Bills Associated with Iowa Nurses Association

Removes the requirement that personnel working in a licensed or registered child care facility must receive a pre-employment physical examination.

Ensures that health insurance providers do not obstruct individuals from accessing necessary prescription medications, particularly when they are stable on a specific treatment recommended by their healthcare provider. It prohibits actions by insurers that may restrict coverage or escalate costs for these individuals, while permitting substitutions or adjustments to covered medications under specific circumstances. Additionally, it outlines regulations and mechanisms for enforcement. It affirms the authority of healthcare providers to prescribe alternative medications when deemed medically necessary and allows insurers to modify their lists of covered medications accordingly. These regulations apply to health plans in the state commencing or continuing after January 1, 2024.

Creates an ARNP preceptor tax credit. An ARNP preceptor must have at least one year of experience and uncompensated for the preceptorship to receive the tax credit. The ARNP will receive up to $2,000 annually in the form of a non-refundable tax credit ($500 for 100 hours of preceptorship, with up to four preceptorships per year). ARNP preceptors cannot carry unused tax credits forward into additional tax years. Applies to tax years beginning January 1, 2025.

Appropriates $1 million to the double up food bucks program.

Requires maternity group homes to be considered as a residential use for zoning purposes. 

Appropriates $300,000 for radon awareness, education, and outreach, including testing kits.

Appropriates $900,000 to implement an plan to reduce the obesity rate. Report due by September 1, 2025.

Increases penalties from a class D to a class C felony for an assault against peace officers, jailers, correctional staff, board of parole members and employees, healthcare providers, National Guard members, and fire fighters. Also protects employees of the Department of Revenue, the Department of Health and Human Services, and the Department of Inspections, Appeals, and Licensing. Expands the scope of assault to encompass incidents involving contact with saliva. Requires person convicted to serve a minimum of seven days if convicted of assault against one of these occupations and does not allow minimum sentence to be waived.

Division 1 - Establishes penalties for unauthorized disclosure of adoption information, excepting department staff who share the information internally in order to provide services for the child. 
Division 2 - Expands the definition of exploitation in regard to dependant adult abuse to include actions such as theft, undue influence, harassment, and deception. Allows courts to access records in cases of suspected dependant adult abuse or financial exploitation and extends this to tribal courts and cases involving Native American individuals.
Division 3 - Requires juvenile courts to reveal specific confidential records to HHS for their review. 
Division 4 - Requires certain professionals to complete two hours of core training on identifying and reporting abuse within six months of starting relevant employment. Additionally, they must undertake at least two hours of further training every three years. Licensing boards overseeing these professionals must ensure compliance with these training mandates for licensure and renewal, with provisions for waivers in certain circumstances like military duty, hardship, or practicing outside the state.

Division V - Allows HHS to establish health care coordination and intervention teams reimbursed by Medicaid to conduct individual case reviews to determine whether additional health services or interventions may be appropriate for an individual's care needs.  The team would review cases involving individuals with complex conditions who are in need of urgent placement and services, but could also include others.  These reviews could be initiated by HHS or a provider (which includes health care providers, mental health professionals, and substance use professionals). 

Signed by Governor April 19, 2024. Divisions I-IV take effect July 1, 2024. Division V takes effect April 19, 2024.

Establishes regulations for firearm hold agreements, defining them as private transactions between federal firearms licensees and individual owners. It provides these licensees with limited liability protection, shielding them from legal action for acts or omissions related to such agreements, except in cases of unlawful conduct. 

Deposits 50% of opioid settlement funds into a new Opioid Settlement Future Fund and annually appropriates $250,000 to HHS for administering the fund, $6,834,680 to the Attorney General for a program to reduce post-surgery opioid use in 10,000 patients, $150,000 for public safety survivor benefits, and $3 million to YSS Ember campus in Cambridge for youth recovery and treatment.  Establishes an Opioid Epidemic Response Advisory Council to involve stakeholders in the development of a comprehensive and effective statewide effort to combat opioid addiction and address the opioid epidemic.  HHS appoints an opioid treatment provider or substance use treatment program, a nonprofit dedicated to ending opioid addiction, judge, public member who is in recovery from an opioid addiction, mental health advocate, and local public health department. The following associations will also appoint members: Board of Pharmacy, Iowa Medical Society (physician), Iowa Psychiatric Society (psychiatrist), EMS Association (EMS ambulance service), and Iowa Hospital Association (hospital representative).  The Office of Drug Policy Control and the Public Safety Commissioner will also each appoint a member.  Four legislators representing each caucus will serve ex-officio, along with representatives from the Departments of Health & Human Services, Corrections, and Management, State Public Defender, and Attorney General.  Authorizes opioid epidemic grants (but does not state how much is available) and caps grant administration at 3%. Effective upon enactment.

