Senate File 505 - Enrolled




                              SENATE FILE       
                              BY  COMMITTEE ON
                                  APPROPRIATIONS

                              (SUCCESSOR TO SSB
                                  1288)
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                                   A BILL FOR
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                                        Senate File 505

                             AN ACT
 RELATING TO APPROPRIATIONS FOR HEALTH AND HUMAN SERVICES
    AND VETERANS AND INCLUDING OTHER RELATED PROVISIONS AND
    APPROPRIATIONS, AND INCLUDING EFFECTIVE DATE AND RETROACTIVE
    AND OTHER APPLICABILITY DATE PROVISIONS.

 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
                           DIVISION I
               DEPARTMENT ON AGING ==== FY 2015=2016
    Section 1.  DEPARTMENT ON AGING.  There is appropriated from
 the general fund of the state to the department on aging for
 the fiscal year beginning July 1, 2015, and ending June 30,
 2016, the following amount, or so much thereof as is necessary,
 to be used 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=time equivalent positions:
 .................................................. $ 11,399,732
 ............................................... FTEs      31.00
    1.  Funds appropriated in this section may be used to
 supplement federal funds under federal regulations. To
 receive funds appropriated in this section, a local area
 agency on aging shall match the funds with moneys from other
 sources according to rules adopted by the department. Funds
 appropriated in this section may be used for elderly services
 not specifically enumerated in this section only if approved
 by an area agency on aging for provision of the service within
 the area.
    2.  Of the funds appropriated in this section, $279,946 is
 transferred to the economic development authority for the Iowa
 commission on volunteer services to be used for the retired and
 senior volunteer program.
    3.  a.  The department on aging shall establish and enforce
 procedures relating to expenditure of state and federal funds
 by area agencies on aging that require compliance with both
 state and federal laws, rules, and regulations, including but
 not limited to all of the following:
    (1)  Requiring that expenditures are incurred only for goods
 or services received or performed prior to the end of the
 fiscal period designated for use of the funds.
    (2)  Prohibiting prepayment for goods or services not
 received or performed prior to the end of the fiscal period
 designated for use of the funds.
    (3)  Prohibiting the prepayment for goods or services
 not defined specifically by good or service, time period, or
 recipient.
    (4)  Prohibiting the establishment of accounts from which
 future goods or services which are not defined specifically by
 good or service, time period, or recipient, may be purchased.
    b.  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
 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.
    4.  Of the funds appropriated in this section, at least
 $250,000 shall be used to fund the unmet needs identified
 through Iowa's aging and disability resource center network.
    5.  Of the funds appropriated in this section, at least
 $600,000 shall be used to fund home and community=based
 services through the area agencies on aging that enable older
 individuals to avoid more costly utilization of residential or
 institutional services and remain in their own homes.
    6.  Of the funds appropriated in this section, $813,666
 shall be used for the purposes of chapter 231E and section
 231.56A, of which $288,666 shall be used for the office of
 substitute decision maker pursuant to chapter 231E, and the
 remainder shall be distributed equally to the area agencies on
 aging to administer the prevention of elder abuse, neglect, and
 exploitation program pursuant to section 231.56A, in accordance
 with the requirements of the federal Older Americans Act of
 1965, 42 U.S.C. {3001 et seq., as amended.
                           DIVISION II
       OFFICE OF LONG=TERM CARE OMBUDSMAN ==== FY 2015=2016
    Sec. 2.  OFFICE OF LONG=TERM CARE OMBUDSMAN.
    1.  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, 2015, and ending June 30, 2016, the following
 amount, or so much thereof as is necessary, to be used for the
 purposes designated:
    For salaries, support, administration, maintenance, and
 miscellaneous purposes, and for not more than the following
 full=time equivalent positions:
 .................................................. $  1,276,783
 ............................................... FTEs      17.00
    2.  Of the funds appropriated in this section, $220,000 shall
 be used to provide additional local long=term care ombudsmen.
    3.  The office of long=term care ombudsman and the department
 of human services shall collaborate to develop a cost
 allocation plan requesting Medicaid administrative funding to
 provide for the claiming of federal financial participation
 for office of long=term care ombudsman activities that are
 performed to assist with administration of the Medicaid
 program.  The cost allocation plan shall document the costs
 that directly benefit the Medicaid program and are consistent
 with federal requirements. The cost allocation plan shall be
 developed in a timely manner to allow for such claiming to
 begin by January 1, 2016.
                          DIVISION III
           DEPARTMENT OF PUBLIC HEALTH ==== FY 2015=2016
    Sec. 3.  DEPARTMENT OF PUBLIC HEALTH.  There is appropriated
 from the general fund of the state to the department of public
 health for the fiscal year beginning July 1, 2015, and ending
 June 30, 2016, the following amounts, or so much thereof as is
 necessary, to be used for the purposes designated:
    1.  ADDICTIVE DISORDERS
    For reducing the prevalence of the use of tobacco, alcohol,
 and other drugs, and treating individuals affected by addictive
 behaviors, including gambling, and for not more than the
 following full=time equivalent positions:
 .................................................. $ 27,263,690
 ............................................... FTEs      10.00
    a.  (1)  Of the funds appropriated in this subsection,
 $5,248,361 shall be used for the tobacco use prevention
 and control initiative, including efforts at the state and
 local levels, as provided in chapter 142A.  The commission
 on tobacco use prevention and control established pursuant
 to section 142A.3 shall advise the director of public health
 in prioritizing funding needs and the allocation of moneys
 appropriated for the programs and initiatives. Activities
 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. To maximize resources, the department
 shall determine if third=party sources are available to
 instead provide nicotine replacement products to an applicant
 prior to provision of such products to an applicant under
 the initiative.  The department shall track and report to
 the individuals specified in this Act, any reduction in
 the provision of nicotine replacement products realized by
 the initiative through implementation of the prerequisite
 screening.
    (2)  (a)  Of the funds allocated in this paragraph "a",
 $453,067 is transferred to the alcoholic beverages division of
 the department of commerce for enforcement of tobacco laws,
 regulations, and ordinances and to engage in tobacco control
 activities approved by the division of tobacco use prevention
 and control of the department of public health as specified
 in the memorandum of understanding entered into between the
 divisions.
    (b)  For the fiscal year beginning July 1, 2015, and ending
 June 30, 2016, the terms of the memorandum of understanding,
 entered into between the division of tobacco use prevention
 and control of the department of public health and the
 alcoholic beverages division of the department of commerce,
 governing compliance checks conducted to ensure licensed retail
 tobacco outlet conformity with tobacco laws, regulations, and
 ordinances relating to persons under eighteen years of age,
 shall continue to restrict the number of such checks to one
 check per retail outlet, and one additional check for any
 retail outlet found to be in violation during the first check.
    b.  Of the funds appropriated in this subsection,
 $22,015,329 shall be used for problem gambling and
 substance=related disorder prevention, treatment, and recovery
 services, including a 24=hour helpline, public information
 resources, professional training, and program evaluation.
    (1)  Of the funds allocated in this paragraph "b",
 $18,903,715 shall be used for substance=related disorder
 prevention and treatment.
    (a)  Of the funds allocated in this subparagraph (1),
 $899,300 shall be used for the public purpose of a grant
 program to provide substance=related disorder prevention
 programming for children.
    (i)  Of the funds allocated in this subparagraph division
 (a), $427,539 shall be used for grant funding for organizations
 that provide programming for children by utilizing mentors.
 Programs approved for such grants shall be certified or must
 be certified within six months of receiving the grant award
 by the Iowa commission on volunteer services as utilizing the
 standards for effective practice for mentoring programs.
    (ii)  Of the funds allocated in this subparagraph division
 (a), $426,839 shall be used for grant funding for organizations
 providing programming that includes youth development and
 leadership services.  The programs shall also be recognized as
 being programs that are scientifically based with evidence of
 their effectiveness in reducing substance=related disorders in
 children.
    (iii)  The department of public health shall utilize a
 request for proposals process to implement the grant program.
    (iv)  All grant recipients shall participate in a program
 evaluation as a requirement for receiving grant funds.
    (v)  Of the funds allocated in this subparagraph division
 (a), up to $44,922 may be used to administer substance=related
 disorder prevention grants and for program evaluations.
    (b)  Of the funds allocated in this subparagraph
 (1), $272,603 shall be used for culturally competent
 substance=related disorder treatment pilot projects.
    (i)  The department shall utilize the amount allocated
 in this subparagraph division (b) for at least three pilot
 projects to provide culturally competent substance=related
 disorder treatment in various areas of the state.  Each pilot
 project shall target a particular ethnic minority population.
 The populations targeted shall include but are not limited to
 African American, Asian, and Latino.
    (ii)  The pilot project requirements shall provide for
 documentation or other means to ensure access to the cultural
 competence approach used by a pilot project so that such
 approach can be replicated and improved upon in successor
 programs.
    (2)  Of the funds allocated in this paragraph "b", up
 to $3,111,614 may be used for problem gambling prevention,
 treatment, and recovery services.
    (a)  Of the funds allocated in this subparagraph (2),
 $2,573,762 shall be used for problem gambling prevention and
 treatment.
    (b)  Of the funds allocated in this subparagraph (2), up to
 $437,852 may be used for a 24=hour helpline, public information
 resources, professional training, and program evaluation.
    (c)  Of the funds allocated in this subparagraph (2), up
 to $100,000 may be used for the licensing of problem gambling
 treatment programs.
    (3)  It is the intent of the general assembly that from the
 moneys allocated in this paragraph "b",  persons with a dual
 diagnosis of substance=related disorder and gambling addiction
 shall be given priority in treatment services.
    c.  Notwithstanding any provision of law to the contrary,
 to standardize the availability, delivery, cost of delivery,
 and accountability of problem gambling and substance=related
 disorder treatment services statewide, the department shall
 continue implementation of a process to create a system
 for delivery of treatment services in accordance with the
 requirements specified in 2008 Iowa Acts, chapter 1187, section
 3, subsection 4.  To ensure the system provides a continuum
 of treatment services that best meets the needs of Iowans,
 the problem gambling and substance=related disorder treatment
 services in any area may be provided either by a single agency
 or by separate agencies submitting a joint proposal.
    (1)  The system for delivery of substance=related disorder
 and problem gambling treatment shall include problem gambling
 prevention.
    (2)  The system for delivery of substance=related disorder
 and problem gambling treatment shall include substance=related
 disorder prevention by July 1, 2016.
    (3)  Of the funds allocated in paragraph "b",  the department
 may use up to $100,000 for administrative costs to continue
 developing and implementing the process in accordance with this
 paragraph "c".
    d.  The requirement of section 123.53, subsection 5, is met
 by the appropriations and allocations made in this division of
 this Act for purposes of substance=related disorder treatment
 and addictive disorders for the fiscal year beginning July 1,
 2015.
    e.  The department of public health shall work with all
 other departments that fund substance=related disorder
 prevention and treatment services and all such departments
 shall, to the extent necessary, collectively meet the state
 maintenance of effort requirements for expenditures for
 substance=related disorder services as required under the
 federal substance=related disorder prevention and treatment
 block grant.
    2.  HEALTHY CHILDREN AND FAMILIES
    For promoting the optimum health status for children,
 adolescents from birth through 21 years of age, and families,
 and for not more than the following full=time equivalent
 positions:
 .................................................. $  4,617,543
 ............................................... FTEs      12.00
    a.  Of the funds appropriated in this subsection, not more
 than $734,841 shall be used for the healthy opportunities for
 parents to experience success (HOPES)=healthy families Iowa
 (HFI) program established pursuant to section 135.106. The
 funding shall be distributed to renew the grants that were
 provided to the grantees that operated the program during the
 fiscal year ending June 30, 2015.
    b.  In order to implement the legislative intent stated in
 sections 135.106 and 256I.9, that priority for home visitation
 program funding be given to programs using evidence=based or
 promising models for home visitation, it is the intent of the
 general assembly to phase in the funding priority in accordance
 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
 paragraph "0b".
    c.  Of the funds appropriated in this subsection, $2,198,828
 shall be used for continuation of the department's initiative
 to provide for adequate developmental surveillance and
 screening during a child's first five years.  The funds shall
 be used first to fully fund the current sites to ensure that
 the sites are fully operational, with the remaining funds
 to be used for expansion to additional sites.  The full
 implementation and expansion shall include enhancing the scope
 of the program through collaboration with the child health
 specialty clinics to promote healthy child development through
 early identification and response to both biomedical and social
 determinants of healthy development; by monitoring child
 health metrics to inform practice, document long=term health
 impacts and savings, and provide for continuous improvement
 through training, education, and evaluation; and by providing
 for practitioner consultation particularly for children with
 behavioral conditions and needs.  The department of public
 health shall also collaborate with the Iowa Medicaid enterprise
 and the child health specialty clinics to integrate the
 activities of the first five initiative into the establishment
 of patient=centered medical homes, community utilities,
 accountable care organizations, and other integrated care
 models developed to improve health quality and population
 health while reducing health care costs. To the maximum extent
 possible, funding allocated in this paragraph shall be utilized
 as matching funds for medical assistance program reimbursement.
    d.  Of the funds appropriated in this subsection, $74,640
 shall be distributed to a statewide dental carrier to provide
 funds to continue the donated dental services program patterned
 after the projects developed by the lifeline network to provide
 dental services to indigent individuals who are elderly or with
 disabilities.
    e.  Of the funds appropriated in this subsection, $111,995
 shall be used for childhood obesity prevention.
    f.  Of the funds appropriated in this subsection, $162,768
 shall be used to provide audiological services and hearing
 aids for children. The department may enter into a contract
 to administer this paragraph.
    g.  Of the funds appropriated in this subsection, $25,000 is
 transferred to the university of Iowa college of dentistry for
 provision of primary dental services to children.  State funds
 shall be matched on a dollar=for=dollar basis.  The university
 of Iowa college of dentistry shall coordinate efforts with the
 department of public health, bureau of oral and health delivery
 systems, to provide dental care to underserved populations
 throughout the state.
    h.  Of the funds appropriated in this subsection, $50,000
 shall be used to address youth suicide prevention.
    i.  Of the funds appropriated in this subsection, $50,000
 shall be used to support the Iowa effort to address the survey
 of children who experience adverse childhood experiences known
 as ACEs.
    j.  The department of public health shall continue to
 administer the program to assist parents in this state with
 costs resulting from the death of a child in accordance with
 the provisions of 2014 Iowa Acts, chapter 1140, section 22,
 subsection 12.
    3.  CHRONIC CONDITIONS
    For serving individuals identified as having chronic
 conditions or special health care needs, and for not more than
 the following full=time equivalent positions:
 .................................................. $  4,955,692
 ............................................... FTEs       5.00
    a.  Of the funds appropriated in this subsection, $159,932
 shall be used for grants to individual patients who have an
 inherited metabolic disorder to assist with the costs of
 medically necessary foods and formula.
    b.  Of the funds appropriated in this subsection, $891,644
 shall be used for the brain injury services program pursuant to
 section 135.22B, including for continuation of the contracts
 for resource facilitator services in accordance with section
 135.22B, subsection 9, and to enhance brain injury training and
 recruitment of service providers on a statewide basis.  Of the
 amount allocated in this paragraph, $95,000 shall be used to
 fund one full=time equivalent position to serve as the state
 brain injury services program manager.
    c.  Of the funds appropriated in this subsection, $547,982
 shall be used as additional funding to leverage federal funding
 through the federal Ryan White Care Act, Tit. II, AIDS drug
 assistance program supplemental drug treatment grants.
    d.  Of the funds appropriated in this subsection, $149,823
 shall be used for the public purpose of continuing to contract
 with an existing national=affiliated organization to provide
 education, client=centered programs, and client and family
 support for people living with epilepsy and their families.
 The amount allocated in this paragraph in excess of $100,000
 shall be matched dollar=for=dollar by the organization
 specified.
    e.  Of the funds appropriated in this subsection, $785,114
 shall be used for child health specialty clinics.
    f.  Of the funds appropriated in this subsection, $400,000
 shall be used by the regional autism assistance program
 established pursuant to section 256.35, and administered by
 the child health specialty clinic located at the university of
 Iowa hospitals and clinics.  The funds shall be used to enhance
 interagency collaboration and coordination of educational,
 medical, and other human services for persons with autism,
 their families, and providers of services, including delivering
 regionalized services of care coordination, family navigation,
 and integration of services through the statewide system of
 regional child health specialty clinics and fulfilling other
 requirements as specified in chapter 225D.  The university of
 Iowa shall not receive funds allocated under this paragraph for
 indirect costs associated with the regional autism assistance
 program.
    g.  Of the funds appropriated in this subsection, $570,993
 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 allocated in this paragraph "g", $150,000 shall
 be used to support a melanoma research symposium, a melanoma
 biorepository and registry, basic and translational melanoma
 research, and clinical trials.
    h.  Of the funds appropriated in this subsection, $126,450
 shall be used for cervical and colon cancer screening, and
 $300,000 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.
    i.  Of the funds appropriated in this subsection, $526,695
 shall be used for the center for congenital and inherited
 disorders.
    j.  Of the funds appropriated in this subsection, $129,411
 shall be used for the prescription drug donation repository
 program created in chapter 135M.
    k.  Of the funds appropriated in this subsection,
 $215,263 shall be used by the department of public health
 for reform=related activities, including but not limited to
 facilitation of communication to stakeholders at the state and
 local level, administering the patient=centered health advisory
 council pursuant to section 135.159, and involvement in health
 care system innovation activities occurring across the state.
    l.  Of the funds appropriated in this subsection, $25,000
 shall be used for administration of chapter 124D, the medical
 cannabidiol Act.
    4.  COMMUNITY CAPACITY
    For strengthening the health care delivery system at the
 local level, and for not more than the following full=time
 equivalent positions:
 .................................................. $  8,821,335
 ............................................... FTEs      11.00
    a.  Of the funds appropriated in this subsection, $99,414
 is allocated for continuation of the child vision screening
 program implemented through the university of Iowa hospitals
 and clinics in collaboration with early childhood Iowa areas.
 The program shall submit a report to the individuals identified
 in this Act for submission of reports regarding the use of
 funds allocated under this paragraph "a".  The report shall
 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; the number,
 age, and location within the state of individuals served;
 the type of services provided to the individuals served; the
 distribution of funds based on service provided; and the
 continuing needs of the program.
    b.  Of the funds appropriated in this subsection, $110,656 is
 allocated for continuation of an initiative implemented at the
 university of Iowa and $99,904 is allocated for continuation of
 an initiative at the state mental health institute at Cherokee
 to expand and improve the workforce engaged in mental health
 treatment and services. The initiatives shall receive input
 from the university of Iowa, the department of human services,
 the department of public health, and the mental health and
 disability services commission to address the focus of the
 initiatives.
    c.  Of the funds appropriated in this subsection, $1,164,628
 shall be used for essential public health services that promote
 healthy aging throughout one's lifespan, contracted through a
 formula for local boards of health, to enhance health promotion
 and disease prevention services.
    d.  Of the funds appropriated in this section, $99,286 shall
 be deposited in the governmental public health system fund
 created in section 135A.8 to be used for the purposes of the
 fund.
    e.  Of the funds appropriated in this subsection, $105,448
 shall be used to continue to address the shortage of mental
 health professionals in the state.
    f.  Of the funds appropriated in this subsection,
 $50,000 shall be used for a grant to a statewide association
 of psychologists that is affiliated with the American
 psychological association to be used for continuation of a
 program to rotate intern psychologists in placements in urban
 and rural mental health professional shortage areas, as defined
 in section 135.180.
    g.  (1)  Of the funds appropriated in this subsection,
 $2,882,969 shall be allocated as a grant to the Iowa primary
 care association to be used pursuant to section 135.153 for
 the statewide coordination of the Iowa collaborative safety
 net provider network. Coordination of the network shall
 focus on increasing access by underserved populations to
 health care services, increasing integration of the health
 system and collaboration across the continuum of care with
 a focus on safety net services, and enhancing the Iowa
 collaborative safety net provider network's communication and
 education efforts. The amount allocated as a grant under this
 subparagraph (1) shall be used as follows to support the Iowa
 collaborative safety net provider network goals of increased
 access, health system integration, and engagement:
    (a)  For distribution to safety net partners in the state
 that work to increase access of the underserved population to
 health services:
 .................................................. $  1,025,485
    (i)  Of the amount allocated in this subparagraph division
 (a), not less than $413,415 shall be distributed to the
 Iowa prescription drug corporation for continuation of the
 pharmaceutical infrastructure for safety net providers as
 described in 2007 Iowa Acts, chapter 218, section 108.
    (ii)  Of the amount allocated in this subparagraph division
 (a), not less than $348,322 shall be distributed to free
 clinics and free clinics of Iowa for necessary infrastructure,
 statewide coordination, provider recruitment, service delivery,
 and provision of assistance to patients in securing a medical
 home inclusive of oral health care.
    (iii)  Of the amount allocated in this subparagraph division
 (a), not less than $50,000 shall be distributed to the Iowa
 coalition against sexual assault to continue a training
 program for sexual assault response team (SART) members,
 including representatives of law enforcement, victim advocates,
 prosecutors, and certified medical personnel.
    (iv)  Of the amount allocated in this subparagraph division
 (a), not less than $213,748 shall be distributed to the Polk
 county medical society for continuation of the safety net
 provider patient access to a specialty health care initiative
 as described in 2007 Iowa Acts, chapter 218, section 109.
    (b)  For distribution to safety net partners in the
 state that work to increase health system integration, care
 coordination, and collaboration across the continuum of care
 with a focus on safety net services. Such efforts shall
 include but not be limited to community care coordination team
 development and integration of medical and behavioral health
 services. Efforts shall also include working, in conjunction
 with the department of human services and the department
 of public health, to support Medicaid managed care efforts
 inclusive of the state innovation model through the continued
 development and implementation of community care coordination
 teams. Implementation of the community care coordination
 teams shall be accomplished through a statewide regionally
 based network that provides an integrated approach to health
 care delivery through care coordination that supports primary
 care providers and links patients with community resources
 necessary to empower patients in addressing biomedical and
 social determinants of health to improve health outcomes:
 .................................................. $  1,672,199
    (c)  For distribution to safety net partners in the state
 that work to serve as a resource for credible, accurate
 information on health care=related needs and services
 for vulnerable populations in the state including the
 Iowa association of rural health clinics for necessary
 infrastructure and service delivery transformation and the Iowa
 primary care association to support partner engagement, program
 management, and statewide coordination of the network:
 .................................................. $    185,285
    (2)  The amount allocated under this paragraph "g" shall
 not be reduced for administrative or other costs prior to
 distribution. The Iowa collaborative safety net provider
 network may continue to distribute funds allocated pursuant to
 this paragraph "g" through existing contracts or renewal of
 existing contracts.
    (3)  For each goal of the Iowa collaborative safety net
 provider network, the Iowa primary care association shall
 submit a progress report to the individuals designated in this
 Act for submission of reports by December 15, 2015, including
 progress in developing and implementing the network, how the
 funds were distributed and used in developing and implementing
 the network, and the remaining needs identified to fully
 develop and implement the network.
    h.  Of the funds appropriated in this subsection, $213,400
 shall be used for continuation of the work of the direct care
 worker advisory council established pursuant to 2008 Iowa Acts,
 chapter 1188, section 69, in implementing the recommendations
 in the final report submitted by the 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 and specialties through various formats
 including online access, community colleges, and other venues;
 exploring new and maintaining existing specialties including
 but not limited to oral health and dementia care; supporting
 instructor training; and assessing and making recommendations
 concerning the Iowa care book and information technology
 systems and infrastructure uses and needs.
    i.  (1)  Of the funds appropriated in this subsection,
 $216,375 shall be used for allocation to an independent
 statewide direct care worker organization selected through a
 request for proposals process.  The contract shall include
 performance and outcomes measures, and shall allow the
 contractor to use a portion of the funds received under the
 contract to collect data to determine results based on the
 performance and outcomes measures.
    (2)  Of the funds appropriated in this subsection, $75,000
 shall be used to provide scholarships or other forms of
 subsidization for direct care worker educational conferences,
 training, or outreach activities.
    j.  Of the funds appropriated in this subsection, the
 department may use up to $58,175 for up to one full=time
 equivalent position to administer the volunteer health care
 provider program pursuant to section 135.24.
    k.  Of the funds appropriated in this subsection, $100,000
 shall be used for a matching dental education loan repayment
 program to be allocated to a dental nonprofit health service
 corporation to continue to develop the criteria and implement
 the loan repayment program.
    l.  Of the funds appropriated in this subsection, $105,823 is
 transferred to the college student aid commission for deposit
 in the rural Iowa primary care trust fund created in section
 261.113 to be used for the purposes of the fund.
    m.  Of the funds appropriated in this subsection, $250,000
 shall be used for the purposes of the Iowa donor registry as
 specified in section 142C.18.
    n.  Of the funds appropriated in this subsection, $100,000
 shall be used for continuation of a grant to a nationally
 affiliated volunteer eye organization that has an established
 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. The organization
 shall submit a report to the individuals identified in this
 Act for submission of reports regarding the use of funds
 allocated under this paragraph "n".  The report shall 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; the number, age, and
 location within the state of individuals served; the type of
 services provided to the individuals served; the distribution
 of funds based on services provided; and the continuing needs
 of the program.
    o.  Of the funds appropriated in this subsection, $2,000,000
 shall be deposited in the medical residency training account
 created in section 135.175, subsection 5, paragraph "a", and
 is appropriated from the account to the department of public
 health to be used for the purposes of the medical residency
 training state matching grants program as specified in section
 135.176. However, notwithstanding any provision to the
 contrary in section 135.176, priority in the awarding of grants
 shall be given to sponsors that propose preference in the use
 of the grant funds for psychiatric residency positions and
 family practice residency positions.
    p.  Of the funds appropriated in this subsection, $156,619
 is allocated to the university of Iowa hospitals and clinics
 to implement a systematic and evidence=based practice
 collaborative care model to improve outcomes of mental health
 treatment in primary care settings in the state.  Funds shall
 be used to establish the collaborative care model in several
 primary care practices in rural and urban areas throughout the
 state, to provide staffing to administer the model, and to
 provide staff training and database management to track and
 manage patient outcomes.
    5.  HEALTHY AGING
    To provide public health services that reduce risks and
 invest in promoting and protecting good health over the
 course of a lifetime with a priority given to older Iowans and
 vulnerable populations:
 .................................................. $  7,297,142
    6.  INFECTIOUS DISEASES
    For reducing the incidence and prevalence of communicable
 diseases, and for not more than the following full=time
 equivalent positions:
 .................................................. $  1,335,155
 ............................................... FTEs       4.00
    7.  PUBLIC PROTECTION
    For protecting the health and safety of the public through
 establishing standards and enforcing regulations, and for not
 more than the following full=time equivalent positions:
 .................................................. $  4,339,191
 ............................................... FTEs    136.00
    a.  Of the funds appropriated in this subsection, not more
 than $454,700 shall be credited to the emergency medical
 services fund created in section 135.25. Moneys in the
 emergency medical services fund are appropriated to the
 department to be used for the purposes of the fund.
    b.  Of the funds appropriated in this subsection, $203,032
 shall be used for sexual violence prevention programming
 through a statewide organization representing programs
 serving victims of sexual violence through the department's
 sexual violence prevention program. The amount allocated
 in this paragraph "b" shall not be used to supplant funding
 administered for other sexual violence prevention or victims
 assistance programs.
    c.  Of the funds appropriated in this subsection, $598,751
 shall be used for the state poison control center. Pursuant
 to the directive under 2014 Iowa Acts, chapter 1140, section
 102, the federal matching funds available to the state poison
 control center from the department 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.
 XXI of the federal Social Security Act and included within the
 department's calculations of the cap.
    d.  Of the funds appropriated in this subsection, $537,750
 shall be used for childhood lead poisoning provisions.
    8.  RESOURCE MANAGEMENT
    For establishing and sustaining the overall ability of the
 department to deliver services to the public, and for not more
 than the following full=time equivalent positions:
 .................................................. $    855,072
 ............................................... FTEs       4.00
    The university of Iowa hospitals and clinics under the
 control of the state board of regents shall not receive
 indirect costs from the funds appropriated in this section.
 The university of Iowa hospitals and clinics billings to the
 department shall be on at least a quarterly basis.
                           DIVISION IV
         DEPARTMENT OF VETERANS AFFAIRS ==== FY 2015=2016
    Sec. 4.  DEPARTMENT OF VETERANS AFFAIRS.  There is
 appropriated from the general fund of the state to the
 department of veterans affairs for the fiscal year beginning
 July 1, 2015, and ending June 30, 2016, the following amounts,
 or so much thereof as is necessary, to be used for the purposes
 designated:
    1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
    For salaries, support, maintenance, and miscellaneous
 purposes, and for not more than the following full=time
 equivalent positions:
 .................................................. $  1,200,546
 ............................................... FTEs      15.00
    2.  IOWA VETERANS HOME
    For salaries, support, maintenance, and miscellaneous
 purposes:
 .................................................. $  7,594,996
    a.  The Iowa veterans home billings involving the department
 of human services shall be submitted to the department on at
 least a monthly basis.
    b.  If there is a change in the employer of employees
 providing services at the Iowa veterans home under a collective
 bargaining agreement, such employees and the agreement shall
 be continued by the successor employer as though there had not
 been a change in employer.
    c.  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
 spouses who are participating in the community reentry program.
    d.  The Iowa veterans home expenditure report shall be
 submitted monthly to the legislative services agency.
    3.  HOME OWNERSHIP ASSISTANCE PROGRAM
    For transfer to the Iowa finance authority for the
 continuation of the home ownership assistance program for
 persons who are or were eligible members of the armed forces of
 the United States, pursuant to section 16.54:
 .................................................. $  2,500,000
    Sec. 5.  LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
 FUND STANDING APPROPRIATIONS.  Notwithstanding the standing
 appropriation in section 35A.16 for the fiscal year beginning
 July 1, 2015, and ending June 30, 2016, 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:
    For the county commissions of veteran affairs fund under
 section 35A.16:
 .................................................. $    990,000
                           DIVISION V
          DEPARTMENT OF HUMAN SERVICES ==== FY 2015=2016
    Sec. 6.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
 GRANT.  There is appropriated from the fund created in section
 8.41 to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, from moneys
 received under the federal temporary assistance for needy
 families (TANF) block grant pursuant to the federal Personal
 Responsibility and Work Opportunity Reconciliation Act of 1996,
 Pub. L. No. 104=193, and successor legislation, the following
 amounts, or so much thereof as is necessary, to be used for the
 purposes designated:
    1.  To be credited to the family investment program account
 and used for assistance under the family investment program
 under chapter 239B:
 .................................................. $  5,136,995
    2.  To be credited to the family investment program account
 and used for the job opportunities and basic skills (JOBS)
 program and implementing family investment agreements in
 accordance with chapter 239B:
 .................................................. $ 10,138,178
    3.  To be used for the family development and
 self=sufficiency grant program in accordance with section
 216A.107:
 .................................................. $  2,898,980
    Notwithstanding section 8.33, moneys appropriated in this
 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. However, unless such moneys are
 encumbered or obligated on or before September 30, 2016, the
 moneys shall revert.
    4.  For field operations:
 .................................................. $ 31,296,232
    5.  For general administration:
 .................................................. $  3,744,000
    6.  For state child care assistance:
 .................................................. $ 35,047,110
    a.  Of the funds appropriated in this subsection,
 $26,328,097 is transferred to the child care and development
 block grant appropriation made by the Eighty=sixth General
 Assembly, 2015 Session, for the federal fiscal year beginning
 October 1, 2015, and ending September 30, 2016. Of this
 amount, $200,000 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. The
 department may contract with institutions of higher education
 or child care resource and referral centers to provide
 the educational opportunities. Allowable administrative
 costs under the contracts shall not exceed 5 percent. The
 application for a grant shall not exceed two pages in length.
    b.  Any funds appropriated in this subsection remaining
 unallocated shall be used for state child care assistance
 payments for families who are employed including but not
 limited to individuals enrolled in the family investment
 program.
