Senate File 561 - Reprinted SENATE FILE 561 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO SSB 1213) (As Amended and Passed by the Senate April 27, 2023 ) A BILL FOR An Act relating to appropriations for veterans and health and 1 human services and including other related provisions and 2 appropriations including health policy oversight, public 3 assistance program provisions and a public assistance 4 modernization fund, sprinkler systems for home and 5 community-based services waiver recipient residences, a 6 state-funded family medicine obstetrics fellowship program 7 and fund, adoption subsidy program nonrecurring adoption 8 expenses, real estate transactions involving departmental 9 institutions, providing penalties, and including effective 10 date and other applicability date provisions. 11 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 12 SF 561 (3) 90 pf/rn/mb
S.F. 561 DIVISION I 1 DEPARTMENT OF VETERANS AFFAIRS FY 2023-2024 2 Section 1. DEPARTMENT OF VETERANS AFFAIRS. There is 3 appropriated from the general fund of the state to the 4 department of veterans affairs for the fiscal year beginning 5 July 1, 2023, and ending June 30, 2024, the following amounts, 6 or so much thereof as is necessary, to be used for the purposes 7 designated: 8 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 9 For salaries, support, maintenance, and miscellaneous 10 purposes, and for not more than the following full-time 11 equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,033,289 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 14 2. IOWA VETERANS HOME 15 For salaries, support, maintenance, and miscellaneous 16 purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,115,335 18 a. The Iowa veterans home billings involving the department 19 of health and human services shall be submitted to the 20 department on at least a monthly basis. 21 b. The Iowa veterans home expenditure report shall be 22 submitted monthly to the general assembly. 23 c. The Iowa veterans home shall continue to include in the 24 annual discharge report applicant information to provide for 25 the collection of demographic information including but not 26 limited to the number of individuals applying for admission and 27 admitted or denied admittance and the basis for the admission 28 or denial; the age, gender, and race of such individuals; 29 and the level of care for which such individuals applied for 30 admission including residential or nursing level of care. 31 3. HOME OWNERSHIP ASSISTANCE PROGRAM 32 For transfer to the Iowa finance authority for the 33 continuation of the home ownership assistance program for 34 persons who are or were eligible members of the armed forces of 35 -1- SF 561 (3) 90 pf/rn/mb 1/ 77
S.F. 561 the United States, pursuant to section 16.54 : 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,200,000 2 Sec. 2. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 3 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 4 appropriation in section 35A.16 for the fiscal year beginning 5 July 1, 2023, and ending June 30, 2024, the amount appropriated 6 from the general fund of the state pursuant to that section 7 for the following designated purposes shall not exceed the 8 following amount: 9 For the county commissions of veteran affairs fund under 10 section 35A.16 : 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 12 DIVISION II 13 DEPARTMENT OF HEALTH AND HUMAN SERVICES AGING FY 14 2023-2024 15 Sec. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES 16 AGING. There is appropriated from the general fund of the 17 state to the department of health and human services for the 18 fiscal year beginning July 1, 2023, and ending June 30, 2024, 19 the following amount, or so much thereof as is necessary, to be 20 used for the purposes designated: 21 For aging programs for the department of health and human 22 services and area agencies on aging to provide citizens of 23 Iowa who are 60 years of age and older with case management, 24 Iowas aging and disabilities resource center, and other 25 services which may include but are not limited to adult 26 day, respite care, chore, information and assistance, and 27 material aid, for information and options counseling for 28 persons with disabilities who are 18 years of age or older, 29 and for salaries, support, administration, maintenance, and 30 miscellaneous purposes, and for not more than the following 31 full-time equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,799,361 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 31.00 34 1. Funds appropriated in this section may be used to 35 -2- SF 561 (3) 90 pf/rn/mb 2/ 77
S.F. 561 supplement federal funds under federal regulations. To 1 receive funds appropriated in this section, a local area 2 agency on aging shall match the funds with moneys from other 3 sources according to rules adopted by the department. Funds 4 appropriated in this section may be used for elderly services 5 not specifically enumerated in this section only if approved 6 by an area agency on aging for provision of the service within 7 the area. 8 2. Of the funds appropriated in this section, $418,700 is 9 transferred to the Iowa commission on volunteer service to be 10 used for the retired and senior volunteer program. 11 3. a. The department of health and human services shall 12 establish and enforce procedures relating to expenditure 13 of state and federal funds by area agencies on aging that 14 require compliance with both state and federal laws, rules, and 15 regulations, including but not limited to all of the following: 16 (1) Requiring that expenditures are incurred only for goods 17 or services received or performed prior to the end of the 18 fiscal period designated for use of the funds. 19 (2) Prohibiting prepayment for goods or services not 20 received or performed prior to the end of the fiscal period 21 designated for use of the funds. 22 (3) Prohibiting prepayment for goods or services not 23 defined specifically by good or service, time period, or 24 recipient. 25 (4) Prohibiting the establishment of accounts from which 26 future goods or services which are not defined specifically by 27 good or service, time period, or recipient, may be purchased. 28 b. The procedures shall provide that if any funds are 29 expended in a manner that is not in compliance with the 30 procedures and applicable federal and state laws, rules, and 31 regulations, and are subsequently subject to repayment, the 32 area agency on aging expending such funds in contravention of 33 such procedures, laws, rules and regulations, not the state, 34 shall be liable for such repayment. 35 -3- SF 561 (3) 90 pf/rn/mb 3/ 77
S.F. 561 4. Of the funds appropriated in this section, $1,312,000 1 shall be used for the purposes of chapter 231E and to 2 administer the prevention of elder abuse, neglect, and 3 exploitation program pursuant to section 231.56A , in accordance 4 with the requirements of the federal Older Americans Act of 5 1965, 42 U.S.C. 3001 et seq., as amended. 6 5. Of the funds appropriated in this section, $1,000,000 7 shall be used to fund continuation of the aging and disability 8 resource center lifelong links to provide individuals and 9 caregivers with information and services to plan for and 10 maintain independence. 11 6. Of the funds appropriated in this section, $850,000 12 shall be used by the department of health and human services, 13 in collaboration with affected stakeholders, to continue to 14 expand the pilot initiative to provide long-term care options 15 counseling utilizing support planning protocols, to assist 16 non-Medicaid eligible consumers who indicate a preference 17 to return to the community and are deemed appropriate for 18 discharge, to return to their community following a nursing 19 facility stay; and shall be used by the department to fund home 20 and community-based services to enable older individuals to 21 avoid more costly utilization of residential or institutional 22 services and remain in their homes. The department shall 23 submit a report regarding the outcomes of the pilot initiative 24 to the governor and the general assembly by December 15, 2023. 25 DIVISION III 26 OFFICE OF LONG-TERM CARE OMBUDSMAN FY 2023-2024 27 Sec. 4. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 28 appropriated from the general fund of the state to the office 29 of long-term care ombudsman for the fiscal year beginning July 30 1, 2023, and ending June 30, 2024, the following amount, or 31 so much thereof as is necessary, to be used for the purposes 32 designated: 33 For salaries, support, administration, maintenance, and 34 miscellaneous purposes, and for not more than the following 35 -4- SF 561 (3) 90 pf/rn/mb 4/ 77
S.F. 561 full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,148,959 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 3 DIVISION IV 4 DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH FY 5 2023-2024 6 Sec. 5. DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC 7 HEALTH. There is appropriated from the general fund of the 8 state to the department of health and human services for the 9 fiscal year beginning July 1, 2023, and ending June 30, 2024, 10 the following amounts, or so much thereof as is necessary, to 11 be used for the purposes designated: 12 1. ADDICTIVE DISORDERS 13 For reducing the prevalence of the use of tobacco, alcohol, 14 and other drugs, and treating individuals affected by addictive 15 behaviors, including gambling, and for not more than the 16 following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,656,992 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 19 a. (1) Of the funds appropriated in this subsection, 20 $4,020,894 shall be used for the tobacco use prevention and 21 control initiative, including efforts at the state and local 22 levels, as provided in chapter 142A . The commission on tobacco 23 use prevention and control established pursuant to section 24 142A.3 shall advise the director of health and human services 25 in prioritizing funding needs and the allocation of moneys 26 appropriated for the programs and initiatives. Activities 27 of the programs and initiatives shall be in alignment with 28 the United States centers for disease control and prevention 29 best practices for comprehensive tobacco control programs 30 that include the goals of preventing youth initiation of 31 tobacco usage, reducing exposure to secondhand smoke, and 32 promotion of tobacco cessation. To maximize resources, 33 the department shall determine if third-party sources are 34 available to instead provide nicotine replacement products 35 -5- SF 561 (3) 90 pf/rn/mb 5/ 77
S.F. 561 to an applicant prior to provision of such products to an 1 applicant under the initiative. The department shall track and 2 report to the governor and the general assembly any reduction 3 in the provision of nicotine replacement products realized 4 by the initiative through implementation of the prerequisite 5 screening. 6 (2) (a) The department shall collaborate with the 7 department of revenue for enforcement of tobacco laws, 8 regulations, and ordinances and to engage in tobacco control 9 activities approved by the departments as specified in 10 the memorandum of understanding entered into between the 11 departments. 12 (b) For the fiscal year beginning July 1, 2023, and ending 13 June 30, 2024, the terms of the memorandum of understanding, 14 entered into between the department of revenue and the 15 department, governing compliance checks conducted to ensure 16 licensed retail tobacco outlet conformity with tobacco laws, 17 regulations, and ordinances relating to persons under 21 years 18 of age, shall continue to restrict the number of such checks to 19 one check per retail outlet, and one additional check for any 20 retail outlet found to be in violation during the first check. 21 b. (1) Of the funds appropriated in this subsection, 22 $19,638,485 shall be used for problem gambling and substance 23 use disorder prevention, treatment, and recovery services, 24 including a 24-hour helpline, public information resources, 25 professional training, youth prevention, and program 26 evaluation. 27 (2) Of the amount allocated under this paragraph, 28 $306,000 shall be utilized by the department to maintain 29 a single statewide 24-hour crisis hotline for the Iowa 30 childrens behavioral health system that incorporates warmline 31 services which may be provided through expansion of existing 32 capabilities as required pursuant to 2018 Iowa Acts, chapter 33 1056, section 16 . 34 c. The requirement of section 123.17, subsection 5 , is met 35 -6- SF 561 (3) 90 pf/rn/mb 6/ 77
S.F. 561 by the appropriations and allocations made in this division of 1 this Act for purposes of substance use disorder treatment and 2 addictive disorders for the fiscal year beginning July 1, 2023. 3 2. HEALTHY CHILDREN AND FAMILIES 4 For promoting the optimum health status for children and 5 adolescents from birth through 21 years of age, and families, 6 and for not more than the following full-time equivalent 7 positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,815,491 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 10 a. Of the funds appropriated in this subsection, not more 11 than $734,000 shall be used for the healthy opportunities for 12 parents to experience success (HOPES)-healthy families Iowa 13 (HFI) program established pursuant to section 135.106 . 14 b. In order to implement the legislative intent stated 15 in sections 135.106 and 256I.9 , priority for home visitation 16 program funding shall be given to programs using evidence-based 17 or promising models for home visitation. 18 c. Of the funds appropriated in this subsection, $3,075,000 19 shall be used for continuation of the departments initiative 20 to provide for adequate developmental surveillance and 21 screening during a childs first five years. The funds shall 22 be used first to fully fund the current sites to ensure that 23 the sites are fully operational, with the remaining funds 24 to be used for expansion to additional sites. The full 25 implementation and expansion shall include enhancing the scope 26 of the initiative through collaboration with the child health 27 specialty clinics to promote healthy child development through 28 early identification and response to both biomedical and social 29 determinants of healthy development; by monitoring child 30 health metrics to inform practice, document long-term health 31 impacts and savings, and provide for continuous improvement 32 through training, education, and evaluation; and by providing 33 for practitioner consultation particularly for children with 34 behavioral conditions and needs. The department shall also 35 -7- SF 561 (3) 90 pf/rn/mb 7/ 77
S.F. 561 collaborate with the Medicaid program and the child health 1 specialty clinics to integrate the activities of the first five 2 initiative into the establishment of patient-centered medical 3 homes, community utilities, accountable care organizations, 4 and other integrated care models developed to improve health 5 quality and population health while reducing health care costs. 6 To the maximum extent possible, funding allocated in this 7 paragraph shall be utilized as matching funds for Medicaid 8 program reimbursement. 9 d. Of the funds appropriated in this subsection, $64,000 10 shall be distributed to a statewide dental carrier to provide 11 funds to continue the donated dental services program patterned 12 after the projects developed by the dental lifeline network to 13 provide dental services to indigent individuals who are elderly 14 or with disabilities. 15 e. Of the funds appropriated in this subsection, $156,000 16 shall be used to provide audiological services and hearing aids 17 for children. 18 f. Of the funds appropriated in this subsection, $23,000 is 19 transferred to the university of Iowa college of dentistry for 20 provision of primary dental services to children. State funds 21 shall be matched on a dollar-for-dollar basis. The university 22 of Iowa college of dentistry shall coordinate efforts with the 23 department to provide dental care to underserved populations 24 throughout the state. 25 g. Of the funds appropriated in this subsection, $50,000 26 shall be used to address youth suicide prevention. 27 h. Of the funds appropriated in this subsection, $40,000 28 shall be used to support the Iowa effort to address the survey 29 of children who experience adverse childhood experiences known 30 as ACEs. 31 i. Of the funds appropriated in this subsection, up to 32 $494,000 shall be used for childhood obesity prevention. 33 3. CHRONIC CONDITIONS 34 For serving individuals identified as having chronic 35 -8- SF 561 (3) 90 pf/rn/mb 8/ 77
S.F. 561 conditions or special health care needs, and for not more than 1 the following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,256,595 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 4 a. Of the funds appropriated in this subsection, $188,000 5 shall be used for grants to individual patients who have an 6 inherited metabolic disorder to assist with the costs of 7 medically necessary foods and formula. 8 b. Of the funds appropriated in this subsection, $1,055,000 9 shall be used for the brain injury services program pursuant 10 to section 135.22B , including $861,000 for contracting with an 11 existing nationally affiliated and statewide organization whose 12 purpose is to educate, serve, and support Iowans with brain 13 injury and their families, for resource facilitator services 14 in accordance with section 135.22B, subsection 9 , and for 15 contracting to enhance brain injury training and recruitment 16 of service providers on a statewide basis. Of the amount 17 allocated in this paragraph, $95,000 shall be used to fund 18 1.00 full-time equivalent position to serve as the state brain 19 injury services program manager. 20 c. Of the funds appropriated in this subsection, $144,000 21 shall be used for the public purpose of continuing to contract 22 with an existing nationally affiliated organization to provide 23 education, client-centered programs, and client and family 24 support for people living with epilepsy and their families. 25 The amount allocated in this paragraph in excess of $50,000 26 shall be matched dollar-for-dollar by the organization 27 specified. Funds allocated under this paragraph shall be 28 distributed in their entirety for the purpose specified on July 29 1, 2023. 30 d. Of the funds appropriated in this subsection, $809,000 31 shall be used for child health specialty clinics. 32 e. Of the funds appropriated in this subsection, $384,000 33 shall be used by the regional autism assistance program 34 established pursuant to section 256.35 , and administered by 35 -9- SF 561 (3) 90 pf/rn/mb 9/ 77
