This bill provides that DHFS may also recover MA overpayments that resulted
from the failure of a recipient to report changes in status that would have affected
the recipient's eligibility for benefits or his or her cost-sharing requirements. The
bill provides that DHFS may recover BadgerCare overpayments for the same
reasons for which DHFS may recover MA overpayments.
The bill also provides that if an MA or BadgerCare recipient fails to repay the
overpaid amount, DHFS may bring an action to enforce repayment or issue an order
to compel repayment. This bill provides for the recovery of overpayments through
a state income tax refund setoff process.
Under current law, the Community Aids Program (CAP) is funded from state
general purpose revenues and federal block grant moneys; under it, DHFS
distributes moneys to county departments of social services, human services,
community programs, and developmental disabilities services for community social,
mental health, developmental disabilities, and alcohol and other drug abuse services
and certain other services. Until January 1, 2006, DHFS may, from general purpose
revenues for CAP, pay for certain MA services provided by the county departments
and by local health departments and pay providers of MA personal care, home
health, and respiratory care services. This bill eliminates the January 1, 2006,
sunset on these payments.
Under current law, during 2006, DHFS must make payments from the MA
trust fund to hold county departments and local health departments harmless for the
elimination, from July 26, 2003, to January 1, 2006, of the community services deficit
reduction benefit (CSDRB), under which counties and local health departments
could claim federal Medicaid matching funds to cover costs for MA services provided
that were not fully reimbursed. This bill eliminates that requirement, authorizes
payments from the general purpose revenues for CAP to city health departments for
this purpose, and eliminates the recommencement of CSDRB.
Current law prohibits DHFS from reimbursing a provider for certain elective
surgical procedures under MA unless the patient receives a second medical opinion
regarding the appropriateness of the procedure. This bill eliminates the
requirement for second medical opinions for elective surgical procedures under MA.
Under current law, as a benefit under MA, DHFS pays the charge for
transportation by an emergency medical vehicle to obtain emergency medical care
and transportation by a specialized medical vehicle or, if first approved by the county
department of human services or social services (county department), by a common
carrier or private motor vehicle to obtain nonemergency medical care. Under the bill,
DHFS pays on behalf of an MA recipient the charge for transportation by an
emergency medical vehicle to obtain emergency medical care and to obtain
nonemergency medical care if transportation by other means is contraindicated.
Otherwise, DHFS pays the charge for transportation to obtain nonemergency
medical services only if it is provided through an entity with which DHFS has
contracted to manage transportation services for MA.
Under BadgerCare, a child or family with an income of at least 150 percent of
the federal poverty level is required to contribute up to 5 percent of income to the cost
of the health care, including a copayment of $1 for each prescription for a generic
drug and a copayment of $3 for each prescription for a brand name drug.
This bill directs DHFS to request one or more waivers from the federal
Department of Health and Human Services to implement cost-saving measures
under BadgerCare that may include: 1) a three-tiered prescription drug copayment
requirement that does not exceed the maximum copayment amount established by
the Group Insurance Board for state employees; 2) a benchmark plan, which is
described in federal regulations as health care coverage that is substantially equal
to the health care coverage offered to federal or state employees or to a health
insurance plan offered by a health maintenance organization that has the largest
commercial enrollment in the state of persons who do not have coverage under; and
3) mandatory copayments for benefits in addition to the copayments for prescription
drugs.
Also under current law, when an MA recipient or a person with coverage under
BadgerCare or SeniorCare, which provides prescription drug assistance for
low-income elderly persons, purchases a prescription drug, he or she pays a
copayment and then DHFS reimburses the pharmacy an amount that is based on a
national average wholesale price, plus a percentage or amount for a dispensing fee.
Under this bill, DHFS must investigate alternatives to using this methodology for
reimbursement for brand name drugs purchased or dispensed under MA,
BadgerCare, and SeniorCare, and must report its findings, conclusions, and
recommendations to DOA.
Currently under CIP, MA recipients who reside in state centers for the
developmentally disabled or other institutions or who meet certain levels of care are
relocated into their communities and provided home and community-based services
by counties. DHFS reimburses the counties. Counties may not use the money to
purchase land or construct buildings. This bill permits counties to use the moneys
to purchase land or construct buildings if the purchase or construction is determined
necessary by DHFS.
