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Amendments › HF 2782

Amendment H-8461 to HF 2782

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

Adopted · May 1, 2026Strike everything: replaces the whole bill

Filed May 1, 2026 in the House by

What it changes

  1. By striking everything after the enacting clause and inserting: “DIVISION I DEPARTMENT OF VETERANS AFFAIRS —— FY 2026-2027 Section
  2. DEPARTMENT OF VETERANS AFFAIRS. There is appropriated from the general fund of the state to the department of veterans affairs for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
  3. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION For salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,369,205 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00
  4. IOWA VETERANS HOME For salaries, support, maintenance, and miscellaneous purposes: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,145,736 a. The Iowa veterans home billings involving the department of health and human services shall be submitted to the department on at least a monthly basis. b. The Iowa veterans home expenditure report shall be submitted monthly to the general assembly.
  5. HOME OWNERSHIP ASSISTANCE PROGRAM For transfer to the Iowa finance authority for the continuation of the home ownership assistance program for persons who are or were eligible members of the armed forces of the United States or eligible service members pursuant to section 16.54: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,200,000 DIVISION II AGING AND DISABILITY SERVICES —— FY 2026-2027 Sec.
  6. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— AGING AND DISABILITY SERVICES. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For aging programs for the department of health and human services and area agencies on aging to provide citizens of Iowa who are 60 years of age and older with case management; for Iowa’s aging and disabilities resource centers; for the return to community program; for the purposes of chapter 231E; to administer the prevention of elder abuse, neglect, and exploitation program pursuant to section 231.56A, in accordance with the requirements of the federal Older Americans Act of 1965, 42 U.S.C. §3001 et seq., as amended; for the operation of the dependent adult abuse services program pursuant to chapter 235B; for matching funding for programs to enable persons with severe physical or mental disabilities to function more independently; for costs associated with centers for independent living; and for other services which may include but are not limited to adult day care, respite care, chore, information and assistance, and material aid; for information and options counseling for persons with disabilities; and for salaries, support, administration, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,379,531 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 101.00
  7. Moneys appropriated in this section may be used to supplement federal moneys received under federal regulations. To receive moneys appropriated in this section, a local area agency on aging shall match the moneys with moneys from other sources according to rules adopted by the department. Moneys appropriated in this section may be used for services not specifically enumerated in this section only if approved by the department as part of an area agency on aging’s area plan.
  8. Of the moneys appropriated in this section, $949,282 is allocated to be used for the comprehensive family support program created in section 231.80 as enacted under this Act.
  9. Of the moneys appropriated in this section, $33,632 is allocated to be used to build community capacity through the coordination and provision of training opportunities in accordance with the consent decree of Conner v. Branstad, No. 4-86-CV-30871 (S.D. Iowa, July 15, 1994). DIVISION III BEHAVIORAL HEALTH —— FY 2026-2027 Sec.
  10. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— BEHAVIORAL HEALTH. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For behavioral health prevention, education, early intervention, treatment, recovery support, and crisis services in order to support statewide access to treatment for behavioral health conditions; stabilization and mitigation of behavioral health crises; and recovery for individuals and families impacted by behavioral health conditions. Activities shall align with accepted best practice guidance standards for behavioral health including those published by the centers for disease control and prevention of the United States department of health and human services, and the substance abuse and mental health services administration of the United States department of health and human services, for health promotion; universal, selective, and indicated prevention; treatment; and recovery services and supports; and shall include a 24-hour helpline, public information resources, professional training, youth prevention, program evaluation, and efforts at the state and local levels, and for not more than the following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,127,121 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 70.00
  11. Of the moneys appropriated in this section, $300,000 is allocated to support the work of the children’s behavioral health system including evidence-based behavioral health prevention, treatment, and recovery services and supports for children and their families.
  12. Of the moneys appropriated in this section, $950,000 is allocated for an integrated substance use disorder managed care system. The department shall maintain the level of mental health and substance use disorder treatment services provided by the managed care contractors, and shall take the steps necessary to continue the federal waivers as needed to maintain the level of services. Sec.
  13. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— SPORTS WAGERING RECEIPTS FUND. There is appropriated from the sports wagering receipts fund created in section 8.57I, to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for behavioral health prevention, education, early intervention, treatment, recovery support, and crisis services in order to support statewide access to treatment for behavioral health conditions; stabilization and mitigation of behavioral health crises; and recovery for individuals and families impacted by behavioral health conditions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 DIVISION IV PUBLIC HEALTH —— FY 2026-2027 Sec.
