| 1 | 1 | | House Study Bill 342 - Introduced HOUSE FILE _____ BY (PROPOSED COMMITTEE ON APPROPRIATIONS BILL BY CHAIRPERSON MOHR) A BILL FOR An Act relating to and making appropriations to the department 1 of veterans affairs and the department of health and human 2 services, and related provisions and appropriations, 3 including aging and disability services; behavioral health, 4 public health, community access and eligibility; the 5 medical assistance program, state supplementary assistance, 6 Hawki, and other health-related programs; reimbursement 7 rates; family well-being and protection; state-operated 8 specialty care, administration and compliance; transfers, 9 cash flows, and nonreversions; prior appropriations; the 10 beer and liquor control fund, and the behavioral health 11 fund; report on nonreversion of moneys; emergency rules; 12 autism spectrum disorder; involuntary commitment hearing 13 testimony; discharge of involuntarily committed persons; 14 medical residency and fellowships; maintenance and costs of 15 juvenile homes; and a hospital directed payment program; 16 and including effective date and retroactive applicability 17 provisions. 18 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 19 TLSB 1004YC (14) 91 lh/ko |
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| 3 | 3 | | H.F. _____ DIVISION I 1 DEPARTMENT OF VETERANS AFFAIRS FY 2025-2026 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, 2025, and ending June 30, 2026, the following amounts, 6 or so much thereof as is necessary, to be used for the purposes 7 designated: 8 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 9 For salaries, support, maintenance, and miscellaneous 10 purposes, and for not more than the following full-time 11 equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,619,205 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 14 2. IOWA VETERANS HOME 15 For salaries, support, maintenance, and miscellaneous 16 purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,234,502 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 3. HOME OWNERSHIP ASSISTANCE PROGRAM 24 For transfer to the Iowa finance authority for the 25 continuation of the home ownership assistance program for 26 persons who are or were eligible members of the armed forces 27 of the United States or eligible service members pursuant to 28 section 16.54: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,200,000 30 4. VETERANS SERVICE ORGANIZATION GRANT FUND 31 Of the moneys allocated under subsection 1, $250,000 shall 32 be deposited in the veterans service organization grant fund 33 created in section 35A.23, as enacted by this division of this 34 Act. 35 -1- LSB 1004YC (14) 91 lh/ko 1/ 47 |
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| 5 | 5 | | H.F. _____ Sec. 2. NEW SECTION . 35A.23 Veterans service organization 1 grant program. 2 1. A veterans service organization grant program is 3 established under the administration and control of the 4 department to award grants to veterans service organizations 5 for the purpose of ensuring adequate staff are employed to 6 assist veterans with claims. 7 2. A veterans service organization grant fund is created 8 within the state treasury under the control of the department. 9 The fund shall consist of moneys appropriated to the fund by 10 the general assembly and any other moneys available to and 11 obtained or accepted by the department for deposit in the fund. 12 All moneys in the fund are appropriated to the department for 13 purposes of administering the program and providing grants 14 under the program. Notwithstanding section 8.33, moneys in 15 the fund that remain unencumbered or unobligated at the close 16 of a fiscal year shall not revert but shall remain available 17 for expenditure for the purposes designated. Notwithstanding 18 section 12C.7, subsection 2, interest or earnings on moneys in 19 the fund shall be credited to the fund. 20 3. a. In administering the program, the department shall 21 award matching funds to veterans service organizations for the 22 purpose of employing staff to assist veterans with claims. 23 b. To receive a grant, a veterans service organization shall 24 demonstrate that moneys have been budgeted and will be expended 25 by the veterans service organization in the amount required to 26 provide matching funds for each staff position for which grant 27 moneys are sought. 28 c. For purposes of this section, veterans service 29 organization means an organization recognized by the United 30 States department of veterans affairs pursuant to 38 C.F.R. 31 14.628(c). 32 4. The department shall adopt rules pursuant to chapter 17A 33 as necessary to implement and administer the program. 34 DIVISION II 35 -2- LSB 1004YC (14) 91 lh/ko 2/ 47 |
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| 7 | 7 | | H.F. _____ AGING AND DISABILITY SERVICES FY 2025-2026 1 Sec. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES AGING 2 AND DISABILITY SERVICES. There is appropriated from the 3 general fund of the state to the department of health and human 4 services for the fiscal year beginning July 1, 2025, and ending 5 June 30, 2026, the following amount, or so much thereof as is 6 necessary, to be used for the purposes designated: 7 For aging programs for the department of health and human 8 services and area agencies on aging to provide citizens of 9 Iowa who are 60 years of age and older with case management; 10 for Iowas aging and disabilities resource centers; for the 11 return to community program; for the purposes of chapter 231E; 12 to administer the prevention of elder abuse, neglect, and 13 exploitation program pursuant to section 231.56A, in accordance 14 with the requirements of the federal Older Americans Act of 15 1965, 42 U.S.C. 3001 et seq., as amended; for the operation 16 of the dependent adult abuse services program pursuant to 17 chapter 235B; for other services which may include but are not 18 limited to adult day care, respite care, chore, information 19 and assistance, and material aid; for information and options 20 counseling for persons with disabilities; and for salaries, 21 support, administration, maintenance, and miscellaneous 22 purposes, and for not more than the following full-time 23 equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,208,822 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 88.00 26 1. Moneys appropriated in this section may be used to 27 supplement federal moneys received under federal regulations. 28 To receive moneys appropriated in this section, a local area 29 agency on aging shall match the moneys with moneys from other 30 sources according to rules adopted by the department. Moneys 31 appropriated in this section may be used for services not 32 specifically enumerated in this section only if approved by the 33 department as part of an area agency on agings area plan. 34 2. Of the moneys appropriated in this section, $949,282 35 -3- LSB 1004YC (14) 91 lh/ko 3/ 47 |
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| 9 | 9 | | H.F. _____ shall be used for the family support center component of the 1 comprehensive family support program under section 225C.47. 2 3. Of the moneys appropriated in this section, $33,632 shall 3 be used to build 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 15, 1994). 7 4. Of the moneys appropriated in this section, $100,000 8 shall be used by the department of health and human services 9 for a dementia services coordinator position. The duties of 10 the dementia services coordinator shall include but are not 11 limited to all of the following: 12 a. Coordinating state-funded and privately funded dementia 13 services within the state. 14 b. Coordinating the implementation of the Alzheimers 15 disease and related dementias state plan. 16 c. Assessing and analyzing dementia-related data collected 17 by the state. 18 d. Evaluating state-funded dementia services. 19 e. Identifying and supporting the development of 20 dementia-specific trainings. 21 f. Performing other duties as may be required to ensure the 22 state is addressing Alzheimers and related dementias. 23 DIVISION III 24 BEHAVIORAL HEALTH FY 2025-2026 25 Sec. 4. DEPARTMENT OF HEALTH AND HUMAN SERVICES 26 BEHAVIORAL HEALTH. There is appropriated from the general fund 27 of the state to the department of health and human services for 28 the fiscal year beginning July 1, 2025, and ending June 30, 29 2026, the following amount, or so much thereof as is necessary, 30 to be used for the purposes designated: 31 For behavioral health prevention, treatment, and recovery 32 efforts to reduce the prevalence of the use of, provide 33 treatment for, and support recovery from alcohol, tobacco, and 34 substance use and misuse, problem gambling, and other addictive 35 -4- LSB 1004YC (14) 91 lh/ko 4/ 47 |
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| 11 | 11 | | H.F. _____ behaviors. Activities shall align with accepted best practice 1 guidance standards for behavioral health including those 2 published by the centers for disease control and prevention of 3 the United States department of health and human services, and 4 the substance abuse and mental health services administration 5 of the United States department of health and human services, 6 for health promotion; universal, selective, and indicated 7 prevention; treatment; and recovery services and supports; and 8 shall include a 24-hour helpline, public information resources, 9 professional training, youth prevention, program evaluation, 10 and efforts at the state and local levels, and for not more 11 than the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,400,114 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 71.00 14 1. Of the moneys appropriated in this section, $300,000 15 shall be used to support the work of the childrens behavioral 16 health system including evidence-based behavioral health 17 prevention, treatment, and recovery services and supports for 18 children and their families pursuant to the intent specified in 19 section 225C.6B, subsection 1. 20 2. Of the moneys appropriated in this section, $950,000 21 shall be used for an integrated substance use disorder managed 22 care system. The department shall maintain the level of mental 23 health and substance use disorder treatment services provided 24 by the managed care contractors, and shall take the steps 25 necessary to continue the federal waivers as needed to maintain 26 the level of services. 27 Sec. 5. DEPARTMENT OF HEALTH AND HUMAN SERVICES SPORTS 28 WAGERING RECEIPTS FUND. There is appropriated from the 29 sports wagering receipts fund created in section 8.57I, to the 30 department of health and human services for the fiscal year 31 beginning July 1, 2025, and ending June 30, 2026, the following 32 amount, or so much thereof as is necessary, to be used for 33 behavioral health prevention, treatment, and recovery efforts 34 to reduce the prevalence of the use of, provide treatment for, 35 -5- LSB 1004YC (14) 91 lh/ko 5/ 47 |
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| 13 | 13 | | H.F. _____ and support recovery from alcohol, tobacco, and substance use 1 and misuse, problem gambling, and other addictive behaviors: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 3 DIVISION IV 4 PUBLIC HEALTH FY 2025-2026 5 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC 6 HEALTH. There is appropriated from the general fund of the 7 state to the department of health and human services for the 8 fiscal year beginning July 1, 2025, and ending June 30, 2026, 9 the following amount, or so much thereof as is necessary, to be 10 used for the purposes designated: 11 For programs that support health promotion, protect the 12 health and safety of the public, conduct disease surveillance 13 and investigation to reduce the incidence of morbidity and 14 mortality, serve individuals with chronic conditions including 15 but not limited to cancer, support the Iowa donor registry as 16 specified in section 142C.18, and strengthen the health care 17 delivery system and workforce to improve health outcomes for 18 all Iowans, and for not more than the following full-time 19 equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,037,821 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 286.00 22 1. Of the moneys appropriated in this section, the following 23 amounts are allocated to the department of health and human 24 services to be used as follows to support the goals of 25 increased access, health system integration, and engagement: 26 a. $600,000 for distribution to a nonprofit organization 27 that established the first statewide drug donation repository 28 for continuation of the pharmaceutical infrastructure for 29 safety net providers established as described in 2007 Iowa 30 Acts, chapter 218, section 108, and for the prescription drug 31 donation repository program established in chapter 135M. 32 Moneys under this paragraph shall be distributed in their 33 entirety on July 1, 2025, for the purpose specified. 34 b. $374,000 for distribution to free clinics, as defined in 35 -6- LSB 1004YC (14) 91 lh/ko 6/ 47 |
