Sections 1045, 1045d, 1045g, 1048m, 1059, 1059g and 1064
Sections 1045d and 1048m require the Department of Health and Family Services (DHFS) to establish a pilot project in Chippewa County to effect all of the following: (a) provide that Chippewa County cannot deny Community Options Program (COP) services to an eligible individual who resides in a Community Based Residential Facility (CBRF) solely because the maximum total amount of funding for persons residing in CBRFs has been reached; (b) in discussing the cost effectiveness of a placement in a CBRF, Chippewa County shall consider all state and federal funds needed for all options considered; and (c) provide that Chippewa County may use COP GPR funds to provide services in any CBRF that has 20 or fewer beds. I am vetoing the provision that Chippewa County cannot deny COP services to an eligible individual who resides in a CBRF solely because the maximum total amount of funding for persons residing in CBRFs has been reached, since I want the county to maintain its current flexibility to determine what percentage of COP funds it plans to use to support individuals residing in CBRFs.
Sections 1045, 1059 and 1064 allow a county to waive the COP assessment, in accordance with guidelines established by DHFS, prior to a person’s admission to a CBRF. In addition, these sections provide that a person seeking admission to a CBRF on a private pay basis may waive the assessment, unless the person is expected to become eligible for Medical Assistance within six months of the assessment. Sections 1045g and 1059g prohibit a county department or aging unit from denying COP services to an individual who has refused an assessment. I am vetoing sections 1045g and 1059g and the provisions that an individual can waive the COP assessment because the information obtained from the assessment is important in choosing the most appropriate and cost effective services for the individual.
7. Report on Huntington’s Disease
Section 9123 (8t)
This section requires the Department of Health and Family Services (DHFS), by January 1, 2000, to submit a report to the Joint Committee on Finance on services provided to individuals with Huntington’s disease. Specifically, the report must include, for each county of the state, the following: (a) the number of individuals with any type of disability receiving services through the Community Options Program (COP) and the Community Integration Program (CIP) and county revenues; (b) the number and percentage of individuals with Huntington’s disease receiving services through these programs; and (c) the types of services that individuals with any type of disability, including Huntington's disease, received under these programs. I am vetoing this section because I am concerned about the increased cost to counties that administer the COP and CIP programs. DHFS classifies Huntington’s disease as dementia and requires no separate reports. Counties would have to undertake a special data collection effort to obtain information on individuals with this disease.
8. Community Integration Program (CIP 1B)
Section 172 [as it relates to s. 20.435 (4) (b)]
Section 172 [as it relates to s. 20.435 (4) (b)] appropriates $181,700 GPR in fiscal year 1999-2000 and $539,800 GPR in fiscal year 2000-2001 to fund 50 new CIP 1B placements in fiscal year 1999-2000 and an additional 50 new CIP 1B placements in fiscal year 2000-2001. Although there is no language in the budget bill that authorizes this increase, the Legislature passed a motion and an amendment during its deliberations to authorize funding for the new CIP 1B placements.
I object to the expansion of funding for this program at the level approved by the Legislature. I am willing to approve an increase of $181,700 GPR in fiscal year 1999-2000 and $359,900 GPR in fiscal year 2000-2001. I am vetoing that part of the bill which funds 50 new CIP 1B slots in fiscal year 2000-2001 by decreasing the Department of Health and Family Services’ s. 20.435 (4) (b) appropriation by $179,900 GPR in fiscal year 2000-2001. This veto is part of a larger write-down of the Medical Assistance appropriation. I am also requesting the Department of Administration secretary not to allot these funds. Elsewhere in the bill is funding for 581 additional Community Options Program placements in fiscal year 2000-2001, a portion of which will be used for community services for developmentally disabled individuals.
9. Uniform Compliance Checks
Section 2485j [as it relates to s. 254.916 (1) (a) and (c), (3) (f), (12) and (13)]
Section 2485j [as it relates to s. 254.916 (1) (a)] defines the authority of the Department of Health and Family Services (DHFS) under Chapter 254, Investigation of the Sale or Gift of Cigarettes or Tobacco Products to Minors, including the requirement that in using statistically sound sampling techniques in designing annual surveys, DHFS must stratify the sample so as to measure compliance by type of retail outlets, excluding a barroom. I am vetoing the provision that excludes barrooms from the sample because, under 42 USC 300x-021, DHFS has included taverns in its sample of outlets and federal regulations require states to maintain consistency in their samples from year-to-year.