Requires a utilization review organization to respond to a request for a prior authorization within 48 hours for urgent requests and 10 days for non-urgent requests, with some exceptions. Utilization review organizations work with healthcare providers and insurance companies to evaluate the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. Requires utilization review organizations to annually review all healthcare services requiring authorization and eliminate unnecessary requirements for routinely approved services. Complaints regarding organizational compliance can be directed to the insurance division, though they won't be considered public records.

Requires health insurance carriers to provide coverage for diagnostic breast cancer examinations but allows copays and other cost sharing for them. Applies to plans issued on or after January 1, 2024.  

Allows licensed physicians and surgeons, as well as osteopathic physicians and surgeons, to serve as staff for medical care ambulance services or non-transport services, provided they can demonstrate appropriate education and additional skills training relevant to out-of-hospital emergency care. Expands the definition of "first responder" in the context of the opioid antagonist medication fund and the newborn safe haven Act to include physicians staffing these services. Signed by governor April 10, 2024. Takes effect July 1, 2024.

Directs HHS to submit a Medicaid waiver request to provide coverage for certain inmates due to be released.

Requires school districts with at least 8,000 students to employ security personnel to guard all school buildings where 9th through 12th grade students attend, unless a majority of that districts school board votes otherwise. Allows school employees to be issued a permit to carry firearms provided they complete a firearm safety training. School employees who possess this permit to have qualified immunity from criminal or civil liability. The bill further requires private security officers and school employees who are licensed to carry a firearm on school property under this bill to participate in annual live scenario training and quarterly live firearms training provided by the Department of Public Safety (DPS). Signed by Governor April 19, 2024. Takes effect July 1, 2024.

Division 1 -- Address Confidentiality Program -- Allows the Secretary of State to use the Address Confidentiality program to send mail to a person at a shelter. The Secretary of State can cancel registration in the Address Confidentiality Program if they receive credible information that the registrant has died. Allows registrant mail to be held for up to 30 days.
Division 2 -- Candidate Eligibility Objections -- Objections to federal candidate eligibility are limited to residency, age, or citizenship requirements in the U.S. Constitution. 
Division 3 -- Ranked Choice Voting -- Bans ranked choice voting and instant runoff voting procedures.
Division 4 -- Absent Voters -- Bans the use of ballot drop boxes. Requires ballots to be returned sealed in multiple envelopes in a specific order. Absentee voters must write their voter identification number on a specific envelope. Shortens the deadline for absentee ballots to be returned to the commissioners office to 5pm the day before election day. 
Division 5 -- People Allowed in Voting Booths -- Prohibits candidates from being in a voting booth with a voter, even if they are assisting them. 
Division 6 -- Voter Registration Database Pilot Program -- Requires the Secretary of State to contract with a 3rd-party vendor to develop a pilot program to allow the state registrar to verify voter registration records. 
Division 7 -- County Hospital Board of Trustees -- Changes Broadlawns trustee terms from 6 year long to 4 year long terms. This change does not impact those currently elected.

Charges Iowa Department of Education (DE) to oversee AEA operations, beginning July 1, 2025. Creates a Division of Special Eduation in DE (13 employees plus 5 employees located in each AEA). Makes local AEA Boards advisory. Permits AEAs to provide evidence-based professional development services within their AEA boundary. Requires AEA administrators be licensed teachers with either a special education endorsement or special education suppor t authorization. Caps AEA administrator salaries at average salary of school administrators within the AEA boundaries.  Requires AEA to establish collaborative relationships with other community agencies. Sets up an AEA Task Force to make further recommendations. Makes changes to AEA funding beginning 7/1/2025 (100% special education goes to schools and schools must use their designated AEA; media services fully fee-for-service (all goes to schools); 100% professional development goes to schools for first year then becomes fully fee for service on 7/1/2026). Bill summary at: https://docs.google.com/document/d/1fjBdDTtw4UMc7731FX-lPYBRKy_NnBRtiUquU8_f1jk/edit. Signed by governor March 27, 2024.

