HF 653 — A bill for an act relating to appropriations for health and human services and veterans and including other related provisions and appropriations, providing penalties, and including effective date and retroactive and other applicability date provisions. (Formerly HSB 206.) Item vetoed. Various effective dates, see bill.

Of the funds appropriated in this subsection, $76,231 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 HFand 653specialties (2)through 87various -11-formats pf/hb/rn/mdincluding 11/151online H.F.access, community colleges, and other venues;

653 and specialties through various formats including online access, community colleges, and other venues;

Of the funds appropriated in this subsection, $191,188 shall be allocated for continuation of the contract with anHouse independentFile statewide653, directp. care worker organization previously selected through a request for proposals process.

12 an independent statewide direct care worker organization previously selected through a request for proposals process.

Of the funds appropriated in this subsection, $96,138 shall be used for continuation of a grant to a nationally affiliated volunteer eye organization that has an established HFprogram 653for (2)children 87and -12-adults pf/hb/rn/mdand 12/151that H.F.is solely dedicated to preserving sight and preventing blindness through education, nationally certified vision screening and training, and community and patient service programs.

653 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.

and the continuing needs ofHouse theFile program.653, p.

13 of the program.

Moneys in the HFemergency 653medical (2)services 87fund -13-are pf/hb/rn/mdappropriated 13/151to H.F.the department to be used for the purposes of the fund.

653 emergency medical services fund are appropriated to the department to be used for the purposes of the fund.

Pursuant to the directive under 2014 Iowa Acts, chapter 1140, section 102, the federal matching funds available to theHouse stateFile poison653, controlp. 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.

14 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.

HFThe 653university (2)of 87Iowa -14-hospitals pf/hb/rn/mdand 14/151clinics H.F.billings to the department shall be on at least a quarterly basis.

653 The university of Iowa hospitals and clinics billings to the department shall be on at least a quarterly basis.

DIVISIONHouse IVFile DEPARTMENT653, OFp. VETERANS AFFAIRS —— FY 2017-2018 Sec.

15 DIVISION IV DEPARTMENT OF VETERANS AFFAIRS —— FY 2017-2018 Sec.

FTEs 15.00 HF2. 653 (2) 87 -15- pf/hb/rn/md 15/151 H.F.

653 2.

HOME OWNERSHIP ASSISTANCE PROGRAM For transfer to the Iowa finance authority for the continuation of the home ownership assistance program for personsHouse whoFile are653, orp. were eligible members of the armed forces of the United States, pursuant to section 16.54:

16 persons who are or were eligible members of the armed forces of the United States, pursuant to section 16.54:

HFFor 653the (2)county 87commissions -16-of pf/hb/rn/mdveteran 16/151affairs H.F.fund under section 35A.16:

653 For the county commissions of veteran affairs fund under section 35A.16:

$ 2,898,980 Notwithstanding section 8.33, moneys appropriated in this subsectionHouse thatFile remain653, unencumberedp. 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.

17 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.

HF4. 653 (2) 87 -17- pf/hb/rn/md 17/151 H.F.

653 4.

$ 1,930,067 Pregnancy prevention grants shall be awarded to programs inHouse existenceFile on653, orp. before July 1, 2017, if the programs have demonstrated positive outcomes.

Grants18 shallin beexistence awardedon toor HFbefore 653July (2)1, 872017, -18-if pf/hb/rn/mdthe 18/151programs H.F.have demonstrated positive outcomes.

653Grants 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.

For the purposes of this subsection, the funds appropriated in subsection 6, paragraph “a”, for transfer to the child care and development block grant HFappropriation 653are (2)considered 87fully -19-expended pf/hb/rn/mdwhen 19/151the H.F.full amount has been transferred.

653House appropriationFile are653, consideredp. fully expended when the full amount has been transferred.

19 b.

Moneys credited to the family investment program (FIP) HFaccount 653for (2)the 87fiscal -20-year pf/hb/rn/mdbeginning 20/151July H.F.1, 2017, and ending June 30, 2018, shall be used to provide assistance in accordance with chapter 239B.

653 account for the fiscal year beginning July 1, 2017, and ending June 30, 2018, shall be used to provide assistance in accordance with chapter 239B.

3.House File 653, p.

20 3.

HF(3) 653The (2)department 87of -21-human pf/hb/rn/mdrights 21/151may H.F.engage in activities to strengthen and improve family outcomes measures and data collection systems under the family development and self-sufficiency grant program.

653 (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.

$ 815,000 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 administerHouse theFile FIP653, diversionp. program.

21 administer the FIP diversion program.

(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 HFassistance 653program (2)requirements. 87 -22- pf/hb/rn/md 22/151 H.F.

653 assistance program requirements.

Of the remainder of the assigned child support collections received by the child support recovery unit, a portion shall be credited to the FIP account, a portion may be used to increase recoveries, and a portionHouse mayFile be653, usedp. to sustain cash flow in the child support payments account.

22 portion may be used to sustain cash flow in the child support payments account.

To be credited to the family investment program (FIP) account and used for family investment program assistance under HFchapter 653239B: (2) 87 -23- pf/hb/rn/md 23/151 H.F.

653 chapter 239B:

or to maximize the use of federal funds, theHouse departmentFile of653, humanp. services may transfer funds within or between any of the appropriations made in this division of this Act and appropriations in law for the federal social services block grant to the department for the following purposes, provided that the combined amount of state and federal temporary assistance for needy families block grant funding for each appropriation remains the same before and after the transfer:

23 the department of human services may transfer funds within or between any of the appropriations made in this division of this Act and appropriations in law for the federal social services block grant to the department for the following purposes, provided that the combined amount of state and federal temporary assistance for needy families block grant funding for each appropriation remains the same before and after the transfer:

HF4. 653 (2) 87 -24- pf/hb/rn/md 24/151 H.F.

653 4.

The department may transfer funds appropriated in this section to the appropriations made in this division of this Act forHouse generalFile administration653, andp. field operations as necessary to administer this section and the overall family investment program.

24 for general administration and field operations as necessary to administer this section and the overall family investment program.

FTEs 459.00 HF1. 653 (2) 87 -25- pf/hb/rn/md 25/151 H.F.

653 1.

Notwithstanding 441 IAC 100.8, providing for termination of rulesHouse relatingFile to653, thep. pilot projects, the rules shall remain in effect until June 30, 2018.

25 rules relating to the pilot projects, the rules shall remain in effect until June 30, 2018.

Any funds remaining in the health care trust fund created in section 453A.35A for the fiscal year beginning July 1, 2017, and ending June 30, 2018, are appropriated to the department of human services to supplement the medical assistance program appropriations made in this division of this Act, for medical assistance reimbursement and associated costs, HFincluding 653program (2)administration 87and -26-costs pf/hb/rn/mdassociated 26/151with H.F.program implementation.

653 including program administration and costs associated with program implementation.

The provisions of this section relating to abortions shall also apply to the Iowa health and wellness plan created pursuantHouse toFile chapter653, 249N.p.

26 pursuant to chapter 249N.

The department shall utilize not more than $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 HF409, 653subsection (2)6. 87 -27- pf/hb/rn/md 27/151 H.F.

653 409, subsection 6.

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 ageHouse whoFile have653, beenp. approved for additional assistance through HF 653 (2) 87 -28- pf/hb/rn/md 28/151 H.F.

65327 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.