Section 2485j [as it relates to s. 254.916 (3) (f)] requires that, excluding investigations conducted under 42 USC 300x-021 and 21 CFR part 897, detailed information concerning the investigation must be reported to DHFS and to the retailer. I am vetoing the provision requiring that investigation results be reported to DHFS because the reports are not necessary for the department’s efforts to collect data to comply with federal law.
Section 2485j [as it relates to s. 254.916 (1) (c) and (12)] exempts surveys conducted by local units of government that have not entered into contracts with DHFS under 42 USC 300x-021 and 21 CFR part 897 from provisions of Chapter 254 and provides that no local surveys may be used for the purpose of issuing warnings or citations or any other enforcement mechanism. I am vetoing these provisions because one of the purposes in creating Chapter 254 was to strengthen compliance checks across the state to achieve a statewide goal of reducing the use of tobacco products by minors. In addition, I am concerned that the provision that precludes local municipalities from using the results of compliance checks for law enforcement purposes may curtail the ability of local governments in enforcing state law prohibiting tobacco sales to minors.
Section 2485j [as it relates to s. 254.916 (13)] exempts the City of Madison or the local health department or local law enforcement agency of the City of Madison from all provisions of Chapter 254. I am vetoing this provision because no county, town, village or city should have a special exemption from the requirements of Chapter 254.
10. Administrative Funding for the Blind and Visually Impaired
Section 172 [as it relates to s. 20.435 (6) (kd)], 226c [as it relates to ss. 20.435 (6) (kd) and 196.218 (5) (a) 10.], 445g and 2332n
These sections provide $100,000 in each year from the universal fund for administrative services under the rehabilitation teaching program for blind and visually impaired persons. I am vetoing these provisions because I am concerned about broadening the use of the universal fund for activities not directly related to telecommunications, such as salary and fringe benefit costs for rehabilitation teachers. The Department of Health and Family Services (DHFS) did not ask for additional funding for rehabilitation teachers in its biennial budget request. However, I want blind and visually impaired persons to receive the same level of services in fiscal year 1999-2000 and fiscal year 2000-2001 that they received in fiscal year 1998-1999. Thus, I am directing the secretary of DHFS to use base resources to continue the fiscal year 1998-1999 level of services.
11. Healthy Families Program
Section 1099g
This section requires the Department of Health and Family Services (DHFS) to distribute $100,000 in each year to Kenosha Area Family and Aging Services, Inc. for the provision of home visiting services for mothers who are under 18 years of age. I am vetoing this section because I object to providing additional funding for home visiting programs. 1997 Wisconsin Act 293 created a home visiting grant program and required DHFS to evaluate the program. It is premature to expand these programs until the evaluation determines whether home visiting programs are effective in reducing the incidence of child abuse and neglect. I am requesting the Department of Administration secretary to place $100,000 GPR in fiscal year 1999-2000 and $100,000 GPR in fiscal year 2000-2001 in unallotted reserve in appropriation s. 20.435 (3) (bc) to lapse to the general fund.
12. Nursing Home Wage Pass-Through
Section 9123 (9m) (b), 9123 (9m) (bg), 9123 (9m) (bm) and 9123 (9m) (c)
Section 9123 (9m) (b), (bg), (bm) and (c) provide a wage pass-through supplement to nursing homes to increase the wages or salaries and fringe benefits or increase staff hours of housekeeping and laundry workers, dietitians, and food workers.
I am vetoing section 9123 (9m) (b), (bg) and (bm), and partially vetoing section 9123 (9m) (c), to eliminate the wage pass-through for housekeeping and laundry workers, dietitians, and food workers because this increase has not been sufficiently justified. Many nursing homes contract for dietary consulting services, and to a lesser extent, laundry and food service workers. Therefore, the wage pass-through may not apply to workers in those areas because the nursing home does not pay their wages directly. In light of evidence of high turnover rates and the threat of declining patient care as a result of low wages for nurse’s assistants, it makes sense at this time to direct scarce state resources to those workers who provide direct care.
I am requesting that the Department of Administration secretary place $1,722,500 GPR in fiscal year 1999-2000 and $2,277,500 GPR in fiscal year 2000-2001 in unallotted reserve in appropriation s. 20.435 (4) (b) to lapse to the general fund.