Requires human growth and development course in grades 7 to 12 to include instruction on pregnancy and fetal development. 

Removes the current $7 million annual cap on the amount of Real Estate Transfer Tax funds that can be transferred to the Housing Trust Fund. 

Changes property tax assessment limitations for commercial child care facilities.  Takes effect upon enactment and applies retroactively to January 1, 2024. This bill is identical to the Governor's tax bill (SSB3038), Division VI, the Childcare Facility Property Tax Assessment Limitations.

Requires health insurance, including private and Medicaid, to cover biomarker testing when it is supported by medical and scientific evidence and has clinical utility (which includes improvement in quality of life and longer survival). Biomarker testing involves analyzing an individual's tissue, blood, or other biospecimen for specific identifiers that can indicate health conditions or disease risk.

Transitions mental health and disabilities services system to a behavioral health service system, and transfers disability services to the HHS' division of aging and disability services. Transition to become effective July 1, 2025. House version includes language on PMICs, allows for-profit companies to be behavioral health district ASOs (Administrative Services Organizations), and eliminates 5% cap on HHS administration.

Makes the following changes to organization, structure, and functions of state and local governments and adjusts code to to reflect these changes.

Division 1 -- Department of Natural Resources (DNR) -- grants the director of the Department of Health and Human Services (HHS) the authority to designate specific children from the state training school to carry out tasks for the DNR within state parks, game and forest areas, and other DNR-controlled lands. Eliminates the requirement for DNR to offer permanent housing to these children.
Division 2 -- Department of Inspections, Appeals, and Licensing (DIAL) -- states that the workers’ compensation commissioner serves at the governor's discretion rather than having a fixed term. Removes the requirement for full-time executive directors for certain boards and allows for the appointment of one individual to serve as executive director for multiple boards. Adjusts the handling of contractor registration fees, consolidating them into a single fund and repealing a related fund. Revises fee-setting procedures for health-related professional boards, granting oversight to the DIAL and requiring annual reviews to ensure fees cover expenses and are comparable to those in other states. Corrects a reference in the state plumbing code and expands the definition of licensing boards to include the real estate appraiser examining board. Aligns references in various sections with recent updates to the department's structure.
Division 3 -- Department of Transportation (DOT) -- transfers the rulemaking authority for safety regulations regarding the movement of implements of husbandry and animal-drawn vehicles on roadways from the DOT to the Department of Public Safety (DPS). Changes the deadline for presenting the DOT's proposed budget to the state transportation commission. Grants the DOT director authority to establish divisions within the DOT as needed. Specifies the DOT's responsibility for departmental operations, planning, programming, highway programs, modal programs, and enforcement activities. 
Division 4 -- Department of Education  (DE) -- gives the DE director authority to assign duties to various divisions within DE and allows for the reassignment of specific responsibilities within DE from July 1, 2024. Modifies salary and benefit handling for full-time salaried employees working less than 12 months per year and permits the employment of hourly staff for less than 12 months annually, with specific wage and benefit protocols outlined. Extends certain extracurricular contract and coaching endorsement provisions to employees of the Iowa educational services for the blind and visually impaired program and employees of the Iowa school for the deaf. Introduces a new code section exempting salaried employees of these programs from vacation leave provisions, instead providing for the accrual of personal leave days. References to "professional" staff are replaced with "salaried" staff. Applies procedures regarding staff discretion and dismissal to salaried staff.
Division 5 -- Department of Corrections (DOC) -- clarifies the governing body when a reserve peace officer is employed by the state of Iowa. Removes certain language related to employees of judicial district departments of correctional services due to their integration into the DOC. Community-based corrections facilities under the DOC's responsibilities for offender control, treatment, and rehabilitation. Adjusts provisions regarding district directors' duties, authority, and compensation. Modifies the coordination between the DOC and judicial district departments for inmate quartering and supervision after working hours. 
