General Assembly: 75 (1993 Regular GA) - Chapter 170 - Appropriations — health and human rights


Published: 1993

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CH. 169 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION 390

is already well underway and has the potential of saving hundreds of thousands of dollars in road use tax funds. These funds are needed to improve the highway transportation system in the state of Iowa. Requests for proposals have already been issued and bids will be evalu- ated based on both the potential for cost savings and maintenance of a high quality of service.

For the above reasons, I hereby respectfully disapprove these items in accordance with Amend- ment IV of the Amendments of 1968 to the Constitution of the State of Iowa. All other items in Senate File 232 are hereby approved as of this date.

Sincerely, TERRY E. BRANSTAD, Governor

CHAPTER 170 APPROPRIATIONS- HEALTH AND HUMAN RIGHTS

H.F. 429

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, and the commission of veterans affairs and provid- ing for the elimination of the health data commission and the department of human rights.

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

Section 1. DEPARTMENT FOR THE BLIND. There is appropriated from the general fund of the state to the department for the blind for the fiscal year beginning July 1, 1993, and end- ing June 30, 1994, 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 fol- lowing full-time equivalent positions: .................................................................. $ .............................................................. FTEs

1,365,822 95.00

Sec. 2. CIVIL 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, 1993, and ending June 30,1994, 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 fol- lowing full-time equivalent positions: .................................................................. $ .............................................................. FTEs

1,079,335 29.00

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, 1993, and ending June 30, 1994, 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:

430,656 28.50

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,219,891 All funds appropriated under this subsection shall be received and disbursed by the direc-

tor of elder affairs for aging programs and services, shall not be used by the department for

391 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION CH. 170

administrative purposes, not more than $151,654 shall be used for area agencies on aging admin- istrative purposes, and shall be used for citizens of Iowa over 60 years of age for case manage- ment for the frail elderly, mental health outreach, Alzheimer's support, retired senior volun- teer program, care review committee coordination, employment, adult day care, respite care, chore, telephone reassurance, information and assistance, and home repair services, including the winterizing of homes, ~nd for the construction of entrance ramps which meet the require- ments of section 104A.4 and make residences accessible to the physically handicapped. Funds appropriated in this subsection may be used to supplement federal funds under federal regu- lations. Funds appropriated in this subsection may be used for elderly services not specifi- cally 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 according to rules promulgated by the department.

Sec. 4. DEPARTMENT OF PUBLIC 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, 1993, and ending June 30, 1994, 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 fol-

lowing full-time equivalent positions: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 $ 00 0 0 0 0 0 00 0 00 0 0 0 0 00 0 0 0 0 0 0 0 0 00 0 0 0000 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 FTEs

2,007,528 59.25

Of the funds appropriated in this lettered paragraph, $7 45,139 shall be used for the chronic renal disease program. The types of assistance available to eligible recipients under the pro- gram may include hospital and medical expenses, home dialysis supplies, insurance premiums, travel expenses, prescription and nonprescription drugs, and lodging expenses for persons in training. The program expenditures shall not exceed this allocation. If projected expenditures will 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 allocations.

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.

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

lowing full-time equivalent positions: 0 0 ~ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 • 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 $ 0 0 00 0 0 0 00 0 000 00 0 000 0 0 000 00 0 00 00 0 000 00 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 00 0 0 0 FTEs

c. HEALTH DELIVERY SYSTEMS

647,253 10.50

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

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 $ 1,153,276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FTEs 12.00

(2) Of the funds appropriated in this lettered paragraph, $196,436 is allocated for the office of rural health to provide technical assistance to rural areas in the area of health care deliv- ery, including technical assistance in the recruitment of physicians and health care professionals.

(3) Of the funds appropriated in this lettered paragraph, $956,840 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 medi- cal technology to determine if infection with hepatitis has occurred. The person shall be

CH. 170 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION 392

entitled to reimbursement from the EMS funds available under this subsection only if the reim- bursement is not available through any employer or third-party payor.

