Senate Study Bill 1213 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON APPROPRIATIONS BILL BY CHAIRPERSON KRAAYENBRINK) A BILL FOR An Act relating to appropriations for veterans and health 1 and human services and including other related provisions 2 and appropriations, providing penalties, and including 3 effective date and retroactive and other applicability date 4 provisions. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 1004XC (2) 90 pf/rn
S.F. _____ 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 14 2. IOWA VETERANS HOME 15 For salaries, support, maintenance, and miscellaneous 16 purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 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- LSB 1004XC (2) 90 pf/rn 1/ 70
S.F. _____ the United States, pursuant to section 16.54 : 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 12 DIVISION II 13 DEPARTMENT OF HEALTH AND HUMAN SERVICES AGING 14 FY 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 34 1. Funds appropriated in this section may be used to 35 -2- LSB 1004XC (2) 90 pf/rn 2/ 70
S.F. _____ 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, $______ shall 9 be used by the Iowa commission on volunteer services for the 10 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- LSB 1004XC (2) 90 pf/rn 3/ 70
S.F. _____ 4. Of the funds appropriated in this section, $_____ shall 1 be used for the purposes of chapter 231E and to administer 2 the prevention of elder abuse, neglect, and exploitation 3 program pursuant to section 231.56A , in accordance with the 4 requirements of the federal Older Americans Act of 1965, 42 5 U.S.C. 3001 et seq., as amended. 6 5. Of the funds appropriated in this section, $______ 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, $_____ shall 12 be used by the department of health and human services, in 13 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- LSB 1004XC (2) 90 pf/rn 4/ 70
S.F. _____ full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 3 DIVISION IV 4 DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH 5 FY 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 19 a. (1) Of the funds appropriated in this subsection, 20 $______ 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- LSB 1004XC (2) 90 pf/rn 5/ 70
S.F. _____ 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 alcoholic beverages division of the department of commerce 8 for enforcement of tobacco laws, regulations, and ordinances 9 and to engage in tobacco control activities approved by the 10 division and the department as specified in the memorandum 11 of understanding entered into between the division and the 12 department. 13 (b) For the fiscal year beginning July 1, 2023, and ending 14 June 30, 2024, the terms of the memorandum of understanding, 15 entered into between the alcoholic beverages division of the 16 department of commerce and the department, governing compliance 17 checks conducted to ensure licensed retail tobacco outlet 18 conformity with tobacco laws, regulations, and ordinances 19 relating to persons under 21 years of age, shall continue to 20 restrict the number of such checks to one check per retail 21 outlet, and one additional check for any retail outlet found to 22 be in violation during the first check. 23 b. (1) Of the funds appropriated in this subsection, 24 $______ shall be used for problem gambling and substance 25 use disorder prevention, treatment, and recovery services, 26 including a 24-hour helpline, public information resources, 27 professional training, youth prevention, and program 28 evaluation. 29 (2) Of the amount allocated under this paragraph, 30 $______ shall be utilized by the department to maintain 31 a single statewide 24-hour crisis hotline for the Iowa 32 childrens behavioral health system that incorporates warmline 33 services which may be provided through expansion of existing 34 capabilities as required pursuant to 2018 Iowa Acts, chapter 35 -6- LSB 1004XC (2) 90 pf/rn 6/ 70
S.F. _____ 1056, section 16 . 1 c. The requirement of section 123.17, subsection 5 , is met 2 by the appropriations and allocations made in this division of 3 this Act for purposes of substance use disorder treatment and 4 addictive disorders for the fiscal year beginning July 1, 2023. 5 2. HEALTHY CHILDREN AND FAMILIES 6 For promoting the optimum health status for children and 7 adolescents from birth through 21 years of age, and families, 8 and for not more than the following full-time equivalent 9 positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 12 a. Of the funds appropriated in this subsection, not more 13 than $_____ shall be used for the healthy opportunities for 14 parents to experience success (HOPES)-healthy families Iowa 15 (HFI) program established pursuant to section 135.106 . 16 b. In order to implement the legislative intent stated 17 in sections 135.106 and 256I.9 , priority for home visitation 18 program funding shall be given to programs using evidence-based 19 or promising models for home visitation. 20 c. Of the funds appropriated in this subsection, $______ 21 shall be used for continuation of the departments initiative 22 to provide for adequate developmental surveillance and 23 screening during a childs first five years. The funds shall 24 be used first to fully fund the current sites to ensure that 25 the sites are fully operational, with the remaining funds 26 to be used for expansion to additional sites. The full 27 implementation and expansion shall include enhancing the scope 28 of the initiative through collaboration with the child health 29 specialty clinics to promote healthy child development through 30 early identification and response to both biomedical and social 31 determinants of healthy development; by monitoring child 32 health metrics to inform practice, document long-term health 33 impacts and savings, and provide for continuous improvement 34 through training, education, and evaluation; and by providing 35 -7- LSB 1004XC (2) 90 pf/rn 7/ 70
S.F. _____ for practitioner consultation particularly for children with 1 behavioral conditions and needs. The department shall also 2 collaborate with the Medicaid program and the child health 3 specialty clinics to integrate the activities of the first five 4 initiative into the establishment of patient-centered medical 5 homes, community utilities, accountable care organizations, 6 and other integrated care models developed to improve health 7 quality and population health while reducing health care costs. 8 To the maximum extent possible, funding allocated in this 9 paragraph shall be utilized as matching funds for Medicaid 10 program reimbursement. 11 d. Of the funds appropriated in this subsection, $_____ 12 shall be distributed to a statewide dental carrier to provide 13 funds to continue the donated dental services program patterned 14 after the projects developed by the dental lifeline network to 15 provide dental services to indigent individuals who are elderly 16 or with disabilities. 17 e. Of the funds appropriated in this subsection, $______ 18 shall be used to provide audiological services and hearing aids 19 for children. 20 f. Of the funds appropriated in this subsection, $_____ is 21 transferred to the university of Iowa college of dentistry for 22 provision of primary dental services to children. State funds 23 shall be matched on a dollar-for-dollar basis. The university 24 of Iowa college of dentistry shall coordinate efforts with the 25 department to provide dental care to underserved populations 26 throughout the state. 27 g. Of the funds appropriated in this subsection, $_____ 28 shall be used to address youth suicide prevention. 29 h. Of the funds appropriated in this subsection, $_____ 30 shall be used to support the Iowa effort to address the survey 31 of children who experience adverse childhood experiences known 32 as ACEs. 33 i. Of the funds appropriated in this subsection, up to 34 $_____ shall be used for childhood obesity prevention. 35 -8- LSB 1004XC (2) 90 pf/rn 8/ 70
S.F. _____ 3. CHRONIC CONDITIONS 1 For serving individuals identified as having chronic 2 conditions or special health care needs, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 6 a. Of the funds appropriated in this subsection, $_____ 7 shall be used for grants to individual patients who have an 8 inherited metabolic disorder to assist with the costs of 9 medically necessary foods and formula. 10 b. Of the funds appropriated in this subsection, $______ 11 shall be used for the brain injury services program pursuant 12 to section 135.22B , including $_____ for contracting with an 13 existing nationally affiliated and statewide organization whose 14 purpose is to educate, serve, and support Iowans with brain 15 injury and their families, for resource facilitator services 16 in accordance with section 135.22B, subsection 9 , and for 17 contracting to enhance brain injury training and recruitment 18 of service providers on a statewide basis. Of the amount 19 allocated in this paragraph, $_____ shall be used to fund _____ 20 full-time equivalent position to serve as the state brain 21 injury services program manager. 22 c. Of the funds appropriated in this subsection, $_____ 23 shall be used for the public purpose of continuing to contract 24 with an existing nationally affiliated organization to provide 25 education, client-centered programs, and client and family 26 support for people living with epilepsy and their families. 27 The amount allocated in this paragraph in excess of $_____ 28 shall be matched dollar-for-dollar by the organization 29 specified. Funds allocated under this paragraph shall be 30 distributed in their entirety for the purpose specified on July 31 1, 2023. 32 d. Of the funds appropriated in this subsection, $_____ 33 shall be used for child health specialty clinics. 34 e. Of the funds appropriated in this subsection, $_____ 35 -9- LSB 1004XC (2) 90 pf/rn 9/ 70
S.F. _____ shall be used by the regional autism assistance program 1 established pursuant to section 256.35 , and administered by 2 the child health specialty clinic located at the university of 3 Iowa hospitals and clinics. The funds shall be used to enhance 4 interagency collaboration and coordination of educational, 5 medical, and other health and human services for persons with 6 autism, their families, and providers of services, including 7 delivering regionalized services of care coordination, 8 family navigation, and integration of services through the 9 statewide system of regional child health specialty clinics and 10 fulfilling other requirements as specified in chapter 225D . 11 The university of Iowa shall not receive funds allocated under 12 this paragraph for indirect costs associated with the regional 13 autism assistance program. 14 f. Of the funds appropriated in this subsection, $_____ 15 shall be used for the comprehensive cancer control program to 16 reduce the burden of cancer in Iowa through prevention, early 17 detection, effective treatment, and ensuring quality of life. 18 Of the funds allocated in this paragraph f, $_____ shall 19 be used to support a melanoma research symposium, a melanoma 20 biorepository and registry, basic and translational melanoma 21 research, and clinical trials. 22 g. Of the funds appropriated in this subsection, $_____ 23 shall be used for cervical and colon cancer screening, and 24 $_____ shall be used to enhance the capacity of the cervical 25 cancer screening program to include provision of recommended 26 prevention and early detection measures to a broader range of 27 low-income women. 28 h. Of the funds appropriated in this subsection, $_____ 29 shall be used for the center for congenital and inherited 30 disorders. 31 4. COMMUNITY CAPACITY 32 For strengthening the health care delivery system at the 33 local level, and for not more than the following full-time 34 equivalent positions: 35 -10- LSB 1004XC (2) 90 pf/rn 10/ 70
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 2 a. Of the funds appropriated in this subsection, $_____ 3 is allocated for continuation of the child vision screening 4 program implemented through the university of Iowa hospitals 5 and clinics in collaboration with early childhood Iowa areas. 6 The program shall submit a report to the department regarding 7 the use of funds allocated under this paragraph a. The 8 report shall include the objectives and results for the 9 program year including the target population and how the funds 10 allocated assisted the program in meeting the objectives; the 11 number, age, and location within the state of individuals 12 served; the type of services provided to the individuals 13 served; the distribution of funds based on the services 14 provided; and the continuing needs of the program. 15 b. Of the funds appropriated in this subsection, 16 $_____ shall be used for a grant to a statewide association 17 of psychologists, that is affiliated with the American 18 psychological association, to be used for continuation of a 19 program to rotate intern psychologists in placements that 20 serve urban and rural mental health professional shortage 21 areas. Once an intern psychologist begins service, the intern 22 psychologist may continue serving in the location of the intern 23 psychologists placement, notwithstanding any change in the 24 mental health professional shortage area designation of such 25 location. The intern psychologist may also provide services 26 via telehealth, to underserved populations, and to Medicaid 27 members. For the purposes of this paragraph b, mental 28 health professional shortage area means a geographic area 29 in this state that has been designated by the United States 30 department of health and human services, health resources and 31 services administration, bureau of health professionals, as 32 having a shortage of mental health professionals. 33 c. Of the funds appropriated in this subsection, the 34 following amounts are allocated to be used as follows 35 -11- LSB 1004XC (2) 90 pf/rn 11/ 70
S.F. _____ to support the goals of increased access, health system 1 integration, and engagement: 2 (1) Not less than $_____ is allocated to the Iowa 3 prescription drug corporation for continuation of the 4 pharmaceutical infrastructure for safety net providers as 5 described in 2007 Iowa Acts, chapter 218, section 108 , and for 6 the prescription drug donation repository program created in 7 chapter 135M . Funds allocated under this subparagraph shall 8 be distributed in their entirety for the purpose specified on 9 July 1, 2023. 10 (2) Not less than $_____ is allocated to free clinics and 11 free clinics of Iowa for necessary infrastructure, statewide 12 coordination, provider recruitment, service delivery, and 13 provision of assistance to patients in securing a medical home 14 inclusive of oral health care. Funds allocated under this 15 subparagraph shall be distributed in their entirety for the 16 purpose specified on July 1, 2023. 17 (3) Not less than $_____ is allocated to the Iowa 18 association of rural health clinics for necessary 19 infrastructure and service delivery transformation. Funds 20 allocated under this subparagraph shall be distributed in their 21 entirety for the purpose specified on July 1, 2023. 22 (4) Not less than $_____ is allocated to the Polk county 23 medical society for continuation of the safety net provider 24 patient access to specialty health care initiative as described 25 in 2007 Iowa Acts, chapter 218, section 109 . Funds allocated 26 under this subparagraph shall be distributed in their entirety 27 for the purpose specified on July 1, 2023. 28 d. Of the funds appropriated in this subsection, $_____ is 29 allocated for the purposes of health care and public health 30 workforce initiatives. 31 e. Of the funds appropriated in this subsection, $_____ 32 shall be used for a matching dental education loan repayment 33 program to be allocated to a dental nonprofit health service 34 corporation to continue to develop the criteria and implement 35 -12- LSB 1004XC (2) 90 pf/rn 12/ 70