Division 6 -- Department of Revenue (DOR) -- specifies that the Iowa Lottery Division is a division within DOR. Changes various provisions governing the duties of the Iowa Lottery administrator, including reporting requirements and board meeting procedures. Grants the DOR the authority to operate self-service kiosks for lottery ticket distribution and adjust distribution requirements accordingly. Makes adjustments to sections regarding lottery retailer selection, license handling, prize awards, and security protocols, replacing outdated terms and clarifying responsibilities. Establishes an exception for the Iowa Lottery Division within DOR's authority to establish, abolish, and consolidate divisions. 
Division 7 -- Iowa Department of Workforce Development (IWD) --  includes the Supplemental Nutrition Assistance Program Employment and Training Program, which is jointly administered with HHS, in the list of programs managed by the IWD. Removes the requirement for community colleges to jointly implement adult education and literacy programs with IWD. However, IWD is still mandated to consult with community colleges when establishing standards and adopting rules for administering the program.
Division 8 -- Department of Public Safety (DPS) -- removes the requirement for the director of the Office of Drug Control Policy to submit an annual report to the governor and general assembly by November 1 of each year regarding activities and programs related to drug enforcement, substance use disorder treatment, and prevention and education programs. 
Division 9 -- Economic Development Authority (IEDA) and Iowa Finance Authority (IFA) Reports -- requires the IEDA director to submit an annual report to the authority board and the general assembly by January 31 each year detailing their activities from the previous fiscal year. Requires the IFA director to submit a similar annual report to the governor and general assembly by January 15 each year.
Division 10 -- Economic Development Authority (IEDA) and Iowa Finance Authority (IFA) Programs -- removes requirements for the IEDA to run certain internship programs and shifts this responsibility to the Iowa Department of Workforce Development. Ensures that any internships or financial aid awarded by the IEDA before the change remains valid under the new setup.
Division 11 -- Department of Health and Human Services (HHS) -- removes the requirement for the council to approve or disapprove licensing applications and related cases. Transfers certain licensing responsibilities for substance use disorder programs from the council to HHS. Updates confidentiality provisions for program records and specifies individuals and officials who may access confidential information. Adjusts procedures for debt setoffs and empowers the HHS director to engage in specific real estate activities. Modifies the process for people who owe child support to withdraw their objections by allowing written requests to be submitted to child support services.
Division 12 -- State Salaries of Appointed State Officers -- Establishes salary ranges for certain appointed state officers for fiscal years starting from July 1, 2024. Specifies that the governor shall set salaries for nonelected individuals appointed within the executive branch of state government. Salary determination considers factors such as the person's experience, changes in job duties, performance, and subordinate salaries. However, certain positions have salary determination responsibilities assigned to specific entities. 
Division 13 -- Office for State-Federal Relations -- Removes the requirement for the office to be situated in Washington, D.C., and instead states that the State-Federal Relations Office is administratively attached to the Office of the Governor.
Division 14 -- Historical Sites -- Removes the requirement for state agencies owning historical sites, except the state board of regents, to enter agreements with the Department of Administrative Services (DAS) for site management. Instead, it mandates DAS to consult with the state historic preservation officer when establishing standards and criteria for historical property acquisition and preservation. Adds developing preservation standards for historical sites to the duties of the state historic preservation officer. Requires state agencies owning historical sites to consult with the preservation officer before making modifications that could affect the site's listing on the national register of historic places and allows them to enter agreements with the preservation officer for site management. 
Division 15 -- Department of Management -- Mandates DOM to oversee a statewide integrated justice information system. Shifts responsibilities from HHS to DOM for maintaining an Iowa statistical analysis center, an Iowa correctional policy project, and a multi agency information system for juvenile and adult court records.

