Bill Text: IA HF2460 | 2015-2016 | 86th General Assembly | Enrolled


Bill Title: A bill for an act relating to appropriations for health and human services and veterans and including other related provisions and appropriations, and including effective date and retroactive and other applicability provisions.

Sponsorship: Committee Bill

Status: (Enrolled - Dead) 2016-05-13 - Sent to Governor. H.J. 999. [HF2460 Detail]

Download: Iowa-2015-HF2460-Enrolled.html
House File 2460 - Enrolled




                              HOUSE FILE       
                              BY  COMMITTEE ON
                                  APPROPRIATIONS

                              (SUCCESSOR TO LSB
                                  5014HB)
 \5
                                   A BILL FOR
 \1
                                        House File 2460

                             AN ACT
 RELATING TO APPROPRIATIONS FOR HEALTH AND HUMAN SERVICES
    AND VETERANS AND INCLUDING OTHER RELATED PROVISIONS
    AND APPROPRIATIONS, AND INCLUDING EFFECTIVE DATE AND
    RETROACTIVE AND OTHER APPLICABILITY PROVISIONS.

 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
                           DIVISION I
               DEPARTMENT ON AGING ==== FY 2016=2017
    Section 1.  2015 Iowa Acts, chapter 137, section 121, is
 amended to read as follows:
    SEC. 121.  DEPARTMENT ON AGING.  There is appropriated
 from the general fund of the state to the department on aging
 for the fiscal year beginning July 1, 2016, and ending June
 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purposes designated:
    For aging programs for the department on aging and area
 agencies on aging to provide citizens of Iowa who are 60 years
 of age and older with case management for frail elders, Iowa's
 aging and disabilities resource center, and other services
 which may include but are not limited to adult day services,
 respite care, chore services, information and assistance,
 and material aid, for information and options counseling for
 persons with disabilities who are 18 years of age or older,
 and for salaries, support, administration, maintenance, and
 miscellaneous purposes, and for not more than the following
 full=time equivalent positions:
 .................................................. $  5,699,866
                                                      12,548,603
 ............................................... FTEs      31.00
    1.  Funds appropriated in this section may be used to
 supplement federal funds under federal regulations. To
 receive funds appropriated in this section, a local area
 agency on aging shall match the funds with moneys from other
 sources according to rules adopted by the department. Funds
 appropriated in this section may be used for elderly services
 not specifically enumerated in this section only if approved
 by an area agency on aging for provision of the service within
 the area.
    2.  Of the funds appropriated in this section, $139,973
  $279,946 is transferred to the economic development authority
 for the Iowa commission on volunteer services to be used for
 the retired and senior volunteer program.
    3.  a.  The department on aging shall establish and enforce
 procedures relating to expenditure of state and federal funds
 by area agencies on aging that require compliance with both
 state and federal laws, rules, and regulations, including but
 not limited to all of the following:
    (1)  Requiring that expenditures are incurred only for
 goods or services received or performed prior to the end of
 the fiscal period designated for use of the funds.
    (2)  Prohibiting prepayment for goods or services not
 received or performed prior to the end of the fiscal period
 designated for use of the funds.
    (3)  Prohibiting the prepayment for goods or services not
 defined specifically by good or service, time period, or
 recipient.
    (4)  Prohibiting the establishment of accounts from which
 future goods or services which are not defined specifically by
 good or service, time period, or recipient, may be purchased.
    b.  The procedures shall provide that if any funds are
 expended in a manner that is not in compliance with the
 procedures and applicable federal and state laws, rules, and
 regulations, and are subsequently subject to repayment, the
 area agency on aging expending such funds in contravention of
 such procedures, laws, rules and regulations, not the state,
 shall be liable for such repayment.
    4.  Of the funds appropriated in this section, at least
 $125,000 $250,000 shall be used to fund the unmet needs
 identified through Iowa's aging and disability resource center
 network.
    5.  Of the funds appropriated in this section, at
 least $300,000 $600,000 shall be used to fund home and
 community=based services through the area agencies on aging
 that enable older individuals to avoid more costly utilization
 of residential or institutional services and remain in their
 own homes.
    6.  Of the funds appropriated in this section, $406,833
  $962,537 shall be used for the purposes of chapter 231E and
 section 231.56A, of which $144,333 $350,000 shall be used for
 the office of substitute decision maker pursuant to chapter
 231E, and the remainder shall be distributed equally to the
 area agencies on aging to administer the prevention of elder
 abuse, neglect, and exploitation program pursuant to section
 231.56A, in accordance with the requirements of the federal
 Older Americans Act of 1965, 42 U.S.C. {3001 et seq., as
 amended.
    7.  Of the funds appropriated in this section, $1,000,000
 shall be used to fund continuation of the aging and disability
 resource center lifelong links to provide individuals and
 caregivers with information and services to plan for and
 maintain independence.
                           DIVISION II
       OFFICE OF LONG=TERM CARE OMBUDSMAN ==== FY 2016=2017
    Sec. 2.  2015 Iowa Acts, chapter 137, section 122, is
 amended to read as follows:
    SEC. 122.  OFFICE OF LONG=TERM CARE OMBUDSMAN.
    1.  There is appropriated from the general fund of the
 state to the office of long=term care ombudsman for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purposes designated:
    For salaries, support, administration, maintenance, and
 miscellaneous purposes, and for not more than the following
 full=time equivalent positions:
 .................................................. $    638,391
                                                       1,376,783
 ............................................... FTEs 17.00
                                                           18.00
    2.  Of the funds appropriated in this section, $110,000
  $220,000 shall be used to continue to provide for additional
 local long=term care ombudsmen.
    3.  Of the funds appropriated in this section, $100,000
 shall be used to provide an additional long=term care
 ombudsman to provide assistance and advocacy related to
 long=term care services and supports under the Medicaid
 program pursuant to section 231.44.
                          DIVISION III
           DEPARTMENT OF PUBLIC HEALTH ==== FY 2016=2017
    Sec. 3.  2015 Iowa Acts, chapter 137, section 123, is
 amended to read as follows:
    SEC. 123.  DEPARTMENT OF PUBLIC HEALTH.  There is
 appropriated from the general fund of the state to the
 department of public health for the fiscal year beginning July
 1, 2016, and ending June 30, 2017, the following amounts, or
 so much thereof as is necessary, to be used for the purposes
 designated:
    1.  ADDICTIVE DISORDERS
    For reducing the prevalence of the use of tobacco, alcohol,
 and other drugs, and treating individuals affected by
 addictive behaviors, including gambling, and for not more than
 the following full=time equivalent positions:
 .................................................. $ 13,631,845
                                                      26,988,690
 ............................................... FTEs      10.00
    a.  (1)  Of the funds appropriated in this subsection,
 $2,624,180 $5,248,361 shall be used for the tobacco use
 prevention and control initiative, including efforts at the
 state and local levels, as provided in chapter 142A.  The
 commission on tobacco use prevention and control established
 pursuant to section 142A.3 shall advise the director of public
 health in prioritizing funding needs and the allocation
 of moneys appropriated for the programs and initiatives.
 Activities of the programs and initiatives shall be in
 alignment with the United States centers for disease control
 and prevention best practices for comprehensive tobacco
 control programs that include the goals of preventing youth
 initiation of tobacco usage, reducing exposure to secondhand
 smoke, and promotion of tobacco cessation. To maximize
 resources, the department shall determine if third=party
 sources are available to instead provide nicotine replacement
 products to an applicant prior to provision of such products
 to an applicant under the initiative.  The department shall
 track and report to the individuals specified in this Act, any
 reduction in the provision of nicotine replacement products
 realized by the initiative through implementation of the
 prerequisite screening.
    (2)  (a)  Of the funds allocated in this paragraph
 "a", $226,533 is transferred to the The department shall
 collaborate with the alcoholic beverages division of the
 department of commerce for enforcement of tobacco laws,
 regulations, and ordinances and to engage in tobacco control
 activities approved by the division of tobacco use prevention
 and control of the department of public health as specified
 in the memorandum of understanding entered into between the
 divisions.
    (b)  For the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, the terms of the memorandum of
 understanding, entered into between the division of tobacco
 use prevention and control of the department of public health
 and the alcoholic beverages division of the department of
 commerce, governing compliance checks conducted to ensure
 licensed retail tobacco outlet conformity with tobacco laws,
 regulations, and ordinances relating to persons under eighteen
  18 years of age, shall continue to restrict the number of such
 checks to one check per retail outlet, and one additional
 check for any retail outlet found to be in violation during
 the first check.
    b.  Of the funds appropriated in this subsection,
 $11,007,664 $21,740,329 shall be used for problem gambling and
 substance=related disorder prevention, treatment, and recovery
 services, including a 24=hour helpline, public information
 resources, professional training, youth prevention, and
 program evaluation.
    (1)  Of the funds allocated in this paragraph "b",
 $9,451,857 shall be used for substance=related disorder
 prevention and treatment.
    (a)  Of the funds allocated in this subparagraph (1),
 $449,650 shall be used for the public purpose of a grant
 program to provide substance=related disorder prevention
 programming for children.
    (i)  Of the funds allocated in this subparagraph
 division (a), $213,769 shall be used for grant funding
 for organizations that provide programming for children
 by utilizing mentors.  Programs approved for such grants
 shall be certified or must be certified within six months of
 receiving the grant award by the Iowa commission on volunteer
 services as utilizing the standards for effective practice for
 mentoring programs.
    (ii)  Of the funds allocated in this subparagraph
 division (a), $213,419 shall be used for grant funding for
 organizations providing programming that includes youth
 development and leadership services.  The programs shall
 also be recognized as being programs that are scientifically
 based with evidence of their effectiveness in reducing
 substance=related disorders in children.
    (iii)  The department of public health shall utilize a
 request for proposals process to implement the grant program.
    (iv)  All grant recipients shall participate in a program
 evaluation as a requirement for receiving grant funds.
    (v)  Of the funds allocated in this subparagraph division
 (a), up to $22,461 may be used to administer substance=related
 disorder prevention grants and for program evaluations.
    (b)  Of the funds allocated in this subparagraph
 (1), $136,301 shall be used for culturally competent
 substance=related disorder treatment pilot projects.
    (i)  The department shall utilize the amount allocated
 in this subparagraph division (b) for at least three pilot
 projects to provide culturally competent substance=related
 disorder treatment in various areas of the state.  Each pilot
 project shall target a particular ethnic minority population.
 The populations targeted shall include but are not limited to
 African American, Asian, and Latino.
    (ii)  The pilot project requirements shall provide for
 documentation or other means to ensure access to the cultural
 competence approach used by a pilot project so that such
 approach can be replicated and improved upon in successor
 programs.
    (2)  Of the funds allocated in this paragraph "b", up
 to $1,555,807 may be used for problem gambling prevention,
 treatment, and recovery services.
    (a)  Of the funds allocated in this subparagraph (2),
 $1,286,881 shall be used for problem gambling prevention and
 treatment.
    (b)  Of the funds allocated in this subparagraph (2),
 up to $218,926 may be used for a 24=hour helpline, public
 information resources, professional training, and program
 evaluation.
    (c)  Of the funds allocated in this subparagraph (2), up
 to $50,000 may be used for the licensing of problem gambling
 treatment programs.
    (3)  It is the intent of the general assembly that from the
 moneys allocated in this paragraph "b",  persons with a dual
 diagnosis of substance=related disorder and gambling addiction
 shall be given priority in treatment services.
    c.  Notwithstanding any provision of law to the contrary,
 to standardize the availability, delivery, cost of delivery,
 and accountability of problem gambling and substance=related
 disorder treatment services statewide, the department shall
 continue implementation of a process to create a system
 for delivery of treatment services in accordance with the
 requirements specified in 2008 Iowa Acts, chapter 1187,
 section 3, subsection 4.  To ensure the system provides a
 continuum of treatment services that best meets the needs of
 Iowans, the problem gambling and substance=related disorder
 treatment services in any area may be provided either by a
 single agency or by separate agencies submitting a joint
 proposal.
    (1)  The system for delivery of substance=related disorder
 and problem gambling treatment shall include problem gambling
 prevention.
    (2)  The system for delivery of substance=related disorder
 and problem gambling treatment shall include substance=related
 disorder prevention by July 1, 2017.
    (3)  Of the funds allocated in paragraph "b",  the department
 may use up to $50,000 for administrative costs to continue
 developing and implementing the process in accordance with
 this paragraph "c".
    d.  The requirement of section 123.53 123.17, subsection
 5, is met by the appropriations and allocations made in
 this division of this Act for purposes of substance=related
 disorder treatment and addictive disorders for the fiscal year
 beginning July 1, 2016.
    e.  The department of public health shall work with all
 other departments that fund substance=related disorder
 prevention and treatment services and all such departments
 shall, to the extent necessary, collectively meet the state
 maintenance of effort requirements for expenditures for
 substance=related disorder services as required under the
 federal substance=related disorder prevention and treatment
 block grant.
    2.  HEALTHY CHILDREN AND FAMILIES
    For promoting the optimum health status for children,
 adolescents from birth through 21 years of age, and families,
 and for not more than the following full=time equivalent
 positions:
 .................................................. $  2,308,771
                                                       5,693,774
 ............................................... FTEs      12.00
    a.  Of the funds appropriated in this subsection,
 not more than $367,420 $734,841 shall be used for the
 healthy opportunities for parents to experience success
 (HOPES)=healthy families Iowa (HFI) program established
 pursuant to section 135.106. The funding shall be distributed
 to renew the grants that were provided to the grantees that
 operated the program during the fiscal year ending June 30,
 2016.
    b.  In order to implement the legislative intent stated in
 sections 135.106 and 256I.9, that priority for home visitation
 program funding be given to programs using evidence=based
 or promising models for home visitation, it is the intent
 of the general assembly to phase in the funding priority in
 accordance with 2012 Iowa Acts, chapter 1133, section 2,
 subsection 2, paragraph "0b".
    c.  Of the funds appropriated in this subsection,
 $1,099,414 $3,275,059 shall be used for continuation of the
 department's initiative to provide for adequate developmental
 surveillance and screening during a child's first five years.
 The funds shall be used first to fully fund the current sites
 to ensure that the sites are fully operational, with the
 remaining funds to be used for expansion to additional sites.
 The full implementation and expansion shall include enhancing
 the scope of the program through collaboration with the child
 health specialty clinics to promote healthy child development
 through early identification and response to both biomedical
 and social determinants of healthy development; by monitoring
 child health metrics to inform practice, document long=term
 health impacts and savings, and provide for continuous
 improvement through training, education, and evaluation; and
 by providing for practitioner consultation particularly for
 children with behavioral conditions and needs.  The department
 of public health shall also collaborate with the Iowa
 Medicaid enterprise and the child health specialty clinics
 to integrate the activities of the first five initiative
 into the establishment of patient=centered medical homes,
 community utilities, accountable care organizations, and other
 integrated care models developed to improve health quality and
 population health while reducing health care costs. To the
 maximum extent possible, funding allocated in this paragraph
 shall be utilized as matching funds for medical assistance
 program reimbursement.
    d.  Of the funds appropriated in this subsection, $37,320
  $74,640 shall be distributed to a statewide dental carrier to
 provide funds to continue the donated dental services program
 patterned after the projects developed by the lifeline network
 to provide dental services to indigent individuals who are
 elderly or with disabilities.
    e.  Of the funds appropriated in this subsection, $55,997
  $111,995 shall be used for childhood obesity prevention.
    f.  Of the funds appropriated in this subsection, $81,384
  $162,768 shall be used to provide audiological services and
 hearing aids for children. The department may enter into a
 contract to administer this paragraph.
    g.  Of the funds appropriated in this subsection, $12,500
  $25,000 is transferred to the university of Iowa college
 of dentistry for provision of primary dental services to
 children.  State funds shall be matched on a dollar=for=dollar
 basis.  The university of Iowa college of dentistry shall
 coordinate efforts with the department of public health,
 bureau of oral and health delivery systems, to provide dental
 care to underserved populations throughout the state.
    h.  Of the funds appropriated in this subsection, $25,000
  $50,000 shall be used to address youth suicide prevention.
    i.  Of the funds appropriated in this subsection, $25,000
  $50,000 shall be used to support the Iowa effort to address
 the survey of children who experience adverse childhood
 experiences known as ACEs.
    j.  The department of public health shall continue to
 administer the program to assist parents in this state with
 costs resulting from the death of a child in accordance with
 the provisions of 2014 Iowa Acts, chapter 1140, section 22,
 subsection 12.
    3.  CHRONIC CONDITIONS
    For serving individuals identified as having chronic
 conditions or special health care needs, and for not more than
 the following full=time equivalent positions:
 .................................................. $  2,477,846
                                                       5,080,692
 ............................................... FTEs       5.00
    a.  Of the funds appropriated in this subsection, $79,966
  $159,932 shall be used for grants to individual patients who
 have an inherited metabolic disorder to assist with the costs
 of medically necessary foods and formula.
    b.  Of the funds appropriated in this subsection, $445,822
  $1,041,644 shall be used for the brain injury services program
 pursuant to section 135.22B, including for continuation of
 the contracts for resource facilitator services in accordance
 with section 135.22B, subsection 9, and to enhance brain
 injury training and recruitment of service providers on a
 statewide basis.  Of the amount allocated in this paragraph,
 $47,500 $95,000 shall be used to fund one full=time equivalent
 position to serve as the state brain injury services program
 manager.
    c.  Of the funds appropriated in this subsection, $273,991
  $547,982 shall be used as additional funding to leverage
 federal funding through the federal Ryan White Care Act, Tit.
 II, AIDS drug assistance program supplemental drug treatment
 grants.
    d.  Of the funds appropriated in this subsection, $74,911
  $149,823 shall be used for the public purpose of continuing
 to contract with an existing national=affiliated organization
 to provide education, client=centered programs, and client
 and family support for people living with epilepsy and their
 families. The amount allocated in this paragraph in excess
 of $50,000 $100,000 shall be matched dollar=for=dollar by the
 organization specified.
    e.  Of the funds appropriated in this subsection, $392,557
  $785,114 shall be used for child health specialty clinics.
    f.  Of the funds appropriated in this subsection,
 $200,000 $400,000 shall be used by the regional autism
 assistance program established pursuant to section 256.35,
 and administered by the child health specialty clinic located
 at the university of Iowa hospitals and clinics.  The funds
 shall be used to enhance interagency collaboration and
 coordination of educational, medical, and other human services
 for persons with autism, their families, and providers of
 services, including delivering regionalized services of
 care coordination, family navigation, and integration of
 services through the statewide system of regional child
 health specialty clinics and fulfilling other requirements
 as specified in chapter 225D.  The university of Iowa shall
 not receive funds allocated under this paragraph for indirect
 costs associated with the regional autism assistance program.
    g.  Of the funds appropriated in this subsection, $285,496
  $594,543 shall be used for the comprehensive cancer control
 program to reduce the burden of cancer in Iowa through
 prevention, early detection, effective treatment, and ensuring
 quality of life. Of the funds allocated in this paragraph
 "g", $75,000 $150,000 shall be used to support a melanoma
 research symposium, a melanoma biorepository and registry,
 basic and translational melanoma research, and clinical
 trials.
    h.  Of the funds appropriated in this subsection, $63,225
  $101,450 shall be used for cervical and colon cancer
 screening, and $150,000 $300,000 shall be used to enhance the
 capacity of the cervical cancer screening program to include
 provision of recommended prevention and early detection
 measures to a broader range of low=income women.
    i.  Of the funds appropriated in this subsection, $263,347
  $526,695 shall be used for the center for congenital and
 inherited disorders.
    j.  Of the funds appropriated in this subsection, $64,705
  $129,411 shall be used for the prescription drug donation
 repository program created in chapter 135M.
    k.  Of the funds appropriated in this subsection, $107,631
  $215,263 shall be used by the department of public health
 for reform=related activities, including but not limited to
 facilitation of communication to stakeholders at the state
 and local level, administering the patient=centered health
 advisory council pursuant to section 135.159, and involvement
 in health care system innovation activities occurring across
 the state.
    l.  Of the funds appropriated in this subsection, $12,500
  $25,000 shall be used for administration of chapter 124D, the
 medical cannabidiol Act.
    4.  COMMUNITY CAPACITY
    For strengthening the health care delivery system at the
 local level, and for not more than the following full=time
 equivalent positions:
 .................................................. $  4,410,667
                                                       7,339,136
 ............................................... FTEs      11.00
                                                           13.00
    a.  Of the funds appropriated in this subsection, $49,707
  $99,414 is allocated for continuation of the child vision
 screening program implemented through the university of Iowa
 hospitals and clinics in collaboration with early childhood
 Iowa areas. The program shall submit a report to the
 individuals identified in this Act for submission of reports
 regarding the use of funds allocated under this paragraph "a".
 The report shall include the objectives and results for the
 program year including the target population and how the funds
 allocated assisted the program in meeting the objectives; the
 number, age, and location within the state of individuals
 served; the type of services provided to the individuals
 served; the distribution of funds based on service provided;
 and the continuing needs of the program.
    b.  Of the funds appropriated in this subsection, $55,328
  $110,656 is allocated for continuation of an initiative
 implemented at the university of Iowa and $49,952 $99,904
  is allocated for continuation of an initiative at the state
 mental health institute at Cherokee to expand and improve the
 workforce engaged in mental health treatment and services.
 The initiatives shall receive input from the university of
 Iowa, the department of human services, the department of
 public health, and the mental health and disability services
 commission to address the focus of the initiatives.
    c.  Of the funds appropriated in this subsection, $582,314
  $1,164,628 shall be used for essential public health services
 that promote healthy aging throughout one's lifespan,
 contracted through a formula for local boards of health, to
 enhance health promotion and disease prevention services.
    d.  Of the funds appropriated in this section subsection,
 $49,643 $99,286 shall be deposited in the governmental public
 health system fund created in section 135A.8 to be used for
 the purposes of the fund.
    e.  Of the funds appropriated in this subsection, $52,724
 shall be used to continue to address the shortage of mental
 health professionals in the state.
    f.  Of the funds appropriated in this subsection, $25,000
  $50,000 shall be used for a grant to a statewide association
 of psychologists that is affiliated with the American
 psychological association to be used for continuation of
 a program to rotate intern psychologists in placements in
 urban and rural mental health professional shortage areas, as
 defined in section 135.180.
    g.  (1)  Of the funds appropriated in this subsection,
 $1,441,484 $1,210,770 shall be allocated as a grant to
 the Iowa primary care association to be used pursuant to
 section 135.153 for the statewide coordination of the Iowa
 collaborative safety net provider network. Coordination of
 the network shall focus on increasing access by underserved
 populations to health care services, increasing integration
 of the health system and collaboration across the continuum
 of care with a focus on safety net services, and enhancing the
 Iowa collaborative safety net provider network's communication
 and education efforts. The amount allocated as a grant under
 this subparagraph (1) shall be used as follows to support
 the Iowa collaborative safety net provider network goals of
 increased access, health system integration, and engagement:
    (a)  For distribution to safety net partners in the state
 that work to increase access of the underserved population to
 health services:
 .................................................. $    512,742
                                                       1,025,485
    (i)  Of the amount allocated in this subparagraph
 division (a), up to $206,707 not less than $413,415 shall be
 distributed to the Iowa prescription drug corporation for
 continuation of the pharmaceutical infrastructure for safety
 net providers as described in 2007 Iowa Acts, chapter 218,
 section 108.
