AB56-SA2,11,1917 20.435 (5) (ct) Mental health consultation program. The amounts in the
18schedule for developing a plan for a mental health consultation program under s.
1951.441. No moneys may be encumbered under this paragraph after June 30, 2021.”.
AB56-SA2,11,20 2062. Page 255, line 18: after that line insert:
AB56-SA2,11,21 21 Section 205c. 20.435 (5) (dg) of the statutes is created to read:
AB56-SA2,11,2422 20.435 (5) (dg) Regional crisis stabilization facilities. The amounts in the
23schedule to provide grants to regional crisis stabilization facilities under s. 51.03
24(7).”.
AB56-SA2,12,1
163. Page 265, line 17: delete that line and substitute:
AB56-SA2,12,2 2 Section 179b. 20.505 (8) (hm) 6e. of the statutes is repealed.”.
AB56-SA2,12,3 364. Page 279, line 8: after that line insert:
AB56-SA2,12,4 4 Section 318f. 20.940 of the statutes is repealed.” .
AB56-SA2,12,5 565. Page 292, line 25: after that line insert:
AB56-SA2,12,6 6 Section 414i. 40.51 (8) of the statutes is amended to read:
AB56-SA2,12,117 40.51 (8) Every health care coverage plan offered by the state under sub. (6)
8shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.728, 632.746
9(1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853,
10632.855, 632.867, 632.87 (3) to (6), 632.885, 632.89, 632.895 (5m) and (8) to (17), and
11632.896.
AB56-SA2,415i 12Section 415i. 40.51 (8m) of the statutes is amended to read:
AB56-SA2,12,1613 40.51 (8m) Every health care coverage plan offered by the group insurance
14board under sub. (7) shall comply with ss. 631.95, 632.728, 632.746 (1) to (8) and (10),
15632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.867,
16632.885, 632.89, and 632.895 (11) (8) and (10) to (17).”.
AB56-SA2,12,18 1766. Page 295, line 23: delete the material beginning with that line and ending
18with page 304, line 9, and substitute:
AB56-SA2,12,19 19 Section 441b. 46.10 (16) of the statutes is amended to read:
AB56-SA2,13,620 46.10 (16) The department shall delegate to county departments under ss.
2151.42 and 51.437 or the local providers of care and services meeting the standards
22established by the department under s. 46.036, the responsibilities vested in the
23department under this section for collection of patient fees for services other than
24those provided at state facilities, those provided to children that are reimbursed

1under a waiver under s. 46.27 (11), 46.275, 46.278, or 46.2785, or those provided
2under the disabled children's long-term support program if the county departments
3or providers meet the conditions that the department determines are appropriate.
4The department may delegate to county departments under ss. 51.42 and 51.437 the
5responsibilities vested in the department under this section for collection of patient
6fees for services provided at the state facilities if the necessary conditions are met.
AB56-SA2,442b 7Section 442b. 46.21 (2m) (b) 1. a. of the statutes is amended to read:
AB56-SA2,13,118 46.21 (2m) (b) 1. a. The powers and duties of the county departments under ss.
946.215, 51.42 and 51.437, including the administration of the long-term support
10community options program under s. 46.27, if the county department under s. 46.215
11is designated as the administering agency under s. 46.27 (3) (b) 1
.
AB56-SA2,443b 12Section 443b. 46.21 (2m) (b) 1. b. of the statutes is repealed.
AB56-SA2,444b 13Section 444b. 46.215 (1) (m) of the statutes is repealed.
AB56-SA2,445b 14Section 445b. 46.22 (1) (b) 1. e. of the statutes is repealed.
AB56-SA2,446b 15Section 446b. 46.23 (3) (bm) of the statutes is repealed.
AB56-SA2,447b 16Section 447b. 46.269 of the statutes is amended to read:
AB56-SA2,14,2 1746.269 Determining financial eligibility for long-term care programs.
18To the extent approved by the federal government, the department or its designee
19shall exclude any assets accumulated in a person's independence account, as defined
20in s. 49.472 (1) (c), and any income or assets from retirement benefits earned or
21accumulated from income or employer contributions while employed and receiving
22state-funded benefits under s. 46.27 or medical assistance under s. 49.472 in
23determining financial eligibility and cost-sharing requirements, if any, for a
24long-term care program under s. 46.27, 46.275 , or 46.277, for the family care
25program that provides the benefit defined in s. 46.2805 (4), for the Family Care