Of the funds appropriated in this section, a sufficient amount is allocated to supplement the incomes of residents of nursing facilities, intermediate care facilities for persons with mental illness, and intermediate care facilities for HFpersons 653with (2)an 87intellectual -29-disability, pf/hb/rn/mdwith 29/151incomes H.F.of less than $50 in the amount necessary for the residents to receive a personal needs allowance of $50 per month pursuant to section House File 653, p.

65328 persons with an intellectual disability, with incomes of less than $50 in the amount necessary for the residents to receive a personal needs allowance of $50 per month pursuant to section 249A.30A.

A portion of the funds appropriated in this section HFmay 653be (2)transferred 87to -30-the pf/hb/rn/mdappropriation 30/151in H.F.this division of this Act for medical contracts to be used for administrative activities associated with the money follows the person demonstration project.

653 may be transferred to the appropriation in this division of this Act for medical contracts to be used for administrative activities associated with the money follows the person demonstration project.

Of the funds appropriated in this section, $349,011 shall be used for the administration of the health insurance premium payment program, including salaries, support, maintenance,House andFile miscellaneous653, purposes.p.

29 maintenance, and miscellaneous purposes.

Each January 1, thereafter, the department shall apply the applicable Medicare anesthesia HFconversion 653factor (2)adjusted 87for -31-the pf/hb/rn/mdstate, 31/151and H.F.converted to a per minute amount.

653 conversion factor adjusted for the state, and converted to a per minute amount.

If federal approval is received, an applicant’s Medicaid coverageHouse shallFile be653, effectivep. on the first day of the month of application, as allowed under the Medicaid state plan.

30 coverage shall be effective on the first day of the month of application, as allowed under the Medicaid state plan.

For the fiscal year beginning July 1, 2017, and ending HFJune 65330, (2)2018, 87the -32-replacement pf/hb/rn/mdgeneration 32/151tax H.F.revenues required to be deposited in the property tax relief fund pursuant to section 437A.8, subsection 4, paragraph “d”, and section 437A.15, subsection 3, paragraph “f”, shall instead be credited to and supplement the appropriation made in this section and used for the allocations made in this section.

653 June 30, 2018, the replacement generation tax revenues required to be deposited in the property tax relief fund pursuant to section 437A.8, subsection 4, paragraph “d”, and section 437A.15, subsection 3, paragraph “f”, shall instead be credited to and supplement the appropriation made in this section and used for the allocations made in this section.

Of the funds appropriated in this section, up to $400,000 mayHouse beFile transferred653, byp. 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.

31 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.

Of the funds appropriated in this section, $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 HFpoverty 653level (2)as 87defined -33-by pf/hb/rn/mdthe 33/151most H.F.recently revised poverty income guidelines published by the United States department of health and human services.

653 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 shall report the implementation of any processHouse improvementFile changes653, andp. any related cost reductions to the individuals specified in this division of this Act for submission of reports upon implementation.

32 process improvement changes and any related cost reductions to the individuals specified in this division of this Act for submission of reports upon implementation.

The department of human services shall include in the Medicaid managed care contracts beginning with the contract period effective July 1, 2017, per member per month capitation payments to managed care organizations that encourage the utilization of home and community-based services as an HFalternative 653to (2)residential 87care -34-for pf/hb/rn/mdmembers. 34/151 H.F.

653 alternative to residential care for members.

The department of human services is solely responsibleHouse forFile distributing653, thep. federal matching funds for such activities.

33 responsible for distributing the federal matching funds for such activities.

Of the amount appropriated in this section, up to $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 HFand 653oversight (2)of 87managed -35-care pf/hb/rn/mdprograms, 35/151and H.F.development of health strategies targeted toward improved quality and reduced costs in the Medicaid program.

653 and oversight of managed care programs, and development of health strategies targeted toward improved quality and reduced costs in the Medicaid program.

Of the funds allocated in this subsection, $25,000 shall be used for the public purpose of continuation of a grant to a child welfare services provider headquartered in a county with a population between 205,000 and 215,000 in the latest certified federal census that provides multiple services including but not limited to a psychiatric medical institution for children, shelter, residential treatment, after school programs, school-based programming, and an Asperger’s syndrome program, to be used for support services for children with autismHouse spectrumFile disorder653, andp. their families.

34 autism spectrum disorder and their families.

Of the funds allocated in this subsection, $25,000 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 HFone’s 653lifespan. (2) 87 -36- pf/hb/rn/md 36/151 H.F.

653 one’s lifespan.

§1382g, the department may take actions including but not limited to increasing the personal needs allowance for residential care facility residents and making programmatic adjustmentsHouse orFile upward653, adjustmentsp. of the residential care facility or in-home health-related care reimbursement rates prescribed in this division of this Act to ensure that federal requirements are met.

In35 addition,adjustments or upward adjustments of the departmentresidential maycare makefacility HFor 653in-home (2)health-related 87care -37-reimbursement pf/hb/rn/mdrates 37/151prescribed H.F.in this division of this Act to ensure that federal requirements are met.

653In addition, the department may make other programmatic and rate adjustments necessary to remain within the amount appropriated in this section while ensuring compliance with federal requirements.

Any state obligation to provide services pursuant to this section is limited to the extent of the funds appropriated HFHouse 653File (2)653, 87p. -38- pf/hb/rn/md 38/151 H.F.

65336 in this section.

If a uniform reduction ordered by the governor under section 8.31 or other operation of law, transfer, or federal funding reduction reduces the appropriation made in this HFsection 653for (2)the 87fiscal -39-year, pf/hb/rn/mdthe 39/151percentage H.F.reduction in the amount paid out to or on behalf of the families participating in the state child care assistance program shall be equal to or less than the percentage reduction made for any other purpose House File 653, p.

65337 section for the fiscal year, the percentage reduction in the amount paid out to or on behalf of the families participating in the state child care assistance program shall be equal to or less than the percentage reduction made for any other purpose payable from the appropriation made in this section and the federal funding relating to it.

$ 11,350,443 HF............................................... 653 (2) 87 -40- pf/hb/rn/md 40/151 H.F.

653 ...............................................

A portion of the moneys appropriated in this section shall be used by the state training school at Eldora for grantsHouse forFile adolescent653, pregnancyp. prevention activities at the institution in the fiscal year beginning July 1, 2017.

38 grants for adolescent pregnancy prevention activities at the institution in the fiscal year beginning July 1, 2017.

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 HFor 653the (2)child 87welfare -41-emergency pf/hb/rn/mdservices 41/151addressed H.F.with the allocation for shelter care.

653 or the child welfare emergency services addressed with the allocation for shelter care.

The department and juvenile court services shall initiateHouse actionFile to653, setp. dispositional review hearings for the placements identified.

39 initiate action to set dispositional review hearings for the placements identified.

Federal funds received by the state during the fiscal HFyear 653beginning (2)July 871, -42-2017, pf/hb/rn/mdas 42/151the H.F.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.

653 year beginning July 1, 2017, 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.

Of the amount allocated in this paragraph “a”, up to $1,556,287House shallFile be653, madep. available to provide school-based supervision of children adjudicated under chapter 232, of which not more than $15,000 may be used for the purpose of training.

40 $1,556,287 shall be made available to provide school-based supervision of children adjudicated under chapter 232, of which not more than $15,000 may be used for the purpose of training.

The state court administrator and the division administrator shall make the determination of the HFdistribution 653amounts (2)on 87or -43-before pf/hb/rn/mdJune 43/15115, H.F.2017.

653 distribution amounts on or before June 15, 2017.

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 enteredHouse underFile chapter653, 232p. which is a charge upon the state under section 232.141, subsection 4.

41 entered under chapter 232 which is a charge upon the state under section 232.141, subsection 4.