    7.  For distribution to counties and regions through the
 property tax relief fund for mental health and disability
 services as provided in an appropriation made for this purpose:
 .................................................. $  4,894,052
    8.  For child and family services:
 .................................................. $ 32,084,430
    9.  For child abuse prevention grants:
 .................................................. $    125,000
    10.  For pregnancy prevention grants on the condition that
 family planning services are funded:
 .................................................. $  1,930,067
    Pregnancy prevention grants shall be awarded to programs
 in  existence on or before July 1, 2015, if the programs have
 demonstrated positive  outcomes.  Grants shall be awarded to
 pregnancy prevention  programs which are developed after July
 1, 2015, if the  programs are based on existing  models that
 have demonstrated positive outcomes.  Grants shall  comply with
 the requirements provided in 1997 Iowa Acts,  chapter 208,
 section 14, subsections 1 and 2, including the  requirement that
 grant programs must emphasize sexual  abstinence.  Priority in
 the awarding of grants shall be given  to programs that serve
 areas of the state which demonstrate  the highest percentage of
 unplanned pregnancies of females of  childbearing age within the
 geographic area to be served by  the grant.
    11.  For technology needs and other resources necessary
 to meet federal welfare reform reporting, tracking, and case
 management requirements:
 .................................................. $  1,037,186
    12.  For the family investment program share of the costs to
 continue to develop and maintain a new, integrated eligibility
 determination system:
 .................................................. $  6,654,880
    13.  a.  Notwithstanding any provision to the contrary,
 including but not limited to requirements in section 8.41 or
 provisions in 2014 or 2015 Iowa Acts regarding the receipt and
 appropriation of federal block grants, federal funds from the
 temporary assistance for needy families block grant received by
 the state and not otherwise appropriated in this section and
 remaining available for the fiscal year beginning July 1, 2015,
 are appropriated to the department of human services to the
 extent as may be necessary to be used in the following priority
 order:  the family investment program, for state child care
 assistance program payments for families who are employed, and
 for the family investment program share of costs to develop and
 maintain a new, integrated eligibility determination system.
 The federal funds appropriated in this paragraph "a" shall be
 expended only after all other funds appropriated in subsection
 1 for the assistance under the family investment program,
 in subsection 6 for child care assistance, or in subsection
 12 for the family investment program share of the costs to
 continue to develop and maintain a new, integrated eligibility
 determination system, as applicable, have been expended. For
 the purposes of this subsection, the funds appropriated in
 subsection 6, paragraph "a", for transfer to the child care
 and development block grant appropriation are considered fully
 expended when the full amount has been transferred.
    b.  The department shall, on a quarterly basis, advise the
 legislative services agency and department of management of
 the amount of funds appropriated in this subsection that was
 expended in the prior quarter.
    14.  Of the amounts appropriated in this section,
 $12,962,008 for the fiscal year beginning July 1, 2015, is
 transferred to the appropriation of the federal social services
 block grant made to the department of human services for that
 fiscal year.
    15.  For continuation of the program providing categorical
 eligibility for the food assistance program as specified for
 the program in the section of this division of this 2015 Act
 relating to the family investment program account:
 .................................................. $    25,000
    16.  The department may transfer funds allocated in this
 section 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
 services referred to in this section and those funded in the
 appropriation made in this division of this Act for the same
 fiscal year for the family investment program from the general
 fund of the state.
    Sec. 7.  FAMILY INVESTMENT PROGRAM ACCOUNT.
    1.  Moneys credited to the family investment program (FIP)
 account for the fiscal year beginning July 1, 2015, and
 ending June 30, 2016, shall be used to provide assistance in
 accordance with chapter 239B.
    2.  The department may use a portion of the moneys credited
 to the FIP account under this section as necessary for
 salaries, support, maintenance, and miscellaneous purposes.
    3.  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
 division of this Act for the same fiscal year for the family
 investment program from the general fund of the state.
    4.  Moneys appropriated in this division of this Act and
 credited to the FIP account for the fiscal year beginning July
 1, 2015, and ending June 30, 2016, are allocated as follows:
    a.  To be retained by the department of human services to
 be used for coordinating with the department of human rights
 to more effectively serve participants in FIP and other shared
 clients and to meet federal reporting requirements under the
 federal temporary assistance for needy families block grant:
 .................................................. $     20,000
    b.  To the department of human rights for staffing,
 administration, and implementation of the family development
 and self=sufficiency grant program in accordance with section
 216A.107:
 .................................................. $  6,192,834
    (1)  Of the funds allocated for the family development
 and self=sufficiency grant program in this paragraph "b",
 not more than 5 percent of the funds shall be used for the
 administration of the grant program.
    (2)  The department of human rights may continue to implement
 the family development and self=sufficiency grant program
 statewide during fiscal year 2015=2016.
    (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.
    c.  For the diversion subaccount of the FIP account:
 .................................................. $    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 administer the FIP diversion program. To the extent
 moneys allocated in this paragraph "c" are not deemed by the
 department 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.
    d.  For the food assistance employment and training program:
 .................................................. $     66,588
    (1)  The department shall apply the federal supplemental
 nutrition assistance program (SNAP) employment and training
 state plan in order to maximize to the fullest extent permitted
 by federal law the use of the 50 percent federal reimbursement
 provisions for the claiming of allowable federal reimbursement
 funds from the United States department of agriculture
 pursuant to the federal SNAP employment and training program
 for providing education, employment, and training services
 for eligible food assistance program participants, including
 but not limited to related dependent care and transportation
 expenses.
    (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
 assistance program requirements. The department shall include
 as many food assistance households as is allowed by federal
 law. The eligibility provisions shall conform to all federal
 requirements including requirements addressing individuals who
 are incarcerated or otherwise ineligible.
    e.  For the JOBS program:
 .................................................. $ 17,540,398
    5.  Of the child support collections assigned under FIP,
 an amount equal to the federal share of support collections
 shall be credited to the child support recovery appropriation
 made in this division of this Act. 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
 portion may be used to sustain cash flow in the child support
 payments account. If as a consequence of the appropriations
 and allocations made in this section the resulting amounts
 are insufficient to sustain cash assistance payments and meet
 federal maintenance of effort requirements, the department
 shall seek supplemental funding. If child support collections
 assigned under FIP are greater than estimated or are otherwise
 determined not to be required for maintenance of effort, the
 state share of either amount may be transferred to or retained
 in the child support payments account.
    6.  The department may adopt emergency rules for the family
 investment, JOBS, food assistance, and medical assistance
 programs if necessary to comply with federal requirements.
    Sec. 8.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There
 is appropriated from the general fund of the state to the
 department of human services for the fiscal year beginning July
 1, 2015, and ending June 30, 2016, the following amount, or
 so much thereof as is necessary, to be used for the purpose
 designated:
    To be credited to the family investment program (FIP)
 account and used for family investment program assistance under
 chapter 239B:
 .................................................. $ 48,673,875
    1.  Of the funds appropriated in this section, $7,402,220 is
 allocated for the JOBS program.
    2.  Of the funds appropriated in this section, $3,313,854 is
 allocated for the family development and self=sufficiency grant
 program.
    3.  Notwithstanding section 8.39, for the fiscal year
 beginning July 1, 2015, 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
 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, 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:
    a.  For the family investment program.
    b.  For child care assistance.
    c.  For child and family services.
    d.  For field operations.
    e.  For general administration.
    f.  For distribution to counties or regions through the
 property tax relief fund for mental health and disability
 services as provided in an appropriation for this purpose.
    This subsection shall not be construed to prohibit the use
 of existing state transfer authority for other purposes. The
 department shall report any transfers made pursuant to this
 subsection to the legislative services agency.
    4.  Of the funds appropriated in this section, $195,678 shall
 be used for continuation of a grant to an Iowa=based nonprofit
 organization with a history of providing tax preparation
 assistance to low=income Iowans in order to expand the usage of
 the earned income tax credit. The purpose of the grant is to
 supply this assistance to underserved areas of the state.
    5.  Of the funds appropriated in this section, $60,000 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, healthy
 living, and social responsibility headquartered in a county
 with a population over 350,000. The funds allocated in this
 subsection shall be used by the recipient organization to
 develop a larger community effort, through public and private
 partnerships, to support a broad=based multi=county fatherhood
 initiative that promotes payment of child support obligations,
 improved family relationships, and full=time employment.
    6.  The department may transfer funds appropriated in this
 section to the appropriations made in this division of this Act
 for general administration and field operations as necessary
 to administer this section and the overall family investment
 program.
    Sec. 9.  CHILD SUPPORT RECOVERY.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2015, and ending
 June 30, 2016, the following amount, or so much thereof as is
 necessary, to be used for the purposes designated:
    For child support recovery, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $ 14,663,373
 ............................................... FTEs     464.00
    1.  The department shall expend up to $24,329, including
 federal financial participation, for the fiscal year beginning
 July 1, 2015, for a child support public awareness campaign.
 The department and the office of the attorney general shall
 cooperate in continuation of the campaign. The public
 awareness campaign shall emphasize, through a variety of
 media activities, the importance of maximum involvement of
 both parents in the lives of their children as well as the
 importance of payment of child support obligations.
    2.  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
 provisions of court orders, including but not limited to
 neutral visitation sites and mediation services.
    3.  The appropriation made to the department for child
 support recovery may be used throughout the fiscal year in the
 manner necessary for purposes of cash flow management, and for
 cash flow management purposes the department may temporarily
 draw more than the amount appropriated, provided the amount
 appropriated is not exceeded at the close of the fiscal year.
    4.  With the exception of the funding amount specified, the
 requirements established under 2001 Iowa Acts, chapter 191,
 section 3, subsection 5, paragraph "c", subparagraph (3), shall
 be applicable to parental obligation pilot projects for the
 fiscal year beginning July 1, 2015, and ending June 30, 2016.
 Notwithstanding 441 IAC 100.8, providing for termination of
 rules relating to the pilot projects, the rules shall remain
 in effect until June 30, 2016.
    Sec. 10.  HEALTH CARE TRUST FUND ==== MEDICAL ASSISTANCE ====
 FY 2015=2016.  Any funds remaining in the health care trust
 fund created in section 453A.35A for the fiscal year beginning
 July 1, 2015, and ending June 30, 2016, 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,
 including program administration and costs associated with
 program implementation.
    Sec. 11.  MEDICAID FRAUD FUND ==== MEDICAL ASSISTANCE ==== FY
 2015=2016.  Any funds remaining in the Medicaid fraud fund
 created in section 249A.50 for the fiscal year beginning
 July 1, 2015, and ending June 30, 2016, are appropriated to
 the department of human services to supplement the medical
 assistance appropriations made in this division of this Act,
 for medical assistance reimbursement and associated costs,
 including program administration and costs associated with
 program implementation.
    Sec. 12.  MEDICAL ASSISTANCE.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2015, and ending June 30,
 2016, the following amount, or so much thereof as is necessary,
 to be used for the purpose designated:
 For medical assistance program reimbursement and associated
 costs as specifically provided in the reimbursement
 methodologies in effect on June 30, 2015, except as otherwise
 expressly authorized by law, consistent with options under
 federal law and regulations, and contingent upon receipt of
 approval from the office of the governor of reimbursement for
 each abortion performed under the program:
 .................................................. $1,303,191,564
    1.  Iowans support reducing the number of abortions
 performed in our state.  Funds appropriated under this section
 shall not be used for abortions, unless otherwise authorized
 under this section.
    2.  The provisions of this section relating to abortions
 shall also apply to the Iowa health and wellness plan created
 pursuant to chapter 249N.
    3.  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
 409, subsection 6. Of the funds allocated in this subsection,
 not more than $5,000 may be expended for administrative
 purposes.
    4.  Of the funds appropriated in this Act to the department
 of public health for addictive disorders, $950,000 for
 the fiscal year beginning July 1, 2015, is transferred
 to the department of human services for an integrated
 substance=related disorder managed care system. The department
 shall not assume management of the substance=related disorder
 system in place of the managed care contractor unless such
 a change in approach is specifically authorized in law.
 The departments of human services and public health shall
 work together to maintain the level of mental health and
 substance=related disorder treatment services provided by the
 managed care contractor through the Iowa plan for behavioral
 health. Each department shall take the steps necessary to
 continue the federal waivers as necessary to maintain the level
 of services.
    5.  a.  The department shall aggressively pursue options for
 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 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 policy
 provisions.
    b.  Of the funds appropriated in this section, $100,000
 shall be used for participation in one or more pilot projects
 operated by a private provider to allow the individual or
 individuals to receive service in the community in accordance
 with principles established in Olmstead v. L.C., 527 U.S. 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
 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.
    6.  Of the funds appropriated in this section, up to
 $3,050,082 may be transferred to the field operations or
 general administration appropriations in this division of this
 Act for operational costs associated with Part D of the federal
 Medicare Prescription Drug Improvement and Modernization Act
 of 2003, Pub. L. No. 108=173.
    7.  Of the funds appropriated in this section, up to $442,100
 may be transferred to the appropriation in this division
 of this Act for medical contracts to be used for clinical
 assessment services and prior authorization of services.
    8.  A portion of the funds appropriated in this section
 may be transferred to the appropriations in this division of
 this Act for general administration, medical contracts, the
 children's health insurance program, or field operations to be
 used for the state match cost to comply with the payment error
 rate measurement (PERM) program for both the medical assistance
 and children's health insurance programs as developed by the
 centers for Medicare and Medicaid services of the United States
 department of health and human services to comply with the
 federal Improper Payments Information Act of 2002, Pub. L. No.
 107=300.
    9.  The department shall continue to implement the
 recommendations of the assuring better child health and
 development initiative II (ABCDII) clinical panel to the
 Iowa early and periodic screening, diagnostic, and treatment
 services healthy mental development collaborative board
 regarding changes to billing procedures, codes, and eligible
 service providers.
    10.  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
 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.
    11.  Of the funds appropriated in this section, the following
 amounts are transferred to the appropriations made in this
 division of this Act for the state mental health institutes:
    a.  Cherokee mental health institute..........  $  9,098,425
    b.  Independence mental health institute......  $  9,045,894
    12.  a.  Of the funds appropriated in this section,
 $4,083,878 is allocated for the state match for a
 disproportionate share hospital payment of $9,089,424 to
 hospitals that meet both of the conditions specified in
 subparagraphs (1) and (2). In addition, the hospitals that
 meet the conditions specified shall either certify public
 expenditures or transfer to the medical assistance program
 an amount equal to provide the nonfederal share for a
 disproportionate share hospital payment of $17,544,006. The
 hospitals that meet the conditions specified shall receive and
 retain 100 percent of the total disproportionate share hospital
 payment of $26,633,430.
    (1)  The hospital qualifies for disproportionate share and
 graduate medical education payments.
    (2)  The hospital is an Iowa state=owned hospital with more
 than 500 beds and eight or more distinct residency specialty
 or subspecialty programs recognized by the American college of
 graduate medical education.
    b.  Distribution of the disproportionate share payments
 shall be made on a monthly basis. The total amount of
 disproportionate share payments including graduate medical
 education, enhanced disproportionate share, and Iowa
 state=owned teaching hospital payments shall not exceed the
 amount of the state's allotment under Pub. L. No. 102=234.
 In addition, the total amount of all disproportionate
 share payments shall not exceed the hospital=specific
 disproportionate share limits under Pub. L. No. 103=66.
    c.  The university of Iowa hospitals and clinics shall either
 certify public expenditures or transfer to the appropriations
 made in this division of this Act for medical assistance an
 amount equal to provide the nonfederal share for increased
 medical assistance payments for inpatient and outpatient
 hospital services of $9,900,000. The university of Iowa
 hospitals and clinics shall receive and retain 100 percent of
 the total increase in medical assistance payments.
    d.  Payment methodologies utilized for disproportionate
 share hospitals and graduate medical education, and other
 supplemental payments under the Medicaid program may be
 adjusted or converted to other methodologies or payment
 types to provide these payments through Medicaid managed care
 implemented beginning January 1, 2016.  The department of human
 services shall obtain approval from the centers for Medicare
 and Medicaid services of the United States department of health
 and human services prior to implementation of any such adjusted
 or converted methodologies or payment types.
    13.  One hundred percent of the nonfederal share of payments
 to area education agencies that are medical assistance
 providers for medical assistance=covered services provided to
 medical assistance=covered children, shall be made from the
 appropriation made in this section.
    14.  Any new or renewed contract entered into by the
 department with a third party to administer services under the
 medical assistance program shall provide that any interest
 earned on payments from the state during the state fiscal year
 shall be remitted to the department and treated as recoveries
 to offset the costs of the medical assistance program.
    15.  A portion of the funds appropriated in this section
 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.
    16.  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, and miscellaneous purposes.
    17.  a.  The department may increase the amounts allocated
 for salaries, support, maintenance, and miscellaneous purposes
 associated with the medical assistance program, as necessary,
 to implement cost containment strategies.  The department shall
 report any such increase to the legislative services agency and
 the department of management.
    b.  If the savings to the medical assistance program from
 cost containment efforts exceed the cost for the fiscal
 year beginning July 1, 2015, the department may transfer any
 savings generated for the fiscal year due to medical assistance
 program cost containment efforts to the appropriation
 made in this division of this Act for medical contracts or
 general administration to defray the increased contract costs
 associated with implementing such efforts.
    c.  The department of human services shall not implement
 the following cost containment measures as recommended by the
 governor for the fiscal year beginning July 1, 2015:
    (1)  A measure to provide uniform rates of $.575 per mile
 based on the 2015 Internal Revenue Service mileage rate and
 of $9.29, the current statewide average, per one=way trip for
 Medicaid program home and community=based services waivers.
    (2)  A measure to accelerate implementation of the provision
 that beginning July 1, 2015, rather than July 1, 2016, the
 department of human services requires services through the
 consumer=directed attendant care option to be provided through
 an agency or consumer choices option.
    d.  The department shall report the implementation of
 any cost containment strategies under this subsection to the
 individuals specified in this Act for submission of reports on
 a quarterly basis.
    18.  For the fiscal year beginning July 1, 2015, and ending
 June 30, 2016, 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.
    19.  The department shall continue to administer the state
 balancing incentive payments program as specified in 2012 Iowa
 Acts, chapter 1133, section 14.
    20.  The department of human services shall execute the state
 innovation model phase II testing grant and shall submit a
 report to the individuals specified in this Act for submission
 of reports regarding the progress of the execution of the
 testing grant on or before September 1, 2015. The progress
 report shall include, at a minimum, dates by which contracts
 will be entered into with vendors, pre=implementation year
 and subsequent test year funds will be expended, and other
 activities will be completed.
    21.  a.  Of the funds appropriated in this section, up
 to $50,000 may be transferred by the department to the
 appropriation made in this division of this Act to the
 department for the same fiscal year for general administration
 to be used for associated administrative expenses and for not
 more than one full=time equivalent position, in addition to
 those authorized for the same fiscal year, to be assigned to
 implementing the project.
    b.  Of the funds appropriated in this section, up to $400,000
 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.  The funds may be used
 for contracts or for personnel in addition to the amounts
 appropriated for and the positions authorized for general
 administration for the fiscal year.
    c.  Of the funds appropriated in this section, up to
 $3,000,000 may be transferred by the department to the
 appropriations made in 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.
    22.  Of the funds appropriated in this section, $250,000
 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
 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 of human services
 shall establish the maximum number of overnight stays and the
 maximum rate reimbursed for overnight lodging, which may be
 based on the state employee rate established by the department
 of administrative services.  The funds allocated in this
 subsection  shall not be used as nonfederal share matching
 funds.
    23.  The department of human services shall adopt rules to
 provide for coverage of telehealth under the Medicaid program.
 The rules shall provide that in=person contact between a
 health care professional and a patient is not required as a
 prerequisite for payment for services appropriately provided
 through telehealth in accordance with generally accepted health
 care practices and standards prevailing in the applicable
 professional community at the time the services are provided.
 Health care services provided through in=person consultations
 or through telehealth shall be treated as equivalent services
 for the purposes of reimbursement.
    24.  The department of human services may adopt emergency
 rules as necessary to implement the governor's Medicaid
 modernization initiative beginning January 1, 2016.
    25.  The number of home and community=based services waiver
 slots available during the fiscal year beginning July 1, 2015,
 shall not be reduced below the number of such slots available
 on January 1, 2015.
    26.  The department of human services shall submit an
 application to the centers for Medicare and Medicaid services
 of the United States department of health and human services
 for a planning grant through the substance abuse and mental
 health services administration of the United States department
 of health and human services to participate in a two=year pilot
 project for certified community behavioral health clinics under
 the federal Protecting Access to Medicare Act of 2014, Pub. L.
 No. 113=93.
    Sec. 13.  MEDICAL CONTRACTS.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2015, and ending June 30,
 2016, the following amount, or so much thereof as is necessary,
 to be used for the purpose designated:
    For medical contracts:
 .................................................. $ 19,613,964
    1.  The department of inspections and appeals shall
 provide all state matching funds for survey and certification
 activities performed by the department of inspections
 and appeals. The department of human services is solely
 responsible for distributing the federal matching funds for
 such activities.
    2.  Of the funds appropriated in this section, $50,000 shall
 be used for continuation of home and community=based services
 waiver quality assurance programs, including the review and
 streamlining of processes and policies related to oversight and
 quality management to meet state and federal requirements.
    3.  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
 and oversight of managed care programs, and development of
 health strategies targeted toward improved quality and reduced
 costs in the Medicaid program.
    4.  Of the funds appropriated in this section, $1,000,000
 shall be used for planning and development, in cooperation with
 the department of public health, of a phased=in program to
 provide a dental home for children.
    5.  Of the funds appropriated in this section, $2,000,000
 shall be used for the autism support program created in chapter
 225D, with the exception of the following amounts of this
 allocation which shall be used as follows:
    a.  Of the funds allocated in this subsection, $250,000
 shall be deposited in the board=certified behavior analyst and
 board=certified assistant behavior analyst grants program fund
 created in section 135.181, as enacted in this Act, to be used
 for the purposes of the fund.
    b.  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
 autism spectrum disorder and their families.
    c.  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
 one's lifespan. The grant recipient shall utilize the funds
 to continue the pilot project to determine the necessary
 support services for children with autism spectrum disorder and
 their families to be included in the children's disabilities
 services system. The grant recipient shall submit findings and
 recommendations based upon the results of the pilot project
 to the individuals specified in this division of this Act for
 submission of reports by December 31, 2015.
    Sec. 14.  STATE SUPPLEMENTARY ASSISTANCE.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For the state supplementary assistance program:
 .................................................. $12,997,187
    2.  The department shall increase the personal needs
 allowance for residents of residential care facilities by the
 same percentage and at the same time as federal supplemental
 security income and federal social security benefits are
 increased due to a recognized increase in the cost of living.
 The department may adopt emergency rules to implement this
 subsection.
    3.  If during the fiscal year beginning July 1, 2015,
 the department projects that state supplementary assistance
 expenditures for a calendar year will not meet the federal
 pass=through requirement specified in Tit. XVI of the federal
 Social Security Act, section 1618, as codified in 42 U.S.C.
 {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
 prescribed in this division of this Act to ensure that federal
 requirements are met. In 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. The department may adopt
 emergency rules to implement the provisions of this subsection.
    Sec. 15.  CHILDREN'S HEALTH INSURANCE PROGRAM.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For maintenance of the healthy and well kids in Iowa (hawk=i)
 program pursuant to chapter 514I, including supplemental dental
 services, for receipt of federal financial participation under
 Tit. XXI of the federal Social Security Act, which creates the
 children's health insurance program:
 .................................................. $ 20,413,844
    2.  Of the funds appropriated in this section, $42,800 is
 allocated for continuation of the contract for outreach with
 the department of public health.
    Sec. 16.  CHILD CARE ASSISTANCE.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2015, and ending
 June 30, 2016, the following amount, or so much thereof as is
 necessary, to be used for the purpose designated:
    For child care programs:
 .................................................. $ 51,408,668
    1.  Of the funds appropriated in this section, $43,689,241
 shall be used for state child care assistance in accordance
 with section 237A.13.
    2.  Nothing in this section shall be construed or is
 intended as or shall imply a grant of entitlement for services
 to persons who are eligible for assistance due to an income
 level consistent with the waiting list requirements of section
 237A.13. Any state obligation to provide services pursuant to
 this section is limited to the extent of the funds appropriated
 in this section.
    3.  Of the funds appropriated in this section, $432,453
 is allocated for the statewide grant program for child care
 resource and referral services under section 237A.26. A list
 of the registered and licensed child care 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.
    4.  Of the funds appropriated in this section, $936,974
 is allocated for child care quality improvement initiatives
 including but not limited to the voluntary quality rating
 system in accordance with section 237A.30.
    5.  Of the funds appropriated in this section, $6,350,000
 shall be credited to the early childhood programs grants
 account in the early childhood Iowa fund created in section
 256I.11. The moneys shall be distributed for funding of
 community=based early childhood programs targeted to children
 from birth through five years of age developed by early
 childhood Iowa areas in accordance with approved community
 plans as provided in section 256I.8.
    6.  The department may use any of the funds appropriated
 in this section as a match to obtain federal funds for use in
 expanding child care assistance and related programs. For
 the purpose of expenditures of state and federal child care
 funding, funds shall be considered obligated at the time
 expenditures are projected or are allocated to the department's
 service areas. Projections shall be based on current and
 projected caseload growth, current and projected provider
 rates, staffing requirements for eligibility determination
 and management of program requirements including data systems
 management, staffing requirements for administration of the
 program, contractual and grant obligations and any transfers
 to other state agencies, and obligations for decategorization
 or innovation projects.
    7.  A portion of the state match for the federal child care
 and development block grant shall be provided as necessary to
 meet federal matching funds requirements through the state
 general fund appropriation made for child development grants
 and other programs for at=risk children in section 279.51.
    8.  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
 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. The percentage reduction to
 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 there is an unanticipated increase in federal funding
 provided for state child care assistance, the entire amount
 of the increase shall be used for state child care assistance
 payments. 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
 assembly to appropriate sufficient funding for the fiscal year
 in order to avoid establishment of waiting list requirements.
    9.  Notwithstanding section 8.33, moneys advanced for
 purposes of the programs developed by early childhood Iowa
 areas, advanced for purposes of wraparound child care, or
 received from the federal appropriations made for the purposes
 of this section 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. 17.  JUVENILE INSTITUTION.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2015, and ending
 June 30, 2016, the following amounts, or so much thereof as is
 necessary, to be used for the purposes designated:
    1.  For operation of the state training school at Eldora and
 for salaries, support, maintenance, and miscellaneous purposes,
 and for not more than the following full=time equivalent
 positions:
 .................................................. $ 12,233,420
 ............................................... FTEs     169.30
    a.  Of the funds appropriated in this subsection, $91,150
 shall be used for distribution to licensed classroom teachers
 at this and other institutions under the control of the
 department of human services based upon the average student
 yearly enrollment at each institution as determined by the
 department.
    b.  The department of human services shall work with the
 department of public health to identify substance abuse
 treatment programs and resources licensed under chapter
 125 to provide appropriate treatment for juveniles with
 substance=related disorders at the state training school at
 Eldora.
    2.  A portion of the moneys appropriated in this section
 shall be used by the state training school at Eldora for
 grants for adolescent pregnancy prevention activities at the
 institution in the fiscal year beginning July 1, 2015.
    Sec. 18.  CHILD AND FAMILY SERVICES.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For child and family services:
 .................................................. $ 85,341,938
    2.  Up to $5,200,000 of the amount of federal temporary
 assistance for needy families block grant funding appropriated
 in this division of this Act for child and family services
 shall be made available for purposes of juvenile delinquent
 graduated sanction services.
    3.  The department may transfer funds appropriated in this
 section as necessary to pay the nonfederal costs of services
 reimbursed under the medical assistance program, state child
 care assistance program, or the family investment program which
 are provided to children who would otherwise receive services
 paid under the appropriation in this section. The department
 may transfer funds appropriated in this section to the
 appropriations made in this division of this Act for general
 administration and for field operations for resources necessary
 to implement and operate the services funded in this section.
    4.  a.  Of the funds appropriated in this section, up to
 $35,821,786 is allocated as the statewide expenditure target
 under section 232.143 for group foster care maintenance and
 services. 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
 or the child welfare emergency services addressed with the
 allocation for shelter care.
    b.  If at any time after September 30, 2015, annualization
 of a service area's current expenditures indicates a service
 area is at risk of exceeding its group foster care expenditure
 target under section 232.143 by more than 5 percent, the
 department and juvenile court services shall examine all
 group foster care placements in that service area in order to
 identify those which might be appropriate for termination.
 In addition, any aftercare services believed to be needed
 for the children whose placements may be terminated shall be
 identified. The department and juvenile court services shall
 initiate action to set dispositional review hearings for the
 placements identified. In such a dispositional review hearing,
 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.
    5.  In accordance with the provisions of section 232.188,
 the department shall continue the child welfare and juvenile
 justice funding initiative during fiscal year 2015=2016. Of
 the funds appropriated in this section, $1,717,753 is allocated
 specifically for expenditure for fiscal year 2015=2016 through
 the decategorization services funding pools and governance
 boards established pursuant to section 232.188.
    6.  A portion of the funds appropriated in this section
 may be used for emergency family assistance to provide other
 resources required for a family participating in a family
 preservation or reunification project or successor project to
 stay together or to be reunified.
    7.  Notwithstanding section 234.35 or any other provision
 of law to the contrary, state funding for shelter care and
 the child welfare emergency services contracting implemented
 to provide for or prevent the need for shelter care shall be
 limited to $8,068,474.
    8.  Federal funds received by the state during the fiscal
 year beginning July 1, 2015, 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.
 Notwithstanding section 8.33, moneys received in accordance
 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 the purposes designated until the
 close of the succeeding fiscal year.
    9.  a.  Of the funds appropriated in this section, up to
 $3,290,000 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, subsection
 4. Of the amount allocated in this paragraph "a", up to
 $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.
 A portion of the cost of each school=based liaison officer
 shall be paid by the school district or other funding source as
 approved by the chief juvenile court officer.
    b.  Of the funds appropriated in this section, up to $748,985
 is allocated for the payment of the expenses of court=ordered
 services provided to children who are under the supervision
 of the department, which expenses are a charge upon the state
 pursuant to section 232.141, subsection 4.
    c.  Notwithstanding section 232.141 or any other provision
 of law to the contrary, the amounts allocated in this
 subsection shall be distributed to the judicial districts
 as determined by the state court administrator and to the
 department's service areas as determined by the administrator
 of the department of human services' division of child and
 family services. The state court administrator and the
 division administrator shall make the determination of the
 distribution amounts on or before June 15, 2015.
    d.  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 if there are insufficient court=ordered
 services funds available in the district court or departmental
 service area distribution amounts to pay for the service. The
 chief juvenile court officer and the departmental service area
 manager shall encourage use of the funds allocated in this
 subsection such that there are sufficient funds to pay for
 all court=related services during the entire year. 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
 funds between the judicial districts' or departmental service
 areas' distribution amounts as prudent.
    e.  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
 entered under chapter 232 which is a charge upon the state
 under section 232.141, subsection 4.
    f.  Of the funds allocated in this subsection, not more than
 $83,000 may be used by the judicial branch for administration
 of the requirements under this subsection.
    g.  Of the funds allocated in this subsection, $17,000
 shall be used by the department of human services to support
 the interstate commission for juveniles in accordance with
 the interstate compact for juveniles as provided in section
 232.173.
    10.  Of the funds appropriated in this section, $8,053,227 is
 allocated for juvenile delinquent graduated sanctions services.
 Any state funds saved as a result of efforts by juvenile court
 services to earn a federal Tit. IV=E match for juvenile court
 services administration may be used for the juvenile delinquent
 graduated sanctions services.
    11.  Of the funds appropriated in this section, $1,608,285 is
 transferred to the department of public health to be used for
 the child protection center grant program for child protection
 centers located in Iowa in accordance with section 135.118.
 The grant amounts under the program shall be equalized so that
 each center receives a uniform base amount of $245,000, and
 the remaining funds shall be awarded through a funding formula
 based upon the volume of children served.
