2712. The department may adopt emergency rules to implement
28this section.
29 Sec. 32. EMERGENCY RULES.
301. If necessary to comply with federal requirements
31including time frames, or if specifically authorized by a
32provision of this division of this Act, the department of
33human services or the mental health and disability services
34commission may adopt administrative rules under section 17A.4,
35subsection 3, and section 17A.5, subsection 2, paragraph “b”,
-55-1to implement the provisions of this division of this Act and
2the rules shall become effective immediately upon filing or
3on a later effective date specified in the rules, unless the
4effective date of the rules is delayed or the applicability
5of the rules is suspended by the administrative rules review
6committee. Any rules adopted in accordance with this section
7shall not take effect before the rules are reviewed by the
8administrative rules review committee. The delay authority
9provided to the administrative rules review committee under
10section 17A.8, subsections 9 and 10, shall be applicable to a
11delay imposed under this section, notwithstanding a provision
12in those subsections making them inapplicable to section 17A.5,
13subsection 2, paragraph “b”. Any rules adopted in accordance
14with the provisions of this section shall also be published as
15a notice of intended action as provided in section 17A.4.
162. If during a fiscal year, the department of human
17services is adopting rules in accordance with this section
18or as otherwise directed or authorized by state law, and
19the rules will result in an expenditure increase beyond the
20amount anticipated in the budget process or if the expenditure
21was not addressed in the budget process for the fiscal
22year, the department shall notify the general assembly and
23the department of management concerning the rules and the
24expenditure increase. The notification shall be provided at
25least 30 calendar days prior to the date notice of the rules
26is submitted to the administrative rules coordinator and the
27administrative code editor.
28 Sec. 33. REPORTS. Unless otherwise provided, any reports or
29other information required to be compiled and submitted under
30this Act during the fiscal year beginning July 1, 2022, shall
31be submitted on or before the dates specified for submission
32of the reports or information.
33 Sec. 34. EFFECTIVE UPON ENACTMENT. The following provision
34of this division of this Act, being deemed of immediate
35importance, takes effect upon enactment:
-56- 1The provision relating to section 232.141 and directing the
2state court administrator and the division administrator of
3the department of human services division of child and family
4services to make the determination, by June 15, 2022, of the
5distribution of funds allocated for the payment of the expenses
6of court-ordered services provided to juveniles which are a
7charge upon the state.
8DIVISION VI
9HEALTH CARE ACCOUNTS AND FUNDS — FY 2022-2023
10 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
11appropriated from the pharmaceutical settlement account created
12in section 249A.33 to the department of human services for the
13fiscal year beginning July 1, 2022, and ending June 30, 2023,
14the following amount, or so much thereof as is necessary, to be
15used for the purpose designated:
16Notwithstanding any provision of law to the contrary, to
17supplement the appropriations made in this Act for health
18program operations under the medical assistance program for the
19fiscal year beginning July 1, 2022, and ending June 30, 2023:
.................................................. $20234,193
21 Sec. 36. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
22SERVICES. Notwithstanding any provision to the contrary and
23subject to the availability of funds, there is appropriated
24from the quality assurance trust fund created in section
25249L.4 to the department of human services for the fiscal year
26beginning July 1, 2022, and ending June 30, 2023, the following
27amounts, or so much thereof as is necessary, for the purposes
28designated:
29To supplement the appropriation made in this Act from the
30general fund of the state to the department of human services
31for medical assistance for the same fiscal year:
.................................................. $3256,305,139
33 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
34DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
35the contrary and subject to the availability of funds, there is
-57-1appropriated from the hospital health care access trust fund
2created in section 249M.4 to the department of human services
3for the fiscal year beginning July 1, 2022, and ending June
430, 2023, the following amounts, or so much thereof as is
5necessary, for the purposes designated:
6To supplement the appropriation made in this Act from the
7general fund of the state to the department of human services
8for medical assistance for the same fiscal year:
.................................................. $933,920,554
10 Sec. 38. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
11FOR FY 2022-2023. Notwithstanding section 8.33, if moneys
12appropriated for purposes of the medical assistance program for
13the fiscal year beginning July 1, 2022, and ending June 30,
142023, from the general fund of the state, the quality assurance
15trust fund, and the hospital health care access trust fund, are
16in excess of actual expenditures for the medical assistance
17program and remain unencumbered or unobligated at the close
18of the fiscal year, the excess moneys shall not revert but
19shall remain available for expenditure for the purposes of the
20medical assistance program until the close of the succeeding
21fiscal year.
