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Senate Study Bill 1199 - IntroducedA Bill ForAn Act 1relating to appropriations for health and human
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2017-2018
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, 2017, and ending June 30,
62018, the following amount, or so much thereof as is necessary,
7to be used for the purposes designated:
8For aging programs for the department on aging and area
9agencies on aging to provide citizens of Iowa who are 60 years
10of age and older with case management for frail elders, Iowa’s
11aging and disabilities resource center, and other services
12which may include but are not limited to adult day services,
13respite care, chore services, information and assistance,
14and material aid, for information and options counseling for
15persons with disabilities who are 18 years of age or older,
16and for salaries, support, administration, maintenance, and
17miscellaneous purposes, and for not more than the following
18full-time equivalent positions:
.................................................. $1911,042,476
............................................... FTEs2027.00
211. Funds appropriated in this section may be used to
22supplement federal funds under federal regulations. To
23receive funds appropriated in this section, a local area
24agency on aging shall match the funds with moneys from other
25sources according to rules adopted by the department. Funds
26appropriated in this section may be used for elderly services
27not specifically enumerated in this section only if approved
28by an area agency on aging for provision of the service within
29the area.
302. Of the funds appropriated in this section, $279,946 is
31transferred to the economic development authority for the Iowa
32commission on volunteer services to be used for the retired and
33senior volunteer program.
343. a. The department on aging shall establish and enforce
35procedures relating to expenditure of state and federal funds
-1-1by area agencies on aging that require compliance with both
2state and federal laws, rules, and regulations, including but
3not limited to all of the following:
4(1) Requiring that expenditures are incurred only for goods
5or services received or performed prior to the end of the
6fiscal period designated for use of the funds.
7(2) Prohibiting prepayment for goods or services not
8received or performed prior to the end of the fiscal period
9designated for use of the funds.
10(3) Prohibiting the prepayment for goods or services
11not defined specifically by good or service, time period, or
12recipient.
13(4) Prohibiting the establishment of accounts from which
14future goods or services which are not defined specifically by
15good or service, time period, or recipient, may be purchased.
16b. The procedures shall provide that if any funds are
17expended in a manner that is not in compliance with the
18procedures and applicable federal and state laws, rules, and
19regulations, and are subsequently subject to repayment, the
20area agency on aging expending such funds in contravention of
21such procedures, laws, rules and regulations, not the state,
22shall be liable for such repayment.
234. Of the funds appropriated in this section, at least
24$250,000 shall be used to fund the unmet needs identified
25through Iowa’s aging and disability resource center network.
265. Of the funds appropriated in this section, at least
27$600,000 shall be used to fund home and community-based
28services through the area agencies on aging that enable older
29individuals to avoid more costly utilization of residential or
30institutional services and remain in their own homes.
316. Of the funds appropriated in this section, $812,537
32shall be used for the purposes of chapter 231E and section
33231.56A, of which $350,000 shall be used for the office of
34substitute decision maker pursuant to chapter 231E, and the
35remainder shall be distributed equally to the area agencies on
-2-1aging to administer the prevention of elder abuse, neglect, and
2exploitation program pursuant to section 231.56A, in accordance
3with the requirements of the federal Older Americans Act of
41965, 42 U.S.C. §3001 et seq., as amended.
57. Of the funds appropriated in this section, $750,000
6shall be used to fund continuation of the aging and disability
7resource center lifelong links to provide individuals and
8caregivers with information and services to plan for and
9maintain independence.
108. Notwithstanding section 8.39, for the fiscal year
11beginning July 1, 2017, the department may transfer funds
12within or between the allocations made in this division of this
13Act for the same fiscal year in accordance with departmental
14priorities. The department shall report any such transfers
15to the individuals specified in this Act for submission of
16reports. This subsection shall not be construed to prohibit
17the use of existing state transfer authority for other
18purposes.
19DIVISION II
20OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2017-2018
21 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
22appropriated from the general fund of the state to the office
23of long-term care ombudsman for the fiscal year beginning July
241, 2017, and ending June 30, 2018, the following amount, or
25so much thereof as is necessary, to be used for the purposes
26designated:
27For salaries, support, administration, maintenance, and
28miscellaneous purposes, and for not more than the following
29full-time equivalent positions:
.................................................. $301,160,281
............................................... FTEs3116.00
32DIVISION III
33DEPARTMENT OF PUBLIC HEALTH — FY 2017-2018
34 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
35from the general fund of the state to the department of public
-3-1health for the fiscal year beginning July 1, 2017, and ending
2June 30, 2018, the following amounts, or so much thereof as is
3necessary, to be used for the purposes designated:
41. ADDICTIVE DISORDERS
5For reducing the prevalence of the use of tobacco, alcohol,
6and other drugs, and treating individuals affected by addictive
7behaviors, including gambling, and for not more than the
8following full-time equivalent positions:
.................................................. $924,985,831
............................................... FTEs1010.00
11a. (1) Of the funds appropriated in this subsection,
12$4,021,225 shall be used for the tobacco use prevention
13and control initiative, including efforts at the state and
14local levels, as provided in chapter 142A. The commission
15on tobacco use prevention and control established pursuant
16to section 142A.3 shall advise the director of public health
17in prioritizing funding needs and the allocation of moneys
18appropriated for the programs and initiatives. Activities
19of the programs and initiatives shall be in alignment with
20the United States centers for disease control and prevention
21best practices for comprehensive tobacco control programs that
22include the goals of preventing youth initiation of tobacco
23usage, reducing exposure to secondhand smoke, and promotion
24of tobacco cessation. To maximize resources, the department
25shall determine if third-party sources are available to
26instead provide nicotine replacement products to an applicant
27prior to provision of such products to an applicant under
28the initiative. The department shall track and report to
29the individuals specified in this Act, any reduction in
30the provision of nicotine replacement products realized by
31the initiative through implementation of the prerequisite
32screening.
33(2) (a) The department shall collaborate with the
34alcoholic beverages division of the department of commerce for
35enforcement of tobacco laws, regulations, and ordinances and to
-4-1engage in tobacco control activities approved by the division
2of tobacco use prevention and control of the department of
3public health as specified in the memorandum of understanding
4entered into between the divisions.
5(b) For the fiscal year beginning July 1, 2017, and ending
6June 30, 2018, the terms of the memorandum of understanding,
7entered into between the division of tobacco use prevention
8and control of the department of public health and the
9alcoholic beverages division of the department of commerce,
10governing compliance checks conducted to ensure licensed retail
11tobacco outlet conformity with tobacco laws, regulations, and
12ordinances relating to persons under 18 years of age, shall
13continue to restrict the number of such checks to one check per
14retail outlet, and one additional check for any retail outlet
15found to be in violation during the first check.
16b. Of the funds appropriated in this subsection,
17$20,964,606 shall be used for problem gambling and
18substance-related disorder prevention, treatment, and recovery
19services, including a 24-hour helpline, public information
20resources, professional training, youth prevention, and program
21evaluation.
22c. The requirement of section 123.17, subsection 5, is met
23by the appropriations and allocations made in this division of
24this Act for purposes of substance-related disorder treatment
25and addictive disorders for the fiscal year beginning July 1,
262017.
272. HEALTHY CHILDREN AND FAMILIES
28For promoting the optimum health status for children,
29adolescents from birth through 21 years of age, and families,
30and for not more than the following full-time equivalent
31positions:
.................................................. $325,325,632
............................................... FTEs3312.00
34a. Of the funds appropriated in this subsection, not more
35than $734,841 shall be used for the healthy opportunities for
-5-1parents to experience success (HOPES)-healthy families Iowa
2(HFI) program established pursuant to section 135.106. The
3funding shall be distributed to renew the grants that were
4provided to the grantees that operated the program during the
5fiscal year ending June 30, 2017.
6b. In order to implement the legislative intent stated in
7sections 135.106 and 256I.9, that priority for home visitation
8program funding be given to programs using evidence-based or
9promising models for home visitation, it is the intent of the
10general assembly to phase in the funding priority in accordance
11with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
12paragraph “0b”.
13c. Of the funds appropriated in this subsection, $3,075,101
14shall be used for continuation of the department’s initiative
15to provide for adequate developmental surveillance and
16screening during a child’s first five years. The funds shall
17be used first to fully fund the current sites to ensure that
18the sites are fully operational, with the remaining funds
19to be used for expansion to additional sites. The full
20implementation and expansion shall include enhancing the scope
21of the program through collaboration with the child health
22specialty clinics to promote healthy child development through
23early identification and response to both biomedical and social
24determinants of healthy development; by monitoring child
25health metrics to inform practice, document long-term health
26impacts and savings, and provide for continuous improvement
27through training, education, and evaluation; and by providing
28for practitioner consultation particularly for children with
29behavioral conditions and needs. The department of public
30health shall also collaborate with the Iowa Medicaid enterprise
31and the child health specialty clinics to integrate the
32activities of the first five initiative into the establishment
33of patient-centered medical homes, community utilities,
34accountable care organizations, and other integrated care
35models developed to improve health quality and population
-6-1health while reducing health care costs. To the maximum extent
2possible, funding allocated in this paragraph shall be utilized
3as matching funds for medical assistance program reimbursement.
4d. Of the funds appropriated in this subsection, $64,640
5shall be distributed to a statewide dental carrier to provide
6funds to continue the donated dental services program patterned
7after the projects developed by the lifeline network to provide
8dental services to indigent individuals who are elderly or with
9disabilities.
10e. Of the funds appropriated in this subsection, $156,482
11shall be used to provide audiological services and hearing
12aids for children. The department may enter into a contract
13to administer this paragraph.
14f. Of the funds appropriated in this subsection, $23,000 is
15transferred to the university of Iowa college of dentistry for
16provision of primary dental services to children. State funds
17shall be matched on a dollar-for-dollar basis. The university
18of Iowa college of dentistry shall coordinate efforts with the
19department of public health, bureau of oral and health delivery
20systems, to provide dental care to underserved populations
21throughout the state.
22g. Of the funds appropriated in this subsection, $50,000
23shall be used to address youth suicide prevention.
24h. Of the funds appropriated in this subsection, $40,511
25shall be used to support the Iowa effort to address the survey
26of children who experience adverse childhood experiences known
27as ACEs.
28i. The department of public health shall continue to
29administer the program to assist parents in this state with
30costs resulting from the death of a child in accordance with
31the provisions of 2014 Iowa Acts, chapter 1140, section 22,
32subsection 12.
333. CHRONIC CONDITIONS
34For serving individuals identified as having chronic
35conditions or special health care needs, and for not more than
-7-1the following full-time equivalent positions:
.................................................. $24,170,750
............................................... FTEs35.00
4a. Of the funds appropriated in this subsection, $153,755
5shall be used for grants to individual patients who have an
6inherited metabolic disorder to assist with the costs of
7medically necessary foods and formula.
8b. Of the funds appropriated in this subsection, $1,020,794
9shall be used for the brain injury services program pursuant
10to section 135.22B, including for contracting with an existing
11nationally affiliated and statewide organization whose purpose
12is to educate, serve, and support Iowans with brain injury and
13their families for resource facilitator services in accordance
14with section 135.22B, subsection 9, and for contracting to
15enhance brain injury training and recruitment of service
16providers on a statewide basis. Of the amount allocated in
17this paragraph, $95,000 shall be used to fund one full-time
18equivalent position to serve as the state brain injury services
19program manager.
20c. Of the funds appropriated in this subsection, $144,097
21shall be used for the public purpose of continuing to contract
22with an existing national-affiliated organization to provide
23education, client-centered programs, and client and family
24support for people living with epilepsy and their families.
25The amount allocated in this paragraph in excess of $100,000
26shall be matched dollar-for-dollar by the organization
27specified.
28d. Of the funds appropriated in this subsection, $809,550
29shall be used for child health specialty clinics.
30e. Of the funds appropriated in this subsection, $384,552
31shall be used by the regional autism assistance program
32established pursuant to section 256.35, and administered by
33the child health specialty clinic located at the university of
34Iowa hospitals and clinics. The funds shall be used to enhance
35interagency collaboration and coordination of educational,
-8-1medical, and other human services for persons with autism,
2their families, and providers of services, including delivering
3regionalized services of care coordination, family navigation,
4and integration of services through the statewide system of
5regional child health specialty clinics and fulfilling other
6requirements as specified in chapter 225D. The university of
7Iowa shall not receive funds allocated under this paragraph for
8indirect costs associated with the regional autism assistance
9program.
10f. Of the funds appropriated in this subsection, $577,375
11shall be used for the comprehensive cancer control program to
12reduce the burden of cancer in Iowa through prevention, early
13detection, effective treatment, and ensuring quality of life.
14Of the funds allocated in this paragraph “f”, $150,000 shall
15be used to support a melanoma research symposium, a melanoma
16biorepository and registry, basic and translational melanoma
17research, and clinical trials.
18g. Of the funds appropriated in this subsection, $97,532
19shall be used for cervical and colon cancer screening, and
20$177,720 shall be used to enhance the capacity of the cervical
21cancer screening program to include provision of recommended
22prevention and early detection measures to a broader range of
23low-income women.
24h. Of the funds appropriated in this subsection, $506,355
25shall be used for the center for congenital and inherited
26disorders.
27i. Of the funds appropriated in this subsection,
28$215,263 shall be used by the department of public health
29for reform-related activities, including but not limited to
30facilitation of communication to stakeholders at the state and
31local level, administering the patient-centered health advisory
32council pursuant to section 135.159, and involvement in health
33care system innovation activities occurring across the state.
34j. Of the funds appropriated in this subsection, $22,100
35shall be used for administration of chapter 124D, the medical
-9-1cannabidiol Act.
24. COMMUNITY CAPACITY
3For strengthening the health care delivery system at the
4local level, and for not more than the following full-time
5equivalent positions:
.................................................. $62,807,776
............................................... FTEs713.00
8a. Of the funds appropriated in this subsection, $95,575
9is allocated for continuation of the child vision screening
10program implemented through the university of Iowa hospitals
11and clinics in collaboration with early childhood Iowa areas.
12The program shall submit a report to the individuals identified
13in this Act for submission of reports regarding the use of
14funds allocated under this paragraph “a”. The report shall
15include the objectives and results for the program year
16including the target population and how the funds allocated
17assisted the program in meeting the objectives; the number,
18age, and location within the state of individuals served;
19the type of services provided to the individuals served; the
20distribution of funds based on service provided; and the
21continuing needs of the program.
22b. Of the funds appropriated in this subsection, $105,656 is
23allocated for continuation of an initiative implemented at the
24university of Iowa to expand and improve the workforce engaged
25in mental health treatment and services. The initiative shall
26receive input from the university of Iowa, the department of
27human services, the department of public health, and the mental
28health and disability services commission to address the focus
29of the initiative.
30c. Of the funds appropriated in this section, $83,315 shall
31be deposited in the governmental public health system fund
32created in section 135A.8 to be used for the purposes of the
33fund.
34d. Of the funds appropriated in this subsection,
35$48,069 shall be used for a grant to a statewide association
-10-1of psychologists that is affiliated with the American
2psychological association to be used for continuation of a
3program to rotate intern psychologists in placements in urban
4and rural mental health professional shortage areas, as defined
5in section 135.180.
6e. Of the funds appropriated in this subsection, the
7following amounts are allocated to be used as follows to
8support the Iowa collaborative safety net provider network
9goals of increased access, health system integration, and
10engagement:
11(1) Not less than $521,863 is allocated to the Iowa
12prescription drug corporation for continuation of the
13pharmaceutical infrastructure for safety net providers as
14described in 2007 Iowa Acts, chapter 218, section 108, and for
15the prescription drug donation repository program created in
16chapter 135M.
17(2) Not less than $334,870 is allocated to free clinics and
18free clinics of Iowa for necessary infrastructure, statewide
19coordination, provider recruitment, service delivery, and
20provision of assistance to patients in securing a medical home
21inclusive of oral health care.
22(3) Not less than $25,000 is allocated to the Iowa
23association of rural health clinics for necessary
24infrastructure and service delivery transformation.
25f. Of the funds appropriated in this subsection, $163,400
26shall be used for continuation of the work of the direct care
27worker advisory council established pursuant to 2008 Iowa Acts,
28chapter 1188, section 69, in implementing the recommendations
29in the final report submitted by the advisory council to the
30governor and the general assembly in March 2012, including
31by continuing to develop, promote, and make available on a
32statewide basis the prepare-to-care core curriculum and its
33associated modules and specialties through various formats
34including online access, community colleges, and other venues;
35exploring new and maintaining existing specialties including
-11-1but not limited to oral health and dementia care; supporting
2instructor training; and assessing and making recommendations
3concerning the Iowa care book and information technology
4systems and infrastructure uses and needs.
5g. Of the funds appropriated in this subsection, $104,019
6shall be allocated for continuation of the contract with
7an independent statewide direct care worker organization
8previously selected through a request for proposals process.
9The contract shall continue to include performance and outcomes
10measures, and shall continue to allow the contractor to use a
11portion of the funds received under the contract to collect
12data to determine results based on the performance and outcomes
13measures.
14h. Of the funds appropriated in this subsection, the
15department may use up to $58,175 for up to one full-time
16equivalent position to administer the volunteer health care
17provider program pursuant to section 135.24.
18i. Of the funds appropriated in this subsection, $96,138
19shall be used for a matching dental education loan repayment
20program to be allocated to a dental nonprofit health service
21corporation to continue to develop the criteria and implement
22the loan repayment program.
23j. Of the funds appropriated in this subsection, $52,911 is
24transferred to the college student aid commission for deposit
25in the rural Iowa primary care trust fund created in section
26261.113 to be used for the purposes of the fund.
27k. Of the funds appropriated in this subsection, $150,000
28shall be used for the purposes of the Iowa donor registry as
29specified in section 142C.18.
30l. Of the funds appropriated in this subsection, $96,138
31shall be used for continuation of a grant to a nationally
32affiliated volunteer eye organization that has an established
33program for children and adults and that is solely dedicated to
34preserving sight and preventing blindness through education,
35nationally certified vision screening and training, and
-12-1community and patient service programs. The organization
2shall submit a report to the individuals identified in this
3Act for submission of reports regarding the use of funds
4allocated under this paragraph “l”. The report shall include
5the objectives and results for the program year including
6the target population and how the funds allocated assisted
7the program in meeting the objectives; the number, age, and
8location within the state of individuals served; the type of
9services provided to the individuals served; the distribution
10of funds based on services provided; and the continuing needs
11of the program.
125. ESSENTIAL PUBLIC HEALTH SERVICES
13To provide public health services that reduce risks and
14invest in promoting and protecting good health over the
15course of a lifetime with a priority given to older Iowans and
16vulnerable populations:
.................................................. $178,197,878
186. INFECTIOUS DISEASES
19For reducing the incidence and prevalence of communicable
20diseases, and for not more than the following full-time
21equivalent positions:
.................................................. $221,646,426
............................................... FTEs234.00
247. PUBLIC PROTECTION
25For protecting the health and safety of the public through
26establishing standards and enforcing regulations, and for not
27more than the following full-time equivalent positions:
.................................................. $284,195,139
............................................... FTEs29138.00
30a. Of the funds appropriated in this subsection, not more
31than $304,700 shall be credited to the emergency medical
32services fund created in section 135.25. Moneys in the
33emergency medical services fund are appropriated to the
34department to be used for the purposes of the fund.
35b. Of the funds appropriated in this subsection, up
-13-1to $243,260 shall be used for sexual violence prevention
2programming through a statewide organization representing
3programs serving victims of sexual violence through the
4department’s sexual violence prevention program, and for
5continuation of a training program for sexual assault
6response team (SART) members, including representatives of
7law enforcement, victim advocates, prosecutors, and certified
8medical personnel. The amount allocated in this paragraph “b”
9shall not be used to supplant funding administered for other
10sexual violence prevention or victims assistance programs.
11c. Of the funds appropriated in this subsection, up to
12$575,627 shall be used for the state poison control center.
13Pursuant to the directive under 2014 Iowa Acts, chapter
141140, section 102, the federal matching funds available to
15the state poison control center from the department of human
16services under the federal Children’s Health Insurance Program
17Reauthorization Act allotment shall be subject to the federal
18administrative cap rule of 10 percent applicable to funding
19provided under Tit.XXI of the federal Social Security Act and
20included within the department’s calculations of the cap.
21d. Of the funds appropriated in this subsection, up to
22$516,982 shall be used for childhood lead poisoning provisions.
238. RESOURCE MANAGEMENT
24For establishing and sustaining the overall ability of the
25department to deliver services to the public, and for not more
26than the following full-time equivalent positions:
.................................................. $27971,215
............................................... FTEs284.00
299. MISCELLANEOUS PROVISIONS
30The university of Iowa hospitals and clinics under the
31control of the state board of regents shall not receive
32indirect costs from the funds appropriated in this section.
33The university of Iowa hospitals and clinics billings to the
34department shall be on at least a quarterly basis.
3510. GENERAL REDUCTION
-14- 1For the period beginning July 1, 2017, and ending June 30,
22018, the department of public health, in consultation with
3the department of management, shall identify and implement a
4reduction in expenditures made from appropriations from the
5general fund to the department of public health in the amount
6of $1,281,367.
711. TRANSFERS
8Notwithstanding section 8.39, for the fiscal year beginning
9July 1, 2017, the department may transfer funds within or
10between any of the allocations or appropriations made in this
11division of this Act for the same fiscal year, to be used in
12accordance with departmental priorities as specified in the
13department’s report to the general assembly submitted pursuant
14to 2016 Iowa Acts, chapter 1139, section 3. The department
15shall report any such transfers to the individuals specified
16in this Act for submission of reports. This subsection shall
17not be construed to prohibit the use of existing state transfer
18authority for other purposes.
19DIVISION IV
20DEPARTMENT OF VETERANS AFFAIRS — FY 2017-2018
21 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is
22appropriated from the general fund of the state to the
23department of veterans affairs for the fiscal year beginning
24July 1, 2017, and ending June 30, 2018, the following amounts,
25or so much thereof as is necessary, to be used for the purposes
26designated:
271. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
28For salaries, support, maintenance, and miscellaneous
29purposes, and for not more than the following full-time
30equivalent positions:
.................................................. $311,142,557
............................................... FTEs3215.00
332. IOWA VETERANS HOME
34For salaries, support, maintenance, and miscellaneous
35purposes:
-15-.................................................. $17,228,140
2a. The Iowa veterans home billings involving the department
3of human services shall be submitted to the department on at
4least a monthly basis.
5b. Within available resources and in conformance with
6associated state and federal program eligibility requirements,
7the Iowa veterans home may implement measures to provide
8financial assistance to or on behalf of veterans or their
9spouses who are participating in the community reentry program.
10c. The Iowa veterans home expenditure report shall be
11submitted monthly to the legislative services agency.
12d. The Iowa veterans home shall continue to include in the
13annual discharge report applicant information to provide for
14the collection of demographic information including but not
15limited to the number of individuals applying for admission and
16admitted or denied admittance and the basis for the admission
17or denial; the age, gender, and race of such individuals;
18and the level of care for which such individuals applied for
19admission including residential or nursing level of care.
203. HOME OWNERSHIP ASSISTANCE PROGRAM
21For transfer to the Iowa finance authority for the
22continuation of the home ownership assistance program for
23persons who are or were eligible members of the armed forces of
24the United States, pursuant to section 16.54:
.................................................. $252,000,000
26 Sec. 5. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
27FUND STANDING APPROPRIATIONS. Notwithstanding the standing
28appropriation in section 35A.16 for the fiscal year beginning
29July 1, 2017, and ending June 30, 2018, the amount appropriated
30from the general fund of the state pursuant to that section
31for the following designated purposes shall not exceed the
32following amount:
33For the county commissions of veteran affairs fund under
34section 35A.16:
.................................................. $35947,925
-16-1DIVISION V
2DEPARTMENT OF HUMAN SERVICES — FY 2017-2018
3 Sec. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
4GRANT. There is appropriated from the fund created in section
58.41 to the department of human services for the fiscal year
6beginning July 1, 2017, and ending June 30, 2018, from moneys
7received under the federal temporary assistance for needy
8families (TANF) block grant pursuant to the federal Personal
9Responsibility and Work Opportunity Reconciliation Act of 1996,
10Pub.L.No.104-193, and successor legislation, the following
11amounts, or so much thereof as is necessary, to be used for the
12purposes designated:
131. To be credited to the family investment program account
14and used for assistance under the family investment program
15under chapter 239B:
.................................................. $165,112,462
172. To be credited to the family investment program account
18and used for the job opportunities and basic skills (JOBS)
19program and implementing family investment agreements in
20accordance with chapter 239B:
.................................................. $215,575,693
223. To be used for the family development and
23self-sufficiency grant program in accordance with section
24216A.107:
.................................................. $252,898,980
26Notwithstanding section 8.33, moneys appropriated in this
27subsection that remain unencumbered or unobligated at the close
28of the fiscal year shall not revert but shall remain available
29for expenditure for the purposes designated until the close of
30the succeeding fiscal year. However, unless such moneys are
31encumbered or obligated on or before September 30, 2017, the
32moneys shall revert.
334. For field operations:
.................................................. $3431,296,232
355. For general administration:
-17-.................................................. $13,744,000
26. For state child care assistance:
.................................................. $347,866,826
4a. Of the funds appropriated in this subsection,
5$26,328,097 is transferred to the child care and development
6block grant appropriation made by the Eighty-seventh General
7Assembly, 2017 session, for the federal fiscal year beginning
8October 1, 2017, and ending September 30, 2018. Of this
9amount, $200,000 shall be used for provision of educational
10opportunities to registered child care home providers in order
11to improve services and programs offered by this category
12of providers and to increase the number of providers. The
13department may contract with institutions of higher education
14or child care resource and referral centers to provide
15the educational opportunities. Allowable administrative
16costs under the contracts shall not exceed 5 percent. The
17application for a grant shall not exceed two pages in length.
18b. Any funds appropriated in this subsection remaining
19unallocated shall be used for state child care assistance
20payments for families who are employed including but not
21limited to individuals enrolled in the family investment
22program.
237. For child and family services:
.................................................. $2432,380,654
258. For child abuse prevention grants:
.................................................. $26125,000
279. For pregnancy prevention grants on the condition that
28family planning services are funded:
.................................................. $291,930,067
30Pregnancy prevention grants shall be awarded to programs
31in existence on or before July 1, 2017, if the programs have
32demonstrated positive outcomes. Grants shall be awarded to
33pregnancy prevention programs which are developed after July
341, 2017, if the programs are based on existing models that
35have demonstrated positive outcomes. Grants shall comply with
-18-1the requirements provided in 1997 Iowa Acts, chapter 208,
2section 14, subsections 1 and 2, including the requirement that
3grant programs must emphasize sexual abstinence. Priority in
4the awarding of grants shall be given to programs that serve
5areas of the state which demonstrate the highest percentage of
6unplanned pregnancies of females of childbearing age within the
7geographic area to be served by the grant.
810. For technology needs and other resources necessary
9to meet federal welfare reform reporting, tracking, and case
10management requirements:
.................................................. $111,037,186
1211. a. Notwithstanding any provision to the contrary,
13including but not limited to requirements in section 8.41 or
14provisions in 2016 or 2017 Iowa Acts regarding the receipt and
15appropriation of federal block grants, federal funds from the
16temporary assistance for needy families block grant received by
17the state and not otherwise appropriated in this section and
18remaining available for the fiscal year beginning July 1, 2017,
19are appropriated to the department of human services to the
20extent as may be necessary to be used in the following priority
21order: the family investment program, for state child care
22assistance program payments for families who are employed, and
23for the family investment program share of costs to develop and
24maintain a new, integrated eligibility determination system.
25The federal funds appropriated in this paragraph “a” shall be
26expended only after all other funds appropriated in subsection
271 for the assistance under the family investment program,
28in subsection 6 for child care assistance, or in subsection
2912 for the family investment program share of the costs to
30continue to develop and maintain a new, integrated eligibility
31determination system, as applicable, have been expended. For
32the purposes of this subsection, the funds appropriated in
33subsection 6, paragraph “a”, for transfer to the child care
34and development block grant appropriation are considered fully
35expended when the full amount has been transferred.
-19- 1b. The department shall, on a quarterly basis, advise the
2legislative services agency and department of management of
3the amount of funds appropriated in this subsection that was
4expended in the prior quarter.
512. Of the amounts appropriated in this section,
6$12,962,008 for the fiscal year beginning July 1, 2017, is
7transferred to the appropriation of the federal social services
8block grant made to the department of human services for that
9fiscal year.
1013. For continuation of the program providing categorical
11eligibility for the food assistance program as specified
12for the program in the section of this division of this Act
13relating to the family investment program account:
.................................................. $1425,000
1514. The department may transfer funds allocated in this
16section to the appropriations made in this division of this Act
17for the same fiscal year for general administration and field
18operations for resources necessary to implement and operate the
19services referred to in this section and those funded in the
20appropriation made in this division of this Act for the same
21fiscal year for the family investment program from the general
22fund of the state.
2315. With the exception of moneys allocated under this
24section for the family development and self-sufficiency grant
25program, to the extent moneys allocated in this section are
26deemed by the department not to be necessary to support the
27purposes for which they are allocated, such moneys may be
28credited to the family investment program account as specified
29under subsection 1 of this section and used for the purposes of
30assistance under the family investment program in accordance
31with chapter 239B in the same fiscal year.
32 Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT.
331. Moneys credited to the family investment program (FIP)
34account for the fiscal year beginning July 1, 2017, and
35ending June 30, 2018, shall be used to provide assistance in
-20-1accordance with chapter 239B.
22. The department may use a portion of the moneys credited
3to the FIP account under this section as necessary for
4salaries, support, maintenance, and miscellaneous purposes.
53. The department may transfer funds allocated in
6subsection 4 to the appropriations made in this division of
7this Act for the same fiscal year for general administration
8and field operations for resources necessary to implement and
9operate the family investment program services referred to in
10this section and those funded in the appropriation made in this
11division of this Act for the same fiscal year for the family
12investment program from the general fund of the state.
134. Moneys appropriated in this division of this Act and
14credited to the FIP account for the fiscal year beginning July
151, 2017, and ending June 30, 2018, are allocated as follows:
16a. To be retained by the department of human services to
17be used for coordinating with the department of human rights
18to more effectively serve participants in FIP and other shared
19clients and to meet federal reporting requirements under the
20federal temporary assistance for needy families block grant:
.................................................. $2120,000
22b. To the department of human rights for staffing,
23administration, and implementation of the family development
24and self-sufficiency grant program in accordance with section
25216A.107:
.................................................. $266,192,834
27(1) Of the funds allocated for the family development
28and self-sufficiency grant program in this paragraph “b”,
29not more than 5 percent of the funds shall be used for the
30administration of the grant program.
31(2) The department of human rights may continue to implement
32the family development and self-sufficiency grant program
33statewide during fiscal year 2017-2018.
34(3) The department of human rights may engage in activities
35to strengthen and improve family outcomes measures and
-21-1data collection systems under the family development and
2self-sufficiency grant program.
3c. For the diversion subaccount of the FIP account:
.................................................. $4815,000
5A portion of the moneys allocated for the subaccount may
6be used for field operations, salaries, data management
7system development, and implementation costs and support
8deemed necessary by the director of human services in order to
9administer the FIP diversion program. To the extent moneys
10allocated in this paragraph “c” are deemed by the department
11not to be necessary to support diversion activities, such
12moneys may be used for other efforts intended to increase
13engagement by family investment program participants in work,
14education, or training activities, or for the purposes of
15assistance under the family investment program in accordance
16with chapter 239B.
17d. For the food assistance employment and training program:
.................................................. $1866,588
19(1) The department shall apply the federal supplemental
20nutrition assistance program (SNAP) employment and training
21state plan in order to maximize to the fullest extent permitted
22by federal law the use of the 50 percent federal reimbursement
23provisions for the claiming of allowable federal reimbursement
24funds from the United States department of agriculture
25pursuant to the federal SNAP employment and training program
26for providing education, employment, and training services
27for eligible food assistance program participants, including
28but not limited to related dependent care and transportation
29expenses.
30(2) The department shall continue the categorical federal
31food assistance program eligibility at 160 percent of the
32federal poverty level and continue to eliminate the asset test
33from eligibility requirements, consistent with federal food
34assistance program requirements. The department shall include
35as many food assistance households as is allowed by federal
-22-1law. The eligibility provisions shall conform to all federal
2requirements including requirements addressing individuals who
3are incarcerated or otherwise ineligible.
4e. For the JOBS program:
.................................................. $513,523,290
65. Of the child support collections assigned under FIP,
7an amount equal to the federal share of support collections
8shall be credited to the child support recovery appropriation
9made in this division of this Act. Of the remainder of the
10assigned child support collections received by the child
11support recovery unit, a portion shall be credited to the FIP
12account, a portion may be used to increase recoveries, and a
13portion may be used to sustain cash flow in the child support
14payments account. If as a consequence of the appropriations
15and allocations made in this section the resulting amounts
16are insufficient to sustain cash assistance payments and meet
17federal maintenance of effort requirements, the department
18shall seek supplemental funding. If child support collections
19assigned under FIP are greater than estimated or are otherwise
20determined not to be required for maintenance of effort, the
21state share of either amount may be transferred to or retained
22in the child support payments account.
236. The department may adopt emergency rules for the family
24investment, JOBS, food assistance, and medical assistance
25programs if necessary to comply with federal requirements.
26 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
27is appropriated from the general fund of the state to the
28department of human services for the fiscal year beginning July
291, 2017, and ending June 30, 2018, the following amount, or
30so much thereof as is necessary, to be used for the purpose
31designated:
32To be credited to the family investment program (FIP)
33account and used for family investment program assistance under
34chapter 239B:
.................................................. $3543,004,480
-23- 11. Of the funds appropriated in this section, $7,947,597 is
2allocated for the JOBS program.
32. Of the funds appropriated in this section, $3,313,854 is
4allocated for the family development and self-sufficiency grant
5program.
63. Notwithstanding section 8.39, for the fiscal year
7beginning July 1, 2017, if necessary to meet federal
8maintenance of effort requirements or to transfer federal
9temporary assistance for needy families block grant funding
10to be used for purposes of the federal social services block
11grant or to meet cash flow needs resulting from delays in
12receiving federal funding or to implement, in accordance with
13this division of this Act, activities currently funded with
14juvenile court services, county, or community moneys and state
15moneys used in combination with such moneys; to comply with
16federal requirements; or to maximize the use of federal funds,
17the department of human services may transfer funds within or
18between any of the appropriations made in this division of this
19Act and appropriations in law for the federal social services
20block grant to the department for the following purposes,
21provided that the combined amount of state and federal
22temporary assistance for needy families block grant funding
23for each appropriation remains the same before and after the
24transfer:
25a. For the family investment program.
26b. For child care assistance.
27c. For child and family services.
28d. For field operations.
29e. For general administration.
30This subsection shall not be construed to prohibit the use
31of existing state transfer authority for other purposes. The
32department shall report any transfers made pursuant to this
33subsection to the legislative services agency.
344. Of the funds appropriated in this section, $195,678 shall
35be used for continuation of a grant to an Iowa-based nonprofit
-24-1organization with a history of providing tax preparation
2assistance to low-income Iowans in order to expand the usage of
3the earned income tax credit. The purpose of the grant is to
4supply this assistance to underserved areas of the state.
55. Of the funds appropriated in this section, $60,000 shall
6be used for the continuation of an unfunded pilot project, as
7defined in 441 IAC 100.1, relating to parental obligations,
8in which the child support recovery unit participates, to
9support the efforts of a nonprofit organization committed
10to strengthening the community through youth development,
11healthy living, and social responsibility headquartered in
12a county with a population over 350,000 according to the
13latest certified federal census. The funds allocated in this
14subsection shall be used by the recipient organization to
15develop a larger community effort, through public and private
16partnerships, to support a broad-based multi-county fatherhood
17initiative that promotes payment of child support obligations,
18improved family relationships, and full-time employment.
196. The department may transfer funds appropriated in this
20section to the appropriations made in this division of this Act
21for general administration and field operations as necessary
22to administer this section and the overall family investment
23program.
24 Sec. 9. CHILD SUPPORT RECOVERY. There is appropriated
25from the general fund of the state to the department of human
26services for the fiscal year beginning July 1, 2017, and ending
27June 30, 2018, the following amount, or so much thereof as is
28necessary, to be used for the purposes designated:
29For child support recovery, including salaries, support,
30maintenance, and miscellaneous purposes, and for not more than
31the following full-time equivalent positions:
.................................................. $3212,586,635
............................................... FTEs33459.00
341. The department shall expend up to $24,329, including
35federal financial participation, for the fiscal year beginning
-25-1July 1, 2017, for a child support public awareness campaign.
2The department and the office of the attorney general shall
3cooperate in continuation of the campaign. The public
4awareness campaign shall emphasize, through a variety of
5media activities, the importance of maximum involvement of
6both parents in the lives of their children as well as the
7importance of payment of child support obligations.
82. Federal access and visitation grant moneys shall be
9issued directly to private not-for-profit agencies that provide
10services designed to increase compliance with the child access
11provisions of court orders, including but not limited to
12neutral visitation sites and mediation services.
133. The appropriation made to the department for child
14support recovery may be used throughout the fiscal year in the
15manner necessary for purposes of cash flow management, and for
16cash flow management purposes the department may temporarily
17draw more than the amount appropriated, provided the amount
18appropriated is not exceeded at the close of the fiscal year.
194. With the exception of the funding amount specified, the
20requirements established under 2001 Iowa Acts, chapter 191,
21section 3, subsection 5, paragraph “c”, subparagraph (3), shall
22be applicable to parental obligation pilot projects for the
23fiscal year beginning July 1, 2017, and ending June 30, 2018.
24Notwithstanding 441 IAC 100.8, providing for termination of
25rules relating to the pilot projects, the rules shall remain
26in effect until June 30, 2018.
27 Sec. 10. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
28FY 2017-2018. Any funds remaining in the health care trust
29fund created in section 453A.35A for the fiscal year beginning
30July 1, 2017, and ending June 30, 2018, are appropriated to
31the department of human services to supplement the medical
32assistance program appropriations made in this division of this
33Act, for medical assistance reimbursement and associated costs,
34including program administration and costs associated with
35program implementation.
-26-1 Sec. 11. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
22017-2018. Any funds remaining in the Medicaid fraud fund
3created in section 249A.50 for the fiscal year beginning
4July 1, 2017, and ending June 30, 2018, are appropriated to
5the department of human services to supplement the medical
6assistance appropriations made in this division of this Act,
7for medical assistance reimbursement and associated costs,
8including program administration and costs associated with
9program implementation.
10 Sec. 12. MEDICAL ASSISTANCE. There is appropriated from the
11general fund of the state to the department of human services
12for the fiscal year beginning July 1, 2017, and ending June 30,
132018, the following amount, or so much thereof as is necessary,
14to be used for the purpose designated:
15For medical assistance program reimbursement and associated
16costs as specifically provided in the reimbursement
17methodologies in effect on June 30, 2017, except as otherwise
18expressly authorized by law, consistent with options under
19federal law and regulations, and contingent upon receipt of
20approval from the office of the governor of reimbursement for
21each abortion performed under the program:
.................................................. $221,284,605,740
231. Iowans support reducing the number of abortions
24performed in our state. Funds appropriated under this section
25shall not be used for abortions, unless otherwise authorized
26under this section.
272. The provisions of this section relating to abortions
28shall also apply to the Iowa health and wellness plan created
29pursuant to chapter 249N.
303. The department shall utilize not more than $60,000 of
31the funds appropriated in this section to continue the AIDS/HIV
32health insurance premium payment program as established in 1992
33Iowa Acts, Second Extraordinary Session, chapter 1001, section
34409, subsection 6. Of the funds allocated in this subsection,
35not more than $5,000 may be expended for administrative
-27-1purposes.
24. Of the funds appropriated in this Act to the department
3of public health for addictive disorders, $950,000 for
4the fiscal year beginning July 1, 2017, is transferred
5to the department of human services for an integrated
6substance-related disorder managed care system. The
7departments of human services and public health shall
8work together to maintain the level of mental health and
9substance-related disorder treatment services provided by the
10managed care contractors. Each department shall take the steps
11necessary to continue the federal waivers as necessary to
12maintain the level of services.
135. a. The department shall aggressively pursue options for
14providing medical assistance or other assistance to individuals
15with special needs who become ineligible to continue receiving
16services under the early and periodic screening, diagnostic,
17and treatment program under the medical assistance program
18due to becoming 21 years of age who have been approved for
19additional assistance through the department’s exception to
20policy provisions, but who have health care needs in excess
21of the funding available through the exception to policy
22provisions.
23b. Of the funds appropriated in this section, $100,000
24shall be used for participation in one or more pilot projects
25operated by a private provider to allow the individual or
26individuals to receive service in the community in accordance
27with principles established in Olmstead v.L.C., 527 U.S.581
28(1999), for the purpose of providing medical assistance or
29other assistance to individuals with special needs who become
30ineligible to continue receiving services under the early and
31periodic screening, diagnostic, and treatment program under
32the medical assistance program due to becoming 21 years of
33age who have been approved for additional assistance through
34the department’s exception to policy provisions, but who have
35health care needs in excess of the funding available through
-28-1the exception to the policy provisions.
26. Of the funds appropriated in this section, up to
3$3,050,082 may be transferred to the field operations or
4general administration appropriations in this division of this
5Act for operational costs associated with Part D of the federal
6Medicare Prescription Drug Improvement and Modernization Act
7of 2003, Pub.L.No.108-173.
87. Of the funds appropriated in this section, up to $442,100
9may be transferred to the appropriation in this division
10of this Act for medical contracts to be used for clinical
11assessment services and prior authorization of services.
128. A portion of the funds appropriated in this section
13may be transferred to the appropriations in this division of
14this Act for general administration, medical contracts, the
15children’s health insurance program, or field operations to be
16used for the state match cost to comply with the payment error
17rate measurement (PERM) program for both the medical assistance
18and children’s health insurance programs as developed by the
19centers for Medicare and Medicaid services of the United States
20department of health and human services to comply with the
21federal Improper Payments Information Act of 2002, Pub.L.No.
22107-300.
239. The department shall continue to implement the
24recommendations of the assuring better child health and
25development initiative II (ABCDII) clinical panel to the
26Iowa early and periodic screening, diagnostic, and treatment
27services healthy mental development collaborative board
28regarding changes to billing procedures, codes, and eligible
29service providers.
3010. Of the funds appropriated in this section, a sufficient
31amount is allocated to supplement the incomes of residents of
32nursing facilities, intermediate care facilities for persons
33with mental illness, and intermediate care facilities for
34persons with an intellectual disability, with incomes of less
35than $50 in the amount necessary for the residents to receive a
-29-1personal needs allowance of $50 per month pursuant to section
2249A.30A.
311. a. Hospitals that meet the conditions specified
4in subparagraphs (1) and (2) shall either certify public
5expenditures or transfer to the medical assistance program
6an amount equal to provide the nonfederal share for a
7disproportionate share hospital payment in an amount up to the
8hospital-specific limit as approved in the Medicaid state plan.
9The hospitals that meet the conditions specified shall receive
10and retain 100 percent of the total disproportionate share
11hospital payment in an amount up to the hospital-specific limit
12as approved in the Medicaid state plan.
13(1) The hospital qualifies for disproportionate share and
14graduate medical education payments.
15(2) The hospital is an Iowa state-owned hospital with more
16than 500 beds and eight or more distinct residency specialty
17or subspecialty programs recognized by the American college of
18graduate medical education.
19b. Distribution of the disproportionate share payments
20shall be made on a monthly basis. The total amount of
21disproportionate share payments including graduate medical
22education, enhanced disproportionate share, and Iowa
23state-owned teaching hospital payments shall not exceed the
24amount of the state’s allotment under Pub.L.No.102-234.
25In addition, the total amount of all disproportionate
26share payments shall not exceed the hospital-specific
27disproportionate share limits under Pub.L.No.103-66.
2812. One hundred percent of the nonfederal share of payments
29to area education agencies that are medical assistance
30providers for medical assistance-covered services provided to
31medical assistance-covered children, shall be made from the
32appropriation made in this section.
3313. A portion of the funds appropriated in this section
34may be transferred to the appropriation in this division of
35this Act for medical contracts to be used for administrative
-30-1activities associated with the money follows the person
2demonstration project.
314. Of the funds appropriated in this section, $349,011
4shall be used for the administration of the health insurance
5premium payment program, including salaries, support,
6maintenance, and miscellaneous purposes.
715. a. The department shall implement all of the following
8cost containment strategies:
9(1) An adjustment to the reimbursement policy in order
10to eliminate the primary care physician rate increase
11originally authorized by the federal Health Care and Education
12Reconciliation Act of 2010, section 1202, Pub.L. No.111-152,
1342 U.S.C. §1396a(a)(13)(C) that allows qualified primary care
14physicians to receive the greater of the Medicare rate or
15Medicaid rate for a specified set of codes.
16(2) A strategy to ensure that total reimbursement for
17Medicare Part A and Medicare Part B crossover claims is limited
18to the Medicaid reimbursement rate.
19(3) An adjustment to Medicaid reimbursement rates for
20physician services by applying a site of service differential
21to reflect the difference between the cost of physician
22services when provided in a health facility setting and the
23cost of physician services when provided in a physician’s
24office.
25(4) An adjustment to the inpatient diagnostic related group
26(DRG) cost threshold formula to be the greater of two times the
27statewide average DRG payment for that case or the hospital’s
28individual DRG payment for that case plus $75,000.
29(5) An adjustment to the Medicaid anesthesia conversion
30factor to be equal to the calendar year 2017 Medicare
31anesthesia conversion factor as adjusted for the state, and
32converted to a per minute amount. Each January 1, thereafter,
33the department shall apply the applicable Medicare anesthesia
34conversion factor adjusted for the state, and converted to a
35per minute amount.
-31- 1(6) An alignment of billing and reimbursement for
2consultation services rendered in an office, other outpatient,
3or inpatient setting with Medicare billing and reimbursement.
4(7) Elimination of the three-month retroactive Medicaid
5coverage benefit for Medicaid applicants effective October 1,
62017. The department shall seek a waiver from the centers for
7Medicare and Medicaid services of the United States department
8of health and human services to implement the strategy.
9If federal approval is received, an applicant’s Medicaid
10coverage shall be effective on the first day of the month of
11application, as allowed under the Medicaid state plan.
12b. The department shall implement the cost containment
13strategies specified in this subsection beginning July 1, 2017,
14or as otherwise specified. If federal approval is required,
15the strategy shall be implemented effective upon receipt of
16federal approval.
17c. The department may adopt emergency rules to implement
18this subsection.
1916. a. The department may increase the amounts allocated
20for salaries, support, maintenance, and miscellaneous purposes
21associated with the medical assistance program, as necessary,
22to implement cost containment strategies. The department shall
23report any such increase to the legislative services agency and
24the department of management.
25b. If the savings to the medical assistance program from
26cost containment efforts exceed the cost for the fiscal
27year beginning July 1, 2017, the department may transfer any
28savings generated for the fiscal year due to medical assistance
29program cost containment efforts to the appropriation
30made in this division of this Act for medical contracts or
31general administration to defray the increased contract costs
32associated with implementing such efforts.
3317. For the fiscal year beginning July 1, 2017, and ending
34June 30, 2018, the replacement generation tax revenues required
35to be deposited in the property tax relief fund pursuant to
-32-1section 437A.8, subsection 4, paragraph “d”, and section
2437A.15, subsection 3, paragraph “f”, shall instead be credited
3to and supplement the appropriation made in this section and
4used for the allocations made in this section.
518. a. Of the funds appropriated in this section, up
6to $50,000 may be transferred by the department to the
7appropriation made in this division of this Act to the
8department for the same fiscal year for general administration
9to be used for associated administrative expenses and for not
10more than one full-time equivalent position, in addition to
11those authorized for the same fiscal year, to be assigned to
12implementing the children’s mental health home project.
13b. Of the funds appropriated in this section, up to $400,000
14may be transferred by the department to the appropriation made
15to the department in this division of this Act for the same
16fiscal year for Medicaid program-related general administration
17planning and implementation activities. The funds may be used
18for contracts or for personnel in addition to the amounts
19appropriated for and the positions authorized for general
20administration for the fiscal year.
21c. Of the funds appropriated in this section, up to
22$3,000,000 may be transferred by the department to the
23appropriations made in this division of this Act for the same
24fiscal year for general administration or medical contracts
25to be used to support the development and implementation of
26standardized assessment tools for persons with mental illness,
27an intellectual disability, a developmental disability, or a
28brain injury.
2919. Of the funds appropriated in this section, $150,000
30shall be used for lodging expenses associated with care
31provided at the university of Iowa hospitals and clinics for
32patients with cancer whose travel distance is 30 miles or more
33and whose income is at or below 200 percent of the federal
34poverty level as defined by the most recently revised poverty
35income guidelines published by the United States department of
-33-1health and human services. The department of human services
2shall establish the maximum number of overnight stays and the
3maximum rate reimbursed for overnight lodging, which may be
4based on the state employee rate established by the department
5of administrative services. The funds allocated in this
6subsection shall not be used as nonfederal share matching
7funds.
820. Of the funds appropriated in this section, up to
9$3,383,880 shall be used for administration of the state family
10planning services program as enacted in this 2017 Act, and
11of this amount, the department may use up to $200,000 for
12administrative expenses.
1321. The department shall report the implementation of
14any cost containment strategies to the individuals specified
15in this division of this Act for submission of reports upon
16implementation.
1722. The department shall report the implementation of any
18process improvement changes and any related cost reductions
19to the individuals specified in this division of this Act for
20submission of reports upon implementation.
2123. The Medicaid managed care organizations shall explore
22options provided by national human services nonprofit
23organizations that provide innovative services for persons with
24behavioral health challenges to incorporate assertive community
25treatment teams into the services provided to individuals with
26severe and persistent mental illness in order to minimize or
27prevent recurrent acute episodes and to enhance quality of life
28and functioning.
2924. To the extent a managed care organization has developed
30a closed or exclusive provider network through contractual
31arrangements with selected providers, such managed care
32organization shall accept into such closed or exclusive network
33any willing licensed or certified health care provider who
34holds a current, active license or certification in good
35standing, as applicable, who is not experiencing adverse care
-34-1quality issues, and who agrees to accept the fee schedule,
2payment, or reimbursement rate for such health care provider in
3that network in the specific geographic area of the licensed or
4certified health care provider.
525. The department of human services shall include in the
6Medicaid managed care contracts beginning with the contract
7period effective July 1, 2017, per member per month capitation
8payments to managed care organizations that encourage the
9utilization of home and community-based services as an
10alternative to residential care for members.
11 Sec. 13. MEDICAL CONTRACTS. There is appropriated from the
12general fund of the state to the department of human services
13for the fiscal year beginning July 1, 2017, and ending June 30,
142018, the following amount, or so much thereof as is necessary,
15to be used for the purpose designated:
16For medical contracts:
.................................................. $1717,626,464
181. The department of inspections and appeals shall
19provide all state matching funds for survey and certification
20activities performed by the department of inspections
21and appeals. The department of human services is solely
22responsible for distributing the federal matching funds for
23such activities.
242. Of the funds appropriated in this section, $50,000 shall
25be used for continuation of home and community-based services
26waiver quality assurance programs, including the review and
27streamlining of processes and policies related to oversight and
28quality management to meet state and federal requirements.
293. Of the amount appropriated in this section, up to
30$200,000 may be transferred to the appropriation for general
31administration in this division of this Act to be used for
32additional full-time equivalent positions in the development of
33key health initiatives such as cost containment, development
34and oversight of managed care programs, and development of
35health strategies targeted toward improved quality and reduced
-35-1costs in the Medicaid program.
24. Of the funds appropriated in this section, $1,000,000
3shall be used for planning and development, in cooperation with
4the department of public health, of a phased-in program to
5provide a dental home for children.
65. Of the funds appropriated in this section, $950,000
7shall be credited to the autism support program fund created
8in section 225D.2 to be used for the autism support program
9created in chapter 225D, with the exception of the following
10amounts of this allocation which shall be used as follows:
11a. Of the amount appropriated in this section, $202,000
12shall be used for the public purpose of providing a one-year
13grant to Drake university to establish a master’s program in
14applied behavioral analysis, including the establishment of
15remote learning sites and a remote system to maximize outreach
16and enrollment in the program.
17b. Of the funds allocated in this subsection, $25,000
18shall be used for the public purpose of continuation of a
19grant to a child welfare services provider headquartered in a
20county with a population between 205,000 and 215,000 in the
21latest certified federal census that provides multiple services
22including but not limited to a psychiatric medical institution
23for children, shelter, residential treatment, after school
24programs, school-based programming, and an Asperger’s syndrome
25program, to be used for support services for children with
26autism spectrum disorder and their families.
27c. Of the funds allocated in this subsection, $25,000
28shall be used for the public purpose of continuing a grant to
29a hospital-based provider headquartered in a county with a
30population between 90,000 and 95,000 in the latest certified
31federal census that provides multiple services including
32but not limited to diagnostic, therapeutic, and behavioral
33services to individuals with autism spectrum disorder across
34one’s lifespan. The grant recipient shall utilize the funds
35to continue the pilot project to determine the necessary
-36-1support services for children with autism spectrum disorder and
2their families to be included in the children’s disabilities
3services system. The grant recipient shall submit findings and
4recommendations based upon the results of the pilot project
5to the individuals specified in this division of this Act for
6submission of reports by December 31, 2017.
7 Sec. 14. STATE SUPPLEMENTARY ASSISTANCE.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2017, and ending June 30, 2018, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13For the state supplementary assistance program:
.................................................. $1410,372,658
152. The department shall increase the personal needs
16allowance for residents of residential care facilities by the
17same percentage and at the same time as federal supplemental
18security income and federal social security benefits are
19increased due to a recognized increase in the cost of living.
20The department may adopt emergency rules to implement this
21subsection.
223. If during the fiscal year beginning July 1, 2017,
23the department projects that state supplementary assistance
24expenditures for a calendar year will not meet the federal
25pass-through requirement specified in Tit.XVI of the federal
26Social Security Act, section 1618, as codified in 42 U.S.C.
27§1382g, the department may take actions including but not
28limited to increasing the personal needs allowance for
29residential care facility residents and making programmatic
30adjustments or upward adjustments of the residential care
31facility or in-home health-related care reimbursement rates
32prescribed in this division of this Act to ensure that federal
33requirements are met. In addition, the department may make
34other programmatic and rate adjustments necessary to remain
35within the amount appropriated in this section while ensuring
-37-1compliance with federal requirements. The department may adopt
2emergency rules to implement the provisions of this subsection.
3 Sec. 15. CHILDREN’S HEALTH INSURANCE PROGRAM.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2017, and ending June 30, 2018, the following
7amount, or so much thereof as is necessary, to be used for the
8purpose designated:
9For maintenance of the healthy and well kids in Iowa (hawk-i)
10program pursuant to chapter 514I, including supplemental dental
11services, for receipt of federal financial participation under
12Tit.XXI of the federal Social Security Act, which creates the
13children’s health insurance program:
.................................................. $148,518,452
152. Of the funds appropriated in this section, $42,800 is
16allocated for continuation of the contract for outreach with
17the department of public health.
18 Sec. 16. CHILD CARE ASSISTANCE. There is appropriated
19from the general fund of the state to the department of human
20services for the fiscal year beginning July 1, 2017, and ending
21June 30, 2018, the following amount, or so much thereof as is
22necessary, to be used for the purpose designated:
23For child care programs:
.................................................. $2439,343,616
251. Of the funds appropriated in this section, $33,493,616
26shall be used for state child care assistance in accordance
27with section 237A.13.
282. Nothing in this section shall be construed or is
29intended as or shall imply a grant of entitlement for services
30to persons who are eligible for assistance due to an income
31level consistent with the waiting list requirements of section
32237A.13. Any state obligation to provide services pursuant to
33this section is limited to the extent of the funds appropriated
34in this section.
353. A list of the registered and licensed child care
-38-1facilities operating in the area served by a child care
2resource and referral service shall be made available to the
3families receiving state child care assistance in that area.
44. Of the funds appropriated in this section, $5,850,000
5shall be credited to the early childhood programs grants
6account in the early childhood Iowa fund created in section
7256I.11. The moneys shall be distributed for funding of
8community-based early childhood programs targeted to children
9from birth through five years of age developed by early
10childhood Iowa areas in accordance with approved community
11plans as provided in section 256I.8.
