21. Eliminating child support compliance requirement
2017 Wisconsin Act 268 prohibits the following individuals from being eligible
for the Medical Assistance program: certain able-bodied adults and able-bodied
parents who refuse to cooperate in determining the paternity of a child, establishing
or enforcing any support order, or obtaining any other payments or property to which
the adult or the child has rights, and certain parents who are delinquent in child
support payments without satisfying an exception or who refuse to cooperate in
providing or obtaining support for their child. This bill eliminates this prohibition
and reinstates the pre-Act 268 requirement that a person seeking Medical
Assistance benefits must cooperate, in accordance with federal law, in good faith with
efforts directed at establishing the paternity of a nonmarital child and obtaining
support payments or any other payments or property to which the person and the
dependent child or children may have rights.
22. Eliminating savings account program
2017 Wisconsin Act 271 requires DHS to submit a request to the federal
government to establish and implement a savings account program, similar in
function and operation to health savings accounts, in the Medical Assistance
program. This bill eliminates that requirement.
23. Long-term care programs; managed care
This bill generally makes changes to certain long-term care programs that
receive funding under the Medical Assistance program. The Family Care program
concluded its expansion statewide replacing the Community Options Program,
known as COP. The bill eliminates the statutory language for the COP program, a
requirement that DHS certify availability of an aging and disability resource center,
and a requirement that aging and disability resource centers perform outreach in
new Family Care program counties. The bill requires aging and disability resource
centers to provide information and assistance on the self-directed services option,
known as IRIS; the Family Care Partnership program; and the program of
all-inclusive care for the elderly, known as PACE, in addition to the current
requirement to provide information and assistance on the Family Care program.
The bill eliminates regional long-term care advisory committees, which, among
other things, evaluate the care management organizations that administer the
Family Care program.
Current law specifies a 45-day deadline by which an applicant for or recipient
of Medical Assistance must file an appeal of his or her eligibility determination. The
bill specifies that for appeals of the adverse benefit determinations described in the
bill made by a care management organization or managed care organization, the
Medical Assistance recipient has 90 days to appeal. The bill also specifies that the
individual seeking an appeal must exhaust the internal appeal procedures of the
care management organization or managed care organization first.
Public assistance
Drug screening and testing requirements
This bill eliminates provisions under current law that, with certain exceptions,
require controlled substance abuse screening and, in some cases, testing and
treatment of all of the following: a) individuals who apply to participate in certain
work experience programs administered by DCF and DWD; b) noncustodial parents
who apply for Wisconsin Works (W-2), administered by DCF; and c) with respect to
the W-2 program, every adult member of an individual's W-2 group whose income
or assets are included in determining the individual's eligibility for a W-2 program.
2. Eliminating FSET drug testing requirement
2015 Wisconsin Act 55 required DHS to promulgate rules to develop and
implement a drug screening, testing, and treatment policy, which DHS promulgated
as DHS 38, Wis. Adm. Code.
2017 Wisconsin Act 370 incorporated into statutes DHS
38 relating to drug screening, testing, and treatment for recipients of the FoodShare
employment and training program, known as FSET. This bill eliminates the
requirement to implement a drug screening, testing, and treatment policy and
removes from the statutes the language incorporated by Act 370.
3. Temporary Assistance for Needy Families allocations
Under current law, DCF allocates federal moneys, including child care
development funds and moneys received under the Temporary Assistance for Needy
Families (TANF) block grant program for various public assistance programs. This
bill modifies certain TANF allocations. This bill specifies that, with respect to a
TANF-funded contract for services, “allocation” means the amount under the
contract that DCF is obligated to pay.
4. TANF reallocations
Under current law, DCF may reallocate funds for one purpose under the TANF
allocations for any other purpose under the TANF allocations through passive review
by JCF. Also under current law, if the TANF moneys received from the federal
government are less than the amounts appropriated for the purposes under the
TANF schedule, DCF is required to create a plan for reducing the amounts of moneys
allocated under the TANF allocations and to carry it out subject to passive review by
JCF. This bill replaces passive review by JCF with a requirement that the secretary
of administration approve a reallocation or a plan to reduce the moneys allocated
under TANF.
5. FSET requirement
2017 Wisconsin Act 264 requires DHS, beginning on October 1, 2019, to require
all able-bodied adults, with some limited exceptions, who seek benefits from the
FoodShare program to participate in the FoodShare employment and training
program, known as FSET, unless they are already employed. This bill eliminates
that requirement for able-bodied adults with dependents but retains the
requirement for able-bodied adults without dependents. FoodShare is also known
as the food stamp program and the federal Supplemental Nutrition Assistance
Program.
