HF 2782 — A bill for an act 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.

5HOME 4OWNERSHIP :ASSISTANCE PROGRAM For transfer to the Iowa finance authority for the continuation of the home ownership assistance program for persons who are or were eligible members of the armed forces of the United States or eligible service members pursuant to section 16.54:

$.................................................. 2,200,000 D I V I SI IO N AGING AND DISABILITY SERVICES — FY 2026-2027 Sec.

2$ .2,200,000 DIVISION II AGING AND DISABILITY SERVICES —— FY 2026-2027 Sec.

DEPARTMENT2. O F HEALTH A N D HUMAN SERVICES — AGING AND DISABILITY SERVICES.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— AGING AND DISABILITY SERVICES.

for Iowa'sIowa’s aging and disabilities resource centers;

to administer the prevention of elder abuse, neglect, and exploitation program pursuant to section 231.56A, in accordance House PileFile 2782, p.

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

$.................................................. 19,379,531 P T E s 1 0 1 , 0 0 1.

$ 19,379,531 ...............................................

FTEs 101.00 1.

Moneys appropriated in this section may be used for services not specifically enumerated in this section only if approved by the department as part of an area agency on aging'saging’s area plan.

Of the moneys appropriated in this section, $949,282 is allocated to be used for the comprehensive family support program created in section 231,80231.80 as enacted under this Act,Act. 3.

3.

Iowa, July 15, 1994),1994). D I V I S I I I B E H A V I O R A L H F Y2 0 2 6 - 2 0 2 7 S e c .

3DDIVISION EIII P A R T O F H E A L T H AND HS E R V I C E S — BEHAVIORAL HEALTH,HEALTH There—— isFY appropriated2026-2027 fromSec. the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

3.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— BEHAVIORAL HEALTH.

There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

Activities shall align with accepted best practice guidance standards for behavioral health including those published by the centers for disease control and prevention of the United States department of health and human services, and the substance abuse and mental health services administration oof f the United States department of health and human services, for health promotion;

$.................................................. 23,127,121 F T E s 7 0 .

0$ 023,127,121 1................................................

OfFTEs the70.00 moneys1. appropriated in this section, $300,000 is allocated to support the work of the children's behavioral health system including evidence-based behavioral health prevention, treatment, and recovery services and supports for c h i l d r e their f a m i l i e s .

Of the moneys appropriated in this section, $300,000 is allocated to support the work of the children’s behavioral health system including evidence-based behavioral health prevention, treatment, and recovery services and supports for children and their families.

The department shall maintain the level of mental health and substance use disorder treatment services provided by the managed care contractors, and shall take the steps necessary to continue the federal waivers as needed to maintain tthe hlevel lof eservices. v o f s e r v i c e s .

DEPARTMENT OOF F HEALTH AAND N D HUMAN SERVICES ——— SPORTS WAGERING RECEIPTS FUND.

There is appropriated from the sports wagering receipts fund created in section 8.571,8.57I, to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for behavioral health prevention, education, early intervention.intervention, House File 2782, p.

House Pile 2782, p.

$.................................................. 1,750,000 D I V I SI VO N P U B L I C H E—A F Y2 0 2 6 - 2 0 2 7 Sec.

5$ .1,750,000 DIVISION IV PUBLIC HEALTH —— FY 2026-2027 Sec.

DEPARTMENT5. O P HEALTH AND HUMAN SERVICES — PUBLIC HEALTH.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PUBLIC HEALTH.

For programs that support health promotion, protect the health and safety of the public, conduct disease surveillance and investigation to reduce the incidence of morbidity and mortality, serve individuals with chronic conditions including but not limited to cancer, support the Iowa donor registry as specified in section 142C.18, and strengthen the health care delivery system and workforce to improve health outcomes for all lowans,Iowans, and for not more than the following full-time equivalent positions:

$.................................................. 21,168,369 P T E s 3 4 8 .

6$ 021,168,369 1................................................

FTEs 348.60 1.

Of the moneys appropriated in this section, $20,000 is allocated to make radon test kits available, free of charge.charge, House File 2782, p.

House File 2782, p.

The department shall provide a link on the department'sdepartment’s internet site for homeowners and renters in the state to order radon test kits.

DDIVISION I V ICOMMUNITY SACCESS VAND OELIGIBILITY N—— CCHILD OSUPPORT MSERVICES M—— UTANF A—— CFY C2026-2027 ESec. S S A N D E L I — IC H I L D S U P P O R T S E R V I C E S — T A N—F F Y 2 0 2 6 - 2 0 2 7 S e c .

66. D E P A R T M E N T O F H E A L S E R V I C EC O M M U N I T Y ACCESS AND ELIGIBILITY.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— COMMUNITY ACCESS AND ELIGIBILITY.

