Bill Text: IA HF2501 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to appropriations for health and human services and veterans and including other related provisions and appropriations, providing penalties, and including effective date and retroactive and other applicability date provisions. (Formerly HSB 700.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2018-05-04 - Withdrawn. H.J. 971. [HF2501 Detail]
Download: Iowa-2017-HF2501-Introduced.html
House File 2501 - Introduced HOUSE FILE BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO HSB 700) A BILL FOR 1 An Act relating to appropriations for health and human 2 services and veterans and including other related provisions 3 and appropriations, providing penalties, and including 4 effective date and retroactive and other applicability date 5 provisions. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 5031HV (1) 87 pf/rn PAG LIN 1 1 DIVISION I 1 2 DEPARTMENT ON AGING ==== FY 2018=2019 1 3 Section 1. 2017 Iowa Acts, chapter 174, section 40, 1 4 unnumbered paragraphs 1 and 2, are amended to read as follows: 1 5 There is appropriated from the general fund of the state 1 6 to the department on aging for the fiscal year beginning July 1 7 1, 2018, and ending June 30, 2019, the following amount, or 1 8 so much thereof as is necessary, to be used for the purposes 1 9 designated: 1 10 For aging programs for the department on aging and area 1 11 agencies on aging to provide citizens of Iowa who are 60 years 1 12 of age and older with case management for frail elders, Iowa's 1 13 aging and disabilities resource center, and other services 1 14 which may include but are not limited to adult day services, 1 15 respite care, chore services, information and assistance, 1 16 and material aid, for information and options counseling for 1 17 persons with disabilities who are 18 years of age or older, 1 18 and for salaries, support, administration, maintenance, and 1 19 miscellaneous purposes, and for not more than the following 1 20 full=time equivalent positions: 1 21 .................................................. $5,521,2381 22 11,042,924 1 23 ............................................... FTEs 27.00 1 24 Sec. 2. 2017 Iowa Acts, chapter 174, section 40, subsections 1 25 2, 4, 5, 6, and 7, are amended to read as follows: 1 26 2. Of the funds appropriated in this section,$139,973 1 27$279,946 is transferred to the economic development authority 1 28 for the Iowa commission on volunteer services to be used for 1 29 the retired and senior volunteer program. 1 30 4. Of the funds appropriated in this section, at least 1 31$125,000$250,000 shall be used to fund the unmet needs 1 32 identified through Iowa's aging and disability resource center 1 33 network. 1 34 5. Of the funds appropriated in this section, at 1 35 least$300,000$600,000 shall be used to fund home and 2 1 community=based services through the area agencies on aging 2 2 that enable older individuals to avoid more costly utilization 2 3 of residential or institutional services and remain in their 2 4 own homes. 2 5 6. Of the funds appropriated in this section,$406,268 2 6$812,537 shall be used for the purposes of chapter 231E and 2 7section 231.56A, of which $175,000 shall be used for the office 2 8 of substitute decision maker pursuant to chapter 231E, and the 2 9 remainder shall be distributed equally to the area agencies on 2 10 agingto administer the prevention of elder abuse, neglect, and 2 11 exploitation program pursuant to section 231.56A, in accordance 2 12 with the requirements of the federal Older Americans Act of 2 13 1965, 42 U.S.C. {3001 et seq., as amended. 2 14 7. Of the funds appropriated in this section,$375,000 2 15$1,000,000 shall be used to fund continuation of the aging 2 16 and disability resource center lifelong links to provide 2 17 individuals and caregivers with information and services to 2 18 plan for and maintain independence. 2 19 Sec. 3. 2017 Iowa Acts, chapter 174, section 40, subsection 2 20 8, is amended by striking the subsection. 2 21 Sec. 4. 2017 Iowa Acts, chapter 174, section 40, is amended 2 22 by adding the following new subsection: 2 23 NEW SUBSECTION. 9. Of the funds appropriated in this 2 24 section, $100,000 shall be used by the department on aging, 2 25 in collaboration with the department of human services and 2 26 affected stakeholders, to design a pilot initiative to provide 2 27 long=term care options counseling utilizing support planning 2 28 protocols, to assist non=Medicaid eligible consumers who 2 29 indicate a preference to return to the community and are 2 30 deemed appropriate for discharge, to return to their community 2 31 following a nursing facility stay. The department on aging 2 32 shall submit the design plan as well as recommendations for 2 33 legislation necessary to administer the initiative, including 2 34 but not limited to legislation to allow the exchange of contact 2 35 information for nursing facility residents appropriate for 3 1 discharge planning, to the governor and the general assembly by 3 2 December 15, 2018. 3 3 DIVISION II 3 4 OFFICE OF LONG=TERM CARE OMBUDSMAN ==== FY 2018=2019 3 5 Sec. 5. 2017 Iowa Acts, chapter 174, section 41, is amended 3 6 to read as follows: 3 7 SEC. 41. OFFICE OF LONG=TERM CARE OMBUDSMAN. There is 3 8 appropriated from the general fund of the state to the office 3 9 of long=term care ombudsman for the fiscal year beginning July 3 10 1, 2018, and ending June 30, 2019, the following amount, or 3 11 so much thereof as is necessary, to be used for the purposes 3 12 designated: 3 13 For salaries, support, administration, maintenance, and 3 14 miscellaneous purposes, and for not more than the following 3 15 full=time equivalent positions: 3 16 .................................................. $580,1403 17 1,149,821 3 18 ............................................... FTEs 16.00 3 19 DIVISION III 3 20 DEPARTMENT OF PUBLIC HEALTH ==== FY 2018=2019 3 21 Sec. 6. 2017 Iowa Acts, chapter 174, section 42, subsections 3 22 1, 2, 3, 4, 5, 6, 7, and 8, are amended to read as follows: 3 23 1. ADDICTIVE DISORDERS 3 24 For reducing the prevalence of the use of tobacco, alcohol, 3 25 and other drugs, and treating individuals affected by addictive 3 26 behaviors, including gambling, and for not more than the 3 27 following full=time equivalent positions: 3 28 .................................................. $12,492,9153 29 24,804,344 3 30 ............................................... FTEs10.003 31 11.00 3 32 a. (1) Of the funds appropriated in this subsection, 3 33$2,010,612$4,021,225 shall be used for the tobacco use 3 34 prevention and control initiative, including efforts at the 3 35 state and local levels, as provided in chapter 142A. The 4 1 commission on tobacco use prevention and control established 4 2 pursuant to section 142A.3 shall advise the director of 4 3 public health in prioritizing funding needs and the allocation 4 4 of moneys appropriated for the programs and initiatives. 4 5 Activities of the programs and initiatives shall be in 4 6 alignment with the United States centers for disease control 4 7 and prevention best practices for comprehensive tobacco control 4 8 programs that include the goals of preventing youth initiation 4 9 of tobacco usage, reducing exposure to secondhand smoke, 4 10 and promotion of tobacco cessation. To maximize resources, 4 11 the department shall determine if third=party sources are 4 12 available to instead provide nicotine replacement products 4 13 to an applicant prior to provision of such products to an 4 14 applicant under the initiative. The department shall track and 4 15 report to the individuals specified in this Act, any reduction 4 16 in the provision of nicotine replacement products realized 4 17 by the initiative through implementation of the prerequisite 4 18 screening. 4 19 (2) (a) The department shall collaborate with the 4 20 alcoholic beverages division of the department of commerce for 4 21 enforcement of tobacco laws, regulations, and ordinances and to 4 22 engage in tobacco control activities approved by the division 4 23 of tobacco use prevention and control of the department of 4 24 public health as specified in the memorandum of understanding 4 25 entered into between the divisions. 4 26 (b) For the fiscal year beginning July 1, 2018, and ending 4 27 June 30, 2019, the terms of the memorandum of understanding, 4 28 entered into between the division of tobacco use prevention 4 29 and control of the department of public health and the 4 30 alcoholic beverages division of the department of commerce, 4 31 governing compliance checks conducted to ensure licensed retail 4 32 tobacco outlet conformity with tobacco laws, regulations, and 4 33 ordinances relating to persons under 18 years of age, shall 4 34 continue to restrict the number of such checks to one check per 4 35 retail outlet, and one additional check for any retail outlet 5 1 found to be in violation during the first check. 5 2 b. Of the funds appropriated in this subsection, 5 3$10,482,303$20,783,119 shall be used for problem gambling and 5 4 substance=related disorder prevention, treatment, and recovery 5 5 services, including a 24=hour helpline, public information 5 6 resources, professional training, youth prevention, and program 5 7 evaluation. 5 8 c. The requirement of section 123.17, subsection 5, is met 5 9 by the appropriations and allocations made in this division of 5 10 this Act for purposes of substance=related disorder treatment 5 11 and addictive disorders for the fiscal year beginning July 1, 5 12 2018. 5 13 d. The department of public health, in collaboration with 5 14 the department of human services, shall engage a stakeholder 5 15 workgroup to review reimbursement provisions applicable 5 16 to substance use disorder services providers. The issues 5 17 considered by the workgroup shall include but are not limited 5 18 to the adequacy of reimbursement provisions including for 5 19 both outpatient and residential treatment, whether it is 5 20 appropriate to rebase reimbursement, whether there is equity in 5 21 reimbursement compared to the reimbursement methodologies used 5 22 for providers of similar behavioral health services, and access 5 23 to substance use disorder services providers including whether 5 24 the designated number of community mental health centers in the 5 25 state is sufficient. The workgroup shall review the reports 5 26 of previous workgroups including those authorized in 2014 Iowa 5 27 Acts, chapter 1140, section 3, subsection 1, and shall report 5 28 the workgroup's findings and recommendations to the general 5 29 assembly on or before December 15, 2018. 5 30 2. HEALTHY CHILDREN AND FAMILIES 5 31 For promoting the optimum health status for children, 5 32 adolescents from birth through 21 years of age, and families, 5 33 and for not more than the following full=time equivalent 5 34 positions: 5 35 .................................................. $2,662,8166 1 5,820,625 6 2 ............................................... FTEs 12.00 6 3 a. Of the funds appropriated in this subsection, not 6 4 more than$367,420$734,841 shall be used for the healthy 6 5 opportunities for parents to experience success (HOPES)=healthy 6 6 families Iowa (HFI) program established pursuant to section 6 7 135.106. The funding shall be distributed to renew the grants 6 8 that were provided to the grantees that operated the program 6 9 during the fiscal year ending June 30, 2018. 6 10 b. In order to implement the legislative intent stated in 6 11 sections 135.106 and 256I.9, that priority for home visitation 6 12 program funding be given to programs using evidence=based or 6 13 promising models for home visitation, it is the intent of the 6 14 general assembly to phase in the funding priority in accordance 6 15 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, 6 16 paragraph "0b". 6 17 c. Of the funds appropriated in this subsection,$1,537,550 6 18$3,075,101 shall be used for continuation of the department's 6 19 initiative to provide for adequate developmental surveillance 6 20 and screening during a child's first five years. The funds 6 21 shall be used first to fully fund the current sites to ensure 6 22 that the sites are fully operational, with the remaining 6 23 funds to be used for expansion to additional sites. The full 6 24 implementation and expansion shall include enhancing the scope 6 25 of the initiative through collaboration with the child health 6 26 specialty clinics to promote healthy child development through 6 27 early identification and response to both biomedical and social 6 28 determinants of healthy development; by monitoring child 6 29 health metrics to inform practice, document long=term health 6 30 impacts and savings, and provide for continuous improvement 6 31 through training, education, and evaluation; and by providing 6 32 for practitioner consultation particularly for children with 6 33 behavioral conditions and needs. The department of public 6 34 health shall also collaborate with the Iowa Medicaid enterprise 6 35 and the child health specialty clinics to integrate the 7 1 activities of the first five initiative into the establishment 7 2 of patient=centered medical homes, community utilities, 7 3 accountable care organizations, and other integrated care 7 4 models developed to improve health quality and population 7 5 health while reducing health care costs. To the maximum extent 7 6 possible, funding allocated in this paragraph shall be utilized 7 7 as matching funds for medical assistance program reimbursement. 7 8 d. Of the funds appropriated in this subsection,$32,320 7 9$64,640 shall be distributed to a statewide dental carrier to 7 10 provide funds to continue the donated dental services program 7 11 patterned after the projects developed by the lifeline network 7 12 to provide dental services to indigent individuals who are 7 13 elderly or with disabilities. 7 14 e. Of the funds appropriated in this subsection,$78,241 7 15$156,482 shall be used to provide audiological services and 7 16 hearing aids for children. The department may enter into a 7 17 contract to administer this paragraph. 7 18 f. Of the funds appropriated in this subsection,$11,500 7 19$23,000 is transferred to the university of Iowa college of 7 20 dentistry for provision of primary dental services to children. 7 21 State funds shall be matched on a dollar=for=dollar basis. 7 22 The university of Iowa college of dentistry shall coordinate 7 23 efforts with the department of public health, bureau of 7 24 oral and health delivery systems, to provide dental care to 7 25 underserved populations throughout the state. 7 26 g. Of the funds appropriated in this subsection,$25,000 7 27$50,000 shall be used to address youth suicide prevention. 7 28 h. Of the funds appropriated in this subsection,$20,255 7 29$40,511 shall be used to support the Iowa effort to address the 7 30 survey of children who experience adverse childhood experiences 7 31 known as ACEs. 7 32 i. The department of public health shall continue to 7 33 administer the program to assist parents in this state with 7 34 costs resulting from the death of a child in accordance with 7 35 the provisions of 2014 Iowa Acts, chapter 1140, section 22, 8 1 subsection 12. 8 2 j. Of the funds appropriated in this subsection, up to 8 3 $494,993 shall be used for childhood obesity prevention. 8 4 3. CHRONIC CONDITIONS 8 5 For serving individuals identified as having chronic 8 6 conditions or special health care needs, and for not more than 8 7 the following full=time equivalent positions: 8 8 .................................................. $2,085,3758 9 4,528,109 8 10 ............................................... FTEs5.008 11 9.00 8 12 a. Of the funds appropriated in this subsection,$76,877 8 13$153,755 shall be used for grants to individual patients who 8 14 have an inherited metabolic disorder to assist with the costs 8 15 of medically necessary foods and formula. 8 16 b. Of the funds appropriated in this subsection,$510,397 8 17$1,055,291 shall be used for the brain injury services program 8 18 pursuant to section 135.22B, including for contracting with an 8 19 existing nationally affiliated and statewide organization whose 8 20 purpose is to educate, serve, and support Iowans with brain 8 21 injury and their families for resource facilitator services 8 22 in accordance with section 135.22B, subsection 9, and for 8 23 contracting to enhance brain injury training and recruitment 8 24 of service providers on a statewide basis. Of the amount 8 25 allocated in this paragraph,$47,500$95,000 shall be used to 8 26 fund one full=time equivalent position to serve as the state 8 27 brain injury services program manager. 8 28 c. Of the funds appropriated in this subsection,$72,048 8 29$144,097 shall be used for the public purpose of continuing 8 30 to contract with an existing national=affiliated organization 8 31 to provide education, client=centered programs, and client 8 32 and family support for people living with epilepsy and their 8 33 families. The amount allocated in this paragraph in excess 8 34 of$50,000$100,000 shall be matched dollar=for=dollar by the 8 35 organization specified. 9 1 d. Of the funds appropriated in this subsection,$404,775 9 2$809,550 shall be used for child health specialty clinics. 9 3 e. Of the funds appropriated in this subsection, 9 4$192,276$384,552 shall be used by the regional autism 9 5 assistance program established pursuant to section 256.35, 9 6 and administered by the child health specialty clinic located 9 7 at the university of Iowa hospitals and clinics. The funds 9 8 shall be used to enhance interagency collaboration and 9 9 coordination of educational, medical, and other human services 9 10 for persons with autism, their families, and providers of 9 11 services, including delivering regionalized services of care 9 12 coordination, family navigation, and integration of services 9 13 through the statewide system of regional child health specialty 9 14 clinics and fulfilling other requirements as specified in 9 15 chapter 225D. The university of Iowa shall not receive funds 9 16 allocated under this paragraph for indirect costs associated 9 17 with the regional autism assistance program. 9 18 f. Of the funds appropriated in this subsection,$288,687 9 19$577,375 shall be used for the comprehensive cancer control 9 20 program to reduce the burden of cancer in Iowa through 9 21 prevention, early detection, effective treatment, and ensuring 9 22 quality of life. Of the funds allocated in this paragraph "f", 9 23$75,000$150,000 shall be used to support a melanoma research 9 24 symposium, a melanoma biorepository and registry, basic and 9 25 translational melanoma research, and clinical trials. 9 26 g. Of the funds appropriated in this subsection,$48,766 9 27$97,532 shall be used for cervical and colon cancer screening, 9 28 and$88,860$177,720 shall be used to enhance the capacity of 9 29 the cervical cancer screening program to include provision 9 30 of recommended prevention and early detection measures to a 9 31 broader range of low=income women. 9 32 h. Of the funds appropriated in this subsection,$253,177 9 33$506,355 shall be used for the center for congenital and 9 34 inherited disorders. 9 35 i. Of the funds appropriated in this subsection,$107,631 10 1$225,263 shall be used by the department of public health 10 2 for reform=related activities, including but not limited to 10 3 facilitation of communication to stakeholders at the state and 10 4 local level, administering the patient=centered health advisory 10 5 council pursuant to section 135.159, and involvement in health 10 6 care system innovation activities occurring across the state. 10 7 j. Of the funds appropriated in this subsection,$11,050 10 8$322,100 shall be used for administration of chapter124D124E, 10 9 the medical cannabidiol Act. 10 10 4. COMMUNITY CAPACITY 10 11 For strengthening the health care delivery system at the 10 12 local level, and for not more than the following full=time 10 13 equivalent positions: 10 14 .................................................. $1,453,88810 15 4,865,152 10 16 ............................................... FTEs 13.00 10 17 a. Of the funds appropriated in this subsection,$47,787 10 18$95,575 is allocated for continuation of the child vision 10 19 screening program implemented through the university of Iowa 10 20 hospitals and clinics in collaboration with early childhood 10 21 Iowa areas. The program shall submit a report to the 10 22 individuals identified in this Act for submission of reports 10 23 regarding the use of funds allocated under this paragraph 10 24 "a". The report shall include the objectives and results for 10 25 the program year including the target population and how the 10 26 funds allocated assisted the program in meeting the objectives; 10 27 the number, age, and location within the state of individuals 10 28 served; the type of services provided to the individuals 10 29 served; the distribution of funds based on service provided; 10 30 and the continuing needs of the program. 10 31b. Of the funds appropriated in this subsection, $52,828 is 10 32 allocated for continuation of an initiative implemented at the 10 33 university of Iowa to expand and improve the workforce engaged 10 34 in mental health treatment and services. The initiative shall 10 35 receive input from the university of Iowa, the department of 11 1 human services, the department of public health, and the mental 11 2 health and disability services commission to address the focus 11 3 of the initiative.11 4c. Of the funds appropriated in this section, $41,657 shall 11 5 be deposited in the governmental public health system fund 11 6 created in section 135A.8 to be used for the purposes of the 11 7 fund.11 8 d. Of the funds appropriated in this subsection,$24,034 11 9$48,069 shall be used for a grant to a statewide association 11 10 of psychologists that is affiliated with the American 11 11 psychological association to be used for continuation of a 11 12 program to rotate intern psychologists in placements in urban 11 13 and rural mental health professional shortage areas, as defined 11 14 in section 135.180. 11 15 e. Of the funds appropriated in this subsection, the 11 16 following amounts are allocated to be used as follows to 11 17 support the Iowa collaborative safety net provider network 11 18 goals of increased access, health system integration, and 11 19 engagement. 11 20 (1) Not less than$260,931$437,829 is allocated to the 11 21 Iowa prescription drug corporation for continuation of the 11 22 pharmaceutical infrastructure for safety net providers as 11 23 described in 2007 Iowa Acts, chapter 218, section 108, and for 11 24 the prescription drug donation repository program created in 11 25 chapter 135M. 11 26 (2) Not less than$167,435$334,870 is allocated to free 11 27 clinics and free clinics of Iowa for necessary infrastructure, 11 28 statewide coordination, provider recruitment, service delivery, 11 29 and provision of assistance to patients in securing a medical 11 30 home inclusive of oral health care. 11 31 (3) Not less than$12,500$25,000 is allocated to the 11 32 Iowa association of rural health clinics for necessary 11 33 infrastructure and service delivery transformation. 11 34 (4) Not less than$50,000$205,493 is allocated to the 11 35 Polk county medical society for continuation of the safety net 12 1 provider patient access to a specialty health care initiative 12 2 as described in 2007 Iowa Acts, chapter 218, section 109. 12 3 f. Of the funds appropriated in this subsection,$38,115 12 4$15,000 shall be used by the department in implementing 12 5 the recommendations in the final report submitted by the 12 6 direct care worker advisory council to the governor and the 12 7 general assembly in March 2012, including by continuing to 12 8 develop, promote, and make available on a statewide basis the 12 9 prepare=to=care core curriculum and its associated modules 12 10 and specialties through various formats including online 12 11 access, community colleges, and other venues; exploring new and 12 12 maintaining existing specialties including but not limited to 12 13 oral health and dementia care; supporting instructor training; 12 14 and assessing and making recommendations concerning the Iowa 12 15 care book and information technology systems and infrastructure 12 16 uses and needs. 12 17 g. Of the funds appropriated in this subsection,$95,594 12 18$176,188 shall be allocated for continuation of the contract 12 19 with an independent statewide direct care worker organization 12 20 previously selected through a request for proposals process. 12 21 The contract shall continue to include performance and outcomes 12 22 measures, and shall continue to allow the contractor to use a 12 23 portion of the funds received under the contract to collect 12 24 data to determine results based on the performance and outcomes 12 25 measures. 12 26 h. Of the funds appropriated in this subsection, the 12 27 department may use up to$29,087$58,175 for up to one 12 28 full=time equivalent position to administer the volunteer 12 29 health care provider program pursuant to section 135.24. 12 30 i. Of the funds appropriated in this subsection,$48,069 12 31$96,138 shall be used for a matching dental education loan 12 32 repayment program to be allocated to a dental nonprofit health 12 33 service corporation to continue to develop the criteria and 12 34 implement the loan repayment program. 12 35j. Of the funds appropriated in this subsection, $26,455 is 13 1 transferred to the college student aid commission for deposit 13 2 in the rural Iowa primary care trust fund created in section 13 3 261.113 to be used for the purposes of the fund.13 4 k. Of the funds appropriated in this subsection,$75,000 13 5$100,000 shall be used for the purposes of the Iowa donor 13 6 registry as specified in section 142C.18. 13 7 l. Of the funds appropriated in this subsection,$48,069 13 8$96,138 shall be used for continuation of a grant to a 13 9 nationally affiliated volunteer eye organization that has an 13 10 established program for children and adults and that is solely 13 11 dedicated to preserving sight and preventing blindness through 13 12 education, nationally certified vision screening and training, 13 13 and community and patient service programs. The organization 13 14 shall submit a report to the individuals identified in this 13 15 Act for submission of reports regarding the use of funds 13 16 allocated under this paragraph "l". The report shall include 13 17 the objectives and results for the program year including 13 18 the target population and how the funds allocated assisted 13 19 the program in meeting the objectives; the number, age, and 13 20 location within the state of individuals served; the type of 13 21 services provided to the individuals served; the distribution 13 22 of funds based on services provided; and the continuing needs 13 23 of the program. 13 24 m. Of the funds appropriated in this subsection,$436,327 13 25$2,000,000 shall be deposited in the medical residency training 13 26 account created in section 135.175, subsection 5, paragraph 13 27 "a", and is appropriated from the account to the department 13 28 of public health to be used for the purposes of the medical 13 29 residency training state matching grants program as specified 13 30 in section 135.176. 13 31 n. Of the funds appropriated in this subsection, $250,000 13 32 shall be used for the public purpose of providing funding to 13 33 Des Moines university to establish a provider education project 13 34 to provide primary care physicians with the training and skills 13 35 necessary to recognize signs of mental illness in patients. 14 1 5. ESSENTIAL PUBLIC HEALTH SERVICES 14 2 To provide public health services that reduce risks and 14 3 invest in promoting and protecting good health over the 14 4 course of a lifetime with a priority given to older Iowans and 14 5 vulnerable populations: 14 6 .................................................. $4,098,93914 7 7,662,464 14 8 6. INFECTIOUS DISEASES 14 9 For reducing the incidence and prevalence of communicable 14 10 diseases, and for not more than the following full=time 14 11 equivalent positions: 14 12 .................................................. $823,21314 13 1,796,426 14 14 ............................................... FTEs 4.00 14 15 7. PUBLIC PROTECTION 14 16 For protecting the health and safety of the public through 14 17 establishing standards and enforcing regulations, and for not 14 18 more than the following full=time equivalent positions: 14 19 .................................................. $2,097,56914 20 4,095,139 14 21 ............................................... FTEs138.0014 22 141.00 14 23 a. Of the funds appropriated in this subsection, not more 14 24 than$152,350$304,700 shall be credited to the emergency 14 25 medical services fund created in section 135.25. Moneys in 14 26 the emergency medical services fund are appropriated to the 14 27 department to be used for the purposes of the fund. 14 28 b. Of the funds appropriated in this subsection, up 14 29 to$121,630$243,260 shall be used for sexual violence 14 30 prevention programming through a statewide organization 14 31 representing programs serving victims of sexual violence 14 32 through the department's sexual violence prevention program, 14 33 and for continuation of a training program for sexual assault 14 34 response team (SART) members, including representatives of 14 35 law enforcement, victim advocates, prosecutors, and certified 15 1 medical personnel. The amount allocated in this paragraph "b" 15 2 shall not be used to supplant funding administered for other 15 3 sexual violence prevention or victims assistance programs. 15 4 c. Of the funds appropriated in this subsection, up to 15 5$287,813$500,000 shall be used for the state poison control 15 6 center. Pursuant to the directive under 2014 Iowa Acts, 15 7 chapter 1140, section 102, the federal matching funds available 15 8 to the state poison control center from the department of human 15 9 services under the federal Children's Health Insurance Program 15 10 Reauthorization Act allotment shall be subject to the federal 15 11 administrative cap rule of 10 percent applicable to funding 15 12 provided under Tit. XXI of the federal Social Security Act and 15 13 included within the department's calculations of the cap. 15 14 d. Of the funds appropriated in this subsection, up to 15 15$258,491$504,796 shall be used for childhood lead poisoning 15 16 provisions. 15 17 8. RESOURCE MANAGEMENT 15 18 For establishing and sustaining the overall ability of the 15 19 department to deliver services to the public, and for not more 15 20 than the following full=time equivalent positions: 15 21 .................................................. $485,60715 22 971,215 15 23 ............................................... FTEs 4.00 15 24 Sec. 7. 2017 Iowa Acts, chapter 174, section 42, subsections 15 25 10 and 11, are amended by striking the subsections. 15 26 DIVISION IV 15 27 DEPARTMENT OF VETERANS AFFAIRS ==== FY 2018=2019 15 28 Sec. 8. 