Senate Study Bill 1267 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON APPROPRIATIONS BILL BY CHAIRPERSON KRAAYENBRINK) A BILL FOR 1 An Act relating to appropriations for health and human 2 services and veterans and including other related provisions 3 and appropriations, providing penalties, and including 4 effective date and retroactive and other applicability date 5 provisions. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 1004XC (10) 89 pf/rn S.F. _____ 1 DIVISION I 2 DEPARTMENT ON AGING —— FY 2021-2022 3 Section 1. DEPARTMENT ON AGING. There is appropriated from 4 the general fund of the state to the department on aging for 5 the fiscal year beginning July 1, 2021, and ending June 30, 6 2022, the following amount, or so much thereof as is necessary, 7 to be used for the purposes designated: 8 For aging programs for the department on aging and area 9 agencies on aging to provide citizens of Iowa who are 60 10 years of age and older with case management, Iowa’s aging and 11 disabilities resource center, and other services which may 12 include but are not limited to adult day, respite care, chore, 13 information and assistance, and material aid, for information 14 and options counseling for persons with disabilities who 15 are 18 years of age or older, and for salaries, support, 16 administration, maintenance, and miscellaneous purposes, and 17 for not more than the following full-time equivalent positions: 18 .................................................. $ 11,164,382 19 ............................................... FTEs 27.00 20 1. Funds appropriated in this section may be used to 21 supplement federal funds under federal regulations. To 22 receive funds appropriated in this section, a local area 23 agency on aging shall match the funds with moneys from other 24 sources according to rules adopted by the department. Funds 25 appropriated in this section may be used for elderly services 26 not specifically enumerated in this section only if approved 27 by an area agency on aging for provision of the service within 28 the area. 29 2. Of the funds appropriated in this section, $279,000 is 30 transferred to the economic development authority for the Iowa 31 commission on volunteer services to be used for the retired and 32 senior volunteer program. 33 3. a. The department on aging shall establish and enforce 34 procedures relating to expenditure of state and federal funds 35 by area agencies on aging that require compliance with both LSB 1004XC (10) 89 -1- pf/rn 1/80 S.F. _____ 1 state and federal laws, rules, and regulations, including but 2 not limited to all of the following: 3 (1) Requiring that expenditures are incurred only for goods 4 or services received or performed prior to the end of the 5 fiscal period designated for use of the funds. 6 (2) Prohibiting prepayment for goods or services not 7 received or performed prior to the end of the fiscal period 8 designated for use of the funds. 9 (3) Prohibiting prepayment for goods or services not 10 defined specifically by good or service, time period, or 11 recipient. 12 (4) Prohibiting the establishment of accounts from which 13 future goods or services which are not defined specifically by 14 good or service, time period, or recipient, may be purchased. 15 b. The procedures shall provide that if any funds are 16 expended in a manner that is not in compliance with the 17 procedures and applicable federal and state laws, rules, and 18 regulations, and are subsequently subject to repayment, the 19 area agency on aging expending such funds in contravention of 20 such procedures, laws, rules and regulations, not the state, 21 shall be liable for such repayment. 22 4. Of the funds appropriated in this section, at least 23 $600,000 shall be used to fund home and community-based 24 services through the area agencies on aging that enable older 25 individuals to avoid more costly utilization of residential or 26 institutional services and remain in their own homes. 27 5. Of the funds appropriated in this section, $812,000 shall 28 be used for the purposes of chapter 231E and to administer 29 the prevention of elder abuse, neglect, and exploitation 30 program pursuant to section 231.56A, in accordance with the 31 requirements of the federal Older Americans Act of 1965, 42 32 U.S.C. §3001 et seq., as amended. 33 6. Of the funds appropriated in this section, $1,000,000 34 shall be used to fund continuation of the aging and disability 35 resource center lifelong links to provide individuals and LSB 1004XC (10) 89 -2- pf/rn 2/80 S.F. _____ 1 caregivers with information and services to plan for and 2 maintain independence. 3 7. Of the funds appropriated in this section, $250,000 4 shall be used by the department on aging, in collaboration with 5 the department of human services and affected stakeholders, 6 to continue to expand the pilot initiative to provide 7 long-term care options counseling utilizing support planning 8 protocols, to assist non-Medicaid eligible consumers who 9 indicate a preference to return to the community and are 10 deemed appropriate for discharge, to return to their community 11 following a nursing facility stay. The department on aging 12 shall submit a report regarding the outcomes of the pilot 13 initiative to the governor and the general assembly by December 14 15, 2021. 