This bill also authorizes Commerce to contract with a person to empty, remove,
and dispose of an underground petroleum product storage tank that has not been
properly closed if Commerce is unable to identify the owner of the tank or Commerce
determines that the owner is unwilling or unable to pay.
Current law authorizes DNR to conduct or fund activities to investigate and
remedy environmental contamination in some situations. This bill increases the
authorized general obligation bonding authority to finance those activities by
$3,000,000.
Other environment
This bill creates an Office of Public Intervenor attached to DOJ. The bill
requires the attorney general to appoint an assistant attorney general to serve as the
public intervenor. The bill authorizes the public intervenor to commence or
intervene in court proceedings whenever necessary to protect the public rights in
water and other natural resources; act as an interested party in actions in which he
or she intervenes, and present evidence, cross-examine witnesses, and file briefs;
and appeal administrative rulings to the courts.
Current law imposes a recycling fee of $3 per ton on solid waste, other than
certain kinds of high-volume industrial waste, disposed of at a landfill or other waste
disposal facility. The recycling fee is deposited into the recycling fund. This bill
increases the recycling fee to $6 per ton.
Current law imposes an environmental repair fee on solid and hazardous waste
disposed of at a landfill or other waste disposal facility. The environmental repair
fee is 50 cents per ton, except that the fee is lower for mining waste and certain kinds
of high-volume industrial waste. The environmental repair fee is deposited into the
environmental fund. This bill increases the environmental repair fee to $1.60 per
ton.
This bill transfers $13,000,000 in fiscal year 2007-08 and $20,000,000 in fiscal
year 2008-09 from the recycling fund to the general fund. The bill also transfers
$4,000,000 in fiscal year 2007-08 from the petroleum inspection fund to the general
fund.
This bill changes the funding source for DNR's administration of the Motor
Vehicle Emission Inspection and Maintenance Program from the general fund to the
transportation fund.
HEALTH AND HUMAN SERVICES
Medical Assistance
Under current law, DHFS administers the Medical Assistance (MA) program
and the BadgerCare health care program, which provide health care benefits for
eligible individuals (generally, pregnant women, certain children, and elderly or
disabled individuals, all of whom must meet specific low-income requirements).
Families, children who do not reside with their parents, and unborn children whose
mothers are not eligible for MA or BadgerCare may be eligible for BadgerCare if their
incomes do not exceed 185 percent of the federal poverty line and they meet certain
nonfinancial criteria, such as not having access to employer-subsidized health care
coverage.
Under this bill, DHFS must request a waiver from, and submit amendments
to the state MA plan to, the secretary of the federal Department of Health and
Human Services to allow DHFS to implement an MA health care program called
BadgerCare Plus (BC+). BC+ would be financed as are other MA programs, partly
with federal funds and partly with state funds. BC+ would replace all of BadgerCare
and part of MA. Thus, individuals who satisfy eligibility criteria under both BC+ and
BadgerCare would receive benefits under BC+, and individuals who satisfy
eligibility criteria under both BC+ and MA would receive benefits under either BC+
or MA, depending on the basis for their eligibility for MA.
BC+ would provide health care benefits to recipients under two different plans,
depending on the basis for the recipient's eligibility. The first plan provides the same
benefits that are provided under regular MA. Individuals eligible for BC+ benefits
under the regular MA plan include: a pregnant woman whose family income does
not exceed 200 percent of the poverty level; a child under one year of age whose
mother, on the day on which the child was born, was eligible for and receiving
benefits under MA or BC+ under the regular MA plan; any child whose family income
does not exceed 200 percent of the poverty level; an individual whose family income
does not exceed 200 percent of the poverty level and who is the parent or caretaker
relative of a child who is, generally, living in the home of the parent or caretaker
relative; certain migrant workers and their dependents; and an individual between
19 and 21 years of age who was in foster care on his or her 18th birthday.