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| 15 | 15 | | H.F. _____ section 135.24, and a nonprofit organization that facilitates 1 the initiation, operation, and collaboration of free clinics 2 for necessary infrastructure, statewide coordination, provider 3 recruitment, service delivery, e-prescribing capacity, and 4 provision of assistance to patients in securing a medical home. 5 Moneys under this paragraph shall be distributed in their 6 entirety on July 1, 2025, for the purpose specified. 7 c. $25,000 for distribution to an organization that raises 8 awareness about issues related to rural health clinics, and 9 necessary infrastructure and service delivery transformation. 10 Moneys under this paragraph shall be distributed in their 11 entirety on July 1, 2025, for the purpose specified. 12 d. $225,000 for distribution to an organization that is 13 the oldest continuously operating medical society in the state 14 for continuation of safety net provider patients access to 15 specialty care as described in 2007 Iowa Acts, chapter 218, 16 section 109. Moneys under this paragraph shall be distributed 17 in their entirety on July 1, 2025, for the purpose specified. 18 2. Of the moneys appropriated in this section, $600,000 19 shall be used for rural psychiatric residencies for residents 20 selected on or before June 30, 2025. 21 3. The university of Iowa hospitals and clinics under 22 the control of the state board of regents shall not receive 23 indirect costs from the moneys appropriated in this section. 24 The university of Iowa hospitals and clinics billings to the 25 department shall be, at a minimum, on a quarterly basis. 26 4. Of the moneys appropriated in this section, $20,000 shall 27 be used to make radon test kits available, free of charge, to 28 homeowners and renters in the state. The department shall 29 provide a link on the departments internet site for homeowners 30 and renters in the state to order radon test kits. 31 5. Of the moneys appropriated in this section, $1,000,000 32 shall be used to provide grants to support the double up 33 food bucks program administered by the Iowa healthiest state 34 initiative to make fresh fruits and vegetables sold at farmers 35 -7- LSB 1004YC (14) 91 lh/ko 7/ 47 |
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| 17 | 17 | | H.F. _____ markets, grocery stores, and other participating locations 1 accessible to individuals and families who reside in this 2 state and receive assistance through the federal supplemental 3 nutrition assistance program. 4 DIVISION V 5 COMMUNITY ACCESS AND ELIGIBILITY FY 2025-2026 6 Sec. 7. DEPARTMENT OF HEALTH AND HUMAN SERVICES COMMUNITY 7 ACCESS AND ELIGIBILITY. There is appropriated from the 8 general fund of the state to the department of health and human 9 services for the fiscal year beginning July 1, 2025, and ending 10 June 30, 2026, the following amount, or so much thereof as is 11 necessary, to be used for the purposes designated: 12 To be used for salaries, support, maintenance, and 13 miscellaneous purposes and for family investment program (FIP) 14 assistance in accordance with chapter 239B, and for other costs 15 associated with providing needs-based benefits or assistance 16 including but not limited to maternal and child health, oral 17 health, obesity prevention, the promotion of independence 18 and self-sufficiency through employment, job opportunities 19 and the basic skills (PROMISE JOBS) program, supplemental 20 nutrition assistance program (SNAP) employment and training, 21 the FIP diversion program, family planning, rent reimbursement, 22 and eligibility determinations for medical assistance, food 23 assistance, and the childrens health insurance program, and 24 for not more than the following full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 68,043,944 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 948.00 27 1. Of the child support collections assigned under FIP, 28 the federal share of the child support collections shall be 29 credited to the child support services appropriation made in 30 this division of this Act. Of the remainder of the child 31 support collections assigned under FIP, a portion shall be 32 credited to community access and eligibility, and the remaining 33 moneys may be used to increase recoveries, to sustain cash flow 34 in the collection services center refund account as provided in 35 -8- LSB 1004YC (14) 91 lh/ko 8/ 47 |
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| 19 | 19 | | H.F. _____ section 252B.13A, or for technology needs. If child support 1 collections assigned under FIP are greater than estimated or 2 are otherwise determined not to be required for maintenance of 3 efforts, the state share of either amount is appropriated to 4 the department for child support services as described in this 5 Act, or may be transferred to or retained in the collection 6 services center refund account. 7 2. Of the moneys appropriated in this section, $3,075,000 8 shall be used for continuation of the departments initiative 9 to provide for adequate developmental surveillance and 10 screening during a childs first five years. The moneys shall 11 be used first to fully fund the current participating counties 12 to ensure that those counties are fully operational, with 13 the remaining moneys to be used for expanding participation 14 to additional counties. Full implementation and expansion 15 shall include enhancing the scope of the initiative through 16 collaboration with child health specialty clinics to promote 17 the use of developmental surveillance and screening to 18 support healthy child development through early identification 19 and response to both biomedical and social determinants of 20 healthy development by providing practitioner consultation 21 and continuous improvement through training and education, 22 particularly for children with behavioral conditions and 23 needs. The department shall also collaborate with the Medicaid 24 program and child health specialty clinics to assist in 25 coordinating the activities of the first five initiative into 26 the establishment of patient-centered medical homes developed 27 to improve health quality and population health while reducing 28 health care costs. To the maximum extent possible, moneys 29 allocated in this subsection shall be utilized as matching 30 moneys for Medicaid program reimbursement. 31 3. Of the moneys appropriated in this section, $1,145,102 32 is allocated to the Iowa commission on volunteer service for 33 programs and grants. 34 4. The university of Iowa hospitals and clinics under 35 -9- LSB 1004YC (14) 91 lh/ko 9/ 47 |
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| 21 | 21 | | H.F. _____ the control of the state board of regents shall not receive 1 indirect costs from the moneys appropriated in this section. 2 The university of Iowa hospitals and clinics billings to the 3 department shall be, at a minimum, on a quarterly basis. 4 CHILD SUPPORT SERVICES 5 Sec. 8. CHILD SUPPORT SERVICES. There is appropriated from 6 the general fund of the state to the department of health and 7 human services for the fiscal year beginning July 1, 2025, and 8 ending June 30, 2026, the following amount, or so much thereof 9 as is necessary, to be used for the purposes designated: 10 For child support services, including salaries, support, 11 maintenance, and miscellaneous purposes, and for not more than 12 the following full-time equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,434,282 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 464.00 15 1. Federal access and visitation grant moneys shall be used 16 for services designed to increase compliance with the child 17 access provisions of court orders, including but not limited to 18 neutral visitation sites and mediation services. 19 2. The appropriation made to the department for child 20 support services may be used throughout the fiscal year in the 21 manner necessary for purposes of cash flow management, and for 22 cash flow management purposes the department may temporarily 23 draw more than the amount appropriated provided the amount 24 appropriated is not exceeded at the close of the fiscal year. 25 TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT 26 Sec. 9. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 27 GRANT. There is appropriated from the special fund created in 28 section 8.41 to the department of health and human services 29 for the fiscal year beginning July 1, 2025, and ending June 30 30, 2026, from moneys received under the federal temporary 31 assistance for needy families (TANF) block grant pursuant 32 to the federal Personal Responsibility and Work Opportunity 33 Reconciliation Act of 1996, Pub. L. No. 104-193, and successor 34 legislation, the following amounts, or so much thereof as is 35 -10- LSB 1004YC (14) 91 lh/ko 10/ 47 |
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| 23 | 23 | | H.F. _____ necessary, to be used for the purposes designated: 1 1. For community access and eligibility, FIP, the PROMISE 2 JOBS program, implementing family investment agreements in 3 accordance with chapter 239B, and for continuation of the 4 program promoting awareness of the benefits of a healthy 5 marriage: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,988,627 7 2. For community access and eligibility to provide 8 pregnancy prevention grants on the condition that family 9 planning services are funded: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 11 Pregnancy prevention grants shall be awarded to programs 12 in existence on or before July 1, 2025, if the programs have 13 demonstrated positive outcomes. Grants shall be awarded 14 to pregnancy prevention programs developed after July 1, 15 2025, if the programs are based on existing models that have 16 demonstrated positive outcomes. Grants shall comply with the 17 requirements provided in 1997 Iowa Acts, chapter 208, section 18 14, subsections 1 and 2, including the requirement that a 19 program awarded a grant must emphasize sexual abstinence. 20 Priority in the awarding of grants shall be given to programs 21 that serve areas of the state which demonstrate the highest 22 percentage of unplanned pregnancies of females of childbearing 23 age within the geographic area to be served by the grant. 24 3. For community access and eligibility to meet one of 25 the four purposes of TANF as specified in 45 C.F.R. 260.20, 26 including by modernizing the program to promote economic 27 mobility and self-sufficiency, ensuring that families are able 28 to overcome benefit cliffs, encouraging healthy families, and 29 streamlining service delivery to reduce duplication: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,000,000 31 4. For technology needs related to child support 32 modernization of the Iowa collections and reporting (ICAR) 33 system and for a closed loop referral system for the thrive 34 Iowa program: 35 -11- LSB 1004YC (14) 91 lh/ko 11/ 47 |
