Senate File 641 - Introduced SENATE FILE 641 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO SF 620) (SUCCESSOR TO SF 582) (SUCCESSOR TO SSB 1171) A BILL FOR An Act relating to matters under the purview of the department 1 of health and human services, including administrative 2 services organizations, child foster care, child and 3 dependent adult abuse, internal audit and examination 4 information, and the region incentive fund in the mental 5 health and disability services regional service fund, 6 health maintenance organizations premium tax, and making 7 appropriations and including effective date and retroactive 8 applicability provisions. 9 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 10 TLSB 1459SW (3) 91 dg/ko
S.F. 641 DIVISION I 1 ADMINISTRATIVE SERVICES ORGANIZATIONS 2 Section 1. Section 97B.1A, subsection 8, paragraph b, Code 3 2025, is amended by adding the following new subparagraph: 4 NEW SUBPARAGRAPH . (10) Employees of an administrative 5 services organization as defined in section 225A.1. 6 Sec. 2. Section 229.1, Code 2025, is amended by adding the 7 following new subsections: 8 NEW SUBSECTION . 2A. Behavioral health district means the 9 same as defined in section 225A.1. 10 NEW SUBSECTION . 7A. Disability access point means an 11 organization designated by the department for a behavioral 12 health district to serve as the primary local access point for 13 individuals with disabilities, and the individuals caregivers, 14 to provide person-centered assistance that facilitates 15 the coordination of the individuals services, simplifies 16 service navigation, and improves overall accessibility to 17 disability-related resources. 18 Sec. 3. Section 229.19, subsection 1, paragraph a, Code 19 2025, is amended by striking the paragraph and inserting in 20 lieu thereof the following: 21 a. (1) The board of supervisors of each county shall 22 appoint an individual to act as an advocate representing the 23 interests of patients involuntarily hospitalized by the court 24 in matters relating to a patients hospitalization or treatment 25 under section 229.14 or 229.15. The individual shall have 26 prior experience advocating for or promoting the welfare and 27 rehabilitation of persons with mental illness. 28 (2) A person appointed under this section shall not be any 29 of the following: 30 (a) An officer or employee of the department. 31 (b) An officer or employee of an administrative services 32 organization. 33 (c) An officer or employee of an agency or facility 34 providing care or treatment to persons with mental illness. 35 -1- LSB 1459SW (3) 91 dg/ko 1/ 33
S.F. 641 (d) An officer or employee of a disability access point. 1 DIVISION II 2 CHILD FOSTER CARE 3 Sec. 4. Section 232.69, subsection 1, paragraph b, 4 subparagraph (9), Code 2025, is amended to read as follows: 5 (9) An employee or operator of a child foster care facility 6 licensed or approved under chapter 237 . 7 Sec. 5. Section 232.78, subsection 8, paragraph a, 8 subparagraph (4), Code 2025, is amended to read as follows: 9 (4) An individual licensed to provide foster care pursuant 10 to licensee or an approved kinship caregiver under chapter 237. 11 If the child is placed with a licensed foster care provider 12 an individual licensee or an approved kinship caregiver , the 13 department shall assign decision-making authority to the foster 14 care provider individual licensee or the approved kinship 15 caregiver for the purpose of applying the reasonable and 16 prudent parent standard during the childs placement. 17 Sec. 6. Section 232.95, subsection 2, paragraph c, 18 subparagraph (4), Code 2025, is amended to read as follows: 19 (4) An individual licensed to provide foster care pursuant 20 to licensee or an approved kinship caregiver under chapter 237. 21 If the child is placed with a licensed foster care provider 22 an individual licensee or an approved kinship caregiver , the 23 department shall assign decision-making authority to the foster 24 care provider individual licensee or approved kinship caregiver 25 for the purpose of applying the reasonable and prudent parent 26 standard during the childs placement. 27 Sec. 7. Section 232.102, subsection 1, paragraph a, 28 subparagraph (4), Code 2025, is amended to read as follows: 29 (4) An individual licensed to provide foster care pursuant 30 to licensee or an approved kinship caregiver under chapter 237. 31 If the child is placed with a licensed foster care provider 32 an individual licensee or an approved kinship caregiver , the 33 department shall assign decision-making authority to the foster 34 care provider individual licensee or approved kinship caregiver 35 -2- LSB 1459SW (3) 91 dg/ko 2/ 33
S.F. 641 for the purpose of applying the reasonable and prudent parent 1 standard during the childs placement. 2 Sec. 8. Section 234.1, subsection 1, paragraph a, 3 subparagraphs (1) and (2), Code 2025, are amended to read as 4 follows: 5 (1) After reaching eighteen years of age, the person has 6 remained continuously and voluntarily under the care of an 7 individual , as defined in section 237.1 , licensed to provide 8 foster care pursuant to licensee or approved kinship caregiver 9 under chapter 237 , or in a supervised apartment living 10 arrangement, in this state. 11 (2) The person aged out of foster care after reaching 12 eighteen years of age and subsequently voluntarily applied 13 for placement with an individual , as defined in section 14 237.1 , licensed to provide foster care pursuant to licensee or 15 approved kinship caregiver under chapter 237 , or for placement 16 in a supervised apartment living arrangement, in this state. 17 Sec. 9. Section 234.7, subsection 1, Code 2025, is amended 18 to read as follows: 19 1. The department shall comply with the provision 20 associated with child foster care licensees provisions under 21 chapter 237 that requires that a childs foster parent require 22 an individual licensee or an approved kinship caregiver to be 23 included in, and be provided timely notice of, planning and 24 review activities associated with the child, including but not 25 limited to permanency planning and placement review meetings, 26 which shall include discussion of the childs rehabilitative 27 treatment needs. 28 Sec. 10. Section 234.39, subsection 2, paragraph b, Code 29 2025, is amended to read as follows: 30 b. This subsection An assignment of support under paragraph 31 a shall not apply when a child is placed with a relative 32 or fictive kin as those terms are defined in section 232.2, 33 who unless the relative or fictive kin is not licensed an 34 individual licensee or an approved kinship caregiver under 35 -3- LSB 1459SW (3) 91 dg/ko 3/ 33
S.F. 641 chapter 237 to provide child foster care . 1 Sec. 11. Section 235A.15, subsection 2, paragraph c, 2 subparagraph (2), Code 2025, is amended to read as follows: 3 (2) To an administrator of a child foster care facility 4 licensed under chapter 237 as defined in section 237.1 if 5 the data concerns a person employed or being considered for 6 employment by the facility. 7 Sec. 12. Section 237.1, Code 2025, is amended to read as 8 follows: 9 237.1 Definitions. 10 As used in this chapter : 11 1. Agency means a person which provides child foster care 12 and which that does not meet the definition of an individual as 13 defined under this section or a kinship caregiver . 14 2. Agency licensee means an agency issued a license under 15 this chapter. 16 3. Approval means the authorization granted to a kinship 17 caregiver by the department through an expedited process under 18 this chapter to provide child foster care, and allows the 19 kinship caregiver to receive maximum financial support and to 20 obtain the information and resources necessary to meet the 21 needs of a child under a court-ordered placement with the 22 kinship caregiver. 23 4. Approved kinship caregiver means a kinship caregiver 24 granted approval under this chapter. 25 5. Child means child the same as defined in section 234.1 . 26 3. 6. Child foster care means the provision of parental 27 nurturing, including but not limited to the furnishing of food, 28 lodging, training, education, supervision, treatment, or other 29 care, to a child on a full-time basis by a person, including a 30 relative or fictive kin of the child if the relative or fictive 31 kin is licensed under this chapter an individual licensee or 32 an approved kinship caregiver , but not including a guardian 33 of the child. Child foster care does not include any of the 34 following care situations: 35 -4- LSB 1459SW (3) 91 dg/ko 4/ 33