The second plan, called the Benchmark Plan, provides specified benefits, such
as coverage for prescription drugs; physicians' services; inpatient and outpatient
hospital services; home health services; physical, occupational, speech, and
pulmonary therapy; treatment for nervous and mental disorders and alcoholism and
other drug abuse problems; durable medical equipment; and transportation to
obtain emergency medical care. Individuals eligible for BC+ benefits under the
Benchmark Plan include: a pregnant woman whose family income exceeds 200
percent, but does not exceed 300 percent, of the poverty level; a child under one year
of age whose mother, on the day on which the child was born, was eligible for and
receiving BC+ benefits under the Benchmark Plan; any child whose family income
exceeds 200 percent, but does not exceed 300 percent, of the poverty level; and an
individual whose family income exceeds 200 percent, but does not exceed 300
percent, of the poverty level and who is the parent or caretaker relative of a child who
is, generally, living in the home of the parent or caretaker relative. In addition, any
child whose family income exceeds 300 percent of the poverty level may purchase
coverage under the Benchmark Plan at the full per member per month cost of the
coverage.
For coverage under both the regular MA plan and the Benchmark Plan, a child
is defined to include an unborn child whose mother is not eligible for MA or BC+ but
satisfies all other eligibility criteria except that she is not a U.S. citizen or qualifying
alien or is an inmate of a public institution. If the mother's family income does not
exceed 200 percent of the poverty level, the unborn child is eligible for prenatal care
under the regular MA plan; if the mother's family income exceeds 200 percent, but
does not exceed 300 percent, of the poverty level, the unborn child is eligible for
prenatal care under the Benchmark Plan.
As a condition of eligibility for BC+, an individual who is eligible for enrollment
in a group health plan must apply for enrollment in that plan if DHFS determines
that it is cost-effective. With exceptions for pregnant women, individuals in foster
care on their 18th birthday, and certain children, no individual whose family income
exceeds 150 percent of the poverty level is eligible for BC+ if the individual has health
care coverage under the state employee health plan or coverage that is provided by
an employer and for which the employer pays at least 80 percent of the premium.
Regardless of family income, however, an unborn child is not eligible for BC+ if the
unborn child or its mother has any type of health insurance coverage. If an
individual whose family income exceeds 150 percent of the poverty level or an unborn
child or its mother had access, in the 12 months before applying for BC+, to health
care coverage under the state employee health plan or coverage that is provided by
an employer and for which the employer pays at least 80 percent of the premium, the
individual or unborn child is not eligible for BC+ unless there is a good cause reason
that the individual or unborn child or its mother did not enroll in the coverage. A
pregnant woman whose family income exceeds 200 percent of the poverty level and
who has health insurance coverage must maintain that coverage as a condition of
eligibility for BC+. If an individual whose family income exceeds 150 percent of the
poverty level had coverage under the state employee health plan or
employer-provided coverage but no longer has the coverage, if an unborn child or its
mother had health insurance coverage but no longer has the coverage, or if a
pregnant woman whose family income exceeds 200 percent of the poverty level did
not maintain the coverage that she had, the individual, unborn child, or pregnant
woman is not eligible for BC+ for three calendar months following the month in
which the coverage ended unless there was a good cause reason for the termination
of the coverage.
With certain exceptions, for an individual whose family income exceeds 150
percent of the poverty level, DHFS must verify directly with the employer, if any,
whether the individual has or had insurance coverage or access. An employer must
supply the information upon request within a certain time or pay a penalty equal to
the full per member per month cost of coverage under BC+ for each month the
individual is covered under BC+ until the employer provides the information.
Penalties are limited to no more than $1,000 in any six-month period for an employer
with fewer than 250 employees, and to no more than $15,000 in any six-month period
for other employers.