6. Eliminating FSET pay-for-performance requirement
2017 Wisconsin Act 266 requires DHS to create and implement a payment
system based on performance for entities that perform administrative functions for
the FoodShare employment and training program, known as FSET. Act 266
specified performance outcomes on which the pay-for-performance system must be
based. This bill eliminates the requirement for DHS to create a pay-for-performance
system for FSET vendors.
7. FoodShare paternity and child support compliance
2017 Wisconsin Act 59 prohibits from being eligible for FoodShare benefits
certain individuals and parents who refuse to cooperate in obtaining child support
or determining the paternity of a child or who are delinquent in child support
payments and do not satisfy an exception. Act 59 prohibits DHS from implementing
these ineligibility provisions unless DCF determines the implementation may be
done in a budget-neutral manner, DHS or DCF has approval from the federal
government to implement the ineligibility provisions in a budget-neutral manner,
and DHS and DCF notify the governor and JCF of the federal approval and
implementation. This bill eliminates all of the ineligibility provisions in FoodShare
for failing to comply with paternity and child support requirements in Act 59.
8. Transform Milwaukee Jobs for Childless Adults program
This bill provides funding for and requires DCF to establish the Transform
Milwaukee Jobs for Childless Adults program, which is identical to the Transform
Milwaukee Jobs program except that it is open to childless adults. Under current
law, the Transform Milwaukee Jobs program provides a wage subsidy for placement
into jobs for qualifying individuals in Milwaukee County. Under current law, in
order to qualify for the Transform Milwaukee Jobs program, a participant must be
a parent or relative who is a primary caregiver of a child.
9. Foster care youth driver's licensing
This bill requires DCF to establish or contract for a driver education program
for individuals who are 15 years of age or older and in out-of-home care. The bill
requires the program to provide assistance with identifying and enrolling in an
appropriate driver education course, obtaining an operator's license, and obtaining
motor vehicle liability insurance. The bill authorizes DCF to pay, for any individual
in the program, any fees required to enroll in a driver education course or to obtain
an operator's license and the cost of motor vehicle liability insurance on the vehicle
owned or used by the individual during the program and after the individual obtains
an operator's license.
10. Grants to support child care in Milwaukee
This bill authorizes DCF to award grants to child care providers to support
access to high-quality child care for families that reside in a geographic area with
high-poverty levels, as identified by DCF, in the city of Milwaukee. To receive the
grants, child care providers must contribute matching funds or in-kind goods or
services equal to 25 percent of the grant. This bill also authorizes DCF to award
grants to child care providers and their employees, and to educational institutions
for the purpose of educating employees of child care providers, to improve the overall
child care quality in that geographic area.
11. Grants for services for homeless and runaway youth
This bill provides an additional $250,000 per year in funding for grants
administered by DCF to support programs that provide services for homeless and
runaway youth. Under current law, DCF awards $150,000 per year for this purpose.
12. Tribal family services grants
This bill requires tribal family services grants, administered by DCF, to be
funded using Indian gaming receipts. The grants may be used for tribal services for
adolescents or victims of domestic abuse, tribal child care, or tribal child welfare
services.
13. Special Supplemental Nutrition Program for Women, Infants, and
Children
This bill makes various changes to the Special Supplemental Nutrition
Program for Women, Infants, and Children, known as the WIC program. The WIC
program provides supplemental foods, nutrition education, and other services to
low-income women, infants, and children that meet eligibility criteria under federal
law. DHS administers portions of the WIC program including authorization of
vendors and distribution centers to accept the method of payment that participants
in the WIC program use to obtain foods approved under the program. Specifically,
the bill does all of the following:
a. Allows DHS to identify an alternate participant, who is someone authorized
by a WIC program participant to request benefits and otherwise participate in the
WIC program, as the WIC program cardholder for purposes of electronic
administration.
b. Adds to the criteria to be an authorized vendor or authorized distribution
center that the vendor or distribution center has an electronic benefit
transfer-capable cash register system or payment device that meets the criteria
specified in the bill.
c. Specifies that, except for certain mobile stores specially authorized in
accordance with federal law, each store is a separate vendor, must have a single, fixed
location, and must be separately authorized under the WIC program.