To be used for salaries, support, maintenance, and miscellaneous purposes and for family investment program (FIP) assistance in accordance with chapter 239B, and for other costs associated with providing needs-based benefits or assistance including but not limited to maternal and child health, oral health, obesity prevention, the promoting independence and self-sufficiency through employment, job opportunities and the basic skills (PROMISE JOBS) program, supplemental nutrition assistance program (SNAP) employment and training, the FIP diversion program, family planning, rent reimbursement, and eligibility determinations for medical assistance, food assistance, and the children'schildren’s health insurance program, and House File 2782, p.

$.................................................. 76,371,516 P T E s 8 8 3 .

9$ 076,371,516 1................................................

OfFTEs the883.90 child1. support collections assigned under PIP, the federal share of the child support collections shall be credited to the child support services appropriation made in this division of this Act.

Of the remainder of the child support collections assigned under PIP,FIP, athe portionfederal shallshare beof credited to community access and eligibility, and the remainingchild moneyssupport maycollections shall be usedcredited to increase recoveries, to sustain cash flow in the collectionchild support services centerappropriation refundmade account as provided in sectionthis 252B.13A,division orof forthis technologyAct. needs.

IfOf the remainder of the child support collections assigned under PIPFIP, area greaterportion thanshall estimatedbe orcredited are otherwise determined not to becommunity requiredaccess forand maintenanceeligibility, ofand efforts, the stateremaining sharemoneys ofmay eitherbe amountused is appropriated to theincrease departmentrecoveries, forto childsustain supportcash servicesflow as described in thisthe divisioncollection ofservices thiscenter Act,refund oraccount mayas beprovided transferred to or retained in thesection collection252B.13A, servicesor centerfor refundtechnology account.needs.

If child support collections assigned under FIP are greater than estimated or are otherwise determined not to be required for maintenance of efforts, the state share of either amount is appropriated to the department for child support services as described in this division of this Act, or may be transferred to or retained in the collection services center refund account.

Of the moneys appropriated in this section, $3,075,000 is allocated for continuation of the department'sdepartment’s initiative to provide for adequate developmental surveillance and screening during a child'schild’s first five years.

PullFull implementation and expansion shall include enhancing the scope of the initiative through collaboration with child health specialty clinics to promote the use of developmental surveillance and screening to support healthy child development through early identification and response to biomedical and social determinants of healthy development by providing practitioner consultation and continuous improvement through training and education, particularly for children with behavioral conditions and needs.

77. .

DEPARTMENT OOF F HEALTH AND HUMAN SERVICES ——— CHILD SUPPORT SERVICES.

$.................................................. 15,644,114 F T E s 4 6 4 .

0$ 015,644,114 1................................................

FTEs 464.00 1.

88. .

DEPARTMENT OOF F HEALTH AAND N D HUMAN SERVICES ——— TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT.

..................................................

..................................................

..................................................

..................................................

$.................................................. 3,533,647 .

$ 3,533,647 6.

..................................................

$.................................................. 65,364,100 D I V I S V I N MEDICAL ASSISTANCE PROGRAM — STATE SUPPLEMENTARY ASSISTANCE — HEALTHY AND WELL KIDS IN IOWA PROGRAM AND OTHER HEALTH-RELATED P R O G R — MF Y2 0 2 6 - 2 0 2 7 Sec.

$ 65,364,100 DIVISION VI MEDICAL ASSISTANCE PROGRAM —— STATE SUPPLEMENTARY ASSISTANCE —— HEALTHY AND WELL KIDS IN IOWA PROGRAM AND OTHER HEALTH-RELATED PROGRAMS —— FY 2026-2027 Sec.

DEPARTMENT OF HEALTH AND HUMAN SERVICES ——— MEDICAL ASSISTANCE PROGRAM, STATE SUPPLEMENTARY ASSISTANCE, AND HEALTHY AND WELL KIDS IN IOWA PROGRAM.

and for maintenance of the healthy and well kids in Iowa (Hawki) program pursuant to chapter 5141,514I, including supplemental dental services, for receipt of federal financial participation under Tit.

XXI of the federal Social Security Act, which creates the children'schildren’s health insurance program;

...............................................

lowansIowans support reducing the number of abortions performed in our state.

Moneys appropriated under this section shall not be used for abortions, unless otherwise authorized under this ssection. e c t i o n .

Of the moneys appropriated in this section, $68,474,831 is allocated for maintenance of the Hawki program pursuant to chapter 5141,514I, including supplemental dental services, for receipt of federal financial participation under Tit.

XXI of the federal Social Security Act, which creates the children'schildren’s health insurance program.

SSec. e c .

110. 0D E P A R T M E N T O F H E A L S E R V I C H E A L T H PROGRAM OPERATIONS.