S.F. 561 the child health specialty clinic located at the university of 1 Iowa hospitals and clinics. The funds shall be used to enhance 2 interagency collaboration and coordination of educational, 3 medical, and other health and human services for persons with 4 autism, their families, and providers of services, including 5 delivering regionalized services of care coordination, 6 family navigation, and integration of services through the 7 statewide system of regional child health specialty clinics and 8 fulfilling other requirements as specified in chapter 225D . 9 The university of Iowa shall not receive funds allocated under 10 this paragraph for indirect costs associated with the regional 11 autism assistance program. 12 f. Of the funds appropriated in this subsection, $577,000 13 shall be used for the comprehensive cancer control program to 14 reduce the burden of cancer in Iowa through prevention, early 15 detection, effective treatment, and ensuring quality of life. 16 Of the funds allocated in this paragraph f, $150,000 shall 17 be used to support a melanoma research symposium, a melanoma 18 biorepository and registry, basic and translational melanoma 19 research, and clinical trials. 20 g. Of the funds appropriated in this subsection, $97,000 21 shall be used for cervical and colon cancer screening, and 22 $177,000 shall be used to enhance the capacity of the cervical 23 cancer screening program to include provision of recommended 24 prevention and early detection measures to a broader range of 25 low-income women. 26 h. Of the funds appropriated in this subsection, $506,000 27 shall be used for the center for congenital and inherited 28 disorders. 29 4. COMMUNITY CAPACITY 30 For strengthening the health care delivery system at the 31 local level, and for not more than the following full-time 32 equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,435,682 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 35 -10- SF 561 (3) 90 pf/rn/mb 10/ 77
S.F. 561 a. Of the funds appropriated in this subsection, $95,000 1 is allocated for continuation of the child vision screening 2 program implemented through the university of Iowa hospitals 3 and clinics in collaboration with early childhood Iowa areas. 4 The program shall submit a report to the department regarding 5 the use of funds allocated under this paragraph a. The 6 report shall include the objectives and results for the 7 program year including the target population and how the funds 8 allocated assisted the program in meeting the objectives; the 9 number, age, and location within the state of individuals 10 served; the type of services provided to the individuals 11 served; the distribution of funds based on the services 12 provided; and the continuing needs of the program. 13 b. Of the funds appropriated in this subsection, 14 $48,000 shall be used for a grant to a statewide association 15 of psychologists, that is affiliated with the American 16 psychological association, to be used for continuation of a 17 program to rotate intern psychologists in placements that 18 serve urban and rural mental health professional shortage 19 areas. Once an intern psychologist begins service, the intern 20 psychologist may continue serving in the location of the intern 21 psychologists placement, notwithstanding any change in the 22 mental health professional shortage area designation of such 23 location. The intern psychologist may also provide services 24 via telehealth, to underserved populations, and to Medicaid 25 members. For the purposes of this paragraph b, mental 26 health professional shortage area means a geographic area 27 in this state that has been designated by the United States 28 department of health and human services, health resources and 29 services administration, bureau of health professionals, as 30 having a shortage of mental health professionals. 31 c. Of the funds appropriated in this subsection, the 32 following amounts are allocated to be used as follows 33 to support the goals of increased access, health system 34 integration, and engagement: 35 -11- SF 561 (3) 90 pf/rn/mb 11/ 77
S.F. 561 (1) Not less than $600,000 is allocated to the Iowa 1 prescription drug corporation for continuation of the 2 pharmaceutical infrastructure originally established for safety 3 net providers as described in 2007 Iowa Acts, chapter 218, 4 section 108 , and for the prescription drug donation repository 5 program created in chapter 135M . Funds allocated under this 6 subparagraph shall be distributed in their entirety for the 7 purpose specified on July 1, 2023. 8 (2) Not less than $334,000 is allocated to free clinics and 9 free clinics of Iowa for necessary infrastructure, statewide 10 coordination, provider recruitment, service delivery, and 11 provision of assistance to patients in securing a medical home 12 inclusive of oral health care. Funds allocated under this 13 subparagraph shall be distributed in their entirety for the 14 purpose specified on July 1, 2023. 15 (3) Not less than $25,000 is allocated to the Iowa 16 association of rural health clinics for necessary 17 infrastructure and service delivery transformation. Funds 18 allocated under this subparagraph shall be distributed in their 19 entirety for the purpose specified on July 1, 2023. 20 (4) Not less than $225,000 is allocated to the Polk 21 county medical society for continuation of the safety net 22 provider patients access to specialty health care initiative as 23 described in 2007 Iowa Acts, chapter 218, section 109 . Funds 24 allocated under this subparagraph shall be distributed in their 25 entirety for the purpose specified on July 1, 2023. 26 d. Of the funds appropriated in this subsection, $191,000 27 is allocated for the purposes of health care and public health 28 workforce initiatives. 29 e. Of the funds appropriated in this subsection, $96,000 30 shall be used for a matching dental education loan repayment 31 program to be allocated to a dental nonprofit health service 32 corporation to continue to develop the criteria and implement 33 the loan repayment program. 34 f. Of the funds appropriated in this subsection, $100,000 35 -12- SF 561 (3) 90 pf/rn/mb 12/ 77
S.F. 561 shall be used for the purposes of the Iowa donor registry as 1 specified in section 142C.18 . 2 g. Of the funds appropriated in this subsection, $96,000 3 shall be used for continuation of a grant to a nationally 4 affiliated volunteer eye organization that has an established 5 program for children and adults and that is solely dedicated to 6 preserving sight and preventing blindness through education, 7 nationally certified vision screening and training, and 8 community and patient service programs. The contractor shall 9 submit a report to the general assembly regarding the use 10 of funds allocated under this paragraph g. The report 11 shall include the objectives and results for the program year 12 including the target population and how the funds allocated 13 assisted the program in meeting the objectives; the number, 14 age, grade level if appropriate, and location within the state 15 of individuals served; the type of services provided to the 16 individuals served; the distribution of funds based on the 17 services provided; and the continuing needs of the program. 18 h. Of the funds appropriated in this subsection, $2,100,000 19 shall be deposited in the medical residency training account 20 created in section 135.175, subsection 5 , paragraph a, and is 21 appropriated from the account to the department to be used for 22 the purposes of the medical residency training state matching 23 grants program as specified in section 135.176 . 24 i. Of the funds appropriated in this subsection, $250,000 25 shall be used for the public purpose of providing funding to 26 Des Moines university to continue a provider education project 27 to provide primary care physicians with the training and skills 28 necessary to recognize the signs of mental illness in patients. 29 j. Of the funds appropriated in this subsection, $800,000 30 shall be used for rural psychiatric residencies to annually 31 fund six psychiatric residents who will provide mental health 32 services in underserved areas of the state. Notwithstanding 33 section 8.33, moneys that remain unencumbered or unobligated 34 at the close of the fiscal year shall not revert but shall 35 -13- SF 561 (3) 90 pf/rn/mb 13/ 77
S.F. 561 remain available for expenditure for the purposes designated 1 for subsequent fiscal years. 2 k. Of the funds appropriated in this subsection, $150,000 3 shall be used for psychiatric training to increase access to 4 mental health care services by expanding the mental health 5 workforce via training of additional physician assistants and 6 nurse practitioners. 7 1. Of the funds appropriated in this subsection, $425,000 8 shall be used for the continuation of a center of excellence 9 program to award two grants to encourage innovation and 10 collaboration among regional health care providers in a rural 11 area based upon the results of a regional community needs 12 assessment to transform health care delivery in order to 13 provide quality, sustainable care that meets the needs of the 14 local communities. An applicant for the grant funds shall 15 specify how the grant funds will be expended to accomplish the 16 goals of the program and shall provide a detailed five-year 17 sustainability plan prior to being awarded any grant funding. 18 Following the receipt of grant funding, a recipient shall 19 submit periodic reports as specified by the department to the 20 governor and the general assembly regarding the recipients 21 expenditure of the grant funds and progress in accomplishing 22 the programs goals. 23 m. Of the funds appropriated in this subsection, $560,000 24 shall be deposited in the family medicine obstetrics fellowship 25 program fund to be used for the state family medicine 26 obstetrics fellowship program in accordance with section 27 135.182, if enacted in this Act, to meet a critical demand for 28 well-trained family medicine obstetrics practitioners in rural 29 and underserved areas in the state. 30 n. Of the funds appropriated in this subsection, $358,201 31 is allocated for the Iowa commission on volunteer service for 32 purposes of the Iowa state commission grant program and the 33 Iowas promise and Iowa mentoring partnership programs. 34 (1) Of the funds allocated in this paragraph, $75,000 shall 35 -14- SF 561 (3) 90 pf/rn/mb 14/ 77
S.F. 561 be used for the purposes of the Iowa state commission grant 1 program and $93,201 shall be used for the purposes of the 2 Iowas promise and Iowa mentoring partnership programs. 3 (2) Notwithstanding section 8.33, funds allocated in this 4 paragraph that remain unencumbered or unobligated at the close 5 of the fiscal year shall not revert but shall remain available 6 for expenditure for the purposes designated until the close of 7 the succeeding fiscal year. 8 5. ESSENTIAL PUBLIC HEALTH SERVICES 9 To provide public health services that reduce risks and 10 invest in promoting and protecting good health over the 11 course of a lifetime with a priority given to older Iowans and 12 vulnerable populations: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 14 6. INFECTIOUS DISEASES 15 For reducing the incidence and prevalence of communicable 16 diseases, and for not more than the following full-time 17 equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,795,902 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 6.00 20 7. PUBLIC PROTECTION 21 For protecting the health and safety of the public through 22 establishing standards and enforcing regulations, and for not 23 more than the following full-time equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,581,792 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 57.00 26 a. Of the funds appropriated in this subsection, not more 27 than $304,000 shall be credited to the emergency medical 28 services fund created in section 135.25 . Moneys in the 29 emergency medical services fund are appropriated to the 30 department to be used for the purposes of the fund. 31 b. Of the funds appropriated in this subsection, up 32 to $243,000 shall be used for sexual violence prevention 33 programming through a statewide organization representing 34 programs serving victims of sexual violence through the 35 -15- SF 561 (3) 90 pf/rn/mb 15/ 77
S.F. 561 departments sexual violence prevention program, and for 1 continuation of a training program for sexual assault 2 response team (SART) members, including representatives of 3 law enforcement, victim advocates, prosecutors, and certified 4 medical personnel. The amount allocated in this paragraph b 5 shall not be used to supplant funding administered for other 6 sexual violence prevention or victims assistance programs. 7 c. Of the funds appropriated in this subsection, up to 8 $750,000 shall be used for the state poison control center. 9 Pursuant to the directive under 2014 Iowa Acts, chapter 1140, 10 section 102 , the federal matching funds available to the 11 state poison control center from the department under the 12 federal Childrens Health Insurance Program Reauthorization Act 13 allotment shall be subject to the federal administrative cap 14 rule of 10 percent applicable to funding provided under Tit. 15 XXI of the federal Social Security Act and included within the 16 departments calculations of the cap. 17 d. Of the funds appropriated in this subsection, up to 18 $504,000 shall be used for childhood lead poisoning provisions. 19 8. RESOURCE MANAGEMENT 20 For establishing and sustaining the overall ability of the 21 department to deliver services to the public, and for not more 22 than the following full-time equivalent positions: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,543 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 25 9. MISCELLANEOUS PROVISIONS 26 The university of Iowa hospitals and clinics under the 27 control of the state board of regents shall not receive 28 indirect costs from the funds appropriated in this section. 29 The university of Iowa hospitals and clinics billings to the 30 department shall be on at least a quarterly basis. 31 10. IOWA HEALTH INFORMATION NETWORK ENHANCEMENTS 32 The department shall work with the board established 33 in chapter 135D to develop plans for program enhancements 34 in the Iowa health information network, for the purpose of 35 -16- SF 561 (3) 90 pf/rn/mb 16/ 77
S.F. 561 empowering Iowa patients to access and direct their health 1 information utilizing the Iowa health information network. 2 Program enhancements shall protect data privacy, facilitate the 3 interchange of health data for the purpose of improving public 4 health outcomes, and increase participation by health care 5 providers. 6 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES SPORTS 7 WAGERING RECEIPTS FUND. There is appropriated from the sports 8 wagering receipts fund created in section 8.57, subsection 6, 9 to the department of health and human services for the fiscal 10 year beginning July 1, 2023, and ending June 30, 2024, the 11 following amount, or so much thereof as is necessary, to be 12 used for the purposes designated: 13 For problem gambling and substance use disorder prevention, 14 treatment, and recovery services, including a 24-hour helpline, 15 public information resources, professional training, youth 16 prevention, and program evaluation: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 18 DIVISION V 19 DEPARTMENT OF HEALTH AND HUMAN SERVICES HUMAN SERVICES 20 FY 2023-2024 21 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 22 GRANT. There is appropriated from the fund created in section 23 8.41 to the department of health and human services for the 24 fiscal year beginning July 1, 2023, and ending June 30, 2024, 25 from moneys received under the federal temporary assistance 26 for needy families (TANF) block grant pursuant to the federal 27 Personal Responsibility and Work Opportunity Reconciliation Act 28 of 1996, Pub. L. No. 104-193, and successor legislation, the 29 following amounts, or so much thereof as is necessary, to be 30 used for the purposes designated: 31 1. To be credited to the family investment program (FIP) 32 account and used for assistance under FIP in accordance with 33 chapter 239B : 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 35 -17- SF 561 (3) 90 pf/rn/mb 17/ 77
S.F. 561 2. To be credited to the FIP account and used for the job 1 opportunities and basic skills (JOBS) program and implementing 2 family investment agreements in accordance with chapter 239B : 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 4 3. To be used for the family development and 5 self-sufficiency grant program in accordance with section 6 216A.107 : 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 8 Notwithstanding section 8.33 , moneys appropriated in this 9 subsection that remain unencumbered or unobligated at the close 10 of the fiscal year shall not revert but shall remain available 11 for expenditure for the purposes designated until the close of 12 the succeeding fiscal year. However, unless such moneys are 13 encumbered or obligated on or before September 30, 2024, the 14 moneys shall revert. 15 4. For field operations: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 17 5. For general administration: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 19 6. For state child care assistance: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 21 a. Of the funds appropriated in this subsection, 22 $26,205,412 is transferred to the child care and development 23 block grant appropriation made by the Ninetieth General 24 Assembly, 2023 session, for the federal fiscal year beginning 25 October 1, 2023, and ending September 30, 2024. Of this 26 amount, $200,000 shall be used for provision of educational 27 opportunities to registered child care home providers in order 28 to improve services and programs offered by this category 29 of providers and to increase the number of providers. The 30 department may contract with institutions of higher education 31 or child care resource and referral centers to provide 32 the educational opportunities. Allowable administrative 33 costs under the contracts shall not exceed 5 percent. The 34 application for a grant shall not exceed two pages in length. 35 -18- SF 561 (3) 90 pf/rn/mb 18/ 77
S.F. 561 b. Any funds appropriated in this subsection remaining 1 unallocated shall be used for state child care assistance 2 payments for families who are employed including but not 3 limited to individuals enrolled in FIP. 4 7. For child and family services: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 6 8. For child abuse prevention grants: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 8 9. For pregnancy prevention grants on the condition that 9 family planning services are funded: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 11 Pregnancy prevention grants shall be awarded to programs 12 in existence on or before July 1, 2023, if the programs have 13 demonstrated positive outcomes. Grants shall be awarded to 14 pregnancy prevention programs which are developed after July 15 1, 2023, if the programs are based on existing models that 16 have demonstrated positive outcomes. Grants shall comply with 17 the requirements provided in 1997 Iowa Acts, chapter 208, 18 section 14, subsections 1 and 2 , including the requirement that 19 grant programs must emphasize sexual abstinence. Priority in 20 the awarding of grants shall be given to programs that serve 21 areas of the state which demonstrate the highest percentage of 22 unplanned pregnancies of females of childbearing age within the 23 geographic area to be served by the grant. 24 10. For technology needs and other resources necessary to 25 meet federal and state reporting, tracking, and case management 26 requirements and other departmental needs: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 28 11. a. Notwithstanding any provision to the contrary, 29 including but not limited to requirements in section 8.41 or 30 provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the 31 receipt and appropriation of federal block grants, federal 32 funds from the temporary assistance for needy families block 33 grant received by the state and not otherwise appropriated 34 in this section and remaining available for the fiscal year 35 -19- SF 561 (3) 90 pf/rn/mb 19/ 77