125. The department may use any of the funds appropriated
13in this section as a match to obtain federal funds for use in
14expanding child care assistance and related programs. For
15the purpose of expenditures of state and federal child care
16funding, funds shall be considered obligated at the time
17expenditures are projected or are allocated to the department’s
18service areas. Projections shall be based on current and
19projected caseload growth, current and projected provider
20rates, staffing requirements for eligibility determination
21and management of program requirements including data systems
22management, staffing requirements for administration of the
23program, contractual and grant obligations and any transfers
24to other state agencies, and obligations for decategorization
25or innovation projects.
266. A portion of the state match for the federal child care
27and development block grant shall be provided as necessary to
28meet federal matching funds requirements through the state
29general fund appropriation made for child development grants
30and other programs for at-risk children in section 279.51.
317. If a uniform reduction ordered by the governor under
32section 8.31 or other operation of law, transfer, or federal
33funding reduction reduces the appropriation made in this
34section for the fiscal year, the percentage reduction in the
35amount paid out to or on behalf of the families participating
-39-1in the state child care assistance program shall be equal to or
2less than the percentage reduction made for any other purpose
3payable from the appropriation made in this section and the
4federal funding relating to it. The percentage reduction to
5the other allocations made in this section shall be the same as
6the uniform reduction ordered by the governor or the percentage
7change of the federal funding reduction, as applicable.
8If there is an unanticipated increase in federal funding
9provided for state child care assistance, the entire amount
10of the increase shall be used for state child care assistance
11payments. If the appropriations made for purposes of the
12state child care assistance program for the fiscal year are
13determined to be insufficient, it is the intent of the general
14assembly to appropriate sufficient funding for the fiscal year
15in order to avoid establishment of waiting list requirements.
168. Notwithstanding section 8.33, moneys advanced for
17purposes of the programs developed by early childhood Iowa
18areas, advanced for purposes of wraparound child care, or
19received from the federal appropriations made for the purposes
20of this section that remain unencumbered or unobligated at the
21close of the fiscal year shall not revert to any fund but shall
22remain available for expenditure for the purposes designated
23until the close of the succeeding fiscal year.
24 Sec. 17. JUVENILE INSTITUTION. There is appropriated
25from the general fund of the state to the department of human
26services for the fiscal year beginning July 1, 2017, and ending
27June 30, 2018, the following amounts, or so much thereof as is
28necessary, to be used for the purposes designated:
291. For operation of the state training school at Eldora and
30for salaries, support, maintenance, and miscellaneous purposes,
31and for not more than the following full-time equivalent
32positions:
.................................................. $3311,350,443
............................................... FTEs34189.00
35Of the funds appropriated in this subsection, $91,150 shall
-40-1be used for distribution to licensed classroom teachers at this
2and other institutions under the control of the department of
3human services based upon the average student yearly enrollment
4at each institution as determined by the department.
52. A portion of the moneys appropriated in this section
6shall be used by the state training school at Eldora for
7grants for adolescent pregnancy prevention activities at the
8institution in the fiscal year beginning July 1, 2017.
9 Sec. 18. CHILD AND FAMILY SERVICES.
101. There is appropriated from the general fund of the
11state to the department of human services for the fiscal year
12beginning July 1, 2017, and ending June 30, 2018, the following
13amount, or so much thereof as is necessary, to be used for the
14purpose designated:
15For child and family services:
.................................................. $1687,329,375
172. The department may transfer funds appropriated in this
18section as necessary to pay the nonfederal costs of services
19reimbursed under the medical assistance program, state child
20care assistance program, or the family investment program which
21are provided to children who would otherwise receive services
22paid under the appropriation in this section. The department
23may transfer funds appropriated in this section to the
24appropriations made in this division of this Act for general
25administration and for field operations for resources necessary
26to implement and operate the services funded in this section.
273. a. Of the funds appropriated in this section, up to
28$35,736,649 is allocated as the statewide expenditure target
29under section 232.143 for group foster care maintenance and
30services. If the department projects that such expenditures
31for the fiscal year will be less than the target amount
32allocated in this paragraph “a”, the department may reallocate
33the excess to provide additional funding for shelter care
34or the child welfare emergency services addressed with the
35allocation for shelter care.
-41- 1b. If at any time after September 30, 2017, annualization
2of a service area’s current expenditures indicates a service
3area is at risk of exceeding its group foster care expenditure
4target under section 232.143 by more than 5 percent, the
5department and juvenile court services shall examine all
6group foster care placements in that service area in order to
7identify those which might be appropriate for termination.
8In addition, any aftercare services believed to be needed
9for the children whose placements may be terminated shall be
10identified. The department and juvenile court services shall
11initiate action to set dispositional review hearings for the
12placements identified. In such a dispositional review hearing,
13the juvenile court shall determine whether needed aftercare
14services are available and whether termination of the placement
15is in the best interest of the child and the community.
164. In accordance with the provisions of section 232.188,
17the department shall continue the child welfare and juvenile
18justice funding initiative during fiscal year 2017-2018. Of
19the funds appropriated in this section, $1,717,753 is allocated
20specifically for expenditure for fiscal year 2017-2018 through
21the decategorization services funding pools and governance
22boards established pursuant to section 232.188.
235. A portion of the funds appropriated in this section
24may be used for emergency family assistance to provide other
25resources required for a family participating in a family
26preservation or reunification project or successor project to
27stay together or to be reunified.
286. Notwithstanding section 234.35 or any other provision
29of law to the contrary, state funding for shelter care and
30the child welfare emergency services contracting implemented
31to provide for or prevent the need for shelter care shall be
32limited to $8,096,158.
337. Federal funds received by the state during the fiscal
34year beginning July 1, 2017, as the result of the expenditure
35of state funds appropriated during a previous state fiscal
-42-1year for a service or activity funded under this section are
2appropriated to the department to be used as additional funding
3for services and purposes provided for under this section.
4Notwithstanding section 8.33, moneys received in accordance
5with this subsection that remain unencumbered or unobligated at
6the close of the fiscal year shall not revert to any fund but
7shall remain available for the purposes designated until the
8close of the succeeding fiscal year.
98. a. Of the funds appropriated in this section, up to
10$3,290,000 is allocated for the payment of the expenses of
11court-ordered services provided to juveniles who are under the
12supervision of juvenile court services, which expenses are a
13charge upon the state pursuant to section 232.141, subsection
144. Of the amount allocated in this paragraph “a”, up to
15$1,556,287 shall be made available to provide school-based
16supervision of children adjudicated under chapter 232, of which
17not more than $15,000 may be used for the purpose of training.
18A portion of the cost of each school-based liaison officer
19shall be paid by the school district or other funding source as
20approved by the chief juvenile court officer.
21b. Of the funds appropriated in this section, up to $748,985
22is allocated for the payment of the expenses of court-ordered
23services provided to children who are under the supervision
24of the department, which expenses are a charge upon the state
25pursuant to section 232.141, subsection 4.
26c. Notwithstanding section 232.141 or any other provision
27of law to the contrary, the amounts allocated in this
28subsection shall be distributed to the judicial districts
29as determined by the state court administrator and to the
30department’s service areas as determined by the administrator
31of the department of human services’ division of child and
32family services. The state court administrator and the
33division administrator shall make the determination of the
34distribution amounts on or before June 15, 2017.
35d. Notwithstanding chapter 232 or any other provision of
-43-1law to the contrary, a district or juvenile court shall not
2order any service which is a charge upon the state pursuant
3to section 232.141 if there are insufficient court-ordered
4services funds available in the district court or departmental
5service area distribution amounts to pay for the service. The
6chief juvenile court officer and the departmental service area
7manager shall encourage use of the funds allocated in this
8subsection such that there are sufficient funds to pay for
9all court-related services during the entire year. The chief
10juvenile court officers and departmental service area managers
11shall attempt to anticipate potential surpluses and shortfalls
12in the distribution amounts and shall cooperatively request the
13state court administrator or division administrator to transfer
14funds between the judicial districts’ or departmental service
15areas’ distribution amounts as prudent.
16e. Notwithstanding any provision of law to the contrary,
17a district or juvenile court shall not order a county to pay
18for any service provided to a juvenile pursuant to an order
19entered under chapter 232 which is a charge upon the state
20under section 232.141, subsection 4.
21f. Of the funds allocated in this subsection, not more than
22$83,000 may be used by the judicial branch for administration
23of the requirements under this subsection.
24g. Of the funds allocated in this subsection, $17,000
25shall be used by the department of human services to support
26the interstate commission for juveniles in accordance with
27the interstate compact for juveniles as provided in section
28232.173.
299. Of the funds appropriated in this section, $12,253,227 is
30allocated for juvenile delinquent graduated sanctions services.
31Any state funds saved as a result of efforts by juvenile court
32services to earn a federal Tit.IV-E match for juvenile court
33services administration may be used for the juvenile delinquent
34graduated sanctions services.
3510. Of the funds appropriated in this section, $1,658,285 is
-44-1transferred to the department of public health to be used for
2the child protection center grant program for child protection
3centers located in Iowa in accordance with section 135.118.
4The grant amounts under the program shall be equalized so that
5each center receives a uniform base amount of $245,000, so that
6$50,000 is awarded to establish a satellite child protection
7center in a city in north central Iowa that is the county
8seat of a county with a population between 44,000 and 45,000
9according to the latest certified federal census, and so that
10the remaining funds are awarded through a funding formula based
11upon the volume of children served.
1211. If the department receives federal approval to
13implement a waiver under Tit.IV-E of the federal Social
14Security Act to enable providers to serve children who remain
15in the children’s families and communities, for purposes of
16eligibility under the medical assistance program through 25
17years of age, children who participate in the waiver shall be
18considered to be placed in foster care.
1912. Of the funds appropriated in this section, $4,025,167 is
20allocated for the preparation for adult living program pursuant
21to section 234.46.
2213. Of the funds appropriated in this section, $227,337
23shall be used for the public purpose of continuing a grant to
24a nonprofit human services organization providing services to
25individuals and families in multiple locations in southwest
26Iowa and Nebraska for support of a project providing immediate,
27sensitive support and forensic interviews, medical exams, needs
28assessments, and referrals for victims of child abuse and their
29nonoffending family members.
3014. Of the funds appropriated in this section, $300,620
31is allocated for the foster care youth council approach of
32providing a support network to children placed in foster care.
3315. Of the funds appropriated in this section, $202,000 is
34allocated for use pursuant to section 235A.1 for continuation
35of the initiative to address child sexual abuse implemented
-45-1pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
221.
316. Of the funds appropriated in this section, $630,240 is
4allocated for the community partnership for child protection
5sites.
617. Of the funds appropriated in this section, $371,250
7is allocated for the department’s minority youth and family
8projects under the redesign of the child welfare system.
918. Of the funds appropriated in this section, $1,186,595
10is allocated for funding of the community circle of care
11collaboration for children and youth in northeast Iowa.
1219. Of the funds appropriated in this section, at least
13$147,158 shall be used for the continuation of the child
14welfare provider training academy, a collaboration between the
15coalition for family and children’s services in Iowa and the
16department.
1720. Of the funds appropriated in this section, $211,872
18shall be used for continuation of the central Iowa system of
19care program grant through June 30, 2018.
2021. Of the funds appropriated in this section, $235,000
21shall be used for the public purpose of the continuation
22and expansion of a system of care program grant implemented
23in Cerro Gordo and Linn counties to utilize a comprehensive
24and long-term approach for helping children and families by
25addressing the key areas in a child’s life of childhood basic
26needs, education and work, family, and community.
2722. Of the funds appropriated in this section, at least
28$25,000 shall be used to continue and to expand the foster
29care respite pilot program in which postsecondary students in
30social work and other human services-related programs receive
31experience by assisting family foster care providers with
32respite and other support.
3323. Of the funds appropriated in this section, $110,000
34shall be used for the public purpose of funding community-based
35services and other supports with a system of care approach
-46-1for children with a serious emotional disturbance and their
2families through a nonprofit provider of child welfare services
3that has been in existence for more than 115 years, is located
4in a county with a population of more than 200,000 but less
5than 220,000 according to the latest certified federal census,
6is licensed as a psychiatric medical institution for children,
7and was a system of care grantee prior to July 1, 2017.
8 Sec. 19. ADOPTION SUBSIDY.
91. There is appropriated from the general fund of the
10state to the department of human services for the fiscal year
11beginning July 1, 2017, and ending June 30, 2018, the following
12amount, or so much thereof as is necessary, to be used for the
13purpose designated:
14a. For adoption subsidy payments and services:
.................................................. $1540,777,910
16b. (1) The funds appropriated in this section shall be used
17as authorized or allowed by federal law or regulation for any
18of the following purposes:
19(a) For adoption subsidy payments and related costs.
20(b) For post-adoption services and for other purposes under
21Tit.IV-B or Tit.IV-E of the federal Social Security Act.
22(2) The department of human services may transfer funds
23appropriated in this subsection to the appropriation for
24child and family services in this Act for the purposes of
25post-adoption services as specified in this paragraph “b”.
262. The department may transfer funds appropriated in
27this section to the appropriation made in this division of
28this Act for general administration for costs paid from the
29appropriation relating to adoption subsidy.
303. Federal funds received by the state during the
31fiscal year beginning July 1, 2017, as the result of the
32expenditure of state funds during a previous state fiscal
33year for a service or activity funded under this section are
34appropriated to the department to be used as additional funding
35for the services and activities funded under this section.
-47-1Notwithstanding section 8.33, moneys received in accordance
2with this subsection that remain unencumbered or unobligated
3at the close of the fiscal year shall not revert to any fund
4but shall remain available for expenditure for the purposes
5designated until the close of the succeeding fiscal year.
6 Sec. 20. JUVENILE DETENTION HOME FUND. Moneys deposited
7in the juvenile detention home fund created in section 232.142
8during the fiscal year beginning July 1, 2017, and ending June
930, 2018, are appropriated to the department of human services
10for the fiscal year beginning July 1, 2017, and ending June 30,
112018, for distribution of an amount equal to a percentage of
12the costs of the establishment, improvement, operation, and
13maintenance of county or multicounty juvenile detention homes
14in the fiscal year beginning July 1, 2015. Moneys appropriated
15for distribution in accordance with this section shall be
16allocated among eligible detention homes, prorated on the basis
17of an eligible detention home’s proportion of the costs of all
18eligible detention homes in the fiscal year beginning July
191, 2015. The percentage figure shall be determined by the
20department based on the amount available for distribution for
21the fund. Notwithstanding section 232.142, subsection 3, the
22financial aid payable by the state under that provision for the
23fiscal year beginning July 1, 2017, shall be limited to the
24amount appropriated for the purposes of this section.
25 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM.
261. There is appropriated from the general fund of the
27state to the department of human services for the fiscal year
28beginning July 1, 2017, and ending June 30, 2018, the following
29amount, or so much thereof as is necessary, to be used for the
30purpose designated:
31For the family support subsidy program subject to the
32enrollment restrictions in section 225C.37, subsection 3:
.................................................. $331,069,282
342. At least $787,500 of the moneys appropriated in this
35section is transferred to the department of public health for
-48-1the family support center component of the comprehensive family
2support program under chapter 225C, subchapter V.
33. If at any time during the fiscal year, the amount of
4funding available for the family support subsidy program
5is reduced from the amount initially used to establish the
6figure for the number of family members for whom a subsidy
7is to be provided at any one time during the fiscal year,
8notwithstanding section 225C.38, subsection 2, the department
9shall revise the figure as necessary to conform to the amount
10of funding available.
11 Sec. 22. CONNER DECREE. There is appropriated from the
12general fund of the state to the department of human services
13for the fiscal year beginning July 1, 2017, and ending June 30,
142018, the following amount, or so much thereof as is necessary,
15to be used for the purpose designated:
16For building community capacity through the coordination
17and provision of training opportunities in accordance with the
18consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
19Iowa, July 14, 1994):
.................................................. $2033,632
21 Sec. 23. MENTAL HEALTH INSTITUTES.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2017, and ending June 30, 2018, the following
25amounts, or so much thereof as is necessary, to be used for the
26purposes designated:
27a. For operation of the state mental health institute at
28Cherokee as required by chapters 218 and 226 for salaries,
29support, maintenance, and miscellaneous purposes, and for not
30more than the following full-time equivalent positions:
.................................................. $3113,870,254
............................................... FTEs32162.00
33b. For operation of the state mental health institute at
34Independence as required by chapters 218 and 226 for salaries,
35support, maintenance, and miscellaneous purposes, and for not
-49-1more than the following full-time equivalent positions:
.................................................. $217,513,621
............................................... FTEs3204.00
42. Notwithstanding sections 218.78 and 249A.11, any revenue
5received from the state mental health institute at Cherokee or
6the state mental health institute at Independence pursuant to
742 C.F.R §438.6(e) may be retained and expended by the mental
8health institute.
93. Notwithstanding any provision of law to the contrary,
10a Medicaid member residing at the state mental health
11institute at Cherokee or the state mental health institute
12at Independence shall retain Medicaid eligibility during
13the period of the Medicaid member’s stay for which federal
14financial participation is available.
15 Sec. 24. STATE RESOURCE CENTERS.
161. There is appropriated from the general fund of the
17state to the department of human services for the fiscal year
18beginning July 1, 2017, and ending June 30, 2018, the following
19amounts, or so much thereof as is necessary, to be used for the
20purposes designated:
21a. For the state resource center at Glenwood for salaries,
22support, maintenance, and miscellaneous purposes:
.................................................. $2317,887,781
24b. For the state resource center at Woodward for salaries,
25support, maintenance, and miscellaneous purposes:
.................................................. $2612,077,034
272. The department may continue to bill for state resource
28center services utilizing a scope of services approach used for
29private providers of intermediate care facilities for persons
30with an intellectual disability services, in a manner which
31does not shift costs between the medical assistance program,
32counties, or other sources of funding for the state resource
33centers.
343. The state resource centers may expand the time-limited
35assessment and respite services during the fiscal year.
-50- 14. If the department’s administration and the department
2of management concur with a finding by a state resource
3center’s superintendent that projected revenues can reasonably
4be expected to pay the salary and support costs for a new
5employee position, or that such costs for adding a particular
6number of new positions for the fiscal year would be less
7than the overtime costs if new positions would not be added,
8the superintendent may add the new position or positions. If
9the vacant positions available to a resource center do not
10include the position classification desired to be filled, the
11state resource center’s superintendent may reclassify any
12vacant position as necessary to fill the desired position. The
13superintendents of the state resource centers may, by mutual
14agreement, pool vacant positions and position classifications
15during the course of the fiscal year in order to assist one
16another in filling necessary positions.
175. If existing capacity limitations are reached in
18operating units, a waiting list is in effect for a service or
19a special need for which a payment source or other funding
20is available for the service or to address the special need,
21and facilities for the service or to address the special need
22can be provided within the available payment source or other
23funding, the superintendent of a state resource center may
24authorize opening not more than two units or other facilities
25and begin implementing the service or addressing the special
26need during fiscal year 2017-2018.
27 Sec. 25. SEXUALLY VIOLENT PREDATORS.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2017, and ending June 30, 2018, the following
31amount, or so much thereof as is necessary, to be used for the
32purpose designated:
33For costs associated with the commitment and treatment of
34sexually violent predators in the unit located at the state
35mental health institute at Cherokee, including costs of legal
-51-1services and other associated costs, including salaries,
2support, maintenance, and miscellaneous purposes, and for not
3more than the following full-time equivalent positions:
.................................................. $49,464,747
............................................... FTEs5112.00
62. Unless specifically prohibited by law, if the amount
7charged provides for recoupment of at least the entire amount
8of direct and indirect costs, the department of human services
9may contract with other states to provide care and treatment
10of persons placed by the other states at the unit for sexually
11violent predators at Cherokee. The moneys received under
12such a contract shall be considered to be repayment receipts
13and used for the purposes of the appropriation made in this
14section.
15 Sec. 26. FIELD OPERATIONS. There is appropriated from the
16general fund of the state to the department of human services
17for the fiscal year beginning July 1, 2017, and ending June 30,
182018, the following amount, or so much thereof as is necessary,
19to be used for the purposes designated:
20For field operations, including salaries, support,
21maintenance, and miscellaneous purposes, and for not more than
22the following full-time equivalent positions:
.................................................. $2348,484,435
............................................... FTEs241,583.00
25Priority in filling full-time equivalent positions shall be
26given to those positions related to child protection services
27and eligibility determination for low-income families.
28 Sec. 27. GENERAL ADMINISTRATION. There is appropriated
29from the general fund of the state to the department of human
30services for the fiscal year beginning July 1, 2017, and ending
31June 30, 2018, the following amount, or so much thereof as is
32necessary, to be used for the purpose designated:
33For general administration, including salaries, support,
34maintenance, and miscellaneous purposes, and for not more than
35the following full-time equivalent positions:
-52-.................................................. $113,883,040
............................................... FTEs2294.00
31. The department shall report at least monthly to the
4legislative services agency concerning the department’s
5operational and program expenditures.
62. Of the funds appropriated in this section, $150,000 shall
7be used to continue the contract for the provision of a program
8to provide technical assistance, support, and consultation to
9providers of habilitation services and home and community-based
10services waiver services for adults with disabilities under the
11medical assistance program.
123. Of the funds appropriated in this section, $50,000
13is transferred to the Iowa finance authority to be used
14for administrative support of the council on homelessness
15established in section 16.2D and for the council to fulfill its
16duties in addressing and reducing homelessness in the state.
174. Of the funds appropriated in this section, $250,000 shall
18be transferred to and deposited in the administrative fund of
19the Iowa ABLE savings plan trust created in section 12I.4, to
20be used for implementation and administration activities of the
21Iowa ABLE savings plan trust.
225. Of the funds appropriated in this section, $200,000
23is transferred to the economic development authority for
24the Iowa commission on volunteer services to continue to be
25used for RefugeeRISE AmeriCorps program established under
26Code section 15H.8 for member recruitment and training to
27improve the economic well-being and health of economically
28disadvantaged refugees in local communities across Iowa. Funds
29transferred may be used to supplement federal funds under
30federal regulations.
316. Of the funds appropriated in this section, $300,000 shall
32be used to contract for children’s well-being collaboratives
33grants for the development and implementation of children’s
34well-being collaboratives to establish and coordinate
35prevention and early intervention services to promote improved
-53-1mental health and well-being for children and families, as
2enacted in this 2017 Act.
3 Sec. 28. DEPARTMENT-WIDE DUTIES. There is appropriated
4from the general fund of the state to the department of human
5services for the fiscal year beginning July 1, 2017, and ending
6June 30, 2018, the following amount, or so much thereof as is
7necessary, to be used for the purposes designated:
8For salaries, support, maintenance, and miscellaneous
9purposes at facilities under the purview of the department of
10human services:
.................................................. $112,879,274
12 Sec. 29. VOLUNTEERS. There is appropriated from the general
13fund of the state to the department of human services for the
14fiscal year beginning July 1, 2017, and ending June 30, 2018,
15the following amount, or so much thereof as is necessary, to be
16used for the purpose designated:
17For development and coordination of volunteer services:
.................................................. $1884,686
19 Sec. 30. GENERAL REDUCTION. For the period beginning July
201, 2017, and ending June 30, 2018, the department of human
21services, in consultation with the department of management,
22shall identify and implement a reduction in expenditures made
23from appropriations from the general fund to the department of
24human services in the amount of $1,467,303.
25 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
26ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
27DEPARTMENT OF HUMAN SERVICES.
281. a. (1) (a) For the fiscal year beginning July 1, 2017,
29the department shall rebase case-mix nursing facility rates
30effective July 1, 2017, to the extent possible within the state
31funding appropriated for this purpose.
32(b) For the fiscal year beginning July 1, 2017, non-case-mix
33and special population nursing facilities shall be reimbursed
34in accordance with the methodology in effect on June 30 of the
35prior fiscal year.
-54- 1(c) For managed care claims, the department of human
2services shall adjust the payment rate floor for nursing
3facilities, annually, to maintain a rate floor that is no
4lower than the Medicaid fee-for-service case-mix adjusted rate
5calculated in accordance with 441 IAC 81.6. The department
6shall then calculate adjusted reimbursement rates, including
7but not limited to add-on-payments, annually, and shall
8notify Medicaid managed care organizations of the adjusted
9reimbursement rates within 30 days of determining the adjusted
10reimbursement rates. Any adjustment of reimbursement rates
11under this subparagraph division shall be budget neutral to the
12state budget.
13(2) For any open or unsettled nursing facility cost report
14for a fiscal year prior to and including the fiscal year
15beginning July 1, 2016, including any cost report remanded on
16judicial review for inclusion of prescription drug, laboratory,
17or x-ray costs, the department shall offset all reported
18prescription drug, laboratory, and x-ray costs with any revenue
19received from Medicare or other revenue source for any purpose.
20For purposes of this subparagraph, a nursing facility cost
21report is not considered open or unsettled if the facility did
22not initiate an administrative appeal under chapter 17A or if
23any appeal rights initiated have been exhausted.
24b. (1) For the fiscal year beginning July 1, 2017,
25the department shall establish the pharmacy dispensing fee
26reimbursement at $10.02 per prescription, until a cost of
27dispensing survey is completed. The actual dispensing fee
28shall be determined by a cost of dispensing survey performed
29by the department and required to be completed by all medical
30assistance program participating pharmacies every two years,
31adjusted as necessary to maintain expenditures within the
32amount appropriated to the department for this purpose for the
33fiscal year.
34(2) The department shall utilize an average acquisition
35cost reimbursement methodology for all drugs covered under the
-55-1medical assistance program in accordance with 2012 Iowa Acts,
2chapter 1133, section 33.
3c. (1) For the fiscal year beginning July 1, 2017,
4reimbursement rates for outpatient hospital services shall
5be rebased effective January 1, 2018, subject to Medicaid
6program upper payment limit rules, and adjusted as necessary
7to maintain expenditures within the amount appropriated to the
8department for this purpose for the fiscal year.
9(2) For the fiscal year beginning July 1, 2017,
10reimbursement rates for inpatient hospital services shall
11remain at the rates in effect on June 30, 2017, subject to
12Medicaid program upper payment limit rules, and adjusted
13as necessary to maintain expenditures within the amount
14appropriated to the department for this purpose for the fiscal
15year.
16(3) For the fiscal year beginning July 1, 2017, the graduate
17medical education and disproportionate share hospital fund
18shall remain at the amount in effect on June 30, 2017, except
19that the portion of the fund attributable to graduate medical
20education shall be reduced in an amount that reflects the
21elimination of graduate medical education payments made to
22out-of-state hospitals.
23(4) In order to ensure the efficient use of limited state
24funds in procuring health care services for low-income Iowans,
25funds appropriated in this Act for hospital services shall
26not be used for activities which would be excluded from a
27determination of reasonable costs under the federal Medicare
28program pursuant to 42 U.S.C.§1395x(v)(1)(N).
29d. For the fiscal year beginning July 1, 2017, reimbursement
30rates for hospices and acute mental hospitals shall be
31increased in accordance with increases under the federal
32Medicare program or as supported by their Medicare audited
33costs.
34e. For the fiscal year beginning July 1, 2017, independent
35laboratories and rehabilitation agencies shall be reimbursed
-56-1using the same methodology in effect on June 30, 2017.
2f. (1) For the fiscal year beginning July 1, 2017,
3reimbursement rates for home health agencies shall continue to
4be based on the Medicare low utilization payment adjustment
5(LUPA) methodology with state geographic wage adjustments.
6The department shall continue to update the rates every two
7years to reflect the most recent Medicare LUPA rates to the
8extent possible within the state funding appropriated for this
9purpose.
10(2) For the fiscal year beginning July 1, 2017, rates for
11private duty nursing and personal care services under the early
12and periodic screening, diagnostic, and treatment program
13benefit shall be calculated based on the methodology in effect
14on June 30, 2017.
15g. For the fiscal year beginning July 1, 2017, federally
16qualified health centers and rural health clinics shall receive
17cost-based reimbursement for 100 percent of the reasonable
18costs for the provision of services to recipients of medical
19assistance.
20h. For the fiscal year beginning July 1, 2017, the
21reimbursement rates for dental services shall remain at the
22rates in effect on June 30, 2017.
23i. (1) For the fiscal year beginning July 1, 2017,
24reimbursement rates for non-state-owned psychiatric medical
25institutions for children shall be based on the reimbursement
26methodology in effect on June 30, 2017.
27(2) As a condition of participation in the medical
28assistance program, enrolled providers shall accept the medical
29assistance reimbursement rate for any covered goods or services
30provided to recipients of medical assistance who are children
31under the custody of a psychiatric medical institution for
32children.
33j. For the fiscal year beginning July 1, 2017, unless
34otherwise specified in this Act, all noninstitutional medical
35assistance provider reimbursement rates shall remain at the
-57-1rates in effect on June 30, 2017, except for area education
2agencies, local education agencies, infant and toddler
3services providers, home and community-based services providers
4including consumer-directed attendant care providers under a
5section 1915(c) or 1915(i) waiver, targeted case management
6providers, and those providers whose rates are required to be
7determined pursuant to section 249A.20.
8k. Notwithstanding any provision to the contrary, for the
9fiscal year beginning July 1, 2017, the reimbursement rate
10for anesthesiologists shall be adjusted to implement the cost
11containment strategies authorized for the medical assistance
12program in this 2017 Act.
13l. Notwithstanding section 249A.20, for the fiscal year
14beginning July 1, 2017, the average reimbursement rate for
15health care providers eligible for use of the federal Medicare
16resource-based relative value scale reimbursement methodology
17under section 249A.20 shall remain at the rate in effect on
18June 30, 2017; however, this rate shall not exceed the maximum
19level authorized by the federal government.
20m. For the fiscal year beginning July 1, 2017, the
21reimbursement rate for residential care facilities shall not
22be less than the minimum payment level as established by the
23federal government to meet the federally mandated maintenance
24of effort requirement. The flat reimbursement rate for
25facilities electing not to file annual cost reports shall not
26be less than the minimum payment level as established by the
27federal government to meet the federally mandated maintenance
28of effort requirement.
29n. For the fiscal year beginning July 1, 2017, the
30reimbursement rates for inpatient mental health services
31provided at hospitals shall remain at the rates in effect on
32June 30, 2017, subject to Medicaid program upper payment limit
33rules; and psychiatrists shall be reimbursed at the medical
34assistance program fee-for-service rate in effect on June 30,
352017.
-58- 1o. For the fiscal year beginning July 1, 2017, community
2mental health centers may choose to be reimbursed for the
3services provided to recipients of medical assistance through
4either of the following options:
5(1) For 100 percent of the reasonable costs of the services.
6(2) In accordance with the alternative reimbursement rate
7methodology approved by the department of human services in
8effect on June 30, 2017.
9p. For the fiscal year beginning July 1, 2017, the
10reimbursement rate for providers of family planning services
11that are eligible to receive a 90 percent federal match shall
12remain at the rates in effect on June 30, 2017.
13q. Unless otherwise subject to a tiered rate methodology,
14for the fiscal year beginning July 1, 2017, the upper
15limits and reimbursement rates for providers of home and
16community-based services waiver services shall be reimbursed
17using the reimbursement methodology in effect on June 30, 2017.
18r. For the fiscal year beginning July 1, 2017, the
19reimbursement rates for emergency medical service providers
20shall remain at the rates in effect on June 30, 2017.
21s. For the fiscal year beginning July 1, 2017, reimbursement
22rates for substance-related disorder treatment programs
23licensed under section 125.13 shall remain at the rates in
24effect on June 30, 2017.
252. For the fiscal year beginning July 1, 2017, the
26reimbursement rate for providers reimbursed under the
27in-home-related care program shall not be less than the minimum
28payment level as established by the federal government to meet
29the federally mandated maintenance of effort requirement.
303. Unless otherwise directed in this section, when the
31department’s reimbursement methodology for any provider
32reimbursed in accordance with this section includes an
33inflation factor, this factor shall not exceed the amount
34by which the consumer price index for all urban consumers
35increased during the calendar year ending December 31, 2002.
-59- 14. Notwithstanding section 234.38, for the fiscal
2year beginning July 1, 2017, the foster family basic daily
3maintenance rate and the maximum adoption subsidy rate for
4children ages 0 through 5 years shall be $16.78, the rate for
5children ages 6 through 11 years shall be $17.45, the rate for
6children ages 12 through 15 years shall be $19.10, and the
7rate for children and young adults ages 16 and older shall
8be $19.35. For youth ages 18 to 21 who have exited foster
9care, the preparation for adult living program maintenance rate
10shall be $602.70 per month. The maximum payment for adoption
11subsidy nonrecurring expenses shall be limited to $500 and the
12disallowance of additional amounts for court costs and other
13related legal expenses implemented pursuant to 2010 Iowa Acts,
14chapter 1031, section 408, shall be continued.
155. For the fiscal year beginning July 1, 2017, the maximum
16reimbursement rates for social services providers under
17contract shall remain at the rates in effect on June 30, 2017,
18or the provider’s actual and allowable cost plus inflation for
19each service, whichever is less. However, if a new service
20or service provider is added after June 30, 2017, the initial
21reimbursement rate for the service or provider shall be based
22upon a weighted average of provider rates for similar services.
236. a. For the fiscal year beginning July 1, 2017, the
24reimbursement rates for resource family recruitment and
25retention contractors shall be established by contract.
26b. For the fiscal year beginning July 1, 2017, the
27reimbursement rates for supervised apartment living foster care
28providers shall be established by contract.
297. a. For the purposes of this subsection, “combined
30reimbursement rate” means the combined service and maintenance
31reimbursement rate for a service level under the department’s
32reimbursement methodology. Effective July 1, 2017, the
33combined reimbursement rate for a group foster care service
34level shall be the amount designated in this subsection.
35However, if a group foster care provider’s reimbursement rate
-60-1for a service level as of June 30, 2017, is more than the rate
2designated in this subsection, the provider’s reimbursement
3shall remain at the higher rate.
4b. Unless a group foster care provider is subject to the
5exception provided in paragraph “a”, effective July 1, 2017,
6the combined reimbursement rates for the service levels under
7the department’s reimbursement methodology shall be as follows:
8(1) For service level, community - D1, the daily rate shall
9be at least $84.17.
10(2) For service level, comprehensive - D2, the daily rate
11shall be at least $119.09.
12(3) For service level, enhanced - D3, the daily rate shall
13be at least $131.09.
148. The group foster care reimbursement rates paid for
15placement of children out of state shall be calculated
16according to the same rate-setting principles as those used for
17in-state providers, unless the director of human services or
18the director’s designee determines that appropriate care cannot
19be provided within the state. The payment of the daily rate
20shall be based on the number of days in the calendar month in
21which service is provided.
229. a. For the fiscal year beginning July 1, 2017, the
23reimbursement rate paid for shelter care and the child welfare
24emergency services implemented to provide or prevent the need
25for shelter care shall be established by contract.
26b. For the fiscal year beginning July 1, 2017, the combined
27service and maintenance components of the reimbursement rate
28paid for shelter care services shall be based on the financial
29and statistical report submitted to the department. The
30maximum reimbursement rate shall be $101.83 per day. The
31department shall reimburse a shelter care provider at the
32provider’s actual and allowable unit cost, plus inflation, not
33to exceed the maximum reimbursement rate.
34c. Notwithstanding section 232.141, subsection 8, for the
35fiscal year beginning July 1, 2017, the amount of the statewide
-61-1average of the actual and allowable rates for reimbursement of
2juvenile shelter care homes that is utilized for the limitation
3on recovery of unpaid costs shall remain at the amount in
4effect for this purpose in the fiscal year beginning July 1,
52016.
610. For the fiscal year beginning July 1, 2017, the
7department shall calculate reimbursement rates for intermediate
8care facilities for persons with an intellectual disability
9at the 80th percentile. Beginning July 1, 2017, the rate
10calculation methodology shall utilize the consumer price index
11inflation factor applicable to the fiscal year beginning July
121, 2017.
1311. For the fiscal year beginning July 1, 2017, for child
14care providers reimbursed under the state child care assistance
15program, the department shall set provider reimbursement
16rates based on the rate reimbursement survey completed in
17December 2004. Effective July 1, 2017, the child care provider
18reimbursement rates shall remain at the rates in effect on June
1930, 2017. The department shall set rates in a manner so as
20to provide incentives for a nonregistered provider to become
21registered by applying the increase only to registered and
22licensed providers.
2312. For the fiscal year beginning July 1, 2017,
24notwithstanding any provision to the contrary under this
25section, affected providers or services shall be reimbursed as
26follows:
27a. For fee-for-service claims, a rate or reimbursement
28shall be calculated based on the methodology otherwise
29specified in this section for the fiscal year beginning July 1,
302017, for the respective provider or service.
31b. For claims subject to a managed care contract with
32the exception of any provider or service to which a rate or
33reimbursement increase is applicable for the fiscal year under
34this section, the rate or reimbursement shall be based on the
35methodology established by the managed care contract. However,
-62-1any rate or reimbursement established under such contract
2shall not be lower than the rate or reimbursement floor
3established by the department of human services as the managed
4care organization rate or reimbursement floor for a respective
5provider or service in effect on April 1, 2016.
613. Notwithstanding any provision to the contrary,
7reimbursement rates and methodologies under this section may
8be adjusted as necessary to implement the cost containment
9strategies authorized for the medical assistance program in
10this 2017 Act.
1114. The department may adopt emergency rules to implement
12this section.
13 Sec. 32. EMERGENCY RULES.
141. If specifically authorized by a provision of this
15division of this Act, the department of human services or
16the mental health and disability services commission may
17adopt administrative rules under section 17A.4, subsection
183, and section 17A.5, subsection 2, paragraph “b”, to
19implement the provisions of this division of this Act and
20the rules shall become effective immediately upon filing or
21on a later effective date specified in the rules, unless the
22effective date of the rules is delayed or the applicability
23of the rules is suspended by the administrative rules review
24committee. Any rules adopted in accordance with this section
25shall not take effect before the rules are reviewed by the
26administrative rules review committee. The delay authority
27provided to the administrative rules review committee under
28section 17A.4, subsection 7, and section 17A.8, subsection 9,
29shall be applicable to a delay imposed under this section,
30notwithstanding a provision in those sections making them
31inapplicable to section 17A.5, subsection 2, paragraph “b”.
32Any rules adopted in accordance with the provisions of this
33section shall also be published as a notice of intended action
34as provided in section 17A.4.
352. If during a fiscal year, the department of human
-63-1services is adopting rules in accordance with this section
2or as otherwise directed or authorized by state law, and the
3rules will result in an expenditure increase beyond the amount
4anticipated in the budget process or if the expenditure was
5not addressed in the budget process for the fiscal year, the
6department shall notify the persons designated by this division
7of this Act for submission of reports, the chairpersons and
8ranking members of the committees on appropriations, and
9the department of management concerning the rules and the
10expenditure increase. The notification shall be provided at
11least 30 calendar days prior to the date notice of the rules
12is submitted to the administrative rules coordinator and the
13administrative code editor.
14 Sec. 33. REPORTS. Any reports or other information
15required to be compiled and submitted under this Act during the
16fiscal year beginning July 1, 2017, shall be submitted to the
17chairpersons and ranking members of the joint appropriations
18subcommittee on health and human services, the legislative
19services agency, and the legislative caucus staffs on or
20before the dates specified for submission of the reports or
21information.
22 Sec. 34. TRANSFER OF MEDICAID MODERNIZATION SAVINGS BETWEEN
23APPROPRIATIONS FY 2017-2018. Notwithstanding section 8.39,
24subsection 1, for the fiscal year beginning July 1, 2017, if
25savings resulting from the governor’s Medicaid modernization
26initiative accrue to the medical contracts or children’s health
27insurance program appropriation from the general fund of the
28state and not to the medical assistance appropriation from the
29general fund of the state under this division of this Act,
30such savings may be transferred to such medical assistance
31appropriation for the same fiscal year without prior written
32consent and approval of the governor and the director of the
33department of management. The department of human services
34shall report any transfers made pursuant to this section to the
35legislative services agency.
-64-1DIVISION VI
2HEALTH CARE ACCOUNTS AND FUNDS — FY 2017-2018
3 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
4appropriated from the pharmaceutical settlement account created
5in section 249A.33 to the department of human services for the
6fiscal year beginning July 1, 2017, and ending June 30, 2018,
7the following amount, or so much thereof as is necessary, to be
8used for the purpose designated:
9Notwithstanding any provision of law to the contrary, to
10supplement the appropriations made in this Act for medical
11contracts under the medical assistance program for the fiscal
12year beginning July 1, 2017, and ending June 30, 2018:
.................................................. $13800,000
14 Sec. 36. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
15SERVICES. Notwithstanding any provision to the contrary and
16subject to the availability of funds, there is appropriated
17from the quality assurance trust fund created in section
18249L.4 to the department of human services for the fiscal year
19beginning July 1, 2017, and ending June 30, 2018, the following
20amounts, or so much thereof as is necessary, for the purposes
21designated:
22To supplement the appropriation made in this Act from the
23general fund of the state to the department of human services
24for medical assistance for the same fiscal year:
.................................................. $2536,705,208
26 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
27DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
28the contrary and subject to the availability of funds, there is
29appropriated from the hospital health care access trust fund
30created in section 249M.4 to the department of human services
31for the fiscal year beginning July 1, 2017, and ending June
3230, 2018, the following amounts, or so much thereof as is
33necessary, for the purposes designated:
34To supplement the appropriation made in this Act from the
35general fund of the state to the department of human services
-65-1for medical assistance for the same fiscal year:
.................................................. $233,920,554
3 Sec. 38. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
4FOR FY 2017-2018. Notwithstanding section 8.33, if moneys
5appropriated for purposes of the medical assistance program for
6the fiscal year beginning July 1, 2017, and ending June 30,
72018, from the general fund of the state, the quality assurance
8trust fund and the hospital health care access trust fund, are
9in excess of actual expenditures for the medical assistance
10program and remain unencumbered or unobligated at the close
11of the fiscal year, the excess moneys shall not revert but
12shall remain available for expenditure for the purposes of the
13medical assistance program until the close of the succeeding
14fiscal year.
15DIVISION VII
16DEPARTMENT ON AGING — FY 2018-2019
17 Sec. 39. DEPARTMENT ON AGING. There is appropriated from
18the general fund of the state to the department on aging for
19the fiscal year beginning July 1, 2018, and ending June 30,
202019, the following amount, or so much thereof as is necessary,
21to be used for the purposes designated:
22For aging programs for the department on aging and area
23agencies on aging to provide citizens of Iowa who are 60 years
24of age and older with case management for frail elders, Iowa’s
25aging and disabilities resource center, and other services
26which may include but are not limited to adult day services,
27respite care, chore services, information and assistance,
28and material aid, for information and options counseling for
29persons with disabilities who are 18 years of age or older,
30and for salaries, support, administration, maintenance, and
31miscellaneous purposes, and for not more than the following
32full-time equivalent positions:
.................................................. $335,521,238
............................................... FTEs3427.00
351. Funds appropriated in this section may be used to
-66-1supplement federal funds under federal regulations. To
2receive funds appropriated in this section, a local area
3agency on aging shall match the funds with moneys from other
4sources according to rules adopted by the department. Funds
5appropriated in this section may be used for elderly services
6not specifically enumerated in this section only if approved
7by an area agency on aging for provision of the service within
8the area.
92. Of the funds appropriated in this section, $139,973 is
10transferred to the economic development authority for the Iowa
11commission on volunteer services to be used for the retired and
12senior volunteer program.
133. a. The department on aging shall establish and enforce
14procedures relating to expenditure of state and federal funds
15by area agencies on aging that require compliance with both
16state and federal laws, rules, and regulations, including but
17not limited to all of the following:
18(1) Requiring that expenditures are incurred only for goods
19or services received or performed prior to the end of the
20fiscal period designated for use of the funds.
21(2) Prohibiting prepayment for goods or services not
22received or performed prior to the end of the fiscal period
23designated for use of the funds.
24(3) Prohibiting the prepayment for goods or services
25not defined specifically by good or service, time period, or
26recipient.
27(4) Prohibiting the establishment of accounts from which
28future goods or services which are not defined specifically by
29good or service, time period, or recipient, may be purchased.
30b. The procedures shall provide that if any funds are
31expended in a manner that is not in compliance with the
32procedures and applicable federal and state laws, rules, and
33regulations, and are subsequently subject to repayment, the
34area agency on aging expending such funds in contravention of
35such procedures, laws, rules and regulations, not the state,
-67-1shall be liable for such repayment.
24. Of the funds appropriated in this section, at least
3$125,000 shall be used to fund the unmet needs identified
4through Iowa’s aging and disability resource center network.
55. Of the funds appropriated in this section, at least
6$300,000 shall be used to fund home and community-based
7services through the area agencies on aging that enable older
8individuals to avoid more costly utilization of residential or
9institutional services and remain in their own homes.
106. Of the funds appropriated in this section, $406,268
11shall be used for the purposes of chapter 231E and section
12231.56A, of which $175,000 shall be used for the office of
13substitute decision maker pursuant to chapter 231E, and the
14remainder shall be distributed equally to the area agencies on
15aging to administer the prevention of elder abuse, neglect, and
16exploitation program pursuant to section 231.56A, in accordance
17with the requirements of the federal Older Americans Act of
181965, 42 U.S.C. §3001 et seq., as amended.
197. Of the funds appropriated in this section, $375,000
20shall be used to fund continuation of the aging and disability
21resource center lifelong links to provide individuals and
22caregivers with information and services to plan for and
23maintain independence.
248. Notwithstanding section 8.39, for the fiscal year
25beginning July 1, 2018, the department may transfer funds
26within or between the allocations made in this division of this
27Act for the same fiscal year in accordance with departmental
28priorities. The department shall report any such transfers
29to the individuals specified in this Act for submission of
30reports. This subsection shall not be construed to prohibit
31the use of existing state transfer authority for other
32purposes.
33DIVISION VIII
34OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2018-2019
35 Sec. 40. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
-68-1appropriated from the general fund of the state to the office
2of long-term care ombudsman for the fiscal year beginning July
31, 2018, and ending June 30, 2019, the following amount, or
4so much thereof as is necessary, to be used for the purposes
5designated:
6For salaries, support, administration, maintenance, and
7miscellaneous purposes, and for not more than the following
8full-time equivalent positions:
.................................................. $9580,140
............................................... FTEs1016.00
11DIVISION IX
12DEPARTMENT OF PUBLIC HEALTH — FY 2018-2019
13 Sec. 41. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
14from the general fund of the state to the department of public
15health for the fiscal year beginning July 1, 2018, and ending
16June 30, 2019, the following amounts, or so much thereof as is
17necessary, to be used for the purposes designated:
181. ADDICTIVE DISORDERS
19For reducing the prevalence of the use of tobacco, alcohol,
20and other drugs, and treating individuals affected by addictive
21behaviors, including gambling, and for not more than the
22following full-time equivalent positions:
.................................................. $2312,492,915
............................................... FTEs2410.00
25a. (1) Of the funds appropriated in this subsection,
26$2,010,612 shall be used for the tobacco use prevention
27and control initiative, including efforts at the state and
28local levels, as provided in chapter 142A. The commission
29on tobacco use prevention and control established pursuant
30to section 142A.3 shall advise the director of public health
31in prioritizing funding needs and the allocation of moneys
32appropriated for the programs and initiatives. Activities
33of the programs and initiatives shall be in alignment with
34the United States centers for disease control and prevention
35best practices for comprehensive tobacco control programs that
-69-1include the goals of preventing youth initiation of tobacco
2usage, reducing exposure to secondhand smoke, and promotion
3of tobacco cessation. To maximize resources, the department
4shall determine if third-party sources are available to
5instead provide nicotine replacement products to an applicant
6prior to provision of such products to an applicant under
7the initiative. The department shall track and report to
8the individuals specified in this Act, any reduction in
9the provision of nicotine replacement products realized by
10the initiative through implementation of the prerequisite
11screening.
12(2) (a) The department shall collaborate with the
13alcoholic beverages division of the department of commerce for
14enforcement of tobacco laws, regulations, and ordinances and to
15engage in tobacco control activities approved by the division
16of tobacco use prevention and control of the department of
17public health as specified in the memorandum of understanding
18entered into between the divisions.
19(b) For the fiscal year beginning July 1, 2018, and ending
20June 30, 2019, the terms of the memorandum of understanding,
21entered into between the division of tobacco use prevention
22and control of the department of public health and the
23alcoholic beverages division of the department of commerce,
24governing compliance checks conducted to ensure licensed retail
25tobacco outlet conformity with tobacco laws, regulations, and
26ordinances relating to persons under 18 years of age, shall
27continue to restrict the number of such checks to one check per
28retail outlet, and one additional check for any retail outlet
29found to be in violation during the first check.
30b. Of the funds appropriated in this subsection,
31$10,482,303 shall be used for problem gambling and
32substance-related disorder prevention, treatment, and recovery
33services, including a 24-hour helpline, public information
34resources, professional training, youth prevention, and program
35evaluation.
-70- 1c. The requirement of section 123.17, subsection 5, is met
2by the appropriations and allocations made in this division of
3this Act for purposes of substance-related disorder treatment
4and addictive disorders for the fiscal year beginning July 1,
52018.
62. HEALTHY CHILDREN AND FAMILIES
7For promoting the optimum health status for children,
8adolescents from birth through 21 years of age, and families,
9and for not more than the following full-time equivalent
10positions:
.................................................. $112,662,816
............................................... FTEs1212.00
13a. Of the funds appropriated in this subsection, not more
14than $367,420 shall be used for the healthy opportunities for
15parents to experience success (HOPES)-healthy families Iowa
16(HFI) program established pursuant to section 135.106. The
17funding shall be distributed to renew the grants that were
18provided to the grantees that operated the program during the
19fiscal year ending June 30, 2018.
20b. In order to implement the legislative intent stated in
21sections 135.106 and 256I.9, that priority for home visitation
22program funding be given to programs using evidence-based or
23promising models for home visitation, it is the intent of the
24general assembly to phase in the funding priority in accordance
25with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
26paragraph “0b”.
27c. Of the funds appropriated in this subsection, $1,537,550
28shall be used for continuation of the department’s initiative
29to provide for adequate developmental surveillance and
30screening during a child’s first five years. The funds shall
31be used first to fully fund the current sites to ensure that
32the sites are fully operational, with the remaining funds
33to be used for expansion to additional sites. The full
34implementation and expansion shall include enhancing the scope
35of the program through collaboration with the child health
-71-1specialty clinics to promote healthy child development through
2early identification and response to both biomedical and social
3determinants of healthy development; by monitoring child
4health metrics to inform practice, document long-term health
5impacts and savings, and provide for continuous improvement
6through training, education, and evaluation; and by providing
7for practitioner consultation particularly for children with
8behavioral conditions and needs. The department of public
9health shall also collaborate with the Iowa Medicaid enterprise
10and the child health specialty clinics to integrate the
11activities of the first five initiative into the establishment
12of patient-centered medical homes, community utilities,
13accountable care organizations, and other integrated care
14models developed to improve health quality and population
15health while reducing health care costs. To the maximum extent
16possible, funding allocated in this paragraph shall be utilized
17as matching funds for medical assistance program reimbursement.
18d. Of the funds appropriated in this subsection, $32,320
19shall be distributed to a statewide dental carrier to provide
20funds to continue the donated dental services program patterned
21after the projects developed by the lifeline network to provide
22dental services to indigent individuals who are elderly or with
23disabilities.
24e. Of the funds appropriated in this subsection, $78,241
25shall be used to provide audiological services and hearing
26aids for children. The department may enter into a contract
27to administer this paragraph.
28f. Of the funds appropriated in this subsection, $11,500 is
29transferred to the university of Iowa college of dentistry for
30provision of primary dental services to children. State funds
31shall be matched on a dollar-for-dollar basis. The university
32of Iowa college of dentistry shall coordinate efforts with the
33department of public health, bureau of oral and health delivery
34systems, to provide dental care to underserved populations
35throughout the state.
-72- 1g. Of the funds appropriated in this subsection, $25,000
2shall be used to address youth suicide prevention.
3h. Of the funds appropriated in this subsection, $20,255
4shall be used to support the Iowa effort to address the survey
5of children who experience adverse childhood experiences known
6as ACEs.
7i. The department of public health shall continue to
8administer the program to assist parents in this state with
9costs resulting from the death of a child in accordance with
10the provisions of 2014 Iowa Acts, chapter 1140, section 22,
11subsection 12.
123. CHRONIC CONDITIONS
13For serving individuals identified as having chronic
14conditions or special health care needs, and for not more than
15the following full-time equivalent positions:
.................................................. $162,085,375
............................................... FTEs175.00
18a. Of the funds appropriated in this subsection, $76,877
19shall be used for grants to individual patients who have an
20inherited metabolic disorder to assist with the costs of
21medically necessary foods and formula.
22b. Of the funds appropriated in this subsection, $510,397
23shall be used for the brain injury services program pursuant
24to section 135.22B, including for contracting with an existing
25nationally affiliated and statewide organization whose purpose
26is to educate, serve, and support Iowans with brain injury and
27their families for resource facilitator services in accordance
28with section 135.22B, subsection 9, and for contracting to
29enhance brain injury training and recruitment of service
30providers on a statewide basis. Of the amount allocated in
31this paragraph, $47,500 shall be used to fund one full-time
32equivalent position to serve as the state brain injury services
33program manager.
34c. Of the funds appropriated in this subsection, $72,048
35shall be used for the public purpose of continuing to contract
-73-1with an existing national-affiliated organization to provide
2education, client-centered programs, and client and family
3support for people living with epilepsy and their families.
4The amount allocated in this paragraph in excess of $50,000
5shall be matched dollar-for-dollar by the organization
6specified.
7d. Of the funds appropriated in this subsection, $404,775
8shall be used for child health specialty clinics.
9e. Of the funds appropriated in this subsection, $192,276
10shall be used by the regional autism assistance program
11established pursuant to section 256.35, and administered by
12the child health specialty clinic located at the university of
13Iowa hospitals and clinics. The funds shall be used to enhance
14interagency collaboration and coordination of educational,
15medical, and other human services for persons with autism,
16their families, and providers of services, including delivering
17regionalized services of care coordination, family navigation,
18and integration of services through the statewide system of
19regional child health specialty clinics and fulfilling other
20requirements as specified in chapter 225D. The university of
21Iowa shall not receive funds allocated under this paragraph for
22indirect costs associated with the regional autism assistance
23program.
24f. Of the funds appropriated in this subsection, $288,687
25shall be used for the comprehensive cancer control program to
26reduce the burden of cancer in Iowa through prevention, early
27detection, effective treatment, and ensuring quality of life.
28Of the funds allocated in this paragraph “f”, $75,000 shall
29be used to support a melanoma research symposium, a melanoma
30biorepository and registry, basic and translational melanoma
31research, and clinical trials.
32g. Of the funds appropriated in this subsection, $48,766
33shall be used for cervical and colon cancer screening, and
34$88,860 shall be used to enhance the capacity of the cervical
35cancer screening program to include provision of recommended
-74-1prevention and early detection measures to a broader range of
2low-income women.
3h. Of the funds appropriated in this subsection, $253,177
4shall be used for the center for congenital and inherited
5disorders.
6i. Of the funds appropriated in this subsection,
7$107,631 shall be used by the department of public health
8for reform-related activities, including but not limited to
9facilitation of communication to stakeholders at the state and
10local level, administering the patient-centered health advisory
11council pursuant to section 135.159, and involvement in health
12care system innovation activities occurring across the state.
13j. Of the funds appropriated in this subsection, $11,050
14shall be used for administration of chapter 124D, the medical
15cannabidiol Act.
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:
.................................................. $201,403,888
............................................... FTEs2113.00
22a. Of the funds appropriated in this subsection, $47,787
23is allocated for continuation of the child vision screening
24program implemented through the university of Iowa hospitals
25and clinics in collaboration with early childhood Iowa areas.
26The program shall submit a report to the individuals identified
27in this Act for submission of reports regarding the use of
28funds allocated under this paragraph “a”. The report shall
29include the objectives and results for the program year
30including the target population and how the funds allocated
31assisted the program in meeting the objectives; the number,
32age, and location within the state of individuals served;
33the type of services provided to the individuals served; the
34distribution of funds based on service provided; and the
35continuing needs of the program.
-75- 1b. Of the funds appropriated in this subsection, $52,828 is
2allocated for continuation of an initiative implemented at the
3university of Iowa to expand and improve the workforce engaged
4in mental health treatment and services. The initiative shall
5receive input from the university of Iowa, the department of
6human services, the department of public health, and the mental
7health and disability services commission to address the focus
8of the initiative.