    (ii)  Of the amount allocated in this subparagraph
 division (a), up to $174,161 not less than $348,322 shall
 be distributed to free clinics and free clinics of Iowa for
 necessary infrastructure, statewide coordination, provider
 recruitment, service delivery, and provision of assistance to
 patients in securing a medical home inclusive of oral health
 care.
    (iii)  Of the amount allocated in this subparagraph
 division (a), up to $25,000 not less than $50,000 shall be
 distributed to the Iowa coalition against sexual assault to
 continue a training program for sexual assault response team
 (SART) members, including representatives of law enforcement,
 victim advocates, prosecutors, and certified medical
 personnel.
    (iv)  Of the amount allocated in this subparagraph
 division (a), up to $106,874 not less than $213,748 shall
 be distributed to the Polk county medical society for
 continuation of the safety net provider patient access to a
 specialty health care initiative as described in 2007 Iowa
 Acts, chapter 218, section 109.
    (c)  For distribution to safety net partners in the state
 that work to serve as a resource for credible, accurate
 information on health care=related needs and services
 for vulnerable populations in the state including the
 Iowa association of rural health clinics for necessary
 infrastructure and service delivery transformation and the
 Iowa primary care association to support partner engagement,
 program management, and statewide coordination of the network:
 .................................................. $     92,642
                                                         185,285
    (2)  The amount allocated under this paragraph "g" shall
 not be reduced for administrative or other costs prior to
 distribution. The Iowa collaborative safety net provider
 network may continue to distribute funds allocated pursuant
 to this paragraph "g" through existing contracts or renewal
 of existing contracts.
    (3)  For each goal of the Iowa collaborative safety net
 provider network, the Iowa primary care association shall
 submit a progress report to the individuals designated in this
 Act for submission of reports by December 15, 2016, including
 progress in developing and implementing the network, how the
 funds were distributed and used in developing and implementing
 the network, and the remaining needs identified to fully
 develop and implement the network.
    h.  Of the funds appropriated in this subsection, $106,700
  $213,400 shall be used for continuation of the work of the
 direct care worker advisory council established pursuant to
 2008 Iowa Acts, chapter 1188, section 69, in implementing
 the recommendations in the final report submitted by the
 advisory council to the governor and the general assembly in
 March 2012, including by  continuing to develop, promote, and
 make available on a statewide basis the prepare=to=care core
 curriculum and its associated modules and specialties through
 various formats including online access, community colleges,
 and other venues; exploring new and maintaining existing
 specialties including but not limited to oral health and
 dementia care; supporting instructor training; and assessing
 and making recommendations concerning the Iowa care book and
 information technology systems and infrastructure uses and
 needs.
    i.  (1)  Of the funds appropriated in this subsection,
 $108,187 $216,375 shall be used for allocation to allocated
 for continuation of the contract with an independent statewide
 direct care worker organization previously selected through a
 request for proposals process.  The contract shall continue to
  include performance and outcomes measures, and shall continue
 to allow the contractor to use a portion of the funds received
 under the contract to collect data to determine results based
 on the performance and outcomes measures.
    (2)  Of the funds appropriated in this subsection, $37,500
  $75,000 shall be used to provide scholarships or other
 forms of subsidization for direct care worker educational
 conferences, training, or outreach activities.
    j.  Of the funds appropriated in this subsection, the
 department may use up to $29,087 $58,175 for up to one
 full=time equivalent position to administer the volunteer
 health care provider program pursuant to section 135.24.
    k.  Of the funds appropriated in this subsection, $50,000
  $100,000 shall be used for a matching dental education loan
 repayment program to be allocated to a dental nonprofit health
 service corporation to continue to develop the criteria and
 implement the loan repayment program.
    l.  Of the funds appropriated in this subsection, $52,911
  $105,823 is transferred to the college student aid commission
 for deposit in the rural Iowa primary care trust fund created
 in section 261.113 to be used for the purposes of the fund.
    m.  Of the funds appropriated in this subsection, $125,000
  $250,000 shall be used for the purposes of the Iowa donor
 registry as specified in section 142C.18.
    n.  Of the funds appropriated in this subsection, $50,000
  $100,000 shall be used for continuation of a grant to a
 nationally affiliated volunteer eye organization that has an
 established program for children and adults and that is solely
 dedicated to preserving sight and preventing blindness through
 education, nationally certified vision screening and training,
 and community and patient service programs. The organization
 shall submit a report to the individuals identified in this
 Act for submission of reports regarding the use of funds
 allocated under this paragraph "n".  The report shall include
 the objectives and results for the program year including
 the target population and how the funds allocated assisted
 the program in meeting the objectives; the number, age, and
 location within the state of individuals served; the type of
 services provided to the individuals served; the distribution
 of funds based on services provided; and the continuing needs
 of the program.
    o.  Of the funds appropriated in this subsection,
 $1,000,000 $2,000,000 shall be deposited in the medical
 residency training account created in section 135.175,
 subsection 5, paragraph "a", and is appropriated from the
 account to the department of public health to be used for the
 purposes of the medical residency training state matching
 grants program as specified in section 135.176. However,
 notwithstanding any provision to the contrary in section
 135.176, priority in the awarding of grants for the fiscal
 year beginning July 1, 2016, shall be given to sponsors
 approved but not funded in the prior fiscal year competitive
 procurement process that proposed preference in the use of
 the grant funds for internal medicine positions, and priority
 in the awarding of the remaining moneys shall be given to
 sponsors that propose preference in the use of the grant
 funds for psychiatric residency positions and family practice
 residency positions.
    p.  Of the funds appropriated in this subsection, $78,309
  $156,619 is allocated to the university of Iowa hospitals and
 clinics to continue a systematic and evidence=based practice
 collaborative care model to improve outcomes of mental health
 treatment in primary care settings in the state.  Funds shall
 be used to establish the collaborative care model in several
 primary care practices in rural and urban areas throughout the
 state, to provide staffing to administer the model, and to
 provide staff training and database management to track and
 manage patient outcomes.
    q.  Of the funds appropriated in this subsection, $100,000
 shall be used by the department of public health to develop
 recommendations to be submitted in a report by December 15,
 2016, as otherwise described in this division of this Act,
 including those for a broader, more systematic and strategic
 workforce initiative, which may include a comprehensive
 study of workforce program needs and the establishment of an
 advisory workgroup.
    5.  HEALTHY AGING
    To provide public health services that reduce risks and
 invest in promoting and protecting good health over the
 course of a lifetime with a priority given to older Iowans and
 vulnerable populations:
 .................................................. $  3,648,571
                                                       7,297,142
    6.  INFECTIOUS DISEASES
    For reducing the incidence and prevalence of communicable
 diseases, and for not more than the following full=time
 equivalent positions:
 .................................................. $    667,577
                                                       1,335,155
 ............................................... FTEs       4.00
    7.  PUBLIC PROTECTION
    For protecting the health and safety of the public through
 establishing standards and enforcing regulations, and for not
 more than the following full=time equivalent positions:
 .................................................. $  2,169,595
                                                       4,399,191
 ............................................... FTEs     136.00
                                                          137.00
    a.  Of the funds appropriated in this subsection, not more
 than $227,350 $454,700 shall be credited to the emergency
 medical services fund created in section 135.25. Moneys in
 the emergency medical services fund are appropriated to the
 department to be used for the purposes of the fund.
    b.  Of the funds appropriated in this subsection, $101,516
  $203,032 shall be used for sexual violence prevention
 programming through a statewide organization representing
 programs serving victims of sexual violence through the
 department's sexual violence prevention program. The amount
 allocated in this paragraph "b" shall not be used to supplant
 funding administered for other sexual violence prevention or
 victims assistance programs.
    c.  Of the funds appropriated in this subsection, $299,375
  $598,751 shall be used for the state poison control center.
 Pursuant to the directive under 2014 Iowa Acts, chapter 1140,
 section 102, the federal matching funds available to the
 state poison control center from the department of human
 services under the federal Children's Health Insurance Program
 Reauthorization Act allotment shall be subject to the federal
 administrative cap rule of 10 percent applicable to funding
 provided under Tit. XXI of the federal Social Security Act and
 included within the department's calculations of the cap.
    d.  Of the funds appropriated in this subsection,
 $268,875 $537,750 shall be used for childhood lead poisoning
 provisions.
    8.  RESOURCE MANAGEMENT
    For establishing and sustaining the overall ability of the
 department to deliver services to the public, and for not more
 than the following full=time equivalent positions:
 .................................................. $    427,536
                                                       1,005,072
 ............................................... FTEs       4.00
    9.  MISCELLANEOUS PROVISIONS
    a.  The university of Iowa hospitals and clinics under
 the control of the state board of regents shall not receive
 indirect costs from the funds appropriated in this section.
 The university of Iowa hospitals and clinics billings to the
 department shall be on at least a quarterly basis.
    b.  The department of public health shall conduct a sampling
 of the entities to which appropriated funds are allocated,
 granted, or otherwise distributed under this section and
 shall require such entities to submit a progress report to the
 department by September 1, 2016, which includes the objectives
 and results of the program since the initial receipt of state
 funding and how the funds are assisting the program in meeting
 the objectives, specifying the target population served and
 the type of services provided, and identifying the continuing
 needs of the recipient entity and the service population. The
 department shall review the information reported and shall
 make recommendations to the governor and the general assembly
 by December 15, 2016, to realign, bundle, or otherwise
 redistribute funding to meet the needs identified and improve
 services during the subsequent fiscal year.
    c.  The department of public health shall submit a report
 to the individuals identified in this Act for submission
 of reports by December 15, 2016, regarding a proposal
 for realigning, bundling, redistributing, or otherwise
 adjusting the department's funding streams to reflect the
 department's priorities and goals and to provide increased
 flexibility in the distribution of funding to meet these
 priorities and goals.  The proposal shall specifically include
 recommendations for a broader, more systematic and strategic
 workforce initiative which may include a comprehensive
 study of workforce program needs and the establishment of an
 advisory workgroup.  The proposal shall also specifically
 include strategies, developed in collaboration with the
 department of education, to encourage elementary and secondary
 education students to pursue careers in the fields of health
 and health care.
                           DIVISION IV
         DEPARTMENT OF VETERANS AFFAIRS ==== FY 2016=2017
    Sec. 4.  2015 Iowa Acts, chapter 137, section 124, is
 amended to read as follows:
    SEC. 124.  DEPARTMENT OF VETERANS AFFAIRS.  There is
 appropriated from the general fund of the state to the
 department of veterans affairs for the fiscal year beginning
 July 1, 2016, and ending June 30, 2017, the following amounts,
 or so much thereof as is necessary, to be used for the
 purposes designated:
    1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
    For salaries, support, maintenance, and miscellaneous
 purposes, and for not more than the following full=time
 equivalent positions:
 .................................................. $    600,273
                                                       1,200,546
 ............................................... FTEs      15.00
    2.  IOWA VETERANS HOME
    For salaries, support, maintenance, and miscellaneous
 purposes:
 .................................................. $  3,797,498
                                                       7,594,996
    a.  The Iowa veterans home billings involving the
 department of human services shall be submitted to the
 department on at least a monthly basis.
    c.  Within available resources and in conformance with
 associated state and federal program eligibility requirements,
 the Iowa veterans home may implement measures to provide
 financial assistance to or on behalf of veterans or their
 spouses who are participating in the community reentry
 program.
    e.  The Iowa veterans home shall expand the annual discharge
 report to also include applicant information and to provide
 for the collection of demographic information including
 but not limited to the number of individuals applying for
 admission and admitted or denied admittance and the basis for
 the admission or denial; the age, gender, and race of such
 individuals; and the level of care for which such individuals
 applied for admission including residential or nursing level
 of care.
    3.  HOME OWNERSHIP ASSISTANCE PROGRAM
    For transfer to the Iowa finance authority for the
 continuation of the home ownership assistance program for
 persons who are or were eligible members of the armed forces
 of the United States, pursuant to section 16.54:
 .................................................. $  1,250,000
                                                       2,500,000
    Sec. 5.  2015 Iowa Acts, chapter 137, section 125, is
 amended to read as follows:
    SEC. 125.  LIMITATION OF COUNTY COMMISSIONS OF VETERAN
 AFFAIRS FUND STANDING APPROPRIATIONS.  Notwithstanding the
 standing appropriation in section 35A.16 for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the amount
 appropriated from the general fund of the state pursuant to
 that section for the following designated purposes shall not
 exceed the following amount:
    For the county commissions of veteran affairs fund under
 section 35A.16:
 .................................................. $    495,000
                                                         990,000
                           DIVISION V
          DEPARTMENT OF HUMAN SERVICES ==== FY 2016=2017
    Sec. 6.  2015 Iowa Acts, chapter 137, section 126, is
 amended to read as follows:
    SEC. 126.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
 GRANT.  There is appropriated from the fund created in section
 8.41 to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, from moneys
 received under the federal temporary assistance for needy
 families (TANF) block grant pursuant to the federal Personal
 Responsibility and Work Opportunity Reconciliation Act of
 1996, Pub. L. No. 104=193, and successor legislation, the
 following amounts, or so much thereof as is necessary, to be
 used for the purposes designated:
    1.  To be credited to the family investment program account
 and used for assistance under the family investment program
 under chapter 239B:
 .................................................. $  2,568,497
                                                       5,112,462
    2.  To be credited to the family investment program account
 and used for the job opportunities and basic skills (JOBS)
 program and implementing family investment agreements in
 accordance with chapter 239B:
 .................................................. $  5,069,089
                                                       5,575,693
    3.  To be used for the family development and
 self=sufficiency grant program in accordance with section
 216A.107:
 .................................................. $  1,449,490
                                                       2,898,980
    Notwithstanding section 8.33, moneys appropriated in this
 subsection that remain unencumbered or unobligated at the
 close of the fiscal year shall not revert but shall remain
 available for expenditure for the purposes designated until
 the close of the succeeding fiscal year. However, unless such
 moneys are encumbered or obligated on or before September 30,
 2016 2017, the moneys shall revert.
    4.  For field operations:
 .................................................. $ 15,648,116
                                                      35,774,331
    5.  For general administration:
 .................................................. $  1,872,000
                                                       3,744,000
    6.  For state child care assistance:
 .................................................. $ 17,523,555
                                                      46,866,826
    a.  Of the funds appropriated in this subsection,
 $13,164,048 $26,328,097 is transferred to the child care and
 development block grant appropriation made by the Eighty=sixth
 General Assembly, 2016 Session, for the federal fiscal year
 beginning October 1, 2016, and ending September 30, 2017. Of
 this amount, $100,000 $200,000 shall be used for provision
 of educational opportunities to registered child care home
 providers in order to improve services and programs offered
 by this category of providers and to increase the number of
 providers. The department may contract with institutions
 of higher education or child care resource and referral
 centers to provide the educational opportunities. Allowable
 administrative costs under the contracts shall not exceed 5
 percent. The application for a grant shall not exceed two
 pages in length.
    b.  Any funds appropriated in this subsection remaining
 unallocated shall be used for state child care assistance
 payments for families who are employed including but not
 limited to individuals enrolled in the family investment
 program.
    7.  For distribution to counties and regions through the
 property tax relief fund for mental health and disability
 services as provided in an appropriation made for this
 purpose:
 .................................................. $  2,447,026
    8.  For child and family services:
 .................................................. $ 16,042,215
                                                      37,256,580
    9.  For child abuse prevention grants:
 .................................................. $     62,500
                                                         125,000
    10.  For pregnancy prevention grants on the condition that
 family planning services are funded:
 .................................................. $    965,033
                                                       1,930,067
    Pregnancy prevention grants shall be awarded to programs
 in existence on or before July 1, 2016, if the programs have
 demonstrated positive  outcomes.  Grants shall be awarded to
 pregnancy prevention  programs which are developed after July
 1, 2016, if the  programs are based on existing  models that
 have demonstrated positive outcomes.  Grants shall  comply with
 the requirements provided in 1997 Iowa Acts,  chapter 208,
 section 14, subsections 1 and 2, including the  requirement
 that grant programs must emphasize sexual  abstinence.
 Priority in the awarding of grants shall be given  to programs
 that serve areas of the state which demonstrate  the highest
 percentage of unplanned pregnancies of females of  childbearing
 age within the geographic area to be served by  the grant.
    11.  For technology needs and other resources necessary
 to meet federal welfare reform reporting, tracking, and case
 management requirements:
 .................................................. $    518,593
                                                       1,037,186
    12.  For the family investment program share of the costs to
 continue to develop and maintain a new, integrated eligibility
 determination system:
 .................................................. $  3,327,440
                                                       5,654,880
    13.  a.  Notwithstanding any provision to the contrary,
 including but not limited to requirements in section 8.41 or
 provisions in 2015 or 2016 Iowa Acts regarding the receipt
 and appropriation of federal block grants, federal funds
 from the temporary assistance for needy families block grant
 received by the state and not otherwise appropriated in this
 section and remaining available for the fiscal year beginning
 July 1, 2016, are appropriated to the department of human
 services to the extent as may be necessary to be used in the
 following priority order:  the family investment program, for
 state child care assistance program payments for families who
 are employed, and for the family investment program share of
 costs to develop and maintain a new, integrated eligibility
 determination system. The federal funds appropriated in this
 paragraph "a" shall be expended only after all other funds
 appropriated in subsection 1 for the assistance under the
 family investment program, in subsection 6 for child care
 assistance, or in subsection 12 for the family investment
 program share of the costs to continue to develop and maintain
 a new, integrated eligibility determination system, as
 applicable, have been expended. For the purposes of this
 subsection, the funds appropriated in subsection 6, paragraph
 "a", for transfer to the child care and development block
 grant appropriation are considered fully expended when the
 full amount has been transferred.
    b.  The department shall, on a quarterly basis, advise the
 legislative services agency and department of management of
 the amount of funds appropriated in this subsection that was
 expended in the prior quarter.
    14.  Of the amounts appropriated in this section,
 $6,481,004 $12,962,008 for the fiscal year beginning July
 1, 2016, is transferred to the appropriation of the federal
 social services block grant made to the department of human
 services for that fiscal year.
    15.  For continuation of the program providing categorical
 eligibility for the food assistance program as specified for
 the program in the section of this division of this 2016 Act
 relating to the family investment program account:
 .................................................. $     12,500
                                                          25,000
    16.  The department may transfer funds allocated in this
 section to the appropriations made in this division of this
 Act for the same fiscal year for general administration and
 field operations for resources necessary to implement and
 operate the services referred to in this section and those
 funded in the appropriation made in this division of this Act
 for the same fiscal year for the family investment program
 from the general fund of the state.
    Sec. 7.  2015 Iowa Acts, chapter 137, section 127, is
 amended to read as follows:
    SEC. 127.  FAMILY INVESTMENT PROGRAM ACCOUNT.
    1.  Moneys credited to the family investment program
 (FIP) account for the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, shall be used to provide assistance in
 accordance with chapter 239B.
    2.  The department may use a portion of the moneys credited
 to the FIP account under this section as necessary for
 salaries, support, maintenance, and miscellaneous purposes.
    3.  The department may transfer funds allocated in
 subsection 4 to the appropriations made in this division of
 this Act for the same fiscal year for general administration
 and field operations for resources necessary to implement and
 operate the family investment program services referred to in
 this section and those funded in the appropriation made in
 this division of this Act for the same fiscal year for the
 family investment program from the general fund of the state.
    4.  Moneys appropriated in this division of this Act and
 credited to the FIP account for the fiscal year beginning July
 1, 2016, and ending June 30, 2017, are allocated as follows:
    a.  To be retained by the department of human services to be
 used for coordinating with the department of human rights to
 more effectively serve participants in FIP and other shared
 clients and to meet federal reporting requirements under the
 federal temporary assistance for needy families block grant:
 .................................................. $     10,000
                                                          20,000
    b.  To the department of human rights for staffing,
 administration, and implementation of the family development
 and self=sufficiency grant program in accordance with section
 216A.107:
 .................................................. $  3,096,417
                                                       6,192,834
    (1)  Of the funds allocated for the family development
 and self=sufficiency grant program in this paragraph "b",
 not more than 5 percent of the funds shall be used for the
 administration of the grant program.
    (2)  The department of human rights may continue to
 implement the family development and self=sufficiency grant
 program statewide during fiscal year 2016=2017.
    (3)  The department of human rights may engage in activities
 to strengthen and improve family outcomes measures and
 data collection systems under the family development and
 self=sufficiency grant program.
    c.  For the diversion subaccount of the FIP account:
 .................................................. $    407,500
                                                         815,000
    A portion of the moneys allocated for the subaccount may
 be used for field operations, salaries, data management
 system development, and implementation costs and support
 deemed necessary by the director of human services in order
 to administer the FIP diversion program. To the extent
 moneys allocated in this paragraph "c" are not deemed by the
 department to be necessary to support diversion activities,
 such moneys may be used for other efforts intended to increase
 engagement by family investment program participants in work,
 education, or training activities.
    d.  For the food assistance employment and training
 program:
 .................................................. $     33,294
                                                          66,588
    (1)  The department shall apply the federal supplemental
 nutrition assistance program (SNAP) employment and training
 state plan in order to maximize to the fullest extent
 permitted by federal law the use of the 50 percent federal
 reimbursement provisions for the claiming of allowable federal
 reimbursement funds from the United States department of
 agriculture pursuant to the federal SNAP employment and
 training program for providing education, employment, and
 training services for eligible food assistance program
 participants, including but not limited to related dependent
 care and transportation expenses.
    (2)  The department shall continue the categorical federal
 food assistance program eligibility at 160 percent of the
 federal poverty level and continue to eliminate the asset test
 from eligibility requirements, consistent with federal food
 assistance program requirements. The department shall include
 as many food assistance households as is allowed by federal
 law. The eligibility provisions shall conform to all federal
 requirements including requirements addressing individuals who
 are incarcerated or otherwise ineligible.
    e.  For the JOBS program:
 .................................................. $  8,770,199
                                                      16,129,101
    5.  Of the child support collections assigned under FIP,
 an amount equal to the federal share of support collections
 shall be credited to the child support recovery appropriation
 made in this division of this Act. Of the remainder of the
 assigned child support collections received by the child
 support recovery unit, a portion shall be credited to the FIP
 account, a portion may be used to increase recoveries, and a
 portion may be used to sustain cash flow in the child support
 payments account. If as a consequence of the appropriations
 and allocations made in this section the resulting amounts
 are insufficient to sustain cash assistance payments and meet
 federal maintenance of effort requirements, the department
 shall seek supplemental funding. If child support collections
 assigned under FIP are greater than estimated or are otherwise
 determined not to be required for maintenance of effort, the
 state share of either amount may be transferred to or retained
 in the child support payments account.