Public assistance
Under current law, DHFS administers a number of public assistance programs
under which eligible persons receive financial, health care, or other types of
assistance. This bill authorizes DHFS to recover benefits incorrectly paid under any
of these assistance programs, and provides that DHFS may recover overpayments
by reducing the benefits of a family or individual who received the overpayments and
who is still receiving benefits. The bill authorizes DHFS to specify by rule other
methods for recovering incorrectly paid benefits, and provides for recovery of these
incorrectly paid benefits through a state income tax refund setoff process.
Current law directs DWD to investigate suspected fraud on the part of
participants in the Aid to Families with Dependent Children (AFDC) Program and
participants in the Wisconsin Works (W-2) Program and to reduce payment errors
in W-2. DHFS may contract with DWD for DWD to investigate suspected fraud and
to conduct activities to reduce payment errors under MA and the food stamp
program, both of which DHFS administers.
Under the bill, DHFS must investigate suspected fraud and reduce payment
errors in the programs that it administers, and DWD may contract with DHFS for
DHFS to investigate suspected fraud and conduct payment error reduction activities
in the programs that DWD administers. In addition, the bill adds three
DHFS-administered programs to the programs for which fraud must be investigated
and payment error reduction activities must be conducted: BadgerCare, the
program under which DHFS provides state supplemental payments to persons
eligible to receive supplemental security income (SSI), and the program under which
DHFS makes monthly payments for the support of dependent children to custodial
parents who are receiving SSI or state supplemental payments.
Under current law, DHFS contracts with county departments, and may
contract with American Indian tribal governing bodies, to administer MA,
BadgerCare, the food stamp program, and the cemetery, funeral, and burial expenses
program, known collectively as "income maintenance" programs, and reimburses the
county departments and tribal governing bodies for their costs of administering
those programs.
This bill provides that DHFS, a county department, or a tribal governing body
may request from any person information that is appropriate and necessary for
determining or verifying eligibility or benefits for a recipient under any of the income
maintenance programs. A person who receives a request for information must
provide the information. The bill also authorizes DHFS, a county department, or a
tribal governing body to compel production of evidence for determining or verifying
eligibility or benefits for an income maintenance program recipient, and prohibits
DHFS, a county department, or a tribal governing body from disclosing, for any
purpose not connected with administration of the income maintenance program,
information obtained as a result. In addition, the bill provides that no person is liable
for allowing access to information in response to a request from DHFS, a county
department, or a tribal governing body or for any other action taken in good faith to
comply with such a request.
Under current law, DHFS reimburses pharmacists and pharmacies for
prescription drugs purchased by persons enrolled in SeniorCare. The
reimbursement rate is equal to 105 percent of the prescription drug reimbursement
rate under MA, plus a dispensing fee, and minus a copayment paid by the SeniorCare
enrollee. This bill reduces the reimbursement rate under SeniorCare to 100 percent
of the prescription drug reimbursement rate under MA, plus the dispensing fee, and
minus the copayment.
Under current law, for each fiscal year DWD allocates moneys, including
federal Child Care Development Funds (CCDF) and federal moneys received under
the federal Temporary Assistance for Needy Families (TANF) block grant program,
for various public assistance programs and for child care-related purposes. This bill
sets the amounts of these allocations for fiscal years 2005-06 and 2006-07 and adds
an allocation to pay for a share of the costs of a mail-order lending library and
information center operated by DPI's Division for Libraries, Technology, and
Community Learning. The bill eliminates an allocation for grants for developing
early childhood centers for providing outreach and training for parents and training
for child care providers, and eliminates the program.
Under current law, county departments pay cemetery, funeral, and burial
expenses for decedents who received certain public assistance benefits and whose
estates are insufficient to pay those expenses. DHFS must reimburse the county
departments for those payments. This bill provides that DHFS must reimburse the
county departments for those payments only to the extent that funds are available
for this purpose.
This bill appropriates moneys to DWD from recovered overpayments and
incorrect or disallowed payments and voluntary repayments of federal CCDF block
grant moneys, federal TANF block grant moneys, and state moneys paid to meet the
maintenance-of-effort requirements under those two federal block grant programs.
The federal block grant moneys and state maintenance-of-effort moneys are used
for various public assistance programs. The appropriation may be used for the
recovery costs, activities to reduce errors in W-2 and the child care subsidy program,
and any of the other purposes for which CCDF and TANF moneys are used.
