Senate File 505 - Introduced




                                 SENATE FILE       
                                 BY  COMMITTEE ON
                                     APPROPRIATIONS

                                 (SUCCESSOR TO SSB
                                     1288)

                                      A BILL FOR

  1 An Act relating to appropriations for health and human services
  2    and veterans and including other related provisions and
  3    appropriations, and including effective date and retroactive
  4    and other applicability date provisions.
  5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
    TLSB 2653SV (2) 86
    pf/rj

PAG LIN



  1  1                           DIVISION I
  1  2               DEPARTMENT ON AGING ==== FY 2015=2016
  1  3    Section 1.  DEPARTMENT ON AGING.  There is appropriated from
  1  4 the general fund of the state to the department on aging for
  1  5 the fiscal year beginning July 1, 2015, and ending June 30,
  1  6 2016, the following amount, or so much thereof as is necessary,
  1  7 to be used for the purposes designated:
  1  8    For aging programs for the department on aging and area
  1  9 agencies on aging to provide citizens of Iowa who are 60 years
  1 10 of age and older with case management for frail elders, Iowa's
  1 11 aging and disabilities resource center, and other services
  1 12 which may include but are not limited to adult day services,
  1 13 respite care, chore services, information and assistance,
  1 14 and material aid, for information and options counseling for
  1 15 persons with disabilities who are 18 years of age or older,
  1 16 and for salaries, support, administration, maintenance, and
  1 17 miscellaneous purposes, and for not more than the following
  1 18 full=time equivalent positions:
  1 19 .................................................. $ 11,436,066
  1 20 ............................................... FTEs      31.00
  1 21    1.  Funds appropriated in this section may be used to
  1 22 supplement federal funds under federal regulations. To
  1 23 receive funds appropriated in this section, a local area
  1 24 agency on aging shall match the funds with moneys from other
  1 25 sources according to rules adopted by the department. Funds
  1 26 appropriated in this section may be used for elderly services
  1 27 not specifically enumerated in this section only if approved
  1 28 by an area agency on aging for provision of the service within
  1 29 the area.
  1 30    2.  Of the funds appropriated in this section, $279,946 is
  1 31 transferred to the economic development authority for the Iowa
  1 32 commission on volunteer services to be used for the retired and
  1 33 senior volunteer program.
  1 34    3.  a.  The department on aging shall establish and enforce
  1 35 procedures relating to expenditure of state and federal funds
  2  1 by area agencies on aging that require compliance with both
  2  2 state and federal laws, rules, and regulations, including but
  2  3 not limited to all of the following:
  2  4    (1)  Requiring that expenditures are incurred only for goods
  2  5 or services received or performed prior to the end of the
  2  6 fiscal period designated for use of the funds.
  2  7    (2)  Prohibiting prepayment for goods or services not
  2  8 received or performed prior to the end of the fiscal period
  2  9 designated for use of the funds.
  2 10    (3)  Prohibiting the prepayment for goods or services
  2 11 not defined specifically by good or service, time period, or
  2 12 recipient.
  2 13    (4)  Prohibiting the establishment of accounts from which
  2 14 future goods or services which are not defined specifically by
  2 15 good or service, time period, or recipient, may be purchased.
  2 16    b.  The procedures shall provide that if any funds are
  2 17 expended in a manner that is not in compliance with the
  2 18 procedures and applicable federal and state laws, rules, and
  2 19 regulations, and are subsequently subject to repayment, the
  2 20 area agency on aging expending such funds in contravention of
  2 21 such procedures, laws, rules and regulations, not the state,
  2 22 shall be liable for such repayment.
  2 23    4.  Of the funds appropriated in this section, at least
  2 24 $250,000 shall be used to fund the unmet needs identified
  2 25 through Iowa's aging and disability resource center network.
  2 26    5.  Of the funds appropriated in this section, at least
  2 27 $600,000 shall be used to fund home and community=based
  2 28 services through the area agencies on aging that enable older
  2 29 individuals to avoid more costly utilization of residential or
  2 30 institutional services and remain in their own homes.
  2 31    6.  Of the funds appropriated in this section, $850,000
  2 32 shall be used for the purposes of chapter 231E and section
  2 33 231.56A, of which $325,000 shall be used for the office of
  2 34 substitute decision maker pursuant to chapter 231E, and the
  2 35 remainder shall be distributed equally to the area agencies on
  3  1 aging to administer the prevention of elder abuse, neglect, and
  3  2 exploitation program pursuant to section 231.56A, in accordance
  3  3 with the requirements of the federal Older Americans Act of
  3  4 1965, 42 U.S.C. {3001 et seq., as amended.
  3  5                           DIVISION II
  3  6       OFFICE OF LONG=TERM CARE OMBUDSMAN ==== FY 2015=2016
  3  7    Sec. 2.  OFFICE OF LONG=TERM CARE OMBUDSMAN.
  3  8    1.  There is appropriated from the general fund of the state
  3  9 to the office of long=term care ombudsman for the fiscal year
  3 10 beginning July 1, 2015, and ending June 30, 2016, the following
  3 11 amount, or so much thereof as is necessary, to be used for the
  3 12 purposes designated:
  3 13    For salaries, support, administration, maintenance, and
  3 14 miscellaneous purposes, and for not more than the following
  3 15 full=time equivalent positions:
  3 16 .................................................. $  1,506,783
  3 17 ............................................... FTEs      21.00
  3 18    2.  Of the funds appropriated in this section, $450,000 shall
  3 19 be used to provide additional local long=term care ombudsmen.
  3 20    3.  The office of long=term care ombudsman and the department
  3 21 of human services shall collaborate to develop a Medicaid
  3 22 state plan amendment to provide for the claiming of federal
  3 23 financial participation for office of long=term care ombudsman
  3 24 activities that are performed to assist with administration of
  3 25 the Medicaid program.  The Medicaid state plan amendment shall
  3 26 be submitted to the centers for Medicare and Medicaid services
  3 27 of the United States department of health and human services in
  3 28 a timely manner to allow for such claiming of federal financial
  3 29 participation beginning January 1, 2016.
  3 30                          DIVISION III
  3 31           DEPARTMENT OF PUBLIC HEALTH ==== FY 2015=2016
  3 32    Sec. 3.  DEPARTMENT OF PUBLIC HEALTH.  There is appropriated
  3 33 from the general fund of the state to the department of public
  3 34 health for the fiscal year beginning July 1, 2015, and ending
  3 35 June 30, 2016, the following amounts, or so much thereof as is
  4  1 necessary, to be used for the purposes designated:
  4  2    1.  ADDICTIVE DISORDERS
  4  3    For reducing the prevalence of the use of tobacco, alcohol,
  4  4 and other drugs, and treating individuals affected by addictive
  4  5 behaviors, including gambling, and for not more than the
  4  6 following full=time equivalent positions:
  4  7 .................................................. $ 27,263,690
  4  8 ............................................... FTEs      10.00
  4  9    a.  (1)  Of the funds appropriated in this subsection,
  4 10 $5,248,361 shall be used for the tobacco use prevention
  4 11 and control initiative, including efforts at the state and
  4 12 local levels, as provided in chapter 142A.  The commission
  4 13 on tobacco use prevention and control established pursuant
  4 14 to section 142A.3 shall advise the director of public health
  4 15 in prioritizing funding needs and the allocation of moneys
  4 16 appropriated for the programs and initiatives. Activities
  4 17 of the programs and initiatives shall be in alignment with
  4 18 the United States centers for disease control and prevention
  4 19 best practices for comprehensive tobacco control programs that
  4 20 include the goals of preventing youth initiation of tobacco
  4 21 usage, reducing exposure to secondhand smoke, and promotion of
  4 22 tobacco cessation.
  4 23    (2)  (a)  Of the funds allocated in this paragraph "a",
  4 24 $453,067 is transferred to the alcoholic beverages division of
  4 25 the department of commerce for enforcement of tobacco laws,
  4 26 regulations, and ordinances and to engage in tobacco control
  4 27 activities approved by the division of tobacco use prevention
  4 28 and control of the department of public health as specified
  4 29 in the memorandum of understanding entered into between the
  4 30 divisions.
  4 31    (b)  For the fiscal year beginning July 1, 2015, and ending
  4 32 June 30, 2016, the terms of the memorandum of understanding,
  4 33 entered into between the division of tobacco use prevention
  4 34 and control of the department of public health and the
  4 35 alcoholic beverages division of the department of commerce,
  5  1 governing compliance checks conducted to ensure licensed retail
  5  2 tobacco outlet conformity with tobacco laws, regulations, and
  5  3 ordinances relating to persons under eighteen years of age,
  5  4 shall continue to restrict the number of such checks to one
  5  5 check per retail outlet, and one additional check for any
  5  6 retail outlet found to be in violation during the first check.
  5  7    b.  Of the funds appropriated in this subsection,
  5  8 $22,015,329 shall be used for problem gambling and
  5  9 substance=related disorder prevention, treatment, and recovery
  5 10 services, including a 24=hour helpline, public information
  5 11 resources, professional training, and program evaluation.
  5 12    (1)  Of the funds allocated in this paragraph "b",
  5 13 $18,903,715 shall be used for substance=related disorder
  5 14 prevention and treatment.
  5 15    (a)  Of the funds allocated in this subparagraph (1),
  5 16 $899,300 shall be used for the public purpose of a grant
  5 17 program to provide substance=related disorder prevention
  5 18 programming for children.
  5 19    (i)  Of the funds allocated in this subparagraph division
  5 20 (a), $427,539 shall be used for grant funding for organizations
  5 21 that provide programming for children by utilizing mentors.
  5 22 Programs approved for such grants shall be certified or must
  5 23 be certified within six months of receiving the grant award
  5 24 by the Iowa commission on volunteer services as utilizing the
  5 25 standards for effective practice for mentoring programs.
  5 26    (ii)  Of the funds allocated in this subparagraph division
  5 27 (a), $426,839 shall be used for grant funding for organizations
  5 28 providing programming that includes youth development and
  5 29 leadership services.  The programs shall also be recognized as
  5 30 being programs that are scientifically based with evidence of
  5 31 their effectiveness in reducing substance=related disorders in
  5 32 children.
  5 33    (iii)  The department of public health shall utilize a
  5 34 request for proposals process to implement the grant program.
  5 35    (iv)  All grant recipients shall participate in a program
  6  1 evaluation as a requirement for receiving grant funds.
  6  2    (v)  Of the funds allocated in this subparagraph division
  6  3 (a), up to $44,922 may be used to administer substance=related
  6  4 disorder prevention grants and for program evaluations.
  6  5    (b)  Of the funds allocated in this subparagraph
  6  6 (1), $272,603 shall be used for culturally competent
  6  7 substance=related disorder treatment pilot projects.
  6  8    (i)  The department shall utilize the amount allocated
  6  9 in this subparagraph division (b) for at least three pilot
  6 10 projects to provide culturally competent substance=related
  6 11 disorder treatment in various areas of the state.  Each pilot
  6 12 project shall target a particular ethnic minority population.
  6 13 The populations targeted shall include but are not limited to
  6 14 African American, Asian, and Latino.
  6 15    (ii)  The pilot project requirements shall provide for
  6 16 documentation or other means to ensure access to the cultural
  6 17 competence approach used by a pilot project so that such
  6 18 approach can be replicated and improved upon in successor
  6 19 programs.
  6 20    (2)  Of the funds allocated in this paragraph "b", up
  6 21 to $3,111,614 may be used for problem gambling prevention,
  6 22 treatment, and recovery services.
  6 23    (a)  Of the funds allocated in this subparagraph (2),
  6 24 $2,573,762 shall be used for problem gambling prevention and
  6 25 treatment.
  6 26    (b)  Of the funds allocated in this subparagraph (2), up to
  6 27 $437,852 may be used for a 24=hour helpline, public information
  6 28 resources, professional training, and program evaluation.
  6 29    (c)  Of the funds allocated in this subparagraph (2), up
  6 30 to $100,000 may be used for the licensing of problem gambling
  6 31 treatment programs.
  6 32    (3)  It is the intent of the general assembly that from the
  6 33 moneys allocated in this paragraph "b",  persons with a dual
  6 34 diagnosis of substance=related disorder and gambling addiction
  6 35 shall be given priority in treatment services.
  7  1    c.  Notwithstanding any provision of law to the contrary,
  7  2 to standardize the availability, delivery, cost of delivery,
  7  3 and accountability of problem gambling and substance=related
  7  4 disorder treatment services statewide, the department shall
  7  5 continue implementation of a process to create a system
  7  6 for delivery of treatment services in accordance with the
  7  7 requirements specified in 2008 Iowa Acts, chapter 1187, section
  7  8 3, subsection 4.  To ensure the system provides a continuum
  7  9 of treatment services that best meets the needs of Iowans,
  7 10 the problem gambling and substance=related disorder treatment
  7 11 services in any area may be provided either by a single agency
  7 12 or by separate agencies submitting a joint proposal.
  7 13    (1)  The system for delivery of substance=related disorder
  7 14 and problem gambling treatment shall include problem gambling
  7 15 prevention.
  7 16    (2)  The system for delivery of substance=related disorder
  7 17 and problem gambling treatment shall include substance=related
  7 18 disorder prevention by July 1, 2016.
  7 19    (3)  Of the funds allocated in paragraph "b",  the department
  7 20 may use up to $100,000 for administrative costs to continue
  7 21 developing and implementing the process in accordance with this
  7 22 paragraph "c".
  7 23    d.  The requirement of section 123.53, subsection 5, is met
  7 24 by the appropriations and allocations made in this division of
  7 25 this Act for purposes of substance=related disorder treatment
  7 26 and addictive disorders for the fiscal year beginning July 1,
  7 27 2015.
  7 28    e.  The department of public health shall work with all
  7 29 other departments that fund substance=related disorder
  7 30 prevention and treatment services and all such departments
  7 31 shall, to the extent necessary, collectively meet the state
  7 32 maintenance of effort requirements for expenditures for
  7 33 substance=related disorder services as required under the
  7 34 federal substance=related disorder prevention and treatment
  7 35 block grant.
  8  1    2.  HEALTHY CHILDREN AND FAMILIES
  8  2    For promoting the optimum health status for children,
  8  3 adolescents from birth through 21 years of age, and families,
  8  4 and for not more than the following full=time equivalent
  8  5 positions:
  8  6 .................................................. $  7,331,602
  8  7 ............................................... FTEs      13.00
  8  8    a.  Of the funds appropriated in this subsection, not more
  8  9 than $734,841 shall be used for the healthy opportunities for
  8 10 parents to experience success (HOPES)=healthy families Iowa
  8 11 (HFI) program established pursuant to section 135.106. The
  8 12 funding shall be distributed to renew the grants that were
  8 13 provided to the grantees that operated the program during the
  8 14 fiscal year ending June 30, 2015.
  8 15    b.  In order to implement the legislative intent stated in
  8 16 sections 135.106 and 256I.9, that priority for home visitation
  8 17 program funding be given to programs using evidence=based or
  8 18 promising models for home visitation, it is the intent of the
  8 19 general assembly to phase in the funding priority in accordance
  8 20 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
  8 21 paragraph 0b.
  8 22    c.  Of the funds appropriated in this subsection, $4,912,887
  8 23 shall be used to expand statewide the department's initiative
  8 24 to provide for adequate developmental surveillance and
  8 25 screening during a child's first five years.  The funds shall
  8 26 be used first to fully fund the current sites to ensure that
  8 27 the sites are fully operational, with the remaining funds
  8 28 to be used for expansion to additional sites.  The full
  8 29 implementation and expansion shall include enhancing the scope
  8 30 of the program through collaboration with the child health
  8 31 specialty clinics to promote healthy child development through
  8 32 early identification and response to both biomedical and social
  8 33 determinants of healthy development; by monitoring child
  8 34 health metrics to inform practice, document long=term health
  8 35 impacts and savings, and provide for continuous improvement
  9  1 through training, education, and evaluation; and by providing
  9  2 for practitioner consultation particularly for children with
  9  3 behavioral conditions and needs.  The department of public
  9  4 health shall also collaborate with the Iowa Medicaid enterprise
  9  5 and the child health specialty clinics to integrate the
  9  6 activities of the first five initiative into the establishment
  9  7 of patient=centered medical homes, community utilities,
  9  8 accountable care organizations, and other integrated care
  9  9 models developed to improve health quality and population
  9 10 health while reducing health care costs. To the maximum extent
  9 11 possible, funding allocated in this paragraph shall be utilized
  9 12 as matching funds for medical assistance program reimbursement.
  9 13    d.  Of the funds appropriated in this subsection, $74,640
  9 14 shall be distributed to a statewide dental carrier to provide
  9 15 funds to continue the donated dental services program patterned
  9 16 after the projects developed by the lifeline network to provide
  9 17 dental services to indigent individuals who are elderly or with
  9 18 disabilities.
  9 19    e.  Of the funds appropriated in this subsection, $111,995
  9 20 shall be used for childhood obesity prevention.
  9 21    f.  Of the funds appropriated in this subsection, $162,768
  9 22 shall be used to provide audiological services and hearing
  9 23 aids for children. The department may enter into a contract
  9 24 to administer this paragraph.
  9 25    g.  Of the funds appropriated in this subsection, $25,000 is
  9 26 transferred to the university of Iowa college of dentistry for
  9 27 provision of primary dental services to children.  State funds
  9 28 shall be matched on a dollar=for=dollar basis.  The university
  9 29 of Iowa college of dentistry shall coordinate efforts with the
  9 30 department of public health, bureau of oral and health delivery
  9 31 systems, to provide dental care to underserved populations
  9 32 throughout the state.
  9 33    h.  Of the funds appropriated in this subsection, $50,000
  9 34 shall be used to address youth suicide prevention.
  9 35    i.  Of the funds appropriated in this subsection, $50,000
 10  1 shall be used to support the Iowa effort to address the survey
 10  2 of children who experience adverse childhood experiences known
 10  3 as ACEs.
 10  4    3.  CHRONIC CONDITIONS
 10  5    For serving individuals identified as having chronic
 10  6 conditions or special health care needs, and for not more than
 10  7 the following full=time equivalent positions:
 10  8 .................................................. $  5,105,861
 10  9 ............................................... FTEs       5.00
 10 10    a.  Of the funds appropriated in this subsection, $159,932
 10 11 shall be used for grants to individual patients who have an
 10 12 inherited metabolic disorder to assist with the costs of
 10 13 medically necessary foods and formula.
 10 14    b.  Of the funds appropriated in this subsection, $891,644
 10 15 shall be used for the brain injury services program pursuant to
 10 16 section 135.22B, including for continuation of the contracts
 10 17 for resource facilitator services in accordance with section
 10 18 135.22B, subsection 9, and to enhance brain injury training and
 10 19 recruitment of service providers on a statewide basis.  Of the
 10 20 amount allocated in this paragraph, $95,000 shall be used to
 10 21 fund one full=time equivalent position to serve as the state
 10 22 brain injury services program manager.
 10 23    c.  Of the funds appropriated in this subsection, $547,982
 10 24 shall be used as additional funding to leverage federal funding
 10 25 through the federal Ryan White Care Act, Tit. II, AIDS drug
 10 26 assistance program supplemental drug treatment grants.
 10 27    d.  Of the funds appropriated in this subsection, $149,823
 10 28 shall be used for the public purpose of continuing to contract
 10 29 with an existing national=affiliated organization to provide
 10 30 education, client=centered programs, and client and family
 10 31 support for people living with epilepsy and their families.
 10 32 The amount allocated in this paragraph in excess of $100,000
 10 33 shall be matched dollar=for=dollar by the organization
 10 34 specified.
 10 35    e.  Of the funds appropriated in this subsection, $785,114
 11  1 shall be used for child health specialty clinics.
 11  2    f.  Of the funds appropriated in this subsection, $400,000
 11  3 shall be used by the regional autism assistance program
 11  4 established pursuant to section 256.35, and administered by
 11  5 the child health specialty clinic located at the university of
 11  6 Iowa hospitals and clinics.  The funds shall be used to enhance
 11  7 interagency collaboration and coordination of educational,
 11  8 medical, and other human services for persons with autism,
 11  9 their families, and providers of services, including delivering
 11 10 regionalized services of care coordination, family navigation,
 11 11 and integration of services through the statewide system of
 11 12 regional child health specialty clinics and fulfilling other
 11 13 requirements as specified in chapter 225D.  The university of
 11 14 Iowa shall not receive funds allocated under this paragraph for
 11 15 indirect costs associated with the regional autism assistance
 11 16 program.
 11 17    g.  Of the funds appropriated in this subsection, $570,993
 11 18 shall be used for the comprehensive cancer control program to
 11 19 reduce the burden of cancer in Iowa through prevention, early
 11 20 detection, effective treatment, and ensuring quality of life.
 11 21 Of the funds allocated in this paragraph "g", $150,000 shall
 11 22 be used to support a melanoma research symposium, a melanoma
 11 23 biorepository and registry, basic and translational melanoma
 11 24 research, and clinical trials.
 11 25    h.  Of the funds appropriated in this subsection, $126,450
 11 26 shall be used for cervical and colon cancer screening, and
 11 27 $300,000 shall be used to enhance the capacity of the cervical
 11 28 cancer screening program to include provision of recommended
 11 29 prevention and early detection measures to a broader range of
 11 30 low=income women.
 11 31    i.  Of the funds appropriated in this subsection, $676,864
 11 32 shall be used for the center for congenital and inherited
 11 33 disorders including to provide for surveillance of stillbirths
 11 34 as defined in section 136A.2.
 11 35    j.  Of the funds appropriated in this subsection, $129,411
 12  1 shall be used for the prescription drug donation repository
 12  2 program created in chapter 135M.
 12  3    k.  Of the funds appropriated in this subsection,
 12  4 $215,263 shall be used by the department of public health
 12  5 for reform=related activities, including but not limited to
 12  6 facilitation of communication to stakeholders at the state and
 12  7 local level, administering the patient=centered health advisory
 12  8 council pursuant to section 135.159, and involvement in health
 12  9 care system innovation activities occurring across the state.
 12 10    l.  Of the funds appropriated in this subsection, $25,000
 12 11 shall be used for administration of chapter 124D, the medical
 12 12 cannabidiol Act, or other Code provisions authorizing the
 12 13 compassionate medical use of cannabis, if enacted by the 2015
 12 14 regular session of the Eighty=sixth General Assembly.
 12 15    4.  COMMUNITY CAPACITY
 12 16    For strengthening the health care delivery system at the
 12 17 local level, and for not more than the following full=time
 12 18 equivalent positions:
 12 19 .................................................. $  8,719,716
 12 20 ............................................... FTEs      11.00
 12 21    a.  Of the funds appropriated in this subsection, $99,414
 12 22 is allocated for continuation of the child vision screening
 12 23 program implemented through the university of Iowa hospitals
 12 24 and clinics in collaboration with early childhood Iowa areas.
 12 25 The program shall submit a report to the individuals identified
 12 26 in this Act for submission of reports regarding the use of
 12 27 funds allocated under this paragraph "a".  The report shall
 12 28 include the objectives and results for the program year
 12 29 including the target population and how the funds allocated
 12 30 assisted the program in meeting the objectives; the number,
 12 31 age, and location within the state of individuals served;
 12 32 the type of services provided to the individuals served; the
 12 33 distribution of funds based on service provided; and the
 12 34 continuing needs of the program.
 12 35    b.  Of the funds appropriated in this subsection, $110,656 is
 13  1 allocated for continuation of an initiative implemented at the
 13  2 university of Iowa and $99,904 is allocated for continuation of
 13  3 an initiative at the state mental health institute at Cherokee
 13  4 to expand and improve the workforce engaged in mental health
 13  5 treatment and services. The initiatives shall receive input
 13  6 from the university of Iowa, the department of human services,
 13  7 the department of public health, and the mental health and
 13  8 disability services commission to address the focus of the
 13  9 initiatives.
 13 10    c.  Of the funds appropriated in this subsection, $1,164,628
 13 11 shall be used for essential public health services that promote
 13 12 healthy aging throughout one's lifespan, contracted through a
 13 13 formula for local boards of health, to enhance health promotion
 13 14 and disease prevention services.
 13 15    d.  Of the funds appropriated in this section, $99,286 shall
 13 16 be deposited in the governmental public health system fund
 13 17 created in section 135A.8 to be used for the purposes of the
 13 18 fund.
 13 19    e.  Of the funds appropriated in this subsection, $105,448
 13 20 shall be used to continue to address the shortage of mental
 13 21 health professionals in the state.
 13 22    f.  Of the funds appropriated in this subsection,
 13 23 $50,000 shall be used for a grant to a statewide association
 13 24 of psychologists that is affiliated with the American
 13 25 psychological association to be used for continuation of a
 13 26 program to rotate intern psychologists in placements in urban
 13 27 and rural mental health professional shortage areas, as defined
 13 28 in section 135.180.
 13 29    g.  (1)  Of the funds appropriated in this subsection,
 13 30 $2,882,969 shall be allocated as a grant to the Iowa primary
 13 31 care association to be used pursuant to section 135.153 for
 13 32 the statewide coordination of the Iowa collaborative safety
 13 33 net provider network. Coordination of the network shall
 13 34 focus on increasing access by underserved populations to
 13 35 health care services, increasing integration of the health
 14  1 system and collaboration across the continuum of care with
 14  2 a focus on safety net services, and enhancing the Iowa
 14  3 collaborative safety net provider network's communication and
 14  4 education efforts. The amount allocated as a grant under this
 14  5 subparagraph (1) shall be used as follows to support the Iowa
 14  6 collaborative safety net provider network goals of increased
 14  7 access, health system integration, and engagement:
 14  8    (a)  For distribution to safety net partners in the state
 14  9 that work to increase access of the underserved population to
 14 10 health services:
 14 11 .................................................. $  1,025,485
 14 12    (i)  Of the amount allocated in this subparagraph
 14 13 division (a), up to $413,415 shall be distributed to the
 14 14 Iowa prescription drug corporation for continuation of the
 14 15 pharmaceutical infrastructure for safety net providers as
 14 16 described in 2007 Iowa Acts, chapter 218, section 108.
 14 17    (ii)  Of the amount allocated in this subparagraph division
 14 18 (a), up to $348,322 shall be distributed to free clinics and
 14 19 free clinics of Iowa for necessary infrastructure, statewide
 14 20 coordination, provider recruitment, service delivery, and
 14 21 provision of assistance to patients in securing a medical home
 14 22 inclusive of oral health care.
 14 23    (iii)  Of the amount allocated in this subparagraph
 14 24 division (a), up to $50,000 shall be distributed to the
 14 25 Iowa coalition against sexual assault to continue a training
 14 26 program for sexual assault response team (SART) members,
 14 27 including representatives of law enforcement, victim advocates,
 14 28 prosecutors, and certified medical personnel.
 14 29    (iv)  Of the amount allocated in this subparagraph division
 14 30 (a), up to $213,748 shall be distributed to the Polk county
 14 31 medical society for continuation of the safety net provider
 14 32 patient access to a specialty health care initiative as
 14 33 described in 2007 Iowa Acts, chapter 218, section 109.
 14 34    (b)  For distribution to safety net partners in the
 14 35 state that work to increase health system integration, care
 15  1 coordination, and collaboration across the continuum of care
 15  2 with a focus on safety net services. Such efforts shall
 15  3 include but not be limited to community care coordination team
 15  4 development and integration of medical and behavioral health
 15  5 services. Efforts shall also include working, in conjunction
 15  6 with the department of human services and the department
 15  7 of public health, to support Medicaid managed care efforts
 15  8 inclusive of the state innovation model through the continued
 15  9 development and implementation of community care coordination
 15 10 teams. Implementation of the community care coordination
 15 11 teams shall be accomplished through a statewide regionally
 15 12 based network that provides an integrated approach to health
 15 13 care delivery through care coordination that supports primary
 15 14 care providers and links patients with community resources
 15 15 necessary to empower patients in addressing biomedical and
 15 16 social determinants of health to improve health outcomes:
 15 17 .................................................. $  1,672,199
 15 18    (c)  For distribution to safety net partners in the state
 15 19 that work to serve as a resource for credible, accurate
 15 20 information on health care=related needs and services
 15 21 for vulnerable populations in the state including the
 15 22 Iowa association of rural health clinics for necessary
 15 23 infrastructure and service delivery transformation and the Iowa
 15 24 primary care association to support partner engagement, program
 15 25 management, and statewide coordination of the network:
 15 26 .................................................. $    185,285
 15 27    (2)  The amount allocated under this paragraph "g" shall
 15 28 not be reduced for administrative or other costs prior to
 15 29 distribution. The Iowa collaborative safety net provider
 15 30 network may continue to distribute funds allocated pursuant to
 15 31 this paragraph "g" through existing contracts or renewal of
 15 32 existing contracts.
 15 33    (3)  For each goal of the Iowa collaborative safety net
 15 34 provider network, the Iowa primary care association shall
 15 35 submit a progress report to the individuals designated in this
 16  1 Act for submission of reports by December 15, 2015, including
 16  2 progress in developing and implementing the network, how the
 16  3 funds were distributed and used in developing and implementing
 16  4 the network, and the remaining needs identified to fully
 16  5 develop and implement the network.
 16  6    h.  Of the funds appropriated in this subsection, $213,400
 16  7 shall be used for continuation of the work of the direct care
 16  8 worker advisory council established pursuant to 2008 Iowa Acts,
 16  9 chapter 1188, section 69, in implementing the recommendations
 16 10 in the final report submitted by the advisory council to the
 16 11 governor and the general assembly in March 2012, including
 16 12 by  continuing to develop, promote, and make available on a
 16 13 statewide basis the prepare=to=care core curriculum and its
 16 14 associated modules and specialties through various formats
 16 15 including online access, community colleges, and other venues;
 16 16 exploring new and maintaining existing specialties including
 16 17 but not limited to oral health and dementia care; supporting
 16 18 instructor training; and assessing and making recommendations
 16 19 concerning the Iowa care book and information technology
 16 20 systems and infrastructure uses and needs.
 16 21    i.  (1)  Of the funds appropriated in this subsection,
 16 22 $216,375 shall be used for allocation to an independent
 16 23 statewide direct care worker organization under continuation
 16 24 of the contract in effect during the fiscal year ending June
 16 25 30, 2015.
 16 26    (2)  Of the funds appropriated in this subsection,
 16 27 $105,000 shall be used to provide scholarships or other
 16 28 forms of subsidization for direct care worker educational
 16 29 conferences, training, or outreach activities, and for the
 16 30 mouth=care=matters oral health care project.
 16 31    j.  Of the funds appropriated in this subsection, the
 16 32 department may use up to $58,175 for up to one full=time
 16 33 equivalent position to administer the volunteer health care
 16 34 provider program pursuant to section 135.24.
 16 35    k.  Of the funds appropriated in this subsection, $100,000
 17  1 shall be used for a matching dental education loan repayment
 17  2 program to be allocated to a dental nonprofit health service
 17  3 corporation to continue to develop the criteria and implement
 17  4 the loan repayment program.
 17  5    l.  Of the funds appropriated in this subsection, $105,823 is
 17  6 transferred to the college student aid commission for deposit
 17  7 in the rural Iowa primary care trust fund created in section
 17  8 261.113 to be used for the purposes of the fund.
 17  9    m.  Of the funds appropriated in this subsection, $250,000
 17 10 shall be used for the purposes of the Iowa donor registry as
 17 11 specified in section 142C.18.
 17 12    n.  Of the funds appropriated in this subsection, $100,000
 17 13 shall be used for continuation of a grant to a nationally
 17 14 affiliated volunteer eye organization that has an established
 17 15 program for children and adults and that is solely dedicated to
 17 16 preserving sight and preventing blindness through education,
 17 17 nationally certified vision screening and training, and
 17 18 community and patient service programs. The organization
 17 19 shall submit a report to the individuals identified in this
 17 20 Act for submission of reports regarding the use of funds
 17 21 allocated under this paragraph "n".  The report shall include
 17 22 the objectives and results for the program year including
 17 23 the target population and how the funds allocated assisted
 17 24 the program in meeting the objectives; the number, age, and
 17 25 location within the state of individuals served; the type of
 17 26 services provided to the individuals served; the distribution
 17 27 of funds based on services provided; and the continuing needs
 17 28 of the program.
 17 29    o.  Of the funds appropriated in this subsection, $25,000
 17 30 shall be used for the continuation of a wellness council under
 17 31 the direction of the director of public health to increase
 17 32 support for wellness activities in the state.
 17 33    p.  Of the funds appropriated in this subsection, $2,000,000
 17 34 shall be deposited in the medical residency training account
 17 35 created in section 135.175, subsection 5, paragraph "a", and
 18  1 is appropriated from the account to the department of public
 18  2 health to be used for the purposes of the medical residency
 18  3 training state matching grants program as specified in section
 18  4 135.176. However, notwithstanding any provision to the
 18  5 contrary in section 135.176, priority in the awarding of grants
 18  6 shall be given to sponsors that propose preference in the use
 18  7 of the grant funds for psychiatric residency positions and
 18  8 family practice residency positions.
 18  9    5.  HEALTHY AGING
 18 10    To provide public health services that reduce risks and
 18 11 invest in promoting and protecting good health over the
 18 12 course of a lifetime with a priority given to older Iowans and
 18 13 vulnerable populations:
 18 14 .................................................. $  7,297,142
 18 15    6.  INFECTIOUS DISEASES
 18 16    For reducing the incidence and prevalence of communicable
 18 17 diseases, and for not more than the following full=time
 18 18 equivalent positions:
 18 19 .................................................. $  1,335,155
 18 20 ............................................... FTEs       4.00
 18 21    7.  PUBLIC PROTECTION
 18 22    For protecting the health and safety of the public through
 18 23 establishing standards and enforcing regulations, and for not
 18 24 more than the following full=time equivalent positions:
 18 25 .................................................. $  4,339,191
 18 26 ............................................... FTEs    135.50
 18 27    a.  Of the funds appropriated in this subsection, not more
 18 28 than $454,700 shall be credited to the emergency medical
 18 29 services fund created in section 135.25. Moneys in the
 18 30 emergency medical services fund are appropriated to the
 18 31 department to be used for the purposes of the fund.
 18 32    b.  Of the funds appropriated in this subsection, $203,032
 18 33 shall be used for sexual violence prevention programming
 18 34 through a statewide organization representing programs
 18 35 serving victims of sexual violence through the department's
 19  1 sexual violence prevention program. The amount allocated
 19  2 in this paragraph "b" shall not be used to supplant funding
 19  3 administered for other sexual violence prevention or victims
 19  4 assistance programs.
 19  5    c.  Of the funds appropriated in this subsection, $598,751
 19  6 shall be used for the state poison control center. Pursuant
 19  7 to the directive under 2014 Iowa Acts, chapter 1140, section
 19  8 102, the federal matching funds available to the state poison
 19  9 control center from the department of human services under the
 19 10 federal Children's Health Insurance Program Reauthorization Act
 19 11 allotment shall be subject to the federal administrative cap
 19 12 rule of 10 percent applicable to funding provided under Tit.
 19 13 XXI of the federal Social Security Act and included within the
 19 14 department's calculations of the cap.
 19 15    d.  Of the funds appropriated in this subsection, $537,750
 19 16 shall be used for childhood lead poisoning provisions.
 19 17    8.  RESOURCE MANAGEMENT
 19 18    For establishing and sustaining the overall ability of the
 19 19 department to deliver services to the public, and for not more
 19 20 than the following full=time equivalent positions:
 19 21 .................................................. $    855,072
 19 22 ............................................... FTEs       4.00
 19 23    The university of Iowa hospitals and clinics under the
 19 24 control of the state board of regents shall not receive
 19 25 indirect costs from the funds appropriated in this section.
 19 26 The university of Iowa hospitals and clinics billings to the
 19 27 department shall be on at least a quarterly basis.
 19 28                           DIVISION IV
 19 29         DEPARTMENT OF VETERANS AFFAIRS ==== FY 2015=2016
 19 30    Sec. 4.  DEPARTMENT OF VETERANS AFFAIRS.  There is
 19 31 appropriated from the general fund of the state to the
 19 32 department of veterans affairs for the fiscal year beginning
 19 33 July 1, 2015, and ending June 30, 2016, the following amounts,
 19 34 or so much thereof as is necessary, to be used for the purposes
 19 35 designated:
 20  1    1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
 20  2    For salaries, support, maintenance, and miscellaneous
 20  3 purposes, and for not more than the following full=time
 20  4 equivalent positions:
 20  5 .................................................. $  1,200,546
 20  6 ............................................... FTEs      15.00
 20  7    2.  IOWA VETERANS HOME
 20  8    For salaries, support, maintenance, and miscellaneous
 20  9 purposes:
 20 10 .................................................. $  7,594,996
 20 11    a.  The Iowa veterans home billings involving the department
 20 12 of human services shall be submitted to the department on at
 20 13 least a monthly basis.
 20 14    b.  If there is a change in the employer of employees
 20 15 providing services at the Iowa veterans home under a collective
 20 16 bargaining agreement, such employees and the agreement shall
 20 17 be continued by the successor employer as though there had not
 20 18 been a change in employer.
 20 19    c.  Within available resources and in conformance with
 20 20 associated state and federal program eligibility requirements,
 20 21 the Iowa veterans home may implement measures to provide
 20 22 financial assistance to or on behalf of veterans or their
 20 23 spouses who are participating in the community reentry program.
 20 24    d.  The Iowa veterans home expenditure report shall be
 20 25 submitted monthly to the legislative services agency.
 20 26    3.  HOME OWNERSHIP ASSISTANCE PROGRAM
 20 27    For transfer to the Iowa finance authority for the
 20 28 continuation of the home ownership assistance program for
 20 29 persons who are or were eligible members of the armed forces of
 20 30 the United States, pursuant to section 16.54:
 20 31 .................................................. $  2,500,000
 20 32    Sec. 5.  LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
 20 33 FUND STANDING APPROPRIATIONS.  Notwithstanding the standing
 20 34 appropriation in section 35A.16 for the fiscal year beginning
 20 35 July 1, 2015, and ending June 30, 2016, the amount appropriated
 21  1 from the general fund of the state pursuant to that section
 21  2 for the following designated purposes shall not exceed the
 21  3 following amount:
 21  4    For the county commissions of veteran affairs fund under
 21  5 section 35A.16:
 21  6 .................................................. $    990,000
 21  7                           DIVISION V
 21  8          DEPARTMENT OF HUMAN SERVICES ==== FY 2015=2016
 21  9    Sec. 6.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
 21 10 GRANT.  There is appropriated from the fund created in section
 21 11 8.41 to the department of human services for the fiscal year
 21 12 beginning July 1, 2015, and ending June 30, 2016, from moneys
 21 13 received under the federal temporary assistance for needy
 21 14 families (TANF) block grant pursuant to the federal Personal
 21 15 Responsibility and Work Opportunity Reconciliation Act of 1996,
 21 16 Pub. L. No. 104=193, and successor legislation, the following
 21 17 amounts, or so much thereof as is necessary, to be used for the
 21 18 purposes designated:
 21 19    1.  To be credited to the family investment program account
 21 20 and used for assistance under the family investment program
 21 21 under chapter 239B:
 21 22 .................................................. $  5,136,995
 21 23    2.  To be credited to the family investment program account
 21 24 and used for the job opportunities and basic skills (JOBS)
 21 25 program and implementing family investment agreements in
 21 26 accordance with chapter 239B:
 21 27 .................................................. $ 10,138,178
 21 28    3.  To be used for the family development and
 21 29 self=sufficiency grant program in accordance with section
 21 30 216A.107:
 21 31 .................................................. $  2,898,980
 21 32    Notwithstanding section 8.33, moneys appropriated in this
 21 33 subsection that remain unencumbered or unobligated at the close
 21 34 of the fiscal year shall not revert but shall remain available
 21 35 for expenditure for the purposes designated until the close of
 22  1 the succeeding fiscal year. However, unless such moneys are
 22  2 encumbered or obligated on or before September 30, 2016, the
 22  3 moneys shall revert.
 22  4    4.  For field operations:
 22  5 .................................................. $ 31,296,232
 22  6    5.  For general administration:
 22  7 .................................................. $  3,744,000
 22  8    6.  For state child care assistance:
 22  9 .................................................. $ 35,047,110
 22 10    a.  Of the funds appropriated in this subsection,
 22 11 $26,328,097 is transferred to the child care and development
 22 12 block grant appropriation made by the Eighty=sixth General
 22 13 Assembly, 2015 Session, for the federal fiscal year beginning
 22 14 October 1, 2015, and ending September 30, 2016. Of this
 22 15 amount, $200,000 shall be used for provision of educational
 22 16 opportunities to registered child care home providers in order
 22 17 to improve services and programs offered by this category
 22 18 of providers and to increase the number of providers. The
 22 19 department may contract with institutions of higher education
 22 20 or child care resource and referral centers to provide
 22 21 the educational opportunities. Allowable administrative
 22 22 costs under the contracts shall not exceed 5 percent. The
 22 23 application for a grant shall not exceed two pages in length.
 22 24    b.  Any funds appropriated in this subsection remaining
 22 25 unallocated shall be used for state child care assistance
 22 26 payments for families who are employed including but not
 22 27 limited to individuals enrolled in the family investment
 22 28 program.
 22 29    7.  For distribution to counties and regions through the
 22 30 property tax relief fund for mental health and disability
 22 31 services as provided in an appropriation made for this purpose:
 22 32 .................................................. $  4,894,052
 22 33    8.  For child and family services:
 22 34 .................................................. $ 32,084,430
 22 35    9.  For child abuse prevention grants:
 23  1 .................................................. $    125,000
 23  2    10.  For pregnancy prevention grants on the condition that
 23  3 family planning services are funded:
 23  4 .................................................. $  1,930,067
 23  5    Pregnancy prevention grants shall be awarded to programs
 23  6 in  existence on or before July 1, 2015, if the programs have
 23  7 demonstrated positive  outcomes.  Grants shall be awarded to
 23  8 pregnancy prevention  programs which are developed after July
 23  9 1, 2015, if the  programs are based on existing  models that
 23 10 have demonstrated positive outcomes.  Grants shall  comply with
 23 11 the requirements provided in 1997 Iowa Acts,  chapter 208,
 23 12 section 14, subsections 1 and 2, including the  requirement that
 23 13 grant programs must emphasize sexual  abstinence.  Priority in
 23 14 the awarding of grants shall be given  to programs that serve
 23 15 areas of the state which demonstrate  the highest percentage of
 23 16 unplanned pregnancies of females of  childbearing age within the
 23 17 geographic area to be served by  the grant.
 23 18    11.  For technology needs and other resources necessary
 23 19 to meet federal welfare reform reporting, tracking, and case
 23 20 management requirements:
 23 21 .................................................. $  1,037,186
 23 22    12.  For the family investment program share of the costs to
 23 23 continue to develop and maintain a new, integrated eligibility
 23 24 determination system:
 23 25 .................................................. $  6,654,880
 23 26    13.  a.  Notwithstanding any provision to the contrary,
 23 27 including but not limited to requirements in section 8.41 or
 23 28 provisions in 2014 or 2015 Iowa Acts regarding the receipt and
 23 29 appropriation of federal block grants, federal funds from the
 23 30 temporary assistance for needy families block grant received by
 23 31 the state and not otherwise appropriated in this section and
 23 32 remaining available for the fiscal year beginning July 1, 2015,
 23 33 are appropriated to the department of human services to the
 23 34 extent as may be necessary to be used in the following priority
 23 35 order:  the family investment program, for state child care
 24  1 assistance program payments for families who are employed, and
 24  2 for the family investment program share of costs to develop and
 24  3 maintain a new, integrated eligibility determination system.
 24  4 The federal funds appropriated in this paragraph "a" shall be
 24  5 expended only after all other funds appropriated in subsection
 24  6 1 for the assistance under the family investment program,
 24  7 in subsection 6 for child care assistance, or in subsection
 24  8 12 for the family investment program share of the costs to
 24  9 continue to develop and maintain a new, integrated eligibility
 24 10 determination system, as applicable, have been expended. For
 24 11 the purposes of this subsection, the funds appropriated in
 24 12 subsection 6, paragraph "a", for transfer to the child care
 24 13 and development block grant appropriation are considered fully
 24 14 expended when the full amount has been transferred.
 24 15    b.  The department shall, on a quarterly basis, advise the
 24 16 legislative services agency and department of management of
 24 17 the amount of funds appropriated in this subsection that was
 24 18 expended in the prior quarter.
 24 19    14.  Of the amounts appropriated in this section,
 24 20 $12,962,008 for the fiscal year beginning July 1, 2015, is
 24 21 transferred to the appropriation of the federal social services
 24 22 block grant made to the department of human services for that
 24 23 fiscal year.
 24 24    15.  For continuation of the program providing categorical
 24 25 eligibility for the food assistance program as specified for
 24 26 the program in the section of this division of this 2015 Act
 24 27 relating to the family investment program account:
 24 28 .................................................. $    25,000
 24 29    16.  The department may transfer funds allocated in this
 24 30 section to the appropriations made in this division of this Act
 24 31 for the same fiscal year for general administration and field
 24 32 operations for resources necessary to implement and operate the
 24 33 services referred to in this section and those funded in the
 24 34 appropriation made in this division of this Act for the same
 24 35 fiscal year for the family investment program from the general
 25  1 fund of the state.
 25  2    Sec. 7.  FAMILY INVESTMENT PROGRAM ACCOUNT.
 25  3    1.  Moneys credited to the family investment program (FIP)
 25  4 account for the fiscal year beginning July 1, 2015, and
 25  5 ending June 30, 2016, shall be used to provide assistance in
 25  6 accordance with chapter 239B.
 25  7    2.  The department may use a portion of the moneys credited
 25  8 to the FIP account under this section as necessary for
 25  9 salaries, support, maintenance, and miscellaneous purposes.
 25 10    3.  The department may transfer funds allocated in
 25 11 subsection 4 to the appropriations made in this division of
 25 12 this Act for the same fiscal year for general administration
 25 13 and field operations for resources necessary to implement and
 25 14 operate the family investment program services referred to in
 25 15 this section and those funded in the appropriation made in this
 25 16 division of this Act for the same fiscal year for the family
 25 17 investment program from the general fund of the state.
 25 18    4.  Moneys appropriated in this division of this Act and
 25 19 credited to the FIP account for the fiscal year beginning July
 25 20 1, 2015, and ending June 30, 2016, are allocated as follows:
 25 21    a.  To be retained by the department of human services to
 25 22 be used for coordinating with the department of human rights
 25 23 to more effectively serve participants in FIP and other shared
 25 24 clients and to meet federal reporting requirements under the
 25 25 federal temporary assistance for needy families block grant:
 25 26 .................................................. $     20,000
 25 27    b.  To the department of human rights for staffing,
 25 28 administration, and implementation of the family development
 25 29 and self=sufficiency grant program in accordance with section
 25 30 216A.107:
 25 31 .................................................. $  6,392,834
 25 32    (1)  Of the funds allocated for the family development
 25 33 and self=sufficiency grant program in this paragraph "b",
 25 34 not more than 5 percent of the funds shall be used for the
 25 35 administration of the grant program.
 26  1    (2)  The department of human rights may continue to implement
 26  2 the family development and self=sufficiency grant program
 26  3 statewide during fiscal year 2015=2016.
 26  4    (3)  The department of human rights may engage in activities
 26  5 to strengthen and improve family outcomes measures and
 26  6 data collection systems under the family development and
 26  7 self=sufficiency grant program.
 26  8    c.  For the diversion subaccount of the FIP account:
 26  9 .................................................. $    815,000
 26 10    A portion of the moneys allocated for the subaccount may
 26 11 be used for field operations, salaries, data management
 26 12 system development, and implementation costs and support
 26 13 deemed necessary by the director of human services in order
 26 14 to administer the FIP diversion program. To the extent
 26 15 moneys allocated in this paragraph "c" are not deemed by the
 26 16 department to be necessary to support diversion activities,
 26 17 such moneys may be used for other efforts intended to increase
 26 18 engagement by family investment program participants in work,
 26 19 education, or training activities.
