5. A program to match retirees with youth to provide the youth with workforce
mentoring.
6. A program to encourage the positive involvement of fathers in their
children's lives.
7. A grant program under which DWD may award up to $1,000,000 to counties
and private entities to provide community-based alcohol and other drug abuse
treatment that is targeted to certain low-income individuals.
The bill also permits DWD to transfer funds received under the federal
temporary assistance for needy families block grant program to other agencies for
various programs.
Under current law, a county department of social or human services must
certify eligibility for and issue food coupons to needy households, except that a
Wisconsin works (W-2) agency is required, to the extent permitted under federal law
or waiver, to certify eligibility for and issue food coupons to eligible participants in
the W-2 program.
This bill requires a W-2 agency, to the extent permitted under federal law or
waiver, also to certify eligibility for and issue food coupons to: 1) persons who may
be required to participate in the food stamp employment and training program; and
2) other persons who are under the age of 61 and who are not disabled.
Under current law, certain federal economic support programs require that a
state maintain or increase its average annual expenditures for those programs. This
is commonly referred to as a maintenance-of-effort requirement.
This bill allows DWD to expend moneys from its economic support programs
appropriation for services to identify funds that may be used for the
maintenance-of-effort requirement.
Currently, under the learnfare program, a child between the ages of 6 and 17
who is the dependent child of a recipient of benefits under the W-2 program must
meet a school attendance requirement to avoid the imposition of certain sanctions.
Currently, DWD may expend moneys for a study of the school attendance
requirement under the learnfare program for children who are 6 to 12 years of age.
This bill eliminates that expenditure authority.
Under current law, if a recipient of certain public assistance benefits dies and
the estate of the deceased recipient is insufficient to pay for the funeral, burial and
cemetery expenses, the county or applicable American Indian tribal governing body
or the organization responsible for burial of the recipient must pay the cemetery
expenses that are not paid by the deceased recipient's estate (but not more than
$1,000) and must pay the funeral and burial expenses that are not paid by the
deceased recipient's estate (but not more than $1,000).
Under this bill, a county, tribal governing body or organization responsible for
burying the recipient is not required to make a payment for funeral, burial or
cemetery expenses if the request for the payment is made more than 12 months after
the recipient died.
Under current law, DWD administers a work experience program for
noncustodial parents (parents who do not live with their children for substantial
periods of time), commonly referred to as the children first program. A parent who
fails to pay court-ordered child support or to meet the child's needs for support
because of unemployment or underemployment is required to participate in the
program, under which the person is provided with certain types of work experience,
job training and job search assistance. Currently, DWD may contract with any
county to administer the children first program. DWD pays the county $200 for each
person who participates in the program in that county.
This bill permits DWD to contract with a W-2 agency or a county to administer
the children first program. The bill requires DWD to pay the administering county
or W-2 agency $400 for each person who participates in the program in the region
in which the county or W-2 agency administers the program.
This bill provides that DHFS may use moneys derived from Indian gaming
compacts to fund relief block grants to American Indian tribal governing bodies.
Wisconsin works
Under current law, two W-2 agencies in Milwaukee County are permitted to
implement a program under which certain participants in community service jobs
(wholly subsidized employment) may be paid wages rather than monthly grants. To
qualify for a wage-paying community service job, the participant must already be
engaged in unsubsidized employment for at least 15 hours per week. Currently, a
W-2 agency may not require a person to work in a wage-paying community service
job more than the lesser of 15 hours per week or the difference between 40 hours and
the number of hours per week that the participant works in unsubsidized
employment. If the participant qualifies for the federal earned income tax credit
(EITC), current law qualifies the participant for the state EITC as well. Currently,
the wage-paying community service job program is scheduled to sunset on October
1, 2001.
This bill eliminates the sunset date for the wage-paying community service job
program and expands the program, beginning on January 1, 2001, to allow all W-2
agencies to implement it for any individual that the W-2 agency determines is
capable of working in an unsubsidized job but who, despite reasonable efforts, is
unable to secure full-time unsubsidized employment. However, the bill caps the
number of slots for the program at 2,500 statewide. Under the bill, a participant in
a wage-paying community service job is disqualified from the state EITC with
respect to any wages earned under the wage-paying community service job.
