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HF 2782
Iowa House•Signed by Governor
Summary
HF 2782, a bill for an act relating to and making appropriations to the department of veterans affairs and the department of health and human services, including aging and disability services, behavioral health, public health, and community access and eligibility; the medical assistance program, state supplementary assistance, Hawki, and other health-related programs; family well-being and protection; state-operated specialty care; administration and compliance; transfers, cash flow, and nonreversions; report on nonreversion of moneys; more options for maternal support program; reimbursement rates review; mental diseases exclusion waiver; full-time equivalent dashboard; comprehensive family support program; federal community mental health services block grant; behavioral health expenditure report; opioid settlement fund; emergency rules; graduate medical education; and special population nursing facilities; and including effective date and retroactive applicability provisions. (Formerly HSB 777.) Effective date: 06/02/2026, 07/01/2026. Applicability date: 07/01/2025, was introduced in the House on Apr 21, 2026 by Rep. Appropriations. It last saw action on Jun 2, 2026: Item vetoed, signed by Governor. H.J. 1174.
Record
Text
HF 2782 has 4 roll calls.
hf2782/enrolled.txtHouseFile2782-EnrolledHouseFile2782ANACTRELATINGTOANDMAKINGAPPROPRIATIONSTOTHEDEPARTMENTOFVETERANSAFFAIRSANDTHEDEPARTMENTOFHEALTHANDHUMANSERVICES,INCLUDINGAGINGANDDISABILITYSERVICES,BEHAVIORALHEALTH,PUBLICHEALTH,ANDCOMMUNITYACCESSANDELIGIBILITY;THEMEDICALASSISTANCEPROGRAM,STATESUPPLEMENTARYASSISTANCE,HAWKI,ANDOTHERHEALTH-RELATEDPROGRAMS;FAMILYWELL-BEINGANDPROTECTION;STATE-OPERATEDSPECIALTYCARE;ADMINISTRATIONANDCOMPLIANCE;TRANSFERS,CASHFLOW,ANDNONREVERSIONS;REPORTONNONREVERSIONOFMONEYS;MOREOPTIONSFORMATERNALSUPPORTPROGRAM;REIMBURSEMENTRATESREVIEW;MENTALDISEASESEXCLUSIONWAIVER;FULL-TIMEEQUIVALENTDASHBOARD;COMPREHENSIVEFAMILYSUPPORTPROGRAM;FEDERALCOMMUNITYMENTALHEALTHSERVICESBLOCKGRANT;BEHAVIORALHEALTHEXPENDITUREREPORT;OPIOIDSETTLEMENTFUND;EMERGENCYRULES;GRADUATEMEDICALEDUCATION;ANDSPECIALPOPULATIONNURSINGFACILITIES;ANDINCLUDINGEFFECTIVEDATEANDRETROACTIVEAPPLICABILITYPROVISIONS.BEITENACTEDBYTHEGENERALASSEMBLYOFTHESTATEOFIOWA:DIVISIONIDEPARTMENTOFVETERANSAFFAIRS——FY2026-2027Section1.DEPARTMENTOFVETERANSAFFAIRS.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofveteransaffairsforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamounts,HouseFile2782,p.2orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:1.DEPARTMENTOFVETERANSAFFAIRSADMINISTRATIONForsalaries,support,maintenance,andmiscellaneouspurposes,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$1,369,205...............................................FTEs15.002.IOWAVETERANSHOMEForsalaries,support,maintenance,andmiscellaneouspurposes:..................................................$8,145,736a.TheIowaveteranshomebillingsinvolvingthedepartmentofhealthandhumanservicesshallbesubmittedtothedepartmentonatleastamonthlybasis.b.TheIowaveteranshomeexpenditurereportshallbesubmittedmonthlytothegeneralassembly.3.HOMEOWNERSHIPASSISTANCEPROGRAMFortransfertotheIowafinanceauthorityforthecontinuationofthehomeownershipassistanceprogramforpersonswhoareorwereeligiblemembersofthearmedforcesoftheUnitedStatesoreligibleservicememberspursuanttosection16.54:..................................................$2,200,000DIVISIONIIAGINGANDDISABILITYSERVICES——FY2026-2027Sec.2.DEPARTMENTOFHEALTHANDHUMANSERVICES——AGINGANDDISABILITYSERVICES.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:ForagingprogramsforthedepartmentofhealthandhumanservicesandareaagenciesonagingtoprovidecitizensofIowawhoare60yearsofageandolderwithcasemanagement;forIowa’saginganddisabilitiesresourcecenters;forthereturntocommunityprogram;forthepurposesofchapter231E;toadministerthepreventionofelderabuse,neglect,andexploitationprogrampursuanttosection231.56A,inaccordanceHouseFile2782,p.3withtherequirementsofthefederalOlderAmericansActof1965,42U.S.C.§3001etseq.,asamended;fortheoperationofthedependentadultabuseservicesprogrampursuanttochapter235B;formatchingfundingforprogramstoenablepersonswithseverephysicalormentaldisabilitiestofunctionmoreindependently;forcostsassociatedwithcentersforindependentliving;andforotherserviceswhichmayincludebutarenotlimitedtoadultdaycare,respitecare,chore,informationandassistance,andmaterialaid;forinformationandoptionscounselingforpersonswithdisabilities;andforsalaries,support,administration,maintenance,andmiscellaneouspurposes,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$19,379,531...............................................FTEs101.001.Moneysappropriatedinthissectionmaybeusedtosupplementfederalmoneysreceivedunderfederalregulations.Toreceivemoneysappropriatedinthissection,alocalareaagencyonagingshallmatchthemoneyswithmoneysfromothersourcesaccordingtorulesadoptedbythedepartment.Moneysappropriatedinthissectionmaybeusedforservicesnotspecificallyenumeratedinthissectiononlyifapprovedbythedepartmentaspartofanareaagencyonaging’sareaplan.2.Ofthemoneysappropriatedinthissection,$949,282isallocatedtobeusedforthecomprehensivefamilysupportprogramcreatedinsection231.80asenactedunderthisAct.3.Ofthemoneysappropriatedinthissection,$33,632isallocatedtobeusedtobuildcommunitycapacitythroughthecoordinationandprovisionoftrainingopportunitiesinaccordancewiththeconsentdecreeofConnerv.Branstad,No.4-86-CV-30871(S.D.Iowa,July15,1994).DIVISIONIIIBEHAVIORALHEALTH——FY2026-2027Sec.3.DEPARTMENTOFHEALTHANDHUMANSERVICES——BEHAVIORALHEALTH.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:HouseFile2782,p.4Forbehavioralhealthprevention,education,earlyintervention,treatment,recoverysupport,andcrisisservicesinordertosupportstatewideaccesstotreatmentforbehavioralhealthconditions;stabilizationandmitigationofbehavioralhealthcrises;andrecoveryforindividualsandfamiliesimpactedbybehavioralhealthconditions.ActivitiesshallalignwithacceptedbestpracticeguidancestandardsforbehavioralhealthincludingthosepublishedbythecentersfordiseasecontrolandpreventionoftheUnitedStatesdepartmentofhealthandhumanservices,andthesubstanceabuseandmentalhealthservicesadministrationoftheUnitedStatesdepartmentofhealthandhumanservices,forhealthpromotion;universal,selective,andindicatedprevention;treatment;andrecoveryservicesandsupports;andshallincludea24-hourhelpline,publicinformationresources,professionaltraining,youthprevention,programevaluation,andeffortsatthestateandlocallevels,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$23,127,121...............................................FTEs70.001.Ofthemoneysappropriatedinthissection,$300,000isallocatedtosupporttheworkofthechildren’sbehavioralhealthsystemincludingevidence-basedbehavioralhealthprevention,treatment,andrecoveryservicesandsupportsforchildrenandtheirfamilies.2.Ofthemoneysappropriatedinthissection,$950,000isallocatedforanintegratedsubstanceusedisordermanagedcaresystem.Thedepartmentshallmaintainthelevelofmentalhealthandsubstanceusedisordertreatmentservicesprovidedbythemanagedcarecontractors,andshalltakethestepsnecessarytocontinuethefederalwaiversasneededtomaintainthelevelofservices.Sec.4.DEPARTMENTOFHEALTHANDHUMANSERVICES——SPORTSWAGERINGRECEIPTSFUND.Thereisappropriatedfromthesportswageringreceiptsfundcreatedinsection8.57I,tothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforbehavioralhealthprevention,education,earlyintervention,HouseFile2782,p.5treatment,recoverysupport,andcrisisservicesinordertosupportstatewideaccesstotreatmentforbehavioralhealthconditions;stabilizationandmitigationofbehavioralhealthcrises;andrecoveryforindividualsandfamiliesimpactedbybehavioralhealthconditions:..................................................