9c. Of the funds appropriated in this section, $41,657 shall
10be deposited in the governmental public health system fund
11created in section 135A.8 to be used for the purposes of the
12fund.
13d. Of the funds appropriated in this subsection,
14$24,034 shall be used for a grant to a statewide association
15of psychologists that is affiliated with the American
16psychological association to be used for continuation of a
17program to rotate intern psychologists in placements in urban
18and rural mental health professional shortage areas, as defined
19in section 135.180.
20e. Of the funds appropriated in this subsection, the
21following amounts are allocated to be used as follows to
22support the Iowa collaborative safety net provider network
23goals of increased access, health system integration, and
24engagement.
25(1) Not less than $260,931 is allocated to the Iowa
26prescription drug corporation for continuation of the
27pharmaceutical infrastructure for safety net providers as
28described in 2007 Iowa Acts, chapter 218, section 108, and for
29the prescription drug donation repository program created in
30chapter 135M.
31(2) Not less than $167,435 is allocated to free clinics and
32free clinics of Iowa for necessary infrastructure, statewide
33coordination, provider recruitment, service delivery, and
34provision of assistance to patients in securing a medical home
35inclusive of oral health care.
-76- 1(3) Not less than $12,500 is allocated to the Iowa
2association of rural health clinics for necessary
3infrastructure and service delivery transformation.
4f. Of the funds appropriated in this subsection, $81,700
5shall be used for continuation of the work of the direct care
6worker advisory council established pursuant to 2008 Iowa Acts,
7chapter 1188, section 69, in implementing the recommendations
8in the final report submitted by the advisory council to the
9governor and the general assembly in March 2012, including
10by continuing to develop, promote, and make available on a
11statewide basis the prepare-to-care core curriculum and its
12associated modules and specialties through various formats
13including online access, community colleges, and other venues;
14exploring new and maintaining existing specialties including
15but not limited to oral health and dementia care; supporting
16instructor training; and assessing and making recommendations
17concerning the Iowa care book and information technology
18systems and infrastructure uses and needs.
19g. Of the funds appropriated in this subsection, $52,009
20shall be allocated for continuation of the contract with
21an independent statewide direct care worker organization
22previously selected through a request for proposals process.
23The contract shall continue to include performance and outcomes
24measures, and shall continue to allow the contractor to use a
25portion of the funds received under the contract to collect
26data to determine results based on the performance and outcomes
27measures.
28h. Of the funds appropriated in this subsection, the
29department may use up to $29,087 for up to one full-time
30equivalent position to administer the volunteer health care
31provider program pursuant to section 135.24.
32i. Of the funds appropriated in this subsection, $48,069
33shall be used for a matching dental education loan repayment
34program to be allocated to a dental nonprofit health service
35corporation to continue to develop the criteria and implement
-77-1the loan repayment program.
2j. Of the funds appropriated in this subsection, $26,455 is
3transferred to the college student aid commission for deposit
4in the rural Iowa primary care trust fund created in section
5261.113 to be used for the purposes of the fund.
6k. Of the funds appropriated in this subsection, $75,000
7shall be used for the purposes of the Iowa donor registry as
8specified in section 142C.18.
9l. Of the funds appropriated in this subsection, $48,069
10shall be used for continuation of a grant to a nationally
11affiliated volunteer eye organization that has an established
12program for children and adults and that is solely dedicated to
13preserving sight and preventing blindness through education,
14nationally certified vision screening and training, and
15community and patient service programs. The organization
16shall submit a report to the individuals identified in this
17Act for submission of reports regarding the use of funds
18allocated under this paragraph “l”. The report shall include
19the objectives and results for the program year including
20the target population and how the funds allocated assisted
21the program in meeting the objectives; the number, age, and
22location within the state of individuals served; the type of
23services provided to the individuals served; the distribution
24of funds based on services provided; and the continuing needs
25of the program.
26m. Of the funds appropriated in this subsection, $436,327
27shall be deposited in the medical residency training account
28created in section 135.175, subsection 5, paragraph “a”, and
29is appropriated from the account to the department of public
30health to be used for the purposes of the medical residency
31training state matching grants program as specified in section
32135.176.
335. ESSENTIAL PUBLIC HEALTH SERVICES
34To provide public health services that reduce risks and
35invest in promoting and protecting good health over the
-78-1course of a lifetime with a priority given to older Iowans and
2vulnerable populations:
.................................................. $34,098,939
46. INFECTIOUS DISEASES
5For reducing the incidence and prevalence of communicable
6diseases, and for not more than the following full-time
7equivalent positions:
.................................................. $8823,213
............................................... FTEs94.00
107. PUBLIC PROTECTION
11For protecting the health and safety of the public through
12establishing standards and enforcing regulations, and for not
13more than the following full-time equivalent positions:
.................................................. $142,097,569
............................................... FTEs15138.00
16a. Of the funds appropriated in this subsection, not more
17than $152,350 shall be credited to the emergency medical
18services fund created in section 135.25. Moneys in the
19emergency medical services fund are appropriated to the
20department to be used for the purposes of the fund.
21b. Of the funds appropriated in this subsection, up
22to $121,630 shall be used for sexual violence prevention
23programming through a statewide organization representing
24programs serving victims of sexual violence through the
25department’s sexual violence prevention program, and for
26continuation of a training program for sexual assault
27response team (SART) members, including representatives of
28law enforcement, victim advocates, prosecutors, and certified
29medical personnel. The amount allocated in this paragraph “b”
30shall not be used to supplant funding administered for other
31sexual violence prevention or victims assistance programs.
32c. Of the funds appropriated in this subsection, up to
33$287,813 shall be used for the state poison control center.
34Pursuant to the directive under 2014 Iowa Acts, chapter
351140, section 102, the federal matching funds available to
-79-1the state poison control center from the department of human
2services under the federal Children’s Health Insurance Program
3Reauthorization Act allotment shall be subject to the federal
4administrative cap rule of 10 percent applicable to funding
5provided under Tit.XXI of the federal Social Security Act and
6included within the department’s calculations of the cap.
7d. Of the funds appropriated in this subsection, up to
8$258,491 shall be used for childhood lead poisoning provisions.
98. RESOURCE MANAGEMENT
10For establishing and sustaining the overall ability of the
11department to deliver services to the public, and for not more
12than the following full-time equivalent positions:
.................................................. $13485,607
............................................... FTEs144.00
159. MISCELLANEOUS PROVISIONS
16The university of Iowa hospitals and clinics under the
17control of the state board of regents shall not receive
18indirect costs from the funds appropriated in this section.
19The university of Iowa hospitals and clinics billings to the
20department shall be on at least a quarterly basis.
2110. GENERAL REDUCTION
22For the period beginning July 1, 2018, and ending June 30,
232019, the department of public health, in consultation with
24the department of management, shall identify and implement a
25reduction in expenditures made from appropriations from the
26general fund of the state to the department of public health in
27the amount of $640,683.
2811. TRANSFERS
29Notwithstanding section 8.39, for the fiscal year beginning
30July 1, 2018, the department may transfer funds within or
31between any of the allocations or appropriations made in this
32division of this Act for the same fiscal year, to be used in
33accordance with departmental priorities as specified in the
34department’s report to the general assembly submitted pursuant
35to 2016 Iowa Acts, chapter 1139, section 3. The department
-80-1shall report any such transfers to the individuals specified
2in this Act for submission of reports. This subsection shall
3not be construed to prohibit the use of existing state transfer
4authority for other purposes.
5DIVISION X
6DEPARTMENT OF VETERANS AFFAIRS — FY 2018-2019
7 Sec. 42. DEPARTMENT OF VETERANS AFFAIRS. There is
8appropriated from the general fund of the state to the
9department of veterans affairs for the fiscal year beginning
10July 1, 2018, and ending June 30, 2019, the following amounts,
11or so much thereof as is necessary, to be used for the purposes
12designated:
131. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
14For salaries, support, maintenance, and miscellaneous
15purposes, and for not more than the following full-time
16equivalent positions:
.................................................. $17571,278
............................................... FTEs1815.00
192. IOWA VETERANS HOME
20For salaries, support, maintenance, and miscellaneous
21purposes:
.................................................. $223,614,070
23a. The Iowa veterans home billings involving the department
24of human services shall be submitted to the department on at
25least a monthly basis.
26b. Within available resources and in conformance with
27associated state and federal program eligibility requirements,
28the Iowa veterans home may implement measures to provide
29financial assistance to or on behalf of veterans or their
30spouses who are participating in the community reentry program.
31c. The Iowa veterans home expenditure report shall be
32submitted monthly to the legislative services agency.
33d. The Iowa veterans home shall continue to include in the
34annual discharge report applicant information and to provide
35for the collection of demographic information including but not
-81-1limited to the number of individuals applying for admission and
2admitted or denied admittance and the basis for the admission
3or denial; the age, gender, and race of such individuals;
4and the level of care for which such individuals applied for
5admission including residential or nursing level of care.
63. HOME OWNERSHIP ASSISTANCE PROGRAM
7For transfer to the Iowa finance authority for the
8continuation of the home ownership assistance program for
9persons who are or were eligible members of the armed forces of
10the United States, pursuant to section 16.54:
.................................................. $111,000,000
12 Sec. 43. LIMITATION OF COUNTY COMMISSIONS OF VETERAN
13AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the
14standing appropriation in section 35A.16 for the fiscal year
15beginning July 1, 2018, and ending June 30, 2019, the amount
16appropriated from the general fund of the state pursuant to
17that section for the following designated purposes shall not
18exceed the following amount:
19For the county commissions of veteran affairs fund under
20section 35A.16:
.................................................. $21473,962
22DIVISION XI
23DEPARTMENT OF HUMAN SERVICES — FY 2018-2019
24 Sec. 44. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
25GRANT. There is appropriated from the fund created in section
268.41 to the department of human services for the fiscal year
27beginning July 1, 2018, and ending June 30, 2019, from moneys
28received under the federal temporary assistance for needy
29families (TANF) block grant pursuant to the federal Personal
30Responsibility and Work Opportunity Reconciliation Act of 1996,
31Pub.L.No.104-193, and successor legislation, the following
32amounts, or so much thereof as is necessary, to be used for the
33purposes designated:
341. To be credited to the family investment program account
35and used for assistance under the family investment program
-82-1under chapter 239B:
.................................................. $22,556,231
32. To be credited to the family investment program account
4and used for the job opportunities and basic skills (JOBS)
5program and implementing family investment agreements in
6accordance with chapter 239B:
.................................................. $72,787,846
83. To be used for the family development and
9self-sufficiency grant program in accordance with section
10216A.107:
.................................................. $111,449,490
12Notwithstanding section 8.33, moneys appropriated in this
13subsection that remain unencumbered or unobligated at the close
14of the fiscal year shall not revert but shall remain available
15for expenditure for the purposes designated until the close of
16the succeeding fiscal year. However, unless such moneys are
17encumbered or obligated on or before September 30, 2018, the
18moneys shall revert.
194. For field operations:
.................................................. $2015,648,116
215. For general administration:
.................................................. $221,872,000
236. For state child care assistance:
.................................................. $2423,933,413
25a. Of the funds appropriated in this subsection,
26$13,164,048 is transferred to the child care and development
27block grant appropriation made by the Eighty-seventh General
28Assembly, 2018 session, for the federal fiscal year beginning
29October 1, 2018, and ending September 30, 2019. Of this
30amount, $100,000 shall be used for provision of educational
31opportunities to registered child care home providers in order
32to improve services and programs offered by this category
33of providers and to increase the number of providers. The
34department may contract with institutions of higher education
35or child care resource and referral centers to provide
-83-1the educational opportunities. Allowable administrative
2costs under the contracts shall not exceed 5 percent. The
3application for a grant shall not exceed two pages in length.
4b. Any funds appropriated in this subsection remaining
5unallocated shall be used for state child care assistance
6payments for families who are employed including but not
7limited to individuals enrolled in the family investment
8program.
97. For child and family services:
.................................................. $1016,190,327
118. For child abuse prevention grants:
.................................................. $1262,500
139. For pregnancy prevention grants on the condition that
14family planning services are funded:
.................................................. $15965,033
16Pregnancy prevention grants shall be awarded to programs
17in existence on or before July 1, 2018, if the programs have
18demonstrated positive outcomes. Grants shall be awarded to
19pregnancy prevention programs which are developed after July
201, 2018, if the programs are based on existing models that
21have demonstrated positive outcomes. Grants shall comply with
22the requirements provided in 1997 Iowa Acts, chapter 208,
23section 14, subsections 1 and 2, including the requirement that
24grant programs must emphasize sexual abstinence. Priority in
25the awarding of grants shall be given to programs that serve
26areas of the state which demonstrate the highest percentage of
27unplanned pregnancies of females of childbearing age within the
28geographic area to be served by the grant.
2910. For technology needs and other resources necessary
30to meet federal welfare reform reporting, tracking, and case
31management requirements:
.................................................. $32518,593
3311. a. Notwithstanding any provision to the contrary,
34including but not limited to requirements in section 8.41 or
35provisions in 2017 or 2018 Iowa Acts regarding the receipt and
-84-1appropriation of federal block grants, federal funds from the
2temporary assistance for needy families block grant received by
3the state and not otherwise appropriated in this section and
4remaining available for the fiscal year beginning July 1, 2018,
5are appropriated to the department of human services to the
6extent as may be necessary to be used in the following priority
7order: the family investment program, for state child care
8assistance program payments for families who are employed, and
9for the family investment program share of costs to develop and
10maintain a new, integrated eligibility determination system.
11The federal funds appropriated in this paragraph “a” shall be
12expended only after all other funds appropriated in subsection
131 for the assistance under the family investment program,
14in subsection 6 for child care assistance, or in subsection
1512 for the family investment program share of the costs to
16continue to develop and maintain a new, integrated eligibility
17determination system, as applicable, have been expended. For
18the purposes of this subsection, the funds appropriated in
19subsection 6, paragraph “a”, for transfer to the child care
20and development block grant appropriation are considered fully
21expended when the full amount has been transferred.
22b. The department shall, on a quarterly basis, advise the
23legislative services agency and department of management of
24the amount of funds appropriated in this subsection that was
25expended in the prior quarter.
2612. Of the amounts appropriated in this section, $6,481,004
27for the fiscal year beginning July 1, 2018, is transferred to
28the appropriation of the federal social services block grant
29made to the department of human services for that fiscal year.
3013. For continuation of the program providing categorical
31eligibility for the food assistance program as specified
32for the program in the section of this division of this Act
33relating to the family investment program account:
.................................................. $3412,500
3514. The department may transfer funds allocated in this
-85-1section to the appropriations made in this division of this Act
2for the same fiscal year for general administration and field
3operations for resources necessary to implement and operate the
4services referred to in this section and those funded in the
5appropriation made in this division of this Act for the same
6fiscal year for the family investment program from the general
7fund of the state.
815. With the exception of moneys allocated under this
9section for the family development and self-sufficiency grant
10program, to the extent moneys allocated in this section are
11deemed by the department not to be necessary to support the
12purposes for which they are allocated, such moneys may be
13credited to the family investment program account as specified
14under subsection 1 of this section and used for the purposes of
15assistance under the family investment program under chapter
16239B in the same fiscal year.
17 Sec. 45. FAMILY INVESTMENT PROGRAM ACCOUNT.
181. Moneys credited to the family investment program (FIP)
19account for the fiscal year beginning July 1, 2018, and
20ending June 30, 2019, shall be used to provide assistance in
21accordance with chapter 239B.
222. The department may use a portion of the moneys credited
23to the FIP account under this section as necessary for
24salaries, support, maintenance, and miscellaneous purposes.
253. The department may transfer funds allocated in
26subsection 4 to the appropriations made in this division of
27this Act for the same fiscal year for general administration
28and field operations for resources necessary to implement and
29operate the family investment program services referred to in
30this section and those funded in the appropriation made in this
31division of this Act for the same fiscal year for the family
32investment program from the general fund of the state.
334. Moneys appropriated in this division of this Act and
34credited to the FIP account for the fiscal year beginning July
351, 2018, and ending June 30, 2019, are allocated as follows:
-86- 1a. To be retained by the department of human services to
2be used for coordinating with the department of human rights
3to more effectively serve participants in FIP and other shared
4clients and to meet federal reporting requirements under the
5federal temporary assistance for needy families block grant:
.................................................. $610,000
7b. To the department of human rights for staffing,
8administration, and implementation of the family development
9and self-sufficiency grant program in accordance with section
10216A.107:
.................................................. $113,096,417
12(1) Of the funds allocated for the family development
13and self-sufficiency grant program in this paragraph “b”,
14not more than 5 percent of the funds shall be used for the
15administration of the grant program.
16(2) The department of human rights may continue to implement
17the family development and self-sufficiency grant program
18statewide during fiscal year 2018-2019.
19(3) The department of human rights may engage in activities
20to strengthen and improve family outcomes measures and
21data collection systems under the family development and
22self-sufficiency grant program.
23c. For the diversion subaccount of the FIP account:
.................................................. $24407,500
25A portion of the moneys allocated for the subaccount may
26be used for field operations, salaries, data management
27system development, and implementation costs and support
28deemed necessary by the director of human services in order to
29administer the FIP diversion program. To the extent moneys
30allocated in this paragraph “c” are deemed by the department
31not to be necessary to support diversion activities, such
32moneys may be used for other efforts intended to increase
33engagement by family investment program participants in work,
34education, or training activities, or for the purposes of
35assistance under the family investment program in accordance
-87-1with chapter 239B.
2d. For the food assistance employment and training program:
.................................................. $333,294
4(1) The department shall apply the federal supplemental
5nutrition assistance program (SNAP) employment and training
6state plan in order to maximize to the fullest extent permitted
7by federal law the use of the 50 percent federal reimbursement
8provisions for the claiming of allowable federal reimbursement
9funds from the United States department of agriculture
10pursuant to the federal SNAP employment and training program
11for providing education, employment, and training services
12for eligible food assistance program participants, including
13but not limited to related dependent care and transportation
14expenses.
15(2) The department shall continue the categorical federal
16food assistance program eligibility at 160 percent of the
17federal poverty level and continue to eliminate the asset test
18from eligibility requirements, consistent with federal food
19assistance program requirements. The department shall include
20as many food assistance households as is allowed by federal
21law. The eligibility provisions shall conform to all federal
22requirements including requirements addressing individuals who
23are incarcerated or otherwise ineligible.
24e. For the JOBS program:
.................................................. $256,761,645
265. Of the child support collections assigned under FIP,
27an amount equal to the federal share of support collections
28shall be credited to the child support recovery appropriation
29made in this division of this Act. Of the remainder of the
30assigned child support collections received by the child
31support recovery unit, a portion shall be credited to the FIP
32account, a portion may be used to increase recoveries, and a
33portion may be used to sustain cash flow in the child support
34payments account. If as a consequence of the appropriations
35and allocations made in this section the resulting amounts
-88-1are insufficient to sustain cash assistance payments and meet
2federal maintenance of effort requirements, the department
3shall seek supplemental funding. If child support collections
4assigned under FIP are greater than estimated or are otherwise
5determined not to be required for maintenance of effort, the
6state share of either amount may be transferred to or retained
7in the child support payments account.
86. The department may adopt emergency rules for the family
9investment, JOBS, food assistance, and medical assistance
10programs if necessary to comply with federal requirements.
11 Sec. 46. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
12is appropriated from the general fund of the state to the
13department of human services for the fiscal year beginning July
141, 2018, and ending June 30, 2019, the following amount, or
15so much thereof as is necessary, to be used for the purpose
16designated:
17To be credited to the family investment program (FIP)
18account and used for family investment program assistance under
19chapter 239B:
.................................................. $2021,502,240
211. Of the funds appropriated in this section, $3,973,798 is
22allocated for the JOBS program.
232. Of the funds appropriated in this section, $1,656,927 is
24allocated for the family development and self-sufficiency grant
25program.
263. Notwithstanding section 8.39, for the fiscal year
27beginning July 1, 2018, if necessary to meet federal
28maintenance of effort requirements or to transfer federal
29temporary assistance for needy families block grant funding
30to be used for purposes of the federal social services block
31grant or to meet cash flow needs resulting from delays in
32receiving federal funding or to implement, in accordance with
33this division of this Act, activities currently funded with
34juvenile court services, county, or community moneys and state
35moneys used in combination with such moneys; to comply with
-89-1federal requirements; or to maximize the use of federal funds,
2the department of human services may transfer funds within or
3between any of the appropriations made in this division of this
4Act and appropriations in law for the federal social services
5block grant to the department for the following purposes,
6provided that the combined amount of state and federal
7temporary assistance for needy families block grant funding
8for each appropriation remains the same before and after the
9transfer:
10a. For the family investment program.
11b. For child care assistance.
12c. For child and family services.
13d. For field operations.
14e. For general administration.
15This subsection shall not be construed to prohibit the use
16of existing state transfer authority for other purposes. The
17department shall report any transfers made pursuant to this
18subsection to the legislative services agency.
194. Of the funds appropriated in this section, $97,839 shall
20be used for continuation of a grant to an Iowa-based nonprofit
21organization with a history of providing tax preparation
22assistance to low-income Iowans in order to expand the usage of
23the earned income tax credit. The purpose of the grant is to
24supply this assistance to underserved areas of the state.
255. Of the funds appropriated in this section, $30,000 shall
26be used for the continuation of an unfunded pilot project, as
27defined in 441 IAC 100.1, relating to parental obligations,
28in which the child support recovery unit participates, to
29support the efforts of a nonprofit organization committed
30to strengthening the community through youth development,
31healthy living, and social responsibility headquartered in
32a county with a population over 350,000 according to the
33latest certified federal census. The funds allocated in this
34subsection shall be used by the recipient organization to
35develop a larger community effort, through public and private
-90-1partnerships, to support a broad-based multi-county fatherhood
2initiative that promotes payment of child support obligations,
3improved family relationships, and full-time employment.
46. The department may transfer funds appropriated in this
5section to the appropriations made in this division of this Act
6for general administration and field operations as necessary
7to administer this section and the overall family investment
8program.
9 Sec. 47. 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, 2018, and ending
12June 30, 2019, 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:
.................................................. $176,293,317
............................................... FTEs18459.00
191. The department shall expend up to $12,164, including
20federal financial participation, for the fiscal year beginning
21July 1, 2018, 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
-91-1cash 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.
44. With the exception of the funding amount specified, the
5requirements established under 2001 Iowa Acts, chapter 191,
6section 3, subsection 5, paragraph “c”, subparagraph (3), shall
7be applicable to parental obligation pilot projects for the
8fiscal year beginning July 1, 2018, and ending June 30, 2019.
9Notwithstanding 441 IAC 100.8, providing for termination of
10rules relating to the pilot projects, the rules shall remain
11in effect until June 30, 2019.
12 Sec. 48. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
13FY 2018-2019. Any funds remaining in the health care trust
14fund created in section 453A.35A for the fiscal year beginning
15July 1, 2018, and ending June 30, 2019, are appropriated to
16the department of human services to supplement the medical
17assistance program appropriations made in this division of this
18Act, for medical assistance reimbursement and associated costs,
19including program administration and costs associated with
20program implementation.
21 Sec. 49. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
222018-2019. Any funds remaining in the Medicaid fraud fund
23created in section 249A.50 for the fiscal year beginning
24July 1, 2018, and ending June 30, 2019, are appropriated to
25the department of human services to supplement the medical
26assistance appropriations made in this division of this Act,
27for medical assistance reimbursement and associated costs,
28including program administration and costs associated with
29program implementation.
30 Sec. 50. MEDICAL ASSISTANCE. There is appropriated from the
31general fund of the state to the department of human services
32for the fiscal year beginning July 1, 2018, and ending June 30,
332019, the following amount, or so much thereof as is necessary,
34to be used for the purpose designated:
35For medical assistance program reimbursement and associated
-92-1costs as specifically provided in the reimbursement
2methodologies in effect on June 30, 2018, except as otherwise
3expressly authorized by law, consistent with options under
4federal law and regulations, and contingent upon receipt of
5approval from the office of the governor of reimbursement for
6each abortion performed under the program:
.................................................. $7642,302,870
81. Iowans support reducing the number of abortions
9performed in our state. Funds appropriated under this section
10shall not be used for abortions, unless otherwise authorized
11under this section.
122. The provisions of this section relating to abortions
13shall also apply to the Iowa health and wellness plan created
14pursuant to chapter 249N.
153. The department shall utilize not more than $30,000 of
16the funds appropriated in this section to continue the AIDS/HIV
17health insurance premium payment program as established in 1992
18Iowa Acts, Second Extraordinary Session, chapter 1001, section
19409, subsection 6. Of the funds allocated in this subsection,
20not more than $2,500 may be expended for administrative
21purposes.
224. Of the funds appropriated in this Act to the department
23of public health for addictive disorders, $475,000 for
24the fiscal year beginning July 1, 2018, is transferred
25to the department of human services for an integrated
26substance-related disorder managed care system. The
27departments of human services and public health shall
28work together to maintain the level of mental health and
29substance-related disorder treatment services provided by the
30managed care contractors. Each department shall take the steps
31necessary to continue the federal waivers as necessary to
32maintain the level of services.
335. a. The department shall aggressively pursue options for
34providing medical assistance or other assistance to individuals
35with special needs who become ineligible to continue receiving
-93-1services under the early and periodic screening, diagnostic,
2and treatment program under the medical assistance program
3due to becoming 21 years of age who have been approved for
4additional assistance through the department’s exception to
5policy provisions, but who have health care needs in excess
6of the funding available through the exception to policy
7provisions.
8b. Of the funds appropriated in this section, $50,000
9shall be used for participation in one or more pilot projects
10operated by a private provider to allow the individual or
11individuals to receive service in the community in accordance
12with principles established in Olmstead v.L.C., 527 U.S.581
13(1999), for the purpose of providing medical assistance or
14other assistance to individuals with special needs who become
15ineligible to continue receiving services under the early and
16periodic screening, diagnostic, and treatment program under
17the medical assistance program due to becoming 21 years of
18age who have been approved for additional assistance through
19the department’s exception to policy provisions, but who have
20health care needs in excess of the funding available through
21the exception to the policy provisions.
226. Of the funds appropriated in this section, up to
23$1,525,041 may be transferred to the field operations or
24general administration appropriations in this division of this
25Act for operational costs associated with Part D of the federal
26Medicare Prescription Drug Improvement and Modernization Act
27of 2003, Pub.L.No.108-173.
287. Of the funds appropriated in this section, up to $221,050
29may be transferred to the appropriation in this division
30of this Act for medical contracts to be used for clinical
31assessment services and prior authorization of services.
328. A portion of the funds appropriated in this section
33may be transferred to the appropriations in this division of
34this Act for general administration, medical contracts, the
35children’s health insurance program, or field operations to be
-94-1used for the state match cost to comply with the payment error
2rate measurement (PERM) program for both the medical assistance
3and children’s health insurance programs as developed by the
4centers for Medicare and Medicaid services of the United States
5department of health and human services to comply with the
6federal Improper Payments Information Act of 2002, Pub.L.No.
7107-300.
89. The department shall continue to implement the
9recommendations of the assuring better child health and
10development initiative II (ABCDII) clinical panel to the
11Iowa early and periodic screening, diagnostic, and treatment
12services healthy mental development collaborative board
13regarding changes to billing procedures, codes, and eligible
14service providers.
1510. Of the funds appropriated in this section, a sufficient
16amount is allocated to supplement the incomes of residents of
17nursing facilities, intermediate care facilities for persons
18with mental illness, and intermediate care facilities for
19persons with an intellectual disability, with incomes of less
20than $50 in the amount necessary for the residents to receive a
21personal needs allowance of $50 per month pursuant to section
22249A.30A.
2311. a. Hospitals that meet the conditions specified
24in subparagraphs (1) and (2) shall either certify public
25expenditures or transfer to the medical assistance program
26an amount equal to provide the nonfederal share for a
27disproportionate share hospital payment in an amount up to the
28hospital-specific limit as approved in the Medicaid state plan.
29The hospitals that meet the conditions specified shall receive
30and retain 100 percent of the total disproportionate share
31hospital payment in an amount up to the hospital-specific limit
32as approved in the Medicaid state plan.
33(1) The hospital qualifies for disproportionate share and
34graduate medical education payments.
35(2) The hospital is an Iowa state-owned hospital with more
-95-1than 500 beds and eight or more distinct residency specialty
2or subspecialty programs recognized by the American college of
3graduate medical education.
4b. Distribution of the disproportionate share payments
5shall be made on a monthly basis. The total amount of
6disproportionate share payments including graduate medical
7education, enhanced disproportionate share, and Iowa
8state-owned teaching hospital payments shall not exceed the
9amount of the state’s allotment under Pub.L.No.102-234.
10In addition, the total amount of all disproportionate
11share payments shall not exceed the hospital-specific
12disproportionate share limits under Pub.L.No.103-66.
1312. One hundred percent of the nonfederal share of payments
14to area education agencies that are medical assistance
15providers for medical assistance-covered services provided to
16medical assistance-covered children, shall be made from the
17appropriation made in this section.
1813. A portion of the funds appropriated in this section
19may be transferred to the appropriation in this division of
20this Act for medical contracts to be used for administrative
21activities associated with the money follows the person
22demonstration project.
2314. Of the funds appropriated in this section, $174,505
24shall be used for the administration of the health insurance
25premium payment program, including salaries, support,
26maintenance, and miscellaneous purposes.
2715. a. The department may increase the amounts allocated
28for salaries, support, maintenance, and miscellaneous purposes
29associated with the medical assistance program, as necessary,
30to implement cost containment strategies. The department shall
31report any such increase to the legislative services agency and
32the department of management.
33b. If the savings to the medical assistance program from
34cost containment efforts exceed the cost for the fiscal
35year beginning July 1, 2018, the department may transfer any
-96-1savings generated for the fiscal year due to medical assistance
2program cost containment efforts to the appropriation
3made in this division of this Act for medical contracts or
4general administration to defray the increased contract costs
5associated with implementing such efforts.
616. For the fiscal year beginning July 1, 2018, and ending
7June 30, 2019, the replacement generation tax revenues required
8to be deposited in the property tax relief fund pursuant to
9section 437A.8, subsection 4, paragraph “d”, and section
10437A.15, subsection 3, paragraph “f”, shall instead be credited
11to and supplement the appropriation made in this section and
12used for the allocations made in this section.
1317. a. Of the funds appropriated in this section, up
14to $25,000 may be transferred by the department to the
15appropriation made in this division of this Act to the
16department for the same fiscal year for general administration
17to be used for associated administrative expenses and for not
18more than one full-time equivalent position, in addition to
19those authorized for the same fiscal year, to be assigned to
20implementing the children’s mental health home project.
21b. Of the funds appropriated in this section, up to $200,000
22may be transferred by the department to the appropriation made
23to the department in this division of this Act for the same
24fiscal year for Medicaid program-related general administration
25planning and implementation activities. The funds may be used
26for contracts or for personnel in addition to the amounts
27appropriated for and the positions authorized for general
28administration for the fiscal year.
29c. Of the funds appropriated in this section, up to
30$1,500,000 may be transferred by the department to the
31appropriations made in this division of this Act for the same
32fiscal year for general administration or medical contracts
33to be used to support the development and implementation of
34standardized assessment tools for persons with mental illness,
35an intellectual disability, a developmental disability, or a
-97-1brain injury.
218. Of the funds appropriated in this section, $75,000
3shall be used for lodging expenses associated with care
4provided at the university of Iowa hospitals and clinics for
5patients with cancer whose travel distance is 30 miles or more
6and whose income is at or below 200 percent of the federal
7poverty level as defined by the most recently revised poverty
8income guidelines published by the United States department of
9health and human services. The department of human services
10shall establish the maximum number of overnight stays and the
11maximum rate reimbursed for overnight lodging, which may be
12based on the state employee rate established by the department
13of administrative services. The funds allocated in this
14subsection shall not be used as nonfederal share matching
15funds.
1619. Of the funds appropriated in this section, up to
17$1,691,940 shall be used for administration of the state
18family planning services program as enacted in this 2017 Act,
19and of this amount the department may use to up $100,000 for
20administrative expenses.
2120. The department shall report the implementation of
22any cost containment strategies to the individuals specified
23in this division of this Act for submission of reports upon
24implementation.
2521. The department shall report the implementation of any
26process improvement changes and any related cost reductions
27to the individuals specified in this division of this Act for
28submission of reports upon implementation.
29 Sec. 51. MEDICAL CONTRACTS. There is appropriated from the
30general fund of the state to the department of human services
31for the fiscal year beginning July 1, 2018, and ending June 30,
322019, the following amount, or so much thereof as is necessary,
33to be used for the purpose designated:
34For medical contracts:
.................................................. $358,813,232
-98- 11. The department of inspections and appeals shall
2provide all state matching funds for survey and certification
3activities performed by the department of inspections
4and appeals. The department of human services is solely
5responsible for distributing the federal matching funds for
6such activities.
72. Of the funds appropriated in this section, $25,000 shall
8be used for continuation of home and community-based services
9waiver quality assurance programs, including the review and
10streamlining of processes and policies related to oversight and
11quality management to meet state and federal requirements.
123. Of the amount appropriated in this section, up to
13$100,000 may be transferred to the appropriation for general
14administration in this division of this Act to be used for
15additional full-time equivalent positions in the development of
16key health initiatives such as cost containment, development
17and oversight of managed care programs, and development of
18health strategies targeted toward improved quality and reduced
19costs in the Medicaid program.
204. Of the funds appropriated in this section, $500,000 shall
21be used for planning and development, in cooperation with the
22department of public health, of a phased-in program to provide
23a dental home for children.
245. Of the funds appropriated in this section, $475,000
25shall be credited to the autism support program fund created
26in section 225D.2 to be used for the autism support program
27created in chapter 225D, with the exception of the following
28amounts of this allocation which shall be used as follows:
29a. Of the funds allocated in this subsection, $125,000
30shall be deposited in the board-certified behavior analyst and
31board-certified assistant behavior analyst grants program fund
32created in section 135.181, to be used for the purposes of the
33fund.
34b. Of the funds allocated in this subsection, $12,500
35shall be used for the public purpose of continuation of a
-99-1grant to a child welfare services provider headquartered in a
2county with a population between 205,000 and 215,000 in the
3latest certified federal census that provides multiple services
4including but not limited to a psychiatric medical institution
5for children, shelter, residential treatment, after school
6programs, school-based programming, and an Asperger’s syndrome
7program, to be used for support services for children with
8autism spectrum disorder and their families.
9c. Of the funds allocated in this subsection, $12,500
10shall be used for the public purpose of continuing a grant to
11a hospital-based provider headquartered in a county with a
12population between 90,000 and 95,000 in the latest certified
13federal census that provides multiple services including
14but not limited to diagnostic, therapeutic, and behavioral
15services to individuals with autism spectrum disorder across
16one’s lifespan. The grant recipient shall utilize the funds
17to continue the pilot project to determine the necessary
18support services for children with autism spectrum disorder and
19their families to be included in the children’s disabilities
20services system. The grant recipient shall submit findings and
21recommendations based upon the results of the pilot project
22to the individuals specified in this division of this Act for
23submission of reports by December 31, 2018.
24 Sec. 52. STATE SUPPLEMENTARY ASSISTANCE.
251. There is appropriated from the general fund of the
26state to the department of human services for the fiscal year
27beginning July 1, 2018, and ending June 30, 2019, the following
28amount, or so much thereof as is necessary, to be used for the
29purpose designated:
30For the state supplementary assistance program:
.................................................. $315,186,329
322. The department shall increase the personal needs
33allowance for residents of residential care facilities by the
34same percentage and at the same time as federal supplemental
35security income and federal social security benefits are
-100-1increased due to a recognized increase in the cost of living.
2The department may adopt emergency rules to implement this
3subsection.
43. If during the fiscal year beginning July 1, 2018,
5the department projects that state supplementary assistance
6expenditures for a calendar year will not meet the federal
7pass-through requirement specified in Tit.XVI of the federal
8Social Security Act, section 1618, as codified in 42 U.S.C.
9§1382g, the department may take actions including but not
10limited to increasing the personal needs allowance for
11residential care facility residents and making programmatic
12adjustments or upward adjustments of the residential care
13facility or in-home health-related care reimbursement rates
14prescribed in this division of this Act to ensure that federal
15requirements are met. In addition, the department may make
16other programmatic and rate adjustments necessary to remain
17within the amount appropriated in this section while ensuring
18compliance with federal requirements. The department may adopt
19emergency rules to implement the provisions of this subsection.
20 Sec. 53. CHILDREN’S HEALTH INSURANCE PROGRAM.
211. There is appropriated from the general fund of the
22state to the department of human services for the fiscal year
23beginning July 1, 2018, and ending June 30, 2019, the following
24amount, or so much thereof as is necessary, to be used for the
25purpose designated:
26For maintenance of the healthy and well kids in Iowa (hawk-i)
27program pursuant to chapter 514I, including supplemental dental
28services, for receipt of federal financial participation under
29Tit.XXI of the federal Social Security Act, which creates the
30children’s health insurance program:
.................................................. $314,259,226
322. Of the funds appropriated in this section, $21,400 is
33allocated for continuation of the contract for outreach with
34the department of public health.
35 Sec. 54. CHILD CARE ASSISTANCE. There is appropriated
-101-1from the general fund of the state to the department of human
2services for the fiscal year beginning July 1, 2018, and ending
3June 30, 2019, the following amount, or so much thereof as is
4necessary, to be used for the purpose designated:
5For child care programs:
.................................................. $619,671,808
71. Of the funds appropriated in this section, $16,746,808
8shall be used for state child care assistance in accordance
9with section 237A.13.
102. Nothing in this section shall be construed or is
11intended as or shall imply a grant of entitlement for services
12to persons who are eligible for assistance due to an income
13level consistent with the waiting list requirements of section
14237A.13. Any state obligation to provide services pursuant to
15this section is limited to the extent of the funds appropriated
16in this section.
173. A list of the registered and licensed child care
18facilities operating in the area served by a child care
19resource and referral service shall be made available to the
20families receiving state child care assistance in that area.
214. Of the funds appropriated in this section, $2,925,000
22shall be credited to the early childhood programs grants
23account in the early childhood Iowa fund created in section
24256I.11. The moneys shall be distributed for funding of
25community-based early childhood programs targeted to children
26from birth through five years of age developed by early
27childhood Iowa areas in accordance with approved community
28plans as provided in section 256I.8.
295. The department may use any of the funds appropriated
30in this section as a match to obtain federal funds for use in
31expanding child care assistance and related programs. For
32the purpose of expenditures of state and federal child care
33funding, funds shall be considered obligated at the time
34expenditures are projected or are allocated to the department’s
35service areas. Projections shall be based on current and
-102-1projected caseload growth, current and projected provider
2rates, staffing requirements for eligibility determination
3and management of program requirements including data systems
4management, staffing requirements for administration of the
5program, contractual and grant obligations and any transfers
6to other state agencies, and obligations for decategorization
7or innovation projects.
86. A portion of the state match for the federal child care
9and development block grant shall be provided as necessary to
10meet federal matching funds requirements through the state
11general fund appropriation made for child development grants
12and other programs for at-risk children in section 279.51.
137. If a uniform reduction ordered by the governor under
14section 8.31 or other operation of law, transfer, or federal
15funding reduction reduces the appropriation made in this
16section for the fiscal year, the percentage reduction in the
17amount paid out to or on behalf of the families participating
18in the state child care assistance program shall be equal to or
19less than the percentage reduction made for any other purpose
20payable from the appropriation made in this section and the
21federal funding relating to it. The percentage reduction to
22the other allocations made in this section shall be the same as
23the uniform reduction ordered by the governor or the percentage
24change of the federal funding reduction, as applicable.
25If there is an unanticipated increase in federal funding
26provided for state child care assistance, the entire amount
27of the increase shall be used for state child care assistance
28payments. If the appropriations made for purposes of the
29state child care assistance program for the fiscal year are
30determined to be insufficient, it is the intent of the general
31assembly to appropriate sufficient funding for the fiscal year
32in order to avoid establishment of waiting list requirements.
338. Notwithstanding section 8.33, moneys advanced for
34purposes of the programs developed by early childhood Iowa
35areas, advanced for purposes of wraparound child care, or
-103-1received from the federal appropriations made for the purposes
2of this section that remain unencumbered or unobligated at the
3close of the fiscal year shall not revert to any fund but shall
4remain available for expenditure for the purposes designated
5until the close of the succeeding fiscal year.
6 Sec. 55. JUVENILE INSTITUTION. There is appropriated
7from the general fund of the state to the department of human
8services for the fiscal year beginning July 1, 2018, and ending
9June 30, 2019, the following amounts, or so much thereof as is
10necessary, to be used for the purposes designated:
111. For operation of the state training school at Eldora and
12for salaries, support, maintenance, and miscellaneous purposes,
13and for not more than the following full-time equivalent
14positions:
.................................................. $155,675,221
............................................... FTEs16189.00
17Of the funds appropriated in this subsection, $45,575 shall
18be used for distribution to licensed classroom teachers at this
19and other institutions under the control of the department of
20human services based upon the average student yearly enrollment
21at each institution as determined by the department.
222. A portion of the moneys appropriated in this section
23shall be used by the state training school at Eldora for
24grants for adolescent pregnancy prevention activities at the
25institution in the fiscal year beginning July 1, 2018.
26 Sec. 56. CHILD AND FAMILY SERVICES.
271. There is appropriated from the general fund of the
28state to the department of human services for the fiscal year
29beginning July 1, 2018, and ending June 30, 2019, the following
30amount, or so much thereof as is necessary, to be used for the
31purpose designated:
32For child and family services:
.................................................. $3343,664,687
342. The department may transfer funds appropriated in this
35section as necessary to pay the nonfederal costs of services
-104-1reimbursed under the medical assistance program, state child
2care assistance program, or the family investment program which
3are provided to children who would otherwise receive services
4paid under the appropriation in this section. The department
5may transfer funds appropriated in this section to the
6appropriations made in this division of this Act for general
7administration and for field operations for resources necessary
8to implement and operate the services funded in this section.
93. a. Of the funds appropriated in this section, up to
10$17,868,324 is allocated as the statewide expenditure target
11under section 232.143 for group foster care maintenance and
12services. If the department projects that such expenditures
13for the fiscal year will be less than the target amount
14allocated in this paragraph “a”, the department may reallocate
15the excess to provide additional funding for shelter care
16or the child welfare emergency services addressed with the
17allocation for shelter care.
18b. If at any time after September 30, 2018, annualization
19of a service area’s current expenditures indicates a service
20area is at risk of exceeding its group foster care expenditure
21target under section 232.143 by more than 5 percent, the
22department and juvenile court services shall examine all
23group foster care placements in that service area in order to
24identify those which might be appropriate for termination.
25In addition, any aftercare services believed to be needed
26for the children whose placements may be terminated shall be
27identified. The department and juvenile court services shall
28initiate action to set dispositional review hearings for the
29placements identified. In such a dispositional review hearing,
30the juvenile court shall determine whether needed aftercare
31services are available and whether termination of the placement
32is in the best interest of the child and the community.
334. In accordance with the provisions of section 232.188,
34the department shall continue the child welfare and juvenile
35justice funding initiative during fiscal year 2018-2019. Of
-105-1the funds appropriated in this section, $858,876 is allocated
2specifically for expenditure for fiscal year 2018-2019 through
3the decategorization services funding pools and governance
4boards established pursuant to section 232.188.
55. A portion of the funds appropriated in this section
6may be used for emergency family assistance to provide other
7resources required for a family participating in a family
8preservation or reunification project or successor project to
9stay together or to be reunified.
106. Notwithstanding section 234.35 or any other provision
11of law to the contrary, state funding for shelter care and
12the child welfare emergency services contracting implemented
13to provide for or prevent the need for shelter care shall be
14limited to $4,048,079.
157. Federal funds received by the state during the fiscal
16year beginning July 1, 2018, as the result of the expenditure
17of state funds appropriated during a previous state fiscal
18year for a service or activity funded under this section are
19appropriated to the department to be used as additional funding
20for services and purposes provided for under this section.
21Notwithstanding section 8.33, moneys received in accordance
22with this subsection that remain unencumbered or unobligated at
23the close of the fiscal year shall not revert to any fund but
24shall remain available for the purposes designated until the
25close of the succeeding fiscal year.
268. a. Of the funds appropriated in this section, up to
27$1,645,000 is allocated for the payment of the expenses of
28court-ordered services provided to juveniles who are under
29the supervision of juvenile court services, which expenses
30are a charge upon the state pursuant to section 232.141,
31subsection 4. Of the amount allocated in this paragraph “a”,
32up to $778,143 shall be made available to provide school-based
33supervision of children adjudicated under chapter 232, of which
34not more than $7,500 may be used for the purpose of training.
35A portion of the cost of each school-based liaison officer
-106-1shall be paid by the school district or other funding source as
2approved by the chief juvenile court officer.
3b. Of the funds appropriated in this section, up to $374,492
4is allocated for the payment of the expenses of court-ordered
5services provided to children who are under the supervision
6of the department, which expenses are a charge upon the state
7pursuant to section 232.141, subsection 4.
8c. Notwithstanding section 232.141 or any other provision
9of law to the contrary, the amounts allocated in this
10subsection shall be distributed to the judicial districts
11as determined by the state court administrator and to the
12department’s service areas as determined by the administrator
13of the department of human services’ division of child and
14family services. The state court administrator and the
15division administrator shall make the determination of the
16distribution amounts on or before June 15, 2018.
17d. Notwithstanding chapter 232 or any other provision of
18law to the contrary, a district or juvenile court shall not
19order any service which is a charge upon the state pursuant
20to section 232.141 if there are insufficient court-ordered
21services funds available in the district court or departmental
22service area distribution amounts to pay for the service. The
23chief juvenile court officer and the departmental service area
24manager shall encourage use of the funds allocated in this
25subsection such that there are sufficient funds to pay for
26all court-related services during the entire year. The chief
27juvenile court officers and departmental service area managers
28shall attempt to anticipate potential surpluses and shortfalls
29in the distribution amounts and shall cooperatively request the
30state court administrator or division administrator to transfer
31funds between the judicial districts’ or departmental service
32areas’ distribution amounts as prudent.
33e. Notwithstanding any provision of law to the contrary,
34a district or juvenile court shall not order a county to pay
35for any service provided to a juvenile pursuant to an order
-107-1entered under chapter 232 which is a charge upon the state
2under section 232.141, subsection 4.
3f. Of the funds allocated in this subsection, not more than
4$41,500 may be used by the judicial branch for administration
5of the requirements under this subsection.
6g. Of the funds allocated in this subsection, $8,500
7shall be used by the department of human services to support
8the interstate commission for juveniles in accordance with
9the interstate compact for juveniles as provided in section
10232.173.
119. Of the funds appropriated in this section, $6,126,613 is
12allocated for juvenile delinquent graduated sanctions services.
13Any state funds saved as a result of efforts by juvenile court
14services to earn a federal Tit.IV-E match for juvenile court
15services administration may be used for the juvenile delinquent
16graduated sanctions services.
1710. Of the funds appropriated in this section, $829,142 is
18transferred to the department of public health to be used for
19the child protection center grant program for child protection
20centers located in Iowa in accordance with section 135.118.
21The grant amounts under the program shall be equalized so that
22each center receives a uniform base amount of $122,500, so that
23$25,000 is awarded to establish a satellite child protection
24center in a city in north central Iowa that is the county
25seat of a county with a population between 44,000 and 45,000
26according to the 2010 federal decennial census, and so that the
27remaining funds are awarded through a funding formula based
28upon the volume of children served.
2911. If the department receives federal approval to
30implement a waiver under Tit.IV-E of the federal Social
31Security Act to enable providers to serve children who remain
32in the children’s families and communities, for purposes of
33eligibility under the medical assistance program through 25
34years of age, children who participate in the waiver shall be
35considered to be placed in foster care.
-108- 112. Of the funds appropriated in this section, $2,012,583 is
2allocated for the preparation for adult living program pursuant
3to section 234.46.
413. Of the funds appropriated in this section, $113,668
5shall be used for the public purpose of continuing a grant to
6a nonprofit human services organization providing services to
7individuals and families in multiple locations in southwest
8Iowa and Nebraska for support of a project providing immediate,
9sensitive support and forensic interviews, medical exams, needs
10assessments, and referrals for victims of child abuse and their
11nonoffending family members.
1214. Of the funds appropriated in this section, $150,310
13is allocated for the foster care youth council approach of
14providing a support network to children placed in foster care.
1515. Of the funds appropriated in this section, $101,000 is
16allocated for use pursuant to section 235A.1 for continuation
17of the initiative to address child sexual abuse implemented
18pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
1921.
2016. Of the funds appropriated in this section, $315,120 is
21allocated for the community partnership for child protection
22sites.
2317. Of the funds appropriated in this section, $185,625
24is allocated for the department’s minority youth and family
25projects under the redesign of the child welfare system.
2618. Of the funds appropriated in this section, $593,297
27is allocated for funding of the community circle of care
28collaboration for children and youth in northeast Iowa.
2919. Of the funds appropriated in this section, at least
30$73,579 shall be used for the continuation of the child
31welfare provider training academy, a collaboration between the
32coalition for family and children’s services in Iowa and the
33department.
3420. Of the funds appropriated in this section, $105,936
35shall be used for continuation of the central Iowa system of
-109-1care program grant through June 30, 2019.
221. Of the funds appropriated in this section, $117,500
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.
922. Of the funds appropriated in this section, at least
10$12,500 shall be used to continue and to expand the foster
11care respite pilot program in which postsecondary students in
12social work and other human services-related programs receive
13experience by assisting family foster care providers with
14respite and other support.
1523. Of the funds appropriated in this section, $55,000
16shall be used for the public purpose of funding community-based
17services and other supports with a system of care approach
18for children with a serious emotional disturbance and their
19families through a nonprofit provider of child welfare services
20that has been in existence for more than 115 years, is located
21in a county with a population of more than 200,000 but less
22than 220,000 according to the latest certified federal census,
23is licensed as a psychiatric medical institution for children,
24and was a system of care grantee prior to July 1, 2018.
25 Sec. 57. ADOPTION SUBSIDY.
261. There is appropriated from the general fund of the
27state to the department of human services for the fiscal year
28beginning July 1, 2018, and ending June 30, 2019, the following
29amount, or so much thereof as is necessary, to be used for the
30purpose designated:
31a. For adoption subsidy payments and services:
.................................................. $3220,388,955
33b. (1) The funds appropriated in this section shall be used
34as authorized or allowed by federal law or regulation for any
35of the following purposes:
-110- 1(a) For adoption subsidy payments and related costs.
2(b) For post-adoption services and for other purposes under
3Tit.IV-B or Tit.IV-E of the federal Social Security Act.
4(2) The department of human services may transfer funds
5appropriated in this subsection to the appropriation for
6child and family services in this Act for the purposes of
7post-adoption services as specified in this paragraph “b”.
82. The department may transfer funds appropriated in
9this section to the appropriation made in this division of
10this Act for general administration for costs paid from the
11appropriation relating to adoption subsidy.
123. Federal funds received by the state during the
13fiscal year beginning July 1, 2018, as the result of the
14expenditure of state funds during a previous state fiscal
15year for a service or activity funded under this section are
16appropriated to the department to be used as additional funding
17for the services and activities funded under this section.
18Notwithstanding section 8.33, moneys received in accordance
19with this subsection that remain unencumbered or unobligated
20at the close of the fiscal year shall not revert to any fund
21but shall remain available for expenditure for the purposes
22designated until the close of the succeeding fiscal year.
23 Sec. 58. JUVENILE DETENTION HOME FUND. Moneys deposited
24in the juvenile detention home fund created in section 232.142
25during the fiscal year beginning July 1, 2018, and ending June
2630, 2019, are appropriated to the department of human services
27for the fiscal year beginning July 1, 2018, and ending June 30,
282019, for distribution of an amount equal to a percentage of
29the costs of the establishment, improvement, operation, and
30maintenance of county or multicounty juvenile detention homes
31in the fiscal year beginning July 1, 2015. Moneys appropriated
32for distribution in accordance with this section shall be
33allocated among eligible detention homes, prorated on the basis
34of an eligible detention home’s proportion of the costs of all
35eligible detention homes in the fiscal year beginning July
-111-11, 2015. The percentage figure shall be determined by the
2department based on the amount available for distribution for
3the fund. Notwithstanding section 232.142, subsection 3, the
4financial aid payable by the state under that provision for the
5fiscal year beginning July 1, 2018, shall be limited to the
6amount appropriated for the purposes of this section.
7 Sec. 59. FAMILY SUPPORT SUBSIDY PROGRAM.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2018, and ending June 30, 2019, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13For the family support subsidy program subject to the
14enrollment restrictions in section 225C.37, subsection 3:
.................................................. $15534,641
162. At least $393,750 of the moneys appropriated in this
17section is transferred to the department of public health for
18the family support center component of the comprehensive family
19support program under chapter 225C, subchapter V.
203. If at any time during the fiscal year, the amount of
21funding available for the family support subsidy program
22is reduced from the amount initially used to establish the
23figure for the number of family members for whom a subsidy
24is to be provided at any one time during the fiscal year,
25notwithstanding section 225C.38, subsection 2, the department
26shall revise the figure as necessary to conform to the amount
27of funding available.
28 Sec. 60. CONNER DECREE. There is appropriated from the
29general fund of the state to the department of human services
30for the fiscal year beginning July 1, 2018, and ending June 30,
312019, the following amount, or so much thereof as is necessary,
32to be used for the purpose designated:
33For building community capacity through the coordination
34and provision of training opportunities in accordance with the
35consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
-112-1Iowa, July 14, 1994):
.................................................. $216,816
3 Sec. 61. MENTAL HEALTH INSTITUTES.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2018, and ending June 30, 2019, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
9a. For operation of the state mental health institute at
10Cherokee as required by chapters 218 and 226 for salaries,
11support, maintenance, and miscellaneous purposes, and for not
12more than the following full-time equivalent positions:
.................................................. $136,935,127
............................................... FTEs14162.00
15b. For operation of the state mental health institute at
16Independence as required by chapters 218 and 226 for salaries,
17support, maintenance, and miscellaneous purposes, and for not
18more than the following full-time equivalent positions:
.................................................. $198,756,810
............................................... FTEs20204.00
212. Notwithstanding sections 218.78 and 249A.11, any revenue
22received from the state mental health institute at Cherokee or
23the state mental health institute at Independence pursuant to
2442 C.F.R §438.6(e) may be retained and expended by the mental
25health institute.
263. Notwithstanding any provision of law to the contrary,
27a Medicaid member residing at the state mental health
28institute at Cherokee or the state mental health institute
29at Independence shall retain Medicaid eligibility during
30the period of the Medicaid member’s stay for which federal
31financial participation is available.
32 Sec. 62. STATE RESOURCE CENTERS.
331. There is appropriated from the general fund of the
34state to the department of human services for the fiscal year
35beginning July 1, 2018, and ending June 30, 2019, the following
-113-1amounts, or so much thereof as is necessary, to be used for the
2purposes designated:
3a. For the state resource center at Glenwood for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $58,943,890
6b. For the state resource center at Woodward for salaries,
7support, maintenance, and miscellaneous purposes:
.................................................. $86,038,517
92. The department may continue to bill for state resource
10center services utilizing a scope of services approach used for
11private providers of intermediate care facilities for persons
12with an intellectual disability services, in a manner which
13does not shift costs between the medical assistance program,
14counties, or other sources of funding for the state resource
15centers.
163. The state resource centers may expand the time-limited
17assessment and respite services during the fiscal year.
184. If the department’s administration and the department
19of management concur with a finding by a state resource
20center’s superintendent that projected revenues can reasonably
21be expected to pay the salary and support costs for a new
22employee position, or that such costs for adding a particular
23number of new positions for the fiscal year would be less
24than the overtime costs if new positions would not be added,
25the superintendent may add the new position or positions. If
26the vacant positions available to a resource center do not
27include the position classification desired to be filled, the
28state resource center’s superintendent may reclassify any
29vacant position as necessary to fill the desired position. The
30superintendents of the state resource centers may, by mutual
31agreement, pool vacant positions and position classifications
32during the course of the fiscal year in order to assist one
33another in filling necessary positions.
345. If existing capacity limitations are reached in
35operating units, a waiting list is in effect for a service or
-114-1a special need for which a payment source or other funding
2is available for the service or to address the special need,
3and facilities for the service or to address the special need
4can be provided within the available payment source or other
5funding, the superintendent of a state resource center may
6authorize opening not more than two units or other facilities
7and begin implementing the service or addressing the special
8need during fiscal year 2018-2019.
