Amendment MR8 SA1-AB1

LRBb1275/1

ALL:all:jf

March 2008 Special Session

2007 - 2008 LEGISLATURE

SENATE AMENDMENT 1, TO ASSEMBLY BILL 1

March 20, 2008 - Offered by Committee on Finance.

AB1-SA1,1,2 At the locations indicated, amend the bill, as shown by assembly bill 1, as follows:

AB1-SA1,1,3 1. Page 3, line 15: after that line insert:

AB1-SA1,1,4 " Section 1g. 13.101 (18) of the statutes is created to read:

AB1-SA1,1,7 13.101 (18) Notwithstanding sub. (4), the committee may not transfer moneys from the appropriation account under s. 20.435 (4) (xc) to another appropriation account.".

AB1-SA1,1,8 2. Page 4, line 16: after that line insert:

AB1-SA1,1,10 " Section 6m. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table

AB1-SA1,2,1 ".

AB1-SA1,2,3 3. Page 4, line 18: on lines 18 and 20, delete "$20,000,000" and substitute "$55,000,000".

AB1-SA1,2,4 4. Page 4, line 25: after that line insert:

AB1-SA1,2,5 " Section 9ac. 20.435 (4) (gp) of the statutes is repealed.

AB1-SA1, s. 9ad Section 9ad. 20.435 (4) (xc) of the statutes is created to read:

AB1-SA1,2,13 20.435 (4) (xc) Hospital assessment fund; hospital payments and refunds. Biennially, from the medical assessment trust fund, the amounts in the schedule for increased payments and refunds to hospitals and for higher capitated payment rates under s. 49.45 (58) (a), as the Medical Assistance nonfederal share, in order to increase payment rates in excess of the aggregate inpatient and outpatient hospital payment rates in effect in fiscal year 2006-07 for services provided by hospitals under the Medical Assistance program administered under subch. IV of ch. 49.

AB1-SA1, s. 9ae Section 9ae. 20.435 (4) (xd) of the statutes is created to read:

AB1-SA1,3,4 20.435 (4) (xd) Hospital assessment fund; Medical Assistance program benefits. Biennially, from the hospital assessment fund, the amounts in the schedule to provide a portion of the state share of Medical Assistance program benefits administered under subch. IV of ch. 49.

AB1-SA1, s. 9af Section 9af. 20.566 (1) (ho) of the statutes is created to read:

AB1-SA1,3,9 20.566 (1) (ho) Collections under multistate streamlined sales tax project. From moneys collected under the multistate streamlined sales tax project as provided under s. 73.03 (28e), a sum sufficient to pay the dues necessary to participate in the governing board of the multistate streamlined sales tax project.

AB1-SA1, s. 9ag Section 9ag. 20.866 (2) (uur) of the statutes is amended to read:

AB1-SA1,3,15 20.866 (2) (uur) Transportation; state highway rehabilitation projects. From the capital improvement fund, a sum sufficient for the department of transportation to fund state highway rehabilitation projects, as provided under s. 84.95. The state may contract public debt in an amount not to exceed $250,000,000 $300,000,000 for this purpose.

AB1-SA1, s. 9ah Section 9ah. 25.17 (1) (gs) of the statutes is created to read:

AB1-SA1,3,17 25.17 (1) (gs) Hospital assessment fund (s. 25.772);

AB1-SA1, s. 9ai Section 9ai. 25.69 of the statutes, as affected by 2007 Wisconsin Act 20, is amended to read:

AB1-SA1,4,2 25.69 Permanent endowment fund. There is established a separate nonlapsible trust fund designated as the permanent endowment fund, consisting of all of the proceeds from the sale of the state's right to receive payments under the Attorneys General Master Tobacco Settlement Agreement of November 23, 1998, and all investment earnings on the proceeds. There is transferred from the permanent endowment fund to the Medical Assistance trust fund $50,000,000 $68,000,000 in each fiscal year.

AB1-SA1, s. 9aj Section 9aj. 25.772 of the statutes is created to read:

AB1-SA1,4,6 25.772 Hospital assessment fund. There is established a separate nonlapsible trust fund designated as the hospital assessment fund, to consist of all moneys received under s. 50.375 from assessments on hospitals.

AB1-SA1, s. 9ak Section 9ak. 46.27 (9) (a) of the statutes is amended to read:

AB1-SA1,4,16 46.27 (9) (a) The department may select up to 5 counties that volunteer to participate in a pilot project under which they will receive certain funds allocated for long-term care. The department shall allocate a level of funds to these counties equal to the amount that would otherwise be paid under s. 20.435 (4) (b), (gp), or (w), or (xd), to nursing homes for providing care because of increased utilization of nursing home services, as estimated by the department. In estimating these levels, the department shall exclude any increased utilization of services provided by state centers for the developmentally disabled. The department shall calculate these amounts on a calendar year basis under sub. (10).