S.F. 641 a. Care furnished by an individual person who receives the 1 child of a personal friend as an occasional and personal guest 2 in the individual persons individuals home, free of charge 3 and not as a business. 4 b. Care furnished by an individual person with whom a child 5 has been placed for lawful adoption, unless that adoption is 6 not completed within two years after placement. 7 c. Care furnished by a private boarding school subject to 8 approval by the state board of education pursuant to section 9 256.11 . 10 d. Child care furnished by a child care center, a child 11 development home, or a child care home as those terms are 12 defined in section 237A.1 . 13 e. Care furnished in a hospital licensed under chapter 135B 14 or care furnished in a nursing facility licensed under chapter 15 135C . 16 f. Care furnished by a relative or fictive kin of a child or 17 an individual person with a meaningful relationship with the 18 child where when the child is not under the placement, care, or 19 supervision of the department. 20 4. 7. Department means the department of health and human 21 services. 22 5. 8. Director means the director of health and human 23 services. 24 6. 9. Facility means the personnel, program, physical 25 plant, and equipment of a licensee or approved kinship 26 caregiver. Facility includes a foster family home . 27 7. 10. Fictive kin means the same as defined in section 28 232.2. 29 11. Foster family home means a single-family home 30 environment in which child foster care is provided. 31 12. Individual means an individual a natural person 32 or a married couple who provides child foster care in a 33 single-family home environment and which does not meet the 34 definition of an agency under this section . 35 -5- LSB 1459SW (3) 91 dg/ko 5/ 33
S.F. 641 8. 13. Individual licensee means an individual, including 1 an individual who is a relative or fictive kin, issued a 2 license under this chapter. 3 14. Kinship caregiver means a relative or fictive kin of a 4 child. 5 15. License means the authorization issued to an 6 individual or an agency by the department under this chapter 7 to provide child foster care. 8 16. Licensee means an individual or an agency licensed 9 under this chapter . 10 9. 17. Reasonable and prudent parent standard means 11 the standard characterized by careful and sensible parenting 12 decisions that maintain the health, safety, and best interests 13 of a child, while at the same time encouraging the emotional 14 and developmental growth of a child, that a caregiver caretaker 15 shall use when determining whether to allow a child in child 16 foster care under the placement, care, or supervision of the 17 department to participate in extracurricular, enrichment, 18 cultural, or social activities. For the purposes of this 19 subsection , caregiver caretaker means an individual or an 20 agency licensed under this chapter a licensee with which a 21 child in child foster care has been placed , an approved kinship 22 caregiver with whom a child in child foster care has been 23 placed, or a juvenile shelter care home approved under chapter 24 232 in which a child in child foster care has been placed. 25 18. Relative means an individual related to a child within 26 the fourth degree of consanguinity or affinity by marriage or 27 through adoption. 28 Sec. 13. Section 237.2, Code 2025, is amended to read as 29 follows: 30 237.2 Purpose. 31 It is the policy of this state to provide appropriate 32 protection for children who are separated from the direct 33 personal care of their parents, relatives, fictive kin, or 34 guardians and, as a result, are subject to difficulty in 35 -6- LSB 1459SW (3) 91 dg/ko 6/ 33
S.F. 641 achieving appropriate physical, mental, emotional, educational, 1 or social development. This chapter shall be construed and 2 administered to further that policy by assuring that child 3 foster care is adequately provided by competently staffed and 4 well-equipped child foster care facilities, including but not 5 limited to residential treatment centers, group homes, and 6 foster family homes. 7 Sec. 14. Section 237.3, Code 2025, is amended to read as 8 follows: 9 237.3 Rules. 10 1. Except as otherwise provided by subsections 3 and 4 , 11 the department shall adopt and enforce in accordance with 12 chapter 17A , administrative rules necessary to implement this 13 chapter . Formulation of the rules shall include consultation 14 with representatives of child foster care providers and other 15 persons affected by this chapter . The rules shall encourage 16 the provision of child foster care in a single-family, home 17 environment, exempting the single-family, home facility 18 foster family homes, and shall exempt foster family homes from 19 inappropriate rules. 20 2. Rules applicable relating to individual licensees and 21 agency licensees, as applicable, shall include but are not 22 limited to all of the following : 23 a. Types of facilities which include but are not limited 24 to group foster care facilities and foster family foster care 25 homes. 26 b. The number, qualifications, character, and parenting 27 ability of personnel necessary to assure the health, safety and 28 welfare of children receiving child foster care. 29 c. Programs for education and in-service training of 30 personnel. 31 d. The physical environment of a facility. 32 e. Policies for intake, assessment, admission and discharge. 33 f. Housing, health, safety, and medical care policies 34 for children receiving child foster care. The medical care 35 -7- LSB 1459SW (3) 91 dg/ko 7/ 33
S.F. 641 policies shall include but are not limited to all of the 1 following: 2 (1) Provision by the department to the foster care provider 3 at or before the time of a childs placement of the a childs 4 health records , and any other information possessed or known 5 about the health of the child or about a member of the childs 6 family that pertains to the childs health , from the department 7 to a licensee or an approved kinship caregiver at or before 8 the time of a childs placement with the licensee or approved 9 kinship caregiver . 10 (2) If the health records supplied to the licensee or 11 approved kinship caregiver in accordance with the childs case 12 permanency plan to the foster care provider are incomplete , or 13 the provider licensee or approved kinship caregiver requests 14 specific health information, provision procedures for obtaining 15 additional health information from the childs parent , or other 16 source , and supplying providing the additional information 17 to the foster care provider licensee or approved kinship 18 caregiver . 19 (3) Provision for emergency health coverage of the child 20 while the child is engaged in temporary , out-of-state travel 21 with the childs foster family individual licensee or approved 22 kinship caregiver . 23 g. (1) The adequacy of programs available to children 24 receiving child foster care provided by agencies, including but 25 not limited to: 26 (a) Dietary services. 27 (b) Social services. 28 (c) Activity programs. 29 (d) Behavior management procedures. 30 (e) Educational programs, including , where appropriate, 31 special education as defined in section 256B.2, subsection 1, 32 paragraph b , where appropriate, which are approved by the 33 state board of education. 34 (2) The department shall not promulgate adopt rules 35 -8- LSB 1459SW (3) 91 dg/ko 8/ 33
