General Assembly: 76 (1995 Regular GA) - Chapter 212 - Appropriations — health and human rights


Published: 1995-05-19

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CH. 212 lAWS OF THE SEVENlY-SIXTH GA., 1995 SESSION

CHAPTER212 APPROPRIATIONS -HEALTH AND HUMAN RIGHTS

H.F. 530

658

AN ACT relating to and making appropriations to the department for the blind, the Iowa state civil rights commission, the department of elder affairs, the Iowa department of public health, the department of human rights, the commission of veterans affairs, and the governor's alliance on substance abuse.

Be It Enacted by the General Assembly of the State of Iowa:

Section 1. DEPARTMENT FOR THE BUND. There is appropriated from the general fund of the state to the department for the blind for the fiscal year beginning July 1, 1995, and ending June 30, 1996, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

1,377,786 95.00

Sec. 2. CML RIGHTS COMMISSION. There is appropriated from the general fund of the state to the Iowa state civil rights commission for the fiscal year beginning July 1, 1995, and ending June 30, 1996, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions:

·························································································································· $ 1,107,462 ................................................................................................................... FTEs 31.00

If the anticipated amount of federal funding from the federal equal employment opportunity commission and the federal department of housing and urban development exceeds $457,900 during the fiscal year beginning July 1, 1995, and ending June 30, 1996, the Iowa state civil rights commission may exceed the staffing level authorized by this section as necessary to hire additional staff to process or to support the processing of employment and housing complaints.

Sec. 3. DEPARTMENT OF ELDER AFFAIRS. There is appropriated from the general fund of the state to the department of elder affairs for the fiscal year beginning July 1, 1995, and ending June 30, 1996, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

1. For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

2. For aging programs and services:

444,877 28.00

·························································································································· $ 2,576,528 All funds appropriated in this subsection shall be received and disbursed by the director

of elder affairs for aging programs and services, shall not be used by the department for administrative purposes, not more than $151,654 shall be used for area agencies on aging administrative purposes, and shall be used for citizens of Iowa over 60 years of age for case management for the frail elderly, mental health outreach, Alzheimer's support, retired senior volunteer program, care review committee coordination, employment, adult day care, respite care, chore services, telephone reassurance, information and assistance, and home repair services, including the winterizing of homes, and for the construction of entrance ramps which make residences accessible to the physically handicapped. Funds appropriated in this subsection may be used to supplement federal funds under federal

659 lAWS OF THE SEVEN1Y-SIXTH GA, 1995 SESSION CH. 212

regulations. Funds appropriated in this subsection may be used for elderly services not specifically enumerated in this subsection only if approved by an area agency on aging for provision of the service within the area.

The department shall maintain policies and procedures regarding Alzheimer's support and the retired senior volunteer program. To receive funds appropriated in this subsection, a local area agency on aging shall match the funds with funds from other sources in accordance with rules adopted by the department.

Sec. 4. GOVERNOR'S SUBSTANCE ABUSE PREVENTION COORDINATOR. There is appropriated from the general fund of the state to the office of the governor's substance abuse prevention coordinator for the fiscal year beginning July 1, 1995, and ending June 30, 1996, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

1. For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

299,252 10.00

2. For the Iowa substance abuse clearinghouse in Cedar Rapids for staff, materials, and operating expenses: .......................................................................................................................... $ 32,894

Sec. 5. DEPARTMENT OF PUBUC HEALTH. There is appropriated from the general fund of the state to the Iowa department of public health for the fiscal year beginning July 1, 1995, and ending June 30, 1996, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

1. a. PlANNING AND ADMINISTRATION DIVISION For salaries, support, maintenance, miscellaneous purposes, and for not more than the

following full-time equivalent positions:

·························································································································· $ 2,089,708 ................................................................................................................... FTEs 64.65

(1) Of the funds appropriated in this lettered paragraph, $741,123 shall be used for the chronic renal disease program. The types of assistance available to eligible recipients under the program may include insurance premiums, travel reimbursement, and prescription and nonprescription drugs. The program expenditures shall not exceed this allocation. If projected expenditures would exceed the allocation, the department shall establish by administrative rule a mechanism to reduce financial assistance under the renal disease program in order to keep expenditures within the amount allocated in this paragraph.

(2) Hospitals shall not collect fees for birth certificates in excess of the fees as set out in the administrative rules of the Iowa department of public health.