Proposes an ammendment to Iowa's Constitution to regulate tax bills and set one flat rate for individual income taxes. The ammendment would require that any bill raising income tax rates or adding new income-based taxes be approved by at least two-thirds of both the Iowa House of Representatives and the Iowa Senate. Additionally, it forbids Iowa from having different income tax rates for different income levels. If passed, the ammendment would need to be voted on again by the next general assembly before being approved by the public.

Appropriates funds from the opioid settlement fund for opioid prevention, treatment, recovery, and infrastructure activities: $1.55 m for prevention/awareness/naloxone distribution; $650k HHS for survellience & overdose mapping; $1m for third party contract to address opioid prescription prevention in medical settings; $500,000 to expand mobile crisis to include substance use disorder responses; $1m peer support overdose response program; $8m in infrastructure funds to expand the number of recovery providers; $3m for YSS Ember project (youth recovery); $3m for recovery housing infrastructure grants (IFA); and $1.5m for scholarships to individuals in recovery (IWD).

Establishes an easy enrollment health care coverage program that utilizes the state income tax form.

Requires Medicaid MCOs to pay providers 100 percent of items or services for which prior authorization was obtained.

Directs the Office to Combat Human Trafficking to meet with stakeholders annually to make recommendations on legislation (annual report each December for the next five years).  Extends the civil statute of limitations for sexual assault and human trafficking offenses against minors to five years after discovery or upon turning 18 (currently nothing in code for human trafficking and sexual assault is one year from age of 18 or four years upon discovery). Allows courts to order video depositions of victims and lists the persons and professionals, excluding the defendant, who may be present. Allows the victim to have someone who provides support to them to be present during the deposition. Moves payment of crime victim compensation to Class A restitution, which no longer allows consideration for the offender's ability to pay. Requires HHS to increase the availability of various recovery and supportive services available to juvenile victims of trafficking, including working with other states for housing outside the state.  Appropriates $750,000 to the Attorney General for a joint unit with the Office to Combat Human Trafficking for investigating and prosecuting human trafficking cases. 

Requires retailers of tobacco devices (glass/metal pipes, not vape products) to have a permit and establishes requirements and restrictions. Revenues go to support substance use disorder and mental health specialty courts (through Office of Drug Control Policy). Effective January 1, 2024.

Makes changes related to the certificate of need (CON) process for health facilities. Exempts community mental health facilities and birth centers from CON requirements. Changes definitions for services subject to CON requirements. Requires CON applications be accompanied by an economic impact statements. Increases thresholds for CON to kick in (currently $1.5 million): $3.5 million in 2023, $4 million in 2028, $4.5 million in in 2033, and $5 million in 2038. Eliminates the Health Facilities Council and gives department the responsibility of making CON decisions.

Repeals gender balance requirements for appointed local and state government boards, councils, commissions. Signed by governor April 3, 2024. Takes effect July 1, 2024.

Makes changes to ambulatory surgical center requirements, which are healthcare facilities where surgeries are performed on an outpatient basis. Clarifies that certain medical practices, such as those conducted by private physicians, podiatrists, or dentists, may or may not fall under the classification of an ASC depending on the nature of the procedures performed. Exempts specific surgical services from needing a certificate of need within ASCs. Sets parameters for ASC licensing and accreditation, aligning them with Medicare standards or other recognized accreditation bodies. Inspection protocols for ASCs are also outlined, allowing for recognition of inspections conducted by approved organizations in place of or in conjunction with government inspections. Signed by governor April 10, 2024. Takes effect July 1, 2024.

Extends postpartum Medicaid coverage from 60 days to 12 months after pregnancy ends. Lowers income eligibility levels for pregnant women and infants under the Medicaid program to 215% of the federal poverty line. Mandates that the submission of state medicaid plan amendments align with federal guidelines.

Allows the Department of Health and Human Services (HHS) to administer the More Options for Maternal Support (MOMS) program directly or through contracted providers of pregnancy support services. Adjusts the language of Iowa code to match with this potential change in administration. Signed by governor April 10, 2024. Takes effect July 1, 2024.

Requires the Department of Health and Human Services to submit an annual report detailing departmental expenditures and statistical reports for programs under its administration. Directs the department to make reportable information and data publicly available, preferably through modernized, interactive displays on its website. Allows the department to compile statistics, conduct research, and issue reports on child abuse and dependent adult abuse, with the condition that identifying details are removed. Takes effect upon enactment and applies retroactively to reports due on or after January 1, 2024. Signed by governor April 10, 2024. 

Makes it an aggravated misdemeanor for foreign individuals who attempt to enter or reenter the state who have previously been denied admission or been deported. Makes it a class D felony if the individual's removal was due to a conviction for certain crimes. Signed by governor April 10, 2024. Takes effect July 1, 2024.

Makes numerous changes to state boards, commissions, committees, councils, and other state government entities.

Dictates that 75% of the funds annually go to the Department of Health and Human Services (HHS), with the remaining 25% allocated to the Office of the Attorney General (AG). These allocations must comply with any existing settlement agreements. Any disbursements from HHS or the AG must be clearly labeled as one-time allocations from the opioid settlement fund. The bill becomes effective immediately upon enactment.

Division 1 – Combines the Economic Emergency Fund (EEF) and the Cash Reserve Fund (CRF), and then eliminates the EEF.  Raises the cap on the CRF from 7.5% to 12.5% of adjusted revenue estimates. Allows expenditures that would have been authorized under the EEF to be acceptable under the CRF.

