Summary of the 2004 Legislative Session

SUMMARY OF THE 2004 LEGISLATIVE SESSION Iowa Department of Human Services

June 2 , 2004 The Iowa Department of Human Services distributes a weekly update to agency staff and other interested parties during the Legislative Session. Recipients are encouraged to share it with others. This is a summary of legislation effecting the Department in the 2004 session. If you are interested in receiving or discontinuing the legislative updates please contact Kate Walton by email at [email protected]

WELCOME

Below you will find an executive summary of bills and appropriations affecting the Department of Human Services that passed and were signed by the Governor during the 2004 Legislative Session. This summary is compiled (and in many cases plagiarized) from the work of countless people in the agency. Any errors are mine. Full text of these bills, as well as a complete legislative history, can be viewed on the General Assembly website at www.legis.state.ia.us . The Legislature Enrolled 203 bills this session, which means 203 pieces of legislation made it all the way through the process to be sent to the Governor for his consideration. The Governor vetoed or item vetoed 29 of those bills.

Thanks for reading--

--Kate

BILLS OF INTEREST

Senate Files

SF 2059 – Expanding Funding for the Iowa Child Abuse Prevention Program (ICAPP) and the Birth Defects Registry

The State of Iowa has been charging $10 in birth certificate registration fees since 1985 for child abuse prevention and $5 since July 2003 for the birth defects registry. The legislature did not appropriate these funds collected from these fees. SF 2059 appropriates the funds for the intended purpose.

Signed by the Governor March 18, 2004 Effective Date Upon Enactment

SF 2167 – Estate Recovery

This bill allows the Department or its representative to file an affidavit to receive funds from bank accounts, insurance proceeds or other resources when the state is entitled to collect funds to repay the deceased person’s Medicaid debt. When an affidavit to claim funds has not been presented by the deceased persons representative within 90 days of the deceased person’s death, this bill gives the estate recovery program a tool to use in securing those abandoned funds. Prior to the passage of this bill, when there is no person associated with the deceased person to file an affidavit, the estate recovery program was not able to recover the funds. The Department estimates the state will receive approximately $200,000 in additional, annual revenue. Signed by the Governor March 29, 2004 Effective Date July 1, 2004

SF 2193 – Commitment of Sexually Violent Predators

The bill amends Iowa Code by removing references to persons who have been found not guilty of a sexually violent offense by reason of insanity. The bill creates a new subsection of the Code to require the court to first determine whether the acts charged were proven as a matter of law. If, as is the case under Iowa law, the court finds that as a matter of the law the finding of not guilty by reason of insanity does require a finding that the underlying elements of the law were proven, no further fact finding is required. If the court finds that, as a matter of law, the finding of not guilty by reason of insanity does not require a finding that the underlying elements of the charge were proven, the chase shall then proceed under the amended criteria.

Signed by the Governor April 12, 2004 Effective Date July 1, 2004

SF 2209 – Banning Mercury Based Preservatives in Vaccines

This legislation went through many forms before going on to final passage. Ultimately, the bill bans anything more than trace amounts of mercury based preservatives in vaccines administered to children. The legislation makes exceptions for the flu shot and any emergency or epidemic vaccinations, as determined by the Director of the Department of Public Health.

Signed by the Governor May 14, 2004 Effective Date July 1, 2004

SF 2234 – Child Custody and Visitation Provisions

This bill amends the dissolution of marriage chapter of the code to add a section that any temporary custody order must include minimum visitation unless the court finds it would not be in the best interest of the child. The legislation also amends the section of the code related to paternity establishment allowing a father to petition for visitation or custody in the same action as for judgment of paternity.

SF 2272 – “812” Bill

This bill makes procedural improvements to the Chapter 812 statues related to detaining criminal defendants who are mentally incompetent. The legislation clarifies procedures in criminal proceedings for defendants who are mentally incompetent, including mandated termination of treatment and placement guidelines.

House Files

HF 22 – Joint Physical Care

This bill provides that if the court orders joint legal custody, the court may also order joint physical care if one parent requests it. If the court denies the request for joint physical care, its determination must include specific findings of fact and conclusions of law that joint physical care would not be in the best interest of the child. Signed by the Governor Effective Date July 1, 2004

HF 250 – Assault Bill

Prior to the passage of this legislation, the law provided for enhanced penalties for assaults against police officers, jailers, correctional staff, health care providers and fire fighters. This bill extends these enhanced penalties to persons who assault DHS employees of our nine facilities and members of the parole board.

HF 2134 – Medical Assistance

This bill puts in place four strategies to help leverage additional Medicaid funds. The first allows the Department to make the Nursing Home Quality Assurance Fee retroactive to October 1st. In the ensuing days, the Department learned the Quality Assurance Fee, as submitted, would not be approved by CMS. The second relates to the ICF/MR provider participation fee. When that fee was established, the two state Resource Centers at Glenwood and Woodward were excluded. The bill lifts that exclusion and expands the potential to leverage funds through the provider participation fee. The third allows Medicaid waiver services to be provided to individuals living in Residential Care Facilities. This was arguably the most controversial aspect of this legislation. Advocates expressed concern that this would provide an incentive for institutional care. Conversely, individuals living in RCFs have been denied access to services they would otherwise be eligible for based solely on where they live. The fourth component expands the State Supplementary payment to reduce Medicaid Part B premium costs.

