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House File 613 - IntroducedA Bill ForAn Act 1relating to public assistance program integrity, making
2appropriations, and including effective date provisions.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2Authentication system for public assistance programs
3 Section 1. NEW SECTION. 239.1 Definitions.
4As used in this chapter, unless the context otherwise
5requires:
61. “Applicant” means an individual who is applying for
7public assistance benefits in the state.
82. “Asset” means the following assets of the members of the
9applicant’s household:
10a. All liquid assets.
11b. All other personal property excluding one vehicle and
12the fair market value in excess of ten thousand dollars of an
13additional vehicle.
143. “Asset test” means the comparison of the collective
15value of all countable assets of the members of the applicant’s
16household to the maximum allowed household asset limit of
17fifteen thousand dollars.
184. “Department” means the department of health and human
19services.
205. “Public assistance” means the supplemental nutrition
21assistance program or SNAP, the medical assistance program
22or Medicaid program as defined in section 249A.2, the family
23investment program as defined in section 239B.1, and the
24children’s health insurance program.
256. “Real-time eligibility system” means real-time electronic
26access to a system that allows verification of all applicable
27public assistance program eligibility information based on the
28most recent information available to the department through
29nonmodeled earned and unearned income, such as commercially
30available wage data.
317. “Recipient” means an individual who is receiving public
32assistance benefits in the state.
338. “Supplemental nutrition assistance program” or “SNAP”
34means benefits provided by the federal program administered
35through 7 C.F.R. pts.270 – 283, as amended.
-1-1 Sec. 2. NEW SECTION. 239.2 Supplemental nutrition
2assistance program — income eligibility.
3The department shall establish the gross countable monthly
4income threshold for the supplemental nutrition assistance
5program at less than or equal to one hundred sixty percent of
6the federal poverty level for the household size.
7 Sec. 3. NEW SECTION. 239.3 Identity authentication —
8rules.
9Unless otherwise prohibited by federal law or regulation,
10prior to the department awarding public assistance benefits, an
11applicant shall complete a computerized identity authentication
12process to confirm the identity of the applicant. Identity
13authentication shall be accomplished through a knowledge-based
14questionnaire consisting of financial and personal questions.
15The questionnaire shall contain questions tailored to assist
16persons without a bank account or those who have poor access
17to financial and banking services or who do not have an
18established credit history. The computerized identity
19authentication process and questionnaire may be completed and
20submitted online, in person, or via telephone by the applicant
21or a person authorized by the applicant. The department may
22adopt rules pursuant to chapter 17A to administer this section.
23 Sec. 4. NEW SECTION. 239.4 Asset test for supplemental
24nutrition assistance program.
251. For the purposes of determining eligibility for receipt
26of SNAP benefits, the department shall conduct an asset test
27on all members of the applicant’s household. The allowable
28financial resources to be included in or excluded from a
29determination of eligibility for SNAP shall be those specified
30in 7 U.S.C.§2014(g)(l), to the extent consistent with the term
31“asset” as defined in this chapter.
322. Prior to determining eligibility for SNAP benefits,
33the department shall access, at a minimum, for every member
34of the applicant’s household, the following information from
35the following federal, state, and miscellaneous sources, or
-2-1successor sources:
2a. Federal sources and information:
3(1) Earned and unearned income information maintained by
4the internal revenue service.
5(2) The following sources and information maintained by the
6United States social security administration:
7(a) Earned income information.
8(b) Death register information.
9(c) Prisoner or incarceration status information.
10(d) Supplemental security income information maintained in
11the state data exchange database.
12(e) Beneficiary records and earnings information maintained
13in the beneficiary and earnings data exchange database.
14(f) Earnings information maintained in the beneficiary
15earnings exchange record system database.
16(3) Income and employment information maintained in the
17national directory of new hires database by the office of child
18support enforcement of the administration for children and
19families.
20b. State sources and information:
21(1) The department’s sources and information including but
22not limited to all of the following:
23(a) Income and employment information maintained by the
24child support recovery unit.
25(b) Child care assistance information maintained by the
26department.
27(c) Enrollment status in other public assistance programs.
28(2) The department of workforce development sources and
29information including all of the following:
30(a) Employment information.
31(b) Employer weekly, monthly, and quarterly reports of
32income and unemployment insurance payments.
33c. Miscellaneous sources:
34(1) Any existing real-time database of persons currently
35receiving benefits in other states, such as the national
-3-1accuracy clearinghouse.
2(2) Any lottery winner databases maintained by the Iowa
31ottery.
4(3) Any existing real-time eligibility system that includes
5employment and income information maintained by a consumer
6reporting agency, as defined by the federal Fair Credit
7Reporting Act, 15 U.S.C. §1681a, for the purpose of obtaining
8real-time employment and income information.
93. Prior to determining eligibility for SNAP benefits, the
10department shall access information for every member of the
11applicant’s household from the following public records:
12a. A nationwide public records data source of physical asset
13ownership. The data source may include but is not limited to
14real property, automobiles, watercraft, aircraft, and luxury
15vehicles, or any other vehicle owned by the applicant.
16b. National and state financial institutions in order
17to locate undisclosed depository accounts or verify account
18balances of disclosed accounts.
194. The department shall enter into a memorandum of
20understanding with any department, division, bureau, section,
21unit, or any other subunit of a department to obtain the
22information specified in this section.
235. The provisions of this section shall not apply if every
24member of the applicant’s household receives supplemental
25security income.
26 Sec. 5. NEW SECTION. 239.5 Verification and authentication
27systems — public assistance programs.
281. No later than July 1, 2025, the department shall
29redesign an existing system; establish a new computerized
30income, asset, and identity eligibility verification system;
31or contract with a third-party vendor to provide for identity
32verification, identity authentication, asset verification, and
33dual enrollment prevention in order to deter waste, fraud, and
34abuse in each public assistance program administered by the
35department.
-4- 12. The department may contract with a third-party vendor
2to develop or provide a service for a real-time eligibility
3system that allows the department to verify or authenticate
4income, assets, and identity eligibility of applicants and
5recipients to prevent fraud, misrepresentation, and inadequate
6documentation when determining eligibility for public
7assistance programs. The system shall be accessed prior to
8determining eligibility, periodically between eligibility
9redeterminations, and during eligibility redeterminations
10and reviews. The department may also contract with a
11third-party vendor to provide information to facilitate
12reviews of recipient eligibility conducted by the department.
13Specifically, the department may contract with a third-party
14consumer reporting agency, as defined by the federal Fair
15Credit Reporting Act, 15 U.S.C. §1681a, for the purpose of
16obtaining real-time employment and income information.
173. A contract entered into under this section shall provide,
18at a minimum, for all of the following:
19a. The establishment of the annual savings amount from
20utilization of the system or service, and a provision that the
21contract may be terminated contingent upon the savings not
22exceeding the total yearly cost to the state for utilization of
23the system or service.
