Iowa House Bill HSB91 Latest Draft

                            House Study Bill 91 - Introduced   SENATE/HOUSE FILE _____   BY (PROPOSED GOVERNOR BILL)   A BILL FOR   An Act relating to the health and well-being of children and 1   families including provisions for rural emergency hospitals, 2   regional centers of excellence, noneconomic damage awards 3   against health care providers, a state-funded family 4   medicine obstetrical fellowship program, self-administered 5   hormonal contraceptives, review and approval of and public 6   policy considerations relating to insurance benefits, 7   maternal support and fatherhood initiatives, state employee 8   parental leave, modification of property tax provisions for 9   certain commercial child care properties, adoption expenses 10   under the adoption subsidy program, and accessibility to the 11   all Iowa scholarship program; providing for appropriations, 12   fines, and penalties; and including effective date and 13   applicability and retroactive applicability provisions. 14   BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 15   TLSB 1511XL (14) 90   pf/rh  

  S.F. _____ H.F. _____   DIVISION I 1   RURAL EMERGENCY HOSPITALS 2   Section 1. Section 135B.1, Code 2023, is amended by adding 3   the following new subsections: 4   NEW SUBSECTION . 5. Rural emergency hospital means a 5   facility that provides rural emergency hospital services in 6   the facility twenty-four hours per day, seven days per week; 7   does not provide any acute care inpatient services with the 8   exception of any distinct part of the facility licensed as a 9   skilled nursing facility providing posthospital extended care 10   services; and meets the criteria specified in section 135B.1A 11   and the federal Consolidated Appropriations Act, Pub. L. No. 12   116-260, 125. 13   NEW SUBSECTION   . 6. Rural emergency hospital services 14   means the following services provided by a rural emergency 15   hospital that do not exceed an annual per patient average of 16   twenty-four hours in such a rural emergency hospital: 17   a. Emergency department services and observation care. 18   For purposes of providing emergency department services, an 19   emergency department of a rural emergency hospital shall 20   be considered staffed if a physician, nurse practitioner, 21   clinical nurse specialist, or physician assistant is available 22   to furnish rural emergency hospital services in the facility 23   twenty-four hours per day. 24   b. At the election of the rural emergency hospital, with 25   respect to services furnished on an outpatient basis, other 26   medical and health services as specified in regulations adopted 27   by the United States secretary of health and human services. 28   Sec. 2. Section 135B.2, Code 2023, is amended to read as 29   follows:   30   135B.2 Purpose. 31   The purpose of this chapter is to provide for the 32   development, establishment and enforcement of basic standards 33   for the care and treatment of individuals in hospitals and 34   rural emergency hospitals and   for the construction, maintenance 35   -1-   LSB 1511XL (14) 90   pf/rh   1/ 44     

  S.F. _____ H.F. _____   and operation of such hospitals, which, in the light of 1   existing knowledge, will promote safe and adequate treatment 2   of such individuals in such   hospitals, in the interest of the 3   health, welfare and safety of the public. 4   Sec. 3. Section 135B.3, Code 2023, is amended to read as 5   follows: 6   135B.3 Licensure. 7   No person or governmental unit, acting severally or jointly 8   with any other person or governmental unit shall establish, 9   conduct or maintain a hospital or rural emergency hospital   in 10   this state without a license. 11   Sec. 4. NEW SECTION   . 135B.3A Rural emergency hospital 12   licensure. 13   1. The department shall adopt rules pursuant to chapter 14   17A to establish minimum standards for the licensure of rural 15   emergency hospitals consistent with the federal Consolidated 16   Appropriations Act, Pub. L. No. 116-260, 125, and with 17   regulations issued by the United States secretary of health and 18   human services for rural emergency hospitals. 19   2. To be eligible for a rural emergency hospital license, a 20   facility shall have been, on or before December 27, 2020, one 21   of the following: 22   a. A licensed critical access hospital. 23   b. A general hospital with not more than fifty licensed 24   beds located in a county in a rural area as defined in section 25   1886(d)(2)(D) of the federal Social Security Act. 26   c. A general hospital with no more than fifty licensed beds 27   that is deemed as being located in a rural area pursuant to 28   section 1886(d)(8)(E) of the federal Social Security Act. 29   Sec. 5. Section 135B.4, Code 2023, is amended to read as   30   follows:   31   135B.4 Application for license. 32   Licenses shall be obtained from the department. 33   Applications shall be upon forms and shall contain information 34   as the department may reasonably require, which may include 35   -2-   LSB 1511XL (14) 90   pf/rh   2/ 44     

  S.F. _____ H.F. _____   affirmative evidence of ability to comply with reasonable 1   standards and rules prescribed under this chapter . Each 2   application for license shall be accompanied by the license 3   fee, which shall be refunded to the applicant if the license 4   is denied and which shall be deposited into the state treasury 5   and credited to the general fund if the license is issued. 6   Hospitals and rural emergency hospitals   having fifty beds or 7   less shall pay an initial license fee of fifteen dollars; 8   hospitals of more than fifty beds and not more than one hundred 9   beds shall pay an initial license fee of twenty-five dollars; 10   all other hospitals shall pay an initial license fee of fifty 11   dollars. 12   Sec. 6. Section 135B.5, subsection 1, Code 2023, is amended 13   to read as follows: 14   1. Upon receipt of an application for license and the 15   license fee, the department shall issue a license if the 16   applicant and hospital facilities comply with this chapter , 17   chapter 135 , and the rules of the department. Each licensee 18   shall receive annual reapproval upon payment of five hundred 19   dollars and upon filing of an application form which is 20   available from the department. The annual licensure fee shall 21   be dedicated to support and provide educational programs on 22   regulatory issues for hospitals and rural emergency hospitals   23   licensed under this chapter . Licenses shall be either general 24   or restricted in form. Each license shall be issued only 25   for the premises and persons or governmental units named in 26   the application and is not transferable or assignable except 27   with the written approval of the department. Licenses shall 28   be posted in a conspicuous place on the licensed premises as 29   prescribed by rule of the department. 30   Sec. 7. Section 135B.5A, Code 2023, is amended to read as 31   follows:   32   135B.5A Conversion of a hospital   relative to certain 33   hospitals   . 34   1. A conversion of a long-term acute care hospital, 35   -3-   LSB 1511XL (14) 90   pf/rh   3/ 44        

  S.F. _____ H.F. _____   rehabilitation hospital, or psychiatric hospital as defined by 1   federal regulations to a general hospital or to a specialty 2   hospital of a different type is a permanent change in bed 3   capacity and shall require a certificate of need pursuant to 4   section 135.63 . 5   2.   A conversion of a critical access hospital or general 6   hospital to a rural emergency hospital or a conversion of a 7   rural emergency hospital to a critical access hospital or 8   general hospital shall not require a certificate of need   9   pursuant to section 135.63. 10   Sec. 8. Section 135B.7, Code 2023, is amended to read as 11   follows: 12   135B.7 Rules and enforcement. 13   1. a. The department, with the approval of the state 14   board of health, shall adopt rules setting out the standards 15   for the different types of hospitals and for rural emergency   16   hospitals to be licensed under this chapter . The department 17   shall enforce the rules. 18   b. Rules or standards shall not be adopted or enforced 19   which would have the effect of denying a license to a hospital ,   20   rural emergency hospital,   or other institution required to be 21   licensed, solely by reason of the school or system of practice 22   employed or permitted to be employed by physicians in the 23   hospital, rural emergency hospital, or other institution   if the 24   school or system of practice is recognized by the laws of this 25   state. 26   2. a. The rules shall state that a hospital or rural 27   emergency hospital shall not deny clinical privileges to 28   physicians and surgeons, podiatric physicians, osteopathic 29   physicians and surgeons, dentists, certified health service 30   providers in psychology, physician assistants, or advanced 31   registered nurse practitioners licensed under chapter 148 , 32   148C , 149 , 152 , or 153 , or section 154B.7 , solely by reason of 33   the license held by the practitioner or solely by reason of 34   the school or institution in which the practitioner received 35   -4-   LSB 1511XL (14) 90   pf/rh   4/ 44                

  S.F. _____ H.F. _____   medical schooling or postgraduate training if the medical 1   schooling or postgraduate training was accredited by an 2   organization recognized by the council on higher education 3   accreditation or an accrediting group recognized by the United 4   States department of education. 5   b. A hospital or rural emergency hospital   may establish 6   procedures for interaction between a patient and a 7   practitioner. The rules shall not prohibit a hospital or 8   rural emergency hospital   from limiting, restricting, or 9   revoking clinical privileges of a practitioner for violation 10   of hospital rules, regulations, or procedures established 11   under this paragraph, when applied in good faith and in a 12   nondiscriminatory manner. 13   c. This subsection shall not require a hospital or rural   14   emergency hospital to expand the hospitals current scope of 15   service delivery solely to offer the services of a class of 16   providers not currently providing services at the hospital 17   or rural emergency hospital   . This section shall not be 18   construed to require a hospital or rural emergency hospital   19   to establish rules which are inconsistent with the scope of 20   practice established for licensure of practitioners to whom 21   this subsection applies. 22   d. This section shall not be construed to authorize the 23   denial of clinical privileges to a practitioner or class of 24   practitioners solely because a hospital or rural emergency   25   hospital has as employees of the hospital or rural emergency 26   hospital identically licensed practitioners providing the same 27   or similar services.   28   3. The rules shall require that a hospital or rural   29   emergency hospital   establish and implement written criteria 30   for the granting of clinical privileges. The written criteria 31   shall include but are not limited to consideration of all of 32   the following: 33   a. The ability of an applicant for privileges to provide 34   patient care services independently and appropriately in the 35   -5-   LSB 1511XL (14) 90   pf/rh   5/ 44                