    12.  If the department receives federal approval to
 implement a waiver under Tit. IV=E of the federal Social
 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.
    13.  Of the funds appropriated in this section, $4,025,167 is
 allocated for the preparation for adult living program pursuant
 to section 234.46.
    14.  Of the funds appropriated in this section, $227,337
 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.
    15.  Of the funds appropriated in this section, $300,620
 is allocated for the foster care youth council approach of
 providing a support network to children placed in foster care.
    16.  Of the funds appropriated in this section, $202,000 is
 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.
    17.  Of the funds appropriated in this section, $630,240 is
 allocated for the community partnership for child protection
 sites.
    18.  Of the funds appropriated in this section, $371,250
 is allocated for the department's minority youth and family
 projects under the redesign of the child welfare system.
    19.  Of the funds appropriated in this section, $1,186,595
 is allocated for funding of the community circle of care
 collaboration for children and youth in northeast Iowa.
    20.  Of the funds appropriated in this section, at least
 $147,158 shall be used for the continuation of the child
 welfare provider training academy, a collaboration between the
 coalition for family and children's services in Iowa and the
 department.
    21.  Of the funds appropriated in this section, $211,872
 shall be used for continuation of the central Iowa system of
 care program grant through June 30, 2016.
    22.  Of the funds appropriated in this section, $235,000
 shall be used for the public purpose of the continuation
 and expansion of a system of care program grant implemented
 in Cerro Gordo and Linn counties to utilize a comprehensive
 and long=term approach for helping children and families by
 addressing the key areas in a child's life of childhood basic
 needs, education and work, family, and community.
    23.  Of the funds appropriated in this section, at least
 $25,000 shall be used to continue and to expand the foster
 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.
    24.  Of the funds appropriated in this section, $110,000
 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 census information
 issued by the United States census bureau, is licensed as a
 psychiatric medical institution for children, and was a system
 of care grantee prior to July 1, 2015.
    Sec. 19.  ADOPTION SUBSIDY.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For adoption subsidy payments and services:
 .................................................. $ 42,998,286
    2.  The department may transfer funds appropriated in
 this section to the appropriation made in this division of
 this Act for general administration for costs paid from the
 appropriation relating to adoption subsidy.
    3.  Federal funds received by the state during the
 fiscal year beginning July 1, 2015, as the result of the
 expenditure of state funds 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 the services and activities funded under this section.
 Notwithstanding section 8.33, moneys received in accordance
 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. 20.  JUVENILE DETENTION HOME FUND.  Moneys deposited
 in the juvenile detention home fund created in section 232.142
 during the fiscal year beginning July 1, 2015, and ending June
 30, 2016, are appropriated to the department of human services
 for the fiscal year beginning July 1, 2015, and ending June 30,
 2016, for distribution of an amount equal to a percentage of
 the costs of the establishment, improvement, operation, and
 maintenance of county or multicounty juvenile detention homes
 in the fiscal year beginning July 1, 2014. Moneys appropriated
 for distribution in accordance with this section shall be
 allocated among eligible detention homes, prorated on the basis
 of an eligible detention home's proportion of the costs of all
 eligible detention homes in the fiscal year beginning July
 1, 2014. The percentage figure shall be determined by the
 department based on the amount available for distribution for
 the fund. Notwithstanding section 232.142, subsection 3, the
 financial aid payable by the state under that provision for the
 fiscal year beginning July 1, 2015, shall be limited to the
 amount appropriated for the purposes of this section.
    Sec. 21.  FAMILY SUPPORT SUBSIDY PROGRAM.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For the family support subsidy program subject to the
 enrollment restrictions in section 225C.37, subsection 3:
 .................................................. $  1,073,932
    2.  The department shall use at least $641,500 of the moneys
 appropriated in this section for the family support center
 component of the comprehensive family support program under
 section 225C.47. Not more than $25,000 of the amount allocated
 in this subsection shall be used for administrative costs.
    3.  If at any time during the fiscal year, the amount of
 funding available for the family support subsidy program
 is reduced from the amount initially used to establish the
 figure for the number of family members for whom a subsidy
 is to be provided at any one time during the fiscal year,
 notwithstanding section 225C.38, subsection 2, the department
 shall revise the figure as necessary to conform to the amount
 of funding available.
    Sec. 22.  CONNER DECREE.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2015, and ending June 30,
 2016, the following amount, or so much thereof as is necessary,
 to be used for the purpose designated:
    For building community capacity through the coordination
 and provision of training opportunities in accordance with the
 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
 Iowa, July 14, 1994):
 .................................................. $     33,632
    Sec. 23.  MENTAL HEALTH INSTITUTES.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2015, and ending
 June 30, 2016, the following amounts, or so much thereof as
 is necessary, to be used for the purposes designated, which
 amounts shall not be transferred or expended for any purpose
 other than the purposes designated, notwithstanding section
 218.6 to the contrary:
    1.  For operation of the state mental health institute at
 Cherokee as required by chapters 218 and 226 for salaries,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $  5,545,616
 ............................................... FTEs     169.20
    2.  For operation of the state mental health institute at
 Independence as required by chapters 218 and 226 for salaries,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $ 10,324,209
 ............................................... FTEs     233.00
    3.  For operation of the state mental health institute
 at Mount Pleasant as required by chapters 218 and 226, for
 purposes of providing adult psychiatric services including
 inpatient acute care, inpatient substance abuse treatment, and
 inpatient dual diagnosis substance use disorder and mental
 illness treatment, at the same level of care and treatment as
 provided on July 1, 2014, for salaries, support, maintenance,
 and miscellaneous purposes, and for not more than the following
 full=time equivalent positions:
 .................................................. $  6,424,880
 ............................................... FTEs      97.68
    Sec. 24.  STATE RESOURCE CENTERS.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, the following
 amounts, or so much thereof as is necessary, to be used for the
 purposes designated:
    a.  For the state resource center at Glenwood for salaries,
 support, maintenance, and miscellaneous purposes:
 .................................................. $ 21,524,482
    b.  For the state resource center at Woodward for salaries,
 support, maintenance, and miscellaneous purposes:
 .................................................. $ 14,583,806
    2.  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.
    3.  The state resource centers may expand the time=limited
 assessment and respite services during the fiscal year.
    4.  If the department's administration and the department
 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. If
 the vacant positions available to a resource center do not
 include the position classification desired to be filled, the
 state resource center's superintendent may reclassify any
 vacant position as necessary to fill the desired position. The
 superintendents of the state resource centers may, by mutual
 agreement, pool vacant positions and position classifications
 during the course of the fiscal year in order to assist one
 another in filling necessary positions.
    5.  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
 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 2015=2016.
    Sec. 25.  SEXUALLY VIOLENT PREDATORS.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    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,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $  9,893,079
 ............................................... FTEs     132.50
    2.  Unless specifically prohibited by law, if the amount
 charged provides for recoupment of at least the entire amount
 of direct and indirect costs, the department of human services
 may contract with other states to provide care and treatment
 of persons placed by the other states at the unit for sexually
 violent predators at Cherokee. The moneys received under
 such a contract shall be considered to be repayment receipts
 and used for the purposes of the appropriation made in this
 section.
    Sec. 26.  FIELD OPERATIONS.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2015, and ending June 30,
 2016, the following amount, or so much thereof as is necessary,
 to be used for the purposes designated:
    For field operations, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $ 58,920,976
 ............................................... FTEs   1,837.00
    1.  As a condition of this appropriation, the department
 shall make every possible effort to fill the entire number of
 positions authorized by this section and, unless specifically
 provided otherwise by an applicable collective bargaining
 agreement, the department is not subject to any approval
 requirement external to the department to fill a field
 operations vacancy within the number of full=time equivalent
 positions authorized by this section. The department shall
 report on the first of each month to the chairpersons and
 ranking members of the appropriations committees of the senate
 and house of representatives, and the persons designated by
 this Act for submission of reports concerning the status of
 filling the positions.
    2.  Priority in filling full=time equivalent positions
 shall be given to those positions related to child protection
 services and eligibility determination for low=income families.
    Sec. 27.  GENERAL ADMINISTRATION.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2015, and ending
 June 30, 2016, the following amount, or so much thereof as is
 necessary, to be used for the purpose designated:
    For general administration, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $ 14,898,198
 ............................................... FTEs     309.00
    1.  Of the funds appropriated in this section, $25,000 is
 allocated for the prevention of disabilities policy council
 created in section 225B.3.
    2.  The department shall report at least monthly to the
 legislative services agency concerning the department's
 operational and program expenditures.
    3.  Of the funds appropriated in this section, $150,000 shall
 be used to continue the contract for the provision of a program
 to provide technical assistance, support, and consultation to
 providers of habilitation services and home and community=based
 services waiver services for adults with disabilities under the
 medical assistance program.
    4.  Of the funds appropriated in this section, $50,000
 is transferred to the Iowa finance authority to be used
 for administrative support of the council on homelessness
 established in section 16.2D and for the council to fulfill its
 duties in addressing and reducing homelessness in the state.
    5.  Of the funds appropriated in this section, $250,000
 shall be transferred to and deposited in the administrative
 fund of the Iowa ABLE savings plan trust created in section
 12I.4, if enacted in this Act, to be used for implementation
 and administration activities of the Iowa ABLE savings plan
 trust.  Such activities may include the funding of a program
 manager position, the issuance of a request for proposals,
 and creation of an informational internet site, but shall not
 include funding for marketing. The appropriation made in this
 section is deemed to meet the requirement in the section of
 the division of this Act, if enacted, relating to contingent
 implementation of chapter 12I.
    Sec. 28.  VOLUNTEERS.  There is appropriated from the general
 fund of the state to the department of human services for the
 fiscal year beginning July 1, 2015, and ending June 30, 2016,
 the following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    For development and coordination of volunteer services:
 .................................................. $     84,686
    Sec. 29.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
 DEPARTMENT OF HUMAN SERVICES.
    1.  a.  (1)  For the fiscal year beginning July 1, 2015,
 the total state funding amount for the nursing facility budget
 shall not exceed $151,421,158.
    (2)  For the fiscal year beginning July 1, 2015, the
 department shall rebase case=mix nursing facility rates
 effective July 1, 2015. However, total nursing facility budget
 expenditures, including both case=mix and noncase=mix, shall
 not exceed the amount specified in subparagraph (1). When
 calculating case=mix per diem cost and the patient=day=weighted
 medians used in rate=setting for nursing facilities effective
 July 1, 2015, the inflation factor applied from the midpoint
 of the cost report period to the first day of the state fiscal
 year rate period shall be adjusted to maintain state funding
 within the amount specified in subparagraph (1).
    (3)  The department, in cooperation with nursing facility
 representatives, shall review projections for state funding
 expenditures for reimbursement of nursing facilities on a
 quarterly basis and the department shall determine if an
 adjustment to the medical assistance reimbursement rate is
 necessary in order to provide reimbursement within the state
 funding amount for the fiscal year. Notwithstanding 2001
 Iowa Acts, chapter 192, section 4, subsection 2, paragraph
 "c", and subsection 3, paragraph "a", subparagraph (2),
 if the state funding expenditures for the nursing facility
 budget for the fiscal year are projected to exceed the amount
 specified in subparagraph (1), the department shall adjust
 the reimbursement for nursing facilities reimbursed under the
 case=mix reimbursement system to maintain expenditures of the
 nursing facility budget within the specified amount for the
 fiscal year.
    (4)  For the fiscal year beginning July 1, 2015, special
 population nursing facilities shall be reimbursed in accordance
 with the methodology in effect on June 30, 2015.
    (5)  For any open or unsettled nursing facility cost report
 for a fiscal year prior to and including the fiscal year
 beginning July 1, 2014, 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.
 For purposes of this subparagraph, a nursing facility cost
 report is not considered open or unsettled if the facility did
 not initiate an administrative appeal under chapter 17A or if
 any appeal rights initiated have been exhausted.
    b.  (1)  For the fiscal year beginning July 1, 2015,
 the department shall establish the pharmacy dispensing fee
 reimbursement at $11.73 per prescription as determined by the
 June 2014 cost of dispensing fee survey.
    (2)  The department shall utilize an average acquisition
 cost reimbursement methodology for all drugs covered under the
 medical assistance program in accordance with 2012 Iowa Acts,
 chapter 1133, section 33.
    (3)  Notwithstanding subparagraph (2), if the centers for
 Medicare and Medicaid services of the United States department
 of health and human services (CMS) requires, as a condition
 of federal Medicaid funding, that the department implement an
 aggregate federal upper limit (FUL) for drug reimbursement
 based on the average manufacturer's price (AMP), the department
 may utilize a reimbursement methodology for all drugs covered
 under the Medicaid program based on the national average drug
 acquisition cost (NADAC) methodology published by CMS, in order
 to assure compliance with the aggregate FUL, minimize outcomes
 of drug reimbursements below pharmacy acquisition costs, limit
 administrative costs, and minimize any change in the aggregate
 reimbursement for drugs.  The department may adopt emergency
 rules to implement this subparagraph.
    c.  (1)  For the fiscal year beginning July 1, 2015,
 reimbursement rates for outpatient hospital services shall
 remain at the rates in effect on June 30, 2015, 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.
    (2)  For the fiscal year beginning July 1, 2015,
 reimbursement rates for inpatient hospital services shall
 be rebased effective October 1, 2015, 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.
    (3)  For the fiscal year beginning July 1, 2015, the graduate
 medical education and disproportionate share hospital fund
 shall remain at the amount in effect on June 30, 2015, except
 that the portion of the fund attributable to graduate medical
 education shall be reduced in an amount that reflects the
 elimination of graduate medical education payments made to
 out=of=state hospitals.
    (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
 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. {1395x(v)(1)(N).
    d.  For the fiscal year beginning July 1, 2015, reimbursement
 rates for rural health clinics, hospices, and acute mental
 hospitals shall be increased in accordance with increases under
 the federal Medicare program or as supported by their Medicare
 audited costs.
    e.  For the fiscal year beginning July 1, 2015, independent
 laboratories and rehabilitation agencies shall be reimbursed
 using the same methodology in effect on June 30, 2015.
    f.  (1)  For the fiscal year beginning July 1, 2015,
 reimbursement rates for home health agencies shall continue to
 be based on the Medicare low utilization payment adjustment
 (LUPA) methodology with state geographic wage adjustments, and
 updated to reflect the most recent Medicare LUPA rates.
    (2)  For the fiscal year beginning July 1, 2015, 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, 2015.
    g.  For the fiscal year beginning July 1, 2015, federally
 qualified health centers shall receive cost=based reimbursement
 for 100 percent of the reasonable costs for the provision of
 services to recipients of medical assistance.
    h.  For the fiscal year beginning July 1, 2015, the
 reimbursement rates for dental services shall remain at the
 rates in effect on June 30, 2015.
    i.  (1)  For the fiscal year beginning July 1, 2015,
 state=owned psychiatric medical institutions for children shall
 receive cost=based reimbursement for 100 percent of the actual
 and allowable costs for the provision of services to recipients
 of medical assistance.
    (2)  For the nonstate=owned psychiatric medical institutions
 for children, reimbursement rates shall be based on the
 reimbursement methodology developed by the Medicaid managed
 care contractor for behavioral health services as required for
 federal compliance.
    (3)  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
 provided to recipients of medical assistance who are children
 under the custody of a psychiatric medical institution for
 children.
    j.  For the fiscal year beginning July 1, 2015, unless
 otherwise specified in this Act, all noninstitutional medical
 assistance provider reimbursement rates shall remain at the
 rates in effect on June 30, 2015, 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
 providers, and those providers whose rates are required to be
 determined pursuant to section 249A.20.
    k.  Notwithstanding any provision to the contrary, for the
 fiscal year beginning July 1, 2015, the reimbursement rate for
 anesthesiologists shall remain at the rate in effect on June
 30, 2015.
    l.  Notwithstanding section 249A.20, for the fiscal year
 beginning July 1, 2015, the average reimbursement rate for
 health care providers eligible for use of the federal Medicare
 resource=based relative value scale reimbursement methodology
 under section 249A.20 shall remain at the rate in effect on
 June 30, 2015; however, this rate shall not exceed the maximum
 level authorized by the federal government.
    m.  For the fiscal year beginning July 1, 2015, the
 reimbursement rate for residential care facilities shall not
 be less than the minimum payment level as established by the
 federal government to meet the federally mandated maintenance
 of effort requirement. The flat reimbursement rate for
 facilities electing not to file annual cost reports shall not
 be less than the minimum payment level as established by the
 federal government to meet the federally mandated maintenance
 of effort requirement.
    n.  For the fiscal year beginning July 1, 2015, the
 reimbursement rates for inpatient mental health services
 provided at hospitals shall be rebased effective October 1,
 2015, 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; and psychiatrists shall be reimbursed at the
 medical assistance program fee=for=service rate in effect on
 June 30, 2015.
    o.  For the fiscal year beginning July 1, 2015, community
 mental health centers may choose to be reimbursed for the
 services provided to recipients of medical assistance through
 either of the following options:
    (1)  For 100 percent of the reasonable costs of the services.
    (2)  In accordance with the alternative reimbursement rate
 methodology established by the medical assistance program's
 managed care contractor for mental health services and approved
 by the department of human services.
    p.  For the fiscal year beginning July 1, 2015, the
 reimbursement rate for providers of family planning services
 that are eligible to receive a 90 percent federal match shall
 remain at the rates in effect on June 30, 2015.
    q.  For the fiscal year beginning July 1, 2015, the upper
 limits on reimbursement rates for providers of home and
 community=based services waiver services shall be increased
 to the extent possible within the $1 million of state funding
 appropriated for this purpose.
    r.  For the fiscal year beginning July 1, 2015, the
 reimbursement rates for emergency medical service providers
 shall remain at the rates in effect on June 30, 2015.
    s.  For the fiscal year beginning July 1, 2015, reimbursement
 rates for substance=related disorder treatment programs
 licensed under section 125.13 shall be increased by 3 percent
 over the rates in effect on June 30, 2015.
    2.  For the fiscal year beginning July 1, 2015, the
 reimbursement rate for providers reimbursed under the
 in=home=related care program shall not be less than the minimum
 payment level as established by the federal government to meet
 the federally mandated maintenance of effort requirement.
    3.  Unless otherwise directed in this section, when the
 department's reimbursement methodology for any provider
 reimbursed in accordance with this section includes an
 inflation factor, this factor shall not exceed the amount
 by which the consumer price index for all urban consumers
 increased during the calendar year ending December 31, 2002.
    4.  For the fiscal year beginning July 1, 2015, 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 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 youth ages 18 to 21 who have
 exited foster care, the preparation for adult living program
 maintenance rate shall be $602.70 per month. The maximum
 payment for adoption 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.
    5.  For the fiscal year beginning July 1, 2015, the maximum
 reimbursement rates for social services providers under
 contract shall remain at the rates in effect on June 30, 2015,
 or the provider's actual and allowable cost plus inflation for
 each service, whichever is less. However, if a new service
 or service provider is added after June 30, 2015, the initial
 reimbursement rate for the service or provider shall be based
 upon a weighted average of provider rates for similar services.
    6.  For the fiscal year beginning July 1, 2015, the
 reimbursement rates for resource family recruitment and
 retention contractors, child welfare emergency services
 contractors, and supervised apartment living foster care
 providers shall be increased by 5 percent over the rates in
 effect on June 30, 2015.
    7.  a.  For the purposes of this subsection, "combined
 reimbursement rate" means the combined service and maintenance
 reimbursement rate for a service level under the department's
 reimbursement methodology. Effective July 1, 2015, the
 combined reimbursement rate for a group foster care service
 level shall be the amount designated in this subsection.
 However, if a group foster care provider's reimbursement rate
 for a service level as of June 30, 2015, is more than the rate
 designated in this subsection, the provider's reimbursement
 shall remain at the higher rate.
    b.  Unless a group foster care provider is subject to the
 exception provided in paragraph "a", effective July 1, 2015,
 the combined reimbursement rates for the service levels under
 the department's reimbursement methodology shall be as follows:
    (1)  For service level, community = D1, the daily rate shall
 be at least $84.17.
    (2)  For service level, comprehensive = D2, the daily rate
 shall be at least $119.09.
    (3)  For service level, enhanced = D3, the daily rate shall
 be at least $131.09.
    8.  The group foster care reimbursement rates paid for
 placement of children out of state shall be calculated
 according to the same rate=setting principles as those used for
 in=state providers, unless the director of human services or
 the director's designee determines that appropriate care cannot
 be provided within the state. The payment of the daily rate
 shall be based on the number of days in the calendar month in
 which service is provided.
    9.  a.  For the fiscal year beginning July 1, 2015, the
 reimbursement rate paid for shelter care and the child welfare
 emergency services implemented to provide or prevent the need
 for shelter care shall be established by contract.
    b.  For the fiscal year beginning July 1, 2015, the combined
 service and maintenance components of the reimbursement rate
 paid for shelter care services shall be based on the financial
 and statistical report submitted to the department. The
 maximum reimbursement rate shall be $101.83 per day. The
 department shall reimburse a shelter care provider at the
 provider's actual and allowable unit cost, plus inflation, not
 to exceed the maximum reimbursement rate.
    c.  Notwithstanding section 232.141, subsection 8, for the
 fiscal year beginning July 1, 2015, the amount of the statewide
 average of the actual and allowable rates for reimbursement of
 juvenile shelter care homes that is utilized for the limitation
 on recovery of unpaid costs shall remain at the amount in
 effect for this purpose in the fiscal year beginning July 1,
 2014.
    10.  For the fiscal year beginning July 1, 2015, the
 department shall calculate reimbursement rates for intermediate
 care facilities for persons with an intellectual disability
 at the 80th percentile. Beginning July 1, 2015, the rate
 calculation methodology shall utilize the consumer price index
 inflation factor applicable to the fiscal year beginning July
 1, 2015.
    11.  For the fiscal year beginning July 1, 2015, for child
 care providers reimbursed under the state child care assistance
 program, the department shall set provider reimbursement
 rates based on the rate reimbursement survey completed in
 December 2004. Effective July 1, 2015, the child care provider
 reimbursement rates shall remain at the rates in effect on June
 30, 2015. The department shall set rates in a manner so as
 to provide incentives for a nonregistered provider to become
 registered by applying the increase only to registered and
 licensed providers.
    12.  For the fiscal year beginning July 1, 2015, if the
 centers for Medicare and Medicaid services of the United
 States department of health and human services approves the
 waivers necessary to implement medical assistance program
 managed care applicable to any providers or services subject to
 reimbursement under this section, notwithstanding any provision
 to the contrary under this section, affected providers or
 services shall instead be reimbursed as follows:
    a.  For fee=for=service claims, reimbursement shall be
 calculated based on the methodology otherwise specified in this
 section for the fiscal year beginning July 1, 2015, for the
 respective provider or service.
    b.  For claims subject to a managed care contract,
 reimbursement shall be based on the methodology established
 by the managed care organization contract.  However, any
 reimbursement established under such contract shall not be
 lower than the reimbursement otherwise specified in this
 section for the fiscal year beginning July 1, 2015, for the
 respective provider or service.
    13.  The department may adopt emergency rules to implement
 this section.
    Sec. 30.  EMERGENCY RULES.
    1.  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, 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. Any rules adopted in accordance with this section
 shall not take effect before the rules are reviewed by the
 administrative rules review committee. 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,
 notwithstanding a provision in those sections making them
 inapplicable to section 17A.5, subsection 2, paragraph "b".
 Any rules adopted in accordance with the provisions of this
 section shall also be published as a notice of intended action
 as provided in section 17A.4.
    2.  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
 ranking members of the committees on appropriations, and
 the department of management concerning the rules and the
 expenditure increase. 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
 administrative code editor.
    Sec. 31.  REPORTS.  Any reports or other information
 required to be compiled and submitted under this Act during the
 fiscal year beginning July 1, 2015, shall be submitted to the
 chairpersons and ranking members of the joint appropriations
 subcommittee on health and human services, the legislative
 services agency, and the legislative caucus staffs on or
 before the dates specified for submission of the reports or
 information.
    Sec. 32.  TRANSFER OF MEDICAID MODERNIZATION SAVINGS BETWEEN
 APPROPRIATIONS FY 2015=2016.  Notwithstanding section 8.39,
 subsection 1, for the fiscal year beginning July 1, 2015, if
 savings resulting from the governor's Medicaid modernization
 initiative accrue to the medical contracts or children's health
 insurance program appropriation from the general fund of the
 state and not to the medical assistance appropriation from the
 general fund of the state under this division of this Act,
 such savings may be transferred to such medical assistance
 appropriation for the same fiscal year without prior written
 consent and approval of the governor and the director of the
 department of management.  The department of human services
 shall report any transfers made pursuant to this section to the
 legislative services agency.
    Sec. 33.  EFFECTIVE UPON ENACTMENT.  The following
 provisions of this division of this Act, being deemed of
 immediate importance, take effect upon enactment:
    1.  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, 2015, of the
 distribution of funds allocated for the payment of the expenses
 of court=ordered services provided to juveniles which are a
 charge upon the state.
                           DIVISION VI
         HEALTH CARE ACCOUNTS AND FUNDS ==== FY 2015=2016
    Sec. 34.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is
 appropriated from the pharmaceutical settlement account created
 in section 249A.33 to the department of human services for the
 fiscal year beginning July 1, 2015, and ending June 30, 2016,
 the following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    Notwithstanding any provision of law to the contrary, to
 supplement the appropriations made in this Act for medical
 contracts under the medical assistance program for the fiscal
 year beginning July 1, 2015, and ending June 30, 2016:
 .................................................. $  2,002,176
    Sec. 35.  QUALITY ASSURANCE TRUST FUND ==== DEPARTMENT OF HUMAN
 SERVICES.  Notwithstanding any provision to the contrary and
 subject to the availability of funds, there is appropriated
 from the quality assurance trust fund created in section
 249L.4 to the department of human services for the fiscal year
 beginning July 1, 2015, and ending June 30, 2016, the following
 amounts, or so much thereof as is necessary, for the purposes
 designated:
    To supplement the appropriation made in this Act from the
 general fund of the state to the department of human services
 for medical assistance for the same fiscal year:
 .................................................. $ 37,205,208
    Sec. 36.  HOSPITAL HEALTH CARE ACCESS TRUST FUND ====
 DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to
 the contrary and subject to the availability of funds, there is
 appropriated from the hospital health care access trust fund
 created in section 249M.4 to the department of human services
 for the fiscal year beginning July 1, 2015, and ending June
 30, 2016, the following amounts, or so much thereof as is
 necessary, for the purposes designated:
    To supplement the appropriation made in this Act from the
 general fund of the state to the department of human services
 for medical assistance for the same fiscal year:
 .................................................. $ 34,700,000
    Sec. 37.  MEDICAL ASSISTANCE PROGRAM ==== NONREVERSION
 FOR FY 2015=2016.  Notwithstanding section 8.33, if moneys
 appropriated for purposes of the medical assistance program for
 the fiscal year beginning July 1, 2015, and ending June 30,
 2016, from the general fund of the state, the quality assurance
 trust fund and the hospital health care access trust fund, are
 in excess of actual expenditures for the medical assistance
 program and remain unencumbered or unobligated at the close
 of the fiscal year, the excess moneys shall not revert but
 shall remain available for expenditure for the purposes of the
 medical assistance program until the close of the succeeding
 fiscal year.
                          DIVISION VII
            PATIENT=CENTERED HEALTH ADVISORY COUNCIL
    Sec. 38.  Section 135.159, subsection 2, paragraph a,
 unnumbered paragraph 1, Code 2015, is amended to read as
 follows:
    The department shall establish an a patient=centered health
  advisory council which shall include but is not limited to
 all of the following members, selected by their respective
 organizations, and any other members the department determines
 necessary to assist in the department's duties at various
 stages of development of the medical home system:
    Sec. 39.  Section 135.159, subsection 2, paragraph b, Code
 2015, is amended to read as follows:
    b.  Public members of the patient=centered health advisory
 council shall receive reimbursement for actual expenses
 incurred while serving in their official capacity only if they
 are not eligible for reimbursement by the organization that
 they represent.
    Sec. 40.  Section 135.159, subsection 10, Code 2015, is
 amended to read as follows:
    10.  The department shall integrate the recommendations and
 policies developed pursuant to section 135.161, Code 2011, into
 the medical home system and shall incorporate the development
 and implementation of the state initiative for prevention
 and chronic care management as developed pursuant to section
 135.161, Code 2011, into the duties of the medical home system
  patient=centered health advisory council beginning January 1,
 2012.
    Sec. 41.  CODE EDITOR DIRECTIVE.  The Code editor shall amend
 the headnote of section 135.159, Code 2015, to read Medical home
 system ==== patient=centered health advisory council ==== development
 and implementation.
                          DIVISION VIII
      PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS
                DECATEGORIZATION ==== FY 2014=2015
    Sec. 42.  DECATEGORIZATION CARRYOVER FUNDING ==== TRANSFER TO
 MEDICAID PROGRAM.  Notwithstanding section 232.188, subsection
 5, paragraph "b", any state appropriated moneys in the funding
 pool that remained unencumbered or unobligated at the close
 of the fiscal year beginning July 1, 2012, 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, 2014, shall
 not revert but shall be transferred to the medical assistance
 program for the fiscal year beginning July 1, 2014.
 COMMUNITY MENTAL HEALTH SERVICES APPROPRIATION ==== FY 2014=2015
    Sec. 43.  2013 Iowa Acts, chapter 136, section 2, subsection
 1, paragraph c, is amended to read as follows:
    c.  The department shall allocate not less than 95 percent
 of the amount of the block grant each federal fiscal year
 to eligible community mental health services providers for
 carrying out the plan submitted to and approved by the federal
 substance abuse and mental health services administration
 for the fiscal year involved, except that for federal fiscal
 year 2014=2015, $1,643,467 of such federal block grant funds
 shall be used for child and family services pursuant to 2013
 Iowa Acts, chapter 138, section 148, as amended by 2014 Iowa
 Acts, chapter 1140, section 25, for the purposes of 2014 Iowa
 Acts, chapter 1140, section 25, subsection 20, relating to
 the community circle of care collaboration for children and
 youth in northeast Iowa, subsection 24 relating to the central
 Iowa system of care program grant, subsection 25 relating
 to the system of care grant implemented in Cerro Gordo and
 Linn counties, and subsection 27 relating to a system of care
 approach for children with a serious emotional disturbance and
 their families through a nonprofit provider of child welfare
 services licensed as a psychiatric medical institution for
 children.
     TEMPORARY ASSISTANCE FOR NEEDY FAMILIES ==== FY 2014=2015
    Sec. 44.  2013 Iowa Acts, chapter 138, section 136,
 subsections 1, 2, 6, and 13, as amended by 2014 Iowa Acts,
 chapter 1140, section 9, are amended to read as follows:
    1.  To be credited to the family investment program account
 and used for assistance under the family investment program
 under chapter 239B:
 .................................................. $  9,879,488
                                                       6,281,222
    2.  To be credited to the family investment program account
 and used for the job opportunities and basic skills (JOBS)
 program and implementing family investment agreements in
 accordance with chapter 239B:
 .................................................. $ 11,091,911
                                                      10,232,340
    6.  For state child care assistance:
 .................................................. $ 35,047,110
                                                      41,210,239
    a.  Of the funds appropriated in this subsection,
 $26,347,110 $26,332,712 is transferred to the child care and
 development block grant appropriation made by the Eighty=fifth
 General Assembly, 2013 Session, in 2013 Iowa Acts, chapter 136,
 section 14 for the federal fiscal year beginning October 1,
 2014, and ending September 30, 2015. Of this amount, $200,000
 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. The department may
 contract with institutions of higher education or child care
 resource and referral centers to provide the educational
 opportunities. Allowable administrative costs under the
 contracts shall not exceed 5 percent. The application for a
 grant shall not exceed two pages in length.
    b.  Any funds appropriated in this subsection remaining
 unallocated shall be used for state child care assistance
 payments for families who are employed, including but not
 limited to individuals enrolled in the family investment
 program who are employed.