(4) The department shall review how medical practice parameters could be implemented in Iowa and report to the general assembly by January 1, 1994.

d. HEALTH DATA COMMISSION For the health data commission:

.................................................................. $ 290,250 The funds appropriated under this lettered paragraph shall be used for the collection, verifi-

cation, updating, and storage of data, including long-term care data, received pursuant to chap- ters 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 mar- ginal cost and a portion of the fixed cost of providing the data.

Prior to December 1, 1993, the commission shall submit to the general assembly a useful, comprehensive report for use by members of the general assembly in making informed deci- sions on public policy issues involving health.

The community health management information system shall report to the general assem- bly by January 15,1994, on the cost-effectiveness of the computerized severity of illness data system, implications of severity and outcome data for the community health management infor- mation system and health care reform, and the utility of the commission's data for health care purchase decisions.

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

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

2,251,256 70.75

b. Of the funds appropriated in this subsection, $77,750 shall be used for chlamydia testing. c. Of the funds appropriated in this subsection, $15,000 is allocated to support the surveil-

lance and reporting of disabilities suffered by persons engaged in agriculture resulting from diseases or injuries, including identifying the amount and severity of agriculture-related inju- ries and diseases in the state, identifying causal factors associated with agriculture-related injuries and diseases, and evaluating the effectiveness of intervention programs designed to reduce injuries and diseases. The department shall cooperate with the department of agricul- ture 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, $74,547 shall be used for the lead abate- ment program.

e. The state university of Iowa hospitals and clinics shall not receive indirect costs from the funds appropriated under this subsection.

f. The department shall maintain a brain and spinal cord injuries registry. *g. The department shall maintain or enter into a contract for the administration of the

water treatment system testing program pursuant to section 711,.16. The department shall establish a separate fund within the department and shall deposit any fees generated by the program pursuant to section 711,.16 in the fund. The moneys in the fund shall be used exclu- sively for carrying out the department's duties under the program. Notwithstanding section 12C. 7, subsection 2, interest or earnings on investments or time deposits of the moneys in the fund shall be credited to the fund. Notwithstanding section 8.99, any unexpended balance in the fund at the end of any fiscal year shall be retained in the fund.*

3. SUBSTANCE ABUSE AND HEALTH PROMOTION DIVISION a. For salaries, support, maintenance, miscellaneous purposes, and for not more than the

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

•Item veto; see message at end of the Act

603,620 23.95

393 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION CH. 170

The tobacco prevention and control advisory committee shall be eliminated July 1, 1993. b. For program grants:

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

sion of aftercare services for persons completing substance abuse treatment. 4. FAMILY AND COMMUNITY HEALTH DIVISION a. For salaries, support, maintenance, miscellaneous purposes, and for not more than the

following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,050,505 .............................................................. FTEs 66.70

(1) Of the funds appropriated in this lettered paragraph at least $587,865 shall be allocated for the birth defects and genetics counseling program and of these funds, $279,402 shall be 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.

(2) Of the funds appropriated in this lettered paragraph, the following amounts shall be allo- cated 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.

(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 deter- mine 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) Of the funds allocated to the mobile and regional child health specialty clinics in sub- paragraph (2), subparagraph subdivision (a), $97,937 shall be used for a specialized medical home care program providing care planning and coordination of community support services for chil- dren who require technical medical care in the home.

(5) The state university of Iowa hospitals and clinics shall not receive indirect costs from the funds for each program.

(6) Of the funds appropriated in this lettered paragraph, $1,279,422 shall be used for mater- nal and child health services.

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

(8) The department shall track the appropriations to the programs listed in this lettered paragraph which were made in the fiscal year beginning July 1, 1991, in accordance with the program performance-based budgeting method. The department shall track all appropriations to the programs made to the department in accordance with the program performance-based budgeting method in the fiscal year beginning July 1, 1995.

(9) The department shall work with the department of elder affairs to realize the "Healthy Iowans 2000" goal of providing nutrition screening to 90 percent of the elderly persons par- ticipating in well-elderly screening clinics, congregate meal programs, and homemaker-home health aide programs, and shall submit a progress report to the general assembly by January 1, 1994, regarding the number of personnel trained and the number of persons served.