2017 Iowa Acts, chapter 174, section 43, is amended 15 29 to read as follows: 15 30 SEC. 43. DEPARTMENT OF VETERANS AFFAIRS. There is 15 31 appropriated from the general fund of the state to the 15 32 department of veterans affairs for the fiscal year beginning 15 33 July 1, 2018, and ending June 30, 2019, the following amounts, 15 34 or so much thereof as is necessary, to be used for the purposes 15 35 designated: 16 1 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 16 2 For salaries, support, maintenance, and miscellaneous 16 3 purposes, and for not more than the following full=time 16 4 equivalent positions: 16 5 .................................................. $571,27816 6 1,150,500 16 7 ............................................... FTEs 15.00 16 8 2. IOWA VETERANS HOME 16 9 For salaries, support, maintenance, and miscellaneous 16 10 purposes: 16 11 .................................................. $3,614,07016 12 7,162,976 16 13 a. The Iowa veterans home billings involving the department 16 14 of human services shall be submitted to the department on at 16 15 least a monthly basis. 16 16 b. Within available resources and in conformance with 16 17 associated state and federal program eligibility requirements, 16 18 the Iowa veterans home may implement measures to provide 16 19 financial assistance to or on behalf of veterans or their 16 20 spouses who are participating in the community reentry program. 16 21 d. The Iowa veterans home shall continue to include in the 16 22 annual discharge report applicant information and to provide 16 23 for the collection of demographic information including but not 16 24 limited to the number of individuals applying for admission and 16 25 admitted or denied admittance and the basis for the admission 16 26 or denial; the age, gender, and race of such individuals; 16 27 and the level of care for which such individuals applied for 16 28 admission including residential or nursing level of care. 16 29 3. HOME OWNERSHIP ASSISTANCE PROGRAM 16 30 For transfer to the Iowa finance authority for the 16 31 continuation of the home ownership assistance program for 16 32 persons who are or were eligible members of the armed forces of 16 33 the United States, pursuant to section 16.54: 16 34 .................................................. $1,000,00016 35 2,000,000 17 1 Sec. 9. 2017 Iowa Acts, chapter 174, section 44, is amended 17 2 to read as follows: 17 3 SEC. 44. LIMITATION OF COUNTY COMMISSIONS OF VETERAN 17 4 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 17 5 standing appropriation in section 35A.16 for the fiscal year 17 6 beginning July 1, 2018, and ending June 30, 2019, the amount 17 7 appropriated from the general fund of the state pursuant to 17 8 that section for the following designated purposes shall not 17 9 exceed the following amount: 17 10 For the county commissions of veteran affairs fund under 17 11 section 35A.16: 17 12 .................................................. $473,96217 13 990,000 17 14 DIVISION V 17 15 DEPARTMENT OF HUMAN SERVICES ==== FY 2018=2019 17 16 Sec. 10. 2017 Iowa Acts, chapter 174, section 45, is amended 17 17 to read as follows: 17 18 SEC. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 17 19 GRANT. There is appropriated from the fund created in section 17 20 8.41 to the department of human services for the fiscal year 17 21 beginning July 1, 2018, and ending June 30, 2019, from moneys 17 22 received under the federal temporary assistance for needy 17 23 families (TANF) block grant pursuant to the federal Personal 17 24 Responsibility and Work Opportunity Reconciliation Act of 1996, 17 25 Pub. L. No. 104=193, and successor legislation, the following 17 26 amounts, or so much thereof as is necessary, to be used for the 17 27 purposes designated: 17 28 1. To be credited to the family investment program account 17 29 and used for assistance under the family investment program 17 30 under chapter 239B: 17 31 .................................................. $2,556,23117 32 4,539,006 17 33 2. To be credited to the family investment program account 17 34 and used for the job opportunities and basic skills (JOBS) 17 35 program and implementing family investment agreements in 18 1 accordance with chapter 239B: 18 2 .................................................. $2,787,84618 3 5,412,060 18 4 3. To be used for the family development and 18 5 self=sufficiency grant program in accordance with section 18 6 216A.107: 18 7 .................................................. $1,449,49018 8 2,883,980 18 9 Notwithstanding section 8.33, moneys appropriated in this 18 10 subsection that remain unencumbered or unobligated at the close 18 11 of the fiscal year shall not revert but shall remain available 18 12 for expenditure for the purposes designated until the close of 18 13 the succeeding fiscal year. However, unless such moneys are 18 14 encumbered or obligated on or before September 30, 2019, the 18 15 moneys shall revert. 18 16 4. For field operations: 18 17 .................................................. $15,648,11618 18 31,296,232 18 19 5. For general administration: 18 20 .................................................. $1,872,00018 21 3,744,000 18 22 6. For state child care assistance: 18 23 .................................................. $23,933,41318 24 47,166,826 18 25 a. Of the funds appropriated in this subsection, 18 26$13,164,048$26,205,412 is transferred to the child care 18 27 and development block grant appropriation made by the 18 28 Eighty=seventh General Assembly, 2018 session, for the federal 18 29 fiscal year beginning October 1, 2018, and ending September 18 30 30, 2019. Of this amount,$100,000$200,000 shall be used 18 31 for provision of educational opportunities to registered 18 32 child care home providers in order to improve services and 18 33 programs offered by this category of providers and to increase 18 34 the number of providers. The department may contract with 18 35 institutions of higher education or child care resource and 19 1 referral centers to provide the educational opportunities. 19 2 Allowable administrative costs under the contracts shall not 19 3 exceed 5 percent. The application for a grant shall not exceed 19 4 two pages in length. 19 5 b. Any funds appropriated in this subsection remaining 19 6 unallocated shall be used for state child care assistance 19 7 payments for families who are employed including but not 19 8 limited to individuals enrolled in the family investment 19 9 program. 19 10 7. For child and family services: 19 11 .................................................. $16,190,32719 12 32,380,654 19 13 8. For child abuse prevention grants: 19 14 .................................................. $62,50019 15 125,000 19 16 9. For pregnancy prevention grants on the condition that 19 17 family planning services are funded: 19 18 .................................................. $965,03319 19 1,913,203 19 20 Pregnancy prevention grants shall be awarded to programs 19 21 in existence on or before July 1, 2018, if the programs have 19 22 demonstrated positive outcomes. Grants shall be awarded to 19 23 pregnancy prevention programs which are developed after July 19 24 1, 2018, if the programs are based on existing models that 19 25 have demonstrated positive outcomes. Grants shall comply with 19 26 the requirements provided in 1997 Iowa Acts, chapter 208, 19 27 section 14, subsections 1 and 2, including the requirement that 19 28 grant programs must emphasize sexual abstinence. Priority in 19 29 the awarding of grants shall be given to programs that serve 19 30 areas of the state which demonstrate the highest percentage of 19 31 unplanned pregnancies of females of childbearing age within the 19 32 geographic area to be served by the grant. 19 33 10. For technology needs and other resources necessary 19 34 to meet federal welfare reform reporting, tracking, and case 19 35 management requirements: 20 1 .................................................. $518,59320 2 1,037,186 20 3 11. a. Notwithstanding any provision to the contrary, 20 4 including but not limited to requirements in section 8.41 or 20 5 provisions in 2017 or 2018 Iowa Acts regarding the receipt and 20 6 appropriation of federal block grants, federal funds from the 20 7 temporary assistance for needy families block grant received 20 8 by the state and not otherwise appropriated in this section 20 9 and remaining available for the fiscal year beginning July 1, 20 10 2018, are appropriated to the department of human services to 20 11 the extent as may be necessary to be used in the following 20 12 priority order: the family investment program, for state child 20 13 care assistance program payments for families who are employed, 20 14 and for the family investment program share of system costs 20 15to develop and maintain a new, integratedfor eligibility 20 16 determinationsystemand related functions. The federal funds 20 17 appropriated in this paragraph "a" shall be expended only after 20 18 all other funds appropriated in subsection 1 for assistance 20 19 under the family investment program, in subsection 6 for child 20 20 care assistance, or in subsection 10 for technology costs 20 21 related to the family investment program, as applicable, have 20 22 been expended. For the purposes of this subsection, the funds 20 23 appropriated in subsection 6, paragraph "a", for transfer 20 24 to the child care and development block grant appropriation 20 25 are considered fully expended when the full amount has been 20 26 transferred. 20 27 b. The department shall, on a quarterly basis, advise the 20 28 legislative services agency and department of management of 20 29 the amount of funds appropriated in this subsection that was 20 30 expended in the prior quarter. 20 31 12. Of the amounts appropriated in this section,$6,481,004 20 32$12,962,008 for the fiscal year beginning July 1, 2018, is 20 33 transferred to the appropriation of the federal social services 20 34 block grant made to the department of human services for that 20 35 fiscal year. 21 1 13. For continuation of the program providing categorical 21 2 eligibility for the food assistance program as specified 21 3 for the program in the section of this division of this Act 21 4 relating to the family investment program account: 21 5 .................................................. $12,50021 6 14,236 21 7 14. The department may transfer funds allocated in this 21 8 section to the appropriations made in this division of this Act 21 9 for the same fiscal year for general administration and field 21 10 operations for resources necessary to implement and operate the 21 11 services referred to in this section and those funded in the 21 12 appropriation made in this division of this Act for the same 21 13 fiscal year for the family investment program from the general 21 14 fund of the state. 21 15 15. With the exception of moneys allocated under this 21 16 section for the family development and self=sufficiency grant 21 17 program, to the extent moneys allocated in this section are 21 18 deemed by the department not to be necessary to support the 21 19 purposes for which they are allocated, such moneys may be 21 20creditedused in the same fiscal year for any other purpose 21 21 for which funds are allocated in this section or in section 7 21 22 of this division for the family investment program account. 21 23 If there are conflicting needs, priority shall first be given 21 24 to the family investment program account as specified under 21 25 subsection 1 of this section and used for the purposes of 21 26 assistance under the family investment program under chapter 21 27 239Bin the same fiscal year, followed by state child care 21 28 assistance program payments for families who are employed, 21 29 followed by other priorities as specified by the department. 21 30 Sec. 11. 2017 Iowa Acts, chapter 174, section 46, subsection 21 31 4, is amended to read as follows: 21 32 4. Moneys appropriated in this division of this Act and 21 33 credited to the FIP account for the fiscal year beginning July 21 34 1, 2018, and ending June 30, 2019, are allocated as follows: 21 35 a. To be retained by the department of human services to 22 1 be used for coordinating with the department of human rights 22 2 to more effectively serve participants in FIP and other shared 22 3 clients and to meet federal reporting requirements under the 22 4 federal temporary assistance for needy families block grant: 22 5 .................................................. $10,00022 6 5,000 22 7 b. To the department of human rights for staffing, 22 8 administration, and implementation of the family development 22 9 and self=sufficiency grant program in accordance with section 22 10 216A.107: 22 11 .................................................. $3,096,41722 12 6,192,834 22 13 (1) Of the funds allocated for the family development 22 14 and self=sufficiency grant program in this paragraph "b", 22 15 not more than 5 percent of the funds shall be used for the 22 16 administration of the grant program. 22 17 (2) The department of human rights may continue to implement 22 18 the family development and self=sufficiency grant program 22 19 statewide during fiscal year 2018=2019. 22 20 (3) The department of human rights may engage in activities 22 21 to strengthen and improve family outcomes measures and 22 22 data collection systems under the family development and 22 23 self=sufficiency grant program. 22 24 c. For the diversion subaccount of the FIP account: 22 25 .................................................. $407,50022 26 749,694 22 27 A portion of the moneys allocated for the subaccount may 22 28 be used for field operations, salaries, data management 22 29 system development, and implementation costs and support 22 30 deemed necessary by the director of human services in order to 22 31 administer the FIP diversion program. To the extent moneys 22 32 allocated in this paragraph "c" are deemed by the department 22 33 not to be necessary to support diversion activities, such 22 34 moneys may be used for other efforts intended to increase 22 35 engagement by family investment program participants in work, 23 1 education, or training activities, or for the purposes of 23 2 assistance under the family investment program in accordance 23 3 with chapter 239B. 23 4 d. For the food assistance employment and training program: 23 5 .................................................. $33,29423 6 66,588 23 7 (1) The department shall apply the federal supplemental 23 8 nutrition assistance program (SNAP) employment and training 23 9 state plan in order to maximize to the fullest extent permitted 23 10 by federal law the use of the 50 percent federal reimbursement 23 11 provisions for the claiming of allowable federal reimbursement 23 12 funds from the United States department of agriculture 23 13 pursuant to the federal SNAP employment and training program 23 14 for providing education, employment, and training services 23 15 for eligible food assistance program participants, including 23 16 but not limited to related dependent care and transportation 23 17 expenses. 23 18 (2) The department shall continue the categorical federal 23 19 food assistance program eligibility at 160 percent of the 23 20 federal poverty level and continue to eliminate the asset test 23 21 from eligibility requirements, consistent with federal food 23 22 assistance program requirements. The department shall include 23 23 as many food assistance households as is allowed by federal 23 24 law. The eligibility provisions shall conform to all federal 23 25 requirements including requirements addressing individuals who 23 26 are incarcerated or otherwise ineligible. 23 27 e. For the JOBS program: 23 28 .................................................. $6,761,64523 29 12,139,821 23 30 Sec. 12. 2017 Iowa Acts, chapter 174, section 46, is amended 23 31 by adding the following new subsection: 23 32 NEW SUBSECTION. 7. The department of human services shall 23 33 convene a workgroup to review opportunities to increase state 23 34 engagement in the supplemental nutrition assistance program 23 35 (SNAP) employment and training program. The workgroup shall 24 1 explore the feasibility of expansion of the current pilot 24 2 program to a statewide basis, the potential involvement of 24 3 community=based organizations to the extent allowed by federal 24 4 law, and the leveraging of state and private funding to match 24 5 available federal funds. The membership of the workgroup 24 6 shall include representatives of the department of human 24 7 services, community colleges, community=based organizations 24 8 serving SNAP recipients, philanthropic organizations, and other 24 9 stakeholders with relevant interest or expertise as determined 24 10 by the department. The workgroup shall submit a report of its 24 11 findings and recommendations to the governor and the general 24 12 assembly by December 15, 2018. 24 13 Sec. 13. 2017 Iowa Acts, chapter 174, section 47, unnumbered 24 14 paragraph 2, is amended to read as follows: 24 15 To be credited to the family investment program (FIP) 24 16 account and used for family investment program assistance under 24 17 chapter 239B: 24 18 .................................................. $21,502,24024 19 40,365,715 24 20 Sec. 14. 2017 Iowa Acts, chapter 174, section 47, 24 21 subsections 1, 2, 4, and 5, are amended to read as follows: 24 22 1. Of the funds appropriated in this section,$3,973,798 24 23$6,727,761 is allocated for the JOBS program. 24 24 2. Of the funds appropriated in this section,$1,656,927 24 25$3,313,854 is allocated for the family development and 24 26 self=sufficiency grant program. 24 27 4. Of the funds appropriated in this section,$97,839 24 28$195,678 shall be used for continuation of a grant to an 24 29 Iowa=based nonprofit organization with a history of providing 24 30 tax preparation assistance to low=income Iowans in order to 24 31 expand the usage of the earned income tax credit. The purpose 24 32 of the grant is to supply this assistance to underserved areas 24 33 of the state. 24 34 5. Of the funds appropriated in this section,$30,000 24 35$70,000 shall be used for the continuation ofan unfunded pilot 25 1 projectthe parenting program, asdefinedspecified in 441 IAC 25 2100.1100, relating to parental obligations, in which the child 25 3 support recovery unit participates, to support the efforts 25 4 of a nonprofit organization committed to strengthening the 25 5 community through youth development, healthy living, and social 25 6 responsibility headquartered in a county with a population 25 7 over 350,000 according to the latest certified federal 25 8 census. The funds allocated in this subsection shall be used 25 9 by the recipient organization to develop a larger community 25 10 effort, through public and private partnerships, to support a 25 11 broad=based multi=countyfatherhoodparenthood initiative that 25 12 promotes payment of child support obligations, improved family 25 13 relationships, and full=time employment. 25 14 Sec. 15. 2017 Iowa Acts, chapter 174, section 48, unnumbered 25 15 paragraph 2, is amended to read as follows: 25 16 For child support recovery, including salaries, support, 25 17 maintenance, and miscellaneous purposes, and for not more than 25 18 the following full=time equivalent positions: 25 19 .................................................. $6,293,31725 20 14,586,635 25 21 ............................................... FTEs 459.00 25 22 Sec. 16. 2017 Iowa Acts, chapter 174, section 48, subsection 25 23 1, is amended to read as follows: 25 24 1. The department shall expend up to$12,164$24,329, 25 25 including federal financial participation, for the fiscal year 25 26 beginning July 1, 2018, for a child support public awareness 25 27 campaign. The department and the office of the attorney 25 28 general shall cooperate in continuation of the campaign. The 25 29 public awareness campaign shall emphasize, through a variety 25 30 of media activities, the importance of maximum involvement of 25 31 both parents in the lives of their children as well as the 25 32 importance of payment of child support obligations. 25 33 Sec. 17. 2017 Iowa Acts, chapter 174, section 51, unnumbered 25 34 paragraph 2, is amended to read as follows: 25 35 For medical assistance program reimbursement and associated 26 1 costs as specifically provided in the reimbursement 26 2 methodologies in effect on June 30, 2018, except as otherwise 26 3 expressly authorized by law, consistent with options under 26 4 federal law and regulations, and contingent upon receipt of 26 5 approval from the office of the governor of reimbursement for 26 6 each abortion performed under the program: 26 7 .................................................. $642,202,87026 8 1,337,946,375 26 9 Sec. 18. 2017 Iowa Acts, chapter 174, section 51, 26 10 subsections 3, 4, 5, 6, 7, 8, 14, 17, 18, and 19, are amended 26 11 to read as follows: 26 12 3. The department shall utilize not more than$30,000 26 13$60,000 of the funds appropriated in this section to continue 26 14 the AIDS/HIV health insurance premium payment program as 26 15 established in 1992 Iowa Acts, Second Extraordinary Session, 26 16 chapter 1001, section 409, subsection 6. Of the funds 26 17 allocated in this subsection, not more than$2,500$5,000 may 26 18 be expended for administrative purposes. 26 19 4. Of the funds appropriated in this Act to the 26 20 department of public health for addictive disorders,$475,000 26 21$950,000 for the fiscal year beginning July 1, 2018, is 26 22 transferred to the department of human services for an 26 23 integrated substance=related disorder managed care system. 26 24 The departments of human services and public health shall 26 25 work together to maintain the level of mental health and 26 26 substance=related disorder treatment services provided by the 26 27 managed care contractors. Each department shall take the steps 26 28 necessary to continue the federal waivers as necessary to 26 29 maintain the level of services. 26 30 5. a. The department shall aggressively pursue options for 26 31 providing medical assistance or other assistance to individuals 26 32 with special needs who become ineligible to continue receiving 26 33 services under the early and periodic screening, diagnostic, 26 34 and treatment program under the medical assistance program 26 35 due to becoming 21 years of age who have been approved for 27 1 additional assistance through the department's exception to 27 2 policy provisions, but who have health care needs in excess 27 3 of the funding available through the exception to policy 27 4 provisions. 27 5 b. Of the funds appropriated in this section,$50,000 27 6$100,000 shall be used for participation in one or more 27 7 pilot projects operated by a private provider to allow the 27 8 individual or individuals to receive service in the community 27 9 in accordance with principles established in Olmstead v. 27 10 L.C., 527 U.S. 581 (1999), for the purpose of providing 27 11 medical assistance or other assistance to individuals with 27 12 special needs who become ineligible to continue receiving 27 13 services under the early and periodic screening, diagnostic, 27 14 and treatment program under the medical assistance program 27 15 due to becoming 21 years of age who have been approved for 27 16 additional assistance through the department's exception to 27 17 policy provisions, but who have health care needs in excess 27 18 of the funding available through the exception to the policy 27 19 provisions. 27 20 6. Of the funds appropriated in this section, up to 27 21$1,525,041$3,050,082 may be transferred to the field 27 22 operations or general administration appropriations in this 27 23 division of this Act for operational costs associated with Part 27 24 D of the federal Medicare Prescription Drug Improvement and 27 25 Modernization Act of 2003, Pub. L. No. 108=173. 27 26 7. Of the funds appropriated in this section, up to 27 27$221,050$442,100 may be transferred to the appropriation in 27 28 this division of this Act for medical contracts to be used 27 29 for clinical assessment services and prior authorization of 27 30 services. 27 31 8. A portion of the funds appropriated in this section 27 32 may be transferred to the appropriations in this division of 27 33 this Act for general administration, medical contracts, the 27 34 children's health insurance program, or field operations to be 27 35 used for the state match cost to comply with the payment error 28 1 rate measurement (PERM) program for both the medical assistance 28 2 and children's health insurance programs as developed by the 28 3 centers for Medicare and Medicaid services of the United States 28 4 department of health and human services to comply with the 28 5 federal Improper Payments Information Act of 2002, Pub. L. 28 6 No. 107=300, and to support other reviews and quality control 28 7 activities to improve the integrity of these programs. 28 8 14. Of the funds appropriated in this section,$174,505 28 9$349,011 shall be used for the administration of the health 28 10 insurance premium payment program, including salaries, support, 28 11 maintenance, and miscellaneous purposes. 28 12 17. a. Of the funds appropriated in this section, up 28 13 to$25,000$50,000 may be transferred by the department to 28 14 the appropriation made in this division of this Act to the 28 15 department for the same fiscal year for general administration 28 16 to be used for associated administrative expenses and for not 28 17 more than one full=time equivalent position, in addition to 28 18 those authorized for the same fiscal year, to be assigned to 28 19 implementing the children's mental health home project. 28 20 b. Of the funds appropriated in this section, up to 28 21$200,000$400,000 may be transferred by the department to 28 22 the appropriation made to the department in this division of 28 23 this Act for the same fiscal year for Medicaid program=related 28 24 general administration planning and implementation activities. 28 25 The funds may be used for contracts or for personnel in 28 26 addition to the amounts appropriated for and the positions 28 27 authorized for general administration for the fiscal year. 28 28 c. Of the funds appropriated in this section, up to 28 29$1,500,000$3,000,000 may be transferred by the department 28 30 to the appropriations made in this division of this Act 28 31 for the same fiscal year for general administration or 28 32 medical contracts to be used to support the development 28 33 and implementation of standardized assessment tools for 28 34 persons with mental illness, an intellectual disability, a 28 35 developmental disability, or a brain injury. 29 1 18. Of the funds appropriated in this section,$75,000 29 2$150,000 shall be used for lodging expenses associated with 29 3 care provided at the university of Iowa hospitals and clinics 29 4 for patients with cancer whose travel distance is 30 miles or 29 5 more and whose income is at or below 200 percent of the federal 29 6 poverty level as defined by the most recently revised poverty 29 7 income guidelines published by the United States department of 29 8 health and human services. The department of human services 29 9 shall establish the maximum number of overnight stays and the 29 10 maximum rate reimbursed for overnight lodging, which may be 29 11 based on the state employee rate established by the department 29 12 of administrative services. The funds allocated in this 29 13 subsection shall not be used as nonfederal share matching 29 14 funds. 29 15 19. Of the funds appropriated in this section, up to 29 16$1,691,940$3,383,880 shall be used for administration of the 29 17 state family planning services program as enacted in this 2017 29 18 Act, and of this amount the department may useto up $100,000 29 19up to $200,000 for administrative expenses. 29 20 Sec. 19. 2017 Iowa Acts, chapter 174, section 51, is amended 29 21 by adding the following new subsections: 29 22 NEW SUBSECTION. 22. Of the funds appropriated in this 29 23 section, $300,000 shall be used by the department of human 29 24 services through a request for proposals process to establish 29 25 a partnership between the university of Iowa hospitals and 29 26 clinics and a nonprofit durable medical equipment provider 29 27 and manufacturer to provide new, refurbished, or repaired 29 28 durable medical equipment to Medicaid members in the state. 29 29 Such durable medical equipment provider and manufacturer 29 30 shall be authorized as a Medicaid provider in the state on or 29 31 after April 1, 2018, and shall have the capability to provide 29 32 assessments for customized wheelchairs, manufacture bathing aid 29 33 equipment and mobility bathing aids, offer in=home care, and 29 34 sell durable medical equipment at cost in Iowa and online as of 29 35 June 1, 2018. 30 1 NEW SUBSECTION. 23. The department of human services shall 30 2 expand Medicaid coverage to provide care for young adults with 30 3 complex medical conditions in a special population nursing 30 4 facility as specified by rule of the department pursuant to 30 5 this subsection. The department shall adopt rules pursuant to 30 6 chapter 17A to expand the criteria for a special population 30 7 nursing facility under the Medicaid program to include a 30 8 nursing facility that serves residents, 100 percent of whom are 30 9 aged 30 and under and require the skilled level of care, and to 30 10 include a nursing facility that serves residents, 100 percent 30 11 of whom require care from a facility licensed by the department 30 12 of inspections and appeals as an intermediate care facility 30 13 for persons with medical complexity as defined by rule of the 30 14 department. 30 15 NEW SUBSECTION. 24. Consistent with the informational 30 16 bulletin published May 9, 2017, by the centers for Medicare and 30 17 Medicaid services of the United States department of health and 30 18 human services, in implementing the regulation that finalized 30 19 criteria for home and community=based settings appropriate for 30 20 provision of home and community=based services, the department 30 21 of human services shall continue progress with the statewide 30 22 transition plan to be approved by March 17, 2019, but shall 30 23 extend the transition period to demonstrate compliance with 30 24 the home and community=based settings criteria until March 17, 30 25 2022, for those settings to which a transition period applies. 30 26 NEW SUBSECTION. 25. The department of human services shall 30 27 utilize $3,000,000 of the funds appropriated under this section 30 28 to adjust current supported community living provider daily 30 29 rate cells under the tiered rate reimbursement methodology 30 30 effective with dates of service beginning July 1, 2018. The 30 31 department shall work with the Medicaid program actuary to 30 32 evaluate the current tiered rates and the tiered rates phase=in 30 33 plan to determine the necessary apportionment of such funds. 