IV-E match for juvenile court services administration may be used for the juvenile delinquent HFgraduated 653sanctions (2)services. 87 -44- pf/hb/rn/md 44/151 H.F.

653 graduated sanctions services.

Of the funds appropriated in this section, $227,337 shallHouse beFile used653, forp. 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.

42 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.

Of the funds appropriated in this section, $202,000 is HFallocated 653for (2)use 87pursuant -45-to pf/hb/rn/mdsection 45/151235A.1 H.F.for continuation of the initiative to address child sexual abuse implemented pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 21.

653 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.

22.House File 653, p.

43 22.

Of the funds appropriated in this section, $110,000 HFshall 653be (2)used 87for -46-the pf/hb/rn/mdpublic 46/151purpose H.F.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, 2017.

653 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, 2017.

§673(a)(8), that remain unencumberedHouse orFile unobligated653, atp. the close of the fiscal year, shall not revert to any fund but shall remain available for the purposes designated in this subsection until expended.

The44 HFunencumbered 653or (2)unobligated 87at -47-the pf/hb/rn/mdclose 47/151of H.F.the fiscal year, shall not revert to any fund but shall remain available for the purposes designated in this subsection until expended.

653The amount of such savings and any corresponding funds remaining at the close of the fiscal year shall be determined separately and any changes in either amount between fiscal years shall not result in an unfunded need.

Notwithstanding section 232.142, subsection 3, the HFfinancial 653aid (2)payable 87by -48-the pf/hb/rn/mdstate 48/151under H.F.that provision for the House File 653, p.

65345 financial aid payable by the state under that provision for the fiscal year beginning July 1, 2017, shall be limited to the amount appropriated for the purposes of this section.

HF1. 653 (2) 87 -49- pf/hb/rn/md 49/151 H.F.

653 1.

a.House File 653, p.

46 a.

For the state resource center at Glenwood for salaries, HFsupport, 653maintenance, (2)and 87miscellaneous -50-purposes: pf/hb/rn/md 50/151 H.F.

653 support, maintenance, and miscellaneous purposes:

The department may continue to bill for state resource center services utilizing a scope of services approach used for private providers of intermediate care facilities for persons with an intellectual disability services, in a manner which doesHouse notFile shift653, costsp. between the medical assistance program, counties, or other sources of funding for the state resource centers.

47 does not shift costs between the medical assistance program, counties, or other sources of funding for the state resource centers.

If existing capacity limitations are reached in operating units, a waiting list is in effect for a service or a special need for which a payment source or other funding is available for the service or to address the special need, and facilities for the service or to address the special need HFcan 653be (2)provided 87within -51-the pf/hb/rn/mdavailable 51/151payment H.F.source or other funding, the superintendent of a state resource center may authorize opening not more than two units or other facilities and begin implementing the service or addressing the special need during fiscal year 2017-2018.

653 can be provided within the available payment source or other funding, the superintendent of a state resource center may authorize opening not more than two units or other facilities and begin implementing the service or addressing the special need during fiscal year 2017-2018.

For costs associated with the commitment and treatment of sexually violent predators in the unit located at the state mentalHouse healthFile institute653, atp. 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:

48 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:

For field operations, including salaries, support, maintenance, and miscellaneous purposes, and for not more than HFthe 653following (2)full-time 87equivalent -52-positions: pf/hb/rn/md 52/151 H.F.

653 the following full-time equivalent positions:

The department shall report at least monthly to the legislativeHouse servicesFile agency653, concerningp. the department’s operational and program expenditures.

49 legislative services agency concerning the department’s operational and program expenditures.

HF5. 653 (2) 87 -53- pf/hb/rn/md 53/151 H.F.

653 5.

There is appropriated from the general fund of the state to the department of human servicesHouse forFile the653, fiscalp. year beginning July 1, 2017, and ending June 30, 2018, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

50 services for the fiscal year beginning July 1, 2017, and ending June 30, 2018, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

$ 84,686 HFSec. 653 (2) 87 -54- pf/hb/rn/md 54/151 H.F.

653 Sec.

The department shall then calculate adjusted reimbursement rates, including but not limited to add-on-payments,House annually,File and653, shallp. notify Medicaid managed care organizations of the adjusted reimbursement rates within 30 days of determining the adjusted reimbursement rates.

51 add-on-payments, annually, and shall notify Medicaid managed care organizations of the adjusted reimbursement rates within 30 days of determining the adjusted reimbursement rates.

HF(2) 653For (2)any 87open -55-or pf/hb/rn/mdunsettled 55/151nursing H.F.facility cost report for a fiscal year prior to and including the fiscal year beginning July 1, 2016, including any cost report remanded on judicial review for inclusion of prescription drug, laboratory, or x-ray costs, the department shall offset all reported prescription drug, laboratory, and x-ray costs with any revenue received from Medicare or other revenue source for any purpose.

653 (2) For any open or unsettled nursing facility cost report for a fiscal year prior to and including the fiscal year beginning July 1, 2016, including any cost report remanded on judicial review for inclusion of prescription drug, laboratory, or x-ray costs, the department shall offset all reported prescription drug, laboratory, and x-ray costs with any revenue received from Medicare or other revenue source for any purpose.

(2) The department shall utilize an average acquisition costHouse reimbursementFile methodology653, forp. all drugs covered under the medical assistance program in accordance with 2012 Iowa Acts, chapter 1133, section 33.

52 cost reimbursement methodology for all drugs covered under the medical assistance program in accordance with 2012 Iowa Acts, chapter 1133, section 33.

(1) For the fiscal year beginning July 1, 2017, reimbursement rates for outpatient hospital services shall be rebased effective January 1, 2018, subject to Medicaid HFprogram 653upper (2)payment 87limit -56-rules, pf/hb/rn/mdand 56/151adjusted H.F.as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.

653 program upper payment limit rules, and adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.

(1) For the fiscal year beginning July 1, 2017, reimbursement rates for home health agencies shall continue to beHouse basedFile on653, thep. Medicare low utilization payment adjustment (LUPA) methodology with state geographic wage adjustments.

HF53 653be (2)based 87on -57-the pf/hb/rn/mdMedicare 57/151low H.F.utilization payment adjustment (LUPA) methodology with state geographic wage adjustments.

653 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.

For the fiscal year beginning July 1, 2017, unless otherwise specified in this Act, all noninstitutional medical assistance provider reimbursement rates shall remain at the rates in effect on June 30, 2017, 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 HFproviders, 653and (2)those 87providers -58-whose pf/hb/rn/mdrates 58/151are H.F.required to be determined pursuant to section 249A.20.

653House providers,File and653, thosep. providers whose rates are required to be determined pursuant to section 249A.20.

54 k.

HF(2) 653In (2)accordance 87with -59-the pf/hb/rn/mdalternative 59/151reimbursement H.F.rate methodology approved by the department of human services in effect on June 30, 2017.

653 (2) In accordance with the alternative reimbursement rate methodology approved by the department of human services in effect on June 30, 2017.

For the fiscal year beginning July 1, 2017, the reimbursement rate for providers of family planning services that are eligible to receive a 90 percent federal match shall remainHouse atFile the653, ratesp. in effect on June 30, 2017.

55 remain at the rates in effect on June 30, 2017.

Notwithstanding section 234.38, for the fiscal year beginning July 1, 2017, the foster family basic daily maintenance rate and the maximum adoption subsidy rate for children ages 0 through 5 years shall be $16.78, the rate for children ages 6 through 11 years shall be $17.45, the rate for HFchildren 653ages (2)12 87through -60-15 pf/hb/rn/mdyears 60/151shall H.F.be $19.10, and the rate for children and young adults ages 16 and older shall be $19.35.

