The Department proposes to update ch.
HFS 132 to reflect current standards of care and practice; enhance the Department's authority relating to the initial licensing of nursing homes; and remove provisions that duplicate applicable federal requirements. The proposed changes do not compromise the care and safety to nursing home residents.
Section
50.02 (2) (a), Stats., gives the Department the authority to establish and enforce regulations and standards for the care, treatment, health, safety, rights, welfare and comfort of residents in nursing homes. It also authorizes the Department to promulgate and enforce administrative rules that provide the conditions of licensure for nursing homes.
Effective November 1, 2004, revisions were made to ch.
HFS 132 to reflect changes that have occurred in service delivery (e.g. pain management and quality assurance) and technology (e.g. electronic records and physical environment), to remove overly prescriptive rules and to make the rules more reflective of and compatible with the comparable federal regulations.
Through this rulemaking initiative, the Department is continuing the rule revision process by further updating the rule to recognize changes in service delivery and technology and by eliminating or modifying state regulations that are already addressed in ch.
50, Stats.; chs.
Comm 61 to
65, also known as the Wisconsin Commercial Building Code; and
42 CFR 483, the federal regulatory requirements for nursing homes. The Department's intent is to streamline ch.
HFS 132, while ensuring a nursing home's responsibility to provide quality care and meet the needs of its residents. In addition, eliminating rules that duplicate federal regulations would reduce the number of citations issued for the same violation.
The Department is also proposing to enhance its authority relating to approving licenses under s.
HFS 132.14. These changes are intended to ensure that new operators applying for a Wisconsin nursing home license are qualified professionals and have demonstrated fiscal responsibility in the operation of health care facilities.
Statutory authority
Staff time required
The Department estimates that it will take approximately 640 hours of staff time to to promulgate the proposed changes to ch.
HFS 132.
Entities affected by rule
The entities affected by the proposed rules are all licensed nursing homes in Wisconsin.
Comparison with federal requirements
Federal conditions of participation for nursing homes are in the Code of Federal Regulations,
42 CFR 483. The federal regulations and existing ch.
HFS 132 address largely similar regulatory areas. Generally, ch.
HFS 132 provides more specificity than the comparable federal regulations for nursing homes.
Health and Family Services
Subject
The Department proposes to amend ch.
HFS 149, rules relating to the selection and monitoring of vendors for the special supplemental food program for women, infants and children (WIC).
Policy analysis
Under the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the federal government provides supplemental foods and nutrition education through payment of cash grants to states that administer the program through local agencies at no cost to eligible persons. The WIC program serves as an adjunct to good health care during critical times of growth and development, in order to prevent the occurrence of health problems. In Wisconsin, the WIC program has 112,000 certified participants, comprised of low-income pregnant and breastfeeding women, infants and children under 5 years of age. Seventy local WIC projects (located in city and county public health departments, private non-profit organizations, and one hospital) administer WIC in designated project service areas. These services include health screening, nutrition assessment and counseling, referrals to other health and social services, and vouchers to purchase nutritious foods at authorized grocery stores and pharmacies (vendors).
The Wisconsin WIC program is responsible for the authorization of some 1,000 vendors to provide food to WIC participants. Applications are screened for basic store and management information, business integrity, and the selection of WIC authorized foods at competitive prices, as determined by prices charged by all stores in a project service area.
Currently applicants for WIC vendor authorization are required under s.
HFS 149.03 (2) (c) to charge a price that is no more than 115% of the average price charged for a standardized combination of foods by other applicants in the project service area in which the grocery store or pharmacy is located. The average price is determined by the Department and based on reported prices of large and small stores statewide for the standardized combination of foods during the previous 6-month period. The Department believes that this method of computing average price may impede the ability of smaller stores to obtain or maintain WIC vendor authorization, due to the smaller stores' inability to offer prices that are competitive with that of larger stores.
The Department proposes to amend s. HFS 149. 03 (2) (c) to remove the requirement that store prices be competitive with all other stores within a project service area to require that prices be competitive with stores within its vendor peer group of similar stores located throughout the state. This change would result in the Department being able to compute average price based on reported prices of the vendor peer group and, therefore, a more equitable process for small store applicants. Prices of these stores will no longer be compared to the prices of larger stores, who can offer lower prices than their smaller counterparts due to economies of scale.
The Department also proposes to amend s.
HFS 149.03 (7) to change the duration of authorization from every two years to every three years. Instead of ending on October 31 of even-numbered years regardless of when authorization was granted, the authorization would end on October 31 of every third year. This is now allowed per federal regulation and would lessen the burden of reauthorization for both the vendors and the state WIC office. In addition, the Department proposes to eliminate the one-year initial certification period, allowing new vendors' authorization period to extend to October 31 of every third year. The one-year certification has not proven to be effective in addressing fraud, and is burdensome for both the vendor and the state WIC office.
Statutory authority
Staff time required
The Department estimates it will take 40 hours of staff time to develop the proposed amendments.
Entities affected by rule
The entities that will be directly affected by the proposed amendments are Wisconsin grocery stores and pharmacies.
Comparison with federal requirements
The Wisconsin WIC program operates under a State Plan pursuant to
7 CFR 246. The Department does not know of any proposed regulations that address the subject of the proposed rules.