 26 20    d.  For the food assistance employment and training program:
 26 21 .................................................. $     66,588
 26 22    (1)  The department shall apply the federal supplemental
 26 23 nutrition assistance program (SNAP) employment and training
 26 24 state plan in order to maximize to the fullest extent permitted
 26 25 by federal law the use of the 50 percent federal reimbursement
 26 26 provisions for the claiming of allowable federal reimbursement
 26 27 funds from the United States department of agriculture
 26 28 pursuant to the federal SNAP employment and training program
 26 29 for providing education, employment, and training services
 26 30 for eligible food assistance program participants, including
 26 31 but not limited to related dependent care and transportation
 26 32 expenses.
 26 33    (2)  The department shall continue the categorical federal
 26 34 food assistance program eligibility at 160 percent of the
 26 35 federal poverty level and continue to eliminate the asset test
 27  1 from eligibility requirements, consistent with federal food
 27  2 assistance program requirements. The department shall include
 27  3 as many food assistance households as is allowed by federal
 27  4 law. The eligibility provisions shall conform to all federal
 27  5 requirements including requirements addressing individuals who
 27  6 are incarcerated or otherwise ineligible.
 27  7    e.  For the JOBS program:
 27  8 .................................................. $ 17,540,398
 27  9    5.  Of the child support collections assigned under FIP,
 27 10 an amount equal to the federal share of support collections
 27 11 shall be credited to the child support recovery appropriation
 27 12 made in this division of this Act. Of the remainder of the
 27 13 assigned child support collections received by the child
 27 14 support recovery unit, a portion shall be credited to the FIP
 27 15 account, a portion may be used to increase recoveries, and a
 27 16 portion may be used to sustain cash flow in the child support
 27 17 payments account. If as a consequence of the appropriations
 27 18 and allocations made in this section the resulting amounts
 27 19 are insufficient to sustain cash assistance payments and meet
 27 20 federal maintenance of effort requirements, the department
 27 21 shall seek supplemental funding. If child support collections
 27 22 assigned under FIP are greater than estimated or are otherwise
 27 23 determined not to be required for maintenance of effort, the
 27 24 state share of either amount may be transferred to or retained
 27 25 in the child support payments account.
 27 26    6.  The department may adopt emergency rules for the family
 27 27 investment, JOBS, food assistance, and medical assistance
 27 28 programs if necessary to comply with federal requirements.
 27 29    Sec. 8.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There
 27 30 is appropriated from the general fund of the state to the
 27 31 department of human services for the fiscal year beginning July
 27 32 1, 2015, and ending June 30, 2016, the following amount, or
 27 33 so much thereof as is necessary, to be used for the purpose
 27 34 designated:
 27 35    To be credited to the family investment program (FIP)
 28  1 account and used for family investment program assistance under
 28  2 chapter 239B:
 28  3 .................................................. $ 49,093,875
 28  4    1.  Of the funds appropriated in this section, $7,402,220 is
 28  5 allocated for the JOBS program.
 28  6    2.  Of the funds appropriated in this section, $3,513,854 is
 28  7 allocated for the family development and self=sufficiency grant
 28  8 program.
 28  9    3.  Notwithstanding section 8.39, for the fiscal year
 28 10 beginning July 1, 2015, if necessary to meet federal
 28 11 maintenance of effort requirements or to transfer federal
 28 12 temporary assistance for needy families block grant funding
 28 13 to be used for purposes of the federal social services block
 28 14 grant or to meet cash flow needs resulting from delays in
 28 15 receiving federal funding or to implement, in accordance with
 28 16 this division of this Act, activities currently funded with
 28 17 juvenile court services, county, or community moneys and state
 28 18 moneys used in combination with such moneys, the department
 28 19 of human services may transfer funds within or between any
 28 20 of the appropriations made in this division of this Act and
 28 21 appropriations in law for the federal social services block
 28 22 grant to the department for the following purposes, provided
 28 23 that the combined amount of state and federal temporary
 28 24 assistance for needy families block grant funding for each
 28 25 appropriation remains the same before and after the transfer:
 28 26    a.  For the family investment program.
 28 27    b.  For child care assistance.
 28 28    c.  For child and family services.
 28 29    d.  For field operations.
 28 30    e.  For general administration.
 28 31    f.  For distribution to counties or regions through the
 28 32 property tax relief fund for mental health and disability
 28 33 services as provided in an appropriation for this purpose.
 28 34    This subsection shall not be construed to prohibit the use
 28 35 of existing state transfer authority for other purposes. The
 29  1 department shall report any transfers made pursuant to this
 29  2 subsection to the legislative services agency.
 29  3    4.  Of the funds appropriated in this section, $195,678 shall
 29  4 be used for continuation of a grant to an Iowa=based nonprofit
 29  5 organization with a history of providing tax preparation
 29  6 assistance to low=income Iowans in order to expand the usage of
 29  7 the earned income tax credit. The purpose of the grant is to
 29  8 supply this assistance to underserved areas of the state.
 29  9    5.  Of the funds appropriated in this section, $80,000 shall
 29 10 be used for the continuation of an unfunded pilot project, as
 29 11 defined in 441 IAC 100.1, relating to parental obligations,
 29 12 in which the child support recovery unit participates, to
 29 13 support the efforts of a nonprofit organization committed to
 29 14 strengthening the community through youth development, healthy
 29 15 living, and social responsibility headquartered in a county
 29 16 with a population over 350,000. The funds allocated in this
 29 17 subsection shall be used by the recipient organization to
 29 18 develop a larger community effort, through public and private
 29 19 partnerships, to support a broad=based multi=county fatherhood
 29 20 initiative that promotes payment of child support obligations,
 29 21 improved family relationships, and full=time employment.
 29 22    6.  Of the funds appropriated in this section, $200,000 shall
 29 23 be used as a grant to a nonprofit organization organized under
 29 24 section 501(c)(4) of the Internal Revenue Code to implement a
 29 25 youth development strategy through after=school programming
 29 26 that promotes academic success, healthy lifestyles, good
 29 27 character, and citizenship.  The organization shall meet all of
 29 28 the following criteria:
 29 29    a.  Operate statewide and provide services through more than
 29 30 one location.
 29 31    b.  Provide the after=school programming for students ages
 29 32 five through eighteen years of age who are members of families
 29 33 eligible for the federal temporary assistance for needy
 29 34 families program.
 29 35    c.  Provide evidence, based on measurable outcomes, that the
 30  1 after=school programming provided results in increased student
 30  2 achievement.
 30  3    7.  The department may transfer funds appropriated in this
 30  4 section to the appropriations made in this division of this Act
 30  5 for general administration and field operations as necessary
 30  6 to administer this section and the overall family investment
 30  7 program.
 30  8    Sec. 9.  CHILD SUPPORT RECOVERY.  There is appropriated
 30  9 from the general fund of the state to the department of human
 30 10 services for the fiscal year beginning July 1, 2015, and ending
 30 11 June 30, 2016, the following amount, or so much thereof as is
 30 12 necessary, to be used for the purposes designated:
 30 13    For child support recovery, including salaries, support,
 30 14 maintenance, and miscellaneous purposes, and for not more than
 30 15 the following full=time equivalent positions:
 30 16 .................................................. $ 14,663,373
 30 17 ............................................... FTEs     464.00
 30 18    1.  The department shall expend up to $24,329, including
 30 19 federal financial participation, for the fiscal year beginning
 30 20 July 1, 2015, for a child support public awareness campaign.
 30 21 The department and the office of the attorney general shall
 30 22 cooperate in continuation of the campaign. The public
 30 23 awareness campaign shall emphasize, through a variety of
 30 24 media activities, the importance of maximum involvement of
 30 25 both parents in the lives of their children as well as the
 30 26 importance of payment of child support obligations.
 30 27    2.  Federal access and visitation grant moneys shall be
 30 28 issued directly to private not=for=profit agencies that provide
 30 29 services designed to increase compliance with the child access
 30 30 provisions of court orders, including but not limited to
 30 31 neutral visitation sites and mediation services.
 30 32    3.  The appropriation made to the department for child
 30 33 support recovery may be used throughout the fiscal year in the
 30 34 manner necessary for purposes of cash flow management, and for
 30 35 cash flow management purposes the department may temporarily
 31  1 draw more than the amount appropriated, provided the amount
 31  2 appropriated is not exceeded at the close of the fiscal year.
 31  3    4.  With the exception of the funding amount specified, the
 31  4 requirements established under 2001 Iowa Acts, chapter 191,
 31  5 section 3, subsection 5, paragraph "c", subparagraph (3), shall
 31  6 be applicable to parental obligation pilot projects for the
 31  7 fiscal year beginning July 1, 2015, and ending June 30, 2016.
 31  8 Notwithstanding 441 IAC 100.8, providing for termination of
 31  9 rules relating to the pilot projects, the rules shall remain
 31 10 in effect until June 30, 2016.
 31 11    Sec. 10.  HEALTH CARE TRUST FUND ==== MEDICAL ASSISTANCE ====
 31 12 FY 2015=2016.  Any funds remaining in the health care trust
 31 13 fund created in section 453A.35A for the fiscal year beginning
 31 14 July 1, 2015, and ending June 30, 2016, are appropriated to
 31 15 the department of human services to supplement the medical
 31 16 assistance program appropriations made in this division of this
 31 17 Act, for medical assistance reimbursement and associated costs,
 31 18 including program administration and costs associated with
 31 19 program implementation.
 31 20    Sec. 11.  MEDICAID FRAUD FUND ==== MEDICAL ASSISTANCE ==== FY
 31 21 2015=2016.  Any funds remaining in the Medicaid fraud fund
 31 22 created in section 249A.50 for the fiscal year beginning
 31 23 July 1, 2015, and ending June 30, 2016, are appropriated to
 31 24 the department of human services to supplement the medical
 31 25 assistance appropriations made in this division of this Act,
 31 26 for medical assistance reimbursement and associated costs,
 31 27 including program administration and costs associated with
 31 28 program implementation.
 31 29    Sec. 12.  MEDICAL ASSISTANCE.
 31 30    1.  There is appropriated from the general fund of the
 31 31 state to the department of human services for the fiscal year
 31 32 beginning July 1, 2015, and ending June 30, 2016, the following
 31 33 amount, or so much thereof as is necessary, to be used for the
 31 34 purpose designated:
 31 35    For medical assistance program reimbursement and associated
 32  1 costs as specifically provided in the reimbursement
 32  2 methodologies in effect on June 30, 2015, except as otherwise
 32  3 expressly authorized by law, including reimbursement for
 32  4 abortion services which shall be available under the medical
 32  5 assistance program only for those abortions which are medically
 32  6 necessary:
 32  7 .................................................. $1,346,353,640
 32  8    2.  Medically necessary abortions are those performed under
 32  9 any of the following conditions:
 32 10    a.  The attending physician certifies that continuing the
 32 11 pregnancy would endanger the life of the pregnant woman.
 32 12    b.  The attending physician certifies that the fetus is
 32 13 physically deformed, mentally deficient, or afflicted with a
 32 14 congenital illness.
 32 15    c.  The pregnancy is the result of a rape which is reported
 32 16 within 45 days of the incident to a law enforcement agency or
 32 17 public or private health agency which may include a family
 32 18 physician.
 32 19    d.  The pregnancy is the result of incest which is reported
 32 20 within 150 days of the incident to a law enforcement agency
 32 21 or  public or private health agency which may include a family
 32 22 physician.
 32 23    e.  Any spontaneous abortion, commonly known as a
 32 24 miscarriage, if not all of the products of conception are
 32 25 expelled.
 32 26    3.  a.  Iowans support reducing the number of abortions
 32 27 performed in our state.  For an abortion covered under the
 32 28 program, except in the case of a medical emergency, as defined
 32 29 in section 135L.1, for any woman, the physician shall certify
 32 30 both of the following:
 32 31    (1)  That the woman has been given the  opportunity to view an
 32 32 ultrasound image of the fetus as part of the standard of care
 32 33 before an abortion is performed.
 32 34    (2)  That the woman has been provided information regarding
 32 35 the options relative to a pregnancy, including continuing the
 33  1 pregnancy to term and retaining parental rights following the
 33  2 child's birth, continuing the pregnancy to term and placing the
 33  3 child for adoption, and terminating the pregnancy.
 33  4    b.  The provisions of this section relating to abortions
 33  5 shall also apply to the Iowa health and wellness plan created
 33  6 pursuant to chapter 249N.
 33  7    4.  The department shall utilize not more than $60,000 of
 33  8 the funds appropriated in this section to continue the AIDS/HIV
 33  9 health insurance premium payment program as established in 1992
 33 10 Iowa Acts, Second Extraordinary Session, chapter 1001, section
 33 11 409, subsection 6. Of the funds allocated in this subsection,
 33 12 not more than $5,000 may be expended for administrative
 33 13 purposes.
 33 14    5.  Of the funds appropriated in this Act to the department
 33 15 of public health for addictive disorders, $950,000 for
 33 16 the fiscal year beginning July 1, 2015, is transferred
 33 17 to the department of human services for an integrated
 33 18 substance=related disorder managed care system. The department
 33 19 shall not assume management of the substance=related disorder
 33 20 system in place of the managed care contractor unless such
 33 21 a change in approach is specifically authorized in law.
 33 22 The departments of human services and public health shall
 33 23 work together to maintain the level of mental health and
 33 24 substance=related disorder treatment services provided by the
 33 25 managed care contractor through the Iowa plan for behavioral
 33 26 health. Each department shall take the steps necessary to
 33 27 continue the federal waivers as necessary to maintain the level
 33 28 of services.
 33 29    6.  a.  The department shall aggressively pursue options for
 33 30 providing medical assistance or other assistance to individuals
 33 31 with special needs who become ineligible to continue receiving
 33 32 services under the early and periodic screening, diagnostic,
 33 33 and treatment program under the medical assistance program
 33 34 due to becoming 21 years of age who have been approved for
 33 35 additional assistance through the department's exception to
 34  1 policy provisions, but who have health care needs in excess
 34  2 of the funding available through the exception to policy
 34  3 provisions.
 34  4    b.  Of the funds appropriated in this section, $100,000
 34  5 shall be used for participation in one or more pilot projects
 34  6 operated by a private provider to allow the individual or
 34  7 individuals to receive service in the community in accordance
 34  8 with principles established in Olmstead v. L.C., 527 U.S. 581
 34  9 (1999), for the purpose of providing medical assistance or
 34 10 other assistance to individuals with special needs who become
 34 11 ineligible to continue receiving services under the early and
 34 12 periodic screening, diagnostic, and treatment program under
 34 13 the medical assistance program due to becoming 21 years of
 34 14 age who have been approved for additional assistance through
 34 15 the department's exception to policy provisions, but who have
 34 16 health care needs in excess of the funding available through
 34 17 the exception to the policy provisions.
 34 18    7.  Of the funds appropriated in this section, up to
 34 19 $3,050,082 may be transferred to the field operations or
 34 20 general administration appropriations in this division of this
 34 21 Act for operational costs associated with Part D of the federal
 34 22 Medicare Prescription Drug Improvement and Modernization Act
 34 23 of 2003, Pub. L. No. 108=173.
 34 24    8.  Of the funds appropriated in this section, up to $442,100
 34 25 may be transferred to the appropriation in this division
 34 26 of this Act for medical contracts to be used for clinical
 34 27 assessment services and prior authorization of services.
 34 28    9.  A portion of the funds appropriated in this section
 34 29 may be transferred to the appropriations in this division of
 34 30 this Act for general administration, medical contracts, the
 34 31 children's health insurance program, or field operations to be
 34 32 used for the state match cost to comply with the payment error
 34 33 rate measurement (PERM) program for both the medical assistance
 34 34 and children's health insurance programs as developed by the
 34 35 centers for Medicare and Medicaid services of the United States
 35  1 department of health and human services to comply with the
 35  2 federal Improper Payments Information Act of 2002, Pub. L. No.
 35  3 107=300.
 35  4    10.  The department shall continue to implement the
 35  5 recommendations of the assuring better child health and
 35  6 development initiative II (ABCDII) clinical panel to the
 35  7 Iowa early and periodic screening, diagnostic, and treatment
 35  8 services healthy mental development collaborative board
 35  9 regarding changes to billing procedures, codes, and eligible
 35 10 service providers.
 35 11    11.  Of the funds appropriated in this section, a sufficient
 35 12 amount is allocated to supplement the incomes of residents of
 35 13 nursing facilities, intermediate care facilities for persons
 35 14 with mental illness, and intermediate care facilities for
 35 15 persons with an intellectual disability, with incomes of less
 35 16 than $50 in the amount necessary for the residents to receive a
 35 17 personal needs allowance of $50 per month pursuant to section
 35 18 249A.30A.
 35 19    12.  Of the funds appropriated in this section, the following
 35 20 amounts are transferred to the appropriations made in this
 35 21 division of this Act for the state mental health institutes:
 35 22    a.  Cherokee mental health institute ................. $  9,098,425
 35 23    b.  Clarinda mental health institute ................. $  1,977,305
 35 24    c.  Independence mental health institute ............. $  9,045,894
 35 25    13.  a.  Of the funds appropriated in this section,
 35 26 $8,596,650 is allocated for the state match for a
 35 27 disproportionate share hospital payment of $19,133,430 to
 35 28 hospitals that meet both of the conditions specified in
 35 29 subparagraphs (1) and (2). In addition, the hospitals that
 35 30 meet the conditions specified shall either certify public
 35 31 expenditures or transfer to the medical assistance program
 35 32 an amount equal to provide the nonfederal share for a
 35 33 disproportionate share hospital payment of $7,500,000. The
 35 34 hospitals that meet the conditions specified shall receive and
 35 35 retain 100 percent of the total disproportionate share hospital
 36  1 payment of $26,633,430.
 36  2    (1)  The hospital qualifies for disproportionate share and
 36  3 graduate medical education payments.
 36  4    (2)  The hospital is an Iowa state=owned hospital with more
 36  5 than 500 beds and eight or more distinct residency specialty
 36  6 or subspecialty programs recognized by the American college of
 36  7 graduate medical education.
 36  8    b.  Distribution of the disproportionate share payments
 36  9 shall be made on a monthly basis. The total amount of
 36 10 disproportionate share payments including graduate medical
 36 11 education, enhanced disproportionate share, and Iowa
 36 12 state=owned teaching hospital payments shall not exceed the
 36 13 amount of the state's allotment under Pub. L. No. 102=234.
 36 14 In addition, the total amount of all disproportionate
 36 15 share payments shall not exceed the hospital=specific
 36 16 disproportionate share limits under Pub. L. No. 103=66.
 36 17    c.  The university of Iowa hospitals and clinics shall either
 36 18 certify public expenditures or transfer to the appropriations
 36 19 made in this division of this Act for medical assistance an
 36 20 amount equal to provide the nonfederal share for increased
 36 21 medical assistance payments for inpatient and outpatient
 36 22 hospital services of $9,900,000. The university of Iowa
 36 23 hospitals and clinics shall receive and retain 100 percent of
 36 24 the total increase in medical assistance payments.
 36 25    d.  Program payments for disproportionate share hospitals
 36 26 and graduate medical education, and the upper payment limits
 36 27 applicable to these programs shall be held harmless from the
 36 28 impacts of Medicaid managed care and the governor's Medicaid
 36 29 modernization initiative.  Payment methodologies utilized
 36 30 for these programs may be adjusted or converted to other
 36 31 methodologies or payment types in order to comply with this
 36 32 hold harmless requirement.
 36 33    14.  One hundred percent of the nonfederal share of payments
 36 34 to area education agencies that are medical assistance
 36 35 providers for medical assistance=covered services provided to
 37  1 medical assistance=covered children, shall be made from the
 37  2 appropriation made in this section.
 37  3    15.  Any new or renewed contract entered into by the
 37  4 department with a third party to administer behavioral health
 37  5 services under the medical assistance program shall provide
 37  6 that any interest earned on payments from the state during
 37  7 the state fiscal year shall be remitted to the department
 37  8 and treated as recoveries to offset the costs of the medical
 37  9 assistance program.
 37 10    16.  A portion of the funds appropriated in this section
 37 11 may be transferred to the appropriation in this division of
 37 12 this Act for medical contracts to be used for administrative
 37 13 activities associated with the money follows the person
 37 14 demonstration project.
 37 15    17.  Of the funds appropriated in this section, $349,011
 37 16 shall be used for the administration of the health insurance
 37 17 premium payment program, including salaries, support,
 37 18 maintenance, and miscellaneous purposes.
 37 19    18.  a.  The department may increase the amounts allocated
 37 20 for salaries, support, maintenance, and miscellaneous purposes
 37 21 associated with the medical assistance program, as necessary,
 37 22 to implement cost containment strategies.  The department shall
 37 23 report any such increase to the legislative services agency and
 37 24 the department of management.
 37 25    b.  If the savings to the medical assistance program from
 37 26 cost containment efforts exceed the cost for the fiscal
 37 27 year beginning July 1, 2015, the department may transfer any
 37 28 savings generated for the fiscal year due to medical assistance
 37 29 program cost containment efforts to the appropriation
 37 30 made in this division of this Act for medical contracts or
 37 31 general administration to defray the increased contract costs
 37 32 associated with implementing such efforts.
 37 33    c.  The department of human services shall not implement
 37 34 the following cost containment measures as recommended by the
 37 35 governor for the fiscal year beginning July 1, 2015:
 38  1    (1)  A measure to provide uniform rates of $.575 per mile
 38  2 based on the 2015 Internal Revenue Service mileage rate and
 38  3 of $9.29, the current statewide average, per one=way trip for
 38  4 Medicaid program home and community=based services waivers.
 38  5    (2)  A measure to cap the total costs of all services
 38  6 received by a recipient of the home and community=based
 38  7 services waiver for individuals with an intellectual disability
 38  8 at the daily intermediate care facility for persons with an
 38  9 intellectual disability (ICF/ID) per diem rate of $346.39 per
 38 10 day based on the 80th percentile of all ICF/ID rates.
 38 11    (3)  A measure to align individual requests for exceptions to
 38 12 policy with the capped total cost of services for a recipient
 38 13 of the home and community=based services waiver for individuals
 38 14 with an intellectual disability as computed under subparagraph
 38 15 (2).
 38 16    (4)  A measure to utilize the supports intensity scale
 38 17 to determine payment amounts and a tiered payment system
 38 18 for the services provided to adults served under the home
 38 19 and community=based services waiver for individuals with an
 38 20 intellectual disability.
 38 21    (5)  A measure to accelerate implementation of the provision
 38 22 that beginning July 1, 2015, rather than July 1, 2016, the
 38 23 department of human services requires services through the
 38 24 consumer=directed attendant care option to be provided through
 38 25 an agency or consumer choices option.
 38 26    (6)  A measure to reallocate funding for community=based
 38 27 systems of care to instead support integrated health homes.
 38 28    (7)  A measure to increase the university of Iowa hospitals
 38 29 and clinics state share responsibility for the supplemental
 38 30 disproportionate share hospital payment to the university of
 38 31 Iowa hospitals and clinics  for the fiscal year beginning July
 38 32 1, 2015.
 38 33    d.  The department shall report the implementation of
 38 34 any cost containment strategies under this subsection to
 38 35 the individuals specified in this division of this Act for
 39  1 submission of reports on a quarterly basis.
 39  2    19.  For the fiscal year beginning July 1, 2015, and ending
 39  3 June 30, 2016, the replacement generation tax revenues required
 39  4 to be deposited in the property tax relief fund pursuant to
 39  5 section 437A.8, subsection 4, paragraph "d", and section
 39  6 437A.15, subsection 3, paragraph "f", shall instead be credited
 39  7 to and supplement the appropriation made in this section and
 39  8 used for the allocations made in this section.
 39  9    20.  The department shall continue to administer the state
 39 10 balancing incentive payments program as specified in 2012 Iowa
 39 11 Acts, chapter 1133, section 14.
 39 12    21.  a.  Of the funds appropriated in this section, $900,000
 39 13 shall be used for continued implementation of the children's
 39 14 mental health home project proposed by the department of human
 39 15 services and reported to the general assembly's mental health
 39 16 and disability services study committee in December 2011. Of
 39 17 this amount, up to $50,000 may be transferred by the department
 39 18 to the appropriation made in this division of this Act to the
 39 19 department for the same fiscal year for general administration
 39 20 to be used for associated administrative expenses and for not
 39 21 more than one full=time equivalent position, in addition to
 39 22 those authorized for the same fiscal year, to be assigned to
 39 23 implementing the project.
 39 24    b.  Of the funds appropriated in this section, up to $400,000
 39 25 may be transferred by the department to the appropriation made
 39 26 to the department in this division of this Act for the same
 39 27 fiscal year for Medicaid program=related general administration
 39 28 planning and implementation activities.  The funds may be used
 39 29 for contracts or for personnel in addition to the amounts
 39 30 appropriated for and the positions authorized for general
 39 31 administration for the fiscal year.
 39 32    c.  Of the funds appropriated in this section, up to
 39 33 $3,000,000 may be transferred by the department to the
 39 34 appropriations made in this division of this Act for the same
 39 35 fiscal year for general administration or medical contracts
 40  1 to be used to support the development and implementation of
 40  2 standardized assessment tools for persons with mental illness,
 40  3 an intellectual disability, a developmental disability, or a
 40  4 brain injury.
 40  5    22.  Of the funds appropriated in this section, $250,000
 40  6 shall be used for lodging expenses associated with care
 40  7 provided at the university of Iowa hospitals and clinics for
 40  8 patients with cancer whose travel distance is 30 miles or more
 40  9 and whose income is at or below 200 percent of the federal
 40 10 poverty level as defined by the most recently revised poverty
 40 11 income guidelines published by the United States department of
 40 12 health and human services. The department of human services
 40 13 shall establish the maximum number of overnight stays and the
 40 14 maximum rate reimbursed for overnight lodging, which may be
 40 15 based on the state employee rate established by the department
 40 16 of administrative services.  The funds allocated in this
 40 17 subsection  shall not be used as nonfederal share matching
 40 18 funds.
 40 19    23.  The department of human services shall adopt rules to
 40 20 provide for coverage of telehealth under the Medicaid program.
 40 21 The rules shall provide that in=person contact between a
 40 22 health care professional and a patient is not required as a
 40 23 prerequisite for payment for services appropriately provided
 40 24 through telehealth in accordance with generally accepted health
 40 25 care practices and standards prevailing in the applicable
 40 26 professional community at the time the services are provided.
 40 27 Health care services provided through in=person consultations
 40 28 or through telehealth shall be treated as equivalent services
 40 29 for the purposes of reimbursement.
 40 30    24.  a.  For inpatient and outpatient services provided
 40 31 by hospitals on or after July 1, 2015, the department of
 40 32 human services shall recalculate and prospectively apply an
 40 33 updated cost=to=charge ratio upon the request of a hospital to
 40 34 implement price or charge reductions, if all of the following
 40 35 criteria are met:
 41  1    (1)  The recalculation of an updated cost=to=charge ratio is
 41  2 budget neutral to the state funding amount appropriated for the
 41  3 respective fiscal year and maintains budget neutral payments or
 41  4 revenue to all hospitals.
 41  5    (2)  The hospital requesting the price or charge reduction
 41  6 submits a proforma cost report and charge master that reflects
 41  7 the anticipated cost=to=charge reduction.
 41  8    b.  Based upon the proforma cost report submitted by the
 41  9 requesting hospital, the department of human services shall
 41 10 prospectively apply the recalculated cost=to=charge ratio as
 41 11 appropriate to submitted claims for health care services.
 41 12    25.  The department of human services shall not adopt
 41 13 emergency rules to implement Medicaid managed care or the
 41 14 governor's Medicaid modernization initiative.
 41 15    26.  The number of home and community=based services waiver
 41 16 slots available during the fiscal year beginning July 1, 2015,
 41 17 shall not be reduced below the number of such slots available
 41 18 on January 1, 2015.
 41 19    Sec. 13.  MEDICAL CONTRACTS.  There is appropriated from the
 41 20 general fund of the state to the department of human services
 41 21 for the fiscal year beginning July 1, 2015, and ending June 30,
 41 22 2016, the following amount, or so much thereof as is necessary,
 41 23 to be used for the purpose designated:
 41 24    For medical contracts:
 41 25 .................................................. $ 22,153,584
 41 26    1.  The department of inspections and appeals shall
 41 27 provide all state matching funds for survey and certification
 41 28 activities performed by the department of inspections
 41 29 and appeals. The department of human services is solely
 41 30 responsible for distributing the federal matching funds for
 41 31 such activities.
 41 32    2.  Of the funds appropriated in this section, $50,000 shall
 41 33 be used for continuation of home and community=based services
 41 34 waiver quality assurance programs, including the review and
 41 35 streamlining of processes and policies related to oversight and
 42  1 quality management to meet state and federal requirements.
 42  2    3.  Of the amount appropriated in this section, up to
 42  3 $200,000 may be transferred to the appropriation for general
 42  4 administration in this division of this Act to be used for
 42  5 additional full=time equivalent positions in the development of
 42  6 key health initiatives such as cost containment, development
 42  7 and oversight of managed care programs, and development of
 42  8 health strategies targeted toward improved quality and reduced
 42  9 costs in the Medicaid program.
 42 10    4.  Of the funds appropriated in this section, $1,000,000
 42 11 shall be used for planning and development, in cooperation with
 42 12 the department of public health, of a phased=in program to
 42 13 provide a dental home for children.
 42 14    5.  Of the funds appropriated in this section, $2,000,000
 42 15 shall be used for the autism support program created in chapter
 42 16 225D.
 42 17    Sec. 14.  STATE SUPPLEMENTARY ASSISTANCE.
 42 18    1.  There is appropriated from the general fund of the
 42 19 state to the department of human services for the fiscal year
 42 20 beginning July 1, 2015, and ending June 30, 2016, the following
 42 21 amount, or so much thereof as is necessary, to be used for the
 42 22 purpose designated:
 42 23    For the state supplementary assistance program:
 42 24 .................................................. $12,997,187
 42 25    2.  The department shall increase the personal needs
 42 26 allowance for residents of residential care facilities by the
 42 27 same percentage and at the same time as federal supplemental
 42 28 security income and federal social security benefits are
 42 29 increased due to a recognized increase in the cost of living.
 42 30 The department may adopt emergency rules to implement this
 42 31 subsection.
 42 32    3.  If during the fiscal year beginning July 1, 2015,
 42 33 the department projects that state supplementary assistance
 42 34 expenditures for a calendar year will not meet the federal
 42 35 pass=through requirement specified in Tit. XVI of the federal
 43  1 Social Security Act, section 1618, as codified in 42 U.S.C.
 43  2 {1382g, the department may take actions including but not
 43  3 limited to increasing the personal needs allowance for
 43  4 residential care facility residents and making programmatic
 43  5 adjustments or upward adjustments of the residential care
 43  6 facility or in=home health=related care reimbursement rates
 43  7 prescribed in this division of this Act to ensure that federal
 43  8 requirements are met. In addition, the department may make
 43  9 other programmatic and rate adjustments necessary to remain
 43 10 within the amount appropriated in this section while ensuring
 43 11 compliance with federal requirements. The department may adopt
 43 12 emergency rules to implement the provisions of this subsection.
 43 13    Sec. 15.  CHILDREN'S HEALTH INSURANCE PROGRAM.
 43 14    1.  There is appropriated from the general fund of the
 43 15 state to the department of human services for the fiscal year
 43 16 beginning July 1, 2015, and ending June 30, 2016, the following
 43 17 amount, or so much thereof as is necessary, to be used for the
 43 18 purpose designated:
 43 19    For maintenance of the healthy and well kids in Iowa (hawk=i)
 43 20 program pursuant to chapter 514I, including supplemental dental
 43 21 services, for receipt of federal financial participation under
 43 22 Tit. XXI of the federal Social Security Act, which creates the
 43 23 children's health insurance program:
 43 24 .................................................. $ 21,163,844
 43 25    2.  Of the funds appropriated in this section, $42,800 is
 43 26 allocated for continuation of the contract for outreach with
 43 27 the department of public health.
 43 28    Sec. 16.  CHILD CARE ASSISTANCE.  There is appropriated
 43 29 from the general fund of the state to the department of human
 43 30 services for the fiscal year beginning July 1, 2015, and ending
 43 31 June 30, 2016, the following amount, or so much thereof as is
 43 32 necessary, to be used for the purpose designated:
 43 33    For child care programs:
 43 34 .................................................. $ 56,638,030
 43 35    1.  Of the funds appropriated in this section, $48,818,603
 44  1 shall be used for state child care assistance in accordance
 44  2 with section 237A.13.
 44  3    2.  Nothing in this section shall be construed or is
 44  4 intended as or shall imply a grant of entitlement for services
 44  5 to persons who are eligible for assistance due to an income
 44  6 level consistent with the waiting list requirements of section
 44  7 237A.13. Any state obligation to provide services pursuant to
 44  8 this section is limited to the extent of the funds appropriated
 44  9 in this section.
 44 10    3.  Of the funds appropriated in this section, $432,453
 44 11 is allocated for the statewide grant program for child care
 44 12 resource and referral services under section 237A.26. A list
 44 13 of the registered and licensed child care facilities operating
 44 14 in the area served by a child care resource and referral
 44 15 service shall be made available to the families receiving state
 44 16 child care assistance in that area.
 44 17    4.  Of the funds appropriated in this section, $936,974
 44 18 is allocated for child care quality improvement initiatives
 44 19 including but not limited to the voluntary quality rating
 44 20 system in accordance with section 237A.30.
 44 21    5.  Of the funds appropriated in this section, $6,350,000
 44 22 shall be credited to the early childhood programs grants
 44 23 account in the early childhood Iowa fund created in section
 44 24 256I.11. The moneys shall be distributed for funding of
 44 25 community=based early childhood programs targeted to children
 44 26 from birth through five years of age developed by early
 44 27 childhood Iowa areas in accordance with approved community
 44 28 plans as provided in section 256I.8.
 44 29    6.  The department may use any of the funds appropriated
 44 30 in this section as a match to obtain federal funds for use in
 44 31 expanding child care assistance and related programs. For
 44 32 the purpose of expenditures of state and federal child care
 44 33 funding, funds shall be considered obligated at the time
 44 34 expenditures are projected or are allocated to the department's
 44 35 service areas. Projections shall be based on current and
 45  1 projected caseload growth, current and projected provider
 45  2 rates, staffing requirements for eligibility determination
 45  3 and management of program requirements including data systems
 45  4 management, staffing requirements for administration of the
 45  5 program, contractual and grant obligations and any transfers
 45  6 to other state agencies, and obligations for decategorization
 45  7 or innovation projects.
 45  8    7.  A portion of the state match for the federal child care
 45  9 and development block grant shall be provided as necessary to
 45 10 meet federal matching funds requirements through the state
 45 11 general fund appropriation made for child development grants
 45 12 and other programs for at=risk children in section 279.51.
 45 13    8.  If a uniform reduction ordered by the governor under
 45 14 section 8.31 or other operation of law, transfer, or federal
 45 15 funding reduction reduces the appropriation made in this
 45 16 section for the fiscal year, the percentage reduction in the
 45 17 amount paid out to or on behalf of the families participating
 45 18 in the state child care assistance program shall be equal to or
 45 19 less than the percentage reduction made for any other purpose
 45 20 payable from the appropriation made in this section and the
 45 21 federal funding relating to it. The percentage reduction to
 45 22 the other allocations made in this section shall be the same as
 45 23 the uniform reduction ordered by the governor or the percentage
 45 24 change of the federal funding reduction, as applicable.
 45 25 If there is an unanticipated increase in federal funding
 45 26 provided for state child care assistance, the entire amount
 45 27 of the increase shall be used for state child care assistance
 45 28 payments. If the appropriations made for purposes of the
 45 29 state child care assistance program for the fiscal year are
 45 30 determined to be insufficient, it is the intent of the general
 45 31 assembly to appropriate sufficient funding for the fiscal year
 45 32 in order to avoid establishment of waiting list requirements.
 45 33    9.  Notwithstanding section 8.33, moneys advanced for
 45 34 purposes of the programs developed by early childhood Iowa
 45 35 areas, advanced for purposes of wraparound child care, or
 46  1 received from the federal appropriations made for the purposes
 46  2 of this section that remain unencumbered or unobligated at the
 46  3 close of the fiscal year shall not revert to any fund but shall
 46  4 remain available for expenditure for the purposes designated
 46  5 until the close of the succeeding fiscal year.
 46  6    10.  Of the funds appropriated in this section, $100,000
 46  7 is transferred to the department of public health to be used
 46  8 to continue a program to assist parents in this state with
 46  9 costs resulting from the death of a child in accordance with
 46 10 this subsection. If it is less costly than administering the
 46 11 program directly, the department shall issue a request for
 46 12 proposals and issue a grant to an appropriate organization to
 46 13 administer the program.
 46 14    a.  The program funding shall be used to assist parents who
 46 15 reside in this state with costs incurred for a funeral, burial
 46 16 or cremation, cemetery costs, or grave marker costs associated
 46 17 with the unintended death of a child of the parent or a child
 46 18 under the care of a guardian or custodian.  The department
 46 19 shall consider the following eligibility factors in developing
 46 20 program requirements:
 46 21    (1)  The child was a stillborn infant or was less than age
 46 22 eighteen at the time of death.
 46 23    (2)  The request for assistance was approved by the local
 46 24 board or department of health or the county general assistance
 46 25 director and may have been referred by a local funeral home.
 46 26    (3)  To be eligible, the parent, guardian, or custodian must
 46 27 have an annual household income that is less than 145 percent
 46 28 of the federal poverty level based on the number of people
 46 29 in the applicant's household as defined by the most recently
 46 30 revised poverty income guidelines published by the United
 46 31 States department of health and human services.
 46 32    (4)  The maximum amount of grant assistance provided to a
 46 33 parent, guardian, or custodian associated with the death of
 46 34 a child is $2,000. If the death is a multiple death and the
 46 35 infants or children are being cremated, or buried together, the
 47  1 same limitation applies.
 47  2    (5)  To the extent the overall amount of assistance received
 47  3 by a recipient for the costs addressed under this subsection
 47  4 does not exceed the overall total of the costs, the recipient
 47  5 may receive other public or private assistance in addition to
 47  6 grant assistance under this section.
 47  7    b.  Notwithstanding section 8.33, moneys transferred by this
 47  8 subsection that remain unencumbered or unobligated at the close
 47  9 of the fiscal year shall not revert but shall remain available
 47 10 for expenditure for the purposes designated until expended.
 47 11    Sec. 17.  JUVENILE INSTITUTIONS.  There is appropriated
 47 12 from the general fund of the state to the department of human
 47 13 services for the fiscal year beginning July 1, 2015, and ending
 47 14 June 30, 2016, the following amounts, or so much thereof as is
 47 15 necessary, to be used for the purposes designated:
 47 16    1.  For the costs of security, building and grounds
 47 17 maintenance, utilities, salary, and support for the facilities
 47 18 located at the Iowa juvenile home at Toledo and for salaries,
 47 19 support, maintenance, and miscellaneous purposes, and for not
 47 20 more than the following full=time equivalent positions:
 47 21 .................................................. $    372,766
 47 22 ............................................... FTEs       2.00
 47 23    2.  For operation of the state training school at Eldora and
 47 24 for salaries, support, maintenance, and miscellaneous purposes,
 47 25 and for not more than the following full=time equivalent
 47 26 positions:
 47 27 .................................................. $ 12,445,552
 47 28 ............................................... FTEs     169.30
 47 29    Of the funds appropriated in this subsection, $91,150 shall
 47 30 be used for distribution to licensed classroom teachers at this
 47 31 and other institutions under the control of the department of
 47 32 human services based upon the average student yearly enrollment
 47 33 at each institution as determined by the department.
 47 34    Sec. 18.  CHILD AND FAMILY SERVICES.
 47 35    1.  There is appropriated from the general fund of the
 48  1 state to the department of human services for the fiscal year
 48  2 beginning July 1, 2015, and ending June 30, 2016, the following
 48  3 amount, or so much thereof as is necessary, to be used for the
 48  4 purpose designated:
 48  5    For child and family services:
 48  6 .................................................. $ 98,182,179
 48  7    2.  Up to $5,200,000 of the amount of federal temporary
 48  8 assistance for needy families block grant funding appropriated
 48  9 in this division of this Act for child and family services
 48 10 shall be made available for purposes of juvenile delinquent
 48 11 graduated sanction services.
 48 12    3.  The department may transfer funds appropriated in this
 48 13 section as necessary to pay the nonfederal costs of services
 48 14 reimbursed under the medical assistance program, state child
 48 15 care assistance program, or the family investment program which
 48 16 are provided to children who would otherwise receive services
 48 17 paid under the appropriation in this section. The department
 48 18 may transfer funds appropriated in this section to the
 48 19 appropriations made in this division of this Act for general
 48 20 administration and for field operations for resources necessary
 48 21 to implement and operate the services funded in this section.
 48 22    4.  a.  Of the funds appropriated in this section, up to
 48 23 $35,821,786 is allocated as the statewide expenditure target
 48 24 under section 232.143 for group foster care maintenance and
 48 25 services. If the department projects that such expenditures
 48 26 for the fiscal year will be less than the target amount
 48 27 allocated in this paragraph "a", the department may reallocate
 48 28 the excess to provide additional funding for shelter care
 48 29 or the child welfare emergency services addressed with the
 48 30 allocation for shelter care.
 48 31    b.  If at any time after September 30, 2015, annualization
 48 32 of a service area's current expenditures indicates a service
 48 33 area is at risk of exceeding its group foster care expenditure
 48 34 target under section 232.143 by more than 5 percent, the
 48 35 department and juvenile court services shall examine all
 49  1 group foster care placements in that service area in order to
 49  2 identify those which might be appropriate for termination.
 49  3 In addition, any aftercare services believed to be needed
 49  4 for the children whose placements may be terminated shall be
 49  5 identified. The department and juvenile court services shall
 49  6 initiate action to set dispositional review hearings for the
 49  7 placements identified. In such a dispositional review hearing,
 49  8 the juvenile court shall determine whether needed aftercare
 49  9 services are available and whether termination of the placement
 49 10 is in the best interest of the child and the community.
 49 11    5.  In accordance with the provisions of section 232.188,
 49 12 the department shall continue the child welfare and juvenile
 49 13 justice funding initiative during fiscal year 2015=2016. Of
 49 14 the funds appropriated in this section, $1,717,753 is allocated
 49 15 specifically for expenditure for fiscal year 2015=2016 through
 49 16 the decategorization services funding pools and governance
 49 17 boards established pursuant to section 232.188.
 49 18    6.  A portion of the funds appropriated in this section
 49 19 may be used for emergency family assistance to provide other
 49 20 resources required for a family participating in a family
 49 21 preservation or reunification project or successor project to
 49 22 stay together or to be reunified.
 49 23    7.  Notwithstanding section 234.35 or any other provision
 49 24 of law to the contrary, state funding for shelter care and
 49 25 the child welfare emergency services contracting implemented
 49 26 to provide for or prevent the need for shelter care shall be
 49 27 limited to $8,068,474.
 49 28    8.  Federal funds received by the state during the fiscal
 49 29 year beginning July 1, 2015, as the result of the expenditure
 49 30 of state funds appropriated during a previous state fiscal
 49 31 year for a service or activity funded under this section are
 49 32 appropriated to the department to be used as additional funding
 49 33 for services and purposes provided for under this section.
 49 34 Notwithstanding section 8.33, moneys received in accordance
 49 35 with this subsection that remain unencumbered or unobligated at
 50  1 the close of the fiscal year shall not revert to any fund but
 50  2 shall remain available for the purposes designated until the
 50  3 close of the succeeding fiscal year.
 50  4    9.  a.  Of the funds appropriated in this section, up to
 50  5 $3,290,000 is allocated for the payment of the expenses of
 50  6 court=ordered services provided to juveniles who are under the
 50  7 supervision of juvenile court services, which expenses are a
 50  8 charge upon the state pursuant to section 232.141, subsection
 50  9 4. Of the amount allocated in this paragraph "a", up to
 50 10 $1,556,287 shall be made available to provide school=based
 50 11 supervision of children adjudicated under chapter 232, of which
 50 12 not more than $15,000 may be used for the purpose of training.
 50 13 A portion of the cost of each school=based liaison officer
 50 14 shall be paid by the school district or other funding source as
 50 15 approved by the chief juvenile court officer.
 50 16    b.  Of the funds appropriated in this section, up to $748,985
 50 17 is allocated for the payment of the expenses of court=ordered
 50 18 services provided to children who are under the supervision
 50 19 of the department, which expenses are a charge upon the state
 50 20 pursuant to section 232.141, subsection 4.
 50 21    c.  Notwithstanding section 232.141 or any other provision
 50 22 of law to the contrary, the amounts allocated in this
 50 23 subsection shall be distributed to the judicial districts
 50 24 as determined by the state court administrator and to the
 50 25 department's service areas as determined by the administrator
 50 26 of the department of human services' division of child and
 50 27 family services. The state court administrator and the
 50 28 division administrator shall make the determination of the
 50 29 distribution amounts on or before June 15, 2015.
 50 30    d.  Notwithstanding chapter 232 or any other provision of
 50 31 law to the contrary, a district or juvenile court shall not
 50 32 order any service which is a charge upon the state pursuant
 50 33 to section 232.141 if there are insufficient court=ordered
 50 34 services funds available in the district court or departmental
 50 35 service area distribution amounts to pay for the service. The
 51  1 chief juvenile court officer and the departmental service area
 51  2 manager shall encourage use of the funds allocated in this
 51  3 subsection such that there are sufficient funds to pay for
 51  4 all court=related services during the entire year. The chief
 51  5 juvenile court officers and departmental service area managers
 51  6 shall attempt to anticipate potential surpluses and shortfalls
 51  7 in the distribution amounts and shall cooperatively request the
 51  8 state court administrator or division administrator to transfer
 51  9 funds between the judicial districts' or departmental service
 51 10 areas' distribution amounts as prudent.
 51 11    e.  Notwithstanding any provision of law to the contrary,
 51 12 a district or juvenile court shall not order a county to pay
 51 13 for any service provided to a juvenile pursuant to an order
 51 14 entered under chapter 232 which is a charge upon the state
 51 15 under section 232.141, subsection 4.
 51 16    f.  Of the funds allocated in this subsection, not more than
 51 17 $83,000 may be used by the judicial branch for administration
 51 18 of the requirements under this subsection.
 51 19    g.  Of the funds allocated in this subsection, $17,000
 51 20 shall be used by the department of human services to support
 51 21 the interstate commission for juveniles in accordance with
 51 22 the interstate compact for juveniles as provided in section
 51 23 232.173.
 51 24    10.  Of the funds appropriated in this section, $8,053,227 is
 51 25 allocated for juvenile delinquent graduated sanctions services.
 51 26 Any state funds saved as a result of efforts by juvenile court
 51 27 services to earn a federal Tit. IV=E match for juvenile court
 51 28 services administration may be used for the juvenile delinquent
 51 29 graduated sanctions services.
 51 30    11.  Of the funds appropriated in this section, $1,608,285 is
 51 31 transferred to the department of public health to be used for
 51 32 the child protection center grant program for child protection
 51 33 centers located in Iowa in accordance with section 135.118.
 51 34 The grant amounts under the program shall be equalized so that
 51 35 each center receives a uniform base amount of $245,000, and
 52  1 the remaining funds shall be awarded through a funding formula
 52  2 based upon the volume of children served.
 52  3    12.  If the department receives federal approval to
 52  4 implement a waiver under Tit. IV=E of the federal Social
 52  5 Security Act to enable providers to serve children who remain
 52  6 in the children's families and communities, for purposes of
 52  7 eligibility under the medical assistance program through 25
 52  8 years of age, children who participate in the waiver shall be
 52  9 considered to be placed in foster care.
 52 10    13.  Of the funds appropriated in this section, $4,025,167 is
 52 11 allocated for the preparation for adult living program pursuant
 52 12 to section 234.46.