Wisconsin Works
Under current law, a person who is eligible for W-2 and who is the custodial
parent of a child who is not more than 12 weeks old may receive a monthly grant of
$673 and may not be required to work in a W-2 employment position. Current law
also provides generally that the period during which one receives a monthly grant
as the custodial parent of an infant counts toward the limits that apply to the period
during which an individual may receive certain benefits only if the child was born
more than ten months after the date on which the individual was first determined
to be eligible for W-2.
Under the bill, a custodial parent of a child who is not more than 26 weeks old
may receive the monthly grant. The custodial parent is not required to work in a W-2
employment position only if the child is not more than 12 weeks old. In addition, the
bill provides that an unmarried woman who would be eligible for W-2 except that
she is not a custodial parent, and who is in the third trimester of a medically verified
pregnancy that is at risk and renders the woman unable to participate in the
workforce, may also receive a monthly grant of $673 and not be required to work in
a W-2 employment position. Under the bill, the period during which one receives a
monthly grant as the custodial parent of an infant counts toward the limits that
apply to the period during which an individual may receive certain benefits
regardless of when the child was born in relation to when the individual was first
determined to be eligible for W-2. If a pregnant woman who is not a custodial parent
receives a monthly grant, however, the period does not count.
Current law directs DWD to continue the creation and implementation of a
subsidized work program under W-2. This bill eliminates this directive and instead
requires DWD to conduct, from January 1, 2006, to June 30, 2007, a pilot project for
a trial jobs plus program. The pilot project must be limited to 1,000 participants and
must be conducted in at least one of the geographical areas established for
administering the W-2 program that is located in Milwaukee County and in at least
two of those geographical areas that are not in Milwaukee County. Under the project,
a W-2 agency pays a wage subsidy, as well as a reimbursement of up to 100 percent
of federal social security taxes, state and federal unemployment contributions, and
worker's compensation insurance premiums, to an employer that employs a project
participant and that agrees to make a good faith effort to retain the participant as
an unsubsidized employee after the wage subsidy ends if the participant completes
the trial job plus. The wage subsidy may not exceed the federal minimum wage for
up to 30 hours of work per week, and any required training activities are counted
toward the participant's work hours. An individual may participate in a trial job plus
for up to six months, with a possible three-month extension.
Under current law, DWD makes job access loans to persons who are eligible for
W-2 and who need such loans to obtain or continue employment. The loans are
funded with federal TANF block grant moneys, general purpose revenue, and job
access loan repayments. This bill eliminates the federal moneys and the general
purpose revenue as funding for job access loans, and provides that job access loan
repayments may be used for administrative costs associated with collecting
delinquent job access loan repayments as well as for job access loans.
Under current law, a child care subsidy is available under W-2 to an individual
who needs child care to maintain employment or pursue basic or technical college
education. Under this subsidy program, DWD reimburses child care providers
directly and distributes funds to county departments and American Indian tribal
governing bodies for child care services. County departments are required to set
maximum reimbursement rates for child care providers under the subsidy program.
This bill authorizes DWD to establish a tiered reimbursement system for the
child care subsidy program, under which the amount that a child care provider would
be reimbursed is based on a child care quality rating system established by DWD.
The amount paid to a child care provider under the tiered reimbursement system
may exceed the maximum reimbursement rate set by the county department.
This bill changes the procedure for collecting benefits that were overpaid under
W-2. Under current law, DWD semiannually pays fees to the clerk of circuit court
for filing warrants constituting liens on the real and personal property of overpaid
persons but pays fees for filing satisfactions, releases, or withdrawals of warrants
when those documents are filed. The bill makes the payment of filing fees for
satisfactions, releases, and withdrawals of warrants semiannual also.
Under current law, DWD must issue and file a notice of withdrawal of a warrant
if a person who received an overpayment complies with a payment schedule
arranged with DWD. This bill makes the issuing and filing of a notice of withdrawal
discretionary with DWD.
Under current law, a levy against the property of a person who received an
overpayment is effective until it is satisfied or released, or until one year from the
date the levy was served, whichever occurs first. Also, any third party in possession
of property subject to levy, such as a financial institution at which an overpaid person
has an account, is entitled to deduct a levy fee of $5 from the proceeds of the levy.
This bill eliminates the one-year time limit so that a levy is effective until satisfied
or released, and provides that, if a third party retains a levy fee, the third party must
increase the amount of the levy by the fee amount before deducting the fee from the
proceeds.
