Relating to and making appropriations to the department of veterans affairs and the department of health and human services, including aging and disability services, behavioral health, public health, and community access and eligibility; the medical assistance program, state supplementary assistance, Hawki, and other health-related programs; family well-being and protection; state-operated specialty care; administration and compliance; transfers, cash flow, and nonreversions; report on nonreversion of moneys; more options for maternal support program; reimbursement rates review; mental diseases exclusion waiver; full-time equivalent dashboard; comprehensive family support program; federal community mental health services block grant; behavioral health expenditure report; opioid settlement fund; emergency rules; graduate medical education; and special population nursing facilities; and including effective date and retroactive applicability provisions

This bill makes appropriations from the general fund of the state to the department of veterans affairs and to the department of health and human services (HHS) for FY 2026-2027. The appropriations from the general fund of the state to the department of veterans affairs include appropriations for administration, the Iowa veterans home, and the home ownership assistance program. The appropriations from the general fund of the state to HHS include appropriations for aging and disability services; behavioral health; public health; community access and eligibility including for child support services; the medical assistance program, state supplementary assistance, the healthy and well kids in Iowa (Hawki) program, and other specified health-related programs including health program operations; family well-being and protection including state child care assistance, early intervention and supports, and child protective services; state-operated specialty care; and administration and compliance. The bill also makes appropriations to HHS from the sports wagering receipts fund, the pharmaceutical settlement account, the quality assurance trust fund, the hospital health care access trust fund, and behavioral health fund. In addition, the bill appropriates to HHS the moneys received by the state under the federal temporary assistance for needy families block grant. The bill includes transfer, cash flow, and nonreversion provisions. The bill requires HHS to report to the general assembly quarterly on expenditure of moneys for which nonreversion authorization is provided for the fiscal year beginning July 1, 2026, and ending June 30, 2027. The bill includes certain requirements for HHS to report and set certain provider reimbursement rates. The bill requires HHS to apply, no later than July 1, 2027, to the federal government for a waiver of Medicaid’s institution for mental diseases exclusion. The bill requires HHS, by July 1, 2026, to reimburse community health centers to at least the same rate that substantially similar behavioral health services are reimbursed by Medicaid. The bill requires HHS to create a dashboard on HHS’s internet site with information related to full-time equivalent positions within the department. The bill creates a comprehensive family support program. Under current law, a certain amount of the federal community mental health services block grant is allocated for distribution to the state’s accredited community mental health centers for federal FY 2025-2026. The bill also applies the allocation to federal FY 2026-2027. The bill eliminates child welfare and juvenile justice decategorization initiative projects and appropriates carryover funding to HHS and juvenile court services. The bill requires the county to pay the cost of transport to a detention location by the sheriff for certain persons with a substance abuse disorder or serious mental impairment prior to a commitment hearing. The bill requires HHS to annually submit a report to the general assembly, no later than December 15, that summarizes HHS’s expenditures to provide behavioral health services to adults and children for the immediately preceding fiscal year. The bill appropriates moneys to HHS from the opioid settlement fund.