S.F. 561 beginning July 1, 2023, are appropriated to the department of 1 health and human services to the extent as may be necessary 2 to be used in the following priority order: for FIP, for 3 state child care assistance program payments for families 4 who are employed, and for the FIP share of system costs for 5 eligibility determination and related functions. The federal 6 funds appropriated in this paragraph a shall be expended 7 only after all other funds appropriated in subsection l for 8 assistance under FIP, in subsection 6 for state child care 9 assistance, or in subsection 10 for technology needs and other 10 resources necessary to meet departmental needs, as applicable, 11 have been expended. For the purposes of this subsection, the 12 funds appropriated in subsection 6, paragraph a, for transfer 13 to the child care and development block grant appropriation 14 are considered fully expended when the full amount has been 15 transferred. 16 b. The department shall, on a quarterly basis, advise the 17 general assembly and department of management of the amount of 18 funds appropriated in this subsection that was expended in the 19 prior quarter. 20 12. Of the amounts appropriated in this section, 21 $12,962,008 for the fiscal year beginning July 1, 2023, is 22 transferred to the appropriation of the federal social services 23 block grant made to the department of health and human services 24 for that fiscal year. 25 13. For continuation of the program providing categorical 26 eligibility for the supplemental nutrition assistance program 27 (SNAP) as specified in section 239.2, if enacted by 2023 Iowa 28 Acts, Senate File 494: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 30 14. The department may transfer funds allocated in this 31 section to the appropriations made in this division of this Act 32 for the same fiscal year for general administration and field 33 operations for resources necessary to implement and operate the 34 services referred to in this section and those funded in the 35 -20- SF 561 (3) 90 pf/rn/mb 20/ 77
S.F. 561 appropriation made in this division of this Act for the same 1 fiscal year for FIP from the general fund of the state. 2 15. With the exception of moneys allocated under this 3 section for the family development and self-sufficiency grant 4 program, to the extent moneys allocated in this section are 5 deemed by the department not to be necessary to support the 6 purposes for which they are allocated, such moneys may be used 7 in the same fiscal year for any other purpose for which funds 8 are allocated in this section or in section 8 of this division 9 of this Act for the FIP account. If there are conflicting 10 needs, priority shall first be given to the FIP account as 11 specified under subsection 1 of this section and used for the 12 purposes of assistance under FIP in accordance with chapter 13 239B , followed by state child care assistance program payments 14 for families who are employed, followed by other priorities as 15 specified by the department. 16 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 17 1. Moneys credited to the FIP account for the fiscal year 18 beginning July 1, 2023, and ending June 30, 2024, shall be used 19 to provide assistance in accordance with chapter 239B . 20 2. The department may use a portion of the moneys credited 21 to the FIP account under this section as necessary for 22 salaries, support, maintenance, and miscellaneous purposes, 23 including administrative and information technology costs 24 associated with rent reimbursement and other income assistance 25 programs administered by the department. 26 3. The department may transfer funds allocated in 27 subsection 4, excluding the allocation under subsection 4, 28 paragraph b, to the appropriations made in this division of 29 this Act for the same fiscal year for general administration 30 and field operations for resources necessary to implement 31 and operate the services referred to in this section and 32 those funded in the appropriations made in section 7 for the 33 temporary assistance for needy families block grant and in 34 section 9 for FIP from the general fund of the state in this 35 -21- SF 561 (3) 90 pf/rn/mb 21/ 77
S.F. 561 division of this Act for the same fiscal year. 1 4. Moneys appropriated in this division of this Act and 2 credited to the FIP account for the fiscal year beginning July 3 1, 2023, and ending June 30, 2024, are allocated as follows: 4 a. To be used by the department of health and human services 5 to more effectively serve participants in FIP and other clients 6 and to meet federal reporting requirements under the federal 7 temporary assistance for needy families block grant: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 9 b. To the department of health and human services for 10 staffing, administration, and implementation of the family 11 development and self-sufficiency grant program in accordance 12 with section 216A.107 : 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,192,834 14 (1) Of the funds allocated for the family development 15 and self-sufficiency grant program in this paragraph b, 16 not more than 5 percent of the funds shall be used for the 17 administration of the grant program. 18 (2) The department of health and human services may continue 19 to implement the family development and self-sufficiency grant 20 program statewide during fiscal year 2023-2024. 21 (3) The department of health and human services may engage 22 in activities to strengthen and improve family outcomes 23 measures and data collection systems under the family 24 development and self-sufficiency grant program. 25 c. For the diversion subaccount of the FIP account: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 27 A portion of the moneys allocated for the diversion 28 subaccount may be used for field operations, salaries, data 29 management system development, and implementation costs and 30 support deemed necessary by the director of health and human 31 services in order to administer the FIP diversion program. To 32 the extent moneys allocated in this paragraph c are deemed 33 by the department not to be necessary to support diversion 34 activities, such moneys may be used for other efforts intended 35 -22- SF 561 (3) 90 pf/rn/mb 22/ 77
S.F. 561 to increase engagement by FIP participants in work, education, 1 or training activities, or for the purposes of assistance under 2 FIP in accordance with chapter 239B . 3 d. For the SNAP employment and training program: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 5 (1) The department shall apply the federal SNAP employment 6 and training state plan in order to maximize to the fullest 7 extent permitted by federal law the use of the 50 percent 8 federal reimbursement provisions for the claiming of allowable 9 federal reimbursement funds from the United States department 10 of agriculture pursuant to the federal SNAP employment and 11 training program for providing education, employment, and 12 training services for eligible SNAP participants, including 13 but not limited to related dependent care and transportation 14 expenses. 15 (2) The department shall continue categorical federal 16 SNAP eligibility as specified in section 239.2, if enacted 17 by 2023 Iowa Acts, Senate File 494, consistent with federal 18 SNAP requirements. The eligibility provisions shall conform 19 to all federal requirements including requirements addressing 20 individuals who are disqualified for committing an intentional 21 program violation or are otherwise ineligible. 22 e. For the JOBS program, not more than: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 24 5. Of the child support collections assigned under FIP, an 25 amount equal to the federal share of support collections shall 26 be credited to the child support services appropriation made 27 in this division of this Act. Of the remainder of the assigned 28 child support collections received by child support services, 29 a portion shall be credited to the FIP account, a portion may 30 be used to increase recoveries, and a portion may be used to 31 sustain cash flow in the child support payments account. If 32 as a consequence of the appropriations and allocations made in 33 this section the resulting amounts are insufficient to sustain 34 cash assistance payments and meet federal maintenance of effort 35 -23- SF 561 (3) 90 pf/rn/mb 23/ 77
S.F. 561 requirements, the department shall seek supplemental funding. 1 If child support collections assigned under FIP are greater 2 than estimated or are otherwise determined not to be required 3 for maintenance of effort, the state share of either amount may 4 be transferred to or retained in the child support payments 5 account. 6 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 7 is appropriated from the general fund of the state to the 8 department of health and human services for the fiscal year 9 beginning July 1, 2023, and ending June 30, 2024, the following 10 amount, or so much thereof as is necessary, to be used for the 11 purpose designated: 12 To be credited to the FIP account and used for FIP assistance 13 in accordance with chapter 239B and for other costs associated 14 with providing needs-based benefits or assistance: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,003,575 16 1. Of the funds appropriated in this section, $6,606,198 is 17 allocated for the JOBS program. 18 2. Of the funds appropriated in this section, $4,313,854 is 19 allocated for the family development and self-sufficiency grant 20 program. 21 3. a. Notwithstanding section 8.39 , for the fiscal 22 year beginning July 1, 2023, if necessary to meet federal 23 maintenance of effort requirements or to transfer federal 24 temporary assistance for needy families block grant funding 25 to be used for purposes of the federal social services block 26 grant or to meet cash flow needs resulting from delays in 27 receiving federal funding or to implement, in accordance with 28 this division of this Act, activities currently funded with 29 juvenile court services, county, or community moneys and 30 state moneys used in combination with such moneys; to comply 31 with federal requirements; or to maximize the use of federal 32 funds; the department of health and human services may transfer 33 funds within or between any of the appropriations made in 34 this division of this Act and appropriations in law for the 35 -24- SF 561 (3) 90 pf/rn/mb 24/ 77
S.F. 561 federal social services block grant to the department for the 1 following purposes, provided that the combined amount of state 2 and federal temporary assistance for needy families block grant 3 funding for each appropriation remains the same before and 4 after the transfer: 5 (1) For FIP. 6 (2) For state child care assistance. 7 (3) For child and family services. 8 (4) For field operations. 9 (5) For general administration. 10 b. This subsection shall not be construed to prohibit the 11 use of existing state transfer authority for other purposes. 12 The department shall report any transfers made pursuant to this 13 subsection to the general assembly. 14 4. Of the funds appropriated in this section, $195,000 15 shall be used for a contract for tax preparation assistance 16 to low-income Iowans to expand the usage of the earned income 17 tax credit. The purpose of the contract is to supply this 18 assistance to underserved areas of the state. The department 19 shall not retain any portion of the allocation under this 20 subsection for administrative costs. 21 5. Of the funds appropriated in this section, $70,000 shall 22 be used for the continuation of the parenting program, as 23 specified in 441 IAC ch. 100 , relating to parental obligations, 24 in which child support services participates, to support the 25 efforts of a nonprofit organization committed to strengthening 26 the community through youth development, healthy living, 27 and social responsibility headquartered in a county with 28 a population over 450,000 according to the 2020 certified 29 federal census. The funds allocated in this subsection shall 30 be used by the recipient organization to develop a larger 31 community effort, through public and private partnerships, to 32 support a broad-based multi-county parenthood initiative that 33 promotes payment of child support obligations, improved family 34 relationships, and full-time employment. 35 -25- SF 561 (3) 90 pf/rn/mb 25/ 77
S.F. 561 6. The department may transfer funds appropriated in this 1 section, excluding the allocation in subsection 2 for the 2 family development and self-sufficiency grant program, to the 3 appropriations made in this division of this Act for general 4 administration and field operations as necessary to administer 5 this section, section 7 for the temporary assistance for needy 6 families block grant, and section 8 for the FIP account. 7 Sec. 10. CHILD SUPPORT SERVICES. There is appropriated from 8 the general fund of the state to the department of health and 9 human services for the fiscal year beginning July 1, 2023, and 10 ending June 30, 2024, the following amount, or so much thereof 11 as is necessary, to be used for the purposes designated: 12 For child support services, including salaries, support, 13 maintenance, and miscellaneous purposes, and for not more than 14 the following full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,914,329 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 17 1. The department shall expend up to $24,000, including 18 federal financial participation, for the fiscal year beginning 19 July 1, 2023, for a child support public awareness campaign. 20 The department and the office of the attorney general shall 21 cooperate in continuation of the campaign. The public 22 awareness campaign shall emphasize, through a variety of 23 media activities, the importance of maximum involvement of 24 both parents in the lives of their children as well as the 25 importance of payment of child support obligations. 26 2. Federal access and visitation grant moneys shall be 27 issued directly to private not-for-profit agencies that provide 28 services designed to increase compliance with the child access 29 provisions of court orders, including but not limited to 30 neutral visitation sites and mediation services. 31 3. The appropriation made to the department for child 32 support services may be used throughout the fiscal year in the 33 manner necessary for purposes of cash flow management, and for 34 cash flow management purposes the department may temporarily 35 -26- SF 561 (3) 90 pf/rn/mb 26/ 77
S.F. 561 draw more than the amount appropriated, provided the amount 1 appropriated is not exceeded at the close of the fiscal year. 2 Sec. 11. HEALTH CARE TRUST FUND MEDICAL ASSISTANCE 3 FY 2023-2024. Any funds remaining in the health care trust 4 fund created in section 453A.35A for the fiscal year beginning 5 July 1, 2023, and ending June 30, 2024, are appropriated to 6 the department of health and human services to supplement 7 the medical assistance program appropriations made in this 8 division of this Act, for medical assistance reimbursement and 9 associated costs, including program administration and costs 10 associated with program implementation. 11 Sec. 12. MEDICAID FRAUD FUND MEDICAL ASSISTANCE FY 12 2023-2024. Any funds remaining in the Medicaid fraud fund 13 created in section 249A.50 for the fiscal year beginning July 14 1, 2023, and ending June 30, 2024, are appropriated to the 15 department of health and human services to supplement the 16 medical assistance appropriations made in this division of this 17 Act, for medical assistance reimbursement and associated costs, 18 including program administration and costs associated with 19 program implementation. 20 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 21 general fund of the state to the department of health and human 22 services for the fiscal year beginning July 1, 2023, and ending 23 June 30, 2024, the following amount, or so much thereof as is 24 necessary, to be used for the purpose designated: 25 For medical assistance program reimbursement and associated 26 costs as specifically provided in the reimbursement 27 methodologies in effect on June 30, 2023, except as otherwise 28 expressly authorized by law, consistent with options under 29 federal law and regulations, and contingent upon receipt of 30 approval from the office of the governor of reimbursement for 31 each abortion performed under the program: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,543,626,779 33 1. Iowans support reducing the number of abortions 34 performed in our state. Funds appropriated under this section 35 -27- SF 561 (3) 90 pf/rn/mb 27/ 77
S.F. 561 shall not be used for abortions, unless otherwise authorized 1 under this section. 2 2. The provisions of this section relating to abortions 3 shall also apply to the Iowa health and wellness plan created 4 pursuant to chapter 249N . 5 3. The department shall utilize not more than $60,000 of 6 the funds appropriated in this section to continue the AIDS/HIV 7 health insurance premium payment program as established in 1992 8 Iowa Acts, Second Extraordinary Session, chapter 1001, section 9 409, subsection 6 . Of the funds allocated in this subsection, 10 not more than $5,000 may be expended for administrative 11 purposes. 12 4. Of the funds appropriated in this Act to the department 13 of health and human services for addictive disorders, $950,000 14 shall be used for an integrated substance use disorder managed 15 care system. The department shall maintain the level of mental 16 health and substance use disorder treatment services provided 17 by the managed care contractors. The department shall take the 18 steps necessary to continue the federal waivers as necessary to 19 maintain the level of services. 20 5. The department shall aggressively pursue options for 21 providing medical assistance or other assistance to individuals 22 with special needs who become ineligible to continue receiving 23 services under the early and periodic screening, diagnostic, 24 and treatment program under the medical assistance program 25 due to becoming 21 years of age who have been approved for 26 additional assistance through the departments exception to 27 policy provisions, but who have health care needs in excess 28 of the funding available through the exception to policy 29 provisions. 30 6. Of the funds appropriated in this section, up to 31 $3,050,082 may be transferred to the field operations or 32 general administration appropriations in this division of this 33 Act for operational costs associated with Part D of the federal 34 Medicare Prescription Drug Improvement and Modernization Act 35 -28- SF 561 (3) 90 pf/rn/mb 28/ 77
S.F. 561 of 2003, Pub. L. No. 108-173. 1 7. Of the funds appropriated in this section, up to $442,100 2 may be transferred to the appropriation in this division of 3 this Act for health program operations to be used for clinical 4 assessment services and prior authorization of services. 5 8. A portion of the funds appropriated in this section may 6 be transferred to the appropriations in this division of this 7 Act for general administration, health program operations, the 8 childrens health insurance program, or field operations to be 9 used for the state match cost to comply with the payment error 10 rate measurement (PERM) program for both the medical assistance 11 and childrens health insurance programs as developed by the 12 centers for Medicare and Medicaid services of the United States 13 department of health and human services to comply with the 14 federal Improper Payments Information Act of 2002, Pub. L. 15 No. 107-300, and to support other reviews and quality control 16 activities to improve the integrity of these programs. 17 9. Of the funds appropriated in this section, a sufficient 18 amount is allocated to supplement the incomes of residents of 19 nursing facilities, intermediate care facilities for persons 20 with mental illness, and intermediate care facilities for 21 persons with an intellectual disability, with incomes of less 22 than $50 in the amount necessary for the residents to receive a 23 personal needs allowance of $50 per month pursuant to section 24 249A.30A . 25 10. One hundred percent of the nonfederal share of payments 26 to area education agencies that are medical assistance 27 providers for medical assistance-covered services provided to 28 medical assistance-covered children, shall be made from the 29 appropriation made in this section. 30 11. A portion of the funds appropriated in this section may 31 be transferred to the appropriation in this division of this 32 Act for health program operations to be used for administrative 33 activities associated with the money follows the person 34 demonstration project. 35 -29- SF 561 (3) 90 pf/rn/mb 29/ 77