30 34 In addition, the department, working with the Medicaid program 30 35 actuary, shall review the current tiered rates and the tiered 31 1 rates phase=in plan and shall propose recommendations for any 31 2 changes. The department shall convene the tiered rate provider 31 3 workgroup initially convened in the fiscal year beginning July 31 4 1, 2016, to review the actuarial findings and recommendations. 31 5 The tiered rates may be adjusted based upon the actuarial 31 6 findings and recommendations if such adjustments are budget 31 7 neutral. A report of the actuarial findings, recommendations, 31 8 and comments provided by the tiered rate provider workgroup 31 9 shall be submitted to the governor and the general assembly by 31 10 December 15, 2018. If additional funding is appropriated to 31 11 implement the recommendations, the additional funding shall be 31 12 incorporated into the managed care organization capitation rate 31 13 setting process for the fiscal year beginning July 1, 2019. 31 14 NEW SUBSECTION. 26. The department of human services shall 31 15 review all current Medicaid fee schedules and shall submit a 31 16 report to the governor and the general assembly by January 15, 31 17 2019, regarding how the current rates compare to the equivalent 31 18 Medicare fee schedules or other appropriate reimbursement 31 19 methodologies for specific services and including a plan for 31 20 phased=in implementation of any changes. 31 21 NEW SUBSECTION. 27. Of the funds appropriated in this 31 22 section, $1,545,530 shall be used and may be transferred to 31 23 other appropriations in this division of this Act as necessary 31 24 to administer the provisions in the division of this Act 31 25 relating to Medicaid program administration. 31 26 NEW SUBSECTION. 28. Of the funds appropriated in this 31 27 section, $876,015 shall be used and may be transferred to other 31 28 appropriations in this division of this Act as necessary to 31 29 administer the provisions of 2018 Iowa Acts, House File 2456, 31 30 as enacted. 31 31 Sec. 20. 2017 Iowa Acts, chapter 174, section 52, is amended 31 32 to read as follows: 31 33 SEC. 52. MEDICAL CONTRACTS. There is appropriated from the 31 34 general fund of the state to the department of human services 31 35 for the fiscal year beginning July 1, 2018, and ending June 30, 32 1 2019, the following amount, or so much thereof as is necessary, 32 2 to be used for the purpose designated: 32 3 For medical contracts: 32 4 .................................................. $8,813,23232 5 16,603,198 32 6 1. The department of inspections and appeals shall 32 7 provide all state matching funds for survey and certification 32 8 activities performed by the department of inspections 32 9 and appeals. The department of human services is solely 32 10 responsible for distributing the federal matching funds for 32 11 such activities. 32 12 2. Of the funds appropriated in this section,$25,000 32 13$50,000 shall be used for continuation of home and 32 14 community=based services waiver quality assurance programs, 32 15 including the review and streamlining of processes and policies 32 16 related to oversight and quality management to meet state and 32 17 federal requirements. 32 18 3. Of the amount appropriated in this section, up to 32 19$100,000$200,000 may be transferred to the appropriation 32 20 for general administration in this division of this Act to 32 21 be used for additional full=time equivalent positions in the 32 22 development of key health initiatives such as cost containment, 32 23 development and oversight of managed care programs, and 32 24 development of health strategies targeted toward improved 32 25 quality and reduced costs in the Medicaid program. 32 26 4. Of the funds appropriated in this section,$500,000 32 27$1,000,000 shall be used for planning and development, 32 28 in cooperation with the department of public health, of a 32 29 phased=in program to provide a dental home for children. 32 30 5. Of the funds appropriated in this section,$475,000 32 31$723,000 shall be credited to the autism support program fund 32 32 created in section 225D.2 to be used for the autism support 32 33 program created in chapter 225D, with the exception of the 32 34 following amounts of this allocation which shall be used as 32 35 follows: 33 1a. Of the funds allocated in this subsection, $125,000 33 2 shall be deposited in the board=certified behavior analyst and 33 3 board=certified assistant behavior analyst grants program fund 33 4 created in section 135.181, to be used for the purposes of the 33 5 fund.33 6 b. Of the funds allocated in this subsection,$12,500 33 7$25,000 shall be used for the public purpose ofcontinuation 33 8 ofa grant to a child welfare services provider headquartered 33 9 in a county with a population between 205,000 and 215,000 in 33 10 the latest certified federal census that provides multiple 33 11 services including but not limited to a psychiatric medical 33 12 institution for children, shelter, residential treatment, after 33 13 school programs, school=based programming, and an Asperger's 33 14 syndrome program, to be used for support services for children 33 15 with autism spectrum disorder and their families. 33 16c. Of the funds allocated in this subsection, $12,500 33 17 shall be used for the public purpose of continuing a grant to 33 18 a hospital=based provider headquartered in a county with a 33 19 population between 90,000 and 95,000 in the latest certified 33 20 federal census that provides multiple services including 33 21 but not limited to diagnostic, therapeutic, and behavioral 33 22 services to individuals with autism spectrum disorder across 33 23 one's lifespan. The grant recipient shall utilize the funds 33 24 to continue the pilot project to determine the necessary 33 25 support services for children with autism spectrum disorder and 33 26 their families to be included in the children's disabilities 33 27 services system. The grant recipient shall submit findings and 33 28 recommendations based upon the results of the pilot project 33 29 to the individuals specified in this division of this Act for 33 30 submission of reports by December 31, 2018.33 31 Sec. 21. 2017 Iowa Acts, chapter 174, section 53, unnumbered 33 32 paragraph 2, is amended to read as follows: 33 33 For the state supplementary assistance program: 33 34 .................................................. $5,186,32933 35 10,250,873 34 1 Sec. 22. 2017 Iowa Acts, chapter 174, section 53, is amended 34 2 by adding the following new subsection: 34 3 NEW SUBSECTION. 4. Notwithstanding section 8.33, moneys 34 4 appropriated in this section that remain unencumbered or 34 5 unobligated at the close of the fiscal year shall not revert 34 6 but shall remain available for expenditure for the purposes 34 7 designated until the close of the succeeding fiscal year. 34 8 Sec. 23. 2017 Iowa Acts, chapter 174, section 54, is amended 34 9 to read as follows: 34 10 SEC. 54. CHILDREN'S HEALTH INSURANCE PROGRAM. 34 11 1. There is appropriated from the general fund of the 34 12 state to the department of human services for the fiscal year 34 13 beginning July 1, 2018, and ending June 30, 2019, the following 34 14 amount, or so much thereof as is necessary, to be used for the 34 15 purpose designated: 34 16 For maintenance of the healthy and well kids in Iowa (hawk=i) 34 17 program pursuant to chapter 514I, including supplemental dental 34 18 services, for receipt of federal financial participation under 34 19 Tit. XXI of the federal Social Security Act, which creates the 34 20 children's health insurance program: 34 21 .................................................. $4,259,22634 22 7,064,057 34 23 2. Of the funds appropriated in this section,$21,400 34 24$42,800 is allocated for continuation of the contract for 34 25 outreach with the department of public health. 34 26 Sec. 24. 2017 Iowa Acts, chapter 174, section 55, unnumbered 34 27 paragraph 2, is amended to read as follows: 34 28 For child care programs: 34 29 .................................................. $19,671,80834 30 40,816,831 34 31 Sec. 25. 2017 Iowa Acts, chapter 174, section 55, 34 32 subsections 1 and 4, are amended to read as follows: 34 33 1. Of the funds appropriated in this section,$16,746,808 34 34$34,966,931 shall be used for state child care assistance in 34 35 accordance with section 237A.13. 35 1 4. Of the funds appropriated in this section,$2,925,000 35 2$5,850,000 shall be credited to the early childhood programs 35 3 grants account in the early childhood Iowa fund created 35 4 in section 256I.11. The moneys shall be distributed for 35 5 funding of community=based early childhood programs targeted 35 6 to children from birth through five years of age developed 35 7 by early childhood Iowa areas in accordance with approved 35 8 community plans as provided in section 256I.8. 35 9 Sec. 26. 2017 Iowa Acts, chapter 174, section 56, is amended 35 10 to read as follows: 35 11 SEC. 56. JUVENILE INSTITUTION. There is appropriated 35 12 from the general fund of the state to the department of human 35 13 services for the fiscal year beginning July 1, 2018, and ending 35 14 June 30, 2019, the following amounts, or so much thereof as is 35 15 necessary, to be used for the purposes designated: 35 16 1. For operation of the state training school at Eldora and 35 17 for salaries, support, maintenance, and miscellaneous purposes, 35 18 and for not more than the following full=time equivalent 35 19 positions: 35 20 .................................................. $5,675,22135 21 12,762,443 35 22 ............................................... FTEs 189.00 35 23 Of the funds appropriated in this subsection,$45,575 35 24$91,150 shall be used for distribution to licensed classroom 35 25 teachers at this and other institutions under the control of 35 26 the department of human services based upon the average student 35 27 yearly enrollment at each institution as determined by the 35 28 department. 35 29 2. A portion of the moneys appropriated in this section 35 30 shall be used by the state training school at Eldora for 35 31 grants for adolescent pregnancy prevention activities at the 35 32 institution in the fiscal year beginning July 1, 2018. 35 33 3. Of the funds appropriated in this subsection, $212,000 35 34 shall be used by the state training school at Eldora for a 35 35 substance use disorder treatment program at the institution in 36 1 the fiscal year beginning July 1, 2018. 36 2 Sec. 27. 2017 Iowa Acts, chapter 174, section 57, is amended 36 3 to read as follows: 36 4 SEC. 57. CHILD AND FAMILY SERVICES. 36 5 1. There is appropriated from the general fund of the 36 6 state to the department of human services for the fiscal year 36 7 beginning July 1, 2018, and ending June 30, 2019, the following 36 8 amount, or so much thereof as is necessary, to be used for the 36 9 purpose designated: 36 10 For child and family services: 36 11 .................................................. $43,639,68736 12 84,939,774 36 13 2. The department may transfer funds appropriated in this 36 14 section as necessary to pay the nonfederal costs of services 36 15 reimbursed under the medical assistance program, state child 36 16 care assistance program, or the family investment program which 36 17 are provided to children who would otherwise receive services 36 18 paid under the appropriation in this section. The department 36 19 may transfer funds appropriated in this section to the 36 20 appropriations made in this division of this Act for general 36 21 administration and for field operations for resources necessary 36 22 to implement and operate the services funded in this section. 36 23 3. a. Of the funds appropriated in this section, up 36 24 to$17,868,324$34,536,648 is allocated as the statewide 36 25 expenditure target under section 232.143 for group foster care 36 26 maintenance and services. If the department projects that such 36 27 expenditures for the fiscal year will be less than the target 36 28 amount allocated in this paragraph "a", the department may 36 29 reallocate the excess to provide additional funding for shelter 36 30 care or the child welfare emergency services addressed with the 36 31 allocation for shelter care. 36 32 b. If at any time after September 30, 2018, annualization 36 33 of a service area's current expenditures indicates a service 36 34 area is at risk of exceeding its group foster care expenditure 36 35 target under section 232.143 by more than 5 percent, the 37 1 department and juvenile court services shall examine all 37 2 group foster care placements in that service area in order to 37 3 identify those which might be appropriate for termination. 37 4 In addition, any aftercare services believed to be needed 37 5 for the children whose placements may be terminated shall be 37 6 identified. The department and juvenile court services shall 37 7 initiate action to set dispositional review hearings for the 37 8 placements identified. In such a dispositional review hearing, 37 9 the juvenile court shall determine whether needed aftercare 37 10 services are available and whether termination of the placement 37 11 is in the best interest of the child and the community. 37 12 4. In accordance with the provisions of section 232.188, 37 13 the department shall continue the child welfare and juvenile 37 14 justice funding initiative during fiscal year 2018=2019. Of 37 15 the funds appropriated in this section,$858,876$1,717,753 37 16 is allocated specifically for expenditure for fiscal year 37 17 2018=2019 through the decategorization services funding pools 37 18 and governance boards established pursuant to section 232.188. 37 19 5. A portion of the funds appropriated in this section 37 20 may be used for emergency family assistance to provide other 37 21 resources required for a family participating in a family 37 22 preservation or reunification project or successor project to 37 23 stay together or to be reunified. 37 24 6. Notwithstanding section 234.35 or any other provision 37 25 of law to the contrary, state funding for shelter care and 37 26 the child welfare emergency services contracting implemented 37 27 to provide for or prevent the need for shelter care shall be 37 28 limited to$4,048,079$8,096,158. 37 29 7. Federal funds received by the state during the fiscal 37 30 year beginning July 1, 2018, as the result of the expenditure 37 31 of state funds appropriated during a previous state fiscal 37 32 year for a service or activity funded under this section are 37 33 appropriated to the department to be used as additional funding 37 34 for services and purposes provided for under this section. 37 35 Notwithstanding section 8.33, moneys received in accordance 38 1 with this subsection that remain unencumbered or unobligated at 38 2 the close of the fiscal year shall not revert to any fund but 38 3 shall remain available for the purposes designated until the 38 4 close of the succeeding fiscal year. 38 5 8. a. Of the funds appropriated in this section, up to 38 6$1,645,000$3,290,000 is allocated for the payment of the 38 7 expenses of court=ordered services provided to juveniles 38 8 who are under the supervision of juvenile court services, 38 9 which expenses are a charge upon the state pursuant to 38 10 section 232.141, subsection 4. Of the amount allocated in 38 11 this paragraph "a", up to$778,143$1,556,287 shall be made 38 12 available to provide school=based supervision of children 38 13 adjudicated under chapter 232, of which not more than$7,500 38 14$15,000 may be used for the purpose of training. A portion of 38 15 the cost of each school=based liaison officer shall be paid by 38 16 the school district or other funding source as approved by the 38 17 chief juvenile court officer. 38 18 b. Of the funds appropriated in this section, up to$374,492 38 19$748,985 is allocated for the payment of the expenses of 38 20 court=ordered services provided to children who are under the 38 21 supervision of the department, which expenses are a charge upon 38 22 the state pursuant to section 232.141, subsection 4. 38 23 c. Notwithstanding section 232.141 or any other provision 38 24 of law to the contrary, the amounts allocated in this 38 25 subsection shall be distributed to the judicial districts 38 26 as determined by the state court administrator and to the 38 27 department's service areas as determined by the administrator 38 28 of the department of human services' division of child and 38 29 family services. The state court administrator and the 38 30 division administrator shall make the determination of the 38 31 distribution amounts on or before June 15, 2018. 38 32 d. Notwithstanding chapter 232 or any other provision of 38 33 law to the contrary, a district or juvenile court shall not 38 34 order any service which is a charge upon the state pursuant 38 35 to section 232.141 if there are insufficient court=ordered 39 1 services funds available in the district court or departmental 39 2 service area distribution amounts to pay for the service. The 39 3 chief juvenile court officer and the departmental service area 39 4 manager shall encourage use of the funds allocated in this 39 5 subsection such that there are sufficient funds to pay for 39 6 all court=related services during the entire year. The chief 39 7 juvenile court officers and departmental service area managers 39 8 shall attempt to anticipate potential surpluses and shortfalls 39 9 in the distribution amounts and shall cooperatively request the 39 10 state court administrator or division administrator to transfer 39 11 funds between the judicial districts' or departmental service 39 12 areas' distribution amounts as prudent. 39 13 e. Notwithstanding any provision of law to the contrary, 39 14 a district or juvenile court shall not order a county to pay 39 15 for any service provided to a juvenile pursuant to an order 39 16 entered under chapter 232 which is a charge upon the state 39 17 under section 232.141, subsection 4. 39 18 f. Of the funds allocated in this subsection, not more 39 19 than$41,500$83,000 may be used by the judicial branch for 39 20 administration of the requirements under this subsection. 39 21 g. Of the funds allocated in this subsection,$8,500$17,000 39 22 shall be used by the department of human services to support 39 23 the interstate commission for juveniles in accordance with 39 24 the interstate compact for juveniles as provided in section 39 25 232.173. 39 26 9. Of the funds appropriated in this section,$6,126,613 39 27$12,253,227 is allocated for juvenile delinquent graduated 39 28 sanctions services. Any state funds saved as a result of 39 29 efforts by juvenile court services to earn a federal Tit. IV=E 39 30 match for juvenile court services administration may be used 39 31 for the juvenile delinquent graduated sanctions services. 39 32 10. Of the funds appropriated in this section,$829,142 39 33$1,658,285 is transferred to the department of public health 39 34 to be used for the child protection center grant program for 39 35 child protection centers located in Iowa in accordance with 40 1 section 135.118. The grant amounts under the program shall be 40 2 equalized so that each center receives a uniform base amount 40 3 of$122,500$245,000, so that$25,000$50,000 is awarded to 40 4 establish a satellite child protection center in a city in 40 5 north central Iowa that is the county seat of a county with 40 6 a population between 44,000 and 45,000 according to the 2010 40 7 federal decennial census, and so that the remaining funds are 40 8 awarded through a funding formula based upon the volume of 40 9 children served. 40 10 11. If the department receives federal approval to 40 11 implement a waiver under Tit. IV=E of the federal Social 40 12 Security Act to enable providers to serve children who remain 40 13 in the children's families and communities, for purposes of 40 14 eligibility under the medical assistance program through 25 40 15 years of age, children who participate in the waiver shall be 40 16 considered to be placed in foster care. 40 17 12. Of the funds appropriated in this section,$2,012,583 40 18$4,025,167 is allocated for the preparation for adult living 40 19 program pursuant to section 234.46. 40 20 13. Of the funds appropriated in this section,$113,668 40 21$227,337 shall be used for the public purpose of continuing 40 22 a grant to a nonprofit human services organization providing 40 23 services to individuals and families in multiple locations in 40 24 southwest Iowa and Nebraska for support of a project providing 40 25 immediate, sensitive support and forensic interviews, medical 40 26 exams, needs assessments, and referrals for victims of child 40 27 abuse and their nonoffending family members. 40 28 14. Of the funds appropriated in this section,$150,310 40 29$300,620 is allocated for the foster care youth council 40 30 approach of providing a support network to children placed in 40 31 foster care. 40 32 15. Of the funds appropriated in this section,$101,000 40 33$202,000 is allocated for use pursuant to section 235A.1 for 40 34 continuation of the initiative to address child sexual abuse 40 35 implemented pursuant to 2007 Iowa Acts, chapter 218, section 41 1 18, subsection 21. 41 2 16. Of the funds appropriated in this section,$315,120 41 3$630,240 is allocated for the community partnership for child 41 4 protection sites. 41 5 17. Of the funds appropriated in this section,$185,625 41 6$371,250 is allocated for the department's minority youth and 41 7 family projects under the redesign of the child welfare system. 41 8 18. Of the funds appropriated in this section,$568,297 41 9$851,595 is allocated for funding of the community circle of 41 10 care collaboration for children and youth in northeast Iowa. 41 11 19. Of the funds appropriated in this section, at least 41 12$73,579$147,158 shall be used for the continuation of the 41 13 child welfare provider training academy, a collaboration 41 14 between the coalition for family and children's services in 41 15 Iowa and the department. 41 16 20. Of the funds appropriated in this section,$105,936 41 17$211,872 shall be used for continuation of the central Iowa 41 18 system of care program grant through June 30, 2019. 41 19 21. Of the funds appropriated in this section,$117,500 41 20$235,000 shall be used for the public purpose of the 41 21 continuation and expansion of a system of care program grant 41 22 implemented in Cerro Gordo and Linn counties to utilize a 41 23 comprehensive and long=term approach for helping children 41 24 and families by addressing the key areas in a child's life 41 25 of childhood basic needs, education and work, family, and 41 26 community. 41 27 22. Of the funds appropriated in this section, at least 41 28$12,500$25,000 shall be used to continue and to expand the 41 29 foster care respite pilot program in which postsecondary 41 30 students in social work and other human services=related 41 31 programs receive experience by assisting family foster care 41 32 providers with respite and other support. 41 33 23. Of the funds appropriated in this section,$55,000 41 34$110,000 shall be used for the public purpose of funding 41 35 community=based services and other supports with a system of 42 1 care approach for children with a serious emotional disturbance 42 2 and their families through a nonprofit provider of child 42 3 welfare services that has been in existence for more than 42 4 115 years, is located in a county with a population of more 42 5 than 200,000 but less than 220,000 according to the latest 42 6 certified federal census, is licensed as a psychiatric medical 42 7 institution for children, and was a system of care grantee 42 8 prior to July 1, 2018. 42 9 Sec. 28. 2017 Iowa Acts, chapter 174, section 58, subsection 42 10 1, paragraph a, is amended to read as follows: 42 11 a. For adoption subsidy payments and services: 42 12 .................................................. $20,388,95542 13 40,445,137 42 14 Sec. 29. 2017 Iowa Acts, chapter 174, section 60, is amended 42 15 to read as follows: 42 16 SEC. 60. FAMILY SUPPORT SUBSIDY PROGRAM. 42 17 1. There is appropriated from the general fund of the 42 18 state to the department of human services for the fiscal year 42 19 beginning July 1, 2018, and ending June 30, 2019, the following 42 20 amount, or so much thereof as is necessary, to be used for the 42 21 purpose designated: 42 22 For the family support subsidy program subject to the 42 23 enrollment restrictions in section 225C.37, subsection 3: 42 24 .................................................. $534,64142 25 949,282 42 26 2. At least$393,750$787,500 of the moneys appropriated in 42 27 this section is transferred to the department of public health 42 28 for the family support center component of the comprehensive 42 29 family support program under chapter 225C, subchapter V. 42 30 3. If at any time during the fiscal year, the amount of 42 31 funding available for the family support subsidy program 42 32 is reduced from the amount initially used to establish the 42 33 figure for the number of family members for whom a subsidy 42 34 is to be provided at any one time during the fiscal year, 42 35 notwithstanding section 225C.38, subsection 2, the department 43 1 shall revise the figure as necessary to conform to the amount 43 2 of funding available. 43 3 Sec. 30. 2017 Iowa Acts, chapter 174, section 61, is amended 43 4 to read as follows: 43 5 SEC. 61. CONNER DECREE. There is appropriated from the 43 6 general fund of the state to the department of human services 43 7 for the fiscal year beginning July 1, 2018, and ending June 30, 43 8 2019, the following amount, or so much thereof as is necessary, 43 9 to be used for the purpose designated: 43 10 For building community capacity through the coordination 43 11 and provision of training opportunities in accordance with the 43 12 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D. 43 13 Iowa, July 14, 1994): 43 14 .................................................. $16,81643 15 33,632 43 16 Sec. 31. 2017 Iowa Acts, chapter 174, section 62, subsection 43 17 1, is amended to read as follows: 43 18 1. There is appropriated from the general fund of the 43 19 state to the department of human services for the fiscal year 43 20 beginning July 1, 2018, and ending June 30, 2019, the following 43 21 amounts, or so much thereof as is necessary, to be used for the 43 22 purposes designated: 43 23 a. For operation of the state mental health institute at 43 24 Cherokee as required by chapters 218 and 226 for salaries, 43 25 support, maintenance, and miscellaneous purposes, and for not 43 26 more than the following full=time equivalent positions: 43 27 .................................................. $6,935,12743 28 13,870,254 43 29 ............................................... FTEs 162.00 43 30 b. For operation of the state mental health institute at 43 31 Independence as required by chapters 218 and 226 for salaries, 43 32 support, maintenance, and miscellaneous purposes, and for not 43 33 more than the following full=time equivalent positions: 43 34 .................................................. $8,756,81043 35 17,513,621 44 1 ............................................... FTEs 204.00 44 2 Sec. 32. 2017 Iowa Acts, chapter 174, section 63, subsection 44 3 1, is amended to read as follows: 44 4 1. There is appropriated from the general fund of the 44 5 state to the department of human services for the fiscal year 44 6 beginning July 1, 2018, and ending June 30, 2019, the following 44 7 amounts, or so much thereof as is necessary, to be used for the 44 8 purposes designated: 44 9 a. For the state resource center at Glenwood for salaries, 44 10 support, maintenance, and miscellaneous purposes: 44 11 .................................................. $8,943,89044 12 16,858,523 44 13 b. For the state resource center at Woodward for salaries, 44 14 support, maintenance, and miscellaneous purposes: 44 15 .................................................. $6,038,51744 16 11,386,679 44 17 Sec. 33. 2017 Iowa Acts, chapter 174, section 64, subsection 44 18 1, is amended to read as follows: 44 19 1. There is appropriated from the general fund of the 44 20 state to the department of human services for the fiscal year 44 21 beginning July 1, 2018, and ending June 30, 2019, the following 44 22 amount, or so much thereof as is necessary, to be used for the 44 23 purpose designated: 44 24 For costs associated with the commitment and treatment of 44 25 sexually violent predators in the unit located at the state 44 26 mental health institute at Cherokee, including costs of legal 44 27 services and other associated costs, including salaries, 44 28 support, maintenance, and miscellaneous purposes, and for not 44 29 more than the following full=time equivalent positions: 44 30 .................................................. $4,732,37344 31 10,864,747 44 32 ............................................... FTEs112.0044 33 132.00 44 34 Sec. 34. 2017 Iowa Acts, chapter 174, section 65, is amended 44 35 to read as follows: 45 1 SEC. 65. FIELD OPERATIONS. There is appropriated from the 45 2 general fund of the state to the department of human services 45 3 for the fiscal year beginning July 1, 2018, and ending June 30, 45 4 2019, the following amount, or so much thereof as is necessary, 45 5 to be used for the purposes designated: 45 6 For field operations, including salaries, support, 45 7 maintenance, and miscellaneous purposes, and for not more than 45 8 the following full=time equivalent positions: 45 9 .................................................. $24,242,21745 10 49,074,517 45 11 ............................................... FTEs1,583.0045 12 1,539.00 45 13 Priority in filling full=time equivalent positions shall be 45 14 given to those positions related to child protection services 45 15 and eligibility determination for low=income families. 45 16 Sec. 35. 2017 Iowa Acts, chapter 174, section 66, is amended 45 17 to read as follows: 45 18 SEC. 66. GENERAL ADMINISTRATION. There is appropriated 45 19 from the general fund of the state to the department of human 45 20 services for the fiscal year beginning July 1, 2018, and ending 45 21 June 30, 2019, the following amount, or so much thereof as is 45 22 necessary, to be used for the purpose designated: 45 23 For general administration, including salaries, support, 45 24 maintenance, and miscellaneous purposes, and for not more than 45 25 the following full=time equivalent positions: 45 26 .................................................. $7,016,52045 27 13,833,040 45 28 ............................................... FTEs 294.00 45 29 2. Of the funds appropriated in this section,$75,000 45 30$150,000 shall be used to continue the contract for the 45 31 provision of a program to provide technical assistance, 45 32 support, and consultation to providers of habilitation services 45 33 and home and community=based services waiver services for 45 34 adults with disabilities under the medical assistance program. 45 35 3. Of the funds appropriated in this section,$25,000 46 1$50,000 is transferred to the Iowa finance authority to be 46 2 used for administrative support of the council on homelessness 46 3 established in section 16.2D and for the council to fulfill its 46 4 duties in addressing and reducing homelessness in the state. 