Under current law, DHSS has an appropriation for employment and training programs, which include the JOBS program and the food stamp employment and training project. Under this appropriation, funds that are not encumbered by December 31 of each year lapse to the general fund on the next January 1 unless transferred to the next calendar year by JCF.
This bill allows DHSS to carry forward for a county funds that are committed to the county under a performance-based contract for a specific calendar year and that are earned by the county in that year to the following calendar year, if the carry-forward is approved by the secretary of administration, without approval of JCF. The funds carried forward do not affect a county's base allocation.
*** Analysis from -0774/2 ***
The low-income energy assistance program (LIEAP) is a federal block grant program designed to support energy costs incurred by low-income households. Current law requires that $2,400,000 of LIEAP block grant funds be allocated to the payment of crisis assistance benefits to meet weather-related or fuel supply shortage emergencies. This bill eliminates this requirement and allows DHSS or, after July 1, 1996, DOA to determine the amount of the allocation.
*** Analysis from -1338/3 ***
Health
Under current law, with certain exceptions, the 3-member cost containment commission is responsible for reviewing and approving the following proposed projects:
A capital expenditure in excess of $1,000,000 made by or on behalf of a hospital.
The implementation of new services to a hospital that exceed $500,000 in a 12-month period.
An expenditure in excess of $500,000 made by or on behalf of a hospital, independent practitioner, limited liability company, partnership, unincorporated medical group or service corporation for clinical medical equipment.
The purchase or acquisition of a hospital.
The construction or operation of an ambulatory surgery center or a home health agency.
Current law sets forth criteria that the commission must use in its review of an application for project approval. These criteria focus on the economic efficiency of and need for the proposed projects. The first priority of the commission in applying the criteria must be cost containment.
The cost containment council represents economic, provider, scientific and consumer viewpoints. It advises the commission, reviews proposed commission rules and periodically reports on the performance of the commission and its operations.
This bill eliminates the cost containment commission, the cost containment council and the capital expenditure review program.
*** Analysis from -0415/3 ***
Under current law, DHSS must investigate the concept of regulating a new category of health care providers known as rural medical centers.
This bill eliminates that requirement and establishes rural medical centers as a category of health care providers that, beginning on January 1, 1997, must be licensed, inspected and otherwise regulated by DHSS. Under the bill, a facility may be regulated as a rural medical center if it is located in a county, city, town or village that has a population of less than 15,000 and in an area that the federal bureau of the census has not defined as an urbanized area, and if it provides 2 or more health care services. "Health care services" means those provided by a hospital, nursing home, hospice, rural health clinic or ambulatory surgery center; or home health services, outpatient physical therapy services, end-stage renal disease services or other services that are specified by DHSS by rule.
The bill establishes licensing procedures and requires that DHSS promulgate rules that establish standards for operation of rural medical centers, minimum requirements for license issuance, licensure fee amounts, and procedures and criteria for waiver of or variance from standards and requirements. The bill authorizes DHSS to conduct unannounced inspections of rural medical centers and requires a rural medical center to provide access to any patient health care records necessary to fulfill the purpose of any DHSS inspections or investigations. The bill prohibits an unlicensed entity from using the phrase "rural medical center" to describe itself, prohibits intentional interference with any investigation by DHSS of alleged violations, prohibits certain intentional retaliation or discrimination against employes or patients and prohibits intentional destruction or modification of original inspection reports.
*** Analysis from -2300/1 ***
Under current law, DHSS allocates $50,000 in each fiscal year as a grant for the provision of direct health care services to migrant workers and their families. A migrant worker is any person who temporarily leaves a principal place of residence outside of this state and comes to this state for not more than 10 months in a year to accept seasonal employment related to unmanufactured agricultural or horticultural commodities. This bill eliminates the migrant health care program.
*** Analysis from -0416/5 ***
Under current law, DHSS is authorized to conduct plan reviews of all capital construction and remodeling for nursing homes and hospitals, to ensure compliance with certain federal life safety code requirements for nursing homes and with certain physical plant requirements. At the same time, DILHR must examine plans of public buildings (which include hospitals and nursing homes) for compliance with building code requirements. Both DHSS and DILHR charge fees for these plan reviews.