24b. That the contract shall not preclude the department
25from continuing to conduct additional eligibility verification
26or authentication processes, to receive, review, or verify
27additional information related to the eligibility of an
28individual, or from contracting with a third-party vendor to
29provide additional eligibility authentication or verification
30information.
314. The department shall seek federal approval as necessary
32to implement and administer this section.
33 Sec. 6. PROGRAM REPORT. The department of health and human
34services shall submit a report to the governor and the general
35assembly by January 15, 2025, and by January 15 annually
-5-1thereafter through January 15, 2030, detailing the impact of
2the identity authentication measures taken under this division
3of this Act.
4DIVISION II
5SUPPLEMENTAL NUTRITION assistance PROGRAM and medicaid program
6integrity and cooperation
7 Sec. 7. Section 234.1, subsection 3, Code 2023, is amended
8by striking the subsection.
9 Sec. 8. Section 234.1, Code 2023, is amended by adding the
10following new subsections:
11 NEW SUBSECTION. 3A. “Department” means the department of
12health and human services.
13 NEW SUBSECTION. 5A. “Supplemental nutrition assistance
14program” or “SNAP” means the same as defined in section 239.1.
15 Sec. 9. Section 234.12A, Code 2023, is amended to read as
16follows:
17234.12A Electronic benefits transfer program.
181. The department of human services shall maintain an
19electronic benefits transfer program utilizing electronic funds
20transfer systems for the food supplemental nutrition assistance
21program. The electronic benefits transfer program implemented
22under this section shall not require a retailer to make cash
23disbursements or to provide, purchase, or upgrade electronic
24funds transfer system equipment as a condition of participation
25in the program.
262. A point-of-sale terminal which is used only for purchases
27from a retailer by electronic benefits transfer utilizing
28electronic funds transfer systems is not a satellite terminal
29as defined in section 527.2.
303. For the purposes of this section, “retailer” means
31a business authorized by the United States department of
32agriculture to accept food supplemental nutrition assistance
33program benefits.
34 Sec. 10. NEW SECTION. 234.12B Ensuring integrity in the
35supplemental nutrition assistance program — rules.
-6- 11. State records — individuals. The department shall
2receive and review all of the following information concerning
3individuals enrolled in the supplemental nutrition assistance
4program that indicates a change in circumstances that may
5affect eligibility:
6a. Death records. On at least a daily basis, information
7from the department including but not limited to death records.
8b. Employment information. On at least a semimonthly
9basis, information from the department of workforce development
10including but not limited to changes in employment or wages.
11c. Residency information. On at least a monthly basis,
12information to confirm Iowa residency or to identify potential
13changes in Iowa residency as identified through an automated
14search process of a database of addresses.
15d. Incarceration information. On at least a monthly basis,
16information from the department of corrections.
172. State records — households — unemployment
18information. The department shall receive and review on at
19least a semimonthly basis, information from the department of
20workforce development including but not limited to potential
21changes in employment, income, or assets that indicate a change
22in circumstances that may affect eligibility.
233. Federal records — households. The department shall
24cross-check information relating to individuals in households
25enrolled in the supplemental nutrition assistance program with
26federal databases including but not limited to all of the
27following, on at least a monthly basis:
28a. Earned income information, death register information,
29incarceration records, supplemental security income
30information, beneficiary records, and earnings information
31maintained by the United States social security administration.
32b. Income and employment information maintained in the
33national directory of new hires database and child support
34enforcement data maintained by the United States department of
35health and human services.
-7- 1c. National fleeing felon information maintained by the
2United States federal bureau of investigation.
34. Rules. The department may adopt rules pursuant to
4chapter 17A to administer this section.
5 Sec. 11. NEW SECTION. 234.12C Required employment
6and training for supplemental nutrition assistance program
7eligibility.
8The department shall require all able-bodied adults without
9dependents to participate in mandatory employment and training
10as a condition of eligibility for supplemental nutrition
11assistance program benefits.
12 Sec. 12. NEW SECTION. 249A.58 Ensuring integrity in the
13medical assistance program — recipient and applicant information
14reviewed — rules.
151. State records — recipients. The department shall
16receive and review all of the following information concerning
17recipients that indicates a change in circumstances that may
18affect eligibility:
19a. Death records. On at least a daily basis, information
20from the department including but not limited to death records.
21b. Employment information. On at least a semimonthly
22basis, information from the department of workforce development
23including but not limited to changes in employment or wages.
24c. Residency information. On at least a monthly basis,
25information to confirm Iowa residency or to identify potential
26changes in Iowa residency as identified through an automated
27search process of a database of addresses.
28d. Unemployment information. On at least a semimonthly
29basis, information from the department of workforce development
30including but not limited to potential changes in employment,
31income, or assets.
322. Federal records — recipients. The department shall
33cross-check information relating to recipients with federal
34databases including but not limited to all of the following, on
35at least a monthly basis:
-8- 1a. Earned income information, death register information,
2incarceration records, supplemental security income
3information, beneficiary records, and earnings information
4maintained by the United States social security administration.
5b. Income and employment information maintained by the
6national directory of new hires database and child support
7enforcement data maintained by the United States department of
8health and human services.
9c. National fleeing felon information maintained by the
10United States federal bureau of investigation.
113. Real-time record review — applicants. Prior to
12determining the eligibility of an applicant subject to an asset
13test for Medicaid, the department shall access information
14for every member of the applicant’s household from the data
15sources specified in this section and shall conduct a review
16of nationwide public records data sources of physical asset
17ownership. The nationwide public records data sources may
18include but are not limited to records of real property and
19automobiles, watercraft, aircraft, luxury vehicles, and any
20other vehicles owned by the applicant.
214. Rules. The department may adopt rules pursuant to
22chapter 17A to administer this section.
23 Sec. 13. NEW SECTION. 249A.59 Cooperation with child
24support services.
251. Unless exempt pursuant to state or federal law or
26regulation, an applicant for or recipient of medical assistance
27shall be required to cooperate with child support services as a
28condition of eligibility.
292. The department shall adopt rules pursuant to chapter 17A
30to administer this section.
31 Sec. 14. MEDICAID — REASONABLE COMPATIBILITY STANDARD
32INCOME THRESHOLD — DETERMINATION OF ELIGIBILITY. The
33department of health and human services shall reduce the
34reasonable compatibility income threshold standard from ten
35percent to five percent when the department is determining
-9-1eligibility for medical assistance, and shall continue to
2utilize income data sources as a tool in the eligibility
3determination process. The department of health and human
4services shall request any federal approval necessary,
5including any Medicaid state plan amendment or waiver, to
6administer this section.
