Read the full stored bill text
House
File
2782
-
Enrolled
House
File
2782
AN
ACT
RELATING
TO
AND
MAKING
APPROPRIATIONS
TO
THE
DEPARTMENT
OF
VETERANS
AFFAIRS
AND
THE
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES,
INCLUDING
AGING
AND
DISABILITY
SERVICES,
BEHAVIORAL
HEALTH,
PUBLIC
HEALTH,
AND
COMMUNITY
ACCESS
AND
ELIGIBILITY;
THE
MEDICAL
ASSISTANCE
PROGRAM,
STATE
SUPPLEMENTARY
ASSISTANCE,
HAWKI,
AND
OTHER
HEALTH-RELATED
PROGRAMS;
FAMILY
WELL-BEING
AND
PROTECTION;
STATE-OPERATED
SPECIALTY
CARE;
ADMINISTRATION
AND
COMPLIANCE;
TRANSFERS,
CASH
FLOW,
AND
NONREVERSIONS;
REPORT
ON
NONREVERSION
OF
MONEYS;
MORE
OPTIONS
FOR
MATERNAL
SUPPORT
PROGRAM;
REIMBURSEMENT
RATES
REVIEW;
MENTAL
DISEASES
EXCLUSION
WAIVER;
FULL-TIME
EQUIVALENT
DASHBOARD;
COMPREHENSIVE
FAMILY
SUPPORT
PROGRAM;
FEDERAL
COMMUNITY
MENTAL
HEALTH
SERVICES
BLOCK
GRANT;
BEHAVIORAL
HEALTH
EXPENDITURE
REPORT;
OPIOID
SETTLEMENT
FUND;
EMERGENCY
RULES;
GRADUATE
MEDICAL
EDUCATION;
AND
SPECIAL
POPULATION
NURSING
FACILITIES;
AND
INCLUDING
EFFECTIVE
DATE
AND
RETROACTIVE
APPLICABILITY
PROVISIONS.
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
DIVISION
I
DEPARTMENT
OF
VETERANS
AFFAIRS
——
FY
2026-2027
Section
1.
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,
2026,
and
ending
June
30,
2027,
the
following
amounts,
House
File
2782,
p.
2
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,369,205
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
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.
.
.
.
.
.
.
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.
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.
.
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.
.
.
.
FTEs
15.00
2.
IOWA
VETERANS
HOME
For
salaries,
support,
maintenance,
and
miscellaneous
purposes:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
8,145,736
a.
The
Iowa
veterans
home
billings
involving
the
department
of
health
and
human
services
shall
be
submitted
to
the
department
on
at
least
a
monthly
basis.
b.
The
Iowa
veterans
home
expenditure
report
shall
be
submitted
monthly
to
the
general
assembly.
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
or
eligible
service
members
pursuant
to
section
16.54:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,200,000
DIVISION
II
AGING
AND
DISABILITY
SERVICES
——
FY
2026-2027
Sec.
2.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
AGING
AND
DISABILITY
SERVICES.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
aging
programs
for
the
department
of
health
and
human
services
and
area
agencies
on
aging
to
provide
citizens
of
Iowa
who
are
60
years
of
age
and
older
with
case
management;
for
Iowa’s
aging
and
disabilities
resource
centers;
for
the
return
to
community
program;
for
the
purposes
of
chapter
231E;
to
administer
the
prevention
of
elder
abuse,
neglect,
and
exploitation
program
pursuant
to
section
231.56A,
in
accordance
House
File
2782,
p.
3
with
the
requirements
of
the
federal
Older
Americans
Act
of
1965,
42
U.S.C.
§3001
et
seq.,
as
amended;
for
the
operation
of
the
dependent
adult
abuse
services
program
pursuant
to
chapter
235B;
for
matching
funding
for
programs
to
enable
persons
with
severe
physical
or
mental
disabilities
to
function
more
independently;
for
costs
associated
with
centers
for
independent
living;
and
for
other
services
which
may
include
but
are
not
limited
to
adult
day
care,
respite
care,
chore,
information
and
assistance,
and
material
aid;
for
information
and
options
counseling
for
persons
with
disabilities;
and
for
salaries,
support,
administration,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
19,379,531
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
101.00
1.
Moneys
appropriated
in
this
section
may
be
used
to
supplement
federal
moneys
received
under
federal
regulations.
To
receive
moneys
appropriated
in
this
section,
a
local
area
agency
on
aging
shall
match
the
moneys
with
moneys
from
other
sources
according
to
rules
adopted
by
the
department.
Moneys
appropriated
in
this
section
may
be
used
for
services
not
specifically
enumerated
in
this
section
only
if
approved
by
the
department
as
part
of
an
area
agency
on
aging’s
area
plan.
2.
Of
the
moneys
appropriated
in
this
section,
$949,282
is
allocated
to
be
used
for
the
comprehensive
family
support
program
created
in
section
231.80
as
enacted
under
this
Act.
3.
Of
the
moneys
appropriated
in
this
section,
$33,632
is
allocated
to
be
used
to
build
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
15,
1994).
DIVISION
III
BEHAVIORAL
HEALTH
——
FY
2026-2027
Sec.
3.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
BEHAVIORAL
HEALTH.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
House
File
2782,
p.
4
For
behavioral
health
prevention,
education,
early
intervention,
treatment,
recovery
support,
and
crisis
services
in
order
to
support
statewide
access
to
treatment
for
behavioral
health
conditions;
stabilization
and
mitigation
of
behavioral
health
crises;
and
recovery
for
individuals
and
families
impacted
by
behavioral
health
conditions.
Activities
shall
align
with
accepted
best
practice
guidance
standards
for
behavioral
health
including
those
published
by
the
centers
for
disease
control
and
prevention
of
the
United
States
department
of
health
and
human
services,
and
the
substance
abuse
and
mental
health
services
administration
of
the
United
States
department
of
health
and
human
services,
for
health
promotion;
universal,
selective,
and
indicated
prevention;
treatment;
and
recovery
services
and
supports;
and
shall
include
a
24-hour
helpline,
public
information
resources,
professional
training,
youth
prevention,
program
evaluation,
and
efforts
at
the
state
and
local
levels,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
23,127,121
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
70.00
1.
Of
the
moneys
appropriated
in
this
section,
$300,000
is
allocated
to
support
the
work
of
the
children’s
behavioral
health
system
including
evidence-based
behavioral
health
prevention,
treatment,
and
recovery
services
and
supports
for
children
and
their
families.
2.
Of
the
moneys
appropriated
in
this
section,
$950,000
is
allocated
for
an
integrated
substance
use
disorder
managed
care
system.
The
department
shall
maintain
the
level
of
mental
health
and
substance
use
disorder
treatment
services
provided
by
the
managed
care
contractors,
and
shall
take
the
steps
necessary
to
continue
the
federal
waivers
as
needed
to
maintain
the
level
of
services.
Sec.
4.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
SPORTS
WAGERING
RECEIPTS
FUND.
There
is
appropriated
from
the
sports
wagering
receipts
fund
created
in
section
8.57I,
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
behavioral
health
prevention,
education,
early
intervention,
House
File
2782,
p.
5
treatment,
recovery
support,
and
crisis
services
in
order
to
support
statewide
access
to
treatment
for
behavioral
health
conditions;
stabilization
and
mitigation
of
behavioral
health
crises;
and
recovery
for
individuals
and
families
impacted
by
behavioral
health
conditions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,750,000
DIVISION
IV
PUBLIC
HEALTH
——
FY
2026-2027
Sec.
5.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
PUBLIC
HEALTH.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
programs
that
support
health
promotion,
protect
the
health
and
safety
of
the
public,
conduct
disease
surveillance
and
investigation
to
reduce
the
incidence
of
morbidity
and
mortality,
serve
individuals
with
chronic
conditions
including
but
not
limited
to
cancer,
support
the
Iowa
donor
registry
as
specified
in
section
142C.18,
and
strengthen
the
health
care
delivery
system
and
workforce
to
improve
health
outcomes
for
all
Iowans,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
21,168,369
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
348.60
1.