Division 2 – Replaces current Iowa law that implements a flat 3.9% income tax rate by 2026 with a 3.65% income tax rate in 2024 (applicable retroactively to 1/1/2024).  Moves the flat income tax rate down to 3.5% in 2025 and subsequent years.

Division 3 – Requires withholding to be adjusted within 60 days and provides penalties for over-withholding.  Effective upon enactment.

Division 4 – Raises on 1/1/2025 the threshold from $200 to $1000 the amount of estimated tax liability a taxpayer can have before they need to make estimated payments.

Division 5 – Ensures that lump sum distributions from retirement accounts are exempt from income taxes. The previously passed law exempted retirement income, but did not specifically exempt qualified lump sum distributions.  Retroactive to 1/1/2024.

Division 6 – Alters the property tax calculation on child care facilities to allow them to be taxed at the same rate as residential property.  Current law taxes commercial properties this way only on the first $150,000 of value and then taxes value above $150,000 at 90% of assessed value.  Retroactive to 1/1/2024.

Division 7 – Makes modifications to the unemployment trust fund and allocations into that fund.  Reduces by half the statewide average weekly wage contribution flowing into the fund and makes a number of other changes to the system.

Adds a narrow window for waiving the civil statute of limitations (SOL) for childhood sexual assault to allow victims to receive compensation under a settlement with the Boy Scouts of America.  Effective 4/19/24 and retroactive to the date when injuries occurred; repeals this on 12/31/2026. 

Appropriates funding for fiscal year 2025 (July 1, 2024-June 30, 2025) for various state agencies. No change in funding for State Library of Iowa, Enrich Iowa, Auditor of State, Treasurer of State, Secretary of State, cultural activities and historical sites, and Civil Rights Commission.  Increases funding for Department of Administrative Services by $116,637; Governor's office by $46,842, Department of Inspections, Appeals & Licensing (DIAL) administration by $548,951, gambling licensing by $152,622, insurance division by $521,161, and the Iowa Utilities Board by $256,571. Cuts IPERS by $148,597.  Many of the increases are actually shifting responsibilities between departments, agencies, and divisions.  More information coming.

Appropriates a total of $1.02 billion for educational programs (an increase of $32.6 million) for the fiscal year beginning July 1, 2024 (FY 2025).  General increases are aligned with allowed growth for schools (2.5%) for community colleges, state universities, Iowa school for the deaf, and educational services for the blind and visually impaired.  New funding for the Department of Education as required in AEA reform: $2.2 million to take over professional development and $10 million for the new special education division. The AEA bill also called for a $14 million appropriation for education support staff (para-educators) contingent upon the AEA legislation being signed, but that is not in the bill. No change in funding for Birth to Age Three Services and child health specialty clinics, school food service, public broadcasting, regional career and technical education partnerships, early head start projects, Jobs for America's Graduates, Reading Research Center, school based mental health training and support, Best Buddies, Last Dollar Scholarship, Future Ready Iowa, Iowa Workforce Grant & Incentive Program, mental health professional loan repayment program, health care loan repayment program, rural Iowa primary care loan repayment program, loan repayment for health care professionals, skilled worker & job creation programs, UI college of nursing, and therapeutic classroom incentive fund and transportation claims.  The nonpartisan staff analysis (dated 4/8/24) is at: https://www.legis.iowa.gov/docs/publications/NOBA/1448874.pdf.