7DIVISION III
8iowa health and wellness plan — reenrollment
9 Sec. 15. IOWA HEALTH AND WELLNESS PLAN — MEMBER
10REENROLLMENT FOLLOWING TERMINATION FOR NONPAYMENT OF MONTHLY
11CONTRIBUTIONS. The department of health and human services
12shall seek approval of an amendment to the section 1115
13demonstration waiver for the Iowa health and wellness plan from
14the centers for Medicare and Medicaid services of the United
15States department of health and human services to provide the
16following:
171. An Iowa health and wellness plan member who is not
18otherwise exempt from payment of a monthly contribution, who
19is subject to payment of a monthly contribution as the result
20of failure to complete required healthy behaviors, and whose
21eligibility for the program is terminated due to nonpayment
22of monthly contributions, shall be allowed to subsequently
23reenroll in the program without first paying any outstanding
24monthly contributions, if the member has not been terminated
25from the program previously for nonpayment of monthly
26contributions.
272. Following an initial termination from the Iowa health
28and wellness plan pursuant to subsection 1, if an Iowa health
29and wellness plan member is subsequently terminated from the
30program pursuant to subsection 1 for nonpayment of monthly
31contributions, the member shall be subject to payment of any
32outstanding monthly contributions accrued since the subsequent
33termination not to exceed the aggregate annual copayment and
34monthly contribution limits prior to reenrollment in the
35program.
-10- 13. This section shall not apply to an Iowa health and
2wellness plan member who is deemed to be in substantial
3compliance with the healthy behaviors requirement to complete a
4wellness examination by providing proof of a scheduled wellness
5examination appointment, if the appointment is scheduled
6no later than ninety days beyond the end of the applicable
7enrollment period.
8DIVISION IV
9MEDICAID DEMONSTRATION WAIVER REQUEST — IOWA HEALTH AND
10WELLNESS PLAN
11 Sec. 16. MEDICAID DEMONSTRATION WAIVER REQUEST — COMMUNITY
12ENGAGEMENT REQUIREMENTS FOR IOWA HEALTH AND WELLNESS PLAN
13MEMBERS.
141. The department of health and human services shall submit
15a request by July 1, 2023, and annually by July 1 thereafter
16until federal approval is received from the centers for
17Medicare and Medicaid services of the United States department
18of health and human services, for a section 1115 demonstration
19waiver to require that as a condition of eligibility, Iowa
20health and wellness plan members participate in community
21engagement activities.
222. The waiver request submitted by the department shall
23require that, unless an individual is exempt pursuant to
24subsection 3, as a condition of eligibility for the Iowa health
25and wellness plan, a recipient shall do one of the following:
26a. Work twenty hours or more per week, averaged on a monthly
27basis.
28b. Participate in and comply with the requirements of a work
29program for twenty hours or more per week, as determined by the
30department.
31c. Volunteer twenty hours or more per week, as determined
32by the department.
33d. Meet a combination of work and work program participation
34requirements for a total of twenty hours or more per week, as
35determined by the department.
-11- 1e. Participate in and comply with the PROMISE JOBS program
2pursuant to chapter 239B.
33. The following individuals shall be exempt from the
4requirements specified in subsection 2:
5a. An individual medically certified as physically or
6mentally unfit for employment.
7b. A woman who is pregnant.
8c. A parent or caretaker responsible for the care of a
9dependent child under six years of age.
10d. A parent or caretaker personally providing the care for a
11dependent child with a serious medical condition or disability,
12as determined by the department.
13e. An individual receiving unemployment compensation and
14complying with work requirements of the federal or state
15unemployment compensation system.
16f. An individual participating in a substance use disorder
17treatment and rehabilitation program.
184. The department shall implement the Medicaid waiver upon
19receipt of federal approval and shall adopt rules pursuant to
20chapter 17A to administer the waiver provisions.
21DIVISION V
22SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM — ELIGIBLE FOODS
23 Sec. 17. SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM —
24INELIGIBLE FOODS. The department of health and human services
25shall request a waiver from the food and nutrition service of
26the United States department of agriculture to provide that
27for the purposes of state administration of the supplemental
28food and nutrition program, eligible foods as defined in 7
29C.F.R.§271.2 do not include candy and non-sugar-free soda.
30The department of health and human services shall implement the
31waiver upon receipt of approval of the waiver.
32 Sec. 18. DEPARTMENT OF HEALTH AND HUMAN SERVICES — DOUBLE
33UP FOOD BUCKS PROGRAM — SUPPLEMENTAL APPROPRIATION. There
34is appropriated from the general fund of the state to the
35department of health and human services for the fiscal year
-12-1beginning July 1, 2023, and ending June 30, 2024, in addition
2to any other funding appropriated for such purposes for the
3same fiscal year, the following amount or so much thereof as is
4necessary, to be used for the purposes designated:
5To provide grants to support the double up food bucks
6program administered by the Iowa healthiest state initiative
7to make fresh fruits and vegetables sold at farmers markets,
8grocery stores, and other participating locations accessible
9to individuals and families who reside in this state and
10receive assistance through the federal supplemental nutrition
11assistance program:
.................................................. $121,000,000
13A grant recipient that receives funding pursuant to this
14section shall provide at least a dollar-for-dollar match of the
15grant assistance.
16Notwithstanding section 8.33, moneys appropriated under this
17section shall not revert at the close of the fiscal year, but
18shall remain available for the purposes designated.
19 Sec. 19. CONTINGENT EFFECTIVE DATE. The following takes
20effect on the date the department of health and human services
21receives federal approval of the waiver request relating to
22supplemental nutrition assistance program ineligible foods as
23specified under this division of this Act, if the waiver is
24approved:
25The section of this division of this Act making a
26supplemental appropriation to the department of health and
27human services to provide grants to support the double up food
28bucks program.
29DIVISION VI
30Implementation provisions
31 Sec. 20. IMPLEMENTATION PROVISIONS.
321. The department of health and human services shall request
33federal approval including for any state plan amendment or
34waiver necessary to administer this Act.
352. If the department of health and human services determines
-13-1that any provision of this Act would result in the denial
2of funds or services from the federal government that would
3otherwise be available or would be inconsistent with the
4requirements of federal law or regulation, such provision shall
5be suspended, but only to the extent necessary to eliminate the
6inconsistency with federal requirements.
73. Unless otherwise provided in a division of this Act, the
8department of health and human services shall implement the
9provisions of this Act in an incremental fashion, beginning
10July 1, 2023, with a goal of full implementation no later
11than June 30, 2025, to minimize duplication of efforts and to
12maximize coordination with the implementation time frames of
13other departmental resource enhancements.
144. The provisions of this Act requiring federal approval
15shall be implemented upon receipt of federal approval.
165. The provisions of this Act not requiring federal approval
17shall be implemented as specified in this Act, or if not
18specified in this Act, no later than June 30, 2025.