(3) Of the funds appropriated in this lettered paragraph, $112,987 shall be used to provide regulatory oversight of accountable health plans.

b. PROFESSIONAL UCENSURE For salaries, support, maintenance, miscellaneous purposes, and for not more than the

following full-time equivalent positions:

·························································································································· $ 765,272 ................................................................................................................... FTEs 11.00

The director of public health, when estimating expenditure requirements for the boards funded under this paragraph, shall base the budget on 85 percent of the average annual fees generated for the previous two fiscal years. The department shall confer with the boards funded under this lettered paragraph in estimating the boards' annual fee generation and administrative costs. When the department develops each board's annual budget, a board's budget shall not exceed 85 percent of fees collected, based on the average of the previous two fiscal years. The department may expend funds in addition to amounts budgeted, if those additional expenditures are directly the result of unanticipated litigation

CH. 212 lAWS OF THE SEVENlY-SIXTH GA, 1995 SESSION 660

costs arising from the discharge of the board's regulato:ry duties. Before the department expends or encumbers an amount in excess of the funds budgeted for a board, the director of the department of management shall approve the expenditure or encumbrance. The amounts necessa:ry to fund the unanticipated litigation in the fiscal year beginning July 1, 1995, shall not exceed 5 percent of the average annual fees generated by the board for the previous two fiscal years.

c. HEALTH DELIVERY SYSTEMS (1) For salaries, support, maintenance, miscellaneous purposes, and for not more than

the following full-time equivalent positions: ............. ······ .... ·········· ..... ······ .............................................................................. $ 1 ,311 ,846 ................................................................................................................... FTEs 19.00

(2) Of the funds appropriated in this lettered paragraph, $163,859 is allocated for the office of rural health to provide technical assistance to rural areas in the area of health care delive:ry.

(3) Of the funds appropriated in this lettered paragraph, $1,015,358 shall be used for the training of emergency medical services (EMS) personnel at the state, county, and local levels.

If a person in the course of responding to an emergency renders aid to an injured person and becomes exposed to bodily fluids of the injured person, that emergency responder shall be entitled to hepatitis testing and immunization in accordance with the latest available medical technology to determine if infection with hepatitis has occurred. The person shall be entitled to reimbursement from the EMS funds available under this lettered paragraph only if the reimbursement is not available through any employer or third-party payor.

(4) Of the funds appropriated in this lettered paragraph, $132,629 shall be used to develop, implement, and maintain rural health provider recruitment and retention efforts.

d. CENTER FOR RURAL HEALTH AND PRIMARY CARE. For primacy care provider recruitment and retention endeavors:

.......................................................................................................................... $ 235,000 e. HEALTH DATA COMMISSION For the health data commission:

·························································································································· $ 75,000 (1) The funds appropriated in this lettered paragraph, plus any other funds received,

shall be used for the collection, verification, updating, and storage of data received pursuant to chapters 145 and 255A, and for the production of mandated reports. The health data commission shall establish a fee schedule, in consultation with its consultant, for the costs of providing data to organizations which request the data. The fee established shall be based upon the marginal cost and a portion of the fixed cost of providing the data.

(2) Prior to December 1, 1995, the commission shall submit to the general assembly a useful, comprehensive report for use by members of the general assembly in making informed decisions on public policy issues involving health.

(3) The health data commission shall provide a match of one dollar in advance of each state dollar provided.

2. HEALTH PROTECTION DMSION a. For salaries, support, maintenance, miscellaneous purposes, and for not more than

the following full-time equivalent positions:

·························································································································· $ 2,148,541 ................................................................................................................... FTEs 78.62

b. Of the funds appropriated in this subsection, $75,000 shall be used for chlamydia testing.

c. Of the funds appropriated in this subsection, $15,000 is allocated to support the surveillance and reporting of disabilities suffered by persons engaged in agriculture resulting from diseases or injuries, including identifying the amount and severity of agriculture- related injuries and diseases in the state, identifying causal factors associated with agriculture-related injuries and diseases, and evaluating the effectiveness of intervention

661 lAWS OF THE SEVEN1Y-SIXTH GA, 1995 SESSION CH. 212

programs designed to reduce injuries and diseases. The department shall cooperate with the department of agriculture and land stewardship, Iowa state university of science and technology, and the college of medicine at the state university of Iowa in accomplishing these duties.

d. Of the funds appropriated in this subsection, $7 4,54 7 shall be used for the lead abate- ment program.

The Iowa department of public health shall organize a coalition to consider federal re- quirements concerning lead poisoning and develop recommendations for submission to the general assembly on or before January 1, 1996, for proposed legislation regarding lead-poisoned persons. The coalition formed shall include, but is not limited to, represen- tatives of real estate agents, landlords, painting contractors, lead inspectors, local public health officials, and consumers.

*e. The radon program shall be eliminated July 1, 1995.* f. The state university of Iowa hospitals and clinics shall not receive indirect costs from

the funds appropriated in this subsection. g. As of July 1, 1995, the department shall no longer inspect laser light shows. 3. SUBSTANCE ABUSE AND HEALTH PROMOTION DMSION a. For salaries, support, maintenance, miscellaneous purposes, and for not more than

the following full-time equivalent positions:

·························································································································· $ 614,617 ................................................................................................................... FTEs 35.48

(1) The division shall continue the task force composed of substance abuse treatment and prevention providers regardless of funding source to study treatment and prevention service areas and the fiscal implications of awarding funds to more than one provider per service area.