1Partnership program, or for the self-directed services option, as defined in s. 46.2897
2(1).
AB56-SA2,448b 3Section 448b. 46.27 of the statutes is repealed.
AB56-SA2,449b 4Section 449b. 46.271 (1) (c) of the statutes is amended to read:
AB56-SA2,14,75 46.271 (1) (c) The department may contract with an aging unit, as defined in
6s. 46.27 46.82 (1) (a), for administration of services under par. (a) if, by resolution,
7the county board of supervisors of that county so requests the department.
AB56-SA2,450b 8Section 450b. 46.275 (3) (e) of the statutes is repealed.
AB56-SA2,451b 9Section 451b. 46.275 (5) (b) 7. of the statutes is amended to read:
AB56-SA2,14,1310 46.275 (5) (b) 7. Provide services in any community-based residential facility
11unless the county or department uses as a service contract the approved model
12contract developed under s. 46.27 (2) (j), 2017 stats., or a contract that includes all
13of the provisions of the approved model contract.
AB56-SA2,452b 14Section 452b. 46.277 (1m) (at) of the statutes is amended to read:
AB56-SA2,14,1815 46.277 (1m) (at) “Private nonprofit agency" has the meaning specified in s.
1646.27 (1) (bm)
means a nonprofit corporation, as defined in s. 181.0103 (17), that
17provides a program of all-inclusive care for the elderly under 42 USC 1395eee or
181396u-4
.
AB56-SA2,453b 19Section 453b. 46.277 (3) (a) of the statutes is amended to read:
AB56-SA2,15,320 46.277 (3) (a) Sections 46.27 (3) (b) and Section 46.275 (3) (a) and (c) to (e) apply
21applies to county participation in this program, except that services provided in the
22program shall substitute for care provided a person in a skilled nursing facility or
23intermediate care facility who meets the level of care requirements for medical
24assistance reimbursement to that facility rather than for care provided at a state
25center for the developmentally disabled. The number of persons who receive services

1provided by the program under this paragraph may not exceed the number of
2nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as
3part of a plan submitted by the facility and approved by the department.
AB56-SA2,454b 4Section 454b. 46.277 (5) (d) 2. (intro.) and b. of the statutes are consolidated,
5renumbered 46.277 (5) (d) 2. and amended to read:
AB56-SA2,15,136 46.277 (5) (d) 2. No county may use funds received under this section to provide
7residential services in any community-based residential facility, as defined in s.
850.01 (1g), unless one of the following applies: b. The the department approves the
9provision of services in a community-based residential facility that entirely consists
10of independent apartments, each of which has an individual lockable entrance and
11exit and individual separate kitchen, bathroom, sleeping and living areas, to
12individuals who are eligible under this section and are physically disabled or are at
13least 65 years of age.
AB56-SA2,455b 14Section 455b. 46.277 (5) (d) 2. a. of the statutes is repealed.
AB56-SA2,456b 15Section 456b. 46.277 (5) (d) 3. of the statutes is amended to read:
AB56-SA2,15,2216 46.277 (5) (d) 3. If subd. 2. a. or b. applies, no county may use funds received
17under this section to pay for services provided to a person who resides or intends to
18reside in a community-based residential facility and who is initially applying for the
19services, if the projected cost of services for the person, plus the cost of services for
20existing participants, would cause the county to exceed the limitation under sub. (3)
21(c). The department may grant an exception to the requirement under this
22subdivision, under the conditions specified by rule, to avoid hardship to the person.
AB56-SA2,457b 23Section 457b. 46.277 (5) (f) of the statutes is amended to read:
AB56-SA2,16,324 46.277 (5) (f) No county or private nonprofit agency may use funds received
25under this subsection to provide services in any community-based residential

