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July 29, 2005 Budget Update: Govenor Signs Act 25 Into Law

On Tuesday, July 25, 2005 Governor Doyle signed the 2005-07 Biennial Budget into law. Below are the veto highlights of the budget relating to long term care. The Governor did veto the nursing home rate increase, which would have provided needed funding to facilities, workers, and care to consumers. The Governor also vetoed the additional $6.8 million that the Legislature added to the Governor's original $10 million cut to MA Personal Care, Home Health, and Private Duty Nursing. This leaves us with a $10 million cut to MA Personal Care, Home Health, and Private Duty Nursing. The $6.8 million he vetoed from those programs will be absorbed by the MA budget.


MA Personal Care, Home Health Care and Private Duty Nursing Cut
The Governor vetoed the additional $6.8 million that the Legislature added to the Governor's original $10 million cut to MA Personal Care, Home Health, and Private Duty Nursing. This leaves the long term care community with a $10 million cut to MA Personal Care, Home Health, and Private Duty Nursing. The $6.8 million he vetoed from those programs will be absorbed by the MA budget.


Nursing Home Bed Assessment – GPR Earned Revenues
Vetoed language specifying that all revenue collected from an assessment on licensed nursing home beds should be deposited in the Medical Assistance trust fund.

Under current law, $13,800,000 of these revenues in FY 05 were deposited in the general fund, and in future fiscal years, 45% of the total revenues from this assessment would be returned to the general fund. The veto maintains the requirement that $13,800,000 in assessment revenues will be returned to the general fund each year, thereby reducing revenues in the trust fund by a corresponding amount.

Nursing Home Rate Increase
The Governor deleted $5,141,700 GPR in FY 06 and $10,118,000 GPR in FY 07. Vetoed the GPR in the bill added by the Legislature. (The Governor eliminated the 1.4% rate increase.)

Community Relocation Initiative
Vetoed the 100-day stay requirement. Vetoed the language requiring DHFS to submit a report to the JCF by January 1, 2007, identifying the effects of the Governor’s Community Relocation Initiative.


Functional Screen
Vetoed the restriction placed on DHFS from using the long-term care functional screen to determine levels of care for nursing home residents and to set Medical Assistance reimbursement rates for nursing homes.

Nursing Home Reimbursement Rates
Vetoed the language directing DHFS to identify the extent to which payments are made to nursing homes for direct care nursing services.

AB 228: Youth Apprenticeship Expansion

Assembly Bill 228 related to increasing the funding for local youth apprenticeship grants for programs that are targeted at providing training in the areas of health care and health care technology. It was introduced by Reps. Loeffelholz, Pettis, Musser, Davis, Freese, Van Roy, Hahn, Hines, Rhoades and Ott: co-sponsored by Sens. Roessler, Carpenter, Erpenbach, Miller and Hansen.

The state’s Youth Apprenticeship program, administered by the Department of Workforce Development (link to attachment), awards grants to local partnerships for local youth apprenticeship programs. These programs, under which employers are recruited to provide on-the-job training and supervision for students, are currently funded with $1,100,000 in general purpose revenues (GPR). AB228 increases the amount appropriated for these grants by $1,400,000 GPR in each of fiscal years 2005−06 and 2006−07. The increased funding is targeted for training and state-required exit testing in the areas of health care and health care technology.

The Workforce Development Committee held a public hearing on the bill on November 17, and it was passed unanimously in Executive Session by the Committee on January 12. It has been referred to the Joint Finance Committee for review. No schedule at this point for further action.

Please call your legislator and ask them to support AB 228.

Health WI

Governor Doyle signed an executive order on July 5, 2006, creating the Healthy Wisconsin Council. The group is charged with developing an action plan to reduce the number of uninsured Wisconsin residents by half by 2010 and to reduce health insurance premiums by as much as 30 percent for businesses. The council held its first meeting Monday, July 31, 2006.

Also, the governor appointed 20 members to the new council, which will be co-chaired by Dr. David Kindig, Emeritus Professor of Population Health Science at the UW-Madison School of Medicine, and Michael Weiden, Partner at Quarles & Brady, LLP.