S.F. _____ the loan repayment program. 1 f. Of the funds appropriated in this subsection, $_____ 2 shall be used for the purposes of the Iowa donor registry as 3 specified in section 142C.18 . 4 g. Of the funds appropriated in this subsection, $_____ 5 shall be used for continuation of a grant to a nationally 6 affiliated volunteer eye organization that has an established 7 program for children and adults and that is solely dedicated to 8 preserving sight and preventing blindness through education, 9 nationally certified vision screening and training, and 10 community and patient service programs. The contractor shall 11 submit a report to the general assembly regarding the use 12 of funds allocated under this paragraph g. The report 13 shall include the objectives and results for the program year 14 including the target population and how the funds allocated 15 assisted the program in meeting the objectives; the number, 16 age, grade level if appropriate, and location within the state 17 of individuals served; the type of services provided to the 18 individuals served; the distribution of funds based on the 19 services provided; and the continuing needs of the program. 20 h. Of the funds appropriated in this subsection, $______ 21 shall be deposited in the medical residency training account 22 created in section 135.175, subsection 5 , paragraph a, and is 23 appropriated from the account to the department to be used for 24 the purposes of the medical residency training state matching 25 grants program as specified in section 135.176 . 26 i. Of the funds appropriated in this subsection, $_____ 27 shall be used for the public purpose of providing funding to 28 Des Moines university to continue a provider education project 29 to provide primary care physicians with the training and skills 30 necessary to recognize the signs of mental illness in patients. 31 j. Of the funds appropriated in this subsection, $_____ 32 shall be used for rural psychiatric residencies to support the 33 annual creation and training of six psychiatric residents who 34 will provide mental health services in underserved areas of 35 -13- LSB 1004XC (2) 90 pf/rn 13/ 70
S.F. _____ the state. Notwithstanding section 8.33, moneys that remain 1 unencumbered or unobligated at the close of the fiscal year 2 shall not revert but shall remain available for expenditure for 3 the purposes designated for subsequent fiscal years. 4 k. Of the funds appropriated in this subsection, $_____ 5 shall be used for psychiatric training to increase access to 6 mental health care services by expanding the mental health 7 workforce via training of additional physician assistants and 8 nurse practitioners. 9 1. Of the funds appropriated in this subsection, $_____ 10 shall be used for the creation or continuation of a center of 11 excellence program to encourage innovation and collaboration 12 among regional health care providers in a rural area based 13 upon the results of a regional community needs assessment to 14 transform health care delivery in order to provide quality, 15 sustainable care that meets the needs of the local communities. 16 An applicant for the funds shall specify how the funds will 17 be expended to accomplish the goals of the program and shall 18 provide a detailed five-year sustainability plan prior to 19 being awarded any funding. Following the receipt of funding, 20 a recipient shall submit periodic reports as specified by the 21 department to the governor and the general assembly regarding 22 the recipients expenditure of the funds and progress in 23 accomplishing the program goals. 24 5. ESSENTIAL PUBLIC HEALTH SERVICES 25 To provide public health services that reduce risks and 26 invest in promoting and protecting good health over the 27 course of a lifetime with a priority given to older Iowans and 28 vulnerable populations: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 30 6. INFECTIOUS DISEASES 31 For reducing the incidence and prevalence of communicable 32 diseases, and for not more than the following full-time 33 equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 35 -14- LSB 1004XC (2) 90 pf/rn 14/ 70
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 1 7. PUBLIC PROTECTION 2 For protecting the health and safety of the public through 3 establishing standards and enforcing regulations, and for not 4 more than the following full-time equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 7 a. Of the funds appropriated in this subsection, not more 8 than $_____ shall be credited to the emergency medical services 9 fund created in section 135.25 . Moneys in the emergency 10 medical services fund are appropriated to the department to be 11 used for the purposes of the fund. 12 b. Of the funds appropriated in this subsection, up to 13 $_____ shall be used for sexual violence prevention programming 14 through a statewide organization representing programs serving 15 victims of sexual violence through the departments sexual 16 violence prevention program, and for continuation of a training 17 program for sexual assault response team (SART) members, 18 including representatives of law enforcement, victim advocates, 19 prosecutors, and certified medical personnel. The amount 20 allocated in this paragraph b shall not be used to supplant 21 funding administered for other sexual violence prevention or 22 victims assistance programs. 23 c. Of the funds appropriated in this subsection, up to 24 $_____ shall be used for the state poison control center. 25 Pursuant to the directive under 2014 Iowa Acts, chapter 1140, 26 section 102 , the federal matching funds available to the 27 state poison control center from the department under the 28 federal Childrens Health Insurance Program Reauthorization Act 29 allotment shall be subject to the federal administrative cap 30 rule of 10 percent applicable to funding provided under Tit. 31 XXI of the federal Social Security Act and included within the 32 departments calculations of the cap. 33 d. Of the funds appropriated in this subsection, up to 34 $_____ shall be used for childhood lead poisoning provisions. 35 -15- LSB 1004XC (2) 90 pf/rn 15/ 70
S.F. _____ 8. RESOURCE MANAGEMENT 1 For establishing and sustaining the overall ability of the 2 department to deliver services to the public, and for not more 3 than the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 6 9. MISCELLANEOUS PROVISIONS 7 The university of Iowa hospitals and clinics under the 8 control of the state board of regents shall not receive 9 indirect costs from the funds appropriated in this section. 10 The university of Iowa hospitals and clinics billings to the 11 department shall be on at least a quarterly basis. 12 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES SPORTS 13 WAGERING RECEIPTS FUND. There is appropriated from the sports 14 wagering receipts fund created in section 8.57, subsection 6, 15 to the department of health and human services for the fiscal 16 year beginning July 1, 2023, and ending June 30, 2024, the 17 following amount, or so much thereof as is necessary, to be 18 used for the purposes designated: 19 For problem gambling and substance use disorder prevention, 20 treatment, and recovery services, including a 24-hour helpline, 21 public information resources, professional training, youth 22 prevention, and program evaluation: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 24 DIVISION V 25 DEPARTMENT OF HEALTH AND HUMAN SERVICES HUMAN RIGHTS 26 Sec. 7. HUMAN RIGHTS. There is appropriated from the 27 general fund of the state to the department of health and human 28 services for the fiscal year beginning July 1, 2023, and ending 29 June 30, 2024, the following amounts, or so much thereof as is 30 necessary, to be used for the purposes designated: 31 1. HUMAN RIGHTS CENTRAL ADMINISTRATION 32 For salaries, support, maintenance, and miscellaneous 33 purposes, and for not more than the following full-time 34 equivalent positions: 35 -16- LSB 1004XC (2) 90 pf/rn 16/ 70
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 2 2. COMMUNITY ADVOCACY AND SERVICES 3 For salaries, support, maintenance, and miscellaneous 4 purposes, and for not more than the following full-time 5 equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 8 3. CRIMINAL AND JUVENILE JUSTICE PLANNING. 9 a. For salaries, support, maintenance, and miscellaneous 10 purposes, and for not more than the following full-time 11 equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 14 b. (1) For a single grant to a program located in a city 15 with a higher than average juvenile crime rate as determined by 16 the department of health and human services and a population 17 greater than 80,000 as determined by the 2020 federal decennial 18 census, which may be used for studying, planning, programming, 19 and capital, that is committed to deterring juvenile 20 delinquency through early intervention in the criminal justice 21 system by providing a comprehensive, multifaceted delivery of 22 social services and which shall meet the guiding principles 23 and standards for assessment centers set forth by the national 24 assessment center association: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 26 (2) The program shall use no more than 5 percent of the 27 grant for administrative costs. 28 (3) A city shall not receive a grant under this paragraph, 29 or a similar grant from the state, for more than two 30 consecutive fiscal years unless no other city meets the 31 requirements specified in subparagraph (1). 32 c. The justice advisory board and the juvenile justice 33 advisory council shall coordinate their efforts in carrying out 34 their respective duties relative to juvenile justice. 35 -17- LSB 1004XC (2) 90 pf/rn 17/ 70
S.F. _____ DIVISION VI 1 DEPARTMENT OF HEALTH AND HUMAN SERVICES HUMAN SERVICES 2 FY 2023-2024 3 Sec. 8. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 4 GRANT. There is appropriated from the fund created in section 5 8.41 to the department of health and human services for the 6 fiscal year beginning July 1, 2023, and ending June 30, 2024, 7 from moneys received under the federal temporary assistance 8 for needy families (TANF) block grant pursuant to the federal 9 Personal Responsibility and Work Opportunity Reconciliation Act 10 of 1996, Pub. L. No. 104-193, and successor legislation, the 11 following amounts, or so much thereof as is necessary, to be 12 used for the purposes designated: 13 1. To be credited to the family investment program account 14 and used for assistance under the family investment program 15 under chapter 239B : 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 17 2. To be credited to the family investment program account 18 and used for the job opportunities and basic skills (JOBS) 19 program and implementing family investment agreements in 20 accordance with chapter 239B : 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 22 3. To be used for the family development and 23 self-sufficiency grant program in accordance with section 24 216A.107 : 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 26 Notwithstanding section 8.33 , moneys appropriated in this 27 subsection that remain unencumbered or unobligated at the close 28 of the fiscal year shall not revert but shall remain available 29 for expenditure for the purposes designated until the close of 30 the succeeding fiscal year. However, unless such moneys are 31 encumbered or obligated on or before September 30, 2024, the 32 moneys shall revert. 33 4. For field operations: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 35 -18- LSB 1004XC (2) 90 pf/rn 18/ 70
S.F. _____ 5. For general administration: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 2 6. For state child care assistance: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 4 a. Of the funds appropriated in this subsection, $______ 5 is transferred to the child care and development block grant 6 appropriation made by the Ninetieth General Assembly, 2023 7 session, for the federal fiscal year beginning October 1, 2023, 8 and ending September 30, 2024. Of this amount, $_____ shall be 9 used for provision of educational opportunities to registered 10 child care home providers in order to improve services and 11 programs offered by this category of providers and to increase 12 the number of providers. The department may contract with 13 institutions of higher education or child care resource and 14 referral centers to provide the educational opportunities. 15 Allowable administrative costs under the contracts shall not 16 exceed 5 percent. The application for a grant shall not exceed 17 two pages in length. 18 b. Any funds appropriated in this subsection remaining 19 unallocated shall be used for state child care assistance 20 payments for families who are employed including but not 21 limited to individuals enrolled in the family investment 22 program. 23 7. For child and family services: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 25 8. For child abuse prevention grants: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 27 9. For pregnancy prevention grants on the condition that 28 family planning services are funded: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 30 Pregnancy prevention grants shall be awarded to programs 31 in existence on or before July 1, 2023, if the programs have 32 demonstrated positive outcomes. Grants shall be awarded to 33 pregnancy prevention programs which are developed after July 34 1, 2023, if the programs are based on existing models that 35 -19- LSB 1004XC (2) 90 pf/rn 19/ 70
S.F. _____ have demonstrated positive outcomes. Grants shall comply with 1 the requirements provided in 1997 Iowa Acts, chapter 208, 2 section 14, subsections 1 and 2 , including the requirement that 3 grant programs must emphasize sexual abstinence. Priority in 4 the awarding of grants shall be given to programs that serve 5 areas of the state which demonstrate the highest percentage of 6 unplanned pregnancies of females of childbearing age within the 7 geographic area to be served by the grant. 8 10. For technology needs and other resources necessary to 9 meet federal and state reporting, tracking, and case management 10 requirements and other departmental needs: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 12 11. a. Notwithstanding any provision to the contrary, 13 including but not limited to requirements in section 8.41 or 14 provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the 15 receipt and appropriation of federal block grants, federal 16 funds from the temporary assistance for needy families block 17 grant received by the state and not otherwise appropriated 18 in this section and remaining available for the fiscal year 19 beginning July 1, 2023, are appropriated to the department of 20 health and human services to the extent as may be necessary to 21 be used in the following priority order: the family investment 22 program, for state child care assistance program payments 23 for families who are employed, and for the family investment 24 program share of system costs for eligibility determination 25 and related functions. The federal funds appropriated in this 26 paragraph a shall be expended only after all other funds 27 appropriated in subsection 1 for assistance under the family 28 investment program, in subsection 6 for state child care 29 assistance, or in subsection 10 for technology needs and other 30 resources necessary to meet departmental needs, as applicable, 31 have been expended. For the purposes of this subsection, the 32 funds appropriated in subsection 6, paragraph a, for transfer 33 to the child care and development block grant appropriation 34 are considered fully expended when the full amount has been 35 -20- LSB 1004XC (2) 90 pf/rn 20/ 70
S.F. _____ transferred. 1 b. The department shall, on a quarterly basis, advise the 2 general assembly and department of management of the amount of 3 funds appropriated in this subsection that was expended in the 4 prior quarter. 5 12. Of the amounts appropriated in this section, $_____ for 6 the fiscal year beginning July 1, 2023, is transferred to the 7 appropriation of the federal social services block grant made 8 to the department of health and human services for that fiscal 9 year. 10 13. For continuation of the program providing categorical 11 eligibility for the supplemental nutrition assistance program 12 (SNAP) as specified for the program in the section of this 13 division of this Act relating to the family investment program 14 account: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 16 14. The department may transfer funds allocated in this 17 section to the appropriations made in this division of this Act 18 for the same fiscal year for general administration and field 19 operations for resources necessary to implement and operate the 20 services referred to in this section and those funded in the 21 appropriation made in this division of this Act for the same 22 fiscal year for the family investment program from the general 23 fund of the state. 24 15. With the exception of moneys allocated under this 25 section for the family development and self-sufficiency grant 26 program, to the extent moneys allocated in this section are 27 deemed by the department not to be necessary to support the 28 purposes for which they are allocated, such moneys may be used 29 in the same fiscal year for any other purpose for which funds 30 are allocated in this section or in section 9 of this division 31 of this Act for the family investment program account. If 32 there are conflicting needs, priority shall first be given 33 to the family investment program account as specified under 34 subsection 1 of this section and used for the purposes of 35 -21- LSB 1004XC (2) 90 pf/rn 21/ 70
