265—43.4(16) Program guidelines.

1. 43.4(1)  Projects meeting the following criteria are eligible for assistance:

   1. a. Written approval from the department for the proposed project is obtained prior to application for loan funds.

   2. b. In order to be approved by the department, the project must demonstrate all of the following components:

      1. (1) The project serves one of the following Medicaid waiver-eligible populations:

         1. 1. Individuals who are currently underserved in community settings, including individuals who are physically aggressive or have behaviors that are difficult to manage or individuals who meet the PMIC level of care; or
         2. 2. Individuals who are currently placed out of state by the department; or
         3. 3. Individuals who are currently receiving care in an Iowa-licensed health care facility.
      2. (2) A plan to provide each Medicaid waiver-eligible individual with crisis stabilization services to ensure that the individual’s behavioral issues are appropriately addressed by the provider.
      3. (3) Policies and procedures that prohibit discharge of the Medicaid waiver-eligible individual from the waiver services provided by the project provider unless an alternative placement that is acceptable to the individual or the individual’s guardian is identified.

   3. c. In order to be approved by the department for application for funding for development of infrastructure in which to provide supportive services under this chapter, a project shall include all of the following components:

      1. (1) Provision of services to Medicaid waiver-eligible individuals who meet the PMIC level of care.
      2. (2) Policies and procedures that prohibit discharge of the Medicaid waiver-eligible individual from the waiver services provided by the project provider, unless an alternative placement that is acceptable to the individual or the individual’s guardian is identified.

2. 43.4(2)  The following types of activities are eligible for assistance:

   1. a. Acquisition and rehabilitation.
   2. b. New construction.
   3. c. Such other similar activities as may be determined by the authority to fall within the guidelines and purposes established for this program.

3. 43.4(3)  Assistance will be provided upon the following terms and conditions:

   1. a. The minimum loan amount is $50,000, and the maximum loan amount is $500,000. The maximum loan term and the amortization period is each 30 years.
   2. b. The acceptable debt service ratio and loan-to-value ratio will be calculated and determined by the authority.
   3. c. Interest rates will be set by the authority, in its sole discretion.
   4. d. Loans shall be secured by a first mortgage to the extent possible. Construction financing may be awarded to projects.
   5. e. Recipients of assistance must agree to observe several covenants and restrictions all in accordance with such loan and mortgage documents as may be required by the authority under this program.
   6. f. The recipient must show that its title in the real estate on which the project is to be located is a marketable title pursuant to Iowa Land Title Examination Standards or other applicable law through a title guaranty certificate issued by the title guaranty division of the Iowa finance authority that shows the recipient as the guaranteed and that includes any endorsements required by the authority.
   7. g. Recipients must execute such documents and instruments and must provide such information, certificates and other items as determined necessary by the authority, in its sole discretion, in connection with any assistance.

4. 43.4(4)  Loan fees.

   1. a. Loan fees are as follows:

      1. (1) Application fee – 0.3 percent of loan amount.
      2. (2) Commitment fee (construction period) – 1.0 percent of loan amount.
      3. (3) Commitment fee (permanent loan) – 2.0 percent of loan amount.
      4. (4) Inspection fee (construction loan) – 0.5 percent of loan amount.
   2. b. The authority may, in limited cases, reduce such fees if necessary in connection with assistance provided under this program. Such decision will be made in the sole discretion of the authority.

For-profit and nonprofit sponsors are eligible to apply for assistance under this program based on the following program guidelines after receiving approval of a service plan to benefit the Medicaid waiver-eligible individuals who reside in the project. The service provider may apply for the loan fund; however, the service provider does not have to be the applicant for the loan fund. If the service provider is not the loan applicant, a memorandum of understanding must exist between the loan applicant and the service provider that shows an obligation on behalf of the service provider to deliver services to the Medicaid waiver-eligible individuals residing in the project and that shows that the loan applicant is obligated to offer housing to the Medicaid waiver-eligible individuals who need the services provided by the service provider.

[ARC 0115D, IAB 3/4/26, effective 4/8/26]