15 DIVISION II 16 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2021-2022 17 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 18 appropriated from the general fund of the state to the office 19 of long-term care ombudsman for the fiscal year beginning July 20 1, 2021, and ending June 30, 2022, the following amount, or 21 so much thereof as is necessary, to be used for the purposes 22 designated: 23 For salaries, support, administration, maintenance, and 24 miscellaneous purposes, and for not more than the following 25 full-time equivalent positions: 26 .................................................. $ 1,149,821 27 ............................................... FTEs 16.00 28 DIVISION III 29 DEPARTMENT OF PUBLIC HEALTH —— FY 2021-2022 30 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 31 from the general fund of the state to the department of public 32 health for the fiscal year beginning July 1, 2021, and ending 33 June 30, 2022, the following amounts, or so much thereof as is 34 necessary, to be used for the purposes designated: 35 1. ADDICTIVE DISORDERS LSB 1004XC (10) 89 -3- pf/rn 3/80 S.F. _____ 1 For reducing the prevalence of the use of tobacco, alcohol, 2 and other drugs, and treating individuals affected by addictive 3 behaviors, including gambling, and for not more than the 4 following full-time equivalent positions: 5 .................................................. $ 23,659,379 6 ............................................... FTEs 12.00 7 a. (1) Of the funds appropriated in this subsection, 8 $4,021,000 shall be used for the tobacco use prevention 9 and control initiative, including efforts at the state and 10 local levels, as provided in chapter 142A. The commission 11 on tobacco use prevention and control established pursuant 12 to section 142A.3 shall advise the director of public health 13 in prioritizing funding needs and the allocation of moneys 14 appropriated for the programs and initiatives. Activities 15 of the programs and initiatives shall be in alignment with 16 the United States centers for disease control and prevention 17 best practices for comprehensive tobacco control programs that 18 include the goals of preventing youth initiation of tobacco 19 usage, reducing exposure to secondhand smoke, and promotion 20 of tobacco cessation. To maximize resources, the department 21 shall determine if third-party sources are available to 22 instead provide nicotine replacement products to an applicant 23 prior to provision of such products to an applicant under 24 the initiative. The department shall track and report to 25 the individuals specified in this Act, any reduction in 26 the provision of nicotine replacement products realized by 27 the initiative through implementation of the prerequisite 28 screening. 29 (2) (a) The department shall collaborate with the 30 alcoholic beverages division of the department of commerce for 31 enforcement of tobacco laws, regulations, and ordinances and to 32 engage in tobacco control activities approved by the division 33 of tobacco use prevention and control of the department of 34 public health as specified in the memorandum of understanding 35 entered into between the divisions. LSB 1004XC (10) 89 -4- pf/rn 4/80 S.F. _____ 1 (b) For the fiscal year beginning July 1, 2021, and ending 2 June 30, 2022, the terms of the memorandum of understanding, 3 entered into between the division of tobacco use prevention 4 and control of the department of public health and the 5 alcoholic beverages division of the department of commerce, 6 governing compliance checks conducted to ensure licensed retail 7 tobacco outlet conformity with tobacco laws, regulations, and 8 ordinances relating to persons under 21 years of age, shall 9 continue to restrict the number of such checks to one check per 10 retail outlet, and one additional check for any retail outlet 11 found to be in violation during the first check. 12 b. (1) Of the funds appropriated in this subsection, 13 $19,639,000 shall be used for problem gambling and 14 substance-related disorder prevention, treatment, and recovery 15 services, including a 24-hour helpline, public information 16 resources, professional training, youth prevention, and program 17 evaluation. 18 (2) Of the amount allocated under this paragraph, $306,000 19 shall be utilized by the department of public health, in 20 collaboration with the department of human services, to 21 maintain a single statewide 24-hour crisis hotline for the Iowa 22 children’s behavioral health system that incorporates warmline 23 services which may be provided through expansion of existing 24 capabilities maintained by the department of public health as 25 required pursuant to 2018 Iowa Acts, chapter 1056, section 16. 26 c. The requirement of section 123.17, subsection 5, is met 27 by the appropriations and allocations made in this division of 28 this Act for purposes of substance-related disorder treatment 29 and addictive disorders for the fiscal year beginning July 1, 30 2021. 