Bill Text: IA SF2418 | 2017-2018 | 87th General Assembly | Enrolled
Bill Title: A bill for an act relating to appropriations for health and human services and veterans and including other related provisions and appropriations, providing penalties, and including effective date and retroactive and other applicability date provisions. (Formerly SSB 3222.) Item vetoed. Various effective dates; see bill.
Spectrum: Committee Bill
Status: (Passed) 2018-06-01 - NOBA: Graybook [SF2418 Detail]
Download: Iowa-2017-SF2418-Enrolled.html
Senate File 2418 - Enrolled
SENATE FILE
BY COMMITTEE ON
APPROPRIATIONS
(SUCCESSOR TO SSB
3222)
\5
A BILL FOR
\1
Senate File 2418
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.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
DEPARTMENT ON AGING ==== FY 2018=2019
Section 1. 2017 Iowa Acts, chapter 174, section 40,
unnumbered paragraphs 1 and 2, are amended to read as follows:
There is appropriated from the general fund of the state
to the department on aging for the fiscal year beginning July
1, 2018, and ending June 30, 2019, the following amount, or
so much thereof as is necessary, to be used for the purposes
designated:
For aging programs for the department on aging and area
agencies on aging to provide citizens of Iowa who are 60 years
of age and older with case management for frail elders, Iowa's
aging and disabilities resource center, and other services
which may include but are not limited to adult day services,
respite care, chore services, information and assistance,
and material aid, for information and options counseling for
persons with disabilities who are 18 years of age or older,
and for salaries, support, administration, maintenance, and
miscellaneous purposes, and for not more than the following
full=time equivalent positions:
.................................................. $ 5,521,238
11,042,924
............................................... FTEs 27.00
Sec. 2. 2017 Iowa Acts, chapter 174, section 40, subsections
2, 4, 5, 6, and 7, are amended to read as follows:
2. Of the funds appropriated in this section, $139,973
$279,946 is transferred to the economic development authority
for the Iowa commission on volunteer services to be used for
the retired and senior volunteer program.
4. Of the funds appropriated in this section, at least
$125,000 shall be used to fund the unmet needs identified
through Iowa's aging and disability resource center network.
5. Of the funds appropriated in this section, at
least $300,000 $600,000 shall be used to fund home and
community=based services through the area agencies on aging
that enable older individuals to avoid more costly utilization
of residential or institutional services and remain in their
own homes.
6. Of the funds appropriated in this section, $406,268
$812,537 shall be used for the purposes of chapter 231E and
section 231.56A, of which $175,000 shall be used for the office
of substitute decision maker pursuant to chapter 231E, and the
remainder shall be distributed equally to the area agencies on
aging to administer the prevention of elder abuse, neglect, and
exploitation program pursuant to section 231.56A, in accordance
with the requirements of the federal Older Americans Act of
1965, 42 U.S.C. {3001 et seq., as amended.
7. Of the funds appropriated in this section, $375,000
$1,000,000 shall be used to fund continuation of the aging
and disability resource center lifelong links to provide
individuals and caregivers with information and services to
plan for and maintain independence.
Sec. 3. 2017 Iowa Acts, chapter 174, section 40, subsection
8, is amended by striking the subsection.
Sec. 4. 2017 Iowa Acts, chapter 174, section 40, is amended
by adding the following new subsection:
NEW SUBSECTION. 9. Of the funds appropriated in this
section, $100,000 shall be used by the department on aging,
in collaboration with the department of human services and
affected stakeholders, to design a pilot initiative to provide
long=term care options counseling utilizing support planning
protocols, to assist non=Medicaid eligible consumers who
indicate a preference to return to the community and are
deemed appropriate for discharge, to return to their community
following a nursing facility stay. The department on aging
shall submit the design plan as well as recommendations for
legislation necessary to administer the initiative, including
but not limited to legislation to allow the exchange of contact
information for nursing facility residents appropriate for
discharge planning, to the governor and the general assembly by
December 15, 2018.
DIVISION II
OFFICE OF LONG=TERM CARE OMBUDSMAN ==== FY 2018=2019
Sec. 5. 2017 Iowa Acts, chapter 174, section 41, is amended
to read as follows:
SEC. 41. OFFICE OF LONG=TERM CARE OMBUDSMAN. There is
appropriated from the general fund of the state to the office
of long=term care ombudsman for the fiscal year beginning July
1, 2018, and ending June 30, 2019, the following amount, or
so much thereof as is necessary, to be used for the purposes
designated:
For salaries, support, administration, maintenance, and
miscellaneous purposes, and for not more than the following
full=time equivalent positions:
.................................................. $ 580,140
1,149,821
............................................... FTEs 16.00
DIVISION III
DEPARTMENT OF PUBLIC HEALTH ==== FY 2018=2019
Sec. 6. 2017 Iowa Acts, chapter 174, section 42, subsections
1, 2, 3, 4, 5, 6, 7, and 8, are amended to read as follows:
1. ADDICTIVE DISORDERS
For reducing the prevalence of the use of tobacco, alcohol,
and other drugs, and treating individuals affected by addictive
behaviors, including gambling, and for not more than the
following full=time equivalent positions:
.................................................. $ 12,492,915
24,804,344
............................................... FTEs 10.00
11.00
a. (1) Of the funds appropriated in this subsection,
$2,010,612 $4,021,225 shall be used for the tobacco use
prevention and control initiative, including efforts at the
state and local levels, as provided in chapter 142A. The
commission on tobacco use prevention and control established
pursuant to section 142A.3 shall advise the director of
public health in prioritizing funding needs and the allocation
of moneys appropriated for the programs and initiatives.
Activities of the programs and initiatives shall be in
alignment with the United States centers for disease control
and prevention best practices for comprehensive tobacco control
programs that include the goals of preventing youth initiation
of tobacco usage, reducing exposure to secondhand smoke,
and promotion of tobacco cessation. To maximize resources,
the department shall determine if third=party sources are
available to instead provide nicotine replacement products
to an applicant prior to provision of such products to an
applicant under the initiative. The department shall track and
report to the individuals specified in this Act, any reduction
in the provision of nicotine replacement products realized
by the initiative through implementation of the prerequisite
screening.
(2) (a) The department shall collaborate with the
alcoholic beverages division of the department of commerce for
enforcement of tobacco laws, regulations, and ordinances and to
engage in tobacco control activities approved by the division
of tobacco use prevention and control of the department of
public health as specified in the memorandum of understanding
entered into between the divisions.
(b) For the fiscal year beginning July 1, 2018, and ending
June 30, 2019, the terms of the memorandum of understanding,
entered into between the division of tobacco use prevention
and control of the department of public health and the
alcoholic beverages division of the department of commerce,
governing compliance checks conducted to ensure licensed retail
tobacco outlet conformity with tobacco laws, regulations, and
ordinances relating to persons under 18 years of age, shall
continue to restrict the number of such checks to one check per
retail outlet, and one additional check for any retail outlet
found to be in violation during the first check.
b. Of the funds appropriated in this subsection,
$10,482,303 $20,783,119 shall be used for problem gambling and
substance=related disorder prevention, treatment, and recovery
services, including a 24=hour helpline, public information
resources, professional training, youth prevention, and program
evaluation.
c. The requirement of section 123.17, subsection 5, is met
by the appropriations and allocations made in this division of
this Act for purposes of substance=related disorder treatment
and addictive disorders for the fiscal year beginning July 1,
2018.
d. The department of public health, in collaboration with
the department of human services, shall engage a stakeholder
workgroup to review reimbursement provisions applicable
to substance use disorder services providers. The issues
considered by the workgroup shall include but are not limited
to the adequacy of reimbursement provisions including for
both outpatient and residential treatment, whether it is
appropriate to rebase reimbursement, whether there is equity in
reimbursement compared to the reimbursement methodologies used
for providers of similar behavioral health services, and access
to substance use disorder services providers including whether
the designated number of community mental health centers in the
state is sufficient. The workgroup shall review the reports
of previous workgroups including those authorized in 2014 Iowa
Acts, chapter 1140, section 3, subsection 1, and shall report
the workgroup's findings and recommendations to the general
assembly on or before December 15, 2018.
2. HEALTHY CHILDREN AND FAMILIES
For promoting the optimum health status for children,
adolescents from birth through 21 years of age, and families,
and for not more than the following full=time equivalent
positions:
.................................................. $ 2,662,816
5,820,625
............................................... FTEs 12.00
13.00
a. Of the funds appropriated in this subsection, not
more than $367,420 $734,841 shall be used for the healthy
opportunities for parents to experience success (HOPES)=healthy
families Iowa (HFI) program established pursuant to section
135.106. The funding shall be distributed to renew the grants
that were provided to the grantees that operated the program
during the fiscal year ending June 30, 2018.
b. In order to implement the legislative intent stated in
sections 135.106 and 256I.9, that priority for home visitation
program funding be given to programs using evidence=based or
promising models for home visitation, it is the intent of the
general assembly to phase in the funding priority in accordance
with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
paragraph "0b".
c. Of the funds appropriated in this subsection, $1,537,550
$3,075,101 shall be used for continuation of the department's
initiative to provide for adequate developmental surveillance
and screening during a child's first five years. The funds
shall be used first to fully fund the current sites to ensure
that the sites are fully operational, with the remaining
funds to be used for expansion to additional sites. The full
implementation and expansion shall include enhancing the scope
of the initiative through collaboration with the child health
specialty clinics to promote healthy child development through
early identification and response to both biomedical and social
determinants of healthy development; by monitoring child
health metrics to inform practice, document long=term health
impacts and savings, and provide for continuous improvement
through training, education, and evaluation; and by providing
for practitioner consultation particularly for children with
behavioral conditions and needs. The department of public
health shall also collaborate with the Iowa Medicaid enterprise
and the child health specialty clinics to integrate the
activities of the first five initiative into the establishment
of patient=centered medical homes, community utilities,
accountable care organizations, and other integrated care
models developed to improve health quality and population
health while reducing health care costs. To the maximum extent
possible, funding allocated in this paragraph shall be utilized
as matching funds for medical assistance program reimbursement.
d. Of the funds appropriated in this subsection, $32,320
$64,640 shall be distributed to a statewide dental carrier to
provide funds to continue the donated dental services program
patterned after the projects developed by the lifeline network
to provide dental services to indigent individuals who are
elderly or with disabilities.
e. Of the funds appropriated in this subsection, $78,241
$156,482 shall be used to provide audiological services and
hearing aids for children. The department may enter into a
contract to administer this paragraph.
f. Of the funds appropriated in this subsection, $11,500
$23,000 is transferred to the university of Iowa college of
dentistry for provision of primary dental services to children.
State funds shall be matched on a dollar=for=dollar basis.
The university of Iowa college of dentistry shall coordinate
efforts with the department of public health, bureau of
oral and health delivery systems, to provide dental care to
underserved populations throughout the state.
g. Of the funds appropriated in this subsection, $25,000
$50,000 shall be used to address youth suicide prevention.
h. Of the funds appropriated in this subsection, $20,255
$40,511 shall be used to support the Iowa effort to address the
survey of children who experience adverse childhood experiences
known as ACEs.
i. The department of public health shall continue to
administer the program to assist parents in this state with
costs resulting from the death of a child in accordance with
the provisions of 2014 Iowa Acts, chapter 1140, section 22,
subsection 12.
j. Of the funds appropriated in this subsection, up to
$494,993 shall be used for childhood obesity prevention.
3. CHRONIC CONDITIONS
For serving individuals identified as having chronic
conditions or special health care needs, and for not more than
the following full=time equivalent positions:
.................................................. $ 2,085,375
4,528,109
............................................... FTEs 5.00
9.00
a. Of the funds appropriated in this subsection, $76,877
$153,755 shall be used for grants to individual patients who
have an inherited metabolic disorder to assist with the costs
of medically necessary foods and formula.
b. Of the funds appropriated in this subsection, $510,397
$1,055,291 shall be used for the brain injury services program
pursuant to section 135.22B, including for contracting with an
existing nationally affiliated and statewide organization whose
purpose is to educate, serve, and support Iowans with brain
injury and their families for resource facilitator services
in accordance with section 135.22B, subsection 9, and for
contracting to enhance brain injury training and recruitment
of service providers on a statewide basis. Of the amount
allocated in this paragraph, $47,500 $95,000 shall be used to
fund one full=time equivalent position to serve as the state
brain injury services program manager.
c. Of the funds appropriated in this subsection, $72,048
$144,097 shall be used for the public purpose of continuing
to contract with an existing national=affiliated organization
to provide education, client=centered programs, and client
and family support for people living with epilepsy and their
families. The amount allocated in this paragraph in excess
of $50,000 $100,000 shall be matched dollar=for=dollar by the
organization specified.
d. Of the funds appropriated in this subsection, $404,775
$809,550 shall be used for child health specialty clinics.
e. Of the funds appropriated in this subsection,
$192,276 $384,552 shall be used by the regional autism
assistance program established pursuant to section 256.35,
and administered by the child health specialty clinic located
at the university of Iowa hospitals and clinics. The funds
shall be used to enhance interagency collaboration and
coordination of educational, medical, and other human services
for persons with autism, their families, and providers of
services, including delivering regionalized services of care
coordination, family navigation, and integration of services
through the statewide system of regional child health specialty
clinics and fulfilling other requirements as specified in
chapter 225D. The university of Iowa shall not receive funds
allocated under this paragraph for indirect costs associated
with the regional autism assistance program.
f. Of the funds appropriated in this subsection, $288,687
$577,375 shall be used for the comprehensive cancer control
program to reduce the burden of cancer in Iowa through
prevention, early detection, effective treatment, and ensuring
quality of life. Of the funds allocated in this paragraph "f",
$75,000 $150,000 shall be used to support a melanoma research
symposium, a melanoma biorepository and registry, basic and
translational melanoma research, and clinical trials.
g. Of the funds appropriated in this subsection, $48,766
$97,532 shall be used for cervical and colon cancer screening,
and $88,860 $177,720 shall be used to enhance the capacity of
the cervical cancer screening program to include provision
of recommended prevention and early detection measures to a
broader range of low=income women.
h. Of the funds appropriated in this subsection, $253,177
$506,355 shall be used for the center for congenital and
inherited disorders.
i. Of the funds appropriated in this subsection, $107,631
$225,263 shall be used by the department of public health
for reform=related activities, including but not limited to
facilitation of communication to stakeholders at the state and
local level, administering the patient=centered health advisory
council pursuant to section 135.159, and involvement in health
care system innovation activities occurring across the state.
j. Of the funds appropriated in this subsection, $11,050
$322,100 shall be used for administration of chapter 124D 124E,
the medical cannabidiol Act.
4. COMMUNITY CAPACITY
For strengthening the health care delivery system at the
local level, and for not more than the following full=time
equivalent positions:
.................................................. $ 1,453,888
4,970,152
............................................... FTEs 13.00
a. Of the funds appropriated in this subsection, $47,787
$95,575 is allocated for continuation of the child vision
screening program implemented through the university of Iowa
hospitals and clinics in collaboration with early childhood
Iowa areas. The program shall submit a report to the
individuals identified in this Act for submission of reports
regarding the use of funds allocated under this paragraph
"a". The report shall include the objectives and results for
the program year including the target population and how the
funds allocated assisted the program in meeting the objectives;
the number, age, and location within the state of individuals
served; the type of services provided to the individuals
served; the distribution of funds based on service provided;
and the continuing needs of the program.
b. Of the funds appropriated in this subsection, $52,828 is
allocated for continuation of an initiative implemented at the
university of Iowa to expand and improve the workforce engaged
in mental health treatment and services. The initiative shall
receive input from the university of Iowa, the department of
human services, the department of public health, and the mental
health and disability services commission to address the focus
of the initiative.
c. Of the funds appropriated in this section, $41,657 shall
be deposited in the governmental public health system fund
created in section 135A.8 to be used for the purposes of the
fund.
d. Of the funds appropriated in this subsection, $24,034
$48,069 shall be used for a grant to a statewide association
of psychologists that is affiliated with the American
psychological association to be used for continuation of a
program to rotate intern psychologists in placements in urban
and rural mental health professional shortage areas, as defined
in section 135.180.
e. Of the funds appropriated in this subsection, the
following amounts are allocated to be used as follows to
support the Iowa collaborative safety net provider network
goals of increased access, health system integration, and
engagement.
(1) Not less than $260,931 $542,829 is allocated to the
Iowa prescription drug corporation for continuation of the
pharmaceutical infrastructure for safety net providers as
described in 2007 Iowa Acts, chapter 218, section 108, and for
the prescription drug donation repository program created in
chapter 135M.
(2) Not less than $167,435 $334,870 is allocated to free
clinics and free clinics of Iowa for necessary infrastructure,
statewide coordination, provider recruitment, service delivery,
and provision of assistance to patients in securing a medical
home inclusive of oral health care.
(3) Not less than $12,500 $25,000 is allocated to the
Iowa association of rural health clinics for necessary
infrastructure and service delivery transformation.
(4) Not less than $50,000 $205,493 is allocated to the
Polk county medical society for continuation of the safety net
provider patient access to a specialty health care initiative
as described in 2007 Iowa Acts, chapter 218, section 109.
f. Of the funds appropriated in this subsection, $38,115
$15,000 shall be used by the department in implementing
the recommendations in the final report submitted by the
direct care worker advisory council to the governor and the
general assembly in March 2012, including by continuing to
develop, promote, and make available on a statewide basis the
prepare=to=care core curriculum and its associated modules
and specialties through various formats including online
access, community colleges, and other venues; exploring new and
maintaining existing specialties including but not limited to
oral health and dementia care; supporting instructor training;
and assessing and making recommendations concerning the Iowa
care book and information technology systems and infrastructure
uses and needs.
g. Of the funds appropriated in this subsection, $95,594
$176,188 shall be allocated for continuation of the contract
with an independent statewide direct care worker organization
previously selected through a request for proposals process.
The contract shall continue to include performance and outcomes
measures, and shall continue to allow the contractor to use a
portion of the funds received under the contract to collect
data to determine results based on the performance and outcomes
measures.
h. Of the funds appropriated in this subsection, the
department may use up to $29,087 $58,175 for up to one
full=time equivalent position to administer the volunteer
health care provider program pursuant to section 135.24.
i. Of the funds appropriated in this subsection, $48,069
$96,138 shall be used for a matching dental education loan
repayment program to be allocated to a dental nonprofit health
service corporation to continue to develop the criteria and
implement the loan repayment program.
j. Of the funds appropriated in this subsection, $26,455 is
transferred to the college student aid commission for deposit
in the rural Iowa primary care trust fund created in section
261.113 to be used for the purposes of the fund.
k. Of the funds appropriated in this subsection, $75,000
$100,000 shall be used for the purposes of the Iowa donor
registry as specified in section 142C.18.
l. Of the funds appropriated in this subsection, $48,069
$96,138 shall be used for continuation of a grant to a
nationally affiliated volunteer eye organization that has an
established program for children and adults and that is solely
dedicated to preserving sight and preventing blindness through
education, nationally certified vision screening and training,
and community and patient service programs. The organization
shall submit a report to the individuals identified in this
Act for submission of reports regarding the use of funds
allocated under this paragraph "l". The report shall include
the objectives and results for the program year including
the target population and how the funds allocated assisted
the program in meeting the objectives; the number, age, and
location within the state of individuals served; the type of
services provided to the individuals served; the distribution
of funds based on services provided; and the continuing needs
of the program.
m. Of the funds appropriated in this subsection, $436,327
$2,000,000 shall be deposited in the medical residency training
account created in section 135.175, subsection 5, paragraph
"a", and is appropriated from the account to the department
of public health to be used for the purposes of the medical
residency training state matching grants program as specified
in section 135.176.
n. Of the funds appropriated in this subsection, $250,000
shall be used for the public purpose of providing funding to
Des Moines university to establish a provider education project
to provide primary care physicians with the training and skills
necessary to recognize signs of mental illness in patients.