CH. 170 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION 394

(10) The department shall continue efforts to realize the "Healthy Iowans 2000" goal of the involvement of 50 counties in the Iowa community nutrition coalition and shall submit a prog· ress report to the general assembly by January 1, 1994.

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

den infant death syndrome required under section 331.802, subsection 3, paragraph "j": •••••••••••••••••• 0 •••••••••• 0 •••••• 0 ••••• 0 ••••••••• 0 •• 0 •••••• 0 •• 0 $ 9,675

c. For grants to local boards of health for the public health nursing program: ••••••••••••••••••••••••• 0 ••• 0 • 0 • 0 •••• 0 • 0 • 0 • 0 •••• 0 ••••• 0 •• 0 • • • • • • • $ 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 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 allo- cated 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 appropri- ated 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 it to counties with demonstrated special needs for pub- lic health nursing.

(5) The department shall maintain rules governing the expenditure of funds appropriated by this lettered paragraph. The rules 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 pro- gram. The evaluation shall include the extent to which the program reduced or prevented inap- propriate 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: •••••••••••••••••••••••••••• 0 • 0 •••••• 0 •••••••• 0 0 •• 0 •• 0 ••• 0 •••••••• $ 8,586,716

Funds appropriated in this lettered paragraph shall be used to provide home care aide ser- vices 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 inap- propriate 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

395 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION CH. 170

any other purposes. In providing services to elderly persons, the service provider shall coor- dinate efforts with the integrated case management for the frail elderly program of the depart- ment of elder affairs. As used in this lettered paragraph:

(1) "Chore services" means services provided to individuals or families, who, due to inca- pacity, 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 paint- ing, and trash removal.

(2) "Elderly person" means a person who is 60 years of age or older. (3) "Home care aide services" means services intended to enhance the capacity of house-

hold 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, inca- pacity, 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 ser- vices, transportation and providing information, assistance, and household management.

(4) "Low-income person" means a person whose income and resources are below the guide- lines 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 coun- ties 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 3 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, county board of social welfare, 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 protec- tive 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 max- imum 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 partici- pated 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 governmen- tal 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 sub- contract requires any service provided away from the home to be documented in a report avail- able for review by the department, and that each home care aide subcontracting agency shall

CH. 170 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION 396

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 ser· vice 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 per· sons 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 in this lettered paragraph an unallocated pool. The department shall also identify any allo- cated funds which the counties do not anticipate spending during the fiscal year. If the antici- pated excess funds to any county are substantial, the department and the county may agree to return those excess funds, if the funds are other than program revenues, to the depart- ment, and if returned, the department shall consider the returned funds a part of the unallo- cated 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' expen- ditures for each county in May of the fiscal year, to determine if any counties possess con- tracted 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 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 ser- vices 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 institu- tionalization, 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 protec- tive 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

Appropriations made in this lettered paragraph shall be provided 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 provi- sions and shall be used to provide treatment of the children in a physician's office and shall include coverage of diagnostic procedures and prescription drugs required for the treat- ment. Services provided under this lettered paragraph shall be reimbursed according to Title XIX 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

397 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION CH. 170

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 in advance of each state dollar provided of four dollars for the fiscal year beginning July 1, 1993.

(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 dupli· cation of services and ensure access to care to the extent as is reasonably possible. The organi- zation 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 admin- istrative costs of the department or the grantee.

h. For the healthy family program: .................................................................. $ 665,000

The moneys appropriated under this lettered paragraph shall be granted pursuant to 1992 Iowa Acts, Second Extraordinary Session, chapter 1001, section 415. The administrative enti- ties shall work collaboratively to assure continuity of the provision of services from the prena- tal 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 concerning the efficiency of the program and make any recommendations for improvements to the general assembly.