 52 13    14.  Of the funds appropriated in this section, $520,150
 52 14 shall be used for juvenile drug courts. The amount allocated
 52 15 in this subsection shall be distributed as follows:
 52 16    To the judicial branch for salaries to assist with the
 52 17 operation of juvenile drug court programs operated in the
 52 18 following jurisdictions:
 52 19    a.  Marshall county:
 52 20 .................................................. $     62,708
 52 21    b.  Woodbury county:
 52 22 .................................................. $    125,682
 52 23    c.  Polk county:
 52 24 .................................................. $    195,892
 52 25    d.  The third judicial district:
 52 26 .................................................. $     67,934
 52 27    e.  The eighth judicial district:
 52 28 .................................................. $     67,934
 52 29    15.  Of the funds appropriated in this section, $227,337
 52 30 shall be used for the public purpose of continuing a grant to
 52 31 a nonprofit human services organization providing services to
 52 32 individuals and families in multiple locations in southwest
 52 33 Iowa and Nebraska for support of a project providing immediate,
 52 34 sensitive support and forensic interviews, medical exams, needs
 52 35 assessments, and referrals for victims of child abuse and their
 53  1 nonoffending family members.
 53  2    16.  Of the funds appropriated in this section, $300,620
 53  3 is allocated for the foster care youth council approach of
 53  4 providing a support network to children placed in foster care.
 53  5    17.  Of the funds appropriated in this section, $202,000 is
 53  6 allocated for use pursuant to section 235A.1 for continuation
 53  7 of the initiative to address child sexual abuse implemented
 53  8 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
 53  9 21.
 53 10    18.  Of the funds appropriated in this section, $630,240 is
 53 11 allocated for the community partnership for child protection
 53 12 sites.
 53 13    19.  Of the funds appropriated in this section, $371,250
 53 14 is allocated for the department's minority youth and family
 53 15 projects under the redesign of the child welfare system.
 53 16    20.  Of the funds appropriated in this section, $1,186,595
 53 17 is allocated for funding of the community circle of care
 53 18 collaboration for children and youth in northeast Iowa.
 53 19    21.  Of the funds appropriated in this section, at least
 53 20 $147,158 shall be used for the continuation of the child
 53 21 welfare provider training academy, a collaboration between the
 53 22 coalition for family and children's services in Iowa and the
 53 23 department.
 53 24    22.  Of the funds appropriated in this section, $25,000
 53 25 shall be used for the public purpose of continuation of a
 53 26 grant to a child welfare services provider headquartered in a
 53 27 county with a population between 205,000 and 215,000 in the
 53 28 latest certified federal census that provides multiple services
 53 29 including but not limited to a psychiatric medical institution
 53 30 for children, shelter, residential treatment, after school
 53 31 programs, school=based programming, and an Asperger's syndrome
 53 32 program, to be used for support services for children with
 53 33 autism spectrum disorder and their families.
 53 34    23.  Of the funds appropriated in this section, $25,000
 53 35 shall be used for the public purpose of continuing a grant to
 54  1 a hospital=based provider headquartered in a county with a
 54  2 population between 90,000 and 95,000 in the latest certified
 54  3 federal census that provides multiple services including
 54  4 but not limited to diagnostic, therapeutic, and behavioral
 54  5 services to individuals with autism spectrum disorder across
 54  6 one's lifespan. The grant recipient shall utilize the funds
 54  7 to continue the pilot project to determine the necessary
 54  8 support services for children with autism spectrum disorder and
 54  9 their families to be included in the children's disabilities
 54 10 services system. The grant recipient shall submit findings and
 54 11 recommendations based upon the results of the pilot project
 54 12 to the individuals specified in this division of this Act for
 54 13 submission of reports by December 31, 2015.
 54 14    24.  Of the funds appropriated in this section, $211,872
 54 15 shall be used for continuation of the central Iowa system of
 54 16 care program grant through June 30, 2016.
 54 17    25.  Of the funds appropriated in this section, $250,000
 54 18 shall be used for the public purpose of the continuation
 54 19 and expansion of a system of care program grant implemented
 54 20 in Cerro Gordo and Linn counties to utilize a comprehensive
 54 21 and long=term approach for helping children and families by
 54 22 addressing the key areas in a child's life of childhood basic
 54 23 needs, education and work, family, and community.
 54 24    26.  Of the funds appropriated in this section, at least
 54 25 $25,000 shall be used to continue and to expand the foster
 54 26 care respite pilot program in which postsecondary students in
 54 27 social work and other human services=related programs receive
 54 28 experience by assisting family foster care providers with
 54 29 respite and other support.
 54 30    27.  Of the funds appropriated in this section, $110,000
 54 31 shall be used for the public purpose of funding community=based
 54 32 services and other supports with a system of care approach
 54 33 for children with a serious emotional disturbance and their
 54 34 families through a nonprofit provider of child welfare services
 54 35 that has been in existence for more than 115 years, is located
 55  1 in a county with a population of more than 200,000 but less
 55  2 than 220,000 according to the latest census information
 55  3 issued by the United States census bureau, is licensed as a
 55  4 psychiatric medical institution for children, and was a system
 55  5 of care grantee prior to July 1, 2015.
 55  6    Sec. 19.  ADOPTION SUBSIDY.
 55  7    1.  There is appropriated from the general fund of the
 55  8 state to the department of human services for the fiscal year
 55  9 beginning July 1, 2015, and ending June 30, 2016, the following
 55 10 amount, or so much thereof as is necessary, to be used for the
 55 11 purpose designated:
 55 12    For adoption subsidy payments and services:
 55 13 .................................................. $ 42,998,286
 55 14    2.  The department may transfer funds appropriated in
 55 15 this section to the appropriation made in this division of
 55 16 this Act for general administration for costs paid from the
 55 17 appropriation relating to adoption subsidy.
 55 18    3.  Federal funds received by the state during the
 55 19 fiscal year beginning July 1, 2015, as the result of the
 55 20 expenditure of state funds during a previous state fiscal
 55 21 year for a service or activity funded under this section are
 55 22 appropriated to the department to be used as additional funding
 55 23 for the services and activities funded under this section.
 55 24 Notwithstanding section 8.33, moneys received in accordance
 55 25 with this subsection that remain unencumbered or unobligated
 55 26 at the close of the fiscal year shall not revert to any fund
 55 27 but shall remain available for expenditure for the purposes
 55 28 designated until the close of the succeeding fiscal year.
 55 29    Sec. 20.  JUVENILE DETENTION HOME FUND.  Moneys deposited
 55 30 in the juvenile detention home fund created in section 232.142
 55 31 during the fiscal year beginning July 1, 2015, and ending June
 55 32 30, 2016, are appropriated to the department of human services
 55 33 for the fiscal year beginning July 1, 2015, and ending June 30,
 55 34 2016, for distribution of an amount equal to a percentage of
 55 35 the costs of the establishment, improvement, operation, and
 56  1 maintenance of county or multicounty juvenile detention homes
 56  2 in the fiscal year beginning July 1, 2014. Moneys appropriated
 56  3 for distribution in accordance with this section shall be
 56  4 allocated among eligible detention homes, prorated on the basis
 56  5 of an eligible detention home's proportion of the costs of all
 56  6 eligible detention homes in the fiscal year beginning July
 56  7 1, 2014. The percentage figure shall be determined by the
 56  8 department based on the amount available for distribution for
 56  9 the fund. Notwithstanding section 232.142, subsection 3, the
 56 10 financial aid payable by the state under that provision for the
 56 11 fiscal year beginning July 1, 2015, shall be limited to the
 56 12 amount appropriated for the purposes of this section.
 56 13    Sec. 21.  FAMILY SUPPORT SUBSIDY PROGRAM.
 56 14    1.  There is appropriated from the general fund of the
 56 15 state to the department of human services for the fiscal year
 56 16 beginning July 1, 2015, and ending June 30, 2016, the following
 56 17 amount, or so much thereof as is necessary, to be used for the
 56 18 purpose designated:
 56 19    For the family support subsidy program subject to the
 56 20 enrollment restrictions in section 225C.37, subsection 3:
 56 21 .................................................. $  1,073,932
 56 22    2.  The department shall use at least $641,500 of the moneys
 56 23 appropriated in this section for the family support center
 56 24 component of the comprehensive family support program under
 56 25 section 225C.47. Not more than $25,000 of the amount allocated
 56 26 in this subsection shall be used for administrative costs.
 56 27    3.  If at any time during the fiscal year, the amount of
 56 28 funding available for the family support subsidy program
 56 29 is reduced from the amount initially used to establish the
 56 30 figure for the number of family members for whom a subsidy
 56 31 is to be provided at any one time during the fiscal year,
 56 32 notwithstanding section 225C.38, subsection 2, the department
 56 33 shall revise the figure as necessary to conform to the amount
 56 34 of funding available.
 56 35    Sec. 22.  CONNER DECREE.  There is appropriated from the
 57  1 general fund of the state to the department of human services
 57  2 for the fiscal year beginning July 1, 2015, and ending June 30,
 57  3 2016, the following amount, or so much thereof as is necessary,
 57  4 to be used for the purpose designated:
 57  5    For building community capacity through the coordination
 57  6 and provision of training opportunities in accordance with the
 57  7 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
 57  8 Iowa, July 14, 1994):
 57  9 .................................................. $     33,632
 57 10    Sec. 23.  MENTAL HEALTH INSTITUTES.  There is appropriated
 57 11 from the general fund of the state to the department of human
 57 12 services for the fiscal year beginning July 1, 2015, and ending
 57 13 June 30, 2016, the following amounts, or so much thereof as is
 57 14 necessary, to be used for the purposes designated:
 57 15    1.  For the state mental health institute at Cherokee for
 57 16 salaries, support, maintenance, and miscellaneous purposes, and
 57 17 for not more than the following full=time equivalent positions:
 57 18 .................................................. $  5,545,616
 57 19 ............................................... FTEs     169.20
 57 20    2.  For the state mental health institute at Clarinda for
 57 21 salaries, support, maintenance, and miscellaneous purposes, and
 57 22 for not more than the following full=time equivalent positions:
 57 23 .................................................. $  1,812,899
 57 24 ............................................... FTEs      86.10
 57 25    3.  For the state mental health institute at Independence for
 57 26 salaries, support, maintenance, and miscellaneous purposes, and
 57 27 for not more than the following full=time equivalent positions:
 57 28 .................................................. $ 10,390,773
 57 29 ............................................... FTEs     233.00
 57 30    Sec. 24.  STATE RESOURCE CENTERS.
 57 31    1.  There is appropriated from the general fund of the
 57 32 state to the department of human services for the fiscal year
 57 33 beginning July 1, 2015, and ending June 30, 2016, the following
 57 34 amounts, or so much thereof as is necessary, to be used for the
 57 35 purposes designated:
 58  1    a.  For the state resource center at Glenwood for salaries,
 58  2 support, maintenance, and miscellaneous purposes:
 58  3 .................................................. $ 22,024,482
 58  4    b.  For the state resource center at Woodward for salaries,
 58  5 support, maintenance, and miscellaneous purposes:
 58  6 .................................................. $ 14,933,806
 58  7    2.  The department may continue to bill for state resource
 58  8 center services utilizing a scope of services approach used for
 58  9 private providers of intermediate care facilities for persons
 58 10 with an intellectual disability services, in a manner which
 58 11 does not shift costs between the medical assistance program,
 58 12 counties, or other sources of funding for the state resource
 58 13 centers.
 58 14    3.  The state resource centers may expand the time=limited
 58 15 assessment and respite services during the fiscal year.
 58 16    4.  If the department's administration and the department
 58 17 of management concur with a finding by a state resource
 58 18 center's superintendent that projected revenues can reasonably
 58 19 be expected to pay the salary and support costs for a new
 58 20 employee position, or that such costs for adding a particular
 58 21 number of new positions for the fiscal year would be less
 58 22 than the overtime costs if new positions would not be added,
 58 23 the superintendent may add the new position or positions. If
 58 24 the vacant positions available to a resource center do not
 58 25 include the position classification desired to be filled, the
 58 26 state resource center's superintendent may reclassify any
 58 27 vacant position as necessary to fill the desired position. The
 58 28 superintendents of the state resource centers may, by mutual
 58 29 agreement, pool vacant positions and position classifications
 58 30 during the course of the fiscal year in order to assist one
 58 31 another in filling necessary positions.
 58 32    5.  If existing capacity limitations are reached in
 58 33 operating units, a waiting list is in effect for a service or
 58 34 a special need for which a payment source or other funding
 58 35 is available for the service or to address the special need,
 59  1 and facilities for the service or to address the special need
 59  2 can be provided within the available payment source or other
 59  3 funding, the superintendent of a state resource center may
 59  4 authorize opening not more than two units or other facilities
 59  5 and begin implementing the service or addressing the special
 59  6 need during fiscal year 2015=2016.
 59  7    Sec. 25.  SEXUALLY VIOLENT PREDATORS.
 59  8    1.  There is appropriated from the general fund of the
 59  9 state to the department of human services for the fiscal year
 59 10 beginning July 1, 2015, and ending June 30, 2016, the following
 59 11 amount, or so much thereof as is necessary, to be used for the
 59 12 purpose designated:
 59 13    For costs associated with the commitment and treatment of
 59 14 sexually violent predators in the unit located at the state
 59 15 mental health institute at Cherokee, including costs of legal
 59 16 services and other associated costs, including salaries,
 59 17 support, maintenance, and miscellaneous purposes, and for not
 59 18 more than the following full=time equivalent positions:
 59 19 .................................................. $  9,893,079
 59 20 ............................................... FTEs     132.50
 59 21    2.  Unless specifically prohibited by law, if the amount
 59 22 charged provides for recoupment of at least the entire amount
 59 23 of direct and indirect costs, the department of human services
 59 24 may contract with other states to provide care and treatment
 59 25 of persons placed by the other states at the unit for sexually
 59 26 violent predators at Cherokee. The moneys received under
 59 27 such a contract shall be considered to be repayment receipts
 59 28 and used for the purposes of the appropriation made in this
 59 29 section.
 59 30    Sec. 26.  FIELD OPERATIONS.  There is appropriated from the
 59 31 general fund of the state to the department of human services
 59 32 for the fiscal year beginning July 1, 2015, and ending June 30,
 59 33 2016, the following amount, or so much thereof as is necessary,
 59 34 to be used for the purposes designated:
 59 35    For field operations, including salaries, support,
 60  1 maintenance, and miscellaneous purposes, and for not more than
 60  2 the following full=time equivalent positions:
 60  3 .................................................. $ 58,920,976
 60  4 ............................................... FTEs   1,837.00
 60  5    1.  As a condition of this appropriation, the department
 60  6 shall make every possible effort to fill the entire number of
 60  7 positions authorized by this section and, unless specifically
 60  8 provided otherwise by an applicable collective bargaining
 60  9 agreement, the department is not subject to any approval
 60 10 requirement external to the department to fill a field
 60 11 operations vacancy within the number of full=time equivalent
 60 12 positions authorized by this section. The department shall
 60 13 report on the first of each month to the chairpersons and
 60 14 ranking members of the appropriations committees of the senate
 60 15 and house of representatives, and the persons designated by
 60 16 this Act for submission of reports concerning the status of
 60 17 filling the positions.
 60 18    2.  Priority in filling full=time equivalent positions
 60 19 shall be given to those positions related to child protection
 60 20 services and eligibility determination for low=income families.
 60 21    Sec. 27.  GENERAL ADMINISTRATION.  There is appropriated
 60 22 from the general fund of the state to the department of human
 60 23 services for the fiscal year beginning July 1, 2015, and ending
 60 24 June 30, 2016, the following amount, or so much thereof as is
 60 25 necessary, to be used for the purpose designated:
 60 26    For general administration, including salaries, support,
 60 27 maintenance, and miscellaneous purposes, and for not more than
 60 28 the following full=time equivalent positions:
 60 29 .................................................. $ 15,161,741
 60 30 ............................................... FTEs     309.00
 60 31    1.  Of the funds appropriated in this section, $38,543 is
 60 32 allocated for the prevention of disabilities policy council
 60 33 created in section 225B.103, if enacted in this Act.
 60 34    2.  The department shall report at least monthly to the
 60 35 legislative services agency concerning the department's
 61  1 operational and program expenditures.
 61  2    3.  Of the funds appropriated in this section, $150,000 shall
 61  3 be used to continue the contract for the provision of a program
 61  4 to provide technical assistance, support, and consultation to
 61  5 providers of habilitation services and home and community=based
 61  6 services waiver services for adults with disabilities under the
 61  7 medical assistance program.
 61  8    4.  Of the funds appropriated in this section, $50,000
 61  9 is transferred to the Iowa finance authority to be used
 61 10 for administrative support of the council on homelessness
 61 11 established in section 16.2D and for the council to fulfill its
 61 12 duties in addressing and reducing homelessness in the state.
 61 13    5.  Of the funds appropriated in this section, $250,000
 61 14 is allocated to an Iowa food bank association selected by
 61 15 the department for the purchase of food on behalf of an Iowa
 61 16 emergency feeding organization or for the distribution of
 61 17 moneys to the Iowa emergency feeding organization for the
 61 18 purchase of food. The moneys allocated in this subsection
 61 19 shall be allocated only to the extent that the allocated moneys
 61 20 are matched on a dollar=for=dollar basis. Notwithstanding
 61 21 section 8.33, moneys allocated in this subsection that remain
 61 22 unencumbered or unobligated at the close of the fiscal year
 61 23 shall not revert but shall remain available for expenditure for
 61 24 the purposes designated until the close of the following fiscal
 61 25 year.
 61 26    6.  Of the funds appropriated in this section, $250,000
 61 27 shall be transferred to and deposited in the administrative
 61 28 fund of the Iowa ABLE savings plan trust created in section
 61 29 12I.4, if enacted in this Act, to be used for implementation
 61 30 and administration activities of the Iowa ABLE savings plan
 61 31 trust.  Such activities may include the funding of a program
 61 32 manager position, the issuance of a request for proposals,
 61 33 and creation of an informational internet site, but shall not
 61 34 include funding for marketing. The appropriation made in this
 61 35 section is deemed to meet the requirement in the section of
 62  1 the division of this Act, if enacted, relating to contingent
 62  2 implementation of chapter 12I.
 62  3    Sec. 28.  VOLUNTEERS.  There is appropriated from the general
 62  4 fund of the state to the department of human services for the
 62  5 fiscal year beginning July 1, 2015, and ending June 30, 2016,
 62  6 the following amount, or so much thereof as is necessary, to be
 62  7 used for the purpose designated:
 62  8    For development and coordination of volunteer services:
 62  9 .................................................. $     84,686
 62 10    Sec. 29.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
 62 11 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
 62 12 DEPARTMENT OF HUMAN SERVICES.
 62 13    1.  a.  (1)  For the fiscal year beginning July 1, 2015,
 62 14 the total state funding amount for the nursing facility budget
 62 15 shall not exceed $321,900,006.
 62 16    (2)  For the fiscal year beginning July 1, 2015, the
 62 17 department shall rebase case=mix nursing facility rates
 62 18 effective July 1, 2015. However, total nursing facility budget
 62 19 expenditures, including both case=mix and noncase=mix, shall
 62 20 not exceed the amount specified in subparagraph (1). When
 62 21 calculating case=mix per diem cost and the patient=day=weighted
 62 22 medians used in rate=setting for nursing facilities effective
 62 23 July 1, 2015, the inflation factor applied from the midpoint
 62 24 of the cost report period to the first day of the state fiscal
 62 25 year rate period shall be adjusted to maintain state funding
 62 26 within the amount specified in subparagraph (1).
 62 27    (3)  The department, in cooperation with nursing facility
 62 28 representatives, shall review projections for state funding
 62 29 expenditures for reimbursement of nursing facilities on a
 62 30 quarterly basis and the department shall determine if an
 62 31 adjustment to the medical assistance reimbursement rate is
 62 32 necessary in order to provide reimbursement within the state
 62 33 funding amount for the fiscal year. Notwithstanding 2001
 62 34 Iowa Acts, chapter 192, section 4, subsection 2, paragraph
 62 35 "c", and subsection 3, paragraph "a", subparagraph (2),
 63  1 if the state funding expenditures for the nursing facility
 63  2 budget for the fiscal year are projected to exceed the amount
 63  3 specified in subparagraph (1), the department shall adjust
 63  4 the reimbursement for nursing facilities reimbursed under the
 63  5 case=mix reimbursement system to maintain expenditures of the
 63  6 nursing facility budget within the specified amount for the
 63  7 fiscal year.
 63  8    (4)  For the fiscal year beginning July 1, 2015, special
 63  9 population nursing facilities shall be reimbursed in accordance
 63 10 with the methodology in effect on June 30, 2015.
 63 11    (5)  For any open or unsettled nursing facility cost report
 63 12 for a fiscal year prior to and including the fiscal year
 63 13 beginning July 1, 2014, including any cost report remanded on
 63 14 judicial review for inclusion of prescription drug, laboratory,
 63 15 or x=ray costs, the department shall offset all reported
 63 16 prescription drug, laboratory, and x=ray costs with any revenue
 63 17 received from Medicare or other revenue source for any purpose.
 63 18 For purposes of this subparagraph, a nursing facility cost
 63 19 report is not considered open or unsettled if the facility did
 63 20 not initiate an administrative appeal under chapter 17A or if
 63 21 any appeal rights initiated have been exhausted.
 63 22    b.  (1)  For the fiscal year beginning July 1, 2015,
 63 23 the department shall establish the pharmacy dispensing fee
 63 24 reimbursement at $11.73 per prescription as determined by the
 63 25 June 2014 cost of dispensing fee survey.
 63 26    (2)  The department shall utilize an average acquisition
 63 27 cost reimbursement methodology for all drugs covered under the
 63 28 medical assistance program in accordance with 2012 Iowa Acts,
 63 29 chapter 1133, section 33.
 63 30    (3)  Notwithstanding subparagraph (2), if the centers for
 63 31 Medicare and Medicaid services of the United States department
 63 32 of health and human services (CMS) requires, as a condition
 63 33 of federal Medicaid funding, that the department implement an
 63 34 aggregate federal upper limit (FUL) for drug reimbursement
 63 35 based on the average manufacturer's price (AMP), the department
 64  1 may utilize a reimbursement methodology for all drugs covered
 64  2 under the Medicaid program based on the national average drug
 64  3 acquisition cost (NADAC) methodology published by CMS, in order
 64  4 to assure compliance with the aggregate FUL, minimize outcomes
 64  5 of drug reimbursements below pharmacy acquisition costs, limit
 64  6 administrative costs, and minimize any change in the aggregate
 64  7 reimbursement for drugs.  The department may adopt emergency
 64  8 rules to implement this subparagraph.
 64  9    c.  (1)  For the fiscal year beginning July 1, 2015,
 64 10 reimbursement rates for outpatient hospital services shall
 64 11 remain at the rates in effect on June 30, 2015, subject
 64 12 to Medicaid program upper payment limit rules and adjusted
 64 13 as necessary to maintain expenditures within the amount
 64 14 appropriated to the department for this purpose for the fiscal
 64 15 year.
 64 16    (2)  For the fiscal year beginning July 1, 2015,
 64 17 reimbursement rates for inpatient hospital services shall be
 64 18 rebased effective October 1, 2015, subject to Medicaid program
 64 19 upper payment limit rules and adjusted as necessary to maintain
 64 20 expenditures within the amount appropriated to the department
 64 21 for this purpose for the fiscal year.
 64 22    (3)  For the fiscal year beginning July 1, 2015, the graduate
 64 23 medical education and disproportionate share hospital fund
 64 24 shall remain at the amount in effect on June 30, 2015, except
 64 25 that the portion of the fund attributable to graduate medical
 64 26 education shall be reduced in an amount that reflects the
 64 27 elimination of graduate medical education payments made to
 64 28 out=of=state hospitals.
 64 29    (4)  In order to ensure the efficient use of limited state
 64 30 funds in procuring health care services for low=income Iowans,
 64 31 funds appropriated in this Act for hospital services shall
 64 32 not be used for activities which would be excluded from a
 64 33 determination of reasonable costs under the federal Medicare
 64 34 program pursuant to 42 U.S.C. {1395x(v)(1)(N).
 64 35    d.  For the fiscal year beginning July 1, 2015, reimbursement
 65  1 rates for rural health clinics, hospices, and acute mental
 65  2 hospitals shall be increased in accordance with increases under
 65  3 the federal Medicare program or as supported by their Medicare
 65  4 audited costs.
 65  5    e.  For the fiscal year beginning July 1, 2015, independent
 65  6 laboratories and rehabilitation agencies shall be reimbursed
 65  7 using the same methodology in effect on June 30, 2015.
 65  8    f.  (1)  For the fiscal year beginning July 1, 2015,
 65  9 reimbursement rates for home health agencies shall continue to
 65 10 be based on the Medicare low utilization payment adjustment
 65 11 (LUPA) methodology with state geographic wage adjustments, and
 65 12 updated to reflect the most recent Medicare LUPA rates.
 65 13    (2)  For the fiscal year beginning July 1, 2015, rates for
 65 14 private duty nursing and personal care services under the early
 65 15 and periodic screening, diagnostic, and treatment program
 65 16 benefit shall be calculated based on the methodology in effect
 65 17 on June 30, 2015.
 65 18    g.  For the fiscal year beginning July 1, 2015, federally
 65 19 qualified health centers shall receive cost=based reimbursement
 65 20 for 100 percent of the reasonable costs for the provision of
 65 21 services to recipients of medical assistance.
 65 22    h.  For the fiscal year beginning July 1, 2015, the
 65 23 reimbursement rates for dental services shall remain at the
 65 24 rates in effect on June 30, 2015.
 65 25    i.  (1)  For the fiscal year beginning July 1, 2015,
 65 26 state=owned psychiatric medical institutions for children shall
 65 27 receive cost=based reimbursement for 100 percent of the actual
 65 28 and allowable costs for the provision of services to recipients
 65 29 of medical assistance.
 65 30    (2)  For the nonstate=owned psychiatric medical institutions
 65 31 for children, reimbursement rates shall be based on the
 65 32 reimbursement methodology developed by the department as
 65 33 required for federal compliance.
 65 34    (3)  As a condition of participation in the medical
 65 35 assistance program, enrolled providers shall accept the medical
 66  1 assistance reimbursement rate for any covered goods or services
 66  2 provided to recipients of medical assistance who are children
 66  3 under the custody of a psychiatric medical institution for
 66  4 children.
 66  5    j.  For the fiscal year beginning July 1, 2015, unless
 66  6 otherwise specified in this Act, all noninstitutional medical
 66  7 assistance provider reimbursement rates shall remain at the
 66  8 rates in effect on June 30, 2015, except for area education
 66  9 agencies, local education agencies, infant and toddler
 66 10 services providers, home and community=based services providers
 66 11 including consumer=directed attendant care providers under a
 66 12 section 1915(c) or 1915(i) waiver, targeted case management
 66 13 providers, and those providers whose rates are required to be
 66 14 determined pursuant to section 249A.20.
 66 15    k.  Notwithstanding any provision to the contrary, for the
 66 16 fiscal year beginning July 1, 2015, the reimbursement rate for
 66 17 anesthesiologists shall remain at the rate in effect on June
 66 18 30, 2015.
 66 19    l.  Notwithstanding section 249A.20, for the fiscal year
 66 20 beginning July 1, 2015, the average reimbursement rate for
 66 21 health care providers eligible for use of the federal Medicare
 66 22 resource=based relative value scale reimbursement methodology
 66 23 under section 249A.20 shall remain at the rate in effect on
 66 24 June 30, 2015; however, this rate shall not exceed the maximum
 66 25 level authorized by the federal government.
 66 26    m.  For the fiscal year beginning July 1, 2015, the
 66 27 reimbursement rate for residential care facilities shall not
 66 28 be less than the minimum payment level as established by the
 66 29 federal government to meet the federally mandated maintenance
 66 30 of effort requirement. The flat reimbursement rate for
 66 31 facilities electing not to file annual cost reports shall not
 66 32 be less than the minimum payment level as established by the
 66 33 federal government to meet the federally mandated maintenance
 66 34 of effort requirement.
 66 35    n.  For the fiscal year beginning July 1, 2015, the
 67  1 reimbursement rates for inpatient mental health services
 67  2 provided at hospitals shall be rebased effective October 1,
 67  3 2015, subject to Medicaid program upper payment limit rules;
 67  4 and psychiatrists shall be reimbursed at the medical assistance
 67  5 program fee=for=service rate in effect on June 30, 2015.
 67  6    o.  For the fiscal year beginning July 1, 2015, community
 67  7 mental health centers may choose to be reimbursed for the
 67  8 services provided to recipients of medical assistance through
 67  9 either of the following options:
 67 10    (1)  For 100 percent of the reasonable costs of the services.
 67 11    (2)  In accordance with the alternative reimbursement rate
 67 12 methodology established by the medical assistance program's
 67 13 managed care contractor for mental health services and approved
 67 14 by the department of human services.
 67 15    p.  For the fiscal year beginning July 1, 2015, the
 67 16 reimbursement rate for providers of family planning services
 67 17 that are eligible to receive a 90 percent federal match shall
 67 18 remain at the rates in effect on June 30, 2015.
 67 19    q.  For the fiscal year beginning July 1, 2015, the upper
 67 20 limits on reimbursement rates for providers of home and
 67 21 community=based services waiver services shall be increased by
 67 22 1.5 percent over the limits in effect on June 30, 2015.
 67 23    r.  For the fiscal year beginning July 1, 2015, the
 67 24 reimbursement rates for emergency medical service providers
 67 25 shall remain at the rates in effect on June 30, 2015.
 67 26    s.  For the fiscal year beginning July 1, 2015, reimbursement
 67 27 rates for substance=related disorder treatment programs
 67 28 licensed under section 125.13 shall be increased by 3 percent
 67 29 over the rates in effect on June 30, 2015.
 67 30    2.  For the fiscal year beginning July 1, 2015, the
 67 31 reimbursement rate for providers reimbursed under the
 67 32 in=home=related care program shall not be less than the minimum
 67 33 payment level as established by the federal government to meet
 67 34 the federally mandated maintenance of effort requirement.
 67 35    3.  Unless otherwise directed in this section, when the
 68  1 department's reimbursement methodology for any provider
 68  2 reimbursed in accordance with this section includes an
 68  3 inflation factor, this factor shall not exceed the amount
 68  4 by which the consumer price index for all urban consumers
 68  5 increased during the calendar year ending December 31, 2002.
 68  6    4.  For the fiscal year beginning July 1, 2015, the foster
 68  7 family basic daily maintenance rate and the maximum adoption
 68  8 subsidy rate for children ages 0 through 5 years shall be
 68  9 $16.78, the rate for children ages 6 through 11 years shall be
 68 10 $17.45, the rate for children ages 12 through 15 years shall
 68 11 be $19.10, and the rate for children and young adults ages 16
 68 12 and older shall be $19.35. For youth ages 18 to 21 who have
 68 13 exited foster care, the preparation for adult living program
 68 14 maintenance rate shall be $602.70 per month. The maximum
 68 15 payment for adoption subsidy nonrecurring expenses shall be
 68 16 limited to $500 and the disallowance of additional amounts
 68 17 for court costs and other related legal expenses implemented
 68 18 pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall
 68 19 be continued.
 68 20    5.  For the fiscal year beginning July 1, 2015, the maximum
 68 21 reimbursement rates for social services providers under
 68 22 contract shall remain at the rates in effect on June 30, 2015,
 68 23 or the provider's actual and allowable cost plus inflation for
 68 24 each service, whichever is less. However, if a new service
 68 25 or service provider is added after June 30, 2015, the initial
 68 26 reimbursement rate for the service or provider shall be based
 68 27 upon a weighted average of provider rates for similar services.
 68 28    6.  For the fiscal year beginning July 1, 2015, the
 68 29 reimbursement rates for resource family recruitment and
 68 30 retention contractors, child welfare emergency services
 68 31 contractors, and supervised apartment living foster care
 68 32 providers shall be increased by 5 percent over the rates in
 68 33 effect on June 30, 2015.
 68 34    7.  For the fiscal year beginning July 1, 2015, the
 68 35 reimbursement rate for safety plan services and family safety,
 69  1 risk, and permanency services (family=centered) shall be
 69  2 increased as follows:
 69  3    a.  The statewide base monthly payment amount for all
 69  4 family safety, risk, and permanency services (family=centered)
 69  5 contractors shall be increased by $25.22 per month over the
 69  6 rate in effect on June 30, 2015.
 69  7    (1)  Family safety, risk, and permanency services
 69  8 Performance Measure 1 payments shall be increased by $5.25 per
 69  9 case over the rate in effect on June 30, 2015.
 69 10    (2)  Family safety, risk, and permanency services
 69 11 Performance Measure 2 payments shall be increased by $13.15 per
 69 12 case over the rate in effect on June 30, 2015.
 69 13    (3)  Family safety, risk, and permanency services
 69 14 Performance Measure 3 payments shall be increased by $26.25 per
 69 15 case over the rate in effect on June 30, 2015.
 69 16    (4)  Family safety, risk, and permanency services
 69 17 Performance Measure 4 payments shall be increased by $26.25 per
 69 18 case over the rate in effect on June 30, 2015.
 69 19    b.  The maximum reimbursement unit rate for safety plan
 69 20 services shall be increased by $27.61 over the rate in effect
 69 21 on June 30, 2015.
 69 22    (1)  Safety plan services Performance Measure 1 payments
 69 23 shall be increased by $5.25 per case over the rate in effect on
 69 24 June 30, 2015.
 69 25    (2)  Safety plan services Performance Measure 2 payments
 69 26 shall be increased by $5.25 per case over the rate in effect on
 69 27 June 30, 2015.
 69 28    8.  a.  For the purposes of this subsection, "combined
 69 29 reimbursement rate" means the combined service and maintenance
 69 30 reimbursement rate for a service level under the department's
 69 31 reimbursement methodology. Effective July 1, 2015, the
 69 32 combined reimbursement rate for a group foster care service
 69 33 level shall be the amount designated in this subsection.
 69 34 However, if a group foster care provider's reimbursement rate
 69 35 for a service level as of June 30, 2015, is more than the rate
 70  1 designated in this subsection, the provider's reimbursement
 70  2 shall remain at the higher rate.
 70  3    b.  Unless a group foster care provider is subject to the
 70  4 exception provided in paragraph "a", effective July 1, 2015,
 70  5 the combined reimbursement rates for the service levels under
 70  6 the department's reimbursement methodology shall be as follows:
 70  7    (1)  For service level, community = D1, the daily rate shall
 70  8 be at least $84.17.
 70  9    (2)  For service level, comprehensive = D2, the daily rate
 70 10 shall be at least $119.09.
 70 11    (3)  For service level, enhanced = D3, the daily rate shall
 70 12 be at least $131.09.
 70 13    9.  The group foster care reimbursement rates paid for
 70 14 placement of children out of state shall be calculated
 70 15 according to the same rate=setting principles as those used for
 70 16 in=state providers, unless the director of human services or
 70 17 the director's designee determines that appropriate care cannot
 70 18 be provided within the state. The payment of the daily rate
 70 19 shall be based on the number of days in the calendar month in
 70 20 which service is provided.
 70 21    10.  a.  For the fiscal year beginning July 1, 2015, the
 70 22 reimbursement rate paid for shelter care and the child welfare
 70 23 emergency services implemented to provide or prevent the need
 70 24 for shelter care shall be established by contract.
 70 25    b.  For the fiscal year beginning July 1, 2015, the combined
 70 26 service and maintenance components of the reimbursement rate
 70 27 paid for shelter care services shall be based on the financial
 70 28 and statistical report submitted to the department. The
 70 29 maximum reimbursement rate shall be $101.83 per day. The
 70 30 department shall reimburse a shelter care provider at the
 70 31 provider's actual and allowable unit cost, plus inflation, not
 70 32 to exceed the maximum reimbursement rate.
 70 33    c.  Notwithstanding section 232.141, subsection 8, for the
 70 34 fiscal year beginning July 1, 2015, the amount of the statewide
 70 35 average of the actual and allowable rates for reimbursement of
 71  1 juvenile shelter care homes that is utilized for the limitation
 71  2 on recovery of unpaid costs shall remain at the amount in
 71  3 effect for this purpose in the fiscal year beginning July 1,
 71  4 2014.
 71  5    11.  For the fiscal year beginning July 1, 2015, the
 71  6 department shall calculate reimbursement rates for intermediate
 71  7 care facilities for persons with an intellectual disability
 71  8 at the 80th percentile. Beginning July 1, 2015, the rate
 71  9 calculation methodology shall utilize the consumer price index
 71 10 inflation factor applicable to the fiscal year beginning July
 71 11 1, 2015.
 71 12    12.  For the fiscal year beginning July 1, 2015, for child
 71 13 care providers reimbursed under the state child care assistance
 71 14 program, the department shall set provider reimbursement
 71 15 rates based on the rate reimbursement survey completed in
 71 16 December 2004. Effective July 1, 2015, the child care provider
 71 17 reimbursement rates shall remain at the rates in effect on June
 71 18 30, 2015. The department shall set rates in a manner so as
 71 19 to provide incentives for a nonregistered provider to become
 71 20 registered by applying the increase only to registered and
 71 21 licensed providers.
 71 22    13.  For the fiscal year beginning July 1, 2015, if the
 71 23 centers for Medicare and Medicaid services of the United
 71 24 States department of health and human services approves the
 71 25 waivers necessary to implement medical assistance program
 71 26 managed care applicable to any providers or services subject to
 71 27 reimbursement under this section, notwithstanding any provision
 71 28 to the contrary under this section, affected providers or
 71 29 services shall instead be reimbursed as follows:
 71 30    a.  For fee=for=service claims, reimbursement rates shall
 71 31 be calculated based on the methodology otherwise specified in
 71 32 this section for the fiscal year beginning July 1, 2015, for
 71 33 the respective provider or service.
 71 34    b.  For claims subject to a managed care contract,
 71 35 reimbursement shall be based on the actuarially sound
 72  1 capitation rates established under the contract.  However,
 72  2 any reimbursement established under such contract shall not
 72  3 be lower than the reimbursement otherwise specified in this
 72  4 section for the fiscal year beginning July 1, 2015, for the
 72  5 respective provider or service.
 72  6    14.  The department may adopt emergency rules to implement
 72  7 this section.
 72  8    Sec. 30.  EMERGENCY RULES.
 72  9    1.  If specifically authorized by a provision of this
 72 10 division of this Act, the department of human services or
 72 11 the mental health and disability services commission may
 72 12 adopt administrative rules under section 17A.4, subsection
 72 13 3, and section 17A.5, subsection 2, paragraph "b", to
 72 14 implement the provisions of this division of this Act and
 72 15 the rules shall become effective immediately upon filing or
 72 16 on a later effective date specified in the rules, unless the
 72 17 effective date of the rules is delayed or the applicability
 72 18 of the rules is suspended by the administrative rules review
 72 19 committee. Any rules adopted in accordance with this section
 72 20 shall not take effect before the rules are reviewed by the
 72 21 administrative rules review committee. The delay authority
 72 22 provided to the administrative rules review committee under
 72 23 section 17A.4, subsection 7, and section 17A.8, subsection 9,
 72 24 shall be applicable to a delay imposed under this section,
 72 25 notwithstanding a provision in those sections making them
 72 26 inapplicable to section 17A.5, subsection 2, paragraph "b".
 72 27 Any rules adopted in accordance with the provisions of this
 72 28 section shall also be published as a notice of intended action
 72 29 as provided in section 17A.4.
 72 30    2.  If during a fiscal year, the department of human
 72 31 services is adopting rules in accordance with this section
 72 32 or as otherwise directed or authorized by state law, and the
 72 33 rules will result in an expenditure increase beyond the amount
 72 34 anticipated in the budget process or if the expenditure was
 72 35 not addressed in the budget process for the fiscal year, the
 73  1 department shall notify the persons designated by this division
 73  2 of this Act for submission of reports, the chairpersons and
 73  3 ranking members of the committees on appropriations, and
 73  4 the department of management concerning the rules and the
 73  5 expenditure increase. The notification shall be provided at
 73  6 least 30 calendar days prior to the date notice of the rules
 73  7 is submitted to the administrative rules coordinator and the
 73  8 administrative code editor.
 73  9    Sec. 31.  REPORTS.  Any reports or other information
 73 10 required to be compiled and submitted under this Act during the
 73 11 fiscal year beginning July 1, 2015, shall be submitted to the
 73 12 chairpersons and ranking members of the joint appropriations
 73 13 subcommittee on health and human services, the legislative
 73 14 services agency, and the legislative caucus staffs on or
 73 15 before the dates specified for submission of the reports or
 73 16 information.
 73 17    Sec. 32.  EFFECTIVE UPON ENACTMENT.  The following
 73 18 provisions of this division of this Act, being deemed of
 73 19 immediate importance, take effect upon enactment:
 73 20    1.  The provision relating to section 232.141 and directing
 73 21 the state court administrator and the division administrator of
 73 22 the department of human services division of child and family
 73 23 services to make the determination, by June 15, 2015, of the
 73 24 distribution of funds allocated for the payment of the expenses
 73 25 of court=ordered services provided to juveniles which are a
 73 26 charge upon the state.
 73 27    2.  The provision prohibiting the department of human
 73 28 services from adopting emergency rules to implement Medicaid
 73 29 managed care or the governor's Medicaid modernization
 73 30 initiative.
 73 31                           DIVISION VI
 73 32         HEALTH CARE ACCOUNTS AND FUNDS ==== FY 2015=2016
 73 33    Sec. 33.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is
 73 34 appropriated from the pharmaceutical settlement account created
 73 35 in section 249A.33 to the department of human services for the
 74  1 fiscal year beginning July 1, 2015, and ending June 30, 2016,
 74  2 the following amount, or so much thereof as is necessary, to be
 74  3 used for the purpose designated:
 74  4    Notwithstanding any provision of law to the contrary, to
 74  5 supplement the appropriations made in this Act for medical
 74  6 contracts under the medical assistance program for the fiscal
 74  7 year beginning July 1, 2015, and ending June 30, 2016:
 74  8 .................................................. $    500,000
 74  9    Sec. 34.  QUALITY ASSURANCE TRUST FUND ==== DEPARTMENT OF HUMAN
 74 10 SERVICES.  Notwithstanding any provision to the contrary and
 74 11 subject to the availability of funds, there is appropriated
 74 12 from the quality assurance trust fund created in section
 74 13 249L.4 to the department of human services for the fiscal year
 74 14 beginning July 1, 2015, and ending June 30, 2016, the following
 74 15 amounts, or so much thereof as is necessary, for the purposes
 74 16 designated:
 74 17    To supplement the appropriation made in this Act from the
 74 18 general fund of the state to the department of human services
 74 19 for medical assistance for the same fiscal year:
 74 20 .................................................. $ 36,705,208
 74 21    Sec. 35.  HOSPITAL HEALTH CARE ACCESS TRUST FUND ====
 74 22 DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to
 74 23 the contrary and subject to the availability of funds, there is
 74 24 appropriated from the hospital health care access trust fund
 74 25 created in section 249M.4 to the department of human services
 74 26 for the fiscal year beginning July 1, 2015, and ending June
 74 27 30, 2016, the following amounts, or so much thereof as is
 74 28 necessary, for the purposes designated:
 74 29    To supplement the appropriation made in this Act from the
 74 30 general fund of the state to the department of human services
 74 31 for medical assistance for the same fiscal year:
 74 32 .................................................. $ 34,700,000
 74 33    Sec. 36.  MEDICAL ASSISTANCE PROGRAM ==== NONREVERSION
 74 34 FOR FY 2015=2016.  Notwithstanding section 8.33, if moneys
 74 35 appropriated for purposes of the medical assistance program for
 75  1 the fiscal year beginning July 1, 2015, and ending June 30,
 75  2 2016, from the general fund of the state, the quality assurance
 75  3 trust fund and the hospital health care access trust fund, are
 75  4 in excess of actual expenditures for the medical assistance
 75  5 program and remain unencumbered or unobligated at the close
 75  6 of the fiscal year, the excess moneys shall not revert but
 75  7 shall remain available for expenditure for the purposes of the
 75  8 medical assistance program until the close of the succeeding
 75  9 fiscal year.
 75 10                          DIVISION VII
 75 11            PATIENT=CENTERED HEALTH ADVISORY COUNCIL
 75 12    Sec. 37.  Section 135.159, subsection 2, paragraph a,
 75 13 unnumbered paragraph 1, Code 2015, is amended to read as
 75 14 follows:
 75 15    The department shall establish an a patient=centered health
 75 16  advisory council which shall include but is not limited to
 75 17 all of the following members, selected by their respective
 75 18 organizations, and any other members the department determines
 75 19 necessary to assist in the department's duties at various
 75 20 stages of development of the medical home system:
 75 21    Sec. 38.  Section 135.159, subsection 2, paragraph b, Code
 75 22 2015, is amended to read as follows:
 75 23    b.  Public members of the patient=centered health advisory
 75 24 council shall receive reimbursement for actual expenses
 75 25 incurred while serving in their official capacity only if they
 75 26 are not eligible for reimbursement by the organization that
 75 27 they represent.
 75 28    Sec. 39.  Section 135.159, subsection 10, Code 2015, is
 75 29 amended to read as follows:
 75 30    10.  The department shall integrate the recommendations and
 75 31 policies developed pursuant to section 135.161, Code 2011, into
 75 32 the medical home system and shall incorporate the development
 75 33 and implementation of the state initiative for prevention
 75 34 and chronic care management as developed pursuant to section
 75 35 135.161, Code 2011, into the duties of the medical home system
 76  1  patient=centered health advisory council beginning January 1,
 76  2 2012.
 76  3    Sec. 40.  CODE EDITOR DIRECTIVE.  The Code editor shall amend
 76  4 the headnote of section 135.159, Code 2015, to read Medical home
 76  5 system ==== patient=centered health advisory council ==== development
 76  6 and implementation.
 76  7                          DIVISION VIII
 76  8      PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS
 76  9                        DECATEGORIZATION
 76 10    Sec. 41.  DECATEGORIZATION CARRYOVER FUNDING ==== TRANSFER TO
 76 11 MEDICAID PROGRAM.  Notwithstanding section 232.188, subsection
 76 12 5, paragraph "b", any state appropriated moneys in the funding
 76 13 pool that remained unencumbered or unobligated at the close
 76 14 of the fiscal year beginning July 1, 2012, and were deemed
 76 15 carryover funding to remain available for the two succeeding
 76 16 fiscal years that still remain unencumbered or unobligated at
 76 17 the close of the fiscal year beginning July 1, 2014, shall
 76 18 not revert but shall be transferred to the medical assistance
 76 19 program for the fiscal year beginning July 1, 2014.
 76 20         COMMUNITY MENTAL HEALTH SERVICES APPROPRIATION
 76 21    Sec. 42.  2013 Iowa Acts, chapter 136, section 2, subsection
 76 22 1, paragraph c, is amended to read as follows:
 76 23    c.  The department shall allocate not less than 95 percent
 76 24 of the amount of the block grant each federal fiscal year
 76 25 to eligible community mental health services providers for
 76 26 carrying out the plan submitted to and approved by the federal
 76 27 substance abuse and mental health services administration
 76 28 for the fiscal year involved, except that for federal fiscal
 76 29 year 2014=2015, $1,643,467 of such federal block grant funds
 76 30 shall be used for child and family services pursuant to 2013
 76 31 Iowa Acts, chapter 138, section 148, as amended by 2014 Iowa
 76 32 Acts, chapter 1140, section 25, for the purposes of 2014 Iowa
 76 33 Acts, chapter 1140, section 25, subsection 20, relating to
 76 34 the community circle of care collaboration for children and
 76 35 youth in northeast Iowa, subsection 24 relating to the central
 77  1 Iowa system of care program grant, subsection 25 relating
 77  2 to the system of care grant implemented in Cerro Gordo and
 77  3 Linn counties, and subsection 27 relating to a system of care
 77  4 approach for children with a serious emotional disturbance and
 77  5 their families through a nonprofit provider of child welfare
 77  6 services licensed as a psychiatric medical institution for
 77  7 children.
