In addition, this bill changes the funding source for making the principal and
interest payments on bonds issued by this state for certain water pollution
abatement purposes from the general fund to the environmental fund.
Current law requires a person to pay DOT an environmental impact fee of $9
upon registering a new motor vehicle, other than a neighborhood electric vehicle, or
upon applying for a new certificate of title following the transfer of a vehicle. The fee
expires on December 31, 2009. This bill eliminates the expiration date for the
environmental impact fee.
Health and human services
Public assistance
Under current law, DHS provides relief block grant moneys to counties and
tribal governing bodies for providing health care services, as well as cash assistance,
(also known as "general relief") to persons who meet the criteria for dependency. This
bill eliminates the relief block grant program.
Under current law, DHS provides benefits under the food stamp program to
qualified aliens. This bill eliminates the provision of food stamp benefits to qualified
aliens.
Under current law, DOA provides heating assistance benefits to eligible
households. One type of eligible household is a household that is entirely composed
of persons receiving food stamps. This bill adds as an eligible household a household
that includes at least one person who is eligible for food stamps and specifies that
such an eligible household may not receive more than $1 in heating assistance
benefits per year.
Under current law, DCF may spend no more than the minimum amount
required under the federal law that provides federal Child Care Development Funds
(CCDF). DCF allocates CCDF for a number of purposes related to child care licensing
and child care programs administered by DCF. This bill eliminates the requirement
that DCF spend no more than the minimum amount required under federal law for
its child care licensing activities and child care programs.
Under current law, DCF allocates specified amounts of federal moneys,
including CCDF and moneys received under the Temporary Assistance for Needy
Families (TANF) block grant program, for various public assistance programs and
for child care-related purposes, including its day care licensing activities. The bill
modifies some of those allocations. The bill also adds an allocation for public
assistance program fraud and error reduction activities and removes an allocation
for the Milwaukee and statewide child welfare information systems.
Under current law, DHS must conduct a three-year pilot program under which
it pays premiums for coverage under the Health Insurance Risk-Sharing Plan
(HIRSP) and copayments under HIRSP for drugs eligible for reimbursement under
the AZT-reimbursement program. HIRSP is, generally, a health insurance program
administered by the HIRSP Authority that provides major medical health insurance
coverage for persons who are covered under Medicare because they are disabled,
persons who have tested positive for HIV, and 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 conditions. This bill makes this pilot
program permanent.
Under current law, DHS pays supplemental monthly payments for the support
of dependent children to custodial parents who are receiving federal supplemental
security income. The Wisconsin Works (W-2) program, administered by DCF,
generally provides work experience and benefits for low-income custodial parents
who are at least 18 years old. One eligibility requirement for the receipt of the state
supplemental payments or for W-2 is that the custodial parent assign to the state
any right he or she has to support from any other person. Of the support that is
assigned to the state, a portion is the state's share and a portion is the federal
government's share. Currently, all of the state's share is paid to the custodial parent,
and a portion of the federal government's share is paid to the custodial parent in
accordance with federal law.
This bill changes the amount of support collected that is paid to the custodial
parent to 75 percent of all support collected, including both the state and federal
shares. The bill also provides that, for determining eligibility for the supplemental
payments for the support of dependent children, DHS must disregard any support
that is received by or that is owed to the custodial parent. In addition, for a custodial
parent who formerly received supplemental payments for the support of dependent
children or participated in W-2 and assigned his or her right to support to the state
but who is no longer receiving those supplemental payments or participating in W-2,
the bill requires that 100 percent of the state's share and the federal government's
share of support arrears that accrued while the custodial parent was receiving those
supplemental payments or participating in W-2 and that are collected after the
custodial parent ceased receiving the payments be paid to the custodial parent.
Currently, the state administers the Emergency Food Assistance Program and
the Special Supplemental Nutrition Program for Women, Infants, and Children to
provide food and information about nutrition to low-income people. This bill
transfers the responsibilities for administering these programs and for developing
a hunger prevention plan from DCF to DHS.
