Individuals with prescription drug coverage under other health plans will be eligible to enroll in SeniorCare. For those who already have a health insurance plan, SeniorCare will coordinate benefit coverage with that plan. Individuals enrolled in Medicaid will not be eligible for the new program, because Wisconsin Medicaid already provides prescription drug coverage.
These proposed rules are nearly identical to the emergency rules the Department issued on September 1, 2002. These rules differ in that they:
• clarify provisions relating to recipients' withdrawal from the program [HFS 109.11 (5) (d) and (e)];
• add a provision allowing the Department to redetermine a recipient's eligibility to participate if the Department receives a bad check for the recipient's program enrollment fee [HFS 109.11 (6) (d)];
• add provisions relating to the Department's ability to redetermine and how the Department may correct benefit levels [HFS 109.13 (5) and (6)];
• add the requirement that the department will reinstate the SeniorCare benefit period for a person who has requested a withdrawal from the program under s.
HFS 109.11 (5) (d) if within 30 calendar days of the effective date of the withdrawal the Department receives the person's request to have SeniorCare benefits restored and the person meets all of the eligibility criteria under [HFS 109.14 (4) (c)];
• add circumstances under which the Department will begin recovery action against any SeniorCare participant to whom or on whose behalf an incorrect payment was made [HFS 109.62 (1) (b) to (d)];
• clarify that, in the event of a recipient's appeal of a Department action, the Department will not suspend, reduce or discontinue a recipient's benefits until a decision is rendered after the hearing [HFS 109.63 (2)]; and
• add a provision describing what will happen if program funding under s.
20.435 (4) (bv), Stats., is completely expended for the payments to SeniorCare providers [HFS 109.73].
Copies of Rule and Contact Person
To find out more about the hearings or to request a copy of the proposed rules, you may also write, phone, or e-mail:
Alfred Matano
Division of Health Care Financing
P.O. Box 309, Room 350
Madison, WI 53701-0309
608-267-6848 or, if you are hearing impaired,
(608) 266-1511 (TTY)
If you are hearing or visually impaired, do not speak English, or have other personal circumstances which might make communication at a hearing difficult and if you, therefore, require an interpreter or a non–English, large–print or taped version of the hearing document, contact the person at the address or phone number above. A person requesting a non–English or sign language interpreter should make that request at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Written comments on the rules received at the above address no later than January 28, 2003 will be given the same consideration as testimony presented at the hearing.
Fiscal Estimate
SeniorCare, established by
2001 Act 16, provides prescription drug assistance to Wisconsin residents over 65 years of age whose income does not exceed 240% of the federal poverty level (FPL) and to those whose income exceeds 240% of the FPL if their prescription drug expenditures bring their net income below the 240% limit (termed spenddown). Participants of SeniorCare are required to pay an annual $20 enrollment fee and copayments of $15 for each name brand drug and $5 for each generic drug. In addition, participants with higher incomes (over 160% of FPL) must first spend $500 (deductible) of their own funds annually for prescription drugs before SeniorCare will reimburse the participant's prescription drug expenditures.
On July 1, 2002, Wisconsin's application for a federal waiver to receive federal matching funds under the MA program for SeniorCare was approved for participants with income less than 200% of the Federal Poverty Level (FPL).
The administrative rule does not have a fiscal effect per se. The fiscal effect of the SeniorCare program was taken into account when the legislation was passed. However, a number of the assumptions underlying the fiscal estimate of the SeniorCare legislation have turned out to be incorrect.
Act 16 provided $49,900,000 GPR under s.
20.435 (4) (bv), Stats., to support benefits under the SeniorCare program. Since the program first begins on September 1, 2002, funding was based on a ten-month period. In addition, when Act 16 was enacted, it was unclear whether Wisconsin would obtain a federal waiver. Consequently, funding was based on the assumption that federal funding would not be available.