22DIVISION VII
23DECATEGORIZATION CARRYOVER FUNDING
24 Sec. 39. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —
25TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
26subsection 5, paragraph “b”, any state-appropriated moneys in
27the funding pool that remained unencumbered or unobligated
28at the close of the fiscal year beginning July 1, 2019, and
29were deemed carryover funding to remain available for the two
30succeeding fiscal years that still remain unencumbered or
31unobligated at the close of the fiscal year beginning July 1,
322021, shall not revert but shall be transferred to the medical
33assistance program for the fiscal year beginning July 1, 2022.
34 Sec. 40. EFFECTIVE DATE. This division of this Act, being
35deemed of immediate importance, takes effect upon enactment.
-58-1 Sec. 41. RETROACTIVE APPLICABILITY. This division of this
2Act applies retroactively to July 1, 2021.
3DIVISION VIII
4TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE
5 Sec. 42. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —
6FY 2021-2022. Notwithstanding any provision to the contrary,
7any funds remaining in the property tax relief fund created
8in section 426B.1 at the close of the fiscal year beginning
9July 1, 2021, shall be transferred to the region incentive fund
10created in the mental health and disability services regional
11service fund pursuant to section 225C.7A.
12 Sec. 43. EFFECTIVE DATE. This division of this Act, being
13deemed of immediate importance, takes effect upon enactment.
14DIVISION IX
15PRIOR APPROPRIATIONS AND OTHER PROVISIONS
16FAMILY INVESTMENT PROGRAM GENERAL FUND
17 Sec. 44. 2021 Iowa Acts, chapter 182, section 9, is amended
18by adding the following new subsection:
19 NEW SUBSECTION. 7. Notwithstanding section 8.33, moneys
20appropriated in this section that remain unencumbered or
21unobligated at the close of the fiscal year shall not revert
22but shall remain available for one-time purposes, and may be
23transferred to the appropriation in this division of this Act
24for general administration for technology purposes, until the
25close of the succeeding fiscal year.
26CHILD AND FAMILY SERVICES
27 Sec. 45. 2021 Iowa Acts, chapter 182, section 19, is amended
28by adding the following new subsection:
29 NEW SUBSECTION. 24. Notwithstanding section 8.33, moneys
30appropriated in this section that remain unencumbered or
31unobligated at the close of the fiscal year shall not revert
32but shall remain available for the purposes designated until
33the close of the succeeding fiscal year.
34FIELD OPERATIONS
35 Sec. 46. 2021 Iowa Acts, chapter 182, section 27, is amended
-59-1by adding the following new subsection:
2 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
3appropriated in this section that remain unencumbered or
4unobligated at the close of the fiscal year shall not revert
5but shall remain available for one-time expenditure purposes
6until the close of the succeeding fiscal year.
7GENERAL ADMINISTRATION
8 Sec. 47. 2021 Iowa Acts, chapter 182, section 28, is amended
9by adding the following new subsection:
10 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
11appropriated in this section that remain unencumbered or
12unobligated at the close of the fiscal year shall not revert
13but shall remain available for one-time expenditure purposes
14until the close of the succeeding fiscal year.
15 Sec. 48. EFFECTIVE DATE. This division of this Act, being
16deemed of immediate importance, takes effect upon enactment.
17DIVISION X
18PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS
19 Sec. 49. COVID-19 FEDERAL REGULATIONS. For the time
20period beginning on the effective date of this division of
21this Act, and ending June 30, 2023, notwithstanding state
22administrative rules to the contrary, to the extent federal
23regulations relating to the COVID-19 pandemic differ from state
24administrative rules, including applicable federal waivers,
25the federal regulations are controlling during the pendency of
26the federally declared state of emergency and for such period
27of time following the end of the federally declared state of
28emergency applicable to the respective federal regulations.
29DIVISION XI
30HEALTH AND HUMAN SERVICES REALIGNMENT
31 Sec. 50. TRANSITION OF DEPARTMENT OF HUMAN SERVICES AND
32DEPARTMENT OF PUBLIC HEALTH INTO DEPARTMENT OF HEALTH AND HUMAN
33SERVICES.
341. Definitions. For the purposes of this section:
35a. “Department of health and human services” or
-60-1“department” means the department of health and human services
2created under this section.
3b. “Transition department” means the department of human
4services or the department of public health.
5c. “Transition departments” means the department of human
6services and the department of public health.
7d. “Transition period” means the period beginning July 1,
82022, and ending June 30, 2023.