Generally, the same copayment requirements that apply under MA apply to
BC+ recipients with benefits under the regular MA plan. BC+ recipients with
benefits under the Benchmark Plan are subject to the copayment and coinsurance
requirements specified in the bill for that plan. A BC+ recipient who is an adult, who
is not a pregnant woman, and whose family income is at least 150 percent of the
poverty level must pay a premium for BC+ coverage that may not exceed 5 percent
of the recipient's family income. A BC+ recipient who is a child whose family income
is at least 200 percent of the poverty level must pay a premium for BC+ coverage that
may not exceed the full per member per month cost of coverage for a child with a
family income equal to 300 percent of the poverty level. A BC+ recipient who is an
unborn child or a pregnant woman whose family income exceeds 200 percent of the
poverty level must pay a premium that may not exceed the full per member per
month cost of coverage for an adult with a family income equal to 300 percent of the
poverty level. If a recipient who is required to pay a premium does not pay it when
due, the recipient's coverage terminates and the recipient may not be eligible for BC+
again for six months.
This bill creates the health care quality fund, consisting of moneys obtained
from an increase in cigarette and other tobacco products taxes, from assessments on
hospitals, and from certain other sources. The health care quality fund is used as
another source of funding for MA and for BadgerCare.
Currently, MA provides federal and state moneys to pay for health care and
long-term care services, including care in a nursing home, for persons who are
low-income, elderly, or disabled and who meet other specific eligibility
requirements. To be eligible for MA for long-term care services, an individual must
meet certain very low income and resource requirements, and may have to reduce
his or her income and resources by paying for his or her own long-term care until the
eligibility requirements are met.
Currently, if a person transfers his or her assets for less than fair market value
for the purpose of reducing his or her income and resources to become eligible for MA
for long-term care services (divestment) on or after the person's look-back date
(generally, three years before the person applies for MA for long-term care services),
the person may be ineligible for MA for a specified time (penalty period). This bill
does all of the following with respect to divestment:
1. Changes the look-back date to five years for transfers that occur on or after
February 8, 2006.
2. Changes the beginning date for the penalty period from the date on which
assets were transferred to the later of the date on which assets were transferred or
the date on which the person applies and is eligible for MA for long-term care
services.
3. Provides that the purchase of a loan, promissory note, mortgage, or life estate
after February 8, 2006, is a divestment and specifies the requirements for when such
a purchase is not to be considered a divestment.
4. Provides that as a condition of receiving MA for long-term care services an
applicant or recipient must disclose any interest he or she or his or her spouse has
in an annuity that was purchased on or after February 8, 2006, or with respect to
which a transaction occurred on or after February 8, 2006.
5. Specifies the conditions under which the purchase of an annuity on or after
February 8, 2006, is not considered a divestment, including designating DHFS as a
remainder beneficiary under the annuity in the first position.
6. Requires DHFS to establish a process, to determine if the divestment rules
would result in undue hardship for a person and should not apply.
7. Provides, generally, that a person is ineligible for MA for long-term care
services if the equity in the person's home exceeds $750,000, unless his or her spouse
or minor or disabled child is living in the home. Under current law, a person's home,
regardless of its value, is not counted when the person's income and resources for MA
eligibility are determined.
This bill requires DHFS to request a waiver from the secretary of the federal
Department of Health and Human Services to conduct a demonstration project
under which DHFS would provide health care coverage of primary and preventive
care for adults under the age of 65 who have family incomes not exceeding 200
percent of the poverty level; who are not otherwise eligible for MA, BadgerCare, or
Medicare; and who did not have coverage under the Health Insurance Risk-Sharing
Plan within six months before applying.
Under current law, DHFS provides block grant moneys to Milwaukee County
for providing health care services to persons who meet certain criteria for
dependency. Under this bill, the amount that DHFS would otherwise provide in such
block grant moneys would be offset by amounts paid for individuals in Milwaukee
County under the demonstration project to provide health care coverage for eligible
adults.
Currently, DHFS may obtain from insurers information DHFS needs to identify
an MA recipient who is eligible for benefits under a disability insurance policy or, if
enrolled as the dependent of a beneficiary, would be eligible for benefits; claims
submittal information; and types of benefits provided under the policy. DHFS must
enter into an agreement with the insurer that identifies the information to be
disclosed, safeguards confidentiality, and specifies how the insurer's reasonable
costs for this work will be determined and paid by the state. Insurers must provide
the information within specified deadlines, and the commissioner of insurance may
initiate enforcement proceedings for noncompliance.
