CR 19-020 Rule Text

DEPARTMENT OF HEALTH SERVICES

TO ADOPT PERMANENT RULES

The Wisconsin Department of Health Services (the Department) proposes an order to repeal DHS 1.065 (1) (c) (Note); to amend DHS 1.065 (3) (d) (Note); and to repeal and recreate ch. DHS 1 (Title), DHS 1.01 to DHS 1.07, relating to uniform fee system.

RULE SUMMARY

Statutes interpreted

Sections 46.03 (18) (a), (b), (c), (d), and (e), and 46.10 (3), (4) (a), (5), (7), (8) (c) to (e), (10), (11), (14) (a) and (16), Stats.

Statutory authority

Sections 227.10 (1) and (2m), and 227.11 (2) (a) and (b), Stats.

Explanation of agency authority

The Legislature directed the Department to establish a uniform system of fees for certain services provided or purchased by the Department or certain county departments. The Department is also directed to make collections, determine ability to pay, enforce or compromise liability and to delegate some of these responsibilities to counties. The proposed rules are necessary to effectuate the purposes of the statutes listed in the “interpreted statutes” section. In addition, the proposed rules are necessary to comply with s. 227.10 (1) and (2m), Stats.

Related statute or rule

None.

Plain language analysis

Chapter DHS 1 is outdated. The rule has not been substantively revised since 1978. The Department proposes to restate its provisions more clearly and to minimize confusion and inconsistency of interpretation.

Summary of, and comparison with, existing or proposed federal regulations

The Department was unable to locate federal regulations that were sufficiently analogous to the proposed rules. However, 42 CFR 51c.303 and 42 CFR 56.303, for example, discuss similar fee, billing, ability to pay and collection requirements to be used by certain federal health centers. Specific program requirements are further contained in compliance manuals (see, for example, Chapter 16, https://bphc.hrsa.gov/programrequirements/compliancemanual/chapter-16.html).

Comparison with rules in adjacent states

Provisions relating to similar subjects of the proposed rule are contained in various sections of code from adjacent states. See, for example, Illinois Admin. Code. tit. 59 §106 (Services Charges), tit. 89 § 103 (Support Responsibility of Relatives), tit. § 545 (Ratemaking), tit. § 560 (Customer Financial Participation), IAC Rules 441.11 (Collection of Public Assistance Debts), IAC Rules 441.36 (Facility Assessments), IAC Rules 445.95 (Collections), Michigan Admin. Code r. 330.8005-330.8284 (Financial Liability for Mental Health Services), Minnesota Rules ch. 9550 Part 9550.6240 (Collections), ch. 9515 Part 9515.2200 (Sources of Income Considered), ch. 9515 Part 9515.2600 (Responsible Relative’s Ability to Pay).

Summary of factual data and analytical methodologies

The Department established an advisory committee comprised of representatives from Jackson, Portage, Marathon, Walworth, Green and Outagamie counties, as well as a representative from the Department of Children and Families. The advisory committee held nine open meetings in 2016 and 2017. The Department also reviewed policies and procedure materials from the Western Region of Integrated Care Consortia (Jackson, Monroe and La Crosse counties), Portage, Walworth, Green, Lafayette, Outagamie, and Marathon County collection procedures. In addition, the department solicited comments about the proposed rulemaking through its website and throughout the entire rule promulgation process.

Analysis and supporting documents used to determine effect on small business

The Department collected public comments in regards to economic impact from August 6, 2018 to August 20, 2018. The Department also established an advisory committee comprised of representatives from Jackson, Portage, Marathon, Walworth, Green and Outagamie counties, as well as a representative from the Department of Children and Families. The advisory committee held nine open meetings in 2016 and 2017. The Department also reviewed policies and procedure materials from the Western Region of Integrated Care Consortia (Jackson, Monroe and La Crosse counties), Portage, Walworth, Green, Lafayette, Outagamie, and Marathon County.

Effect on small business

The proposed rule does not affect small business.

Agency contacts

Mary P. Jablonski

Section Chief

Bureau of Fiscal Services – Revenue & Cash Management

[phone]

[e-mail]

Barry Kasten

Administrative Rule Coordinator

Division of Enterprise Services

[phone]

[e-mail]

Statement on quality of agency data

The Department did not rely upon any data in preparing the proposed rule.

Place where comments are to be submitted and deadline for submission

Comments may be submitted to the agency contact person that is listed above or by accessing https://www.dhs.wisconsin.gov/rules/permanent.htm until the deadline given in the upcoming notice of public hearing. The notice of public hearing and deadline for submitting comments will be published in the Wisconsin Administrative Register and to the department’s website, at https://www.dhs.wisconsin.gov/rules/permanent.htm. Comments may also be submitted through the Wisconsin Administrative Rules Website, at: https://docs.legis.wisconsin.gov/code/chr/active.

RULE TEXT

SECTION 1. DHS 1 (Title) is repealed and recreated to read:

Uniform Fees, Liability and Collections

SECTION 2. DHS 1.01 is repealed and recreated to read:

DHS 1.01 Authority and purpose.

This chapter is authorized by s. 227.11 (2) and interprets ss. 46.03 (18) and 46.10, Stats., to establish a system for determining fees, liability, billing, and collection practices for services.

SECTION 3. DHS 1.02 is repealed and recreated to read:

DHS 1.02 Definitions.

“Administratively unfeasible” means the cost of collection would likely exceed the fee established for a service.

“Client” means a person that has received services.

“County department” means any of the following:

(a)

A county department of social services under ss. 46.215, 46.22, or 46.23, Stats.

(b)

A county department of community programs under s. 51.42, Stats.

(c)

A county department of developmental disabilities services under s. 51.437, Stats.

“Collection period” means the period of time calculated for each unit of service, which begins on the day a service is provided and ends as provided in ss. 893.87, 893.40, Stats., or as provided under any other applicable statute of limitations.

“Services” means services provided to a person by the department or a county department, or care, maintenance, services and supplies described in s. 46.10 (2), Stats., except:

(d)

Services provided by the department or a county department under ch. 48, subch. III of ch. 49, Stats.

(e)

Community-based juvenile delinquency-related services.

(f)

Juvenile correctional services.