Bill Number: HF891
Title: Health & Human Services (HHS) Budget

Budget for health and human services programs for FY 2022, which begins on July 1, 2022.  Spends $2.048 billion (an increase of $59.4 million).  AGING: No change in funding for aging programs: $600,000 for home and community-based services through Area Agencies on Aging, $1 million for LifeLongLinks (Aging & Disability Resource Centers), $812,000 for elder abuse and exploitation programs, and $250,000 for pilot return to community program). No change in funding of Office of Long-Term Care Ombudsman.  PUBLIC HEALTH:  Overall increase of $2.1 million. No change in funding for Addictive Disorders (total $23,659,379, of which $19,638,485 goes substance use program – which is only $515 below current levels).  Continues $1.75 million from sports wagering fund for problem gambling and substance use prevention/treatment/recovery services funding. Increases funding for pharmaceutical infrastructure/donated drug program by $1 million ($600,000, plus $1 million in one-time funds to automate processing of donated medications);rural psychiatric residencies by $200,000 ($600,000 will support six residents); medical residency state matching grant program by $100,000 ($2.1 million); and special foods for individuals with inherited metabolic disorders such as phenylketonuria/PKU by $35,000 ($188,000).  New funding ($425,000) for one Center of Excellence to encourage innovation and collaboration among regional health providers to transform health care delivery. No change in funding for the donated dental services program for people with disabilities and older persons ($64,000); University of Iowa dental services to children ($23,000); audiology services and hearing aids for children ($156,000); youth suicide prevention ($50,000); survey of children with Adverse Childhood Experiences/ACES ($40,000); childhood obesity prevention ($494,000); dental education loan repayment program ($96,000); brain injury services ($1,055,000); epilepsy support ($144,000); child health specialty clinics ($809,000) and regional autism program in these clinics ($384,000); cervical and colon cancer screening ($274,000); Lions Club childhood vision screening ($95,000) and Prevent Blindness Iowa vision screening ($96,000); psychologist internship program ($48,000; language changed slightly to allow for telehealth services delivered into other areas); rural health clinics ($25,000); specialty health care programs/Polk County Medical Society ($225,000); free clinics ($334,000);public health/direct care/health care workforce initiatives ($191,000); psychiatric training for ARNPs and PAs ($150,000); EMS Services ($304,000); Sexual Violence Prevention Program & Sexual Assault Response Team/SART Training ($243,000); and essential public health services ($7.7 million); and infectious diseases ($1.8 million). VETERAN SERVICES: No change in funding for county veteran commissions ($990,000).  HUMAN SERVICES/MEDICAID: Increases overall funding by $44.2 million for Medicaid (enhanced federal match gives legislators room to increase spending in areas without big increase in appropriation) and$359,00 for the children’s health insurance program (hawk-I). Includes $11,002,240 increase in reimbursement for Home and Community Based Service/HCBS waiver providers (5.25% increase), $7,134,214 increase in reimbursement for habilitation providers, $2 million increase in home health provider rates, $1,031,530 to reduce children’s mental health HCBS waiver waiting list, $3.9 million increase in Psychiatric Medical Institutions for Children/PMIC reimbursement rates (27.7% increase), and $100,000 to improve ambulance reimbursements. Delays nursing home rate rebasing until July 1, 2023 (FY 2024) but allows up to $19 million to be used to apply an inflationary factor for rates (no change in methodology for special population nursing facility rates). Directs DHS to convene a work group of stakeholders to review nursing facility rebasing and consider quarterly rebasing, review the case-mix methodology, consideration of patient acuity, and use of cost reports (report 12/1/21). Increases the pharmacist dispensing fee by 31 cents (to $10.38; estimated cost is $567,445). All other provider rates and reimbursement processes remain the same(no funding for hospital rebasing).  