Under this bill, DHFS may receive health care services coverage information
from, in addition to insurers, self-insured plans, service benefits plans, and
pharmacy benefits managers (third parties). DHFS may also gather information
about BadgerCare recipients who are eligible or who would be eligible as dependents
for health care coverage from a third party. DHFS must pay compensation for
providing the information. DHFS may notify the attorney general of third parties,
other than insurers, that fail to provide information requested.
Under the bill, third parties must accept assignment to DHFS of an individual's
right to receive payment from the third party for a health care item or service paid
for under MA, BadgerCare, or a program administered under MA under a federal
waiver. Third parties must also accept DHFS's right to recover third-party
payments for which assignment had not been accepted. A third party must respond
to an inquiry by DHFS concerning a claim for payment of a health care item or service
if the inquiry is made within 36 months after the item or service is provided. Further,
third parties must agree not to deny a DHFS claim on the basis of certain
circumstances, if submitted less than 36 months after the health care item or service
is provided and if action by DHFS to enforce its rights is commenced less than 72
months after DHFS submits the claim.
Under current law, nursing home reimbursements for care provided to MA
recipients are determined under a system that considers, among other things, direct
care costs, as adjusted by DHFS for regional labor cost variations. For this purpose,
DHFS treats the counties of Dane, Iowa, Columbia, and Sauk as a single labor region.
This bill adds Rock County to this labor region.
Currently, under the MA waiver community integration program for persons
relocated from, or meeting requirements of, MA reimbursements to nursing homes
(commonly known as CIP II), DHFS provides enhanced MA reimbursement for up
to 150 persons who are diverted from imminent entry into nursing homes. Enhanced
reimbursement for more than 150 persons must be approved by JCF. This bill
requires the approval from the secretary of administration instead of from JCF.
Under current law, some individuals who are eligible for MA are also eligible
for Medicare Part D, which is the portion of the federal health insurance program
that provides prescription drug coverage for individuals who are, generally, 65 years
of age or older or disabled. Enrollment in Medicare Part D is voluntary. Not all Part
D plans in which individuals may enroll cover all of the prescription drugs that may
be covered under Medicare Part D.
Under this bill, if an individual is eligible for both MA and Medicare Part D, MA
will not pay for any prescription drug for which there may be coverage under
Medicare Part D, whether or not the individual is enrolled in Medicare Part D and,
if he or she is enrolled, whether or not the individual's Part D plan covers the drug.
Currently, some individuals who are eligible for MA are also eligible for
Medicare, a federal health insurance program for individuals who are, generally, 65
years of age or older or disabled. Medicare Part A covers hospital and related
services, and coverage is automatic. Medicare Part B covers outpatient, nursing, and
physician services and various other health care services, such as diagnostic tests.
Enrollment in Medicare Part B is voluntary, and an enrollee must pay a premium.
Current law does not require an individual who is eligible for both MA and Medicare
to enroll in Medicare Part B, and DHFS reimburses providers under MA for services
that would be covered under Medicare Part B if the individual were enrolled in
Medicare Part B.
This bill provides that DHFS may require an individual who is eligible for
Medicare and for MA services under a number of eligibility categories to enroll in
Medicare Part B as a condition of receiving those MA services. If DHFS requires an
individual to enroll in Medicare Part B, DHFS must pay the monthly premiums for
the coverage. Because MA does not pay for benefits to which an individual is entitled
under another benefit program, MA would no longer pay for any benefits that are
covered under Medicare Part B after the individual enrolls in Medicare Part B.
Currently, one category of MA recipients is termed "categorically needy"; these
persons have incomes and resources at the eligible levels and can be determined to
be retroactively eligible for MA for a certain period of months. Another category of
recipients is termed "medically needy"; these persons have resources at eligible
levels and incur medical expenses that, if paid, bring their incomes to eligible levels.