46 5 4. Of the funds appropriated in this section,$100,000 46 6$200,000 shall be transferred to and deposited in the 46 7 administrative fund of the Iowa ABLE savings plan trust 46 8 created in section 12I.4, to be used for implementation and 46 9 administration activities of the Iowa ABLE savings plan trust. 46 10 5. Of the funds appropriated in this section,$100,000 46 11$200,000 is transferred to the economic development authority 46 12 for the Iowa commission on volunteer services to continue 46 13 to be used for RefugeeRISE AmeriCorps program established 46 14 under section 15H.8 for member recruitment and training to 46 15 improve the economic well=being and health of economically 46 16 disadvantaged refugees in local communities across Iowa. Funds 46 17 transferred may be used to supplement federal funds under 46 18 federal regulations. 46 19 7. Of the funds appropriated in this section, $300,000 shall 46 20 be used to contract for children's well=being collaboratives 46 21 grants for the development and implementation of children's 46 22 well=being collaboratives to establish and coordinate 46 23 prevention and early intervention services to promote improved 46 24 mental health and well=being for children and families, as 46 25 enacted in 2017 Iowa Acts, chapter 174, section 88. 46 26 8. The department of human services shall submit the 46 27 strategic plan to create and implement a children's mental 46 28 health system submitted to the governor by the children's 46 29 system state board established by Executive Order Number Two 46 30 issued April 23, 2018, to the general assembly by November 15, 46 31 2018. 46 32 Sec. 36. 2017 Iowa Acts, chapter 174, section 67, is amended 46 33 to read as follows: 46 34 SEC. 67. DEPARTMENT=WIDE DUTIES. There is appropriated 46 35 from the general fund of the state to the department of human 47 1 services for the fiscal year beginning July 1, 2018, and ending 47 2 June 30, 2019, the following amount, or so much thereof as is 47 3 necessary, to be used for the purposes designated: 47 4 For salaries, support, maintenance, and miscellaneous 47 5 purposes at facilities under the purview of the department of 47 6 human services: 47 7 .................................................. $1,439,63747 8 2,879,274 47 9 Sec. 37. 2017 Iowa Acts, chapter 174, section 68, is amended 47 10 to read as follows: 47 11 SEC. 68. VOLUNTEERS. There is appropriated from the general 47 12 fund of the state to the department of human services for the 47 13 fiscal year beginning July 1, 2018, and ending June 30, 2019, 47 14 the following amount, or so much thereof as is necessary, to be 47 15 used for the purpose designated: 47 16 For development and coordination of volunteer services: 47 17 .................................................. $42,34347 18 84,686 47 19 Sec. 38. 2017 Iowa Acts, chapter 174, section 70, subsection 47 20 1, paragraph f, subparagraph (1), is amended to read as 47 21 follows: 47 22 (1) For the fiscal year beginning July 1, 2018, 47 23 reimbursement rates for home health agencies shall continue to 47 24 be based on the Medicare low utilization payment adjustment 47 25 (LUPA) methodology with state geographic wage adjustments and 47 26 shall be adjusted to increase the rates to the extent possible 47 27 within the $1,000,000 of state funding appropriated for this 47 28 purpose. The department shall continue to update the rates 47 29 every two years to reflect the most recent Medicare LUPA rates 47 30 to the extent possible within the state funding appropriated 47 31 for this purpose. 47 32 Sec. 39. 2017 Iowa Acts, chapter 174, section 70, subsection 47 33 1, paragraphs j and k, are amended to read as follows: 47 34 j. For the fiscal year beginning July 1, 2018, unless 47 35 otherwise specified in this Act, all noninstitutional medical 48 1 assistance provider reimbursement rates shall remain at the 48 2 rates in effect on June 30, 2018, except for area education 48 3 agencies, local education agencies, infant and toddler 48 4 services providers, home and community=based services providers 48 5 including consumer=directed attendant care providers under a 48 6 section 1915(c) or 1915(i) waiver, targeted case management 48 7 providers,andthose providers whose rates are required to be 48 8 determined pursuant to section 249A.20, or to meet federal 48 9 mental health parity requirements. 48 10 k. Notwithstanding any provision to the contrary, for the 48 11 fiscal year beginning July 1, 2018, the reimbursement rate 48 12 for anesthesiologists shallbe adjusted to implement the cost 48 13 containment strategies authorized for the medical assistance 48 14 program in this 2017 Actremain at the rate in effect on June 48 15 30, 2018, and updated on January 1, 2019, to align with the 48 16 most current Iowa Medicare anesthesia base rate. 48 17 Sec. 40. 2017 Iowa Acts, chapter 174, section 70, subsection 48 18 11, is amended to read as follows: 48 19 11. a.For the fiscal year beginning July 1, 2018, 48 20Effective July 1, 2018, the child care provider reimbursement 48 21 rates shall remain at the rates in effect on June 30, 2018. 48 22 Effective January 1, 2019, for child care providers reimbursed 48 23 under the state child care assistance program, the department 48 24 shallsetutilize $3,000,000 of the amount appropriated for 48 25 child care assistance under this division to increase provider 48 26 reimbursement rates based on the rate reimbursement survey 48 27 completed in December20042014.Effective July 1, 2018, 48 28 the child care provider reimbursement rates shall remain at 48 29 the rates in effect on June 30, 2018.The department shall 48 30 increase the lowest rate that is furthest from the fiftieth 48 31 percentile to a rate consistent with the relative percentage of 48 32 the second lowest rate as compared to the fiftieth percentile. 48 33 As funds remain available, the department shall increase 48 34 the subsequent lowest rates in a similar manner until the 48 35 $3,000,000 is projected to be fully expended in the fiscal 49 1 year. The department shall set rates in a manner so as to 49 2 provide incentives for a nonregistered provider to become 49 3 registered by applying the increase only to registered and 49 4 licensed providers. 49 5 b. Effective January 1, 2019, for infant and toddler 49 6 child care providers reimbursed under the state child 49 7 care assistance program, the department shall set provider 49 8 reimbursement rates at the seventy=fifth percentile of the rate 49 9 reimbursement survey completed in December 2014, within the 49 10 expected increase for the federal child care and development 49 11 block grant expenditure requirement for infant and toddler 49 12 quality improvement, subject to quality rating system criteria 49 13 developed pursuant to section 237A.30. The department shall 49 14 set rates in a manner so as to provide incentives for a 49 15 nonregistered provider to become registered by applying the 49 16 increase only to registered and licensed providers. 49 17 Sec. 41. 2017 Iowa Acts, chapter 174, section 70, subsection 49 18 13, is amended by striking the subsection. 49 19 Sec. 42. REPEAL. 2017 Iowa Acts, chapter 174, section 69, 49 20 is repealed. 49 21 DIVISION VI 49 22 HEALTH CARE ACCOUNTS AND FUNDS ==== FY 2018=2019 49 23 Sec. 43. 2017 Iowa Acts, chapter 174, section 75, is amended 49 24 to read as follows: 49 25 SEC. 75. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 49 26 appropriated from the pharmaceutical settlement account created 49 27 in section 249A.33 to the department of human services for the 49 28 fiscal year beginning July 1, 2018, and ending June 30, 2019, 49 29 the following amount, or so much thereof as is necessary, to be 49 30 used for the purpose designated: 49 31 Notwithstanding any provision of law to the contrary, to 49 32 supplement the appropriations made in this Act for medical 49 33 contracts under the medical assistance program for the fiscal 49 34 year beginning July 1, 2018, and ending June 30, 2019: 49 35 .................................................. $400,00050 1 1,446,266 50 2 Sec. 44. 2017 Iowa Acts, chapter 174, section 76, is amended 50 3 to read as follows: 50 4 SEC. 76. QUALITY ASSURANCE TRUST FUND ==== DEPARTMENT OF HUMAN 50 5 SERVICES. Notwithstanding any provision to the contrary and 50 6 subject to the availability of funds, there is appropriated 50 7 from the quality assurance trust fund created in section 50 8 249L.4 to the department of human services for the fiscal year 50 9 beginning July 1, 2018, and ending June 30, 2019, the following 50 10 amounts, or so much thereof as is necessary, for the purposes 50 11 designated: 50 12 To supplement the appropriation made in this Act from the 50 13 general fund of the state to the department of human services 50 14 for medical assistance for the same fiscal year: 50 15 .................................................. $18,352,60450 16 36,705,208 50 17 Sec. 45. 2017 Iowa Acts, chapter 174, section 77, is amended 50 18 to read as follows: 50 19 SEC. 77. HOSPITAL HEALTH CARE ACCESS TRUST FUND ==== 50 20 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 50 21 the contrary and subject to the availability of funds, there is 50 22 appropriated from the hospital health care access trust fund 50 23 created in section 249M.4 to the department of human services 50 24 for the fiscal year beginning July 1, 2018, and ending June 50 25 30, 2019, the following amounts, or so much thereof as is 50 26 necessary, for the purposes designated: 50 27 To supplement the appropriation made in this Act from the 50 28 general fund of the state to the department of human services 50 29 for medical assistance for the same fiscal year: 50 30 .................................................. $16,960,27750 31 33,920,554 50 32 DIVISION VII 50 33 PRIOR YEAR APPROPRIATIONS AND OTHER PROVISIONS 50 34 FEDERAL FUNDING 50 35 Sec. 46. 2017 Iowa Acts, chapter 165, section 13, subsection 51 1 3, paragraphs b and e, are amended to read as follows: 51 2 b. Child and family services: 51 3 (1) FFY 2017=2018: 51 4 .................................................. $7,672,39051 5 8,022,390 51 6 (2) FFY 2018=2019: 51 7 .................................................. $7,672,39051 8 8,272,390 51 9 e. For distribution to counties for state case services 51 10 provided for persons with mental illness, intellectual 51 11 disability, or a developmental disability in accordance with 51 12 section 331.440, Code 2013, or in accordance with a dispute 51 13 resolution process implemented in accordance with section 51 14 331.394, subsections 5 or 6: 51 15 (1) FFY 2017=2018: 51 16 .................................................. $600,00051 17 250,000 51 18 (2) FFY 2018=2019: 51 19 .................................................. $600,00051 20 0 51 21 Moneys appropriated in this lettered paragraph "e" 51 22 that remain unencumbered or unallocated at the close of a 51 23 federal fiscal year shall not revert but shall be retained 51 24 by the department and used to supplement amounts otherwise 51 25 appropriated for child and family services under paragraph "b". 51 26 TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) 51 27 Sec. 47. 2017 Iowa Acts, chapter 174, section 6, is amended 51 28 to read as follows: 51 29 SEC. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 51 30 GRANT. There is appropriated from the fund created in section 51 31 8.41 to the department of human services for the fiscal year 51 32 beginning July 1, 2017, and ending June 30, 2018, from moneys 51 33 received under the federal temporary assistance for needy 51 34 families (TANF) block grant pursuant to the federal Personal 51 35 Responsibility and Work Opportunity Reconciliation Act of 1996, 52 1 Pub. L. No. 104=193, and successor legislation, the following 52 2 amounts, or so much thereof as is necessary, to be used for the 52 3 purposes designated: 52 4 1. To be credited to the family investment program account 52 5 and used for assistance under the family investment program 52 6 under chapter 239B: 52 7 .................................................. $5,112,46252 8 4,539,006 52 9 2. To be credited to the family investment program account 52 10 and used for the job opportunities and basic skills (JOBS) 52 11 program and implementing family investment agreements in 52 12 accordance with chapter 239B: 52 13 .................................................. $5,575,69352 14 5,412,060 52 15 3. To be used for the family development and 52 16 self=sufficiency grant program in accordance with section 52 17 216A.107: 52 18 .................................................. $2,898,98052 19 2,883,980 52 20 Notwithstanding section 8.33, moneys appropriated in this 52 21 subsection that remain unencumbered or unobligated at the close 52 22 of the fiscal year shall not revert but shall remain available 52 23 for expenditure for the purposes designated until the close of 52 24 the succeeding fiscal year. However, unless such moneys are 52 25 encumbered or obligated on or before September 30, 2018, the 52 26 moneys shall revert. 52 27 4. For field operations: 52 28 .................................................. $ 31,296,232 52 29 5. For general administration: 52 30 .................................................. $ 3,744,000 52 31 6. For state child care assistance: 52 32 .................................................. $47,866,82652 33 53,603,561 52 34 a. Of the funds appropriated in this subsection, 52 35$26,328,097$26,205,412 is transferred to the child care 53 1 and development block grant appropriation made by the 53 2 Eighty=seventh General Assembly, 2017 session, for the federal 53 3 fiscal year beginning October 1, 2017, and ending September 30, 53 4 2018. Of this amount, $200,000 shall be used for provision 53 5 of educational opportunities to registered child care home 53 6 providers in order to improve services and programs offered 53 7 by this category of providers and to increase the number of 53 8 providers. The department may contract with institutions 53 9 of higher education or child care resource and referral 53 10 centers to provide the educational opportunities. Allowable 53 11 administrative costs under the contracts shall not exceed 5 53 12 percent. The application for a grant shall not exceed two 53 13 pages in length. 53 14 b. Any funds appropriated in this subsection remaining 53 15 unallocated shall be used for state child care assistance 53 16 payments for families who are employed including but not 53 17 limited to individuals enrolled in the family investment 53 18 program. 53 19 7. For child and family services: 53 20 .................................................. $ 32,380,654 53 21 8. For child abuse prevention grants: 53 22 .................................................. $ 125,000 53 23 9. For pregnancy prevention grants on the condition that 53 24 family planning services are funded: 53 25 .................................................. $1,930,06753 26 1,913,203 53 27 Pregnancy prevention grants shall be awarded to programs 53 28 in existence on or before July 1, 2017, if the programs have 53 29 demonstrated positive outcomes. Grants shall be awarded to 53 30 pregnancy prevention programs which are developed after July 53 31 1, 2017, if the programs are based on existing models that 53 32 have demonstrated positive outcomes. Grants shall comply with 53 33 the requirements provided in 1997 Iowa Acts, chapter 208, 53 34 section 14, subsections 1 and 2, including the requirement that 53 35 grant programs must emphasize sexual abstinence. Priority in 54 1 the awarding of grants shall be given to programs that serve 54 2 areas of the state which demonstrate the highest percentage of 54 3 unplanned pregnancies of females of childbearing age within the 54 4 geographic area to be served by the grant. 54 5 10. For technology needs and other resources necessary 54 6 to meet federal welfare reform reporting, tracking, and case 54 7 management requirements: 54 8 .................................................. $1,037,18654 9 294,155 54 10 11. a. Notwithstanding any provision to the contrary, 54 11 including but not limited to requirements in section 8.41 or 54 12 provisions in 2016 or 2017 Iowa Acts regarding the receipt and 54 13 appropriation of federal block grants, federal funds from the 54 14 temporary assistance for needy families block grant received by 54 15 the state and not otherwise appropriated in this section and 54 16 remaining available for the fiscal year beginning July 1, 2017, 54 17 are appropriated to the department of human services to the 54 18 extent as may be necessary to be used in the following priority 54 19 order: the family investment program, for state child care 54 20 assistance program payments for families who are employed, and 54 21 for the family investment program share of costs to develop and 54 22 maintain a new, integrated eligibility determination system. 54 23 The federal funds appropriated in this paragraph "a" shall be 54 24 expended only after all other funds appropriated in subsection 54 25 1 for assistance under the family investment program, in 54 26 subsection 6 for child care assistance, or in subsection 10 54 27 for technology costs related to the family investment program, 54 28 as applicable, have been expended. For the purposes of this 54 29 subsection, the funds appropriated in subsection 6, paragraph 54 30 "a", for transfer to the child care and development block grant 54 31 appropriation are considered fully expended when the full 54 32 amount has been transferred. 54 33 b. The department shall, on a quarterly basis, advise the 54 34 legislative services agency and department of management of 54 35 the amount of funds appropriated in this subsection that was 55 1 expended in the prior quarter. 55 2 12. Of the amounts appropriated in this section, 55 3 $12,962,008 for the fiscal year beginning July 1, 2017, is 55 4 transferred to the appropriation of the federal social services 55 5 block grant made to the department of human services for that 55 6 fiscal year. 55 7 13. For continuation of the program providing categorical 55 8 eligibility for the food assistance program as specified 55 9 for the program in the section of this division of this Act 55 10 relating to the family investment program account: 55 11 .................................................. $25,00055 12 14,236 55 13 14. The department may transfer funds allocated in this 55 14 section to the appropriations made in this division of this Act 55 15 for the same fiscal year for general administration and field 55 16 operations for resources necessary to implement and operate the 55 17 services referred to in this section and those funded in the 55 18 appropriation made in this division of this Act for the same 55 19 fiscal year for the family investment program from the general 55 20 fund of the state. 55 21 15. With the exception of moneys allocated under this 55 22 section for the family development and self=sufficiency grant 55 23 program, to the extent moneys allocated in this section are 55 24 deemed by the department not to be necessary to support the 55 25 purposes for which they are allocated, such moneys may be 55 26creditedused in the same fiscal year for any other purpose for 55 27 which funds are allocated in this section or in section 7 of 55 28 this division for the family investment program account. If 55 29 there are competing needs, priority shall first be given to the 55 30 family investment program account as specified under subsection 55 31 1 of this section and used for the purposes of assistance 55 32 under the family investment program in accordance with chapter 55 33 239Bin the same fiscal year, followed by state child care 55 34 assistance program payments for families who are employed, 55 35 followed by other priorities as specified by the department. 56 1 MEDICAID TRANSFERS TO SUPPORT REVIEWS AND QUALITY CONTROL 56 2 ACTIVITIES 56 3 Sec. 48. 2017 Iowa Acts, chapter 174, section 12, subsection 56 4 8, is amended to read as follows: 56 5 8. A portion of the funds appropriated in this section 56 6 may be transferred to the appropriations in this division of 56 7 this Act for general administration, medical contracts, the 56 8 children's health insurance program, or field operations to be 56 9 used for the state match cost to comply with the payment error 56 10 rate measurement (PERM) program for both the medical assistance 56 11 and children's health insurance programs as developed by the 56 12 centers for Medicare and Medicaid services of the United States 56 13 department of health and human services to comply with the 56 14 federal Improper Payments Information Act of 2002, Pub. L. 56 15 No. 107=300, and to support other reviews and quality control 56 16 activities to improve the integrity of these programs. 56 17 STATE SUPPLEMENTARY ASSISTANCE 56 18 Sec. 49. 2017 Iowa Acts, chapter 174, section 14, is amended 56 19 by adding the following new subsection: 56 20 NEW SUBSECTION. 4. Notwithstanding section 8.33, moneys 56 21 appropriated in this section that remain unencumbered or 56 22 unobligated at the close of the fiscal year shall not revert 56 23 but shall remain available for expenditure for the purposes 56 24 designated until the close of the succeeding fiscal year. 56 25 JUVENILE INSTITUTION 56 26 Sec. 50. 2017 Iowa Acts, chapter 174, section 17, is amended 56 27 by adding the following new subsection: 56 28 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys 56 29 appropriated in this section that remain unencumbered or 56 30 unobligated at the close of the fiscal year shall not revert 56 31 but shall remain available for expenditure for the purposes 56 32 designated until the close of the succeeding fiscal year. 56 33 MENTAL HEALTH INSTITUTES 56 34 Sec. 51. 2017 Iowa Acts, chapter 174, section 23, is amended 56 35 by adding the following new subsection: 57 1 NEW SUBSECTION. 4. Notwithstanding section 8.33, moneys 57 2 appropriated in this section that remain unencumbered or 57 3 unobligated at the close of the fiscal year shall not revert 57 4 but shall remain available for expenditure for the purposes 57 5 designated until the close of the succeeding fiscal year. 57 6 STATE RESOURCE CENTERS 57 7 Sec. 52. 2017 Iowa Acts, chapter 174, section 24, is amended 57 8 by adding the following new subsection: 57 9 NEW SUBSECTION. 6. Notwithstanding section 8.33, and 57 10 notwithstanding the amount limitation specified in section 57 11 222.92, moneys appropriated in this section that remain 57 12 unencumbered or unobligated at the close of the fiscal year 57 13 shall not revert but shall remain available for expenditure 57 14 for the purposes designated until the close of the succeeding 57 15 fiscal year. 57 16 SEXUALLY VIOLENT PREDATORS 57 17 Sec. 53. 2017 Iowa Acts, chapter 174, section 25, is amended 57 18 by adding the following new subsection: 57 19 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys 57 20 appropriated in this section that remain unencumbered or 57 21 unobligated at the close of the fiscal year shall not revert 57 22 but shall remain available for expenditure for the purposes 57 23 designated until the close of the succeeding fiscal year. 57 24 Sec. 54. EFFECTIVE DATE. This division of this Act, being 57 25 deemed of immediate importance, takes effect upon enactment. 57 26 Sec. 55. RETROACTIVE APPLICABILITY. This division of this 57 27 Act applies retroactively to July 1, 2017. 57 28 DIVISION VIII 57 29 DECATEGORIZATION 57 30 Sec. 56. DECATEGORIZATION CARRYOVER FUNDING ==== TRANSFER TO 57 31 MEDICAID PROGRAM. Notwithstanding section 232.188, subsection 57 32 5, paragraph "b", any state appropriated moneys in the funding 57 33 pool that remained unencumbered or unobligated at the close 57 34 of the fiscal year beginning July 1, 2015, and were deemed 57 35 carryover funding to remain available for the two succeeding 58 1 fiscal years that still remain unencumbered or unobligated at 58 2 the close of the fiscal year beginning July 1, 2017, shall 58 3 not revert but shall be transferred to the medical assistance 58 4 program for the fiscal year beginning July 1, 2018. 58 5 Sec. 57. EFFECTIVE DATE. This division of this Act, being 58 6 deemed of immediate importance, takes effect upon enactment. 58 7 Sec. 58. RETROACTIVE APPLICABILITY. This division of this 58 8 Act applies retroactively to July 1, 2017. 58 9 DIVISION IX 58 10 STATE CASES 58 11 Sec. 59. Section 218.99, Code 2018, is amended to read as 58 12 follows: 58 13 218.99 Counties to be notified of patients' personal 58 14 accounts. 58 15 The administrator in control of a state institution shall 58 16 direct the business manager of each institution under the 58 17 administrator's jurisdiction which is mentioned in section 58 18 331.424, subsection 1, paragraph "a", subparagraphs (1) and 58 19 (2), and for which services are paid under section 331.424A, 58 20 to quarterly inform the county of residence of any patient or 58 21 resident who has an amount in excess of two hundred dollars on 58 22 account in the patients' personal deposit fund and the amount 58 23 on deposit. The administrators shall direct the business 58 24 manager to further notify the county of residence at least 58 25 fifteen days before the release of funds in excess of two 58 26 hundred dollars or upon the death of the patient or resident. 58 27 If the patient or resident has no residency in this state 58 28 or the person's residency is unknownso that the person is 58 29 deemed to be a state case, notice shall be made to the director 58 30 of human services and the administrator in control of the 58 31 institution involved. 58 32 Sec. 60. Section 222.60, subsection 1, paragraph b, Code 58 33 2018, is amended to read as follows: 58 34 b. The state when the person is a resident in another state 58 35 or in a foreign country, or when the person's residence is 59 1 unknown.The payment responsibility shall be deemed to be a 59 2 state case.59 3 Sec. 61. Section 222.60, subsection 2, paragraph b, Code 59 4 2018, is amended to read as follows: 59 5 b. The cost of a regional administrator=required diagnosis 59 6 and an evaluation is at the mental health and disability 59 7 services region's expense.For a state caseWhen a person is 59 8 a resident in another state or in a foreign country, or when 59 9 the persons' residence is unknown, the state may apply the 59 10 diagnosis and evaluation provisions of this subsection at the 59 11 state's expense. 59 12 Sec. 62. Section 222.65, subsection 1, Code 2018, is amended 59 13 to read as follows: 59 14 1. If the administrator concurs with a certified 59 15 determination as to residency of the personso that the 59 16 person is deemed a state casein another state or in a foreign 59 17 country, or the person's residence is unknown under section 59 18 222.60, the administrator shall cause the person either to be 59 19 transferred to a resource center or a special unit or to be 59 20 transferred to the place of foreign residency. 59 21 Sec. 63. Section 222.66, Code 2018, is amended to read as 59 22 follows: 59 23 222.66 Transfers ====state casesno residency in the state or 59 24 residency unknown ==== expenses. 59 251.The transfer to a resource center or a special unit or 59 26 to the place of residency of a person with an intellectual 59 27 disability who has no residence in this state or whose 59 28 residency is unknown, shall be made in accordance with such 59 29 directions as shall be prescribed by the administrator and 59 30 when practicable by employees of the state resource center or 59 31 the special unit. The actual and necessary expenses of such 59 32 transfers shall be paid by the department on itemized vouchers 59 33 sworn to by the claimants and approved by the administrator and 59 34 the approved amount is appropriated to the department from any 59 35 funds in the state treasury not otherwise appropriated. 60 12. The case of a person with an intellectual disability 60 2 who is determined to have no residence in this state or whose 60 3 residence is unknown shall be considered a state case.60 4 Sec. 64. Section 222.67, Code 2018, is amended to read as 60 5 follows: 60 6 222.67 Charge on finding of residency. 60 7 If a person has been received into a resource center or a 60 8 special unit as a patient whose residency is unknown and the 60 9 administrator determines that the residency of the patient 60 10 was at the time of admission in a county of this state, the 60 11 administrator shall certify the determination and charge 60 12 all legal costs and expenses pertaining to the admission 60 13 and support of the patient to the county of residence. The 60 14 certification shall be sent to the county of residence. The 60 15 certification shall be accompanied by a copy of the evidence 60 16 supporting the determination. If the person's residency status 60 17 has been determined in accordance with section 331.394, the 60 18 legal costs and expenses shall be charged to the countyor as a 60 19 state casein accordance with that determination. The costs 60 20 and expenses shall be collected as provided by law in other 60 21 cases. 60 22 Sec. 65. Section 222.70, Code 2018, is amended to read as 60 23 follows: 60 24 222.70 Residency disputes. 60 25 If a dispute arises between counties or between the 60 26 department and a county as to the residency of a person 60 27 admitted to a resource center,or a special unit, or a 60 28 community=based service, the dispute shall be resolved as 60 29 provided in section 331.394. 60 30 Sec. 66. Section 226.45, Code 2018, is amended to read as 60 31 follows: 60 32 226.45 Reimbursement to county or state. 60 33 If a patient is not receiving medical assistance under 60 34 chapter 249A and the amounttoin the account of any patient 60 35 in the patients' personal deposit fund exceeds two hundred 61 1 dollars, the business manager of the hospital may apply any 61 2 of the excess to reimburse the county of residence or the 61 3 statefor a state casewhen the patient is a resident in 61 4 another state or in a foreign country, or when the patient's 61 5 residence is unknown for liability incurred by the county or 61 6 the state for the payment of care, support and maintenance of 61 7 the patient, when billed by the county of residence or by the 61 8 administratorfor a state casewhen the patient is a resident 61 9 in another state or in a foreign country, or when the patient's 61 10 residence is unknown. 61 11 Sec. 67. Section 230.1, subsection 1, paragraph b, Code 61 12 2018, is amended to read as follows: 61 13 b. By the stateas a state caseif such person has no 61 14 residence in this state, if the person's residence is unknown, 61 15 or if the person is under eighteen years of age. 61 16 Sec. 68. Section 230.2, Code 2018, is amended to read as 61 17 follows: 61 18 230.2 Finding of residence. 61 19 If a person's residency status is disputed, the residency 61 20 shall be determined in accordance with section 331.394. 