Public notices
Health and Family Services
(Medical Assistance Reimbursement of Nursing Homes)
State of Wisconsin Medicaid Nursing Facility Payment Plan: FY 05-06
The State of Wisconsin reimburses Medicaid-certified nursing facilities for long-term care and health care services provided to eligible persons under the authority of Title XIX of the Federal Social Security Act and ss.
49.43 to
49.47, Wisconsin Statutes. This program, administered by the State's Department of Health and Family Services, is called Medical Assistance (MA) or Medicaid. Federal statutes and regulations require that a state plan be developed that provides the methods and standards for setting payment rates for nursing facility services covered by the payment system. A plan that describes the nursing home reimbursement system for Wisconsin is now in effect as approved by the Centers for Medicare and Medicaid Services (CMS).
The Department is proposing changes in the methods of payment to nursing homes and, therefore, in the plan describing the nursing home reimbursement system. The changes are effective July 1, 2005.
The proposed changes would update the payment system and make various payment-related policy changes. Some of the changes are necessary to implement various budget policies being considered in the Wisconsin 2005-2007 Biennial Budget. Some of the changes are technical in nature; some clarify various payment plan provisions.
The estimated increase in annual aggregate expenditures attributable to these changes for nursing homes serving MA residents is approximately $36,747,130 all funds, ($21,313,335 federal financial participation), excluding patient liability.
The proposed changes are being implemented to comply with Wisconsin Statutes governing Medicaid payment systems, particularly s.
49.45 (6m), Wis. Stats.
The proposed changes are as follows:
1.
Modify the methodology to adjust the reimbursement for nursing homes within the parameters of 2005-2007 Biennial Budget Bill and to disburse the $34,479,166 allotted in the bill to a rate increase of approximately 5% for nursing facilities and $2,267,964 allotted in the bill to a rate increase of approximately 3% for ICF-MRs. These modifications will include adjustments to the maximums, per diems, and other payment parameters in Sections
5.400,
5.500,
5.700,
5.800 and
5.900, the inflation and deflation factors in Section
5.300, and targets in Sections
3.000 and
5.000.
2.
Change references to previous years for descriptive reasons where necessary.
3. Modify the labor factors listed in Section
5.410.
4. Create a new cost center combining Support Services, Administration and Fuel and Utilities into a single cost center.
5. Change the dates of the definitions of base cost reporting period, common period, and rate payment year in Sections
1.302,
1.303, and
1.314 to reflect the 2005-2006 period.
6. Re-write Section
3.775 Special Allowances for Facilities Operated by Local Units of Government.
7.
Modify the calculation for the Medicare Upper Limit in Section
3.780 for ICF-MRs.
8.
Modify Section
3.900,
Reimbursement of State-Operated Facilities to include tribal-operated facilities.
9. Modify the targets in the property allowance in Section
3.532.
10. Modify Sections
2.710,
3.651 and
5.920,
Exceptional Medicaid/Medicare Utilization Incentive to clarify issues concerning the movement of beds and homes in Milwaukee.
11. Delete Sections
1.270 (3) and 1,270
(4), disallowance from working capital interest expense.
12. Modify Section
5.150,
All Non-Expendable, Reusable Materials, to differentiate between cushions and seating arrangements in wheelchairs.
13. Modify Section
3.531 (b),
Maximum on Equalized Value.
14. Clarify Section
3.802,
Ancillary Billable Services, to state that ancillaries mentioned in this section cannot be paid as part of the rate but can be billed by the facilities.
15. Revise Sections
1.256,
Hospice and 1.315
Patient Days.
16. Modify Section
3.600,
Capital Incentives, to address patient lifts.
17. Modify Section
2.720,
Private Room Incentive, to include a due date for filing an affidavit.
18. Create a quality-of-care incentive in Section
2.700,
Provider Incentives.
Copies of the Proposed Changes:
Copies of the proposed changes and proposed rates may be obtained free of charge by writing to:
Division of Health Care Financing
Attention: Nursing Home Medicaid Payment Plan
P.O. Box 309
Madison, WI 53701-0309
or by faxing James Cobb at 608-264-7720.
The available proposed changes may be reviewed at the main office at any county department of social services or human services.
Written Comments/Meetings:
Written comments on the proposed changes may be sent to the Division of Health Care Financing, at the above address. The comments will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily in Room 350 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed changes based on comments received. There will also be public meetings to seek input on the proposed plan amendment. If you would like to be sent a public meeting notice, please write to the above address. Revisions may also be made in the proposed changes based on comments received at these forums.
