64. Lafayette County Sheriff's Department
This provision appropriates $50,000 PR in each year of the biennium to award a law enforcement grant to the Lafayette County Sheriff's Department.
I am vetoing section 9126 (1q) and partially vetoing section 481 [as it relates to s. 20.455 (2) (kd)] by lining out the amounts under s. 20.455 (2) (kd) and writing in smaller amounts that reduce the appropriation by $50,000 in each year of the biennium because I object to providing a grant to one specific recipient. I encourage the Lafayette County Sheriff to work with the Attorney General to pursue funding to address law enforcement needs in the county. D. INVESTING IN INFRASTRUCTURE
65. State Broadband Office Funding
Section 9136 (2q)
This section limits expenditure authority provided to the Public Service Commission for operations of the State Broadband Office to the 2015-17 biennium only. Funding would not be included in the base year for purposes of developing the 2017-19 biennial budget.
I am vetoing this section because I object to providing this funding on a one-time basis. The work of the State Broadband Office is ongoing; therefore, its funding should be as well. The office continues to perform duties vital to broadband expansion in this state, including maintenance of the state's broadband map, coordination with telecommunications providers, and outreach to communities and other stakeholders. With this veto, the office can continue to perform these important duties.
66. Environmental Impact Statement – East Arterial Highway
Section 2551u
This section requires the Department of Transportation to conduct an environmental impact statement in the 2015-17 fiscal biennium for a proposed major east arterial highway that begins at the intersection of STH 54 and STH 73 in the village of Port Edwards and extends to the intersection of STH 54 and CTH W in the city of Wisconsin Rapids with funding from the department's major highway development program. This section requires the department to conduct the environmental impact statement notwithstanding the current law requirement that the Transportation Projects Commission recommend the preparation of an environmental impact statement or environmental assessment for a proposed major highway development project before the department undertakes such an action.
I am vetoing this section because this requirement is premature. The conditions to be evaluated by the environmental impact statement may change significantly before the project is enumerated. Consequently, a second environmental impact study may be needed before the project advances, leading to unnecessary and inefficient department expenditures.
67. State Highway Program Audit
Section 9145 (1d)
This section requests the Joint Legislative Audit Committee to direct the Legislative Audit Bureau to conduct a performance evaluation audit of the Department of Transportation's state highway program and provide a report of its findings by January 1, 2017. The audit would be required to examine and provide recommendations on topics including: evaluating the department's traffic forecasting methodologies; assessing the processes and factors the department uses to select the timing, type and scope of highway improvements; determining if the department can reduce safety-related highway expenditures without significantly decreasing public safety; evaluating the department's compliance with federal and state minimum highway design and construction standards between fiscal year 2005-06 and fiscal year 2014-15; and auditing the department's compliance with state bidding laws between fiscal year 2005-06 and fiscal year 2014-15.
I am vetoing this section because the Joint Legislative Audit Committee already has the authority to request such an audit under current law.
68. Bicycle and Pedestrian Facilities on State Highway Projects
Section 9345 (6j)
This section specifies the initial applicability of provisions in the bill that change the requirements for constructing bicycle and pedestrian facilities on state highway projects. Under the bill, current law is replaced with a requirement that the Department of Transportation give due consideration to establishing bicycle and pedestrian facilities on all new highway construction and reconstruction projects using state or federal funds. Under one of the provisions, the department is prevented from constructing bicycle or pedestrian facilities using state funds in whole or in part unless it received approval from each municipality in which a highway project is located.
I am partially vetoing this section so that the requirement for municipal approval to expend state funds on bicycle and pedestrian facilities does not apply to projects that are already underway. I object to the potential delay of these existing projects that applying the new process of municipal approval may create.
69. Rail Fixed Guideway Transportation Systems
Section 2574 [as it pertains to counties with a first class city]
This provision directs that a county with a first class city may not incur any direct or indirect expenses, or forfeit revenue, related to the operation or accommodation of a rail fixed guideway transportation system in the first class city unless those expenses or revenues are reimbursed by the first class city.
I am partially vetoing this provision to remove the phrase "or accommodation" because I object to the inclusion of ambiguous language that may have unintended consequences. I am also removing this phrase because it is unnecessary as the intention of the provision may be achieved without the inclusion of this ambiguous phrase.