    6.  The department may adopt emergency rules for the family
 investment, JOBS, food assistance, and medical assistance
 programs if necessary to comply with federal requirements.
    Sec. 8.  2015 Iowa Acts, chapter 137, section 128, is
 amended to read as follows:
    SEC. 128.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There
 is appropriated from the general fund of the state to the
 department of human services for the fiscal year beginning
 July 1, 2016, and ending June 30, 2017, the following amount,
 or so much thereof as is necessary, to be used for the purpose
 designated:
    To be credited to the family investment program (FIP)
 account and used for family investment program assistance
 under chapter 239B:
 .................................................. $ 24,336,937
                                                      48,673,875
    1.  Of the funds appropriated in this section, $3,701,110
  $10,553,408 is allocated for the JOBS program.
    2.  Of the funds appropriated in this section, $1,656,927
  $3,313,854 is allocated for the family development and
 self=sufficiency grant program.
    3.  Notwithstanding section 8.39, for the fiscal year
 beginning July 1, 2016, if necessary to meet federal
 maintenance of effort requirements; or to transfer federal
 temporary assistance for needy families block grant funding
 to be used for purposes of the federal social services block
 grant; or to meet cash flow needs resulting from delays in
 receiving federal funding; or to implement, in accordance with
 this division of this Act, activities currently funded with
 juvenile court services, county, or community moneys and state
 moneys used in combination with such moneys; to comply with
 federal requirements; or to maximize the use of federal funds,
 the department of human services may transfer funds within
 or between any of the appropriations made in this division
 of this Act and appropriations in law for the federal social
 services block grant to the department for the following
 purposes, provided that the combined amount of state and
 federal temporary assistance for needy families block grant
 funding for each appropriation remains the same before and
 after the transfer:
    a.  For the family investment program.
    b.  For child care assistance.
    c.  For child and family services.
    d.  For field operations.
    e.  For general administration.
    f.  For distribution to counties or regions through the
 property tax relief fund for mental health and disability
 services as provided in an appropriation for this purpose.
    This subsection shall not be construed to prohibit the use
 of existing state transfer authority for other purposes. The
 department shall report any transfers made pursuant to this
 subsection to the legislative services agency.
    4.  Of the funds appropriated in this section, $97,839
  $195,678 shall be used for continuation of a grant to an
 Iowa=based nonprofit organization with a history of providing
 tax preparation assistance to low=income Iowans in order to
 expand the usage of the earned income tax credit. The purpose
 of the grant is to supply this assistance to underserved areas
 of the state.
    5.  Of the funds appropriated in this section, $30,000
  $60,000 shall be used for the continuation of an unfunded
 pilot project, as defined in 441 IAC 100.1, relating to
 parental obligations, in which the child support recovery
 unit participates, to support the efforts of a nonprofit
 organization committed to strengthening the community through
 youth development, healthy living, and social responsibility
 headquartered in a county with a population over 350,000.
 The funds allocated in this subsection shall be used by
 the recipient organization to develop a larger community
 effort, through public and private partnerships, to support
 a broad=based multi=county fatherhood initiative that
 promotes payment of child support obligations, improved family
 relationships, and full=time employment.
    6.  The department may transfer funds appropriated in
 this section to the appropriations made in this division of
 this Act for general administration and field operations as
 necessary to administer this section and the overall family
 investment program.
    Sec. 9.  2015 Iowa Acts, chapter 137, section 129, is
 amended to read as follows:
    SEC. 129.  CHILD SUPPORT RECOVERY.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, the following amount, or so much thereof
 as is necessary, to be used for the purposes designated:
    For child support recovery, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $  7,331,686
                                                      14,663,373
 ............................................... FTEs     464.00
    1.  The department shall expend up to $12,164 $24,329,
 including federal financial participation, for the fiscal year
 beginning July 1, 2016, for a child support public awareness
 campaign. The department and the office of the attorney
 general shall cooperate in continuation of the campaign. The
 public awareness campaign shall emphasize, through a variety
 of media activities, the importance of maximum involvement of
 both parents in the lives of their children as well as the
 importance of payment of child support obligations.
    2.  Federal access and visitation grant moneys shall be
 issued directly to private not=for=profit agencies that
 provide services designed to increase compliance with the
 child access provisions of court orders, including but not
 limited to neutral visitation sites and mediation services.
    3.  The appropriation made to the department for child
 support recovery may be used throughout the fiscal year in the
 manner necessary for purposes of cash flow management, and for
 cash flow management purposes the department may temporarily
 draw more than the amount appropriated, provided the amount
 appropriated is not exceeded at the close of the fiscal year.
    4.  With the exception of the funding amount specified,
 the requirements established under 2001 Iowa Acts, chapter
 191, section 3, subsection 5, paragraph "c", subparagraph (3),
 shall be applicable to parental obligation pilot projects
 for the fiscal year beginning July 1, 2016, and ending June
 30, 2017. Notwithstanding 441 IAC 100.8, providing for
 termination of rules relating to the pilot projects, the rules
 shall remain in effect until June 30, 2017.
    Sec. 10.  2015 Iowa Acts, chapter 137, section 132, is
 amended to read as follows:
    SEC. 132.  MEDICAL ASSISTANCE.  There is appropriated from
 the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, the following amount, or so much thereof
 as is necessary, to be used for the purpose designated:
    For medical assistance program reimbursement and
 associated costs as specifically provided in the reimbursement
 methodologies in effect on June 30, 2016, except as otherwise
 expressly authorized by law, consistent with options under
 federal law and regulations, and contingent upon receipt of
 approval from the office of the governor of reimbursement for
 each abortion performed under the program:
 .................................................. $651,595,782
                                                     1,318,246,446
    1.  Iowans support reducing the number of abortions
 performed in our state.  Funds appropriated under this section
 shall not be used for abortions, unless otherwise authorized
 under this section.
    2.  The provisions of this section relating to abortions
 shall also apply to the Iowa health and wellness plan created
 pursuant to chapter 249N.
    3.  The department shall utilize not more than $30,000
  $60,000 of the funds appropriated in this section to continue
 the AIDS/HIV health insurance premium payment program as
 established in 1992 Iowa Acts, Second Extraordinary Session,
 chapter 1001, section 409, subsection 6. Of the funds
 allocated in this subsection, not more than $2,500 $5,000 may
 be expended for administrative purposes.
    4.  Of the funds appropriated in this Act to the
 department of public health for addictive disorders,
 $475,000 $950,000 for the fiscal year beginning July 1,
 2016, is transferred to the department of human services
 for an integrated substance=related disorder managed care
 system. The department shall not assume management of the
 substance=related disorder system in place of the managed care
 contractor unless such a change in approach is specifically
 authorized in law. The departments of human services and
 public health shall work together to maintain the level
 of mental health and substance=related disorder treatment
 services provided by the managed care contractor through the
 Iowa plan for behavioral health contractors. Each department
 shall take the steps necessary to continue the federal waivers
 as necessary to maintain the level of services.
    5.  a.  The department shall aggressively pursue options
 for providing medical assistance or other assistance to
 individuals with special needs who become ineligible to
 continue receiving services under the early and periodic
 screening, diagnostic, and treatment program under the
 medical assistance program due to becoming 21 years of age
 who have been approved for additional assistance through the
 department's exception to policy provisions, but who have
 health care needs in excess of the funding available through
 the exception to policy provisions.
    b.  Of the funds appropriated in this section, $50,000
  $100,000 shall be used for participation in one or more
 pilot projects operated by a private provider to allow the
 individual or individuals to receive service in the community
 in accordance with principles established in Olmstead v.
 L.C., 527 U.S. 581 (1999), for the purpose of providing
 medical assistance or other assistance to individuals with
 special needs who become ineligible to continue receiving
 services under the early and periodic screening, diagnostic,
 and treatment program under the medical assistance program
 due to becoming 21 years of age who have been approved for
 additional assistance through the department's exception to
 policy provisions, but who have health care needs in excess
 of the funding available through the exception to the policy
 provisions.
    6.  Of the funds appropriated in this section, up to
 $1,525,041 $3,050,082 may be transferred to the field
 operations or general administration appropriations in this
 division of this Act for operational costs associated with
 Part D of the federal Medicare Prescription Drug Improvement
 and Modernization Act of 2003, Pub. L. No. 108=173.
    7.  Of the funds appropriated in this section, up to
 $221,050 $442,100 may be transferred to the appropriation in
 this division of this Act for medical contracts to be used
 for clinical assessment services and prior authorization of
 services.
    8.  A portion of the funds appropriated in this section
 may be transferred to the appropriations in this division of
 this Act for general administration, medical contracts, the
 children's health insurance program, or field operations to
 be used for the state match cost to comply with the payment
 error rate measurement (PERM) program for both the medical
 assistance and children's health insurance programs as
 developed by the centers for Medicare and Medicaid services
 of the United States department of health and human services
 to comply with the federal Improper Payments Information Act
 of 2002, Pub. L. No. 107=300.
    9.  The department shall continue to implement the
 recommendations of the assuring better child health and
 development initiative II (ABCDII) clinical panel to the
 Iowa early and periodic screening, diagnostic, and treatment
 services healthy mental development collaborative board
 regarding changes to billing procedures, codes, and eligible
 service providers.
    10.  Of the funds appropriated in this section, a sufficient
 amount is allocated to supplement the incomes of residents of
 nursing facilities, intermediate care facilities for persons
 with mental illness, and intermediate care facilities for
 persons with an intellectual disability, with incomes of
 less than $50 in the amount necessary for the residents to
 receive a personal needs allowance of $50 per month pursuant
 to section 249A.30A.
    11.  Of the funds appropriated in this section, the
 following amounts are transferred to the appropriations made
 in this division of this Act for the state mental health
 institutes:
    a.  Cherokee mental health institute   $  4,549,212
    b.  Independence mental health institute   $  4,522,947
    12.  a.  Of the funds appropriated in this section,
 $2,041,939 $3,000,000 is allocated for the state match for
 a disproportionate share hospital payment of $4,544,712
  $6,861,848 to hospitals that meet both of the conditions
 specified in subparagraphs (1) and (2). In addition, the
 hospitals that meet the conditions specified shall either
 certify public expenditures or transfer to the medical
 assistance program an amount equal to provide the nonfederal
 share for a disproportionate share hospital payment of
 $8,772,003 $19,771,582. The hospitals that meet the
 conditions specified shall receive and retain 100 percent
 of the total disproportionate share hospital payment of
 $13,316,715 $26,633,430.
    (1)  The hospital qualifies for disproportionate share and
 graduate medical education payments.
    (2)  The hospital is an Iowa state=owned hospital with more
 than 500 beds and eight or more distinct residency specialty
 or subspecialty programs recognized by the American college
 of graduate medical education.
    b.  Distribution of the disproportionate share payments
 shall be made on a monthly basis. The total amount of
 disproportionate share payments including graduate medical
 education, enhanced disproportionate share, and Iowa
 state=owned teaching hospital payments shall not exceed the
 amount of the state's allotment under Pub. L. No. 102=234.
 In addition, the total amount of all disproportionate
 share payments shall not exceed the hospital=specific
 disproportionate share limits under Pub. L. No. 103=66.
    c.  The university of Iowa hospitals and clinics shall
 either certify public expenditures or transfer to the
 appropriations made in this division of this Act for medical
 assistance an amount equal to provide the nonfederal share
 for increased medical assistance payments for inpatient and
 outpatient hospital services of $4,950,000 $9,900,000. The
 university of Iowa hospitals and clinics shall receive and
 retain 100 percent of the total increase in medical assistance
 payments.
    d.  Payment methodologies utilized for disproportionate
 share hospitals and graduate medical education, and other
 supplemental payments under the Medicaid program may be
 adjusted or converted to other methodologies or payment types
 to provide these payments through Medicaid managed care after
 April 1, 2016.  The department of human services shall obtain
 approval from the centers for Medicare and Medicaid services
 of the United States department of health and human services
 prior to implementation of any such adjusted or converted
 methodologies or payment types.
    13.  One hundred percent of the nonfederal share of payments
 to area education agencies that are medical assistance
 providers for medical assistance=covered services provided to
 medical assistance=covered children, shall be made from the
 appropriation made in this section.
    14.  Any new or renewed contract entered into by the
 department with a third party to administer services under the
 medical assistance program shall provide that any interest
 earned on payments from the state during the state fiscal year
 shall be remitted to the department and treated as recoveries
 to offset the costs of the medical assistance program.
    15.  A portion of the funds appropriated in this section
 may be transferred to the appropriation in this division of
 this Act for medical contracts to be used for administrative
 activities associated with the money follows the person
 demonstration project.
    16.  Of the funds appropriated in this section, $174,505
  $349,011 shall be used for the administration of the health
 insurance premium payment program, including salaries,
 support, maintenance, and miscellaneous purposes.
    17.  a.  The department may increase the amounts allocated
 for salaries, support, maintenance, and miscellaneous purposes
 associated with the medical assistance program, as necessary,
 to implement cost containment strategies.  The department
 shall report any such increase to the legislative services
 agency and the department of management.
    b.  If the savings to the medical assistance program
 from cost containment efforts exceed the cost for the
 fiscal year beginning July 1, 2016, the department may
 transfer any savings generated for the fiscal year due to
 medical assistance program cost containment efforts to the
 appropriation made in this division of this Act for medical
 contracts or general administration to defray the increased
 contract costs associated with implementing such efforts.
    18.  For the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, the replacement generation tax revenues
 required to be deposited in the property tax relief fund
 pursuant to section 437A.8, subsection 4, paragraph "d", and
 section 437A.15, subsection 3, paragraph "f", shall instead
 be credited to and supplement the appropriation made in this
 section and used for the allocations made in this section.
    19.  The department shall continue to administer the state
 balancing incentive payments program as specified in 2012 Iowa
 Acts, chapter 1133, section 14.
    20.  a.  Of the funds appropriated in this section, up
 to $25,000 $50,000 may be transferred by the department to
 the appropriation made in this division of this Act to the
 department for the same fiscal year for general administration
 to be used for associated administrative expenses and for not
 more than one full=time equivalent position, in addition to
 those authorized for the same fiscal year, to be assigned to
 implementing the children's mental health home project.
    b.  Of the funds appropriated in this section, up to
 $200,000 $400,000 may be transferred by the department to the
 appropriation made to the department in this division of this
 Act for the same fiscal year for Medicaid program=related
 general administration planning and implementation activities.
 The funds may be used for contracts or for personnel in
 addition to the amounts appropriated for and the positions
 authorized for general administration for the fiscal year.
    c.  Of the funds appropriated in this section, up to
 $1,500,000 $3,000,000 may be transferred by the department
 to the appropriations made in this division of this Act
 for the same fiscal year for general administration or
 medical contracts to be used to support the development
 and implementation of standardized assessment tools for
 persons with mental illness, an intellectual disability, a
 developmental disability, or a brain injury.
    21.  Of the funds appropriated in this section, $125,000
  $250,000 shall be used for lodging expenses associated with
 care provided at the university of Iowa hospitals and clinics
 for patients with cancer whose travel distance is 30 miles
 or more and whose income is at or below 200 percent of the
 federal poverty level as defined by the most recently revised
 poverty income guidelines published by the United States
 department of health and human services. The department of
 human services shall establish the maximum number of overnight
 stays and the maximum rate reimbursed for overnight lodging,
 which may be based on the state employee rate established
 by the department of administrative services.  The funds
 allocated in this subsection  shall not be used as nonfederal
 share matching funds.
    23.  The department of human services  shall not implement
 the following cost containment strategies as recommended by
 the governor for the fiscal year beginning July 1, 2016:
    a.  A policy to ensure that reimbursement for Medicare
 Part A and Medicare Part B crossover claims is limited to the
 Medicaid reimbursement rate.
    b.  An adjustment to the reimbursement policy in order
 to end the primary care physician rate increase originally
 authorized by the federal Health Care and Education
 Reconciliation Act of 2010, section 1202, Pub. L. No. 111=152,
 42 U.S.C. {1396a(a)(13)(C) that allows qualified primary care
 physicians to receive the greater of the Medicare rate or
 Medicaid rate for a specified set of codes.
    24.  The department shall report the implementation of
 any cost containment strategies to the individuals specified
 in this division of this Act for submission of reports upon
 implementation.
    25.  The department shall report the implementation of any
 improved processing changes and any related cost reductions
 to the individuals specified in this division of this Act for
 submission of reports upon implementation.
    26.  Of the funds appropriated in this section, $2,000,000
 shall be used to implement reductions in the waiting lists
 of all medical assistance home and community=based services
 waivers.
    27.  The department shall submit a report to the individuals
 identified in this Act for submission of reports, regarding
 the impact of changes in home and community=based services
 waiver supported employment and prevocational services by
 December 15, 2016.
    28.  Any dental benefit manager contracting with the
 department of human services for the dental wellness plan
 on or after July 1, 2016, shall meet the same contract
 requirements. Readiness review of such a dental benefit
 manager shall be based on the criteria applicable to the
 dental wellness plan when implemented on May 1, 2014,
 including but not limited to network adequacy, access to
 services, performance measures, benefit design, and other
 requirements as determined by the department for the dental
 wellness program. Any dental benefit manager that has been
 approved by a readiness review prior to July 1, 2016, shall
 not be required to repeat such review for the department.
    29.  The department of human services shall review the
 fiscal impact and potential benefit to Medicaid recipients of
 including single=tablet regimens or long=acting alternatives
 for the treatment of HIV or acquired immune deficiency
 syndrome on the preferred drug list, as an alternative
 to multi=tablet regimens. The department shall identify
 opportunities to align the cost of single=tablet regimens for
 the treatment of HIV or acquired immune deficiency syndrome
 with the corresponding multi=tablet regimens, and shall pursue
 manufacturer supplemental rebate offers through the sovereign
 states drug consortium supplemental rebate negotiation process
 to determine if any supplemental rebate opportunities are
 available for calendar year 2018.  If such opportunities
 are available, the department shall implement any such
 supplemental rebate offer opportunities beginning in calendar
 year 2018.
    Sec. 11.  2015 Iowa Acts, chapter 137, section 133, is
 amended to read as follows:
    SEC. 133.  MEDICAL CONTRACTS.  There is appropriated from
 the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, the following amount, or so much thereof
 as is necessary, to be used for the purpose designated:
    For medical contracts:
 .................................................. $  9,806,982
                                                      17,045,964
    1.  The department of inspections and appeals shall
 provide all state matching funds for survey and certification
 activities performed by the department of inspections
 and appeals. The department of human services is solely
 responsible for distributing the federal matching funds for
 such activities.
    2.  Of the funds appropriated in this section, $25,000
  $50,000 shall be used for continuation of home and
 community=based services waiver quality assurance programs,
 including the review and streamlining of processes and
 policies related to oversight and quality management to meet
 state and federal requirements.
    3.  Of the amount appropriated in this section, up to
 $100,000 $200,000 may be transferred to the appropriation
 for general administration in this division of this Act
 to be used for additional full=time equivalent positions
 in the development of key health initiatives such as cost
 containment, development and oversight of managed care
 programs, and development of health strategies targeted toward
 improved quality and reduced costs in the Medicaid program.
    4.  Of the funds appropriated in this section, $500,000
  $1,000,000 shall be used for planning and development,
 in cooperation with the department of public health, of a
 phased=in program to provide a dental home for children.
    5.  Of the funds appropriated in this section, $1,000,000
  $2,000,000 shall be credited to the autism support program
 fund created in section 225D.2 to be used for the autism
 support program created in chapter 225D, with the exception of
 the following amounts of this allocation which shall be used
 as follows:
    a.  Of the funds allocated in this subsection, $125,000
  $250,000 shall be deposited in the board=certified behavior
 analyst and board=certified assistant behavior analyst grants
 program fund created in section 135.181, as enacted in this
 Act, to be used for the purposes of the fund.
    b.  Of the funds allocated in this subsection, $12,500
  $25,000 shall be used for the public purpose of continuation
 of a grant to a child welfare services provider headquartered
 in a county with a population between 205,000 and 215,000 in
 the latest certified federal census that provides multiple
 services including but not limited to a psychiatric medical
 institution for children, shelter, residential treatment,
 after school programs, school=based programming, and an
 Asperger's syndrome program, to be used for support services
 for children with autism spectrum disorder and their families.
    c.  Of the funds allocated in this subsection, $12,500
  $25,000 shall be used for the public purpose of continuing a
 grant to a hospital=based provider headquartered in a county
 with a population between 90,000 and 95,000 in the latest
 certified federal census that provides multiple services
 including but not limited to diagnostic, therapeutic, and
 behavioral services to individuals with autism spectrum
 disorder across one's lifespan. The grant recipient shall
 utilize the funds to continue the pilot project to determine
 the necessary support services for children with autism
 spectrum disorder and their families to be included in the
 children's disabilities services system. The grant recipient
 shall submit findings and recommendations based upon the
 results of the pilot project to the individuals specified
 in this division of this Act for submission of reports by
 December 31, 2015 2016.
    Sec. 12.  2015 Iowa Acts, chapter 137, section 134, is
 amended to read as follows:
    SEC. 134.  STATE SUPPLEMENTARY ASSISTANCE.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    For the state supplementary assistance program:
 .................................................. $  6,498,593
                                                      11,611,442
    2.  The department shall increase the personal needs
 allowance for residents of residential care facilities by the
 same percentage and at the same time as federal supplemental
 security income and federal social security benefits are
 increased due to a recognized increase in the cost of living.
 The department may adopt emergency rules to implement this
 subsection.
    3.  If during the fiscal year beginning July 1, 2016,
 the department projects that state supplementary assistance
 expenditures for a calendar year will not meet the federal
 pass=through requirement specified in Tit. XVI of the federal
 Social Security Act, section 1618, as codified in 42 U.S.C.
 {1382g, the department may take actions including but not
 limited to increasing the personal needs allowance for
 residential care facility residents and making programmatic
 adjustments or upward adjustments of the residential care
 facility or in=home health=related care reimbursement rates
 prescribed in this division of this Act to ensure that federal
 requirements are met. In addition, the department may make
 other programmatic and rate adjustments necessary to remain
 within the amount appropriated in this section while ensuring
 compliance with federal requirements. The department may
 adopt emergency rules to implement the provisions of this
 subsection.
    Sec. 13.  2015 Iowa Acts, chapter 137, section 135, is
 amended to read as follows:
    SEC. 135.  CHILDREN'S HEALTH INSURANCE PROGRAM.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    For maintenance of the healthy and well kids in Iowa
 (hawk=i) program pursuant to chapter 514I, including
 supplemental dental services, for receipt of federal financial
 participation under Tit. XXI of the federal Social Security
 Act, which creates the children's health insurance program:
 .................................................. $ 10,206,922
                                                       9,176,652
    2.  Of the funds appropriated in this section, $21,400
  $42,800 is allocated for continuation of the contract for
 outreach with the department of public health.