Of
the
moneys
appropriated
in
this
section,
$191,000
is
allocated
to
the
university
of
Iowa
hospitals
and
clinics
to
administer
a
child
vision
screening
program
through
continuation
of
an
existing
contract.
The
program
shall
submit
a
report
to
the
department
regarding
the
use
of
funds
allocated
under
this
subsection.
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
moneys
based
on
the
services
provided;
and
the
continuing
needs
of
the
program.
2.
Of
the
moneys
appropriated
in
this
section,
$144,000
is
allocated
for
the
public
purpose
of
allowing
the
department
House
File
2782,
p.
6
to
continue
an
existing
contract
with
an
existing
affiliated
organization
to
provide
education,
client-centered
programs,
and
client
and
family
support,
for
people
living
with
epilepsy
and
their
families.
The
moneys
allocated
in
excess
of
$50,000
shall
be
matched
dollar
for
dollar
by
the
existing
affiliated
organization.
Moneys
under
this
section
shall
be
distributed
in
their
entirety
on
July
1,
2026,
for
the
purpose
specified.
3.
Of
the
moneys
appropriated
in
this
section,
the
following
amounts
are
allocated
to
the
department
of
health
and
human
services
to
be
used
as
follows
to
support
the
goals
of
increased
access,
health
system
integration,
and
engagement:
a.
$600,000
for
distribution
to
a
nonprofit
organization
that
established
the
first
statewide
drug
donation
repository
for
continuation
of
the
pharmaceutical
infrastructure
for
safety
net
providers
established
as
described
in
2007
Iowa
Acts,
chapter
218,
section
108,
and
for
the
prescription
drug
donation
repository
program
established
in
chapter
135M.
Moneys
under
this
paragraph
shall
be
distributed
in
their
entirety
on
July
1,
2026,
for
the
purpose
specified.
b.
$374,000
for
distribution
to
free
clinics,
as
defined
in
section
135.24,
and
a
nonprofit
organization
that
facilitates
the
initiation,
operation,
and
collaboration
of
free
clinics
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.
Of
the
moneys
allocated,
$40,000
shall
be
used
to
lower
fees
associated
with
using
an
electronic
prescribing
system.
Moneys
under
this
paragraph
shall
be
distributed
in
their
entirety
on
July
1,
2026,
for
the
purpose
specified.
c.
$25,000
for
distribution
to
an
organization
that
raises
awareness
about
issues
related
to
rural
health
clinics
for
necessary
infrastructure
and
service
delivery
transformation.
Moneys
under
this
paragraph
shall
be
distributed
in
their
entirety
on
July
1,
2026,
for
the
purpose
specified.
4.
Of
the
moneys
appropriated
in
this
section,
$400,000
is
allocated
for
rural
psychiatric
residencies
for
residents
selected
on
or
before
June
30,
2026.
5.
Of
the
moneys
appropriated
in
this
section,
$20,000
is
allocated
to
make
radon
test
kits
available,
free
of
charge,
House
File
2782,
p.
7
to
homeowners
and
renters
in
the
state.
The
department
shall
provide
a
link
on
the
department’s
internet
site
for
homeowners
and
renters
in
the
state
to
order
radon
test
kits.
6.
Of
the
moneys
appropriated
in
this
section,
$1,500,000
is
allocated
for
awarding
grants
for
medical
residency
programs
in
the
state
that
meet
the
following
criteria:
a.
The
medical
residency
program
is
not
related
to
the
practice
of
family
medicine.
b.
The
medical
residency
program
is
not
located
in
a
county
that
has
a
population
of
one
hundred
fifty
thousand
or
more
based
on
the
most
recent
federal
decennial
census,
and
in
which
the
main
campus
of
an
institution
of
higher
learning
governed
by
the
state
board
of
regents
is
located.
7.
The
university
of
Iowa
hospitals
and
clinics
under
the
control
of
the
state
board
of
regents
shall
not
receive
indirect
costs
from
the
moneys
appropriated
in
this
section.
The
university
of
Iowa
hospitals
and
clinics
billings
to
the
department
shall
be,
at
a
minimum,
on
a
quarterly
basis.
DIVISION
V
COMMUNITY
ACCESS
AND
ELIGIBILITY
——
CHILD
SUPPORT
SERVICES
——
TANF
——
FY
2026-2027
Sec.
6.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
COMMUNITY
ACCESS
AND
ELIGIBILITY.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
To
be
used
for
salaries,
support,
maintenance,
and
miscellaneous
purposes
and
for
family
investment
program
(FIP)
assistance
in
accordance
with
chapter
239B,
and
for
other
costs
associated
with
providing
needs-based
benefits
or
assistance
including
but
not
limited
to
maternal
and
child
health,
oral
health,
obesity
prevention,
the
promoting
independence
and
self-sufficiency
through
employment,
job
opportunities
and
the
basic
skills
(PROMISE
JOBS)
program,
supplemental
nutrition
assistance
program
(SNAP)
employment
and
training,
the
FIP
diversion
program,
family
planning,
rent
reimbursement,
and
eligibility
determinations
for
medical
assistance,
food
assistance,
and
the
children’s
health
insurance
program,
and
House
File
2782,
p.
8
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
76,371,516
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
883.90
1.
Of
the
child
support
collections
assigned
under
FIP,
the
federal
share
of
the
child
support
collections
shall
be
credited
to
the
child
support
services
appropriation
made
in
this
division
of
this
Act.
Of
the
remainder
of
the
child
support
collections
assigned
under
FIP,
a
portion
shall
be
credited
to
community
access
and
eligibility,
and
the
remaining
moneys
may
be
used
to
increase
recoveries,
to
sustain
cash
flow
in
the
collection
services
center
refund
account
as
provided
in
section
252B.13A,
or
for
technology
needs.
If
child
support
collections
assigned
under
FIP
are
greater
than
estimated
or
are
otherwise
determined
not
to
be
required
for
maintenance
of
efforts,
the
state
share
of
either
amount
is
appropriated
to
the
department
for
child
support
services
as
described
in
this
division
of
this
Act,
or
may
be
transferred
to
or
retained
in
the
collection
services
center
refund
account.
2.
Of
the
moneys
appropriated
in
this
section,
$3,075,000
is
allocated
for
continuation
of
the
department’s
initiative
to
provide
for
adequate
developmental
surveillance
and
screening
during
a
child’s
first
five
years.
The
moneys
shall
first
be
used
to
fully
fund
the
current
participating
counties
to
ensure
that
those
counties
are
fully
operational,
with
the
remaining
moneys
to
be
used
for
expanding
participation
to
additional
counties.
Full
implementation
and
expansion
shall
include
enhancing
the
scope
of
the
initiative
through
collaboration
with
child
health
specialty
clinics
to
promote
the
use
of
developmental
surveillance
and
screening
to
support
healthy
child
development
through
early
identification
and
response
to
biomedical
and
social
determinants
of
healthy
development
by
providing
practitioner
consultation
and
continuous
improvement
through
training
and
education,
particularly
for
children
with
behavioral
conditions
and
needs.
The
department
shall
also
collaborate
with
the
Medicaid
program
and
child
health
specialty
clinics
to
assist
in
coordinating
the
activities
of
the
first
five
initiative
into
the
establishment
of
patient-centered
medical
homes
developed
to
improve
health
quality
and
population
health
while
reducing
health
care
costs.
House
File
2782,
p.
9
To
the
maximum
extent
possible,
moneys
allocated
in
this
subsection
shall
be
utilized
as
matching
moneys
for
Medicaid
program
reimbursement.
3.
Of
the
moneys
appropriated
in
this
section,
$1,145,102
is
allocated
to
the
Iowa
commission
on
volunteer
service
created
in
section
15H.2
for
programs
and
grants.
4.
The
university
of
Iowa
hospitals
and
clinics
under
the
control
of
the
state
board
of
regents
shall
not
receive
indirect
costs
from
the
moneys
appropriated
in
this
section.
