Scope statements
Corrections
Subject
Establishing an annual fee to partially offset the costs of monitoring persons who are required to register as sex offenders and who are in the custody of the Department of Corrections or who are on probation, parole, or extended supervision.
Policy analysis
Objective of the rule. The objective of the rule is to establish an annual fee to partially offset the costs of monitoring persons who are required to register as sex offenders and who are in the custody of the Department of Corrections or who are on probation, parole, or extended supervision.
Description of existing policies relevant to the rule and of new policies proposed to be included in the rule, and an analysis of policy alternatives:
2005 Wisconsin Act 25, Section
2223 created section
301.45 (10), Stats., which gives the Department of Corrections authority to establish an annual fee to partially offset the costs of monitoring persons who are required to register as sex offenders and who are in the Department's custody or who are on probation, parole or extended supervision. The annual fee is not to exceed $50.00.
The alternatives to the proposed policy would result in not establishing the annual fee as provided under the recently passed legislation.
Comparison with federal regulations
There is no current or proposed federal regulation which addresses the subject of the proposed rule.
Statutory authority
Staff time required
The Department estimates that it will take approximately 10 hours to develop this rule, including drafting the rule and complying with rulemaking requirements.
Health and Family Services
Subject
The Department of Health and Family Services proposes to amend chs.
HFS 110 and
HFS 111, relating to emergency medical technicians (EMTs).
Policy analysis
There are two levels of emergency medical services care in Wisconsin. They are basic life support and advanced life support. These two levels are distinguished by the skills and medications that can be used by emergency medical services personnel when performing pre-hospital care.
Requirements for basic life support are codified in chs.
HFS 110 and
HFS 113. At the basic life support level, the department licenses individuals as emergency medical technician-basic (EMT-Basic) and emergency medical technician-intravenous (EMT-Basic IV) and certifies individuals as First Responders. Requirements for advanced life support are codified in chs.
HFS 111 and
HFS 112. At the advanced life support level, the department licenses individuals as provisional emergency medical technician- intermediate (Provisional EMT- Intermediate), emergency medical technician-intermediate (EMT-Intermediate), and emergency medical technician-paramedic (EMT-Paramedic).
Licensure, certification, title, and service level designations of emergency medical service personnel are based on the training and competency requirements of the “Wisconsin Revision of the National Standard Curriculum" (Wisconsin Curriculum). The Wisconsin Curriculum is based on the National Standard Curriculum developed by the National Highway Traffic Safety Administration (NHTSA). To receive and maintain licensure as an emergency medical services professional in Wisconsin, an individual must meet the training and competency requirements of the Wisconsin Curriculum for the appropriate discipline.
In 2001, based on national recommendations, the department revised the Wisconsin Curriculum for the EMT-Intermediate level and adopted higher training and competency standards for EMT-Intermediate licensure. EMT-Intermediate licensees who were trained under the 1989 (or earlier) National Standard Curriculum for EMT-Intermediate, while still considered advanced life support, were renamed Provisional EMT-Intermediate and given until December 31, 2005 to meet the new training and competency requirements. As required under s.
HFS 111.045, licensees who did not meet the December deadline will be renamed EMT-Basic IV effective July 1, 2006.
The training and competency requirements for the EMT-Basic IV license are the training and competency requirements from the 1989 (or earlier) version of the National Standard Curriculum for EMT-Intermediate which makes the EMT-Basic IV skill set and competencies identical to the skill set and competencies of the Provisional EMT-Intermediate, an advanced life support level of care. Nevertheless, the department codified the EMT-Basic IV service level as basic life support under ch.
HFS 110 instead of advanced life support under ch.
HFS 111.
The department's placement of the EMT-Basic IV designation as basic life support under ch.
HFS 110 has had an inadvertent and negative impact on ambulance service providers and may eventually negatively impact the communities that they serve.
At least 70% of the revenues ambulance service providers generate come from government (Medicare and Medicaid) and non-government insurers that base the level of reimbursement on the level of skilled service the patient receives, that is, whether the patient receives emergency medical services from an individual who is licensed at the basic life support level of care under ch.
