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Senate
File
649
-
Introduced
SENATE
FILE
649
BY
COMMITTEE
ON
APPROPRIATIONS
(SUCCESSOR
TO
SSB
1237)
A
BILL
FOR
An
Act
relating
to
and
making
appropriations
to
the
department
1
of
veterans
affairs
and
the
department
of
health
and
human
2
services,
and
related
provisions
and
appropriations,
3
including
aging
and
disability
services;
behavioral
health,
4
public
health,
community
access
and
eligibility;
the
medical
5
assistance
program,
state
supplementary
assistance,
Hawki,
6
and
other
health-related
programs;
family
well-being
and
7
protection;
state-operated
specialty
care;
administration
8
and
compliance;
transfers,
cash
flows,
and
nonreversions;
9
prior
appropriations;
the
beer
and
liquor
control
fund,
10
and
the
behavioral
health
fund;
report
on
nonreversion
of
11
moneys;
emergency
rules;
more
options
for
maternal
support
12
program;
and
a
hospital
directed
payment
program;
and
13
including
effective
date
and
retroactive
applicability
14
provisions.
15
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
16
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DIVISION
I
1
DEPARTMENT
OF
VETERANS
AFFAIRS
——
FY
2025-2026
2
Section
1.
DEPARTMENT
OF
VETERANS
AFFAIRS.
There
is
3
appropriated
from
the
general
fund
of
the
state
to
the
4
department
of
veterans
affairs
for
the
fiscal
year
beginning
5
July
1,
2025,
and
ending
June
30,
2026,
the
following
amounts,
6
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
7
designated:
8
1.
DEPARTMENT
OF
VETERANS
AFFAIRS
ADMINISTRATION
9
For
salaries,
support,
maintenance,
and
miscellaneous
10
purposes,
for
not
more
than
the
following
full-time
equivalent
11
positions:
12
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.
$
1,369,205
13
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.
FTEs
15.00
14
2.
IOWA
VETERANS
HOME
15
For
salaries,
support,
maintenance,
and
miscellaneous
16
purposes:
17
.
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.
$
8,145,736
18
a.
The
Iowa
veterans
home
billings
involving
the
department
19
of
health
and
human
services
shall
be
submitted
to
the
20
department
on
at
least
a
monthly
basis.
21
b.
The
Iowa
veterans
home
expenditure
report
shall
be
22
submitted
monthly
to
the
general
assembly.
23
3.
HOME
OWNERSHIP
ASSISTANCE
PROGRAM
24
For
transfer
to
the
Iowa
finance
authority
for
the
25
continuation
of
the
home
ownership
assistance
program
for
26
persons
who
are
or
were
eligible
members
of
the
armed
forces
27
of
the
United
States
or
eligible
service
members
pursuant
to
28
section
16.54:
29
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.
$
2,700,000
30
DIVISION
II
31
AGING
AND
DISABILITY
SERVICES
——
FY
2025-2026
32
Sec.
2.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
AGING
33
AND
DISABILITY
SERVICES.
There
is
appropriated
from
the
34
general
fund
of
the
state
to
the
department
of
health
and
human
35
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services
for
the
fiscal
year
beginning
July
1,
2025,
and
ending
1
June
30,
2026,
the
following
amount,
or
so
much
thereof
as
is
2
necessary,
to
be
used
for
the
purposes
designated:
3
For
aging
programs
for
the
department
of
health
and
human
4
services
and
area
agencies
on
aging
to
provide
citizens
of
5
Iowa
who
are
60
years
of
age
and
older
with
case
management;
6
for
Iowa’s
aging
and
disabilities
resource
centers;
for
the
7
return
to
community
program;
for
the
purposes
of
chapter
231E;
8
to
administer
the
prevention
of
elder
abuse,
neglect,
and
9
exploitation
program
pursuant
to
section
231.56A,
in
accordance
10
with
the
requirements
of
the
federal
Older
Americans
Act
of
11
1965,
42
U.S.C.
§3001
et
seq.,
as
amended;
for
the
operation
of
12
the
dependent
adult
abuse
services
program
pursuant
to
chapter
13
235B;
and
for
other
services
which
may
include
but
are
not
14
limited
to
adult
day
care,
respite
care,
chore,
information
15
and
assistance,
and
material
aid,
for
information
and
options
16
counseling
for
persons
with
disabilities,
and
for
salaries,
17
support,
administration,
maintenance,
and
miscellaneous
18
purposes:
19
.
.
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.
$
19,208,180
20
1.
Moneys
appropriated
in
this
section
may
be
used
to
21
supplement
federal
moneys
received
under
federal
regulations.
22
To
receive
moneys
appropriated
in
this
section,
a
local
area
23
agency
on
aging
shall
match
the
moneys
with
moneys
from
other
24
sources
according
to
rules
adopted
by
the
department.
Moneys
25
appropriated
in
this
section
may
be
used
for
services
not
26
specifically
enumerated
in
this
section
only
if
approved
by
the
27
department
as
part
of
an
area
agency
on
aging’s
area
plan.
28
2.
Of
the
moneys
appropriated
in
this
section,
$949,282
29
shall
be
used
for
the
family
support
center
component
of
the
30
comprehensive
family
support
program
under
section
225C.47.
31
3.
Of
the
moneys
appropriated
in
this
section,
$33,632
shall
32
be
used
to
build
community
capacity
through
the
coordination
33
and
provision
of
training
opportunities
in
accordance
with
the
34
consent
decree
of
Conner
v.
Branstad,
No.
4-86-CV-30871
(S.D.
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Iowa,
July
15,
1994).
1
DIVISION
III
2
BEHAVIORAL
HEALTH
——
FY
2025-2026
3
Sec.
3.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
4
BEHAVIORAL
HEALTH.
There
is
appropriated
from
the
general
fund
5
of
the
state
to
the
department
of
health
and
human
services
for
6
the
fiscal
year
beginning
July
1,
2025,
and
ending
June
30,
7
2026,
the
following
amount,
or
so
much
thereof
as
is
necessary,
8
to
be
used
for
the
purposes
designated:
9
For
behavioral
health
prevention,
treatment,
and
recovery
10
efforts
to
reduce
the
prevalence
of
the
use
of,
provide
11
treatment
for,
and
support
recovery
from
alcohol,
tobacco,
and
12
substance
use
and
misuse,
problem
gambling,
and
other
addictive
13
behaviors.
Activities
shall
align
with
accepted
best
practice
14
guidance
standards
for
behavioral
health
including
those
15
published
by
the
centers
for
disease
control
and
prevention
of
16
the
United
States
department
of
health
and
human
services,
and
17
the
substance
abuse
and
mental
health
services
administration
18
of
the
United
States
department
of
health
and
human
services,
19
for
health
promotion;
universal,
selective,
and
indicated
20
prevention;
treatment;
and
recovery
services
and
supports;
and
21
shall
include
a
24-hour
helpline,
public
information
resources,
22
professional
training,
youth
prevention,
program
evaluation,
23
and
efforts
at
the
state
and
local
levels:
24
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.
$
24,442,121
25
1.
Of
the
moneys
appropriated
in
this
section,
$300,000
26
shall
be
used
to
support
the
work
of
the
children’s
behavioral
27
health
system
including
evidence-based
behavioral
health
28
prevention,
treatment,
and
recovery
services
and
supports
for
29
children
and
their
families
pursuant
to
the
intent
specified
in
30
section
225C.6B,
subsection
1.
31
2.
Of
the
moneys
appropriated
in
this
section,
$950,000
32
shall
be
used
for
an
integrated
substance
use
disorder
managed
33
care
system.
The
department
shall
maintain
the
level
of
mental
34
health
and
substance
use
disorder
treatment
services
provided
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by
the
managed
care
contractors,
and
shall
take
the
steps
1
necessary
to
continue
the
federal
waivers
as
needed
to
maintain
2
the
level
of
services.
3
Sec.
4.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
SPORTS
4
WAGERING
RECEIPTS
FUND.
There
is
appropriated
from
the
5
sports
wagering
receipts
fund
created
in
section
8.57I,
to
the
6
department
of
health
and
human
services
for
the
fiscal
year
7
beginning
July
1,
2025,
and
ending
June
30,
2026,
the
following
8
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
9
behavioral
health
prevention,
treatment,
and
recovery
efforts
10
to
reduce
the
prevalence
of
the
use
of,
provide
treatment
for,
11
and
support
recovery
from
alcohol,
tobacco,
and
substance
use
12
and
misuse,
problem
gambling,
and
other
addictive
behaviors:
13
.
.
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.
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.
.
.
$
1,750,000
14
DIVISION
IV
15
PUBLIC
HEALTH
——
FY
2025-2026
16
Sec.
5.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
PUBLIC
17
HEALTH.