Natural Resources
Notice of Availability of a Legislative Report Relating to Wisconsin's Air State Implementation Plan
All interested persons are advised that the Department of Natural Resources (DNR) intends to submit proposed rules as contained in Natural Resources Board Order AM-46-04 (Clearinghouse Rule No. 04-107) to the United States Environmental Protection Agency (USEPA) for incorporation into Wisconsin's air state implementation plan to meet requirements contained in the Federal Clean Air Act
42 USC 7401, et seq . DNR has submitted these proposed rules establishing programs for registration and general air permits and all supporting information as a report to the legislative standing committees for environmental matters as required under s.
285.14 (2), Stats. Information on AM-46-04 can be viewed on the following website:
https://apps4.dhfs.state.wi.us/admrules/public/Rmo?nRmoId=186
If you are unable to make copies of this information from the website and would like copies of the information supplied to the Wisconsin legislative committees, please call Ralph Patterson, DNR, at 608-267-7546 or send a request via email to
Ralph.Patterson@dnr.state.wi.us.
Workforce Development
2005 Child Care Copay Schedule
(Effective March 27, 2005)
|
Child Care Co-Payment Schedule for Licensed and Certified Care
|
|
Look down the column of the appropriate family size until you find the gross family monthly income level at or just less than the family income. Look to the right to find the appropriate co-payment by family and type of care.
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|
Gross Monthly Family Income-
Family Size:
|
Weekly Licensed Care
Co-Pay Amount
Children in Subsidized Care:
|
Weekly Certified Care
Co-Pay Amount
Children in Subsidized Care:
|
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10 or more
|
1
|
2
|
3
|
4
|
5 or more
|
1
|
2
|
3
|
4
|
5 or more
|
70% FPL
|
748
|
939
|
1129
|
1319
|
1509
|
1699
|
1889
|
2080
|
2270
|
5
|
8
|
13
|
16
|
21
|
2
|
6
|
9
|
12
|
15
|
75% FPL
|
802
|
1006
|
1209
|
1413
|
1617
|
1821
|
2024
|
2228
|
2432
|
5
|
11
|
15
|
20
|
24
|
4
|
7
|
10
|
14
|
16
|
80% FPL
|
855
|
1073
|
1290
|
1507
|
1725
|
1942
|
2159
|
2377
|
2594
|
7
|
12
|
17
|
22
|
27
|
6
|
8
|
12
|
16
|
19
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
85% FPL
|
909
|
1140
|
1371
|
1602
|
1832
|
2063
|
2294
|
2525
|
2756
|
11
|
15
|
20
|
25
|
32
|
7
|
11
|
14
|
18
|
21
|
90% FPL
|
962
|
1207
|
1451
|
1696
|
1940
|
2185
|
2429
|
2674
|
2918
|
12
|
19
|
24
|
30
|
36
|
8
|
13
|
16
|
21
|
26
|
95% FPL
|
1016
|
1274
|
1532
|
1790
|
2048
|
2306
|
2564
|
2822
|
3080
|
15
|
22
|
29
|
36
|
42
|
11
|
16
|
21
|
24
|
30
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
100% FPL
|
1069
|
1341
|
1613
|
1884
|
2156
|
2428
|
2699
|
2971
|
3243
|
17
|
25
|
32
|
40
|
46
|
12
|
16
|
22
|
27
|
33
|
105% FPL
|
1123
|
1408
|
1693
|
1978
|
2264
|
2549
|
2834
|
3119
|
3405
|
20
|
27
|
35
|
42
|
49
|
14
|
19
|
24
|
29
|
35
|
110% FPL
|
1176
|
1475
|
1774
|
2073
|
2371
|
2670
|
2969
|
3268
|
3567
|
22
|
30
|
36
|
44
|
51
|
16
|
21
|
26
|
30
|
36
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
115% FPL
|
1230
|
1542
|
1854
|
2167
|
2479
|
2792
|
3104
|
3416
|
3729
|
25
|
32
|
40
|
47
|
54
|
17
|
22
|
28
|
33
|
39
|
120% FPL
|
1283
|
1609
|
1935
|
2261
|
2587
|
2913
|
3239
|
3565
|
3891
|
27
|
35
|
42
|
49
|
57
|
19
|
25
|
29
|
35
|
40
|
125% FPL
|
1336
|
1676
|
2016
|
2355
|
2695
|
3034
|
3374
|
3714
|
4053
|
30
|
38
|
45