HFS 110 or
113 or an advanced life support level of care under ch.
HFS 111 or
112. As a result, ambulance service providers that employ individuals licensed at the EMT-Basic IV level bear the higher equipment, salary, and training costs associated with maintaining the advanced life support level of care, but are reimbursed at rates for basic life support level of care.
Statutory authority
Staff time required
The department estimates that it will take approximately 80 hours to develop the proposed rules. The Department will use the assistance of the Emergency Medical Services Advisory Board to develop the continuing education requirements in ch.
HFS 110.
Entities affected by the rule
The citizens of Wisconsin, counties, emergency medical technicians, and ambulance service providers
Comparison with federal regulations
There are no federal regulations that are governing or applicable to these rules.
Health and Family Services
Subject
The Department of Health and Family Services proposes to modify ch.
HFS 129, relating to the certification of programs and requirements for training and testing of nurse aides, home health aides, and hospice aides.
Policy analysis
Chapter
HFS 129 establishes conditions of certification of instructional programs, including standards for instructors, curriculum and criteria for the competency evaluation programs for persons who work as nurse aides in hospitals, nursing homes, facilities for the developmentally disabled, home health agencies or hospices. HFS 129 also establishes standards for the development of a registry of persons who have satisfactorily completed the training program, competency program or who otherwise are eligible for listing in the registry.
This Statement of Scope replaces the Statement of Scope published in May 2003 to include notice of additional changes that the department proposes to make due to recent modifications to the program including the requirements for the training and testing of feeding assistants as set forth under
42 CFR 483.35 and
483.160, medication aides as set for the under
42 CFR 60, and the process to waive the two-year prohibition of a nurse aide training program under Public Law 105-15 (H.R. 968).
The Department proposes to revise ch.
HFS 129 for several reasons:
1. To include requirements for the training and testing of feeding assistants and medication aides.
Feeding assistants differ from nurse aides in that a feeding assistant may only assist residents who have no feeding complications with the activities of eating and drinking. A medication aide is a nurse aide who is also approved to administer medications under the supervision of a licensed nurse.
2. To reflect the Department's decision to standardize the administration and operation of nurse aide competency evaluation statewide by contracting for this service.
Federal regulations set forth under CFR 483.152 and 483.154 authorize states to choose to offer a nurse aide training and competency evaluation program, or to review, and approve or disapprove program applications upon request. The Department has been reviewing, and approving or disapproving nurse aide training and competency evaluation programs based on standards in ch.
HFS 129.08. Anyone who meets those standards may conduct a testing program.
However, the Department believes that specifying standards for competency evaluation programs cannot assure the maintenance of neutral and objective facility-sponsored instructional and competency evaluation tests that are free from possible conflicts of interest posed by the need to meet facility staffing requirements. Therefore, the Department proposes to modify ch.
HFS 129 to reflect the Department's contracting out the implementation of such competency testing.
3. To improve the accuracy and integrity of the nurse aide registry.
Under
42 CFR 483.152 (2), s.
146.40 (4g), Wis Stats., and ch.
HFS 129.10 of the Wisconsin Administrative Code, the Department is required to maintain a list, known as a “registry," of all persons deemed qualified to work in Wisconsin as a nurse aide. Aside from committing an offense that would bar a person from remaining on the list, the Department intends to add state provisions for removing a person's name from the list. The Department believes that the list of qualified nurse aides, currently numbering over 183,000, contains many persons who no longer are available to or interested in working as a nurse aide. Therefore, the Department intends to modify ch.
HFS 129 to require nurse aides to periodically update their registration information and, in the process, allow the Department to maintain a more accurate list of nurse aides. Periodic updating will also provide the Department the opportunity to verify the information provided by nurse aides.
4. To clarify who may be included on the registry and who is eligible to work as a nurse aide and, specifically, as a medication aide. The Department will also clarify the circumstances under which a person not currently included on the registry may work in a health care facility, such as an RN, LPN, etc.