There
is
appropriated
from
the
general
fund
of
the
18
state
to
the
department
of
health
and
human
services
for
the
19
fiscal
year
beginning
July
1,
2025,
and
ending
June
30,
2026,
20
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
21
used
for
the
purposes
designated:
22
For
programs
that
support
health
promotion,
protect
the
23
health
and
safety
of
the
public,
conduct
disease
surveillance
24
and
investigation
to
reduce
the
incidence
of
morbidity
and
25
mortality,
serve
individuals
with
chronic
conditions
including
26
but
not
limited
to
cancer,
support
the
Iowa
donor
registry
as
27
specified
in
section
142C.18,
and
strengthen
the
health
care
28
delivery
system
and
workforce
to
improve
health
outcomes
for
29
all
Iowans:
30
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.
.
$
22,413,369
31
1.
Of
the
moneys
appropriated
in
this
section,
the
following
32
amounts
are
allocated
to
the
department
of
health
and
human
33
services
to
be
used
as
follows
to
support
the
goals
of
34
increased
access,
health
system
integration,
and
engagement:
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a.
$600,000
for
distribution
to
a
nonprofit
organization
1
that
established
the
first
statewide
drug
donation
repository
2
for
continuation
of
the
pharmaceutical
infrastructure
for
3
safety
net
providers
established
as
described
in
2007
Iowa
4
Acts,
chapter
218,
section
108,
and
for
the
prescription
drug
5
donation
repository
program
established
in
chapter
135M.
6
Moneys
under
this
paragraph
shall
be
distributed
in
their
7
entirety
on
July
1,
2025,
for
the
purpose
specified.
8
b.
$374,000
for
distribution
to
free
clinics,
as
defined
in
9
section
135.24,
and
a
nonprofit
organization
that
facilitates
10
the
initiation,
operation,
and
collaboration
of
free
clinics
11
for
necessary
infrastructure,
statewide
coordination,
provider
12
recruitment,
service
delivery,
and
provision
of
assistance
to
13
patients
in
securing
a
medical
home
inclusive
of
oral
health
14
care.
Of
the
moneys
allocated,
$40,000
shall
be
used
to
lower
15
fees
associated
with
using
an
electronic
prescribing
system.
16
Moneys
under
this
paragraph
shall
be
distributed
in
their
17
entirety
on
July
1,
2025,
for
the
purpose
specified.
18
c.
$25,000
for
distribution
to
an
organization
that
raises
19
awareness
about
issues
related
to
rural
health
clinics,
and
20
necessary
infrastructure
and
service
delivery
transformation.
21
Moneys
under
this
paragraph
shall
be
distributed
in
their
22
entirety
on
July
1,
2025,
for
the
purpose
specified.
23
d.
$225,000
for
distribution
to
an
organization
that
is
24
the
oldest
continuously
operating
medical
society
in
the
state
25
for
continuation
of
safety
net
provider
patients
access
to
26
specialty
care
as
described
in
2007
Iowa
Acts,
chapter
218,
27
section
109.
Moneys
under
this
paragraph
shall
be
distributed
28
in
their
entirety
on
July
1,
2025,
for
the
purpose
specified.
29
2.
Of
the
moneys
appropriated
in
this
section,
$600,000
30
shall
be
used
for
rural
psychiatric
residencies
for
residents
31
selected
on
or
before
June
30,
2025.
32
3.
The
university
of
Iowa
hospitals
and
clinics
under
33
the
control
of
the
state
board
of
regents
shall
not
receive
34
indirect
costs
from
the
moneys
appropriated
in
this
section.
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The
university
of
Iowa
hospitals
and
clinics
billings
to
the
1
department
shall
be,
at
a
minimum,
on
a
quarterly
basis.
2
DIVISION
V
3
COMMUNITY
ACCESS
AND
ELIGIBILITY
——
FY
2025-2026
4
Sec.
6.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
COMMUNITY
5
ACCESS
AND
ELIGIBILITY.
There
is
appropriated
from
the
6
general
fund
of
the
state
to
the
department
of
health
and
human
7
services
for
the
fiscal
year
beginning
July
1,
2025,
and
ending
8
June
30,
2026,
the
following
amount,
or
so
much
thereof
as
is
9
necessary,
to
be
used
for
the
purposes
designated:
10
To
be
used
for
salaries,
support,
maintenance,
and
11
miscellaneous
purposes
and
for
family
investment
program
(FIP)
12
assistance
in
accordance
with
chapter
239B,
and
for
other
costs
13
associated
with
providing
needs-based
benefits
or
assistance
14
including
but
not
limited
to
maternal
and
child
health,
oral
15
health,
obesity
prevention,
the
promotion
of
independence
16
and
self-sufficiency
through
employment,
job
opportunities
17
and
the
basic
skills
(PROMISE
JOBS)
program,
supplemental
18
nutrition
assistance
program
(SNAP)
employment
and
training,
19
the
FIP
diversion
program,
family
planning,
rent
reimbursement,
20
and
eligibility
determinations
for
medical
assistance,
food
21
assistance,
and
the
children’s
health
insurance
program:
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
68,542,456
23
1.
Of
the
child
support
collections
assigned
under
FIP,
24
the
federal
share
of
the
child
support
collections
shall
be
25
credited
to
the
child
support
services
appropriation
made
in
26
this
division
of
this
Act.
Of
the
remainder
of
the
child
27
support
collections
assigned
under
FIP,
a
portion
shall
be
28
credited
to
community
access
and
eligibility,
and
the
remaining
29
moneys
may
be
used
to
increase
recoveries,
to
sustain
cash
flow
30
in
the
collection
services
center
refund
account
as
provided
in
31
section
252B.13A,
or
for
technology
needs.
If
child
support
32
collections
assigned
under
FIP
are
greater
than
estimated
or
33
are
otherwise
determined
not
to
be
required
for
maintenance
of
34
efforts,
the
state
share
of
either
amount
is
appropriated
to
35
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1004SV
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6/
32
S.F.
649
the
department
for
child
support
services
as
described
in
this
1
Act,
or
may
be
transferred
to
or
retained
in
the
collection
2
services
center
refund
account.
3
2.
Of
the
moneys
appropriated
in
this
section,
$3,075,000
4
shall
be
used
for
continuation
of
the
department’s
initiative
5
to
provide
for
adequate
developmental
surveillance
and
6
screening
during
a
child’s
first
five
years.
The
moneys
shall
7
be
used
first
to
fully
fund
the
current
participating
counties
8
to
ensure
that
those
counties
are
fully
operational,
with
9
the
remaining
moneys
to
be
used
for
expanding
participation
10
to
additional
counties.
Full
implementation
and
expansion
11
shall
include
enhancing
the
scope
of
the
initiative
through
12
collaboration
with
child
health
specialty
clinics
to
promote
13
the
use
of
developmental
surveillance
and
screening
to
14
support
healthy
child
development
through
early
identification
15
and
response
to
both
biomedical
and
social
determinants
of
16
healthy
development
by
providing
practitioner
consultation
17
and
continuous
improvement
through
training
and
education,
18
particularly
for
children
with
behavioral
conditions
and
19
needs.
The
department
shall
also
collaborate
with
the
Medicaid
20
program
and
child
health
specialty
clinics
to
assist
in
21
coordinating
the
activities
of
the
first
five
initiative
into
22
the
establishment
of
patient-centered
medical
homes
developed
23
to
improve
health
quality
and
population
health
while
reducing
24
health
care
costs.
To
the
maximum
extent
possible,
moneys
25
allocated
in
this
subsection
shall
be
utilized
as
matching
26
moneys
for
Medicaid
program
reimbursement.
27
3.
Of
the
moneys
appropriated
in
this
section,
$1,145,102
28
is
allocated
to
the
Iowa
commission
on
volunteer
service
for
29
programs
and
grants.
30
4.
The
university
of
Iowa
hospitals
and
clinics
under
31
the
control
of
the
state
board
of
regents
shall
not
receive
32
indirect
costs
from
the
moneys
appropriated
in
this
section.
33
The
university
of
Iowa
hospitals
and
clinics
billings
to
the
34
department
shall
be,
at
a
minimum,
on
a
quarterly
basis.
35
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32
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649
CHILD
SUPPORT
SERVICES
1
Sec.
7.
CHILD
SUPPORT
SERVICES.
There
is
appropriated
from
2
the
general
fund
of
the
state
to
the
department
of
health
and
3
human
services
for
the
fiscal
year
beginning
July
1,
2025,
and
4
ending
June
30,
2026,
the
following
amount,
or
so
much
thereof
5
as
is
necessary,
to
be
used
for
the
purposes
designated:
6
For
child
support
services,
including
salaries,
support,
7
maintenance,
and
miscellaneous
purposes:
8
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
15,644,114
9
1.
Federal
access
and
visitation
grant
moneys
shall
be
used
10
for
services
designed
to
increase
compliance
with
the
child
11
access
provisions
of
court
orders,
including
but
not
limited
to
12
neutral
visitation
sites
and
mediation
services.
13
2.