ThereDEPARTMENT isOF appropriatedHEALTH fromAND theHUMAN generalSERVICES fund—— ofHEALTH thePROGRAM stateOPERATIONS. to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated;

ForThere healthis programappropriated operationsfrom andthe general fund of the autismstate supportto programthe underdepartment sectionof 225D.2,health and human services for notthe morefiscal thanyear beginning July 1, 2026, and ending June 30, 2027, the following full-timeamount, equivalentor positions;so much thereof as is necessary, to be used for the purposes designated:

$For 40,342,766health Fprogram Toperations Eand sthe 9autism 7support .program under section 225D.2, and for not more than the following full-time equivalent positions:

0.................................................. 0 1.

$ 40,342,766 ...............................................

FTEs 97.00 1.

House PileFile 2782, p.

Pursuant to the directive under 2014 Iowa Acts, chapter 1140, section 102, the federal matching moneys available to the nonprofit organization from the department under the federal Children'sChildren’s Health Insurance Program Reauthorization Act of 2009 shall be subject to the federal administrative cap rule of 10 percent applicable to moneys provided under Tit.

XXI of the federal Social Security Act, and shall be included in the department'sdepartment’s calculations of the cap.

SSec. e c .

111. 1D E P A R T M E N T O F H E A L S E R V I C E S A N PHARMACEUTICAL SETTLEMENT ACCOUNT, There is appropriated from the pharmaceutical settlement account created in section 249A,33 to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PHARMACEUTICAL SETTLEMENT ACCOUNT.

There is appropriated from the pharmaceutical settlement account created in section 249A.33 to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

$.................................................. 234,193 Sec, 12.

DEPARTMENT$ OF234,193 HEALTHSec. AND HUMAN SERVICES QUALITY A S S U R AT R U F U N D , 1.

Notwithstanding12. any provision of law to the contrary, and subject to the availability of moneys, there is appropriated from the quality assurance trust fund created in section 249L,4 to the department of health and human services for the fiscal House File 2782, p.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— QUALITY ASSURANCE TRUST FUND.

1.

Notwithstanding any provision of law to the contrary, and subject to the availability of moneys, there is appropriated from the quality assurance trust fund created in section 249L.4 to the department of health and human services for the fiscal House File 2782, p.

..................................................

Notwithstanding section 249L.4, subsection 2, after the appropriation in subsection 1, any moneys remaining in the quality assurance trust fund for the fiscal year beginning July 1, 2026, and ending June 30, 2027, are appropriated to the department of health and human services to supplement the appropriation made in this Act from the general fund of the state for the medical assistance program for the same fiscal yyear. e a r .

113. 3 .

DEPARTMENT OOF F HEALTH AND HUMAN SERVICES ——— HOSPITAL HHEALTH ECARE AACCESS LCTRUST AFUND. R A C C ET R U F U N D .

..................................................

SSec. e c .

114. D E P A R T O FH E A LA N D H U MS E R V I—C E S BEHAVIORAL HEALTH FUND.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— BEHAVIORAL HEALTH FUND.

$.................................................. 5,580,938 S e c1 5 .

R$ E5,580,938 ISec. M B U R R A T E S .

15.

REIMBURSEMENT RATES.

(2) July 1, 2025, through December 31, 2025, the department of health and human services shall calculate each nursing facility'sfacility’s case-mix index for rates effective July 1, 2026.

(3) January 1, 2026, through June 30, 2026, the department of health and human services shall calculate each nursing facility'sfacility’s case-mix index for rates effective January 1, 2027.

16 shall be used to increase to the extent possible, compared with rates in effect on June 30, 2026, reimbursement rates for providers of HedicaidMedicaid home and community-based services waiver services used most frequently by elderly waiver recipients including attendant care, homemaker, and assisted living sservices. e r v i c e s .

(2) Minimum Medicaid reimbursement rates for all provider and service types shall be no lower than the reimbursement rates established in the department'sdepartment’s minimum fee schedule.

DDIVISION IVII V I S V I I FAMILY WELL-BEING AND PROTECTION ——— FY 2026-2027 Sec.

DEPARTMENT OF HEALTH AND HUMAN SERVICES ——— STATE CHILD CARE ASSISTANCE.

$.................................................. 32,723,000 F T E s 5 3 .

0$ 032,723,000 1................................................

FTEs 53.00 1.

117. 7 .DEPARTMENT O F HEALTH AND HUMAN SERVICES — EARLY House File 2782, p.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— EARLY House File 2782, p.

There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated;designated:

$.................................................. 36,495,203 F T E s 2 8 .

0$ 036,495,203 1................................................

