Funding Positions
PR-REV $192,000
GPR $143,300 1.71
FED 125,100 1.06
PR 899,000 3.82
Total $1,167,400 6.59
Governor: Provide $62,300 GPR, $55,800 FED, and $509,800 PR in 1999-00 and $81,000 GPR, $69,300 FED, and $389,200 PR in 2000-01 and 1.71 GPR positions, 1.06 FED positions and 3.82 PR positions, beginning in 1999-00, to implement caregiver background check requirements established in 1997 Wisconsin Act 27.
The requested funding would support: (a) processing background checks for new child care and health care providers licensed by DHFS and non-client residents of the facility, if any; (b) conducting rehabilitation reviews and appeals when a person contests a license denial or employment bar as a result of a negative finding from a background check; and (c) ongoing maintenance costs and enhancements for the linked computer system that searches state databases to conduct background checks. DHFS would establish an electronic reporting system to accept information from counties on foster care license denials and day care certification denials and maintain a data base of that information ($121,600 all funds).
Program revenue funds would include: (a) $126,900 in 1999-00 and $47,000 in 2000-01 from the current annual bed fees assessed to nursing homes and hospitals; and (b) revenue from new fees for background checks and rehabilitation reviews created in the bill.
Statutory Changes. Authorize DHFS to charge facilities a fee for any requested background check for an employe or contractor which would be paid in addition to the current fee of $2 to $13 charged by DOJ for checking state criminal records. Authorize DHFS to charge a fee for persons who request a rehabilitation review. Specify that these fees could not exceed the reasonable cost of obtaining the information. DHFS plans to charge a fee of $2.50 for each background check and $50 for each rehabilitation review. DHFS estimates that revenue from the proposed fees would generate an estimated $91,600 in 1999-00 and $100,400 in 2000-01. Finally, specify that all revenue from background checks would be credited to the Division of Supportive Living's licensing and support services appropriation.
Modify provisions for the application of the required background checks related to employes and contractors by only requiring background checks for those persons that would provide direct care to clients that is more intensive than negligible care in quantity or quality or in the amount of time required to provide the care. Under current law, any employe or contractor that would have access to clients would be subject to the background checks. This change would not affect the current law requirement that any non-client resident with access to the entity's clients would be subject to the background check requirements. This change for employes and contractors applies both to children's facilities and health care facilities.
[Bill Sections: 445, 1161, 1163 thru 1165, 1167, 1168, 1172, 1178, 1181, 1516 thru 1522 and 9423(9)]
5. SOCIAL SERVICES BLOCK GRANT REDUCTIONS -- STATE OPERATIONS
Funding Positions
GPR - $14,400 - 0.11
FED - 3,661,600 34.49
PR 3,264,100 33.10
Total - $411,900 - 1.50
Governor: Provide -$3,000 GPR, -$1,624,200 FED and -32.10 FED positions and $1,600,000 PR and 32.10 PR positions in 1999-00 and -$11,400 GPR, -0.11 GPR position, -$2,037,400 FED and -34.49 FED positions and $1,664,100 PR and 33.10 PR position in 2000-01 to reflect reductions in the amount of federal social services block grant (SSBG) budgeted for state operations. These changes are based on a 17% reduction in the SSBG effective in federal fiscal year 1998-99 and an anticipated 10.5% reduction in federal fiscal year 2000-01. PR funding would be available from federal TANF block grant funds transferred from DWD.
Day Care Licensing Positions. Provide -$3,000 GPR, -$1,631,300 FED and $1,600,000 PR in 1999-00 to convert 32.10 FED positions to PR positions supported by TANF funds transferred from DWD. These positions are currently funded from GPR, the SSBG and childcare licensing fees.
Supplies and Services Reduction. Increase supplies and services funding in the Division of Children and Family Services (DCFS), the Division of Supportive Living (DSL) and the Division of Management and Technology (DMT) by $80,700 FED in 1999-00 and reduce funding for this purpose by $171,400 FED in 2000-01.
Staff Vacancies. Reduce salary funding for DCFS, DSL and DMT by $73,600 FED in 1999-00 and $102,400 FED in 2000-01. Divisions would absorb these reductions by keeping positions vacant as they occur.
Miscellaneous Position Changes. Provide -$8,400 GPR and -0.11 GPR position, -$132,300 FED and -2.39 FED positions and $64,100 PR and 1.0 PR position in 2000-01 for DCFS. These changes include funding 1.0 position in the Bureau of Milwaukee Child Welfare with TANF funds transferred from DWD and claiming federal Title IV-E funds for 1.0 position that is currently funded entirely with GPR funds and using the GPR from this position to support a portion of the costs of another position currently funded with SSBG funds.
6. INFORMATION TECHNOLOGY -- COMPLIANCE WITH HIPPA HEALTH DATA STANDARDS
FED $4,583,800
PR 1,322,600
Total $5,906,400
Governor: Provide $930,200 FED and $305,600 PR in 1999-00 and $3,653,600 FED and $1,017,000 PR in 2000-01 to implement changes in DHFS computer systems to comply with new standards for the electronic transmission of health data for certain administrative and financial transactions published by the U.S. Department of Health and Human Services (DHHS), as required under the Health Insurance Portability and Accountability Act of 1996 (HIPPA).
Under HIPPA, all health plans, health care clearinghouses and health care providers that conduct specified transactions electronically must comply with standards published by DHHS within two years (or, for small health plans, within three years) of their adoption. DHHS has published standards for: (a) certain standardized uniform transactions and data elements; (b) unique identifiers for health providers; and (c) code sets and classification systems for data elements of specified transactions. DHHS will publish additional standards for data security, procedures for the electronic transmission and authentication of signatures relating to specified transactions and unique identifiers for individuals, employers and health plans. This funding would be used to modify computer systems to comply with the three sets of published standards.