Beginning on October 1, 1995, this bill exempts hospitals and nursing homes from DILHR's review for compliance with building code requirements. Instead, the bill requires DHSS to conduct plan reviews of hospitals and nursing homes for compliance with both the building code requirements and with the physical plant and life safety code requirements. The bill requires DHSS to promulgate rules that establish fees for the reviews that are less than the sum of the amounts collected by both DHSS and DILHR. However, until DHSS promulgates these rules or until June 30, 1996, whichever is earlier, the bill permits DHSS to collect fees that are equal to the amounts collected by both DHSS and DILHR.
*** Analysis from -2487/2 ***
Under current law, a community-based residential facility (C-BRF) is annually licensed by DHSS and annually pays a fee, plus a per resident fee, based on the C-BRF's licensed capacity. Certain adult family homes are annually licensed by county departments of social services, human services, community programs or developmental disabilities services or by DHSS.
Beginning on January 1, 1996, this bill changes the licensure period for a C-BRF and for a licensed adult family home to 2 years, increases biennial license fees for C-BRFs and establishes license fees for licensed adult family homes.
Under current law, DHSS may order certain sanctions against a C-BRF that violates specific statutes or rules and, if the C-BRF fails to comply with such an order, may directly assess forfeitures (civil monetary penalties). Under this bill, if DHSS provides notice and explanations of sanctions or penalties, DHSS may, without issuing an order, assess forfeitures against a C-BRF that violates statutes or rules.
*** Analysis from -2290/1 ***
Under current law, DHSS must award grants to local health departments to fund specified activities related to lead poisoning or lead exposure, including educational programs, screening, care coordination and follow-up services such as lead inspection. Certain grants are awarded under criteria that ensure that funding is provided for areas, including Milwaukee, with significant incidence of lead poisoning or lead exposure. This bill eliminates these grants under the program.
*** Analysis from -2353/2 ***
Under current law, DHSS provides funds to the Marquette University School of Dentistry to provide dental services at clinics in the city of Milwaukee. This bill provides that the school of dentistry must also use the funds to provide dental services at correctional centers in Milwaukee County.
*** Analysis from -0410/1 ***
Under current law, DHSS is authorized to award grants to provide mammography services to women who are 40 years or older. The women must live in any of 12 rural counties that are specified in rules promulgated by DHSS as having the highest incidence of late-stage breast cancer in this state.
This bill expands the purpose of grants for mammography services to include breast cancer screening services and makes these services available statewide to women who are 40 years of age or older.
*** Analysis from -0418/1 ***
Under current law, DHSS must carry out a statewide immunization program to eliminate mumps, measles, German measles, diptheria, whooping cough, poliomyelitis and any other diseases that DHSS has specified by rule and to protect against tetanus. Annually by July 1 until July 1, 1994, DHSS must submit a report for distribution to the standing committees of the legislature on the success of the statewide immunization program. This bill extends the reporting requirement until July 1, 1996.
*** Analysis from -0733/1 ***
Under current law, DHSS is required to distribute not more than $375,600 in fiscal year 1993-94 and not more than $491,500 in fiscal year 1994-95 to reimburse or supplement the reimbursement of the cost of certain drugs for certain individuals who are infected with the human immunodeficiency virus (HIV). This bill removes this statutory allocation. This allows DHSS to determine the amount that will be used for drug reimbursement for HIV-infected individuals, subject to the availability of funds in the pertinent appropriation.