653 children ages 12 through 15 years shall be $19.10, and the rate for children and young adults ages 16 and older shall be $19.35.

For the fiscal year beginning July 1, 2017, the maximum reimbursementHouse ratesFile for653, socialp. services providers under contract shall remain at the rates in effect on June 30, 2017, or the provider’s actual and allowable cost plus inflation for each service, whichever is less.

56 reimbursement rates for social services providers under contract shall remain at the rates in effect on June 30, 2017, or the provider’s actual and allowable cost plus inflation for each service, whichever is less.

Unless a group foster care provider is subject to the exception provided in paragraph “a”, effective July 1, 2017, HFthe 653combined (2)reimbursement 87rates -61-for pf/hb/rn/mdthe 61/151service H.F.levels under the department’s reimbursement methodology shall be as follows:

653 the combined reimbursement rates for the service levels under the department’s reimbursement methodology shall be as follows:

The payment of the daily rate shallHouse beFile based653, onp. the number of days in the calendar month in which service is provided.

57 shall be based on the number of days in the calendar month in which service is provided.

HF10. 653 (2) 87 -62- pf/hb/rn/md 62/151 H.F.

653 10.

For the fiscal year beginning July 1, 2017, affected providersHouse orFile services653, shallp. be reimbursed as follows:

58 providers or services shall be reimbursed as follows:

Notwithstanding any provision to the contrary, reimbursement rates and methodologies under this section may HFbe 653adjusted (2)as 87necessary -63-to pf/hb/rn/mdimplement 63/151the H.F.cost containment strategies authorized for the medical assistance program in this 2017 Act.

653 be adjusted as necessary to implement the cost containment strategies authorized for the medical assistance program in this 2017 Act.

The delay authority provided to the administrative rules review committee under section 17A.4, subsection 7, and section 17A.8, subsection 9, shall be applicable to a delay imposed under this section, notwithstandingHouse aFile provision653, inp. those sections making them inapplicable to section 17A.5, subsection 2, paragraph “b”.

59 notwithstanding a provision in those sections making them inapplicable to section 17A.5, subsection 2, paragraph “b”.

If during a fiscal year, the department of human services is adopting rules in accordance with this section or as otherwise directed or authorized by state law, and the rules will result in an expenditure increase beyond the amount anticipated in the budget process or if the expenditure was not addressed in the budget process for the fiscal year, the department shall notify the persons designated by this division of this Act for submission of reports, the chairpersons and HFranking 653members (2)of 87the -64-committees pf/hb/rn/mdon 64/151appropriations, H.F.and the department of management concerning the rules and the expenditure increase.

653 ranking members of the committees on appropriations, and the department of management concerning the rules and the expenditure increase.

The department of human services shallHouse reportFile any653, transfersp. made pursuant to this section to the legislative services agency.

60 shall report any transfers made pursuant to this section to the legislative services agency.

The provision relating to section 232.141 and directing the state court administrator and the division administrator of the department of human services division of child and family services to make the determination, by June 15, 2017, of the HFdistribution 653of (2)funds 87allocated -65-for pf/hb/rn/mdthe 65/151payment H.F.of the expenses of court-ordered services provided to juveniles which are a charge upon the state.

653 distribution of funds allocated for the payment of the expenses of court-ordered services provided to juveniles which are a charge upon the state.

Notwithstanding any provision to theHouse contraryFile and653, subjectp. 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, 2017, and ending June 30, 2018, the following amounts, or so much thereof as is HF 653 (2) 87 -66- pf/hb/rn/md 66/151 H.F.

65361 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, 2017, and ending June 30, 2018, the following amounts, or so much thereof as is necessary, 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-timeHouse equivalentFile positions:653, p.

HF62 653full-time (2)equivalent 87positions: -67- pf/hb/rn/md 67/151 H.F.

653 ..................................................

The procedures shall provide that if any funds are expended in a manner that is not in compliance with the procedures and applicable federal and state laws, rules, and HFregulations, 653and (2)are 87subsequently -68-subject pf/hb/rn/mdto 68/151repayment, H.F.the area agency on aging expending such funds in contravention of such procedures, laws, rules and regulations, not the state, House File 653, p.

65363 regulations, and are subsequently subject to repayment, the area agency on aging expending such funds in contravention of such procedures, laws, rules and regulations, not the state, shall be liable for such repayment.

HFDIVISION 653VIII (2)OFFICE 87OF -69-LONG-TERM pf/hb/rn/mdCARE 69/151OMBUDSMAN H.F.—— FY 2018-2019 Sec.

653 DIVISION VIII OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2018-2019 Sec.

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:House File 653, p.

64 designated:

Activities HFof 653the (2)programs 87and -70-initiatives pf/hb/rn/mdshall 70/151be H.F.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.

653 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.

The department shall track and report to the individuals specified in this Act, any reduction in theHouse provisionFile of653, nicotinep. replacement products realized by the initiative through implementation of the prerequisite screening.

65 the provision of nicotine replacement products realized by the initiative through implementation of the prerequisite screening.

Of the funds appropriated in this subsection, $10,482,303 shall be used for problem gambling and substance-related disorder prevention, treatment, and recovery HFservices, 653including (2)a 8724-hour -71-helpline, pf/hb/rn/mdpublic 71/151information H.F.resources, professional training, youth prevention, and program evaluation.

653 services, including a 24-hour helpline, public information resources, professional training, youth prevention, and program evaluation.

FTEs 12.00 a.House File 653, p.

66 a.

The funds shall be used first to fully fund the current sites to ensure that the sites are fully operational, with the remaining funds HFto 653be (2)used 87for -72-expansion pf/hb/rn/mdto 72/151additional H.F.sites.

653 to be used for expansion to additional sites.

To the maximum extent possible, funding allocated in this paragraph shall be utilized asHouse matchingFile funds653, forp. medical assistance program reimbursement.

67 as matching funds for medical assistance program reimbursement.

The university of Iowa college of dentistry shall coordinate efforts with the HFdepartment 653of (2)public 87health, -73-bureau pf/hb/rn/mdof 73/151oral H.F.and health delivery systems, to provide dental care to underserved populations throughout the state.

653 department of public health, bureau of oral and health delivery systems, to provide dental care to underserved populations throughout the state.

Of the funds appropriated in this subsection, $76,877 shall be used for grants to individual patients who have an inherited metabolic disorder to assist with the costs of medicallyHouse necessaryFile foods653, andp. formula.

68 medically necessary foods and formula.

Of the amount allocated in this paragraph, $47,500 shall be used to fund one full-time equivalent position to serve as the state brain injury services HFprogram 653manager. (2) 87 -74- pf/hb/rn/md 74/151 H.F.

653 program manager.

Of the funds appropriated in this subsection, $288,687 shallHouse beFile used653, forp. the comprehensive cancer control program to reduce the burden of cancer in Iowa through prevention, early detection, effective treatment, and ensuring quality of life.

69 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 appropriated in this subsection, $48,766 HFshall 653be (2)used 87for -75-cervical pf/hb/rn/mdand 75/151colon H.F.cancer screening, and $88,860 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.

653 shall be used for cervical and colon cancer screening, and $88,860 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.