 77  8             TEMPORARY ASSISTANCE FOR NEEDY FAMILIES
 77  9    Sec. 43.  2013 Iowa Acts, chapter 138, section 136,
 77 10 subsections 1, 2, 6, and 13, as amended by 2014 Iowa Acts,
 77 11 chapter 1140, section 9, are amended to read as follows:
 77 12    1.  To be credited to the family investment program account
 77 13 and used for assistance under the family investment program
 77 14 under chapter 239B:
 77 15 .................................................. $  9,879,488
 77 16                                                       6,281,222
 77 17    2.  To be credited to the family investment program account
 77 18 and used for the job opportunities and basic skills (JOBS)
 77 19 program and implementing family investment agreements in
 77 20 accordance with chapter 239B:
 77 21 .................................................. $ 11,091,911
 77 22                                                      10,232,340
 77 23    6.  For state child care assistance:
 77 24 .................................................. $ 35,047,110
 77 25                                                      41,210,239
 77 26    a.  Of the funds appropriated in this subsection,
 77 27 $26,347,110 $26,332,712 is transferred to the child care and
 77 28 development block grant appropriation made by the Eighty=fifth
 77 29 General Assembly, 2013 Session, in 2013 Iowa Acts, chapter 136,
 77 30 section 14 for the federal fiscal year beginning October 1,
 77 31 2014, and ending September 30, 2015. Of this amount, $200,000
 77 32 shall be used for provision of educational opportunities to
 77 33 registered child care home providers in order to improve
 77 34 services and programs offered by this category of providers
 77 35 and to increase the number of providers. The department may
 78  1 contract with institutions of higher education or child care
 78  2 resource and referral centers to provide the educational
 78  3 opportunities. Allowable administrative costs under the
 78  4 contracts shall not exceed 5 percent. The application for a
 78  5 grant shall not exceed two pages in length.
 78  6    b.  Any funds appropriated in this subsection remaining
 78  7 unallocated shall be used for state child care assistance
 78  8 payments for families who are employed, including but not
 78  9 limited to individuals enrolled in the family investment
 78 10 program who are employed.
 78 11    13.  a.  Notwithstanding any provision to the contrary,
 78 12 including but not limited to requirements in section 8.41 or
 78 13 provisions in 2013 or 2014 Iowa Acts regarding the receipt and
 78 14 appropriation of federal block grants, federal funds from the
 78 15 temporary assistance for needy families block grant received
 78 16 by the state not otherwise appropriated in this section and
 78 17 remaining available for the fiscal year beginning July 1, 2014,
 78 18 are appropriated to the department of human services to the
 78 19 extent as may be necessary to be used in the following priority
 78 20 order:  the family investment program, for state child care
 78 21 assistance program payments for individuals enrolled in the
 78 22 family investment program families who are employed, and for
 78 23 the family investment program share of costs to develop and
 78 24 maintain a new, integrated eligibility determination system.
 78 25 The federal funds appropriated in this paragraph "a" shall be
 78 26 expended only after all other funds appropriated in subsection
 78 27 1 for the assistance under the family investment program,
 78 28 in subsection 6 for child care assistance, or in subsection
 78 29 12 for the family investment program share of the costs to
 78 30 continue to develop and maintain a new, integrated eligibility
 78 31 determination system, as applicable, have been expended.  For
 78 32 the purposes of this subsection, the funds appropriated in
 78 33 subsection 6, paragraph "a", for transfer to the child care and
 78 34 development block grant are considered fully expended when the
 78 35 full amount has been transferred.
 79  1    b.  The department shall, on a quarterly basis, advise the
 79  2 legislative services agency and department of management of
 79  3 the amount of funds appropriated in this subsection that was
 79  4 expended in the prior quarter.
 79  5                   CHILD SUPPORT RECOVERY UNIT
 79  6    Sec. 44.  2013 Iowa Acts, chapter 138, section 139,
 79  7 unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter
 79  8 1140, section 12, is amended to read as follows:
 79  9    For child support recovery, including salaries, support,
 79 10 maintenance, and miscellaneous purposes, and for not more than
 79 11 the following full=time equivalent positions:
 79 12 .................................................. $ 14,911,230
 79 13                                                      14,771,230
 79 14 ............................................... FTEs     464.00
 79 15                       MEDICAL ASSISTANCE
 79 16    Sec. 45.  2013 Iowa Acts, chapter 139, section 142,
 79 17 unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter
 79 18 1140, section 14, is amended to read as follows:
 79 19    For medical assistance program reimbursement and associated
 79 20 costs as specifically provided in the reimbursement
 79 21 methodologies in effect on June 30, 2014, except as otherwise
 79 22 expressly authorized by law, consistent with options under
 79 23 federal law and regulations, and contingent upon receipt of
 79 24 approval from the office of the governor of reimbursement for
 79 25 each abortion performed under the program:
 79 26 .................................................. $1,250,658,393
 79 27                                                     1,310,299,250
 79 28                        MEDICAL CONTRACTS
 79 29    Sec. 46.  2013 Iowa Acts, chapter 138, section 143,
 79 30 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts,
 79 31 chapter 1140, section 19, are amended to read as follows:
 79 32    There is appropriated from the general fund of the state to
 79 33 the department of human services for the fiscal year beginning
 79 34 July 1, 2014, and ending June 30, 2015, the following amount,
 79 35 or so much thereof as is necessary, to be used for the purpose
 80  1 designated:
 80  2    For medical contracts:
 80  3 .................................................. $ 17,148,576
 80  4                                                      12,896,400
 80  5                 STATE SUPPLEMENTARY ASSISTANCE
 80  6    Sec. 47.  2013 Iowa Acts, chapter 138, section 144,
 80  7 subsection 1, as amended by 2014 Iowa Acts, chapter 1140,
 80  8 section 20, is amended to read as follows:
 80  9    1.  There is appropriated from the general fund of the
 80 10 state to the department of human services for the fiscal year
 80 11 beginning July 1, 2014, and ending June 30, 2015, the following
 80 12 amount, or so much thereof as is necessary, to be used for the
 80 13 purpose designated:
 80 14    For the state supplementary assistance program:
 80 15 .................................................. $ 14,121,154
 80 16                                                      12,965,318
 80 17              CHILDREN'S HEALTH INSURANCE PROGRAM/
 80 18              HEALTHY AND WELL KIDS IN IOWA PROGRAM
 80 19    Sec. 48.  2013 Iowa Acts, chapter 138, section 145,
 80 20 subsection 1, as amended by 2014 Iowa Acts, chapter 1140,
 80 21 section 21, is amended to read as follows:
 80 22    1.  There is appropriated from the general fund of the
 80 23 state to the department of human services for the fiscal year
 80 24 beginning July 1, 2014, and ending June 30, 2015, the following
 80 25 amount, or so much thereof as is necessary, to be used for the
 80 26 purpose designated:
 80 27    For maintenance of the healthy and well kids in Iowa (hawk=i)
 80 28 program pursuant to chapter 514I, including supplemental dental
 80 29 services, for receipt of federal financial participation under
 80 30 Tit. XXI of the federal Social Security Act, which creates the
 80 31 children's health insurance program:
 80 32 .................................................. $ 45,877,998
 80 33                                                      45,097,085
 80 34                      CHILD CARE ASSISTANCE
 80 35    Sec. 49.  2013 Iowa Acts, chapter 138, section 146,
 81  1 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts,
 81  2 chapter 1140, section 22, are amended to read as follows:
 81  3    There is appropriated from the general fund of the state to
 81  4 the department of human services for the fiscal year beginning
 81  5 July 1, 2014, and ending June 30, 2015, the following amount,
 81  6 or so much thereof as is necessary, to be used for the purpose
 81  7 designated:
 81  8    For child care programs:
 81  9 .................................................. $ 47,132,080
 81 10                                                      36,303,944
 81 11    CHILDREN ADJUDICATED AS DELINQUENT AND CHILD IN NEED OF
 81 12                      ASSISTANCE PLACEMENTS
 81 13    Sec. 50.  2013 Iowa Acts, chapter 138, unnumbered paragraphs
 81 14 1 and 2, as amended by 2014 Iowa Acts, chapter 1140, section
 81 15 24, are amended to read as follows:
 81 16    There is appropriated from the general fund of the state to
 81 17 the department of human services for the fiscal year beginning
 81 18 July 1, 2014, and ending June 30, 2015, the following amount,
 81 19 or so much thereof as is necessary, to be used for the purposes
 81 20 designated:
 81 21    For the placement costs of female children adjudicated as
 81 22 delinquent and male and female children adjudicated as a child
 81 23 in need of assistance:
 81 24 .................................................. $  2,000,000
 81 25                                                       1,400,000
 81 26                    CHILD AND FAMILY SERVICES
 81 27    Sec. 51.  2013 Iowa Acts, chapter 138, section 148,
 81 28 subsection 1, as amended by 2014 Iowa Acts, chapter 1140,
 81 29 section 25, is amended to read as follows:
 81 30    1.  There is appropriated from the general fund of the
 81 31 state to the department of human services for the fiscal year
 81 32 beginning July 1, 2014, and ending June 30, 2015, the following
 81 33 amount, or so much thereof as is necessary, to be used for the
 81 34 purpose designated:
 81 35    For child and family services:
 82  1 .................................................. $ 94,857,554
 82  2                                                      91,364,087
 82  3                        ADOPTION SUBSIDY
 82  4    Sec. 52.  2013 Iowa Acts, chapter 138, section 149,
 82  5 subsection 1, as amended by 2014 Iowa Acts, chapter 1140,
 82  6 section 26, is amended to read as follows:
 82  7    1.  There is appropriated from the general fund of the
 82  8 state to the department of human services for the fiscal year
 82  9 beginning July 1, 2014, and ending June 30, 2015, the following
 82 10 amount, or so much thereof as is necessary, to be used for the
 82 11 purpose designated:
 82 12    For adoption subsidy payments and services:
 82 13 .................................................. $ 42,580,749
 82 14                                                      41,744,149
 82 15                     FAMILY SUPPORT SUBSIDY
 82 16    Sec. 53.  2013 Iowa Acts, chapter 138, section 151,
 82 17 subsection 1, as amended by 2014 Iowa Acts, chapter 1140,
 82 18 section 27, is amended to read as follows:
 82 19    1.  There is appropriated from the general fund of the
 82 20 state to the department of human services for the fiscal year
 82 21 beginning July 1, 2014, and ending June 30, 2015, the following
 82 22 amount, or so much thereof as is necessary, to be used for the
 82 23 purpose designated:
 82 24    For the family support subsidy program subject to the
 82 25 enrollment restrictions in section 225C.37, subsection 3:
 82 26 .................................................. $  1,079,739
 82 27                                                         579,739
 82 28                        FIELD OPERATIONS
 82 29    Sec. 54.  2013 Iowa Acts, chapter 138, section 156,
 82 30 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts,
 82 31 chapter 1140, section 32, are amended to read as follows:
 82 32    There is appropriated from the general fund of the state to
 82 33 the department of human services for the fiscal year beginning
 82 34 July 1, 2014, and ending June 30, 2015, the following amount,
 82 35 or so much thereof as is necessary, to be used for the purposes
 83  1 designated:
 83  2    For field operations, including salaries, support,
 83  3 maintenance, and miscellaneous purposes, and for not more than
 83  4 the following full=time equivalent positions:
 83  5 .................................................. $ 65,170,976
 83  6                                                      61,170,976
 83  7 ............................................... FTEs   1,837.00
 83  8                     GENERAL ADMINISTRATION
 83  9    Sec. 55.  2013 Iowa Acts, chapter 138, section 157,
 83 10 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts,
 83 11 chapter 1140, section 33, are amended to read as follows:
 83 12    There is appropriated from the general fund of the state to
 83 13 the department of human services for the fiscal year beginning
 83 14 July 1, 2014, and ending June 30, 2015, the following amount,
 83 15 or so much thereof as is necessary, to be used for the purpose
 83 16 designated:
 83 17    For general administration, including salaries, support,
 83 18 maintenance, and miscellaneous purposes, and for not more than
 83 19 the following full=time equivalent positions:
 83 20 .................................................. $ 16,072,302
 83 21                                                      15,072,302
 83 22 ............................................... FTEs     309.00
 83 23                PHARMACEUTICAL SETTLEMENT ACCOUNT
 83 24    Sec. 56.  2013 Iowa Acts, chapter 138, section 162, as
 83 25 amended by 2014 Iowa Acts, chapter 1140, section 47, is amended
 83 26 to read as follows:
 83 27    SEC. 162.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is
 83 28 appropriated from the pharmaceutical settlement account created
 83 29 in section 249A.33 to the department of human services for the
 83 30 fiscal year beginning July 1, 2014, and ending June 30, 2015,
 83 31 the following amount, or so much thereof as is necessary, to be
 83 32 used for the purpose designated:
 83 33    Notwithstanding any provision of law to the contrary, to
 83 34 supplement the appropriations made in this Act for medical
 83 35 contracts under the medical assistance program for the fiscal
 84  1 year beginning July 1, 2014, and ending June 30, 2015:
 84  2 .................................................. $  5,467,564
 84  3                                                       6,969,740
 84  4                  QUALITY ASSURANCE TRUST FUND
 84  5    Sec. 57.  2013 Iowa Acts, chapter 138, section 163, as
 84  6 amended by 2014 Iowa Acts, chapter 1140, section 48, is amended
 84  7 to read as follows:
 84  8    SEC. 163.  QUALITY ASSURANCE TRUST FUND ==== DEPARTMENT OF
 84  9 HUMAN SERVICES.  Notwithstanding any provision to the contrary
 84 10 and subject to the availability of funds, there is appropriated
 84 11 from the quality assurance trust fund created in section
 84 12 249L.4 to the department of human services for the fiscal year
 84 13 beginning July 1, 2014, and ending June 30, 2015, the following
 84 14 amounts, or so much thereof as is necessary, for the purposes
 84 15 designated:
 84 16    To supplement the appropriation made in this Act from the
 84 17 general fund of the state to the department of human services
 84 18 for medical assistance for the same fiscal year:
 84 19 .................................................. $ 29,195,653
 84 20                                                      29,695,653
 84 21    Sec. 58.  EFFECTIVE UPON ENACTMENT.  This division of this
 84 22 Act, being deemed of immediate importance, takes effect upon
 84 23 enactment.
 84 24    Sec. 59.  RETROACTIVE APPLICABILITY.  This division of this
 84 25 Act is retroactively applicable to July 1, 2014.
 84 26                           DIVISION IX
 84 27                  QUALITY ASSURANCE ASSESSMENT
 84 28    Sec. 60.  Section 249L.3, subsection 1, paragraph d, Code
 84 29 2015, is amended to read as follows:
 84 30    d.  The aggregate quality assurance assessments imposed
 84 31 under this chapter shall not exceed the lower of be established
 84 32 at three percent of the aggregate non=Medicare revenues of a
 84 33 nursing facility or the maximum amount that may be assessed
 84 34  pursuant to the indirect guarantee threshold as established
 84 35 pursuant to 42 C.F.R. {433.68(f)(3)(i), and shall be stated on
 85  1 a per=patient=day basis.
 85  2                           DIVISION X
 85  3                   HEALTH POLICY ==== OVERSIGHT
 85  4    Sec. 61.  NEW SECTION.  2.70  Legislative health policy
 85  5 oversight committee.
 85  6    1.  A legislative health policy oversight committee
 85  7 is created to provide a formal venue for oversight of
 85  8 and stakeholder engagement in, the design, development,
 85  9 implementation, administration, and funding associated
 85 10 with general state health care policy, with a particular
 85 11 focus on the Medicaid program. The overall purpose of the
 85 12 committee is to ensure that health care policy in this state
 85 13 is consumer=focused and provides for accessible, accountable,
 85 14 efficient, cost=effective, and quality health care.  The goal
 85 15 of the committee is to continue to further health policy that
 85 16 improves health care, improves population health, reduces
 85 17 health care costs, and integrates medical and social services
 85 18 and supports into a holistic health system.
 85 19    2.  a.  The committee shall include all of the following
 85 20 members:
 85 21    (1)  The co=chairpersons and ranking members of the
 85 22 legislative joint appropriations subcommittee on health
 85 23 and human services, or members of the joint appropriations
 85 24 subcommittee designated by the respective co=chairpersons or
 85 25 ranking members.
 85 26    (2)  The chairpersons and ranking members of the
 85 27 human resources committees of the senate and house of
 85 28 representatives, or members of the respective committees
 85 29 designated by the respective chairpersons or ranking members.
 85 30    (3)  The chairpersons and ranking members of the
 85 31 appropriations committees of the senate and house of
 85 32 representatives, or members of the respective committees
 85 33 designated by the respective chairpersons or ranking members.
 85 34    b.  The members of the committee shall receive a per diem as
 85 35 provided in section 2.10.
 86  1    c.  The committee shall meet at least quarterly, but may meet
 86  2 as often as necessary.  The committee may request information
 86  3 from sources as deemed appropriate, and the department of human
 86  4 services and other agencies of state government shall provide
 86  5 information to the committee as requested.  The legislative
 86  6 services agency shall provide staff support to the committee.
 86  7    d.  The committee shall select co=chairpersons, one
 86  8 representing the senate and one representing the house of
 86  9 representatives, annually, from its membership. A majority of
 86 10 the members of the committee shall constitute a quorum.
 86 11    e.  The committee may contract for the services of persons
 86 12 who are qualified by education, expertise, or experience to
 86 13 advise, consult with, or otherwise assist the committee in the
 86 14 performance of its duties.
 86 15    3.  The committee shall submit a report to the governor and
 86 16 the general assembly by December 15, annually.
 86 17    Sec. 62.  NEW SECTION.  231.44  Utilization of resources
 86 18 == assistance and advocacy related to long=term services and
 86 19 supports under the Medicaid program.
 86 20    1.  The office of long=term care ombudsman may utilize its
 86 21 available resources to provide assistance and advocacy services
 86 22 to potential or actual recipients, or the families or legal
 86 23 representatives of such potential or actual recipients, of
 86 24 long=term services and supports provided through the Medicaid
 86 25 program.  Such assistance and advocacy shall include but is not
 86 26 limited to all of the following:
 86 27    a.  Providing information, education, consultation, and
 86 28 assistance regarding eligibility for, enrollment in, and the
 86 29 obtaining of long=term services and supports through the
 86 30 Medicaid program.
 86 31    b.  Identifying and referring individuals who may be eligible
 86 32 for and in need of long=term services and supports to the
 86 33 Medicaid program.
 86 34    c.  Developing procedures for tracking and reporting
 86 35 individual requests for assistance with the obtaining of
 87  1 necessary services and supports.
 87  2    d.  Providing consultation for individuals transitioning into
 87  3 or out of an institutional setting or across levels of care.
 87  4    e.  Identifying gaps in or duplication of services provided
 87  5 to older individuals and persons with disabilities and
 87  6 developing strategies to improve the delivery and coordination
 87  7 of these services for these individuals.
 87  8    f.  Providing advice, assistance, and negotiation relating
 87  9 to the preparation and filing of complaints, grievances, and
 87 10 appeals of complaints or grievances relating to long=term
 87 11 services and supports under the Medicaid program.
 87 12    g.  Providing individual case advocacy services in
 87 13 administrative hearings and legal representation for judicial
 87 14 proceedings related to long=term services and supports under
 87 15 the Medicaid program.
 87 16    2.  A representative of the office of long=term care
 87 17 ombudsman providing assistance and advocacy services authorized
 87 18 under this section for an individual, shall be provided
 87 19 access to the individual,  and shall be provided access to
 87 20 the individual's medical and social records as authorized by
 87 21 the individual or the individual's legal representative, as
 87 22 necessary to carry out the duties specified in this section.
 87 23    3.  A representative of the office of long=term care
 87 24 ombudsman providing assistance and advocacy services authorized
 87 25 under this section for an individual, shall be provided access
 87 26 to administrative records related to the provision of the
 87 27 long=term services and supports to the individual, as necessary
 87 28 to carry out the duties specified in this section.
 87 29    4.  For the purposes of this section:
 87 30    a.  "Institutional setting" includes a long=term care
 87 31 facility, an elder group home, or an assisted living program.
 87 32    b.  "Long=term services and supports" means the broad range of
 87 33 health, health=related, and personal care assistance services
 87 34 and supports, provided in both institutional settings and home
 87 35 and community=based settings, necessary for older individuals
 88  1 and persons with disabilities who experience limitations in
 88  2 their capacity for self=care due to a physical, cognitive, or
 88  3 mental disability or condition.
 88  4    Sec. 63.  MEDICAID MANAGED CARE ORGANIZATIONS ==== UTILIZATION
 88  5 OF CAPITATED PAYMENTS.
 88  6    1.  All of the following shall apply to Medicaid managed care
 88  7 contracts entered into on or after July 1, 2015:
 88  8    a.  Two percent of the Medicaid capitation payment amount
 88  9 specified under the contract shall be withheld by the state to
 88 10 be used to provide for Medicaid program oversight, including
 88 11 for a health consumer ombudsman function, and for quality
 88 12 improvement.
 88 13    b. The minimum medical loss ratio applicable to Medicaid
 88 14    managed care shall be established at no less than eighty=five
 88 15    percent.  The portion of the Medicaid capitation payment paid
 88 16 to a Medicaid managed care contractor that is required to be
 88 17 dedicated to meeting the minimum medical loss ratio shall be
 88 18 allocated to a Medicaid claims fund.  Expenditures of moneys
 88 19 in the Medicaid claims fund shall comply with all of the
 88 20 following:
 88 21    (1)  Only expenditures for medical claims shall be
 88 22 considered in computing the minimum medical loss ratio
 88 23 as specified in the contract. For the purposes of the
 88 24 computation, "medical claims" means only the costs of claims
 88 25 for direct delivery of covered benefits incurred during the
 88 26 applicable minimum medical loss ratio reporting period, not
 88 27 otherwise defined or designated as administrative costs,
 88 28 population health benefits or quality improvement, or profit in
 88 29 this section.
 88 30    (2)  If a Medicaid managed care contractor does not meet
 88 31 the minimum medical loss ratio established under the contract
 88 32 for the reporting period specified, the Medicaid managed
 88 33 care contractor shall remit the excess amount, multiplied
 88 34 by the total contract revenue, to the state for community
 88 35 reinvestment, oversight, and quality improvement.
 89  1    c.  The portion of the Medicaid capitation payment that is
 89  2 not required to be dedicated to meeting the minimum medical
 89  3 loss ratio, shall be allocated to an administrative fund.
 89  4 Expenditure or use of moneys in the administrative fund shall
 89  5 comply with all of the following:
 89  6    (1)  Funds in the administrative fund may be used for
 89  7 population health and quality improvement activities
 89  8 including conflict or reinvestment free case management, care
 89  9 coordination, community benefit expenditures, nontraditional
 89 10 consumer=centered services that address social determinants
 89 11 of health, health information technology, data collection and
 89 12 analysis, and other population health and quality improvement
 89 13 activities as specified by rule of the department of human
 89 14 services.
 89 15    (2)  Administrative costs shall not exceed the percentage
 89 16 applicable to the Medicaid program for administrative costs for
 89 17 FY 2015 of a maximum of 4 percent calculated as a percentage of
 89 18 the Medicaid capitation payment during the applicable minimum
 89 19 medical loss ratio reporting period. Administrative functions
 89 20 and costs shall not be shifted to providers or other entities
 89 21 as a means of administrative cost avoidance.
 89 22    (3)  Profit, including reserves and earnings on reserves
 89 23 such as investment income and earned interest, as a percentage
 89 24 of the Medicaid capitated payment, shall be limited to a
 89 25 maximum of 3 percent during the applicable minimum medical loss
 89 26 ratio reporting period.
 89 27    (4)  Any funds remaining in the administrative fund
 89 28 following allowable expenditures or uses specified in
 89 29 subparagraphs (1), (2), and (3) shall be remitted to the state
 89 30 for community reinvestment, oversight, and quality improvement.
 89 31    2.  The department of human services shall specify by rule
 89 32 reporting requirements for Medicaid managed care contractors
 89 33 under this section.
 89 34    Sec. 64.  PROPOSAL FOR A HEALTH CONSUMER OMBUDSMAN
 89 35 ALLIANCE.  The office of long=term care ombudsman shall
 90  1 collaborate with the department on aging, the office of
 90  2 substitute decision maker, the department of veterans affairs,
 90  3 the department of human services, the department of public
 90  4 health, the department of inspections and appeals, the
 90  5 designated protection and advocacy agency as provided in
 90  6 section 135C.2, subsection 4, the civil rights commission, the
 90  7 senior health insurance information program, the Iowa insurance
 90  8 consumer advocate, Iowa legal aid, and other consumer advocates
 90  9 and consumer assistance programs, to develop a proposal for the
 90 10 establishment of a health consumer ombudsman alliance. The
 90 11 purpose of the alliance is to provide a permanent coordinated
 90 12 system of independent consumer supports to ensure that
 90 13 consumers, including consumers covered under Medicaid managed
 90 14 care, obtain and maintain essential health care, are provided
 90 15 unbiased information in understanding coverage models, and are
 90 16 assisted in resolving problems regarding health care services,
 90 17 coverage, access, and rights. The proposal developed shall
 90 18 include annual budget projections and shall be submitted to the
 90 19 governor and the general assembly no later than December 15,
 90 20 2015.
 90 21    Sec. 65.  FUNCTIONAL, LEVEL OF CARE, AND NEEDS=BASED
 90 22 ASSESSMENTS ==== CASE MANAGEMENT.
 90 23    1.  The department of human services shall contract
 90 24 with a conflict free third party to conduct initial and
 90 25 subsequent functional, level of care, and needs assessments and
 90 26 reassessments of consumers who may be eligible for long=term
 90 27 services and supports and are subject to a Medicaid managed
 90 28 care contract.  Such assessments and reassessments shall not
 90 29 be completed by a Medicaid managed care organization under
 90 30 contract with the state or by any entity that is not deemed
 90 31 conflict free. If a managed care contractor becomes aware that
 90 32 an applicant may require long=term services and supports or
 90 33 that an enrolled consumer's functional level of care, support
 90 34 needs, or medical status has changed, the Medicaid managed care
 90 35 contractor shall notify the department and the conflict free
 91  1 third party shall administer any assessment or reassessment
 91  2 in response to the notification.  A case manager or Medicaid
 91  3 managed care contractor shall not alter a consumer's service
 91  4 plan independent of the prior administration of an assessment
 91  5 or reassessment conducted by the conflict free third party.
 91  6 The department of human services shall retain authority to
 91  7 determine or redetermine a consumer's categorical, financial,
 91  8 level of care or needs=based eligibility based on the conflict
 91  9 free third party assessment or reassessment.
 91 10    2.  The department of human services shall provide for
 91 11 administration of non=biased, community=based, in=person
 91 12 options counseling by a conflict free third party for
 91 13 applicants for a Medicaid managed care plan.
 91 14    3.  Case management under a Medicaid managed care contract
 91 15 shall be administered in a conflict free manner.
 91 16    4.  For the purposes of this section, "conflict free" means
 91 17 conflict free pursuant to specifications of the balancing
 91 18 incentive program requirements.
 91 19                           DIVISION XI
 91 20                             AUTISM
 91 21    Sec. 66.  Section 225D.1, subsections 3 and 8, Code 2015, are
 91 22 amended to read as follows:
 91 23    3.  "Autism service provider" means a person providing
 91 24 applied behavioral analysis, who meets all of the following
 91 25 criteria:
 91 26    a.  Is any of the following:
 91 27    (1)  Is certified as a behavior analyst by the behavior
 91 28 analyst certification board or is a health professional
 91 29 licensed under chapter 147.
 91 30    (2)  Is a board=certified assistant behavior analyst who
 91 31 performs duties, identified by and based on the standards of
 91 32 the behavior analyst certification board, under the supervision
 91 33 of a board=certified behavior analyst.
 91 34    b.  Is approved as a member of the provider network by the
 91 35 department.
 92  1    8.  "Eligible individual" means a child less than nine
 92  2  fifteen years of age who has been diagnosed with autism based
 92  3 on a diagnostic assessment of autism, is not otherwise eligible
 92  4 for coverage for applied behavioral analysis treatment under
 92  5 the medical assistance program, section 514C.28, or private
 92  6 insurance coverage, and whose household income does not exceed
 92  7 four hundred percent of the federal poverty level.
 92  8    Sec. 67.  Section 225D.2, subsection 2, paragraph c, Code
 92  9 2015, is amended to read as follows:
 92 10    c.  Notwithstanding the age limitation for an eligible
 92 11 individual, a provision that if an eligible individual reaches
 92 12 nine fifteen years of age prior to completion of the maximum
 92 13 applied behavioral analysis treatment period specified in
 92 14 paragraph "b", the individual may complete such treatment in
 92 15 accordance with the individual's treatment plan, not to exceed
 92 16 the maximum treatment period.
 92 17    Sec. 68.  Section 225D.2, subsection 2, Code 2015, is amended
 92 18 by adding the following new paragraph:
 92 19    NEW PARAGRAPH.  l.  Proof of eligibility for the autism
 92 20 support program that includes a written denial for coverage or
 92 21 a benefits summary indicating that applied behavioral analysis
 92 22 treatment is not a covered benefit for which the applicant
 92 23 is eligible, under the Medicaid program, section 514C.28, or
 92 24 private insurance coverage.
 92 25                          DIVISION XII
 92 26               OFFICE OF SUBSTITUTE DECISIONMAKER
 92 27    Sec. 69.  Section 231E.4, subsection 3, paragraph a, Code
 92 28 2015, is amended to read as follows:
 92 29    a.  Select persons through a request for proposals process to
 92 30 establish local offices of substitute decision maker in each
 92 31 of the planning and service areas. Local offices shall be
 92 32 established statewide on or before July 1, 2015 2017.
 92 33                          DIVISION XIII
 92 34                       DEMENTIA WORKFORCE
 92 35    Sec. 70.  INTERAGENCY DEMENTIA PROFICIENT WORKFORCE TASK
 93  1 FORCE.  The department on aging shall convene an interagency
 93  2 task force, in collaboration with the office of long=term
 93  3 care ombudsman, the office of substitute decision maker, the
 93  4 departments of public health, human services, and inspections
 93  5 and appeals, and the Alzheimer's association, to review the
 93  6 recommendations for a standard curriculum model for dementia
 93  7 education submitted by the Alzheimer's association dementia
 93  8 education task force to the department on aging in June 2010,
 93  9 in the Iowa dementia education project final report, and the
 93 10 curricula=related recommendations submitted by the direct care
 93 11 worker task force  and the direct care worker advisory council;
 93 12 identify staff, in settings in which individuals with dementia
 93 13 may seek services and care, who should have some level of
 93 14 dementia proficiency and analyze gaps in existing training
 93 15 and educational requirements; and develop an implementation
 93 16 plan to transition toward competency=based dementia curricula
 93 17 and training that achieves dementia proficiency across a
 93 18 broader care continuum.  To the greatest extent possible,
 93 19 the plan shall address training strategies for different
 93 20 settings, levels of skill, and licensure.  The plan shall
 93 21 include a timeline for implementation, fiscal implications of
 93 22 recommendations, and identification of key decision points
 93 23 for the general assembly.  The task force shall provide
 93 24 opportunities for stakeholder input from affected industry,
 93 25 education, professional, employee, and consumer organizations.
 93 26 The task force shall submit its  recommendations to the governor
 93 27 and the general assembly no later than December 15, 2015.
 93 28                          DIVISION XIV
 93 29         PHARMACEUTICAL COLLECTION AND DISPOSAL PROGRAM
 93 30    Sec. 71.  Section 155A.43, Code 2015, is amended to read as
 93 31 follows:
 93 32    155A.43  Pharmaceutical collection and disposal program ====
 93 33 annual allocation.
 93 34    Of the fees collected pursuant to sections 124.301 and
 93 35 147.80 and chapter 155A by the board of pharmacy, and retained
 94  1 by the board pursuant to section 147.82, not more than
 94  2 one hundred twenty=five seventy=five thousand dollars may
 94  3 be allocated annually by the board for administering the
 94  4 pharmaceutical collection and disposal program originally
 94  5 established pursuant to 2009 Iowa Acts, ch. 175, {9. The
 94  6 program shall provide for the management and disposal of
 94  7 unused, excess, and expired pharmaceuticals. The board of
 94  8 pharmacy may cooperate with the Iowa pharmacy association and
 94  9 may consult with the department and sanitary landfill operators
 94 10 in administering the program.
 94 11                           DIVISION XV
 94 12             MEDICAID STATE PLAN ==== FAMILY PLANNING
 94 13    Sec. 72.  MEDICAID STATE PLAN AMENDMENT ==== FAMILY
 94 14 PLANNING.  The department of human services shall amend the
 94 15 medical assistance state plan to include, effective no later
 94 16 than January 1, 2016, the eligibility provisions of the Iowa
 94 17 family planning network section 1115 demonstration waiver in
 94 18 effect on January 1, 2015. The department shall implement
 94 19 the state plan amendment upon receipt of approval by the
 94 20 centers for Medicare and Medicaid services of the United States
 94 21 department of health and human services.
 94 22    Sec. 73.  EFFECTIVE DATE.  This division of this Act, being
 94 23 deemed of immediate importance, takes effect upon enactment.
 94 24                          DIVISION XVI
 94 25                  IOWA ABLE SAVINGS PLAN TRUST
 94 26    Sec. 74.  NEW SECTION.  12I.1  Purpose and definitions.
 94 27    1.  The general assembly finds that the general welfare
 94 28 and well=being of the state are directly related to the
 94 29 health, maintenance, independence, and quality of life of its
 94 30 disabled residents, and that a vital and valid public purpose
 94 31 is served by the creation and implementation of programs that
 94 32 encourage and make possible savings to secure funding for
 94 33 disability=related expenses on behalf of individuals with
 94 34 disabilities that will supplement, but not supplant, other
 94 35 benefits provided by various federal, state, and private
 95  1 sources.  The creation of the means of encouragement for
 95  2 citizens to invest in such a program represents the carrying
 95  3 out of a vital and valid public purpose.  In order to make
 95  4 available to the citizens of the state an opportunity to fund
 95  5 future disability=related expenses of individuals, it is
 95  6 necessary that a public trust be established in which moneys
 95  7 may be invested for payment of future disability=related
 95  8 expenses of an individual.
 95  9    2.  As used in this chapter, unless the context otherwise
 95 10 requires:
 95 11    a.  "Account balance limit" means the maximum allowable
 95 12 aggregate balance of an account established for a designated
 95 13 beneficiary.  Account earnings, if any, are included in the
 95 14 account balance limit.
 95 15    b.  "Account owner" means an individual who enters into a
 95 16 participation agreement under this chapter for the payment
 95 17 of qualified disability expenses on behalf of a designated
 95 18 beneficiary.
 95 19    c.  "Contracting state" means the same as defined in section
 95 20 529A of the Internal Revenue Code.
 95 21    d.  "Designated beneficiary" means an individual who is a
 95 22 resident of this state or a resident of a contracting state and
 95 23 who meets the definition of "eligible individual" in section
 95 24 529A of the Internal Revenue Code.
 95 25    e.  "Internal Revenue Code" means the Internal Revenue Code
 95 26 of 1986, as amended, and regulations promulgated thereunder.
 95 27    f.  "Iowa ABLE savings plan trust" or "trust" means the trust
 95 28 created under section 12I.2.
 95 29    g.  "Participation agreement" means an agreement between the
 95 30 account owner and the trust entered into under this chapter.
 95 31    h.  "Qualified ABLE program" means the same as defined in
 95 32 section 529A of the Internal Revenue Code.
 95 33    i.  "Qualified disability expenses" means the same as defined
 95 34 in section 529A of the Internal Revenue Code.
 95 35    j.  "Resident" shall be defined by rules adopted by the
 96  1 treasurer of state.  The rules shall determine residency in
 96  2 such manner as may be required or permitted under section
 96  3 529A of the Internal Revenue Code, or, in the absence of any
 96  4 guidance under federal law, as the treasurer of state deems
 96  5 advisable for the purpose of satisfying the requirements of
 96  6 section 529A of the Internal Revenue Code.
 96  7    Sec. 75.  NEW SECTION.  12I.2  Creation of Iowa ABLE savings
 96  8 plan trust.
 96  9    An Iowa ABLE savings plan trust is created.  The treasurer of
 96 10 state is the trustee of the trust, and has all powers necessary
 96 11 to carry out and effectuate the purposes, objectives, and
 96 12 provisions of this chapter pertaining to the trust, including
 96 13 the power to do all of the following:
 96 14    1.  Make and enter into contracts necessary for the
 96 15 administration of the trust created under this chapter.
 96 16    2.  Enter into agreements with this state or any other
 96 17 state, or any federal or other state agency, or other entity as
 96 18 required to implement this chapter.
 96 19    3.  Carry out the duties and obligations of the trust
 96 20 pursuant to this chapter.
 96 21    4.  Accept any grants, gifts, legislative appropriations,
 96 22 and other moneys from the state, any unit of federal, state, or
 96 23 local government, or any other person, firm, partnership, or
 96 24 corporation which the treasurer of state shall deposit into the
 96 25 administrative fund or program fund.
 96 26    5.  Participate in any federal, state, or local governmental
 96 27 program for the benefit of the trust.
 96 28    6.  Procure insurance against any loss in connection with the
 96 29 property, assets, or activities of the trust.
 96 30    7.  Enter into participation agreements with account owners.
 96 31    8.  Make payments to designated beneficiaries pursuant to
 96 32 participation agreements.
 96 33    9.  Make refunds to account owners upon the termination
 96 34 of participation agreements, and partial nonqualified
 96 35 distributions to account owners, pursuant to this chapter and
 97  1 the limitations and restrictions set forth in this chapter.
 97  2    10.  Invest moneys from the program fund in any investments
 97  3 that are determined by the treasurer of state to be
 97  4 appropriate.
 97  5    11.  Engage investment advisors, if necessary, to assist in
 97  6 the investment of trust assets.
 97  7    12.  Contract for goods and services and engage personnel
 97  8 as necessary, including consultants, actuaries, managers,
 97  9 legal counsel, and auditors for the purpose of rendering
 97 10 professional, managerial, and technical assistance and advice
 97 11 to the treasurer of state regarding trust administration and
 97 12 operation.
 97 13    13.  Establish, impose, and collect administrative fees
 97 14 and charges in connection with transactions of the trust, and
 97 15 provide for reasonable service charges, including penalties for
 97 16 cancellations and late payments with respect to participation
 97 17 agreements.
 97 18    14.  Administer the funds of the trust.
 97 19    15.  Prepare and file reports and notices.
 97 20    16.  Enter into agreements with contracting states to permit
 97 21 residents of the contracting state to participate in the Iowa
 97 22 ABLE savings plan trust.
 97 23    17.  Adopt rules pursuant to chapter 17A for the
 97 24 administration of this chapter.
 97 25    Sec. 76.  NEW SECTION.  12I.3  Participation agreements for
 97 26 trust.
 97 27    On or after July 1, 2016, the trust may enter into
 97 28 participation agreements with account owners pursuant to the
 97 29 following terms and agreements:
 97 30    1.  a.  Unless otherwise permitted under section 529A of the
 97 31 Internal Revenue Code, the treasurer of state shall allow only
 97 32 one participation agreement per designated beneficiary.
 97 33    b.  Unless otherwise permitted under section 529A of the
 97 34 Internal Revenue Code, the account owner must also be the
 97 35 designated beneficiary of the account.  However, a trustee or
 98  1 legal guardian may be designated as custodian of an account for
 98  2 a designated beneficiary who is a minor or who lacks capacity
 98  3 to enter into a participation agreement if such designation is
 98  4 not prohibited under section 529A of the Internal Revenue Code.
 98  5    c.  The treasurer of state shall set an annual contribution
 98  6 limit and account balance limit to maintain compliance with
 98  7 section 529A of the Internal Revenue Code. A contribution
 98  8 shall not be permitted to the extent it exceeds the annual
 98  9 contribution limit or causes the aggregate balance of the
 98 10 account established for the designated beneficiary to exceed
 98 11 the applicable account balance limit.
 98 12    d.  The maximum amount that may be deducted per year for
 98 13 Iowa income tax purposes by an individual for contributions on
 98 14 behalf of any one designated beneficiary that is a resident
 98 15 of this state shall not exceed the maximum deductible amount
 98 16 determined for the year pursuant to section 12D.3, subsection
 98 17 1, paragraph "a".
 98 18    e.  Participation agreements may be amended to provide
 98 19 for adjusted levels of contributions based upon changed
 98 20 circumstances or changes in disability=related expenses.
 98 21    f.  Any person may make contributions pursuant to a
 98 22 participation agreement on behalf of a designated beneficiary
 98 23 under rules adopted by the treasurer of state.
 98 24    2.  The execution of a participation agreement by the trust
 98 25 shall not guarantee in any way that future disability=related
 98 26 expenses will be equal to projections and estimates provided by
 98 27 the trust or that the account owner or designated beneficiary
 98 28 is guaranteed any of the following:
 98 29    a.  A return of principal.
 98 30    b.  A rate of interest or other return from the trust.
 98 31    c.  Payment of interest or other return from the trust.
 98 32    3.  a.  A designated beneficiary under a participation
 98 33 agreement may be changed as permitted under rules adopted by
 98 34 the treasurer of state upon written request of the account
 98 35 owner as long as such change would be permitted by section 529A
 99  1 of the Internal Revenue Code.
 99  2    b.  Participation agreements may otherwise be freely amended
 99  3 throughout their terms in order to enable account owners to
 99  4 increase or decrease the level of participation, change the
 99  5 designated beneficiary, and carry out similar matters as
 99  6 authorized by rule.
 99  7    4.  Each participation agreement shall provide that the
 99  8 participation agreement may be canceled upon the terms and
 99  9 conditions, and upon payment of applicable fees and costs set
 99 10 forth and contained in the rules adopted by the treasurer of
 99 11 state.
 99 12    Sec. 77.  NEW SECTION.  12I.4  Program and administrative
 99 13 funds ==== investment and payment.
 99 14    1.  a.  The treasurer of state shall segregate moneys
 99 15 received by the trust into two funds:  the program fund and the
 99 16 administrative fund.
 99 17    b.  All moneys paid by account owners or other persons
 99 18 on behalf of a designated beneficiary in connection with
 99 19 participation agreements shall be deposited as received into
 99 20 separate accounts for each designated beneficiary within the
 99 21 program fund.
 99 22    c.  Contributions to the trust made on behalf of designated
 99 23 beneficiaries may only be made in the form of cash.
 99 24    d.  An account owner or designated beneficiary is
 99 25 not permitted to provide investment direction regarding
 99 26 contributions or earnings held by the trust.
 99 27    2.  Moneys accrued by account owners in the program fund
 99 28 of the trust may be used for payments of qualified disability
 99 29 expenses.
 99 30    3.  Moneys in the account of a designated beneficiary may
 99 31 be claimed by the Iowa Medicaid program as provided in section
 99 32 529A(f) of the Internal Revenue Code and subject to limitations
 99 33 imposed by the treasurer of state.
 99 34    4.  The trust shall comply with Pub. L. No. 113=295, {103,
 99 35 regarding treatment of ABLE accounts under certain federal
100  1 programs.
100  2    5.  Moneys in the funds are not subject to section 8.33.
100  3 Notwithstanding section 12C.7, interest or earnings on moneys
100  4 in the funds shall be credited to the funds.
100  5    Sec. 78.  NEW SECTION.  12I.5  Cancellation of agreements.
100  6    An account owner may cancel a participation agreement at
100  7 will. Upon cancellation of a participation agreement, an
100  8 account owner shall be entitled to the return of the account
100  9 owner's account balance.
100 10    Sec. 79.  NEW SECTION.  12I.6  Repayment and ownership of
100 11 payments and investment income ==== transfer of ownership rights.
100 12    1.  a.  An account owner retains ownership of all
100 13 contributions made on behalf of a designated beneficiary under
100 14 a participation agreement up to the date of utilization for
100 15 payment of qualified disability expenses of the designated
100 16 beneficiary.
100 17    b.  All income derived from the investment of the
100 18 contributions made on behalf of a designated beneficiary shall
100 19 be considered to be held in trust for the benefit of the
100 20 designated beneficiary.
100 21    2.  In the event the trust is terminated prior to payment of
100 22 qualified disability expenses for the designated beneficiary,
100 23 the account owner is entitled to a refund of the account
100 24 owner's account balance.
100 25    3.  Any amounts which may be paid to any person or persons
100 26 pursuant to the Iowa ABLE savings plan trust but which are not
100 27 listed in this section are owned by the trust.
100 28    4.  An account owner may transfer ownership rights to
100 29 another designated beneficiary, including a gift of the
100 30 ownership rights to a designated beneficiary who is a minor, in
100 31 accordance with rules adopted by the treasurer of state and the
100 32 terms of the participation agreement, so long as the transfer
100 33 would be permitted by section 529A of the Internal Revenue
100 34 Code.
100 35    5.  An account owner or designated beneficiary shall not be
101  1 entitled to utilize any interest in the trust as security for
101  2 a loan.
101  3    Sec. 80.  NEW SECTION.  12I.7  Reports ==== annual audited
101  4 financial report ==== reports under federal law.
101  5    1.  a.  The treasurer of state shall submit an annual
101  6 audited financial report, prepared in accordance with generally
101  7 accepted accounting principles, on the operations of the trust
101  8 by November 1 to the governor and the general assembly.
101  9    b.  The annual audit shall be made either by the auditor
101 10 of state or by an independent certified public accountant
101 11 designated by the auditor of state and shall include direct and
101 12 indirect costs attributable to the use of outside consultants,
101 13 independent contractors, and any other persons who are not
101 14 state employees.
101 15    2.  The annual audit shall be supplemented by all of the
101 16 following information prepared by the treasurer of state:
101 17    a.  Any related studies or evaluations prepared in the
101 18 preceding year.
101 19    b.  A summary of the benefits provided by the trust,
101 20 including the number of account owners and designated
101 21 beneficiaries in the trust, or, if the trust has caused this
101 22 state to become a contracting state pursuant to section 12I.10,
101 23 a summary of the benefits provided to Iowa residents by the
101 24 contracted qualified ABLE program, including the number of
101 25 account owners and designated beneficiaries in the contracted
101 26 qualified ABLE program who are Iowa residents.
101 27    c.  Any other information deemed relevant by the treasurer of
101 28 state in order to make a full, fair, and effective disclosure
101 29 of the operations of the trust or the contracted qualified ABLE
101 30 program if applicable.
101 31    3.  The treasurer of state shall prepare and submit to the
101 32 secretary of the United States treasury or other required party
101 33 any reports, notices, or statements required under section 529A
101 34 of the Internal Revenue Code.
101 35    Sec. 81.  NEW SECTION.  12I.8  Tax considerations.
102  1    1.  For federal income tax purposes, the Iowa ABLE savings
102  2 plan trust shall be considered a qualified ABLE program exempt
102  3 from taxation pursuant to section 529A of the Internal Revenue
102  4 Code and shall be operated so that it meets the requirements of
102  5 section 529A of the Internal Revenue Code.
102  6    2.  State income tax treatment of the Iowa ABLE savings plan
102  7 trust shall be as provided in section 422.7, subsections 34 and
102  8 34A.
102  9    3.  State inheritance tax treatment of interests in Iowa ABLE
102 10 savings plans shall be as provided in section 450.4, subsection
102 11 9.
102 12    Sec. 82.  NEW SECTION.  12I.9  Property rights to assets in
102 13 trust.
102 14    1.  The assets of the trust shall at all times be preserved,
102 15 invested, and expended solely and only for the purposes of the
102 16 trust and shall be held in trust for the account owners and
102 17 designated beneficiaries.
102 18    2.  Except as provided in section 12I.4, subsection 3, no
102 19 property rights in the trust shall exist in favor of the state.
102 20    3.  Except as provided in section 12I.4, subsection 3, the
102 21 assets of the trust shall not be transferred or used by the
102 22 state for any purposes other than the purposes of the trust.