Additionally, under the bill, the participant need not be engaged in unsubsidized
employment to qualify for a wage-paying community service job. Finally, the bill
allows a W-2 agency to require a participant in a wage-paying community service
job to work in a community service job for not more than 30 hours per week and to
participate in job search activities for not more than ten hours per week.
This bill requires a W-2 agency to assess the educational needs of an individual
whom the W-2 agency proposes to place in unsubsidized employment or a trial job.
Under the bill, if the W-2 agency determines that the individual needs basic
education, such as courses leading to the granting of the equivalent of a high school
diploma, and if the individual wishes to pursue the basic education, the W-2 agency
must make basic education a part of an employability plan that the W-2 agency
develops for the individual. The bill requires the W-2 agency to pay for the basic
education services.
Under current law, with certain limited exceptions, a participant in the W-2
program may be required to work in a community service job for not more than 30
hours per week and to participate in education or training activities for not more
than ten hours per week. If the W-2 agency requires fewer than 30 hours of work
per week because the participant has part-time unsubsidized employment, the
participant's grant amount may be reduced by an amount equal to the product of
$5.15 and the difference between 30 and the number of hours that the participant
is required to work. This bill specifies that if a W-2 agency places a person in a
community service job for fewer than 30 hours per week because that person has
part-time unsubsidized employment, the W-2 agency may reduce the monthly grant
in accordance with a schedule developed by DWD.
Under current law, a child care subsidy is available to a parent or guardian of
a child who is under the age of 13 if the parent or guardian meets certain income and
asset limits and needs child care to participate in certain work-related activities,
including employment skills training. If child care is needed in order to participate
in employment skills training (which includes English as a second language courses,
high school graduation equivalency courses and technical college courses), the
parent or guardian must demonstrate that he or she has been employed in an
unsubsidized job for at least nine consecutive months or that he or she is a
participant in a W-2 employment position in order to receive a child care subsidy.
Under this bill, if a person wishes to receive a subsidy for child care that is
needed in order to pursue basic education (such as English as a second language
courses, high school graduation equivalency courses or literacy tutoring), that
person must demonstrate that he or she is employed in unsubsidized employment
(without regard to length of employment) or that he or she is a participant in a W-2
employment position. A person who wishes to receive a subsidy for child care that
is needed in order for the person to participate in a course of study at a technical
college, or to pursue education that provides an employment skill, must demonstrate
that he or she has been working in unsubsidized employment for three months (and
continues to be so employed) or that he or she is in a W-2 employment position. As
under current law, the W-2 agency must determine that the basic, technical or other
education would facilitate the person's efforts to obtain employment.
Under current law, a contract to operate as a W-2 agency must require that the
W-2 agency provide, or contract with another person to provide, credit
establishment and credit repair assistance to W-2 participants. Currently, DWD
may allocate not more than $3,000,000 annually for credit assistance to W-2
recipients in the city of Milwaukee.
Under this bill, rather than requiring credit establishment and credit repair
services, a W-2 agency contract must require that the W-2 agency provide, or
contract with another to provide, budgeting and financial planning services. The bill
eliminates the allocation for credit establishment and credit repair services offered
to W-2 participants in the city of Milwaukee.
Current contracts between DWD and W-2 agencies require the agencies to offer
follow-up services for 60 days after a W-2 participant moves from a W-2
employment position to unsubsidized employment. This bill permits a W-2 agency,
subsequent to that follow-up period, to offer case management services, including
the provision of employment skills training, English as a second language classes
and basic education, to an individual who has moved from a W-2 employment
position to unsubsidized employment, regardless of the individual's income or asset
level.
Currently, in calculating a person's income for the purpose of determining
financial eligibility for W-2 or for a W-2 child care subsidy, a W-2 agency must
include child support payments received by the person on behalf of any child who is
a member of that person's household. This bill removes child support payments from
the income consideration. The bill also directs the W-2 agency to include in the
calculation of income for W-2 child care eligibility net earnings and certain
business-related expenses reported to the Internal Revenue Service for farm and
self-employment income.