$1,750,000DIVISIONIVPUBLICHEALTH——FY2026-2027Sec.5.DEPARTMENTOFHEALTHANDHUMANSERVICES——PUBLICHEALTH.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Forprogramsthatsupporthealthpromotion,protectthehealthandsafetyofthepublic,conductdiseasesurveillanceandinvestigationtoreducetheincidenceofmorbidityandmortality,serveindividualswithchronicconditionsincludingbutnotlimitedtocancer,supporttheIowadonorregistryasspecifiedinsection142C.18,andstrengthenthehealthcaredeliverysystemandworkforcetoimprovehealthoutcomesforallIowans,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$21,168,369...............................................FTEs348.601.Ofthemoneysappropriatedinthissection,$191,000isallocatedtotheuniversityofIowahospitalsandclinicstoadministerachildvisionscreeningprogramthroughcontinuationofanexistingcontract.Theprogramshallsubmitareporttothedepartmentregardingtheuseoffundsallocatedunderthissubsection.Thereportshallincludetheobjectivesandresultsfortheprogramyearincludingthetargetpopulationandhowthefundsallocatedassistedtheprograminmeetingtheobjectives;thenumber,age,andlocationwithinthestateofindividualsserved;thetypeofservicesprovidedtotheindividualsserved;thedistributionofmoneysbasedontheservicesprovided;andthecontinuingneedsoftheprogram.2.Ofthemoneysappropriatedinthissection,$144,000isallocatedforthepublicpurposeofallowingthedepartmentHouseFile2782,p.6tocontinueanexistingcontractwithanexistingaffiliatedorganizationtoprovideeducation,client-centeredprograms,andclientandfamilysupport,forpeoplelivingwithepilepsyandtheirfamilies.Themoneysallocatedinexcessof$50,000shallbematcheddollarfordollarbytheexistingaffiliatedorganization.MoneysunderthissectionshallbedistributedintheirentiretyonJuly1,2026,forthepurposespecified.3.Ofthemoneysappropriatedinthissection,thefollowingamountsareallocatedtothedepartmentofhealthandhumanservicestobeusedasfollowstosupportthegoalsofincreasedaccess,healthsystemintegration,andengagement:a.$600,000fordistributiontoanonprofitorganizationthatestablishedthefirststatewidedrugdonationrepositoryforcontinuationofthepharmaceuticalinfrastructureforsafetynetprovidersestablishedasdescribedin2007IowaActs,chapter218,section108,andfortheprescriptiondrugdonationrepositoryprogramestablishedinchapter135M.MoneysunderthisparagraphshallbedistributedintheirentiretyonJuly1,2026,forthepurposespecified.b.$374,000fordistributiontofreeclinics,asdefinedinsection135.24,andanonprofitorganizationthatfacilitatestheinitiation,operation,andcollaborationoffreeclinicsfornecessaryinfrastructure,statewidecoordination,providerrecruitment,servicedelivery,andprovisionofassistancetopatientsinsecuringamedicalhomeinclusiveoforalhealthcare.Ofthemoneysallocated,$40,000shallbeusedtolowerfeesassociatedwithusinganelectronicprescribingsystem.MoneysunderthisparagraphshallbedistributedintheirentiretyonJuly1,2026,forthepurposespecified.c.$25,000fordistributiontoanorganizationthatraisesawarenessaboutissuesrelatedtoruralhealthclinicsfornecessaryinfrastructureandservicedeliverytransformation.MoneysunderthisparagraphshallbedistributedintheirentiretyonJuly1,2026,forthepurposespecified.4.Ofthemoneysappropriatedinthissection,$400,000isallocatedforruralpsychiatricresidenciesforresidentsselectedonorbeforeJune30,2026.5.Ofthemoneysappropriatedinthissection,$20,000isallocatedtomakeradontestkitsavailable,freeofcharge,HouseFile2782,p.7tohomeownersandrentersinthestate.Thedepartmentshallprovidealinkonthedepartment’sinternetsiteforhomeownersandrentersinthestatetoorderradontestkits.6.Ofthemoneysappropriatedinthissection,$1,500,000isallocatedforawardinggrantsformedicalresidencyprogramsinthestatethatmeetthefollowingcriteria:a.Themedicalresidencyprogramisnotrelatedtothepracticeoffamilymedicine.b.Themedicalresidencyprogramisnotlocatedinacountythathasapopulationofonehundredfiftythousandormorebasedonthemostrecentfederaldecennialcensus,andinwhichthemaincampusofaninstitutionofhigherlearninggovernedbythestateboardofregentsislocated.7.TheuniversityofIowahospitalsandclinicsunderthecontrolofthestateboardofregentsshallnotreceiveindirectcostsfromthemoneysappropriatedinthissection.TheuniversityofIowahospitalsandclinicsbillingstothedepartmentshallbe,ataminimum,onaquarterlybasis.DIVISIONVCOMMUNITYACCESSANDELIGIBILITY——CHILDSUPPORTSERVICES——TANF——FY2026-2027Sec.6.DEPARTMENTOFHEALTHANDHUMANSERVICES——COMMUNITYACCESSANDELIGIBILITY.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Tobeusedforsalaries,support,maintenance,andmiscellaneouspurposesandforfamilyinvestmentprogram(FIP)assistanceinaccordancewithchapter239B,andforothercostsassociatedwithprovidingneeds-basedbenefitsorassistanceincludingbutnotlimitedtomaternalandchildhealth,oralhealth,obesityprevention,thepromotingindependenceandself-sufficiencythroughemployment,jobopportunitiesandthebasicskills(PROMISEJOBS)program,supplementalnutritionassistanceprogram(SNAP)employmentandtraining,theFIPdiversionprogram,familyplanning,rentreimbursement,andeligibilitydeterminationsformedicalassistance,foodassistance,andthechildren’shealthinsuranceprogram,andHouseFile2782,p.8fornotmorethanthefollowingfull-timeequivalentpositions:..................................................$76,371,516...............................................FTEs883.901.OfthechildsupportcollectionsassignedunderFIP,thefederalshareofthechildsupportcollectionsshallbecreditedtothechildsupportservicesappropriationmadeinthisdivisionofthisAct.OftheremainderofthechildsupportcollectionsassignedunderFIP,aportionshallbecreditedtocommunityaccessandeligibility,andtheremainingmoneysmaybeusedtoincreaserecoveries,tosustaincashflowinthecollectionservicescenterrefundaccountasprovidedinsection252B.13A,orfortechnologyneeds.IfchildsupportcollectionsassignedunderFIParegreaterthanestimatedorareotherwisedeterminednottoberequiredformaintenanceofefforts,thestateshareofeitheramountisappropriatedtothedepartmentforchildsupportservicesasdescribedinthisdivisionofthisAct,ormaybetransferredtoorretainedinthecollectionservicescenterrefundaccount.2.Ofthemoneysappropriatedinthissection,$3,075,000isallocatedforcontinuationofthedepartment’sinitiativetoprovideforadequatedevelopmentalsurveillanceandscreeningduringachild’sfirstfiveyears.Themoneysshallfirstbeusedtofullyfundthecurrentparticipatingcountiestoensurethatthosecountiesarefullyoperational,withtheremainingmoneystobeusedforexpandingparticipationtoadditionalcounties.Fullimplementationandexpansionshallincludeenhancingthescopeoftheinitiativethroughcollaborationwithchildhealthspecialtyclinicstopromotetheuseofdevelopmentalsurveillanceandscreeningtosupporthealthychilddevelopmentthroughearlyidentificationandresponsetobiomedicalandsocialdeterminantsofhealthydevelopmentbyprovidingpractitionerconsultationandcontinuousimprovementthroughtrainingandeducation,particularlyforchildrenwithbehavioralconditionsandneeds.ThedepartmentshallalsocollaboratewiththeMedicaidprogramandchildhealthspecialtyclinicstoassistincoordinatingtheactivitiesofthefirstfiveinitiativeintotheestablishmentofpatient-centeredmedicalhomesdevelopedtoimprovehealthqualityandpopulationhealthwhilereducinghealthcarecosts.HouseFile2782,p.9Tothemaximumextentpossible,moneysallocatedinthissubsectionshallbeutilizedasmatchingmoneysforMedicaidprogramreimbursement.3.Ofthemoneysappropriatedinthissection,$1,145,102isallocatedtotheIowacommissiononvolunteerservicecreatedinsection15H.2forprogramsandgrants.4.TheuniversityofIowahospitalsandclinicsunderthecontrolofthestateboardofregentsshallnotreceiveindirectcostsfromthemoneysappropriatedinthissection.TheuniversityofIowahospitalsandclinicsbillingstothedepartmentshallbe,ataminimum,onaquarterlybasis.Sec.7.DEPARTMENTOFHEALTHANDHUMANSERVICES——CHILDSUPPORTSERVICES.