    Sec. 14.  2015 Iowa Acts, chapter 137, section 136, is
 amended to read as follows:
    SEC. 136.  CHILD CARE ASSISTANCE.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, the following amount, or so much thereof
 as is necessary, to be used for the purpose designated:
    For child care programs:
 .................................................. $ 25,704,334
                                                      36,389,561
    1.  Of the funds appropriated in this section, $21,844,620
  $30,039,561 shall be used for state child care assistance in
 accordance with section 237A.13.
    2.  Nothing in this section shall be construed or is
 intended as or shall imply a grant of entitlement for services
 to persons who are eligible for assistance due to an income
 level consistent with the waiting list requirements of
 section 237A.13. Any state obligation to provide services
 pursuant to this section is limited to the extent of the funds
 appropriated in this section.
    3.  Of the funds appropriated in this section, $216,226
 is allocated for the statewide grant program for child care
 resource and referral services under section 237A.26. A list
 of the registered and licensed child care facilities operating
 in the area served by a child care resource and referral
 service shall be made available to the families receiving
 state child care assistance in that area.
    4.  Of the funds appropriated in this section, $468,487
 is allocated for child care quality improvement initiatives
 including but not limited to the voluntary quality rating
 system in accordance with section 237A.30.
    5.  Of the funds appropriated in this section, $3,175,000
  $6,350,000 shall be credited to the early childhood programs
 grants account in the early childhood Iowa fund created
 in section 256I.11. The moneys shall be distributed for
 funding of community=based early childhood programs targeted
 to children from birth through five years of age developed
 by early childhood Iowa areas in accordance with approved
 community plans as provided in section 256I.8.
    6.  The department may use any of the funds appropriated
 in this section as a match to obtain federal funds for use
 in expanding child care assistance and related programs.
 For the purpose of expenditures of state and federal child
 care funding, funds shall be considered obligated at the
 time expenditures are projected or are allocated to the
 department's service areas. Projections shall be based on
 current and projected caseload growth, current and projected
 provider rates, staffing requirements for eligibility
 determination and management of program requirements
 including data systems management, staffing requirements
 for administration of the program, contractual and grant
 obligations and any transfers to other state agencies, and
 obligations for decategorization or innovation projects.
    7.  A portion of the state match for the federal child care
 and development block grant shall be provided as necessary to
 meet federal matching funds requirements through the state
 general fund appropriation made for child development grants
 and other programs for at=risk children in section 279.51.
    8.  If a uniform reduction ordered by the governor under
 section 8.31 or other operation of law, transfer, or federal
 funding reduction reduces the appropriation made in this
 section for the fiscal year, the percentage reduction in the
 amount paid out to or on behalf of the families participating
 in the state child care assistance program shall be equal
 to or less than the percentage reduction made for any other
 purpose payable from the appropriation made in this section
 and the federal funding relating to it. The percentage
 reduction to the other allocations made in this section shall
 be the same as the uniform reduction ordered by the governor
 or the percentage change of the federal funding reduction, as
 applicable. If there is an unanticipated increase in federal
 funding provided for state child care assistance, the entire
 amount of the increase shall be used for state child care
 assistance payments. If the appropriations made for purposes
 of the state child care assistance program for the fiscal year
 are determined to be insufficient, it is the intent of the
 general assembly to appropriate sufficient funding for the
 fiscal year in order to avoid establishment of waiting list
 requirements.
    9.  Notwithstanding section 8.33, moneys advanced for
 purposes of the programs developed by early childhood Iowa
 areas, advanced for purposes of wraparound child care, or
 received from the federal appropriations made for the purposes
 of this section that remain unencumbered or unobligated at
 the close of the fiscal year shall not revert to any fund
 but shall remain available for expenditure for the purposes
 designated until the close of the succeeding fiscal year.
    Sec. 15.  2015 Iowa Acts, chapter 137, section 137, is
 amended to read as follows:
    SEC. 137.  JUVENILE INSTITUTION.  There is appropriated
 from the general fund of the state to the department of
 human services for the fiscal year beginning July 1, 2016,
 and ending June 30, 2017, the following amounts, or so
 much thereof as is necessary, to be used for the purposes
 designated:
    1.  For operation of the state training school at Eldora
 and for salaries, support, maintenance, and miscellaneous
 purposes, and for not more than the following full=time
 equivalent positions:
 .................................................. $  6,116,710
                                                      12,233,420
 ............................................... FTEs     169.30
                                                          188.30
    Of the funds appropriated in this subsection, $45,575
  $91,150 shall be used for distribution to licensed classroom
 teachers at this and other institutions under the control
 of the department of human services based upon the average
 student yearly enrollment at each institution as determined
 by the department.
    2.  A portion of the moneys appropriated in this section
 shall be used by the state training school at Eldora for
 grants for adolescent pregnancy prevention activities at the
 institution in the fiscal year beginning July 1, 2016.
    Sec. 16.  2015 Iowa Acts, chapter 137, section 138, is
 amended to read as follows:
    SEC. 138.  CHILD AND FAMILY SERVICES.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    For child and family services:
 .................................................. $ 42,670,969
                                                      84,482,419
    2.  Up to $2,600,000 of the amount of federal temporary
 assistance for needy families block grant funding appropriated
 in this division of this Act for child and family services
 shall be made available for purposes of juvenile delinquent
 graduated sanction services.
    3.  The department may transfer funds appropriated in this
 section as necessary to pay the nonfederal costs of services
 reimbursed under the medical assistance program, state child
 care assistance program, or the family investment program
 which are provided to children who would otherwise receive
 services paid under the appropriation in this section. The
 department may transfer funds appropriated in this section
 to the appropriations made in this division of this Act for
 general administration and for field operations for resources
 necessary to implement and operate the services funded in this
 section.
    4.  a.  Of the funds appropriated in this section, up
 to $17,910,893 $35,736,649 is allocated as the statewide
 expenditure target under section 232.143 for group foster care
 maintenance and services. If the department projects that
 such expenditures for the fiscal year will be less than the
 target amount allocated in this paragraph "a", the department
 may reallocate the excess to provide additional funding for
 shelter care or the child welfare emergency services addressed
 with the allocation for shelter care.
    b.  If at any time after September 30, 2016, annualization
 of a service area's current expenditures indicates a service
 area is at risk of exceeding its group foster care expenditure
 target under section 232.143 by more than 5 percent, the
 department and juvenile court services shall examine all
 group foster care placements in that service area in order to
 identify those which might be appropriate for termination.
 In addition, any aftercare services believed to be needed
 for the children whose placements may be terminated shall
 be identified. The department and juvenile court services
 shall initiate action to set dispositional review hearings for
 the placements identified. In such a dispositional review
 hearing, the juvenile court shall determine whether needed
 aftercare services are available and whether termination of
 the placement is in the best interest of the child and the
 community.
    5.  In accordance with the provisions of section 232.188,
 the department shall continue the child welfare and juvenile
 justice funding initiative during fiscal year 2016=2017. Of
 the funds appropriated in this section, $858,876 $1,717,753
  is allocated specifically for expenditure for fiscal year
 2016=2017 through the decategorization services funding pools
 and governance boards established pursuant to section 232.188.
    6.  A portion of the funds appropriated in this section
 may be used for emergency family assistance to provide other
 resources required for a family participating in a family
 preservation or reunification project or successor project to
 stay together or to be reunified.
    7.  Notwithstanding section 234.35 or any other provision
 of law to the contrary, state funding for shelter care and
 the child welfare emergency services contracting implemented
 to provide for or prevent the need for shelter care shall be
 limited to $4,034,237 $8,096,158.
    8.  Federal funds received by the state during the fiscal
 year beginning July 1, 2016, as the result of the expenditure
 of state funds appropriated during a previous state fiscal
 year for a service or activity funded under this section
 are appropriated to the department to be used as additional
 funding for services and purposes provided for under this
 section. Notwithstanding section 8.33, moneys received in
 accordance with this subsection that remain unencumbered or
 unobligated at the close of the fiscal year shall not revert
 to any fund but shall remain available for the purposes
 designated until the close of the succeeding fiscal year.
    9.  a.  Of the funds appropriated in this section, up to
 $1,645,000 $3,290,000 is allocated for the payment of the
 expenses of court=ordered services provided to juveniles
 who are under the supervision of juvenile court services,
 which expenses are a charge upon the state pursuant to
 section 232.141, subsection 4. Of the amount allocated in
 this paragraph "a", up to $778,143 $1,556,287 shall be made
 available to provide school=based supervision of children
 adjudicated under chapter 232, of which not more than $7,500
  $15,000 may be used for the purpose of training. A portion of
 the cost of each school=based liaison officer shall be paid by
 the school district or other funding source as approved by the
 chief juvenile court officer.
    b.  Of the funds appropriated in this section, up to
 $374,492 $748,985 is allocated for the payment of the expenses
 of court=ordered services provided to children who are under
 the supervision of the department, which expenses are a charge
 upon the state pursuant to section 232.141, subsection 4.
    c.  Notwithstanding section 232.141 or any other provision
 of law to the contrary, the amounts allocated in this
 subsection shall be distributed to the judicial districts
 as determined by the state court administrator and to the
 department's service areas as determined by the administrator
 of the department of human services' division of child and
 family services. The state court administrator and the
 division administrator shall make the determination of the
 distribution amounts on or before June 15, 2016.
    d.  Notwithstanding chapter 232 or any other provision of
 law to the contrary, a district or juvenile court shall not
 order any service which is a charge upon the state pursuant
 to section 232.141 if there are insufficient court=ordered
 services funds available in the district court or departmental
 service area distribution amounts to pay for the service. The
 chief juvenile court officer and the departmental service area
 manager shall encourage use of the funds allocated in this
 subsection such that there are sufficient funds to pay for
 all court=related services during the entire year. The chief
 juvenile court officers and departmental service area managers
 shall attempt to anticipate potential surpluses and shortfalls
 in the distribution amounts and shall cooperatively request
 the state court administrator or division administrator to
 transfer funds between the judicial districts' or departmental
 service areas' distribution amounts as prudent.
    e.  Notwithstanding any provision of law to the contrary,
 a district or juvenile court shall not order a county to pay
 for any service provided to a juvenile pursuant to an order
 entered under chapter 232 which is a charge upon the state
 under section 232.141, subsection 4.
    f.  Of the funds allocated in this subsection, not more
 than $41,500 $83,000 may be used by the judicial branch for
 administration of the requirements under this subsection.
    g.  Of the funds allocated in this subsection, $8,500
  $17,000 shall be used by the department of human services to
 support the interstate commission for juveniles in accordance
 with the interstate compact for juveniles as provided in
 section 232.173.
    10.  Of the funds appropriated in this section, $4,026,613
  $13,253,227 is allocated for juvenile delinquent graduated
 sanctions services. Any state funds saved as a result of
 efforts by juvenile court services to earn a federal Tit. IV=E
 match for juvenile court services administration may be used
 for the juvenile delinquent graduated sanctions services.
    11.  Of the funds appropriated in this section, $804,142
  $1,658,285 is transferred to the department of public health
 to be used for the child protection center grant program for
 child protection centers located in Iowa in accordance with
 section 135.118.  The grant amounts under the program shall be
 equalized so that each center receives a uniform base amount
 of $122,500 $245,000, so that $50,000 is awarded to establish
 a satellite child protection center in a city in north central
 Iowa that is the county seat of a county with a population
 between 44,000 and 45,000 according to the 2010 federal
 decennial census, and so that the remaining funds shall be are
  awarded through a funding formula based upon the volume of
 children served.
    12.  If the department receives federal approval to
 implement a waiver under Tit. IV=E of the federal Social
 Security Act to enable providers to serve children who remain
 in the children's families and communities, for purposes of
 eligibility under the medical assistance program through 25
 years of age, children who participate in the waiver shall be
 considered to be placed in foster care.
    13.  Of the funds appropriated in this section, $2,012,583
  $4,025,167 is allocated for the preparation for adult living
 program pursuant to section 234.46.
    14.  Of the funds appropriated in this section, $113,668
  $227,337 shall be used for the public purpose of continuing
 a grant to a nonprofit human services organization providing
 services to individuals and families in multiple locations in
 southwest Iowa and Nebraska for support of a project providing
 immediate, sensitive support and forensic interviews, medical
 exams, needs assessments, and referrals for victims of child
 abuse and their nonoffending family members.
    15.  Of the funds appropriated in this section, $150,310
  $300,620 is allocated for the foster care youth council
 approach of providing a support network to children placed in
 foster care.
    16.  Of the funds appropriated in this section, $101,000
  $202,000 is allocated for use pursuant to section 235A.1 for
 continuation of the initiative to address child sexual abuse
 implemented pursuant to 2007 Iowa Acts, chapter 218, section
 18, subsection 21.
    17.  Of the funds appropriated in this section, $315,120
  $630,240 is allocated for the community partnership for child
 protection sites.
    18.  Of the funds appropriated in this section, $185,625
  $371,250 is allocated for the department's minority youth
 and family projects under the redesign of the child welfare
 system.
    19.  Of the funds appropriated in this section, $593,297
  $1,186,595 is allocated for funding of the community circle of
 care collaboration for children and youth in northeast Iowa.
    20.  Of the funds appropriated in this section, at least
 $73,579 $147,158 shall be used for the continuation of the
 child welfare provider training academy, a collaboration
 between the coalition for family and children's services in
 Iowa and the department.
    21.  Of the funds appropriated in this section, $105,936
  $211,872 shall be used for continuation of the central Iowa
 system of care program grant through June 30, 2017.
    22.  Of the funds appropriated in this section, $117,500
  $235,000 shall be used for the public purpose of the
 continuation and expansion of a system of care program grant
 implemented in Cerro Gordo and Linn counties to utilize a
 comprehensive and long=term approach for helping children
 and families by addressing the key areas in a child's life
 of childhood basic needs, education and work, family, and
 community.
    23.  Of the funds appropriated in this section, at least
 $12,500 $25,000 shall be used to continue and to expand the
 foster care respite pilot program in which postsecondary
 students in social work and other human services=related
 programs receive experience by assisting family foster care
 providers with respite and other support.
    24.  Of the funds appropriated in this section, $55,000
  $110,000 shall be used for the public purpose of funding
 community=based services and other supports with a system
 of care approach for children with a serious emotional
 disturbance and their families through a nonprofit provider
 of child welfare services that has been in existence for more
 than 115 years, is located in a county with a population of
 more than 200,000 but less than 220,000 according to the
 latest census information issued by the United States census
 bureau, is licensed as a psychiatric medical institution for
 children, and was a system of care grantee prior to July 1,
 2016.
    Sec. 17.  2015 Iowa Acts, chapter 137, section 139, is
 amended to read as follows:
    SEC. 139.  ADOPTION SUBSIDY.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    a.  For adoption subsidy payments and services:
 .................................................. $ 21,499,143
                                                      43,046,664
    b.  (1)  The funds appropriated in this section shall be
 used as authorized or allowed by federal law or regulation for
 any of the following purposes:
    (a)  For adoption subsidy payments and related costs.
    (b)  For post=adoption services and for other purposes
 under Tit. IV=B or Tit. IV=E of the federal Social Security
 Act.
    (2)  The department of human services may transfer funds
 appropriated in this subsection to the appropriation for
 child and family services in this Act for the purposes of
 post=adoption services as specified in this paragraph "b".
    2.  The department may transfer funds appropriated in
 this section to the appropriation made in this division of
 this Act for general administration for costs paid from the
 appropriation relating to adoption subsidy.
    3.  Federal funds received by the state during the fiscal
 year beginning July 1, 2016, as the result of the expenditure
 of state funds during a previous state fiscal year for a
 service or activity funded under this section are appropriated
 to the department to be used as additional funding for
 the services and activities funded under this section.
 Notwithstanding section 8.33, moneys received in accordance
 with this subsection that remain unencumbered or unobligated
 at the close of the fiscal year shall not revert to any fund
 but shall remain available for expenditure for the purposes
 designated until the close of the succeeding fiscal year.
    Sec. 18.  2015 Iowa Acts, chapter 137, section 141, is
 amended to read as follows:
    SEC. 141.  FAMILY SUPPORT SUBSIDY PROGRAM.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    For the family support subsidy program subject to the
 enrollment restrictions in section 225C.37, subsection 3:
 .................................................. $    536,966
                                                       1,069,282
    2.  The department shall use at At least $320,750 $727,500
  of the moneys appropriated in this section is transferred
 to the department of public health for the family support
 center component of the comprehensive family support program
 under section 225C.47 chapter 225C, subchapter V. Not more
 than $12,500 of the amount allocated in this subsection shall
 be used for administrative costs.  The department of human
 services shall submit a report to the individuals identified
 in this Act for submission of reports by December 15, 2016,
 regarding the outcomes of the program and recommendations for
 future program improvement.
    3.  If at any time during the fiscal year, the amount of
 funding available for the family support subsidy program
 is reduced from the amount initially used to establish the
 figure for the number of family members for whom a subsidy
 is to be provided at any one time during the fiscal year,
 notwithstanding section 225C.38, subsection 2, the department
 shall revise the figure as necessary to conform to the amount
 of funding available.
    Sec. 19.  2015 Iowa Acts, chapter 137, section 142, is
 amended to read as follows:
    SEC. 142.  CONNER DECREE.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June
 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purpose designated:
    For building community capacity through the coordination
 and provision of training opportunities in accordance with the
 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
 Iowa, July 14, 1994):
 .................................................. $     16,816
                                                          33,632
    Sec. 20.  2015 Iowa Acts, chapter 137, section 143, is
 amended to read as follows:
    SEC. 143.  MENTAL HEALTH INSTITUTES.  There is appropriated
 from the general fund of the state to the department of
 human services for the fiscal year beginning July 1, 2016,
 and ending June 30, 2017, the following amounts, or so
 much thereof as is necessary, to be used for the purposes
 designated which amounts shall not be transferred or
 expended for any purpose other than the purposes designated,
 notwithstanding section 218.6 to the contrary:
    1.  For operation of the state mental health institute at
 Cherokee as required by chapters 218 and 226 for salaries,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $  2,772,808
                                                      14,644,041
 ............................................... FTEs     169.20
    2.  For operation of the state mental health institute at
 Independence as required by chapters 218 and 226 for salaries,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $  5,162,104
                                                      18,552,103
 ............................................... FTEs     233.00
    Sec. 21.  2015 Iowa Acts, chapter 137, section 144, is
 amended to read as follows:
    SEC. 144.  STATE RESOURCE CENTERS.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amounts, or so much thereof as is necessary, to be
 used for the purposes designated:
    a.  For the state resource center at Glenwood for salaries,
 support, maintenance, and miscellaneous purposes:
 .................................................. $ 10,762,241
                                                      20,719,486
    b.  For the state resource center at Woodward for salaries,
 support, maintenance, and miscellaneous purposes:
 .................................................. $  7,291,903
                                                      14,053,011
    2.  The department may continue to bill for state resource
 center services utilizing a scope of services approach used
 for private providers of intermediate care facilities for
 persons with an intellectual disability services, in a manner
 which does not shift costs between the medical assistance
 program, counties, or other sources of funding for the state
 resource centers.
    3.  The state resource centers may expand the time=limited
 assessment and respite services during the fiscal year.
    4.  If the department's administration and the department
 of management concur with a finding by a state resource
 center's superintendent that projected revenues can reasonably
 be expected to pay the salary and support costs for a new
 employee position, or that such costs for adding a particular
 number of new positions for the fiscal year would be less than
 the overtime costs if new positions would not be added, the
 superintendent may add the new position or positions. If the
 vacant positions available to a resource center do not include
 the position classification desired to be filled, the state
 resource center's superintendent may reclassify any vacant
 position as necessary to fill the desired position. The
 superintendents of the state resource centers may, by mutual
 agreement, pool vacant positions and position classifications
 during the course of the fiscal year in order to assist one
 another in filling necessary positions.
    5.  If existing capacity limitations are reached in
 operating units, a waiting list is in effect for a service or
 a special need for which a payment source or other funding
 is available for the service or to address the special need,
 and facilities for the service or to address the special need
 can be provided within the available payment source or other
 funding, the superintendent of a state resource center may
 authorize opening not more than two units or other facilities
 and begin implementing the service or addressing the special
 need during fiscal year 2016=2017.
    Sec. 22.  2015 Iowa Acts, chapter 137, section 145, is
 amended to read as follows:
    SEC. 145.  SEXUALLY VIOLENT PREDATORS.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    For costs associated with the commitment and treatment of
 sexually violent predators in the unit located at the state
 mental health institute at Cherokee, including costs of legal
 services and other associated costs, including salaries,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $  4,946,539
                                                      10,193,079
 ............................................... FTEs     132.50
    2.  Unless specifically prohibited by law, if the amount
 charged provides for recoupment of at least the entire amount
 of direct and indirect costs, the department of human services
 may contract with other states to provide care and treatment
 of persons placed by the other states at the unit for sexually
 violent predators at Cherokee. The moneys received under
 such a contract shall be considered to be repayment receipts
 and used for the purposes of the appropriation made in this
 section.
    Sec. 23.  2015 Iowa Acts, chapter 137, section 146, is
 amended to read as follows:
    SEC. 146.  FIELD OPERATIONS.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June
 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purposes designated:
    For field operations, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $ 29,460,488
                                                      54,442,877
 ............................................... FTEs   1,837.00
    2.  Priority in filling full=time equivalent positions
 shall be given to those positions related to child protection
 services and eligibility determination for low=income
 families.
    Sec. 24.  2015 Iowa Acts, chapter 137, section 147, is
 amended to read as follows:
    SEC. 147.  GENERAL ADMINISTRATION.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, the following amount, or so much thereof
 as is necessary, to be used for the purpose designated:
    For general administration, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $  7,449,099
                                                      15,673,198
 ............................................... FTEs     309.00
    2.  Of the funds appropriated in this section, $75,000
  $150,000 shall be used to continue the contract for the
 provision of a program to provide technical assistance,
 support, and consultation to providers of habilitation
 services and home and community=based services waiver services
 for adults with disabilities under the medical assistance
 program.
    3.  Of the funds appropriated in this section, $25,000
  $50,000 is transferred to the Iowa finance authority to be
 used for administrative support of the council on homelessness
 established in section 16.2D and for the council to fulfill
 its duties in addressing and reducing homelessness in the
 state.
    4.  Of the funds appropriated in this section, $125,000
  $250,000 shall be transferred to and deposited in the
 administrative fund of the Iowa ABLE savings plan trust
 created in section 12I.4, if enacted in this or any other Act,
  to be used for implementation and administration activities of
 the Iowa ABLE savings plan trust.
    5.  Of the funds appropriated in this section, $300,000
 shall be used to contract for planning grants for the
 development and implementation of children's mental health
 crisis services as provided in this Act.
    6.  Of the funds appropriated in this section, $200,000
 shall be used to continue to expand the provision of
 nationally accredited and recognized internet=based training
 to include mental health and disability services providers.