Appropriates $2.2 billion for health and human services programs (including Medicaid) for the fiscal year beginning July 1, 2024 (FY 2025).  This is an increase of $63.1 million. Appropriates $467.7 million from other funds (a decrease of $540,000). Aging & Disability Services ($19,088,714): Increases funding for department duties by $155,157. Eliminates line items but not the responsibility for the work. Codifies area agency on aging language that has been in the budget for more than a decade. Because of budget restructuring, this includes aging programs, general administration, field operations, state supplementary assistance, health program operations, Conner decree training, and the family support subsidy/child at home pilot. Behavioral Health ($24,400,114):  No change in funding. Continues two line items at current levels (Children's Behavioral Health System - $300,000; managed care substance use treatment transfer - $950,000). Maintains $1.75 million transfer from sports wagering receipts fund. Because of budget restructuring, this includes general administration, addictive disorders, and healthy children/families. Public Health ($22,916,821): No change in funding.  No change in earmarked funds: brain injury facilitators and training ($1.055 million), epilepsy education and support ($144,000), psychology postdoctoral internships ($48,000), SafeNetRx prescription drug donation program ($600,000), rural health clinics ($25,000), free clinics ($334,000), specialty care access ($225,000), medical residencies ($2.1 million), rural psychiatric residencies ($800,000), psychiatric training for PAs & nurse practitioners ($150,000), Center of Excellence program ($425,000), and family medicine/obstetrics fellowship ($560,000). Because of budget restructuring, this includes healthy children/families, chronic conditions, community capacity, essential public health services, infectious diseases, public protection, congenital & inherited disorders registry, and psychiatric residency funding. Community Access ($68,043,944): This is a decrease of $2.1 million (primarily due to decreased enrollment in PROMISE JOBS and Family Investment Program/FIP). Because of budget restructuring, this includes some aging programs, human rights administration, general administration, field operations, FIP/Promise Jobs, Medicaid, children's health insurance (hawk-I), volunteer programs, chronic conditions, community capacity, and public protection).  No change for First Five Health Mental Development programs ($3.1 million), pregnancy prevention grants ($1.9 million), childcare assistance ($47.2 million), and child protective services ($62.4 million). Adds new $3 million appropriation for a new kinship stipend program (paying family members or fictive kin as foster parents for relative children placed in their care). Increases Medicaid by $84.4 million (total $1.63 billion). This includes increases of $40.9 million increase to meet expected need, $16.5 million to replace federal funds used to increase HCBS waiver rates (aka "ARPA backfill"), and $3.6 million for children's health insurance program to meet expected need. Does NOT include $14.6 million to increase HCBS waiver rates by 5% as requested by the Governor. No change in funding for nursing home facility improvements ($900,000), and state family planning services ($3.4 million).  Reimbursement Rates: No change in Medicaid or child welfare reimbursement rates. Health Program Operations ($39,597,231): This is an increase of $1.2 million due to contract increases. No change for state poison control center ($750,000).  Childcare Assistance ($34,966,931): No change in funding. Early Intervention & Supports ($35,277,739): No change in funding for human rights administration, community advocacy and services, early childhood Iowa ($29,256,799), More Options for Maternal Support ($1 million), and child abuse prevention (no longer line item).  Child Protective Services ($164,644,037): This is a $2.6 million increase for programs that include child and family services and the adoption subsidy.  No change in funding for decategorization ($1,717,000), group foster care ($40.5 million), court-ordered services ($748,000), child protection center grants ($1,658,000), Project Harmony for child abuse victims ($227,000), and adoption subsidies ($40.9 million). Increases funding for Preparation for Adult Living by $334,000 (total $4,359,500). State Specialty Care Services ($100,006,128): This is a small increase ($35,259) for state-owned institutions. Increases Cherokee MHI by $2.6 million, Independence MHI by $3.1 million, sex offender civil commitment at Cherokee MHI by $1.9 million, and Eldora State Training School by $961,124. No change in funding for Woodward State Resource Center ($13.4 million) and reduces funding for the Glenwood State Resource Center by $11 million ($5.3 million). Administration & Compliance ($21,194,894): Small increase of $93,902.  No change in funding for ABLE Savings Account administration ($200,000) and long-term care ombudsman ($1,148,959).  Other: Gives HHS the ability to transfer funds as needed to continue realignment and maximize federal support. Allows HHS to use funds that are not used for their original purpose to pay for the Thrive Iowa Program. Increase the number of rural psychiatric residencies from six to eight annually. Allows HHS to use SSA and FIP unused funds to support "program integrity, compliance, and efficiency." Allows the Office of Public Guardian to carry over unused funds into the next fiscal year. Splits LIHEAP (Low Income Home Energy Assistance Program) administration between contractors (8.4%) and HHS (1.6%); currently the cap on administration is 10% with $377,000 going to HHS.  Removes language about an additional amount money to be transferred from the beer & liquor control fund for substance use disorder treatment (legislators have never transferred more than the base $2 million). Requires HHS to collaborate with the Department of Revenue on tobacco control enforcement. Requires the legislature to appropriate enough money each year to fully fund personal needs allowance (which is currently $50/month) and requires the allowance to be increased at the same percentage and at same time federal SSI benefits are increased. Transfers the replacement generation tax that had been going to mental health property tax relief to Medicaid (remaining funds were minimal = $12,954). Transfers remaining funds in the Medicaid Fraud Fund ($150,000) to Medicaid. Allows Medicaid recipients residing in a State MHI to keep their Medicaid eligibility during their stay at the MHI. Permits the HHS to bill for State Resource Center services utilizing a scope of services approach in a manner that does not shift costs between the Medicaid program, the MHDS regions, or other State Resource Center funding sources. Moves juvenile detention funding and current formula into Code (so it doesn't have to be in the budget each year).  States that child support recovery for state foster care payments does not apply when a child is placed with a relative or fictive kin who is not licensed as a child foster care provider. Requires nursing home quality assurance assessments to be paid monthly (rather than quarterly). Removes the requirement that quality assurance assessment forms be submitted within 30 days of the end of each calendar quarter. Includes standing (automatic) appropriation for child abuse prevention ($233,000), psychiatry residencies ($1.1 million), and the congenital and inherited disorders registry ($224,000). Requires HHS to work with the Iowa Health Information Network to enhance the program to give Iowans access and use their health information. You can find the nonpartisan staff review (dated 4/9/24) at: https://www.legis.iowa.gov/docs/publications/NOBA/1448980.pdf.