Currently, if an MA applicant is found to be retroactively eligible as a "categorically
needy" recipient and a provider has billed the recipient directly for services provided
during the retroactive period, the provider, upon notice that the applicant is
retroactively eligible, must submit claims for MA payment to DHFS. When paid by
DHFS, the provider must reimburse the MA recipient for payment the recipient or
another person made to the provider for services provided to the recipient during the
retroactively eligible period. Regardless of the amount the provider has charged the
MA recipient, the provider may not be required to reimburse the recipient more than
the amount that the provider is paid for the services by MA.
This bill eliminates the prohibition on requiring a health care provider to
reimburse for services paid for by a "categorically needy" MA recipient in an amount
that is greater than the provider is paid for the services under the MA program.
Instead, the bill requires that the health care provider reimburse the MA recipient
or another person in the amount that the recipient or other person has paid the
provider for the recipient's care and extends this repayment requirement to
"medically needy" MA recipients.
Currently, in addition to providing family planning as a benefit to MA
recipients, DHFS administers, under a waiver of federal Medicaid laws, a
demonstration project to provide family planning services to women between the
ages of 15 and 44 with family incomes of not more than 185 percent of the federal
poverty level.
This bill requires DHFS to request an amended federal waiver for the
demonstration project to provide family planning under MA to men between the ages
of 15 and 44 and to increase the financial eligibility limitation under the
demonstration project to 200 percent of the federal poverty level.
Children
Under current law, DHFS provides or oversees county provision of, various
services to children and families. These services include services for children in need
of protection or services and their families; adoption services; licensing of child
welfare agencies, foster homes, group homes, day care centers, and shelter care
facilities; investigating cases of suspected child abuse or neglect; providing a state
supplemental food program for women, infants, and children; and distributing
funding for children's community programs, child abuse and neglect prevention
programs, food distribution programs, domestic abuse services, tribal adolescent
services, community action programs to assist poor persons, and a brighter futures
initiative to prevent delinquent behavior, alcohol and other drug abuse, child abuse
and neglect, and nonmarital pregnancy.
This bill creates the Department of Children and Families (DCF), effective July
1, 2008, and transfers from DHFS to DCF the duty to provide or oversee the provision
of these services. The bill also renames DHFS the Department of Health Services.
Under current law, DWD administers the Wisconsin Works (W-2) program,
which provides work experience and benefits for low-income custodial parents, job
search assistance, and child care subsidies. DWD also administers the program for
establishing and enforcing child and spousal support and establishing paternity and
medical support liability. This bill transfers from DWD to DCF the responsibility for
administering these programs.
Under current law, DHFS administers the 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 be
selected to participate in the program.
This bill requires DCF, beginning January 1, 2009, 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 be selected to
participate in the program.
The bill directs DCF to award grants to applying counties, local health
departments, Indian tribes, private nonprofit agencies, and local partnerships
(organizations) to provide voluntary one-time home visits to all first-time parents
in the community served by the organization. The purposes of the home visits are
to provide those parents with basic information regarding infant health and
nutrition, the care, safety, and development of infants, emergency services for
infants, and shaken baby syndrome and impacted babies; 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.
Recently, the U.S. Congress enacted the Adam Walsh Child Protection and
Safety Act of 2006, which requires the states to conduct criminal records checks,
including fingerprint-based checks of national crime information databases, of
prospective foster or adoptive parents and to check any child abuse or neglect
registry maintained by any other state in which a prospective foster or adoptive
parent or any other adult living in the home of that prospective parent (adult
resident) has resided in the preceding five years before the prospective foster or
adoptive parent may be finally approved for placement of a child, regardless of
whether foster care maintenance or adoption assistance payments will be provided
on behalf of the child.
This bill conforms state law relating to background checks of prospective foster
parents, adoptive parents, and adult residents to federal law, as affected by the Adam
Walsh Act.