5. ESSENTIAL PUBLIC HEALTH SERVICES
To provide public health services that reduce risks and
invest in promoting and protecting good health over the
course of a lifetime with a priority given to older Iowans and
vulnerable populations:
.................................................. $ 4,098,939
7,662,464
6. INFECTIOUS DISEASES
For reducing the incidence and prevalence of communicable
diseases, and for not more than the following full=time
equivalent positions:
.................................................. $ 823,213
1,796,426
............................................... FTEs 4.00
7. PUBLIC PROTECTION
For protecting the health and safety of the public through
establishing standards and enforcing regulations, and for not
more than the following full=time equivalent positions:
.................................................. $ 2,097,569
4,095,139
............................................... FTEs 138.00
141.00
a. Of the funds appropriated in this subsection, not more
than $152,350 $304,700 shall be credited to the emergency
medical services fund created in section 135.25. Moneys in
the emergency medical services fund are appropriated to the
department to be used for the purposes of the fund.
b. Of the funds appropriated in this subsection, up
to $121,630 $243,260 shall be used for sexual violence
prevention programming through a statewide organization
representing programs serving victims of sexual violence
through the department's sexual violence prevention program,
and for continuation of a training program for sexual assault
response team (SART) members, including representatives of
law enforcement, victim advocates, prosecutors, and certified
medical personnel. The amount allocated in this paragraph "b"
shall not be used to supplant funding administered for other
sexual violence prevention or victims assistance programs.
c. Of the funds appropriated in this subsection, up to
$287,813 $500,000 shall be used for the state poison control
center. Pursuant to the directive under 2014 Iowa Acts,
chapter 1140, section 102, the federal matching funds available
to the state poison control center from the department of human
services under the federal Children's Health Insurance Program
Reauthorization Act allotment shall be subject to the federal
administrative cap rule of 10 percent applicable to funding
provided under Tit. XXI of the federal Social Security Act and
included within the department's calculations of the cap.
d. Of the funds appropriated in this subsection, up to
$258,491 $504,796 shall be used for childhood lead poisoning
provisions.
8. RESOURCE MANAGEMENT
For establishing and sustaining the overall ability of the
department to deliver services to the public, and for not more
than the following full=time equivalent positions:
.................................................. $ 485,607
971,215
............................................... FTEs 4.00
Sec. 7. 2017 Iowa Acts, chapter 174, section 42, subsections
10 and 11, are amended by striking the subsections.
DIVISION IV
DEPARTMENT OF VETERANS AFFAIRS ==== FY 2018=2019
Sec. 8. 2017 Iowa Acts, chapter 174, section 43, is amended
to read as follows:
SEC. 43. DEPARTMENT OF VETERANS AFFAIRS. There is
appropriated from the general fund of the state to the
department of veterans affairs for the fiscal year beginning
July 1, 2018, and ending June 30, 2019, the following amounts,
or so much thereof as is necessary, to be used for the purposes
designated:
1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full=time
equivalent positions:
.................................................. $ 571,278
1,150,500
............................................... FTEs 15.00
2. IOWA VETERANS HOME
For salaries, support, maintenance, and miscellaneous
purposes:
.................................................. $ 3,614,070
7,162,976
a. The Iowa veterans home billings involving the department
of human services shall be submitted to the department on at
least a monthly basis.
b. Within available resources and in conformance with
associated state and federal program eligibility requirements,
the Iowa veterans home may implement measures to provide
financial assistance to or on behalf of veterans or their
spouses who are participating in the community reentry program.
d. The Iowa veterans home shall continue to include in the
annual discharge report applicant information and to provide
for the collection of demographic information including but not
limited to the number of individuals applying for admission and
admitted or denied admittance and the basis for the admission
or denial; the age, gender, and race of such individuals;
and the level of care for which such individuals applied for
admission including residential or nursing level of care.
3. HOME OWNERSHIP ASSISTANCE PROGRAM
For transfer to the Iowa finance authority for the
continuation of the home ownership assistance program for
persons who are or were eligible members of the armed forces of
the United States, pursuant to section 16.54:
.................................................. $ 1,000,000
2,000,000
Sec. 9. 2017 Iowa Acts, chapter 174, section 44, is amended
to read as follows:
SEC. 44. LIMITATION OF COUNTY COMMISSIONS OF VETERAN
AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the
standing appropriation in section 35A.16 for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, the amount
appropriated from the general fund of the state pursuant to
that section for the following designated purposes shall not
exceed the following amount:
For the county commissions of veteran affairs fund under
section 35A.16:
.................................................. $ 473,962
990,000
DIVISION V
DEPARTMENT OF HUMAN SERVICES ==== FY 2018=2019
Sec. 10. 2017 Iowa Acts, chapter 174, section 45, is amended
to read as follows:
SEC. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
GRANT. There is appropriated from the fund created in section
8.41 to the department of human services for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, from moneys
received under the federal temporary assistance for needy
families (TANF) block grant pursuant to the federal Personal
Responsibility and Work Opportunity Reconciliation Act of 1996,
Pub. L. No. 104=193, and successor legislation, the following
amounts, or so much thereof as is necessary, to be used for the
purposes designated:
1. To be credited to the family investment program account
and used for assistance under the family investment program
under chapter 239B:
.................................................. $ 2,556,231
4,539,006
2. To be credited to the family investment program account
and used for the job opportunities and basic skills (JOBS)
program and implementing family investment agreements in
accordance with chapter 239B:
.................................................. $ 2,787,846
5,412,060
3. To be used for the family development and
self=sufficiency grant program in accordance with section
216A.107:
.................................................. $ 1,449,490
2,883,980
Notwithstanding section 8.33, moneys appropriated in this
subsection that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for expenditure for the purposes designated until the close of
the succeeding fiscal year. However, unless such moneys are
encumbered or obligated on or before September 30, 2019, the
moneys shall revert.
4. For field operations:
.................................................. $ 15,648,116
31,296,232
5. For general administration:
.................................................. $ 1,872,000
3,744,000
6. For state child care assistance:
.................................................. $ 23,933,413
47,166,826
a. Of the funds appropriated in this subsection,
$13,164,048 $26,205,412 is transferred to the child care
and development block grant appropriation made by the
Eighty=seventh General Assembly, 2018 session, for the federal
fiscal year beginning October 1, 2018, and ending September
30, 2019. Of this amount, $100,000 $200,000 shall be used
for provision of educational opportunities to registered
child care home providers in order to improve services and
programs offered by this category of providers and to increase
the number of providers. The department may contract with
institutions of higher education or child care resource and
referral centers to provide the educational opportunities.
Allowable administrative costs under the contracts shall not
exceed 5 percent. The application for a grant shall not exceed
two pages in length.
b. Any funds appropriated in this subsection remaining
unallocated shall be used for state child care assistance
payments for families who are employed including but not
limited to individuals enrolled in the family investment
program.
7. For child and family services:
.................................................. $ 16,190,327
32,380,654
8. For child abuse prevention grants:
.................................................. $ 62,500
125,000
9. For pregnancy prevention grants on the condition that
family planning services are funded:
.................................................. $ 965,033
1,913,203
Pregnancy prevention grants shall be awarded to programs
in existence on or before July 1, 2018, if the programs have
demonstrated positive outcomes. Grants shall be awarded to
pregnancy prevention programs which are developed after July
1, 2018, if the programs are based on existing models that
have demonstrated positive outcomes. Grants shall comply with
the requirements provided in 1997 Iowa Acts, chapter 208,
section 14, subsections 1 and 2, including the requirement that
grant programs must emphasize sexual abstinence. Priority in
the awarding of grants shall be given to programs that serve
areas of the state which demonstrate the highest percentage of
unplanned pregnancies of females of childbearing age within the
geographic area to be served by the grant.
10. For technology needs and other resources necessary
to meet federal welfare reform reporting, tracking, and case
management requirements:
.................................................. $ 518,593
1,037,186
11. a. Notwithstanding any provision to the contrary,
including but not limited to requirements in section 8.41 or
provisions in 2017 or 2018 Iowa Acts regarding the receipt and
appropriation of federal block grants, federal funds from the
temporary assistance for needy families block grant received
by the state and not otherwise appropriated in this section
and remaining available for the fiscal year beginning July 1,
2018, are appropriated to the department of human services to
the extent as may be necessary to be used in the following
priority order: the family investment program, for state child
care assistance program payments for families who are employed,
and for the family investment program share of system costs
to develop and maintain a new, integrated for eligibility
determination system and related functions. The federal funds
appropriated in this paragraph "a" shall be expended only after
all other funds appropriated in subsection 1 for assistance
under the family investment program, in subsection 6 for child
care assistance, or in subsection 10 for technology costs
related to the family investment program, as applicable, have
been expended. For the purposes of this subsection, the funds
appropriated in subsection 6, paragraph "a", for transfer
to the child care and development block grant appropriation
are considered fully expended when the full amount has been
transferred.
b. The department shall, on a quarterly basis, advise the
legislative services agency and department of management of
the amount of funds appropriated in this subsection that was
expended in the prior quarter.
12. Of the amounts appropriated in this section, $6,481,004
$12,962,008 for the fiscal year beginning July 1, 2018, is
transferred to the appropriation of the federal social services
block grant made to the department of human services for that
fiscal year.
13. For continuation of the program providing categorical
eligibility for the food assistance program as specified
for the program in the section of this division of this Act
relating to the family investment program account:
.................................................. $ 12,500
14,236
14. The department may transfer funds allocated in this
section to the appropriations made in this division of this Act
for the same fiscal year for general administration and field
operations for resources necessary to implement and operate the
services referred to in this section and those funded in the
appropriation made in this division of this Act for the same
fiscal year for the family investment program from the general
fund of the state.
15. With the exception of moneys allocated under this
section for the family development and self=sufficiency grant
program, to the extent moneys allocated in this section are
deemed by the department not to be necessary to support the
purposes for which they are allocated, such moneys may be
credited used in the same fiscal year for any other purpose
for which funds are allocated in this section or in section 7
of this division for the family investment program account.
If there are conflicting needs, priority shall first be given
to the family investment program account as specified under
subsection 1 of this section and used for the purposes of
assistance under the family investment program under chapter
239B in the same fiscal year, followed by state child care
assistance program payments for families who are employed,
followed by other priorities as specified by the department.
Sec. 11. 2017 Iowa Acts, chapter 174, section 46, subsection
4, is amended to read as follows:
4. Moneys appropriated in this division of this Act and
credited to the FIP account for the fiscal year beginning July
1, 2018, and ending June 30, 2019, are allocated as follows:
a. To be retained by the department of human services to
be used for coordinating with the department of human rights
to more effectively serve participants in FIP and other shared
clients and to meet federal reporting requirements under the
federal temporary assistance for needy families block grant:
.................................................. $ 10,000
5,000
b. To the department of human rights for staffing,
administration, and implementation of the family development
and self=sufficiency grant program in accordance with section
216A.107:
.................................................. $ 3,096,417
6,192,834
(1) Of the funds allocated for the family development
and self=sufficiency grant program in this paragraph "b",
not more than 5 percent of the funds shall be used for the
administration of the grant program.
(2) The department of human rights may continue to implement
the family development and self=sufficiency grant program
statewide during fiscal year 2018=2019.
(3) The department of human rights may engage in activities
to strengthen and improve family outcomes measures and
data collection systems under the family development and
self=sufficiency grant program.
c. For the diversion subaccount of the FIP account:
.................................................. $ 407,500
749,694
A portion of the moneys allocated for the subaccount may
be used for field operations, salaries, data management
system development, and implementation costs and support
deemed necessary by the director of human services in order to
administer the FIP diversion program. To the extent moneys
allocated in this paragraph "c" are deemed by the department
not to be necessary to support diversion activities, such
moneys may be used for other efforts intended to increase
engagement by family investment program participants in work,
education, or training activities, or for the purposes of
assistance under the family investment program in accordance
with chapter 239B.
d. For the food assistance employment and training program:
.................................................. $ 33,294
66,588
(1) The department shall apply the federal supplemental
nutrition assistance program (SNAP) employment and training
state plan in order to maximize to the fullest extent permitted
by federal law the use of the 50 percent federal reimbursement
provisions for the claiming of allowable federal reimbursement
funds from the United States department of agriculture
pursuant to the federal SNAP employment and training program
for providing education, employment, and training services
for eligible food assistance program participants, including
but not limited to related dependent care and transportation
expenses.
(2) The department shall continue the categorical federal
food assistance program eligibility at 160 percent of the
federal poverty level and continue to eliminate the asset test
from eligibility requirements, consistent with federal food
assistance program requirements. The department shall include
as many food assistance households as is allowed by federal
law. The eligibility provisions shall conform to all federal
requirements including requirements addressing individuals who
are incarcerated or otherwise ineligible.
e. For the JOBS program:
.................................................. $ 6,761,645
12,139,821
Sec. 12. 2017 Iowa Acts, chapter 174, section 46, is amended
by adding the following new subsection:
NEW SUBSECTION. 7. The department of human services shall
convene a workgroup to review opportunities to increase state
engagement in the supplemental nutrition assistance program
(SNAP) employment and training program. The workgroup shall
explore the feasibility of expansion of the current pilot
program to a statewide basis, the potential involvement of
community=based organizations to the extent allowed by federal
law, and the leveraging of state and private funding to match
available federal funds. The membership of the workgroup
shall include representatives of the department of human
services, community colleges, community=based organizations
serving SNAP recipients, philanthropic organizations, and other
stakeholders with relevant interest or expertise as determined
by the department. The workgroup shall submit a report of its
findings and recommendations to the governor and the general
assembly by December 15, 2018.
Sec. 13. 2017 Iowa Acts, chapter 174, section 47, unnumbered
paragraph 2, is amended to read as follows:
To be credited to the family investment program (FIP)
account and used for family investment program assistance under
chapter 239B:
.................................................. $ 21,502,240
40,365,715
Sec. 14. 2017 Iowa Acts, chapter 174, section 47,
subsections 1, 2, 4, and 5, are amended to read as follows:
1. Of the funds appropriated in this section, $3,973,798
$6,727,761 is allocated for the JOBS program.
2. Of the funds appropriated in this section, $1,656,927
$3,313,854 is allocated for the family development and
self=sufficiency grant program.
4. Of the funds appropriated in this section, $97,839
$195,678 shall be used for continuation of a grant to an
Iowa=based nonprofit organization with a history of providing
tax preparation assistance to low=income Iowans in order to
expand the usage of the earned income tax credit. The purpose
of the grant is to supply this assistance to underserved areas
of the state.
5. Of the funds appropriated in this section, $30,000
$70,000 shall be used for the continuation of an unfunded pilot
project the parenting program, as defined specified in 441 IAC
100.1 100, relating to parental obligations, in which the child
support recovery unit participates, to support the efforts
of a nonprofit organization committed to strengthening the
community through youth development, healthy living, and social
responsibility headquartered in a county with a population
over 350,000 according to the latest certified federal
census. The funds allocated in this subsection shall be used
by the recipient organization to develop a larger community
effort, through public and private partnerships, to support a
broad=based multi=county fatherhood parenthood initiative that
promotes payment of child support obligations, improved family
relationships, and full=time employment.
Sec. 15. 2017 Iowa Acts, chapter 174, section 48, unnumbered
paragraph 2, is amended to read as follows:
For child support recovery, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full=time equivalent positions:
.................................................. $ 6,293,317
14,586,635
............................................... FTEs 459.00
Sec. 16. 2017 Iowa Acts, chapter 174, section 48, subsection
1, is amended to read as follows:
1. The department shall expend up to $12,164 $24,329,
including federal financial participation, for the fiscal year
beginning July 1, 2018, for a child support public awareness
campaign. The department and the office of the attorney
general shall cooperate in continuation of the campaign. The
public awareness campaign shall emphasize, through a variety
of media activities, the importance of maximum involvement of
both parents in the lives of their children as well as the
importance of payment of child support obligations.
Sec. 17. 2017 Iowa Acts, chapter 174, section 48, subsection
4, is amended by striking the subsection.
Sec. 18. 2017 Iowa Acts, chapter 174, section 51, unnumbered
paragraph 2, is amended to read as follows:
For medical assistance program reimbursement and associated
costs as specifically provided in the reimbursement
methodologies in effect on June 30, 2018, except as otherwise
expressly authorized by law, consistent with options under
federal law and regulations, and contingent upon receipt of
approval from the office of the governor of reimbursement for
each abortion performed under the program:
.................................................. $642,202,870
1,337,841,375
Sec. 19. 2017 Iowa Acts, chapter 174, section 51,
subsections 3, 4, 5, 6, 7, 8, 14, 17, 18, and 19, are amended
to read as follows:
3. The department shall utilize not more than $30,000
$60,000 of the funds appropriated in this section to continue
the AIDS/HIV health insurance premium payment program as
established in 1992 Iowa Acts, Second Extraordinary Session,
chapter 1001, section 409, subsection 6. Of the funds
allocated in this subsection, not more than $2,500 $5,000 may
be expended for administrative purposes.
4. Of the funds appropriated in this Act to the
department of public health for addictive disorders, $475,000
$950,000 for the fiscal year beginning July 1, 2018, is
transferred to the department of human services for an
integrated substance=related disorder managed care system.
The departments of human services and public health shall
work together to maintain the level of mental health and
substance=related disorder treatment services provided by the
managed care contractors. Each department shall take the steps
necessary to continue the federal waivers as necessary to
maintain the level of services.
5. a. The department shall aggressively pursue options for
providing medical assistance or other assistance to individuals
with special needs who become ineligible to continue receiving
services under the early and periodic screening, diagnostic,
and treatment program under the medical assistance program
due to becoming 21 years of age who have been approved for
additional assistance through the department's exception to
policy provisions, but who have health care needs in excess
of the funding available through the exception to policy
provisions.
b. Of the funds appropriated in this section, $50,000
$100,000 shall be used for participation in one or more
pilot projects operated by a private provider to allow the
individual or individuals to receive service in the community
in accordance with principles established in Olmstead v.
L.C., 527 U.S. 581 (1999), for the purpose of providing
medical assistance or other assistance to individuals with
special needs who become ineligible to continue receiving
services under the early and periodic screening, diagnostic,
and treatment program under the medical assistance program
due to becoming 21 years of age who have been approved for
additional assistance through the department's exception to
policy provisions, but who have health care needs in excess
of the funding available through the exception to the policy
provisions.
6. Of the funds appropriated in this section, up to
$1,525,041 $3,050,082 may be transferred to the field
operations or general administration appropriations in this
division of this Act for operational costs associated with Part
D of the federal Medicare Prescription Drug Improvement and
Modernization Act of 2003, Pub. L. No. 108=173.
7. Of the funds appropriated in this section, up to
$221,050 $442,100 may be transferred to the appropriation in
this division of this Act for medical contracts to be used
for clinical assessment services and prior authorization of
services.