(2) By July 1, 1997, the commission on substance abuse, in conjunction with the divi- sion, shall coordinate delivery of substance abuse services involving prevention, social and medical detoxification, and other treatment by medical and nonmedical providers to uninsured and court-ordered substance abuse patients in all counties of the state.

b. For program grants:

·························································································································· $ 8,390,159 Of the funds appropriated in this lettered paragraph, $193,500 shall be used for the

provision of aftercare services for persons completing substance abuse treatment. Of the funds appropriated in this lettered paragraph, a minimum of $950,000 shall be

used by the Iowa department of public health to implement an integrated substance abuse managed care system. The Iowa department of public health and the department of hu- man services shall collaborate with other appropriate state agencies, shall consider the recommendations of the 1994legislative interim study committee findings and the recom- mendations of the center for substance abuse technical assistance team in the develop- ment of an integrated managed care system, and shall assist in the submission of an appli- cation for a federal waiver relating to the system to the federal Health Care Financing Administration (HCF A). As part of this collaboration, the Iowa department of public health shall request outside technical assistance to provide recommendations on implementing this system. The Iowa department of public health and the department of human services shall implement an integrated managed care system starting July 1, 1995.

4. FAMILY AND COMMUNITY HEALTH DMSION a. For salaries, support, maintenance, miscellaneous purposes, and for not more than

the following full-time equivalent positions:

·························································································································· $ 3,040,236 ................................................................................................................... FTEs 62.00

(1) Of the funds appropriated in this lettered paragraph at least $587,865 shall be allo- cated by the division for the birth defects and genetics counseling program and of these funds, $279,402 is allocated for regional genetic counseling services contracted from the state university of Iowa hospitals and clinics under the control of the state board of regents.

"Item veto; see message at end of the Act

CH. 212 lAWS OF THE SEVEN1Y-SIXTH GA, 1995 SESSION 662

(2) Of the funds appropriated in this lettered paragraph, the following amounts are allocated to the state university of Iowa hospitals and clinics under the control of the state board of regents for the following programs under the Iowa specialized child health care services:

(a) Mobile and regional child health specialty clinics:

·························································································································· $ 392,931 The regional clinic located in Sioux City shall maintain a social worker component to

assist the families of children participating in the clinic program. Of the funds allocated in this subparagraph, $97,937 shall be used for a specialized

medical home care program providing care planning and coordination of community support services for children who require technical medical care in the home.

(b) Muscular dystrophy and related genetic disease programs:

·························································································································· $ 115,613 (c) Statewide perinatal program:

·························································································································· $ 61,693 (3) The birth defects and genetic counseling service shall apply a sliding fee scale to

determine the amount a person receiving the services is required to pay for the services. These fees shall be considered repayment receipts and used for the program.

(4) The state university of Iowa hospitals and clinics shall not receive indirect costs from the funds allocated in this lettered paragraph.

(5) Of the funds appropriated in this lettered paragraph, $1,001,209 shall be used for maternal and child health services.

(6) If during the 1995-1996 fiscal year, the federal government incorporates the special supplemental nutrition program for women, infants, and children into a block grant, the department of human services, Iowa department of public health, or any other state agency which administers the block grant shall require a competitive bid process for infant formula purchased by or for families under the block grant.

(7) The Iowa department of public health shall administer the statewide maternal and child health program, conduct mobile and regional child health specialty clinics, and conduct other activities to improve the health of low-income women and children and to promote the welfare of children with actual or potential handicapping conditions and chronic illnesses in accordance with the requirements of Title V of the federal Social Security Act.

(8) The department may budget for the programs in the family and community health division in accordance with the performance-based budgeting method. Notwithstanding section 8.23, for the budget process for the fiscal year beginning July 1, 1996, the department is not required to submit a budget for the programs using 75 percent base budgeting and decision package methodology. The department shall work cooperatively with the council on human investment in transitioning the performance-based budgeting method to the outcomes-based budget model developed by the council.

(9) The department shall continue efforts to realize the "Healthy Iowans 2000" goal of promoting prevention and health promotion to improve the quality of life of Iowans and to hold down health care costs and shall submit an annual "Healthy Iowans 2000" progress report to the general assembly on January 1 of each fiscal year.

b. Sudden infant death syndrome autopsies: For reimbursing counties for expenses resulting from autopsies of suspected victims of

sudden infant death syndrome required under section 331.802, subsection 3, paragraph "j":

·························································································································· $ 9,675 c. For grants to local boards of health for the public health nursing program:

·························································································································· $ 2,511,871 (1) Funds appropriated in this lettered paragraph shall be used to maintain and expand

the existing public health nursing program for elderly and low-income persons with the objective of preventing or reducing inappropriate institutionalization. The funds shall not be used for any other purpose. As used in this lettered paragraph, "elderly person" means

663 lAWS OF THE SEVEN1Y-SIXTH GA, 1995 SESSION CH. 212

a person who is 60 years of age or older and "low-income person" means a person whose income and resources are below the guidelines established by the department.

(2) One-fourth of the total amount to be allocated shall be divided so that an equal amount is available for use in each county in the state. Three-fourths of the total amount to be allocated shall be divided so that the share available for use in each county is proportionate to the number of elderly and low-income persons living in that county in relation to the total number of elderly and low-income persons living in the state.