Division I – Income Tax Cut – Current law ratchets the income tax down to 3.9% by 2026.  This bill would instead lower that rate to 3.8% and have it take effect in 2025.  Also lowers the alternative minimum tax from 4.4 to 4.3%, also in 2025. 

Division II – Targeted Jobs Withholding Credit – Makes changes to the pilot program (in use in Sioux City and some other border communities), including raising an employer’s qualifying investment from $500K to $1M and changing the program’s sunset date from June 30, 2024 to June 30, 2027.

Division III – Franchise Tax changes dealing with financial institutions’ investments.

Division IV – Makes a number of property tax corrective changes, including changing dates by which local governments need to file reports with the Department of Management, the dates statements to taxpayers needs to be sent out, the information included in those statements, the examples provided to the taxpayers, etc.  This division allows Lee County to decide their courthouse/county seat situation. The division takes steps to protect the confidentiality of homestead credit applicants over the age of 65.  This division also extends by 3 years certain housing TIF projects that faced challenges due to COVID supply chain shortages.  

Division V – Compensation Elected County Officials – The bill makes a number of changes, including allowing county supervisors to establish or eliminate county compensation boards.  

Division VI – City & County Levy Growth Limitations – The bill adds a bracket into the calculations on how much cities and counties are allowed to raise their levies.  Under last year’s bill, there were three: 0% to 3% increase in growth is allowed to maintain their levy, 3%-6% growth is allowed to increase their levy by 2%, and growth exceeding 6% is allowed to increase their levy by 3%.  Under the bill, the new brackets would be: 0% to 2.75% allowed to maintain same levy, 2.75% to 4% allowed a 1% increase, 4% to 6% allowed a 2% increase, over 6% allowed a 3% increase. 

Division VII – Public Utility/Pipeline property tax assessment limitations – Under current law, property owned by such entities are assessed by the Department of Revenue and distributed to the local entities.  The bill removes the state part of this returning it to the local governments, and institutes a 2% per year rollback until those properties are assessed at 90% in 2029 (same as commercial). 

Division VIII – Taxpayer Relief Fund – The bill makes changes to the thresholds used when State revenues come in at certain levels, and how those funds are transferred.  

Division IX – Makes a corrective change to the MEGA sites bill, SF 574.

Aims to address the stigma surrounding mental health by introducing the term "brain health" as a synonym. It emphasizes that the brain is susceptible to diseases and disorders, and maintaining its health is crucial for overall well-being. By promoting awareness and education, the bill seeks to encourage Iowans to take preventive measures and seek early treatment for brain health issues. The Senate resolves to recognize "brain health" as encompassing all aspects of the brain that affect mood and behavior, and encourages its use alongside existing terms like mental health and mental illness to promote a stigma-free environment for accessing brain health services.

This bill replaces the income tax rate in the Iowa Code (set to hit 3.9% in 2026) with a rate of 3.775% in 2026 and 3.65% in 2027.  The bill also sets up a long-term plan to eventually eliminate Iowa’s income tax.  The bill would invest roughly $2.6 Billion of the Taxpayer Relief Fund (current balance of more than $3 Billion) and then transfer 5% of the proceeds each year into an Income Tax Elimination Fund which could be used to ratchet down the income tax rate until it eventually hits zero.  The funds would be managed by the Iowa Public Employee Retirement System (IPERS).