OfFTEs the28.00 moneys1. appropriated in this section, not more than $734,000 is allocated for the healthy opportunities for parents to experience success (HOPES) — healthy families Iowa (HFI) program established pursuant to section 135.106.

Of the moneys appropriated in this section, not more than $734,000 is allocated for the healthy opportunities for parents to experience success (HOPES) – healthy families Iowa (HFI) program established pursuant to section 135.106.

Of the moneys appropriated in this section, $29,256,799 shall be deposited in the early childhood Iowa fund created in ssection e256I.11. c t i2 5 6 1 .

1 1 .

SSec. e c .

118. 8D E P A R T M E N T O F H E A L S E R V I C EC H I L D PROTECTIVE SERVICES.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— CHILD PROTECTIVE SERVICES.

$164,527,690.................................................. F T E s 9 7 7 .

0$164,527,690 0............................................... 1.

FTEs 977.00 1.

Notwithstanding chapter 232 or any other provision of law to the contrary, a district or juvenile court shall not order any service which is a charge upon the state pursuant to section 232.141, subsection 4, if the moneys allocated under paragraph ^^a"“a” for court-ordered services are insufficient to pay for the service.

19 rrelated ecosts. l a tc o s t s .

Any moneys remaining after the allocation under paragraph ^^a"“a” is designated and allocated as state savings resulting from implementation of the federal Fostering Connections to Success and Increasing Adoptions Act of 2008, Pub.

S673(a)(8),§673(a)(8), and shall be used for post-adoption services and for other purposes allowed under those federal Acts and regulations, and Tit.

To increase access to child protection center services for children in rural areas, the funding formula for awarding the remaining moneys shall provide for awarding an enhanced amount to eligible grantees to develop and maintain satellite centers in underserved regions of the sstate. t a t e .

20 DDIVISION IVIII V I SV I I I STATE-OPERATED SPECIALTY CARE ——— FY 2026-2027 Sec.

DEPARTMENT OF HEALTH AND HUMAN SERVICES ——— STATE-OPERATED SPECIALTY CARE.

$100,225,768.................................................. FTEs 1,304.45 1.

$100,225,768 ...............................................

FTEs 1,304.45 1.

Of the moneys appropriated in this section, the following amounts are allocated tto o each institution aas s follows:

aa. .

For the state mental health institute aat t Cherokee:

..................................................

..................................................

For the civil commitment unit for sexual offenders at CCherokee: h e r o k e e :

..................................................

..................................................

..................................................

For outstanding obligations related to workers'workers’ compensation, the sick leave insurance program, unemployment, and other costs related tto o the closure oof f the state resource ccenter eat nGlenwood: ta tG l e n w o o d :

$.................................................. 942,227 D I V I SI XO N A D M I N I S T A N C O M P L I — NF Y2 0 2 6 - 2 0 2 7 S e c .

2$ 0D942,227 EDIVISION PIX AADMINISTRATION RAND TCOMPLIANCE M—— EFY N2026-2027 TSec. O F H E A L S E R V I C E S — N ACCOUNTABILITY, COMPLIANCE, AND PROGRAM INTEGRITY.

20.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— ACCOUNTABILITY, COMPLIANCE, AND PROGRAM INTEGRITY.

$.................................................. 23,152,404 F T E s 3 8 2 .

0$ 023,152,404 1................................................

FTEs 382.00 1.

DDIVISION I V I S X O N TRANSFERS, CASH FLOW, AND NONREVERSIONS ——— FY 2026-2027 Sec.

221. 1 .

DEPARTMENT OOF F HEALTH AND HUMAN SERVICES ——— TTRANSFERS RAND ACASH NFLOW. S FA N C A SF L O W .

Notwithstanding any provision of law to the contrary, the department of health and human services may transfer moneys appropriated in this Act to support continuing alignment efforts, to maximize federal support in accordance with the department'sdepartment’s federal costs allocation plan, and to secure resources necessary to implement and administer the services for which moneys are appropriated.

22 fiscal year, the department may transfer any savings to the appropriations made in this Act for health program operations, or for accountability, compliance, and program integrity, to defray the costs associated with ongoing cost management eefforts. f f o r t s .

Notwithstanding any provision of law to the contrary, the department may transfer moneys appropriated under this Act for child protective services to pay the nonfederal share costs of services reimbursed under the medical assistance program, state child care assistance program, or family investment program which are provided to children who would otherwise receive services paid by the appropriation for child protective sservices. e r v i c e s .

The department may transfer moneys from the temporary assistance for needy families block grant to the federal social services block grant appropriation, and to the child care and development block grant appropriation, in accordance with ffederal elaw. d e l a w .

DEPARTMENT OOF F HEALTH AND HUMAN SERVICES ——— NNONREVERSIONS. O N R E V E R S I O N S .