92. Creation of department of health and human services
10— transition period — powers and duties. Notwithstanding
11any conflicting provision of law to the contrary, there is
12created a department of health and human services. During
13the transition period, the department of health and human
14services shall have and may exercise all of the policymaking
15functions, regulatory and enforcement powers, rights, duties,
16and responsibilities of the department of human services and
17the department of public health as prescribed by law or rule
18in effect on July 1, 2022, including but not limited to those
19relating to:
20a. All obligations and contracts of a transition
21department, including obligations and contracts related to a
22grant program.
23b. All property and records in the custody of a transition
24department.
25c. All funds appropriated to a transition department by the
26general assembly and all state, federal, and other funds for
27which expenditure by a transition department is authorized.
28d. Complaints, investigations, contested cases, causes of
29action, and statutes of limitations involving a transition
30department.
31(1) All complaints, investigations, contested cases, or
32a remand of an action by a reviewing court pending before a
33transition department or an authorized person of a transition
34department shall continue without change in status before
35the department and shall be governed by the laws and rules
-61-1applicable to the complaint, investigation, contested case, or
2remand action or proceeding in effect on July 1, 2022.
3(2) Any cause of action or statute of limitation relating
4to a transition department shall not be affected as a result
5of the transition and such cause of action or statute of
6limitation shall apply to the department.
7e. Rules, policies, and forms. All rules, policies, and
8forms adopted by or on behalf of a transition department shall
9become rules, policies, and forms of the department and shall
10remain in effect unless altered by the department.
11f. Licenses, permits, and certifications. All licenses,
12permits, and certifications issued by a transition department
13shall continue in effect as a license, permit, or certification
14of the department in accordance with the law or rule governing
15the license, permit, or certification in effect on July 1,
162022, until the license, permit, or certification expires, is
17suspended or revoked, or otherwise becomes invalid by the terms
18of such law or rule.
19g. References to a department or director. All references
20to the department of public health or the department of human
21services in law or in rule shall be interpreted to mean the
22department of health and human services, and all references to
23the director of public health or the director of human services
24shall be interpreted to mean the director of the department of
25health and human services.
26h. Departmental structure.
27(1) Any transition department, transition department
28subunit, or transition department body created or established
29by law and in existence on July 1, 2022, shall continue in
30full force and effect and shall not be permanently abolished,
31merged, or otherwise altered until amended, repealed, or
32supplemented by action of the general assembly.
33(2) This paragraph shall not prohibit a transition
34department, transition department subunit, or transition
35department body created or established by law in existence on
-62-1July 1, 2022, from sharing or coordinating responsibilities
2or functions under their respective purviews nor prohibit
3the director from temporarily integrating such departments,
4subunits, or bodies or the responsibilities or functions under
5their respective purviews in furtherance of the transition plan
6during the transition period.
73. Transition period leadership. During the transition
8period, the director of human services shall continue to act
9as the director of human services, shall assume the duties of
10the director of public health, shall act as the director of
11the department of health and human services, and may thereby
12exercise any policymaking functions, regulatory and enforcement
13powers, rights, duties, and responsibilities of the director
14of human services and the director of public health including
15those duties prescribed by law for the department of human
16services or the department of public health in effect on July
171, 2022.
184. Federal authorization and effective date of
19authorizations. If a transition department or the department
20determines that a waiver or authorization from the federal
21government is necessary to administer any provision of
22this section, the department shall request the waiver or
23authorization, and notwithstanding any other effective date to
24the contrary, the provision shall take effect only upon receipt
25of federal approval.
265. Initial written transition plan.
27a. On or before September 30, 2022, the transition
28departments or department shall publish on their respective
29internet sites an initial written transition plan for merging
30the functions of the transition departments into the department
31of health and human services effective July 1, 2023, in order
32to do all of the following:
33(1) More efficiently and effectively manage health and
34human services programs that are the responsibility of the
35state.
-63- 1(2) Establish a health and human services policy for the
2state.
3(3) Promote health and the quality of life in the health and
4human services field.
5b. The transition plan shall describe, at a minimum, all of
6the following:
7(1) The tasks that require completion before July 1, 2023,
8including a description of how the transition departments shall
9solicit comment from stakeholders, including employees of the
10transition departments, clients and partners of the transition
11departments, members of the public, and members of the general
12assembly.
13(2) The proposed organizational structure of the
14department, at a minimum, including the division level of
15the table of organization. Any personnel in the state merit
16system of employment who are mandatorily transferred due to the
17transition shall be so transferred without any loss in salary,
18benefits, or accrued years of service.
19(3) Proposed changes to any transition department boards,
20commissions, committees, councils, or other bodies and their
21functions.
22(4) Office space and infrastructure requirements related
23to the transition.
24(5) Any work site location changes for transitioning
25employees.
26(6) The transition of service delivery sites.