9 Sec. 63. SEXUALLY VIOLENT PREDATORS.
101. There is appropriated from the general fund of the
11state to the department of human services for the fiscal year
12beginning July 1, 2018, and ending June 30, 2019, the following
13amount, or so much thereof as is necessary, to be used for the
14purpose designated:
15For costs associated with the commitment and treatment of
16sexually violent predators in the unit located at the state
17mental health institute at Cherokee, including costs of legal
18services and other associated costs, including salaries,
19support, maintenance, and miscellaneous purposes, and for not
20more than the following full-time equivalent positions:
.................................................. $214,732,373
............................................... FTEs22112.00
232. Unless specifically prohibited by law, if the amount
24charged provides for recoupment of at least the entire amount
25of direct and indirect costs, the department of human services
26may contract with other states to provide care and treatment
27of persons placed by the other states at the unit for sexually
28violent predators at Cherokee. The moneys received under
29such a contract shall be considered to be repayment receipts
30and used for the purposes of the appropriation made in this
31section.
32 Sec. 64. FIELD OPERATIONS. There is appropriated from the
33general fund of the state to the department of human services
34for the fiscal year beginning July 1, 2018, and ending June 30,
352019, the following amount, or so much thereof as is necessary,
-115-1to be used for the purposes designated:
2For field operations, including salaries, support,
3maintenance, and miscellaneous purposes, and for not more than
4the following full-time equivalent positions:
.................................................. $524,242,217
............................................... FTEs61,583.00
7Priority in filling full-time equivalent positions shall be
8given to those positions related to child protection services
9and eligibility determination for low-income families.
10 Sec. 65. GENERAL ADMINISTRATION. There is appropriated
11from the general fund of the state to the department of human
12services for the fiscal year beginning July 1, 2018, and ending
13June 30, 2019, the following amount, or so much thereof as is
14necessary, to be used for the purpose designated:
15For general administration, including salaries, support,
16maintenance, and miscellaneous purposes, and for not more than
17the following full-time equivalent positions:
.................................................. $186,941,520
............................................... FTEs19294.00
201. The department shall report at least monthly to the
21legislative services agency concerning the department’s
22operational and program expenditures.
232. Of the funds appropriated in this section, $75,000 shall
24be used to continue the contract for the provision of a program
25to provide technical assistance, support, and consultation to
26providers of habilitation services and home and community-based
27services waiver services for adults with disabilities under the
28medical assistance program.
293. Of the funds appropriated in this section, $25,000
30is transferred to the Iowa finance authority to be used
31for administrative support of the council on homelessness
32established in section 16.2D and for the council to fulfill its
33duties in addressing and reducing homelessness in the state.
344. Of the funds appropriated in this section, $125,000 shall
35be transferred to and deposited in the administrative fund of
-116-1the Iowa ABLE savings plan trust created in section 12I.4, to
2be used for implementation and administration activities of the
3Iowa ABLE savings plan trust.
45. Of the funds appropriated in this section, $100,000
5is transferred to the economic development authority for
6the Iowa commission on volunteer services to continue to be
7used for RefugeeRISE AmeriCorps program established under
8Code section 15H.8 for member recruitment and training to
9improve the economic well-being and health of economically
10disadvantaged refugees in local communities across Iowa. Funds
11transferred may be used to supplement federal funds under
12federal regulations.
13 Sec. 66. DEPARTMENT-WIDE DUTIES. There is appropriated
14from the general fund of the state to the department of human
15services for the fiscal year beginning July 1, 2018, and ending
16June 30, 2019, the following amount, or so much thereof as is
17necessary, to be used for the purposes designated:
18For salaries, support, maintenance, and miscellaneous
19purposes at facilities under the purview of the department of
20human services:
.................................................. $211,439,637
22 Sec. 67. VOLUNTEERS. There is appropriated from the general
23fund of the state to the department of human services for the
24fiscal year beginning July 1, 2018, and ending June 30, 2019,
25the following amount, or so much thereof as is necessary, to be
26used for the purpose designated:
27For development and coordination of volunteer services:
.................................................. $2842,343
29 Sec. 68. GENERAL REDUCTION. For the period beginning July
301, 2018, and ending June 30, 2019, the department of human
31services, in consultation with the department of management,
32shall identify and implement a reduction in expenditures made
33from appropriations from the general fund to the department of
34human services in the amount of $733,651.
35 Sec. 69. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
-117-1ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
2DEPARTMENT OF HUMAN SERVICES.
31. a. (1) (a) For the fiscal year beginning July
41, 2018, case-mix, non-case mix, and special population
5nursing facilities shall be reimbursed in accordance with the
6methodology in effect on June 30, 2018.
7(b) For managed care claims, the department of human
8services shall adjust the payment rate floor for nursing
9facilities, annually, to maintain a rate floor that is no
10lower than the Medicaid fee-for-service case-mix adjusted rate
11calculated in accordance with 441 IAC 81.6. The department
12shall then calculate adjusted reimbursement rates, including
13but not limited to add-on-payments, annually, and shall
14notify Medicaid managed care organizations of the adjusted
15reimbursement rates within 30 days of determining the adjusted
16reimbursement rates. Any adjustment of reimbursement rates
17under this subparagraph division shall be budget neutral to the
18state budget.
19(2) For any open or unsettled nursing facility cost report
20for a fiscal year prior to and including the fiscal year
21beginning July 1, 2017, including any cost report remanded on
22judicial review for inclusion of prescription drug, laboratory,
23or x-ray costs, the department shall offset all reported
24prescription drug, laboratory, and x-ray costs with any revenue
25received from Medicare or other revenue source for any purpose.
26For purposes of this subparagraph, a nursing facility cost
27report is not considered open or unsettled if the facility did
28not initiate an administrative appeal under chapter 17A or if
29any appeal rights initiated have been exhausted.
30b. (1) For the fiscal year beginning July 1, 2018,
31the department shall establish the pharmacy dispensing fee
32reimbursement at $10.02 per prescription, until a cost of
33dispensing survey is completed. The actual dispensing fee
34shall be determined by a cost of dispensing survey performed
35by the department and required to be completed by all medical
-118-1assistance program participating pharmacies every two years,
2adjusted as necessary to maintain expenditures within the
3amount appropriated to the department for this purpose for the
4fiscal year.
5(2) The department shall utilize an average acquisition
6cost reimbursement methodology for all drugs covered under the
7medical assistance program in accordance with 2012 Iowa Acts,
8chapter 1133, section 33.
9c. (1) For the fiscal year beginning July 1, 2018,
10reimbursement rates for outpatient hospital services shall
11remain at the rates in effect on June 30, 2018, subject to
12Medicaid program upper payment limit rules, and adjusted
13as necessary to maintain expenditures within the amount
14appropriated to the department for this purpose for the fiscal
15year.
16(2) For the fiscal year beginning July 1, 2018,
17reimbursement rates for inpatient hospital services shall
18be rebased effective October 1, 2018, subject to Medicaid
19program upper payment limit rules, and adjusted as necessary
20to maintain expenditures within the amount appropriated to the
21department for this purpose for the fiscal year.
22(3) For the fiscal year beginning July 1, 2018, the graduate
23medical education and disproportionate share hospital fund
24shall remain at the amount in effect on June 30, 2018, except
25that the portion of the fund attributable to graduate medical
26education shall be reduced in an amount that reflects the
27elimination of graduate medical education payments made to
28out-of-state hospitals.
29(4) In order to ensure the efficient use of limited state
30funds in procuring health care services for low-income Iowans,
31funds appropriated in this Act for hospital services shall
32not be used for activities which would be excluded from a
33determination of reasonable costs under the federal Medicare
34program pursuant to 42 U.S.C.§1395x(v)(1)(N).
35d. For the fiscal year beginning July 1, 2018, reimbursement
-119-1rates for hospices and acute mental hospitals shall be
2increased in accordance with increases under the federal
3Medicare program or as supported by their Medicare audited
4costs.
5e. For the fiscal year beginning July 1, 2018, independent
6laboratories and rehabilitation agencies shall be reimbursed
7using the same methodology in effect on June 30, 2018.
8f. (1) For the fiscal year beginning July 1, 2018,
9reimbursement rates for home health agencies shall continue to
10be based on the Medicare low utilization payment adjustment
11(LUPA) methodology with state geographic wage adjustments.
12The department shall continue to update the rates every two
13years to reflect the most recent Medicare LUPA rates to the
14extent possible within the state funding appropriated for this
15purpose.
16(2) For the fiscal year beginning July 1, 2018, rates for
17private duty nursing and personal care services under the early
18and periodic screening, diagnostic, and treatment program
19benefit shall be calculated based on the methodology in effect
20on June 30, 2018.
21g. For the fiscal year beginning July 1, 2018, federally
22qualified health centers and rural health clinics shall receive
23cost-based reimbursement for 100 percent of the reasonable
24costs for the provision of services to recipients of medical
25assistance.
26h. For the fiscal year beginning July 1, 2018, the
27reimbursement rates for dental services shall remain at the
28rates in effect on June 30, 2018.
29i. (1) For the fiscal year beginning July 1, 2018,
30reimbursement rates for the non-state-owned psychiatric medical
31institution for children shall be based on the methodology in
32effect on June 30, 2018.
33(2) As a condition of participation in the medical
34assistance program, enrolled providers shall accept the medical
35assistance reimbursement rate for any covered goods or services
-120-1provided to recipients of medical assistance who are children
2under the custody of a psychiatric medical institution for
3children.
4j. For the fiscal year beginning July 1, 2018, unless
5otherwise specified in this Act, all noninstitutional medical
6assistance provider reimbursement rates shall remain at the
7rates in effect on June 30, 2018, except for area education
8agencies, local education agencies, infant and toddler
9services providers, home and community-based services providers
10including consumer-directed attendant care providers under a
11section 1915(c) or 1915(i) waiver, targeted case management
12providers, and those providers whose rates are required to be
13determined pursuant to section 249A.20.
14k. Notwithstanding any provision to the contrary, for the
15fiscal year beginning July 1, 2018, the reimbursement rate
16for anesthesiologists shall be adjusted to implement the cost
17containment strategies authorized for the medical assistance
18program in this 2017 Act.
19l. Notwithstanding section 249A.20, for the fiscal year
20beginning July 1, 2018, 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, 2018; however, this rate shall not exceed the maximum
25level authorized by the federal government.
26m. For the fiscal year beginning July 1, 2018, 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, 2018, the
-121-1reimbursement rates for inpatient mental health services
2provided at hospitals shall remain at the rates in effect on
3June 30, 2018, subject to Medicaid program upper payment limit
4rules; and psychiatrists shall be reimbursed at the medical
5assistance program fee-for-service rate in effect on June 30,
62018.
7o. For the fiscal year beginning July 1, 2018, community
8mental health centers may choose to be reimbursed for the
9services provided to recipients of medical assistance through
10either of the following options:
11(1) For 100 percent of the reasonable costs of the services.
12(2) In accordance with the alternative reimbursement rate
13methodology approved by the department of human services in
14effect on June 30, 2018.
15p. For the fiscal year beginning July 1, 2018, the
16reimbursement rate for providers of family planning services
17that are eligible to receive a 90 percent federal match shall
18remain at the rates in effect on June 30, 2018.
19q. Unless otherwise subject to a tiered rate methodology,
20for the fiscal year beginning July 1, 2018, the upper
21limits and reimbursement rates for providers of home and
22community-based services waiver services shall be reimbursed
23using the reimbursement methodology in effect on June 30, 2018.
24r. For the fiscal year beginning July 1, 2018, the
25reimbursement rates for emergency medical service providers
26shall remain at the rates in effect on June 30, 2018.
27s. For the fiscal year beginning July 1, 2018, reimbursement
28rates for substance-related disorder treatment programs
29licensed under section 125.13 shall remain at the rates in
30effect on June 30, 2018.
312. For the fiscal year beginning July 1, 2018, the
32reimbursement rate for providers reimbursed under the
33in-home-related care program shall not be less than the minimum
34payment level as established by the federal government to meet
35the federally mandated maintenance of effort requirement.
-122- 13. Unless otherwise directed in this section, when the
2department’s reimbursement methodology for any provider
3reimbursed in accordance with this section includes an
4inflation factor, this factor shall not exceed the amount
5by which the consumer price index for all urban consumers
6increased during the calendar year ending December 31, 2002.
74. Notwithstanding section 234.38, for the fiscal
8year beginning July 1, 2018, the foster family basic daily
9maintenance rate and the maximum adoption subsidy rate for
10children ages 0 through 5 years shall be $16.78, the rate for
11children ages 6 through 11 years shall be $17.43, the rate for
12children ages 12 through 15 years shall be $19.10, and the
13rate for children and young adults ages 16 and older shall
14be $19.35. For youth ages 18 to 21 who have exited foster
15care, the preparation for adult living program maintenance rate
16shall be $602.70 per month. The maximum payment for adoption
17subsidy nonrecurring expenses shall be limited to $500 and the
18disallowance of additional amounts for court costs and other
19related legal expenses implemented pursuant to 2010 Iowa Acts,
20chapter 1031, section 408, shall be continued.
215. For the fiscal year beginning July 1, 2018, the maximum
22reimbursement rates for social services providers under
23contract shall remain at the rates in effect on June 30, 2018,
24or the provider’s actual and allowable cost plus inflation for
25each service, whichever is less. However, if a new service
26or service provider is added after June 30, 2018, the initial
27reimbursement rate for the service or provider shall be based
28upon a weighted average of provider rates for similar services.
296. a. For the fiscal year beginning July 1, 2018, the
30reimbursement rates for resource family recruitment and
31retention contractors shall be established by contract.
32b. For the fiscal year beginning July 1, 2018, the
33reimbursement rates for supervised apartment living foster care
34providers shall be established by contract.
357. a. For the purposes of this subsection, “combined
-123-1reimbursement rate” means the combined service and maintenance
2reimbursement rate for a service level under the department’s
3reimbursement methodology. Effective July 1, 2018, the
4combined reimbursement rate for a group foster care service
5level shall be the amount designated in this subsection.
6However, if a group foster care provider’s reimbursement rate
7for a service level as of June 30, 2018, is more than the rate
8designated in this subsection, the provider’s reimbursement
9shall remain at the higher rate.
10b. Unless a group foster care provider is subject to the
11exception provided in paragraph “a”, effective July 1, 2018,
12the combined reimbursement rates for the service levels under
13the department’s reimbursement methodology shall be as follows:
14(1) For service level, community - D1, the daily rate shall
15be at least $84.17.
16(2) For service level, comprehensive - D2, the daily rate
17shall be at least $119.09.
18(3) For service level, enhanced - D3, the daily rate shall
19be at least $131.09.
208. The group foster care reimbursement rates paid for
21placement of children out of state shall be calculated
22according to the same rate-setting principles as those used for
23in-state providers, unless the director of human services or
24the director’s designee determines that appropriate care cannot
25be provided within the state. The payment of the daily rate
26shall be based on the number of days in the calendar month in
27which service is provided.
289. a. For the fiscal year beginning July 1, 2018, the
29reimbursement rate paid for shelter care and the child welfare
30emergency services implemented to provide or prevent the need
31for shelter care shall be established by contract.
32b. For the fiscal year beginning July 1, 2018, the combined
33service and maintenance components of the reimbursement rate
34paid for shelter care services shall be based on the financial
35and statistical report submitted to the department. The
-124-1maximum reimbursement rate shall be $101.83 per day. The
2department shall reimburse a shelter care provider at the
3provider’s actual and allowable unit cost, plus inflation, not
4to exceed the maximum reimbursement rate.
5c. Notwithstanding section 232.141, subsection 8, for the
6fiscal year beginning July 1, 2018, 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,
112017.
1210. For the fiscal year beginning July 1, 2018, the
13department shall calculate reimbursement rates for intermediate
14care facilities for persons with an intellectual disability
15at the 80th percentile. Beginning July 1, 2018, the rate
16calculation methodology shall utilize the consumer price index
17inflation factor applicable to the fiscal year beginning July
181, 2018.
1911. For the fiscal year beginning July 1, 2018, for child
20care providers reimbursed under the state child care assistance
21program, the department shall set provider reimbursement
22rates based on the rate reimbursement survey completed in
23December 2004. Effective July 1, 2018, the child care provider
24reimbursement rates shall remain at the rates in effect on June
2530, 2018. The department shall set rates in a manner so as
26to provide incentives for a nonregistered provider to become
27registered by applying the increase only to registered and
28licensed providers.
2912. For the fiscal year beginning July 1, 2018,
30notwithstanding any provision to the contrary under this
31section, affected providers or services shall be reimbursed as
32follows:
33a. For fee-for-service claims, reimbursement shall be
34calculated based on the methodology otherwise specified in this
35section for the fiscal year beginning July 1, 2018, for the
-125-1respective provider or service.
2b. For claims subject to a managed care contract with the
3exception of any provider or service to which a reimbursement
4increase is applicable for the fiscal year under this section,
5reimbursement shall be based on the methodology established by
6the managed care contract. However, any rate or reimbursement
7established under such contract shall not be lower than the
8rate or reimbursement floor established by the department
9of human services as the managed care organization rate or
10reimbursement floor for a respective provider or service in
11effect on April 1, 2016.
1213. Notwithstanding any provision to the contrary,
13reimbursement rates and methodologies under this section may
14be adjusted as necessary to implement the cost containment
15strategies authorized for the medical assistance program in
16this 2017 Act.
1714. The department may adopt emergency rules to implement
18this section.
19 Sec. 70. EMERGENCY RULES.
201. If specifically authorized by a provision of this
21division of this Act, the department of human services or
22the mental health and disability services commission may
23adopt administrative rules under section 17A.4, subsection
243, and section 17A.5, subsection 2, paragraph “b”, to
25implement the provisions of this division of this Act and
26the rules shall become effective immediately upon filing or
27on a later effective date specified in the rules, unless the
28effective date of the rules is delayed or the applicability
29of the rules is suspended by the administrative rules review
30committee. Any rules adopted in accordance with this section
31shall not take effect before the rules are reviewed by the
32administrative rules review committee. The delay authority
33provided to the administrative rules review committee under
34section 17A.4, subsection 7, and section 17A.8, subsection 9,
35shall be applicable to a delay imposed under this section,
-126-1notwithstanding a provision in those sections making them
2inapplicable to section 17A.5, subsection 2, paragraph “b”.
3Any rules adopted in accordance with the provisions of this
4section shall also be published as a notice of intended action
5as provided in section 17A.4.
62. If during a fiscal year, the department of human
7services is adopting rules in accordance with this section
8or as otherwise directed or authorized by state law, and the
9rules will result in an expenditure increase beyond the amount
10anticipated in the budget process or if the expenditure was
11not addressed in the budget process for the fiscal year, the
12department shall notify the persons designated by this division
13of this Act for submission of reports, the chairpersons and
14ranking members of the committees on appropriations, and
15the department of management concerning the rules and the
16expenditure increase. The notification shall be provided at
17least 30 calendar days prior to the date notice of the rules
18is submitted to the administrative rules coordinator and the
19administrative code editor.
20 Sec. 71. REPORTS. Any reports or other information
21required to be compiled and submitted under this Act during the
22fiscal year beginning July 1, 2018, shall be submitted to the
23chairpersons and ranking members of the joint appropriations
24subcommittee on health and human services, the legislative
25services agency, and the legislative caucus staffs on or
26before the dates specified for submission of the reports or
27information.
28 Sec. 72. TRANSFER OF MEDICAID MODERNIZATION SAVINGS BETWEEN
29APPROPRIATIONS FY 2018-2019. Notwithstanding section 8.39,
30subsection 1, for the fiscal year beginning July 1, 2018, if
31savings resulting from the governor’s Medicaid modernization
32initiative accrue to the medical contracts or children’s health
33insurance program appropriation from the general fund of the
34state and not to the medical assistance appropriation from the
35general fund of the state under this division of this Act,
-127-1such savings may be transferred to such medical assistance
2appropriation for the same fiscal year without prior written
3consent and approval of the governor and the director of the
4department of management. The department of human services
5shall report any transfers made pursuant to this section to the
6legislative services agency.
7DIVISION XII
8HEALTH CARE ACCOUNTS AND FUNDS — FY 2018-2019
9 Sec. 73. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
10appropriated from the pharmaceutical settlement account created
11in section 249A.33 to the department of human services for the
12fiscal year beginning July 1, 2018, and ending June 30, 2019,
13the following amount, or so much thereof as is necessary, to be
14used for the purpose designated:
15Notwithstanding any provision of law to the contrary, to
16supplement the appropriations made in this Act for medical
17contracts under the medical assistance program for the fiscal
18year beginning July 1, 2018, and ending June 30, 2019:
.................................................. $19400,000
20 Sec. 74. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
21SERVICES. Notwithstanding any provision to the contrary and
22subject to the availability of funds, there is appropriated
23from the quality assurance trust fund created in section
24249L.4 to the department of human services for the fiscal year
25beginning July 1, 2018, and ending June 30, 2019, the following
26amounts, or so much thereof as is necessary, for the purposes
27designated:
28To supplement the appropriation made in this Act from the
29general fund of the state to the department of human services
30for medical assistance for the same fiscal year:
.................................................. $3118,352,604
32 Sec. 75. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
33DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
34the contrary and subject to the availability of funds, there is
35appropriated from the hospital health care access trust fund
-128-1created in section 249M.4 to the department of human services
2for the fiscal year beginning July 1, 2018, and ending June
330, 2019, the following amounts, or so much thereof as is
4necessary, for the purposes designated:
5To supplement the appropriation made in this Act from the
6general fund of the state to the department of human services
7for medical assistance for the same fiscal year:
.................................................. $816,960,277
9 Sec. 76. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
10FOR FY 2018-2019. Notwithstanding section 8.33, if moneys
11appropriated for purposes of the medical assistance program for
12the fiscal year beginning July 1, 2018, and ending June 30,
132019, from the general fund of the state, the quality assurance
14trust fund and the hospital health care access trust fund, are
15in excess of actual expenditures for the medical assistance
16program and remain unencumbered or unobligated at the close
17of the fiscal year, the excess moneys shall not revert but
18shall remain available for expenditure for the purposes of the
19medical assistance program until the close of the succeeding
20fiscal year.
21DIVISION XIII
22Child care facility fund — USE FOR field operations
23 Sec. 77. CHILD CARE FACILITY FUND — USE FOR FIELD
24OPERATIONS. Notwithstanding section 237A.4A, subsection 5,
25Code 2017, for the fiscal year beginning July 1, 2017, and
26ending June 30, 2018, in addition to the costs of dedicated
27staffing to perform the duties described in section 237A.4A,
28up to $590,082 of the moneys in the child care facility fund
29may be used by the department of human services for additional
30expenditures of the child care regulatory unit within the
31department’s field operations.
32 Sec. 78. EFFECTIVE UPON ENACTMENT. This division of this
33Act, being deemed of immediate importance, takes effect upon
34enactment.
35DIVISION XIV
-129-1Biologics and genetically targeted drugs — Medicaid
2 Sec. 79. Section 249A.20A, subsection 3, Code 2017, is
3amended to read as follows:
43. a. The pharmaceutical and therapeutics committee shall
5recommend a preferred drug list to the department.
6b. The committee shall develop the preferred drug list
7by considering each drug’s clinically meaningful therapeutic
8advantages in terms of safety, effectiveness, and clinical
9outcome.
10c. The committee shall use evidence-based research methods
11in selecting the drugs to be included on the preferred drug
12list.
13d. When making recommendations or determinations regarding
14beneficiary access to drugs and biological products for rare
15diseases and drugs and biological products that are genetically
16targeted, the committee shall request and consider information
17from individuals who possess scientific or medical training
18with respect to the drug, biological product, or rare disease.
19e. The committee shall periodically review all drug classes
20included on the preferred drug list and may amend the list to
21ensure that the list provides for medically appropriate drug
22therapies for medical assistance recipients and achieves cost
23savings to the medical assistance program.
24f. The department may procure a sole source contract
25with an outside entity or contractor to provide professional
26administrative support to the pharmaceutical and therapeutics
27committee in researching and recommending drugs to be placed on
28the preferred drug list.
29 Sec. 80. Section 249A.24, Code 2017, is amended by adding
30the following new subsection:
31 NEW SUBSECTION. 2A. When making recommendations or
32determinations regarding beneficiary access to drugs and
33biological products for rare diseases and drugs and biological
34products that are genetically targeted, the commission shall
35request and consider information from individuals who possess
-130-1scientific or medical training with respect to the drug,
2biological product, or rare disease.
3DIVISION XV
4Public Assistance Programs Oversight
5 Sec. 81. 2017 Iowa Acts, House File 531, section 2,
6subsection 1, as enacted, is amended to read as follows:
71. The department of human services shall review state
8efforts, including pilot programs related to data sharing
9between states and technology-based solutions designed to curb
10interstate dual participation, to address program integrity
11for public assistance programs including Medicaid, the family
12investment program (FIP), the supplemental nutrition assistance
13program (SNAP), and the child care assistance program. As
14part of the review, the department shall explore opportunities
15to join existing pilot efforts in collaboration with other
16states including the effort involving the national accuracy
17clearinghouse, or to develop a separate pilot effort in Iowa.
18 Sec. 82. EFFECTIVE UPON ENACTMENT. This division of this
19Act, being deemed of immediate importance, takes effect upon
20enactment.
21 Sec. 83. RETROACTIVE APPLICABILITY. This division of this
22Act applies retroactively to March 30, 2017.
23DIVISION XVI
24Background check private sector alternatives
25 Sec. 84. BACKGROUND CHECK — PRIVATE SECTOR
26ALTERNATIVES. The department of human services and the
27department of public safety shall jointly review private sector
28alternatives to the performance of state mandated criminal
29background checks currently performed solely by the department
30of public safety. The departments shall submit a report to
31the governor and the general assembly by December 15, 2017,
32including a description of the process used in reviewing
33private sector alternatives to perform criminal background
34checks, the findings from the review, and recommendations for
35utilizing private sector entities as an alternative to the
-131-1department of public safety in performing criminal background
2checks.
3DIVISION XVII
4psychiatric BED TRACKING SYSTEM
5 Sec. 85. DEPARTMENT OF HUMAN SERVICES PSYCHIATRIC BED
6TRACKING SYSTEM. The department of human services shall amend
7its administrative rules pursuant to chapter 17A to require
8the state mental health institutes and hospitals licensed
9to provide inpatient psychiatric treatment and services to
10participate in the psychiatric bed tracking system and to
11ensure updates are made, at a minimum, two times per day to
12the psychiatric bed tracking system. Updates shall include
13information on the availability of inpatient child, adult,
14and geriatric psychiatric beds staffed and available and
15information on the gender that can be accepted for each
16available bed.
17DIVISION XVIII
18CHILDREN’S WELL-BEING COLLABORATIVES AND ADVISORY COMMITTEE
19 Sec. 86. CHILDREN’S WELL-BEING COLLABORATIVES — GRANTS.
201. The department of human services shall establish a
21request for proposals process which shall be based upon
22recommendations for the development and implementation
23of children’s well-being collaboratives described in the
24children’s mental health study report submitted by the
25department to the general assembly on December 15, 2016.
262. A well-being collaborative shall consist of a
27broad-based group of entities in a defined geographical area
28represented by a lead agency. Entities in the well-being
29collaborative shall include a broad-based representation of key
30providers including but not limited to providers of prevention
31and early intervention services and mental health services to
32the target population.
333. A well-being collaborative shall be responsible for
34developing interagency coordination and collaboration for
35the provision of prevention and early intervention services
-132-1within the designated geographic area and shall, at a minimum,
2demonstrate all of the following:
3a. Experience and a strong understanding of how best to
4engage children and families to achieve positive mental health
5and well-being outcomes.
6b. An ability to provide or administer prevention services
7for the improvement of children’s mental health and well-being.
8c. Experience and effectiveness in coordinating the
9collaborative efforts of multiple stakeholders working toward
10a common goal of improving the effectiveness of the group’s
11efforts to achieve measurable improved outcomes.
124. A well-being collaborative shall build and maintain
13intentional collaboration among all entities with the goal of
14providing measurable improvements in outcomes for children and
15families.
165. A well-being collaborative shall build and improve
17coordination and effectiveness among entities to develop and
18provide primary, secondary, and tertiary prevention and early
19intervention services that are nonduplicative and that are
20aligned to meet the needs of children and families in the
21geographic area.
226. A well-being collaborative shall provide technical
23assistance to a diverse array of stakeholders, facilitate
24the distribution of public awareness materials that include
25information aimed at reducing the stigma of mental illness,
26and provide updates on changes in state and federal policy
27in relation to prevention and early intervention efforts
28concerning children’s mental health and well-being.
297. A well-being collaborative shall establish or enhance
30collaborative efforts in all of the following areas:
31a. The selection and implementation of evidence-based or
32promising prevention and early intervention models.
33b. Understanding funding sources and how to utilize
34available funding most effectively.
35c. The adoption or development, implementation, and
-133-1analysis of community needs assessments.
2d. The development, implementation, and analysis of a
3community work plan based on the results of the community needs
4assessment.
5e. The adoption or development and implementation of a
6uniform family assessment.
7f. The utilization of research and data analysis to guide
8the work of the well-being collaborative.
9g. The provision of culturally competent services and the
10ability to address issues relating to the disproportionate
11representation of a population group.
12h. The development of public awareness and training
13programs, including programs aimed at reducing the stigma of
14mental illness.
15i. The recruitment and retention of members in the
16well-being collaborative with a focus on achieving the goals
17and outcomes of the collaborative and supporting all members in
18the collaborative.
198. Each grantee shall submit reports to the department of
20human services by December 15, 2017, and April 15, 2018, to
21include information relating to the accomplishments and future
22plans of each well-being collaborative.
23 Sec. 87. CHILDREN’S MENTAL HEALTH AND WELL-BEING ADVISORY
24COMMITTEE. The department of human services shall create and
25provide support to a children’s mental health and well-being
26advisory committee to continue efforts relating to improving
27children’s mental health crisis services and children’s
28well-being learning labs and supporting the children’s
29well-being collaboratives.
30DIVISION XIX
31state family planning services program
32 Sec. 88. NEW SECTION. 217.41B State family planning
33services program — establishment — discontinuation of Medicaid
34family planning network waiver.
351. The department of human services shall discontinue the
-134-1Medicaid family planning network waiver effective July 1, 2017,
2and shall instead establish a state family planning services
3program. The state program shall replicate the eligibility
4requirements and other provisions included in the Medicaid
5family planning network waiver as approved by the centers for
6Medicare and Medicaid services of the United States department
7of health and human services in effect on June 30, 2017.
82. Distribution of family planning services program funds
9under this section shall be made in a manner that continues
10access to family planning services.
113. Distribution of family planning services program funds
12shall not be made to any entity that performs abortions or that
13maintains or operates a facility where abortions are performed.
14For the purposes of this section, “abortion” does not include
15any of the following:
16a. The treatment of a woman for a physical disorder,
17physical injury, or physical illness, including a
18life-endangering physical condition caused by or arising from
19the pregnancy itself, that would, as certified by a physician,
20place the woman in danger of death.
21b. The treatment of a woman for a spontaneous abortion,
22commonly known as a miscarriage, when not all of the products
23of human conception are expelled.
244. Family planning services program funds distributed in
25accordance with this section shall not be used for direct or
26indirect costs, including but not limited to administrative
27costs or expenses, overhead, employee salaries, rent, and
28telephone and other utility costs, related to providing
29abortions as specified in subsection 3.
30 Sec. 89. EMERGENCY RULES. The department of human services
31may adopt emergency rules under section 17A.4, subsection 3,
32and section 17A.5, subsection 2, paragraph “b”, to implement
33the provisions of this division of this Act, and the rules
34shall be effective immediately upon filing unless a later date
35is specified in the rules. Any rules adopted in accordance
-135-1with this section shall also be published as a notice of
2intended action as provided in section 17A.4.
3 Sec. 90. EFFECTIVE UPON ENACTMENT. This division of this
4Act, being deemed of immediate importance, takes effect upon
5enactment.
6DIVISION XX
7MEDICAID HOME AND COMMUNITY-BASED SERVICES PROVIDERS —
8COST-REPORTING
9 Sec. 91. MEDICAID HOME AND COMMUNITY-BASED SERVICES
10PROVIDERS — TIERED RATES AND DOCUMENTATION CHANGES —
11EMERGENCY RULES.
121. Beginning July 1, 2017, the department of human
13services shall discontinue application of the retrospectively
14limited cost settlement methodology based on submission of
15required cost reports under 441 IAC 79.1, and shall implement
16tiered rates for providers of supported community living,
17day habilitation and adult day services for persons with an
18intellectual disability under the home and community-based
19services waiver program. The tiered rates shall be implemented
20in a phased-in approach to accommodate transition of providers
21to the revised reimbursement model. The department of human
22services and Medicaid managed care organizations may also
23establish tiered rates for other services.
242. The department of human services shall amend 441 IAC
2524.4 relating to standards of service for providers of services
26to persons with mental illness, intellectual disabilities, or
27developmental disabilities pursuant to chapter 225C and 441
28IAC 79.3(2) relating to medical clinical records for providers
29of services under the Medicaid program pursuant to chapter
30249A, to provide, effective November 1, 2017, that in addition
31to allowing documentation of the provision of services or
32standards of service in a narrative format, the following
33providers may also provide documentation in a checkbox form
34format in accordance with the provider’s organizational
35policies and procedures and in compliance with procedures
-136-1established by the centers for Medicare and Medicaid services
2of the United States department of health and human services:
3a. Advanced registered nurse practitioners.
4b. Psychologists.
5c. Community mental health centers.
6d. Home and community-based habilitation services
7providers.
8e. Behavioral health intervention.
9f. Case management services including home and
10community-based services case management services.
11g. Home and community-based services waiver services.
12h. Behavioral health services.
13i. Community-based neurobehavioral rehabilitation
14residential services and intermittent services.
153. The department of human services may adopt emergency
16rules under section 17A.4, subsection 3, and section 17A.5,
17subsection 2, paragraph “b”, to implement the provisions of
18this division of this Act, and the rules shall be effective
19immediately upon filing unless a later date is specified in the
20rules. Any rules adopted in accordance with this section shall
21also be published as a notice of intended action as provided
22in section 17A.4.
23 Sec. 92. EFFECTIVE UPON ENACTMENT. This division of this
24Act, being deemed of immediate importance, takes effect upon
25enactment.
26DIVISION XXI
27TELEHEALTH PARITY INTERIM COMMITTEE
28 Sec. 93. TELEHEALTH PARITY INTERIM COMMITTEE.
291. The legislative council is requested to establish
30a study committee for the 2017 interim to examine issues
31relating to telehealth parity for private insurance and state
32employee health plans. The study committee shall consult with
33stakeholders to evaluate the benefits of telehealth parity
34within the context of the needs of Iowans such as access to
35health care, review existing policies related to telehealth
-137-1reimbursement and the impact on private insurance and state
2employee health plans, consider the costs associated with
3telehealth service utilization, consider telehealth’s potential
4impact to economic development opportunities for Iowa’s
5rural communities, and evaluate obstacles such as broadband
6accessibility.
72. The members of the committee shall include:
8a. Ten members of the general assembly as voting members.
9(1) Three members shall be appointed by the majority leader
10of the senate, two by the minority leader of the senate, three
11by the speaker of the house of representatives, and two by the
12minority leader of the house of representatives.
13(2) The legislators appointed shall include:
14(a) The chairpersons and ranking members of the general
15assembly’s committees on human resources or a member of the
16committee designated by the chairperson or ranking member.
17(b) The co-chairpersons and ranking members of the joint
18appropriations subcommittee on health and human services, or a
19member of the subcommittee designated by the co-chairperson or
20ranking member.
21b. One representative of each of the following
22organizations as nonvoting members:
23(1) The signal center for health innovation.
24(2) The Iowa hospital association.
25(3) An independent medical clinic.
26(4) The Iowa medical society.
27(5) The Iowa healthcare association.
28(6) The federation of Iowa insurers.
29(7) AARP Iowa.
30(8) The Iowa telecommunications association.
31(9) A mental health and disability services region.
32c. The following agency directors or commissioner as ex
33officio nonvoting members:
34(1) The director of public health, or the director’s
35designee.
-138- 1(2) The director of the department of administrative
2services, or the director’s designee.
3(3) The director of the department on aging, or the
4director’s designee.
5(4) The commissioner of insurance or the commissioner’s
6designee.
73. The interim committee may request information and
8assistance from state agencies as applicable to the purpose of
9the interim committee, as needed to complete the work of the
10interim committee.
114. The interim committee shall submit its findings and
12recommendations to the general assembly by December 15, 2017,
13for consideration during the 2018 legislative session.
14DIVISION XXII
15Alzheimer’s and other forms of Dementia — Health and
16Resilience Outreach (HERO) project — DEMENTIA-SPECIFIC CARE
17 Sec. 94. HERO PROJECT. The department of public health
18shall collaborate with stakeholders that support individuals
19with Alzheimer’s disease to identify funding opportunities
20to support the health and resilience outreach (HERO) project
21for individuals caring for a family member with Alzheimer’s or
22other forms of dementia.
23 Sec. 95. ACCESS TO DEMENTIA-SPECIFIC CARE. The department
24on aging, the department of public health, the department of
25inspections and appeals, and the department of human services
26shall jointly analyze and make recommendations regarding
27options for coordination between state agencies and private
28entities to promote increased access to dementia-specific care
29in both residential and home and community-based settings. The
30analyses and recommendations shall address barriers to, gaps
31in, and opportunities for increased access, the availability of
32services in home and community-based settings as an alternative
33to residential settings, and any changes in law necessary to
34better address the needs of individuals with dementia and their
35families. The departments shall submit a joint report of
-139-1findings and recommendations to the governor and the general
2assembly by December 15, 2017.
3DIVISION XXIII
4Office of Minority and multicultural health — REPEAL
5 Sec. 96. Section 135.159, subsection 3, paragraph i, Code
62017, is amended to read as follows:
7i. For children, coordinate with and integrate guidelines,
8data, and information from existing newborn and child health
9programs and entities, including but not limited to the healthy
10opportunities for parents to experience success – healthy
11families Iowa program, the early childhood Iowa initiative,
12the center for congenital and inherited disorders screening
13and health care programs, standards of care for pediatric
14health guidelines, the office of minority and multicultural
15health established in section 135.12, the oral health bureau
16established in section 135.15, and other similar programs and
17services.
18 Sec. 97. REPEAL. Section 135.12, Code 2017, is repealed.
19DIVISION XXIV
20Prior year appropriations and other prior provisions
21Adoption subsidy payments and services
22 Sec. 98. 2015 Iowa Acts, chapter 137, section 139, as
23amended by 2016 Iowa Acts, chapter 1139, section 17, subsection
241, is amended by adding the following new paragraph:
25 NEW PARAGRAPH. c. Notwithstanding section 8.33,
26moneys corresponding to the state savings resulting from
27implementation of the federal Fostering Connections to Success
28and Increasing Adoptions Act of 2008, Pub.L. No.110-351,
29and successor legislation, as determined in accordance with
3042 U.S.C. §673(a)(8), that remain unencumbered or unobligated
31at the close of the fiscal year, shall not revert to any fund
32but shall remain available for the purposes designated in this
33subsection until expended. The amount of such savings and any
34corresponding funds remaining at the close of the fiscal year
35shall be determined separately and any changes in either amount
-140-1between fiscal years shall not result in an unfunded need.
2DECATEGORIZATION
3 Sec. 99. DECATEGORIZATION CARRYOVER FUNDING — TRANSFER TO
4MEDICAID PROGRAM. Notwithstanding section 232.188, subsection
55, paragraph “b”, any state appropriated moneys in the funding
6pool that remained unencumbered or unobligated at the close
7of the fiscal year beginning July 1, 2014, and were deemed
8carryover funding to remain available for the two succeeding
9fiscal years that still remain unencumbered or unobligated at
10the close of the fiscal year beginning July 1, 2016, shall
11not revert but shall be transferred to the medical assistance
12program for the fiscal year beginning July 1, 2017.
13 Sec. 100. EFFECTIVE UPON ENACTMENT. This division of this
14Act, being deemed of immediate importance, takes effect upon
15enactment.
16 Sec. 101. RETROACTIVE APPLICABILITY. This division of this
17Act applies retroactively to July 1, 2016.
18DIVISION XXV
19Nonparticipating provider reimbursement fund and IowaCare
20Account — balances — reversions
21 Sec. 102. NONPARTICIPATING PROVIDER REIMBURSEMENT FUND AND
22IOWACARE ACCOUNT — AVAILABILITY — REVERSIONS.
23Notwithstanding any provision of law to the contrary, for the
24fiscal year beginning July 1, 2016, and ending June 30, 2017,
25there is appropriated from the IowaCare account established in
26section 249J.24, Code 2013, and the nonparticipating provider
27reimbursement fund established in section 249J.24A, Code
282013, to the department of human services medical assistance
29appropriation in this 2017 Act any unencumbered or unobligated
30moneys from the account and fund to be used for the purposes of
31the IowaCare account as provided in section 249J.24, Code 2013.
32Notwithstanding section 8.33, moneys appropriated in this
33section that remain unencumbered or unobligated at the close of
34a fiscal year shall not revert but shall remain available for
35expenditure for the purposes designated until expended.
-141-1 Sec. 103. EFFECTIVE UPON ENACTMENT. This division of this
2Act, being deemed of immediate importance, takes effect upon
3enactment.
4DIVISION XXVI
5Hospital Health Care Access Assessment Program — repeal
6 Sec. 104. Section 249M.5, Code 2017, is amended to read as
7follows:
8249M.5 Future repeal.
9This chapter is repealed July 1, 2017 2019.
10 Sec. 105. EFFECTIVE UPON ENACTMENT. This division of this
11Act, being deemed of immediate importance, takes effect upon
12enactment.
13 Sec. 106. RETROACTIVE APPLICABILITY. This division of this
14Act applies retroactively to June 30, 2017.
15DIVISION XXVII
16Custodial Care
17 Sec. 107. Section 249.12, Code 2017, is amended to read as
18follows:
19249.12 Cost-related system.
201. In order to assure that the necessary data is available
21to aid the general assembly to determine appropriate funding
22for the custodial care program, the department of human
23services shall develop a cost-related system for financial
24supplementation to individuals who need custodial care and who
25have insufficient resources to purchase the care needed.
262. All privately operated licensed custodial facilities in
27Iowa shall cooperate with the department of human services to
28develop the cost-related plan. After the plan is implemented,
29state supplemental funds shall not be used for the care of
30any individual in facilities that have not submitted cost
31statements to the department of human services.
323. Beginning July 1, 2017, privately operated licensed
33custodial facilities in Iowa shall be reimbursed based on the
34maximum per diem rates established by the general assembly
35through the appropriations process.
-142-1DIVISION XXVIII
2Juvenile beds cap
3 Sec. 108. Section 232.142, subsection 5, Code 2017, is
4amended to read as follows:
55. The director shall approve annually all such homes
6established and maintained under the provisions of this
7chapter. A home shall not be approved unless it complies with
8minimal rules and standards adopted by the director and has
9been inspected by the department of inspections and appeals.
10The statewide number of beds in the homes approved by the
11director shall not exceed two hundred sixty-two seventy-two
12 beds beginning July 1, 2017, and shall not exceed two hundred
13eighty-two beds beginning July 1, 2018, and thereafter.
14DIVISION XXIX
15TRANSFERS OF FUNDS BETWEEN DHS INSTITUTIONS
16 Sec. 109. Section 218.6, Code 2017, is amended to read as
17follows:
18218.6 Transfer of appropriations made to institutions.
19Notwithstanding section 8.39, subsection 1, without the
20prior written consent and approval of the governor and the
21director of the department of management, the director of human
22services may transfer funds between the appropriations made for
23the same type of institution institutions, listed as follows:
241. The state resource centers.
252. The state mental health institutes.
263. The state juvenile institutions consisting of the state
27 training school and the Iowa juvenile home.
284. The civil commitment unit for sexual offenders.
29DIVISION XXX
30PELVIC EXAMS — PRIOR CONSENT
31 Sec. 110. NEW SECTION. 147.114 Prior informed consent
32relative to pelvic examinations — patient under anesthesia or
33unconscious — penalties.
341. A person licensed or certified to practice a
35profession, or a student undertaking a course of instruction
-143-1or participating in a clinical training or residency program
2for a profession, shall not perform a pelvic examination on an
3anesthetized or unconscious patient unless one of the following
4conditions is met:
5a. The patient or the patient’s authorized representative
6provides prior written informed consent to the pelvic
7examination, and the pelvic examination is necessary for
8preventive, diagnostic, or treatment purposes.
9b. The patient or the patient’s authorized representative
10has provided prior written informed consent to a surgical
11procedure or diagnostic examination to be performed on the
12patient, and the performance of a pelvic examination is within
13the scope of care ordered for that surgical procedure or
14diagnostic examination.
15c. The patient is unconscious and incapable of providing
16prior informed consent, and the pelvic examination is necessary
17for diagnostic or treatment purposes.
18d. A court has ordered the performance of the pelvic
19examination for the purposes of collection of evidence.
202. A person who violates this section is subject to the
21penalty specified under section 147.86, and any professional
22disciplinary provisions, as applicable.
23EXPLANATION
24The inclusion of this explanation does not constitute agreement with
25the explanation’s substance by the members of the general assembly.
26This bill relates to appropriations for health and human
27services for fiscal years 2017-2018 and 2018-2019 to the
28department of veterans affairs, Iowa veterans home, department
29on aging (IDA), office of long-term care ombudsman, department
30of public health (DPH), Iowa finance authority, department of
31human rights, and department of human services (DHS).
32The bill is organized into divisions.
33DEPARTMENT ON AGING. This division makes appropriations
34from the general fund of the state to the department on aging
35for FY 2017-2018 and FY 2018-2019.
-144- 1OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
2appropriations from the general fund of the state to the office
3of long-term care ombudsman for FY 2017-2018 and FY 2018-2019.
4DEPARTMENT OF PUBLIC HEALTH. This division makes
5appropriations from the general fund of the state to the
6department of public health for FY 2017-2018 and FY 2018-2019.
7DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
8division makes appropriations from the general fund of the
9state to the department of veterans affairs for FY 2017-2018
10and FY 2018-2019 for administration, the Iowa veterans home,
11for transfer to the Iowa finance authority for the home
12ownership assistance program, and for the county commissions
13of veteran affairs.
14DEPARTMENT OF HUMAN SERVICES. This division makes
15appropriations from the general fund of the state and the
16federal temporary assistance for needy families block grant to
17DHS for FY 2017-2018 and FY 2018-2019. The allocation for the
18family development and self-sufficiency grant program is made
19directly to the department of human rights. The reimbursement
20section addresses reimbursement for providers reimbursed by the
21department of human services.
22HEALTH CARE ACCOUNTS AND FUNDS. This division makes
23certain health-related appropriations for FY 2017-2018 and
24FY 2018-2019. A number of the appropriations are made for
25purposes of the medical assistance (Medicaid) program in
26addition to the general fund appropriations made for this
27purpose for the same fiscal year.
28CHILD CARE FACILITY FUND — USE FOR FIELD OPERATIONS. This
29division provides for the use of a specified amount of the
30moneys in the child care facility fund for field operations
31related to the child care regulatory unit in FY 2017-2018.
32This division takes effect upon enactment.
33BIOLOGICS AND GENETICALLY TARGETED DRUGS — MEDICAID.
34 This division directs the pharmaceutical and therapeutics
35committee and the drug utilization review committee when
-145-1making recommendations or determinations regarding Medicaid
2beneficiary access to drugs and biological products for rare
3diseases and drugs and biological products that are genetically
4targeted, to request and consider information from individuals
5who possess scientific or medical training with respect to the
6drug, biological product, or rare disease.
7PUBLIC ASSISTANCE PROGRAMS OVERSIGHT. This division amends
82017 Iowa Acts, House File 531, to specifically include the
9national accuracy clearinghouse in the pilot efforts DHS is to
10explore in addressing program integrity for public assistance
11programs. The division takes effect upon enactment and is
12retroactively applicable to March 30, 2017.
13BACKGROUND CHECKS — PRIVATE SECTOR ALTERNATIVES. This
14division directs DHS and the department of public safety to
15jointly review private sector alternatives to the performance
16of state mandated criminal background checks currently
17performed solely by the department of public safety. The
18departments shall submit a report to the governor and the
19general assembly by December 15, 2017, including a description
20of the process used in reviewing private sector alternatives,
21findings from the review, and recommendations for utilizing
22private sector entities as an alternative to the department of
23public safety in performing criminal background checks.
24PSYCHIATRIC BED TRACKING SYSTEM. This division directs
25DHS to amend administrative rules to require the state
26mental health institutes and hospitals licensed to provide
27inpatient psychiatric treatment and services to participate
28in the psychiatric bed tracking system and to ensure updates,
29including the availability of inpatient child, adult,
30and geriatric psychiatric beds staffed and available and
31information on the gender that can be accepted for each
32available bed, are made, at a minimum two times per day to the
33psychiatric bed tracking system.
34CHILDREN’S WELL-BEING COLLABORATIVES AND ADVISORY COMMITTEE.
35 This division directs DHS to establish a request for proposals
-146-1process, based upon recommendations for the development
2and implementation of children’s well-being collaboratives
3described in the children’s mental health and well-being
4workgroup final report submitted by the department on
5December 15, 2016, to issue grants to children’s well-being
6collaboratives. Entities selected as well-being collaboratives
7shall include a broad-based representation of key providers,
8and each entity shall be responsible for developing interagency
9coordination and collaboration, provide technical assistance to
10a diverse array of stakeholders, distribute public awareness
11materials, and provide updates on changes in state and federal
12policy in relation to prevention and early intervention efforts
13concerning children’s mental health and well-being. Each
14grantee is required to submit two reports: one by December
1515, 2017, and the other by April 15, 2018. The division also
16directs DHS to create and provide support to a children’s
17mental health and well-being advisory committee to continue
18efforts relating to improving children’s mental health crisis
19services and children’s well-being learning labs and supporting
20the children’s well-being collaboratives.
21STATE FAMILY PLANNING SERVICES PROGRAM. This division
22establishes the state family planning services program July 1,
232017, and discontinues the Medicaid family planning network
24waiver in effect on June 30, 2017. The state program is to
25replicate the eligibility requirements and other provisions
26included in the Medicaid waiver program. Distribution of
27family planning services program funds shall not be made to
28any entity that performs abortions as defined in the division,
29including for direct or indirect costs related to providing
30abortions. The division provides for emergency rulemaking and
31takes effect upon enactment.
32MEDICAID HOME AND COMMUNITY-BASED SERVICES (HCBS) PROVIDERS
33TIERED REIMBURSEMENT — DOCUMENTATION. This division
34directs DHS to discontinue application of the retrospectively
35limited cost settlement methodology based on submission
-147-1of required cost reports and to implement tiered rates for
2providers of supported community living, day habilitation,
3and adult day services for persons with an intellectual
4disability under the home and community-based services
5waiver program. The tiered rates shall be implemented in a
6phased-in approach to accommodate transition of providers to
7the revised reimbursement model. DHS and Medicaid managed
8care organizations may also establish tiered rates for
9other services. The division also directs DHS to amend
10administrative rules to allow documentation of certain
11providers specified in the division to submit documentation in
12a checkbox form format rather than in a narrative format. The
13division authorizes DHS to adopt emergency rules to implement
14the division. The division takes effect upon enactment.
15TELEHEALTH PARITY INTERIM COMMITTEE. This division
16requests that the legislative council create a legislative
17interim committee to study and make recommendations regarding
18telehealth parity.
19ALZHEIMER’S AND OTHER FORMS OF DEMENTIA — HEALTH AND
20RESILIENCE OUTREACH (HERO) PROJECT. This division directs
21DPH to collaborate with stakeholders that support individuals
22with Alzheimer’s disease to identify funding opportunities
23to support the health and resilience outreach (HERO) project
24for individuals caring for a family member with Alzheimer’s
25or other forms of dementia. The division also directs the
26department on aging, DPH, the department of inspections and
27appeals, and DHS to analyze and make recommendations regarding
28options for coordination between state agencies and private
29entities to promote increased access to dementia-specific
30care in both residential and community-based settings. The
31departments shall submit a joint report of findings and
32recommendations to the governor and the general assembly by
33December 15, 2017.
34OFFICE OF MINORITY AND MULTICULTURAL HEALTH. This division
35repeals Code section 135.12, the office of minority and
-148-1multicultural health, and makes conforming changes in the Code.
2PRIOR YEAR APPROPRIATIONS AND PROVISIONS. This division
3provides for the nonreversion of funds appropriated for FY
42016-2017 for adoption subsidy payments and services; and
5provides for transfer to the medical assistance appropriation
6for FY 2016-2017 of state-appropriated moneys in the funding
7pool for decategorization that remain unencumbered or
8unobligated at the close of the fiscal year beginning July
91, 2014, and that were deemed carryover funding to remain
10available for the two succeeding fiscal years that still remain
11unencumbered or unobligated at the close of the fiscal year
12beginning July 1, 2016. These provisions take effect upon
13enactment and are retroactively applicable to July 1, 2016.
14NONPARTICIPATING PROVIDER REIMBURSEMENT FUND AND IOWACARE
15ACCOUNT REVERSIONS. This division provides that for FY
162016–2017, any moneys remaining in the nonparticipating
17provider reimbursement fund or the IowaCare account are
18appropriated to the department of human services medical
19assistance appropriation to be used for the purposes of the
20IowaCare account as provided in Code section 249J.24. Moneys
21that remain unencumbered or unobligated at the close of a
22fiscal year shall not revert but shall remain available for
23expenditure for the purposes designated until expended. This
24provision takes effect upon enactment.
25HOSPITAL HEALTH CARE ACCESS ASSESSMENT REPEAL. This
26division extends the repeal of the hospital health care access
27assessment program from July 1, 2017, to July 1, 2019. This
28provision takes effect upon enactment and is retroactively
29applicable to June 30, 2017.
30CUSTODIAL CARE REIMBURSEMENT. This division amends
31provisions related to reimbursement of custodial care provided
32for persons receiving state supplementary assistance. Under
33current law, DHS is required to develop a cost-related system
34for financial supplementation to individuals who need custodial
35care and who have insufficient resources to purchase the care
-149-1needed. In developing the cost-related system, all privately
2operated licensed custodial facilities in the state are
3required to cooperate with DHS to develop the plan, and once
4the plan is developed, state supplemental funds are prohibited
5from being used for the care of any individual in a facility
6that has not submitted costs statements to DHS. Under the
7division, the prohibition that no state supplemental funds are
8to be used for the care of any individual in a facility that has
9not submitted cost statements to DHS is eliminated and instead,
10beginning July 1, 2018, all privately operated licensed
11custodial facilities in Iowa are to be reimbursed based on the
12maximum per diem rates established by the general assembly.
13JUVENILE BED CAP. This division increases the statewide
14number of beds in juvenile homes approved by the director of
15the department of human services from not to exceed 262 to not
16to exceed 272 beginning July 1, 2017, and not to exceed 282
17beginning July 1, 2018, and thereafter.
18TRANSFERS OF FUNDS BETWEEN DHS INSTITUTIONS. This division
19provides that, in addition to authorizing the transfer of
20funds between the appropriations made for facilities under the
21purview of the department of human services including the state
22resource centers, the state mental health institutes, and the
23state training school, transfers are also authorized between
24these institutions and the civil commitment unit for sexual
25offenders.
26PELVIC EXAMS — PRIOR CONSENT. This division prohibits
27a person licensed or certified to practice a health-related
28profession or a student undertaking a course of professional
29instruction or participating in a clinical training or
30residency program for such a profession as defined in Code
31section 147.1 (health-related professions), from performing a
32pelvic examination on an anesthetized or unconscious patient
33unless one of four specified conditions is met. A person who
34violates a provision of the division is subject to the existing
35penalty in Code section 147.86, which is a serious misdemeanor,
-150-1and to any professional disciplinary provisions, as applicable.
2A serious misdemeanor is punishable by confinement for no more
3than one year and a fine of at least $315 but not more than
4$1,875.