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| 25 | 25 | | H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,000,000 1 5. For early intervention and supports for the family 2 development and self-sufficiency (FaDSS) grant program in 3 accordance with section 216A.107: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 5 Of the moneys allocated for the FaDSS grant program in this 6 subsection, not more than 5 percent of the moneys shall be used 7 for administrative purposes. 8 6. For early intervention and supports for child abuse 9 prevention grants: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 11 7. For accountability, compliance, program integrity, 12 technology needs, and other resources necessary to meet 13 federal and state reporting, tracking, and case management 14 requirements, and other departmental needs: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,533,647 16 8. For state child care assistance: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 18 9. For child protective services: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,364,100 20 10. For child protective services for the kinship caregiver 21 payment program: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,000,000 23 DIVISION VI 24 MEDICAL ASSISTANCE PROGRAM STATE SUPPLEMENTARY ASSISTANCE 25 HEALTHY AND WELL KIDS IN IOWA PROGRAM AND OTHER HEALTH-RELATED 26 PROGRAMS FY 2025-2026 27 Sec. 10. MEDICAL ASSISTANCE PROGRAM, STATE SUPPLEMENTARY 28 ASSISTANCE, AND HEALTHY AND WELL KIDS IN IOWA PROGRAM. There 29 is appropriated from the general fund of the state to the 30 department of health and human services for the fiscal year 31 beginning July 1, 2025, and ending June 30, 2026, the following 32 amount, or so much thereof as is necessary, to be used for the 33 purposes designated: 34 For medical assistance program reimbursement and associated 35 -12- LSB 1004YC (14) 91 lh/ko 12/ 47 |
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| 27 | 27 | | H.F. _____ costs as specifically provided in the reimbursement 1 methodologies in effect on June 30, 2025, except as otherwise 2 expressly authorized by law, consistent with federal law and 3 regulations, and contingent upon receipt of approval from the 4 office of the governor of reimbursement for each abortion 5 performed under the medical assistance program; for the state 6 supplementary assistance program; for the health insurance 7 premium payment program; and for maintenance of the healthy and 8 well kids in Iowa (Hawki) program pursuant to chapter 514I, 9 including supplemental dental services, for receipt of federal 10 financial participation under Tit. XXI of the federal Social 11 Security Act, which creates the childrens health insurance 12 program; and for other specified health-related programs: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,899,238,628 14 1. Of the moneys appropriated in this section, 15 $1,833,843,866 is allocated for medical assistance program 16 reimbursement and associated costs. 17 a. Of the moneys allocated in this subsection, $794,859 18 shall be used for the renovation and construction of certain 19 nursing facilities, consistent with chapter 249K. 20 b. Of the moneys allocated in this subsection, $3,383,880 21 shall be used for program administration, outreach, and 22 enrollment activities of the state family planning services 23 program pursuant to section 217.41B, and of this amount, the 24 department may use $200,000 for administrative expenses. 25 2. Iowans support reducing the number of abortions 26 performed in our state. Moneys appropriated under this section 27 shall not be used for abortions, unless otherwise authorized 28 under this section. 29 3. The provisions of this section relating to abortions 30 shall also apply to the Iowa health and wellness plan created 31 pursuant to chapter 249N. 32 4. Of the moneys appropriated in this section, $4,479,762 is 33 allocated for the state supplementary assistance program. 34 5. Of the moneys appropriated in this section, $61,275,000 35 -13- LSB 1004YC (14) 91 lh/ko 13/ 47 |
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| 29 | 29 | | H.F. _____ is allocated for maintenance of the Hawki program pursuant 1 to chapter 514I, including supplemental dental services, for 2 receipt of federal financial participation under Tit. XXI of 3 the federal Social Security Act, which creates the childrens 4 health insurance program. 5 HEALTH PROGRAM OPERATIONS 6 Sec. 11. HEALTH PROGRAM OPERATIONS. There is appropriated 7 from the general fund of the state to the department of health 8 and human services for the fiscal year beginning July 1, 9 2025, and ending June 30, 2026, the following amount, or so 10 much thereof as is necessary, to be used for the purposes 11 designated: 12 For health program operations, and the autism support 13 program under section 225D.2, and for not more than the 14 following full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,652,231 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 82.00 17 1. The department of inspections, appeals, and licensing 18 shall provide all state matching moneys for survey and 19 certification activities performed by the department of 20 inspections, appeals, and licensing. The department of health 21 and human services shall be solely responsible for distributing 22 the federal matching moneys for such activities. 23 2. Of the moneys appropriated in this section, a sufficient 24 amount shall be allocated for the administration of the health 25 insurance premium payment program, including salaries, support, 26 maintenance, and miscellaneous purposes. 27 3. Of the moneys appropriated in this section, $750,000 28 shall be allocated for a nonprofit organization that provides 29 access to emergency poison information and treatment. Pursuant 30 to the directive under 2014 Iowa Acts, chapter 1140, section 31 102, the federal matching moneys available to the nonprofit 32 organization from the department under the federal Childrens 33 Health Insurance Program Reauthorization Act of 2009 shall be 34 subject to the federal administrative cap rule of 10 percent 35 -14- LSB 1004YC (14) 91 lh/ko 14/ 47 |
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| 30 | 30 | | |
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| 31 | 31 | | H.F. _____ applicable to moneys provided under Tit. XXI of the federal 1 Social Security Act and shall be included in the departments 2 calculations of the cap. 3 4. Of the moneys appropriated in this section, $55,000 4 shall be allocated to expand enrollment in the ground emergency 5 medical transportation program pursuant to section 249A.5, if 6 enacted by 2025 Iowa Acts, House File 977. 7 5. Unless otherwise provided by law, if a contract for 8 services provided under this section initially entered into 9 during the fiscal year beginning July 1, 2025, and ending 10 June 30, 2026, provides for an annual increase of the cost of 11 services provided under the contract, the annual increase shall 12 not exceed the amount by which the consumer price index for 13 all urban consumers increased during the immediately preceding 14 calendar year. This subsection shall not affect a contract 15 entered into on or before June 30, 2025, that is for a term of 16 more than one year. 17 HEALTH CARE ACCOUNTS AND FUNDS 18 Sec. 12. PHARMACEUTICAL SETTLEMENT ACCOUNT DEPARTMENT 19 OF HEALTH AND HUMAN SERVICES. There is appropriated from the 20 pharmaceutical settlement account created in section 249A.33 to 21 the department of health and human services for the fiscal year 22 beginning July 1, 2025, and ending June 30, 2026, the following 23 amount, or so much thereof as is necessary, to be used for the 24 purposes designated: 25 Notwithstanding any provision of law to the contrary, to 26 supplement the appropriation made in this Act from the general 27 fund of the state for health program operations under the 28 medical assistance program for the same fiscal year: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 30 Sec. 13. QUALITY ASSURANCE TRUST FUND DEPARTMENT OF 31 HEALTH AND HUMAN SERVICES. Notwithstanding any provision of 32 law to the contrary, and subject to the availability of moneys, 33 there is appropriated from the quality assurance trust fund 34 created in section 249L.4 to the department of health and human 35 -15- LSB 1004YC (14) 91 lh/ko 15/ 47 |
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| 32 | 32 | | |
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| 33 | 33 | | H.F. _____ services for the fiscal year beginning July 1, 2025, and ending 1 June 30, 2026, the following amount, or so much thereof as is 2 necessary, for the purposes designated: 3 To supplement the appropriation made in this Act from the 4 general fund of the state to the department of health and human 5 services for medical assistance for the same fiscal year: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $111,216,205 7 Sec. 14. HOSPITAL HEALTH CARE ACCESS TRUST FUND 8 DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding 9 any provision of law to the contrary, and subject to the 10 availability of moneys, there is appropriated from the hospital 11 health care access trust fund created in section 249M.4 to the 12 department of health and human services for the fiscal year 13 beginning July 1, 2025, and ending June 30, 2026, the following 14 amount, or so much thereof as is necessary, for the purposes 15 designated: 16 To supplement the appropriation made in this Act from the 17 general fund of the state to the department of health and human 18 services for medical assistance for the same fiscal year: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 20 NURSING FACILITIES MEDICAID REIMBURSEMENT METHODOLOGY 21 PROPOSAL 22 Sec. 15. NURSING FACILITIES MEDICAID REIMBURSEMENT 23 METHODOLOGY PROPOSAL. 24 1. By April 1, 2026, the department of health and human 25 services shall develop a reimbursement methodology proposal for 26 reimbursement of nursing facilities under the Medicaid program 27 that includes all of the following: 28 a. A base-rate payment component. 29 b. A quality assurance assessment pass-through component. 30 c. A quality assurance add-on component, which includes a 31 fixed fee payment and a quality-based payment. 32 2. The reimbursement methodology proposal shall include 33 recommendations developed by the department of health and human 34 services, in consultation with stakeholders including the Iowa 35 -16- LSB 1004YC (14) 91 lh/ko 16/ 47 |
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| 34 | 34 | | |
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| 35 | 35 | | H.F. _____ health care association and leadingage Iowa, for specific 1 metrics the department of health and human services will use 2 to determine whether a nursing facility is eligible to receive 3 all or a portion of the quality-based payment portion of the 4 reimbursement to the nursing facility. 5 3. The total state expenditures for reimbursement of 6 nursing facilities under the Medicaid program using the 7 reimbursement methodology proposed in this section shall 8 not exceed the amount appropriated for this purpose for the 9 applicable fiscal year. 10 NURSING FACILITY BED FORECASTING FORMULA 11 Sec. 16. NURSING FACILITY BED FORECASTING FORMULA WORK 12 GROUP. 13 1. The department of health and human services shall 14 establish a work group to make recommendations for a 15 forecasting formula to ensure a sufficient number of nursing 16 facility beds are available to meet the future demand for 17 nursing facility beds. 18 2. The work group shall include all of the following 19 members: 20 a. The director of health and human services, or the 21 directors designee. 22 b. The director of the department of inspections, appeals, 23 and licensing, or the directors designee. 24 c. Multiple representatives of nursing facilities located 25 in this state. 26 d. A representative from each managed care organization 27 acting pursuant to a contract with the department of health and 28 human services to administer the medical assistance program 29 under chapter 249A. 30 e. A representative of appropriate stakeholders as 31 determined by the director of health and human services. 32 3. On or before July 1, 2026, the department of health and 33 human services shall use the recommendations from the work 34 group to develop and implement a forecasting formula to ensure 35 -17- LSB 1004YC (14) 91 lh/ko 17/ 47 |
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| 36 | 36 | | |