27(7) Procedures for the transfer and reconciliation of
28budgeting and funding between the transition departments and
29the department.
30(8) The transition of technology services of the transition
31departments to the department.
32(9) Any additional known tasks that may require completion
33after the transition on July 1, 2023.
34c. The written transition plan published under paragraph
35“b” shall:
-64- 1(1) Include a detailed timeline for the completion of the
2tasks described.
3(2) Be updated quarterly during the remainder of the
4transition period.
5(3) Describe how information will be provided to clients
6of the transition departments and the department regarding any
7changes in service delivery.
8(4) Describe how the transition to the department will be
9funded, including how expenses associated with the transition
10will be managed; how funding for services provided by the
11transition departments will be managed to ensure provision
12of services by the transition departments and the department
13without interruption; and how federal funds will be used by
14or transferred between the transition departments and the
15department to ensure provision of services by the transition
16departments and the department without interruption.
176. Statutory and administrative rule updates.
18a. Legislative changes required to implement the
19transition. Additional legislation is necessary to fully
20implement the transition. The director of the department
21of health and human services shall, in compliance with
22section 2.16, prepare draft legislation for submission to the
23legislative services agency, as necessary, for consideration
24by the general assembly during the 2023 legislative
25session, to implement the transition effective July 1, 2023.
26Notwithstanding any provision to the contrary in section 2.16,
27the draft legislation shall be submitted to the legislative
28services agency by October 1, 2022.
29b. Update of administrative code required by the
30transition. In updating references and the format in the
31Iowa administrative code, in order to correspond to the
32transferring of duties of the transition departments, the
33administrative rules coordinator and the administrative rules
34review committee, in consultation with the administrative code
35editor, shall collectively develop a schedule for the necessary
-65-1updating of the Iowa administrative code.
2DIVISION XII
3NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY
4OF CARE RATE ADD-ON PROGRAM
5 Sec. 51. Section 249L.2, subsections 6 and 7, Code 2022, are
6amended by striking the subsections.
7 Sec. 52. Section 249L.2, subsection 8, Code 2022, is amended
8to read as follows:
98. “Nursing facility” means a licensed nursing facility as
10defined in section 135C.1 that is a freestanding facility or
11a nursing facility operated by a hospital licensed pursuant
12to chapter 135B, but does not include a distinct-part skilled
13nursing unit or a swing-bed unit operated by a hospital, or
14a nursing facility owned by the state or federal government
15or other governmental unit.“Nursing facility” includes a
16non-state government-owned nursing facility if the nursing
17facility participates in the non-state government-owned nursing
18facility quality of care rate add-on program.
19 Sec. 53. REPEAL. 2019 Iowa Acts, chapter 85, sections 103,
20104, and 108, are repealed.
21 Sec. 54. REPEAL. 2020 Iowa Acts, chapter 1063, section 390,
22is repealed.
23DIVISION XIII
24HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —
25ADMINISTRATION
26 Sec. 55. HEARING AID AND AUDIOLOGIC SERVICES FUNDING
27PROGRAM ADMINISTRATION. The Iowa department of public
28health shall not enter into a contract with a third party to
29administer the hearing aids and audiologic services funding
30program and shall adopt rules pursuant to chapter 17A to
31administer the program within the department, including but not
32limited to the administration of the application process, the
33determination of applicants’ eligibility, the enrollment of
34eligible applicants into the program, the maintenance of the
35hearing aids and audiologic services funding waitlist, and the
-66-1reimbursement of providers.
2DIVISION XIV
3HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —
4FY 2021-2022 NONREVERSION
5 Sec. 56. 2021 Iowa Acts, chapter 182, section 3, subsection
62, paragraph e, is amended to read as follows:
7e. Of the funds appropriated in this subsection, $156,000
8shall be used to provide audiological services and hearing
9aids for children. Notwithstanding section 8.33, moneys
10appropriated in this paragraph that remain unencumbered or
11unobligated at the close of the fiscal year shall not revert
12but shall remain available for expenditure for the purposes
13designated until the close of the succeeding fiscal year. The
14amount that does not revert shall be reported by the department
15to the general assembly.
16 Sec. 57. EFFECTIVE DATE. This division of this Act, being
17deemed of immediate importance, takes effect upon enactment.