(3) In order to receive allocations under this lettered paragraph, the local board of health having jurisdiction shall prepare a proposal for the use of the allocated funds available for that jurisdiction that will provide the maximum benefits of expanded public health nursing care to elderly and low-income persons in the jurisdiction. After approval of the proposal by the department, the department shall enter into a contract with the local board of health. The local board of health shall subcontract with a nonprofit nurses' association, an independent nonprofit agency, or a suitable local governmental body to use the allocated funds to provide public health nursing care. Local boards of health shall make an effort to prevent duplication of services.

(4) If by July 30 of the fiscal year, the department is unable to conclude contracts for use of the allocated funds in a county, the department shall consider the unused funds appropriated under this lettered paragraph an unallocated pool. If the unallocated pool is $50,000 or more it shall be reallocated to the counties in substantially the same manner as the original allocations. The reallocated funds are available for use in those counties during the period beginning January 1 and ending June 30 of the fiscal year. If the unallocated pool is less than $50,000, the department may allocate the pool to counties with demonstrated special needs for public health nursing.

(5) The department shall maintain rules governing the expenditure of funds appropriated in this lettered paragraph. The rules shall require each local agency receiving funds to establish and use a sliding fee scale for those persons able to pay for all or a portion of the cost of the care.

(6) The department shall annually evaluate the success of the public health nursing program. The evaluation shall include the extent to which the program reduced or prevented inappropriate institutionalization, the extent to which the program increased the availability of public health nursing care to elderly and low-income persons, and the extent of public health nursing care provided to elderly and low-income persons. The department shall submit a report of each annual evaluation to the governor and the general assembly.

d. For grants to county boards of supervisors for the home care aide program:

·························································································································· $ 8,586,716 Funds appropriated in this lettered paragraph shall be used to provide home care aide

services with emphasis on services to elderly and persons below the poverty level and children and adults in need of protective services with the objective of preventing or reducing inappropriate institutionalization. In addition, up to 15 percent of the funds appropriated in this lettered paragraph may be used to provide chore services. The funds shall not be used for any other purposes. In providing services to elderly persons, the service provider shall coordinate efforts with the integrated case management for the frail elderly program of the department of elder affairs. As used in this lettered paragraph:

(1) "Chore services" means services provided to individuals or families, who, due to incapacity, or illness, are unable to perform certain home maintenance functions. The services include but are not limited to yard work such as mowing lawns, raking leaves, and shoveling walks; window and door maintenance such as hanging screen windows and doors, replacing windowpanes, and washing windows; and minor repairs to walls, floors, stairs, railings, and handles. It also includes heavy house cleaning which includes cleaning attics or basements to remove fire hazards, moving heavy furniture, extensive wall washing, floor care or painting, and trash removal.

(2) "Elderly person" means a person who is 60 years of age or older.

CH. 212 lAWS OF THE SEVENlY-SIXTH GA., 1995 SESSION 664

(3) "Home care aide services" means services intended to enhance the capacity of household members to attain or maintain the independence of the household members and provided by trained and supervised workers to individuals or families, who, due to the absence, incapacity, or limitations of the usual homemaker, are experiencing stress or crisis. The services include but are not limited to essential shopping, housekeeping, meal preparation, child care, respite care, money management and consumer education, family management, personal services, transportation and providing information, assistance, and household management.

(4) "Low-income person" means a person whose income and resources are below the guidelines established by the department.

(5) "Protective services" means those home care aide services intended to stabilize a child's or an adult's residential environment and relationships with relatives, caretakers, and other persons or household members in order to alleviate a situation involving abuse or neglect or to otherwise protect the child or adult from a threat of abuse or neglect.

The amount appropriated in this lettered paragraph shall be allocated for use in the counties of the state. Fifteen percent of the amount shall be divided so that an equal amount is available for use in each county in the state. The following percentages of the remaining amount shall be allocated to each county according to that county's proportion of residents with the following demographic characteristics: 60 percent according to the number of elderly persons living in the county, 20 percent according to the number of persons below the poverty level living in the county, and 20 percent according to the number of substantiated cases of child abuse in the county during the three most recent fiscal years for which data is available.

In order to receive allocations in this lettered paragraph, the county board of supervisors, after consultation with the local boards of health, human services county cluster boards, area agency on aging advisory council, local office of the department of human services, and other in-home health care provider agencies in the jurisdiction, shall prepare a proposal for the use of the allocated funds available for that jurisdiction that will provide the maximum benefits of home care aide services to elderly and low-income persons and children and adults in need of protective services in the jurisdiction. An agency requesting service or financial information about a current subcontractor shall provide similar information concerning its own home care aide or chore services program to the current subcontractor. The proposal may provide that a maximum of 15 percent of the allocated funds will be used to provide chore services. The proposal shall include a statement assuring that children and adults in need of protective services are given priority for home care aide services and that the appropriate local agencies have participated in the planning for the proposal. After approval of the proposal by the department, the department shall enter into a contract with the county board of supervisors or a governmental body designated by the county board of supervisors. The county board of supervisors or its designee shall subcontract with a nonprofit nurses' association, an independent nonprofit agency, the department of human services, or a suitable local governmental body to use the allocated funds to provide home care aide services and chore services providing that the subcontract requires any service provided away from the home to be documented in a report available for review by the department, and that each home care aide subcontracting agency shall maintain the direct service workers' time assigned to direct client service at 70 percent or more of the workers' paid time and that not more than 35 percent of the total cost of the service be included in the combined costs for service administration and agency administration. The subcontract shall require that each home care aide subcontracting agency shall pay the employer's contribution of social security and provide workers' compensation coverage for persons providing direct home care aide service and meet any other applicable legal requirements of an employer-employee relationship.