Notwithstanding section 8.33, and notwithstanding the nonreversion amount limitation specified for state resource centers in section 222.92, subsection 4, moneys appropriated under this Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025,2026, and ending June 30, 2027, for the purposes of state-operated specialty care, 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 for subsequent fiscal years.

DDIVISION IXI VREPORT ION SXNONREVERSION IOOF NMONEYS R E P OO NN O N R E V E O FM O N E Y S Sec.

223. 3 .

DEPARTMENT OOF F HEALTH AND HUMAN SERVICES ——— REPORT ON NONREVERSION OF MONEYS.

The department of health and human services shall report the expenditure of any moneys for which nonreversion authorization was provided for the fiscal year beginning July 1, 2026, and ending June 30, 2027, to the general assembly on a quarterly basis beginning October 1, 02027. 2 7 .

DDIVISION IXII VEMERGENCY IRULES S X I I E M E R G R U L E S Sec.

DEPARTMENT OOF F HEALTH AND HUMAN SERVICES ——— EEMERGENCY MRULES. E R G R U L E S .

If necessary to comply with federal requirements, including time frames, the department of health and human services shall adopt administrative rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph ^''b",“b”, to implement the applicable provisions of this Act.

The notification shall be provided at least thirty calendar days prior to the date notice of the rules is submitted to the administrative rules coordinator and the aadministrative dcode meditor. i n i s t r a t i v e c o d e e d i t o r , D I V I SX I I I M O R E O P T I O M A T E R N A L S U P P O R T P R O G R A M A P P R O P R I A T I O N N O N R E V E R S I O N Sec.

DIVISION XIII MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM APPROPRIATION NONREVERSION Sec.

NEW SUBSECTION.SUBSECTION .

26,26. EFFECTIVE DATE.

EFFECTIVE DATE.

SSec. e c .

227. R E T R O A C T I V E A P P L T h i s d i v i st h i so f Act applies retroactively to July 1, 2025.

DRETROACTIVE IAPPLICABILITY. V I S X I V R E I M B U R SR A T — SR E V I E W Sec.

This division of this Act applies retroactively to July 1, 2025.

DIVISION XIV REIMBURSEMENT RATES —— REVIEW Sec.

NEW SUBSECTION.SUBSECTION .

On or before October 1 of the calendar year immediately succeeding the calendar year in which the review is conducted, the department shall submit a report to the governor and the general assembly detailing the results of the department'sdepartment’s review and recommendations for rate House File 2782, p.

NEW SUBSECTION.SUBSECTION .

The department shall compare each provider reimbursement rate in the following mmanner: a n n e r :

((1) 1For )For all medical and health services other than dental services, to reimbursement rates under the federal Medicare pprogram. r o g r a m .

((2) 2For )For dental services, to reimbursement rates for Medicaid programs in states contiguous to Iowa.

On or before January 15 of each calendar year, the department shall submit to the general assembly a report summarizing the department'sdepartment’s review under paragraph D“a”. I V I SX VO N M E N TD I S E A E X C L U S I W A I V E R Sec.

DIVISION XV MENTAL DISEASES EXCLUSION —— WAIVER Sec.

DEPARTMENT OF HEALTH AND HUMAN SERVICES ——— MEDICAL DISEASES EXCLUSION WAIVER.

No later than July 1, 2027, the department of health and human services shall apply to the centers for Medicare and Medicaid services of the United States department of health and human services for a waiver of Medicaid'sMedicaid’s institution for mental diseases exclusion.

DDIVISION IXVI V I S X V I DEPARTMENT OF HEALTH AND HUMAN SERVICES —— FULL-TIME EQUIVALENT DDASHBOARD ASec. S H B O A R D S e c .

331. 1D E P A R T M E N T O F H E A L S E R V I C E S N FULL-TIME EQUIVALENT DASHBOARD.

DEPARTMENT OF HEALTH AND HUMAN SERVICES —— FULL-TIME EQUIVALENT DASHBOARD.

House PileFile 2782, p.

DDIVISION IXVII VCOMPREHENSIVE IFAMILY SXSUPPORT VPROGRAM I I C O M P R E H E N S I S U P P O R T P R O G R A M Sec.

231,80231.80 Comprehensive family support pprogram. r o g r a m .

For the purposes of this section, unless the context otherwise requires;requires:

a,a. ^Comprehensive family support" means services and supports that assist families caring for an individual with a disability who is a member of the family, including but not limited to programs, services, parent-to-parent support, assistive devices, and various adaptations that allow an individual with a disability to participate more fully in family and community life.

b,“Comprehensive (1)family "^Family"support” means services and supports that assist families caring for an individual with a groupdisability who is a member of interdependentthe personsfamily, livingincluding but not limited to programs, services, parent-to-parent support, assistive devices, and various adaptations that allow an individual with a disability to participate more fully in thefamily sameand household.community life.

b.

