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Amendments › HF 2698

Amendment H-8348 to HF 2698

Relating to and making appropriations for veterans and health and human services, including other related provisions and appropriations including but not limited to the personal needs allowance for certain persons under Medicaid and the state supplementary assistance programs, replacement generation tax revenues, the Medicaid fraud and health care trust funds, the retention of certain revenues by the mental health institutes, the retention of Medicaid eligibility by residents of mental health institutes, the scope of services of the state resource centers, the appropriation of moneys in the juvenile detention home fund, the family investment program account and diversion program, the child support collection services center refund account, the quality assurance assessment payment period, the centers of excellence grant program, an assisted living program revised payment model study, funding for county commissions of veteran affairs, foster care provisions including those relating to a relative or fictive kin, health care employment agencies and health care technology platforms, medical cannabidiol practitioner requirements, nursing facility oversight, and state-funded psychiatry residency and fellowship positions, providing penalties, and including effective date and retroactive applicability provisions

Adopted · April 18, 2024Strike everything: replaces the whole bill

Filed April 18, 2024 in the House by

What it changes

  1. By striking everything after the enacting clause and inserting: “DIVISION I DEPARTMENT OF VETERANS AFFAIRS —— FY 2024-2025 Section
  2. 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, 2024, and ending June 30, 2025, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
  3. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION For salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,369,205 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00
  4. IOWA VETERANS HOME For salaries, support, maintenance, and miscellaneous purposes: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,145,736 a. The Iowa veterans home billings involving the department of health and human services shall be submitted to the department on at least a monthly basis. b. The Iowa veterans home expenditure report shall be submitted monthly to the general assembly.
  5. 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: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,200,000 DIVISION II AGING AND DISABILITY SERVICES —— FY 2024-2025 Sec.
  6. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— AGING AND DISABILITY SERVICES. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For aging programs for the department of health and human services and area agencies on aging to provide citizens of Iowa who are 60 years of age and older with case management; Iowa’s aging and disabilities resource centers; for the return to community program; for the purposes of chapter 231E, 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; for the reporting and evaluation of cases of dependant adult abuse pursuant to chapter 235B; and for other services which may include but are not limited to adult day, respite care, chore, information and assistance, and material aid, for information and options counseling for persons with disabilities, and for salaries, support, administration, maintenance, and miscellaneous purposes: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,088,714
  7. Funds appropriated in this section may be used to supplement federal funds under federal regulations. To receive funds appropriated in this section, a local area agency on aging shall match the funds with moneys from other sources according to rules adopted by the department. Funds appropriated in this section may be used for services not specifically enumerated in this section only if approved by the department as part of an area agency on aging’s area plan.
  8. Of the funds appropriated in this section, $949,282 shall be used for the family support center component of the comprehensive family support program under chapter 225C, subchapter V.
  9. Of the funds appropriated in this section, $33,632 shall be used to build 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). DIVISION III BEHAVIORAL HEALTH —— FY 2024-2025 Sec.
  10. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— BEHAVIORAL HEALTH. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For behavioral health prevention, treatment, and recovery efforts to reduce the prevalence of the use of, provide treatment for, and support recovery from tobacco and substance use and misuse pursuant to the applicable policy, purpose, and intent described in sections 125.1 and 142A.1, alcohol, problem gambling, and other addictive behaviors. Activities shall align with accepted best practice guidance standards for behavioral health including those published by the centers for disease control and prevention and the substance abuse and mental health services administration of the United States department of health and human services for health promotion; universal, selective, and indicated prevention; treatment; and recovery services and supports; and shall include a 24-hour helpline, public information resources, professional training, youth prevention, program evaluation, and efforts at the state and local levels: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,400,114
  11. Of the funds appropriated in this section, $300,000 shall be used to support the work of the children’s behavioral health system including evidence-based behavioral health prevention, treatment, and recovery services and supports for children and their families pursuant to the intent specified in section 225C.6B, subsection
  13. Of the funds appropriated in this section, $950,000 shall be used for an integrated substance use disorder managed care system. The department shall maintain the level of mental health and substance use disorder treatment services provided by the managed care contractors. The department shall take the steps necessary to continue the federal waivers as needed to maintain the level of services. Sec.
  14. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— SPORTS WAGERING RECEIPTS FUND. There is appropriated from the sports wagering receipts fund created in section 8.57, subsection 6, to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for behavioral health prevention, treatment, and recovery efforts to reduce the prevalence of the use of, provide treatment for, and support recovery from tobacco and substance use and misuse pursuant to the applicable policy, purpose, and intent described in sections 125.1 and 142A.1, alcohol, problem gambling, and other addictive behaviors: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 DIVISION IV PUBLIC HEALTH —— FY 2024-2025 Sec.
  15. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PUBLIC HEALTH. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For programs that support health promotion, protect the health and safety of the public, conduct disease surveillance and investigation to reduce the incidence of morbidity and mortality, serve individuals with chronic conditions including but not limited to cancer, support the Iowa donor registry as specified in section 142C.18, and strengthen the health care delivery system and workforce to improve health outcomes for all Iowans: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 22,531,821