8. A portion of the funds appropriated in this section
may be transferred to the appropriations in this division of
this Act for general administration, medical contracts, the
children's health insurance program, or field operations to be
used for the state match cost to comply with the payment error
rate measurement (PERM) program for both the medical assistance
and children's health insurance programs as developed by the
centers for Medicare and Medicaid services of the United States
department of health and human services to comply with the
federal Improper Payments Information Act of 2002, Pub. L.
No. 107=300, and to support other reviews and quality control
activities to improve the integrity of these programs.
14. Of the funds appropriated in this section, $174,505
$349,011 shall be used for the administration of the health
insurance premium payment program, including salaries, support,
maintenance, and miscellaneous purposes.
17. a. Of the funds appropriated in this section, up
to $25,000 $50,000 may be transferred by the department to
the appropriation made in this division of this Act to the
department for the same fiscal year for general administration
to be used for associated administrative expenses and for not
more than one full=time equivalent position, in addition to
those authorized for the same fiscal year, to be assigned to
implementing the children's mental health home project.
b. Of the funds appropriated in this section, up to
$200,000 $400,000 may be transferred by the department to
the appropriation made to the department in this division of
this Act for the same fiscal year for Medicaid program=related
general administration planning and implementation activities.
The funds may be used for contracts or for personnel in
addition to the amounts appropriated for and the positions
authorized for general administration for the fiscal year.
c. Of the funds appropriated in this section, up to
$1,500,000 $3,000,000 may be transferred by the department
to the appropriations made in this division of this Act
for the same fiscal year for general administration or
medical contracts to be used to support the development
and implementation of standardized assessment tools for
persons with mental illness, an intellectual disability, a
developmental disability, or a brain injury.
18. Of the funds appropriated in this section, $75,000
$150,000 shall be used for lodging expenses associated with
care provided at the university of Iowa hospitals and clinics
for patients with cancer whose travel distance is 30 miles or
more and whose income is at or below 200 percent of the federal
poverty level as defined by the most recently revised poverty
income guidelines published by the United States department of
health and human services. The department of human services
shall establish the maximum number of overnight stays and the
maximum rate reimbursed for overnight lodging, which may be
based on the state employee rate established by the department
of administrative services. The funds allocated in this
subsection shall not be used as nonfederal share matching
funds.
19. Of the funds appropriated in this section, up to
$1,691,940 $3,383,880 shall be used for administration of the
state family planning services program as enacted in this 2017
Act, and of this amount the department may use to up $100,000
up to $200,000 for administrative expenses.
Sec. 20. 2017 Iowa Acts, chapter 174, section 51, is amended
by adding the following new subsections:
NEW SUBSECTION. 22. Of the funds appropriated in this
section, $195,000 shall be used by the department of human
services through a request for proposals process to establish
a partnership between the university of Iowa hospitals
and clinics and a durable medical equipment provider and
manufacturer to provide new, refurbished, or repaired durable
medical equipment to Medicaid members in the state. Such
durable medical equipment provider and manufacturer shall be
authorized as a Medicaid provider in the state on or after
April 1, 2018, and shall have the capability to provide
assessments for customized wheelchairs, manufacture bathing aid
equipment and mobility bathing aids, offer in=home care, and
sell durable medical equipment at cost in Iowa and online.
NEW SUBSECTION. 23. The department of human services shall
expand Medicaid coverage to provide care for young adults with
complex medical conditions in a special population nursing
facility as specified by rule of the department pursuant to
this subsection. The department shall adopt rules pursuant to
chapter 17A to expand the criteria for a special population
nursing facility under the Medicaid program to include a
nursing facility that serves residents, 100 percent of whom are
aged 30 and under and require the skilled level of care, and to
include a nursing facility that serves residents, 100 percent
of whom require care from a facility licensed by the department
of inspections and appeals as an intermediate care facility
for persons with medical complexity as defined by rule of the
department.
NEW SUBSECTION. 24. Consistent with the informational
bulletin published May 9, 2017, by the centers for Medicare and
Medicaid services of the United States department of health and
human services, in implementing the regulation that finalized
criteria for home and community=based settings appropriate for
provision of home and community=based services, the department
of human services shall continue progress with the statewide
transition plan to be approved by March 17, 2019, but shall
extend the transition period to demonstrate compliance with
the home and community=based settings criteria until March 17,
2022, for those settings to which a transition period applies.
NEW SUBSECTION. 25. The department of human services shall
utilize $3,000,000 of the funds appropriated under this section
to adjust current supported community living provider daily
rate cells under the tiered rate reimbursement methodology
effective with dates of service beginning July 1, 2018. The
department shall work with the Medicaid program actuary to
evaluate the current tiered rates and the tiered rates phase=in
plan to determine the necessary apportionment of such funds.
In addition, the department, working with the Medicaid program
actuary, shall review the current tiered rates and the tiered
rates phase=in plan and shall propose recommendations for any
changes. The department shall convene the tiered rate provider
workgroup initially convened in the fiscal year beginning July
1, 2016, to review the actuarial findings and recommendations.
The tiered rates may be adjusted based upon the actuarial
findings and recommendations if such adjustments are budget
neutral. A report of the actuarial findings, recommendations,
and comments provided by the tiered rate provider workgroup
shall be submitted to the governor and the general assembly by
December 15, 2018. If additional funding is appropriated to
implement the recommendations, the additional funding shall be
incorporated into the managed care organization capitation rate
setting process for the fiscal year beginning July 1, 2019.
NEW SUBSECTION. 26. The department of human services shall
review all current Medicaid fee schedules and shall submit a
report to the governor and the general assembly by January 15,
2019, regarding how the current rates compare to the equivalent
Medicare fee schedules or other appropriate reimbursement
methodologies for specific services and including a plan for
phased=in implementation of any changes.
NEW SUBSECTION. 27. Of the funds appropriated in this
section, $1,545,530 shall be used and may be transferred to
other appropriations in this division of this Act as necessary
to administer the provisions in the division of this Act
relating to Medicaid program administration.
NEW SUBSECTION. 28. Of the funds appropriated in this
section, $876,015 shall be used and may be transferred to other
appropriations in this division of this Act as necessary to
administer the provisions of 2018 Iowa Acts, House File 2456,
as enacted.
Sec. 21. 2017 Iowa Acts, chapter 174, section 52, is amended
to read as follows:
SEC. 52. MEDICAL CONTRACTS. There is appropriated from the
general fund of the state to the department of human services
for the fiscal year beginning July 1, 2018, and ending June 30,
2019, the following amount, or so much thereof as is necessary,
to be used for the purpose designated:
For medical contracts:
.................................................. $ 8,813,232
16,603,198
1. The department of inspections and appeals shall
provide all state matching funds for survey and certification
activities performed by the department of inspections
and appeals. The department of human services is solely
responsible for distributing the federal matching funds for
such activities.
2. Of the funds appropriated in this section, $25,000
$50,000 shall be used for continuation of home and
community=based services waiver quality assurance programs,
including the review and streamlining of processes and policies
related to oversight and quality management to meet state and
federal requirements.
3. Of the amount appropriated in this section, up to
$100,000 $200,000 may be transferred to the appropriation
for general administration in this division of this Act to
be used for additional full=time equivalent positions in the
development of key health initiatives such as cost containment,
development and oversight of managed care programs, and
development of health strategies targeted toward improved
quality and reduced costs in the Medicaid program.
4. Of the funds appropriated in this section, $500,000
$1,000,000 shall be used for planning and development,
in cooperation with the department of public health, of a
phased=in program to provide a dental home for children.
5. Of the funds appropriated in this section, $475,000
$573,000 shall be credited to the autism support program fund
created in section 225D.2 to be used for the autism support
program created in chapter 225D, with the exception of the
following amounts of this allocation which shall be used as
follows:
a. Of the funds allocated in this subsection, $125,000
shall be deposited in the board=certified behavior analyst and
board=certified assistant behavior analyst grants program fund
created in section 135.181, to be used for the purposes of the
fund.
b. Of the funds allocated in this subsection, $12,500
$25,000 shall be used for the public purpose of continuation
of a grant to a nonprofit provider of child welfare services
provider headquartered that has been in existence for more than
115 years, is located in a county with a population between
205,000 200,000 and 215,000 in 220,000 according to the latest
certified federal census that provides multiple services
including but not limited to, is licensed as a psychiatric
medical institution for children, shelter, residential
treatment, after school programs, and provides school=based
programming, and an Asperger's syndrome program, to be used for
support services for children with autism spectrum disorder and
their families.
c. Of the funds allocated in this subsection, $12,500
shall be used for the public purpose of continuing a grant to
a hospital=based provider headquartered in a county with a
population between 90,000 and 95,000 in the latest certified
federal census that provides multiple services including
but not limited to diagnostic, therapeutic, and behavioral
services to individuals with autism spectrum disorder across
one's lifespan. The grant recipient shall utilize the funds
to continue the pilot project to determine the necessary
support services for children with autism spectrum disorder and
their families to be included in the children's disabilities
services system. The grant recipient shall submit findings and
recommendations based upon the results of the pilot project
to the individuals specified in this division of this Act for
submission of reports by December 31, 2018.
Sec. 22. 2017 Iowa Acts, chapter 174, section 53, unnumbered
paragraph 2, is amended to read as follows:
For the state supplementary assistance program:
.................................................. $ 5,186,329
10,250,873
Sec. 23. 2017 Iowa Acts, chapter 174, section 53, is amended
by adding the following new subsection:
NEW SUBSECTION. 4. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
Sec. 24. 2017 Iowa Acts, chapter 174, section 54, is amended
to read as follows:
SEC. 54. CHILDREN'S HEALTH INSURANCE PROGRAM.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, the following
amount, or so much thereof as is necessary, to be used for the
purpose designated:
For maintenance of the healthy and well kids in Iowa (hawk=i)
program pursuant to chapter 514I, including supplemental dental
services, for receipt of federal financial participation under
Tit. XXI of the federal Social Security Act, which creates the
children's health insurance program:
.................................................. $ 4,259,226
7,064,057
2. Of the funds appropriated in this section, $21,400
$42,800 is allocated for continuation of the contract for
outreach with the department of public health.
Sec. 25. 2017 Iowa Acts, chapter 174, section 55, unnumbered
paragraph 2, is amended to read as follows:
For child care programs:
.................................................. $ 19,671,808
40,816,931
Sec. 26. 2017 Iowa Acts, chapter 174, section 55,
subsections 1 and 4, are amended to read as follows:
1. Of the funds appropriated in this section, $16,746,808
$34,966,931 shall be used for state child care assistance in
accordance with section 237A.13.
4. Of the funds appropriated in this section, $2,925,000
$5,850,000 shall be credited to the early childhood programs
grants account in the early childhood Iowa fund created
in section 256I.11. The moneys shall be distributed for
funding of community=based early childhood programs targeted
to children from birth through five years of age developed
by early childhood Iowa areas in accordance with approved
community plans as provided in section 256I.8.
Sec. 27. 2017 Iowa Acts, chapter 174, section 56, is amended
to read as follows:
SEC. 56. JUVENILE INSTITUTION. There is appropriated
from the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2018, and ending
June 30, 2019, the following amounts, or so much thereof as is
necessary, to be used for the purposes designated:
1. For operation of the state training school at Eldora and
for salaries, support, maintenance, and miscellaneous purposes,
and for not more than the following full=time equivalent
positions:
.................................................. $ 5,675,221
12,762,443
............................................... FTEs 189.00
Of the funds appropriated in this subsection, $45,575
$91,150 shall be used for distribution to licensed classroom
teachers at this and other institutions under the control of
the department of human services based upon the average student
yearly enrollment at each institution as determined by the
department.
2. A portion of the moneys appropriated in this section
shall be used by the state training school at Eldora for
grants for adolescent pregnancy prevention activities at the
institution in the fiscal year beginning July 1, 2018.
3. Of the funds appropriated in this subsection, $212,000
shall be used by the state training school at Eldora for a
substance use disorder treatment program at the institution in
the fiscal year beginning July 1, 2018.
Sec. 28. 2017 Iowa Acts, chapter 174, section 57, is amended
to read as follows:
SEC. 57. CHILD AND FAMILY SERVICES.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, the following
amount, or so much thereof as is necessary, to be used for the
purpose designated:
For child and family services:
.................................................. $ 43,639,687
84,939,774
2. The department may transfer funds appropriated in this
section as necessary to pay the nonfederal costs of services
reimbursed under the medical assistance program, state child
care assistance program, or the family investment program which
are provided to children who would otherwise receive services
paid under the appropriation in this section. The department
may transfer funds appropriated in this section to the
appropriations made in this division of this Act for general
administration and for field operations for resources necessary
to implement and operate the services funded in this section.
3. a. Of the funds appropriated in this section, up
to $17,868,324 $34,536,648 is allocated as the statewide
expenditure target under section 232.143 for group foster care
maintenance and services. If the department projects that such
expenditures for the fiscal year will be less than the target
amount allocated in this paragraph "a", the department may
reallocate the excess to provide additional funding for shelter
care or the child welfare emergency services addressed with the
allocation for shelter care.
b. If at any time after September 30, 2018, annualization
of a service area's current expenditures indicates a service
area is at risk of exceeding its group foster care expenditure
target under section 232.143 by more than 5 percent, the
department and juvenile court services shall examine all
group foster care placements in that service area in order to
identify those which might be appropriate for termination.
In addition, any aftercare services believed to be needed
for the children whose placements may be terminated shall be
identified. The department and juvenile court services shall
initiate action to set dispositional review hearings for the
placements identified. In such a dispositional review hearing,
the juvenile court shall determine whether needed aftercare
services are available and whether termination of the placement
is in the best interest of the child and the community.
4. In accordance with the provisions of section 232.188,
the department shall continue the child welfare and juvenile
justice funding initiative during fiscal year 2018=2019. Of
the funds appropriated in this section, $858,876 $1,717,753
is allocated specifically for expenditure for fiscal year
2018=2019 through the decategorization services funding pools
and governance boards established pursuant to section 232.188.
5. A portion of the funds appropriated in this section
may be used for emergency family assistance to provide other
resources required for a family participating in a family
preservation or reunification project or successor project to
stay together or to be reunified.
6. Notwithstanding section 234.35 or any other provision
of law to the contrary, state funding for shelter care and
the child welfare emergency services contracting implemented
to provide for or prevent the need for shelter care shall be
limited to $4,048,079 $8,096,158.
7. Federal funds received by the state during the fiscal
year beginning July 1, 2018, as the result of the expenditure
of state funds appropriated during a previous state fiscal
year for a service or activity funded under this section are
appropriated to the department to be used as additional funding
for services and purposes provided for under this section.
Notwithstanding section 8.33, moneys received in accordance
with this subsection that remain unencumbered or unobligated at
the close of the fiscal year shall not revert to any fund but
shall remain available for the purposes designated until the
close of the succeeding fiscal year.
8. a. Of the funds appropriated in this section, up to
$1,645,000 $3,290,000 is allocated for the payment of the
expenses of court=ordered services provided to juveniles
who are under the supervision of juvenile court services,
which expenses are a charge upon the state pursuant to
section 232.141, subsection 4. Of the amount allocated in
this paragraph "a", up to $778,143 $1,556,287 shall be made
available to provide school=based supervision of children
adjudicated under chapter 232, of which not more than $7,500
$15,000 may be used for the purpose of training. A portion of
the cost of each school=based liaison officer shall be paid by
the school district or other funding source as approved by the
chief juvenile court officer.
b. Of the funds appropriated in this section, up to $374,492
$748,985 is allocated for the payment of the expenses of
court=ordered services provided to children who are under the
supervision of the department, which expenses are a charge upon
the state pursuant to section 232.141, subsection 4.
c. Notwithstanding section 232.141 or any other provision
of law to the contrary, the amounts allocated in this
subsection shall be distributed to the judicial districts
as determined by the state court administrator and to the
department's service areas as determined by the administrator
of the department of human services' division of child and
family services. The state court administrator and the
division administrator shall make the determination of the
distribution amounts on or before June 15, 2018.
d. Notwithstanding chapter 232 or any other provision of
law to the contrary, a district or juvenile court shall not
order any service which is a charge upon the state pursuant
to section 232.141 if there are insufficient court=ordered
services funds available in the district court or departmental
service area distribution amounts to pay for the service. The
chief juvenile court officer and the departmental service area
manager shall encourage use of the funds allocated in this
subsection such that there are sufficient funds to pay for
all court=related services during the entire year. The chief
juvenile court officers and departmental service area managers
shall attempt to anticipate potential surpluses and shortfalls
in the distribution amounts and shall cooperatively request the
state court administrator or division administrator to transfer
funds between the judicial districts' or departmental service
areas' distribution amounts as prudent.
e. Notwithstanding any provision of law to the contrary,
a district or juvenile court shall not order a county to pay
for any service provided to a juvenile pursuant to an order
entered under chapter 232 which is a charge upon the state
under section 232.141, subsection 4.
f. Of the funds allocated in this subsection, not more
than $41,500 $83,000 may be used by the judicial branch for
administration of the requirements under this subsection.
g. Of the funds allocated in this subsection, $8,500 $17,000
shall be used by the department of human services to support
the interstate commission for juveniles in accordance with
the interstate compact for juveniles as provided in section
232.173.
9. Of the funds appropriated in this section, $6,126,613
$12,253,227 is allocated for juvenile delinquent graduated
sanctions services. Any state funds saved as a result of
efforts by juvenile court services to earn a federal Tit. IV=E
match for juvenile court services administration may be used
for the juvenile delinquent graduated sanctions services.
10. Of the funds appropriated in this section, $829,142
$1,658,285 is transferred to the department of public health
to be used for the child protection center grant program for
child protection centers located in Iowa in accordance with
section 135.118. The grant amounts under the program shall be
equalized so that each center receives a uniform base amount
of $122,500 $245,000, so that $25,000 $50,000 is awarded to
establish a satellite child protection center in a city in
north central Iowa that is the county seat of a county with
a population between 44,000 and 45,000 according to the 2010
federal decennial census, and so that the remaining funds are
awarded through a funding formula based upon the volume of
children served.
11. If the department receives federal approval to
implement a waiver under Tit. IV=E of the federal Social
Security Act to enable providers to serve children who remain
in the children's families and communities, for purposes of
eligibility under the medical assistance program through 25
years of age, children who participate in the waiver shall be
considered to be placed in foster care.
12. Of the funds appropriated in this section, $2,012,583
$4,025,167 is allocated for the preparation for adult living
program pursuant to section 234.46.
13. Of the funds appropriated in this section, $113,668
$227,337 shall be used for the public purpose of continuing
a grant to a nonprofit human services organization providing
services to individuals and families in multiple locations in
southwest Iowa and Nebraska for support of a project providing
immediate, sensitive support and forensic interviews, medical
exams, needs assessments, and referrals for victims of child
abuse and their nonoffending family members.
14. Of the funds appropriated in this section, $150,310
$300,620 is allocated for the foster care youth council
approach of providing a support network to children placed in
foster care.
15. Of the funds appropriated in this section, $101,000
$202,000 is allocated for use pursuant to section 235A.1 for
continuation of the initiative to address child sexual abuse
implemented pursuant to 2007 Iowa Acts, chapter 218, section
18, subsection 21.
16. Of the funds appropriated in this section, $315,120
$630,240 is allocated for the community partnership for child
protection sites.
17. Of the funds appropriated in this section, $185,625
$371,250 is allocated for the department's minority youth and
family projects under the redesign of the child welfare system.