18DIVISION XV
19ADMISSION OR TRANSFER OF PERSONS WITH A DIAGNOSIS OF AN
20INTELLECTUAL DISABILITY TO A STATE MENTAL HEALTH INSTITUTE
21 Sec. 58. Section 4.1, subsection 9A, Code 2022, is amended
22by striking the subsection and inserting in lieu thereof the
23following:
249A. “Intellectual disability” means a diagnosis of
25intellectual disability or intellectual developmental disorder,
26global developmental delay, or unspecified intellectual
27disability or intellectual developmental disorder which
28diagnosis shall be made only when the onset of the person’s
29condition was during the developmental period and based on an
30assessment of the person’s intellectual functioning and level
31of adaptive skills. A diagnosis of intellectual disability
32shall be made by a licensed psychologist or psychiatrist who
33is professionally trained to administer the tests required to
34assess intellectual functioning and to evaluate a person’s
35adaptive skills and shall be made in accordance with the
-67-1criteria provided in the current version of the diagnostic
2and statistical manual of mental disorders published by the
3American psychiatric association.
4 Sec. 59. Section 226.8, Code 2022, is amended to read as
5follows:
6226.8 Persons with a diagnosis of an intellectual disability
7not receivable — exception — admission or transfer to state
8mental health institute.
91. A Admission or transfer pursuant to section 222.7 to
10a state mental health institute of a person who has with a
11diagnosis of an intellectual disability, as defined in section
124.1, shall not be admitted, or transferred pursuant to section
13222.7, to a state mental health institute unless a professional
14diagnostic evaluation indicates that such only occur under the
15following conditions:
16a. If all of the following requirements are met:
17(1) The person has been determined by the state mental
18health institute to meet admission criteria for inpatient
19psychiatric care.
20(2) The state mental health institute has determined the
21person will benefit from psychiatric treatment or from some
22other specific program available at the state mental health
23institute to which it is proposed to admit or transfer the
24person.
25(3) There is sufficient capacity available at the state
26mental health institute to support the needs of the person.
27b. If determined appropriate for the person at the
28sole discretion of the director of human services, the
29administrator, or the director’s or administrator’s designee.
302. Charges for the care of any person with a diagnosis of
31 an intellectual disability admitted to a state mental health
32institute shall be made by the institute in the manner provided
33by chapter 230, but the liability of any other person to any
34county mental health and disability services region for the
35cost of care of such person with a diagnosis of an intellectual
-68-1disability shall be as prescribed by section 222.78.
2DIVISION XVI
3Colleges OF medicine and dentistry — residency — reports
4 Sec. 60. Section 262.9, Code 2022, is amended by adding the
5following new subsection:
6 NEW SUBSECTION. 39. Adopt a policy requiring that not less
7than seventy-five percent of the students who are accepted
8at the college of medicine in the doctor of medicine program
9and who are accepted at the college of dentistry at the state
10university of Iowa be residents of Iowa or persons who were,
11prior to applying to such college, enrolled in an eligible
12postsecondary institution as defined in section 261E.2.
13 Sec. 61. Section 263.2, Code 2022, is amended to read as
14follows:
15263.2 Degrees — reports.
161. A person shall not be admitted to courses of instruction
17in the university if the person has not completed the
18elementary instruction in such branches as are taught in the
19public or accredited nonpublic schools throughout the state.
202. Graduates of the university shall receive degrees or
21diplomas, or other evidences of distinction such as are usually
22conferred and granted by universities and are authorized by the
23state board of regents.
243. The state university of Iowa, in collaboration with the
25university hospitals and clinics, shall submit an annual report
26to the general assembly providing the following information:
27a. The states in which members of each graduating class
28from the college of dentistry and the college of medicine’s
29doctor of medicine program reside during the year immediately
30following graduation. The information shall be categorized
31by either residents of Iowa at the time of application to the
32college or nonresidents at the time of application to the
33college.
34b. The states in which the university of Iowa hospitals and
35clinics primary care and specialty residents reside in the year
-69-1following completion of medical residency and whether following
2residency such residents accepted fellowships. The information
3shall be categorized by primary care and the various areas of
4specialty, and shall specify whether the medical residents
5were residents of Iowa prior to applying for admission at an
6undergraduate college or university, received a baccalaureate
7degree from a postsecondary institution in Iowa, or graduated
8from a medical school in Iowa, whether or not the medical
9residents were residents of the state at the time of acceptance
10into the university of Iowa hospitals and clinics’ residency
11programs and, if any residents accepted fellowships following
12residency, the states in which the fellowships are offered and
13the areas of specialty under the fellowships.
14DIVISION XVII
15MEDICAL RESIDENCY POSITIONS AND AUDITION cLINICALS
16 Sec. 62. MEDICAL RESIDENCY POSITIONS AND AUDITION CLINICALS
17— MEDICAL STUDENTS AND APPLICANTS MEETING CERTAIN CRITERIA —
18ANNUAL REPORT.