Under current law, if a court assigned to exercise jurisdiction under the
Children's Code (juvenile court) issues an order placing, or maintaining the
placement of, a child outside the home, the order must include findings that
continued placement of the child in the home would be contrary to the welfare of the
child, that reasonable efforts have been made to prevent the removal of the child from
the home, and that reasonable efforts have been made to achieve the goal of the
child's permanency plan, which is a plan designed to ensure that the child is
reunified with his or her family whenever appropriate or that the child quickly
attains a placement providing long-term stability. This bill requires the juvenile
court to make the finding that reasonable efforts have been made to achieve the goal
of the child's permanency plan in a termination of parental rights order.
Under current law, in an action affecting the family (for example, a divorce
proceeding), if the circuit court finds that neither parent is able to care for the child
adequately or is fit and proper to have care and custody of the child, the circuit court
may declare the child to be in need of protection or services and transfer legal custody
of the child to the county or to a licensed child welfare agency. This bill requires a
circuit court that so transfers legal custody of a child to refer the matter to the
juvenile court intake worker, who must conduct an intake inquiry to determine
whether a petition alleging the child to be in need of protection or services should be
filed with the juvenile court, and to include in the order transferring legal custody
of the child a finding that placement of the child in his or her home would be contrary
to the welfare of the child and, subject to certain exceptions, a finding that reasonable
efforts have been made to prevent the removal of the child from the home.
The bill also requires a juvenile court, when ordering a child to be placed outside
the home under the supervision of a county or, in Milwaukee County, DHFS, to order
the child into the placement and care responsibility of the county or DHFS and to
assign the county or DHFS primary responsibility for providing services to the child.
In addition, the bill requires a county, DHFS, or DOC, when placing a child outside
the home under a voluntary agreement, to explicitly state in the voluntary
agreement that the county, DHFS, or DOC has placement and care responsibility for
the child and has primary responsibility for providing services to the child.
This bill requires DWD to provide a child care quality rating system for child
care providers licensed by DHFS that receive reimbursement under the W-2
program or that volunteer for rating under the system. 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 to a foster parent for the care and maintenance of a child.
This bill permits DHFS in fiscal year 2007-08 and DCF in fiscal year 2008-09
to expend not more than a total of $500,000 in certain federal revenues received in
fiscal year 2006-07 or 2007-08 for unexpected or unusually high-cost out-of-home
care placements of Indian children ordered by tribal courts.
Public assistance
Currently, under Senior Care, DHFS reimburses pharmacists and pharmacies
for providing prescription drugs to elderly persons at reduced rates. DHFS provides
payments from general purpose revenues, rebate payments made by prescription
drug manufacturers, and federal funds.
This bill establishes the health care quality fund, consisting of moneys obtained
from an increase in cigarette and other tobacco products taxes and certain other
moneys and used as another source of Senior Care funding.
Under current law, a person who applies for benefits under Wisconsin Works,
MA, or the food stamp program must provide, as a condition of eligibility, a
declaration of citizenship or satisfactory immigration status. Federal law provides
that no federal moneys will be provided to a state for MA expenditures made on
behalf of a person who declares that he or she is a citizen or national of the United
States unless the person presents satisfactory documentary evidence of citizenship
or nationality. Federal law specifies the documentary evidence that is satisfactory
and certain exemptions to the requirement. This bill conforms state law to federal
law.
Under the Chronic Disease Program, DHFS currently provides financial
assistance for the cost of medical care to persons with chronic kidney disease, cystic
fibrosis, and hemophilia.
This bill requires health insurers, self-insured plans, service benefits plans,
and pharmacy benefits managers (third parties) to provide to DHFS information
from their records to identify persons receiving benefits under the Chronic Disease
Program and under Senior Care who are eligible, or would be eligible as dependents,
for third-party health care coverage and imposes other requirements on third
parties that are similar to those by which third-party liability is determined and
enforced under MA.
