Scope statements
Health and Family Services
Subject
To amend sections
HFS 107.113 and
107.12 to permit greater flexibility to providers and recipients in scheduling private duty nursing (PDN) and respiratory care services (RCS) benefits covered by Wisconsin Medical Assistance (MA).
Policy analysis
Chapter
HFS 107 sets forth the Wisconsin MA covered services and reimbursement requirements for providers. As written, the rule limits the amount of time a nurse may provide direct PDN or RCS care to an MA recipient. This serves to assure the health, safety, and welfare of the recipient.
In particular, s.
HFS 107.113 (5) (d), governing RCS, currently provides that “[s]ervices provided by one individual in excess of 12 continuous hours per day or 60 hours per week" are not covered services. The PDN rule has a similar but not identical limitation. That rule, s.
HFS 107.12 (2) (b), states that PDN “is limited to 12 continuous hours in each 24 hour period and no more than 60 hours in a calendar week," and that “[a] prior authorization request for 2 consecutive 12-hour periods shall not be approved."
The Department has determined that strict adherence to the above requirements sometimes creates an unjustified burden to both consumers and providers. Therefore, the Department is seeking to amend the rules to reduce these restrictions.
Two committees advise the Department on issues relating to home health care. Both of these committees, the Home Care Consumer Advisory Committee and the Home Care Advisory Committee, have requested a change such as the Department is now considering. The providers affected by these requirements are home health agencies and nurses in independent practice.
Statutory authority
Staff time required
Division of Health Care Financing staff estimate that rule development will require about 100 hours over the course of six to twelve months to develop and promulgate the proposed rules.
Veterans Affairs
Subject
Creation of ch.
VA 17 of the Wisconsin Administrative Code, relating to the Military Funeral Honors Program.
Objective of the rule. The proposed rule would implement the following criteria relative to the operation and management of the Military Funeral Honors Program.
- Establish a 90 day timeline from the date of honors being performed within which a veterans service organization must submit a completed reimbursement stipend form in order to receive payment.
- Scale the amount of the stipend to the level of honors performed.
- Require veterans service organizations to complete and be certified/recognized, or scheduled to complete a designated training program in order to be eligible for the state stipend reimbursement.
- Upon federal funding becoming available for reimbursement to veterans service organizations performing honors, require that the organization must first request federal reimbursement before requesting state reimbursement for honors performed that day.
- Require that any veteran being interred at a State Veterans Cemetery receive honors from the department's honors teams, unless the veteran's family directs otherwise.
- In order for veterans service organization to be eligible to purchase the “MFH Burial Coin" from an authorized vendor, to be given to a family when the flag is presented, the organization must be certified/recognized by completing a designated training program.
Policy analysis
Due to the continued increase of veteran deaths the usage of the Military Funeral Honors Program continues to increase. With the continued increase of funeral directors requesting honors through the Program and the number of veterans service organizations assisting with conducting honors, the overall program costs continue to rise. In order to provide professional and dignified honors for a veteran and his/her family, in a cost-effective manner, rules should be established for the conduct of honors and the reimbursement to organizations. The proposed rules would permit the department to more adequately address the quality of honors being provided and the standards for reimbursement.
Statutory authority
Staff time required
Approximately 15 hours of Department of Veterans Affairs staff time will be needed to promulgate the rules.
Veterinary Examining Board
Subject
2001 Wisconsin Act 76 amended s.
453.06 (2m) (b), Stats. That section previously required an applicant for a temporary postgraduate training permit to either have completed the national licensure examination, be scheduled to take the examination or be waiting for the results of the national examination. Act 76 removed that requirement.
Policy analysis
There should not be a conflict between the statute and the administrative code.
Statutory authority
Staff time required
50 hours.
Veterinary Examining Board
Subject
Special use authorization to humane societies and animal shelters permitting them to acquire controlled substances for the exclusive purpose of euthanizing animals in their care.
Objective of the Rule. To permit humane societies, wildlife breeding organizations and wildlife research organizations to possess emergency medical kits containing controlled substances to be utilized to sedate animals in the field for the purpose of isolation, transport or emergency care.
Policy analysis
The special use authorization issued by the Wisconsin Controlled Substances Board authorizes humane societies, wildlife breeders and wildlife research organizations to possess controlled substances only for the purpose of euthanizing animals in their care. If the purpose is only to sedate the animal for the purpose of transport, medical care or protection of the public, a veterinarian must be involved. This is often difficult or impossible on short notice. The proposed rule would permit these organizations to maintain an emergency medical kit to be utilized by authorized personnel under the oversight of a licensed veterinarian, pursuant to guidelines formulated by the U.S. Drug Enforcement Administration and provided to the Veterinary Examining Board. Availability of these kits to sedate animals in the field will benefit wildlife as well as enhancing the public health, safety and welfare.
Statutory authority
Staff time required
50 hours.
Veterinary Examining Board
Subject
Requirements for delegation of veterinary medical acts by veterinary students, certified veterinary technicians and unlicensed veterinary assistants. The proposed amendment would permit veterinarians to delegate services to unlicensed persons consisting of muscular or skeletal manipulation pursuant to a written agreement between the veterinarian and the unlicensed assistant.
Objective of the Rule. To permit persons with training in chiropractic or physical therapy to provide those services to animals other than humans under the general supervision of a licensed veterinarian.
Policy analysis
Persons licensed to practice chiropractic or physical therapy are frequently providing those services to animals - often without referral or supervision by a licensed veterinarian. Additionally, veterinarians are often asked by clients to refer animals to chiropractors or physical therapists for care. Under current rules, those services may be delegated under immediate on-premises supervision of a veterinarian, which means that the veterinarian must either stand by at the place where the animal is kept while the services are provided, or that the animals be brought to the veterinary clinic. The former alternative is expensive and wasteful. The latter alternative is difficult or impossible to accomplish in the case, for example, of an equine patient. The proposed rule would legitimize what is already occurring.
Statutory authority