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| 37 | 37 | | H.F. _____ a sufficient number of nursing facility beds are available to 1 meet the future demand for nursing facility beds. 2 4. The department of health and human services shall 3 consider the forecasting formula developed and implemented 4 under subsection 3 to complete the formal review of an 5 application for a certificate of need under section 10A.719. 6 PERSONAL NEEDS ALLOWANCE 7 Sec. 17. PERSONAL NEEDS ALLOWANCE. Of the moneys 8 appropriated for the medical assistance program reimbursement 9 and associated costs as specifically provided in the 10 reimbursement methodologies in effect on June 30, 2025, 11 $991,540 shall be allocated to provide for the increased 12 monthly personal needs allowance under section 249A.30A. 13 Sec. 18. Section 249A.30A, Code 2025, is amended to read as 14 follows: 15 249A.30A Medical assistance personal needs allowance. 16 1. The personal needs allowance under the medical 17 assistance program, which may be retained by a person who is a 18 resident of a nursing facility, an intermediate care facility 19 for persons with an intellectual disability, or an intermediate 20 care facility for persons with mental illness, as defined in 21 section 135C.1 , or a person who is a resident of a psychiatric 22 medical institution for children as defined in section 135H.1 , 23 shall be fifty sixty-five dollars per month. 24 2. A resident who has income of less than fifty sixty-five 25 dollars per month shall receive a supplement from the state in 26 the amount necessary to receive a personal needs allowance of 27 fifty dollars per month. The general assembly shall annually 28 appropriate a sufficient amount from the general fund of the 29 state to the department of health and human services for this 30 purpose. 31 DIVISION VII 32 REIMBURSEMENT RATES 33 Sec. 19. REIMBURSEMENT METHODOLOGY. Reimbursement for 34 medical assistance, state supplementary assistance, and social 35 -18- LSB 1004YC (14) 91 lh/ko 18/ 47 |
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| 38 | 38 | | |
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| 39 | 39 | | H.F. _____ service providers and services reimbursed under the purview of 1 the department of health and human services shall remain at the 2 current reimbursement rate, or shall be determined pursuant to 3 the reimbursement methodology in effect on June 30, 2025, with 4 the exception of the following: 5 1. If reimbursement is otherwise negotiated by contract or 6 pursuant to an updated fee schedule. 7 2. As otherwise provided in this division of this Act. 8 Sec. 20. REIMBURSEMENT RATES MEDICAL ASSISTANCE PROGRAM, 9 STATE SUPPLEMENTARY ASSISTANCE, HEALTHY AND WELL KIDS IN 10 IOWA, AND OTHER HEALTH-RELATED PROGRAMS. Of the moneys 11 appropriated for medical assistance program reimbursement and 12 associated costs as specifically provided in the reimbursement 13 methodologies June 30, 2025, the following amounts, or so 14 much thereof as is necessary, are allocated to the department 15 of health and human services to be used for the following 16 purposes: 17 1. a. Notwithstanding any provision of law to the contrary, 18 for the fiscal year beginning July 1, 2025, and ending June 19 30, 2026, the department of health and human services shall 20 rebase case-mix nursing facility rates beginning July 1, 2025, 21 using the Medicaid cost reports on file for the period ending 22 December 31, 2024, to the extent possible within state funding, 23 including no more than $25,000,000 from the allocation provided 24 for medical assistance program reimbursement and associated 25 costs. 26 b. The department of health and human services shall 27 calculate each nursing facilitys case-mix index for the period 28 beginning July 1, 2024, using weighting based on the current 29 patient-driven payment model schedule. Rosters shall be 30 made to show a separate calculation to determine the average 31 case-mix index for a nursing-facility-wide case-mix index, and 32 a case-mix index for the residents of a nursing facility who 33 are Medicaid recipients using all minimum data set reports by 34 the nursing facility for the previous semiannual period using a 35 -19- LSB 1004YC (14) 91 lh/ko 19/ 47 |
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| 40 | 40 | | |
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| 41 | 41 | | H.F. _____ day weighted calculation. 1 2. For the fiscal year beginning July 1, 2025, Medicaid 2 provider and service rates shall be adjusted to 85 percent of 3 the benchmark rates based on the departments 2024 Medicaid 4 rate review for dentists, excluding orthodontic services. 5 3. For the fiscal year beginning July 1, 2025, $420,000 6 shall be used to increase to the extent possible reimbursement 7 rates for maternal health providers compared to the rates in 8 effect on June 30, 2025. 9 4. For the fiscal year beginning July 1, 2025, the pharmacy 10 dispensing fee shall be adjusted to $11.10. The change 11 in dispensing fee shall become effective following federal 12 approval of the Medicaid state plan. 13 5. a. For the fiscal year beginning July 1, 2025, 14 reimbursement rates for home health agencies shall continue to 15 be based on the Medicare low utilization payment adjustment 16 (LUPA) methodology with state geographic wage adjustments, and 17 shall be adjusted to increase the rates to the extent possible. 18 b. For the fiscal year beginning July 1, 2026, and for 19 each fiscal year thereafter, the department shall review the 20 reimbursement rates for home health agencies and pharmacy 21 dispensing fees. 22 6. On or before December 15, 2025, the department shall 23 review the current rate limit calculation and application for 24 special population nursing facility rates. 25 Sec. 21. REIMBURSEMENT RATES CHILD PROTECTIVE 26 SERVICES. Of the moneys appropriated for child, family, and 27 adoption services, the following amounts, or so much thereof 28 as is necessary, are allocated to the department of health and 29 human services for the following purposes: 30 1. For the fiscal year beginning July 1, 2025, $3,245,594 31 shall be used to increase to the extent possible reimbursement 32 rates for qualified residential treatment program providers 33 compared to rates in effect June 30, 2025. 34 2. For the fiscal year beginning July 1, 2025, $1,590,842 35 -20- LSB 1004YC (14) 91 lh/ko 20/ 47 |
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| 42 | 42 | | |
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| 43 | 43 | | H.F. _____ shall be used to increase to the extent possible reimbursement 1 rates for shelter care providers compared to rates in effect 2 June 30, 2025. 3 DIVISION VIII 4 FAMILY WELL-BEING AND PROTECTION FY 2025-2026 5 STATE CHILD CARE ASSISTANCE 6 Sec. 22. STATE CHILD CARE ASSISTANCE. There is appropriated 7 from the general fund of the state to the department of health 8 and human services for the fiscal year beginning July 1, 9 2025, and ending June 30, 2026, the following amount, or so 10 much thereof as is necessary, to be used for the purposes 11 designated: 12 For state child care assistance in accordance with sections 13 237A.13 and 237A.14, and for not more than the following 14 full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 34,966,931 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 38.00 17 1. If the appropriation made for purposes of the state child 18 care assistance program for the fiscal year is determined to 19 be insufficient, it is the intent of the general assembly to 20 appropriate sufficient moneys for the fiscal year to avoid 21 application of waiting list requirements. 22 2. 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 moneys 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 EARLY INTERVENTION AND SUPPORTS 28 Sec. 23. EARLY INTERVENTION AND SUPPORTS. There is 29 appropriated from the general fund of the state to the 30 department of health and human services for the fiscal year 31 beginning July 1, 2025, and ending June 30, 2026, the following 32 amount, or so much thereof as is necessary, to be used for the 33 purposes designated: 34 For promoting optimum health status for children and 35 -21- LSB 1004YC (14) 91 lh/ko 21/ 47 |
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| 44 | 44 | | |
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| 45 | 45 | | H.F. _____ adolescents from birth through 21 years of age, and for 1 families, and for not more than the following full-time 2 equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,277,739 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 25.00 5 1. Of the moneys appropriated in this section, not more 6 than $734,000 shall be used for the healthy opportunities for 7 parents to experience success (HOPES)-healthy families Iowa 8 (HFI) program established pursuant to section 135.106. 9 2. Of the moneys appropriated in this section, $4,313,854 10 is allocated for the FaDSS grant program, and not more than 5 11 percent of the moneys shall be used for administration of the 12 grant program. 13 3. Of the moneys appropriated in this section, $29,256,799 14 shall be deposited in the early childhood Iowa fund created in 15 section 256I.11. 16 4. Of the moneys appropriated in this section, $1,000,000 17 shall be used for the purposes of program administration and 18 provision of pregnancy support services through the more 19 options for maternal support program in accordance with section 20 217.41C. 21 CHILD PROTECTIVE SERVICES 22 Sec. 24. CHILD PROTECTIVE SERVICES. There is appropriated 23 from the general fund of the state to the department of health 24 and human services for the fiscal year beginning July 1, 25 2025, and ending June 30, 2026, the following amount, or so 26 much thereof as is necessary, to be used for the purposes 27 designated: 28 For child, family, and adoption services, and for salaries, 29 support, maintenance, and miscellaneous purposes, and for not 30 more than the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $170,398,711 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 977.00 33 1. Of the moneys appropriated in this section, $1,717,000 34 is allocated specifically for expenditure for the fiscal 35 -22- LSB 1004YC (14) 91 lh/ko 22/ 47 |
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| 46 | 46 | | |
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| 47 | 47 | | H.F. _____ year beginning July 1, 2025, through the decategorization 1 services funding pools and decategorization governance boards 2 established pursuant to section 232.188. 3 2. A portion of the moneys appropriated in this section 4 may be used to provide other resources, based on client need, 5 required to support family preservation, emergency client need, 6 or family reunification efforts. 7 3. Of the moneys appropriated in this section, a sufficient 8 amount is allocated for foster family care, group foster care 9 maintenance and services, shelter care, child welfare emergency 10 services, qualified residential treatment programs, supervised 11 apartment living contracts, and for medical assistance program 12 reimbursement and associated costs. 13 4. Federal moneys received by the state during the fiscal 14 year beginning July 1, 2025, as the result of the expenditure 15 of state moneys appropriated during a previous state fiscal 16 year for a service or activity funded under this section, are 17 appropriated to the department to be used as additional moneys 18 for services and purposes provided for under this section. 19 Notwithstanding section 8.33, moneys appropriated under this 20 subsection that remain unencumbered or unobligated at the close 21 of the fiscal year shall not revert but shall remain available 22 for the purposes designated until the close of the succeeding 23 fiscal year. 24 5. a. Of the moneys appropriated in this section, $748,000 25 is allocated for the payment of the expenses of court-ordered 26 services provided to children who are under the supervision 27 of the department, which expenses are a charge upon the state 28 pursuant to section 232.141, subsection 4. 29 b. Notwithstanding chapter 232 or any other provision of 30 law to the contrary, a district or juvenile court shall not 31 order any service which is a charge upon the state pursuant to 32 section 232.141, subsection 4, if the moneys allocated under 33 paragraph a for court-ordered services are insufficient to 34 pay for the service. 35 -23- LSB 1004YC (14) 91 lh/ko 23/ 47 |
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| 48 | 48 | | |