S.F. _____ assistance under the family investment program in accordance 1 with chapter 239B , followed by state child care assistance 2 program payments for families who are employed, followed by 3 other priorities as specified by the department. 4 Sec. 9. FAMILY INVESTMENT PROGRAM ACCOUNT. 5 1. Moneys credited to the family investment program (FIP) 6 account for the fiscal year beginning July 1, 2023, and 7 ending June 30, 2024, shall be used to provide assistance in 8 accordance with chapter 239B . 9 2. The department may use a portion of the moneys credited 10 to the FIP account under this section as necessary for 11 salaries, support, maintenance, and miscellaneous purposes, 12 including administrative and information technology costs 13 associated with rent reimbursement and other income assistance 14 programs administered by the department. 15 3. The department may transfer funds allocated in 16 subsection 4, excluding the allocation under subsection 4, 17 paragraph b, to the appropriations made in this division of 18 this Act for the same fiscal year for general administration 19 and field operations for resources necessary to implement 20 and operate the services referred to in this section and 21 those funded in the appropriations made in section 8 for the 22 temporary assistance for needy families block grant and in 23 section 10 for the family investment program from the general 24 fund of the state in this division of this Act for the same 25 fiscal year. 26 4. Moneys appropriated in this division of this Act and 27 credited to the FIP account for the fiscal year beginning July 28 1, 2023, and ending June 30, 2024, are allocated as follows: 29 a. To be used by the department of health and human services 30 to more effectively serve participants in FIP and other 31 programs and to meet federal reporting requirements under the 32 federal temporary assistance for needy families block grant: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 34 b. To be used by the department of health and human services 35 -22- LSB 1004XC (2) 90 pf/rn 22/ 70
S.F. _____ for staffing, administration, and implementation of the family 1 development and self-sufficiency grant program in accordance 2 with section 216A.107 : 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 4 (1) Of the funds allocated for the family development 5 and self-sufficiency grant program in this paragraph b, 6 not more than 5 percent of the funds shall be used for the 7 administration of the grant program. 8 (2) The department of health and human services may continue 9 to implement the family development and self-sufficiency grant 10 program statewide during fiscal year 2023-2024. 11 (3) The department of health and human services may engage 12 in activities to strengthen and improve family outcomes 13 measures and data collection systems under the family 14 development and self-sufficiency grant program. 15 c. For the diversion subaccount of the FIP account: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 17 A portion of the moneys allocated for the diversion 18 subaccount may be used for field operations, salaries, data 19 management system development, and implementation costs and 20 support deemed necessary by the director of health and human 21 services in order to administer the FIP diversion program. 22 To the extent moneys allocated in this paragraph c are 23 deemed by the department not to be necessary to support 24 diversion activities, such moneys may be used for other efforts 25 intended to increase engagement by family investment program 26 participants in work, education, or training activities, or for 27 the purposes of assistance under the family investment program 28 in accordance with chapter 239B . 29 d. For the SNAP employment and training program: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 31 (1) The department shall apply the federal SNAP employment 32 and training state plan in order to maximize to the fullest 33 extent permitted by federal law the use of the 50 percent 34 federal reimbursement provisions for the claiming of allowable 35 -23- LSB 1004XC (2) 90 pf/rn 23/ 70
S.F. _____ federal reimbursement funds from the United States department 1 of agriculture pursuant to the federal SNAP employment and 2 training program for providing education, employment, and 3 training services for eligible SNAP participants, including 4 but not limited to related dependent care and transportation 5 expenses. 6 (2) The department shall continue the categorical 7 federal SNAP eligibility at 160 percent of the federal 8 poverty level and continue to eliminate the asset test from 9 eligibility requirements, consistent with federal SNAP program 10 requirements. The department shall include as many SNAP 11 households as is allowed by federal law. The eligibility 12 provisions shall conform to all federal requirements including 13 requirements addressing individuals who are disqualified for 14 committing an intentional program violation or are otherwise 15 ineligible. 16 e. For the JOBS program, not more than: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 18 5. Of the child support collections assigned under FIP, an 19 amount equal to the federal share of support collections shall 20 be credited to the child support services appropriation made 21 in this division of this Act. Of the remainder of the assigned 22 child support collections received by child support services, 23 a portion shall be credited to the FIP account, a portion may 24 be used to increase recoveries, and a portion may be used to 25 sustain cash flow in the child support payments account. If 26 as a consequence of the appropriations and allocations made in 27 this section the resulting amounts are insufficient to sustain 28 cash assistance payments and meet federal maintenance of effort 29 requirements, the department shall seek supplemental funding. 30 If child support collections assigned under FIP are greater 31 than estimated or are otherwise determined not to be required 32 for maintenance of effort, the state share of either amount may 33 be transferred to or retained in the child support payments 34 account. 35 -24- LSB 1004XC (2) 90 pf/rn 24/ 70
S.F. _____ Sec. 10. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 1 is appropriated from the general fund of the state to the 2 department of health and human services for the fiscal year 3 beginning July 1, 2023, and ending June 30, 2024, the following 4 amount, or so much thereof as is necessary, to be used for the 5 purpose designated: 6 To be credited to the family investment program (FIP) 7 account and used for family investment program assistance 8 under chapter 239B and other costs associated with providing 9 needs-based benefits or assistance: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 11 1. Of the funds appropriated in this section, $_____ is 12 allocated for the JOBS program. 13 2. Of the funds appropriated in this section, $_____ is 14 allocated for the family development and self-sufficiency grant 15 program. 16 3. a. Notwithstanding section 8.39 , for the fiscal 17 year beginning July 1, 2023, if necessary to meet federal 18 maintenance of effort requirements or to transfer federal 19 temporary assistance for needy families block grant funding 20 to be used for purposes of the federal social services block 21 grant or to meet cash flow needs resulting from delays in 22 receiving federal funding or to implement, in accordance with 23 this division of this Act, activities currently funded with 24 juvenile court services, county, or community moneys and 25 state moneys used in combination with such moneys; to comply 26 with federal requirements; or to maximize the use of federal 27 funds; the department of health and human services may transfer 28 funds within or between any of the appropriations made in 29 this division of this Act and appropriations in law for the 30 federal social services block grant to the department for the 31 following purposes, provided that the combined amount of state 32 and federal temporary assistance for needy families block grant 33 funding for each appropriation remains the same before and 34 after the transfer: 35 -25- LSB 1004XC (2) 90 pf/rn 25/ 70
S.F. _____ (1) For the family investment program. 1 (2) For state child care assistance. 2 (3) For child and family services. 3 (4) For field operations. 4 (5) For general administration. 5 b. This subsection shall not be construed to prohibit the 6 use of existing state transfer authority for other purposes. 7 The department shall report any transfers made pursuant to this 8 subsection to the general assembly. 9 4. Of the funds appropriated in this section, $_____ shall 10 be used for a contract for tax preparation assistance to 11 low-income Iowans to expand the usage of the earned income 12 tax credit. The purpose of the contract is to supply this 13 assistance to underserved areas of the state. The department 14 shall not retain any portion of the allocation under this 15 subsection for administrative costs. 16 5. Of the funds appropriated in this section, $_____ shall 17 be used for the continuation of the parenting program, as 18 specified in 441 IAC ch. 100 , relating to parental obligations, 19 in which child support services participates, to support the 20 efforts of a nonprofit organization committed to strengthening 21 the community through youth development, healthy living, 22 and social responsibility headquartered in a county with 23 a population over 450,000 according to the 2020 certified 24 federal census. The funds allocated in this subsection shall 25 be used by the recipient organization to develop a larger 26 community effort, through public and private partnerships, to 27 support a broad-based multi-county parenthood initiative that 28 promotes payment of child support obligations, improved family 29 relationships, and full-time employment. 30 6. The department may transfer funds appropriated in this 31 section, excluding the allocation in subsection 2 for the 32 family development and self-sufficiency grant program, to the 33 appropriations made in this division of this Act for general 34 administration and field operations as necessary to administer 35 -26- LSB 1004XC (2) 90 pf/rn 26/ 70
S.F. _____ this section, section 8 for the temporary assistance for needy 1 families block grant, and section 9 for the family investment 2 program account. 3 Sec. 11. CHILD SUPPORT SERVICES. There is appropriated from 4 the general fund of the state to the department of health and 5 human services for the fiscal year beginning July 1, 2023, and 6 ending June 30, 2024, the following amount, or so much thereof 7 as is necessary, to be used for the purposes designated: 8 For child support services, including salaries, support, 9 maintenance, and miscellaneous purposes, and for not more than 10 the following full-time equivalent positions: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 13 1. The department shall expend up to $_____, including 14 federal financial participation, for the fiscal year beginning 15 July 1, 2023, for a child support public awareness campaign. 16 The department and the office of the attorney general shall 17 cooperate in continuation of the campaign. The public 18 awareness campaign shall emphasize, through a variety of 19 media activities, the importance of maximum involvement of 20 both parents in the lives of their children as well as the 21 importance of payment of child support obligations. 22 2. Federal access and visitation grant moneys shall be 23 issued directly to private not-for-profit agencies that provide 24 services designed to increase compliance with the child access 25 provisions of court orders, including but not limited to 26 neutral visitation sites and mediation services. 27 3. The appropriation made to the department for child 28 support services may be used throughout the fiscal year in the 29 manner necessary for purposes of cash flow management, and for 30 cash flow management purposes the department may temporarily 31 draw more than the amount appropriated, provided the amount 32 appropriated is not exceeded at the close of the fiscal year. 33 Sec. 12. HEALTH CARE TRUST FUND MEDICAL ASSISTANCE 34 FY 2023-2024. Any funds remaining in the health care trust 35 -27- LSB 1004XC (2) 90 pf/rn 27/ 70
S.F. _____ fund created in section 453A.35A for the fiscal year beginning 1 July 1, 2023, and ending June 30, 2024, are appropriated to 2 the department of health and human services to supplement 3 the medical assistance program appropriations made in this 4 division of this Act, for medical assistance reimbursement and 5 associated costs, including program administration and costs 6 associated with program implementation. 7 Sec. 13. MEDICAID FRAUD FUND MEDICAL ASSISTANCE FY 8 2023-2024. Any funds remaining in the Medicaid fraud fund 9 created in section 249A.50 for the fiscal year beginning July 10 1, 2023, and ending June 30, 2024, are appropriated to the 11 department of health and human services to supplement the 12 medical assistance appropriations made in this division of this 13 Act, for medical assistance reimbursement and associated costs, 14 including program administration and costs associated with 15 program implementation. 16 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the 17 general fund of the state to the department of health and human 18 services for the fiscal year beginning July 1, 2023, and ending 19 June 30, 2024, the following amount, or so much thereof as is 20 necessary, to be used for the purpose designated: 21 For medical assistance program reimbursement and associated 22 costs as specifically provided in the reimbursement 23 methodologies in effect on June 30, 2023, except as otherwise 24 expressly authorized by law, consistent with options under 25 federal law and regulations, and contingent upon receipt of 26 approval from the office of the governor of reimbursement for 27 each abortion performed under the program: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 29 1. Iowans support reducing the number of abortions 30 performed in our state. Funds appropriated under this section 31 shall not be used for abortions, unless otherwise authorized 32 under this section. 33 2. The provisions of this section relating to abortions 34 shall also apply to the Iowa health and wellness plan created 35 -28- LSB 1004XC (2) 90 pf/rn 28/ 70
S.F. _____ pursuant to chapter 249N . 1 3. The department shall utilize not more than $_____ of the 2 funds appropriated in this section to continue the AIDS/HIV 3 health insurance premium payment program as established in 1992 4 Iowa Acts, Second Extraordinary Session, chapter 1001, section 5 409, subsection 6 . Of the funds allocated in this subsection, 6 not more than $5,000.00 may be expended for administrative 7 purposes. 8 4. Of the funds appropriated in this Act to the department 9 of health and human services for addictive disorders, $______ 10 shall be used for an integrated substance use disorder managed 11 care system. The department shall maintain the level of mental 12 health and substance use disorder treatment services provided 13 by the managed care contractors. The department shall take the 14 steps necessary to continue the federal waivers as necessary to 15 maintain the level of services. 16 5. The department shall aggressively pursue options for 17 providing medical assistance or other assistance to individuals 18 with special needs who become ineligible to continue receiving 19 services under the early and periodic screening, diagnostic, 20 and treatment program under the medical assistance program 21 due to becoming 21 years of age who have been approved for 22 additional assistance through the departments exception to 23 policy provisions, but who have health care needs in excess 24 of the funding available through the exception to policy 25 provisions. 26 6. Of the funds appropriated in this section, up to 27 $_____ may be transferred to the field operations or general 28 administration appropriations in this division of this Act 29 for operational costs associated with Part D of the federal 30 Medicare Prescription Drug Improvement and Modernization Act 31 of 2003, Pub. L. No. 108-173. 32 7. Of the funds appropriated in this section, up to $_____ 33 may be transferred to the appropriation in this division of 34 this Act for health program operations to be used for clinical 35 -29- LSB 1004XC (2) 90 pf/rn 29/ 70