    13.  a.  Notwithstanding any provision to the contrary,
 including but not limited to requirements in section 8.41 or
 provisions in 2013 or 2014 Iowa Acts regarding the receipt and
 appropriation of federal block grants, federal funds from the
 temporary assistance for needy families block grant received
 by the state not otherwise appropriated in this section and
 remaining available for the fiscal year beginning July 1, 2014,
 are appropriated to the department of human services to the
 extent as may be necessary to be used in the following priority
 order:  the family investment program, for state child care
 assistance program payments for individuals enrolled in the
 family investment program families who are employed, and for
 the family investment program share of costs to develop and
 maintain a new, integrated eligibility determination system.
 The federal funds appropriated in this paragraph "a" shall be
 expended only after all other funds appropriated in subsection
 1 for the assistance under the family investment program,
 in subsection 6 for child care assistance, or in subsection
 12 for the family investment program share of the costs to
 continue to develop and maintain a new, integrated eligibility
 determination system, as applicable, have been expended.  For
 the purposes of this subsection, the funds appropriated in
 subsection 6, paragraph "a", for transfer to the child care and
 development block grant are considered fully expended when the
 full amount has been transferred.
    b.  The department shall, on a quarterly basis, advise the
 legislative services agency and department of management of
 the amount of funds appropriated in this subsection that was
 expended in the prior quarter.
 CHILD SUPPORT RECOVERY UNIT ==== CARRYFORWARD FUNDING ==== TRANSFER
              TO MEDICAID PROGRAM FOR FY 2015=2016
    Sec. 45.  2013 Iowa Acts, chapter 138, section 139, as
 amended by 2014 Iowa Acts, chapter 1140, section 12, is amended
 by adding the following new subsection:
    NEW SUBSECTION.  5.  Notwithstanding section 8.33, moneys
 appropriated in this section that remain unencumbered or
 unobligated at the close of the fiscal year ending June 30,
 2015, shall not revert but shall be transferred to the medical
 assistance appropriation for the fiscal year beginning July 1,
 2015, to be used for the medical assistance program for that
 fiscal year.
               MEDICAL ASSISTANCE ==== FY 2014=2015
    Sec. 46.  2013 Iowa Acts, chapter 139, section 142,
 unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter
 1140, section 14, is amended to read as follows:
    For medical assistance program reimbursement and associated
 costs as specifically provided in the reimbursement
 methodologies in effect on June 30, 2014, except as otherwise
 expressly authorized by law, consistent with options under
 federal law and regulations, and contingent upon receipt of
 approval from the office of the governor of reimbursement for
 each abortion performed under the program:
 .................................................. $1,250,658,393
                                                     1,266,486,529
         DISPROPORTIONATE SHARE HOSPITAL ==== FY 2014=2015
    Sec. 47.  2013 Iowa Acts, chapter 138, section 142,
 subsection 11, paragraph a, unnumbered paragraph 1, as amended
 by 2014 Iowa Acts, chapter 1140, section 15, is amended to read
 as follows:
    Of the funds appropriated in this section, $8,391,922
  $5,591,922 is allocated for the state match for a
 disproportionate share hospital payment of $19,133,430
  $12,749,481 to hospitals that meet both of the conditions
 specified in subparagraphs (1) and (2). In addition, the
 hospitals that meet the conditions specified shall either
 certify public expenditures or transfer to the medical
 assistance program an amount equal to provide the nonfederal
 share for a disproportionate share hospital payment of
 $7,500,000 $13,883,949. The hospitals that meet the conditions
 specified shall receive and retain 100 percent of the total
 disproportionate share hospital payment of $26,633,430.
 MEDICAL CONTRACTS CARRYFORWARD FUNDING ==== TRANSFER TO MEDICAID
                    PROGRAM FOR FY 2015=2016
    Sec. 48.  2013 Iowa Acts, chapter 138, section 143, as
 amended by 2014 Iowa Acts, chapter 1140, section 19, is amended
 by adding the following new subsection:
    NEW SUBSECTION.  9.  Notwithstanding section 8.33, moneys
 appropriated in this section that remain unencumbered
 or unobligated at the close of the fiscal year shall not
 revert but shall be transferred to the medical assistance
 appropriation for the fiscal year beginning July 1, 2015, to be
 used for the medical assistance program for that fiscal year.
   STATE SUPPLEMENTARY ASSISTANCE ==== CARRYFORWARD FUNDING ====
          TRANSFER TO MEDICAID PROGRAM FOR FY 2015=2016
    Sec. 49.  2013 Iowa Acts, chapter 138, section 144, as
 amended by 2014 Iowa Acts, chapter 1140, section 20, is amended
 by adding the following new subsection:
    NEW SUBSECTION.  4.  Notwithstanding section 8.33, moneys
 appropriated in this section that remain unencumbered
 or unobligated at the close of the fiscal year shall not
 revert but shall be transferred to the medical assistance
 appropriation for the fiscal year beginning July 1, 2015, to be
 used for the medical assistance program for that fiscal year.
  CHILDREN'S HEALTH INSURANCE PROGRAM/HEALTHY AND WELL KIDS IN
   IOWA PROGRAM CARRYFORWARD FUNDING ==== TRANSFER TO MEDICAID
                    PROGRAM FOR FY 2015=2016
    Sec. 50.  2013 Iowa Acts, chapter 138, section 145, as
 amended by 2014 Iowa Acts, chapter 1140, section 21, is amended
 by adding the following new subsection:
    NEW SUBSECTION.  3.  Notwithstanding section 8.33, moneys
 appropriated in this section that remain unencumbered
 or unobligated at the close of the fiscal year shall not
 revert but shall be transferred to the medical assistance
 appropriation for the fiscal year beginning July 1, 2015, to be
 used for the medical assistance program for that same fiscal
 year.
              CHILD CARE ASSISTANCE ==== FY 2014=2015
    Sec. 51.  2013 Iowa Acts, chapter 138, section 146,
 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts,
 chapter 1140, section 22, are amended to read as follows:
    There is appropriated from the general fund of the state to
 the department of human services for the fiscal year beginning
 July 1, 2014, and ending June 30, 2015, the following amount,
 or so much thereof as is necessary, to be used for the purpose
 designated:
    For child care programs:
 .................................................. $ 47,132,080
                                                      36,303,944
    Sec. 52.  2013 Iowa Acts, chapter 138, section 146,
 subsection 1, as amended by 2014 Iowa Acts, chapter 1140,
 section 22, is amended to read as follows:
    1.  Of the funds appropriated in this section, $39,412,653
  $28,484,517 shall be used for state child care assistance in
 accordance with section 237A.13.
 CHILD AND FAMILY SERVICES ==== CARRYFORWARD FUNDING ==== TRANSFER
              TO MEDICAID PROGRAM FOR FY 2015=2016
    Sec. 53.  2013 Iowa Acts, chapter 138, section 148, as
 amended by 2014 Iowa Acts, chapter 1140, section 25, is amended
 by adding the following new subsection:
    NEW SUBSECTION.  29.  Notwithstanding section 8.33, of the
 moneys appropriated in this section that remain unencumbered or
 unobligated at the close of the fiscal year, $8,293,467 shall
 not revert but shall be transferred to the medical assistance
 appropriation for the fiscal year beginning July 1, 2015, to be
 used for the medical assistance program for that fiscal year.
    ADOPTION SUBSIDY ==== CARRYFORWARD FUNDING ==== TRANSFER TO
                MEDICAID PROGRAM FOR FY 2015=2016
    Sec. 54.  2013 Iowa Acts, chapter 138, section 149, as
 amended by 2014 Iowa Acts, chapter 1140, section 26, is amended
 by adding the following new subsection:
    NEW SUBSECTION.  4.  Notwithstanding section 8.33, moneys
 appropriated in this section that remain unencumbered
 or unobligated at the close of the fiscal year shall not
 revert but shall be transferred to the medical assistance
 appropriation for the fiscal year beginning July 1, 2015, to be
 used for the medical assistance program for that fiscal year.
 FAMILY SUPPORT SUBSIDY ==== CARRYFORWARD FUNDING ==== TRANSFER TO
                MEDICAID PROGRAM FOR FY 2015=2016
    Sec. 55.  2013 Iowa Acts, chapter 138, section 151, as
 amended by 2014 Iowa Acts, chapter 1140, section 27, is amended
 by adding the following new subsection:
    NEW SUBSECTION.  4.  Notwithstanding section 8.33, moneys
 appropriated in this section that remain unencumbered
 or unobligated at the close of the fiscal year shall not
 revert but shall be transferred to the medical assistance
 appropriation for the fiscal year beginning July 1, 2015, to be
 used for the medical assistance program for that fiscal year.
 CLARINDA AND INDEPENDENCE MENTAL HEALTH INSTITUTES CARRYFORWARD
    FUNDING ==== TRANSFER TO MEDICAID PROGRAM FOR FY 2015=2016
    Sec. 56.  2013 Iowa Acts, chapter 138, section 153,
 subsections 2 and 3, as amended by 2014 Iowa Acts, chapter
 1140, section 29, are amended to read as follows:
    2.  a.  For the state mental health institute at Clarinda for
 salaries, support, maintenance, and miscellaneous purposes, and
 for not more than the following full=time equivalent positions:
 .................................................. $  6,787,309
 ............................................... FTEs      86.10
    b.  Notwithstanding section 8.33, moneys appropriated in
 this subsection that remain unencumbered or unobligated at
 the close of the fiscal year shall not revert but shall be
 transferred to the medical assistance appropriation for the
 fiscal year beginning July 1, 2015, to be used for the medical
 assistance program for that fiscal year.
    3.  a.  For the state mental health institute at Independence
 for salaries, support, maintenance, and miscellaneous purposes,
 and for not more than the following full=time equivalent
 positions:
 .................................................. $ 10,484,386
 ............................................... FTEs     233.00
    b.  Notwithstanding section 8.33, moneys appropriated in
 this subsection that remain unencumbered or unobligated at
 the close of the fiscal year shall not revert but shall be
 transferred to the medical assistance appropriation for the
 fiscal year beginning July 1, 2015, to be used for the medical
 assistance program for that fiscal year.
  GLENWOOD AND WOODWARD STATE RESOURCE CENTERS ==== CARRYFORWARD
    FUNDING ==== TRANSFER TO MEDICAID PROGRAM FOR FY 2015=2016
    Sec. 57.  2013 Iowa Acts, chapter 138, section 154,
 subsection 1, as amended by 2014 Iowa Acts, chapter 1140,
 section 30, is amended to read as follows:
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2014, and ending June 30, 2015, the following
 amounts, or so much thereof as is necessary, to be used for the
 purposes designated:
    a.  For the state resource center at Glenwood for salaries,
 support, maintenance, and miscellaneous purposes:
 .................................................. $ 21,695,266
    Notwithstanding section 8.33, moneys appropriated in this
 paragraph "a" that remain unencumbered or unobligated at
 the close of the fiscal year shall not revert but shall be
 transferred to the medical assistance appropriation for the
 fiscal year beginning July 1, 2015, to be used for the medical
 assistance program for that fiscal year.
    b.  For the state resource center at Woodward for salaries,
 support, maintenance, and miscellaneous purposes:
 .................................................. $ 14,855,693
    Notwithstanding section 8.33, moneys appropriated in this
 paragraph "b" that remain unencumbered or unobligated at
 the close of the fiscal year shall not revert but shall be
 transferred to the medical assistance appropriation for the
 fiscal year beginning July 1, 2015, to be used for the medical
 assistance program for that fiscal year.
                FIELD OPERATIONS ==== FY 2014=2015
    Sec. 58.  2013 Iowa Acts, chapter 138, section 156,
 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts,
 chapter 1140, section 32, are amended to read as follows:
    There is appropriated from the general fund of the state to
 the department of human services for the fiscal year beginning
 July 1, 2014, and ending June 30, 2015, the following amount,
 or so much thereof as is necessary, to be used for the purposes
 designated:
    For field operations, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $ 65,170,976
                                                      61,170,976
 ............................................... FTEs   1,837.00
             GENERAL ADMINISTRATION ==== FY 2014=2015
    Sec. 59.  2013 Iowa Acts, chapter 138, section 157,
 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts,
 chapter 1140, section 33, are amended to read as follows:
    There is appropriated from the general fund of the state to
 the department of human services for the fiscal year beginning
 July 1, 2014, and ending June 30, 2015, the following amount,
 or so much thereof as is necessary, to be used for the purpose
 designated:
    For general administration, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $ 16,072,302
                                                      15,072,302
 ............................................... FTEs     309.00
    CHILDREN ADJUDICATED AS DELINQUENT AND CHILD IN NEED OF
   ASSISTANCE PLACEMENTS ==== CARRYFORWARD FUNDING FY 2015=2016
    Sec. 60.  2013 Iowa Acts, chapter 138, section 147A, as
 enacted by 2014 Iowa Acts, chapter 1140, section 24, is amended
 by adding the following new subsection:
    NEW SUBSECTION.  4.  Notwithstanding section 8.33, moneys
 appropriated in this section that remain unencumbered
 or unobligated at the close of the fiscal year shall not
 revert but shall be transferred to the medical assistance
 appropriation for the fiscal year beginning July 1, 2015, to be
 used for the medical assistance program for that fiscal year.
    Sec. 61.  EFFECTIVE UPON ENACTMENT.  This division of this
 Act, being deemed of immediate importance, takes effect upon
 enactment.
    Sec. 62.  RETROACTIVE APPLICABILITY.  This division of this
 Act is retroactively applicable to July 1, 2014.
                           DIVISION IX
                   HEALTH POLICY ==== OVERSIGHT
    Sec. 63.  HEALTH POLICY OVERSIGHT ==== MEDICAID MANAGED CARE.
    1.  The department of human services shall partner with
 appropriate stakeholders to convene monthly statewide public
 meetings to receive input and recommendations from stakeholders
 and members of the public regarding Medicaid managed care,
 beginning in March 2016.  The meetings shall be held in
 both rural and urban areas, in small communities and large
 population centers, and in a manner that is geographically
 balanced.  The input and recommendations of the public meetings
 shall be compiled by the department of human services and
 submitted to the executive committee of the medical assistance
 advisory council created in section 249A.4B.
    2.  a.  The executive committee of the medical assistance
 advisory council shall review the compilation of the input and
 recommendations of the public meetings convened pursuant to
 subsection 1, and shall submit recommendations based upon the
 compilation to the director of human services on a quarterly
 basis.
    b.  The director of human services shall submit the
 compilation and the recommendations made under paragraph "a" to
 the legislative health policy oversight committee created in
 section 2.45.
    Sec. 64.  Section 2.45, Code 2015, is amended by adding the
 following new subsection:
    NEW SUBSECTION.  6.  The legislative health policy oversight
 committee, which shall be composed of members appointed by the
 legislative council.  The legislative health policy oversight
 committee shall receive updates and review data, public input
 and concerns, and make recommendations for improvements to and
 changes in law or rule regarding Medicaid managed care.
    Sec. 65.  NEW SECTION.  231.44  Utilization of resources
 ==== assistance and advocacy related to long=term services and
 supports under the Medicaid program.
    1.  The office of long=term care ombudsman may utilize
 its available resources to provide assistance and advocacy
 services to eligible recipients, or the families or legal
 representatives of such eligible recipients, of long=term
 services and supports provided through the Medicaid program.
 Such assistance and advocacy shall include but is not limited
 to all of the following:
    a.  Assisting recipients in understanding the services,
 coverage, and access provisions and their rights under Medicaid
 managed care.
    b.  Developing procedures for the tracking and reporting
 of the outcomes of individual requests for assistance, the
 obtaining of necessary services and supports, and other aspects
 of the services provided to eligible recipients.
    c.  Providing advice and assistance relating to the
 preparation and filing of complaints, grievances, and appeals
 of complaints or grievances, including through processes
 available under managed care plans and the state appeals
 process, relating to long=term services and supports under the
 Medicaid program.
    2.  A representative of the office of long=term care
 ombudsman providing assistance and advocacy services authorized
 under this section for an individual, shall be provided
 access to the individual,  and shall be provided access to
 the individual's medical and social records as authorized by
 the individual or the individual's legal representative, as
 necessary to carry out the duties specified in this section.
    3.  A representative of the office of long=term care
 ombudsman providing assistance and advocacy services authorized
 under this section for an individual, shall be provided access
 to administrative records related to the provision of the
 long=term services and supports to the individual, as necessary
 to carry out the duties specified in this section.
    4.  For the purposes of this section:
    a.  "Institutional setting" includes a long=term care
 facility, an elder group home, or an assisted living program.
    b.  "Long=term services and supports" means the broad range of
 health, health=related, and personal care assistance services
 and supports, provided in both institutional settings and home
 and community=based settings, necessary for older individuals
 and persons with disabilities who experience limitations in
 their capacity for self=care due to a physical, cognitive, or
 mental disability or condition.
    Sec. 66.  PROPOSAL FOR A HEALTH CONSUMER OMBUDSMAN
 ALLIANCE.  The office of long=term care ombudsman shall
 collaborate with the department on aging, the office of
 substitute decision maker, the department of veterans affairs,
 the department of human services, the department of public
 health, the department of inspections and appeals, the
 designated protection and advocacy agency as provided in
 section 135C.2, subsection 4, the civil rights commission, the
 senior health insurance information program, the Iowa insurance
 consumer advocate, Iowa legal aid, and other consumer advocates
 and consumer assistance programs, to develop a proposal for the
 establishment of a health consumer ombudsman alliance. The
 purpose of the alliance is to provide a permanent coordinated
 system of independent consumer supports to ensure that
 consumers, including consumers covered under Medicaid managed
 care, obtain and maintain essential health care, are provided
 unbiased information in understanding coverage models, and are
 assisted in resolving problems regarding health care services,
 coverage, access, and rights. The proposal developed shall
 include annual budget projections and shall be submitted to the
 governor and the general assembly no later than December 15,
 2015.
    Sec. 67.  LEVEL OF CARE ASSESSMENTS AND REASSESSMENTS,
 OPTIONS COUNSELING, AND CASE MANAGEMENT.
    1.  a.  The department of human services shall contract with
 a conflict free third party to conduct initial level of care
 assessments and reassessments for Medicaid program applicants
 or members who are not enrolled in a Medicaid managed care
 plan.
    b.  A Medicaid managed care contractor shall conduct initial
 level of care assessments and reassessments for Medicaid
 program members enrolled in the contractor's plan, and shall
 submit the results to the department.
    c.  All level of care assessments and reassessments shall be
 conducted using an assessment tool approved by the department
 and shall be conflict free.
    d.  The department shall determine the level of care of an
 applicant or member based upon the results of the assessments
 or reassessments conducted  and submitted in accordance with
 this subsection.
    e.  Level of care reassessments shall be conducted annually
 or when the needs of a member change.
    2.  A Medicaid member's service plan shall reflect
 the member's needs and goals based upon the assessment or
 reassessment conducted pursuant to subsection 1. A member's
 service plan shall not be changed prior to the completion of a
 functional or needs reassessment, and any subsequent service
 plan shall be based on the reassessment.
    3.  The department shall provide for administration of
 nonbiased, community=based, in=person options counseling by a
 conflict free third party for applicants for a Medicaid managed
 care plan.
    4.  Case management under a Medicaid managed care contract
 shall be administered in a conflict free manner.
    5.  For the purposes of this section, "conflict free" means
 conflict free pursuant to specifications of the balancing
 incentive program requirements.
                           DIVISION X
                             AUTISM
    Sec. 68.  NEW SECTION.  135.181  Behavior analyst and board
 certified assistant behavior analyst grants program ==== fund.
    1.  The department shall establish a board=certified
 behavior analyst and board=certified assistant behavior
 analyst grants program to provide grants to Iowa resident and
 nonresident applicants who have been accepted for admission or
 are attending a board of regents university, community college,
 or an accredited private institution, are enrolled in a program
 to be eligible for board certification as a behavior analyst
 or assistant behavior analyst, and demonstrate financial
 need.  Priority in the awarding of a grant shall be given to
 applicants who are residents of Iowa.
    2.  The department, in cooperation with the department
 of education, shall adopt rules pursuant to chapter 17A to
 establish minimum standards for applicants to be eligible for a
 grant that address all of the following:
    a.  Eligibility requirements for and qualifications of an
 applicant to receive a grant.
    b.  The application process for the grant.
    c.  Criteria for preference in awarding of the grants.
    d.  Determination of the amount of a grant.
    e.  Use of the funds awarded.
    3.  a.  A board=certified behavior analyst and
 board=certified assistant behavior analyst grants program fund
 is created in the state treasury as a separate fund under
 the control of the department. The fund shall consist of
 moneys appropriated from the general fund of the state for
 the purposes of the fund and moneys from any other public or
 private source available.
    b.  The department may receive contributions, grants, and
 in=kind contributions to support the purposes of the fund. Not
 more than five percent of the moneys in the fund may be used
 annually for administrative costs.
    c.  The fund shall be separate from the general fund of  the
 state and shall not be considered part of the general fund of
 the state. The moneys in the fund shall not be considered
 revenue of the state, but rather shall be moneys of the fund.
 Moneys within the fund are not subject to section 8.33 and
 shall not be transferred, used, obligated, appropriated, or
 otherwise encumbered, except to provide for the purposes of
 this section.  Notwithstanding section 12C.7, subsection 2,
 interest or earnings on moneys deposited in the fund shall be
 credited to the fund.
    d.  The moneys in the fund are appropriated to the department
 and shall be used to provide grants to individuals who meet the
 criteria established under this section.
    Sec. 69.  Section 225D.1, subsection 3, Code 2015, is amended
 to read as follows:
    3.  "Autism service provider" means a person providing
 applied behavioral analysis, who meets all of the following
 criteria:
    a.  Is any of the following:
    (1)  Is certified as a behavior analyst by the behavior
 analyst certification board or, is a health professional
 licensed under chapter 147 psychologist licensed under chapter
 154B, or is a psychiatrist licensed under chapter 148.
    (2)  Is a board=certified assistant behavior analyst who
 performs duties, identified by and based on the standards of
 the behavior analyst certification board, under the supervision
 of a board=certified behavior analyst.
    b.  Is approved as a member of the provider network by the
 department.
    Sec. 70.  Section 225D.2, subsection 2, Code 2015, is amended
 by adding the following new paragraph:
    NEW PARAGRAPH.  l.  Proof of eligibility for the autism
 support program that includes a written denial for coverage or
 a benefits summary indicating that applied behavioral analysis
 treatment is not a covered benefit for which the applicant
 is eligible, under the Medicaid program, section 514C.28, or
 private insurance coverage.
    Sec. 71.  Section 225D.2, subsection 5, paragraph a, Code
 2015, is amended to read as follows:
    a.  An autism support fund is created in the state treasury
 under the authority of the department. Moneys appropriated
 to and all other moneys specified for deposit in the fund
 shall be deposited in the fund and used for the purposes of
 the program.  Notwithstanding section 12C.7, interest or
 earnings on moneys in the fund shall be credited to the fund.
 Notwithstanding section 8.33, moneys credited to the fund that
 remain unexpended or unobligated at the end of a fiscal year
 shall not revert to any other fund.
                           DIVISION XI
               OFFICE OF SUBSTITUTE DECISION MAKER
    Sec. 72.  Section 231E.4, subsection 3, paragraph a, Code
 2015, is amended to read as follows:
    a.  Select persons through a request for proposals process to
 establish local offices of substitute decision maker in each
 of the planning and service areas. Local offices shall be
 established statewide on or before July 1, 2015 2017.
                          DIVISION XII
                       DEMENTIA WORKFORCE
    Sec. 73.  INTERAGENCY DEMENTIA PROFICIENT WORKFORCE TASK
 FORCE.  The department on aging shall convene an interagency
 task force, in collaboration with the office of long=term
 care ombudsman, the office of substitute decision maker, the
 departments of public health, human services, and inspections
 and appeals, and the Alzheimer's association, to review the
 recommendations for a standard curriculum model for dementia
 education submitted by the Alzheimer's association dementia
 education task force to the department on aging in June 2010,
 in the Iowa dementia education project final report, and the
 curricula=related recommendations submitted by the direct care
 worker task force  and the direct care worker advisory council;
 identify staff, in settings in which individuals with dementia
 may seek services and care, who should have some level of
 dementia proficiency and analyze gaps in existing training
 and educational requirements; and develop an implementation
 plan to transition toward competency=based dementia curricula
 and training that achieves dementia proficiency across a
 broader care continuum.  To the greatest extent possible,
 the plan shall address training strategies for different
 settings, levels of skill, and licensure.  The plan shall
 include a timeline for implementation, fiscal implications of
 recommendations, and identification of key decision points
 for the general assembly.  The task force shall provide
 opportunities for stakeholder input from affected industry,
 education, professional, employee, and consumer organizations.
 The task force shall submit its  recommendations to the governor
 and the general assembly no later than December 15, 2015.
                          DIVISION XIII
         PHARMACEUTICAL COLLECTION AND DISPOSAL PROGRAM
    Sec. 74.  Section 155A.43, Code 2015, is amended to read as
 follows:
    155A.43  Pharmaceutical collection and disposal program ====
 annual allocation.
    Of the fees collected pursuant to sections 124.301 and
 147.80 and chapter 155A by the board of pharmacy, and retained
 by the board pursuant to section 147.82, not more than
 one hundred twenty=five seventy=five thousand dollars may
 be allocated annually by the board for administering the
 pharmaceutical collection and disposal program originally
 established pursuant to 2009 Iowa Acts, ch. 175, {9. The
 program shall provide for the management and disposal of
 unused, excess, and expired pharmaceuticals. The board of
 pharmacy may cooperate with the Iowa pharmacy association and
 may consult with the department and sanitary landfill operators
 in administering the program.
                          DIVISION XIV
                  PREREQUISITES FOR AN ABORTION
    Sec. 75.  NEW SECTION.  146A.1  Prerequisites for an abortion.
    Except in the case of a medical emergency, as defined in
 section 135L.1, for any woman, the physician shall certify both
 of the following before performing an abortion:
    1.  That the woman has been given the opportunity to view an
 ultrasound image of the fetus as part of the standard of care.
    2.  That the woman has been provided information regarding
 the options relative to a pregnancy, including continuing the
 pregnancy to term and retaining parental rights following the
 child's birth, continuing the pregnancy to term and placing the
 child for adoption, and terminating the pregnancy.
                           DIVISION XV
                  IOWA ABLE SAVINGS PLAN TRUST
    Sec. 76.  NEW SECTION.  12I.1  Purpose and definitions.
    1.  The general assembly finds that the general welfare
 and well=being of the state are directly related to the
 health, maintenance, independence, and quality of life of its
 disabled residents, and that a vital and valid public purpose
 is served by the creation and implementation of programs that
 encourage and make possible savings to secure funding for
 disability=related expenses on behalf of individuals with
 disabilities that will supplement, but not supplant, other
 benefits provided by various federal, state, and private
 sources.  The creation of the means of encouragement for
 citizens to invest in such a program represents the carrying
 out of a vital and valid public purpose.  In order to make
 available to the citizens of the state an opportunity to fund
 future disability=related expenses of individuals, it is
 necessary that a public trust be established in which moneys
 may be invested for payment of future disability=related
 expenses of an individual.
    2.  As used in this chapter, unless the context otherwise
 requires:
    a.  "Account balance limit" means the maximum allowable
 aggregate balance of an account established for a designated
 beneficiary.  Account earnings, if any, are included in the
 account balance limit.
    b.  "Account owner" means an individual who enters into a
 participation agreement under this chapter for the payment
 of qualified disability expenses on behalf of a designated
 beneficiary.
    c.  "Contracting state" means the same as defined in section
 529A of the Internal Revenue Code.
    d.  "Designated beneficiary" means an individual who is a
 resident of this state or a resident of a contracting state and
 who meets the definition of "eligible individual" in section
 529A of the Internal Revenue Code.
    e.  "Internal Revenue Code" means the Internal Revenue Code
 of 1986, as amended, and regulations promulgated thereunder.
    f.  "Iowa ABLE savings plan trust" or "trust" means the trust
 created under section 12I.2.
    g.  "Participation agreement" means an agreement between the
 account owner and the trust entered into under this chapter.
    h.  "Qualified ABLE program" means the same as defined in
 section 529A of the Internal Revenue Code.
    i.  "Qualified disability expenses" means the same as defined
 in section 529A of the Internal Revenue Code.
    j.  "Resident" shall be defined by rules adopted by the
 treasurer of state.  The rules shall determine residency in
 such manner as may be required or permitted under section
 529A of the Internal Revenue Code, or, in the absence of any
 guidance under federal law, as the treasurer of state deems
 advisable for the purpose of satisfying the requirements of
 section 529A of the Internal Revenue Code.
    Sec. 77.  NEW SECTION.  12I.2  Creation of Iowa ABLE savings
 plan trust.
 An Iowa ABLE savings plan trust is created.  The treasurer of
 state is the trustee of the trust, and has all powers necessary
 to carry out and effectuate the purposes, objectives, and
 provisions of this chapter pertaining to the trust, including
 the power to do all of the following:
    1.  Make and enter into contracts necessary for the
 administration of the trust created under this chapter.
    2.  Enter into agreements with this state or any other
 state, or any federal or other state agency, or other entity as
 required to implement this chapter.
    3.  Carry out the duties and obligations of the trust
 pursuant to this chapter.
    4.  Accept any grants, gifts, legislative appropriations,
 and other moneys from the state, any unit of federal, state, or
 local government, or any other person, firm, partnership, or
 corporation which the treasurer of state shall deposit into the
 administrative fund or program fund.
    5.  Participate in any federal, state, or local governmental
 program for the benefit of the trust.
    6.  Procure insurance against any loss in connection with the
 property, assets, or activities of the trust.
    7.  Enter into participation agreements with account owners.
    8.  Make payments to designated beneficiaries pursuant to
 participation agreements.
    9.  Make refunds to account owners upon the termination
 of participation agreements, and partial nonqualified
 distributions to account owners, pursuant to this chapter and
 the limitations and restrictions set forth in this chapter.
    10.  Invest moneys from the program fund in any investments
 that are determined by the treasurer of state to be
 appropriate.
    11.  Engage investment advisors, if necessary, to assist in
 the investment of trust assets.
    12.  Contract for goods and services and engage personnel
 as necessary, including consultants, actuaries, managers,
 legal counsel, and auditors for the purpose of rendering
 professional, managerial, and technical assistance and advice
 to the treasurer of state regarding trust administration and
 operation.
    13.  Establish, impose, and collect administrative fees
 and charges in connection with transactions of the trust, and
 provide for reasonable service charges, including penalties for
 cancellations and late payments with respect to participation
 agreements.
    14.  Administer the funds of the trust.
    15.  Prepare and file reports and notices.
    16.  Enter into agreements with contracting states to permit
 residents of the contracting state to participate in the Iowa
 ABLE savings plan trust.
    17.  Adopt rules pursuant to chapter 17A for the
 administration of this chapter.
    Sec. 78.  NEW SECTION.  12I.3  Participation agreements for
 trust.
    On or after July 1, 2016, the trust may enter into
 participation agreements with account owners pursuant to the
 following terms and agreements:
    1.  a.  Unless otherwise permitted under section 529A of the
 Internal Revenue Code, the treasurer of state shall allow only
 one participation agreement per designated beneficiary.
    b.  Unless otherwise permitted under section 529A of the
 Internal Revenue Code, the account owner must also be the
 designated beneficiary of the account.  However, a trustee or
 legal guardian may be designated as custodian of an account for
 a designated beneficiary who is a minor or who lacks capacity
 to enter into a participation agreement if such designation is
 not prohibited under section 529A of the Internal Revenue Code.
    c.  The treasurer of state shall set an annual contribution
 limit and account balance limit to maintain compliance with
 section 529A of the Internal Revenue Code. A contribution
 shall not be permitted to the extent it exceeds the annual
 contribution limit or causes the aggregate balance of the
 account established for the designated beneficiary to exceed
 the applicable account balance limit.
    d.  The maximum amount that may be deducted per year for
 Iowa income tax purposes by an individual for contributions on
 behalf of any one designated beneficiary that is a resident
 of this state shall not exceed the maximum deductible amount
 determined for the year pursuant to section 12D.3, subsection
 1, paragraph "a".
    e.  Participation agreements may be amended to provide
 for adjusted levels of contributions based upon changed
 circumstances or changes in disability=related expenses.
    f.  Any person may make contributions pursuant to a
 participation agreement on behalf of a designated beneficiary
 under rules adopted by the treasurer of state.