S.F. 641 which that regulate individual licensees or approved kinship 1 caregivers in the subject areas enumerated in this paragraph 2 g . 3 h. Policies for involvement of biological parents. 4 i. Records a licensee or approved kinship caregiver is 5 required to keep, and reports a licensee or approved kinship 6 caregiver is required to make to the department. 7 j. Prior to the licensing of an individual as a foster 8 family home , completion of a required, written social 9 assessment of the quality of the living situation in the home 10 of the individual an individuals prospective foster family 11 home , and completion of a required compilation of personal 12 references for the individual , other than those references 13 given provided by the individual. 14 k. Elements of a foster care placement agreement outlining 15 rights and responsibilities associated with an individual or 16 kinship caregiver providing family child foster care. The 17 rights and responsibilities shall include but are not limited 18 to all of the following: 19 (1) Receiving information prior to the childs placement 20 regarding risk factors concerning the child that are known to 21 the department, including but not limited to notice if the 22 child is required to register under chapter 692A . 23 (2) Having regularly scheduled meetings with each case 24 manager assigned to the child. 25 (3) Receiving access to any reports prepared by a service 26 provider who is working with the child unless the access is 27 prohibited by state or federal law. 28 3. Rules governing fire safety in facilities with a facility 29 in which child foster care is provided by agencies an agency 30 shall be promulgated adopted by the director of the department 31 of inspections, appeals, and licensing pursuant to section 32 10A.511 , after consultation with the director. 33 4. Rules governing sanitation, water, and waste disposal 34 standards for facilities shall be promulgated adopted by the 35 -9- LSB 1459SW (3) 91 dg/ko 9/ 33
S.F. 641 department pursuant to section 135.11 , after consultation with 1 the director . 2 5. In case of a conflict between rules promulgated adopted 3 pursuant to subsections 3 and 4 and local rules ordinances , the 4 more stringent requirement applies shall apply . 5 6. Rules of adopted by the department shall not prohibit 6 the licensing , as foster family homes, of individuals who are 7 a departmental employees employee not directly engaged in the 8 administration of the child foster care program pursuant to 9 this chapter , as an individual licensee . 10 7. If an agency is accredited by the joint commission on 11 the accreditation of health care organizations under the joint 12 commissions consolidated standards for residential settings , 13 or by the council on accreditation of services for families and 14 children , the department shall modify the facility licensure 15 standards applied to the agency in order to avoid duplicating 16 duplication of standards applied through accreditation. 17 8. The department, in consultation with the judicial 18 branch, residential treatment providers, the foster care 19 provider association, and other parties which may be affected, 20 shall review the licensing rules pertaining to licensing of 21 residential treatment facilities, and examine whether determine 22 if the rules allow the residential treatment facilities to 23 accept and provide effective treatment to juveniles with 24 serious problems who might not otherwise be placed in those 25 residential treatment facilities. 26 9. The department shall adopt rules specifying that specify 27 the elements of a preadoptive care agreement outlining the 28 rights and responsibilities associated with a person providing 29 preadoptive care, as defined in section 232.2 . 30 10. The department shall adopt rules to administer the 31 exception to the definition of child care in section 237A.1, 32 subsection 2 , paragraph l , allowing allow a child care 33 facility , for purposes of providing to provide respite care 34 to in a foster family home , to provide care, supervision, 35 -10- LSB 1459SW (3) 91 dg/ko 10/ 33
S.F. 641 or guidance of a child for a period of twenty-four hours or 1 more to a child who is placed with the licensed foster family 2 home an individual licensee, as provided in section 237A.1, 3 subsection 2, paragraph l . 4 11. The department shall adopt rules to require the 5 department or a representative of the department to visit a 6 child placed with an individual licensee or approved kinship 7 caregiver within two weeks of the child being placed with the 8 individual licensee or approved kinship caregiver, and at least 9 once each calendar month thereafter. 10 12. The department shall adopt rules that would allow 11 each individual licensees licensee and each approved kinship 12 caregiver to apply the reasonable and prudent parent standard 13 to create opportunities for a child to participate in age or 14 developmentally appropriate activities. 15 Sec. 15. Section 237.4, unnumbered paragraph 1, Code 2025, 16 is amended to read as follows: 17 An individual or an agency , as defined in section 237.1 , 18 shall not provide child foster care unless the individual 19 or agency obtains a license issued under this chapter is 20 a licensee . However, a license under this chapter is not 21 required of the following: 22 Sec. 16. Section 237.4, subsection 8, Code 2025, is amended 23 to read as follows: 24 8. An individual providing child care as a babysitter at the 25 request of a parent, guardian , fictive kin, or relative having 26 lawful custody of the child. 27 Sec. 17. Section 237.5A, Code 2025, is amended to read as 28 follows: 29 237.5A Foster parent training. 30 1. As a condition for initial licensure, each individual 31 licensee shall complete thirty hours of foster parent training 32 offered or approved by the department. However, if the 33 individual licensee has completed relevant training or has a 34 combination of completed relevant training and experience, 35 -11- LSB 1459SW (3) 91 dg/ko 11/ 33
S.F. 641 and the department deems such training or combination to be 1 an acceptable equivalent to all or a portion of the initial 2 licensure training requirement, or based upon the circumstances 3 of the child and the individual licensee the department finds 4 there is other good cause, the department may waive all or 5 a portion of the training requirement. Prior to renewal 6 of licensure, each individual licensee shall also annually 7 complete six hours of foster parent training. The training 8 shall include but is not limited to physical care, education, 9 learning disabilities, referral to and receipt of necessary 10 professional services, behavioral assessment and modification, 11 self-assessment, self-living skills, and biological parent 12 contact. An individual licensee may complete the training as 13 part of an approved training program offered by a public or 14 private agency with expertise in the provision of child foster 15 care or in related subject areas. The department shall adopt 16 rules to implement and enforce this training requirement. 17 2. A An individual licensee who is unable to complete six 18 hours of foster parent training annually prior to licensure 19 renewal because the individual licensee is engaged in active 20 duty in the military service shall be considered to be in 21 compliance with the training requirement for licensure renewal. 22 3. The department or the departments agent shall notify an 23 individual licensee within a reasonable amount of time of any 24 training the department believes would benefit the individual 25 licensee in the provision of child foster care. 26 Sec. 18. NEW SECTION . 237.5B Approved kinship caregiver. 27 1. A kinship caregiver shall not provide child foster care 28 unless the kinship caregiver has been granted approval under 29 this section. 30 2. A kinship caregiver shall apply for approval by 31 submitting a completed application to the department on a form 32 furnished by the department. 33 3. The department, after notice and opportunity for an 34 evidentiary hearing, may deny an application for approval 35 -12- LSB 1459SW (3) 91 dg/ko 12/ 33