13. Supplemental Outpatient Hospital Payments
Section 1384g
This section directs the Department of Health and Family Services (DHFS) to distribute not more than $2,451,000 (all funds) in each fiscal year, beginning on July 1, 2000, as a supplemental payment to hospitals for which Medical Assistance (MA) revenues were at least 8% of the hospital’s total revenues in the hospital’s most recent fiscal year prior to the year of the payment. I am partially vetoing this provision to make this a one-time payment in fiscal year 2000-2001. The intent of the payment is to offset a portion of hospitals’ increasing costs related to providing uncompensated care to patients without health insurance coverage. With the BadgerCare program in place, these costs are likely to decline, therefore reducing the need for an on-going supplemental payment.
I am also partially vetoing this section to correct a technical error in the statutory language outlining the distribution methodology. The methodology contained in this section would result in each hospital’s supplemental payment being equal to the hospital’s total amount of MA revenues in the previous year. I am partially vetoing the section to correct the methodology so that each qualifying hospital would receive the percentage of the supplemental funds available that is equal to that hospital’s percentage share of total MA revenues of all qualifying hospitals.
Finally, I am also partially vetoing this section to allow DHFS to calculate payments based on data from the prior state fiscal year, as opposed to calculating the payments based on each hospital’s fiscal year. Not all hospitals operate on the same fiscal year. Requiring DHFS to calculate payments over differing time periods is needlessly burdensome. This partial veto will standardize the time period over which all payments are calculated.
14. Medical Assistance Asset Test
Sections 1433t, 1433tm, 1433u, 1437m, 1437n, 1437p, 1437q, 1439g and 1439q
These sections eliminate the asset test for AFDC-related Medical Assistance (MA) eligibility. No funding was provided for this provision based on the assumption that all adults who do not meet the current AFDC-related categorically needy MA test would be BadgerCare eligible. I am vetoing this provision because I disagree with this assumption. BadgerCare will not cover the following individuals: (1) nonlegally responsible relative caregivers; (2) adult parents and their spouses with access to an employer-subsidized family group health plan where the employer pays at least 80% of the premium; and (3) adult parents and their spouses with health insurance coverage in the last three months that meets the Health Insurance Portability and Accountability Act of 1996 (HIPAA) standard plan definition. The Department of Health and Family Services estimates that the elimination of the asset test will increase MA program costs by approximately $1,723,900 GPR and $2,460,000 FED per year.
15. Irrevocable Burial Trusts and Medical Assistance (MA) Eligibility
Sections 2923mn and 9442 (2c)
Under the budget bill, the amount of an irrevocable burial trust that may be excluded from assets when calculating MA eligibility increases from $2,000 to $2,500 on January 1, 2001, and to $3,000 on July 1, 2001. Because funding has only been provided for the last six months of the 1999-2001 biennium, this provision creates a significant cost-to-continue problem for the next biennium, which is unacceptable.
I am vetoing section 2923mn and partially vetoing section 9442 (2c) to eliminate the second increase from $2,500 to $3,000 because it commits the state to increased general purpose revenue expenditures in the next biennium.
16. Medical Assistance (MA) School-Based Services
Sections 1427j and 9123 (13d)
Section 1427j directs the Department of Health and Family Services (DHFS) to reimburse school districts, cooperative educational service agencies and the Department of Public Instruction (DPI) (on behalf of the Wisconsin Center for the Blind and Visually Impaired and the Wisconsin School for the Deaf) for 90% of the federal share of allowable administrative costs on a quarterly basis. I am partially vetoing this section to eliminate the requirement that DHFS reimburse these entities on a quarterly basis. Reimbursement on a quarterly basis does not coincide with the nine-month school year and this requirement would be administratively cumbersome to DHFS and to school districts. The reimbursement schedule currently in place, under which school districts receive reimbursement twice per year, is sufficient to ensure regular participation in the program.
Section 9123 (13d) specifies that DHFS shall reimburse school districts, cooperative educational service agencies and DPI (on behalf of the Wisconsin Center for the Blind and Visually Impaired and the Wisconsin School for the Deaf) for 90% of the federal share received for school-based services in excess of $16,100,000 annually. Under this provision, participating entities would receive 60% of the federal reimbursement for school medical services provided and 90% of federal reimbursement for administrative costs until federal reimbursement exceeds $16,100,000, at which point participating entities will receive 90% of federal reimbursement for both school medical services and administrative costs. The section further directs DHFS to submit, as part of its 2001-2003 biennial budget request, an increase in the percentage of the federal share received by educational entities for the provision of school-based services to reflect the total percentage of the federal share for which these educational entities were reimbursed in state fiscal year 1999-2000. I am vetoing this directive because it replaces the two-tiered reimbursement system aimed at encouraging participation in the program, with a flat, blended rate. I am directing DHFS to monitor participation based on the new rates and, if it is determined that improvements are needed, to propose a different rate structure in the next biennial budget.