The
appropriation
made
to
the
department
for
child
14
support
services
may
be
used
throughout
the
fiscal
year
in
the
15
manner
necessary
for
purposes
of
cash
flow
management,
and
for
16
cash
flow
management
purposes
the
department
may
temporarily
17
draw
more
than
the
amount
appropriated
provided
the
amount
18
appropriated
is
not
exceeded
at
the
close
of
the
fiscal
year.
19
DIVISION
VI
20
MEDICAL
ASSISTANCE
PROGRAM
——
STATE
SUPPLEMENTARY
ASSISTANCE
——
21
HEALTHY
AND
WELL
KIDS
IN
IOWA
PROGRAM
AND
OTHER
HEALTH-RELATED
22
PROGRAMS
——
FY
2025-2026
23
Sec.
8.
MEDICAL
ASSISTANCE
PROGRAM,
STATE
SUPPLEMENTARY
24
ASSISTANCE,
AND
HEALTHY
AND
WELL
KIDS
IN
IOWA
PROGRAM.
There
25
is
appropriated
from
the
general
fund
of
the
state
to
the
26
department
of
health
and
human
services
for
the
fiscal
year
27
beginning
July
1,
2025,
and
ending
June
30,
2026,
the
following
28
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
29
purposes
designated:
30
For
medical
assistance
program
reimbursement
and
associated
31
costs
as
specifically
provided
in
the
reimbursement
32
methodologies
in
effect
on
June
30,
2025,
except
as
otherwise
33
expressly
authorized
by
law,
consistent
with
federal
law
and
34
regulations,
and
contingent
upon
receipt
of
approval
from
the
35
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32
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649
office
of
the
governor
of
reimbursement
for
each
abortion
1
performed
under
the
medical
assistance
program;
for
the
state
2
supplementary
assistance
program;
for
the
health
insurance
3
premium
payment
program;
and
for
maintenance
of
the
healthy
and
4
well
kids
in
Iowa
(Hawki)
program
pursuant
to
chapter
514I,
5
including
supplemental
dental
services,
for
receipt
of
federal
6
financial
participation
under
Tit.
XXI
of
the
federal
Social
7
Security
Act,
which
creates
the
children’s
health
insurance
8
program;
and
for
other
specified
health-related
programs:
9
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,900,804,677
10
1.
Of
the
moneys
appropriated
in
this
section,
11
$1,808,383,124
is
allocated
for
medical
assistance
program
12
reimbursement
and
associated
costs.
13
a.
Of
the
moneys
allocated
in
this
subsection,
$800,000
14
shall
be
used
for
the
renovation
and
construction
of
certain
15
nursing
facilities,
consistent
with
chapter
249K.
16
b.
Of
the
moneys
allocated
in
this
subsection,
$3,383,880
17
shall
be
used
for
program
administration,
outreach,
and
18
enrollment
activities
of
the
state
family
planning
services
19
program
pursuant
to
section
217.41B,
and
of
this
amount,
the
20
department
may
use
$200,000
for
administrative
expenses.
21
c.
Of
the
moneys
allocated
in
this
subsection,
$5,000,000
22
shall
be
used
to
expand
the
capacity
of
intermittent
23
community-based
services
that
allow
an
individual
to
remain
24
in
the
community
and
that
provide
support
to
the
individual,
25
including
employment
services,
hourly
supported
community
26
living
services,
respite
services,
and
day
habilitation
27
services.
28
2.
Iowans
support
reducing
the
number
of
abortions
29
performed
in
our
state.
Moneys
appropriated
under
this
section
30
shall
not
be
used
for
abortions,
unless
otherwise
authorized
31
under
this
section.
32
3.
The
provisions
of
this
section
relating
to
abortions
33
shall
also
apply
to
the
Iowa
health
and
wellness
plan
created
34
pursuant
to
chapter
249N.
35
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32
S.F.
649
4.
Of
the
moneys
appropriated
in
this
section,
$4,479,762
is
1
allocated
for
the
state
supplementary
assistance
program.
2
5.
Of
the
moneys
appropriated
in
this
section,
$60,521,998
3
is
allocated
for
maintenance
of
the
Hawki
program
pursuant
4
to
chapter
514I,
including
supplemental
dental
services,
for
5
receipt
of
federal
financial
participation
under
Tit.
XXI
of
6
the
federal
Social
Security
Act,
which
creates
the
children’s
7
health
insurance
program.
8
HEALTH
PROGRAM
OPERATIONS
9
Sec.
9.
HEALTH
PROGRAM
OPERATIONS.
There
is
appropriated
10
from
the
general
fund
of
the
state
to
the
department
of
health
11
and
human
services
for
the
fiscal
year
beginning
July
1,
12
2025,
and
ending
June
30,
2026,
the
following
amount,
or
so
13
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
14
designated:
15
For
health
program
operations,
and
the
autism
support
16
program
under
section
225D.2:
17
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
39,672,433
18
1.
The
department
of
inspections,
appeals,
and
licensing
19
shall
provide
all
state
matching
moneys
for
survey
and
20
certification
activities
performed
by
the
department
of
21
inspections,
appeals,
and
licensing.
The
department
of
health
22
and
human
services
shall
be
solely
responsible
for
distributing
23
the
federal
matching
moneys
for
such
activities.
24
2.
Of
the
moneys
appropriated
in
this
section,
a
sufficient
25
amount
shall
be
used
for
the
administration
of
the
health
26
insurance
premium
payment
program,
including
salaries,
support,
27
maintenance,
and
miscellaneous
purposes.
28
3.
Of
the
moneys
appropriated
in
this
section,
$750,000
29
shall
be
used
for
a
nonprofit
organization
that
provides
access
30
to
emergency
poison
information
and
treatment.
Pursuant
to
31
the
directive
under
2014
Iowa
Acts,
chapter
1140,
section
32
102,
the
federal
matching
moneys
available
to
the
nonprofit
33
organization
from
the
department
under
the
federal
Children’s
34
Health
Insurance
Program
Reauthorization
Act
of
2009
shall
be
35
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10/
32
S.F.
649
subject
to
the
federal
administrative
cap
rule
of
10
percent
1
applicable
to
moneys
provided
under
Tit.
XXI
of
the
federal
2
Social
Security
Act
and
shall
be
included
in
the
department’s
3
calculations
of
the
cap.
4
4.
Unless
otherwise
provided
by
law,
if
a
contract
for
5
services
provided
under
this
section
initially
entered
into
6
during
the
fiscal
year
beginning
July
1,
2025,
and
ending
7
June
30,
2026,
provides
for
an
annual
increase
of
the
cost
of
8
services
provided
under
the
contract,
the
annual
increase
shall
9
not
exceed
the
amount
by
which
the
consumer
price
index
for
10
all
urban
consumers
increased
during
the
immediately
preceding
11
calendar
year.
This
subsection
shall
not
affect
a
contract
12
entered
into
on
or
before
June
30,
2025,
that
is
for
a
term
of
13
more
than
one
year.
14
HEALTH
CARE
ACCOUNTS
AND
FUNDS
15
Sec.
10.
PHARMACEUTICAL
SETTLEMENT
ACCOUNT
——
DEPARTMENT
16
OF
HEALTH
AND
HUMAN
SERVICES.
There
is
appropriated
from
the
17
pharmaceutical
settlement
account
created
in
section
249A.33
to
18
the
department
of
health
and
human
services
for
the
fiscal
year
19
beginning
July
1,
2025,
and
ending
June
30,
2026,
the
following
20
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
21
purposes
designated:
22
Notwithstanding
any
provision
of
law
to
the
contrary,
to
23
supplement
the
appropriation
made
in
this
Act
from
the
general
24
fund
of
the
state
for
health
program
operations
under
the
25
medical
assistance
program
for
the
same
fiscal
year:
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
234,193
27
Sec.
11.
QUALITY
ASSURANCE
TRUST
FUND
——
DEPARTMENT
OF
28
HEALTH
AND
HUMAN
SERVICES.
Notwithstanding
any
provision
of
29
law
to
the
contrary
and
subject
to
the
availability
of
moneys,
30
there
is
appropriated
from
the
quality
assurance
trust
fund
31
created
in
section
249L.4
to
the
department
of
health
and
human
32
services
for
the
fiscal
year
beginning
July
1,
2025,
and
ending
33
June
30,
2026,
the
following
amount,
or
so
much
thereof
as
is
34
necessary,
for
the
purposes
designated:
35
-11-
LSB
1004SV
(1)
91
lh/ko
11/
32
S.F.
649
To
supplement
the
appropriation
made
in
this
Act
from
the
1
general
fund
of
the
state
to
the
department
of
health
and
human
2
services
for
medical
assistance
for
the
same
fiscal
year:
3
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$111,216,205
4
Sec.
12.
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND
——
5
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES.
