AB591: Bill Text

AB591, s. 77 Section 77. 49.153 of the statutes is created to read:

AB591,54,5 49.153 Wisconsin works health plan. (1) Definitions. In this section:

AB591,54,9 (a) "Employer-subsidized health care coverage" means health care coverage for which the employer pays at least 50% of the cost of coverage for the employe, excluding dependent coverage, or a higher percentage as determined by the department by rule.

AB591,54,12 (b) "Unsubsidized employer-offered health care coverage" means health insurance coverage for which the employer pays less than 50% of the cost of coverage for the employe excluding dependent coverage.

AB591,54,17 (2) Administration. The department of health and family services shall provide health services and benefits under sub. (4) to individuals who have been determined by a Wisconsin works agency to be eligible under sub. (3) for such services and benefits. The Wisconsin works agency shall provide the department of health and family services with a list of eligible individuals.

AB591,55,2 (3) Eligibility. (a) General provisions. 1. A Wisconsin works agency shall determine eligibility for benefits and services under this section, in accordance with rules promulgated by the department of industry, labor and job development. An individual who applies for and receives benefits and services under this section is considered to have assigned to the state any rights to medical support or other payment of medical expenses from any other person, including rights to unpaid amounts accrued at the time of application for benefits and services under this section and any rights to support accruing during the time for which benefits and services under this section are provided. Eligibility for benefits and services under this section begins on the first day of the month in which the application is made.

AB591,55,6 2. An individual who is eligible for the health care coverage under this section remains eligible under this section for 12 consecutive months or until the individual has access to unsubsidized employer-offered health care coverage, whichever is later.

AB591,55,9 (b) Wisconsin works groups. Except as provided in pars. (d) and (e), an individual who is a member of a Wisconsin works group is eligible for benefits and services under this section if all of the following conditions apply:

AB591,55,11 1. The individual meets the criteria under s. 49.145 (2) (c), (f), (g), (i), (L) and (m) and resides in this state.

AB591,55,13 2. The Wisconsin works group meets the resource limitation under s. 49.145 (3) (a).

AB591,55,18 3. The gross income of the Wisconsin works group is at or below 165% of the poverty line, or, for a Wisconsin works group that is already receiving health care coverage under this section, the gross income is at or below 200% of the poverty line. In calculating the gross income of the Wisconsin works group, the department shall include income described under s. 49.145 (3) (b) 1. to 3.

AB591,55,21 (c) Pregnant women. Except as provided in par. (e), a pregnant woman whose pregnancy has been medically verified and who has no dependent children is eligible for benefits and services under this section if she meets the following conditions:

AB591,55,23 1. The woman meets the criteria under s. 49.145 (2) (c), (g), (i), (L) and (m) and resides in this state.

AB591,55,24 2. The woman meets the resource limitation under s. 49.145 (3) (a).

AB591,56,3 3. The gross income of the woman is at or below 165% of the poverty line. In calculating gross income under this subdivision, the Wisconsin works agency shall include income described under s. 49.145 (3) (b) 1. and 3.

AB591,56,7 (d) Minor parents. An individual who is a custodial parent and who is under the age of 18, and any dependent children with respect to whom the individual is a custodial parent, are eligible for benefits and services under this section only if the individual meets any of the following conditions:

AB591,56,11 1. The individual resides with his or her custodial parent and the gross income of the parent does not exceed 165% of the poverty line. In calculating the gross income of the custodial parent, the department shall include income described under s. 49.145 (3) (b) 1. to 3.

AB591,56,16 2. The individual is in a court-ordered out-of-home placement or an independent living arrangement supervised by an adult and the gross income of the individual does not exceed 165% of the poverty line. In calculating the gross income of the individual, the department shall include income described under s. 49.145 (3) (b) 1. to 3.

AB591,56,21 (e) Access to employer-subsidized health care coverage. An individual is eligible for health care coverage under this section only if the individual has not had access to employer-subsidized health care coverage for the 18 months immediately preceding application for health care coverage under this section. This paragraph does not apply to any of the following:

AB591,57,2 1. An individual who has lost access to employer-subsidized health care coverage within the 18 months immediately preceding application for health care coverage under this subsection because of the termination by the employer of the employment relationship for a reason other than misconduct on the part of the employe and who has not had access to employer-subsidized health care coverage since the termination.