AB1-SA1, s. 9aL Section 9aL. 46.27 (10) (a) 1. of the statutes is amended to read:

AB1-SA1,4,23 46.27 (10) (a) 1. The department shall determine for each county participating in the pilot project under sub. (9) a funding level of state medical assistance expenditures to be received by the county. This level shall equal the amount that the department determines would otherwise be paid under s. 20.435 (4) (b), (gp), or (w), or (xd), or because of increased utilization of nursing home services, as estimated by the department.

AB1-SA1, s. 9am Section 9am. 46.275 (5) (a) of the statutes is amended to read:

AB1-SA1,5,6 46.275 (5) (a) Medical Assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, Medical Assistance reimbursement is also available for services provided jointly by these counties.

AB1-SA1, s. 9an Section 9an. 46.275 (5) (c) of the statutes is amended to read:

AB1-SA1,5,14 46.275 (5) (c) The total allocation under s. 20.435 (4) (b), (gp), (o), and (w), and (xd) to counties and to the department under sub. (3r) for services provided under this section may not exceed the amount approved by the federal department of health and human services. A county may use funds received under this section only to provide services to persons who meet the requirements under sub. (4) and may not use unexpended funds received under this section to serve other developmentally disabled persons residing in the county.

AB1-SA1, s. 9ao Section 9ao. 46.283 (5) of the statutes is amended to read:

AB1-SA1,5,20 46.283 (5) Funding. From the appropriation accounts under s. 20.435 (4) (b), (bm), (gp), (pa), and (w), and (xd) and (7) (b), (bd), and (md), the department may contract with organizations that meet standards under sub. (3) for performance of the duties under sub. (4) and shall distribute funds for services provided by resource centers.

AB1-SA1, s. 9ap Section 9ap. 46.284 (5) (a) of the statutes, as affected by 2007 Wisconsin Act 20, is amended to read:

AB1-SA1,6,4 46.284 (5) (a) From the appropriation accounts under s. 20.435 (4) (b), (g), (gp), (im), (o), and (w), and (xd) and (7) (b), (bd), and (g), the department shall provide funding on a capitated payment basis for the provision of services under this section. Notwithstanding s. 46.036 (3) and (5m), a care management organization that is under contract with the department may expend the funds, consistent with this section, including providing payment, on a capitated basis, to providers of services under the family care benefit.

AB1-SA1, s. 9aq Section 9aq. 46.485 (2g) (intro.) of the statutes is amended to read:

AB1-SA1,6,11 46.485 (2g) (intro.) From the appropriation accounts under s. 20.435 (4) (b) and (gp) (xd), the department may in each fiscal year transfer funds to the appropriation under s. 20.435 (7) (kb) for distribution under this section and from the appropriation account under s. 20.435 (7) (mb) the department may not shall distribute more than $1,330,500 in each fiscal year to applying counties in this state that meet all of the following requirements, as determined by the department:

AB1-SA1, s. 9ar Section 9ar. 46.513 of the statutes is repealed.

AB1-SA1, s. 9bd Section 9bd. 49.155 (6m) of the statutes is created to read:

AB1-SA1,6,14 49.155 (6m) Authorization for payment. (a) In this subsection:

AB1-SA1,6,15 1. "Certified provider" means a child care provider certified under s. 48.651.

AB1-SA1,6,19 2. "Child care administrative agency" means any agency that has a contract with the department to administer child care funds or any agency that has a subcontract to administer child care funds with an agency that has a contract with the department.

AB1-SA1,6,20 3. "Licensed provider" means a child care provider licensed under s. 48.65.

AB1-SA1,6,22 (b) A child care administrative agency shall authorize payment to child care providers as follows:

AB1-SA1,6,24 1. For a licensed provider, the child care administrative agency shall authorize payment based on authorized units of service, except as follows:

AB1-SA1,7,4 a. The child care administrative agency may authorize payment to a licensed provider based on units of service used by each child, up to the maximum number of authorized units, with the reimbursement rate increased by 10 percent to account for absent days, if the schedule of child care to be used is expected to vary widely.

AB1-SA1,7,8 b. The child care administrative agency may authorize payment to a licensed provider based on units of service used by each child, up to the maximum number of authorized units, if the child care administrative agency has documented 3 separate occasions on which the provider significantly overreported the attendance of a child.

AB1-SA1,7,11 2. For a certified provider, the child care administrative agency shall authorize payment for units of service used by each child, up to the maximum number of authorized units, except as provided in par. (c).

AB1-SA1,7,20 (c) A child care administrative agency may authorize payment to a licensed or certified provider to hold a slot for a child if the child's parent has a temporary break in employment and intends to return to work and to continue to use the services of the provider upon returning to work. The child care administrative agency may authorize payment for no more than 6 weeks if the absence is due to a medical reason and is documented by a physician or for no more than 4 weeks if the absence is due to another reason. The department and child care administrative agency may not consider payment for a temporary absence to be an overpayment if the parent intended to, but does not actually, return to work.