19EXPLANATION
20The inclusion of this explanation does not constitute agreement with
21the explanation’s substance by the members of the general assembly.
22This bill relates to various public assistance programs.
23DIVISION I. This division establishes the income threshold
24for the supplemental nutrition assistance program (SNAP) at
25less than or equal to 160 percent of the federal poverty level.
26The division also requires that prior to the department of
27health and human services (HHS) awarding public assistance
28benefits to an applicant, the applicant shall complete a
29computerized identity authentication process to confirm the
30identity of the applicant through the use of a knowledge-based
31questionnaire consisting of financial and personal questions
32tailored to assist persons without a bank account or those
33who have poor access to financial and banking services or who
34do not have an established credit history. The computerized
35identity authentication process and questionnaire may be
-14-1submitted online, in person, or via telephone by the applicant
2or a person authorized by the applicant. The bill also
3requires HHS to conduct an asset test on all members of
4the household of an applicant for SNAP benefits. The bill
5specifies the minimum information, federal, state, and other
6data sources, and public records that HHS must access prior to
7determining eligibility for an applicant’s SNAP benefits. The
8bill requires HHS to enter into a memorandum of understanding
9with any department or subunit of a department to obtain the
10information specified. The bill’s provisions do not apply if
11every member of the applicant’s household receives supplemental
12security income.
13The bill provides that no later than July 1, 2025, HHS
14shall redesign an existing system, establish a new identity
15eligibility verification system, or contract with a third-party
16vendor to provide verification, authentication, and dual
17enrollment prevention systems for public assistance programs.
18The department may also contract with a third-party vendor
19to develop or provide a real-time eligibility system. All
20contracts are subject to minimum requirements specified in the
21bill.
22The bill authorizes HHS to adopt administrative rules to
23administer the bill and requires HHS to submit an annual report
24to the governor and the general assembly to assess the impact
25of the bill.
26DIVISION II. This division relates to SNAP and Medicaid
27program integrity by requiring HHS to, within specified time
28frames, receive and review state and federal information
29from various entities concerning individuals or individuals
30in households enrolled in SNAP or the Medicaid program
31that indicates a change in circumstances that may affect
32eligibility. The information relates to death, employment,
33residency, incarceration, and unemployment information.
34Additionally, the bill requires HHS to cross-check information
35relating to individuals in households enrolled in SNAP or
-15-1the Medicaid program, as applicable, with specified federal
2databases. With regard to the Medicaid program only, the bill
3also requires that prior to determining eligibility for the
4Medicaid program, HHS shall access information for every member
5of an applicant’s household from the data sources outlined in
6the bill and conduct a review of nationwide public records data
7sources of physical asset ownership. The bill also requires
8an applicant for Medicaid benefits to cooperate with child
9support services as a condition of eligibility as specified
10under federal law.
11The bill requires HHS to use a reasonable compatibility
12standard threshold of 5 percent rather than 10 percent in
13determining eligibility for Medicaid.
14DIVISION III. This division requires HHS to seek federal
15approval of an amendment to the section 1115 demonstration
16waiver for the Iowa health and wellness plan to provide both
17of the following: (1) that an Iowa health and wellness
18plan member who is not otherwise exempt from payment of a
19monthly contribution, who is subject to payment of a monthly
20contribution as the result of failure to complete required
21healthy behaviors, and whose eligibility for the program is
22terminated due to nonpayment of monthly contributions, shall be
23allowed to subsequently reenroll in the program without first
24paying any outstanding monthly contributions, if the member has
25not been terminated from the program previously for nonpayment
26of monthly contributions, and (2) following an initial
27termination from the Iowa health and wellness plan, if an Iowa
28health and wellness plan member is subsequently terminated
29from the program for nonpayment of monthly contributions, the
30member shall be subject to payment of any outstanding monthly
31contributions accrued since the subsequent termination not to
32exceed program limits prior to reenrollment in the program.
33The bill does not apply to an Iowa health and wellness plan
34member who is deemed to be in substantial compliance with the
35requirement to complete a wellness examination by providing
-16-1proof of a scheduled examination appointment if the appointment
2is scheduled no later than 90 days beyond the end of the
3applicable enrollment period.
4DIVISION IV. This division requires HHS to submit a
5request for federal approval by July 1, 2023, and annually
6by July 1 thereafter until federal approval is received, for
7a waiver to require that as a condition of eligibility, Iowa
8health and wellness plan members participate in community
9engagement activities. The bill specifies the types of
10community engagement activities to be required under the waiver
11submitted and provides exceptions to required participation
12in community engagement activities. The bill directs HHS to
13implement the waiver upon receipt of federal approval and to
14adopt administrative rules to administer the waiver provisions.
15DIVISION V. This division requires HHS to request a waiver
16from the United States department of agriculture, food and
17nutrition service, to provide that eligible foods under
18the state administration of SNAP do not include candy and
19non-sugar-free soda. The department is directed to implement
20the waiver upon receipt of approval of the waiver.
21The division also relates to the double up food bucks program
22by making a supplemental appropriation from the general fund of
23the state to HHS for fiscal year 2023-2024, in addition to any
24other funding appropriated for such purpose for the same fiscal
25year, to provide grants to support the double up food bucks
26program administered by the Iowa healthiest state initiative
27to make fresh fruits and vegetables sold at farmers markets,
28grocery stores, and other participating locations accessible to
29individuals and families who reside in this state and receive
30assistance through SNAP. The division requires a double
31up food bucks program grant recipient to provide at least
32a dollar-for-dollar match of the grant assistance. Moneys
33appropriated under the division do not revert at the close of
34the fiscal year but remain available for the purposes of the
35double up food bucks program.
-17- 1The supplemental appropriation for the double up food bucks
2program takes effect on the date HHS receives federal approval
3of the SNAP waiver, if the waiver is approved.
4DIVISION VI. This division provides implementation
5provisions for the bill. The bill requires HHS to request
6federal approval including for any state plan amendment or
7waiver necessary to administer the bill. If HHS determines
8that any provision of the bill would result in the denial
9of funds or services from the federal government that would
10otherwise be available or would be inconsistent with the
11requirements of federal law or regulation, such provision shall
12be suspended, but only to the extent necessary to eliminate
13the inconsistency with federal requirements. Unless otherwise
14provided in the bill, HHS shall implement the provisions of the
15bill in an incremental fashion, beginning July 1, 2023, with
16a goal of full implementation no later than June 30, 2025, to
17minimize duplication of efforts and to maximize coordination
18with the implementation time frames of other departmental
19resource enhancements. The provisions of the bill requiring
20federal approval shall be implemented upon receipt of federal
21approval. The provisions of the bill not requiring federal
22approval shall be implemented as specified in the bill, and
23if it not specified in the bill, then not later than June 30,
242025.