AB591,57,6 2. An individual who has lost access to employer-subsidized health care coverage within the 18 months immediately preceding application for health care coverage under this subsection because of the termination by the employe of the employment relationship for just cause.

AB591,57,8 3. A dependent child who has lost eligibility for employer-subsidized health care coverage for any reason.

AB591,57,11 (f) Ineligibility. No individual is eligible for health care coverage under this section in a month in which that individual is eligible for employer-subsidized health care coverage.

AB591,57,18 (4) Wisconsin works health plan. (a) Health maintenance organization contract. The department of health and family services shall contract with one or more health maintenance organizations or other health care providers to provide health care services under this subsection. Each contract for the provision of health care services entered into by the department of health and family services under this subsection shall be awarded on the basis of a competitive process in accordance with procedures established by the department of health and family services.

AB591,57,22 (b) Health care services provided. 1. Except as provided in subd. 2., the Wisconsin works health plan shall cover the care and services required under a state plan for medical assistance under 42 USC 1396d and any additional care and services established by the department of health and family services by rule.

AB591,57,24 2. The Wisconsin works health plan shall not cover the following goods and services:

AB591,57,25 a. Nonpreventive dental care.

AB591,58,1 b. Eyeglasses.

AB591,58,2 c. Hearing aids.

AB591,58,4 d. Home health, private duty nursing and personal care services in excess of 40 visits per year.

AB591,58,5 e. Nursing home services in excess of 30 days.

AB591,58,6 f. Over-the-counter drugs.

AB591,58,8 g. Treatment of nervous or mental disorders and alcoholism or other drug abuse problems in excess of the minimum coverage required under s. 632.89 (2).

AB591,58,14 (c) Distribution of payments. From the appropriations under s. 20.435 (1) (b) and (o), the department of health and family services shall make payments to a health maintenance organization or other health care provider with which the department of health and family services has contracted under par. (a) in accordance with the payment schedule established by the department of health and family services by rule.

AB591,58,25 (d) Premiums. An individual who receives the Wisconsin works health plan shall pay to the Wisconsin works agency a monthly premium in accordance with criteria based on income, resources and family size and established by the department of industry, labor and job development by rule. The employer of a participant in a trial job shall deduct the premium established by the department of industry, labor and job development from the participant's wages and shall pay the premium amount withheld to the Wisconsin works agency. The Wisconsin works agency shall deduct the established premium on a prorated basis from the biweekly grant payment of a participant in a community service job and shall deduct the established premium from the monthly grant of a participant in a transitional placement.

AB591, s. 78 Section 78. 49.155 of the statutes is created to read:

AB591,59,5 49.155 Wisconsin works; child care subsidy. (1) Eligibility. A Wisconsin works agency shall determine eligibility for a child care subsidy under this section. An individual may receive a child care subsidy under this section if the individual meets all of the following conditions:

AB591,59,11 (a) The individual is a custodial parent of a child who is under the age of 10, or is a person who, under s. 48.57 (3m), is providing care and maintenance for a child who is under the age of 10, and child care services are needed in order for the individual to meet the school attendance requirement under s. 49.26 (1) (ge) or to work, seek work, or participate in any of the following activities approved by the Wisconsin works agency:

AB591,59,12 1. Training provided by an employer during the regular hours of employment.

AB591,59,14 2. Other employment skills training, as defined by the department by rule, if the individual meets any of the following conditions:

AB591,59,16 a. The individual has been employed in unsubsidized employment for 9 consecutive months and continues to be so employed.

AB591,59,18 b. The individual has successfully participated in a trial job or community service job for 60 consecutive days and continues to so participate.

AB591,59,22 (b) The individual meets the eligibility conditions under s. 49.145 (2) (c) to (g) and (3) (a), except that an individual may be eligible for a child care subsidy under this section regardless of the number of days the individual has resided in this state prior to applying for the child care subsidy.