5. To make ch.
HFS 129 more consistent with current federal regulations governing nurse aides.
The Department proposes to update aspects of ch.
HFS 129 to reflect federal requirements established since ch.
HFS 129 was originally promulgated April 1992. Specifically, the Department will propose to incorporate federal requirements relating to:
Withdrawal of Department approval of a nurse aide training and competency evaluation program or a nurse aide competency evaluation program if the entity providing the program refuses to permit unannounced visits by the Department.
Nurse aide training needing to be performed by or under the general supervision of a RN who possesses a minimum of 2 years of nursing experience, at least 1 year of which must be in the provision of long term care facility services.
The inability of a facility to charge fees for training and competency testing to a person who is employed by or has received an offer of employment from a health care facility. In addition, in the case of a person becoming employed by federally certified nursing home within 12 months after completing a training and testing program, the requirement for the Department to reimburse the person for the costs of such training and testing.
Requiring that the skills demonstration part of the evaluation be performed in a facility or laboratory setting comparable to the setting in which the person will function as a nurse aide and be administered and evaluated by a RN with at least 1 year's experience in providing care for the elderly or the chronically ill of any age.
Requiring a competency testing program to use a system that prevents disclosure of both the pool of questions and the individual competency evaluations.
Requiring that the skills demonstrated must consist of a demonstration of randomly selected items drawn from a pool consisting of the tasks generally performed by nurse aides.
Establishing what happens if a person does not complete the evaluation satisfactorily, and impose a maximum number of three times that person may attempt to complete the evaluation successfully.
6. To expand the mechanisms available to the Department for enforcing compliance of training and testing programs.
Existing enforcement options in ch.
HFS 129.05 (2) (c) are limited to suspension or revocation of certification or imposing a plan of correction. Although these are valuable enforcement tools, they do not give the Department the flexibility it needs to tailor its response to the severity of non-compliance with this chapter. The Department will propose to revise ch.
HFS 129 to include additional enforcement options such as requiring a training or competency program whose approval has been revoked to remain ineligible to submit a new nurse aide training or testing program application for a period of up to one year, issuing a statement of deficiency and placing conditions on certification. The Department also will propose additional enforcement penalties for instructors and examiners who fail to follow program requirements.
7. To include the feeding assistant training and testing program requirements.
The Department proposes updating ch.
HFS 129 to include reference to federal regulations set forth under CFR 483.35 and 483.160 which authorize states to choose to offer a paid feeding assistant training and competency evaluation program, or to review, and approve or disapprove program applications upon request. This training and testing is conducted in nursing homes or intermediate care facility for persons with mental retardation (ICFs/MR), to assist residents who have no feeding complications with the activities of eating and drinking. The feeding assistant is not permitted to provide any other nursing or nursing related service.
8. To include the medication aide training and testing program requirements.
Federal regulations set forth under
42 CFR 483.60 permit the use of unlicensed personnel, if State law permits, to administer drugs under the general supervision of a licensed nurse. This training and testing is conducted in nursing homes, technical colleges and private enterprises. The Department proposes to update ch.
HFS 129 to include these medication aide requirements.
9. To include the process for requesting, reviewing and approving or disapproving waivers to Federal sanctions to training programs.
]The Department proposes to include reference to Public Law 105-15 (H.R. 968), revised specific provisions of the Social Security Act, which permits a State to waive the two-year prohibition of Nurse Aide Training offered in (not by) certain nursing homes if the State:
Determines there is no other such program offered within a reasonable distance of the facility,
Assures, through an oversight effort, that an adequate environment exists for operating the program in the facility, and
Provides notice of such determination and assurances to the State long term care ombudsman.
Statutory authority
Staff time required
The Department estimates that it will take approximately 50 hours to draft the rulemaking order. The Department will also seek the participation of the Bureau on Aging and Long Term Care, the Department of Workforce Development, the Department of Public Education, the Wisconsin Association of Homes and Services for the Aging, the Wisconsin Health and Hospital Association, the Wisconsin Health Care Association, the Wisconsin Technical College System, the Wisconsin Long Term Care Workforce Alliance and private industry.
