A claim under par. (a)
is not allowable if the decedent has a surviving child who is under age 21 or disabled or a surviving spouse.
If the department's claim is not allowable because of par. (d)
and the estate includes an interest in a home, the court exercising probate jurisdiction shall, in the final judgment, assign the interest in the home subject to a lien in favor of the department for the amount described in par. (a)
. The personal representative shall record the final judgment as provided in s. 863.29
The department may not enforce the lien under par. (e)
as long as any of the following survive the decedent:
The department may enforce a lien under par. (e)
by foreclosure in the same manner as a mortgage on real property.
The department shall administer the program under this section and may contract with an entity to administer all or a portion of the program, including gathering and providing the department with information needed to recover payment of aid provided under s. 49.68
. All funds received under this subsection, net of any amount claimed under s. 867.035 (3)
, shall be remitted for deposit in the general fund.
The department may recover amounts under this section for the provision of aid provided under s. 49.68
paid on and after September 1, 1995.
The department may file a claim under sub. (2)
only with respect to a client who dies after September 1, 1995.
The department shall promulgate rules establishing standards for determining whether the application of this section would work an undue hardship in individual cases. If the department determines that the application of this section would work an undue hardship in a particular case, the department shall waive application of this section in that case.
History: 1995 a. 27
; Stats. 1995 s. 49.682; 1995 a. 225
Cystic fibrosis aids. 49.683(1)
The department may provide financial assistance for costs of medical care of persons over the age of 18 years with the diagnosis of cystic fibrosis who meet financial requirements established by the department by rule under s. 49.687 (1)
History: 1973 c. 300
; Stats. 1973 s. 146.35; 1973 c. 336
; Stats. 1973 s. 146.36; 1975 c. 39
; 1979 c. 34
s. 2102 (43) (a)
; 1983 a. 27
; Stats. 1983 s. 49.483; 1993 a. 16
; 1995 a. 27
; Stats. 1995 s. 49.683.
Hemophilia treatment services. 49.685(1)(a)
"Comprehensive hemophilia treatment center" means a center, and its satellite facilities, approved by the department, which provide services, including development of the maintenance program, to persons with hemophilia and other related congenital bleeding disorders.
"Hemophilia" means a bleeding disorder resulting from a genetically determined clotting factor abnormality or deficiency.
"Home care" means the self-infusion of a clotting factor on an outpatient basis by the patient or the infusion of a clotting factor to a patient on an outpatient basis by a person trained in such procedures.
"Maintenance program" means the individual's therapeutic and treatment regimen, including medical, dental, social and vocational rehabilitation including home health care.
"Net worth" means the sum of the value of liquid assets, real property, after excluding the first $10,000 of the full value of the home derived by dividing the assessed value by the assessment ratio of the taxation district.
"Physician director" means the medical director of the comprehensive hemophilia treatment center which is directly responsible for an individual's maintenance program.
(2) Assistance program.
The department shall establish a program of financial assistance to persons suffering from hemophilia and other related congenital bleeding disorders. The program shall assist such persons to purchase the blood derivatives and supplies necessary for home care. The program shall be administered through the comprehensive hemophilia treatment centers.
Any permanent resident of this state who suffers from hemophilia or other related congenital bleeding disorder may participate in the program if that person meets the requirements of this section and s. 49.687
and the standards set by rule under this section and s. 49.687
. The person shall enter into an agreement with the comprehensive hemophilia treatment center for a maintenance program to be followed by that person as a condition for continued eligibility. The physician director or a designee shall, at least once in each 6-month period, review the maintenance program and verify that the person is complying with the program.
(5) Recovery from other sources.
The department is responsible for payments for blood products and supplies used in home care by persons participating in the program. The department may enter into agreements with comprehensive hemophilia treatment centers under which the treatment center assumes the responsibility for recovery of the payments from a 3rd party, including any insurer.
The department shall, by rule, establish a reasonable cost for blood products and supplies used in home care as a basis of reimbursement under this section.
Reimbursement shall not be made under this section for any blood products or supplies which are not purchased from or provided by a comprehensive hemophilia treatment center, or a source approved by the treatment center. Reimbursement shall not be made under this section for any portion of the costs of blood products or supplies which are payable under any other state or federal program or under any grant, contract and any other contractual arrangement.
The reasonable cost, determined under par. (a)
, of blood products and supplies used in home care for which reimbursement is not prohibited under par. (b)
, shall be reimbursed under this section after deduction of the patient's liability, determined under sub. (7)
The percentage of the patient's liability for the reasonable costs for blood products and supplies which are determined to be eligible for reimbursement under sub. (6)
shall be based upon the income and the size of the person's family unit, according to standards to be established by the department under s. 49.687
In determining income, only the income of the patient and persons responsible for the patient's support under s. 49.90
may be considered.
In determining family size, only persons who are related to the patient as parent, spouse, legal dependent or, if under the age of 18, as brother or sister may be considered.
In determining net worth, only the net worth of the patient and persons responsible for the patient's support under s. 49.90
will be considered.
Individual liability shall be determined at the time of initial treatment and shall be redetermined annually or upon the patient's notification to the department of a change in family size or financial condition.
(8) Department's duties.
The department shall:
Extend financial assistance under this section to eligible persons suffering from hemophilia or other related congenital bleeding disorders.
Employ administrative personnel to implement this section.
Promulgate all rules necessary to implement this section.
AZT and pentamidine reimbursement program. 49.686(1)(a)
"AIDS" means acquired immunodeficiency syndrome.
"Gross income" means all income, from whatever source derived and in whatever form realized, whether in money, property or services.
