DHS 38 Proposed Permanent Rule Public Hearing August 21, 2017 - - PowerPoint PPT Presentation

Wisconsin Department of Health Services

DHS 38 Proposed Permanent Rule

Public Hearing

August 21, 2017

Presentation Outline

 Purpose of Hearing  Background  Proposed Rule  Comments

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Purpose of the Hearing

 Thank you for your attendance today.  The purpose of this hearing is to gather

comments from the public on the proposed permanent rule, DHS 38, regarding conditions of participation in the FoodShare Employment and Training program.

 At the end of this presentation, you may

provide your comments. Please hold all comments until that time.

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Background – Current Law

 Able-bodied adults without dependents are

required to meet a work requirement of 80 hours of work or work-related activities per month to maintain FoodShare eligibility.

 One way able-bodied adults are able to meet

this requirement today by participating in an approved employment and training program, such as the FoodShare Employment and Training (FSET) program.

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Background

Section 49.79 (9) (d) was added to statutory requirements under the 2015-2017 biennial budget.

Directs the Department of Health Services (DHS) to develop and implement a drug screening, testing, and treatment policy to screen and, if indicated, test and treat participants in an employment and training program within the state’s FoodShare program who are able-bodied adults for use of a controlled substance without a valid prescription for the controlled substance.

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Background

DHS is required to develop rules to implement the policy.

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Proposed Rule

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DHS 38.02: Definitions

(2) “Administering agency” means an administrative agency within the executive branch under ch. 15, Stats., or an entity that contracts with the state such as, single county consortia under s. 49.78 (1r), Stats.; multicounty consortia under s. 49.78 (1) (br), Stats.; or a tribal governing body under s. 49.78 (1) (cr), Stats.

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DHS 38.04: Screening

(1) WHO MUST COMPLETE A SCREENING

• QUESTIONNAIRE. At the time of application and

at annual redetermination, an administering agency shall administer to any individual, as defined in 38.02(8) of this chapter, a controlled substance abuse screening questionnaire approved by the department, which may include questions related to controlled substance abuse as well as related criminal background.

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DHS 38.05: Testing

(1) WHO MAY BE REQUIRED TO UNDERGO DRUG

• TESTING. An individual whose answers on the

screening questionnaire indicate possible use

• f a controlled substance without a prescription
• rder shall be required to undergo a test for the

use of a controlled substance.

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DHS 38.05: Testing

(2) NATURE OF TESTING REQUIRED. Testing shall consist of laboratory analysis of a specimen collected from an individual, by a qualified drug testing vendor

• r provider approved by the department, in a manner

specified by the department that is consistent with guidelines from the U.S. department of health and human services. A qualified drug testing vendor shall analyze the specimen for the presence of controlled substances specified by the department. (continued on next slide)

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DHS 38.05: Testing

(2) continued: The department may require the use of a specific testing service procured through state contracting if the department determines that volume discounts

• r other preferential pricing terms can be achieved

through a statewide contract.

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DHS 38.05: Testing

(3) CONTRACT FOR TESTING SERVICES. Subject to the department’s approval, the administering agency may contract with a qualified drug testing vendor to collect a specimen, carry out laboratory analysis of the specimen, store the specimen for confirmatory testing if required, complete confirmatory testing, provide review by a medical review officer, and document and report test results to the administering agency. (continued on next slide)

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DHS 38.05: Testing

(3) continued: The department may require the use of a specific testing service procured through state contracting if the department determines that volume discounts

• r other preferential pricing terms can be achieved

through a statewide contract.

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DHS 38.05: Testing

(7) ACCEPTING TEST RESULTS FROM ANOTHER

• PROGRAM. Results of a drug test performed by

administering agency for the purpose of FoodShare eligibility or another state program, including a work experience program under ss. 49.162, 49.36, or 108.133, Stats., an income and maintenance program under s. 49.45 (23) (g), Stats., or a drug test carried out by the Wisconsin department of corrections, or other drug testing providers as (continued on next slide)

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DHS 38.05: Testing

(7) continued: approved by the department can be used by an administering agency to determine whether to refer an individual to treatment if the prior test results are provided directly to the administering agency, all the controlled substances required by the department to be tested under this chapter are included in the prior test results, and the test

• ccurred within the previous 90 days.

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DHS 38.05: Testing

(10) EXCEPTION OF TESTING REQUIREMENTS. Individuals may forego initial drug testing requirements under this chapter if they indicate in their drug screening questionnaire that they are ready to enter treatment.

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DHS 38.06 : Treatment

(1) WHO MAY BE REQUIRED TO PARTICIPATE IN

CONTROLLED SUBSTANCE ABUSE TREATMENT. Every

individual who undergoes a test under s. DHS 38.05 and tests positive for the use of a controlled substance without presenting a valid prescription, and as determined by the medical review officer for the drug testing vendor, shall be required to participate in controlled substance abuse treatment to remain eligible to participate in an employment and training program.

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DHS 38.06: Treatment

(2) REFERRAL FOR TREATMENT. The administering agency shall provide information to every individual required to participate in substance abuse treatment about treatment program providers and county-specific assessment and enrollment activities required for entry into treatment. The administering agency shall monitor the individual’s progress in entering and completing treatment and (continued on next slide)

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DHS 38.06: Treatment

(2) continued: the results of a random testing for the use of a controlled substance carried out during and at the conclusion of treatment.