Children
Under current law, the court assigned to exercise jurisdiction under the
Children's Code (juvenile court) may appoint a relative of a child as his or her
guardian if the juvenile court makes certain findings, including a finding that the
child has been adjudged to be in need of protection or services and has been placed
outside of his or her home under an order of the juvenile court for one year or longer.
This bill permits any person, not just a relative, to be appointed as the guardian
of a child who has been adjudged to be in need of protection or services. The bill also
eliminates the one-year waiting period and permits a child who has been adjudged
to be in need of protection or services or whose parents' parental rights have been
terminated to be placed directly in the home of a guardian without first having been
placed in another out-of-home placement. In addition, the bill permits the parental
rights of a parent of a child in need of protection or services for whom a guardian has
been appointed to be terminated on the grounds of abandonment if, when the
juvenile court appointed the guardian, the juvenile court provided the parent with
notice of any grounds for termination of parental rights that may be applicable and
of the conditions necessary for the child to be returned home and the parent has
failed to communicate with the child for at least three months.
Currently, a relative who is appointed as the guardian of a child in need of
protection or services and who meets certain other requirements is eligible to receive
long-term kinship care payments of $215 per month for providing care and
maintenance for the child. This bill permits a county department or, in Milwaukee
County, DHFS to provide monthly subsidized guardianship payments to a person
who is appointed as the guardian for a child in need of protection of services, was the
licensed foster parent or treatment foster parent of the child before that
appointment, has passed a home inspection and criminal background investigation,
and has entered into a subsidized guardianship agreement with the county
department or DHFS. The bill also permits a county department or DHFS, upon the
death, incapacity, resignation, or removal of the subsidized guardian, to provide
monthly subsidized guardianship payments for a period of up to 12 months to an
interim caretaker who has passed a home inspection and criminal background
investigation.
Under the bill, the amount of a monthly subsidized guardianship payment is
equal to the amount of the monthly foster care or treatment foster care payment
received by the guardian immediately before the guardianship order was granted.
In addition, a subsidized guardian who meets the applicable eligibility requirements
is eligible for adoption assistance and for a child care subsidy under W-2 and a child
who is in the care of a subsidized guardian and who meets the applicable eligibility
requirements is eligible for MA.
Under current law, DHFS administers a child abuse and neglect prevention
program under which DHFS awards grants to counties and Indian tribes that offer
voluntary home visitation services to first-time parents who are eligible for MA.
Current law requires DHFS to determine the amount of a grant awarded to a county
or an Indian tribe in excess of the statutory minimum grant amount of $10,000 based
on the number of births that are funded by MA in that county or the reservation of
that Indian tribe in proportion to the number of those births in all of the counties and
the reservations of all of the Indian tribes to which grants are awarded. Currently,
no more than six rural counties, three urban counties, and two Indian tribes may
participate in the program.
This bill requires DHFS to determine the amount of a grant in excess of the
statutory minimum based on the number of births that are funded by MA in a county
or a reservation of an Indian tribe without regard to the number of those births in
other counties and reservations. The bill also eliminates the caps on the number of
counties and Indian tribes that may participate in the program.
In addition, the bill directs DHFS to award grants to applying county
departments, local health departments, Indian tribes, private nonprofit agencies,
and local partnerships to provide voluntary, onetime home visits to all first-time
parents in the community served by the organization. The purposes of the home
visits are to provide the parents with basic information regarding infant health and
nutrition, the care, safety, and development of infants, and emergency services for
infants; to identify the needs of the parents; and to provide the parents with referrals
to programs, services, and other resources that may meet those needs.
Under current federal law, the state receives payments under Title IV-B of the
federal Social Security Act (Title IV-B) for child and family services and under Title
IV-E of the federal Social Security Act (Title IV-E) for foster care and adoption
assistance. The state is required to have state plans that meet the requirements of
the titles, and the programs administered by the state under these titles must be in
substantial conformity with the state plan requirements. If the programs are not in
substantial conformity, federal law requires a certain percentage of Title IV-B and
Title IV-E funds to be withheld from the state. Federal law also requires the state
to implement a corrective action plan to achieve substantial conformity and requires
the federal Department of Health and Human Services to suspend the withholding
of the funds while the corrective action plan is in effect.
This bill appropriates general purpose revenues to DHFS to achieve
substantial conformity with the state plan requirements of Title IV-B and Title
IV-E.