191. The university of Iowa hospitals and clinics shall offer
20an interview for an available medical residency position to
21any applicant who has a residency specialty in obstetrics and
22gynecology, psychiatry, general surgery, emergency medicine,
23cardiology, neurology, or primary care and who also is a
24resident of Iowa, attended and earned an undergraduate degree
25from an Iowa college or university, or attended and earned a
26medical degree from a medical school in Iowa.
272. The university of Iowa hospitals and clinics shall
28provide the opportunity to a medical student attending a
29medical school in Iowa to participate in an audition clinical
30in the medical residency specialty for which the medical
31student applies to allow the university to constructively
32review the student in a clinical setting.
333. The university of Iowa hospitals and clinics shall submit
34a report to the governor and the general assembly by January
3515, annually, regarding the interviews and audition clinicals
-70-1as specified in this section during the prior fiscal year.
2Specifically, the report shall include for each interview or
3audition clinical the name of the student’s or applicant’s
4medical school, whether an applicant was offered and
5participated in an interview, whether the student was offered
6and participated in an audition clinical, whether the applicant
7was accepted for one of the residency program positions, and
8the total number of available residency positions filled by an
9applicant meeting the criteria under this section.
10DIVISION XVIII
11HEALTH CARRIERS — TELEHEALTH
12 Sec. 63. Section 514C.34, subsection 3, Code 2022, is
13amended to read as follows:
143. a. Health care services that are delivered by telehealth
15must be appropriate and delivered in accordance with applicable
16law and generally accepted health care practices and standards
17prevailing at the time the health care services are provided,
18including all rules adopted by the appropriate professional
19licensing board, pursuant to chapter 147, having oversight
20of the health care professional providing the health care
21services.
22b. A health carrier shall not exclude a health care
23professional who provides services for mental health
24conditions, illnesses, injuries, or diseases and who is
25physically located out-of-state from participating as a
26provider, via telehealth, under a policy, plan, or contract
27offered by the health carrier in the state if all of the
28following requirements are met:
29(1) The health care professional is licensed in this state
30by the appropriate professional licensing board and is able
31to deliver health care services for mental health conditions,
32illnesses, injuries, or diseases via telehealth in compliance
33with paragraph “a”.
34(2) The health care professional is able to satisfy the same
35criteria that the health carrier uses to qualify a health care
-71-1professional who is located in the state, and who holds the
2same license as the out-of-state professional, to participate
3as a provider, via telehealth, under a policy, plan, or
4contract offered by the health carrier in the state.
5 Sec. 64. EFFECTIVE DATE. This division of this Act, being
6deemed of immediate importance, takes effect upon enactment.
7 Sec. 65. APPLICABILITY. This division of this Act applies
8to health carriers that deliver, issue for delivery, continue,
9or renew a policy, contract, or plan in this state on or after
10the effective date of this Act.
11DIVISION XIX
12NURSING FACILITY CONSTRUCTION OR EXPANSION RELIEF
13 Sec. 66. Section 249K.2, subsection 4, Code 2022, is amended
14to read as follows:
154. “Major renovations” means construction or facility
16improvements to a nursing facility in which the total amount
17expended exceeds one million five seven hundred fifty thousand
18dollars.
19 Sec. 67. Section 249K.5, subsection 2, Code 2022, is amended
20by adding the following new paragraph:
21 NEW PARAGRAPH. c. The nursing facility for which relief
22or an exception is requested is proposing replacement or
23enhancement of an HVAC, as defined in section 105.2, system for
24improved infection control.
25 Sec. 68. ADMINISTRATIVE RULES — ADOPTION AND
26AMENDMENT. The department of human services shall adopt or
27amend rules pursuant to chapter 17A to administer this division
28of this Act. Specifically, the department shall amend rules
29relating to nursing facility additional requirements for all
30requests for the capital cost per diem instant relief add-on
31and enhanced nondirect care rate component limit to provide
32that with regard to the additional requirements a nursing
33facility must meet, the facility has Medicaid utilization at
34or above forty percent for the two-month period before the
35request for additional reimbursement is submitted. Medicaid
-72-1utilization for this purpose is calculated as total nursing
2facility Medicaid patient days divided by total in-house
3patient days as reported on the facility’s most current
4financial and statistical report.
5DIVISION XX
6Health Care providers — covid-19 and experimental treatments
7 Sec. 69. Section 144E.2, subsection 1, paragraphs a, c, and
8e, Code 2022, are amended to read as follows:
9a. Has a terminal illness, attested to by the patient’s a
10 treating physician, or is receiving mechanical ventilation to
11prolong life.
12c. Has received a recommendation from the individual’s a
13 physician for an investigational drug, biological product, or
14device.
