6. To expand the mechanisms available to the Department for enforcing compliance of training and testing programs.
Existing enforcement options in ch.
HFS 129.05 (2) (c) are limited to suspension or revocation of certification or imposing a plan of correction. Although these are valuable enforcement tools, they do not give the Department the flexibility it needs to tailor its response to the severity of non-compliance with this chapter. The Department will propose to revise ch.
HFS 129 to include additional enforcement options such as requiring a training or competency program whose approval has been revoked to remain ineligible to submit a new nurse aide training or testing program application for a period of up to one year, issuing a statement of deficiency and placing conditions on certification. The Department also will propose additional enforcement penalties for instructors and examiners who fail to follow program requirements.
7. To include the feeding assistant training and testing program requirements.
The Department proposes updating ch.
HFS 129 to include reference to federal regulations set forth under CFR 483.35 and 483.160 which authorize states to choose to offer a paid feeding assistant training and competency evaluation program, or to review, and approve or disapprove program applications upon request. This training and testing is conducted in nursing homes or intermediate care facility for persons with mental retardation (ICFs/MR), to assist residents who have no feeding complications with the activities of eating and drinking. The feeding assistant is not permitted to provide any other nursing or nursing related service.
8. To include the medication aide training and testing program requirements.
Federal regulations set forth under
42 CFR 483.60 permit the use of unlicensed personnel, if State law permits, to administer drugs under the general supervision of a licensed nurse. This training and testing is conducted in nursing homes, technical colleges and private enterprises. The Department proposes to update ch.
HFS 129 to include these medication aide requirements.
9. To include the process for requesting, reviewing and approving or disapproving waivers to Federal sanctions to training programs.
]The Department proposes to include reference to Public Law 105-15 (H.R. 968), revised specific provisions of the Social Security Act, which permits a State to waive the two-year prohibition of Nurse Aide Training offered in (not by) certain nursing homes if the State:
Determines there is no other such program offered within a reasonable distance of the facility,
Assures, through an oversight effort, that an adequate environment exists for operating the program in the facility, and
Provides notice of such determination and assurances to the State long term care ombudsman.
Statutory authority
Staff time required
The Department estimates that it will take approximately 50 hours to draft the rulemaking order. The Department will also seek the participation of the Bureau on Aging and Long Term Care, the Department of Workforce Development, the Department of Public Education, the Wisconsin Association of Homes and Services for the Aging, the Wisconsin Health and Hospital Association, the Wisconsin Health Care Association, the Wisconsin Technical College System, the Wisconsin Long Term Care Workforce Alliance and private industry.
Entities affected by the rule
Facilities for the Developmentally Disabled, Home Health Agencies, High Schools, Hospice Agencies, Hospitals, Nursing Homes, Private Programs, Technical Colleges, State Agencies, and Universities.
Comparison with federal regulations
Federal conditions of participation for the Registry of nurse aides, nurse aide training and testing programs, and training of paid feeding assistants are in the Code of Federal Regulations,
42 CFR 483. These regulations establish conditions and standards for maintenance and operation of a nurse aide registry, and for conducting training and testing programs for nurse aides and paid feeding assistants. State and federal regulations for registry services and the training and testing of nurse aide and paid feeding assistants are comparable; however, the state requirements augment more general federal regulations by providing specificity in certain areas
. The intent of these regulations is to foster safe and adequate care and treatment of clients by these caregivers.
Insurance
Subject
Objective of the rule. By motion on March 1, 2006 the Joint Committee for Review of Administrative Rules (JCRAR) voted to suspend specific subsections of ch.
Ins 9, Wis. Adm. Code. At the hearing, JCRAR asked the Office to modify those same provisions by rule. The Office will consider modifying ch.
Ins 9, Wis. Adm. Code, with respect to the matters governed by the suspended provisions. Modifications under consideration include: deleting the term “limited scope plan" and replacing it with the appropriate plan or plans including defined network, preferred provider and limited service health organization; modify the emergency medical care provisions, modify language for insurers related to use of utilization management, and modify language related to providers hours of operation.
Policy analysis
A description of existing policies relevant to the rule and of new policies proposed to be included in the rule and an analysis of policy alternatives: Revisions to ch.
Ins 9, Wis. Adm. Code, became effective March 1, 2006. New policies proposed for consideration in this notice of scope include elimination of application of the revised rule to limited scope plans, consider whether the revised rule provides the appropriate standard for coverage of emergency care treatment, and adjusting the language of the revised rule as it relates to utilization management and provider hours of operation. In accordance with the Office's agreement to address the JCRAR's motions, the Office intends to modify specific portions of the revised ch.
Ins 9, Wis. Adm. Code.
There is no viable alternative to establishing by rule the requirements for these health insurance products. The statutory framework contained within ch.
609 and s.
632.85, Wis. Stats., raise the issues that the proposed rule will address.
Statutory authority
Staff time required
200 hours.