If by July 30 of the fiscal year, the department is unable to conclude contracts for use of the allocated funds in a county, the department shall consider the unused funds appropriated

665 lAWS OF THE SEVENTY-SIXTH GA, 1995 SESSION CH. 212

in this lettered paragraph an unallocated pool. The department shall also identify any allocated funds which the counties do not anticipate spending during the fiscal year. If the amount of anticipated excess funds to any county is substantial, the department and the county may agree to return those excess funds, if the funds are other than program revenues, to the department, and if returned, the department shall consider the returned funds a part of the unallocated pool. The department shall, prior to February 15 of the fiscal year, reallocate the funds in the unallocated pool among the counties in which the department has concluded contracts under this lettered paragraph. The department shall also review the first 10 months' expenditures for each county in May of the fiscal year, to determine if any counties possess contracted funds which they do not anticipate spending. If such funds are identified and the county agrees to release the funds, the released funds will be considered a new reallocation pool. The department may, prior to June 1 of the fiscal year, reallocate funds from this new reallocation pool to those counties which have experienced a high utilization of protective service hours for children and dependent adults.

The department shall maintain rules governing the expenditure of funds appropriated in this lettered paragraph. The rules shall require each local agency receiving funds to establish and use a sliding fee scale for those persons able to pay for all or a portion of the cost of the services and shall require the payments to be applied to the cost of the services. The department shall also maintain rules for standards regarding training, supervision, recordkeeping, appeals, program evaluation, cost analysis, and financial audits, and rules specifying reporting requirements.

The department shall annually evaluate the success of the home care aide program. The evaluation shall include a description of the program and its implementation, the extent of local participation, the extent to which the program reduced or prevented inappropriate institutionalization, the extent to which the program provided or increased the availability of home care aide services to elderly and low-income persons and children and adults in need of protective services, any problems and recommendations concerning the program, and an analysis of the costs of services across the state. The department shall submit a report of the annual evaluation to the governor and the general assembly.

e. For the development and maintenance of well-elderly clinics in the state:

·························································································································· $ 585,337 The appropriation in this lettered paragraph shall be distributed by a formula to well-

elderly clinics located in counties which provide funding on a matching basis for the well- elderly clinics.

f. For the physician care for children program:

·························································································································· $ 411,187 The physician services shall be subject to managed care and selective contracting

provisions and shall be used to provide for the medical treatment of children and shall include coverage of diagnostic procedures, prescription drugs, and physician-ordered treatments necessary to treat an acute condition. Services provided under this lettered paragraph shall be reimbursed according to medical assistance reimbursement rates.

g. For primary and preventive health care for children:

·························································································································· $ 75,000 Funds appropriated in this lettered paragraph shall be for the public purpose of providing

a renewable grant, following a request for proposals, to a statewide charitable organization within the meaning of section 501 (c) (3) of the Internal Revenue Code which was organized prior to April1, 1989, and has as one of its purposes the sponsorship or support for programs designed to improve the quality, awareness, and availability of health care for the young, to serve as the funding mechanism for the provision of primary health care and preventive services to children in the state who are uninsured and who are not eligible under any public plan of health insurance, provided all of the following conditions are met:

(1) The organization shall provide a match of four dollars in advance of each state dollar provided.

CH. 212 lAWS OF THE SEVEN1Y-SIXTH GA, 1995 SESSION 666

(2) The organization coordinates services with new or existing public programs and services provided by or funded by appropriate state agencies in an effort to avoid inappropriate duplication of services and ensure access to care to the extent as is reasonably possible. The organization shall work with the Iowa department of public health, family and community health division, to ensure duplication is minimized.

(3) The organization's governing board includes in its membership representatives from the executive and legislative branches of state government.

( 4) Grant funds are available as needed to provide services and shall not be used for administrative costs of the department or the grantee.

h. For the Iowa healthy family program under section 135.106: .......................................................................................................................... $ 665,000

The moneys appropriated in this lettered paragraph shall be granted pursuant to 1992 Iowa Acts, Second Extraordinary Session, chapter 1001, section 415, except that the grants shall be extended for an additional year. Notwithstanding the provisions of 1992 Iowa Acts, Second Extraordinary Session, chapter 1001, section 416, the use of mid-level practitioners to improve access to prenatal care shall include obstetrical-gynecological nurse practitioners and family nurse practitioners focusing on maternal and child health. The department is encouraged to expand funding eligibility under the program to private physician and clinic-sponsored programs servicing low-income populations. The administrative entities of the Iowa health family program shall work collaboratively to assure continuity of the provision of services from the prenatal to the preschool period to an individual client by having a single resource mother work with that client. The department shall submit an annual report to the general assembly concerning the efficiency of the healthy family program and make any recommendations for improvements. By January 1, 1996, the department shall submit a report to the governor and the general assembly on the efforts to increase the use of mid-level practitioners under the program. Any funds contracted to agencies under this paragraph which are projected to be unused at the close of the fiscal year shall be allowed to be reallocated within the health family program by April 1, 1996.

