Appropriations – Week of April 28, 2011

STAFF CONTACT:  Theresa Kehoe

SF 527 – IA Finance Authority Rent Subsidy Program

SF 532 – Flood Mitigation

HF 649 – Health & Human Services FY12 Budget

FLOOR ACTION:

SF 527 appropriates $658,000 from the General Fund to the Iowa Finance Authority (IFA) in FY12 for the Rent Subsidy Program. This is a new General Fund appropriation. The Program was previously funded through the Senior Living Trust Fund at $700,000 in FY11. IFA is permitted to use up to $35,000 for administrative costs. The Auditor is requested to review the outside audit of the Iowa Finance Authority. IFA is permitted to use money in the Shelter Assistance Fund for service evaluation and federal match for the Homeless Management Information System. IFA is also allowed to use up to 2 percent of the total amount of grants awarded through the Shelter Assistance Fund to be used for administrative costs. The bill creates a Community Housing for Persons with Disabilities Loan Program Fund. The funds are to be used for a revolving loan program under the Iowa Finance Authority to help keep Medicaid waiver-eligible individuals out of institutions and in permanent supportive housing. [4/26: 26-24 (party-line)]

COMMITTEE ACTION:

SF 532 establishes a flood mitigation board to oversee the flood mitigation program. The board is responsible for reviewing flood mitigation project plans that apply for financial assistance from the flood mitigation fund or by using state sales tax revenue growth from that governmental entity. Flood mitigation projects requesting financial assistance shall be reviewed by the board, with the board considering the following factors:
** Whether the project will mitigate future flooding of property that has sustained significant flood damage in the past and is likely to sustain significant damage in the future;
** Whether the project addresses the impact the proposed project would have on flooding both upstream and downstream of the proposed project;
** Whether the area that would benefit from the project is valuable to the economic viability of the state or is of historic value to the state.

A project shall not be approved unless at least 50 percent of the nonfederal federal portion of the total cost comes from local funds. Additionally, the project must be accompanied by nonpublic investment in the area totaling an amount equal to or more than 50 percent of the total project costs. Nonpublic investment would include capital investments or infrastructure improvements made by nonpublic entities. Projects eligible under this program must be undertaken by a qualified governmental entity, which includes a county, city or a joint board established by a 28E agreement between a county and one or more cities located in the county. Following approval of a flood mitigation project plan by the state flood mitigation board, the governmental entity would adopt a resolution requesting the establishment of an account in the sales tax increment finance fund of the state treasury. The money in this account would be the amount of increased sales and service taxes collected in the jurisdiction of the governmental entity above the base year, which is the year the flood mitigation project plan was approved by the board. Money remitted from the flood project’s sales tax increment account must be deposited into entity’s flood project fund for the purposes of financing the project. The total amount of money that can accrue in the sales tax increment fund could not exceed $30 million annually. Each account (or project) could not accrue more than $15 million annually. The bill also creates a flood mitigation fund as an alternative future funding source but does not provide any appropriations for the flood mitigation fund. [4/25: 20-1 (Bolkcom “no”]

HF 649 appropriates a total of $1,477,400,000 from the General Fund for fiscal year 2012 and $1,544,400,000 for fiscal year 2013 (as passed by the House). HF 649 also appropriates $473.9 million from other funds for both fiscal year 2012 and 2013. The bill:
** Provides funding for the Departments of Aging, Human Services, Public Health and Veterans Affairs, including the Veterans Home.
** Replaces $508 million of one-time funding from other funds to the general fund, which gives the illusion of dramatic increases.
** Underfunds Medicaid by $35.3 million.
** Amends the definition of medically necessary abortion covered by Medicaid by eliminating cases of rape, incest and fetal anomalies.
** Eliminates state funding for all tobacco prevention funding.
** Eliminates child care quality spending and underfunds child care assistance subsidy.
** Includes a budget for fiscal year 2013.