Under current law, information received by DHFS, DOC, a county department,
or a licensed child welfare agency (collectively "agency") about an individual who is
in the care or legal custody of the agency is confidential and may not be disclosed
except under certain conditions. Similarly, treatment records concerning an
individual who has received services for mental illness, developmental disabilities,
alcoholism, or drug dependence that are maintained by DHFS, a county department,
or a treatment facility are confidential and may be released without the informed
consent of the subject of the record only under certain circumstances.
This bill permits an agency to enter information received about an individual
in its care or legal custody, and a person maintaining treatment records to enter
information concerning the subject of the record, into the statewide automated child
welfare information system (WISACWIS). The bill also permits DHFS, DOC, a
county department, or any other organization that has entered into an information
sharing and access agreement with DHFS, DOC, or a county department and that
has been approved for access to WISACWIS by DHFS to have access to information
concerning a client that is maintained on WISACWIS if access is necessary to enable
DHFS, DOC, the county department, or other organization to perform its duties or
to delivery services to a client.
This bill transfers from DHFS to DWD the authority to license day care centers,
to promulgate rules establishing minimum requirements for day care center
licensure and minimum standards for day care center operation, to inspect and
investigate day care centers, and to impose sanctions and penalties for operating a
day care center without a license or for violating a provision of day care center
licensure or a minimum standard for the operation of a day care center.
This bill requires DWD to provide a child care quality rating system for child
care providers licensed by DWD, certified by a county department for reimbursement
under W-2, or established or contracted for by a school board. The rating
information must be made available, including on DWD's Internet site, to parents,
guardians, and legal custodians of children who are recipients, or prospective
recipients, of care and supervision from a child care provider.
This bill increases the age-related basic maintenance rates that are paid by the
state or a county department to a foster parent for the care and maintenance of a
child.
This bill permits DHFS or a county department to recover an overpayment of
foster care, treatment foster care, kinship care, long-term kinship care, subsidized
guardianship, or adoption assistance payments by reducing future payments. The
bill also permits DHFS to specify by rule other methods for recovering those
payments.
Under current law, $340,000 in federal TANF block grant moneys is transferred
from DWD to the Child Abuse and Neglect Prevention Board (CANPB) in each fiscal
year. This bill eliminates this transfer and instead appropriates general purpose
revenues to the CANPB to award grants to organizations for the establishment of
child abuse and neglect prevention programs, early childhood family education
centers, and right from the start projects.
Under current law, the Office of Justice Assistance in DOA provides $185,000
annually to DHFS for grants for children's community programs, including grants
to the Career Youth Development Center in Milwaukee, the Milwaukee Police
Athletic League, court-appointed special advocate programs, and the Children's
Safe House Child Care Program in Kenosha County. This bill eliminates these
grants.
Health
Under current law, DHFS must establish minimum standards for, register, and
otherwise regulate sanitarians, who apply environmental control measures under
the public health laws to prevent and control preventable diseases. This bill
transfers the duty to regulate sanitarians from DHFS to DRL.
Under current law if DHFS is notified that a child under six years of age has
an elevated blood lead level, DHFS must ensure that an investigation is conducted
of the dwelling where the child resides and any educational or child care facility the
child attends. DHFS may investigate a dwelling or educational or child care facility
if a child under six years of age who resides in the dwelling or attends the facility has
blood lead poisoning or lead exposure. If DHFS determines that a lead hazard is
present in the dwelling or educational or child care facility, DHFS may take a variety
of actions, including, notifying the owner or ordering the owner to reduce or
eliminate the hazard. If DHFS notifies an owner of a dwelling that a child under six
years of age who resides in the dwelling has an elevated blood lead level, the owner
must obtain either a certificate of lead-free status or a certificate of lead-safe status
for the dwelling. DHFS may not authorize the issuance of successive certificates of
lead-safe status valid for less than 12 months unless the applicant shows a special
need for such a certificate. DHFS must maintain a statewide registry of all issued
certificates of lead-free or lead-safe status.
This bill provides that if DHFS determines that a lead hazard is present in a
child's dwelling or in an educational or child care facility, the local health department
must issue, and DHFS may issue, an order requiring the owner of the premises to
reduce or eliminate the lead hazard. The bill eliminates the requirement that the
owner of a dwelling obtain a certificate of lead-free or lead-safe status if DHFS
notifies the owner that a child under six years of age who resides in the dwelling has
an elevated blood lead level.