Entities affected by the rule
Facilities for the Developmentally Disabled, Home Health Agencies, High Schools, Hospice Agencies, Hospitals, Nursing Homes, Private Programs, Technical Colleges, State Agencies, and Universities.
Comparison with federal regulations
Federal conditions of participation for the Registry of nurse aides, nurse aide training and testing programs, and training of paid feeding assistants are in the Code of Federal Regulations,
42 CFR 483. These regulations establish conditions and standards for maintenance and operation of a nurse aide registry, and for conducting training and testing programs for nurse aides and paid feeding assistants. State and federal regulations for registry services and the training and testing of nurse aide and paid feeding assistants are comparable; however, the state requirements augment more general federal regulations by providing specificity in certain areas
. The intent of these regulations is to foster safe and adequate care and treatment of clients by these caregivers.
Insurance
Subject
Objective of the rule. By motion on March 1, 2006 the Joint Committee for Review of Administrative Rules (JCRAR) voted to suspend specific subsections of ch.
Ins 9, Wis. Adm. Code. At the hearing, JCRAR asked the Office to modify those same provisions by rule. The Office will consider modifying ch.
Ins 9, Wis. Adm. Code, with respect to the matters governed by the suspended provisions. Modifications under consideration include: deleting the term “limited scope plan" and replacing it with the appropriate plan or plans including defined network, preferred provider and limited service health organization; modify the emergency medical care provisions, modify language for insurers related to use of utilization management, and modify language related to providers hours of operation.
Policy analysis
A description of existing policies relevant to the rule and of new policies proposed to be included in the rule and an analysis of policy alternatives: Revisions to ch.
Ins 9, Wis. Adm. Code, became effective March 1, 2006. New policies proposed for consideration in this notice of scope include elimination of application of the revised rule to limited scope plans, consider whether the revised rule provides the appropriate standard for coverage of emergency care treatment, and adjusting the language of the revised rule as it relates to utilization management and provider hours of operation. In accordance with the Office's agreement to address the JCRAR's motions, the Office intends to modify specific portions of the revised ch.
Ins 9, Wis. Adm. Code.
There is no viable alternative to establishing by rule the requirements for these health insurance products. The statutory framework contained within ch.
609 and s.
632.85, Wis. Stats., raise the issues that the proposed rule will address.
Statutory authority
Staff time required
200 hours.
Entities affected by the rule
The proposed rule will affect insurers which offer defined network plans, health maintenance organizations, limited scope plans, preferred provider plans and limited service health organization plans. Insurers will be required to revise their relationships, including provider and insurance contracts, with health care providers, health care provider networks, employers and individuals.
Comparison with federal regulations
The Office is unaware of any proposed or existing federal regulation that is intended to address the activities to be regulated by this proposed rule.
Insurance
Subject
Objective of the rule. By motion on March 1, 2006 the Joint Committee for Review of Administrative Rules (JCRAR) voted to suspend s.
Ins 9.32 (2) (c) and
(e) 1., Wis. Adm. Code, and the phrase “(c) and “ in s.
Ins 9.33, Wis. Adm. Code. At the hearing, JCRAR requested the Office to modify these provisions by rule. The Office, after consulting with interested parties, including consumer representatives, insurers, and representatives of Wisconsin health care providers, will consider appropriate modifications to ch.
Ins 9, Wis. Adm. Code, to address the topic of the JCRAR suspended provisions.
Policy analysis
Chapter
Ins 9, Wis. Adm. Code, became effective March 1, 2006. Chapter
Ins 9 includes the provisions cited above which address the circumstances where an operation or procedure is performed by an in-panel provider but some ancillary services, such as anesthesiology, radiology or lab tests, are performed by non-participating providers. OCI will, after consulting with interested parties, consider whether there are alternative standards, or alternative implementation, that may more appropriately address this matter than the standards included in the suspended provisions of revised ch.
Ins 9, Wis. Adm. Code.
There is no viable alternative to establishing by rule the requirements for these health insurance products. The statutory framework contained within ch.