The
university
of
Iowa
hospitals
and
clinics
billings
to
the
department
shall
be,
at
a
minimum,
on
a
quarterly
basis.
Sec.
7.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
CHILD
SUPPORT
SERVICES.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
child
support
services,
including
salaries,
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
15,644,114
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
464.00
1.
Federal
access
and
visitation
grant
moneys
shall
be
used
for
services
designed
to
increase
compliance
with
the
child
access
provisions
of
court
orders,
including
but
not
limited
to
neutral
visitation
sites
and
mediation
services.
2.
Moneys
appropriated
in
this
section
may
be
used
throughout
the
fiscal
year
in
the
manner
necessary
for
cash
flow
management.
For
cash
flow
management
under
this
subsection,
the
department
may
temporarily
draw
more
than
the
amount
appropriated
provided
the
amount
appropriated
is
not
exceeded
at
the
close
of
the
fiscal
year.
Sec.
8.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
TEMPORARY
ASSISTANCE
FOR
NEEDY
FAMILIES
BLOCK
GRANT.
There
is
appropriated
from
the
special
fund
created
in
section
8.41
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
from
moneys
received
under
the
federal
temporary
assistance
for
needy
families
(TANF)
block
grant
pursuant
to
the
federal
Personal
House
File
2782,
p.
10
Responsibility
and
Work
Opportunity
Reconciliation
Act
of
1996,
Pub.
L.
No.
104-193,
and
successor
legislation,
including
TANF
block
grant
moneys
received
in
any
prior
fiscal
year
that
were
deposited
in
the
special
fund
and
remain
unencumbered
or
unobligated
on
June
30,
2026,
the
following
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
1.
For
community
access
and
eligibility:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,566,312
2.
For
community
access
and
eligibility
to
provide
pregnancy
prevention
grants
on
the
condition
that
family
planning
services
are
funded:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,913,203
Pregnancy
prevention
grants
shall
be
awarded
to
programs
in
existence
on
or
before
July
1,
2026,
if
the
programs
have
demonstrated
positive
outcomes.
Grants
shall
be
awarded
to
pregnancy
prevention
programs
developed
after
July
1,
2026,
if
the
programs
are
based
on
existing
models
that
have
demonstrated
positive
outcomes.
Grants
must
comply
with
the
requirements
provided
in
1997
Iowa
Acts,
chapter
208,
section
14,
subsections
1
and
2,
including
the
requirement
that
a
program
awarded
a
grant
must
emphasize
sexual
abstinence.
Priority
in
awarding
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.
3.
To
meet
one
of
the
four
purposes
of
TANF
as
specified
in
45
C.F.R.
§260.20,
including
by
modernizing
the
program
to
promote
economic
mobility
and
self-sufficiency,
ensuring
that
families
are
able
to
overcome
benefit
cliffs,
encouraging
healthy
families,
and
streamlining
service
delivery
to
reduce
duplication:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
25,000,000
4.
For
early
intervention
and
supports
for
child
abuse
prevention
and
the
family
development
and
self-sufficiency
(FaDSS)
grant
program
in
accordance
with
section
216A.107:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,013,980
5.
For
accountability,
compliance,
program
integrity,
technology
needs,
and
other
resources
necessary
to
meet
House
File
2782,
p.
11
federal
and
state
reporting,
tracking,
and
case
management
requirements,
and
other
departmental
needs:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,533,647
6.
For
state
child
care
assistance:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
42,281,826
7.
For
child
protective
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
65,364,100
DIVISION
VI
MEDICAL
ASSISTANCE
PROGRAM
——
STATE
SUPPLEMENTARY
ASSISTANCE
——
HEALTHY
AND
WELL
KIDS
IN
IOWA
PROGRAM
AND
OTHER
HEALTH-RELATED
PROGRAMS
——
FY
2026-2027
Sec.
9.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
MEDICAL
ASSISTANCE
PROGRAM,
STATE
SUPPLEMENTARY
ASSISTANCE,
AND
HEALTHY
AND
WELL
KIDS
IN
IOWA
PROGRAM.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
medical
assistance
program
reimbursement
and
associated
costs
as
specifically
provided
in
the
reimbursement
methodologies
in
effect
on
June
30,
2026,
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
medical
assistance
program;
for
the
state
supplementary
assistance
program;
for
the
health
insurance
premium
payment
program;
and
for
maintenance
of
the
healthy
and
well
kids
in
Iowa
(Hawki)
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;
and
for
other
specified
health-related
programs:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,992,550,706
1.
Of
the
moneys
appropriated
in
this
section,
$1,919,596,113
is
allocated
for
medical
assistance
program
reimbursement
and
associated
costs.
Of
the
moneys
allocated
in
this
subsection,
$3,383,880
shall
be
used
for
program
administration,
outreach,
and
enrollment
activities
of
the
House
File
2782,
p.
12
state
family
planning
services
program
pursuant
to
section
217.41B
,
and
of
this
amount,
the
department
may
use
$200,000
for
administrative
expenses.
2.
Iowans
support
reducing
the
number
of
abortions
performed
in
our
state.
Moneys
appropriated
under
this
section
shall
not
be
used
for
abortions,
unless
otherwise
authorized
under
this
section.
3.
The
provisions
of
this
section
relating
to
abortions
shall
also
apply
to
the
Iowa
health
and
wellness
plan
created
pursuant
to
chapter
249N
.
4.
Of
the
moneys
appropriated
in
this
section,
$4,479,762
is
allocated
for
the
state
supplementary
assistance
program.
5.
Of
the
moneys
appropriated
in
this
section,
$68,474,831
is
allocated
for
maintenance
of
the
Hawki
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.
Sec.
10.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
HEALTH
PROGRAM
OPERATIONS.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
health
program
operations
and
the
autism
support
program
under
section
225D.2,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
40,342,766
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
97.00
1.
The
department
of
inspections,
appeals,
and
licensing
shall
provide
all
state
matching
moneys
for
survey
and
certification
activities
performed
by
the
department
of
inspections,
appeals,
and
licensing.
The
department
of
health
and
human
services
shall
be
solely
responsible
for
distributing
the
federal
matching
moneys
for
such
activities.
2.
Of
the
moneys
appropriated
in
this
section,
a
sufficient
amount
is
allocated
for
the
administration
of
the
health
insurance
premium
payment
program,
including
salaries,
support,
maintenance,
and
miscellaneous
purposes.
House
File
2782,
p.
13
3.
Of
the
moneys
appropriated
in
this
section,
$750,000
is
allocated
for
a
nonprofit
organization
that
provides
access
to
emergency
poison
information
and
treatment.
Pursuant
to
the
directive
under
2014
Iowa
Acts,
chapter
1140,
section
102,
the
federal
matching
moneys
available
to
the
nonprofit
organization
from
the
department
under
the
federal
Children’s
Health
Insurance
Program
Reauthorization
Act
of
2009
shall
be
subject
to
the
federal
administrative
cap
rule
of
10
percent
applicable
to
moneys
provided
under
Tit.
XXI
of
the
federal
Social
Security
Act,
and
shall
be
included
in
the
department’s
calculations
of
the
cap.
4.
Unless
otherwise
provided
by
law,
if
a
contract
for
services
provided
under
this
section
initially
entered
into
during
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
provides
for
an
annual
increase
of
the
cost
of
services
provided
under
the
contract,
the
annual
increase
shall
not
exceed
the
amount
by
which
the
consumer
price
index
for
all
urban
consumers
increased
during
the
immediately
preceding
calendar
year.
This
subsection
does
not
affect
a
contract
entered
into
on
or
before
June
30,
2026,
that
is
for
a
term
of
more
than
one
year.
Sec.
11.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
PHARMACEUTICAL
SETTLEMENT
ACCOUNT.