  S.F. _____ H.F. _____   hospital or rural emergency hospital . 1   b. The license held by the applicant to practice. 2   c. The training, experience, and competence of the 3   applicant. 4   d. The relationship between the applicants request for the 5   granting of privileges and the hospitals or rural emergency   6   hospitals current scope of patient care services, as well as 7   the hospitals or rural emergency hospitals determination of 8   the necessity to grant privileges to a practitioner authorized 9   to provide comprehensive, appropriate, and cost-effective 10   services. 11   4. The department shall also adopt rules requiring 12   hospitals and rural emergency hospitals   to establish and 13   implement protocols for responding to the needs of patients who 14   are victims of domestic abuse, as defined in section 236.2 . 15   5. The department shall also adopt rules requiring 16   hospitals and rural emergency hospitals   to establish and 17   implement protocols for responding to the needs of patients who 18   are victims of elder abuse, as defined in section 235F.1 . 19   Sec. 9. Section 135B.7A, Code 2023, is amended to read as 20   follows: 21   135B.7A Procedures  orders. 22   The department shall adopt rules that require hospitals 23   and rural emergency hospitals   to establish procedures for 24   authentication of all verbal orders by a practitioner within 25   a period not to exceed thirty days following a patients 26   discharge. 27   Sec. 10. Section 135B.8, Code 2023, is amended to read as 28   follows:   29   135B.8 Effective date of rules.   30   Any hospital or rural emergency hospital   which is in 31   operation at the time of promulgation of any applicable 32   rules or minimum standards under this chapter shall be given 33   a reasonable time, not to exceed one year from the date of 34   such promulgation, within which to comply with such rules and 35   -6-   LSB 1511XL (14) 90   pf/rh   6/ 44          

  S.F. _____ H.F. _____   minimum standards. 1   Sec. 11. Section 135B.9, Code 2023, is amended to read as 2   follows: 3   135B.9 Inspections and qualifications for hospital and rural   4   emergency hospital   inspectors  protection and advocacy agency 5   investigations. 6   1. The department shall make or cause to be made inspections 7   as it deems necessary in order to determine compliance with 8   applicable rules. Hospital and rural emergency hospital   9   inspectors shall meet the following qualifications: 10   a. Be free of conflicts of interest. A hospital or rural   11   emergency hospital inspector shall not participate in an 12   inspection or complaint investigation of a hospital or rural 13   emergency hospital   in which the inspector or a member of the 14   inspectors immediate family works or has worked within the 15   last two years. For purposes of this paragraph, immediate 16   family member means a spouse; natural or adoptive parent, 17   child, or sibling; or stepparent, stepchild, or stepsibling. 18   b. Complete a yearly conflict of interest disclosure 19   statement. 20   c. Biennially, complete a minimum of ten hours of continuing 21   education pertaining to hospital or rural emergency hospital   22   operations including but not limited to quality and process 23   improvement standards, trauma system standards, and regulatory 24   requirements. 25   2. In the state resource centers and state mental health 26   institutes operated by the department of human services, the 27   designated protection and advocacy agency as provided in 28   section 135C.2, subsection 4 , shall have the authority to 29   investigate all complaints of abuse and neglect of persons 30   with developmental disabilities or mental illnesses if the 31   complaints are reported to the protection and advocacy agency 32   or if there is probable cause to believe that the abuse has 33   occurred. Such authority shall include the examination of all 34   records pertaining to the care provided to the residents and 35   -7-   LSB 1511XL (14) 90   pf/rh   7/ 44          

  S.F. _____ H.F. _____   contact or interview with any resident, employee, or any other 1   person who might have knowledge about the operation of the 2   institution. 3   Sec. 12. Section 135B.12, Code 2023, is amended to read as 4   follows: 5   135B.12 Confidentiality. 6   The departments final findings or the final survey findings 7   of the joint commission on the accreditation of health care 8   organizations or the American osteopathic association with 9   respect to compliance by a hospital or rural emergency hospital   10   with requirements for licensing or accreditation shall be made 11   available to the public in a readily available form and place. 12   Other information relating to a hospital or rural emergency   13   hospital   obtained by the department which does not constitute 14   the departments findings from an inspection of the hospital 15   or rural emergency hospital or the final survey findings of 16   the joint commission on the accreditation of health care 17   organizations or the American osteopathic association shall 18   not be made available to the public, except in proceedings 19   involving the denial, suspension, or revocation of a license 20   under this chapter . The name of a person who files a complaint 21   with the department shall remain confidential and shall not 22   be subject to discovery, subpoena, or other means of legal 23   compulsion for its release to a person other than department 24   employees or agents involved in the investigation of the 25   complaint. 26   Sec. 13. Section 135B.14, Code 2023, is amended to read as   27   follows: 28   135B.14 Judicial review.   29   Judicial review of the action of the department may be sought 30   in accordance with chapter 17A . Notwithstanding the terms of 31   chapter 17A , the Iowa administrative procedure Act, petitions 32   for judicial review may be filed in the district court of the 33   county in which the hospital or rural emergency hospital   is 34   located or to be located, and the status quo of the petitioner 35   -8-   LSB 1511XL (14) 90   pf/rh   8/ 44       

  S.F. _____ H.F. _____   or licensee shall be preserved pending final disposition of the 1   matter in the courts. 2   Sec. 14. Section 135B.15, Code 2023, is amended to read as 3   follows: 4   135B.15 Penalties. 5   Any person establishing, conducting, managing, or operating 6   any hospital or rural emergency hospital   without a license 7   shall be guilty of a serious misdemeanor, and each day of 8   continuing violation after conviction shall be considered a 9   separate offense. 10   Sec. 15. Section 135B.16, Code 2023, is amended to read as 11   follows: 12   135B.16 Injunction. 13   Notwithstanding the existence or pursuit of any other 14   remedy, the department may, in the manner provided by law, 15   maintain an action in the name of the state for injunction 16   or other process against any person or governmental unit to 17   restrain or prevent the establishment, conduct, management or 18   operation of a hospital or rural emergency hospital   without a 19   license. 20   Sec. 16. Section 135B.20, subsection 3, Code 2023, is 21   amended to read as follows: 22   3. Hospital shall mean   means all hospitals and rural 23   emergency hospitals licensed under this chapter . 24   Sec. 17. Section 135B.33, subsection 1, unnumbered 25   paragraph 1, Code 2023, is amended to read as follows: 26   Subject to availability of funds, the Iowa department of 27   public health shall provide technical planning assistance to 28   local boards of health and hospital or rural emergency hospital 29   governing boards to ensure access to hospital   such services in 30   rural areas. The department shall encourage the local boards 31   of health and hospital or rural emergency hospital   governing 32   boards to adopt a long-term community health services and 33   developmental plan including the following: 34   Sec. 18. Section 135B.34, subsection 7, Code 2023, is 35   -9-   LSB 1511XL (14) 90   pf/rh   9/ 44            

  S.F. _____ H.F. _____   amended to read as follows: 1   7. For the purposes of this section ,   comprehensive 2   preliminary background check : 3   a. Comprehensive preliminary background check means the 4   same as defined in section 135C.1 . 5   b. Hospital means a hospital or rural emergency hospital 6   licensed under this chapter. 7   Sec. 19. EMERGENCY RULEMAKING AUTHORITY. The department of 8   inspections and appeals may adopt emergency rules under section 9   17A.4, subsection 3, and section 17A.5, subsection 2, paragraph 10   b, to implement the provisions of this division of this Act 11   and the rules shall be effective immediately upon filing unless 12   a later date is specified in the rules. Any rules adopted 13   in accordance with this section shall also be published as a 14   notice of intended action as provided in section 17A.4. 15   Sec. 20. EFFECTIVE DATE. This division of this Act, being 16   deemed of immediate importance, takes effect upon enactment. 17   DIVISION II 18   REGIONAL CENTERS OF EXCELLENCE GRANT PROGRAM 19   Sec. 21. REGIONAL CENTERS OF EXCELLENCE PROGRAM  GRANTS  20   APPROPRIATION. There is appropriated from the general fund of 21   the state to the department of health and human services for 22   the fiscal year beginning July 1, 2023, and ending June 30, 23   2024, the following amount, or so much thereof as is necessary, 24   to be used for the purposes designated: 25   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 26   The funds appropriated in this section shall be used for 27   the continuation of a center of excellence program to award 28   four grants to encourage innovation and collaboration among 29   regional health care providers in a rural area based upon the 30   results of a regional community needs assessment to transform 31   health care delivery in order to provide quality, sustainable 32   care that meets the needs of the local communities. An 33   applicant for the grant funds shall specify how the funds will 34   be expended to accomplish the goals of the program and shall 35   -10-   LSB 1511XL (14) 90   pf/rh   10/ 44              

  S.F. _____ H.F. _____   provide a detailed five-year sustainability plan prior to being 1   awarded any funding. Following the receipt of grant funding, 2   a recipient shall submit periodic reports as specified by the 3   department to the governor and the general assembly regarding 4   the recipients expenditure of the funds and progress in 5   accomplishing the programs goals. 6   DIVISION III 7   NONECONOMIC DAMAGE AWARDS AGAINST HEALTH CARE PROVIDERS 8   Sec. 22. Section 147.136A, subsection 1, paragraph b, Code 9   2023, is amended to read as follows: 10   b. (1)   Noneconomic damages means damages arising from 11   pain, suffering, inconvenience, physical impairment, mental 12   anguish, emotional pain and suffering, loss of chance, loss of 13   consortium, or any other nonpecuniary damages. 14   (2)   Noneconomic damages does not include the loss of 15   dependent care, including the loss of child care, due to the 16   death of or severe injury to a spouse or parent who is the 17   primary caregiver of a child under the age of eighteen or a   18   disabled adult. Such damages shall be considered economic   19   damages. 20   Sec. 23. Section 147.136A, subsection 2, Code 2023, is 21   amended to read as follows: 22   2. The total amount recoverable in any civil action for 23   noneconomic damages for personal injury or death, whether in 24   tort, contract, or otherwise, against a health care provider 25   shall be limited to two hundred fifty thousand dollars   for any 26   occurrence resulting in injury or death of a patient regardless 27   of the number of plaintiffs, derivative claims, theories of 28   liability, or defendants in the civil action, shall not exceed 29   two hundred fifty thousand dollars   unless the jury determines 30   that there is a substantial or permanent loss or impairment of 31   a bodily function, substantial disfigurement, or death, which 32   warrants a finding that imposition of such a limitation would 33   deprive the plaintiff of just compensation for the injuries 34   sustained , in which case the amount recoverable shall not   35   -11-   LSB 1511XL (14) 90   pf/rh   11/ 44                