S.F. _____ assessment services and prior authorization of services. 1 8. A portion of the funds appropriated in this section may 2 be transferred to the appropriations in this division of this 3 Act for general administration, health program operations, the 4 childrens health insurance program, or field operations to be 5 used for the state match cost to comply with the payment error 6 rate measurement (PERM) program for both the medical assistance 7 and childrens health insurance programs as developed by the 8 centers for Medicare and Medicaid services of the United States 9 department of health and human services to comply with the 10 federal Improper Payments Information Act of 2002, Pub. L. 11 No. 107-300, and to support other reviews and quality control 12 activities to improve the integrity of these programs. 13 9. Of the funds appropriated in this section, a sufficient 14 amount is allocated to supplement the incomes of residents of 15 nursing facilities, intermediate care facilities for persons 16 with mental illness, and intermediate care facilities for 17 persons with an intellectual disability, with incomes of less 18 than $50.00 in the amount necessary for the residents to 19 receive a personal needs allowance of $50.00 per month pursuant 20 to section 249A.30A . 21 10. One hundred percent of the nonfederal share of payments 22 to area education agencies that are medical assistance 23 providers for medical assistance-covered services provided to 24 medical assistance-covered children, shall be made from the 25 appropriation made in this section. 26 11. A portion of the funds appropriated in this section may 27 be transferred to the appropriation in this division of this 28 Act for health program operations to be used for administrative 29 activities associated with the money follows the person 30 demonstration project. 31 12. Of the funds appropriated in this section, $_____ shall 32 be used for the administration of the health insurance premium 33 payment program, including salaries, support, maintenance, and 34 miscellaneous purposes. 35 -30- LSB 1004XC (2) 90 pf/rn 30/ 70
S.F. _____ 13. a. The department may increase the amounts allocated 1 for salaries, support, maintenance, and miscellaneous purposes 2 associated with the medical assistance program, as necessary, 3 to sustain cost management efforts. The department shall 4 report any such increase to the general assembly and the 5 department of management. 6 b. If the savings to the medical assistance program from 7 ongoing cost management efforts exceed the associated cost 8 for the fiscal year beginning July 1, 2023, the department 9 may transfer any savings generated for the fiscal year due 10 to medical assistance program cost management efforts to the 11 appropriation made in this division of this Act for health 12 program operations or general administration to defray the 13 costs associated with implementing the efforts. 14 14. For the fiscal year beginning July 1, 2023, and ending 15 June 30, 2024, the replacement generation tax revenues required 16 to be deposited in the property tax relief fund pursuant to 17 section 437A.8, subsection 4 , paragraph d, and section 18 437A.15, subsection 3 , paragraph f, shall instead be credited 19 to and supplement the appropriation made in this section and 20 used for the allocations made in this section. 21 15. a. Of the funds appropriated in this section, 22 up to $_____ may be transferred by the department to the 23 appropriation made in this division of this Act to the 24 department for the same fiscal year for general administration 25 to be used for associated administrative expenses and for not 26 more than 1.00 full-time equivalent position, in addition to 27 those authorized for the same fiscal year, to be assigned to 28 implementing the childrens mental health home project. 29 b. Of the funds appropriated in this section, up to $_____ 30 may be transferred by the department to the appropriation made 31 to the department in this division of this Act for the same 32 fiscal year for Medicaid program-related general administration 33 planning and implementation activities. The funds may be used 34 for contracts or for personnel in addition to the amounts 35 -31- LSB 1004XC (2) 90 pf/rn 31/ 70
S.F. _____ appropriated for and the positions authorized for general 1 administration for the fiscal year. 2 c. Of the funds appropriated in this section, up to $_____ 3 may be transferred by the department to the appropriations 4 made in this division of this Act for the same fiscal year 5 for general administration or health program operations to 6 be used to support the development and implementation of 7 standardized assessment tools for persons with mental illness, 8 an intellectual disability, a developmental disability, or a 9 brain injury. 10 16. Of the funds appropriated in this section, $_____ 11 shall be used for lodging expenses associated with care 12 provided at the university of Iowa hospitals and clinics for 13 patients with cancer whose travel distance is 30 miles or more 14 and whose income is at or below 200 percent of the federal 15 poverty level as defined by the most recently revised poverty 16 income guidelines published by the United States department of 17 health and human services. The department of health and human 18 services shall establish the maximum number of overnight stays 19 and the maximum rate reimbursed for overnight lodging, which 20 may be based on the state employee rate established by the 21 department of administrative services. The funds allocated in 22 this subsection shall not be used as nonfederal share matching 23 funds. 24 17. Of the funds appropriated in this section, up to $______ 25 shall be used for administration of the state family planning 26 services program pursuant to section 217.41B , and of this 27 amount, the department may use up to $_____ for administrative 28 expenses. 29 18. Of the funds appropriated in this section, $______ 30 shall be used and may be transferred to other appropriations 31 in this division of this Act as necessary to administer the 32 provisions in the division of this Act relating to Medicaid 33 program administration. 34 19. The department shall comply with the centers for 35 -32- LSB 1004XC (2) 90 pf/rn 32/ 70
S.F. _____ Medicare and Medicaid services guidance related to Medicaid 1 program and childrens health insurance program maintenance 2 of effort provisions, including eligibility standards, 3 methodologies, procedures, and continuous enrollment, to 4 receive the enhanced federal medical assistance percentage 5 under section 6008(b) of the federal Families First Coronavirus 6 Response Act, Pub. L. No. 116-127. The department shall 7 utilize and implement all tools, processes, and resources 8 available to expediently return to normal eligibility and 9 enrollment operations in compliance with federal guidance and 10 expectations. 11 20. A portion of the funds appropriated in this section 12 may be transferred to the appropriation made in this division 13 of this Act for the childrens health insurance program, 14 if the childrens health insurance program appropriation 15 is insufficient to cover the designated purposes of that 16 appropriation. 17 Sec. 15. HEALTH PROGRAM OPERATIONS. There is appropriated 18 from the general fund of the state to the department of health 19 and human services for the fiscal year beginning July 1, 2023, 20 and ending June 30, 2024, the following amount, or so much 21 thereof as is necessary, to be used for the purpose designated: 22 For health program operations: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 24 1. The department of inspections, appeals, and licensing 25 shall provide all state matching funds for survey and 26 certification activities performed by the department of 27 inspections, appeals, and licensing. The department of health 28 and human services is solely responsible for distributing the 29 federal matching funds for such activities. 30 2. Of the funds appropriated in this section, $_____ shall 31 be used for continuation of home and community-based services 32 waiver quality assurance programs, including the review and 33 streamlining of processes and policies related to oversight and 34 quality management to meet state and federal requirements. 35 -33- LSB 1004XC (2) 90 pf/rn 33/ 70
S.F. _____ 3. Of the amount appropriated in this section, up to 1 $_____ may be transferred to the appropriation for general 2 administration in this division of this Act to be used for 3 additional full-time equivalent positions in the development 4 of key health initiatives such as development and oversight 5 of managed care programs and development of health strategies 6 targeted toward improved quality and reduced costs in the 7 Medicaid program. 8 4. Of the funds appropriated in this section, $______ shall 9 be used for planning and development of a phased-in program to 10 provide a dental home for children. 11 5. a. Of the funds appropriated in this section, $_____ 12 shall be credited to the autism support program fund created 13 in section 225D.2 to be used for the autism support program 14 created in chapter 225D , with the exception of the following 15 amount of this allocation which shall be used as follows: 16 b. Of the funds allocated in this subsection, $_____ shall 17 be used for the public purpose of continuation of a grant to 18 a nonprofit provider of child welfare services that has been 19 in existence for more than 115 years, is located in a county 20 with a population between 220,000 and 250,000 according to the 21 2020 federal decennial census, is licensed as a psychiatric 22 medical institution for children, and provides school-based 23 programming, to be used for support services for children with 24 autism spectrum disorder and their families. 25 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE. 26 1. There is appropriated from the general fund of the state 27 to the department of health and human services for the fiscal 28 year beginning July 1, 2023, and ending June 30, 2024, the 29 following amount, or so much thereof as is necessary, to be 30 used for the purpose designated: 31 For the state supplementary assistance program: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 33 2. The department shall increase the personal needs 34 allowance for residents of residential care facilities by the 35 -34- LSB 1004XC (2) 90 pf/rn 34/ 70
S.F. _____ same percentage and at the same time as federal supplemental 1 security income and federal social security benefits are 2 increased due to a recognized increase in the cost of living. 3 The department may adopt emergency rules to implement this 4 subsection. 5 3. If during the fiscal year beginning July 1, 2023, 6 the department projects that state supplementary assistance 7 expenditures for a calendar year will not meet the federal 8 pass-through requirement specified in Tit. XVI of the federal 9 Social Security Act, section 1618, as codified in 42 U.S.C. 10 1382g, the department may take actions including but not 11 limited to increasing the personal needs allowance for 12 residential care facility residents and making programmatic 13 adjustments or upward adjustments of the residential care 14 facility or in-home health-related care reimbursement rates 15 prescribed in this division of this Act to ensure that federal 16 requirements are met. In addition, the department may make 17 other programmatic and rate adjustments necessary to remain 18 within the amount appropriated in this section while ensuring 19 compliance with federal requirements. The department may adopt 20 emergency rules to implement the provisions of this subsection. 21 4. Notwithstanding section 8.33 , moneys appropriated 22 in this section that remain unencumbered or unobligated 23 at the close of the fiscal year shall not revert but 24 shall remain available for expenditure for the purposes 25 designated, including for liability amounts associated with the 26 supplemental nutrition assistance program payment error rate, 27 until the close of the succeeding fiscal year. 28 Sec. 17. CHILDRENS HEALTH INSURANCE PROGRAM. 29 1. There is appropriated from the general fund of the state 30 to the department of health and human services for the fiscal 31 year beginning July 1, 2023, and ending June 30, 2024, the 32 following amount, or so much thereof as is necessary, to be 33 used for the purpose designated: 34 For maintenance of the healthy and well kids in Iowa (Hawki) 35 -35- LSB 1004XC (2) 90 pf/rn 35/ 70
S.F. _____ program pursuant to chapter 514I , including supplemental dental 1 services, for receipt of federal financial participation under 2 Tit. XXI of the federal Social Security Act, which creates the 3 childrens health insurance program: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 5 2. Of the funds appropriated in this section, $_____ is 6 allocated for continuation of the contract for outreach. 7 3. A portion of the funds appropriated in this section may 8 be transferred to the appropriations made in this division of 9 this Act for field operations or health program operations 10 to be used for the integration of Hawki program eligibility, 11 payment, and administrative functions under the purview of the 12 department of health and human services, including for the 13 Medicaid management information system upgrade. 14 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated from 15 the general fund of the state to the department of health and 16 human services for the fiscal year beginning July 1, 2023, and 17 ending June 30, 2024, the following amount, or so much thereof 18 as is necessary, to be used for the purpose designated: 19 For child care programs: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 21 1. Of the funds appropriated in this section, $_____ shall 22 be used for state child care assistance in accordance with 23 section 237A.13 . 24 2. Nothing in this section shall be construed or is 25 intended as or shall imply a grant of entitlement for services 26 to persons who are eligible for assistance due to an income 27 level consistent with the waiting list requirements of section 28 237A.13 . Any state obligation to provide services pursuant to 29 this section is limited to the extent of the funds appropriated 30 in this section. 31 3. A list of the registered and licensed child care 32 facilities operating in the area served by a child care 33 resource and referral service shall be made available to the 34 families receiving state child care assistance in that area. 35 -36- LSB 1004XC (2) 90 pf/rn 36/ 70
S.F. _____ 4. Of the funds appropriated in this section, $_____ shall 1 be credited to the early childhood programs grants account in 2 the early childhood Iowa fund created in section 256I.11 . The 3 moneys shall be distributed for funding of community-based 4 early childhood programs targeted to children from birth 5 through five years of age developed by early childhood Iowa 6 areas in accordance with approved community plans as provided 7 in section 256I.8 . 8 5. The department may use any of the funds appropriated 9 in this section as a match to obtain federal funds for use in 10 expanding child care assistance and related programs. For 11 the purpose of expenditures of state and federal child care 12 funding, funds shall be considered obligated at the time 13 expenditures are projected or are allocated to the departments 14 service areas. Projections shall be based on current and 15 projected caseload growth, current and projected provider 16 rates, staffing requirements for eligibility determination 17 and management of program requirements including data systems 18 management, staffing requirements for administration of the 19 program, contractual and grant obligations and any transfers 20 to other state agencies, and obligations for decategorization 21 or innovation projects. 22 6. A portion of the state match for the federal child care 23 and development block grant shall be provided as necessary to 24 meet federal matching funds requirements through the state 25 general fund appropriation made for child development grants 26 and other programs for at-risk children in section 279.51 . 27 7. If a uniform reduction ordered by the governor under 28 section 8.31 or other operation of law, transfer, or federal 29 funding reduction reduces the appropriation made in this 30 section for the fiscal year, the percentage reduction in the 31 amount paid out to or on behalf of the families participating 32 in the state child care assistance program shall be equal to or 33 less than the percentage reduction made for any other purpose 34 payable from the appropriation made in this section and the 35 -37- LSB 1004XC (2) 90 pf/rn 37/ 70