61 21 Otherwise, the district court may, when the person is 61 22 ordered placed in a hospital for psychiatric examination and 61 23 appropriate treatment, or as soon thereafter as the court 61 24 obtains the proper information, make one of the following 61 25 determinations and enter of record whether the residence of the 61 26 person is in a county or the person isdeemed to be a state case 61 27a resident in another state or in a foreign country, or when 61 28 the person's residence is unknown, as follows: 61 29 1. That the person's residence is in the county from which 61 30 the person was placed in the hospital. 61 31 2. That the person's residence is in another county of the 61 32 state. 61 33 3. That the person's residence is in a foreign state or 61 34 countryand the person is deemed to be a state case. 61 35 4. That the person's residence is unknownand the person is 62 1 deemed to be a state case. 62 2 Sec. 69. Section 230.8, Code 2018, is amended to read as 62 3 follows: 62 4 230.8 Transfers of persons with mental illness ==== expenses. 62 5 The transfer to any state hospitals or to the places of their 62 6 residence of persons with mental illness who have no residence 62 7 in this state or whose residence is unknownand deemed to be a 62 8 state case, shall be made according to the directions of the 62 9 administrator, and when practicable by employees of the state 62 10 hospitals. The actual and necessary expenses of such transfers 62 11 shall be paid by the department on itemized vouchers sworn to 62 12 by the claimants and approved by the administrator. 62 13 Sec. 70. Section 230.9, Code 2018, is amended to read as 62 14 follows: 62 15 230.9 Subsequent discovery of residence. 62 16 If, after a person has been received by a state hospital 62 17 for persons with mental illnessas a state case patient62 18 whose residence is supposed to be outside this state, the 62 19 administrator determines that the residence of the person 62 20 was, at the time of admission or commitment, in a county of 62 21 this state, the administrator shall certify the determination 62 22 and charge all legal costs and expenses pertaining to the 62 23 admission or commitment and support of the person to the county 62 24 of residence. The certification shall be sent to the county 62 25 of residence. The certification shall be accompanied by a 62 26 copy of the evidence supporting the determination. The costs 62 27 and expenses shall be collected as provided by law in other 62 28 cases. If the person's residency status has been determined in 62 29 accordance with section 331.394, the legal costs and expenses 62 30 shall be chargedto the county of residence or as a state case62 31 in accordance with that determination. 62 32 Sec. 71. Section 230.11, Code 2018, is amended to read as 62 33 follows: 62 34 230.11 Recovery of costs from state. 62 35 Costs and expenses attending the taking into custody, 63 1 care, and investigation of a person who has been admitted 63 2 or committed to a state hospital, United States department 63 3 of veterans affairs hospital, or other agency of the United 63 4 States government, for persons with mental illness and who 63 5 has no residence in this state or whose residence is unknown, 63 6 including cost of commitment, if any, shall be paidas a state 63 7 caseas approved by the administrator. The amount of the costs 63 8 and expenses approved by the administrator is appropriated 63 9 to the department from any money in the state treasury 63 10 not otherwise appropriated. Payment shall be made by the 63 11 department on itemized vouchers executed by the auditor of the 63 12 county which has paid them, and approved by the administrator. 63 13 Sec. 72. Section 249A.26, subsection 2, paragraph b, Code 63 14 2018, is amended to read as follows: 63 15 b. The state shall pay for one hundred percent of the 63 16 nonfederal share of the costs of case management provided for 63 17 adults, day treatment, partial hospitalization, and the home 63 18 and community=based services waiver servicesfor persons who 63 19 have no residence in this state or whose residence is unknown 63 20 so that the persons are deemed to be state cases. 63 21 Sec. 73. Section 249A.26, subsection 7, Code 2018, is 63 22 amended by striking the subsection. 63 23 Sec. 74. Section 331.394, Code 2018, is amended to read as 63 24 follows: 63 25 331.394 County of residence ==== services to residents ==== 63 26 service authorization appeals ==== disputes between counties or 63 27 regionsand the department. 63 28 1. For the purposes of this section, unless the context 63 29 otherwise requires: 63 30 a. "County of residence" means the county in this state in 63 31 which, at the time a person applies for or receives services, 63 32 the person is living and has established an ongoing presence 63 33 with the declared, good faith intention of living in the 63 34 county for a permanent or indefinite period of time. The 63 35 county of residence of a person who is a homeless person 64 1 is the county where the homeless person usually sleeps. A 64 2 person maintains residency in the county or state in which the 64 3 person last resided while the person is present in another 64 4 county or this state receiving services in a hospital, a 64 5 correctional facility, a halfway house for community=based 64 6 corrections or substance=related treatment, a nursing facility, 64 7 an intermediate care facility for persons with an intellectual 64 8 disability, or a residential care facility, or for the purpose 64 9 of attending a college or university. 64 10 b. "Homeless person" means the same as defined in section 64 11 48A.2. 64 12 c. "Mental health professional" means the same as defined 64 13 in section 228.1. 64 14 d. "Person" means a person who is a United States citizen or 64 15 a qualified alien as defined in 8 U.S.C. {1641. 64 16 2. If a person appeals a decision regarding a service 64 17 authorization or other services=related decision made by a 64 18 regional administrator that cannot be resolved informally, 64 19 the appeal shall be heard in a contested case proceeding by a 64 20 state administrative law judge. The administrative law judge's 64 21 decision shall be considered final agency action under chapter 64 22 17A. 64 23 3. If a service authorization or other services=related 64 24 decision made by a regional administrator concerning a person 64 25 varies from the type and amount of service identified to be 64 26 necessary for the person in a clinical determination made by a 64 27 mental health professional and the mental health professional 64 28 believes that failure to provide the type and amount of service 64 29 identified could cause an immediate danger to the person's 64 30 health or safety, the person may request an expedited review 64 31 of the regional administrator's decision to be made by the 64 32 department of human services. An expedited review held in 64 33 accordance with this subsection is subject to the following 64 34 procedures: 64 35 a. The request for the expedited review shall be filed 65 1 within five business days of receiving the notice of decision 65 2 by the regional administrator. The request must be in writing, 65 3 plainly state the request for an expedited review in the 65 4 caption and body of the request, and be supported by written 65 5 documentation from the mental health professional who made the 65 6 clinical determination stating how the notice of decision on 65 7 services could cause an immediate danger to the person's health 65 8 or safety. 65 9 b. The expedited review shall be performed by a mental 65 10 health professional, who is either the administrator of the 65 11 division of mental health and disability services of the 65 12 department of human services or the administrator's designee. 65 13 If the administrator is not a mental health professional, 65 14 the expedited review shall be performed by a designee of the 65 15 administrator who is a mental health professional and is free 65 16 of any conflict of interest to perform the expedited review. 65 17 The expedited review shall be performed within two business 65 18 days of the time the request is filed. If the reviewer 65 19 determines the information submitted in connection with the 65 20 request is inadequate to perform the review, the reviewer shall 65 21 request the submission of additional information and the review 65 22 shall be performed within two business days of the time that 65 23 adequate information is submitted. The regional administrator 65 24 and the person, with the assistance of the mental health 65 25 professional who made the clinical determination, shall each 65 26 provide a brief statement of facts, conclusions, and reasons 65 27 for the decision made. Supporting clinical information shall 65 28 also be attached. All information related to the proceedings 65 29 and any related filings shall be considered to be mental health 65 30 information subject to chapter 228. 65 31 c. The administrator or designee shall issue an order, 65 32 including a brief statement of findings of fact, conclusions of 65 33 law, and policy reasons for the order, to justify the decision 65 34 made concerning the expedited review. If the decision concurs 65 35 with the contention that there is an immediate danger to the 66 1 person's health or safety, the order shall identify the type 66 2 and amount of service which shall be provided for the person. 66 3 The administrator or designee shall give such notice as is 66 4 practicable to persons who are required to comply with the 66 5 order. The order is effective when issued. 66 6 d. The decision of the administrator or designee shall be 66 7 considered a final agency action and is subject to judicial 66 8 review in accordance with section 17A.19. The record for 66 9 judicial review consists of any documents regarding the matter 66 10 that were considered or prepared by the administrator or 66 11 designee. The administrator or designee shall maintain these 66 12 documents as the official record of the decision. If the 66 13 matter is appealed to the district court, the record shall be 66 14 filed as confidential. 66 15 4. If a county of residence is part of a mental health and 66 16 disability services region that has agreed to pool funding and 66 17 liability for services, the responsibilities of the county 66 18 under law regarding such services shall be performed on behalf 66 19 of the county by the regional administrator. The county of 66 20 residence or the county's mental health and disability services 66 21 region, as applicable, is responsible for paying the public 66 22 costs of the mental health and disability services that are 66 23 not covered by the medical assistance program under chapter 66 24 249A and are provided in accordance with the region's approved 66 25 service management plan to persons who are residents of the 66 26 county or region. 66 27 5. a. The dispute resolution process implemented in 66 28 accordance with this subsection applies to residency disputes. 66 29 The dispute resolution process is not applicable to disputes 66 30 involving persons committed to a state facility pursuant to 66 31 chapter 812 or rule of criminal procedure 2.22, Iowa court 66 32 rules, or to disputes involving service authorization decisions 66 33 made by a region. 66 34 b. If a county,or region, or the department, as applicable, 66 35 receives a billing for services provided to a resident 67 1 in another county or region, or objects to a residency 67 2 determination certified bythe department oranother county's 67 3 or region's regional administrator and asserts either that the 67 4 person has residency in another county or region or the person 67 5 is not a resident of this stateor the person's residency is 67 6 unknown so that the person is deemed a state case, the person's 67 7 residency status shall be determined as provided in this 67 8 subsection.The county or region shall notify the department 67 9 of the county's or region's assertion within one hundred twenty 67 10 days of receiving the billing.If the county or region asserts 67 11 that the person has residency in another county or region, 67 12thatthe county or region shallbe notified at the same time 67 13 as the department. If the department disputes a residency 67 14 determination certification made by a regional administrator, 67 15 the department shall notify the affected counties or regions of 67 16 the department's assertionnotify the other county or region 67 17 within one hundred twenty days of receiving the billing for 67 18 services. 67 19 c. Thedepartment,county,or region that received the 67 20 notification, as applicable, shall respond to the party that 67 21 provided the notification within forty=five days of receiving 67 22 the notification. If the parties cannot agree to a settlement 67 23 as to the person's residency status within ninety days of the 67 24 date of notification, on motion of any of the parties, the 67 25 matter shall be referred to the department of inspections and 67 26 appeals for a contested case hearing under chapter 17A before 67 27 an administrative law judge assigned in accordance with section 67 28 10A.801 to determine the person's residency status. 67 29 d. (1) The administrative law judge's determination 67 30 of the person's residency status shall be considered final 67 31 agency action, notwithstanding contrary provisions of section 67 32 17A.15. The party that does not prevail in the determination 67 33 or subsequent judicial review is liable for costs associated 67 34 with the proceeding, including reimbursement of the department 67 35 of inspections and appeals' actual costs associated with 68 1 the administrative proceeding. Judicial review of the 68 2 determination may be sought in accordance with section 17A.19. 68 3 (2) If following the determination of a person's residency 68 4 status in accordance with this subsection, additional evidence 68 5 becomes available that merits a change in that determination, 68 6 the parties affected may change the determination by mutual 68 7 agreement. Otherwise, a party may move that the matter be 68 8 reconsidered by thedepartment,county,or region, or by the 68 9 administrative law judge. 68 10 e. (1) Unless a petition is filed for judicial review, 68 11 the administrative law judge's determination of the person's 68 12 residency status shall result in one of the following: 68 13 (a) If a county or region is determined to be the person's 68 14 residence, the county or region shall pay the amounts due and 68 15 shall reimburse any other amounts paid for services provided by 68 16 the other county or regionor the departmenton the person's 68 17 behalf prior to the determination. 68 18 (b) If it is determined that the person is not a resident 68 19 of this stateor the person's residency is unknown so that the 68 20 person is deemed to be a state case, the department shall pay 68 21 the amounts due and shall reimburse the county or region, as 68 22 applicable, for any payment made on behalf of the person prior 68 23 to the determinationneither the region in which the services 68 24 were provided nor the state shall be liable for payment of 68 25 amounts due for services provided to the person prior to the 68 26 determination. 68 27 (2) The payment or reimbursement shall be remitted within 68 28 forty=five days of the date the determination was issued. 68 29 After the forty=five=day period, a penalty of not greater than 68 30 one percent per month may be added to the amount due. 68 31 6. a. The dispute resolution process implemented in 68 32 accordance with this subsection applies beginning July 1, 2012, 68 33 to billing disputes between the state and a county or region, 68 34 other than residency disputes or other dispute processes under 68 35 this section, involving the responsibility for service costs 69 1 for services provided on or after July 1, 2011, under any of 69 2 the following: 69 3 (1) Chapter 221. 69 4 (2) Chapter 222. 69 5 (3) Chapter 229. 69 6 (4) Chapter 230. 69 7 (5) Chapter 249A. 69 8 (6) Chapter 812. 69 9 b. If a county, region, or the department, as applicable, 69 10 disputes a billing for service costs listed in paragraph "a", 69 11 the dispute shall be resolved as provided in this subsection. 69 12 The county or region shall notify the department of the 69 13 county's or region's assertion within ninety days of receiving 69 14 the billing. However, for services provided on or after July 69 15 1, 2011, for which a county has received the billing as of July 69 16 1, 2012, the county shall notify the department of the county's 69 17 assertion on or before October 1, 2012. If the department 69 18 disputes such a billing of a regional administrator, the 69 19 department shall notify the affected counties or regions of the 69 20 department's assertion. 69 21 c. The department, county, or region that received the 69 22 notification, as applicable, shall respond to the party 69 23 that provided the notification within forty=five days of 69 24 receiving the notification. If the parties cannot agree to a 69 25 settlement as to the dispute within ninety days of the date 69 26 of notification, on motion of any of the parties, the matter 69 27 shall be referred to the department of inspections and appeals 69 28 for a contested case hearing under chapter 17A before an 69 29 administrative law judge assigned in accordance with section 69 30 10A.801 to determine facts and issue a decision to resolve the 69 31 dispute. 69 32 d. (1) The administrative law judge's decision is a final 69 33 agency action, notwithstanding contrary provisions of section 69 34 17A.15. The party that does not prevail in the decision or 69 35 subsequent judicial review is liable for costs associated with 70 1 the proceeding, including reimbursement of the department of 70 2 inspections and appeals' actual costs associated with the 70 3 administrative proceeding. Judicial review of the decision may 70 4 be sought in accordance with section 17A.19. 70 5 (2) If following the decision regarding a dispute in 70 6 accordance with this subsection, additional evidence becomes 70 7 available that merits a change in that decision, the parties 70 8 affected may change the decision by mutual agreement. 70 9 Otherwise, a party may move that the matter be reconsidered by 70 10 the department, county, or region, or by the administrative law 70 11 judge. 70 12 e. (1) Unless a petition is filed for judicial review, 70 13 the administrative law judge's decision regarding a disputed 70 14 billing shall result in one of the following: 70 15 (a) If a county or region is determined to be responsible 70 16 for the disputed amounts, the county or region shall pay 70 17 the amounts due and shall reimburse any other amounts paid 70 18 for services provided by the other county or region or the 70 19 department on the person's behalf prior to the decision. 70 20 (b) If it is determined that the state is responsible for 70 21 the disputed amounts, the state shall pay the amounts due and 70 22 shall reimburse the county or region, as applicable, for any 70 23 payment made on behalf of the person prior to the decision. 70 24 (2) The payment or reimbursement shall be remitted within 70 25 forty=five days of the date the decision was issued. After 70 26 the forty=five=day period, a penalty of not greater than one 70 27 percent per month may be added to the amount due. 70 28 Sec. 75. REPEAL. Section 226.9C, Code 2018, is repealed. 70 29 DIVISION X 70 30 IOWA DEPARTMENT ON AGING ==== MEDICAID CLAIMING 70 31 Sec. 76. IOWA DEPARTMENT ON AGING ==== MEDICAID CLAIMING. The 70 32 department on aging and the department of human services shall 70 33 collaborate to develop a cost allocation plan requesting 70 34 Medicaid administrative funding to provide for the claiming 70 35 of federal financial participation for aging and disability 71 1 resource center activities that are performed to assist with 71 2 administration of the Medicaid program. By January 1, 2019, 71 3 the department of human services shall submit to the centers 71 4 for Medicare and Medicaid services of the United States 71 5 department of health and human services any Medicaid state plan 71 6 amendment as necessary and shall enter into an interagency 71 7 agreement with the department on aging to implement this 71 8 section. 71 9 Sec. 77. EFFECTIVE DATE. This division of this Act, being 71 10 deemed of immediate importance, takes effect upon enactment. 71 11 DIVISION XI 71 12 EXECUTIVE DIRECTOR ==== DEPARTMENT OF VETERANS AFFAIRS 71 13 Sec. 78. 2008 Iowa Acts, chapter 1191, section 14, 71 14 subsection 3, is amended to read as follows: 71 15 3. The following are range 3 positions: administrator of 71 16 the division of criminal and juvenile justice planning of the 71 17 department of human rights, administrator of the division of 71 18 community action agencies of the department of human rights, 71 19executive director of the department of veterans affairs,and 71 20 chairperson and members of the employment appeal board of the 71 21 department of inspections and appeals. 71 22 Sec. 79. 2008 Iowa Acts, chapter 1191, section 14, 71 23 subsection 5, as amended by 2013 Iowa Acts, chapter 123, 71 24 section 63, is amended to read as follows: 71 25 5. The following are range 5 positions: administrator of 71 26 the division of homeland security and emergency management of 71 27 the department of public defense, state public defender, drug 71 28 policy coordinator, labor commissioner, workers' compensation 71 29 commissioner, director of the department of cultural affairs, 71 30 director of the department of elder affairs, director of the 71 31 law enforcement academy, members of the property assessment 71 32 appeal board, executive director of the department of veterans 71 33 affairs, and administrator of the historical division of the 71 34 department of cultural affairs. 71 35 Sec. 80. EFFECTIVE DATE. This division of this Act, being 72 1 deemed of immediate importance, takes effect upon enactment. 72 2 DIVISION XII 72 3 FAMILY PLANNING SERVICES PROGRAM 72 4 Sec. 81. Section 217.41B, subsection 3, Code 2018, is 72 5 amended to read as follows: 72 6 3.a. (1) Distribution of family planning services program 72 7 funds shall not be made to any entity that performs abortions 72 8 or that maintains or operates a facility where abortions 72 9 are performed, which shall not be interpreted to include a 72 10 nonpublic entity that is a distinct location of a nonprofit 72 11 health care delivery system, if the distinct location provides 72 12 family planning services but does not perform abortions 72 13 or maintain or operate as a facility where abortions are 72 14 performed. 72 15 (2) The department of human services shall adopt rules 72 16 pursuant to chapter 17A to require that as a condition of 72 17 eligibility as a provider under the family planning services 72 18 program, each distinct location of a nonprofit health care 72 19 delivery system shall enroll in the program as a separate 72 20 provider, be assigned a distinct provider identification 72 21 number, and complete an attestation that abortions are not 72 22 performed at the distinct location. 72 23 (3) For the purposes of this section, "nonprofit health 72 24 care delivery system" means an Iowa nonprofit corporation 72 25 that controls, directly or indirectly, a regional health 72 26 care network consisting of hospital facilities and various 72 27 ambulatory and clinic locations that provide a range of 72 28 primary, secondary, and tertiary inpatient, outpatient, and 72 29 physician services. 72 30 b. For the purposes of this section, "abortion" does not 72 31 include any of the following: 72 32a.(1) The treatment of a woman for a physical 72 33 disorder, physical injury, or physical illness, including a 72 34 life=endangering physical condition caused by or arising from 72 35 the pregnancy itself, that would, as certified by a physician, 73 1 place the woman in danger of death. 73 2b.(2) The treatment of a woman for a spontaneous abortion, 73 3 commonly known as a miscarriage, when not all of the products 73 4 of human conception are expelled. 73 5 DIVISION XIII 73 6 PROVISIONAL REGIONALIZATION AUTHORIZATION 73 7 Sec. 82. Section 331.389, subsection 1, paragraphs b and c, 73 8 Code 2018, are amended to read as follows: 73 9b. The director of human services shall exempt a county 73 10 from being required to enter into a regional service system if 73 11 the county furnishes evidence that the county complies with 73 12 the requirements in subsection 3, paragraphs "c", "d", "e", 73 13 and "f", and is able to provide the core services required 73 14 by law to the county's residents in a manner that is as cost 73 15 effective and with outcomes that are at least equal to what 73 16 could be provided to the residents if the county would provide 73 17 the services through a regional service system. The director 73 18 shall identify criteria for evaluating the evidence provided by 73 19 counties applying for the exemption. The criteria identified 73 20 shall be specified in rule adopted by the state commission.73 21c.b. If a county has been exemptedpursuant to this 73 22 subsectionprior to July 1, 2014, from the requirement to enter 73 23 into a regional service system, the county and the county's 73 24 board of supervisors shall fulfill all requirements under 73 25 this chapter and chapter 225C for a regional service system, 73 26 regional service system management plan, regional governing 73 27 board, and regional administrator, and any other provisions 73 28 applicable to a region of counties providing local mental 73 29 health and disability services. 73 30 Sec. 83. Section 331.389, subsection 2, Code 2018, is 73 31 amended to read as follows: 73 32 2. The director of human services shall approve any region 73 33 meeting the requirements of subsection 3.However, the 73 34 director of human services, in consultation with the state 73 35 commission, may grant a waiver from the requirement relating to 74 1 the minimum number of counties if there is convincing evidence 74 2 that compliance with such requirement is not workable.74 3 Sec. 84. Section 331.389, subsection 3, paragraph a, Code 74 4 2018, is amended to read as follows: 74 5 a. The counties comprising the region are contiguousexcept 74 6 that a region may include a county that is not contiguous with 74 7 any of the other counties in the region, if the county that is 74 8 not contiguous has had a formal relationship for two years or 74 9 longer with one or more of the other counties in the region for 74 10 the provision of mental health and disability services. 74 11 Sec. 85. Section 331.389, subsection 4, paragraph c, Code 74 12 2018, is amended to read as follows: 74 13 c. During the period of April 2, 2013, through July 1, 74 14 2013, the department shall work with any county that has not 74 15 agreed to be part of a region in accordance with paragraph 74 16 "a" and with the regions forming around the county to resolve 74 17 issues preventing the county from joining a region. By July 74 18 1, 2013, a county that has not agreed to be part of a region 74 19 in accordance with paragraph "a" shall be assigned by the 74 20 department to a region, unless exemptedpursuant to subsection 74 21 1prior to July 1, 2014. 74 22 Sec. 86. Section 331.389, subsection 4, paragraph e, 74 23 unnumbered paragraph 1, Code 2018, is amended to read as 74 24 follows: 74 25 On or before June 30, 2014, unless exemptedpursuant to 74 26 subsection 1prior to July 1, 2014, all counties shall be 74 27 in compliance with all of the following mental health and 74 28 disability services region implementation criteria: 74 29 Sec. 87. Section 331.424A, subsection 8, Code 2018, is 74 30 amended to read as follows: 74 31 8. a. For the fiscal year beginning July 1, 2017, the 74 32 regional per capita expenditure target amount is the sum of the 74 33 base expenditure amount for all counties in the region divided 74 34 by the population of the region. However, a regional per 74 35 capita expenditure target amount shall not exceed the statewide 75 1 per capita expenditure target amount. For the fiscal year 75 2 beginning July 1, 2018, and each subsequent fiscal year, the 75 3 regional per capita expenditure target amount for each region 75 4 is equal to the regional per capita expenditure target amount 75 5 for the fiscal year beginning July 1, 2017. 75 6 b. Notwithstanding paragraph "a", for the fiscal year 75 7 beginning July 1, 2019, the regional per capita expenditure 75 8 target amount for a region formed pursuant to the section of 75 9 this Act which authorizes regionalization is the sum of the 75 10 base expenditure amount for all counties in the region divided 75 11 by the population of the region. However, the regional per 75 12 capita expenditure target amount shall not exceed the statewide 75 13 per capita expenditure target amount. For the fiscal year 75 14 beginning July 1, 2020, and each subsequent fiscal year, the 75 15 regional per capita expenditure target amount for the region 75 16 shall be equal to the regional per capita expenditure target 75 17 amount for the fiscal year beginning July 1, 2019. 75 18 Sec. 88. MENTAL HEALTH AND DISABILITY SERVICES ==== 75 19 REGIONALIZATION AUTHORIZATION. 75 20 1. Upon receiving a request from any county within the 75 21 county social services mental health and disability services 75 22 region to be removed from the region, the director of human 75 23 services may authorize the county to join with other counties 75 24 requesting to be removed from the county social services mental 75 25 health and disability services region in the formation of a 75 26 proposed new mental health and disability services region. 75 27 2. County formation of a proposed new mental health and 75 28 disability services region pursuant to this section is subject 75 29 to all of the following: 75 30 a. The aggregate population of all counties forming 75 31 the region is at least 100,000 and includes at least one 75 32 incorporated city with a population of more than 24,000. For 75 33 purposes of this subparagraph, "population" means the same as 75 34 defined in section 331.388, subsection 3, Code 2018. 75 35 b. Notwithstanding section 331.389, subsection 4, on or 76 1 before February 1, 2019, the counties forming the region have 76 2 complied with section 331.389, subsection 3, as amended in 76 3 this division of this Act, and all of the following additional 76 4 requirements: 76 5 (1) The board of supervisors of each county forming the 76 6 region has voted to approve a chapter 28E agreement. 76 7 (2) The duly authorized representatives of all the counties 76 8 forming the region have signed a chapter 28E agreement that is 76 9 in compliance with section 331.392 and 441 IAC 25.14. 76 10 (3) The county board of supervisors' or supervisors' 76 11 designee members and other members of the region's governing 76 12 board are appointed in accordance with section 331.390. 76 13 (4) Executive staff for the region's regional administrator 76 14 are identified or engaged. 76 15 (5) The regional service management plan is developed in 76 16 accordance with section 331.393 and 441 IAC 25.18 and 441 IAC 76 17 25.21 and is submitted to the department. 