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Forchildsupportservices,includingsalaries,support,maintenance,andmiscellaneouspurposes,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$15,644,114...............................................FTEs464.001.Federalaccessandvisitationgrantmoneysshallbeusedforservicesdesignedtoincreasecompliancewiththechildaccessprovisionsofcourtorders,includingbutnotlimitedtoneutralvisitationsitesandmediationservices.2.Moneysappropriatedinthissectionmaybeusedthroughoutthefiscalyearinthemannernecessaryforcashflowmanagement.Forcashflowmanagementunderthissubsection,thedepartmentmaytemporarilydrawmorethantheamountappropriatedprovidedtheamountappropriatedisnotexceededatthecloseofthefiscalyear.Sec.8.DEPARTMENTOFHEALTHANDHUMANSERVICES——TEMPORARYASSISTANCEFORNEEDYFAMILIESBLOCKGRANT.Thereisappropriatedfromthespecialfundcreatedinsection8.41tothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,frommoneysreceivedunderthefederaltemporaryassistanceforneedyfamilies(TANF)blockgrantpursuanttothefederalPersonalHouseFile2782,p.10ResponsibilityandWorkOpportunityReconciliationActof1996,Pub.L.No.104-193,andsuccessorlegislation,includingTANFblockgrantmoneysreceivedinanypriorfiscalyearthatweredepositedinthespecialfundandremainunencumberedorunobligatedonJune30,2026,thefollowingamounts,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:1.Forcommunityaccessandeligibility:..................................................$12,566,3122.Forcommunityaccessandeligibilitytoprovidepregnancypreventiongrantsontheconditionthatfamilyplanningservicesarefunded:..................................................$1,913,203PregnancypreventiongrantsshallbeawardedtoprogramsinexistenceonorbeforeJuly1,2026,iftheprogramshavedemonstratedpositiveoutcomes.GrantsshallbeawardedtopregnancypreventionprogramsdevelopedafterJuly1,2026,iftheprogramsarebasedonexistingmodelsthathavedemonstratedpositiveoutcomes.Grantsmustcomplywiththerequirementsprovidedin1997IowaActs,chapter208,section14,subsections1and2,includingtherequirementthataprogramawardedagrantmustemphasizesexualabstinence.Priorityinawardinggrantsshallbegiventoprogramsthatserveareasofthestatewhichdemonstratethehighestpercentageofunplannedpregnanciesoffemalesofchildbearingagewithinthegeographicareatobeservedbythegrant.3.TomeetoneofthefourpurposesofTANFasspecifiedin45C.F.R.§260.20,includingbymodernizingtheprogramtopromoteeconomicmobilityandself-sufficiency,ensuringthatfamiliesareabletoovercomebenefitcliffs,encouraginghealthyfamilies,andstreamliningservicedeliverytoreduceduplication:..................................................$25,000,0004.Forearlyinterventionandsupportsforchildabusepreventionandthefamilydevelopmentandself-sufficiency(FaDSS)grantprograminaccordancewithsection216A.107:..................................................$3,013,9805.Foraccountability,compliance,programintegrity,technologyneeds,andotherresourcesnecessarytomeetHouseFile2782,p.11federalandstatereporting,tracking,andcasemanagementrequirements,andotherdepartmentalneeds:..................................................$3,533,6476.Forstatechildcareassistance:..................................................$42,281,8267.Forchildprotectiveservices:..................................................$65,364,100DIVISIONVIMEDICALASSISTANCEPROGRAM——STATESUPPLEMENTARYASSISTANCE——HEALTHYANDWELLKIDSINIOWAPROGRAMANDOTHERHEALTH-RELATEDPROGRAMS——FY2026-2027Sec.9.DEPARTMENTOFHEALTHANDHUMANSERVICES——MEDICALASSISTANCEPROGRAM,STATESUPPLEMENTARYASSISTANCE,ANDHEALTHYANDWELLKIDSINIOWAPROGRAM.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:FormedicalassistanceprogramreimbursementandassociatedcostsasspecificallyprovidedinthereimbursementmethodologiesineffectonJune30,2026,exceptasotherwiseexpresslyauthorizedbylaw,consistentwithoptionsunderfederallawandregulations,andcontingentuponreceiptofapprovalfromtheofficeofthegovernorofreimbursementforeachabortionperformedunderthemedicalassistanceprogram;forthestatesupplementaryassistanceprogram;forthehealthinsurancepremiumpaymentprogram;andformaintenanceofthehealthyandwellkidsinIowa(Hawki)programpursuanttochapter514I,includingsupplementaldentalservices,forreceiptoffederalfinancialparticipationunderTit.XXIofthefederalSocialSecurityAct,whichcreatesthechildren’shealthinsuranceprogram;andforotherspecifiedhealth-relatedprograms:...............................................$1,992,550,7061.Ofthemoneysappropriatedinthissection,$1,919,596,113isallocatedformedicalassistanceprogramreimbursementandassociatedcosts.Ofthemoneysallocatedinthissubsection,$3,383,880shallbeusedforprogramadministration,outreach,andenrollmentactivitiesoftheHouseFile2782,p.12statefamilyplanningservicesprogrampursuanttosection217.41B,andofthisamount,thedepartmentmayuse$200,000foradministrativeexpenses.2.Iowanssupportreducingthenumberofabortionsperformedinourstate.Moneysappropriatedunderthissectionshallnotbeusedforabortions,unlessotherwiseauthorizedunderthissection.3.TheprovisionsofthissectionrelatingtoabortionsshallalsoapplytotheIowahealthandwellnessplancreatedpursuanttochapter249N.4.Ofthemoneysappropriatedinthissection,$4,479,762isallocatedforthestatesupplementaryassistanceprogram.5.Ofthemoneysappropriatedinthissection,$68,474,831isallocatedformaintenanceoftheHawkiprogrampursuanttochapter514I,includingsupplementaldentalservices,forreceiptoffederalfinancialparticipationunderTit.XXIofthefederalSocialSecurityAct,whichcreatesthechildren’shealthinsuranceprogram.Sec.10.DEPARTMENTOFHEALTHANDHUMANSERVICES——HEALTHPROGRAMOPERATIONS.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Forhealthprogramoperationsandtheautismsupportprogramundersection225D.2,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$40,342,766...............................................FTEs97.001.Thedepartmentofinspections,appeals,andlicensingshallprovideallstatematchingmoneysforsurveyandcertificationactivitiesperformedbythedepartmentofinspections,appeals,andlicensing.Thedepartmentofhealthandhumanservicesshallbesolelyresponsiblefordistributingthefederalmatchingmoneysforsuchactivities.2.Ofthemoneysappropriatedinthissection,asufficientamountisallocatedfortheadministrationofthehealthinsurancepremiumpaymentprogram,includingsalaries,support,maintenance,andmiscellaneouspurposes.HouseFile2782,p.133.Ofthemoneysappropriatedinthissection,$750,000isallocatedforanonprofitorganizationthatprovidesaccesstoemergencypoisoninformationandtreatment.Pursuanttothedirectiveunder2014IowaActs,chapter1140,section102,thefederalmatchingmoneysavailabletothenonprofitorganizationfromthedepartmentunderthefederalChildren’sHealthInsuranceProgramReauthorizationActof2009shallbesubjecttothefederaladministrativecapruleof10percentapplicabletomoneysprovidedunderTit.XXIofthefederalSocialSecurityAct,andshallbeincludedinthedepartment’scalculationsofthecap.4.Unlessotherwiseprovidedbylaw,ifacontractforservicesprovidedunderthissectioninitiallyenteredintoduringthefiscalyearbeginningJuly1,2026,andendingJune30,2027,providesforanannualincreaseofthecostofservicesprovidedunderthecontract,theannualincreaseshallnotexceedtheamountbywhichtheconsumerpriceindexforallurbanconsumersincreasedduringtheimmediatelyprecedingcalendaryear.ThissubsectiondoesnotaffectacontractenteredintoonorbeforeJune30,2026,thatisforatermofmorethanoneyear.Sec.11.DEPARTMENTOFHEALTHANDHUMANSERVICES——PHARMACEUTICALSETTLEMENTACCOUNT.Thereisappropriatedfromthepharmaceuticalsettlementaccountcreatedinsection249A.33tothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Notwithstandinganyprovisionoflawtothecontrary,tosupplementtheappropriationmadeinthisActfromthegeneralfundofthestateforhealthprogramoperationsunderthemedicalassistanceprogramforthesamefiscalyear:..................................................