The following table identifies how this funding would be allocated within DHFS and the sources of funding that would be used to support modifications to DHFS computer systems.
1999-00 2000-01
Appropriation and Revenue Source FED PR FED PR
Centers for the Developmentally Disabled
(medical assistance) $0 $25,000 $0 $90,000
Mental Health Institutes
(county funds, MA and other third-party payers) 0 50,000 0 160,000
MA contracts administration
(federal MA matching funds) 637,200 0 2,533,300 0
Health care information
(assessments to health care providers) 0 17,500 0 52,600
Health facilities plan review
(nursing home and hospital plan review fees) 0 28,800 0 94,300
MA administration
(federal MA matching funds) 25,900 0 90,800 0
MA survey and certification operations
(federal MA matching funds) 28,800 0 94,300 0
DHFS information systems
(PR-S funds transferred from other DHFS programs) 0 184,300 0 620,100
Income augmentation services
(Title IV-E funds) 238,300 0 935,200 0
Total $930,200 $305,600 $3,653,600 $1,017,000
7. DELETE VACANT POSITIONS
Funding Positions
GPR - $273,200 - 1.22
FED - 57,400 - 1.00
PR - 85,000 - 0.58
Total - $415,600 - 2.80
Governor: Reduce funding by $207,800 ($136,600 GPR, $28,700 FED and $42,500 PR) annually and delete 2.80 positions (1.22 GPR positions, 1.00 FED position and 0.58 PR position) beginning in 1999-00. These positions have been vacant for more than 15 months.
8. PARTNERSHIP PROGRAM POSITIONS
Funding Positions
GPR $225,500 2.00
FED 225,500 2.00
PR - $38,500 0.00
Total $412,500 4.00
Governor: Provide $96,500 GPR, $96,500 FED and -$34,300 PR in 1999-00 and $129,000 GPR, $129,000 FED and -$4,200 PR in 2000-01 to support 2.0 GPR two-year project positions and 2.0 FED two-year project positions, beginning in 1999-00, which will no longer be funded from a Robert Wood Johnson grant after September 1, 1999. These project positions, which would terminate on September 1, 2001, would be funded with MA administration funds on a 50% GPR/50% FED basis. The four positions currently administer the partnership program, a managed care program that integrates all acute, primary and long-term care services for persons with significant and chronic illness or disability. These positions would continue to monitor contracts, implement fully capitated MA/Medicare service contracts and collect cost and utilization data. In addition, the bill would transfer support for these positions from the Division of Supportive Living to the DHFS Office of Strategic Finance.
9. FEDERAL REVENUE REESTIMATES
FED $2,799,800
Governor: Provide $962,700 in 1999-00 and $1,837,100 in 2000-01 to reflect reestimates of the amount of federal funding that will be available to support selected federally-funded state operations, aids and local assistance program in the next biennium. This item includes: (a) $138,600 in 1999-00 and $191,200 in 2000-01 for MA administration; (b) -$79,100 in 1999-00 and $768,300 in 2000-01 for federal projects operations; (c) -$124,300 in 1999-00 and -$370,700 in 2000-01 for local assistance programs administered by the Division of Children and Family Services; (d) $105,600 in 1999-00 and $104,700 in 2000-01 for state foster care and adoption assistance operations; (e) $296,700 in 2000-01 for disability determinations operations; (f) $850,900 annually for community mental health block grant assistance to counties; (g) $75,000 in 1999-00 from Title IV-E income augmentation revenues to support a fatherhood initiative administered by DWD; and (h) -$4,000 annually from the social services block grant for the displaced homemakers program.
10. PROGRAM REVENUE REESTIMATES
Funding Positions
PR - $28,076,900 - 0.50
Governor: Reduce funding by $13,091,900 in 1999-00 and $14,985,000 in 2000-01 and delete 0.50 position, beginning in 2000-01, to reflect reestimates of program revenue required to support certain programs administered by DHFS. The following table identifies the components of this item.
1999-00 2000-01
Funding Positions Funding Positions
Radiation Protection $0 0.00 -$16,500 -0.50
Care and Treatment Facilities -- Activity Therapy 55,000 0.00 55,000 0.00
Care and Treatment Facilities -- Gifts and Grants 50,000 0.00 50,000 0.00
Care and Treatment Facilities -- Institutional Services 143,000 0.00 143,000 0.00
Health Facilities Review Fees -63,500 0.00 -63,500 0.00
Nursing Facility Resident Protection 150,000 0.00 150,000 0.00
Severely Emotionally Disturbed Children -5,043,600 0.00 -5,043,600 0.00
SSI Caretaker Supplement -9,235,100 0.00 -10,590,100 0.00
Administration and Support -47,700 0.00 -69,300 0.00
DHFS Information Systems 900,000 0.00 400,000 0.00
Total -$13,091,900 0.00 - $14,985,000 -0.50
Several of the most significant items are described below.
Caretaker Supplement. Reduce funding by $9,235,100 in 1999-00 and $10,590,100 in 2000-01 to reflect reestimates of the amount of TANF funding transferred from DWD that will be required to support SSI caretaker supplement payments in the 1999-01 biennium, based on the current $100 per child per month benefit level. DHFS provides SSI recipients with dependent children a caretaker supplement payment to support the costs of care for these children. DHFS base funding for these payments ($13,472,400) was provided in 1998-99 under the assumption that the supplement would be supported entirely with TANF funds. However, the federal Social Security Administration has permitted the state to partially support SSI caretaker supplement payments with GPR funds budgeted for the state SSI supplement and count these GPR funds in meeting the state's maintenance-of-effort requirement. Consequently, base TANF funding can be deleted to reflect the availability of these GPR funds.