  14. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PUBLIC HEALTH. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For programs that support health promotion, protect the health and safety of the public, conduct disease surveillance and investigation to reduce the incidence of morbidity and mortality, serve individuals with chronic conditions including but not limited to cancer, support the Iowa donor registry as specified in section 142C.18, and strengthen the health care delivery system and workforce to improve health outcomes for all Iowans, and for not more than the following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,168,369 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 348.60
  15. Of the moneys appropriated in this section, $191,000 is allocated to the university of Iowa hospitals and clinics to administer a child vision screening program through continuation of an existing contract. The program shall submit a report to the department regarding the use of funds allocated under this subsection. The report shall include the objectives and results for the program year including the target population and how the funds allocated assisted the program in meeting the objectives; the number, age, and location within the state of individuals served; the type of services provided to the individuals served; the distribution of moneys based on the services provided; and the continuing needs of the program.
  16. Of the moneys appropriated in this section, $144,000 is allocated for the public purpose of allowing the department to continue an existing contract with an existing affiliated organization to provide education, client-centered programs, and client and family support, for people living with epilepsy and their families. The moneys allocated in excess of $50,000 shall be matched dollar for dollar by the existing affiliated organization. Moneys under this section shall be distributed in their entirety on July 1, 2026, for the purpose specified.
  17. Of the moneys appropriated in this section, the following amounts are allocated to the department of health and human services to be used as follows to support the goals of increased access, health system integration, and engagement: a. $600,000 for distribution to a nonprofit organization that established the first statewide drug donation repository for continuation of the pharmaceutical infrastructure for safety net providers established as described in 2007 Iowa Acts, chapter 218, section 108, and for the prescription drug donation repository program established in chapter 135M. Moneys under this paragraph shall be distributed in their entirety on July 1, 2026, for the purpose specified. b. $374,000 for distribution to free clinics, as defined in section 135.24, and a nonprofit organization that facilitates the initiation, operation, and collaboration of free clinics for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in securing a medical home inclusive of oral health care. Of the moneys allocated, $40,000 shall be used to lower fees associated with using an electronic prescribing system. Moneys under this paragraph shall be distributed in their entirety on July 1, 2026, for the purpose specified. c. $25,000 for distribution to an organization that raises awareness about issues related to rural health clinics for necessary infrastructure and service delivery transformation. Moneys under this paragraph shall be distributed in their entirety on July 1, 2026, for the purpose specified.
  18. Of the moneys appropriated in this section, $400,000 is allocated for rural psychiatric residencies for residents selected on or before June 30,
  20. Of the moneys appropriated in this section, $20,000 is allocated to make radon test kits available, free of charge, to homeowners and renters in the state. The department shall provide a link on the department’s internet site for homeowners and renters in the state to order radon test kits.
  21. Of the moneys appropriated in this section, $1,500,000 is allocated for awarding grants for medical residency programs in the state that meet the following criteria: a. The medical residency program is not related to the practice of family medicine. b. The medical residency program is not located in a county that has a population of one hundred fifty thousand or more based on the most recent federal decennial census, and in which the main campus of an institution of higher learning governed by the state board of regents is located.
  22. The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the moneys appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be, at a minimum, on a quarterly basis. DIVISION V COMMUNITY ACCESS AND ELIGIBILITY —— CHILD SUPPORT SERVICES —— TANF —— FY 2026-2027 Sec.
  23. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— COMMUNITY ACCESS AND ELIGIBILITY. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: To be used for salaries, support, maintenance, and miscellaneous purposes and for family investment program (FIP) assistance in accordance with chapter 239B, and for other costs associated with providing needs-based benefits or assistance including but not limited to maternal and child health, oral health, obesity prevention, the promoting independence and self-sufficiency through employment, job opportunities and the basic skills (PROMISE JOBS) program, supplemental nutrition assistance program (SNAP) employment and training, the FIP diversion program, family planning, rent reimbursement, and eligibility determinations for medical assistance, food assistance, and the children’s health insurance program, and for not more than the following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 76,371,516 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 883.90
  24. Of the child support collections assigned under FIP, the federal share of the child support collections shall be credited to the child support services appropriation made in this division of this Act. Of the remainder of the child support collections assigned under FIP, a portion shall be credited to community access and eligibility, and the remaining moneys may be used to increase recoveries, to sustain cash flow in the collection services center refund account as provided in section 252B.13A, or for technology needs. If child support collections assigned under FIP are greater than estimated or are otherwise determined not to be required for maintenance of efforts, the state share of either amount is appropriated to the department for child support services as described in this division of this Act, or may be transferred to or retained in the collection services center refund account.
