This Week in the Legislature: Week of June 1, 2015  

2015-17 State Biennial Budget

The Joint Committee on Finance (JCF) met on Wednesday and Friday last week. Action was taken on the following items:

Family Care and IRIS
  • The JCF deleted all of the statutory changes recommended by the Governor.
  • Retained savings amount of $14,336,900.
  • The JCF required DHS to submit a request to the federal Centers for Medicare and Medicaid Services (CMS) for changes to the state's current waiver under which Family Care and IRIS operates.

-Request must provide for the expansion of Family Care statewide. 

-If waiver approved, Family Care program must be available statewide by January 1, 2017 or a date determined by DHS (whichever is later).
-No JCF approval needed for the expansion of Family Care.
-DHS authority to eliminate the waiver programs after Family Care is available to all eligible residents in a county (CIP, CORP, COP).
  • The waiver request must also include the following components:
-Specify that MA-funded long-term care consumers receive both long-term care and acute care services, including Medicare-funded services to the extent allowable by CMS, from integrated health agencies (IHAs).
-Increase the size of regions currently served by managed care entities, such that each region has sufficient population to allow for adequate risk management by IHAs.
-Specify that there shall be no less than five regions.
-Require multiple IHAs in all regions of the state.
-Require IHAs to make available a consumer-directed option under the long-term care program.
-Modify the state's long-term care programs, including allowing for audits of providers, in order to improve accountability in the provision of services.
-Establish an open enrollment period for the state's long-term care programs that coincides with the open enrollment period for the Medicare program.
-Require that rates paid to IHAs be set through an independent actuarial study.
-The preservation of the current "any willing provider" requirement for long-term care providers for a minimum of three years after the implementation date of the program in each region.
  • Direct DHS to consult with stakeholders, including representatives of consumers of long-term care and long-term care providers, and the public prior to developing its final waiver request.
  • Require DHS to develop its final recommendations in accordance with the ten key principles determined by CMS to be essential elements of a strong managed long-term services and supports program.
  • Require DHS to submit a summary of the proposed concept plan associated with the waiver request to the JCF for review and approval or disapproval without changes no later than April 1, 2016 prior to DHS submitting any proposed changes to the state's MA waiver agreements or a state plan amendment to CMS for approval.
  • Require DHS to include in its 2017-19 biennial budget request any proposed statutory changes necessary to conform statutes to the approved waiver or state plan amendment.
  • Specify that a long-term care district is permitted to operate a health maintenance organization.
  • Specify that, in addition to the current statutory responsibilities, long-term care advisory committees are responsible for providing for review and assessment of the self-directed services option.
ADRCs
  • The JCF deleted the Governor's recommendation to modify the statutory requirements of ADRCs.
  • Deleted the Governor's recommendation to eliminate ADRC governing boards.
  • Required DHS to evaluate the functional screen and options counseling for reliability and consistency among ADRCs, and to provide a report regarding these activities by January 1, 2017.
  • Required DHS to assess which responsibilities of ADRC governing boards are duplicative with current DHS procedures, and to propose changes to the statutory requirements of these boards that remove duplication to the JCF no later than July 1, 2016.
  • Deleted the Governor's recommendation to eliminate long-term care advisory committees.

Integration of Income Maintenance Consortia and ADRCs 

  • The JCF required DHS to study the integration of income maintenance consortia and aging and disability resource centers, and to present a report to the JCF no later than April 1, 2016 with recommendations regarding potential efficiencies that may be gained, if any, from the integration of these entities, as well as whether such a merger would be appropriate in light of the responsibilities of each entity.
Children's COP
  • The Governor's budget:
-Effective July 1, 2016, creates a Children's Community Options Program (CCOP) by repealing the Family Support Program and consolidating funding currently budgeted for that program and funding that currently supports long-term care services for children under COP.
-Directs DHS to allocate funds to county or private, nonprofit agencies to provide long-term community support services to children who have a disability.
  • Counties indicated concern with the proposal and indicated could withdraw opposition contingent on written agreement from DHS on the following items:
-Counties have right of first refusal on contracts.
-Service array available to children and families will not be reduced.
-Documentation and reporting requirements remain unchanged.
-Parental obligations remain the same.
-Eligibility, as determined by the children's functional screen, is kept the same.
  • The JCF adopted the Governor's recommendation with minor modifications.
Dementia Care Specialists
  • The JCF adopted the Governor's recommendation to provide one-time funding of $1,128,000 in FY 17 to fund 12 grants to support DCS positions at ADRCs.
Children's Long-Term Care Services
  • The JCF adopted the Governor's recommendation to provide a 3% annual increase to the CLTS program and for autism services.
  • The JCF also adopted the Governor's recommendation to direct excess funds from school-based services to reduce waitlists for children's long-term care services.
  • Provided $886,300 in FY 16 and $912,900 in FY 17 to provide services to approximately 50 children on the CLTS and autism services waitlists.
MA Reimbursement for Nursing Homes
  • The JCF provided $7,617,400 in FY 17 for a 1% acuity adjustment for nursing homes, beginning in FY 17.
  • Directed DHS to study the labor region methodology, and to propose changes to labor region methodology, as necessary, such that any proposed labor region methodology results in adjustments to direct care costs that reflect labor costs for nursing homes in each county no later than July 1, 2016.
Exempt IMDs and State-Only Licensed Facilities from the Bed Tax
  • Exempt county government-owned IMDs and state-only licensed facilities from the nursing home bed assessment, unless CMS determines that exempting these facilities would not be permissible under federal statutes or rules relating to state health care provider assessments.
Healthy Aging Grants
  • The JCF provided $200,000 GPR in one-time funding each year of the 2015-17 biennium for a grant to a private, non-profit entity that will use these funds to conduct the following activities:
-Coordinate the implementation of evidence-based health promotion programs in healthy aging.
-Coordinate with academic and research institutes regarding research on healthy aging.
-Serve as a statewide clearinghouse on evidence-based disease prevention and health promotion programs.
-Provide training and technical assistance to the staff of county departments, administering agencies, and other providers of services to aging populations.
-Collect and disseminate information on disease prevention and health promotion in healthy aging.
-Coordinate public awareness activities related to disease prevention and health promotion in aging.
-Advise DHS on public policy issues concerning disease prevention and health promotion in aging.