Current law requires, DHS to deliver food stamp benefits by means of an
electronic benefit transfer system. This bill authorizes DHS to deliver any benefits
that DHS administers by means of an electronic benefit transfer system if DHS
obtains any necessary federal approval for using an electronic benefit transfer
system; promulgates a rule adopting an electronic benefits transfer system; and
allows county and tribal governments to opt out of the electronic benefit transfer
system if the cost to the county and tribal governments of delivering benefits
electronically is greater than delivering benefits by other means.
Wisconsin Works
Under current law, a person who meets the eligibility requirements 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. Current law also provides generally that receiving a monthly grant as the
custodial parent of an infant counts toward the time limits that apply to how long 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.
This bill provides that if a person who is a custodial parent was participating
in W-2 for at least three months before receiving a custodial parent grant, the person
may receive the grant until the child is 26 weeks old instead of 12 weeks old and may
not be required to work in a W-2 employment position during that time.
Additionally, 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
pregnancy that is at risk and that renders the woman unable to participate in the
workforce may also receive a monthly grant of $673 and may not be required to work
in a W-2 employment position. The bill provides that receiving a monthly grant as
the custodial parent of an infant counts toward the time limits that apply to how long
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, unless
the child was conceived as a result of sexual assault or incest. Receipt of a monthly
grant as an unmarried pregnant woman, however, does not count toward the time
limits.
This bill makes a number of changes to W-2, including the following:
1. Eliminating the limits on the lengths of time during which a participant may
participate in a particular type of employment position, but retaining the overall
lifetime limit for participation of 60 months.
2. Removing the specifications on the number of hours a participant in a
community service job placement or a transitional placement may be required to
engage in certain job-related activities and educational or training activities, but
retaining an overall requirement of not more than 40 hours per week.
3. Requiring DCF to specify guidelines for determining when a participant is
demonstrating a refusal to participate.
4. Providing that a W-2 participant who refuses to participate is ineligible for
W-2 for three months. Under current law, a W-2 participant who refuses to
participate three times is ineligible to participate in that employment position.
5. Eliminating the Learnfare Program, which subjected individuals who failed
to meet certain school attendance requirements to sanctions, and requiring W-2
agencies to provide information and services aimed at connecting W-2 participants,
youth, and parents with their communities, their schools, employers, workforce
development programs, child care providers, and other resources.
Currently 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, may receive a child care subsidy
if the individual needs child care services to participate in various educational or
work activities and satisfies other eligibility criteria. A W-2 agency determines an
individual's eligibility for a child care subsidy and then refers the individual to a
county department of social services or human services (county department) for local
administration of child care assistance, including determining the amount of the
copayment for child care that the individual must pay, providing a voucher for
payment of child care services, and assisting individuals to identify child care
providers and select appropriate child care arrangements.
This bill authorizes DCF to contract with a county department, W-2 agency,
child care resource and referral agency, or other agency to determine eligibility for
a child subsidy of individuals who reside in a particular geographic region or who are
members of a particular Indian tribal unit and to administer child care assistance
at the local level.
Current law provides that the cost to administer the program may not exceed
5 percent of the total distributed in the current year for child care services, 5 percent
of the total distributed in the previous year for child care services, or $20,000,
whichever is greatest. This bill requires the department to allocate at least $20,000
per year to each contract for administrative responsibilities for each geographic
region or Indian tribal unit.
This bill requires court-ordered child or family support received by an
applicant or recipient under the W-2 child care subsidy program to be included in
income for determining child care copayment amounts and financial eligibility for a
child care subsidy.
This bill authorizes DCF to do any of the following to reduce costs under the
W-2 child care subsidy program:
1. Increase the copayments that individuals who receive a subsidy pay by up
to 10 percent.
2. Implement a waiting list.
The bill also requires DCF to implement, effective January 1, 2010, an
attendance-based rate structure for child care provider reimbursements and to
increase copayments paid by individuals who receive a child care subsidy to reduce
costs under the child care subsidy program by $1,520,000 in fiscal year 2009-10 and
by $4,200,000 in fiscal year 2010-11.
Under current law, DCF must establish a program to investigate suspected
fraudulent activity on the part of W-2 participants, and counties and tribal
governing bodies may establish such programs. If a county or tribal governing body
establishes a program, it must pay to DCF 50 percent of the amount that it recovers
in the first month of the program's operation, 66 percent of the amount that it
recovers in the second month, and all amounts recovered after the second month.