Under current law, DHFS provides benefits under the federal Food Stamp
Program and contracts with DWD for administration of an employment and training
program for Food Stamp Program recipients. This bill transfers, administration of
the employment and training program for food stamp recipients to DHFS, which may
contract with county departments of social services and human services and with
tribal governing bodies to administer the program.
Under current law, an individual is ineligible for food stamps in any month in
which the individual is not in compliance with various child support enforcement
requirements, such as refusing to cooperate with efforts to establish paternity with
respect to a child or being delinquent in the payment of child support. This bill
removes noncompliance with the child support enforcement requirements as a basis
for ineligibility for food stamps.
Wisconsin Works
Currently the Wisconsin Works (W-2) program provides work experience and
benefits for low-income custodial parents who are at least 18 years old; job search
assistance to noncustodial parents who are required to pay child support, to minor
custodial parents, and to pregnant women who are not custodial parents; and child
care subsidies for certain parents who need child care services to participate in
various educational or work activities. W-2 is administered by DWD, which
contracts with W-2 agencies to administer W-2 on the local level.
The work components under W-2, called employment positions, consist of three
categories: trial jobs, community service jobs, and transitional placements. A
participant in an employment position must search for unsubsidized employment
the entire time that he or she is participating in the W-2 employment position.
Under current law, DWD is directed to continue the creation and implementation of
a subsidized work program.
This bill eliminates the latter directive and requires DWD to conduct and
evaluate, from January 1, 2008, to December 31, 2009, a real work, real pay pilot
project, limited to 500 participants and conducted in at least one of the areas of the
state established for administering the W-2 program that is located in Milwaukee
County and in at least two areas that are not in Milwaukee County. Under the
project, a W-2 agency pays a wage subsidy, which may not exceed the federal
minimum wage for no more than 30 hours of work per week, to an employer that
employs a project participant. The employer is also reimbursed for up to 100 percent
of federal social security taxes, state and federal unemployment contributions, and
worker's compensation insurance premiums paid on behalf of a participant. An
employer that employs a participant and receives a wage subsidy must agree to make
a good faith effort to retain the participant as an unsubsidized employee after the
wage subsidy ends if the participant successfully completes participation in the pilot
project.
Under current law, a person who is eligible for W-2 and who is the custodial
parent of a child who is 12 weeks old or less may receive a monthly grant of $673 and
may not be required to work in a W-2 employment position. This bill provides that
the custodial parent of a child who is 26 weeks old or less may receive the monthly
grant and may not be required to work in a W-2 employment position. In addition,
the bill provides that an unmarried woman who would be eligible for W-2 except that
she is not a custodial parent may also receive a monthly grant of $673 and may not
be required to work in a W-2 employment position if she is in the third trimester of
a medically verified pregnancy that is at risk and that renders the woman unable to
participate in the workforce.
Under W-2, an individual who is the parent of a child under the age of 13 or,
if the child is disabled, under the age of 19, is eligible for a child care subsidy if the
individual needs child care services to participate in various educational or work
activities and satisfies other eligibility criteria, one of which is that the individual's
family income may not exceed 185 percent of the poverty line. If an individual is
already receiving a child care subsidy, however, family income may be as high as 200
percent of the poverty line. This bill changes these maximum family income levels
to 175 percent of the poverty line for an individual who is first applying for a child
care subsidy and to 190 percent of the poverty line for an individual who is already
receiving a subsidy.
Health
Under current law, DHFS administers a program under which individuals with
a human immunodeficiency virus (HIV) infection may be reimbursed for the cost of
the drug azidothymidine (AZT) or other cost-effective alternatives. DHFS also
administers a program under which individuals with an HIV infection may have
their health insurance premiums subsidized if they are on unpaid medical leave, or
have had to discontinue their employment or reduce their hours, because of a medical
condition arising from or related to the HIV infection.