*** Analysis from -2160/4 ***
Children
Under current law, DHSS investigates and licenses child welfare agencies, group homes, shelter care facilities (nonsecure places of temporary care and physical custody for children) and day care centers. Currently, DHSS, a county department and, if licensed to do so by DHSS, a child welfare agency investigate and license foster homes and treatment foster homes. This bill requires that, as part of the prelicensing investigation of a child welfare agency, group home, shelter care facility or day care center, DHSS, with the assistance of DOJ, conduct a background investigation of the applicant for the license. If the applicant is applying for a license to operate a day care center for 4 to 8 children, DHSS must also conduct a background investigation of the employes and prospective employes of the day care center. The bill also requires a shelter care facility, child welfare agency, group home or day care center that cares for 9 or more children to conduct a background investigation of all employes and prospective employes as a condition of initial licensure or license renewal. Under the bill, if the person being investigated is a nonresident, or at any time within the preceding 5 years has been a nonresident, or if the person conducting the investigation has a reasonable basis for further investigation of the person, the person conducting the investigation must require the person to be photographed and fingerprinted and DOJ may submit the fingerprints to the federal bureau of investigation for the purpose of verifying the identity of the person fingerprinted and obtaining his or her arrest and conviction record. DHSS may not issue a license to or renew the license of, and a shelter care facility, child welfare agency, group home or day care center may not employ, any person who has been convicted of a felony drug violation, who has had imposed on him or her an increased penalty for habitual criminality, for certain domestic abuse offenses, for use of a dangerous weapon, for committing a violent crime in a school zone, for use of a bulletproof garment, for concealing his or her identity or for a hate crime or, subject to certain exceptions, who has been convicted of a crime against life and bodily security, a crime against sexual morality or a crime against children. DHSS may order a child welfare agency, group home, shelter care facility or day care center that employs a person who has been so convicted or so punished to terminate the employment of that person immediately on receipt of the order. The bill also requires DHSS, a county department or a child welfare agency to conduct the same background investigation of an applicant for a foster home or a treatment foster home license and any adult resident of the home and to deny licensure to any applicant who has been so convicted or so punished.
*** Analysis from -2487/2 ***
Under current law, no person may establish a shelter care facility without first obtaining a license from DHSS. Current law does not specify a licensure period or a license fee for shelter care facilities. This bill establishes a 2-year licensure period for shelter care facilities and a biennial fee of $180, plus $24 per child, based on licensed capacity.
Under current law, a child welfare agency that provides care and maintenance for children must pay a biennial license fee of $75, plus $10 per child, based on licensed capacity. This bill raises that fee to $180, plus $24 per child, based on licensed capacity.
Under current law, a child welfare agency that places children in foster homes or group homes must pay a biennial license fee of $200. This bill raises that fee to $220.
Under current law, a group home must pay a biennial license fee of $75, plus $10 per child, based on licensed capacity. This bill raises that fee to $180, plus $24 per child, based on licensed capacity.
Under current law, a day care center that provides care and supervision for 9 or more children must pay a biennial license fee of $25, plus $5 per child, based on licensed capacity. This bill raises the per child fee to $10 per child.
Under current law, DHSS may order certain sanctions against a child welfare agency, shelter care facility, group home or day care center (licensee) that violates a provision of licensure or a rule promulgated by DHSS. If the licensee fails to comply with such an order, DHSS may, after providing notice and an explanation of the penalties and appeal process, directly assess forfeitures (civil monetary penalties) of not less than $10 or more than $50 for each day of violation. This bill increases that maximum daily forfeiture amount to $1,000. The bill also permits DHSS, after providing notice and an explanation of the penalties and appeal process, to assess a forfeiture against a licensee that violates a provision of licensure or a rule, without first ordering a sanction against the licensee.
*** Analysis from -2422/2 ***
Under current law, a person whose birth parent's rights have been terminated, or who has been adopted, in this state may request DHSS to provide the person, after the person reaches 18 years of age, with medical or genetic information filed with DHSS by the person's birth parents, with a copy of the person's original birth certificate and with the identity and location of the person's birth parents. If the person's birth parent has not filed the medical or genetic information with DHSS or has not filed an affidavit authorizing DHSS to disclose the person's original birth certificate or the identity and location of the birth parent, DHSS must conduct a search for the birth parent to obtain the medical or genetic information or to inform the birth parent that he or she may file an affidavit authorizing that disclosure. This process is called the adoption search program. This bill permits DHSS to contract with a county department or a licensed child welfare agency to administer the adoption search program.
*** Analysis from -2423/1 ***
Under current law, DHSS provides adoption services for children with special needs. This bill requires DHSS to develop a plan by July 1, 1997, for contracting out the adoption services currently provided by DHSS for children with special needs.
*** Analysis from -0474/4 ***
Under current law, DHSS administers various child care grant programs. Current law specifies certain procedures and eligibility criteria that DHSS must follow in awarding grants under those programs. This bill simplifies those procedures and criteria by eliminating certain requirements specified in current law.
