Requirements for grant of temporary certificates to applicants for certification of dietitians.

Objective of the Rule. To allow applicants to obtain a temporary certificate and take the examination as soon as possible, without a 120 day wait.

The current rules set forth the requirements for grant of temporary certificates to applicants for certification as dietitians. Those provisions specify that an application for examination must be submitted at least 120 days prior to the date of the next scheduled examination. The rules also set forth the examination provisions for applicants seeking a certificate as a dietitian. Because the American Dietetic Association's pre-licensing procedures are now computer assisted, an applicant may schedule the examination at his or her convenience. There is therefore no reason to require a 120 day wait.

Sections 15.08 (5) (b) and 227.11 (2), Stats.

50 hours.

The Department proposes to amend chs. HFS 105 and 107 to allow the Wisconsin Medicaid (MA) home care programs to operate more flexibly and efficiently. The proposed amendments would increase the conformance of administrative rules with current accepted service technologies and delivery systems, state statutes, and federal regulations.

Chapter HFS 105 establishes the certification requirements of providers reimbursed by MA. Ch. HFS 107 sets forth the requirements that providers must follow to be reimbursed by MA for services delivered. The specific provider types affected by these proposed rules include home health agencies, personal care agencies, nurses in independent practice, physical and occupational therapy assistants.

The Department has identified provisions in chs. HFS 105 and 107 that do not conform to current state statutes, federal regulations, or current medical service provision standards and practices. In addition, both the Home Care Advisory Committee and the Home Care Consumer Advisory Committee have recommended that the Department initiate a thorough review and amendment of some administrative rules relating to home care. Generally, the proposed amendments would create opportunities for greater operating efficiencies for both home care service providers and the Department.

Potential revisions affecting all fee-for-service home care providers include provisions relating to the qualifications and duties of the provider, infection control measures, recipient rights, reviews for plans of care, documentation, requirements for staffing cases according to level of case complexity, medication administration restrictions for children and those adults unable to self-direct, and limitations on covered services.

Potential revisions affecting specific providers include the following:

•Home health agencies – Ventilator-type dependency for covered respiratory care services, certification requirements of nurses who provide respiratory care services, conditions of reimbursement for immunizations, and the requirements of care coordinators.

•Personal care agencies – Correcting the number of hours of personal care reimbursed without prior authorization from 250 hours to 50 hours, recipient discharge, and restrictions on some skilled nursing tasks that can be performed by personal care workers.

•Nurses in independent practice – Ventilator-type dependency for covered respiratory care services, certification requirements of nurses who provide respiratory care services, requirements of nurses in independent practice to provide intermittent skilled nursing when home health agencies are not available, requirements of care coordinators on private duty and respiratory care services cases, and supervision of licensed practical nurses.

•Occupational and physical therapy assistants – Supervision requirements.

• Other – The Department seeks to add provider certification standards for a community-based benefit for children whose health care needs are medically complex.

These proposed changes to HFS 105 and 107 are in addition to much narrower changes the Department announced in a separate Statement of Scope published in the July 15, 2003 Wisconsin Administrative Register. In that Statement of Scope, the Department announced its intent to amend sections HFS 107.113 and 107.12 to permit greater flexibility to providers and consumers in scheduling private duty nursing (PDN) and respiratory care services (RCS) benefits covered by MA.

Section 49.45 (10), Stats.

Department staff estimate it will take Division of Health Care Financing staff about 500 hours over the course of one to two years to develop and promulgate the proposed rules.

Remove Gray Wolves from the “Wisconsin Threatened Species List" s. NR 27.03 (3) (a) (1) and add them to the “Protected Wild Animals List" s. NR 10.02 (1).

The 1999 Wisconsin Wolf Management plan indicates that Gray Wolves (Canis lupus) should be removed from the State Threatened Species list when the state population exceeds 250 wolves, outside Indian reservations, for one year based upon the late winter count. The winter count of gray wolves outside of Indian Reservations in 2002-03 was 329 (total statewide count was 335-357). The winter count of wolves outside Indian reservations in 2001-02 was 309 (total count 323). Thus the Wisconsin wolf population has achieved the delisting goal set forth in the 1999 plan.

The wolf population was down to 15 animals in 1985, and has increased each year since then, except 1993 during a major mange outbreak. Average annual increase has been about 20% since 1985. Although this rate will not last indefinitely, the population continues to grow. Although State delisting will initially have minimum affect on wolf management, it will set the stage for a more flexible management system when Federal delisting is completed. State delisting will also symbolize the recovery of the gray wolf population in the state, and the need to no longer treat wolves as endangered or threatened, but as a protected Wisconsin non-game mammal. After federal delisting has been completed, authority for management of gray wolves will be returned to the State of Wisconsin. The department will manage wolves as prescribed in the 1999 Wolf Management Plan. One of these management practices will include giving authority to landowners to kill wolves in the act of attacking domestic animals on private land, with the requirement that the local conservation warden is contacted within 24 hours. Other practices that will be considered following federal and state delisting would include: issuing permits to landowners with chronic wolf problems to kill a limited number of wolves on their land, allowing USDA-Wildlife Services to conduct proactive controls, allowing other law enforcement officers to dispatch nuisance wolves, and consider the possibility of a public harvest if the wolf population outside Indian reservations exceeds 350.

The Department of Natural Resources, Bureau of Endangered Resources, would like to hold public hearings to obtain public comments on the delisting of Gray Wolves in Wisconsin. We propose to hold hearings in Madison, Eau Claire, Superior, Rhinelander, Stevens Point, Green Bay and Milwaukee.

Following these public hearings, comments will be examined and the Endangered Resources Program will return to the NRB to make recommendations on wolf delisting.

Sections 29.604 and 29.039, Stats.

Approximately 45 hours will be needed by the Department.

Chapter NR 20 pertaining to sport fishing for yellow perch in Green Bay and its major tributaries and ch. NR 25 pertaining to commercial fishing for yellow perch in Green Bay.

In October of 2001 the Natural Resources Board adopted FH-12-01, reducing the sport fishing daily bag limit for yellow perch from Green Bay and reducing the total allowable commercial harvest of yellow perch from Green Bay. Under that rule, on July 1, 2004, both the sport bag limit and the commercial harvest limit will revert to previous levels.

The harvest reductions implemented under FH-12-01 were needed to protect the remaining Green Bay yellow perch population, which had declined over 90% between 1988 and 2000. Although the yellow perch population has stabilized at a low level, it has not recovered to the point that the previous harvest levels are appropriate.

Because the yellow perch population of Green Bay is not fully restored, the Department will propose new sport bag and commercial harvest limits, to take effect on July 1, 2004. The new limits will depend on assessments conducted during the summer of 2003.

The proposed rule does not represent a change in sport or commercial fishing management policy. This action is proposed pursuant to NRB policy: NR 1.04 (4) The fishery resources of the Great Lakes, though renewable, experience dynamic changes and are limited. The resources will be managed in accordance with sound management principles to attain optimum sustainable utilization. Management measures may include but are not limited to seasons, bag and quota limits, limitations on the type and amount of fishing gear, limitation as to participation in the fisheries and allocation of allowable harvest among various users and the establishment of restricted areas.

Sections 29.014, 29.014 (1), 29.519 (1), and 227.11 (2) (a), Stats.

Approximately 15 hours will be needed by the Department, not including the collection and analysis of biological data.

Chapter NR 25 pertaining to marking of commercial trap nets.