The report shall includeHouse theFile objectives653, andp. results for the program year including the target population and how the funds allocated assisted the program in meeting the objectives;

70 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;

HFthe 653type (2)of 87services -76-provided pf/hb/rn/mdto 76/151the H.F.individuals served;

653 the type of services provided to the individuals served;

(2) Not less than $167,435 is allocated to free clinics and free clinics of Iowa for necessary infrastructure, statewide HFHouse 653File (2)653, 87p. -77- pf/hb/rn/md 77/151 H.F.

65371 coordination, provider recruitment, service delivery, and provision of assistance to patients in securing a medical home inclusive of oral health care.

Of the funds appropriated in this subsection, the department may use up to $29,087 for up to one full-time HFequivalent 653position (2)to 87administer -78-the pf/hb/rn/mdvolunteer 78/151health H.F.care provider program pursuant to section 135.24.

653 equivalent position to administer the volunteer health care provider program pursuant to section 135.24.

Of the funds appropriated in this subsection, $48,069 shall be used for a matching dental education loan repayment programHouse toFile be653, allocatedp. to a dental nonprofit health service corporation to continue to develop the criteria and implement the loan repayment program.

72 program to be allocated to a dental nonprofit health service corporation to continue to develop the criteria and implement the loan repayment program.

Of the funds appropriated in this subsection, $436,327 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 HFhealth 653to (2)be 87used -79-for pf/hb/rn/mdthe 79/151purposes H.F.of the medical residency training state matching grants program as specified in section 135.176.

653 health to be used for the purposes of the medical residency training state matching grants program as specified in section 135.176.

..................................................House File 653, p.

73 ..................................................

The amount allocated in this paragraph “b” HFshall 653not (2)be 87used -80-to pf/hb/rn/mdsupplant 80/151funding H.F.administered for other sexual violence prevention or victims assistance programs.

653 shall not be used to supplant funding administered for other sexual violence prevention or victims assistance programs.

d.House File 653, p.

74 d.

TRANSFERS Notwithstanding section 8.39, for the fiscal year beginning HFJuly 6531, (2)2018, 87the -81-department pf/hb/rn/mdmay 81/151transfer H.F.funds within or between any of the allocations or appropriations made in this division of this Act for the same fiscal year, to be used in accordance with departmental priorities as specified in the department’s report to the general assembly submitted pursuant to 2016 Iowa Acts, chapter 1139, section 3.

653 July 1, 2018, the department may transfer funds within or between any of the allocations or appropriations made in this division of this Act for the same fiscal year, to be used in accordance with departmental priorities as specified in the department’s report to the general assembly submitted pursuant to 2016 Iowa Acts, chapter 1139, section 3.

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, orHouse soFile much653, thereofp. as is necessary, to be used for the purposes designated:

75 or so much thereof as is necessary, to be used for the purposes designated:

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 HFspouses 653who (2)are 87participating -82-in pf/hb/rn/mdthe 82/151community H.F.reentry program.

653 spouses who are participating in the community reentry program.

Notwithstanding the standing appropriation in section 35A.16 for the fiscal year beginningHouse JulyFile 1,653, 2018,p. 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:

76 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:

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 HFResponsibility 653and (2)Work 87Opportunity -83-Reconciliation pf/hb/rn/mdAct 83/151of H.F.1996, Pub.

653 Responsibility and Work Opportunity Reconciliation Act of 1996, Pub.

4.House File 653, p.

77 4.

Of this HFamount, 653$100,000 (2)shall 87be -84-used pf/hb/rn/mdfor 84/151provision H.F.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.

653 amount, $100,000 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.

Grants shall comply with the requirements provided in 1997 Iowa Acts, chapter 208, sectionHouse 14,File subsections653, 1p. and 2, including the requirement that grant programs must emphasize sexual abstinence.

78 section 14, subsections 1 and 2, including the requirement that grant programs must emphasize sexual abstinence.

For technology needs and other resources necessary HFto 653meet (2)federal 87welfare -85-reform pf/hb/rn/mdreporting, 85/151tracking, H.F.and case management requirements:

653 to meet federal welfare reform reporting, tracking, and case management requirements:

Of the amounts appropriated in this section, $6,481,004 for the fiscal year beginning July 1, 2018, is transferred to theHouse appropriationFile of653, thep. federal social services block grant made to the department of human services for that fiscal year.

79 the appropriation of the federal social services block grant made to the department of human services for that fiscal year.

For continuation of the program providing categorical HFeligibility 653for (2)the 87food -86-assistance pf/hb/rn/mdprogram 86/151as H.F.specified for the program in the section of this division of this Act relating to the family investment program account:

653 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:

The department may transfer funds allocated in subsection 4 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 family investment program services referred to in this section and those funded in the appropriation made in this HFdivision 653of (2)this 87Act -87-for pf/hb/rn/mdthe 87/151same H.F.fiscal year for the family House File 653, p.

65380 division of this Act for the same fiscal year for the family investment program from the general fund of the state.

To the extent moneys allocated in this paragraph “c” are deemed by the department HFnot 653to (2)be 87necessary -88-to pf/hb/rn/mdsupport 88/151diversion H.F.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 House File 653, p.

65381 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.

Of the remainder of the assigned child support collections received by the child HFsupport 653recovery (2)unit, 87a -89-portion pf/hb/rn/mdshall 89/151be H.F.credited to the FIP account, a portion may be used to increase recoveries, and a portion may be used to sustain cash flow in the child support payments account.

653 support recovery unit, a portion shall be credited to the FIP account, a portion may be used to increase recoveries, and a portion may be used to sustain cash flow in the child support payments account.

If child support collections assigned under FIP are greater than estimated or are otherwise determinedHouse notFile to653, bep. required for maintenance of effort, the state share of either amount may be transferred to or retained in the child support payments account.

82 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.

Notwithstanding section 8.39, for the fiscal year beginning July 1, 2018, if necessary to meet federal maintenance of effort requirements or to transfer federal temporary assistance for needy families block grant funding to be used for purposes of the federal social services block HFgrant 653or (2)to 87meet -90-cash pf/hb/rn/mdflow 90/151needs H.F.resulting from delays in receiving federal funding or to implement, in accordance with this division of this Act, activities currently funded with juvenile court services, county, or community moneys and state moneys used in combination with such moneys;

653 grant or to meet cash flow needs resulting from delays in receiving federal funding or to implement, in accordance with this division of this Act, activities currently funded with juvenile court services, county, or community moneys and state moneys used in combination with such moneys;

or to maximize the use of federal funds, the department of human services may transfer funds within or between any of the appropriations made in this division of this Act and appropriations in law for the federal social services block grant to the department for the following purposes, provided that the combined amount of state and federal temporary assistance for needy families block grant funding for each appropriation remains the same before and after the transfer:House File 653, p.

83 transfer:

Of the funds appropriated in this section, $30,000 shall be used for the continuation of an unfunded pilot project, as defined in 441 IAC 100.1, 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, HFhealthy 653living, (2)and 87social -91-responsibility pf/hb/rn/mdheadquartered 91/151in H.F.a county with a population over 350,000 according to the latest certified federal census.

653 healthy living, and social responsibility headquartered in a county with a population over 350,000 according to the latest certified federal census.

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,House toFile be653, usedp. for the purposes designated:

84 necessary, to be used for the purposes designated:

Federal access and visitation grant moneys shall be issued directly to private not-for-profit agencies that provide services designed to increase compliance with the child access HFprovisions 653of (2)court 87orders, -92-including pf/hb/rn/mdbut 92/151not H.F.limited to neutral visitation sites and mediation services.

653 provisions of court orders, including but not limited to neutral visitation sites and mediation services.