|
51
|
61
|
21
|
26
|
32
|
36
|
43
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
130% FPL
|
1390
|
1743
|
2096
|
2449
|
2803
|
3156
|
3509
|
3862
|
4215
|
32
|
41
|
49
|
58
|
66
|
22
|
28
|
35
|
40
|
46
|
135% FPL
|
1443
|
1810
|
2177
|
2544
|
2910
|
3277
|
3644
|
4011
|
4377
|
35
|
44
|
54
|
64
|
72
|
25
|
30
|
38
|
44
|
50
|
140% FPL
|
1497
|
1877
|
2258
|
2638
|
3018
|
3399
|
3779
|
4159
|
4540
|
37
|
47
|
57
|
66
|
77
|
26
|
33
|
40
|
47
|
53
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
145% FPL
|
1550
|
1944
|
2338
|
2732
|
3126
|
3520
|
3914
|
4308
|
4702
|
40
|
49
|
58
|
69
|
79
|
28
|
35
|
41
|
49
|
55
|
150% FPL
|
1604
|
2011
|
2419
|
2826
|
3234
|
3641
|
4049
|
4456
|
4864
|
42
|
51
|
62
|
71
|
82
|
29
|
36
|
43
|
50
|
57
|
155% FPL
|
1657
|
2078
|
2499
|
2920
|
3342
|
3763
|
4184
|
4605
|
5026
|
44
|
54
|
64
|
73
|
84
|
30
|
39
|
44
|
52
|
58
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
160% FPL
|
1711
|
2145
|
2580
|
3015
|
3449
|
3884
|
4319
|
4753
|
5188
|
47
|
57
|
67
|
77
|
87
|
33
|
40
|
47
|
54
|
61
|
165% FPL
|
1764
|
2212
|
2661
|
3109
|
3557
|
4005
|
4454
|
4902
|
5350
|
48
|
59
|
69
|
78
|
89
|
34
|
41
|
49
|
55
|
62
|
170% FPL
|
1818
|
2279
|
2741
|
3203
|
3665
|
4127
|
4589
|
5050
|
5512
|
49
|
62
|
71
|
82
|
91
|
35
|
43
|
50
|
57
|
63
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
175% FPL
|
1871
|
2346
|
2822
|
3297
|
3773
|
4248
|
4724
|
5199
|
5674
|
50
|
63
|
74
|
84
|
93
|
35
|
44
|
51
|
58
|
65
|
180% FPL
|
1925
|
2414
|
2903
|
3392
|
3881
|
4370
|
4859
|
5348
|
5837
|
53
|
66
|
77
|
87
|
96
|
36
|
47
|
54
|
61
|
68
|
185% FPL
|
1978
|
2481
|
2983
|
3486
|
3988
|
4491
|
4993
|
5496
|
5999
|
54
|
67
|
79
|
88
|
98
|
37
|
49
|
55
|
62
|
69
|
|
<<<---------- +185% of the Federal Poverty Level ------------->>>
|
190% FPL
|
2031
|
2548
|
3064
|
3580
|
4096
|
4612
|
5128
|
5645
|
6161
|
55
|
69
|
82
|
91
|
100
|
40
|
50
|
57
|
63
|
71
|
195% FPL
|
2085
|
2615
|
3144
|
3674
|
4204
|
4734
|
5263
|
5793
|
6323
|
57
|
71
|
84
|
93
|
104
|
40
|
52
|
59
|
66
|
72
|
200% FPL
|
2138
|
2682
|
3225
|
3768
|
4312
|
4855
|
5398
|
5942
|
6485
|
59
|
72
|
86
|
96
|
105
|
41
|
54
|
61
|
67
|
73
|
|
<<<---------- +200% of the Federal Poverty Level ------------->>>
|
Note: The copayment rate for teen parents who are not Learnfare participants is minimum copay and is found by selecting the lowest income line (70%) FPL and then finding the copayment listed, under either licensed care or certified care, for the appropriate number of children. Parents who have left a W-2 employment position for unsubsidized work also qualify for the minimum copay for one month. Families with children who are authorized for 20 hours or less are subject to one half of their share of the family copay listed above for those children. No copay is required for parents who participate in Learnfare or Food Stamp Employment and Training. Foster parents do not have a copayment responsibility for the foster children in their care. Kinship care relatives caring for a child under a court order do not have a copayment responsibility. Kinship care relatives caring for a child without a court order pay the minimum copay, unless they are receiving a child care subsidy for another child who is subject to a copayment greater than the minimum copay.
Note: Pursuant to s.
DWD 56.08 (3), the Department of Workforce Development is authorized to adjust the co-pay schedule with publication in the Wisconsin Administrative Register.