•The Governor’s budget would replace the State’s current IGT program, which uses county nursing facility losses to capture Federal Medicaid matching funds, with a new IGT program that relies on borrowed county dollars  annually transferred to the State and matched by the federal government. Rock, Sheboygan and Walworth have agreed to serve as the transfer counties. •This change is necessary to address federal concerns with the current IGT program and to capture significantly more federal Medicaid funds. •An IGT program similar to that proposed by the Governor is used by approximately 26 other states.