Signed by the Governor April 16, 2004 Effective Date Upon Enactment

HF 2146 – Sex Offender Registry

The bill requires persons convicted of incest committed against a dependent adult to register with the Department of Public Safety’s Sex Offender Registry. A dependent adult is a person over 18 who is unable to protect their own interests or unable to adequately perform or obtain services necessary to meet essential human needs.

HF 2150 – Child Endangerment Offenses

This bill establishes a child endangerment offense for permitting the presence of a child or minor at a location where a controlled substance manufacturing violation occurs. It adds the provision that the new child endangerment offense classified by a class D felony and punishable by confinement shall not be imposed if the person was convicted and sentenced for a child endangerment offense based on the same facts.

HF 2327 – Child Abuse Assessment Requirements Involving Notification of Parents

This bill places language enacted through the federal Child Abuse Prevention and Treatment Act into the Iowa Code. The bill requires the Department to notify a person alleged responsibly for abuse, if it is a parent, what the specific complaint or allegation is. The bill also requires additional training for Department workers regarding their legal duties to protect the constitutional and statutory rights of a child and the child’s family.

HF 2328 – DHS Confidentiality Bill

This legislation was originally a Governor’s proposal in the 2002 Legislative session. It allows for increased access to information by the public and General Assembly for a more open child protection system. The bill allows for release of information related to type of service and juvenile court involvement with a family when a fatality or near fatality occurs. The bill also establishes a process for dissemination of information to legislative designees – allowing a designated legislator to review the records in a fatal or near fatal incident and make general statements to the public about the Department’s handling of a case. Establishes a legal procedure for members of the public to seek a juvenile court order for additional information if they believe the Department has not substantially complied with the request for release of information. Would also allow the Department to seek a judicial determination of approval to release information to respond to public comment on a case.

HF 2350 – DHS FIP Bill

This bill made several changes to the Family Investment Program. Language was included that eliminated the truancy provisions for FIP families. Families on FIP are now subject to the same truancy regulations as non-FIP families. The bill also allowed the Department to disregard the value of one motor vehicle for the purposes of qualifying for FIP. Prior to the passage of this bill, Iowa had one of the lowest motor vehicle disregards in the country. The bill also made a number of changes to the administration of Family Investment Agreements and Limited Benefit plans, to make the program more consistent with best practices and the realities faced by families on FIP.

HF 2362 – Duties of the Birth Defects Institute, Studying Stillbirths

This bill directed the Department of Public Health to develop a work group to study still births and requires a report to the General Assembly. It also renames the Iowa Birth Defects Institute to the Center for Congenital and Inherited Disorders. Expands the duties of the Iowa Birth Defects Registry to include tracking still births.

HF 2378 – DHS Miller Trust

This bill is largely technical in nature. The federal government requires states to cover nursing facility care for individuals with income greater than the $1692 limit by allowing individuals to divert their income to a Medical Assistance Special Needs Trust (Miller Trust). The state captures these funds and uses them to the cost of nursing home care. This bill brings the Miller Trust guidelines in line with the acuity based reimbursement system adopted by the legislature three years ago. The bill brings income limits for the Miller Trust in line to match with average charges for nursing facility care, at the individual’s level of care. This will result in better identification of individuals able to participate in the cost of their own care. It also bases the income limit for Medicaid payment of nursing facility care on the actual level of care being received. Signed by the Governor Effective Date July 1, 2004

HF 2390 – DHS Technical Changes

Makes technical changes to Child Support Recovery Unit and Division of Behavioral, Developmental and Protective Services.

HF 2462 – Child Welfare Diversion and Mediation Projects

This bill directs the Department to implement one or more child welfare diversion and mediation projects through the office of the county attorney. The projects are to be implemented in FY 2005 and the purposes of the project are to divert selected child abuse and neglect cases from child in need of assistance (CINA) adjudication, improve permanency for children, promote family unification and reduce state expenditures associated with the adjudication of child protection cases. The Department is to collaborate with the pilot project sites to analyze the effectiveness of the projects.

HF 2481 – Expanding Circumstances for Juvenile Court to act on a CINA order

This bill amends the Code to authorize the court, upon a motion, to terminate an order and release the child if the court finds the purposes of the order have been accomplished and the child is no longer in need of supervision, care or treatment. The bill also provides an opportunity for a juvenile court to modify a dispositional order or to vacate or substitute a dispositional order. Additional grounds are provided if the court finds that the purposes of the order cannot reasonably be accomplished, the efforts made to effect the purposes of the order were unsuccessful and the continuation of supervision, care or treatment is unjustified or unwarranted. The bill also allows for the hearing required to modify an order may be waived upon agreement by all parties.