There
is
appropriated
from
the
pharmaceutical
settlement
account
created
in
section
249A.33
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
Notwithstanding
any
provision
of
law
to
the
contrary,
to
supplement
the
appropriation
made
in
this
Act
from
the
general
fund
of
the
state
for
health
program
operations
under
the
medical
assistance
program
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
234,193
Sec.
12.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
QUALITY
ASSURANCE
TRUST
FUND.
1.
Notwithstanding
any
provision
of
law
to
the
contrary,
and
subject
to
the
availability
of
moneys,
there
is
appropriated
from
the
quality
assurance
trust
fund
created
in
section
249L.4
to
the
department
of
health
and
human
services
for
the
fiscal
House
File
2782,
p.
14
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
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
health
and
human
services
for
medical
assistance
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$111,216,205
2.
Notwithstanding
section
249L.4,
subsection
2,
after
the
appropriation
in
subsection
1,
any
moneys
remaining
in
the
quality
assurance
trust
fund
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
are
appropriated
to
the
department
of
health
and
human
services
to
supplement
the
appropriation
made
in
this
Act
from
the
general
fund
of
the
state
for
the
medical
assistance
program
for
the
same
fiscal
year.
Sec.
13.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND.
1.
Notwithstanding
any
provision
of
law
to
the
contrary,
and
subject
to
the
availability
of
moneys,
there
is
appropriated
from
the
hospital
health
care
access
trust
fund
created
in
section
249M.4,
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
for
the
purposes
designated:
To
supplement
the
appropriation
made
in
this
Act
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
medical
assistance
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,920,554
2.
Notwithstanding
section
249M.4,
subsection
2,
after
the
appropriation
in
subsection
1,
any
moneys
remaining
in
the
hospital
health
care
access
trust
fund
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
are
appropriated
to
the
department
of
health
and
human
services
to
supplement
the
appropriation
made
in
this
Act
from
the
general
fund
of
the
state
for
the
medical
assistance
program
for
the
same
fiscal
year.
Sec.
14.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
BEHAVIORAL
HEALTH
FUND.
Notwithstanding
section
225A.7,
subsection
2,
and
subject
to
the
availability
of
moneys,
there
House
File
2782,
p.
15
is
appropriated
from
the
behavioral
health
fund
established
in
section
225A.7,
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
for
the
purposes
designated:
To
supplement
the
appropriation
made
in
this
Act
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
medical
assistance
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,580,938
Sec.
15.
REIMBURSEMENT
RATES.
1.
Reimbursement
for
medical
assistance,
state
supplementary
assistance,
and
social
service
providers
and
services
reimbursed
under
the
purview
of
the
department
of
health
and
human
services
shall
remain
at
the
reimbursement
rate
in
effect
on
June
30,
2026,
or
shall
be
determined
pursuant
to
the
reimbursement
methodology
in
effect
on
June
30,
2026,
with
the
exception
of
the
following:
a.
If
reimbursement
is
otherwise
negotiated
by
contract
or
pursuant
to
an
updated
fee
schedule.
b.
As
otherwise
provided
in
this
section.
2.
a.
(1)
Notwithstanding
any
provision
of
law
to
the
contrary,
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
department
of
health
and
human
services
shall
reimburse
case-mix
nursing
facility
rates
based
on
the
methodology
in
effect
on
June
30,
2026.
(2)
July
1,
2025,
through
December
31,
2025,
the
department
of
health
and
human
services
shall
calculate
each
nursing
facility’s
case-mix
index
for
rates
effective
July
1,
2026.
(3)
January
1,
2026,
through
June
30,
2026,
the
department
of
health
and
human
services
shall
calculate
each
nursing
facility’s
case-mix
index
for
rates
effective
January
1,
2027.
(4)
All
nursing
facility
rate
adjustments
under
this
paragraph
shall
be
budget
neutral.
b.
For
the
fiscal
year
beginning
July
1,
2026,
$1,167,867
shall
be
used
to
increase
to
the
extent
possible
reimbursement
rates
for
ambulatory
surgical
centers
compared
to
rates
in
effect
on
June
30,
2026.
c.
For
the
fiscal
year
beginning
July
1,
2026,
$3,000,000
House
File
2782,
p.
16
shall
be
used
to
increase
to
the
extent
possible,
compared
with
rates
in
effect
on
June
30,
2026,
reimbursement
rates
for
providers
of
Medicaid
home
and
community-based
services
waiver
services
used
most
frequently
by
elderly
waiver
recipients
including
attendant
care,
homemaker,
and
assisted
living
services.
d.
(1)
Adjustments
to
Medicaid
reimbursement
rates
developed
using
cost
reports
shall
be
applied
starting
on
the
effective
date
specified
in
the
applicable
rate
letter
issued
to
a
provider.
(2)
Minimum
Medicaid
reimbursement
rates
for
all
provider
and
service
types
shall
be
no
lower
than
the
reimbursement
rates
established
in
the
department’s
minimum
fee
schedule.
(3)
Any
increase
in
a
Medicaid
reimbursement
rate
specified
under
this
section
shall
be
effective
October
1,
2026.
DIVISION
VII
FAMILY
WELL-BEING
AND
PROTECTION
——
FY
2026-2027
Sec.
16.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
STATE
CHILD
CARE
ASSISTANCE.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
state
child
care
assistance
in
accordance
with
sections
237A.13
and
237A.14,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
32,723,000
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
53.00
1.
If
the
appropriation
made
for
purposes
of
the
state
child
care
assistance
program
for
the
fiscal
year
is
determined
to
be
insufficient,
it
is
the
intent
of
the
general
assembly
to
appropriate
sufficient
moneys
for
the
fiscal
year
to
avoid
application
of
waiting
list
requirements.
2.
A
portion
of
the
state
match
for
the
federal
child
care
and
development
block
grant
shall
be
provided
as
necessary
to
meet
federal
matching
moneys
requirements
through
the
state
general
fund
appropriation
made
for
child
development
grants
and
other
programs
for
at-risk
children
in
section
279.51.
Sec.
17.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
EARLY
House
File
2782,
p.
17
INTERVENTION
AND
SUPPORTS.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
promotion
of
optimum
health
status
for
children
and
adolescents
from
birth
through
21
years
of
age,
and
for
families,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
36,495,203
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
28.00
1.
Of
the
moneys
appropriated
in
this
section,
not
more
than
$734,000
is
allocated
for
the
healthy
opportunities
for
parents
to
experience
success
(HOPES)
–
healthy
families
Iowa
(HFI)
program
established
pursuant
to
section
135.106.
2.
Of
the
moneys
appropriated
in
this
section,
$4,313,854
is
allocated
for
the
FaDSS
grant
program,
and
not
more
than
5
percent
of
the
allocated
moneys
shall
be
used
for
administration
of
the
grant
program.
3.
Of
the
moneys
appropriated
in
this
section,
$29,256,799
shall
be
deposited
in
the
early
childhood
Iowa
fund
created
in
section
256I.11.
4.
Of
the
moneys
appropriated
in
this
section,
$1,493,299
is
allocated
for
program
administration
and
provision
of
pregnancy
support
services
through
the
more
options
for
maternal
support
program
pursuant
to
section
217.41C.
Sec.
18.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
CHILD
PROTECTIVE
SERVICES.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
child,
family,
and
adoption
services,
and
for
salaries,
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$164,527,690
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
977.00
1.
Based
on
client
need,
a
portion
of
the
moneys
appropriated
in
this
section
may
be
used
to
provide
other
House
File
2782,
p.
18
resources
required
to
support
family
preservation,
emergency
client
need,
or
family
reunification
efforts.
2.
Of
the
moneys
appropriated
in
this
section,
a
sufficient
amount
is
allocated
for
foster
family
care,
group
foster
care
maintenance
and
services,
shelter
care,
child
welfare
emergency
services,
qualified
residential
treatment
programs,
supervised
apartment
living
contracts,
and
for
medical
assistance
program
reimbursement
and
associated
costs.
3.
Federal
moneys
received
by
the
state
during
the
fiscal
year
beginning
July
1,
2026,
as
the
result
of
the
expenditure
of
state
moneys
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
moneys
for
services
and
purposes
provided
under
this
section.
