BCS 219279 (09/15/2025)
Migrant worker with out-of-state family was not a “childless adult”

Preliminary Recitals

Pursuant to a petition filed July 21, 2025, under Wis. Stat., §49.45(5)(a), to review a decision by Waushara County Human Services to deny Emergency Services Medical Assistance (MA), a hearing was held on September 10, 2025, by telephone. A hearing set for September 3, 2025 was rescheduled at the petitioner’s request.

The issue for determination is whether petitioner is non-financially eligible for Emergency MA coverage.

PARTIES IN INTEREST:

Petitioner:
—

Petitioner’s Representative:
Atty. Erica Sweitzer-Beckman
Legal Action of Wisconsin
31 S Mills St
Madison, WI 53711

Respondent:
Department of Health Services
1 West Wilson Street, Room 651
Madison, WI 53703
By: Roxanne Binkowski
Waushara County Human Services
213 West Park Street
PO Box 1230
Wautoma, WI 54982-1230

ADMINISTRATIVE LAW JUDGE:
Brian C. Schneider
Division of Hearings and Appeals

Findings of Fact

1. Petitioner (CARES # —) is a migrant worker from — working in Waushara County under the —.
2. Petitioner’s wife and three children live in —. The family is intact; petitioner works in the United States for approximately six months. He has regular contact with the family and sends all earned income to them after paying his own expenses. He is not elderly or disabled.
3. In late May, 2025, petitioner suffered a heart attack, resulting in emergency treatment and several weeks of hospitalization. He applied for Emergency MA on June 3, 2025. The application was denied by a notice dated June 5, 2025 on the basis that, as a childless adult, he did not qualify for the program under Department policy.

Discussion

Emergency Services MA is a limited benefit for immigrants who do not qualify for other forms of Medicaid because of their immigration status. BadgerCare Plus (BC+) Handbook, §39.1. A migrant worker can qualify for Emergency Services if he currently is working in Wisconsin even if he does not intend to reside in Wisconsin. Handbook, §12.2. Among other requirements, the applicant must qualify for BC+ under a category other than childless adult. Id.

Standard BC+ rules are used to determine who is included in the migrant worker’s assistance group. Id. Typically a BC+ household is all individuals residing in or temporarily absent from the same residence. Handbook, §2.4. A childless adult is a person who does not have any dependent children residing with him at least 40% of the time. Handbook, §2.2.7.

When petitioner’s information was entered into the Department’s computer data base, the system classified him as a childless adult. He is alone in this state, and the rest of the family has never resided here. Ms. Binkowski queried the Department Problem Resolution Team with the issue, and the response was that petitioner must be considered a childless adult. Therefore, the Department’s position is that a migrant worker such as petitioner, whose family has no connection to the state, must be considered a childless adult because the dependent children do not live with him in the same residence in this state.

The Handbook, §2.2.1, considers an applicant to be a parent if the child is under the care of that person at least 40% of the time. In petitioner’s case, his children are under his care 100% of the time; he and the child’s mother are not divorced or even separated as that term is generally defined. He is away from home for work purposes. Even if the time he spends in Wisconsin is not considered as having the children under his care, he still is home with them more than 40% of the time (November through mid-April is 5½ months, which is more than 40% of the year).

The Resolution Team response is that the 40% policy refers to time in the person’s household each month. The problem is that the Handbook, §2.2.1, does not say that or even imply that the 40% policy refers to time in the household per month. §2.2.1.2, referenced in the Team response, specifically concerns parents who do not live together; it is captioned “Joint Placement.” Petitioner and his spouse continue to live together permanently despite his work taking him away for half the year, so §2.2.1.2 does not apply.

I conclude that petitioner is a caretaker parent for purposes of Emergency Services MA. He is a member of an intact family that includes minor children, and his sole reason for being in this state alone is his migrant work.

I note that I do not consider the reference to the Modified Adjusted Gross Income Test rules in the Handbook, §2.3.1.1, to be applicable. The fiscal test group classification is not the same as the determination of non-financial eligibility. A person must first be non-financially eligible before the fiscal test group is determined. I also do not consider the temporary absence policy to be applicable to this situation. See Handbook, §2.4.2. That policy refers to the temporary absence of a person from the Wisconsin resident’s household, such as a child going to school. Petitioner is temporarily absent from his home in —; his family is not temporarily absent from this state.

I will order the county agency to continue processing petitioner’s application for Emergency Services MA as a caretaker of minor children. Not only does petitioner’s case fall within the definition under the Handbook, §2.2.1, it also reflects reality.

Conclusions of Law

The agency erred by excluding petitioner from Emergency Services MA eligibility as a childless adult because, in actuality, he is the caretaker of dependent children.

THEREFORE, it is

Ordered

That the matter be remanded to the agency with instructions to continue processing petitioner’s application for Emergency Services MA as a caretaker of minor children, and to issue a determination within 10 days of this decision subject to any additional, necessary verification requirements.

[Request for a rehearing and appeal to court instructions omitted.]