-18-pf/rh
2appropriations, and including effective date provisions.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2Authentication system for public assistance programs
3 Section 1. NEW SECTION. 239.1 Definitions.
4As used in this chapter, unless the context otherwise
5requires:
61. “Applicant” means an individual who is applying for
7public assistance benefits in the state.
82. “Asset” means the following assets of the members of the
9applicant’s household:
10a. All liquid assets.
11b. All other personal property excluding one vehicle and
12the fair market value in excess of ten thousand dollars of an
13additional vehicle.
143. “Asset test” means the comparison of the collective
15value of all countable assets of the members of the applicant’s
16household to the maximum allowed household asset limit of
17fifteen thousand dollars.
184. “Department” means the department of health and human
19services.
205. “Public assistance” means the supplemental nutrition
21assistance program or SNAP, the medical assistance program
22or Medicaid program as defined in section 249A.2, the family
23investment program as defined in section 239B.1, and the
24children’s health insurance program.
256. “Real-time eligibility system” means real-time electronic
26access to a system that allows verification of all applicable
27public assistance program eligibility information based on the
28most recent information available to the department through
29nonmodeled earned and unearned income, such as commercially
30available wage data.
317. “Recipient” means an individual who is receiving public
32assistance benefits in the state.
338. “Supplemental nutrition assistance program” or “SNAP”
34means benefits provided by the federal program administered
35through 7 C.F.R. pts.270 – 283, as amended.
-1-1 Sec. 2. NEW SECTION. 239.2 Supplemental nutrition
2assistance program — income eligibility.
3The department shall establish the gross countable monthly
4income threshold for the supplemental nutrition assistance
5program at less than or equal to one hundred sixty percent of
6the federal poverty level for the household size.
7 Sec. 3. NEW SECTION. 239.3 Identity authentication —
8rules.
9Unless otherwise prohibited by federal law or regulation,
10prior to the department awarding public assistance benefits, an
11applicant shall complete a computerized identity authentication
12process to confirm the identity of the applicant. Identity
13authentication shall be accomplished through a knowledge-based
14questionnaire consisting of financial and personal questions.
15The questionnaire shall contain questions tailored to assist
16persons without a bank account or those who have poor access
17to financial and banking services or who do not have an
18established credit history. The computerized identity
19authentication process and questionnaire may be completed and
20submitted online, in person, or via telephone by the applicant
21or a person authorized by the applicant. The department may
22adopt rules pursuant to chapter 17A to administer this section.
23 Sec. 4. NEW SECTION. 239.4 Asset test for supplemental
24nutrition assistance program.
251. For the purposes of determining eligibility for receipt
26of SNAP benefits, the department shall conduct an asset test
27on all members of the applicant’s household. The allowable
28financial resources to be included in or excluded from a
29determination of eligibility for SNAP shall be those specified
30in 7 U.S.C.§2014(g)(l), to the extent consistent with the term
31“asset” as defined in this chapter.
322. Prior to determining eligibility for SNAP benefits,
33the department shall access, at a minimum, for every member
34of the applicant’s household, the following information from
35the following federal, state, and miscellaneous sources, or
-2-1successor sources:
2a. Federal sources and information:
3(1) Earned and unearned income information maintained by
4the internal revenue service.
5(2) The following sources and information maintained by the
6United States social security administration:
7(a) Earned income information.
8(b) Death register information.
9(c) Prisoner or incarceration status information.
10(d) Supplemental security income information maintained in
11the state data exchange database.
12(e) Beneficiary records and earnings information maintained
13in the beneficiary and earnings data exchange database.
14(f) Earnings information maintained in the beneficiary
15earnings exchange record system database.
16(3) Income and employment information maintained in the
17national directory of new hires database by the office of child
18support enforcement of the administration for children and
19families.
20b. State sources and information:
21(1) The department’s sources and information including but
22not limited to all of the following:
23(a) Income and employment information maintained by the
24child support recovery unit.
25(b) Child care assistance information maintained by the
26department.
27(c) Enrollment status in other public assistance programs.
28(2) The department of workforce development sources and
29information including all of the following:
30(a) Employment information.
31(b) Employer weekly, monthly, and quarterly reports of
32income and unemployment insurance payments.
33c. Miscellaneous sources:
34(1) Any existing real-time database of persons currently
35receiving benefits in other states, such as the national
-3-1accuracy clearinghouse.
2(2) Any lottery winner databases maintained by the Iowa
31ottery.
4(3) Any existing real-time eligibility system that includes
5employment and income information maintained by a consumer
6reporting agency, as defined by the federal Fair Credit
7Reporting Act, 15 U.S.C. §1681a, for the purpose of obtaining
8real-time employment and income information.
93. Prior to determining eligibility for SNAP benefits, the
10department shall access information for every member of the
11applicant’s household from the following public records:
12a. A nationwide public records data source of physical asset
13ownership. The data source may include but is not limited to
14real property, automobiles, watercraft, aircraft, and luxury
15vehicles, or any other vehicle owned by the applicant.
16b. National and state financial institutions in order
17to locate undisclosed depository accounts or verify account
18balances of disclosed accounts.
194. The department shall enter into a memorandum of
20understanding with any department, division, bureau, section,
21unit, or any other subunit of a department to obtain the
22information specified in this section.
235. The provisions of this section shall not apply if every
24member of the applicant’s household receives supplemental
25security income.
26 Sec. 5. NEW SECTION. 239.5 Verification and authentication
27systems — public assistance programs.
281. No later than July 1, 2025, the department shall
29redesign an existing system; establish a new computerized
30income, asset, and identity eligibility verification system;
31or contract with a third-party vendor to provide for identity
32verification, identity authentication, asset verification, and
33dual enrollment prevention in order to deter waste, fraud, and
34abuse in each public assistance program administered by the
35department.
-4- 12. The department may contract with a third-party vendor
2to develop or provide a service for a real-time eligibility
3system that allows the department to verify or authenticate
4income, assets, and identity eligibility of applicants and
5recipients to prevent fraud, misrepresentation, and inadequate
6documentation when determining eligibility for public
7assistance programs. The system shall be accessed prior to
8determining eligibility, periodically between eligibility
9redeterminations, and during eligibility redeterminations
10and reviews. The department may also contract with a
11third-party vendor to provide information to facilitate
12reviews of recipient eligibility conducted by the department.
13Specifically, the department may contract with a third-party
14consumer reporting agency, as defined by the federal Fair
15Credit Reporting Act, 15 U.S.C. §1681a, for the purpose of
16obtaining real-time employment and income information.
173. A contract entered into under this section shall provide,
18at a minimum, for all of the following:
19a. The establishment of the annual savings amount from
20utilization of the system or service, and a provision that the
21contract may be terminated contingent upon the savings not
22exceeding the total yearly cost to the state for utilization of
23the system or service.