Notwithstanding
section
8.33,
moneys
appropriated
under
this
subsection
that
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
for
the
purposes
designated
until
the
close
of
the
succeeding
fiscal
year.
4.
a.
Of
the
moneys
appropriated
in
this
section,
$748,000
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.
b.
Notwithstanding
chapter
232
or
any
other
provision
of
law
to
the
contrary,
a
district
or
juvenile
court
shall
not
order
any
service
which
is
a
charge
upon
the
state
pursuant
to
section
232.141,
subsection
4,
if
the
moneys
allocated
under
paragraph
“a”
for
court-ordered
services
are
insufficient
to
pay
for
the
service.
5.
Of
the
moneys
appropriated
in
this
section,
$4,359,500
is
allocated
for
the
preparation
for
adult
living
program
established
pursuant
to
section
234.46.
6.
Of
the
moneys
appropriated
in
this
section,
a
portion
may
be
used
for
family-centered
services
for
purposes
of
complying
with
the
federal
Family
First
Prevention
Services
Act
of
2018,
Pub.
L.
No.
115-123,
and
successor
legislation.
7.
a.
Of
the
moneys
appropriated
in
this
section,
$38,414,178
is
allocated
for
adoption
subsidy
payments
and
House
File
2782,
p.
19
related
costs.
b.
Any
moneys
remaining
after
the
allocation
under
paragraph
“a”
is
designated
and
allocated
as
state
savings
resulting
from
implementation
of
the
federal
Fostering
Connections
to
Success
and
Increasing
Adoptions
Act
of
2008,
Pub.
L.
No.
110-351,
and
successor
legislation,
as
determined
in
accordance
with
42
U.S.C.
§673(a)(8),
and
shall
be
used
for
post-adoption
services
and
for
other
purposes
allowed
under
those
federal
Acts
and
regulations,
and
Tit.
IV-B
or
Tit.
IV-E
of
the
federal
Social
Security
Act.
8.
Of
the
moneys
appropriated
in
this
section,
a
sufficient
amount
is
allocated
to
support
training
needs
for
child
welfare
providers
and
to
address
disproportionality
within
the
child
welfare
system.
9.
Of
the
moneys
appropriated
in
this
subsection,
$1,658,000
shall
be
allocated
for
child
protection
centers
located
in
Iowa
pursuant
to
the
child
protection
center
grant
program
under
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
moneys
are
awarded
through
a
funding
formula
based
upon
the
volume
of
children
served
by
a
center.
To
increase
access
to
child
protection
center
services
for
children
in
rural
areas,
the
funding
formula
for
awarding
the
remaining
moneys
shall
provide
for
awarding
an
enhanced
amount
to
eligible
grantees
to
develop
and
maintain
satellite
centers
in
underserved
regions
of
the
state.
10.
Of
the
moneys
appropriated
in
this
subsection,
up
to
$227,000
shall
be
used
for
the
public
purpose
of
continuing
a
grant
to
a
nonprofit
human
services
organization
that
provides
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.
11.
If
a
separate
funding
source
is
available
that
reduces
the
need
for
state
moneys
within
an
allocation
under
this
section,
the
allocated
state
moneys
may
be
redistributed
to
other
allocations
under
this
section
for
the
same
fiscal
year.
House
File
2782,
p.
20
DIVISION
VIII
STATE-OPERATED
SPECIALTY
CARE
——
FY
2026-2027
Sec.
19.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
STATE-OPERATED
SPECIALTY
CARE.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
salaries,
support,
maintenance,
and
miscellaneous
purposes
at
institutions
under
the
jurisdiction
of
the
department
of
health
and
human
services,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$100,225,768
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
1,304.45
1.
The
department
shall
utilize
the
moneys
appropriated
in
this
section
as
necessary
to
maximize
bed
capacity
and
to
most
effectively
meet
the
needs
of
the
individuals
served.
2.
Of
the
moneys
appropriated
in
this
section,
the
following
amounts
are
allocated
to
each
institution
as
follows:
a.
For
the
state
mental
health
institute
at
Cherokee:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
19,878,962
b.
For
the
state
mental
health
institute
at
Independence:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
23,760,205
c.
For
the
civil
commitment
unit
for
sexual
offenders
at
Cherokee:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
23,272,111
d.
For
the
state
resource
center
at
Woodward:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,567,092
e.
For
the
state
training
school
at
Eldora:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
19,805,171
f.
For
outstanding
obligations
related
to
workers’
compensation,
the
sick
leave
insurance
program,
unemployment,
and
other
costs
related
to
the
closure
of
the
state
resource
center
at
Glenwood:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
942,227
DIVISION
IX
ADMINISTRATION
AND
COMPLIANCE
——
FY
2026-2027
Sec.
20.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
ACCOUNTABILITY,
COMPLIANCE,
AND
PROGRAM
INTEGRITY.
There
House
File
2782,
p.
21
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
accountability,
compliance,
and
program
integrity,
including
salaries,
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
23,152,404
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
382.00
1.
Of
the
moneys
appropriated
in
this
section,
$2,602,312
is
allocated
for
foster
care
review
and
the
court
appointed
special
advocate
program,
including
for
salaries,
support,
maintenance,
and
miscellaneous
purposes.
2.
Of
the
moneys
appropriated
in
this
section,
$1,148,959
is
allocated
for
the
office
of
long-term
care
ombudsman
for
salaries,
support,
administration,
maintenance,
and
miscellaneous
purposes.
DIVISION
X
TRANSFERS,
CASH
FLOW,
AND
NONREVERSIONS
——
FY
2026-2027
Sec.
21.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
TRANSFERS
AND
CASH
FLOW.
1.
Notwithstanding
any
provision
of
law
to
the
contrary,
the
department
of
health
and
human
services
may
transfer
moneys
appropriated
in
this
Act
to
support
continuing
alignment
efforts,
to
maximize
federal
support
in
accordance
with
the
department’s
federal
costs
allocation
plan,
and
to
secure
resources
necessary
to
implement
and
administer
the
services
for
which
moneys
are
appropriated.
The
department
shall
report
any
transfers
made
pursuant
to
this
subsection
to
the
general
assembly.
On
or
before
December
1,
2026,
the
department
shall
report
to
the
chairpersons
of
the
health
and
human
services
appropriations
subcommittee
the
allocations
and
full-time
equivalent
positions
for
each
division
of
the
department
for
the
fiscal
year
beginning
July
1,
2027.
2.
If,
due
to
ongoing
cost
management
efforts,
appropriations
under
this
Act
for
the
Medicaid
program
exceed
the
associated
costs
for
the
Medicaid
program
for
the
House
File
2782,
p.
22
fiscal
year,
the
department
may
transfer
any
savings
to
the
appropriations
made
in
this
Act
for
health
program
operations,
or
for
accountability,
compliance,
and
program
integrity,
to
defray
the
costs
associated
with
ongoing
cost
management
efforts.
3.
Notwithstanding
any
provision
of
law
to
the
contrary,
the
department
may
transfer
moneys
appropriated
under
this
Act
for
child
protective
services
to
pay
the
nonfederal
share
costs
of
services
reimbursed
under
the
medical
assistance
program,
state
child
care
assistance
program,
or
family
investment
program
which
are
provided
to
children
who
would
otherwise
receive
services
paid
by
the
appropriation
for
child
protective
services.
4.
The
department
may
transfer
moneys
from
the
temporary
assistance
for
needy
families
block
grant
to
the
federal
social
services
block
grant
appropriation,
and
to
the
child
care
and
development
block
grant
appropriation,
in
accordance
with
federal
law.
5.
To
the
extent
the
department
determines
that
moneys
appropriated
under
this
Act,
or
allocated
for
a
specific
purpose
under
this
Act,
will
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year,
such
unencumbered
or
unobligated
moneys
may
be
used
in
the
same
fiscal
year
for
any
other
purpose
for
which
the
appropriated
moneys
may
be
used,
or
for
any
other
allocation
within
the
same
appropriation.
