Health & Family Services
(Management & Technology,
Strategic Finance, Chs. HFS 1-)
Notice is hereby given that, pursuant to ss. 46.286 (4) to (7), 46.288 (1) to (3), 50.02 (2) (d) and 50.36 (2) (c), Stats., as created by 1999 Wis. Act 9, and ss. 227.11 (2) (a) and 227.24 (4), Stats., the Department of Health and Family Services will hold public hearings to consider the amendment of ss. HFS 68.04 (1) and 105.47 (1), and the creation of ch. HFS 10, ss. HFS 82.06 (2m), 83.06 (7), 88.06 (1) (a) 4. and (4), 89.29 (1m), 89.295, 105.47 (3), 107.28 (1) (c), 124.255, 132.52 (7), and 134.52 (5), relating to the Family Care benefit for long-term care, and emergency rules published on February 1, 2000 on the same subject.
Hearing Information
April 25, 2000 Jackson Co. Dept. of Health
Tuesday and Human Services
1:00 p.m. 420 Highway 54 West
Black River Falls, WI
April 27, 2000 Liberty Hall
Thursday 800 Eisenhower Drive
10:00 a.m. Kimberly, WI
May 2, 2000 Washington park Senior Center
Tuesday 4420 W. Vliet Street
10:00 a.m. Milwaukee, WI
May 4, 2000 The Pointe
Thursday 8269 S. Highway 51
1:00 p.m. Minocqua, WI
May 8, 2000 WI Dept. of Health & Family
Monday Service Bldg., Room 751
10:00 a.m. 1 W. Wilson Street
Madison, WI
The hearing sites are fully accessible to people with disabilities.
Analysis Prepared by the Department of Health and Family Services
Legislation establishing a flexible Family Care benefit to help arrange or finance long-term care services to older people and adults with physical or developmental disabilities was enacted as part of 1999 Wis. Act 9. The benefit is an entitlement for those who meet established criteria. It may be accessed only through enrollment in Care Management Organizations (CMOs) that meet requirements specified in the legislation.
The Act also authorizes the Department of Health and Family Services to contract with Aging and Disability Resource Centers to provide broad information and assistance services, long-term care counseling, determinations of functional and financial eligibility for the Family Care benefit, assistance in enrolling in a Care Management Organization if the person chooses to do so, and eligibility determination for certain other benefits, including Medicaid, and other services.
Until July 1, 2001, the Department of Health and Family Services is authorized to contract with CMOs and Resource Centers in pilot counties to serve up to 29% of the state's eligible population. Further expansion is possible only with the explicit authorization of the Governor and the Legislature.
When Aging and Disability Resource Centers become available in a county, the legislation requires nursing homes, community–based residential facilities, adult family homes and residential care apartment complexes to provide certain information to prospective residents and to refer them to the Resource Center. Penalties are provided for non-compliance.
These proposed rules interpret this new legislation, the main body of which is in newly enacted ss. 46.2805 to 46.2895, Stats. The Department of Health and Family Services is specifically directed to promulgate rules by ss. 46.286 (4) to (7), 46.288 (1) to (3), 50.02 (2) (d) and 50.36 (2) (c), Stats. Related rules, also in the rulemaking order and within the Department's authority, clarify and implement other provisions of the Family Care legislation. The rules address the following:
•
Contracting procedures and performance standards for Aging and Disability Resource Centers.
•
Application procedures and eligibility and entitlement criteria for the Family Care benefit.
•
Description of the Family Care benefit that provides a wide range of long-term care services.
•
Certification and contracting procedures for Care Management Organizations.
•
Certification and performance standards and operational requirements for CMOs.
•
Protection of client rights, including notification and due process requirements, complaint, grievance, Department review, and fair hearing processes.
•
Recovery of incorrectly and correctly paid benefits.
•
Requirements of hospitals, long-term care facilities and Resource Centers related to referral and counseling about long-term care options.
Contact Person and Availability of Emergency and Proposed Permanent Rules
The hearing agenda, emergency rules and proposed permanent rules are all available through the Department's web site at:
http://www.
dhfs.state.wi.us/LTCare/index.htm.
To find out more about the hearing or to request a written copy of the emergency or proposed permanent rules, write, phone or e-mail:
Bonnie Niemann
Office of Strategic Finance
P.O. Box 7850
Madison, Wisconsin 53707-7850
Telephone: 608-266-3816
or, if you are hearing impaired, 608-266-3683 (TTY)
Fax: 608-267-0358
If you are hearing or visually impaired, do not speak English, or have circumstances which might make communication at a hearing difficult and if you, therefore, require an interpreter or a non-English, large print or taped version of the hearing document, contact the person at the address or phone number shown above. Persons requesting a non-English or sign language interpreter should contact the person at the address or phone number given above at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Written comments received by mail, fax or e-mail at an above address no later than 5:00 p.m., May 12, 2000, will be given the same consideration as testimony presented at a hearing.
Fiscal Estimate
This order creates rules that specify how the family care benefit, established under ss. 46.2805 to 46.2895, as created by 1999 Wis. Act 9, will be implemented.