Notwithstanding
6
any
provision
of
law
to
the
contrary
and
subject
to
the
7
availability
of
moneys,
there
is
appropriated
from
the
hospital
8
health
care
access
trust
fund
created
in
section
249M.4
to
the
9
department
of
health
and
human
services
for
the
fiscal
year
10
beginning
July
1,
2025,
and
ending
June
30,
2026,
the
following
11
amount,
or
so
much
thereof
as
is
necessary,
for
the
purposes
12
designated:
13
To
supplement
the
appropriation
made
in
this
Act
from
the
14
general
fund
of
the
state
to
the
department
of
health
and
human
15
services
for
medical
assistance
for
the
same
fiscal
year:
16
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,920,554
17
SEX
REASSIGNMENT
SURGERY
OR
TREATMENT
18
Sec.
13.
MEDICAL
ASSISTANCE
PROGRAM
——
SEX
REASSIGNMENT
19
SURGERY
OR
TREATMENT.
Moneys
appropriated
in
this
Act
from
20
the
general
fund
of
the
state
to
the
department
of
health
and
21
human
services
for
the
fiscal
year
beginning
July
1,
2025,
and
22
ending
June
30,
2026,
and
allocated
for
the
medical
assistance
23
program,
shall
not
be
used
for
sex
reassignment
surgery
24
or
treatment
related
to
an
individual’s
gender
dysphoria
25
diagnosis.
The
department
of
health
and
human
services
shall
26
adopt
rules
pursuant
to
chapter
17A
to
administer
this
section.
27
Sec.
14.
REIMBURSEMENT
RATES.
28
1.
Reimbursement
for
medical
assistance,
state
29
supplementary
assistance,
and
social
service
providers
and
30
services
reimbursed
under
the
purview
of
the
department
31
of
health
and
human
services
shall
remain
at
the
current
32
reimbursement
rate,
or
shall
be
determined
pursuant
to
the
33
reimbursement
methodology
in
effect
on
June
30,
2025,
with
the
34
following
exceptions:
35
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a.
If
reimbursement
is
otherwise
negotiated
by
contract
or
1
pursuant
to
an
updated
fee
schedule.
2
b.
As
otherwise
provided
in
this
division.
3
2.
Of
the
moneys
appropriated
for
medical
assistance
4
program
reimbursement
and
associated
costs
as
specifically
5
provided
in
the
reimbursement
methodologies
in
effect
June
6
30,
2025,
the
following
amounts,
or
so
much
thereof
as
is
7
necessary,
are
allocated
to
the
department
of
health
and
human
8
services
to
be
used
for
the
following
purposes:
9
a.
(1)
Notwithstanding
any
provision
of
law
to
the
10
contrary,
for
the
fiscal
year
beginning
July
1,
2025,
and
11
ending
June
30,
2026,
the
department
of
health
and
human
12
services
shall
rebase
case-mix
nursing
facility
rates
beginning
13
July
1,
2025,
using
the
Medicaid
cost
reports
on
file
for
14
the
period
ending
December
31,
2024,
to
the
extent
possible
15
within
state
funding,
including
no
more
than
$16,000,000
16
from
the
allocation
provided
for
medical
assistance
program
17
reimbursement
and
associated
costs.
18
(2)
The
department
of
health
and
human
services
shall
19
calculate
each
nursing
facility’s
case-mix
index
for
the
period
20
beginning
July
1,
2024,
using
weighting
based
on
the
current
21
patient-driven
payment
model
schedule.
Rosters
shall
be
22
made
to
show
a
separate
calculation
to
determine
the
average
23
case-mix
index
for
a
nursing-facility-wide
case-mix
index,
and
24
a
case-mix
index
for
the
residents
of
a
nursing
facility
who
25
are
Medicaid
recipients
using
all
minimum
data
set
reports
by
26
the
nursing
facility
for
the
previous
semiannual
period
using
a
27
day
weighted
calculation.
28
b.
For
the
fiscal
year
beginning
July
1,
2025,
$420,000
29
shall
be
used
to
increase
to
the
extent
possible
reimbursement
30
rates
for
maternal
health
providers
compared
to
the
rates
in
31
effect
on
June
30,
2025.
32
c.
For
the
fiscal
year
beginning
July
1,
2025,
$2,000
shall
33
be
used
to
increase
to
the
extent
possible
reimbursement
rates
34
for
certified
nurse
midwives
compared
to
the
rates
in
effect
35
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on
June
30,
2025.
1
d.
For
the
fiscal
year
beginning
July
1,
2025,
reimbursement
2
rates
for
home
health
agencies
shall
continue
to
be
based
3
on
the
Medicare
low
utilization
payment
adjustment
(LUPA)
4
methodology
with
state
geographic
wage
adjustments
and
shall
be
5
adjusted
to
increase
the
rates
to
the
extent
possible.
6
e.
For
the
fiscal
year
beginning
July
1,
2026,
and
for
7
each
fiscal
year
thereafter,
the
department
shall
review
the
8
reimbursement
rates
for
home
health
agencies
and
pharmacy
9
dispensing
fees.
10
NURSING
FACILITIES
——
REIMBURSEMENT
METHODOLOGY
PROPOSAL
11
Sec.
15.
NURSING
FACILITIES
——
MEDICAID
REIMBURSEMENT
12
METHODOLOGY
PROPOSAL.
13
1.
By
April
1,
2026,
the
department
of
health
and
human
14
services
shall
develop
a
reimbursement
methodology
proposal
for
15
reimbursement
of
nursing
facilities
under
the
Medicaid
program
16
that
includes
all
of
the
following:
17
a.
A
base-rate
payment
component.
18
b.
A
quality
assurance
assessment
pass-through
component.
19
c.
A
quality
assurance
add-on
component,
which
includes
a
20
fixed
fee
payment
and
a
quality-based
payment.
21
2.
The
reimbursement
methodology
proposal
shall
include
22
recommendations
developed
by
the
department
of
health
and
human
23
services,
in
consultation
with
stakeholders
including
the
Iowa
24
health
care
association
and
leadingage
Iowa,
for
specific
25
metrics
the
department
of
health
and
human
services
will
use
26
to
determine
whether
a
nursing
facility
is
eligible
to
receive
27
all
or
a
portion
of
the
quality-based
payment
portion
of
the
28
reimbursement
to
the
nursing
facility.
29
3.
The
total
state
expenditures
for
reimbursement
of
30
nursing
facilities
under
the
Medicaid
program
using
the
31
reimbursement
methodology
proposed
in
this
section
shall
32
not
exceed
the
amount
appropriated
for
this
purpose
for
the
33
applicable
fiscal
year.
34
NURSING
FACILITY
FORECASTING
FORMULA
35
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Sec.
16.
NURSING
FACILITY
BED
FORECASTING
FORMULA
——
WORK
1
GROUP.
2
1.
The
department
of
health
and
human
services
shall
3
establish
a
work
group
to
make
recommendations
for
a
4
forecasting
formula
to
ensure
a
sufficient
number
of
nursing
5
facility
beds
are
available
to
meet
the
future
demand
for
6
nursing
facility
beds.
7
2.
The
work
group
shall
include
all
of
the
following
8
members:
9
a.
The
director
of
health
and
human
services,
or
the
10
director’s
designee.
11
b.
The
director
of
the
department
of
inspections,
appeals,
12
and
licensing,
or
the
director’s
designee.
13
c.
Multiple
representatives
of
nursing
facilities
located
14
in
this
state.
15
d.
A
representative
from
each
managed
care
organization
16
acting
pursuant
to
a
contract
with
the
department
of
health
and
17
human
services
to
administer
the
medical
assistance
program
18
under
chapter
249A.
19
e.
A
representative
of
appropriate
stakeholders
as
20
determined
by
the
director
of
health
and
human
services.
21
3.
On
or
before
July
1,
2026,
the
department
of
health
and
22
human
services
shall
use
the
recommendations
from
the
work
23
group
to
develop
and
implement
a
forecasting
formula
to
ensure
24
a
sufficient
number
of
nursing
facility
beds
are
available
to
25
meet
the
future
demand
for
nursing
facility
beds.
26
4.
The
department
of
health
and
human
services
shall
27
consider
the
forecasting
formula
developed
and
implemented
28
under
subsection
3
to
complete
the
formal
review
of
an
29
application
for
a
certificate
of
need
under
section
10A.719.
30
DIVISION
VII
31
FAMILY
WELL-BEING
AND
PROTECTION
——
FY
2025-2026
32
STATE
CHILD
CARE
ASSISTANCE
33
Sec.
17.
STATE
CHILD
CARE
ASSISTANCE.
There
is
appropriated
34
from
the
general
fund
of
the
state
to
the
department
of
health
35
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649
and
human
services
for
the
fiscal
year
beginning
July
1,
1
2025,
and
ending
June
30,
2026,
the
following
amount,
or
so
2
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
3
designated:
4
For
state
child
care
assistance
in
accordance
with
sections
5
237A.13
and
237A.14:
6
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
34,983,000
7
1.
If
the
appropriation
made
for
purposes
of
the
state
child
8
care
assistance
program
for
the
fiscal
year
are
determined
to
9
be
insufficient,
it
is
the
intent
of
the
general
assembly
to
10
appropriate
sufficient
moneys
for
the
fiscal
year
to
avoid
11
application
of
waiting
list
requirements.