24b. That the contract shall not preclude the department
25from continuing to conduct additional eligibility verification
26or authentication processes, to receive, review, or verify
27additional information related to the eligibility of an
28individual, or from contracting with a third-party vendor to
29provide additional eligibility authentication or verification
30information.
314. The department shall seek federal approval as necessary
32to implement and administer this section.
33 Sec. 6. PROGRAM REPORT. The department of health and human
34services shall submit a report to the governor and the general
35assembly by January 15, 2025, and by January 15 annually
-5-1thereafter through January 15, 2030, detailing the impact of
2the identity authentication measures taken under this division
3of this Act.
4DIVISION II
5SUPPLEMENTAL NUTRITION assistance PROGRAM and medicaid program
6integrity and cooperation
7 Sec. 7. Section 234.1, subsection 3, Code 2023, is amended
8by striking the subsection.
9 Sec. 8. Section 234.1, Code 2023, is amended by adding the
10following new subsections:
11 NEW SUBSECTION. 3A. “Department” means the department of
12health and human services.
13 NEW SUBSECTION. 5A. “Supplemental nutrition assistance
14program” or “SNAP” means the same as defined in section 239.1.
15 Sec. 9. Section 234.12A, Code 2023, is amended to read as
16follows:
17234.12A Electronic benefits transfer program.
181. The department of human services shall maintain an
19electronic benefits transfer program utilizing electronic funds
20transfer systems for the food supplemental nutrition assistance
21program. The electronic benefits transfer program implemented
22under this section shall not require a retailer to make cash
23disbursements or to provide, purchase, or upgrade electronic
24funds transfer system equipment as a condition of participation
25in the program.
262. A point-of-sale terminal which is used only for purchases
27from a retailer by electronic benefits transfer utilizing
28electronic funds transfer systems is not a satellite terminal
29as defined in section 527.2.
303. For the purposes of this section, “retailer” means
31a business authorized by the United States department of
32agriculture to accept food supplemental nutrition assistance
33program benefits.
34 Sec. 10. NEW SECTION. 234.12B Ensuring integrity in the
35supplemental nutrition assistance program — rules.
-6- 11. State records — individuals. The department shall
2receive and review all of the following information concerning
3individuals enrolled in the supplemental nutrition assistance
4program that indicates a change in circumstances that may
5affect eligibility:
6a. Death records. On at least a daily basis, information
7from the department including but not limited to death records.
8b. Employment information. On at least a semimonthly
9basis, information from the department of workforce development
10including but not limited to changes in employment or wages.
11c. Residency information. On at least a monthly basis,
12information to confirm Iowa residency or to identify potential
13changes in Iowa residency as identified through an automated
14search process of a database of addresses.
15d. Incarceration information. On at least a monthly basis,
16information from the department of corrections.
172. State records — households — unemployment
18information. The department shall receive and review on at
19least a semimonthly basis, information from the department of
20workforce development including but not limited to potential
21changes in employment, income, or assets that indicate a change
22in circumstances that may affect eligibility.
233. Federal records — households. The department shall
24cross-check information relating to individuals in households
25enrolled in the supplemental nutrition assistance program with
26federal databases including but not limited to all of the
27following, on at least a monthly basis:
28a. Earned income information, death register information,
29incarceration records, supplemental security income
30information, beneficiary records, and earnings information
31maintained by the United States social security administration.
32b. Income and employment information maintained in the
33national directory of new hires database and child support
34enforcement data maintained by the United States department of
35health and human services.
-7- 1c. National fleeing felon information maintained by the
2United States federal bureau of investigation.
34. Rules. The department may adopt rules pursuant to
4chapter 17A to administer this section.
5 Sec. 11. NEW SECTION. 234.12C Required employment
6and training for supplemental nutrition assistance program
7eligibility.
8The department shall require all able-bodied adults without
9dependents to participate in mandatory employment and training
10as a condition of eligibility for supplemental nutrition
11assistance program benefits.
12 Sec. 12. NEW SECTION. 249A.58 Ensuring integrity in the
13medical assistance program — recipient and applicant information
14reviewed — rules.
151. State records — recipients. The department shall
16receive and review all of the following information concerning
17recipients that indicates a change in circumstances that may
18affect eligibility:
19a. Death records. On at least a daily basis, information
20from the department including but not limited to death records.
21b. Employment information. On at least a semimonthly
22basis, information from the department of workforce development
23including but not limited to changes in employment or wages.
24c. Residency information. On at least a monthly basis,
25information to confirm Iowa residency or to identify potential
26changes in Iowa residency as identified through an automated
27search process of a database of addresses.
28d. Unemployment information. On at least a semimonthly
29basis, information from the department of workforce development
30including but not limited to potential changes in employment,
31income, or assets.
322. Federal records — recipients. The department shall
33cross-check information relating to recipients with federal
34databases including but not limited to all of the following, on
35at least a monthly basis:
-8- 1a. Earned income information, death register information,
2incarceration records, supplemental security income
3information, beneficiary records, and earnings information
4maintained by the United States social security administration.
5b. Income and employment information maintained by the
6national directory of new hires database and child support
7enforcement data maintained by the United States department of
8health and human services.
9c. National fleeing felon information maintained by the
10United States federal bureau of investigation.
113. Real-time record review — applicants. Prior to
12determining the eligibility of an applicant subject to an asset
13test for Medicaid, the department shall access information
14for every member of the applicant’s household from the data
15sources specified in this section and shall conduct a review
16of nationwide public records data sources of physical asset
17ownership. The nationwide public records data sources may
18include but are not limited to records of real property and
19automobiles, watercraft, aircraft, luxury vehicles, and any
20other vehicles owned by the applicant.
214. Rules. The department may adopt rules pursuant to
22chapter 17A to administer this section.
23 Sec. 13. NEW SECTION. 249A.59 Cooperation with child
24support services.
251. Unless exempt pursuant to state or federal law or
26regulation, an applicant for or recipient of medical assistance
27shall be required to cooperate with child support services as a
28condition of eligibility.
292. The department shall adopt rules pursuant to chapter 17A
30to administer this section.
31 Sec. 14. MEDICAID — REASONABLE COMPATIBILITY STANDARD
32INCOME THRESHOLD — DETERMINATION OF ELIGIBILITY. The
33department of health and human services shall reduce the
34reasonable compatibility income threshold standard from ten
35percent to five percent when the department is determining
-9-1eligibility for medical assistance, and shall continue to
2utilize income data sources as a tool in the eligibility
3determination process. The department of health and human
4services shall request any federal approval necessary,
5including any Medicaid state plan amendment or waiver, to
6administer this section.