S.F. 641 or continued approval if the applicant or approved kinship 1 caregiver violates this chapter or rules adopted pursuant to 2 this chapter. 3 Sec. 19. Section 237.6, Code 2025, is amended to read as 4 follows: 5 237.6 Restricted use of facility. 6 1. A licensee or approved kinship caregiver shall not 7 furnish child foster care in a building or on premises not 8 designated in the licensees license or the kinship caregivers 9 approval . 10 2. A licensee shall not furnish child foster care to a 11 greater number of children than is designated in the licensees 12 license, unless authorized by the department. Multiple 13 3. The department may issue multiple licenses authorizing 14 separate and distinct parts of a an agency licensees facility 15 to provide different categories of child foster care may be 16 issued . 17 Sec. 20. Section 237.8, Code 2025, is amended to read as 18 follows: 19 237.8 Personnel. 20 1. A person shall not be allowed to provide services in a an 21 agency licensees facility if the person has a disease which is 22 transmissible to other persons through required contact in the 23 workplace, which presents a significant risk of infecting other 24 persons, which presents a substantial possibility of harming 25 other persons, or for which no reasonable accommodation can 26 eliminate the risk of infecting other persons. 27 2. a. (1) If a person is being considered for licensure 28 or approval under this chapter , or if a person is being 29 considered for employment involving by an agency licensee and 30 the employment involves direct responsibility for a child or , 31 is in a facility where children reside, by a licensee under 32 this chapter , or if a requires the person will to reside in a 33 facility utilized by a an agency licensee, and if the person 34 has been convicted of a crime or has a record of founded child 35 -13- LSB 1459SW (3) 91 dg/ko 13/ 33
S.F. 641 abuse, the record check evaluation system of the department , 1 and the agency licensee for an a prospective employee of the 2 agency licensee , shall perform an evaluation to determine 3 whether the crime or founded child abuse warrants prohibition 4 of licensure, approval, employment, or residence in the 5 facility. The record check evaluation system shall conduct 6 criminal and child abuse record checks in this state and may 7 conduct these checks in other states. The evaluation shall 8 be performed in accordance with procedures adopted for this 9 purpose by the department. 10 (2) If the criminal and child abuse record checks conducted 11 in this state under subparagraph (1) for an individual a person 12 being considered for licensure as an agency licensee under this 13 chapter , or for employment involving by an agency licensee and 14 the employment involves direct responsibility for a child or , 15 is in a facility where children reside, by a licensee under 16 this chapter , or for an individual who will requires the person 17 to reside in a facility utilized by a an agency licensee, have 18 been completed and the individual person either does not have 19 a record of crime or founded child abuse or the record check 20 evaluation systems evaluation of the record has determined 21 that prohibition of the individuals licensure or employment 22 is not warranted, the individual person may be provisionally 23 approved for licensure or employment licensed or employed 24 pending the outcome of the fingerprint-based criminal history 25 check conducted pursuant to subparagraph (4). 26 (3) An individual A person being considered for licensure 27 as an agency licensee under this chapter , or a person being 28 considered for employment involving by an agency licensee if 29 the employment involves direct responsibility for a child or , 30 is in a facility where children reside, by a licensee under 31 this chapter , or for an individual who will requires the person 32 to reside in a facility utilized by a an agency licensee, shall 33 not be granted a license or be employed and an evaluation shall 34 not be performed under this subsection , if the individual 35 -14- LSB 1459SW (3) 91 dg/ko 14/ 33
S.F. 641 person has been convicted of any of the following felony 1 offenses: 2 (a) Within the five-year period preceding the application 3 date, a drug-related offense. 4 (b) Child endangerment or neglect or abandonment of a 5 dependent person. 6 (c) Domestic abuse. 7 (d) A crime against a child, including but not limited to 8 sexual exploitation of a minor. 9 (e) A forcible felony. 10 (4) If an individual a person is being considered for 11 licensure or approval under this chapter , or if a person is 12 being considered for employment involving by an agency licensee 13 and the employment involves direct responsibility for a child 14 or , is in a facility where children reside, by a licensee under 15 this chapter , or if an individual will requires the person to 16 reside in a facility utilized by a an agency licensee, or if 17 an individual is subject to licensure under this chapter as 18 a foster parent, in addition to the record checks conducted 19 under subparagraph (1), the individuals persons fingerprints 20 shall be provided to the department of public safety for 21 submission through the state criminal history repository to 22 the United States department of justice, federal bureau of 23 investigation for a national criminal history check. The cost 24 of the criminal history check conducted under this subparagraph 25 is shall be the responsibility of the department. 26 (5) If the criminal and child abuse record checks conducted 27 in this state under subparagraph (1) for an individual a person 28 being considered for licensure as a foster parent an individual 29 licensee or for approval as an approved kinship caregiver 30 have been completed and the individual person either does not 31 have a record of crime or founded abuse , or the record check 32 evaluation systems evaluation of the record has determined 33 that prohibition of the individuals persons licensure 34 or approval is not warranted, the individual person may be 35 -15- LSB 1459SW (3) 91 dg/ko 15/ 33
S.F. 641 provisionally approved for licensure licensed or approved 1 pending the outcome of the fingerprint-based criminal history 2 check conducted pursuant to subparagraph (4). 3 (6) An applicant for a license as an individual applying 4 to be a foster parent licensee or for approval as an approved 5 kinship caregiver shall not be granted a license or approval, 6 and an evaluation shall not be performed under this subsection , 7 if the individual applicant has been convicted of any of the 8 following felony offenses: 9 (a) Within the five-year period preceding the application 10 date, a drug-related offense. 11 (b) Child endangerment or neglect or abandonment of a 12 dependent person. 13 (c) Domestic abuse. 14 (d) A crime against a child, including but not limited to 15 sexual exploitation of a minor. 16 (e) A forcible felony. 17 b. Except as otherwise provided in paragraph a , if the 18 record check evaluation system determines that a person has 19 committed a crime or has a record of founded child abuse and 20 is licensed, approved, employed by a an agency licensee, or 21 resides in a licensed facility , the record check evaluation 22 system shall notify the licensee or approved kinship caregiver 23 that an evaluation will be conducted to determine whether 24 prohibition of the persons licensure, approval, employment, or 25 residence is warranted. 26 c. In an evaluation, the record check evaluation system , and 27 the agency licensee for an employee or prospective employee of 28 the agency licensee shall consider the nature and seriousness 29 of the crime or founded child abuse in relation to the position 30 sought or held, the time elapsed since the commission of the 31 crime or founded child abuse, the circumstances under which 32 the crime or founded child abuse was committed, the degree of 33 rehabilitation, the likelihood that the person will commit the 34 crime or founded child abuse again, and the number of crimes 35 -16- LSB 1459SW (3) 91 dg/ko 16/ 33