18. Of the funds appropriated in this section, $568,297
$851,595 is allocated for funding of the community circle of
care collaboration for children and youth in northeast Iowa.
19. Of the funds appropriated in this section, at least
$73,579 $147,158 shall be used for the continuation of the
child welfare provider training academy, a collaboration
between the coalition for family and children's services in
Iowa and the department.
20. Of the funds appropriated in this section, $105,936
$211,872 shall be used for continuation of the central Iowa
system of care program grant through June 30, 2019.
21. Of the funds appropriated in this section, $117,500
$235,000 shall be used for the public purpose of the
continuation and expansion of a system of care program grant
implemented in Cerro Gordo and Linn counties to utilize a
comprehensive and long=term approach for helping children
and families by addressing the key areas in a child's life
of childhood basic needs, education and work, family, and
community.
22. Of the funds appropriated in this section, at least
$12,500 $25,000 shall be used to continue and to expand the
foster care respite pilot program in which postsecondary
students in social work and other human services=related
programs receive experience by assisting family foster care
providers with respite and other support.
23. Of the funds appropriated in this section, $55,000
$110,000 shall be used for the public purpose of funding
community=based services and other supports with a system of
care approach for children with a serious emotional disturbance
and their families through a nonprofit provider of child
welfare services that has been in existence for more than
115 years, is located in a county with a population of more
than 200,000 but less than 220,000 according to the latest
certified federal census, is licensed as a psychiatric medical
institution for children, and was a system of care grantee
prior to July 1, 2018.
Sec. 29. 2017 Iowa Acts, chapter 174, section 58, subsection
1, paragraph a, is amended to read as follows:
a. For adoption subsidy payments and services:
.................................................. $ 20,388,955
40,445,137
Sec. 30. 2017 Iowa Acts, chapter 174, section 60, is amended
to read as follows:
SEC. 60. FAMILY SUPPORT SUBSIDY PROGRAM.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, the following
amount, or so much thereof as is necessary, to be used for the
purpose designated:
For the family support subsidy program subject to the
enrollment restrictions in section 225C.37, subsection 3:
.................................................. $ 534,641
949,282
2. At least $393,750 $787,500 of the moneys appropriated in
this section is transferred to the department of public health
for the family support center component of the comprehensive
family support program under chapter 225C, subchapter V.
3. If at any time during the fiscal year, the amount of
funding available for the family support subsidy program
is reduced from the amount initially used to establish the
figure for the number of family members for whom a subsidy
is to be provided at any one time during the fiscal year,
notwithstanding section 225C.38, subsection 2, the department
shall revise the figure as necessary to conform to the amount
of funding available.
Sec. 31. 2017 Iowa Acts, chapter 174, section 61, is amended
to read as follows:
SEC. 61. CONNER DECREE. There is appropriated from the
general fund of the state to the department of human services
for the fiscal year beginning July 1, 2018, and ending June 30,
2019, the following amount, or so much thereof as is necessary,
to be used for the purpose designated:
For building community capacity through the coordination
and provision of training opportunities in accordance with the
consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
Iowa, July 14, 1994):
.................................................. $ 16,816
33,632
Sec. 32. 2017 Iowa Acts, chapter 174, section 62, subsection
1, is amended to read as follows:
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, the following
amounts, or so much thereof as is necessary, to be used for the
purposes designated:
a. For operation of the state mental health institute at
Cherokee as required by chapters 218 and 226 for salaries,
support, maintenance, and miscellaneous purposes, and for not
more than the following full=time equivalent positions:
.................................................. $ 6,935,127
13,870,254
............................................... FTEs 162.00
b. For operation of the state mental health institute at
Independence as required by chapters 218 and 226 for salaries,
support, maintenance, and miscellaneous purposes, and for not
more than the following full=time equivalent positions:
.................................................. $ 8,756,810
17,513,621
............................................... FTEs 204.00
Sec. 33. 2017 Iowa Acts, chapter 174, section 63, subsection
1, is amended to read as follows:
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, the following
amounts, or so much thereof as is necessary, to be used for the
purposes designated:
a. For the state resource center at Glenwood for salaries,
support, maintenance, and miscellaneous purposes:
.................................................. $ 8,943,890
16,858,523
b. For the state resource center at Woodward for salaries,
support, maintenance, and miscellaneous purposes:
.................................................. $ 6,038,517
11,386,679
Sec. 34. 2017 Iowa Acts, chapter 174, section 64, subsection
1, is amended to read as follows:
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, the following
amount, or so much thereof as is necessary, to be used for the
purpose designated:
For costs associated with the commitment and treatment of
sexually violent predators in the unit located at the state
mental health institute at Cherokee, including costs of legal
services and other associated costs, including salaries,
support, maintenance, and miscellaneous purposes, and for not
more than the following full=time equivalent positions:
.................................................. $ 4,732,373
10,864,747
............................................... FTEs 112.00
132.00
Sec. 35. 2017 Iowa Acts, chapter 174, section 65, is amended
to read as follows:
SEC. 65. FIELD OPERATIONS. There is appropriated from the
general fund of the state to the department of human services
for the fiscal year beginning July 1, 2018, and ending June 30,
2019, the following amount, or so much thereof as is necessary,
to be used for the purposes designated:
For field operations, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full=time equivalent positions:
.................................................. $ 24,242,217
49,074,517
............................................... FTEs 1,583.00
1,539.00
Priority in filling full=time equivalent positions shall be
given to those positions related to child protection services
and eligibility determination for low=income families.
Sec. 36. 2017 Iowa Acts, chapter 174, section 66, is amended
to read as follows:
SEC. 66. GENERAL ADMINISTRATION. There is appropriated
from the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2018, and ending
June 30, 2019, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For general administration, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full=time equivalent positions:
.................................................. $ 7,016,520
13,833,040
............................................... FTEs 294.00
2. Of the funds appropriated in this section, $75,000
$150,000 shall be used to continue the contract for the
provision of a program to provide technical assistance,
support, and consultation to providers of habilitation services
and home and community=based services waiver services for
adults with disabilities under the medical assistance program.
3. Of the funds appropriated in this section, $25,000
$50,000 is transferred to the Iowa finance authority to be
used for administrative support of the council on homelessness
established in section 16.2D and for the council to fulfill its
duties in addressing and reducing homelessness in the state.
4. Of the funds appropriated in this section, $100,000
$200,000 shall be transferred to and deposited in the
administrative fund of the Iowa ABLE savings plan trust
created in section 12I.4, to be used for implementation and
administration activities of the Iowa ABLE savings plan trust.
5. Of the funds appropriated in this section, $100,000
$200,000 is transferred to the economic development authority
for the Iowa commission on volunteer services to continue
to be used for RefugeeRISE AmeriCorps program established
under section 15H.8 for member recruitment and training to
improve the economic well=being and health of economically
disadvantaged refugees in local communities across Iowa. Funds
transferred may be used to supplement federal funds under
federal regulations.
7. Of the funds appropriated in this section, $300,000 shall
be used to contract for children's well=being collaboratives
grants for the development and implementation of children's
well=being collaboratives to establish and coordinate
prevention and early intervention services to promote improved
mental health and well=being for children and families, as
enacted in 2017 Iowa Acts, chapter 174, section 88.
8. The department of human services shall submit the
strategic plan to create and implement a children's mental
health system submitted to the governor by the children's
system state board established by Executive Order Number Two
issued April 23, 2018, to the general assembly by November 15,
2018.
Sec. 37. 2017 Iowa Acts, chapter 174, section 67, is amended
to read as follows:
SEC. 67. DEPARTMENT=WIDE DUTIES. There is appropriated
from the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2018, and ending
June 30, 2019, the following amount, or so much thereof as is
necessary, to be used for the purposes designated:
For salaries, support, maintenance, and miscellaneous
purposes at facilities under the purview of the department of
human services:
.................................................. $ 1,439,637
2,879,274
Sec. 38. 2017 Iowa Acts, chapter 174, section 68, is amended
to read as follows:
SEC. 68. VOLUNTEERS. There is appropriated from the general
fund of the state to the department of human services for the
fiscal year beginning July 1, 2018, and ending June 30, 2019,
the following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For development and coordination of volunteer services:
.................................................. $ 42,343
84,686
Sec. 39. 2017 Iowa Acts, chapter 174, section 70, subsection
1, paragraph f, subparagraph (1), is amended to read as
follows:
(1) For the fiscal year beginning July 1, 2018,
reimbursement rates for home health agencies shall continue to
be based on the Medicare low utilization payment adjustment
(LUPA) methodology with state geographic wage adjustments and
shall be adjusted to increase the rates to the extent possible
within the $1,000,000 of state funding appropriated for this
purpose. The department shall continue to update the rates
every two years to reflect the most recent Medicare LUPA rates
to the extent possible within the state funding appropriated
for this purpose.
Sec. 40. 2017 Iowa Acts, chapter 174, section 70, subsection
1, paragraphs j and k, are amended to read as follows:
j. For the fiscal year beginning July 1, 2018, unless
otherwise specified in this Act, all noninstitutional medical
assistance provider reimbursement rates shall remain at the
rates in effect on June 30, 2018, except for area education
agencies, local education agencies, infant and toddler
services providers, home and community=based services providers
including consumer=directed attendant care providers under a
section 1915(c) or 1915(i) waiver, targeted case management
providers, and those providers whose rates are required to be
determined pursuant to section 249A.20, or to meet federal
mental health parity requirements.
k. Notwithstanding any provision to the contrary, for the
fiscal year beginning July 1, 2018, the reimbursement rate
for anesthesiologists shall be adjusted to implement the cost
containment strategies authorized for the medical assistance
program in this 2017 Act remain at the rate in effect on June
30, 2018, and updated on January 1, 2019, to align with the
most current Iowa Medicare anesthesia base rate.
Sec. 41. 2017 Iowa Acts, chapter 174, section 70, subsection
7, is amended to read as follows:
7. a. For the purposes of this subsection, "combined
reimbursement rate" means the combined service and maintenance
reimbursement rate for a service level under the department's
reimbursement methodology. Effective July 1, 2018, the
combined reimbursement rate for a group foster care service
level shall be the amount designated in this subsection.
However, if a group foster care provider's reimbursement rate
for a service level as of June 30, 2018, is more than the rate
designated in this subsection, the provider's reimbursement
shall remain at the higher rate.
b. Unless a group foster care provider is subject to the
exception provided in paragraph "a", effective July 1, 2018,
the combined reimbursement rates for the service levels under
the department's reimbursement methodology shall be as follows:
(1) For service level, community = D1, the daily rate shall
be at least $84.17.
(2) For service level, comprehensive = D2, the daily rate
shall be at least $119.09.
(3) For service level, enhanced = D3, the daily rate shall
be at least $131.09 established by contract.
Sec. 42. 2017 Iowa Acts, chapter 174, section 70, subsection
11, is amended to read as follows:
11. a. For the fiscal year beginning July 1, 2018,
Effective July 1, 2018, the child care provider reimbursement
rates shall remain at the rates in effect on June 30, 2018.
Effective January 1, 2019, for child care providers reimbursed
under the state child care assistance program, the department
shall set utilize $3,000,000 of the amount appropriated for
child care assistance under this division to increase provider
reimbursement rates based on the rate reimbursement survey
completed in December 2004 2014. Effective July 1, 2018,
the child care provider reimbursement rates shall remain at
the rates in effect on June 30, 2018. The department shall
increase the lowest rate that is furthest from the fiftieth
percentile to a rate consistent with the relative percentage of
the second lowest rate as compared to the fiftieth percentile.
As funds remain available, the department shall increase
the subsequent lowest rates in a similar manner until the
$3,000,000 is projected to be fully expended in the fiscal
year. The department shall set rates in a manner so as to
provide incentives for a nonregistered provider to become
registered by applying the increase only to registered and
licensed providers.
b. Effective January 1, 2019, for infant and toddler
child care providers reimbursed under the state child
care assistance program, the department shall set provider
reimbursement rates at the seventy=fifth percentile of the rate
reimbursement survey completed in December 2014, within the
expected increase for the federal child care and development
block grant expenditure requirement for infant and toddler
quality improvement, subject to quality rating system criteria
developed pursuant to section 237A.30. The department shall
set rates in a manner so as to provide incentives for a
nonregistered provider to become registered by applying the
increase only to registered and licensed providers.
Sec. 43. 2017 Iowa Acts, chapter 174, section 70, subsection
13, is amended by striking the subsection.
Sec. 44. REPEAL. 2017 Iowa Acts, chapter 174, section 69,
is repealed.
DIVISION VI
HEALTH CARE ACCOUNTS AND FUNDS ==== FY 2018=2019
Sec. 45. 2017 Iowa Acts, chapter 174, section 75, is amended
to read as follows:
SEC. 75. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
appropriated from the pharmaceutical settlement account created
in section 249A.33 to the department of human services for the
fiscal year beginning July 1, 2018, and ending June 30, 2019,
the following amount, or so much thereof as is necessary, to be
used for the purpose designated:
Notwithstanding any provision of law to the contrary, to
supplement the appropriations made in this Act for medical
contracts under the medical assistance program for the fiscal
year beginning July 1, 2018, and ending June 30, 2019:
.................................................. $ 400,000
1,446,266
Sec. 46. 2017 Iowa Acts, chapter 174, section 76, is amended
to read as follows:
SEC. 76. QUALITY ASSURANCE TRUST FUND ==== DEPARTMENT OF HUMAN
SERVICES. Notwithstanding any provision to the contrary and
subject to the availability of funds, there is appropriated
from the quality assurance trust fund created in section
249L.4 to the department of human services for the fiscal year
beginning July 1, 2018, and ending June 30, 2019, the following
amounts, or so much thereof as is necessary, for the purposes
designated:
To supplement the appropriation made in this Act from the
general fund of the state to the department of human services
for medical assistance for the same fiscal year:
.................................................. $ 18,352,604
36,705,208
Sec. 47. 2017 Iowa Acts, chapter 174, section 77, is amended
to read as follows:
SEC. 77. HOSPITAL HEALTH CARE ACCESS TRUST FUND ====
DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
the contrary and subject to the availability of funds, there is
appropriated from the hospital health care access trust fund
created in section 249M.4 to the department of human services
for the fiscal year beginning July 1, 2018, and ending June
30, 2019, the following amounts, or so much thereof as is
necessary, for the purposes designated:
To supplement the appropriation made in this Act from the
general fund of the state to the department of human services
for medical assistance for the same fiscal year:
.................................................. $ 16,960,277
33,920,554
DIVISION VII
PRIOR YEAR APPROPRIATIONS AND OTHER PROVISIONS
FEDERAL FUNDING
Sec. 48. 2017 Iowa Acts, chapter 165, section 13, subsection
3, paragraphs b and e, are amended to read as follows:
b. Child and family services:
(1) FFY 2017=2018:
.................................................. $ 7,672,390
8,022,390
(2) FFY 2018=2019:
.................................................. $ 7,672,390
8,272,390
e. For distribution to counties for state case services
provided for persons with mental illness, intellectual
disability, or a developmental disability in accordance with
section 331.440, Code 2013, or in accordance with a dispute
resolution process implemented in accordance with section
331.394, subsections 5 or 6:
(1) FFY 2017=2018:
.................................................. $ 600,000
250,000
(2) FFY 2018=2019:
.................................................. $ 600,000
0
Moneys appropriated in this lettered paragraph "e"
that remain unencumbered or unallocated at the close of a
federal fiscal year shall not revert but shall be retained
by the department and used to supplement amounts otherwise
appropriated for child and family services under paragraph "b".
TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF)
Sec. 49. 2017 Iowa Acts, chapter 174, section 6, is amended
to read as follows:
SEC. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
GRANT. There is appropriated from the fund created in section
8.41 to the department of human services for the fiscal year
beginning July 1, 2017, and ending June 30, 2018, from moneys
received under the federal temporary assistance for needy
families (TANF) block grant pursuant to the federal Personal
Responsibility and Work Opportunity Reconciliation Act of 1996,
Pub. L. No. 104=193, and successor legislation, the following
amounts, or so much thereof as is necessary, to be used for the
purposes designated:
1. To be credited to the family investment program account
and used for assistance under the family investment program
under chapter 239B:
.................................................. $ 5,112,462
4,539,006
2. To be credited to the family investment program account
and used for the job opportunities and basic skills (JOBS)
program and implementing family investment agreements in
accordance with chapter 239B:
.................................................. $ 5,575,693
5,412,060
3. To be used for the family development and
self=sufficiency grant program in accordance with section
216A.107:
.................................................. $ 2,898,980
2,883,980
Notwithstanding section 8.33, moneys appropriated in this
subsection that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for expenditure for the purposes designated until the close of
the succeeding fiscal year. However, unless such moneys are
encumbered or obligated on or before September 30, 2018, the
moneys shall revert.
4. For field operations:
.................................................. $ 31,296,232
5. For general administration:
.................................................. $ 3,744,000
6. For state child care assistance:
.................................................. $ 47,866,826
53,603,561
a. Of the funds appropriated in this subsection,
$26,328,097 $26,205,412 is transferred to the child care
and development block grant appropriation made by the
Eighty=seventh General Assembly, 2017 session, for the federal
fiscal year beginning October 1, 2017, and ending September 30,
2018. Of this amount, $200,000 shall be used for provision
of educational opportunities to registered child care home
providers in order to improve services and programs offered
by this category of providers and to increase the number of
providers. The department may contract with institutions
of higher education or child care resource and referral
centers to provide the educational opportunities. Allowable
administrative costs under the contracts shall not exceed 5
percent. The application for a grant shall not exceed two
pages in length.
b. Any funds appropriated in this subsection remaining
unallocated shall be used for state child care assistance
payments for families who are employed including but not
limited to individuals enrolled in the family investment
program.
7. For child and family services:
.................................................. $ 32,380,654
8. For child abuse prevention grants:
.................................................. $ 125,000
9. For pregnancy prevention grants on the condition that
family planning services are funded:
.................................................. $ 1,930,067
1,913,203
Pregnancy prevention grants shall be awarded to programs
in existence on or before July 1, 2017, if the programs have
demonstrated positive outcomes. Grants shall be awarded to
pregnancy prevention programs which are developed after July
1, 2017, if the programs are based on existing models that
have demonstrated positive outcomes. Grants shall comply with
the requirements provided in 1997 Iowa Acts, chapter 208,
section 14, subsections 1 and 2, including the requirement that
grant programs must emphasize sexual abstinence. Priority in
the awarding of grants shall be given to programs that serve
areas of the state which demonstrate the highest percentage of
unplanned pregnancies of females of childbearing age within the
geographic area to be served by the grant.
10. For technology needs and other resources necessary
to meet federal welfare reform reporting, tracking, and case
management requirements:
.................................................. $ 1,037,186
294,155
11. a. Notwithstanding any provision to the contrary,
including but not limited to requirements in section 8.41 or
provisions in 2016 or 2017 Iowa Acts regarding the receipt and
appropriation of federal block grants, federal funds from the
temporary assistance for needy families block grant received by
the state and not otherwise appropriated in this section and
remaining available for the fiscal year beginning July 1, 2017,
are appropriated to the department of human services to the
extent as may be necessary to be used in the following priority
order: the family investment program, for state child care
assistance program payments for families who are employed, and
for the family investment program share of costs to develop and
maintain a new, integrated eligibility determination system.