7DIVISION III
8iowa health and wellness plan — reenrollment
9 Sec. 15. IOWA HEALTH AND WELLNESS PLAN — MEMBER
10REENROLLMENT FOLLOWING TERMINATION FOR NONPAYMENT OF MONTHLY
11CONTRIBUTIONS. The department of health and human services
12shall seek approval of an amendment to the section 1115
13demonstration waiver for the Iowa health and wellness plan from
14the centers for Medicare and Medicaid services of the United
15States department of health and human services to provide the
16following:
171. An Iowa health and wellness plan member who is not
18otherwise exempt from payment of a monthly contribution, who
19is subject to payment of a monthly contribution as the result
20of failure to complete required healthy behaviors, and whose
21eligibility for the program is terminated due to nonpayment
22of monthly contributions, shall be allowed to subsequently
23reenroll in the program without first paying any outstanding
24monthly contributions, if the member has not been terminated
25from the program previously for nonpayment of monthly
26contributions.
272. Following an initial termination from the Iowa health
28and wellness plan pursuant to subsection 1, if an Iowa health
29and wellness plan member is subsequently terminated from the
30program pursuant to subsection 1 for nonpayment of monthly
31contributions, the member shall be subject to payment of any
32outstanding monthly contributions accrued since the subsequent
33termination not to exceed the aggregate annual copayment and
34monthly contribution limits prior to reenrollment in the
35program.
-10- 13. This section shall not apply to an Iowa health and
2wellness plan member who is deemed to be in substantial
3compliance with the healthy behaviors requirement to complete a
4wellness examination by providing proof of a scheduled wellness
5examination appointment, if the appointment is scheduled
6no later than ninety days beyond the end of the applicable
7enrollment period.
8DIVISION IV
9MEDICAID DEMONSTRATION WAIVER REQUEST — IOWA HEALTH AND
10WELLNESS PLAN
11 Sec. 16. MEDICAID DEMONSTRATION WAIVER REQUEST — COMMUNITY
12ENGAGEMENT REQUIREMENTS FOR IOWA HEALTH AND WELLNESS PLAN
13MEMBERS.
141. The department of health and human services shall submit
15a request by July 1, 2023, and annually by July 1 thereafter
16until federal approval is received from the centers for
17Medicare and Medicaid services of the United States department
18of health and human services, for a section 1115 demonstration
19waiver to require that as a condition of eligibility, Iowa
20health and wellness plan members participate in community
21engagement activities.
222. The waiver request submitted by the department shall
23require that, unless an individual is exempt pursuant to
24subsection 3, as a condition of eligibility for the Iowa health
25and wellness plan, a recipient shall do one of the following:
26a. Work twenty hours or more per week, averaged on a monthly
27basis.
28b. Participate in and comply with the requirements of a work
29program for twenty hours or more per week, as determined by the
30department.
31c. Volunteer twenty hours or more per week, as determined
32by the department.
33d. Meet a combination of work and work program participation
34requirements for a total of twenty hours or more per week, as
35determined by the department.
-11- 1e. Participate in and comply with the PROMISE JOBS program
2pursuant to chapter 239B.
33. The following individuals shall be exempt from the
4requirements specified in subsection 2:
5a. An individual medically certified as physically or
6mentally unfit for employment.
7b. A woman who is pregnant.
8c. A parent or caretaker responsible for the care of a
9dependent child under six years of age.
10d. A parent or caretaker personally providing the care for a
11dependent child with a serious medical condition or disability,
12as determined by the department.
13e. An individual receiving unemployment compensation and
14complying with work requirements of the federal or state
15unemployment compensation system.
16f. An individual participating in a substance use disorder
17treatment and rehabilitation program.
184. The department shall implement the Medicaid waiver upon
19receipt of federal approval and shall adopt rules pursuant to
20chapter 17A to administer the waiver provisions.
21DIVISION V
22SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM — ELIGIBLE FOODS
23 Sec. 17. SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM —
24INELIGIBLE FOODS. The department of health and human services
25shall request a waiver from the food and nutrition service of
26the United States department of agriculture to provide that
27for the purposes of state administration of the supplemental
28food and nutrition program, eligible foods as defined in 7
29C.F.R.§271.2 do not include candy and non-sugar-free soda.
30The department of health and human services shall implement the
31waiver upon receipt of approval of the waiver.
32 Sec. 18. DEPARTMENT OF HEALTH AND HUMAN SERVICES — DOUBLE
33UP FOOD BUCKS PROGRAM — SUPPLEMENTAL APPROPRIATION. There
34is appropriated from the general fund of the state to the
35department of health and human services for the fiscal year
-12-1beginning July 1, 2023, and ending June 30, 2024, in addition
2to any other funding appropriated for such purposes for the
3same fiscal year, the following amount or so much thereof as is
4necessary, to be used for the purposes designated:
5To provide grants to support the double up food bucks
6program administered by the Iowa healthiest state initiative
7to make fresh fruits and vegetables sold at farmers markets,
8grocery stores, and other participating locations accessible
9to individuals and families who reside in this state and
10receive assistance through the federal supplemental nutrition
11assistance program:
.................................................. $121,000,000
13A grant recipient that receives funding pursuant to this
14section shall provide at least a dollar-for-dollar match of the
15grant assistance.
16Notwithstanding section 8.33, moneys appropriated under this
17section shall not revert at the close of the fiscal year, but
18shall remain available for the purposes designated.
19 Sec. 19. CONTINGENT EFFECTIVE DATE. The following takes
20effect on the date the department of health and human services
21receives federal approval of the waiver request relating to
22supplemental nutrition assistance program ineligible foods as
23specified under this division of this Act, if the waiver is
24approved:
25The section of this division of this Act making a
26supplemental appropriation to the department of health and
27human services to provide grants to support the double up food
28bucks program.
29DIVISION VI
30Implementation provisions
31 Sec. 20. IMPLEMENTATION PROVISIONS.
321. The department of health and human services shall request
33federal approval including for any state plan amendment or
34waiver necessary to administer this Act.
352. If the department of health and human services determines
-13-1that any provision of this Act would result in the denial
2of funds or services from the federal government that would
3otherwise be available or would be inconsistent with the
4requirements of federal law or regulation, such provision shall
5be suspended, but only to the extent necessary to eliminate the
6inconsistency with federal requirements.
73. Unless otherwise provided in a division of this Act, the
8department of health and human services shall implement the
9provisions of this Act in an incremental fashion, beginning
10July 1, 2023, with a goal of full implementation no later
11than June 30, 2025, to minimize duplication of efforts and to
12maximize coordination with the implementation time frames of
13other departmental resource enhancements.
144. The provisions of this Act requiring federal approval
15shall be implemented upon receipt of federal approval.
165. The provisions of this Act not requiring federal approval
17shall be implemented as specified in this Act, or if not
18specified in this Act, no later than June 30, 2025.