    7.  Of the funds appropriated in this section, $300,000
 is transferred to the economic development authority for
 the Iowa commission on volunteer services to be used for
 RefugeeRISE AmeriCorps program member recruitment and training
 to improve the economic well=being and health of economically
 disadvantaged refugees in local communities across Iowa.
 Funds transferred may be used to supplement federal funds
 under federal regulations.
    Sec. 25.  2015 Iowa Acts, chapter 137, is amended by adding
 the following new section:
    NEW SECTION.  SEC. 147A.  DEPARTMENT=WIDE DUTIES.  There
 is appropriated from the general fund of the state to the
 department of human services for the fiscal year beginning
 July 1, 2016, and ending June 30, 2017, the following amount,
 or so much thereof as is necessary, to be used for the
 purposes designated:
    For salaries, support, maintenance, and miscellaneous
 purposes at facilities under the purview of the  department of
 human services:
 .................................................. $  2,879,274
    Sec. 26.  2015 Iowa Acts, chapter 137, section 148, is
 amended to read as follows:
    SEC. 148.  VOLUNTEERS.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June
 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purpose designated:
    For development and coordination of volunteer services:
 .................................................. $     42,343
                                                          84,686
    Sec. 27.  2015 Iowa Acts, chapter 137, section 149, is
 amended to read as follows:
    SEC. 149.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
 DEPARTMENT OF HUMAN SERVICES.
    1.  a.(1)  For the fiscal year beginning July 1, 2016,
 the total state funding amount for the nursing facility budget
 shall not exceed $151,421,458.
    (2)  The department, in cooperation with nursing facility
 representatives, shall review projections for state funding
 expenditures for reimbursement of nursing facilities on a
 quarterly basis and the department shall determine if an
 adjustment to the medical assistance reimbursement rate is
 necessary in order to provide reimbursement within the state
 funding amount for the fiscal year. Notwithstanding 2001
 Iowa Acts, chapter 192, section 4, subsection 2, paragraph
 "c", and subsection 3, paragraph "a", subparagraph (2), if
 the state funding expenditures for the nursing facility
 budget for the fiscal year are projected to exceed the amount
 specified in subparagraph (1), the department shall adjust
 the reimbursement for nursing facilities reimbursed under the
 case=mix reimbursement system to maintain expenditures of the
 nursing facility budget within the specified amount for the
 fiscal year. 
    (3)  (a)  For the fiscal year beginning July 1, 2016,
 case=mix, non=case mix, and special population nursing
 facilities shall be reimbursed in accordance with the
 methodology in effect on June 30, 2016.
    (b)  For managed care claims, the department of human
 services shall adjust the payment rate floor for nursing
 facilities, annually, to maintain a rate floor that is no
 lower than the Medicaid fee=for=service case=mix adjusted rate
 calculated in accordance with 441 IAC 81.6.  The department
 shall then calculate adjusted reimbursement rates, including
 but not limited to add=on=payments, annually, and shall
 notify Medicaid managed care organizations of the adjusted
 reimbursement rates within 30 days of determining the adjusted
 reimbursement rates. Any adjustment of reimbursement rates
 under this subparagraph division shall be budget neutral to
 the state budget.
    (4)  For any open or unsettled nursing facility cost report
 for a fiscal year prior to and including the fiscal year
 beginning July 1, 2015, including any cost report remanded
 on judicial review for inclusion of prescription drug,
 laboratory, or x=ray costs, the department shall offset all
 reported prescription drug, laboratory, and x=ray costs with
 any revenue received from Medicare or other revenue source for
 any purpose. For purposes of this subparagraph, a nursing
 facility cost report is not considered open or unsettled
 if the facility did not initiate an administrative appeal
 under chapter 17A or if any appeal rights initiated have been
 exhausted.
    b.  (1)  For the fiscal year beginning July 1, 2016,
 the department shall establish the pharmacy dispensing fee
 reimbursement at $11.73 per prescription, until a cost of
 dispensing survey is completed. The actual dispensing fee
 shall be determined by a cost of dispensing survey performed
 by the department and required to be completed by all medical
 assistance program participating pharmacies every two years,
 adjusted as necessary to maintain expenditures within the
 amount appropriated to the department for this purpose for the
 fiscal year.
    (2)  The department shall utilize an average acquisition
 cost reimbursement methodology for all drugs covered under the
 medical assistance program in accordance with 2012 Iowa Acts,
 chapter 1133, section 33.
    (3)  Notwithstanding subparagraph (2), if the centers
 for Medicare and Medicaid services of the United States
 department of health and human services (CMS) requires, as a
 condition of federal Medicaid funding, that the department
 implement an aggregate federal upper limit (FUL) for drug
 reimbursement based on the average manufacturer's price (AMP),
 the department may utilize a reimbursement methodology for
 all drugs covered under the Medicaid program based on the
 national average drug acquisition cost (NADAC) methodology
 published by CMS, in order to assure compliance with the
 aggregate FUL, minimize outcomes of drug reimbursements below
 pharmacy acquisition costs, limit administrative costs, and
 minimize any change in the aggregate reimbursement for drugs.
 The department may adopt emergency rules to implement this
 subparagraph.
    c.  (1)  For the fiscal year beginning July 1, 2016,
 reimbursement rates for outpatient hospital services shall
 remain at the rates in effect on June 30, 2016, subject to
 Medicaid program upper payment limit rules, and adjusted
 as necessary to maintain expenditures within the amount
 appropriated to the department for this purpose for the fiscal
 year.
    (2)  For the fiscal year beginning July 1, 2016,
 reimbursement rates for inpatient hospital services shall
 remain at the rates in effect on June 30, 2016, subject to
 Medicaid program upper payment limit rules, and adjusted
 as necessary to maintain expenditures within the amount
 appropriated to the department for this purpose for the fiscal
 year.
    (3)  For the fiscal year beginning July 1, 2016, the
 graduate medical education and disproportionate share hospital
 fund shall remain at the amount in effect on June 30, 2016,
 except that the portion of the fund attributable to graduate
 medical education shall be reduced in an amount that reflects
 the elimination of graduate medical education payments made to
 out=of=state hospitals.
    (4)  In order to ensure the efficient use of limited state
 funds in procuring health care services for low=income Iowans,
 funds appropriated in this Act for hospital services shall
 not be used for activities which would be excluded from a
 determination of reasonable costs under the federal Medicare
 program pursuant to 42 U.S.C. {1395x(v)(1)(N).
    d.  For the fiscal year beginning July 1, 2016,
 reimbursement rates for rural health clinics, hospices, and
 acute mental hospitals shall be increased in accordance with
 increases under the federal Medicare program or as supported
 by their Medicare audited costs.
    e.  For the fiscal year beginning July 1, 2016, independent
 laboratories and rehabilitation agencies shall be reimbursed
 using the same methodology in effect on June 30, 2016.
    f.  (1)  For the fiscal year beginning July 1, 2016,
 reimbursement rates for home health agencies shall continue to
 be based on the Medicare low utilization payment adjustment
 (LUPA) methodology with state geographic wage adjustments,
 and updated to reflect the most recent Medicare LUPA rates
  shall be adjusted to increase the rates to the extent possible
 within the $1,000,000 of state funding appropriated for this
 purpose. The department shall continue to update the rates
 every two years to reflect the most recent Medicare LUPA
 rates.
    (2)  For the fiscal year beginning July 1, 2016, rates
 for private duty nursing and personal care services under
 the early and periodic screening, diagnostic, and treatment
 program benefit shall be calculated based on the methodology
 in effect on June 30, 2016.
    g.  For the fiscal year beginning July 1, 2016, federally
 qualified health centers and rural health clinics shall
 receive cost=based reimbursement for 100 percent of the
 reasonable costs for the provision of services to recipients
 of medical assistance.
    h.  For the fiscal year beginning July 1, 2016, the
 reimbursement rates for dental services shall remain at the
 rates in effect on June 30, 2016.
    i.  (1)  For the fiscal year beginning July 1, 2016,
 state=owned psychiatric medical institutions for children
 shall receive cost=based reimbursement for 100 percent of the
 actual and allowable costs for the provision of services to
 recipients of medical assistance.
    (2)  For the nonstate=owned psychiatric medical
 institutions for children, reimbursement rates shall be based
 on the reimbursement methodology developed by the Medicaid
 managed care contractor for behavioral health services as
 required for federal compliance in effect on June 30, 2016.
    (3)  As a condition of participation in the medical
 assistance program, enrolled providers shall accept the
 medical assistance reimbursement rate for any covered goods
 or services provided to recipients of medical assistance
 who are children under the custody of a psychiatric medical
 institution for children.
    j.  For the fiscal year beginning July 1, 2016, unless
 otherwise specified in this Act, all noninstitutional
 medical assistance provider reimbursement rates shall remain
 at the rates in effect on June 30, 2016, except for area
 education agencies, local education agencies, infant and
 toddler services providers, home and community=based services
 providers including consumer=directed attendant care providers
 under a section 1915(c) or 1915(i) waiver, targeted case
 management providers, and those providers whose rates are
 required to be determined pursuant to section 249A.20.
    k.  Notwithstanding any provision to the contrary, for the
 fiscal year beginning July 1, 2016, the reimbursement rate for
 anesthesiologists shall remain at the rate in effect on June
 30, 2016.
    l.  Notwithstanding section 249A.20, for the fiscal year
 beginning July 1, 2016, the average reimbursement rate for
 health care providers eligible for use of the federal Medicare
 resource=based relative value scale reimbursement methodology
 under section 249A.20 shall remain at the rate in effect on
 June 30, 2016; however, this rate shall not exceed the maximum
 level authorized by the federal government.
    m.  For the fiscal year beginning July 1, 2016, the
 reimbursement rate for residential care facilities shall not
 be less than the minimum payment level as established by the
 federal government to meet the federally mandated maintenance
 of effort requirement. The flat reimbursement rate for
 facilities electing not to file annual cost reports shall not
 be less than the minimum payment level as established by the
 federal government to meet the federally mandated maintenance
 of effort requirement.
    n.  For the fiscal year beginning July 1, 2016, the
 reimbursement rates for inpatient mental health services
 provided at hospitals shall remain at the rates in effect on
 June 30, 2016, subject to Medicaid program upper payment limit
 rules; and psychiatrists shall be reimbursed at the medical
 assistance program fee=for=service rate in effect on June 30,
 2016.
    o.  For the fiscal year beginning July 1, 2016, community
 mental health centers may choose to be reimbursed for the
 services provided to recipients of medical assistance through
 either of the following options:
    (1)  For 100 percent of the reasonable costs of the
 services.
    (2)  In accordance with the alternative reimbursement rate
 methodology established by the medical assistance program's
 managed care contractor for mental health services and
  approved by the department of human services in effect on June
 30, 2016.
    p.  For the fiscal year beginning July 1, 2016, the
 reimbursement rate for providers of family planning services
 that are eligible to receive a 90 percent federal match shall
 remain at the rates in effect on June 30, 2016.
    q.  For the fiscal year beginning July 1, 2016, the upper
 limits on and reimbursement rates for providers of home and
 community=based services waiver services shall remain at the
 limits in effect on June 30, 2016 for which the rate floor
 is based on the average aggregate reimbursement rate for the
 fiscal year beginning July 1, 2014, shall be determined as
 follows:
    (1)  For fee=for=service claims, the reimbursement rate
 shall be increased by 1 percent over the rates in effect on
 June 30, 2016.
    (2)  For managed care claims, the reimbursement rate floor
 shall be increased by 1 percent over the rate floor in effect
 on April 1, 2016.
    r.  For the fiscal year beginning July 1, 2016, the
 reimbursement rates for emergency medical service providers
 shall remain at the rates in effect on June 30, 2016.
    2.  For the fiscal year beginning July 1, 2016, the
 reimbursement rate for providers reimbursed under the
 in=home=related care program shall not be less than the
 minimum payment level as established by the federal government
 to meet the federally mandated maintenance of effort
 requirement.
    3.  Unless otherwise directed in this section, when the
 department's reimbursement methodology for any provider
 reimbursed in accordance with this section includes an
 inflation factor, this factor shall not exceed the amount
 by which the consumer price index for all urban consumers
 increased during the calendar year ending December 31, 2002.
    4.  For Notwithstanding section 234.38, for the fiscal
 year beginning July 1, 2016, the foster family basic daily
 maintenance rate and the maximum adoption subsidy rate for
 children ages 0 through 5 years shall be $16.78, the rate for
 children ages 6 through 11 years shall be $17.45, the rate for
 children ages 12 through 15 years shall be $19.10, and the
 rate for children and young adults ages 16 and older shall be
 $19.35. For youth ages 18 to 21 who have exited foster care,
 the preparation for adult living program maintenance rate
 shall be $602.70 per month. The maximum payment for adoption
 subsidy nonrecurring expenses shall be limited to $500 and the
 disallowance of additional amounts for court costs and other
 related legal expenses implemented pursuant to 2010 Iowa Acts,
 chapter 1031, section 408, shall be continued.
    5.  For the fiscal year beginning July 1, 2016, the maximum
 reimbursement rates for social services providers under
 contract shall remain at the rates in effect on June 30, 2016,
 or the provider's actual and allowable cost plus inflation for
 each service, whichever is less. However, if a new service
 or service provider is added after June 30, 2016, the initial
 reimbursement rate for the service or provider shall be
 based upon a weighted average of provider rates for similar
 services.
    6.  For the fiscal year beginning July 1, 2016, the
 reimbursement rates for resource family recruitment and
 retention contractors, child welfare emergency services
 contractors, and supervised apartment living foster care
 providers shall remain at the rates in effect on June 30,
 2016.
    7.  a.  For the purposes of this subsection, "combined
 reimbursement rate" means the combined service and maintenance
 reimbursement rate for a service level under the department's
 reimbursement methodology. Effective July 1, 2016, the
 combined reimbursement rate for a group foster care service
 level shall be the amount designated in this subsection.
 However, if a group foster care provider's reimbursement rate
 for a service level as of June 30, 2016, is more than the rate
 designated in this subsection, the provider's reimbursement
 shall remain at the higher rate.
    b.  Unless a group foster care provider is subject to
 the exception provided in paragraph "a", effective July 1,
 2016, the combined reimbursement rates for the service levels
 under the department's reimbursement methodology shall be as
 follows:
    (1)  For service level, community = D1, the daily rate shall
 be at least $84.17.
    (2)  For service level, comprehensive = D2, the daily rate
 shall be at least $119.09.
    (3)  For service level, enhanced = D3, the daily rate shall
 be at least $131.09.
    8.  The group foster care reimbursement rates paid for
 placement of children out of state shall be calculated
 according to the same rate=setting principles as those used
 for in=state providers, unless the director of human services
 or the director's designee determines that appropriate care
 cannot be provided within the state. The payment of the daily
 rate shall be based on the number of days in the calendar
 month in which service is provided.
    9.  a.  For the fiscal year beginning July 1, 2016, the
 reimbursement rate paid for shelter care and the child welfare
 emergency services implemented to provide or prevent the need
 for shelter care shall be established by contract.
    b.  For the fiscal year beginning July 1, 2016, the combined
 service and maintenance components of the reimbursement rate
 paid for shelter care services shall be based on the financial
 and statistical report submitted to the department. The
 maximum reimbursement rate shall be $101.83 per day. The
 department shall reimburse a shelter care provider at the
 provider's actual and allowable unit cost, plus inflation, not
 to exceed the maximum reimbursement rate.
    c.  Notwithstanding section 232.141, subsection 8, for
 the fiscal year beginning July 1, 2016, the amount of the
 statewide average of the actual and allowable rates for
 reimbursement of juvenile shelter care homes that is utilized
 for the limitation on recovery of unpaid costs shall remain
 at the amount in effect for this purpose in the fiscal year
 beginning July 1, 2015.
    10.  For the fiscal year beginning July 1, 2016,
 the department shall calculate reimbursement rates for
 intermediate care facilities for persons with an intellectual
 disability at the 80th percentile. Beginning July 1, 2016,
 the rate calculation methodology shall utilize the consumer
 price index inflation factor applicable to the fiscal year
 beginning July 1, 2016.
    11.  For the fiscal year beginning July 1, 2016, for
 child care providers reimbursed under the state child
 care assistance program, the department shall set provider
 reimbursement rates based on the rate reimbursement survey
 completed in December 2004. Effective July 1, 2016, the child
 care provider reimbursement rates shall remain at the rates
 in effect on June 30, 2016. The department shall set rates
 in a manner so as to provide incentives for a nonregistered
 provider to become registered by applying the increase only to
 registered and licensed providers.
    11A.  For the fiscal year beginning July 1, 2016,
 notwithstanding any provision to the contrary under this
 section, affected providers or services shall be reimbursed
 as follows:
    a.  For fee=for=service claims, reimbursement shall be
 calculated based on the methodology otherwise specified in
 this section for the fiscal year beginning July 1, 2016, for
 the respective provider or service.
    b.  For claims subject to a managed care contract:
    (1)  With the exception of any provider or service to
 which a reimbursement increase is applicable for the fiscal
 year under this section, reimbursement shall be based on
 the methodology established by the managed care contract.
 However, any reimbursement established under such contract
 shall not be lower than the rate floor established by the
 department of human services as the managed care organization
 provider or service reimbursement rate floor for the
 respective provider or service in effect on April 1, 2016.
    (2)  For any provider or service to which a reimbursement
 increase is applicable for the fiscal year under this section,
 upon the effective date of the reimbursement increase, the
 department of human services shall modify the rate floor in
 effect on April 1, 2016, to reflect the increase specified
 under this section. Any reimbursement established under the
 managed care contract shall not be lower than the rate floor
 as modified by the department of human services to reflect the
 provider rate increase specified under this section.
    13.  The department may adopt emergency rules to implement
 this section.
    Sec. 28.  2015 Iowa Acts, chapter 137, is amended by adding
 the following new section:
    NEW SECTION.  SEC. 151A.  TRANSFER OF MEDICAID
 MODERNIZATION SAVINGS BETWEEN APPROPRIATIONS FY
 2016=2017.  Notwithstanding section 8.39, subsection 1, for
 the fiscal year beginning July 1, 2016, if savings resulting
 from the governor's Medicaid modernization initiative accrue
 to the medical contracts or children's health insurance
 program appropriation from the general fund of the state
 and not to the medical assistance appropriation from the
 general fund of the state under this division of this Act,
 such savings may be transferred to such medical assistance
 appropriation for the same fiscal year without prior written
 consent and approval of the governor and the director of the
 department of management. The department of human services
 shall report any transfers made pursuant to this section to
 the legislative services agency.
                           DIVISION VI
         HEALTH CARE ACCOUNTS AND FUNDS ==== FY 2016=2017
    Sec. 29.  2015 Iowa Acts, chapter 137, section 152, is
 amended to read as follows:
    SEC. 152.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is
 appropriated from the pharmaceutical settlement account
 created in section 249A.33 to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June
 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purpose designated:
    Notwithstanding any provision of law to the contrary, to
 supplement the appropriations made in this Act for medical
 contracts under the medical assistance program for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017:
 .................................................. $  1,001,088
                                                       1,300,000
    Sec. 30.  2015 Iowa Acts, chapter 137, section 153, is
 amended to read as follows:
    SEC. 153.  QUALITY ASSURANCE TRUST FUND ==== DEPARTMENT
 OF HUMAN SERVICES.  Notwithstanding any provision to the
 contrary and subject to the availability of funds, there is
 appropriated from the quality assurance trust fund created in
 section 249L.4 to the department of human services for the
 fiscal year beginning July 1, 2016, and ending June 30, 2017,
 the following amounts, or so much thereof as is necessary, for
 the purposes designated:
    To supplement the appropriation made in this Act from the
 general fund of the state to the department of human services
 for medical assistance for the same fiscal year:
 .................................................. $ 18,602,604
                                                      36,705,208
    Sec. 31.  2015 Iowa Acts, chapter 137, section 154, is
 amended to read as follows:
    SEC. 154.  HOSPITAL HEALTH CARE ACCESS TRUST FUND ====
 DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision
 to the contrary and subject to the availability of funds,
 there is appropriated from the hospital health care access
 trust fund created in section 249M.4 to the department of
 human services for the fiscal year beginning July 1, 2016,
 and ending June 30, 2017, the following amounts, or so much
 thereof as is necessary, for the purposes designated:
    To supplement the appropriation made in this Act from the
 general fund of the state to the department of human services
 for medical assistance for the same fiscal year:
 .................................................. $ 17,350,000
                                                      34,700,000
                          DIVISION VII
   PROPERTY TAX RELIEF FUND BLOCK GRANT MONEY ==== FY 2016=2017
    Sec. 32.  2015 Iowa Acts, chapter 137, section 157, is
 amended to read as follows:
    SEC. 157.  PROPERTY TAX RELIEF FUND BLOCK GRANT MONEYS.  The
 moneys transferred to the property tax relief fund for the
 fiscal year beginning July 1, 2015 2016, from the federal
 social services block grant pursuant to 2015 Iowa Acts,
 House File 630, and from the federal temporary assistance for
 needy families block grant, totaling at least $11,774,275
  $7,456,296, are appropriated to the department of human
 services for the fiscal year beginning July 1, 2015 2016,
 and ending June 30, 2016 2017, to be used for the purposes
 designated, notwithstanding any provision of law to the
 contrary:
    1.  For distribution to any mental health and disability
 services region where 25 percent of the region's projected
 expenditures exceeds the region's projected fund balance:
 .................................................. $    480,000
    a.  For purposes of this subsection:
    (1)  "Available funds" means a county mental health and
 services fund balance on June 30, 2015, plus the maximum
 amount a county was allowed to levy for the fiscal year
 beginning July 1, 2015.
    (2)  "Projected expenditures" means the actual expenditures
 of a mental health and disability services region as of June
 30, 2015, multiplied by an annual inflation rate of 2 percent
 plus the projected costs for new core services administered by
 the region as provided in a region's regional service system
 management plan approved pursuant to section 331.393 for the
 fiscal year beginning July 1, 2015.
    (3)  "Projected fund balance" means the difference between
 a mental health and disability services region's available
 funds and projected expenditures.
    b.  If sufficient funds are not available to implement this
 subsection, the department of human services shall distribute
 funds to a region in proportion to the availability of funds.
    2.  To be transferred to the appropriation in this Act for
 child and family services for the fiscal year beginning July
 1, 2016, to be used for the purpose of that appropriation:
 .................................................. $  5,407,137
                                                       6,880,223
                          DIVISION VIII
         PRIOR YEAR APPROPRIATIONS AND OTHER PROVISIONS
         FAMILY INVESTMENT PROGRAM ACCOUNT FY 2015=2016
    Sec. 33.  2015 Iowa Acts, chapter 137, section 7, subsection
 4, paragraph e, is amended to read as follows:
    e.  For the JOBS program:
 .................................................. $ 17,540,398
                                                      17,140,398
       FAMILY INVESTMENT PROGRAM GENERAL FUND FY 2015=2016
    Sec. 34.  2015 Iowa Acts, chapter 137, section 8, unnumbered
 paragraph 2, is amended to read as follows:
    To be credited to the family investment program (FIP)
 account and used for family investment program assistance
 under chapter 239B:
 .................................................. $ 48,673,875
                                                      44,773,875
    Sec. 35.  2015 Iowa Acts, chapter 137, section 8, subsection
 1, is amended to read as follows:
    1.  Of the funds appropriated in this section, $7,402,220
  $7,002,220 is allocated for the JOBS program.