$234,193Sec.12.DEPARTMENTOFHEALTHANDHUMANSERVICES——QUALITYASSURANCETRUSTFUND.1.Notwithstandinganyprovisionoflawtothecontrary,andsubjecttotheavailabilityofmoneys,thereisappropriatedfromthequalityassurancetrustfundcreatedinsection249L.4tothedepartmentofhealthandhumanservicesforthefiscalHouseFile2782,p.14yearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,forthepurposesdesignated:TosupplementtheappropriationmadeinthisActfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesformedicalassistanceforthesamefiscalyear:..................................................$111,216,2052.Notwithstandingsection249L.4,subsection2,aftertheappropriationinsubsection1,anymoneysremaininginthequalityassurancetrustfundforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,areappropriatedtothedepartmentofhealthandhumanservicestosupplementtheappropriationmadeinthisActfromthegeneralfundofthestateforthemedicalassistanceprogramforthesamefiscalyear.Sec.13.DEPARTMENTOFHEALTHANDHUMANSERVICES——HOSPITALHEALTHCAREACCESSTRUSTFUND.1.Notwithstandinganyprovisionoflawtothecontrary,andsubjecttotheavailabilityofmoneys,thereisappropriatedfromthehospitalhealthcareaccesstrustfundcreatedinsection249M.4,tothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,forthepurposesdesignated:TosupplementtheappropriationmadeinthisActfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesformedicalassistanceforthesamefiscalyear:..................................................$33,920,5542.Notwithstandingsection249M.4,subsection2,aftertheappropriationinsubsection1,anymoneysremaininginthehospitalhealthcareaccesstrustfundforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,areappropriatedtothedepartmentofhealthandhumanservicestosupplementtheappropriationmadeinthisActfromthegeneralfundofthestateforthemedicalassistanceprogramforthesamefiscalyear.Sec.14.DEPARTMENTOFHEALTHANDHUMANSERVICES——BEHAVIORALHEALTHFUND.Notwithstandingsection225A.7,subsection2,andsubjecttotheavailabilityofmoneys,thereHouseFile2782,p.15isappropriatedfromthebehavioralhealthfundestablishedinsection225A.7,tothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,forthepurposesdesignated:TosupplementtheappropriationmadeinthisActfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesformedicalassistanceforthefiscalyearbeginningJuly1,2026,andendingJune30,2027:..................................................$5,580,938Sec.15.REIMBURSEMENTRATES.1.Reimbursementformedicalassistance,statesupplementaryassistance,andsocialserviceprovidersandservicesreimbursedunderthepurviewofthedepartmentofhealthandhumanservicesshallremainatthereimbursementrateineffectonJune30,2026,orshallbedeterminedpursuanttothereimbursementmethodologyineffectonJune30,2026,withtheexceptionofthefollowing:a.Ifreimbursementisotherwisenegotiatedbycontractorpursuanttoanupdatedfeeschedule.b.Asotherwiseprovidedinthissection.2.a.(1)Notwithstandinganyprovisionoflawtothecontrary,forthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thedepartmentofhealthandhumanservicesshallreimbursecase-mixnursingfacilityratesbasedonthemethodologyineffectonJune30,2026.(2)July1,2025,throughDecember31,2025,thedepartmentofhealthandhumanservicesshallcalculateeachnursingfacility’scase-mixindexforrateseffectiveJuly1,2026.(3)January1,2026,throughJune30,2026,thedepartmentofhealthandhumanservicesshallcalculateeachnursingfacility’scase-mixindexforrateseffectiveJanuary1,2027.(4)Allnursingfacilityrateadjustmentsunderthisparagraphshallbebudgetneutral.b.ForthefiscalyearbeginningJuly1,2026,$1,167,867shallbeusedtoincreasetotheextentpossiblereimbursementratesforambulatorysurgicalcenterscomparedtoratesineffectonJune30,2026.c.ForthefiscalyearbeginningJuly1,2026,$3,000,000HouseFile2782,p.16shallbeusedtoincreasetotheextentpossible,comparedwithratesineffectonJune30,2026,reimbursementratesforprovidersofMedicaidhomeandcommunity-basedserviceswaiverservicesusedmostfrequentlybyelderlywaiverrecipientsincludingattendantcare,homemaker,andassistedlivingservices.d.(1)AdjustmentstoMedicaidreimbursementratesdevelopedusingcostreportsshallbeappliedstartingontheeffectivedatespecifiedintheapplicablerateletterissuedtoaprovider.(2)MinimumMedicaidreimbursementratesforallproviderandservicetypesshallbenolowerthanthereimbursementratesestablishedinthedepartment’sminimumfeeschedule.(3)AnyincreaseinaMedicaidreimbursementratespecifiedunderthissectionshallbeeffectiveOctober1,2026.DIVISIONVIIFAMILYWELL-BEINGANDPROTECTION——FY2026-2027Sec.16.DEPARTMENTOFHEALTHANDHUMANSERVICES——STATECHILDCAREASSISTANCE.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Forstatechildcareassistanceinaccordancewithsections237A.13and237A.14,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$32,723,000...............................................FTEs53.001.Iftheappropriationmadeforpurposesofthestatechildcareassistanceprogramforthefiscalyearisdeterminedtobeinsufficient,itistheintentofthegeneralassemblytoappropriatesufficientmoneysforthefiscalyeartoavoidapplicationofwaitinglistrequirements.2.Aportionofthestatematchforthefederalchildcareanddevelopmentblockgrantshallbeprovidedasnecessarytomeetfederalmatchingmoneysrequirementsthroughthestategeneralfundappropriationmadeforchilddevelopmentgrantsandotherprogramsforat-riskchildreninsection279.51.Sec.17.DEPARTMENTOFHEALTHANDHUMANSERVICES——EARLYHouseFile2782,p.17INTERVENTIONANDSUPPORTS.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Forpromotionofoptimumhealthstatusforchildrenandadolescentsfrombirththrough21yearsofage,andforfamilies,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$36,495,203...............................................FTEs28.001.Ofthemoneysappropriatedinthissection,notmorethan$734,000isallocatedforthehealthyopportunitiesforparentstoexperiencesuccess(HOPES)–healthyfamiliesIowa(HFI)programestablishedpursuanttosection135.106.2.Ofthemoneysappropriatedinthissection,$4,313,854isallocatedfortheFaDSSgrantprogram,andnotmorethan5percentoftheallocatedmoneysshallbeusedforadministrationofthegrantprogram.3.Ofthemoneysappropriatedinthissection,$29,256,799shallbedepositedintheearlychildhoodIowafundcreatedinsection256I.11.4.Ofthemoneysappropriatedinthissection,$1,493,299isallocatedforprogramadministrationandprovisionofpregnancysupportservicesthroughthemoreoptionsformaternalsupportprogrampursuanttosection217.41C.Sec.18.DEPARTMENTOFHEALTHANDHUMANSERVICES——CHILDPROTECTIVESERVICES.