17. BadgerCare Outreach
Section 1476f
This provision directs the Department of Health and Family Services (DHFS) to coordinate with the Department of Public Instruction (DPI) to develop and implement an outreach mailing targeted at families of children enrolled in the federal school lunch program to inform them of the BadgerCare program.
I am vetoing this provision because a similar effort is already underway. DPI recently sent a letter to every school district in the state encouraging them to inform families of the BadgerCare program. As a result, the Milwaukee Public Schools created a flyer about BadgerCare which was distributed to students. Several other school districts have included BadgerCare information with applications for the federal school lunch program. In addition, it is my understanding that President Clinton has initiated a similar campaign at the federal level. I am directing DHFS to continue to coordinate with DPI to conduct BadgerCare outreach activities in Wisconsin schools.
18. Nocturnal Enuresis Feasibility Study
Section 9123 (7t)
This section directs the Department of Health and Family Services (DHFS) to conduct a study on the cost and efficacy of urine alarms used in conjunction with behavior modification therapy and case management, including bimonthly visits with a specialist, as a treatment for nocturnal enuresis (commonly referred to as bedwetting).
I am vetoing this study because the Wisconsin Medical Assistance (MA) program currently covers a number of methods and services that parents can use to address this problem, including case management, counseling and urine alarms. DHFS has concluded the successful use of urine alarms is best achieved when supervised by the child’s primary care physician as part of a comprehensive care plan. In addition, current literature and recommendations from the Nocturnal Enuresis Society do not indicate the need for outside supervision in conjunction with the use of urine alarms. Finally, the vast majority of MA recipients with this diagnosis are children who are enrolled in managed care plans. Health maintenance organizations routinely evaluate the effectiveness of such treatments and choose what they believe to be the most effective option.
Sections 30d, 172 [as it relates to s. 20.436 (1) (tb) and (tc)], 717t, 2486g, 9101 (20c) and 9158 (11mg)
These sections create the Tobacco Control Board (board) to develop a state plan for spending the funds received under the tobacco settlement and set aside $25,992,000 of those funds in a separate segregated fund. The board is attached administratively to the Department of Health and Family Services (DHFS). The sections also define the duties of the board, identify the activities on which the funds can be spent and provide 2.0 FTE SEG positions. An annual report is required each year evaluating the success of the grant program and audits are required of the University of Wisconsin Center for Tobacco Research and Intervention and the Medical College of Wisconsin. Finally, the Department of Administration (DOA) is required to study the possibility of selling and transferring the state's rights to the monies to establish a permanent endowment fund.
Prior to outlining my vetoes, I want to underscore the importance of investing dollars in worthy and effective programs to prevent smoking, as well as further research on both the health-effects of smoking and medical care for those who suffer from tobacco's ill effects. I fully expect this funding, which provides more than ample resources, will enable Wisconsin to be a bold leader in an aggressive battle to tackle smoking.
First, I am partially vetoing section 30d [as it relates to the board members, terms and number of meetings] because I am dissatisfied with the board's composition. My concern with the board as statutorily constituted stems from what I believe is an unbalanced composition that keeps important constituencies, such as retailers and parents of teenagers, from having a place at the table. I am also vetoing section 9158 (11mg) which specifies the expiration dates of certain members because it is no longer necessary if the specific membership of the board is not set statutorily.
Second, I am partially vetoing section 30d [as it relates to DHFS sending the board's budget to DOA without changes] because it is inconsistent with language which governs all attached boards. Under s. 15.03, "budgeting, program coordination and related management functions shall be performed under the direction and supervision of the head of the department" to which the board is attached. The agency that is responsible for the state's tobacco control program should have input into the board's budget, and my partial veto ensures this input will occur.