        MEDICAL ASSISTANCE APPROPRIATION ==== FY 2015=2016
    Sec. 36.  2015 Iowa Acts, chapter 137, section 12,
 unnumbered paragraph 2, is amended to read as follows:
    For medical assistance program reimbursement and
 associated costs as specifically provided in the reimbursement
 methodologies in effect on June 30, 2015, except as otherwise
 expressly authorized by law, consistent with options under
 federal law and regulations, and contingent upon receipt of
 approval from the office of the governor of reimbursement for
 each abortion performed under the program:
 .................................................. $1,303,191,564
                                                     1,318,191,564
           MODERNIZATION EMERGENCY RULES FY 2015=2016
    Sec. 37.  2015 Iowa Acts, chapter 137, section 12,
 subsection 24, is amended to read as follows:
    24.  The department of human services may adopt emergency
 rules as necessary to implement the governor's Medicaid
 modernization initiative beginning January 1, 2016.
            AUTISM SUPPORT PROGRAM FUND FY 2015=2016
    Sec. 38.  2015 Iowa Acts, chapter 137, section 13,
 subsection 5, unnumbered paragraph 1, is amended to read as
 follows:
    Of the funds appropriated in this section, $2,000,000
 shall be credited to the autism support program fund created
 in section 225D.2 to be used for the autism support program
 created in chapter 225D, with the exception of the following
 amounts of this allocation which shall be used as follows:
           STATE SUPPLEMENTARY ASSISTANCE FY 2015=2016
    Sec. 39.  2015 Iowa Acts, chapter 137, section 14,
 unnumbered paragraph 2, is amended to read as follows:
    For the state supplementary assistance program:
 .................................................. $ 12,997,187
                                                      11,897,187
               CHILD CARE ASSISTANCE FY 2015=2016
    Sec. 40.  2015 Iowa Acts, chapter 137, section 16,
 unnumbered paragraph 2, is amended to read as follows:
    For child care programs:
 .................................................. $ 51,408,668
                                                      41,408,668
    Sec. 41.  2015 Iowa Acts, chapter 137, section 16,
 subsection 1, is amended to read as follows:
    1.  Of the funds appropriated in this section, $43,689,241
  $33,689,241 shall be used for state child care assistance in
 accordance with section 237A.13.
    Sec. 42.  2015 Iowa Acts, chapter 137, section 16,
 subsection 9, is amended to read as follows:
    9.  Notwithstanding section 8.33, moneys advanced for
 purposes of the programs developed by early childhood Iowa
 areas, advanced for purposes of wraparound child care,
  appropriated in this section or received from the federal
 appropriations made for the purposes of this section that
 remain unencumbered or unobligated at the close of the fiscal
 year shall not revert to any fund but shall remain available
 for expenditure for the purposes designated until the close
 of the succeeding fiscal year.
              NURSING FACILITY BUDGET FY 2015=2016
    Sec. 43.  2015 Iowa Acts, chapter 137, section 29,
 subsection 1, paragraph a, subparagraph (1), is amended to
 read as follows:
    (1)  For the fiscal year beginning July 1, 2015, the total
 state funding amount for the nursing facility budget shall not
 exceed $151,421,158 $227,131,737.
    Sec. 44.  EFFECTIVE UPON ENACTMENT.  This division of this
 Act, being deemed of immediate importance, takes effect upon
 enactment.
    Sec. 45.  RETROACTIVE APPLICABILITY.  This division of this
 Act is retroactively applicable to July 1, 2015.
                           DIVISION IX
                        DECATEGORIZATION
    Sec. 46.  DECATEGORIZATION CARRYOVER FUNDING ==== TRANSFER TO
 MEDICAID PROGRAM.  Notwithstanding section 232.188, subsection
 5, paragraph "b", any state appropriated moneys in the funding
 pool that remained unencumbered or unobligated at the close
 of the fiscal year beginning July 1, 2013, and were deemed
 carryover funding to remain available for the two succeeding
 fiscal years that still remain unencumbered or unobligated at
 the close of the fiscal year beginning July 1, 2015, shall
 not revert but shall be transferred to the medical assistance
 program for the fiscal year beginning July 1, 2015.
    Sec. 47.  EFFECTIVE UPON ENACTMENT.  This division of this
 Act, being deemed of immediate importance, takes effect upon
 enactment.
    Sec. 48.  RETROACTIVE APPLICABILITY.  This division of this
 Act is retroactively applicable to July 1, 2015.
                           DIVISION X
                          CODE CHANGES
           LOCAL OFFICES OF SUBSTITUTE DECISION MAKER
    Sec. 49.  Section 231E.4, subsection 3, paragraph a, Code
 2016, is amended to read as follows:
    a.  Select persons through a request for proposals process
 to establish local offices of substitute decision maker in
 each of the planning and service areas. Local offices shall
 be established statewide on or before July 1, 2017 2018.
  INSTITUTIONS FOR PERSONS WITH AN INTELLECTUAL DISABILITY ====
                           ASSESSMENT
    Sec. 50.  Section 222.60A, Code 2016, is amended to read as
 follows:
    222.60A  Cost of assessment.
    Notwithstanding any provision of this chapter to the
 contrary, any amount attributable to any fee assessed
  assessment pursuant to section 249A.21 that would otherwise
 be the liability of any county shall be paid by the state.
 The department may transfer funds from the appropriation for
 medical assistance to pay any amount attributable to any fee
 assessed assessment pursuant to section 249A.21 that is a
 liability of the state.
    Sec. 51.  Section 249A.12, subsection 3, paragraph c, Code
 2016, is amended to read as follows:
    c.  Effective February 1, 2002, the The state shall be
 responsible for all of the nonfederal share of the costs of
 intermediate care facility for persons with an intellectual
 disability services provided under medical assistance
 attributable to the assessment fee for intermediate care
 facilities for individuals with an intellectual disability
 imposed pursuant to section 249A.21. Effective February 1,
 2003, a A county is not required to reimburse the department
 and shall not be billed for the nonfederal share of the costs
 of such services attributable to the assessment fee.
    Sec. 52.  Section 249A.21, Code 2016, is amended to read as
 follows:
    249A.21  Intermediate care facilities for persons with an
 intellectual disability ==== assessment.
    1.  The department may assess An intermediate care
 facilities facility for persons with an intellectual
 disability, as defined in section 135C.1, a fee in shall be
 assessed an amount for the preceding calendar quarter, not to
 exceed six percent of the total annual revenue of the facility
 for the preceding fiscal year actual paid claims for the
 previous quarter.
    2.  The assessment shall be paid by each intermediate care
 facility for persons with an intellectual disability to the
 department in equal monthly amounts on or before the fifteenth
 day of each month on a quarterly basis. The department may
 deduct the monthly amount from medical assistance payments to
 a facility described in subsection 1. The amount deducted
 from payments shall not exceed the total amount of the
 assessments due An intermediate care facility for persons with
 an intellectual disability shall submit the assessment amount
 no later than thirty days following the end of each calendar
 quarter.
    3.  Revenue from the assessments shall be credited The
 department shall collect the assessment imposed and shall
 credit all revenues collected to the state medical assistance
 appropriation. This revenue may be used only for services
 for which federal financial participation under the medical
 assistance program is available to match state funds.
    4.  If the department determines that an intermediate care
 facility for persons with an intellectual disability has
 underpaid or overpaid the assessment, the department shall
 notify the  intermediate care facility for persons with an
 intellectual disability of the amount of the unpaid assessment
 or refund due.  Such payment or refund shall be due or
 refunded within thirty days of the issuance of the notice.
    5.  An intermediate care facility for persons with an
 intellectual disability that fails to pay the assessment
 within the time frame specified in this section shall pay,
 in addition to the outstanding assessment, a penalty in the
 amount of one and five=tenths percent of the assessment amount
 owed for each month or portion of each month the payment
 is overdue.  However, if the department determines that
 good cause is shown for failure to comply with payment of
 the assessment, the department shall waive the penalty or a
 portion of the penalty.
    6.  If an assessment has not been received by the department
 by the last day of the third month after the payment is due,
 the department shall suspend payment due the intermediate care
 facility for persons with an intellectual disability under the
 medical assistance program including payments made on behalf
 of the medical assistance program by a Medicaid managed care
 contractor.
    7.  The assessment imposed under this section constitutes
 a debt due and owing the state and may be collected by civil
 action, including but not limited to the filing of tax liens,
 and any other method provided for by law.
    8.  If federal financial participation to match the
 assessments made under subsection 1 becomes unavailable under
 federal law, the department shall terminate the imposing
 of the assessments beginning on the date that the federal
 statutory, regulatory, or interpretive change takes effect.
    5.  9.  The department of human services may procure a sole
 source contract to implement the provisions of this section.
    6.  10.  The department may adopt administrative rules under
 section 17A.4, subsection 3, and section 17A.5, subsection 2,
 paragraph "b", to implement this section, and any fee assessed
 pursuant to this section against an intermediate care facility
 for persons with an intellectual disability that is operated
 by the state may be made retroactive to October 1, 2003.
                           DIVISION XI
             HOSPITAL HEALTH CARE ACCESS ASSESSMENT
    Sec. 53.  Section 249M.5, Code 2016, is amended to read as
 follows:
    249M.5  Future repeal.
 This chapter is repealed June 30, 2016 July 1, 2017.
    Sec. 54.  REVIEW OF ALTERNATIVE ASSESSMENT
 METHODOLOGY.  The department of human services shall
 explore alternative hospital health care access assessment
 methodologies and shall make recommendations to the governor
 and the general assembly by December 15, 2016, regarding
 continuation of the hospital health care access assessment
 program beyond July 1, 2017, and an alternative assessment
 methodology. Any continuation of the program and assessment
 methodology shall meet all of the following guidelines:
    1.  All funds generated by the assessment shall be returned
 to participating hospitals in the form of higher Medicaid
 payments, with the exception of $3,800,000 which shall be used
 to supplement the medical assistance appropriation.
    2.  Continuation of the program and any new assessment
 methodology shall be subject to any required federal approval.
    3.  Any new assessment methodology shall minimize the
 negative financial impact on participating hospitals to the
 greatest extent possible.
    4.  Any new assessment methodology shall result in at
 least the same if not a greater aggregate financial benefit
 to participating hospitals compared with the  benefit existing
 under the program prior to July 1, 2016.
    5.  Only participating hospitals subject to imposition
 of the assessment shall receive a financial return from the
 program.
    6.  Any continuation of the program shall include a means
 of tracking the financial return to individual participating
 hospitals.
    7.  Any quality metrics utilized by the program, if
 continued, shall align with similar metrics being used under
 Medicare and the state innovation model initiative process.
    8.  Any new assessment methodology shall incorporate a
 recognition of the increased costs attributable to care and
 services such as inpatient psychiatric care, rehabilitation
 services, and neonatal intensive care units.
    9.  Any continuation of the program shall include oversight
 and review by the hospital health care access trust fund board
 created in section 249M.4.
    Sec. 55.  EFFECTIVE UPON ENACTMENT.  This division of this
 Act, being deemed of immediate importance, takes effect upon
 enactment.
    Sec. 56.  RETROACTIVE APPLICABILITY.  The section of this
 division of this Act amending section 249M.5, Code 2016, is
 retroactively applicable to June 30, 2016.
                          DIVISION XII
                     AUTISM SUPPORT PROGRAM
    Sec. 57.  Section 135.181, subsections 1 and 2, Code 2016,
 are amended to read as follows:
    1.  The department shall establish a board=certified
 behavior analyst and board=certified assistant behavior
 analyst grants program to provide grants to Iowa resident and
 nonresident applicants who have been accepted for admission
 or are attending a board of regents university, community
 college, or an accredited private institution, within or
 outside the state of Iowa, are enrolled in a program that is
 accredited and meets coursework requirements to prepare the
 applicant to be eligible for board certification as a behavior
 analyst or assistant behavior analyst, and demonstrate
 financial need. Priority in the awarding of a grant shall be
 given to applicants who are residents of Iowa.
    2.  The department, in cooperation with the department
 of education, shall adopt rules pursuant to chapter 17A to
 establish minimum standards for applicants to be eligible for
 a grant that address all of the following:
    a.  Eligibility requirements for and qualifications of
 an applicant to receive a grant.  The applicant shall agree
 to practice in the state of Iowa for a period of time, not
 to exceed four years, as specified in the contract entered
 into between the applicant and the department at the time the
 grant is awarded. In addition, the applicant shall agree, as
 specified in the contract, that during the contract period,
 the applicant will assist in supervising an individual working
 toward board certification as a behavior analyst or assistant
 behavior analyst or to consult with schools and service
 providers that provide services and supports to individuals
 with autism.
    b.  The application process for the grant.
    c.  Criteria for preference in awarding of the grants.
 Priority in the awarding of a grant shall be given to
 applicants who are residents of Iowa.
    d.  Determination of the amount of a grant.  The amount
 of funding awarded to each applicant shall be based on the
 applicant's enrollment status, the number of applicants, and
 the total amount of available funds. The total amount of
 funds awarded to an individual applicant shall not exceed
 fifty percent of the total costs attributable to program
 tuition and fees, annually.
    e.  Use of the funds awarded.  Funds awarded may be used
 to offset the costs attributable to tuition and fees for the
 accredited behavior analyst or  assistant behavior analyst
 program.
    Sec. 58.  Section 135.181, Code 2016, is amended by adding
 the following new subsection:
    NEW SUBSECTION.  4.  The department shall submit a report
 to the governor and the general assembly no later than January
 1, annually, that includes but is not limited to all of the
 following:
    a.  The number of applications received for the immediately
 preceding fiscal year.
    b.  The number of applications approved and the total amount
 of funding awarded in grants in the immediately preceding
 fiscal year.
    c.  The cost of administering the program in the immediately
 preceding fiscal year.
    d.  Recommendations for any changes to the program.
    Sec. 59.  Section 225D.1, subsection 8, Code 2016, is
 amended to read as follows:
    8.  "Eligible individual" means a child less than nine
  fourteen years of age who has been diagnosed with autism
 based on a diagnostic assessment of autism, is not otherwise
 eligible for coverage for applied behavioral analysis
 treatment under the medical assistance program, section
 514C.28, or private insurance coverage, and whose household
 income does not exceed four five hundred percent of the
 federal poverty level.
    Sec. 60.  Section 225D.2, subsection 2, paragraphs c and d,
 Code 2016, are amended to read as follows:
    c.  Notwithstanding the age limitation for an eligible
 individual, a provision that if an eligible individual reaches
 nine fourteen years of age prior to completion of the maximum
 applied behavioral analysis treatment period specified in
 paragraph "b", the individual may complete such treatment in
 accordance with the individual's treatment plan, not to exceed
 the maximum treatment period.
    d.  A graduated schedule for cost=sharing by an eligible
 individual based on a percentage of the total benefit amount
 expended for the eligible individual, annually. Cost=sharing
 shall be applicable to eligible individuals with household
 incomes at or above two hundred percent of the federal poverty
 level in incrementally increased amounts up to a maximum of
 ten fifteen percent. The rules shall provide a financial
 hardship exemption from payment of the cost=sharing based on
 criteria established by rule of the department.
    Sec. 61.  AUTISM SUPPORT FUND ==== TRANSFER.
 Notwithstanding section 225D.2, moneys credited to the autism
 support fund that remain unexpended or unobligated at the
 close of the fiscal year beginning July 1, 2015, shall be
 transferred to the appropriation in this Act for medical
 contracts to be used for the purpose of that appropriation for
 the succeeding fiscal year.
    Sec. 62.  EFFECTIVE DATE.  The section of this division
 of this Act providing for transfer of moneys in the autism
 support fund that remain unexpended or unobligated at the
 close of the fiscal year beginning July 1, 2015, being deemed
 of immediate importance, takes effect upon enactment.
    Sec. 63.  RETROACTIVE APPLICABILITY.  The section of this
 division of this Act providing for transfer of moneys in the
 autism support fund that remain unexpended or unobligated
 at the close of the fiscal year beginning July 1, 2015, is
 retroactively applicable to July 1, 2015.
                          DIVISION XIII
             CHILDREN'S MENTAL HEALTH AND WELL=BEING
    Sec. 64.  CHILDREN'S MENTAL HEALTH CRISIS SERVICES ====
 PLANNING GRANTS.
    1.  The department of human services shall establish
 a request for proposals process, in cooperation with the
 departments of public health and education and the judicial
 branch, which shall be based upon recommendations for
 children's mental health crisis services described in the
 children's mental health and well=being workgroup final report
 submitted to the department on December 15, 2015.
    2.  Planning grants shall be awarded to two lead entities.
 Each lead entity should be a member of a specifically
 designated coalition of three to four other entities that
 propose to serve different geographically defined areas of
 the state, but a lead entity shall not be a mental health and
 disability services region.
    3.  The request for proposals shall require each grantee to
 develop a plan for children's mental health crisis services
 for the grantee's defined geographic area that includes all
 of the following:
    a.  Identification of the existing children's mental health
 crisis services in the defined area.
    b.  Identification of gaps in children's mental health
 crisis services in the defined area.
    c.  A plan for collection of data that demonstrates the
 effects of children's mental health crisis services through
 the collection of outcome data and surveys of the children
 affected and their families.
    d.  A method for using federal, state, and other funding
 including funding currently available, to implement and
 support children's mental health crisis services.
    e.  Utilization of collaborative processes developed from
 the recommendations from the children's mental health and
 well=being workgroup final report submitted to the department
 on December 15, 2015.
    f.  A recommendation for any additional state funding
 needed to establish a children's mental health crisis service
 system in the defined area.
    g.  A recommendation for statewide standard requirements
 for children's mental health crisis services, as defined in
 the children's mental health and well=being workgroup final
 report submitted to the department of human services on
 December 15, 2015, including but not limited to all of the
 following:
    (1)  Standardized primary care practitioner screenings.
    (2)  Standardized mental health crisis screenings.
    (3)  Standardized mental health and substance use disorder
 assessments.
    (4)  Requirements for certain inpatient psychiatric
 hospitals and psychiatric medical institutions for children
 to accept and treat all children regardless of the acuity of
 their condition.
    4.  Each grantee shall submit a report to the department
 by December 15, 2016. The department shall combine the
 essentials of each report and shall submit a report to
 the general assembly by January 15, 2017, regarding the
 department's conclusions and recommendations.
    Sec. 65.  CHILDREN'S WELL=BEING LEARNING LABS.  The
 department of human services, utilizing existing departmental
 resources and with the continued assistance of a private child
 welfare foundation focused on improving child well=being,
 shall study and collect data on emerging, collaborative
 efforts in existing programs engaged in addressing well=being
 for children with complex needs and their families in
 communities across the state.  The department shall establish
 guidelines based upon recommendations in the children's mental
 health and well=being workgroup final report submitted to
 the department on December 15, 2015, to select three to five
 such programs to be designated learning labs to enable the
 department to engage in a multi=site learning process during
 the 2016 calendar year with a goal of creating an expansive
 structured learning network. The department shall submit
 a report with recommendations including lessons learned,
 suggested program design refinements, and implications for
 funding, policy changes, and best practices to the general
 assembly by January 15, 2017.
    Sec. 66.  DEPARTMENT OF HUMAN SERVICES ==== ADDITIONAL
 STUDY REPORTS.  The department of human services shall, in
 consultation with the department of public health, the mental
 health and disability services commission, and the mental
 health planning council, submit a report with recommendations
 to the general assembly by December 15, 2016, regarding all of
 the following:
    1.  The creation and implementation of a statewide
 children's mental health crisis service system to include
 but not be limited to an inventory of all current children's
 mental health crisis service systems in the state including
 children's mental health crisis service system telephone
 lines.  The report shall include recommendations regarding
 proposed changes to improve the effectiveness of and access to
 children's mental health crisis services.
    2.  The development and implementation of a children's
 mental health public education and awareness campaign that
 targets the reduction of stigma for children with mental
 illness and that supports children with mental illness and
 their families in seeking effective treatment. The plan shall
 include potential methods for funding such a campaign.
    Sec. 67.  CHILDREN'S MENTAL HEALTH AND WELL=BEING ADVISORY
 COMMITTEE.  The department of human services shall create and
 provide support to a children's mental health and well=being
 advisory committee to continue the coordinated efforts of
 the children's mental health subcommittee and the children's
 well=being subcommittee of the children's mental health
 and well=being workgroup. Consideration shall be given to
 continued service by members of the children's mental health
 and well=being workgroup created pursuant to 2015 Iowa Acts,
 ch. 137, and representatives from the departments of human
 services, public health, and education; the judicial branch;
 and other appropriate stakeholders designated by the director.
 The advisory committee shall do all of the following:
    1.  Provide guidance regarding implementation of the
 recommendations in the children's mental health and well=being
 workgroup final report submitted to the department on December
 15, 2015, and subsequent reports required by this Act.
    2.  Select and study additional children's well=being
 learning labs to assure a continued commitment to joint
 learning and comparison for all learning lab sites.
                          DIVISION XIV
                   OPIOID ANTAGONIST REVISION
    Sec. 68.  Section 135.190, subsection 1, as enacted by 2016
 Iowa Acts, Senate File 2218, section 1, is amended by adding
 the following new paragraph:
    NEW PARAGRAPH.  0a.  "Licensed health care professional"
 means the same as defined in section 280.16.
    Sec. 69.  Section 135.190, as enacted by 2016 Iowa Acts,
 Senate File 2218, section 1, is amended by adding the
 following new subsections:
    NEW SUBSECTION.  1A.  a.  Notwithstanding any other
 provision of law to the contrary, a licensed health care
 professional may prescribe an opioid antagonist to a person
 in a position to assist.
    b.  (1)  Notwithstanding any other provision of law to the
 contrary, a pharmacist licensed under chapter 155A may, by
 standing order or through collaborative agreement, dispense,
 furnish, or otherwise provide an opioid antagonist to a person
 in a position to assist.
    (2)  A pharmacist who dispenses, furnishes, or otherwise
 provides an opioid antagonist pursuant to a valid
 prescription, standing order, or collaborative agreement shall
 provide instruction to the recipient in accordance with any
 protocols and instructions developed by the department under
 this section.
    NEW SUBSECTION.  4.  The department may adopt rules pursuant
 to chapter 17A to implement and administer this section.
    Sec. 70.  Section 135.190, subsection 3, as enacted by 2016
 Iowa Acts, Senate File 2218, section 1, is amended to read as
 follows:
    3.  A person in a position to assist or a prescriber of an
 opioid antagonist who has acted reasonably and in good faith
 shall not be liable for any injury arising from the provision,
 administration, or assistance in the administration of an
 opioid antagonist as provided in this section.