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Forchild,family,andadoptionservices,andforsalaries,support,maintenance,andmiscellaneouspurposes,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$164,527,690...............................................FTEs977.001.Basedonclientneed,aportionofthemoneysappropriatedinthissectionmaybeusedtoprovideotherHouseFile2782,p.18resourcesrequiredtosupportfamilypreservation,emergencyclientneed,orfamilyreunificationefforts.2.Ofthemoneysappropriatedinthissection,asufficientamountisallocatedforfosterfamilycare,groupfostercaremaintenanceandservices,sheltercare,childwelfareemergencyservices,qualifiedresidentialtreatmentprograms,supervisedapartmentlivingcontracts,andformedicalassistanceprogramreimbursementandassociatedcosts.3.FederalmoneysreceivedbythestateduringthefiscalyearbeginningJuly1,2026,astheresultoftheexpenditureofstatemoneysappropriatedduringapreviousstatefiscalyearforaserviceoractivityfundedunderthissection,areappropriatedtothedepartmenttobeusedasadditionalmoneysforservicesandpurposesprovidedunderthissection.Notwithstandingsection8.33,moneysappropriatedunderthissubsectionthatremainunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforthepurposesdesignateduntilthecloseofthesucceedingfiscalyear.4.a.Ofthemoneysappropriatedinthissection,$748,000isallocatedforthepaymentoftheexpensesofcourt-orderedservicesprovidedtochildrenwhoareunderthesupervisionofthedepartment,whichexpensesareachargeuponthestatepursuanttosection232.141,subsection4.b.Notwithstandingchapter232oranyotherprovisionoflawtothecontrary,adistrictorjuvenilecourtshallnotorderanyservicewhichisachargeuponthestatepursuanttosection232.141,subsection4,ifthemoneysallocatedunderparagraph“a”forcourt-orderedservicesareinsufficienttopayfortheservice.5.Ofthemoneysappropriatedinthissection,$4,359,500isallocatedforthepreparationforadultlivingprogramestablishedpursuanttosection234.46.6.Ofthemoneysappropriatedinthissection,aportionmaybeusedforfamily-centeredservicesforpurposesofcomplyingwiththefederalFamilyFirstPreventionServicesActof2018,Pub.L.No.115-123,andsuccessorlegislation.7.a.Ofthemoneysappropriatedinthissection,$38,414,178isallocatedforadoptionsubsidypaymentsandHouseFile2782,p.19relatedcosts.b.Anymoneysremainingaftertheallocationunderparagraph“a”isdesignatedandallocatedasstatesavingsresultingfromimplementationofthefederalFosteringConnectionstoSuccessandIncreasingAdoptionsActof2008,Pub.L.No.110-351,andsuccessorlegislation,asdeterminedinaccordancewith42U.S.C.§673(a)(8),andshallbeusedforpost-adoptionservicesandforotherpurposesallowedunderthosefederalActsandregulations,andTit.IV-BorTit.IV-EofthefederalSocialSecurityAct.8.Ofthemoneysappropriatedinthissection,asufficientamountisallocatedtosupporttrainingneedsforchildwelfareprovidersandtoaddressdisproportionalitywithinthechildwelfaresystem.9.Ofthemoneysappropriatedinthissubsection,$1,658,000shallbeallocatedforchildprotectioncenterslocatedinIowapursuanttothechildprotectioncentergrantprogramundersection135.118.Thegrantamountsundertheprogramshallbeequalizedsothateachcenterreceivesauniformbaseamountof$245,000,andtheremainingmoneysareawardedthroughafundingformulabaseduponthevolumeofchildrenservedbyacenter.Toincreaseaccesstochildprotectioncenterservicesforchildreninruralareas,thefundingformulaforawardingtheremainingmoneysshallprovideforawardinganenhancedamounttoeligiblegranteestodevelopandmaintainsatellitecentersinunderservedregionsofthestate.10.Ofthemoneysappropriatedinthissubsection,upto$227,000shallbeusedforthepublicpurposeofcontinuingagranttoanonprofithumanservicesorganizationthatprovidesservicestoindividualsandfamiliesinmultiplelocationsinsouthwestIowaandNebraska,forsupportofaprojectprovidingimmediate,sensitivesupportandforensicinterviews,medicalexams,needsassessments,andreferralsforvictimsofchildabuseandtheirnonoffendingfamilymembers.11.Ifaseparatefundingsourceisavailablethatreducestheneedforstatemoneyswithinanallocationunderthissection,theallocatedstatemoneysmayberedistributedtootherallocationsunderthissectionforthesamefiscalyear.HouseFile2782,p.20DIVISIONVIIISTATE-OPERATEDSPECIALTYCARE——FY2026-2027Sec.19.DEPARTMENTOFHEALTHANDHUMANSERVICES——STATE-OPERATEDSPECIALTYCARE.ThereisappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Forsalaries,support,maintenance,andmiscellaneouspurposesatinstitutionsunderthejurisdictionofthedepartmentofhealthandhumanservices,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$100,225,768...............................................FTEs1,304.451.Thedepartmentshallutilizethemoneysappropriatedinthissectionasnecessarytomaximizebedcapacityandtomosteffectivelymeettheneedsoftheindividualsserved.2.Ofthemoneysappropriatedinthissection,thefollowingamountsareallocatedtoeachinstitutionasfollows:a.ForthestatementalhealthinstituteatCherokee:..................................................$19,878,962b.ForthestatementalhealthinstituteatIndependence:..................................................$23,760,205c.ForthecivilcommitmentunitforsexualoffendersatCherokee:..................................................$23,272,111d.ForthestateresourcecenteratWoodward:..................................................$12,567,092e.ForthestatetrainingschoolatEldora:..................................................$19,805,171f.Foroutstandingobligationsrelatedtoworkers’compensation,thesickleaveinsuranceprogram,unemployment,andothercostsrelatedtotheclosureofthestateresourcecenteratGlenwood:..................................................$942,227DIVISIONIXADMINISTRATIONANDCOMPLIANCE——FY2026-2027Sec.20.DEPARTMENTOFHEALTHANDHUMANSERVICES——ACCOUNTABILITY,COMPLIANCE,ANDPROGRAMINTEGRITY.ThereHouseFile2782,p.21isappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofasisnecessary,tobeusedforthepurposesdesignated:Foraccountability,compliance,andprogramintegrity,includingsalaries,support,maintenance,andmiscellaneouspurposes,andfornotmorethanthefollowingfull-timeequivalentpositions:..................................................$23,152,404...............................................FTEs382.001.Ofthemoneysappropriatedinthissection,$2,602,312isallocatedforfostercarereviewandthecourtappointedspecialadvocateprogram,includingforsalaries,support,maintenance,andmiscellaneouspurposes.2.Ofthemoneysappropriatedinthissection,$1,148,959isallocatedfortheofficeoflong-termcareombudsmanforsalaries,support,administration,maintenance,andmiscellaneouspurposes.DIVISIONXTRANSFERS,CASHFLOW,ANDNONREVERSIONS——FY2026-2027Sec.21.DEPARTMENTOFHEALTHANDHUMANSERVICES——TRANSFERSANDCASHFLOW.1.Notwithstandinganyprovisionoflawtothecontrary,thedepartmentofhealthandhumanservicesmaytransfermoneysappropriatedinthisActtosupportcontinuingalignmentefforts,tomaximizefederalsupportinaccordancewiththedepartment’sfederalcostsallocationplan,andtosecureresourcesnecessarytoimplementandadministertheservicesforwhichmoneysareappropriated.Thedepartmentshallreportanytransfersmadepursuanttothissubsectiontothegeneralassembly.OnorbeforeDecember1,2026,thedepartmentshallreporttothechairpersonsofthehealthandhumanservicesappropriationssubcommitteetheallocationsandfull-timeequivalentpositionsforeachdivisionofthedepartmentforthefiscalyearbeginningJuly1,2027.2.If,duetoongoingcostmanagementefforts,appropriationsunderthisActfortheMedicaidprogramexceedtheassociatedcostsfortheMedicaidprogramfortheHouseFile2782,p.22fiscalyear,thedepartmentmaytransferanysavingstotheappropriationsmadeinthisActforhealthprogramoperations,orforaccountability,compliance,andprogramintegrity,todefraythecostsassociatedwithongoingcostmanagementefforts.3.Notwithstandinganyprovisionoflawtothecontrary,thedepartmentmaytransfermoneysappropriatedunderthisActforchildprotectiveservicestopaythenonfederalsharecostsofservicesreimbursedunderthemedicalassistanceprogram,statechildcareassistanceprogram,orfamilyinvestmentprogramwhichareprovidedtochildrenwhowouldotherwisereceiveservicespaidbytheappropriationforchildprotectiveservices.4.Thedepartmentmaytransfermoneysfromthetemporaryassistanceforneedyfamiliesblockgranttothefederalsocialservicesblockgrantappropriation,andtothechildcareanddevelopmentblockgrantappropriation,inaccordancewithfederallaw.5.TotheextentthedepartmentdeterminesthatmoneysappropriatedunderthisAct,orallocatedforaspecificpurposeunderthisAct,willremainunencumberedorunobligatedatthecloseofthefiscalyear,suchunencumberedorunobligatedmoneysmaybeusedinthesamefiscalyearforanyotherpurposeforwhichtheappropriatedmoneysmaybeused,orforanyotherallocationwithinthesameappropriation.Sec.22.DEPARTMENTOFHEALTHANDHUMANSERVICES——NONREVERSIONS.1.Notwithstandingsection8.33,moneysappropriatedunderthisActfromthegeneralfundofthestateandthetemporaryassistanceforneedyfamiliesblockgranttothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,forthepurposesoftheFaDSSgrantprogram,thatremainunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforexpenditureforthepurposesdesignateduntilthecloseofthesucceedingfiscalyear.2.Notwithstandingsection8.33,ofthemoneysappropriatedunderthisActfromthegeneralfundofthestate,thequalityassurancetrustfund,andthehospitalhealthcareaccesstrustHouseFile2782,p.23fundtothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,forthepurposesofthemedicalassistanceprogram,theamountinexcessofactualexpendituresforthemedicalassistanceprogramthatremainsunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforexpenditureforthemedicalassistanceprogramuntilthecloseofthesucceedingfiscalyear.3.Notwithstandingsection8.33,andnotwithstandingthenonreversionamountlimitationspecifiedforstateresourcecentersinsection222.92,subsection4,moneysappropriatedunderthisActfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,forthepurposesofstate-operatedspecialtycare,thatremainunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforexpenditureforthepurposesdesignatedforsubsequentfiscalyears.4.Notwithstandingsection8.33,moneysappropriatedinthisActfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,fortheIowacommissiononvolunteerserviceforprogramsandgrants,thatremainunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforexpenditureforthepurposesdesignatedforsubsequentfiscalyears.5.Notwithstandingsection8.33,moneysappropriatedunderthisActfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,andallocatedforruralpsychiatricresidencies,thatremainunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforexpenditureforthepurposesdesignateduntilthecloseofthesucceedingfiscalyear.6.Notwithstandingsection8.33,moneysappropriatedunderthisActfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,andallocatedforadoptionsubsidypaymentsandrelatedcosts,orforpost-adoptionHouseFile2782,p.24servicesandallowablerelatedpurposes,thatremainunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforexpenditureforadoptionreinvestmentobligations.7.Notwithstandingsection8.33,moneysappropriatedunderthisActfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,andallocatedforchildprotectiveservices,thatremainunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforexpenditureforthepurposesdesignateduntilthecloseofthesucceedingfiscalyear.DIVISIONXIREPORTONNONREVERSIONOFMONEYSSec.23.DEPARTMENTOFHEALTHANDHUMANSERVICES——REPORTONNONREVERSIONOFMONEYS.ThedepartmentofhealthandhumanservicesshallreporttheexpenditureofanymoneysforwhichnonreversionauthorizationwasprovidedforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,tothegeneralassemblyonaquarterlybasisbeginningOctober1,2027.DIVISIONXIIEMERGENCYRULESSec.24.DEPARTMENTOFHEALTHANDHUMANSERVICES——EMERGENCYRULES.1.Ifnecessarytocomplywithfederalrequirements,includingtimeframes,thedepartmentofhealthandhumanservicesshalladoptadministrativerulesundersection17A.4,subsection3,andsection17A.5,subsection2,paragraph“b”,toimplementtheapplicableprovisionsofthisAct.Therulesshallbeeffectiveimmediatelyuponfilingunlessalaterdateisspecifiedintherules.Anyrulesadoptedinaccordancewiththissectionshallalsobepublishedasanoticeofintendedactionasprovidedinsection17A.4.2.Ifthedepartmentofhealthandhumanservicesadoptsemergencyrulesinaccordancewiththissection,orasotherwisedirectedorauthorizedbystatelaw,andtheruleswillresultinanincreaseinexpendituresbeyondtheamountanticipatedinthebudgetforthefiscalyear,oriftheHouseFile2782,p.25expenditureswerenotaddressedinthebudgetforthefiscalyear,thedepartmentshallnotifythegeneralassemblyandthedepartmentofmanagementconcerningtherulesandtheincreaseinexpenditures.Thenotificationshallbeprovidedatleastthirtycalendardayspriortothedatenoticeoftherulesissubmittedtotheadministrativerulescoordinatorandtheadministrativecodeeditor.DIVISIONXIIIMOREOPTIONSFORMATERNALSUPPORTPROGRAMAPPROPRIATIONNONREVERSIONSec.25.2025IowaActs,chapter169,section27,isamendedbyaddingthefollowingnewsubsection:NEWSUBSECTION.8.Notwithstandingsection8.33,moneysappropriatedfromthegeneralfundofthestatetothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2025,andendingJune30,2026,forthemoreoptionsformaternalsupportprogramcreatedinsection217.41Cthatremainunencumberedorunobligatedatthecloseofthefiscalyearshallnotrevertbutshallremainavailableforexpenditureforthepurposesdesignateduntilthecloseofthesucceedingfiscalyear.Sec.26.EFFECTIVEDATE.ThisdivisionofthisAct,beingdeemedofimmediateimportance,takeseffectuponenactment.Sec.27.RETROACTIVEAPPLICABILITY.ThisdivisionofthisActappliesretroactivelytoJuly1,2025.DIVISIONXIVREIMBURSEMENTRATES——REVIEWSec.28.Section235.2,Code2026,isamendedbyaddingthefollowingnewsubsection:NEWSUBSECTION.9.Uponimplementationbythedepartmentofauniformcostreportforsheltercareandqualifiedresidentialtreatmentproviders,bienniallyconductareviewofsheltercareandqualifiedresidentialtreatmentprovidercostscomparedtocurrentsheltercareandqualifiedresidentialtreatmentproviderrates.OnorbeforeOctober1ofthecalendaryearimmediatelysucceedingthecalendaryearinwhichthereviewisconducted,thedepartmentshallsubmitareporttothegovernorandthegeneralassemblydetailingtheresultsofthedepartment’sreviewandrecommendationsforrateHouseFile2782,p.26adjustments.Sec.29.Section249A.4,Code2026,isamendedbyaddingthefollowingnewsubsection:NEWSUBSECTION.15.a.Conductanannualreviewofproviderreimbursementratesformedicalandhealthservicesprovidedunderthischapterthatarereimbursedbyastatewidefeescheduleandthatarenotperiodicallyupdatedorrebasedpursuanttofederalorstatelaworrule.Thedepartmentshallcompareeachproviderreimbursementrateinthefollowingmanner:(1)Forallmedicalandhealthservicesotherthandentalservices,toreimbursementratesunderthefederalMedicareprogram.(2)Fordentalservices,toreimbursementratesforMedicaidprogramsinstatescontiguoustoIowa.b.OnorbeforeJanuary15ofeachcalendaryear,thedepartmentshallsubmittothegeneralassemblyareportsummarizingthedepartment’sreviewunderparagraph“a”.DIVISIONXVMENTALDISEASESEXCLUSION——WAIVERSec.30.DEPARTMENTOFHEALTHANDHUMANSERVICES——MEDICALDISEASESEXCLUSIONWAIVER.NolaterthanJuly1,2027,thedepartmentofhealthandhumanservicesshallapplytothecentersforMedicareandMedicaidservicesoftheUnitedStatesdepartmentofhealthandhumanservicesforawaiverofMedicaid’sinstitutionformentaldiseasesexclusion.DIVISIONXVIDEPARTMENTOFHEALTHANDHUMANSERVICES——FULL-TIMEEQUIVALENTDASHBOARDSec.31.DEPARTMENTOFHEALTHANDHUMANSERVICES——FULL-TIMEEQUIVALENTDASHBOARD.Pursuanttosection217.22,thedepartmentofhealthandhumanservicesshallmakepubliclyavailableinformationonfull-timeequivalentpositionsasdescribedinsection8.36A,thatdetailsallofthefollowing:1.Thenumberoffull-timeequivalentpositionsauthorizedbythegeneralassemblyforthedepartment,categorizedbythedepartmentdivisionorappropriation.2.Thenumberoffilledfull-time,part-time,ortemporarypositionsbydepartmentdivisionorappropriation.HouseFile2782,p.273.Thepercentageofmoneysfromeachfederal,state,orotherfundingsourceforeachdepartmentdivisionanddepartmentappropriation.DIVISIONXVIICOMPREHENSIVEFAMILYSUPPORTPROGRAMSec.32.NEWSECTION.231.80Comprehensivefamilysupportprogram.1.Forthepurposesofthissection,unlessthecontextotherwiserequires:a.