These rules provide specificity relating to eligibility and entitlement for the family care benefit, application for the benefit, cost sharing requirements, standards for aging and disability resource centers and for care management organizations, protections of the rights of family care applicants and enrollees, recovery of correctly and incorrectly paid family care benefits, and requirements for hospitals, nursing homes, community-based residential facilities, residential care apartment complexes, and adult family homes to provide information to certain patients, residents and prospective residents and to refer them to aging and disability resource centers.
These rules will not affect the expenditures or revenues of state governmental or local governments. These rules add specificity to the statutory requirements enacted by the Legislature and do not create new requirements that would affect expenditures or revenues. All costs of implementing the family care benefit were taken into consideration by the Legislature during development of the 99-01 biennial budget.
Initial Regulatory Flexibility Analysis
These rules apply to the following organizations: The Department of Health and Family Services, the Division of Hearings and Appeals in the Department of Administration, county agencies designated by the department to determine financial eligibility for the family care benefit; all organizations seeking or holding contracts with the department to operate an aging and disability resource center or a care management organization; and hospitals, nursing homes, community-based residential facilities, residential care apartment complexes and adult family homes in areas where an aging and disability resource center is under contract with the Department.
Some affected community-based residential facilities and adult family homes may be “small businesses" as defined in s. 227.114 (1) (a), Stats. These rules implement requirements, established in 1999 Wis. Act 9, that these facilities and homes provide certain information to residents and prospective residents and make certain referrals to an aging and disability resource center. The rules specify that the facility provide to prospective residents information, provided by the Department or by a resource center, obtain written verification that the information was provided and refer the prospective resident to the resource center. The Department has considered the methods for reducing the impact of these rules on small businesses specified in s. 227.114 (2), Stats., and has determined that establishing other standards for small businesses would be contrary to the statutory objectives that are the basis for the proposed rules.
No new professional skills are necessary for facilities and homes to comply with these requirements.
Notice of Proposed Rules
Health and Family Services
(Community Services, Chs. HFS 30--)
(Health, Chs. HFS 110--)
Notice is hereby given that pursuant to ss. 50.02 (2), 50.36 (1), 50.51 (2), 50.95, Stats., and according to the procedures set forth in s. 227.16 (2) (e), Stats., the Department of Health and Family Services will repeal s. HSS 133.03 (6); renumber s. HSS 133.03 (7) to (9); amend ss. HSS 82.03 (2) (a) and Note and (7) and 82.04 (4) (b) and (5), HFS 83.07 (6) (b) 2., (11) (intro.), (13) and Note and (14), HSS 88.03 (2) (a) and Note, (b) 1. and (c), (3) (d) and (7) (a) and 88.04 (4), HSS 131.14 (5) (table) and (5), (6) (title) and (intro.), (8), (10) and (11) (a), HFS 132.14 (6) and 132.31 (6) (e) and HFS 134.14 (5); repeal and recreate ss. HSS 82.03 (4) (a) and (b), HFS 83.07 (7) and Note, HSS 88.03 (4), HSS 131.14 (7) and HSS 133.03 (5); and create ss. HFS 124.03 (7), HFS 132.14 (8), HSS 133.03 (9) and HFS 134.14 (5m), relating to non-expiring licenses for community-based residential facilities (CBRFs), hospices, nursing homes, home health agencies, facilities for the developmentally disabled (FDDs), rural medical centers and certain adult family homes, and for certifying certain adult family homes and for approving hospitals, as herein proposed, without public hearing, unless a petition for a hearing is received by the Department within 30 days after the publication of this notice on April
15, 2000. A petition for a hearing will be accepted if signed by any of the following who will be affected by the proposed rule: 25 persons; the representative of an association that represents a farm, labor, business or professional group; or a municipality.
Contact Information
If you have any questions about this rule or about filing a written petition for a hearing, contact:
Julie Hagen
Telephone (608) 266-3306
Bureau of Quality Assurance
P.O. Box 2969
Madison, WI 53701
Analysis Prepared by the Dept. of Health & Family Services
Statutory authority: The Department's authority to repeal, renumber, amend, repeal and recreate and create these rules is found in ss. 50.02 (2), 50.032 (2), 50.033 (2), 50.36 (1), 50.49 (2), 50.51 (2) and 50.95, Stats.
Statutes interpreted: The rules interpret ss. 50.03 (4) (c) 1. and 2., 50.032 (2) and (2r), 50.033 (2) and (2m), 50.355, 50.49 (6) (b) and (d), 50.52 (4), 50.535 and 50.93 (2) (a) and (3m), Stats.
This order amends the Department's rules for licensing community-based residential facilities (CBRFs), hospices, nursing homes, home health agencies, facilities for the developmentally disabled (FDDs), rural medical centers and certain adult family homes, for certifying certain adult family homes and for approving hospitals, to do the following:
1) Provide for non-expiring licenses and certification;
2) Replace a process for applying for renewal of a license or certification with a requirement that the licensee or certificate holder submit an annual or biennial report to the Department in the form and containing the information that the Department requires; and
3) In regard to hospitals, for which there has not been a requirement in statute or rule for renewal of an approval, add a requirement that the approval holder submit an annual report to the Department in the form and containing the information that the Department requires.