Entities affected by the rule
The proposed rule will affect insurers which offer defined network plans, health maintenance organizations, limited scope plans, preferred provider plans and limited service health organization plans. Insurers will be required to revise their relationships, including provider and insurance contracts, with health care providers, health care provider networks, employers and individuals.
Comparison with federal regulations
The Office is unaware of any proposed or existing federal regulation that is intended to address the activities to be regulated by this proposed rule.
Insurance
Subject
Objective of the rule. By motion on March 1, 2006 the Joint Committee for Review of Administrative Rules (JCRAR) voted to suspend s.
Ins 9.32 (2) (c) and
(e) 1., Wis. Adm. Code, and the phrase “(c) and “ in s.
Ins 9.33, Wis. Adm. Code. At the hearing, JCRAR requested the Office to modify these provisions by rule. The Office, after consulting with interested parties, including consumer representatives, insurers, and representatives of Wisconsin health care providers, will consider appropriate modifications to ch.
Ins 9, Wis. Adm. Code, to address the topic of the JCRAR suspended provisions.
Policy analysis
Chapter
Ins 9, Wis. Adm. Code, became effective March 1, 2006. Chapter
Ins 9 includes the provisions cited above which address the circumstances where an operation or procedure is performed by an in-panel provider but some ancillary services, such as anesthesiology, radiology or lab tests, are performed by non-participating providers. OCI will, after consulting with interested parties, consider whether there are alternative standards, or alternative implementation, that may more appropriately address this matter than the standards included in the suspended provisions of revised ch.
Ins 9, Wis. Adm. Code.
There is no viable alternative to establishing by rule the requirements for these health insurance products. The statutory framework contained within ch.
609 and s.
632.85, Wis. Stats., raise the issues that the proposed rule will address.
Statutory authority
Staff time required
200 hours.
Entities affected by the rule
The proposed rule will affect insurers which offer defined network plans, health maintenance organizations, preferred provider plans and limited service health organization plans. Insurers will be required to revise their relationships, including provider and insurance contracts, with health care providers, health care provider networks, employers and individuals.
Comparison with federal regulations
The Office is unaware of any proposed or existing federal regulation that is intended to address the activities to be regulated by this proposed rule.
Natural Resources
Subject
Objective of the rule. Modifications to portions of ch.
NR 22, pertaining to Wisconsin-Iowa boundary waters. The proposed changes would implement harvest restrictions for commercially-caught shovelnose sturgeon in Wisconsin-Iowa waters of the Mississippi River.
Policy analysis
The Department is beginning the process of recommending changes to Wisconsin administrative code relating to commercial fishing for shovelnose sturgeon. The Department anticipates requesting hearings on these changes in June, 2006, and holding hearings, if approved, in August 2006.
Statutory authority
Staff time required
The Department anticipates spending approximately 160 hours in the rule development process.
Entities affected by the rule
Fewer than five commercial fishermen licensed by Wisconsin will be affected by the proposed rule changes.
Comparison with federal regulations
Authority to promulgate fishing regulations is granted to States. No federal regulations apply to the proposed changes in regulating recreational fishing and clamming activity.
Public Service Commission
Subject
Objective of the rule. This rulemaking will create rules regarding statewide energy efficiency and renewable resource programs as required under
2005 Wisconsin Act 141.
Policy analysis
2005 Wisconsin Act 141 revises the statutes to create a structure under which energy utilities collectively establish and fund statewide energy efficiency and renewable resource programs that will help achieve environmentally sound and adequate energy supplies at reasonable cost. These rules will address issues such as:
Procedures for contracting with program administrators.
Criteria for selection of program administrators.
Procedures and criteria for Commission review of contracts with program administrators.
Procedures and criteria for Commission review of programs.
Minimum requirements for the programs.
Comparison with federal regulations
The Commission is unaware of any federal regulation in this area.
Statutory authority
Staff time required
The Commission estimates that approximately 500 hours of Commission staff time will be required in this rulemaking.
Other resources necessary to develop rule
Commission staff may meet and consult with former members of the Governor's Task Force on Energy Efficiency and Renewables during the course of this rulemaking.
Entities affected by the rule
The rulemaking will affect investor-owned and municipal electric and natural gas utilities, and retail electric cooperatives.
Public Service Commission
Subject
Objective of the rule. This rulemaking will revise Wis. Admin. Code ch.
PSC 118 to reflect changes found in
2005 Wisconsin Act 141 regarding renewable resource credits.
Policy analysis
2005 Wisconsin Act 141 revises Wis. Stat. s.
196.378 regarding renewable energy sources and renewable resource credits. These credits may be generated and used by a utility to meet its required renewable energy percentage, or sold to another utility for its use in meeting its percentage. These rules will address issues such as the requirements for creation and use of a renewable resource credit and a regional credit tracking system.
Comparison with federal regulations
There are various federal regulations concerning renewable energy, but the Commission is not aware of any federal regulation in this specific area.
Statutory authority