-151-pf/hb/rn
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2017-2018
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, 2017, and ending June 30,
62018, the following amount, or so much thereof as is necessary,
7to be used for the purposes designated:
8For aging programs for the department on aging and area
9agencies on aging to provide citizens of Iowa who are 60 years
10of age and older with case management for frail elders, Iowa’s
11aging and disabilities resource center, and other services
12which may include but are not limited to adult day services,
13respite care, chore services, information and assistance,
14and material aid, for information and options counseling for
15persons with disabilities who are 18 years of age or older,
16and for salaries, support, administration, maintenance, and
17miscellaneous purposes, and for not more than the following
18full-time equivalent positions:
.................................................. $1911,042,476
............................................... FTEs2027.00
211. Funds appropriated in this section may be used to
22supplement federal funds under federal regulations. To
23receive funds appropriated in this section, a local area
24agency on aging shall match the funds with moneys from other
25sources according to rules adopted by the department. Funds
26appropriated in this section may be used for elderly services
27not specifically enumerated in this section only if approved
28by an area agency on aging for provision of the service within
29the area.
302. Of the funds appropriated in this section, $279,946 is
31transferred to the economic development authority for the Iowa
32commission on volunteer services to be used for the retired and
33senior volunteer program.
343. a. The department on aging shall establish and enforce
35procedures relating to expenditure of state and federal funds
-1-1by area agencies on aging that require compliance with both
2state and federal laws, rules, and regulations, including but
3not limited to all of the following:
4(1) Requiring that expenditures are incurred only for goods
5or services received or performed prior to the end of the
6fiscal period designated for use of the funds.
7(2) Prohibiting prepayment for goods or services not
8received or performed prior to the end of the fiscal period
9designated for use of the funds.
10(3) Prohibiting the prepayment for goods or services
11not defined specifically by good or service, time period, or
12recipient.
13(4) Prohibiting the establishment of accounts from which
14future goods or services which are not defined specifically by
15good or service, time period, or recipient, may be purchased.
16b. The procedures shall provide that if any funds are
17expended in a manner that is not in compliance with the
18procedures and applicable federal and state laws, rules, and
19regulations, and are subsequently subject to repayment, the
20area agency on aging expending such funds in contravention of
21such procedures, laws, rules and regulations, not the state,
22shall be liable for such repayment.
234. Of the funds appropriated in this section, at least
24$250,000 shall be used to fund the unmet needs identified
25through Iowa’s aging and disability resource center network.
265. Of the funds appropriated in this section, at least
27$600,000 shall be used to fund home and community-based
28services through the area agencies on aging that enable older
29individuals to avoid more costly utilization of residential or
30institutional services and remain in their own homes.
316. Of the funds appropriated in this section, $812,537
32shall be used for the purposes of chapter 231E and section
33231.56A, of which $350,000 shall be used for the office of
34substitute decision maker pursuant to chapter 231E, and the
35remainder shall be distributed equally to the area agencies on
-2-1aging to administer the prevention of elder abuse, neglect, and
2exploitation program pursuant to section 231.56A, in accordance
3with the requirements of the federal Older Americans Act of
41965, 42 U.S.C. §3001 et seq., as amended.
57. Of the funds appropriated in this section, $750,000
6shall be used to fund continuation of the aging and disability
7resource center lifelong links to provide individuals and
8caregivers with information and services to plan for and
9maintain independence.
108. Notwithstanding section 8.39, for the fiscal year
11beginning July 1, 2017, the department may transfer funds
12within or between the allocations made in this division of this
13Act for the same fiscal year in accordance with departmental
14priorities. The department shall report any such transfers
15to the individuals specified in this Act for submission of
16reports. This subsection shall not be construed to prohibit
17the use of existing state transfer authority for other
18purposes.
19DIVISION II
20OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2017-2018
21 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
22appropriated from the general fund of the state to the office
23of long-term care ombudsman for the fiscal year beginning July
241, 2017, and ending June 30, 2018, the following amount, or
25so much thereof as is necessary, to be used for the purposes
26designated:
27For salaries, support, administration, maintenance, and
28miscellaneous purposes, and for not more than the following
29full-time equivalent positions:
.................................................. $301,160,281
............................................... FTEs3116.00
32DIVISION III
33DEPARTMENT OF PUBLIC HEALTH — FY 2017-2018
34 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
35from the general fund of the state to the department of public
-3-1health for the fiscal year beginning July 1, 2017, and ending
2June 30, 2018, the following amounts, or so much thereof as is
3necessary, to be used for the purposes designated:
41. ADDICTIVE DISORDERS
5For reducing the prevalence of the use of tobacco, alcohol,
6and other drugs, and treating individuals affected by addictive
7behaviors, including gambling, and for not more than the
8following full-time equivalent positions:
.................................................. $924,985,831
............................................... FTEs1010.00
11a. (1) Of the funds appropriated in this subsection,
12$4,021,225 shall be used for the tobacco use prevention
13and control initiative, including efforts at the state and
14local levels, as provided in chapter 142A. The commission
15on tobacco use prevention and control established pursuant
16to section 142A.3 shall advise the director of public health
17in prioritizing funding needs and the allocation of moneys
18appropriated for the programs and initiatives. Activities
19of the programs and initiatives shall be in alignment with
20the United States centers for disease control and prevention
21best practices for comprehensive tobacco control programs that
22include the goals of preventing youth initiation of tobacco
23usage, reducing exposure to secondhand smoke, and promotion
24of tobacco cessation. To maximize resources, the department
25shall determine if third-party sources are available to
26instead provide nicotine replacement products to an applicant
27prior to provision of such products to an applicant under
28the initiative. The department shall track and report to
29the individuals specified in this Act, any reduction in
30the provision of nicotine replacement products realized by
31the initiative through implementation of the prerequisite
32screening.
33(2) (a) The department shall collaborate with the
34alcoholic beverages division of the department of commerce for
35enforcement of tobacco laws, regulations, and ordinances and to
-4-1engage in tobacco control activities approved by the division
2of tobacco use prevention and control of the department of
3public health as specified in the memorandum of understanding
4entered into between the divisions.
5(b) For the fiscal year beginning July 1, 2017, and ending
6June 30, 2018, the terms of the memorandum of understanding,
7entered into between the division of tobacco use prevention
8and control of the department of public health and the
9alcoholic beverages division of the department of commerce,
10governing compliance checks conducted to ensure licensed retail
11tobacco outlet conformity with tobacco laws, regulations, and
12ordinances relating to persons under 18 years of age, shall
13continue to restrict the number of such checks to one check per
14retail outlet, and one additional check for any retail outlet
15found to be in violation during the first check.
16b. Of the funds appropriated in this subsection,
17$20,964,606 shall be used for problem gambling and
18substance-related disorder prevention, treatment, and recovery
19services, including a 24-hour helpline, public information
20resources, professional training, youth prevention, and program
21evaluation.
22c. The requirement of section 123.17, subsection 5, is met
23by the appropriations and allocations made in this division of
24this Act for purposes of substance-related disorder treatment
25and addictive disorders for the fiscal year beginning July 1,
262017.
272. HEALTHY CHILDREN AND FAMILIES
28For promoting the optimum health status for children,
29adolescents from birth through 21 years of age, and families,
30and for not more than the following full-time equivalent
31positions:
.................................................. $325,325,632
............................................... FTEs3312.00
34a. Of the funds appropriated in this subsection, not more
35than $734,841 shall be used for the healthy opportunities for
-5-1parents to experience success (HOPES)-healthy families Iowa
2(HFI) program established pursuant to section 135.106. The
3funding shall be distributed to renew the grants that were
4provided to the grantees that operated the program during the
5fiscal year ending June 30, 2017.
6b. In order to implement the legislative intent stated in
7sections 135.106 and 256I.9, that priority for home visitation
8program funding be given to programs using evidence-based or
9promising models for home visitation, it is the intent of the
10general assembly to phase in the funding priority in accordance
11with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
12paragraph “0b”.
13c. Of the funds appropriated in this subsection, $3,075,101
14shall be used for continuation of the department’s initiative
15to provide for adequate developmental surveillance and
16screening during a child’s first five years. The funds shall
17be used first to fully fund the current sites to ensure that
18the sites are fully operational, with the remaining funds
19to be used for expansion to additional sites. The full
20implementation and expansion shall include enhancing the scope
21of the program through collaboration with the child health
22specialty clinics to promote healthy child development through
23early identification and response to both biomedical and social
24determinants of healthy development; by monitoring child
25health metrics to inform practice, document long-term health
26impacts and savings, and provide for continuous improvement
27through training, education, and evaluation; and by providing
28for practitioner consultation particularly for children with
29behavioral conditions and needs. The department of public
30health shall also collaborate with the Iowa Medicaid enterprise
31and the child health specialty clinics to integrate the
32activities of the first five initiative into the establishment
33of patient-centered medical homes, community utilities,
34accountable care organizations, and other integrated care
35models developed to improve health quality and population
-6-1health while reducing health care costs. To the maximum extent
2possible, funding allocated in this paragraph shall be utilized
3as matching funds for medical assistance program reimbursement.
4d. Of the funds appropriated in this subsection, $64,640
5shall be distributed to a statewide dental carrier to provide
6funds to continue the donated dental services program patterned
7after the projects developed by the lifeline network to provide
8dental services to indigent individuals who are elderly or with
9disabilities.
10e. Of the funds appropriated in this subsection, $156,482
11shall be used to provide audiological services and hearing
12aids for children. The department may enter into a contract
13to administer this paragraph.
14f. Of the funds appropriated in this subsection, $23,000 is
15transferred to the university of Iowa college of dentistry for
16provision of primary dental services to children. State funds
17shall be matched on a dollar-for-dollar basis. The university
18of Iowa college of dentistry shall coordinate efforts with the
19department of public health, bureau of oral and health delivery
20systems, to provide dental care to underserved populations
21throughout the state.
22g. Of the funds appropriated in this subsection, $50,000
23shall be used to address youth suicide prevention.
24h. Of the funds appropriated in this subsection, $40,511
25shall be used to support the Iowa effort to address the survey
26of children who experience adverse childhood experiences known
27as ACEs.
28i. The department of public health shall continue to
29administer the program to assist parents in this state with
30costs resulting from the death of a child in accordance with
31the provisions of 2014 Iowa Acts, chapter 1140, section 22,
32subsection 12.
333. CHRONIC CONDITIONS
34For serving individuals identified as having chronic
35conditions or special health care needs, and for not more than
-7-1the following full-time equivalent positions:
.................................................. $24,170,750
............................................... FTEs35.00
4a. Of the funds appropriated in this subsection, $153,755
5shall be used for grants to individual patients who have an
6inherited metabolic disorder to assist with the costs of
7medically necessary foods and formula.
8b. Of the funds appropriated in this subsection, $1,020,794
9shall be used for the brain injury services program pursuant
10to section 135.22B, including for contracting with an existing
11nationally affiliated and statewide organization whose purpose
12is to educate, serve, and support Iowans with brain injury and
13their families for resource facilitator services in accordance
14with section 135.22B, subsection 9, and for contracting to
15enhance brain injury training and recruitment of service
16providers on a statewide basis. Of the amount allocated in
17this paragraph, $95,000 shall be used to fund one full-time
18equivalent position to serve as the state brain injury services
19program manager.
20c. Of the funds appropriated in this subsection, $144,097
21shall be used for the public purpose of continuing to contract
22with an existing national-affiliated organization to provide
23education, client-centered programs, and client and family
24support for people living with epilepsy and their families.
25The amount allocated in this paragraph in excess of $100,000
26shall be matched dollar-for-dollar by the organization
27specified.
28d. Of the funds appropriated in this subsection, $809,550
29shall be used for child health specialty clinics.
30e. Of the funds appropriated in this subsection, $384,552
31shall be used by the regional autism assistance program
32established pursuant to section 256.35, and administered by
33the child health specialty clinic located at the university of
34Iowa hospitals and clinics. The funds shall be used to enhance
35interagency collaboration and coordination of educational,
-8-1medical, and other human services for persons with autism,
2their families, and providers of services, including delivering
3regionalized services of care coordination, family navigation,
4and integration of services through the statewide system of
5regional child health specialty clinics and fulfilling other
6requirements as specified in chapter 225D. The university of
7Iowa shall not receive funds allocated under this paragraph for
8indirect costs associated with the regional autism assistance
9program.
10f. Of the funds appropriated in this subsection, $577,375
11shall be used for the comprehensive cancer control program to
12reduce the burden of cancer in Iowa through prevention, early
13detection, effective treatment, and ensuring quality of life.
14Of the funds allocated in this paragraph “f”, $150,000 shall
15be used to support a melanoma research symposium, a melanoma
16biorepository and registry, basic and translational melanoma
17research, and clinical trials.
18g. Of the funds appropriated in this subsection, $97,532
19shall be used for cervical and colon cancer screening, and
20$177,720 shall be used to enhance the capacity of the cervical
21cancer screening program to include provision of recommended
22prevention and early detection measures to a broader range of
23low-income women.
24h. Of the funds appropriated in this subsection, $506,355
25shall be used for the center for congenital and inherited
26disorders.
27i. Of the funds appropriated in this subsection,
28$215,263 shall be used by the department of public health
29for reform-related activities, including but not limited to
30facilitation of communication to stakeholders at the state and
31local level, administering the patient-centered health advisory
32council pursuant to section 135.159, and involvement in health
33care system innovation activities occurring across the state.
34j. Of the funds appropriated in this subsection, $22,100
35shall be used for administration of chapter 124D, the medical
-9-1cannabidiol Act.
24. COMMUNITY CAPACITY
3For strengthening the health care delivery system at the
4local level, and for not more than the following full-time
5equivalent positions:
.................................................. $62,807,776
............................................... FTEs713.00
8a. Of the funds appropriated in this subsection, $95,575
9is allocated for continuation of the child vision screening
10program implemented through the university of Iowa hospitals
11and clinics in collaboration with early childhood Iowa areas.
12The program shall submit a report to the individuals identified
13in this Act for submission of reports regarding the use of
14funds allocated under this paragraph “a”. The report shall
15include the objectives and results for the program year
16including the target population and how the funds allocated
17assisted the program in meeting the objectives; the number,
18age, and location within the state of individuals served;
19the type of services provided to the individuals served; the
20distribution of funds based on service provided; and the
21continuing needs of the program.
22b. Of the funds appropriated in this subsection, $105,656 is
23allocated for continuation of an initiative implemented at the
24university of Iowa to expand and improve the workforce engaged
25in mental health treatment and services. The initiative shall
26receive input from the university of Iowa, the department of
27human services, the department of public health, and the mental
28health and disability services commission to address the focus
29of the initiative.
30c. Of the funds appropriated in this section, $83,315 shall
31be deposited in the governmental public health system fund
32created in section 135A.8 to be used for the purposes of the
33fund.
34d. Of the funds appropriated in this subsection,
35$48,069 shall be used for a grant to a statewide association
-10-1of psychologists that is affiliated with the American
2psychological association to be used for continuation of a
3program to rotate intern psychologists in placements in urban
4and rural mental health professional shortage areas, as defined
5in section 135.180.
6e. Of the funds appropriated in this subsection, the
7following amounts are allocated to be used as follows to
8support the Iowa collaborative safety net provider network
9goals of increased access, health system integration, and
10engagement:
11(1) Not less than $521,863 is allocated to the Iowa
12prescription drug corporation for continuation of the
13pharmaceutical infrastructure for safety net providers as
14described in 2007 Iowa Acts, chapter 218, section 108, and for
15the prescription drug donation repository program created in
16chapter 135M.
17(2) Not less than $334,870 is allocated to free clinics and
18free clinics of Iowa for necessary infrastructure, statewide
19coordination, provider recruitment, service delivery, and
20provision of assistance to patients in securing a medical home
21inclusive of oral health care.
22(3) Not less than $25,000 is allocated to the Iowa
23association of rural health clinics for necessary
24infrastructure and service delivery transformation.
25f. Of the funds appropriated in this subsection, $163,400
26shall be used for continuation of the work of the direct care
27worker advisory council established pursuant to 2008 Iowa Acts,
28chapter 1188, section 69, in implementing the recommendations
29in the final report submitted by the advisory council to the
30governor and the general assembly in March 2012, including
31by continuing to develop, promote, and make available on a
32statewide basis the prepare-to-care core curriculum and its
33associated modules and specialties through various formats
34including online access, community colleges, and other venues;
35exploring new and maintaining existing specialties including
-11-1but not limited to oral health and dementia care; supporting
2instructor training; and assessing and making recommendations
3concerning the Iowa care book and information technology
4systems and infrastructure uses and needs.
5g. Of the funds appropriated in this subsection, $104,019
6shall be allocated for continuation of the contract with
7an independent statewide direct care worker organization
8previously selected through a request for proposals process.
9The contract shall continue to include performance and outcomes
10measures, and shall continue to allow the contractor to use a
11portion of the funds received under the contract to collect
12data to determine results based on the performance and outcomes
13measures.
14h. Of the funds appropriated in this subsection, the
15department may use up to $58,175 for up to one full-time
16equivalent position to administer the volunteer health care
17provider program pursuant to section 135.24.
18i. Of the funds appropriated in this subsection, $96,138
19shall be used for a matching dental education loan repayment
20program to be allocated to a dental nonprofit health service
21corporation to continue to develop the criteria and implement
22the loan repayment program.
23j. Of the funds appropriated in this subsection, $52,911 is
24transferred to the college student aid commission for deposit
25in the rural Iowa primary care trust fund created in section
26261.113 to be used for the purposes of the fund.
27k. Of the funds appropriated in this subsection, $150,000
28shall be used for the purposes of the Iowa donor registry as
29specified in section 142C.18.
30l. Of the funds appropriated in this subsection, $96,138
31shall be used for continuation of a grant to a nationally
32affiliated volunteer eye organization that has an established
33program for children and adults and that is solely dedicated to
34preserving sight and preventing blindness through education,
35nationally certified vision screening and training, and
-12-1community and patient service programs. The organization
2shall submit a report to the individuals identified in this
3Act for submission of reports regarding the use of funds
4allocated under this paragraph “l”. The report shall include
5the objectives and results for the program year including
6the target population and how the funds allocated assisted
7the program in meeting the objectives; the number, age, and
8location within the state of individuals served; the type of
9services provided to the individuals served; the distribution
10of funds based on services provided; and the continuing needs
11of the program.
125. ESSENTIAL PUBLIC HEALTH SERVICES
13To provide public health services that reduce risks and
14invest in promoting and protecting good health over the
15course of a lifetime with a priority given to older Iowans and
16vulnerable populations:
.................................................. $178,197,878
186. INFECTIOUS DISEASES
19For reducing the incidence and prevalence of communicable
20diseases, and for not more than the following full-time
21equivalent positions:
.................................................. $221,646,426
............................................... FTEs234.00
247. PUBLIC PROTECTION
25For protecting the health and safety of the public through
26establishing standards and enforcing regulations, and for not
27more than the following full-time equivalent positions:
.................................................. $284,195,139
............................................... FTEs29138.00
30a. Of the funds appropriated in this subsection, not more
31than $304,700 shall be credited to the emergency medical
32services fund created in section 135.25. Moneys in the
33emergency medical services fund are appropriated to the
34department to be used for the purposes of the fund.
35b. Of the funds appropriated in this subsection, up
-13-1to $243,260 shall be used for sexual violence prevention
2programming through a statewide organization representing
3programs serving victims of sexual violence through the
4department’s sexual violence prevention program, and for
5continuation of a training program for sexual assault
6response team (SART) members, including representatives of
7law enforcement, victim advocates, prosecutors, and certified
8medical personnel. The amount allocated in this paragraph “b”
9shall not be used to supplant funding administered for other
10sexual violence prevention or victims assistance programs.
11c. Of the funds appropriated in this subsection, up to
12$575,627 shall be used for the state poison control center.
13Pursuant to the directive under 2014 Iowa Acts, chapter
141140, section 102, the federal matching funds available to
15the state poison control center from the department of human
16services under the federal Children’s Health Insurance Program
17Reauthorization Act allotment shall be subject to the federal
18administrative cap rule of 10 percent applicable to funding
19provided under Tit.XXI of the federal Social Security Act and
20included within the department’s calculations of the cap.
21d. Of the funds appropriated in this subsection, up to
22$516,982 shall be used for childhood lead poisoning provisions.
238. RESOURCE MANAGEMENT
24For establishing and sustaining the overall ability of the
25department to deliver services to the public, and for not more
26than the following full-time equivalent positions:
.................................................. $27971,215
............................................... FTEs284.00
299. MISCELLANEOUS PROVISIONS
30The university of Iowa hospitals and clinics under the
31control of the state board of regents shall not receive
32indirect costs from the funds appropriated in this section.
33The university of Iowa hospitals and clinics billings to the
34department shall be on at least a quarterly basis.
3510. GENERAL REDUCTION
-14- 1For the period beginning July 1, 2017, and ending June 30,
22018, the department of public health, in consultation with
3the department of management, shall identify and implement a
4reduction in expenditures made from appropriations from the
5general fund to the department of public health in the amount
6of $1,281,367.
711. TRANSFERS
8Notwithstanding section 8.39, for the fiscal year beginning
9July 1, 2017, the department may transfer funds within or
10between any of the allocations or appropriations made in this
11division of this Act for the same fiscal year, to be used in
12accordance with departmental priorities as specified in the
13department’s report to the general assembly submitted pursuant
14to 2016 Iowa Acts, chapter 1139, section 3. The department
15shall report any such transfers to the individuals specified
16in this Act for submission of reports. This subsection shall
17not be construed to prohibit the use of existing state transfer
18authority for other purposes.
19DIVISION IV
20DEPARTMENT OF VETERANS AFFAIRS — FY 2017-2018
21 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is
22appropriated from the general fund of the state to the
23department of veterans affairs for the fiscal year beginning
24July 1, 2017, and ending June 30, 2018, the following amounts,
25or so much thereof as is necessary, to be used for the purposes
26designated:
271. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
28For salaries, support, maintenance, and miscellaneous
29purposes, and for not more than the following full-time
30equivalent positions:
.................................................. $311,142,557
............................................... FTEs3215.00
332. IOWA VETERANS HOME
34For salaries, support, maintenance, and miscellaneous
35purposes:
-15-.................................................. $17,228,140
2a. The Iowa veterans home billings involving the department
3of human services shall be submitted to the department on at
4least a monthly basis.
5b. Within available resources and in conformance with
6associated state and federal program eligibility requirements,
7the Iowa veterans home may implement measures to provide
8financial assistance to or on behalf of veterans or their
9spouses who are participating in the community reentry program.
10c. The Iowa veterans home expenditure report shall be
11submitted monthly to the legislative services agency.
12d. The Iowa veterans home shall continue to include in the
13annual discharge report applicant information to provide for
14the collection of demographic information including but not
15limited to the number of individuals applying for admission and
16admitted or denied admittance and the basis for the admission
17or denial; the age, gender, and race of such individuals;
18and the level of care for which such individuals applied for
19admission including residential or nursing level of care.
203. HOME OWNERSHIP ASSISTANCE PROGRAM
21For transfer to the Iowa finance authority for the
22continuation of the home ownership assistance program for
23persons who are or were eligible members of the armed forces of
24the United States, pursuant to section 16.54:
.................................................. $252,000,000
26 Sec. 5. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
27FUND STANDING APPROPRIATIONS. Notwithstanding the standing
28appropriation in section 35A.16 for the fiscal year beginning
29July 1, 2017, and ending June 30, 2018, the amount appropriated
30from the general fund of the state pursuant to that section
31for the following designated purposes shall not exceed the
32following amount:
33For the county commissions of veteran affairs fund under
34section 35A.16:
.................................................. $35947,925
-16-1DIVISION V
2DEPARTMENT OF HUMAN SERVICES — FY 2017-2018
3 Sec. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
4GRANT. There is appropriated from the fund created in section
58.41 to the department of human services for the fiscal year
6beginning July 1, 2017, and ending June 30, 2018, from moneys
7received under the federal temporary assistance for needy
8families (TANF) block grant pursuant to the federal Personal
9Responsibility and Work Opportunity Reconciliation Act of 1996,
10Pub.L.No.104-193, and successor legislation, the following
11amounts, or so much thereof as is necessary, to be used for the
12purposes designated:
131. To be credited to the family investment program account
14and used for assistance under the family investment program
15under chapter 239B:
.................................................. $165,112,462
172. To be credited to the family investment program account
18and used for the job opportunities and basic skills (JOBS)
19program and implementing family investment agreements in
20accordance with chapter 239B:
.................................................. $215,575,693
223. To be used for the family development and
23self-sufficiency grant program in accordance with section
24216A.107:
.................................................. $252,898,980
26Notwithstanding section 8.33, moneys appropriated in this
27subsection that remain unencumbered or unobligated at the close
28of the fiscal year shall not revert but shall remain available
29for expenditure for the purposes designated until the close of
30the succeeding fiscal year. However, unless such moneys are
31encumbered or obligated on or before September 30, 2017, the
32moneys shall revert.
334. For field operations:
.................................................. $3431,296,232
355. For general administration:
-17-.................................................. $13,744,000
26. For state child care assistance:
.................................................. $347,866,826
4a. Of the funds appropriated in this subsection,
5$26,328,097 is transferred to the child care and development
6block grant appropriation made by the Eighty-seventh General
7Assembly, 2017 session, for the federal fiscal year beginning
8October 1, 2017, and ending September 30, 2018. Of this
9amount, $200,000 shall be used for provision of educational
10opportunities to registered child care home providers in order
11to improve services and programs offered by this category
12of providers and to increase the number of providers. The
13department may contract with institutions of higher education
14or child care resource and referral centers to provide
15the educational opportunities. Allowable administrative
16costs under the contracts shall not exceed 5 percent. The
17application for a grant shall not exceed two pages in length.
18b. Any funds appropriated in this subsection remaining
19unallocated shall be used for state child care assistance
20payments for families who are employed including but not
21limited to individuals enrolled in the family investment
22program.
237. For child and family services:
.................................................. $2432,380,654
258. For child abuse prevention grants:
.................................................. $26125,000
279. For pregnancy prevention grants on the condition that
28family planning services are funded:
.................................................. $291,930,067
30Pregnancy prevention grants shall be awarded to programs
31in existence on or before July 1, 2017, if the programs have
32demonstrated positive outcomes. Grants shall be awarded to
33pregnancy prevention programs which are developed after July
341, 2017, if the programs are based on existing models that
35have demonstrated positive outcomes. Grants shall comply with
-18-1the requirements provided in 1997 Iowa Acts, chapter 208,
2section 14, subsections 1 and 2, including the requirement that
3grant programs must emphasize sexual abstinence. Priority in
4the awarding of grants shall be given to programs that serve
5areas of the state which demonstrate the highest percentage of
6unplanned pregnancies of females of childbearing age within the
7geographic area to be served by the grant.
810. For technology needs and other resources necessary
9to meet federal welfare reform reporting, tracking, and case
10management requirements:
.................................................. $111,037,186
1211. a. Notwithstanding any provision to the contrary,
13including but not limited to requirements in section 8.41 or
14provisions in 2016 or 2017 Iowa Acts regarding the receipt and
15appropriation of federal block grants, federal funds from the
16temporary assistance for needy families block grant received by
17the state and not otherwise appropriated in this section and
18remaining available for the fiscal year beginning July 1, 2017,
19are appropriated to the department of human services to the
20extent as may be necessary to be used in the following priority
21order: the family investment program, for state child care
22assistance program payments for families who are employed, and
23for the family investment program share of costs to develop and
24maintain a new, integrated eligibility determination system.
25The federal funds appropriated in this paragraph “a” shall be
26expended only after all other funds appropriated in subsection
271 for the assistance under the family investment program,
28in subsection 6 for child care assistance, or in subsection
2912 for the family investment program share of the costs to
30continue to develop and maintain a new, integrated eligibility
31determination system, as applicable, have been expended. For
32the purposes of this subsection, the funds appropriated in
33subsection 6, paragraph “a”, for transfer to the child care
34and development block grant appropriation are considered fully
35expended when the full amount has been transferred.
-19- 1b. The department shall, on a quarterly basis, advise the
2legislative services agency and department of management of
3the amount of funds appropriated in this subsection that was
4expended in the prior quarter.
512. Of the amounts appropriated in this section,
6$12,962,008 for the fiscal year beginning July 1, 2017, is
7transferred to the appropriation of the federal social services
8block grant made to the department of human services for that
9fiscal year.
1013. For continuation of the program providing categorical
11eligibility for the food assistance program as specified
12for the program in the section of this division of this Act
13relating to the family investment program account:
.................................................. $1425,000
1514. The department may transfer funds allocated in this
16section to the appropriations made in this division of this Act
17for the same fiscal year for general administration and field
18operations for resources necessary to implement and operate the
19services referred to in this section and those funded in the
20appropriation made in this division of this Act for the same
21fiscal year for the family investment program from the general
22fund of the state.
2315. With the exception of moneys allocated under this
24section for the family development and self-sufficiency grant
25program, to the extent moneys allocated in this section are
26deemed by the department not to be necessary to support the
27purposes for which they are allocated, such moneys may be
28credited to the family investment program account as specified
29under subsection 1 of this section and used for the purposes of
30assistance under the family investment program in accordance
31with chapter 239B in the same fiscal year.
32 Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT.
331. Moneys credited to the family investment program (FIP)
34account for the fiscal year beginning July 1, 2017, and
35ending June 30, 2018, shall be used to provide assistance in
-20-1accordance with chapter 239B.
22. The department may use a portion of the moneys credited
3to the FIP account under this section as necessary for
4salaries, support, maintenance, and miscellaneous purposes.
53. The department may transfer funds allocated in
6subsection 4 to the appropriations made in this division of
7this Act for the same fiscal year for general administration
8and field operations for resources necessary to implement and
9operate the family investment program services referred to in
10this section and those funded in the appropriation made in this
11division of this Act for the same fiscal year for the family
12investment program from the general fund of the state.
134. Moneys appropriated in this division of this Act and
14credited to the FIP account for the fiscal year beginning July
151, 2017, and ending June 30, 2018, are allocated as follows:
16a. To be retained by the department of human services to
17be used for coordinating with the department of human rights
18to more effectively serve participants in FIP and other shared
19clients and to meet federal reporting requirements under the
20federal temporary assistance for needy families block grant:
.................................................. $2120,000
22b. To the department of human rights for staffing,
23administration, and implementation of the family development
24and self-sufficiency grant program in accordance with section
25216A.107:
.................................................. $266,192,834
27(1) Of the funds allocated for the family development
28and self-sufficiency grant program in this paragraph “b”,
29not more than 5 percent of the funds shall be used for the
30administration of the grant program.
31(2) The department of human rights may continue to implement
32the family development and self-sufficiency grant program
33statewide during fiscal year 2017-2018.
34(3) The department of human rights may engage in activities
35to strengthen and improve family outcomes measures and
-21-1data collection systems under the family development and
2self-sufficiency grant program.
3c. For the diversion subaccount of the FIP account:
.................................................. $4815,000
5A portion of the moneys allocated for the subaccount may
6be used for field operations, salaries, data management
7system development, and implementation costs and support
8deemed necessary by the director of human services in order to
9administer the FIP diversion program. To the extent moneys
10allocated in this paragraph “c” are deemed by the department
11not to be necessary to support diversion activities, such
12moneys may be used for other efforts intended to increase
13engagement by family investment program participants in work,
14education, or training activities, or for the purposes of
15assistance under the family investment program in accordance
16with chapter 239B.
17d. For the food assistance employment and training program:
.................................................. $1866,588
19(1) The department shall apply the federal supplemental
20nutrition assistance program (SNAP) employment and training
21state plan in order to maximize to the fullest extent permitted
22by federal law the use of the 50 percent federal reimbursement
23provisions for the claiming of allowable federal reimbursement
24funds from the United States department of agriculture
25pursuant to the federal SNAP employment and training program
26for providing education, employment, and training services
27for eligible food assistance program participants, including
28but not limited to related dependent care and transportation
29expenses.
30(2) The department shall continue the categorical federal
31food assistance program eligibility at 160 percent of the
32federal poverty level and continue to eliminate the asset test
33from eligibility requirements, consistent with federal food
34assistance program requirements. The department shall include
35as many food assistance households as is allowed by federal
-22-1law. The eligibility provisions shall conform to all federal
2requirements including requirements addressing individuals who
3are incarcerated or otherwise ineligible.
4e. For the JOBS program:
.................................................. $513,523,290
65. Of the child support collections assigned under FIP,
7an amount equal to the federal share of support collections
8shall be credited to the child support recovery appropriation
9made in this division of this Act. Of the remainder of the
10assigned child support collections received by the child
11support recovery unit, a portion shall be credited to the FIP
12account, a portion may be used to increase recoveries, and a
13portion may be used to sustain cash flow in the child support
14payments account. If as a consequence of the appropriations
15and allocations made in this section the resulting amounts
16are insufficient to sustain cash assistance payments and meet
17federal maintenance of effort requirements, the department
18shall seek supplemental funding. If child support collections
19assigned under FIP are greater than estimated or are otherwise
20determined not to be required for maintenance of effort, the
21state share of either amount may be transferred to or retained
22in the child support payments account.
236. The department may adopt emergency rules for the family
24investment, JOBS, food assistance, and medical assistance
25programs if necessary to comply with federal requirements.
26 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
27is appropriated from the general fund of the state to the
28department of human services for the fiscal year beginning July
291, 2017, and ending June 30, 2018, the following amount, or
30so much thereof as is necessary, to be used for the purpose
31designated:
32To be credited to the family investment program (FIP)
33account and used for family investment program assistance under
34chapter 239B:
.................................................. $3543,004,480
-23- 11. Of the funds appropriated in this section, $7,947,597 is
2allocated for the JOBS program.
32. Of the funds appropriated in this section, $3,313,854 is
4allocated for the family development and self-sufficiency grant
5program.
63. Notwithstanding section 8.39, for the fiscal year
7beginning July 1, 2017, if necessary to meet federal
8maintenance of effort requirements or to transfer federal
9temporary assistance for needy families block grant funding
10to be used for purposes of the federal social services block
11grant or to meet cash flow needs resulting from delays in
12receiving federal funding or to implement, in accordance with
13this division of this Act, activities currently funded with
14juvenile court services, county, or community moneys and state
15moneys used in combination with such moneys; to comply with
16federal requirements; or to maximize the use of federal funds,
17the department of human services may transfer funds within or
18between any of the appropriations made in this division of this
19Act and appropriations in law for the federal social services
20block grant to the department for the following purposes,
21provided that the combined amount of state and federal
22temporary assistance for needy families block grant funding
23for each appropriation remains the same before and after the
24transfer:
25a. For the family investment program.
26b. For child care assistance.
27c. For child and family services.
28d. For field operations.
29e. For general administration.
30This subsection shall not be construed to prohibit the use
31of existing state transfer authority for other purposes. The
32department shall report any transfers made pursuant to this
33subsection to the legislative services agency.
344. Of the funds appropriated in this section, $195,678 shall
35be used for continuation of a grant to an Iowa-based nonprofit
-24-1organization with a history of providing tax preparation
2assistance to low-income Iowans in order to expand the usage of
3the earned income tax credit. The purpose of the grant is to
4supply this assistance to underserved areas of the state.
55. Of the funds appropriated in this section, $60,000 shall
6be used for the continuation of an unfunded pilot project, as
7defined in 441 IAC 100.1, relating to parental obligations,
8in which the child support recovery unit participates, to
9support the efforts of a nonprofit organization committed
10to strengthening the community through youth development,
11healthy living, and social responsibility headquartered in
12a county with a population over 350,000 according to the
13latest certified federal census. The funds allocated in this
14subsection shall be used by the recipient organization to
15develop a larger community effort, through public and private
16partnerships, to support a broad-based multi-county fatherhood
17initiative that promotes payment of child support obligations,
18improved family relationships, and full-time employment.
196. The department may transfer funds appropriated in this
20section to the appropriations made in this division of this Act
21for general administration and field operations as necessary
22to administer this section and the overall family investment
23program.
24 Sec. 9. CHILD SUPPORT RECOVERY. There is appropriated
25from the general fund of the state to the department of human
26services for the fiscal year beginning July 1, 2017, and ending
27June 30, 2018, the following amount, or so much thereof as is
28necessary, to be used for the purposes designated:
29For child support recovery, including salaries, support,
30maintenance, and miscellaneous purposes, and for not more than
31the following full-time equivalent positions:
.................................................. $3212,586,635
............................................... FTEs33459.00
341. The department shall expend up to $24,329, including
35federal financial participation, for the fiscal year beginning
-25-1July 1, 2017, for a child support public awareness campaign.
2The department and the office of the attorney general shall
3cooperate in continuation of the campaign. The public
4awareness campaign shall emphasize, through a variety of
5media activities, the importance of maximum involvement of
6both parents in the lives of their children as well as the
7importance of payment of child support obligations.
82. Federal access and visitation grant moneys shall be
9issued directly to private not-for-profit agencies that provide
10services designed to increase compliance with the child access
11provisions of court orders, including but not limited to
12neutral visitation sites and mediation services.
133. The appropriation made to the department for child
14support recovery may be used throughout the fiscal year in the
15manner necessary for purposes of cash flow management, and for
16cash flow management purposes the department may temporarily
17draw more than the amount appropriated, provided the amount
18appropriated is not exceeded at the close of the fiscal year.
194. With the exception of the funding amount specified, the
20requirements established under 2001 Iowa Acts, chapter 191,
21section 3, subsection 5, paragraph “c”, subparagraph (3), shall
22be applicable to parental obligation pilot projects for the
23fiscal year beginning July 1, 2017, and ending June 30, 2018.
24Notwithstanding 441 IAC 100.8, providing for termination of
25rules relating to the pilot projects, the rules shall remain
26in effect until June 30, 2018.
27 Sec. 10. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
28FY 2017-2018. Any funds remaining in the health care trust
29fund created in section 453A.35A for the fiscal year beginning
30July 1, 2017, and ending June 30, 2018, are appropriated to
31the department of human services to supplement the medical
32assistance program appropriations made in this division of this
33Act, for medical assistance reimbursement and associated costs,
34including program administration and costs associated with
35program implementation.
-26-1 Sec. 11. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
22017-2018. Any funds remaining in the Medicaid fraud fund
3created in section 249A.50 for the fiscal year beginning
4July 1, 2017, and ending June 30, 2018, are appropriated to
5the department of human services to supplement the medical
6assistance appropriations made in this division of this Act,
7for medical assistance reimbursement and associated costs,
8including program administration and costs associated with
9program implementation.
10 Sec. 12. MEDICAL ASSISTANCE. There is appropriated from the
11general fund of the state to the department of human services
12for the fiscal year beginning July 1, 2017, and ending June 30,
132018, the following amount, or so much thereof as is necessary,
14to be used for the purpose designated:
15For medical assistance program reimbursement and associated
16costs as specifically provided in the reimbursement
17methodologies in effect on June 30, 2017, except as otherwise
18expressly authorized by law, consistent with options under
19federal law and regulations, and contingent upon receipt of
20approval from the office of the governor of reimbursement for
21each abortion performed under the program:
.................................................. $221,284,605,740
231. Iowans support reducing the number of abortions
24performed in our state. Funds appropriated under this section
25shall not be used for abortions, unless otherwise authorized
26under this section.
272. The provisions of this section relating to abortions
28shall also apply to the Iowa health and wellness plan created
29pursuant to chapter 249N.
303. The department shall utilize not more than $60,000 of
31the funds appropriated in this section to continue the AIDS/HIV
32health insurance premium payment program as established in 1992
33Iowa Acts, Second Extraordinary Session, chapter 1001, section
34409, subsection 6. Of the funds allocated in this subsection,
35not more than $5,000 may be expended for administrative
-27-1purposes.
24. Of the funds appropriated in this Act to the department
3of public health for addictive disorders, $950,000 for
4the fiscal year beginning July 1, 2017, is transferred
5to the department of human services for an integrated
6substance-related disorder managed care system. The
7departments of human services and public health shall
8work together to maintain the level of mental health and
9substance-related disorder treatment services provided by the
10managed care contractors. Each department shall take the steps
11necessary to continue the federal waivers as necessary to
12maintain the level of services.
135. a. The department shall aggressively pursue options for
14providing medical assistance or other assistance to individuals
15with special needs who become ineligible to continue receiving
16services under the early and periodic screening, diagnostic,
17and treatment program under the medical assistance program
18due to becoming 21 years of age who have been approved for
19additional assistance through the department’s exception to
20policy provisions, but who have health care needs in excess
21of the funding available through the exception to policy
22provisions.
23b. Of the funds appropriated in this section, $100,000
24shall be used for participation in one or more pilot projects
25operated by a private provider to allow the individual or
26individuals to receive service in the community in accordance
27with principles established in Olmstead v.L.C., 527 U.S.581
28(1999), for the purpose of providing medical assistance or
29other assistance to individuals with special needs who become
30ineligible to continue receiving services under the early and
31periodic screening, diagnostic, and treatment program under
32the medical assistance program due to becoming 21 years of
33age who have been approved for additional assistance through
34the department’s exception to policy provisions, but who have
35health care needs in excess of the funding available through
-28-1the exception to the policy provisions.
26. Of the funds appropriated in this section, up to
3$3,050,082 may be transferred to the field operations or
4general administration appropriations in this division of this
5Act for operational costs associated with Part D of the federal
6Medicare Prescription Drug Improvement and Modernization Act
7of 2003, Pub.L.No.108-173.
87. Of the funds appropriated in this section, up to $442,100
9may be transferred to the appropriation in this division
10of this Act for medical contracts to be used for clinical
11assessment services and prior authorization of services.
128. A portion of the funds appropriated in this section
13may be transferred to the appropriations in this division of
14this Act for general administration, medical contracts, the
15children’s health insurance program, or field operations to be
16used for the state match cost to comply with the payment error
17rate measurement (PERM) program for both the medical assistance
18and children’s health insurance programs as developed by the
19centers for Medicare and Medicaid services of the United States
20department of health and human services to comply with the
21federal Improper Payments Information Act of 2002, Pub.L.No.
22107-300.
239. The department shall continue to implement the
24recommendations of the assuring better child health and
25development initiative II (ABCDII) clinical panel to the
26Iowa early and periodic screening, diagnostic, and treatment
27services healthy mental development collaborative board
28regarding changes to billing procedures, codes, and eligible
29service providers.
3010. Of the funds appropriated in this section, a sufficient
31amount is allocated to supplement the incomes of residents of
32nursing facilities, intermediate care facilities for persons
33with mental illness, and intermediate care facilities for
34persons with an intellectual disability, with incomes of less
35than $50 in the amount necessary for the residents to receive a
-29-1personal needs allowance of $50 per month pursuant to section
2249A.30A.
311. a. Hospitals that meet the conditions specified
4in subparagraphs (1) and (2) shall either certify public
5expenditures or transfer to the medical assistance program
6an amount equal to provide the nonfederal share for a
7disproportionate share hospital payment in an amount up to the
8hospital-specific limit as approved in the Medicaid state plan.
9The hospitals that meet the conditions specified shall receive
10and retain 100 percent of the total disproportionate share
11hospital payment in an amount up to the hospital-specific limit
12as approved in the Medicaid state plan.
13(1) The hospital qualifies for disproportionate share and
14graduate medical education payments.
15(2) The hospital is an Iowa state-owned hospital with more
16than 500 beds and eight or more distinct residency specialty
17or subspecialty programs recognized by the American college of
18graduate medical education.
19b. Distribution of the disproportionate share payments
20shall be made on a monthly basis. The total amount of
21disproportionate share payments including graduate medical
22education, enhanced disproportionate share, and Iowa
23state-owned teaching hospital payments shall not exceed the
24amount of the state’s allotment under Pub.L.No.102-234.
25In addition, the total amount of all disproportionate
26share payments shall not exceed the hospital-specific
27disproportionate share limits under Pub.L.No.103-66.
2812. One hundred percent of the nonfederal share of payments
29to area education agencies that are medical assistance
30providers for medical assistance-covered services provided to
31medical assistance-covered children, shall be made from the
32appropriation made in this section.
3313. A portion of the funds appropriated in this section
34may be transferred to the appropriation in this division of
35this Act for medical contracts to be used for administrative
-30-1activities associated with the money follows the person
2demonstration project.
314. Of the funds appropriated in this section, $349,011
4shall be used for the administration of the health insurance
5premium payment program, including salaries, support,
6maintenance, and miscellaneous purposes.
715. a. The department shall implement all of the following
8cost containment strategies:
9(1) An adjustment to the reimbursement policy in order
10to eliminate the primary care physician rate increase
11originally authorized by the federal Health Care and Education
12Reconciliation Act of 2010, section 1202, Pub.L. No.111-152,
1342 U.S.C. §1396a(a)(13)(C) that allows qualified primary care
14physicians to receive the greater of the Medicare rate or
15Medicaid rate for a specified set of codes.
16(2) A strategy to ensure that total reimbursement for
17Medicare Part A and Medicare Part B crossover claims is limited
18to the Medicaid reimbursement rate.
19(3) An adjustment to Medicaid reimbursement rates for
20physician services by applying a site of service differential
21to reflect the difference between the cost of physician
22services when provided in a health facility setting and the
23cost of physician services when provided in a physician’s
24office.
25(4) An adjustment to the inpatient diagnostic related group
26(DRG) cost threshold formula to be the greater of two times the
27statewide average DRG payment for that case or the hospital’s
28individual DRG payment for that case plus $75,000.
29(5) An adjustment to the Medicaid anesthesia conversion
30factor to be equal to the calendar year 2017 Medicare
31anesthesia conversion factor as adjusted for the state, and
32converted to a per minute amount. Each January 1, thereafter,
33the department shall apply the applicable Medicare anesthesia
34conversion factor adjusted for the state, and converted to a
35per minute amount.
-31- 1(6) An alignment of billing and reimbursement for
2consultation services rendered in an office, other outpatient,
3or inpatient setting with Medicare billing and reimbursement.
4(7) Elimination of the three-month retroactive Medicaid
5coverage benefit for Medicaid applicants effective October 1,
62017. The department shall seek a waiver from the centers for
7Medicare and Medicaid services of the United States department
8of health and human services to implement the strategy.
9If federal approval is received, an applicant’s Medicaid
10coverage shall be effective on the first day of the month of
11application, as allowed under the Medicaid state plan.
12b. The department shall implement the cost containment
13strategies specified in this subsection beginning July 1, 2017,
14or as otherwise specified. If federal approval is required,
15the strategy shall be implemented effective upon receipt of
16federal approval.
17c. The department may adopt emergency rules to implement
18this subsection.
1916. a. The department may increase the amounts allocated
20for salaries, support, maintenance, and miscellaneous purposes
21associated with the medical assistance program, as necessary,
22to implement cost containment strategies. The department shall
23report any such increase to the legislative services agency and
24the department of management.
25b. If the savings to the medical assistance program from
26cost containment efforts exceed the cost for the fiscal
27year beginning July 1, 2017, the department may transfer any
28savings generated for the fiscal year due to medical assistance
29program cost containment efforts to the appropriation
30made in this division of this Act for medical contracts or
31general administration to defray the increased contract costs
32associated with implementing such efforts.
3317. For the fiscal year beginning July 1, 2017, and ending
34June 30, 2018, the replacement generation tax revenues required
35to be deposited in the property tax relief fund pursuant to
-32-1section 437A.8, subsection 4, paragraph “d”, and section
2437A.15, subsection 3, paragraph “f”, shall instead be credited
3to and supplement the appropriation made in this section and
4used for the allocations made in this section.
518. a. Of the funds appropriated in this section, up
6to $50,000 may be transferred by the department to the
7appropriation made in this division of this Act to the
8department for the same fiscal year for general administration
9to be used for associated administrative expenses and for not
10more than one full-time equivalent position, in addition to
11those authorized for the same fiscal year, to be assigned to
12implementing the children’s mental health home project.
13b. Of the funds appropriated in this section, up to $400,000
14may be transferred by the department to the appropriation made
15to the department in this division of this Act for the same
16fiscal year for Medicaid program-related general administration
17planning and implementation activities. The funds may be used
18for contracts or for personnel in addition to the amounts
19appropriated for and the positions authorized for general
20administration for the fiscal year.
21c. Of the funds appropriated in this section, up to
22$3,000,000 may be transferred by the department to the
23appropriations made in this division of this Act for the same
24fiscal year for general administration or medical contracts
25to be used to support the development and implementation of
26standardized assessment tools for persons with mental illness,
27an intellectual disability, a developmental disability, or a
28brain injury.
2919. Of the funds appropriated in this section, $150,000
30shall be used for lodging expenses associated with care
31provided at the university of Iowa hospitals and clinics for
32patients with cancer whose travel distance is 30 miles or more
33and whose income is at or below 200 percent of the federal
34poverty level as defined by the most recently revised poverty
35income guidelines published by the United States department of
-33-1health and human services. The department of human services
2shall establish the maximum number of overnight stays and the
3maximum rate reimbursed for overnight lodging, which may be
4based on the state employee rate established by the department
5of administrative services. The funds allocated in this
6subsection shall not be used as nonfederal share matching
7funds.
820. Of the funds appropriated in this section, up to
9$3,383,880 shall be used for administration of the state family
10planning services program as enacted in this 2017 Act, and
11of this amount, the department may use up to $200,000 for
12administrative expenses.
1321. The department shall report the implementation of
14any cost containment strategies to the individuals specified
15in this division of this Act for submission of reports upon
16implementation.
1722. The department shall report the implementation of any
18process improvement changes and any related cost reductions
19to the individuals specified in this division of this Act for
20submission of reports upon implementation.
2123. The Medicaid managed care organizations shall explore
22options provided by national human services nonprofit
23organizations that provide innovative services for persons with
24behavioral health challenges to incorporate assertive community
25treatment teams into the services provided to individuals with
26severe and persistent mental illness in order to minimize or
27prevent recurrent acute episodes and to enhance quality of life
28and functioning.
2924. To the extent a managed care organization has developed
30a closed or exclusive provider network through contractual
31arrangements with selected providers, such managed care
32organization shall accept into such closed or exclusive network
33any willing licensed or certified health care provider who
34holds a current, active license or certification in good
35standing, as applicable, who is not experiencing adverse care
-34-1quality issues, and who agrees to accept the fee schedule,
2payment, or reimbursement rate for such health care provider in
3that network in the specific geographic area of the licensed or
4certified health care provider.
525. The department of human services shall include in the
6Medicaid managed care contracts beginning with the contract
7period effective July 1, 2017, per member per month capitation
8payments to managed care organizations that encourage the
9utilization of home and community-based services as an
10alternative to residential care for members.
11 Sec. 13. MEDICAL CONTRACTS. There is appropriated from the
12general fund of the state to the department of human services
13for the fiscal year beginning July 1, 2017, and ending June 30,
142018, the following amount, or so much thereof as is necessary,
15to be used for the purpose designated:
16For medical contracts:
.................................................. $1717,626,464
181. The department of inspections and appeals shall
19provide all state matching funds for survey and certification
20activities performed by the department of inspections
21and appeals. The department of human services is solely
22responsible for distributing the federal matching funds for
23such activities.
242. Of the funds appropriated in this section, $50,000 shall
25be used for continuation of home and community-based services
26waiver quality assurance programs, including the review and
27streamlining of processes and policies related to oversight and
28quality management to meet state and federal requirements.
293. Of the amount appropriated in this section, up to
30$200,000 may be transferred to the appropriation for general
31administration in this division of this Act to be used for
32additional full-time equivalent positions in the development of
33key health initiatives such as cost containment, development
34and oversight of managed care programs, and development of
35health strategies targeted toward improved quality and reduced
-35-1costs in the Medicaid program.
24. Of the funds appropriated in this section, $1,000,000
3shall be used for planning and development, in cooperation with
4the department of public health, of a phased-in program to
5provide a dental home for children.
65. Of the funds appropriated in this section, $950,000
7shall be credited to the autism support program fund created
8in section 225D.2 to be used for the autism support program
9created in chapter 225D, with the exception of the following
10amounts of this allocation which shall be used as follows:
11a. Of the amount appropriated in this section, $202,000
12shall be used for the public purpose of providing a one-year
13grant to Drake university to establish a master’s program in
14applied behavioral analysis, including the establishment of
15remote learning sites and a remote system to maximize outreach
16and enrollment in the program.
17b. Of the funds allocated in this subsection, $25,000
18shall be used for the public purpose of continuation of a
19grant to a child welfare services provider headquartered in a
20county with a population between 205,000 and 215,000 in the
21latest certified federal census that provides multiple services
22including but not limited to a psychiatric medical institution
23for children, shelter, residential treatment, after school
24programs, school-based programming, and an Asperger’s syndrome
25program, to be used for support services for children with
26autism spectrum disorder and their families.
27c. Of the funds allocated in this subsection, $25,000
28shall be used for the public purpose of continuing a grant to
29a hospital-based provider headquartered in a county with a
30population between 90,000 and 95,000 in the latest certified
31federal census that provides multiple services including
32but not limited to diagnostic, therapeutic, and behavioral
33services to individuals with autism spectrum disorder across
34one’s lifespan. The grant recipient shall utilize the funds
35to continue the pilot project to determine the necessary
-36-1support services for children with autism spectrum disorder and
2their families to be included in the children’s disabilities
3services system. The grant recipient shall submit findings and
4recommendations based upon the results of the pilot project
5to the individuals specified in this division of this Act for
6submission of reports by December 31, 2017.
7 Sec. 14. STATE SUPPLEMENTARY ASSISTANCE.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2017, and ending June 30, 2018, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13For the state supplementary assistance program:
.................................................. $1410,372,658
152. The department shall increase the personal needs
16allowance for residents of residential care facilities by the
17same percentage and at the same time as federal supplemental
18security income and federal social security benefits are
19increased due to a recognized increase in the cost of living.
20The department may adopt emergency rules to implement this
21subsection.
223. If during the fiscal year beginning July 1, 2017,
23the department projects that state supplementary assistance
24expenditures for a calendar year will not meet the federal
25pass-through requirement specified in Tit.XVI of the federal
26Social Security Act, section 1618, as codified in 42 U.S.C.
27§1382g, the department may take actions including but not
28limited to increasing the personal needs allowance for
29residential care facility residents and making programmatic
30adjustments or upward adjustments of the residential care
31facility or in-home health-related care reimbursement rates
32prescribed in this division of this Act to ensure that federal
33requirements are met. In addition, the department may make
34other programmatic and rate adjustments necessary to remain
35within the amount appropriated in this section while ensuring
-37-1compliance with federal requirements. The department may adopt
2emergency rules to implement the provisions of this subsection.
3 Sec. 15. CHILDREN’S HEALTH INSURANCE PROGRAM.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2017, and ending June 30, 2018, the following
7amount, or so much thereof as is necessary, to be used for the
8purpose designated:
9For maintenance of the healthy and well kids in Iowa (hawk-i)
10program pursuant to chapter 514I, including supplemental dental
11services, for receipt of federal financial participation under
12Tit.XXI of the federal Social Security Act, which creates the
13children’s health insurance program:
.................................................. $148,518,452
152. Of the funds appropriated in this section, $42,800 is
16allocated for continuation of the contract for outreach with
17the department of public health.
18 Sec. 16. CHILD CARE ASSISTANCE. There is appropriated
19from the general fund of the state to the department of human
20services for the fiscal year beginning July 1, 2017, and ending
21June 30, 2018, the following amount, or so much thereof as is
22necessary, to be used for the purpose designated:
23For child care programs:
.................................................. $2439,343,616
251. Of the funds appropriated in this section, $33,493,616
26shall be used for state child care assistance in accordance
27with section 237A.13.
282. Nothing in this section shall be construed or is
29intended as or shall imply a grant of entitlement for services
30to persons who are eligible for assistance due to an income
31level consistent with the waiting list requirements of section
32237A.13. Any state obligation to provide services pursuant to
33this section is limited to the extent of the funds appropriated
34in this section.
353. A list of the registered and licensed child care
-38-1facilities operating in the area served by a child care
2resource and referral service shall be made available to the
3families receiving state child care assistance in that area.
44. Of the funds appropriated in this section, $5,850,000
5shall be credited to the early childhood programs grants
6account in the early childhood Iowa fund created in section
7256I.11. The moneys shall be distributed for funding of
8community-based early childhood programs targeted to children
9from birth through five years of age developed by early
10childhood Iowa areas in accordance with approved community
11plans as provided in section 256I.8.
125. The department may use any of the funds appropriated
13in this section as a match to obtain federal funds for use in
14expanding child care assistance and related programs. For
15the purpose of expenditures of state and federal child care
16funding, funds shall be considered obligated at the time
17expenditures are projected or are allocated to the department’s
18service areas. Projections shall be based on current and
19projected caseload growth, current and projected provider
20rates, staffing requirements for eligibility determination
21and management of program requirements including data systems
22management, staffing requirements for administration of the
23program, contractual and grant obligations and any transfers
24to other state agencies, and obligations for decategorization
25or innovation projects.