12
2.
A
portion
of
the
state
match
for
the
federal
child
care
13
and
development
block
grant
shall
be
provided
as
necessary
to
14
meet
federal
matching
moneys
requirements
through
the
state
15
general
fund
appropriation
made
for
child
development
grants
16
and
other
programs
for
at-risk
children
in
section
279.51.
17
EARLY
INTERVENTION
AND
SUPPORTS
18
Sec.
18.
EARLY
INTERVENTION
AND
SUPPORTS.
There
is
19
appropriated
from
the
general
fund
of
the
state
to
the
20
department
of
health
and
human
services
for
the
fiscal
year
21
beginning
July
1,
2025,
and
ending
June
30,
2026,
the
following
22
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
23
purposes
designated:
24
For
promoting
optimum
health
status
for
children
and
25
adolescents
from
birth
through
21
years
of
age,
and
for
26
families:
27
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
36,301,904
28
1.
Of
the
moneys
appropriated
in
this
section,
not
more
29
than
$734,000
shall
be
used
for
the
healthy
opportunities
for
30
parents
to
experience
success
(HOPES)-healthy
families
Iowa
31
(HFI)
program
established
pursuant
to
section
135.106.
32
2.
Of
the
moneys
appropriated
in
this
section,
$4,313,854
33
is
allocated
for
the
FaDSS
grant
program,
and
not
more
than
5
34
percent
of
the
moneys
shall
be
used
for
administration
of
the
35
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649
grant
program.
1
3.
Of
the
moneys
appropriated
in
this
section,
$29,256,799
2
shall
be
deposited
in
the
early
childhood
Iowa
fund
created
in
3
section
256I.11.
4
4.
Of
the
moneys
appropriated
in
this
section,
$1,000,000
5
shall
be
used
for
the
purposes
of
program
administration
and
6
provision
of
pregnancy
support
services
through
the
more
7
options
for
maternal
support
program
in
accordance
with
section
8
217.41C.
9
CHILD
PROTECTIVE
SERVICES
10
Sec.
19.
CHILD
PROTECTIVE
SERVICES.
There
is
appropriated
11
from
the
general
fund
of
the
state
to
the
department
of
health
12
and
human
services
for
the
fiscal
year
beginning
July
1,
13
2025,
and
ending
June
30,
2026,
the
following
amount,
or
so
14
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
15
designated:
16
For
child,
family,
and
adoption
services,
and
for
salaries,
17
support,
maintenance,
and
miscellaneous
purposes:
18
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$166,308,818
19
1.
Of
the
moneys
appropriated
in
this
section,
$1,717,000
20
is
allocated
specifically
for
expenditure
for
the
fiscal
21
year
beginning
July
1,
2025,
through
the
decategorization
22
services
funding
pools
and
decategorization
governance
boards
23
established
pursuant
to
section
232.188.
24
2.
A
portion
of
the
moneys
appropriated
in
this
section
25
may
be
used
to
provide
other
resources
based
on
client
need
26
required
to
support
family
preservation,
emergency
client
need,
27
or
family
reunification
efforts.
28
3.
Of
the
moneys
appropriated
in
this
section,
a
sufficient
29
amount
is
allocated
for
foster
family
care,
group
foster
care
30
maintenance
and
services,
shelter
care,
child
welfare
emergency
31
services,
qualified
residential
treatment
programs,
supervised
32
apartment
living
contracts,
and
for
medical
assistance
program
33
reimbursement
and
associated
costs.
34
4.
Federal
moneys
received
by
the
state
during
the
fiscal
35
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649
year
beginning
July
1,
2025,
as
the
result
of
the
expenditure
1
of
state
moneys
appropriated
during
a
previous
state
fiscal
2
year
for
a
service
or
activity
funded
under
this
section,
are
3
appropriated
to
the
department
to
be
used
as
additional
moneys
4
for
services
and
purposes
provided
for
under
this
section.
5
Notwithstanding
section
8.33,
moneys
appropriated
under
this
6
subsection
that
remain
unencumbered
or
unobligated
at
the
close
7
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
8
for
the
purposes
designated
until
the
close
of
the
succeeding
9
fiscal
year.
10
5.
a.
Of
the
moneys
appropriated
in
this
section,
$748,000
11
is
allocated
for
the
payment
of
the
expenses
of
court-ordered
12
services
provided
to
children
who
are
under
the
supervision
13
of
the
department,
which
expenses
are
a
charge
upon
the
state
14
pursuant
to
section
232.141,
subsection
4.
15
b.
Notwithstanding
chapter
232
or
any
other
provision
of
16
law
to
the
contrary,
a
district
or
juvenile
court
shall
not
17
order
any
service
which
is
a
charge
upon
the
state
pursuant
to
18
section
232.141,
subsection
4,
if
the
court-ordered
services
19
distribution
amount
is
insufficient
to
pay
for
the
service.
20
6.
Of
the
moneys
appropriated
in
this
section,
$1,658,000
21
shall
be
used
for
child
protection
centers
located
in
Iowa
22
pursuant
to
the
child
protection
center
grant
program
under
23
section
135.118.
The
grant
amounts
under
the
program
shall
be
24
equalized
so
that
each
center
receives
a
uniform
base
amount
25
of
$245,000,
and
the
remaining
moneys
are
awarded
through
a
26
funding
formula
based
upon
the
volume
of
children
served
by
a
27
center.
To
increase
access
to
child
protection
center
services
28
for
children
in
rural
areas,
the
funding
formula
for
awarding
29
the
remaining
moneys
shall
provide
for
awarding
an
enhanced
30
amount
to
eligible
grantees
to
develop
and
maintain
satellite
31
centers
in
underserved
regions
of
the
state.
32
7.
Of
the
moneys
appropriated
in
this
section,
$4,359,500
33
is
allocated
for
the
preparation
for
adult
living
program
34
established
pursuant
to
section
234.46.
35
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649
8.
Of
the
moneys
appropriated
in
this
section,
up
to
1
$227,000
shall
be
used
for
the
public
purpose
of
continuing
a
2
grant
to
a
nonprofit
human
services
organization
that
provides
3
services
to
individuals
and
families
in
multiple
locations
in
4
southwest
Iowa
and
Nebraska,
for
support
of
a
project
providing
5
immediate,
sensitive
support
and
forensic
interviews,
medical
6
exams,
needs
assessments,
and
referrals
for
victims
of
child
7
abuse
and
their
nonoffending
family
members.
8
9.
Of
the
moneys
appropriated
in
this
section,
a
portion
may
9
be
used
for
family-centered
services
for
purposes
of
complying
10
with
the
federal
Family
First
Prevention
Services
Act
of
2018,
11
Pub.
L.
No.
115-123,
and
successor
legislation.
12
10.
a.
Of
the
moneys
appropriated
in
this
section,
a
13
sufficient
amount
is
allocated
for
adoption
subsidy
payments
14
and
related
costs.
15
b.
Any
moneys
remaining
after
the
allocation
under
16
paragraph
“a”
are
designated
and
allocated
as
state
savings
17
resulting
from
implementation
of
the
federal
Fostering
18
Connections
to
Success
and
Increasing
Adoptions
Act
of
2008,
19
Pub.
L.
No.
110-351,
and
successor
legislation,
as
determined
20
in
accordance
with
42
U.S.C.
§673(a)(8),
and
shall
be
used
for
21
post-adoption
services
and
for
other
purposes
allowed
under
22
those
federal
laws,
Tit.
IV-B
or
Tit.
IV-E
of
the
federal
23
Social
Security
Act.
24
11.
Of
the
moneys
appropriated
in
this
section,
a
sufficient
25
amount
is
allocated
to
support
training
needs
for
child
welfare
26
providers
and
to
address
disproportionality
within
the
child
27
welfare
system.
28
12.
If
a
separate
funding
source
is
identified
that
reduces
29
the
need
for
state
moneys
within
an
allocation
under
this
30
section,
the
allocated
state
moneys
may
be
redistributed
to
31
other
allocations
under
this
section
for
the
same
fiscal
year.
32
DIVISION
VIII
33
STATE-OPERATED
SPECIALTY
CARE
——
FY
2025-2026
34
Sec.
20.
STATE-OPERATED
SPECIALTY
CARE.
There
is
35
-19-
LSB
1004SV
(1)
91
lh/ko
19/
32
S.F.
649
appropriated
from
the
general
fund
of
the
state
to
the
1
department
of
health
and
human
services
for
the
fiscal
year
2
beginning
July
1,
2025,
and
ending
June
30,
2026,
the
following
3
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
4
purposes
designated:
5
For
salaries,
support,
maintenance,
and
miscellaneous
6
purposes
at
institutions
under
the
jurisdiction
of
the
7
department
of
health
and
human
services:
8
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$102,337,130
9
1.