The Iowa department of public health and the department of human services shall determine if expenses under any portion of the healthy family program would qualify for payment under the medical assistance program and if so, shall apply to the federal government for a medical assistance waiver. The Iowa department of public health and the department of human services shall evaluate the funding change's potential impact upon clients of the healthy family program.

Contingent upon appropriation by the general assembly, the healthy opportunities for parents to experience success program, authorized in the 1992 Iowa Acts, Second Extraordinary Session, chapter 1001, section 414, shall be implemented or expanded in the following priority order:

(1) Expansion of the program to be fully funded in Scott, Woodbury, and Polk counties. (2) Implementation of the program in Adams, Decatur, Ringgold, and Union counties. (3) Implementation of the program in Boone and Dickinson counties. If there is inadequate funding for the priority in subparagraph (1), the moneys available

shall be divided among the three counties. If the implementation in any county enumerated in subparagraph (2) or (3) is unsuccessful, the contractor may substitute another county with similar demographics.

5. STATE BOARD OF DENTAL EXAMINERS For salaries, support, maintenance, miscellaneous purposes, and for not more than the

following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

6. STATE BOARD OF MEDICAL EXAMINERS

285,314 4.00

For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions:

667 lAWS OF THE SEVENlY-SIXTH GA, 1995 SESSION

·························································································································· $ ................................................................................................................... FTEs

7. STATE BOARD OF NURSING EXAMINERS

CH. 212

1,002,545 18.00

For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

8. STATE BOARD OF PHARMACY EXAMINERS

923,661 17.00

For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

657,113 11.00

9. The state board of medical examiners, the state board of pharmacy examiners, the state board of dental examiners, and the state board of nursing examiners shall prepare estimates of projected receipts to be generated by the licensing, certification, and examination fees of each board as well as a projection of the fairly apportioned administrative costs and rental expenses attributable to each board. Each board shall annually review and adjust its schedule of fees so that, as nearly as possible, projected receipts equal projected costs.

10. The state board of medical examiners, the state board of pharmacy examiners, the state board of dental examiners, and the state board of nursing examiners shall retain their individual executive officers, but are strongly encouraged to share administrative, clerical, and investigative staffs to the greatest extent possible.

11. A local health care provider or nonprofit health care organization seeking grant moneys administered by the Iowa department of public health shall provide documentation that the provider or organization has coordinated its services with other local entities providing similar services.

Sec. 6. DEPARTMENT OF HUMAN RIGHTS. There is appropriated from the general fund of the state to the department of human rights for the fiscal year beginning July 1, 1995, and ending June 30, 1996, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

1. CENTRAL ADMINISTRATION DMSION For salaries, support, maintenance, miscellaneous purposes, and for not more than the

following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

2. COMMUNITY ACTION AGENCIES DIVISION For the expenses of the community action agencies commission:

.......................................................................................................................... $ 3. DEAF SERVICES DIVISION

181,314 6.60

3,366

For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

248,574 8.00

The fees collected by the division for provision of interpretation services by the division to obligated agencies shall be disbursed pursuant to the provisions of section 8.32, and shall be dedicated and used by the division for the provision of continued and expanded interpretation services.

4. PERSONS WITH DISABILITIES DIVISION For salaries, support, maintenance, miscellaneous purposes, and for not more than the

following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

57,206 1.0

CH. 212 lAWS OF THE SEVEN1Y-SIXTH GA, 1995 SESSION 668

5. IATINO AFFAIRS DMSION For salaries, support, maintenance, miscellaneous purposes, and for not more than the

following full-time equivalent positions: .......................................................................................................................... $ ................................................................................................................... FTEs

6. STATUS OF WOMEN DMSION

97,207 2.00

For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions:

·························································································································· $ 390,486 ................................................................................................................... FTEs 4.50

a. Of the funds appropriated in this subsection, at least $125,775 shall be spent for the displaced homemaker program.

b. Of the funds appropriated in this subsection, at least $42,5 70 shall be spent for domestic violence and sexual assault -related grants.

c. Of the funds appropriated in this subsection, at least $41,297 shall be spent for the mentoring project for family investment program participants developed in accordance with section 239.22.

7. STATUS OF AFRICAN-AMERICANS DMSION For salaries, support, maintenance, miscellaneous purposes, and for not more than the

following full-time equivalent positions:

·························································································································· $ ................................................................................................................... FTEs

8. CRIMINAL AND JUVENILE JUSTICE PlANNING DMSION

99,301 2.00

For salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions:

·························································································································· $ 459,523 ................................................................................................................... FTEs 10.05

a. The criminal and juvenile justice planning advisory council and the juvenile justice advisory council shall coordinate their efforts in carrying out their respective duties relative to juvenile justice.

b. Of the funds appropriated in this subsection, at least $36,300 shall be spent for expenses relating to the administration of federal funds for juvenile assistance. It is the intent of the general assembly that the department of human rights employ sufficient staff to meet the federal funding match requirements established by the federal office for juvenile justice delinquency prevention. The governor's advisory council on juvenile justice shall determine the staffing level necessary to carry out federal and state mandates for juvenile justice.

