45 CFR Part 92 provides uniform administrative requirements for grants and cooperative agreements from the federal Department of Health and Human Services to state, local, and tribal governments.
The Legislative Audit Bureau has confirmed that the department is responsible for monitoring compliance with federal regulations and cost circulars by anyone to whom the department passes federal funds.
Comparison with similar rules in adjacent states
Illinois:
Illinois has a levels of care system group homes and residential care centers. Most residential care is subject to a hybrid rate-setting system. The rules provide that the state reimburses providers through payment made according to standard reimbursement levels that are negotiated through contract. For performance residential programs, the state sets staffing ratios and agrees upon salaries for various types of employees with the provider. Food and laundry, building, and administrative costs are based on median historical costs and are capped. This calculation of reimbursable costs provides the provider with an amount of money that the provider has discretion to use.
Iowa:
Iowa has established a weighted average rate for services providers offer. The weighted average rate was established in 1997. In 1998, existing providers had a one-time opportunity to negotiate their rates. The rates may only be changed if there is an across-the-board increase or decrease in rates. The Department of Human Services negotiates rates with a new provider or an existing provider adding an new service.
Minnesota:
Rates for residential facilities are set by a negotiation process between the facility and the county where the facility is located. Once a rate is negotiated, the facility and the county enter into a contract and the facility send the contract paperwork to the state. Facilities are also required to submit cost information each year. When the reimbursement rate is calculated, the facilities are allocated a percentage of the rate for room and board, and a percentage of the rate for administration.
Michigan:
Counties negotiate contracts with providers and the state approves the contracts.
Analysis used to determine effect on small business
The rule provides procedures to implement rate regulation that is directed by s. 49.343, Stats.
Effect on Small Business
The rule will affect small businesses, but will not have a significant economic effect on a substantial number of small businesses.
Small business regulatory coordinator
The Department's Small Business Regulatory Coordinator is Elaine Pridgen, elaine.pridgen@wisconsin.gov; (608) 267-9403.
Fiscal Estimate
State fiscal effect
Indeterminate.
Local fiscal effect
Indeterminate.
Assumptions used in arriving at fiscal estimate
2009 Wisconsin Act 28 directed the Department to implement rate regulation effective January 1, 2011. Prior to the passage of Act 28, the rates charged by Group Home and Residential Care Centers (RCCs) varied widely. Group Homes and RCCs were able to set their own rates and to charge those rates to the Department and County Child Welfare agencies. From 1998 to 2009, the cost of a Group Home placement grew an average of 5.8% annually and the cost of a RCC placement grew an average of 6.1% annually. At the same time, the Consumer Price Index grew an average of 2.4% annually. The current system lacks transparency, predictability and consistency across counties. In addition, the cost of a placement is not related to the complexity or quality of care provided to a child.
By regulating rates, the Department expects to achieve cost containment, transparency, and consistency across counties. In addition, the rate regulation initiative will enable the Department to align rates with the complexity and quality of care provided to a child. The fiscal impact to the Department and county child welfare agencies cannot be determined because individual provider rates have not been certified.
Agency Contact Person
Ron Hermes, Director, Bureau of Permanence and Out-of-Home Care, Division of Safety and Permanence, (608) 267-3832, ron.hermes@wisconsin.gov.
Notice of Hearing
Regulation and Licensing —
Veterinary Examining Board
NOTICE IS HEREBY GIVEN that pursuant to the authority vested in the Veterinary Examining Board, the board will hold a public hearing at the time and place indicated below to consider an emergency order and an order adopting permanent rules to amend sections VE 2.01 (2); 3.03 (intro.) and (5), relating to the requirements for the initial licensure of veterinarians, specifically, the procedures for, and the types of examinations required.
Hearing Information
Date and Time   Location
May 25, 2011   Room 121A
Wednesday   1400 E. Washington Avenue
at 9:30 A.M.   Madison, WI 53703
Appearances at the Hearing
Interested persons are invited to present information at the hearing. Even if appearing at the hearing in person, you are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to the Veterinary Examining Board at the Department of Regulation and Licensing, Division of Board Services, P.O. Box 8935, Madison, Wisconsin 53708.
Submittal of Written Comments
Comments may be submitted to Kris Anderson, Paralegal, Department of Regulation and Licensing, Division of Board Services, 1400 East Washington Avenue, Room 151, P.O. Box 8935, Madison, WI 53708-8935, or by email to kristine1.anderson@wisconsin.gov. Written comments must be received on or before the date and time of the hearing to be included in the record of rule-making proceedings.
Copies of Proposed Rule
Copies of this proposed rule are available upon request to Kris Anderson, Paralegal, Department of Regulation and Licensing, Division of Board Services, 1400 East Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53708, or by email at Kristine1.Anderson@wisconsin.gov.
Analysis Prepared by the Department of Regulation and Licensing
Statute(s) interpreted
Sections 453.06 (1) and 453.065, Stats.
Statutory authority
Sections 15.08 (5) (b), 227.11 (2), 453.03, and 453.06 (1), Stats.
Related statute or rule
Emergency Rule 1103, containing the same provisions as those proposed for this permanent rule, was published on March 28, 2011. There are no related statutes or rules other than the emergency rule and those indicated above.
Explanation of agency authority
The veterinary examining board is authorized under Wis. Stat. sections 453.03 and 453.06 (1) to promulgate rules relating to licensure qualifications, including determining the qualifications licensure candidates must meet to sit for the licensing examination, as well as establishing procedures for taking the examination.
Plain language analysis
This proposed rule-making first clarifies the date by which a Wisconsin veterinary licensure candidate who has not yet graduated from veterinary school must graduate to be eligible to take the North American Veterinary Licensing Examination (NAVLE). It also makes the deadline for submitting NAVLE applications to the board earlier to comply with the National Board of Veterinary Medical Examiner's (NVBME) requirements and to allow adequate time for departmental processing prior to the board's notification of approved examination applicants to the NBVME.
The NAVLE is offered twice per year, during a four-week “testing window" in November-December and a two-week window in April. The precise dates of the testing windows vary from one year to the next. Section VE 2.01 (2), Wis. Admin. Code, currently provides that to be eligible to sit for the NAVLE, a licensure applicant who has not already graduated from veterinary college must expect to graduate in not more than 8 months. However, Rule VE 2.01 (2) does not specify the date an applicant should use for calculating the 8-month deadline. The proposed amendment to the rule clarifies that the 8-month period begins on the last day of the applicable testing window.
Next, per NBVME procedures, all NAVLE examination applicants must file two applications, one directly to NAVLE, and one through the applicant's state or regional licensing agency. In Wisconsin, NAVLE applicants submit their state applications to the veterinary examining board. The board's agreement with the NBVME calls for the board to provide the NVBME with a list of eligible examination applicants either by August 11 for the November-December testing window or by January 13 for the April window. The current version of Wis. Admin. Code s. VE 3.03 (intro.) specifies deadlines for applicants' examination applications to the board that do not allow the board to comply with the terms of its NBVME agreement. The proposed amendment to the introductory section of VE 3.03 resolves the conflict between the rule and the agreement.
Finally, this proposed rule-making implements the legislation enacted by 2009 Wis. Act 396, which became effective on June 2, 2010. Act 396 affords licensure candidates who are graduating from a foreign veterinary college or one not approved by the Wisconsin veterinary examining board, the option of showing successful completion of the program for the Assessment of Veterinary Education Equivalence (PAVE) as an alternative to the requirement of having successfully completed the American Veterinary Medical Association (AMVA) Education Commission for Foreign Veterinary Graduates Certification (ECFVGC) program. The amendment to Wis. Admin. Code s. VE 3.03 (5) provides that alternative.
SECTION 1 requires that a Wisconsin veterinary licensure candidate who has not yet graduated from veterinary school must have an expected graduation date no later than eight months after the last day of the applicable NAVLE testing window.
SECTION 2 requires that veterinary licensure candidates file their state NAVLE applications with the veterinary examining board at least 140 days before the first day of the applicable testing window.
This section further allows a licensure candidate who has graduated from a foreign veterinary college or one not approved by the board to present evidence of successful completion of either the ECFVGC program or PAVE. This section additionally requires that if a licensure candidate has not yet graduated from veterinary college, the dean of his or her school must provide evidence directly to the board that the applicant has an expected graduation date no later than eight months after the last day of the applicable NAVLE testing window.
Summary of related federal requirements
There are no existing or proposed federal regulations addressing the deadlines for state veterinary licensure candidates to submit applications to take the NAVLE or regarding a state's acceptance of successful completion of PAVE as an alternative to the ECFVGC requirement for graduates of foreign veterinary colleges.
Comparison with similar rules in adjacent states
Illinois:
Illinois licensure candidates who have graduated from an approved program must file an examination application at least 60 days before the date of examination. 68 Ill. Admin. Code 1500.10 a).
A candidate not yet graduated from an approved veterinary program may take the licensure examination prior to graduation by providing certification of his or her upcoming graduation from the college being attended. If certification of graduation is not received within 90 days after the scheduled graduation date, the results of the examination are void. 68 Ill. Admin. Code 1500.10 b) 1).
A person applying to take the licensure examination who has graduated from an unapproved program must verify enrollment in either PAVE or the ECFVGC program. 68 Ill. Admin. Code 1500.11 a) 1).
A candidate enrolled in an unapproved veterinary program may take the licensure examination prior to graduation if the applicant provides certification of graduation from the college, along with verification of enrollment in either PAVE or the ECFVGC program. If certification of graduation is not received within 90 days after the scheduled graduation date, the results of the licensure examination are void. 68 Ill. Admin. Code 1500.10 c) 1).
