•1,018 people with physical disabilities chose to live in the community where they were able to access community activities, rather than live in nursing facilities.
•People with developmental disabilities have been served in the community at a cost that is within the institutional budget for this population.
•Frail elders and people with physical disabilities are being served in the community at a cost below that of institutional care, resulting in a level of savings under the Medical Assistance Program in SFY 2010 of $5.9 million for the people relocated during the year.
•567 elders and 245 people with physical disabilities, who were determined to be at imminent risk of having to move to a nursing facility, were able to remain in community-based settings because diversion funding was made available.

I trust you will find the enclosed report useful. Please contact Fredi-Ellen Bove, Deputy Administrator of the Division of Long Term Care at 608-261-5987 if you have any questions.

I am writing to report that, after six months in operation, BadgerCare Plus Basic is financially solvent and successfully meeting the health care needs of 5,066 Wisconsin residents.

This letter and the attached statistics fulfill the Department's legislative reporting requirements for Basic under section 49.67 of the Wisconsin Statutes.

With the successful launch of BadgerCare Plus Basic on July 1, 2010, uninsured Wisconsin residents gained another option for health care access. Basic was created to provide an affordable coverage choice to those on the waitlist for the BadgerCare Plus Core Plan. Core enrollment was capped in October 2009 due to limited federal funding. The Core wait list was established at that time.

For $130 per month, Basic provides access to ten doctor's visits per year, a comprehensive generic drug benefit, one inpatient hospital stay and five outpatient hospital procedures before a hospital deductible is applied. Other professional medical services are also covered. Though the plan's benefits are very limited, Basic provides protection and peace of mind for those who have no other access to health insurance. Basic is self-funded, and state taxpayers pay nothing to support the program.

Per the specific reporting requirements identified in s. 49.67 (9g), claims payments for Basic totaled $3,203,769 through December 13, 2010. Premium revenue totaling $3,451,680 had been collected as of the same date. Additional reserve revenue of $1 million remains available to support Basic through the federal State Health Access Program (SHAP) grant administered by the Health Resource Services Administration (HRSA). In short, BadgerCare Plus Basic is solvent after its first six months of operation.

In August, DHS notified members already enrolled in Basic of opportunities to pay premiums in advance at a discounted rate. Advance payments reduce adverse selection by increasing member longevity in the plan. Beginning with the October 2010 benefit month, Basic members have options to pay a $360 quarterly premium, a $660 semi-annual premium or a $1,200 annual premium. More than 1,200 existing members have opted to make an advance premium payment.

No changes to premiums or provider payment rates have been implemented since the program began on July 1, 2010. Effective January 1, 2011, Basic benefits and cost-sharing are being adjusted as follows:
•Co-payments for brand name prescriptions are increasing from $5 to $10.
•Radiology co-payments, tiered at $5 and $20, will be implemented.
•Vaccination co-payments of $10 will be implemented.
•Covered emergency room visits will be reduced from five to two per enrollment year.

As of December 14, 5,066 people were enrolled in BadgerCare Plus Basic. Member demographic information, including age, gender and county of residence, is attached. Enrolling in Basic requires beginning an application for the BadgerCare Plus Core Plan online at access.wi.gov or by phone. That process involves reporting income and insurance information to determine if the applicant is eligible to be added to the Core waitlist. Since enrollment for Basic began, 876 Basic applicants were determined ineligible at the point of applying for the Core waitlist.

Once individuals have enrolled, the Basic verification process uses a variety of wage, income and insurance databases to verify the information members have reported. Disparities trigger DHS follow-up and potential disenrollment. As of September 15, DHS had determined 91 individuals ineligible for Basic due to other insurance.

In July, the Centers for Medicare and Medicaid Services (CMS) approved the Department's amendment to the Core Plan waiver to create a waitlist bypass into Core for Basic members based on medical severity. This policy allows Basic members to be tracked into a benefit more appropriate to their health care needs. The initial medical criterion for this policy was a cancer diagnosis. This month, the Department expanded the criteria to include severe cardiac conditions. More than 100 Basic members have transitioned to Core as a result of these policies. Other Basic members are being transitioned to Well Woman Medicaid and SSI Medicaid, as appropriate.

In its second quarter of operation, BadgerCare Plus Basic continues to be an important and successful link to health care for thousands of Wisconsin residents.

A24 In 1997 Act 27, the 1997-99 Biennial Budget, the Legislature established requirements in state law intended to strengthen protections for children and vulnerable adults in organized care settings. The provisions require, among other things, that designated caregivers conduct background checks on all new and existing staff and bar them from employing anyone who has committed certain crimes or acts. Effective July 1, 2008, the Department of Health and Family Services (DHFS) became the Department of Health Services (DHS) and the DHFS Division of Children and Family Services became the Department of Children and Families (DCF) as a result of 2007 Act 20 (the 2007-09 biennial budget bill). DHS, DCF and (for certain child care providers) counties and local school boards must perform checks on a provider before issuing a license or other credential. Individuals who have committed prohibited crimes or acts may apply to DHS and/or DCF, counties, or school boards for a waiver of the employment or licensing bans upon evidence of rehabilitation.

Sections 48.685 (5g) and 50.065 (5g) of the Wisconsin Statutes direct DHS and DCF to submit an annual report to the legislature that specifies the number of persons who have sought waivers of employment or licensing bans by requesting to demonstrate that they have been rehabilitated. The report must also specify the number of requests that were approved and the reasons for the success or failure of the requests. DHS has continued to utilize the skills, support and knowledge of its personnel to process all rehabilitation review applications and we are, therefore, submitting a joint report. Attached is the report for 2010.

Questions about this report should be referred to the Department of Health Services, Diane Welsh, Chief Legal Counsel, at 608-266-9622.

This report is transmitted as required by s. 20.002 (11)(f), Wisconsin Statutes, (for distribution to the appropriate standing committees under s. 13.172 (3), Wisconsin Statutes) and confirms that the Department of Administration has found it necessary to exercise the "temporary reallocation of balances" authority provided by this section in order to meet payment responsibilities and cover resulting negative cash balances during the month of November 2010.

On November 1, 2010, the Worker's Compensation Fund cash balance closed at a negative $1.6 million (its intra-month low). This negative balance continued through November 16, 2010, when the fund's cash balance closed at a positive $45 thousand. The negative balance was due to the difference in the timing of revenues and expenditures.

On November 1, 2010, the Mediation Fund cash balance closed at a negative $35 thousand. This negative balance continued through November 19, 2010, when the fund's cash balance closed at a positive $300 thousand. The Mediation Fund cash balance reached its intra-month low of a negative $52 thousand on November 18, 2010. The negative balance was due to the difference in the timing of revenues and expenditures.

On November 22, 2010, the Police and Fire Protection Fund cash balance closed at a negative $47.6 million (its intra-month low). This negative balance continued through November 30, 2010, when the fund's cash balance closed at a negative $43.3 million. The negative balance was due to the difference in the timing of revenues and expenditures.

The Worker's Compensation Fund, Mediation Fund, and Police and Fire Protection Fund shortfalls were not in excess of the statutory interfund borrowing limitations and did not exceed the balances of the funds available for interfund borrowing.

The distribution of interest earnings to investment pool participants is based on the average daily balance in the pool and each fund's share. Therefore, the monthly calculation by the State Controller's Office will automatically reflect the use of these temporary reallocations of balance authority, and as a result, the funds requiring the use of the authority will effectively bear the interest cost.