(1) “Family” means a group of interdependent persons living in the same household.

(a) The individual'sindividual’s parent.

(b) The individual'sindividual’s sibling.

(c) The individual'sindividual’s grandparent, aunt, or uncle.

(d) The individual'sindividual’s legal custodian.

(e) A person providing short-term foster care to the individual with a disability subject to a case permanency plan that provides for reunification between the individual and the individual'sindividual’s parent.

(2) '^Family"“Family” does not include a person who is employed to provide services to an individual with a disability in an out-of-home setting, including but not limited to a hospital, nursing facility, personal care home, board and care home, group foster care home, or other institutional setting.

c,c. ^Individual with a disability" means an individual who is less than twenty-two years of age and meets the definition of developmental disability in 42 U.S.C.

S15002.“Individual with a disability” means an individual who is less than twenty-two years of age and meets the definition of developmental disability in 42 U.S.C.

d,§15002. '^Services and support" means assistance intended to enable an individual with a disability to control the individual's environment, to remain living with the individual's family, to function more independently, and House File 2782, p.

28d. to increase the integration of the individual into the individual's community including but not limited to funding for purchase of equipment, respite care, supplies, assistive technology, and payment of other costs attributable to the individual's disability which are identified by the individual's family.

“Services and support” means assistance intended to enable an individual with a disability to control the individual’s environment, to remain living with the individual’s family, to function more independently, and House File 2782, p.

28 to increase the integration of the individual into the individual’s community including but not limited to funding for purchase of equipment, respite care, supplies, assistive technology, and payment of other costs attributable to the individual’s disability which are identified by the individual’s family.

The family intends for the family member who is an individual with a disability to remain living in the family'sfamily’s hhome. o m e .

The family'sfamily’s taxable income is less than sixty thousand dollars for the most recently completed tax year.

Ensure services and support are provided in a timely manner and emergency access to needed services and support is House PileFile 2782, p.

Utilize state, regional, and local media to publicize the pprogram. r o g r a m , g.

Incorporateg. a process to appeal the department's or family support center's denial of services and support to a family under the program, including reasonable efforts by the department to utilize telecommunications in the appeal process.

Incorporate a process to appeal the department’s or family support center’s denial of services and support to a family under the program, including reasonable efforts by the department to utilize telecommunications in the appeal process.

Make payment for services and support directly to families by voucher or other appropriate means,means. k.

k.

The identification of services and support must be based upon the specific needs of the individual with a disability and the individual'sindividual’s family which are not met by other service programs available to the individual with a disability and the individual'sindividual’s family.

The Code editor is directed to designate section 231.80, as enacted in this division of this Act, as subchapter VIII of chapter 231 entitled ^Comprehensive“Comprehensive Family Support Program".Program”.

DDIVISION IXVIII VFEDERAL ICOMMUNITY fMENTAL XHEALTH VSERVICES IBLOCK IGRANT ISec. nfr Ifw rnrn Inim nrli) rhnpl iI l l'".

IllIiii36. T.

ili2025 iiIowa Acts, chapter 152, section 2, subsection 1, paragraph d, ibis imandadamended to roadread oiijas folluwA.follows:

fpdpnlFor finealthe federal fiscal year beginning OcteobogOctober ili|i"iaQ2G^1, Qftd2025, ewdingand Dopbomborending JQiSeptember aOfl6|30, moBGya2026, Qllooabodof tsoOf the moneys allocated to providers under paragraph ^^o"i“c”, 70 pci'eenLpercent afof Lhethe BieuGyemoneys »llooatodallocated oaoheach fodosglfederal fiatmlfiscal bliallyear Beshall JimilbuLudbe distributed by a hr>h-aii.i/->yaTbehavioral Viaalt-ihealth in4-t-a4T.i.TTe>administrative oe..•r.jaT^jservices ^organization /sr.or the department of health and human services to the state’s accredited community mental health centers designated by the department of health and human services under section 225A.3, as enacted by 2024 Iowa Acts, chapter 1161, section 3.

bheCommunity departmentmental q£health hoalthcenters that receive moneys distributed under this paragraph shall use the moneys for the purposes of training staff, providing services to adults with a serious mental illness, or providing services to children with a serious emotional disturbance, and humanshall oorviooobill treatment dollars related to such services to the etate^edepartment 4-»/qof miaT^4->V>i^.a14-Khealth faand hhuman rservices .through the department’s claims system.

^The r.department of health and human services shall publish the amounts to be distributed to community mental health centers on the department’s internet site on or before October 1, 2025, and on or before October 1, 2026, and distribute the moneys to the recipients on a quarterly basis.