Medical assistance
Under current law, certain people are eligible for MA because of substantial
medical needs that consume so much of their income as to qualify them as
low-income. This category of MA recipients is commonly referred to as medically
needy. Other people are eligible for MA by virtue of their receipt of other federal
assistance, such as SSI. This category of MA recipients is commonly referred to as
categorically needy.
This bill directs DHFS to seek federal approval and to request any necessary
waivers to expand MA eligibility to disabled persons who would qualify for SSI but
for excess income and assets. Under the bill, a disabled person whose family's income
is less than 250% of the federal poverty line and whose assets do not exceed $20,000
is eligible to receive MA if the person pays a monthly premium and a one-time initial
premium established by DHFS. The bill directs DHFS, however, to pay the monthly
premium for a person who is eligible for this MA purchase plan and who is receiving
services under COP. The bill also authorizes DHFS to pay for that person's one-time
entry premium.
The bill also requires DHFS to evaluate how to coordinate the MA purchase
plan with HIRSP, which provides major medical health insurance coverage for,
among others, persons who are covered under medicare because they are disabled
but for which persons who are eligible for MA are not eligible. DHFS is required, if
necessary, to develop proposed legislation that coordinates the two programs and
that addresses the provision of health care coverage for individuals who are eligible
for both HIRSP and the MA purchase plan.
Under the current MA program, DHFS certifies persons or facilities that meet
certain criteria as providers and pays for services and items that MA recipients
receive from the certified providers. DHFS is authorized or required to enforce
numerous sanctions, including decertification or suspension from the MA program,
against providers who fail to comply with requirements under the program or to
whom improper or erroneous payments or overpayments have been made. To
implement these sanctions, DHFS must provide written notice, a fair hearing and
a written decision.
This bill prohibits MA providers from submitting false claims for payment of
services or items. The bill permits DHFS to assess forfeitures for violations of the
prohibitions and to impose a surcharge on a forfeiture that is assessed.
The bill authorizes DHFS to require certain MA providers, as a condition of
certification, to file with DHFS a surety bond, payable to DHFS, under terms and in
an amount specified by DHFS, that would reasonably pay the amount of a recovery
and DHFS's costs to pursue recovery of overpayments or to investigate and pursue
allegations of false claims or statements.
The bill authorizes DHFS, if DHFS first makes specified findings, to prescribe
MA provider certification criteria that limit the number of providers of particular
services or that limit the amount of resources, including employes and equipment,
that a certified provider may use to provide MA services and items.
The bill makes various changes relating to the procedures for the recovery by
DHFS of improper or erroneous MA payments or overpayments.
The bill eliminates DHFS's general authority to suspend a provider, but
authorizes DHFS, if certain criteria are met, to suspend certification for a provider
pending a hearing on whether the provider must be decertified for violation of federal
or state laws. The bill eliminates the right of notice, a fair hearing and a written
decision for most sanctions against providers that DHFS may enforce, except for
decertification from or restriction of a provider's participation in the MA program.
The bill authorizes DHFS to prescribe conditions of MA participation and
reimbursement terms and to impose additional sanctions for noncompliance. The
bill requires immediate access, upon request by DHFS, to provider records and
specifies that a provider's failure to provide access constitutes grounds for
decertification.
The bill changes provisions concerning liability for repayment of improper or
erroneous payments or overpayments of a provider who sells or otherwise transfers
ownership of his or her business. Under the bill, before such a sale or transfer may
take place, the provider must notify DHFS of the impending sale and DHFS must
inform the provider of the extent of liability, if any. If liability exists, the provider
must so inform the prospective transferee of the extent of the liability and the
liability attaches to both the provider and the transferee, with the sale or other
transfer conditioned upon repayment. If the provider fails to inform the transferee,
liability does not attach to the transferee. Repayment must be made prior to the sale
or transfer and, if not done, the sale or transfer is void.
Currently, a person who disposes of assets for less than the fair market value
in order to qualify for MA is ineligible for MA for a certain period. Current law
specifies that a transfer of assets to an irrevocable annuity is a transfer that is below
the fair market value if the amount of the transfer exceeds the expected benefit.