S.F. _____ federal funding relating to it. The percentage reduction to 1 the other allocations made in this section shall be the same as 2 the uniform reduction ordered by the governor or the percentage 3 change of the federal funding reduction, as applicable. If 4 there is an unanticipated increase in federal funding provided 5 for state child care services, the entire amount of the 6 increase, except as necessary to meet federal requirements 7 including quality set asides, shall be used for state child 8 care assistance payments. If the appropriations made for 9 purposes of the state child care assistance program for the 10 fiscal year are determined to be insufficient, it is the intent 11 of the general assembly to appropriate sufficient funding for 12 the fiscal year in order to avoid establishment of waiting list 13 requirements. 14 8. Notwithstanding section 8.33 , moneys advanced for 15 purposes of the programs developed by early childhood Iowa 16 areas, advanced for purposes of wraparound child care, or 17 received from the federal appropriations made for the purposes 18 of this section that remain unencumbered or unobligated at the 19 close of the fiscal year shall not revert to any fund but shall 20 remain available for expenditure for the purposes designated 21 until the close of the succeeding fiscal year. 22 Sec. 19. JUVENILE INSTITUTION. There is appropriated from 23 the general fund of the state to the department of health and 24 human services for the fiscal year beginning July 1, 2023, and 25 ending June 30, 2024, the following amounts, or so much thereof 26 as is necessary, to be used for the purposes designated: 27 1. a. For operation of the state training school at Eldora 28 and for salaries, support, maintenance, and miscellaneous 29 purposes, and for not more than the following full-time 30 equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 33 b. Of the funds appropriated in this subsection, $_____ 34 shall be used for distribution to licensed classroom teachers 35 -38- LSB 1004XC (2) 90 pf/rn 38/ 70
S.F. _____ at this and other institutions under the control of the 1 department of health and human services based upon the average 2 student yearly enrollment at each institution as determined by 3 the department. 4 2. A portion of the moneys appropriated in this section 5 shall be used by the state training school at Eldora for 6 grants for adolescent pregnancy prevention activities at the 7 institution in the fiscal year beginning July 1, 2023. 8 3. Of the funds appropriated in this subsection, $_____ 9 shall be used by the state training school at Eldora for a 10 substance use disorder treatment program at the institution for 11 the fiscal year beginning July 1, 2023. 12 4. 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. 20. CHILD AND FAMILY SERVICES. 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 purpose designated: 23 For child and family services: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 25 2. The department may transfer funds appropriated in this 26 section as necessary to pay the nonfederal costs of services 27 reimbursed under the medical assistance program, state child 28 care assistance program, or the family investment program which 29 are provided to children who would otherwise receive services 30 paid under the appropriation in this section. The department 31 may transfer funds appropriated in this section to the 32 appropriations made in this division of this Act for general 33 administration and for field operations for resources necessary 34 to implement and operate the services funded in this section. 35 -39- LSB 1004XC (2) 90 pf/rn 39/ 70
S.F. _____ 3. Of the funds appropriated in this section, up to $_____ 1 is allocated for group foster care maintenance and services. 2 4. In accordance with the provisions of section 232.188 , 3 the department shall continue the child welfare and juvenile 4 justice funding initiative during fiscal year 2023-2024. Of 5 the funds appropriated in this section, $_____ is allocated 6 specifically for expenditure for fiscal year 2023-2024 through 7 the decategorization services funding pools and governance 8 boards established pursuant to section 232.188 . 9 5. A portion of the funds appropriated in this section 10 may be used for emergency family assistance to provide other 11 resources required for a family participating in a family 12 preservation or reunification project or successor project to 13 stay together or to be reunified. 14 6. Of the funds appropriated in this section, a sufficient 15 amount is allocated for shelter care and the child welfare 16 emergency services contracting implemented to provide for or 17 prevent the need for shelter care. 18 7. Federal funds received by the state during the fiscal 19 year beginning July 1, 2023, as the result of the expenditure 20 of state funds appropriated during a previous state fiscal 21 year for a service or activity funded under this section are 22 appropriated to the department to be used as additional funding 23 for services and purposes provided for under this section. 24 Notwithstanding section 8.33 , moneys received in accordance 25 with this subsection that remain unencumbered or unobligated at 26 the close of the fiscal year shall not revert to any fund but 27 shall remain available for the purposes designated until the 28 close of the succeeding fiscal year. 29 8. a. Of the funds appropriated in this section, up 30 to $_____ is allocated for the payment of the expenses of 31 court-ordered services provided to juveniles who are under the 32 supervision of juvenile court services, which expenses are a 33 charge upon the state pursuant to section 232.141, subsection 34 4 . Of the amount allocated in this paragraph a, up to $_____ 35 -40- LSB 1004XC (2) 90 pf/rn 40/ 70
S.F. _____ shall be made available to provide school-based supervision of 1 children adjudicated under chapter 232 , of which not more than 2 $_____ may be used for the purpose of training. A portion of 3 the cost of each school-based liaison officer shall be paid by 4 the school district or other funding source as approved by the 5 chief juvenile court officer. 6 b. Of the funds appropriated in this section, up to $_____ 7 is allocated for the payment of the expenses of court-ordered 8 services provided to children who are under the supervision 9 of the department, which expenses are a charge upon the state 10 pursuant to section 232.141, subsection 4 . 11 c. Notwithstanding section 232.141 or any other provision 12 of law to the contrary, the amounts allocated in this 13 subsection shall be distributed to the judicial districts 14 as determined by the state court administrator and to the 15 departments service areas as determined by the department. 16 The state court administrator and the department shall make the 17 determination of the distribution amounts on or before June 15, 18 2023. 19 d. Notwithstanding chapter 232 or any other provision of 20 law to the contrary, a district or juvenile court shall not 21 order any service which is a charge upon the state pursuant 22 to section 232.141 if there are insufficient court-ordered 23 services funds available in the district court or departmental 24 service area distribution amounts to pay for the service. The 25 chief juvenile court officer and the departmental service area 26 manager shall encourage use of the funds allocated in this 27 subsection such that there are sufficient funds to pay for 28 all court-related services during the entire year. The chief 29 juvenile court officers and departmental service area managers 30 shall attempt to anticipate potential surpluses and shortfalls 31 in the distribution amounts and shall cooperatively request 32 the state court administrator or department to transfer funds 33 between the judicial districts or departmental service areas 34 distribution amounts as prudent. 35 -41- LSB 1004XC (2) 90 pf/rn 41/ 70
S.F. _____ e. Notwithstanding any provision of law to the contrary, 1 a district or juvenile court shall not order a county to pay 2 for any service provided to a juvenile pursuant to an order 3 entered under chapter 232 which is a charge upon the state 4 under section 232.141, subsection 4 . 5 f. Of the funds allocated in this subsection, not more than 6 $_____ may be used by the judicial branch for administration of 7 the requirements under this subsection. 8 g. Of the funds allocated in this subsection, $_____ shall 9 be used by the department of health and human services to 10 support the interstate commission for juveniles in accordance 11 with the interstate compact for juveniles as provided in 12 section 232.173 . 13 9. Of the funds appropriated in this section, $_____ is 14 allocated for juvenile delinquent graduated sanctions services. 15 Any state funds saved as a result of efforts by juvenile court 16 services to earn a federal Tit. IV-E match for juvenile court 17 services administration may be used for the juvenile delinquent 18 graduated sanctions services. 19 10. Of the funds appropriated in this section, $_____ shall 20 be used for the child protection center grant program for 21 child protection centers located in Iowa in accordance with 22 section 135.118 . The grant amounts under the program shall be 23 equalized so that each center receives a uniform base amount 24 of $_____, and so that the remaining funds are awarded through 25 a funding formula based upon the volume of children served. 26 To increase access to child protection center services for 27 children in rural areas, the funding formula for the awarding 28 of the remaining funds shall provide for the awarding of an 29 enhanced amount to eligible grantees to develop and maintain 30 satellite centers in underserved regions of the state. 31 11. Of the funds appropriated in this section, $_____ is 32 allocated for the preparation for adult living program pursuant 33 to section 234.46 . 34 12. Of the funds appropriated in this section, $_____ shall 35 -42- LSB 1004XC (2) 90 pf/rn 42/ 70
S.F. _____ be used for the public purpose of continuing a grant to a 1 nonprofit human services organization, providing services to 2 individuals and families in multiple locations in southwest 3 Iowa and Nebraska for support of a project providing immediate, 4 sensitive support and forensic interviews, medical exams, needs 5 assessments, and referrals for victims of child abuse and their 6 nonoffending family members. 7 13. Of the funds appropriated in this section, $_____ 8 is allocated for the foster care youth council approach of 9 providing a support network to children placed in foster care. 10 14. Of the funds appropriated in this section, $_____ is 11 allocated for use pursuant to section 235A.1 for continuation 12 of the initiative to address child sexual abuse implemented 13 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 14 21 . 15 15. Of the funds appropriated in this section, $_____ is 16 allocated for the community partnership for child protection 17 sites. 18 16. Of the funds appropriated in this section, $_____ 19 is allocated for the departments minority youth and family 20 projects under the redesign of the child welfare system. 21 17. Of the funds appropriated in this section, $_____ 22 is allocated for funding of the community circle of care 23 collaboration for children and youth in northeast Iowa. 24 18. Of the funds appropriated in this section, at least 25 $_____ shall be used for the continuation of the child welfare 26 provider training program. 27 19. Of the funds appropriated in this section, $_____ 28 shall be used for continuation of the central Iowa system of 29 care program grant for the purposes of funding community-based 30 services and other supports with a system of care approach for 31 children with serious emotional disturbance and their families 32 through a nonprofit provider that is located in a county 33 with a population of more than 450,000 according to the 2020 34 certified federal census, is licensed as a psychiatric medical 35 -43- LSB 1004XC (2) 90 pf/rn 43/ 70
S.F. _____ institution for children, and was a system of care grantee 1 prior to July 1, 2023. 2 20. Of the funds appropriated in this section, $_____ 3 shall be used for the public purpose of the continuation 4 and expansion of a system of care program grant implemented 5 in Cerro Gordo and Linn counties to utilize a comprehensive 6 and long-term approach for helping children and families by 7 addressing the key areas in a childs life of childhood basic 8 needs, education and work, family, and community. 9 21. Of the funds appropriated in this section, $_____ shall 10 be used for the public purpose of funding community-based 11 services and other supports with a system of care approach 12 for children with a serious emotional disturbance and their 13 families through a nonprofit provider of child welfare services 14 that has been in existence for more than 115 years, is located 15 in a county with a population of more than 230,000 according to 16 the 2020 certified federal census, is licensed as a psychiatric 17 medical institution for children, and was a system of care 18 grantee prior to July 1, 2023. 19 22. If a separate funding source is identified that reduces 20 the need for state funds within an allocation under this 21 section, the allocated state funds may be redistributed to 22 other allocations under this section for the same fiscal year. 23 23. Of the funds appropriated in this section, a portion may 24 be used for family-centered services for purposes of complying 25 with the federal Family First Prevention Services Act of 2018, 26 Pub. L. No. 115-123, and successor legislation. 27 24. Of the funds appropriated in this section, $_____ 28 shall be used to support placements in qualified residential 29 treatment programs. 30 Sec. 21. CHILD ADVOCACY BOARD. There is appropriated from 31 the general fund of the state to the department of health and 32 human services for the fiscal year beginning July 1, 2023, and 33 ending June 30, 2024, the following amount, or so much thereof 34 as is necessary, to be used for the purposes designated: 35 -44- LSB 1004XC (2) 90 pf/rn 44/ 70
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 1 1. For foster care review and the court appointed special 2 advocate program, including salaries, support, maintenance, and 3 miscellaneous purposes, and for not more than the following 4 full-time equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 7 2. The department of health and human services, in 8 coordination with the child advocacy board, shall submit an 9 application for funding available pursuant to Tit. IV-E of the 10 federal Social Security Act for claims for child advocacy board 11 administrative review costs. 12 3. The court appointed special advocate program shall 13 investigate and develop opportunities for expanding 14 fund-raising for the program. 15 4. Administrative costs of the department of health and 16 human services for items funded under this section shall not 17 exceed 4 percent of the amount appropriated in this section. 18 5. The department of health and human services shall not 19 reallocate moneys appropriated to the child advocacy board in 20 this section. 21 Sec. 22. EARLY CHILDHOOD IOWA FUND GENERAL AID. There 22 is appropriated from the general fund of the state to the 23 department of health and human services for the fiscal year 24 beginning July 1, 2023, and ending June 30, 2024, the following 25 amount, or so much thereof as is necessary, to be used for the 26 purposes designated. 27 For deposit in the school ready children grants account of 28 the early childhood Iowa fund created in section 256I.11 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 30 1. From the moneys deposited in the school ready children 31 grants account for the fiscal year beginning July 1, 2023, and 32 ending June 30, 2024, not more than $__________ is allocated 33 for the early childhood Iowa program and other technical 34 assistance activities. Moneys allocated under this subsection 35 -45- LSB 1004XC (2) 90 pf/rn 45/ 70
