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HF2578: Health & Human Services Budget


Appropriates $2.1 billion to the Departments on Aging, Public Health, Human Services and Veterans Affairs for the state fiscal year beginning July 1, 2022 (FY23). This is an increase of $20.7 million (less than 1%).  Aging: No change in funding for the Office of Public Guardian, the Office of Long-Term Care Ombudsman, or other aging programs except an increase of $600,000 to expand the Return to Community Pilot Project to help keep older Iowans in their homes longer ($850,000 total).  Public Health:  No change in funding, except to add $200,000 for two more rural psychiatric residencies (six total).  Continues earmarked funding at current levels (including SafeNetRx, rural health clinics, free clinics, dental programs, caregivers, psychologist internships, specialty care access, PA/ARNP mental health training, public health workforce initiatives, SART training). Includes transfer of funds from Sports Wagering Fund to substance use and gambling treatment fund to maintain current funding ($1.75 million).  Federal Grants (TANF): No change in funding for child abuse prevention grants ($125,000), pregnancy prevention grants ($1.9 million), and childcare ($47.2 million). No change in state funding for childcare ($40.8 million). Human Services/Medicaid: Increases Medicaid funding by $6.3 million ($1.5 billion total); $1,339,971 to increase Intermediate Care Facility serving individuals with  Intellectual Disabilities (ICF/ID) to increase wages of direct care staff; $1,777,082 to provide incentives for rural home health providers (the rate structure is to include a telehealth component to incentivize supervision of skilled care without additional travel time); $3 million to increase PMIC/BHIS (behavioral health intervention services at Psychiatric Medical Institutions for Children); and $385,000 increase for applied behavior analysis (ABA) rate increases. No increase for residential substance use treatment provider rates. Requires development of psychiatric tiered rates. Makes functional family and multi systemic therapy a covered Medicaid service.   The following items are no longer included in the Medicaid budget, but have been shifted to federal COVID-relief (ARPA) funds: increase $14.7 million for HCBS provider rates (including habilitation, consumer choice option, consumer-directed attendant care) to be used to increase direct support staff wages; increase of $7.4 million to take another 250 individuals off the HCBS/Intellectual Disability waiver waiting list; and the costs associated with adding functional family and multi-systemic therapy to Medicaid ($200,000).  Human Services/Health Programs: Cuts funding for the Autism Support Program by $385,000 to reflect actual utilization (total $188,000). Increases funding for the Children's Health Insurance Program (hawk-I) by $704,045 to cover anticipated need (total $38.7 million). Human Services/Child Welfare: Increases shelter care rates by $649,029 and rates for Qualified Residential Treatment Programs (QRTP, previously group care) by $3,850,718. No change in reimbursement for juvenile detention, and increases funding for the Eldora State Training School by $209,803 (total $17.6 million).  Human Services/Institutions: Increases funding for Cherokee MHI by $156,000, Independence MHI by $137,000, Glenwood State Resource Center by $1.5 million, and Woodward State Resource Center by $1.2 million (most to replace enhanced federal match during COVID public health emergency). Increases funding for the Civil Commitment Unit by $248,000 for a new transition ward and staff. Other Funding: Increases DHS field operations funding by $5.3 million to hire 50 new staff to lower caseloads. Continues $800,000 appropriation for nursing home renovation and construction (previously funded through the Infrastructure budget).  New Programs: Adds $500,000 for a new MOMS (More Options for Maternal Support) program, which provides grants to non-profits to provide a broad range of services and supports for pregnant women and new moms (a program administrator will be selected to give out and monitor compliance of grants).  Requires DHS to review data on postpartum coverage and report back to the Legislature by December 15, 2022 (number of people receiving postpartum service's services utilized, costs of services, and information on the number of states providing Medicaid postpartum coverage beyond 60 days, related costs, and data on 12-month postpartum coverage). Adds $1.2 million to create a new Psychiatry Residency Program to add 12 psychiatry residencies at state institutions (MHIs, state resource centers, Eldora, Oakdale). Other Changes: Clarifies that federal public health emergency rules trump administrative rules; adds language allowing the merge of the Departments of Public Health and Human Services to move forward (new name "Department of Health and Human Services") and specifies transition period powers and duties (initial transition plan due 9/30/2022);  repeals the non-state government-owned nursing facility quality of care rate add-on program; allows funds for the audiological services and hearing aids for children to carry forward (the $156,000 appropriation made for the current fiscal year is not expected to be fully used); updates the definition of "intellectual disability" in Iowa Code and amends requirements for admission or transfer to a state MHI of a person with an intellectual disability (only the DHS director or the MHI can determine if the person is eligible and if they have the capacity to serve the person appropriately); exempts Medicaid and hawk-I programs from insurance mandates, unless they are specifically directed to comply; updates MH/DS Region requirements and clarifies that a single-county region must be in compliance with all regional requirements; prohibits insurance companies from excluding out-of-state telehealth companies from their networks if the professionals providing the service are licensed in Iowa; changes major renovation threshold for nursing homes from $1.5 million to $750,000; adds the replacement of HVAC to the criteria under which a nursing facility may request instant rate relief; restricts the State Auditor from accessing an individual's name and address from a reportable disease report; and requires state and local agency employees accessing personally identifiable data in reportable disease reports to have undergone data confidentiality training. Takes effect July 1, 2022. Telehealth provider insurance mandates take effect upon enactment. More detail at:

Recent Actions
Position: Track
Topic/Subject: Budgets

Last Modified: 06/28/2022

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