The federal funds appropriated in this paragraph "a" shall be
expended only after all other funds appropriated in subsection
1 for assistance under the family investment program, in
subsection 6 for child care assistance, or in subsection 10
for technology costs related to the family investment program,
as applicable, have been expended. For the purposes of this
subsection, the funds appropriated in subsection 6, paragraph
"a", for transfer to the child care and development block grant
appropriation are considered fully expended when the full
amount has been transferred.
b. The department shall, on a quarterly basis, advise the
legislative services agency and department of management of
the amount of funds appropriated in this subsection that was
expended in the prior quarter.
12. Of the amounts appropriated in this section,
$12,962,008 for the fiscal year beginning July 1, 2017, is
transferred to the appropriation of the federal social services
block grant made to the department of human services for that
fiscal year.
13. For continuation of the program providing categorical
eligibility for the food assistance program as specified
for the program in the section of this division of this Act
relating to the family investment program account:
.................................................. $ 25,000
14,236
14. The department may transfer funds allocated in this
section to the appropriations made in this division of this Act
for the same fiscal year for general administration and field
operations for resources necessary to implement and operate the
services referred to in this section and those funded in the
appropriation made in this division of this Act for the same
fiscal year for the family investment program from the general
fund of the state.
15. With the exception of moneys allocated under this
section for the family development and self=sufficiency grant
program, to the extent moneys allocated in this section are
deemed by the department not to be necessary to support the
purposes for which they are allocated, such moneys may be
credited used in the same fiscal year for any other purpose for
which funds are allocated in this section or in section 7 of
this division for the family investment program account. If
there are competing needs, priority shall first be given to the
family investment program account as specified under subsection
1 of this section and used for the purposes of assistance
under the family investment program in accordance with chapter
239B in the same fiscal year, followed by state child care
assistance program payments for families who are employed,
followed by other priorities as specified by the department.
MEDICAID TRANSFERS TO SUPPORT REVIEWS AND QUALITY CONTROL
ACTIVITIES
Sec. 50. 2017 Iowa Acts, chapter 174, section 12, subsection
8, is amended to read as follows:
8. A portion of the funds appropriated in this section
may be transferred to the appropriations in this division of
this Act for general administration, medical contracts, the
children's health insurance program, or field operations to be
used for the state match cost to comply with the payment error
rate measurement (PERM) program for both the medical assistance
and children's health insurance programs as developed by the
centers for Medicare and Medicaid services of the United States
department of health and human services to comply with the
federal Improper Payments Information Act of 2002, Pub. L.
No. 107=300, and to support other reviews and quality control
activities to improve the integrity of these programs.
STATE SUPPLEMENTARY ASSISTANCE
Sec. 51. 2017 Iowa Acts, chapter 174, section 14, is amended
by adding the following new subsection:
NEW SUBSECTION. 4. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
JUVENILE INSTITUTION
Sec. 52. 2017 Iowa Acts, chapter 174, section 17, is amended
by adding the following new subsection:
NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
MENTAL HEALTH INSTITUTES
Sec. 53. 2017 Iowa Acts, chapter 174, section 23, is amended
by adding the following new subsection:
NEW SUBSECTION. 4. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
STATE RESOURCE CENTERS
Sec. 54. 2017 Iowa Acts, chapter 174, section 24, is amended
by adding the following new subsection:
NEW SUBSECTION. 6. Notwithstanding section 8.33, and
notwithstanding the amount limitation specified in section
222.92, moneys appropriated in this section that remain
unencumbered or unobligated at the close of the fiscal year
shall not revert but shall remain available for expenditure
for the purposes designated until the close of the succeeding
fiscal year.
SEXUALLY VIOLENT PREDATORS
Sec. 55. 2017 Iowa Acts, chapter 174, section 25, is amended
by adding the following new subsection:
NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
Sec. 56. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
Sec. 57. RETROACTIVE APPLICABILITY. This division of this
Act applies retroactively to July 1, 2017.
DIVISION VIII
DECATEGORIZATION
Sec. 58. DECATEGORIZATION CARRYOVER FUNDING ==== TRANSFER TO
MEDICAID PROGRAM. Notwithstanding section 232.188, subsection
5, paragraph "b", any state appropriated moneys in the funding
pool that remained unencumbered or unobligated at the close
of the fiscal year beginning July 1, 2015, and were deemed
carryover funding to remain available for the two succeeding
fiscal years that still remain unencumbered or unobligated at
the close of the fiscal year beginning July 1, 2017, shall
not revert but shall be transferred to the medical assistance
program for the fiscal year beginning July 1, 2018.
Sec. 59. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
Sec. 60. RETROACTIVE APPLICABILITY. This division of this
Act applies retroactively to July 1, 2017.
DIVISION IX
STATE CASES
Sec. 61. Section 218.99, Code 2018, is amended to read as
follows:
218.99 Counties to be notified of patients' personal
accounts.
The administrator in control of a state institution shall
direct the business manager of each institution under the
administrator's jurisdiction which is mentioned in section
331.424, subsection 1, paragraph "a", subparagraphs (1) and
(2), and for which services are paid under section 331.424A,
to quarterly inform the county of residence of any patient or
resident who has an amount in excess of two hundred dollars on
account in the patients' personal deposit fund and the amount
on deposit. The administrators shall direct the business
manager to further notify the county of residence at least
fifteen days before the release of funds in excess of two
hundred dollars or upon the death of the patient or resident.
If the patient or resident has no residency in this state
or the person's residency is unknown so that the person is
deemed to be a state case, notice shall be made to the director
of human services and the administrator in control of the
institution involved.
Sec. 62. Section 222.60, subsection 1, paragraph b, Code
2018, is amended to read as follows:
b. The state when the person is a resident in another state
or in a foreign country, or when the person's residence is
unknown. The payment responsibility shall be deemed to be a
state case.
Sec. 63. Section 222.60, subsection 2, paragraph b, Code
2018, is amended to read as follows:
b. The cost of a regional administrator=required diagnosis
and an evaluation is at the mental health and disability
services region's expense. For a state case When a person is
a resident in another state or in a foreign country, or when
the persons' residence is unknown, the state may apply the
diagnosis and evaluation provisions of this subsection at the
state's expense.
Sec. 64. Section 222.65, subsection 1, Code 2018, is amended
to read as follows:
1. If the administrator concurs with a certified
determination as to residency of the person so that the
person is deemed a state case in another state or in a foreign
country, or the person's residence is unknown under section
222.60, the administrator shall cause the person either to be
transferred to a resource center or a special unit or to be
transferred to the place of foreign residency.
Sec. 65. Section 222.66, Code 2018, is amended to read as
follows:
222.66 Transfers ==== state cases no residency in the state or
residency unknown ==== expenses.
1. The transfer to a resource center or a special unit or
to the place of residency of a person with an intellectual
disability who has no residence in this state or whose
residency is unknown, shall be made in accordance with such
directions as shall be prescribed by the administrator and
when practicable by employees of the state resource center or
the special unit. The actual and necessary expenses of such
transfers shall be paid by the department on itemized vouchers
sworn to by the claimants and approved by the administrator and
the approved amount is appropriated to the department from any
funds in the state treasury not otherwise appropriated.
2. The case of a person with an intellectual disability
who is determined to have no residence in this state or whose
residence is unknown shall be considered a state case.
Sec. 66. Section 222.67, Code 2018, is amended to read as
follows:
222.67 Charge on finding of residency.
If a person has been received into a resource center or a
special unit as a patient whose residency is unknown and the
administrator determines that the residency of the patient
was at the time of admission in a county of this state, the
administrator shall certify the determination and charge
all legal costs and expenses pertaining to the admission
and support of the patient to the county of residence. The
certification shall be sent to the county of residence. The
certification shall be accompanied by a copy of the evidence
supporting the determination. If the person's residency status
has been determined in accordance with section 331.394, the
legal costs and expenses shall be charged to the county or as a
state case in accordance with that determination. The costs
and expenses shall be collected as provided by law in other
cases.
Sec. 67. Section 222.70, Code 2018, is amended to read as
follows:
222.70 Residency disputes.
If a dispute arises between counties or between the
department and a county as to the residency of a person
admitted to a resource center, or a special unit, or a
community=based service, the dispute shall be resolved as
provided in section 331.394.
Sec. 68. Section 226.45, Code 2018, is amended to read as
follows:
226.45 Reimbursement to county or state.
If a patient is not receiving medical assistance under
chapter 249A and the amount to in the account of any patient
in the patients' personal deposit fund exceeds two hundred
dollars, the business manager of the hospital may apply any
of the excess to reimburse the county of residence or the
state for a state case when the patient is a resident in
another state or in a foreign country, or when the patient's
residence is unknown for liability incurred by the county or
the state for the payment of care, support and maintenance of
the patient, when billed by the county of residence or by the
administrator for a state case when the patient is a resident
in another state or in a foreign country, or when the patient's
residence is unknown.
Sec. 69. Section 230.1, subsection 1, paragraph b, Code
2018, is amended to read as follows:
b. By the state as a state case if such person has no
residence in this state, if the person's residence is unknown,
or if the person is under eighteen years of age.
Sec. 70. Section 230.2, Code 2018, is amended to read as
follows:
230.2 Finding of residence.
If a person's residency status is disputed, the residency
shall be determined in accordance with section 331.394.
Otherwise, the district court may, when the person is
ordered placed in a hospital for psychiatric examination and
appropriate treatment, or as soon thereafter as the court
obtains the proper information, make one of the following
determinations and enter of record whether the residence of the
person is in a county or the person is deemed to be a state case
a resident in another state or in a foreign country, or when
the person's residence is unknown, as follows:
1. That the person's residence is in the county from which
the person was placed in the hospital.
2. That the person's residence is in another county of the
state.
3. That the person's residence is in a foreign state or
country and the person is deemed to be a state case.
4. That the person's residence is unknown and the person is
deemed to be a state case.
Sec. 71. Section 230.8, Code 2018, is amended to read as
follows:
230.8 Transfers of persons with mental illness ==== expenses.
The transfer to any state hospitals or to the places of their
residence of persons with mental illness who have no residence
in this state or whose residence is unknown and deemed to be a
state case, shall be made according to the directions of the
administrator, and when practicable by employees of the state
hospitals. The actual and necessary expenses of such transfers
shall be paid by the department on itemized vouchers sworn to
by the claimants and approved by the administrator.
Sec. 72. Section 230.9, Code 2018, is amended to read as
follows:
230.9 Subsequent discovery of residence.
If, after a person has been received by a state hospital
for persons with mental illness as a state case patient
whose residence is supposed to be outside this state, the
administrator determines that the residence of the person
was, at the time of admission or commitment, in a county of
this state, the administrator shall certify the determination
and charge all legal costs and expenses pertaining to the
admission or commitment and support of the person to the county
of residence. The certification shall be sent to the county
of residence. The certification shall be accompanied by a
copy of the evidence supporting the determination. The costs
and expenses shall be collected as provided by law in other
cases. If the person's residency status has been determined in
accordance with section 331.394, the legal costs and expenses
shall be charged to the county of residence or as a state case
in accordance with that determination.
Sec. 73. Section 230.11, Code 2018, is amended to read as
follows:
230.11 Recovery of costs from state.
Costs and expenses attending the taking into custody,
care, and investigation of a person who has been admitted
or committed to a state hospital, United States department
of veterans affairs hospital, or other agency of the United
States government, for persons with mental illness and who
has no residence in this state or whose residence is unknown,
including cost of commitment, if any, shall be paid as a state
case as approved by the administrator. The amount of the costs
and expenses approved by the administrator is appropriated
to the department from any money in the state treasury
not otherwise appropriated. Payment shall be made by the
department on itemized vouchers executed by the auditor of the
county which has paid them, and approved by the administrator.
Sec. 74. Section 249A.26, subsection 2, paragraph b, Code
2018, is amended to read as follows:
b. The state shall pay for one hundred percent of the
nonfederal share of the costs of case management provided for
adults, day treatment, partial hospitalization, and the home
and community=based services waiver services for persons who
have no residence in this state or whose residence is unknown
so that the persons are deemed to be state cases.
Sec. 75. Section 249A.26, subsection 7, Code 2018, is
amended by striking the subsection.
Sec. 76. Section 331.394, Code 2018, is amended to read as
follows:
331.394 County of residence ==== services to residents ====
service authorization appeals ==== disputes between counties or
regions and the department.
1. For the purposes of this section, unless the context
otherwise requires:
a. "County of residence" means the county in this state in
which, at the time a person applies for or receives services,
the person is living and has established an ongoing presence
with the declared, good faith intention of living in the
county for a permanent or indefinite period of time. The
county of residence of a person who is a homeless person
is the county where the homeless person usually sleeps. A
person maintains residency in the county or state in which the
person last resided while the person is present in another
county or this state receiving services in a hospital, a
correctional facility, a halfway house for community=based
corrections or substance=related treatment, a nursing facility,
an intermediate care facility for persons with an intellectual
disability, or a residential care facility, or for the purpose
of attending a college or university.
b. "Homeless person" means the same as defined in section
48A.2.
c. "Mental health professional" means the same as defined
in section 228.1.
d. "Person" means a person who is a United States citizen or
a qualified alien as defined in 8 U.S.C. {1641.
2. If a person appeals a decision regarding a service
authorization or other services=related decision made by a
regional administrator that cannot be resolved informally,
the appeal shall be heard in a contested case proceeding by a
state administrative law judge. The administrative law judge's
decision shall be considered final agency action under chapter
17A.
3. If a service authorization or other services=related
decision made by a regional administrator concerning a person
varies from the type and amount of service identified to be
necessary for the person in a clinical determination made by a
mental health professional and the mental health professional
believes that failure to provide the type and amount of service
identified could cause an immediate danger to the person's
health or safety, the person may request an expedited review
of the regional administrator's decision to be made by the
department of human services. An expedited review held in
accordance with this subsection is subject to the following
procedures:
a. The request for the expedited review shall be filed
within five business days of receiving the notice of decision
by the regional administrator. The request must be in writing,
plainly state the request for an expedited review in the
caption and body of the request, and be supported by written
documentation from the mental health professional who made the
clinical determination stating how the notice of decision on
services could cause an immediate danger to the person's health
or safety.
b. The expedited review shall be performed by a mental
health professional, who is either the administrator of the
division of mental health and disability services of the
department of human services or the administrator's designee.
If the administrator is not a mental health professional,
the expedited review shall be performed by a designee of the
administrator who is a mental health professional and is free
of any conflict of interest to perform the expedited review.
The expedited review shall be performed within two business
days of the time the request is filed. If the reviewer
determines the information submitted in connection with the
request is inadequate to perform the review, the reviewer shall
request the submission of additional information and the review
shall be performed within two business days of the time that
adequate information is submitted. The regional administrator
and the person, with the assistance of the mental health
professional who made the clinical determination, shall each
provide a brief statement of facts, conclusions, and reasons
for the decision made. Supporting clinical information shall
also be attached. All information related to the proceedings
and any related filings shall be considered to be mental health
information subject to chapter 228.
c. The administrator or designee shall issue an order,
including a brief statement of findings of fact, conclusions of
law, and policy reasons for the order, to justify the decision
made concerning the expedited review. If the decision concurs
with the contention that there is an immediate danger to the
person's health or safety, the order shall identify the type
and amount of service which shall be provided for the person.
The administrator or designee shall give such notice as is
practicable to persons who are required to comply with the
order. The order is effective when issued.
d. The decision of the administrator or designee shall be
considered a final agency action and is subject to judicial
review in accordance with section 17A.19. The record for
judicial review consists of any documents regarding the matter
that were considered or prepared by the administrator or
designee. The administrator or designee shall maintain these
documents as the official record of the decision. If the
matter is appealed to the district court, the record shall be
filed as confidential.
4. If a county of residence is part of a mental health and
disability services region that has agreed to pool funding and
liability for services, the responsibilities of the county
under law regarding such services shall be performed on behalf
of the county by the regional administrator. The county of
residence or the county's mental health and disability services
region, as applicable, is responsible for paying the public
costs of the mental health and disability services that are
not covered by the medical assistance program under chapter
249A and are provided in accordance with the region's approved
service management plan to persons who are residents of the
county or region.
5. a. The dispute resolution process implemented in
accordance with this subsection applies to residency disputes.
The dispute resolution process is not applicable to disputes
involving persons committed to a state facility pursuant to
chapter 812 or rule of criminal procedure 2.22, Iowa court
rules, or to disputes involving service authorization decisions
made by a region.
b. If a county, or region, or the department, as applicable,
receives a billing for services provided to a resident
in another county or region, or objects to a residency
determination certified by the department or another county's
or region's regional administrator and asserts either that the
person has residency in another county or region or the person
is not a resident of this state or the person's residency is
unknown so that the person is deemed a state case, the person's
residency status shall be determined as provided in this
subsection. The county or region shall notify the department
of the county's or region's assertion within one hundred twenty
days of receiving the billing. If the county or region asserts
that the person has residency in another county or region,
that the county or region shall be notified at the same time
as the department. If the department disputes a residency
determination certification made by a regional administrator,
the department shall notify the affected counties or regions of
the department's assertion notify the other county or region
within one hundred twenty days of receiving the billing for
services.
c. The department, county, or region that received the
notification, as applicable, shall respond to the party that
provided the notification within forty=five days of receiving
the notification. If the parties cannot agree to a settlement
as to the person's residency status within ninety days of the
date of notification, on motion of any of the parties, the
matter shall be referred to the department of inspections and
appeals for a contested case hearing under chapter 17A before
an administrative law judge assigned in accordance with section
10A.801 to determine the person's residency status.
d. (1) The administrative law judge's determination
of the person's residency status shall be considered final
agency action, notwithstanding contrary provisions of section
17A.15. The party that does not prevail in the determination
or subsequent judicial review is liable for costs associated
with the proceeding, including reimbursement of the department
of inspections and appeals' actual costs associated with
the administrative proceeding. Judicial review of the
determination may be sought in accordance with section 17A.19.
(2) If following the determination of a person's residency
status in accordance with this subsection, additional evidence
becomes available that merits a change in that determination,
the parties affected may change the determination by mutual
agreement. Otherwise, a party may move that the matter be
reconsidered by the department, county, or region, or by the
administrative law judge.
e. (1) Unless a petition is filed for judicial review,
the administrative law judge's determination of the person's
residency status shall result in one of the following:
(a) If a county or region is determined to be the person's
residence, the county or region shall pay the amounts due and
shall reimburse any other amounts paid for services provided by
the other county or region or the department on the person's
behalf prior to the determination.
(b) If it is determined that the person is not a resident
of this state or the person's residency is unknown so that the
person is deemed to be a state case, the department shall pay
the amounts due and shall reimburse the county or region, as
applicable, for any payment made on behalf of the person prior
to the determination neither the region in which the services
were provided nor the state shall be liable for payment of
amounts due for services provided to the person prior to the
determination.
(2) The payment or reimbursement shall be remitted within
forty=five days of the date the determination was issued.
After the forty=five=day period, a penalty of not greater than
one percent per month may be added to the amount due.
6. a. The dispute resolution process implemented in
accordance with this subsection applies beginning July 1, 2012,
to billing disputes between the state and a county or region,
other than residency disputes or other dispute processes under
this section, involving the responsibility for service costs
for services provided on or after July 1, 2011, under any of
the following:
(1) Chapter 221.
(2) Chapter 222.
(3) Chapter 229.
(4) Chapter 230.
(5) Chapter 249A.
(6) Chapter 812.
b. If a county, region, or the department, as applicable,
disputes a billing for service costs listed in paragraph "a",
the dispute shall be resolved as provided in this subsection.