d. Adds to the activities prohibited under the WIC program engaging in
trafficking. Trafficking in WIC benefits is defined in the bill as engaging in any of
the following: buying, selling, stealing, or otherwise exchanging, including
exchanging firearms, ammunition, explosives, or controlled substances, a payment
method of obtaining WIC-approved foods for cash or consideration other than WIC
approved foods; intentionally purchasing and reselling for cash or consideration a
product that is obtained using a method of obtaining WIC-approved foods; or
intentionally purchasing with cash or consideration a product that was originally
purchased with a method of obtaining WIC-approved foods. A person who performs
any of the prohibited practices under the bill or under current law is subject to a
felony with a penalty of a fine not to exceed $10,000 or imprisonment not to exceed
three years and six months, or both for the first offense and for a second or
subsequent offense a felony with a penalty of a fine not to exceed $10,000 or
imprisonment not to exceed six years, or both.
e. Incorporates infant formula suppliers into the types of entities for which
DHS must promulgate rules regarding standards for authorization.
f. Adds civil monetary penalty, warning letter, and implementation of a
corrective action plan to the list of consequences for violating a rule promulgated by
DHS relating to the WIC program.
g. Specifies that information about an applicant for, participant in, or vendor
in the WIC program is confidential and then specifies who may access that
confidential information and for what purposes.
h. Makes some additional changes to the language of the WIC program
statutes.
Wisconsin Works
W-2 lifetime maximum
The Wisconsin Works (W-2) program under current law, which DCF
administers, provides work experience and benefits for low-income custodial
parents who are at least 18 years old. This bill increases the lifetime maximum for
W-2 participation of an individual or any adult member of the individual's W-2
group from 48 months to 60 months. Under current law, a W-2 group includes any
nonmarital coparent or any spouse of an individual who resides in the same
household as the individual.
2. W-2 work experience programs
Under current law, the W-2 program provides a work experience program
known as the “Trial Employment Match Program,” or “TEMP.” Under current law,
participants in TEMP are placed in a job and the agency administering the W-2
program subsidizes the participants' employment for up to 40 hours per week. This
bill changes the name of TEMP to “Subsidized Employment Placement,” removes the
40-hour per week cap on the subsidy, and allows a W-2 agency to negotiate with the
employer a maximum number of hours per week for which the participant is eligible
to receive a subsidy. This bill also removes the current 24-month participation limit
for TEMP and community service and transitional placement jobs, which are also
under W-2.
3. Work experience program: educational and training component
The work experience programs under W-2 currently include educational and
training components, not to exceed ten hours per week in the community service job
program or 12 hours per week in the transitional placement program. This bill
removes the time limitations on educational and training components of a W-2
program. Also under current law, a person may participate in a technical college
education program under W-2, as long as the person works in a community service
job or transitional placement for 25 hours per week in addition to participating in the
technical college educational program. This bill removes the 25-hour requirement
of the work component for participation in the technical college education program
under W-2.
4. Program time limit for caretaker of an infant
Under current law, a person who meets the eligibility requirements for W-2 and
who is the custodial parent of a child who is eight weeks old or less may receive
monthly grants of $673 and may not be required to work in a W-2 employment
position during that time, unless another adult member of the custodial parent's
W-2 group is participating in, or is eligible to participate in, a W-2 employment
position or is employed in unsubsidized employment. This bill extends these
monthly benefits to the custodial parent of a child who is 12 weeks old or less.
5. Wisconsin Shares maximum reimbursement rate
Under the Wisconsin Shares program under W-2, an individual who is the
parent of a child under the age of 13 or, if the child is disabled, under the age of 19
who needs child care services to participate in various education or work activities,
and who satisfies other eligibility criteria, may receive a subsidy for child care
services.
DCF determines the maximum subsidy rates for Wisconsin Shares child care
subsidies. DCF also determines the maximum subsidy rates for services provided
by certified family child care providers, but may set the rate for Level I certified
family child care providers at no more than 75 percent of the licensed child care rate
and for Level II certified family child care providers at no more than 50 percent of
the licensed child care rate. Under this bill, the maximum rate for Level I or Level
II certified family child care providers may not exceed the licensed child care rate.
6. Internet service provider subscriptions
This bill allows a person who meets the eligibility requirements for W-2 to
apply for and receive from DCF a monthly amount sufficient to pay the cost of an
Internet service provider subscription or $57, whichever is lower.