S.F. 561 12. Of the funds appropriated in this section, $349,011 1 shall be used for the administration of the health insurance 2 premium payment program, including salaries, support, 3 maintenance, and miscellaneous purposes. 4 13. a. The department may increase the amounts allocated 5 for salaries, support, maintenance, and miscellaneous purposes 6 associated with the medical assistance program, as necessary, 7 to sustain cost management efforts. The department shall 8 report any such increase to the general assembly and the 9 department of management. 10 b. If the savings to the medical assistance program from 11 ongoing cost management efforts exceed the associated cost 12 for the fiscal year beginning July 1, 2023, the department 13 may transfer any savings generated for the fiscal year due 14 to medical assistance program cost management efforts to the 15 appropriation made in this division of this Act for health 16 program operations or general administration to defray the 17 costs associated with implementing the efforts. 18 14. For the fiscal year beginning July 1, 2023, and ending 19 June 30, 2024, the replacement generation tax revenues required 20 to be deposited in the property tax relief fund pursuant to 21 section 437A.8, subsection 4 , paragraph d, and section 22 437A.15, subsection 3 , paragraph f, shall instead be credited 23 to and supplement the appropriation made in this section and 24 used for the allocations made in this section. 25 15. a. Of the funds appropriated in this section, up 26 to $50,000 may be transferred by the department to the 27 appropriation made in this division of this Act to the 28 department for the same fiscal year for general administration 29 to be used for associated administrative expenses and for not 30 more than 1.00 full-time equivalent position, in addition to 31 those authorized for the same fiscal year, to be assigned to 32 implementing the childrens mental health home project. 33 b. Of the funds appropriated in this section, up to $400,000 34 may be transferred by the department to the appropriation made 35 -30- SF 561 (3) 90 pf/rn/mb 30/ 77
S.F. 561 to the department in this division of this Act for the same 1 fiscal year for Medicaid program-related general administration 2 planning and implementation activities. The funds may be used 3 for contracts or for personnel in addition to the amounts 4 appropriated for and the positions authorized for general 5 administration for the fiscal year. 6 c. Of the funds appropriated in this section, up to 7 $3,000,000 may be transferred by the department to the 8 appropriations made in this division of this Act for the 9 same fiscal year for general administration or health 10 program operations to be used to support the development 11 and implementation of standardized assessment tools for 12 persons with mental illness, an intellectual disability, a 13 developmental disability, or a brain injury. 14 16. Of the funds appropriated in this section, $150,000 15 shall be used for lodging expenses associated with care 16 provided at the university of Iowa hospitals and clinics for 17 patients with cancer whose travel distance is 30 miles or more 18 and whose income is at or below 200 percent of the federal 19 poverty level as defined by the most recently revised poverty 20 income guidelines published by the United States department of 21 health and human services. The department of health and human 22 services shall establish the maximum number of overnight stays 23 and the maximum rate reimbursed for overnight lodging, which 24 may be based on the state employee rate established by the 25 department of administrative services. The funds allocated in 26 this subsection shall not be used as nonfederal share matching 27 funds. 28 17. Of the funds appropriated in this section, up to 29 $3,383,880 shall be used for administration of the state family 30 planning services program pursuant to section 217.41B , and 31 of this amount, the department may use up to $200,000 for 32 administrative expenses. 33 18. Of the funds appropriated in this section, $1,545,530 34 shall be used and may be transferred to other appropriations 35 -31- SF 561 (3) 90 pf/rn/mb 31/ 77
S.F. 561 in this division of this Act as necessary to administer the 1 provisions in the division of this Act relating to Medicaid 2 program administration. 3 19. The department shall comply with the centers for 4 Medicare and Medicaid services guidance related to Medicaid 5 program and childrens health insurance program maintenance 6 of effort provisions, including eligibility standards, 7 methodologies, procedures, and continuous enrollment, to 8 receive the enhanced federal medical assistance percentage 9 under section 6008(b) of the federal Families First Coronavirus 10 Response Act, Pub. L. No. 116-127 and section 5131 of the 11 federal Consolidated Appropriations Act, 2023, Pub. L. No. 12 117-328. The department shall utilize and implement all tools, 13 processes, and resources available to expediently return to 14 normal eligibility and enrollment operations in compliance with 15 federal guidance and expectations. 16 20. A portion of the funds appropriated in this section 17 may be transferred to the appropriation made in this division 18 of this Act for the childrens health insurance program, 19 if the childrens health insurance program appropriation 20 is insufficient to cover the designated purposes of that 21 appropriation. 22 21. Notwithstanding any provision to the contrary, of the 23 funds appropriated in this section, $13,000,000 shall be used 24 to increase reimbursement rates for mental health and substance 25 use disorder providers in accordance with a methodology 26 determined by the department. Of the amount allocated 27 under this subsection, $7,000,000 shall be used to increase 28 reimbursement rates for individual mental health therapy 29 providers, $3,000,000 shall be used to increase reimbursement 30 rates for mental health providers, and $3,000,000 shall be used 31 to increase reimbursement rates for substance use disorder 32 providers. 33 22. Of the funds appropriated in this section, $5,500,000 34 shall be used to maintain the reimbursement rates of eligible 35 -32- SF 561 (3) 90 pf/rn/mb 32/ 77
S.F. 561 home and community-based services providers at the rates 1 in effect on June 30, 2023, and to reduce the home and 2 community-based services intellectual disabilities waiver 3 waiting list to the extent possible. 4 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated 5 from the general fund of the state to the department of health 6 and human services for the fiscal year beginning July 1, 2023, 7 and ending June 30, 2024, the following amount, or so much 8 thereof as is necessary, to be used for the purpose designated: 9 For health program operations: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,446,067 11 1. The department of inspections, appeals, and licensing 12 shall provide all state matching funds for survey and 13 certification activities performed by the department of 14 inspections, appeals, and licensing. The department of health 15 and human services is solely responsible for distributing the 16 federal matching funds for such activities. 17 2. Of the funds appropriated in this section, $50,000 shall 18 be used for continuation of home and community-based services 19 waiver quality assurance programs, including the review and 20 streamlining of processes and policies related to oversight and 21 quality management to meet state and federal requirements. 22 3. Of the amount appropriated in this section, up to 23 $200,000 may be transferred to the appropriation for general 24 administration in this division of this Act to be used for 25 additional full-time equivalent positions in the development 26 of key health initiatives such as development and oversight 27 of managed care programs and development of health strategies 28 targeted toward improved quality and reduced costs in the 29 Medicaid program. 30 4. Of the funds appropriated in this section, $1,000,000 31 shall be used for planning and development of a phased-in 32 program to provide a dental home for children. 33 5. a. Of the funds appropriated in this section, $188,000 34 shall be credited to the autism support program fund created 35 -33- SF 561 (3) 90 pf/rn/mb 33/ 77
S.F. 561 in section 225D.2 to be used for the autism support program 1 created in chapter 225D , with the exception of the following 2 amount of this allocation which shall be used as follows: 3 b. Of the funds allocated in this subsection, $25,000 shall 4 be used for the public purpose of continuation of a grant to 5 a nonprofit provider of child welfare services that has been 6 in existence for more than 115 years, is located in a county 7 with a population between 220,000 and 250,000 according to the 8 2020 federal decennial census, is licensed as a psychiatric 9 medical institution for children, and provides school-based 10 programming, to be used for support services for children with 11 autism spectrum disorder and their families. 12 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 13 1. There is appropriated from the general fund of the state 14 to the department of health and human services for the fiscal 15 year beginning July 1, 2023, and ending June 30, 2024, the 16 following amount, or so much thereof as is necessary, to be 17 used for the purpose designated: 18 For the state supplementary assistance program: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,349,002 20 2. The department shall increase the personal needs 21 allowance for residents of residential care facilities by the 22 same percentage and at the same time as federal supplemental 23 security income and federal social security benefits are 24 increased due to a recognized increase in the cost of living. 25 The department may adopt emergency rules to implement this 26 subsection. 27 3. If during the fiscal year beginning July 1, 2023, 28 the department projects that state supplementary assistance 29 expenditures for a calendar year will not meet the federal 30 pass-through requirement specified in Tit. XVI of the federal 31 Social Security Act, section 1618, as codified in 42 U.S.C. 32 1382g, the department may take actions including but not 33 limited to increasing the personal needs allowance for 34 residential care facility residents and making programmatic 35 -34- SF 561 (3) 90 pf/rn/mb 34/ 77
S.F. 561 adjustments or upward adjustments of the residential care 1 facility or in-home health-related care reimbursement rates 2 prescribed in this division of this Act to ensure that federal 3 requirements are met. In addition, the department may make 4 other programmatic and rate adjustments necessary to remain 5 within the amount appropriated in this section while ensuring 6 compliance with federal requirements. The department may adopt 7 emergency rules to implement the provisions of this subsection. 8 4. Notwithstanding section 8.33 , moneys appropriated in 9 this section that remain unencumbered or unobligated at the 10 close of the fiscal year shall not revert but shall remain 11 available for expenditure for the purposes designated, 12 including for liability amounts associated with the SNAP 13 payment error rate, until the close of the succeeding fiscal 14 year. 15 Sec. 16. CHILDRENS HEALTH INSURANCE PROGRAM. 16 1. There is appropriated from the general fund of the state 17 to the department of health and human services for the fiscal 18 year beginning July 1, 2023, and ending June 30, 2024, the 19 following amount, or so much thereof as is necessary, to be 20 used for the purpose designated: 21 For maintenance of the healthy and well kids in Iowa (Hawki) 22 program pursuant to chapter 514I , including supplemental dental 23 services, for receipt of federal financial participation under 24 Tit. XXI of the federal Social Security Act, which creates the 25 childrens health insurance program: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 38,661,688 27 2. Of the funds appropriated in this section, a sufficient 28 amount is allocated for continuation of the contract for 29 outreach. 30 3. A portion of the funds appropriated in this section may 31 be transferred to the appropriations made in this division of 32 this Act for field operations or health program operations 33 to be used for the integration of Hawki program eligibility, 34 payment, and administrative functions under the purview of the 35 -35- SF 561 (3) 90 pf/rn/mb 35/ 77
S.F. 561 department of health and human services, including for the 1 Medicaid management information system upgrade. 2 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated from 3 the general fund of the state to the department of health and 4 human services for the fiscal year beginning July 1, 2023, and 5 ending June 30, 2024, the following amount, or so much thereof 6 as is necessary, to be used for the purpose designated: 7 For child care programs: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 64,223,730 9 1. Of the funds appropriated in this section, $34,966,931 10 shall be used for state child care assistance in accordance 11 with section 237A.13 . 12 2. Nothing in this section shall be construed or is 13 intended as or shall imply a grant of entitlement for services 14 to persons who are eligible for assistance due to an income 15 level consistent with the waiting list requirements of section 16 237A.13 . Any state obligation to provide services pursuant to 17 this section is limited to the extent of the funds appropriated 18 in this section. 19 3. A list of the registered and licensed child care 20 facilities operating in the area served by a child care 21 resource and referral service shall be made available to the 22 families receiving state child care assistance in that area. 23 4. Of the funds appropriated in this section, $29,256,799 24 shall be deposited in the school ready children grants account 25 of the early childhood Iowa fund created in section 256I.11, 26 and shall be allocated as follows for the fiscal year beginning 27 July 1, 2023: 28 a. Of the amount deposited under this subsection, not 29 more than $265,950 is allocated for the early childhood Iowa 30 program and other technical assistance activities. Moneys 31 allocated under this lettered paragraph may be used by the 32 early childhood Iowa state board for the purpose of skills 33 development and support for ongoing training of staff. The 34 early childhood Iowa state board may reserve a portion of the 35 -36- SF 561 (3) 90 pf/rn/mb 36/ 77
S.F. 561 allocation under paragraph b, not to exceed $88,650, for 1 the technical assistance expenses of the early childhood Iowa 2 program, including the reimbursement of staff. However, except 3 as otherwise provided in this subsection, moneys shall not be 4 used for additional staff or for the reimbursement of staff. 5 b. Of the amount deposited under this subsection, 6 $2,318,018 shall be used for efforts to improve the quality 7 of early care, health, and education programs. Moneys 8 allocated pursuant to this lettered paragraph may be used 9 for additional staff and for the reimbursement of staff in 10 early childhood Iowa areas and for local quality improvement 11 efforts. The early childhood Iowa state board shall determine 12 the methodology to make the most productive use of the funding, 13 which may include use of the distribution formula, grants, or 14 other means. 15 c. Of the amount deposited under this subsection, $825,030 16 shall be used for support of professional development and 17 training activities for persons working in early care, 18 health, and education by the early childhood Iowa state 19 board in collaboration with the professional development 20 component group maintained by the early childhood Iowa 21 stakeholders alliance pursuant to section 256I.12, and the 22 early childhood Iowa area boards. Expenditures shall be 23 limited to professional development and training activities, 24 and strategic plan implementation staff as agreed upon by the 25 parties participating in the collaboration as approved by the 26 early childhood Iowa state board. 27 d. Of the amount deposited under this subsection, $200,000 28 shall be used to invest in the states early childhood database 29 system that integrates state administrative data to provide 30 results that inform and improve the early childhood system of 31 programs and services in the state. 32 e. Of the amount deposited under this subsection, 33 $5,850,000 shall be distributed for funding of community-based 34 early childhood programs targeted to children from birth 35 -37- SF 561 (3) 90 pf/rn/mb 37/ 77
S.F. 561 through five years of age developed by early childhood Iowa 1 areas in accordance with approved community plans as provided 2 in section 256I.8. Up to $65,000 of the funds allocated in 3 this paragraph may be used for additional technical assistance 4 staff. 5 5. The department may use any of the funds appropriated 6 in this section as a match to obtain federal funds for use in 7 expanding child care assistance and related programs. For 8 the purpose of expenditures of state and federal child care 9 funding, funds shall be considered obligated at the time 10 expenditures are projected or are allocated to the departments 11 service areas. Projections shall be based on current and 12 projected caseload growth, current and projected provider 13 rates, staffing requirements for eligibility determination 14 and management of program requirements including data systems 15 management, staffing requirements for administration of the 16 program, contractual and grant obligations and any transfers 17 to other state agencies, and obligations for decategorization 18 or innovation projects. 19 6. A portion of the state match for the federal child care 20 and development block grant shall be provided as necessary to 21 meet federal matching funds requirements through the state 22 general fund appropriation made for child development grants 23 and other programs for at-risk children in section 279.51 . 24 7. If a uniform reduction ordered by the governor under 25 section 8.31 or other operation of law, transfer, or federal 26 funding reduction reduces the appropriation made in this 27 section for the fiscal year, the percentage reduction in the 28 amount paid out to or on behalf of the families participating 29 in the state child care assistance program shall be equal to or 30 less than the percentage reduction made for any other purpose 31 payable from the appropriation made in this section and the 32 federal funding relating to it. The percentage reduction to 33 the other allocations made in this section shall be the same as 34 the uniform reduction ordered by the governor or the percentage 35 -38- SF 561 (3) 90 pf/rn/mb 38/ 77