AB591,60,2 (c) The individual is a member of a Wisconsin works group whose gross income is at or below 165% of the poverty line. In calculating the gross income of the Wisconsin works group, the department shall include income described under s. 49.145 (3) (b) 1. to 3.

AB591,60,4 (d) The individual satisfies other eligibility criteria established by the department by rule.

AB591,60,7 (2) Distribution of child care funds. From the appropriation under s. 20.445 (3 (dz), the department shall distribute funds allocated for child care services under this section.

AB591,60,14 (3) Use of child care funds. (a) A Wisconsin works agency may provide child care services itself; purchase child care services from a child care provider; provide vouchers to an eligible parent for the payment of child care services provided by a child care provider; reimburse an eligible parent for payments made by the parent to a child care provider for child care services; adopt, with the approval of the department, any other arrangement that the Wisconsin works agency considers appropriate; or use any combination of these methods to provide child care.

AB591,60,18 (b) With the approval of the department, a Wisconsin works agency may spend moneys distributed under this section for start-up, improvement or expansion of child care services or facilities or for the recruitment, education or training of persons providing child care.

AB591,60,22 (4) Choice of provider. An eligible individual shall choose whether the child care will be provided by a day care provider licensed under s. 48.65, a day care provider certified under s. 48.651, or a provider of provisional certified family care, as defined by the department by rule.

AB591,61,2 (5) Liability for payment. An individual who receives aid under this section is liable for a portion of the cost of child care received, payable in accordance with a sliding scale formula established by the department that is based on the individual's ability to pay.

AB591,61,7 (6) Child care rates and quality standards. (a) The department shall establish the maximum rate that a Wisconsin works agency may pay for child care services provided under this section. The department shall set the rate at a reasonable and customary level that does not preclude eligible individuals from having a reasonable selection of child care providers.

AB591,61,16 (b) 1. The department shall promulgate rules to establish quality of care standards for child care providers that are higher than the quality of care standards required for licensure under s. 48.65 or for certification under s. 48.651. The standards established by rules promulgated under this subdivision shall consist of the standards provided for the accreditation of day care centers by the National Association for the Education of Young Children or any other comparable standards that the department may establish, including standards regarding the turnover of child care provider staff and the training and benefits provided for child care provider staff.

AB591,61,22 2. To the extent permitted under federal law, the department shall also promulgate rules to establish a system of rates or a program of grants that the department will pay to child care providers that meet the higher quality of care standards established by rules promulgated under subd. 1. If a system of rates is established by the rules promulgated under this subdivision, the rates under that system shall be higher than the rates established under par. (a).

AB591,62,2 (7) Refusal to pay child care providers. A Wisconsin works agency may refuse to pay a child care provider for child care provided under this section if any of the following applies to the child care provider, employe or person living on the premises where child care is provided:

AB591,62,4 (a) The person has been convicted of a felony or misdemeanor that the Wisconsin works agency determines substantially relates to the care of children.

AB591,62,6 (b) The person is the subject of a pending criminal charge that the Wisconsin works agency determines substantially relates to the care of children.

AB591,62,8 (c) The person has been determined under s. 48.981 to have abused or neglected a child.

AB591, s. 79 Section 79. 49.157 of the statutes is created to read:

AB591,62,14 49.157 Wisconsin works; transportation assistance. (1) Eligibility. In accordance with rules promulgated by the department, a Wisconsin works agency shall determine the eligibility of an individual for financial assistance for transportation costs associated with transporting a child to and from a child care provider.

AB591,62,16 (2) Distribution of Funds. The department shall distribute the funds allocated under s. 49.181 (1) (h) for transportation assistance to Wisconsin works agencies.

AB591, s. 80 Section 80. 49.159 of the statutes is created to read:

AB591,62,24 49.159 Wisconsin works; noncustodial and minor and other custodial parents. (1) Noncustodial parents. An individual who would be eligible under s. 49.145 except that the individual is the noncustodial parent of a dependent child, is eligible for services under this subsection if the dependent child's custodial parent is a participant. The Wisconsin works agency may provide job search assistance and case management designed to enable eligible noncustodial parents to obtain and retain employment.