266. A portion of the state match for the federal child care
27and development block grant shall be provided as necessary to
28meet federal matching funds requirements through the state
29general fund appropriation made for child development grants
30and other programs for at-risk children in section 279.51.
317. If a uniform reduction ordered by the governor under
32section 8.31 or other operation of law, transfer, or federal
33funding reduction reduces the appropriation made in this
34section for the fiscal year, the percentage reduction in the
35amount paid out to or on behalf of the families participating
-39-1in the state child care assistance program shall be equal to or
2less than the percentage reduction made for any other purpose
3payable from the appropriation made in this section and the
4federal funding relating to it. The percentage reduction to
5the other allocations made in this section shall be the same as
6the uniform reduction ordered by the governor or the percentage
7change of the federal funding reduction, as applicable.
8If there is an unanticipated increase in federal funding
9provided for state child care assistance, the entire amount
10of the increase shall be used for state child care assistance
11payments. If the appropriations made for purposes of the
12state child care assistance program for the fiscal year are
13determined to be insufficient, it is the intent of the general
14assembly to appropriate sufficient funding for the fiscal year
15in order to avoid establishment of waiting list requirements.
168. Notwithstanding section 8.33, moneys advanced for
17purposes of the programs developed by early childhood Iowa
18areas, advanced for purposes of wraparound child care, or
19received from the federal appropriations made for the purposes
20of this section that remain unencumbered or unobligated at the
21close of the fiscal year shall not revert to any fund but shall
22remain available for expenditure for the purposes designated
23until the close of the succeeding fiscal year.
24 Sec. 17. JUVENILE INSTITUTION. There is appropriated
25from the general fund of the state to the department of human
26services for the fiscal year beginning July 1, 2017, and ending
27June 30, 2018, the following amounts, or so much thereof as is
28necessary, to be used for the purposes designated:
291. For operation of the state training school at Eldora and
30for salaries, support, maintenance, and miscellaneous purposes,
31and for not more than the following full-time equivalent
32positions:
.................................................. $3311,350,443
............................................... FTEs34189.00
35Of the funds appropriated in this subsection, $91,150 shall
-40-1be used for distribution to licensed classroom teachers at this
2and other institutions under the control of the department of
3human services based upon the average student yearly enrollment
4at each institution as determined by the department.
52. A portion of the moneys appropriated in this section
6shall be used by the state training school at Eldora for
7grants for adolescent pregnancy prevention activities at the
8institution in the fiscal year beginning July 1, 2017.
9 Sec. 18. CHILD AND FAMILY SERVICES.
101. There is appropriated from the general fund of the
11state to the department of human services for the fiscal year
12beginning July 1, 2017, and ending June 30, 2018, the following
13amount, or so much thereof as is necessary, to be used for the
14purpose designated:
15For child and family services:
.................................................. $1687,329,375
172. The department may transfer funds appropriated in this
18section as necessary to pay the nonfederal costs of services
19reimbursed under the medical assistance program, state child
20care assistance program, or the family investment program which
21are provided to children who would otherwise receive services
22paid under the appropriation in this section. The department
23may transfer funds appropriated in this section to the
24appropriations made in this division of this Act for general
25administration and for field operations for resources necessary
26to implement and operate the services funded in this section.
273. a. Of the funds appropriated in this section, up to
28$35,736,649 is allocated as the statewide expenditure target
29under section 232.143 for group foster care maintenance and
30services. If the department projects that such expenditures
31for the fiscal year will be less than the target amount
32allocated in this paragraph “a”, the department may reallocate
33the excess to provide additional funding for shelter care
34or the child welfare emergency services addressed with the
35allocation for shelter care.
-41- 1b. If at any time after September 30, 2017, annualization
2of a service area’s current expenditures indicates a service
3area is at risk of exceeding its group foster care expenditure
4target under section 232.143 by more than 5 percent, the
5department and juvenile court services shall examine all
6group foster care placements in that service area in order to
7identify those which might be appropriate for termination.
8In addition, any aftercare services believed to be needed
9for the children whose placements may be terminated shall be
10identified. The department and juvenile court services shall
11initiate action to set dispositional review hearings for the
12placements identified. In such a dispositional review hearing,
13the juvenile court shall determine whether needed aftercare
14services are available and whether termination of the placement
15is in the best interest of the child and the community.
164. In accordance with the provisions of section 232.188,
17the department shall continue the child welfare and juvenile
18justice funding initiative during fiscal year 2017-2018. Of
19the funds appropriated in this section, $1,717,753 is allocated
20specifically for expenditure for fiscal year 2017-2018 through
21the decategorization services funding pools and governance
22boards established pursuant to section 232.188.
235. A portion of the funds appropriated in this section
24may be used for emergency family assistance to provide other
25resources required for a family participating in a family
26preservation or reunification project or successor project to
27stay together or to be reunified.
286. Notwithstanding section 234.35 or any other provision
29of law to the contrary, state funding for shelter care and
30the child welfare emergency services contracting implemented
31to provide for or prevent the need for shelter care shall be
32limited to $8,096,158.
337. Federal funds received by the state during the fiscal
34year beginning July 1, 2017, as the result of the expenditure
35of state funds appropriated during a previous state fiscal
-42-1year for a service or activity funded under this section are
2appropriated to the department to be used as additional funding
3for services and purposes provided for under this section.
4Notwithstanding section 8.33, moneys received in accordance
5with this subsection that remain unencumbered or unobligated at
6the close of the fiscal year shall not revert to any fund but
7shall remain available for the purposes designated until the
8close of the succeeding fiscal year.
98. a. Of the funds appropriated in this section, up to
10$3,290,000 is allocated for the payment of the expenses of
11court-ordered services provided to juveniles who are under the
12supervision of juvenile court services, which expenses are a
13charge upon the state pursuant to section 232.141, subsection
144. Of the amount allocated in this paragraph “a”, up to
15$1,556,287 shall be made available to provide school-based
16supervision of children adjudicated under chapter 232, of which
17not more than $15,000 may be used for the purpose of training.
18A portion of the cost of each school-based liaison officer
19shall be paid by the school district or other funding source as
20approved by the chief juvenile court officer.
21b. Of the funds appropriated in this section, up to $748,985
22is allocated for the payment of the expenses of court-ordered
23services provided to children who are under the supervision
24of the department, which expenses are a charge upon the state
25pursuant to section 232.141, subsection 4.
26c. Notwithstanding section 232.141 or any other provision
27of law to the contrary, the amounts allocated in this
28subsection shall be distributed to the judicial districts
29as determined by the state court administrator and to the
30department’s service areas as determined by the administrator
31of the department of human services’ division of child and
32family services. The state court administrator and the
33division administrator shall make the determination of the
34distribution amounts on or before June 15, 2017.
35d. Notwithstanding chapter 232 or any other provision of
-43-1law to the contrary, a district or juvenile court shall not
2order any service which is a charge upon the state pursuant
3to section 232.141 if there are insufficient court-ordered
4services funds available in the district court or departmental
5service area distribution amounts to pay for the service. The
6chief juvenile court officer and the departmental service area
7manager shall encourage use of the funds allocated in this
8subsection such that there are sufficient funds to pay for
9all court-related services during the entire year. The chief
10juvenile court officers and departmental service area managers
11shall attempt to anticipate potential surpluses and shortfalls
12in the distribution amounts and shall cooperatively request the
13state court administrator or division administrator to transfer
14funds between the judicial districts’ or departmental service
15areas’ distribution amounts as prudent.
16e. Notwithstanding any provision of law to the contrary,
17a district or juvenile court shall not order a county to pay
18for any service provided to a juvenile pursuant to an order
19entered under chapter 232 which is a charge upon the state
20under section 232.141, subsection 4.
21f. Of the funds allocated in this subsection, not more than
22$83,000 may be used by the judicial branch for administration
23of the requirements under this subsection.
24g. Of the funds allocated in this subsection, $17,000
25shall be used by the department of human services to support
26the interstate commission for juveniles in accordance with
27the interstate compact for juveniles as provided in section
28232.173.
299. Of the funds appropriated in this section, $12,253,227 is
30allocated for juvenile delinquent graduated sanctions services.
31Any state funds saved as a result of efforts by juvenile court
32services to earn a federal Tit.IV-E match for juvenile court
33services administration may be used for the juvenile delinquent
34graduated sanctions services.
3510. Of the funds appropriated in this section, $1,658,285 is
-44-1transferred to the department of public health to be used for
2the child protection center grant program for child protection
3centers located in Iowa in accordance with section 135.118.
4The grant amounts under the program shall be equalized so that
5each center receives a uniform base amount of $245,000, so that
6$50,000 is awarded to establish a satellite child protection
7center in a city in north central Iowa that is the county
8seat of a county with a population between 44,000 and 45,000
9according to the latest certified federal census, and so that
10the remaining funds are awarded through a funding formula based
11upon the volume of children served.
1211. If the department receives federal approval to
13implement a waiver under Tit.IV-E of the federal Social
14Security Act to enable providers to serve children who remain
15in the children’s families and communities, for purposes of
16eligibility under the medical assistance program through 25
17years of age, children who participate in the waiver shall be
18considered to be placed in foster care.
1912. Of the funds appropriated in this section, $4,025,167 is
20allocated for the preparation for adult living program pursuant
21to section 234.46.
2213. Of the funds appropriated in this section, $227,337
23shall be used for the public purpose of continuing a grant to
24a nonprofit human services organization providing services to
25individuals and families in multiple locations in southwest
26Iowa and Nebraska for support of a project providing immediate,
27sensitive support and forensic interviews, medical exams, needs
28assessments, and referrals for victims of child abuse and their
29nonoffending family members.
3014. Of the funds appropriated in this section, $300,620
31is allocated for the foster care youth council approach of
32providing a support network to children placed in foster care.
3315. Of the funds appropriated in this section, $202,000 is
34allocated for use pursuant to section 235A.1 for continuation
35of the initiative to address child sexual abuse implemented
-45-1pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
221.
316. Of the funds appropriated in this section, $630,240 is
4allocated for the community partnership for child protection
5sites.
617. Of the funds appropriated in this section, $371,250
7is allocated for the department’s minority youth and family
8projects under the redesign of the child welfare system.
918. Of the funds appropriated in this section, $1,186,595
10is allocated for funding of the community circle of care
11collaboration for children and youth in northeast Iowa.
1219. Of the funds appropriated in this section, at least
13$147,158 shall be used for the continuation of the child
14welfare provider training academy, a collaboration between the
15coalition for family and children’s services in Iowa and the
16department.
1720. Of the funds appropriated in this section, $211,872
18shall be used for continuation of the central Iowa system of
19care program grant through June 30, 2018.
2021. Of the funds appropriated in this section, $235,000
21shall be used for the public purpose of the continuation
22and expansion of a system of care program grant implemented
23in Cerro Gordo and Linn counties to utilize a comprehensive
24and long-term approach for helping children and families by
25addressing the key areas in a child’s life of childhood basic
26needs, education and work, family, and community.
2722. Of the funds appropriated in this section, at least
28$25,000 shall be used to continue and to expand the foster
29care respite pilot program in which postsecondary students in
30social work and other human services-related programs receive
31experience by assisting family foster care providers with
32respite and other support.
3323. Of the funds appropriated in this section, $110,000
34shall be used for the public purpose of funding community-based
35services and other supports with a system of care approach
-46-1for children with a serious emotional disturbance and their
2families through a nonprofit provider of child welfare services
3that has been in existence for more than 115 years, is located
4in a county with a population of more than 200,000 but less
5than 220,000 according to the latest certified federal census,
6is licensed as a psychiatric medical institution for children,
7and was a system of care grantee prior to July 1, 2017.
8 Sec. 19. ADOPTION SUBSIDY.
91. There is appropriated from the general fund of the
10state to the department of human services for the fiscal year
11beginning July 1, 2017, and ending June 30, 2018, the following
12amount, or so much thereof as is necessary, to be used for the
13purpose designated:
14a. For adoption subsidy payments and services:
.................................................. $1540,777,910
16b. (1) The funds appropriated in this section shall be used
17as authorized or allowed by federal law or regulation for any
18of the following purposes:
19(a) For adoption subsidy payments and related costs.
20(b) For post-adoption services and for other purposes under
21Tit.IV-B or Tit.IV-E of the federal Social Security Act.
22(2) The department of human services may transfer funds
23appropriated in this subsection to the appropriation for
24child and family services in this Act for the purposes of
25post-adoption services as specified in this paragraph “b”.
262. The department may transfer funds appropriated in
27this section to the appropriation made in this division of
28this Act for general administration for costs paid from the
29appropriation relating to adoption subsidy.
303. Federal funds received by the state during the
31fiscal year beginning July 1, 2017, as the result of the
32expenditure of state funds during a previous state fiscal
33year for a service or activity funded under this section are
34appropriated to the department to be used as additional funding
35for the services and activities funded under this section.
-47-1Notwithstanding section 8.33, moneys received in accordance
2with this subsection that remain unencumbered or unobligated
3at the close of the fiscal year shall not revert to any fund
4but shall remain available for expenditure for the purposes
5designated until the close of the succeeding fiscal year.
6 Sec. 20. JUVENILE DETENTION HOME FUND. Moneys deposited
7in the juvenile detention home fund created in section 232.142
8during the fiscal year beginning July 1, 2017, and ending June
930, 2018, are appropriated to the department of human services
10for the fiscal year beginning July 1, 2017, and ending June 30,
112018, for distribution of an amount equal to a percentage of
12the costs of the establishment, improvement, operation, and
13maintenance of county or multicounty juvenile detention homes
14in the fiscal year beginning July 1, 2015. Moneys appropriated
15for distribution in accordance with this section shall be
16allocated among eligible detention homes, prorated on the basis
17of an eligible detention home’s proportion of the costs of all
18eligible detention homes in the fiscal year beginning July
191, 2015. The percentage figure shall be determined by the
20department based on the amount available for distribution for
21the fund. Notwithstanding section 232.142, subsection 3, the
22financial aid payable by the state under that provision for the
23fiscal year beginning July 1, 2017, shall be limited to the
24amount appropriated for the purposes of this section.
25 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM.
261. There is appropriated from the general fund of the
27state to the department of human services for the fiscal year
28beginning July 1, 2017, and ending June 30, 2018, the following
29amount, or so much thereof as is necessary, to be used for the
30purpose designated:
31For the family support subsidy program subject to the
32enrollment restrictions in section 225C.37, subsection 3:
.................................................. $331,069,282
342. At least $787,500 of the moneys appropriated in this
35section is transferred to the department of public health for
-48-1the family support center component of the comprehensive family
2support program under chapter 225C, subchapter V.
33. If at any time during the fiscal year, the amount of
4funding available for the family support subsidy program
5is reduced from the amount initially used to establish the
6figure for the number of family members for whom a subsidy
7is to be provided at any one time during the fiscal year,
8notwithstanding section 225C.38, subsection 2, the department
9shall revise the figure as necessary to conform to the amount
10of funding available.
11 Sec. 22. CONNER DECREE. There is appropriated from the
12general fund of the state to the department of human services
13for the fiscal year beginning July 1, 2017, and ending June 30,
142018, the following amount, or so much thereof as is necessary,
15to be used for the purpose designated:
16For building community capacity through the coordination
17and provision of training opportunities in accordance with the
18consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
19Iowa, July 14, 1994):
.................................................. $2033,632
21 Sec. 23. MENTAL HEALTH INSTITUTES.
221. There is appropriated from the general fund of the
23state to the department of human services for the fiscal year
24beginning July 1, 2017, and ending June 30, 2018, the following
25amounts, or so much thereof as is necessary, to be used for the
26purposes designated:
27a. For operation of the state mental health institute at
28Cherokee as required by chapters 218 and 226 for salaries,
29support, maintenance, and miscellaneous purposes, and for not
30more than the following full-time equivalent positions:
.................................................. $3113,870,254
............................................... FTEs32162.00
33b. For operation of the state mental health institute at
34Independence as required by chapters 218 and 226 for salaries,
35support, maintenance, and miscellaneous purposes, and for not
-49-1more than the following full-time equivalent positions:
.................................................. $217,513,621
............................................... FTEs3204.00
42. Notwithstanding sections 218.78 and 249A.11, any revenue
5received from the state mental health institute at Cherokee or
6the state mental health institute at Independence pursuant to
742 C.F.R §438.6(e) may be retained and expended by the mental
8health institute.
93. Notwithstanding any provision of law to the contrary,
10a Medicaid member residing at the state mental health
11institute at Cherokee or the state mental health institute
12at Independence shall retain Medicaid eligibility during
13the period of the Medicaid member’s stay for which federal
14financial participation is available.
15 Sec. 24. STATE RESOURCE CENTERS.
161. There is appropriated from the general fund of the
17state to the department of human services for the fiscal year
18beginning July 1, 2017, and ending June 30, 2018, the following
19amounts, or so much thereof as is necessary, to be used for the
20purposes designated:
21a. For the state resource center at Glenwood for salaries,
22support, maintenance, and miscellaneous purposes:
.................................................. $2317,887,781
24b. For the state resource center at Woodward for salaries,
25support, maintenance, and miscellaneous purposes:
.................................................. $2612,077,034
272. The department may continue to bill for state resource
28center services utilizing a scope of services approach used for
29private providers of intermediate care facilities for persons
30with an intellectual disability services, in a manner which
31does not shift costs between the medical assistance program,
32counties, or other sources of funding for the state resource
33centers.
343. The state resource centers may expand the time-limited
35assessment and respite services during the fiscal year.
-50- 14. If the department’s administration and the department
2of management concur with a finding by a state resource
3center’s superintendent that projected revenues can reasonably
4be expected to pay the salary and support costs for a new
5employee position, or that such costs for adding a particular
6number of new positions for the fiscal year would be less
7than the overtime costs if new positions would not be added,
8the superintendent may add the new position or positions. If
9the vacant positions available to a resource center do not
10include the position classification desired to be filled, the
11state resource center’s superintendent may reclassify any
12vacant position as necessary to fill the desired position. The
13superintendents of the state resource centers may, by mutual
14agreement, pool vacant positions and position classifications
15during the course of the fiscal year in order to assist one
16another in filling necessary positions.
175. If existing capacity limitations are reached in
18operating units, a waiting list is in effect for a service or
19a special need for which a payment source or other funding
20is available for the service or to address the special need,
21and facilities for the service or to address the special need
22can be provided within the available payment source or other
23funding, the superintendent of a state resource center may
24authorize opening not more than two units or other facilities
25and begin implementing the service or addressing the special
26need during fiscal year 2017-2018.
27 Sec. 25. SEXUALLY VIOLENT PREDATORS.
281. There is appropriated from the general fund of the
29state to the department of human services for the fiscal year
30beginning July 1, 2017, and ending June 30, 2018, the following
31amount, or so much thereof as is necessary, to be used for the
32purpose designated:
33For costs associated with the commitment and treatment of
34sexually violent predators in the unit located at the state
35mental health institute at Cherokee, including costs of legal
-51-1services and other associated costs, including salaries,
2support, maintenance, and miscellaneous purposes, and for not
3more than the following full-time equivalent positions:
.................................................. $49,464,747
............................................... FTEs5112.00
62. Unless specifically prohibited by law, if the amount
7charged provides for recoupment of at least the entire amount
8of direct and indirect costs, the department of human services
9may contract with other states to provide care and treatment
10of persons placed by the other states at the unit for sexually
11violent predators at Cherokee. The moneys received under
12such a contract shall be considered to be repayment receipts
13and used for the purposes of the appropriation made in this
14section.
15 Sec. 26. FIELD OPERATIONS. There is appropriated from the
16general fund of the state to the department of human services
17for the fiscal year beginning July 1, 2017, and ending June 30,
182018, the following amount, or so much thereof as is necessary,
19to be used for the purposes designated:
20For field operations, including salaries, support,
21maintenance, and miscellaneous purposes, and for not more than
22the following full-time equivalent positions:
.................................................. $2348,484,435
............................................... FTEs241,583.00
25Priority in filling full-time equivalent positions shall be
26given to those positions related to child protection services
27and eligibility determination for low-income families.
28 Sec. 27. GENERAL ADMINISTRATION. There is appropriated
29from the general fund of the state to the department of human
30services for the fiscal year beginning July 1, 2017, and ending
31June 30, 2018, the following amount, or so much thereof as is
32necessary, to be used for the purpose designated:
33For general administration, including salaries, support,
34maintenance, and miscellaneous purposes, and for not more than
35the following full-time equivalent positions:
-52-.................................................. $113,883,040
............................................... FTEs2294.00
31. The department shall report at least monthly to the
4legislative services agency concerning the department’s
5operational and program expenditures.
62. Of the funds appropriated in this section, $150,000 shall
7be used to continue the contract for the provision of a program
8to provide technical assistance, support, and consultation to
9providers of habilitation services and home and community-based
10services waiver services for adults with disabilities under the
11medical assistance program.
123. Of the funds appropriated in this section, $50,000
13is transferred to the Iowa finance authority to be used
14for administrative support of the council on homelessness
15established in section 16.2D and for the council to fulfill its
16duties in addressing and reducing homelessness in the state.
174. Of the funds appropriated in this section, $250,000 shall
18be transferred to and deposited in the administrative fund of
19the Iowa ABLE savings plan trust created in section 12I.4, to
20be used for implementation and administration activities of the
21Iowa ABLE savings plan trust.
225. Of the funds appropriated in this section, $200,000
23is transferred to the economic development authority for
24the Iowa commission on volunteer services to continue to be
25used for RefugeeRISE AmeriCorps program established under
26Code section 15H.8 for member recruitment and training to
27improve the economic well-being and health of economically
28disadvantaged refugees in local communities across Iowa. Funds
29transferred may be used to supplement federal funds under
30federal regulations.
316. Of the funds appropriated in this section, $300,000 shall
32be used to contract for children’s well-being collaboratives
33grants for the development and implementation of children’s
34well-being collaboratives to establish and coordinate
35prevention and early intervention services to promote improved
-53-1mental health and well-being for children and families, as
2enacted in this 2017 Act.
3 Sec. 28. DEPARTMENT-WIDE DUTIES. There is appropriated
4from the general fund of the state to the department of human
5services for the fiscal year beginning July 1, 2017, and ending
6June 30, 2018, the following amount, or so much thereof as is
7necessary, to be used for the purposes designated:
8For salaries, support, maintenance, and miscellaneous
9purposes at facilities under the purview of the department of
10human services:
.................................................. $112,879,274
12 Sec. 29. VOLUNTEERS. There is appropriated from the general
13fund of the state to the department of human services for the
14fiscal year beginning July 1, 2017, and ending June 30, 2018,
15the following amount, or so much thereof as is necessary, to be
16used for the purpose designated:
17For development and coordination of volunteer services:
.................................................. $1884,686
19 Sec. 30. GENERAL REDUCTION. For the period beginning July
201, 2017, and ending June 30, 2018, the department of human
21services, in consultation with the department of management,
22shall identify and implement a reduction in expenditures made
23from appropriations from the general fund to the department of
24human services in the amount of $1,467,303.
25 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
26ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
27DEPARTMENT OF HUMAN SERVICES.
281. a. (1) (a) For the fiscal year beginning July 1, 2017,
29the department shall rebase case-mix nursing facility rates
30effective July 1, 2017, to the extent possible within the state
31funding appropriated for this purpose.
32(b) For the fiscal year beginning July 1, 2017, non-case-mix
33and special population nursing facilities shall be reimbursed
34in accordance with the methodology in effect on June 30 of the
35prior fiscal year.
-54- 1(c) For managed care claims, the department of human
2services shall adjust the payment rate floor for nursing
3facilities, annually, to maintain a rate floor that is no
4lower than the Medicaid fee-for-service case-mix adjusted rate
5calculated in accordance with 441 IAC 81.6. The department
6shall then calculate adjusted reimbursement rates, including
7but not limited to add-on-payments, annually, and shall
8notify Medicaid managed care organizations of the adjusted
9reimbursement rates within 30 days of determining the adjusted
10reimbursement rates. Any adjustment of reimbursement rates
11under this subparagraph division shall be budget neutral to the
12state budget.
13(2) For any open or unsettled nursing facility cost report
14for a fiscal year prior to and including the fiscal year
15beginning July 1, 2016, including any cost report remanded on
16judicial review for inclusion of prescription drug, laboratory,
17or x-ray costs, the department shall offset all reported
18prescription drug, laboratory, and x-ray costs with any revenue
19received from Medicare or other revenue source for any purpose.
20For purposes of this subparagraph, a nursing facility cost
21report is not considered open or unsettled if the facility did
22not initiate an administrative appeal under chapter 17A or if
23any appeal rights initiated have been exhausted.
24b. (1) For the fiscal year beginning July 1, 2017,
25the department shall establish the pharmacy dispensing fee
26reimbursement at $10.02 per prescription, until a cost of
27dispensing survey is completed. The actual dispensing fee
28shall be determined by a cost of dispensing survey performed
29by the department and required to be completed by all medical
30assistance program participating pharmacies every two years,
31adjusted as necessary to maintain expenditures within the
32amount appropriated to the department for this purpose for the
33fiscal year.
34(2) The department shall utilize an average acquisition
35cost reimbursement methodology for all drugs covered under the
-55-1medical assistance program in accordance with 2012 Iowa Acts,
2chapter 1133, section 33.
3c. (1) For the fiscal year beginning July 1, 2017,
4reimbursement rates for outpatient hospital services shall
5be rebased effective January 1, 2018, subject to Medicaid
6program upper payment limit rules, and adjusted as necessary
7to maintain expenditures within the amount appropriated to the
8department for this purpose for the fiscal year.
9(2) For the fiscal year beginning July 1, 2017,
10reimbursement rates for inpatient hospital services shall
11remain at the rates in effect on June 30, 2017, subject to
12Medicaid program upper payment limit rules, and adjusted
13as necessary to maintain expenditures within the amount
14appropriated to the department for this purpose for the fiscal
15year.
16(3) For the fiscal year beginning July 1, 2017, the graduate
17medical education and disproportionate share hospital fund
18shall remain at the amount in effect on June 30, 2017, except
19that the portion of the fund attributable to graduate medical
20education shall be reduced in an amount that reflects the
21elimination of graduate medical education payments made to
22out-of-state hospitals.
23(4) In order to ensure the efficient use of limited state
24funds in procuring health care services for low-income Iowans,
25funds appropriated in this Act for hospital services shall
26not be used for activities which would be excluded from a
27determination of reasonable costs under the federal Medicare
28program pursuant to 42 U.S.C.§1395x(v)(1)(N).
29d. For the fiscal year beginning July 1, 2017, reimbursement
30rates for hospices and acute mental hospitals shall be
31increased in accordance with increases under the federal
32Medicare program or as supported by their Medicare audited
33costs.
34e. For the fiscal year beginning July 1, 2017, independent
35laboratories and rehabilitation agencies shall be reimbursed
-56-1using the same methodology in effect on June 30, 2017.
2f. (1) For the fiscal year beginning July 1, 2017,
3reimbursement rates for home health agencies shall continue to
4be based on the Medicare low utilization payment adjustment
5(LUPA) methodology with state geographic wage adjustments.
6The department shall continue to update the rates every two
7years to reflect the most recent Medicare LUPA rates to the
8extent possible within the state funding appropriated for this
9purpose.
10(2) For the fiscal year beginning July 1, 2017, rates for
11private duty nursing and personal care services under the early
12and periodic screening, diagnostic, and treatment program
13benefit shall be calculated based on the methodology in effect
14on June 30, 2017.
15g. For the fiscal year beginning July 1, 2017, federally
16qualified health centers and rural health clinics shall receive
17cost-based reimbursement for 100 percent of the reasonable
18costs for the provision of services to recipients of medical
19assistance.
20h. For the fiscal year beginning July 1, 2017, the
21reimbursement rates for dental services shall remain at the
22rates in effect on June 30, 2017.
23i. (1) For the fiscal year beginning July 1, 2017,
24reimbursement rates for non-state-owned psychiatric medical
25institutions for children shall be based on the reimbursement
26methodology in effect on June 30, 2017.
27(2) As a condition of participation in the medical
28assistance program, enrolled providers shall accept the medical
29assistance reimbursement rate for any covered goods or services
30provided to recipients of medical assistance who are children
31under the custody of a psychiatric medical institution for
32children.
33j. For the fiscal year beginning July 1, 2017, unless
34otherwise specified in this Act, all noninstitutional medical
35assistance provider reimbursement rates shall remain at the
-57-1rates in effect on June 30, 2017, except for area education
2agencies, local education agencies, infant and toddler
3services providers, home and community-based services providers
4including consumer-directed attendant care providers under a
5section 1915(c) or 1915(i) waiver, targeted case management
6providers, and those providers whose rates are required to be
7determined pursuant to section 249A.20.
8k. Notwithstanding any provision to the contrary, for the
9fiscal year beginning July 1, 2017, the reimbursement rate
10for anesthesiologists shall be adjusted to implement the cost
11containment strategies authorized for the medical assistance
12program in this 2017 Act.
13l. Notwithstanding section 249A.20, for the fiscal year
14beginning July 1, 2017, the average reimbursement rate for
15health care providers eligible for use of the federal Medicare
16resource-based relative value scale reimbursement methodology
17under section 249A.20 shall remain at the rate in effect on
18June 30, 2017; however, this rate shall not exceed the maximum
19level authorized by the federal government.
20m. For the fiscal year beginning July 1, 2017, the
21reimbursement rate for residential care facilities shall not
22be less than the minimum payment level as established by the
23federal government to meet the federally mandated maintenance
24of effort requirement. The flat reimbursement rate for
25facilities electing not to file annual cost reports shall not
26be less than the minimum payment level as established by the
27federal government to meet the federally mandated maintenance
28of effort requirement.
29n. For the fiscal year beginning July 1, 2017, the
30reimbursement rates for inpatient mental health services
31provided at hospitals shall remain at the rates in effect on
32June 30, 2017, subject to Medicaid program upper payment limit
33rules; and psychiatrists shall be reimbursed at the medical
34assistance program fee-for-service rate in effect on June 30,
352017.
-58- 1o. For the fiscal year beginning July 1, 2017, community
2mental health centers may choose to be reimbursed for the
3services provided to recipients of medical assistance through
4either of the following options:
5(1) For 100 percent of the reasonable costs of the services.
6(2) In accordance with the alternative reimbursement rate
7methodology approved by the department of human services in
8effect on June 30, 2017.
9p. For the fiscal year beginning July 1, 2017, the
10reimbursement rate for providers of family planning services
11that are eligible to receive a 90 percent federal match shall
12remain at the rates in effect on June 30, 2017.
13q. Unless otherwise subject to a tiered rate methodology,
14for the fiscal year beginning July 1, 2017, the upper
15limits and reimbursement rates for providers of home and
16community-based services waiver services shall be reimbursed
17using the reimbursement methodology in effect on June 30, 2017.
18r. For the fiscal year beginning July 1, 2017, the
19reimbursement rates for emergency medical service providers
20shall remain at the rates in effect on June 30, 2017.
21s. For the fiscal year beginning July 1, 2017, reimbursement
22rates for substance-related disorder treatment programs
23licensed under section 125.13 shall remain at the rates in
24effect on June 30, 2017.
252. For the fiscal year beginning July 1, 2017, the
26reimbursement rate for providers reimbursed under the
27in-home-related care program shall not be less than the minimum
28payment level as established by the federal government to meet
29the federally mandated maintenance of effort requirement.
303. Unless otherwise directed in this section, when the
31department’s reimbursement methodology for any provider
32reimbursed in accordance with this section includes an
33inflation factor, this factor shall not exceed the amount
34by which the consumer price index for all urban consumers
35increased during the calendar year ending December 31, 2002.
-59- 14. Notwithstanding section 234.38, for the fiscal
2year beginning July 1, 2017, the foster family basic daily
3maintenance rate and the maximum adoption subsidy rate for
4children ages 0 through 5 years shall be $16.78, the rate for
5children ages 6 through 11 years shall be $17.45, the rate for
6children ages 12 through 15 years shall be $19.10, and the
7rate for children and young adults ages 16 and older shall
8be $19.35. For youth ages 18 to 21 who have exited foster
9care, the preparation for adult living program maintenance rate
10shall be $602.70 per month. The maximum payment for adoption
11subsidy nonrecurring expenses shall be limited to $500 and the
12disallowance of additional amounts for court costs and other
13related legal expenses implemented pursuant to 2010 Iowa Acts,
14chapter 1031, section 408, shall be continued.
155. For the fiscal year beginning July 1, 2017, the maximum
16reimbursement rates for social services providers under
17contract shall remain at the rates in effect on June 30, 2017,
18or the provider’s actual and allowable cost plus inflation for
19each service, whichever is less. However, if a new service
20or service provider is added after June 30, 2017, the initial
21reimbursement rate for the service or provider shall be based
22upon a weighted average of provider rates for similar services.
236. a. For the fiscal year beginning July 1, 2017, the
24reimbursement rates for resource family recruitment and
25retention contractors shall be established by contract.
26b. For the fiscal year beginning July 1, 2017, the
27reimbursement rates for supervised apartment living foster care
28providers shall be established by contract.
297. a. For the purposes of this subsection, “combined
30reimbursement rate” means the combined service and maintenance
31reimbursement rate for a service level under the department’s
32reimbursement methodology. Effective July 1, 2017, the
33combined reimbursement rate for a group foster care service
34level shall be the amount designated in this subsection.
35However, if a group foster care provider’s reimbursement rate
-60-1for a service level as of June 30, 2017, is more than the rate
2designated in this subsection, the provider’s reimbursement
3shall remain at the higher rate.
4b. Unless a group foster care provider is subject to the
5exception provided in paragraph “a”, effective July 1, 2017,
6the combined reimbursement rates for the service levels under
7the department’s reimbursement methodology shall be as follows:
8(1) For service level, community - D1, the daily rate shall
9be at least $84.17.
10(2) For service level, comprehensive - D2, the daily rate
11shall be at least $119.09.
12(3) For service level, enhanced - D3, the daily rate shall
13be at least $131.09.
148. The group foster care reimbursement rates paid for
15placement of children out of state shall be calculated
16according to the same rate-setting principles as those used for
17in-state providers, unless the director of human services or
18the director’s designee determines that appropriate care cannot
19be provided within the state. The payment of the daily rate
20shall be based on the number of days in the calendar month in
21which service is provided.
229. a. For the fiscal year beginning July 1, 2017, the
23reimbursement rate paid for shelter care and the child welfare
24emergency services implemented to provide or prevent the need
25for shelter care shall be established by contract.
26b. For the fiscal year beginning July 1, 2017, the combined
27service and maintenance components of the reimbursement rate
28paid for shelter care services shall be based on the financial
29and statistical report submitted to the department. The
30maximum reimbursement rate shall be $101.83 per day. The
31department shall reimburse a shelter care provider at the
32provider’s actual and allowable unit cost, plus inflation, not
33to exceed the maximum reimbursement rate.
34c. Notwithstanding section 232.141, subsection 8, for the
35fiscal year beginning July 1, 2017, the amount of the statewide
-61-1average of the actual and allowable rates for reimbursement of
2juvenile shelter care homes that is utilized for the limitation
3on recovery of unpaid costs shall remain at the amount in
4effect for this purpose in the fiscal year beginning July 1,
52016.
610. For the fiscal year beginning July 1, 2017, the
7department shall calculate reimbursement rates for intermediate
8care facilities for persons with an intellectual disability
9at the 80th percentile. Beginning July 1, 2017, the rate
10calculation methodology shall utilize the consumer price index
11inflation factor applicable to the fiscal year beginning July
121, 2017.
1311. For the fiscal year beginning July 1, 2017, for child
14care providers reimbursed under the state child care assistance
15program, the department shall set provider reimbursement
16rates based on the rate reimbursement survey completed in
17December 2004. Effective July 1, 2017, the child care provider
18reimbursement rates shall remain at the rates in effect on June
1930, 2017. The department shall set rates in a manner so as
20to provide incentives for a nonregistered provider to become
21registered by applying the increase only to registered and
22licensed providers.
2312. For the fiscal year beginning July 1, 2017,
24notwithstanding any provision to the contrary under this
25section, affected providers or services shall be reimbursed as
26follows:
27a. For fee-for-service claims, a rate or reimbursement
28shall be calculated based on the methodology otherwise
29specified in this section for the fiscal year beginning July 1,
302017, for the respective provider or service.
31b. For claims subject to a managed care contract with
32the exception of any provider or service to which a rate or
33reimbursement increase is applicable for the fiscal year under
34this section, the rate or reimbursement shall be based on the
35methodology established by the managed care contract. However,
-62-1any rate or reimbursement established under such contract
2shall not be lower than the rate or reimbursement floor
3established by the department of human services as the managed
4care organization rate or reimbursement floor for a respective
5provider or service in effect on April 1, 2016.
613. Notwithstanding any provision to the contrary,
7reimbursement rates and methodologies under this section may
8be adjusted as necessary to implement the cost containment
9strategies authorized for the medical assistance program in
10this 2017 Act.
1114. The department may adopt emergency rules to implement
12this section.
13 Sec. 32. EMERGENCY RULES.
141. If specifically authorized by a provision of this
15division of this Act, the department of human services or
16the mental health and disability services commission may
17adopt administrative rules under section 17A.4, subsection
183, and section 17A.5, subsection 2, paragraph “b”, to
19implement the provisions of this division of this Act and
20the rules shall become effective immediately upon filing or
21on a later effective date specified in the rules, unless the
22effective date of the rules is delayed or the applicability
23of the rules is suspended by the administrative rules review
24committee. Any rules adopted in accordance with this section
25shall not take effect before the rules are reviewed by the
26administrative rules review committee. The delay authority
27provided to the administrative rules review committee under
28section 17A.4, subsection 7, and section 17A.8, subsection 9,
29shall be applicable to a delay imposed under this section,
30notwithstanding a provision in those sections making them
31inapplicable to section 17A.5, subsection 2, paragraph “b”.
32Any rules adopted in accordance with the provisions of this
33section shall also be published as a notice of intended action
34as provided in section 17A.4.
352. If during a fiscal year, the department of human
-63-1services is adopting rules in accordance with this section
2or as otherwise directed or authorized by state law, and the
3rules will result in an expenditure increase beyond the amount
4anticipated in the budget process or if the expenditure was
5not addressed in the budget process for the fiscal year, the
6department shall notify the persons designated by this division
7of this Act for submission of reports, the chairpersons and
8ranking members of the committees on appropriations, and
9the department of management concerning the rules and the
10expenditure increase. The notification shall be provided at
11least 30 calendar days prior to the date notice of the rules
12is submitted to the administrative rules coordinator and the
13administrative code editor.
14 Sec. 33. REPORTS. Any reports or other information
15required to be compiled and submitted under this Act during the
16fiscal year beginning July 1, 2017, shall be submitted to the
17chairpersons and ranking members of the joint appropriations
18subcommittee on health and human services, the legislative
19services agency, and the legislative caucus staffs on or
20before the dates specified for submission of the reports or
21information.
22 Sec. 34. TRANSFER OF MEDICAID MODERNIZATION SAVINGS BETWEEN
23APPROPRIATIONS FY 2017-2018. Notwithstanding section 8.39,
24subsection 1, for the fiscal year beginning July 1, 2017, if
25savings resulting from the governor’s Medicaid modernization
26initiative accrue to the medical contracts or children’s health
27insurance program appropriation from the general fund of the
28state and not to the medical assistance appropriation from the
29general fund of the state under this division of this Act,
30such savings may be transferred to such medical assistance
31appropriation for the same fiscal year without prior written
32consent and approval of the governor and the director of the
33department of management. The department of human services
34shall report any transfers made pursuant to this section to the
35legislative services agency.
-64-1DIVISION VI
2HEALTH CARE ACCOUNTS AND FUNDS — FY 2017-2018
3 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
4appropriated from the pharmaceutical settlement account created
5in section 249A.33 to the department of human services for the
6fiscal year beginning July 1, 2017, and ending June 30, 2018,
7the following amount, or so much thereof as is necessary, to be
8used for the purpose designated:
9Notwithstanding any provision of law to the contrary, to
10supplement the appropriations made in this Act for medical
11contracts under the medical assistance program for the fiscal
12year beginning July 1, 2017, and ending June 30, 2018:
.................................................. $13800,000
14 Sec. 36. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
15SERVICES. Notwithstanding any provision to the contrary and
16subject to the availability of funds, there is appropriated
17from the quality assurance trust fund created in section
18249L.4 to the department of human services for the fiscal year
19beginning July 1, 2017, and ending June 30, 2018, the following
20amounts, or so much thereof as is necessary, for the purposes
21designated:
22To supplement the appropriation made in this Act from the
23general fund of the state to the department of human services
24for medical assistance for the same fiscal year:
.................................................. $2536,705,208
26 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
27DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
28the contrary and subject to the availability of funds, there is
29appropriated from the hospital health care access trust fund
30created in section 249M.4 to the department of human services
31for the fiscal year beginning July 1, 2017, and ending June
3230, 2018, the following amounts, or so much thereof as is
33necessary, for the purposes designated:
34To supplement the appropriation made in this Act from the
35general fund of the state to the department of human services
-65-1for medical assistance for the same fiscal year:
.................................................. $233,920,554
3 Sec. 38. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
4FOR FY 2017-2018. Notwithstanding section 8.33, if moneys
5appropriated for purposes of the medical assistance program for
6the fiscal year beginning July 1, 2017, and ending June 30,
72018, from the general fund of the state, the quality assurance
8trust fund and the hospital health care access trust fund, are
9in excess of actual expenditures for the medical assistance
10program and remain unencumbered or unobligated at the close
11of the fiscal year, the excess moneys shall not revert but
12shall remain available for expenditure for the purposes of the
13medical assistance program until the close of the succeeding
14fiscal year.
15DIVISION VII
16DEPARTMENT ON AGING — FY 2018-2019
17 Sec. 39. DEPARTMENT ON AGING. There is appropriated from
18the general fund of the state to the department on aging for
19the fiscal year beginning July 1, 2018, and ending June 30,
202019, the following amount, or so much thereof as is necessary,
21to be used for the purposes designated:
22For aging programs for the department on aging and area
23agencies on aging to provide citizens of Iowa who are 60 years
24of age and older with case management for frail elders, Iowa’s
25aging and disabilities resource center, and other services
26which may include but are not limited to adult day services,
27respite care, chore services, information and assistance,
28and material aid, for information and options counseling for
29persons with disabilities who are 18 years of age or older,
30and for salaries, support, administration, maintenance, and
31miscellaneous purposes, and for not more than the following
32full-time equivalent positions:
.................................................. $335,521,238
............................................... FTEs3427.00
351. Funds appropriated in this section may be used to
-66-1supplement federal funds under federal regulations. To
2receive funds appropriated in this section, a local area
3agency on aging shall match the funds with moneys from other
4sources according to rules adopted by the department. Funds
5appropriated in this section may be used for elderly services
6not specifically enumerated in this section only if approved
7by an area agency on aging for provision of the service within
8the area.
92. Of the funds appropriated in this section, $139,973 is
10transferred to the economic development authority for the Iowa
11commission on volunteer services to be used for the retired and
12senior volunteer program.
133. a. The department on aging shall establish and enforce
14procedures relating to expenditure of state and federal funds
15by area agencies on aging that require compliance with both
16state and federal laws, rules, and regulations, including but
17not limited to all of the following:
18(1) Requiring that expenditures are incurred only for goods
19or services received or performed prior to the end of the
20fiscal period designated for use of the funds.
21(2) Prohibiting prepayment for goods or services not
22received or performed prior to the end of the fiscal period
23designated for use of the funds.
24(3) Prohibiting the prepayment for goods or services
25not defined specifically by good or service, time period, or
26recipient.
27(4) Prohibiting the establishment of accounts from which
28future goods or services which are not defined specifically by
29good or service, time period, or recipient, may be purchased.
30b. The procedures shall provide that if any funds are
31expended in a manner that is not in compliance with the
32procedures and applicable federal and state laws, rules, and
33regulations, and are subsequently subject to repayment, the
34area agency on aging expending such funds in contravention of
35such procedures, laws, rules and regulations, not the state,
-67-1shall be liable for such repayment.
24. Of the funds appropriated in this section, at least
3$125,000 shall be used to fund the unmet needs identified
4through Iowa’s aging and disability resource center network.
55. Of the funds appropriated in this section, at least
6$300,000 shall be used to fund home and community-based
7services through the area agencies on aging that enable older
8individuals to avoid more costly utilization of residential or
9institutional services and remain in their own homes.
106. Of the funds appropriated in this section, $406,268
11shall be used for the purposes of chapter 231E and section
12231.56A, of which $175,000 shall be used for the office of
13substitute decision maker pursuant to chapter 231E, and the
14remainder shall be distributed equally to the area agencies on
15aging to administer the prevention of elder abuse, neglect, and
16exploitation program pursuant to section 231.56A, in accordance
17with the requirements of the federal Older Americans Act of
181965, 42 U.S.C. §3001 et seq., as amended.
197. Of the funds appropriated in this section, $375,000
20shall be used to fund continuation of the aging and disability
21resource center lifelong links to provide individuals and
22caregivers with information and services to plan for and
23maintain independence.
248. Notwithstanding section 8.39, for the fiscal year
25beginning July 1, 2018, the department may transfer funds
26within or between the allocations made in this division of this
27Act for the same fiscal year in accordance with departmental
28priorities. The department shall report any such transfers
29to the individuals specified in this Act for submission of
30reports. This subsection shall not be construed to prohibit
31the use of existing state transfer authority for other
32purposes.
33DIVISION VIII
34OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2018-2019
35 Sec. 40. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
-68-1appropriated from the general fund of the state to the office
2of long-term care ombudsman for the fiscal year beginning July
31, 2018, and ending June 30, 2019, the following amount, or
4so much thereof as is necessary, to be used for the purposes
5designated:
6For salaries, support, administration, maintenance, and
7miscellaneous purposes, and for not more than the following
8full-time equivalent positions:
.................................................. $9580,140
............................................... FTEs1016.00
11DIVISION IX
12DEPARTMENT OF PUBLIC HEALTH — FY 2018-2019
13 Sec. 41. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
14from the general fund of the state to the department of public
15health for the fiscal year beginning July 1, 2018, and ending
16June 30, 2019, the following amounts, or so much thereof as is
17necessary, to be used for the purposes designated:
181. ADDICTIVE DISORDERS
19For reducing the prevalence of the use of tobacco, alcohol,
20and other drugs, and treating individuals affected by addictive
21behaviors, including gambling, and for not more than the
22following full-time equivalent positions:
.................................................. $2312,492,915
............................................... FTEs2410.00
25a. (1) Of the funds appropriated in this subsection,
26$2,010,612 shall be used for the tobacco use prevention
27and control initiative, including efforts at the state and
28local levels, as provided in chapter 142A. The commission
29on tobacco use prevention and control established pursuant
30to section 142A.3 shall advise the director of public health
31in prioritizing funding needs and the allocation of moneys
32appropriated for the programs and initiatives. Activities
33of the programs and initiatives shall be in alignment with
34the United States centers for disease control and prevention
35best practices for comprehensive tobacco control programs that
-69-1include the goals of preventing youth initiation of tobacco
2usage, reducing exposure to secondhand smoke, and promotion
3of tobacco cessation. To maximize resources, the department
4shall determine if third-party sources are available to
5instead provide nicotine replacement products to an applicant
6prior to provision of such products to an applicant under
7the initiative. The department shall track and report to
8the individuals specified in this Act, any reduction in
9the provision of nicotine replacement products realized by
10the initiative through implementation of the prerequisite
11screening.
12(2) (a) The department shall collaborate with the
13alcoholic beverages division of the department of commerce for
14enforcement of tobacco laws, regulations, and ordinances and to
15engage in tobacco control activities approved by the division
16of tobacco use prevention and control of the department of
17public health as specified in the memorandum of understanding
18entered into between the divisions.
19(b) For the fiscal year beginning July 1, 2018, and ending
20June 30, 2019, the terms of the memorandum of understanding,
21entered into between the division of tobacco use prevention
22and control of the department of public health and the
23alcoholic beverages division of the department of commerce,
24governing compliance checks conducted to ensure licensed retail
25tobacco outlet conformity with tobacco laws, regulations, and
26ordinances relating to persons under 18 years of age, shall
27continue to restrict the number of such checks to one check per
28retail outlet, and one additional check for any retail outlet
29found to be in violation during the first check.
30b. Of the funds appropriated in this subsection,
31$10,482,303 shall be used for problem gambling and
32substance-related disorder prevention, treatment, and recovery
33services, including a 24-hour helpline, public information
34resources, professional training, youth prevention, and program
35evaluation.
-70- 1c. The requirement of section 123.17, subsection 5, is met
2by the appropriations and allocations made in this division of
3this Act for purposes of substance-related disorder treatment
4and addictive disorders for the fiscal year beginning July 1,
52018.
62. HEALTHY CHILDREN AND FAMILIES
7For promoting the optimum health status for children,
8adolescents from birth through 21 years of age, and families,
9and for not more than the following full-time equivalent
10positions:
.................................................. $112,662,816
............................................... FTEs1212.00
13a. Of the funds appropriated in this subsection, not more
14than $367,420 shall be used for the healthy opportunities for
15parents to experience success (HOPES)-healthy families Iowa
16(HFI) program established pursuant to section 135.106. The
17funding shall be distributed to renew the grants that were
18provided to the grantees that operated the program during the
19fiscal year ending June 30, 2018.
20b. In order to implement the legislative intent stated in
21sections 135.106 and 256I.9, that priority for home visitation
22program funding be given to programs using evidence-based or
23promising models for home visitation, it is the intent of the
24general assembly to phase in the funding priority in accordance
25with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
26paragraph “0b”.
27c. Of the funds appropriated in this subsection, $1,537,550
28shall be used for continuation of the department’s initiative
29to provide for adequate developmental surveillance and
30screening during a child’s first five years. The funds shall
31be used first to fully fund the current sites to ensure that
32the sites are fully operational, with the remaining funds
33to be used for expansion to additional sites. The full
34implementation and expansion shall include enhancing the scope
35of the program through collaboration with the child health
-71-1specialty clinics to promote healthy child development through
2early identification and response to both biomedical and social
3determinants of healthy development; by monitoring child
4health metrics to inform practice, document long-term health
5impacts and savings, and provide for continuous improvement
6through training, education, and evaluation; and by providing
7for practitioner consultation particularly for children with
8behavioral conditions and needs. The department of public
9health shall also collaborate with the Iowa Medicaid enterprise
10and the child health specialty clinics to integrate the
11activities of the first five initiative into the establishment
12of patient-centered medical homes, community utilities,
13accountable care organizations, and other integrated care
14models developed to improve health quality and population
15health while reducing health care costs. To the maximum extent
16possible, funding allocated in this paragraph shall be utilized
17as matching funds for medical assistance program reimbursement.
18d. Of the funds appropriated in this subsection, $32,320
19shall be distributed to a statewide dental carrier to provide
20funds to continue the donated dental services program patterned
21after the projects developed by the lifeline network to provide
22dental services to indigent individuals who are elderly or with
23disabilities.
24e. Of the funds appropriated in this subsection, $78,241
25shall be used to provide audiological services and hearing
26aids for children. The department may enter into a contract
27to administer this paragraph.
28f. Of the funds appropriated in this subsection, $11,500 is
29transferred to the university of Iowa college of dentistry for
30provision of primary dental services to children. State funds
31shall be matched on a dollar-for-dollar basis. The university
32of Iowa college of dentistry shall coordinate efforts with the
33department of public health, bureau of oral and health delivery
34systems, to provide dental care to underserved populations
35throughout the state.
-72- 1g. Of the funds appropriated in this subsection, $25,000
2shall be used to address youth suicide prevention.
3h. Of the funds appropriated in this subsection, $20,255
4shall be used to support the Iowa effort to address the survey
5of children who experience adverse childhood experiences known
6as ACEs.
7i. The department of public health shall continue to
8administer the program to assist parents in this state with
9costs resulting from the death of a child in accordance with
10the provisions of 2014 Iowa Acts, chapter 1140, section 22,
11subsection 12.
123. CHRONIC CONDITIONS
13For serving individuals identified as having chronic
14conditions or special health care needs, and for not more than
15the following full-time equivalent positions:
.................................................. $162,085,375
............................................... FTEs175.00
18a. Of the funds appropriated in this subsection, $76,877
19shall be used for grants to individual patients who have an
20inherited metabolic disorder to assist with the costs of
21medically necessary foods and formula.
22b. Of the funds appropriated in this subsection, $510,397
23shall be used for the brain injury services program pursuant
24to section 135.22B, including for contracting with an existing
25nationally affiliated and statewide organization whose purpose
26is to educate, serve, and support Iowans with brain injury and
27their families for resource facilitator services in accordance
28with section 135.22B, subsection 9, and for contracting to
29enhance brain injury training and recruitment of service
30providers on a statewide basis. Of the amount allocated in
31this paragraph, $47,500 shall be used to fund one full-time
32equivalent position to serve as the state brain injury services
33program manager.
34c. Of the funds appropriated in this subsection, $72,048
35shall be used for the public purpose of continuing to contract
-73-1with an existing national-affiliated organization to provide
2education, client-centered programs, and client and family
3support for people living with epilepsy and their families.
4The amount allocated in this paragraph in excess of $50,000
5shall be matched dollar-for-dollar by the organization
6specified.
7d. Of the funds appropriated in this subsection, $404,775
8shall be used for child health specialty clinics.
9e. Of the funds appropriated in this subsection, $192,276
10shall be used by the regional autism assistance program
11established pursuant to section 256.35, and administered by
12the child health specialty clinic located at the university of
13Iowa hospitals and clinics. The funds shall be used to enhance
14interagency collaboration and coordination of educational,
15medical, and other human services for persons with autism,
16their families, and providers of services, including delivering
17regionalized services of care coordination, family navigation,
18and integration of services through the statewide system of
19regional child health specialty clinics and fulfilling other
20requirements as specified in chapter 225D. The university of
21Iowa shall not receive funds allocated under this paragraph for
22indirect costs associated with the regional autism assistance
23program.
24f. Of the funds appropriated in this subsection, $288,687
25shall be used for the comprehensive cancer control program to
26reduce the burden of cancer in Iowa through prevention, early
27detection, effective treatment, and ensuring quality of life.
28Of the funds allocated in this paragraph “f”, $75,000 shall
29be used to support a melanoma research symposium, a melanoma
30biorepository and registry, basic and translational melanoma
31research, and clinical trials.
32g. Of the funds appropriated in this subsection, $48,766
33shall be used for cervical and colon cancer screening, and
34$88,860 shall be used to enhance the capacity of the cervical
35cancer screening program to include provision of recommended
-74-1prevention and early detection measures to a broader range of
2low-income women.
3h. Of the funds appropriated in this subsection, $253,177
4shall be used for the center for congenital and inherited
5disorders.
6i. Of the funds appropriated in this subsection,
7$107,631 shall be used by the department of public health
8for reform-related activities, including but not limited to
9facilitation of communication to stakeholders at the state and
10local level, administering the patient-centered health advisory
11council pursuant to section 135.159, and involvement in health
12care system innovation activities occurring across the state.
13j. Of the funds appropriated in this subsection, $11,050
14shall be used for administration of chapter 124D, the medical
15cannabidiol Act.
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:
.................................................. $201,403,888
............................................... FTEs2113.00
22a. Of the funds appropriated in this subsection, $47,787
23is allocated for continuation of the child vision screening
24program implemented through the university of Iowa hospitals
25and clinics in collaboration with early childhood Iowa areas.
26The program shall submit a report to the individuals identified
27in this Act for submission of reports regarding the use of
28funds allocated under this paragraph “a”. The report shall
29include the objectives and results for the program year
30including the target population and how the funds allocated
31assisted the program in meeting the objectives; the number,
32age, and location within the state of individuals served;
33the type of services provided to the individuals served; the
34distribution of funds based on service provided; and the
35continuing needs of the program.
-75- 1b. Of the funds appropriated in this subsection, $52,828 is
2allocated for continuation of an initiative implemented at the
3university of Iowa to expand and improve the workforce engaged
4in mental health treatment and services. The initiative shall
5receive input from the university of Iowa, the department of
6human services, the department of public health, and the mental
7health and disability services commission to address the focus
8of the initiative.