    2.  The execution of a participation agreement by the trust
 shall not guarantee in any way that future disability=related
 expenses will be equal to projections and estimates provided by
 the trust or that the account owner or designated beneficiary
 is guaranteed any of the following:
    a.  A return of principal.
    b.  A rate of interest or other return from the trust.
    c.  Payment of interest or other return from the trust.
    3.  a.  A designated beneficiary under a participation
 agreement may be changed as permitted under rules adopted by
 the treasurer of state upon written request of the account
 owner as long as such change would be permitted by section 529A
 of the Internal Revenue Code.
    b.  Participation agreements may otherwise be freely amended
 throughout their terms in order to enable account owners to
 increase or decrease the level of participation, change the
 designated beneficiary, and carry out similar matters as
 authorized by rule.
    4.  Each participation agreement shall provide that the
 participation agreement may be canceled upon the terms and
 conditions, and upon payment of applicable fees and costs set
 forth and contained in the rules adopted by the treasurer of
 state.
    Sec. 79.  NEW SECTION.  12I.4  Program and administrative
 funds ==== investment and payment.
    1.  a.  The treasurer of state shall segregate moneys
 received by the trust into two funds:  the program fund and the
 administrative fund.
    b.  All moneys paid by account owners or other persons
 on behalf of a designated beneficiary in connection with
 participation agreements shall be deposited as received into
 separate accounts for each designated beneficiary within the
 program fund.
    c.  Contributions to the trust made on behalf of designated
 beneficiaries may only be made in the form of cash.
    d.  An account owner or designated beneficiary is
 not permitted to provide investment direction regarding
 contributions or earnings held by the trust.
    2.  Moneys accrued by account owners in the program fund
 of the trust may be used for payments of qualified disability
 expenses.
    3.  Moneys in the account of a designated beneficiary may
 be claimed by the Iowa Medicaid program as provided in section
 529A(f) of the Internal Revenue Code and subject to limitations
 imposed by the treasurer of state.
    4.  The trust shall comply with Pub. L. No. 113=295, {103,
 regarding treatment of ABLE accounts under certain federal
 programs.
    5.  Moneys in the funds are not subject to section 8.33.
 Notwithstanding section 12C.7, interest or earnings on moneys
 in the funds shall be credited to the funds.
    Sec. 80.  NEW SECTION.  12I.5  Cancellation of agreements.
    An account owner may cancel a participation agreement at
 will. Upon cancellation of a participation agreement, an
 account owner shall be entitled to the return of the account
 owner's account balance.
    Sec. 81.  NEW SECTION.  12I.6  Repayment and ownership of
 payments and investment income ==== transfer of ownership rights.
    1.  a.  An account owner retains ownership of all
 contributions made on behalf of a designated beneficiary under
 a participation agreement up to the date of utilization for
 payment of qualified disability expenses of the designated
 beneficiary.
    b.  All income derived from the investment of the
 contributions made on behalf of a designated beneficiary shall
 be considered to be held in trust for the benefit of the
 designated beneficiary.
    2.  In the event the trust is terminated prior to payment of
 qualified disability expenses for the designated beneficiary,
 the account owner is entitled to a refund of the account
 owner's account balance.
    3.  Any amounts which may be paid to any person or persons
 pursuant to the Iowa ABLE savings plan trust but which are not
 listed in this section are owned by the trust.
    4.  An account owner may transfer ownership rights to
 another designated beneficiary, including a gift of the
 ownership rights to a designated beneficiary who is a minor, in
 accordance with rules adopted by the treasurer of state and the
 terms of the participation agreement, so long as the transfer
 would be permitted by section 529A of the Internal Revenue
 Code.
    5.  An account owner or designated beneficiary shall not be
 entitled to utilize any interest in the trust as security for
 a loan.
    Sec. 82.  NEW SECTION.  12I.7  Reports ==== annual audited
 financial report ==== reports under federal law.
    1.  a.  The treasurer of state shall submit an annual
 audited financial report, prepared in accordance with generally
 accepted accounting principles, on the operations of the trust
 by November 1 to the governor and the general assembly.
    b.  The annual audit shall be made either by the auditor
 of state or by an independent certified public accountant
 designated by the auditor of state and shall include direct and
 indirect costs attributable to the use of outside consultants,
 independent contractors, and any other persons who are not
 state employees.
    2.  The annual audit shall be supplemented by all of the
 following information prepared by the treasurer of state:
    a.  Any related studies or evaluations prepared in the
 preceding year.
    b.  A summary of the benefits provided by the trust,
 including the number of account owners and designated
 beneficiaries in the trust, or, if the trust has caused this
 state to become a contracting state pursuant to section 12I.10,
 a summary of the benefits provided to Iowa residents by the
 contracted qualified ABLE program, including the number of
 account owners and designated beneficiaries in the contracted
 qualified ABLE program who are Iowa residents.
    c.  Any other information deemed relevant by the treasurer of
 state in order to make a full, fair, and effective disclosure
 of the operations of the trust or the contracted qualified ABLE
 program if applicable.
    3.  The treasurer of state shall prepare and submit to the
 secretary of the United States treasury or other required party
 any reports, notices, or statements required under section 529A
 of the Internal Revenue Code.
    Sec. 83.  NEW SECTION.  12I.8  Tax considerations.
    1.  For federal income tax purposes, the Iowa ABLE savings
 plan trust shall be considered a qualified ABLE program exempt
 from taxation pursuant to section 529A of the Internal Revenue
 Code and shall be operated so that it meets the requirements of
 section 529A of the Internal Revenue Code.
    2.  State income tax treatment of the Iowa ABLE savings plan
 trust shall be as provided in section 422.7, subsections 34 and
 34A.
    3.  State inheritance tax treatment of interests in Iowa ABLE
 savings plans shall be as provided in section 450.4, subsection
 9.
    Sec. 84.  NEW SECTION.  12I.9  Property rights to assets in
 trust.
    1.  The assets of the trust shall at all times be preserved,
 invested, and expended solely and only for the purposes of the
 trust and shall be held in trust for the account owners and
 designated beneficiaries.
    2.  Except as provided in section 12I.4, subsection 3, no
 property rights in the trust shall exist in favor of the state.
    3.  Except as provided in section 12I.4, subsection 3, the
 assets of the trust shall not be transferred or used by the
 state for any purposes other than the purposes of the trust.
    Sec. 85.  NEW SECTION.  12I.10  Implementation as a
 contracting state ==== tax considerations.
    1.  The general assembly acknowledges that section 529A of
 the Internal Revenue Code permits access to qualified ABLE
 programs by residents of a state without such a program.  The
 general assembly finds that becoming a contracting state may
 accomplish the public purpose set forth in section 12I.1,
 subsection 1, in the same manner as if the qualified ABLE
 program under the Iowa ABLE savings plan trust were to be
 implemented and administered by this state.  To that end,
 the treasurer of state, as trustee of the trust, may defer
 implementation of the qualified ABLE program under the trust
 and alternatively cause this state to become a contracting
 state by entering into an agreement with another state with a
 qualified ABLE program to provide Iowa residents access to that
 state's qualified ABLE program.  The trust shall not enter into
 an agreement pursuant to this section unless the treasurer,
 as trustee of the trust, determines that all of the following
 requirements are satisfied:
    a.  The program is a qualified ABLE program.
    b.  The qualified ABLE program provides comparable benefits
 and protections to Iowa residents as would be provided under
 the Iowa ABLE savings plan trust.
    c.  That entering into an agreement for access to the
 qualified ABLE program would not result in increased costs to
 the state or to account owners and designated beneficiaries as
 compared to the costs of implementing and administering the
 qualified ABLE program under the Iowa ABLE savings plan trust.
    d.  The qualified ABLE program will be audited annually by
 an independent certified public accountant or by the state
 auditor, or similar public official, of the state that has
 implemented the qualified ABLE program.
    e.  The qualified ABLE program will provide information to
 the treasurer of state as trustee of the trust so as to allow
 the trustee to fulfill the reporting requirements in section
 12I.7.
    2.  a.  The maximum amount that may be deducted per year for
 Iowa income tax purposes by an individual for contributions on
 behalf of any one designated beneficiary that is a resident of
 this state to the qualified ABLE program with which the state
 has contracted pursuant to this section shall not exceed the
 maximum deductible amount determined for the year pursuant to
 section 12D.3, subsection 1, paragraph "a".
    b.  State income tax treatment of the qualified ABLE program
 with which the state has contracted pursuant to this section
 shall be as provided in section 422.7, subsections 34 and 34A.
    3.  State inheritance tax treatment of interests in the
 qualified ABLE program with which the state has contracted
 pursuant to this section shall be as provided in section 450.4,
 subsection 9.
    Sec. 86.  NEW SECTION.  12I.11  Construction.
    This chapter shall be construed liberally in order to
 effectuate its purpose.
    Sec. 87.  Section 422.7, Code 2015, is amended by adding the
 following new subsections:
    NEW SUBSECTION.  34.  a.  Subtract the amount contributed
 during the tax year on behalf of a designated beneficiary
 that is a resident of this state to the Iowa ABLE savings
 plan trust or to the qualified ABLE program with which the
 state has contracted pursuant to section 12I.10, not to exceed
 the maximum contribution level established in section 12I.3,
 subsection 1, paragraph "d", or section 12I.10, subsection 2,
 paragraph "a", as applicable.
    b.  Add the amount resulting from the cancellation of a
 participation agreement refunded to the taxpayer as an account
 owner in the Iowa ABLE savings plan trust or the qualified
 ABLE program with which the state has contracted pursuant to
 section 12I.10 to the extent previously deducted pursuant
 to this subsection by the taxpayer or any other person as a
 contribution to the trust or qualified ABLE program.
    c.  Add the amount resulting from a withdrawal made by a
 taxpayer from the Iowa ABLE savings plan trust or the qualified
 ABLE program with which the state has contracted pursuant to
 section 12I.10 for purposes other than the payment of qualified
 disability expenses to the extent previously deducted pursuant
 to this subsection by the taxpayer or any other person as a
 contribution to the trust or qualified ABLE program.
    NEW SUBSECTION.  34A.  Subtract, to the extent included,
 income from interest and earnings received from the Iowa ABLE
 savings plan trust created in chapter 12I, or received by a
 resident account owner from a qualified ABLE program with which
 the state has contracted pursuant to section 12I.10.
    Sec. 88.  Section 450.4, Code 2015, is amended by adding the
 following new subsection:
    NEW SUBSECTION.  9.  On the value of any interest in the Iowa
 ABLE savings plan trust created in chapter 12I, or any interest
 held by a resident account owner in a qualified ABLE program
 with which the state has contracted pursuant to section 12I.10.
    Sec. 89.  CONTINGENT IMPLEMENTATION.  The implementation of
 chapter 12I as enacted in this division of this Act is subject
 to an appropriation with the stated purpose of the Iowa ABLE
 Savings Plan Trust.
    Sec. 90.  APPLICABILITY.  The section of this division of
 this Act amending section 450.4 applies to estates of decedents
 dying on or after January 1, 2016.
    Sec. 91.  APPLICABILITY.  The section of this division of
 this Act amending section 422.7 applies to tax years beginning
 on or after January 1, 2016.
                          DIVISION XVI
        STATE CHILD CARE ASSISTANCE ==== INCOME ELIGIBILITY
    Sec. 92.  Section 237A.13, subsection 7, paragraph c, Code
 2015, is amended to read as follows:
    c.  Families with an income of more than one hundred
 percent but not more than one hundred forty=five fifty percent
 of the federal poverty level whose members, for at least
 twenty=eight hours per week in the aggregate, are employed
 or are participating at a satisfactory level in an approved
 training program or educational program.
    Sec. 93.  DIRECTIVE TO DEPARTMENT OF HUMAN SERVICES ON
 CHILD CARE ASSISTANCE.  The department of human services shall
 amend its administrative rules relating to income eligibility
 for state child care assistance, according to family size for
 children needing basic care, to families whose nonexempt gross
 monthly income does not exceed 150 percent of the federal
 poverty level.
                          DIVISION XVII
   COUNTY MENTAL HEALTH AND DISABILITIES SERVICES FUNDING ====
                EQUALIZATION AND MEDICAID OFFSET
    Sec. 94.  Section 331.424A, subsection 8, unnumbered
 paragraph 1, Code 2015, is amended to read as follows:
 Notwithstanding subsection 6, for the fiscal years beginning
 July 1, 2013, July 1, 2014, and July 1, 2015, and July 1, 2016,
  county revenues from taxes levied by the county and credited
 to the county services fund shall not exceed the lower of the
 following amounts:
    Sec. 95.  Section 426B.3, subsection 1, Code 2015, is amended
 to read as follows:
    1.  For the fiscal years beginning July 1, 2013, July
 1, 2014, and July 1, 2015, and July 1, 2016, the state and
 county funding for the mental health and disability services
 administered or paid for by counties shall be provided based on
 a statewide per capita expenditure target amount computed in
 accordance with this section and section 331.424A.
    Sec. 96.  Section 426B.3, subsection 4, paragraph a, Code
 2015, is amended to read as follows:
    a.  For the fiscal years beginning July 1, 2013, July 1,
 2014, and July 1, 2015, and July 1, 2016, a county with a county
 population expenditure target amount that exceeds the amount
 of the county's base year expenditures for mental health and
 disabilities services shall receive an equalization payment for
 the difference.
    Sec. 97.  Section 426B.3, subsection 5, Code 2015, is amended
 by striking the subsection.
                         DIVISION XVIII
                    MEDICAID OFFSET PAYMENTS
    Sec. 98.  Section 426B.3, subsection 5, paragraph e,
 subparagraph (1), Code 2015, is amended to read as follows:
    (1)  (a)  If the county receives an equalization payment
 in the fiscal year following the calculation year, the county
 shall repay the Medicaid offset amount to the state from that
 equalization payment. A county's repayment pursuant to this
 subparagraph shall be remitted on or before January 1 of the
 fiscal year in which the equalization payment is received and
 the repayment shall be credited to the property tax relief
 fund. Moneys credited to the property tax relief fund in
 accordance with this subparagraph are subject to appropriation
 by the general assembly to support mental health and disability
 services administered by the regional system. The department
 of human services' annual budget shall include recommendations
 for reinvestment of the amounts credited to the fund to address
 core and additional core services administered by the regional
 system.
    (b)  Notwithstanding any provision to the contrary in
 subparagraph division (a), during the fiscal year beginning
 July 1, 2014, any repayment received pursuant to subparagraph
 division (a) shall not be subject to appropriation by the
 general assembly to support mental health and disabilities
 services administered by the regional system, but instead
 shall be transferred to the department of human services to
 supplement the medical assistance program appropriations for
 the fiscal year beginning July 1, 2015.
                          DIVISION XIX
         PROPERTY TAX RELIEF FUND ==== BLOCK GRANT MONEYS
    Sec. 99.  PROPERTY TAX RELIEF FUND BLOCK GRANT MONEY.  The
 moneys transferred to the property tax relief fund for the
 fiscal year beginning July 1, 2015, from the federal social
 services block grant pursuant to 2015 Iowa Acts, House File
 630, and from the federal temporary assistance for needy
 families block grant, totaling at least $11,774,275, are
 appropriated to the department of human services for the fiscal
 year beginning July 1, 2015, and ending June 30, 2016, to be
 used for the purposes designated, notwithstanding any provision
 of law to the contrary:
    1.  For distribution to any mental health and disability
 services region where 25 percent of the region's projected
 expenditures exceeds the region's projected fund balance:
 .................................................. $    960,000
    a.  For purposes of this subsection:
    (1)  "Available funds" means a county mental health and
 services fund balance on June 30, 2015, plus the maximum amount
 a county was allowed to levy for the fiscal year beginning July
 1, 2015.
    (2)  "Projected expenditures" means the actual expenditures
 of a mental health and disability services region as of June
 30, 2015, multiplied by an annual inflation rate of 2 percent
 plus the projected costs for new core services administered by
 the region as provided in a region's regional service system
 management plan approved pursuant to section 331.393 for the
 fiscal year beginning July 1, 2015.
    (3)  "Projected fund balance" means the difference between a
 mental health and disability services region's available funds
 and projected expenditures.
    b.  If sufficient funds are not available to implement this
 subsection, the department of human services shall distribute
 funds to a region in proportion to the availability of funds.
    c.  A mental health and disability services region with
 a population of 35,000 or less, as determined by the latest
 federal decennial census, shall work with the department of
 human services to determine whether the region shall join
 another region approved by the department in accordance with
 section 331.389 to increase the availability of and access to
 needed mental health and disability services.
    2.  To be transferred to the appropriation in this Act for
 child and family services for the fiscal year beginning July 1,
 2015, to be used for the purpose of that appropriation:
 .................................................. $ 10,814,275
                           DIVISION XX
            STUDY ==== CHILD WELFARE ADVISORY COMMITTEE
    Sec. 100.  STUDY ==== CHILD WELFARE ADVISORY COMMITTEE.  The
 child welfare advisory committee of the council on human
 services established pursuant to section 217.3A shall study
 procedures in the department of human services for receiving
 complaints from families involved in guardianship, placement,
 and custody proceedings; and the specificity and clarity of
 court orders issued in foster care placements pursuant to
 the State of Iowa Primary Review of Tit. IV=E Foster Care
 Eligibility Report of Findings for October 1, 2012, through
 March 31, 2013.  The committee shall submit a report with
 findings and recommendations to the governor and general
 assembly on or before December 15, 2015.
                          DIVISION XXI
     COVERAGE OF SERVICES PROVIDED BY A PHYSICAL THERAPIST,
          OCCUPATIONAL THERAPIST, OR SPEECH PATHOLOGIST
    Sec. 101.  NEW SECTION.  514C.30  Services provided by
 a physical therapist, occupational therapist, or speech
 pathologist.
    1.  Notwithstanding the uniformity of treatment requirements
 of section 514C.6, a policy, contract, or plan providing
 for third=party payment or prepayment of health or medical
 expenses shall not impose a copayment or coinsurance amount
 on an insured for services provided by a physical therapist
 licensed pursuant to chapter 148A, by an occupational therapist
 licensed pursuant to chapter 148B, or by a speech pathologist
 licensed pursuant to 154F that is greater than the copayment or
 coinsurance amount imposed on the insured for services provided
 by a person engaged in the practice of medicine and surgery
 or osteopathic medicine and surgery under chapter 148 for the
 same or a similar diagnosed condition even if a different
 nomenclature is used to describe the condition for which the
 services are provided.
    2.  This section applies to the following classes of
 third=party payment provider policies, contracts, or plans
 delivered, issued for delivery, continued, or renewed in this
 state on or after July 1, 2015:
    a.  Individual or group accident and sickness insurance
 providing coverage on an expense=incurred basis.
    b.  An individual or group hospital or medical service
 contract issued pursuant to chapter 509, 514, or 514A.
    c.  An individual or group health maintenance organization
 contract regulated under chapter 514B.
    d.  A plan established pursuant to chapter 509A for public
 employees.
    e.  An organized delivery system licensed by the director of
 public health.
    3.  This section shall not apply to accident=only,
 specified disease, short=term hospital or medical, hospital
 confinement indemnity, credit, dental, vision, Medicare
 supplement, long=term care, basic hospital and medical=surgical
 expense coverage as defined by the commissioner, disability
 income insurance coverage, coverage issued as a supplement
 to liability insurance, workers' compensation or similar
 insurance, or automobile medical payment insurance.
                          DIVISION XXII
        CHILDREN'S MENTAL HEALTH AND WELL=BEING WORKGROUP
    Sec. 102.  CHILDREN'S MENTAL HEALTH WORKGROUP.  The
 department of human services, in cooperation with the
 departments of education and public health, shall facilitate
 a study by a workgroup of stakeholders which shall make
 recommendations relating to children's mental health.  The
 workgroup shall study incorporating a coordinated response
 in children's mental health services that emphasizes
 implementation of mental health issues across the various
 systems that serve children, taking into account the effects
 of mental health, child welfare, and child welfare systems
 and services, and that specifically addresses the effects of
 adverse childhood experiences and child poverty.  The workgroup
 shall create interdepartmental awareness of issues relating
 to children's mental health.  The workgroup shall develop
 interdepartmental strategies for helping improve children's
 mental health and shall develop strategies to promote community
 partnerships to help address issues of children's mental
 health.  In carrying out its charge, the workgroup shall review
 a 2014 report by the children's defense fund on the state of
 America's children containing the most recent and reliable
 national and state=by=state data on many complex issues
 affecting children's health, including data on more than 7,000
 homeless public school students in Iowa.  The workgroup shall
 submit a report on the study with recommendations, including
 but not limited to recommendations relating to the creation and
 implementation of a children's mental health crisis response
 system to aid parents and other custodians in dealing with
 children experiencing a mental health crisis.  The workgroup
 shall submit its report to the governor and the general
 assembly on or before December 15, 2015.
                         DIVISION XXIII
            PREVENTION OF DISABILITIES POLICY COUNCIL
    Sec. 103.  Section 225B.8, Code 2015, is amended to read as
 follows:
    225B.8  Repeal.
    1.  This chapter is repealed July 1, 2015 2016.
    2.  Prior to June 30, 2016, the state mental health and
 disability services commission created in section 225C.5 and
 the Iowa developmental disabilities council appointed by
 the governor shall work with the prevention of disabilities
 policy council, the department of human services, and the Iowa
 department of public health to provide for the transfer of the
 duties of the prevention of disabilities policy council to the
 state mental health and disability services commission, the
 Iowa developmental disabilities council, or the Iowa department
 of public health.
                          DIVISION XXIV
        HOSPITAL AND LONG=TERM CARE PHARMACY PRACTICE ====
        PNEUMOCOCCAL VACCINES ==== BOARD OF PHARMACY RULES
    Sec. 104.  HOSPITAL AND LONG=TERM CARE PHARMACY PRACTICE ====
 PNEUMOCOCCAL VACCINES ==== BOARD OF PHARMACY RULES.  The board
 of pharmacy shall adopt rules pursuant to chapter 17A relating
 to hospital and long=term care pharmacy practices that allow,
 as authorized by federal law, in addition to influenza and
 pneumococcal polysaccharide vaccines, that a written or verbal
 patient=specific medication administration order shall not
 be required prior to administration to an adult patient of
 pneumococcal conjugate vaccine pursuant to physician=approved
 hospital or facility policy and after the patient has been
 assessed for contraindications.
                          DIVISION XXV
  HEALTHY AND WELL KIDS IN IOWA PROGRAM ==== CONTINUED ENROLLMENT
    Sec. 105.  Section 514I.8, subsection 3, Code 2015, is
 amended to read as follows:
    3.  In accordance with the rules adopted by the board, a
 child may be determined to be presumptively eligible for the
 program pending a final eligibility determination. Following
 final determination of eligibility, a child shall be eligible
 for a twelve=month period. At the end of the twelve=month
 period, a review of the circumstances of the child's family
 shall be conducted to establish eligibility and cost sharing
 for the subsequent twelve=month period.  Pending such review
 of the circumstances of the child's family, the child shall
 continue to be eligible for and remain enrolled in the same
 plan if the family complies with requirements to provide
 information and verification of income, otherwise cooperates
 in the annual review process, and submits the completed
 review form and any information necessary to establish
 continued eligibility in a timely manner in accordance with
 administrative rules.
                          DIVISION XXVI
             PERSONNEL SETTLEMENT AGREEMENT PAYMENTS
    Sec. 106.  PERSONNEL SETTLEMENT AGREEMENT PAYMENTS.  As a
 condition of the appropriations in this 2015 Act, the moneys
 appropriated and any other moneys available shall not be used
 for payment of a personnel settlement agreement that contains a
 confidentiality provision intended to prevent public disclosure
 of the agreement or any terms of the agreement.
                         DIVISION XXVII
             MEDICAID REIMBURSEMENT ==== PSYCHOLOGISTS
    Sec. 107.  Section 249A.15, Code 2015, is amended to read as
 follows:
    249A.15  Licensed psychologists eligible for payment.
    The department shall adopt rules pursuant to chapter 17A
 entitling psychologists who are licensed pursuant to chapter
 154B and psychologists who are licensed in the state where
 the services are provided and have a doctorate degree in
 psychology, have had at least two years of clinical experience
 in a recognized health setting, or have met the standards of a
 national register of health service providers in psychology,
 to payment for services provided to recipients of medical
 assistance, subject to limitations and exclusions the
 department finds necessary on the basis of federal laws and
 regulations and of funds available for the medical assistance
 program.
                         DIVISION XXVIII
            HOME MODIFICATION ASSISTANCE PROGRAM PLAN
    Sec. 108.  HOME MODIFICATION ASSISTANCE PROGRAM PLAN.
    1.  The aging and disability resource center and the mental
 health and disability services commission shall jointly
 develop a plan for a home modification assistance program to
 provide grants and individual income tax credits to assist with
 expenses related to the making of permanent home modifications
 that permit individuals with a disability in this state to
 remain in their homes and age in place.  The plan shall include
 the following components:
    a.  The plan shall develop criteria and procedures for
 establishing eligibility of individuals with a disability
 under the program, and in doing so the plan shall utilize the
 definition of disability found in 42 U.S.C. {12102 and shall
 require appropriate certifications from the primary health care
 providers of individuals with a disability.
    b.  The plan shall establish criteria for determining the
 type of home modification expenses that will be eligible for a
 grant or tax credit award under the program.
    c.  The plan shall develop criteria and procedures for
 receiving grants and tax credits under the program, and shall
 determine the maximum amount of grants and tax credits that
 may be provided to an individual with a disability under the
 program.
    d.  The plan shall provide that individuals with a disability
 shall utilize any funding for home modification under the
 Medicaid program to the fullest extent possible before becoming
 eligible to participate in the home modification assistance
 program to ensure that the program's grants and tax credits do
 not supplant available Medicaid program resources.
    e.  The plan shall provide that grants under the program
 shall be available to individuals with a disability with annual
 incomes that do not exceed 250 percent of the federal poverty
 level, and that individual income tax credits under the program
 shall be available to individuals with a disability with annual
 incomes exceeding 250 percent but not exceeding 450 percent of
 the federal poverty level.
    f.  The plan shall avoid placing unrealistic expectations
 and overly burdensome requirements on individuals with a
 disability and their families, particularly those living in
 rural areas.
    2.  In developing the plan for the home modification
 assistance program, the aging and disability resource center
 and the mental health and disability services commission shall
 seek input from and consult with the department on aging, the
 department of human services, the department of revenue, and
 other interested public and private stakeholders.
    3.  The aging and disability resource center and the mental
 health and disability services commission shall submit the plan
 on or before December 15, 2015, to the chairpersons and ranking
 members of the joint appropriations subcommittee on health and
 human services, to the chairpersons and ranking members of the
 senate and house standing committees on human resources, to
 the chairpersons and ranking members of the senate and house
 standing committees on ways and means, and to the governor.
                          DIVISION XXIX
               MEDICAID PROGRAM ASSET VERIFICATION
    Sec. 109.  MEDICAID PROGRAM ==== ASSET VERIFICATION.  The
 department of human services shall issue a request for
 proposals to contract with a third=party vendor to establish
 an electronic asset verification system for the purposes of
 compliance with 42 U.S.C. {1396w requiring determination
 or redetermination of the eligibility of an individual
 who is an applicant for or recipient of medical assistance
 under the Medicaid state plan on the basis of being aged,
 blind, or disabled in accordance with 42 U.S.C. {1396w. The
 third=party vendor selected shall be able to demonstrate in
 writing its current relationships or contracts with financial
 institutions in the state and nationally. Participation by
 financial institutions in providing account balances for asset
 verification shall remain voluntary.
    Sec. 110.  EFFECTIVE UPON ENACTMENT.  This division of this
 Act, being deemed of immediate importance, takes effect upon
 enactment.
                          DIVISION XXX
        REFUGEE FAMILY SUPPORT SERVICES ==== APPROPRIATION
    Sec. 111.  REFUGEE FAMILY SUPPORT SERVICES PILOT PROGRAM.
    1.  The bureau of refugee services within the department
 of human services shall establish, promote, and administer a
 refugee family support services pilot program for purposes of
 providing a grant to a state, local, or community organization
 working with refugee populations to contract with and train
 multiple refugees to act as refugee community navigators.
    2.  An organization awarded a grant pursuant to this section
 shall recruit and train multiple refugee community navigators
 to educate and provide direct assistance to their respective
 refugee communities so the refugee communities can successfully
 access and utilize existing community resources and services.
    3.  The refugee community navigators shall train other
 refugee community members and shall offer home=based,
 peer=group learning sessions about resources in the community.
    4.  A grant awarded pursuant to this section shall be
 used for employment costs of a program manager and community
 navigator coordinator, and contract and stipend costs for
 multiple refugee community navigators for each organization.
    5.  The bureau of refugee services shall award one grant to
 a state, local, or community organization through a competitive
 application process.  The bureau shall provide moneys over a
 three=year period to an organization awarded a grant.
    6.  A state, local, or community organization awarded a grant
 pursuant to this section shall provide the bureau with annual
 progress reports.  The bureau of refugee services shall present
 a report of the program goals and outcomes to the general
 assembly.
    7.  The bureau of refugee services shall conduct a
 comprehensive review of the refugee family support services
 pilot program and shall, by December 31, 2017, submit a
 report of its review, as well as any recommendations and cost
 projections of its recommendations to the governor and the
 general assembly.
    8.  The bureau of refugee services may expend program moneys
 for administrative expenses as provided by law.
    Sec. 112.  REFUGEE FAMILY SUPPORT SERVICES PILOT PROGRAM
 APPROPRIATION.  There is appropriated from the general fund of
 the state to the department of human services for the fiscal
 year beginning July 1, 2015, and ending June 30, 2016, the
 following amount, or so much thereof as is necessary, to be
 used for the purposes designated:
    For a pilot project pursuant to the refugee family support
 services pilot project program created in this division of this
 Act in a county with a population over 350,000 as determined by
 the 2010 federal decennial census:
 .................................................. $    100,000
    The amount appropriated under this section shall not
 be reduced for administrative or other costs prior to
 distribution.
    Notwithstanding section 8.33, moneys appropriated in this
 section 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.
                          DIVISION XXXI
                 PHYSICIAN ASSISTANT SUPERVISION
    Sec. 113.  ADMINISTRATIVE RULES ==== PHYSICIAN SUPERVISION OF
 PHYSICIAN ASSISTANTS.  The boards of medicine and physician
 assistants shall jointly adopt rules pursuant to chapter 17A
 to establish specific minimum standards or a definition of
 supervision for appropriate supervision of physician assistants
 by physicians.  The boards shall jointly file notices of
 intended action pursuant to section 17A.4, subsection 1,
 paragraph "a", on or before February 1, 2016, for adoption of
 such rules.
                         DIVISION XXXII
                  QUALITY ASSURANCE ASSESSMENT
    Sec. 114.  Section 249L.3, subsection 1, paragraph d, Code
 2015, is amended to read as follows:
    d.  The aggregate quality assurance assessments imposed
 under this chapter shall not exceed the lower of be established
 at three percent of the aggregate non=Medicare revenues of a
 nursing facility or the maximum amount that may be assessed
  pursuant to the indirect guarantee threshold as established
 pursuant to 42 C.F.R. {433.68(f)(3)(i), and shall be stated
 on a per=patient=day basis.  The aggregate quality assurance
 assessment shall be recalibrated only concurrently with any
 nursing facility rebasing.
                         DIVISION XXXIII
                       HOSPITAL ASSESSMENT
    Sec. 115.  HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM ====
 TRANSITION TO MANAGED CARE.
    1.  The department of human services shall include in any
 Medicaid managed care contract entered into on or after July 1,
 2015, a mechanism by which the capitated payment received by
 the managed care contractor reflects the amount necessary to
 continue reimbursement of participating hospitals by managed
 care contractors in accordance with the provisions of chapter
 249M.  Such reimbursement shall preferably be provided through
 lump sum payments to participating hospitals. Notwithstanding
 any provisions of chapter 249M to the contrary, the department
 may make administrative modifications to the hospital health
 care access assessment program to comply with this section.