76 18 (6) The initial regional service management plan shall 76 19 identify the service provider network for the region, identify 76 20 the information technology and data management capacity to be 76 21 employed to support regional functions, and establish business 76 22 functions, accounting procedures, and other administrative 76 23 processes. 76 24 c. Each county forming the region shall submit the 76 25 compliance information required in paragraph "b" to the 76 26 director of human services on or before February 1, 2019. 76 27 Within 45 days of receipt of such information, the director 76 28 of human services shall determine if the region is in full 76 29 compliance and shall approve the region if the region has met 76 30 all of the requirements of this section. 76 31 d. The director of human services shall work with a county 76 32 making a request under this section that has not agreed or 76 33 is unable to join the proposed new region to resolve issues 76 34 preventing the county from joining the proposed new region. 76 35 e. By February 1, 2019, the director of human services shall 77 1 assign a county making a request under this section that has 77 2 not reached an agreement to be part of the proposed new region 77 3 to an existing region or to the new proposed region, consistent 77 4 with this section. 77 5 3. If approved by the department, the region shall commence 77 6 full operations no later than July 1, 2019. 77 7 Sec. 89. EFFECTIVE DATE. This division of this Act, being 77 8 deemed of immediate importance, takes effect upon enactment. 77 9 DIVISION XIV 77 10 MANDATORY REPORTER TRAINING AND CERTIFICATION WORKGROUP 77 11 Sec. 90. DEPARTMENT OF HUMAN SERVICES ==== MANDATORY REPORTER 77 12 TRAINING AND CERTIFICATION WORKGROUP. The department of human 77 13 services, in cooperation with the departments of education 77 14 and public health, shall facilitate a study by a workgroup of 77 15 stakeholders to make recommendations relating to mandatory 77 16 child abuse and mandatory dependent adult abuse reporter 77 17 training and certification requirements. The workgroup shall 77 18 develop interdepartmental strategies for improving mandatory 77 19 child abuse and mandatory dependent adult abuse reporter 77 20 training and certification requirements. The workgroup 77 21 shall consist of representatives from the departments of 77 22 human services, education, public health, public safety, and 77 23 human rights, the department on aging, and the office of the 77 24 attorney general; a court appointed special advocate; and other 77 25 experts the department of human services deems necessary. The 77 26 membership of the workgroup shall also include four members of 77 27 the general assembly. The legislative members shall serve as 77 28 ex officio, nonvoting members of the workgroup, with one member 77 29 to be appointed by each of the following: the majority leader 77 30 of the senate, the minority leader of the senate, the speaker 77 31 of the house of representatives, and the minority leader of the 77 32 house of representatives. The workgroup shall submit a report 77 33 with recommendations, including but not limited to strategies 77 34 developed and other proposed improvements, to the governor and 77 35 the general assembly on or before December 15, 2018. 78 1 DIVISION XV 78 2 NURSING FACILITY QUALITY ASSURANCE ASSESSMENT 78 3 Sec. 91. Section 249L.3, subsection 1, paragraph d, Code 78 4 2018, is amended to read as follows: 78 5 d. The aggregate quality assurance assessments imposed under 78 6 this chapter shall not exceedthe lower of three percent of the 78 7 aggregate non=Medicare revenues of a nursing facility orthe 78 8 maximum amount that may be assessed pursuant to the indirect 78 9 guarantee threshold as established pursuant to 42 C.F.R. 78 10 {433.68(f)(3)(i), and shall be stated on a per=patient=day 78 11 basis. 78 12 Sec. 92. Section 249L.4, subsection 2, Code 2018, is amended 78 13 to read as follows: 78 14 2. Moneys in the trust fund shall be used, subject to 78 15 their appropriation by the general assembly, by the department 78 16 only for reimbursement of nursing facility services for which 78 17 federal financial participation under the medical assistance 78 18 program is available to match state funds.Any moneysMoneys 78 19 appropriated from the trust fund for reimbursement of nursing 78 20 facilities, in addition to the quality assurance assessment 78 21 pass=through and the quality assurance assessment rate add=on 78 22 which shall be used as specified in subsection 5, paragraph "b", 78 23 shall be used in a manner such that no less than thirty=five 78 24 percent of the amount received by a nursing facility is used 78 25 for increases in compensation and costs of employment for 78 26 direct care workers, and no less than sixty percent of the 78 27 total is used to increase compensation and costs of employment 78 28 for all nursing facility staff. For the purposes of use of 78 29 such funds, "direct care worker", "nursing facility staff", 78 30 "increases in compensation", and "costs of employment" mean as 78 31 defined or specified in this chapter. 78 32 Sec. 93. DIRECTIVES TO DEPARTMENT OF HUMAN SERVICES. 78 33 1. The department of human services shall request approval 78 34 from the centers for Medicare and Medicaid services of the 78 35 United States department of health and human services for any 79 1 waiver or state plan amendment necessary to administer this 79 2 division of this Act. 79 3 2. The change in the quality assurance assessment shall 79 4 accrue beginning on the first day of the calendar quarter 79 5 following the date of approval of any waiver or state plan 79 6 amendment. 79 7 DIVISION XVI 79 8 SEXUAL OFFENSES AND SEX OFFENDERS 79 9 Sec. 94. Section 229A.2, subsection 4, Code 2018, is amended 79 10 to read as follows: 79 11 4. "Discharge" means an unconditional discharge from the 79 12 sexually violent predator program. A person released from a 79 13 secure facility into a transitional release program or released 79 14 withor withoutsupervision is not considered to be discharged. 79 15 Sec. 95. Section 229A.5B, subsection 1, unnumbered 79 16 paragraph 1, Code 2018, is amended to read as follows: 79 17 A person who is detained pursuant to section 229A.5 or is 79 18 subject to an order of civil commitment under this chapter 79 19 shall remain in custody unless released by court order or 79 20 discharged under section 229A.8 or 229A.10. A person who has 79 21 been placed in a transitional release program or who is under 79 22 release withor withoutsupervision is considered to be in 79 23 custody. A person in custody under this chapter shall not do 79 24 any of the following: 79 25 Sec. 96. Section 229A.5C, subsection 4, Code 2018, is 79 26 amended to read as follows: 79 27 4. A person who committed a public offense while in a 79 28 transitional release program or on release withor without79 29 supervision may be returned to a secure facility operated by 79 30 the department of human services upon completion of any term 79 31 of confinement that resulted from the commission of the public 79 32 offense. 79 33 Sec. 97. Section 229A.6A, subsection 1, paragraph d, Code 79 34 2018, is amended to read as follows: 79 35 d. To a facility for placement or treatment in a 80 1 transitional release program or for release withor without80 2 supervision. A transport order is not required under this 80 3 paragraph. 80 4 Sec. 98. Section 229A.7, subsection 7, Code 2018, is amended 80 5 to read as follows: 80 6 7. The control, care, and treatment of a person determined 80 7 to be a sexually violent predator shall be provided at a 80 8 facility operated by the department of human services. At all 80 9 times prior to placement in a transitional release program 80 10 or release withor withoutsupervision, persons committed 80 11 for control, care, and treatment by the department of human 80 12 services pursuant to this chapter shall be kept in a secure 80 13 facility and those patients shall be segregated at all times 80 14 from any other patient under the supervision of the department 80 15 of human services. A person committed pursuant to this chapter 80 16 to the custody of the department of human services may be kept 80 17 in a facility or building separate from any other patient 80 18 under the supervision of the department of human services. 80 19 The department of human services may enter into a chapter 80 20 28E agreement with the department of corrections or other 80 21 appropriate agency in this state or another state for the 80 22 confinement of patients who have been determined to be sexually 80 23 violent predators. Patients who are in the custody of the 80 24 director of the department of corrections pursuant to a chapter 80 25 28E agreement and who have not been placed in a transitional 80 26 release program or released withor withoutsupervision shall 80 27 be housed and managed separately from criminal offenders in 80 28 the custody of the director of the department of corrections, 80 29 and except for occasional instances of supervised incidental 80 30 contact, shall be segregated from those offenders. 80 31 Sec. 99. Section 229A.8B, subsection 3, Code 2018, is 80 32 amended to read as follows: 80 33 3. Upon the return of the committed person to a secure 80 34 facility, the director of human services or the director's 80 35 designee shall notify the court that issued the ex parte order 81 1 that the absconder has been returned to a secure facility, and 81 2 the court shall set a hearingwithin five daysto determine if 81 3 a violation occurred. If a court order was not issued, the 81 4 director or the director's designee shall contact the nearest 81 5 district court with jurisdiction to set a hearing to determine 81 6 whether a violation of the rules or directives occurred. The 81 7 court shall schedule a hearingwithin five days ofafter 81 8 receiving notice that the committed person has been returned 81 9 from the transitional release program to a secure facility. 81 10 Sec. 100. Section 229A.9A, Code 2018, is amended to read as 81 11 follows: 81 12 229A.9A Release withor withoutsupervision. 81 13 1. In any proceeding under section 229A.8, the court may 81 14 order the committed person released withor withoutsupervision 81 15 if any of the following apply: 81 16 a. The attorney general stipulates to the release withor 81 17 withoutsupervision. 81 18 b. The court or jury has determined that the person should 81 19 bedischargedreleased fromthe programa secure facility or 81 20 a transitional release program, but the court has determined 81 21 the person suffers from a mental abnormality and it is in the 81 22 best interest of the community to order release withor without81 23 supervision before the committed person is discharged. 81 24 2. If release withor withoutsupervision is ordered, the 81 25 department of human services shall prepare within sixty days of 81 26 the order of the court a release plan addressing the person's 81 27 needs for counseling, medication, community support services, 81 28 residential services, vocational services, alcohol or other 81 29 drug abuse treatment, sex offender treatment, or any other 81 30 treatment or supervision necessary. 81 31 3. The court shall set a hearing on the release plan 81 32 prepared by the department of human services before the 81 33 committed person is released from a secure facility or a 81 34 transitional release program. 81 35 4. If the court orders release with supervision, the court 82 1 shall order supervision by an agency with jurisdiction that 82 2 is familiar with the placement of criminal offenders in the 82 3 community. The agency with jurisdiction shall be responsible 82 4 for initiating proceedings for violations of the release plan 82 5 as provided in section 229A.9B.If the court orders release 82 6 without supervision, the agency with jurisdiction shall also be 82 7 responsible for initiating proceedings for any violations of 82 8 the release plan as provided in section 229A.9B.82 9 5. A committed person may not petition the court for release 82 10 withor withoutsupervision. 82 11 6. A committed person released withor withoutsupervision 82 12 is not considered discharged from civil commitment under this 82 13 chapter. 82 14 7. After being released withor withoutsupervision, the 82 15 person may petition the court for discharge as provided in 82 16 section 229A.8. 82 17 8. The court shall retain jurisdiction over the committed 82 18 person who has been released withor withoutsupervision until 82 19 the person is discharged from the program. The department 82 20 of human services or a judicial district department of 82 21 correctional services shall not be held liable for any acts 82 22 committed by a committed person who has been ordered released 82 23 withor withoutsupervision. 82 24 Sec. 101. Section 229A.9B, Code 2018, is amended to read as 82 25 follows: 82 26 229A.9B Violations of release withor withoutsupervision. 82 27 1. If a committed person violates the release plan, the 82 28 agency with jurisdiction over the person may request the 82 29districtcourt to issue an emergency ex parte order directing 82 30 any law enforcement officer to take the person into custody 82 31 so that the person can be returned to a secure facility. 82 32 The request for an ex parte order may be made orally or by 82 33 telephone, but the original written request or a facsimile copy 82 34 of the request shall be filed with the clerk of court no later 82 35 than 4:30 p.m. on the next business day the office of the clerk 83 1 of court is open. 83 2 2. If a committed person has absconded in violation of the 83 3 conditions of the person's release plan, a presumption arises 83 4 that the person poses a risk to public safety. The department 83 5 of human services or contracting agency, in cooperation with 83 6 local law enforcement agencies, may make a public announcement 83 7 about the absconder. The public announcement may include a 83 8 description of the committed person, that the committed person 83 9 is on release withor withoutsupervision from the sexually 83 10 violent predator program, and any other information pertinent 83 11 to public safety. 83 12 3. Upon the return of the committed person to a secure 83 13 facility, the director of human services or the director's 83 14 designee shall notify the court that issued the ex parte 83 15 order that the committed person has been returned to a secure 83 16 facility, and the court shall set hearingwithin five daysto 83 17 determine if a violation occurred. If a court order was not 83 18 issued, the director or the director's designee shall contact 83 19 the nearest district court with jurisdiction to set a hearing 83 20 to determine whether a violation of the conditions of the 83 21 release plan occurred. The court shall schedule a hearing 83 22within five days ofafter receiving notice that the committed 83 23 person has been returned to a secure facility. 83 24 4. At the hearing, the burden shall be upon the attorney 83 25 general to show by a preponderance of the evidence that a 83 26 violation of the release plan occurred. 83 27 5. If the court determines a violation occurred, the court 83 28 shall receive release recommendations from the department of 83 29 human services and either order that the committed person be 83 30 returned to release withor withoutsupervision or placed 83 31 in a transitional release program, or be confined in a 83 32 secure facility. The court may impose further conditions 83 33 upon the committed person if returned to release withor 83 34 withoutsupervision or placed in the transitional release 83 35 program. If the court determines no violation occurred, the 84 1 committed person shall be returned to release withor without84 2 supervision. 84 3 Sec. 102. Section 232.68, subsection 2, paragraph a, 84 4 subparagraph (3), Code 2018, is amended to read as follows: 84 5 (3) The commission of a sexual offense with or to a child 84 6 pursuant to chapter 709, section 726.2, or section 728.12, 84 7 subsection 1, as a result of the acts or omissions of the 84 8 person responsible for the care of the child or of a person who 84 9 is fourteen years of age or older and resides in a home with 84 10 the child. Notwithstanding section 702.5, the commission of 84 11 a sexual offense under this subparagraph includes any sexual 84 12 offense referred to in this subparagraph with or to a person 84 13 under the age of eighteen years. 84 14 Sec. 103. Section 232.68, subsection 2, paragraph a, 84 15 subparagraph (9), Code 2018, is amended to read as follows: 84 16 (9) (a)KnowinglyA person who is responsible for the 84 17 care of a child knowingly allowinga personanother person 84 18 custodyorof, controlofover, or unsupervised access to a 84 19child or minorchild under the age of fourteen or a child with 84 20 a physical or mental disability, after knowing theperson 84 21other person is required to register or is on the sex offender 84 22 registry under chapter 692Afor a violation of section 726.6. 84 23 (b) This subparagraph does not apply in any of the following 84 24 circumstances: 84 25 (i) A child living with a parent or guardian who is a sex 84 26 offender required to register or on the sex offender registry 84 27 under chapter 692A. 84 28 (ii) A child living with a parent or guardian who is married 84 29 to and living with a sex offender required to register or on 84 30 the sex offender registry under chapter 692A. 84 31 (iii) A child who is a sex offender required to register or 84 32 on the sex offender registry under chapter 692A who is living 84 33 with the child's parent, guardian, or foster parent and is also 84 34 living with the child to whom access was allowed. 84 35 (c) For purposes of this subparagraph, "control over" means 85 1 any of the following: 85 2 (i) A person who has accepted, undertaken, or assumed 85 3 supervision of a child from the parent or guardian of the 85 4 child. 85 5 (ii) A person who has undertaken or assumed temporary 85 6 supervision of a child without explicit consent from the parent 85 7 or guardian of the child. 85 8 Sec. 104. Section 901A.2, subsection 6, Code 2018, is 85 9 amended to read as follows: 85 10 6. A person who has been placed in a transitional release 85 11 program, released withor withoutsupervision, or discharged 85 12 pursuant to chapter 229A, and who is subsequently convicted of 85 13 a sexually predatory offense or a sexually violent offense, 85 14 shall be sentenced to life in prison on the same terms as 85 15 a class "A" felon under section 902.1, notwithstanding any 85 16 other provision of the Code to the contrary. The terms and 85 17 conditions applicable to sentences for class "A" felons under 85 18 chapters 901 through 909 shall apply to persons sentenced under 85 19 this subsection. However, if the person commits a sexually 85 20 violent offense which is a misdemeanor offense under chapter 85 21 709, the person shall be sentenced to life in prison, with 85 22 eligibility for parole as provided in chapter 906. 85 23 DIVISION XVII 85 24 MEDICAID RETROACTIVE ELIGIBILITY 85 25 Sec. 105. 2017 Iowa Acts, chapter 174, section 12, 85 26 subsection 15, paragraph a, subparagraph (7), is amended to 85 27 read as follows: 85 28 (7) (a) Elimination of the three=month retroactive 85 29 Medicaid coverage benefit for Medicaid applicants effective 85 30 October 1, 2017. The department shall seek a waiver from 85 31 the centers for Medicare and Medicaid services of the United 85 32 States department of health and human services to implement 85 33 the strategy. If federal approval is received, an applicant's 85 34 Medicaid coverage shall be effective on the first day of the 85 35 month of application, as allowed under the Medicaid state plan. 86 1 (b) Effective July 1, 2018, a three=month retroactive 86 2 Medicaid coverage benefit shall apply to a Medicaid applicant 86 3 who is otherwise Medicaid=eligible and is a resident of a 86 4 nursing facility licensed under chapter 135C. The department 86 5 shall seek federal approval for any Medicaid waiver or state 86 6 plan amendment necessary to implement this subparagraph (b). 86 7 Sec. 106. EFFECTIVE DATE. This division of this Act, being 86 8 deemed of immediate importance, takes effect upon enactment. 86 9 DIVISION XVIII 86 10 MENTAL HEALTH AND DISABILITY SERVICES ==== TRANSFER OF FUNDS 86 11 Sec. 107. MENTAL HEALTH AND DISABILITY SERVICES ==== TRANSFER 86 12 OF FUNDS. Notwithstanding section 331.424A, a county with a 86 13 population of over 300,000 based on the most recent federal 86 14 decennial census, may transfer funds from any other fund of 86 15 the county not comprised of revenue generated by a levy to the 86 16 mental health and disability regional services fund for the 86 17 purposes of providing mental health and disability services for 86 18 the fiscal year beginning July 1, 2018, and ending June 30, 86 19 2019. The county shall submit a report to the governor and the 86 20 general assembly by September 1, 2019, including the source of 86 21 any funds transferred, the amount of the funds transferred, and 86 22 the mental health and disability services provided with the 86 23 transferred funds. 86 24 DIVISION XIX 86 25 MISCELLANEOUS TECHNICAL PROVISIONS 86 26 Sec. 108. Section 135.15, Code 2018, is amended to read as 86 27 follows: 86 28 135.15 Oral and health delivery system bureau established ==== 86 29 responsibilities. 86 30 An oral and health delivery system bureau is established 86 31 within the division of health promotion and chronic disease 86 32 prevention of the department. The bureau shall be responsible 86 33 for all of the following: 86 34 1. Providing population=based oral health services, 86 35 including public health training, improvement of dental support 87 1 systems for families, technical assistance, awareness=building 87 2 activities, and educational services, at the state and local 87 3 level to assist Iowans in maintaining optimal oral health 87 4 throughout all stages of life. 87 5 2. Performing infrastructure building and enabling services 87 6 through the administration of state and federal grant programs 87 7 targeting access improvement, prevention, and local oral 87 8 health programs utilizing maternal and child health programs, 87 9 Medicaid, and other new or existing programs. 87 10 3. Leveraging federal, state, and local resources for 87 11 programs under the purview of the bureau. 87 12 4. Facilitating ongoing strategic planning and application 87 13 of evidence=based research in oral health care policy 87 14 development that improves oral health care access and the 87 15 overall oral health of all Iowans. 87 16 5. Developing and implementing an ongoing oral health 87 17 surveillance system for the evaluation and monitoring of 87 18 the oral health status of children and other underserved 87 19 populations. 87 20 6. Facilitating the provision of oral health services 87 21 through dental homes. For the purposes of this section, 87 22 "dental home" means a network of individualized care based on 87 23 risk assessment, which includes oral health education, dental 87 24 screenings, preventive services, diagnostic services, treatment 87 25 services, and emergency services. 87 26 Sec. 109. Section 135.175, subsection 1, paragraph a, Code 87 27 2018, is amended to read as follows: 87 28 a. A health care workforce support initiative is established 87 29 to provide for the coordination and support of various efforts 87 30 to address the health care workforce shortage in this state. 87 31 This initiative shall include the medical residency training 87 32 state matching grants program created in section 135.176, 87 33 the nurse residency state matching grants program created in 87 34 section 135.178, and the fulfilling Iowa's need for dentists 87 35 matching grant program created in section 135.179. 88 1 Sec. 110. Section 135.175, subsection 5, Code 2018, is 88 2 amended by adding the following new paragraph: 88 3 NEW PARAGRAPH. b. The nurse residency state matching grants 88 4 program account. The nurse residency state matching grants 88 5 program account shall be under the control of the department 88 6 and the moneys in the account shall be used for the purposes of 88 7 the nurse residency state matching grants program as specified 88 8 in section 135.178. Moneys in the account shall consist of 88 9 moneys appropriated or allocated for deposit in or received 88 10 by the fund or the account and specifically dedicated to the 88 11 nurse residency state matching grants program account for the 88 12 purposes of such account. 88 13 Sec. 111. Section 135.175, subsection 6, paragraph a, Code 88 14 2018, is amended to read as follows: 88 15 a. Moneys in the fund and the accounts in the fund shall 88 16 only be appropriated in a manner consistent with the principles 88 17 specified and the strategic plan developed pursuant to section 88 18 135.163 to support the medical residency training state 88 19 matching grants program, the nurse residency state matching 88 20 grants program, the fulfilling Iowa's need for dentists 88 21 matching grant program, and to provide funding for state health 88 22 care workforce shortage programs as provided in this section. 88 23 DIVISION XX 88 24 STATE TRAINING SCHOOL ==== ELDORA 88 25 Sec. 112. Section 233A.1, Code 2018, is amended to read as 88 26 follows: 88 27 233A.1 State training school ==== Eldoraand Toledo. 88 28 1. Effective January 1, 1992, a diagnosis and evaluation 88 29 center and other units are established atEldorathe 88 30 state training school to providetocourt=committed 88 31 male juvenile delinquents a program which focuses upon 88 32 appropriate developmental skills, treatment, placements, and 88 33 rehabilitation. 88 34 2. The diagnosis and evaluation center which is used to 88 35 identify appropriate treatment and placement alternatives for 89 1 juveniles and any other units for juvenile delinquents which 89 2 are located at Eldoraand the unit for juvenile delinquents at 89 3 Toledoshalltogetherbe known as the "state training school". 89 4 For the purposes of this chapter "director" means the director 89 5 of human services and "superintendent" means the administrator 89 6 in charge of the diagnosis and evaluation center for juvenile 89 7 delinquents and other units atEldora and the unit for juvenile 89 8 delinquents at Toledothe state training school. 89 9 3. The number of children present at any one time at the 89 10 state training schoolat Eldorashall not exceed the population 89 11 guidelines established under 1990 Iowa Acts, ch. 1239, {21, as 89 12 adjusted for subsequent changes in the capacity at the training 89 13 school. 89 14 Sec. 113. Section 233A.14, Code 2018, is amended to read as 89 15 follows: 89 16 233A.14 Transfers to other institutions. 89 17 The administrator may transfer to theschoolsstate training 89 18 school minor wards of the state from any institution under the 89 19 administrator's charge but no person shall be so transferred 89 20 who is mentally ill or has an intellectual disability. Any 89 21 child in theschoolsstate training school who is mentally ill 89 22 or has an intellectual disability may be transferred by the 89 23 administrator to the proper state institution. 89 24 Sec. 114. Section 915.29, subsection 1, unnumbered 89 25 paragraph 1, Code 2018, is amended to read as follows: 89 26 The department of human services shall notify a registered 89 27 victim regarding a juvenile adjudicated delinquent for a 89 28 violent crime, committed to the custody of the department of 89 29 human services, and placed at the state training schoolat 89 30 Eldora or Toledo, of the following: 89 31 DIVISION XXI 89 32 GERIATRIC PATIENT HOUSING REVIEW 89 33 Sec. 115. GERIATRIC PATIENT HOUSING REVIEW. 89 34 1. During the 2018 legislative interim, the department 89 35 on aging and the departments of human services, inspections 90 1 and appeals, and corrections, cooperatively, shall review 90 2 issues and develop policy recommendations relating to housing 90 3 for geriatric persons, including geriatric individuals 90 4 who are registered on the sex offender registry or who are 90 5 sexually aggressive. The review shall address all aspects 90 6 of the issue including the feasibility of private entities 90 7 utilizing facilities located at Mount Pleasant, Clarinda, 90 8 or other vacant, state=owned facilities to care for such 90 9 geriatric persons; related workforce recruitment and training; 90 10 requirements that a facility must meet in order to receive 90 11 Medicaid reimbursement; and any other information or issues 90 12 deemed appropriate by the agencies. 90 13 2. The agencies shall submit a joint report with 90 14 recommendations to the governor and general assembly by 90 15 December 15, 2018. 90 16 DIVISION XXII 90 17 DISTRIBUTION OF FEDERAL FUNDS ==== RESTRICTIONS ==== ABORTION 90 18 Sec. 116. DISTRIBUTION OF FEDERAL PUBLIC HEALTH SERVICES 90 19 ACT FUNDS FOR FAMILY PLANNING. 90 20 1. The department of public health shall annually apply 90 21 to the United States department of health and human services 90 22 for grant funding under Tit. X of the federal Public Health 90 23 Services Act, 42 U.S.C. {300 et seq. The department shall 90 24 distribute all grant funding received to applicants in the 90 25 following order of priority: 90 26 a. Public entities that provide family planning services 90 27 including state, county, or local community health clinics and 90 28 federally qualified health centers. 90 29 b. Nonpublic entities that, in addition to family planning 90 30 services, provide required primary health services as described 90 31 in 42 U.S.C. {254b(b)(1)(A). 90 32 c. Nonpublic entities that provide family planning 90 33 services but do not provide required primary health services as 90 34 described in 42 U.S.C. {254b(b)(1)(A). 90 35 2. Distribution of funds under this section shall be made in 91 1 a manner that continues access to family planning services. 91 2 3. Distribution of funds shall not be made to any entity 91 3 that performs abortions or that maintains or operates a 91 4 facility where abortions are performed. For the purposes of 91 5 this section, "abortion" does not include any of the following: 91 6 a. The treatment of a woman for a physical disorder, 91 7 physical injury, or physical illness, including a 91 8 life=endangering physical condition caused by or arising from 91 9 the pregnancy itself, that would, as certified by a physician, 91 10 place the woman in danger of death. 91 11 b. The treatment of a woman for a spontaneous abortion, 91 12 commonly known as a miscarriage. 91 13 4. Funds distributed in accordance with this section shall 91 14 not be used for direct or indirect costs, including but not 91 15 limited to administrative costs or expenses, overhead, employee 91 16 salaries, rent, and telephone and other utility costs, related 91 17 to providing abortions as specified in this section. 