  25. Of the moneys appropriated in this section, $3,075,000 is allocated for continuation of the department’s initiative to provide for adequate developmental surveillance and screening during a child’s first five years. The moneys shall first be used to fully fund the current participating counties to ensure that those counties are fully operational, with the remaining moneys to be used for expanding participation to additional counties. Full implementation and expansion shall include enhancing the scope of the initiative through collaboration with child health specialty clinics to promote the use of developmental surveillance and screening to support healthy child development through early identification and response to biomedical and social determinants of healthy development by providing practitioner consultation and continuous improvement through training and education, particularly for children with behavioral conditions and needs. The department shall also collaborate with the Medicaid program and child health specialty clinics to assist in coordinating the activities of the first five initiative into the establishment of patient-centered medical homes developed to improve health quality and population health while reducing health care costs. To the maximum extent possible, moneys allocated in this subsection shall be utilized as matching moneys for Medicaid program reimbursement.
  26. Of the moneys appropriated in this section, $1,145,102 is allocated to the Iowa commission on volunteer service created in section 15H.2 for programs and grants.
  27. The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the moneys appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be, at a minimum, on a quarterly basis. Sec.
  28. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— CHILD SUPPORT SERVICES. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For child support services, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,644,114 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00
  29. Federal access and visitation grant moneys shall be used for services designed to increase compliance with the child access provisions of court orders, including but not limited to neutral visitation sites and mediation services.
  30. Moneys appropriated in this section may be used throughout the fiscal year in the manner necessary for cash flow management. For cash flow management under this subsection, the department may temporarily draw more than the amount appropriated provided the amount appropriated is not exceeded at the close of the fiscal year. Sec.
  31. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT. There is appropriated from the special fund created in section 8.41 to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, from moneys received under the federal temporary assistance for needy families (TANF) block grant pursuant to the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. No. 104-193, and successor legislation, including TANF block grant moneys received in any prior fiscal year that were deposited in the special fund and remain unencumbered or unobligated on June 30, 2026, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
  32. For community access and eligibility: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,566,312
  33. For community access and eligibility to provide pregnancy prevention grants on the condition that family planning services are funded: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 Pregnancy prevention grants shall be awarded to programs in existence on or before July 1, 2026, if the programs have demonstrated positive outcomes. Grants shall be awarded to pregnancy prevention programs developed after July 1, 2026, if the programs are based on existing models that have demonstrated positive outcomes. Grants must comply with the requirements provided in 1997 Iowa Acts, chapter 208, section 14, subsections 1 and 2, including the requirement that a program awarded a grant must emphasize sexual abstinence. Priority in awarding grants shall be given to programs that serve areas of the state which demonstrate the highest percentage of unplanned pregnancies of females of childbearing age within the geographic area to be served by the grant.
  34. To meet one of the four purposes of TANF as specified in 45 C.F.R. §260.20, including by modernizing the program to promote economic mobility and self-sufficiency, ensuring that families are able to overcome benefit cliffs, encouraging healthy families, and streamlining service delivery to reduce duplication: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,000,000
  35. For early intervention and supports for child abuse prevention and the family development and self-sufficiency (FaDSS) grant program in accordance with section 216A.107: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,013,980
  36. For accountability, compliance, program integrity, technology needs, and other resources necessary to meet federal and state reporting, tracking, and case management requirements, and other departmental needs: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,533,647
  37. For state child care assistance: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,281,826
  38. For child protective services: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,364,100 DIVISION VI MEDICAL ASSISTANCE PROGRAM —— STATE SUPPLEMENTARY ASSISTANCE —— HEALTHY AND WELL KIDS IN IOWA PROGRAM AND OTHER HEALTH-RELATED PROGRAMS —— FY 2026-2027 Sec.
  39. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— MEDICAL ASSISTANCE PROGRAM, STATE SUPPLEMENTARY ASSISTANCE, AND HEALTHY AND WELL KIDS IN IOWA PROGRAM. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2026, except as otherwise expressly authorized by law, consistent with options under federal law and regulations, and contingent upon receipt of approval from the office of the governor of reimbursement for each abortion performed under the medical assistance program; for the state supplementary assistance program; for the health insurance premium payment program; and for maintenance of the healthy and well kids in Iowa (Hawki) program pursuant to chapter 514I, including supplemental dental services, for receipt of federal financial participation under Tit. XXI of the federal Social Security Act, which creates the children’s health insurance program; and for other specified health-related programs: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,992,550,706
  40. Of the moneys appropriated in this section, $1,919,596,113 is allocated for medical assistance program reimbursement and associated costs. Of the moneys allocated in this subsection, $3,383,880 shall be used for program administration, outreach, and enrollment activities of the state family planning services program pursuant to section 217.41B , and of this amount, the department may use $200,000 for administrative expenses.
  41. Iowans support reducing the number of abortions performed in our state. Moneys appropriated under this section shall not be used for abortions, unless otherwise authorized under this section.
  42. The provisions of this section relating to abortions shall also apply to the Iowa health and wellness plan created pursuant to chapter 249N .