15e. Has documentation from the individual’s a physician that
16the individual meets the requirements of this subsection.
17 Sec. 70. Section 144E.2, subsection 2, Code 2022, is amended
18to read as follows:
192. “Investigational drug, biological product, or device”
20means a any of the following:
21a. Adrug, biological product, or device that has
22successfully completed phase 1 of a United States food and drug
23administration-approved clinical trial but has not yet been
24approved for general use by the United States food and drug
25administration and remains under investigation in a United
26States food and drug administration-approved clinical trial.
27b. An off-label use of a drug.
28 Sec. 71. Section 144E.2, Code 2022, is amended by adding the
29following new subsection:
30 NEW SUBSECTION. 2A. “Off-label use of a drug” means
31the legal, prescribed use of a drug in a manner different
32from that described on the United States food and drug
33administration-approved drug label, including the use of a
34drug for a different disease or medical condition or giving
35a drug at a different dose or through a different route of
-73-1administration other than that approved by the United States
2food and drug administration.
3 Sec. 72. Section 144E.2, subsection 4, unnumbered paragraph
41, Code 2022, is amended to read as follows:
5“Written informed consent” means a written document that
6is signed by the patient, a parent of a minor patient, or a
7legal guardian or other legal representative of the patient and
8attested to by the patient’s a treating physician and a witness
9and that includes all of the following:
10 Sec. 73. Section 144E.2, subsection 4, paragraphs b and d,
11Code 2022, are amended to read as follows:
12b. An attestation that the patient concurs with the
13patient’s a treating physician in believing that all products
14and treatments approved by the United States food and drug
15administration are unlikely to prolong the patient’s life.
16d. A description of the best and worst potential outcomes
17of using the investigational drug, biological product, or
18device and a realistic description of the most likely outcome.
19The description shall include the possibility that new,
20unanticipated, different, or worse symptoms might result
21and that death could be hastened by use of the proposed
22investigational drug, biological product, or device. The
23description shall be based on the a treating physician’s
24knowledge of the proposed investigational drug, biological
25product, or device in conjunction with an awareness of the
26patient’s condition.
27 Sec. 74. Section 144E.4, Code 2022, is amended by adding the
28following new subsection:
29 NEW SUBSECTION. 5. This chapter does not create a duty
30for a hospital licensed under chapter 135B to credential any
31physician.
32 Sec. 75. Section 144E.8, subsection 1, Code 2022, is amended
33to read as follows:
341. This chapter shall not create a private cause of
35action against a manufacturer of an investigational drug,
-74-1biological product, or device, against a physician, health care
2practitioner, or facility that provides necessary follow-up
3care, or against any other person or entity involved in the
4care of an eligible patient using the investigational drug,
5biological product, or device for any harm done to the eligible
6patient resulting from the investigational drug, biological
7product, or device, if the manufacturer or other person or
8entity is complying in good faith with the terms of this
9chapter and has exercised reasonable care.
10 Sec. 76. Section 144E.9, Code 2022, is amended to read as
11follows:
12144E.9 Assisting suicide.
13This chapter shall not be construed to allow a patient’s
14treating physician to assist the a patient in committing or
15attempting to commit suicide as prohibited in section 707A.2.
16 Sec. 77. Section 686D.6, Code 2022, is amended to read as
17follows:
18686D.6 Liability of and disciplinary actions against health
19care providers.
201. A health care provider shall not be liable for civil
21damages or subject to disciplinary action by the health
22care provider’s licensing board for causing or contributing,
23directly or indirectly, to the death or injury of an individual
24as a result of the health care provider’s acts or omissions
25while providing or arranging health care in support of the
26state’s response to COVID-19. This subsection shall apply to
27all of the following:
28a. Injury or death resulting from screening, assessing,
29diagnosing, caring for, or treating individuals with a
30suspected or confirmed case of COVID-19.
31b. Prescribing, administering, or dispensing a
32pharmaceutical for off-label use to treat a patient with a
33suspected or confirmed case of COVID-19.
34c. Acts or omissions while providing health care to
35individuals unrelated to COVID-19 when those acts or omissions
-75-1support the state’s response to COVID-19, including any of the
2following:
3(1) Delaying or canceling nonurgent or elective dental,
4medical, or surgical procedures, or altering the diagnosis or
5treatment of an individual in response to any federal or state
6statute, regulation, order, or public health guidance.
7(2) Diagnosing or treating patients outside the normal
8scope of the health care provider’s license or practice.
9(3) Using medical devices, equipment, or supplies outside
10of their normal use for the provision of health care, including
11using or modifying medical devices, equipment, or supplies for
12an unapproved use.
