If a district board's allowable levy is greater than its actual levy in any year, the
district board may by a three-fourths vote increase its limit in the succeeding year
by the difference, up to a maximum of 0.5 percent of its actual levy. If a district board
wishes to exceed its limit, it must adopt a resolution to that effect and hold a
district-wide referendum. If a district board exceeds its limit without the approval
of the electors, the state technical college system board must reduce the district's aid
payments by the amount of the excess.
Current law requires that the Board of Regents of the UW System and the
chancellor of UW-Madison submit compensation plans for UW employees to the
director of the Office of State Employment Relations (OSER), who then makes
recommendations for UW employee compensation to the Joint Committee on
Employment Relations (JCOER) for approval. This bill eliminates the requirements
that the Board of Regents and the chancellor of UW-Madison submit the plans to the
director of OSER and receive JCOER approval. In addition, the bill eliminates all
funding for the Board of Regents from the compensation reserve, a pool of moneys
used to fund salary adjustments for UW System employees. Under the bill, salary
adjustments are funded from moneys directly appropriated to the Board of Regents.
Current law requires the Board of Regents to establish policies for transferring
credits between institutions within the system. The policies must designate the
courses that are transferable without loss of credit toward graduation or toward
completion of a specific course of study. In addition, current law allows the Board of
Regents to establish policies for transferring credits with educational institutions
outside the system. Current law also allows the TCS Board, in agreement with the
Board of Regents, to designate courses that are transferable for collegiate credit
between the technical colleges and the UW System.
This bill requires the Board of Regents and the TCS Board to enter into an
agreement regarding transfer of credit for courses generally required for an
undergraduate degree that are prerequisite or otherwise in addition to the courses
required for an undergraduate degree in a specific course of study (core general
education courses). The agreement must ensure that, beginning in the 2014-15
academic year, not fewer than 30 credits of such courses are transferable within and
between each UW school and technical college. The agreement must also ensure that
the courses are transferrable without loss of credit toward graduation or toward
completion of a specific course of study.
The bill also requires the Board of Regents and the TCS Board to ensure that
in-state tribally controlled colleges (tribal colleges) and that nonprofit institutions
of higher education that are members of the Wisconsin Association of Independent
Colleges and Universities have an opportunity to participate in the agreement. If a
tribal college or private school participates, the agreement must ensure that credits
for core general educational courses are transferable within and between each
participating tribal college and private school, as well as UW schools and technical
colleges.
Under current law, a veteran who was a resident of this state when he or she
entered the armed forces and who meets certain additional criteria is eligible for a
full remission of tuition and segregated fees at a UW institution, or of tuition and
materials fees at a technical college, for 128 credits or eight semesters, whichever is
longer. This bill makes the following changes to this fee remission program for
eligible veterans:
1. The veteran must have been a resident of this state when he or she entered
the armed forces or for at least five consecutive years.
2. In determining a veteran's residence at the time he or she entered the armed
forces, the state from which the veteran entered is irrelevant.
3. A veteran must maintain a cumulative grade point average of at least 2.0 to
remain eligible for the fee remission.
Under current law, the spouse and children of a veteran who was a resident of
this state when he or she entered the armed forces and to whom one of the following
applies is eligible for the same tuition remission:
1. The veteran, while a state resident, died while on active duty, as the result
of a service-connected disability, or in the line of duty while in training.
2. The veteran has been awarded at least a 30 percent service-connected
disability rating by the U.S. Department of Veterans Affairs.
Under current law, with certain exceptions, a spouse is eligible for a fee
remission under this program only if he or she is a state resident and only for the first
ten years after the veteran receives the disability rating or after the veteran dies.
A child is eligible only if he or she is a state resident and is at least 17 and not yet
26 years old. This bill makes the same changes to this fee remission program as it
makes to the first-described program and eliminates the ten-year limitation for a
spouse.
With certain exceptions, current law, beginning on July 1, 2013, prohibits the
Board of Regents and all UW Schools, including the UW-Extension (UW schools)
from being a member, shareholder, or partner in organizations that provide
telecommunications services, including Internet-related services. Current law
includes an exception for organizations that are comprised entirely of universities
and university-affiliated research facilities.
This bill creates a new exception for an organization that advances research or
higher education, except that an association called WiscNet does not qualify for the
new exception. The bill's new exception applies if the Board of Regents or a UW
school served as a member, shareholder, or partner in the organization on February
1, 2013, or if the DOA secretary determines that the organization qualifies for the
exception. If the bill's new exception applies, the Board of Regents or UW school may
use the organization's services and may also participate in the organization's
operations or provide certain services to the organization, but only if the
participation, or provision of services, is in connection with the Board of Regents' or
UW school's use of the organization's services.
This bill makes an appropriation to the Board of Regents for costs incurred by
the UW Carbone Cancer Center (center) that relate to translational imaging
research, research imaging and scanning, research imaging equipment, and the
Wisconsin Oncology Network. The bill also requires the center to submit a plan to
the secretary of administration for raising matching funds from federal, private, and
other sources to help defray the foregoing costs. The bill prohibits any release of
moneys from the appropriation until the secretary of administration approves the
fund-raising plan.
This bill directs the Board of Regents annually to allocate $1,500,000 for the
Wisconsin Academy for Rural Medicine and the Training in Urban Medicine and
Public Health Program at the UW School of Medicine and Public Health.
Other educational and cultural agencies
Current law appropriates to the Higher Educational Aids Board certain
general purpose revenue for the support of Wisconsin residents who are pursuing
doctor of dental surgery degrees at the Marquette University Dental School and caps
the number of students who may be so funded at 160. This bill increases that cap
to 200.
Under current law, the Educational Approval Board (EAB) inspects and
approves private trade, correspondence, business, and technical schools to protect
the students of those schools, prevent fraud, and encourage accepted educational
standards at those schools. Currently, EAB is attached to the TCS Board for
administrative purposes. This bill attaches EAB to DSPS for administrative
purposes.
Employment
Currently, with limited exceptions, in order to become and remain eligible to
receive unemployment insurance benefits for any week, a claimant is required,
among other things, to register for work and to conduct a reasonable search for
suitable work within that week, which must include at least two actions that
constitute a reasonable search as prescribed by rule by DWD. This bill requires each
claimant to register for work in the manner directed by DWD and increases the
minimum number of actions that a claimant must undertake to become and remain
eligible for benefits to at least four actions per week.
Environment
Air quality
The federal government has delegated to DNR the authority to administer the
federal Clean Air Act in this state. The Clean Air Act requires operators of certain
stationary sources of air pollution, such as large factories, to have operation permits
(federal operation permits). State law requires operators of additional stationary
sources of air pollution to have operation permits (state operation permits).
Generally, current law requires an operator who has a federal operation permit
to pay an annual fee of $35.71 per ton of certain pollutants emitted in the previous
year, subject to a cap. This bill increases the amount of the annual fee imposed on
operators who have federal operation permits to $46.71 per ton in 2014 and $59.81
per ton in 2015. After 2015, the fee per ton is increased by 4 percent annually.
Generally, current law requires an operator who has a state operation permit
to pay a fee of $300 per year. This bill increases the fee to $725 per year.
Environmental cleanup
Currently, this state operates a program known as PECFA to reimburse owners
of certain petroleum product storage tanks for a portion of the costs of cleaning up
discharges from those tanks. Under current law, DSPS administers PECFA, with
involvement by DNR. Current law also authorizes DSPS to provide funding for the
removal of abandoned underground petroleum product storage tanks. This bill
transfers the administration of PECFA and the authority to fund the removal of
those tanks from DSPS to DNR.
Water quality
Under current law, both DSPS and DNR administer laws regarding erosion
control at construction sites. DSPS has erosion control authority over building sites
for public buildings, buildings that are places of employment (commercial buildings),
and one-family and two-family dwellings. DNR has erosion control authority over
sites where the construction activities do not include the construction of a building,
such as sites involving street or bridge construction.
This bill transfers from DSPS to DNR erosion control authority over
construction sites with a land disturbance area of one or more acres, regardless of
whether the construction activity includes the construction of a building. Under the
bill, DSPS retains authority over construction sites with a land disturbance area of
less than one acre and that involve the construction of a commercial building or a
one-family or two-family dwelling.
Current law requires certain persons who discharge storm water to obtain a
storm water discharge permit. This bill specifies that this permit requirement
applies to conveyances of storm water associated with a construction site, including
a building construction site.
Under the Clean Water Fund Program, this state provides financial assistance
for projects for controlling water pollution, including loans at subsidized interest
rates. This bill sets the present value of the Clean Water Fund Program subsidies
that may be provided during the 2013-15 biennium at $76,700,000.
Under the Safe Drinking Water Loan Program, this state provides loans at
subsidized interest rates to local governmental units for projects for the construction
or modification of public water systems. This bill sets the present value of the Safe
Drinking Water Loan Program subsidies that may be provided during the 2013-15
biennium at $29,600,000 and increases the general obligation bonding authority for
the Safe Drinking Water Loan Program by $7,100,000.
Under current law, DNR administers a program to provide financial assistance
for projects to reduce nonpoint source water pollution in areas that are targeted due
to surface water quality problems. This bill increases the authorized general
obligation bonding authority for this program by $7,000,000.
Under current law, DNR administers programs to provide financial assistance
for the management of urban storm water runoff and for flood control and riparian
restoration projects. This bill increases the general obligation bonding authority for
these programs by $5,000,000.
Current law authorizes DNR to pay a portion of the costs of a project to remove
contaminated sediment from Lake Michigan or Lake Superior or their tributaries.
This bill increases the general obligation bonding authority for sediment removal
projects by $5,000,000.
GAMbling
Current law regulates the operation of crane games by requiring DOA
registration of a crane game before it is set up for play, and before the owner may
collect any proceeds from the game. A crane game is an amusement device involving
skill that rewards the player exclusively with prizes, toys, and novelties of limited
value contained within the device. This bill repeals all provisions that regulate the
operation of crane games.
Under current law, a lottery prize winner may receive payment of the prize
either in the form of a lump sum or in installments as an annuity. If a prize winner
dies before all of the annuity payments are made, the remainder of the prize may be
paid to the person's estate. This bill specifically provides that in the case of the death
of a prize winner, any installments that have not been paid shall be paid to the
winner's estate. The bill also authorizes the personal representative of an estate to
choose for the estate to receive the remaining installments as a lump sum. It also
allows persons, other than prize winners, who are receiving annuity payments of
unpaid prize money to choose a lump sum payment. The ability to choose a lump sum
payment is not available when the prize money is from a multistate lottery.
health and human services
Public assistance
Under current law, DHS administers the federal Supplemental Nutrition
Assistance Program (SNAP), formerly known as the food stamp program and
currently known in Wisconsin as FoodShare, under which eligible households
receive benefits to purchase food at retail food stores. Under current law, with
certain exceptions, DHS may require a recipient of SNAP benefits who is able and
who is 18 to 60 years of age to participate in the FoodShare employment and training
program (FSET) to be eligible for SNAP benefits, including an individual who is the
caretaker of a child under the age of 12 weeks.
This bill authorizes DHS to implement a federal policy under which DHS may
limit the amount of SNAP benefits that an able-bodied adult may receive to three
months during a three-year period if the adult does not meet certain work
requirements. An able-bodied adult, as defined by the bill, is an individual who is
18 to 49 years old, is fit for employment, is not a parent of a household member who
is younger than 18, is not pregnant, and is not otherwise exempt from specific work
requirements under federal law. DHS may implement this policy in addition to the
current employment and training program. This bill also expands the FSET
participation requirement exception for an individual who is the caretaker of a child
under the age of 12 weeks to a caretaker of a child under the age of six years to comply
with federal law.
Under current law, the transitional jobs demonstration project, under which
DCF pays wage subsidies to employers who employ low-income individuals in
transitional jobs, will end on July 1, 2013. This bill creates a Transform Milwaukee
Jobs program (TMJ program) that is very similar to the transitional jobs
demonstration project. Under the TMJ program, an employer, or a person with
which DCF contracts to administer the program (contractor), that employs a
program participant must employ the participant at least 20 hours per week at a
location in this state and pay at least minimum wage. DCF pays the employer or
contractor a wage subsidy that is equal to the wage the employer or contractor pays
the participant, up to 40 hours per week at minimum wage, and may reimburse the
employer or contractor for certain taxes and other expenses that are attributable to
employment of the participant.
Current law prohibits any person from disclosing information about
individuals applying for or receiving benefits under a number of public assistance
programs for any purpose not related to administration of the programs. DCF is
authorized, however, to disclose such information to DOR for the sole purpose of
administering state taxes. The bill provides that DCF and DHS may disclose such
information by transmitting or allowing access to electronic data, that administering
state taxes includes verifying refundable income tax credits, and that the
information may also be disclosed for the purpose of collecting debts owed to DOR.
Wisconsin Works
The Wisconsin Works (W-2) program under current law, which is administered
by DCF, provides work experience and benefits for low-income custodial parents who
are at least 18 years old. Also, 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, who needs child care services
to participate in various educational or work activities, and who satisfies other
eligibility criteria may receive a child care subsidy for child care services under the
W-2 program. This child care subsidy program is known as Wisconsin Shares. The
bill makes the following changes to Wisconsin Shares:
1. Under current law, DCF reimburses child care providers or distributes funds
to county departments or tribal governing bodies for child care services provided
under Wisconsin Shares and to private nonprofit agencies that provide child care for
children of migrant workers. This bill provides that, in addition to the ways in which
DCF may distribute child care subsidy funds under current law, DCF may issue
benefits directly to individuals who are eligible for the subsidies.
2. Under current law, counties set maximum rates, which are approved by DCF,
for child care services under Wisconsin Shares. However, DCF may modify an
individual child care provider's maximum rate on the basis of the child care
provider's quality rating under the quality rating plan known as YoungStar. Current
law allows DCF to increase the maximum rate for a provider who receives a four-star
rating under YoungStar by up to 5 percent. Under this bill, DCF determines the
maximum rates for child care services under Wisconsin Shares. This bill also
authorizes DCF to increase the maximum rate for a child care provider who receives
a four-star rating under YoungStar by up to 10 percent beginning January 1, 2014.
3. Under current law, individuals receiving child care subsidies under
Wisconsin Shares must pay, as a copayment for the child care, a percentage of the cost
of the child care specified by DCF in a printed copayment schedule. The bill changes
the copayments that eligible individuals must pay for child care to the difference
between the cost of the child care provided by the provider selected by the individual
and the subsidy amount.
4. Under the bill, if a noncustodial parent of a child is required to pay child
support and the custodial parent of the child is a participant in W-2 or is eligible to
receive a child care subsidy for the child under Wisconsin Shares, the noncustodial
parent is eligible to receive the following services and benefits under W-2:
a. Job search assistance and case management services.
b. A monetary stipend for up to four months.
c. Work experience in one trial employment match program job.
5. The bill allows any noncustodial parent who is ineligible for a job access loan
solely because the individual is not a custodial parent to receive a job access loan
under W-2 to enable the individual to obtain or continue employment.
6. The bill provides that an individual who is eligible for a child care subsidy
under Wisconsin Shares may use the subsidy for child care that is provided by an
out-of-state provider. The rate at which the out-of-state provider is paid is based
on the maximum rate paid to a provider in the county in which the eligible individual
resides or the out-of-state provider's actual rate, whichever is lower.
W-2 provides work experience to a participant through placement in one of a
number of different employment positions, depending on the participant's skills,
training, and experience. For one of the employment positions, called trial jobs, a
W-2 agency pays a wage subsidy to a private employer that employs a W-2
participant. The bill terminates the trial job employment position and replaces it
with a trial employment match program (TEMP) that has the same features as the
trial job employment position, except for a few changes.
Under current law, a W-2 agency pays an employer a wage subsidy of not more
than $300 per month for full-time employment of a participant in a trial job. Under
the bill, in TEMP the W-2 agency and employer negotiate the wage subsidy, which
is be paid for every hour that the participant actually works, up to 40 hours per week,
at not less than the applicable minimum wage. In addition, the W-2 agency may
reimburse the employer for all or a portion of certain taxes and other costs associated
with employment of the participant. The bill changes the maximum time in a TEMP
job from up to three months to up to six months, with a possible three-month
extension. Currently, an employer that employs a participant in a trial job must
agree to make a good faith effort to retain the participant as a permanent
unsubsidized employee after the wage subsidy under the trial job ends. For TEMP
the bill adds that, if the employer does not retain the participant, the employer must
serve as an employment reference for the participant or must provide the W-2
agency with a written performance evaluation with recommendations for
improvement.
In addition to replacing trial jobs with TEMP, the bill repeals the real work, real
pay employment position in W-2, eliminates the subsidized private sector
employment program, and eliminates the workforce attachment and advancement
program.
Medical Assistance
Currently, DHS administers the Medical Assistance (MA) program, which is a
joint federal and state program that provides health services to individuals who have
limited resources. Some services are provided through programs that operate under
a waiver of federal Medicaid laws, including services provided through BadgerCare
Plus (BC+) and BadgerCare Plus Core (BC+ Core). Under current law, BC+ has a
standard plan with a larger set of benefits and a Benchmark plan with fewer
benefits.
Under current law, family income is the total gross earned and unearned
income received by all members of a family. Beginning on January 1, 2014, under
the bill, for purposes of determining eligibility for BC+ and BC+ Core, family income
is defined under a federal regulation that uses an income calculation based on
modified adjusted gross income. The bill also makes other changes to calculation of
income and family size for BC+ and BC+ Core on January 1, 2014, or sooner.
Under current law, certain individuals are eligible for benefits under the BC+
standard plan. Beginning in January 1, 2014, under the bill, a pregnant woman
must have an income that does not exceed 133 percent of the federal poverty line
(FPL) to be eligible for BC+ standard plan benefits. Also, beginning on January 1,
2014, the bill reduces the income eligibility level for the BC+ standard plan for
parents and caretaker relatives from not more than 200 percent of the FPL to not
more than 100 percent of the FPL before a 5 percent income disregard is applied. The
bill defines, beginning on January 1, 2014, for purposes of eligibility of a parent or
caretaker relative, a "dependent child." The bill also changes criteria for
presumptive eligibility, retroactive eligibility, and transitional MA.
The bill retains the current law ineligibility provisions for certain individuals
with health insurance coverage or access to coverage during certain times and adds,
with certain limitations, individuals to the types of individuals for whom access to
coverage results in ineligibility and specifies the types of insurance that result in
ineligibility. Under the bill, certain individuals are ineligible for BC+ if they have
private major medical insurance with a certain premium. The bill also adds certain
individuals to those who are ineligible for BC+ for three months for not maintaining
certain types of health coverage.
Beginning on January 1, 2014, the bill eliminates eligibility for the BC+
Benchmark plan for all of the following individuals: pregnant women whose family
income exceeds 200 percent but does not exceed 300 percent of the FPL and children
under one year of age of those women; certain other pregnant women; and parents
or caretaker relatives whose family income includes self-employment income and
does not exceed 200 percent of the FPL under a certain calculation. Under the bill,
beginning on January 1, 2014, an unborn child whose family income exceeds 200
percent of the FPL but does not exceed 300 percent of the FPL is eligible for
Benchmark but only for prenatal care benefits. On January 1, 2014, the bill
eliminates the ability for children whose family incomes exceed 300 percent of the
FPL to receive Benchmark plan benefits by paying the full member per month cost
of coverage.
If the federal Department of Health and Human Services (federal DHHS)
allows, under the bill, DHS may provide an alternate Benchmark plan to adult
individuals who are not pregnant, whose family incomes exceed 100 percent of the
FPL, and who are otherwise eligible for BC+. The alternate Benchmark plan, if
provided, provides coverage for benefits similar to those in a commercial, major
medical insurance policy and may charge higher copayments than are charged for
the standard plan, with certain limitations.
The bill allows DHS to administer medical home initiatives as service delivery
mechanisms to provide and coordinate care for individuals who are eligible for
services under a fee-for-service model of MA, including BC+ and BC+ Core.
Current law requires certain individuals to pay premiums for BC+. The bill
requires an adult parent or adult caretaker who is not pregnant, disabled, or
American Indian and whose family income exceeds 133 percent of the FPL and, if the
federal DHHS approves, a child who is not disabled and whose family income is at
a level determined by DHS but at least 150 percent of the FPL, to pay a premium for
BC+.
Under current law, if an individual does not pay a required premium or requests
termination of coverage under BC+, the coverage under BC+ is terminated and a
six-month ineligibility period begins. The bill changes the ineligibility period for an
adult to 12 months except for any month in which the former recipient's family
income does not exceed 133 percent of the FPL. For a child, the bill retains the six
month ineligibility period except for any month in which the child's family income
does not exceed 150 percent of the FPL; however, if the federal DHHS approves, the
ineligibility period becomes 12 months.
Under current law, DHS also administers BC+ Core, which provides basic
primary and preventive care to adults who are under age 65, who have family
incomes that do not exceed 200 percent of the FPL, and who are not otherwise eligible
for MA, including BC+. The bill requires certain childless adults with a family
income exceeding 133 percent of the FPL to pay a premium for BC+ Core benefits.
Beginning January 1, 2014, the bill allows only those individuals whose family
incomes do not exceed 100 percent of the FPL, before a 5 percent income disregard
is applied, to be eligible for BC+ Core.
The bill allows DHS to enroll a child who is receiving services through the early
intervention program in a special plan, if the federal DHHS approves.
Under current law, DHS is required to develop a purchasing pool, which is not
an MA program and is known as Badger Rx Gold, for pharmacy benefits and set
eligibility requirements to obtain prescription drug coverage through the purchasing
pool. The bill eliminates Badger Rx Gold.
Under current law, an individual who would be eligible for MA based on
eligibility for supplemental security income (SSI), but who is not eligible for SSI
because he or she is employed and has too much earned and unearned income to be
eligible, may pay premiums for coverage under MA if his or her family's net income
is less than 250 percent of the FPL and his or her assets do not exceed $15,000,
excluding certain assets. This program is known as the MA purchase plan (MAPP).
The bill makes a number of changes to the eligibility and premium
requirements under MAPP. Under current law, when determining an individual's
net income, certain disregards are deducted from the individual's and his or her
spouse's total earned income, then the individual's and his or her spouse's total
unearned income is added. Under the bill, the same disregards are deducted from
the individual's and his or her spouse's earned and unearned income combined, then
a new deduction of up to $500 per month of the individual's out-of-pocket medical
and remedial expenses and long-term care costs is applied. The bill requires that,
to be engaged in gainful employment, which is required for eligibility, an individual
must be paying, or having withheld, certain taxes, and requires that DHS verify,
through documentation provided by the individual, both the individual's income
from work activity and payment or withholding of taxes.
Currently, premiums for MA coverage under MAPP are calculated by adding
together all of the individual's unearned income, after certain specified amounts are
deducted, and then adding 3 percent of the individual's earned income. DHS waives
any premiums below $25 per month. In addition, DHS does not assess a premium
if the individual's total earned and unearned income is below 150 percent of the FPL
for a family the size of the individual's family. Under the bill, an individual whose
total earned and unearned income is at least 150 percent of the FPL
for an individual
is required to pay a premium. The premium is equal to 3 percent of the individual's
total earned and unearned income, after deducting the same amounts that are
deducted under current law from an individual's unearned income, and then
rounded down to the nearest $25. A minimum monthly premium of $50 is set,
however, for anyone whose calculated premium is below that amount.
Certain MA programs consider an individual's income and assets when
determining eligibility and any cost-sharing requirements. Under the bill, when
determining eligibility or cost-sharing requirements under various MA programs,
including Family Care and MAPP, DHS must exclude, to the extent approved by the
federal government, independence accounts and retirement benefits that
accumulated or were earned through employment income or employer contributions
while the individual was employed and receiving MA coverage under MAPP. An
independence account is a DHS-approved account that consists of savings from
income earned while an individual is covered under MAPP.
Under current law, an individual who divests income or assets, or disposes of
income or assets for less than fair market value, may be ineligible for MA for a certain
period of time. Current law specifies a method for determining the starting date for
an ineligibility period for MA resulting from a divestment. This bill specifies that the
current law method applies to applicants for MA. For recipients of long-term care
services through MA, the bill sets as the starting date for an ineligibility period the
first day of the month following the month in which the individual receives advance
notice of that ineligibility period.
Under current law, the purchase by an individual or his or her spouse of a
promissory note, loan, or mortgage is a transfer of assets for less than fair market
value that triggers an ineligibility period unless certain circumstances apply,
including that the loan's terms prohibit cancellation of the balance upon the death
of the lender. This bill specifies that a promissory note in which the debtor is a
presumptive heir of the lender or in which neither the lender nor debtor has any
incentive to enforce repayment is considered canceled upon the death of the lender
for purposes of divestment and eligibility for MA.
Current law provides for protection of certain income and resources for a spouse
who is not receiving long-term care services through MA, known as the community
spouse, of an institutionalized individual. This bill specifies that even though the
community spouse's resources are considered unavailable, the transfer of those
resources or other assets by the community spouse within the first five years of the
institutionalized spouse's eligibility for MA may result in a period of ineligibility for
MA. The bill also allows DHS to deny MA eligibility to an institutionalized spouse
if the institutionalized spouse and community spouse do not provide the total value
of their assets and information on income and resources to the extent required under
federal law or do not sign the MA application.
Current law allows a community spouse to have a minimum monthly
maintenance needs allowance (MMMNA) and the community spouse is allowed a
resource allowance to generate the income to provide the MMMNA. If either spouse
establishes at a fair hearing that the resource allowance determined outside the fair
hearing does not generate enough income to meet the MMMNA, DHS is required to
establish an amount that results in a sufficient MMMNA. The bill specifies on what
DHS must base the amount to be used to raise the income to the level of the MMMNA
and that any resource may be transferred to provide that amount.
Under current law, eligibility for the MA program for the medically indigent is
contingent on the applicant's property not exceeding certain parameters including
that the total face value of all life insurance policies that have a cash surrender value
is $1,500 or less. The bill changes this parameter such that those applicants are
eligible only if the combined cash surrender value of all life insurance policies with
cash surrender values, including riders and other attachments, is $1,500 or less.
One of the benefits provided under MA is psychosocial services provided by the
staff of a community-based psychosocial service program. This benefit, however, is
available to a recipient under MA only if the county in which the recipient resides
elects to make this benefit available under MA, in which case DHS reimburses a
provider of the services for the portion of the allowable MA charge that is provided
by the federal government and the county reimburses the provider for the remainder
of the allowable MA charge. The bill provides that, if a county delivers this MA
benefit on a regional basis, DHS will reimburse a provider both for the allowable MA
charge that is provided by the federal government and for the remainder of the
allowable charge.
Federal law requires that an MA recipient receive benefits in the state in which
he or she resides. With some exceptions, the bill requires DHS to electronically verify
the residence of an applicant for MA for purposes of determining eligibility and of a
recipient of MA for purposes of determining continued eligibility when a recipient's
eligibility is reviewed. If DHS is unable to electronically verify residence, an
applicant or recipient must then provide DHS with adequate proof of residency.
Under current law, if an MA recipient has health care coverage from another
source (third party), such as a health insurance policy or an employer's self-insured
health plan, DHS is entitled to be reimbursed by the third party for any MA
payments that DHS has made. This bill requires a third party to accept claims from
DHS electronically for reimbursement of payments made under MA.
Children
Under current law, if a county that investigates a report of child abuse or
neglect determines that a specific person has abused or neglected the child, the
person may appeal the determination in accordance with procedures established by
DCF by rule. This bill requires a county that makes an initial determination that
a specific person has abused or neglected a child to provide the person with an
opportunity for a review of that initial determination in accordance with rules
promulgated by DCF before the county may make a final determination. The bill also
grants the person the right to a contested case hearing on that determination and
judicial review of the final administrative decision following the contested case
hearing.
Subject to certain exceptions, current law requires DCF to maintain the
confidentiality of records kept or information received about an individual who is or
was in the care or legal custody of DCF. The bill permits DCF to provide to DOR
information concerning a recipient of payments for out-of-home care for a child
solely for the purposes of administering state taxes and collecting debts owed to
DOR.