    Sec. 71.  Section 147A.18, subsections 1 and 5, as enacted
 by 2016 Iowa Acts, Senate File 2218, section 3, are amended to
 read as follows:
    1.  a.  Notwithstanding any other provision of law to the
 contrary, a licensed health care professional may prescribe
 an opioid antagonist in the name of a service program, law
 enforcement agency, or fire department to be maintained for
 use as provided in this section.
    b.  (1)  Notwithstanding any other provision of law to the
 contrary, a pharmacist licensed under chapter 155A may, by
 standing order or through collaborative agreement, dispense,
 furnish, or otherwise provide an opioid antagonist in the
 name of a service program, law enforcement agency, or fire
 department to be maintained for use as provided in this
 section.
    (2)  A pharmacist who dispenses, furnishes, or otherwise
 provides an opioid antagonist pursuant to a valid
 prescription, standing order, or collaborative agreement shall
 provide instruction to the recipient in accordance with the
 protocols and instructions developed by the department under
 this section.
    5.  The department shall may adopt rules pursuant to chapter
 17A to implement and administer this section, including but
 not limited to standards and procedures for the prescription,
 distribution, storage, replacement, and administration of
 opioid antagonists, and for the training and authorization
 to be required for first responders to administer an opioid
 antagonist.
    Sec. 72.  OPIOID ANTAGONIST IMPLEMENTATION
 CONTINGENCY.  2016 Iowa Acts, Senate File 2218, section
 4, is repealed.
    Sec. 73.  2016 Iowa Acts, Senate File 2218, as enacted, is
 amended by adding the following new section:
    NEW SECTION.  SEC. ___.  EFFECTIVE UPON ENACTMENT.  This
 Act, being deemed of immediate importance, takes effect upon
 enactment.
    Sec. 74.  EFFECTIVE DATE.  This division of this Act, being
 deemed of immediate importance, takes effect upon enactment.
    Sec. 75.  RETROACTIVE APPLICABILITY.  This division of this
 Act applies retroactively to April 6, 2016.
                           DIVISION XV
                     NURSING GRANT PROGRAMS
    Sec. 76.  Section 135.178, Code 2016, is amended to read as
 follows:
    135.178  Nurse residency state matching grants program ====
 repeal.
    1.  The department shall establish a nurse residency state
 matching grants program to provide matching state funding
 to sponsors of nurse residency programs in this state to
 establish, expand, or support nurse residency programs that
 meet standards adopted by rule of the department. Funding for
 the program may be provided through the health care workforce
 shortage fund or the nurse residency state matching grants
 program account created in section 135.175. The department,
 in cooperation with the Iowa board of nursing, the department
 of education, Iowa institutions of higher education with board
 of nursing=approved programs to educate nurses, and the Iowa
 nurses association, shall adopt rules pursuant to chapter 17A
 to establish minimum standards for nurse residency programs
 to be eligible for a matching grant that address all of the
 following:
    a.  1.  Eligibility requirements for and qualifications of
 a sponsor of a nurse residency program to receive a grant,
 including that the program includes both rural and urban
 components.
    b.  2.  The application process for the grant.
    c.  3.  Criteria for preference in awarding of the grants.
    d.  4.  Determination of the amount of a grant.
    e.  5.  Use of the funds awarded. Funds may be used to pay
 the costs of establishing, expanding, or supporting a nurse
 residency program as specified in this section, including but
 not limited to the costs associated with residency stipends
 and nursing faculty stipends.
    2.  This section is repealed June 30, 2016.
    Sec. 77.  Section 261.129, Code 2016, is amended to read as
 follows:
    261.129  Iowa needs nurses now initiative ==== repeal.
    1.  Nurse educator incentive payment program.
    a.  The commission shall establish a nurse educator
 incentive payment program. Funding for the program may
 be provided through the health care workforce shortage
 fund or the health care professional and Iowa needs nurses
 now initiative account created in section 135.175. For
 the purposes of this subsection, "nurse educator" means a
 registered nurse who holds a master's degree or doctorate
 degree and is employed as a faculty member who teaches nursing
 in a nursing education program as provided in 655 IAC 2.6 at a
 community college, an accredited private institution, or an
 institution of higher education governed by the state board
 of regents.
    b.  The program shall consist of incentive payments to
 recruit and retain nurse educators. The program shall provide
 for incentive payments of up to twenty thousand dollars for a
 nurse educator who remains teaching in a qualifying teaching
 position for a period of not less than four consecutive
 academic years.
    c.  The nurse educator and the commission shall enter
 into an agreement specifying the obligations of the nurse
 educator and the commission. If the nurse educator leaves
 the qualifying teaching position prior to teaching for four
 consecutive academic years, the nurse educator shall be liable
 to repay the incentive payment amount to the state, plus
 interest as specified by rule. However, if the nurse educator
 leaves the qualifying teaching position involuntarily, the
 nurse educator shall be liable to repay only a pro rata
 amount of the incentive payment based on incompleted years of
 service.
    d.  The commission, in consultation with the department
 of public health, the board of nursing, the department of
 education, and the Iowa nurses association, shall adopt
 rules pursuant to chapter 17A relating to the establishment
 and administration of the nurse educator incentive payment
 program. The rules shall include provisions specifying what
 constitutes a qualifying teaching position.
    2.  Nursing faculty fellowship program.
    a.  The commission shall establish a nursing faculty
 fellowship program to provide funds to nursing schools in
 the state, including but not limited to nursing schools
 located at community colleges, for fellowships for individuals
 employed in qualifying positions on the nursing faculty.
 Funding for the program may be provided through the health
 care workforce shortage fund or the health care professional
 and the Iowa needs nurses now initiative account created in
 section 135.175. The program shall be designed to assist
 nursing schools in filling vacancies in qualifying positions
 throughout the state.
    b.  The commission, in consultation with the department
 of public health, the board of nursing, the department of
 education, and the Iowa nurses association, and in cooperation
 with nursing schools throughout the state, shall develop a
 distribution formula which shall provide that no more than
 thirty percent of the available moneys are awarded to a single
 nursing school. Additionally, the program shall limit funding
 for a qualifying position in a nursing school to no more than
 ten thousand dollars per year for up to three years.
    c.  The commission, in consultation with the department
 of public health, the board of nursing, the department of
 education, and the Iowa nurses association, shall adopt
 rules pursuant to chapter 17A to administer the program. The
 rules shall include provisions specifying what constitutes a
 qualifying position at a nursing school.
    d.  In determining eligibility for a fellowship, the
 commission shall consider all of the following:
    (1)  The length of time a qualifying position has gone
 unfilled at a nursing school.
    (2)  Documented recruiting efforts by a nursing school.
    (3)  The geographic location of a nursing school.
    (4)  The type of nursing program offered at the nursing
 school, including associate, bachelor's, master's, or doctoral
 degrees in nursing, and the need for the specific nursing
 program in the state.
    3.  Nurse educator scholarship program.
    a.  The commission shall establish a nurse educator
 scholarship program. Funding for the program may be provided
 through the health care workforce shortage fund or the health
 care professional and the Iowa needs nurses now initiative
 account created in section 135.175. The goal of the nurse
 educator scholarship program is to address the waiting list of
 qualified applicants to Iowa's nursing schools by providing
 incentives for the training of additional nursing educators.
 For the purposes of this subsection, "nurse educator" means
 a registered nurse who holds a master's degree or doctorate
 degree and is employed as a faculty member who teaches nursing
 in a nursing education program as provided in 655 IAC 2.6 at a
 community college, an accredited private institution, or an
 institution of higher education governed by the state board
 of regents.
    b.  The program shall consist of scholarships to further
 advance the education of nurses to become nurse educators.
 The program shall provide for scholarship payments in an
 amount established by rule for students who are preparing to
 teach in qualifying teaching positions.
    c.  The commission, in consultation with the department
 of public health, the board of nursing, the department of
 education, and the Iowa nurses association, shall adopt rules
 pursuant to chapter 17A relating to the establishment and
 administration of the nurse educator scholarship program. The
 rules shall include provisions specifying what constitutes
 a qualifying teaching position and the amount of any
 scholarship.
    4.  Nurse educator scholarship=in=exchange=for=service
 program.
    a.  The commission shall establish a nurse educator
 scholarship=in=exchange=for=service program. Funding for the
 program may be provided through the health care workforce
 shortage fund or the health care professional and Iowa needs
 nurses now initiative account created in section 135.175. The
 goal of the nurse educator scholarship=in=exchange=for=service
 program is to address the waiting list of qualified applicants
 to Iowa's nursing schools by providing incentives for the
 education of additional nursing educators. For the purposes
 of this subsection, "nurse educator" means a registered
 nurse who holds a master's degree or doctorate degree and is
 employed as a faculty member who teaches nursing in a nursing
 education program as provided in 655 IAC 2.6 at a community
 college, an accredited private institution, or an institution
 of higher education governed by the state board of regents.
    b.  The program shall consist of scholarships to
 further advance the education of nurses to become
 nurse educators. The program shall provide for
 scholarship=in=exchange=for=service payments in an amount
 established by rule for students who are preparing to teach in
 qualifying teaching positions for a period of not less than
 four consecutive academic years.
    c.  The scholarship=in=exchange=for=service recipient
 and the commission shall enter into an agreement specifying
 the obligations of the applicant and the commission.
 If the nurse educator leaves the qualifying teaching
 position prior to teaching for four consecutive academic
 years, the nurse educator shall be liable to repay the
 scholarship=in=exchange=for=service amount to the state plus
 interest as specified by rule. However, if the nurse educator
 leaves the qualified teaching position involuntarily, the
 nurse educator shall be liable to repay only a pro rata amount
 of the scholarship based on incomplete years of service.
    d.  The receipt of a nurse educator
 scholarship=in=exchange=for=service shall not impact
 eligibility of an individual for other financial incentives
 including but not limited to loan forgiveness programs.
    e.  The commission, in consultation with the department
 of public health, the board of nursing, the department
 of education, and the Iowa nurses association, shall
 adopt rules pursuant to chapter 17A relating to the
 establishment and administration of the nurse educator
 scholarship=in=exchange=for=service program. The rules
 shall include the provisions specifying what constitutes
 a qualifying teaching position and the amount of any
 scholarship=in=exchange=for=service.
    5.  Repeal.  This section is repealed June 30, 2016.
    Sec. 78.  EFFECTIVE UPON ENACTMENT.  This division of this
 Act, being deemed of immediate importance, takes effect upon
 enactment.
    Sec. 79.  RETROACTIVE APPLICABILITY.  This division of this
 Act is retroactively applicable to June 30, 2016.
                          DIVISION XVI
   NON=STATE GOVERNMENT=OWNED NURSING FACILITY UPPER PAYMENT
               LIMIT SUPPLEMENTAL PAYMENT PROGRAM
    Sec. 80.  Section 249L.2, Code 2016, is amended by adding
 the following new subsections:
    NEW SUBSECTION.  5A.  "Non=state governmental entity" means
 a hospital authority, hospital district, health care district,
 city, or county.
    NEW SUBSECTION.  5B.  "Non=state government=owned nursing
 facility" means a nursing facility owned or operated by
 a non=state governmental entity for which a non=state
 governmental entity holds the nursing facility's license and
 is party to the nursing facility's Medicaid contract.
    Sec. 81.  Section 249L.2, subsection 6, Code 2016, is
 amended to read as follows:
    6.  "Nursing facility" means a licensed nursing facility as
 defined in section 135C.1 that is a freestanding facility or
 a nursing facility operated by a hospital licensed pursuant
 to chapter 135B, but does not include a distinct=part skilled
 nursing unit or a swing=bed unit operated by a hospital, or
 a nursing facility owned by the state or federal government
 or other governmental unit.  "Nursing facility" includes a
 non=state government=owned nursing facility if the nursing
 facility participates in the non=state government=owned
 nursing facility upper payment limit supplemental payment
 program.
    Sec. 82.  NON=STATE GOVERNMENT=OWNED NURSING FACILITY UPPER
 PAYMENT LIMIT SUPPLEMENTAL PAYMENT PROGRAM.
    1.  The department of human services shall submit, to
 the centers for Medicare and Medicaid services (CMS) of the
 United States department of health and human services, a
 Medicaid state plan amendment to allow qualifying non=state
 government=owned nursing facilities to receive a supplemental
 payment  in accordance with the upper payment limit
 requirements pursuant to 42 C.F.R. {447.272.  The supplemental
 payment shall be in addition to the greater of the Medicaid
 fee=for=service per diem reimbursement rate or the per diem
 payment established for the nursing facility under a Medicaid
 managed care contract.
    2.  At a minimum, the Medicaid state plan amendment shall
 provide for all of the following:
    a.  A non=state governmental entity shall provide the state
 share of the expected supplemental payment in the form of an
 intergovernmental transfer to the state.
    b.  The state shall claim federal matching funds and shall
 make supplemental payments to eligible non=state governmental
 entities based on the supplemental amount as calculated by
 the state for each nursing facility for which a non=state
 governmental entity owns the nursing facility's license.
 A managed care contractor shall not retain any portion of
 the supplemental payment, but shall treat the supplemental
 payment as a pass through payment to the eligible non=state
 governmental entity.
    c.  The supplemental payment program shall be budget
 neutral to the state. No general fund revenue shall
 be expended under the program including for costs of
 administration. If payments under the program result in
 overpayment to a nursing facility, or if CMS disallows federal
 participation related to a nursing facility's receipt or
 use of supplemental payments authorized under the program,
 the state may recoup an amount equivalent to the amount of
 supplemental payments overpaid or disallowed.  Supplemental
 payments shall be subject to any adjustment for payments
 made in error, including but not limited to adjustments made
 by state or federal law, and the state may recoup an amount
 equivalent to any such adjustment.
    d.  A nursing facility participating in the program shall
 notify the state of any changes in ownership that may affect
 the nursing facility's continued eligibility for the program
 within thirty days of any such change.
    e.  No portion of the supplemental payment paid to a
 participating nursing facility may be used for contingent
 fees. Expenditures for development fees, legal fees,
 or consulting fees shall not exceed five percent of
 the supplemental funds received, annually, and any such
 expenditures shall be reported to the department of human
 services, and included in the department's annual report
 pursuant to subsection 3.
    f.  The supplemental payment paid to a participating
 nursing facility shall only be used as specified in state and
 federal law.  Supplemental payments paid to a participating
 nursing facility shall only be used as follows:
    (1)  A portion of the amount received may be used for
 nursing facility quality improvement initiatives including
 but not limited to educational scholarships and nonmandatory
 training.  Priority in the awarding of contracts for such
 training shall be for Iowa=based organizations.
    (2)  A portion of the amount received may be used for
 nursing facility remodeling or renovation.  Priority in the
 awarding of contracts for such remodeling or renovations shall
 be for Iowa=based organizations and skilled laborers.
    (3)  A portion of the amount received may be used for health
 information technology infrastructure and software.   Priority
 in the awarding of contracts for such health information
 technology infrastructure and software shall be for Iowa=based
 organizations.
    (4)  A portion of the amount received may be used for
 endowments to offset costs associated with maintenance of
 hospitals licensed under chapter 135B and nursing facilities
 licensed under chapter 135C.
    g.  A non=state governmental entity shall only be eligible
 for supplemental payments attributable to up to 10 percent of
 the potential non=state government=owned nursing facilities
 licensed in the state.
    3.  Following receipt of approval and implementation of the
 program, the department shall submit a report to the governor
 and the general assembly, annually,  on or before December
 15, regarding the program.  The report shall include, at a
 minimum, the name and location of participating non=state
 governmental entities and the non=state government=owned
 nursing facilities with which the non=state  governmental
 entities have partnered to participate in the program; the
 amount of the matching funds provided by each non=state
 governmental entity; the net supplemental payment amount
 received by each participating non=governmental entity and
 non=state government=owned nursing facility; and the amount
 expended for each of the specified categories of approved
 expenditure.
    4.  The department of human services shall work
 collaboratively with representatives of nursing facilities,
 hospitals, and other affected stakeholders in adopting
 administrative rules, and in implementing and administering
 this program.
    5.  As used in this section:
    a.  "Non=state governmental entity" means a hospital
 authority, hospital district, health care district, city, or
 county.
    b.  "Non=state government=owned nursing facility" means a
 nursing facility owned or operated by a non=state governmental
 entity for which a non=state governmental entity holds
 the nursing facility's license and is party to the nursing
 facility's Medicaid contract.
    Sec. 83.  EFFECTIVE UPON ENACTMENT.  This division of this
 Act, being deemed of immediate importance, takes effect upon
 enactment.
    Sec. 84.  IMPLEMENTATION PROVISIONS.
    1.  The section of this division of this Act directing the
 department of human services to submit a Medicaid state plan
 amendment to CMS shall be implemented as soon as possible
 following enactment, consistent with all applicable federal
 requirements.
    2.  The sections of this division of this Act amending
 section 249L.2, shall only be implemented upon receipt by
 the department of human services of approval of the Medicaid
 state plan amendment by the centers for Medicare and Medicaid
 services of the United States department of health and human
 services, and if such approval is received, are applicable no
 earlier than the first day of the calendar quarter following
 the date of receipt of such approval.
                          DIVISION XVII
                       TRAUMA CARE SYSTEM
    Sec. 85.  Section 147A.23, subsection 2, paragraph c, Code
 2016, is amended to read as follows:
    c.  (1)  Upon verification and the issuance of a certificate
 of verification, a hospital or emergency care facility agrees
 to maintain a level of commitment and resources sufficient to
 meet responsibilities and standards as required by the trauma
 care criteria established by rule under this subchapter.
 Verifications are valid for a period of three years or as
 determined by the department and are renewable. As part
 of the verification and renewal process, the department
 may conduct periodic on=site reviews of the services and
 facilities of the hospital or emergency care facility.
    (2)  Notwithstanding subparagraph (1), the department shall
 not decrease a level II certificate of verification issued to
 a trauma care facility by the department on or before July 1,
 2015, unless the facility subsequently fails to comply with
 the trauma care criteria established in administrative rules
 in effect on July 1, 2015.
    Sec. 86.  EFFECTIVE UPON ENACTMENT.  This division of this
 Act, being deemed of immediate importance, takes effect upon
 enactment.
    Sec. 87.  RETROACTIVE APPLICABILITY.  This division of this
 Act applies retroactively to June 30, 2015.
                         DIVISION XVIII
    MENTAL HEALTH AND DISABILITY SERVICES REGIONS ==== FUNDING
    Sec. 88.  MENTAL HEALTH AND DISABILITY SERVICES REGIONS ====
 FUNDING.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    For a grant to a five=county mental health and disability
 services region with a population of between 290,000 to
 300,000 as determined by the latest federal decennial census,
 for the provision of mental health and disability services
 within the region:
 .................................................. $    500,000
    The moneys appropriated in this subsection are contingent
 upon the continuation of sustainable service funding
 relationships between all counties in the region for the
 fiscal year beginning July 1, 2016, and ending June 30, 2017.
 The department and the region shall enter into a memorandum of
 understanding regarding the use of the moneys by the region
 prior to the region's receipt of moneys under this subsection.
    2.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    For a grant to a single=county mental health and disability
 services region with a population of over 350,000 as
 determined by the latest federal decennial census, for the
 provision of mental health and disability services within the
 region:
 .................................................. $  2,500,000
    The department shall work with the region awarded moneys
 pursuant to this subsection to a complete a three=year
 sustainable cash flow funding plan for the delivery of mental
 health and disability services in the region to be submitted
 to the department by November 15, 2016. The department and
 the region shall enter into a memorandum of understanding
 regarding the use of the moneys and detailing the provisions
 of the plan prior to the region's receipt of moneys under this
 subsection.
    3.  The department shall distribute moneys appropriated
 in this section within 60 days of the date of signing of the
 memorandum of understanding between the department and each
 region.
    4.  Moneys awarded under this section shall be used by
 the regions consistent with each region's service system
 management plan as approved by the department.
                          DIVISION XIX
 MENTAL HEALTH AND DISABILITY SERVICES REDESIGN PROGRESS REPORT
    Sec. 89.  MENTAL HEALTH AND DISABILITY SERVICES REDESIGN
 PROGRESS REPORT.  The department of human services shall
 review and report progress on the implementation of the
 adult mental health and disability services redesign and
 shall identify any challenges faced in achieving the goals
 of the redesign.  The progress report shall include but
 not be limited to information regarding the mental health
 and disability services regional service system including
 governance, management, and administration; the implementation
 of best practices including evidence=based best practices;
 the availability of, access to, and provision of initial core
 services and additional core services to and for required core
 service populations and additional core service populations;
 and the financial stability and fiscal viability of the
 redesign.  The department shall submit its report with
 findings to the governor and the general assembly no later
 than November 15, 2016.
                           DIVISION XX
                 REFUGEERISE AMERICORPS PROGRAM
    Sec. 90.  Section 15H.5, subsection 5, paragraph a, Code
 2016, is amended to read as follows:
    a.  Funding for the Iowa summer youth corps program, the
 Iowa green corps program established pursuant to section
 15H.6, and the Iowa reading corps program established
 pursuant to section 15H.7, and the RefugeeRISE AmeriCorps
 program established pursuant to section 15H.8, shall be
 obtained from private sector, and local, state, and federal
 government sources, or from other available funds credited
 to the community programs account, which shall be created
 within the economic development authority under the authority
 of the commission. Moneys available in the account for a
 fiscal year are appropriated to the commission to be used
 for the programs. The commission may establish an escrow
 account within the authority and obligate moneys within
 that escrow account for tuition or program payments to be
 made beyond the term of any fiscal year. Notwithstanding
 section 12C.7, subsection 2, interest earned on moneys in the
 community programs account shall be credited to the account.
 Notwithstanding section 8.33, moneys in the community programs
 account or escrow account shall not revert to the general fund
 but shall remain available for expenditure in future fiscal
 years.
    Sec. 91.  NEW SECTION.  15H.8  RefugeeRISE AmeriCorps
 program.
    1.  a.  The Iowa commission on volunteer service, in
 collaboration with the department of human services, shall
 establish a Refugee Rebuild, Integrate, Serve, Empower
 (RefugeeRISE) AmeriCorps program to increase community
 integration and engagement for diverse refugee communities in
 rural and urban areas across the state.
    b.  The commission, in collaboration with the department
 of human services, may adopt rules pursuant to chapter 17A to
 implement and administer this section.
    2.  The commission may use moneys in and lawfully available
 to the community programs account created in section 15H.5 to
 fund the program.
    3.  The commission shall submit an annual report to the
 general assembly and the department of human services relating
 to the efficacy of the program.
                          DIVISION XXI
                   MENINGOCOCCAL IMMUNIZATION
    Sec. 92.  Section 139A.8, subsection 2, Code 2016, is
 amended by adding the following new paragraph:
    NEW PARAGRAPH.  e.  A person shall not be enrolled in school
 in the seventh grade or twelfth grade in Iowa without evidence
 of adequate immunization against meningococcal disease in
 accordance with standards approved by the United States public
 health service of the United States department of health
 and human services for such biological products and is in
 accordance with immunization practices recommended by the
 advisory committee on immunization practices of the centers
 for disease control and prevention.