This bill provides that a transfer of an asset to an irrevocable annuity, or a
transfer of an asset by promissory note or similar instrument, is a transfer for the
fair market value of the asset if certain conditions are met.
Under current law, DHFS must recover from the estate of a deceased MA
recipient the amount of MA paid on behalf of the recipient while the recipient was
a resident in a nursing home or an inpatient in a medical institution and the amount
of MA paid on behalf of the recipient for certain services received by the recipient
after the recipient was over the age of 55. One mechanism for recovery is a claim filed
against the estate, which may include a lien placed on the home of a recipient who
is a nursing home resident and not expected to return home. Currently, a lien may
only be for the amount of MA paid on behalf of the recipient while the recipient
resides in a nursing home.
This bill expands the estate recovery program as follows:
1. In addition to obtaining a lien on the home of a nursing home resident who
is not expected to return home, the bill directs DHFS to obtain a lien on the home of
an inpatient in a hospital who is not expected to return home. The lien, in both cases,
is for the amount of MA paid on behalf of that recipient that is generally recoverable,
rather than only the amount paid while the recipient was in the nursing home (or
hospital).
2. DHFS must recover expenditures for personal care services, which include
assistance with meals, dressing, movement, bathing or other personal needs or
maintenance.
Under current law, a court may reduce DHFS's claim in an estate by up to
$3,000 to allow heirs and beneficiaries to retain certain personal property, including
up to $1,000 in tangible personal property that is not used in trade, agriculture or
other business. This bill allows a court to reduce DHFS's claim in an estate by up
to $5,000, including $3,000 in tangible personal property that is not used in trade,
agriculture or other business.
Under current law, payments to nursing homes for care provided to recipients
of MA are determined under a payment system that considers specific allowable
costs, under standards prescribed by DHFS. The standards for payment of allowable
direct care costs, support service costs, heating fuel and utility costs and
administrative and general costs of a nursing home may not be less than the median
for such costs of a sample of all nursing homes. Payment for net property taxes or
municipal services are required to be made on a range from actual costs to a
maximum limit determined by DHFS. Payment for capital costs of a nursing home
must be based on the home's replacement value, subject to DHFS limitations, except
that DHFS may not reduce final capital payment by more than $3.50 per patient day
and except that DHFS limitations do not apply to certain nursing homes that have
high capital costs. DHFS must calculate a payment for a nursing home by applying
specified standards and considering specified cost centers and allowable costs.
Payments are based on cost reports from the nursing home's previous fiscal year.
This bill eliminates the requirement that DHFS base payment on information
from cost reports from the nursing home's previous fiscal year. The bill also
eliminates the requirement that the standards for payment by DHFS of allowable
costs for direct care, support services, heating fuel and utilities, administration and
general services be not less than the median for such costs for a sample of all nursing
homes, although the bill still requires DHFS to consider a sampling of nursing homes
in determining payment. The bill eliminates the limitation on the amount by which
DHFS may reduce final capital costs payment of a nursing home. The bill revises the
standard for payment for net property taxes or municipal services to limit the
payment to actual previous costs, subject to a maximum determined by DHFS.
Under current federal law, with certain exceptions, states are permitted to
require an individual who is eligible for MA to enroll in a managed care plan
(generally a health maintenance organization, or HMO) rather than receiving
services under the traditional fee-for-service system. Federal law prohibits states
from requiring a child who is in foster care to enroll in a managed care plan as a
condition of receiving MA.
This bill authorizes DHFS to request a waiver from the secretary of the federal
department of health and human services to permit DHFS to require children in
foster care to enroll in a managed care plan as a condition of receiving MA. If the
waiver is granted and in effect, the bill permits DHFS to implement the waiver.
This bill requires DHFS to request a waiver from the secretary of the federal
department of health and human services to permit DHFS to cover under MA clinical
evaluation services for certain persons with HIV. The bill limits coverage to $500 per
year per person.
Currently, DHFS must annually submit to JCF a report on nursing home bed
utilization by MA recipients for the previous year. If the report indicates that the
utilization has decreased, DHFS must include a proposal to transfer funds from the
MA appropriation account to the COP appropriation account for expenditure for
noninstitutional long-term support services.