 The department of human services shall work with participating
 providers, including health systems and the Iowa hospital
 association, to effectuate this section.
    2.  The department of human services shall submit
 recommendations for any changes in statute or rules regarding
 the hospital health care access assessment program necessitated
 by the transition to managed care to the individuals identified
 in this Act for submission of reports by December 15, 2015.
                         DIVISION XXXIV
          BOARD OF RESPIRATORY CARE AND POLYSOMNOGRAPHY
    Sec. 116.  BOARD OF RESPIRATORY CARE AND POLYSOMNOGRAPHY.  If
 funding is appropriated for a fee=supported board of
 respiratory care and polysomnography to administer chapter
 148G, as enacted in 2015 Iowa Acts, House File 203, the
 fee=supported model shall provide for repayment of the funds
 appropriated to the state by June 30, 2018.
                          DIVISION XXXV
                  FOOD ASSISTANCE PROGRAM BONUS
    Sec. 117.  FOOD ASSISTANCE PROGRAM BONUS.  Any funds
 available to the department of human services during the fiscal
 year beginning July 1, 2015, received from the United States
 department of agriculture's food and nutrition service for
 achieving a low case and procedural error rate and for ranking
 third in the nation on certain case=related measures under the
 supplemental nutrition assistance program, shall be used by the
 department for the purposes of the appropriation in this Act
 for the same fiscal year for the medical assistance program.
                         DIVISION XXXVI
             MEDICAL ASSISTANCE SPECIAL NEEDS TRUST
    Sec. 118.  Section 633C.1, subsection 8, Code 2015, is
 amended by striking the subsection.
    Sec. 119.  Section 633C.2, Code 2015, is amended by striking
 the section and inserting in lieu thereof the following:
    633C.2  Disposition of medical assistance special needs
 trusts.
    Any income or assets added to or received by and any income
 or principal retained in a medical assistance special needs
 trust shall be used in accordance with a standard that is
 no more restrictive than specified under federal law. All
 distributions from a medical assistance special needs trust
 shall be for the sole benefit of the beneficiary to enhance
 the quality of life of the beneficiary, and the trustee shall
 have sole discretion regarding such disbursements to ensure
 compliance with beneficiary eligibility requirements. Any
 distinct disbursement in excess of one thousand dollars shall
 be subject to review by the district court sitting in probate.
 The department shall adopt rules pursuant to chapter 17A for
 the establishment and disposition of medical assistance special
 needs trusts in accordance with this section.
    Sec. 120.  Section 633C.4, subsection 2, Code 2015, is
 amended to read as follows:
    2.  The trustee of a medical assistance income trust or
 a medical assistance special needs trust is a fiduciary for
 purposes of chapter 633A and, in the exercise of the trustee's
 fiduciary duties, the state shall be considered a beneficiary
 of the trust. Regardless of the terms of the trust, the
 trustee shall not take any action that is not prudent in light
 of the state's interest in the trust.  Notwithstanding any
 provision of  chapter 633A to the contrary, the trustee of a
 medical assistance special needs trust shall be subject to the
 jurisdiction of the district court sitting in probate and shall
 submit an accounting of the disposition of the trust to the
 district court sitting in probate on an annual basis.
                         DIVISION XXXVII
               DEPARTMENT ON AGING ==== FY 2016=2017
    Sec. 121.  DEPARTMENT ON AGING.  There is appropriated from
 the general fund of the state to the department on aging for
 the fiscal year beginning July 1, 2016, and ending June 30,
 2017, the following amount, or so much thereof as is necessary,
 to be used 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=time equivalent positions:
 .................................................. $  5,699,866
 ............................................... FTEs      31.00
    1.  Funds appropriated in this section may be used to
 supplement federal funds under federal regulations. To
 receive funds appropriated in this section, a local area
 agency on aging shall match the funds with moneys from other
 sources according to rules adopted by the department. Funds
 appropriated in this section may be used for elderly services
 not specifically enumerated in this section only if approved
 by an area agency on aging for provision of the service within
 the area.
    2.  Of the funds appropriated in this section, $139,973 is
 transferred to the economic development authority for the Iowa
 commission on volunteer services to be used for the retired and
 senior volunteer program.
    3.  a.  The department on aging shall establish and enforce
 procedures relating to expenditure of state and federal funds
 by area agencies on aging that require compliance with both
 state and federal laws, rules, and regulations, including but
 not limited to all of the following:
    (1)  Requiring that expenditures are incurred only for goods
 or services received or performed prior to the end of the
 fiscal period designated for use of the funds.
    (2)  Prohibiting prepayment for goods or services not
 received or performed prior to the end of the fiscal period
 designated for use of the funds.
    (3)  Prohibiting the prepayment for goods or services
 not defined specifically by good or service, time period, or
 recipient.
    (4)  Prohibiting the establishment of accounts from which
 future goods or services which are not defined specifically by
 good or service, time period, or recipient, may be purchased.
    b.  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
 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.
    4.  Of the funds appropriated in this section, at least
 $125,000 shall be used to fund the unmet needs identified
 through Iowa's aging and disability resource center network.
    5.  Of the funds appropriated in this section, at least
 $300,000 shall be used to fund home and community=based
 services through the area agencies on aging that enable older
 individuals to avoid more costly utilization of residential or
 institutional services and remain in their own homes.
    6.  Of the funds appropriated in this section, $406,833
 shall be used for the purposes of chapter 231E and section
 231.56A, of which $144,333 shall be used for the office of
 substitute decision maker pursuant to chapter 231E, and the
 remainder shall be distributed equally to the area agencies on
 aging to administer the prevention of elder abuse, neglect, and
 exploitation program pursuant to section 231.56A, in accordance
 with the requirements of the federal Older Americans Act of
 1965, 42 U.S.C. {3001 et seq., as amended.
                        DIVISION XXXVIII
       OFFICE OF LONG=TERM CARE OMBUDSMAN ==== FY 2016=2017
    Sec. 122.  OFFICE OF LONG=TERM CARE OMBUDSMAN.
    1.  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, 2016, and ending June 30, 2017, the following
 amount, or so much thereof as is necessary, to be used for the
 purposes designated:
    For salaries, support, administration, maintenance, and
 miscellaneous purposes, and for not more than the following
 full=time equivalent positions:
 .................................................. $    638,391
 ............................................... FTEs      17.00
    2.  Of the funds appropriated in this section, $110,000 shall
 be used to continue to provide for additional local long=term
 care ombudsmen.
                         DIVISION XXXIX
           DEPARTMENT OF PUBLIC HEALTH ==== FY 2016=2017
    Sec. 123.  DEPARTMENT OF PUBLIC HEALTH.  There is
 appropriated from the general fund of the state to the
 department of public health for the fiscal year beginning July
 1, 2016, and ending June 30, 2017, the following amounts, or
 so much thereof as is necessary, to be used for the purposes
 designated:
    1.  ADDICTIVE DISORDERS
    For reducing the prevalence of the use of tobacco, alcohol,
 and other drugs, and treating individuals affected by addictive
 behaviors, including gambling, and for not more than the
 following full=time equivalent positions:
 .................................................. $ 13,631,845
 ............................................... FTEs      10.00
    a.  (1)  Of the funds appropriated in this subsection,
 $2,624,180 shall be used for the tobacco use prevention
 and control initiative, including efforts at the state and
 local levels, as provided in chapter 142A.  The commission
 on tobacco use prevention and control established pursuant
 to section 142A.3 shall advise the director of public health
 in prioritizing funding needs and the allocation of moneys
 appropriated for the programs and initiatives. Activities
 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. To maximize resources, the department
 shall determine if third=party sources are available to
 instead provide nicotine replacement products to an applicant
 prior to provision of such products to an applicant under
 the initiative.  The department shall track and report to
 the individuals specified in this Act, any reduction in
 the provision of nicotine replacement products realized by
 the initiative through implementation of the prerequisite
 screening.
    (2)  (a)  Of the funds allocated in this paragraph "a",
 $226,533 is transferred to the alcoholic beverages division of
 the department of commerce for enforcement of tobacco laws,
 regulations, and ordinances and to engage in tobacco control
 activities approved by the division of tobacco use prevention
 and control of the department of public health as specified
 in the memorandum of understanding entered into between the
 divisions.
    (b)  For the fiscal year beginning July 1, 2016, and ending
 June 30, 2017, the terms of the memorandum of understanding,
 entered into between the division of tobacco use prevention
 and control of the department of public health and the
 alcoholic beverages division of the department of commerce,
 governing compliance checks conducted to ensure licensed retail
 tobacco outlet conformity with tobacco laws, regulations, and
 ordinances relating to persons under eighteen years of age,
 shall continue to restrict the number of such checks to one
 check per retail outlet, and one additional check for any
 retail outlet found to be in violation during the first check.
    b.  Of the funds appropriated in this subsection,
 $11,007,664 shall be used for problem gambling and
 substance=related disorder prevention, treatment, and recovery
 services, including a 24=hour helpline, public information
 resources, professional training, and program evaluation.
    (1)  Of the funds allocated in this paragraph "b", $9,451,857
 shall be used for substance=related disorder prevention and
 treatment.
    (a)  Of the funds allocated in this subparagraph (1),
 $449,650 shall be used for the public purpose of a grant
 program to provide substance=related disorder prevention
 programming for children.
    (i)  Of the funds allocated in this subparagraph division
 (a), $213,769 shall be used for grant funding for organizations
 that provide programming for children by utilizing mentors.
 Programs approved for such grants shall be certified or must
 be certified within six months of receiving the grant award
 by the Iowa commission on volunteer services as utilizing the
 standards for effective practice for mentoring programs.
    (ii)  Of the funds allocated in this subparagraph division
 (a), $213,419 shall be used for grant funding for organizations
 providing programming that includes youth development and
 leadership services.  The programs shall also be recognized as
 being programs that are scientifically based with evidence of
 their effectiveness in reducing substance=related disorders in
 children.
    (iii)  The department of public health shall utilize a
 request for proposals process to implement the grant program.
    (iv)  All grant recipients shall participate in a program
 evaluation as a requirement for receiving grant funds.
    (v)  Of the funds allocated in this subparagraph division
 (a), up to $22,461 may be used to administer substance=related
 disorder prevention grants and for program evaluations.
    (b)  Of the funds allocated in this subparagraph
 (1), $136,301 shall be used for culturally competent
 substance=related disorder treatment pilot projects.
    (i)  The department shall utilize the amount allocated
 in this subparagraph division (b) for at least three pilot
 projects to provide culturally competent substance=related
 disorder treatment in various areas of the state.  Each pilot
 project shall target a particular ethnic minority population.
 The populations targeted shall include but are not limited to
 African American, Asian, and Latino.
    (ii)  The pilot project requirements shall provide for
 documentation or other means to ensure access to the cultural
 competence approach used by a pilot project so that such
 approach can be replicated and improved upon in successor
 programs.
    (2)  Of the funds allocated in this paragraph "b", up
 to $1,555,807 may be used for problem gambling prevention,
 treatment, and recovery services.
    (a)  Of the funds allocated in this subparagraph (2),
 $1,286,881 shall be used for problem gambling prevention and
 treatment.
    (b)  Of the funds allocated in this subparagraph (2), up to
 $218,926 may be used for a 24=hour helpline, public information
 resources, professional training, and program evaluation.
    (c)  Of the funds allocated in this subparagraph (2), up
 to $50,000 may be used for the licensing of problem gambling
 treatment programs.
    (3)  It is the intent of the general assembly that from the
 moneys allocated in this paragraph "b",  persons with a dual
 diagnosis of substance=related disorder and gambling addiction
 shall be given priority in treatment services.
    c.  Notwithstanding any provision of law to the contrary,
 to standardize the availability, delivery, cost of delivery,
 and accountability of problem gambling and substance=related
 disorder treatment services statewide, the department shall
 continue implementation of a process to create a system
 for delivery of treatment services in accordance with the
 requirements specified in 2008 Iowa Acts, chapter 1187, section
 3, subsection 4.  To ensure the system provides a continuum
 of treatment services that best meets the needs of Iowans,
 the problem gambling and substance=related disorder treatment
 services in any area may be provided either by a single agency
 or by separate agencies submitting a joint proposal.
    (1)  The system for delivery of substance=related disorder
 and problem gambling treatment shall include problem gambling
 prevention.
    (2)  The system for delivery of substance=related disorder
 and problem gambling treatment shall include substance=related
 disorder prevention by July 1, 2017.
    (3)  Of the funds allocated in paragraph "b",  the department
 may use up to $50,000 for administrative costs to continue
 developing and implementing the process in accordance with this
 paragraph "c".
    d.  The requirement of section 123.53, subsection 5, is met
 by the appropriations and allocations made in this division of
 this Act for purposes of substance=related disorder treatment
 and addictive disorders for the fiscal year beginning July 1,
 2016.
    e.  The department of public health shall work with all
 other departments that fund substance=related disorder
 prevention and treatment services and all such departments
 shall, to the extent necessary, collectively meet the state
 maintenance of effort requirements for expenditures for
 substance=related disorder services as required under the
 federal substance=related disorder prevention and treatment
 block grant.
    2.  HEALTHY CHILDREN AND FAMILIES
    For promoting the optimum health status for children,
 adolescents from birth through 21 years of age, and families,
 and for not more than the following full=time equivalent
 positions:
 .................................................. $  2,308,771
 ............................................... FTEs      12.00
    a.  Of the funds appropriated in this subsection, not more
 than $367,420 shall be used for the healthy opportunities for
 parents to experience success (HOPES)=healthy families Iowa
 (HFI) program established pursuant to section 135.106. The
 funding shall be distributed to renew the grants that were
 provided to the grantees that operated the program during the
 fiscal year ending June 30, 2016.
    b.  In order to implement the legislative intent stated in
 sections 135.106 and 256I.9, that priority for home visitation
 program funding be given to programs using evidence=based or
 promising models for home visitation, it is the intent of the
 general assembly to phase in the funding priority in accordance
 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2,
 paragraph "0b".
    c.  Of the funds appropriated in this subsection, $1,099,414
 shall be used for continuation of the department's initiative
 to provide for adequate developmental surveillance and
 screening during a child's first five years.  The funds shall
 be used first to fully fund the current sites to ensure that
 the sites are fully operational, with the remaining funds
 to be used for expansion to additional sites.  The full
 implementation and expansion shall include enhancing the scope
 of the program through collaboration with the child health
 specialty clinics to promote healthy child development through
 early identification and response to both biomedical and social
 determinants of healthy development; by monitoring child
 health metrics to inform practice, document long=term health
 impacts and savings, and provide for continuous improvement
 through training, education, and evaluation; and by providing
 for practitioner consultation particularly for children with
 behavioral conditions and needs.  The department of public
 health shall also collaborate with the Iowa Medicaid enterprise
 and the child health specialty clinics to integrate the
 activities of the first five initiative into the establishment
 of patient=centered medical homes, community utilities,
 accountable care organizations, and other integrated care
 models developed to improve health quality and population
 health while reducing health care costs. To the maximum extent
 possible, funding allocated in this paragraph shall be utilized
 as matching funds for medical assistance program reimbursement.
    d.  Of the funds appropriated in this subsection, $37,320
 shall be distributed to a statewide dental carrier to provide
 funds to continue the donated dental services program patterned
 after the projects developed by the lifeline network to provide
 dental services to indigent individuals who are elderly or with
 disabilities.
    e.  Of the funds appropriated in this subsection, $55,997
 shall be used for childhood obesity prevention.
    f.  Of the funds appropriated in this subsection, $81,384
 shall be used to provide audiological services and hearing
 aids for children. The department may enter into a contract
 to administer this paragraph.
    g.  Of the funds appropriated in this subsection, $12,500 is
 transferred to the university of Iowa college of dentistry for
 provision of primary dental services to children.  State funds
 shall be matched on a dollar=for=dollar basis.  The university
 of Iowa college of dentistry shall coordinate efforts with the
 department of public health, bureau of oral and health delivery
 systems, to provide dental care to underserved populations
 throughout the state.
    h.  Of the funds appropriated in this subsection, $25,000
 shall be used to address youth suicide prevention.
    i.  Of the funds appropriated in this subsection, $25,000
 shall be used to support the Iowa effort to address the survey
 of children who experience adverse childhood experiences known
 as ACEs.
    j.  The department of public health shall continue to
 administer the program to assist parents in this state with
 costs resulting from the death of a child in accordance with
 the provisions of 2014 Iowa Acts, chapter 1140, section 22,
 subsection 12.
    3.  CHRONIC CONDITIONS
 For serving individuals identified as having chronic
 conditions or special health care needs, and for not more than
 the following full=time equivalent positions:
 .................................................. $  2,477,846
 ............................................... FTEs       5.00
    a.  Of the funds appropriated in this subsection, $79,966
 shall be used for grants to individual patients who have an
 inherited metabolic disorder to assist with the costs of
 medically necessary foods and formula.
    b.  Of the funds appropriated in this subsection, $445,822
 shall be used for the brain injury services program pursuant to
 section 135.22B, including for continuation of the contracts
 for resource facilitator services in accordance with section
 135.22B, subsection 9, and to enhance brain injury training and
 recruitment of service providers on a statewide basis.  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 program manager.
    c.  Of the funds appropriated in this subsection, $273,991
 shall be used as additional funding to leverage federal funding
 through the federal Ryan White Care Act, Tit. II, AIDS drug
 assistance program supplemental drug treatment grants.
    d.  Of the funds appropriated in this subsection, $74,911
 shall be used for the public purpose of continuing to contract
 with an existing national=affiliated organization to provide
 education, client=centered programs, and client and family
 support for people living with epilepsy and their families.
 The amount allocated in this paragraph in excess of $50,000
 shall be matched dollar=for=dollar by the organization
 specified.
    e.  Of the funds appropriated in this subsection, $392,557
 shall be used for child health specialty clinics.
    f.  Of the funds appropriated in this subsection, $200,000
 shall be used by the regional autism assistance program
 established pursuant to section 256.35, and administered by
 the child health specialty clinic located at the university of
 Iowa hospitals and clinics.  The funds shall be used to enhance
 interagency collaboration and coordination of educational,
 medical, and other human services for persons with autism,
 their families, and providers of services, including delivering
 regionalized services of care coordination, family navigation,
 and integration of services through the statewide system of
 regional child health specialty clinics and fulfilling other
 requirements as specified in chapter 225D.  The university of
 Iowa shall not receive funds allocated under this paragraph for
 indirect costs associated with the regional autism assistance
 program.
    g.  Of the funds appropriated in this subsection, $285,496
 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 allocated in this paragraph "g", $75,000 shall
 be used to support a melanoma research symposium, a melanoma
 biorepository and registry, basic and translational melanoma
 research, and clinical trials.
    h.  Of the funds appropriated in this subsection, $63,225
 shall be used for cervical and colon cancer screening, and
 $150,000 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.
    i.  Of the funds appropriated in this subsection, $263,347
 shall be used for the center for congenital and inherited
 disorders.
    j.  Of the funds appropriated in this subsection, $64,705
 shall be used for the prescription drug donation repository
 program created in chapter 135M.
    k.  Of the funds appropriated in this subsection,
 $107,631 shall be used by the department of public health
 for reform=related activities, including but not limited to
 facilitation of communication to stakeholders at the state and
 local level, administering the patient=centered health advisory
 council pursuant to section 135.159, and involvement in health
 care system innovation activities occurring across the state.
    l.  Of the funds appropriated in this subsection, $12,500
 shall be used for administration of chapter 124D, the medical
 cannabidiol Act.
    4.  COMMUNITY CAPACITY
    For strengthening the health care delivery system at the
 local level, and for not more than the following full=time
 equivalent positions:
 .................................................. $  4,410,667
 ............................................... FTEs      11.00
    a.  Of the funds appropriated in this subsection, $49,707
 is allocated for continuation of the child vision screening
 program implemented through the university of Iowa hospitals
 and clinics in collaboration with early childhood Iowa areas.
 The program shall submit a report to the individuals identified
 in this Act for submission of reports regarding the use of
 funds allocated under this paragraph "a".  The report shall
 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; the number,
 age, and location within the state of individuals served;
 the type of services provided to the individuals served; the
 distribution of funds based on service provided; and the
 continuing needs of the program.
    b.  Of the funds appropriated in this subsection, $55,328 is
 allocated for continuation of an initiative implemented at the
 university of Iowa and $49,952 is allocated for continuation of
 an initiative at the state mental health institute at Cherokee
 to expand and improve the workforce engaged in mental health
 treatment and services. The initiatives shall receive input
 from the university of Iowa, the department of human services,
 the department of public health, and the mental health and
 disability services commission to address the focus of the
 initiatives.
    c.  Of the funds appropriated in this subsection, $582,314
 shall be used for essential public health services that promote
 healthy aging throughout one's lifespan, contracted through a
 formula for local boards of health, to enhance health promotion
 and disease prevention services.
    d.  Of the funds appropriated in this section, $49,643 shall
 be deposited in the governmental public health system fund
 created in section 135A.8 to be used for the purposes of the
 fund.
    e.  Of the funds appropriated in this subsection, $52,724
 shall be used to continue to address the shortage of mental
 health professionals in the state.
    f.  Of the funds appropriated in this subsection,
 $25,000 shall be used for a grant to a statewide association
 of psychologists that is affiliated with the American
 psychological association to be used for continuation of a
 program to rotate intern psychologists in placements in urban
 and rural mental health professional shortage areas, as defined
 in section 135.180.
    g.  (1)  Of the funds appropriated in this subsection,
 $1,441,484 shall be allocated as a grant to the Iowa primary
 care association to be used pursuant to section 135.153 for
 the statewide coordination of the Iowa collaborative safety
 net provider network. Coordination of the network shall
 focus on increasing access by underserved populations to
 health care services, increasing integration of the health
 system and collaboration across the continuum of care with
 a focus on safety net services, and enhancing the Iowa
 collaborative safety net provider network's communication and
 education efforts. The amount allocated as a grant under this
 subparagraph (1) shall be used as follows to support the Iowa
 collaborative safety net provider network goals of increased
 access, health system integration, and engagement:
    (a)  For distribution to safety net partners in the state
 that work to increase access of the underserved population to
 health services:
 .................................................. $    512,742
    (i)  Of the amount allocated in this subparagraph
 division (a), up to $206,707 shall be distributed to the
 Iowa prescription drug corporation for continuation of the
 pharmaceutical infrastructure for safety net providers as
 described in 2007 Iowa Acts, chapter 218, section 108.
    (ii)  Of the amount allocated in this subparagraph division
 (a), up to $174,161 shall be distributed to free clinics and
 free clinics of Iowa for necessary infrastructure, statewide
 coordination, provider recruitment, service delivery, and
 provision of assistance to patients in securing a medical home
 inclusive of oral health care.
    (iii)  Of the amount allocated in this subparagraph
 division (a), up to $25,000 shall be distributed to the
 Iowa coalition against sexual assault to continue a training
 program for sexual assault response team (SART) members,
 including representatives of law enforcement, victim advocates,
 prosecutors, and certified medical personnel.
    (iv)  Of the amount allocated in this subparagraph division
 (a), up to $106,874 shall be distributed to the Polk county
 medical society for continuation of the safety net provider
 patient access to a specialty health care initiative as
 described in 2007 Iowa Acts, chapter 218, section 109.
    (b)  For distribution to safety net partners in the
 state that work to increase health system integration, care
 coordination, and collaboration across the continuum of care
 with a focus on safety net services. Such efforts shall
 include but not be limited to community care coordination team
 development and integration of medical and behavioral health
 services. Efforts shall also include working, in conjunction
 with the department of human services and the department
 of public health, to support Medicaid managed care efforts
 inclusive of the state innovation model through the continued
 development and implementation of community care coordination
 teams. Implementation of the community care coordination
 teams shall be accomplished through a statewide regionally
 based network that provides an integrated approach to health
 care delivery through care coordination that supports primary
 care providers and links patients with community resources
 necessary to empower patients in addressing biomedical and
 social determinants of health to improve health outcomes:
 .................................................. $    836,099
    (c)  For distribution to safety net partners in the state
 that work to serve as a resource for credible, accurate
 information on health care=related needs and services
 for vulnerable populations in the state including the
 Iowa association of rural health clinics for necessary
 infrastructure and service delivery transformation and the Iowa
 primary care association to support partner engagement, program
 management, and statewide coordination of the network:
 .................................................. $     92,642
    (2)  The amount allocated under this paragraph "g" shall
 not be reduced for administrative or other costs prior to
 distribution. The Iowa collaborative safety net provider
 network may continue to distribute funds allocated pursuant to
 this paragraph "g" through existing contracts or renewal of
 existing contracts.
    (3)  For each goal of the Iowa collaborative safety net
 provider network, the Iowa primary care association shall
 submit a progress report to the individuals designated in this
 Act for submission of reports by December 15, 2016, including
 progress in developing and implementing the network, how the
 funds were distributed and used in developing and implementing
 the network, and the remaining needs identified to fully
 develop and implement the network.
    h.  Of the funds appropriated in this subsection, $106,700
 shall be used for continuation of the work of the direct care
 worker advisory council established pursuant to 2008 Iowa Acts,
 chapter 1188, section 69, in implementing the recommendations
 in the final report submitted by the 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 and specialties through various formats
 including online access, community colleges, and other venues;
 exploring new and maintaining existing specialties including
 but not limited to oral health and dementia care; supporting
 instructor training; and assessing and making recommendations
 concerning the Iowa care book and information technology
 systems and infrastructure uses and needs.
    i.  (1)  Of the funds appropriated in this subsection,
 $108,187 shall be used for allocation to an independent
 statewide direct care worker organization selected through a
 request for proposals process.  The contract shall include
 performance and outcomes measures, and shall allow the
 contractor to use a portion of the funds received under the
 contract to collect data to determine results based on the
 performance and outcomes measures.
    (2)  Of the funds appropriated in this subsection, $37,500
 shall be used to provide scholarships or other forms of
 subsidization for direct care worker educational conferences,
 training, or outreach activities.
    j.  Of the funds appropriated in this subsection, the
 department may use up to $29,087 for up to one full=time
 equivalent position to administer the volunteer health care
 provider program pursuant to section 135.24.
    k.  Of the funds appropriated in this subsection, $50,000
 shall be used for a matching dental education loan repayment
 program to be allocated to a dental nonprofit health service
 corporation to continue to develop the criteria and implement
 the loan repayment program.
    l.  Of the funds appropriated in this subsection, $52,911 is
 transferred to the college student aid commission for deposit
 in the rural Iowa primary care trust fund created in section
 261.113 to be used for the purposes of the fund.
    m.  Of the funds appropriated in this subsection, $125,000
 shall be used for the purposes of the Iowa donor registry as
 specified in section 142C.18.
    n.  Of the funds appropriated in this subsection, $50,000
 shall be used for continuation of a grant to a nationally
 affiliated volunteer eye organization that has an established
 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. The organization
 shall submit a report to the individuals identified in this
 Act for submission of reports regarding the use of funds
 allocated under this paragraph "n".  The report shall 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; the number, age, and
 location within the state of individuals served; the type of
 services provided to the individuals served; the distribution
 of funds based on services provided; and the continuing needs
 of the program.
    o.  Of the funds appropriated in this subsection, $1,000,000
 shall be deposited in the medical residency training account
 created in section 135.175, subsection 5, paragraph "a", and
 is appropriated from the account to the department of public
 health to be used for the purposes of the medical residency
 training state matching grants program as specified in section
 135.176. However, notwithstanding any provision to the
 contrary in section 135.176, priority in the awarding of grants
 shall be given to sponsors that propose preference in the use
 of the grant funds for psychiatric residency positions and
 family practice residency positions.
    p.  Of the funds appropriated in this subsection, $78,309  is
 allocated to the university of Iowa hospitals and clinics to
 continue a systematic and evidence=based practice collaborative
 care model to improve outcomes of mental health treatment in
 primary care settings in the state.  Funds shall be used to
 establish the collaborative care model in several primary care
 practices in rural and urban areas throughout the state, to
 provide staffing to administer the model, and to provide staff
 training and database management to track and manage patient
 outcomes.
    5.  HEALTHY AGING
    To provide public health services that reduce risks and
 invest in promoting and protecting good health over the
 course of a lifetime with a priority given to older Iowans and
 vulnerable populations:
 .................................................. $  3,648,571
    6.  INFECTIOUS DISEASES
    For reducing the incidence and prevalence of communicable
 diseases, and for not more than the following full=time
 equivalent positions:
 .................................................. $    667,577
 ............................................... FTEs       4.00
    7.  PUBLIC PROTECTION
    For protecting the health and safety of the public through
 establishing standards and enforcing regulations, and for not
 more than the following full=time equivalent positions:
 .................................................. $  2,169,595
 ............................................... FTEs    136.00
    a.  Of the funds appropriated in this subsection, not more
 than $227,350 shall be credited to the emergency medical
 services fund created in section 135.25. Moneys in the
 emergency medical services fund are appropriated to the
 department to be used for the purposes of the fund.
    b.  Of the funds appropriated in this subsection, $101,516
 shall be used for sexual violence prevention programming
 through a statewide organization representing programs
 serving victims of sexual violence through the department's
 sexual violence prevention program. The amount allocated
 in this paragraph "b" shall not be used to supplant funding
 administered for other sexual violence prevention or victims
 assistance programs.
    c.  Of the funds appropriated in this subsection, $299,375
 shall be used for the state poison control center. Pursuant
 to the directive under 2014 Iowa Acts, chapter 1140, section
 102, the federal matching funds available to the state poison
 control center from the department 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.
 XXI of the federal Social Security Act and included within the
 department's calculations of the cap.
    d.  Of the funds appropriated in this subsection, $268,875
 shall be used for childhood lead poisoning provisions.
    8.  RESOURCE MANAGEMENT
    For establishing and sustaining the overall ability of the
 department to deliver services to the public, and for not more
 than the following full=time equivalent positions:
 .................................................. $    427,536
 ............................................... FTEs       4.00
    The university of Iowa hospitals and clinics under the
 control of the state board of regents shall not receive
 indirect costs from the funds appropriated in this section.
 The university of Iowa hospitals and clinics billings to the
 department shall be on at least a quarterly basis.
                           DIVISION XL
         DEPARTMENT OF VETERANS AFFAIRS ==== FY 2016=2017
    Sec. 124.  DEPARTMENT OF VETERANS AFFAIRS.  There is
 appropriated from the general fund of the state to the
 department of veterans affairs for the fiscal year beginning
 July 1, 2016, and ending June 30, 2017, the following amounts,
 or so much thereof as is necessary, to be used for the purposes
 designated:
    1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
    For salaries, support, maintenance, and miscellaneous
 purposes, and for not more than the following full=time
 equivalent positions:
 .................................................. $    600,273
 ............................................... FTEs      15.00
    2.  IOWA VETERANS HOME
    For salaries, support, maintenance, and miscellaneous
 purposes:
 .................................................. $  3,797,498
    a.  The Iowa veterans home billings involving the department
 of human services shall be submitted to the department on at
 least a monthly basis.
    b.  If there is a change in the employer of employees
 providing services at the Iowa veterans home under a collective
 bargaining agreement, such employees and the agreement shall
 be continued by the successor employer as though there had not
 been a change in employer.
    c.  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
 spouses who are participating in the community reentry program.
    d.  The Iowa veterans home expenditure report shall be
 submitted monthly to the legislative services agency.