"HIV" means any strain of human immunodeficiency virus, which causes acquired immunodeficiency syndrome.
"HIV infection" means the pathological state produced by a human body in response to the presence of HIV.
"Residence" means the concurrence of physical presence with intent to remain in a place of fixed habitation. Physical presence is prima facie evidence of intent to remain.
"Validated test result" means a result of a test for the presence of HIV, antigen or nonantigenic products of HIV or an antibody to HIV that meets the validation requirements determined to be necessary by the state epidemiologist.
From the appropriation under s. 20.435 (1) (am)
, the department may reimburse or supplement the reimbursement of the cost of AZT, the drug pentamidine and any drug approved for reimbursement under sub. (4) (c)
for an individual who is eligible under sub. (3)
An individual is eligible to receive the reimbursement specified under sub. (2)
if he or she meets all of the following criteria:
Has an infection that is certified by a physician to be an HIV infection.
Has a prescription issued by a physician for AZT, for pentamidine or for a drug approved for reimbursement under sub. (4) (c)
Has applied for coverage under and has been denied eligibility for medical assistance within 12 months prior to application for reimbursement under sub. (2)
Has no insurance coverage for AZT, the drug pentamidine or any drug approved for reimbursement under sub. (4) (c)
or, if he or she has insurance coverage, the coverage is inadequate to pay the full cost of the individual's prescribed dosage of AZT, the drug pentamidine or any drug approved for reimbursement under sub. (4) (c)
Is an individual whose annual gross household income is at or below 200% of the poverty line.
(4) Departmental duties.
The department shall do all of the following:
Determine the eligibility of individuals applying for reimbursement, or a supplement to the reimbursement, of the costs of AZT or the drug pentamidine.
Within the limits of sub. (5)
and of the funds specified under sub. (2)
and under a schedule that the department shall establish based on the ability of individuals to pay, reimburse or supplement the reimbursement of the eligible individuals.
After consulting with individuals, including those not employed by the department, with expertise in issues relative to drugs for the treatment of HIV infection and AIDS, determine which, if any, drugs that are cost-effective alternatives to AZT and pentamidine may also have costs reimbursed under this section.
(5) Reimbursement limitation.
Reimbursement may not be made under this section for any portion of the costs of AZT, the drug pentamidine or any drug approved for reimbursement under sub. (4) (c)
which are payable by an insurer, as defined in s. 600.03 (27)
History: 1989 a. 31
; 1991 a. 39
; 1993 a. 16
; 1995 a. 27
; Stats. 1995 s. 49.686.
Disease aids; patient financial and liability requirements. 49.687(1)(1)
The department shall promulgate rules that require a person who is eligible for benefits under s. 49.68
and whose current income exceeds specified limits to obligate or expend specified portions of the income for medical care for treatment of kidney disease, cystic fibrosis or hemophilia before receiving benefits under s. 49.68
The department shall develop and implement a sliding scale of patient liability for kidney disease aid under s. 49.68
, cystic fibrosis aid under s. 49.683
and hemophilia treatment under s. 49.685
, based on the patient's ability to pay for treatment. To ensure that the needs for treatment of patients with lower incomes receive priority within the availability of funds under s. 20.435 (1) (e)
, the department shall revise the sliding scale for patient liability by January 1, 1994, and shall, every 3 years thereafter by January 1, review and, if necessary, revise the sliding scale.
History: 1983 a. 27
; 1989 a. 56
; 1991 a. 39
; 1993 a. 16
; 1995 a. 27
; Stats. 1995 s. 49.687.
49.70 County home; establishment. 49.70(1)
Each county may establish a county home for the relief and support of dependent persons pursuant to s. 46.17
In all counties whose population is less than 250,000 such county home shall be governed pursuant to ss. 46.18
No county in which a county home is established shall contract to conduct the same or to support and maintain the inmates thereof; and all agreements in violation of this subsection are void.
The trustees or any person employed by the county board pursuant to subs. (1)
, may administer oaths concerning any matter submitted to the trustees or person employed by the county board, in connection with their functions.
The uniform accounting system established by s. 50.03 (10)
shall be used by each county home and shall be subject to the conditions enumerated therein.
History: 1971 c. 125
; 1975 c. 413
; 1977 c. 26
; 1991 a. 316
; 1995 a. 27
; Stats. 1995 s. 49.70.
County didn't violate (3) by terminating county home operations, conveying home's assets and leasing physical plant to private operator. Local Union 2490 v. Waukesha County, 143 W (2d) 438, 422 NW (2d) 117 (Ct. App. 1988).
County homes; commitments; admissions. 49.703(1)(1)
Any person upon his or her application to the board of trustees may be admitted to the county home upon such terms as may be prescribed by the board. If the person or his or her relatives are unable to pay for his or her care and maintenance the person may be admitted as a charge of the county of his or her residence.
The county board of any county may by resolution provide that the county shall bear the expense of maintaining all dependent persons committed or admitted to the county home, and may repeal any resolution adopted under this subsection.
History: 1977 c. 428
, 1985 a. 29
; 1995 a. 27
; Stats. 1995 s. 49.703.
County hospitals; establishment. 49.71(1)
Each county may establish a county hospital for the treatment of dependent persons, under s. 46.17
, and other persons authorized under s. 46.21 (4m)
In counties with a population of 500,000 or more, an institution established under sub. (1)
shall be governed under s. 46.21
or 59.79 (10)
, but in all other counties it shall be governed under ss. 46.18
The uniform accounting system established by s. 50.03 (10)
shall be used by each county hospital and shall be subject to the conditions enumerated therein.
County hospitals; admissions.