Under current law, DHFS funds certain preventive health care services for
low-income, underinsured, and uninsured women under the Well-Woman Program.
Current law requires that DHFS charge women whose income exceeds 150 percent
of the federal poverty line a copayment for breast cancer screenings provided under
the Well-Woman Program.
This bill eliminates the copayment for breast cancer screenings under the
Well-Woman Program but provides that women whose income exceeds 250 percent
of the federal poverty line are not eligible for breast cancer screenings under the
program. The bill also allows DHFS to reimburse providers for case management
services under the Well-Woman Program.
Under current law, DHFS makes grants to entities, including technical
colleges, to provide training programs and administer examinations that fulfill the
emergency medical technician — basic licensure and relicensure requirements. This
bill directs DHFS to provide the emergency medical technician — basic training and
examination funding directly to ambulance service providers rather than to the
entities that provide the training and administer the examinations. The bill requires
ambulance service providers to report to DHFS on expenditures of the funds as a
condition of relicensure and requires the Emergency Medical Services Board to
recommend a formula for disbursing the funds among ambulance service providers.
Mental illness and developmental disabilities
Under current law, annually DHFS may allocate funds to public or nonprofit
private entities to provide mental health services to homeless individuals with
chronic mental illness. This bill transfers to the Department of Commerce the
program to provide mental health services to homeless individuals with chronic
mental illness.
This bill requires DHFS to award grants to organizations in fiscal years
2005-06 and 2006-07 to provide screening, assessment, and treatment for female
prisoners and offenders from Milwaukee County who have committed nonviolent
crimes, to assist in community reintegration, and to provide at-risk assessments and
support services for the dependent children of the prisoners and offenders.
The bill also requires DHFS, during the 2005-07 fiscal biennium, to award
grants to counties with populations of less than 500,000 and to tribal governing
bodies in the counties to promote collaboration among county departments and tribal
agencies for the mental health and substance abuse screening, assessment, and
treatment of abused and neglected children and their parents.
Under the current Guardianship Grant Program, DHFS annually awards
grants to private, nonprofit agencies and county departments for the purposes of
recruiting, training, monitoring, and assisting guardians for persons who are
adjudicated incompetent. This bill eliminates the requirement that grant recipients
recruit individuals or organizations to act as guardians and monitor their
performance and eliminates community need for guardians as a basis for awarding
grants.
Under current law, DHFS must distribute federal funds to phase in initial
recovery-oriented mental health system changes, strategies for prevention and
early intervention, and consumer and family involvement for individuals with
mental illness. DHFS must eliminate funding for each grant recipient after three
years and must require that community mental health services developed under a
grant are continued by use of savings made available from strategies developed
under the grant. This bill eliminates the latter two requirements.
Under current law, DHFS annually must reduce by $500,000 the amount by
which accumulated expenses of providing care for patients of the state mental health
institutes exceed the revenues received for providing that care until the expenses are
in balance with the revenues. DHFS also must implement a plan to assure that
revenues are sufficient to cover anticipated expenditures for providing care for
mental health institute patients and report to DOA every three months concerning
implementation of the plan. DHFS must report to JCF annually the amount of
expenses that exceed revenues and the actions of DHFS to reduce those expenses.
This bill eliminates all of these requirements.
Other health and human services
Under the current Domestic Abuse Grants Program, DHFS awards grants to
organizations that provide various types of domestic abuse services. This bill
requires DHFS to award a grant of $563,500 in each fiscal year to the Refugee Family
Strengthening Project for providing domestic abuse services to the refugee
population, including the cost of hiring bilingual staff persons, especially those who
speak Hmong.
Currently, DHFS administers Family Care, a program that provides a flexible
long-term care benefit called the family care benefit. A person must be at least 18
years of age, meet functional and financial eligibility requirements, and have a
physical disability, a developmental disability, or infirmities of aging to qualify for
the family care benefit. Currently, the family care benefit is an entitlement for
certain persons who are eligible for MA. By January 1, 2006, DHFS must extend
entitlement to certain persons who are not MA eligible. This bill delays this
requirement until January 1, 2008.