Third, while I recognize there was substantial compromise in reconciling the funding level proposed by each house, I still believe the final, agreed upon amount is too high. As a result, I am partially vetoing section 717t so that a total of $23,500,000 SEG will be available for the biennium, which will save $2,492,000. As a result, I am writing down the amounts in s. 20.436 (1) (tb), the administrative appropriation, by $200,000 SEG in fiscal year 1999-2000 and in s. 20.436 (1) (tc), the grants appropriation, by $2,292,000 SEG in fiscal year 2000-2001 to what I believe are more reasonable funding levels. I am requesting the Department of Administration secretary not to allot these funds. I am retaining the full amount of funding for administration in fiscal year 2000-2001 in order to ensure that the board has sufficient funding to reimburse DHFS for the cost of services, such as accounting or personnel, provided to the board.
Fourth, I am partially vetoing section 2486g which describes the duties of the board to eliminate the provision that the plan for spending the tobacco settlement funds must conform to the model developed by the Centers for Disease Control and be modeled after successful tobacco control programs in other states. While I understand it is not effective practice to reinvent the wheel, I believe the board members should not be constrained by these limitations. I want to provide each member with greater flexibility and encourage creativity and forward-thinking as they develop and propose programs to meet the specific needs of Wisconsin residents.
Finally, section 9101 (20c) requires DOA to study the possibility of selling and transferring Wisconsin's rights to the tobacco settlement funds in order to create a permanent endowment fund. The study is to be completed by January 1, 2000. I am partially vetoing this section to eliminate the study due date in order to provide more time for the department to complete a thorough and comprehensive review.
20. Women, Infants and Children (WIC) Electronic Benefits Transfer
Sections 34b, 2435q and 9123 (8d)
These sections establish a WIC Council attached to the Department of Health and Family Services (DHFS) which will review the program and make recommendations on needed changes in policy and procedures to the DHFS secretary and the Legislature. They also require DHFS to study the feasibility of an electronic benefits transfer program for WIC and submit the study to the Joint Committee on Finance (JCF) by January 1, 2002. The study would specify the information systems requirements, the compatibility of such a system with existing electronic benefits transfer programs and the costs of such a system.
I am vetoing the provisions establishing a council because it is duplicative. DHFS already has an advisory council which addresses policies and procedures in the WIC program. I am also partially vetoing the specific topics to be addressed in the feasibility study. I am interested in the possibility of using the electronic transfer of benefits in the future and I would like to learn what other states are developing now. However, I believe it is premature to conduct the study as proposed given the difficulty several states are experiencing in trying to develop this type of system. I am also vetoing the provision requiring the submission of the study to JCF and the due date, to provide DHFS some additional flexibility.
_Toc40102816121. Community Health Centers and the Minority Health Program
Sections 172 [as it relates to s. 20.435 (5) (fh)] and 2400m
Section 2400m provides $3,500,000 GPR in fiscal year 1999-2000 and $4,000,000 GPR in fiscal year 2000-2001 for federally qualified health centers. Section 2400m also provides $100,000 GPR in each fiscal year for the Mary Mahoney Health Services Center in Milwaukee. Finally, section 172 [as it relates to s. 20.435 (5) (fh)] provides $300,000 GPR annually to support a minority health program which will provide grants to improve minority health and a minority health media campaign.
While the federally qualified health centers provide a valuable service, I believe the amounts appropriated are excessive. Therefore, I am vetoing section 2400m [as it relates to the federally qualified health centers' allocation language] in order to reduce funding for these centers to $2,500,000 in fiscal year 1999-2000 and $3,000,000 in fiscal year 2000-2001. I am also partially vetoing funding in fiscal year 2000-2001 in section 2400m [as it relates to the Mary Mahoney Center] and the minority health program to avoid building these costs into the next biennium's base spending. Instead, I am asking these programs to apply for additional funding through a grant from the Tobacco Control Board. I am requesting that the Department of Administration secretary place $1,000,000 GPR in fiscal year 1999-2000 and $1,100,000 GPR in fiscal year 2000-2001 into unallotted reserve in appropriation s. 20.435 (5) (fh) to lapse to the general fund. I am also writing in a smaller amount in s. 20.435 (5) (fh) to reflect the GPR reduction in funding for the minority health program which should seek support in the second year from tobacco settlement funds. I am requesting the Department of Administration secretary not to allot the $300,000 for the minority health program.