Sec.
22.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
NONREVERSIONS.
1.
Notwithstanding
section
8.33,
moneys
appropriated
under
this
Act
from
the
general
fund
of
the
state
and
the
temporary
assistance
for
needy
families
block
grant
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
for
the
purposes
of
the
FaDSS
grant
program,
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.
2.
Notwithstanding
section
8.33,
of
the
moneys
appropriated
under
this
Act
from
the
general
fund
of
the
state,
the
quality
assurance
trust
fund,
and
the
hospital
health
care
access
trust
House
File
2782,
p.
23
fund
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
for
the
purposes
of
the
medical
assistance
program,
the
amount
in
excess
of
actual
expenditures
for
the
medical
assistance
program
that
remains
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
for
expenditure
for
the
medical
assistance
program
until
the
close
of
the
succeeding
fiscal
year.
3.
Notwithstanding
section
8.33,
and
notwithstanding
the
nonreversion
amount
limitation
specified
for
state
resource
centers
in
section
222.92,
subsection
4,
moneys
appropriated
under
this
Act
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
for
the
purposes
of
state-operated
specialty
care,
that
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
for
expenditure
for
the
purposes
designated
for
subsequent
fiscal
years.
4.
Notwithstanding
section
8.33,
moneys
appropriated
in
this
Act
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
for
the
Iowa
commission
on
volunteer
service
for
programs
and
grants,
that
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
for
expenditure
for
the
purposes
designated
for
subsequent
fiscal
years.
5.
Notwithstanding
section
8.33,
moneys
appropriated
under
this
Act
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
and
allocated
for
rural
psychiatric
residencies,
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.
6.
Notwithstanding
section
8.33,
moneys
appropriated
under
this
Act
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
and
allocated
for
adoption
subsidy
payments
and
related
costs,
or
for
post-adoption
House
File
2782,
p.
24
services
and
allowable
related
purposes,
that
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
for
expenditure
for
adoption
reinvestment
obligations.
7.
Notwithstanding
section
8.33,
moneys
appropriated
under
this
Act
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
and
allocated
for
child
protective
services,
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
XI
REPORT
ON
NONREVERSION
OF
MONEYS
Sec.
23.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
REPORT
ON
NONREVERSION
OF
MONEYS.
The
department
of
health
and
human
services
shall
report
the
expenditure
of
any
moneys
for
which
nonreversion
authorization
was
provided
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
to
the
general
assembly
on
a
quarterly
basis
beginning
October
1,
2027.
DIVISION
XII
EMERGENCY
RULES
Sec.
24.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
EMERGENCY
RULES.
1.
If
necessary
to
comply
with
federal
requirements,
including
time
frames,
the
department
of
health
and
human
services
shall
adopt
administrative
rules
under
section
17A.4,
subsection
3,
and
section
17A.5,
subsection
2,
paragraph
“b”,
to
implement
the
applicable
provisions
of
this
Act.
The
rules
shall
be
effective
immediately
upon
filing
unless
a
later
date
is
specified
in
the
rules.
Any
rules
adopted
in
accordance
with
this
section
shall
also
be
published
as
a
notice
of
intended
action
as
provided
in
section
17A.4.
2.
If
the
department
of
health
and
human
services
adopts
emergency
rules
in
accordance
with
this
section,
or
as
otherwise
directed
or
authorized
by
state
law,
and
the
rules
will
result
in
an
increase
in
expenditures
beyond
the
amount
anticipated
in
the
budget
for
the
fiscal
year,
or
if
the
House
File
2782,
p.
25
expenditures
were
not
addressed
in
the
budget
for
the
fiscal
year,
the
department
shall
notify
the
general
assembly
and
the
department
of
management
concerning
the
rules
and
the
increase
in
expenditures.
The
notification
shall
be
provided
at
least
thirty
calendar
days
prior
to
the
date
notice
of
the
rules
is
submitted
to
the
administrative
rules
coordinator
and
the
administrative
code
editor.
DIVISION
XIII
MORE
OPTIONS
FOR
MATERNAL
SUPPORT
PROGRAM
APPROPRIATION
NONREVERSION
Sec.
25.
2025
Iowa
Acts,
chapter
169,
section
27
,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
8.
Notwithstanding
section
8.33,
moneys
appropriated
from
the
general
fund
of
the
state
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2025,
and
ending
June
30,
2026,
for
the
more
options
for
maternal
support
program
created
in
section
217.41C
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.
26.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
Sec.
27.
RETROACTIVE
APPLICABILITY.
This
division
of
this
Act
applies
retroactively
to
July
1,
2025.
DIVISION
XIV
REIMBURSEMENT
RATES
——
REVIEW
Sec.
28.
Section
235.2,
Code
2026,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
9.
Upon
implementation
by
the
department
of
a
uniform
cost
report
for
shelter
care
and
qualified
residential
treatment
providers,
biennially
conduct
a
review
of
shelter
care
and
qualified
residential
treatment
provider
costs
compared
to
current
shelter
care
and
qualified
residential
treatment
provider
rates.
On
or
before
October
1
of
the
calendar
year
immediately
succeeding
the
calendar
year
in
which
the
review
is
conducted,
the
department
shall
submit
a
report
to
the
governor
and
the
general
assembly
detailing
the
results
of
the
department’s
review
and
recommendations
for
rate
House
File
2782,
p.
26
adjustments.
Sec.
29.
Section
249A.4,
Code
2026,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
15.
a.
Conduct
an
annual
review
of
provider
reimbursement
rates
for
medical
and
health
services
provided
under
this
chapter
that
are
reimbursed
by
a
statewide
fee
schedule
and
that
are
not
periodically
updated
or
rebased
pursuant
to
federal
or
state
law
or
rule.
The
department
shall
compare
each
provider
reimbursement
rate
in
the
following
manner:
(1)
For
all
medical
and
health
services
other
than
dental
services,
to
reimbursement
rates
under
the
federal
Medicare
program.
(2)
For
dental
services,
to
reimbursement
rates
for
Medicaid
programs
in
states
contiguous
to
Iowa.
b.
On
or
before
January
15
of
each
calendar
year,
the
department
shall
submit
to
the
general
assembly
a
report
summarizing
the
department’s
review
under
paragraph
“a”
.
DIVISION
XV
MENTAL
DISEASES
EXCLUSION
——
WAIVER
Sec.
30.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
MEDICAL
DISEASES
EXCLUSION
WAIVER.
No
later
than
July
1,
2027,
the
department
of
health
and
human
services
shall
apply
to
the
centers
for
Medicare
and
Medicaid
services
of
the
United
States
department
of
health
and
human
services
for
a
waiver
of
Medicaid’s
institution
for
mental
diseases
exclusion.
DIVISION
XVI
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
FULL-TIME
EQUIVALENT
DASHBOARD
Sec.
31.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
FULL-TIME
EQUIVALENT
DASHBOARD.
Pursuant
to
section
217.22,
the
department
of
health
and
human
services
shall
make
publicly
available
information
on
full-time
equivalent
positions
as
described
in
section
8.36A,
that
details
all
of
the
following:
1.
The
number
of
full-time
equivalent
positions
authorized
by
the
general
assembly
for
the
department,
categorized
by
the
department
division
or
appropriation.
2.
The
number
of
filled
full-time,
part-time,
or
temporary
positions
by
department
division
or
appropriation.
House
File
2782,
p.
27
3.
The
percentage
of
moneys
from
each
federal,
state,
or
other
funding
source
for
each
department
division
and
department
appropriation.
DIVISION
XVII
COMPREHENSIVE
FAMILY
SUPPORT
PROGRAM
Sec.
32.
NEW
SECTION
.
231.80
Comprehensive
family
support
program.
1.
For
the
purposes
of
this
section,
unless
the
context
otherwise
requires:
a.
