The hearing site is fully accessible to people with disabilities.
Analysis Prepared by the Department of Health and Family Services
Under the Community Options Program (COP) and related home and community-based medical assistance (MA) waivers, federal and state funds are provided to implement care plans for eligible individuals to enable them to live in community-based settings rather than nursing homes despite disabilities or functional limitations.
Statutory language was added by 1997 Wisconsin Act 27 to restrict the use of Community Options and certain MA Waiver funds (COP-W and CIP II) to paying for services for persons living in their own homes, except under certain circumstances. One of the exceptions permits the use of these funds to pay for services for a person residing in a community-based residential facility (CBRF) if additional conditions are met. One of those conditions is if the county long- term support agency documents that the option of in-home services has been discussed with the person, is thoroughly evaluated and is found to be “infeasible" as determined by the county agency in accordance with rules promulgated by the Department. Of the five conditions, this is the only one that is required to be determined in accordance with administrative rules.
The rulemaking order that is the subject of this public hearing establishes criteria for a county agency to make a determination that home care is not possible for a program participant. Upon meeting the criteria in the rules, along with the four criteria in the statutes, the county agency is permitted to use COP, COP-W or CIP II funds to pay for services for the program participant in a CBRF. The rulemaking order also amends s. HFS 73.10 to delete the 25% limit on spending for services to program participants who live in CBRFs. 1997 Wisconsin Act 27 deleted that limit from the program statutes.
Contact Person
To find out more about the hearing or to request a written copy of the rules, write, phone, or e-mail:
Susan Veleke
Long Term Support Section
Bureau of Aging and Long Term Care Resources
P. O. Box 7851
Madison, WI 53707-7851
608/267-7285 or,
if you are hearing impaired,
FAX 608/267-3203
If you are hearing or visually impaired, do not speak English, or have other personal circumstances which might make communication at the 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 above. A person requesting a non-English or sign language interpreter should make that request at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Written comments on the proposed rules received by mail, fax, or e-mail at the above address no later than 4:00 p.m. on June 27, 2000 will receive the same consideration as testimony presented at the hearing.
Fiscal Estimate
These rules add specificity to the statutory requirement enacted by the Legislature and do not create new requirements that would affect expenditures or revenues of state government or local governments. Local governments are provided state and federal funds to implement COP, COP-W, and CIP II programs. These rules provide detail as to conditions for allowable uses of funds under those programs. A copy of the full fiscal estimate may be obtained from Susan Veleke, who may be contacted via the contact information provided in this notice.
Initial Regulatory Flexibility Analysis
The rules will affect local agencies that expend funds under the COP, COP-W, and CIP II programs. As part of the existing care planning process for eligible individuals, county agencies will have to determine if home care is infeasible in accordance with this rule before authorizing COP, COP-W, or CIP II funding as payment for services for persons residing in a CBRF. No new professional skills are necessary to comply with the new rule and no small businesses as defined under s. 227.114, Stats., are affected by this rule.
Notice of Hearings
Health & Family Services
(Medical Assistance, Chs. HFS 101-)
Notice is hereby given that, pursuant to ss. 49.45 (10) and 49.472 (3) (h), (4) (a) (intro.) and 2. a., Stats., as created by 1999 Wis. Act 9, and ss. 227.11 (2) and 227.24 (1), Stats., the Department of Health and Family Services will hold public hearings to consider proposed amendments to amend and create chs. HFS 101-103 and 108 relating to the operation of the Medicaid Purchase Plan health insurance program, and emergency rules published on March 15, 2000 on the same subject.
Hearing Information
June 15, 2000 Room 152-A
Thursday State Office Building
Beginning at 11:00 a.m. 200 N. Jefferson Street
GREEN BAY, WI
June 16, 2000 Room 40
Friday State Office Building
Beginning at 11:00 a.m. 819 N. 6th Street
MILWAUKEE, WI
June 19, 2000 Room 751
Monday State Office Bldg.
Beginning at 11:00 a.m. 1 W. Wilson Street
MADISON, WI
June 20, 2000 Room 123
Tuesday State Office Bldg.