9. COMMUNTIY GRANT FUND For the community grant fund established under section 232.190 for new grants and the

continuation of existing grants for the fiscal year beginning July 1, 1995, and ending June 30, 1996, to be used for the purposes of the community grant fund:

·························································································································· $ 1,800,000 New grant proposals and continuation grant recipients shall demonstrate community

collaboration, not merely disbursements of funds to various organizations, and shall show significant progress toward achieving objectives set forth in the proposal such as process and impact evaluation objectives, including objectives related to the number of persons served. Letters of support shall include specific commitments and shall be binding.

10. SHARED STAFF. Except for the persons with disabilities division which shall be administered by the director of the department of human rights, the divisions of the department of human rights shall retain their individual administrators, but shall share staff to the greatest extent possible.

Sec. 7. COMMISSION OF VETERANS AFFAIRS. There is appropriated from the general fund of the state to the commission of veterans affairs for the fiscal year beginning July 1, 1995, and ending June 30, 1996, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

669 lAWS OF THE SEVENIY-SIXTH GA, 1995 SESSION CH. 212

1. COMMISSION OF VETERANS AFFAIRS ADMINISTRATION For salaries, support, maintenance, and miscellaneous purposes, and for not more than

the following full-time equivalent positions: .......................................................................................................................... $ 213,107 ................................................................................................................... FTEs 5.00

The commission of veterans affairs may use the gifts accepted by the chairperson of the commission of veterans affairs, or designee, and other resources available to the commission for use at its Camp Dodge office. The commission shall report annually to the governor and the general assembly on monetary gifts received by the commission for the Camp Dodge office.

2. WAR ORPHANS For the war orphans educational aid fund established pursuant to chapter 35:

·························································································································· $ 4,800 3. IOWA VETERANS HOME For salaries, support, maintenance, and miscellaneous purposes and for not more than

the following full-time equivalent positions:

·························································································································· $ 37,795,008 ................................................................................................................... FTEs 803.62

a. The Iowa veterans home may use the gifts accepted by the chairperson of the commission of veterans affairs and other resources available to the commission for use at the Iowa veterans home.

b. If medical assistance revenues are expanded at the Iowa veterans home, and this expansion results in medical assistance reimbursements which exceed the amount budgeted for that purpose in the fiscal year beginning July 1, 1995, and ending June 30, 1996, the Iowa veterans home may expend the excess amounts to exceed the number of full-time equivalent positions authorized in this section for the purpose of meeting related certification requirements or to provide additional beds. The expenditure of additional funds received, as outlined in this paragraph, is subject to the approval by the department of management.

*Sec. 8. DEPARTMENT OF HUMAN RIGHTS- ADMINISTRATWE STRUCTURE. The divisions of the department of human rights shall study options for transferring the responsibilities of the department into other agencies of state government, should the department of human rights be eliminated at the commencement of the fiscal year beginning July 1, 1996. The goal of the shift of the administrative responsibilities of the divisions is to eliminate duplication and increase efficiency while maintaining the advocacy responsibilities of the divisions. The study shall include advantages and disadvantages of any proposed options. The divisions shall report the study findings to the governor and the general assembly on or before December 15, 1995. The study shall include the following:

1. The community action agencies division shall identify the most appropriate state agencies as options for relocation for administrative efficiency.

2. The deaf services division shall plan for becoming a separate department of state government.

3. The Iowa state civil rights commission and the divisions of persons with disabilities, Latino affairs, and the status of African-Americans shall plan for incorporating the divisions' functions into the commission.

4. The division on the status of women and the director of the department of economic development shall plan for incorporating the division into the department.

5. The criminal and juvenile justice planning division shall consult with the office of the attorney general and the governor's substance abuse coordinator to identify the most appropriate state agency to which the division would relocate.*

Sec. 9. Section 216A2, Code 1995, is amended to read as follows: 216A2 APPOINTMENT OF DEPARTMENT DIRECTOR AND ADMINISTRATORS. The governor shall appoint a director of the department of human rights, subject to

confirmation by the senate. The department director shall serve at the pleasure of the governor. The department director shall:

•nem veto; see message at end of the Act

CH. 212 lAWS OF THE SEVEN1Y-SIXTH GA, 1995 SESSION 670

1. Establish general operating policies for the department to provide general unifor- mity among the divisions while providing for necessary flexibility.

2. Receive budgets submitted by each commission and reconcile the budgets among the divisions. The department director shall submit a budget for the department, subject to the budget requirements pursuant to chapter 8.

3. Coordinate and supervise personnel services and shared administrative support ser- vices to assure maximum support and assistance to the divisions.

4. Identify and, with the chief administrative officers of each division, facilitate the opportunities for consolidation and efficiencies within the department.