9c. Of the funds appropriated in this section, $41,657 shall
10be deposited in the governmental public health system fund
11created in section 135A.8 to be used for the purposes of the
12fund.
13d. Of the funds appropriated in this subsection,
14$24,034 shall be used for a grant to a statewide association
15of psychologists that is affiliated with the American
16psychological association to be used for continuation of a
17program to rotate intern psychologists in placements in urban
18and rural mental health professional shortage areas, as defined
19in section 135.180.
20e. Of the funds appropriated in this subsection, the
21following amounts are allocated to be used as follows to
22support the Iowa collaborative safety net provider network
23goals of increased access, health system integration, and
24engagement.
25(1) Not less than $260,931 is allocated to the Iowa
26prescription drug corporation for continuation of the
27pharmaceutical infrastructure for safety net providers as
28described in 2007 Iowa Acts, chapter 218, section 108, and for
29the prescription drug donation repository program created in
30chapter 135M.
31(2) Not less than $167,435 is allocated to free clinics and
32free clinics of Iowa for necessary infrastructure, statewide
33coordination, provider recruitment, service delivery, and
34provision of assistance to patients in securing a medical home
35inclusive of oral health care.
-76- 1(3) Not less than $12,500 is allocated to the Iowa
2association of rural health clinics for necessary
3infrastructure and service delivery transformation.
4f. Of the funds appropriated in this subsection, $81,700
5shall be used for continuation of the work of the direct care
6worker advisory council established pursuant to 2008 Iowa Acts,
7chapter 1188, section 69, in implementing the recommendations
8in the final report submitted by the advisory council to the
9governor and the general assembly in March 2012, including
10by continuing to develop, promote, and make available on a
11statewide basis the prepare-to-care core curriculum and its
12associated modules and specialties through various formats
13including online access, community colleges, and other venues;
14exploring new and maintaining existing specialties including
15but not limited to oral health and dementia care; supporting
16instructor training; and assessing and making recommendations
17concerning the Iowa care book and information technology
18systems and infrastructure uses and needs.
19g. Of the funds appropriated in this subsection, $52,009
20shall be allocated for continuation of the contract with
21an independent statewide direct care worker organization
22previously selected through a request for proposals process.
23The contract shall continue to include performance and outcomes
24measures, and shall continue to allow the contractor to use a
25portion of the funds received under the contract to collect
26data to determine results based on the performance and outcomes
27measures.
28h. Of the funds appropriated in this subsection, the
29department may use up to $29,087 for up to one full-time
30equivalent position to administer the volunteer health care
31provider program pursuant to section 135.24.
32i. Of the funds appropriated in this subsection, $48,069
33shall be used for a matching dental education loan repayment
34program to be allocated to a dental nonprofit health service
35corporation to continue to develop the criteria and implement
-77-1the loan repayment program.
2j. Of the funds appropriated in this subsection, $26,455 is
3transferred to the college student aid commission for deposit
4in the rural Iowa primary care trust fund created in section
5261.113 to be used for the purposes of the fund.
6k. Of the funds appropriated in this subsection, $75,000
7shall be used for the purposes of the Iowa donor registry as
8specified in section 142C.18.
9l. Of the funds appropriated in this subsection, $48,069
10shall be used for continuation of a grant to a nationally
11affiliated volunteer eye organization that has an established
12program for children and adults and that is solely dedicated to
13preserving sight and preventing blindness through education,
14nationally certified vision screening and training, and
15community and patient service programs. The organization
16shall submit a report to the individuals identified in this
17Act for submission of reports regarding the use of funds
18allocated under this paragraph “l”. The report shall include
19the objectives and results for the program year including
20the target population and how the funds allocated assisted
21the program in meeting the objectives; the number, age, and
22location within the state of individuals served; the type of
23services provided to the individuals served; the distribution
24of funds based on services provided; and the continuing needs
25of the program.
26m. Of the funds appropriated in this subsection, $436,327
27shall be deposited in the medical residency training account
28created in section 135.175, subsection 5, paragraph “a”, and
29is appropriated from the account to the department of public
30health to be used for the purposes of the medical residency
31training state matching grants program as specified in section
32135.176.
335. ESSENTIAL PUBLIC HEALTH SERVICES
34To provide public health services that reduce risks and
35invest in promoting and protecting good health over the
-78-1course of a lifetime with a priority given to older Iowans and
2vulnerable populations:
.................................................. $34,098,939
46. INFECTIOUS DISEASES
5For reducing the incidence and prevalence of communicable
6diseases, and for not more than the following full-time
7equivalent positions:
.................................................. $8823,213
............................................... FTEs94.00
107. PUBLIC PROTECTION
11For protecting the health and safety of the public through
12establishing standards and enforcing regulations, and for not
13more than the following full-time equivalent positions:
.................................................. $142,097,569
............................................... FTEs15138.00
16a. Of the funds appropriated in this subsection, not more
17than $152,350 shall be credited to the emergency medical
18services fund created in section 135.25. Moneys in the
19emergency medical services fund are appropriated to the
20department to be used for the purposes of the fund.
21b. Of the funds appropriated in this subsection, up
22to $121,630 shall be used for sexual violence prevention
23programming through a statewide organization representing
24programs serving victims of sexual violence through the
25department’s sexual violence prevention program, and for
26continuation of a training program for sexual assault
27response team (SART) members, including representatives of
28law enforcement, victim advocates, prosecutors, and certified
29medical personnel. The amount allocated in this paragraph “b”
30shall not be used to supplant funding administered for other
31sexual violence prevention or victims assistance programs.
32c. Of the funds appropriated in this subsection, up to
33$287,813 shall be used for the state poison control center.
34Pursuant to the directive under 2014 Iowa Acts, chapter
351140, section 102, the federal matching funds available to
-79-1the state poison control center from the department of human
2services under the federal Children’s Health Insurance Program
3Reauthorization Act allotment shall be subject to the federal
4administrative cap rule of 10 percent applicable to funding
5provided under Tit.XXI of the federal Social Security Act and
6included within the department’s calculations of the cap.
7d. Of the funds appropriated in this subsection, up to
8$258,491 shall be used for childhood lead poisoning provisions.
98. RESOURCE MANAGEMENT
10For establishing and sustaining the overall ability of the
11department to deliver services to the public, and for not more
12than the following full-time equivalent positions:
.................................................. $13485,607
............................................... FTEs144.00
159. MISCELLANEOUS PROVISIONS
16The university of Iowa hospitals and clinics under the
17control of the state board of regents shall not receive
18indirect costs from the funds appropriated in this section.
19The university of Iowa hospitals and clinics billings to the
20department shall be on at least a quarterly basis.
2110. GENERAL REDUCTION
22For the period beginning July 1, 2018, and ending June 30,
232019, the department of public health, in consultation with
24the department of management, shall identify and implement a
25reduction in expenditures made from appropriations from the
26general fund of the state to the department of public health in
27the amount of $640,683.
2811. TRANSFERS
29Notwithstanding section 8.39, for the fiscal year beginning
30July 1, 2018, the department may transfer funds within or
31between any of the allocations or appropriations made in this
32division of this Act for the same fiscal year, to be used in
33accordance with departmental priorities as specified in the
34department’s report to the general assembly submitted pursuant
35to 2016 Iowa Acts, chapter 1139, section 3. The department
-80-1shall report any such transfers to the individuals specified
2in this Act for submission of reports. This subsection shall
3not be construed to prohibit the use of existing state transfer
4authority for other purposes.
5DIVISION X
6DEPARTMENT OF VETERANS AFFAIRS — FY 2018-2019
7 Sec. 42. DEPARTMENT OF VETERANS AFFAIRS. There is
8appropriated from the general fund of the state to the
9department of veterans affairs for the fiscal year beginning
10July 1, 2018, and ending June 30, 2019, the following amounts,
11or so much thereof as is necessary, to be used for the purposes
12designated:
131. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
14For salaries, support, maintenance, and miscellaneous
15purposes, and for not more than the following full-time
16equivalent positions:
.................................................. $17571,278
............................................... FTEs1815.00
192. IOWA VETERANS HOME
20For salaries, support, maintenance, and miscellaneous
21purposes:
.................................................. $223,614,070
23a. The Iowa veterans home billings involving the department
24of human services shall be submitted to the department on at
25least a monthly basis.
26b. Within available resources and in conformance with
27associated state and federal program eligibility requirements,
28the Iowa veterans home may implement measures to provide
29financial assistance to or on behalf of veterans or their
30spouses who are participating in the community reentry program.
31c. The Iowa veterans home expenditure report shall be
32submitted monthly to the legislative services agency.
33d. The Iowa veterans home shall continue to include in the
34annual discharge report applicant information and to provide
35for the collection of demographic information including but not
-81-1limited to the number of individuals applying for admission and
2admitted or denied admittance and the basis for the admission
3or denial; the age, gender, and race of such individuals;
4and the level of care for which such individuals applied for
5admission including residential or nursing level of care.
63. HOME OWNERSHIP ASSISTANCE PROGRAM
7For transfer to the Iowa finance authority for the
8continuation of the home ownership assistance program for
9persons who are or were eligible members of the armed forces of
10the United States, pursuant to section 16.54:
.................................................. $111,000,000
12 Sec. 43. LIMITATION OF COUNTY COMMISSIONS OF VETERAN
13AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the
14standing appropriation in section 35A.16 for the fiscal year
15beginning July 1, 2018, and ending June 30, 2019, the amount
16appropriated from the general fund of the state pursuant to
17that section for the following designated purposes shall not
18exceed the following amount:
19For the county commissions of veteran affairs fund under
20section 35A.16:
.................................................. $21473,962
22DIVISION XI
23DEPARTMENT OF HUMAN SERVICES — FY 2018-2019
24 Sec. 44. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
25GRANT. There is appropriated from the fund created in section
268.41 to the department of human services for the fiscal year
27beginning July 1, 2018, and ending June 30, 2019, from moneys
28received under the federal temporary assistance for needy
29families (TANF) block grant pursuant to the federal Personal
30Responsibility and Work Opportunity Reconciliation Act of 1996,
31Pub.L.No.104-193, and successor legislation, the following
32amounts, or so much thereof as is necessary, to be used for the
33purposes designated:
341. To be credited to the family investment program account
35and used for assistance under the family investment program
-82-1under chapter 239B:
.................................................. $22,556,231
32. To be credited to the family investment program account
4and used for the job opportunities and basic skills (JOBS)
5program and implementing family investment agreements in
6accordance with chapter 239B:
.................................................. $72,787,846
83. To be used for the family development and
9self-sufficiency grant program in accordance with section
10216A.107:
.................................................. $111,449,490
12Notwithstanding section 8.33, moneys appropriated in this
13subsection that remain unencumbered or unobligated at the close
14of the fiscal year shall not revert but shall remain available
15for expenditure for the purposes designated until the close of
16the succeeding fiscal year. However, unless such moneys are
17encumbered or obligated on or before September 30, 2018, the
18moneys shall revert.
194. For field operations:
.................................................. $2015,648,116
215. For general administration:
.................................................. $221,872,000
236. For state child care assistance:
.................................................. $2423,933,413
25a. Of the funds appropriated in this subsection,
26$13,164,048 is transferred to the child care and development
27block grant appropriation made by the Eighty-seventh General
28Assembly, 2018 session, for the federal fiscal year beginning
29October 1, 2018, and ending September 30, 2019. Of this
30amount, $100,000 shall be used for provision of educational
31opportunities to registered child care home providers in order
32to improve services and programs offered by this category
33of providers and to increase the number of providers. The
34department may contract with institutions of higher education
35or child care resource and referral centers to provide
-83-1the educational opportunities. Allowable administrative
2costs under the contracts shall not exceed 5 percent. The
3application for a grant shall not exceed two pages in length.
4b. Any funds appropriated in this subsection remaining
5unallocated shall be used for state child care assistance
6payments for families who are employed including but not
7limited to individuals enrolled in the family investment
8program.
97. For child and family services:
.................................................. $1016,190,327
118. For child abuse prevention grants:
.................................................. $1262,500
139. For pregnancy prevention grants on the condition that
14family planning services are funded:
.................................................. $15965,033
16Pregnancy prevention grants shall be awarded to programs
17in existence on or before July 1, 2018, if the programs have
18demonstrated positive outcomes. Grants shall be awarded to
19pregnancy prevention programs which are developed after July
201, 2018, if the programs are based on existing models that
21have demonstrated positive outcomes. Grants shall comply with
22the requirements provided in 1997 Iowa Acts, chapter 208,
23section 14, subsections 1 and 2, including the requirement that
24grant programs must emphasize sexual abstinence. Priority in
25the awarding of grants shall be given to programs that serve
26areas of the state which demonstrate the highest percentage of
27unplanned pregnancies of females of childbearing age within the
28geographic area to be served by the grant.
2910. For technology needs and other resources necessary
30to meet federal welfare reform reporting, tracking, and case
31management requirements:
.................................................. $32518,593
3311. a. Notwithstanding any provision to the contrary,
34including but not limited to requirements in section 8.41 or
35provisions in 2017 or 2018 Iowa Acts regarding the receipt and
-84-1appropriation of federal block grants, federal funds from the
2temporary assistance for needy families block grant received by
3the state and not otherwise appropriated in this section and
4remaining available for the fiscal year beginning July 1, 2018,
5are appropriated to the department of human services to the
6extent as may be necessary to be used in the following priority
7order: the family investment program, for state child care
8assistance program payments for families who are employed, and
9for the family investment program share of costs to develop and
10maintain a new, integrated eligibility determination system.
11The federal funds appropriated in this paragraph “a” shall be
12expended only after all other funds appropriated in subsection
131 for the assistance under the family investment program,
14in subsection 6 for child care assistance, or in subsection
1512 for the family investment program share of the costs to
16continue to develop and maintain a new, integrated eligibility
17determination system, as applicable, have been expended. For
18the purposes of this subsection, the funds appropriated in
19subsection 6, paragraph “a”, for transfer to the child care
20and development block grant appropriation are considered fully
21expended when the full amount has been transferred.
22b. The department shall, on a quarterly basis, advise the
23legislative services agency and department of management of
24the amount of funds appropriated in this subsection that was
25expended in the prior quarter.
2612. Of the amounts appropriated in this section, $6,481,004
27for the fiscal year beginning July 1, 2018, is transferred to
28the appropriation of the federal social services block grant
29made to the department of human services for that fiscal year.
3013. For continuation of the program providing categorical
31eligibility for the food assistance program as specified
32for the program in the section of this division of this Act
33relating to the family investment program account:
.................................................. $3412,500
3514. The department may transfer funds allocated in this
-85-1section to the appropriations made in this division of this Act
2for the same fiscal year for general administration and field
3operations for resources necessary to implement and operate the
4services referred to in this section and those funded in the
5appropriation made in this division of this Act for the same
6fiscal year for the family investment program from the general
7fund of the state.
815. With the exception of moneys allocated under this
9section for the family development and self-sufficiency grant
10program, to the extent moneys allocated in this section are
11deemed by the department not to be necessary to support the
12purposes for which they are allocated, such moneys may be
13credited to the family investment program account as specified
14under subsection 1 of this section and used for the purposes of
15assistance under the family investment program under chapter
16239B in the same fiscal year.
17 Sec. 45. FAMILY INVESTMENT PROGRAM ACCOUNT.
181. Moneys credited to the family investment program (FIP)
19account for the fiscal year beginning July 1, 2018, and
20ending June 30, 2019, shall be used to provide assistance in
21accordance with chapter 239B.
222. The department may use a portion of the moneys credited
23to the FIP account under this section as necessary for
24salaries, support, maintenance, and miscellaneous purposes.
253. The department may transfer funds allocated in
26subsection 4 to the appropriations made in this division of
27this Act for the same fiscal year for general administration
28and field operations for resources necessary to implement and
29operate the family investment program services referred to in
30this section and those funded in the appropriation made in this
31division of this Act for the same fiscal year for the family
32investment program from the general fund of the state.
334. Moneys appropriated in this division of this Act and
34credited to the FIP account for the fiscal year beginning July
351, 2018, and ending June 30, 2019, are allocated as follows:
-86- 1a. To be retained by the department of human services to
2be used for coordinating with the department of human rights
3to more effectively serve participants in FIP and other shared
4clients and to meet federal reporting requirements under the
5federal temporary assistance for needy families block grant:
.................................................. $610,000
7b. To the department of human rights for staffing,
8administration, and implementation of the family development
9and self-sufficiency grant program in accordance with section
10216A.107:
.................................................. $113,096,417
12(1) Of the funds allocated for the family development
13and self-sufficiency grant program in this paragraph “b”,
14not more than 5 percent of the funds shall be used for the
15administration of the grant program.
16(2) The department of human rights may continue to implement
17the family development and self-sufficiency grant program
18statewide during fiscal year 2018-2019.
19(3) The department of human rights may engage in activities
20to strengthen and improve family outcomes measures and
21data collection systems under the family development and
22self-sufficiency grant program.
23c. For the diversion subaccount of the FIP account:
.................................................. $24407,500
25A portion of the moneys allocated for the subaccount may
26be used for field operations, salaries, data management
27system development, and implementation costs and support
28deemed necessary by the director of human services in order to
29administer the FIP diversion program. To the extent moneys
30allocated in this paragraph “c” are deemed by the department
31not to be necessary to support diversion activities, such
32moneys may be used for other efforts intended to increase
33engagement by family investment program participants in work,
34education, or training activities, or for the purposes of
35assistance under the family investment program in accordance
-87-1with chapter 239B.
2d. For the food assistance employment and training program:
.................................................. $333,294
4(1) The department shall apply the federal supplemental
5nutrition assistance program (SNAP) employment and training
6state plan in order to maximize to the fullest extent permitted
7by federal law the use of the 50 percent federal reimbursement
8provisions for the claiming of allowable federal reimbursement
9funds from the United States department of agriculture
10pursuant to the federal SNAP employment and training program
11for providing education, employment, and training services
12for eligible food assistance program participants, including
13but not limited to related dependent care and transportation
14expenses.
15(2) The department shall continue the categorical federal
16food assistance program eligibility at 160 percent of the
17federal poverty level and continue to eliminate the asset test
18from eligibility requirements, consistent with federal food
19assistance program requirements. The department shall include
20as many food assistance households as is allowed by federal
21law. The eligibility provisions shall conform to all federal
22requirements including requirements addressing individuals who
23are incarcerated or otherwise ineligible.
24e. For the JOBS program:
.................................................. $256,761,645
265. Of the child support collections assigned under FIP,
27an amount equal to the federal share of support collections
28shall be credited to the child support recovery appropriation
29made in this division of this Act. Of the remainder of the
30assigned child support collections received by the child
31support recovery unit, a portion shall be credited to the FIP
32account, a portion may be used to increase recoveries, and a
33portion may be used to sustain cash flow in the child support
34payments account. If as a consequence of the appropriations
35and allocations made in this section the resulting amounts
-88-1are insufficient to sustain cash assistance payments and meet
2federal maintenance of effort requirements, the department
3shall seek supplemental funding. If child support collections
4assigned under FIP are greater than estimated or are otherwise
5determined not to be required for maintenance of effort, the
6state share of either amount may be transferred to or retained
7in the child support payments account.
86. The department may adopt emergency rules for the family
9investment, JOBS, food assistance, and medical assistance
10programs if necessary to comply with federal requirements.
11 Sec. 46. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
12is appropriated from the general fund of the state to the
13department of human services for the fiscal year beginning July
141, 2018, and ending June 30, 2019, the following amount, or
15so much thereof as is necessary, to be used for the purpose
16designated:
17To be credited to the family investment program (FIP)
18account and used for family investment program assistance under
19chapter 239B:
.................................................. $2021,502,240
211. Of the funds appropriated in this section, $3,973,798 is
22allocated for the JOBS program.
232. Of the funds appropriated in this section, $1,656,927 is
24allocated for the family development and self-sufficiency grant
25program.
263. Notwithstanding section 8.39, for the fiscal year
27beginning July 1, 2018, if necessary to meet federal
28maintenance of effort requirements or to transfer federal
29temporary assistance for needy families block grant funding
30to be used for purposes of the federal social services block
31grant or to meet cash flow needs resulting from delays in
32receiving federal funding or to implement, in accordance with
33this division of this Act, activities currently funded with
34juvenile court services, county, or community moneys and state
35moneys used in combination with such moneys; to comply with
-89-1federal requirements; or to maximize the use of federal funds,
2the department of human services may transfer funds within or
3between any of the appropriations made in this division of this
4Act and appropriations in law for the federal social services
5block grant to the department for the following purposes,
6provided that the combined amount of state and federal
7temporary assistance for needy families block grant funding
8for each appropriation remains the same before and after the
9transfer:
10a. For the family investment program.
11b. For child care assistance.
12c. For child and family services.
13d. For field operations.
14e. For general administration.
15This subsection shall not be construed to prohibit the use
16of existing state transfer authority for other purposes. The
17department shall report any transfers made pursuant to this
18subsection to the legislative services agency.
194. Of the funds appropriated in this section, $97,839 shall
20be used for continuation of a grant to an Iowa-based nonprofit
21organization with a history of providing tax preparation
22assistance to low-income Iowans in order to expand the usage of
23the earned income tax credit. The purpose of the grant is to
24supply this assistance to underserved areas of the state.
255. Of the funds appropriated in this section, $30,000 shall
26be used for the continuation of an unfunded pilot project, as
27defined in 441 IAC 100.1, relating to parental obligations,
28in which the child support recovery unit participates, to
29support the efforts of a nonprofit organization committed
30to strengthening the community through youth development,
31healthy living, and social responsibility headquartered in
32a county with a population over 350,000 according to the
33latest certified federal census. The funds allocated in this
34subsection shall be used by the recipient organization to
35develop a larger community effort, through public and private
-90-1partnerships, to support a broad-based multi-county fatherhood
2initiative that promotes payment of child support obligations,
3improved family relationships, and full-time employment.
46. The department may transfer funds appropriated in this
5section to the appropriations made in this division of this Act
6for general administration and field operations as necessary
7to administer this section and the overall family investment
8program.
9 Sec. 47. 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, 2018, and ending
12June 30, 2019, 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:
.................................................. $176,293,317
............................................... FTEs18459.00
191. The department shall expend up to $12,164, including
20federal financial participation, for the fiscal year beginning
21July 1, 2018, 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
-91-1cash 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.
44. With the exception of the funding amount specified, the
5requirements established under 2001 Iowa Acts, chapter 191,
6section 3, subsection 5, paragraph “c”, subparagraph (3), shall
7be applicable to parental obligation pilot projects for the
8fiscal year beginning July 1, 2018, and ending June 30, 2019.
9Notwithstanding 441 IAC 100.8, providing for termination of
10rules relating to the pilot projects, the rules shall remain
11in effect until June 30, 2019.
12 Sec. 48. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
13FY 2018-2019. Any funds remaining in the health care trust
14fund created in section 453A.35A for the fiscal year beginning
15July 1, 2018, and ending June 30, 2019, are appropriated to
16the department of human services to supplement the medical
17assistance program appropriations made in this division of this
18Act, for medical assistance reimbursement and associated costs,
19including program administration and costs associated with
20program implementation.
21 Sec. 49. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
222018-2019. Any funds remaining in the Medicaid fraud fund
23created in section 249A.50 for the fiscal year beginning
24July 1, 2018, and ending June 30, 2019, are appropriated to
25the department of human services to supplement the medical
26assistance appropriations made in this division of this Act,
27for medical assistance reimbursement and associated costs,
28including program administration and costs associated with
29program implementation.
30 Sec. 50. MEDICAL ASSISTANCE. There is appropriated from the
31general fund of the state to the department of human services
32for the fiscal year beginning July 1, 2018, and ending June 30,
332019, the following amount, or so much thereof as is necessary,
34to be used for the purpose designated:
35For medical assistance program reimbursement and associated
-92-1costs as specifically provided in the reimbursement
2methodologies in effect on June 30, 2018, except as otherwise
3expressly authorized by law, consistent with options under
4federal law and regulations, and contingent upon receipt of
5approval from the office of the governor of reimbursement for
6each abortion performed under the program:
.................................................. $7642,302,870
81. Iowans support reducing the number of abortions
9performed in our state. Funds appropriated under this section
10shall not be used for abortions, unless otherwise authorized
11under this section.
122. The provisions of this section relating to abortions
13shall also apply to the Iowa health and wellness plan created
14pursuant to chapter 249N.
153. The department shall utilize not more than $30,000 of
16the funds appropriated in this section to continue the AIDS/HIV
17health insurance premium payment program as established in 1992
18Iowa Acts, Second Extraordinary Session, chapter 1001, section
19409, subsection 6. Of the funds allocated in this subsection,
20not more than $2,500 may be expended for administrative
21purposes.
224. Of the funds appropriated in this Act to the department
23of public health for addictive disorders, $475,000 for
24the fiscal year beginning July 1, 2018, is transferred
25to the department of human services for an integrated
26substance-related disorder managed care system. The
27departments of human services and public health shall
28work together to maintain the level of mental health and
29substance-related disorder treatment services provided by the
30managed care contractors. Each department shall take the steps
31necessary to continue the federal waivers as necessary to
32maintain the level of services.
335. a. The department shall aggressively pursue options for
34providing medical assistance or other assistance to individuals
35with special needs who become ineligible to continue receiving
-93-1services under the early and periodic screening, diagnostic,
2and treatment program under the medical assistance program
3due to becoming 21 years of age who have been approved for
4additional assistance through the department’s exception to
5policy provisions, but who have health care needs in excess
6of the funding available through the exception to policy
7provisions.
8b. Of the funds appropriated in this section, $50,000
9shall be used for participation in one or more pilot projects
10operated by a private provider to allow the individual or
11individuals to receive service in the community in accordance
12with principles established in Olmstead v.L.C., 527 U.S.581
13(1999), for the purpose of providing medical assistance or
14other assistance to individuals with special needs who become
15ineligible to continue receiving services under the early and
16periodic screening, diagnostic, and treatment program under
17the medical assistance program due to becoming 21 years of
18age who have been approved for additional assistance through
19the department’s exception to policy provisions, but who have
20health care needs in excess of the funding available through
21the exception to the policy provisions.
226. Of the funds appropriated in this section, up to
23$1,525,041 may be transferred to the field operations or
24general administration appropriations in this division of this
25Act for operational costs associated with Part D of the federal
26Medicare Prescription Drug Improvement and Modernization Act
27of 2003, Pub.L.No.108-173.
287. Of the funds appropriated in this section, up to $221,050
29may be transferred to the appropriation in this division
30of this Act for medical contracts to be used for clinical
31assessment services and prior authorization of services.
328. A portion of the funds appropriated in this section
33may be transferred to the appropriations in this division of
34this Act for general administration, medical contracts, the
35children’s health insurance program, or field operations to be
-94-1used for the state match cost to comply with the payment error
2rate measurement (PERM) program for both the medical assistance
3and children’s health insurance programs as developed by the
4centers for Medicare and Medicaid services of the United States
5department of health and human services to comply with the
6federal Improper Payments Information Act of 2002, Pub.L.No.
7107-300.
89. The department shall continue to implement the
9recommendations of the assuring better child health and
10development initiative II (ABCDII) clinical panel to the
11Iowa early and periodic screening, diagnostic, and treatment
12services healthy mental development collaborative board
13regarding changes to billing procedures, codes, and eligible
14service providers.
1510. Of the funds appropriated in this section, a sufficient
16amount is allocated to supplement the incomes of residents of
17nursing facilities, intermediate care facilities for persons
18with mental illness, and intermediate care facilities for
19persons with an intellectual disability, with incomes of less
20than $50 in the amount necessary for the residents to receive a
21personal needs allowance of $50 per month pursuant to section
22249A.30A.
2311. a. Hospitals that meet the conditions specified
24in subparagraphs (1) and (2) shall either certify public
25expenditures or transfer to the medical assistance program
26an amount equal to provide the nonfederal share for a
27disproportionate share hospital payment in an amount up to the
28hospital-specific limit as approved in the Medicaid state plan.
29The hospitals that meet the conditions specified shall receive
30and retain 100 percent of the total disproportionate share
31hospital payment in an amount up to the hospital-specific limit
32as approved in the Medicaid state plan.
33(1) The hospital qualifies for disproportionate share and
34graduate medical education payments.
35(2) The hospital is an Iowa state-owned hospital with more
-95-1than 500 beds and eight or more distinct residency specialty
2or subspecialty programs recognized by the American college of
3graduate medical education.
4b. Distribution of the disproportionate share payments
5shall be made on a monthly basis. The total amount of
6disproportionate share payments including graduate medical
7education, enhanced disproportionate share, and Iowa
8state-owned teaching hospital payments shall not exceed the
9amount of the state’s allotment under Pub.L.No.102-234.
10In addition, the total amount of all disproportionate
11share payments shall not exceed the hospital-specific
12disproportionate share limits under Pub.L.No.103-66.
1312. One hundred percent of the nonfederal share of payments
14to area education agencies that are medical assistance
15providers for medical assistance-covered services provided to
16medical assistance-covered children, shall be made from the
17appropriation made in this section.
1813. A portion of the funds appropriated in this section
19may be transferred to the appropriation in this division of
20this Act for medical contracts to be used for administrative
21activities associated with the money follows the person
22demonstration project.
2314. Of the funds appropriated in this section, $174,505
24shall be used for the administration of the health insurance
25premium payment program, including salaries, support,
26maintenance, and miscellaneous purposes.
2715. a. The department may increase the amounts allocated
28for salaries, support, maintenance, and miscellaneous purposes
29associated with the medical assistance program, as necessary,
30to implement cost containment strategies. The department shall
31report any such increase to the legislative services agency and
32the department of management.
33b. If the savings to the medical assistance program from
34cost containment efforts exceed the cost for the fiscal
35year beginning July 1, 2018, the department may transfer any
-96-1savings generated for the fiscal year due to medical assistance
2program cost containment efforts to the appropriation
3made in this division of this Act for medical contracts or
4general administration to defray the increased contract costs
5associated with implementing such efforts.
616. For the fiscal year beginning July 1, 2018, and ending
7June 30, 2019, the replacement generation tax revenues required
8to be deposited in the property tax relief fund pursuant to
9section 437A.8, subsection 4, paragraph “d”, and section
10437A.15, subsection 3, paragraph “f”, shall instead be credited
11to and supplement the appropriation made in this section and
12used for the allocations made in this section.
1317. a. Of the funds appropriated in this section, up
14to $25,000 may be transferred by the department to the
15appropriation made in this division of this Act to the
16department for the same fiscal year for general administration
17to be used for associated administrative expenses and for not
18more than one full-time equivalent position, in addition to
19those authorized for the same fiscal year, to be assigned to
20implementing the children’s mental health home project.
21b. Of the funds appropriated in this section, up to $200,000
22may be transferred by the department to the appropriation made
23to the department in this division of this Act for the same
24fiscal year for Medicaid program-related general administration
25planning and implementation activities. The funds may be used
26for contracts or for personnel in addition to the amounts
27appropriated for and the positions authorized for general
28administration for the fiscal year.
29c. Of the funds appropriated in this section, up to
30$1,500,000 may be transferred by the department to the
31appropriations made in this division of this Act for the same
32fiscal year for general administration or medical contracts
33to be used to support the development and implementation of
34standardized assessment tools for persons with mental illness,
35an intellectual disability, a developmental disability, or a
-97-1brain injury.
218. Of the funds appropriated in this section, $75,000
3shall be used for lodging expenses associated with care
4provided at the university of Iowa hospitals and clinics for
5patients with cancer whose travel distance is 30 miles or more
6and whose income is at or below 200 percent of the federal
7poverty level as defined by the most recently revised poverty
8income guidelines published by the United States department of
9health and human services. The department of human services
10shall establish the maximum number of overnight stays and the
11maximum rate reimbursed for overnight lodging, which may be
12based on the state employee rate established by the department
13of administrative services. The funds allocated in this
14subsection shall not be used as nonfederal share matching
15funds.
1619. Of the funds appropriated in this section, up to
17$1,691,940 shall be used for administration of the state
18family planning services program as enacted in this 2017 Act,
19and of this amount the department may use to up $100,000 for
20administrative expenses.
2120. The department shall report the implementation of
22any cost containment strategies to the individuals specified
23in this division of this Act for submission of reports upon
24implementation.
2521. The department shall report the implementation of any
26process improvement changes and any related cost reductions
27to the individuals specified in this division of this Act for
28submission of reports upon implementation.
29 Sec. 51. MEDICAL CONTRACTS. There is appropriated from the
30general fund of the state to the department of human services
31for the fiscal year beginning July 1, 2018, and ending June 30,
322019, the following amount, or so much thereof as is necessary,
33to be used for the purpose designated:
34For medical contracts:
.................................................. $358,813,232
-98- 11. The department of inspections and appeals shall
2provide all state matching funds for survey and certification
3activities performed by the department of inspections
4and appeals. The department of human services is solely
5responsible for distributing the federal matching funds for
6such activities.
72. Of the funds appropriated in this section, $25,000 shall
8be used for continuation of home and community-based services
9waiver quality assurance programs, including the review and
10streamlining of processes and policies related to oversight and
11quality management to meet state and federal requirements.
123. Of the amount appropriated in this section, up to
13$100,000 may be transferred to the appropriation for general
14administration in this division of this Act to be used for
15additional full-time equivalent positions in the development of
16key health initiatives such as cost containment, development
17and oversight of managed care programs, and development of
18health strategies targeted toward improved quality and reduced
19costs in the Medicaid program.
204. Of the funds appropriated in this section, $500,000 shall
21be used for planning and development, in cooperation with the
22department of public health, of a phased-in program to provide
23a dental home for children.
245. Of the funds appropriated in this section, $475,000
25shall be credited to the autism support program fund created
26in section 225D.2 to be used for the autism support program
27created in chapter 225D, with the exception of the following
28amounts of this allocation which shall be used as follows:
29a. Of the funds allocated in this subsection, $125,000
30shall be deposited in the board-certified behavior analyst and
31board-certified assistant behavior analyst grants program fund
32created in section 135.181, to be used for the purposes of the
33fund.
34b. Of the funds allocated in this subsection, $12,500
35shall be used for the public purpose of continuation of a
-99-1grant to a child welfare services provider headquartered in a
2county with a population between 205,000 and 215,000 in the
3latest certified federal census that provides multiple services
4including but not limited to a psychiatric medical institution
5for children, shelter, residential treatment, after school
6programs, school-based programming, and an Asperger’s syndrome
7program, to be used for support services for children with
8autism spectrum disorder and their families.
9c. Of the funds allocated in this subsection, $12,500
10shall be used for the public purpose of continuing a grant to
11a hospital-based provider headquartered in a county with a
12population between 90,000 and 95,000 in the latest certified
13federal census that provides multiple services including
14but not limited to diagnostic, therapeutic, and behavioral
15services to individuals with autism spectrum disorder across
16one’s lifespan. The grant recipient shall utilize the funds
17to continue the pilot project to determine the necessary
18support services for children with autism spectrum disorder and
19their families to be included in the children’s disabilities
20services system. The grant recipient shall submit findings and
21recommendations based upon the results of the pilot project
22to the individuals specified in this division of this Act for
23submission of reports by December 31, 2018.
24 Sec. 52. STATE SUPPLEMENTARY ASSISTANCE.
251. There is appropriated from the general fund of the
26state to the department of human services for the fiscal year
27beginning July 1, 2018, and ending June 30, 2019, the following
28amount, or so much thereof as is necessary, to be used for the
29purpose designated:
30For the state supplementary assistance program:
.................................................. $315,186,329
322. The department shall increase the personal needs
33allowance for residents of residential care facilities by the
34same percentage and at the same time as federal supplemental
35security income and federal social security benefits are
-100-1increased due to a recognized increase in the cost of living.
2The department may adopt emergency rules to implement this
3subsection.
43. If during the fiscal year beginning July 1, 2018,
5the department projects that state supplementary assistance
6expenditures for a calendar year will not meet the federal
7pass-through requirement specified in Tit.XVI of the federal
8Social Security Act, section 1618, as codified in 42 U.S.C.
9§1382g, the department may take actions including but not
10limited to increasing the personal needs allowance for
11residential care facility residents and making programmatic
12adjustments or upward adjustments of the residential care
13facility or in-home health-related care reimbursement rates
14prescribed in this division of this Act to ensure that federal
15requirements are met. In addition, the department may make
16other programmatic and rate adjustments necessary to remain
17within the amount appropriated in this section while ensuring
18compliance with federal requirements. The department may adopt
19emergency rules to implement the provisions of this subsection.
20 Sec. 53. CHILDREN’S HEALTH INSURANCE PROGRAM.
211. There is appropriated from the general fund of the
22state to the department of human services for the fiscal year
23beginning July 1, 2018, and ending June 30, 2019, the following
24amount, or so much thereof as is necessary, to be used for the
25purpose designated:
26For maintenance of the healthy and well kids in Iowa (hawk-i)
27program pursuant to chapter 514I, including supplemental dental
28services, for receipt of federal financial participation under
29Tit.XXI of the federal Social Security Act, which creates the
30children’s health insurance program:
.................................................. $314,259,226
322. Of the funds appropriated in this section, $21,400 is
33allocated for continuation of the contract for outreach with
34the department of public health.
35 Sec. 54. CHILD CARE ASSISTANCE. There is appropriated
-101-1from the general fund of the state to the department of human
2services for the fiscal year beginning July 1, 2018, and ending
3June 30, 2019, the following amount, or so much thereof as is
4necessary, to be used for the purpose designated:
5For child care programs:
.................................................. $619,671,808
71. Of the funds appropriated in this section, $16,746,808
8shall be used for state child care assistance in accordance
9with section 237A.13.
102. Nothing in this section shall be construed or is
11intended as or shall imply a grant of entitlement for services
12to persons who are eligible for assistance due to an income
13level consistent with the waiting list requirements of section
14237A.13. Any state obligation to provide services pursuant to
15this section is limited to the extent of the funds appropriated
16in this section.
173. A list of the registered and licensed child care
18facilities operating in the area served by a child care
19resource and referral service shall be made available to the
20families receiving state child care assistance in that area.
214. Of the funds appropriated in this section, $2,925,000
22shall be credited to the early childhood programs grants
23account in the early childhood Iowa fund created in section
24256I.11. The moneys shall be distributed for funding of
25community-based early childhood programs targeted to children
26from birth through five years of age developed by early
27childhood Iowa areas in accordance with approved community
28plans as provided in section 256I.8.
295. The department may use any of the funds appropriated
30in this section as a match to obtain federal funds for use in
31expanding child care assistance and related programs. For
32the purpose of expenditures of state and federal child care
33funding, funds shall be considered obligated at the time
34expenditures are projected or are allocated to the department’s
35service areas. Projections shall be based on current and
-102-1projected caseload growth, current and projected provider
2rates, staffing requirements for eligibility determination
3and management of program requirements including data systems
4management, staffing requirements for administration of the
5program, contractual and grant obligations and any transfers
6to other state agencies, and obligations for decategorization
7or innovation projects.
86. A portion of the state match for the federal child care
9and development block grant shall be provided as necessary to
10meet federal matching funds requirements through the state
11general fund appropriation made for child development grants
12and other programs for at-risk children in section 279.51.
137. If a uniform reduction ordered by the governor under
14section 8.31 or other operation of law, transfer, or federal
15funding reduction reduces the appropriation made in this
16section for the fiscal year, the percentage reduction in the
17amount paid out to or on behalf of the families participating
18in the state child care assistance program shall be equal to or
19less than the percentage reduction made for any other purpose
20payable from the appropriation made in this section and the
21federal funding relating to it. The percentage reduction to
22the other allocations made in this section shall be the same as
23the uniform reduction ordered by the governor or the percentage
24change of the federal funding reduction, as applicable.
25If there is an unanticipated increase in federal funding
26provided for state child care assistance, the entire amount
27of the increase shall be used for state child care assistance
28payments. If the appropriations made for purposes of the
29state child care assistance program for the fiscal year are
30determined to be insufficient, it is the intent of the general
31assembly to appropriate sufficient funding for the fiscal year
32in order to avoid establishment of waiting list requirements.
338. Notwithstanding section 8.33, moneys advanced for
34purposes of the programs developed by early childhood Iowa
35areas, advanced for purposes of wraparound child care, or
-103-1received from the federal appropriations made for the purposes
2of this section that remain unencumbered or unobligated at the
3close of the fiscal year shall not revert to any fund but shall
4remain available for expenditure for the purposes designated
5until the close of the succeeding fiscal year.
6 Sec. 55. JUVENILE INSTITUTION. There is appropriated
7from the general fund of the state to the department of human
8services for the fiscal year beginning July 1, 2018, and ending
9June 30, 2019, the following amounts, or so much thereof as is
10necessary, to be used for the purposes designated:
111. For operation of the state training school at Eldora and
12for salaries, support, maintenance, and miscellaneous purposes,
13and for not more than the following full-time equivalent
14positions:
.................................................. $155,675,221
............................................... FTEs16189.00
17Of the funds appropriated in this subsection, $45,575 shall
18be used for distribution to licensed classroom teachers at this
19and other institutions under the control of the department of
20human services based upon the average student yearly enrollment
21at each institution as determined by the department.
222. A portion of the moneys appropriated in this section
23shall be used by the state training school at Eldora for
24grants for adolescent pregnancy prevention activities at the
25institution in the fiscal year beginning July 1, 2018.
26 Sec. 56. CHILD AND FAMILY SERVICES.
271. There is appropriated from the general fund of the
28state to the department of human services for the fiscal year
29beginning July 1, 2018, and ending June 30, 2019, the following
30amount, or so much thereof as is necessary, to be used for the
31purpose designated:
32For child and family services:
.................................................. $3343,664,687
342. The department may transfer funds appropriated in this
35section as necessary to pay the nonfederal costs of services
-104-1reimbursed under the medical assistance program, state child
2care assistance program, or the family investment program which
3are provided to children who would otherwise receive services
4paid under the appropriation in this section. The department
5may transfer funds appropriated in this section to the
6appropriations made in this division of this Act for general
7administration and for field operations for resources necessary
8to implement and operate the services funded in this section.
93. a. Of the funds appropriated in this section, up to
10$17,868,324 is allocated as the statewide expenditure target
11under section 232.143 for group foster care maintenance and
12services. If the department projects that such expenditures
13for the fiscal year will be less than the target amount
14allocated in this paragraph “a”, the department may reallocate
15the excess to provide additional funding for shelter care
16or the child welfare emergency services addressed with the
17allocation for shelter care.
18b. If at any time after September 30, 2018, annualization
19of a service area’s current expenditures indicates a service
20area is at risk of exceeding its group foster care expenditure
21target under section 232.143 by more than 5 percent, the
22department and juvenile court services shall examine all
23group foster care placements in that service area in order to
24identify those which might be appropriate for termination.
25In addition, any aftercare services believed to be needed
26for the children whose placements may be terminated shall be
27identified. The department and juvenile court services shall
28initiate action to set dispositional review hearings for the
29placements identified. In such a dispositional review hearing,
30the juvenile court shall determine whether needed aftercare
31services are available and whether termination of the placement
32is in the best interest of the child and the community.
334. In accordance with the provisions of section 232.188,
34the department shall continue the child welfare and juvenile
35justice funding initiative during fiscal year 2018-2019. Of
-105-1the funds appropriated in this section, $858,876 is allocated
2specifically for expenditure for fiscal year 2018-2019 through
3the decategorization services funding pools and governance
4boards established pursuant to section 232.188.
55. A portion of the funds appropriated in this section
6may be used for emergency family assistance to provide other
7resources required for a family participating in a family
8preservation or reunification project or successor project to
9stay together or to be reunified.
106. Notwithstanding section 234.35 or any other provision
11of law to the contrary, state funding for shelter care and
12the child welfare emergency services contracting implemented
13to provide for or prevent the need for shelter care shall be
14limited to $4,048,079.
157. Federal funds received by the state during the fiscal
16year beginning July 1, 2018, as the result of the expenditure
17of state funds appropriated during a previous state fiscal
18year for a service or activity funded under this section are
19appropriated to the department to be used as additional funding
20for services and purposes provided for under this section.
21Notwithstanding section 8.33, moneys received in accordance
22with this subsection that remain unencumbered or unobligated at
23the close of the fiscal year shall not revert to any fund but
24shall remain available for the purposes designated until the
25close of the succeeding fiscal year.
268. a. Of the funds appropriated in this section, up to
27$1,645,000 is allocated for the payment of the expenses of
28court-ordered services provided to juveniles who are under
29the supervision of juvenile court services, which expenses
30are a charge upon the state pursuant to section 232.141,
31subsection 4. Of the amount allocated in this paragraph “a”,
32up to $778,143 shall be made available to provide school-based
33supervision of children adjudicated under chapter 232, of which
34not more than $7,500 may be used for the purpose of training.
35A portion of the cost of each school-based liaison officer
-106-1shall be paid by the school district or other funding source as
2approved by the chief juvenile court officer.
3b. Of the funds appropriated in this section, up to $374,492
4is allocated for the payment of the expenses of court-ordered
5services provided to children who are under the supervision
6of the department, which expenses are a charge upon the state
7pursuant to section 232.141, subsection 4.
8c. Notwithstanding section 232.141 or any other provision
9of law to the contrary, the amounts allocated in this
10subsection shall be distributed to the judicial districts
11as determined by the state court administrator and to the
12department’s service areas as determined by the administrator
13of the department of human services’ division of child and
14family services. The state court administrator and the
15division administrator shall make the determination of the
16distribution amounts on or before June 15, 2018.
17d. Notwithstanding chapter 232 or any other provision of
18law to the contrary, a district or juvenile court shall not
19order any service which is a charge upon the state pursuant
20to section 232.141 if there are insufficient court-ordered
21services funds available in the district court or departmental
22service area distribution amounts to pay for the service. The
23chief juvenile court officer and the departmental service area
24manager shall encourage use of the funds allocated in this
25subsection such that there are sufficient funds to pay for
26all court-related services during the entire year. The chief
27juvenile court officers and departmental service area managers
28shall attempt to anticipate potential surpluses and shortfalls
29in the distribution amounts and shall cooperatively request the
30state court administrator or division administrator to transfer
31funds between the judicial districts’ or departmental service
32areas’ distribution amounts as prudent.
33e. Notwithstanding any provision of law to the contrary,
34a district or juvenile court shall not order a county to pay
35for any service provided to a juvenile pursuant to an order
-107-1entered under chapter 232 which is a charge upon the state
2under section 232.141, subsection 4.
3f. Of the funds allocated in this subsection, not more than
4$41,500 may be used by the judicial branch for administration
5of the requirements under this subsection.
6g. Of the funds allocated in this subsection, $8,500
7shall be used by the department of human services to support
8the interstate commission for juveniles in accordance with
9the interstate compact for juveniles as provided in section
10232.173.
119. Of the funds appropriated in this section, $6,126,613 is
12allocated for juvenile delinquent graduated sanctions services.
13Any state funds saved as a result of efforts by juvenile court
14services to earn a federal Tit.IV-E match for juvenile court
15services administration may be used for the juvenile delinquent
16graduated sanctions services.
1710. Of the funds appropriated in this section, $829,142 is
18transferred to the department of public health to be used for
19the child protection center grant program for child protection
20centers located in Iowa in accordance with section 135.118.
21The grant amounts under the program shall be equalized so that
22each center receives a uniform base amount of $122,500, so that
23$25,000 is awarded to establish a satellite child protection
24center in a city in north central Iowa that is the county
25seat of a county with a population between 44,000 and 45,000
26according to the 2010 federal decennial census, and so that the
27remaining funds are awarded through a funding formula based
28upon the volume of children served.
2911. If the department receives federal approval to
30implement a waiver under Tit.IV-E of the federal Social
31Security Act to enable providers to serve children who remain
32in the children’s families and communities, for purposes of
33eligibility under the medical assistance program through 25
34years of age, children who participate in the waiver shall be
35considered to be placed in foster care.
-108- 112. Of the funds appropriated in this section, $2,012,583 is
2allocated for the preparation for adult living program pursuant
3to section 234.46.
413. Of the funds appropriated in this section, $113,668
5shall be used for the public purpose of continuing a grant to
6a nonprofit human services organization providing services to
7individuals and families in multiple locations in southwest
8Iowa and Nebraska for support of a project providing immediate,
9sensitive support and forensic interviews, medical exams, needs
10assessments, and referrals for victims of child abuse and their
11nonoffending family members.
1214. Of the funds appropriated in this section, $150,310
13is allocated for the foster care youth council approach of
14providing a support network to children placed in foster care.
1515. Of the funds appropriated in this section, $101,000 is
16allocated for use pursuant to section 235A.1 for continuation
17of the initiative to address child sexual abuse implemented
18pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
1921.
2016. Of the funds appropriated in this section, $315,120 is
21allocated for the community partnership for child protection
22sites.
2317. Of the funds appropriated in this section, $185,625
24is allocated for the department’s minority youth and family
25projects under the redesign of the child welfare system.
2618. Of the funds appropriated in this section, $593,297
27is allocated for funding of the community circle of care
28collaboration for children and youth in northeast Iowa.
2919. Of the funds appropriated in this section, at least
30$73,579 shall be used for the continuation of the child
31welfare provider training academy, a collaboration between the
32coalition for family and children’s services in Iowa and the
33department.
3420. Of the funds appropriated in this section, $105,936
35shall be used for continuation of the central Iowa system of
-109-1care program grant through June 30, 2019.
221. Of the funds appropriated in this section, $117,500
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.
922. Of the funds appropriated in this section, at least
10$12,500 shall be used to continue and to expand the foster
11care respite pilot program in which postsecondary students in
12social work and other human services-related programs receive
13experience by assisting family foster care providers with
14respite and other support.
1523. Of the funds appropriated in this section, $55,000
16shall be used for the public purpose of funding community-based
17services and other supports with a system of care approach
18for children with a serious emotional disturbance and their
19families through a nonprofit provider of child welfare services
20that has been in existence for more than 115 years, is located
21in a county with a population of more than 200,000 but less
22than 220,000 according to the latest certified federal census,
23is licensed as a psychiatric medical institution for children,
24and was a system of care grantee prior to July 1, 2018.
25 Sec. 57. ADOPTION SUBSIDY.
261. There is appropriated from the general fund of the
27state to the department of human services for the fiscal year
28beginning July 1, 2018, and ending June 30, 2019, the following
29amount, or so much thereof as is necessary, to be used for the
30purpose designated:
31a. For adoption subsidy payments and services:
.................................................. $3220,388,955
33b. (1) The funds appropriated in this section shall be used
34as authorized or allowed by federal law or regulation for any
35of the following purposes:
-110- 1(a) For adoption subsidy payments and related costs.
2(b) For post-adoption services and for other purposes under
3Tit.IV-B or Tit.IV-E of the federal Social Security Act.
4(2) The department of human services may transfer funds
5appropriated in this subsection to the appropriation for
6child and family services in this Act for the purposes of
7post-adoption services as specified in this paragraph “b”.
82. The department may transfer funds appropriated in
9this section to the appropriation made in this division of
10this Act for general administration for costs paid from the
11appropriation relating to adoption subsidy.
123. Federal funds received by the state during the
13fiscal year beginning July 1, 2018, as the result of the
14expenditure of state funds during a previous state fiscal
15year for a service or activity funded under this section are
16appropriated to the department to be used as additional funding
17for the services and activities funded under this section.
18Notwithstanding section 8.33, moneys received in accordance
19with this subsection that remain unencumbered or unobligated
20at the close of the fiscal year shall not revert to any fund
21but shall remain available for expenditure for the purposes
22designated until the close of the succeeding fiscal year.
23 Sec. 58. JUVENILE DETENTION HOME FUND. Moneys deposited
24in the juvenile detention home fund created in section 232.142
25during the fiscal year beginning July 1, 2018, and ending June
2630, 2019, are appropriated to the department of human services
27for the fiscal year beginning July 1, 2018, and ending June 30,
282019, for distribution of an amount equal to a percentage of
29the costs of the establishment, improvement, operation, and
30maintenance of county or multicounty juvenile detention homes
31in the fiscal year beginning July 1, 2015. Moneys appropriated
32for distribution in accordance with this section shall be
33allocated among eligible detention homes, prorated on the basis
34of an eligible detention home’s proportion of the costs of all
35eligible detention homes in the fiscal year beginning July
-111-11, 2015. The percentage figure shall be determined by the
2department based on the amount available for distribution for
3the fund. Notwithstanding section 232.142, subsection 3, the
4financial aid payable by the state under that provision for the
5fiscal year beginning July 1, 2018, shall be limited to the
6amount appropriated for the purposes of this section.
7 Sec. 59. FAMILY SUPPORT SUBSIDY PROGRAM.
81. There is appropriated from the general fund of the
9state to the department of human services for the fiscal year
10beginning July 1, 2018, and ending June 30, 2019, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13For the family support subsidy program subject to the
14enrollment restrictions in section 225C.37, subsection 3:
.................................................. $15534,641
162. At least $393,750 of the moneys appropriated in this
17section is transferred to the department of public health for
18the family support center component of the comprehensive family
19support program under chapter 225C, subchapter V.
203. If at any time during the fiscal year, the amount of
21funding available for the family support subsidy program
22is reduced from the amount initially used to establish the
23figure for the number of family members for whom a subsidy
24is to be provided at any one time during the fiscal year,
25notwithstanding section 225C.38, subsection 2, the department
26shall revise the figure as necessary to conform to the amount
27of funding available.
28 Sec. 60. CONNER DECREE. There is appropriated from the
29general fund of the state to the department of human services
30for the fiscal year beginning July 1, 2018, and ending June 30,
312019, the following amount, or so much thereof as is necessary,
32to be used for the purpose designated:
33For building community capacity through the coordination
34and provision of training opportunities in accordance with the
35consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
-112-1Iowa, July 14, 1994):
.................................................. $216,816
3 Sec. 61. MENTAL HEALTH INSTITUTES.
41. There is appropriated from the general fund of the
5state to the department of human services for the fiscal year
6beginning July 1, 2018, and ending June 30, 2019, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
9a. For operation of the state mental health institute at
10Cherokee as required by chapters 218 and 226 for salaries,
11support, maintenance, and miscellaneous purposes, and for not
12more than the following full-time equivalent positions:
.................................................. $136,935,127
............................................... FTEs14162.00
15b. For operation of the state mental health institute at
16Independence as required by chapters 218 and 226 for salaries,
17support, maintenance, and miscellaneous purposes, and for not
18more than the following full-time equivalent positions:
.................................................. $198,756,810
............................................... FTEs20204.00
212. Notwithstanding sections 218.78 and 249A.11, any revenue
22received from the state mental health institute at Cherokee or
23the state mental health institute at Independence pursuant to
2442 C.F.R §438.6(e) may be retained and expended by the mental
25health institute.
263. Notwithstanding any provision of law to the contrary,
27a Medicaid member residing at the state mental health
28institute at Cherokee or the state mental health institute
29at Independence shall retain Medicaid eligibility during
30the period of the Medicaid member’s stay for which federal
31financial participation is available.
32 Sec. 62. STATE RESOURCE CENTERS.
331. There is appropriated from the general fund of the
34state to the department of human services for the fiscal year
35beginning July 1, 2018, and ending June 30, 2019, the following
-113-1amounts, or so much thereof as is necessary, to be used for the
2purposes designated:
3a. For the state resource center at Glenwood for salaries,
4support, maintenance, and miscellaneous purposes:
.................................................. $58,943,890
6b. For the state resource center at Woodward for salaries,
7support, maintenance, and miscellaneous purposes:
.................................................. $86,038,517
92. The department may continue to bill for state resource
10center services utilizing a scope of services approach used for
11private providers of intermediate care facilities for persons
12with an intellectual disability services, in a manner which
13does not shift costs between the medical assistance program,
14counties, or other sources of funding for the state resource
15centers.
163. The state resource centers may expand the time-limited
17assessment and respite services during the fiscal year.
184. If the department’s administration and the department
19of management concur with a finding by a state resource
20center’s superintendent that projected revenues can reasonably
21be expected to pay the salary and support costs for a new
22employee position, or that such costs for adding a particular
23number of new positions for the fiscal year would be less
24than the overtime costs if new positions would not be added,
25the superintendent may add the new position or positions. If
26the vacant positions available to a resource center do not
27include the position classification desired to be filled, the
28state resource center’s superintendent may reclassify any
29vacant position as necessary to fill the desired position. The
30superintendents of the state resource centers may, by mutual
31agreement, pool vacant positions and position classifications
32during the course of the fiscal year in order to assist one
33another in filling necessary positions.