The Health Insurance Risk-Sharing Plan (HIRSP) under current law provides
major medical health insurance coverage for persons who are covered under
Medicare because they are disabled; persons who have tested positive for human
immunodeficiency virus (HIV); persons who have been refused coverage, or coverage
at an affordable price, in the private health insurance market because of their mental
or physical health condition; and persons who do not currently have health insurance
coverage, but who were covered under certain types of health insurance coverage for
at least 18 months in the past. Specifically excluded from coverage under HIRSP are
persons who are eligible for coverage under MA.
This bill provides that persons who are eligible for only certain limited services
provided under MA are not ineligible for HIRSP coverage solely because of their
eligibility for those MA services.
The bill also specifically provides that persons who are eligible for the following
programs or benefits are ineligible for HIRSP coverage: BadgerCare; a program
providing long-term care for children with disabilities and their families, including
in-home habilitation services for children with autism spectrum disorders; the
community integration programs (known as "CIP IA," "CIP IB," and "CIP II"); the
waiver program under the Long-Term Support Community Options Program
(known as "COP-Waiver"); the Program for All-inclusive Care for the Elderly
(known as PACE); the Wisconsin Partnership Program (known as Partnership); and
medical assistance provided under the Family Care Program.
Under current law, a person with coverage under HIRSP (called an "eligible
person") who is not covered under Medicare pays a deductible under HIRSP that
ranges from $500 to $2,500, an eligible person with Medicare coverage pays a
deductible that is equal to the deductible under part A of Medicare. Current law also
provides that HIRSP pays at least 80 percent of an eligible person's covered costs
after those costs exceed the person's deductible, and pays 100 percent of covered costs
after the aggregate of covered costs not paid by HIRSP and the deductible exceeds
$2,000 for an eligible person not covered under Medicare and $500 for an eligible
person covered under Medicare. Currently, however, the deductible under part A of
Medicare exceeds $500. Thus, under the law, HIRSP begins paying 100 percent of
covered costs incurred by an eligible person covered under Medicare before the
person has paid the deductible.
This bill corrects this inconsistency and provides that HIRSP pays 100 percent
of covered costs for an eligible person covered under Medicare after the covered costs
exceed the lesser of $2,000 or the person's deductible, which is equal to the deductible
under part A of Medicare.
Under current law, HIRSP payment rates for prescription drugs are the same
as payment rates under MA. This bill allows DHFS, with the approval of the HIRSP
Board of Governors, to set HIRSP prescription drug payment rates.
Current law authorizes DHFS to establish, for prescription drug coverage,
copayment amounts, coinsurance rates, and copayment and coinsurance
out-of-pocket limits over which HIRSP pays 100 percent of the covered costs
incurred by the covered person during the remainder of the calendar year. This bill
allows DHFS to establish a three-tiered copayment structure for prescription drug
benefits. The bill allows DHFS to establish the out-of-pocket limit for prescription
drug coverage at $300 for persons who are also covered under Medicare and at $300
or $400 for other covered persons, depending on coverage selected. The bill allows
DHFS to provide that only certain copayment amounts count toward the
out-of-pocket limit.
Under current law, DHFS may request from health insurers information to
enable DHFS to identify MA beneficiaries who are eligible, or who would be eligible
as dependents, for health insurance coverage. An insurer that receives a request
must provide the information. Under this bill, DHFS must provide any information
that it receives from a health insurer to DWD for purposes of DWD's program related
to child and spousal support, paternity establishment, and medical support liability.
DWD may allow county and tribal child support agencies access to the information,
subject to use and disclosure restrictions under current law, and must consult with
DHFS regarding procedures to safeguard the confidentiality of the information.
Currently, DHFS and certain providers of direct care or treatment services
must conduct background checks of caregivers. DHFS may charge a background
check fee, which may not exceed the reasonable costs of conducting the background
check. The revenue from these fees along with revenue from other licensing and
regulatory fees are appropriated to DHFS for its licensing and regulatory activities.
This bill eliminates the reasonable cost restriction on the amount of
background check fees. The bill also authorizes DHFS to use revenue from
background check, licensing, and regulatory fees to investigate abuse, neglect, or
misappropriation by caregivers.
Currently, direct care and treatment providers who are subject to the
background check requirement may not employ or contract with a caregiver who has
been convicted of a serious crime. If a caregiver is not a Wisconsin resident or resided
outside Wisconsin before serving as a caregiver, the provider may request that the
caregiver provide fingerprints for a search of criminal history records maintained by
the Federal Bureau of Investigation (FBI). A provider may share criminal history
information concerning a caregiver with other providers.