Spending Summary

Senate Amendment:

** Overall reduction of $3 million to reach Senate target that was $3 million below the House target.
** Strikes the FY13 budget.
** Raises the existing nursing facility quality assurance fee to drawn down more federal dollars and to fund re-basing.
** Creates a pharmacy assessment fee to drawn down more federal dollars and allow raising the pharmacy dispensing reimbursement rate.
** Underfunds Medicaid by $35.3 million (exactly the same as the House).
** Restores $128,950 to hawk-I outreach programs to ensure all eligible children are enrolled in the health insurance program.
** Increases funding to the Home and Community Based Elderly Waiver by $1 million, which raises the monthly cap.
** Provides an additional $1.2 million to Psychiatric Medical Institutes for Children (PMICs) to meet a CMS regulation regarding pharmaceuticals.
** Restores $450,000 to the Area Agencies on Aging for services to seniors.
** Appropriates $6.1 million to reduce the waiting lists for all seven Home and Community Based Services (HCBS) waivers.
** Restores $93,000 for Medicaid family planning services.
** Restores $750,000 for Medicaid children’s chiropractic services.
** Appropriates $3.5 million for Medicaid MMIS and Eligibility (computer upgrades). House funded out of Pooled Technology. Senate from the general fund.
** $150,000 for implementing a uniform cost report (saves providers time and effort).
** $50,000 to IME for audit technical assistance.
** $200,000 to IME for implementing a provider payment system (was part of SF 480).
** $20,000 to IME for planning related to an All Payer Claims database (SF 480).
** $100,000 for implementing an Accountable Care Organization (ACO) pilot project.
** $100,000 to IME for e-Health records (brings in federal money at 90/10 match rate).
** Restores $32,512 to Child Health Specialty Clinics.
** Restores $42,365 to ABCDII/First 5 (children’s mental health).
** Restores $5 million to tobacco prevention programs.
** Appropriates $25,000 for a vision screening pilot program.
** Restores $324,273 for direct care workers.
** Restores $68,332 Safety Net providers family planning services.
** Restores $23,774 to PKU.
** Restores $107,052 to the Center for Congenital Disorders.
** Restores $97,990 to Safety Net Collaborative.
** $134,214 to Health Care Access (reform councils).
** Restores $39,000 to Health Aging at IDPH.
** Restores EMS funding of $50,000.
** $79,966 to Public Health (corrections).
** Provides an increase of $100,000 for brain injury facilitators.
** Restores $500,000 to shelter beds.
** Increases child care subsidy by $2,027,847.
** Restores $2 million for child care quality initiatives.
** Restores $600,000 to juvenile graduated sanctions.
** Appropriates $300,000 for children’s system of care initiative.
** Reduces the increase to ICCCC by $163,987. This is still an increase of $200,000 over FY11.
** Adds hospital indemnification language.
** Adds intent language related to home visitation services.
** Allows child welfare provider training dollars to carry forward.
** Makes a technical correction to the dental loan repayment program.
** Restores language on Medicaid and IowaCare medically necessary abortions to language that had been in the bill since 1978.
** Adds language on duties of conservators. This is a rewrite of SF 492.
** Moves the dental loan repayment program to a different section.
** Updates the IowaCare Nonparticipating Provider fund language.
** Allows waiver provider training funds to carry forward.
** Continues the work of the mental health/courts commitment workgroup.
** Allows DHS to transfer between Resource Centers and Toledo and Eldora.
** Adds the ban on BPAs in baby bottles, pacifiers and sippy cups.
** Fixes the juvenile institution enrollment cap.
** Directs CJJP to convene the study on detention center funding instead of DHS.
** Makes corrections to the false claims act that was enacted in SF 2088 last year to comply with CMS.
** Makes changes to the roll-out of the IowaCare regional provider plan, including shifting more care to Broadlawns and less to the FQHC’s.
** Adds the e-Health language originally in SF 404.
** Moves disaster case management to Homeland Security from DHS.
** Requires DHS to report to the Legislature before implementing Medicaid cost containment strategies.
** Adds language about child care centers at fitness centers. [4/25: 13-8 (party-line)]