“Comprehensive
family
support”
means
services
and
supports
that
assist
families
caring
for
an
individual
with
a
disability
who
is
a
member
of
the
family,
including
but
not
limited
to
programs,
services,
parent-to-parent
support,
assistive
devices,
and
various
adaptations
that
allow
an
individual
with
a
disability
to
participate
more
fully
in
family
and
community
life.
b.
(1)
“Family”
means
a
group
of
interdependent
persons
living
in
the
same
household.
A
family
consists
of
an
individual
with
a
disability
and
any
of
the
following:
(a)
The
individual’s
parent.
(b)
The
individual’s
sibling.
(c)
The
individual’s
grandparent,
aunt,
or
uncle.
(d)
The
individual’s
legal
custodian.
(e)
A
person
providing
short-term
foster
care
to
the
individual
with
a
disability
subject
to
a
case
permanency
plan
that
provides
for
reunification
between
the
individual
and
the
individual’s
parent.
(2)
“Family”
does
not
include
a
person
who
is
employed
to
provide
services
to
an
individual
with
a
disability
in
an
out-of-home
setting,
including
but
not
limited
to
a
hospital,
nursing
facility,
personal
care
home,
board
and
care
home,
group
foster
care
home,
or
other
institutional
setting.
c.
“Individual
with
a
disability”
means
an
individual
who
is
less
than
twenty-two
years
of
age
and
meets
the
definition
of
developmental
disability
in
42
U.S.C.
§15002.
d.
“Services
and
support”
means
assistance
intended
to
enable
an
individual
with
a
disability
to
control
the
individual’s
environment,
to
remain
living
with
the
individual’s
family,
to
function
more
independently,
and
House
File
2782,
p.
28
to
increase
the
integration
of
the
individual
into
the
individual’s
community
including
but
not
limited
to
funding
for
purchase
of
equipment,
respite
care,
supplies,
assistive
technology,
and
payment
of
other
costs
attributable
to
the
individual’s
disability
which
are
identified
by
the
individual’s
family.
2.
A
comprehensive
family
support
program
is
created
under
the
purview
of
the
department
to
provide
a
statewide
system
of
services
and
support
to
eligible
families.
The
program
shall
be
implemented
in
a
manner
that
enables
a
family
member
of
an
individual
with
a
disability
to
identify
the
needed
services
and
support.
3.
Eligibility
for
the
program
is
limited
to
families
who
meet
all
of
the
following
criteria:
a.
The
family
resides
in
the
state
of
Iowa.
b.
The
family
intends
for
the
family
member
who
is
an
individual
with
a
disability
to
remain
living
in
the
family’s
home.
c.
The
family’s
taxable
income
is
less
than
sixty
thousand
dollars
for
the
most
recently
completed
tax
year.
4.
A
family
may
apply
to
the
department
or
to
a
family
support
center
for
assistance
under
the
comprehensive
family
support
program.
The
department
or
family
support
center
shall
determine
eligibility
for
the
comprehensive
family
support
program
in
accordance
with
subsection
3.
5.
The
department
shall
adopt
rules
pursuant
to
chapter
17A
to
implement
the
comprehensive
family
support
program.
The
comprehensive
family
support
program
must
do
all
of
the
following:
a.
To
the
extent
possible,
incorporate
in
the
application
process
the
eligibility
determination
processes
that
the
department
uses
for
other
disability
services
programs.
b.
Ensure
the
ability
of
families
to
maintain
control
of
decisions
which
affect
an
individual
with
a
disability
who
is
a
member
of
a
family.
c.
Utilize
existing
local
agencies
to
provide
facilities
and
a
single
entry
point
for
program
applicants.
d.
Ensure
services
and
support
are
provided
in
a
timely
manner
and
emergency
access
to
needed
services
and
support
is
House
File
2782,
p.
29
provided.
e.
Ensure
technical
assistance
is
provided
to
providers
and
users
of
services
and
support.
f.
Utilize
state,
regional,
and
local
media
to
publicize
the
program.
g.
Incorporate
a
process
to
appeal
the
department’s
or
family
support
center’s
denial
of
services
and
support
to
a
family
under
the
program,
including
reasonable
efforts
by
the
department
to
utilize
telecommunications
in
the
appeal
process.
h.
Identify
the
services
and
support,
and
service
provider
components,
included
in
the
program.
i.
Upon
request
by
a
family
member,
provide
a
family
with
assistance
in
locating
a
service
provider.
j.
Make
payment
for
services
and
support
directly
to
families
by
voucher
or
other
appropriate
means.
k.
Utilize
a
voucher
system
for
payment
for
the
family
support
center
component
of
the
program
under
subsection
7.
6.
Services
and
support
provided
under
the
comprehensive
family
support
program
shall
not
be
used
to
supplant
other
services
and
support
available
to
a
family
of
an
individual
with
a
disability
but
shall
be
used
to
meet
family
needs
that
will
not
be
met
without
the
program.
7.
The
comprehensive
family
support
program
shall
include
a
family
support
center
component.
Under
the
component,
a
family
member
of
an
individual
with
a
disability
shall
be
assisted
by
a
family
support
center
in
identifying
the
services
and
support
to
be
provided
to
the
family
under
the
family
support
subsidy
program
or
the
comprehensive
family
support
program.
The
identification
of
services
and
support
must
be
based
upon
the
specific
needs
of
the
individual
with
a
disability
and
the
individual’s
family
which
are
not
met
by
other
service
programs
available
to
the
individual
with
a
disability
and
the
individual’s
family.
8.
The
comprehensive
family
support
program
shall
be
funded
by
appropriations
made
by
the
general
assembly
for
purposes
of
the
program.
Notwithstanding
section
8.33,
moneys
appropriated
for
the
comprehensive
family
support
program
under
this
section
that
remain
unobligated
or
unexpended
at
the
close
of
each
fiscal
year
shall
not
revert
but
shall
remain
available
for
House
File
2782,
p.
30
expenditure
for
the
purposes
designated
until
the
close
of
the
immediately
succeeding
fiscal
year.
Sec.
33.
CODE
EDITOR
DIRECTIVE.
The
Code
editor
is
directed
to
designate
section
231.80,
as
enacted
in
this
division
of
this
Act,
as
subchapter
VIII
of
chapter
231
entitled
“Comprehensive
Family
Support
Program”.
Sec.
34.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
Sec.
35.
RETROACTIVE
APPLICABILITY.
This
division
of
this
Act
applies
retroactively
to
July
1,
2025.
DIVISION
XVIII
FEDERAL
COMMUNITY
MENTAL
HEALTH
SERVICES
BLOCK
GRANT
Sec.
36.
2025
Iowa
Acts,
chapter
152,
section
2,
subsection
1,
paragraph
d,
is
amended
to
read
as
follows:
d.
For
the
federal
fiscal
year
beginning
October
1,
2025,
and
ending
September
30,
2026,
of
Of
the
moneys
allocated
to
providers
under
paragraph
“c”,
70
percent
of
the
moneys
allocated
each
federal
fiscal
year
shall
be
distributed
by
a
behavioral
health
administrative
services
organization
or
the
department
of
health
and
human
services
to
the
state’s
accredited
community
mental
health
centers
designated
by
the
department
of
health
and
human
services
under
section
225A.3
,
as
enacted
by
2024
Iowa
Acts,
chapter
1161,
section
3
.
Community
mental
health
centers
that
receive
moneys
distributed
under
this
paragraph
shall
use
the
moneys
for
the
purposes
of
training
staff,
providing
services
to
adults
with
a
serious
mental
illness,
or
providing
services
to
children
with
a
serious
emotional
disturbance,
and
shall
bill
treatment
dollars
related
to
such
services
to
the
department
of
health
and
human
services
through
the
department’s
claims
system.
The
department
of
health
and
human
services
shall
publish
the
amounts
to
be
distributed
to
community
mental
health
centers
on
the
department’s
internet
site
on
or
before
October
1,
2025,
and
on
or
before
October
1,
2026,
and
distribute
the
moneys
to
the
recipients
on
a
quarterly
basis.