91 18 5. The department of public health shall submit a report to 91 19 the governor and the general assembly, annually by January 1, 91 20 listing any entities that received funds pursuant to subsection 91 21 1, paragraph "c", and the amount and type of funds received by 91 22 such entities during the preceding calendar year. The report 91 23 shall provide a detailed explanation of how the department 91 24 determined that distribution of funds to such an entity, 91 25 instead of to an entity described in subsection 1, paragraph 91 26 "a" or "b", was necessary to prevent severe limitation or 91 27 elimination of access to family planning services in the region 91 28 of the state where the entity is located. 91 29 Sec. 117. ADMINISTRATION OF PERSONAL RESPONSIBILITY 91 30 EDUCATION PROGRAM AND ABSTINENCE EDUCATION GRANT PROGRAM 91 31 FUNDS. Any contract entered into on or after July 1, 2018, 91 32 by the department of public health to administer the personal 91 33 responsibility education program as specified in 42 U.S.C. 91 34 {713 or to administer the abstinence education grant program 91 35 authorized pursuant to section 510 of Tit. V of the federal 92 1 Social Security Act, shall exclude as an eligible applicant any 92 2 applicant entity that provides abortions, maintains or operates 92 3 a facility where abortions are performed, or regularly makes 92 4 referrals to an entity that provides abortions or maintains or 92 5 operates a facility where abortions are performed. For the 92 6 purposes of this section, such referrals include but are not 92 7 limited to referrals made by reference to an internet site or 92 8 by linking to an internet site maintained by an entity that 92 9 provides abortions or maintains or operates a facility where 92 10 abortions are performed. 92 11 Sec. 118. AWARD OF COMMUNITY ADOLESCENT PREGNANCY 92 12 PREVENTION AND SERVICES PROGRAM GRANT FUNDS. Any contract 92 13 entered into on or after July 1, 2018, by the department of 92 14 human services to award a community adolescent pregnancy 92 15 prevention and services program grant using federal temporary 92 16 assistance for needy families block grant funds appropriated 92 17 to the department shall exclude as an eligible applicant any 92 18 applicant entity that provides abortions, maintains or operates 92 19 a facility where abortions are performed, or regularly makes 92 20 referrals to an entity that provides abortions or maintains or 92 21 operates a facility where abortions are performed. For the 92 22 purposes of this section, such referrals include but are not 92 23 limited to referrals made by reference to an internet site or 92 24 by linking to an internet site maintained by an entity that 92 25 provides abortions or maintains or operates a facility where 92 26 abortions are performed. 92 27 DIVISION XXIII 92 28 WRONGFUL BIRTH OR WRONGFUL LIFE CAUSE OF ACTION 92 29 Sec. 119. NEW SECTION. 613.15B Wrongful birth or wrongful 92 30 life cause of action ==== prohibitions ==== exceptions. 92 31 1. A cause of action shall not arise and damages shall not 92 32 be awarded, on behalf of any person, based on a wrongful birth 92 33 claim that, but for an act or omission of the defendant, a 92 34 child would not or should not have been born. 92 35 2. A cause of action shall not arise and damages shall not 93 1 be awarded, on behalf of any person, based on a wrongful life 93 2 claim that, but for an act or omission of the defendant, the 93 3 person bringing the action would not or should not have been 93 4 born. 93 5 3. The prohibitions specified in this section apply to any 93 6 claim regardless of whether the child is born healthy or with a 93 7 birth defect or disorder or other adverse medical condition. 93 8 However, the prohibitions specified in this section shall not 93 9 apply to any of the following: 93 10 a. A civil action for damages for an intentional or grossly 93 11 negligent act or omission, including any act or omission that 93 12 constitutes a public offense. 93 13 b. A civil action for damages for the intentional failure 93 14 of a physician to comply with the duty imposed by licensure 93 15 pursuant to chapter 148 to provide a patient with all 93 16 information reasonably necessary to make decisions about a 93 17 pregnancy. 93 18 Sec. 120. EFFECTIVE DATE. This division of this Act, being 93 19 deemed of immediate importance, takes effect upon enactment. 93 20 Sec. 121. APPLICABILITY. This division of this Act applies 93 21 on or after the effective date of this division of this Act to 93 22 causes of action that accrue on or after that date. A cause of 93 23 action that accrues before the effective date of this division 93 24 of this Act is governed by the law in effect prior to the 93 25 effective date of this division of this Act. 93 26 DIVISION XXIV 93 27 TRANSFERS OF FUNDS BETWEEN DHS INSTITUTIONS 93 28 Sec. 122. Section 218.6, Code 2018, is amended to read as 93 29 follows: 93 30 218.6 Transfer of appropriations made to institutions. 93 31 1. Notwithstanding section 8.39, subsection 1, without the 93 32 prior written consent and approval of the governor and the 93 33 director of the department of management, the director of human 93 34 services may transfer funds between the appropriations made for 93 35 the institutions, listed as follows: 94 11.a. The state resource centers. 94 22.b. The state mental health institutes. 94 33.c. The state training school. 94 44.d. The civil commitment unit for sexual offenders. 94 5 2. The department shall report any transfer made pursuant 94 6 to subsection 1 during a fiscal quarter to the legislative 94 7 services agency within thirty days of the beginning of the 94 8 subsequent fiscal quarter. 94 9 DIVISION XXV 94 10 MEDICAL CANNABIDIOL 94 11 Sec. 123. Section 124E.7, subsections 7 and 8, Code 2018, 94 12 are amended to read as follows: 94 13 7. A medical cannabidiol manufacturer shall not employ 94 14 a person who is under eighteen years of age or who has been 94 15 convicted of a disqualifying felony offense. An employee 94 16 of a medical cannabidiol manufacturer shall be subject to a 94 17 background investigation conducted by the division of criminal 94 18 investigation of the department of public safety and a national 94 19 criminal history background check pursuant to section 124E.19. 94 20 8. A medical cannabidiol manufacturer owner shall not have 94 21 been convicted of a disqualifying felony offense and shall be 94 22 subject to a background investigation conducted by the division 94 23 of criminal investigation of the department of public safety 94 24 and a national criminal history background check pursuant to 94 25 section 124E.19. 94 26 Sec. 124. Section 124E.9, subsections 7 and 8, Code 2018, 94 27 are amended to read as follows: 94 28 7. A medical cannabidiol dispensary shall not employ a 94 29 person who is under eighteen years of age or who has been 94 30 convicted of a disqualifying felony offense. An employee 94 31 of a medical cannabidiol dispensary shall be subject to a 94 32 background investigation conducted by the division of criminal 94 33 investigation of the department of public safety and a national 94 34 criminal history background check pursuant to section 124E.19. 94 35 8. A medical cannabidiol dispensary owner shall not have 95 1 been convicted of a disqualifying felony offense and shall be 95 2 subject to a background investigation conducted by the division 95 3 of criminal investigation of the department of public safety 95 4 and a national criminal history background check pursuant to 95 5 section 124E.19. 95 6 Sec. 125. Section 124E.10, Code 2018, is amended by striking 95 7 the section and inserting in lieu thereof the following: 95 8 124E.10 Fees. 95 9 All fees collected by the department under this chapter 95 10 shall be retained by the department for operation of the 95 11 medical cannabidiol registration card program and the medical 95 12 cannabidiol manufacturer and medical cannabidiol dispensary 95 13 licensing programs. The moneys retained by the department 95 14 shall be considered repayment receipts as defined in section 95 15 8.2 and shall be used for any of the department's duties 95 16 under this chapter, including but not limited to the addition 95 17 of full=time equivalent positions for program services and 95 18 investigations. Notwithstanding section 8.33, moneys retained 95 19 by the department pursuant to this section shall not revert to 95 20 the general fund of the state but shall remain available for 95 21 expenditure only for the purposes specified in this section. 95 22 Sec. 126. NEW SECTION. 124E.19 Background investigations. 95 23 1. The division of criminal investigation of the 95 24 department of public safety shall conduct thorough 95 25 background investigations for the purposes of licensing 95 26 medical cannabidiol manufacturers and medical cannabidiol 95 27 dispensaries under this chapter. The results of any background 95 28 investigation conducted pursuant to this section shall be 95 29 presented to the department. 95 30 a. An applicant for a medical cannabidiol manufacturer 95 31 license or a medical cannabidiol dispensary license and their 95 32 owners, investors, and employees shall submit all required 95 33 information on a form prescribed by the department of public 95 34 safety. 95 35 b. The department shall charge an applicant for a medical 96 1 cannabidiol manufacturer license or a medical cannabidiol 96 2 dispensary license a fee determined by the department of public 96 3 safety and adopted by the department by rule to defray the 96 4 costs associated with background investigations conducted 96 5 pursuant to the requirements of this section. The fee shall 96 6 be in addition to any other fees charged by the department. 96 7 The fee may be retained by the department of public safety and 96 8 shall be considered repayment receipts as defined in section 96 9 8.2. 96 10 2. The department shall require an applicant for a medical 96 11 cannabidiol manufacturer license or a medical cannabidiol 96 12 dispensary license, their owners and investors, and applicants 96 13 for employment at a medical cannabidiol manufacturer or 96 14 medical cannabidiol dispensary to submit fingerprints and other 96 15 required identifying information to the department on a form 96 16 prescribed by the department of public safety. The department 96 17 shall submit the fingerprint cards and other identifying 96 18 information to the division of criminal investigation of the 96 19 department of public safety for submission to the federal 96 20 bureau of investigation for the purpose of conducting a 96 21 national criminal history record check. The department may 96 22 require employees and contractors involved in carrying out 96 23 a background investigation to submit fingerprints and other 96 24 identifying information for the same purpose. 96 25 3. The department may enter into a chapter 28E agreement 96 26 with the department of public safety to meet the requirements 96 27 of this section. 96 28 4. An applicant for a medical cannabidiol manufacturer 96 29 license or a medical cannabidiol dispensary license shall 96 30 submit information and fees required by this section at the 96 31 time of application. 96 32 5. The results of background investigations conducted 96 33 pursuant to this section shall not be considered public records 96 34 under chapter 22. 96 35 Sec. 127. EFFECTIVE UPON ENACTMENT. This division of this 97 1 Act, being deemed of immediate importance, takes effect upon 97 2 enactment. 97 3 DIVISION XXVI 97 4 DEPARTMENT OF HUMAN SERVICES PROGRAMS AND ACTIVITIES 97 5 INMATES OF PUBLIC INSTITUTIONS ==== MEDICAID 97 6 Sec. 128. Section 249A.38, Code 2018, is amended to read as 97 7 follows: 97 8 249A.38 Inmates of public institutions ==== suspension or 97 9 termination of medical assistance. 97 10 1.The following conditions shall apply toFollowing the 97 11 first thirty days of commitment, the department shall suspend 97 12 the eligibility of an individual who is an inmate of a public 97 13 institution as defined in 42 C.F.R. {435.1010, who is enrolled 97 14 in the medical assistance program at the time of commitment to 97 15 the public institution, and who remains eligible for medical 97 16 assistance as an individual except for the individual's 97 17 institutional status:97 18a. The department shall suspend the individual's 97 19 eligibility for up to the initial twelve months of the period 97 20 of commitment. The department shall delay the suspension 97 21 of eligibility for a period of up to the first thirty days 97 22 of commitment if such delay is approved by the centers for 97 23 Medicare and Medicaid services of the United States department 97 24 of health and human services. If such delay is not approved, 97 25 the department shall suspend eligibility during the entirety 97 26 of the initial twelve months of the period of commitment. 97 27 Claims submitted on behalf of the individual under the medical 97 28 assistance program for covered services provided during the 97 29 delay period shall only be reimbursed if federal financial 97 30 participation is applicable to such claims.97 31b.The department shall terminate an individual's 97 32 eligibility following a twelve=month period of suspension 97 33 of the individual's eligibility under paragraph "a", during 97 34 the period of the individual's commitment to the public 97 35 institution. 98 1 2. a. A public institution shall provide the department and 98 2 the social security administration with a monthly report of the 98 3 individuals who are committed to the public institution and of 98 4 the individuals who are discharged from the public institution. 98 5 The monthly report to the department shall include the date 98 6 of commitment or the date of discharge, as applicable, of 98 7 each individual committed to or discharged from the public 98 8 institution during the reporting period. The monthly report 98 9 shall be made through the reporting system created by the 98 10 department for public, nonmedical institutions to report inmate 98 11 populations. Any medical assistance expenditures, including 98 12 but not limited to monthly managed care capitation payments, 98 13 provided on behalf of an individual who is an inmate of a 98 14 public institution but is not reported to the department 98 15 in accordance with this subsection, shall be the financial 98 16 responsibility of the respective public institution. 98 17 b. The department shall provide a public institution with 98 18 the forms necessary to be used by the individual in expediting 98 19 restoration of the individual's medical assistance benefits 98 20 upon discharge from the public institution. 98 213. This section applies to individuals as specified in 98 22 subsection 1 on or after January 1, 2012.98 234.3. The department may adopt rules pursuant to chapter 98 24 17A to implement this section. 98 25 MEDICAID PROGRAM ADMINISTRATION 98 26 Sec. 129. MEDICAID PROGRAM ADMINISTRATION. 98 27 1. PROVIDER PROCESSES AND PROCEDURES. 98 28 a. When all of the required documents and other information 98 29 necessary to process a claim have been received by a managed 98 30 care organization, the managed care organization shall 98 31 either provide payment to the claimant within the timelines 98 32 specified in the managed care contract or, if the managed 98 33 care organization is denying the claim in whole or in part, 98 34 shall provide notice to the claimant including the reasons for 98 35 such denial consistent with national industry best practice 99 1 guidelines. 99 2 b. A managed care organization shall correct any identified 99 3 system configuration error within a reasonable time frame 99 4 approved by the department, and shall fully and accurately 99 5 reprocess claims affected by such errors within thirty days 99 6 of the successful system correction. The department shall 99 7 define "system configuration error" as appropriate to include 99 8 errors in provider data caused by a managed care organization 99 9 or improper claims edits that result in incorrect payments to 99 10 providers. 99 11 c. A managed care organization shall provide written notice 99 12 to affected individuals at least sixty days prior to making 99 13 any program or procedural change, as determined necessary by 99 14 the department. The department shall develop and distribute a 99 15 list of the types of changes that require the sixty=day notice 99 16 to the managed care organizations effective July 1, 2018. 99 17 Such changes may include but are not limited to billing and 99 18 collection provisions, provider network provisions, member or 99 19 provider services, and prior authorization requirements. 99 20 d. The department of human services shall engage dedicated 99 21 provider relations staff to assist Medicaid providers in 99 22 resolving billing conflicts with managed care organizations 99 23 including those involving denied claims, technical omissions, 99 24 or incomplete information. If the provider relations staff 99 25 observe trends evidencing fraudulent claims or improper 99 26 reimbursement, the staff shall forward such evidence to the 99 27 department of human services for further review. 99 28 e. The department of human services shall adopt rules 99 29 pursuant to chapter 17A to require the inclusion by a managed 99 30 care organization of advanced registered nurse practitioners 99 31 and physician assistants as primary care providers for the 99 32 purposes of population health management. 99 33 f. The department of human services shall provide for the 99 34 development and shall require the use of standardized Medicaid 99 35 provider enrollment forms to be used by the department and 100 1 uniform Medicaid provider credentialing specifications to be 100 2 used by managed care organizations. 100 3 2. MEMBER SERVICES AND PROCESSES. 100 4 a. If a Medicaid member is receiving court=ordered services 100 5 or treatment for a substance=related disorder pursuant to 100 6 chapter 125 or for a mental illness pursuant to chapter 229, 100 7 such services or treatment shall be provided and reimbursed 100 8 for an initial period of three days before a managed care 100 9 organization may apply medical necessity criteria to determine 100 10 the most appropriate services, treatment, or placement for the 100 11 Medicaid member. 100 12 b. The department of human services shall maintain and 100 13 update Medicaid member eligibility files in a timely manner 100 14 consistent with national industry best practices. 100 15 c. The department of human services shall utilize an 100 16 independent, external quality review vendor to complete a 100 17 review of a random case sample of decreased level of care 100 18 determinations using national best practices to ensure that 100 19 appropriate medically necessary services are provided to 100 20 meet Medicaid member needs. The department shall report the 100 21 findings of the review to the governor and the general assembly 100 22 by December 15, 2018, including any plan necessary to address 100 23 the findings. 100 24 d. The department of human services, on an annual basis, 100 25 shall conduct an analysis of all Medicaid member appeals that 100 26 have been dismissed, withdrawn, or overturned to determine 100 27 if there are any negative patterns or trends based on the 100 28 analysis. The services of any member whose appeal is subject 100 29 to the analysis shall continue for the period during which an 100 30 interdisciplinary team conducts a new assessment to determine 100 31 which services are medically necessary for that member, which 100 32 period shall not exceed ninety days. A report of the analysis 100 33 and findings shall be submitted to the governor and the general 100 34 assembly on a biannual basis and the department shall develop a 100 35 plan as necessary to address any negative patterns or trends 101 1 identified by the analysis. 101 2 3. MEDICAID PROGRAM REVIEW AND OVERSIGHT. 101 3 a. (1) The department of human services shall facilitate a 101 4 workgroup, in collaboration with representatives of the managed 101 5 care organizations and health home providers, to review the 101 6 health home programs. The review shall include all of the 101 7 following: 101 8 (a) An analysis of the state plan amendments applicable to 101 9 health homes. 101 10 (b) An analysis of the current health home system, including 101 11 the rationale for any recommended changes. 101 12 (c) The development of a clear and consistent delivery 101 13 model linked to program=determined outcomes and data reporting 101 14 requirements. 101 15 (d) A work plan to be used in communicating with 101 16 stakeholders regarding the administration and operation of the 101 17 health home programs. 101 18 (2) The department of human services shall submit a 101 19 report of the workgroup's findings, recommendations, and 101 20 any actions taken by December 15, 2018, to the governor and 101 21 to the Eighty=eighth General Assembly, 2019 session, for 101 22 consideration. 101 23 (3) The workgroup and the workgroup's activities shall 101 24 not affect the department's authority to apply or enforce the 101 25 Medicaid state plan amendment relative to health homes. 101 26 b. The department of human services, in collaboration 101 27 with Medicaid providers and managed care organizations, shall 101 28 initiate a review process to determine the effectiveness of 101 29 prior authorizations used by the managed care organizations 101 30 with the goal of making adjustments based on relevant 101 31 service costs and member outcomes data utilizing existing 101 32 industry=accepted standards. Prior authorization policies 101 33 shall comply with existing rules, guidelines, and procedures 101 34 developed by the centers for Medicare and Medicaid services of 101 35 the United States department of health and human services. 102 1 c. The department of human services shall enter into a 102 2 contract with an independent review organization to perform 102 3 an audit of a random sample of small dollar claims paid to 102 4 or denied Medicaid long=term services and supports providers 102 5 during the first quarter of the 2018 calendar year. The 102 6 department of human services shall submit a report of 102 7 the findings of the audit to the governor and the general 102 8 assembly by February 1, 2019. The department may take any 102 9 action specified in the managed care contract relative to 102 10 any claim the auditor determines to be incorrectly paid or 102 11 denied, subject to appeal by the managed care organization 102 12 to the director of human services. For the purposes of this 102 13 paragraph, "small dollar claims" means those claims less than 102 14 or equal to two thousand five hundred dollars. 102 15 MEDICAID PROGRAM PHARMACY COPAYMENT 102 16 Sec. 130. 2005 Iowa Acts, chapter 167, section 42, is 102 17 amended to read as follows: 102 18 SEC. 42. COPAYMENTS FOR PRESCRIPTION DRUGS UNDER THE 102 19 MEDICAL ASSISTANCE PROGRAM. The department of human services 102 20 shall require recipients of medical assistance to paythe 102 21 following copaymentsa copayment of $1 on each prescription 102 22 filled for a covered prescription drug, including each refill 102 23 of such prescription, as follows:102 241.A copayment of $1 on each prescription filled for each 102 25 covered nonpreferred generic prescription drug. 102 262. A copayment of $1 for each covered preferred brand=name 102 27 or generic prescription drug.102 283. A copayment of $1 for each covered nonpreferred 102 29 brand=name prescription drug for which the cost to the state is 102 30 up to and including $25.102 314. A copayment of $2 for each covered nonpreferred 102 32 brand=name prescription drug for which the cost to the state is 102 33 more than $25 and up to and including $50.102 345. A copayment of $3 for each covered nonpreferred 102 35 brand=name prescription drug for which the cost to the state 103 1 is more than $50.103 2 MEDICAL ASSISTANCE ADVISORY COUNCIL 103 3 Sec. 131. Section 249A.4B, subsection 2, paragraph a, 103 4 subparagraphs (27) and (28), Code 2018, are amended by striking 103 5 the subparagraphs. 103 6 Sec. 132. MEDICAL ASSISTANCE ADVISORY COUNCIL ==== REVIEW OF 103 7 MEDICAID MANAGED CARE REPORT DATA. The executive committee 103 8 of the medical assistance advisory council shall review 103 9 the data collected and analyzed for inclusion in periodic 103 10 reports to the general assembly, including but not limited 103 11 to the information and data specified in 2016 Iowa Acts, 103 12 chapter 1139, section 93, to determine which data points and 103 13 information should be included and analyzed to more accurately 103 14 identify trends and issues with, and promote the effective and 103 15 efficient administration of, Medicaid managed care for all 103 16 stakeholders. At a minimum, the areas of focus shall include 103 17 consumer protection, provider network access and safeguards, 103 18 outcome achievement, and program integrity. The executive 103 19 committee shall report its findings and recommendations to the 103 20 medical assistance advisory council for review and comment by 103 21 October 1, 2018, and shall submit a final report of findings 103 22 and recommendations to the governor and the general assembly by 103 23 December 31, 2018. 103 24 TARGETED CASE MANAGEMENT AND INPATIENT PSYCHIATRIC SERVICES 103 25 REIMBURSEMENT 103 26 Sec. 133. Section 249A.31, Code 2018, is amended to read as 103 27 follows: 103 28 249A.31 Cost=based reimbursement. 103 29 1.Providers of individual case management services for 103 30 persons with an intellectual disability, a developmental 103 31 disability, or chronic mental illness shall receive cost=based 103 32 reimbursement for one hundred percent of the reasonable 103 33 costs for the provision of the services in accordance with 103 34 standards adopted by the mental health and disability services 103 35 commission pursuant to section 225C.6.Effective July 1, 2018, 104 1 targeted case management services shall be reimbursed based 104 2 on a statewide fee schedule amount developed by rule of the 104 3 department pursuant to chapter 17A. 104 4 2. Effective July 1,20102014,the department shall apply 104 5 a cost=based reimbursement methodology for reimbursement of 104 6 psychiatric medical institution for childrenproviders of 104 7 inpatient psychiatric services for individuals under twenty=one 104 8 years of age shall be reimbursed as follows: 104 9 a. For non=state=owned providers, services shall be 104 10 reimbursed according to a fee schedule without reconciliation. 104 11 b. For state=owned providers, services shall be reimbursed 104 12 at one hundred percent of the actual and allowable cost of 104 13 providing the service. 104 14 DIVISION XXVII 104 15 PREAPPLICATION SCREENING ASSESSMENT 104 16 Sec. 134. Section 229.5A, Code 2018, is amended to read as 104 17 follows: 104 18 229.5A Preapplication screening assessment ==== program. 104 19 Prior to filing an application pursuant to section 229.6, 104 20 the clerk of the district court or the clerk's designee 104 21 shall inform the interested person referred to in section 104 22 229.6, subsection 1, about the option of requesting a 104 23 preapplication screening assessment through a preapplication 104 24 screening assessment program, if available.The state court 104 25 administrator shall prescribe practices and procedures for 104 26 implementation of the preapplication screening assessment 104 27 program.104 28 Sec. 135. Section 602.1209, subsection 16, Code 2018, is 104 29 amended to read as follows: 104 30 16. Prescribe practices and procedures for the 104 31 implementation of the preapplication screening assessment 104 32 program referred to insectionssection 125.74and 229.5A. 104 33 DIVISION XXVIII 104 34 COVERAGE OF BEHAVIORAL HEALTH SERVICES PROVIDED BY CERTAIN 104 35 PROVIDERS 105 1 Sec. 136. Section 249A.15, Code 2018, is amended to read as 105 2 follows: 105 3 249A.15 Licensed psychologists eligible for payment ==== 105 4 provisional licensees. 105 5 1. The department shall adopt rules pursuant to chapter 105 6 17A entitling psychologists who are licensed pursuant to 105 7 chapter 154B and psychologists who are licensed in the state 105 8 where the services are provided and have a doctorate degree 105 9 in psychology, have had at least two years of clinical 105 10 experience in a recognized health setting, or have met the 105 11 standards of a national register of health service providers 105 12 in psychology, to payment for services provided to recipients 105 13 of medical assistance, subject to limitations and exclusions 105 14 the department finds necessary on the basis of federal laws and 105 15 regulations and of funds available for the medical assistance 105 16 program. The rules shall also provide that an individual, who 105 17 holds a provisional license to practice psychology pursuant 105 18 to section 154B.6, is entitled to payment under this section 105 19 for services provided to recipients of medical assistance, 105 20 when such services are provided under the supervision of a 105 21 supervisor who meets the qualifications determined by the board 105 22 of psychology by rule, and claims for payment for such services 105 23 are submitted by the supervisor. 105 24 2. Entitlement to payment under this section is applicable 105 25 to services provided to recipients of medical assistance 105 26 under both the fee=for=service and managed care payment and 105 27 delivery systems. Neither the fee=for=service nor the managed 105 28 care payment and delivery system shall impose a practice 105 29 or supervision restriction which is inconsistent with or 105 30 more restrictive than the authority already granted by law, 105 31 including the authority to provide supervision in person or 105 32 remotely through electronic means as specified by rule of the 105 33 board of psychology. 105 34 Sec. 137. Section 249A.15A, Code 2018, is amended to read 105 35 as follows: 106 1 249A.15A Licensed marital and family therapists, licensed 106 2 master social workers, licensed mental health counselors, and 106 3 certified alcohol and drug counselors ==== temporary licensees. 106 4 1. The department shall adopt rules pursuant to chapter 106 5 17A entitling marital and family therapists who are licensed 106 6 pursuant to chapter 154D to payment for behavioral health 106 7 services provided to recipients of medical assistance, subject 106 8 to limitations and exclusions the department finds necessary 106 9 on the basis of federal laws and regulations. The rules shall 106 10 also provide that a marital and family therapist, who holds 106 11 a temporary license to practice marital and family therapy 106 12 pursuant to section 154D.7, is entitled to payment under this 106 13 section for behavioral health services provided to recipients 106 14 of medical assistance, when such services are provided under 106 15 the supervision of a qualified supervisor as determined by the 106 16 board of behavioral science by rule, and claims for payment for 106 17 such services are submitted by the qualified supervisor. 106 18 2. The department shall adopt rules pursuant to chapter 106 19 17A entitling master social workers who hold a master's 106 20 degree approved by the board of social work, are licensed as 106 21 a master social worker pursuant to section 154C.3, subsection 106 22 1, paragraph "b", and provide treatment services under the 106 23 supervision of an independent social worker licensed pursuant 106 24 to section 154C.3, subsection 1, paragraph "c", to payment 106 25 for behavioral health services provided to recipients of 106 26 medical assistance, subject to limitations and exclusions the 106 27 department finds necessary on the basis of federal laws and 106 28 regulations. 