Although the federal wavier will significantly reduce the need for state funds, the original cost projections substantially underestimated the benefit costs for SeniorCare. Current projections, that include the benefit of federal funding, anticipate that total SeniorCare costs in FY 03 will total $100 million all funds and $48 million GPR. The net result is that budgeted funding is projected to be adequate to fund projected costs of the program in FY 03.
Initial Regulatory Flexibility Analysis
The rules for the SeniorCare program apply to the Department, to families that are applicants or recipients of the health care coverage provided by SeniorCare and to county social service or human service departments that take applications and determine eligibility for SeniorCare. The rules will not directly affect small businesses as “small business" is defined in s.
227.114 (1) (a), Stats.
Notice of Hearings
NOTICE IS HEREBY GIVEN That pursuant to ss.
115.28 (9) and
227.11 (2) (a), Stats., and interpreting s.
115.28 (9), Stats., the Department of Public Instruction will hold public hearings as follows to consider the creation of Ch.
PI 23, relating to ESEA intradistrict safe school transfer options. The hearings will be held as follows:
Hearing Date, Time and Location
Date: January 30, 2003
Time: 4:00 - 6:00 p.m.
Location: Madison
GEF 3 Building
125 South Webster St.
Room 041
Date: February 3, 2003
Time: 4:00 – 6:00 p.m.
Location: Waukesha
Waukesha Public Library
321 Wisconsin Avenue
Cutler Room
Date: February 19, 2003
Time: 4:00 – 6:00 p.m.
Location: Tomahawk
CESA 9
304 Kaphaem Road
Conference Room
The hearing sites are fully accessible to people with disabilities. If you require reasonable accommodation to access a meeting, please call Michael Thompson, Federal Policy Initiatives Advisor, at (608) 266-3584 or leave a message with the Teletypewriter (TTY) at (608) 267-2427 at least 10 days prior to the hearing date. Reasonable accommodation includes materials prepared in an alternative format, as provided under the Americans with Disabilities Act.
Copies of Rule and Contact Person
The administrative rule is available on the internet at
http://www.dpi.state.wi.us/dpi/dfm/pb/safesch.html. A copy of the proposed rule and the fiscal estimate may be obtained by sending an email request to
lori.slauson@ dpi.state.wi.us or by writing to:
Lori Slauson,
Administrative Rules and Federal Grants Coordinator
Department of Public Instruction
125 South Webster Street
P.O. Box 7841
Madison, WI 53707
Written comments on the proposed rules received by Ms. Slauson at the above address no later than February 24, 2003, will be given the same consideration as testimony presented at the hearing. Comments submitted via email will not be accepted as formal testimony.
Analysis by the Department of Public Instruction
Public Law 107-110 section 9532 reauthorizing the Elementary and Secondary Education Act (ESEA), requires each state receiving ESEA funds to establish and implement a statewide policy that allows students who attend persistently dangerous public schools to attend safe public schools. This provision also allows students who become victims of a violent criminal offense while in or on the grounds of a public school they attend to attend safe public schools. Each state must certify to the U. S. Department of Education that it has developed an unsafe school policy.
To comply with the ESEA and to remain eligible to receive more than $250 million in federal funds, the proposed rules:
• Specify criteria to determine whether a school is persistently dangerous.
• Define the terms “victim" and “violent criminal offense."
• Specify school board notification and pupil transfer requirements.
Fiscal Estimate
The Elementary and Secondary Education Act (ESEA) requires each state receiving ESEA funds to establish and implement a statewide policy that allows students who attend persistently dangerous public schools to attend safe public schools. This provision also allows students who become victims of a violent criminal offense while in or on the grounds of a public school they attend to attend safe public schools. To meet the ESEA requirements, the rules 1) specify criteria to determine whether a school is persistently dangerous, 2) define the terms “victim" and “violent criminal offense," and 3) specify school board notification and pupil transfer requirements.
