The Governor recommended repealing the caps on MA home health care services and other community care. NOTE: Implementation of the community care caps had been enjoined as of March, 1996, by a Dane County Circuit Court based on the Department's failure to follow rule-making procedures.  

The Governor recommended amending probate law to allow DHFS to recover funds from joint bank accounts and payable-on-death bank accounts. The 1995-97 biennial budget act had authorized DHFS to make recoveries from these accounts but did not modify probate law to be consistent with this expanded authority. The Governor also recommended allowing guardians to probate a decedent's estate through the transfer by affidavit process, for transfers that occur on or after the effective date of the budget bill. The proposal would change the law to specify that guardians would have the authority, as do heirs currently, to receive information on decedent's accounts at savings banks and savings and loans, and that guardians, upon release of the property to DHFS through the transfer by affidavit process, would be released from any obligation to other creditors or heirs of the decedent. The changes would also impose the following obligations on guardians, as they are currently imposed on heirs, to:

1. Notify DHFS of the intention to request a transfer by affidavit and to supply required information to DHFS; and
2. Supply proof at the time of filing an affidavit to transfer property, that the required notice to DHFS was provided, if the decedent received MA services or other public assistance subject to estate recovery

The proposal would authorize DHFS to establish a reasonable payment schedule subject to reasonable interest if the heirs wish to satisfy a claim without selling a non-liquid asset that is subject to recovery.

SSI provides income supplements for very low-income elderly, disabled and blind persons. 1997 figures: Individuals/Couples living in their own household who have less than $484 (individuals)/$726 (couples) in monthly countable income and $2,000 (individuals)/$3,000 (couples) in non-exempt assets receive a supplement to bring their monthly income up to $567.78 (individual)/$858.05 (couple). Of these amounts $83.78 (individuals)/$132.05 (couples) is the state supplement. These amounts represent 88% of the federal poverty level for one person and 99% for two persons. Individuals who qualify for SSI automatically qualify for Medical Assistance as well.

The Governor recommended decreasing the state's share of SSI payments by $10.5 million to re- flect federal changes that eliminate SSI eligibility for:

(a) persons for whom alcohol and other drug abuse is a major factor contributing to their disability;

(b) non-citizens (legal immigrants); and

(c) certain children.

(This will result in approximately 5,800 Wisconsin individuals losing SSI and MA.)

However, the federal government requires a "Maintenance of Effort," i.e., a state can not spend less in total dollars than spent in the prior year. Wisconsin has a Maintenance of Effort requirement to spend $128.1 million in SSI, i.e., Wisconsin cannot decrease the total expenditures for the state supplement below $128.1 million. Normally, because of the Maintenance of Effort requirement, the SSI state supplement would have been increased for all the remaining elderly, disabled and blind recipients who are not being discontinued. Instead, the Governor's budget proposes to shift SSI state funds to fund Wisconsin Works (W-2) payments to SSI parents with children. This frees up other state funds that would have been used for W-2, but SSI recipients get less of an increase in their state supplement than they would otherwise be entitled to.  

The Governor recommends a 3% annual increase in the Elderly and Disabled Transportation Assistance program (county transit aid and capital grants). The increase would be $199,200 in FY 98 and $404,400 in FY 99 for a total of $603,600. The overall Department of Transportation budget is projected to increase by $32.2 million in FY 98 and $21.6 million in FY 99. The 3% Elderly and Disabled Transportation increase represents only 1% of the total Department of Transportation budget increase.

The Ombudsman program is operated by the Wisconsin Board on Aging and Long-Term Care and investigates complaints and mediates disputes on behalf of residents of nursing homes, community- based residential facilities and the Community Options Program. The Governor proposes to restore the two Ombudsman positions he vetoed in AB 739 (1995 Act 464).

On April 24, 1997, the Joint Finance Committee took up the Board on Aging and Long Term Care's budget and increased the Governor's budget proposal for ombudsman. In addition to the two new ombudsman the Governor proposed, Joint Finance voted to provide three more positions (total of five over the biennium) plus the Committee restored the Volunteer Ombudsman Coordinator position.

The Governor recommended that DHFS be authorized to establish, in geographic areas determined by DHFS, a pilot project under which the Department could contract with a private or public entity to:

• serve as a clearinghouse of information for individuals who are interested in home or community- based long-term support services or institutional long-term care services;
• perform assessments, similar to those required under the Community Options Program, using the DHFS- established assessment method, to determine an individual's functional abilities, disabilities, personal preferences and need for community-based or institutional long-term services; and
• collect information specified by DHFS on the individuals served by the entity and provide that information to DHFS.

The Governor proposed to use the general COP appropriation to fund the contract payments and allow funds not used in first year of biennium for the second year's contract payments.

The Governor proposed to move the program from the Office of Commissioner of Insurance (OCI) to the Division of Health in the Department of Health and Family Services (DHFS). The Governor also proposed to combine HIRSP administration with the Medical Assistance Program. This means that while the HIRSP benefit package will remain the same, only Medical Assistance providers could be used and they would be reimbursed at Medical Assistance (i.e., lower than private pay or most other insurers) rates. Over time the day-to-day administration of the plan would move from Blue Cross & Blue Shield United of Wisconsin to EDS, the Medical Assistance fiscal agent. Finally, the Governor proposed to allow for estate recovery of premium subsidies paid by the state for HIRSP enrollees.