S.F. _____ may be used by the early childhood Iowa state board for the 1 purpose of skills development and support for ongoing training 2 of staff. However, except as otherwise provided in this 3 section, moneys shall not be used for additional staff or for 4 the reimbursement of staff. 5 2. Of the amount appropriated in this section for deposit 6 in the school ready children grants account of the early 7 childhood Iowa fund, $__________ shall be used for efforts 8 to improve the quality of early care, health, and education 9 programs. Moneys allocated pursuant to this subsection may be 10 used for additional staff and for the reimbursement of staff. 11 The early childhood Iowa state board may reserve a portion of 12 the allocation, not to exceed $__________, for the technical 13 assistance expenses of the early childhood Iowa program, 14 including the reimbursement of staff, and shall distribute 15 the remainder to early childhood Iowa areas for local quality 16 improvement efforts through a methodology identified by the 17 early childhood Iowa state board to make the most productive 18 use of the funding, which may include use of the distribution 19 formula, grants, or other means. 20 3. Of the amount appropriated in this section for deposit 21 in the school ready children grants account of the early 22 childhood Iowa fund, $__________ shall be used for support 23 of professional development and training activities for 24 persons working in early care, health, and education by 25 the early childhood Iowa state board in collaboration with 26 the professional development component groups maintained by 27 the early childhood Iowa stakeholders alliance pursuant to 28 section 256I.12 , and the early childhood Iowa area boards. 29 Expenditures shall be limited to professional development and 30 training activities agreed upon by the parties participating in 31 the collaboration as approved by the early childhood Iowa state 32 board. 33 4. Of the amount appropriated in this section for deposit 34 in the school ready children grants account of the early 35 -46- LSB 1004XC (2) 90 pf/rn 46/ 70
S.F. _____ childhood Iowa fund, $__________ shall be used to invest in 1 this states early childhood database system that integrates 2 state administrative data to provide results that inform and 3 improve the early childhood system of programs and services in 4 this state. 5 Sec. 23. ADOPTION SUBSIDY. 6 1. There is appropriated from the general fund of the state 7 to the department of health and human services for the fiscal 8 year beginning July 1, 2023, and ending June 30, 2024, the 9 following amount, or so much thereof as is necessary, to be 10 used for the purpose designated: 11 a. For adoption subsidy payments and related costs and for 12 other operations and services provided for under paragraph b 13 and paragraph c, subparagraph (2): 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 15 b. Of the funds appropriated in this section, up to $_____ 16 may be transferred to the appropriation for department-wide 17 duties in this division of this Act to be used for facility 18 operations. 19 c. (1) Of the funds appropriated in this section remaining 20 after the transfer of funds under paragraph b, a sufficient 21 amount is allocated for adoption subsidy payments and related 22 costs. 23 (2) Any funds appropriated in this section remaining after 24 the allocation under subparagraph (1) are designated and 25 allocated as state savings resulting from implementation of 26 the federal Fostering Connections to Success and Increasing 27 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 28 legislation, as determined in accordance with 42 U.S.C. 29 673(a)(8), and shall be used for post-adoption services and 30 for other purposes allowed under these federal laws, Tit. IV-B 31 or Tit. IV-E of the federal Social Security Act. 32 (a) The department of health and human services may transfer 33 funds allocated in this subparagraph (2) to the appropriation 34 for child and family services in this division of this Act for 35 -47- LSB 1004XC (2) 90 pf/rn 47/ 70
S.F. _____ the purposes designated in this subparagraph (2). 1 (b) Notwithstanding section 8.33, moneys allocated 2 under this subparagraph (2) shall not revert to any fund but 3 shall remain available for the purposes designated in this 4 subparagraph (2) until expended. 5 2. The department may transfer funds appropriated in this 6 section remaining after the transfer of funds under subsection 7 1, paragraph b, to the appropriation made in this division 8 of this Act for general administration for costs paid from the 9 appropriation relating to adoption subsidy. 10 3. Federal funds received by the state during the 11 fiscal year beginning July 1, 2023, as the result of the 12 expenditure of state funds during a previous state fiscal 13 year for a service or activity funded under this section are 14 appropriated to the department to be used as additional funding 15 for the services and activities funded under this section. 16 Notwithstanding section 8.33 , moneys received in accordance 17 with this subsection that remain unencumbered or unobligated 18 at the close of the fiscal year shall not revert to any fund 19 but shall remain available for expenditure for the purposes 20 designated until the close of the succeeding fiscal year. 21 4. Notwithstanding section 8.33, moneys appropriated in 22 this section that remain unencumbered or unobligated at the 23 close of the fiscal year shall not revert but shall remain 24 available for the purposes designated until the close of the 25 succeeding fiscal year. 26 Sec. 24. JUVENILE DETENTION HOME FUND. Moneys deposited 27 in the juvenile detention home fund created in section 232.142 28 during the fiscal year beginning July 1, 2023, and ending June 29 30, 2024, are appropriated to the department of health and 30 human services for the fiscal year beginning July 1, 2023, and 31 ending June 30, 2024, for distribution of an amount equal to 32 a percentage of the costs of the establishment, improvement, 33 operation, and maintenance of county or multicounty juvenile 34 detention homes in the fiscal year beginning July 1, 2022. 35 -48- LSB 1004XC (2) 90 pf/rn 48/ 70
S.F. _____ Moneys appropriated for distribution in accordance with 1 this section shall be allocated among eligible detention 2 homes, prorated on the basis of an eligible detention homes 3 proportion of the costs of all eligible detention homes in the 4 fiscal year beginning July 1, 2022. The percentage figure 5 shall be determined by the department of health and human 6 services based on the amount available for distribution for 7 the fund. Notwithstanding section 232.142 , the financial aid 8 percentage of total costs payable by the state under that 9 provision for the fiscal year beginning July 1, 2023, shall be 10 limited to the amount appropriated for the purposes of this 11 section. 12 Sec. 25. FAMILY SUPPORT SUBSIDY PROGRAM. 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 family support subsidy program subject to the 19 enrollment restrictions in section 225C.37, subsection 3 : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 21 2. At least $_____ of the moneys appropriated in this 22 section shall be used for the family support center component 23 of the comprehensive family support program under chapter 225C, 24 subchapter V . 25 3. If at any time during the fiscal year, the amount of 26 funding available for the family support subsidy program 27 is reduced from the amount initially used to establish the 28 figure for the number of family members for whom a subsidy 29 is to be provided at any one time during the fiscal year, 30 notwithstanding section 225C.38, subsection 2 , the department 31 shall revise the figure as necessary to conform to the amount 32 of funding available. 33 Sec. 26. CONNER DECREE. There is appropriated from the 34 general fund of the state to the department of health and human 35 -49- LSB 1004XC (2) 90 pf/rn 49/ 70
S.F. _____ services for the fiscal year beginning July 1, 2023, and ending 1 June 30, 2024, the following amount, or so much thereof as is 2 necessary, to be used for the purpose designated: 3 For building community capacity through the coordination 4 and provision of training opportunities in accordance with the 5 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 6 Iowa, July 14, 1994): 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 8 Sec. 27. MENTAL HEALTH INSTITUTES. 9 1. There is appropriated from the general fund of the state 10 to the department of health and human services for the fiscal 11 year beginning July 1, 2023, and ending June 30, 2024, the 12 following amounts, or so much thereof as is necessary, to be 13 used for the purposes designated: 14 a. For operation of the state mental health institute at 15 Cherokee 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 20 b. For operation of the state mental health institute at 21 Independence as required by chapters 218 and 226 for salaries, 22 support, maintenance, and miscellaneous purposes, and for not 23 more than the following full-time equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 26 2. a. Notwithstanding sections 218.78 and 249A.11 , any 27 revenue received from the state mental health institute at 28 Cherokee or the state mental health institute at Independence 29 pursuant to 42 C.F.R. 438.6(e) may be retained and expended 30 by the mental health institute. 31 b. Notwithstanding sections 218.78 and 249A.11, any 32 COVID-19 related funding received through federal funding 33 sources by the state mental health institute at Cherokee or the 34 state mental health institute at Independence may be retained 35 -50- LSB 1004XC (2) 90 pf/rn 50/ 70
S.F. _____ and expended by the mental health institute. 1 3. Notwithstanding any provision of law to the contrary, 2 a Medicaid member residing at the state mental health 3 institute at Cherokee or the state mental health institute 4 at Independence shall retain Medicaid eligibility during 5 the period of the Medicaid members stay for which federal 6 financial participation is available. 7 4. Notwithstanding section 8.33 , moneys appropriated in 8 this section that remain unencumbered or unobligated at the 9 close of the fiscal year shall not revert but shall remain 10 available for expenditure for the purposes designated until the 11 close of the succeeding fiscal year. 12 Sec. 28. STATE RESOURCE CENTERS. 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 amounts, or so much thereof as is necessary, to be 17 used for the purposes designated: 18 a. For the state resource center at Glenwood for salaries, 19 support, maintenance, and miscellaneous purposes: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 21 b. For the state resource center at Woodward for salaries, 22 support, maintenance, and miscellaneous purposes: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 24 2. The department may continue to bill for state resource 25 center services utilizing a scope of services approach used for 26 private providers of intermediate care facilities for persons 27 with an intellectual disability services, in a manner which 28 does not shift costs between the medical assistance program, 29 mental health and disability services regions, or other sources 30 of funding for the state resource centers. 31 3. The state resource centers may expand the time-limited 32 assessment and respite services during the fiscal year. 33 4. If the departments administration and the department 34 of management concur with a finding by a state resource 35 -51- LSB 1004XC (2) 90 pf/rn 51/ 70
S.F. _____ centers superintendent that projected revenues can reasonably 1 be expected to pay the salary and support costs for a new 2 employee position, or that such costs for adding a particular 3 number of new positions for the fiscal year would be less 4 than the overtime costs if new positions would not be added, 5 the superintendent may add the new position or positions. If 6 the vacant positions available to a resource center do not 7 include the position classification desired to be filled, the 8 state resource centers superintendent may reclassify any 9 vacant position as necessary to fill the desired position. The 10 superintendents of the state resource centers may, by mutual 11 agreement, pool vacant positions and position classifications 12 during the course of the fiscal year in order to assist one 13 another in filling necessary positions. 14 5. If existing capacity limitations are reached in 15 operating units, a waiting list is in effect for a service or 16 a special need for which a payment source or other funding 17 is available for the service or to address the special need, 18 and facilities for the service or to address the special need 19 can be provided within the available payment source or other 20 funding, the superintendent of a state resource center may 21 authorize opening not more than two units or other facilities 22 and begin implementing the service or addressing the special 23 need during fiscal year 2023-2024. 24 6. Notwithstanding section 8.33 , and notwithstanding 25 the amount limitation specified in section 222.92 , moneys 26 appropriated in this section that remain unencumbered or 27 unobligated at the close of the fiscal year shall not revert 28 but shall remain available for expenditure for the purposes 29 designated until the close of the succeeding fiscal year. 30 Sec. 29. SEXUALLY VIOLENT PREDATORS. 31 1. There is appropriated from the general fund of the state 32 to the department of health and human services for the fiscal 33 year beginning July 1, 2023, and ending June 30, 2024, the 34 following amount, or so much thereof as is necessary, to be 35 -52- LSB 1004XC (2) 90 pf/rn 52/ 70
S.F. _____ used for the purpose designated: 1 For costs associated with the commitment and treatment of 2 sexually violent predators in the unit located at the state 3 mental health institute at Cherokee, including costs of legal 4 services and other associated costs, including salaries, 5 support, maintenance, and miscellaneous purposes, and for not 6 more than the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 9 2. Unless specifically prohibited by law, if the amount 10 charged provides for recoupment of at least the entire amount 11 of direct and indirect costs, the department of health and 12 human services may contract with other states to provide 13 care and treatment of persons placed by the other states at 14 the unit for sexually violent predators at Cherokee. The 15 moneys received under such a contract shall be considered 16 to be repayment receipts and used for the purposes of the 17 appropriation made in this section. 18 3. Notwithstanding section 8.33 , moneys appropriated in 19 this section that remain unencumbered or unobligated at the 20 close of the fiscal year shall not revert but shall remain 21 available for expenditure for the purposes designated until the 22 close of the succeeding fiscal year. 23 Sec. 30. FIELD OPERATIONS. 24 1. There is appropriated from the general fund of the state 25 to the department of health and human services for the fiscal 26 year beginning July 1, 2023, and ending June 30, 2024, the 27 following amount, or so much thereof as is necessary, to be 28 used for the purposes designated: 29 For field operations, including salaries, support, 30 maintenance, and miscellaneous purposes, and for not more than 31 the following full-time equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 34 2. Priority in filling full-time equivalent positions 35 -53- LSB 1004XC (2) 90 pf/rn 53/ 70