Recipients
of
the
moneys
shall
submit
quarterly
reports
to
the
department
of
health
and
human
services
containing
data
consistent
with
performance
measures
approved
by
the
federal
substance
abuse
and
mental
health
services
administration.
House
File
2782,
p.
31
DIVISION
XIX
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
BEHAVIORAL
HEALTH
EXPENDITURE
REPORT
Sec.
37.
NEW
SECTION
.
225A.10
Behavioral
health
services
expenditure
report.
No
later
than
December
15
of
each
year,
the
department
shall
submit
to
the
general
assembly
a
summary
of
the
department’s
expenditures
for
behavioral
health
services
for
adults
and
children
for
the
immediately
preceding
fiscal
year,
including
a
summary
of
which
appropriations
or
funding
sources
were
used
to
fund
the
expenditures.
DIVISION
XX
OPIOID
SETTLEMENT
FUND
——
FY
2026-2027
Sec.
38.
OPIOID
SETTLEMENT
FUND
——
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES.
1.
There
is
appropriated
from
the
opioid
settlement
fund
created
in
section
12.51
to
the
department
of
health
and
human
services
for
the
fiscal
year
beginning
July
1,
2026,
and
ending
June
30,
2027,
the
following
amount,
or
so
much
thereof
is
as
necessary,
for
the
purposes
designated:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,000,000
2.
Notwithstanding
any
provision
of
law
to
the
contrary,
of
the
moneys
appropriated
to
the
department
of
health
and
human
services
under
subsection
1,
the
department
shall
disburse
to
an
opioid
treatment
program
that
operates
a
facility
with
at
least
one
hundred
fifty
licensed
beds
that
provides
medical
detoxification
stabilization
and
residential
substance
abuse
disorder
treatment
to
support
comprehensive
addiction
and
co-occuring
mental
health
treatment,
and
provides
24-hour
medical
detoxification,
residential
treatment,
and
medication-assisted
treatment.
a.
Moneys
disbursed
under
this
subsection
shall
be
used
by
the
recipient
in
compliance
with
the
requirements
of
the
national
opioid
settlement
agreements
and
section
12.51.
b.
The
recipient
shall
utilize
the
indicators
and
outcomes
identified
under
section
12.51,
subsection
2,
paragraph
“b”,
subparagraph
(3),
subparagraph
division
(c),
to
determine
whether
the
services
and
activities
that
are
funded
by
the
disbursement
achieve
the
intended
outcomes,
and
shall
report
House
File
2782,
p.
32
the
recipient’s
findings
to
the
department
of
health
and
human
services.
DIVISION
XXI
GRADUATE
MEDICAL
EDUCATION
Sec.
39.
2025
Iowa
Acts,
chapter
120,
section
19,
is
amended
to
read
as
follows:
SEC.
19.
TRANSFER
OF
MONEYS.
Notwithstanding
section
8.33
or
any
other
provision
to
the
contrary,
any
unobligated
or
unencumbered
moneys
in
any
of
the
following
accounts
or
funds
or
constituting
any
specified
appropriation,
shall
not
revert
but
are
appropriated
to
the
department
of
health
and
human
services
to
fund
Medicaid
graduate
medical
education
efforts
award
grants
to
start
medical
residency
programs
in
the
state
that
are
not
related
to
the
practice
of
family
medicine,
are
not
located
in
a
county
which
has
a
population
of
one
hundred
fifty
thousand
or
more
based
on
the
most
recent
federal
decennial
census,
and
in
which
the
main
campus
of
an
institution
of
higher
learning
governed
by
the
state
board
of
regents
is
located
.
1.
The
health
care
workforce
shortage
fund
created
in
section
135.175,
subsection
1
,
paragraph
“b”,
Code
2025.
2.
The
medical
residency
training
account
created
in
section
135.175,
subsection
5
,
paragraph
“a”,
Code
2025
,
except
$298,000
of
such
moneys
is
appropriated
to
the
department
of
health
and
human
services
for
the
purposes
of
implementing
the
waiver
of
Medicaid’s
institution
for
mental
diseases
exclusion
the
department
must
apply
for
under
this
2026
Iowa
Act
.
3.
The
nurse
residency
state
matching
grants
program
account
created
in
section
135.175,
subsection
5
,
paragraph
“b”,
Code
2025.
4.
The
health
care
workforce
shortage
national
initiatives
account
created
in
section
135.175,
subsection
5
,
paragraph
“c”,
Code
2025.
5.
The
family
medicine
obstetrics
fellowship
program
fund
created
in
section
135.193
,
Code
2025.
6.
Moneys
appropriated
to
the
department
of
health
and
human
services
for
rural
psychiatric
residencies
to
fund
psychiatric
residents
to
provide
mental
health
services
in
underserved
areas
of
the
state
as
described
in
the
following:
House
File
2782,
p.
33
a.
2024
Iowa
Acts,
chapter
1157,
section
5,
subsection
3
,
and
2024
Iowa
Acts,
chapter
1157,
section
22,
subsection
5
.
b.
2023
Iowa
Acts,
chapter
112,
section
5,
subsection
4,
paragraph
“j”
,
as
amended
by
2024
Iowa
Acts,
chapter
1157,
section
29
.
c.
2022
Iowa
Acts,
chapter
1131,
section
3,
subsection
4,
paragraph
“j”
,
as
amended
by
2024
Iowa
Acts,
chapter
1157,
section
23
.
d.
2021
Iowa
Acts,
chapter
182,
section
3,
subsection
4,
paragraph
“j”
.
e.
2019
Iowa
Acts,
chapter
85,
section
3,
subsection
4,
paragraph
“j”
,
as
amended
by
2020
Iowa
Acts,
chapter
1121,
section
19
.
DIVISION
XXII
MEDICAID
REIMBURSEMENT
RATE
——
SPECIAL
POPULATION
NURSING
FACILITIES
Sec.
40.
Section
249A.2,
Code
2026,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
15.
“Special
population
nursing
facility”
refers
to
a
nursing
facility
that
serves
one
of
the
following
populations
and
has
been
designated
as
a
special
population
nursing
facility
by
the
department:
a.
One
hundred
percent
of
the
residents
served
are
aged
thirty
and
under
and
require
a
skilled
level
of
care.
b.
Seventy
percent
of
the
residents
served
require
a
skilled
level
of
care
for
neurological
disorders.
c.
One
hundred
percent
of
the
residents
require
care
from
a
facility
licensed
by
the
department
of
inspections,
appeals,
and
licensing
as
an
intermediate
care
facility
for
persons
with
mental
illness.
d.
One
hundred
percent
of
the
residents
require
care
from
a
facility
licensed
by
the
department
of
inspections,
appeals,
and
licensing
as
an
intermediate
care
facility
for
persons
with
medical
complexity.
Sec.
41.
NEW
SECTION
.
249A.38C
Medicaid
reimbursement
rate
——
special
population
nursing
facilities.
The
provider
reimbursement
rate
for
each
special
population
nursing
facility
must
be
the
special
population
nursing
facility’s
average
allowable
per
diem
costs
as
adjusted
in
House
File
2782,
p.
34
compliance
with
applicable
federal
laws
and
regulations,
including
the
upper
payment
limits
specified
in
42
C.F.R.
§447.272(b).
If
a
special
population
nursing
facility
subject
to
this
section
increases
the
special
population
nursing
facility’s
number
of
beds
or
expands
to
provide
additional
services
on
or
after
July
1,
2026,
the
reimbursement
rate
in
this
section
shall
apply
to
such
additional
beds
or
services.
______________________________
PAT
GRASSLEY
Speaker
of
the
House
______________________________
AMY
SINCLAIR
President
of
the
Senate
I
hereby
certify
that
this
bill
originated
in
the
House
and
is
known
as
House
File
2782,
Ninety-first
General
Assembly.
______________________________
MEGHAN
NELSON
Chief
Clerk
of
the
House
Approved
_______________,
2026
______________________________
KIM
REYNOLDS
Governor