22. Consolidated Contracts
Sections 999m and 9323 (11m)
These sections require the Department of Health and Family Services (DHFS) to submit a plan to the Joint Committee on Finance (JCF) for approval under the 14-day passive approval process to consolidate a variety of public health contracts for such activities as lead poisoning prevention and family planning. This language was developed in response to concerns from many organizations and public health departments that the inclusion of the family planning funds in the consolidated contract would politicize the provision of these services, as it already had in two counties, if the contract had to be approved by the county board of supervisors. To ensure that these services continue to be provided statewide and to not impede the progress of the rest of the consolidated contract proposal, I have directed DHFS to remove family planning services from the consolidated contract. I am vetoing the language requiring JCF review since the primary problem it was designed to address has been resolved.
23. Newborn Hearing Screening Program
Sections 172 [as it relates to s. 20.435 (5) (jk)], 368r, 368s, 434r, 434s, 434t, 1649r, 1649s, 2439r, 2439s and 9423 (11g)
These provisions establish a newborn hearing screening program under which grants would be made to hospitals to purchase equipment for hearing tests and to provide training. The program would be funded by a $2 increase in the cost of a birth certificate for the period October 1, 1999, (or on the first day of the month after publication, whichever is later) through December 31, 2001. The Department of Health and Family Services (DHFS) is required to collect data on the number of babies born in hospitals that test hearing. If, by August 5, 2003, DHFS determines that less than 88% of babies born in the state are delivered at hospitals which do not administer hearing tests, then DHFS must require all hospitals in the state to provide the tests.
I believe this program has merit, but I believe that funding the program with increased fees from birth certificates is inappropriate. As a result, I am vetoing the appropriation under s. 20.435 (5) (jk) and other sections related to the funding for this program. I am, however, retaining the programmatic language and asking the groups that support this program to work together to propose a more appropriate source of funding for the program.
24. Birth and Developmental Outcome Program
Section 172 [as it relates to s. 20.435 (1) (a)]
Section 172 [as it relates to s. 20.435 (1) (a)] provides $100,000 GPR in fiscal year 1999-2000 and $200,000 GPR in fiscal year 2000-2001 to purchase the services of a medical records abstractor to collect and study data on children with birth defects. I am reducing funding for this purpose by $100,000 in the second year because there was no justification to document the need for increasing the level of funding for this program in the second year. By lining out s. 20.435 (1) (a) and writing in a smaller amount, I am vetoing the part of the bill that funds this provision. I am also requesting the Department of Administration secretary not to allot these funds.
25. Health Insurance Risk Sharing Plan (HIRSP)
Sections 2277t and 2278g
Section 2277t allows the HIRSP Board or the Department of Health and Family Services (DHFS) to adjust the income eligibility brackets for the premium and deductible subsidies by the consumer price index. Prior to making these adjustments, the HIRSP Board and DHFS must obtain approval of the Joint Committee on Finance (JCF). I am partially vetoing the provision that requires JCF approval because the additional oversight provided by the committee is unnecessary.
Section 2278g requires DHFS to obtain approval from the HIRSP Board before developing rules on cost containment strategies such as prior authorization requirements. I am vetoing this provision to ensure that departmental staff have flexibility in establishing cost containment strategies. However, I am directing the DHFS secretary to consult with the HIRSP Board with respect to these policies prior to issuing any new rules.
26. Caregiver Background Checks Recidivism Study
Section 9111 (4xx)
This section directs the Department of Corrections (DOC), in conjunction with the University of Wisconsin-Madison (UW), to prepare a report on the correlation between prior convictions and the propensity to commit future acts of abuse, neglect or misappropriation. I am partially vetoing this section to delete DOC participation in the study. Many crimes of abuse, neglect and misappropriation are misdemeanors, and records of these crimes are kept at the county level. Court records, not DOC records, are a more appropriate and comprehensive source of data for this study. I am requesting the UW to submit the report to the Legislature in the manner provided under s. 13.172 (3) of the statutes no later than June 30, 2001.
27. Income Augmentation Contract
Sections 456r, 1091k and 9323 (13f)
These sections require the Department of Health and Family Services (DHFS) to perform activities to augment income received under 42 USC 670 to 679a, 42 USC 1395 to 1395ddd and 42 USC 1396 to 1396v (foster care, Medicaid and Medicare). Under these sections, DHFS is required to perform these activities itself and may not contract with any person to perform these activities. I am vetoing these sections because I want DHFS to have the flexibility to augment federal income in a manner that maximizes the amount of income the state receives from the federal government. The vendor currently under contract with DHFS has already documented $68.1 million in retroactive claims that the state has since collected.
28. Data Collection Proposals