  S.F. _____ H.F. _____   exceed one million dollars . 1   Sec. 24. EFFECTIVE DATE. This division of this Act, being 2   deemed of immediate importance, takes effect upon enactment. 3   Sec. 25. APPLICABILITY. This division of this Act applies 4   to causes of actions accrued on or after the effective date of 5   this Act. 6   DIVISION IV 7   STATE-FUNDED FAMILY MEDICINE OBSTETRICS FELLOWSHIP PROGRAM 8   Sec. 26. NEW SECTION   . 135.182 State-funded family medicine 9   obstetrics fellowship program  fund. 10   1. The department shall establish a family medicine 11   obstetrics fellowship program to increase access to family 12   medicine obstetrics practitioners in rural and underserved 13   areas of the state. A person who has completed an 14   accreditation council for graduate medical education residency 15   program in family medicine is eligible for participation 16   in the fellowship program. Participating fellows shall 17   enter into a program agreement with a participating teaching 18   hospital which, at a minimum, requires the fellow to complete a 19   one-year fellowship and to engage in full-time family medicine 20   obstetrics practice in a rural or underserved area of the 21   state for a period of at least five years within nine months 22   following completion of the fellowship and receipt of a license 23   to practice medicine in the state. 24   2. Each fellow participating in the program shall be 25   eligible for a salary and benefits including a stipend as 26   determined by the participating teaching hospital which shall 27   be funded through the family medicine obstetrics fellowship 28   program fund. 29   3. The department shall adopt rules pursuant to chapter 30   17A to administer the program, including defining rural and 31   underserved areas for the purpose of the required full-time 32   practice of a person following completion of the fellowship. 33   4. a. A family medicine obstetrics fellowship program 34   fund is created in the state treasury consisting of the moneys 35   -12-   LSB 1511XL (14) 90   pf/rh   12/ 44    

  S.F. _____ H.F. _____   appropriated or credited to the fund by law. Notwithstanding 1   section 8.33, moneys in the fund at the end of each fiscal year 2   shall not revert to any other fund but shall remain in the fund 3   for use in subsequent fiscal years. Moneys in the fund are 4   appropriated to the department to be used to fund fellowship 5   positions as provided in this section. 6   b. For the fiscal year beginning July 1, 2023, and each 7   fiscal year beginning July 1 thereafter, there is appropriated 8   from the general fund of the state to the family medicine 9   obstetrics fellowship program fund an amount sufficient to 10   support the creation of four fellowship positions as provided 11   in this section. 12   5. The department and the participating teaching hospitals 13   shall regularly evaluate and document their experiences 14   including identifying ways the program may be modified or 15   expanded to facilitate increased access to family medicine 16   obstetrics practitioners in rural and underserved areas of the 17   state. The department shall submit an annual report to the 18   general assembly by January 1. The report shall include the 19   number of fellowships funded to date and any other information 20   identified by the department and the participating teaching 21   hospitals as indicators of outcomes and the effectiveness of 22   the program. 23   6. For the purposes of this section, teaching hospital 24   means a hospital or medical center that provides medical 25   education to prospective and current health professionals. 26   Sec. 27. STATE-FUNDED FAMILY MEDICINE OBSTETRICS FELLOWSHIP 27   PROGRAM AND FUND  APPROPRIATION. There is appropriated from 28   the general fund of the state to the department of health and 29   human services for the fiscal year beginning July 1, 2023, and 30   ending June 30, 2024, the following amount, or so much thereof 31   as is necessary, to be used for the purposes designated: 32   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 560,000 33   For deposit in the family medicine obstetrics fellowship 34   program fund to be utilized in creating and providing for four 35   -13-   LSB 1511XL (14) 90   pf/rh   13/ 44  

  S.F. _____ H.F. _____   family medicine obstetrics fellowship positions during the 1   fiscal year in accordance with the family medicine obstetrics 2   fellowship program created in this division of this Act. 3   DIVISION V 4   SELF-ADMINISTERED HORMONAL CONTRACEPTIVES 5   Sec. 28. Section 155A.3, Code 2023, is amended by adding the 6   following new subsections: 7   NEW SUBSECTION   . 10A. Department means the department of 8   health and human services. 9   NEW SUBSECTION   . 45A. Self-administered hormonal 10   contraceptive means a self-administered hormonal contraceptive 11   that is approved by the United States food and drug 12   administration to prevent pregnancy. Self-administered 13   hormonal contraceptive includes an oral hormonal contraceptive, 14   a hormonal vaginal ring, and a hormonal contraceptive patch, 15   but does not include any drug intended to induce an abortion as 16   defined in section 146.1. 17   NEW SUBSECTION   . 45B. Standing order means a preauthorized 18   medication order with specific instructions from the medical 19   director of the department to dispense a medication under 20   clearly defined circumstances. 21   Sec. 29. NEW SECTION   . 155A.49 Pharmacist dispensing of 22   self-administered hormonal contraceptives  standing order  23   requirements  limitations of liability. 24   1. a. Notwithstanding any provision of law to the contrary, 25   a pharmacist may dispense a self-administered hormonal 26   contraceptive to a patient who is at least eighteen years of 27   age, pursuant to a standing order established by the medical 28   director of the department in accordance with this section. 29   b. In dispensing a self-administered hormonal contraceptive 30   to a patient under this section, a pharmacist shall comply with 31   all of the following: 32   (1) For an initial dispensing of a self-administered 33   hormonal contraceptive, the pharmacist may dispense only up 34   to a three-month supply at one time of the self-administered 35   -14-   LSB 1511XL (14) 90   pf/rh   14/ 44      

  S.F. _____ H.F. _____   hormonal contraceptive. 1   (2) For any subsequent dispensing of the same 2   self-administered hormonal contraceptive, the pharmacist 3   may dispense up to a twelve-month supply at one time of the 4   self-administered hormonal contraceptive. 5   2. A pharmacist who dispenses a self-administered hormonal 6   contraceptive in accordance with this section shall not 7   require any other prescription drug order authorized by a 8   practitioner prior to dispensing the self-administered hormonal 9   contraceptive to a patient. 10   3. The medical director of the department may establish a 11   standing order authorizing the dispensing of self-administered 12   hormonal contraceptives by a pharmacist who does all of the 13   following: 14   a. Complies with the standing order established pursuant to 15   this section. 16   b. Retains a record of each patient to whom a 17   self-administered hormonal contraceptive is dispensed under 18   this section and submits the record to the department. 19   4. The standing order shall require a pharmacist who 20   dispenses self-administered hormonal contraceptives under this 21   section to do all of the following: 22   a. Complete a standardized training program and continuing 23   education requirements approved by the board in consultation 24   with the board of medicine and the department that are related 25   to prescribing self-administered hormonal contraceptives and 26   include education regarding all contraceptive methods approved 27   by the United States food and drug administration. 28   b. Obtain a completed self-screening risk assessment, 29   approved by the department in collaboration with the board and 30   the board of medicine, from each patient, verify the identity 31   and age of each patient, and perform a blood pressure screening 32   on each patient prior to dispensing the self-administered 33   hormonal contraceptive to the patient. 34   c. Provide the patient with all of the following: 35   -15-   LSB 1511XL (14) 90   pf/rh   15/ 44  

  S.F. _____ H.F. _____   (1) Written information regarding all of the following: 1   (a) The importance of completing an appointment with the 2   patients primary care or womens health care practitioner 3   to obtain preventative care, including but not limited to 4   recommended tests and screenings. 5   (b) The effectiveness and availability of long-acting 6   reversible contraceptives as an alternative to 7   self-administered hormonal contraceptives. 8   (2) A copy of the record of the pharmacists encounter with 9   the patient that includes all of the following: 10   (a) The patients completed self-screening risk assessment. 11   (b) A description of the contraceptive dispensed, or the 12   basis for not dispensing a contraceptive. 13   (3) Patient counseling regarding all of the following: 14   (a) The appropriate administration and storage of the 15   self-administered hormonal contraceptive. 16   (b) Potential side effects and risks of the 17   self-administered hormonal contraceptive. 18   (c) The need for backup contraception. 19   (d) When to seek emergency medical attention. 20   (e) The risk of contracting a sexually transmitted 21   infection or disease, and ways to reduce such a risk. 22   5. The standing order established pursuant to this section 23   shall prohibit a pharmacist who dispenses a self-administered 24   hormonal contraceptive under this section from doing any of the 25   following: 26   a. Requiring a patient to schedule an appointment with 27   the pharmacist for the prescribing or dispensing of a 28   self-administered hormonal contraceptive. 29   b. Dispensing self-administered hormonal contraceptives 30   to a patient for more than twenty-seven months after the 31   date a self-administered hormonal contraceptive is initially 32   dispensed to the patient, if the patient has not consulted with 33   a primary care or womens health care practitioner during the 34   preceding twenty-seven months, in which case the pharmacist 35   -16-   LSB 1511XL (14) 90   pf/rh   16/ 44  

  S.F. _____ H.F. _____   shall refer the patient to a primary care or womens health 1   care practitioner. 2   c. Dispensing a self-administered hormonal contraceptive to 3   a patient if the results of the self-screening risk assessment 4   completed by a patient pursuant to subsection 4, paragraph 5   b , indicate it is unsafe for the pharmacist to dispense the 6   self-administered hormonal contraceptive to the patient, in 7   which case the pharmacist shall refer the patient to a primary 8   care or womens health care practitioner. 9   6. A pharmacist who dispenses a self-administered hormonal 10   contraceptive and the medical director of the department who 11   establishes a standing order in compliance with this section 12   shall be immune from criminal and civil liability arising 13   from any damages caused by the dispensing, administering, 14   or use of a self-administered hormonal contraceptive or the 15   establishment of the standing order. The medical director of 16   the department shall be considered to be acting within the 17   scope of the medical directors office and employment for 18   purposes of chapter 669 in the establishment of a standing 19   order in compliance with this section. 20   7. The department, in collaboration with the board and 21   the board of medicine, and in consideration of the guidelines 22   established by the American congress of obstetricians and 23   gynecologists, shall adopt rules pursuant to chapter 17A to 24   administer this chapter. 25   Sec. 30. Section 514C.19, Code 2023, is amended to read as 26   follows:   27   514C.19 Prescription contraceptive coverage. 28   1. Notwithstanding the uniformity of treatment requirements 29   of section 514C.6 , a group policy ,   or contract , or plan 30   providing for third-party payment or prepayment of health or 31   medical expenses shall not do either of the following   comply 32   as follows :   33   a. Exclude   Such policy, contract, or plan shall not 34   exclude or restrict benefits for prescription contraceptive 35   -17-   LSB 1511XL (14) 90   pf/rh   17/ 44           

  S.F. _____ H.F. _____   drugs or prescription contraceptive devices which prevent 1   conception and which are approved by the United States 2   food and drug administration, or generic equivalents 3   approved as substitutable by the United States food and 4   drug administration, if such policy , or contract , or plan 5   provides benefits for other outpatient prescription drugs 6   or devices. However, such policy, contract, or plan shall   7   specifically provide for payment of a self-administered 8   hormonal contraceptive, as prescribed by a practitioner as   9   defined in section 155A.3, or as prescribed by standing order 10   and dispensed by a pharmacist pursuant to section 155A.49,   11   including payment for up to an initial three-month supply 12   of a self-administered hormonal contraceptive dispensed at 13   one time and for up to a twelve-month supply of the same   14   self-administered hormonal contraceptive subsequently dispensed 15   at one time. 16   b. Exclude Such policy, contract, or plan shall not exclude 17   or restrict benefits for outpatient contraceptive services 18   which are provided for the purpose of preventing conception if 19   such policy ,   or contract , or plan provides benefits for other 20   outpatient services provided by a health care professional. 21   2. A person who provides a group policy ,   or contract , or 22   plan   providing for third-party payment or prepayment of health 23   or medical expenses which is subject to subsection 1 shall not 24   do any of the following: 25   a. Deny to an individual eligibility, or continued 26   eligibility, to enroll in or to renew coverage under the terms 27   of the policy ,   or contract , or plan because of the individuals 28   use or potential use of such prescription contraceptive drugs 29   or devices, or use or potential use of outpatient contraceptive 30   services.   31   b. Provide a monetary payment or rebate to a covered 32   individual to encourage such individual to accept less than the 33   minimum benefits provided for under subsection 1 . 34   c. Penalize or otherwise reduce or limit the reimbursement 35   -18-   LSB 1511XL (14) 90   pf/rh   18/ 44                           

  S.F. _____ H.F. _____   of a health care professional because such professional 1   prescribes contraceptive drugs or devices, or provides 2   contraceptive services. 3   d. Provide incentives, monetary or otherwise, to a health 4   care professional to induce such professional to withhold 5   from a covered individual contraceptive drugs or devices, or 6   contraceptive services. 7   3. This section shall not be construed to prevent a 8   third-party payor from including deductibles, coinsurance, or 9   copayments under the policy ,   or contract, or plan as follows: 10   a. A deductible, coinsurance, or copayment for benefits 11   for prescription contraceptive drugs shall not be greater than 12   such deductible, coinsurance, or copayment for any outpatient 13   prescription drug for which coverage under the policy ,   or 14   contract , or plan is provided. 15   b. A deductible, coinsurance, or copayment for benefits for 16   prescription contraceptive devices shall not be greater than 17   such deductible, coinsurance, or copayment for any outpatient 18   prescription device for which coverage under the policy ,   or 19   contract , or plan is provided. 20   c. A deductible, coinsurance, or copayment for benefits for 21   outpatient contraceptive services shall not be greater than 22   such deductible, coinsurance, or copayment for any outpatient 23   health care services for which coverage under the policy ,   or 24   contract , or plan is provided. 25   4. This section shall not be construed to require a 26   third-party payor under a policy , or contract , or plan 27   to provide benefits for experimental or investigational 28   contraceptive drugs or devices, or experimental or 29   investigational contraceptive services, except to the extent 30   that such policy ,   or contract , or plan provides coverage for 31   other experimental or investigational outpatient prescription 32   drugs or devices, or experimental or investigational outpatient 33   health care services.   34   5. This section shall not be construed to limit or otherwise   35   -19-   LSB 1511XL (14) 90   pf/rh   19/ 44                    

  S.F. _____ H.F. _____   discourage the use of generic equivalent drugs approved by the 1   United States food and drug administration, whenever available 2   and appropriate. This section , when a brand name drug is 3   requested by a covered individual and a suitable generic 4   equivalent is available and appropriate, shall not be construed 5   to prohibit a third-party payor from requiring the covered 6   individual to pay a deductible, coinsurance, or copayment 7   consistent with subsection 3 , in addition to the difference of 8   the cost of the brand name drug less the maximum covered amount 9   for a generic equivalent. 10   6. A person who provides an individual policy ,   or contract , 11   or plan providing for third-party payment or prepayment of 12   health or medical expenses shall make available a coverage 13   provision that satisfies the requirements in subsections 14   1 through 5 in the same manner as such requirements are 15   applicable to a group policy ,   or contract , or plan under those 16   subsections. The policy , or contract , or plan shall provide 17   that the individual policyholder may reject the coverage 18   provision at the option of the policyholder. 19   7. a. This section applies to the following classes of 20   third-party payment provider contracts ,   or policies , or plans 21   delivered, issued for delivery, continued, or renewed in this 22   state on or after July 1, 2000   January 1, 2024 : 23   (1) Individual or group accident and sickness insurance 24   providing coverage on an expense-incurred basis. 25   (2) An individual or group hospital or medical service 26   contract issued pursuant to chapter 509 , 514 , or 514A . 27   (3) An individual or group health maintenance organization 28   contract regulated under chapter 514B . 29   (4) Any other entity engaged in the business of insurance, 30   risk transfer, or risk retention, which is subject to the 31   jurisdiction of the commissioner. 32   (5) A plan established pursuant to chapter 509A for public 33   employees. 34   b. This section shall not apply to accident-only, 35   -20-   LSB 1511XL (14) 90   pf/rh   20/ 44                 

  S.F. _____ H.F. _____   specified disease, short-term hospital or medical, hospital 1   confinement indemnity, credit, dental, vision, Medicare 2   supplement, long-term care, basic hospital and medical-surgical 3   expense coverage as defined by the commissioner, disability 4   income insurance coverage, coverage issued as a supplement 5   to liability insurance, workers compensation or similar 6   insurance, or automobile medical payment insurance. 7   8.   This section shall not be construed to require a 8   third-party payor to provide payment to a practitioner for the   9   dispensing of a self-administered hormonal contraceptive to 10   replace a self-administered hormonal contraceptive that has   11   been dispensed to a covered person and that has been misplaced, 12   stolen, or destroyed. This section shall not be construed to 13   require a third-party payor to replace covered prescriptions   14   that are misplaced, stolen, or destroyed. 15   9. For the purposes of this section, self-administered 16   hormonal contraceptive and standing order mean the same as 17   defined in section 155A.3.   18   Sec. 31. INFORMATION PROGRAM FOR DRUG PRESCRIBING AND 19   DISPENSING  SELF-ADMINISTERED HORMONAL CONTRACEPTIVES. The 20   board of pharmacy in collaboration with the board of medicine 21   and the department of health and human services shall expand 22   the information program for drug prescribing and dispensing 23   established pursuant to section 124.551, to collect from 24   pharmacists information relating to the dispensing of 25   self-administered hormonal contraceptives as provided pursuant 26   to section 155A.49. The board of pharmacy shall adopt 27   rules pursuant to chapter 17A related to registration of 28   participating pharmacists, the information to be reported by a 29   pharmacist to the information program, access to information 30   from the program, and other rules necessary to carry out the 31   purposes and to enforce the provisions of this section. 32   Sec. 32. APPLICATION TO MEDICAID PROGRAM. This division 33   of this Act shall apply to the Medicaid program including a 34   managed care organization acting pursuant to a contract with 35   -21-   LSB 1511XL (14) 90   pf/rh   21/ 44                     

  S.F. _____ H.F. _____   the department of health and human services to administer 1   the Medicaid program under chapter 249A. However, if it is 2   determined that any provision of this division of this Act 3   would cause denial of federal funds under Tit. XVIII or XIX 4   of the federal Social Security Act, or would otherwise be 5   inconsistent or conflict with the requirements of federal law 6   or regulation, such provision shall be suspended, but only to 7   the extent necessary to prevent denial of such funds or to 8   eliminate the inconsistency or conflict with the requirements 9   of federal law or regulation. 10   DIVISION VI 11   INSURANCE BENEFITS  REVIEW AND APPROVAL  PUBLIC POLICY 12   CONSIDERATIONS 13   Sec. 33. Section 509.3, Code 2023, is amended by adding the 14   following new subsection: 15   NEW SUBSECTION   . 3. a. A policy or policy form in 16   connection with a policy of group accident or health insurance, 17   or combination thereof, that is issued in this state shall 18   not contain a provision that is unjust, unfair, inequitable, 19   misleading, deceptive, encourages misrepresentation of the 20   policy, or that is otherwise contrary to public policy. 21   b. It shall be unlawful for a carrier to issue a policy, or 22   to use a policy form in connection with a policy, after notice 23   from the commissioner of insurance that the policy or policy 24   form violates paragraph a . 25   c. A carrier shall have twenty days after receipt of a 26   notice under paragraph b to request a hearing to contest 27   the commissioners notice. The hearing shall be conducted 28   pursuant to chapter 17A. If the hearing results in a decision 29   that affirms the commissioners notice, the decision shall 30   be provided to the carrier in writing and shall specify the 31   reasons for the decision. 32   Sec. 34. NEW SECTION   . 513B.4C Filing requirement  prior 33   approval. 34   1. a. A group policy of insurance against loss or expense 35   -22-   LSB 1511XL (14) 90   pf/rh   22/ 44    

  S.F. _____ H.F. _____   from sickness, or from the bodily injury or death by accident 1   of the insured, shall not be issued or delivered in this state 2   by a carrier until a copy of the policy has been filed with, and 3   approved by, the commissioner. 4   b. An application, rider, or endorsement shall not be used 5   in connection with a group policy under paragraph a until a 6   copy of the policy form has been filed with, and approved by, 7   the commissioner. 8   2. A filing under subsection 1 shall be deemed approved 9   unless disapproved by the commissioner within thirty days of 10   the date the filing is received by the commissioner. 11   Sec. 35. NEW SECTION   . 513B.4D Filing  disapproval. 12   1. a. The commissioner shall provide notice to a 13   carrier that has filed a policy form pursuant to section 14   513B.4C, subsection 1, if upon review of the policy form the 15   commissioner finds any of the following: 16   (1) The benefits provided are unreasonable in relation to 17   the premium charged. 18   (2) The policy form contains a provision that is unjust, 19   unfair, inequitable, misleading, deceptive, encourages 20   misrepresentation of the policy, or is otherwise contrary to 21   public policy. 22   b. The notice under paragraph a shall do all of the 23   following: 24   (1) Advise the carrier that the policy form does not comply 25   with this section, or with the rules adopted pursuant to 26   chapter 17 to implement and administer this section. 27   (2) Advise the carrier that it shall be unlawful for the 28   carrier to issue the policy form or to use the policy form in 29   connection with any policy. 30   (3) Provide the specific reasons for the commissioners 31   disapproval of the policy form. 32   2. A carrier shall have twenty days after receipt of a 33   notice under subsection 1 to request a hearing to contest 34   the commissioners notice. The hearing shall be conducted 35   -23-   LSB 1511XL (14) 90   pf/rh   23/ 44   

  S.F. _____ H.F. _____   pursuant to chapter 17A. If the hearing results in a decision 1   that affirms the commissioners notice, the decision shall 2   be provided to the carrier in writing and shall specify the 3   reasons for the decision. 4   Sec. 36. NEW SECTION . 513B.4E Withdrawal of approval. 5   1. The commissioner may, after opportunity for hearing, 6   withdraw the commissioners previous approval of a policy form 7   under section 513B.4C if the policy form is in violation of 8   section 513B.4D, subsection 1, paragraph a . The hearing shall 9   be conducted pursuant to chapter 17A. Notice to the carrier 10   of the hearing shall specify the matters to be considered at 11   the hearing. 12   2. It shall be unlawful for a carrier to issue a policy 13   form, or to use a policy form in connection with any group 14   policy, on or after the effective date of the commissioners 15   withdrawal of a previous approval of the policy form. 16   3. If a hearing results in a decision to withdraw a previous 17   approval of a policy form, the decision shall be provided to 18   the carrier in writing and shall specify the reasons for the 19   commissioners withdrawal of the prior approval. 20   DIVISION VII 21   MORE OPTIONS FOR MATERNAL SUPPORT (MOMS) PROGRAM  FATHERHOOD 22   INITIATIVES 23   Sec. 37. Section 217.41C, subsection 1, paragraph c, Code 24   2023, is amended to read as follows: 25   c. For the purposes of this section , pregnancy support 26   services means those nonmedical services that promote 27   childbirth by providing information, counseling, and support 28   services that assist pregnant women or women who believe they 29   may be pregnant and men who are involved or who think they   30   might be involved in a pregnancy to choose childbirth and to 31   make informed decisions regarding the choice of adoption or 32   parenting with respect to their children. 33   Sec. 38. Section 217.41C, Code 2023, is amended by adding 34   the following new subsections: 35   -24-   LSB 1511XL (14) 90   pf/rh   24/ 44     

  S.F. _____ H.F. _____   NEW SUBSECTION . 8. The department shall develop and 1   maintain a virtual clearinghouse of pregnancy support 2   services and resources including but not limited to all of the 3   following: 4   a. Pregnancy resource center and maternity home information 5   including contact information, location, and services provided. 6   b. Assistance in accessing public assistance including but 7   not limited to the special supplemental nutrition program for 8   women, infants, and children and the supplemental nutrition 9   assistance program. 10   c. Educational resources. 11   d. Housing assistance. 12   e. Recovery and mental health services. 13   f. Family planning education. 14   g. Adoption and foster care information and services. 15   h. Healing and support services for abortion survivors and 16   their families. 17   NEW SUBSECTION   . 9. Beginning July 1, 2023, and thereafter, 18   funding for the program may be used for all of the following 19   purposes: 20   a. Fatherhood engagement grants. The department may 21   award grants to nonprofit, community-based organizations to 22   address the needs of fathers by assisting fathers in finding 23   employment, managing child support obligations, transitioning 24   from a period of incarceration, accessing health care, 25   understanding child development, and enhancing parenting skills 26   using evidence-based parenting education. Priority in the 27   awarding of grants shall be based on the demonstrated need 28   in a geographic area and the prevalence of the population to 29   be served as indicated by factors including but not limited 30   to the service areas unemployment rate, incarceration rate, 31   number of public assistance recipients, number of single-parent 32   households, level of housing instability, and graduation rates. 33   b. Fatherhood communications initiative. The department 34   shall administer a communications initiative on responsible 35   -25-   LSB 1511XL (14) 90   pf/rh   25/ 44    

  S.F. _____ H.F. _____   fatherhood including but not limited to a public internet site 1   that provides access to resources on effective parenting and 2   assistance in receiving parenting support and services. 3   c. Mentoring school-aged males grant program. The 4   department may award three-year renewable grants to nonprofit 5   organizations that provide mentorship, social and academic 6   support, and life skills development to school-aged males. 7   Priority in the awarding of grants shall be based on the 8   demonstrated need in a geographic area and the prevalence of 9   the population to be served as indicated by factors including 10   but not limited to the service areas unemployment rate, 11   incarceration rate, number of public assistance recipients, 12   number of single-parent households, level of housing 13   instability, and graduation rates. The department shall 14   provide technical assistance to grantees to ensure program 15   sustainability following the end of the three-year grant 16   period. 17   Sec. 39. MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM  18   APPROPRIATION. There is appropriated from the general fund of 19   the state to the department of health and human services for 20   the fiscal year beginning July 1, 2023, and ending June 30, 21   2024, the following amount, or so much thereof as is necessary, 22   to be used for the purposes designated: 23   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 24   To be used for the purposes of the more options for maternal 25   support program created in section 217.41C, including for 26   program administration, the provision of services, and for 27   funding of fatherhood engagement grants, the fatherhood 28   communications initiative, and the mentoring school-aged males 29   grant program. 30   Sec. 40. 2022 Iowa Acts, chapter 1131, section 28, 31   subsection 8, is amended to read as follows:   32   8. Of the funds appropriated under this section, $500,000 33   shall be used for the purposes of program administration and 34   provision of pregnancy support services through the more 35   -26-   LSB 1511XL (14) 90   pf/rh   26/ 44  

  S.F. _____ H.F. _____   options for maternal support program created in this Act. 1   Notwithstanding section 8.33, moneys appropriated in this   2   subsection that remain unencumbered or unobligated at the close 3   of the fiscal year shall not revert but shall remain available 4   for the purposes designated until the close of the succeeding   5   fiscal year.   6   Sec. 41. EFFECTIVE DATE. The following, being deemed of 7   immediate importance, takes effect upon enactment: 8   The section of this division of this Act amending 2022 Iowa 9   Acts, chapter 1131, section 28, subsection 8. 10   DIVISION VIII 11   STATE EMPLOYEE PAID PARENTAL LEAVE BENEFIT 12   Sec. 42. NEW SECTION   . 70A.31 Paid parental leave. 13   1. A state employee entitled to leave under the federal 14   Family and Medical Leave Act of 1993 shall be provided paid 15   leave for such time as specified in this section for the birth 16   or placement for adoption with the employee of a child if the 17   leave is taken within twelve months following any such birth 18   or adoption. 19   2. a. For the birth of a child, a state employee parent who 20   gave birth shall be entitled to up to four weeks of paid leave 21   and a state employee parent who did not give birth shall be 22   entitled to up to one week of paid leave. 23   b. For the placement for adoption of a child, a state 24   employee parent shall be entitled to up to four weeks of paid 25   leave. 26   3. The department of administrative services shall adopt 27   rules to implement this section. 28   DIVISION IX   29   PROPERTY TAX MODIFICATIONS  LICENSED COMMERCIAL CHILD CARE   30   CENTERS AND CHILD CARE FACILITIES   31   Sec. 43. Section 441.21, subsection 5, paragraph b, 32   subparagraph (2), unnumbered paragraph 1, Code 2023, is amended 33   to read as follows: 34   For Except for property subject to subparagraph (3), for 35   -27-   LSB 1511XL (14) 90   pf/rh   27/ 44          

  S.F. _____ H.F. _____   valuations established for the assessment year beginning 1   January 1, 2022, and each assessment year thereafter, the 2   portion of actual value at which each property unit of 3   commercial property shall be assessed shall be the sum of the 4   following: 5   Sec. 44. Section 441.21, subsection 5, paragraph b, Code 6   2023, is amended by adding the following new subparagraph: 7   NEW SUBPARAGRAPH   . (3) (a) For valuations established 8   for the assessment year beginning January 1, 2023, and each 9   assessment year thereafter, the portion of actual value at 10   which each portion of a property unit of commercial property 11   that is primarily used as a child care center or child care 12   facility, as defined in section 237A.1, and for which an 13   application has been allowed under this subparagraph, shall be 14   assessed at an amount equal to the product of the assessment 15   limitation percentage applicable to residential property under 16   subsection 4 for that assessment year multiplied by the actual 17   value of the property. 18   (b) A person who wishes to qualify for the assessment 19   limitation under this subparagraph shall file an application 20   with the assessor not later than July 1 of the assessment 21   year for which the person is first requesting the assessment 22   limitation on forms provided by the department of revenue. 23   The application shall describe the property and its location 24   and include other information required by the department of 25   revenue. The application shall be accompanied by a copy 26   of the license to operate as a child care center or child 27   care facility issued by the department of health and human 28   services or other proof of eligibility set forth in rule by the 29   department of revenue. Upon allowance of the application, the 30   assessment limitation shall be applied to the portion of the 31   property unit of commercial property that is primarily used as 32   a child care center or child care facility for successive years 33   without further filing as long as the portion of the property 34   unit continues to be classified as commercial property and is 35   -28-   LSB 1511XL (14) 90   pf/rh   28/ 44   

  S.F. _____ H.F. _____   used for the purposes specified in the application. 1   (c) Not later than July 6 of each year, the assessor shall 2   remit the applications for the assessment limitation to the 3   county auditor with the assessors recommendation for allowance 4   or disallowance. If the assessor recommends disallowance, the 5   assessor shall submit the reasons for the recommendation, in 6   writing, to the county auditor. 7   (d) Not later than July 15 of each year, the county auditor 8   shall forward the applications for the assessment limitation 9   to the board of supervisors. The board shall determine the 10   eligibility for each application on or before September 1 of 11   each year. If the board disallows a claim, it shall send 12   written notice, by mail, to the applicant at the applicants 13   last-known address. The notice shall state the reasons for 14   disallowing the application and shall state the applicants 15   right to appeal the boards action to the district court under 16   subparagraph division (f). 17   (e) All applications that have been allowed by the board of 18   supervisors shall be certified on or before October 1, in each 19   year, by the board of supervisors to the county auditor. 20   (f) Within thirty days following the date of the notice of 21   disallowance under subparagraph division (d), the applicant may 22   appeal the disallowance to the district court of the county in 23   which the property is situated. 24   (g) If the person ceases to use the property as a child 25   care center or child care facility, the person shall provide 26   written notice to the assessor by July 1 following the date on 27   which the use has changed. If, at any time within thirty-six 28   months following the date that an application is allowed, 29   the board determines that the person received an assessment 30   limitation under this subparagraph that the person is not 31   entitled to, the treasurer shall collect from the person the 32   amount of additional tax that would have been assessed on the 33   property if the property received the assessment limitations 34   under subparagraph (2), and the amount shall become a lien 35   -29-   LSB 1511XL (14) 90   pf/rh   29/ 44  

  S.F. _____ H.F. _____   on the property that received the assessment limitation and 1   shall be collected by the county treasurer in the same manner 2   as other taxes. Prior to the boards determination that a 3   person received an assessment limitation that the person is 4   not entitled to, the board shall notify the person by mail and 5   conduct a hearing. 6   (h) The assessor shall retain a permanent file of current 7   applications made under this subparagraph. The county recorder 8   shall give notice to the assessor of each transfer of title 9   filed in the recorders office. The notice from the county 10   recorder shall describe the property transferred, the name of 11   the person transferring title to the property, and the name of 12   the person to whom title to the property has been transferred. 13   The assessor shall file a notice of transfer of property for 14   which an application is filed when notice is received from the 15   office of the county recorder. 16   (i) The department shall adopt rules to implement and 17   administer this subparagraph. 18   Sec. 45. Section 441.21, subsection 5, paragraph e, 19   subparagraphs (1) and (3), Code 2023, are amended to read as 20   follows: 21   (1) For each fiscal year beginning on or after July 1, 2023, 22   there is appropriated from the general fund of the state to 23   the department of revenue the sum of one hundred twenty-five 24   million dollars to be used for payments under this paragraph 25   calculated as a result of the assessment limitations imposed 26   under paragraph b , subparagraph (2), subparagraph division 27   (a) ;   , and paragraph c , subparagraph (2), subparagraph 28   division (a) ; and paragraph   b , subparagraph (3), for the 29   portion of actual value of each property unit subject to the   30   assessment limitation under paragraph b , subparagraph (3), 31   that is less than or equal to one hundred fifty thousand   32   dollars . 33   (3) On or before July 1 of each fiscal year, the assessor 34   shall report to the county auditor that portion of the total 35   -30-   LSB 1511XL (14) 90   pf/rh   30/ 44             

  S.F. _____ H.F. _____   actual value of all commercial property and industrial property 1   in the county that is subject to the assessment limitations 2   imposed under paragraph b , subparagraph (2), subparagraph 3   division (a) ;   , and paragraph c , subparagraph (2), 4   subparagraph division (a) ,   ; and paragraph b , subparagraph 5   (3), for the portion of actual value of each property unit   6   subject to the assessment limitation under paragraph b , 7   subparagraph (3), that is less than or equal to one hundred 8   fifty thousand dollars,   for the assessment year used to 9   calculate the taxes due and payable in that fiscal year. 10   Sec. 46. Section 441.21, subsection 5, paragraph e, 11   subparagraph (4), subparagraph division (a), Code 2023, is 12   amended to read as follows: 13   (a) The product of the portion of the total actual value 14   of all commercial property, industrial property, and property 15   valued by the department under chapter 434 in the county 16   that is subject to the assessment limitations imposed under 17   paragraph b , subparagraph (2), subparagraph division (a) ;   , 18   and   paragraph c , subparagraph (2), subparagraph division 19   (a) , ; and paragraph b , subparagraph (3), for the portion of 20   actual value of each property unit subject to the assessment   21   limitation under paragraph b , subparagraph (3), that is less 22   than or equal to one hundred fifty thousand dollars,   for the 23   applicable assessment year used to calculate taxes which are 24   due and payable in the applicable fiscal year multiplied by the 25   difference, stated as a percentage, between ninety percent and 26   the assessment limitation percentage applicable to residential 27   property under subsection 4 for the applicable assessment year. 28   Sec. 47. EFFECTIVE DATE. This division of this Act, being 29   deemed of immediate importance, takes effect upon enactment. 30   Sec. 48. RETROACTIVE APPLICABILITY. The following apply 31   retroactively to assessment years beginning on or after January 32   1, 2023: 33   1. The section of this division of this Act amending 34   section 441.21, subsection 5, paragraph b, subparagraph (2), 35   -31-   LSB 1511XL (14) 90   pf/rh   31/ 44                          

  S.F. _____ H.F. _____   unnumbered paragraph 1. 1   2. The section of this division of this Act enacting section 2   441.21, subsection 5, paragraph b, subparagraph (3). 3   Sec. 49. APPLICABILITY. The following apply July 1, 2024, 4   for payments under section 441.21, subsection 5, paragraph e, 5   for fiscal years beginning on or after that date: 6   1. The section of this division of this Act amending section 7   441.21, subsection 5, paragraph e, subparagraphs (1) and (3). 8   2. The section of this division of this Act amending 9   section 441.21, subsection 5, paragraph e, subparagraph (4), 10   subparagraph division (a). 11   DIVISION X 12   NONRECURRING ADOPTION EXPENSES  ADOPTION SUBSIDY PROGRAM 13   Sec. 50. NEW SECTION   . 234.48 Adoption subsidy  14   nonrecurring adoption expenses. 15   Notwithstanding any provision to the contrary, the maximum 16   reimbursement provided to an adoptive parent under the 17   adoption subsidy program for nonrecurring adoption expenses 18   is one thousand dollars. For the purposes of this section, 19   nonrecurring adoption expenses means the same as defined in 45 20   C.F.R. 1356.41. The department shall adopt rules pursuant to 21   chapter 17A to administer this section. 22   Sec. 51. REPEAL. 2010 Iowa Acts, chapter 1031, section 408, 23   is repealed. 24   DIVISION XI 25   ALL IOWA OPPORTUNITY SCHOLARSHIP PROGRAM 26   Sec. 52. Section 261.87, subsection 1, paragraph b, 27   unnumbered paragraph 1, Code 2023, is amended to read as 28   follows: 29   Eligible foster care student means a person under   30   twenty-six years of age who has a high school diploma or a high 31   school equivalency diploma under chapter 259A and is described 32   by any of the following: 33   Sec. 53. Section 261.87, subsection 2, paragraph f, Code 34   2023, is amended to read as follows:   35   -32-   LSB 1511XL (14) 90   pf/rh   32/ 44     

  S.F. _____ H.F. _____   f. (1) Begins Except as provided in subparagraph (2), 1   begins   enrollment at an eligible institution within two 2   academic years of graduation from high school or receipt of 3   a high school equivalency diploma under chapter 259A and 4   continuously receives awards as a full-time or part-time 5   student to maintain eligibility. However, the student may 6   defer or suspend participation in the program for up to two 7   years in order to pursue obligations that meet conditions 8   established by the commission by rule or to fulfill military 9   obligations. 10   (2)   The requirements of subparagraph (1) do not apply to an 11   eligible foster care student. 12   Sec. 54. APPLICABILITY. This division of this Act applies 13   to applications submitted under the all Iowa opportunity 14   scholarship program established pursuant to section 261.87 15   before, on, or after the effective date of this division of 16   this Act. 17   EXPLANATION 18   The inclusion of this explanation does not constitute agreement with 19   the explanations substance by the members of the general assembly. 20   This bill relates to the health and well-being of children 21   and families. The bill is constructed in divisions. 22   DIVISION I  RURAL EMERGENCY HOSPITALS. This division 23   provides for state licensure of rural emergency hospitals 24   (REHs). Under the federal Consolidated Appropriations Act of 25   2021 (federal Act), REHs were established as a new provider 26   type. Effective January 1, 2023, REHs are eligible to enroll 27   in Medicare and to receive an enhanced reimbursement rate for   28   eligible services consisting of the outpatient prospective 29   payment system rate plus a 5 percent add-on and a fixed monthly 30   payment. In order to be classified as an REH under the federal 31   Act, a facility must meet certain requirements, including 32   applicable state licensing requirements. The division provides 33   a process for such licensure. The division provides emergency 34   rulemaking authority to implement the division. The division 35   -33-   LSB 1511XL (14) 90   pf/rh   33/ 44          

  S.F. _____ H.F. _____   takes effect upon enactment. 1   DIVISION II  REGIONAL CENTERS OF EXCELLENCE GRANT PROGRAM. 2   This division appropriates $1 million from the general fund 3   of the state to the department of health and human services 4   (HHS) for fiscal year 2023-2024 for continuation of a regional 5   center of excellence program to award four grants to encourage 6   innovation and collaboration among regional health care 7   providers in a rural area based upon the results of a regional 8   community needs assessment to transform health care delivery in 9   order to provide quality, sustainable care that meets the needs 10   of the local communities. An applicant for the grant funds 11   shall specify how the funds will be expended to accomplish the 12   goals of the program and shall provide a detailed five-year 13   sustainability plan prior to being awarded any funding. 14   Following the receipt of grant funding, a recipient shall 15   submit periodic reports as specified by HHS to the governor and 16   the general assembly regarding the recipients expenditure of 17   the funds and progress in accomplishing the program goals. 18   DIVISION III  NONECONOMIC DAMAGE AWARDS AGAINST HEALTH 19   CARE PROVIDERS. This division of the bill relates to 20   noneconomic damage awards against health care providers. 21   Current law provides that in a civil action brought against 22   a health care provider, the maximum amount of noneconomic 23   damages that a patient may recover for personal injury or 24   death is $250,000, unless the jury determines that there is 25   a substantial or permanent loss or impairment of a bodily 26   function, substantial disfigurement, or death, which warrants 27   a finding that imposition of such a limitation would deprive 28   the plaintiff of just compensation for the injuries sustained. 29   In such a case, there is no cap on the amount of noneconomic 30   damages that a patient may recover. The bill makes two 31   changes to current law. First, the bill establishes that the 32   definition of noneconomic damages does not include the loss of 33   dependent care due to the death of or severe injury to a spouse 34   or parent who is the primary caregiver of a child or disabled 35   -34-   LSB 1511XL (14) 90   pf/rh   34/ 44  

  S.F. _____ H.F. _____   adult. Instead, such damages are economic damages. Second, 1   the bill provides a $1 million cap on noneconomic damages when 2   the jury finds that there is substantial or permanent loss or 3   impairment of a bodily function, substantial disfigurement, or 4   death which warrants exceeding the $250,000 cap. The bill does 5   not amend the current exception to the cap for cases in which 6   the defendants actions constitute actual malice. 7   The division of the bill takes effect upon enactment and 8   applies to causes of action accrued on or after that date. 9   DIVISION IV  STATE-FUNDED FAMILY MEDICINE OBSTETRICS 10   FELLOWSHIP PROGRAM AND FUND. This division requires HHS to 11   establish a family medicine obstetrics fellowship program to 12   increase access to family medicine obstetrics practitioners 13   in rural and underserved areas of the state. A person who 14   has completed an accreditation council for graduate medical 15   education residency program in family medicine is eligible for 16   participation in the fellowship program. Participating fellows 17   shall enter into a program agreement with a participating 18   teaching hospital which, at a minimum, requires the fellow 19   to complete a one-year fellowship and to engage in full-time 20   family medicine obstetrics practice in a rural or underserved 21   area of the state for a period of at least five years within 22   nine months following completion of the fellowship and receipt 23   of a license to practice medicine in the state. Each fellow 24   participating in the program shall be eligible for salary and 25   benefits including a stipend as determined by the participating 26   teaching hospital and funded through the family medicine 27   obstetrics fellowship program fund. 28   The division requires HHS to adopt administrative rules 29   to administer the program, including defining rural and 30   underserved areas for the purpose of the required full-time 31   practice of a person following completion of the fellowship. 32   The division creates a family medicine obstetrics fellowship 33   program fund in the state treasury consisting of the moneys 34   appropriated or credited to the fund by law. Moneys in the 35   -35-   LSB 1511XL (14) 90   pf/rh   35/ 44  

  S.F. _____ H.F. _____   fund at the end of each fiscal year shall not revert to any 1   other fund but shall remain in the fund for use in subsequent 2   fiscal years. Moneys in the fund are appropriated to HHS 3   to be used to fund fellowship positions as provided in the 4   division. The division appropriates a sufficient amount from 5   the general fund of the state to the fund annually to support 6   the creation of four fellowship positions. The division 7   provides an appropriation for deposit in the fund for fiscal 8   year 2023-2024. 9   The division requires HHS and the participating teaching 10   hospitals to regularly evaluate and document their experiences 11   including identifying ways the program may be modified or 12   expanded to facilitate increased access to family medicine 13   obstetrics practitioners in rural and underserved areas of the 14   state. The department shall submit an annual report to the 15   general assembly by January 1. The report shall include the 16   number of fellowships funded to date and any other information 17   identified by HHS and the participating teaching hospitals as 18   indicators of outcomes and the effectiveness of the program. 19   DIVISION V  SELF-ADMINISTERED HORMONAL CONTRACEPTIVES. 20   This division relates to the dispensing of self-administered 21   hormonal contraceptives by a pharmacist. The division 22   defines self-administered hormonal contraceptive as a 23   self-administered hormonal contraceptive that is approved by 24   the United States food and drug administration to prevent 25   pregnancy, including an oral hormonal contraceptive, a hormonal 26   vaginal ring, and a hormonal contraceptive patch, but not 27   including any drug intended to induce an abortion. 28   The division provides that notwithstanding any provision 29   of law to the contrary, a pharmacist may dispense a 30   self-administered hormonal contraceptive to a patient who 31   is at least 18 years of age pursuant to a standing order 32   established by the medical director of HHS (medical director). 33   For an initial dispensing, a pharmacist may dispense only up 34   to a three-month supply at one time of the self-administered 35   -36-   LSB 1511XL (14) 90   pf/rh   36/ 44  

  S.F. _____ H.F. _____   hormonal contraceptive, and for any subsequent dispensing 1   of the same self-administered hormonal contraceptive, a 2   12-month supply at one time. Additionally, the division 3   prohibits a pharmacist who dispenses a self-administered 4   hormonal contraceptive in accordance with the division from 5   requiring any other prescription drug order authorized by a 6   practitioner prior to dispensing the self-administered hormonal 7   contraceptive. 8   The division authorizes the medical director to establish a 9   standing order authorizing the dispensing of self-administered 10   hormonal contraceptives by any pharmacist who complies with the 11   standing order and retains and submits the patients record to 12   HHS. 13   The standing order includes requiring a pharmacist who 14   dispenses a self-administered hormonal contraceptive under the 15   division to: complete a standardized training program and 16   continuing education requirements related to prescribing the 17   hormonal contraceptives; obtain a completed self-screening risk 18   assessment from each patient, verify the identity and age of 19   each patient, and perform a blood pressure screening on each 20   patient before dispensing the hormonal contraceptives; provide 21   the patient with certain written information; provide the 22   patient with a copy of the record of the pharmacists encounter 23   with the patient; and provide patient counseling. 24   The standing order would prohibit a pharmacist who dispenses 25   hormonal contraceptives under the division from requiring a 26   patient to schedule an appointment with the pharmacist for 27   the prescribing or dispensing of the hormonal contraceptive; 28   dispensing the hormonal contraceptives to a patient for more 29   than 27 months after the date initially dispensed without the 30   patients attestation that the patient has consulted with a 31   practitioner during the preceding 27 months; and dispensing 32   the hormonal contraceptives to a patient if the results of the 33   patients self-screening risk assessment indicate it is unsafe 34   for the pharmacist to dispense the hormonal contraceptives 35   -37-   LSB 1511XL (14) 90   pf/rh   37/ 44  

  S.F. _____ H.F. _____   to the patient, in which case the pharmacist shall refer the 1   patient to a practitioner. 2   The division provides immunity for a pharmacist who 3   dispenses a self-administered hormonal contraceptive and 4   for the medical director who establishes a standing order 5   in compliance with the division from criminal and civil 6   liability arising from any damages caused by the dispensing, 7   administering, or use of a self-administered hormonal 8   contraceptive or the establishment of the standing order. 9   Additionally, the medical director shall be considered to be 10   acting within the scope of the medical directors office and 11   employment for purposes of Code chapter 669 (Iowa tort claims 12   Act) in the establishment of a standing order in compliance 13   with the division. 14   The division requires HHS, in collaboration with the 15   boards of pharmacy and medicine, and in consideration of 16   the guidelines established by the American congress of 17   obstetricians and gynecologists, to adopt administrative rules 18   to administer the provisions of the division. 19   The division amends prescription contraceptive coverage 20   provisions to require that a group policy, contract, or plan 21   delivered, issued for delivery, continued, or renewed in the 22   state on or after January 1, 2024, providing for third-party 23   payment or prepayment of health or medical expenses, shall 24   specifically provide for payment of self-administered hormonal 25   contraceptives, prescribed and dispensed as specified in the 26   division, including those dispensed at one time. The division 27   provides, however, that the provisions relating to coverage are 28   not to be construed to require a third-party payor to provide 29   payment to a practitioner for dispensing a self-administered 30   hormonal contraceptive to replace a self-administered 31   hormonal contraceptive that has been dispensed to a covered 32   person and that has been misplaced, stolen, or destroyed. 33   These provisions are also not to be construed to require a 34   third-party payor to replace covered prescriptions that are 35   -38-   LSB 1511XL (14) 90   pf/rh   38/ 44  