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| 49 | 49 | | H.F. _____ 6. Of the moneys appropriated in this section, $1,658,000 1 shall be allocated for child protection centers located in Iowa 2 pursuant to the child protection center grant program under 3 section 135.118. The grant amounts under the program shall be 4 equalized so that each center receives a uniform base amount 5 of $245,000, and the remaining moneys are awarded through a 6 funding formula based upon the volume of children served by a 7 center. To increase access to child protection center services 8 for children in rural areas, the funding formula for awarding 9 the remaining moneys shall provide for awarding an enhanced 10 amount to eligible grantees to develop and maintain satellite 11 centers in underserved regions of the state. 12 7. Of the moneys appropriated in this section, $4,359,500 13 is allocated for the preparation for adult living program 14 established pursuant to section 234.46. 15 8. Of the moneys appropriated in this section, up to 16 $227,000 shall be used for the public purpose of continuing a 17 grant to a nonprofit human services organization that provides 18 services to individuals and families in multiple locations in 19 southwest Iowa and Nebraska, for support of a project providing 20 immediate, sensitive support and forensic interviews, medical 21 exams, needs assessments, and referrals for victims of child 22 abuse and their nonoffending family members. 23 9. Of the moneys 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 10. a. Of the moneys appropriated in this section, 28 $39,673,470 is allocated for adoption subsidy payments and 29 related costs. 30 b. Of the moneys allocated in this subsection, $148,232 31 shall be used to increase the adoption subsidy pursuant to 32 section 600.17 by 5 percent compared to the rates in effect on 33 June 30, 2025, for a child adopted after July 1, 2025. 34 c. Any moneys remaining after the allocations under 35 -24- LSB 1004YC (14) 91 lh/ko 24/ 47 |
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| 50 | 50 | | |
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| 51 | 51 | | H.F. _____ paragraphs a and b are designated and allocated as state 1 savings resulting from implementation of the federal Fostering 2 Connections to Success and Increasing Adoptions Act of 2008, 3 Pub. L. No. 110-351, and successor legislation, as determined 4 in accordance with 42 U.S.C. 673(a)(8), and shall be used for 5 post-adoption services and for other purposes allowed under 6 those federal laws, Tit. IV-B or Tit. IV-E of the federal 7 Social Security Act. 8 11. Of the moneys appropriated in this section, a sufficient 9 amount is allocated to support training needs for child welfare 10 providers and to address disproportionality within the child 11 welfare system. 12 12. Of the moneys appropriated in this section, $308,756 13 shall be allocated to increase the foster care reimbursement 14 rates pursuant to section 234.38 by 5 percent compared to the 15 rates in effect on June 30, 2025, not to exceed the maximum 16 reimbursement rate established in section 234.38. 17 13. If a separate funding source is available that reduces 18 the need for state moneys within an allocation under this 19 section, the allocated state moneys may be redistributed to 20 other allocations under this section for the same fiscal year. 21 DIVISION IX 22 STATE-OPERATED SPECIALTY CARE FY 2025-2026 23 Sec. 25. STATE-OPERATED SPECIALTY CARE. There is 24 appropriated from the general fund of the state to the 25 department of health and human services for the fiscal year 26 beginning July 1, 2025, and ending June 30, 2026, the following 27 amount, or so much thereof as is necessary, to be used for the 28 purposes designated: 29 For salaries, support, maintenance, and miscellaneous 30 purposes at institutions under the jurisdiction of the 31 department of health and human services, and for not more than 32 the following full-time equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $102,343,507 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 756.00 35 -25- LSB 1004YC (14) 91 lh/ko 25/ 47 |
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| 52 | 52 | | |
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| 53 | 53 | | H.F. _____ 1. The department shall utilize the moneys appropriated in 1 this section as necessary to maximize bed capacity and to most 2 effectively meet the needs of the individuals served. 3 2. Of the moneys appropriated in this section, the following 4 amounts are allocated to each institution as follows: 5 a. For the state mental health institute at Cherokee: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,738,275 7 b. For the state mental health institute at Independence: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,215,468 9 c. For the civil commitment unit for sexual offenders at 10 Cherokee: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,898,416 12 d. For the state resource center at Woodward: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,217,377 14 e. For the state resource center at Glenwood: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,453,792 16 f. For the state training school at Eldora: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,820,177 18 DIVISION X 19 ADMINISTRATION AND COMPLIANCE FY 2025-2026 20 Sec. 26. ACCOUNTABILITY, COMPLIANCE, AND PROGRAM 21 INTEGRITY. There is appropriated from the general fund of the 22 state to the department of health and human services for the 23 fiscal year beginning July 1, 2025, and ending June 30, 2026, 24 the following amount, or so much thereof as is necessary, to be 25 used for the purposes designated: 26 For accountability, compliance, and program integrity, 27 including salaries, support, maintenance, and miscellaneous 28 purposes, and for not more than the following full-time 29 equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,242,539 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 411.00 32 1. Of the moneys appropriated in this section, $200,000 33 shall be transferred to and deposited in the Iowa ABLE savings 34 plan trust administrative fund created in section 12I.4, to be 35 -26- LSB 1004YC (14) 91 lh/ko 26/ 47 |
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| 54 | 54 | | |
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| 55 | 55 | | H.F. _____ used for implementation and administration activities of the 1 Iowa ABLE savings plan trust. 2 2. Of the moneys appropriated in this section, $2,602,312 3 shall be allocated for foster care review and the court 4 appointed special advocate program, including for salaries, 5 support, maintenance, and miscellaneous purposes. 6 3. Of the moneys appropriated in this section, $1,148,959 7 shall be allocated for the office of long-term care ombudsman 8 for salaries, support, administration, maintenance, and 9 miscellaneous purposes. 10 DIVISION XI 11 DEPARTMENT OF HEALTH AND HUMAN SERVICES TRANSFERS, CASH FLOW, 12 AND NONREVERSIONS FY 2025-2026 13 Sec. 27. DEPARTMENT OF HEALTH AND HUMAN SERVICES TRANSFERS 14 AND CASH FLOW. 15 1. Notwithstanding any provision of law to the contrary, 16 the department of health and human services may transfer moneys 17 appropriated in this Act to support continuing alignment 18 efforts, to maximize federal support in accordance with the 19 departments federal costs allocation plan, and for resources 20 necessary to implement and administer the services for which 21 moneys are appropriated. The department shall report any 22 transfers made pursuant to this subsection to the general 23 assembly. 24 2. If, due to ongoing cost management efforts, the 25 appropriations under this Act for the Medicaid program 26 exceed the associated costs for the Medicaid program for the 27 fiscal year, the department may transfer any savings to the 28 appropriations made in this Act for health program operations, 29 or for accountability, compliance, and program integrity, 30 to defray the costs associated with ongoing cost management 31 efforts. 32 3. Notwithstanding any provision of law to the contrary, 33 the department may transfer moneys appropriated under this Act 34 for child protective services to pay the nonfederal share costs 35 -27- LSB 1004YC (14) 91 lh/ko 27/ 47 |
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| 56 | 56 | | |
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| 57 | 57 | | H.F. _____ of services reimbursed under the medical assistance program, 1 state child care assistance program, or the family investment 2 program which are provided to children who would otherwise 3 receive services paid by the appropriation for child protective 4 services. 5 4. The department may transfer moneys from the temporary 6 assistance for needy families block grant to the federal social 7 services block grant appropriation, and to the child care and 8 development block grant appropriation, in accordance with 9 federal law. 10 5. To the extent the department determines that moneys 11 appropriated under this Act, or allocated for a specific 12 purpose under this Act, will remain unencumbered or unobligated 13 at the close of the fiscal year, such unencumbered or 14 unobligated moneys may be used in the same fiscal year for any 15 other purpose for which the appropriated moneys may be used, or 16 for any other allocation within the same appropriation. 17 6. To the extent the department determines that moneys 18 appropriated under this Act will remain unencumbered or 19 unobligated at the close of the fiscal year, and that services 20 will not be impacted, the department may utilize up to 21 $3,000,000 of such unencumbered or unobligated moneys to 22 develop and support the thrive Iowa program, a closed-loop 23 referral system utilizing a navigator model, that acts as the 24 connection point to link Iowans on an individualized path to 25 prosperity and self-sufficiency to available resources in all 26 sectors of the community. 27 Sec. 28. DEPARTMENT OF HEALTH AND HUMAN SERVICES 28 NONREVERSIONS. 29 1. Notwithstanding section 8.33, moneys appropriated under 30 this Act from the general fund of the state and the temporary 31 assistance for needy families block grant to the department of 32 health and human services for the fiscal year beginning July 1, 33 2025, and ending June 30, 2026, for the purposes of the FaDSS 34 grant program that remain unencumbered or unobligated at the 35 -28- LSB 1004YC (14) 91 lh/ko 28/ 47 |
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| 58 | 58 | | |
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| 59 | 59 | | H.F. _____ close of the fiscal year shall not revert, but shall remain 1 available for expenditure for the purposes designated until the 2 close of the succeeding fiscal year. 3 2. Notwithstanding section 8.33, of the moneys appropriated 4 under this Act from the general fund of the state, the quality 5 assurance trust fund, and the hospital health care access trust 6 fund to the department of health and human services for the 7 fiscal year beginning July 1, 2025, and ending June 30, 2026, 8 for the purposes of the medical assistance program, the amount 9 in excess of actual expenditures for the medical assistance 10 program that remains unencumbered or unobligated at the close 11 of the fiscal year shall not revert, but shall remain available 12 for expenditure for the medical assistance program until the 13 close of the succeeding fiscal year. 14 3. Notwithstanding section 8.33, and notwithstanding the 15 nonreversion amount limitation specified for state resource 16 centers in section 222.92, subsection 4, moneys appropriated 17 under this Act from the general fund of the state to the 18 department of health and human services for the fiscal 19 year beginning July 1, 2025, and ending June 30, 2026, for 20 the purposes of state-operated specialty care that remain 21 unencumbered or unobligated at the close of the fiscal year 22 shall not revert, but shall remain available for expenditure 23 for the purposes designated for subsequent fiscal years. 24 4. Notwithstanding section 8.33, moneys appropriated in 25 this Act from the general fund of the state to the department 26 of health and human services for the fiscal year beginning July 27 1, 2025, and ending June 30, 2026, for the Iowa commission 28 on volunteer service for programs and grants that remain 29 unencumbered or unobligated at the close of the fiscal year 30 shall not revert, but shall remain available for expenditure 31 for the purposes designated for subsequent fiscal years. 32 5. Notwithstanding section 8.33, moneys appropriated under 33 this Act from the general fund of the state to the department 34 of health and human services for the fiscal year beginning July 35 -29- LSB 1004YC (14) 91 lh/ko 29/ 47 |