345. If existing capacity limitations are reached in
35operating units, a waiting list is in effect for a service or
-114-1a special need for which a payment source or other funding
2is available for the service or to address the special need,
3and facilities for the service or to address the special need
4can be provided within the available payment source or other
5funding, the superintendent of a state resource center may
6authorize opening not more than two units or other facilities
7and begin implementing the service or addressing the special
8need during fiscal year 2018-2019.
9 Sec. 63. SEXUALLY VIOLENT PREDATORS.
101. There is appropriated from the general fund of the
11state to the department of human services for the fiscal year
12beginning July 1, 2018, and ending June 30, 2019, the following
13amount, or so much thereof as is necessary, to be used for the
14purpose designated:
15For costs associated with the commitment and treatment of
16sexually violent predators in the unit located at the state
17mental health institute at Cherokee, including costs of legal
18services and other associated costs, including salaries,
19support, maintenance, and miscellaneous purposes, and for not
20more than the following full-time equivalent positions:
.................................................. $214,732,373
............................................... FTEs22112.00
232. Unless specifically prohibited by law, if the amount
24charged provides for recoupment of at least the entire amount
25of direct and indirect costs, the department of human services
26may contract with other states to provide care and treatment
27of persons placed by the other states at the unit for sexually
28violent predators at Cherokee. The moneys received under
29such a contract shall be considered to be repayment receipts
30and used for the purposes of the appropriation made in this
31section.
32 Sec. 64. FIELD OPERATIONS. There is appropriated from the
33general fund of the state to the department of human services
34for the fiscal year beginning July 1, 2018, and ending June 30,
352019, the following amount, or so much thereof as is necessary,
-115-1to be used for the purposes designated:
2For field operations, including salaries, support,
3maintenance, and miscellaneous purposes, and for not more than
4the following full-time equivalent positions:
.................................................. $524,242,217
............................................... FTEs61,583.00
7Priority in filling full-time equivalent positions shall be
8given to those positions related to child protection services
9and eligibility determination for low-income families.
10 Sec. 65. GENERAL ADMINISTRATION. There is appropriated
11from the general fund of the state to the department of human
12services for the fiscal year beginning July 1, 2018, and ending
13June 30, 2019, the following amount, or so much thereof as is
14necessary, to be used for the purpose designated:
15For general administration, including salaries, support,
16maintenance, and miscellaneous purposes, and for not more than
17the following full-time equivalent positions:
.................................................. $186,941,520
............................................... FTEs19294.00
201. The department shall report at least monthly to the
21legislative services agency concerning the department’s
22operational and program expenditures.
232. Of the funds appropriated in this section, $75,000 shall
24be used to continue the contract for the provision of a program
25to provide technical assistance, support, and consultation to
26providers of habilitation services and home and community-based
27services waiver services for adults with disabilities under the
28medical assistance program.
293. Of the funds appropriated in this section, $25,000
30is transferred to the Iowa finance authority to be used
31for administrative support of the council on homelessness
32established in section 16.2D and for the council to fulfill its
33duties in addressing and reducing homelessness in the state.
344. Of the funds appropriated in this section, $125,000 shall
35be transferred to and deposited in the administrative fund of
-116-1the Iowa ABLE savings plan trust created in section 12I.4, to
2be used for implementation and administration activities of the
3Iowa ABLE savings plan trust.
45. Of the funds appropriated in this section, $100,000
5is transferred to the economic development authority for
6the Iowa commission on volunteer services to continue to be
7used for RefugeeRISE AmeriCorps program established under
8Code section 15H.8 for member recruitment and training to
9improve the economic well-being and health of economically
10disadvantaged refugees in local communities across Iowa. Funds
11transferred may be used to supplement federal funds under
12federal regulations.
13 Sec. 66. DEPARTMENT-WIDE DUTIES. There is appropriated
14from the general fund of the state to the department of human
15services for the fiscal year beginning July 1, 2018, and ending
16June 30, 2019, the following amount, or so much thereof as is
17necessary, to be used for the purposes designated:
18For salaries, support, maintenance, and miscellaneous
19purposes at facilities under the purview of the department of
20human services:
.................................................. $211,439,637
22 Sec. 67. VOLUNTEERS. There is appropriated from the general
23fund of the state to the department of human services for the
24fiscal year beginning July 1, 2018, and ending June 30, 2019,
25the following amount, or so much thereof as is necessary, to be
26used for the purpose designated:
27For development and coordination of volunteer services:
.................................................. $2842,343
29 Sec. 68. GENERAL REDUCTION. For the period beginning July
301, 2018, and ending June 30, 2019, the department of human
31services, in consultation with the department of management,
32shall identify and implement a reduction in expenditures made
33from appropriations from the general fund to the department of
34human services in the amount of $733,651.
35 Sec. 69. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
-117-1ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
2DEPARTMENT OF HUMAN SERVICES.
31. a. (1) (a) For the fiscal year beginning July
41, 2018, case-mix, non-case mix, and special population
5nursing facilities shall be reimbursed in accordance with the
6methodology in effect on June 30, 2018.
7(b) For managed care claims, the department of human
8services shall adjust the payment rate floor for nursing
9facilities, annually, to maintain a rate floor that is no
10lower than the Medicaid fee-for-service case-mix adjusted rate
11calculated in accordance with 441 IAC 81.6. The department
12shall then calculate adjusted reimbursement rates, including
13but not limited to add-on-payments, annually, and shall
14notify Medicaid managed care organizations of the adjusted
15reimbursement rates within 30 days of determining the adjusted
16reimbursement rates. Any adjustment of reimbursement rates
17under this subparagraph division shall be budget neutral to the
18state budget.
19(2) For any open or unsettled nursing facility cost report
20for a fiscal year prior to and including the fiscal year
21beginning July 1, 2017, including any cost report remanded on
22judicial review for inclusion of prescription drug, laboratory,
23or x-ray costs, the department shall offset all reported
24prescription drug, laboratory, and x-ray costs with any revenue
25received from Medicare or other revenue source for any purpose.
26For purposes of this subparagraph, a nursing facility cost
27report is not considered open or unsettled if the facility did
28not initiate an administrative appeal under chapter 17A or if
29any appeal rights initiated have been exhausted.
30b. (1) For the fiscal year beginning July 1, 2018,
31the department shall establish the pharmacy dispensing fee
32reimbursement at $10.02 per prescription, until a cost of
33dispensing survey is completed. The actual dispensing fee
34shall be determined by a cost of dispensing survey performed
35by the department and required to be completed by all medical
-118-1assistance program participating pharmacies every two years,
2adjusted as necessary to maintain expenditures within the
3amount appropriated to the department for this purpose for the
4fiscal year.
5(2) The department shall utilize an average acquisition
6cost reimbursement methodology for all drugs covered under the
7medical assistance program in accordance with 2012 Iowa Acts,
8chapter 1133, section 33.
9c. (1) For the fiscal year beginning July 1, 2018,
10reimbursement rates for outpatient hospital services shall
11remain at the rates in effect on June 30, 2018, subject to
12Medicaid program upper payment limit rules, and adjusted
13as necessary to maintain expenditures within the amount
14appropriated to the department for this purpose for the fiscal
15year.
16(2) For the fiscal year beginning July 1, 2018,
17reimbursement rates for inpatient hospital services shall
18be rebased effective October 1, 2018, subject to Medicaid
19program upper payment limit rules, and adjusted as necessary
20to maintain expenditures within the amount appropriated to the
21department for this purpose for the fiscal year.
22(3) For the fiscal year beginning July 1, 2018, the graduate
23medical education and disproportionate share hospital fund
24shall remain at the amount in effect on June 30, 2018, except
25that the portion of the fund attributable to graduate medical
26education shall be reduced in an amount that reflects the
27elimination of graduate medical education payments made to
28out-of-state hospitals.
29(4) In order to ensure the efficient use of limited state
30funds in procuring health care services for low-income Iowans,
31funds appropriated in this Act for hospital services shall
32not be used for activities which would be excluded from a
33determination of reasonable costs under the federal Medicare
34program pursuant to 42 U.S.C.§1395x(v)(1)(N).
35d. For the fiscal year beginning July 1, 2018, reimbursement
-119-1rates for hospices and acute mental hospitals shall be
2increased in accordance with increases under the federal
3Medicare program or as supported by their Medicare audited
4costs.
5e. For the fiscal year beginning July 1, 2018, independent
6laboratories and rehabilitation agencies shall be reimbursed
7using the same methodology in effect on June 30, 2018.
8f. (1) For the fiscal year beginning July 1, 2018,
9reimbursement rates for home health agencies shall continue to
10be based on the Medicare low utilization payment adjustment
11(LUPA) methodology with state geographic wage adjustments.
12The department shall continue to update the rates every two
13years to reflect the most recent Medicare LUPA rates to the
14extent possible within the state funding appropriated for this
15purpose.
16(2) For the fiscal year beginning July 1, 2018, rates for
17private duty nursing and personal care services under the early
18and periodic screening, diagnostic, and treatment program
19benefit shall be calculated based on the methodology in effect
20on June 30, 2018.
21g. For the fiscal year beginning July 1, 2018, federally
22qualified health centers and rural health clinics shall receive
23cost-based reimbursement for 100 percent of the reasonable
24costs for the provision of services to recipients of medical
25assistance.
26h. For the fiscal year beginning July 1, 2018, the
27reimbursement rates for dental services shall remain at the
28rates in effect on June 30, 2018.
29i. (1) For the fiscal year beginning July 1, 2018,
30reimbursement rates for the non-state-owned psychiatric medical
31institution for children shall be based on the methodology in
32effect on June 30, 2018.
33(2) As a condition of participation in the medical
34assistance program, enrolled providers shall accept the medical
35assistance reimbursement rate for any covered goods or services
-120-1provided to recipients of medical assistance who are children
2under the custody of a psychiatric medical institution for
3children.
4j. For the fiscal year beginning July 1, 2018, unless
5otherwise specified in this Act, all noninstitutional medical
6assistance provider reimbursement rates shall remain at the
7rates in effect on June 30, 2018, except for area education
8agencies, local education agencies, infant and toddler
9services providers, home and community-based services providers
10including consumer-directed attendant care providers under a
11section 1915(c) or 1915(i) waiver, targeted case management
12providers, and those providers whose rates are required to be
13determined pursuant to section 249A.20.
14k. Notwithstanding any provision to the contrary, for the
15fiscal year beginning July 1, 2018, the reimbursement rate
16for anesthesiologists shall be adjusted to implement the cost
17containment strategies authorized for the medical assistance
18program in this 2017 Act.
19l. Notwithstanding section 249A.20, for the fiscal year
20beginning July 1, 2018, 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, 2018; however, this rate shall not exceed the maximum
25level authorized by the federal government.
26m. For the fiscal year beginning July 1, 2018, 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, 2018, the
-121-1reimbursement rates for inpatient mental health services
2provided at hospitals shall remain at the rates in effect on
3June 30, 2018, subject to Medicaid program upper payment limit
4rules; and psychiatrists shall be reimbursed at the medical
5assistance program fee-for-service rate in effect on June 30,
62018.
7o. For the fiscal year beginning July 1, 2018, community
8mental health centers may choose to be reimbursed for the
9services provided to recipients of medical assistance through
10either of the following options:
11(1) For 100 percent of the reasonable costs of the services.
12(2) In accordance with the alternative reimbursement rate
13methodology approved by the department of human services in
14effect on June 30, 2018.
15p. For the fiscal year beginning July 1, 2018, the
16reimbursement rate for providers of family planning services
17that are eligible to receive a 90 percent federal match shall
18remain at the rates in effect on June 30, 2018.
19q. Unless otherwise subject to a tiered rate methodology,
20for the fiscal year beginning July 1, 2018, the upper
21limits and reimbursement rates for providers of home and
22community-based services waiver services shall be reimbursed
23using the reimbursement methodology in effect on June 30, 2018.
24r. For the fiscal year beginning July 1, 2018, the
25reimbursement rates for emergency medical service providers
26shall remain at the rates in effect on June 30, 2018.
27s. For the fiscal year beginning July 1, 2018, reimbursement
28rates for substance-related disorder treatment programs
29licensed under section 125.13 shall remain at the rates in
30effect on June 30, 2018.
312. For the fiscal year beginning July 1, 2018, the
32reimbursement rate for providers reimbursed under the
33in-home-related care program shall not be less than the minimum
34payment level as established by the federal government to meet
35the federally mandated maintenance of effort requirement.
-122- 13. Unless otherwise directed in this section, when the
2department’s reimbursement methodology for any provider
3reimbursed in accordance with this section includes an
4inflation factor, this factor shall not exceed the amount
5by which the consumer price index for all urban consumers
6increased during the calendar year ending December 31, 2002.
74. Notwithstanding section 234.38, for the fiscal
8year beginning July 1, 2018, the foster family basic daily
9maintenance rate and the maximum adoption subsidy rate for
10children ages 0 through 5 years shall be $16.78, the rate for
11children ages 6 through 11 years shall be $17.43, the rate for
12children ages 12 through 15 years shall be $19.10, and the
13rate for children and young adults ages 16 and older shall
14be $19.35. For youth ages 18 to 21 who have exited foster
15care, the preparation for adult living program maintenance rate
16shall be $602.70 per month. The maximum payment for adoption
17subsidy nonrecurring expenses shall be limited to $500 and the
18disallowance of additional amounts for court costs and other
19related legal expenses implemented pursuant to 2010 Iowa Acts,
20chapter 1031, section 408, shall be continued.
215. For the fiscal year beginning July 1, 2018, the maximum
22reimbursement rates for social services providers under
23contract shall remain at the rates in effect on June 30, 2018,
24or the provider’s actual and allowable cost plus inflation for
25each service, whichever is less. However, if a new service
26or service provider is added after June 30, 2018, the initial
27reimbursement rate for the service or provider shall be based
28upon a weighted average of provider rates for similar services.
296. a. For the fiscal year beginning July 1, 2018, the
30reimbursement rates for resource family recruitment and
31retention contractors shall be established by contract.
32b. For the fiscal year beginning July 1, 2018, the
33reimbursement rates for supervised apartment living foster care
34providers shall be established by contract.
357. a. For the purposes of this subsection, “combined
-123-1reimbursement rate” means the combined service and maintenance
2reimbursement rate for a service level under the department’s
3reimbursement methodology. Effective July 1, 2018, the
4combined reimbursement rate for a group foster care service
5level shall be the amount designated in this subsection.
6However, if a group foster care provider’s reimbursement rate
7for a service level as of June 30, 2018, is more than the rate
8designated in this subsection, the provider’s reimbursement
9shall remain at the higher rate.
10b. Unless a group foster care provider is subject to the
11exception provided in paragraph “a”, effective July 1, 2018,
12the combined reimbursement rates for the service levels under
13the department’s reimbursement methodology shall be as follows:
14(1) For service level, community - D1, the daily rate shall
15be at least $84.17.
16(2) For service level, comprehensive - D2, the daily rate
17shall be at least $119.09.
18(3) For service level, enhanced - D3, the daily rate shall
19be at least $131.09.
208. The group foster care reimbursement rates paid for
21placement of children out of state shall be calculated
22according to the same rate-setting principles as those used for
23in-state providers, unless the director of human services or
24the director’s designee determines that appropriate care cannot
25be provided within the state. The payment of the daily rate
26shall be based on the number of days in the calendar month in
27which service is provided.
289. a. For the fiscal year beginning July 1, 2018, the
29reimbursement rate paid for shelter care and the child welfare
30emergency services implemented to provide or prevent the need
31for shelter care shall be established by contract.
32b. For the fiscal year beginning July 1, 2018, the combined
33service and maintenance components of the reimbursement rate
34paid for shelter care services shall be based on the financial
35and statistical report submitted to the department. The
-124-1maximum reimbursement rate shall be $101.83 per day. The
2department shall reimburse a shelter care provider at the
3provider’s actual and allowable unit cost, plus inflation, not
4to exceed the maximum reimbursement rate.
5c. Notwithstanding section 232.141, subsection 8, for the
6fiscal year beginning July 1, 2018, 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,
112017.
1210. For the fiscal year beginning July 1, 2018, the
13department shall calculate reimbursement rates for intermediate
14care facilities for persons with an intellectual disability
15at the 80th percentile. Beginning July 1, 2018, the rate
16calculation methodology shall utilize the consumer price index
17inflation factor applicable to the fiscal year beginning July
181, 2018.
1911. For the fiscal year beginning July 1, 2018, for child
20care providers reimbursed under the state child care assistance
21program, the department shall set provider reimbursement
22rates based on the rate reimbursement survey completed in
23December 2004. Effective July 1, 2018, the child care provider
24reimbursement rates shall remain at the rates in effect on June
2530, 2018. The department shall set rates in a manner so as
26to provide incentives for a nonregistered provider to become
27registered by applying the increase only to registered and
28licensed providers.
2912. For the fiscal year beginning July 1, 2018,
30notwithstanding any provision to the contrary under this
31section, affected providers or services shall be reimbursed as
32follows:
33a. For fee-for-service claims, reimbursement shall be
34calculated based on the methodology otherwise specified in this
35section for the fiscal year beginning July 1, 2018, for the
-125-1respective provider or service.
2b. For claims subject to a managed care contract with the
3exception of any provider or service to which a reimbursement
4increase is applicable for the fiscal year under this section,
5reimbursement shall be based on the methodology established by
6the managed care contract. However, any rate or reimbursement
7established under such contract shall not be lower than the
8rate or reimbursement floor established by the department
9of human services as the managed care organization rate or
10reimbursement floor for a respective provider or service in
11effect on April 1, 2016.
1213. Notwithstanding any provision to the contrary,
13reimbursement rates and methodologies under this section may
14be adjusted as necessary to implement the cost containment
15strategies authorized for the medical assistance program in
16this 2017 Act.
1714. The department may adopt emergency rules to implement
18this section.
19 Sec. 70. EMERGENCY RULES.
201. If specifically authorized by a provision of this
21division of this Act, the department of human services or
22the mental health and disability services commission may
23adopt administrative rules under section 17A.4, subsection
243, and section 17A.5, subsection 2, paragraph “b”, to
25implement the provisions of this division of this Act and
26the rules shall become effective immediately upon filing or
27on a later effective date specified in the rules, unless the
28effective date of the rules is delayed or the applicability
29of the rules is suspended by the administrative rules review
30committee. Any rules adopted in accordance with this section
31shall not take effect before the rules are reviewed by the
32administrative rules review committee. The delay authority
33provided to the administrative rules review committee under
34section 17A.4, subsection 7, and section 17A.8, subsection 9,
35shall be applicable to a delay imposed under this section,
-126-1notwithstanding a provision in those sections making them
2inapplicable to section 17A.5, subsection 2, paragraph “b”.
3Any rules adopted in accordance with the provisions of this
4section shall also be published as a notice of intended action
5as provided in section 17A.4.
62. If during a fiscal year, the department of human
7services is adopting rules in accordance with this section
8or as otherwise directed or authorized by state law, and the
9rules will result in an expenditure increase beyond the amount
10anticipated in the budget process or if the expenditure was
11not addressed in the budget process for the fiscal year, the
12department shall notify the persons designated by this division
13of this Act for submission of reports, the chairpersons and
14ranking members of the committees on appropriations, and
15the department of management concerning the rules and the
16expenditure increase. The notification shall be provided at
17least 30 calendar days prior to the date notice of the rules
18is submitted to the administrative rules coordinator and the
19administrative code editor.
20 Sec. 71. REPORTS. Any reports or other information
21required to be compiled and submitted under this Act during the
22fiscal year beginning July 1, 2018, shall be submitted to the
23chairpersons and ranking members of the joint appropriations
24subcommittee on health and human services, the legislative
25services agency, and the legislative caucus staffs on or
26before the dates specified for submission of the reports or
27information.
28 Sec. 72. TRANSFER OF MEDICAID MODERNIZATION SAVINGS BETWEEN
29APPROPRIATIONS FY 2018-2019. Notwithstanding section 8.39,
30subsection 1, for the fiscal year beginning July 1, 2018, if
31savings resulting from the governor’s Medicaid modernization
32initiative accrue to the medical contracts or children’s health
33insurance program appropriation from the general fund of the
34state and not to the medical assistance appropriation from the
35general fund of the state under this division of this Act,
-127-1such savings may be transferred to such medical assistance
2appropriation for the same fiscal year without prior written
3consent and approval of the governor and the director of the
4department of management. The department of human services
5shall report any transfers made pursuant to this section to the
6legislative services agency.
7DIVISION XII
8HEALTH CARE ACCOUNTS AND FUNDS — FY 2018-2019
9 Sec. 73. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
10appropriated from the pharmaceutical settlement account created
11in section 249A.33 to the department of human services for the
12fiscal year beginning July 1, 2018, and ending June 30, 2019,
13the following amount, or so much thereof as is necessary, to be
14used for the purpose designated:
15Notwithstanding any provision of law to the contrary, to
16supplement the appropriations made in this Act for medical
17contracts under the medical assistance program for the fiscal
18year beginning July 1, 2018, and ending June 30, 2019:
.................................................. $19400,000
20 Sec. 74. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
21SERVICES. Notwithstanding any provision to the contrary and
22subject to the availability of funds, there is appropriated
23from the quality assurance trust fund created in section
24249L.4 to the department of human services for the fiscal year
25beginning July 1, 2018, and ending June 30, 2019, the following
26amounts, or so much thereof as is necessary, for the purposes
27designated:
28To supplement the appropriation made in this Act from the
29general fund of the state to the department of human services
30for medical assistance for the same fiscal year:
.................................................. $3118,352,604
32 Sec. 75. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
33DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
34the contrary and subject to the availability of funds, there is
35appropriated from the hospital health care access trust fund
-128-1created in section 249M.4 to the department of human services
2for the fiscal year beginning July 1, 2018, and ending June
330, 2019, the following amounts, or so much thereof as is
4necessary, for the purposes designated:
5To supplement the appropriation made in this Act from the
6general fund of the state to the department of human services
7for medical assistance for the same fiscal year:
.................................................. $816,960,277
9 Sec. 76. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
10FOR FY 2018-2019. Notwithstanding section 8.33, if moneys
11appropriated for purposes of the medical assistance program for
12the fiscal year beginning July 1, 2018, and ending June 30,
132019, from the general fund of the state, the quality assurance
14trust fund and the hospital health care access trust fund, are
15in excess of actual expenditures for the medical assistance
16program and remain unencumbered or unobligated at the close
17of the fiscal year, the excess moneys shall not revert but
18shall remain available for expenditure for the purposes of the
19medical assistance program until the close of the succeeding
20fiscal year.
21DIVISION XIII
22Child care facility fund — USE FOR field operations
23 Sec. 77. CHILD CARE FACILITY FUND — USE FOR FIELD
24OPERATIONS. Notwithstanding section 237A.4A, subsection 5,
25Code 2017, for the fiscal year beginning July 1, 2017, and
26ending June 30, 2018, in addition to the costs of dedicated
27staffing to perform the duties described in section 237A.4A,
28up to $590,082 of the moneys in the child care facility fund
29may be used by the department of human services for additional
30expenditures of the child care regulatory unit within the
31department’s field operations.
32 Sec. 78. EFFECTIVE UPON ENACTMENT. This division of this
33Act, being deemed of immediate importance, takes effect upon
34enactment.
35DIVISION XIV
-129-1Biologics and genetically targeted drugs — Medicaid
2 Sec. 79. Section 249A.20A, subsection 3, Code 2017, is
3amended to read as follows:
43. a. The pharmaceutical and therapeutics committee shall
5recommend a preferred drug list to the department.
6b. The committee shall develop the preferred drug list
7by considering each drug’s clinically meaningful therapeutic
8advantages in terms of safety, effectiveness, and clinical
9outcome.
10c. The committee shall use evidence-based research methods
11in selecting the drugs to be included on the preferred drug
12list.
13d. When making recommendations or determinations regarding
14beneficiary access to drugs and biological products for rare
15diseases and drugs and biological products that are genetically
16targeted, the committee shall request and consider information
17from individuals who possess scientific or medical training
18with respect to the drug, biological product, or rare disease.
19e. The committee shall periodically review all drug classes
20included on the preferred drug list and may amend the list to
21ensure that the list provides for medically appropriate drug
22therapies for medical assistance recipients and achieves cost
23savings to the medical assistance program.
24f. The department may procure a sole source contract
25with an outside entity or contractor to provide professional
26administrative support to the pharmaceutical and therapeutics
27committee in researching and recommending drugs to be placed on
28the preferred drug list.
29 Sec. 80. Section 249A.24, Code 2017, is amended by adding
30the following new subsection:
31 NEW SUBSECTION. 2A. When making recommendations or
32determinations regarding beneficiary access to drugs and
33biological products for rare diseases and drugs and biological
34products that are genetically targeted, the commission shall
35request and consider information from individuals who possess
-130-1scientific or medical training with respect to the drug,
2biological product, or rare disease.
3DIVISION XV
4Public Assistance Programs Oversight
5 Sec. 81. 2017 Iowa Acts, House File 531, section 2,
6subsection 1, as enacted, is amended to read as follows:
71. The department of human services shall review state
8efforts, including pilot programs related to data sharing
9between states and technology-based solutions designed to curb
10interstate dual participation, to address program integrity
11for public assistance programs including Medicaid, the family
12investment program (FIP), the supplemental nutrition assistance
13program (SNAP), and the child care assistance program. As
14part of the review, the department shall explore opportunities
15to join existing pilot efforts in collaboration with other
16states including the effort involving the national accuracy
17clearinghouse, or to develop a separate pilot effort in Iowa.
18 Sec. 82. EFFECTIVE UPON ENACTMENT. This division of this
19Act, being deemed of immediate importance, takes effect upon
20enactment.
21 Sec. 83. RETROACTIVE APPLICABILITY. This division of this
22Act applies retroactively to March 30, 2017.
23DIVISION XVI
24Background check private sector alternatives
25 Sec. 84. BACKGROUND CHECK — PRIVATE SECTOR
26ALTERNATIVES. The department of human services and the
27department of public safety shall jointly review private sector
28alternatives to the performance of state mandated criminal
29background checks currently performed solely by the department
30of public safety. The departments shall submit a report to
31the governor and the general assembly by December 15, 2017,
32including a description of the process used in reviewing
33private sector alternatives to perform criminal background
34checks, the findings from the review, and recommendations for
35utilizing private sector entities as an alternative to the
-131-1department of public safety in performing criminal background
2checks.
3DIVISION XVII
4psychiatric BED TRACKING SYSTEM
5 Sec. 85. DEPARTMENT OF HUMAN SERVICES PSYCHIATRIC BED
6TRACKING SYSTEM. The department of human services shall amend
7its administrative rules pursuant to chapter 17A to require
8the state mental health institutes and hospitals licensed
9to provide inpatient psychiatric treatment and services to
10participate in the psychiatric bed tracking system and to
11ensure updates are made, at a minimum, two times per day to
12the psychiatric bed tracking system. Updates shall include
13information on the availability of inpatient child, adult,
14and geriatric psychiatric beds staffed and available and
15information on the gender that can be accepted for each
16available bed.
17DIVISION XVIII
18CHILDREN’S WELL-BEING COLLABORATIVES AND ADVISORY COMMITTEE
19 Sec. 86. CHILDREN’S WELL-BEING COLLABORATIVES — GRANTS.
201. The department of human services shall establish a
21request for proposals process which shall be based upon
22recommendations for the development and implementation
23of children’s well-being collaboratives described in the
24children’s mental health study report submitted by the
25department to the general assembly on December 15, 2016.
262. A well-being collaborative shall consist of a
27broad-based group of entities in a defined geographical area
28represented by a lead agency. Entities in the well-being
29collaborative shall include a broad-based representation of key
30providers including but not limited to providers of prevention
31and early intervention services and mental health services to
32the target population.
333. A well-being collaborative shall be responsible for
34developing interagency coordination and collaboration for
35the provision of prevention and early intervention services
-132-1within the designated geographic area and shall, at a minimum,
2demonstrate all of the following:
3a. Experience and a strong understanding of how best to
4engage children and families to achieve positive mental health
5and well-being outcomes.
6b. An ability to provide or administer prevention services
7for the improvement of children’s mental health and well-being.
8c. Experience and effectiveness in coordinating the
9collaborative efforts of multiple stakeholders working toward
10a common goal of improving the effectiveness of the group’s
11efforts to achieve measurable improved outcomes.
124. A well-being collaborative shall build and maintain
13intentional collaboration among all entities with the goal of
14providing measurable improvements in outcomes for children and
15families.
165. A well-being collaborative shall build and improve
17coordination and effectiveness among entities to develop and
18provide primary, secondary, and tertiary prevention and early
19intervention services that are nonduplicative and that are
20aligned to meet the needs of children and families in the
21geographic area.
226. A well-being collaborative shall provide technical
23assistance to a diverse array of stakeholders, facilitate
24the distribution of public awareness materials that include
25information aimed at reducing the stigma of mental illness,
26and provide updates on changes in state and federal policy
27in relation to prevention and early intervention efforts
28concerning children’s mental health and well-being.
297. A well-being collaborative shall establish or enhance
30collaborative efforts in all of the following areas:
31a. The selection and implementation of evidence-based or
32promising prevention and early intervention models.
33b. Understanding funding sources and how to utilize
34available funding most effectively.
35c. The adoption or development, implementation, and
-133-1analysis of community needs assessments.
2d. The development, implementation, and analysis of a
3community work plan based on the results of the community needs
4assessment.
5e. The adoption or development and implementation of a
6uniform family assessment.
7f. The utilization of research and data analysis to guide
8the work of the well-being collaborative.
9g. The provision of culturally competent services and the
10ability to address issues relating to the disproportionate
11representation of a population group.
12h. The development of public awareness and training
13programs, including programs aimed at reducing the stigma of
14mental illness.
15i. The recruitment and retention of members in the
16well-being collaborative with a focus on achieving the goals
17and outcomes of the collaborative and supporting all members in
18the collaborative.
198. Each grantee shall submit reports to the department of
20human services by December 15, 2017, and April 15, 2018, to
21include information relating to the accomplishments and future
22plans of each well-being collaborative.
23 Sec. 87. CHILDREN’S MENTAL HEALTH AND WELL-BEING ADVISORY
24COMMITTEE. The department of human services shall create and
25provide support to a children’s mental health and well-being
26advisory committee to continue efforts relating to improving
27children’s mental health crisis services and children’s
28well-being learning labs and supporting the children’s
29well-being collaboratives.
30DIVISION XIX
31state family planning services program
32 Sec. 88. NEW SECTION. 217.41B State family planning
33services program — establishment — discontinuation of Medicaid
34family planning network waiver.
351. The department of human services shall discontinue the
-134-1Medicaid family planning network waiver effective July 1, 2017,
2and shall instead establish a state family planning services
3program. The state program shall replicate the eligibility
4requirements and other provisions included in the Medicaid
5family planning network waiver as approved by the centers for
6Medicare and Medicaid services of the United States department
7of health and human services in effect on June 30, 2017.
82. Distribution of family planning services program funds
9under this section shall be made in a manner that continues
10access to family planning services.
113. Distribution of family planning services program funds
12shall not be made to any entity that performs abortions or that
13maintains or operates a facility where abortions are performed.
14For the purposes of this section, “abortion” does not include
15any of the following:
16a. The treatment of a woman for a physical disorder,
17physical injury, or physical illness, including a
18life-endangering physical condition caused by or arising from
19the pregnancy itself, that would, as certified by a physician,
20place the woman in danger of death.
21b. The treatment of a woman for a spontaneous abortion,
22commonly known as a miscarriage, when not all of the products
23of human conception are expelled.
244. Family planning services program funds distributed in
25accordance with this section shall not be used for direct or
26indirect costs, including but not limited to administrative
27costs or expenses, overhead, employee salaries, rent, and
28telephone and other utility costs, related to providing
29abortions as specified in subsection 3.
30 Sec. 89. EMERGENCY RULES. The department of human services
31may adopt emergency rules under section 17A.4, subsection 3,
32and section 17A.5, subsection 2, paragraph “b”, to implement
33the provisions of this division of this Act, and the rules
34shall be effective immediately upon filing unless a later date
35is specified in the rules. Any rules adopted in accordance
-135-1with this section shall also be published as a notice of
2intended action as provided in section 17A.4.
3 Sec. 90. EFFECTIVE UPON ENACTMENT. This division of this
4Act, being deemed of immediate importance, takes effect upon
5enactment.
6DIVISION XX
7MEDICAID HOME AND COMMUNITY-BASED SERVICES PROVIDERS —
8COST-REPORTING
9 Sec. 91. MEDICAID HOME AND COMMUNITY-BASED SERVICES
10PROVIDERS — TIERED RATES AND DOCUMENTATION CHANGES —
11EMERGENCY RULES.
121. Beginning July 1, 2017, the department of human
13services shall discontinue application of the retrospectively
14limited cost settlement methodology based on submission of
15required cost reports under 441 IAC 79.1, and shall implement
16tiered rates for providers of supported community living,
17day habilitation and adult day services for persons with an
18intellectual disability under the home and community-based
19services waiver program. The tiered rates shall be implemented
20in a phased-in approach to accommodate transition of providers
21to the revised reimbursement model. The department of human
22services and Medicaid managed care organizations may also
23establish tiered rates for other services.
242. The department of human services shall amend 441 IAC
2524.4 relating to standards of service for providers of services
26to persons with mental illness, intellectual disabilities, or
27developmental disabilities pursuant to chapter 225C and 441
28IAC 79.3(2) relating to medical clinical records for providers
29of services under the Medicaid program pursuant to chapter
30249A, to provide, effective November 1, 2017, that in addition
31to allowing documentation of the provision of services or
32standards of service in a narrative format, the following
33providers may also provide documentation in a checkbox form
34format in accordance with the provider’s organizational
35policies and procedures and in compliance with procedures
-136-1established by the centers for Medicare and Medicaid services
2of the United States department of health and human services:
3a. Advanced registered nurse practitioners.
4b. Psychologists.
5c. Community mental health centers.
6d. Home and community-based habilitation services
7providers.
8e. Behavioral health intervention.
9f. Case management services including home and
10community-based services case management services.
11g. Home and community-based services waiver services.
12h. Behavioral health services.
13i. Community-based neurobehavioral rehabilitation
14residential services and intermittent services.
153. The department of human services may adopt emergency
16rules under section 17A.4, subsection 3, and section 17A.5,
17subsection 2, paragraph “b”, to implement the provisions of
18this division of this Act, and the rules shall be effective
19immediately upon filing unless a later date is specified in the
20rules. Any rules adopted in accordance with this section shall
21also be published as a notice of intended action as provided
22in section 17A.4.
23 Sec. 92. EFFECTIVE UPON ENACTMENT. This division of this
24Act, being deemed of immediate importance, takes effect upon
25enactment.
26DIVISION XXI
27TELEHEALTH PARITY INTERIM COMMITTEE
28 Sec. 93. TELEHEALTH PARITY INTERIM COMMITTEE.
291. The legislative council is requested to establish
30a study committee for the 2017 interim to examine issues
31relating to telehealth parity for private insurance and state
32employee health plans. The study committee shall consult with
33stakeholders to evaluate the benefits of telehealth parity
34within the context of the needs of Iowans such as access to
35health care, review existing policies related to telehealth
-137-1reimbursement and the impact on private insurance and state
2employee health plans, consider the costs associated with
3telehealth service utilization, consider telehealth’s potential
4impact to economic development opportunities for Iowa’s
5rural communities, and evaluate obstacles such as broadband
6accessibility.
72. The members of the committee shall include:
8a. Ten members of the general assembly as voting members.
9(1) Three members shall be appointed by the majority leader
10of the senate, two by the minority leader of the senate, three
11by the speaker of the house of representatives, and two by the
12minority leader of the house of representatives.
13(2) The legislators appointed shall include:
14(a) The chairpersons and ranking members of the general
15assembly’s committees on human resources or a member of the
16committee designated by the chairperson or ranking member.
17(b) The co-chairpersons and ranking members of the joint
18appropriations subcommittee on health and human services, or a
19member of the subcommittee designated by the co-chairperson or
20ranking member.
21b. One representative of each of the following
22organizations as nonvoting members:
23(1) The signal center for health innovation.
24(2) The Iowa hospital association.
25(3) An independent medical clinic.
26(4) The Iowa medical society.
27(5) The Iowa healthcare association.
28(6) The federation of Iowa insurers.
29(7) AARP Iowa.
30(8) The Iowa telecommunications association.
31(9) A mental health and disability services region.
32c. The following agency directors or commissioner as ex
33officio nonvoting members:
34(1) The director of public health, or the director’s
35designee.
-138- 1(2) The director of the department of administrative
2services, or the director’s designee.
3(3) The director of the department on aging, or the
4director’s designee.
5(4) The commissioner of insurance or the commissioner’s
6designee.
73. The interim committee may request information and
8assistance from state agencies as applicable to the purpose of
9the interim committee, as needed to complete the work of the
10interim committee.
114. The interim committee shall submit its findings and
12recommendations to the general assembly by December 15, 2017,
13for consideration during the 2018 legislative session.
14DIVISION XXII
15Alzheimer’s and other forms of Dementia — Health and
16Resilience Outreach (HERO) project — DEMENTIA-SPECIFIC CARE
17 Sec. 94. HERO PROJECT. The department of public health
18shall collaborate with stakeholders that support individuals
19with Alzheimer’s disease to identify funding opportunities
20to support the health and resilience outreach (HERO) project
21for individuals caring for a family member with Alzheimer’s or
22other forms of dementia.
23 Sec. 95. ACCESS TO DEMENTIA-SPECIFIC CARE. The department
24on aging, the department of public health, the department of
25inspections and appeals, and the department of human services
26shall jointly analyze and make recommendations regarding
27options for coordination between state agencies and private
28entities to promote increased access to dementia-specific care
29in both residential and home and community-based settings. The
30analyses and recommendations shall address barriers to, gaps
31in, and opportunities for increased access, the availability of
32services in home and community-based settings as an alternative
33to residential settings, and any changes in law necessary to
34better address the needs of individuals with dementia and their
35families. The departments shall submit a joint report of
-139-1findings and recommendations to the governor and the general
2assembly by December 15, 2017.
3DIVISION XXIII
4Office of Minority and multicultural health — REPEAL
5 Sec. 96. Section 135.159, subsection 3, paragraph i, Code
62017, is amended to read as follows:
7i. For children, coordinate with and integrate guidelines,
8data, and information from existing newborn and child health
9programs and entities, including but not limited to the healthy
10opportunities for parents to experience success – healthy
11families Iowa program, the early childhood Iowa initiative,
12the center for congenital and inherited disorders screening
13and health care programs, standards of care for pediatric
14health guidelines, the office of minority and multicultural
15health established in section 135.12, the oral health bureau
16established in section 135.15, and other similar programs and
17services.
18 Sec. 97. REPEAL. Section 135.12, Code 2017, is repealed.
19DIVISION XXIV
20Prior year appropriations and other prior provisions
21Adoption subsidy payments and services
22 Sec. 98. 2015 Iowa Acts, chapter 137, section 139, as
23amended by 2016 Iowa Acts, chapter 1139, section 17, subsection
241, is amended by adding the following new paragraph:
25 NEW PARAGRAPH. c. Notwithstanding section 8.33,
26moneys corresponding to the state savings resulting from
27implementation of the federal Fostering Connections to Success
28and Increasing Adoptions Act of 2008, Pub.L. No.110-351,
29and successor legislation, as determined in accordance with
3042 U.S.C. §673(a)(8), that remain unencumbered or unobligated
31at the close of the fiscal year, shall not revert to any fund
32but shall remain available for the purposes designated in this
33subsection until expended. The amount of such savings and any
34corresponding funds remaining at the close of the fiscal year
35shall be determined separately and any changes in either amount
-140-1between fiscal years shall not result in an unfunded need.
2DECATEGORIZATION
3 Sec. 99. DECATEGORIZATION CARRYOVER FUNDING — TRANSFER TO
4MEDICAID PROGRAM. Notwithstanding section 232.188, subsection
55, paragraph “b”, any state appropriated moneys in the funding
6pool that remained unencumbered or unobligated at the close
7of the fiscal year beginning July 1, 2014, and were deemed
8carryover funding to remain available for the two succeeding
9fiscal years that still remain unencumbered or unobligated at
10the close of the fiscal year beginning July 1, 2016, shall
11not revert but shall be transferred to the medical assistance
12program for the fiscal year beginning July 1, 2017.
13 Sec. 100. EFFECTIVE UPON ENACTMENT. This division of this
14Act, being deemed of immediate importance, takes effect upon
15enactment.
16 Sec. 101. RETROACTIVE APPLICABILITY. This division of this
17Act applies retroactively to July 1, 2016.
18DIVISION XXV
19Nonparticipating provider reimbursement fund and IowaCare
20Account — balances — reversions
21 Sec. 102. NONPARTICIPATING PROVIDER REIMBURSEMENT FUND AND
22IOWACARE ACCOUNT — AVAILABILITY — REVERSIONS.
23Notwithstanding any provision of law to the contrary, for the
24fiscal year beginning July 1, 2016, and ending June 30, 2017,
25there is appropriated from the IowaCare account established in
26section 249J.24, Code 2013, and the nonparticipating provider
27reimbursement fund established in section 249J.24A, Code
282013, to the department of human services medical assistance
29appropriation in this 2017 Act any unencumbered or unobligated
30moneys from the account and fund to be used for the purposes of
31the IowaCare account as provided in section 249J.24, Code 2013.
32Notwithstanding section 8.33, moneys appropriated in this
33section that remain unencumbered or unobligated at the close of
34a fiscal year shall not revert but shall remain available for
35expenditure for the purposes designated until expended.
-141-1 Sec. 103. EFFECTIVE UPON ENACTMENT. This division of this
2Act, being deemed of immediate importance, takes effect upon
3enactment.
4DIVISION XXVI
5Hospital Health Care Access Assessment Program — repeal
6 Sec. 104. Section 249M.5, Code 2017, is amended to read as
7follows:
8249M.5 Future repeal.
9This chapter is repealed July 1, 2017 2019.
10 Sec. 105. EFFECTIVE UPON ENACTMENT. This division of this
11Act, being deemed of immediate importance, takes effect upon
12enactment.
13 Sec. 106. RETROACTIVE APPLICABILITY. This division of this
14Act applies retroactively to June 30, 2017.
15DIVISION XXVII
16Custodial Care
17 Sec. 107. Section 249.12, Code 2017, is amended to read as
18follows:
19249.12 Cost-related system.
201. In order to assure that the necessary data is available
21to aid the general assembly to determine appropriate funding
22for the custodial care program, the department of human
23services shall develop a cost-related system for financial
24supplementation to individuals who need custodial care and who
25have insufficient resources to purchase the care needed.
262. All privately operated licensed custodial facilities in
27Iowa shall cooperate with the department of human services to
28develop the cost-related plan. After the plan is implemented,
29state supplemental funds shall not be used for the care of
30any individual in facilities that have not submitted cost
31statements to the department of human services.
323. Beginning July 1, 2017, privately operated licensed
33custodial facilities in Iowa shall be reimbursed based on the
34maximum per diem rates established by the general assembly
35through the appropriations process.
-142-1DIVISION XXVIII
2Juvenile beds cap
3 Sec. 108. Section 232.142, subsection 5, Code 2017, is
4amended to read as follows:
55. The director shall approve annually all such homes
6established and maintained under the provisions of this
7chapter. A home shall not be approved unless it complies with
8minimal rules and standards adopted by the director and has
9been inspected by the department of inspections and appeals.
10The statewide number of beds in the homes approved by the
11director shall not exceed two hundred sixty-two seventy-two
12 beds beginning July 1, 2017, and shall not exceed two hundred
13eighty-two beds beginning July 1, 2018, and thereafter.
14DIVISION XXIX
15TRANSFERS OF FUNDS BETWEEN DHS INSTITUTIONS
16 Sec. 109. Section 218.6, Code 2017, is amended to read as
17follows:
18218.6 Transfer of appropriations made to institutions.
19Notwithstanding section 8.39, subsection 1, without the
20prior written consent and approval of the governor and the
21director of the department of management, the director of human
22services may transfer funds between the appropriations made for
23the same type of institution institutions, listed as follows:
241. The state resource centers.
252. The state mental health institutes.
263. The state juvenile institutions consisting of the state
27 training school and the Iowa juvenile home.
284. The civil commitment unit for sexual offenders.
29DIVISION XXX
30PELVIC EXAMS — PRIOR CONSENT
31 Sec. 110. NEW SECTION. 147.114 Prior informed consent
32relative to pelvic examinations — patient under anesthesia or
33unconscious — penalties.
341. A person licensed or certified to practice a
35profession, or a student undertaking a course of instruction
-143-1or participating in a clinical training or residency program
2for a profession, shall not perform a pelvic examination on an
3anesthetized or unconscious patient unless one of the following
4conditions is met:
5a. The patient or the patient’s authorized representative
6provides prior written informed consent to the pelvic
7examination, and the pelvic examination is necessary for
8preventive, diagnostic, or treatment purposes.
9b. The patient or the patient’s authorized representative
10has provided prior written informed consent to a surgical
11procedure or diagnostic examination to be performed on the
12patient, and the performance of a pelvic examination is within
13the scope of care ordered for that surgical procedure or
14diagnostic examination.
15c. The patient is unconscious and incapable of providing
16prior informed consent, and the pelvic examination is necessary
17for diagnostic or treatment purposes.
18d. A court has ordered the performance of the pelvic
19examination for the purposes of collection of evidence.
202. A person who violates this section is subject to the
21penalty specified under section 147.86, and any professional
22disciplinary provisions, as applicable.
23EXPLANATION
24The inclusion of this explanation does not constitute agreement with
25the explanation’s substance by the members of the general assembly.
26This bill relates to appropriations for health and human
27services for fiscal years 2017-2018 and 2018-2019 to the
28department of veterans affairs, Iowa veterans home, department
29on aging (IDA), office of long-term care ombudsman, department
30of public health (DPH), Iowa finance authority, department of
31human rights, and department of human services (DHS).
32The bill is organized into divisions.
33DEPARTMENT ON AGING. This division makes appropriations
34from the general fund of the state to the department on aging
35for FY 2017-2018 and FY 2018-2019.
-144- 1OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes
2appropriations from the general fund of the state to the office
3of long-term care ombudsman for FY 2017-2018 and FY 2018-2019.
4DEPARTMENT OF PUBLIC HEALTH. This division makes
5appropriations from the general fund of the state to the
6department of public health for FY 2017-2018 and FY 2018-2019.
7DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
8division makes appropriations from the general fund of the
9state to the department of veterans affairs for FY 2017-2018
10and FY 2018-2019 for administration, the Iowa veterans home,
11for transfer to the Iowa finance authority for the home
12ownership assistance program, and for the county commissions
13of veteran affairs.
14DEPARTMENT OF HUMAN SERVICES. This division makes
15appropriations from the general fund of the state and the
16federal temporary assistance for needy families block grant to
17DHS for FY 2017-2018 and FY 2018-2019. The allocation for the
18family development and self-sufficiency grant program is made
19directly to the department of human rights. The reimbursement
20section addresses reimbursement for providers reimbursed by the
21department of human services.
22HEALTH CARE ACCOUNTS AND FUNDS. This division makes
23certain health-related appropriations for FY 2017-2018 and
24FY 2018-2019. A number of the appropriations are made for
25purposes of the medical assistance (Medicaid) program in
26addition to the general fund appropriations made for this
27purpose for the same fiscal year.
28CHILD CARE FACILITY FUND — USE FOR FIELD OPERATIONS. This
29division provides for the use of a specified amount of the
30moneys in the child care facility fund for field operations
31related to the child care regulatory unit in FY 2017-2018.
32This division takes effect upon enactment.
33BIOLOGICS AND GENETICALLY TARGETED DRUGS — MEDICAID.
34 This division directs the pharmaceutical and therapeutics
35committee and the drug utilization review committee when
-145-1making recommendations or determinations regarding Medicaid
2beneficiary access to drugs and biological products for rare
3diseases and drugs and biological products that are genetically
4targeted, to request and consider information from individuals
5who possess scientific or medical training with respect to the
6drug, biological product, or rare disease.
7PUBLIC ASSISTANCE PROGRAMS OVERSIGHT. This division amends
82017 Iowa Acts, House File 531, to specifically include the
9national accuracy clearinghouse in the pilot efforts DHS is to
10explore in addressing program integrity for public assistance
11programs. The division takes effect upon enactment and is
12retroactively applicable to March 30, 2017.
13BACKGROUND CHECKS — PRIVATE SECTOR ALTERNATIVES. This
14division directs DHS and the department of public safety to
15jointly review private sector alternatives to the performance
16of state mandated criminal background checks currently
17performed solely by the department of public safety. The
18departments shall submit a report to the governor and the
19general assembly by December 15, 2017, including a description
20of the process used in reviewing private sector alternatives,
21findings from the review, and recommendations for utilizing
22private sector entities as an alternative to the department of
23public safety in performing criminal background checks.
24PSYCHIATRIC BED TRACKING SYSTEM. This division directs
25DHS to amend administrative rules to require the state
26mental health institutes and hospitals licensed to provide
27inpatient psychiatric treatment and services to participate
28in the psychiatric bed tracking system and to ensure updates,
29including the availability of inpatient child, adult,
30and geriatric psychiatric beds staffed and available and
31information on the gender that can be accepted for each
32available bed, are made, at a minimum two times per day to the
33psychiatric bed tracking system.
34CHILDREN’S WELL-BEING COLLABORATIVES AND ADVISORY COMMITTEE.
35 This division directs DHS to establish a request for proposals
-146-1process, based upon recommendations for the development
2and implementation of children’s well-being collaboratives
3described in the children’s mental health and well-being
4workgroup final report submitted by the department on
5December 15, 2016, to issue grants to children’s well-being
6collaboratives. Entities selected as well-being collaboratives
7shall include a broad-based representation of key providers,
8and each entity shall be responsible for developing interagency
9coordination and collaboration, provide technical assistance to
10a diverse array of stakeholders, distribute public awareness
11materials, and provide updates on changes in state and federal
12policy in relation to prevention and early intervention efforts
13concerning children’s mental health and well-being. Each
14grantee is required to submit two reports: one by December
1515, 2017, and the other by April 15, 2018. The division also
16directs DHS to create and provide support to a children’s
17mental health and well-being advisory committee to continue
18efforts relating to improving children’s mental health crisis
19services and children’s well-being learning labs and supporting
20the children’s well-being collaboratives.
21STATE FAMILY PLANNING SERVICES PROGRAM. This division
22establishes the state family planning services program July 1,
232017, and discontinues the Medicaid family planning network
24waiver in effect on June 30, 2017. The state program is to
25replicate the eligibility requirements and other provisions
26included in the Medicaid waiver program. Distribution of
27family planning services program funds shall not be made to
28any entity that performs abortions as defined in the division,
29including for direct or indirect costs related to providing
30abortions. The division provides for emergency rulemaking and
31takes effect upon enactment.
32MEDICAID HOME AND COMMUNITY-BASED SERVICES (HCBS) PROVIDERS
33TIERED REIMBURSEMENT — DOCUMENTATION. This division
34directs DHS to discontinue application of the retrospectively
35limited cost settlement methodology based on submission
-147-1of required cost reports and to implement tiered rates for
2providers of supported community living, day habilitation,
3and adult day services for persons with an intellectual
4disability under the home and community-based services
5waiver program. The tiered rates shall be implemented in a
6phased-in approach to accommodate transition of providers to
7the revised reimbursement model. DHS and Medicaid managed
8care organizations may also establish tiered rates for
9other services. The division also directs DHS to amend
10administrative rules to allow documentation of certain
11providers specified in the division to submit documentation in
12a checkbox form format rather than in a narrative format. The
13division authorizes DHS to adopt emergency rules to implement
14the division. The division takes effect upon enactment.
15TELEHEALTH PARITY INTERIM COMMITTEE. This division
16requests that the legislative council create a legislative
17interim committee to study and make recommendations regarding
18telehealth parity.
19ALZHEIMER’S AND OTHER FORMS OF DEMENTIA — HEALTH AND
20RESILIENCE OUTREACH (HERO) PROJECT. This division directs
21DPH to collaborate with stakeholders that support individuals
22with Alzheimer’s disease to identify funding opportunities
23to support the health and resilience outreach (HERO) project
24for individuals caring for a family member with Alzheimer’s
25or other forms of dementia. The division also directs the
26department on aging, DPH, the department of inspections and
27appeals, and DHS to analyze and make recommendations regarding
28options for coordination between state agencies and private
29entities to promote increased access to dementia-specific
30care in both residential and community-based settings. The
31departments shall submit a joint report of findings and
32recommendations to the governor and the general assembly by
33December 15, 2017.
34OFFICE OF MINORITY AND MULTICULTURAL HEALTH. This division
35repeals Code section 135.12, the office of minority and
-148-1multicultural health, and makes conforming changes in the Code.
2PRIOR YEAR APPROPRIATIONS AND PROVISIONS. This division
3provides for the nonreversion of funds appropriated for FY
42016-2017 for adoption subsidy payments and services; and
5provides for transfer to the medical assistance appropriation
6for FY 2016-2017 of state-appropriated moneys in the funding
7pool for decategorization that remain unencumbered or
8unobligated at the close of the fiscal year beginning July
91, 2014, and that were deemed carryover funding to remain
10available for the two succeeding fiscal years that still remain
11unencumbered or unobligated at the close of the fiscal year
12beginning July 1, 2016. These provisions take effect upon
13enactment and are retroactively applicable to July 1, 2016.
14NONPARTICIPATING PROVIDER REIMBURSEMENT FUND AND IOWACARE
15ACCOUNT REVERSIONS. This division provides that for FY
162016–2017, any moneys remaining in the nonparticipating
17provider reimbursement fund or the IowaCare account are
18appropriated to the department of human services medical
19assistance appropriation to be used for the purposes of the
20IowaCare account as provided in Code section 249J.24. Moneys
21that remain unencumbered or unobligated at the close of a
22fiscal year shall not revert but shall remain available for
23expenditure for the purposes designated until expended. This
24provision takes effect upon enactment.
25HOSPITAL HEALTH CARE ACCESS ASSESSMENT REPEAL. This
26division extends the repeal of the hospital health care access
27assessment program from July 1, 2017, to July 1, 2019. This
28provision takes effect upon enactment and is retroactively
29applicable to June 30, 2017.
30CUSTODIAL CARE REIMBURSEMENT. This division amends
31provisions related to reimbursement of custodial care provided
32for persons receiving state supplementary assistance. Under
33current law, DHS is required to develop a cost-related system
34for financial supplementation to individuals who need custodial
35care and who have insufficient resources to purchase the care
-149-1needed. In developing the cost-related system, all privately
2operated licensed custodial facilities in the state are
3required to cooperate with DHS to develop the plan, and once
4the plan is developed, state supplemental funds are prohibited
5from being used for the care of any individual in a facility
6that has not submitted costs statements to DHS. Under the
7division, the prohibition that no state supplemental funds are
8to be used for the care of any individual in a facility that has
9not submitted cost statements to DHS is eliminated and instead,
10beginning July 1, 2018, all privately operated licensed
11custodial facilities in Iowa are to be reimbursed based on the
12maximum per diem rates established by the general assembly.
13JUVENILE BED CAP. This division increases the statewide
14number of beds in juvenile homes approved by the director of
15the department of human services from not to exceed 262 to not
16to exceed 272 beginning July 1, 2017, and not to exceed 282
17beginning July 1, 2018, and thereafter.
18TRANSFERS OF FUNDS BETWEEN DHS INSTITUTIONS. This division
19provides that, in addition to authorizing the transfer of
20funds between the appropriations made for facilities under the
21purview of the department of human services including the state
22resource centers, the state mental health institutes, and the
23state training school, transfers are also authorized between
24these institutions and the civil commitment unit for sexual
25offenders.
26PELVIC EXAMS — PRIOR CONSENT. This division prohibits
27a person licensed or certified to practice a health-related
28profession or a student undertaking a course of professional
29instruction or participating in a clinical training or
30residency program for such a profession as defined in Code
31section 147.1 (health-related professions), from performing a
32pelvic examination on an anesthetized or unconscious patient
33unless one of four specified conditions is met. A person who
34violates a provision of the division is subject to the existing
35penalty in Code section 147.86, which is a serious misdemeanor,
-150-1and to any professional disciplinary provisions, as applicable.
2A serious misdemeanor is punishable by confinement for no more
3than one year and a fine of at least $315 but not more than
4$1,875.
-151-pf/hb/rn