Any funds remaining in the health care trust fund created in section 453A.35A for the fiscal year beginning July 1, 2018, and ending June 30, 2019, are appropriated to the department of human services to supplement the medical assistanceHouse programFile appropriations653, madep. in this division of this Act, for medical assistance reimbursement and associated costs, including program administration and costs associated with program implementation.

85 assistance program appropriations made in this division of this Act, for medical assistance reimbursement and associated costs, including program administration and costs associated with program implementation.

There is appropriated from the HFgeneral 653fund (2)of 87the -93-state pf/hb/rn/mdto 93/151the H.F.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:

653 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:

Of the funds allocated in this subsection, not more than $2,500 may be expended for administrative purposes.House File 653, p.

86 purposes.

Each department shall take the steps HFnecessary 653to (2)continue 87the -94-federal pf/hb/rn/mdwaivers 94/151as H.F.necessary to maintain the level of services.

653 necessary to continue the federal waivers as necessary to maintain the level of services.

Of the funds appropriated in this section, up to $1,525,041 may be transferred to the field operations or general administration appropriations in this division of this ActHouse forFile operational653, costsp. associated with Part D of the federal Medicare Prescription Drug Improvement and Modernization Act of 2003, Pub.

87 Act for operational costs associated with Part D of the federal Medicare Prescription Drug Improvement and Modernization Act of 2003, Pub.

Of the funds appropriated in this section, up to $221,050 may be transferred to the appropriation in this division of this Act for medical contracts to be used for clinical HFassessment 653services (2)and 87prior -95-authorization pf/hb/rn/mdof 95/151services. H.F.

653 assessment services and prior authorization of services.

TheHouse hospitalsFile that653, meetp. the conditions specified shall receive and retain 100 percent of the total disproportionate share HF 653 (2) 87 -96- pf/hb/rn/md 96/151 H.F.

65388 The hospitals that meet the conditions specified shall receive and retain 100 percent of the total disproportionate share hospital payment in an amount up to the hospital-specific limit as approved in the Medicaid state plan.

The department shall HFreport 653any (2)such 87increase -97-to pf/hb/rn/mdthe 97/151legislative H.F.services agency and the department of management.

653House reportFile any653, suchp. increase to the legislative services agency and the department of management.

89 b.

Of the funds appropriated in this section, up to $1,500,000 may be transferred by the department to the HFappropriations 653made (2)in 87this -98-division pf/hb/rn/mdof 98/151this H.F.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.

653House appropriationsFile made653, inp. 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.

90 18.

There is appropriated from the general fund of the state to the department of human services HFfor 653the (2)fiscal 87year -99-beginning pf/hb/rn/mdJuly 99/1511, H.F.2018, and ending June 30, 2019, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

653 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:

The department of human services is solely responsible for distributing the federal matching funds for suchHouse activities.File 653, p.

91 such activities.

Of the funds allocated in this subsection, $125,000 shall be deposited in the board-certified behavior analyst and HFboard-certified 653assistant (2)behavior 87analyst -100-grants pf/hb/rn/mdprogram 100/151fund H.F.created in section 135.181, to be used for the purposes of the fund.

653 board-certified assistant behavior analyst grants program fund created in section 135.181, to be used for the purposes of the fund.

Of the funds allocated in this subsection, $12,500 shallHouse beFile used653, forp. 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.

92 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.

HF.................................................. 653 (2) 87 -101- pf/hb/rn/md 101/151 H.F.

653 ..................................................

§1382g, the department may take actions including but not limited to increasing the personal needs allowance for residential care facility residents and making programmatic adjustments or upward adjustments of the residential care facility or in-home health-related care reimbursement rates prescribedHouse inFile this653, divisionp. of this Act to ensure that federal requirements are met.

93 prescribed in this division of this Act to ensure that federal requirements are met.

HF.................................................. 653 (2) 87 -102- pf/hb/rn/md 102/151 H.F.

653 ..................................................

A list of the registered and licensed child care facilitiesHouse operatingFile in653, thep. area served by a child care resource and referral service shall be made available to the families receiving state child care assistance in that area.

94 facilities operating in the area served by a child care resource and referral service shall be made available to the families receiving state child care assistance in that area.

The department may use any of the funds appropriated in this section as a match to obtain federal funds for use in HFexpanding 653child (2)care 87assistance -103-and pf/hb/rn/mdrelated 103/151programs. H.F.

653 expanding child care assistance and related programs.

The percentage reduction to theHouse otherFile allocations653, madep. in this section shall be the same as the uniform reduction ordered by the governor or the percentage change of the federal funding reduction, as applicable.

95 the other allocations made in this section shall be the same as the uniform reduction ordered by the governor or the percentage change of the federal funding reduction, as applicable.

If the appropriations made for purposes of the state child care assistance program for the fiscal year are determined to be insufficient, it is the intent of the general HFassembly 653to (2)appropriate 87sufficient -104-funding pf/hb/rn/mdfor 104/151the H.F.fiscal year in order to avoid establishment of waiting list requirements.

653 assembly to appropriate sufficient funding for the fiscal year in order to avoid establishment of waiting list requirements.

Sec.House File 653, p.

96 Sec.

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 HFpurpose 653designated: (2) 87 -105- pf/hb/rn/md 105/151 H.F.

653 purpose designated:

In such a dispositional review hearing, theHouse juvenileFile court653, shallp. determine whether needed aftercare HF 653 (2) 87 -106- pf/hb/rn/md 106/151 H.F.

65397 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.

Of the funds appropriated in this section, up to $1,645,000 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, HFsubsection 6534. (2) 87 -107- pf/hb/rn/md 107/151 H.F.

653Of subsectionthe 4.amount allocated in this paragraph “a”, up to $778,143 shall be made available to provide school-based supervision of children adjudicated under chapter 232, of which House File 653, p.

Of98 the amount allocated in this paragraph “a”, up to $778,143 shall be made available to provide school-based supervision of children adjudicated under chapter 232, of which not more than $7,500 may be used for the purpose of training.

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 HFfunds 653between (2)the 87judicial -108-districts’ pf/hb/rn/mdor 108/151departmental H.F.service areas’ distribution amounts as prudent.

653 funds between the judicial districts’ or departmental service areas’ distribution amounts as prudent.

f.House File 653, p.

99 f.

IV-E of the federal Social HFSecurity 653Act (2)to 87enable -109-providers pf/hb/rn/mdto 109/151serve H.F.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.

653 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.

Of the funds appropriated in this section, $113,668 shall be used for the public purpose of continuing a grant to a nonprofit human services organization providing services to individualsHouse andFile families653, inp. 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.

100 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.

Of the funds appropriated in this section, at least $73,579 shall be used for the continuation of the child HFwelfare 653provider (2)training 87academy, -110-a pf/hb/rn/mdcollaboration 110/151between H.F.the coalition for family and children’s services in Iowa and the department.

653 welfare provider training academy, a collaboration between the coalition for family and children’s services in Iowa and the department.

Of the funds appropriated in this section, at least $12,500 shall be used to continue and to expand the foster careHouse respiteFile pilot653, programp. 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.

101 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.

HFa. 653 (2) 87 -111- pf/hb/rn/md 111/151 H.F.

653 a.

§673(a)(8), that remain unencumbered or unobligated at the close of the fiscal year, shall not revert to any fund but shall remain available for the purposesHouse designatedFile in653, thisp. subsection until expended.

102 purposes designated in this subsection until expended.

Notwithstanding section 8.33, moneys received in accordance HFwith 653this (2)subsection 87that -112-remain pf/hb/rn/mdunencumbered 112/151or H.F.unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

653 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 expenditure for the purposes designated until the close of the succeeding fiscal year.

Sec.House File 653, p.

103 Sec.

At least $393,750 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 HFsupport 653program (2)under 87chapter -113-225C, pf/hb/rn/mdsubchapter 113/151V. H.F.

653 support program under chapter 225C, subchapter V.

For operation of the state mental health institute at Cherokee as required by chapters 218 and 226 for salaries, support,House maintenance,File and653, miscellaneousp. purposes, and for not more than the following full-time equivalent positions:

104 support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

HF.................................................. 653 (2) 87 -114- pf/hb/rn/md 114/151 H.F.

653 ..................................................

The department may continue to bill for state resource center services utilizing a scope of services approach used for private providers of intermediate care facilities for persons with an intellectual disability services, in a manner which does not shift costs between the medical assistance program, counties, or other sources of funding for the state resource centers.House File 653, p.

105 centers.

If the department’s administration and the department HFof 653management (2)concur 87with -115-a pf/hb/rn/mdfinding 115/151by H.F.a state resource center’s superintendent that projected revenues can reasonably be expected to pay the salary and support costs for a new employee position, or that such costs for adding a particular number of new positions for the fiscal year would be less than the overtime costs if new positions would not be added, the superintendent may add the new position or positions.

653 of management concur with a finding by a state resource center’s superintendent that projected revenues can reasonably be expected to pay the salary and support costs for a new employee position, or that such costs for adding a particular number of new positions for the fiscal year would be less than the overtime costs if new positions would not be added, the superintendent may add the new position or positions.

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, HFHouse 653File (2)653, 87p. -116- pf/hb/rn/md 116/151 H.F.

653106 support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

$ 7,016,520 HF............................................... 653 (2) 87 -117- pf/hb/rn/md 117/151 H.F.

653 ...............................................

2.House File 653, p.

107 2.

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 HFJune 65330, (2)2019, 87the -118-following pf/hb/rn/mdamount, 118/151or H.F.so much thereof as is necessary, to be used for the purposes designated:

653 June 30, 2019, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

There is appropriated from the general fund of the state to the department of human services for the fiscalHouse yearFile beginning653, Julyp. 1, 2018, and ending June 30, 2019, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

108 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:

The department shall then calculate adjusted reimbursement rates, including but not limited to add-on-payments, annually, and shall notify Medicaid managed care organizations of the adjusted reimbursement rates within 30 days of determining the adjusted HFreimbursement 653rates. (2) 87 -119- pf/hb/rn/md 119/151 H.F.

653 reimbursement rates.

For purposes of this subparagraph, a nursing facility cost report is not considered open or unsettled if the facility did notHouse initiateFile an653, administrativep. appeal under chapter 17A or if any appeal rights initiated have been exhausted.

109 not initiate an administrative appeal under chapter 17A or if any appeal rights initiated have been exhausted.

HF(2) 653For (2)the 87fiscal -120-year pf/hb/rn/mdbeginning 120/151July H.F.1, 2018, reimbursement rates for inpatient hospital services shall be rebased effective October 1, 2018, subject to Medicaid program upper payment limit rules, and adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.

653 (2) For the fiscal year beginning July 1, 2018, reimbursement rates for inpatient hospital services shall be rebased effective October 1, 2018, subject to Medicaid program upper payment limit rules, and adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.

(4) In order to ensure the efficient use of limited state funds in procuring health care services for low-income Iowans, funds appropriated in this Act for hospital services shall notHouse beFile used653, forp. activities which would be excluded from a determination of reasonable costs under the federal Medicare program pursuant to 42 U.S.C.

110 not be used for activities which would be excluded from a determination of reasonable costs under the federal Medicare program pursuant to 42 U.S.C.

HF(2) 653For (2)the 87fiscal -121-year pf/hb/rn/mdbeginning 121/151July H.F.1, 2018, rates for private duty nursing and personal care services under the early and periodic screening, diagnostic, and treatment program benefit shall be calculated based on the methodology in effect on June 30, 2018.

653 (2) For the fiscal year beginning July 1, 2018, rates for private duty nursing and personal care services under the early and periodic screening, diagnostic, and treatment program benefit shall be calculated based on the methodology in effect on June 30, 2018.

(2) As a condition of participation in the medical assistance program, enrolled providers shall accept the medical assistance reimbursement rate for any covered goods or services providedHouse toFile recipients653, ofp. medical assistance who are children under the custody of a psychiatric medical institution for children.

111 provided to recipients of medical assistance who are children under the custody of a psychiatric medical institution for children.

Notwithstanding any provision to the contrary, for the fiscal year beginning July 1, 2018, the reimbursement rate HFfor 653anesthesiologists (2)shall 87be -122-adjusted pf/hb/rn/mdto 122/151implement H.F.the cost containment strategies authorized for the medical assistance program in this 2017 Act.

653 for anesthesiologists shall be adjusted to implement the cost containment strategies authorized for the medical assistance program in this 2017 Act.

and psychiatrists shall be reimbursed at the medical assistance programHouse fee-for-serviceFile rate653, inp. effect on June 30, 2018.

112 program fee-for-service rate in effect on June 30, 2018.

For the fiscal year beginning July 1, 2018, the reimbursement rate for providers of family planning services HFthat 653are (2)eligible 87to -123-receive pf/hb/rn/mda 123/15190 H.F.percent federal match shall remain at the rates in effect on June 30, 2018.

653 that are eligible to receive a 90 percent federal match shall remain at the rates in effect on June 30, 2018.

Notwithstanding section 234.38, for the fiscal year beginning July 1, 2018, the foster family basic daily maintenance rate and the maximum adoption subsidy rate for childrenHouse agesFile 0653, throughp. 5 years shall be $16.78, the rate for children ages 6 through 11 years shall be $17.43, the rate for children ages 12 through 15 years shall be $19.10, and the rate for children and young adults ages 16 and older shall be $19.35.

113 children ages 0 through 5 years shall be $16.78, the rate for children ages 6 through 11 years shall be $17.43, the rate for children ages 12 through 15 years shall be $19.10, and the rate for children and young adults ages 16 and older shall be $19.35.

The maximum payment for adoption HFsubsidy 653nonrecurring (2)expenses 87shall -124-be pf/hb/rn/mdlimited 124/151to H.F.$500 and the disallowance of additional amounts for court costs and other related legal expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall be continued.

653 subsidy nonrecurring expenses shall be limited to $500 and the disallowance of additional amounts for court costs and other related legal expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall be continued.

(1)House ForFile service653, level,p. community - D1, the daily rate shall be at least $84.17.

(2)114 (1) For service level, comprehensivecommunity - D2,D1, the daily rate HFshall 653be (2)at 87least -125-$84.17. pf/hb/rn/md 125/151 H.F.

653(2) For service level, comprehensive - D2, the daily rate shall be at least $119.09.

Beginning July 1, 2018, the rate calculation methodology shall utilize the consumer price index HFinflation 653factor (2)applicable 87to -126-the pf/hb/rn/mdfiscal 126/151year H.F.beginning July House File 653, p.

653115 inflation factor applicable to the fiscal year beginning July 1, 2018.

HFSec. 653 (2) 87 -127- pf/hb/rn/md 127/151 H.F.

653 Sec.

If specifically authorized by a provision of this division of this Act, the department of human services or the mental health and disability services commission may adopt administrative rules under section 17A.4, subsection 3,House andFile section653, 17A.5,p. subsection 2, paragraph “b”, to implement the provisions of this division of this Act and the rules shall become effective immediately upon filing or on a later effective date specified in the rules, unless the effective date of the rules is delayed or the applicability of the rules is suspended by the administrative rules review committee.