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| 60 | 60 | | |
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| 61 | 61 | | H.F. _____ 1, 2025, and ending June 30, 2026, and allocated for rural 1 psychiatric residencies that remain unencumbered or unobligated 2 at the close of the fiscal year shall not revert, but shall 3 remain available for expenditure for the purposes designated 4 until the close of the succeeding fiscal year. 5 6. Notwithstanding section 8.33, moneys appropriated 6 under this Act from the general fund of the state to the 7 department of health and human services for the fiscal 8 year beginning July 1, 2025, and ending June 30, 2026, and 9 allocated for adoption subsidy payments and related costs, or 10 for post-adoption services and related allowable purposes, 11 that remain unencumbered or unobligated at the close of the 12 fiscal year shall not revert, but shall remain available for 13 expenditure for the purposes designated until the close of the 14 succeeding fiscal year. 15 DIVISION XII 16 DEPARTMENT OF HEALTH AND HUMAN SERVICES PRIOR APPROPRIATIONS 17 AND OTHER PROVISIONS 18 THRIVE IOWA PROGRAM CLOSED-LOOP REFERRAL SYSTEM 19 Sec. 29. 2024 Iowa Acts, chapter 1157, section 21, 20 subsection 6, is amended to read as follows: 21 6. To the extent the department determines that moneys 22 appropriated under this Act will remain unencumbered or 23 unobligated at the close of the fiscal year or that services 24 will not be impacted, the department may utilize up to 25 $3,000,000 of such unencumbered or unobligated moneys 26 appropriated to develop and support the thrive Iowa program, 27 a closed-loop referral system utilizing a navigator model, 28 that acts as the connection point to link Iowans on an 29 individualized path to prosperity and self-sufficiency 30 to available resources in all sectors of the community. 31 Notwithstanding section 8.33, any moneys utilized for this 32 purpose shall not revert but shall remain available for 33 expenditure for the purposes designated. 34 COMMUNITY ACCESS AND ELIGIBILITY 35 -30- LSB 1004YC (14) 91 lh/ko 30/ 47 |
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| 62 | 62 | | |
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| 63 | 63 | | H.F. _____ Sec. 30. 2024 Iowa Acts, chapter 1157, section 22, is 1 amended by adding the following new subsection: 2 NEW SUBSECTION . 7. Notwithstanding section 8.33, moneys 3 appropriated under this Act from the general fund of the state 4 to the department of health and human services for the fiscal 5 year beginning July 1, 2024, and ending June 30, 2025, and 6 allocated for community access and eligibility that remain 7 unencumbered or unobligated at the close of the fiscal year 8 shall not revert but shall remain available for expenditure for 9 the purposes designated, or are appropriated to the department 10 for any purpose described in this division of this Act or to be 11 used as necessary to enhance the departments accountability, 12 compliance, program integrity, and efficiency, until the close 13 of the succeeding fiscal year. 14 Sec. 31. EFFECTIVE DATE. This division of this Act, being 15 deemed of immediate importance, takes effect upon enactment. 16 Sec. 32. RETROACTIVE APPLICABILITY. This division of this 17 Act applies retroactively to July 1, 2024. 18 DIVISION XIII 19 BEER AND LIQUOR CONTROL FUND BEHAVIORAL HEALTH FUND 20 Sec. 33. 2024 Iowa Acts, chapter 1157, is amended by adding 21 the following new section: 22 NEW SECTION . SEC. 4A. IN LIEU OF STANDING 23 APPROPRIATION. The moneys appropriated and allocated in this 24 division of this Act for purposes of treatment and prevention 25 of substance use and misuse and addictive behaviors are in lieu 26 of the standing appropriation to the department of health and 27 human services pursuant to section 123.17, subsection 5, for 28 the fiscal year beginning July 1, 2024. 29 Sec. 34. 2024 Iowa Acts, chapter 1161, section 14, is 30 amended by striking the section and inserting in lieu thereof 31 the following: 32 SEC. 14. Section 123.17, subsection 5 , Code 2024, is amended 33 to read as follows: 34 5. After any transfer provided for in subsection 3 is 35 -31- LSB 1004YC (14) 91 lh/ko 31/ 47 |
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| 64 | 64 | | |
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| 65 | 65 | | H.F. _____ made, the department shall transfer into a special revenue 1 account in the general fund of the state, a sum of money at 2 least equal to seven percent of the gross amount of sales made 3 by the department from the beer and liquor control fund on a 4 monthly basis but not less than nine million dollars annually. 5 Of the amounts transferred, two one million dollars, plus an 6 additional amount determined by the general assembly, shall be 7 appropriated to the department of health and human services for 8 use by the staff who administer the comprehensive substance use 9 disorder program under chapter 125 for substance use disorder 10 treatment and prevention programs shall be transferred to the 11 behavioral health fund established under section 225A.7 . Any 12 amounts received in excess of the amounts appropriated to the 13 department of health and human services for use by the staff 14 who administer the comprehensive substance use disorder program 15 under chapter 125 transferred to the behavioral health fund 16 shall be considered part of the general fund balance. 17 Sec. 35. EFFECTIVE DATE. This division of this Act, being 18 deemed of immediate importance, takes effect upon enactment. 19 Sec. 36. RETROACTIVE APPLICABILITY. This division of this 20 Act applies retroactively to July 1, 2024. 21 DIVISION XIV 22 REPORT ON NONREVERSION OF MONEYS 23 Sec. 37. REPORT ON NONREVERSION OF MONEYS. The department 24 of health and human services shall report the expenditure of 25 any moneys for which nonreversion authorization was provided 26 for the fiscal year beginning July 1, 2024, and ending June 30, 27 2025, to the general assembly on a quarterly basis beginning 28 October 1, 2025. 29 DIVISION XV 30 EMERGENCY RULES 31 Sec. 38. EMERGENCY RULES. 32 1. If necessary to comply with federal requirements, 33 including time frames, the department of health and human 34 services or the mental health and disability services 35 -32- LSB 1004YC (14) 91 lh/ko 32/ 47 |
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| 66 | 66 | | |
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| 67 | 67 | | H.F. _____ commission shall adopt administrative rules under section 1 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph 2 b, to implement the applicable provisions of this Act. The 3 rules shall be effective immediately upon filing unless a 4 later date is specified in the rules. Any rules adopted in 5 accordance with this section shall also be published as a 6 notice of intended action as provided in section 17A.4. 7 2. If the department of health and human services adopts 8 emergency rules in accordance with this section, or as 9 otherwise directed or authorized by state law, and the rules 10 will result in an increase in expenditures beyond the amount 11 anticipated in the budget for the fiscal year, or if the 12 expenditures were not addressed in the budget for the fiscal 13 year, the department shall notify the general assembly and the 14 department of management concerning the rules and the increase 15 in expenditures. The notification shall be provided at least 16 thirty calendar days prior to the date notice of the rules 17 is submitted to the administrative rules coordinator and the 18 administrative code editor. 19 DIVISION XVI 20 MATTERS RELATED TO AUTISM SPECTRUM DISORDER 21 Sec. 39. Section 225D.2, Code 2025, is amended by adding the 22 following new subsection: 23 NEW SUBSECTION . 4A. The department shall not approve a new 24 application for the autism support program on or after July 25 1, 2025. The department shall continue to provide treatment 26 and make payments pursuant to the program for an eligible 27 individual whose application is approved on or before June 30, 28 2025, if the individual remains eligible for the program. 29 Sec. 40. NEW SECTION . 225D.3 Future repeal. 30 This chapter is repealed July 1, 2027. 31 Sec. 41. Section 514I.5, subsection 4, paragraph c, Code 32 2025, is amended by adding the following new subparagraph: 33 NEW SUBPARAGRAPH . (18) Applied behavior analysis services 34 for the treatment of autism spectrum disorder. 35 -33- LSB 1004YC (14) 91 lh/ko 33/ 47 |
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| 68 | 68 | | |
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| 69 | 69 | | H.F. _____ Sec. 42. TRANSFER OF MONEYS. Upon repeal of chapter 225D on 1 July 1, 2027, any unencumbered and unobligated moneys remaining 2 in the autism support fund created in section 225D.2, are 3 transferred to the Hawki trust fund created in section 514I.11. 4 DIVISION XVII 5 INVOLUNTARY COMMITMENT HEARING TESTIMONY 6 Sec. 43. Section 125.82, subsection 3, Code 2025, is amended 7 to read as follows: 8 3. a. The person who filed the application , and a the 9 licensed physician and surgeon , or osteopathic physician and 10 surgeon, mental health professional, or certified alcohol and 11 drug counselor certified by the nongovernmental Iowa board of 12 certification who has examined the respondent in connection 13 with the commitment hearing , shall be present at the hearing, 14 unless the court for good cause finds that their presence or 15 testimony is not necessary any of the following apply: 16 (1) The court finds for good cause that the presence or 17 testimony of the person who examined the respondent is not 18 necessary. Good cause may include but is not limited to a 19 waiver under subparagraph (3) . 20 (2) The court grants an application to allow a physician 21 assistant licensed under chapter 148C or an advanced registered 22 nurse practitioner licensed under chapter 152 to be present 23 and testify at the hearing on behalf of the licensed physician 24 and surgeon, osteopathic physician and surgeon, mental health 25 professional, or certified alcohol and drug counselor who 26 examined the respondent in connection with the commitment 27 hearing. An application under this subparagraph shall contain 28 all of the following: 29 (a) A sworn statement that the physician assistant or 30 advanced registered nurse practitioner witnessed the physician 31 and surgeon, osteopathic physician and surgeon, mental health 32 professional, or certified alcohol and drug counselor examine 33 the respondent in connection with the commitment hearing. 34 (b) A sworn statement that the physician assistant or 35 -34- LSB 1004YC (14) 91 lh/ko 34/ 47 |
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| 70 | 70 | | |
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| 71 | 71 | | H.F. _____ advanced registered nurse practitioner has reviewed the written 1 report of the examination prepared pursuant to section 125.80. 2 (c) A sworn statement that the physician and surgeon, 3 osteopathic physician and surgeon, mental health professional, 4 or certified alcohol and drug counselor is unable to attend the 5 hearing. 6 (3) The applicant, respondent, and the respondents 7 attorney may waive the presence, televised appearance, or 8 telephonic appearance of the licensed physician and surgeon , or 9 osteopathic physician and surgeon, mental health professional, 10 or certified alcohol and drug counselor who examined the 11 respondent and agree to submit as evidence the written report 12 of the licensed physician and surgeon or osteopathic physician 13 and surgeon, mental health professional, or certified alcohol 14 and drug counselor of examination prepared pursuant to 15 section 125.80 . The respondents attorney shall inform the 16 court if the respondents attorney reasonably believes that 17 the respondent, due to diminished capacity, cannot make an 18 adequately considered waiver decision. Good cause for finding 19 that the testimony of the licensed physician and surgeon or 20 osteopathic physician and surgeon, mental health professional, 21 or certified alcohol and drug counselor who examined the 22 respondent is not necessary may include but is not limited to 23 such a waiver. 24 b. If the court determines that the testimony of the 25 licensed physician and surgeon , or osteopathic physician and 26 surgeon, mental health professional, or certified alcohol and 27 drug counselor is necessary, the court may allow the licensed 28 physician and surgeon , or osteopathic physician and surgeon, 29 mental health professional, or certified alcohol and drug 30 counselor to testify by telephone or televised means. 31 c. The respondent shall be present at the hearing unless 32 prior to the hearing the respondents attorney stipulates in 33 writing that the attorney has conversed with the respondent, 34 and that in the attorneys judgment either the respondent 35 -35- LSB 1004YC (14) 91 lh/ko 35/ 47 |