HF 2528 – Consideration of a Juvenile Court Order in a Custody Proceeding

This bill amends the dissolution of marriage chapter and adds an item to the list of factors the District Court considers in determining whether there has been a substantial change of circumstances, which may warrant a modification of a child support order. This addition allows the District court to consider the entry of a juvenile court dispositional order placing custody or physical care of the child with the person who is obligated to pay child support for a child.

HF 2537 – MH/DD/BI/MR Redesign

This bill addresses the redesign of the system for services and other support provided for persons with mental illness, mental retardation or other developmental disabilities or brain injury. The bill changes the name of the Commission to the Mental Health, Mental Retardation, Developmental Disabilities and Brain Injury Commission. It also changes the term “single entry point process” to “central point of coordination process.” The bill lays out the legislative intent for redesign to be implemented over a number of years and directs the work of the Commission going forward. Language was also included creating a legal settlement dispute resolution process to hear disputes concerning the legal settlement of an individual related to the State Resource Centers, the state Mental Health Institutes and the Medicaid program.

BILLS OF INTEREST VETOED BY THE GOVERNOR

SF 2183 – Providing Incentives for Purchase of Long Term Care Insurance

SF 2190 – Establishing a Task Force for Long Term Care Service Delivery

HF 2402 – Executive Branch Transfer of Appropriations

HF 2455 – Covenant Marriage

HF 2554 – Prescription Drug Assistance Program

HF 2039 – 98 % Expenditure Limitation (Item vetoed)

APPROPRIATIONS

SF 2288 – Federal Block Grant

SF 2298 – Omnibus Appropriations (Item Vetoed) NOTE: Summary prepared in its entirety by the Department’s Fiscal Services Division Items of note in SF 2298:

 All operations appropriations, i.e., those that fund staff who deliver the myriad of agency programs, will be forced to manage with approximately $9 million less than needed in salary adjustment funding as neither the Governor nor the Legislature provided dollars for the growth in salary and benefits. In addition, no funding was provided for the increased cost of doing business due to growing rates/prices for utilities, supplies, contracts, etc., especially a concern at the nine facilities.

 Funding ($334,327) for food assistance EBT retailer fees was restored (the Governor’s budget had eliminated the fee); $2.8 M was added to help address a growing shortfall in the Federal Maintenance of Effort requirement for TANF funding.

 Medical Assistance which funds services to Iowans who depend on Medicaid for health insurance, starts SFY 05 under funded, the result of the elimination through the Legislative process of most of the cost savings proposals. Estimates of the shortfall range from $20 M to as much as $56 M. With no direction given to the Department to reduce eligibility or services, the appropriation is destined for a supplemental, the size of which will depend in large part on the increase in the number of Iowans eligible for Medicaid. The companion appropriation, Medical Contracts which funds the administrative supports for the Medicaid program will be challenged to sustain current operations at the funding level while transitioning to the new Iowa Medicaid Enterprise.

 Children’s Health Insurance Program (the primary source of funding for HAWK-I) received $1 M in additional funding over SFY 04 on the projected growth in the number of children/families as well as rate increases for the managed care contracts for SFY 05.  The Civil Commitment Unit for Sexual Offenders ended the appropriation process with just under $700,000 less than recommended by the Governor. This funding level is insufficient to sustain the SFY 05 projected growth in patients and required staff. Designed as an entitlement program, creation of a waiting list is not an option. All other options are being explored including the possibility of a supplemental appropriation.

 The Resource Centers at Woodward and Glenwood which operate in a net budgeting environment and are both working closing with the Department of Justice to resolve outstanding issues are insufficiently funded at just over $13 M. As with CCUSO, options are being reviewed including unit closures, reducing staff, and the possibility of additional funding when the Legislature reconvenes.

 The Child and Family Services appropriation, which funds child welfare programs, received an increase in TANF funds of $8.2 M to offset a like reduction of state general funds. These TANF funds are directed to Decat and the Graduated Sanctions Programs within the Juvenile Justice portion of the appropriation. As a result, the SFY 04 funding level (prior to the SFY 04 mandated $10 M reduction) is sustained. At just under $7 M, no additional funding was allocated for shelter care. The allocation for group care was increased by $4 M but no new funds were appropriated which may necessitate a shift of funds from other services. The funding available for the growth in adoption subsidy is inadequate with the expectation that efforts will be made to bring the growth in the program under control.

 Field Operations is funded at a level just slightly over the Governor’s recommendation. With no salary adjustment funding, there are no funds to increase the number of staff; therefore as the number of Iowans needing services from DHS increases, so will caseloads.

 Child Support Recovery and General Administration were reduced by $200,000 and $96,000 respectively in addition to no salary adjustment or inflation funding.

HF 2577 – Health Iowans Tobacco Trust

Item of note in HF 2577

An appropriation of $274,000 was made to the Department’s general administration for the purpose of administering health related programs. This appropriation came about as a result of the Department’s identification of some general fund monies previously allocated to the hawk-i program that will exceed that program’s estimated need in FY 05.

DISCLAIMER

This legislative update is provided in the spirit of information and education. The opinions expressed by the contributors do not necessarily reflect those of the department or its programs. The department shall not be liable for any damages that may result from errors or omissions in information distributed in this update.