This bill requires DHFS to conduct a three-year pilot program under which
DHFS may pay premiums and copayments for drugs that are eligible for
reimbursement under the AZT-reimbursement program, for individuals under the
Health Insurance Risk-Sharing Plan (HIRSP), which is the health insurance
program that provides major medical health insurance coverage for disabled persons
covered under Medicare, persons with HIV, and persons who have been refused
coverage in the private health insurance market. The pilot program is limited to 100
individuals at any given time who: 1) are eligible for the AZT-reimbursement
program; 2) do not have health insurance coverage; and 3) are not eligible for the
health insurance premium subsidy program.
Currently, DHFS administers the Well-Woman Program, under which certain
medical services related to breast cancer, cervical cancer, and multiple sclerosis and
certain general medical services are provided to underinsured and uninsured women
of low income.
This bill requires health insurers, self-insured plans, service benefits plans,
and pharmacy benefits managers (third parties) to provide information to DHFS to
identify persons receiving benefits under the Well-Woman Program who are eligible,
or would be eligible as dependents, for third-party health care coverage and imposes
other requirements on third parties that are similar to those by which third-party
liability is determined and enforced under MA.
This bill does all of following:
1. Provides that the HIRSP Authority is to be treated as a state agency for all
purposes under the Wisconsin Retirement System, including the purpose of
providing fringe benefits, such as participation in the pension plan and health
insurance coverage, to its employees.
2. Requires the Investment Board, if requested by the HIRSP Authority, to
invest funds of the HIRSP Authority in the state investment fund and permits the
HIRSP Authority to participate in the local government pooled-investment fund.
3. Allows prescription drugs to be provided under HIRSP by a network of
pharmacists and pharmacies that are approved by the HIRSP Authority Board of
Directors.
4. Requires payments to providers under HIRSP to consist of usual and
customary payment rates instead of the allowable charges for services and articles
under MA.
5. Expands eligibility for premium and deductible subsidies to all persons with
coverage under HIRSP with incomes below a specified level.
Under current law, DHFS annually assesses hospitals a statewide total of
$1,500,000, in proportion to each hospital's respective gross private-pay patient
revenues during the hospital's most recent fiscal year. Moneys from the assessments
pay for a portion of MA benefits, certain long-term care pilot projects under COP, and
services under Family Care. This bill eliminates the current hospital assessments
and instead authorizes DHFS to collect an annual assessment on hospitals based on
claims. Under the bill, the assessments are based on a rate not to exceed 1 percent
of a hospital's gross revenues, as adjusted by DHFS. The assessments are deposited
into the health care quality fund, as created in the bill.
Currently, DHFS subsidizes the premium costs for health insurance coverage,
except for Medicare premiums, of low-income persons who are unable to continue
employment or must reduce employment hours because of illnesses or medical
conditions arising from HIV infections. Medicare has separate programs of coverage
for hospital care, physicians' services, and prescription drugs. This bill authorizes
DHFS to subsidize the premium costs for Medicare prescription drug coverage for
these persons.
This bill requires DHFS to award a grant of at least $167,000 in each fiscal year
to an organization for services to consumers and providers of supportive home care
and personal care.
Long-term care
Under current law, DHFS administers a variety of long-term care programs for
people who are aged or have a disability. Under the Community Options Program
(COP), Community Options Waiver Program (COP Waiver), and the Community
Integration Program for people who are relocated or diverted from nursing homes
(CIP II), counties provide community-based long-term care services to persons who
are aged or have a physical or developmental disability and qualify for MA. A
number of counties have implemented the Family Care program to provide
long-term care services for a capitated payment rate and information and referrals
related to long-term care options. Finally, in several counties, organizations
administer the Wisconsin Partnership Program or the Program for All-Inclusive
Care for the Elderly (PACE), capitated payment rate programs to provide both
long-term care and acute health care services to elderly people or people with
physical disabilities who are eligible for nursing home care.
Current law requires that DHFS obtain approval from JCF before expanding
use of capitated rate payment programs to provide long-term care services. This bill
eliminates this requirement.