Health
Medical marijuana
Current law prohibits a person from manufacturing, distributing, or delivering
tetrahydrocannabinols; possessing THC with the intent to manufacture, distribute,
or deliver it; possessing or attempting to possess THC; using drug paraphernalia; or
possessing drug paraphernalia. This bill creates a medical use defense to such
THC-related prosecutions and forfeiture actions for a person who is registered with
DHS as having a specified debilitating medical condition or undergoing a specified
debilitating treatment. The bill also prohibits the arrest or prosecution of such a
person for those offenses. The defense and prohibition do not apply under certain
circumstances, such as a) if the person does not have a valid registry identification
card; b) if the amount of cannabis involved is more than 12 plants or three ounces of
leaves or flowers; c) if, while under the influence of THC, the person drives a motor
vehicle or engages in other conduct that endangers another person; or d) if the person
smokes cannabis on a school bus or public transit or on school premises.
Under the bill, DHS must establish a medical cannabis registry, and a person
may apply to DHS for a registry identification card. The bill specifies that the
following medical conditions or treatments qualify a person for the registry: cancer,
glaucoma, AIDS or HIV, Crohn's disease, a hepatitis C virus infection, Alzheimer's
disease, amytrophic lateral sclerosis, nail-patella syndrome, Ehlers-Danlos
Syndrome, post-traumatic stress disorder, or the treatment of these conditions;
opioid abatement or reduction or treatment for opioid addiction; a chronic or
debilitating disease or medical condition or the treatment of such a disease or
condition that causes cachexia, severe pain, severe nausea, seizures, or severe and
persistent muscle spasms; and any other medical condition or treatment DHS
designates as a debilitating medical condition or treatment. DHS must issue a
qualified applicant a registry identification card unless, in the previous ten years,
the applicant was serving a sentence or on probation for certain violent felony
convictions. DHS must keep registry information and applications confidential
except for verifying status for law enforcement purposes.
Under the bill, DATCP must license and regulate dispensaries to facilitate
medical THC. The bill prohibits a dispensary from being located within 500 feet of
a school, from distributing to one person more than 12 cannabis plants or three
ounces of cannabis leaves or flowers, and from possessing an excessive quantity of
cannabis. An applicant for a dispensary license must pay an initial application fee
determined by DATCP, but a minimum of $250, and a dispensary must pay an annual
fee determined by DHS, but a minimum of $5,000.
The bill requires DATCP to determine policies that allow entities to grow
cannabis and distribute it to dispensaries. The bill also requires DATCP to register
entities as THC-testing laboratories. The bill also imposes a surcharge on the sale
of cannabis and tetrahydrocannabinols by a dispensary. The surcharge is equal to
10 percent of the sales price.
This bill affirmatively states that no employer is required to permit or
accommodate the use, consumption, possession, transfer, display, transportation,
sale, or cultivation of medical marijuana at a place of employment by an employee.
The bill expressly allows an employer to have a policy regarding marijuana use by
its employees.
2. Prescription drug importation program
This bill requires DHS, in consultation with persons interested in the sale and
pricing of prescription drugs and federal officials and agencies, to design and
implement a prescription drug importation program for the benefit of and that
generates savings for Wisconsin residents. The bill establishes requirements for the
program including all of the following: DHS must designate a state agency to become
or contract with a licensed wholesale distributor and seek federal certification and
approval to import prescription drugs; the importation program must comply with
certain federal regulations and import from Canadian suppliers only prescription
drugs that are not brand-name drugs, have fewer than four competitor drugs in this
country, and for which importation creates substantial savings; DHS must ensure
that prescription drugs imported under the program are not distributed, dispensed,
or sold outside of Wisconsin; and the importation program must have an audit
procedure to ensure the program complies with certain requirements specified in the
bill. Before submitting the proposed implementation program to the federal
government for certification, DHS must submit the proposed importation to JCF for
its approval.
3. Dental therapy training program
This bill requires DHS to award onetime grants on a competitive basis to
educational institutions for costs associated with beginning a dental therapy
training program.
4. Evidence-based oral health grants and Seal-A-Smile program
This bill expands the grants awarded annually by DHS for the Seal-A-Smile
program and modifies the scope of other grants awarded by DHS from fluoride
programs to include grants for fluoride varnish and other evidence-based oral health
activities. Under current law, DHS annually awards grants totaling $25,000 for
fluoride supplements, $25,000 for a fluoride mouth-rinse program, and $120,000 for
a school-based dental sealant program. Under the bill, DHS is required to award
grants totaling no less than $50,000 for fluoride varnish and other evidence-based
oral health activities, $700,000 for school-based preventive dental services, and
$100,000 for school-based restorative dental services, except that in fiscal year
2019-20, DHS is required to award $525,000 for school-based preventive dental
services, $100,000 for school-based restorative dental services, and $50,000 for
fluoride varnish and other evidence-based oral health activities.