102 23    Sec. 83.  NEW SECTION.  12I.10  Implementation as a
102 24 contracting state ==== tax considerations.
102 25    1.  The general assembly acknowledges that section 529A of
102 26 the Internal Revenue Code permits access to qualified ABLE
102 27 programs by residents of a state without such a program.  The
102 28 general assembly finds that becoming a contracting state may
102 29 accomplish the public purpose set forth in section 12I.1,
102 30 subsection 1, in the same manner as if the qualified ABLE
102 31 program under the Iowa ABLE savings plan trust were to be
102 32 implemented and administered by this state.  To that end,
102 33 the treasurer of state, as trustee of the trust, may defer
102 34 implementation of the qualified ABLE program under the trust
102 35 and alternatively cause this state to become a contracting
103  1 state by entering into an agreement with another state with a
103  2 qualified ABLE program to provide Iowa residents access to that
103  3 state's qualified ABLE program.  The trust shall not enter into
103  4 an agreement pursuant to this section unless the treasurer,
103  5 as trustee of the trust, determines that all of the following
103  6 requirements are satisfied:
103  7    a.  The program is a qualified ABLE program.
103  8    b.  The qualified ABLE program provides comparable benefits
103  9 and protections to Iowa residents as would be provided under
103 10 the Iowa ABLE savings plan trust.
103 11    c.  That entering into an agreement for access to the
103 12 qualified ABLE program would not result in increased costs to
103 13 the state or to account owners and designated beneficiaries as
103 14 compared to the costs of implementing and administering the
103 15 qualified ABLE program under the Iowa ABLE savings plan trust.
103 16    d.  The qualified ABLE program will be audited annually by
103 17 an independent certified public accountant or by the state
103 18 auditor, or similar public official, of the state that has
103 19 implemented the qualified ABLE program.
103 20    e.  The qualified ABLE program will provide information to
103 21 the treasurer of state as trustee of the trust so as to allow
103 22 the trustee to fulfill the reporting requirements in section
103 23 12I.7.
103 24    2.  a.  The maximum amount that may be deducted per year for
103 25 Iowa income tax purposes by an individual for contributions on
103 26 behalf of any one designated beneficiary that is a resident of
103 27 this state to the qualified ABLE program with which the state
103 28 has contracted pursuant to this section shall not exceed the
103 29 maximum deductible amount determined for the year pursuant to
103 30 section 12D.3, subsection 1, paragraph "a".
103 31    b.  State income tax treatment of the qualified ABLE program
103 32 with which the state has contracted pursuant to this section
103 33 shall be as provided in section 422.7, subsections 34 and 34A.
103 34    3.  State inheritance tax treatment of interests in the
103 35 qualified ABLE program with which the state has contracted
104  1 pursuant to this section shall be as provided in section 450.4,
104  2 subsection 9.
104  3    Sec. 84.  NEW SECTION.  12I.11  Construction.
104  4    This chapter shall be construed liberally in order to
104  5 effectuate its purpose.
104  6    Sec. 85.  Section 422.7, Code 2015, is amended by adding the
104  7 following new subsections:
104  8    NEW SUBSECTION.  34.  a.  Subtract the amount contributed
104  9 during the tax year on behalf of a designated beneficiary
104 10 that is a resident of this state to the Iowa ABLE savings
104 11 plan trust or to the qualified ABLE program with which the
104 12 state has contracted pursuant to section 12I.10, not to exceed
104 13 the maximum contribution level established in section 12I.3,
104 14 subsection 1, paragraph "d", or section 12I.10, subsection 2,
104 15 paragraph "a", as applicable.
104 16    b.  Add the amount resulting from the cancellation of a
104 17 participation agreement refunded to the taxpayer as an account
104 18 owner in the Iowa ABLE savings plan trust or the qualified
104 19 ABLE program with which the state has contracted pursuant to
104 20 section 12I.10 to the extent previously deducted pursuant
104 21 to this subsection by the taxpayer or any other person as a
104 22 contribution to the trust or qualified ABLE program.
104 23    c.  Add the amount resulting from a withdrawal made by a
104 24 taxpayer from the Iowa ABLE savings plan trust or the qualified
104 25 ABLE program with which the state has contracted pursuant to
104 26 section 12I.10 for purposes other than the payment of qualified
104 27 disability expenses to the extent previously deducted pursuant
104 28 to this subsection by the taxpayer or any other person as a
104 29 contribution to the trust or qualified ABLE program.
104 30    NEW SUBSECTION.  34A.  Subtract, to the extent included,
104 31 income from interest and earnings received from the Iowa ABLE
104 32 savings plan trust created in chapter 12I, or received by a
104 33 resident account owner from a qualified ABLE program with which
104 34 the state has contracted pursuant to section 12I.10.
104 35    Sec. 86.  Section 450.4, Code 2015, is amended by adding the
105  1 following new subsection:
105  2    NEW SUBSECTION.  9.  On the value of any interest in the Iowa
105  3 ABLE savings plan trust created in chapter 12I, or any interest
105  4 held by a resident account owner in a qualified ABLE program
105  5 with which the state has contracted pursuant to section 12I.10.
105  6    Sec. 87.  CONTINGENT IMPLEMENTATION.  The implementation of
105  7 chapter 12I as enacted in this division of this Act is subject
105  8 to an appropriation with the stated purpose of the Iowa ABLE
105  9 Savings Plan Trust.
105 10    Sec. 88.  APPLICABILITY.  The section of this division of
105 11 this Act amending section 450.4 applies to estates of decedents
105 12 dying on or after January 1, 2016.
105 13    Sec. 89.  APPLICABILITY.  The section of this division of
105 14 this Act amending section 422.7 applies to tax years beginning
105 15 on or after January 1, 2016.
105 16                          DIVISION XVII
105 17        STATE CHILD CARE ASSISTANCE ==== INCOME ELIGIBILITY
105 18    Sec. 90.  Section 237A.13, subsection 7, paragraph c, Code
105 19 2015, is amended to read as follows:
105 20    c.  Families with an income of more than one hundred
105 21 percent but not more than one hundred forty=five sixty percent
105 22 of the federal poverty level whose members, for at least
105 23 twenty=eight hours per week in the aggregate, are employed
105 24 or are participating at a satisfactory level in an approved
105 25 training program or educational program.
105 26    Sec. 91.  DIRECTIVE TO DEPARTMENT OF HUMAN SERVICES ON
105 27 CHILD CARE ASSISTANCE.  The department of human services shall
105 28 amend its administrative rules relating to income eligibility
105 29 for state child care assistance, according to family size for
105 30 children needing basic care, to families whose nonexempt gross
105 31 monthly income does not exceed 160 percent of the federal
105 32 poverty level.
105 33                         DIVISION XVIII
105 34   COUNTY MENTAL HEALTH AND DISABILITIES SERVICES FUNDING ====
105 35                EQUALIZATION AND MEDICAID OFFSET
106  1    Sec. 92.  Section 331.424A, subsection 8, unnumbered
106  2 paragraph 1, Code 2015, is amended to read as follows:
106  3    Notwithstanding subsection 6, for the fiscal years beginning
106  4 July 1, 2013, July 1, 2014, and July 1, 2015, and July 1, 2016,
106  5  county revenues from taxes levied by the county and credited
106  6 to the county services fund shall not exceed the lower of the
106  7 following amounts:
106  8    Sec. 93.  Section 426B.3, subsection 1, Code 2015, is amended
106  9 to read as follows:
106 10    1.  For the fiscal years beginning July 1, 2013, July
106 11 1, 2014, and July 1, 2015, and July 1, 2016, the state and
106 12 county funding for the mental health and disability services
106 13 administered or paid for by counties shall be provided based on
106 14 a statewide per capita expenditure target amount computed in
106 15 accordance with this section and section 331.424A.
106 16    Sec. 94.  Section 426B.3, subsection 4, paragraph a, Code
106 17 2015, is amended to read as follows:
106 18    a.  For the fiscal years beginning July 1, 2013, July 1,
106 19 2014, and July 1, 2015, and July 1, 2016, a county with a county
106 20 population expenditure target amount that exceeds the amount
106 21 of the county's base year expenditures for mental health and
106 22 disabilities services shall receive an equalization payment for
106 23 the difference.
106 24    Sec. 95.  Section 426B.3, subsection 5, Code 2015, is amended
106 25 by striking the subsection.
106 26                          DIVISION XIX
106 27      MEDICAID OFFSET PAYMENTS ==== PROPERTY TAX RELIEF FUND
106 28                         APPROPRIATIONS
106 29    Sec. 96.  MEDICAID OFFSET PAYMENTS ==== PROPERTY TAX RELIEF
106 30 FUND APPROPRIATION.
106 31    1.  Of the moneys credited to the property tax relief fund
106 32 pursuant to section 426B.3, subsection 5, paragraph "e",
106 33 subparagraph (1), Code 2015, in the fiscal year beginning July
106 34 1, 2014, and ending June 30, 2015, there is appropriated to the
106 35 department of human services for the fiscal year beginning July
107  1 1, 2015, and ending June 30, 2016, the following amounts, to be
107  2 used for the purposes designated, notwithstanding any contrary
107  3 provision of chapter 426B:
107  4    a.  For reductions in the waiting lists of all medical
107  5 assistance home and community=based services waivers:
107  6 .................................................. $  5,092,000
107  7    b.  For allocation to the department on aging for a grant
107  8 to a nationally affiliated organization providing support and
107  9 education to people living with Alzheimer's disease and other
107 10 related dementias to be used for a statewide public awareness
107 11 campaign regarding the signs of Alzheimer's disease and other
107 12 related dementias and the resources available to such people:
107 13 .................................................. $    100,000
107 14    c.  For development of an application for a planning
107 15 grant through the substance abuse and mental health services
107 16 administration of the United States department of health and
107 17 human services to participate in a two=year pilot project for
107 18 certified community behavioral health clinics under the federal
107 19 Protecting Access to Medicare Act of 2014, Pub. L. No. 113=93:
107 20 .................................................. $    240,000
107 21    The department may use the funds allocated pursuant to this
107 22 paragraph to contract for necessary support to develop and
107 23 submit the application for the planning grant. The department
107 24 shall submit the application for the planning grant to the
107 25 centers for Medicare and Medicaid services of the United States
107 26 department of health and human services upon completion of the
107 27 application.
107 28    2.  Of the moneys credited to the property tax relief
107 29 fund pursuant to section 426B.3, subsection 5, paragraph e,
107 30 subparagraph (1), Code 2015, in the fiscal year beginning July
107 31 1, 2014, and ending June 30, 2015, there is appropriated to
107 32 the department of human services for the fiscal year beginning
107 33 July 1, 2015, and ending June 30, 2016, the following amount,
107 34 or so much thereof as is necessary, to be used for the purpose
107 35 designated:
108  1    a.  For distribution to a mental health and disability
108  2 services region where 25 percent of a region's projected
108  3 expenditures exceeds the region's projected fund balance:
108  4 .................................................. $  4,554,651
108  5    b.  For purposes of this section:
108  6    (1)  "Available funds" means a county mental health and
108  7 services fund balance on June 30, 2015, plus the maximum amount
108  8 a county was allowed to levy for the fiscal year beginning July
108  9 1, 2015.
108 10    (2)  "Projected expenditures" means the actual expenditures
108 11 of a mental health and disability services region as of June
108 12 30, 2015, multiplied by an annual inflation rate equal to
108 13 2 percent plus the projected costs for core services and
108 14 additional core services administered by the region as provided
108 15 in a region's regional service system management plan approved
108 16 pursuant to section 331.393 for the fiscal year beginning July
108 17 1, 2015.
108 18    (3)  "Projected fund balance" means the difference between a
108 19 mental health and disability services region's available funds
108 20 and projected expenditures.
108 21    c.  If sufficient funds are not available to implement this
108 22 subsection, the department of human services shall distribute
108 23 funds to a region in proportion to the availability of funds.
108 24                           DIVISION XX
108 25 PROPERTY TAX RELIEF FUND ==== BLOCK GRANT MONEYS ==== MENTAL HEALTH
108 26                           INSTITUTES
108 27    Sec. 97.  MENTAL HEALTH INSTITUTES.  The moneys transferred
108 28 to the property tax relief fund for the fiscal year beginning
108 29 July 1, 2015, from the federal social services block grant
108 30 pursuant to 2015 Iowa Acts, House File 630, if enacted, and
108 31 from the federal temporary assistance for needy families block
108 32 grant, totaling at least $11,774,275, are appropriated to the
108 33 department of human services for the fiscal year beginning July
108 34 1, 2015, and ending June 30, 2016, to be used for the purposes
108 35 designated:
109  1    1.  For the state mental health institute at Clarinda for
109  2 salaries, support, maintenance, and miscellaneous purposes:
109  3 .................................................. $  4,836,507
109  4    2.  For the state mental health institute at Mount Pleasant
109  5 for salaries, support, maintenance, and miscellaneous purposes,
109  6 and for not more than the following full=time equivalent
109  7 positions:
109  8 .................................................. $  6,937,768
109  9 ............................................... FTEs      97.68
109 10                          DIVISION XXI
109 11            STUDY ==== CHILD WELFARE ADVISORY COMMITTEE
109 12    Sec. 98.  STUDY ==== CHILD WELFARE ADVISORY COMMITTEE.  The
109 13 child welfare advisory committee of the council on human
109 14 services established pursuant to section 217.3A shall study
109 15 procedures in the department of human services for receiving
109 16 complaints from families involved in guardianship, placement,
109 17 and custody proceedings; the specificity and clarity of court
109 18 orders issued in foster care placements pursuant to the State
109 19 of Iowa Primary Review of Tit. IV=E Foster Care Eligibility
109 20 Report of Findings for October 1, 2012, through March 31, 2013;
109 21 caseload trends of social workers, including an analysis of how
109 22 Iowa compares nationally and with best practices as defined
109 23 by national associations; and immunity provisions for social
109 24 workers employed by the department of human services and basic
109 25 qualifications of social workers employed by the department
109 26 of human services.  The committee shall submit a report with
109 27 findings and recommendations to the governor and general
109 28 assembly on or before December 15, 2015.
109 29                          DIVISION XXII
109 30     COVERAGE OF SERVICES PROVIDED BY A PHYSICAL THERAPIST,
109 31          OCCUPATIONAL THERAPIST, OR SPEECH PATHOLOGIST
109 32    Sec. 99.  NEW SECTION.  514C.30  Services provided by
109 33 a physical therapist, occupational therapist, or speech
109 34 pathologist.
109 35    1.  Notwithstanding the uniformity of treatment requirements
110  1 of section 514C.6, a policy, contract, or plan providing
110  2 for third=party payment or prepayment of health or medical
110  3 expenses shall not impose a copayment or coinsurance amount
110  4 on an insured for services provided by a physical therapist
110  5 licensed pursuant to chapter 148A, by an occupational therapist
110  6 licensed pursuant to chapter 148B, or by a speech pathologist
110  7 licensed pursuant to 154F that is greater than the copayment or
110  8 coinsurance amount imposed on the insured for services provided
110  9 by a person engaged in the practice of medicine and surgery
110 10 or osteopathic medicine and surgery under chapter 148 for the
110 11 same or a similar diagnosed condition even if a different
110 12 nomenclature is used to describe the condition for which the
110 13 services are provided.
110 14    2.  This section applies to the following classes of
110 15 third=party payment provider policies, contracts, or plans
110 16 delivered, issued for delivery, continued, or renewed in this
110 17 state on or after July 1, 2015:
110 18    a.  Individual or group accident and sickness insurance
110 19 providing coverage on an expense=incurred basis.
110 20    b.  An individual or group hospital or medical service
110 21 contract issued pursuant to chapter 509, 514, or 514A.
110 22    c.  An individual or group health maintenance organization
110 23 contract regulated under chapter 514B.
110 24    d.  A plan established pursuant to chapter 509A for public
110 25 employees.
110 26    e.  An organized delivery system licensed by the director of
110 27 public health.
110 28    3.  This section shall not apply to accident=only,
110 29 specified disease, short=term hospital or medical, hospital
110 30 confinement indemnity, credit, dental, vision, Medicare
110 31 supplement, long=term care, basic hospital and medical=surgical
110 32 expense coverage as defined by the commissioner, disability
110 33 income insurance coverage, coverage issued as a supplement
110 34 to liability insurance, workers' compensation or similar
110 35 insurance, or automobile medical payment insurance.
111  1                         DIVISION XXIII
111  2        CHILDREN'S MENTAL HEALTH AND WELL=BEING WORKGROUP
111  3    Sec. 100.  CHILDREN'S MENTAL HEALTH AND WELL=BEING
111  4 WORKGROUP.  The department of human services, in cooperation
111  5 with the departments of education and public health, shall
111  6 facilitate a workgroup of stakeholders to study and make
111  7 recommendations relating to children's mental health and
111  8 well=being in this state.  The issues that may be considered
111  9 by the workgroup include developing a strategic plan for
111 10 data systems to provide for a comprehensive analysis of
111 11 the mental health and well=being of children in this state;
111 12 creating a comprehensive system of care for children that
111 13 incorporates a coordinated response to mental health issues
111 14 across many disciplines including education, public health,
111 15 mental health, child welfare, and child welfare systems
111 16 and services and that specifically addresses the effects of
111 17 adverse childhood experiences and extreme child poverty and
111 18 homelessness; and building interdepartmental awareness of
111 19 issues relating to child mental health and well=being and
111 20 creating interdepartmental strategies for helping improve
111 21 child mental health and well=being and understanding impacts
111 22 on education and employment outcomes; examining child care
111 23 quality and affordability; and determining how government can
111 24 create community partnerships to help address issues of child
111 25 mental health and well=being. In carrying out the charge
111 26 of the workgroup, the workgroup shall review a 2014 report
111 27 by the children's defense fund on the state of America's
111 28 children containing the most recent and reliable national and
111 29 state=by=state data on many complex issues affecting children's
111 30 health and well=being, including data on more than 7,000
111 31 homeless public school students in Iowa.  The workgroup shall
111 32 develop and recommend proactive strategies across state systems
111 33 to address these most complex needs impacting children's mental
111 34 health and well=being which will also aid different populations
111 35 of children with fewer challenges.  The workgroup shall submit
112  1 a report on the study and make recommendations to the governor
112  2 and the general assembly on or before December 15, 2015.
112  3                          DIVISION XXIV
112  4            PREVENTION OF DISABILITIES POLICY COUNCIL
112  5    Sec. 101.  NEW SECTION.  225B.101  Findings and intent.
112  6    1.  The general assembly finds that:
112  7    a.  Between ten and twenty percent of Iowans have a
112  8 disability that affects their ability to learn, work,
112  9 communicate, perform activities of daily living, and
112 10 participate in everyday community life.  These disabilities
112 11 are the result of genetics, environmental factors, injury, or
112 12 illness; may occur at any point in life; may be mild, severe,
112 13 or intermittent; and are often very costly for the individuals
112 14 affected, their families, and government both in terms of
112 15 quality of life and financial expenditures.
112 16    b.  Most disabilities are due to conditions that can be
112 17 prevented, can be minimized if recognized and treated early, or
112 18 can be reduced through appropriate accommodation.
112 19    c.  A need exists to optimize the use of cost=effective
112 20 prevention of disability strategies in state policies and
112 21 programs in order to reduce the cost of disabilities to Iowa's
112 22 citizens and government.
112 23    2.  It is the intent of the general assembly to establish
112 24 a structure and process to identify opportunities to enhance
112 25 prevention of disability efforts in Iowa, design cross=agency
112 26 strategies to address the prevention of disabilities, integrate
112 27 and coordinate proven prevention of disability strategies
112 28 within state programs, and inform the general assembly about
112 29 priority prevention of disability policies and programs.
112 30    Sec. 102.  NEW SECTION.  225B.102  Definitions.
112 31    As used in this chapter, unless the context otherwise
112 32 requires:
112 33    1.  "Council" means the prevention of disabilities policy
112 34 council.
112 35    2.  "Disability" means an individual who meets the definition
113  1 in 42 U.S.C. {12102.
113  2    3.  "Prevention" activities include policies, programs, and
113  3 practices that do any of the following:
113  4    a.  Prevent a disability or a condition that leads to a
113  5 disability from occurring.
113  6    b.  Identify a disability or a condition that leads to a
113  7 disability early on so that intervention can eliminate the risk
113  8 of a disability or minimize the disability's effect.
113  9    c.  Reduce the effects of a disability on an individual's
113 10 health and independence.
113 11    Sec. 103.  NEW SECTION.  225B.103  Prevention of disabilities
113 12 policy council established ==== membership ==== duties.
113 13    1.  A prevention of disabilities policy council is
113 14 established to focus state prevention of disability efforts
113 15 and provide oversight in the development and operation of a
113 16 coordinated prevention of disabilities system. The council
113 17 shall consist of the following members:
113 18    a.  Three providers of disability prevention services
113 19 appointed by the governor and confirmed by the senate. The
113 20 governor may consider recommendations from the prevention of
113 21 disabilities policy council in making appointments.
113 22    b.  Three persons with expertise in priority prevention areas
113 23 appointed by the governor and confirmed by the senate. The
113 24 governor may consider recommendations from the prevention of
113 25 disabilities policy council in making appointments.
113 26    c.  Three persons with disabilities or family members
113 27 of a person with disabilities appointed by the governor,
113 28 and confirmed by the senate. The governor may consider
113 29 recommendations from the prevention of disabilities policy
113 30 council in making appointments.
113 31    d.  One representative each from the department on aging,
113 32 department of education, department of human services, and
113 33 department of public health appointed by the directors of the
113 34 respective agencies.
113 35    e.  Two members of the senate appointed by the senate
114  1 majority leader and minority leader and two members of the
114  2 house of representatives appointed by the speaker of the house
114  3 and the house minority leader.
114  4    2.  Members of the council appointed by the governor shall
114  5 serve three=year staggered terms for terms beginning and ending
114  6 as provided in section 69.19. Members representing the state
114  7 departments shall serve one=year terms and shall serve as ex
114  8 officio, nonvoting members.  Members of the general assembly
114  9 appointed to the council shall serve two=year terms as provided
114 10 in section 69.16B and shall serve as ex officio, nonvoting
114 11 members. Vacancies on the council shall be filled in the same
114 12 manner as original appointments. Members are entitled to
114 13 reimbursement of actual expenses incurred in performance of
114 14 their official duties.
114 15    3.  The council shall do all of the following:
114 16    a.  Review the prevention of disabilities activities of
114 17 public and private entities and provide recommendations to
114 18 optimize the planning, implementation, and evaluation of
114 19 prevention of disabilities efforts.
114 20    b.  Promote cooperative and complementary planning among the
114 21 public, nonpublic, and volunteer sectors involved in prevention
114 22 of disabilities activities.
114 23    c.  Facilitate coordination of prevention of disabilities
114 24 activities among state departments to develop an integrated
114 25 system of care.
114 26    d.  Provide support and technical assistance to public
114 27 or nonpublic entities to identify, seek, implement, and
114 28 evaluate state, federal, and private grants for prevention of
114 29 disabilities activities.
114 30    e.  Encourage research into the causes and prevention of
114 31 disabilities, including methods to evaluate the effectiveness
114 32 of prevention efforts.
114 33    f.  Promote professional and provider training in
114 34 evidence=based prevention of disabilities measures and assure
114 35 adequate dissemination of such to appropriate entities.
115  1    g.  Submit to the governor and general assembly annually by
115  2 November 1 a report that includes all of the following:
115  3    (1)  A summary of all disabilities prevention activities
115  4 conducted since the preceding annual report.
115  5    (2)  Recommendations for policy and priorities for the
115  6 prevention of disabilities.
115  7    4.  The council shall meet at least six times during the
115  8 year. A majority of the members of the council constitutes a
115  9 quorum and a quorum is necessary to act on matters within the
115 10 purview of the council.
115 11    Sec. 104.  NEW SECTION.  225B.104  Rules.
115 12    The department of human services shall adopt and update
115 13 administrative rules as necessary to implement the provisions
115 14 of this chapter. All rules adopted by the department of human
115 15 services pursuant to this section are subject to approval by
115 16 the council.
115 17    Sec. 105.  NEW SECTION.  225B.105  Coordination with state
115 18 agencies.
115 19    1.  The directors or deputy directors of the state
115 20 departments on aging, and of education, human services, and
115 21 public health shall meet at least annually with the council and
115 22 shall do all of the following:
115 23    a.  Provide an update to the council regarding the status
115 24 of prevention of disabilities policies and programs with
115 25 each respective department and provide recommendations about
115 26 priorities the council should consider in the next year.
115 27    b.  Receive new policy and program recommendations from the
115 28 council regarding the prevention of disabilities.
115 29    2.  The council may seek and receive data from state
115 30 departments that will aid in developing, implementing, and
115 31 evaluating prevention of disabilities efforts and systems in
115 32 Iowa.
115 33    Sec. 106.  NEW SECTION.  225B.106  Coordination with
115 34 disability groups.
115 35    The chairpersons and designated staff of chairpersons of
116  1 public and private state disabilities prevention groups shall
116  2 meet with the council at least annually to do all of the
116  3 following:
116  4    1.  Identify ways to incorporate prevention of disabilities
116  5 activities within Iowa's disabilities services system.
116  6    2.  Assist in developing a policy agenda for prevention of
116  7 disabilities services system improvements.
116  8    Sec. 107.  NEW SECTION.  225B.107  Evaluation.
116  9    The state's prevention of disability effort and the council
116 10 are subject to review and evaluation by the governor and the
116 11 general assembly.
116 12                          DIVISION XXV
116 13 FACILITY FOR PERSONS WITH AGGRESSIVE OR PSYCHIATRIC BEHAVIORS
116 14                      ==== INTERIM COMMITTEE
116 15    Sec. 108.  FACILITY FOR PERSONS WITH AGGRESSIVE OR
116 16 PSYCHIATRIC BEHAVIORS ==== INTERIM COMMITTEE ==== REPORT.
116 17    1.  The legislative council is requested to establish an
116 18 interim study committee relating to the establishment of one
116 19 or more facilities to provide care and treatment for persons
116 20 who are sexually aggressive, combative, or who have unmet
116 21 geropsychiatric needs.
116 22    2.  The study committee shall be composed of ten members
116 23 of the general assembly.  Five members shall be members of
116 24 the senate, three of whom shall be appointed by the majority
116 25 leader of the senate, and two of whom shall be appointed by
116 26 the minority leader of the senate.  Five members shall be
116 27 members of the house of representatives, three of whom shall
116 28 be appointed by the speaker of the house of representatives,
116 29 and two of whom shall be appointed by the minority leader of
116 30 the house of representatives.
116 31    3.  The study committee shall receive testimony from
116 32 stakeholders with an interest or expertise relating to the
116 33 care and treatment of persons who are sexually aggressive,
116 34 combative, or who have unmet geropsychiatric needs including
116 35 health care providers, long=term care facilities, hospitals,
117  1 health systems, and other entities; consumers and families of
117  2 consumers; individuals involved in the delivery and financing
117  3 of related services and supports; and representatives of
117  4 agencies responsible for oversight, funding, and regulation of
117  5 such services and supports.
117  6    4.  The study committee shall specifically address and
117  7 make recommendations relating to the characteristics of the
117  8 residents for such a facility and the size of the resident
117  9 populations to be served; options for creating a new facility
117 10 or expanding an existing facility; workforce recruitment,
117 11 training, and compensation issues; requirements that the
117 12 facility or facilities must meet in order to qualify for
117 13 Medicaid reimbursement; and any other information deemed
117 14 appropriate by the committee.
117 15    5.  The study committee shall meet during the 2015
117 16 legislative interim and shall submit a report and
117 17 recommendations to the general assembly by January 1, 2016.
117 18                          DIVISION XXVI
117 19    ANATOMICAL GIFT PUBLIC AWARENESS AND TRANSPLANTATION FUND
117 20    Sec. 109.  Section 142C.15, subsection 4, paragraph c,
117 21 unnumbered paragraph 1, Code 2015, is amended to read as
117 22 follows:
117 23    Not more than fifty percent of the Any unobligated moneys
117 24 in the fund annually may be expended in the form of grants to
117 25 transplant recipients, transplant candidates, living organ
117 26 donors, or to legal representatives on behalf of transplant
117 27 recipients, transplant candidates, or living organ donors.
117 28 Transplant recipients, transplant candidates, living organ
117 29 donors, or the legal representatives of transplant recipients,
117 30 transplant candidates, or living organ donors shall submit
117 31 grant applications with supporting documentation provided
117 32 by a hospital that performs transplants, verifying that the
117 33 person by or for whom the application is submitted requires a
117 34 transplant or is a living organ donor and specifying the amount
117 35 of the costs associated with the following, if funds are not
118  1 available from any other third=party payor:
118  2                         DIVISION XXVII
118  3        HOSPITAL AND LONG=TERM CARE PHARMACY PRACTICE ====
118  4        PNEUMOCOCCAL VACCINES ==== BOARD OF PHARMACY RULES
118  5    Sec. 110.  HOSPITAL AND LONG=TERM CARE PHARMACY PRACTICE ====
118  6 PNEUMOCOCCAL VACCINES ==== BOARD OF PHARMACY RULES.  The board
118  7 of pharmacy shall adopt rules pursuant to chapter 17A relating
118  8 to hospital and long=term care pharmacy practices that allow,
118  9 as authorized by federal law, in addition to influenza and
118 10 pneumococcal polysaccharide vaccines, that a written or verbal
118 11 patient=specific medication administration order shall not
118 12 be required prior to administration to an adult patient of
118 13 pneumococcal conjugate vaccine pursuant to physician=approved
118 14 hospital or facility policy and after the patient has been
118 15 assessed for contraindications.
118 16                         DIVISION XXVIII
118 17  HEALTHY AND WELL KIDS IN IOWA PROGRAM ==== CONTINUED ENROLLMENT
118 18    Sec. 111.  Section 514I.8, subsection 3, Code 2015, is
118 19 amended to read as follows:
118 20    3.  In accordance with the rules adopted by the board, a
118 21 child may be determined to be presumptively eligible for the
118 22 program pending a final eligibility determination. Following
118 23 final determination of eligibility, a child shall be eligible
118 24 for a twelve=month period. At the end of the twelve=month
118 25 period, a review of the circumstances of the child's family
118 26 shall be conducted to establish eligibility and cost sharing
118 27 for the subsequent twelve=month period.  Pending such review
118 28 of the circumstances of the child's family, the child shall
118 29 continue to be eligible for and remain enrolled in the same
118 30 plan if the family complies with requirements to provide
118 31 information and verification of income, otherwise cooperates
118 32 in the annual review process, and submits the completed
118 33 review form and any information necessary to establish
118 34 continued eligibility in a timely manner in accordance with
118 35 administrative rules.
119  1                          DIVISION XXIX
119  2             PERSONNEL SETTLEMENT AGREEMENT PAYMENTS
119  3    Sec. 112.  PERSONNEL SETTLEMENT AGREEMENT PAYMENTS.  As a
119  4 condition of the appropriations in this 2015 Act, the moneys
119  5 appropriated and any other moneys available shall not be used
119  6 for payment of a personnel settlement agreement that contains a
119  7 confidentiality provision intended to prevent public disclosure
119  8 of the agreement or any terms of the agreement.
119  9                          DIVISION XXX
119 10             MEDICAID REIMBURSEMENT == PSYCHIATRISTS
119 11    Sec. 113.  Section 249A.15, Code 2015, is amended to read as
119 12 follows:
119 13    249A.15  Licensed psychologists eligible for payment.
119 14    The department shall adopt rules pursuant to chapter 17A
119 15 entitling psychologists who are licensed pursuant to chapter
119 16 154B and psychologists who are licensed in the state where
119 17 the services are provided and have a doctorate degree in
119 18 psychology, have had at least two years of clinical experience
119 19 in a recognized health setting, or have met the standards of a
119 20 national register of health service providers in psychology,
119 21 to payment for services provided to recipients of medical
119 22 assistance, subject to limitations and exclusions the
119 23 department finds necessary on the basis of federal laws and
119 24 regulations and of funds available for the medical assistance
119 25 program.
119 26                          DIVISION XXXI
119 27               DEPARTMENT ON AGING ==== FY 2016=2017
119 28    Sec. 114.  DEPARTMENT ON AGING.  There is appropriated from
119 29 the general fund of the state to the department on aging for
119 30 the fiscal year beginning July 1, 2016, and ending June 30,
119 31 2017, the following amount, or so much thereof as is necessary,
119 32 to be used for the purposes designated:
119 33    For aging programs for the department on aging and area
119 34 agencies on aging to provide citizens of Iowa who are 60 years
119 35 of age and older with case management for frail elders, Iowa's
120  1 aging and disabilities resource center, and other services
120  2 which may include but are not limited to adult day services,
120  3 respite care, chore services, information and assistance,
120  4 and material aid, for information and options counseling for
120  5 persons with disabilities who are 18 years of age or older,
120  6 and for salaries, support, administration, maintenance, and
120  7 miscellaneous purposes, and for not more than the following
120  8 full=time equivalent positions:
120  9 .................................................. $  5,718,033
120 10 ............................................... FTEs      31.00
120 11    1.  Funds appropriated in this section may be used to
120 12 supplement federal funds under federal regulations. To
120 13 receive funds appropriated in this section, a local area
120 14 agency on aging shall match the funds with moneys from other
120 15 sources according to rules adopted by the department. Funds
120 16 appropriated in this section may be used for elderly services
120 17 not specifically enumerated in this section only if approved
120 18 by an area agency on aging for provision of the service within
120 19 the area.
120 20    2.  Of the funds appropriated in this section, $139,973 is
120 21 transferred to the economic development authority for the Iowa
120 22 commission on volunteer services to be used for the retired and
120 23 senior volunteer program.
120 24    3.  a.  The department on aging shall establish and enforce
120 25 procedures relating to expenditure of state and federal funds
120 26 by area agencies on aging that require compliance with both
120 27 state and federal laws, rules, and regulations, including but
120 28 not limited to all of the following:
120 29    (1)  Requiring that expenditures are incurred only for goods
120 30 or services received or performed prior to the end of the
120 31 fiscal period designated for use of the funds.
120 32    (2)  Prohibiting prepayment for goods or services not
120 33 received or performed prior to the end of the fiscal period
120 34 designated for use of the funds.
120 35    (3)  Prohibiting the prepayment for goods or services
121  1 not defined specifically by good or service, time period, or
121  2 recipient.
121  3    (4)  Prohibiting the establishment of accounts from which
121  4 future goods or services which are not defined specifically by
121  5 good or service, time period, or recipient, may be purchased.
121  6    b.  The procedures shall provide that if any funds are
121  7 expended in a manner that is not in compliance with the
121  8 procedures and applicable federal and state laws, rules, and
121  9 regulations, and are subsequently subject to repayment, the
121 10 area agency on aging expending such funds in contravention of
121 11 such procedures, laws, rules and regulations, not the state,
121 12 shall be liable for such repayment.
121 13    4.  Of the funds appropriated in this section, at least
121 14 $125,000 shall be used to fund the unmet needs identified
121 15 through Iowa's aging and disability resource center network.
121 16    5.  Of the funds appropriated in this section, at least
121 17 $300,000 shall be used to fund home and community=based
121 18 services through the area agencies on aging that enable older
121 19 individuals to avoid more costly utilization of residential or
121 20 institutional services and remain in their own homes.
121 21    6.  Of the funds appropriated in this section, $425,000
121 22 shall be used for the purposes of chapter 231E and section
121 23 231.56A, of which $162,500 shall be used for the office of
121 24 substitute decision maker pursuant to chapter 231E, and the
121 25 remainder shall be distributed equally to the area agencies on
121 26 aging to administer the prevention of elder abuse, neglect, and
121 27 exploitation program pursuant to section 231.56A, in accordance
121 28 with the requirements of the federal Older Americans Act of
121 29 1965, 42 U.S.C. {3001 et seq., as amended.
121 30                         DIVISION XXXII
121 31       OFFICE OF LONG=TERM CARE OMBUDSMAN ==== FY 2016=2017
121 32    Sec. 115.  OFFICE OF LONG=TERM CARE OMBUDSMAN.
121 33    1.  There is appropriated from the general fund of the state
121 34 to the office of long=term care ombudsman for the fiscal year
121 35 beginning July 1, 2016, and ending June 30, 2017, the following
122  1 amount, or so much thereof as is necessary, to be used for the
122  2 purposes designated:
122  3    For salaries, support, administration, maintenance, and
122  4 miscellaneous purposes, and for not more than the following
122  5 full=time equivalent positions:
122  6 .................................................. $    753,392
122  7 ............................................... FTEs      21.00
122  8    2.  Of the funds appropriated in this section, $225,000 shall
122  9 be used to continue to provide for additional local long=term
122 10 care ombudsmen.
122 11                         DIVISION XXXIII
122 12           DEPARTMENT OF PUBLIC HEALTH ==== FY 2016=2017
122 13    Sec. 116.  DEPARTMENT OF PUBLIC HEALTH.  There is
122 14 appropriated from the general fund of the state to the
122 15 department of public health for the fiscal year beginning July
122 16 1, 2016, and ending June 30, 2017, the following amounts, or
122 17 so much thereof as is necessary, to be used for the purposes
122 18 designated:
122 19    1.  ADDICTIVE DISORDERS
122 20    For reducing the prevalence of the use of tobacco, alcohol,
122 21 and other drugs, and treating individuals affected by addictive
122 22 behaviors, including gambling, and for not more than the
122 23 following full=time equivalent positions:
122 24 .................................................. $ 13,631,845
122 25 ............................................... FTEs      10.00
122 26    a.  (1)  Of the funds appropriated in this subsection,
122 27 $2,624,181 shall be used for the tobacco use prevention
122 28 and control initiative, including efforts at the state and
122 29 local levels, as provided in chapter 142A.  The commission
122 30 on tobacco use prevention and control established pursuant
122 31 to section 142A.3 shall advise the director of public health
122 32 in prioritizing funding needs and the allocation of moneys
122 33 appropriated for the programs and initiatives. Activities
122 34 of the programs and initiatives shall be in alignment with
122 35 the United States centers for disease control and prevention
123  1 best practices for comprehensive tobacco control programs that
123  2 include the goals of preventing youth initiation of tobacco
123  3 usage, reducing exposure to secondhand smoke, and promotion of
123  4 tobacco cessation.
123  5    (2)  (a)  Of the funds allocated in this paragraph "a",
123  6 $226,534 is transferred to the alcoholic beverages division of
123  7 the department of commerce for enforcement of tobacco laws,
123  8 regulations, and ordinances and to engage in tobacco control
123  9 activities approved by the division of tobacco use prevention
123 10 and control of the department of public health as specified
123 11 in the memorandum of understanding entered into between the
123 12 divisions.
123 13    (b)  For the fiscal year beginning July 1, 2016, and ending
123 14 June 30, 2017, the terms of the memorandum of understanding,
123 15 entered into between the division of tobacco use prevention
123 16 and control of the department of public health and the
123 17 alcoholic beverages division of the department of commerce,
123 18 governing compliance checks conducted to ensure licensed retail
123 19 tobacco outlet conformity with tobacco laws, regulations, and
123 20 ordinances relating to persons under eighteen years of age,
123 21 shall continue to restrict the number of such checks to one
123 22 check per retail outlet, and one additional check for any
123 23 retail outlet found to be in violation during the first check.
123 24    b.  Of the funds appropriated in this subsection,
123 25 $11,007,664 shall be used for problem gambling and
123 26 substance=related disorder prevention, treatment, and recovery
123 27 services, including a 24=hour helpline, public information
123 28 resources, professional training, and program evaluation.
123 29    (1)  Of the funds allocated in this paragraph "b", $9,451,857
123 30 shall be used for substance=related disorder prevention and
123 31 treatment.
123 32    (a)  Of the funds allocated in this subparagraph (1),
123 33 $449,650 shall be used for the public purpose of a grant
123 34 program to provide substance=related disorder prevention
123 35 programming for children.
124  1    (i)  Of the funds allocated in this subparagraph division
124  2 (a), $213,770 shall be used for grant funding for organizations
124  3 that provide programming for children by utilizing mentors.
124  4 Programs approved for such grants shall be certified or must
124  5 be certified within six months of receiving the grant award
124  6 by the Iowa commission on volunteer services as utilizing the
124  7 standards for effective practice for mentoring programs.
124  8    (ii)  Of the funds allocated in this subparagraph division
124  9 (a), $213,420 shall be used for grant funding for organizations
124 10 providing programming that includes youth development and
124 11 leadership services.  The programs shall also be recognized as
124 12 being programs that are scientifically based with evidence of
124 13 their effectiveness in reducing substance=related disorders in
124 14 children.
124 15    (iii)  The department of public health shall utilize a
124 16 request for proposals process to implement the grant program.
124 17    (iv)  All grant recipients shall participate in a program
124 18 evaluation as a requirement for receiving grant funds.
124 19    (v)  Of the funds allocated in this subparagraph division
124 20 (a), up to $22,461 may be used to administer substance=related
124 21 disorder prevention grants and for program evaluations.
124 22    (b)  Of the funds allocated in this subparagraph
124 23 (1), $136,302 shall be used for culturally competent
124 24 substance=related disorder treatment pilot projects.
124 25    (i)  The department shall utilize the amount allocated
124 26 in this subparagraph division (b) for at least three pilot
124 27 projects to provide culturally competent substance=related
124 28 disorder treatment in various areas of the state.  Each pilot
124 29 project shall target a particular ethnic minority population.
124 30 The populations targeted shall include but are not limited to
124 31 African American, Asian, and Latino.
124 32    (ii)  The pilot project requirements shall provide for
124 33 documentation or other means to ensure access to the cultural
124 34 competence approach used by a pilot project so that such
124 35 approach can be replicated and improved upon in successor
125  1 programs.
125  2    (2)  Of the funds allocated in this paragraph "b", up
125  3 to $1,555,807 may be used for problem gambling prevention,
125  4 treatment, and recovery services.
125  5    (a)  Of the funds allocated in this subparagraph (2),
125  6 $1,286,881 shall be used for problem gambling prevention and
125  7 treatment.
125  8    (b)  Of the funds allocated in this subparagraph (2), up to
125  9 $218,926 may be used for a 24=hour helpline, public information
125 10 resources, professional training, and program evaluation.
125 11    (c)  Of the funds allocated in this subparagraph (2), up
125 12 to $50,000 may be used for the licensing of problem gambling
125 13 treatment programs.
125 14    (3)  It is the intent of the general assembly that from the
125 15 moneys allocated in this paragraph "b",  persons with a dual
125 16 diagnosis of substance=related disorder and gambling addiction
125 17 shall be given priority in treatment services.
125 18    c.  Notwithstanding any provision of law to the contrary,
125 19 to standardize the availability, delivery, cost of delivery,
125 20 and accountability of problem gambling and substance=related
125 21 disorder treatment services statewide, the department shall
125 22 continue implementation of a process to create a system
125 23 for delivery of treatment services in accordance with the
125 24 requirements specified in 2008 Iowa Acts, chapter 1187, section
125 25 3, subsection 4.  To ensure the system provides a continuum
125 26 of treatment services that best meets the needs of Iowans,
125 27 the problem gambling and substance=related disorder treatment
125 28 services in any area may be provided either by a single agency
125 29 or by separate agencies submitting a joint proposal.
125 30    (1)  The system for delivery of substance=related disorder
125 31 and problem gambling treatment shall include problem gambling
125 32 prevention.
125 33    (2)  The system for delivery of substance=related disorder
125 34 and problem gambling treatment shall include substance=related
125 35 disorder prevention by July 1, 2017.
126  1    (3)  Of the funds allocated in paragraph "b",  the department
126  2 may use up to $50,000 for administrative costs to continue
126  3 developing and implementing the process in accordance with this
126  4 paragraph "c".
126  5    d.  The requirement of section 123.53, subsection 5, is met
126  6 by the appropriations and allocations made in this division of
126  7 this Act for purposes of substance=related disorder treatment
126  8 and addictive disorders for the fiscal year beginning July 1,
126  9 2016.
126 10    e.  The department of public health shall work with all
126 11 other departments that fund substance=related disorder
126 12 prevention and treatment services and all such departments
126 13 shall, to the extent necessary, collectively meet the state
126 14 maintenance of effort requirements for expenditures for
126 15 substance=related disorder services as required under the
126 16 federal substance=related disorder prevention and treatment
126 17 block grant.
126 18    2.  HEALTHY CHILDREN AND FAMILIES
126 19    For promoting the optimum health status for children,
126 20 adolescents from birth through 21 years of age, and families,
126 21 and for not more than the following full=time equivalent
126 22 positions:
126 23 .................................................. $  3,665,801
126 24 ............................................... FTEs      13.00
126 25    a.  Of the funds appropriated in this subsection, not more
126 26 than $367,421 shall be used for the healthy opportunities for
126 27 parents to experience success (HOPES)=healthy families Iowa
126 28 (HFI) program established pursuant to section 135.106. The
126 29 funding shall be distributed to renew the grants that were
126 30 provided to the grantees that operated the program during the
126 31 fiscal year ending June 30, 2016.
126 32    b.  In order to implement the legislative intent stated in
126 33 sections 135.106 and 256I.9, that priority for home visitation
126 34 program funding be given to programs using evidence=based or
126 35 promising models for home visitation, it is the intent of the
127  1 general assembly to phase in the funding priority in accordance
127  2 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
127  3 paragraph 0b.
127  4    c.  Of the funds appropriated in this subsection, $2,456,444
127  5 shall be used to continue to expand statewide the department's
127  6 initiative to provide for adequate developmental surveillance
127  7 and screening during a child's first five years.  The funds
127  8 shall be used first to fully fund the current sites to ensure
127  9 that the sites are fully operational, with the remaining
127 10 funds to be used for expansion to additional sites.  The full
127 11 implementation and expansion shall include enhancing the scope
127 12 of the program through collaboration with the child health
127 13 specialty clinics to promote healthy child development through
127 14 early identification and response to both biomedical and social
127 15 determinants of healthy development; by monitoring child
127 16 health metrics to inform practice, document long=term health
127 17 impacts and savings, and provide for continuous improvement
127 18 through training, education, and evaluation; and by providing
127 19 for practitioner consultation particularly for children with
127 20 behavioral conditions and needs.  The department of public
127 21 health shall also collaborate with the Iowa Medicaid enterprise
127 22 and the child health specialty clinics to integrate the
127 23 activities of the first five initiative into the establishment
127 24 of patient=centered medical homes, community utilities,
127 25 accountable care organizations, and other integrated care
127 26 models developed to improve health quality and population
127 27 health while reducing health care costs. To the maximum extent
127 28 possible, funding allocated in this paragraph shall be utilized
127 29 as matching funds for medical assistance program reimbursement.
127 30    d.  Of the funds appropriated in this subsection, $37,320
127 31 shall be distributed to a statewide dental carrier to provide
127 32 funds to continue the donated dental services program patterned
127 33 after the projects developed by the lifeline network to provide
127 34 dental services to indigent individuals who are elderly or with
127 35 disabilities.
128  1    e.  Of the funds appropriated in this subsection, $55,998
128  2 shall be used for childhood obesity prevention.
128  3    f.  Of the funds appropriated in this subsection, $81,384
128  4 shall be used to provide audiological services and hearing
128  5 aids for children. The department may enter into a contract
128  6 to administer this paragraph.
128  7    g.  Of the funds appropriated in this subsection, $12,500 is
128  8 transferred to the university of Iowa college of dentistry for
128  9 provision of primary dental services to children.  State funds
128 10 shall be matched on a dollar=for=dollar basis.  The university
128 11 of Iowa college of dentistry shall coordinate efforts with the
128 12 department of public health, bureau of oral and health delivery
128 13 systems, to provide dental care to underserved populations
128 14 throughout the state.
128 15    h.  Of the funds appropriated in this subsection, $25,000
128 16 shall be used to address youth suicide prevention.
128 17    i.  Of the funds appropriated in this subsection, $25,000
128 18 shall be used to support the Iowa effort to address the survey
128 19 of children who experience adverse childhood experiences known
128 20 as ACEs.