70. Freight Optimization Modeling Consultant Contract
These provisions allocate $1,600,000 GPR in the Joint Committee on Finance's general purpose revenue funds general program supplementation appropriation in fiscal year 2015-16 for the purpose of funding a consultant contract for freight optimization modeling services and establish a new Department of Transportation GPR appropriation to expend these funds. Prior to any such expenditures, the Wisconsin Economic Development Corporation and the department are required to conduct a joint study of the effects of freight optimization modeling on economic development and transportation infrastructure prioritization and submit a report by June 30, 2016, to the Joint Committee on Finance. The department may submit a s. 13.10 request along with the report to supplement the new GPR appropriation to contract with a consultant for freight optimization modeling. If the request is approved by the Committee, the department may amend an existing contract without needing a request for proposal or may issue a new request for proposal. I am vetoing these provisions because they infringe on the authority of the Wisconsin Economic Development Corporation and the department to determine the appropriate use of resources related to their statutory duties. In addition, I am partially vetoing section 481 [as it relates to s. 20.395 (4) (bk)] to delete the GPR appropriation for freight optimization modeling. In addition, by lining out the appropriation under s. 20.865 (4) (a) and writing in a smaller amount that deletes $1,600,000 in fiscal year 2015-16, I am vetoing the portion of the bill that funds these provisions. Finally, I am requesting the Department of Administration secretary not to allot these funds. 71. Amortization Schedule for Commercial Paper
Section 239r
This section requires the Department of Administration to establish a planned amortization schedule for the repayment of principal on the State's short-term, general obligation commercial paper programs, so that a uniform portion of the principal amount of such obligations is planned to be retired annually. This section defines the short-term commercial paper program as a short-term debt obligation issued in lieu of long-term state general obligation debt.
I am vetoing this section because it is unnecessary and will impede the ability of the executive branch to administer state government debt management in the most efficient and effective way possible. The department will ensure that the State's general obligation commercial paper program continues to be administered consistent with current practices and in the best interest of the State's overall debt management.
72. General Transportation Aids Appeals Process
Sections 648r and 2595k
Section 2595k establishes an appeals process for counties and municipalities to challenge general transportation aid payments if a county or municipality believes that a reporting error resulted in an incorrect aid payment. If an error under this appeals process is substantiated, section 648r gives the Department of Transportation the authority to make a corrected aid payment out of the existing sum sufficient appropriation for correction of transportation aid payments. Section 2595k also requires the department to promulgate administrative rules that establish submission requirements and arbitration procedures for the appeals process.
I am partially vetoing section 648r and vetoing section 2595k in its entirety because this provision is unnecessary and redundant. The department already has procedures in place for local governments to request a corrected aid payment from the existing sum sufficient appropriation.
E. REFORMING HEALTH CARE ENTITLEMENTS
73. Family Care and IRIS Programs
Section 9118 (9)
Broadly, this provision requires the Department of Health Services to submit two waiver requests to the federal Centers for Medicare and Medicaid Services. The first waiver expands Family Care statewide by January 1, 2017, or upon approval of the waiver, whichever is later. The second makes a variety of reforms to the Family Care and Include, Respect, I Self-Direct (IRIS) programs, including requiring integrated health agencies to offer to long-term care participants both acute care and long-term care services. Integrated health agencies are required to offer all of the services currently offered in the current IRIS program to maintain a self-direction program for consumers.
In addition, the provision requires the waiver to meet certain benchmark requirements and the department is required to hold a specified number of public hearings and to consult with stakeholders in the waiver development process. Further, the department is required to report to the Joint Committee on Finance with progress reports as well as for approval or disapproval of the final waiver package.
Further, the provision requires the department to include in its 2017-19 biennial budget request, any proposed statutory changes necessary to conform statutes to the approved waiver or state plan amendment.
I believe these reforms to our state's long-term care programs will help improve outcomes for the state's elderly and disabled residents by offering consumers integrated health, behavioral and long-term care under a single provider. These reforms not only improve outcomes for the state's most vulnerable residents, but help to ensure that these vital safety net programs are run in a more efficient, equitable and sustainable manner.
However, I am partially vetoing this provision to make several common sense changes in order to best serve the consumers of long-term care services. First, I am vetoing the requirement that there be no less than five long-term care regions because I object to creating a fixed number of regions. Allowing the department to define the number of long-term care regions in the state gives it the flexibility to create the number of regions that makes the most sense for consumers.
Secondly, I am vetoing the requirement that rates paid to integrated health agencies are set through a separate actuarial study because it is unnecessary. The state and federal government already require the rates paid through the long-term care programs be actuarially sound.
Lastly, I am partially vetoing the requirement that the open enrollment period coincide with the Medicare open enrollment period because I object to specifying the timing of the open enrollment period in the bill. The department will set an open enrollment period which makes the most sense for Wisconsin consumers as part of its waiver submission.