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

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

6. STATE BOARD OF MEDICAL EXAMINERS

256,294 4.00

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

7. STATE BOARD OF NURSING EXAMINERS

966,939 18.00

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

8. STATE BOARD OF PHARMACY EXAMINERS

867,622 16.00

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

636,874 11.40

9. Professional licensure pursuant to subsection 1, paragraph "b", and the professional prac- tice boards pursuant to subsections 5 through 8 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.

CH. 170 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION 398

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 inves- tigative staffs to the greatest extent possible.

Sec. 5. 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, 1993 and ending June 30, 1994, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

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

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

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

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

221,698 7.60

3,526

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

276,874 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 interpreta- tion services.

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

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

5. LATINO AFFAIRS DIVISION

97,853 2.00

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

6. STATUS OF WOMEN DIVISION

87,797 2.00

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

340,788 4.00

Of the funds appropriated in this subsection, no less than $125,775 shall be spent for the displaced homemaker program.

Of the funds appropriated in this subsection, no less than $42,570 shall be spent for domes- tic violence and sexual assault-related grants.

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

lowing full-time equivalent positions: ............... · ................................................... $ .............................................................. FTEs

8. CRIMINAL AND JUVENILE JUSTICE PLANNING DIVISION

76,177 2.00

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

351,345 9.75

399 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION CH. 170

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

b. Of the funds appropriated in this subsection, no less than $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 fed- eral funding match requirements established by the federal office for juvenile justice delin- quency 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. PROGRAM PERFORMANCE-BASED BUDGETING. The department shall track all appropriations made to the programs of the department in

accordance with the program performance-based budgeting method in the fiscal year begin- ning July 1, 1995.

Sec. 6. COMMISSION OF VETERANS AFF AffiS. There is appropriated from the general fund of the state to the commission of veterans affairs for the fiscal year beginning July 1, 1993, and ending June 30, 1994, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

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

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

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

.................................................................. $ 3. lOW A VETERANS HOME

145,462 4.16

6,000

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

32,046,739 689.54

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

b. The commission of veterans affairs may adopt emergency rules to provide for medical assistance reimbursement for the care and treatment of medical assistance-eligible individuals admitted to the Iowa veterans home. If the rules result in medical assistance reimbursement to the Iowa veterans home which exceeds the amount budgeted for that purpose in the fiscal year beginning July 1, 1993, and ending June 30, 1994, 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.

Sec. 7. INTERIM STUDIES- SUBSTANCE ABUSE CARE AND TREATMENT PRO- GRAM AND DEPARTMENT OF HUMAN RIGHTS.

1. The legislative council is requested to provide for a study of programs and services avail- able in this state for substance abuse care and treatment, the continuum of needs of substance abusers and whether the needs are being met satisfactorily, funding available for substance abuse care and treatment, including federal and state moneys, and payment mechanisms for the care and treatment, including medical assistance and third-party sources of payment, and the limitations of the payment. The study shall include a report to the general assembly, with recommendations to address identified problem areas on or before January 15, 1994.

2. The legislative council is requested to provide for a study of the organizational structure of the department of human rights. The study shall include a report to the general assembly, with identified problem areas, on or before January 15, 1994.

CH. 170 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION 400

Sec. 8. Section 145.3, subsection 4, paragraph d, Code 1993, is amended to read as follows: d. Additional or alternative information related to the intent and purpose of this chapter

as outlined in section 145.1 be submitted to the commission, except that in no event shall hospi- tals with fewer than one hundred licensed acute care beds be required to install computerized severity-of-illness systems before July 1, !9931994. Prior to July 11994,! hospital with one hundred beds or more shall not be required to submit additional data beyond the data required to be submitted from the computerized severity-of-illness system as of January 11993, and such a hospital shall not be required to expend additional moneys beyond the cost of operating ! computerized severity-of-illness system as of January 11993.

Sec. 9. NEW SECTION. 145.1A REPEAL. This chapter is repealed effective July 1, 1994.

Sec. 10. NEW SECTION. 216A.5 REPEAL. This chapter is repealed effective July 1, 1997.

