Relating to matters under the purview of the department of health and human services, including administrative services organizations, child foster care, child and dependent adult abuse, internal audit and examination information, and the region incentive fund in the mental health and disability services regional service fund, health maintenance organization’s premium tax, and making appropriations and including effective date and retroactive applicability provisions

This bill relates to matters under the purview of the department of health and human services (HHS). DIVISION I —— ADMINISTRATIVE SERVICES ORGANIZATIONS. The bill excludes persons employed by an administrative services organization (ASO) from the definition of an employee for the purposes of the Iowa public employees’ retirement system. The bill defines “behavioral health district” and “disability access point”. The bill prohibits an ASO, an officer or an employee of an ASO, or an officer or an employee of a disability access point from acting as a county’s advocate to represent the interests of patients involuntarily hospitalized by the court in matters relating to a patient’s hospitalization or treatment. DIVISION II —— CHILD FOSTER CARE. Under current law, a person’s periodic support payments pursuant to an order or judgment are deemed assigned to HHS if the person is or has a child receiving foster care services. The assignment does not apply when a child is placed with a relative or fictive kin of the child who is not licensed to provide child foster care. The bill permits the assignment unless the relative or fictive kin is not licensed to provide child foster care and is not an approved kinship caregiver. The bill defines “approval” as the authorization granted to a kinship caregiver by HHS through an expedited process under Code chapter 237 to receive maximum financial support and to obtain the information and resources necessary to meet the needs of a child under a court-ordered placement with the kinship caregiver. The bill defines “fictive kin” as an adult person who is not a relative of a child but who has an emotionally positive significant relationship with the child or the child’s family. The bill defines “foster family home” as a licensed single-family home environment in which child foster care is provided. The bill defines “individual” as a natural person or a married couple. The bill defines “kinship caregiver” as a relative or fictive kin of a child. The bill defines “license” as the authorization issued to an individual or an agency by HHS to provide child foster care. The bill defines “relative” as an individual related to a child within the fourth degree of consanguinity or affinity by marriage or through adoption. The bill also defines “agency licensee”, “approved kinship caregiver”, and “individual licensee”.3 (streamlined sales and use tax Act —— exemptions). DIVISION III —— CHILD AND DEPENDENT ADULT ABUSE. The bill requires HHS to adopt rules to administer the child protection center grant program. The bill allows a community-based entity to apply for and receive funds appropriated to HHS by the general assembly for child abuse prevention. Under current law, only a community-based volunteer coalition or council can apply for and receive such funds. The bill makes child abuse information, and information obtained in the course of an assessment or evaluation of a report of dependent adult abuse, confidential records. The bill defines “exploitation of a dependent adult” as a fraudulent or otherwise illegal, unauthorized, or improper attempt, act, or process by a caretaker or fiduciary to use the physical or financial resources of a dependent adult for the purpose of monetary or personal benefit, profit, or gain, or to deprive the dependent adult of the use of the dependent adult’s physical or financial resources, including any benefits, belongings, or assets. Under current law, upon a showing of probable cause that a dependent adult has been financially exploited a court may authorize a person, who is also authorized by HHS, to gain access to the financial records of the dependent adult. The bill amends the statute so the person authorized by the court and HHS can gain access to financial records that HHS has a reasonable belief are related to the financial resources of the dependent adult. The bill authorizes an instrumentality of the state to access dependent adult abuse records. The bill requires the director of HHS to require providers under the medical assistance program to share information with HHS as necessary to identify, prevent, or respond to child or dependent adult abuse. DIVISION IV —— DEPARTMENT OF HEALTH AND HUMAN SERVICES —— INTERNAL AUDITS AND EXAMINATIONS. The bill requires an internal audit or examination conducted by or on behalf of HHS to be conducted in accordance with the most recent global internal audit standards published by the institute of internal auditors. The bill requires information created or received by HHS in the course of an internal audit or examination conducted by or on behalf of HHS, including allegations of misconduct or noncompliance, and all internal audit or examination workpapers, to be treated as confidential.41. Information shared with the auditor may not be disclosed by the auditor unless the director of HHS authorizes the disclosure in writing or the information is contained in HHS’s final report for the internal audit or examination. DIVISION V —— REGION INCENTIVE FUND —— DISTRIBUTIONS AND TRANSFERS. The bill appropriates from the region incentive fund of the mental health and disability services regional service fund to HHS for FY 2024-2025, an amount as necessary to ensure the continuity of care for persons transferring services from the mental health and disability services system to the behavioral health services system (BHSS) and for distribution to ASOs to be used for expenses related to the duties of the ASO under the BHSS. The moneys used by an ASO do not count toward any limit on the ASO’s administrative costs. The bill requires any unobligated and unencumbered moneys remaining in the mental health and disability services regional service fund on June 30, 2025, to be transferred to the behavioral health fund. This division of the bill is effective upon enactment and applies retroactively to July 1, 2024. DIVISION VI —— HEALTH MAINTENANCE ORGANIZATION —— APPLICABLE PERCENTAGE FOR PREMIUM TAX.5 percent of the premiums received and taxable. The bill changes such amount to the applicable percent of the premiums received and taxable.9 percent for the 2027 calendar year and all subsequent calendar years. This division of the bill is effective upon enactment and applies retroactively to January 1, 2024.