^Recipients ^of thatthe rf?irfnnrftmoneys Tt.^r.^yoshall dsubmit iquarterly oreports tto rthe idepartment bof und<iMr..-tpfaii.Qrhealth .and human services containing data consistent with performance measures approved by the federal substance abuse and mental health services administration.

,House jFile U2782, Kp. ^a.tal iiljgHoooir 'Or -p^gov-i-d-^n^—&er-v->aQO bo ohAJidgion Ti7it-h a ctarinnc—lamr^i-TQna-l -fiin,t-n,r_han.r?ft^K-i11^ h(?nH-h a m <h n m a n .

-31 gDIVISION aXIX jDEPARTMENT tOF ^HEALTH TAND -HUMAN +-V.QSERVICES g.T.4-0—— aBEHAVIORAL <-hoHEALTH Tn,M^ayeEXPENDITURE r.jnn-11REPORT ^^Sec. 1y drpartmffln^ hoan-h ini.tT.a» fTT^y^fffirn i7r"taV1rg data r^nnintan*- porf^T-maT^^^a thT frd^rn"* i n h n t anhnnrr hea1fah-o o rvicoo -Iv^ House File 2782, p.

3137. D I V I S I OX I X DEPARTMENT OF HEALTH AND HUMAN SERVICES BEHAVIORAL HEALTH E X P E N D I T U R E P O R T Sec.

37- NEW SECTION,SECTION. 225A.10 Behavioral health services expenditure report.

No225A.10 laterBehavioral than December 15 of each year, the department shall submit to the general assembly a summary of the department's expenditures for behavioral health services forexpenditure adultsreport. and children for the immediately preceding fiscal year, including a summary of which appropriations or funding sources were used to fund the expenditures.

ONo Plater Ithan ODecember I15 DDBTrPLEilENiTof Feach Uyear, Nthe Ddepartment Ei¥shall asubmit oto athe cgeneral aassembly o a 7summary Sof othe odepartment’s i3expenditures 0for ■behavioral Ohealth nservices Ofor Iadults Dand SErpilLEMENT'-PUNDchildren HUHiUI?for othe uimmediately npreceding vfiscal iyear, oincluding ua ssummary ,of Thnrnwhich ifappropriations Rppropr.ior atiedfunding fromsources fljTiaatadwere inused eeofciaa laiBl to bhiO—dQipaiBi'timQint^MOifi—hioalfah^indHpmmonfund \the —expenditures. i r-i"*- 1, T'Tf.

nntiDIVISION nniiing^XX f/-si1OPIOID wgSETTLEMENT atn/^nn4-^FUND rNr-—— oFY mno^2026-2027 ,f]ioror>fSec. ic ao no0PCB^agy,1 -■£or tha-^itW^pao o .b ^ oo AgnQii>odf;

^38. 11 111111111 11 I OOP I OOP Af, ^-hn mnnnyo ip p r f^pr i a<-oH.

_H_hQOPIOID y<-Tn^Ti4-SETTLEMENT hoa-T-fc-hFUND -—— aDEPARTMENT ^OF gVial^lHEALTH AAND .fcr.o^±ino.nt-—pr_^f^r_aTn_i-ha1-HUMAN aSERVICES. rw iin ib i|i riitih nh 1m n< - nnn VinnHjc^La— Li^anearl 4-K-:^4- rn]->r<ran/p9 fSQr<^f>r treatm ent ffnppnr^ rT>Tnpr-f>.hft.nR-ijnp ^ ^ rQg jdOHtlinHJ—■tr.paitim'=^" i T n n r^ i n - > f i n n ~ a r t - r o a 4 - m a f s ^ n lln n n T H J-g Ja ii-r-cn n H a r thffi ■r,pi7,i,niiifinifB.ii nii irnmpi i anPBwJoy.fr.J^ l-ihp>MriiPanT-r.Qm^^<-^-q,f„f]l" f\mnn hmr'yi^n-o.am^n -a-n/i— RT, p i a n tnhial Wlr^r.4-^ f ^ to CT ^ .

finhp-iT-arjT-aph1. (T) , ii r- ^ j Vj B1VH ( 17) j /^'=^i--ft.r.nijLn«a llih iijL ¥ iU i House File 2782, p.

32There p4^n4-Pis fappropriated jfrom rfllththe iiflopioid huiTiansettlement -JtL-fund Dcreated Iin Vsection I12.51 SXto Xthe INdepartment Gof Rhealth Aand Dhuman Uservices Mfor Ethe Dfiscal Iyear Ebeginning DJuly U1, C2026, Aand Tending IJune O30, N2027, Sec.the following amount, or so much thereof is as necessary, for the purposes designated:

..................................................

$ 3,000,000 2.