31 2. HEALTHY CHILDREN AND FAMILIES 32 For promoting the optimum health status for children and 33 adolescents from birth through 21 years of age, and families, 34 and for not more than the following full-time equivalent 35 positions: LSB 1004XC (10) 89 -5- pf/rn 5/80 S.F. _____ 1 .................................................. $ 5,816,681 2 ............................................... FTEs 14.00 3 a. Of the funds appropriated in this subsection, not more 4 than $734,000 shall be used for the healthy opportunities for 5 parents to experience success (HOPES)-healthy families Iowa 6 (HFI) program established pursuant to section 135.106. 7 b. In order to implement the legislative intent stated 8 in sections 135.106 and 256I.9, priority for home visitation 9 program funding shall be given to programs using evidence-based 10 or promising models for home visitation. 11 c. Of the funds appropriated in this subsection, $3,075,000 12 shall be used for continuation of the department’s initiative 13 to provide for adequate developmental surveillance and 14 screening during a child’s first five years. The funds shall 15 be used first to fully fund the current sites to ensure that 16 the sites are fully operational, with the remaining funds 17 to be used for expansion to additional sites. The full 18 implementation and expansion shall include enhancing the scope 19 of the initiative through collaboration with the child health 20 specialty clinics to promote healthy child development through 21 early identification and response to both biomedical and social 22 determinants of healthy development; by monitoring child 23 health metrics to inform practice, document long-term health 24 impacts and savings, and provide for continuous improvement 25 through training, education, and evaluation; and by providing 26 for practitioner consultation particularly for children with 27 behavioral conditions and needs. The department of public 28 health shall also collaborate with the Iowa Medicaid enterprise 29 and the child health specialty clinics to integrate the 30 activities of the first five initiative into the establishment 31 of patient-centered medical homes, community utilities, 32 accountable care organizations, and other integrated care 33 models developed to improve health quality and population 34 health while reducing health care costs. To the maximum extent 35 possible, funding allocated in this paragraph shall be utilized LSB 1004XC (10) 89 -6- pf/rn 6/80 S.F. _____ 1 as matching funds for medical assistance program reimbursement. 2 d. Of the funds appropriated in this subsection, $64,000 3 shall be distributed to a statewide dental carrier to provide 4 funds to continue the donated dental services program patterned 5 after the projects developed by the dental lifeline network to 6 provide dental services to indigent individuals who are elderly 7 or with disabilities. 8 e. Of the funds appropriated in this subsection, $156,000 9 shall be used to provide audiological services and hearing aids 10 for children. 11 f. Of the funds appropriated in this subsection, $23,000 is 12 transferred to the university of Iowa college of dentistry for 13 provision of primary dental services to children. State funds 14 shall be matched on a dollar-for-dollar basis. The university 15 of Iowa college of dentistry shall coordinate efforts with the 16 department of public health, oral and health delivery system 17 bureau, to provide dental care to underserved populations 18 throughout the state. 19 g. Of the funds appropriated in this subsection, $50,000 20 shall be used to address youth suicide prevention. 21 h. Of the funds appropriated in this subsection, $40,000 22 shall be used to support the Iowa effort to address the survey 23 of children who experience adverse childhood experiences known 24 as ACEs. 25 i. Of the funds appropriated in this subsection, up to 26 $494,000 shall be used for childhood obesity prevention. 27 3. CHRONIC CONDITIONS 28 For serving individuals identified as having chronic 29 conditions or special health care needs, and for not more than 30 the following full-time equivalent positions: 31 .................................................. $ 4,223,373 32 ............................................... FTEs 10.00 33 a. Of the funds appropriated in this subsection, $153,000 34 shall be used for grants to individual patients who have an 35 inherited metabolic disorder to assist with the costs of LSB 1004XC (10) 89 -7- pf/rn 7/80 S.F. _____ 1 medically necessary foods and formula. 2 b. Of the funds appropriated in this subsection, $1,055,000 3 shall be used for the brain injury services program pursuant 4 to section 135.22B, including $861,000 for contracting with an 5 existing nationally affiliated and statewide organization whose 6 purpose is to educate, serve, and support Iowans with brain 7 injury and their families, for resource facilitator services 8 in accordance with section 135.22B, subsection 9, and for 9 contracting to enhance brain injury training and recruitment 10 of service providers on a statewide basis. Of the amount 11 allocated in this paragraph, $95,000 shall be used to fund 12 1.00 full-time equivalent position to serve as the state brain 13 injury services program manager. 14 c. Of the funds appropriated in this subsection, $144,000 15 shall be used for the public purpose of continuing to contract 16 with an existing nationally affiliated organization to provide 17 education, client-centered programs, and client and family 18 support for people living with epilepsy and their families. 19 The amount allocated in this paragraph in excess of $50,000