    3.  HOME OWNERSHIP ASSISTANCE PROGRAM
    For transfer to the Iowa finance authority for the
 continuation of the home ownership assistance program for
 persons who are or were eligible members of the armed forces of
 the United States, pursuant to section 16.54:
 .................................................. $  1,250,000
    Sec. 125.  LIMITATION OF COUNTY COMMISSIONS OF VETERAN
 AFFAIRS FUND STANDING APPROPRIATIONS.  Notwithstanding the
 standing appropriation in section 35A.16 for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, 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:
    For the county commissions of veteran affairs fund under
 section 35A.16:
 .................................................. $    495,000
                          DIVISION XLI
          DEPARTMENT OF HUMAN SERVICES ==== FY 2016=2017
    Sec. 126.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
 GRANT.  There is appropriated from the fund created in section
 8.41 to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, from moneys
 received under the federal temporary assistance for needy
 families (TANF) block grant pursuant to the federal Personal
 Responsibility and Work Opportunity Reconciliation Act of 1996,
 Pub. L. No. 104=193, and successor legislation, the following
 amounts, or so much thereof as is necessary, to be used for the
 purposes designated:
    1.  To be credited to the family investment program account
 and used for assistance under the family investment program
 under chapter 239B:
 .................................................. $  2,568,497
    2.  To be credited to the family investment program account
 and used for the job opportunities and basic skills (JOBS)
 program and implementing family investment agreements in
 accordance with chapter 239B:
 .................................................. $  5,069,089
    3.  To be used for the family development and
 self=sufficiency grant program in accordance with section
 216A.107:
 .................................................. $  1,449,490
    Notwithstanding section 8.33, moneys appropriated in this
 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. However, unless such moneys are
 encumbered or obligated on or before September 30, 2016, the
 moneys shall revert.
    4.  For field operations:
 .................................................. $ 15,648,116
    5.  For general administration:
 .................................................. $  1,872,000
    6.  For state child care assistance:
 .................................................. $ 17,523,555
    a.  Of the funds appropriated in this subsection,
 $13,164,048 is transferred to the child care and development
 block grant appropriation made by the Eighty=sixth General
 Assembly, 2016 Session, for the federal fiscal year beginning
 October 1, 2016, and ending September 30, 2017. Of this
 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. The
 department may contract with institutions of higher education
 or child care resource and referral centers to provide
 the educational opportunities. Allowable administrative
 costs under the contracts shall not exceed 5 percent. The
 application for a grant shall not exceed two pages in length.
    b.  Any funds appropriated in this subsection remaining
 unallocated shall be used for state child care assistance
 payments for families who are employed including but not
 limited to individuals enrolled in the family investment
 program.
    7.  For distribution to counties and regions through the
 property tax relief fund for mental health and disability
 services as provided in an appropriation made for this purpose:
 .................................................. $  2,447,026
    8.  For child and family services:
 .................................................. $ 16,042,215
    9.  For child abuse prevention grants:
 .................................................. $     62,500
    10.  For pregnancy prevention grants on the condition that
 family planning services are funded:
 .................................................. $    965,033
    Pregnancy prevention grants shall be awarded to programs
 in existence on or before July 1, 2016, if the programs have
 demonstrated positive  outcomes.  Grants shall be awarded to
 pregnancy prevention  programs which are developed after July
 1, 2016, if the  programs are based on existing  models that
 have demonstrated positive outcomes.  Grants shall  comply with
 the requirements provided in 1997 Iowa Acts,  chapter 208,
 section 14, subsections 1 and 2, including the  requirement that
 grant programs must emphasize sexual  abstinence.  Priority in
 the awarding of grants shall be given  to programs that serve
 areas of the state which demonstrate  the highest percentage of
 unplanned pregnancies of females of  childbearing age within the
 geographic area to be served by  the grant.
    11.  For technology needs and other resources necessary
 to meet federal welfare reform reporting, tracking, and case
 management requirements:
 .................................................. $    518,593
    12.  For the family investment program share of the costs to
 continue to develop and maintain a new, integrated eligibility
 determination system:
 .................................................. $  3,327,440
    13.  a.  Notwithstanding any provision to the contrary,
 including but not limited to requirements in section 8.41 or
 provisions in 2015 or 2016 Iowa Acts regarding the receipt and
 appropriation of federal block grants, federal funds from the
 temporary assistance for needy families block grant received by
 the state and not otherwise appropriated in this section and
 remaining available for the fiscal year beginning July 1, 2016,
 are appropriated to the department of human services to the
 extent as may be necessary to be used in the following priority
 order:  the family investment program, for state child care
 assistance program payments for families who are employed, and
 for the family investment program share of costs to develop and
 maintain a new, integrated eligibility determination system.
 The federal funds appropriated in this paragraph "a" shall be
 expended only after all other funds appropriated in subsection
 1 for the assistance under the family investment program,
 in subsection 6 for child care assistance, or in subsection
 12 for the family investment program share of the costs to
 continue to develop and maintain a new, integrated eligibility
 determination system, as applicable, have been expended. For
 the purposes of this subsection, the funds appropriated in
 subsection 6, paragraph "a", for transfer to the child care
 and development block grant appropriation are considered fully
 expended when the full amount has been transferred.
    b.  The department shall, on a quarterly basis, advise the
 legislative services agency and department of management of
 the amount of funds appropriated in this subsection that was
 expended in the prior quarter.
    14.  Of the amounts appropriated in this section, $6,481,004
 for the fiscal year beginning July 1, 2016, is transferred to
 the appropriation of the federal social services block grant
 made to the department of human services for that fiscal year.
    15.  For continuation of the program providing categorical
 eligibility for the food assistance program as specified for
 the program in the section of this division of this 2016 Act
 relating to the family investment program account:
 .................................................. $    12,500
    16.  The department may transfer funds allocated in this
 section 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
 services referred to in this section and those funded in the
 appropriation made in this division of this Act for the same
 fiscal year for the family investment program from the general
 fund of the state.
    Sec. 127.  FAMILY INVESTMENT PROGRAM ACCOUNT.
    1.  Moneys credited to the family investment program (FIP)
 account for the fiscal year beginning July 1, 2016, and
 ending June 30, 2017, shall be used to provide assistance in
 accordance with chapter 239B.
    2.  The department may use a portion of the moneys credited
 to the FIP account under this section as necessary for
 salaries, support, maintenance, and miscellaneous purposes.
    3.  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
 division of this Act for the same fiscal year for the family
 investment program from the general fund of the state.
    4.  Moneys appropriated in this division of this Act and
 credited to the FIP account for the fiscal year beginning July
 1, 2016, and ending June 30, 2017, are allocated as follows:
    a.  To be retained by the department of human services to
 be used for coordinating with the department of human rights
 to more effectively serve participants in FIP and other shared
 clients and to meet federal reporting requirements under the
 federal temporary assistance for needy families block grant:
 .................................................. $     10,000
    b.  To the department of human rights for staffing,
 administration, and implementation of the family development
 and self=sufficiency grant program in accordance with section
 216A.107:
 .................................................. $  3,096,417
    (1)  Of the funds allocated for the family development
 and self=sufficiency grant program in this paragraph "b",
 not more than 5 percent of the funds shall be used for the
 administration of the grant program.
    (2)  The department of human rights may continue to implement
 the family development and self=sufficiency grant program
 statewide during fiscal year 2016=2017.
    (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.
    c.  For the diversion subaccount of the FIP account:
 .................................................. $    407,500
    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 administer the FIP diversion program. To the extent
 moneys allocated in this paragraph "c" are not deemed by the
 department 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.
    d.  For the food assistance employment and training program:
 .................................................. $     33,294
    (1)  The department shall apply the federal supplemental
 nutrition assistance program (SNAP) employment and training
 state plan in order to maximize to the fullest extent permitted
 by federal law the use of the 50 percent federal reimbursement
 provisions for the claiming of allowable federal reimbursement
 funds from the United States department of agriculture
 pursuant to the federal SNAP employment and training program
 for providing education, employment, and training services
 for eligible food assistance program participants, including
 but not limited to related dependent care and transportation
 expenses.
    (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
 assistance program requirements. The department shall include
 as many food assistance households as is allowed by federal
 law. The eligibility provisions shall conform to all federal
 requirements including requirements addressing individuals who
 are incarcerated or otherwise ineligible.
    e.  For the JOBS program:
 .................................................. $  8,770,199
    5.  Of the child support collections assigned under FIP,
 an amount equal to the federal share of support collections
 shall be credited to the child support recovery appropriation
 made in this division of this Act. 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
 portion may be used to sustain cash flow in the child support
 payments account. If as a consequence of the appropriations
 and allocations made in this section the resulting amounts
 are insufficient to sustain cash assistance payments and meet
 federal maintenance of effort requirements, the department
 shall seek supplemental funding. If child support collections
 assigned under FIP are greater than estimated or are otherwise
 determined not to be required for maintenance of effort, the
 state share of either amount may be transferred to or retained
 in the child support payments account.
    6.  The department may adopt emergency rules for the family
 investment, JOBS, food assistance, and medical assistance
 programs if necessary to comply with federal requirements.
    Sec. 128.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There
 is appropriated from the general fund of the state to the
 department of human services for the fiscal year beginning July
 1, 2016, and ending June 30, 2017, the following amount, or
 so much thereof as is necessary, to be used for the purpose
 designated:
    To be credited to the family investment program (FIP)
 account and used for family investment program assistance under
 chapter 239B:
 .................................................. $ 24,336,937
    1.  Of the funds appropriated in this section, $3,701,110 is
 allocated for the JOBS program.
    2.  Of the funds appropriated in this section, $1,656,927 is
 allocated for the family development and self=sufficiency grant
 program.
    3.  Notwithstanding section 8.39, for the fiscal year
 beginning July 1, 2016, 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
 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, 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:
    a.  For the family investment program.
    b.  For child care assistance.
    c.  For child and family services.
    d.  For field operations.
    e.  For general administration.
    f.  For distribution to counties or regions through the
 property tax relief fund for mental health and disability
 services as provided in an appropriation for this purpose.
    This subsection shall not be construed to prohibit the use
 of existing state transfer authority for other purposes. The
 department shall report any transfers made pursuant to this
 subsection to the legislative services agency.
    4.  Of the funds appropriated in this section, $97,839 shall
 be used for continuation of a grant to an Iowa=based nonprofit
 organization with a history of providing tax preparation
 assistance to low=income Iowans in order to expand the usage of
 the earned income tax credit. The purpose of the grant is to
 supply this assistance to underserved areas of the state.
    5.  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, healthy
 living, and social responsibility headquartered in a county
 with a population over 350,000. The funds allocated in this
 subsection shall be used by the recipient organization to
 develop a larger community effort, through public and private
 partnerships, to support a broad=based multi=county fatherhood
 initiative that promotes payment of child support obligations,
 improved family relationships, and full=time employment.
    6.  The department may transfer funds appropriated in this
 section to the appropriations made in this division of this Act
 for general administration and field operations as necessary
 to administer this section and the overall family investment
 program.
    Sec. 129.  CHILD SUPPORT RECOVERY.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and ending
 June 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purposes designated:
    For child support recovery, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $  7,331,686
 ............................................... FTEs     464.00
    1.  The department shall expend up to $12,164, including
 federal financial participation, for the fiscal year beginning
 July 1, 2016, for a child support public awareness campaign.
 The department and the office of the attorney general shall
 cooperate in continuation of the campaign. The public
 awareness campaign shall emphasize, through a variety of
 media activities, the importance of maximum involvement of
 both parents in the lives of their children as well as the
 importance of payment of child support obligations.
    2.  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
 provisions of court orders, including but not limited to
 neutral visitation sites and mediation services.
    3.  The appropriation made to the department for child
 support recovery may be used throughout the fiscal year in the
 manner necessary for purposes of cash flow management, and for
 cash flow management purposes the department may temporarily
 draw more than the amount appropriated, provided the amount
 appropriated is not exceeded at the close of the fiscal year.
    4.  With the exception of the funding amount specified, the
 requirements established under 2001 Iowa Acts, chapter 191,
 section 3, subsection 5, paragraph "c", subparagraph (3), shall
 be applicable to parental obligation pilot projects for the
 fiscal year beginning July 1, 2016, and ending June 30, 2017.
 Notwithstanding 441 IAC 100.8, providing for termination of
 rules relating to the pilot projects, the rules shall remain
 in effect until June 30, 2017.
    Sec. 130.  HEALTH CARE TRUST FUND ==== MEDICAL ASSISTANCE ====
 FY 2016=2017.  Any funds remaining in the health care trust
 fund created in section 453A.35A for the fiscal year beginning
 July 1, 2016, and ending June 30, 2017, 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,
 including program administration and costs associated with
 program implementation.
    Sec. 131.  MEDICAID FRAUD FUND ==== MEDICAL ASSISTANCE ==== FY
 2016=2017.  Any funds remaining in the Medicaid fraud fund
 created in section 249A.50 for the fiscal year beginning
 July 1, 2016, and ending June 30, 2017, are appropriated to
 the department of human services to supplement the medical
 assistance appropriations made in this division of this Act,
 for medical assistance reimbursement and associated costs,
 including program administration and costs associated with
 program implementation.
    Sec. 132.  MEDICAL ASSISTANCE.  There is appropriated from
 the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and ending
 June 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purpose designated:
    For medical assistance program reimbursement and associated
 costs as specifically provided in the reimbursement
 methodologies in effect on June 30, 2016, except as otherwise
 expressly authorized by law, consistent with options under
 federal law and regulations, and contingent upon receipt of
 approval from the office of the governor of reimbursement for
 each abortion performed under the program:
 .................................................. $651,595,782
    1.  Iowans support reducing the number of abortions
 performed in our state.  Funds appropriated under this section
 shall not be used for abortions, unless otherwise authorized
 under this section.
    2.  The provisions of this section relating to abortions
 shall also apply to the Iowa health and wellness plan created
 pursuant to chapter 249N.
    3.  The department shall utilize not more than $30,000 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
 409, subsection 6. Of the funds allocated in this subsection,
 not more than $2,500 may be expended for administrative
 purposes.
    4.  Of the funds appropriated in this Act to the department
 of public health for addictive disorders, $475,000 for
 the fiscal year beginning July 1, 2016, is transferred
 to the department of human services for an integrated
 substance=related disorder managed care system. The department
 shall not assume management of the substance=related disorder
 system in place of the managed care contractor unless such
 a change in approach is specifically authorized in law.
 The departments of human services and public health shall
 work together to maintain the level of mental health and
 substance=related disorder treatment services provided by the
 managed care contractor through the Iowa plan for behavioral
 health. Each department shall take the steps necessary to
 continue the federal waivers as necessary to maintain the level
 of services.
    5.  a.  The department shall aggressively pursue options for
 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 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 policy
 provisions.
    b.  Of the funds appropriated in this section, $50,000
 shall be used for participation in one or more pilot projects
 operated by a private provider to allow the individual or
 individuals to receive service in the community in accordance
 with principles established in Olmstead v. L.C., 527 U.S. 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
 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.
    6.  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
 Act for operational costs associated with Part D of the federal
 Medicare Prescription Drug Improvement and Modernization Act
 of 2003, Pub. L. No. 108=173.
    7.  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
 assessment services and prior authorization of services.
    8.  A portion of the funds appropriated in this section
 may be transferred to the appropriations in this division of
 this Act for general administration, medical contracts, the
 children's health insurance program, or field operations to be
 used for the state match cost to comply with the payment error
 rate measurement (PERM) program for both the medical assistance
 and children's health insurance programs as developed by the
 centers for Medicare and Medicaid services of the United States
 department of health and human services to comply with the
 federal Improper Payments Information Act of 2002, Pub. L. No.
 107=300.
    9.  The department shall continue to implement the
 recommendations of the assuring better child health and
 development initiative II (ABCDII) clinical panel to the
 Iowa early and periodic screening, diagnostic, and treatment
 services healthy mental development collaborative board
 regarding changes to billing procedures, codes, and eligible
 service providers.
    10.  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
 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.
    11.  Of the funds appropriated in this section, the following
 amounts are transferred to the appropriations made in this
 division of this Act for the state mental health institutes:
    a.  Cherokee mental health institute..........  $  4,549,212
    b.  Independence mental health institute......  $  4,522,947
    12.  a.  Of the funds appropriated in this section,
 $2,041,939 is allocated for the state match for a
 disproportionate share hospital payment of $4,544,712 to
 hospitals that meet both of the conditions specified in
 subparagraphs (1) and (2). In addition, the hospitals that
 meet the conditions specified shall either certify public
 expenditures or transfer to the medical assistance program
 an amount equal to provide the nonfederal share for a
 disproportionate share hospital payment of $8,772,003. The
 hospitals that meet the conditions specified shall receive and
 retain 100 percent of the total disproportionate share hospital
 payment of $13,316,715.
    (1)  The hospital qualifies for disproportionate share and
 graduate medical education payments.
    (2)  The hospital is an Iowa state=owned hospital with more
 than 500 beds and eight or more distinct residency specialty
 or subspecialty programs recognized by the American college of
 graduate medical education.
    b.  Distribution of the disproportionate share payments
 shall be made on a monthly basis. The total amount of
 disproportionate share payments including graduate medical
 education, enhanced disproportionate share, and Iowa
 state=owned teaching hospital payments shall not exceed the
 amount of the state's allotment under Pub. L. No. 102=234.
 In addition, the total amount of all disproportionate
 share payments shall not exceed the hospital=specific
 disproportionate share limits under Pub. L. No. 103=66.
    c.  The university of Iowa hospitals and clinics shall either
 certify public expenditures or transfer to the appropriations
 made in this division of this Act for medical assistance an
 amount equal to provide the nonfederal share for increased
 medical assistance payments for inpatient and outpatient
 hospital services of $4,950,000. The university of Iowa
 hospitals and clinics shall receive and retain 100 percent of
 the total increase in medical assistance payments.
    d.  Payment methodologies utilized for disproportionate
 share hospitals and graduate medical education, and other
 supplemental payments under the Medicaid program may be
 adjusted or converted to other methodologies or payment types
 to provide these payments through Medicaid managed care.  The
 department of human services shall obtain approval from the
 centers for Medicare and Medicaid services of the United States
 department of health and human services prior to implementation
 of any such adjusted or converted methodologies or payment
 types.
    13.  One hundred percent of the nonfederal share of payments
 to area education agencies that are medical assistance
 providers for medical assistance=covered services provided to
 medical assistance=covered children, shall be made from the
 appropriation made in this section.
    14.  Any new or renewed contract entered into by the
 department with a third party to administer services under the
 medical assistance program shall provide that any interest
 earned on payments from the state during the state fiscal year
 shall be remitted to the department and treated as recoveries
 to offset the costs of the medical assistance program.
    15.  A portion of the funds appropriated in this section
 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.
    16.  Of the funds appropriated in this section, $174,505
 shall be used for the administration of the health insurance
 premium payment program, including salaries, support,
 maintenance, and miscellaneous purposes.
    17.  a.  The department may increase the amounts allocated
 for salaries, support, maintenance, and miscellaneous purposes
 associated with the medical assistance program, as necessary,
 to implement cost containment strategies.  The department shall
 report any such increase to the legislative services agency and
 the department of management.
    b.  If the savings to the medical assistance program from
 cost containment efforts exceed the cost for the fiscal
 year beginning July 1, 2016, the department may transfer any
 savings generated for the fiscal year due to medical assistance
 program cost containment efforts to the appropriation
 made in this division of this Act for medical contracts or
 general administration to defray the increased contract costs
 associated with implementing such efforts.
    c.  The department of human services shall not implement the
 cost containment measures to provide uniform rates of $.575 per
 mile based on the 2015 Internal Revenue Service mileage rate
 and of $9.29, the current statewide average, per one=way trip
 for Medicaid program home and community=based services waivers
 as recommended by the governor for the fiscal year beginning
 July 1, 2016.
    d.  The department shall report the implementation of
 any cost containment strategies under this subsection to the
 individuals specified in this Act for submission of reports on
 a quarterly basis.
    18.  For the fiscal year beginning July 1, 2016, and ending
 June 30, 2017, 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.
    19.  The department shall continue to administer the state
 balancing incentive payments program as specified in 2012 Iowa
 Acts, chapter 1133, section 14.
    20.  a.  Of the funds appropriated in this section, up
 to $25,000 may be transferred by the department to the
 appropriation made in this division of this Act to the
 department for the same fiscal year for general administration
 to be used for associated administrative expenses and for not
 more than one full=time equivalent position, in addition to
 those authorized for the same fiscal year, to be assigned to
 implementing the project.
    b.  Of the funds appropriated in this section, up to $200,000
 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.  The funds may be used
 for contracts or for personnel in addition to the amounts
 appropriated for and the positions authorized for general
 administration for the fiscal year.
    c.  Of the funds appropriated in this section, up to
 $1,500,000 may be transferred by the department to the
 appropriations made in 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.
    21.  Of the funds appropriated in this section, $125,000
 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
 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 of human services
 shall establish the maximum number of overnight stays and the
 maximum rate reimbursed for overnight lodging, which may be
 based on the state employee rate established by the department
 of administrative services.  The funds allocated in this
 subsection  shall not be used as nonfederal share matching
 funds.
    22.  The number of home and community=based services waiver
 slots available during the fiscal year beginning July 1, 2016,
 shall not be reduced below the number of such slots available
 on January 1, 2015.
    Sec. 133.  MEDICAL CONTRACTS.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June 30,
 2017, the following amount, or so much thereof as is necessary,
 to be used for the purpose designated:
    For medical contracts:
 .................................................. $  9,806,982
    1.  The department of inspections and appeals shall
 provide all state matching funds for survey and certification
 activities performed by the department of inspections
 and appeals. The department of human services is solely
 responsible for distributing the federal matching funds for
 such activities.
    2.  Of the funds appropriated in this section, $25,000 shall
 be used for continuation of home and community=based services
 waiver quality assurance programs, including the review and
 streamlining of processes and policies related to oversight and
 quality management to meet state and federal requirements.
    3.  Of the amount appropriated in this section, up to
 $100,000 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
 and oversight of managed care programs, and development of
 health strategies targeted toward improved quality and reduced
 costs in the Medicaid program.
    4.  Of the funds appropriated in this section, $500,000 shall
 be used for planning and development, in cooperation with the
 department of public health, of a phased=in program to provide
 a dental home for children.
    5.  Of the funds appropriated in this section, $1,000,000
 shall be used for the autism support program created in chapter
 225D, with the exception of the following amounts of this
 allocation which shall be used as follows:
    a.  Of the funds allocated in this subsection, $125,000
 shall be deposited in the board=certified behavior analyst and
 board=certified assistant behavior analyst grants program fund
 created in section 135.181, as enacted in this Act, to be used
 for the purposes of the fund.
    b.  Of the funds allocated in this subsection, $12,500
 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
 autism spectrum disorder and their families.
    c.  Of the funds allocated in this subsection, $12,500
 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. The grant recipient shall utilize the funds
 to continue the pilot project to determine the necessary
 support services for children with autism spectrum disorder and
 their families to be included in the children's disabilities
 services system. The grant recipient shall submit findings and
 recommendations based upon the results of the pilot project
 to the individuals specified in this division of this Act for
 submission of reports by December 31, 2015.
    Sec. 134.  STATE SUPPLEMENTARY ASSISTANCE.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For the state supplementary assistance program:
 .................................................. $ 6,498,593
    2.  The department shall increase the personal needs
 allowance for residents of residential care facilities by the
 same percentage and at the same time as federal supplemental
 security income and federal social security benefits are
 increased due to a recognized increase in the cost of living.
 The department may adopt emergency rules to implement this
 subsection.
    3.  If during the fiscal year beginning July 1, 2016,
 the department projects that state supplementary assistance
 expenditures for a calendar year will not meet the federal
 pass=through requirement specified in Tit. XVI of the federal
 Social Security Act, section 1618, as codified in 42 U.S.C.
 {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
 prescribed in this division of this Act to ensure that federal
 requirements are met. In 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. The department may adopt
 emergency rules to implement the provisions of this subsection.
    Sec. 135.  CHILDREN'S HEALTH INSURANCE PROGRAM.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For maintenance of the healthy and well kids in Iowa (hawk=i)
 program pursuant to chapter 514I, including supplemental dental
 services, for receipt of federal financial participation under
 Tit. XXI of the federal Social Security Act, which creates the
 children's health insurance program:
 .................................................. $ 10,206,922
    2.  Of the funds appropriated in this section, $21,400 is
 allocated for continuation of the contract for outreach with
 the department of public health.
    Sec. 136.  CHILD CARE ASSISTANCE.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and ending
 June 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purpose designated:
    For child care programs:
 .................................................. $ 25,704,334
    1.  Of the funds appropriated in this section, $21,844,620
 shall be used for state child care assistance in accordance
 with section 237A.13.
    2.  Nothing in this section shall be construed or is
 intended as or shall imply a grant of entitlement for services
 to persons who are eligible for assistance due to an income
 level consistent with the waiting list requirements of section
 237A.13. Any state obligation to provide services pursuant to
 this section is limited to the extent of the funds appropriated
 in this section.
    3.  Of the funds appropriated in this section, $216,226
 is allocated for the statewide grant program for child care
 resource and referral services under section 237A.26. A list
 of the registered and licensed child care 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.
    4.  Of the funds appropriated in this section, $468,487
 is allocated for child care quality improvement initiatives
 including but not limited to the voluntary quality rating
 system in accordance with section 237A.30.
    5.  Of the funds appropriated in this section, $3,175,000
 shall be credited to the early childhood programs grants
 account in the early childhood Iowa fund created in section
 256I.11. The moneys shall be distributed for funding of
 community=based early childhood programs targeted to children
 from birth through five years of age developed by early
 childhood Iowa areas in accordance with approved community
 plans as provided in section 256I.8.
    6.  The department may use any of the funds appropriated
 in this section as a match to obtain federal funds for use in
 expanding child care assistance and related programs. For
 the purpose of expenditures of state and federal child care
 funding, funds shall be considered obligated at the time
 expenditures are projected or are allocated to the department's
 service areas. Projections shall be based on current and
 projected caseload growth, current and projected provider
 rates, staffing requirements for eligibility determination
 and management of program requirements including data systems
 management, staffing requirements for administration of the
 program, contractual and grant obligations and any transfers
 to other state agencies, and obligations for decategorization
 or innovation projects.
    7.  A portion of the state match for the federal child care
 and development block grant shall be provided as necessary to
 meet federal matching funds requirements through the state
 general fund appropriation made for child development grants
 and other programs for at=risk children in section 279.51.
    8.  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
 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. The percentage reduction to
 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 there is an unanticipated increase in federal funding
 provided for state child care assistance, the entire amount
 of the increase shall be used for state child care assistance
 payments. 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
 assembly to appropriate sufficient funding for the fiscal year
 in order to avoid establishment of waiting list requirements.
    9.  Notwithstanding section 8.33, moneys advanced for
 purposes of the programs developed by early childhood Iowa
 areas, advanced for purposes of wraparound child care, or
 received from the federal appropriations made for the purposes
 of this section 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. 137.  JUVENILE INSTITUTION.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and ending
 June 30, 2017, the following amounts, or so much thereof as is
 necessary, to be used for the purposes designated:
    1.  For operation of the state training school at Eldora and
 for salaries, support, maintenance, and miscellaneous purposes,
 and for not more than the following full=time equivalent
 positions:
 .................................................. $  6,116,710
 ............................................... FTEs     169.30
    Of the funds appropriated in this subsection, $45,575 shall
 be used for distribution to licensed classroom teachers at this
 and other institutions under the control of the department of
 human services based upon the average student yearly enrollment
 at each institution as determined by the department.
    2.  A portion of the moneys appropriated in this section
 shall be used by the state training school at Eldora for
 grants for adolescent pregnancy prevention activities at the
 institution in the fiscal year beginning July 1, 2016.
    Sec. 138.  CHILD AND FAMILY SERVICES.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For child and family services:
 .................................................. $ 42,670,969
    2.  Up to $2,600,000 of the amount of federal temporary
 assistance for needy families block grant funding appropriated
 in this division of this Act for child and family services
 shall be made available for purposes of juvenile delinquent
 graduated sanction services.
    3.  The department may transfer funds appropriated in this
 section as necessary to pay the nonfederal costs of services
 reimbursed under the medical assistance program, state child
 care assistance program, or the family investment program which
 are provided to children who would otherwise receive services
 paid under the appropriation in this section. The department
 may transfer funds appropriated in this section to the
 appropriations made in this division of this Act for general
 administration and for field operations for resources necessary
 to implement and operate the services funded in this section.
    4.  a.  Of the funds appropriated in this section, up to
 $17,910,893 is allocated as the statewide expenditure target
 under section 232.143 for group foster care maintenance and
 services. 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
 or the child welfare emergency services addressed with the
 allocation for shelter care.
    b.  If at any time after September 30, 2016, annualization
 of a service area's current expenditures indicates a service
 area is at risk of exceeding its group foster care expenditure
 target under section 232.143 by more than 5 percent, the
 department and juvenile court services shall examine all
 group foster care placements in that service area in order to
 identify those which might be appropriate for termination.
 In addition, any aftercare services believed to be needed
 for the children whose placements may be terminated shall be
 identified. The department and juvenile court services shall
 initiate action to set dispositional review hearings for the
 placements identified. In such a dispositional review hearing,
 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.
    5.  In accordance with the provisions of section 232.188,
 the department shall continue the child welfare and juvenile
 justice funding initiative during fiscal year 2016=2017. Of
 the funds appropriated in this section, $858,876 is allocated
 specifically for expenditure for fiscal year 2016=2017 through
 the decategorization services funding pools and governance
 boards established pursuant to section 232.188.
    6.  A portion of the funds appropriated in this section
 may be used for emergency family assistance to provide other
 resources required for a family participating in a family
 preservation or reunification project or successor project to
 stay together or to be reunified.
    7.  Notwithstanding section 234.35 or any other provision
 of law to the contrary, state funding for shelter care and
 the child welfare emergency services contracting implemented
 to provide for or prevent the need for shelter care shall be
 limited to $4,034,237.
    8.  Federal funds received by the state during the fiscal
 year beginning July 1, 2016, 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.
 Notwithstanding section 8.33, moneys received in accordance
 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 the purposes designated until the
 close of the succeeding fiscal year.
    9.  a.  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,
 subsection 4. Of 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.
 A portion of the cost of each school=based liaison officer
 shall be paid by the school district or other funding source as
 approved by the chief juvenile court officer.
    b.  Of the funds appropriated in this section, up to $374,492
 is allocated for the payment of the expenses of court=ordered
 services provided to children who are under the supervision
 of the department, which expenses are a charge upon the state
 pursuant to section 232.141, subsection 4.
    c.  Notwithstanding section 232.141 or any other provision
 of law to the contrary, the amounts allocated in this
 subsection shall be distributed to the judicial districts
 as determined by the state court administrator and to the
 department's service areas as determined by the administrator
 of the department of human services' division of child and
 family services. The state court administrator and the
 division administrator shall make the determination of the
 distribution amounts on or before June 15, 2016.
    d.  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 if there are insufficient court=ordered
 services funds available in the district court or departmental
 service area distribution amounts to pay for the service. The
 chief juvenile court officer and the departmental service area
 manager shall encourage use of the funds allocated in this
 subsection such that there are sufficient funds to pay for
 all court=related services during the entire year. 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
 funds between the judicial districts' or departmental service
 areas' distribution amounts as prudent.
    e.  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
 entered under chapter 232 which is a charge upon the state
 under section 232.141, subsection 4.
    f.  Of the funds allocated in this subsection, not more than
 $41,500 may be used by the judicial branch for administration
 of the requirements under this subsection.
    g.  Of the funds allocated in this subsection, $8,500
 shall be used by the department of human services to support
 the interstate commission for juveniles in accordance with
 the interstate compact for juveniles as provided in section
 232.173.
    10.  Of the funds appropriated in this section, $4,026,613 is
 allocated for juvenile delinquent graduated sanctions services.
 Any state funds saved as a result of efforts by juvenile court
 services to earn a federal Tit. IV=E match for juvenile court
 services administration may be used for the juvenile delinquent
 graduated sanctions services.
    11.  Of the funds appropriated in this section, $804,142 is
 transferred to the department of public health to be used for
 the child protection center grant program for child protection
 centers located in Iowa in accordance with section 135.118.
 The grant amounts under the program shall be equalized so that
 each center receives a uniform base amount of $122,500, and
 the remaining funds shall be awarded through a funding formula
 based upon the volume of children served.
    12.  If the department receives federal approval to
 implement a waiver under Tit. IV=E of the federal Social
 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.