It is assumed that very few school districts will be affected by these rules because:
• The rules only allow pupils to transfer from an unsafe school within a school district to another school or charter school within the same school district. Therefore, the rules will only affect school districts that have more than one elementary, middle or high school. Out of 426 school districts, approximately 190 school districts have more than one elementary, middle or high school.
• The rules will most likely only affect school districts with more than one middle or high school. It is unlikely that an elementary school would fall under the rule's definition of schools that are “persistently dangerous" or that an elementary pupil would become a “victim of a violent criminal offense." Of 426 school districts, approximately 80 school districts have more than one middle or high school.
• To be identified as persistently dangerous, a school must have expelled the greater of 1% of the pupils enrolled or 5 pupils for assault, endangering behaviors or weapons-related offenses. Schools must meet this criteria for 3 or more consecutive years. It is projected, based on current department data, that few schools will meet the rule's criteria for 3 or more consecutive years.
It is not known how many schools have a pupil who has been a victim of a violent criminal offense while in or on the grounds of a public elementary or secondary school that the pupil attends. However, because the rules only affect school districts with more than one elementary, middle or high school and assuming it will be highly unusual for an elementary pupil to be a victim of a violent criminal offense while on school grounds, approximately 80 school districts may be affected.
Affected school districts may incur additional costs associated with the rule's notification requirements and transporting pupils who reside 2 or more miles from the nearest public school they are entitled to attend. These costs are indeterminate.
It is important to note that these rules must be promulgated for Wisconsin to remain eligible to receive more than $250 million in federal Elementary and Secondary Education Act funds.
These proposed rules are not expected to result in new costs for the department.
Initial Regulatory Flexibility Analysis
The proposed rules are not anticipated to have a fiscal effect on small businesses as defined under s.
227.114 (1) (a), Stats.
Notice of Proposed Rule
NOTICE IS HEREBY GIVEN That pursuant to s.
227.11 (2) (a), Stats., and interpreting subchs.
III and
V of ch. 77, Stats., and according to the procedure set forth in s.
227.16 (2) (e), Stats., the Department of Revenue will adopt the following rules as proposed in this notice without public hearing unless, within 30 days after publication of this notice on
January 15, 2003, it is petitioned for a public hearing by 25 natural persons who will be affected by the rule, a municipality which will be affected by the rule, or an association which is representative of a farm, labor, business or professional group which will be affected by the rule.
Contact Person
Please contact Mark Wipperfurth at (608) 266-8253 or
mwipperf@dor.state.wi.us, if you have any questions regarding this proposed rule order.
Analysis by the Department of Revenue
SECTION 1. Tax 11.001 (intro.), (1), (2) and (3) (intro.) are renumbered Tax 11.001 (1) and (2) (a) to (c), subs. (3) (a) to (d) are renumbered sub. (3) (a) 1. to 4., and subs. (4) to (6) are renumbered sub. (2) (d) to (f), to conform the numbering to Legislative Council Rules Clearinghouse (“Clearinghouse") standards. As renumbered:
• Subsection (1) is revised, to place the introductory clause for definitions in a separate subsection.
• Subsection (2) (a) is revised, to remove substantive provisions from the definition of “consumers."
• Subsection (2) (c) is revised, to reference the definition of “retailer" to the statutory definition and to remove a substantive provision.
• Subsection (3) (a) 1., 2. and 3. are revised, to reflect correct punctuation, per Clearinghouse standards and to move substantive provisions in the definition of “retailer" to a separate subsection.
• Subsection (2) (d) is revised, to include the football stadium tax in the definition of “stadium tax," allowed pursuant to
1999 Wis. Act 167, effective May 27, 2000.
• Subsection (2) (e) is revised, to reflect that the definition of “tax" includes county and stadium sales and use taxes.
SECTION 2. Tax 11.001(1) (title), (2) (title) and (3) (title) are created, to conform format to Clearinghouse standards.