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| 72 | 72 | | |
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| 73 | 73 | | H.F. _____ cannot make a meaningful contribution to the hearing , or that 1 the respondent has waived the right to be present, and the 2 basis for the attorneys conclusions. A stipulation to the 3 respondents absence shall be reviewed by the court before the 4 hearing, and may be rejected if it appears that insufficient 5 grounds are stated or that the respondents interests would not 6 be served by the respondents absence. 7 Sec. 44. Section 229.12, subsection 3, paragraph b, Code 8 2025, is amended to read as follows: 9 b. (1) The licensed physician or mental health professional 10 who examined the respondent shall be present at the hearing 11 unless the court for good cause finds that the licensed 12 physicians or mental health professionals presence or 13 testimony is not necessary any of the following apply: 14 (a) The court finds for good cause that the licensed 15 physicians or mental health professionals presence is not 16 necessary . Good cause may include but is not limited to a 17 waiver under subparagraph division (c). 18 (b) The court grants an application to allow a physician 19 assistant licensed under chapter 148C or an advanced registered 20 nurse practitioner licensed under chapter 152 to be present 21 and testify at the hearing on behalf of the licensed physician 22 or mental health professional who examined the respondent in 23 connection with the commitment hearing. An application under 24 this subparagraph division shall contain all of the following: 25 (i) A sworn statement that the physician assistant or 26 advanced registered nurse practitioner witnessed the licensed 27 physician or mental health professional examine the respondent. 28 (ii) A sworn statement that the physician assistant or 29 advanced registered nurse practitioner has reviewed the written 30 report of the examination prepared pursuant to section 229.10. 31 (iii) A sworn statement that the licensed physician or 32 mental health professional who examined the respondent is 33 unable to attend the hearing. 34 (c) The applicant, respondent, and the respondents 35 -36- LSB 1004YC (14) 91 lh/ko 36/ 47 |
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| 74 | 74 | | |
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| 75 | 75 | | H.F. _____ attorney may waive the presence, televised appearance, or the 1 telephonic appearance of the licensed physician or mental 2 health professional who examined the respondent and agree to 3 submit as evidence the written report of the licensed physician 4 or mental health professional of the examination prepared 5 pursuant to section 229.10 . The respondents attorney shall 6 inform the court if the respondents attorney reasonably 7 believes that the respondent, due to diminished capacity, 8 cannot make an adequately considered waiver decision. Good 9 cause for finding that the testimony of the licensed physician 10 or mental health professional who examined the respondent is 11 not necessary may include but is not limited to such a waiver. 12 (2) If the court determines that the testimony of the 13 licensed physician or mental health professional is necessary, 14 the court may allow the licensed physician or the mental health 15 professional to testify by telephone or televised means. 16 DIVISION XVIII 17 DISCHARGE OF INVOLUNTARILY COMMITTED PERSONS 18 Sec. 45. Section 125.2, Code 2025, is amended by adding the 19 following new subsections: 20 NEW SUBSECTION . 01. Administrative services organization 21 means the same as defined in section 225A.1. 22 NEW SUBSECTION . 001. Behavioral health district means the 23 same as defined in section 225A.1. 24 Sec. 46. Section 125.85, subsection 4, Code 2025, is amended 25 by striking the subsection. 26 Sec. 47. Section 125.85, Code 2025, is amended by adding the 27 following new subsections: 28 NEW SUBSECTION . 6. Prior to a discharge of a respondent 29 under this section, the facility treating the respondent shall 30 do all of the following: 31 a. Refer the respondent to an administrative services 32 organization for evaluation, system navigation, and 33 postdischarge services. 34 b. Assess the respondent for suicide risk. 35 -37- LSB 1004YC (14) 91 lh/ko 37/ 47 |
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| 76 | 76 | | |
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| 77 | 77 | | H.F. _____ c. Provide the respondent or the respondents legal 1 representative with a discharge report. The discharge report 2 shall include all of the following: 3 (1) The respondents name and address. 4 (2) The dates, times, and locations of all postdischarge 5 appointments scheduled for the respondent. 6 (3) A list of each medication prescribed for the respondent 7 before or during the respondents treatment, including 8 psychiatric and nonpsychiatric medications. 9 (4) Contact information for the administrative services 10 organization to which the respondent was referred under 11 paragraph a . 12 (5) A written patient-centered aftercare plan, including 13 crisis prevention and steps to address the respondents ongoing 14 care needs. 15 (6) (a) Educational materials for the respondent and 16 individuals who are willing to support the respondent after the 17 respondents discharge. 18 (b) Educational materials shall be developed by the 19 department for distribution to facilities. Educational 20 materials shall include but not be limited to all of the 21 following: 22 (i) Descriptions of the symptoms of a substance use 23 disorder. 24 (ii) Warning signs of decompensation. 25 (iii) Information regarding the availability of other 26 educational services, services offered in the respondents 27 community, and services offered statewide. 28 d. Notify all of the following persons: 29 (1) The administrative services organization to which the 30 respondent was referred under paragraph a . 31 (2) The respondents legal guardian, parent, spouse, 32 attorney in fact under chapter 144B, or adult siblings, as 33 applicable. 34 NEW SUBSECTION . 7. a. The administrative services 35 -38- LSB 1004YC (14) 91 lh/ko 38/ 47 |
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| 78 | 78 | | |
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| 79 | 79 | | H.F. _____ organization to which a respondent was referred under 1 subsection 6, paragraph a , shall do all of the following in 2 relation to the discharged respondent: 3 (1) Coordinate postdischarge care, including but not 4 limited to contacting the respondent to ensure the respondent 5 attends scheduled appointments and receives necessary care and 6 services. 7 (2) Follow up with the respondent in a timely manner. 8 Follow-ups shall include but not be limited to home visits, 9 telephone calls, and other means of contacting the respondent. 10 b. An administrative services organization may delegate 11 duties required under this subsection to a managed care 12 organization acting pursuant to a contract with the department 13 to administer the Medicaid program under chapter 249A, if the 14 respondent referred to the administrative services organization 15 qualifies for Medicaid. 16 NEW SUBSECTION . 8. a. Each administrative services 17 organization shall make a quarterly report to the department, 18 and the report shall include all of the following: 19 (1) The number of respondents discharged and referred to 20 the administrative services organization during the reporting 21 period. 22 (2) The outcome of each discharged respondent. 23 (3) Any issues encountered while ensuring each respondents 24 postdischarge continuity of care. 25 b. A report under this section shall be considered a 26 confidential record under section 22.7. 27 c. A report under this section shall comply with the federal 28 Health Insurance Portability and Accountability Act of 1996, 29 Pub. L. No. 104-191. 30 NEW SUBSECTION . 9. Following a respondents discharge from 31 a facility or from treatment, the administrator of the facility 32 shall immediately report the discharge to the court which 33 ordered the respondents commitment or treatment. The court 34 shall issue an order confirming the respondents discharge 35 -39- LSB 1004YC (14) 91 lh/ko 39/ 47 |
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| 80 | 80 | | |
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| 81 | 81 | | H.F. _____ and terminating the proceedings in which the respondents 1 commitment or treatment was ordered. Copies of the order 2 confirming the discharge and terminating the proceedings shall 3 be sent by regular mail to the facility and the respondent. 4 NEW SUBSECTION . 10. The department shall adopt rules 5 pursuant to chapter 17A to implement and administer this 6 section. 7 Sec. 48. Section 229.1, Code 2025, is amended by adding the 8 following new subsections: 9 NEW SUBSECTION . 01. Administrative services organization 10 means the same as defined in section 225A.1. 11 NEW SUBSECTION . 001. Behavioral health district means the 12 same as defined in section 225A.1. 13 Sec. 49. Section 229.16, Code 2025, is amended to read as 14 follows: 15 229.16 Discharge and termination of proceeding. 16 1. When the condition of , in the opinion of the chief 17 medical officer, a patient who is hospitalized pursuant to a 18 report issued whose treatment was recommended under section 19 229.14, subsection 1 , paragraph b , or is receiving treatment 20 pursuant to a report issued under section 229.14, subsection 21 1 , paragraph c , or is in full-time care and custody pursuant 22 to a report issued under section 229.14, subsection 1 , 23 paragraph d , is such that in the opinion of the chief medical 24 officer the patient no longer requires treatment or care for 25 serious mental impairment, the chief medical officer shall 26 tentatively discharge the patient and immediately report that 27 fact the discharge to the court which ordered the patients 28 hospitalization or care and custody treatment . Upon receiving 29 the report, the court shall issue an order confirming the 30 patients discharge from the hospital or from care and custody, 31 as the case may be, and shall terminate terminating the 32 proceedings pursuant to in which the order patients treatment 33 was issued ordered . Copies of the order shall be sent by 34 regular mail to the hospital, the patient, and the applicant if 35 -40- LSB 1004YC (14) 91 lh/ko 40/ 47 |
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| 82 | 82 | | |