Current law does not specify how a county or tribal governing body is to use recovered
amounts that it retains, but DCF must use recovered moneys received from a county
or tribal governing body for W-2 benefits.
This bill provides that a county human or social services department, W-2
agency, or tribal governing body that administers W-2 may establish a program to
investigate suspected fraudulent activity on the part of W-2 participants, may retain
any amounts that are recovered, and must use the recovered moneys to pay cash
benefits to W-2 participants.
Medical Assistance
BadgerCare Plus (BC+) is a Medical Assistance (MA) program, administered
by DHS, that provides health care benefits under two different plans, depending on
the basis for a recipient's eligibility, to recipients who satisfy eligibility criteria. The
first plan provides the same benefits that are provided under regular MA. The
second plan, called the Benchmark Plan, provides specified benefits, including, but
not limited to, coverage for prescription drugs; physicians' services; inpatient and
outpatient hospital services; home health services; physical, occupational, and
speech therapy; treatment for nervous and mental disorders and alcoholism and
other drug abuse problems; durable medical equipment; and transportation to
obtain emergency medical care. In addition to individuals who are eligible for the
regular MA plan or for the Benchmark Plan, any child whose family income exceeds
300 percent of the poverty level may purchase coverage under the Benchmark Plan
at the full cost of the coverage.
This bill makes a number of changes to BC+, including the following:
1. Directs DHS to provide prenatal care services under the regular MA plan for
a pregnant woman with presumptive eligibility (has not applied for benefits but
satisfies the eligibility criteria) whose income is not greater than 200 percent of the
poverty level and to provide prenatal care services under the Benchmark Plan for a
pregnant woman with presumptive eligibility whose income is greater than 200
percent but not greater than 300 percent of the poverty level.
2. Provides that any pregnant woman is eligible for BC+ benefits for any of the
three months before applying for benefits if she met the eligibility criteria during
that month. Under current law, only a pregnant woman whose family income is less
than 150 percent of the poverty level is eligible for BC+ benefits for any of the three
months before she applied for benefits.
3. Provides that only a pregnant woman with family income greater than 300
percent of the poverty level may obtain eligibility for BC+ benefits if medical
expenses reduce her family income to the applicable limit for eligibility. Current law
provides that any pregnant woman or unborn child may obtain eligibility if medical
expenses reduce income to the applicable limit for eligibility.
4. Provides that in determining financial eligibility for BC+ benefits, a person's
income is reduced by the amount of a court-ordered child or family support or
maintenance obligation, up to the amount of the person's income. Current law
reduces income by the amount the person actually pays in court-ordered child or
family support or maintenance.
5. Provides that a person who loses eligibility for BC+ benefits for six months
for failure to pay a premium retains eligibility in any month during that six-month
period when his or her family income is not more than 150 percent of the poverty
level.
6. Extends eligibility for MA coverage for 12, rather than 18, months for a
person over 18 years of age who was receiving MA when BC+ was implemented, who
lost eligibility for MA solely because of the implementation of BC+, and who does not
meet the income eligibility criteria of BC+.
7. Provides that, if approval of the state plan amendments does not allow for
federal funding for benefits for any part of an eligibility group, DHS may pay for
benefits for that part of the group.
Under current law, an individual who would be eligible for MA based on
eligibility for supplemental security income, but who is not eligible for supplemental
security income because he or she is employed, may pay premiums for coverage
under MA if his or her family's net income is less than 250 percent of the poverty level
and his or her assets do not exceed $15,000. This program is known as the MA
purchase plan. When determining the value of the individual's assets for continued
eligibility under the MA purchase plan, DHS excludes amounts in a DHS-approved
account that consists solely of savings from the individual's employment after the
individual's coverage under the MA purchase plan began. These accounts are known
as independence accounts.
Under current law, if an individual who has coverage under MA through the MA
purchase plan ceases employment, he or she is no longer eligible for the MA purchase
plan and is not eligible for MA unless his or her income and assets meets the income
and asset eligibility requirements for MA generally. This bill provides that any
moneys in an individual's independence account will be excluded from the
calculation of assets when determining the individual's eligibility for MA.