74. Labor Region Methodology Study
Section 9118 (4u)
This provision requires the Department of Health Services to study the labor region methodology used to assist with the determination of Medical Assistance reimbursement rates. The department is also required to propose, to the Legislature no later than July 1, 2016, any necessary changes to the 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. This section also prohibits the department from implementing any proposed changes to the methodology without enactment of legislation.
I am vetoing this provision to eliminate the labor region methodology requirements, as these requirements are administratively burdensome and duplicative. The department already regularly evaluates the labor region methodology and may recommend changes if needed.
75. Dispute Resolution Process Relating Health Insurance Coverage of Chiropractic Treatment
Sections 4590r and 9122
The provision requires the Commissioner of Insurance to promulgate rules that provide for an independent process for resolving disputes related to insurer conduct with respect to statutory requirements for chiropractic coverage, access and reimbursement. The provision also specifies the criteria that must be included in the rules and authorizes the Commissioner of Insurance to promulgate emergency rules for the period before the effective date of permanent rules without being required to provide evidence that an emergency rule is necessary for the preservation of public peace, health, safety or welfare, or being required to provide a finding of emergency.
I am vetoing this provision because it would establish a unique method for dispute resolution for a single profession, which may result in administrative challenges and consumer confusion.
76. FoodShare Employment and Training Drug Testing
Section 1833
This provision requires the Department of Health Services to promulgate rules to develop and implement a drug screening, testing and treatment program that incorporates the provisions of 2015 Assembly Bill 191, as passed by the Assembly, that relate to screening and testing of FoodShare Employment and Training participants who are able-bodied adults without dependent children and are subject to FoodShare work requirements.
The department is required to include the following elements in its administrative rules: (a) only participants for whom there is a reasonable suspicion of use of a controlled substance without a valid prescription may be subject to testing; (b) if a person tests negative for use of a controlled substance, or tests positive but possesses a valid prescription, the individual will have satisfactorily completed the requirements of the provision; (c) if a participant tests positive and does not have a valid prescription, the individual must participate in state-sponsored substance abuse treatment to remain eligible for the employment and training program; and (d) while participating in state- sponsored treatment, the individual must submit to random testing in order to remain eligible for the employment and training program, and if an individual tests positive, the individual may begin treatment again, one time, and remain eligible for the program.
Subject to the promulgation of rules, the department shall screen and, if indicated, test and treat participants in an employment and training program who are able-bodied adults for illegal use of a controlled substance without a valid prescription for the controlled substance.
I am partially vetoing this provision in two ways. First, I am partially vetoing the requirement that treatment be state-sponsored because I object to requiring the state to cover all treatment costs, if the person has other coverage. This partial veto provides access to treatment while ensuring that the state is the payer of last resort.
Further, I am vetoing the requirement that testing is based on reasonable suspicion because I object to limiting the department's ability to determine which program participants will be screened and, if indicated, tested for illegal use of a controlled substance.
77. Grants to an Organization that Provides Advanced Life Support Training
Sections 481 [as it relates to appropriation s. 20.435 (1) (ch)], 668r, 668s, 9118 (3q) and 9418 (7q) These provisions appropriate $20,000 GPR in each year of the 2015-17 biennium for a grant to an entity that provides or facilitates advanced life support training to doctors, physician's assistants, nurse practitioners, registered nurses and paramedics who work in rural areas in Wisconsin. The provisions specify that the funding is only to be provided in the 2015-17 biennium.
I am partially vetoing section 481 [as it relates to s. 20.435 (1) (ch)] and vetoing sections 668r, 668s, 9118 (3q) and 9418 (7q) because I object to earmarking these funds. By lining out the appropriation under s. 20.435 (1) (ch) and writing in smaller amounts that delete $20,000 in each fiscal year, I am vetoing the part of the bill that funds this provision. I am also requesting the Department of Administration secretary not to allot these funds. 78. Repeal Health Care Provider Fees for Data Collection and Dissemination
This provision establishes the funding level for the Joint Committee on Finance general purpose revenue funds general program supplementation appropriation under s. 20.865 (4) (a) for the 2015-17 biennium. Included in that amount is an unreserved amount of $1,000,000 in fiscal year 2015-16, which was placed in the appropriation through the Committee’s actions which required the Department of Health Services to lapse $1,000,000 from the program revenue balance of the general program operations; health care information appropriation to the general fund in fiscal year 2015-16. I am partially vetoing section 481 [as it relates to s. 20.865 (4) (a)] by lining out the amount under s. 20.865 (4) (a) and writing in a smaller amount that reduces the appropriation by $1,000,000 in fiscal year 2015-16 because I object to increasing the Committee’s supplemental appropriation without sufficient detail as to how these funds are intended to be used. I am also requesting the Department of Administration secretary not to allot these funds. 79. County-to-County Nursing Home Bed Transfers
Section 9118 (7g)
This section requires the Department of Health Services to develop a policy that specifies procedures for applying for, and receiving approval of, the transfer of available, licensed nursing home beds among counties and requires the department to report to the Joint Committee on Finance no later than July 1, 2016.