S.F. 561 change of the federal funding reduction, as applicable. If 1 there is an unanticipated increase in federal funding provided 2 for state child care services, the entire amount of the 3 increase, except as necessary to meet federal requirements 4 including quality set asides, shall be used for state child 5 care assistance payments. If the appropriations made for 6 purposes of the state child care assistance program for the 7 fiscal year are determined to be insufficient, it is the intent 8 of the general assembly to appropriate sufficient funding for 9 the fiscal year in order to avoid establishment of waiting list 10 requirements. 11 8. Notwithstanding section 8.33 , moneys advanced for 12 purposes of the programs developed by early childhood Iowa 13 areas, advanced for purposes of wraparound child care, or 14 received from the federal appropriations made for the purposes 15 of this section that remain unencumbered or unobligated at the 16 close of the fiscal year shall not revert to any fund but shall 17 remain available for expenditure for the purposes designated 18 until the close of the succeeding fiscal year. 19 Sec. 18. JUVENILE INSTITUTION. There is appropriated from 20 the general fund of the state to the department of health and 21 human services for the fiscal year beginning July 1, 2023, and 22 ending June 30, 2024, the following amounts, or so much thereof 23 as is necessary, to be used for the purposes designated: 24 1. a. For operation of the state training school at Eldora 25 and for salaries, support, maintenance, and miscellaneous 26 purposes, and for not more than the following full-time 27 equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,568,511 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 30 b. Of the funds appropriated in this subsection, $91,000 31 shall be used for distribution to licensed classroom teachers 32 at this and other institutions under the control of the 33 department of health and human services based upon the average 34 student yearly enrollment at each institution as determined by 35 -39- SF 561 (3) 90 pf/rn/mb 39/ 77
S.F. 561 the department. 1 2. A portion of the moneys appropriated in this section 2 shall be used by the state training school at Eldora for 3 grants for adolescent pregnancy prevention activities at the 4 institution in the fiscal year beginning July 1, 2023. 5 3. Of the funds appropriated in this subsection, $212,000 6 shall be used by the state training school at Eldora for a 7 substance use disorder treatment program at the institution for 8 the fiscal year beginning July 1, 2023. 9 4. Notwithstanding section 8.33 , moneys appropriated in 10 this section that remain unencumbered or unobligated at the 11 close of the fiscal year shall not revert but shall remain 12 available for expenditure for the purposes designated until the 13 close of the succeeding fiscal year. 14 Sec. 19. CHILD AND FAMILY SERVICES. 15 1. There is appropriated from the general fund of the state 16 to the department of health and human services for the fiscal 17 year beginning July 1, 2023, and ending June 30, 2024, the 18 following amount, or so much thereof as is necessary, to be 19 used for the purpose designated: 20 For child and family services: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 79,027,794 22 2. The department may transfer funds appropriated in this 23 section as necessary to pay the nonfederal costs of services 24 reimbursed under the medical assistance program, the state 25 child care assistance program, or FIP which are provided to 26 children who would otherwise receive services paid under the 27 appropriation in this section. The department may transfer 28 funds appropriated in this section to the appropriations made 29 in this division of this Act for general administration and 30 for field operations for resources necessary to implement and 31 operate the services funded in this section. 32 3. Of the funds appropriated in this section, up to 33 $40,500,000 is allocated for group foster care maintenance and 34 services. 35 -40- SF 561 (3) 90 pf/rn/mb 40/ 77
S.F. 561 4. In accordance with the provisions of section 232.188 , 1 the department shall continue the child welfare and juvenile 2 justice funding initiative during fiscal year 2023-2024. Of 3 the funds appropriated in this section, $1,717,000 is allocated 4 specifically for expenditure for fiscal year 2023-2024 through 5 the decategorization services funding pools and governance 6 boards established pursuant to section 232.188 . 7 5. A portion of the funds appropriated in this section 8 may be used for emergency family assistance to provide other 9 resources required for a family participating in a family 10 preservation or reunification project or successor project to 11 stay together or to be reunified. 12 6. Of the funds appropriated in this section, a sufficient 13 amount is allocated for shelter care and the child welfare 14 emergency services contracting implemented to provide for or 15 prevent the need for shelter care. 16 7. Federal funds received by the state during the fiscal 17 year beginning July 1, 2023, as the result of the expenditure 18 of state funds appropriated during a previous state fiscal 19 year for a service or activity funded under this section are 20 appropriated to the department to be used as additional funding 21 for services and purposes provided for under this section. 22 Notwithstanding section 8.33 , moneys received in accordance 23 with this subsection that remain unencumbered or unobligated at 24 the close of the fiscal year shall not revert to any fund but 25 shall remain available for the purposes designated until the 26 close of the succeeding fiscal year. 27 8. a. Of the funds appropriated in this section, up to 28 $748,000 is allocated for the payment of the expenses of 29 court-ordered services provided to children who are under the 30 supervision of the department, which expenses are a charge upon 31 the state pursuant to section 232.141, subsection 4 . 32 b. Notwithstanding section 232.141 or any other 33 provision of law to the contrary, the amounts allocated in 34 this subsection shall be distributed as determined by the 35 -41- SF 561 (3) 90 pf/rn/mb 41/ 77
S.F. 561 department. The department shall make the determination of the 1 distribution amounts on or before June 15, 2023. 2 c. Notwithstanding chapter 232 or any other provision 3 of law to the contrary, a district or juvenile court shall 4 not order any service which is a charge upon the state 5 pursuant to section 232.141 if the court-ordered services 6 distribution amount is insufficient to pay for the service. 7 The department shall encourage use of the funds allocated in 8 this subsection such that there are sufficient funds to pay 9 for all court-related services during the entire year. The 10 department shall attempt to anticipate potential surpluses 11 and shortfalls in the distribution amounts and shall transfer 12 distribution amounts as prudent. 13 d. Notwithstanding any provision of law to the contrary, 14 a district or juvenile court shall not order a county to pay 15 for any service provided to a juvenile pursuant to an order 16 entered under chapter 232 which is a charge upon the state 17 under section 232.141, subsection 4 . 18 9. Of the funds appropriated in this section, $1,658,000 19 shall be used for the child protection center grant program for 20 child protection centers located in Iowa in accordance with 21 section 135.118 . The grant amounts under the program shall be 22 equalized so that each center receives a uniform base amount of 23 $245,000, and so that the remaining funds are awarded through 24 a funding formula based upon the volume of children served. 25 To increase access to child protection center services for 26 children in rural areas, the funding formula for the awarding 27 of the remaining funds shall provide for the awarding of an 28 enhanced amount to eligible grantees to develop and maintain 29 satellite centers in underserved regions of the state. 30 10. Of the funds appropriated in this section, up to 31 $4,025,000 is allocated for the preparation for adult living 32 program pursuant to section 234.46 . 33 11. Of the funds appropriated in this section, $227,000 34 shall be used for the public purpose of continuing a grant to a 35 -42- SF 561 (3) 90 pf/rn/mb 42/ 77
S.F. 561 nonprofit human services organization, providing services to 1 individuals and families in multiple locations in southwest 2 Iowa and Nebraska for support of a project providing immediate, 3 sensitive support and forensic interviews, medical exams, needs 4 assessments, and referrals for victims of child abuse and their 5 nonoffending family members. 6 12. Of the funds appropriated in this section, $300,000 7 is allocated for the foster care youth council approach of 8 providing a support network to children placed in foster care. 9 13. Of the funds appropriated in this section, $202,000 is 10 allocated for use pursuant to section 235A.1 for continuation 11 of the initiative to address child sexual abuse implemented 12 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 13 21 . 14 14. Of the funds appropriated in this section, $630,000 is 15 allocated for the community partnership for child protection 16 sites. 17 15. Of the funds appropriated in this section, up to 18 $371,000 is allocated for the departments minority youth and 19 family projects under the redesign of the child welfare system. 20 16. Of the funds appropriated in this section, $851,000 21 is allocated for funding of the community circle of care 22 collaboration for children and youth in northeast Iowa. 23 17. Of the funds appropriated in this section, at least 24 $147,000 shall be used for the continuation of the child 25 welfare provider training program. 26 18. Of the funds appropriated in this section, $211,000 27 shall be used for continuation of the central Iowa system of 28 care program grant for the purposes of funding community-based 29 services and other supports with a system of care approach for 30 children with serious emotional disturbance and their families 31 through a nonprofit provider that is located in a county 32 with a population of more than 450,000 according to the 2020 33 certified federal census, is licensed as a psychiatric medical 34 institution for children, and was a system of care grantee 35 -43- SF 561 (3) 90 pf/rn/mb 43/ 77
S.F. 561 prior to July 1, 2023. 1 19. Of the funds appropriated in this section, $235,000 2 shall be used for the public purpose of the continuation 3 and expansion of a system of care program grant implemented 4 in Cerro Gordo and Linn counties to utilize a comprehensive 5 and long-term approach for helping children and families by 6 addressing the key areas in a childs life of childhood basic 7 needs, education and work, family, and community. 8 20. Of the funds appropriated in this section, $110,000 9 shall be used for the public purpose of funding community-based 10 services and other supports with a system of care approach 11 for children with a serious emotional disturbance and their 12 families through a nonprofit provider of child welfare services 13 that has been in existence for more than 115 years, is located 14 in a county with a population of more than 230,000 according to 15 the 2020 certified federal census, is licensed as a psychiatric 16 medical institution for children, and was a system of care 17 grantee prior to July 1, 2023. 18 21. If a separate funding source is identified that reduces 19 the need for state funds within an allocation under this 20 section, the allocated state funds may be redistributed to 21 other allocations under this section for the same fiscal year. 22 22. Of the funds appropriated in this section, a portion may 23 be used for family-centered services for purposes of complying 24 with the federal Family First Prevention Services Act of 2018, 25 Pub. L. No. 115-123, and successor legislation. 26 Sec. 20. ADOPTION SUBSIDY. 27 1. There is appropriated from the general fund of the state 28 to the department of health and human services for the fiscal 29 year beginning July 1, 2023, and ending June 30, 2024, the 30 following amount, or so much thereof as is necessary, to be 31 used for the purpose designated: 32 a. For adoption subsidy payments and related costs and for 33 other operations and services provided for under paragraph b: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,883,507 35 -44- SF 561 (3) 90 pf/rn/mb 44/ 77
S.F. 561 b. (1) Of the funds appropriated in this section, a 1 sufficient amount is allocated for adoption subsidy payments 2 and related costs. 3 (2) Any funds appropriated in this section remaining after 4 the allocation under subparagraph (1) are designated and 5 allocated as state savings resulting from implementation of 6 the federal Fostering Connections to Success and Increasing 7 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 8 legislation, as determined in accordance with 42 U.S.C. 9 673(a)(8), and shall be used for post-adoption services and 10 for other purposes allowed under these federal laws, Tit. IV-B 11 or Tit. IV-E of the federal Social Security Act. 12 (a) The department of health and human services may transfer 13 funds allocated in this subparagraph (2) to the appropriation 14 for child and family services in this division of this Act for 15 the purposes designated in this subparagraph (2). 16 (b) Notwithstanding section 8.33, moneys allocated 17 under this subparagraph (2) shall not revert to any fund but 18 shall remain available for the purposes designated in this 19 subparagraph (2) until expended. 20 2. The department may transfer funds appropriated in this 21 section remaining after the transfer of funds under subsection 22 1, paragraph b, to the appropriation made in this division 23 of this Act for general administration for costs paid from the 24 appropriation relating to adoption subsidy. 25 3. Federal funds received by the state during the 26 fiscal year beginning July 1, 2023, as the result of the 27 expenditure of state funds during a previous state fiscal 28 year for a service or activity funded under this section are 29 appropriated to the department to be used as additional funding 30 for the services and activities funded under this section. 31 Notwithstanding section 8.33 , moneys received in accordance 32 with this subsection that remain unencumbered or unobligated 33 at the close of the fiscal year shall not revert to any fund 34 but shall remain available for expenditure for the purposes 35 -45- SF 561 (3) 90 pf/rn/mb 45/ 77
S.F. 561 designated until the close of the succeeding fiscal year. 1 4. Notwithstanding section 8.33, moneys appropriated in 2 this section that remain unencumbered or unobligated at the 3 close of the fiscal year shall not revert but shall remain 4 available for the purposes designated until the close of the 5 succeeding fiscal year. 6 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM. 7 1. There is appropriated from the general fund of the state 8 to the department of health and human services for the fiscal 9 year beginning July 1, 2023, and ending June 30, 2024, the 10 following amount, or so much thereof as is necessary, to be 11 used for the purpose designated: 12 For the family support subsidy program subject to the 13 enrollment restrictions in section 225C.37, subsection 3 : 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 15 2. At least $931,536 of the moneys appropriated in this 16 section shall be used for the family support center component 17 of the comprehensive family support program under chapter 225C, 18 subchapter V . 19 3. If at any time during the fiscal year, the amount of 20 funding available for the family support subsidy program 21 is reduced from the amount initially used to establish the 22 figure for the number of family members for whom a subsidy 23 is to be provided at any one time during the fiscal year, 24 notwithstanding section 225C.38, subsection 2 , the department 25 shall revise the figure as necessary to conform to the amount 26 of funding available. 27 Sec. 22. CONNER DECREE. There is appropriated from the 28 general fund of the state to the department of health and human 29 services for the fiscal year beginning July 1, 2023, and ending 30 June 30, 2024, the following amount, or so much thereof as is 31 necessary, to be used for the purpose designated: 32 For building community capacity through the coordination 33 and provision of training opportunities in accordance with the 34 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 35 -46- SF 561 (3) 90 pf/rn/mb 46/ 77
S.F. 561 Iowa, July 14, 1994): 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 2 Sec. 23. MENTAL HEALTH INSTITUTES. 3 1. There is appropriated from the general fund of the state 4 to the department of health and human services for the fiscal 5 year beginning July 1, 2023, and ending June 30, 2024, the 6 following amounts, or so much thereof as is necessary, to be 7 used for the purposes designated: 8 a. For operation of the state mental health institute at 9 Cherokee as required by chapters 218 and 226 for salaries, 10 support, maintenance, and miscellaneous purposes, and for not 11 more than the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,923,252 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 188.00 14 b. For operation of the state mental health institute at 15 Independence as required by chapters 218 and 226 for salaries, 16 support, maintenance, and miscellaneous purposes, and for not 17 more than the following full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,811,470 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 211.00 20 2. a. Notwithstanding sections 218.78 and 249A.11 , any 21 revenue received from the state mental health institute at 22 Cherokee or the state mental health institute at Independence 23 pursuant to 42 C.F.R. 438.6(e) may be retained and expended 24 by the mental health institute. 25 b. Notwithstanding sections 218.78 and 249A.11, any 26 COVID-19 related funding received through federal funding 27 sources by the state mental health institute at Cherokee or the 28 state mental health institute at Independence may be retained 29 and expended by the mental health institute. 30 3. Notwithstanding any provision of law to the contrary, 31 a Medicaid member residing at the state mental health 32 institute at Cherokee or the state mental health institute 33 at Independence shall retain Medicaid eligibility during 34 the period of the Medicaid members stay for which federal 35 -47- SF 561 (3) 90 pf/rn/mb 47/ 77
S.F. 561 financial participation is available. 1 4. Notwithstanding section 8.33 , moneys appropriated in 2 this section that remain unencumbered or unobligated at the 3 close of the fiscal year shall not revert but shall remain 4 available for expenditure for the purposes designated until the 5 close of the succeeding fiscal year. 6 Sec. 24. STATE RESOURCE CENTERS. 7 1. There is appropriated from the general fund of the state 8 to the department of health and human services for the fiscal 9 year beginning July 1, 2023, and ending June 30, 2024, the 10 following amounts, or so much thereof as is necessary, to be 11 used for the purposes designated: 12 a. For the state resource center at Glenwood for salaries, 13 support, maintenance, and miscellaneous purposes: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,255,132 15 b. For the state resource center at Woodward for salaries, 16 support, maintenance, and miscellaneous purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,389,577 18 2. The department may continue to bill for state resource 19 center services utilizing a scope of services approach used for 20 private providers of intermediate care facilities for persons 21 with an intellectual disability services, in a manner which 22 does not shift costs between the medical assistance program, 23 mental health and disability services regions, or other sources 24 of funding for the state resource centers. 25 3. The state resource centers may expand the time-limited 26 assessment and respite services during the fiscal year. 27 4. If the departments administration and the department 28 of management concur with a finding by a state resource 29 centers superintendent that projected revenues can reasonably 30 be expected to pay the salary and support costs for a new 31 employee position, or that such costs for adding a particular 32 number of new positions for the fiscal year would be less 33 than the overtime costs if new positions would not be added, 34 the superintendent may add the new position or positions. If 35 -48- SF 561 (3) 90 pf/rn/mb 48/ 77