The county or region shall notify the department of the
county's or region's assertion within ninety days of receiving
the billing. However, for services provided on or after July
1, 2011, for which a county has received the billing as of July
1, 2012, the county shall notify the department of the county's
assertion on or before October 1, 2012. If the department
disputes such a billing of a regional administrator, the
department shall notify the affected counties or regions of the
department's assertion.
c. The department, county, or region that received the
notification, as applicable, shall respond to the party
that provided the notification within forty=five days of
receiving the notification. If the parties cannot agree to a
settlement as to the dispute within ninety days of the date
of notification, on motion of any of the parties, the matter
shall be referred to the department of inspections and appeals
for a contested case hearing under chapter 17A before an
administrative law judge assigned in accordance with section
10A.801 to determine facts and issue a decision to resolve the
dispute.
d. (1) The administrative law judge's decision is a final
agency action, notwithstanding contrary provisions of section
17A.15. The party that does not prevail in the decision or
subsequent judicial review is liable for costs associated with
the proceeding, including reimbursement of the department of
inspections and appeals' actual costs associated with the
administrative proceeding. Judicial review of the decision may
be sought in accordance with section 17A.19.
(2) If following the decision regarding a dispute in
accordance with this subsection, additional evidence becomes
available that merits a change in that decision, the parties
affected may change the decision by mutual agreement.
Otherwise, a party may move that the matter be reconsidered by
the department, county, or region, or by the administrative law
judge.
e. (1) Unless a petition is filed for judicial review,
the administrative law judge's decision regarding a disputed
billing shall result in one of the following:
(a) If a county or region is determined to be responsible
for the disputed amounts, the county or region shall pay
the amounts due and shall reimburse any other amounts paid
for services provided by the other county or region or the
department on the person's behalf prior to the decision.
(b) If it is determined that the state is responsible for
the disputed amounts, the state shall pay the amounts due and
shall reimburse the county or region, as applicable, for any
payment made on behalf of the person prior to the decision.
(2) The payment or reimbursement shall be remitted within
forty=five days of the date the decision was issued. After
the forty=five=day period, a penalty of not greater than one
percent per month may be added to the amount due.
Sec. 77. REPEAL. Section 226.9C, Code 2018, is repealed.
DIVISION X
IOWA DEPARTMENT ON AGING ==== MEDICAID CLAIMING
Sec. 78. IOWA DEPARTMENT ON AGING ==== MEDICAID CLAIMING. The
department on aging and the department of human services shall
collaborate to develop a cost allocation plan requesting
Medicaid administrative funding to provide for the claiming
of federal financial participation for aging and disability
resource center activities that are performed to assist with
administration of the Medicaid program. By January 1, 2019,
the department of human services shall submit to the centers
for Medicare and Medicaid services of the United States
department of health and human services any Medicaid state plan
amendment as necessary and shall enter into an interagency
agreement with the department on aging to implement this
section.
Sec. 79. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XI
EXECUTIVE DIRECTOR ==== DEPARTMENT OF VETERANS AFFAIRS
Sec. 80. 2008 Iowa Acts, chapter 1191, section 14,
subsection 3, is amended to read as follows:
3. The following are range 3 positions: administrator of
the division of criminal and juvenile justice planning of the
department of human rights, administrator of the division of
community action agencies of the department of human rights,
executive director of the department of veterans affairs, and
chairperson and members of the employment appeal board of the
department of inspections and appeals.
Sec. 81. 2008 Iowa Acts, chapter 1191, section 14,
subsection 5, as amended by 2013 Iowa Acts, chapter 123,
section 63, is amended to read as follows:
5. The following are range 5 positions: administrator of
the division of homeland security and emergency management of
the department of public defense, state public defender, drug
policy coordinator, labor commissioner, workers' compensation
commissioner, director of the department of cultural affairs,
director of the department of elder affairs, director of the
law enforcement academy, members of the property assessment
appeal board, executive director of the department of veterans
affairs, and administrator of the historical division of the
department of cultural affairs.
Sec. 82. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XII
FAMILY PLANNING SERVICES PROGRAM
Sec. 83. Section 217.41B, subsection 3, Code 2018, is
amended to read as follows:
3.a. (1) Distribution of family planning services program
funds shall not be made to any entity that performs abortions
or that maintains or operates a facility where abortions
are performed, which shall not be interpreted to include a
nonpublic entity that is a distinct location of a nonprofit
health care delivery system, if the distinct location provides
family planning services but does not perform abortions
or maintain or operate as a facility where abortions are
performed.
(2) The department of human services shall adopt rules
pursuant to chapter 17A to require that as a condition of
eligibility as a provider under the family planning services
program, each distinct location of a nonprofit health care
delivery system shall enroll in the program as a separate
provider, be assigned a distinct provider identification
number, and complete an attestation that abortions are not
performed at the distinct location.
(3) For the purposes of this section, "nonprofit health
care delivery system" means an Iowa nonprofit corporation
that controls, directly or indirectly, a regional health
care network consisting of hospital facilities and various
ambulatory and clinic locations that provide a range of
primary, secondary, and tertiary inpatient, outpatient, and
physician services.
b. For the purposes of this section, "abortion" does not
include any of the following:
a. (1) The treatment of a woman for a physical
disorder, physical injury, or physical illness, including a
life=endangering physical condition caused by or arising from
the pregnancy itself, that would, as certified by a physician,
place the woman in danger of death.
b. (2) The treatment of a woman for a spontaneous abortion,
commonly known as a miscarriage, when not all of the products
of human conception are expelled.
DIVISION XIII
PROVISIONAL REGIONALIZATION AUTHORIZATION
Sec. 84. Section 331.389, subsection 1, paragraphs b and c,
Code 2018, are amended to read as follows:
b. The director of human services shall exempt a county
from being required to enter into a regional service system if
the county furnishes evidence that the county complies with
the requirements in subsection 3, paragraphs "c", "d", "e",
and "f", and is able to provide the core services required
by law to the county's residents in a manner that is as cost
effective and with outcomes that are at least equal to what
could be provided to the residents if the county would provide
the services through a regional service system. The director
shall identify criteria for evaluating the evidence provided by
counties applying for the exemption. The criteria identified
shall be specified in rule adopted by the state commission.
c. b. If a county has been exempted pursuant to this
subsection prior to July 1, 2014, from the requirement to enter
into a regional service system, the county and the county's
board of supervisors shall fulfill all requirements under
this chapter and chapter 225C for a regional service system,
regional service system management plan, regional governing
board, and regional administrator, and any other provisions
applicable to a region of counties providing local mental
health and disability services.
Sec. 85. Section 331.389, subsection 2, Code 2018, is
amended to read as follows:
2. The director of human services shall approve any region
meeting the requirements of subsection 3. However, the
director of human services, in consultation with the state
commission, may grant a waiver from the requirement relating to
the minimum number of counties if there is convincing evidence
that compliance with such requirement is not workable.
Sec. 86. Section 331.389, subsection 3, paragraph a, Code
2018, is amended to read as follows:
a. The counties comprising the region are contiguous except
that a region may include a county that is not contiguous with
any of the other counties in the region, if the county that is
not contiguous has had a formal relationship for two years or
longer with one or more of the other counties in the region for
the provision of mental health and disability services.
Sec. 87. Section 331.389, subsection 4, paragraph c, Code
2018, is amended to read as follows:
c. During the period of April 2, 2013, through July 1,
2013, the The department shall work with any county that has
not agreed to be part of a region in accordance with paragraph
"a" and with the regions forming around the county to resolve
issues preventing the county from joining a region. By July
1, 2013, a A county that has not agreed to be part of a region
in accordance with paragraph "a" shall be assigned by the
department to a region, unless exempted pursuant to subsection
1 prior to July 1, 2014.
Sec. 88. Section 331.389, subsection 4, paragraph e,
unnumbered paragraph 1, Code 2018, is amended to read as
follows:
On or before June 30, 2014, unless exempted pursuant to
subsection 1 prior to July 1, 2014, all counties shall be
in compliance with all of the following mental health and
disability services region implementation criteria:
Sec. 89. Section 331.424A, subsection 8, Code 2018, is
amended to read as follows:
8. a. For the fiscal year beginning July 1, 2017, the
regional per capita expenditure target amount is the sum of the
base expenditure amount for all counties in the region divided
by the population of the region. However, a regional per
capita expenditure target amount shall not exceed the statewide
per capita expenditure target amount. For the fiscal year
beginning July 1, 2018, and each subsequent fiscal year, the
regional per capita expenditure target amount for each region
is equal to the regional per capita expenditure target amount
for the fiscal year beginning July 1, 2017.
b. Notwithstanding paragraph "a", for the fiscal year
beginning July 1, 2019, the regional per capita expenditure
target amount for a region formed pursuant to the section of
this Act which authorizes regionalization is the sum of the
base expenditure amount for all counties in the region divided
by the population of the region. However, the regional per
capita expenditure target amount shall not exceed the statewide
per capita expenditure target amount. For the fiscal year
beginning July 1, 2020, and each subsequent fiscal year, the
regional per capita expenditure target amount for the region
shall be equal to the regional per capita expenditure target
amount for the fiscal year beginning July 1, 2019.
Sec. 90. MENTAL HEALTH AND DISABILITY SERVICES ====
REGIONALIZATION AUTHORIZATION.
1. Upon receiving a request from any county within the
county social services mental health and disability services
region to be removed from the region, the director of human
services may authorize the county to join with other counties
requesting to be removed from the county social services mental
health and disability services region in the formation of a
proposed new mental health and disability services region.
2. County formation of a proposed new mental health and
disability services region pursuant to this section is subject
to all of the following:
a. The aggregate population of all counties forming
the region is at least 100,000 and includes at least one
incorporated city with a population of more than 24,000. For
purposes of this subparagraph, "population" means the same as
defined in section 331.388, subsection 3, Code 2018.
b. Notwithstanding section 331.389, subsection 4, on or
before February 1, 2019, the counties forming the region have
complied with section 331.389, subsection 3, as amended in
this division of this Act, and all of the following additional
requirements:
(1) The board of supervisors of each county forming the
region has voted to approve a chapter 28E agreement.
(2) The duly authorized representatives of all the counties
forming the region have signed a chapter 28E agreement that is
in compliance with section 331.392 and 441 IAC 25.14.
(3) The county board of supervisors' or supervisors'
designee members and other members of the region's governing
board are appointed in accordance with section 331.390.
(4) Executive staff for the region's regional administrator
are identified or engaged.
(5) The regional service management plan is developed in
accordance with section 331.393 and 441 IAC 25.18 and 441 IAC
25.21 and is submitted to the department.
(6) The initial regional service management plan shall
identify the service provider network for the region, identify
the information technology and data management capacity to be
employed to support regional functions, and establish business
functions, accounting procedures, and other administrative
processes.
c. Each county forming the region shall submit the
compliance information required in paragraph "b" to the
director of human services on or before February 1, 2019.
Within 45 days of receipt of such information, the director
of human services shall determine if the region is in full
compliance and shall approve the region if the region has met
all of the requirements of this section.
d. The director of human services shall work with a county
making a request under this section that has not agreed or
is unable to join the proposed new region to resolve issues
preventing the county from joining the proposed new region.
e. By February 1, 2019, the director of human services shall
assign a county making a request under this section that has
not reached an agreement to be part of the proposed new region
to an existing region or to the new proposed region, consistent
with this section.
3. If approved by the department, the region shall commence
full operations no later than July 1, 2019.
Sec. 91. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XIV
MANDATORY REPORTER TRAINING AND CERTIFICATION WORKGROUP
Sec. 92. DEPARTMENT OF HUMAN SERVICES ==== MANDATORY REPORTER
TRAINING AND CERTIFICATION WORKGROUP. The department of human
services, in cooperation with the departments of education
and public health, shall facilitate a study by a workgroup of
stakeholders to make recommendations relating to mandatory
child abuse and mandatory dependent adult abuse reporter
training and certification requirements. The workgroup shall
develop interdepartmental strategies for improving mandatory
child abuse and mandatory dependent adult abuse reporter
training and certification requirements. The workgroup
shall consist of representatives from the departments of
human services, education, public health, public safety, and
human rights, the department on aging, and the office of the
attorney general; a court appointed special advocate; and other
experts the department of human services deems necessary. The
membership of the workgroup shall also include four members of
the general assembly. The legislative members shall serve as
ex officio, nonvoting members of the workgroup, with one member
to be appointed by each of the following: the majority leader
of the senate, the minority leader of the senate, the speaker
of the house of representatives, and the minority leader of the
house of representatives. The workgroup shall submit a report
with recommendations, including but not limited to strategies
developed and other proposed improvements, to the governor and
the general assembly on or before December 15, 2018.
DIVISION XV
NURSING FACILITY QUALITY ASSURANCE ASSESSMENT
Sec. 93. Section 249L.3, subsection 1, paragraph d, Code
2018, is amended to read as follows:
d. The aggregate quality assurance assessments imposed under
this chapter shall not exceed the lower of three percent of the
aggregate non=Medicare revenues of a nursing facility or the
maximum amount that may be assessed pursuant to the indirect
guarantee threshold as established pursuant to 42 C.F.R.
{433.68(f)(3)(i), and shall be stated on a per=patient=day
basis.
Sec. 94. Section 249L.4, subsection 2, Code 2018, is amended
to read as follows:
2. Moneys in the trust fund shall be used, subject to
their appropriation by the general assembly, by the department
only for reimbursement of nursing facility services for which
federal financial participation under the medical assistance
program is available to match state funds. Any moneys Moneys
appropriated from the trust fund for reimbursement of nursing
facilities, in addition to the quality assurance assessment
pass=through and the quality assurance assessment rate add=on
which shall be used as specified in subsection 5, paragraph "b",
shall be used in a manner such that no less than thirty=five
percent of the amount received by a nursing facility is used
for increases in compensation and costs of employment for
direct care workers, and no less than sixty percent of the
total is used to increase compensation and costs of employment
for all nursing facility staff. For the purposes of use of
such funds, "direct care worker", "nursing facility staff",
"increases in compensation", and "costs of employment" mean as
defined or specified in this chapter.
Sec. 95. DIRECTIVES TO DEPARTMENT OF HUMAN SERVICES.
1. The department of human services shall request approval
from the centers for Medicare and Medicaid services of the
United States department of health and human services for any
waiver or state plan amendment necessary to administer this
division of this Act.
2. The change in the quality assurance assessment shall
accrue beginning on the first day of the calendar quarter
following the date of approval of any waiver or state plan
amendment.
DIVISION XVI
SEXUAL OFFENSES AND SEX OFFENDERS
Sec. 96. Section 229A.2, subsection 4, Code 2018, is amended
to read as follows:
4. "Discharge" means an unconditional discharge from the
sexually violent predator program. A person released from a
secure facility into a transitional release program or released
with or without supervision is not considered to be discharged.
Sec. 97. Section 229A.5B, subsection 1, unnumbered
paragraph 1, Code 2018, is amended to read as follows:
A person who is detained pursuant to section 229A.5 or is
subject to an order of civil commitment under this chapter
shall remain in custody unless released by court order or
discharged under section 229A.8 or 229A.10. A person who has
been placed in a transitional release program or who is under
release with or without supervision is considered to be in
custody. A person in custody under this chapter shall not do
any of the following:
Sec. 98. Section 229A.5C, subsection 4, Code 2018, is
amended to read as follows:
4. A person who committed a public offense while in a
transitional release program or on release with or without
supervision may be returned to a secure facility operated by
the department of human services upon completion of any term
of confinement that resulted from the commission of the public
offense.
Sec. 99. Section 229A.6A, subsection 1, paragraph d, Code
2018, is amended to read as follows:
d. To a facility for placement or treatment in a
transitional release program or for release with or without
supervision. A transport order is not required under this
paragraph.
Sec. 100. Section 229A.7, subsection 7, Code 2018, is
amended to read as follows:
7. The control, care, and treatment of a person determined
to be a sexually violent predator shall be provided at a
facility operated by the department of human services. At all
times prior to placement in a transitional release program
or release with or without supervision, persons committed
for control, care, and treatment by the department of human
services pursuant to this chapter shall be kept in a secure
facility and those patients shall be segregated at all times
from any other patient under the supervision of the department
of human services. A person committed pursuant to this chapter
to the custody of the department of human services may be kept
in a facility or building separate from any other patient
under the supervision of the department of human services.
The department of human services may enter into a chapter
28E agreement with the department of corrections or other
appropriate agency in this state or another state for the
confinement of patients who have been determined to be sexually
violent predators. Patients who are in the custody of the
director of the department of corrections pursuant to a chapter
28E agreement and who have not been placed in a transitional
release program or released with or without supervision shall
be housed and managed separately from criminal offenders in
the custody of the director of the department of corrections,
and except for occasional instances of supervised incidental
contact, shall be segregated from those offenders.
Sec. 101. Section 229A.8B, subsection 3, Code 2018, is
amended to read as follows:
3. Upon the return of the committed person to a secure
facility, the director of human services or the director's
designee shall notify the court that issued the ex parte order
that the absconder has been returned to a secure facility, and
the court shall set a hearing within five days to determine if
a violation occurred. If a court order was not issued, the
director or the director's designee shall contact the nearest
district court with jurisdiction to set a hearing to determine
whether a violation of the rules or directives occurred. The
court shall schedule a hearing within five days of after
receiving notice that the committed person has been returned
from the transitional release program to a secure facility.
Sec. 102. Section 229A.9A, Code 2018, is amended to read as
follows:
229A.9A Release with or without supervision.
1. In any proceeding under section 229A.8, the court may
order the committed person released with or without supervision
if any of the following apply:
a. The attorney general stipulates to the release with or
without supervision.
b. The court or jury has determined that the person should
be discharged released from the program a secure facility or
a transitional release program, but the court has determined
the person suffers from a mental abnormality and it is in the
best interest of the community to order release with or without
supervision before the committed person is discharged.
2. If release with or without supervision is ordered, the
department of human services shall prepare within sixty days of
the order of the court a release plan addressing the person's
needs for counseling, medication, community support services,
residential services, vocational services, alcohol or other
drug abuse treatment, sex offender treatment, or any other
treatment or supervision necessary.
3. The court shall set a hearing on the release plan
prepared by the department of human services before the
committed person is released from a secure facility or a
transitional release program.
4. If the court orders release with supervision, the court
shall order supervision by an agency with jurisdiction that
is familiar with the placement of criminal offenders in the
community. The agency with jurisdiction shall be responsible
for initiating proceedings for violations of the release plan
as provided in section 229A.9B. If the court orders release
without supervision, the agency with jurisdiction shall also be
responsible for initiating proceedings for any violations of
the release plan as provided in section 229A.9B.
5. A committed person may not petition the court for release
with or without supervision.
6. A committed person released with or without supervision
is not considered discharged from civil commitment under this
chapter.
7. After being released with or without supervision, the
person may petition the court for discharge as provided in
section 229A.8.
8. The court shall retain jurisdiction over the committed
person who has been released with or without supervision until
the person is discharged from the program. The department
of human services or a judicial district department of
correctional services shall not be held liable for any acts
committed by a committed person who has been ordered released
with or without supervision.
Sec. 103. Section 229A.9B, Code 2018, is amended to read as
follows:
229A.9B Violations of release with or without supervision.