                          DIVISION XXII
                 MEDICAID MANAGED CARE OVERSIGHT
      REPORTING AND PUBLIC POSTING OF REPORTS ==== CONSUMER
     PROTECTION, OUTCOME ACHIEVEMENT, AND PROGRAM INTEGRITY
                           INFORMATION
    Sec. 93.  DEPARTMENT OF HUMAN SERVICES ==== REPORTS.  The
 department of human services shall submit to the chairpersons
 and ranking members of the human resources committees of
 the senate and the house of representatives and to the
 chairpersons and ranking members of the joint appropriations
 subcommittee on health and human services, quarterly reports,
 and an annual report beginning December 15, 2016, and annually
 by December 15, thereafter, regarding Medicaid program
 consumer protections, outcome achievement, and program
 integrity as specified in this division. The reports shall be
 based on and updated to include the most recent information
 available. The reports shall include an executive summary
 of the information and data compiled, an analysis of the
 information and data, and any trends or issues identified
 through such analysis, to the extent such information is not
 otherwise considered confidential or protected information
 pursuant to federal or state law. The joint appropriations
 subcommittee on health and human services shall dedicate a
 meeting of the subcommittee during the subsequent session of
 the general assembly to review the annual report.
    1.  CONSUMER PROTECTION.
    The general assembly recognizes the need for ongoing review
 of Medicaid member engagement with and feedback regarding
 Medicaid managed care. The Iowa high quality health care
 initiative shall ensure access to medically necessary services
 and shall ensure that Medicaid members are fully engaged in
 their own health care in order to achieve overall positive
 health outcomes. The consumer protection component of the
 reports submitted as required under this section shall be
 based on all of the following reports relating to member and
 provider services:
    a.  Member enrollment and disenrollment.
    b.  Member grievances and appeals including all of the
 following:
    (1)  The percentage of grievances and appeals resolved
 timely.
    (2)  The number of grievances and appeals received.
    c.  Member call center performance including the service
 level for members, providers, and pharmacy.
    d.  Prior authorization denials and modifications including
 all of the following:
    (1)  The percentage of prior authorizations approved,
 denied, and modified.
    (2)  The percentage of prior authorizations processed
 within required timeframes.
    e.  Provider network access including key gaps in provider
 coverage based on contract time, distance standards, and
 market share.
    f.  Care coordination and case management, including the
 ratio of members to care coordinators or case managers, and
 the average number of contacts made with members per reporting
 period.
    g.  Level of care and functional assessments, including the
 percentage of level of care assessments completed timely.
    h.  Population=specific reporting including all of the
 following:
    (1)  General population, including adults and children.
    (2)  Special needs, including adults and children.
    (3)  Behavioral health, including adults and children.
    (4)  Elderly.
    i.  Number of individuals served on the home and
 community=based services (HCBS) waivers by waiver type, and
 HCBS waiver waiting list reductions or increases.
    2.  OUTCOME ACHIEVEMENT.
    The primary focus of the general assembly in moving to
 Medicaid managed care is to improve the quality of care and
 outcomes for Medicaid members. The state has demonstrated
 how preventive services and the coordination of care for all
 of a Medicaid member's treatment significantly improve the
 health and well=being of the state's most vulnerable citizens.
 In order to ensure continued improvement, ongoing review of
 member outcomes as well as of the process that supports a
 strong provider network is necessary. The outcome achievement
 component of the reports submitted as required under this
 section shall be based on all of the following reports:
    a.  Contract management including all of the following:
    (1)  Claims processing including all of the following:
    (a)  The percentage of claims paid, denied, and disputed,
 and the ten most common reasons for claims denials.
    (b)  The percentage of claims adjudicated timely.
    (2)  Encounter data including all of the following:
    (a)  Timeliness.
    (b)  Completeness.
    (c)  Accuracy.
    (3)  Value=based purchasing (VBP) enrollment including the
 percentage of members covered by a VBP arrangement.
    (4)  Financial information including all of the following:
    (a)  Managed care organization capitation payments.
    (b)  The medical loss ratio, administrative loss ratio, and
 underwriting ratio.
    (c)  Program cost savings.
    (5)  Utilization of health care services by diagnostic
 related group and ambulatory payment classification as well
 as total claims volume.
    (6)  Utilization of value=added services.
    (7)  Payment of claims by department=identified provider
 type.
    b.  Member health outcomes including all of the following:
    (1)  Annual health care effectiveness and information set
 (HEDIS) performance.
    (2)  Other quality measures including all of the following:
    (a)  Behavioral health.
    (b)  Children's health outcomes.
    (c)  Prenatal and birth outcomes.
    (d)  Chronic condition management.
    (e)  Adult preventative care.
    (3)  Value index score (VIS) performance.
    (4)  Annual consumer assessment of health care providers
 and systems (CAHPS) performance.
    (5)  Utilization information including all of the
 following:
    (a)  Inpatient hospital admissions and potential
 preventative admissions.
    (b)  Readmissions.
    (c)  Outpatient visits.
    (d)  Emergency department visits and potentially
 preventable emergency department visits.
    c.  Consumer satisfaction survey.
    3.  PROGRAM INTEGRITY.
    a.  The Medicaid program has traditionally included
 comprehensive oversight and program integrity controls.
 Under Medicaid managed care, federal, state, and contractual
 safeguards will continue to be incorporated to prevent,
 detect, and eliminate provider fraud, waste, and abuse
 to maintain a sustainable Medicaid program. The program
 integrity component of the reports submitted as required under
 this section shall be based on all of the following reports
 relating to program integrity:
    (1)  The level of fraud, waste, and abuse identified by the
 managed care organizations.
    (2)  Managed care organization adherence to the program
 integrity plan, including identification of program
 overpayments.
    (3)  Notification of the state by the managed care
 organizations  regarding fraud, waste, and abuse.
    (4)  The impact of program activities on capitation
 payments.
    (5)  Enrollment and payment information including all of
 the following:
    (a)  Eligibility.
    (b)  Third=party liability.
    (6)  Managed care organization reserves compared to minimum
 reserves required by the insurance division of the department
 of commerce.
    (7)  A summary report by the insurance division of the
 department of commerce including information relating
 to health maintenance organization licensure, the annual
 independent audit, insurance division reporting, and
 reinsurance.
    b.  The results of any external quality review organization
 review shall be submitted directly to the governor, the
 general assembly, and the health policy oversight committee
 created in section 2.45.
    c.  The department of human services shall require each
 Medicaid managed care organization to authorize the national
 committee for quality assurance (NCQA) to submit directly to
 the governor, the general assembly, and the health policy
 oversight committee created  in section 2.45, the evaluation
 report upon which the Medicaid managed care organization's
 NCQA accreditation was granted, and any subsequent evaluations
 of the Medicaid managed care organization.
    4.  INCLUSION OF INFORMATION FROM OTHER OVERSIGHT ENTITIES.
    The council on human services, the medical assistance
 advisory council, the hawk=i board, the mental health and
 disability services commission, and the office of long=term
 care ombudsman shall regularly review Medicaid managed care
 as it relates to the entity's respective statutory duties.
 These entities shall submit executive summaries of pertinent
 information regarding their deliberations during the prior
 year relating to Medicaid managed care to the department
 of human services no later than November 15, annually, for
 inclusion in the annual report submitted as required under
 this section.
    5.  PUBLIC POSTING OF INFORMATION REPORTED.
    The department of human services shall post all of the
 reports specified under this section, as the information
 becomes available and to the extent such information is not
 otherwise considered confidential or protected information
 pursuant to federal or state law, on the Iowa health link
 internet site.
    Sec. 94.  ADDITIONAL OVERSIGHT.
    1.  The council on human services, the medical assistance
 advisory council, and the hawk=i board shall submit to the
 chairpersons and ranking members of the human resources
 committees of the senate and the house of representatives
 and to the chairpersons and ranking members of the joint
 appropriations subcommittee on health and human services, on a
 quarterly basis, minutes of their respective meetings during
 which the council or board addressed Medicaid managed care.
    2.  The director of human services shall submit the
 compilation of the input and recommendations from stakeholders
 and Medicaid members attending the public meetings convened
 pursuant to 2015 Iowa Acts, chapter 137, section 63, to the
 chairpersons and ranking members of the human resources
 committees of the senate and the house of representatives
 and to the chairpersons and ranking members of the joint
 appropriations subcommittee on health and human services, on
 a quarterly basis.
    Sec. 95.  PROGRAM POLICY IMPROVEMENT.  The department
 of human services shall ensure that Medicaid managed care
 organizations comply with all of the following:
    1.  In accordance with 42 C.F.R. {438.420, a  Medicaid
 managed care organization, upon a recipient's request, shall
 continue a recipient's benefits during an appeal process. If,
 as allowed when final resolution of an appeal is adverse to
 the Medicaid recipient, the Medicaid managed care organization
 chooses to recover the costs of the services furnished to the
 recipient while an appeal is pending, the Medicaid managed
 care organization shall provide adequate prior notice of
 potential recovery of costs to the recipient at the time the
 appeal is filed.
    2.  A Medicaid managed care organization shall allow
 providers to appeal on a recipient's behalf if the recipient
 designates the provider as the recipient's representative.
    3.  a.  A Medicaid managed care organization may include as
 a primary care provider any provider designated by the state
 as a primary care provider, subject to a provider's respective
 state certification standards, including but not limited to
 all of the following:
    (1)  A physician who is a family or general practitioner,
 a pediatrician, an internist, an obstetrician, or a
 gynecologist.
    (2)  An advanced registered nurse practitioner.
    (3)  A physician assistant.
    (4)  A chiropractor licensed pursuant to chapter 151.
    b.  A Medicaid managed care organization shall not impose
 more restrictive, scope of practice requirements or standards
 of practice on a primary care provider than those prescribed
 by state law as a prerequisite for participation in the
 managed care organization's provider network.
    Sec. 96.  SINGLE=CASE AGREEMENT.  A Medicaid managed care
 organization shall, at the request of a Medicaid recipient,
 attempt to negotiate in good faith a single=case agreement
 with a recipient's out=of=network provider, including a
 provider outside of the state, to provide for continuity of
 care when the recipient has an existing relationship with such
 provider.  If a provider of a medically necessary service
 is not available within the managed care organization's
 network, the managed care organization shall, at the request
 of a Medicaid recipient, attempt to negotiate in good faith
 a single=case agreement with an out=of=network provider,
 regardless of the existence of an established relationship
 between the recipient and the provider.
                HEALTH POLICY OVERSIGHT COMMITTEE
    Sec. 97.  Section 2.45, subsection 6, Code 2016, is amended
 to read as follows:
    6.  The legislative health policy oversight committee,
 which shall be composed of ten members of the general
 assembly, consisting of five members from each house, to be
  appointed by the legislative council. The legislative health
 policy oversight committee shall receive updates and review
 data, public input and concerns, and make recommendations for
 improvements to and changes in law or rule regarding meet at
 least two times, annually, during the legislative interim
 to provide continuing oversight for Medicaid managed care,
 and to ensure effective and efficient administration of the
 program, address stakeholder concerns, monitor program costs
 and expenditures, and make recommendations.
                     MANAGED CARE OMBUDSMAN
    Sec. 98.  Section 231.44, Code 2016, is amended by adding
 the following new subsection:
    NEW SUBSECTION.  3A.  The office of long=term care ombudsman
 and representatives of the office, when providing assistance
 and advocacy services under this section, shall be considered
 a health oversight agency as defined in 45 C.F.R. {164.501 for
 the purposes of health oversight activities as described in
 45 C.F.R. {164.512(d). Recipient information available to
 the office of long=term care ombudsman and representatives
 of the office under this subsection shall be limited to the
 recipient's protected health information as defined in 45
 C.F.R. {160.103 for the purpose of recipient case resolution.
 When providing assistance and advocacy services under this
 section, the office of long=term care ombudsman shall act
 as an independent agency, and the office of long=term care
 ombudsman and representatives of the office shall be free of
 any undue influence that restrains the ability of the office
 or the office's representatives from providing such services
 and assistance. The office of long=term care ombudsman shall
 adopt rules applicable to long=term care ombudsmen providing
 assistance and advocacy services under this section to
 authorize such ombudsmen to function in a manner consistent
 with long=term care ombudsmen under the federal Act.
               MEDICAL ASSISTANCE ADVISORY COUNCIL
    Sec. 99.  Section 249A.4B, Code 2016, is amended to read as
 follows:
    249A.4B  Medical assistance advisory council.
    1.  A medical assistance advisory council is created to
 comply with 42 C.F.R. {431.12 based on section 1902(a)(4) of
 the federal Social Security Act and to advise the director
 about health and medical care services under the medical
 assistance program. The council shall meet no more than
 quarterly. The director of public health and a public member
 of the council selected by the public members of the council
 specified in subsection 2, paragraph "b", shall serve as
 chairperson co=chairpersons of the council.
    2.  The council shall include all of the following voting
  members:
    a.  The president, or the president's representative, of
 each of the following professional or business entities, or
 a member of each of the following professional or business
 entities, selected by the entity:
    (1)  The Iowa medical society.
    (2)  The Iowa osteopathic medical association.
    (3)  The Iowa academy of family physicians.
    (4)  The Iowa chapter of the American academy of pediatrics.
    (5)  The Iowa physical therapy association.
    (6)  The Iowa dental association.
    (7)  The Iowa nurses association.
    (8)  The Iowa pharmacy association.
    (9)  The Iowa podiatric medical society.
    (10)  The Iowa optometric association.
    (11)  The Iowa association of community providers.
    (12)  The Iowa psychological association.
    (13)  The Iowa psychiatric society.
    (14)  The Iowa chapter of the national association of social
 workers.
    (15)  The coalition for family and children's services in
 Iowa.
    (16)  The Iowa hospital association.
    (17)  The Iowa association of rural health clinics.
    (18)  The Iowa primary care association.
    (19)  Free clinics of Iowa.
    (20)  The opticians' association of Iowa, inc.
    (21)  The Iowa association of hearing health professionals.
    (22)  The Iowa speech and hearing association.
    (23)  The Iowa health care association.
    (24)  The Iowa association of area agencies on aging.
    (25)  AARP.
    (26)  The Iowa caregivers association.
    (27)  The Iowa coalition of home and community=based
 services for seniors.
    (28)  The Iowa adult day services association.
    (29)  Leading age Iowa.
    (30)  The Iowa association for home care.
    (31)  The Iowa council of health care centers.
    (32)  The Iowa physician assistant society.
    (33)  The Iowa association of nurse practitioners.
    (34)  The Iowa nurse practitioner society.
    (35)  The Iowa occupational therapy association.
    (36)  The ARC of Iowa, formerly known as the association for
 retarded citizens of Iowa.
    (37)  The national alliance for the mentally ill of Iowa on
 mental illness.
    (38)  The Iowa state association of counties.
    (39)  The Iowa developmental disabilities council.
    (40)  The Iowa chiropractic society.
    (41)  The Iowa academy of nutrition and dietetics.
    (42)  The Iowa behavioral health association.
    (43)  The midwest association for medical equipment
 services or an affiliated Iowa organization.
    b.  Public Ten public representatives which may include
 members of consumer groups, including recipients of medical
 assistance or their families, consumer organizations, and
 others, equal in number to the number of representatives
 of the professional and business entities specifically
 represented under paragraph "a", appointed by the governor
 for staggered terms of two years each, none of whom shall be
 members of, or practitioners of, or have a pecuniary interest
 in any of the professional or business entities specifically
 represented under paragraph "a", and a majority of whom shall
 be current or former recipients of medical assistance or
 members of the families of current or former recipients.
    c.  A member of the hawk=i board created in section 514I.5,
 selected by the members of the hawk=i board.
    3.  The council shall include all of the following nonvoting
 members:
    c.  a.  The director of public health, or the director's
 designee.
    d.  b.  The director of the department on aging, or the
 director's designee.
    c.  The long=term care ombudsman, or the long=term care
 ombudsman's designee.
    e.  d.  The dean of Des Moines university ==== osteopathic
 medical center, or the dean's designee.
    f.  e.  The dean of the university of Iowa college of
 medicine, or the dean's designee.
    g.  f.  The following members of the general assembly, each
 for a term of two years as provided in section 69.16B:
    (1)  Two members of the house of representatives, one
 appointed by the speaker of the house of representatives
 and one appointed by the minority leader of the house of
 representatives from their respective parties.
    (2)  Two members of the senate, one appointed by the
 president of the senate after consultation with the majority
 leader of the senate and one appointed by the minority leader
 of the senate.
    3.  4.  a.  An executive committee of the council is created
 and shall consist of the following members of the council:
    (1)  Five of the professional or business entity members
 designated pursuant to subsection 2, paragraph "a", and
 selected by the members specified under that paragraph, as
 voting members.
    (2)  Five of the public members appointed pursuant to
 subsection 2, paragraph "b", and selected by the members
 specified under that paragraph, as voting members. Of the
 five public members, at least one member shall be a recipient
 of medical assistance.
    (3)  The director of public health, or the director's
 designee, as a nonvoting member.
    b.  The executive committee shall meet on a monthly basis.
 The director of public health and the public member serving
 as co=chairperson of the council shall serve as chairperson
  co=chairpersons of the executive committee.
    c.  Based upon the deliberations of the council and the
 executive committee, the executive committee shall make
 recommendations to the director regarding the budget, policy,
 and administration of the medical assistance program.
    4.  5.  For each council meeting, other than those held
 during the time the general assembly is in session, each
 legislative member of the council shall be reimbursed for
 actual travel and other necessary expenses and shall receive
 a per diem as specified in section 7E.6 for each day in
 attendance, as shall the members of the council or the
 executive committee who are recipients or the family members
 of recipients of medical assistance, regardless of whether the
 general assembly is in session.
    5.  6.  The department shall provide staff support and
 independent technical assistance to the council and the
 executive committee.
    6.  7.  The director shall consider the recommendations
 offered by the council and the executive committee in
 the director's preparation of medical assistance budget
 recommendations to the council on human services pursuant to
 section 217.3 and in implementation of medical assistance
 program policies.
    Sec. 100.  APPOINTMENT OF PUBLIC REPRESENTATIVES TO
 MEDICAL ASSISTANCE ADVISORY COUNCIL ==== 2016.  The director
 of human services shall make recommendations to the governor
 for appointment of public representatives to the medical
 assistance advisory council pursuant to section 249A.4B,
 subsection 1, paragraph "b", in order to fill all public
 representative positions on the council no later than June 30,
 2016.
    Sec. 101.  EFFECTIVE UPON ENACTMENT.  The following
 provision of this division of this Act, being deemed of
 immediate importance, takes effect upon enactment:
    1.  The section of this division of this Act directing
 the appointment of public representatives to the medical
 assistance advisory council no later than June 30, 2016.
            CONTINUATION OF STATEWIDE PUBLIC MEETINGS
    Sec. 102.  2015 Iowa Acts, chapter 137, section 63, is
 amended to read as follows:
    SEC. 63.  HEALTH POLICY OVERSIGHT ==== MEDICAID MANAGED CARE.
    1.  The department of human services shall partner with
 appropriate stakeholders to convene monthly statewide public
 meetings beginning in March 2016, and bi=monthly statewide
 public meetings beginning March 2017 and continuing through
 December 31, 2017, to receive input and recommendations from
 stakeholders and members of the public regarding Medicaid
 managed care, beginning in March 2016.  The meetings shall
 be held in both rural and urban areas, in small communities
 and large population centers, and in a manner that is
 geographically balanced.  The department shall encourage
 representatives of Medicaid managed care organizations to
 attend the public meetings.  The input and recommendations of
 the public meetings shall be compiled by the department of
 human services and submitted to the executive committee of
 the medical assistance advisory council created in section
 249A.4B.
    2.  a.  The executive committee of the medical assistance
 advisory council shall review the compilation of the input and
 recommendations of the public meetings convened pursuant to
 subsection 1, and shall submit recommendations based upon the
 compilation to the director of human services on a quarterly
 basis through December 31, 2017.
    b.  The director of human services shall submit the
 compilation and the recommendations made under paragraph "a"
 to the legislative health policy oversight committee created
 in section 2.45 through December 31, 2017.
    Sec. 103.  EFFECTIVE UPON ENACTMENT.  The sections of this
 division of this Act amending 2015 Iowa Acts, chapter 137,
 section 63, being deemed of immediate importance, takes effect
 upon enactment.
                         HAWK=I PROGRAM
    Sec. 104.  Section 514I.5, subsection 8, paragraph d, Code
 2016, is amended by adding the following new subparagraph:
    NEW SUBPARAGRAPH.  (17)  Occupational therapy.
    Sec. 105.  Section 514I.5, Code 2016, is amended by adding
 the following new subsection:
    NEW SUBSECTION.  10.  The hawk=i board shall monitor
 the capacity of Medicaid managed care organizations to
 specifically and appropriately address the unique needs of
 children and children's health delivery.
                         DIVISION XXIII
                          FOOD PROGRAM
    Sec. 106.  IOWA EMERGENCY FOOD PURCHASE PROGRAM.  There
 is appropriated from the general fund of the state to the
 department of agriculture and land stewardship for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017, the
 following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    1.  For purposes of supporting an Iowa emergency food
 purchase program:
 .................................................. $    100,000
    2.  The purpose of the Iowa emergency food purchase
 program is to relieve situations of emergency experienced by
 families or individuals who reside in this state, including
 low=income families and individuals and unemployed families
 and individuals, by distributing food to those persons.
    3.  The Iowa emergency food purchase program shall be
 managed by an Iowa food bank association selected by the
 department. The department may enter into a contract with the
 Iowa food bank association. The Iowa food bank association
 managing the program shall distribute food under the program
 to emergency feeding organizations in this state. The Iowa
 food bank association shall report to the department as
 required by the department.
    4.  The moneys appropriated in this section shall be
 allocated to support the Iowa emergency food purchase program
 only to the extent that the allocated moneys are matched on a
 dollar=for=dollar basis.
    5.  "Iowa food bank association" means a private nonprofit
 entity that meets all of the following requirements:
    a.  The association is organized under chapter 504.
    b.  The association qualifies under section 501(c)(3) of the
 Internal Revenue Code as an organization exempt from federal
 income tax under section 501(a) of the Internal Revenue Code.
    c.  The association's members include food banks, or
 affiliations of food banks, that together serve all counties
 in this state.
    d.  The association's principal office is located in this
 state.


                                                             
                               LINDA UPMEYER
                               Speaker of the House


                                                             
                               PAM JOCHUM
                               President of the Senate
    I hereby certify that this bill originated in the House and
 is known as House File 2460, Eighty=sixth General Assembly.


                                                             
                               CARMINE BOAL
                               Chief Clerk of the House
 Approved                , 2016


                                                             
                               TERRY E. BRANSTAD
                               Governor

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