128 21    3.  CHRONIC CONDITIONS
128 22    For serving individuals identified as having chronic
128 23 conditions or special health care needs, and for not more than
128 24 the following full=time equivalent positions:
128 25 .................................................. $  2,552,931
128 26 ............................................... FTEs       5.00
128 27    a.  Of the funds appropriated in this subsection, $79,966
128 28 shall be used for grants to individual patients who have an
128 29 inherited metabolic disorder to assist with the costs of
128 30 medically necessary foods and formula.
128 31    b.  Of the funds appropriated in this subsection, $445,822
128 32 shall be used for the brain injury services program pursuant to
128 33 section 135.22B, including for continuation of the contracts
128 34 for resource facilitator services in accordance with section
128 35 135.22B, subsection 9, and to enhance brain injury training and
129  1 recruitment of service providers on a statewide basis.  Of the
129  2 amount allocated in this paragraph, $47,500 shall be used to
129  3 fund one full=time equivalent position to serve as the state
129  4 brain injury services program manager.
129  5    c.  Of the funds appropriated in this subsection, $273,991
129  6 shall be used as additional funding to leverage federal funding
129  7 through the federal Ryan White Care Act, Tit. II, AIDS drug
129  8 assistance program supplemental drug treatment grants.
129  9    d.  Of the funds appropriated in this subsection, $74,912
129 10 shall be used for the public purpose of continuing to contract
129 11 with an existing national=affiliated organization to provide
129 12 education, client=centered programs, and client and family
129 13 support for people living with epilepsy and their families.
129 14 The amount allocated in this paragraph in excess of $50,000
129 15 shall be matched dollar=for=dollar by the organization
129 16 specified.
129 17    e.  Of the funds appropriated in this subsection, $392,557
129 18 shall be used for child health specialty clinics.
129 19    f.  Of the funds appropriated in this subsection, $200,000
129 20 shall be used by the regional autism assistance program
129 21 established pursuant to section 256.35, and administered by
129 22 the child health specialty clinic located at the university of
129 23 Iowa hospitals and clinics.  The funds shall be used to enhance
129 24 interagency collaboration and coordination of educational,
129 25 medical, and other human services for persons with autism,
129 26 their families, and providers of services, including delivering
129 27 regionalized services of care coordination, family navigation,
129 28 and integration of services through the statewide system of
129 29 regional child health specialty clinics and fulfilling other
129 30 requirements as specified in chapter 225D.  The university of
129 31 Iowa shall not receive funds allocated under this paragraph for
129 32 indirect costs associated with the regional autism assistance
129 33 program.
129 34    g.  Of the funds appropriated in this subsection, $285,497
129 35 shall be used for the comprehensive cancer control program to
130  1 reduce the burden of cancer in Iowa through prevention, early
130  2 detection, effective treatment, and ensuring quality of life.
130  3 Of the funds allocated in this paragraph "g", $75,000 shall
130  4 be used to support a melanoma research symposium, a melanoma
130  5 biorepository and registry, basic and translational melanoma
130  6 research, and clinical trials.
130  7    h.  Of the funds appropriated in this subsection, $63,225
130  8 shall be used for cervical and colon cancer screening, and
130  9 $150,000 shall be used to enhance the capacity of the cervical
130 10 cancer screening program to include provision of recommended
130 11 prevention and early detection measures to a broader range of
130 12 low=income women.
130 13    i.  Of the funds appropriated in this subsection, $338,432
130 14 shall be used for the center for congenital and inherited
130 15 disorders including to provide for surveillance of stillbirths
130 16 as defined in section 136A.2.
130 17    j.  Of the funds appropriated in this subsection, $64,706
130 18 shall be used for the prescription drug donation repository
130 19 program created in chapter 135M.
130 20    k.  Of the funds appropriated in this subsection,
130 21 $107,632 shall be used by the department of public health
130 22 for reform=related activities, including but not limited to
130 23 facilitation of communication to stakeholders at the state and
130 24 local level, administering the patient=centered health advisory
130 25 council pursuant to section 135.159, and involvement in health
130 26 care system innovation activities occurring across the state.
130 27    l.  Of the funds appropriated in this subsection, $12,500
130 28 shall be used for administration of chapter 124D, the medical
130 29 cannabidiol Act, or other Code provisions authorizing the
130 30 compassionate medical use of cannabis, if enacted by the 2016
130 31 regular session of the Eighty=sixth General Assembly.
130 32    4.  COMMUNITY CAPACITY
130 33    For strengthening the health care delivery system at the
130 34 local level, and for not more than the following full=time
130 35 equivalent positions:
131  1 .................................................. $  4,359,858
131  2 ............................................... FTEs      11.00
131  3    a.  Of the funds appropriated in this subsection, $49,707
131  4 is allocated for continuation of the child vision screening
131  5 program implemented through the university of Iowa hospitals
131  6 and clinics in collaboration with early childhood Iowa areas.
131  7 The program shall submit a report to the individuals identified
131  8 in this Act for submission of reports regarding the use of
131  9 funds allocated under this paragraph "a".  The report shall
131 10 include the objectives and results for the program year
131 11 including the target population and how the funds allocated
131 12 assisted the program in meeting the objectives; the number,
131 13 age, and location within the state of individuals served;
131 14 the type of services provided to the individuals served; the
131 15 distribution of funds based on service provided; and the
131 16 continuing needs of the program.
131 17    b.  Of the funds appropriated in this subsection, $55,328 is
131 18 allocated for continuation of an initiative implemented at the
131 19 university of Iowa and $49,952 is allocated for continuation of
131 20 an initiative at the state mental health institute at Cherokee
131 21 to expand and improve the workforce engaged in mental health
131 22 treatment and services. The initiatives shall receive input
131 23 from the university of Iowa, the department of human services,
131 24 the department of public health, and the mental health and
131 25 disability services commission to address the focus of the
131 26 initiatives.
131 27    c.  Of the funds appropriated in this subsection, $582,314
131 28 shall be used for essential public health services that promote
131 29 healthy aging throughout one's lifespan, contracted through a
131 30 formula for local boards of health, to enhance health promotion
131 31 and disease prevention services.
131 32    d.  Of the funds appropriated in this section, $49,643 shall
131 33 be deposited in the governmental public health system fund
131 34 created in section 135A.8 to be used for the purposes of the
131 35 fund.
132  1    e.  Of the funds appropriated in this subsection, $52,724
132  2 shall be used to continue to address the shortage of mental
132  3 health professionals in the state.
132  4    f.  Of the funds appropriated in this subsection,
132  5 $25,000 shall be used for a grant to a statewide association
132  6 of psychologists that is affiliated with the American
132  7 psychological association to be used for continuation of a
132  8 program to rotate intern psychologists in placements in urban
132  9 and rural mental health professional shortage areas, as defined
132 10 in section 135.180.
132 11    g.  (1)  Of the funds appropriated in this subsection,
132 12 $1,441,485 shall be allocated as a grant to the Iowa primary
132 13 care association to be used pursuant to section 135.153 for
132 14 the statewide coordination of the Iowa collaborative safety
132 15 net provider network. Coordination of the network shall
132 16 focus on increasing access by underserved populations to
132 17 health care services, increasing integration of the health
132 18 system and collaboration across the continuum of care with
132 19 a focus on safety net services, and enhancing the Iowa
132 20 collaborative safety net provider network's communication and
132 21 education efforts. The amount allocated as a grant under this
132 22 subparagraph (1) shall be used as follows to support the Iowa
132 23 collaborative safety net provider network goals of increased
132 24 access, health system integration, and engagement:
132 25    (a)  For distribution to safety net partners in the state
132 26 that work to increase access of the underserved population to
132 27 health services:
132 28 .................................................. $    512,743
132 29    (i)  Of the amount allocated in this subparagraph
132 30 division (a), up to $206,708 shall be distributed to the
132 31 Iowa prescription drug corporation for continuation of the
132 32 pharmaceutical infrastructure for safety net providers as
132 33 described in 2007 Iowa Acts, chapter 218, section 108.
132 34    (ii)  Of the amount allocated in this subparagraph division
132 35 (a), up to $174,161 shall be distributed to free clinics and
133  1 free clinics of Iowa for necessary infrastructure, statewide
133  2 coordination, provider recruitment, service delivery, and
133  3 provision of assistance to patients in securing a medical home
133  4 inclusive of oral health care.
133  5    (iii)  Of the amount allocated in this subparagraph
133  6 division (a), up to $25,000 shall be distributed to the
133  7 Iowa coalition against sexual assault to continue a training
133  8 program for sexual assault response team (SART) members,
133  9 including representatives of law enforcement, victim advocates,
133 10 prosecutors, and certified medical personnel.
133 11    (iv)  Of the amount allocated in this subparagraph division
133 12 (a), up to $106,874 shall be distributed to the Polk county
133 13 medical society for continuation of the safety net provider
133 14 patient access to a specialty health care initiative as
133 15 described in 2007 Iowa Acts, chapter 218, section 109.
133 16    (b)  For distribution to safety net partners in the
133 17 state that work to increase health system integration, care
133 18 coordination, and collaboration across the continuum of care
133 19 with a focus on safety net services. Such efforts shall
133 20 include but not be limited to community care coordination team
133 21 development and integration of medical and behavioral health
133 22 services. Efforts shall also include working, in conjunction
133 23 with the department of human services and the department
133 24 of public health, to support Medicaid managed care efforts
133 25 inclusive of the state innovation model through the continued
133 26 development and implementation of community care coordination
133 27 teams. Implementation of the community care coordination
133 28 teams shall be accomplished through a statewide regionally
133 29 based network that provides an integrated approach to health
133 30 care delivery through care coordination that supports primary
133 31 care providers and links patients with community resources
133 32 necessary to empower patients in addressing biomedical and
133 33 social determinants of health to improve health outcomes:
133 34 .................................................. $    836,100
133 35    (c)  For distribution to safety net partners in the state
134  1 that work to serve as a resource for credible, accurate
134  2 information on health care=related needs and services
134  3 for vulnerable populations in the state including the
134  4 Iowa association of rural health clinics for necessary
134  5 infrastructure and service delivery transformation and the Iowa
134  6 primary care association to support partner engagement, program
134  7 management, and statewide coordination of the network:
134  8 .................................................. $     92,643
134  9    (2)  The amount allocated under this paragraph "g" shall
134 10 not be reduced for administrative or other costs prior to
134 11 distribution. The Iowa collaborative safety net provider
134 12 network may continue to distribute funds allocated pursuant to
134 13 this paragraph "g" through existing contracts or renewal of
134 14 existing contracts.
134 15    (3)  For each goal of the Iowa collaborative safety net
134 16 provider network, the Iowa primary care association shall
134 17 submit a progress report to the individuals designated in this
134 18 Act for submission of reports by December 15, 2016, including
134 19 progress in developing and implementing the network, how the
134 20 funds were distributed and used in developing and implementing
134 21 the network, and the remaining needs identified to fully
134 22 develop and implement the network.
134 23    h.  Of the funds appropriated in this subsection, $106,700
134 24 shall be used for continuation of the work of the direct care
134 25 worker advisory council established pursuant to 2008 Iowa Acts,
134 26 chapter 1188, section 69, in implementing the recommendations
134 27 in the final report submitted by the advisory council to the
134 28 governor and the general assembly in March 2012, including
134 29 by  continuing to develop, promote, and make available on a
134 30 statewide basis the prepare=to=care core curriculum and its
134 31 associated modules and specialties through various formats
134 32 including online access, community colleges, and other venues;
134 33 exploring new and maintaining existing specialties including
134 34 but not limited to oral health and dementia care; supporting
134 35 instructor training; and assessing and making recommendations
135  1 concerning the Iowa care book and information technology
135  2 systems and infrastructure uses and needs.
135  3    i.  (1)  Of the funds appropriated in this subsection,
135  4 $108,188 shall be used for allocation to an independent
135  5 statewide direct care worker organization under continuation
135  6 of the contract in effect during the fiscal year ending June
135  7 30, 2016.
135  8    (2)  Of the funds appropriated in this subsection,
135  9 $52,500 shall be used to provide scholarships or other
135 10 forms of subsidization for direct care worker educational
135 11 conferences, training, or outreach activities, and for the
135 12 mouth=care=matters oral health care project.
135 13    j.  Of the funds appropriated in this subsection, the
135 14 department may use up to $29,088 for up to one full=time
135 15 equivalent position to administer the volunteer health care
135 16 provider program pursuant to section 135.24.
135 17    k.  Of the funds appropriated in this subsection, $50,000
135 18 shall be used for a matching dental education loan repayment
135 19 program to be allocated to a dental nonprofit health service
135 20 corporation to continue to develop the criteria and implement
135 21 the loan repayment program.
135 22    l.  Of the funds appropriated in this subsection, $52,912 is
135 23 transferred to the college student aid commission for deposit
135 24 in the rural Iowa primary care trust fund created in section
135 25 261.113 to be used for the purposes of the fund.
135 26    m.  Of the funds appropriated in this subsection, $125,000
135 27 shall be used for the purposes of the Iowa donor registry as
135 28 specified in section 142C.18.
135 29    n.  Of the funds appropriated in this subsection, $50,000
135 30 shall be used for continuation of a grant to a nationally
135 31 affiliated volunteer eye organization that has an established
135 32 program for children and adults and that is solely dedicated to
135 33 preserving sight and preventing blindness through education,
135 34 nationally certified vision screening and training, and
135 35 community and patient service programs. The organization
136  1 shall submit a report to the individuals identified in this
136  2 Act for submission of reports regarding the use of funds
136  3 allocated under this paragraph "n".  The report shall include
136  4 the objectives and results for the program year including
136  5 the target population and how the funds allocated assisted
136  6 the program in meeting the objectives; the number, age, and
136  7 location within the state of individuals served; the type of
136  8 services provided to the individuals served; the distribution
136  9 of funds based on services provided; and the continuing needs
136 10 of the program.
136 11    o.  Of the funds appropriated in this subsection, $12,500
136 12 shall be used for the continuation of a wellness council under
136 13 the direction of the director of public health to increase
136 14 support for wellness activities in the state.
136 15    p.  Of the funds appropriated in this subsection, $1,000,000
136 16 shall be deposited in the medical residency training account
136 17 created in section 135.175, subsection 5, paragraph "a", and
136 18 is appropriated from the account to the department of public
136 19 health to be used for the purposes of the medical residency
136 20 training state matching grants program as specified in section
136 21 135.176. However, notwithstanding any provision to the
136 22 contrary in section 135.176, priority in the awarding of grants
136 23 shall be given to sponsors that propose preference in the use
136 24 of the grant funds for psychiatric residency positions and
136 25 family practice residency positions.
136 26    5.  HEALTHY AGING
136 27    To provide public health services that reduce risks and
136 28 invest in promoting and protecting good health over the
136 29 course of a lifetime with a priority given to older Iowans and
136 30 vulnerable populations:
136 31 .................................................. $  3,648,571
136 32    6.  INFECTIOUS DISEASES
136 33    For reducing the incidence and prevalence of communicable
136 34 diseases, and for not more than the following full=time
136 35 equivalent positions:
137  1 .................................................. $    667,578
137  2 ............................................... FTEs       4.00
137  3    7.  PUBLIC PROTECTION
137  4    For protecting the health and safety of the public through
137  5 establishing standards and enforcing regulations, and for not
137  6 more than the following full=time equivalent positions:
137  7 .................................................. $  2,169,596
137  8 ............................................... FTEs    135.50
137  9    a.  Of the funds appropriated in this subsection, not more
137 10 than $227,350 shall be credited to the emergency medical
137 11 services fund created in section 135.25. Moneys in the
137 12 emergency medical services fund are appropriated to the
137 13 department to be used for the purposes of the fund.
137 14    b.  Of the funds appropriated in this subsection, $101,516
137 15 shall be used for sexual violence prevention programming
137 16 through a statewide organization representing programs
137 17 serving victims of sexual violence through the department's
137 18 sexual violence prevention program. The amount allocated
137 19 in this paragraph "b" shall not be used to supplant funding
137 20 administered for other sexual violence prevention or victims
137 21 assistance programs.
137 22    c.  Of the funds appropriated in this subsection, $299,376
137 23 shall be used for the state poison control center. Pursuant
137 24 to the directive under 2014 Iowa Acts, chapter 1140, section
137 25 102, the federal matching funds available to the state poison
137 26 control center from the department of human services under the
137 27 federal Children's Health Insurance Program Reauthorization Act
137 28 allotment shall be subject to the federal administrative cap
137 29 rule of 10 percent applicable to funding provided under Tit.
137 30 XXI of the federal Social Security Act and included within the
137 31 department's calculations of the cap.
137 32    d.  Of the funds appropriated in this subsection, $268,875
137 33 shall be used for childhood lead poisoning provisions.
137 34    8.  RESOURCE MANAGEMENT
137 35    For establishing and sustaining the overall ability of the
138  1 department to deliver services to the public, and for not more
138  2 than the following full=time equivalent positions:
138  3 .................................................. $    427,536
138  4 ............................................... FTEs       4.00
138  5    The university of Iowa hospitals and clinics under the
138  6 control of the state board of regents shall not receive
138  7 indirect costs from the funds appropriated in this section.
138  8 The university of Iowa hospitals and clinics billings to the
138  9 department shall be on at least a quarterly basis.
138 10                         DIVISION XXXIV
138 11         DEPARTMENT OF VETERANS AFFAIRS ==== FY 2016=2017
138 12    Sec. 117.  DEPARTMENT OF VETERANS AFFAIRS.  There is
138 13 appropriated from the general fund of the state to the
138 14 department of veterans affairs for the fiscal year beginning
138 15 July 1, 2016, and ending June 30, 2017, the following amounts,
138 16 or so much thereof as is necessary, to be used for the purposes
138 17 designated:
138 18    1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
138 19    For salaries, support, maintenance, and miscellaneous
138 20 purposes, and for not more than the following full=time
138 21 equivalent positions:
138 22 .................................................. $    600,273
138 23 ............................................... FTEs      15.00
138 24    2.  IOWA VETERANS HOME
138 25    For salaries, support, maintenance, and miscellaneous
138 26 purposes:
138 27 .................................................. $  3,797,498
138 28    a.  The Iowa veterans home billings involving the department
138 29 of human services shall be submitted to the department on at
138 30 least a monthly basis.
138 31    b.  If there is a change in the employer of employees
138 32 providing services at the Iowa veterans home under a collective
138 33 bargaining agreement, such employees and the agreement shall
138 34 be continued by the successor employer as though there had not
138 35 been a change in employer.
139  1    c.  Within available resources and in conformance with
139  2 associated state and federal program eligibility requirements,
139  3 the Iowa veterans home may implement measures to provide
139  4 financial assistance to or on behalf of veterans or their
139  5 spouses who are participating in the community reentry program.
139  6    d.  The Iowa veterans home expenditure report shall be
139  7 submitted monthly to the legislative services agency.
139  8    3.  HOME OWNERSHIP ASSISTANCE PROGRAM
139  9    For transfer to the Iowa finance authority for the
139 10 continuation of the home ownership assistance program for
139 11 persons who are or were eligible members of the armed forces of
139 12 the United States, pursuant to section 16.54:
139 13 .................................................. $  1,250,000
139 14    Sec. 118.  LIMITATION OF COUNTY COMMISSIONS OF VETERAN
139 15 AFFAIRS FUND STANDING APPROPRIATIONS.  Notwithstanding the
139 16 standing appropriation in section 35A.16 for the fiscal year
139 17 beginning July 1, 2016, and ending June 30, 2017, the amount
139 18 appropriated from the general fund of the state pursuant to
139 19 that section for the following designated purposes shall not
139 20 exceed the following amount:
139 21    For the county commissions of veteran affairs fund under
139 22 section 35A.16:
139 23 .................................................. $    495,000
139 24                          DIVISION XXXV
139 25          DEPARTMENT OF HUMAN SERVICES ==== FY 2016=2017
139 26    Sec. 119.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
139 27 GRANT.  There is appropriated from the fund created in section
139 28 8.41 to the department of human services for the fiscal year
139 29 beginning July 1, 2016, and ending June 30, 2017, from moneys
139 30 received under the federal temporary assistance for needy
139 31 families (TANF) block grant pursuant to the federal Personal
139 32 Responsibility and Work Opportunity Reconciliation Act of 1996,
139 33 Pub. L. No. 104=193, and successor legislation, the following
139 34 amounts, or so much thereof as is necessary, to be used for the
139 35 purposes designated:
140  1    1.  To be credited to the family investment program account
140  2 and used for assistance under the family investment program
140  3 under chapter 239B:
140  4 .................................................. $  2,568,498
140  5    2.  To be credited to the family investment program account
140  6 and used for the job opportunities and basic skills (JOBS)
140  7 program and implementing family investment agreements in
140  8 accordance with chapter 239B:
140  9 .................................................. $  5,069,089
140 10    3.  To be used for the family development and
140 11 self=sufficiency grant program in accordance with section
140 12 216A.107:
140 13 .................................................. $  1,449,490
140 14    Notwithstanding section 8.33, moneys appropriated in this
140 15 subsection that remain unencumbered or unobligated at the close
140 16 of the fiscal year shall not revert but shall remain available
140 17 for expenditure for the purposes designated until the close of
140 18 the succeeding fiscal year. However, unless such moneys are
140 19 encumbered or obligated on or before September 30, 2016, the
140 20 moneys shall revert.
140 21    4.  For field operations:
140 22 .................................................. $ 15,648,116
140 23    5.  For general administration:
140 24 .................................................. $  1,872,000
140 25    6.  For state child care assistance:
140 26 .................................................. $ 17,523,555
140 27    a.  Of the funds appropriated in this subsection,
140 28 $13,164,049 is transferred to the child care and development
140 29 block grant appropriation made by the Eighty=sixth General
140 30 Assembly, 2016 Session, for the federal fiscal year beginning
140 31 October 1, 2016, and ending September 30, 2017. Of this
140 32 amount, $100,000 shall be used for provision of educational
140 33 opportunities to registered child care home providers in order
140 34 to improve services and programs offered by this category
140 35 of providers and to increase the number of providers. The
141  1 department may contract with institutions of higher education
141  2 or child care resource and referral centers to provide
141  3 the educational opportunities. Allowable administrative
141  4 costs under the contracts shall not exceed 5 percent. The
141  5 application for a grant shall not exceed two pages in length.
141  6    b.  Any funds appropriated in this subsection remaining
141  7 unallocated shall be used for state child care assistance
141  8 payments for families who are employed including but not
141  9 limited to individuals enrolled in the family investment
141 10 program.
141 11    7.  For distribution to counties and regions through the
141 12 property tax relief fund for mental health and disability
141 13 services as provided in an appropriation made for this purpose:
141 14 .................................................. $  2,447,026
141 15    8.  For child and family services:
141 16 .................................................. $ 16,042,215
141 17    9.  For child abuse prevention grants:
141 18 .................................................. $     62,500
141 19    10.  For pregnancy prevention grants on the condition that
141 20 family planning services are funded:
141 21 .................................................. $    965,034
141 22    Pregnancy prevention grants shall be awarded to programs
141 23 in existence on or before July 1, 2016, if the programs have
141 24 demonstrated positive  outcomes.  Grants shall be awarded to
141 25 pregnancy prevention  programs which are developed after July
141 26 1, 2016, if the  programs are based on existing  models that
141 27 have demonstrated positive outcomes.  Grants shall  comply with
141 28 the requirements provided in 1997 Iowa Acts,  chapter 208,
141 29 section 14, subsections 1 and 2, including the  requirement that
141 30 grant programs must emphasize sexual  abstinence.  Priority in
141 31 the awarding of grants shall be given  to programs that serve
141 32 areas of the state which demonstrate  the highest percentage of
141 33 unplanned pregnancies of females of  childbearing age within the
141 34 geographic area to be served by  the grant.
141 35    11.  For technology needs and other resources necessary
142  1 to meet federal welfare reform reporting, tracking, and case
142  2 management requirements:
142  3 .................................................. $    518,593
142  4    12.  For the family investment program share of the costs to
142  5 continue to develop and maintain a new, integrated eligibility
142  6 determination system:
142  7 .................................................. $  3,327,440
142  8    13.  a.  Notwithstanding any provision to the contrary,
142  9 including but not limited to requirements in section 8.41 or
142 10 provisions in 2015 or 2016 Iowa Acts regarding the receipt and
142 11 appropriation of federal block grants, federal funds from the
142 12 temporary assistance for needy families block grant received by
142 13 the state and not otherwise appropriated in this section and
142 14 remaining available for the fiscal year beginning July 1, 2016,
142 15 are appropriated to the department of human services to the
142 16 extent as may be necessary to be used in the following priority
142 17 order:  the family investment program, for state child care
142 18 assistance program payments for families who are employed, and
142 19 for the family investment program share of costs to develop and
142 20 maintain a new, integrated eligibility determination system.
142 21 The federal funds appropriated in this paragraph "a" shall be
142 22 expended only after all other funds appropriated in subsection
142 23 1 for the assistance under the family investment program,
142 24 in subsection 6 for child care assistance, or in subsection
142 25 12 for the family investment program share of the costs to
142 26 continue to develop and maintain a new, integrated eligibility
142 27 determination system, as applicable, have been expended. For
142 28 the purposes of this subsection, the funds appropriated in
142 29 subsection 6, paragraph "a", for transfer to the child care
142 30 and development block grant appropriation are considered fully
142 31 expended when the full amount has been transferred.
142 32    b.  The department shall, on a quarterly basis, advise the
142 33 legislative services agency and department of management of
142 34 the amount of funds appropriated in this subsection that was
142 35 expended in the prior quarter.
143  1    14.  Of the amounts appropriated in this section, $6,481,004
143  2 for the fiscal year beginning July 1, 2016, is transferred to
143  3 the appropriation of the federal social services block grant
143  4 made to the department of human services for that fiscal year.
143  5    15.  For continuation of the program providing categorical
143  6 eligibility for the food assistance program as specified for
143  7 the program in the section of this division of this 2016 Act
143  8 relating to the family investment program account:
143  9 .................................................. $    12,500
143 10    16.  The department may transfer funds allocated in this
143 11 section to the appropriations made in this division of this Act
143 12 for the same fiscal year for general administration and field
143 13 operations for resources necessary to implement and operate the
143 14 services referred to in this section and those funded in the
143 15 appropriation made in this division of this Act for the same
143 16 fiscal year for the family investment program from the general
143 17 fund of the state.
143 18    Sec. 120.  FAMILY INVESTMENT PROGRAM ACCOUNT.
143 19    1.  Moneys credited to the family investment program (FIP)
143 20 account for the fiscal year beginning July 1, 2016, and
143 21 ending June 30, 2017, shall be used to provide assistance in
143 22 accordance with chapter 239B.
143 23    2.  The department may use a portion of the moneys credited
143 24 to the FIP account under this section as necessary for
143 25 salaries, support, maintenance, and miscellaneous purposes.
143 26    3.  The department may transfer funds allocated in
143 27 subsection 4 to the appropriations made in this division of
143 28 this Act for the same fiscal year for general administration
143 29 and field operations for resources necessary to implement and
143 30 operate the family investment program services referred to in
143 31 this section and those funded in the appropriation made in this
143 32 division of this Act for the same fiscal year for the family
143 33 investment program from the general fund of the state.
143 34    4.  Moneys appropriated in this division of this Act and
143 35 credited to the FIP account for the fiscal year beginning July
144  1 1, 2016, and ending June 30, 2017, are allocated as follows:
144  2    a.  To be retained by the department of human services to
144  3 be used for coordinating with the department of human rights
144  4 to more effectively serve participants in FIP and other shared
144  5 clients and to meet federal reporting requirements under the
144  6 federal temporary assistance for needy families block grant:
144  7 .................................................. $     10,000
144  8    b.  To the department of human rights for staffing,
144  9 administration, and implementation of the family development
144 10 and self=sufficiency grant program in accordance with section
144 11 216A.107:
144 12 .................................................. $  3,196,417
144 13    (1)  Of the funds allocated for the family development
144 14 and self=sufficiency grant program in this paragraph "b",
144 15 not more than 5 percent of the funds shall be used for the
144 16 administration of the grant program.
144 17    (2)  The department of human rights may continue to implement
144 18 the family development and self=sufficiency grant program
144 19 statewide during fiscal year 2016=2017.
144 20    (3)  The department of human rights may engage in activities
144 21 to strengthen and improve family outcomes measures and
144 22 data collection systems under the family development and
144 23 self=sufficiency grant program.
144 24    c.  For the diversion subaccount of the FIP account:
144 25 .................................................. $    407,500
144 26    A portion of the moneys allocated for the subaccount may
144 27 be used for field operations, salaries, data management
144 28 system development, and implementation costs and support
144 29 deemed necessary by the director of human services in order
144 30 to administer the FIP diversion program. To the extent
144 31 moneys allocated in this paragraph "c" are not deemed by the
144 32 department to be necessary to support diversion activities,
144 33 such moneys may be used for other efforts intended to increase
144 34 engagement by family investment program participants in work,
144 35 education, or training activities.
145  1    d.  For the food assistance employment and training program:
145  2 .................................................. $     33,294
145  3    (1)  The department shall apply the federal supplemental
145  4 nutrition assistance program (SNAP) employment and training
145  5 state plan in order to maximize to the fullest extent permitted
145  6 by federal law the use of the 50 percent federal reimbursement
145  7 provisions for the claiming of allowable federal reimbursement
145  8 funds from the United States department of agriculture
145  9 pursuant to the federal SNAP employment and training program
145 10 for providing education, employment, and training services
145 11 for eligible food assistance program participants, including
145 12 but not limited to related dependent care and transportation
145 13 expenses.
145 14    (2)  The department shall continue the categorical federal
145 15 food assistance program eligibility at 160 percent of the
145 16 federal poverty level and continue to eliminate the asset test
145 17 from eligibility requirements, consistent with federal food
145 18 assistance program requirements. The department shall include
145 19 as many food assistance households as is allowed by federal
145 20 law. The eligibility provisions shall conform to all federal
145 21 requirements including requirements addressing individuals who
145 22 are incarcerated or otherwise ineligible.
145 23    e.  For the JOBS program:
145 24 .................................................. $  8,770,199
145 25    5.  Of the child support collections assigned under FIP,
145 26 an amount equal to the federal share of support collections
145 27 shall be credited to the child support recovery appropriation
145 28 made in this division of this Act. Of the remainder of the
145 29 assigned child support collections received by the child
145 30 support recovery unit, a portion shall be credited to the FIP
145 31 account, a portion may be used to increase recoveries, and a
145 32 portion may be used to sustain cash flow in the child support
145 33 payments account. If as a consequence of the appropriations
145 34 and allocations made in this section the resulting amounts
145 35 are insufficient to sustain cash assistance payments and meet
146  1 federal maintenance of effort requirements, the department
146  2 shall seek supplemental funding. If child support collections
146  3 assigned under FIP are greater than estimated or are otherwise
146  4 determined not to be required for maintenance of effort, the
146  5 state share of either amount may be transferred to or retained
146  6 in the child support payments account.
146  7    6.  The department may adopt emergency rules for the family
146  8 investment, JOBS, food assistance, and medical assistance
146  9 programs if necessary to comply with federal requirements.
146 10    Sec. 121.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There
146 11 is appropriated from the general fund of the state to the
146 12 department of human services for the fiscal year beginning July
146 13 1, 2016, and ending June 30, 2017, the following amount, or
146 14 so much thereof as is necessary, to be used for the purpose
146 15 designated:
146 16    To be credited to the family investment program (FIP)
146 17 account and used for family investment program assistance under
146 18 chapter 239B:
146 19 .................................................. $ 24,546,938
146 20    1.  Of the funds appropriated in this section, $3,701,110 is
146 21 allocated for the JOBS program.
146 22    2.  Of the funds appropriated in this section, $1,756,927 is
146 23 allocated for the family development and self=sufficiency grant
146 24 program.
146 25    3.  Notwithstanding section 8.39, for the fiscal year
146 26 beginning July 1, 2016, if necessary to meet federal
146 27 maintenance of effort requirements or to transfer federal
146 28 temporary assistance for needy families block grant funding
146 29 to be used for purposes of the federal social services block
146 30 grant or to meet cash flow needs resulting from delays in
146 31 receiving federal funding or to implement, in accordance with
146 32 this division of this Act, activities currently funded with
146 33 juvenile court services, county, or community moneys and state
146 34 moneys used in combination with such moneys, the department
146 35 of human services may transfer funds within or between any
147  1 of the appropriations made in this division of this Act and
147  2 appropriations in law for the federal social services block
147  3 grant to the department for the following purposes, provided
147  4 that the combined amount of state and federal temporary
147  5 assistance for needy families block grant funding for each
147  6 appropriation remains the same before and after the transfer:
147  7    a.  For the family investment program.
147  8    b.  For child care assistance.
147  9    c.  For child and family services.
147 10    d.  For field operations.
147 11    e.  For general administration.
147 12    f.  For distribution to counties or regions through the
147 13 property tax relief fund for mental health and disability
147 14 services as provided in an appropriation for this purpose.
147 15    This subsection shall not be construed to prohibit the use
147 16 of existing state transfer authority for other purposes. The
147 17 department shall report any transfers made pursuant to this
147 18 subsection to the legislative services agency.
147 19    4.  Of the funds appropriated in this section, $97,839 shall
147 20 be used for continuation of a grant to an Iowa=based nonprofit
147 21 organization with a history of providing tax preparation
147 22 assistance to low=income Iowans in order to expand the usage of
147 23 the earned income tax credit. The purpose of the grant is to
147 24 supply this assistance to underserved areas of the state.
147 25    5.  Of the funds appropriated in this section, $40,000 shall
147 26 be used for the continuation of an unfunded pilot project, as
147 27 defined in 441 IAC 100.1, relating to parental obligations,
147 28 in which the child support recovery unit participates, to
147 29 support the efforts of a nonprofit organization committed to
147 30 strengthening the community through youth development, healthy
147 31 living, and social responsibility headquartered in a county
147 32 with a population over 350,000. The funds allocated in this
147 33 subsection shall be used by the recipient organization to
147 34 develop a larger community effort, through public and private
147 35 partnerships, to support a broad=based multi=county fatherhood
148  1 initiative that promotes payment of child support obligations,
148  2 improved family relationships, and full=time employment.
148  3    6.  Of the funds appropriated in this section, $100,000
148  4 shall be used to continue a grant to a nonprofit organization
148  5 organized under section 501(c)(4) of the Internal Revenue Code
148  6 to continue a youth development strategy through after=school
148  7 programming that promotes academic success, healthy lifestyles,
148  8 good character, and citizenship.  The organization shall meet
148  9 all of the following criteria:
148 10    a.  Operate statewide and provide services through more than
148 11 one location.
148 12    b.  Provide the after=school programming for students ages
148 13 five through eighteen years of age who are members of families
148 14 eligible for the federal temporary assistance for needy
148 15 families program.
148 16    c.  Provide evidence, based on measurable outcomes, that the
148 17 after=school programming provided results in increased student
148 18 achievement.
148 19    7.  The department may transfer funds appropriated in this
148 20 section to the appropriations made in this division of this Act
148 21 for general administration and field operations as necessary
148 22 to administer this section and the overall family investment
148 23 program.
148 24    Sec. 122.  CHILD SUPPORT RECOVERY.  There is appropriated
148 25 from the general fund of the state to the department of human
148 26 services for the fiscal year beginning July 1, 2016, and ending
148 27 June 30, 2017, the following amount, or so much thereof as is
148 28 necessary, to be used for the purposes designated:
148 29    For child support recovery, including salaries, support,
148 30 maintenance, and miscellaneous purposes, and for not more than
148 31 the following full=time equivalent positions:
148 32 .................................................. $  7,331,687
148 33 ............................................... FTEs     464.00
148 34    1.  The department shall expend up to $12,165, including
148 35 federal financial participation, for the fiscal year beginning
149  1 July 1, 2016, for a child support public awareness campaign.
149  2 The department and the office of the attorney general shall
149  3 cooperate in continuation of the campaign. The public
149  4 awareness campaign shall emphasize, through a variety of
149  5 media activities, the importance of maximum involvement of
149  6 both parents in the lives of their children as well as the
149  7 importance of payment of child support obligations.
149  8    2.  Federal access and visitation grant moneys shall be
149  9 issued directly to private not=for=profit agencies that provide
149 10 services designed to increase compliance with the child access
149 11 provisions of court orders, including but not limited to
149 12 neutral visitation sites and mediation services.
149 13    3.  The appropriation made to the department for child
149 14 support recovery may be used throughout the fiscal year in the
149 15 manner necessary for purposes of cash flow management, and for
149 16 cash flow management purposes the department may temporarily
149 17 draw more than the amount appropriated, provided the amount
149 18 appropriated is not exceeded at the close of the fiscal year.
149 19    4.  With the exception of the funding amount specified, the
149 20 requirements established under 2001 Iowa Acts, chapter 191,
149 21 section 3, subsection 5, paragraph "c", subparagraph (3), shall
149 22 be applicable to parental obligation pilot projects for the
149 23 fiscal year beginning July 1, 2016, and ending June 30, 2017.
149 24 Notwithstanding 441 IAC 100.8, providing for termination of
149 25 rules relating to the pilot projects, the rules shall remain
149 26 in effect until June 30, 2017.
149 27    Sec. 123.  HEALTH CARE TRUST FUND ==== MEDICAL ASSISTANCE ====
149 28 FY 2016=2017.  Any funds remaining in the health care trust
149 29 fund created in section 453A.35A for the fiscal year beginning
149 30 July 1, 2016, and ending June 30, 2017, are appropriated to
149 31 the department of human services to supplement the medical
149 32 assistance program appropriations made in this division of this
149 33 Act, for medical assistance reimbursement and associated costs,
149 34 including program administration and costs associated with
149 35 program implementation.
150  1    Sec. 124.  MEDICAID FRAUD FUND ==== MEDICAL ASSISTANCE ==== FY
150  2 2016=2017.  Any funds remaining in the Medicaid fraud fund
150  3 created in section 249A.50 for the fiscal year beginning
150  4 July 1, 2016, and ending June 30, 2017, are appropriated to
150  5 the department of human services to supplement the medical
150  6 assistance appropriations made in this division of this Act,
150  7 for medical assistance reimbursement and associated costs,
150  8 including program administration and costs associated with
150  9 program implementation.
150 10    Sec. 125.  MEDICAL ASSISTANCE.
150 11    1.  There is appropriated from the general fund of the
150 12 state to the department of human services for the fiscal year
150 13 beginning July 1, 2016, and ending June 30, 2017, the following
150 14 amount, or so much thereof as is necessary, to be used for the
150 15 purpose designated:
150 16    For medical assistance program reimbursement and associated
150 17 costs as specifically provided in the reimbursement
150 18 methodologies in effect on June 30, 2016, except as otherwise
150 19 expressly authorized by law, including reimbursement for
150 20 abortion services which shall be available under the medical
150 21 assistance program only for those abortions which are medically
150 22 necessary:
150 23 .................................................. $673,176,820
150 24    2.  Medically necessary abortions are those performed under
150 25 any of the following conditions:
150 26    a.  The attending physician certifies that continuing the
150 27 pregnancy would endanger the life of the pregnant woman.
150 28    b.  The attending physician certifies that the fetus is
150 29 physically deformed, mentally deficient, or afflicted with a
150 30 congenital illness.
150 31    c.  The pregnancy is the result of a rape which is reported
150 32 within 45 days of the incident to a law enforcement agency or
150 33 public or private health agency which may include a family
150 34 physician.
150 35    d.  The pregnancy is the result of incest which is reported
151  1 within 150 days of the incident to a law enforcement agency
151  2 or  public or private health agency which may include a family
151  3 physician.
151  4    e.  Any spontaneous abortion, commonly known as a
151  5 miscarriage, if not all of the products of conception are
151  6 expelled.
151  7    3.  a.  Iowans support reducing the number of abortions
151  8 performed in our state.  For an abortion covered under the
151  9 program, except in the case of a medical emergency, as defined
151 10 in section 135L.1, for any woman, the physician shall certify
151 11 both of the following:
151 12    (1)  That the woman has been given the opportunity to view an
151 13 ultrasound image of the fetus as part of the standard of care
151 14 before an abortion is performed.
151 15    (2)  That the woman has been provided information regarding
151 16 the options relative to a pregnancy, including continuing the
151 17 pregnancy to term and retaining parental rights following the
151 18 child's birth, continuing the pregnancy to term and placing the
151 19 child for adoption, and terminating the pregnancy.
151 20    b.  The provisions of this section relating to abortions
151 21 shall also apply to the Iowa health and wellness plan created
151 22 pursuant to chapter 249N.
151 23    4.  The department shall utilize not more than $30,000 of
151 24 the funds appropriated in this section to continue the AIDS/HIV
151 25 health insurance premium payment program as established in 1992
151 26 Iowa Acts, Second Extraordinary Session, chapter 1001, section
151 27 409, subsection 6. Of the funds allocated in this subsection,
151 28 not more than $2,500 may be expended for administrative
151 29 purposes.
151 30    5.  Of the funds appropriated in this Act to the department
151 31 of public health for addictive disorders, $475,000 for
151 32 the fiscal year beginning July 1, 2016, is transferred
151 33 to the department of human services for an integrated
151 34 substance=related disorder managed care system. The department
151 35 shall not assume management of the substance=related disorder
152  1 system in place of the managed care contractor unless such
152  2 a change in approach is specifically authorized in law.
152  3 The departments of human services and public health shall
152  4 work together to maintain the level of mental health and
152  5 substance=related disorder treatment services provided by the
152  6 managed care contractor through the Iowa plan for behavioral
152  7 health. Each department shall take the steps necessary to
152  8 continue the federal waivers as necessary to maintain the level
152  9 of services.
152 10    6.  a.  The department shall aggressively pursue options for
152 11 providing medical assistance or other assistance to individuals
152 12 with special needs who become ineligible to continue receiving
152 13 services under the early and periodic screening, diagnostic,
152 14 and treatment program under the medical assistance program
152 15 due to becoming 21 years of age who have been approved for
152 16 additional assistance through the department's exception to
152 17 policy provisions, but who have health care needs in excess
152 18 of the funding available through the exception to policy
152 19 provisions.
152 20    b.  Of the funds appropriated in this section, $50,000
152 21 shall be used for participation in one or more pilot projects
152 22 operated by a private provider to allow the individual or
152 23 individuals to receive service in the community in accordance
152 24 with principles established in Olmstead v. L.C., 527 U.S. 581
152 25 (1999), for the purpose of providing medical assistance or
152 26 other assistance to individuals with special needs who become
152 27 ineligible to continue receiving services under the early and
152 28 periodic screening, diagnostic, and treatment program under
152 29 the medical assistance program due to becoming 21 years of
152 30 age who have been approved for additional assistance through
152 31 the department's exception to policy provisions, but who have
152 32 health care needs in excess of the funding available through
152 33 the exception to the policy provisions.
152 34    7.  Of the funds appropriated in this section, up to
152 35 $1,525,041 may be transferred to the field operations or
153  1 general administration appropriations in this division of this
153  2 Act for operational costs associated with Part D of the federal
153  3 Medicare Prescription Drug Improvement and Modernization Act
153  4 of 2003, Pub. L. No. 108=173.
153  5    8.  Of the funds appropriated in this section, up to $221,050
153  6 may be transferred to the appropriation in this division
153  7 of this Act for medical contracts to be used for clinical
153  8 assessment services and prior authorization of services.
153  9    9.  A portion of the funds appropriated in this section
153 10 may be transferred to the appropriations in this division of
153 11 this Act for general administration, medical contracts, the
153 12 children's health insurance program, or field operations to be
153 13 used for the state match cost to comply with the payment error
153 14 rate measurement (PERM) program for both the medical assistance
153 15 and children's health insurance programs as developed by the
153 16 centers for Medicare and Medicaid services of the United States
153 17 department of health and human services to comply with the
153 18 federal Improper Payments Information Act of 2002, Pub. L. No.
153 19 107=300.
153 20    10.  The department shall continue to implement the
153 21 recommendations of the assuring better child health and
153 22 development initiative II (ABCDII) clinical panel to the
153 23 Iowa early and periodic screening, diagnostic, and treatment
153 24 services healthy mental development collaborative board
153 25 regarding changes to billing procedures, codes, and eligible
153 26 service providers.
153 27    11.  Of the funds appropriated in this section, a sufficient
153 28 amount is allocated to supplement the incomes of residents of
153 29 nursing facilities, intermediate care facilities for persons
153 30 with mental illness, and intermediate care facilities for
153 31 persons with an intellectual disability, with incomes of less
153 32 than $50 in the amount necessary for the residents to receive a
153 33 personal needs allowance of $50 per month pursuant to section
153 34 249A.30A.
153 35    12.  Of the funds appropriated in this section, the following
154  1 amounts are transferred to the appropriations made in this
154  2 division of this Act for the state mental health institutes:
154  3    a.  Cherokee mental health institute ................. $  4,549,213
154  4    b.  Clarinda mental health institute ................. $    988,653
154  5    c.  Independence mental health institute ............. $  4,522,947
154  6    13.  a.  Of the funds appropriated in this section,
154  7 $4,298,325 is allocated for the state match for a
154  8 disproportionate share hospital payment of $9,566,715 to
154  9 hospitals that meet both of the conditions specified in
154 10 subparagraphs (1) and (2). In addition, the hospitals that
154 11 meet the conditions specified shall either certify public
154 12 expenditures or transfer to the medical assistance program
154 13 an amount equal to provide the nonfederal share for a
154 14 disproportionate share hospital payment of $3,750,000. The
154 15 hospitals that meet the conditions specified shall receive and
154 16 retain 100 percent of the total disproportionate share hospital
154 17 payment of $13,316,715.
154 18    (1)  The hospital qualifies for disproportionate share and
154 19 graduate medical education payments.
154 20    (2)  The hospital is an Iowa state=owned hospital with more
154 21 than 500 beds and eight or more distinct residency specialty
154 22 or subspecialty programs recognized by the American college of
154 23 graduate medical education.
154 24    b.  Distribution of the disproportionate share payments
154 25 shall be made on a monthly basis. The total amount of
154 26 disproportionate share payments including graduate medical
154 27 education, enhanced disproportionate share, and Iowa
154 28 state=owned teaching hospital payments shall not exceed the
154 29 amount of the state's allotment under Pub. L. No. 102=234.
154 30 In addition, the total amount of all disproportionate
154 31 share payments shall not exceed the hospital=specific
154 32 disproportionate share limits under Pub. L. No. 103=66.
154 33    c.  The university of Iowa hospitals and clinics shall either
154 34 certify public expenditures or transfer to the appropriations
154 35 made in this division of this Act for medical assistance an
155  1 amount equal to provide the nonfederal share for increased
155  2 medical assistance payments for inpatient and outpatient
155  3 hospital services of $4,950,000. The university of Iowa
155  4 hospitals and clinics shall receive and retain 100 percent of
155  5 the total increase in medical assistance payments.
155  6    d.  Program payments for disproportionate share hospitals
155  7 and graduate medical education, and the upper payment limits
155  8 applicable to these programs shall be held harmless from the
155  9 impacts of Medicaid managed care and the governor's Medicaid
155 10 modernization initiative.  Payment methodologies utilized
155 11 for these programs may be adjusted or converted to other
155 12 methodologies or payment types in order to comply with this
155 13 hold harmless requirement.
155 14    14.  One hundred percent of the nonfederal share of payments
155 15 to area education agencies that are medical assistance
155 16 providers for medical assistance=covered services provided to
155 17 medical assistance=covered children, shall be made from the
155 18 appropriation made in this section.
155 19    15.  Any new or renewed contract entered into by the
155 20 department with a third party to administer behavioral health
155 21 services under the medical assistance program shall provide
155 22 that any interest earned on payments from the state during
155 23 the state fiscal year shall be remitted to the department
155 24 and treated as recoveries to offset the costs of the medical
155 25 assistance program.
155 26    16.  A portion of the funds appropriated in this section
155 27 may be transferred to the appropriation in this division of
155 28 this Act for medical contracts to be used for administrative
155 29 activities associated with the money follows the person
155 30 demonstration project.