“Comprehensivefamilysupport”meansservicesandsupportsthatassistfamiliescaringforanindividualwithadisabilitywhoisamemberofthefamily,includingbutnotlimitedtoprograms,services,parent-to-parentsupport,assistivedevices,andvariousadaptationsthatallowanindividualwithadisabilitytoparticipatemorefullyinfamilyandcommunitylife.b.(1)“Family”meansagroupofinterdependentpersonslivinginthesamehousehold.Afamilyconsistsofanindividualwithadisabilityandanyofthefollowing:(a)Theindividual’sparent.(b)Theindividual’ssibling.(c)Theindividual’sgrandparent,aunt,oruncle.(d)Theindividual’slegalcustodian.(e)Apersonprovidingshort-termfostercaretotheindividualwithadisabilitysubjecttoacasepermanencyplanthatprovidesforreunificationbetweentheindividualandtheindividual’sparent.(2)“Family”doesnotincludeapersonwhoisemployedtoprovideservicestoanindividualwithadisabilityinanout-of-homesetting,includingbutnotlimitedtoahospital,nursingfacility,personalcarehome,boardandcarehome,groupfostercarehome,orotherinstitutionalsetting.c.“Individualwithadisability”meansanindividualwhoislessthantwenty-twoyearsofageandmeetsthedefinitionofdevelopmentaldisabilityin42U.S.C.§15002.d.“Servicesandsupport”meansassistanceintendedtoenableanindividualwithadisabilitytocontroltheindividual’senvironment,toremainlivingwiththeindividual’sfamily,tofunctionmoreindependently,andHouseFile2782,p.28toincreasetheintegrationoftheindividualintotheindividual’scommunityincludingbutnotlimitedtofundingforpurchaseofequipment,respitecare,supplies,assistivetechnology,andpaymentofothercostsattributabletotheindividual’sdisabilitywhichareidentifiedbytheindividual’sfamily.2.Acomprehensivefamilysupportprogramiscreatedunderthepurviewofthedepartmenttoprovideastatewidesystemofservicesandsupporttoeligiblefamilies.Theprogramshallbeimplementedinamannerthatenablesafamilymemberofanindividualwithadisabilitytoidentifytheneededservicesandsupport.3.Eligibilityfortheprogramislimitedtofamilieswhomeetallofthefollowingcriteria:a.ThefamilyresidesinthestateofIowa.b.Thefamilyintendsforthefamilymemberwhoisanindividualwithadisabilitytoremainlivinginthefamily’shome.c.Thefamily’staxableincomeislessthansixtythousanddollarsforthemostrecentlycompletedtaxyear.4.Afamilymayapplytothedepartmentortoafamilysupportcenterforassistanceunderthecomprehensivefamilysupportprogram.Thedepartmentorfamilysupportcentershalldetermineeligibilityforthecomprehensivefamilysupportprograminaccordancewithsubsection3.5.Thedepartmentshalladoptrulespursuanttochapter17Atoimplementthecomprehensivefamilysupportprogram.Thecomprehensivefamilysupportprogrammustdoallofthefollowing:a.Totheextentpossible,incorporateintheapplicationprocesstheeligibilitydeterminationprocessesthatthedepartmentusesforotherdisabilityservicesprograms.b.Ensuretheabilityoffamiliestomaintaincontrolofdecisionswhichaffectanindividualwithadisabilitywhoisamemberofafamily.c.Utilizeexistinglocalagenciestoprovidefacilitiesandasingleentrypointforprogramapplicants.d.EnsureservicesandsupportareprovidedinatimelymannerandemergencyaccesstoneededservicesandsupportisHouseFile2782,p.29provided.e.Ensuretechnicalassistanceisprovidedtoprovidersandusersofservicesandsupport.f.Utilizestate,regional,andlocalmediatopublicizetheprogram.g.Incorporateaprocesstoappealthedepartment’sorfamilysupportcenter’sdenialofservicesandsupporttoafamilyundertheprogram,includingreasonableeffortsbythedepartmenttoutilizetelecommunicationsintheappealprocess.h.Identifytheservicesandsupport,andserviceprovidercomponents,includedintheprogram.i.Uponrequestbyafamilymember,provideafamilywithassistanceinlocatingaserviceprovider.j.Makepaymentforservicesandsupportdirectlytofamiliesbyvoucherorotherappropriatemeans.k.Utilizeavouchersystemforpaymentforthefamilysupportcentercomponentoftheprogramundersubsection7.6.Servicesandsupportprovidedunderthecomprehensivefamilysupportprogramshallnotbeusedtosupplantotherservicesandsupportavailabletoafamilyofanindividualwithadisabilitybutshallbeusedtomeetfamilyneedsthatwillnotbemetwithouttheprogram.7.Thecomprehensivefamilysupportprogramshallincludeafamilysupportcentercomponent.Underthecomponent,afamilymemberofanindividualwithadisabilityshallbeassistedbyafamilysupportcenterinidentifyingtheservicesandsupporttobeprovidedtothefamilyunderthefamilysupportsubsidyprogramorthecomprehensivefamilysupportprogram.Theidentificationofservicesandsupportmustbebaseduponthespecificneedsoftheindividualwithadisabilityandtheindividual’sfamilywhicharenotmetbyotherserviceprogramsavailabletotheindividualwithadisabilityandtheindividual’sfamily.8.Thecomprehensivefamilysupportprogramshallbefundedbyappropriationsmadebythegeneralassemblyforpurposesoftheprogram.Notwithstandingsection8.33,moneysappropriatedforthecomprehensivefamilysupportprogramunderthissectionthatremainunobligatedorunexpendedatthecloseofeachfiscalyearshallnotrevertbutshallremainavailableforHouseFile2782,p.30expenditureforthepurposesdesignateduntilthecloseoftheimmediatelysucceedingfiscalyear.Sec.33.CODEEDITORDIRECTIVE.TheCodeeditorisdirectedtodesignatesection231.80,asenactedinthisdivisionofthisAct,assubchapterVIIIofchapter231entitled“ComprehensiveFamilySupportProgram”.Sec.34.EFFECTIVEDATE.ThisdivisionofthisAct,beingdeemedofimmediateimportance,takeseffectuponenactment.Sec.35.RETROACTIVEAPPLICABILITY.ThisdivisionofthisActappliesretroactivelytoJuly1,2025.DIVISIONXVIIIFEDERALCOMMUNITYMENTALHEALTHSERVICESBLOCKGRANTSec.36.2025IowaActs,chapter152,section2,subsection1,paragraphd,isamendedtoreadasfollows:d.ForthefederalfiscalyearbeginningOctober1,2025,andendingSeptember30,2026,ofOfthemoneysallocatedtoprovidersunderparagraph“c”,70percentofthemoneysallocatedeachfederalfiscalyearshallbedistributedbyabehavioralhealthadministrativeservicesorganizationorthedepartmentofhealthandhumanservicestothestate’saccreditedcommunitymentalhealthcentersdesignatedbythedepartmentofhealthandhumanservicesundersection225A.3,asenactedby2024IowaActs,chapter1161,section3.Communitymentalhealthcentersthatreceivemoneysdistributedunderthisparagraphshallusethemoneysforthepurposesoftrainingstaff,providingservicestoadultswithaseriousmentalillness,orprovidingservicestochildrenwithaseriousemotionaldisturbance,andshallbilltreatmentdollarsrelatedtosuchservicestothedepartmentofhealthandhumanservicesthroughthedepartment’sclaimssystem.Thedepartmentofhealthandhumanservicesshallpublishtheamountstobedistributedtocommunitymentalhealthcentersonthedepartment’sinternetsiteonorbeforeOctober1,2025,andonorbeforeOctober1,2026,anddistributethemoneystotherecipientsonaquarterlybasis.Recipientsofthemoneysshallsubmitquarterlyreportstothedepartmentofhealthandhumanservicescontainingdataconsistentwithperformancemeasuresapprovedbythefederalsubstanceabuseandmentalhealthservicesadministration.HouseFile2782,p.31DIVISIONXIXDEPARTMENTOFHEALTHANDHUMANSERVICES——BEHAVIORALHEALTHEXPENDITUREREPORTSec.37.NEWSECTION.225A.10Behavioralhealthservicesexpenditurereport.NolaterthanDecember15ofeachyear,thedepartmentshallsubmittothegeneralassemblyasummaryofthedepartment’sexpendituresforbehavioralhealthservicesforadultsandchildrenfortheimmediatelyprecedingfiscalyear,includingasummaryofwhichappropriationsorfundingsourceswereusedtofundtheexpenditures.DIVISIONXXOPIOIDSETTLEMENTFUND——FY2026-2027Sec.38.OPIOIDSETTLEMENTFUND——DEPARTMENTOFHEALTHANDHUMANSERVICES.1.Thereisappropriatedfromtheopioidsettlementfundcreatedinsection12.51tothedepartmentofhealthandhumanservicesforthefiscalyearbeginningJuly1,2026,andendingJune30,2027,thefollowingamount,orsomuchthereofisasnecessary,forthepurposesdesignated:..................................................