AB591,63,8 (2) Minor custodial parents; financial and employment counseling. A custodial parent who is under the age of 18 is eligible, regardless of that individual's or that individual's parent's income or assets, to meet with a financial and employment planner. The financial and employment planner may provide the individual with information regarding Wisconsin works eligibility, available child care services, employment and financial planning, family planning services, community resources, eligibility for food stamps and other food and nutrition programs.

AB591,63,12 (3) Other custodial parents. A custodial parent in a Wisconsin works group in which the other custodial parent is a participant in a Wisconsin works employment position is eligible for employment training and job search assistance services provided by the Wisconsin works agency.

AB591, s. 81 Section 81. 49.161 of the statutes is created to read:

AB591,63,17 49.161 Wisconsin works; overpayments. The department shall recover an overpayment of benefits paid under s. 49.148 from an individual who continues to receive benefits under s. 49.148 by reducing the amount of the individual's benefit payment by no more than 10%.

AB591, s. 82 Section 82. 49.181 of the statutes is created to read:

AB591,63,22 49.181 Public assistance and local assistance funding. (1) Funds distribution. Except as provided in sub. (2), within the limits of the appropriation under s. 20.435 (4) (dz), the department shall allocate the following amounts for the following purposes:

AB591,64,2 (a) Child care for recipients and former recipients of aid to families with dependent children. For child care services under s. 49.50 (6g) and for child care services and related transportation costs under s. 49.50 (6e) (a) or (b) and (6k) (b), the department shall allocate $4,713,000 in fiscal year 1995-96 and $5,687,400 in fiscal year 1996-97.

AB591,64,5 (b) Low-income and at-risk child care. For low-income and at-risk child care services under s. 46.98 (2m) to (4), the department shall allocate $21,404,100 in fiscal year 1995-96 and $21,504,800 in fiscal year 1996-97.

AB591,64,11 (c) Income maintenance payments to individuals. For income maintenance payments to individuals under s. 49.52 and for foster care and treatment foster care provided by nonlegally responsible relatives under state or county administered programs, if the relatives are licensed to operate foster homes or treatment foster homes under s. 48.62, the department shall allocate $141,277,600 in fiscal year 1995-96 and $132,968,700 in fiscal year 1996-97.

AB591,64,18 (d) Public assistance administration and medical assistance eligibility determination. For payment distribution under s. 49.52 (1) for county administration of public assistance benefits and medical assistance eligibility determination, for payments to American Indian tribes for administration of public assistance benefits, and for fraud investigation and error reduction under s. 49.197 (1m) and (4), the department shall allocate $28,189,100 in fiscal year 1995-96 and $28,864,400 in fiscal year 1996-97.

AB591,64,22 (e) Emergency assistance for families with needy children. For emergency assistance for families with needy children under s. 49.19 (11) (b), the department shall allocate $1,659,700 in fiscal year 1995-96 and $1,659,700 in fiscal year 1996-97.

AB591,65,3 (f) Learnfare; job opportunities and basic skills program; food stamp employment and training; parental responsibility pilot program. For the learnfare program under s. 49.50 (7), the job opportunities and basic skills program under s. 49.193, the food stamp employment and training project under s. 49.124 and the parental responsibility pilot program under s. 49.25, the department shall allocate $25,045,800 in fiscal year 1995-96 and $26,447,100 in fiscal year 1996-97.

AB591,65,6 (g) Learnfare case management. For case management for learnfare pupils under s. 46.62, the department shall allocate $1,289,300 in fiscal year 1995-96 and $1,309,500 in fiscal year 1996-97.

AB591,65,14 (h) Wisconsin works administration. For payments to Wisconsin works agencies under s. 49.52 (1) for administration of Wisconsin works benefits under ss. 49.141 to 49.151 and 49.155 to 49.161, for Wisconsin works health care coverage eligibility determination under s. 49.153 and for fraud investigation and error reduction under s. 49.197 (1m) and (4) and for payments to individuals under s. 49.148 for Wisconsin works employment positions and under ss. 49.155 and 49.157 for child care and related transportation services, the department shall allocate $0 for fiscal year 1996-97.