5. In cooperation with the commissions, make recommendations to the governor re- garding the appointment of the administrator of each division.

6. Serve as an ex officio member of all commissions or councils within the department. 7. Serve as chairperson of the human rights administrative-coordinating council. 8. Evaluate each administrator, after receiving recommendations from the appropriate

commissions or councils, and submit a written report of the completed evaluations to the governor and the appropriate commissions or councils, annually.

9. Administer the division of persons with disabilities. The governor shall appoint the administrators of each of the divisions. except for the

division of persons with disabilities. subject to confirmation by the senate. Each adminis- trator shall serve at the pleasure of the governor and is exempt from the merit system provisions of chapter 19A The governor shall set the salacy of the division administrators within the ranges set by the general assembly.

Sec. 10. Section 216A71, subsection 1, Code 1995, is amended to read as follows: 1. "Administrator" means the administrator of the divisioa of peFSoRs vAth disahilities

of the department of human rights.

Sec. 11. Section 216All2, unnumbered paragraph 1, Code 1995, is amended to read as follows:

A commission on the deaf is established, consisting of seven members appointed by the governor, subject to confirmation by the senate. Lists of nominees for appointment to membership on the commission may be submitted by the Iowa association of the deaf, the Iowa state registry of interpreters for the deaf, the Iowa school for the deaf, and the com- mission of persons with disabilities. At least four members shall be persons who are deaf and who cannot hear human speech with or without use of amplification and at least one member who is hard-of-hearing. All members shall reside in Iowa. The members of the commission shall appoint the chairperson of the commission. A majority of the members of the commission constitutes a quorum.

Approved May 19, 1995, except the items which I hereby disapprove and which are designated as Section 5, subsection 2, paragraph e in its entirety and Section 8 in its entirety. My reasons for vetoing these items are delineated in the item veto message pertaining to this Act to the Secretary of State this same date, a copy of which is attached hereto.

TERRY E. BRANSTAD, Governor

Dear Mr. Secretary:

I hereby transmit House File 530, an Act relating to and making appropriations to the Department for the Blind, the Iowa State Civil Rights Commission, the Department of Elder Affairs, the Iowa Department of Public Health, the Department of Human Rights, the Commission of Veterans Affairs, and the Governor's Alliance on Substance Abuse.

House File 530 is, therefore, approved on this date with the following exceptions which I hereby disapprove.

671 lAWS OF THE SEVENTY-SIXTH GA, 1995 SESSION CH. 213

I am unable to approve the item designated as Section 5, subsection 2, paragraph e, in its entirety. This item would eliminate the radon certification programs in the Department of Public Health effective July 1, 1995. Programs to certify persons qualified and trained to perform radon testing and abatement services were established in 1989. A federal survey issued at that time revealed that 70-75 percent of Iowans' homes had unacceptably high levels of radon, a radioactive gas that significantly increases one's risk of lung cancer. The certification programs were implemented to encourage Iowans to take action to test for and reduce radon levels in their homes and to provide protection from unscrupulous indi- viduals who might try to bilk them out of thousands of dollars by performing shoddy or unnecessary work. The certification programs have been effective in meeting these goals and for that reason should be continued.

I am unable to approve the item designated as Section 8, in its entirety. This item directs the divisions within the Department of Human Rights to "study" options for transferring the department's responsibilities to other agencies within state government. A review of the department's responsibilities to determine if opportunities exist to eliminate duplication and to increase efficiencies is appropriate and I will be asking the department to work with the Department of Management to conduct such a study. However, the options to be recommended should be based on findings which result from the study. They should not be assumed prior to the study and specifically prescribed as they are in this bill. For that reason, the item can not be approved.

For the above reasons, I hereby respectfully disapprove these items in accordance with Amendment N of the Amendments of 1968 to the Constitution of the State of Iowa. All other items in House File 530 are hereby approved as of this date.

Sincerely, TERRY E. BRANSTAD, Governor

CHAPTER213 CREDffiNG THE REBUILD IOWA INFRASTRUCTURE FUND- MISCELlANEOUS

APPROPRIATION PROVISIONS H.F. 584

AN ACf relating to state appropriation matters by providing for the crediting of moneys to the rebuild Iowa infrastructure fund, revising education appropriation provisions, and other properly related matters, and providing an effective date.

Be It Enacted by the General Assembly of the State of Iowa:

Section 1. REBUILD IOWA INFRASTRUCTURE FUND. On or after July 1, 1995, the department of management shall estimate the amount of funds that would be credited to the Iowa economic emergency fund from the ending balance of the general fund of the state at the close of the fiscal year beginning July 1, 1994, following the appropriation to the cash reserve fund and payment of the items in the schedule submitted in the governor's budget for the fiscal year beginning July 1, 1995, pursuant to the provisions of section 8.57. If funds are estimated to be available to be credited to the Iowa economic emergency fund, the department shall credit not more than $50,000,000 of the ending balance to the rebuild Iowa infrastructure fund and the amount to be credited to the Iowa economic emer- gency fund made pursuant to section 8.57, subsection 2, is reduced accordingly. The credit