S.F. 561 the vacant positions available to a resource center do not 1 include the position classification desired to be filled, the 2 state resource centers superintendent may reclassify any 3 vacant position as necessary to fill the desired position. The 4 superintendents of the state resource centers may, by mutual 5 agreement, pool vacant positions and position classifications 6 during the course of the fiscal year in order to assist one 7 another in filling necessary positions. 8 5. If existing capacity limitations are reached in 9 operating units, a waiting list is in effect for a service or 10 a special need for which a payment source or other funding 11 is available for the service or to address the special need, 12 and facilities for the service or to address the special need 13 can be provided within the available payment source or other 14 funding, the superintendent of a state resource center may 15 authorize opening not more than two units or other facilities 16 and begin implementing the service or addressing the special 17 need during fiscal year 2023-2024. 18 6. Notwithstanding section 8.33 , and notwithstanding 19 the amount limitation specified in section 222.92 , moneys 20 appropriated in this section that remain unencumbered or 21 unobligated at the close of the fiscal year shall not revert 22 but shall remain available for expenditure for the purposes 23 designated until the close of the succeeding fiscal year. 24 Sec. 25. SEXUALLY VIOLENT PREDATORS. 25 1. There is appropriated from the general fund of the state 26 to the department of health and human services for the fiscal 27 year beginning July 1, 2023, and ending June 30, 2024, the 28 following amount, or so much thereof as is necessary, to be 29 used for the purpose designated: 30 For costs associated with the commitment and treatment of 31 sexually violent predators in the unit located at the state 32 mental health institute at Cherokee, including costs of legal 33 services and other associated costs, including salaries, 34 support, maintenance, and miscellaneous purposes, and for not 35 -49- SF 561 (3) 90 pf/rn/mb 49/ 77
S.F. 561 more than the following full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,865,337 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 167.00 3 2. Unless specifically prohibited by law, if the amount 4 charged provides for recoupment of at least the entire amount 5 of direct and indirect costs, the department of health and 6 human services may contract with other states to provide 7 care and treatment of persons placed by the other states at 8 the unit for sexually violent predators at Cherokee. The 9 moneys received under such a contract shall be considered 10 to be repayment receipts and used for the purposes of the 11 appropriation made in this section. 12 3. Notwithstanding section 8.33 , moneys appropriated in 13 this section that remain unencumbered or unobligated at the 14 close of the fiscal year shall not revert but shall remain 15 available for expenditure for the purposes designated until the 16 close of the succeeding fiscal year. 17 Sec. 26. FIELD OPERATIONS. 18 1. There is appropriated from the general fund of the state 19 to the department of health and human services for the fiscal 20 year beginning July 1, 2023, and ending June 30, 2024, the 21 following amount, or so much thereof as is necessary, to be 22 used for the purposes designated: 23 For field operations, including salaries, support, 24 maintenance, and miscellaneous purposes, and for not more than 25 the following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 72,056,945 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,589.00 28 2. Of the funds appropriated in this section, $1,370,436 29 shall be used for the purpose of increasing compensation for 30 child welfare case workers and to support case workers with 31 complex cases in all service areas. 32 3. In addition to subsection 2, priority in filling 33 full-time equivalent positions shall be given to those 34 positions related to child protection services and eligibility 35 -50- SF 561 (3) 90 pf/rn/mb 50/ 77
S.F. 561 determination for low-income families. 1 Sec. 27. GENERAL ADMINISTRATION. There is appropriated 2 from the general fund of the state to the department of health 3 and human services for the fiscal year beginning July 1, 2023, 4 and ending June 30, 2024, the following amount, or so much 5 thereof as is necessary, to be used for the purpose designated: 6 For general administration, including salaries, support, 7 maintenance, and miscellaneous purposes, and for not more than 8 the following full-time equivalent positions: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,913,662 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 341.86 11 1. The department shall report at least monthly to the 12 general assembly concerning the departments operational and 13 program expenditures. 14 2. Of the funds appropriated in this section, $150,000 shall 15 be used for the provision of a program to provide technical 16 assistance, support, and consultation to providers of home and 17 community-based services under the medical assistance program. 18 3. Of the funds appropriated in this section, $50,000 19 is transferred to the Iowa finance authority to be used 20 for administrative support of the council on homelessness 21 established in section 16.2D and for the council to fulfill its 22 duties in addressing and reducing homelessness in the state. 23 4. Of the funds appropriated in this section, $200,000 shall 24 be transferred to and deposited in the administrative fund of 25 the Iowa ABLE savings plan trust created in section 12I.4 , to 26 be used for implementation and administration activities of the 27 Iowa ABLE savings plan trust. 28 5. Of the funds appropriated in this section, $200,000 is 29 transferred to the Iowa commission on volunteer service to 30 continue to be used for the RefugeeRISE AmeriCorps program 31 established under section 15H.8 for member recruitment and 32 training to improve the economic well-being and health of 33 economically disadvantaged refugees in local communities across 34 Iowa. Funds transferred may be used to supplement federal 35 -51- SF 561 (3) 90 pf/rn/mb 51/ 77
S.F. 561 funds under federal regulations. 1 6. Of the funds appropriated in this section, up to $300,000 2 shall be used as follows: 3 a. To fund not more than 1.00 full-time equivalent position 4 to address the departments responsibility to support the work 5 of the childrens behavioral health system state board and 6 implementation of the services required pursuant to section 7 331.397. 8 b. To support the cost of establishing and implementing new 9 or additional services required pursuant to sections 331.397 10 and 331.397A. 11 c. Of the amount allocated, $32,000 shall be used to support 12 the costs of establishing and implementing new or additional 13 services required pursuant to sections 331.397 and 331.397A. 14 7. Of the funds appropriated in this section, $800,000 shall 15 be used for the renovation and construction of certain nursing 16 facilities, consistent with the provisions of chapter 249K. 17 8. Of the funds appropriated under this section, $1,000,000 18 shall be used for the purposes of program administration and 19 provision of pregnancy support services through the more 20 options for maternal support program in accordance with section 21 217.41C. 22 9. Of the funds appropriated under this section, $2,602,312 23 shall be used for the child advocacy board for foster care 24 review and the court appointed special advocate program, 25 including for salaries, support, maintenance, and miscellaneous 26 purposes. 27 a. The department, in coordination with the child advocacy 28 board, shall submit an application for funding available 29 pursuant to Tit. IV-E of the federal Social Security Act for 30 claims for child advocacy board administrative review costs. 31 b. The court appointed special advocate program shall 32 investigate and develop opportunities for expanding fundraising 33 for the program. 34 c. Administrative costs charged by the department for items 35 -52- SF 561 (3) 90 pf/rn/mb 52/ 77
S.F. 561 funded under this subsection shall not exceed 4 percent of the 1 amount appropriated in this subsection. 2 Sec. 28. DEPARTMENT-WIDE DUTIES. 3 There is appropriated from the general fund of the state to 4 the department of health and human services for the fiscal year 5 beginning July 1, 2023, and ending June 30, 2024, the following 6 amount, or so much thereof as is necessary, to be used for the 7 purposes designated: 8 For salaries, support, maintenance, and miscellaneous 9 purposes at facilities under the purview of the department of 10 health and human services: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,157,590 12 The department shall submit a report to the general assembly 13 detailing the expenditure of the funds appropriated under this 14 section. 15 Sec. 29. VOLUNTEERS. There is appropriated from the 16 general fund of the state to the department of health and human 17 services for the fiscal year beginning July 1, 2023, and ending 18 June 30, 2024, the following amount, or so much thereof as is 19 necessary, to be used for the purpose designated: 20 For development and coordination of volunteer services: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 22 Sec. 30. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 23 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 24 DEPARTMENT OF HEALTH AND HUMAN SERVICES. 25 1. a. (1) (a) (i) Notwithstanding any provision of 26 law to the contrary, for the fiscal period beginning July 1, 27 2023, and ending June 30, 2025, the department of health and 28 human services shall rebase case-mix nursing facility rates 29 beginning July 1, 2023, using the Medicaid cost reports on file 30 for the period ending December 31, 2022, and applying a minimum 31 occupancy factor of 70 percent, as provided pursuant to 2021 32 Iowa Acts, chapter 182, section 39, to the extent possible 33 within the state funding, including the $15,000,000 provided 34 for this purpose. 35 -53- SF 561 (3) 90 pf/rn/mb 53/ 77
S.F. 561 (ii) For the fiscal year beginning July 1, 2023, the 1 department of health and human services shall determine and 2 adjust each nursing facilitys case-mix index on a semiannual 3 basis. A separate calculation shall be made to determine the 4 average case-mix index for a nursing facility-wide case-mix 5 index, and a case-mix index for the residents of a nursing 6 facility who are medical assistance program recipients using 7 all of the minimum data set reports by the nursing facility for 8 the previous semiannual period of the state fiscal year using a 9 day weighted calculation. 10 (b) For the fiscal year beginning July 1, 2023, non-case-mix 11 and special population nursing facilities shall be reimbursed 12 in accordance with the methodology in effect on June 30, 2023. 13 (c) For managed care claims, the department of health 14 and human services shall adjust the payment rate floor for 15 nursing facilities, annually, to maintain a rate floor that is 16 no lower than the Medicaid fee-for-service case-mix adjusted 17 rate calculated in accordance with subparagraph division 18 (a) and 441 IAC 81.6 . The department shall then calculate 19 adjusted reimbursement rates, including but not limited to 20 add-on payments, annually, and shall notify Medicaid managed 21 care organizations of the adjusted reimbursement rates within 22 30 days of determining the adjusted reimbursement rates. Any 23 adjustment of reimbursement rates under this subparagraph 24 division shall be budget neutral to the state budget. 25 (d) For the fiscal year beginning July 1, 2023, Medicaid 26 managed care long-term services and supports capitation rates 27 shall be adjusted to reflect the case-mix adjusted rates 28 specified pursuant to subparagraph division (a) for the patient 29 populations residing in Medicaid-certified nursing facilities. 30 (2) Medicaid managed care organizations shall adjust 31 facility-specific rates based upon payment rate listings issued 32 by the department. The rate adjustments shall be applied 33 prospectively from the effective date of the rate letter issued 34 by the department. 35 -54- SF 561 (3) 90 pf/rn/mb 54/ 77
S.F. 561 b. (1) For the fiscal year beginning July 1, 2023, the 1 department shall establish the fee-for-service pharmacy 2 dispensing fee reimbursement at $10.38 per prescription, 3 until a cost of dispensing survey is completed. The actual 4 dispensing fee shall be determined by a cost of dispensing 5 survey performed by the department and required to be completed 6 by all medical assistance program participating pharmacies 7 every two years, adjusted as necessary to maintain expenditures 8 within the amount appropriated to the department for this 9 purpose for the fiscal year. A change in the dispensing 10 fee shall become effective following federal approval of the 11 Medicaid state plan. 12 (2) The department shall utilize an average acquisition 13 cost reimbursement methodology for all drugs covered under the 14 medical assistance program in accordance with 2012 Iowa Acts, 15 chapter 1133, section 33. 16 c. (1) For the fiscal year beginning July 1, 2023, 17 reimbursement rates for outpatient hospital services shall 18 be rebased effective January 1, 2024, subject to Medicaid 19 program upper payment limit rules, and adjusted as necessary 20 to maintain expenditures within the amount appropriated to the 21 department for this purpose for the fiscal year. 22 (2) For the fiscal year beginning July 1, 2023, 23 reimbursement rates for inpatient hospital services shall 24 remain at the rates in effect on June 30, 2023, subject to 25 Medicaid program upper payment limit rules, and adjusted 26 as necessary to maintain expenditures within the amount 27 appropriated to the department for this purpose for the fiscal 28 year. 29 (3) For the fiscal year beginning July 1, 2023, under 30 both fee-for-service and managed care administration of 31 the Medicaid program, critical access hospitals shall be 32 reimbursed for inpatient and outpatient services based on the 33 hospital-specific critical access hospital cost adjustment 34 factor methodology utilizing the most recent and complete cost 35 -55- SF 561 (3) 90 pf/rn/mb 55/ 77
S.F. 561 reporting period as applied prospectively within the funds 1 appropriated for such purpose for the fiscal year. 2 (4) For the fiscal year beginning July 1, 2023, the graduate 3 medical education and disproportionate share hospital fund 4 shall remain at the amount in effect on June 30, 2023, except 5 that the portion of the fund attributable to graduate medical 6 education shall be reduced in an amount that reflects the 7 elimination of graduate medical education payments made to 8 out-of-state hospitals. 9 (5) In order to ensure the efficient use of limited state 10 funds in procuring health care services for low-income Iowans, 11 funds appropriated in this Act for hospital services shall 12 not be used for activities which would be excluded from a 13 determination of reasonable costs under the federal Medicare 14 program pursuant to 42 U.S.C. 1395x(v)(1)(N). 15 d. For the fiscal year beginning July 1, 2023, reimbursement 16 rates for hospices and acute psychiatric hospitals shall be 17 increased in accordance with increases under the federal 18 Medicare program or as supported by their Medicare audited 19 costs. 20 e. For the fiscal year beginning July 1, 2023, independent 21 laboratories and rehabilitation agencies shall be reimbursed 22 using the same methodology in effect on June 30, 2023. 23 f. (1) For the fiscal year beginning July 1, 2023, 24 reimbursement rates for home health agencies shall continue to 25 be based on the Medicare low utilization payment adjustment 26 (LUPA) methodology with state geographic wage adjustments. 27 The department shall continue to update the rates every two 28 years to reflect the most recent Medicare LUPA rates to the 29 extent possible within the state funding appropriated for this 30 purpose. 31 (2) For the fiscal year beginning July 1, 2023, the 32 department shall continue the reimbursement rate structure that 33 provides incentives to home health care providers located in 34 rural areas and providing home health care to Medicaid members. 35 -56- SF 561 (3) 90 pf/rn/mb 56/ 77
S.F. 561 The rate structure shall include a telehealth component to 1 incentivize the provision of necessary supervision for skilled 2 care without requiring travel time. For the purposes of this 3 subparagraph (2), rural area means an area that is not an 4 Iowa core based statistical area as defined by the federal 5 office of management and budget. 6 (3) For the fiscal year beginning July 1, 2023, rates for 7 private duty nursing and personal care services under the early 8 and periodic screening, diagnostic, and treatment program 9 benefit shall be calculated based on the methodology in effect 10 on June 30, 2023. 11 g. For the fiscal year beginning July 1, 2023, federally 12 qualified health centers and rural health clinics shall receive 13 cost-based reimbursement for 100 percent of the reasonable 14 costs for the provision of services to recipients of medical 15 assistance. 16 h. For the fiscal year beginning July 1, 2023, the 17 reimbursement rates for dental services shall remain at the 18 rates in effect on June 30, 2023, unless the department is 19 able to adjust rates in a budget neutral manner within overall 20 dental program expenditures. 21 i. (1) For the fiscal year beginning July 1, 2023, 22 reimbursement rates for non-state-owned psychiatric medical 23 institutions for children shall be based on the reimbursement 24 methodology in effect on June 30, 2023. 25 (2) As a condition of participation in the medical 26 assistance program, enrolled providers shall accept the medical 27 assistance reimbursement rate for any covered goods or services 28 provided to recipients of medical assistance who are children 29 under the custody of a psychiatric medical institution for 30 children. 31 j. For the fiscal year beginning July 1, 2023, unless 32 otherwise specified in this Act, all noninstitutional medical 33 assistance provider reimbursement rates shall remain at the 34 rates in effect on June 30, 2023, except for area education 35 -57- SF 561 (3) 90 pf/rn/mb 57/ 77