Iowa:
Iowa licensure candidates must submit their state NAVLE applications to the NBVME according to rules established by the NBVME. The Iowa Board of Veterinary Medicine requires candidates to provide it with proof of having completed the NBVME NAVLE application process according to NBVME rules. Iowa Admin. Code s. 811—6.1(1). The NBVME must receive candidates' NAVLE applications by August 1 for the November-December examination, and January 3 for the April 2011 examination. Thus, Iowa candidates must complete their NAVLE application process approximately 115 days before both the December-November and April testing windows.
An Iowa licensure candidate who has graduated from a foreign veterinary college that is only AVMA-listed, as opposed to AVMA-accredited, must also have successfully completed the ECFVGC program or PAVE. Iowa Admin. Code s. 811—6.4(2), (4).
Iowa licensure candidates attending an AVMA-accredited school, but who have not yet graduated, may qualify to take the NAVLE if their expected date of graduation is within 6 months of the examination date. Iowa Admin. Code s. 811—6.1(1). No information about the precise date from which to calculate the 6-month period is available. The Iowa code does not address pre-graduation NAVLE applicants expecting to graduate from a non-AMVA-accredited school.
Michigan:
Michigan's administrative code governing the licensure of veterinarians is out of date, and is undergoing revision. The information in the immediately following paragraph comes from an on-line licensure application packet, published on the veterinary medicine page of the Michigan Department of Community Health's (MCDH) website at: http://michigan.
gov/documents/mdch_vet_full_appkt_88535_7.pdf.
Michigan licensure candidates who have graduated from an AMVA-approved college must submit their state NAVLE applications to the NBVME according to rules established by the NBVME.
Both as currently written and under the proposed revisions, the Michigan code requires that candidates for veterinary licensure who have graduated from a foreign veterinary college must take the NAVLE, and must have successfully completed the ECFVGC program. Michigan does not accept PAVE certification for graduates of foreign colleges. Michigan Admincode R 338.4902, Rule 2 (1).
Also both as currently written and under the proposed revisions, the Michigan code does not address licensure for candidates who have not yet graduated from veterinary college, whether AMVA-approved or not.
Minnesota:
Minnesota's administrative code on veterinary licensure addresses only application fees (a) for licensure; (b) to take to “the national veterinary licensing examination"; and (c) to take the Minnesota Veterinary Jurisprudence Examination. Minn. Admincode s. 9100.0400, Subparts 1. and 3. The code does not identify a specific national examination, and it makes no reference to ECFVGC or PAVE.
The Minnesota statutes provide that to qualify for veterinary licensure, all candidates must either have graduated from an accredited or approved veterinary college, or successfully completed the ECFVGC program or PAVE. Minn. Stat. s. 156.02, subd. 1., subd. 2. (2). If a licensure candidate has not yet graduated from an accredited or approved college, he or she must be a last-year student in good standing. Minn. Stat. s. 156.02, subd. 1. (3). The licensure application must be filed at least 60 days prior to the date of “the examination," where no specific examination is named. Minn. Stat. s. 156.02, subd. 1.
According to its website, the Minnesota Board of Veterinary Medicine requires that candidates for initial licensure must pass both the NAVLE and the Minnesota Veterinary Jurisprudence Examination. The Minnesota board's rules for licensure application can be found at its website: http://www.vetmed.state.mn.us/beta/Default.aspx?
tabid=807
. The website directs candidates to the NBVME website to find NAVLE applications. The NVBME's NAVLE page indicates that Minnesota candidates must submit their state NAVLE applications directly to the NBVME by NAVLE deadlines.
Summary of factual data and analytical methodologies
These proposed rules are for the purpose of first, resolving the inconsistency between the current rules in Wisconsin regarding NAVLE application deadlines and those prescribed by the NBVME; and second, implementing recent legislation allowing foreign veterinary graduates applying for Wisconsin licensure to show evidence of successful completion of PAVE as an alternative to the ECFVGC. Accomplishing those objectives did not require analysis of factual data.
Effect on Small Business
These proposed rules have been reviewed by the department's Small Business Review Advisory Committee to determine whether the rules will have any significant economic impact on a substantial number of small businesses, as defined in s. 227.114 (1), Stats.
Small business regulatory coordinator
The Department's Regulatory Review Coordinator may be contacted by email at john.murray@wisconsin.gov, or by calling (608) 266-2112.
Fiscal Estimate
The department estimates that the proposed rule will have no significant fiscal impact.
Anticipated costs incurred by the private sector
The department finds that these amendments to sections VE 2.01 and 3.03 will have no significant fiscal effect on the private sector.
Agency Contact Person
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Links to Admin. Code and Statutes in this Register are to current versions, which may not be the version that was referred to in the original published document.