106 29 3. The department shall adopt rules pursuant to chapter 17A 106 30 entitling mental health counselors who are licensed pursuant 106 31 to chapter 154D to payment for behavioral health services 106 32 provided to recipients of medical assistance, subject to 106 33 limitations and exclusions the department finds necessary on 106 34 the basis of federal laws and regulations. The rules shall 106 35 also provide that a mental health counselor, who holds a 107 1 temporary license to practice mental health counseling pursuant 107 2 to section 154D.7, is entitled to payment under this section 107 3 for behavioral health services provided to recipients of 107 4 medical assistance, when such services are provided under the 107 5 supervision of a qualified supervisor as determined by the 107 6 board of behavioral science by rule, and claims for payment for 107 7 such services are submitted by the qualified supervisor. 107 8 4. The department shall adopt rules pursuant to chapter 17A 107 9 entitling alcohol and drug counselors who are certified by the 107 10 nongovernmental Iowa board of substance abuse certification to 107 11 payment for behavioral health services provided to recipients 107 12 of medical assistance, subject to limitations and exclusions 107 13 the department finds necessary on the basis of federal laws and 107 14 regulations. 107 15 5. Entitlement to payment under this section is applicable 107 16 to services provided to recipients of medical assistance 107 17 under both the fee=for=service and managed care payment and 107 18 delivery systems. Neither the fee=for=service nor the managed 107 19 care payment and delivery system shall impose a practice 107 20 or supervision restriction which is inconsistent with or 107 21 more restrictive than the authority already granted by law, 107 22 including the authority to provide supervision in person or 107 23 remotely through electronic means as specified by rule of the 107 24 applicable licensing board. 107 25 Sec. 138. NEW SECTION. 514C.32 Services provided by 107 26 certain licensed master social workers, licensed mental health 107 27 counselors, and licensed marital and family therapists. 107 28 1. Notwithstanding section 514C.6, a policy or contract 107 29 providing for third=party payment or prepayment of health or 107 30 medical expenses shall include a provision for the payment of 107 31 necessary behavioral health services provided by any of the 107 32 following: 107 33 a. A licensed master social worker who is licensed by the 107 34 board of social work as a master social worker pursuant to 107 35 section 154C.3, subsection 1, paragraph "b", and who provides 108 1 services under the supervision of an independent social worker 108 2 licensed pursuant to section 154C.3, subsection 1, paragraph 108 3 "c". 108 4 b. A licensed mental health counselor or a licensed 108 5 marital and family therapist who holds a temporary license to 108 6 practice mental health counseling or marital and family therapy 108 7 pursuant to section 154D.7, and who provides services under 108 8 the supervision of a qualified supervisor as determined by the 108 9 board of behavioral science by rule. 108 10 2. A policy or contract subject to this section shall 108 11 not impose a practice or supervision restriction which is 108 12 inconsistent with or more restrictive than the authority 108 13 already granted by law, including the authority to provide 108 14 supervision in person or remotely through electronic means as 108 15 specified by rule of the applicable licensing board. 108 16 3. The requirements of this section apply to and supersede 108 17 any conflicting requirements regarding services provided under 108 18 a policy or contract, which is delivered, issued for delivery, 108 19 continued, or renewed in this state on or after the effective 108 20 date of this Act, and apply to and supersede any conflicting 108 21 requirements regarding services contained in an existing policy 108 22 or contract on the policy's or contract's anniversary or 108 23 renewal date, whichever is later. 108 24 4. For the purposes of this section, third=party payment or 108 25 prepayment includes an individual or group policy of accident 108 26 or health insurance or individual or group hospital or health 108 27 care service contract issued pursuant to chapter 509, 514, or 108 28 514A, an individual or group health maintenance organization 108 29 contract issued and regulated under chapter 514B, or a 108 30 preferred provider organization contract regulated pursuant to 108 31 chapter 514F. 108 32 5. Nothing in this section shall be interpreted to require 108 33 an individual or group health maintenance organization or a 108 34 preferred provider organization or arrangement to provide 108 35 payment or prepayment for services provided by a licensed 109 1 master social worker providing behavioral health services 109 2 under the supervision of an independent social worker, or to 109 3 a licensed mental health counselor or licensed marital and 109 4 family therapist who holds a temporary license to practice 109 5 mental health counseling or marital and family therapy 109 6 providing behavioral health services under the supervision of 109 7 a qualified supervisor, as specified in this section, unless 109 8 the supervising independent social worker or the qualified 109 9 supervisor, respectively, has entered into a contract or other 109 10 agreement to provide behavioral health services with the 109 11 individual or group health maintenance organization or the 109 12 preferred provider organization or arrangement. 109 13 Sec. 139. NEW SECTION. 514C.33 Services provided by 109 14 provisionally licensed psychologists. 109 15 1. Notwithstanding section 514C.6, a policy or contract 109 16 providing for third=party payment or prepayment of health or 109 17 medical expenses shall include a provision for the payment of 109 18 necessary behavioral health services provided by a person who 109 19 holds a provisional license to practice psychology pursuant to 109 20 section 154B.6, and who practices under the supervision of a 109 21 supervisor who meets the qualifications determined by the board 109 22 of psychology by rule. 109 23 2. A policy or contract subject to this section shall 109 24 not impose a practice or supervision restriction which is 109 25 inconsistent with or more restrictive than the authority 109 26 already granted by law, including the authority to provide 109 27 supervision in person or remotely through electronic means as 109 28 specified by rule of the board of psychology. 109 29 3. The requirements of this section apply to and supersede 109 30 any conflicting requirements regarding services provided under 109 31 a policy or contract which is delivered, issued for delivery, 109 32 continued, or renewed in this state on or after the effective 109 33 date of this Act, and apply to and supersede any conflicting 109 34 requirements regarding services contained in an existing policy 109 35 or contract on the policy's or contract's anniversary or 110 1 renewal date, whichever is later. 110 2 4. For the purposes of this section, third=party payment or 110 3 prepayment includes an individual or group policy of accident 110 4 or health insurance or individual or group hospital or health 110 5 care service contract issued pursuant to chapter 509, 514, or 110 6 514A, an individual or group health maintenance organization 110 7 contract issued and regulated under chapter 514B, or a 110 8 preferred provider organization contract regulated pursuant to 110 9 chapter 514F. 110 10 5. Nothing in this section shall be interpreted to require 110 11 an individual or group health maintenance organization or a 110 12 preferred provider organization or arrangement to provide 110 13 payment or prepayment for services provided by a provisionally 110 14 licensed psychologist providing behavioral health services 110 15 under the supervision of a supervisor as specified in this 110 16 section, unless the supervisor has entered into a contract or 110 17 other agreement to provide behavioral health services with the 110 18 individual or group health maintenance organization or the 110 19 preferred provider organization or arrangement. 110 20 Sec. 140. EFFECTIVE DATE. This division of this Act, being 110 21 deemed of immediate importance, takes effect upon enactment. 110 22 DIVISION XXIX 110 23 PHARMACY BENEFITS MANAGER ==== RIGHTS OF COVERED INDIVIDUALS 110 24 Sec. 141. NEW SECTION. 510B.10 Rights related to covered 110 25 individuals. 110 26 1. A pharmacy or pharmacist, as defined in section 155A.3, 110 27 has the right to provide a covered individual information 110 28 regarding the amount of the covered individual's cost share 110 29 for a prescription drug. A pharmacy benefits manager shall 110 30 not prohibit a pharmacy or pharmacist from discussing any such 110 31 information or from selling a more affordable alternative to 110 32 the covered individual, if one is available. 110 33 2. A health benefit plan, as defined in section 514J.102, 110 34 issued or renewed on or after July 1, 2018, that provides 110 35 coverage for pharmacy benefits shall not require a covered 111 1 individual to pay a copayment for pharmacy benefits that 111 2 exceeds the pharmacy's or pharmacist's submitted charges. 111 3 3. Any amount paid by a covered individual for a covered 111 4 prescription drug pursuant to this section shall be applied 111 5 toward any deductible imposed by the covered individual's 111 6 health benefit plan in accordance with the covered individual's 111 7 health benefit plan coverage documents. 111 8 4. To the extent that any provision of this section is 111 9 inconsistent or conflicts with applicable federal law, rule, 111 10 or regulation, such federal law, rule, or regulation shall 111 11 prevail to the extent necessary to eliminate the inconsistency 111 12 or conflict. 111 13 EXPLANATION 111 14 The inclusion of this explanation does not constitute agreement with 111 15 the explanation's substance by the members of the general assembly. 111 16 This bill relates to appropriations for health and human 111 17 services for fiscal year 2018=2019 to the department of 111 18 veterans affairs, Iowa veterans home, department on aging 111 19 (IDA), office of long=term care ombudsman, department of public 111 20 health (DPH), Iowa finance authority, department of human 111 21 rights, and department of human services (DHS). 111 22 The bill is organized into divisions. 111 23 DEPARTMENT ON AGING. This division makes appropriations 111 24 from the general fund of the state to the department on aging 111 25 for FY 2018=2019. 111 26 OFFICE OF LONG=TERM CARE OMBUDSMAN. This division makes 111 27 appropriations from the general fund of the state to the office 111 28 of long=term care ombudsman for FY 2018=2019. 111 29 DEPARTMENT OF PUBLIC HEALTH. This division makes 111 30 appropriations from the general fund of the state to the 111 31 department of public health for FY 2018=2019. 111 32 DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This 111 33 division makes appropriations from the general fund of the 111 34 state to the department of veterans affairs for FY 2018=2019 111 35 for administration, the Iowa veterans home, for transfer to 112 1 the Iowa finance authority for the home ownership assistance 112 2 program, and for the county commissions of veteran affairs. 112 3 DEPARTMENT OF HUMAN SERVICES. This division makes 112 4 appropriations from the general fund of the state and the 112 5 federal temporary assistance for needy families block grant 112 6 to DHS for FY 2018=2019. The allocation for the family 112 7 development and self=sufficiency grant program is made directly 112 8 to the department of human rights. The reimbursement section 112 9 addresses reimbursement for providers reimbursed by the 112 10 department of human services. 112 11 HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain 112 12 health=related appropriations for FY 2018=2019. A number 112 13 of the appropriations are made for purposes of the medical 112 14 assistance (Medicaid) program in addition to the general fund 112 15 appropriations made for this purpose for the same fiscal year. 112 16 PRIOR YEAR APPROPRIATIONS AND OTHER PROVISIONS. This 112 17 division adjusts allocations and provides for the 112 18 prioritization of the use of TANF funds that are not necessary 112 19 for the purposes for which they are allocated; provides 112 20 that any portion of the funds transferred from the Medicaid 112 21 appropriation to the appropriations for general administration, 112 22 medical contracts, the children's health insurance program, or 112 23 field operations may be used, in addition to the payment error 112 24 rate measurement (PERM) program, for other reviews and quality 112 25 control activities to improve program integrity; provides for 112 26 the nonreversion of funds appropriated for FY 2017=2018 for 112 27 state supplementary assistance, the juvenile institution, the 112 28 mental health institutes, the state resource centers, and 112 29 sexually violent predators; and adjusts the state payment 112 30 program federal funds amounts appropriated for federal fiscal 112 31 years 2017=2018 and 2018=2019. These provisions take effect 112 32 upon enactment and are retroactively applicable to July 1, 112 33 2017. 112 34 DECATEGORIZATION. This division provides for the transfer 112 35 to the medical assistance appropriation for FY 2018=2019 113 1 of state=appropriated moneys in the funding pool for 113 2 decategorization that remain unencumbered or unobligated at 113 3 the close of the fiscal year beginning July 1, 2015, and that 113 4 were deemed carryover funding to remain available for the two 113 5 succeeding fiscal years that still remain unencumbered or 113 6 unobligated at the close of the fiscal year beginning July 113 7 1, 2017. This provision takes effect upon enactment and is 113 8 retroactively applicable to July 1, 2017. 113 9 STATE CASES. This division eliminates the state's 113 10 responsibility for payment of the costs of mental health 113 11 and disability services provided to an individual whose 113 12 county of residence cannot be determined, and eliminates 113 13 the responsibility of both the state and any region for the 113 14 costs of mental health and disability services provided to an 113 15 individual who is not a resident of the state. The division 113 16 makes other conforming changes related to the elimination of 113 17 the references to state cases. 113 18 MEDICAID CLAIMING. This division authorizes the department 113 19 on aging to implement Medicaid claiming for certain aging and 113 20 disability resource center activities. The division takes 113 21 effect upon enactment. 113 22 VETERANS AFFAIRS ==== EXECUTIVE DIRECTOR. This division 113 23 provides that the salary range for the executive director of 113 24 the department of veterans affairs is a range 5 rather than a 113 25 range 3 position. This division takes effect upon enactment. 113 26 FAMILY PLANNING SERVICES PROGRAM. This division provides 113 27 for the participation of certain providers in the state family 113 28 planning services program by allowing that any entity that 113 29 performs abortions or that maintains or operates a facility 113 30 where abortions are performed is not to be interpreted to 113 31 include a nonpublic entity that is a distinct location of 113 32 a nonprofit health care delivery system, if the distinct 113 33 location provides family planning services but does not perform 113 34 abortions or maintain or operate as a facility where abortions 113 35 are performed. 114 1 PROVISIONAL REGIONALIZATION AUTHORIZATION. This division 114 2 provides that upon receiving a request to be removed from the 114 3 region from any county within the county social services mental 114 4 health and disability services region, the director of the 114 5 department of human services may authorize the county to join 114 6 in the formation of a proposed new mental health and disability 114 7 services region, subject to certain requirements. The division 114 8 provides that if approved by the department, the region shall 114 9 commence full operations no later than July 1, 2019. 114 10 The division amends current law to specify that only a 114 11 region formed prior to July 1, 2014, may be exempt from 114 12 the requirement to enter into a regional mental health and 114 13 disabilities services region under Code section 331.389. 114 14 The division takes effect upon enactment. 114 15 MANDATORY REPORTER TRAINING AND CERTIFICATION WORKGROUP. 114 16 This division requires the department of human services 114 17 to facilitate a study by a workgroup, in cooperation with 114 18 the departments of education and public health, related to 114 19 mandatory child abuse and mandatory dependent adult abuse 114 20 reporter training and certification requirements. The 114 21 workgroup is required to develop interdepartmental strategies 114 22 for improving mandatory child abuse and mandatory dependent 114 23 adult abuse reporter training and certification requirements 114 24 and to submit a report with recommendations to the governor and 114 25 the general assembly on or before December 15, 2018. 114 26 NURSING FACILITY QUALITY ASSURANCE ASSESSMENT. This 114 27 division adjusts the maximum amount for the nursing facility 114 28 quality assurance assessment to provide that the maximum shall 114 29 not exceed the maximum amount allowed under federal law, rather 114 30 than the lower of 3 percent of the aggregate non=Medicare 114 31 revenues of a nursing facility or the maximum amount allowed 114 32 under federal law. The division also clarifies that the 114 33 moneys in the quality assurance trust fund are to be used by 114 34 the department of human services only for reimbursement of 114 35 nursing facility services for which Medicaid federal financial 115 1 participation is available. 115 2 SEXUAL OFFENSES AND SEX OFFENDERS. This division relates to 115 3 sexually violent predators and accumulation of earned time by 115 4 offenders. 115 5 The division strikes a provision permitting a person 115 6 committed as a sexually violent predator under Code chapter 115 7 229A (committed person) to be released from a secure facility 115 8 or a transitional release program without supervision. 115 9 Currently, a committed person may be released with or without 115 10 supervision. 115 11 Currently, if a committed person absconds from the 115 12 transitional release program, the court is required to set a 115 13 hearing within five days of the committed person's return to a 115 14 secure facility in order to determine if a violation occurred. 115 15 The division strikes the five=day requirement and instead 115 16 requires the court to schedule a hearing after receiving notice 115 17 that the committed person has been returned to the secure 115 18 facility. 115 19 Under current law, if the court or jury has determined that a 115 20 committed person should be discharged from the sexually violent 115 21 predator program, the court may release the committed person 115 22 with or without supervision prior to such discharge, if the 115 23 court determines it is in the best interests of the community. 115 24 Under the division, if the court or jury has determined that a 115 25 committed person should be released from a secure facility or a 115 26 transitional release program, but the court has determined the 115 27 committed person suffers from a mental abnormality and it is in 115 28 the best interest of the community, the court shall release the 115 29 committed person with supervision prior to discharge. 115 30 Currently, the department of human services is the only 115 31 designated agency that is not liable for the acts of a 115 32 committed person released with supervision. Under the 115 33 division, if a committed person is released with supervision, 115 34 the division specifies that a judicial district of department 115 35 of correctional services shall not be held liable for any acts 116 1 of the committed person. 116 2 If a person is released with supervision, and the person 116 3 absconds in violation of the release plan, the division strikes 116 4 the requirement that a hearing be held within five days of 116 5 the committed person's return to a secure facility in order 116 6 to determine if a violation occurred and instead requires the 116 7 court to schedule a hearing after the committed person has been 116 8 returned to a secure facility. 116 9 The division also provides that child abuse includes a 116 10 person who is responsible for the care of a child knowingly 116 11 allowing another person custody of, control over, or 116 12 unsupervised access to a child under the age of 14 or a child 116 13 with a physical or mental disability, after knowing the other 116 14 person is required to register or is on the sex offender 116 15 registry. The division provides exceptions for a child living 116 16 with a parent or guardian who is a sex offender required to 116 17 register or on the sex offender registry, a child living with 116 18 a parent or guardian who is married to and living with a sex 116 19 offender required to register or on the sex offender registry, 116 20 and a child who is a sex offender required to register or on the 116 21 sex offender registry who is living with the child's parent, 116 22 guardian, or foster parent and is also living with the child to 116 23 whom access was allowed. 116 24 MEDICAID RETROACTIVE ELIGIBILITY. This division provides 116 25 that effective July 1, 2018, a three=month retroactive Medicaid 116 26 coverage benefit shall apply to Medicaid applicants who are 116 27 residents of licensed nursing facilities. The division takes 116 28 effect upon enactment. 116 29 MENTAL HEALTH AND DISABILITY SERVICES ==== TRANSFER OF FUNDS. 116 30 This division provides that notwithstanding a provision to the 116 31 contrary, a county with a population of over 300,000 based on 116 32 the most recent federal decennial census, may transfer funds 116 33 from any other fund of the county not comprised of revenue 116 34 generated by a levy to the mental health and disability 116 35 regional services fund for purposes of providing mental health 117 1 and disability services for the fiscal year beginning July 1, 117 2 2018, and ending June 30, 2019. The county is required to 117 3 submit a report to the governor and the general assembly by 117 4 September 1, 2019, regarding the activities related to the 117 5 transfer of any funds. 117 6 MISCELLANEOUS TECHNICAL PROVISIONS. This division makes 117 7 technical changes to Code section 135.15, updating the name of 117 8 the oral health bureau to the oral and health delivery system 117 9 bureau and providing a context for the use of the definition 117 10 of "dental home"; and to Code section 135.175 relating to the 117 11 nurse residency state matching grants program. 117 12 STATE TRAINING SCHOOL. This division relates to the state 117 13 training school at Eldora. Under current law, "state training 117 14 school" is defined to include units for juvenile delinquents 117 15 located at Eldora and Toledo. The division amends the 117 16 definition of "state training school" to eliminate references 117 17 to Toledo and makes conforming changes to Code sections 233A.14 117 18 (transfers to other institutions) and 915.29 (notification of 117 19 victim of juvenile by department of human services). 117 20 GERIATRIC PATIENT HOUSING REVIEW. This division requires 117 21 the department on aging and the department of human services, 117 22 inspections and appeals, and corrections during the 2018 117 23 legislative interim to cooperatively review issues and develop 117 24 policy recommendations relating to housing for geriatric 117 25 persons including geriatric individuals on the sex offender 117 26 registry or who are sexually aggressive. The agencies are 117 27 directed to submit a joint report with recommendations to the 117 28 governor and general assembly by December 15, 2018. 117 29 DISTRIBUTION OF FEDERAL FUNDS ==== ABORTIONS. This division 117 30 includes limitations on the distribution to certain applicants 117 31 of federal funds received under Title X of the federal Public 117 32 Health Services Act, the personal responsibility education 117 33 program, the abstinence education grant program, and the 117 34 community adolescent pregnancy prevention and services grant 117 35 program, based on whether the applicant performs abortions or 118 1 maintains or operates a facility where abortions are performed. 118 2 WRONGFUL BIRTH OR WRONGFUL LIFE CAUSE OF ACTION. This 118 3 division relates to causes of action for wrongful birth and 118 4 wrongful life. The division prohibits a cause of action and 118 5 the awarding of damages on behalf of a person, based on a 118 6 wrongful birth claim that, but for an act or omission of the 118 7 defendant, a child would not or should not have been born. The 118 8 division also prohibits a cause of action and the awarding of 118 9 damages on behalf of any person, based on a wrongful life claim 118 10 that, but for an act or omission of the defendant, the person 118 11 bringing the action would not or should not have been born. 118 12 The prohibitions apply to any claim regardless of whether 118 13 the child is born healthy or with a birth defect or disorder or 118 14 other adverse medical condition. However, the division does 118 15 not apply to a civil action for damages for an intentional 118 16 or grossly negligent act or omission, including any act or 118 17 omission that constitutes a public offense, or to a civil 118 18 action for damages for the intentional failure of a physician 118 19 to comply with the duty imposed by licensure to provide a 118 20 patient with all information reasonably necessary to make 118 21 decisions about a pregnancy. 118 22 The division takes effect upon enactment and applies to a 118 23 cause of action that accrues on or after the effective date of 118 24 the division. A cause of action that accrues before that date 118 25 is governed by the law applicable to such a cause of action 118 26 prior to that date. 118 27 The division, in part, is a response to the Iowa supreme 118 28 court's decision in Plowman v. Fort Madison Community Hospital, 118 29 No. 15=0974 (June 2, 2017), holding, in part, that a wrongful 118 30 birth action fits within common law tort principles governing 118 31 medical negligence claims. 118 32 TRANSFER OF FUNDS BETWEEN DHS INSTITUTIONS. This division 118 33 requires the department of human services to report any 118 34 transfer made during a fiscal quarter by the director of DHS 118 35 between appropriations made to the institutions under the 119 1 purview of the department, that are not subject to prior 119 2 written consent and approval of the governor and the department 119 3 of management, to the legislative services agency within 30 119 4 days of the beginning of the subsequent fiscal quarter. 119 5 MEDICAL CANNABIDIOL. This division relates to the 119 6 collection of fees and the performance of background 119 7 investigations under the medical cannabidiol Act (Code chapter 119 8 124E). 119 9 With respect to fees collected by the department of public 119 10 health pursuant to Code chapter 124E, the department shall 119 11 use such fees for the operation of the medical cannabidiol 119 12 registration card program and the medical cannabidiol 119 13 manufacturer and medical cannabidiol dispensary licensing 119 14 programs. Any remaining funds are to be used to administer any 119 15 of the department's duties under Code chapter 124E, including 119 16 the addition of full=time equivalent positions for program 119 17 services and investigations. 119 18 The division also directs the division of criminal 119 19 investigation of the department of public safety to conduct 119 20 background investigations of applicants for medical cannabidiol 119 21 manufacturer and medical cannabidiol dispensary licenses, 119 22 including employees, owners of, and investors in, any such 119 23 applicants. In addition to the background investigation, 119 24 the department of public safety must require applicants, 119 25 their employees, and their owners and investors to submit 119 26 fingerprints and other identifying information to the 119 27 department for submittal to the federal bureau of investigation 119 28 for the purpose of conducting a national criminal history 119 29 record check. The department of public safety shall collect 119 30 fees to offset the costs associated with the background 119 31 investigations and the criminal history record checks. 119 32 The division takes effect upon enactment. 119 33 DHS PROGRAMS AND ACTIVITIES. This division relates to 119 34 programs and activities under the purview of the department of 119 35 human services including inmates of public institutions under 120 1 the Medicaid program; Medicaid program administration; Medicaid 120 2 program pharmacy copayments; the medical assistance advisory 120 3 council; and reimbursement for targeted case management 120 4 services and for inpatient psychiatric services for individuals 120 5 under 21 years of age. 120 6 PREAPPLICATION SCREENING ASSESSMENTS. This division relates 120 7 to preapplication screening assessments for mental health and 120 8 substance abuse commitments. Under current law, the state 120 9 court administrator prescribes practices and procedures for 120 10 implementation of the preapplication screening assessment 120 11 program for both mental health and substance abuse commitments. 120 12 The division strikes the requirements the court administrator 120 13 prescribes practices and procedures for implementation of the 120 14 preapplication screening assessment program for the mental 120 15 health commitments. Under 2018 Acts, House File 2456, section 120 16 15, the department of human services, in coordination with the 120 17 mental health and disability services commission, instead is 120 18 required to adopt administrative rules pursuant to Code chapter 120 19 17A, relating to the civil commitment prescreening assessments. 120 20 COVERAGE OF BEHAVIORAL HEALTH SERVICES PROVIDED BY CERTAIN 120 21 PROVIDERS. This division provides for coverage under the 120 22 Medicaid program and through third=party payment or prepayment 120 23 policies or contracts for licensed marital and family 120 24 therapists, licensed master social workers, licensed mental 120 25 health counselors, and psychologists, holding provisional 120 26 or temporary licenses and practicing under the supervision 120 27 of a specified supervisor. The division takes effect upon 120 28 enactment. 120 29 PHARMACY BENEFITS MANAGER ==== RIGHTS OF COVERED INDIVIDUALS. 120 30 This division establishes certain requirements regarding a 120 31 pharmacy benefits manager relative to a covered individual. LSB 5031HV (1) 87 pf/rn