S.F. 561 agencies, local education agencies, infant and toddler 1 services providers, home and community-based services providers 2 including consumer-directed attendant care providers under a 3 section 1915(c) or 1915(i) waiver, targeted case management 4 providers, and those providers whose rates are required to be 5 determined pursuant to section 249A.20 , or to meet federal 6 mental health parity requirements. 7 k. Notwithstanding any provision to the contrary, for the 8 fiscal year beginning July 1, 2023, the reimbursement rate for 9 anesthesiologists shall remain at the rates in effect on June 10 30, 2023, and updated on January 1, 2024, to align with the 11 most current Iowa Medicare anesthesia rate. 12 l. Notwithstanding section 249A.20 , for the fiscal year 13 beginning July 1, 2023, the average reimbursement rate for 14 health care providers eligible for use of the federal Medicare 15 resource-based relative value scale reimbursement methodology 16 under section 249A.20 shall remain at the rate in effect on 17 June 30, 2023; however, this rate shall not exceed the maximum 18 level authorized by the federal government. 19 m. For the fiscal year beginning July 1, 2023, the 20 reimbursement rate for residential care facilities shall not 21 be less than the minimum payment level as established by the 22 federal government to meet the federally mandated maintenance 23 of effort requirement. The flat reimbursement rate for 24 facilities electing not to file annual cost reports shall not 25 be less than the minimum payment level as established by the 26 federal government to meet the federally mandated maintenance 27 of effort requirement. 28 n. (1) For the fiscal year beginning July 1, 2023, the 29 reimbursement rates for inpatient mental health services 30 provided at hospitals shall remain at the rates in effect on 31 June 30, 2023, subject to Medicaid program upper payment limit 32 rules and adjusted as necessary to maintain expenditures within 33 the amount appropriated to the department for this purpose for 34 the fiscal year; and psychiatrists shall be reimbursed at the 35 -58- SF 561 (3) 90 pf/rn/mb 58/ 77
S.F. 561 medical assistance program fee-for-service rate in effect on 1 June 30, 2023. 2 (2) The department of health and human services shall 3 continue the tiered rate reimbursement methodology for 4 psychiatric intensive inpatient care. 5 o. For the fiscal year beginning July 1, 2023, community 6 mental health centers may choose to be reimbursed for the 7 services provided to recipients of medical assistance through 8 either of the following options: 9 (1) For 100 percent of the reasonable costs of the services. 10 (2) In accordance with the alternative reimbursement rate 11 methodology approved by the department of health and human 12 services in effect on June 30, 2023. 13 p. For the fiscal year beginning July 1, 2023, the 14 reimbursement rate for providers of family planning services 15 that are eligible to receive a 90 percent federal match shall 16 remain at the rates in effect on June 30, 2023. 17 q. For the fiscal year beginning July 1, 2023, the 18 reimbursement rates for emergency medical service providers 19 shall remain at the rates in effect on June 30, 2023, or as 20 approved by the centers for Medicare and Medicaid services of 21 the United States department of health and human services. 22 r. For the fiscal year beginning July 1, 2023, reimbursement 23 rates for substance use disorder treatment programs licensed 24 under section 125.13 shall remain at the rates in effect on 25 June 30, 2023. 26 s. For the fiscal year beginning July 1, 2023, assertive 27 community treatment per diem rates shall remain at the rates in 28 effect on June 30, 2023. 29 t. For the fiscal year beginning July 1, 2023, the 30 reimbursement rate for family-centered services providers shall 31 be established by contract. 32 u. For the fiscal year beginning July 1, 2023, the 33 reimbursement rate for air ambulance services shall remain at 34 the rate in effect on June 30, 2023. 35 -59- SF 561 (3) 90 pf/rn/mb 59/ 77
S.F. 561 v. For the fiscal year beginning July 1, 2023, all applied 1 behavioral analysis services reimbursement rates shall remain 2 at the rates in effect on June 30, 2023. 3 w. For the fiscal year beginning July 1, 2023, all 4 behavioral health intervention services reimbursement rates 5 shall remain at the rates in effect on June 30, 2023. 6 2. For the fiscal year beginning July 1, 2023, the 7 reimbursement rate for providers reimbursed under the 8 in-home-related care program shall not be less than the minimum 9 payment level as established by the federal government to meet 10 the federally mandated maintenance of effort requirement. 11 3. Unless otherwise directed in this section, when the 12 departments reimbursement methodology for any provider 13 reimbursed in accordance with this section includes an 14 inflation factor, this factor shall not exceed the amount 15 by which the consumer price index for all urban consumers 16 increased during the most recently ended calendar year. 17 4. Notwithstanding section 234.38 , for the fiscal 18 year beginning July 1, 2023, the foster family basic daily 19 maintenance rate and the maximum adoption subsidy rate for 20 children ages 0 through 5 years shall be $16.78, the rate for 21 children ages 6 through 11 years shall be $17.45, the rate for 22 children ages 12 through 15 years shall be $19.10, and the 23 rate for children and young adults ages 16 and older shall be 24 $19.35. For youth ages 18 to 23 who have exited foster care, 25 the preparation for adult living program maintenance rate shall 26 be up to $602.70 per month as calculated based on the age of the 27 participant. 28 5. For the fiscal year beginning July 1, 2023, the maximum 29 reimbursement rates for social services providers under 30 contract shall remain at the rates in effect on June 30, 2023, 31 or the providers actual and allowable cost plus inflation for 32 each service, whichever is less. However, if a new service 33 or service provider is added after June 30, 2023, the initial 34 reimbursement rate for the service or provider shall be based 35 -60- SF 561 (3) 90 pf/rn/mb 60/ 77
S.F. 561 upon a weighted average of provider rates for similar services. 1 6. a. For the fiscal year beginning July 1, 2023, the 2 reimbursement rates for resource family recruitment and 3 retention contractors shall be established by contract. 4 b. For the fiscal year beginning July 1, 2023, the 5 reimbursement rates for supervised apartment living foster care 6 providers shall be established by contract. 7 7. For the fiscal year beginning July 1, 2023, the 8 reimbursement rate for group foster care providers shall be the 9 combined service and maintenance reimbursement rate established 10 by contract. 11 8. The group foster care reimbursement rates paid for 12 placement of children out of state shall be calculated 13 according to the same rate-setting principles as those used for 14 in-state providers, unless the director of health and human 15 services or the directors designee determines that appropriate 16 care cannot be provided within the state. The payment of the 17 daily rate shall be based on the number of days in the calendar 18 month in which service is provided. 19 9. a. For the fiscal year beginning July 1, 2023, the 20 reimbursement rate paid for shelter care and the child welfare 21 emergency services implemented to provide or prevent the need 22 for shelter care shall be established by contract. 23 b. For the fiscal year beginning July 1, 2023, the combined 24 service and maintenance components of the per day reimbursement 25 rate paid for shelter care services shall be based on the 26 financial and statistical report submitted to the department. 27 The maximum per day reimbursement rate shall be the maximum 28 per day reimbursement rate in effect on June 30, 2023. The 29 department shall reimburse a shelter care provider at the 30 providers actual and allowable unit cost, plus inflation, not 31 to exceed the maximum reimbursement rate. 32 10. For the fiscal year beginning July 1, 2023, the 33 department shall calculate reimbursement rates for intermediate 34 care facilities for persons with an intellectual disability 35 -61- SF 561 (3) 90 pf/rn/mb 61/ 77
S.F. 561 at the 80th percentile. Beginning July 1, 2023, the rate 1 calculation methodology shall utilize the consumer price index 2 inflation factor applicable to the fiscal year beginning July 3 1, 2023. 4 11. The department may adopt emergency rules to implement 5 this section. 6 Sec. 31. EMERGENCY RULES. 7 1. If necessary to comply with federal requirements 8 including time frames, or if specifically authorized by a 9 provision of this division of this Act, the department of 10 health and human services or the mental health and disability 11 services commission shall adopt administrative rules under 12 section 17A.4, subsection 3, and section 17A.5, subsection 2, 13 paragraph b, to implement the provisions of this division 14 of this Act and shall submit such rules to the administrative 15 rules coordinator and the administrative code editor pursuant 16 to section 17A.5, subsection 1, within the same period. The 17 rules shall be effective immediately upon filing unless a 18 later date is specified in the rules. Any rules adopted in 19 accordance with this section shall also be published as a 20 notice of intended action as provided in section 17A.4. 21 2. If during a fiscal year, the department of health and 22 human services is adopting rules in accordance with this 23 section or as otherwise directed or authorized by state 24 law, and the rules will result in an expenditure increase 25 beyond the amount anticipated in the budget process or if the 26 expenditure was not addressed in the budget process for the 27 fiscal year, the department shall notify the general assembly 28 and the department of management concerning the rules and the 29 expenditure increase. The notification shall be provided at 30 least thirty calendar days prior to the date notice of the 31 rules is submitted to the administrative rules coordinator and 32 the administrative code editor. 33 Sec. 32. REPORTS. Unless otherwise provided, any reports or 34 other information required to be compiled and submitted under 35 -62- SF 561 (3) 90 pf/rn/mb 62/ 77
S.F. 561 this Act during the fiscal year beginning July 1, 2023, shall 1 be submitted on or before the dates specified for submission 2 of the reports or information. 3 Sec. 33. EFFECTIVE UPON ENACTMENT. The following provision 4 of this division of this Act, being deemed of immediate 5 importance, takes effect upon enactment: 6 The provision relating to section 232.141 and directing 7 the department of health and human services to make the 8 determination, by June 15, 2023, of the distribution of funds 9 allocated for the payment of the expenses of court-ordered 10 services provided to juveniles which are a charge upon the 11 state. 12 DIVISION VI 13 DEPARTMENT OF HEALTH AND HUMAN SERVICES HUMAN RIGHTS 14 Sec. 34. DEPARTMENT OF HEALTH AND HUMAN SERVICES HUMAN 15 RIGHTS. There is appropriated from the general fund of the 16 state to the department of health and human services for the 17 fiscal year beginning July 1, 2023, and ending June 30, 2024, 18 the following amounts, or so much thereof as is necessary, to 19 be used for the purposes designated: 20 1. HUMAN RIGHTS CENTRAL ADMINISTRATION 21 For salaries, support, maintenance, and miscellaneous 22 purposes, and for not more than the following full-time 23 equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 186,913 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.54 26 2. COMMUNITY ADVOCACY AND SERVICES 27 For salaries, support, maintenance, and miscellaneous 28 purposes, and for not more than the following full-time 29 equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 956,894 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 7.55 32 3. CRIMINAL AND JUVENILE JUSTICE PLANNING 33 a. For salaries, support, maintenance, and miscellaneous 34 purposes, and for not more than the following full-time 35 -63- SF 561 (3) 90 pf/rn/mb 63/ 77
S.F. 561 equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,318,547 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 9.00 3 b. (1) For a single grant to a program located in a city 4 with a higher than average juvenile crime rate as determined by 5 the department of health and human services and a population 6 greater than 80,000 as determined by the 2020 federal decennial 7 census, which may be used for studying, planning, programming, 8 and capital, that is committed to deterring juvenile 9 delinquency through early intervention in the criminal justice 10 system by providing a comprehensive, multifaceted delivery of 11 social services and which shall meet the guiding principles 12 and standards for assessment centers set forth by the national 13 assessment center association: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 140,000 15 (2) The program shall use no more than 5 percent of the 16 grant for administrative costs. 17 (3) A city shall not receive a grant under this paragraph, 18 or a similar grant from the state, for more than two 19 consecutive fiscal years unless no other city meets the 20 requirements specified in subparagraph (1). 21 c. The justice advisory board and the juvenile justice 22 advisory council shall coordinate their efforts in carrying out 23 their respective duties relative to juvenile justice. 24 Sec. 35. JUVENILE DETENTION HOME FUND. Moneys deposited 25 in the juvenile detention home fund created in section 232.142 26 during the fiscal year beginning July 1, 2023, and ending June 27 30, 2024, are appropriated to the department of health and 28 human services for the fiscal year beginning July 1, 2023, and 29 ending June 30, 2024, for distribution of an amount equal to 30 a percentage of the costs of the establishment, improvement, 31 operation, and maintenance of county or multicounty juvenile 32 detention homes in the fiscal year beginning July 1, 2022. 33 Moneys appropriated for distribution in accordance with 34 this section shall be allocated among eligible detention 35 -64- SF 561 (3) 90 pf/rn/mb 64/ 77
S.F. 561 homes, prorated on the basis of an eligible detention homes 1 proportion of the costs of all eligible detention homes in the 2 fiscal year beginning July 1, 2022. The percentage figure 3 shall be determined by the department of health and human 4 services based on the amount available for distribution for 5 the fund. Notwithstanding section 232.142, the financial aid 6 percentage of total costs payable by the state under that 7 provision for the fiscal year beginning July 1, 2023, shall be 8 limited to the amount appropriated for the purposes of this 9 section. 10 DIVISION VII 11 HEALTH AND HUMAN SERVICES HEALTH CARE ACCOUNTS AND FUNDS 12 FY 2023-2024 13 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT DEPARTMENT 14 OF HEALTH AND HUMAN SERVICES. There is appropriated from the 15 pharmaceutical settlement account created in section 249A.33 to 16 the department of health and human services for the fiscal year 17 beginning July 1, 2023, and ending June 30, 2024, the following 18 amount, or so much thereof as is necessary, to be used for the 19 purpose designated: 20 Notwithstanding any provision of law to the contrary, to 21 supplement the appropriations made in this Act for health 22 program operations under the medical assistance program for the 23 fiscal year beginning July 1, 2023, and ending June 30, 2024: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 25 Sec. 37. QUALITY ASSURANCE TRUST FUND DEPARTMENT OF 26 HEALTH AND HUMAN SERVICES. Notwithstanding any provision to 27 the contrary and subject to the availability of funds, there is 28 appropriated from the quality assurance trust fund created in 29 section 249L.4 to the department of health and human services 30 for the fiscal year beginning July 1, 2023, and ending June 31 30, 2024, the following amounts, or so much thereof as is 32 necessary, for the purposes designated: 33 To supplement the appropriation made in this Act from the 34 general fund of the state to the department of health and human 35 -65- SF 561 (3) 90 pf/rn/mb 65/ 77
S.F. 561 services for medical assistance for the same fiscal year: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $111,216,205 2 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any 4 provision to the contrary and subject to the availability of 5 funds, there is appropriated from the hospital health care 6 access trust fund created in section 249M.4 to the department 7 of health and human services for the fiscal year beginning July 8 1, 2023, and ending June 30, 2024, the following amounts, or so 9 much thereof as is necessary, for the purposes designated: 10 To supplement the appropriation made in this Act from the 11 general fund of the state to the department of health and human 12 services for medical assistance for the same fiscal year: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 14 Sec. 39. MEDICAL ASSISTANCE PROGRAM NONREVERSION 15 FOR FY 2023-2024. Notwithstanding section 8.33 , if moneys 16 appropriated for purposes of the medical assistance program for 17 the fiscal year beginning July 1, 2023, and ending June 30, 18 2024, from the general fund of the state, the quality assurance 19 trust fund, and the hospital health care access trust fund, are 20 in excess of actual expenditures for the medical assistance 21 program and remain unencumbered or unobligated at the close 22 of the fiscal year, the excess moneys shall not revert but 23 shall remain available for expenditure for the purposes of the 24 medical assistance program until the close of the succeeding 25 fiscal year. 26 DIVISION VIII 27 DECATEGORIZATION CARRYOVER FUNDING TRANSFER TO MEDICAID 28 PROGRAM 29 Sec. 40. DECATEGORIZATION CARRYOVER FUNDING FY 2021 30 TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188, 31 subsection 5, paragraph b, any state-appropriated moneys in 32 the funding pool that remained unencumbered or unobligated at 33 the close of the fiscal year beginning July 1, 2020, and were 34 deemed carryover funding to remain available for the three 35 -66- SF 561 (3) 90 pf/rn/mb 66/ 77
S.F. 561 succeeding fiscal years that still remain unencumbered or 1 unobligated at the close of the fiscal year beginning July 1, 2 2023, shall not revert but shall be transferred to the medical 3 assistance program for the fiscal year beginning July 1, 2024. 4 DIVISION IX 5 HEALTH AND HUMAN SERVICES PRIOR APPROPRIATIONS AND OTHER 6 PROVISIONS 7 FAMILY INVESTMENT PROGRAM GENERAL FUND 8 Sec. 41. 2022 Iowa Acts, chapter 1131, section 9, is amended 9 by adding the following new subsection: 10 NEW SUBSECTION . 7. Notwithstanding section 8.33, moneys 11 appropriated in this section that remain unencumbered or 12 unobligated at the close of the fiscal year shall not revert 13 but shall remain available for the purposes designated until 14 the close of the succeeding fiscal year. 15 STATE CHILD CARE ASSISTANCE 16 Sec. 42. 2022 Iowa Acts, chapter 1131, section 17, 17 subsection 8, is amended to read as follows: 18 8. Notwithstanding section 8.33 , moneys advanced for 19 purposes of the programs developed by early childhood Iowa 20 areas, advanced for purposes of wraparound child care, or 21 received from the federal appropriations made for the purposes 22 of appropriated in this section that remain unencumbered or 23 unobligated at the close of the fiscal year shall not revert 24 to any fund but shall remain available for expenditure for the 25 purposes designated until the close of the succeeding fiscal 26 year. 27 CHILD AND FAMILY SERVICES 28 Sec. 43. 2022 Iowa Acts, chapter 1131, section 19, is 29 amended by adding the following new subsection: 30 NEW SUBSECTION . 25. Notwithstanding section 8.33, moneys 31 appropriated in this section that remain unencumbered or 32 unobligated at the close of the fiscal year shall not revert 33 but shall remain available for the purposes designated until 34 the close of the succeeding fiscal year. 35 -67- SF 561 (3) 90 pf/rn/mb 67/ 77