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DHS 38.06: Treatment

(3) SUBSTANCE ABUSE EVALUATION AND

• ASSESSMENT. A treatment provider may conduct a

substance abuse evaluation and assessment and take any of the following actions based on the evaluation and assessment:

(a) If a treatment provider determines an individual does not need substance abuse treatment, the provider shall notify the administering agency of its determination. (continued on next slide)

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DHS 38.06: Treatment

(3) continued (b) If a treatment provider determines an individual is in need of substance abuse treatment, the provider shall refer the individual to an appropriate treatment program to begin treatment and shall notify the administering agency of the referral and the expected begin date and duration of treatment. (continued on next slide)

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DHS 38.06: Treatment

(3) continued (c) If a treatment provider determines an individual is in need of treatment but is unable to refer the individual because there is a waiting list for enrollment in appropriate treatment programs, the provider shall notify the administering agency when the individual is expected to be enrolled.

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DHS 38.06: Treatment

(4) ELIGIBILITY OF INDIVIDUAL TO PARTICIPATE IN

AN EMPLOYMENT AND TRAINING PROGRAM WHEN TREATMENT IS NOT NEEDED OR THE INDIVIDUAL IS PLACED ON A WAITING LIST.

(a) An individual who has been determined by a treatment program after assessment not to need treatment will have satisfied the requirements of this chapter and may participate in an employment and training program. (continued on next slide)

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DHS 38.06: Treatment

(4) continued (b) An individual who is on a waiting list for enrollment in an appropriate treatment program shall continue to take all necessary steps to continue seeking enrollment in an appropriate treatment program. The individual is eligible to participate in an employment and training program during the waiting list period, provided the individual is not eligible for immediate enrollment in another appropriate treatment program.

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DHS 38 Requirements

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Requirement Impact of Requirement Results Consequence for Refusal to Complete Requirement Drug Screening Assessment Negative result: Eligible for participation in FSET with no further action required Positive result: Required to submit to a drug test in order to participate in FSET Ineligible for participation in FSET until the screening is completed Drug Test Negative result: Eligible for participation in FSET with no further action required Positive result: Required to submit to treatment in order to participate in FSET Ineligible for participation in FSET until the drug test is completed Substance Abuse Treatment Full completion of substance abuse treatment program Ineligible for participation in FSET until the treatment is sought

DHS 38.10: Payment of Related Costs

(1) An administering agency shall pay for all costs related to screening individuals for controlled substance abuse, including the costs of producing, administering, and reviewing screening questionnaires. (2) An administering agency shall pay for all costs related to testing individuals for controlled substance abuse, including any costs related to contracting with qualified drug testing vendors sunder s. DHS 38.05 (3).

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DHS 38.10: Payment of Related Costs

(3) The department shall fund treatment costs not otherwise covered by Medicaid or other private insurance at rates no higher than Medicaid rates.

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Effective Date

This rule shall take effect on November 1, 2018, pursuant to Wis. Stat. § 227.22(2) (b), or

• n the first day of the first month after

publication if this rule is published after November 1, 2018.

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Providing Comments

To ensure an orderly and efficient process:

 Sign in if you would like to provide a comment during the

meeting today.

 You will be given a number that will be called when it is

your turn to speak.

 Speak into the microphone so you can be heard.  Keep your comments to the topic at hand – the DHS 38

Proposed Rule.

 You will have five minutes to speak.  If you have written comments, leave them with the

designated individual.

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Comments

 All comments that are properly submitted will be given

equal weight regardless of the method in which they are submitted.

 Written comments may be submitted through August 28,

2017.

 You may provide comments in your desired language.

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Comments

Comments may be submitted through the following methods:

 Going to the DHS website at

https://www.dhs.wisconsin.gov/rules/permanent.htm to view the options to submit comments for DHS 38

 Using the Wisconsin Legislature’s website:

http://docs.legis.wisconsin.gov/code/chr/comment

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Comments

Writing to:

Wisconsin Medicaid Program Wisconsin Department of Health Services 1 W. Wilson St. Madison, WI 53703

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Nondiscrimination Statement

THE STATE OF WISCONSIN DEPARTMENT OF HEALTH SERVICES (DHS) complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. DHS does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. DHS:

 Provides free aids and services to people with disabilities to communicate effectively with us, such as: – Qualified sign language interpreters – Written information in other formats (large print, audio, accessible electronic formats, other formats)  Provides free language services to people whose primary language is not English, such as: – Qualified interpreters – Information written in other languages

If you need these services, contact Al Matano at: Department of Health Services Division of Medicaid Services P.O. Box 309 Madison, WI 53707-0309 Telephone: 608-267-6848 (voice) Fax: 608-261-7792 Email: alfred.matano@dhs.wisconsin.gov

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Nondiscrimination Statement

If you believe that DHS has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Department of Health Services Civil Rights Compliance Attn: Attorney Pamela McGillivray 1 West Wilson Street, Room 651 P.O. Box 7850 Madison, WI 53707-7850 Telephone: 608-266-1258 (voice), 711, or 1-800-947-3529 (TTY) Fax: 608-267-1434 Email: dhscrc@dhs.wisconsin.gov You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Pamela McGillivray is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf,

• r by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue SW Room 509F, HHH Building Washington, DC 20201 Telephone: 1-800-868-1019, 1-800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

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Nondiscrimination Statement

USDA Nondiscrimination Statement In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, religious creed, disability, age, political beliefs, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: https://www.ascr.usda.gov/how-file-program-discrimination-complaint, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov. This institution is an equal opportunity provider.

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Language Assistance

If you would like to see this presentation in your desired language, email alfred.matano@dhs.wisconsin.gov.

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Language Assistance

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DHS 38 Proposed Permanent Rule Public Hearing

The video for this public hearing and the presentation will be made available at https://www.dhs.wisconsin.gov/rules/ permanent.htm after the hearing.

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