S.F. 641 or founded child abuses committed by the person involved. The 1 record check evaluation system may permit a person who is 2 evaluated to be licensed, approved, employed, or to reside in a 3 facility , or to continue to be licensed, approved, employed, 4 or to reside in a licensed facility, if the person complies 5 with the record check evaluation systems conditions relating 6 to the persons licensure, approval, employment, or residence, 7 which may include completion of additional training. For an 8 employee or prospective employee of a an agency licensee, 9 these conditional requirements shall be developed with the 10 agency licensee. The record check evaluation system has shall 11 have final authority in determining whether prohibition of 12 the persons licensure, approval, employment, or residence is 13 warranted and in developing any conditional requirements under 14 this paragraph. 15 d. If the record check evaluation system determines that the 16 person has committed a crime or has a record of founded child 17 abuse which that warrants prohibition of licensure, approval, 18 employment, or residence, the person shall not be licensed or 19 approved under this chapter and shall not be employed by a an 20 agency licensee or reside in a licensed facility. 21 3. In addition to the record checks required under 22 subsection 2 , the record check evaluation system may conduct 23 dependent adult abuse record checks in this state and may 24 conduct these checks in other states , on a random basis. The 25 provisions of subsection 2 , relative to an evaluation following 26 a determination that a person has been convicted of a crime 27 or has a record of founded child abuse, shall also apply to a 28 random check conducted under this subsection . 29 4. A An agency licensee shall inform all new applicants 30 for employment of the possibility of the performance of a 31 record check and shall obtain, from the applicant, a signed 32 acknowledgment of the receipt of the information. 33 5. A An agency licensee shall include the following inquiry 34 in an application for employment: 35 -17- LSB 1459SW (3) 91 dg/ko 17/ 33
S.F. 641 Do you have a record of founded child or dependent adult 1 abuse , or have you ever been convicted of a crime, in this 2 state or any other state? 3 Sec. 21. Section 237.9, Code 2025, is amended to read as 4 follows: 5 237.9 Confidential information. 6 A person who receives information from or through the 7 department concerning a child who has received or is receiving 8 child foster care, a relative or guardian of the child, a 9 single-family, home licensee, or an individual employee of 10 a licensee, shall not disclose that information directly or 11 indirectly, except as authorized by section 217.30 , or as 12 authorized or required by section 232.69 . if the information 13 concerns any of the following: 14 1. A child who has received or is receiving child foster 15 care. 16 2. A relative, fictive kin, or guardian of a child who has 17 received or is receiving child foster care. 18 3. An individual licensee. 19 4. An employee of a licensee. 20 5. An approved kinship caregiver. 21 Sec. 22. Section 237.10, Code 2025, is amended to read as 22 follows: 23 237.10 Child foster care providers Individual licensees and 24 approved kinship caregivers . 25 1. a. The department shall notify an individual licensee or 26 approved kinship caregiver of any appropriate meetings relating 27 to the case permanency plan of a child in the care of the 28 individual licensee or approved kinship caregiver . 29 b. The department shall notify an individual licensee 30 or approved kinship caregiver of any meetings known to the 31 department relating to the individualized education program 32 of a child in the care of the individual licensee or approved 33 kinship caregiver . 34 c. The department shall notify an individual licensee or 35 -18- LSB 1459SW (3) 91 dg/ko 18/ 33
S.F. 641 approved kinship caregiver of any medical appointments required 1 or scheduled in consultation with the department relating to 2 a child in the care of the individual licensee or approved 3 kinship caregiver . 4 2. The department or the departments agent may share 5 otherwise confidential information about a child with an 6 individual licensee or approved kinship caregiver being 7 considered as a possible placement for the child to the extent 8 such disclosure is relevant to the placement decision and the 9 proper care of the child. The department or the departments 10 agent may facilitate sharing the contact information of 11 previous individual licensees and approved kinship caregivers 12 for a child with the next individual licensee or approved 13 kinship caregiver in an effort to support the continuity of 14 care for a child. 15 3. Upon placement of a child with an individual licensee 16 or approved kinship caregiver , the department shall provide 17 the individual licensee or approved kinship caregiver with 18 information that would allow the individual licensee or 19 approved kinship caregiver to contact the department or an 20 agent of the department for assistance relating to child foster 21 care. 22 4. Prior to disclosing an individual licensees or approved 23 kinship caregivers private address, work address, or contact 24 information, the department shall evaluate possible safety 25 concerns to determine whether such information may be released 26 without posing a risk to the safety of the individual licensee, 27 the approved kinship caregiver, the child, or any other person. 28 5. The department shall notify an individual licensee or 29 approved kinship caregiver within a reasonable amount of time 30 of any change in a law or regulation rule that would have a 31 substantive impact on the individual licensees or approved 32 kinship caregivers obligations and responsibilities relating 33 to child foster care. 34 6. a. The department shall provide written notice to 35 -19- LSB 1459SW (3) 91 dg/ko 19/ 33
S.F. 641 an individual licensee , or an approved kinship caregiver, a 1 minimum of ten days prior to the removal of a child from the 2 care of the individual licensee or approved kinship caregiver . 3 Such notice shall include the reasons for the childs removal. 4 b. This subsection shall not apply if the health or safety 5 of the child or another person is threatened by the childs 6 presence in the childs current placement home , if the court 7 orders the removal of a child from the individual licensee or 8 the approved kinship caregiver , if the child is absent from the 9 home placement without authorization, if the child is being 10 moved to the home of a biological parent or legal guardian, or 11 if the individual licensee or approved kinship caregiver is 12 alleged to have committed child abuse or neglect. 13 7. a. An individual licensee or approved kinship caregiver 14 shall provide written notice to the department a minimum of ten 15 days prior to a request to remove a child from the individual 16 licensees care or the approved kinship caregivers care . 17 b. This subsection shall not apply to a situation where the 18 health or safety of the child or another person is threatened 19 by the childs presence in the childs current placement home . 20 8. At the conclusion of an investigation conducted by 21 the department that may affect an individual licensees 22 ability , or an approved kinship caregivers ability, to 23 provide child foster care in the future, the department shall 24 provide the individual licensee or approved kinship caregiver 25 with a written report that details the conclusions of the 26 investigation. 27 9. a. The department shall require an individual licensee 28 or approved kinship caregiver to attempt, to the extent 29 reasonably possible, to maintain a childs culture and beliefs. 30 b. An individual licensee or an approved kinship caregiver 31 shall be allowed to provide child foster care, according to 32 the individual licensees or the approved kinship caregivers 33 own culture and beliefs, if such child foster care does not 34 actively discourage a child to disregard the childs own 35 -20- LSB 1459SW (3) 91 dg/ko 20/ 33