1. If a committed person violates the release plan, the
agency with jurisdiction over the person may request the
district court to issue an emergency ex parte order directing
any law enforcement officer to take the person into custody
so that the person can be returned to a secure facility.
The request for an ex parte order may be made orally or by
telephone, but the original written request or a facsimile copy
of the request shall be filed with the clerk of court no later
than 4:30 p.m. on the next business day the office of the clerk
of court is open.
2. If a committed person has absconded in violation of the
conditions of the person's release plan, a presumption arises
that the person poses a risk to public safety. The department
of human services or contracting agency, in cooperation with
local law enforcement agencies, may make a public announcement
about the absconder. The public announcement may include a
description of the committed person, that the committed person
is on release with or without supervision from the sexually
violent predator program, and any other information pertinent
to public safety.
3. Upon the return of the committed person to a secure
facility, the director of human services or the director's
designee shall notify the court that issued the ex parte
order that the committed person has been returned to a secure
facility, and the court shall set hearing within five days to
determine if a violation occurred. If a court order was not
issued, the director or the director's designee shall contact
the nearest district court with jurisdiction to set a hearing
to determine whether a violation of the conditions of the
release plan occurred. The court shall schedule a hearing
within five days of after receiving notice that the committed
person has been returned to a secure facility.
4. At the hearing, the burden shall be upon the attorney
general to show by a preponderance of the evidence that a
violation of the release plan occurred.
5. If the court determines a violation occurred, the court
shall receive release recommendations from the department of
human services and either order that the committed person be
returned to release with or without supervision or placed
in a transitional release program, or be confined in a
secure facility. The court may impose further conditions
upon the committed person if returned to release with or
without supervision or placed in the transitional release
program. If the court determines no violation occurred, the
committed person shall be returned to release with or without
supervision.
Sec. 104. Section 232.68, subsection 2, paragraph a,
subparagraph (3), Code 2018, is amended to read as follows:
(3) The commission of a sexual offense with or to a child
pursuant to chapter 709, section 726.2, or section 728.12,
subsection 1, as a result of the acts or omissions of the
person responsible for the care of the child or of a person who
is fourteen years of age or older and resides in a home with
the child. Notwithstanding section 702.5, the commission of
a sexual offense under this subparagraph includes any sexual
offense referred to in this subparagraph with or to a person
under the age of eighteen years.
Sec. 105. Section 232.68, subsection 2, paragraph a,
subparagraph (9), Code 2018, is amended to read as follows:
(9) (a) Knowingly A person who is responsible for the
care of a child knowingly allowing a person another person
custody or of, control of over, or unsupervised access to a
child or minor child under the age of fourteen or a child with
a physical or mental disability, after knowing the person
other person is required to register or is on the sex offender
registry under chapter 692A for a violation of section 726.6.
(b) This subparagraph does not apply in any of the following
circumstances:
(i) A child living with a parent or guardian who is a sex
offender required to register or on the sex offender registry
under chapter 692A.
(ii) A child living with a parent or guardian who is married
to and living with a sex offender required to register or on
the sex offender registry under chapter 692A.
(iii) A child who is a sex offender required to register or
on the sex offender registry under chapter 692A who is living
with the child's parent, guardian, or foster parent and is also
living with the child to whom access was allowed.
(c) For purposes of this subparagraph, "control over" means
any of the following:
(i) A person who has accepted, undertaken, or assumed
supervision of a child from the parent or guardian of the
child.
(ii) A person who has undertaken or assumed temporary
supervision of a child without explicit consent from the parent
or guardian of the child.
Sec. 106. Section 901A.2, subsection 6, Code 2018, is
amended to read as follows:
6. A person who has been placed in a transitional release
program, released with or without supervision, or discharged
pursuant to chapter 229A, and who is subsequently convicted of
a sexually predatory offense or a sexually violent offense,
shall be sentenced to life in prison on the same terms as
a class "A" felon under section 902.1, notwithstanding any
other provision of the Code to the contrary. The terms and
conditions applicable to sentences for class "A" felons under
chapters 901 through 909 shall apply to persons sentenced under
this subsection. However, if the person commits a sexually
violent offense which is a misdemeanor offense under chapter
709, the person shall be sentenced to life in prison, with
eligibility for parole as provided in chapter 906.
DIVISION XVII
MEDICAID RETROACTIVE ELIGIBILITY
Sec. 107. 2017 Iowa Acts, chapter 174, section 12,
subsection 15, paragraph a, subparagraph (7), is amended to
read as follows:
(7) (a) Elimination of the three=month retroactive
Medicaid coverage benefit for Medicaid applicants effective
October 1, 2017. The department shall seek a waiver from
the centers for Medicare and Medicaid services of the United
States department of health and human services to implement
the strategy. If federal approval is received, an applicant's
Medicaid coverage shall be effective on the first day of the
month of application, as allowed under the Medicaid state plan.
(b) Effective July 1, 2018, a three=month retroactive
Medicaid coverage benefit shall apply to a Medicaid applicant
who is otherwise Medicaid=eligible and is a resident of a
nursing facility licensed under chapter 135C. The department
shall seek federal approval for any Medicaid waiver or state
plan amendment necessary to implement this subparagraph (b).
Sec. 108. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XVIII
MENTAL HEALTH AND DISABILITY SERVICES ==== TRANSFER OF FUNDS
Sec. 109. MENTAL HEALTH AND DISABILITY SERVICES ==== TRANSFER
OF FUNDS. Notwithstanding section 331.432, a county with a
population of over 300,000 based on the most recent federal
decennial census, may transfer funds from any other fund of the
county to the mental health and disability regional services
fund for the purposes of providing mental health and disability
services for the fiscal year beginning July 1, 2018, and
ending June 30, 2019. The county shall submit a report to
the governor and the general assembly by September 1, 2019,
including the source of any funds transferred, the amount of
the funds transferred, and the mental health and disability
services provided with the transferred funds.
DIVISION XIX
MISCELLANEOUS TECHNICAL PROVISIONS
Sec. 110. Section 135.15, Code 2018, is amended to read as
follows:
135.15 Oral and health delivery system bureau established ====
responsibilities.
An oral and health delivery system bureau is established
within the division of health promotion and chronic disease
prevention of the department. The bureau shall be responsible
for all of the following:
1. Providing population=based oral health services,
including public health training, improvement of dental support
systems for families, technical assistance, awareness=building
activities, and educational services, at the state and local
level to assist Iowans in maintaining optimal oral health
throughout all stages of life.
2. Performing infrastructure building and enabling services
through the administration of state and federal grant programs
targeting access improvement, prevention, and local oral
health programs utilizing maternal and child health programs,
Medicaid, and other new or existing programs.
3. Leveraging federal, state, and local resources for
programs under the purview of the bureau.
4. Facilitating ongoing strategic planning and application
of evidence=based research in oral health care policy
development that improves oral health care access and the
overall oral health of all Iowans.
5. Developing and implementing an ongoing oral health
surveillance system for the evaluation and monitoring of
the oral health status of children and other underserved
populations.
6. Facilitating the provision of oral health services
through dental homes. For the purposes of this section,
"dental home" means a network of individualized care based on
risk assessment, which includes oral health education, dental
screenings, preventive services, diagnostic services, treatment
services, and emergency services.
Sec. 111. Section 135.175, subsection 1, paragraph a, Code
2018, is amended to read as follows:
a. A health care workforce support initiative is established
to provide for the coordination and support of various efforts
to address the health care workforce shortage in this state.
This initiative shall include the medical residency training
state matching grants program created in section 135.176,
the nurse residency state matching grants program created in
section 135.178, and the fulfilling Iowa's need for dentists
matching grant program created in section 135.179.
Sec. 112. Section 135.175, subsection 5, Code 2018, is
amended by adding the following new paragraph:
NEW PARAGRAPH. b. The nurse residency state matching grants
program account. The nurse residency state matching grants
program account shall be under the control of the department
and the moneys in the account shall be used for the purposes of
the nurse residency state matching grants program as specified
in section 135.178. Moneys in the account shall consist of
moneys appropriated or allocated for deposit in or received
by the fund or the account and specifically dedicated to the
nurse residency state matching grants program account for the
purposes of such account.
Sec. 113. Section 135.175, subsection 6, paragraph a, Code
2018, is amended to read as follows:
a. Moneys in the fund and the accounts in the fund shall
only be appropriated in a manner consistent with the principles
specified and the strategic plan developed pursuant to section
135.163 to support the medical residency training state
matching grants program, the nurse residency state matching
grants program, the fulfilling Iowa's need for dentists
matching grant program, and to provide funding for state health
care workforce shortage programs as provided in this section.
DIVISION XX
STATE TRAINING SCHOOL ==== ELDORA
Sec. 114. Section 233A.1, Code 2018, is amended to read as
follows:
233A.1 State training school ==== Eldora and Toledo.
1. Effective January 1, 1992, a diagnosis and evaluation
center and other units are established at Eldora the
state training school to provide to court=committed
male juvenile delinquents a program which focuses upon
appropriate developmental skills, treatment, placements, and
rehabilitation.
2. The diagnosis and evaluation center which is used to
identify appropriate treatment and placement alternatives for
juveniles and any other units for juvenile delinquents which
are located at Eldora and the unit for juvenile delinquents at
Toledo shall together be known as the "state training school".
For the purposes of this chapter "director" means the director
of human services and "superintendent" means the administrator
in charge of the diagnosis and evaluation center for juvenile
delinquents and other units at Eldora and the unit for juvenile
delinquents at Toledo the state training school.
3. The number of children present at any one time at the
state training school at Eldora shall not exceed the population
guidelines established under 1990 Iowa Acts, ch. 1239, {21, as
adjusted for subsequent changes in the capacity at the training
school.
Sec. 115. Section 233A.14, Code 2018, is amended to read as
follows:
233A.14 Transfers to other institutions.
The administrator may transfer to the schools state training
school minor wards of the state from any institution under the
administrator's charge but no person shall be so transferred
who is mentally ill or has an intellectual disability. Any
child in the schools state training school who is mentally ill
or has an intellectual disability may be transferred by the
administrator to the proper state institution.
Sec. 116. Section 915.29, subsection 1, unnumbered
paragraph 1, Code 2018, is amended to read as follows:
The department of human services shall notify a registered
victim regarding a juvenile adjudicated delinquent for a
violent crime, committed to the custody of the department of
human services, and placed at the state training school at
Eldora or Toledo, of the following:
DIVISION XXI
GERIATRIC PATIENT HOUSING REVIEW
Sec. 117. GERIATRIC PATIENT HOUSING REVIEW.
1. During the 2018 legislative interim, the department
on aging and the departments of human services, inspections
and appeals, and corrections, cooperatively, shall review
issues and develop policy recommendations relating to housing
for geriatric persons, including geriatric individuals
who are registered on the sex offender registry or who are
sexually aggressive. The review shall address all aspects
of the issue including the feasibility of private entities
utilizing facilities located at Mount Pleasant, Clarinda,
or other vacant, state=owned facilities to care for such
geriatric persons; related workforce recruitment and training;
requirements that a facility must meet in order to receive
Medicaid reimbursement; and any other information or issues
deemed appropriate by the agencies.
2. The agencies shall submit a joint report with
recommendations to the governor and general assembly by
December 15, 2018.
DIVISION XXII
WRONGFUL BIRTH OR WRONGFUL LIFE CAUSE OF ACTION
Sec. 118. NEW SECTION. 613.15B Wrongful birth or wrongful
life cause of action ==== prohibitions ==== exceptions.
1. A cause of action shall not arise and damages shall not
be awarded, on behalf of any person, based on a wrongful birth
claim that, but for an act or omission of the defendant, a
child would not or should not have been born.
2. A cause of action shall not arise and damages shall not
be awarded, on behalf of any person, based on a wrongful life
claim that, but for an act or omission of the defendant, the
person bringing the action would not or should not have been
born.
3. The prohibitions specified in this section apply to any
claim regardless of whether the child is born healthy or with a
birth defect or disorder or other adverse medical condition.
However, the prohibitions specified in this section shall not
apply to any of the following:
a. A civil action for damages for an intentional or grossly
negligent act or omission, including any act or omission that
constitutes a public offense.
b. A civil action for damages for the intentional failure
of a physician to comply with the duty imposed by licensure
pursuant to chapter 148 to provide a patient with all
information reasonably necessary to make decisions about a
pregnancy.
Sec. 119. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
Sec. 120. APPLICABILITY. This division of this Act applies
on or after the effective date of this division of this Act to
causes of action that accrue on or after that date. A cause of
action that accrues before the effective date of this division
of this Act is governed by the law in effect prior to the
effective date of this division of this Act.
DIVISION XXIII
TRANSFERS OF FUNDS BETWEEN DHS INSTITUTIONS
Sec. 121. Section 218.6, Code 2018, is amended to read as
follows:
218.6 Transfer of appropriations made to institutions.
1. Notwithstanding section 8.39, subsection 1, without the
prior written consent and approval of the governor and the
director of the department of management, the director of human
services may transfer funds between the appropriations made for
the institutions, listed as follows:
1. a. The state resource centers.
2. b. The state mental health institutes.
3. c. The state training school.
4. d. The civil commitment unit for sexual offenders.
2. The department shall report any transfer made pursuant
to subsection 1 during a fiscal quarter to the legislative
services agency within thirty days of the beginning of the
subsequent fiscal quarter.
DIVISION XXIV
MEDICAL CANNABIDIOL
Sec. 122. Section 124E.7, subsections 7 and 8, Code 2018,
are amended to read as follows:
7. A medical cannabidiol manufacturer shall not employ
a person who is under eighteen years of age or who has been
convicted of a disqualifying felony offense. An employee
of a medical cannabidiol manufacturer shall be subject to a
background investigation conducted by the division of criminal
investigation of the department of public safety and a national
criminal history background check pursuant to section 124E.19.
8. A medical cannabidiol manufacturer owner shall not have
been convicted of a disqualifying felony offense and shall be
subject to a background investigation conducted by the division
of criminal investigation of the department of public safety
and a national criminal history background check pursuant to
section 124E.19.
Sec. 123. Section 124E.9, subsections 7 and 8, Code 2018,
are amended to read as follows:
7. A medical cannabidiol dispensary shall not employ a
person who is under eighteen years of age or who has been
convicted of a disqualifying felony offense. An employee
of a medical cannabidiol dispensary shall be subject to a
background investigation conducted by the division of criminal
investigation of the department of public safety and a national
criminal history background check pursuant to section 124E.19.
8. A medical cannabidiol dispensary owner shall not have
been convicted of a disqualifying felony offense and shall be
subject to a background investigation conducted by the division
of criminal investigation of the department of public safety
and a national criminal history background check pursuant to
section 124E.19.
Sec. 124. Section 124E.10, Code 2018, is amended by striking
the section and inserting in lieu thereof the following:
124E.10 Fees.
All fees collected by the department under this chapter
shall be retained by the department for operation of the
medical cannabidiol registration card program and the medical
cannabidiol manufacturer and medical cannabidiol dispensary
licensing programs. The moneys retained by the department
shall be considered repayment receipts as defined in section
8.2 and shall be used for any of the department's duties
under this chapter, including but not limited to the addition
of full=time equivalent positions for program services and
investigations. Notwithstanding section 8.33, moneys retained
by the department pursuant to this section shall not revert to
the general fund of the state but shall remain available for
expenditure only for the purposes specified in this section.
Sec. 125. NEW SECTION. 124E.19 Background investigations.
1. The division of criminal investigation of the
department of public safety shall conduct thorough
background investigations for the purposes of licensing
medical cannabidiol manufacturers and medical cannabidiol
dispensaries under this chapter. The results of any background
investigation conducted pursuant to this section shall be
presented to the department.
a. An applicant for a medical cannabidiol manufacturer
license or a medical cannabidiol dispensary license and their
owners, investors, and employees shall submit all required
information on a form prescribed by the department of public
safety.
b. The department shall charge an applicant for a medical
cannabidiol manufacturer license or a medical cannabidiol
dispensary license a fee determined by the department of public
safety and adopted by the department by rule to defray the
costs associated with background investigations conducted
pursuant to the requirements of this section. The fee shall
be in addition to any other fees charged by the department.
The fee may be retained by the department of public safety and
shall be considered repayment receipts as defined in section
8.2.
2. The department shall require an applicant for a medical
cannabidiol manufacturer license or a medical cannabidiol
dispensary license, their owners and investors, and applicants
for employment at a medical cannabidiol manufacturer or
medical cannabidiol dispensary to submit fingerprints and other
required identifying information to the department on a form
prescribed by the department of public safety. The department
shall submit the fingerprint cards and other identifying
information to the division of criminal investigation of the
department of public safety for submission to the federal
bureau of investigation for the purpose of conducting a
national criminal history record check. The department may
require employees and contractors involved in carrying out
a background investigation to submit fingerprints and other
identifying information for the same purpose.
3. The department may enter into a chapter 28E agreement
with the department of public safety to meet the requirements
of this section.
4. An applicant for a medical cannabidiol manufacturer
license or a medical cannabidiol dispensary license shall
submit information and fees required by this section at the
time of application.
5. The results of background investigations conducted
pursuant to this section shall not be considered public records
under chapter 22.
Sec. 126. EFFECTIVE UPON ENACTMENT. This division of this
Act, being deemed of immediate importance, takes effect upon
enactment.
DIVISION XXV
DEPARTMENT OF HUMAN SERVICES PROGRAMS AND ACTIVITIES
INMATES OF PUBLIC INSTITUTIONS ==== MEDICAID
Sec. 127. Section 249A.38, Code 2018, is amended to read as
follows:
249A.38 Inmates of public institutions ==== suspension or
termination of medical assistance.
1. The following conditions shall apply to Following the
first thirty days of commitment, the department shall suspend
the eligibility of an individual who is an inmate of a public
institution as defined in 42 C.F.R. {435.1010, who is enrolled
in the medical assistance program at the time of commitment to
the public institution, and who remains eligible for medical
assistance as an individual except for the individual's
institutional status:
a. The department shall suspend the individual's
eligibility for up to the initial twelve months of the period
of commitment. The department shall delay the suspension
of eligibility for a period of up to the first thirty days
of commitment if such delay is approved by the centers for
Medicare and Medicaid services of the United States department
of health and human services. If such delay is not approved,
the department shall suspend eligibility during the entirety
of the initial twelve months of the period of commitment.
Claims submitted on behalf of the individual under the medical
assistance program for covered services provided during the
delay period shall only be reimbursed if federal financial
participation is applicable to such claims.
b. The department shall terminate an individual's
eligibility following a twelve=month period of suspension
of the individual's eligibility under paragraph "a", during
the period of the individual's commitment to the public
institution.
2. a. A public institution shall provide the department and
the social security administration with a monthly report of the
individuals who are committed to the public institution and of
the individuals who are discharged from the public institution.
The monthly report to the department shall include the date
of commitment or the date of discharge, as applicable, of
each individual committed to or discharged from the public
institution during the reporting period. The monthly report
shall be made through the reporting system created by the
department for public, nonmedical institutions to report inmate
populations. Any medical assistance expenditures, including
but not limited to monthly managed care capitation payments,
provided on behalf of an individual who is an inmate of a
public institution but is not reported to the department
in accordance with this subsection, shall be the financial
responsibility of the respective public institution.
b. The department shall provide a public institution with
the forms necessary to be used by the individual in expediting
restoration of the individual's medical assistance benefits
upon discharge from the public institution.
3. This section applies to individuals as specified in
subsection 1 on or after January 1, 2012.