Other members of the council are listed below:
• Bob Bass, Board Vice-Chair, Wisconsin Federation of Cooperatives.
• Wayne Corey, Executive Director, Wisconsin Independent Businesses Inc.
• Tim Cullen, Senior VP, Anthem Blue Cross/Blue Shield
• Rep. Curt Gielow
• Dr. Tito Izard, Chief Medical Officer, Milwaukee Health Services Inc.
• Al Jacobs, Executive Director, WEA Trust
• Mickey Judkins, owner, Details
• Sen. Julie Lassa
• David Newby, President, Wisconsin State AFL-CIO
• Jim Riordan, CEO, WPS Insurance
• Sen. Carol Roessler
• Dr. Rene Settle-Robinson, President, Cream City Medical Society
• Kristine Seymour, Senior VP, Humana
• Randy Smith, President, City Brewery
• Mary Starmann-Harrison, CEO, SMSS Health Systems
• John Torinus, CEO, Serigraph Printing
• Gregory T. Troy, VP and Chief Human Resources Officer, Modine Manufacturing
• Dan Velicor, Director of Global Benefits, Kohler Company.


For more information about the Council, including minutes and future meeting dates and agendas please visit their website.

5% Increase

ACT NOW: In early September Secretary Nelson provided the DHFS budget Governor Doyle for the 2007-09 fiscal years. Her budget, as a result of the Governor's request, included no increases to Medicaid reimbursement rates to the Community Integration Program (CIP), the Community Options Program (COP), personal care, nursing homes, or home health. Currently the Governor is review the budget and is considering changes, as he sees fit. His budget will them be delivered to the Legislature for their consideration in January or February, where it will be taken up by the Joint Committee on Finance and later by both the Senate and Assembly.

There are several opportunities for the long term care community to inform elected officials of their desire to see a rate increase for all long term care programs and community aides. The Alliance takes a position that all long term care programs and community aides deserve a 5% rate increase in the 2007-09 budget. We believe that such an increase will allow for raises in wages, better benefits, increased retention, and overall better quality of care. But in order to accomplish this the entire long term care community needs to help!

Between now and June the Alliance will be corresponding regularly with the long term care community asking them to write letters, make phone calls, set up site visits with legislators, and participate in other related activities. The voice of the long term care community has been too quiet for too long and we need to educate decision makers about the concerns and needs of consumers, workers, and providers.

The first step of our campaign is to let Governor Doyle know that we want a rate increase. Governor Doyle is hearing from dozens of groups regarding the biennial budget. He needs to hearing from us! The Alliance is asking you to write a letter to Governor Doyle requesting a 5% rate increase in CIP, COP, personal care, nursing homes, home health, and community aides. The Alliance hopes to flood his office with over 1000 letters - in order to get our point across. So not only are we asking you to write a letter, but to ask your employees, co-workers, friends and family. Together we can do it!


Please follow these simple steps and utilize these resources.

1. Develop an effective message.

2. Review agency sample letter or direct care worker sample letter.

3. Craft your own letter using the letter template and add the message you created using step 1.

4. Fax a copy or mail a copy of your letter to the Alliance. This allows us to estimate how many letters were sent, for media purposes. Please fax or mail to:

125 N. Executive Drive, Suite 102
Brookfield, WI 53005
FAX: (262) 821-4445

5. Mail a copy to Governor Doyle:

The Honorable Jim Doyle 
Governor, State of Wisconsin 
P.O. Box 7863 
Madison, WI  53707-7863

6. If you are a provider of long term care services, set up a staff meeting and request workers to write letters. Follow steps 1-5 with them. Ask consumers and family members to do the same.


Thank you!

Letter to Govenor Doyle

Please mail your letters by December 1st to Governor Doyle regarding the 5% Medicaid reimbursement rate increase for the Community Integration Program (CIP), the Community Options Program (COP), personal care, home health and nursing homes, as well as a 5% rate increase in Community Aides. This is your opportunity to impact the Governor's budget and ensure that workers receive a wage increase and benefits.

The article in the October newsletter, which can now be found in our website Archives outlines how to write a letter and provides sample letters to work from. Now is the critical time for you to influence the Governor.

Members and representatives of the Alliance met with Secretary Nelson and her staff earlier to this week to inform her of the Alliance's formal position on the 5% rate increase. We also shared the Alliance letter to Governor Doyle and that we are mobilizing the long term care grassroots to work on behalf of this effort. Secretary Nelson said that the Governor is waiting to review the revenue forecast in late November to decide if and where additional revenues will be allocated.

The Alliance is currently working to set up a meeting with the Governor's office in early December. Your letters is of vital importance to our meeting and the Governor's decision on whether to support the Alliance position.