The
department
shall
utilize
the
moneys
appropriated
in
10
this
section
as
necessary
to
maximize
bed
capacity
and
to
most
11
effectively
meet
the
needs
of
the
individuals
served.
12
2.
Of
the
moneys
appropriated
in
this
section,
the
following
13
amounts
are
allocated
to
each
institution
as
follows:
14
a.
For
the
state
mental
health
institute
at
Cherokee:
15
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
19,694,904
16
b.
For
the
state
mental
health
institute
at
Independence:
17
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
24,378,189
18
c.
For
the
civil
commitment
unit
for
sexual
offenders
at
19
Cherokee:
20
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
18,941,250
21
d.
For
the
state
resource
center
at
Woodward:
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,164,449
23
e.
For
the
state
resource
center
at
Glenwood:
24
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,296,062
25
f.
For
the
state
training
school
at
Eldora:
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
19,862,275
27
DIVISION
IX
28
ADMINISTRATION
AND
COMPLIANCE
——
FY
2025-2026
29
Sec.
21.
ACCOUNTABILITY,
COMPLIANCE,
PROGRAM
INTEGRITY,
AND
30
FULL-TIME
EQUIVALENT
POSITIONS.
There
is
appropriated
from
the
31
general
fund
of
the
state
to
the
department
of
health
and
human
32
services
for
the
fiscal
year
beginning
July
1,
2025,
and
ending
33
June
30,
2026,
the
following
amount,
or
so
much
thereof
as
is
34
necessary,
to
be
used
for
the
purposes
designated:
35
-20-
LSB
1004SV
(1)
91
lh/ko
20/
32
S.F.
649
For
accountability,
compliance,
and
program
integrity,
1
including
salaries,
support,
maintenance,
and
miscellaneous
2
purposes:
3
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
21,904,214
4
1.
Of
the
moneys
appropriated
in
this
section,
$2,602,312
5
shall
be
used
for
foster
care
review
and
the
court
appointed
6
special
advocate
program,
including
for
salaries,
support,
7
maintenance,
and
miscellaneous
purposes.
8
2.
Of
the
moneys
appropriated
in
this
section,
$1,148,959
9
shall
be
used
for
the
office
of
long-term
care
ombudsman
10
for
salaries,
support,
administration,
maintenance,
and
11
miscellaneous
purposes.
12
3.
For
the
fiscal
year
beginning
July
1,
2025,
and
ending
13
June
30,
2026,
the
department
of
health
and
human
services
may
14
utilize
moneys
appropriated
in
this
Act
from
the
general
fund
15
of
the
state
to
the
department
for
up
to
4,148.00
full-time
16
equivalent
positions.
The
department
shall
report
to
the
17
general
assembly
by
December
15,
2025,
the
distribution
of
the
18
approved
number
of
full-time
equivalent
positions
across
the
19
organizational
divisions
of
the
department.
20
DIVISION
X
21
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
TRANSFERS,
CASH
FLOW,
22
AND
NONREVERSIONS
——
FY
2025-2026
23
Sec.
22.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
TRANSFERS
24
AND
CASH
FLOW.
25
1.
Notwithstanding
any
provision
of
law
to
the
contrary,
26
the
department
of
health
and
human
services
may
transfer
moneys
27
appropriated
in
this
Act
to
support
continuing
alignment
28
efforts,
to
maximize
federal
support
in
accordance
with
the
29
department’s
federal
costs
allocation
plan,
and
for
resources
30
necessary
to
implement
and
administer
the
services
for
which
31
moneys
are
appropriated.
The
department
shall
report
any
32
transfers
made
pursuant
to
this
subsection
to
the
general
33
assembly.
34
2.
If,
due
to
ongoing
cost
management
efforts,
the
35
-21-
LSB
1004SV
(1)
91
lh/ko
21/
32
S.F.
649
appropriations
under
this
Act
for
the
Medicaid
program
1
exceed
the
associated
costs
for
the
Medicaid
program
for
the
2
fiscal
year,
the
department
may
transfer
any
savings
to
the
3
appropriations
made
in
this
Act
for
health
program
operations,
4
or
for
accountability,
compliance,
and
program
integrity,
5
to
defray
the
costs
associated
with
ongoing
cost
management
6
efforts.
7
3.
Notwithstanding
any
provision
of
law
to
the
contrary,
8
the
department
may
transfer
moneys
appropriated
under
this
Act
9
for
child
protective
services
to
pay
the
nonfederal
share
costs
10
of
services
reimbursed
under
the
medical
assistance
program,
11
state
child
care
assistance
program,
or
the
family
investment
12
program
which
are
provided
to
children
who
would
otherwise
13
receive
services
paid
by
the
appropriation
for
child
protective
14
services.
15
4.
The
department
may
transfer
moneys
from
the
temporary
16
assistance
for
needy
families
block
grant
to
the
federal
social
17
services
block
grant
appropriation,
and
to
the
child
care
and
18
development
block
grant
appropriation,
in
accordance
with
19
federal
law.
20
5.
To
the
extent
the
department
determines
that
moneys
21
appropriated
under
this
Act,
or
allocated
for
a
specific
22
purpose
under
this
Act,
will
remain
unencumbered
or
unobligated
23
at
the
close
of
the
fiscal
year,
such
unencumbered
or
24
unobligated
moneys
may
be
used
in
the
same
fiscal
year
for
any
25
other
purpose
for
which
the
appropriated
moneys
may
be
used,
or
26
for
any
other
allocation
within
the
same
appropriation.
27
Sec.
23.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
28
NONREVERSIONS.
29
1.
Notwithstanding
section
8.33,
moneys
appropriated
under
30
this
Act
from
the
general
fund
of
the
state
and
the
temporary
31
assistance
for
needy
families
block
grant
to
the
department
of
32
health
and
human
services
for
the
fiscal
year
beginning
July
1,
33
2025,
and
ending
June
30,
2026,
for
the
purposes
of
the
FaDSS
34
grant
program
that
remain
unencumbered
or
unobligated
at
the
35
-22-
LSB
1004SV
(1)
91
lh/ko
22/
32
S.F.
649
close
of
the
fiscal
year
shall
not
revert,
but
shall
remain
1
available
for
expenditure
for
the
purposes
designated
until
the
2
close
of
the
succeeding
fiscal
year.
3
2.
Notwithstanding
section
8.33,
of
the
moneys
appropriated
4
under
this
Act
from
the
general
fund
of
the
state,
the
quality
5
assurance
trust
fund,
and
the
hospital
health
care
access
trust
6
fund
to
the
department
of
health
and
human
services
for
the
7
fiscal
year
beginning
July
1,
2025,
and
ending
June
30,
2026,
8
for
the
purposes
of
the
medical
assistance
program,
the
amount
9
in
excess
of
actual
expenditures
for
the
medical
assistance
10
program
that
remains
unencumbered
or
unobligated
at
the
close
11
of
the
fiscal
year
shall
not
revert,
but
shall
remain
available
12
for
expenditure
for
the
medical
assistance
program
until
the
13
close
of
the
succeeding
fiscal
year.
14
3.
Notwithstanding
section
8.33,
and
notwithstanding
the
15
nonreversion
amount
limitation
specified
for
state
resource
16
centers
in
section
222.92,
subsection
4,
moneys
appropriated
17
under
this
Act
from
the
general
fund
of
the
state
to
the
18
department
of
health
and
human
services
for
the
fiscal
19
year
beginning
July
1,
2025,
and
ending
June
30,
2026,
for
20
the
purposes
of
state-operated
specialty
care
that
remain
21
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
22
shall
not
revert,
but
shall
remain
available
for
expenditure
23
for
the
purposes
designated
for
subsequent
fiscal
years.
24
4.
Notwithstanding
section
8.33,
moneys
appropriated
in
25
this
Act
from
the
general
fund
of
the
state
to
the
department
26
of
health
and
human
services
for
the
fiscal
year
beginning
July
27
1,
2025,
and
ending
June
30,
2026,
for
the
Iowa
commission
28
on
volunteer
service
for
programs
and
grants
that
remain
29
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
30
shall
not
revert,
but
shall
remain
available
for
expenditure
31
for
the
purposes
designated
for
subsequent
fiscal
years.
32
5.
Notwithstanding
section
8.33,
moneys
appropriated
under
33
this
Act
from
the
general
fund
of
the
state
to
the
department
34
of
health
and
human
services
for
the
fiscal
year
beginning
July
35
-23-
LSB
1004SV
(1)
91
lh/ko
23/
32
S.F.
649
1,
2025,
and
ending
June
30,
2026,
and
allocated
for
rural
1
psychiatric
residencies
that
remain
unencumbered
or
unobligated
2
at
the
close
of
the
fiscal
year
shall
not
revert,
but
shall
3
remain
available
for
expenditure
for
the
purposes
designated
4
until
the
close
of
the
succeeding
fiscal
year.
5
6.