13(4) Conducting tests or providing treatment to any
14individual outside the premises of a health care facility.
15(5) Acts or omissions undertaken by a health care provider
16because of a lack of staffing, facilities, medical devices,
17equipment, supplies, or other resources attributable to
18COVID-19 that renders the health care provider unable to
19provide the level or manner of care to any person that
20otherwise would have been required in the absence of COVID-19.
21(6) Acts or omissions undertaken by a health care provider
22relating to use or nonuse of personal protective equipment.
232. This section shall not relieve any person of liability
24for civil damages or a health care provider from disciplinary
25action by the health care provider’s licensing board for any
26act or omission which constitutes recklessness or willful
27misconduct.
28 Sec. 78. EFFECTIVE DATE. This division of this Act, being
29deemed of immediate importance, takes effect upon enactment.
30DIVISION XXI
31Health-related data
32 Sec. 79. Section 11.41, subsection 3, Code 2022, is amended
33to read as follows:
343. If the information, records, instrumentalities, and
35properties sought by the auditor of state are required by law
-76-1to be kept confidential, the auditor of state shall have access
2to the information, records, instrumentalities, and properties,
3but shall maintain the confidentiality of all such information
4and is subject to the same penalties as the lawful custodian
5of the information for dissemination of the information.
6However, the auditor of state shall not have access to the
7income tax returns of individuals or to an individual’s name
8or residential address from a reportable disease report under
9section 139A.3.
10 Sec. 80. Section 135.166, subsection 2, Code 2022, is
11amended to read as follows:
122. Unless otherwise authorized or required by state or
13federal law, data collected under this section shall not
14include the social security number or name of the individual
15subject of the data.
16 Sec. 81. Section 139A.3, Code 2022, is amended by adding the
17following new subsection:
18 NEW SUBSECTION. 1A. A state or local agency employee
19or agent shall not have access to personally identifiable
20information included in a reportable disease report provided
21to or maintained by the department, a local board, or a local
22department, unless the employee or agent has completed data
23confidentiality training.
24DIVISION XXII
25Psychiatry residency program
26 Sec. 82. NEW SECTION. 135.180 State-funded psychiatry
27residency program — fund — appropriations.
281. The university of Iowa hospitals and clinics shall
29administer a state-funded psychiatry residency program
30in cooperation with the state mental health institutes at
31Independence and Cherokee, the state resource centers at
32Glenwood and Woodward, the state training school at Eldora,
33and the Iowa medical and classification center at Oakdale.
34The university of Iowa hospitals and clinics shall expand the
35psychiatry residency program to provide additional residency
-77-1positions by providing financial support for residency
2positions which are in excess of the federal residency cap
3established by the federal Balanced Budget Act of 1997, Pub.L.
4No.105-33. Participating residents shall complete a portion
5of their psychiatry training at one of the state mental health
6institutes, the state resource centers, the state training
7school, or the Iowa medical and classification center at
8Oakdale. For accreditation-required clinical experiences not
9available at the state mental health institutes, the state
10resource centers, the state training school, or the Iowa
11medical and classification center at Oakdale, the psychiatry
12residency program and its residents may utilize clinical
13rotations at the university of Iowa hospitals and clinics and
14its affiliates across the state.
152. The residency program shall provide for the awarding
16of twelve residency positions for each class of residents.
17Preference in the awarding of residency positions shall
18be given to candidates who are residents of Iowa, attended
19and earned an undergraduate degree from an Iowa college or
20university, or attended and earned a medical degree from a
21medical school in Iowa.
223. A psychiatry residency program fund is created in
23the state treasury consisting of the moneys appropriated or
24credited to the fund by law. Notwithstanding section 8.33,
25moneys in the fund at the end of each fiscal year shall not
26revert to any other fund but shall remain in the psychiatry
27residency program fund for use in subsequent fiscal years.
28Moneys in the fund are appropriated to the university of Iowa
29hospitals and clinics to be used for the purposes of the
30program. For fiscal years beginning on or after July 1, 2023,
31there is appropriated from the general fund of the state to the
32psychiatry residency program fund the following amounts to be
33used for the purposes of the program:
34a. For the fiscal year beginning July 1, 2023, one million
35two hundred thousand dollars.
-78- 1b. For the fiscal year beginning July 1, 2024, two million
2four hundred thousand dollars.
3c. For the fiscal year beginning July 1, 2025, three million
4six hundred thousand dollars.
5d. For the fiscal year beginning July 1, 2026, and each
6fiscal year thereafter, four million eight hundred thousand
7dollars.
pf/rn/md