S.F. 641 culture and beliefs and a biological parent whose parental 1 rights have not been terminated or a legal guardian for the 2 child does not object to the practice or activity that is 3 consistent with the individual licensees or the approved 4 kinship caregivers own culture and beliefs. 5 10. a. The department or the departments agent shall 6 consider the needs and scheduling demands of a child, the 7 childs parents, the childs siblings, and the individual 8 licensee or approved kinship caregiver caring for the child 9 when scheduling supervised or any other visitation between the 10 child and the childs siblings, family members, or fictive kin. 11 b. The department shall not require an individual licensee 12 or an approved kinship caregiver to conduct , or to be present 13 during , supervised visits scheduled pursuant to paragraph a . 14 11. The department shall accept information from an 15 individual licensee or approved kinship caregiver relating to 16 medical appointments, treatment needs, educational progress, 17 and educational services for a child placed with the individual 18 licensee or approved kinship caregiver . The department shall 19 consider all such information when developing or modifying 20 a childs case permanency plan , and in the coordination of 21 care and decisions related to services and care necessary 22 for the child. The information the department receives from 23 an individual licensees will licensee or an approved kinship 24 caregiver shall be reviewed and considered as decisions about 25 the childs progress and needs are made. 26 12. The department shall maintain a process to allow an each 27 individual licensee and each approved kinship caregiver to file 28 complaints a complaint with the department electronically for 29 an alleged violations violation relating to this section . 30 13. The department shall adopt rules pursuant to chapter 17A 31 to implement this section . 32 Sec. 23. Section 237.13, Code 2025, is amended to read as 33 follows: 34 237.13 Foster family home insurance fund. 35 -21- LSB 1459SW (3) 91 dg/ko 21/ 33
S.F. 641 1. For the purposes of this section , foster home means an 1 individual, as defined in section 237.1, subsection 7 , who is 2 licensed to provide child foster care and shall also be known 3 as a licensed foster home . 4 2. The foster family home insurance fund shall be 5 administered by the department. The fund shall consist of all 6 moneys appropriated by the general assembly for deposit in the 7 fund. The department shall use moneys in the fund to provide 8 home and property coverage for foster parents to cover damages 9 to property resulting from the actions of a foster child 10 residing in a foster family home or to reimburse foster parents 11 for the cost of purchasing foster care liability insurance and 12 to perform the administrative functions necessary to carry out 13 this section . The department may establish limitations of 14 liability for individual claims as deemed reasonable by the 15 department. 16 3. 2. The department shall adopt rules, pursuant to chapter 17 17A , to carry out the provisions of this section . 18 Sec. 24. Section 237.14, Code 2025, is amended to read as 19 follows: 20 237.14 Enhanced child foster care services. 21 The department shall provide for enhanced child foster 22 care services by establishing supplemental per diem or 23 performance-based contracts that include payment of costs 24 relating to payments of principal and interest for bonds and 25 notes issued pursuant to section 16.57 with facilities licensed 26 under this chapter which that provide special services to 27 children who would otherwise be placed in a state juvenile 28 institution or an out-of-state program. Before completion of 29 the departments budget estimate as required by section 8.23 , 30 the department shall determine and include in the estimate the 31 amount which should be appropriated for enhanced child foster 32 care services for the forthcoming fiscal year in order to 33 provide sufficient services. 34 Sec. 25. Section 237.14A, Code 2025, is amended to read as 35 -22- LSB 1459SW (3) 91 dg/ko 22/ 33
S.F. 641 follows: 1 237.14A Reasonable and prudent parent standard immunity 2 from liability. 3 The department, or any individual, kinship caregiver, 4 agency, or juvenile shelter care home that applies the 5 reasonable and prudent parent standard reasonably and in good 6 faith in regard to a child in child foster care shall have 7 immunity from civil or criminal liability which might otherwise 8 be incurred or imposed. This section shall not remove or limit 9 any existing liability protection afforded under any other law. 10 Sec. 26. Section 237.15, subsection 1, paragraph a, Code 11 2025, is amended to read as follows: 12 a. The efforts to place the child with a relative or fictive 13 kin . 14 Sec. 27. Section 237.15, subsection 5, Code 2025, is amended 15 by striking the subsection. 16 Sec. 28. Section 237A.1, subsection 2, paragraph l, Code 17 2025, is amended to read as follows: 18 l. A child care facility providing respite care to a 19 licensed in a foster family home for a period of twenty-four 20 hours or more to a child who is placed with that licensed 21 foster family home an individual licensee under chapter 237 . 22 Sec. 29. Section 237A.3A, subsection 1, paragraph d, Code 23 2025, is amended to read as follows: 24 d. A person who holds a child foster care license licensee 25 or an approved kinship caregiver under chapter 237 shall 26 register as a child development home provider in order to 27 provide child care. 28 Sec. 30. Section 237C.1, subsection 2, paragraph f, Code 29 2025, is amended to read as follows: 30 f. Care furnished by a child foster care facility licensed 31 licensee or approved kinship caregiver under chapter 237. 32 Sec. 31. Section 237C.3, subsection 2, Code 2025, is amended 33 to read as follows: 34 2. Standards established by the department under this 35 -23- LSB 1459SW (3) 91 dg/ko 23/ 33
S.F. 641 chapter shall at a minimum address the basic health and 1 educational needs of children; protection of children from 2 mistreatment, abuse, and neglect; background and records checks 3 of persons providing care to children in facilities certified 4 under this chapter ; the use of seclusion, restraint, or other 5 restrictive interventions; health; safety; emergency; and the 6 physical premises on which care is provided by a childrens 7 residential facility. The background check requirements shall 8 be substantially equivalent to those applied under chapter 9 237 for a child foster care facility provider licensee or an 10 approved kinship caregiver . 11 Sec. 32. Section 282.19, subsection 2, Code 2025, is amended 12 to read as follows: 13 2. A child who is living in a licensed individual or 14 agency child foster care facility , or with an approved kinship 15 caregiver , as those terms are defined in section 237.1, or in 16 an unlicensed relative foster care placement, shall remain 17 enrolled in and attend an accredited school in the school 18 district in which the child resided and is enrolled at the 19 time of placement, unless it is determined by the juvenile 20 court or the public or private agency of this state that has 21 responsibility for the childs placement that remaining in such 22 school is not in the best interests of the child. If such 23 a determination is made, the child may attend an accredited 24 school located in the school district in which the child is 25 living and not in the school district in which the child 26 resided prior to receiving foster care. 27 Sec. 33. Section 335.25, subsection 2, paragraph c, Code 28 2025, is amended to read as follows: 29 c. Family home means a community-based residential home 30 which is licensed as a residential care facility under chapter 31 135C or as a child foster care facility under chapter 237 to 32 provide room and board, personal care, habilitation services, 33 and supervision in a family environment exclusively for not 34 more than eight persons with a developmental disability or 35 -24- LSB 1459SW (3) 91 dg/ko 24/ 33
S.F. 641 brain injury and any necessary support personnel. However, 1 family home does not mean an individual a foster family home 2 licensed under chapter 237 . 3 Sec. 34. Section 414.22, subsection 2, paragraph c, Code 4 2025, is amended to read as follows: 5 c. Family home means a community-based residential home 6 which is licensed as a residential care facility under chapter 7 135C or as a child foster care facility under chapter 237 to 8 provide room and board, personal care, habilitation services, 9 and supervision in a family environment exclusively for not 10 more than eight persons with a developmental disability or 11 brain injury and any necessary support personnel. However, 12 family home does not mean an individual a foster care family 13 home licensed under chapter 237 . 14 Sec. 35. Section 423.3, subsection 18, paragraph b, Code 15 2025, is amended to read as follows: 16 b. Residential facilities in which an agency licensed by the 17 department of health and human services provides child foster 18 care pursuant to chapter 237 , other than those maintained by 19 individuals as defined in section 237.1, subsection 7 . 20 Sec. 36. Section 709.16, subsection 2, paragraph b, 21 subparagraph (1), Code 2025, is amended to read as follows: 22 (1) A child foster care facility licensed under section 23 237.4 chapter 237 . 24 Sec. 37. RULES. The department of health and human services 25 shall adopt rules pursuant to chapter 17A to administer this 26 division of this Act, including rules for the approval of 27 relatives or fictive kin to provide child foster care. 28 DIVISION III 29 CHILD AND DEPENDENT ADULT ABUSE 30 Sec. 38. Section 135.118, Code 2025, is amended by adding 31 the following new subsection: 32 NEW SUBSECTION . 5. The department shall adopt rules 33 pursuant to chapter 17A to administer this section. 34 Sec. 39. Section 235A.1, subsection 1, paragraph b, Code 35 -25- LSB 1459SW (3) 91 dg/ko 25/ 33