This bill authorizes DHS to provide incentive payments to DCF for identifying
children who are receiving benefits under MA and who have health insurance
coverage or access to health insurance coverage and authorizes DCF to provide this
information to DHS.
The bill creates the Wisconsin Quality Home Care Authority (WQHCA), which
is a public body corporate and politic created by state law, but which is not a state
agency. A majority of members of the WQHCA board of directors must represent the
interests of recipients of home care services. The WQHCA is subject to requirements
such as state purchasing requirements, lobbying laws, and the code of ethics for
public officials. The WQHCA is exempt from state employment requirements, and
its employees are excluded from the state retirement system. The bill requires the
WQHCA to establish and maintain a registry of providers; provide referrals to
individuals seeking home care services; determine the eligibility of providers for
placement on the registry; develop a recruitment program for providers; operate a
backup provider system with a 24-hour per day call service; conduct activities to
improve the supply and quality of home care providers; and perform other tasks.
This bill provides home care providers collective bargaining rights under state
law in a manner similar to that provided state employees under the State
Employment Labor Relations Act (SELRA). The collective bargaining unit is
structured as one statewide unit and DHS acts as the state employer.
Under current law, some MA waiver programs and other programs provide a
benefit for personal care services. This bill requires that an adult who 1) hires an
individual home care provider other than an agency, county, or independent living
center employee or a health care provider; 2) is a resident of a county that agrees to
abide by certain requirements or that offers certain programs; and 3) is a recipient
of a home care benefit through the Family Care Program, an MA waiver program,
a self-directed supports option program, an amendment to the state medical
assistance plan, or the Program of All-Inclusive Care for the Elderly, must comply
with certain requirements with regard to the hiring of the home care provider. The
requirements include hiring only a provider eligible for inclusion on a registry
maintained by the WQHCA and compensating providers in accordance with any
state collective bargaining agreement pertaining to home care providers.
This bill allows DHS to charge a fee to certify entities providing personal care
services and allows DHS to promulgate emergency rules for certification of entities
providing personal care services.
Under current law, in certain counties, a person who meets certain functional
and financial criteria and who is either a frail elder or a person who is at least 18
years old with a physical disability or a developmental disability is eligible for and
may obtain the family care benefit, which is financial assistance for long-term care.
This bill makes the following changes to the Family Care Program:
1. Requires that all individuals meet the functional eligibility requirements to
be eligible for family care benefit. Currently, an individual may be eligible for the
family care benefit if he or she does not meet the functional eligibility requirements
for the family care benefit but meets other requirements.
2. Lengthens the deadline for care management organizations to provide the
family care benefit to those entitled to it from 24 months to 36 months.
3. Decreases the ratio of long-term care advocates to one for every 3,500
individuals under age 60 who receive the family care benefit.
4. Eliminates the requirement that DHS allot money for the contract to provide
advocacy services.
5. Requires that, for developmentally disabled individuals receiving the family
care benefit, the care management organization, instead of the county, pay for
services, including mental health services, covered by the Family Care Program.
Under current law, DHS regulates various types of long-term care providers,
including three- and four-bed adult family homes.
This bill requires DHS to regulate one- and two-bed adult family homes. The
bill provides that after the Family Care Program is implemented in a county, one-
and two-bed adult family homes may not provide services for a person who is a
recipient of services under the Family Care Program, a community-based long-term
care MA waiver program, or supplemental security income unless the home is
certified by DHS. Under the bill, DHS must certify one- and two-bed adult family
homes based on certification standards established by DHS. In addition, DHS must
certify one- and two-bed adult family homes that were certified by a county if the
operator attests that they satisfy the certification standards established by DHS.
DHS may impose fees for certification. In addition, DHS may inspect one- and
two-bed adult family homes and revoke their certification for failure to satisfy
certification standards.
Currently, physical therapy, occupational therapy, and services for speech,
hearing, or language disorders (therapy services) are covered under MA if they are
provided by a person who is certified by DHS to provide the services.
This bill provides that if a county spends more to provide therapy services for
children participating in the Birth to 3 Program, under which counties provide
services to infants and toddlers with developmental delays, than the county is
reimbursed under standard MA reimbursement rates, and the federal government
reimburses the state the federal share of MA for the county expenditures that are in
excess of the standard MA reimbursement, DHS may disburse the federal share on
the excess county expenditures to the county.
