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Public Notices

Public Notice

Health & Family Services

(Medical Assistance Reimbursement for Case Management Services:
Targeted Case Management for Child Welfare Clients in Out-of-Home Care)

The State of Wisconsin reimburses providers for case management services provided to Medical Assistance recipients under the authority of Title XIX of the Social Security Act and ss. 49.43 to 49.47, Wisconsin Statutes. This program, administered by the State's Department of Health and Family Services, is called Medical Assistance (MA) or Medicaid. Federal statutes and regulations require that a state plan be developed that provides the methods and standards for reimbursement of covered services. A plan that describes the reimbursement system for the services (methods and standards for reimbursement) is now in effect.

Among providers of case management services are those who provide targeted case management for families with children up to the age of 21 who are at risk of physical, mental, or emotional dysfunction. The recipients of this service make up what is called Target Group N.

The Wisconsin Department of Health and Family Services is proposing to modify the rate methodology for targeted case management (TCM) services delivered by the Bureau of Milwaukee Child Welfare or its subcontractors for those clients in Target Group N where the child has been placed in substitute (out-of-home) care within Milwaukee County. The Department's proposal involves no change in the definition of the already existing group and the benefits remain the same.

The state's estimate of any expected increase or decrease in annual aggregate Medicaid expenditures shows an increase of $17,814,708 (Federal Financial Participation-FFP $10,482,174) in state fiscal year (SFY) '98 and $35,629,416 (FFP $20,964,348) in SFY '99. A decrease would take place in Title IV-E expenditures of $12,470,296 (FFP $6,235,148) in SFY '98 and $24,940,591 (FFP $12,470,296) in SFY '99.

The billing process will be established in such a manner as to prevent the processing of duplicate billings for the same client for the same service period. This will be accomplished by installing edits between procedure codes in the Wisconsin Medicaid Management Information System (MMIS) system. The methodology also contains a provision for adjusting the rate to an actual cost basis after completion of the federal fiscal year. In addition, amendments are being proposed to the Department's Cost Allocation Plan to ensure avoidance of duplicate claims for TCM and Title IV-E.

The Department is changing its methods and standards in this manner because this is a more efficient and comprehensive way to track the time expended in delivering these case management services.

The methodology uses the federally approved Random Moment Time Study (RMTS) as a tool in developing the monthly rate per client. Initially the Department will implement the new rate methodology in Milwaukee effective April 1, 1998. Based on legislation and other factors, the Department may implement the methodology on a statewide basis.

Proposed Change

The proposed change is to:

▶ Create a new rate methodology which will employ the Random Moment Time Study (RMTS) as a tool in developing the monthly rate per client for targeted case management services.

Copies of the Available Proposed Changes

A copy of the proposed change may be obtained free of charge by calling or writing as follows:

Regular Mail

Attention: State Plan Coordinator

Bureau of Health Care Financing

P.O. Box 309

Madison, WI 53701-0309

Phone

James Johnston

Policy Section Chief

[phone]

FAX

[phone]

Attention: State Plan Coordinator

E-Mail

[e-mail]

A copy of the proposed change are available for review at the main office of any county department of social services or human services.

Written Comments

Written comments are welcome. Written comments on the proposed changes may be sent by FAX, e-mail, or regular mail to the Bureau of Health Care Financing. The FAX number is [phone]. The e-mail address is [e-mail]. Regular mail can be sent to the above address. All written comments will be reviewed and considered.

The written comments will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily in Room 250 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed changed methodology, based on comments received.

Public Notice

Natural Resources

(Environmental Protection - WPDES, Chs. NR 200-)

Notice of intent to implement and enforce federal pretreatment standards and requirements related to General Pretreatment Regulations, Pesticide Chemicals, Leather Tanning and Finishing, and Pulp, Paper, and Paperboard Manufacturing pursuant to s. NR 211.34 (2), Wis. Adm. Code.

The Department of Natural Resources will implement and enforce the following federal regulations relating to wastewater pretreatment standards and requirements that limit concentrations or quantities of wastewater pollutants that may be introduced into publicly-owned treatment works. These standards and requirements will be implemented and enforced as of one of the federally-enforced compliance dates or July 1, 1998, whichever date is later; November 6, 1999 for pesticide chemicals; April 16, 2001 for pulp, paper, and paperboard. As provided in s. NR 211.34 (2), Wis. Adm. Code, the Department of Natural Resources will adopt these standards and requirements into the Wisconsin Administrative Code as soon as possible.

1. General Pretreatment Regulation Category Amendments to standards and limitations for industrial
wastewater discharges for existing and new sources.

(Codified in 40 CFR part 403)

60 FR 54768-54769   (1995)

61 FR 15660   (1996)

62 FR 38414-38415   (1997)

2. Pesticide Chemicals Category Adoption of standards and limitations for industrial
wastewater discharges for existing and new sources.

(Codified in 40 CFR part 455)

61 FR 57548-57566   (1996)

3. Leather Tanning and Finishing Category Amendments to standards and limitations for industrial
wastewater discharges for existing and new sources.

(Codified in 40 CFR part 425)

61 FR 35684-35685   (1996)

4. Pulp, Paper, and Paperboard Manufacturing Adoption of standards and limitations for industrial
Category wastewater discharges for existing and new sources.

(Codified in 40 CFR part 430)

63 FR 18636-18751   (1998)

Regulations Available

The regulations referenced above are available at:

Department of Natural Resources Central Office

101 South Webster Street

Madison, WI

Office of the Secretary of State

10th Floor, 30 West Mifflin Street

Madison, WI

Office of the Revisor of Statutes

Suite 800, 131 West Wilson Street

Madison, WI

Public Notice

Workforce Development

Revised Child Care Co-Payment Schedule under s. DWD 56.08, Wis. Adm. Code. The rule provides that adjustments to the Co-Payment Schedule shall be published in the Wisconsin Administrative Register. The newest adjustment to the schedule provides lower child care co-payment requirements for foster parents, kinship care parents, and minor teen parents who are not Learnfare participants.