  16. Of the funds appropriated in this section, $2,100,000 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 to be used for the purposes of the medical residency training state matching grants program as specified in section 135.176.
  17. Of the funds appropriated in this section, the following amounts are allocated to be used as follows to support the goals of increased access, health system integration, and engagement: a. $600,000 is allocated to the Iowa prescription drug corporation for continuation of the pharmaceutical infrastructure for safety net providers originally established as described in 2007 Iowa Acts, chapter 218, section 108, and for the prescription drug donation repository program created in chapter 135M. Funds allocated under this paragraph shall be distributed in their entirety for the purpose specified on July 1,
  18. b. $374,000 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. Of the funds allocated, $40,000 shall be used to cover fees associated with using an electronic prescribing system. Funds allocated under this paragraph shall be distributed in their entirety for the purpose specified on July 1,
  19. c. $25,000 is allocated to the Iowa association of rural health clinics for necessary infrastructure and service delivery transformation. Funds allocated under this paragraph shall be distributed in their entirety for the purpose specified on July 1,
  20. d. $225,000 is allocated to the Polk county medical society for continuation of the safety net provider patients access to specialty care initiative as described in 2007 Iowa Acts, chapter 218, section
  21. Funds allocated under this paragraph shall be distributed in their entirety for the purpose specified on July 1,
  23. Of the funds appropriated in this section, $800,000 shall be used for rural psychiatric residencies to annually fund eight psychiatric residents who will provide mental health services in underserved areas of the state.
  24. Of the funds appropriated in this section, $560,000 shall be deposited in the state-funded family medicine obstetrics fellowship program fund to be used for the state-funded family medicine obstetrics fellowship program, in accordance with section 135.193.
  25. The department shall work with the board established in chapter 135D to develop plans for program enhancements in the Iowa health information network for the purpose of empowering Iowa patients to access and direct their health information utilizing the Iowa health information network. Program enhancements shall protect data privacy, facilitate the interchange of health data for the purpose of improving public health outcomes, and increase participation by health care providers.
  26. The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the funds appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be on at least a quarterly basis. DIVISION V COMMUNITY ACCESS AND ELIGIBILITY —— FY 2024-2025 Sec.
  27. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— COMMUNITY ACCESS AND ELIGIBILITY. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for the purposes designated: To be used for salaries, support, maintenance, and miscellaneous purposes and for family investment program (FIP) assistance in accordance with chapter 239B, and for other costs associated with providing needs-based benefits or assistance including but not limited to maternal and child health, oral health, obesity prevention, the promoting independence and self-sufficiency through employment, job opportunities and basic skills (PROMISE JOBS) program, supplemental nutrition assistance program (SNAP) employment and training, the FIP diversion program, family planning, rent reimbursement, and eligibility determinations for medical assistance, food assistance, and the children’s health insurance program: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 68,043,944
  28. Of the child support collections assigned under FIP, the federal share of support collections shall be credited to the child support services appropriation made in this division of this Act. Of the remainder of the assigned child support collections received by child support services, a portion shall be credited to community access and eligibility, and the remaining funds may be used to increase recoveries, to sustain cash flow in the child support payments account, or for technology needs. If child support collections assigned under FIP are greater than estimated or are otherwise determined not to be required for maintenance of effort, the state share of either amount may be transferred to or retained in the child support payments account.
  29. Of the funds appropriated in this section, $3,075,000 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 participating counties to ensure that those counties are fully operational, with the remaining funds to be used for expanding participation to additional counties. The full implementation and expansion shall include enhancing the scope of the initiative through collaboration with the child health specialty clinics to promote the use of developmental surveillance and screening to support healthy child development through early identification and response to both biomedical and social determinants of healthy development by providing practitioner consultation and continuous improvement through training and education, particularly for children with behavioral conditions and needs. The department shall also collaborate with the Medicaid program and the child health specialty clinics to assist in coordinating the activities of the first five initiative into the establishment of patient-centered medical homes developed to improve health quality and population health while reducing health care costs. To the maximum extent possible, funding allocated in this subsection shall be utilized as matching funds for Medicaid program reimbursement.
  30. Of the funds appropriated in this section, $1,145,102 is allocated to the Iowa commission on volunteer service for programs and grants.
  31. The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the funds appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be on at least a quarterly basis. CHILD SUPPORT SERVICES Sec.
  32. CHILD SUPPORT SERVICES. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For child support services, including salaries, support, maintenance, and miscellaneous purposes: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,434,282
  33. Federal access and visitation grant moneys shall be used for services designed to increase compliance with the child access provisions of court orders, including but not limited to neutral visitation sites and mediation services.
  34. The appropriation made to the department for child support services may be used throughout the fiscal year in the manner necessary for purposes of cash flow management, and for cash flow management purposes the department may temporarily draw more than the amount appropriated, provided the amount appropriated is not exceeded at the close of the fiscal year. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT Sec.
  35. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT. There is appropriated from the special fund created in section 8.41 to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, 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:
  36. For community access and eligibility, FIP, the PROMISE JOBS program, implementing family investment agreements in accordance with chapter 239B, and for continuation of the program promoting awareness of the benefits of a healthy marriage: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,988,627
  37. For community access and eligibility to provide pregnancy prevention grants on the condition that family planning services are funded: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 Pregnancy prevention grants shall be awarded to programs in existence on or before July 1, 2024, if the programs have demonstrated positive outcomes. Grants shall be awarded to pregnancy prevention programs which are developed after July 1, 2024, 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.
  38. For community access and eligibility to meet one of the four core purposes of TANF as specified in 45 C.F.R. §260.20, including by modernizing the program to promote economic mobility and self-sufficiency, ensuring that families are able to overcome benefit cliffs, encouraging healthy families, and streamlining service delivery to reduce duplication: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,000,000
  39. For technology needs related to child support modernization of the Iowa collections and reporting (ICAR) system and for a closed loop referral system for the thrive Iowa program: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,000,000
  40. For early intervention and supports for the family development and self-sufficiency (FaDSS) grant program in accordance with section 216A.107: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 Of the funds allocated for the FaDSS grant program in this subsection, not more than 5 percent of the funds shall be used for administrative purposes.
  41. For early intervention and supports for child abuse prevention grants: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000
  42. For accountability, compliance, program integrity, technology needs, and other resources necessary to meet federal and state reporting, tracking, and case management requirements and other departmental needs: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,533,647
  43. For state child care assistance: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826
  44. For child protective services: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,364,100
  45. For child protective services for the kinship stipend program: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,000,000 DIVISION VI MEDICAL ASSISTANCE —— STATE SUPPLEMENTARY ASSISTANCE —— HEALTHY AND WELL KIDS IN IOWA PROGRAM AND OTHER HEALTH-RELATED PROGRAMS —— FY 2024-2025 Sec.
  46. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY ASSISTANCE, AND HEALTHY AND WELL KIDS IN IOWA PROGRAM. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2024, 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; for the state supplementary assistance program; for the health insurance premium payment program; and for maintenance of the healthy and well kids in Iowa (Hawki) 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; and for other specified health-related programs: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,650,866,536
  47. Of the funds appropriated in this section, $1,605,063,804 is allocated for medical assistance program reimbursement and associated costs. a. Of the funds allocated in this subsection, $800,000 shall be used for the renovation and construction of certain nursing facilities, consistent with the provisions of chapter 249K. b. Of the funds allocated in this subsection, $3,383,880 shall be used for program administration, outreach, and enrollment activities of the state family planning services program pursuant to section 217.41B, and of this amount, the department may use $200,000 for administrative expenses. c. Of the funds allocated in this subsection, $1,700,000 shall be used to provide for additional home and community-based services waiver slots for individuals with an intellectual disability.
  48. Iowans support reducing the number of abortions performed in our state. Funds appropriated under this section shall not be used for abortions, unless otherwise authorized under this section.
  49. The provisions of this section relating to abortions shall also apply to the Iowa health and wellness plan created pursuant to chapter 249N.
  50. Of the funds appropriated in this section, $4,479,762 is allocated for the state supplementary assistance program.
  51. Of the funds appropriated in this section, $41,322,970 is allocated for maintenance of the Hawki 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. HEALTH PROGRAM OPERATIONS Sec.
  52. HEALTH PROGRAM OPERATIONS. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For health program operations and the autism support program: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,597,231
  53. The department of inspections, appeals, and licensing shall provide all state matching funds for survey and certification activities performed by the department of inspections, appeals, and licensing. The department of health and human services is solely responsible for distributing the federal matching funds for such activities.
  54. Of the funds appropriated in this section, a sufficient amount shall be used for the administration of the health insurance premium payment program, including salaries, support, maintenance, and miscellaneous purposes.
  55. Of the funds appropriated in this section, $750,000 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 under the federal Children’s Health Insurance Program Reauthorization Act of 2009 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.
  56. Unless otherwise provided, annual increases for services provided through contracts funded under this section shall not exceed the amount by which the consumer price index for all urban consumers increased during the most recently ended calendar year. HEALTH CARE ACCOUNTS AND FUNDS Sec.
  57. PHARMACEUTICAL SETTLEMENT ACCOUNT —— DEPARTMENT OF HEALTH AND HUMAN SERVICES. There is appropriated from the pharmaceutical settlement account created in section 249A.33 to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, or so much thereof as is necessary, to be used for the purposes designated: Notwithstanding any provision of law to the contrary, to supplement the appropriation made in this Act for health program operations under the medical assistance program for the same fiscal year: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 Sec.
  58. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HEALTH AND 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 health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, 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 health and human services for medical assistance for the same fiscal year: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $111,216,205 Sec.
  59. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— DEPARTMENT OF HEALTH AND 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 health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, the following amount, 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 health and human services for medical assistance for the same fiscal year: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 REIMBURSEMENT RATES Sec.
  60. REIMBURSEMENT RATES.

Shortened here; the full amendment is in the official document.

Official amendment (PDF) · In the Bill Book