S.F. 641 2025, is amended to read as follows: 1 b. Funds for the programs or projects shall be applied 2 for and received by a community-based volunteer coalition or 3 council entity . 4 Sec. 40. Section 235A.15, subsection 1, Code 2025, is 5 amended to read as follows: 6 1. Notwithstanding chapter 22 , the Child abuse information 7 shall be confidential and shall not be a public record under 8 chapter 22. The confidentiality of all child abuse information 9 shall be maintained, except as specifically provided by this 10 section . 11 Sec. 41. Section 235B.2, subsection 5, paragraph a, 12 subparagraph (1), subparagraph division (c), Code 2025, is 13 amended to read as follows: 14 (c) Exploitation of a dependent adult which means the a 15 fraudulent or otherwise illegal, unauthorized, or improper 16 attempt, act , or process of taking unfair advantage by a 17 caretaker or fiduciary to use the physical or financial 18 resources of a dependent adult or the adults physical 19 or financial resources, without the informed consent of 20 the dependent adult, including theft, by the use of undue 21 influence, harassment, duress, deception, false representation, 22 or false pretenses for any of the following purposes: 23 (i) Monetary or personal benefit, profit, or gain. 24 (ii) To deprive the dependent adult of the use of the 25 dependent adults physical or financial resources, including 26 any benefits, belongings, or assets . 27 Sec. 42. Section 235B.3, subsection 7, Code 2025, is amended 28 to read as follows: 29 7. a. Upon a showing of probable cause that a dependent 30 adult has been abused, a court may authorize a person, also 31 authorized by the department, to make an evaluation, to enter 32 the residence of, and to examine the dependent adult. 33 b. Upon a showing of probable cause that there has been 34 exploitation of a dependent adult has been financially 35 -26- LSB 1459SW (3) 91 dg/ko 26/ 33
S.F. 641 exploited , a court may authorize a person, also authorized by 1 the department, to make an evaluation, and to gain access to 2 the financial records that the department reasonably believes 3 are related to the resources of the dependent adult. 4 Sec. 43. Section 235B.6, subsection 1, Code 2025, is amended 5 to read as follows: 6 1. Notwithstanding chapter 22 , the Dependent adult abuse 7 information shall be confidential and shall not be a public 8 record under chapter 22. The confidentiality of all dependent 9 adult abuse information shall be maintained, except as 10 specifically provided by subsections 2 and 3 . 11 Sec. 44. Section 235B.6, subsection 2, paragraph e, 12 subparagraph (2), Code 2025, is amended to read as follows: 13 (2) Registry or department personnel when necessary to 14 the performance of their official duties , or a person , an 15 instrumentality of the state, or an agency under contract with 16 the department to carry out official duties and functions of 17 the registry . 18 Sec. 45. Section 249A.4, Code 2025, is amended by adding the 19 following new subsection: 20 NEW SUBSECTION . 16. Require providers to share information 21 with the department as necessary to identify, prevent, or 22 respond to child abuse as defined in section 232.68, and 23 dependent adult abuse as defined in section 235B.2. 24 DIVISION IV 25 DEPARTMENT OF HEALTH AND HUMAN SERVICES CONFIDENTIALITY OF 26 INTERNAL AUDIT AND EXAMINATION INFORMATION 27 Sec. 46. Section 11.41, subsection 4, paragraph a, Code 28 2025, is amended by adding the following new subparagraph: 29 NEW SUBPARAGRAPH . (10) Information created or received by 30 the department of health and human services in the course of 31 an internal audit or examination, including any allegations 32 of misconduct or noncompliance and all audit or examination 33 workpapers, as specified in section 217.31A. 34 Sec. 47. NEW SECTION . 217.31A Internal audits and 35 -27- LSB 1459SW (3) 91 dg/ko 27/ 33
S.F. 641 examinations confidentiality. 1 1. Information created or received by the department in 2 the course of an internal audit or examination, including any 3 allegations of misconduct or noncompliance, and all audit or 4 examination workpapers, shall be maintained as confidential. 5 2. Information maintained as confidential under subsection 6 1 may be disclosed for any of the following reasons: 7 a. As necessary to complete the audit or examination. 8 b. To the extent the departments auditor is required by law 9 to report the same or to testify in court. 10 DIVISION V 11 REGION INCENTIVE FUND DISTRIBUTIONS AND TRANSFERS 12 Sec. 48. DEPARTMENT OF HEALTH AND HUMAN SERVICES 13 BEHAVIORAL HEALTH SERVICES SYSTEM REGION INCENTIVE FUND. 14 1. For purposes of this section: 15 a. Administrative services organization means the same as 16 defined in 2024 Iowa Acts, chapter 1161, section 1. 17 b. Behavioral health fund means the behavioral health 18 fund established in 2024 Iowa Acts, chapter 1161, section 7, 19 subsection 2. 20 c. Behavioral health services system means the behavioral 21 health services system established in 2024 Iowa Acts, chapter 22 1161, section 3, subsection 1. 23 d. Mental health and disability services system means 24 the mental health and disability services system described in 25 section 225C.6B. 26 2. Notwithstanding any provision of law to the contrary, 27 there is appropriated from the region incentive fund created 28 in section 225C.7A, subsection 8, to the department of health 29 and human services for the fiscal year beginning July 1, 2024, 30 and ending June 30, 2025, an amount necessary to ensure the 31 continuity of care for persons transferring from the mental 32 health and disability services system to the behavioral 33 health services system, and for distribution to administrative 34 services organizations to be used for expenses related to the 35 -28- LSB 1459SW (3) 91 dg/ko 28/ 33
S.F. 641 duties of the administrative services organizations under the 1 behavioral health services system. 2 3. Moneys distributed to and used by an administrative 3 services organization pursuant to subsection 1, shall 4 not be considered in the computation of any limit on the 5 administrative costs of an administrative services organization 6 including those prescribed in 2024 Iowa Acts, chapter 1161, 7 section 7, subsection 5. 8 4. Moneys in the mental health and disability services 9 regional service fund established in section 225C.7A, 10 subsection 1, that remain unencumbered or unobligated on June 11 30, 2025, shall be transferred to the behavioral health fund. 12 Sec. 49. EFFECTIVE DATE. This division of this Act, being 13 deemed of immediate importance, takes effect upon enactment. 14 Sec. 50. RETROACTIVE APPLICABILITY. This division of this 15 Act applies retroactively to July 1, 2024. 16 DIVISION VI 17 HEALTH MAINTENANCE ORGANIZATION APPLICABLE PERCENTAGE FOR 18 PREMIUM TAX 19 Sec. 51. Section 432.1, subsection 2, unnumbered paragraph 20 1, Code 2025, is amended to read as follows: 21 The applicable percent for purposes of subsection 1 of this 22 section , section 432.1B, and section 432.2 is the following: 23 Sec. 52. Section 432.1B, subsection 1, Code 2025, is amended 24 to read as follows: 25 1. Pursuant to section 514B.31, subsection 3 , a health 26 maintenance organization contracting with the department of 27 health and human services to administer the medical assistance 28 program under chapter 249A , shall pay as taxes to the director 29 of the department of revenue for deposit in the Medicaid 30 managed care organization premiums fund created in section 31 249A.13 , an amount equal to two and one-half the applicable 32 percent , as provided in section 432.1, subsection 2, of the 33 premiums received and taxable under section 514B.31, subsection 34 3 . 35 -29- LSB 1459SW (3) 91 dg/ko 29/ 33