S.F. _____ shall be given to those positions related to child protection 1 services and eligibility determination for low-income families. 2 Sec. 31. GENERAL ADMINISTRATION. There is appropriated 3 from the general fund of the state to the department of health 4 and human services for the fiscal year beginning July 1, 2023, 5 and ending June 30, 2024, the following amount, or so much 6 thereof as is necessary, to be used for the purpose designated: 7 For general administration, including salaries, support, 8 maintenance, and miscellaneous purposes, and for not more than 9 the following full-time equivalent positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 12 1. The department shall report at least monthly to the 13 general assembly concerning the departments operational and 14 program expenditures. 15 2. Of the funds appropriated in this section, $_____ shall 16 be used for the provision of a program to provide technical 17 assistance, support, and consultation to providers of home and 18 community-based services under the medical assistance program. 19 3. Of the funds appropriated in this section, $_____ 20 is transferred to the Iowa finance authority to be used 21 for administrative support of the council on homelessness 22 established in section 16.2D and for the council to fulfill its 23 duties in addressing and reducing homelessness in the state. 24 4. Of the funds appropriated in this section, $_____ shall 25 be transferred to and deposited in the administrative fund of 26 the Iowa ABLE savings plan trust created in section 12I.4 , to 27 be used for implementation and administration activities of the 28 Iowa ABLE savings plan trust. 29 5. Of the funds appropriated in this section, $_____ 30 shall be used by the Iowa commission on volunteer services 31 to continue to support the RefugeeRISE AmeriCorps program 32 established under section 15H.8 for member recruitment and 33 training to improve the economic well-being and health of 34 economically disadvantaged refugees in local communities across 35 -54- LSB 1004XC (2) 90 pf/rn 54/ 70
S.F. _____ Iowa. The funds may be used to supplement federal funds under 1 federal regulations. 2 6. Of the funds appropriated in this section, up to $_____ 3 shall be used as follows: 4 a. To fund not more than 1.00 full-time equivalent position 5 to address the departments responsibility to support the work 6 of the childrens behavioral health system state board and 7 implementation of the services required pursuant to section 8 331.397. 9 b. To support the cost of establishing and implementing new 10 or additional services required pursuant to sections 331.397 11 and 331.397A. 12 c. Of the amount allocated, $_____ shall be used to support 13 the costs of establishing and implementing new or additional 14 services required pursuant to sections 331.397 and 331.397A. 15 7. Of the funds appropriated in this section, $_____ shall 16 be used for the renovation and construction of certain nursing 17 facilities, consistent with the provisions of chapter 249K. 18 8. Of the funds appropriated under this section, $_____ 19 shall be used for the purposes of program administration 20 and provision of pregnancy support services through the 21 more options for maternal support program created in section 22 217.41C. 23 Sec. 32. DEPARTMENT-WIDE DUTIES. There is appropriated 24 from the general fund of the state to the department of health 25 and human services for the fiscal year beginning July 1, 26 2023, and ending June 30, 2024, the following amount, or so 27 much thereof as is necessary, to be used for the purposes 28 designated: 29 For salaries, support, maintenance, and miscellaneous 30 purposes at facilities under the purview of the department of 31 health and human services: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 33 Sec. 33. IOWA COMMISSION ON VOLUNTEER SERVICE. 34 1. a. There is appropriated from the general fund of the 35 -55- LSB 1004XC (2) 90 pf/rn 55/ 70
S.F. _____ state to the department of health and human services for the 1 fiscal year beginning July 1, 2023, and ending June 30, 2024, 2 the following amount, or so much thereof as is necessary, for 3 use by the Iowa commission on volunteer service for purposes 4 of the Iowa state commission grant program, the Iowas promise 5 and Iowa mentoring partnership programs, for coordination 6 of volunteer services, and for not more than the following 7 full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs ___ 10 b. Of the moneys appropriated in this section, the 11 department shall allocate $__________ for purposes of the Iowa 12 state commission grant program and $__________ for purposes of 13 the Iowas promise and Iowa mentoring partnership programs. 14 2. Notwithstanding section 8.33, moneys appropriated in 15 this section that remain unencumbered or unobligated at the 16 close of the fiscal year shall not revert but shall remain 17 available for expenditure for the purposes designated until the 18 close of the succeeding fiscal year. 19 Sec. 34. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 20 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 21 DEPARTMENT OF HEALTH AND HUMAN SERVICES. 22 1. a. (1) (a) Notwithstanding any provision of law to 23 the contrary, for the fiscal year beginning July 1, 2023, the 24 department of health and human services shall rebase case-mix 25 nursing facility rates using the Medicaid cost reports on file 26 for the period ending December 31, 2022, and applying a minimum 27 occupancy factor of 70 percent as provided pursuant to 2021 28 Iowa Acts, chapter 182, section 39. 29 (b) For the fiscal year beginning July 1, 2023, non-case-mix 30 and special population nursing facilities shall be reimbursed 31 in accordance with the methodology in effect on June 30, 2023. 32 (c) For managed care claims, the department of health 33 and human services shall adjust the payment rate floor for 34 nursing facilities, annually, to maintain a rate floor that is 35 -56- LSB 1004XC (2) 90 pf/rn 56/ 70
S.F. _____ no lower than the Medicaid fee-for-service case-mix adjusted 1 rate calculated in accordance with subparagraph division 2 (a) and 441 IAC 81.6 . The department shall then calculate 3 adjusted reimbursement rates, including but not limited to 4 add-on payments, annually, and shall notify Medicaid managed 5 care organizations of the adjusted reimbursement rates within 6 30 days of determining the adjusted reimbursement rates. Any 7 adjustment of reimbursement rates under this subparagraph 8 division shall be budget neutral to the state budget. 9 (d) For the fiscal year beginning July 1, 2023, Medicaid 10 managed care long-term services and supports capitation rates 11 shall be adjusted to reflect the case-mix adjusted rates 12 specified pursuant to subparagraph division (a) for the patient 13 populations residing in Medicaid-certified nursing facilities. 14 (2) Medicaid managed care organizations shall adjust 15 facility-specific rates based upon payment rate listings issued 16 by the department. The rate adjustments shall be applied 17 prospectively from the effective date of the rate letter issued 18 by the department. 19 b. (1) For the fiscal year beginning July 1, 2023, the 20 department shall establish the fee-for-service pharmacy 21 dispensing fee reimbursement at $____ per prescription, until a 22 cost of dispensing survey is completed. The actual dispensing 23 fee shall be determined by a cost of dispensing survey 24 performed by the department and required to be completed by all 25 medical assistance program participating pharmacies every two 26 years, adjusted as necessary to maintain expenditures within 27 the amount appropriated to the department for this purpose for 28 the fiscal year. A change in the dispensing fee shall become 29 effective following federal approval of the Medicaid state 30 plan. 31 (2) The department shall utilize an average acquisition 32 cost reimbursement methodology for all drugs covered under the 33 medical assistance program in accordance with 2012 Iowa Acts, 34 chapter 1133, section 33. 35 -57- LSB 1004XC (2) 90 pf/rn 57/ 70
S.F. _____ c. (1) For the fiscal year beginning July 1, 2023, 1 reimbursement rates for outpatient hospital services shall 2 remain at the rates in effect on June 30, 2023, subject to 3 Medicaid program upper payment limit rules, and adjusted 4 as necessary to maintain expenditures within the amount 5 appropriated to the department for this purpose for the fiscal 6 year. 7 (2) For the fiscal year beginning July 1, 2023, 8 reimbursement rates for inpatient hospital services shall 9 be rebased effective October 1, 2023, subject to Medicaid 10 program upper payment limit rules, and adjusted as necessary 11 to maintain expenditures within the amount appropriated to the 12 department for this purpose for the fiscal year. 13 (3) For the fiscal year beginning July 1, 2023, under 14 both fee-for-service and managed care administration of 15 the Medicaid program, critical access hospitals shall be 16 reimbursed for inpatient and outpatient services based on the 17 hospital-specific critical access hospital cost adjustment 18 factor methodology utilizing the most recent and complete cost 19 reporting period as applied prospectively within the funds 20 appropriated for such purpose for the fiscal year. 21 (4) For the fiscal year beginning July 1, 2023, the graduate 22 medical education and disproportionate share hospital fund 23 shall remain at the amount in effect on June 30, 2023, except 24 that the portion of the fund attributable to graduate medical 25 education shall be reduced in an amount that reflects the 26 elimination of graduate medical education payments made to 27 out-of-state hospitals. 28 (5) In order to ensure the efficient use of limited state 29 funds in procuring health care services for low-income Iowans, 30 funds appropriated in this Act for hospital services shall 31 not be used for activities which would be excluded from a 32 determination of reasonable costs under the federal Medicare 33 program pursuant to 42 U.S.C. 1395x(v)(1)(N). 34 d. For the fiscal year beginning July 1, 2023, reimbursement 35 -58- LSB 1004XC (2) 90 pf/rn 58/ 70
S.F. _____ rates for hospices and acute psychiatric hospitals shall be 1 increased in accordance with increases under the federal 2 Medicare program or as supported by their Medicare audited 3 costs. 4 e. For the fiscal year beginning July 1, 2023, independent 5 laboratories and rehabilitation agencies shall be reimbursed 6 using the same methodology in effect on June 30, 2023. 7 f. (1) For the fiscal year beginning July 1, 2023, 8 reimbursement rates for home health agencies shall continue to 9 be based on the Medicare low utilization payment adjustment 10 (LUPA) methodology with state geographic wage adjustments. The 11 department shall continue to update the rates every two years 12 to reflect the most recent Medicare LUPA rates. 13 (2) For the fiscal year beginning July 1, 2023, the 14 department shall continue the reimbursement rate structure that 15 provides incentives to home health care providers located in 16 rural areas and providing home health care to Medicaid members. 17 The rate structure shall include a telehealth component to 18 incentivize the provision of necessary supervision for skilled 19 care without requiring travel time. For the purposes of this 20 subparagraph (2), rural area means an area that is not an 21 Iowa core based statistical area as defined by the federal 22 office of management and budget. 23 (3) For the fiscal year beginning July 1, 2023, rates for 24 private duty nursing and personal care services under the early 25 and periodic screening, diagnostic, and treatment program 26 benefit shall be calculated based on the methodology in effect 27 on June 30, 2023. 28 g. For the fiscal year beginning July 1, 2023, federally 29 qualified health centers and rural health clinics shall receive 30 cost-based reimbursement for 100 percent of the reasonable 31 costs for the provision of services to recipients of medical 32 assistance. 33 h. For the fiscal year beginning July 1, 2023, the 34 reimbursement rates for dental services shall remain at the 35 -59- LSB 1004XC (2) 90 pf/rn 59/ 70
S.F. _____ rates in effect on June 30, 2023. 1 i. (1) For the fiscal year beginning July 1, 2023, 2 reimbursement rates for non-state-owned psychiatric medical 3 institutions for children shall be based on the reimbursement 4 methodology in effect on June 30, 2023. 5 (2) As a condition of participation in the medical 6 assistance program, enrolled providers shall accept the medical 7 assistance reimbursement rate for any covered goods or services 8 provided to recipients of medical assistance who are children 9 under the custody of a psychiatric medical institution for 10 children. 11 j. For the fiscal year beginning July 1, 2023, unless 12 otherwise specified in this Act, all noninstitutional medical 13 assistance provider reimbursement rates shall remain at the 14 rates in effect on June 30, 2023, except for area education 15 agencies, local education agencies, infant and toddler 16 services providers, home and community-based services providers 17 including consumer-directed attendant care providers under a 18 section 1915(c) or 1915(i) waiver, targeted case management 19 providers, and those providers whose rates are required to be 20 determined pursuant to section 249A.20 , or to meet federal 21 mental health parity requirements. 22 k. Notwithstanding any provision to the contrary, for the 23 fiscal year beginning July 1, 2023, the reimbursement rate for 24 anesthesiologists shall remain at the rates in effect on June 25 30, 2023, and updated on January 1, 2024, to align with the 26 most current Iowa Medicare anesthesia rate. 27 l. Notwithstanding section 249A.20 , for the fiscal year 28 beginning July 1, 2023, the average reimbursement rate for 29 health care providers eligible for use of the federal Medicare 30 resource-based relative value scale reimbursement methodology 31 under section 249A.20 shall remain at the rate in effect on 32 June 30, 2023; however, this rate shall not exceed the maximum 33 level authorized by the federal government. 34 m. For the fiscal year beginning July 1, 2023, the 35 -60- LSB 1004XC (2) 90 pf/rn 60/ 70
S.F. _____ reimbursement rate for residential care facilities shall not 1 be less than the minimum payment level as established by the 2 federal government to meet the federally mandated maintenance 3 of effort requirement. The flat reimbursement rate for 4 facilities electing not to file annual cost reports shall not 5 be less than the minimum payment level as established by the 6 federal government to meet the federally mandated maintenance 7 of effort requirement. 8 n. (1) For the fiscal year beginning July 1, 2023, the 9 reimbursement rates for inpatient mental health services 10 provided at hospitals shall be rebased effective October 1, 11 2023, subject to Medicaid program upper payment limit rules 12 and adjusted as necessary to maintain expenditures within the 13 amount appropriated to the department for this purpose for 14 the fiscal year; and psychiatrists shall be reimbursed at the 15 medical assistance program fee-for-service rate in effect on 16 June 30, 2023. 17 (2) The department of health and human services shall 18 continue the tiered rate reimbursement methodology for 19 psychiatric intensive inpatient care. 20 o. For the fiscal year beginning July 1, 2023, community 21 mental health centers may choose to be reimbursed for the 22 services provided to recipients of medical assistance through 23 either of the following options: 24 (1) For 100 percent of the reasonable costs of the services. 25 (2) In accordance with the alternative reimbursement rate 26 methodology approved by the department of health and human 27 services in effect on June 30, 2023. 28 p. For the fiscal year beginning July 1, 2023, the 29 reimbursement rate for providers of family planning services 30 that are eligible to receive a 90 percent federal match shall 31 remain at the rates in effect on June 30, 2023. 32 q. For the fiscal year beginning July 1, 2023, reimbursement 33 rates for intermediate care facility for persons with an 34 intellectual disability providers shall remain at the rates in 35 -61- LSB 1004XC (2) 90 pf/rn 61/ 70
S.F. _____ effect on June 30, 2023. 1 r. For the fiscal year beginning July 1, 2023, the 2 reimbursement rates for emergency medical service providers 3 shall remain at the rates in effect on June 30, 2023, or as 4 approved by the centers for Medicare and Medicaid services of 5 the United States department of health and human services. 6 s. For the fiscal year beginning July 1, 2023, reimbursement 7 rates for substance use disorder treatment programs licensed 8 under section 125.13 shall remain at the rates in effect on 9 June 30, 2023. 10 t. For the fiscal year beginning July 1, 2023, assertive 11 community treatment per diem rates shall remain at the rates in 12 effect on June 30, 2023. 13 u. For the fiscal year beginning July 1, 2023, the 14 reimbursement rate for family-centered services providers shall 15 be established by contract. 16 v. For the fiscal year beginning July 1, 2023, the 17 reimbursement rate for air ambulance services shall remain at 18 the rate in effect on June 30, 2023. 19 w. For the fiscal year beginning July 1, 2023, all applied 20 behavioral analysis services reimbursement rates shall remain 21 at the rates in effect on June 30, 2023. 22 x. For the fiscal year beginning July 1, 2023, all 23 behavioral health intervention services reimbursement rates 24 shall remain at the rates in effect on June 30, 2023. 25 2. For the fiscal year beginning July 1, 2023, the 26 reimbursement rate for providers reimbursed under the 27 in-home-related care program shall not be less than the minimum 28 payment level as established by the federal government to meet 29 the federally mandated maintenance of effort requirement. 30 3. Unless otherwise directed in this section, when the 31 departments reimbursement methodology for any provider 32 reimbursed in accordance with this section includes an 33 inflation factor, this factor shall not exceed the amount 34 by which the consumer price index for all urban consumers 35 -62- LSB 1004XC (2) 90 pf/rn 62/ 70