155 31    17.  Of the funds appropriated in this section, $174,506
155 32 shall be used for the administration of the health insurance
155 33 premium payment program, including salaries, support,
155 34 maintenance, and miscellaneous purposes.
155 35    18.  a.  The department may increase the amounts allocated
156  1 for salaries, support, maintenance, and miscellaneous purposes
156  2 associated with the medical assistance program, as necessary,
156  3 to implement cost containment strategies.  The department shall
156  4 report any such increase to the legislative services agency and
156  5 the department of management.
156  6    b.  If the savings to the medical assistance program from
156  7 cost containment efforts exceed the cost for the fiscal
156  8 year beginning July 1, 2016, the department may transfer any
156  9 savings generated for the fiscal year due to medical assistance
156 10 program cost containment efforts to the appropriation
156 11 made in this division of this Act for medical contracts or
156 12 general administration to defray the increased contract costs
156 13 associated with implementing such efforts.
156 14    c.  The department of human services shall not implement
156 15 the following cost containment measures as recommended by the
156 16 governor for the fiscal year beginning July 1, 2016:
156 17    (1)  A measure to provide uniform rates of $.575 per mile
156 18 based on the 2015 Internal Revenue Service mileage rate and
156 19 of $9.29, the current statewide average, per one=way trip for
156 20 Medicaid program home and community=based services waivers.
156 21    (2)  A measure to cap the total costs of all services
156 22 received by a recipient of the home and community=based
156 23 services waiver for individuals with an intellectual disability
156 24 at the daily intermediate care facility for persons with an
156 25 intellectual disability (ICF/ID) per diem rate of $346.39 per
156 26 day based on the 80th percentile of all ICF/ID rates.
156 27    (3)  A measure to align individual requests for exceptions to
156 28 policy with the capped total cost of services for a recipient
156 29 of the home and community=based services waiver for individuals
156 30 with an intellectual disability as computed under subparagraph
156 31 (2).
156 32    (4)  A measure to utilize the supports intensity scale
156 33 to determine payment amounts and a tiered payment system
156 34 for the services provided to adults served under the home
156 35 and community=based services waiver for individuals with an
157  1 intellectual disability.
157  2    (5)  A measure to reallocate funding for community=based
157  3 systems of care to instead support integrated health homes.
157  4    (6)  A measure to increase the university of Iowa hospitals
157  5 and clinics state share responsibility for the supplemental
157  6 disproportionate share hospital payment to the university of
157  7 Iowa hospitals and clinics  for the fiscal year beginning July
157  8 1, 2016.
157  9    d.  The department shall report the implementation of
157 10 any cost containment strategies under this subsection to
157 11 the individuals specified in this division of this Act for
157 12 submission of reports on a quarterly basis.
157 13    19.  For the fiscal year beginning July 1, 2016, and ending
157 14 June 30, 2017, the replacement generation tax revenues required
157 15 to be deposited in the property tax relief fund pursuant to
157 16 section 437A.8, subsection 4, paragraph "d", and section
157 17 437A.15, subsection 3, paragraph "f", shall instead be credited
157 18 to and supplement the appropriation made in this section and
157 19 used for the allocations made in this section.
157 20    20.  The department shall continue to administer the state
157 21 balancing incentive payments program as specified in 2012 Iowa
157 22 Acts, chapter 1133, section 14.
157 23    21.  a.  Of the funds appropriated in this section, $450,000
157 24 shall be used for continued implementation of the children's
157 25 mental health home project proposed by the department of human
157 26 services and reported to the general assembly's mental health
157 27 and disability services study committee in December 2011. Of
157 28 this amount, up to $25,000 may be transferred by the department
157 29 to the appropriation made in this division of this Act to the
157 30 department for the same fiscal year for general administration
157 31 to be used for associated administrative expenses and for not
157 32 more than one full=time equivalent position, in addition to
157 33 those authorized for the same fiscal year, to be assigned to
157 34 implementing the project.
157 35    b.  Of the funds appropriated in this section, up to $200,000
158  1 may be transferred by the department to the appropriation made
158  2 to the department in this division of this Act for the same
158  3 fiscal year for Medicaid program=related general administration
158  4 planning and implementation activities.  The funds may be used
158  5 for contracts or for personnel in addition to the amounts
158  6 appropriated for and the positions authorized for general
158  7 administration for the fiscal year.
158  8    c.  Of the funds appropriated in this section, up to
158  9 $1,500,000 may be transferred by the department to the
158 10 appropriations made in this division of this Act for the same
158 11 fiscal year for general administration or medical contracts
158 12 to be used to support the development and implementation of
158 13 standardized assessment tools for persons with mental illness,
158 14 an intellectual disability, a developmental disability, or a
158 15 brain injury.
158 16    22.  Of the funds appropriated in this section, $125,000
158 17 shall be used for lodging expenses associated with care
158 18 provided at the university of Iowa hospitals and clinics for
158 19 patients with cancer whose travel distance is 30 miles or more
158 20 and whose income is at or below 200 percent of the federal
158 21 poverty level as defined by the most recently revised poverty
158 22 income guidelines published by the United States department of
158 23 health and human services. The department of human services
158 24 shall establish the maximum number of overnight stays and the
158 25 maximum rate reimbursed for overnight lodging, which may be
158 26 based on the state employee rate established by the department
158 27 of administrative services.  The funds allocated in this
158 28 subsection  shall not be used as nonfederal share matching
158 29 funds.
158 30    23.  a.  For inpatient and outpatient services provided by
158 31 hospitals on or after July 1, 2016, the department of human
158 32 services shall continue to recalculate and prospectively
158 33 apply an updated cost=to=charge ratio upon the request of a
158 34 hospital to implement price or charge reductions, if all of the
158 35 following criteria are met:
159  1    (1)  The recalculation of an updated cost=to=charge ratio is
159  2 budget neutral to the state funding amount appropriated for the
159  3 respective fiscal year and maintains budget neutral payments or
159  4 revenue to all hospitals.
159  5    (2)  The hospital requesting the price or charge reduction
159  6 submits a proforma cost report and charge master that reflects
159  7 the anticipated cost=to=charge reduction.
159  8    b.  Based upon the proforma cost report submitted by the
159  9 requesting hospital, the department of human services shall
159 10 prospectively apply the recalculated cost=to=charge ratio as
159 11 appropriate to submitted claims for health care services.
159 12    24.  The department of human services shall not adopt
159 13 emergency rules to implement Medicaid managed care or the
159 14 governor's Medicaid modernization initiative.
159 15    25.  The number of home and community=based services waiver
159 16 slots available during the fiscal year beginning July 1, 2016,
159 17 shall not be reduced below the number of such slots available
159 18 on January 1, 2015.
159 19    Sec. 126.  MEDICAL CONTRACTS.  There is appropriated from the
159 20 general fund of the state to the department of human services
159 21 for the fiscal year beginning July 1, 2016, and ending June 30,
159 22 2017, the following amount, or so much thereof as is necessary,
159 23 to be used for the purpose designated:
159 24    For medical contracts:
159 25 .................................................. $ 11,076,792
159 26    1.  The department of inspections and appeals shall
159 27 provide all state matching funds for survey and certification
159 28 activities performed by the department of inspections
159 29 and appeals. The department of human services is solely
159 30 responsible for distributing the federal matching funds for
159 31 such activities.
159 32    2.  Of the funds appropriated in this section, $25,000 shall
159 33 be used for continuation of home and community=based services
159 34 waiver quality assurance programs, including the review and
159 35 streamlining of processes and policies related to oversight and
160  1 quality management to meet state and federal requirements.
160  2    3.  Of the amount appropriated in this section, up to
160  3 $100,000 may be transferred to the appropriation for general
160  4 administration in this division of this Act to be used for
160  5 additional full=time equivalent positions in the development of
160  6 key health initiatives such as cost containment, development
160  7 and oversight of managed care programs, and development of
160  8 health strategies targeted toward improved quality and reduced
160  9 costs in the Medicaid program.
160 10    4.  Of the funds appropriated in this section, $500,000 shall
160 11 be used for planning and development, in cooperation with the
160 12 department of public health, of a phased=in program to provide
160 13 a dental home for children.
160 14    5.  Of the funds appropriated in this section, $1,000,000
160 15 shall be used for the autism support program created in chapter
160 16 225D.
160 17    Sec. 127.  STATE SUPPLEMENTARY ASSISTANCE.
160 18    1.  There is appropriated from the general fund of the
160 19 state to the department of human services for the fiscal year
160 20 beginning July 1, 2016, and ending June 30, 2017, the following
160 21 amount, or so much thereof as is necessary, to be used for the
160 22 purpose designated:
160 23    For the state supplementary assistance program:
160 24 .................................................. $ 6,498,594
160 25    2.  The department shall increase the personal needs
160 26 allowance for residents of residential care facilities by the
160 27 same percentage and at the same time as federal supplemental
160 28 security income and federal social security benefits are
160 29 increased due to a recognized increase in the cost of living.
160 30 The department may adopt emergency rules to implement this
160 31 subsection.
160 32    3.  If during the fiscal year beginning July 1, 2016,
160 33 the department projects that state supplementary assistance
160 34 expenditures for a calendar year will not meet the federal
160 35 pass=through requirement specified in Tit. XVI of the federal
161  1 Social Security Act, section 1618, as codified in 42 U.S.C.
161  2 {1382g, the department may take actions including but not
161  3 limited to increasing the personal needs allowance for
161  4 residential care facility residents and making programmatic
161  5 adjustments or upward adjustments of the residential care
161  6 facility or in=home health=related care reimbursement rates
161  7 prescribed in this division of this Act to ensure that federal
161  8 requirements are met. In addition, the department may make
161  9 other programmatic and rate adjustments necessary to remain
161 10 within the amount appropriated in this section while ensuring
161 11 compliance with federal requirements. The department may adopt
161 12 emergency rules to implement the provisions of this subsection.
161 13    Sec. 128.  CHILDREN'S HEALTH INSURANCE PROGRAM.
161 14    1.  There is appropriated from the general fund of the
161 15 state to the department of human services for the fiscal year
161 16 beginning July 1, 2016, and ending June 30, 2017, the following
161 17 amount, or so much thereof as is necessary, to be used for the
161 18 purpose designated:
161 19    For maintenance of the healthy and well kids in Iowa (hawk=i)
161 20 program pursuant to chapter 514I, including supplemental dental
161 21 services, for receipt of federal financial participation under
161 22 Tit. XXI of the federal Social Security Act, which creates the
161 23 children's health insurance program:
161 24 .................................................. $ 10,581,922
161 25    2.  Of the funds appropriated in this section, $21,400 is
161 26 allocated for continuation of the contract for outreach with
161 27 the department of public health.
161 28    Sec. 129.  CHILD CARE ASSISTANCE.  There is appropriated
161 29 from the general fund of the state to the department of human
161 30 services for the fiscal year beginning July 1, 2016, and ending
161 31 June 30, 2017, the following amount, or so much thereof as is
161 32 necessary, to be used for the purpose designated:
161 33    For child care programs:
161 34 .................................................. $ 28,319,015
161 35    1.  Of the funds appropriated in this section, $24,409,301
162  1 shall be used for state child care assistance in accordance
162  2 with section 237A.13.
162  3    2.  Nothing in this section shall be construed or is
162  4 intended as or shall imply a grant of entitlement for services
162  5 to persons who are eligible for assistance due to an income
162  6 level consistent with the waiting list requirements of section
162  7 237A.13. Any state obligation to provide services pursuant to
162  8 this section is limited to the extent of the funds appropriated
162  9 in this section.
162 10    3.  Of the funds appropriated in this section, $216,227
162 11 is allocated for the statewide grant program for child care
162 12 resource and referral services under section 237A.26. A list
162 13 of the registered and licensed child care facilities operating
162 14 in the area served by a child care resource and referral
162 15 service shall be made available to the families receiving state
162 16 child care assistance in that area.
162 17    4.  Of the funds appropriated in this section, $468,487
162 18 is allocated for child care quality improvement initiatives
162 19 including but not limited to the voluntary quality rating
162 20 system in accordance with section 237A.30.
162 21    5.  Of the funds appropriated in this section, $3,175,000
162 22 shall be credited to the early childhood programs grants
162 23 account in the early childhood Iowa fund created in section
162 24 256I.11. The moneys shall be distributed for funding of
162 25 community=based early childhood programs targeted to children
162 26 from birth through five years of age developed by early
162 27 childhood Iowa areas in accordance with approved community
162 28 plans as provided in section 256I.8.
162 29    6.  The department may use any of the funds appropriated
162 30 in this section as a match to obtain federal funds for use in
162 31 expanding child care assistance and related programs. For
162 32 the purpose of expenditures of state and federal child care
162 33 funding, funds shall be considered obligated at the time
162 34 expenditures are projected or are allocated to the department's
162 35 service areas. Projections shall be based on current and
163  1 projected caseload growth, current and projected provider
163  2 rates, staffing requirements for eligibility determination
163  3 and management of program requirements including data systems
163  4 management, staffing requirements for administration of the
163  5 program, contractual and grant obligations and any transfers
163  6 to other state agencies, and obligations for decategorization
163  7 or innovation projects.
163  8    7.  A portion of the state match for the federal child care
163  9 and development block grant shall be provided as necessary to
163 10 meet federal matching funds requirements through the state
163 11 general fund appropriation made for child development grants
163 12 and other programs for at=risk children in section 279.51.
163 13    8.  If a uniform reduction ordered by the governor under
163 14 section 8.31 or other operation of law, transfer, or federal
163 15 funding reduction reduces the appropriation made in this
163 16 section for the fiscal year, the percentage reduction in the
163 17 amount paid out to or on behalf of the families participating
163 18 in the state child care assistance program shall be equal to or
163 19 less than the percentage reduction made for any other purpose
163 20 payable from the appropriation made in this section and the
163 21 federal funding relating to it. The percentage reduction to
163 22 the other allocations made in this section shall be the same as
163 23 the uniform reduction ordered by the governor or the percentage
163 24 change of the federal funding reduction, as applicable.
163 25 If there is an unanticipated increase in federal funding
163 26 provided for state child care assistance, the entire amount
163 27 of the increase shall be used for state child care assistance
163 28 payments. If the appropriations made for purposes of the
163 29 state child care assistance program for the fiscal year are
163 30 determined to be insufficient, it is the intent of the general
163 31 assembly to appropriate sufficient funding for the fiscal year
163 32 in order to avoid establishment of waiting list requirements.
163 33    9.  Notwithstanding section 8.33, moneys advanced for
163 34 purposes of the programs developed by early childhood Iowa
163 35 areas, advanced for purposes of wraparound child care, or
164  1 received from the federal appropriations made for the purposes
164  2 of this section that remain unencumbered or unobligated at the
164  3 close of the fiscal year shall not revert to any fund but shall
164  4 remain available for expenditure for the purposes designated
164  5 until the close of the succeeding fiscal year.
164  6    10.  Of the funds appropriated in this section, $50,000
164  7 is transferred to the department of public health to be used
164  8 to continue a program to assist parents in this state with
164  9 costs resulting from the death of a child in accordance with
164 10 this subsection. If it is less costly than administering the
164 11 program directly, the department shall issue a request for
164 12 proposals and issue a grant to an appropriate organization to
164 13 administer the program.
164 14    a.  The program funding shall be used to assist parents who
164 15 reside in this state with costs incurred for a funeral, burial
164 16 or cremation, cemetery costs, or grave marker costs associated
164 17 with the unintended death of a child of the parent or a child
164 18 under the care of a guardian or custodian.  The department
164 19 shall consider the following eligibility factors in developing
164 20 program requirements:
164 21    (1)  The child was a stillborn infant or was less than age
164 22 eighteen at the time of death.
164 23    (2)  The request for assistance was approved by the local
164 24 board or department of health or the county general assistance
164 25 director and may have been referred by a local funeral home.
164 26    (3)  To be eligible, the parent, guardian, or custodian must
164 27 have an annual household income that is less than 145 percent
164 28 of the federal poverty level based on the number of people
164 29 in the applicant's household as defined by the most recently
164 30 revised poverty income guidelines published by the United
164 31 States department of health and human services.
164 32    (4)  The maximum amount of grant assistance provided to a
164 33 parent, guardian, or custodian associated with the death of
164 34 a child is $2,000. If the death is a multiple death and the
164 35 infants or children are being cremated, or buried together, the
165  1 same limitation applies.
165  2    (5)  To the extent the overall amount of assistance received
165  3 by a recipient for the costs addressed under this subsection
165  4 does not exceed the overall total of the costs, the recipient
165  5 may receive other public or private assistance in addition to
165  6 grant assistance under this section.
165  7    b.  Notwithstanding section 8.33, moneys transferred by this
165  8 subsection that remain unencumbered or unobligated at the close
165  9 of the fiscal year shall not revert but shall remain available
165 10 for expenditure for the purposes designated until expended.
165 11    Sec. 130.  JUVENILE INSTITUTIONS.  There is appropriated
165 12 from the general fund of the state to the department of human
165 13 services for the fiscal year beginning July 1, 2016, and ending
165 14 June 30, 2017, the following amounts, or so much thereof as is
165 15 necessary, to be used for the purposes designated:
165 16    1.  For the costs of security, building and grounds
165 17 maintenance, utilities, salary, and support for the facilities
165 18 located at the Iowa juvenile home at Toledo and for salaries,
165 19 support, maintenance, and miscellaneous purposes, and for not
165 20 more than the following full=time equivalent positions:
165 21 .................................................. $    186,383
165 22 ............................................... FTEs       2.00
165 23    2.  For operation of the state training school at Eldora and
165 24 for salaries, support, maintenance, and miscellaneous purposes,
165 25 and for not more than the following full=time equivalent
165 26 positions:
165 27 .................................................. $  6,222,776
165 28 ............................................... FTEs     169.30
165 29    Of the funds appropriated in this subsection, $45,575 shall
165 30 be used for distribution to licensed classroom teachers at this
165 31 and other institutions under the control of the department of
165 32 human services based upon the average student yearly enrollment
165 33 at each institution as determined by the department.
165 34    Sec. 131.  CHILD AND FAMILY SERVICES.
165 35    1.  There is appropriated from the general fund of the
166  1 state to the department of human services for the fiscal year
166  2 beginning July 1, 2016, and ending June 30, 2017, the following
166  3 amount, or so much thereof as is necessary, to be used for the
166  4 purpose designated:
166  5    For child and family services:
166  6 .................................................. $ 49,091,090
166  7    2.  Up to $2,600,000 of the amount of federal temporary
166  8 assistance for needy families block grant funding appropriated
166  9 in this division of this Act for child and family services
166 10 shall be made available for purposes of juvenile delinquent
166 11 graduated sanction services.
166 12    3.  The department may transfer funds appropriated in this
166 13 section as necessary to pay the nonfederal costs of services
166 14 reimbursed under the medical assistance program, state child
166 15 care assistance program, or the family investment program which
166 16 are provided to children who would otherwise receive services
166 17 paid under the appropriation in this section. The department
166 18 may transfer funds appropriated in this section to the
166 19 appropriations made in this division of this Act for general
166 20 administration and for field operations for resources necessary
166 21 to implement and operate the services funded in this section.
166 22    4.  a.  Of the funds appropriated in this section, up to
166 23 $17,910,893 is allocated as the statewide expenditure target
166 24 under section 232.143 for group foster care maintenance and
166 25 services. If the department projects that such expenditures
166 26 for the fiscal year will be less than the target amount
166 27 allocated in this paragraph "a", the department may reallocate
166 28 the excess to provide additional funding for shelter care
166 29 or the child welfare emergency services addressed with the
166 30 allocation for shelter care.
166 31    b.  If at any time after September 30, 2016, annualization
166 32 of a service area's current expenditures indicates a service
166 33 area is at risk of exceeding its group foster care expenditure
166 34 target under section 232.143 by more than 5 percent, the
166 35 department and juvenile court services shall examine all
167  1 group foster care placements in that service area in order to
167  2 identify those which might be appropriate for termination.
167  3 In addition, any aftercare services believed to be needed
167  4 for the children whose placements may be terminated shall be
167  5 identified. The department and juvenile court services shall
167  6 initiate action to set dispositional review hearings for the
167  7 placements identified. In such a dispositional review hearing,
167  8 the juvenile court shall determine whether needed aftercare
167  9 services are available and whether termination of the placement
167 10 is in the best interest of the child and the community.
167 11    5.  In accordance with the provisions of section 232.188,
167 12 the department shall continue the child welfare and juvenile
167 13 justice funding initiative during fiscal year 2016=2017. Of
167 14 the funds appropriated in this section, $858,877 is allocated
167 15 specifically for expenditure for fiscal year 2016=2017 through
167 16 the decategorization services funding pools and governance
167 17 boards established pursuant to section 232.188.
167 18    6.  A portion of the funds appropriated in this section
167 19 may be used for emergency family assistance to provide other
167 20 resources required for a family participating in a family
167 21 preservation or reunification project or successor project to
167 22 stay together or to be reunified.
167 23    7.  Notwithstanding section 234.35 or any other provision
167 24 of law to the contrary, state funding for shelter care and
167 25 the child welfare emergency services contracting implemented
167 26 to provide for or prevent the need for shelter care shall be
167 27 limited to $4,034,237.
167 28    8.  Federal funds received by the state during the fiscal
167 29 year beginning July 1, 2016, as the result of the expenditure
167 30 of state funds appropriated during a previous state fiscal
167 31 year for a service or activity funded under this section are
167 32 appropriated to the department to be used as additional funding
167 33 for services and purposes provided for under this section.
167 34 Notwithstanding section 8.33, moneys received in accordance
167 35 with this subsection that remain unencumbered or unobligated at
168  1 the close of the fiscal year shall not revert to any fund but
168  2 shall remain available for the purposes designated until the
168  3 close of the succeeding fiscal year.
168  4    9.  a.  Of the funds appropriated in this section, up to
168  5 $1,645,000 is allocated for the payment of the expenses of
168  6 court=ordered services provided to juveniles who are under
168  7 the supervision of juvenile court services, which expenses
168  8 are a charge upon the state pursuant to section 232.141,
168  9 subsection 4. Of the amount allocated in this paragraph "a",
168 10 up to $778,144 shall be made available to provide school=based
168 11 supervision of children adjudicated under chapter 232, of which
168 12 not more than $7,500 may be used for the purpose of training.
168 13 A portion of the cost of each school=based liaison officer
168 14 shall be paid by the school district or other funding source as
168 15 approved by the chief juvenile court officer.
168 16    b.  Of the funds appropriated in this section, up to $374,493
168 17 is allocated for the payment of the expenses of court=ordered
168 18 services provided to children who are under the supervision
168 19 of the department, which expenses are a charge upon the state
168 20 pursuant to section 232.141, subsection 4.
168 21    c.  Notwithstanding section 232.141 or any other provision
168 22 of law to the contrary, the amounts allocated in this
168 23 subsection shall be distributed to the judicial districts
168 24 as determined by the state court administrator and to the
168 25 department's service areas as determined by the administrator
168 26 of the department of human services' division of child and
168 27 family services. The state court administrator and the
168 28 division administrator shall make the determination of the
168 29 distribution amounts on or before June 15, 2016.
168 30    d.  Notwithstanding chapter 232 or any other provision of
168 31 law to the contrary, a district or juvenile court shall not
168 32 order any service which is a charge upon the state pursuant
168 33 to section 232.141 if there are insufficient court=ordered
168 34 services funds available in the district court or departmental
168 35 service area distribution amounts to pay for the service. The
169  1 chief juvenile court officer and the departmental service area
169  2 manager shall encourage use of the funds allocated in this
169  3 subsection such that there are sufficient funds to pay for
169  4 all court=related services during the entire year. The chief
169  5 juvenile court officers and departmental service area managers
169  6 shall attempt to anticipate potential surpluses and shortfalls
169  7 in the distribution amounts and shall cooperatively request the
169  8 state court administrator or division administrator to transfer
169  9 funds between the judicial districts' or departmental service
169 10 areas' distribution amounts as prudent.
169 11    e.  Notwithstanding any provision of law to the contrary,
169 12 a district or juvenile court shall not order a county to pay
169 13 for any service provided to a juvenile pursuant to an order
169 14 entered under chapter 232 which is a charge upon the state
169 15 under section 232.141, subsection 4.
169 16    f.  Of the funds allocated in this subsection, not more than
169 17 $41,500 may be used by the judicial branch for administration
169 18 of the requirements under this subsection.
169 19    g.  Of the funds allocated in this subsection, $8,500
169 20 shall be used by the department of human services to support
169 21 the interstate commission for juveniles in accordance with
169 22 the interstate compact for juveniles as provided in section
169 23 232.173.
169 24    10.  Of the funds appropriated in this section, $4,026,614 is
169 25 allocated for juvenile delinquent graduated sanctions services.
169 26 Any state funds saved as a result of efforts by juvenile court
169 27 services to earn a federal Tit. IV=E match for juvenile court
169 28 services administration may be used for the juvenile delinquent
169 29 graduated sanctions services.
169 30    11.  Of the funds appropriated in this section, $804,143 is
169 31 transferred to the department of public health to be used for
169 32 the child protection center grant program for child protection
169 33 centers located in Iowa in accordance with section 135.118.
169 34 The grant amounts under the program shall be equalized so that
169 35 each center receives a uniform base amount of $122,500, and
170  1 the remaining funds shall be awarded through a funding formula
170  2 based upon the volume of children served.
170  3    12.  If the department receives federal approval to
170  4 implement a waiver under Tit. IV=E of the federal Social
170  5 Security Act to enable providers to serve children who remain
170  6 in the children's families and communities, for purposes of
170  7 eligibility under the medical assistance program through 25
170  8 years of age, children who participate in the waiver shall be
170  9 considered to be placed in foster care.
170 10    13.  Of the funds appropriated in this section, $2,012,584 is
170 11 allocated for the preparation for adult living program pursuant
170 12 to section 234.46.
170 13    14.  Of the funds appropriated in this section, $260,075
170 14 shall be used for juvenile drug courts. The amount allocated
170 15 in this subsection shall be distributed as follows:
170 16    To the judicial branch for salaries to assist with the
170 17 operation of juvenile drug court programs operated in the
170 18 following jurisdictions:
170 19    a.  Marshall county:
170 20 .................................................. $     31,354
170 21    b.  Woodbury county:
170 22 .................................................. $     62,841
170 23    c.  Polk county:
170 24 .................................................. $     97,946
170 25    d.  The third judicial district:
170 26 .................................................. $     33,967
170 27    e.  The eighth judicial district:
170 28 .................................................. $     33,967
170 29    15.  Of the funds appropriated in this section, $113,669
170 30 shall be used for the public purpose of continuing a grant to
170 31 a nonprofit human services organization providing services to
170 32 individuals and families in multiple locations in southwest
170 33 Iowa and Nebraska for support of a project providing immediate,
170 34 sensitive support and forensic interviews, medical exams, needs
170 35 assessments, and referrals for victims of child abuse and their
171  1 nonoffending family members.
171  2    16.  Of the funds appropriated in this section, $150,310
171  3 is allocated for the foster care youth council approach of
171  4 providing a support network to children placed in foster care.
171  5    17.  Of the funds appropriated in this section, $101,000 is
171  6 allocated for use pursuant to section 235A.1 for continuation
171  7 of the initiative to address child sexual abuse implemented
171  8 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
171  9 21.
171 10    18.  Of the funds appropriated in this section, $315,120 is
171 11 allocated for the community partnership for child protection
171 12 sites.
171 13    19.  Of the funds appropriated in this section, $185,625
171 14 is allocated for the department's minority youth and family
171 15 projects under the redesign of the child welfare system.
171 16    20.  Of the funds appropriated in this section, $593,298
171 17 is allocated for funding of the community circle of care
171 18 collaboration for children and youth in northeast Iowa.
171 19    21.  Of the funds appropriated in this section, at least
171 20 $73,579 shall be used for the continuation of the child
171 21 welfare provider training academy, a collaboration between the
171 22 coalition for family and children's services in Iowa and the
171 23 department.
171 24    22.  Of the funds appropriated in this section, $12,500
171 25 shall be used for the public purpose of continuation of a
171 26 grant to a child welfare services provider headquartered in a
171 27 county with a population between 205,000 and 215,000 in the
171 28 latest certified federal census that provides multiple services
171 29 including but not limited to a psychiatric medical institution
171 30 for children, shelter, residential treatment, after school
171 31 programs, school=based programming, and an Asperger's syndrome
171 32 program, to be used for support services for children with
171 33 autism spectrum disorder and their families.
171 34    23.  Of the funds appropriated in this section, $12,500
171 35 shall be used for the public purpose of continuing a grant to
172  1 a hospital=based provider headquartered in a county with a
172  2 population between 90,000 and 95,000 in the latest certified
172  3 federal census that provides multiple services including
172  4 but not limited to diagnostic, therapeutic, and behavioral
172  5 services to individuals with autism spectrum disorder across
172  6 one's lifespan. The grant recipient shall utilize the funds
172  7 to continue the pilot project to determine the necessary
172  8 support services for children with autism spectrum disorder and
172  9 their families to be included in the children's disabilities
172 10 services system. The grant recipient shall submit findings and
172 11 recommendations based upon the results of the pilot project
172 12 to the individuals specified in this division of this Act for
172 13 submission of reports by December 31, 2016.
172 14    24.  Of the funds appropriated in this section, $105,936
172 15 shall be used for continuation of the central Iowa system of
172 16 care program grant through June 30, 2017.
172 17    25.  Of the funds appropriated in this section, $125,000
172 18 shall be used for the public purpose of the continuation
172 19 and expansion of a system of care program grant implemented
172 20 in Cerro Gordo and Linn counties to utilize a comprehensive
172 21 and long=term approach for helping children and families by
172 22 addressing the key areas in a child's life of childhood basic
172 23 needs, education and work, family, and community.
172 24    26.  Of the funds appropriated in this section, at least
172 25 $12,500 shall be used to continue and to expand the foster
172 26 care respite pilot program in which postsecondary students in
172 27 social work and other human services=related programs receive
172 28 experience by assisting family foster care providers with
172 29 respite and other support.
172 30    27.  Of the funds appropriated in this section, $55,000
172 31 shall be used for the public purpose of funding community=based
172 32 services and other supports with a system of care approach
172 33 for children with a serious emotional disturbance and their
172 34 families through a nonprofit provider of child welfare services
172 35 that has been in existence for more than 115 years, is located
173  1 in a county with a population of more than 200,000 but less
173  2 than 220,000 according to the latest census information
173  3 issued by the United States census bureau, is licensed as a
173  4 psychiatric medical institution for children, and was a system
173  5 of care grantee prior to July 1, 2016.
173  6    Sec. 132.  ADOPTION SUBSIDY.
173  7    1.  There is appropriated from the general fund of the
173  8 state to the department of human services for the fiscal year
173  9 beginning July 1, 2016, and ending June 30, 2017, the following
173 10 amount, or so much thereof as is necessary, to be used for the
173 11 purpose designated:
173 12    For adoption subsidy payments and services:
173 13 .................................................. $ 21,499,143
173 14    2.  The department may transfer funds appropriated in
173 15 this section to the appropriation made in this division of
173 16 this Act for general administration for costs paid from the
173 17 appropriation relating to adoption subsidy.
173 18    3.  Federal funds received by the state during the
173 19 fiscal year beginning July 1, 2016, as the result of the
173 20 expenditure of state funds during a previous state fiscal
173 21 year for a service or activity funded under this section are
173 22 appropriated to the department to be used as additional funding
173 23 for the services and activities funded under this section.
173 24 Notwithstanding section 8.33, moneys received in accordance
173 25 with this subsection that remain unencumbered or unobligated
173 26 at the close of the fiscal year shall not revert to any fund
173 27 but shall remain available for expenditure for the purposes
173 28 designated until the close of the succeeding fiscal year.
173 29    Sec. 133.  JUVENILE DETENTION HOME FUND.  Moneys deposited
173 30 in the juvenile detention home fund created in section 232.142
173 31 during the fiscal year beginning July 1, 2016, and ending June
173 32 30, 2017, are appropriated to the department of human services
173 33 for the fiscal year beginning July 1, 2016, and ending June 30,
173 34 2017, for distribution of an amount equal to a percentage of
173 35 the costs of the establishment, improvement, operation, and
174  1 maintenance of county or multicounty juvenile detention homes
174  2 in the fiscal year beginning July 1, 2015. Moneys appropriated
174  3 for distribution in accordance with this section shall be
174  4 allocated among eligible detention homes, prorated on the basis
174  5 of an eligible detention home's proportion of the costs of all
174  6 eligible detention homes in the fiscal year beginning July
174  7 1, 2015. The percentage figure shall be determined by the
174  8 department based on the amount available for distribution for
174  9 the fund. Notwithstanding section 232.142, subsection 3, the
174 10 financial aid payable by the state under that provision for the
174 11 fiscal year beginning July 1, 2016, shall be limited to the
174 12 amount appropriated for the purposes of this section.
174 13    Sec. 134.  FAMILY SUPPORT SUBSIDY PROGRAM.
174 14    1.  There is appropriated from the general fund of the
174 15 state to the department of human services for the fiscal year
174 16 beginning July 1, 2016, and ending June 30, 2017, the following
174 17 amount, or so much thereof as is necessary, to be used for the
174 18 purpose designated:
174 19    For the family support subsidy program subject to the
174 20 enrollment restrictions in section 225C.37, subsection 3:
174 21 .................................................. $    536,966
174 22    2.  The department shall use at least $320,750 of the moneys
174 23 appropriated in this section for the family support center
174 24 component of the comprehensive family support program under
174 25 section 225C.47. Not more than $12,500 of the amount allocated
174 26 in this subsection shall be used for administrative costs.
174 27    3.  If at any time during the fiscal year, the amount of
174 28 funding available for the family support subsidy program
174 29 is reduced from the amount initially used to establish the
174 30 figure for the number of family members for whom a subsidy
174 31 is to be provided at any one time during the fiscal year,
174 32 notwithstanding section 225C.38, subsection 2, the department
174 33 shall revise the figure as necessary to conform to the amount
174 34 of funding available.
174 35    Sec. 135.  CONNER DECREE.  There is appropriated from the
175  1 general fund of the state to the department of human services
175  2 for the fiscal year beginning July 1, 2016, and ending June 30,
175  3 2017, the following amount, or so much thereof as is necessary,
175  4 to be used for the purpose designated:
175  5    For building community capacity through the coordination
175  6 and provision of training opportunities in accordance with the
175  7 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
175  8 Iowa, July 14, 1994):
175  9 .................................................. $     16,816
175 10    Sec. 136.  MENTAL HEALTH INSTITUTES.  There is appropriated
175 11 from the general fund of the state to the department of human
175 12 services for the fiscal year beginning July 1, 2016, and ending
175 13 June 30, 2017, the following amounts, or so much thereof as is
175 14 necessary, to be used for the purposes designated:
175 15    1.  For the state mental health institute at Cherokee for
175 16 salaries, support, maintenance, and miscellaneous purposes, and
175 17 for not more than the following full=time equivalent positions:
175 18 .................................................. $  2,772,808
175 19 ............................................... FTEs     169.20
175 20    2.  For the state mental health institute at Clarinda for
175 21 salaries, support, maintenance, and miscellaneous purposes, and
175 22 for not more than the following full=time equivalent positions:
175 23 .................................................. $    906,450
175 24 ............................................... FTEs      86.10
175 25    3.  For the state mental health institute at Independence for
175 26 salaries, support, maintenance, and miscellaneous purposes, and
175 27 for not more than the following full=time equivalent positions:
175 28 .................................................. $  5,195,387
175 29 ............................................... FTEs     233.00
175 30    Sec. 137.  STATE RESOURCE CENTERS.
175 31    1.  There is appropriated from the general fund of the
175 32 state to the department of human services for the fiscal year
175 33 beginning July 1, 2016, and ending June 30, 2017, the following
175 34 amounts, or so much thereof as is necessary, to be used for the
175 35 purposes designated:
176  1    a.  For the state resource center at Glenwood for salaries,
176  2 support, maintenance, and miscellaneous purposes:
176  3 .................................................. $ 11,012,241
176  4    b.  For the state resource center at Woodward for salaries,
176  5 support, maintenance, and miscellaneous purposes:
176  6 .................................................. $  7,466,903
176  7    2.  The department may continue to bill for state resource
176  8 center services utilizing a scope of services approach used for
176  9 private providers of intermediate care facilities for persons
176 10 with an intellectual disability services, in a manner which
176 11 does not shift costs between the medical assistance program,
176 12 counties, or other sources of funding for the state resource
176 13 centers.
176 14    3.  The state resource centers may expand the time=limited
176 15 assessment and respite services during the fiscal year.
176 16    4.  If the department's administration and the department
176 17 of management concur with a finding by a state resource
176 18 center's superintendent that projected revenues can reasonably
176 19 be expected to pay the salary and support costs for a new
176 20 employee position, or that such costs for adding a particular
176 21 number of new positions for the fiscal year would be less
176 22 than the overtime costs if new positions would not be added,
176 23 the superintendent may add the new position or positions. If
176 24 the vacant positions available to a resource center do not
176 25 include the position classification desired to be filled, the
176 26 state resource center's superintendent may reclassify any
176 27 vacant position as necessary to fill the desired position. The
176 28 superintendents of the state resource centers may, by mutual
176 29 agreement, pool vacant positions and position classifications
176 30 during the course of the fiscal year in order to assist one
176 31 another in filling necessary positions.
176 32    5.  If existing capacity limitations are reached in
176 33 operating units, a waiting list is in effect for a service or
176 34 a special need for which a payment source or other funding
176 35 is available for the service or to address the special need,
177  1 and facilities for the service or to address the special need
177  2 can be provided within the available payment source or other
177  3 funding, the superintendent of a state resource center may
177  4 authorize opening not more than two units or other facilities
177  5 and begin implementing the service or addressing the special
177  6 need during fiscal year 2016=2017.
177  7    Sec. 138.  SEXUALLY VIOLENT PREDATORS.
177  8    1.  There is appropriated from the general fund of the
177  9 state to the department of human services for the fiscal year
177 10 beginning July 1, 2016, and ending June 30, 2017, the following
177 11 amount, or so much thereof as is necessary, to be used for the
177 12 purpose designated:
177 13    For costs associated with the commitment and treatment of
177 14 sexually violent predators in the unit located at the state
177 15 mental health institute at Cherokee, including costs of legal
177 16 services and other associated costs, including salaries,
177 17 support, maintenance, and miscellaneous purposes, and for not
177 18 more than the following full=time equivalent positions:
177 19 .................................................. $  4,946,540
177 20 ............................................... FTEs     132.50
177 21    2.  Unless specifically prohibited by law, if the amount
177 22 charged provides for recoupment of at least the entire amount
177 23 of direct and indirect costs, the department of human services
177 24 may contract with other states to provide care and treatment
177 25 of persons placed by the other states at the unit for sexually
177 26 violent predators at Cherokee. The moneys received under
177 27 such a contract shall be considered to be repayment receipts
177 28 and used for the purposes of the appropriation made in this
177 29 section.
177 30    Sec. 139.  FIELD OPERATIONS.  There is appropriated from the
177 31 general fund of the state to the department of human services
177 32 for the fiscal year beginning July 1, 2016, and ending June 30,
177 33 2017, the following amount, or so much thereof as is necessary,
177 34 to be used for the purposes designated:
177 35    For field operations, including salaries, support,
178  1 maintenance, and miscellaneous purposes, and for not more than
178  2 the following full=time equivalent positions:
178  3 .................................................. $ 29,460,488
178  4 ............................................... FTEs   1,837.00
178  5    1.  As a condition of this appropriation, the department
178  6 shall make every possible effort to fill the entire number of
178  7 positions authorized by this section and, unless specifically
178  8 provided otherwise by an applicable collective bargaining
178  9 agreement, the department is not subject to any approval
178 10 requirement external to the department to fill a field
178 11 operations vacancy within the number of full=time equivalent
178 12 positions authorized by this section. The department shall
178 13 report on the first of each month to the chairpersons and
178 14 ranking members of the appropriations committees of the senate
178 15 and house of representatives, and the persons designated by
178 16 this Act for submission of reports concerning the status of
178 17 filling the positions.
178 18    2.  Priority in filling full=time equivalent positions
178 19 shall be given to those positions related to child protection
178 20 services and eligibility determination for low=income families.
178 21    Sec. 140.  GENERAL ADMINISTRATION.  There is appropriated
178 22 from the general fund of the state to the department of human
178 23 services for the fiscal year beginning July 1, 2016, and ending
178 24 June 30, 2017, the following amount, or so much thereof as is
178 25 necessary, to be used for the purpose designated:
178 26    For general administration, including salaries, support,
178 27 maintenance, and miscellaneous purposes, and for not more than
178 28 the following full=time equivalent positions:
178 29 .................................................. $  7,580,871
178 30 ............................................... FTEs     309.00
178 31    1.  Of the funds appropriated in this section, $19,272 is
178 32 allocated for the prevention of disabilities policy council
178 33 created in section 225B.103, if enacted in this or any other
178 34 Act.
178 35    2.  The department shall report at least monthly to the
179  1 legislative services agency concerning the department's
179  2 operational and program expenditures.
179  3    3.  Of the funds appropriated in this section, $75,000 shall
179  4 be used to continue the contract for the provision of a program
179  5 to provide technical assistance, support, and consultation to
179  6 providers of habilitation services and home and community=based
179  7 services waiver services for adults with disabilities under the
179  8 medical assistance program.
179  9    4.  Of the funds appropriated in this section, $25,000
179 10 is transferred to the Iowa finance authority to be used
179 11 for administrative support of the council on homelessness
179 12 established in section 16.2D and for the council to fulfill its
179 13 duties in addressing and reducing homelessness in the state.
179 14    5.  Of the funds appropriated in this section, $125,000
179 15 is allocated to an Iowa food bank association selected by
179 16 the department for the purchase of food on behalf of an Iowa
179 17 emergency feeding organization or for the distribution of
179 18 moneys to the Iowa emergency feeding organization for the
179 19 purchase of food. The moneys allocated in this subsection
179 20 shall be allocated only to the extent that the allocated moneys
179 21 are matched on a dollar=for=dollar basis. Notwithstanding
179 22 section 8.33, moneys allocated in this subsection that remain
179 23 unencumbered or unobligated at the close of the fiscal year
179 24 shall not revert but shall remain available for expenditure for
179 25 the purposes designated until the close of the following fiscal
179 26 year.
179 27    6.  Of the funds appropriated in this section, $125,000 shall
179 28 be transferred to and deposited in the administrative fund of
179 29 the Iowa ABLE savings plan trust created in section 12I.4, if
179 30 enacted in this or any other Act, to be used for implementation
179 31 and administration activities of the Iowa ABLE savings plan
179 32 trust.
179 33    Sec. 141.  VOLUNTEERS.  There is appropriated from the
179 34 general fund of the state to the department of human services
179 35 for the fiscal year beginning July 1, 2016, and ending June 30,
180  1 2017, the following amount, or so much thereof as is necessary,
180  2 to be used for the purpose designated:
180  3    For development and coordination of volunteer services:
180  4 .................................................. $     42,343
180  5    Sec. 142.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
180  6 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
180  7 DEPARTMENT OF HUMAN SERVICES.
180  8    1.  a.  (1)  For the fiscal year beginning July 1, 2016,
180  9 the total state funding amount for the nursing facility budget
180 10 shall not exceed $160,950,003.
180 11    (2)  The department, in cooperation with nursing facility
180 12 representatives, shall review projections for state funding
180 13 expenditures for reimbursement of nursing facilities on a
180 14 quarterly basis and the department shall determine if an
180 15 adjustment to the medical assistance reimbursement rate is
180 16 necessary in order to provide reimbursement within the state
180 17 funding amount for the fiscal year. Notwithstanding 2001
180 18 Iowa Acts, chapter 192, section 4, subsection 2, paragraph
180 19 "c", and subsection 3, paragraph "a", subparagraph (2),
180 20 if the state funding expenditures for the nursing facility
180 21 budget for the fiscal year are projected to exceed the amount
180 22 specified in subparagraph (1), the department shall adjust
180 23 the reimbursement for nursing facilities reimbursed under the
180 24 case=mix reimbursement system to maintain expenditures of the
180 25 nursing facility budget within the specified amount for the
180 26 fiscal year.
180 27    (3)  For the fiscal year beginning July 1, 2016, special
180 28 population nursing facilities shall be reimbursed in accordance
180 29 with the methodology in effect on June 30, 2016.
180 30    (4)  For any open or unsettled nursing facility cost report
180 31 for a fiscal year prior to and including the fiscal year
180 32 beginning July 1, 2015, including any cost report remanded on
180 33 judicial review for inclusion of prescription drug, laboratory,
180 34 or x=ray costs, the department shall offset all reported
180 35 prescription drug, laboratory, and x=ray costs with any revenue
181  1 received from Medicare or other revenue source for any purpose.
181  2 For purposes of this subparagraph, a nursing facility cost
181  3 report is not considered open or unsettled if the facility did
181  4 not initiate an administrative appeal under chapter 17A or if
181  5 any appeal rights initiated have been exhausted.
181  6    b.  (1)  For the fiscal year beginning July 1, 2016,
181  7 the department shall establish the pharmacy dispensing fee
181  8 reimbursement at $11.73 per prescription, until a cost of
181  9 dispensing survey is completed. The actual dispensing fee
181 10 shall be determined by a cost of dispensing survey performed
181 11 by the department and required to be completed by all medical
181 12 assistance program participating pharmacies every two years,
181 13 adjusted as necessary to maintain expenditures within the
181 14 amount appropriated to the department for this purpose for the
181 15 fiscal year.
181 16    (2)  The department shall utilize an average acquisition
181 17 cost reimbursement methodology for all drugs covered under the
181 18 medical assistance program in accordance with 2012 Iowa Acts,
181 19 chapter 1133, section 33.
181 20    (3)  Notwithstanding subparagraph (2), if the centers for
181 21 Medicare and Medicaid services of the United States department
181 22 of health and human services (CMS) requires, as a condition
181 23 of federal Medicaid funding, that the department implement an
181 24 aggregate federal upper limit (FUL) for drug reimbursement
181 25 based on the average manufacturer's price (AMP), the department
181 26 may utilize a reimbursement methodology for all drugs covered
181 27 under the Medicaid program based on the national average drug
181 28 acquisition cost (NADAC) methodology published by CMS, in order
181 29 to assure compliance with the aggregate FUL, minimize outcomes
181 30 of drug reimbursements below pharmacy acquisition costs, limit
181 31 administrative costs, and minimize any change in the aggregate
181 32 reimbursement for drugs.  The department may adopt emergency
181 33 rules to implement this subparagraph.
181 34    c.  (1)  For the fiscal year beginning July 1, 2016,
181 35 reimbursement rates for outpatient hospital services shall
182  1 remain at the rates in effect on June 30, 2016, subject
182  2 to Medicaid program upper payment limit rules and adjusted
182  3 as necessary to maintain expenditures within the amount
182  4 appropriated to the department for this purpose for the fiscal
182  5 year.
182  6    (2)  For the fiscal year beginning July 1, 2016,
182  7 reimbursement rates for inpatient hospital services shall
182  8 remain at the rates in effect on June 30, 2016, subject
182  9 to Medicaid program upper payment limit rules and adjusted
182 10 as necessary to maintain expenditures within the amount
182 11 appropriated to the department for this purpose for the fiscal
182 12 year.
182 13    (3)  For the fiscal year beginning July 1, 2016, the graduate
182 14 medical education and disproportionate share hospital fund
182 15 shall remain at the amount in effect on June 30, 2016, except
182 16 that the portion of the fund attributable to graduate medical
182 17 education shall be reduced in an amount that reflects the
182 18 elimination of graduate medical education payments made to
182 19 out=of=state hospitals.