    13.  Of the funds appropriated in this section, $2,012,583 is
 allocated for the preparation for adult living program pursuant
 to section 234.46.
    14.  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
 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.
    15.  Of the funds appropriated in this section, $150,310
 is allocated for the foster care youth council approach of
 providing a support network to children placed in foster care.
    16.  Of the funds appropriated in this section, $101,000 is
 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.
    17.  Of the funds appropriated in this section, $315,120 is
 allocated for the community partnership for child protection
 sites.
    18.  Of the funds appropriated in this section, $185,625
 is allocated for the department's minority youth and family
 projects under the redesign of the child welfare system.
    19.  Of the funds appropriated in this section, $593,297
 is allocated for funding of the community circle of care
 collaboration for children and youth in northeast Iowa.
    20.  Of the funds appropriated in this section, at least
 $73,579 shall be used for the continuation of the child
 welfare provider training academy, a collaboration between the
 coalition for family and children's services in Iowa and the
 department.
    21.  Of the funds appropriated in this section, $105,936
 shall be used for continuation of the central Iowa system of
 care program grant through June 30, 2017.
    22.  Of the funds appropriated in this section, $117,500
 shall be used for the public purpose of the continuation
 and expansion of a system of care program grant implemented
 in Cerro Gordo and Linn counties to utilize a comprehensive
 and long=term approach for helping children and families by
 addressing the key areas in a child's life of childhood basic
 needs, education and work, family, and community.
    23.  Of the funds appropriated in this section, at least
 $12,500 shall be used to continue and to expand the foster
 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.
    24.  Of the funds appropriated in this section, $55,000
 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 census information
 issued by the United States census bureau, is licensed as a
 psychiatric medical institution for children, and was a system
 of care grantee prior to July 1, 2016.
    Sec. 139.  ADOPTION SUBSIDY.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For adoption subsidy payments and services:
 .................................................. $ 21,499,143
    2.  The department may transfer funds appropriated in
 this section to the appropriation made in this division of
 this Act for general administration for costs paid from the
 appropriation relating to adoption subsidy.
    3.  Federal funds received by the state during the
 fiscal year beginning July 1, 2016, as the result of the
 expenditure of state funds 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 the services and activities funded under this section.
 Notwithstanding section 8.33, moneys received in accordance
 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. 140.  JUVENILE DETENTION HOME FUND.  Moneys deposited
 in the juvenile detention home fund created in section 232.142
 during the fiscal year beginning July 1, 2016, and ending June
 30, 2017, are appropriated to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June 30,
 2017, for distribution of an amount equal to a percentage of
 the costs of the establishment, improvement, operation, and
 maintenance of county or multicounty juvenile detention homes
 in the fiscal year beginning July 1, 2015. Moneys appropriated
 for distribution in accordance with this section shall be
 allocated among eligible detention homes, prorated on the basis
 of an eligible detention home's proportion of the costs of all
 eligible detention homes in the fiscal year beginning July
 1, 2015. The percentage figure shall be determined by the
 department based on the amount available for distribution for
 the fund. Notwithstanding section 232.142, subsection 3, the
 financial aid payable by the state under that provision for the
 fiscal year beginning July 1, 2016, shall be limited to the
 amount appropriated for the purposes of this section.
    Sec. 141.  FAMILY SUPPORT SUBSIDY PROGRAM.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    For the family support subsidy program subject to the
 enrollment restrictions in section 225C.37, subsection 3:
 .................................................. $    536,966
    2.  The department shall use at least $320,750 of the moneys
 appropriated in this section for the family support center
 component of the comprehensive family support program under
 section 225C.47. Not more than $12,500 of the amount allocated
 in this subsection shall be used for administrative costs.
    3.  If at any time during the fiscal year, the amount of
 funding available for the family support subsidy program
 is reduced from the amount initially used to establish the
 figure for the number of family members for whom a subsidy
 is to be provided at any one time during the fiscal year,
 notwithstanding section 225C.38, subsection 2, the department
 shall revise the figure as necessary to conform to the amount
 of funding available.
    Sec. 142.  CONNER DECREE.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June 30,
 2017, the following amount, or so much thereof as is necessary,
 to be used for the purpose designated:
    For building community capacity through the coordination
 and provision of training opportunities in accordance with the
 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
 Iowa, July 14, 1994):
 .................................................. $     16,816
    Sec. 143.  MENTAL HEALTH INSTITUTES.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and ending
 June 30, 2017, the following amounts, or so much thereof as is
 necessary, to be used for the purposes designated which amounts
 shall not be transferred or expended for any purpose other than
 the purposes designated, notwithstanding section 218.6 to the
 contrary:
    1.  For operation of the state mental health institute at
 Cherokee as required by chapters 218 and 226 for salaries,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $  2,772,808
 ............................................... FTEs     169.20
    2.  For operation of the state mental health institute at
 Independence as required by chapters 218 and 226 for salaries,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $  5,162,104
 ............................................... FTEs     233.00
    3.  For operation of the state mental health institute
 at Mount Pleasant as required by chapters 218 and 226, for
 purposes of providing adult psychiatric services including
 inpatient acute care, inpatient substance abuse treatment, and
 inpatient dual diagnosis substance use disorder and mental
 illness treatment, at the same level of care and treatment as
 provided on July 1, 2014, for salaries, support, maintenance,
 and miscellaneous purposes, and for not more than the following
 full=time equivalent positions:
 .................................................. $  3,212,440
 ............................................... FTEs      97.68
    Sec. 144.  STATE RESOURCE CENTERS.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the following
 amounts, or so much thereof as is necessary, to be used for the
 purposes designated:
    a.  For the state resource center at Glenwood for salaries,
 support, maintenance, and miscellaneous purposes:
 .................................................. $ 10,762,241
    b.  For the state resource center at Woodward for salaries,
 support, maintenance, and miscellaneous purposes:
 .................................................. $  7,291,903
    2.  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.
    3.  The state resource centers may expand the time=limited
 assessment and respite services during the fiscal year.
    4.  If the department's administration and the department
 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. If
 the vacant positions available to a resource center do not
 include the position classification desired to be filled, the
 state resource center's superintendent may reclassify any
 vacant position as necessary to fill the desired position. The
 superintendents of the state resource centers may, by mutual
 agreement, pool vacant positions and position classifications
 during the course of the fiscal year in order to assist one
 another in filling necessary positions.
    5.  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
 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 2016=2017.
    Sec. 145.  SEXUALLY VIOLENT PREDATORS.
    1.  There is appropriated from the general fund of the
 state to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the following
 amount, or so much thereof as is necessary, to be used for the
 purpose designated:
    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,
 support, maintenance, and miscellaneous purposes, and for not
 more than the following full=time equivalent positions:
 .................................................. $  4,946,539
 ............................................... FTEs     132.50
    2.  Unless specifically prohibited by law, if the amount
 charged provides for recoupment of at least the entire amount
 of direct and indirect costs, the department of human services
 may contract with other states to provide care and treatment
 of persons placed by the other states at the unit for sexually
 violent predators at Cherokee. The moneys received under
 such a contract shall be considered to be repayment receipts
 and used for the purposes of the appropriation made in this
 section.
    Sec. 146.  FIELD OPERATIONS.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June 30,
 2017, the following amount, or so much thereof as is necessary,
 to be used for the purposes designated:
    For field operations, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $ 29,460,488
 ............................................... FTEs   1,837.00
    1.  As a condition of this appropriation, the department
 shall make every possible effort to fill the entire number of
 positions authorized by this section and, unless specifically
 provided otherwise by an applicable collective bargaining
 agreement, the department is not subject to any approval
 requirement external to the department to fill a field
 operations vacancy within the number of full=time equivalent
 positions authorized by this section. The department shall
 report on the first of each month to the chairpersons and
 ranking members of the appropriations committees of the senate
 and house of representatives, and the persons designated by
 this Act for submission of reports concerning the status of
 filling the positions.
    2.  Priority in filling full=time equivalent positions
 shall be given to those positions related to child protection
 services and eligibility determination for low=income families.
    Sec. 147.  GENERAL ADMINISTRATION.  There is appropriated
 from the general fund of the state to the department of human
 services for the fiscal year beginning July 1, 2016, and ending
 June 30, 2017, the following amount, or so much thereof as is
 necessary, to be used for the purpose designated:
    For general administration, including salaries, support,
 maintenance, and miscellaneous purposes, and for not more than
 the following full=time equivalent positions:
 .................................................. $  7,449,099
 ............................................... FTEs     309.00
    1.  The department shall report at least monthly to the
 legislative services agency concerning the department's
 operational and program expenditures.
    2.  Of the funds appropriated in this section, $75,000 shall
 be used to continue the contract for the provision of a program
 to provide technical assistance, support, and consultation to
 providers of habilitation services and home and community=based
 services waiver services for adults with disabilities under the
 medical assistance program.
    3.  Of the funds appropriated in this section, $25,000
 is transferred to the Iowa finance authority to be used
 for administrative support of the council on homelessness
 established in section 16.2D and for the council to fulfill its
 duties in addressing and reducing homelessness in the state.
    4.  Of the funds appropriated in this section, $125,000 shall
 be transferred to and deposited in the administrative fund of
 the Iowa ABLE savings plan trust created in section 12I.4, if
 enacted in this or any other Act, to be used for implementation
 and administration activities of the Iowa ABLE savings plan
 trust.
    Sec. 148.  VOLUNTEERS.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June 30,
 2017, the following amount, or so much thereof as is necessary,
 to be used for the purpose designated:
    For development and coordination of volunteer services:
 .................................................. $     42,343
    Sec. 149.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
 DEPARTMENT OF HUMAN SERVICES.
    1.  a.  (1)  For the fiscal year beginning July 1, 2016,
 the total state funding amount for the nursing facility budget
 shall not exceed $151,421,458.
    (2)  The department, in cooperation with nursing facility
 representatives, shall review projections for state funding
 expenditures for reimbursement of nursing facilities on a
 quarterly basis and the department shall determine if an
 adjustment to the medical assistance reimbursement rate is
 necessary in order to provide reimbursement within the state
 funding amount for the fiscal year. Notwithstanding 2001
 Iowa Acts, chapter 192, section 4, subsection 2, paragraph
 "c", and subsection 3, paragraph "a", subparagraph (2),
 if the state funding expenditures for the nursing facility
 budget for the fiscal year are projected to exceed the amount
 specified in subparagraph (1), the department shall adjust
 the reimbursement for nursing facilities reimbursed under the
 case=mix reimbursement system to maintain expenditures of the
 nursing facility budget within the specified amount for the
 fiscal year.
    (3)  For the fiscal year beginning July 1, 2016, special
 population nursing facilities shall be reimbursed in accordance
 with the methodology in effect on June 30, 2016.
    (4)  For any open or unsettled nursing facility cost report
 for a fiscal year prior to and including the fiscal year
 beginning July 1, 2015, 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.
 For purposes of this subparagraph, a nursing facility cost
 report is not considered open or unsettled if the facility did
 not initiate an administrative appeal under chapter 17A or if
 any appeal rights initiated have been exhausted.
    b.  (1)  For the fiscal year beginning July 1, 2016,
 the department shall establish the pharmacy dispensing fee
 reimbursement at $11.73 per prescription, until a cost of
 dispensing survey is completed. The actual dispensing fee
 shall be determined by a cost of dispensing survey performed
 by the department and required to be completed by all medical
 assistance program participating pharmacies every two years,
 adjusted as necessary to maintain expenditures within the
 amount appropriated to the department for this purpose for the
 fiscal year.
    (2)  The department shall utilize an average acquisition
 cost reimbursement methodology for all drugs covered under the
 medical assistance program in accordance with 2012 Iowa Acts,
 chapter 1133, section 33.
    (3)  Notwithstanding subparagraph (2), if the centers for
 Medicare and Medicaid services of the United States department
 of health and human services (CMS) requires, as a condition
 of federal Medicaid funding, that the department implement an
 aggregate federal upper limit (FUL) for drug reimbursement
 based on the average manufacturer's price (AMP), the department
 may utilize a reimbursement methodology for all drugs covered
 under the Medicaid program based on the national average drug
 acquisition cost (NADAC) methodology published by CMS, in order
 to assure compliance with the aggregate FUL, minimize outcomes
 of drug reimbursements below pharmacy acquisition costs, limit
 administrative costs, and minimize any change in the aggregate
 reimbursement for drugs.  The department may adopt emergency
 rules to implement this subparagraph.
    c.  (1)  For the fiscal year beginning July 1, 2016,
 reimbursement rates for outpatient hospital services shall
 remain at the rates in effect on June 30, 2016, 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.
    (2)  For the fiscal year beginning July 1, 2016,
 reimbursement rates for inpatient hospital services shall
 remain at the rates in effect on June 30, 2016, 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.
    (3)  For the fiscal year beginning July 1, 2016, the graduate
 medical education and disproportionate share hospital fund
 shall remain at the amount in effect on June 30, 2016, except
 that the portion of the fund attributable to graduate medical
 education shall be reduced in an amount that reflects the
 elimination of graduate medical education payments made to
 out=of=state hospitals.
    (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
 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. {1395x(v)(1)(N).
    d.  For the fiscal year beginning July 1, 2016, reimbursement
 rates for rural health clinics, hospices, and acute mental
 hospitals shall be increased in accordance with increases under
 the federal Medicare program or as supported by their Medicare
 audited costs.
    e.  For the fiscal year beginning July 1, 2016, independent
 laboratories and rehabilitation agencies shall be reimbursed
 using the same methodology in effect on June 30, 2016.
    f.  (1)  For the fiscal year beginning July 1, 2016,
 reimbursement rates for home health agencies shall continue to
 be based on the Medicare low utilization payment adjustment
 (LUPA) methodology with state geographic wage adjustments, and
 updated to reflect the most recent Medicare LUPA rates.
    (2)  For the fiscal year beginning July 1, 2016, 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, 2016.
    g.  For the fiscal year beginning July 1, 2016, federally
 qualified health centers shall receive cost=based reimbursement
 for 100 percent of the reasonable costs for the provision of
 services to recipients of medical assistance.
    h.  For the fiscal year beginning July 1, 2016, the
 reimbursement rates for dental services shall remain at the
 rates in effect on June 30, 2016.
    i.  (1)  For the fiscal year beginning July 1, 2016,
 state=owned psychiatric medical institutions for children shall
 receive cost=based reimbursement for 100 percent of the actual
 and allowable costs for the provision of services to recipients
 of medical assistance.
    (2)  For the nonstate=owned psychiatric medical institutions
 for children, reimbursement rates shall be based on the
 reimbursement methodology developed by the Medicaid managed
 care contractor for behavioral health services as required for
 federal compliance.
    (3)  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
 provided to recipients of medical assistance who are children
 under the custody of a psychiatric medical institution for
 children.
    j.  For the fiscal year beginning July 1, 2016, unless
 otherwise specified in this Act, all noninstitutional medical
 assistance provider reimbursement rates shall remain at the
 rates in effect on June 30, 2016, 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
 providers, and those providers whose rates are required to be
 determined pursuant to section 249A.20.
    k.  Notwithstanding any provision to the contrary, for the
 fiscal year beginning July 1, 2016, the reimbursement rate for
 anesthesiologists shall remain at the rate in effect on June
 30, 2016.
    l.  Notwithstanding section 249A.20, for the fiscal year
 beginning July 1, 2016, the average reimbursement rate for
 health care providers eligible for use of the federal Medicare
 resource=based relative value scale reimbursement methodology
 under section 249A.20 shall remain at the rate in effect on
 June 30, 2016; however, this rate shall not exceed the maximum
 level authorized by the federal government.
    m.  For the fiscal year beginning July 1, 2016, the
 reimbursement rate for residential care facilities shall not
 be less than the minimum payment level as established by the
 federal government to meet the federally mandated maintenance
 of effort requirement. The flat reimbursement rate for
 facilities electing not to file annual cost reports shall not
 be less than the minimum payment level as established by the
 federal government to meet the federally mandated maintenance
 of effort requirement.
    n.  For the fiscal year beginning July 1, 2016, the
 reimbursement rates for inpatient mental health services
 provided at hospitals shall remain at the rates in effect on
 June 30, 2016, subject to Medicaid program upper payment limit
 rules; and psychiatrists shall be reimbursed at the medical
 assistance program fee=for=service rate in effect on June 30,
 2016.
    o.  For the fiscal year beginning July 1, 2016, community
 mental health centers may choose to be reimbursed for the
 services provided to recipients of medical assistance through
 either of the following options:
    (1)  For 100 percent of the reasonable costs of the services.
    (2)  In accordance with the alternative reimbursement rate
 methodology established by the medical assistance program's
 managed care contractor for mental health services and approved
 by the department of human services.
    p.  For the fiscal year beginning July 1, 2016, the
 reimbursement rate for providers of family planning services
 that are eligible to receive a 90 percent federal match shall
 remain at the rates in effect on June 30, 2016.
    q.  For the fiscal year beginning July 1, 2016, the upper
 limits on reimbursement rates for providers of home and
 community=based services waiver services shall remain at the
 limits in effect on June 30, 2016.
    r.  For the fiscal year beginning July 1, 2016, the
 reimbursement rates for emergency medical service providers
 shall remain at the rates in effect on June 30, 2016.
    s.  For the fiscal year beginning July 1, 2016, reimbursement
 rates for substance=related disorder treatment programs
 licensed under section 125.13 shall remain at the rates in
 effect on June 30, 2016.
    2.  For the fiscal year beginning July 1, 2016, the
 reimbursement rate for providers reimbursed under the
 in=home=related care program shall not be less than the minimum
 payment level as established by the federal government to meet
 the federally mandated maintenance of effort requirement.
    3.  Unless otherwise directed in this section, when the
 department's reimbursement methodology for any provider
 reimbursed in accordance with this section includes an
 inflation factor, this factor shall not exceed the amount
 by which the consumer price index for all urban consumers
 increased during the calendar year ending December 31, 2002.
    4.  For the fiscal year beginning July 1, 2016, 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 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 youth ages 18 to 21 who have
 exited foster care, the preparation for adult living program
 maintenance rate shall be $602.70 per month. The maximum
 payment for adoption 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.
    5.  For the fiscal year beginning July 1, 2016, the maximum
 reimbursement rates for social services providers under
 contract shall remain at the rates in effect on June 30, 2016,
 or the provider's actual and allowable cost plus inflation for
 each service, whichever is less. However, if a new service
 or service provider is added after June 30, 2016, the initial
 reimbursement rate for the service or provider shall be based
 upon a weighted average of provider rates for similar services.
    6.  For the fiscal year beginning July 1, 2016, the
 reimbursement rates for resource family recruitment and
 retention contractors, child welfare emergency services
 contractors, and supervised apartment living foster care
 providers shall remain at the rates in effect on June 30, 2016.
    7.  a.  For the purposes of this subsection, "combined
 reimbursement rate" means the combined service and maintenance
 reimbursement rate for a service level under the department's
 reimbursement methodology. Effective July 1, 2016, the
 combined reimbursement rate for a group foster care service
 level shall be the amount designated in this subsection.
 However, if a group foster care provider's reimbursement rate
 for a service level as of June 30, 2016, is more than the rate
 designated in this subsection, the provider's reimbursement
 shall remain at the higher rate.
    b.  Unless a group foster care provider is subject to the
 exception provided in paragraph "a", effective July 1, 2016,
 the combined reimbursement rates for the service levels under
 the department's reimbursement methodology shall be as follows:
    (1)  For service level, community = D1, the daily rate shall
 be at least $84.17.
    (2)  For service level, comprehensive = D2, the daily rate
 shall be at least $119.09.
    (3)  For service level, enhanced = D3, the daily rate shall
 be at least $131.09.
    8.  The group foster care reimbursement rates paid for
 placement of children out of state shall be calculated
 according to the same rate=setting principles as those used for
 in=state providers, unless the director of human services or
 the director's designee determines that appropriate care cannot
 be provided within the state. The payment of the daily rate
 shall be based on the number of days in the calendar month in
 which service is provided.
    9.  a.  For the fiscal year beginning July 1, 2016, the
 reimbursement rate paid for shelter care and the child welfare
 emergency services implemented to provide or prevent the need
 for shelter care shall be established by contract.
    b.  For the fiscal year beginning July 1, 2016, the combined
 service and maintenance components of the reimbursement rate
 paid for shelter care services shall be based on the financial
 and statistical report submitted to the department. The
 maximum reimbursement rate shall be $101.83 per day. The
 department shall reimburse a shelter care provider at the
 provider's actual and allowable unit cost, plus inflation, not
 to exceed the maximum reimbursement rate.
    c.  Notwithstanding section 232.141, subsection 8, for the
 fiscal year beginning July 1, 2016, the amount of the statewide
 average of the actual and allowable rates for reimbursement of
 juvenile shelter care homes that is utilized for the limitation
 on recovery of unpaid costs shall remain at the amount in
 effect for this purpose in the fiscal year beginning July 1,
 2015.
    10.  For the fiscal year beginning July 1, 2016, the
 department shall calculate reimbursement rates for intermediate
 care facilities for persons with an intellectual disability
 at the 80th percentile. Beginning July 1, 2016, the rate
 calculation methodology shall utilize the consumer price index
 inflation factor applicable to the fiscal year beginning July
 1, 2016.
    11.  For the fiscal year beginning July 1, 2016, for child
 care providers reimbursed under the state child care assistance
 program, the department shall set provider reimbursement
 rates based on the rate reimbursement survey completed in
 December 2004. Effective July 1, 2016, the child care provider
 reimbursement rates shall remain at the rates in effect on June
 30, 2016. The department shall set rates in a manner so as
 to provide incentives for a nonregistered provider to become
 registered by applying the increase only to registered and
 licensed providers.
    12.  For the fiscal year beginning July 1, 2016, if the
 centers for Medicare and Medicaid services of the United
 States department of health and human services approves the
 waivers necessary to implement medical assistance program
 managed care applicable to any providers or services subject to
 reimbursement under this section, notwithstanding any provision
 to the contrary under this section, affected providers or
 services shall instead be reimbursed as follows:
    a.  For fee=for=service claims, reimbursement shall be
 calculated based on the methodology otherwise specified in this
 section for the fiscal year beginning July 1, 2016, for the
 respective provider or service.
    b.  For claims subject to a managed care contract,
 reimbursement shall be based on the methodology established
 by the managed care organization contract.  However, any
 reimbursement established under such contract shall not be
 lower than the reimbursement otherwise specified in this
 section for the fiscal year beginning July 1, 2016, for the
 respective provider or service.
    13.  The department may adopt emergency rules to implement
 this section.
    Sec. 150.  EMERGENCY RULES.
    1.  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, 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. Any rules adopted in accordance with this section
 shall not take effect before the rules are reviewed by the
 administrative rules review committee. 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,
 notwithstanding a provision in those sections making them
 inapplicable to section 17A.5, subsection 2, paragraph "b".
 Any rules adopted in accordance with the provisions of this
 section shall also be published as a notice of intended action
 as provided in section 17A.4.
    2.  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
 ranking members of the committees on appropriations, and
 the department of management concerning the rules and the
 expenditure increase. 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
 administrative code editor.
    Sec. 151.  REPORTS.  Any reports or other information
 required to be compiled and submitted under this Act during the
 fiscal year beginning July 1, 2016, shall be submitted to the
 chairpersons and ranking members of the joint appropriations
 subcommittee on health and human services, the legislative
 services agency, and the legislative caucus staffs on or
 before the dates specified for submission of the reports or
 information.
                          DIVISION XLII
         HEALTH CARE ACCOUNTS AND FUNDS ==== FY 2016=2017
    Sec. 152.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is
 appropriated from the pharmaceutical settlement account created
 in section 249A.33 to the department of human services for the
 fiscal year beginning July 1, 2016, and ending June 30, 2017,
 the following amount, or so much thereof as is necessary, to be
 used for the purpose designated:
    Notwithstanding any provision of law to the contrary, to
 supplement the appropriations made in this Act for medical
 contracts under the medical assistance program for the fiscal
 year beginning July 1, 2016, and ending June 30, 2017:
 .................................................. $  1,001,088
    Sec. 153.  QUALITY ASSURANCE TRUST FUND ==== DEPARTMENT OF
 HUMAN SERVICES.  Notwithstanding any provision to the contrary
 and subject to the availability of funds, there is appropriated
 from the quality assurance trust fund created in section
 249L.4 to the department of human services for the fiscal year
 beginning July 1, 2016, and ending June 30, 2017, the following
 amounts, or so much thereof as is necessary, for the purposes
 designated:
    To supplement the appropriation made in this Act from the
 general fund of the state to the department of human services
 for medical assistance for the same fiscal year:
 .................................................. $ 18,602,604
    Sec. 154.  HOSPITAL HEALTH CARE ACCESS TRUST FUND ====
 DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to
 the contrary and subject to the availability of funds, there is
 appropriated from the hospital health care access trust fund
 created in section 249M.4 to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June
 30, 2017, the following amounts, or so much thereof as is
 necessary, for the purposes designated:
    To supplement the appropriation made in this Act from the
 general fund of the state to the department of human services
 for medical assistance for the same fiscal year:
 .................................................. $ 17,350,000
    Sec. 155.  MEDICAL ASSISTANCE PROGRAM ==== NONREVERSION
 FOR FY 2016=2017.  Notwithstanding section 8.33, if moneys
 appropriated for purposes of the medical assistance program for
 the fiscal year beginning July 1, 2016, and ending June 30,
 2017, from the general fund of the state, the quality assurance
 trust fund and the hospital health care access trust fund, are
 in excess of actual expenditures for the medical assistance
 program and remain unencumbered or unobligated at the close
 of the fiscal year, the excess moneys shall not revert but
 shall remain available for expenditure for the purposes of the
 medical assistance program until the close of the succeeding
 fiscal year.
                         DIVISION XLIII
          REFUGEE FAMILY SUPPORT SERVICES PILOT PROGRAM
    Sec. 156.  REFUGEE FAMILY SUPPORT SERVICES PILOT PROGRAM
 APPROPRIATION ==== FY 2016=2017.  There is appropriated from the
 general fund of the state to the department of human services
 for the fiscal year beginning July 1, 2016, and ending June 30,
 2017, the following amount, or so much thereof as is necessary,
 to be used for the purposes designated:
    For continuation of a pilot project pursuant to the refugee
 family support services pilot project program created in
 this 2015 Act in a county with a population over 350,000 as
 determined by the 2010 federal decennial census:
 .................................................. $     50,000
    The amount appropriated under this section shall not
 be reduced for administrative or other costs prior to
 distribution.
    Notwithstanding section 8.33, moneys appropriated in this
 section 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.
    Sec. 157.  PROPERTY TAX RELIEF FUND BLOCK GRANT MONEYS.  The
 moneys transferred to the property tax relief fund for the
 fiscal year beginning July 1, 2015, from the federal social
 services block grant pursuant to 2015 Iowa Acts, House File
 630, and from the federal temporary assistance for needy
 families block grant, totaling at least $11,774,275, are
 appropriated to the department of human services for the fiscal
 year beginning July 1, 2015, and ending June 30, 2016, to be
 used for the purposes designated, notwithstanding any provision
 of law to the contrary:
    1.  For distribution to any mental health and disability
 services region where 25 percent of the region's projected
 expenditures exceeds the region's projected fund balance:
 .................................................. $    480,000
    a.  For purposes of this subsection:
    (1)  "Available funds" means a county mental health and
 services fund balance on June 30, 2015, plus the maximum amount
 a county was allowed to levy for the fiscal year beginning July
 1, 2015.
    (2)  "Projected expenditures" means the actual expenditures
 of a mental health and disability services region as of June
 30, 2015, multiplied by an annual inflation rate of 2 percent
 plus the projected costs for new core services administered by
 the region as provided in a region's regional service system
 management plan approved pursuant to section 331.393 for the
 fiscal year beginning July 1, 2015.
    (3)  "Projected fund balance" means the difference between a
 mental health and disability services region's available funds
 and projected expenditures.
    b.  If sufficient funds are not available to implement this
 subsection, the department of human services shall distribute
 funds to a region in proportion to the availability of funds.
    2.  To be transferred to the appropriation in this Act for
 child and family services for the fiscal year beginning July 1,
 2016, to be used for the purpose of that appropriation:
 .................................................. $  5,407,137
                          DIVISION XLIV
             PERSONNEL SETTLEMENT AGREEMENT PAYMENTS
    Sec. 158.  PERSONNEL SETTLEMENT AGREEMENT PAYMENTS.  As
 a condition of the appropriations in this Act, the moneys
 appropriated and any other moneys available shall not be used
 for payment of a personnel settlement agreement that contains a
 confidentiality provision intended to prevent public disclosure
 of the agreement or any terms of the agreement.
                          DIVISION XLV
 CLARINDA STATE MENTAL HEALTH INSTITUTE ==== PRIVATE PROVIDER ====
                         SHARED SERVICES
    Sec. 159.  CLARINDA ==== PRIVATE PROVIDER.
    1.  Within 30 days of the effective date of an appropriation
 to the department of human services for the fiscal year
 beginning July 1, 2014, and ending June 30, 2015, for operation
 of the state mental health institute at Clarinda in the fiscal
 year beginning July 1, 2015, the department of human services
 shall issue a request for proposals for the purpose of entering
 into a contract to engage an in=state private nursing home
 provider to provide care and treatment for adult persons who
 are sexually aggressive or combative due to a mental illness or
 who have unmet geropsychiatric needs, beginning December 16,
 2015, at the state mental health institute at Clarinda.  The
 request for proposals shall specify that the provider shall
 have an authorized bed capacity of not fewer than 15 beds.
    2.  The contract executed by the department of human
 services with the private provider of geropsychiatric care and
 treatment after December 15, 2015, at the state mental health
 institute at Clarinda shall require the private provider to
 give preference in employment to qualified former employees
 providing such care and treatment at the state mental health
 institute at Clarinda between January 1 and December 15, 2015.
      CLARINDA == SHARED SERVICES == 2015=2016 FISCAL YEAR
    Sec. 160.  2015 Iowa Acts, Senate File 497, section 3,
 subsection 1, paragraph g, if enacted, is amended to read as
 follows:
    g.  For the operation of the Clarinda correctional facility,
 including salaries, support, maintenance, and miscellaneous
 purposes:
 .................................................. $ 25,933,430
    Moneys received by the department of corrections as
 reimbursement for services provided to the Clarinda youth
 corporation any private provider contracting with the
 department of human services or the department of corrections
  are appropriated to the department of corrections and shall be
 used for the purpose of operating the Clarinda correctional
 facility.
      CLARINDA == SHARED SERVICES == 2016=2017 FISCAL YEAR
    Sec. 161.  2015 Iowa Acts, Senate File 497, section 25,
 subsection 1, paragraph g, if enacted, is amended to read as
 follows:
    g.  For the operation of the Clarinda correctional facility,
 including salaries, support, maintenance, and miscellaneous
 purposes:
 .................................................. $ 12,966,715
    Moneys received by the department of corrections as
 reimbursement for services provided to the Clarinda youth
 corporation any private provider contracting with the
 department of human services or the department of corrections
  are appropriated to the department of corrections and shall be
 used for the purpose of operating the Clarinda correctional
 facility.
                          DIVISION XLVI
                 CONDITIONAL EFFECTIVE DATE AND
              RETROACTIVE APPLICABILITY PROVISIONS
    Sec. 162.  EFFECTIVE UPON ENACTMENT.  Unless otherwise
 provided, this Act, if approved by the governor on or after
 July 1, 2015, takes effect upon enactment.
    Sec. 163.  RETROACTIVE APPLICABILITY.  Unless otherwise
 provided, this Act, if approved by the governor on or after
 July 1, 2015, applies retroactively to July 1, 2015.


                                                             
                               PAM JOCHUM
                               President of the Senate


                                                             
                               KRAIG PAULSEN
                               Speaker of the House
    I hereby certify that this bill originated in the Senate and
 is known as Senate File 505, Eighty=sixth General Assembly.


                                                             
                               MICHAEL E. MARSHALL
                               Secretary of the Senate
 Approved                , 2015


                                                             
                               TERRY E. BRANSTAD
                               Governor

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