This bill provides that if a direct care and treatment provider obtains
information from the FBI regarding a caregiver's arrest or conviction record, the
provider may use the information only to determine whether the caregiver is
disqualified from serving as a caregiver. (A provider may still share criminal history
information concerning a caregiver with other providers.) The bill grants to a
provider immunity from civil liability for using arrest and conviction information
provided by the FBI to make an employment determination regarding the caregiver.
The limitation on the use of arrest and conviction information and the civil liability
immunity provision apply only to information that a provider requests from the FBI
before September 30, 2007.
This bill authorizes DHFS, upon the request of a county board, to assist in
recruiting and training people to provide personal care services. Personal care
services are medically oriented activities that assist a person with activities of daily
living, such as assistance with bathing, toileting, skin care, and meal preparation.
Under current law, the state registrar or a local registrar must charge $12 for
issuing a copy of a birth certificate. Of this sum, $7 is appropriated to the Child Abuse
and Neglect Prevention Board (CANPB) for CANPB expenses, for the Early
Childhood Family Education Center Grant Program, for technical assistance, and
for grants to organizations for services related to child abuse and neglect. This bill
increases the fee for issuance of a copy of a birth certificate to $15, and appropriates
$9 to CANPB.
Under current law, for the filing of a birth certificate more than 365 days after
the birth, the state registrar must charge $20 plus a fee of $5 for issuance of the birth
certificate. This bill increases the latter fee from $5 to $15, and appropriates $9 to
CANPB.
Under current law, DHFS makes two-year loans to establish programs to
provide housing for groups of persons who are recovering from alcohol or other drug
abuse. This bill eliminates this loan program.
local government
This bill creates levy limits that apply to cities, villages, towns, and counties
(political subdivisions) for the property tax levies that are imposed in December 2005
and 2006. Generally, the bill prohibits a city, village, or town from increasing its levy
by a percentage that exceeds the sum of 60 percent of the percentage change in the
equalized assessed value of new construction located in the region in which the city,
village, or town is located plus the rate of inflation. The bill generally prohibits a
county from increasing its levy by a percentage that exceeds the sum of 60 percent
of the percentage change in the equalized assessed value of new construction located
in the county plus the rate of inflation.
This bill provides adjustments to the levy limit for political subdivisions that
transfer the provision of services, for cities or villages that annex town territory, and
for a county levy that relates to a county Children with Disabilities Education Board.
The levy limit may be exceeded if a political subdivision's governing body adopts a
resolution to do so and the resolution is approved in a referendum. A town with a
population of less than 2,000 may exceed the levy limit if a resolution to do so is
approved by the electors at an annual or special town meeting.
Under the bill, a political subdivision's levy limit does not generally apply to any
amount levied to pay debt service or to the amount that a first class city (presently
only Milwaukee) levies for school purposes. Currently, a first class city school district
is not authorized to levy a tax; the city in which the school district is located levies
a tax for school purposes.
Under the current Expenditure Restraint Program, the state makes an annual
payment to any municipality that has a property tax rate greater than five mills and
that limits the growth of its municipal budget according to a formula based,
generally, on the sum of 60 percent of the percentage change in the equalized
assessed value of new construction located in the municipality plus the rate of
inflation.
This bill eliminates the Expenditure Restraint Program and replaces it with
the Municipal Levy Restraint Program, under which the state, beginning in 2007,
makes an annual payment to any municipality that has a property tax rate greater
than five mills and that limits its property tax levy to an amount that is no greater
than the maximum allowable levy according to a formula that is based, generally, on
the sum of 60 percent of the percentage change in the equalized assessed value of new
construction located in the region in which the municipality is located plus the rate
of inflation.
This bill creates the County Levy Restraint Program, under which the state
makes an annual payment, beginning in 2007, to any county that limits its property
tax levy to an amount that is no greater than the maximum allowable levy according
to a formula that is based, generally, on the sum of 60 percent of the percentage
change in the equalized assessed value of new construction located in the county plus
the rate of inflation.
Under current law, municipalities may enter into agreements to share
revenues from taxes and special charges with other municipalities and with
federally recognized American Indian tribes or bands if the signatory to an
agreement is contiguous to at least one other signatory. A municipal revenue sharing
agreement must be for a minimum term of ten years, describe the boundaries within
which the revenues are to be shared, and describe the method of determining the
amount of revenues to be shared.