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| 83 | 83 | | H.F. _____ the applicant has filed a written waiver signed by the patient. 1 2. If a patient is receiving inpatient care, prior to a 2 discharge of the patient under subsection 1, the facility or 3 hospital treating the patient shall do all of the following: 4 a. Refer the patient to an administrative services 5 organization for evaluation, system navigation, and 6 postdischarge services. 7 b. Assess the patient for suicide risk. 8 c. Provide the patient or the patients legal representative 9 with a discharge report. The discharge report shall include 10 all of the following: 11 (1) The patients name and address. 12 (2) The dates, times, and locations of all postdischarge 13 appointments scheduled for the patient. 14 (3) A list of each medication prescribed for the patient 15 before or during the patients treatment, including psychiatric 16 and nonpsychiatric medications. 17 (4) Contact information for the administrative services 18 organization to which the patient was referred under paragraph 19 a . 20 (5) A written patient-centered aftercare plan, including 21 crisis prevention and steps to address the patients ongoing 22 care needs. 23 (6) (a) Educational materials for the patient and 24 individuals who are willing to support the patient after the 25 patients discharge. 26 (b) Educational materials shall be developed by the 27 department for distribution to facilities and hospitals 28 treating persons with a mental illness. Educational materials 29 shall include but not be limited to all of the following: 30 (i) Descriptions of the symptoms of mental illness. 31 (ii) Warning signs of decompensation. 32 (iii) Information regarding the availability of other 33 educational services, services offered in the patients 34 community, and services offered statewide. 35 -41- LSB 1004YC (14) 91 lh/ko 41/ 47 |
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| 84 | 84 | | |
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| 85 | 85 | | H.F. _____ d. Notify all of the following persons: 1 (1) The administrative services organization to which the 2 patient was referred under paragraph a . 3 (2) The patients legal guardian, parent, spouse, attorney 4 in fact under chapter 144B, or adult siblings, as applicable. 5 3. a. The administrative services organization to which a 6 patient was referred under subsection 2, paragraph a , shall do 7 all of the following in relation to the discharged patient: 8 (1) Coordinate postdischarge care, including but not 9 limited to contacting the patient to ensure the patient 10 attends scheduled appointments and receives necessary care and 11 services. 12 (2) Follow up with the patient in a timely manner. 13 Follow-ups shall include but not be limited to home visits, 14 telephone calls, and other means of contacting the patient. 15 b. An administrative services organization may delegate 16 duties required under this subsection to a managed care 17 organization acting pursuant to a contract with the department 18 to administer the Medicaid program under chapter 249A, if the 19 patient referred to the administrative services organization 20 qualifies for Medicaid. 21 4. a. Each administrative services organization shall make 22 a quarterly report to the department, and the report shall 23 include all of the following: 24 (1) The number of patients discharged and referred to the 25 administrative services organization during the reporting 26 period. 27 (2) The outcomes of each discharged patient. 28 (3) Any issue encountered while ensuring each patients 29 postdischarge continuity of care. 30 b. A report under this section shall be considered a 31 confidential record under section 22.7. 32 c. A report under this section shall comply with the federal 33 Health Insurance Portability and Accountability Act of 1996, 34 Pub. L. No. 104-191. 35 -42- LSB 1004YC (14) 91 lh/ko 42/ 47 |
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| 86 | 86 | | |
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| 87 | 87 | | H.F. _____ 5. The department shall adopt rules pursuant to chapter 17A 1 to implement this section. 2 DIVISION XIX 3 MEDICAL RESIDENCY AND FELLOWSHIP POSITIONS RESIDENTS OF IOWA 4 Sec. 50. Section 262.9, subsection 39, paragraph e, 5 subparagraph (2), if enacted by 2025 Iowa Acts, House File 516, 6 section 1, is amended to read as follows: 7 (2) An individual who has lived in Iowa for at least four 8 consecutive years immediately preceding the date the individual 9 applies for admission to begins classes at the college of 10 medicine in the doctor of medicine program or the college of 11 dentistry at the state university of Iowa, or for begins a 12 residency at the university of Iowa hospitals and clinics. 13 DIVISION XX 14 MAINTENANCE AND COSTS OF JUVENILE HOMES 15 Sec. 51. Section 232.142, subsection 6, paragraph b, Code 16 2025, is amended to read as follows: 17 b. (1) Moneys deposited in the juvenile detention home 18 fund during a fiscal year are appropriated to the department 19 for the same fiscal year for distribution of an amount equal to 20 a percentage of the costs of the establishment, improvement, 21 operation, and maintenance of county or multicounty juvenile 22 detention homes in the prior immediately preceding fiscal year. 23 Such percentage shall be determined by the department based on 24 the amount available for distribution from the fund. 25 (2) Moneys appropriated for distribution in accordance with 26 this subsection shall be allocated among eligible detention 27 homes, as follows: 28 (a) One hundred twenty-five thousand dollars shall be 29 distributed to each eligible county or multicounty juvenile 30 detention home. 31 (b) Appropriated moneys remaining after the distribution 32 in subparagraph division (a) shall be prorated and distributed 33 on the basis of an eligible county or multicounty juvenile 34 detention homes proportion of the costs of all eligible 35 -43- LSB 1004YC (14) 91 lh/ko 43/ 47 |
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| 88 | 88 | | |
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| 89 | 89 | | H.F. _____ county or multicounty juvenile detention homes in the prior 1 immediately preceding fiscal year. 2 DIVISION XXI 3 HOSPITAL DIRECTED PAYMENT PROGRAM 4 Sec. 52. NEW SECTION . 249O.1 Definitions. 5 As used in this chapter, unless the context otherwise 6 requires: 7 1. Centers for Medicare and Medicaid services means the 8 centers for Medicare and Medicaid services of the United States 9 department of health and human services. 10 2. Department means the department of health and human 11 services. 12 3. Hospital means a nonstate-owned hospital licensed by 13 the state. 14 4. Hospital directed payment program means a program that 15 provides a state directed payment to a hospital for inpatient 16 and outpatient hospital services. 17 5. State directed payment means the same as defined in 42 18 C.F.R. 438.2. 19 Sec. 53. NEW SECTION . 249O.2 Hospital directed payment 20 program. 21 1. Prior to the department administering a hospital 22 directed payment program under this chapter for any specific 23 fiscal year, the department shall submit any authorizing 24 documentation necessary to the centers for Medicare and 25 Medicaid services for approval. Upon receipt of approval from 26 the centers for Medicare and Medicaid services, the department 27 shall administer the hospital directed payment program during 28 the specified fiscal year. 29 2. a. For the sole purpose of the hospital directed payment 30 program, the department may impose an assessment on a hospital. 31 The total amount of assessments collected by the department 32 shall not exceed the amount necessary to fully fund the 33 nonfederal share of the maximum state directed payment allowed 34 under federal regulations. 35 -44- LSB 1004YC (14) 91 lh/ko 44/ 47 |
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| 90 | 90 | | |
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| 91 | 91 | | H.F. _____ b. The department shall establish requirements for timely 1 payment of an assessment, and any penalties for late payment 2 or nonpayment of an assessment. Any assessment imposed under 3 this section shall constitute a debt due the state and may be 4 collected by civil action under any method provided by law. 5 c. The department and a third-party administrator contracted 6 with the department may collectively assess and collect an 7 administrative fee of no more than four percent of the amount 8 of each assessment imposed. 9 3. Any assessments and penalties collected under this 10 section shall be used for the purposes of the hospital directed 11 payment program. 12 4. a. The hospital directed payment program shall not 13 be administered, an assessment shall not be imposed, and a 14 hospital shall not be required to pay an assessment if federal 15 financial participation is not available, or if the hospital 16 directed payment program and imposition of an assessment are 17 not approved by the centers for Medicare and Medicaid services. 18 b. If federal law or policy significantly impacts the 19 hospital directed payment program as determined by the 20 department, the department, in collaboration with stakeholders, 21 may terminate the hospital directed payment program. 22 5. The department shall adopt rules pursuant to chapter 17A 23 as necessary to administer this chapter. 24 EXPLANATION 25 The inclusion of this explanation does not constitute agreement with 26 the explanations substance by the members of the general assembly. 27 This bill makes appropriations from the general fund of 28 the state to the department of veterans affairs and to the 29 department of health and human services (HHS) for fiscal 30 year 2025-2026. The appropriations from the general fund 31 of the state to the department of veterans affairs include 32 appropriations for administration, the Iowa veterans home, and 33 the home ownership assistance program. The appropriations from 34 the general fund of the state to HHS include appropriations 35 -45- LSB 1004YC (14) 91 lh/ko 45/ 47 |
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| 92 | 92 | | |
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| 93 | 93 | | H.F. _____ for aging and disability services; behavioral health; public 1 health; community access and eligibility including for child 2 support services; the medical assistance program, state 3 supplementary assistance, the healthy and well kids in Iowa 4 (Hawki) program, and other specified health-related programs 5 including health program operations; reimbursement rates; 6 family well-being and protection including state child 7 care assistance, early intervention and supports, and child 8 protective services; state-operated specialty care; and 9 administration and compliance. 10 The bill also makes appropriations to HHS from the sports 11 wagering receipts fund, the pharmaceutical settlement account, 12 the quality assurance trust fund, and the hospital health care 13 access trust fund. 14 The bill transfers money from the beer and liquor control 15 fund to the behavioral health fund. 16 The bill requires HHS to develop a reimbursement methodology 17 proposal for reimbursement of nursing facilities under the 18 medical assistance program. 19 The bill limits how moneys appropriated to the early 20 childhood Iowa fund shall be used by HHS. 21 The bill repeals the autism support program, requires the 22 Hawki program to cover applied behavior analysis services for 23 the treatment of autism spectrum disorder, and transfers any 24 unencumbered and unobligated moneys remaining in the autism 25 support fund to the Hawki trust fund upon the repeal of the 26 autism support program. 27 The bill allows an assistant or an advanced registered nurse 28 practitioner to testify in an involuntary commitment hearing 29 for a substance abuse disorder or a serious mental impairment. 30 The bill requires a facility or a hospital treating an 31 involuntarily committed person to perform certain actions prior 32 to the discharge of the person, and the referred administrative 33 services organization to coordinate the discharged persons 34 care and provide quarterly reports to HHS. 35 -46- LSB 1004YC (14) 91 lh/ko 46/ 47 |
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| 94 | 94 | | |
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| 95 | 95 | | H.F. _____ The bill amends the definition of resident of Iowa in 2025 1 Iowa Acts, House File 516. 2 The bill amends how moneys in the juvenile detention home 3 fund are allocated under Code section 232.142(6)(b). 4 The bill requires HHS to submit documentation to the federal 5 centers for Medicare and Medicaid services for approval to 6 administer a hospital directed payment program. Upon receipt 7 of approval, the bill permits HHS to administer a hospital 8 directed payment program. HHS may impose an assessment on a 9 hospital. 10 The bill includes transfer, cash flow, and nonreversion 11 provisions, emergency rulemaking authority, and reporting 12 requirements. 13 -47- LSB 1004YC (14) 91 lh/ko 47/ 47 |
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