$3,000,0002.Notwithstandinganyprovisionoflawtothecontrary,ofthemoneysappropriatedtothedepartmentofhealthandhumanservicesundersubsection1,thedepartmentshalldisbursetoanopioidtreatmentprogramthatoperatesafacilitywithatleastonehundredfiftylicensedbedsthatprovidesmedicaldetoxificationstabilizationandresidentialsubstanceabusedisordertreatmenttosupportcomprehensiveaddictionandco-occuringmentalhealthtreatment,andprovides24-hourmedicaldetoxification,residentialtreatment,andmedication-assistedtreatment.a.Moneysdisbursedunderthissubsectionshallbeusedbytherecipientincompliancewiththerequirementsofthenationalopioidsettlementagreementsandsection12.51.b.Therecipientshallutilizetheindicatorsandoutcomesidentifiedundersection12.51,subsection2,paragraph“b”,subparagraph(3),subparagraphdivision(c),todeterminewhethertheservicesandactivitiesthatarefundedbythedisbursementachievetheintendedoutcomes,andshallreportHouseFile2782,p.32therecipient’sfindingstothedepartmentofhealthandhumanservices.DIVISIONXXIGRADUATEMEDICALEDUCATIONSec.39.2025IowaActs,chapter120,section19,isamendedtoreadasfollows:SEC.19.TRANSFEROFMONEYS.Notwithstandingsection8.33oranyotherprovisiontothecontrary,anyunobligatedorunencumberedmoneysinanyofthefollowingaccountsorfundsorconstitutinganyspecifiedappropriation,shallnotrevertbutareappropriatedtothedepartmentofhealthandhumanservicestofundMedicaidgraduatemedicaleducationeffortsawardgrantstostartmedicalresidencyprogramsinthestatethatarenotrelatedtothepracticeoffamilymedicine,arenotlocatedinacountywhichhasapopulationofonehundredfiftythousandormorebasedonthemostrecentfederaldecennialcensus,andinwhichthemaincampusofaninstitutionofhigherlearninggovernedbythestateboardofregentsislocated.1.Thehealthcareworkforceshortagefundcreatedinsection135.175,subsection1,paragraph“b”,Code2025.2.Themedicalresidencytrainingaccountcreatedinsection135.175,subsection5,paragraph“a”,Code2025,except$298,000ofsuchmoneysisappropriatedtothedepartmentofhealthandhumanservicesforthepurposesofimplementingthewaiverofMedicaid’sinstitutionformentaldiseasesexclusionthedepartmentmustapplyforunderthis2026IowaAct.3.Thenurseresidencystatematchinggrantsprogramaccountcreatedinsection135.175,subsection5,paragraph“b”,Code2025.4.Thehealthcareworkforceshortagenationalinitiativesaccountcreatedinsection135.175,subsection5,paragraph“c”,Code2025.5.Thefamilymedicineobstetricsfellowshipprogramfundcreatedinsection135.193,Code2025.6.Moneysappropriatedtothedepartmentofhealthandhumanservicesforruralpsychiatricresidenciestofundpsychiatricresidentstoprovidementalhealthservicesinunderservedareasofthestateasdescribedinthefollowing:HouseFile2782,p.33a.2024IowaActs,chapter1157,section5,subsection3,and2024IowaActs,chapter1157,section22,subsection5.b.2023IowaActs,chapter112,section5,subsection4,paragraph“j”,asamendedby2024IowaActs,chapter1157,section29.c.2022IowaActs,chapter1131,section3,subsection4,paragraph“j”,asamendedby2024IowaActs,chapter1157,section23.d.2021IowaActs,chapter182,section3,subsection4,paragraph“j”.e.2019IowaActs,chapter85,section3,subsection4,paragraph“j”,asamendedby2020IowaActs,chapter1121,section19.DIVISIONXXIIMEDICAIDREIMBURSEMENTRATE——SPECIALPOPULATIONNURSINGFACILITIESSec.40.Section249A.2,Code2026,isamendedbyaddingthefollowingnewsubsection:NEWSUBSECTION.15.“Specialpopulationnursingfacility”referstoanursingfacilitythatservesoneofthefollowingpopulationsandhasbeendesignatedasaspecialpopulationnursingfacilitybythedepartment:a.Onehundredpercentoftheresidentsservedareagedthirtyandunderandrequireaskilledlevelofcare.b.Seventypercentoftheresidentsservedrequireaskilledlevelofcareforneurologicaldisorders.c.Onehundredpercentoftheresidentsrequirecarefromafacilitylicensedbythedepartmentofinspections,appeals,andlicensingasanintermediatecarefacilityforpersonswithmentalillness.d.Onehundredpercentoftheresidentsrequirecarefromafacilitylicensedbythedepartmentofinspections,appeals,andlicensingasanintermediatecarefacilityforpersonswithmedicalcomplexity.Sec.41.NEWSECTION.249A.38CMedicaidreimbursementrate——specialpopulationnursingfacilities.Theproviderreimbursementrateforeachspecialpopulationnursingfacilitymustbethespecialpopulationnursingfacility’saverageallowableperdiemcostsasadjustedinHouseFile2782,p.34compliancewithapplicablefederallawsandregulations,includingtheupperpaymentlimitsspecifiedin42C.F.R.§447.272(b).Ifaspecialpopulationnursingfacilitysubjecttothissectionincreasesthespecialpopulationnursingfacility’snumberofbedsorexpandstoprovideadditionalservicesonorafterJuly1,2026,thereimbursementrateinthissectionshallapplytosuchadditionalbedsorservices.______________________________PATGRASSLEYSpeakeroftheHouse______________________________AMYSINCLAIRPresidentoftheSenateIherebycertifythatthisbilloriginatedintheHouseandisknownasHouseFile2782,Ninety-firstGeneralAssembly.______________________________MEGHANNELSONChiefClerkoftheHouseApproved_______________,2026______________________________KIMREYNOLDSGovernor
A bill for an act relating to and making appropriations to the department of veterans affairs and the department of health and human services, including aging and disability services, behavioral health, public health, and community access and eligibility; the medical assistance program, state supplementary assistance, Hawki, and other health-related programs; family well-being and protection; state-operated specialty care; administration and compliance; transfers, cash flow, and nonreversions; report on nonreversion of moneys; more options for maternal support program; reimbursement rates review; mental diseases exclusion waiver; full-time equivalent dashboard; comprehensive family support program; federal community mental health services block grant; behavioral health expenditure report; opioid settlement fund; emergency rules; graduate medical education; and special population nursing facilities; and including effective date and retroactive applicability provisions. (Formerly HSB 777.) Effective date: 06/02/2026, 07/01/2026. Applicability date: 07/01/2025.
Sponsors
Rep. Appropriations sponsors HF 2782 alone.
Committees
HF 2782 went before 1 committee: Appropriations.
History
HF 2782 has taken 21 actions since Apr 21, 2026, the latest on Jun 2, 2026.
| Chamber | Action | |||
|---|---|---|---|---|
Jun 2, 2026 | House | Item vetoed, signed by Governor. H.J. 1174. | ||
May 18, 2026 | House | Reported correctly enrolled, signed by Speaker and President, and sent to Governor. H.J. 1164. | ||
May 12, 2026 | House | NOBA: Final | ||
May 2, 2026 | Senate | Message from House. S.J. 963. | ||
May 2, 2026 | Senate | Read first time, attached to SF 2483. S.J. 963. |
Votes
HF 2782 went to 4 roll calls across both chambers, the latest on May 2, 2026 at 30–14.
| Chamber | Question | Yea | Nay | |||
|---|---|---|---|---|---|---|
May 2, 2026 | Senate | Shall the bill pass? | 30 | 14 | ||
May 1, 2026 | House | Shall amendment H–8465, to amendment H–8461, be adopted? | 24 | 59 | ||
May 1, 2026 | House | Shall the bill pass? | 59 | 24 | ||
May 1, 2026 | House | Shall the rules be suspended to consider amendment H–8466, to amendment H–8461? | 25 | 58 |
Source: legis.iowa.gov · legiscan.com