Notwithstanding any provision of law to the contrary, of the moneys appropriated to the department of health and human services under subsection 1, the department shall disburse to an opioid treatment program that operates a facility with at least one hundred fifty licensed beds that provides medical detoxification stabilization and residential substance abuse disorder treatment to support comprehensive addiction and co-occuring mental health treatment, and provides 24-hour medical detoxification, residential treatment, and medication-assisted treatment.

a.

Moneys disbursed under this subsection shall be used by the recipient in compliance with the requirements of the national opioid settlement agreements and section 12.51.

b.

The recipient shall utilize the indicators and outcomes identified under section 12.51, subsection 2, paragraph “b”, subparagraph (3), subparagraph division (c), to determine whether the services and activities that are funded by the disbursement achieve the intended outcomes, and shall report House File 2782, p.

32 the recipient’s findings to the department of health and human services.

DIVISION XXI GRADUATE MEDICAL EDUCATION Sec.

2025 Iowa Acts, chapter 120, section 19, is amended tto o read aas sfollows: f o l l o w s :

Notwithstanding section 8.33 or any other provision to the contrary, any unobligated or unencumbered moneys in any of the following accounts or funds or constituting any specified appropriation, shall not revert but are appropriated to the department of health and human services to fund ModicQidMedicaid graduate medical education efforts award grants to start medical residency programs in the state that are not related to the practice of family medicine, are not located in a county which has a population of one hundred fifty thousand or more based on the most recent federal decennial census, and in which the main campus of an institution of higher learning governed by the state board of regents is located.located .

The health care workforce shortage fund created in section 135.175, subsection 1, paragraph ^^b".“b”, Code 2025.

Code 2025.

The medical residency training account created in section 135.175, subsection 5, paragraph ^^a",“a”, Code 2025, except $298,000 of such moneys is appropriated to the department of health and human services for the purposes of implementing the waiver of Medicaid^sMedicaid’s institution for mental diseases exclusion the department must apply for under this 2026 Iowa Act.

The nurse residency state matching grants program account created in section 135.175, subsection 5, paragraph "b".“b”, Code 2025.

Code 2025.

The health care workforce shortage national initiatives account created in section 135.175, subsection 5, paragraph "c".“c”, Code 2025.

Code 2025.

2023 Iowa Acts, chapter 112, section 5, subsection 4, paragraph '"j",“j”, as amended by 2024 Iowa Acts, chapter 1157, ssection e29. c t i2 9 .

cc. .

22022 0Iowa 2IowaActs, ActSr chapter 1131, section 3, subsection 4, paragraph j",“j”, as amended by 2024 Iowa Acts, chapter 1157, ssection e23. c t i2 3 .

dd. .

22021 0Iowa 2Iowa Acts, chapter 182, section 3, subsection 4, paragraph 3“j”. .

ee. .

22019 0Iowa 1Iowa Acts, chapter 85, section 3, subsection 4, paragraph j",“j”, as amended by 2020 Iowa Acts, chapter 1121, ssection e19. c t i1 9 .

DDIVISION IXXII VMEDICAID IREIMBURSEMENT SRATE X—— XSPECIAL IPOPULATION INURSING MFACILITIES E D I C A I D R E I M B U R S ES P E C I A L P O P N U R S I N G F A C I L I T I E S Sec.

NEW SUBSECTION.SUBSECTION .

'^''Special“Special population nursing facility''facility” refers to a nursing facility that serves one of the following populations and has been designated as a special population nursing facility by the department:

One hundred percent of the residents require care from a facility licensed by the department of inspections, appeals, and licensing as an intermediate care facility for persons with mmental eillness. n t i l l n e s s .

249A.38C Medicaid reimbursement rate ——— special population nursing facilities.

The provider reimbursement rate for each special population nursing facility must be the special population nursing facility'sfacility’s average allowable per diem costs as adjusted in House File 2782, p.

If a special population nursing facility subject to this section increases the special population nursing facility'sfacility’s number of beds or expands to provide additional services on or after July 1, 2026, the reimbursement rate in this section shall apply to such additional beds or services.

P______________________________ A______________________________ gPAT rGRASSLEY aAMY sSINCLAIR sSpeaker lof ethe :House President of the Senate I hereby certify that this bill originated in the House and is known as House File 2782, Ninety-first General Assembly.

AMY______________________________ SINQJilAiRMEGHAN speakerNELSON orChief theClerk Houseof P r e s i d et h e S e n a t e I hereby certify that this bill originated in the House andApproved is_______________, known2026 as______________________________ HouseKIM FileREYNOLDS 2782,Governor Ninety-first General Assembly.

RESRAli NELSON fief Clerk o ft h e H o u s e Approved , 2026^ K I R S Y N O L D G o v e r n o r