Beginning at 11:00 a.m. 610 Gibson Street
EAU CLAIRE, WI
All hearing sites are fully accessible to people with disabilities. For the Madison hearing, parking for people with disabilities is available in the parking lot behind the building or in the Doty Street Parking Ramp. Disabled persons may enter directly from the parking lot behind the west side of the building or from Wilson Street through the side entrance at the eastern entrance to the building.
Analysis Prepared by the Department of Health and Family Services
The order that creates the rules for which the hearing is being held specify the manner in which a new program called the Medicaid Purchase Plan, established under s. 49.472, Stats., as created by 1999 Wisconsin Act 9, will operate. Under the Medicaid Purchase Plan, working adults with disabilities whose family net income is less than 250% of the poverty line are eligible to purchase Medicaid, the name given to Medical Assistance in Wisconsin, on a sliding-fee scale. The order incorporates the rules for operation of the Medicaid Purchase Plan into chs. HFS 101 to 103 and 108, four of the Department's chapters of rules for operation of the Medical Assistance program.
The Medicaid Purchase Plan is projected to provide health care coverage to 1,200 Wisconsin residents with disabilities by the end of Fiscal Year 2001.
Health care coverage under the Medicaid Purchase Plan is identical to the comprehensive package of services provided by Medical Assistance. Persons enrolled in the Medicaid Purchase Plan would also be eligible for Wisconsin's home and community-based waivers under s. 46.27, Stats., provided they meet the functional criteria for these waivers.
The rules created and amended by this order modify the current Medical Assistance rules to accommodate the Medicaid Purchase Plan and in the process provide more specificity than s. 49.472, Stats., as created by Act 9, regarding the non-financial and financial conditions of eligibility for persons under the Medicaid Purchase Plan; define whose income is used when determining eligibility and the monthly premium amount; explain statutory conditions for continuing eligibility; explain how the monthly premium amount is calculated; describe the processes associated with the independence account; and set forth how the Department, in addition to providing Medical Assistance coverage, is to purchase group health coverage offered by the employer of an eligible person or an ineligible family member of an eligible member for the Medicaid Purchase Plan if the Department determines that purchasing that coverage would not cost more than providing Medical Assistance coverage.
The Department obtained approval for the Medicaid Purchase Plan from the federal Health Care Financing Administration (HCFA) on October 27, 1999 effective March 15, 2000, and on March 15, 2000, the Department published emergency rules for the operation of the Medicaid Purchase Plan.
Contact Person
To find out more about the hearing or to request a copy of the rules, write or phone:
Melissa Wittman
Center for Delivery Systems Development
Office of Strategic Finance
P.O. Box 1379
1 South Pinckney Street
Room 340
Madison, WI 53701-1379
608-264-9964 or,
if you are hearing impaired,
608-266-1511 (TDD)
If you are hearing or visually impaired, do not speak English, or have circumstances that 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 on the proposed rules received at the above address no later than June 30, 2000 will be given the same consideration as testimony presented at the hearing.
Fiscal Estimate
This order creates rules that specify how the Medicaid Purchase Plan, established under s. 49.472 Stats., will work. The Medicaid Purchase Plan makes eligible working adults with disabilities and net family incomes less than 250% of the federal poverty level to purchase Medical Assistance (MA) on a sliding-fee scale.
These rules will not affect the expenditures or revenues of state government or local governments. Costs of implementing the Medicaid Purchase Plan were taken into consideration by the Legislature during the development of the 1999-01 biennial budget.
A copy of the full fiscal estimate may be obtained from Melissa Wittman who may be contacted via the contact information in this notice.
Initial Regulatory Flexibility Analysis
The rules for the Medicaid Purchase Plan apply to the Department, individuals that are applicants or recipients of the health care coverage provided by the Medicaid Purchase Plan and to county social service or human service departments that take applications and determine eligibility for the Medicaid Purchase Plan. The rules do not directly affect small businesses as a “small business" is defined in s. 227.114 (1) (a), Stats.
Notice of Hearings
Health & Family Services
(Health, Chs. HFS 110-)
Notice is hereby given that pursuant to ss. 146.50 (6m), (13) (b) and (c) and 227.11 (2) (a), Stats., the Department of Health and Family Services will hold public hearings to consider the repeal and recreation of chs. HFS 110 and HFS 112, Wis. Adm. Code, relating to the licensing of ambulance service providers, licensing of emergency medical technicians-basic, and licensing of emergency medical technicians-paramedics.