Approved April20, 1999, except the item which I hereby disapprove and which is designated as Section 4, subsection 2, paragraph g in its entirety. My reason for vetoing the item is delineated in the item veto message pertaining to this Act to the Speaker of the House this same date, a copy of which is attached hereto.

TERRY E. BRANSTAD, Governor

Dear Mr. Speaker:

I hereby transmit House File 429, an Act relating to and making appropriations to the Depart- ment 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, and the Commis- sion of Veterans Affairs and providing for the elimination of the Health Data Commission and the Department of Human Rights.

House File 429 is, therefore, approved on this date with the following exception which I hereby disapprove.

I am unable to approve the item designated as Section 4, subsection 2, paragraph g, in its entirety. This provision would require the Department of Public Health to establish a revolv- ing fund to administer the water treatment testing program. The Department has statutory authority to contract for administration of the program and to charge a fee for that purpose, therefore, creation of a new revolving fund is unnecessary.

For the above reason, I hereby respectfully disapprove this item in accordance with Amend- ment IV of the Amendments of 1968 to the Constitution of the State of Iowa. All other items in House File 429 are hereby approved as of this date.

Sincerely, TERRY E. BRANSTAD, Governor

401 LAWS OF THE SEVENTY -FIFTH G.A., 1993 SESSION

CHAPTER 171 APPROPRIATIONS - JUSTICE SYSTEM

S.F. 267

CH. 171

AN ACT relating to and making appropriations to the justice system, providing for other related matters concerning the justice system, and providing effective and retroactive applicabil- ity dates.

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

Section 1. DEPARTMENT OF JUSTICE. There is appropriated from the general fund of the state to the department of justice for the fiscal year beginning July 1, 1993, and ending June 30, 1994, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

1. For the general office of attorney general for salaries, support, maintenance, miscellane- ous purposes including odometer fraud enforcement, and for not more than the following full- time equivalent positions: .................................................................. $ .............................................................. FTEs

4,613,628 169.00

2. Prosecuting attorney training program for salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions: .................................................................. $ .............................................................. FTEs

110,000 4.00

a. In addition to the funds appropriated in this subsection for the fiscal year beginning July 1, 1993, and ending June 30, 1994, the attorney general shall provide up to $41,000 in state matching funds from moneys retained by the attorney general from property forfeited pur- suant to section 809.13, for the prosecuting attorney training program, the prosecuting intern program, or both. Counties participating in the prosecuting intern program shall match the state funds.

b. In addition to the funds appropriated in this subsection for the fiscal year beginning July 1, 1993, and ending June 30, 1994, and the moneys retained by the attorney general pursuant to paragraph "a", the attorney general shall provide up to $10,000 in state matching funds from moneys retained by the attorney general from property forfeited pursuant to section 809.13, for the office of the prosecuting attorneys training coordinator to use for continuation of the domestic violence response enhancement program established in accordance with 1992 Iowa Acts, chapter 1240, section 1, subsection 2, paragraph "b".

c. The prosecuting attorney training program shall use a portion of the funds appropriated in this subsection for educational purposes to implement the recommendations of the equality in the courts task force.

3. In addition to the funds appropriated in subsection 1, there is appropriated from the general fund of the state to the department of justice for the fiscal year beginning July 1, 1993, and ending June 30, 1994, an amount not exceeding $200,000 to be used for the enforcement of the Iowa competition law. The expenditure of the funds appropriated in this subsection is con- tingent upon receipt by the general fund of the state of an amount at least equal to either the expenditures from damages awarded to the state or a political subdivision of the state by a civil judgment under chapter 553, if the judgment authorizes the use of the award for enforcement purposes or costs or attorneys fees awarded the state in state or federal antitrust actions. However, if the funds received as a result of these judgments are in excess of $200,000, the excess funds shall not be appropriated to the department of justice pursuant to this sub- section.

4. In addition to the funds appropriated in subsection 1, there is appropriated from the general fund of the state to the department of justice for the fiscal year beginning July 1, 1993, and ending June 30, 1994, an amount not exceeding $125,000 to be used for public education relat- ing to consumer fraud and for enforcement of section 714.16, and an amount not exceeding