DHS currently does not certify special educators to provide therapy services
under MA. This bill provides that services to assess and promote skill acquisition
that are provided by special educators to children participating in the Birth to 3
Program are covered under MA if the county pays the entire state share of MA for
the services. The bill requires DHS to establish certification criteria for special
educators.
This bill requires DHS to request a waiver of federal Medicaid law to allow the
state to provide home and community-based services under MA to children who
participate in the Birth to 3 Program. The bill provides that if the waiver is granted,
counties must pay the nonfederal share of MA costs for services provided under the
waiver.
This bill specifies that DHS may implement through MA the state plan option
under the federal Social Security Act, which provides federal funding for home and
community-based services for people with mental illness.
Under current law, DHS reimburses certain costs of services provided by a state
center for the developmentally disabled. Under the community integration program
for residents of state centers for the developmentally disabled (the CIP IA program),
DHS must reduce the reimbursement to a center by $325 per day following the
relocation of an individual from the center to a community setting. This bill
eliminates the fixed amount of the reduction.
Under current law, if a person under the age of 22 or a person over the age of
64 is civilly committed in a state mental health institute, DHS pays the portion not
paid by the federal government of the costs of the services the state mental health
institute provides. Under this bill, the county must pay the portion not paid by the
federal government.
Under current law, DHS has a waiver of federal Medicaid law to conduct a
demonstration project to provide family planning services under MA to women
between the ages of 15 and 44 with family incomes of not more than 200 percent of
the federal poverty level. This bill allows DHS to request an amended waiver from
the federal Department of Health and Human Services to expand the current family
planning demonstration project to include men.
Under current law, DHS administers the Senior Care Program to provide
prescription drugs to certain elderly persons at reduced prices. Pharmacies may
charge a Senior Care enrollee only the program payment rate for prescription drugs,
until the enrollee has met an annual deductible, if applicable, and thereafter may
charge the enrollee only a specified copayment amount. When an enrollee pays only
the copayment, DHS reimburses the pharmacy the program payment rate minus the
copayment. The program payment rate is equal to 105 percent of the MA
prescription drug payment rate plus a dispensing fee. This bill reduces the program
payment rate to 100 percent of the MA prescription drug payment rate plus a
dispensing fee.
Current law requires that DHS establish a mechanism for reviewing petitions
from nursing homes for modification of MA payments and develop criteria for
granting modifications. Upon conducting a review, DHS may modify an MA payment
to a nursing home, as long as the modified payment does not exceed federal
maximum reimbursement levels. This bill repeals the requirement that DHS
establish a mechanism for reviewing petitions from nursing homes to modify MA
payments.
Current law requires the Board of Regents of the UW System to transfer
$15,000,000 to the Medical Assistance trust fund in each fiscal year through
2010-11. This bill increases the amount that the Board of Regents must annually
transfer to the Medical Assistance trust fund to $27,500,000, effective for fiscal year
2008-09, and requires the Board of Regents to make the transfer through fiscal year
2012-13.
Currently, the federal government pays a specified percentage of the allowable
costs of MA benefits. Currently, for some MA benefits, the provider contributes the
entire state share of the cost of providing the benefit and the state disburses to the
provider the federal share of the allowable costs of providing the benefit.
This bill provides that regardless of whether the specified federal percentages
for federal fiscal years 2009 or 2010 are increased above the percentages published
on November 28, 2007, and November 26, 2008, for certain benefits for which the
state disburses the federal share to the provider, the state shall use the percentages
published on those dates to calculate the federal share for benefits provided between
October 1, 2008, and December 31, 2010.
Health
Current law prohibits smoking in mass transit vehicles and specified indoor
locations, including inpatient health care facilities, such as community
based-residential facilities and nursing homes, prisons and jails, restaurants, and
governmental buildings.
With limited exceptions, a smoking area may be designated at an indoor
location by the person who is in charge of that location.
Under this bill, smoking areas at the specified indoor locations may no longer
be designated, resulting in a complete ban on indoor smoking at those locations with
exceptions for private residences, a limited number of designated rooms in lodging
establishments and certain residence rooms in assisted living facilities. In addition
to the specified indoor locations listed under current law, the bill prohibits smoking
in any public place or place of employment.
Current law provides exemptions from the prohibition against smoking for
bowling centers, taverns, halls used for private functions, rooms in which the main
occupants are smokers, and areas of facilities that are used to manufacture or
assemble goods, products, or merchandise. This bill eliminates these exemptions.
Current law allows smoking in any restaurant that has a seating capacity of no
more than 50 individuals, or that holds a liquor license, if the sale of alcohol
beverages accounts for more than 50 percent of the restaurant's receipts. This bill
prohibits smoking in any restaurant regardless of the seating capacity or the number
of liquor sale receipts.
Current law allows smoking in any tavern holding a "Class B" intoxicating
liquor license or Class "B" fermented malt beverages license issued by a municipality.
This bill prohibits smoking in any tavern. The bill also specifically prohibits smoking
in private clubs.
Under current law, smoking is prohibited outside in limited instances. This bill
adds a general prohibition against smoking outside within less than a reasonable
distance from any entrance to a building, a window that may be opened, or a
ventilation opening that draws air inside. The bill also specifically prohibits smoking
in sports arenas and bus shelters.
Current law does not limit the authority of a municipality or county to enact
smoking ordinances that protect the public's health and comfort. This bill makes no
change in this provision.
This bill requires that persons in charge of places where smoking is prohibited
enforce the prohibitions by taking certain steps to ensure compliance, such as asking
a person who is smoking to leave and refusing to serve the person if the place is a
restaurant, tavern, or private club.
Under current law, the Group Insurance Board, attached to DETF, administers
a pharmacy benefits purchasing program that is available for all public and private
sector employers in this state and all residents of this state. The program for private
sector employers and other residents of this state, developed under contract with
Navitus Health Solutions, is called BadgerRx Gold. This bill transfers the BadgerRx
Gold program to DHS.
Under current law, DHS awards grants to organizations to provide mental
health treatment and other services to women who are convicted of non-violent
offenses and their dependent children. This bill eliminates this grant program.
Long-term care
Currently, the state imposes a monthly, per-bed assessment on nursing homes
that may not exceed $75. This bill increases the maximum amount of the assessment
to $150 in fiscal year 2009-10 and $170 in each fiscal year thereafter.
Current law imposes a cap on the number of nursing home beds that may be
licensed statewide. DHS allocates the number of authorized licensed beds among
seven planning areas and to nursing homes within the planning areas. A nursing
home may transfer an authorized licensed bed to another nursing home if the
receiving nursing home is in the same planning area as the transferring nursing
home or in a county adjoining the planning area and the transferring and receiving
nursing homes are under common ownership. This bill allows a nursing home to
transfer an authorized licensed bed to another nursing home regardless of location
or ownership of the nursing homes as long as the nursing homes notify DHS and DHS
approves the transfer.
Currently, DHS may place a monitor in, and the secretary of health services
may petition for appointment of a receiver for, a nursing home or community-based
residential facility (CBRF) when any of several conditions (for example, operating
without a license or in the event of an emergency) exist. This bill specifies two
additional conditions for placement of a monitor or petitioning for appointment of a
receiver: 1) DHS or the nursing home or CBRF determines that estimated operating
expenses of the nursing home or CBRF significantly exceed anticipated revenues;
and 2) the nursing home or CBRF or its operator has been charged with or convicted
of MA fraud, fraud under the federal Medicare Program, or the abuse or neglect of
residents of the nursing home or CBRF. The bill also permits a monitor placed in a
nursing home or CBRF to assist in financial management.
Currently, licensure fees for CBRFs and adult family homes (AFHs), as well as
the certification fee for adult day care centers (ADCCs), are established by statute,
though DHS may increase the certification fee for ADCCs by rule. This bill increases
the licensure fees for CBRFs and AFHs and the certification fee for ADCCs. In
addition, the bill authorizes DHS to increase the licensure fees for CBRFs and AFHs
by rule.
This bill authorizes DHS to assess a $200 fee against a hospital, nursing home,
CBRF, residential care apartment complex, AFH, hospice, home health agency, or
ADCC if DHS takes enforcement action against the facility or provider and
subsequently conducts an on-site inspection to review the facility's or provider's
action to correct the violation.