Transfer of Information Technology Services to DOA - GAB
  • Part of a larger multi-agency consolidation of technology services.
  • The JCF required DOA to develop a plan for transfer of human resources, payroll, finance, budgeting, procurement, and IT services from multiple agencies to DOA and submit the plan to JCF for approval by March 1, 2016 for implementation by July 1, 2016.
  • DOA must report which services it will provide to each agency, which agency positions would be deleted or transferred, and the number and type of positions and funding that will be transferred to DOA.
  • JCF must approve the plan.  
DNR Conservation Grants
  • The Governor's budget eliminated Department of Natural Resources (DNR) Grants statutorily directed to non-profit conservation organizations (NCO's).
  • The grants have been provided to (NCO's) in order to assist the DNR or other (NCO's) with a variety of conservation related efforts.
  • From the county perspective, the elimination of the grants primarily affects the Wisconsin County Forest Association (WCFA).
  • The JCF took action to reinstate the DNR capacity grants applicable to the Wisconsin County Forest Association.
  • The JCF action is consistent with current law authorizing up to a $50,000 dollar match per county and or up to 50% of dues per member to be subsidized with funds from the county forest administration grant program.
DNR Stewardship Program
  • The omnibus motion passed by the JCF included:
  • Current law bond authorization for local assistance stewardship grants ($6,000,000 annually).
  • Additional bond authorization for county forest grants ($5,000,000 annually).
  • Additional bond authorization for DNR acquisition ($9,000,000 annually).
  • Additional bond authorization for Nonprofit Conservation Organizations (NCO's) ($7,000,000 annually).
Shoreland Zoning
  • The JCF added language to the budget related to shoreland zoning that:
  • Limits the DNR or a county's ability to regulate outdoor lighting.
  • Limits a county's ability to charge a fee or require approval for  the restoration of a non-conforming structure within a shoreland zone, so long as that non-conforming structure is not greater in size than the original footprint.
  • Provides that county shoreland zoning requirements of vertical or lateral expansion of a non-conforming structure may be enacted, so long as such standards do not conflict with DNR standards.
  • Limits DNR and county standards related to impervious surfaces. 
  • Provides that a county may not regulate any shoreland zoning matter in a manner more restrictive than current rules promulgated by the DNR.
  • Counties would still be able to regulate matters that DNR rules do not speak to. 
  • A county may not compel a property owner to establish a vegetative buffer zone on currently developed land, nor expand an existing buffer zone on such land. 
  • The DNR may not appeal to a county a decision by a county board of adjustment to deny or grant a variance.
At the conclusion of Friday's meeting, the co-chairs of the JCF indicated the committee would meet again once a deal was reached on the Department of Transportation budget. Items remaining for the committee's consideration include:
  • Transportation finance and funding.
  • General fund taxes.
  • Financing for a new arena for the Milwaukee Bucks.
View WCA's communications to the JCF here.

Budget Webinars
The WCA Government Affairs Team is hosting weekly budget webinars on Mondays during state budget deliberations. An email with additional detail and registration information is sent early each week. The deadline for registering for each webinar is 8:00 a.m. on the day of the webinar and note that each week the link to join is different.
To register for the June 8 webinar, click here.

Webinars are recorded each week and placed on the WCA website under Legislative>State Budget>2015-2017 State Budget>WCA Webinars shortly after the conclusion of each webinar.  Listen to the Monday, June 1 webinar here.

Committee Hearings for the Week of June 1, 2015
Note: The Committee hearings and bills listed below reflect action on legislation impacting county government. See a complete listing of weekly hearings here.

Tuesday, June 2, 2015
Senate Committee on Judiciary and Public Safety, 10:00 a.m.
Senate Bill 173 - the effective date of amendments to the Uniform Interstate Family Support Act. WCA is monitoring this bill.

Senate Bill 181 - competency determination hearings and commitment. WCA is monitoring this bill.

Wednesday, June 3, 2015
Assembly Committee on Children and Families, 1:00 p.m.
Assembly Bill 238 - the effective date of amendments to the Uniform Interstate Family Support Act. WCA is monitoring this bill.

WCA Upcoming Meetings
For a complete listing of upcoming WCA meetings, please click here.

Questions? Contact Our Government Affairs Team  
If you have any questions about anything happening at the state level, please feel free to contact any member of the WCA Government Affairs Team at 866.404.2700 or via email:

Kyle Christianson - Director of Government Affairs 
Sarah Diedrick-Kasdorf - Deputy Director of Government Affairs 
David Callender - Government Affairs Associate 
Daniel Bahr - Government Affairs Associate 
 
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