*** Analysis from -0517/4 ***
Under current law, DHSS distributes state revenues, as community aids, and federal child care grant moneys to counties for child care services for parents who are gainfully employed and who need child care services (low-income child care); for parents who are at-risk of becoming eligible for AFDC (at-risk child care); and for parents who need child care services to prevent or remedy child abuse or neglect, to alleviate stress in the family or to preserve the family unit (respite child care). This bill requires DHSS to recover overpayments made for low-income, at-risk and respite child care. The bill requires DHSS to promulgate rules regarding the recovery of those child care overpayments.
*** Analysis from -0475/3 ***
Currently, if the at-risk child care funds distributed to a county are insufficient to meet the needs of all eligible parents, the county must distribute those funds to the following persons according to the following order of priority: 1) to parents who are working and who have been recipients of AFDC within the last 12 months (transitional child care); 2) to parents who are working and who have been recipients of AFDC, but not within the last 12 months (post-transitional child care); and 3) to participants in the new hope project (a program to assist low-income people in finding jobs). This bill eliminates the order of priority for at-risk child care funds.
*** Analysis from -0477/5 ***
Under current law, unspent or unencumbered child care funds that DHSS carries forward from one calendar year to the next may be used to provide child care in counties with unmet needs, to provide child care start-up and expansion grants and to provide training for child care providers. This bill eliminates the use of those funds for child care start-up and expansion grants and permits DHSS to use those funds to provide child care for certain recipients of AFDC and for former recipients of AFDC and to automate state child care licensing.
*** Analysis from -2609/2 ***
Current law appropriates a sum sufficient to provide state aid for certain county-administered public assistance programs, including AFDC, and for the cost of foster care and treatment foster care provided by certain nonlegally responsible relatives under state-administered or county-administered programs. Currently, this aid for the cost of this foster care by nonlegally responsible relatives is provided by reimbursing counties for their costs of providing this foster care. As a result, counties need not use community aids foster care funds for foster care provided by nonlegally responsible relatives under state-administered or county-administered programs. This bill limits the amount that may be paid from the sum sufficient appropriation to a county for foster care provided by nonlegally responsible relatives to the amount that the county received for these reimbursements in 1994.
*** Analysis from -2158/2 ***
Under current law, the child abuse and neglect prevention board awards general purpose revenues (GPR), program revenues (PR) received by the board as contributions, gifts, grants and bequests and segregated revenues (SEG) received by the children's trust fund as contributions, gifts, grants and bequests, to nonprofit organizations and public agencies to provide parenting education services and culturally competent outreach services to the parents of newborn infants (right from the start program). This bill eliminates GPR funding for this program and provides instead for PR funding from duplicate birth certificate fees for the program. The bill also increases the fee for a copy of a birth certificate from $10 to $15 and increases the amount of that fee that is credited to the board from $5 to $7.50.
*** Analysis from -2159/1 ***
Under current law, DHSS awards grants to counties that have high numbers of substantiated cases of child abuse and neglect to provide 24-hour crisis and respite care for abused and neglected children (children-in-crisis program). This bill eliminates this program.
*** Analysis from -2294/1 ***
Under current law, DHSS must allocate $250,000 in each fiscal year to enter into a contract with an organization to provide services in Milwaukee County to divert youths from gang activities. In addition, current law requires DHSS to allocate $300,000 in each fiscal year to that organization for alcohol and other drug abuse (AODA) education and treatment services for participants in the organization's youth diversion program. This bill eliminates the allocation to that organization for AODA education and treatment.
*** Analysis from -2718/4 ***
Mental illness and developmental disabilities
Under current law, a law enforcement officer or a juvenile court intake worker may take a person into custody, in a process known as emergency detention, if the officer or worker has cause to believe that the person is mentally ill, drug dependent or developmentally disabled and if the person evidences certain dangerousness. The law enforcement officer must transport the person to a mental health treatment facility, where the treatment director must, within 24 hours, determine if the person must be detained and, if the person consents, treated. If the person is detained, he or she must be released within 72 hours, excluding holidays and weekends, or a petition for commitment must be filed against the person. Individuals who act in accordance with the authorization provided by these laws are not liable in civil court for actions taken in good faith.