AB1-SA1, s. 9be Section 9be. 49.175 (1) (p) of the statutes, as affected by 2007 Wisconsin Act 20, is amended to read:

AB1-SA1,7,25 49.175 (1) (p) Direct child care services. For direct child care services under s. 49.155, $340,601,800 $359,201,800 in fiscal year 2007-08 and $355,352,000 in fiscal year 2008-09.

AB1-SA1, s. 9bf Section 9bf. 49.45 (2) (a) 17. of the statutes is amended to read:

AB1-SA1,8,6 49.45 (2) (a) 17. Notify the governor, the joint committee on legislative organization, the joint committee on finance and appropriate standing committees, as determined by the presiding officer of each house, if the appropriation accounts under s. 20.435 (4) (b) and (gp) (xd) are insufficient to provide the state share of medical assistance.

AB1-SA1, s. 9bg Section 9bg. 49.45 (5m) (ag) of the statutes is repealed.

AB1-SA1, s. 9bh Section 9bh. 49.45 (5m) (am) of the statutes is amended to read:

AB1-SA1,8,17 49.45 (5m) (am) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall distribute not more than $2,256,000 $5,256,000 in each fiscal year 2007-08 and each fiscal year thereafter, to provide supplemental funds to rural hospitals that, as determined by the department, have high utilization of inpatient services by patients whose care is provided from governmental sources, and to provide supplemental funds to critical access hospitals, except that the department may not distribute funds to a rural hospital or to a critical access hospital to the extent that the distribution would exceed any limitation under 42 USC 1396b (i) (3).

AB1-SA1, s. 9bi Section 9bi. 49.45 (6m) (ag) (intro.) of the statutes, as affected by 2007 Wisconsin Act 97, is amended to read:

AB1-SA1,9,2 49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this subsection made under s. 20.435 (4) (b), (gp), (o), (pa), or (w), or (xd) shall, except as provided in pars. (bg), (bm), and (br), be determined according to a prospective payment system updated annually by the department. The payment system shall implement standards that are necessary and proper for providing patient care and that meet quality and safety standards established under subch. II of ch. 50 and ch. 150. The payment system shall reflect all of the following:

AB1-SA1, s. 9bk Section 9bk. 49.45 (6v) (b) of the statutes is amended to read:

AB1-SA1,9,9 49.45 (6v) (b) The department shall, each year, submit to the joint committee on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that provides information on the utilization of beds by recipients of medical assistance in facilities and a discussion and detailed projection of the likely balances, expenditures, encumbrances and carry over of currently appropriated amounts in the appropriation accounts under s. 20.435 (4) (b), (gp), and (o), and (xd).

AB1-SA1, s. 9bL Section 9bL. 49.45 (6x) (a) of the statutes is amended to read:

AB1-SA1,9,16 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall distribute not more than $4,748,000 in each fiscal year, to provide funds to an essential access city hospital, except that the department may not allocate funds to an essential access city hospital to the extent that the allocation would exceed any limitation under 42 USC 1396b (i) (3).

AB1-SA1, s. 9bm Section 9bm. 49.45 (6y) (a) of the statutes is amended to read:

AB1-SA1,9,25 49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall may distribute funding in each fiscal year to provide supplemental payment to hospitals that enter into a contract under s. 49.02 (2) to provide health care services funded by a relief block grant, as determined by the department, for hospital services that are not in excess of the hospitals' customary charges for the services, as limited under 42 USC 1396b (i) (3). If no relief block grant is awarded under this chapter or if the allocation of funds to such hospitals would exceed any limitation under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that have not entered into a contract under s. 49.02 (2).

AB1-SA1, s. 9bn Section 9bn. 49.45 (6y) (am) of the statutes is amended to read:

AB1-SA1,10,10 49.45 (6y) (am) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (h), (gp), (o), and (w), and (xd), the department shall distribute funding in each fiscal year to provide supplemental payments to hospitals that enter into contracts under s. 49.02 (2) with a county having a population of 500,000 or more to provide health care services funded by a relief block grant, as determined by the department, for hospital services that are not in excess of the hospitals' customary charges for the services, as limited under 42 USC 1396b (i) (3).

AB1-SA1, s. 9bp Section 9bp. 49.45 (6z) (a) (intro.) of the statutes, as affected by 2007 Wisconsin Act 20, is amended to read:

AB1-SA1,10,24 49.45 (6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department may distribute funding in each fiscal year to supplement payment for services to hospitals that enter into indigent care agreements, in accordance with the approved state plan for services under 42 USC 1396a, with relief agencies that administer the medical relief block grant under this chapter, if the department determines that the hospitals serve a disproportionate number of low-income patients with special needs. If no medical relief block grant under this chapter is awarded or if the allocation of funds to such hospitals would exceed any limitation under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that have not entered into indigent care agreements. The department may not distribute funds under this subsection to the extent that the distribution would do any of the following:

AB1-SA1, s. 9bq Section 9bq. 49.45 (8) (b) of the statutes is amended to read: