Amendment SSA1-SB21

SB21-SSA1,9113 Section 9113. Nonstatutory provisions; Employment Relations Commission.

SB21-SSA1,9114 Section 9114. Nonstatutory provisions; Financial Institutions.

SB21-SSA1,9115 Section 9115. Nonstatutory provisions; Government Accountability Board.

SB21-SSA1,9116 Section 9116. Nonstatutory provisions; Governor.

SB21-SSA1,9117 Section 9117. Nonstatutory provisions; Health and Educational Facilities Authority.

SB21-SSA1,9118 Section 9118. Nonstatutory provisions; Health Services.

SB21-SSA1,1489,13 (1) Community mental health allocation. Notwithstanding section 46.40 (7m) of the statutes, as created by this act, the department of health services may distribute one-half of the amount allocated for community mental health services in fiscal year 2015-16 after the effective date of this subsection.

SB21-SSA1,1490,10 (1q) Community mental health services funds. Before developing a method for distributing community mental health services funds under section 46.40 (7m) of the statutes, as created by this act, for 2016 and thereafter, the department of health services shall consult with the Wisconsin Counties Association and other persons and organizations with an interest in mental health services on the distribution method. The department of health services before implementing the distribution method shall submit the proposed distribution method to the joint committee on finance. If the cochairpersons of the committee do not notify the department of health services within 14 working days after the date of the submittal of the proposed distribution method by the department of health services that the committee has scheduled a meeting for the purpose of reviewing the proposed distribution method, the department of health services shall implement the proposed distribution method as submitted to the committee. If, within 14 working days after the date of the submittal of the proposed distribution method by the department of health services, the cochairpersons of the committee notify the department of health services that the committee has scheduled a meeting for the purpose of reviewing the proposed distribution method, the department of health services may implement the proposed distribution method only as approved by, or as modified and approved by, the committee.

SB21-SSA1,1490,11 (2) Transfer of food safety, recreational facilities, and lodging.

SB21-SSA1,1490,16 (a) Assets and liabilities. The assets and liabilities of the department of health services that the secretary of administration determines to be primarily related to food, lodging, and recreation oversight under sections 252.18, 254.47, and 254.61 to 254.87, 2013 stats., become the assets and liabilities of the department of agriculture, trade and consumer protection on the effective date of this paragraph.

SB21-SSA1,1490,22 (b) Employee transfer. All incumbent employees who hold positions in the department of health services performing duties that the secretary of administration determines to be primarily related to sections 252.18, 254.47, and 254.61 to 254.87, 2013 stats., and the full-time equivalent positions held by those employees, are transferred to the department of agriculture, trade and consumer protection on the effective date of this paragraph.

SB21-SSA1,1491,3 (c) Employee status. Employees transferred under paragraph (b) have all the rights and the same status under chapter 230 of the statutes in the department of agriculture, trade and consumer protection that they enjoyed in the department of health services immediately before the transfer. Notwithstanding section 230.28 (4) of the statutes, no employee so transferred who has attained permanent status in class is required to serve a probationary period.

SB21-SSA1,1491,9 (d) Tangible personal property. On the effective date of this paragraph, all tangible personal property, including records, of the department of health services that the secretary of administration determines to be primarily related to food, lodging, and recreation oversight under sections 252.18, 254.47, and 254.61 to 254.87, 2013 stats., is transferred to the department of agriculture, trade and consumer protection.

SB21-SSA1,1491,18 (e) Contracts. All contracts that were entered into by the department of health services that the secretary of administration determines to be primarily related to food, lodging, and recreation oversight under sections 252.18, 254.47, and 254.61 to 254.87, 2013 stats., and that are in effect on the effective date of this paragraph remain in effect and are transferred to the department of agriculture, trade and consumer protection. The department of agriculture, trade and consumer protection shall carry out any obligations under such a contract until the contract is modified or rescinded by the department of agriculture, trade and consumer protection to the extent allowed under the contract.

SB21-SSA1,1492,2 (f) Rules and orders. All rules in chapters DHS 172, 175, 178, 192, 195, 196, 196 appendix, 197, and 198, Wisconsin administrative code, and all other rules promulgated, and all orders issued, by the department of health services that the secretary of administration determines to be primarily related to sections 252.18, 254.47, and 254.61 to 254.87, 2013 stats., and that are in effect on the effective date of this paragraph shall remain in effect until their specified expiration date or until amended or repealed by the department of agriculture, trade and consumer protection.

SB21-SSA1,1492,10 (g) Pending matters. Any matter pending with the department of health services on the effective date of this paragraph that the secretary of administration determines to be related to food, lodging, and recreation oversight under section 252.18 or 254.47, or sections 254.61 to 254.87, 2013 stats., is transferred to the department of agriculture, trade and consumer protection, and all materials submitted to or actions taken by the department of health services with respect to the pending matter are considered as having been submitted to or taken by the department of agriculture, trade and consumer protection.

SB21-SSA1,1492,12 (3) Transfer of body art and tanning facility regulation functions to the department of safety and professional services.

SB21-SSA1,1492,17 (a) Assets and liabilities. On the effective date of this paragraph, the assets and liabilities of the department of health services that are primarily related to the regulation of tattooing, body piercing, and tanning under section 255.08, 2013 stats., and sections 252.23 to 252.25, 2013 stats., become the assets and liabilities of the department of safety and professional services.

SB21-SSA1,1492,23 (b) Tangible personal property. On the effective date of this paragraph, all tangible personal property, including records, of the department of health services that are primarily related to the regulation of tattooing, body piercing, and tanning under section 255.08, 2013 stats., and sections 252.23 to 252.25, 2013 stats., as determined by the secretary of administration, is transferred to the department of safety and professional services.

SB21-SSA1,1493,7 (c) Pending matters. Any matter pending with the department of health services that is primarily related to the regulation of tattooing, body piercing, and tanning under section 255.08, 2013 stats., and sections 252.23 to 252.25, 2013 stats., on the effective date of this paragraph is transferred to the department of safety and professional services. All materials submitted to or actions taken by the department of health services that are primarily related to the regulation of tattooing, body piercing, and tanning under section 255.08, 2013 stats., and sections 252.23 to 252.25, 2013 stats., are considered as having been submitted to or taken by the department of safety and professional services.

SB21-SSA1,1493,14 (d) Contracts. All contracts entered into by the department of health services that are primarily related to the regulation of tattooing, body piercing, and tanning under section 255.08, 2013 stats., and sections 252.23 to 252.25, 2013 stats., in effect on the effective date of this paragraph remain in effect and are transferred to the department of safety and professional services. The department of safety and professional services shall carry out any obligations under those contracts unless modified or rescinded by that department to the extent allowed under the contract.

SB21-SSA1,1493,25 (e) Rules and orders. All rules in chapters DHS 161 and DHS 173, Wisconsin Administrative Code, and any other rules promulgated by the department of health services that are primarily related to the regulation of tattooing, body piercing, and tanning under section 255.08, 2013 stats., and sections 252.23 to 252.25, 2013 stats., in effect on the effective date of this paragraph remain in effect until their specified expiration dates or until amended or repealed by the department of safety and professional services. All orders issued by the department of health services that are primarily related to the regulation of tattooing, body piercing, and tanning under section 255.08, 2013 stats., and sections 252.23 to 252.25, 2013 stats., in effect on the effective date of this paragraph remain in effect until their specified expiration dates or until modified or rescinded by the department of safety and professional services.

SB21-SSA1,1494,4 (f) Credential fees. Notwithstanding sections 463.10 (3), 463.12 (3), and 463.25 (2) (b) of the statutes, fees for the issuance and renewal of licenses and permits issued under sections 463.10, 463.12, and 463.25 of the statutes shall, for years 2015 and 2016, be according to the rules described under paragraph (e).

SB21-SSA1,1494,5 (3g) Nursing home bed transfer.

SB21-SSA1,1494,7 (a) In this section, "nursing home" has the meaning given in section 50.01 (3) of the statutes.

SB21-SSA1,1494,11 (b) Notwithstanding sections 150.33, 150.35, and 150.39 of the statutes, from the nursing home beds that are available under section 150.31 of the statutes, the department of health services shall, following submission of the application under paragraph (c), redistribute 3 beds to a nursing home that satisfies all of the following:

SB21-SSA1,1494,13 1. On the effective date of this subdivision, it has a licensed bed capacity of no more than 75.

SB21-SSA1,1494,15 2. On the effective date of this subdivision, it is covered by a permit under section 647.02 of the statutes.

SB21-SSA1,1494,18 3. On the effective date of this subdivision, it is located in a county that has a population of at least 380,000 and that is adjacent to a county that has a population of at least of 750,000.

SB21-SSA1,1494,21 (c) A person may not receive approval for the beds unless the person submits to the department of health services, on a form provided by the department, an application that meets the requirements under section 150.33 (2) of the statutes.

SB21-SSA1,1495,2 (3q) Advanced life support training grant. From the appropriation account under section 20.435 (1) (ch) of the statutes the department of health services shall allocate as a grant to an entity that provides or facilitates advanced life support training to physicians, physician's assistants, nurse practitioners, registered nurses, and emergency medical technicians — paramedics, who work in rural areas in this state, $20,000 in each fiscal year of the 2015-2017 fiscal biennium.

SB21-SSA1,1495,6 (4f) Healthy aging grant. From the appropriation account under section 20.435 (7) (cx) of the statutes the department of health services shall allocate as a grant $200,000 in each fiscal year of the 2015-17 fiscal biennium to a private, nonprofit entity that conducts all of the following activities:

SB21-SSA1,1495,8 (a) Coordinating the implementation of evidence-based health promotion programs in healthy aging.

SB21-SSA1,1495,10 (b) Coordinating with academic and research institutes regarding research on healthy aging.

SB21-SSA1,1495,12 (c) Serving as a statewide clearinghouse on evidence-based disease prevention and health promotion programs.

SB21-SSA1,1495,15 (d) Providing training and technical assistance to the staff of county departments, administering agencies, and other providers of services to aging populations.

SB21-SSA1,1495,17 (e) Collecting and disseminating information on disease prevention and health promotion in healthy aging populations.

SB21-SSA1,1495,19 (f) Coordinating public awareness activities related to disease prevention and health promotion in aging populations.

SB21-SSA1,1495,21 (g) Advising the department of health services on public policy issues concerning disease prevention and health promotion in aging.

SB21-SSA1,1496,6 (4u) Labor region methodology study. The department of health services shall study the labor region methodology, including the methodology under section 49.45 (6m) (ar) of the statutes, used to assist with the determination of Medical Assistance reimbursement rates, and no later than July 1, 2016, shall submit to the legislature under section 13.172 (2) of the statutes an implementation plan for incorporating any necessary changes to labor region methodology such that the proposed labor region methodology results in adjustments to direct care costs that reflect labor costs for nursing homes in each county. The department of health services may not implement any proposed changes to labor region methodology without the enactment of legislation.

SB21-SSA1,1496,11 (5) Requirements for FoodShare employment and training program drug screening. The department of health services shall address, in the department's biennial budget request under section 16.42 of the statutes for the 2017-19 fiscal biennium, any future fiscal impact resulting from actions taken under section 49.79 (9) (d) of the statutes, as created by this act.

SB21-SSA1,1496,17 (6) Requirements for assistance for childless adults demonstration project. If, during the 2015-17 fiscal biennium, the secretary of the federal department of health and human services approves, in whole or in part, the amendment to the waiver under section 49.45 (23) (a) of the statutes that is requested under section 49.45 (23) (g) 1. of the statutes, as created by this act, the department of health services shall do all of the following:

SB21-SSA1,1496,22 (a) Identify, in its quarterly report to the joint committee on finance under section 49.45 (2n) of the statutes, any costs incurred or savings realized in the 2015-17 fiscal biennium as a result of actions taken under section 49.45 (23) (g) 1. a. to e. of the statutes, as created by this act, as approved by the secretary of the federal department of health and human services.

SB21-SSA1,1497,2 (b) Address, in the department's biennial budget request under section 16.42 of the statutes for the 2017-19 fiscal biennium, any future fiscal impact resulting from actions taken under section 49.45 (23) (g) 1. a. to e. of the statutes, as created by this act, as approved by the secretary of the federal department of health and human services.

SB21-SSA1,1497,6 (7) Mental health crisis services grants. From the appropriation account under section 20.435 (2) (gk) of the statutes, the department of health services shall award a total of $1,500,000 in fiscal year 2015-16 as onetime grants to counties for mental health crisis services.

SB21-SSA1,1497,12 (7g) County-to-county nursing home bed transfers. The department of health services shall develop a policy that specifies procedures for applying for, and receiving approval of, the transfer of available, licensed nursing home beds among counties under section 150.345 of the statutes. The department of health services shall submit a report on the resulting policy to the joint committee on finance no later than July 1, 2016.

SB21-SSA1,1497,13 (9) Changes to family care program.

SB21-SSA1,1497,14 (a) Definitions. In this subsection:

SB21-SSA1,1497,15 1. "Department" means the department of health services.

SB21-SSA1,1497,18 2. "Family care program" means the program under sections 46.2805 to 46.2895 of the statutes that provides the family care benefit as defined in section 46.2805 (4) of the statutes.

SB21-SSA1,1497,21 3. "IRIS" means the self-directed services option program, known as Include, Respect, I Self-direct, operated by the department under a waiver from the secretary of the federal department of health and human services under 42 USC 1396n (c).

SB21-SSA1,1498,8 (b) Family care in all counties. The department shall request any approval or submit any waiver request necessary to the federal department of health and human services to administer the family care program in every county in the state. If the federal department of health and human services does not disapprove the request, the department shall ensure that the family care program is available to eligible residents of every county in the state by January 1, 2017, or by a date specified by the department, whichever is later. If the department specifies a later date than January 1, 2017, it shall submit a notice of that date to the legislative reference bureau for publication in the Wisconsin Administrative Register. If the federal department of health and human services does not disapprove the request, the department is not required to comply with section 46.281 (1g) (b) of the statutes to expand the family care program to every county in the state.

SB21-SSA1,1498,12 (c) Waiver request; generally. Subject to paragraphs (d) and (e), the department shall request from the federal department of health and human services a state plan amendment or an amendment to the waiver under which the family care program and IRIS operate that includes all of the following:

SB21-SSA1,1498,17 1. Providing both long-term care and primary and acute care services through integrated health agencies to long-term care consumers whose care is reimbursed by the Medical Assistance program and including, to the extent allowable by the federal department of health and human services, long-term care consumers who receive both Medical Assistance and Medicare funded services.

SB21-SSA1,1498,20 2. Increasing the size of regions currently served by care management organizations under the family care program such that each region has sufficient population to allow for adequate risk management by integrated health agencies.

SB21-SSA1,1498,21 3. Subject to subdivision 2., designating no fewer than 5 regions in the state.

SB21-SSA1,1498,23 4. Specifying that each one of the regions under subdivision 3. is served by multiple integrated health agencies.

SB21-SSA1,1499,9 5. Requiring integrated health agencies to make available a consumer-directed option under the long-term care program in which the integrated health agency would assist individuals in developing individualized support and services plans, ensure that all services are paid according to the plan, and assist enrollees in managing all fiscal requirements, including the ability to select, direct, and employ persons offering any of the services available under the IRIS program as of July 1, 2015, and the ability to manage, using the services of an integrated health agency serving as a fiscal intermediary, an individual home and community-based services budget allowance based on a functional assessment performed by a qualified entity and the availability of family and other caregivers who can help provide needed support.

SB21-SSA1,1499,11 6. Modifying the state's long-term care program, including allowing for audits of providers, in order to improve accountability in the provision of services.

SB21-SSA1,1499,13 7. Establishing an open enrollment period for the state's long-term care program that coincides with the open enrollment period for the Medicare program.

SB21-SSA1,1499,15 8. Requiring that rates paid to integrated health agencies for services are set through an independent, actuarial study.

SB21-SSA1,1499,23 9. Preserving, for a minimum of 3 years in each region after the date of implementation of the waiver under this paragraph in that region, the requirement that an integrated health agency contract for long-term care services with any long-term care service provider that agrees to accept the reimbursement rate that the integrated health agency pays to similar providers for the same services and satisfies any quality of care, utilization, or other criteria that the integrated health agency requires of other providers with which it contracts to provide the same long-term care services.

SB21-SSA1,1500,3 (d) Consultation with stakeholders; key principles. Before developing its final waiver or state plan amendment request to be submitted to the joint committee on finance under paragraph (e), the department shall do all of the following:

SB21-SSA1,1500,6 1. Consult with persons interested in the long-term care program, including representatives of consumers of long-term care and long-term care providers and the public.

SB21-SSA1,1500,12 2. Submit as part of the quarterly reports on the Medical Assistance program due by September 30, 2015, and December 30, 2015, a progress report on the development of the waiver request including information regarding outcomes from discussions with representatives of consumers of long-term care and long-term care providers and any discussions with the federal centers for Medicare and Medicaid services.

SB21-SSA1,1500,13 3. Hold no less than 2 public hearings regarding the waiver request.

SB21-SSA1,1500,16 4. Develop the final waiver request in accordance with key principles determined by the federal centers for Medicare and Medicaid services to be essential elements of a strong, managed long-term services and supports program including:

SB21-SSA1,1500,17 a. Adequate planning and transition strategies.

SB21-SSA1,1500,18 b. Engagement of interested persons.

SB21-SSA1,1500,20 c. Enhanced provision of services in home-based and community-based settings.

SB21-SSA1,1500,23 d. Alignment of payment structures with programmatic goals, including improving the health and experience of enrollees and reducing costs through those improvements.

SB21-SSA1,1501,3 e. Support for eligible individuals, including counseling regarding options and enrollment from an independent source at no cost to the individual and the availability of ombudsman resources.

SB21-SSA1,1501,4 f. Person-centered processes, including an option to self-direct services.

SB21-SSA1,1501,5 g. A comprehensive and integrated service package.

SB21-SSA1,1501,6 h. Qualified providers.

SB21-SSA1,1501,8 i. Enrollee protections, including systems to manage incidents and appeals processes for enrollees.

SB21-SSA1,1501,9 j. Comprehensive quality assurance and oversight procedures.

SB21-SSA1,1501,19 (e) Committee approval. No later than April 1, 2016, and before the department submits any proposed changes to the state waiver or state plan amendment under paragraph (c), the department shall submit a summary of the proposed concept plan for the waiver amendment request under paragraph (c) to the joint committee on finance for approval or disapproval by the joint committee on finance. The procedures under section 13.10 of the statutes do not apply to this paragraph and the joint committee on finance may not modify the summary of the proposed concept plan submitted under this paragraph. The department may not submit any proposed changes to the state waiver or state plan amendment under paragraph (c) unless the proposed concept plan is approved by the joint committee on finance.

SB21-SSA1,1501,20 (f) Implementation of waiver; conformation with statutes.

SB21-SSA1,1502,2 1. Notwithstanding sections 46.2803 to 46.2895 of the statutes and any rules promulgated under those sections, if the federal department of health and human services approves of a waiver or state plan amendment substantially similar to that requested in paragraph (c) and approved by the joint committee on finance under paragraph (e), the department may implement any changes to the family care program and IRIS in accordance with the approved waiver or state plan amendment.

SB21-SSA1,1502,7 2. If the waiver or state plan amendment request is not approved by the federal department of health and human services or if the approved waiver or state plan amendment is not substantially similar to that requested under paragraph (c), the department may not implement the waiver or state plan amendment and the family care program and IRIS shall operate under the statutes in effect on July 1, 2015.

SB21-SSA1,1502,14 3. The department shall include in its 2017-19 biennial budget request any proposed statutory changes necessary to conform the statutes to the approved waiver or state plan amendment. The department shall maintain statutory language in section 46.2895 of the statutes relating to long-term care districts created by tribes or bands until the federal department of health and human services approves a waiver request related to those long-term care districts, if such a waiver request is being pursued.

SB21-SSA1,1502,21 (g) Other long-term care programs. If the federal department of health and human services does not disapprove the request to administer the family care program in every county in the state under paragraph (b), the department may elect to discontinue enrollment of participants in or administration of any of the programs under section 46.271, 46.275, 46.277, 46.278, or 46.2785 of the statutes in a county at any time determined by the department that is after the date that the family care program is available to all eligible residents of that county.

SB21-SSA1,1502,22 (9q) Aging and disability resource centers.

SB21-SSA1,1503,2 (a) By January 1, 2017, the department of health services shall evaluate the functional screening and options counseling for reliability and consistency among resource centers, as defined in section 46.2805 (10) of the statutes, and submit a report to the joint committee on finance on that evaluation.

SB21-SSA1,1503,7 (b) By no later than July 1, 2016, the department of health services shall assess which responsibilities of resource center governing boards described under section 46.283 (6) of the statutes are duplicative of functions performed by the department of health services and shall propose changes to the statutory requirements for the resource center governing boards to remove any duplication of functions.

SB21-SSA1,1503,13 (c) By no later than April 1, 2016, the department shall study the integration of income maintenance consortia and aging and disability resource centers, as defined in section 46.2805 (10) of the statutes, and shall present a report to the joint committee on finance with recommendations regarding potential efficiencies that may be gained, if any, from the integration of these entities and whether an integration would be appropriate considering the responsibilities of each entity.

SB21-SSA1,1503,20 (10) Merger of divisions into Medicaid services division. Before March 31, 2016, the department of health services shall submit to the state budget office in the department of administration a report of the final organization of the merger of the division of the department of health services relating to long-term care and the division of the department of health services relating to health care access and accountability into a single division of the department of health services relating to Medicaid services.

SB21-SSA1,1504,2 (10u) Food safety fees. During the period beginning on the effective date of this subsection and ending on July 1, 2016, neither the department of health services nor any local health department designated as an agent of the department may modify any fee established under section 254.71 of the statutes or, with respect to restaurants and temporary restaurants, under section 254.68 or 254.69 (2) of the statutes.