This bill provides that the transfer of funds from MA to COP may not reduce
the MA appropriation account balance below the amount necessary to ensure that
the appropriation account will end the current fiscal year or the current fiscal
biennium with a positive balance. The bill requires that DHFS's report to JCF
include a discussion and detailed projection of the likely balances, expenditures,
encumbrances and carry-over of currently appropriated amounts in the MA
appropriation accounts.
Currently, MA recipients may obtain coverage for inpatient hospital services
and outpatient services for treatment of alcohol or other drug abuse. This bill
provides that MA recipients may receive, until July 1, 2003, residential treatment
services for alcohol and other drug abuse, limited to 45 days of treatment services per
treatment episode. The benefit may be provided only in a facility of fewer than 16
beds in a county, city, town or village that elects both to become certified as a provider
of the services, or to contract with a certified provider to provide the services, and to
pay the amount of the allowable charges for the services under the MA program that
is not provided by the federal government.
Under current law, dental services are provided to MA recipients on a
fee-for-service basis or under some form of managed care, such as through
enrollment by a recipient in a health maintenance organization that provides dental
services. This bill increases the amount paid under the MA program for dental
services providers who provide services on a fee-for-services basis.
Currently, DHFS annually may distribute no more than $2,256,000 of MA
moneys as supplements to rural hospitals that, compared to other rural hospitals,
have a high utilization of inpatient services by persons whose care is provided from
governmental sources. This bill authorizes DHFS to distribute the supplements of
MA moneys also to critical access hospitals. A critical access hospital is a hospital
that DHFS determines meets specific federal medicaid requirements and has
specific federal certification.
Under current law, at the request of DHFS, health insurers must provide
information to enable DHFS to identify MA recipients who are eligible, or who would
be eligible as dependents, for health insurance coverage. This bill authorizes DHFS
to provide any information that it receives from a health insurer to DWD. The two
departments must agree on procedures to safeguard the confidentiality of the
information.
Currently, DHFS is authorized to provide enhanced reimbursement under CIP
for a person who was relocated to the community from an intermediate care facility
for the mentally retarded that closes. This bill additionally authorizes DHFS to
provide enhanced reimbursement under CIP for a person who is relocated to the
community from an intermediate care facility for the mentally retarded, or a distinct
part of the facility, that has a DHFS-approved plan of closure and that intends to
close within 12 months.
Children
Under current law, DHFS awards grants for various programs relating to youth
alcohol and other drug abuse, adolescent pregnancy and other adolescent services.
These programs include a neighborhood drug use and violence prevention program,
a community alcohol and other drug abuse prevention program, a drug prevention
program for Milwaukee public high school athletes, an adolescent self-sufficiency
program, an adolescent pregnancy prevention program, an adolescent resource
center in Milwaukee, a minority adolescent parenting skills program in Milwaukee
and an adolescent choices project.
This bill eliminates all of these programs. The bill directs DHFS to award
grants to public and private organizations operating in Milwaukee County; county
departments of human services, social services, community programs or
developmental disabilities services operating in counties other than Milwaukee
County; and federally recognized American Indian tribes or bands in this state to
provide programs to prevent and reduce the incidence of youth violence and other
delinquent behavior, youth alcohol and other drug use and abuse, nonmarital
pregnancy and child abuse and neglect; to increase the use of abstinence as a method
of preventing nonmarital pregnancy; and to increase adolescent self-sufficiency by
encouraging high school graduation, vocational preparedness, improved social and
other interpersonal skills and responsible decision making. The bill requires DHFS
to provide a set of benchmark indicators to measure the outcomes that are expected
of a program receiving a grant and permits DHFS to renew a grant only if the
recipient shows improvement on those indicators.
Under current law, an agency that is responsible for investigating reports of
suspected or threatened child abuse or neglect must determine, within 60 days after
receipt of such a report, whether abuse or neglect has occurred or is likely to occur.
Currently, there is no procedure for appealing that determination. This bill provides
that if such a determination contains a finding that a specific person has abused or
neglected a child, that person may appeal that finding in accordance with procedures
established by DHFS.