19EXPLANATION
20The inclusion of this explanation does not constitute agreement with
21the explanation’s substance by the members of the general assembly.
22This bill relates to various public assistance programs.
23DIVISION I. This division establishes the income threshold
24for the supplemental nutrition assistance program (SNAP) at
25less than or equal to 160 percent of the federal poverty level.
26The division also requires that prior to the department of
27health and human services (HHS) awarding public assistance
28benefits to an applicant, the applicant shall complete a
29computerized identity authentication process to confirm the
30identity of the applicant through the use of a knowledge-based
31questionnaire consisting of financial and personal questions
32tailored to assist persons without a bank account or those
33who have poor access to financial and banking services or who
34do not have an established credit history. The computerized
35identity authentication process and questionnaire may be
-14-1submitted online, in person, or via telephone by the applicant
2or a person authorized by the applicant. The bill also
3requires HHS to conduct an asset test on all members of
4the household of an applicant for SNAP benefits. The bill
5specifies the minimum information, federal, state, and other
6data sources, and public records that HHS must access prior to
7determining eligibility for an applicant’s SNAP benefits. The
8bill requires HHS to enter into a memorandum of understanding
9with any department or subunit of a department to obtain the
10information specified. The bill’s provisions do not apply if
11every member of the applicant’s household receives supplemental
12security income.
13The bill provides that no later than July 1, 2025, HHS
14shall redesign an existing system, establish a new identity
15eligibility verification system, or contract with a third-party
16vendor to provide verification, authentication, and dual
17enrollment prevention systems for public assistance programs.
18The department may also contract with a third-party vendor
19to develop or provide a real-time eligibility system. All
20contracts are subject to minimum requirements specified in the
21bill.
22The bill authorizes HHS to adopt administrative rules to
23administer the bill and requires HHS to submit an annual report
24to the governor and the general assembly to assess the impact
25of the bill.
26DIVISION II. This division relates to SNAP and Medicaid
27program integrity by requiring HHS to, within specified time
28frames, receive and review state and federal information
29from various entities concerning individuals or individuals
30in households enrolled in SNAP or the Medicaid program
31that indicates a change in circumstances that may affect
32eligibility. The information relates to death, employment,
33residency, incarceration, and unemployment information.
34Additionally, the bill requires HHS to cross-check information
35relating to individuals in households enrolled in SNAP or
-15-1the Medicaid program, as applicable, with specified federal
2databases. With regard to the Medicaid program only, the bill
3also requires that prior to determining eligibility for the
4Medicaid program, HHS shall access information for every member
5of an applicant’s household from the data sources outlined in
6the bill and conduct a review of nationwide public records data
7sources of physical asset ownership. The bill also requires
8an applicant for Medicaid benefits to cooperate with child
9support services as a condition of eligibility as specified
10under federal law.
11The bill requires HHS to use a reasonable compatibility
12standard threshold of 5 percent rather than 10 percent in
13determining eligibility for Medicaid.
14DIVISION III. This division requires HHS to seek federal
15approval of an amendment to the section 1115 demonstration
16waiver for the Iowa health and wellness plan to provide both
17of the following: (1) that an Iowa health and wellness
18plan member who is not otherwise exempt from payment of a
19monthly contribution, who is subject to payment of a monthly
20contribution as the result of failure to complete required
21healthy behaviors, and whose eligibility for the program is
22terminated due to nonpayment of monthly contributions, shall be
23allowed to subsequently reenroll in the program without first
24paying any outstanding monthly contributions, if the member has
25not been terminated from the program previously for nonpayment
26of monthly contributions, and (2) following an initial
27termination from the Iowa health and wellness plan, if an Iowa
28health and wellness plan member is subsequently terminated
29from the program for nonpayment of monthly contributions, the
30member shall be subject to payment of any outstanding monthly
31contributions accrued since the subsequent termination not to
32exceed program limits prior to reenrollment in the program.
33The bill does not apply to an Iowa health and wellness plan
34member who is deemed to be in substantial compliance with the
35requirement to complete a wellness examination by providing
-16-1proof of a scheduled examination appointment if the appointment
2is scheduled no later than 90 days beyond the end of the
3applicable enrollment period.
4DIVISION IV. This division requires HHS to submit a
5request for federal approval by July 1, 2023, and annually
6by July 1 thereafter until federal approval is received, for
7a waiver to require that as a condition of eligibility, Iowa
8health and wellness plan members participate in community
9engagement activities. The bill specifies the types of
10community engagement activities to be required under the waiver
11submitted and provides exceptions to required participation
12in community engagement activities. The bill directs HHS to
13implement the waiver upon receipt of federal approval and to
14adopt administrative rules to administer the waiver provisions.
15DIVISION V. This division requires HHS to request a waiver
16from the United States department of agriculture, food and
17nutrition service, to provide that eligible foods under
18the state administration of SNAP do not include candy and
19non-sugar-free soda. The department is directed to implement
20the waiver upon receipt of approval of the waiver.
21The division also relates to the double up food bucks program
22by making a supplemental appropriation from the general fund of
23the state to HHS for fiscal year 2023-2024, in addition to any
24other funding appropriated for such purpose for the same fiscal
25year, to provide grants to support the double up food bucks
26program administered by the Iowa healthiest state initiative
27to make fresh fruits and vegetables sold at farmers markets,
28grocery stores, and other participating locations accessible to
29individuals and families who reside in this state and receive
30assistance through SNAP. The division requires a double
31up food bucks program grant recipient to provide at least
32a dollar-for-dollar match of the grant assistance. Moneys
33appropriated under the division do not revert at the close of
34the fiscal year but remain available for the purposes of the
35double up food bucks program.
-17- 1The supplemental appropriation for the double up food bucks
2program takes effect on the date HHS receives federal approval
3of the SNAP waiver, if the waiver is approved.
4DIVISION VI. This division provides implementation
5provisions for the bill. The bill requires HHS to request
6federal approval including for any state plan amendment or
7waiver necessary to administer the bill. If HHS determines
8that any provision of the bill would result in the denial
9of funds or services from the federal government that would
10otherwise be available or would be inconsistent with the
11requirements of federal law or regulation, such provision shall
12be suspended, but only to the extent necessary to eliminate
13the inconsistency with federal requirements. Unless otherwise
14provided in the bill, HHS shall implement the provisions of the
15bill in an incremental fashion, beginning July 1, 2023, with
16a goal of full implementation no later than June 30, 2025, to
17minimize duplication of efforts and to maximize coordination
18with the implementation time frames of other departmental
19resource enhancements. The provisions of the bill requiring
20federal approval shall be implemented upon receipt of federal
21approval. The provisions of the bill not requiring federal
22approval shall be implemented as specified in the bill, and
23if it not specified in the bill, then not later than June 30,
242025.
-18-pf/rh