S.F. 641 Sec. 53. EFFECTIVE DATE. This division of this Act, being 1 deemed of immediate importance, takes effect upon enactment. 2 Sec. 54. RETROACTIVE APPLICABILITY. This division of this 3 Act applies retroactively to January 1, 2024. 4 EXPLANATION 5 The inclusion of this explanation does not constitute agreement with 6 the explanations substance by the members of the general assembly. 7 This bill relates to matters under the purview of the 8 department of health and human services (HHS). 9 DIVISION I ADMINISTRATIVE SERVICES ORGANIZATIONS. The 10 bill excludes persons employed by an administrative services 11 organization (ASO) from the definition of an employee for the 12 purposes of the Iowa public employees retirement system. 13 The bill defines behavioral health district and 14 disability access point. 15 The bill prohibits an ASO, an officer or an employee of an 16 ASO, or an officer or an employee of a disability access point 17 from acting as a countys advocate to represent the interests 18 of patients involuntarily hospitalized by the court in matters 19 relating to a patients hospitalization or treatment. 20 DIVISION II CHILD FOSTER CARE. Under current law, a 21 persons periodic support payments pursuant to an order or 22 judgment are deemed assigned to HHS if the person is or has a 23 child receiving foster care services. The assignment does not 24 apply when a child is placed with a relative or fictive kin of 25 the child who is not licensed to provide child foster care. 26 The bill permits the assignment unless the relative or fictive 27 kin is not licensed to provide child foster care and is not an 28 approved kinship caregiver. 29 The bill defines approval as the authorization granted 30 to a kinship caregiver by HHS through an expedited process 31 under Code chapter 237 to receive maximum financial support 32 and to obtain the information and resources necessary to meet 33 the needs of a child under a court-ordered placement with the 34 kinship caregiver. 35 -30- LSB 1459SW (3) 91 dg/ko 30/ 33
S.F. 641 The bill defines fictive kin as an adult person who is 1 not a relative of a child but who has an emotionally positive 2 significant relationship with the child or the childs family. 3 The bill defines foster family home as a licensed 4 single-family home environment in which child foster care is 5 provided. 6 The bill defines individual as a natural person or a 7 married couple. 8 The bill defines kinship caregiver as a relative or 9 fictive kin of a child. 10 The bill defines license as the authorization issued to an 11 individual or an agency by HHS to provide child foster care. 12 The bill defines relative as an individual related to a 13 child within the fourth degree of consanguinity or affinity by 14 marriage or through adoption. 15 The bill also defines agency licensee, approved kinship 16 caregiver, and individual licensee. 17 The bill makes several changes to Code chapter 237 and to 18 Code sections 232.78 (temporary custody of a child pursuant to 19 ex parte court order), 232.98 (hearing concerning temporary 20 removal), 232.102 (transfer of legal custody of child and 21 placement), 234.1 (child and family services definitions), 22 234.39 (child and family services responsibility for costs 23 of services), 237A.1 (child care facilities definitions), 24 237A.3A (child development homes), and 423.3 (streamlined sales 25 and use tax Act exemptions). 26 DIVISION III CHILD AND DEPENDENT ADULT ABUSE. The bill 27 requires HHS to adopt rules to administer the child protection 28 center grant program. 29 The bill allows a community-based entity to apply for and 30 receive funds appropriated to HHS by the general assembly 31 for child abuse prevention. Under current law, only a 32 community-based volunteer coalition or council can apply for 33 and receive such funds. 34 The bill makes child abuse information, and information 35 -31- LSB 1459SW (3) 91 dg/ko 31/ 33
S.F. 641 obtained in the course of an assessment or evaluation of a 1 report of dependent adult abuse, confidential records. 2 The bill defines exploitation of a dependent adult as 3 a fraudulent or otherwise illegal, unauthorized, or improper 4 attempt, act, or process by a caretaker or fiduciary to use the 5 physical or financial resources of a dependent adult for the 6 purpose of monetary or personal benefit, profit, or gain, or to 7 deprive the dependent adult of the use of the dependent adults 8 physical or financial resources, including any benefits, 9 belongings, or assets. 10 Under current law, upon a showing of probable cause that 11 a dependent adult has been financially exploited a court may 12 authorize a person, who is also authorized by HHS, to gain 13 access to the financial records of the dependent adult. The 14 bill amends the statute so the person authorized by the court 15 and HHS can gain access to financial records that HHS has a 16 reasonable belief are related to the financial resources of the 17 dependent adult. 18 The bill authorizes an instrumentality of the state to 19 access dependent adult abuse records. 20 The bill requires the director of HHS to require providers 21 under the medical assistance program to share information with 22 HHS as necessary to identify, prevent, or respond to child or 23 dependent adult abuse. 24 DIVISION IV DEPARTMENT OF HEALTH AND HUMAN SERVICES 25 CONFIDENTIALITY OF INTERNAL AUDIT AND EXAMINATION INFORMATION. 26 The bill makes information, including allegations of misconduct 27 or noncompliance and audit or examination workpapers, created 28 or received by HHS during an internal audit or examination 29 (information) confidential. HHS may disclose the information 30 as necessary to complete an audit or examination, or to the 31 extent HHSs auditor is required by law to report the same or 32 to testify in court. The bill also prevents the state auditor 33 from accessing the information except as required to comply 34 with the standards for engagement described in Code section 35 -32- LSB 1459SW (3) 91 dg/ko 32/ 33
S.F. 641 11.3 (when audits and examinations begin), to comply with state 1 or federal regulations, or in case of alleged or suspected 2 embezzlement or theft. 3 DIVISION V REGION INCENTIVE FUND DISTRIBUTIONS AND 4 TRANSFERS. The bill appropriates from the region incentive 5 fund of the mental health and disability services regional 6 service fund to HHS for FY 2024-2025, an amount as necessary to 7 ensure the continuity of care for persons transferring services 8 from the mental health and disability services system to the 9 behavioral health services system (BHSS) and for distribution 10 to ASOs to be used for expenses related to the duties of the ASO 11 under the BHSS. The moneys used by an ASO do not count toward 12 any limit on the ASOs administrative costs. 13 The bill requires any unobligated and unencumbered moneys 14 remaining in the mental health and disability services regional 15 service fund on June 30, 2025, to be transferred to the 16 behavioral health fund. 17 This division of the bill is effective upon enactment and 18 applies retroactively to July 1, 2024. 19 DIVISION VI HEALTH MAINTENANCE ORGANIZATION APPLICABLE 20 PERCENTAGE FOR PREMIUM TAX. Under current law, a health 21 maintenance organization contracting with HHS to administer the 22 medical assistance program must pay taxes to the director of 23 the department of revenue for deposit in the Medicaid managed 24 care organization premiums fund, an amount equal to 2.5 percent 25 of the premiums received and taxable. The bill changes such 26 amount to the applicable percent of the premiums received and 27 taxable. The applicable percent is defined in Code section 28 432.1(2) (tax on gross premiums exclusions), and is .95 29 percent for the 2025 calendar year, .925 percent for the 2026 30 calendar year, and .9 percent for the 2027 calendar year and 31 all subsequent calendar years. 32 This division of the bill is effective upon enactment and 33 applies retroactively to January 1, 2024. 34 -33- LSB 1459SW (3) 91 dg/ko 33/ 33