  S.F. _____ H.F. _____   misplaced, stolen, or destroyed. 1   The division also requires the board of pharmacy in 2   collaboration with the board of medicine and HHS to expand 3   the information program for drug prescribing to collect 4   from pharmacists information relating to the dispensing of 5   self-administered hormonal contraceptives as provided in the 6   division. 7   The division applies to the Medicaid program as specified in 8   the bill. 9   DIVISION VI  INSURANCE BENEFITS  REVIEW AND APPROVAL 10    PUBLIC POLICY CONSIDERATIONS. This division prohibits 11   a policy or policy form (form) in connection with a group 12   accident or health insurance policy (group policy) that is 13   issued in this state from containing a provision that is 14   unjust, unfair, inequitable, misleading, deceptive, encourages 15   misrepresentation, or that is otherwise contrary to public 16   policy (contrary to policy). The division makes it unlawful 17   for a carrier to issue a policy or to use a form in connection 18   with any group policy after notice from the commissioner of 19   insurance (commissioner) that the policy or form violates the 20   prohibition. A carrier has 20 days after receipt of the notice 21   to request a hearing to contest the commissioners notice. The 22   hearing shall be conducted pursuant to Code chapter 17A and 23   if it results in a decision that affirms the commissioners 24   notice, the decision shall be provided to the carrier in 25   writing and specify the reasons for the decision. 26   A group policy of insurance against loss or expense from 27   sickness, or from the bodily injury or death by accident of 28   the insured (accident and health policy), shall not be issued 29   or delivered in this state by a carrier until a copy of the 30   policy has been filed with, and approved by, the commissioner. 31   Applications, riders, or endorsements shall not be used in 32   connection with the accident and health policy until a copy 33   of the policy form has been filed with, and approved by, 34   the commissioner. A filing shall be deemed approved unless 35   -39-   LSB 1511XL (14) 90   pf/rh   39/ 44  

  S.F. _____ H.F. _____   disapproved by the commissioner within 30 days. If upon review 1   of a form the commissioner finds that the benefits provided 2   are unreasonable in relation to the premium charged, or that 3   the form contains a provision contrary to public policy, the 4   commissioner shall provide notice to the carrier that advises 5   the carrier as detailed in the bill. The carrier has 20 6   days after receipt of the notice to request a hearing, to be 7   conducted pursuant to Code chapter 17A. The division permits 8   the commissioner, after opportunity for hearing, to withdraw 9   the commissioners previous approval of a form in circumstances 10   detailed in the division. A carrier is prohibited from issuing 11   a form, or from using a form in connection with any group 12   policy, on or after the effective date of the commissioners 13   withdrawal of the previous approval. If a hearing results in a 14   decision to withdraw a previous approval, the decision shall be 15   provided to the carrier in writing. 16   DIVISION VII  MORE OPTIONS FOR MATERNAL SUPPORT (MOMS) 17   PROGRAM  FATHERHOOD INITIATIVES. This division relates to 18   the more options for maternal support (MOMS) program. The 19   bill adds as part of the definition of pregnancy support 20   services services to men who are involved or think they might 21   be involved in a pregnancy. As part of the MOMS program, 22   the division requires HHS to develop and maintain a virtual 23   clearinghouse of pregnancy support services and resources. The 24   services and resources include but are not limited to pregnancy 25   resource center and maternity home information; assistance in 26   accessing public assistance including but not limited to the 27   special supplemental nutrition program for women, infants, and 28   children program and the supplemental nutrition assistance 29   program; educational resources; housing assistance; recovery 30   and mental health services; family planning education; adoption 31   and foster care information and services; and healing and 32   support services for abortion survivors and their families. 33   As part of the MOMS program, beginning July 1, 2023, and 34   thereafter, funding for the program may be used for fatherhood 35   -40-   LSB 1511XL (14) 90   pf/rh   40/ 44  

  S.F. _____ H.F. _____   engagement grants to nonprofit, community-based organizations 1   to address the needs of fathers by assisting fathers in 2   finding employment, managing child support obligations, 3   transitioning from a period of incarceration, accessing health 4   care, understanding child development, and enhancing parenting 5   skills using evidence-based parenting education; a fatherhood 6   communications initiative administered by HHS, including but 7   not limited to a public internet site that provides access to 8   resources on effective parenting and assistance in receiving 9   parenting support and services; and a mentoring school-aged 10   males grant program to provide mentorship, social and academic 11   support, and life skills development to school-aged males. 12   The division also appropriates $2 million from the general 13   fund of the state to HHS for fiscal year 2023-2024 to be used 14   for the MOMS program including for program administration, the 15   provision of services, and for funding of fatherhood engagement 16   grants, the fatherhood communications initiative, and the 17   mentoring school-aged males grant program. 18   The division provides that the funding appropriated for the 19   MOMS program for fiscal year 2022-2023 is not to revert, but 20   is to remain available for the MOMS program for fiscal year 21   2023-2024. This provision takes effect upon enactment. 22   DIVISION VIII  STATE EMPLOYEE PAID PARENTAL LEAVE BENEFIT. 23   This division provides that a state employee entitled to leave 24   under the federal Family and Medical Leave Act of 1993 shall 25   be provided paid leave for the birth or adoption of a child if 26   the leave is taken within 12 months following any such birth or 27   adoption. The division provides that a state employee parent 28   who gives birth or adopts a child shall be entitled to up to 29   four weeks of paid leave while a state employee parent of a 30   child who did not give birth shall be entitled to up to one 31   week of paid leave. The division requires the department of 32   administrative services to adopt rules to implement this paid 33   parental leave benefit. 34   DIVISION IX  PROPERTY TAX MODIFICATIONS  LICENSED   35   -41-   LSB 1511XL (14) 90   pf/rh   41/ 44  

  S.F. _____ H.F. _____   COMMERCIAL CHILD CARE CENTERS AND CHILD CARE FACILITIES. This 1   division relates to property taxation for commercial child care 2   centers and facilities. Code section 441.21(5) determines the 3   amount of actual value of commercial property that is subject 4   to property tax. The amount is the sum of the residential 5   assessment limitation to the portion of the propertys value 6   that does not exceed $150,000 plus 90 percent of the propertys 7   value in excess of $150,000. The division excludes property 8   primarily used as a child care center or child care facility 9   from that determination and instead specifies that for 10   assessment years beginning on or after January 1, 2023, the 11   amount of actual value of such properties that is subject to 12   property tax and for which an application has been allowed is 13   equal to the product of the assessment limitation percentage 14   applicable to residential property multiplied by the actual 15   value of the property. 16   This division establishes an application and approval 17   procedure for the assessment limitation and amends provisions 18   relating to the calculation of payments to local governments as 19   the result of the application of certain assessment limitations 20   under Code section 441.21(5)(e). 21   The division takes effect upon enactment, applies 22   retroactively to assessment years beginning on or after January 23   1, 2023, and applies to payments to local governments under 24   Code section 441.21(5)(e) for fiscal years beginning on or 25   after July 1, 2024. 26   DIVISION X  NONRECURRING ADOPTION EXPENSES  ADOPTION   27   SUBSIDY PROGRAM. This division provides that the maximum 28   reimbursement provided to an adoptive parent under the adoption 29   subsidy program for nonrecurring adoption expenses is $1,000. 30   The division defines nonrecurring adoption expenses as the 31   reasonable and necessary adoption fees, court costs, attorney 32   fees, and other expenses which are directly related to the 33   legal adoption of a child with special needs which are not 34   incurred in violation of state, tribal, or federal law, and 35   -42-   LSB 1511XL (14) 90   pf/rh   42/ 44  

  S.F. _____ H.F. _____   which have not been reimbursed from other sources or other 1   funds. Under federal regulation, other expenses which 2   are directly related to the legal adoption of a child with 3   special needs means the costs of the adoption incurred by 4   or on behalf of the parents and for which parents carry the 5   ultimate liability for payment. Such costs may include the 6   adoption study, including health and psychological examination, 7   supervision of the placement prior to adoption, transportation, 8   and the reasonable costs of lodging and food for the child or 9   the adoptive parents when necessary to complete the placement 10   or adoption process. The department of health and human 11   services shall adopt administrative rules to administer the 12   division. The division also repeals a provision in 2010 Iowa 13   Acts which limited the nonrecurring adoption expenses to $500 14   and prohibited additional amounts for court costs and other 15   related legal expenses. 16   DIVISION XI  ALL IOWA OPPORTUNITY SCHOLARSHIP PROGRAM. 17   This division relates to the all Iowa opportunity scholarship 18   program (program), which provides scholarships to Iowa 19   students who graduate from high school or receive a high 20   school equivalency diploma to help such students attend a 21   community college in this state or an institution of higher 22   learning governed by the state board of regents. The program 23   prioritizes awarding scholarships to certain students, 24   including eligible foster care students. Eligible foster care 25   students are students who age out of Iowas foster care system, 26   age out of the state training school, or are adopted from 27   Iowas foster care system after reaching 16 years of age. 28   Current law requires that, in order to be eligible to 29   receive a scholarship under the program, the student must begin 30   enrollment at a community college or institution of higher 31   learning governed by the state board of regents within two 32   academic years of graduation from high school or receipt of a 33   high school equivalency diploma and continuously receive awards 34   as a full-time or part-time student to maintain eligibility. 35   -43-   LSB 1511XL (14) 90   pf/rh   43/ 44  

  S.F. _____ H.F. _____   The division strikes these requirements for eligible foster 1   care students. The division also provides that, for purposes 2   of the program, eligible foster care student does not include 3   a person who is 26 years of age or older. 4   The division applies to applications submitted under 5   the program before, on, or after the effective date of the 6   division. 7   -44-   LSB 1511XL (14) 90   pf/rh   44/ 44