Notwithstanding
section
8.33,
moneys
appropriated
6
under
this
Act
from
the
general
fund
of
the
state
to
the
7
department
of
health
and
human
services
for
the
fiscal
8
year
beginning
July
1,
2025,
and
ending
June
30,
2026,
and
9
allocated
for
adoption
subsidy
payments
and
related
costs,
or
10
for
post-adoption
services
and
related
allowable
purposes,
11
that
remain
unencumbered
or
unobligated
at
the
close
of
the
12
fiscal
year
shall
not
revert,
but
shall
remain
available
for
13
expenditure
for
the
purposes
designated
until
the
close
of
the
14
succeeding
fiscal
year.
15
DIVISION
XI
16
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
PRIOR
APPROPRIATIONS
17
AND
OTHER
PROVISIONS
18
THRIVE
IOWA
PROGRAM
CLOSED-LOOP
REFERRAL
SYSTEM
19
Sec.
24.
2024
Iowa
Acts,
chapter
1157,
section
21,
20
subsection
6,
is
amended
to
read
as
follows:
21
6.
To
the
extent
the
department
determines
that
moneys
22
appropriated
under
this
Act
will
remain
unencumbered
or
23
unobligated
at
the
close
of
the
fiscal
year
or
that
services
24
will
not
be
impacted,
the
department
may
utilize
up
to
25
$3,000,000
of
such
unencumbered
or
unobligated
moneys
26
appropriated
to
develop
and
support
the
thrive
Iowa
program,
27
a
closed-loop
referral
system
utilizing
a
navigator
model,
28
that
acts
as
the
connection
point
to
link
Iowans
on
an
29
individualized
path
to
prosperity
and
self-sufficiency
30
to
available
resources
in
all
sectors
of
the
community.
31
Notwithstanding
section
8.33,
any
moneys
utilized
for
this
32
purpose
shall
not
revert
but
shall
remain
available
for
33
expenditure
for
the
purposes
designated.
34
COMMUNITY
ACCESS
AND
ELIGIBILITY
35
-24-
LSB
1004SV
(1)
91
lh/ko
24/
32
S.F.
649
Sec.
25.
2024
Iowa
Acts,
chapter
1157,
section
22,
is
1
amended
by
adding
the
following
new
subsection:
2
NEW
SUBSECTION
.
7.
Notwithstanding
section
8.33,
moneys
3
appropriated
under
this
Act
from
the
general
fund
of
the
state
4
to
the
department
of
health
and
human
services
for
the
fiscal
5
year
beginning
July
1,
2024,
and
ending
June
30,
2025,
and
6
allocated
for
community
access
and
eligibility
that
remain
7
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
8
shall
not
revert
but
shall
remain
available
for
expenditure
for
9
the
purposes
designated,
or
are
appropriated
to
the
department
10
for
any
purpose
described
in
this
division
of
this
Act
or
to
be
11
used
as
necessary
to
enhance
the
department’s
accountability,
12
compliance,
program
integrity,
and
efficiency,
until
the
close
13
of
the
succeeding
fiscal
year.
14
Sec.
26.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
15
deemed
of
immediate
importance,
takes
effect
upon
enactment.
16
Sec.
27.
RETROACTIVE
APPLICABILITY.
This
division
of
this
17
Act
applies
retroactively
to
July
1,
2024.
18
DIVISION
XII
19
BEER
AND
LIQUOR
CONTROL
FUND
——
BEHAVIORAL
HEALTH
FUND
20
Sec.
28.
2024
Iowa
Acts,
chapter
1157,
is
amended
by
adding
21
the
following
new
section:
22
NEW
SECTION
.
SEC.
4A.
IN
LIEU
OF
STANDING
23
APPROPRIATION.
The
moneys
appropriated
and
allocated
in
this
24
division
of
this
Act
for
purposes
of
treatment
and
prevention
25
of
substance
use
and
misuse
and
addictive
behaviors
are
in
lieu
26
of
the
standing
appropriation
to
the
department
of
health
and
27
human
services
pursuant
to
section
123.17,
subsection
5,
for
28
the
fiscal
year
beginning
July
1,
2024.
29
Sec.
29.
2024
Iowa
Acts,
chapter
1161,
section
14,
is
30
amended
by
striking
the
section
and
inserting
in
lieu
thereof
31
the
following:
32
SEC.
14.
Section
123.17,
subsection
5
,
Code
2024,
is
amended
33
to
read
as
follows:
34
5.
After
any
transfer
provided
for
in
subsection
3
is
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made,
the
department
shall
transfer
into
a
special
revenue
1
account
in
the
general
fund
of
the
state,
a
sum
of
money
at
2
least
equal
to
seven
percent
of
the
gross
amount
of
sales
made
3
by
the
department
from
the
beer
and
liquor
control
fund
on
a
4
monthly
basis
but
not
less
than
nine
million
dollars
annually.
5
Of
the
amounts
transferred,
two
one
million
dollars,
plus
an
6
additional
amount
determined
by
the
general
assembly,
shall
be
7
appropriated
to
the
department
of
health
and
human
services
for
8
use
by
the
staff
who
administer
the
comprehensive
substance
use
9
disorder
program
under
chapter
125
for
substance
use
disorder
10
treatment
and
prevention
programs
shall
be
transferred
to
the
11
behavioral
health
fund
established
under
section
225A.7
.
Any
12
amounts
received
in
excess
of
the
amounts
appropriated
to
the
13
department
of
health
and
human
services
for
use
by
the
staff
14
who
administer
the
comprehensive
substance
use
disorder
program
15
under
chapter
125
transferred
to
the
behavioral
health
fund
16
shall
be
considered
part
of
the
general
fund
balance.
17
Sec.
30.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
18
deemed
of
immediate
importance,
takes
effect
upon
enactment.
19
Sec.
31.
RETROACTIVE
APPLICABILITY.
This
division
of
this
20
Act
applies
retroactively
to
July
1,
2024.
21
DIVISION
XIII
22
REPORT
ON
NONREVERSION
OF
MONEYS
23
Sec.
32.
REPORT
ON
NONREVERSION
OF
MONEYS.
The
department
24
of
health
and
human
services
shall
report
the
expenditure
of
25
any
moneys
for
which
nonreversion
authorization
was
provided
26
for
the
fiscal
year
beginning
July
1,
2024,
and
ending
June
30,
27
2025,
to
the
general
assembly
on
a
quarterly
basis
beginning
28
October
1,
2025.
29
DIVISION
XIV
30
EMERGENCY
RULES
31
Sec.
33.
EMERGENCY
RULES.
32
1.
If
necessary
to
comply
with
federal
requirements,
33
including
time
frames,
the
department
of
health
and
human
34
services
or
the
mental
health
and
disability
services
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commission
shall
adopt
administrative
rules
under
section
1
17A.4,
subsection
3,
and
section
17A.5,
subsection
2,
paragraph
2
“b”,
to
implement
the
applicable
provisions
of
this
Act.
The
3
rules
shall
be
effective
immediately
upon
filing
unless
a
4
later
date
is
specified
in
the
rules.
Any
rules
adopted
in
5
accordance
with
this
section
shall
also
be
published
as
a
6
notice
of
intended
action
as
provided
in
section
17A.4.
7
2.
If
the
department
of
health
and
human
services
adopts
8
emergency
rules
in
accordance
with
this
section,
or
as
9
otherwise
directed
or
authorized
by
state
law,
and
the
rules
10
will
result
in
an
increase
in
expenditures
beyond
the
amount
11
anticipated
in
the
budget
for
the
fiscal
year,
or
if
the
12
expenditures
were
not
addressed
in
the
budget
for
the
fiscal
13
year,
the
department
shall
notify
the
general
assembly
and
the
14
department
of
management
concerning
the
rules
and
the
increase
15
in
expenditures.
The
notification
shall
be
provided
at
least
16
thirty
calendar
days
prior
to
the
date
notice
of
the
rules
17
is
submitted
to
the
administrative
rules
coordinator
and
the
18
administrative
code
editor.
19
DIVISION
XV
20
MORE
OPTIONS
FOR
MATERNAL
SUPPORT
PROGRAM
21
Sec.
34.
Section
217.41C,
subsection
1,
paragraph
c,
22
subparagraph
(2),
Code
2025,
is
amended
to
read
as
follows:
23
(2)
“Provider
of
pregnancy
support
services”
or
“provider”
24
means
a
nonprofit
organization
that
provides
pregnancy
support
25
services
under
contract
with
the
program
administrator
or
the
26
department.
27
Sec.
35.
Section
217.41C,
subsections
3,
5,
and
6,
Code
28
2025,
are
amended
to
read
as
follows:
29
3.
The
department
may
shall
administer
the
program
directly
30
through
providers
of
pregnancy
support
services
or
may
issue
31
a
request
for
proposals
to
select
a
program
administrator
for
32
the
program
.
If
the
department
issues
a
request
for
proposals
33
and
selects
a
program
administrator,
the
program
administrator
34
shall
meet
all
of
the
following
requirements:
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a.