609 and s.
632.85, Wis. Stats., raise the issues that the proposed rule will address.
Statutory authority
Staff time required
200 hours.
Entities affected by the rule
The proposed rule will affect insurers which offer defined network plans, health maintenance organizations, preferred provider plans and limited service health organization plans. Insurers will be required to revise their relationships, including provider and insurance contracts, with health care providers, health care provider networks, employers and individuals.
Comparison with federal regulations
The Office is unaware of any proposed or existing federal regulation that is intended to address the activities to be regulated by this proposed rule.
Natural Resources
Subject
Objective of the rule. Modifications to portions of ch.
NR 22, pertaining to Wisconsin-Iowa boundary waters. The proposed changes would implement harvest restrictions for commercially-caught shovelnose sturgeon in Wisconsin-Iowa waters of the Mississippi River.
Policy analysis
The Department is beginning the process of recommending changes to Wisconsin administrative code relating to commercial fishing for shovelnose sturgeon. The Department anticipates requesting hearings on these changes in June, 2006, and holding hearings, if approved, in August 2006.
Statutory authority
Staff time required
The Department anticipates spending approximately 160 hours in the rule development process.
Entities affected by the rule
Fewer than five commercial fishermen licensed by Wisconsin will be affected by the proposed rule changes.
Comparison with federal regulations
Authority to promulgate fishing regulations is granted to States. No federal regulations apply to the proposed changes in regulating recreational fishing and clamming activity.
Public Service Commission
Subject
Objective of the rule. This rulemaking will create rules regarding statewide energy efficiency and renewable resource programs as required under
2005 Wisconsin Act 141.
Policy analysis
2005 Wisconsin Act 141 revises the statutes to create a structure under which energy utilities collectively establish and fund statewide energy efficiency and renewable resource programs that will help achieve environmentally sound and adequate energy supplies at reasonable cost. These rules will address issues such as:
Procedures for contracting with program administrators.
Criteria for selection of program administrators.
Procedures and criteria for Commission review of contracts with program administrators.
Procedures and criteria for Commission review of programs.
Minimum requirements for the programs.
Comparison with federal regulations
The Commission is unaware of any federal regulation in this area.
Statutory authority
Staff time required
The Commission estimates that approximately 500 hours of Commission staff time will be required in this rulemaking.
Other resources necessary to develop rule
Commission staff may meet and consult with former members of the Governor's Task Force on Energy Efficiency and Renewables during the course of this rulemaking.
Entities affected by the rule
The rulemaking will affect investor-owned and municipal electric and natural gas utilities, and retail electric cooperatives.
Public Service Commission
Subject
Objective of the rule. This rulemaking will revise Wis. Admin. Code ch.
PSC 118 to reflect changes found in
2005 Wisconsin Act 141 regarding renewable resource credits.
Policy analysis
2005 Wisconsin Act 141 revises Wis. Stat. s.
196.378 regarding renewable energy sources and renewable resource credits. These credits may be generated and used by a utility to meet its required renewable energy percentage, or sold to another utility for its use in meeting its percentage. These rules will address issues such as the requirements for creation and use of a renewable resource credit and a regional credit tracking system.
Comparison with federal regulations
There are various federal regulations concerning renewable energy, but the Commission is not aware of any federal regulation in this specific area.
Statutory authority
Staff time required
The Commission estimates that approximately 500 hours of Commission staff time will be required in this rulemaking.
Other resources necessary to develop rule
Commission staff may meet and consult with former members of the Governor's Task Force on Energy Efficiency and Renewables during the course of this rulemaking.
Entities affected by the rule
The rulemaking will affect all electric providers and wholesale suppliers. It may also affect the members or customers of a wholesale supplier. (
See Wis. Stat. ss.
196.378 (1) (c) and
(p)).
Public Service Commission
Subject
Objective of the rule. The proposed rule revisions adopt, for state purposes, changes to the federal pipeline safety code that have been enacted since the last revisions to the state pipeline safety code were enacted. The state has adopted federal pipeline safety provisions in Wis. Admin. Code ch.