HUMAN SERVICES/CHILDREN: Increases funding for Eldora State Training School by $1.4 million ($17.4 million). No change in funding formula for juvenile detention. No change in funding for child welfare ($89.1 million, including $31.5 million for group foster care), childcare, decategorization ($1.7 million) and allows unspent FY 2019 funds to roll over into FY 2021,court-ordered services ($3.3 million), school-based supervision ($1.6 million), juvenile delinquent graduated sanctions ($12.3 million), child protection centers ($1.7 million) and CPC community partnerships ($630,000), Preparation for Adult Living/PAL ($4.03 million), Project Harmony for child abuse survivors ($227,000), child sexual abuse initiative ($202,000), minority youth and family projects ($371,000), online child welfare provider training ($147,000), and Tanager Place behavioral health clinic for children ($110,000). Maintains standing appropriation for child abuse prevention ($233,000) and block grant (TANF) funding for child abuse prevention ($125,00). HUMAN SERVICES/FAMILY SUPPORT:  Increase of $1 million for family investment program/FIP for FADDS (Family Development and Self Sufficiency grants) and $478,000 for diversion services. No change in child abuse prevention grants ($125,000), pregnancy prevention grants ($1.9 million), PROMISE Jobs ($12 million), childcare ($47.2 million), and Family Support Subsidy/Children at Home ($949,282). HUMAN SERVICES/OTHER DISABILITY:  Increases funding for MHIs ($1.2 million for Cherokee, $450,735 for Independence).Cuts funding for Glenwood by $1.9 million and increases funding for Woodward by $1.3 million. No change in funding for State Supplemental Assistance/SSA ($7.4 million), HCBS Waiver habilitation provider technical assistance ($150,000),Iowa ABLE administration ($200,000), standardized assessments for persons with MI/ID/DD/BI ($3 million), applied behavior analysis/ABA coverage for children without any other insurance coverage ($573,000), and support for Children’s System State Board/other children’s behavioral health system administration ($300,000). HUMAN SERVICES/OTHER: Increases funding for the civil commitment unit for sexual offenders by $1.6 million ($13.6 million total).  Increases DHS field operations by $5 million ($60.4 million total). No change in funding for Refugee RISE funding to improve economic well-being and health of economically disadvantaged refugees ($200,000, and I-SMILE dental home initiative to connect children with dental services ($1 million).Adds $800,000 appropriation for nursing home infrastructure (previously funded in the infrastructure budget).  LAW CHANGES:  Adds in HF 485 (effective upon enactment), which prohibits the Board of Social Work and Board of Behavioral Science from requiring social worker, marital and family therapist, and mental health counselor supervision be completed in-person; prohibits the Board of Behavioral Science from requiring supervised clinical experience hours for marital or family therapists or mental health counselors in excess of the hours required for social workers; and allows LMFTs and LMHCs to supervise social workers going for their LISW.Adds in HF 852, which extends medical malpractice coverage for medical residents as a part of their matching grants for 7/1/2021 through 6/30/2026. Amends Physician Orders for Scope of Treatment (POST) to conform with national standards.States that federal COVID-19 regulations during the emergency supersede state administrative rules (i.e. Medicaid “flexibilities” allowed by federal government are to remain in effect, despite state rules that may be to the contrary).  Requires DHS to provide home and property coverage for foster parents to cover damages to property resulting from the actions of a foster child living in the home (allows DHS to establish a “reasonable limit”). Allows Polk County to transfer other county funds into the MH/DS Regional Services Fund (requires reporting).  Extends the repeal of the Hospital Health Care Access Assessment Program until July 1, 2023 (was set to end July 1, 2021). Requires DHS and Iowa Medicaid to review state and federal policies, laws, and administrative rules, and report back (by 10/1/21) with recommendations on how to make sure pediatric health services (including occupational therapy, physical therapy, speech-language pathology, and applied behavioral analysis) for Medicaid-eligible children are consistent with the EPSDT (Early Periodic Screening Diagnostic Treatment) program. Expands the requirements for MCO payment of court-ordered substance use disorder and mental health treatment services beyond orders via Chapter 125 and 229 for three days. You can find the final nonpartisan staff review of this budget at: effect 7/1/21.

Status: Signed
Recent Action: 5/17 - Passed House (54-34) 5/17 - Passed Passed Senate (43-1) 6/16 - Signed by Governor


Last Modified: 07/07/2021