116 3, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions of this division of this Act and the rules shall become effective immediately upon filing or on a later effective date specified in the rules, unless the effective date of the rules is delayed or the applicability of the rules is suspended by the administrative rules review committee.

The notification shall be provided at least 30 calendar days prior to the date notice of the rules is submitted to the administrative rules coordinator and the HFadministrative 653code (2)editor. 87 -128- pf/hb/rn/md 128/151 H.F.

653 administrative code editor.

Sec.House File 653, p.

117 Sec.

DIVISION XII HEALTH CARE ACCOUNTS AND FUNDS —— FY 2018-2019 HFSec. 653 (2) 87 -129- pf/hb/rn/md 129/151 H.F.

653 Sec.

Notwithstanding any provision to the contrary and subjectHouse toFile the653, availabilityp. 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:

118 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:

$ 16,960,277 HFSec. 653 (2) 87 -130- pf/hb/rn/md 130/151 H.F.

653 Sec.

Notwithstanding section 237A.4A, subsection 5, Code 2017, for the fiscal year beginning July 1, 2017, and endingHouse JuneFile 30,653, 2018,p. in addition to the costs of dedicated staffing to perform the duties described in section 237A.4A, up to $590,082 of the moneys in the child care facility fund may be used by the department of human services for additional expenditures of the child care regulatory unit within the department’s field operations.

119 ending June 30, 2018, in addition to the costs of dedicated staffing to perform the duties described in section 237A.4A, up to $590,082 of the moneys in the child care facility fund may be used by the department of human services for additional expenditures of the child care regulatory unit within the department’s field operations.

The committee shall develop the preferred drug list by considering each drug’s clinically meaningful therapeutic advantages in terms of safety, effectiveness, and clinical HFoutcome. 653 (2) 87 -131- pf/hb/rn/md 131/151 H.F.

653 outcome.

The department may procure a sole source contract with an outside entity or contractor to provide professional administrative support to the pharmaceutical and therapeutics committee in researching and recommending drugs to be placed on theHouse preferredFile drug653, list.p.

120 the preferred drug list.

2017 Iowa Acts, House File 531, section 2, HFsubsection 6531, (2)as 87enacted, -132-is pf/hb/rn/mdamended 132/151to H.F.read as follows:

653 subsection 1, as enacted, is amended to read as follows:

The departments shall submit a report to theHouse governorFile and653, thep. general assembly by December 15, 2017, including a description of the process used in reviewing private sector alternatives to perform criminal background checks, the findings from the review, and recommendations for utilizing private sector entities as an alternative to the department of public safety in performing criminal background checks.

121 the governor and the general assembly by December 15, 2017, including a description of the process used in reviewing private sector alternatives to perform criminal background checks, the findings from the review, and recommendations for utilizing private sector entities as an alternative to the department of public safety in performing criminal background checks.

DEPARTMENT OF HUMAN SERVICES PSYCHIATRIC BED HFTRACKING 653SYSTEM. (2) 87 -133- pf/hb/rn/md 133/151 H.F.

653 TRACKING SYSTEM.

A well-being collaborative shall be responsible for developing interagency coordination and collaboration for theHouse provisionFile of653, preventionp. and early intervention services within the designated geographic area and shall, at a minimum, demonstrate all of the following:

122 the provision of prevention and early intervention services within the designated geographic area and shall, at a minimum, demonstrate all of the following:

HFb. 653 (2) 87 -134- pf/hb/rn/md 134/151 H.F.

653 b.

The development, implementation, and analysis of a community work plan based on the results of the community needs assessment.House File 653, p.

123 assessment.

The adoption or development and implementation of a HFuniform 653family (2)assessment. 87 -135- pf/hb/rn/md 135/151 H.F.

653 uniform family assessment.

The state program shall replicate the eligibility requirements and other provisions included in the Medicaid family planning network waiver as approved by the centers for HFMedicare 653and (2)Medicaid 87services -136-of pf/hb/rn/mdthe 136/151United H.F.States department of health and human services in effect on June 30, 2017.

653House MedicareFile and653, Medicaidp. services of the United States department of health and human services in effect on June 30, 2017.

124 2.

HFDIVISION 653XX (2)MEDICAID 87HOME -137-AND pf/hb/rn/mdCOMMUNITY-BASED 137/151SERVICES H.F.PROVIDERS —— TIERED RATES AND DOCUMENTATION CHANGES Sec.

653 DIVISION XX MEDICAID HOME AND COMMUNITY-BASED SERVICES PROVIDERS —— TIERED RATES AND DOCUMENTATION CHANGES Sec.

1.House File 653, p.

125 1.

HFd. 653 (2) 87 -138- pf/hb/rn/md 138/151 H.F.

653 d.

The department of human services may adopt emergency rulesHouse underFile section653, 17A.4,p. subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions of this division of this Act, and the rules shall be effective immediately upon filing unless a later date is specified in the rules.

126 rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions of this division of this Act, and the rules shall be effective immediately upon filing unless a later date is specified in the rules.

The study committee shall consult with stakeholders to evaluate the benefits of telehealth parity within the context of the needs of Iowans such as access to health care, review existing policies related to telehealth reimbursement and the impact on private insurance and state employee health plans, consider the costs associated with telehealth service utilization, consider telehealth’s potential impact to economic development opportunities for Iowa’s rural communities, and evaluate obstacles such as broadband HFaccessibility. 653 (2) 87 -139- pf/hb/rn/md 139/151 H.F.

653 accessibility.

(b) The co-chairpersons and ranking members of the joint appropriations subcommittee on health and human services, or a member of the subcommittee designated by the co-chairperson or rankingHouse member.File 653, p.

127 ranking member.

(4) The commissioner of insurance or the commissioner’s HFdesignee. 653 (2) 87 -140- pf/hb/rn/md 140/151 H.F.

653 designee.

The department onHouse aging,File the653, departmentp. of public health, the department of inspections and appeals, and the department of human services shall jointly analyze and make recommendations regarding options for coordination between state agencies and private entities to promote increased access to dementia-specific care in both residential and home and community-based settings.

128 on aging, the department of public health, the department of inspections and appeals, and the department of human services shall jointly analyze and make recommendations regarding options for coordination between state agencies and private entities to promote increased access to dementia-specific care in both residential and home and community-based settings.

Section 135.159, subsection 3, paragraph i, Code HF2017, 653is (2)amended 87to -141-read pf/hb/rn/mdas 141/151follows: H.F.

653 2017, is amended to read as follows:

Notwithstanding section 8.33, moneys corresponding to the state savings resulting from implementation of the federal Fostering Connections to Success andHouse IncreasingFile Adoptions653, Actp. of 2008, Pub.

129 and Increasing Adoptions Act of 2008, Pub.

Notwithstanding section 232.188, subsection 5, paragraph “b”, any state appropriated moneys in the funding HFpool 653that (2)remained 87unencumbered -142-or pf/hb/rn/mdunobligated 142/151at H.F.the close of the fiscal year beginning July 1, 2014, 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, 2016, shall not revert but shall be transferred to the medical assistance program for the fiscal year beginning July 1, 2017.

653 pool that remained unencumbered or unobligated at the close of the fiscal year beginning July 1, 2014, 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, 2016, shall not revert but shall be transferred to the medical assistance program for the fiscal year beginning July 1, 2017.