5. Minority health grant funding
This bill modifies the funding for the DHS minority health program through
which DHS annually awards grants to organizations for activities to improve the
health status of economically disadvantaged minority group members. Under
current law, DHS awards grants of up to $50,000 per year per applicant from
program revenues. The bill instead uses general purpose revenues for these grants
and eliminates the program revenues appropriation. Current law requires that
applicants that are not federally qualified health centers receive priority for grants.
The bill requires that applicants providing maternal and child health services also
receive priority for these grants.
Under current law, DHS is also required to award, from the same program
revenues appropriation, a grant of up to $50,000 to a private nonprofit corporation
to conduct a public information campaign on minority health. Under the bill, this
grant is also funded by general purpose revenues.
6. Infant mortality prevention program
This bill requires DHS to allocate five of its full-time equivalent positions to
staff an infant mortality prevention program.
7. Title V and Title X family planning funding
Current law requires DHS to apply for federal Title X grant funds and to
distribute any funds received to public entities for family planning and related
preventive health services. This bill eliminates that requirement.
Under current law, DHS must allocate women's health funds, which are federal
Title V funds and women's health block grant funds, to develop and maintain an
integrated system of community health services and maximize coordination of
family planning services. Current law excludes from the definition of “family
planning” performance, promotion, encouragement, or counseling in favor of, or
referral either directly or through an intermediary for, voluntary termination of
pregnancy but includes in the definition of “family planning” the provision of
nondirective information explaining prenatal care and delivery or infant care, foster
care, or adoption. DHS must distribute women's health funds only to public entities.
Currently, those public entities may provide some or all of the funds to other public
entities or private entities as long as the recipients of the funds do not provide
abortion services, make referrals for abortion services, or have an affiliate that
provides abortion services or makes referrals for abortion services. The bill retains
the authorization for the public entity that receives funds from DHS to provide some
or all of the funds to other public or private entities but eliminates the restriction on
which public or private entities may receive those funds. The bill also includes in the
definition of “family planning” the provision of nondirective information explaining
pregnancy termination.
8. Multiple sclerosis services
This bill allows DHS to allocate and expend, as part of its implementation of the
Well-Woman Program, up to $60,000 as reimbursement for the provision of multiple
sclerosis services to women. Current law requires DHS to allocate and expend at
least $60,000 for these services; the bill sets a limit of $60,000.
9. Youth wellness program
This bill provides funding to American Indian tribes to fund architectural plans
for a youth wellness center.
10. Dementia training for health care providers
This bill requires DHS to establish a two-year academic detailing primary care
clinic dementia training program for health care providers in ten primary care clinics
in the state through a contract with the Wisconsin Alzheimer's Institute. As part of
the training program, DHS must provide primary care providers with clinical
training and access to educational resources on best practices for diagnosis and
management of common cognitive disorders and referral strategies to dementia
specialists for complicated or rare cognitive or behavioral disorders. DHS must also
ensure that the program includes at least the following components: a) the most
current research on effective clinical treatments and practices is systematically
evaluated by the academic detailing team; b) information gathered and evaluated
regarding the effective clinical treatments and practices is packaged into an easily
accessible format that is clinically relevant, rigorously sourced, and compellingly
formatted; and c) training is provided for clinicians to serve as academic detailers.
11. Healthy aging grant program
This bill requires DHS to award in each fiscal year a grant of $250,000 to an
entity that conducts programs in healthy aging.
12. Graduate medical training support grants
This bill combines, in a continuing appropriation, funding for grants DHS
awards to assist rural hospitals and groups of rural hospitals in procuring
infrastructure and increasing case volume to develop accredited graduate medical
training programs with funding for grants DHS awards to hospitals to support
existing graduate medical training programs. The bill also expands eligibility for
both types of grants to all specialties. Under current law, in order to be eligible for
a grant, a hospital has to have an existing graduate medical training program in
certain prescribed specialty areas or a plan to develop a graduate medical training
program in one or more of those specialties.
13. Assisted living reporting and fees
This bill requires certain assisted living facilities, specifically adult day
centers, community-based residential facilities, and residential care apartment
complexes, to submit biennial reports to DHS through an online system prescribed
by DHS. Under current law, some assisted living facilities have no statutory
reporting requirements and others have annual rather than biennial requirements.
Current law also requires written reports rather than online submissions.