S.F. _____ increased during the most recently ended calendar year. 1 4. Notwithstanding section 234.38 , for the fiscal 2 year beginning July 1, 2023, the foster family basic daily 3 maintenance rate and the maximum adoption subsidy rate for 4 children ages 0 through 5 years shall be $____, the rate for 5 children ages 6 through 11 years shall be $____, the rate for 6 children ages 12 through 15 years shall be $____, and the 7 rate for children and young adults ages 16 and older shall 8 be $____. For youth ages 18 to 23 who have exited foster 9 care, the preparation for adult living program maintenance 10 rate shall be up to $_____ per month as calculated based on 11 the age of the participant. The maximum payment for adoption 12 subsidy nonrecurring expenses shall be limited to $500 and the 13 disallowance of additional amounts for court costs and other 14 related legal expenses implemented pursuant to 2010 Iowa Acts, 15 chapter 1031, section 408 , shall be continued. 16 5. For the fiscal year beginning July 1, 2023, the maximum 17 reimbursement rates for social services providers under 18 contract shall remain at the rates in effect on June 30, 2023, 19 or the providers actual and allowable cost plus inflation for 20 each service, whichever is less. However, if a new service 21 or service provider is added after June 30, 2023, the initial 22 reimbursement rate for the service or provider shall be based 23 upon a weighted average of provider rates for similar services. 24 6. a. For the fiscal year beginning July 1, 2023, the 25 reimbursement rates for resource family recruitment and 26 retention contractors shall be established by contract. 27 b. For the fiscal year beginning July 1, 2023, the 28 reimbursement rates for supervised apartment living foster care 29 providers shall be established by contract. 30 7. For the fiscal year beginning July 1, 2023, the 31 reimbursement rate for group foster care providers shall be the 32 combined service and maintenance reimbursement rate established 33 by contract. 34 8. The group foster care reimbursement rates paid for 35 -63- LSB 1004XC (2) 90 pf/rn 63/ 70
S.F. _____ placement of children out of state shall be calculated 1 according to the same rate-setting principles as those used for 2 in-state providers, unless the director of health and human 3 services or the directors designee determines that appropriate 4 care cannot be provided within the state. The payment of the 5 daily rate shall be based on the number of days in the calendar 6 month in which service is provided. 7 9. a. For the fiscal year beginning July 1, 2023, the 8 reimbursement rate paid for shelter care and the child welfare 9 emergency services implemented to provide or prevent the need 10 for shelter care shall be established by contract. 11 b. For the fiscal year beginning July 1, 2023, the combined 12 service and maintenance components of the per day reimbursement 13 rate paid for shelter care services shall be based on the 14 financial and statistical report submitted to the department. 15 The maximum per day reimbursement rate shall be the maximum 16 per day reimbursement rate in effect on June 30, 2023. The 17 department shall reimburse a shelter care provider at the 18 providers actual and allowable unit cost, plus inflation, not 19 to exceed the maximum reimbursement rate. 20 10. For the fiscal year beginning July 1, 2023, the 21 department shall calculate reimbursement rates for intermediate 22 care facilities for persons with an intellectual disability 23 at the 80th percentile. Beginning July 1, 2023, the rate 24 calculation methodology shall utilize the consumer price index 25 inflation factor applicable to the fiscal year beginning July 26 1, 2023. 27 11. Effective July 1, 2023, child care provider 28 reimbursement rates shall remain at the rates in effect on June 29 30, 2023. The department shall set rates in a manner so as 30 to provide incentives for a nonregistered provider to become 31 registered by applying any increase only to registered and 32 licensed providers. 33 12. The department may adopt emergency rules to implement 34 this section. 35 -64- LSB 1004XC (2) 90 pf/rn 64/ 70
S.F. _____ Sec. 35. EMERGENCY RULES. 1 1. If necessary to comply with federal requirements 2 including time frames, or if specifically authorized by a 3 provision of this division of this Act, the department of 4 health and human services or the mental health and disability 5 services commission shall adopt administrative rules under 6 section 17A.4, subsection 3, and section 17A.5, subsection 2, 7 paragraph b, to implement the provisions of this division 8 of this Act and shall submit such rules to the administrative 9 rules coordinator and the administrative code editor pursuant 10 to section 17A.5, subsection 1. The rules shall be effective 11 immediately upon filing unless a later date is specified in the 12 rules. Any rules adopted in accordance with this section shall 13 also be published as a notice of intended action as provided 14 in section 17A.4. 15 2. If during a fiscal year, the department of health and 16 human services is adopting rules in accordance with this 17 section or as otherwise directed or authorized by state 18 law, and the rules will result in an expenditure increase 19 beyond the amount anticipated in the budget process or if the 20 expenditure was not addressed in the budget process for the 21 fiscal year, the department shall notify the general assembly 22 and the department of management concerning the rules and the 23 expenditure increase. The notification shall be provided at 24 least 30 calendar days prior to the date notice of the rules 25 is submitted to the administrative rules coordinator and the 26 administrative code editor. 27 Sec. 36. REPORTS. Unless otherwise provided, any reports or 28 other information required to be compiled and submitted under 29 this Act during the fiscal year beginning July 1, 2023, shall 30 be submitted on or before the dates specified for submission 31 of the reports or information. 32 Sec. 37. EFFECTIVE UPON ENACTMENT. The following provision 33 of this division of this Act, being deemed of immediate 34 importance, takes effect upon enactment: 35 -65- LSB 1004XC (2) 90 pf/rn 65/ 70
S.F. _____ The provision relating to section 232.141 and directing the 1 state court administrator and the department of health and 2 human services to make the determination, by June 15, 2023, 3 of the distribution of funds allocated for the payment of the 4 expenses of court-ordered services provided to juveniles which 5 are a charge upon the state. 6 DIVISION VII 7 HEALTH CARE ACCOUNTS AND FUNDS FY 2023-2024 8 Sec. 38. PHARMACEUTICAL SETTLEMENT ACCOUNT DEPARTMENT 9 OF HEALTH AND HUMAN SERVICES. There is appropriated from the 10 pharmaceutical settlement account created in section 249A.33 to 11 the department of health and human services for the fiscal year 12 beginning July 1, 2023, and ending June 30, 2024, the following 13 amount, or so much thereof as is necessary, to be used for the 14 purpose designated: 15 Notwithstanding any provision of law to the contrary, to 16 supplement the appropriations made in this Act for health 17 program operations under the medical assistance program for the 18 fiscal year beginning July 1, 2023, and ending June 30, 2024: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 20 Sec. 39. QUALITY ASSURANCE TRUST FUND DEPARTMENT OF 21 HEALTH AND HUMAN SERVICES. Notwithstanding any provision to 22 the contrary and subject to the availability of funds, there is 23 appropriated from the quality assurance trust fund created in 24 section 249L.4 to the department of health and human services 25 for the fiscal year beginning July 1, 2023, and ending June 26 30, 2024, the following amounts, or so much thereof as is 27 necessary, for the purposes designated: 28 To supplement the appropriation made in this Act from the 29 general fund of the state to the department of health and human 30 services for medical assistance for the same fiscal year: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 32 Sec. 40. HOSPITAL HEALTH CARE ACCESS TRUST FUND 33 DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any 34 provision to the contrary and subject to the availability of 35 -66- LSB 1004XC (2) 90 pf/rn 66/ 70
S.F. _____ funds, there is appropriated from the hospital health care 1 access trust fund created in section 249M.4 to the department 2 of health and human services for the fiscal year beginning July 3 1, 2023, and ending June 30, 2024, the following amounts, or so 4 much thereof as is necessary, for the purposes designated: 5 To supplement the appropriation made in this Act from the 6 general fund of the state to the department of health and human 7 services for medical assistance for the same fiscal year: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ___ 9 Sec. 41. MEDICAL ASSISTANCE PROGRAM NONREVERSION 10 FOR FY 2023-2024. Notwithstanding section 8.33 , if moneys 11 appropriated for purposes of the medical assistance program for 12 the fiscal year beginning July 1, 2023, and ending June 30, 13 2024, from the general fund of the state, the quality assurance 14 trust fund, and the hospital health care access trust fund, are 15 in excess of actual expenditures for the medical assistance 16 program and remain unencumbered or unobligated at the close 17 of the fiscal year, the excess moneys shall not revert but 18 shall remain available for expenditure for the purposes of the 19 medical assistance program until the close of the succeeding 20 fiscal year. 21 DIVISION VIII 22 DECATEGORIZATION CARRYOVER FUNDING 23 Sec. 42. DECATEGORIZATION CARRYOVER FUNDING FY 2020 24 TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188, 25 subsection 5, paragraph b, any state-appropriated moneys in 26 the funding pool that remained unencumbered or unobligated at 27 the close of the fiscal year beginning July 1, 2019, and were 28 deemed carryover funding to remain available for the three 29 succeeding fiscal years that still remain unencumbered or 30 unobligated at the close of the fiscal year beginning July 1, 31 2022, shall not revert but shall be transferred to the medical 32 assistance program for the fiscal year beginning July 1, 2023. 33 Sec. 43. EFFECTIVE DATE. This division of this Act, being 34 deemed of immediate importance, takes effect upon enactment. 35 -67- LSB 1004XC (2) 90 pf/rn 67/ 70
S.F. _____ Sec. 44. RETROACTIVE APPLICABILITY. This division of this 1 Act applies retroactively to July 1, 2022. 2 DIVISION IX 3 TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE 4 Sec. 45. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE 5 FY 2022-2023. Notwithstanding any provision to the contrary, 6 any funds remaining in the property tax relief fund created 7 in section 426B.1 at the close of the fiscal year beginning 8 July 1, 2022, shall be transferred to the region incentive fund 9 created in the mental health and disability services regional 10 service fund pursuant to section 225C.7A. 11 Sec. 46. EFFECTIVE DATE. This division of this Act, being 12 deemed of immediate importance, takes effect upon enactment. 13 DIVISION X 14 PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS 15 Sec. 47. COVID-19 FEDERAL REGULATIONS. For the time 16 period beginning on the effective date of this division of 17 this Act, and ending June 30, 2024, notwithstanding state 18 administrative rules to the contrary, to the extent federal 19 regulations relating to the COVID-19 pandemic differ from state 20 administrative rules, including applicable federal waivers, 21 the federal regulations are controlling during the pendency of 22 the federally declared state of emergency and for such period 23 of time following the end of the federally declared state of 24 emergency applicable to the respective federal regulations. 25 EXPLANATION 26 The inclusion of this explanation does not constitute agreement with 27 the explanations substance by the members of the general assembly. 28 This bill relates to appropriations for health and human 29 services for FY 2023-2024 to the department of veterans 30 affairs, the Iowa veterans home, the department of health and 31 human services aging, the office of the long-term care 32 ombudsman, the department of health and human services 33 public health, and the department of health and human services 34 human services. 35 -68- LSB 1004XC (2) 90 pf/rn 68/ 70
S.F. _____ DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This 1 division makes appropriations from the general fund of the 2 state to the department of veterans affairs for administration, 3 for the Iowa veterans home, for transfer to the Iowa finance 4 authority for the home ownership assistance program, and for 5 the county commissions of veterans affairs. 6 DEPARTMENT OF HEALTH AND HUMAN SERVICES AGING. This 7 division makes appropriations from the general fund of the 8 state to the department of health and human services for 9 programs and services related to aging. 10 LONG-TERM CARE OMBUDSMAN. This division makes 11 appropriations from the general fund of the state to the office 12 of the long-term care ombudsman. 13 DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH. 14 This division makes appropriations from the general fund of 15 the state and from the sports wagering receipts fund to the 16 department of health and human services for programs and 17 services related to public health. 18 DEPARTMENT OF HEALTH AND HUMAN SERVICES HUMAN RIGHTS. 19 This division makes appropriations from the general fund of 20 the state to the department of health and human services for 21 programs and services related to human rights. 22 DEPARTMENT OF HEALTH AND HUMAN SERVICES HUMAN SERVICES. 23 This division makes appropriations from the general fund of the 24 state and the federal temporary assistance for needy families 25 block grant to the department of health and human services for 26 programs and services relating to human services including 27 early childhood Iowa, the Iowa commission on volunteer 28 services, and the child advocacy board. The reimbursement 29 section addresses reimbursement for providers reimbursed by the 30 department of health and human services. 31 HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain 32 health-related appropriations. A number of the appropriations 33 are made for purposes of the Medicaid program in addition to 34 the general fund appropriations made for this purpose for the 35 -69- LSB 1004XC (2) 90 pf/rn 69/ 70
S.F. _____ same fiscal year. 1 DECATEGORIZATION AND CARRYOVER FUNDING. This division 2 provides for the transfer of carryover decategorization funds 3 that remained unencumbered or unobligated at the close of the 4 fiscal year beginning July 1, 2022, to the Medicaid program for 5 FY 2023-2024. The division takes effect upon enactment and is 6 retroactively applicable to July 1, 2022. 7 TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE. This division 8 transfers any funds remaining in the property tax relief fund 9 created in Code section 426B.1 at the close of FY 2022-2023 10 to the region incentive fund created in the mental health and 11 disability services regional service fund pursuant to Code 12 section 225C.7A. The division takes effect upon enactment. 13 PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS. 14 This division provides that for FY 2023-2024, notwithstanding 15 state administrative rules to the contrary, to the extent 16 federal regulations relating to the COVID-19 pandemic differ 17 from state administrative rules, including applicable federal 18 waivers, the federal regulations are controlling during the 19 pendency of the federally declared state of emergency and for 20 such period of time following the end of the federally declared 21 state of emergency applicable to the respective federal 22 regulations. 23 -70- LSB 1004XC (2) 90 pf/rn 70/ 70