PSC 135.
Policy analysis
Under an agreement with the federal Department of Transportation, Office of Pipeline Safety, the Commission is authorized to enforce federal natural gas pipeline safety requirements as set out in the Code of Federal Regulations,
49 CFR Parts 192,
193 and
199. As part of the agreement, the Commission agrees to adopt those parts of the federal code that apply to pipeline safety. The state adopts the federal pipeline safety code in Wis. Admin. Code s.
PSC 135.019. The Commission last promulgated revisions to s. PSC 135 in 2003. Since then, the federal DOT has adopted several final rules which revise the pipeline safety code. These changes include:
Federal Amendment 192-94, relating to consensus industry standards and various technical standards. This rule took effect July 14, 2004.
Federal Amendment 192-95, relating to pipeline integrity management in high consequence areas. This rule took effect on January 14, 2004.
Federal Amendment 192-96, relating to the operation and capacity of existing pressure limiting and regulating stations on gas pipelines, and establishing an appropriate pressure limit. This rule took effect on September 14, 2004.
Federal Amendment 192-97, relating to transmission lines accommodating the passage of internal inspection devices. This rule took effect on July 28, 2004.
Federal Amendment 192-98, relating to periodic underwater inspections of pipeline facilities located in the Gulf of Mexico and its inlets in waters less than 15 feet deep. This rule took effect on September 9, 2004.
Federal Amendment 192-99, relating to the requirements for pipeline operators to develop and implement public awareness programs. This rule took effect June 20, 2005.
Federal Amendment 192-100, relating to programs conducted by operators of gas and hazardous liquid pipelines to qualify individuals who perform certain safety-related tasks on pipelines. This rule took effect July 1, 2005.
In this proceeding, the Commission will consider rule revisions designed to codify for state purposes these recently-enacted federal changes.
Comparison with federal regulations
Under an agreement with the federal Department of Transportation, Office of Pipeline Safety, the Commission is authorized to enforce federal natural gas pipeline safety requirements as set out in the Code of Federal Regulations,
49 CFR Parts 192,
193 and
199. As part of the agreement, the Commission agrees to adopt those parts of the federal code that apply to pipeline safety.
Statutory authority
Staff time required
The Commission estimates that fewer than 200 hours of employee time will be required to develop the rules.
Other resources necessary to develop rule
No additional resources are likely to be needed in order to complete this project.
Entities affected by the rule
Every gas public utility and gas pipeline operator that operates gas transmission or distribution facilities in this state.
This rule would be adopted because it could be expanded to include the great lakes navigable waters in the future.
Workforce Development
Subject
Ch.
DWD 59, grants supporting community child care initiatives.
Policy analysis
Grants supporting community child care initiatives award federal child care funds to local governments and tribes that supply the required matching funds and meet other eligibility criteria for receiving the grants. Grants have been awarded to fund activities such as accommodation of children with disabilities, education of providers, and staff retention strategies. In recent years funding for this program has been cut by 86%. The reduced funding necessitates a change in the procedure for awarding the grants.
The current procedure for awarding grants provides for an initial one-year grant followed by 2 grant cycles of continuing grants. Under current law initial grantees receive up to continuing grants of up to 75% of the amount of their initial grants, and then may also compete, along with any eligible jurisdiction in the state, for the remaining 25% as initial grantees. This 2-step procedure was developed when funding for the program was $14 to 17 million. With the funding reduced to $2.4 million, a 2-step procedure is cumbersome and inefficient. The department proposes to focus the dramatically reduced funding on localities and tribes with a proven track record by removing the 75% ceiling on a grantee's continuing grants compared to their initial grant. This allows all funds to be awarded to continuing grantees for the next 2 grant cycles. Current grantees have shown an interest in the program, have the match on hand, and have the demand of grant-funded activities. There are currently 48 grantees representing approximately 86 local jurisdictions.
Statutory authority
Entities affected by the rule
Local governments and tribes.
Comparison with federal requirements
There are no comparable federal requirements.
Staff time required
75 hours.