  43. Of the moneys appropriated in this section, $4,479,762 is allocated for the state supplementary assistance program.
  44. Of the moneys appropriated in this section, $68,474,831 is allocated for maintenance of the Hawki program pursuant to chapter 514I , including supplemental dental services, for receipt of federal financial participation under Tit. XXI of the federal Social Security Act, which creates the children’s health insurance program. Sec.
  45. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— HEALTH PROGRAM OPERATIONS. There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: For health program operations and the autism support program under section 225D.2, and for not more than the following full-time equivalent positions: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,342,766 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 97.00
  46. The department of inspections, appeals, and licensing shall provide all state matching moneys for survey and certification activities performed by the department of inspections, appeals, and licensing. The department of health and human services shall be solely responsible for distributing the federal matching moneys for such activities.
  47. Of the moneys appropriated in this section, a sufficient amount is allocated for the administration of the health insurance premium payment program, including salaries, support, maintenance, and miscellaneous purposes.
  48. Of the moneys appropriated in this section, $750,000 is allocated for a nonprofit organization that provides access to emergency poison information and treatment. Pursuant to the directive under 2014 Iowa Acts, chapter 1140, section 102, the federal matching moneys available to the nonprofit organization from the department under the federal Children’s Health Insurance Program Reauthorization Act of 2009 shall be subject to the federal administrative cap rule of 10 percent applicable to moneys provided under Tit. XXI of the federal Social Security Act, and shall be included in the department’s calculations of the cap.
  49. Unless otherwise provided by law, if a contract for services provided under this section initially entered into during the fiscal year beginning July 1, 2026, and ending June 30, 2027, provides for an annual increase of the cost of services provided under the contract, the annual increase shall not exceed the amount by which the consumer price index for all urban consumers increased during the immediately preceding calendar year. This subsection does not affect a contract entered into on or before June 30, 2026, that is for a term of more than one year. Sec.
  50. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PHARMACEUTICAL SETTLEMENT ACCOUNT. There is appropriated from the pharmaceutical settlement account created in section 249A.33 to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: Notwithstanding any provision of law to the contrary, to supplement the appropriation made in this Act from the general fund of the state for health program operations under the medical assistance program for the same fiscal year: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 Sec.
  51. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— QUALITY ASSURANCE TRUST FUND.
  52. Notwithstanding any provision of law to the contrary, and subject to the availability of moneys, there is appropriated from the quality assurance trust fund created in section 249L.4 to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, for the purposes designated: To supplement the appropriation made in this Act from the general fund of the state to the department of health and human services for medical assistance for the same fiscal year: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $111,216,205
  53. Notwithstanding section 249L.4, subsection 2, after the appropriation in subsection 1, any moneys remaining in the quality assurance trust fund for the fiscal year beginning July 1, 2026, and ending June 30, 2027, are appropriated to the department of health and human services to supplement the appropriation made in this Act from the general fund of the state for the medical assistance program for the same fiscal year. Sec.
  54. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— HOSPITAL HEALTH CARE ACCESS TRUST FUND.
  55. Notwithstanding any provision of law to the contrary, and subject to the availability of moneys, there is appropriated from the hospital health care access trust fund created in section 249M.4, to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, for the purposes designated: To supplement the appropriation made in this Act from the general fund of the state to the department of health and human services for medical assistance for the same fiscal year: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554
  56. Notwithstanding section 249M.4, subsection 2, after the appropriation in subsection 1, any moneys remaining in the hospital health care access trust fund for the fiscal year beginning July 1, 2026, and ending June 30, 2027, are appropriated to the department of health and human services to supplement the appropriation made in this Act from the general fund of the state for the medical assistance program for the same fiscal year. Sec.
  57. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— BEHAVIORAL HEALTH FUND. Notwithstanding section 225A.7, subsection 2, and subject to the availability of moneys, there is appropriated from the behavioral health fund established in section 225A.7, to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, for the purposes designated: To supplement the appropriation made in this Act from the general fund of the state to the department of health and human services for medical assistance for the fiscal year beginning July 1, 2026, and ending June 30, 2027: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,580,938 Sec.
  58. REIMBURSEMENT RATES.
  59. Reimbursement for medical assistance, state supplementary assistance, and social service providers and services reimbursed under the purview of the department of health and human services shall remain at the reimbursement rate in effect on June 30, 2026, or shall be determined pursuant to the reimbursement methodology in effect on June 30, 2026, with the exception of the following: a. If reimbursement is otherwise negotiated by contract or pursuant to an updated fee schedule. b. As otherwise provided in this section.
  60. a. (1) Notwithstanding any provision of law to the contrary, for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the department of health and human services shall reimburse case-mix nursing facility rates based on the methodology in effect on June 30,

Shortened here; the full amendment is in the official document.

Official amendment (PDF) · In the Bill Book