This bill authorizes a treatment director of a mental health treatment facility or his or her designee to evaluate and diagnose, as well as treat, an individual who so consents and who has been transported to the facility under emergency detention or who has voluntarily entered the facility. The immunity in civil court that is provided to individuals who act in accordance with the laws under emergency detention is, by the bill, extended to the evaluation and diagnosis of persons under emergency detention or who voluntarily enter mental health treatment facilities. The bill also specifically extends immunity to the making of a determination that an individual has or does not have mental illness or is or is not dangerous. Lastly, the bill extends immunity to a director of a treatment facility, or his or her designee, who under a court order evaluates, diagnoses or treats an individual who is confined in a jail.
*** Analysis from -2415/1 ***
This bill requires DHSS to investigate the feasibility of and analyze the potential savings and efficiencies of contracting with a private vendor to operate the state centers for the developmentally disabled and selling the state centers for the developmentally disabled to such a private vendor. By June 30, 1996, DHSS must report the findings resulting from its investigation and analysis to the appropriate standing committees of the legislature and to the governor.
*** Analysis from -0450/3 ***
Under this bill, beginning on January 1, 1996, a county must annually establish, from the sum of the county's annual allocation of moneys under the community integration program for persons relocated or meeting reimbursable levels of care (commonly known as "CIP II") and under the community options program, a maximum amount of not more than 25% for expenditure for services to persons residing in C-BRFs. The county must deny eligibility to these persons if they are initially applying for CIP II or community options program services and if the funding for their care would exceed the 25% maximum, unless DHSS, under criteria promulgated as rules, grants an exception based on the person's hardship that would result if the requirement is enforced. If a county's services, under CIP II or the community options program, to persons residing in community-based residential facilities exceed the 25% maximum as of January 1, 1996, the county may seek a waiver of the requirement from DHSS. DHSS must provide technical assistance to counties to explore alternative methods of providing services. DHSS also must submit, by October 1, 1995, rules establishing criteria for hardship exceptions, as proposed, and the proposed standards for granting variances to counties to DOA for review and approval.
*** Analysis from -0448/2 ***
Under this bill, community options program services that are funded solely from state general purpose revenues may not be used to provide services in a C-BRF with more than 8 beds unless DHSS approves. DHSS is authorized to approve the provision if the C-BRF is composed of independent apartments for certain disabled or elderly residents or if the C-BRF meets standards that, under the bill, DHSS must establish by January 1, 1996. DHSS must submit the proposed standards to DOA for approval by October 1, 1995.
*** Analysis from -0449/3 ***
This bill requires DHSS to develop, by January 1, 1996, a model contract for purchase of long-term community support services under the community options program for persons who reside in C-BRFs. Under the bill, county departments of social services, human services, community programs or developmental disabilities services, agencies of county and tribal governments that are directed by county or tribal commissions on aging and private nonprofit agencies that contract with providers for these services must use the model contract.
*** Analysis from -0438/3 ***
Under current law, long-term support services under the community options program are funded from state revenues; under a waiver of federal medicaid laws, home and community-based services under the community options program are funded from a combination of state revenues and federal medicaid funds. The latter funding is commonly known as "COP waiver" funding. If a person who is eligible for community options program services and for medical assistance refuses the offer of community options program services that are funded under the "COP waiver", the person may not receive community options program services that are funded solely from state revenues, except for services funded during a 90-day period in which an application for "COP waiver" funding is processed. A person who is denied services on this basis may not request a hearing to review the denial.
This bill expands the limitation on use of solely state-funded community options program services by denying these services to persons who are eligible for and are offered and yet refuse home and community-based services under the community integration programs for persons who are relocated from certain institutions or who meet certain level-of-care requirements.
*** Analysis from -0445/1 ***
Current federal medicaid law prohibits federal funding, under this state's medical assistance program, of mentally ill persons aged 21 to 64 who receive services in a facility that the federal health care financing administration finds is an institution for mental diseases (IMD). Currently, 2 programs under DHSS fund, from state revenues, services for persons who reside in or who are relocated into communities from facilities that are found to be IMDs.
This bill expands eligibility for a program that funds services for persons who reside in or who are relocated from IMDs. The bill permits funding, at a rate that is 90% of the medical assistance reimbursement rate for the IMD in fiscal year 1987-88, for community-based care for persons who are at least 65 and are relocated from an IMD, if the IMD closes a bed for the relocation.
*** Analysis from -2078/1 ***
This bill eliminates an appropriation to DHSS to provide community mental health protection and advocacy services.