Be
a
nonprofit
entity
incorporated
in
this
state
with
a
1
tax-exempt
status
pursuant
to
section
501(c)(3)
of
the
Internal
2
Revenue
Code
.
3
b.
Create
and
maintain,
and
have
systems
and
processes
in
4
place
to
successfully
manage,
a
statewide
network
of
providers
5
of
pregnancy
support
services.
6
c.
Have
a
commitment
to
promoting
healthy
pregnancies
and
7
childbirth
instead
of
abortion
as
a
fundamental
part
of
the
8
program
administrator’s
mission.
9
d.
Maintain
records
for
each
provider
of
pregnancy
support
10
services.
11
e.
Monitor
compliance
with
the
terms
and
conditions
of
a
12
contract
with
a
provider
of
pregnancy
support
services.
13
5.
The
department
shall
adopt
rules
pursuant
to
chapter
14
17A
to
administer
the
program.
If
the
department
selects
a
15
program
administrator
through
a
request
for
proposals
process,
16
the
Notwithstanding
chapter
8A,
subchapter
III,
the
department
17
shall
use
an
application
process
to
approve
and
contract
with
18
each
provider
upon
verification
that
the
provider
meets
the
19
requirements
under
subsection
4.
The
department
shall
provide
20
technical
assistance
to
the
program
administrator,
monitor
21
the
program
administrator
for
adherence
to
state
and
federal
22
requirements,
and
collect
and
maintain
program
data
prospective
23
providers
to
facilitate
and
expedite
provider
participation
in
24
the
program
.
25
6.
Beginning
October
1,
2024,
and
on
Annually,
on
or
before
26
October
1
annually
thereafter
,
the
department
shall
submit
to
27
the
general
assembly
publish
on
the
department’s
internet
site,
28
pursuant
to
section
217.22,
the
following
program
information
29
relative
to
the
prior
immediately
preceding
fiscal
year:
30
a.
The
total
number
of
providers
of
pregnancy
support
31
services
by
geographical
region
and
the
total
number
of
32
unduplicated
clients
served
by
each
provider
by
gender
and
age.
33
b.
A
description
of
outreach
efforts
by
an
administrator,
34
providers
of
pregnancy
support
services,
and
the
department.
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c.
Total
program
expenditures.
1
d.
The
amounts
attributable
to
any
program
administrator
2
contract
administration
and
to
each
contract
with
a
provider
3
of
pregnancy
support
services
.
4
e.
The
outcomes
based
on
outcome
measures
included
in
the
5
contracts
with
any
program
administrator
and
each
provider
of
6
pregnancy
support
services
.
7
DIVISION
XVI
8
HOSPITAL
DIRECTED
PAYMENT
PROGRAM
9
Sec.
36.
NEW
SECTION
.
249O.1
Definitions.
10
As
used
in
this
chapter,
unless
the
context
otherwise
11
requires:
12
1.
“Centers
for
Medicare
and
Medicaid
services”
means
the
13
centers
for
Medicare
and
Medicaid
services
of
the
United
States
14
department
of
health
and
human
services.
15
2.
“Department”
means
the
department
of
health
and
human
16
services.
17
3.
“Hospital”
means
a
non-state-owned
hospital
licensed
by
18
the
state.
19
4.
“Hospital
directed
payment
program”
means
a
program
that
20
provides
a
state
directed
payment
to
a
hospital
for
inpatient
21
and
outpatient
hospital
services.
22
5.
“State
directed
payment”
means
the
same
as
defined
in
42
23
C.F.R.
§438.2.
24
Sec.
37.
NEW
SECTION
.
249O.2
Hospital
directed
payment
25
program.
26
1.
Prior
to
the
department
administering
a
hospital
27
directed
payment
program
under
this
chapter
for
any
specific
28
fiscal
year,
the
department
shall
submit
any
authorizing
29
documentation
necessary
to
the
centers
for
Medicare
and
30
Medicaid
services
for
approval.
Upon
receipt
of
approval
from
31
the
centers
for
Medicare
and
Medicaid
services,
the
department
32
shall
administer
the
hospital
directed
payment
program
during
33
the
specified
fiscal
year.
34
2.
a.
For
the
sole
purpose
of
the
hospital
directed
payment
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program,
the
department
may
impose
an
assessment
on
a
hospital.
1
The
total
amount
of
assessments
collected
by
the
department
2
shall
not
exceed
the
amount
necessary
to
fully
fund
the
3
nonfederal
share
of
the
maximum
state
directed
payment
allowed
4
under
federal
regulations.
5
b.
The
department
shall
establish
requirements
for
timely
6
payment
of
an
assessment,
and
any
penalties
for
late
payment
7
or
nonpayment
of
an
assessment.
Any
assessment
imposed
under
8
this
section
shall
constitute
a
debt
due
the
state
and
may
be
9
collected
by
civil
action
under
any
method
provided
by
law.
10
c.
The
department
and
a
third-party
administrator
contracted
11
with
the
department
may
collectively
assess
and
collect
an
12
administrative
fee
of
no
more
than
four
percent
of
the
amount
13
of
each
assessment
imposed.
14
3.
Any
assessments
and
penalties
collected
under
this
15
section
shall
be
used
for
the
purposes
of
the
hospital
directed
16
payment
program.
17
4.
a.
The
hospital
directed
payment
program
shall
not
18
be
administered,
an
assessment
shall
not
be
imposed,
and
a
19
hospital
shall
not
be
required
to
pay
an
assessment
if
federal
20
financial
participation
is
not
available,
or
if
the
hospital
21
directed
payment
program
and
imposition
of
an
assessment
are
22
not
approved
by
the
centers
for
Medicare
and
Medicaid
services.
23
b.
If
federal
law
or
policy
significantly
impacts
the
24
hospital
directed
payment
program
as
determined
by
the
25
department,
the
department,
in
collaboration
with
stakeholders,
26
may
terminate
the
hospital
directed
payment
program.
27
5.
The
department
shall
adopt
rules
pursuant
to
chapter
17A
28
as
necessary
to
administer
this
chapter.
29
EXPLANATION
30
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
31
the
explanation’s
substance
by
the
members
of
the
general
assembly.
32
This
bill
makes
appropriations
from
the
general
fund
of
33
the
state
to
the
department
of
veterans
affairs
and
to
the
34
department
of
health
and
human
services
(HHS)
for
fiscal
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year
2025-2026.
The
appropriations
from
the
general
fund
1
of
the
state
to
the
department
of
veterans
affairs
include
2
appropriations
for
administration,
the
Iowa
veterans
home,
and
3
the
home
ownership
assistance
program.
The
appropriations
from
4
the
general
fund
of
the
state
to
HHS
include
appropriations
5
for
aging
and
disability
services;
behavioral
health;
public
6
health;
community
access
and
eligibility
including
for
child
7
support
services;
the
medical
assistance
program,
state
8
supplementary
assistance,
the
healthy
and
well
kids
in
Iowa
9
(Hawki)
program,
and
other
specified
health-related
programs
10
including
health
program
operations;
family
well-being
and
11
protection
including
state
child
care
assistance,
early
12
intervention
and
supports,
and
child
protective
services;
13
state-operated
specialty
care;
and
administration
and
14
compliance.
15
The
bill
also
makes
appropriations
to
HHS
from
the
sports
16
wagering
receipts
fund,
the
pharmaceutical
settlement
account,
17
the
quality
assurance
trust
fund,
and
the
hospital
health
care
18
access
trust
fund.
19
The
bill
transfers
money
from
the
beer
and
liquor
control
20
fund
to
the
behavioral
health
fund.
21
The
bill
requires
HHS
to
develop
a
reimbursement
methodology
22
proposal
for
reimbursement
of
nursing
facilities
under
the
23
medical
assistance
program.
24
The
bill
requires
HHS
to
establish
a
work
group
to
make
25
recommendations
for
a
forecasting
formula
(formula)
related
26
to
the
future
demand
for
nursing
facility
beds.
HHS
shall
27
use
the
work
group’s
recommendations
to
develop
and
implement
28
a
forecasting
formula.
HHS
shall
consider
the
formula
to
29
complete
the
formal
review
of
an
application
for
a
certificate
30
of
need.
31
The
bill
limits
how
moneys
appropriated
to
the
early
32
childhood
Iowa
fund
shall
be
used
by
HHS.
33
The
bill
eliminates
the
option
for
HHS
to
select
a
program
34
administrator
to
administer
the
more
options
for
maternal
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support
program,
and
requires
that
HHS
administer
the
program.
1
The
bill
requires
HHS
to
submit
documentation
to
the
federal
2
centers
for
Medicare
and
Medicaid
services
for
approval
to
3
administer
a
hospital
directed
payment
program.
Upon
receipt
4
of
approval,
the
bill
permits
HHS
to
administer
a
hospital
5
directed
payment
program.
HHS
may
impose
an
assessment
on
a
6
hospital.
7
The
bill
includes
transfer,
cash
flow,
and
nonreversion
8
provisions,
emergency
rulemaking
authority,
and
reporting
9
requirements.
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