4. 3. The department may adopt rules pursuant to chapter
17A to implement this section.
MEDICAID PROGRAM ADMINISTRATION
Sec. 128. MEDICAID PROGRAM ADMINISTRATION.
1. PROVIDER PROCESSES AND PROCEDURES.
a. When all of the required documents and other information
necessary to process a claim have been received by a managed
care organization, the managed care organization shall
either provide payment to the claimant within the timelines
specified in the managed care contract or, if the managed
care organization is denying the claim in whole or in part,
shall provide notice to the claimant including the reasons for
such denial consistent with national industry best practice
guidelines.
b. A managed care organization shall correct any identified
system configuration error within a reasonable time frame
approved by the department, and shall fully and accurately
reprocess claims affected by such errors within thirty days
of the successful system correction. The department shall
define "system configuration error" as appropriate to include
errors in provider data caused by a managed care organization
or improper claims edits that result in incorrect payments to
providers.
c. A managed care organization shall provide written notice
to affected individuals at least sixty days prior to making
any program or procedural change, as determined necessary by
the department. The department shall develop and distribute a
list of the types of changes that require the sixty=day notice
to the managed care organizations effective July 1, 2018.
Such changes may include but are not limited to billing and
collection provisions, provider network provisions, member or
provider services, and prior authorization requirements.
d. The department of human services shall engage dedicated
provider relations staff to assist Medicaid providers in
resolving billing conflicts with managed care organizations
including those involving denied claims, technical omissions,
or incomplete information. If the provider relations staff
observe trends evidencing fraudulent claims or improper
reimbursement, the staff shall forward such evidence to the
department of human services for further review.
e. The department of human services shall adopt rules
pursuant to chapter 17A to require the inclusion by a managed
care organization of advanced registered nurse practitioners
and physician assistants as primary care providers for the
purposes of population health management.
f. The department of human services shall provide for the
development and shall require the use of standardized Medicaid
provider enrollment forms to be used by the department and
uniform Medicaid provider credentialing specifications to be
used by managed care organizations.
2. MEMBER SERVICES AND PROCESSES.
a. If a Medicaid member is receiving court=ordered services
or treatment for a substance=related disorder pursuant to
chapter 125 or for a mental illness pursuant to chapter 229,
such services or treatment shall be provided and reimbursed
for an initial period of three days before a managed care
organization may apply medical necessity criteria to determine
the most appropriate services, treatment, or placement for the
Medicaid member.
b. The department of human services shall maintain and
update Medicaid member eligibility files in a timely manner
consistent with national industry best practices.
c. The department of human services shall utilize an
independent, external quality review vendor to complete a
review of a random case sample of decreased level of care
determinations using national best practices to ensure that
appropriate medically necessary services are provided to
meet Medicaid member needs. The department shall report the
findings of the review to the governor and the general assembly
by December 15, 2018, including any plan necessary to address
the findings.
d. The department of human services, on an annual basis,
shall conduct an analysis of all Medicaid member appeals that
have been dismissed, withdrawn, or overturned to determine
if there are any negative patterns or trends based on the
analysis. The services of any member whose appeal is subject
to the analysis shall continue for the period during which an
interdisciplinary team conducts a new assessment to determine
which services are medically necessary for that member, which
period shall not exceed ninety days. A report of the analysis
and findings shall be submitted to the governor and the general
assembly on a biannual basis and the department shall develop a
plan as necessary to address any negative patterns or trends
identified by the analysis.
3. MEDICAID PROGRAM REVIEW AND OVERSIGHT.
a. (1) The department of human services shall facilitate a
workgroup, in collaboration with representatives of the managed
care organizations and health home providers, to review the
health home programs. The review shall include all of the
following:
(a) An analysis of the state plan amendments applicable to
health homes.
(b) An analysis of the current health home system, including
the rationale for any recommended changes.
(c) The development of a clear and consistent delivery
model linked to program=determined outcomes and data reporting
requirements.
(d) A work plan to be used in communicating with
stakeholders regarding the administration and operation of the
health home programs.
(2) The department of human services shall submit a
report of the workgroup's findings, recommendations, and
any actions taken by December 15, 2018, to the governor and
to the Eighty=eighth General Assembly, 2019 session, for
consideration.
(3) The workgroup and the workgroup's activities shall
not affect the department's authority to apply or enforce the
Medicaid state plan amendment relative to health homes.
b. The department of human services, in collaboration
with Medicaid providers and managed care organizations, shall
initiate a review process to determine the effectiveness of
prior authorizations used by the managed care organizations
with the goal of making adjustments based on relevant
service costs and member outcomes data utilizing existing
industry=accepted standards. Prior authorization policies
shall comply with existing rules, guidelines, and procedures
developed by the centers for Medicare and Medicaid services of
the United States department of health and human services.
c. The department of human services shall enter into a
contract with an independent review organization to perform
an audit of a random sample of small dollar claims paid to
or denied Medicaid long=term services and supports providers
during the first quarter of the 2018 calendar year. The
department of human services shall submit a report of
the findings of the audit to the governor and the general
assembly by February 1, 2019. The department may take any
action specified in the managed care contract relative to
any claim the auditor determines to be incorrectly paid or
denied, subject to appeal by the managed care organization
to the director of human services. For the purposes of this
paragraph, "small dollar claims" means those claims less than
or equal to two thousand five hundred dollars.
MEDICAID PROGRAM PHARMACY COPAYMENT
Sec. 129. 2005 Iowa Acts, chapter 167, section 42, is
amended to read as follows:
SEC. 42. COPAYMENTS FOR PRESCRIPTION DRUGS UNDER THE
MEDICAL ASSISTANCE PROGRAM. The department of human services
shall require recipients of medical assistance to pay the
following copayments a copayment of $1 on each prescription
filled for a covered prescription drug, including each refill
of such prescription, as follows:
1. A copayment of $1 on each prescription filled for each
covered nonpreferred generic prescription drug.
2. A copayment of $1 for each covered preferred brand=name
or generic prescription drug.
3. A copayment of $1 for each covered nonpreferred
brand=name prescription drug for which the cost to the state is
up to and including $25.
4. A copayment of $2 for each covered nonpreferred
brand=name prescription drug for which the cost to the state is
more than $25 and up to and including $50.
5. A copayment of $3 for each covered nonpreferred
brand=name prescription drug for which the cost to the state
is more than $50.
MEDICAL ASSISTANCE ADVISORY COUNCIL
Sec. 130. Section 249A.4B, subsection 2, paragraph a,
subparagraphs (27) and (28), Code 2018, are amended by striking
the subparagraphs.
Sec. 131. MEDICAL ASSISTANCE ADVISORY COUNCIL ==== REVIEW OF
MEDICAID MANAGED CARE REPORT DATA. The executive committee
of the medical assistance advisory council shall review
the data collected and analyzed for inclusion in periodic
reports to the general assembly, including but not limited
to the information and data specified in 2016 Iowa Acts,
chapter 1139, section 93, to determine which data points and
information should be included and analyzed to more accurately
identify trends and issues with, and promote the effective and
efficient administration of, Medicaid managed care for all
stakeholders. At a minimum, the areas of focus shall include
consumer protection, provider network access and safeguards,
outcome achievement, and program integrity. The executive
committee shall report its findings and recommendations to the
medical assistance advisory council for review and comment by
October 1, 2018, and shall submit a final report of findings
and recommendations to the governor and the general assembly by
December 31, 2018.
TARGETED CASE MANAGEMENT AND INPATIENT PSYCHIATRIC SERVICES
REIMBURSEMENT
Sec. 132. Section 249A.31, Code 2018, is amended to read as
follows:
249A.31 Cost=based reimbursement.
1. Providers of individual case management services for
persons with an intellectual disability, a developmental
disability, or chronic mental illness shall receive cost=based
reimbursement for one hundred percent of the reasonable
costs for the provision of the services in accordance with
standards adopted by the mental health and disability services
commission pursuant to section 225C.6. Effective July 1, 2018,
targeted case management services shall be reimbursed based
on a statewide fee schedule amount developed by rule of the
department pursuant to chapter 17A.
2. Effective July 1, 2010 2014, the department shall apply
a cost=based reimbursement methodology for reimbursement of
psychiatric medical institution for children providers of
inpatient psychiatric services for individuals under twenty=one
years of age shall be reimbursed as follows:
a. For non=state=owned providers, services shall be
reimbursed according to a fee schedule without reconciliation.
b. For state=owned providers, services shall be reimbursed
at one hundred percent of the actual and allowable cost of
providing the service.
DIVISION XXVI
PREAPPLICATION SCREENING ASSESSMENT
Sec. 133. Section 229.5A, Code 2018, is amended to read as
follows:
229.5A Preapplication screening assessment ==== program.
Prior to filing an application pursuant to section 229.6,
the clerk of the district court or the clerk's designee
shall inform the interested person referred to in section
229.6, subsection 1, about the option of requesting a
preapplication screening assessment through a preapplication
screening assessment program, if available. The state court
administrator shall prescribe practices and procedures for
implementation of the preapplication screening assessment
program.
Sec. 134. Section 602.1209, subsection 16, Code 2018, is
amended to read as follows:
16. Prescribe practices and procedures for the
implementation of the preapplication screening assessment
program referred to in sections section 125.74 and 229.5A.
DIVISION XXVII
COVERAGE OF BEHAVIORAL HEALTH SERVICES PROVIDED BY CERTAIN
PROVIDERS
Sec. 135. Section 249A.15, Code 2018, is amended to read as
follows:
249A.15 Licensed psychologists eligible for payment ====
provisional licensees.
1. The department shall adopt rules pursuant to chapter
17A entitling psychologists who are licensed pursuant to
chapter 154B and psychologists who are licensed in the state
where the services are provided and have a doctorate degree
in psychology, have had at least two years of clinical
experience in a recognized health setting, or have met the
standards of a national register of health service providers
in psychology, to payment for services provided to recipients
of medical assistance, subject to limitations and exclusions
the department finds necessary on the basis of federal laws and
regulations and of funds available for the medical assistance
program. The rules shall also provide that an individual, who
holds a provisional license to practice psychology pursuant
to section 154B.6, is entitled to payment under this section
for services provided to recipients of medical assistance,
when such services are provided under the supervision of a
supervisor who meets the qualifications determined by the board
of psychology by rule, and claims for payment for such services
are submitted by the supervisor.
2. Entitlement to payment under this section is applicable
to services provided to recipients of medical assistance
under both the fee=for=service and managed care payment and
delivery systems. Neither the fee=for=service nor the managed
care payment and delivery system shall impose a practice
or supervision restriction which is inconsistent with or
more restrictive than the authority already granted by law,
including the authority to provide supervision in person or
remotely through electronic means as specified by rule of the
board of psychology.
Sec. 136. Section 249A.15A, Code 2018, is amended to read
as follows:
249A.15A Licensed marital and family therapists, licensed
master social workers, licensed mental health counselors, and
certified alcohol and drug counselors ==== temporary licensees.
1. The department shall adopt rules pursuant to chapter
17A entitling marital and family therapists who are licensed
pursuant to chapter 154D to payment for behavioral health
services provided to recipients of medical assistance, subject
to limitations and exclusions the department finds necessary
on the basis of federal laws and regulations. The rules shall
also provide that a marital and family therapist, who holds
a temporary license to practice marital and family therapy
pursuant to section 154D.7, is entitled to payment under this
section for behavioral health services provided to recipients
of medical assistance, when such services are provided under
the supervision of a qualified supervisor as determined by the
board of behavioral science by rule, and claims for payment for
such services are submitted by the qualified supervisor.
2. The department shall adopt rules pursuant to chapter
17A entitling master social workers who hold a master's
degree approved by the board of social work, are licensed as
a master social worker pursuant to section 154C.3, subsection
1, paragraph "b", and provide treatment services under the
supervision of an independent social worker licensed pursuant
to section 154C.3, subsection 1, paragraph "c", to payment
for behavioral health services provided to recipients of
medical assistance, subject to limitations and exclusions the
department finds necessary on the basis of federal laws and
regulations.
3. The department shall adopt rules pursuant to chapter 17A
entitling mental health counselors who are licensed pursuant
to chapter 154D to payment for behavioral health services
provided to recipients of medical assistance, subject to
limitations and exclusions the department finds necessary on
the basis of federal laws and regulations. The rules shall
also provide that a mental health counselor, who holds a
temporary license to practice mental health counseling pursuant
to section 154D.7, is entitled to payment under this section
for behavioral health services provided to recipients of
medical assistance, when such services are provided under the
supervision of a qualified supervisor as determined by the
board of behavioral science by rule, and claims for payment for
such services are submitted by the qualified supervisor.
4. The department shall adopt rules pursuant to chapter 17A
entitling alcohol and drug counselors who are certified by the
nongovernmental Iowa board of substance abuse certification to
payment for behavioral health services provided to recipients
of medical assistance, subject to limitations and exclusions
the department finds necessary on the basis of federal laws and
regulations.
5. Entitlement to payment under this section is applicable
to services provided to recipients of medical assistance
under both the fee=for=service and managed care payment and
delivery systems. Neither the fee=for=service nor the managed
care payment and delivery system shall impose a practice
or supervision restriction which is inconsistent with or
more restrictive than the authority already granted by law,
including the authority to provide supervision in person or
remotely through electronic means as specified by rule of the
applicable licensing board.
Sec. 137. NEW SECTION. 514C.32 Services provided by
certain licensed master social workers, licensed mental health
counselors, and licensed marital and family therapists.
1. Notwithstanding section 514C.6, a policy or contract
providing for third=party payment or prepayment of health or
medical expenses shall include a provision for the payment of
necessary behavioral health services provided by any of the
following:
a. A licensed master social worker who is licensed by the
board of social work as a master social worker pursuant to
section 154C.3, subsection 1, paragraph "b", and who provides
services under the supervision of an independent social worker
licensed pursuant to section 154C.3, subsection 1, paragraph
"c".
b. A licensed mental health counselor or a licensed
marital and family therapist who holds a temporary license to
practice mental health counseling or marital and family therapy
pursuant to section 154D.7, and who provides services under
the supervision of a qualified supervisor as determined by the
board of behavioral science by rule.
2. A policy or contract subject to this section shall
not impose a practice or supervision restriction which is
inconsistent with or more restrictive than the authority
already granted by law, including the authority to provide
supervision in person or remotely through electronic means as
specified by rule of the applicable licensing board.
3. The requirements of this section apply to and supersede
any conflicting requirements regarding services provided under
a policy or contract, which is delivered, issued for delivery,
continued, or renewed in this state on or after the effective
date of this Act, and apply to and supersede any conflicting
requirements regarding services contained in an existing policy
or contract on the policy's or contract's anniversary or
renewal date, whichever is later.
4. For the purposes of this section, third=party payment or
prepayment includes an individual or group policy of accident
or health insurance or individual or group hospital or health
care service contract issued pursuant to chapter 509, 514, or
514A, an individual or group health maintenance organization
contract issued and regulated under chapter 514B, or a
preferred provider organization contract regulated pursuant to
chapter 514F.
5. Nothing in this section shall be interpreted to require
an individual or group health maintenance organization or a
preferred provider organization or arrangement to provide
payment or prepayment for services provided by a licensed
master social worker providing behavioral health services
under the supervision of an independent social worker, or to
a licensed mental health counselor or licensed marital and
family therapist who holds a temporary license to practice
mental health counseling or marital and family therapy
providing behavioral health services under the supervision of
a qualified supervisor, as specified in this section, unless
the supervising independent social worker or the qualified
supervisor, respectively, has entered into a contract or other
agreement to provide behavioral health services with the
individual or group health maintenance organization or the
preferred provider organization or arrangement.
Sec. 138. NEW SECTION. 514C.33 Services provided by
provisionally licensed psychologists.
1. Notwithstanding section 514C.6, a policy or contract
providing for third=party payment or prepayment of health or
medical expenses shall include a provision for the payment of
necessary behavioral health services provided by a person who
holds a provisional license to practice psychology pursuant to
section 154B.6, and who practices under the supervision of a
supervisor who meets the qualifications determined by the board
of psychology by rule.
2. A policy or contract subject to this section shall
not impose a practice or supervision restriction which is
inconsistent with or more restrictive than the authority
already granted by law, including the authority to provide
supervision in person or remotely through electronic means as
specified by rule of the board of psychology.
3. The requirements of this section apply to and supersede
any conflicting requirements regarding services provided under
a policy or contract which is delivered, issued for delivery,
continued, or renewed in this state on or after the effective
date of this Act, and apply to and supersede any conflicting
requirements regarding services contained in an existing policy
or contract on the policy's or contract's anniversary or
renewal date, whichever is later.
4. For the purposes of this section, third=party payment or
prepayment includes an individual or group policy of accident
or health insurance or individual or group hospital or health
care service contract issued pursuant to chapter 509, 514, or
514A, an individual or group health maintenance organization
contract issued and regulated under chapter 514B, or a
preferred provider organization contract regulated pursuant to
chapter 514F.
5. Nothing in this section shall be interpreted to require
an individual or group health maintenance organization or a
preferred provider organization or arrangement to provide
payment or prepayment for services provided by a provisionally
licensed psychologist providing behavioral health services
under the supervision of a supervisor as specified in this
section, unless the supervisor has entered into a contract or
other agreement to provide behavioral health services with the
individual or group health maintenance organization or the
preferred provider organization or arrangement.
Sec. 139. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XXVIII
PHARMACY BENEFITS MANAGER ==== RIGHTS OF COVERED INDIVIDUALS
Sec. 140. NEW SECTION. 510B.10 Rights related to covered
individuals.
1. A pharmacy or pharmacist, as defined in section 155A.3,
has the right to provide a covered individual information
regarding the amount of the covered individual's cost share
for a prescription drug. A pharmacy benefits manager shall
not prohibit a pharmacy or pharmacist from discussing any such
information or from selling a more affordable alternative to
the covered individual, if one is available.
2. A health benefit plan, as defined in section 514J.102,
issued or renewed on or after July 1, 2018, that provides
coverage for pharmacy benefits shall not require a covered
individual to pay a copayment for pharmacy benefits that
exceeds the pharmacy's or pharmacist's submitted charges.
3. Any amount paid by a covered individual for a covered
prescription drug pursuant to this section shall be applied
toward any deductible imposed by the covered individual's
health benefit plan in accordance with the covered individual's
health benefit plan coverage documents.
4. To the extent that any provision of this section is
inconsistent or conflicts with applicable federal law, rule,
or regulation, such federal law, rule, or regulation shall
prevail to the extent necessary to eliminate the inconsistency
or conflict.
DIVISION XXIX
FOSTER CARE AND ADOPTED CHILDREN
Sec. 141. FOSTER CARE AND ADOPTED CHILDREN ==== ANNUAL MEDICAL
VISIT.
1. The department of human services shall adopt rules
pursuant to chapter 17A to require every child receiving foster
care to receive an annual visit to a medical professional.
2. The department shall submit a request to the United
States department of health and human services to allow the
department to adopt rules requiring a child adopted from foster
care and whose parents receive an adoption subsidy to receive
an annual visit to a medical professional.
CHARLES SCHNEIDER
President of the Senate
LINDA UPMEYER
Speaker of the House
I hereby certify that this bill originated in the Senate and
is known as Senate File 2418, Eighty=seventh General Assembly.
W. CHARLES SMITHSON
Secretary of the Senate
Approved , 2018
KIM REYNOLDS
Governor
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