AB591,65,18 (2) Transfer of funds. With the approval of the secretary of administration, the department may use up to 30% of the amounts required to be allocated under any paragraph under sub. (1) for any other purpose described under sub. (1) (a) to (g) in each fiscal year.

AB591, s. 83 Section 83. 49.181 (1) (intro.), (a), (c), (d), (f) and (g) and (2) of the statutes, as created by 1995 Wisconsin Act .... (this act), are amended to read:

AB591,65,23 49.181 (1) Funds distribution. (intro.) Within the limits of the appropriation under s. 20.435 (4) (dz) 20.445 (3) (dz), the department shall allocate the following amounts for the following purposes:

AB591,66,3 (a) Child care for recipients and former recipients of aid to families with dependent children. For child care services under s. 49.50 (6g) 49.191 (2) and for child care services and related transportation costs under s. 49.50 (6e) 49.191 (1) (a) or (b) and (6k) (3) (b), the department shall allocate $4,713,000 in fiscal year 1995-96 and $5,687,400 in fiscal year 1996-97.

AB591,66,10 (c) Income maintenance payments to individuals. For income maintenance payments to individuals under s. 49.52 and 49.33, for foster care and treatment foster care provided by nonlegally responsible relatives under state or county administered programs, if the relatives are licensed to operate foster homes or treatment foster homes under s. 48.62 and for kinship care under s. 48.57 (3m), the department shall allocate $141,277,600 in fiscal year 1995-96 and $132,968,700 in fiscal year 1996-97.

AB591,66,17 (d) Public assistance administration and medical assistance eligibility determination. For payment distribution under s. 49.52 (1) 49.33 for county administration of public assistance benefits and medical assistance eligibility determination, for payments to American Indian tribes for administration of public assistance benefits, and for fraud investigation and error reduction under s. 49.197 (1m) and (4), the department shall allocate $28,189,100 in fiscal year 1995-96 and $28,864,400 in fiscal year 1996-97.

AB591,66,23 (f) Learnfare; job opportunities and basic skills program; food stamp employment and training; parental responsibility pilot program. For the learnfare program under s. 49.50 (7) 49.26 (1), the job opportunities and basic skills program under s. 49.193, the food stamp employment and training project under s. 49.124 and the parental responsibility pilot program under s. 49.25, the department shall allocate $25,045,800 in fiscal year 1995-96 and $26,447,100 in fiscal year 1996-97.

AB591,67,3 (g) Learnfare case management. For case management for learnfare pupils under s. 46.62 49.26 (2), the department shall allocate $1,289,300 in fiscal year 1995-96 and $1,309,500 in fiscal year 1996-97.

AB591,67,7 (2) Transfer of funds. With the approval of the secretary of administration, the department may use up to 30% of the amounts required to be allocated under any paragraph under sub. (1) for any other purpose described under sub. (1) (a) to (g) (h) in each fiscal year.

AB591, s. 84 Section 84. 49.19 (4e) (a) of the statutes is amended to read:

AB591,67,15 49.19 (4e) (a) Except as provided in par. (b), if If a person applying for aid is under 18 years of age, has never married and is pregnant or has a dependent child in his or her care, the person is not eligible for aid unless he or she lives in a place maintained by his or her parent, legal guardian or other adult relative as the parent's, guardian's or other adult relative's own home or lives in a foster home, treatment foster home, maternity home or other supportive living arrangement supervised by an adult.

AB591, s. 85 Section 85. 49.19 (4e) (c) of the statutes is created to read:

AB591,67,21 49.19 (4e) (c) The department shall request a waiver from the secretary of the federal department of health and human services to require, without exception, that a person applying for aid who is under 18 years of age, has never married and is pregnant or has a dependent child in his or her care meet the requirements of par. (a). If a waiver is granted and in effect, par. (b) does not apply.