S.F. 561 FIELD OPERATIONS 1 Sec. 44. 2022 Iowa Acts, chapter 1131, section 27, is 2 amended by adding the following new subsection: 3 NEW SUBSECTION . 3. Notwithstanding section 8.33, moneys 4 appropriated in this section that remain unencumbered or 5 unobligated at the close of the fiscal year shall not revert 6 but shall remain available for the purposes designated until 7 the close of the succeeding fiscal year. 8 MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM 9 Sec. 45. 2022 Iowa Acts, chapter 1131, section 28, 10 subsection 8, is amended to read as follows: 11 8. Of the funds appropriated under this section, $500,000 12 shall be used for the purposes of program administration 13 and provision of pregnancy support services through the 14 more options for maternal support program created in this 15 Act. Notwithstanding section 8.33, moneys allocated in this 16 subsection that remain unencumbered or unobligated at the close 17 of the fiscal year shall not revert but shall remain available 18 for the purposes designated until the close of the succeeding 19 fiscal year. 20 GENERAL ADMINISTRATION 21 Sec. 46. 2022 Iowa Acts, chapter 1131, section 28, is 22 amended by adding the following new subsection: 23 NEW SUBSECTION . 9. Notwithstanding section 8.33, moneys 24 appropriated in this section that remain unencumbered or 25 unobligated at the close of the fiscal year shall not revert 26 but shall remain available for the purposes designated until 27 the close of the succeeding fiscal year. 28 QUALITY ASSURANCE TRUST FUND 29 Sec. 47. 2022 Iowa Acts, chapter 1131, section 36, 30 unnumbered paragraph 2, is amended to read as follows: 31 To supplement the appropriation made in this Act from the 32 general fund of the state to the department of health and human 33 services for medical assistance for the same fiscal year: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 56,305,139 35 -68- SF 561 (3) 90 pf/rn/mb 68/ 77
S.F. 561 66,282,906 1 Sec. 48. EFFECTIVE DATE. This division of this Act, being 2 deemed of immediate importance, takes effect upon enactment. 3 DIVISION X 4 HEALTH AND HUMAN SERVICES REPORT ON NONREVERSION OF FUNDS 5 Sec. 49. REPORT ON NONREVERSION OF FUNDS. The department 6 of health and human services shall report the expenditure of 7 any moneys for which nonreversion authorization was provided 8 for the fiscal year beginning July 1, 2022, and ending June 30, 9 2023, to the general assembly on a quarterly basis beginning 10 October 1, 2023. 11 DIVISION XI 12 ELIMINATION OF REPEAL OF HOSPITAL HEALTH CARE ACCESS ASSESSMENT 13 PROGRAM 14 Sec. 50. REPEAL. Section 249M.5, Code 2023, is repealed. 15 Sec. 51. EFFECTIVE DATE. This division of this Act, being 16 deemed of immediate importance, takes effect upon enactment. 17 DIVISION XII 18 HEALTH AND HUMAN SERVICES REALIGNMENT PROVISIONS 19 DIRECTOR OF HEALTH AND HUMAN SERVICES INSTITUTIONS BUYING 20 AND SELLING OF REAL ESTATE FUND 21 Sec. 52. Section 218.94, as amended by 2023 Iowa Acts, 22 Senate File 514, section 411, as enacted is amended to read as 23 follows: 24 218.94 Director may buy and sell real estate options 25 fund . 26 1. a. The director may secure options to purchase real 27 estate, to acquire and sell real estate, and to grant utility 28 easements, for the proper uses of the institutions. Real 29 estate shall be acquired and sold and utility easements 30 granted, upon such terms and conditions as the director may 31 determine. Upon sale of the real estate, the proceeds shall 32 be deposited with the treasurer of state and credited to the 33 general fund of the state in a health and human services 34 capital reinvestment fund created in the state treasury under 35 -69- SF 561 (3) 90 pf/rn/mb 69/ 77
S.F. 561 the control of the department . There is appropriated from the 1 general such capital reinvestment fund of the state a sum equal 2 to the proceeds deposited and credited to the general capital 3 reinvestment fund of the state to the department, which may be 4 used to purchase other real estate , or for capital improvements 5 upon property under the directors control , or for improvements 6 to property which is owned by the state and utilized by the 7 department . 8 b. Notwithstanding section 8.33, moneys in the capital 9 reinvestment fund shall not revert at the close of a fiscal 10 year, and shall not be transferred, used, obligated, 11 appropriated, or otherwise encumbered, except as provided in 12 this section. Notwithstanding section 12C.7, subsection 2, 13 interest or earnings on moneys deposited in the fund shall be 14 credited to the fund. 15 c. Any proceeds from the sale of real estate that were 16 credited to the general fund of the state pursuant to section 17 218.94, Code 2022, and that remain available on June 30, 2023, 18 are transferred to the capital reinvestment fund to be used for 19 the purposes of the fund. 20 2. The costs incident to securing of options, acquisition 21 and sale of real estate and granting of utility easements, 22 including but not limited to appraisals, invitations for 23 offers, abstracts, and other necessary costs, may be paid 24 from moneys appropriated for support and maintenance to the 25 institution at which the real estate is located . Such costs 26 shall be and the source from which the moneys were appropriated 27 shall be reimbursed from the proceeds of the sale. 28 SCHOOL READY CHILDREN GRANTS ACCOUNT 29 Sec. 53. Section 256I.11, subsection 2, unnumbered 30 paragraph 1, as amended by 2023 Iowa Acts, Senate File 514, 31 section 1005, is amended to read as follows: 32 A school ready children grants account is created in the 33 fund under the authority of the director of the department of 34 education . Moneys credited to the account are appropriated 35 -70- SF 561 (3) 90 pf/rn/mb 70/ 77
S.F. 561 to and shall be distributed by the department of education in 1 the form of grants to early childhood Iowa areas pursuant to 2 criteria established by the state board in accordance with law. 3 DIVISION XIII 4 HEALTH POLICY OVERSIGHT COMMITTEE MEDICAID PROGRAM 5 Sec. 54. Section 2.45, subsection 5, Code 2023, is amended 6 to read as follows: 7 5. The legislative health policy oversight committee, 8 which shall be composed of ten members of the general 9 assembly, consisting of five members from each house, to 10 be appointed by the legislative council. The legislative 11 health policy oversight committee shall may meet at least two 12 times, annually , during the legislative interim to provide 13 continuing oversight for Medicaid managed care, and to ensure 14 effective and efficient administration of the program, address 15 stakeholder concerns, monitor program costs and expenditures, 16 and make recommendations. 17 DIVISION XIV 18 PUBLIC ASSISTANCE PROGRAM PROVISIONS 19 Sec. 55. Section 234.1, subsection 6, as enacted by 2023 20 Iowa Acts, Senate File 514, section 669, is amended to read as 21 follows: 22 6. Supplemental nutrition assistance program or SNAP 23 means benefits provided by the federal program administered 24 through 7 C.F.R. pts. 270 280 283 , as amended. 25 Sec. 56. Section 239.1, subsections 2 and 3, if enacted by 26 2023 Iowa Acts, Senate File 494, are amended by striking the 27 subsections and inserting in lieu thereof the following: 28 2. Asset for the purposes of the asset test for the 29 supplemental nutrition assistance program under section 239.4 30 means all of the following resources countable toward the 31 maximum allowed household asset limit of fifteen thousand 32 dollars: 33 a. All liquid resources. 34 b. All other personal property excluding one vehicle and 35 -71- SF 561 (3) 90 pf/rn/mb 71/ 77
S.F. 561 the fair market value in excess of ten thousand dollars of an 1 additional vehicle. 2 3. Asset test for the purposes of the asset test for 3 the supplemental nutrition assistance program under section 4 239.4 means the comparison of the collective value of all 5 countable assets of the members of the applicants household to 6 the maximum allowed household asset limit of fifteen thousand 7 dollars. 8 Sec. 57. Section 239.4, subsection 1, if enacted by 2023 9 Iowa Acts, Senate File 494, is amended to read as follows: 10 1. For the purposes of determining eligibility for receipt 11 of SNAP benefits, the department shall conduct an asset test 12 on all members of the applicants household. The allowable 13 financial resources to be included in or excluded from a 14 determination of eligibility for SNAP shall be those specified 15 in 7 U.S.C. 2014(g)(1) 7 U.S.C. 2014(g) , to the extent 16 consistent with the term asset as defined in this chapter. 17 Sec. 58. Section 239.9, subsection 1, if enacted by 2023 18 Iowa Acts, Senate File 494, is amended to read as follows: 19 1. Following a review of an applicants or recipients 20 eligibility under this chapter, the department may refer cases 21 of suspected fraud along with any supportive information to 22 the department of inspections , and appeals , and licensing for 23 review. 24 Sec. 59. Section 239.10, subsection 1, if enacted by 2023 25 Iowa Acts, Senate File 494, is amended to read as follows: 26 1. The department of health and human services shall adopt 27 rules pursuant to chapter 17A to administer this chapter. 28 Sec. 60. 2023 Iowa Acts, Senate File 494, if enacted, is 29 amended by adding the following new section: 30 NEW SECTION . SEC. 10A. NEW SECTION . 239.11 Public 31 assistance modernization fund. 32 1. A public assistance modernization fund is created in 33 the state treasury under the control of the department. The 34 fund shall consist of moneys appropriated or transferred to, or 35 -72- SF 561 (3) 90 pf/rn/mb 72/ 77
S.F. 561 deposited in, the fund as provided by law. 1 2. The moneys in the fund shall be used and shall be 2 appropriated only for the purposes of modernizing information 3 technology systems and for other modernization initiatives 4 related to delivery of public assistance programs. 5 3. The moneys deposited in the fund are not subject to 6 section 8.33 and shall not be transferred, used, obligated, 7 appropriated, or otherwise encumbered except as provided in 8 this section. Notwithstanding section 12C.7, subsection 2, 9 interest or earnings on moneys deposited in the state capitol 10 maintenance fund shall be credited to the fund. 11 4. This section is repealed July 1, 2028. 12 Sec. 61. 2023 Iowa Acts, Senate File 494, section 12, 13 subsection 6, if enacted, is amended to read as follows: 14 6. The department of health and human services may contract 15 with multiple third-party vendors to administer this Act. 16 Sec. 62. ONE-TIME SETTLEMENT FUNDS DEPOSIT IN PUBLIC 17 ASSISTANCE MODERNIZATION FUND. For the fiscal year beginning 18 July 1, 2023, and ending June 30, 2024, the department of 19 health and human services shall deposit up to $8,000,000 20 received from one-time medical assistance settlement funds in 21 the public assistance modernization fund, if enacted in this 22 division of this Act. 23 DIVISION XV 24 HOME AND COMMUNITY-BASED SERVICES WAIVER RECIPIENT RESIDENCES 25 SPRINKLER SYSTEMS 26 Sec. 63. Section 335.34, Code 2023, is amended to read as 27 follows: 28 335.34 Home and community-based services waiver recipient 29 residence. 30 1. A county, county board of supervisors, or county zoning 31 commission shall consider the residence of the recipient of 32 services under a home and community-based services waiver as 33 a residential use of property for the purposes of zoning and 34 shall treat the use of the residence as a permitted use in all 35 -73- SF 561 (3) 90 pf/rn/mb 73/ 77
S.F. 561 residential zones or districts, including all single-family 1 residential zones or districts, of the county. 2 2. A county, county board of supervisors, or a county zoning 3 commission shall not require that the recipient, or the owner 4 of such a residence if other than the recipient, obtain a 5 conditional use permit, special use permit, special exception, 6 or variance. A county, county board of supervisors, or county 7 zoning commission shall not establish limitations regarding the 8 proximity of one such residence to another. 9 3. A county, county board of supervisors, or a county 10 zoning commission shall not classify such a residence as a 11 residential group R-3 occupancy or as a care facility within 12 a dwelling for the purposes of enforcement of compliance 13 with the sprinkler systems provisions specified in section 14 903.3.1.3 of the international building code or section P2904 15 of the international residential code, if adopted, or if such 16 residence is inspected by the county. 17 3. 4. This section applies to the residence of a recipient 18 of services under a home and community-based services waiver if 19 the residence meets any of the following conditions: 20 a. The residence is a single-family dwelling owned or rented 21 by the recipient. 22 b. The residence is a multifamily dwelling which does not 23 hold itself out to the public as a community-based residential 24 provider otherwise regulated by law, including but not limited 25 to a residential care facility, and which provides dwelling 26 units to no more than four recipients of services under a home 27 and community-based services waiver at any one time. 28 4. 5. For the purposes of this section , home and 29 community-based services waiver means waiver as defined in 30 section 249A.29 . 31 Sec. 64. Section 414.32, Code 2023, is amended to read as 32 follows: 33 414.32 Home and community-based services waiver recipient 34 residence. 35 -74- SF 561 (3) 90 pf/rn/mb 74/ 77
S.F. 561 1. A city, city council, or city zoning commission shall 1 consider the residence of the recipient of services under a 2 home and community-based services waiver as a residential use 3 of property for the purposes of zoning and shall treat the use 4 of the residence as a permitted use in all residential zones 5 or districts, including all single-family residential zones or 6 districts, of the city. 7 2. A city, city council, or city zoning commission shall 8 not require that the recipient, or owner of such residence if 9 other than the recipient, obtain a conditional use permit, 10 special use permit, special exception, or variance. A city, 11 city council, or city zoning commission shall not establish 12 limitations regarding the proximity of one such residence to 13 another. 14 3. A city, city council, or city zoning commission shall not 15 classify such a residence as a residential group R-3 occupancy 16 or as a care facility within a dwelling for the purposes of 17 enforcement of compliance with the sprinkler systems provisions 18 specified in section 903.3.1.3 of the international building 19 code or section P2904 of the international residential code, if 20 adopted, or if such residence is inspected by the city. 21 3. 4. This section applies to the residence of a recipient 22 of services under a home and community-based services waiver if 23 the residence meets any of the following conditions: 24 a. The residence is a single-family dwelling owned or rented 25 by the recipient. 26 b. The residence is a multifamily dwelling which does not 27 hold itself out to the public as a community-based residential 28 provider otherwise regulated by law, including but not limited 29 to a residential care facility, and which provides dwelling 30 units to no more than four recipients of services under a home 31 and community-based services waiver at any one time. 32 4. 5. For the purposes of this section , home and 33 community-based services waiver means waiver as defined in 34 section 249A.29 . 35 -75- SF 561 (3) 90 pf/rn/mb 75/ 77
S.F. 561 Sec. 65. EFFECTIVE DATE. This division of this Act, being 1 deemed of immediate importance, takes effect upon enactment. 2 DIVISION XVI 3 STATE-FUNDED FAMILY MEDICINE OBSTETRICS FELLOWSHIP PROGRAM 4 Sec. 66. NEW SECTION . 135.182 State-funded family medicine 5 obstetrics fellowship program fund. 6 1. The department shall establish a state-funded family 7 medicine obstetrics fellowship program to increase access 8 to family medicine obstetrics practitioners in rural and 9 underserved areas of the state. A person who has completed an 10 accreditation council for graduate medical education residency 11 program in family medicine is eligible for participation 12 in the fellowship program. Participating fellows shall 13 enter into a program agreement with a participating teaching 14 hospital which, at a minimum, requires the fellow to complete a 15 one-year fellowship and to engage in full-time family medicine 16 obstetrics practice in a rural or underserved area of the 17 state for a period of at least five years within nine months 18 following completion of the fellowship and receipt of a license 19 to practice medicine in the state. 20 2. Each fellow participating in the program shall be 21 eligible for a salary and benefits including a stipend as 22 determined by the participating teaching hospital which shall 23 be funded through the family medicine obstetrics fellowship 24 program fund. 25 3. The department shall adopt rules pursuant to chapter 26 17A to administer the program, including defining rural and 27 underserved areas for the purpose of the required full-time 28 practice of a person following completion of the fellowship. 29 4. a. A family medicine obstetrics fellowship program 30 fund is created in the state treasury consisting of the moneys 31 appropriated or credited to the fund by law. Notwithstanding 32 section 8.33, moneys in the fund at the end of each fiscal year 33 shall not revert to any other fund but shall remain in the fund 34 for use in subsequent fiscal years. Moneys in the fund are 35 -76- SF 561 (3) 90 pf/rn/mb 76/ 77
S.F. 561 appropriated to the department to be used to fund fellowship 1 positions as provided in this section. 2 b. For the fiscal year beginning July 1, 2023, and each 3 fiscal year beginning July 1 thereafter, there is appropriated 4 from the general fund of the state for deposit in the family 5 medicine obstetrics fellowship program fund an amount 6 sufficient to support the creation of four fellowship positions 7 as provided in this section. 8 5. The department and the participating teaching hospitals 9 shall regularly evaluate and document their experiences 10 including identifying ways the program may be modified or 11 expanded to facilitate increased access to family medicine 12 obstetrics practitioners in rural and underserved areas of the 13 state. The department shall submit an annual report to the 14 general assembly by January 1. The report shall include the 15 number of fellowships funded to date and any other information 16 identified by the department and the participating teaching 17 hospitals as indicators of outcomes and the effectiveness of 18 the program. 19 6. For the purposes of this section, teaching hospital 20 means a hospital or medical center that provides medical 21 education to prospective and current health professionals. 22 DIVISION XVII 23 ADOPTION SUBSIDY PROGRAM NONRECURRING ADOPTION EXPENSES 24 Sec. 67. NEW SECTION . 234.48 Adoption subsidy 25 nonrecurring adoption expenses. 26 Notwithstanding any provision to the contrary, the maximum 27 reimbursement provided to an adoptive parent under the 28 adoption subsidy program for nonrecurring adoption expenses 29 is one thousand dollars. For the purposes of this section, 30 nonrecurring adoption expenses means the same as defined in 45 31 C.F.R. 1356.41. The department shall adopt rules pursuant to 32 chapter 17A to administer this section. 33 Sec. 68. REPEAL. 2010 Iowa Acts, chapter 1031, section 408, 34 is repealed. 35 -77- SF 561 (3) 90 pf/rn/mb 77/ 77