I am vetoing this section because it is unnecessary. Current law already specifies the requirements that must be met for a transfer of licensed beds. However, I am directing the department to review current procedures and prepare a plan to address any issues that arise from that review.
80. Exempt Institutions for Mental Disease and County-Operated Nursing Homes from Bed Assessment
Sections 481 [as it relates to s. 20.435 (2) (a)], 1875d, 1875e and 1875f This provision exempts county government-owned institutions for mental disease and state-only licensed facilities from the nursing home bed assessment, unless the Centers for Medicare and Medicaid Services determines that exempting these facilities would not be permissible under federal statutes or rules relating to state health care provider assessments.
I am vetoing this provision because I object to exempting county-owned and state-only licensed institutions for mental disease from the nursing home bed assessment. This provision creates an additional financial burden on private facilities, thus risking access to care for some of our most vulnerable citizens. By lining out s. 20.435 (2) (a) and writing in a smaller amount that reduces the appropriation by $320,300 in each fiscal year, I am vetoing the part of the bill that funds this provision. I am also requesting the Department of Administration secretary not to allot these funds. 81. Nonemergency Medical Transportation
Section 9118 (11f)
This provision requires the Department of Health Services, to the extent permitted by contract, to modify the current nonemergency medical transportation contract and exclude the following counties: Jefferson, Kenosha, Milwaukee, Ozaukee, Racine, Walworth, Washington and Waukesha. In addition, the provision requires that, if the contract is modified, the department must make alternative arrangements with counties, health maintenance organizations or transportation providers to provide nonemergency medical transportation services to Medical Assistance recipients who reside in the excluded counties, no later than January 1, 2016.
I am vetoing this provision because I object to excluding specific counties from the current nonemergency medical transportation contract. All counties should be served by the same contract in order to provide uniform, equitable and cost-effective transportation services under the Medical Assistance program to all eligible program recipients.
82. Healthy Aging Grants
Sections 703r and 9118 (4f)
This provision provides one-time funding in each year of the 2015-17 biennium for grants to a private, nonprofit entity that will use these funds to conduct the following activities: coordinate the implementation of evidence-based health promotion programs in healthy aging; coordinate with academic and research institutes regarding research on healthy aging; serve as a statewide clearinghouse on evidence-based disease prevention and health promotion programs; provide training and technical assistance to the staff of county departments, administering agencies and other providers of services to aging populations; collect and disseminate information on disease prevention and health promotion in healthy aging; coordinate public awareness activities related to disease prevention and health promotion in aging; and advise the Department of Health Services on public policy issues concerning disease prevention and health promotion in aging. In addition, the provision creates an annual GPR appropriation, entitled "Healthy aging; evidence-based training and prevention" among the department's programs for disability and elder services.
I am partially vetoing this provision to remove the overly restrictive grant administration requirements. Instead, I am allowing the department more flexibility to best address healthy aging issues.
83. Enhanced Dental Services Reimbursement Pilot Program
Sections 1798 [as it relates to setting the rates in statute, specifying the length of the pilot program, and requiring an evaluation and report to the Joint Committee on Finance] and 9318 (2)
This provision requires the Department of Health Services to request a waiver from the federal government to conduct a pilot program to provide an enhanced Medicaid payment for pediatric and adult emergency dental services in Brown, Polk, Racine and Marathon counties. The reimbursement is specified at 80 percent of the median fee for each procedure, or the usual and customary charge, whichever is less. In addition, the department is required to work collaboratively with the American Dental Association's Health Policy Institute to prepare an evaluation of the pilot program on a quarterly basis, beginning at the end of the first quarter in which the pilot program becomes effective. Further, the department is required to submit a report to the Joint Committee on Finance regarding dental care utilization, the number of Medicaid participating dentists in the state, the fiscal impact of the pilot program, a comparison of the pilot program as administered under a fee-for-service system and under a health maintenance organization system, and the impact of the pilot program on oral health outcomes.