182 20    (4)  In order to ensure the efficient use of limited state
182 21 funds in procuring health care services for low=income Iowans,
182 22 funds appropriated in this Act for hospital services shall
182 23 not be used for activities which would be excluded from a
182 24 determination of reasonable costs under the federal Medicare
182 25 program pursuant to 42 U.S.C. {1395x(v)(1)(N).
182 26    d.  For the fiscal year beginning July 1, 2016, reimbursement
182 27 rates for rural health clinics, hospices, and acute mental
182 28 hospitals shall be increased in accordance with increases under
182 29 the federal Medicare program or as supported by their Medicare
182 30 audited costs.
182 31    e.  For the fiscal year beginning July 1, 2016, independent
182 32 laboratories and rehabilitation agencies shall be reimbursed
182 33 using the same methodology in effect on June 30, 2016.
182 34    f.  (1)  For the fiscal year beginning July 1, 2016,
182 35 reimbursement rates for home health agencies shall continue to
183  1 be based on the Medicare low utilization payment adjustment
183  2 (LUPA) methodology with state geographic wage adjustments, and
183  3 updated to reflect the most recent Medicare LUPA rates.
183  4    (2)  For the fiscal year beginning July 1, 2016, rates for
183  5 private duty nursing and personal care services under the early
183  6 and periodic screening, diagnostic, and treatment program
183  7 benefit shall be calculated based on the methodology in effect
183  8 on June 30, 2016.
183  9    g.  For the fiscal year beginning July 1, 2016, federally
183 10 qualified health centers shall receive cost=based reimbursement
183 11 for 100 percent of the reasonable costs for the provision of
183 12 services to recipients of medical assistance.
183 13    h.  For the fiscal year beginning July 1, 2016, the
183 14 reimbursement rates for dental services shall remain at the
183 15 rates in effect on June 30, 2016.
183 16    i.  (1)  For the fiscal year beginning July 1, 2016,
183 17 state=owned psychiatric medical institutions for children shall
183 18 receive cost=based reimbursement for 100 percent of the actual
183 19 and allowable costs for the provision of services to recipients
183 20 of medical assistance.
183 21    (2)  For the nonstate=owned psychiatric medical institutions
183 22 for children, reimbursement rates shall be based on the
183 23 reimbursement methodology developed by the department as
183 24 required for federal compliance.
183 25    (3)  As a condition of participation in the medical
183 26 assistance program, enrolled providers shall accept the medical
183 27 assistance reimbursement rate for any covered goods or services
183 28 provided to recipients of medical assistance who are children
183 29 under the custody of a psychiatric medical institution for
183 30 children.
183 31    j.  For the fiscal year beginning July 1, 2016, unless
183 32 otherwise specified in this Act, all noninstitutional medical
183 33 assistance provider reimbursement rates shall remain at the
183 34 rates in effect on June 30, 2016, except for area education
183 35 agencies, local education agencies, infant and toddler
184  1 services providers, home and community=based services providers
184  2 including consumer=directed attendant care providers under a
184  3 section 1915(c) or 1915(i) waiver, targeted case management
184  4 providers, and those providers whose rates are required to be
184  5 determined pursuant to section 249A.20.
184  6    k.  Notwithstanding any provision to the contrary, for the
184  7 fiscal year beginning July 1, 2016, the reimbursement rate for
184  8 anesthesiologists shall remain at the rate in effect on June
184  9 30, 2016.
184 10    l.  Notwithstanding section 249A.20, for the fiscal year
184 11 beginning July 1, 2016, the average reimbursement rate for
184 12 health care providers eligible for use of the federal Medicare
184 13 resource=based relative value scale reimbursement methodology
184 14 under section 249A.20 shall remain at the rate in effect on
184 15 June 30, 2016; however, this rate shall not exceed the maximum
184 16 level authorized by the federal government.
184 17    m.  For the fiscal year beginning July 1, 2016, the
184 18 reimbursement rate for residential care facilities shall not
184 19 be less than the minimum payment level as established by the
184 20 federal government to meet the federally mandated maintenance
184 21 of effort requirement. The flat reimbursement rate for
184 22 facilities electing not to file annual cost reports shall not
184 23 be less than the minimum payment level as established by the
184 24 federal government to meet the federally mandated maintenance
184 25 of effort requirement.
184 26    n.  For the fiscal year beginning July 1, 2016, the
184 27 reimbursement rates for inpatient mental health services
184 28 provided at hospitals shall remain at the rates in effect on
184 29 June 30, 2016, subject to Medicaid program upper payment limit
184 30 rules; and psychiatrists shall be reimbursed at the medical
184 31 assistance program fee=for=service rate in effect on June 30,
184 32 2016.
184 33    o.  For the fiscal year beginning July 1, 2016, community
184 34 mental health centers may choose to be reimbursed for the
184 35 services provided to recipients of medical assistance through
185  1 either of the following options:
185  2    (1)  For 100 percent of the reasonable costs of the services.
185  3    (2)  In accordance with the alternative reimbursement rate
185  4 methodology established by the medical assistance program's
185  5 managed care contractor for mental health services and approved
185  6 by the department of human services.
185  7    p.  For the fiscal year beginning July 1, 2016, the
185  8 reimbursement rate for providers of family planning services
185  9 that are eligible to receive a 90 percent federal match shall
185 10 remain at the rates in effect on June 30, 2016.
185 11    q.  For the fiscal year beginning July 1, 2016, the upper
185 12 limits on reimbursement rates for providers of home and
185 13 community=based services waiver services shall remain at the
185 14 limits in effect on June 30, 2016.
185 15    r.  For the fiscal year beginning July 1, 2016, the
185 16 reimbursement rates for emergency medical service providers
185 17 shall remain at the rates in effect on June 30, 2016.
185 18    s.  For the fiscal year beginning July 1, 2016, reimbursement
185 19 rates for substance=related disorder treatment programs
185 20 licensed under section 125.13 shall remain at the rates in
185 21 effect on June 30, 2016.
185 22    2.  For the fiscal year beginning July 1, 2016, the
185 23 reimbursement rate for providers reimbursed under the
185 24 in=home=related care program shall not be less than the minimum
185 25 payment level as established by the federal government to meet
185 26 the federally mandated maintenance of effort requirement.
185 27    3.  Unless otherwise directed in this section, when the
185 28 department's reimbursement methodology for any provider
185 29 reimbursed in accordance with this section includes an
185 30 inflation factor, this factor shall not exceed the amount
185 31 by which the consumer price index for all urban consumers
185 32 increased during the calendar year ending December 31, 2002.
185 33    4.  For the fiscal year beginning July 1, 2016, the foster
185 34 family basic daily maintenance rate and the maximum adoption
185 35 subsidy rate for children ages 0 through 5 years shall be
186  1 $16.78, the rate for children ages 6 through 11 years shall be
186  2 $17.45, the rate for children ages 12 through 15 years shall
186  3 be $19.10, and the rate for children and young adults ages 16
186  4 and older shall be $19.35. For youth ages 18 to 21 who have
186  5 exited foster care, the preparation for adult living program
186  6 maintenance rate shall be $602.70 per month. The maximum
186  7 payment for adoption subsidy nonrecurring expenses shall be
186  8 limited to $500 and the disallowance of additional amounts
186  9 for court costs and other related legal expenses implemented
186 10 pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall
186 11 be continued.
186 12    5.  For the fiscal year beginning July 1, 2016, the maximum
186 13 reimbursement rates for social services providers under
186 14 contract shall remain at the rates in effect on June 30, 2016,
186 15 or the provider's actual and allowable cost plus inflation for
186 16 each service, whichever is less. However, if a new service
186 17 or service provider is added after June 30, 2016, the initial
186 18 reimbursement rate for the service or provider shall be based
186 19 upon a weighted average of provider rates for similar services.
186 20    6.  For the fiscal year beginning July 1, 2016, the
186 21 reimbursement rates for resource family recruitment and
186 22 retention contractors, child welfare emergency services
186 23 contractors, and supervised apartment living foster care
186 24 providers shall remain at the rates in effect on June 30, 2016.
186 25    7.  For the fiscal year beginning July 1, 2016, the
186 26 reimbursement rate for safety plan services and family safety,
186 27 risk, and permanency services (family=centered) shall be as
186 28 follows:
186 29    a.  The statewide base monthly payment amount for all
186 30 family safety, risk, and permanency services (family=centered)
186 31 contractors shall be the rate in effect on June 30, 2016.
186 32    (1)  Family safety, risk, and permanency services
186 33 Performance Measure 1 payments shall be the rate in effect on
186 34 June 30, 2016.
186 35    (2)  Family safety, risk, and permanency services
187  1 Performance Measure 2 payments shall be the rate in effect on
187  2 June 30, 2016.
187  3    (3)  Family safety, risk, and permanency services
187  4 Performance Measure 3 payments shall be the rate in effect on
187  5 June 30, 2016.
187  6    (4)  Family safety, risk, and permanency services
187  7 Performance Measure 4 payments shall be the rate in effect on
187  8 June 30, 2016.
187  9    b.  The maximum reimbursement unit rate for safety plan
187 10 services shall be the rate in effect on June 30, 2016.
187 11    (1)  Safety plan services Performance Measure 1 payments
187 12 shall be the rate in effect on June 30, 2016.
187 13    (2)  Safety plan services Performance Measure 2 payments
187 14 shall be the rate in effect on June 30, 2016.
187 15    8.  a.  For the purposes of this subsection, "combined
187 16 reimbursement rate" means the combined service and maintenance
187 17 reimbursement rate for a service level under the department's
187 18 reimbursement methodology. Effective July 1, 2016, the
187 19 combined reimbursement rate for a group foster care service
187 20 level shall be the amount designated in this subsection.
187 21 However, if a group foster care provider's reimbursement rate
187 22 for a service level as of June 30, 2016, is more than the rate
187 23 designated in this subsection, the provider's reimbursement
187 24 shall remain at the higher rate.
187 25    b.  Unless a group foster care provider is subject to the
187 26 exception provided in paragraph "a", effective July 1, 2016,
187 27 the combined reimbursement rates for the service levels under
187 28 the department's reimbursement methodology shall be as follows:
187 29    (1)  For service level, community = D1, the daily rate shall
187 30 be at least $84.17.
187 31    (2)  For service level, comprehensive = D2, the daily rate
187 32 shall be at least $119.09.
187 33    (3)  For service level, enhanced = D3, the daily rate shall
187 34 be at least $131.09.
187 35    9.  The group foster care reimbursement rates paid for
188  1 placement of children out of state shall be calculated
188  2 according to the same rate=setting principles as those used for
188  3 in=state providers, unless the director of human services or
188  4 the director's designee determines that appropriate care cannot
188  5 be provided within the state. The payment of the daily rate
188  6 shall be based on the number of days in the calendar month in
188  7 which service is provided.
188  8    10.  a.  For the fiscal year beginning July 1, 2016, the
188  9 reimbursement rate paid for shelter care and the child welfare
188 10 emergency services implemented to provide or prevent the need
188 11 for shelter care shall be established by contract.
188 12    b.  For the fiscal year beginning July 1, 2016, the combined
188 13 service and maintenance components of the reimbursement rate
188 14 paid for shelter care services shall be based on the financial
188 15 and statistical report submitted to the department. The
188 16 maximum reimbursement rate shall be $101.83 per day. The
188 17 department shall reimburse a shelter care provider at the
188 18 provider's actual and allowable unit cost, plus inflation, not
188 19 to exceed the maximum reimbursement rate.
188 20    c.  Notwithstanding section 232.141, subsection 8, for the
188 21 fiscal year beginning July 1, 2016, the amount of the statewide
188 22 average of the actual and allowable rates for reimbursement of
188 23 juvenile shelter care homes that is utilized for the limitation
188 24 on recovery of unpaid costs shall remain at the amount in
188 25 effect for this purpose in the fiscal year beginning July 1,
188 26 2015.
188 27    11.  For the fiscal year beginning July 1, 2016, the
188 28 department shall calculate reimbursement rates for intermediate
188 29 care facilities for persons with an intellectual disability
188 30 at the 80th percentile. Beginning July 1, 2016, the rate
188 31 calculation methodology shall utilize the consumer price index
188 32 inflation factor applicable to the fiscal year beginning July
188 33 1, 2016.
188 34    12.  For the fiscal year beginning July 1, 2016, for child
188 35 care providers reimbursed under the state child care assistance
189  1 program, the department shall set provider reimbursement
189  2 rates based on the rate reimbursement survey completed in
189  3 December 2004. Effective July 1, 2016, the child care provider
189  4 reimbursement rates shall remain at the rates in effect on June
189  5 30, 2016. The department shall set rates in a manner so as
189  6 to provide incentives for a nonregistered provider to become
189  7 registered by applying the increase only to registered and
189  8 licensed providers.
189  9    13.  For the fiscal year beginning July 1, 2016, if the
189 10 centers for Medicare and Medicaid services of the United
189 11 States department of health and human services approves the
189 12 waivers necessary to implement medical assistance program
189 13 managed care applicable to any providers or services subject to
189 14 reimbursement under this section, notwithstanding any provision
189 15 to the contrary under this section, affected providers or
189 16 services shall instead be reimbursed as follows:
189 17    a.  For fee=for=service claims, reimbursement rates shall
189 18 be calculated based on the methodology otherwise specified in
189 19 this section for the fiscal year beginning July 1, 2016, for
189 20 the respective provider or service.
189 21    b.  For claims subject to a managed care contract,
189 22 reimbursement shall be based on the actuarially sound
189 23 capitation rates established under the contract.  However,
189 24 any reimbursement established under such contract shall not
189 25 be lower than the reimbursement otherwise specified in this
189 26 section for the fiscal year beginning July 1, 2016, for the
189 27 respective provider or service.
189 28    14.  The department may adopt emergency rules to implement
189 29 this section.
189 30    Sec. 143.  EMERGENCY RULES.
189 31    1.  If specifically authorized by a provision of this
189 32 division of this Act, the department of human services or
189 33 the mental health and disability services commission may
189 34 adopt administrative rules under section 17A.4, subsection
189 35 3, and section 17A.5, subsection 2, paragraph "b", to
190  1 implement the provisions of this division of this Act and
190  2 the rules shall become effective immediately upon filing or
190  3 on a later effective date specified in the rules, unless the
190  4 effective date of the rules is delayed or the applicability
190  5 of the rules is suspended by the administrative rules review
190  6 committee. Any rules adopted in accordance with this section
190  7 shall not take effect before the rules are reviewed by the
190  8 administrative rules review committee. The delay authority
190  9 provided to the administrative rules review committee under
190 10 section 17A.4, subsection 7, and section 17A.8, subsection 9,
190 11 shall be applicable to a delay imposed under this section,
190 12 notwithstanding a provision in those sections making them
190 13 inapplicable to section 17A.5, subsection 2, paragraph "b".
190 14 Any rules adopted in accordance with the provisions of this
190 15 section shall also be published as a notice of intended action
190 16 as provided in section 17A.4.
190 17    2.  If during a fiscal year, the department of human
190 18 services is adopting rules in accordance with this section
190 19 or as otherwise directed or authorized by state law, and the
190 20 rules will result in an expenditure increase beyond the amount
190 21 anticipated in the budget process or if the expenditure was
190 22 not addressed in the budget process for the fiscal year, the
190 23 department shall notify the persons designated by this division
190 24 of this Act for submission of reports, the chairpersons and
190 25 ranking members of the committees on appropriations, and
190 26 the department of management concerning the rules and the
190 27 expenditure increase. The notification shall be provided at
190 28 least 30 calendar days prior to the date notice of the rules
190 29 is submitted to the administrative rules coordinator and the
190 30 administrative code editor.
190 31    Sec. 144.  REPORTS.  Any reports or other information
190 32 required to be compiled and submitted under this Act during the
190 33 fiscal year beginning July 1, 2016, shall be submitted to the
190 34 chairpersons and ranking members of the joint appropriations
190 35 subcommittee on health and human services, the legislative
191  1 services agency, and the legislative caucus staffs on or
191  2 before the dates specified for submission of the reports or
191  3 information.
191  4    Sec. 145.  EFFECTIVE UPON ENACTMENT.  The following
191  5 provisions of this division of this Act, being deemed of
191  6 immediate importance, take effect upon enactment:
191  7    1.  The provision relating to section 232.141 and directing
191  8 the state court administrator and the division administrator of
191  9 the department of human services division of child and family
191 10 services to make the determination, by June 15, 2016, of the
191 11 distribution of funds allocated for the payment of the expenses
191 12 of court=ordered services provided to juveniles which are a
191 13 charge upon the state.
191 14                         DIVISION XXXVI
191 15         HEALTH CARE ACCOUNTS AND FUNDS ==== FY 2016=2017
191 16    Sec. 146.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is
191 17 appropriated from the pharmaceutical settlement account created
191 18 in section 249A.33 to the department of human services for the
191 19 fiscal year beginning July 1, 2016, and ending June 30, 2017,
191 20 the following amount, or so much thereof as is necessary, to be
191 21 used for the purpose designated:
191 22    Notwithstanding any provision of law to the contrary, to
191 23 supplement the appropriations made in this Act for medical
191 24 contracts under the medical assistance program for the fiscal
191 25 year beginning July 1, 2016, and ending June 30, 2017:
191 26 .................................................. $    250,000
191 27    Sec. 147.  QUALITY ASSURANCE TRUST FUND ==== DEPARTMENT OF
191 28 HUMAN SERVICES.  Notwithstanding any provision to the contrary
191 29 and subject to the availability of funds, there is appropriated
191 30 from the quality assurance trust fund created in section
191 31 249L.4 to the department of human services for the fiscal year
191 32 beginning July 1, 2016, and ending June 30, 2017, the following
191 33 amounts, or so much thereof as is necessary, for the purposes
191 34 designated:
191 35    To supplement the appropriation made in this Act from the
192  1 general fund of the state to the department of human services
192  2 for medical assistance for the same fiscal year:
192  3 .................................................. $ 18,352,604
192  4    Sec. 148.  HOSPITAL HEALTH CARE ACCESS TRUST FUND ====
192  5 DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to
192  6 the contrary and subject to the availability of funds, there is
192  7 appropriated from the hospital health care access trust fund
192  8 created in section 249M.4 to the department of human services
192  9 for the fiscal year beginning July 1, 2016, and ending June
192 10 30, 2017, the following amounts, or so much thereof as is
192 11 necessary, for the purposes designated:
192 12    To supplement the appropriation made in this Act from the
192 13 general fund of the state to the department of human services
192 14 for medical assistance for the same fiscal year:
192 15 .................................................. $ 17,350,000
192 16    Sec. 149.  MEDICAL ASSISTANCE PROGRAM ==== NONREVERSION
192 17 FOR FY 2016=2017.  Notwithstanding section 8.33, if moneys
192 18 appropriated for purposes of the medical assistance program for
192 19 the fiscal year beginning July 1, 2016, and ending June 30,
192 20 2017, from the general fund of the state, the quality assurance
192 21 trust fund and the hospital health care access trust fund, are
192 22 in excess of actual expenditures for the medical assistance
192 23 program and remain unencumbered or unobligated at the close
192 24 of the fiscal year, the excess moneys shall not revert but
192 25 shall remain available for expenditure for the purposes of the
192 26 medical assistance program until the close of the succeeding
192 27 fiscal year.
192 28                         DIVISION XXXVII
192 29 PROPERTY TAX RELIEF FUND ==== BLOCK GRANT MONEYS ==== MENTAL HEALTH
192 30                           INSTITUTES
192 31    Sec. 150.  MENTAL HEALTH INSTITUTES.  The moneys transferred
192 32 to the property tax relief fund for the fiscal year beginning
192 33 July 1, 2016, from the federal social services block grant
192 34 pursuant to 2015 Iowa Acts, House File 630, if enacted, and
192 35 from the federal temporary assistance for needy families block
193  1 grant, totaling at least $11,774,275, are appropriated to the
193  2 department of human services for the fiscal year beginning July
193  3 1, 2016, and ending June 30, 2017, to be used for the purposes
193  4 designated:
193  5    1.  For the state mental health institute at Clarinda for
193  6 salaries, support, maintenance, and miscellaneous purposes:
193  7 .................................................. $  2,418,254
193  8    2.  For the state mental health institute at Mount Pleasant
193  9 for salaries, support, maintenance, and miscellaneous purposes,
193 10 and for not more than the following full=time equivalent
193 11 positions:
193 12 .................................................. $  3,468,884
193 13 ............................................... FTEs      97.68
193 14                        DIVISION XXXVIII
193 15             PERSONNEL SETTLEMENT AGREEMENT PAYMENTS
193 16    Sec. 151.  PERSONNEL SETTLEMENT AGREEMENT PAYMENTS.  As a
193 17 condition of the appropriations in this 2016 Act, the moneys
193 18 appropriated and any other moneys available shall not be used
193 19 for payment of a personnel settlement agreement that contains a
193 20 confidentiality provision intended to prevent public disclosure
193 21 of the agreement or any terms of the agreement.
193 22                           EXPLANATION
193 23 The inclusion of this explanation does not constitute agreement with
193 24 the explanation's substance by the members of the general assembly.
193 25    This bill relates to appropriations for health and human
193 26 services made in fiscal years 2015=2016 and 2016=2017 to the
193 27 department of veterans affairs, Iowa veterans home, department
193 28 on aging (IDA), office of long=term care ombudsman, department
193 29 of public health (DPH), Iowa finance authority, department of
193 30 human rights, and department of human services (DHS).
193 31    The bill is organized into divisions.
193 32    DEPARTMENT ON AGING.  These divisions make appropriations
193 33 from the general fund of the state for the department on aging
193 34 for FY 2015=2016 and FY 2016=2017.
193 35    OFFICE OF LONG=TERM CARE OMBUDSMAN.  These divisions make
194  1 appropriations from the general fund of the state for the
194  2 office of long=term care ombudsman for FY 2015=2016 and FY
194  3 2016=2017.
194  4    DEPARTMENT OF PUBLIC HEALTH.  These divisions make
194  5 appropriations from the general fund of the state for the
194  6 department of public health for  FY 2015=2016 and FY 2016=2017.
194  7    DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME.
194  8  These divisions make appropriations from the general fund
194  9 of the state for the department of veterans affairs for
194 10 FY 2015=2016 and FY 2016=2017 for administration, the Iowa
194 11 veterans home, for transfer to the Iowa finance authority for
194 12 the home ownership assistance program, and for the county
194 13 commissions of veterans affairs.
194 14    DEPARTMENT OF HUMAN SERVICES.  These divisions make
194 15 appropriations from the general fund of the state and the
194 16 federal temporary assistance for needy families block grant to
194 17 DHS for FY 2015=2016 and FY 2016=2017. The allocation for the
194 18 family development and self=sufficiency grant program is made
194 19 directly to the department of human rights. The reimbursement
194 20 section addresses reimbursement for providers reimbursed by the
194 21 department of human services. The bill provides for separate
194 22 appropriations for medical assistance program costs and other
194 23 departmental expenditures associated with the redesign of
194 24 mental health and disability services and for Iowa health and
194 25 wellness plan expenditures.
194 26    HEALTH CARE ACCOUNTS AND FUND.  These divisions make
194 27 certain health=related appropriations for FY 2015=2016 and
194 28 FY 2016=2017. A number of the appropriations are made for
194 29 purposes of the medical assistance (Medicaid) program in
194 30 addition to the general fund appropriations made for this
194 31 purpose for the same fiscal year.
194 32    MEDICAL ASSISTANCE PROGRAM NONREVERSION.  These divisions
194 33 provide that if the total amounts appropriated from all sources
194 34 for the Medicaid program for FY 2015=2016 or FY 2016=2017
194 35 exceed the amount needed, the excess remains available to be
195  1 used for the program in the succeeding fiscal year.
195  2    MEDICAL HOME SYSTEM ADVISORY COUNCIL.  This division amends
195  3 the Code to rename the medical home system advisory council the
195  4 patient=centered health advisory council.
195  5    PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS.  This
195  6 division includes amendments to appropriations and other
195  7 provisions made in prior years. The division is effective upon
195  8 enactment and is retroactively applicable to July 1, 2014, and
195  9 includes:
195 10    DECATEGORIZATION CARRYOVER FUNDING.  This division directs
195 11 that moneys remaining in the funding pool that are unencumbered
195 12 or unobligated at the close of FY 2012=2013 and were deemed
195 13 carryover funds do not revert to the general fund of the state
195 14 but are transferred to the Medicaid program for FY 2014=2015.
195 15    ADJUSTMENT OF AMOUNTS OF PRIOR APPROPRIATIONS AND
195 16 ALLOCATIONS.  The division adjusts amounts appropriated
195 17 and allocated for FY 2014=2015 for community mental health
195 18 services, the temporary assistance for needy families program,
195 19 the child support recovery unit, Medicaid, medical contracts,
195 20 state supplementary assistance, the children's health insurance
195 21 program/healthy and well kids in Iowa program, child care
195 22 assistance, juvenile child in need of assistance placements,
195 23 child and family services, adoption subsidy, family support
195 24 subsidy, field operations, general administration, the
195 25 pharmaceutical settlement account, and the quality assurance
195 26 trust fund.
195 27    MENTAL HEALTH AND DISABILITY SERVICES REGIONAL FUNDING
195 28 APPROPRIATION.  This division provides that for FFY 2014=2015,
195 29 FFY 2015=2016, and FFY 2016=2017, from the federal social
195 30 services block grant, if allocated, moneys in an amount
195 31 totaling at least $11,774,275 annually, are appropriated to DHS
195 32 for each of the state fiscal years beginning July 1, 2015, and
195 33 July 1, 2016, to be distributed to mental health and disability
195 34 service regions through the property tax relief fund for mental
195 35 health and disability services in accordance with Code section
196  1 426B.3.
196  2    QUALITY ASSURANCE ASSESSMENT.  This division establishes
196  3 the aggregate quality assurance assessments imposed on nursing
196  4 facilities at 3 percent of the aggregate non=Medicare revenues
196  5 of a nursing facility.  Current law provides for a range in
196  6 establishing the amount.
196  7    HEALTH OVERSIGHT.  This division establishes a committee
196  8 comprised of legislators to provide oversight for health
196  9 policy in the state.  The division also specifies limitations
196 10 on the use of capitated payments to  Medicaid managed care
196 11 organizations.  The division provides for an interagency study
196 12 to develop a proposal for a health consumer ombudsman alliance,
196 13 for third=party assessment of consumer service plans, and for
196 14 assistance and advocacy relating to long=term services and
196 15 supports.
196 16    AUTISM.  This division amends provisions of the autism
196 17 support program (Code chapter 225D).  The division amends
196 18 the definition of "autism service provider" to include a
196 19 board=certified assistant behavior analyst who performs duties
196 20 under the supervision of a board=certified behavior analyst
196 21 and eliminates the inclusion of a health professional licensed
196 22 under Code chapter 147 from the definition.  The division also
196 23 increases the age limit for an eligible child from 9 to 15
196 24 years, and provides that proof of eligibility for the program
196 25 includes a written denial or a coverage of benefits summary
196 26 that indicates that applied behavioral analysis treatment is
196 27 not covered under the individual's coverage.
196 28    OFFICE OF SUBSTITUTE DECISION MAKER.  This division extends
196 29 from July 1, 2015, to July 1, 2017, the date by which local
196 30 offices of the office of substitute decision maker are to be
196 31 established statewide.
196 32    DEMENTIA WORKFORCE.  This division provides for the
196 33 establishment of an interagency dementia=proficient workforce
196 34 task force to review recommendations for a standard curriculum
196 35 model for dementia education, identify staff who should
197  1 have some level of dementia proficiency, and develop an
197  2 implementation plan to transition toward competency=based
197  3 dementia curricula and training to achieve dementia proficiency
197  4 across the care continuum.  The task force is directed to
197  5 submit its recommendations to the governor and the general
197  6 assembly by December 15, 2015.
197  7    PHARMACEUTICAL COLLECTION AND DISPOSAL PROGRAM.  This
197  8 division increases the codified limitation on the portion
197  9 of certain fees collected by the board of pharmacy that may
197 10 be used for administering the pharmaceutical collection and
197 11 disposal program from $125,000 to $175,000.
197 12    MEDICAID STATE PLAN ==== FAMILY PLANNING.  This division
197 13 directs the department of human services to amend the Medicaid
197 14 state plan to include the eligibility provisions of the Iowa
197 15 family planning network section 1115 demonstration waiver in
197 16 effect on January 1, 2015.  The state plan amendment would be
197 17 effective no later than January 1, 2016.  DHS is to implement
197 18 the state plan amendment upon receipt of federal approval.
197 19 This division takes effect upon enactment.
197 20    IOWA ABLE SAVINGS PLAN TRUST.  This division creates an
197 21 Iowa ABLE (Achieving A Better Life Experience) savings plan
197 22 trust and provides for various Iowa individual income tax and
197 23 inheritance tax benefits.
197 24    BACKGROUND.  On December 19, 2014, the federal Achieving
197 25 A Better Life Experience Act of 2014 (ABLE Act) was enacted
197 26 as part of the federal Tax Increase Prevention Act of 2014
197 27 (Pub. L. No. 113=295).  The ABLE Act allows states to create
197 28 programs to assist individuals in saving private funds for
197 29 the purpose of supporting individuals with disabilities.
197 30 Qualifying state programs will allow for the establishment
197 31 of accounts into which eligible disabled individuals or
197 32 others may make contributions for the payment of future
197 33 disability=related expenses of the eligible disabled
197 34 individual.  Funds and earnings in accounts established
197 35 under qualifying state programs are afforded federal benefits
198  1 in certain circumstances, including federal tax exemption,
198  2 bankruptcy protection, and exclusion from consideration under
198  3 certain means=tested programs, such as Medicaid or supplemental
198  4 security income.
198  5    IOWA ABLE SAVINGS PLAN TRUST.  The division creates the Iowa
198  6 ABLE savings plan trust (trust) under the treasurer of state
198  7 (state treasurer) that will meet the requirements of {529A of
198  8 the Internal Revenue Code (federal ABLE program).  The state
198  9 treasurer is the trustee of the trust and has numerous powers,
198 10 as specified in the division, for the purpose of carrying out
198 11 the purpose of the trust.
198 12    The trust is authorized to enter into participation
198 13 agreements beginning July 1, 2016, with individuals for the
198 14 payment of future qualified disability expenses, and to enter
198 15 into contracts with other states (contracting state) to allow
198 16 these states' residents access to the Iowa ABLE program.
198 17 "Qualified disability expenses" means the same as defined
198 18 under the federal ABLE program, which generally defines the
198 19 term to include expenses related to a designated beneficiary's
198 20 education, housing, transportation, employment training and
198 21 support, assistive technology and personal support services,
198 22 health, prevention and wellness, financial management and
198 23 administrative services, legal fees, expenses for oversight and
198 24 monitoring, funeral and burial expenses, and other expenses
198 25 approved by the secretary of the United States treasury
198 26 (secretary).
198 27    Unless otherwise allowed under the federal ABLE program,
198 28 the person with whom the state treasurer enters into a
198 29 participation agreement must be both the account owner and
198 30 designated beneficiary.  However, the division allows a trustee
198 31 or legal guardian to be designated as custodian of an account
198 32 for a designated beneficiary who is a minor or who lacks
198 33 capacity to enter into a participation agreement, provided
198 34 such designation would be allowed under the federal ABLE
198 35 program.  "Designated beneficiary" is defined in the division
199  1 as a person who is a resident of Iowa or a contracting state
199  2 and who qualifies as an eligible individual under the federal
199  3 ABLE program, which includes individuals who are entitled
199  4 to benefits based on blindness or disability under Title II
199  5 (disability insurance) or Title XVI (supplemental security
199  6 income) of the federal Social Security Act if such blindness
199  7 or disability occurred before attaining 26 years of age, and
199  8 if such individual files a disability certification with the
199  9 secretary.
199 10    The division requires the state treasurer to maintain a
199 11 separate account in the trust for each designated beneficiary
199 12 of a participation agreement.  Unless otherwise allowed under
199 13 the federal ABLE program, only one participation agreement
199 14 shall be allowed per designated beneficiary.  Any person is
199 15 allowed to make contributions in the form of cash to an account
199 16 on behalf of a designated beneficiary.  The trust is required
199 17 to maintain limits on the annual contributions to an account,
199 18 and the aggregate balance in an account, matching those set
199 19 forth in the federal ABLE program, which prohibits annual
199 20 contributions to an account from exceeding the annual gift tax
199 21 exclusion amount ($14,000 for 2015), and prohibits an aggregate
199 22 account balance from exceeding the limit set by a state under
199 23 its qualified tuition program (currently $320,000 for Iowa).
199 24    The division also permits the treasurer of state to defer
199 25 implementation of the Iowa ABLE program and alternatively enter
199 26 into an agreement with another state's qualified ABLE program
199 27 to provide Iowa residents access to that state's program, if
199 28 certain requirements specified in the division are satisfied.
199 29    The division provides other various terms and conditions for
199 30 participation agreements, use and segregation of trust funds,
199 31 cancellation of agreements and refund of account balances, and
199 32 ownership rights in the trust.  The division provides that
199 33 an account may be claimed by the Iowa Medicaid program upon
199 34 the death of the designated beneficiary, in accordance with
199 35 the federal ABLE program.  The division requires the state
200  1 treasurer to prepare and submit audited financial reports to
200  2 the governor and general assembly, and further requires the
200  3 state treasurer to comply with any reporting requirements of
200  4 the federal ABLE program.
200  5    IOWA TAX BENEFITS.  The division provides several tax
200  6 benefits under the trust.  First, the value of any interest
200  7 in the trust or other contracted state's qualified ABLE
200  8 program of a decedent who was an Iowa resident dying on or
200  9 after January 1, 2016, is excluded from the Iowa inheritance
200 10 tax.  Second, contributions to the trust or other contracted
200 11 state's qualified ABLE program made on or after January 1,
200 12 2016, on behalf of a designated beneficiary who is an Iowa
200 13 resident are deductible from the Iowa individual income tax
200 14 up to the maximum amount allowed per beneficiary per year for
200 15 purposes of the Iowa educational savings plan trust in Code
200 16 chapter 12D.  For 2015, that amount is set at $3,163.  Any
200 17 amounts refunded to a taxpayer from the cancellation of a
200 18 participation agreement or that are withdrawn for purposes
200 19 other than the payment of qualified disability expenses of the
200 20 designated beneficiary must be included in Iowa net income to
200 21 the extent they were previously deducted by the taxpayer or any
200 22 other person as a contribution.  Third, income and earnings
200 23 from the trust or received by resident account owners from a
200 24 contracted state's qualified ABLE program are exempt from the
200 25 Iowa individual income tax.  The individual income tax benefits
200 26 apply to tax years beginning on or after January 1, 2016.
200 27    CONTINGENT IMPLEMENTATION.  The implementation of the
200 28 division is subject to an appropriation with the purpose of the
200 29 trust stated.
200 30    CHILD CARE ASSISTANCE.  The division requires the department
200 31 of human services to amend its administrative rules relating to
200 32 income eligibility for state child care assistance, according
200 33 to family size for children needing basic care, to families
200 34 whose nonexempt gross monthly income does not exceed 160
200 35 percent of the federal poverty level.  The division makes a
201  1 conforming Code change to Code section 237A.13 relating to
201  2 waiting lists for state child care assistance.
201  3    COUNTY MENTAL HEALTH AND DISABILITIES SERVICES FUNDING
201  4 ==== EQUALIZATION AND MEDICAID OFFSET.  The mental health and
201  5 disability services (MH/DS) levy limitations and equalization
201  6 payment provisions based on general population funding of
201  7 $47.28 per capita are currently in effect through FY 2015=2016.
201  8 This division amends Code sections 331.424A, relating to
201  9 the MH/DS levy, and 426B.3, relating to per capita funding,
201 10 equalization, and Medicaid offset, to extend these provisions
201 11 by one year to FY 2016=2017.  The division eliminates the
201 12 county repayment of Medicaid offset amounts in Code section
201 13 426B.3, subsection 5, to the state effective July 1, 2015.
201 14    MEDICAID OFFSET PAYMENTS ==== PROPERTY TAX RELIEF FUND
201 15 APPROPRIATIONS.  This division makes appropriations from the
201 16 moneys credited to the property tax relief fund in the form
201 17 of county Medicaid offset payments for the FY 2015=2016.  The
201 18 moneys are appropriated to DHS for reductions in the waiting
201 19 lists of all Medicaid home and community=based services
201 20 waivers; for a grant for a public awareness campaign regarding
201 21 the signs of Alzheimer's disease and other related dementias
201 22 and the resources available to people living with Alzheimer's
201 23 disease and other related dementias; for development of an
201 24 application for a planning grant through the substance abuse
201 25 and mental health services administration of the United States
201 26 department of health and human services to participate in
201 27 a two=year pilot for certified community behavioral health
201 28 clinics. The division provides that moneys credited to
201 29 the property tax relief fund in the form of county Medicaid
201 30 offset payments for FY 2015=2016 shall be distributed to a
201 31 mental health and disability services region if 25 percent of
201 32 the region's FY 2015=2016 projected expenditures exceed the
201 33 region's FY 2015=2016 projected fund balance.
201 34    PROPERTY TAX RELIEF FUND ==== BLOCK GRANT FUNDS ==== MENTAL
201 35 HEALTH INSTITUTES APPROPRIATIONS.  This division provides for
202  1 the appropriation of moneys transferred to the property tax
202  2 relief fund from the federal social services block grant for
202  3 FY 2015=2016 to the mental health institutes at Mount Pleasant
202  4 and Clarinda.
202  5    CHILD WELFARE ADVISORY COMMITTEE.  This division requires
202  6 the child welfare advisory committee of the council on human
202  7 services to study procedures in the department of human
202  8 services for receiving complaints from families involved
202  9 in guardianship, placement, and custody proceedings, the
202 10 specificity and clarity of court orders issued in foster care
202 11 placement cases, caseload trends of social workers including
202 12 an analysis of how Iowa compares nationally and with best
202 13 practices as defined by national associations, and immunity
202 14 provisions for social workers employed by the department of
202 15 human services and basic qualifications of social workers
202 16 employed by the department of human services.  The committee is
202 17 required to  submit a report with findings and recommendations
202 18 to the governor and general assembly on or before December 15,
202 19 2015.
202 20    COVERAGE OF SERVICES PROVIDED BY A PHYSICAL THERAPIST,
202 21 OCCUPATIONAL THERAPIST, OR SPEECH PATHOLOGIST.  This division
202 22 provides that a policy, contract, or plan providing for
202 23 third=party payment or prepayment of health or medical
202 24 expenses shall not impose a copayment or coinsurance amount
202 25 on an insured for services provided by a physical therapist,
202 26 occupational therapist, or speech pathologist that is greater
202 27 than the copayment or coinsurance amount imposed on the insured
202 28 for services rendered by a person engaged in the practice of
202 29 medicine and surgery or osteopathic medicine and surgery for
202 30 the same or a similar diagnosed condition even if a different
202 31 nomenclature is used to describe the condition for which the
202 32 services are provided.
202 33    The division applies to specified individual and group
202 34 policies, contracts, and plans that are issued for delivery,
202 35 continued, or renewed in this state on or after July 1, 2015.
203  1 CHILDREN'S MENTAL HEALTH AND WELL=BEING WORKGROUP.  This
203  2 division directs the department of human services, in
203  3 cooperation with the departments of education and public
203  4 health, to facilitate a workgroup of stakeholders to study
203  5 and make recommendations relating to children's mental health
203  6 and well=being in the state.  The division specifies the
203  7 issues that may be considered by the workgroup, including a
203  8 strategic plan for data systems; a comprehensive system of
203  9 care for children that incorporates a coordinated response to
203 10 mental health issues across many disciplines, and specifically
203 11 addresses the effects of adverse childhood experiences
203 12 and extreme child poverty and homelessness; and increasing
203 13 awareness of and creating strategies to address child mental
203 14 health and well=being.  The workgroup is directed to review
203 15 the 2014 report of the children's defense fund on the state
203 16 of America's children and the most complex issues affecting
203 17 children's health and well=being and to develop and recommend
203 18 proactive strategies to address the information presented. The
203 19 workgroup is directed to submit a report to the governor and
203 20 the general assembly by December 15, 2015.
203 21    PREVENTION OF DISABILITIES POLICY COUNCIL.  This division
203 22 relates to the prevention of disabilities policy council.
203 23    In 1991, the general assembly established the prevention
203 24 of disabilities council (council) in Code chapter 225B.  The
203 25 council was created to establish a system to coordinate
203 26 prevention of disability activities among state departments and
203 27 to assist the governor and the general assembly in determining
203 28 priorities and establishing policies for the prevention of
203 29 disabilities.
203 30    The division amends provisions in Code chapter 225B relating
203 31 to prevention activities of the council, council membership,
203 32 duties, and coordination efforts with state agencies and
203 33 disability groups, and related definitions.
203 34    The division defines prevention activities of the council
203 35 to include policies, programs, and practices that prevent a
204  1 disability or a condition that leads to a disability from
204  2 occurring; that identify a disability or a condition that leads
204  3 to a disability early on so that the intervention can eliminate
204  4 the risk of a disability or minimize the disability's effect;
204  5 or that reduce the effects of a disability on an individual's
204  6 health and independence.  The division amends the definition of
204  7 a disability to be the same as the federal definition under the
204  8 federal Americans with Disabilities Act (42 U.S.C. {12102).
204  9    The division provides that the council replaces the current
204 10 Iowa developmental disabilities council, to be abolished by
204 11 law July 1, 2015, in providing recommendations for individual
204 12 appointments of voting members to the council and council
204 13 membership is expanded to include ex officio representatives
204 14 from the department on aging, and the departments of education,
204 15 public health, and human services.
204 16    The duties of the council are expanded to include reviewing
204 17 the prevention of disabilities activities of public and
204 18 private entities and providing recommendations to optimize
204 19 the planning, implementation, and evaluation of prevention of
204 20 disabilities efforts; promoting cooperative and complementary
204 21 planning among the public, nonpublic, and volunteer sectors
204 22 involved in prevention of disabilities activities; facilitating
204 23 coordination of prevention of disabilities activities
204 24 among state departments to develop an integrated system of
204 25 care; providing support and technical assistance to public
204 26 or nonpublic entities to identify, seek, implement, and
204 27 evaluate state, federal, and private grants for prevention
204 28 of disabilities activities; encouraging research into the
204 29 causes and prevention of disabilities, including methods to
204 30 evaluate the effectiveness of prevention efforts; and promoting
204 31 professional and provider training in evidence=based prevention
204 32 of disabilities measures and assure adequate dissemination of
204 33 such to appropriate entities.
204 34    The division provides that the directors or deputy directors
204 35 of the state department on aging, and the departments of
205  1 education, human services, and public health shall meet at
205  2 least annually with the council to provide updates to the
205  3 council regarding the status of prevention of disabilities
205  4 policies and receive new policy and program recommendations
205  5 from the council regarding the prevention of disabilities.
205  6 Chairpersons and staff of public and private state disability
205  7 groups are encouraged to meet with the council annually
205  8 to identify ways to incorporate prevention of disabilities
205  9 activities within Iowa's disabilities services system and
205 10 to assist in developing a policy agenda for prevention of
205 11 disabilities system improvements.
205 12    The division directs the department of human services to
205 13 adopt rules to implement the division, subject to council
205 14 approval.
205 15    FACILITY FOR PERSONS WITH AGGRESSIVE OR PSYCHIATRIC
205 16 BEHAVIORS ==== INTERIM COMMITTEE ==== REPORT.  This division
205 17 relates to the housing of persons who are sexually aggressive
205 18 or combative or who have unmet geropsychiatric needs.  The
205 19 division requests the legislative council to establish
205 20 an interim legislative study committee relating to the
205 21 establishment of one or more facilities to provide care and
205 22 treatment for persons who are sexually aggressive, combative,
205 23 or who have unmet geropsychiatric needs. The study committee
205 24 shall receive testimony from certain stakeholders with
205 25 interests or expertise in the resident population identified
205 26 for care and treatment, and shall specifically address and
205 27 make recommendations relating to the characteristics of the
205 28 residents for such a facility and the size of the resident
205 29 population to be served; options for creating a new facility
205 30 or expanding an existing facility; workforce recruitment,
205 31 training, and compensation issues; Medicaid reimbursement
205 32 qualifications; and any other information deemed appropriate
205 33 by the committee.
205 34    The committee must provide a report of findings and
205 35 recommendations to the governor and general assembly by January
206  1 1, 2016.
206  2    ANATOMICAL GIFT PUBLIC AWARENESS AND TRANSPLANTATION FUND.
206  3  This division provides that instead of a limitation of not
206  4 more than 50 percent, any unobligated moneys in the anatomical
206  5 gift public awareness and transplantation fund, annually, may
206  6 be expended in the form of grants to transplant recipients,
206  7 transplant candidates, or living organ donors, or to legal
206  8 representatives on behalf of transplant recipients, transplant
206  9 candidates, or living organ donors.  Such grants are based on
206 10 grant applications submitted with supporting documentation
206 11 provided by a hospital that performs transplants, verifying
206 12 that the person by or for whom the application is submitted
206 13 requires a transplant or is a living organ donor and specifying
206 14 the amount of the costs associated with the costs of the organ
206 15 transplantation procedure, the costs of post=transplantation
206 16 drug or other therapy, and other transplantation costs
206 17 including but not limited to food, lodging, and transportation,
206 18 if funds are not available from any other third=party payor.
206 19 Under current law, not more than 5 percent of the moneys in
206 20 the fund may be used by the Iowa department of public health
206 21 for administrative costs and of the remaining moneys in the
206 22 fund, not more than 20 percent annually may be expended in
206 23 the form of grants to state agencies or to nonprofit legal
206 24 entities with an interest in anatomical gift public awareness
206 25 and transplantation to conduct public awareness projects; and
206 26 not more than 30 percent annually may be expended in the form
206 27 of grants to hospitals for reimbursement for costs directly
206 28 related to the development of in=hospital anatomical gift
206 29 public awareness projects, anatomical gift referral protocols,
206 30 and associated administrative expenses.
206 31    HOSPITAL AND LONG=TERM CARE PHARMACY PRACTICE ====
206 32 PNEUMOCOCCAL VACCINES.  This division directs the board of
206 33 pharmacy to adopt rules pursuant to chapter 17A relating to
206 34 hospital and long=term care pharmacy practice that allow,
206 35 as authorized by federal law, in addition to influenza and
207  1 pneumococcal polysaccharide vaccines, that a written or verbal
207  2 patient=specific medication administration order shall not
207  3 be required prior to administration to an adult patient of
207  4 pneumococcal conjugate vaccine pursuant to physician=approved
207  5 hospital or facility policy and after the patient has been
207  6 assessed for contraindications.
207  7    HEALTHY AND WELL KIDS IN IOWA PROGRAM ==== CONTINUED
207  8 ENROLLMENT.  This division provides that at the end of the
207  9 12=month eligibility period when a child's family circumstances
207 10 are subject to review to determine continued eligibility,
207 11 pending such review,  the child shall continue to be eligible
207 12 for and remain enrolled in the same plan if the family complies
207 13 with requirements to provide information and verification of
207 14 income, otherwise cooperates in the annual review process,
207 15 and submits the completed review form and any information
207 16 necessary to establish continued eligibility in a timely manner
207 17 in accordance with administrative rules.
207 18    PERSONNEL SETTLEMENT AGREEMENT PAYMENTS.  This division
207 19 provides that as a condition of the appropriations in the
207 20 Act, the moneys appropriated and any other moneys available
207 21 shall not be used for payment of a personnel settlement
207 22 agreement that contains a confidentiality provision intended to
207 23 prevent public disclosure of the agreement or any terms of the
207 24 agreement.
207 25    MEDICAID REIMBURSEMENT == PSYCHOLOGISTS.  The division
207 26 provides that in addition to psychologists who are licensed
207 27 in the state where the services are provided and meet other
207 28 specifications, psychologists who are licensed under Code
207 29 chapter 154B (psychologists) are entitled to payment for
207 30 services provided to recipients of Medicaid, subject to
207 31 limitations and exclusions the department of human services
207 32 finds necessary based on federal law and funds available.
       LSB 2653SV (2) 86
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