1facility unless the county or agency uses as a service contract the approved model
2contract developed under s. 46.27 (2) (j), 2017 stats., or a contract that includes all
3of the provisions of the approved model contract.
AB56-SA2,458b 4Section 458b. 46.278 (4) (a) of the statutes is amended to read:
AB56-SA2,16,125 46.278 (4) (a) Sections 46.27 (3) (b) and Section 46.275 (3) (a) and (c) to (e) apply
6applies to county participation in a program, except that services provided in the
7program shall substitute for care provided a person in an intermediate care facility
8for persons with an intellectual disability or in a brain injury rehabilitation facility
9who meets the intermediate care facility for persons with an intellectual disability
10or brain injury rehabilitation facility level of care requirements for medical
11assistance reimbursement to that facility rather than for care provided at a state
12center for the developmentally disabled.
AB56-SA2,459b 13Section 459b. 46.2803 of the statutes is repealed.
AB56-SA2,460b 14Section 460b. 46.2805 (1) (b) of the statutes is amended to read:
AB56-SA2,16,1715 46.2805 (1) (b) A demonstration program known as the Wisconsin partnership
16Family Care Partnership program under a federal waiver authorized under 42 USC
171315 1396n.
AB56-SA2,461b 18Section 461b. 46.281 (1d) of the statutes is amended to read:
AB56-SA2,17,219 46.281 (1d) Waiver request. The department shall request from the secretary
20of the federal department of health and human services any waivers of federal
21medicaid laws necessary to permit the use of federal moneys to provide the family
22care benefit and the self-directed services option to recipients of medical assistance.
23The department shall implement any waiver that is approved and that is consistent
24with ss. 46.2805 to 46.2895. Regardless of whether a waiver is approved, the

1department may implement operation of resource centers, care management
2organizations, and the family care benefit.
AB56-SA2,462b 3Section 462b. 46.281 (1n) (d) of the statutes is repealed.
AB56-SA2,463b 4Section 463b. 46.281 (3) of the statutes is repealed.
AB56-SA2,464b 5Section 464b. 46.2825 of the statutes is repealed.
AB56-SA2,465b 6Section 465b. 46.283 (3) (f) of the statutes is amended to read:
AB56-SA2,17,127 46.283 (3) (f) Assistance to a person who is eligible for the family care benefit
8with respect to the person's choice of whether or not to enroll in the self-directed
9services option, as defined in s. 46.2899 (1),
a care management organization for the
10family care benefit or the Family Care Partnership program, or the program of
11all-inclusive care for the elderly
and, if so, which available long-term care program
12or
care management organization would best meet his or her needs.
AB56-SA2,466b 13Section 466b. 46.283 (4) (e) of the statutes is repealed.
AB56-SA2,467b 14Section 467b. 46.283 (4) (f) of the statutes is amended to read:
AB56-SA2,17,1815 46.283 (4) (f) Perform a functional screening and a financial and cost-sharing
16screening for any resident, as specified in par. (e), who requests a screening and
17assist any resident who is eligible and chooses to enroll in a care management
18organization or the self-directed services option to do so.
AB56-SA2,468b 19Section 468b. 46.283 (6) (b) 7. of the statutes is repealed.
AB56-SA2,469b 20Section 469b. 46.283 (6) (b) 9. of the statutes is amended to read:
AB56-SA2,17,2421 46.283 (6) (b) 9. Review the number and types of grievances and appeals
22concerning the long-term care system in the area served by related to the resource
23center, to determine if a need exists for system changes, and recommend system or
24other changes if appropriate.
AB56-SA2,470b 25Section 470b. 46.283 (6) (b) 10. of the statutes is repealed.
AB56-SA2,471b
1Section 471b. 46.285 (intro.) of the statutes is renumbered 46.285 and
2amended to read:
AB56-SA2,18,8 346.285 Operation of resource center and care management
4organization.
In order to meet federal requirements and assure federal financial
5participation in funding of the family care benefit, a county, a tribe or band, a
6long-term care district or an organization, including a private, nonprofit
7corporation, may not directly operate both a resource center and a care management
8organization, except as follows:.
AB56-SA2,472b 9Section 472b. 46.285 (1) of the statutes is repealed.
AB56-SA2,473b 10Section 473b. 46.285 (2) of the statutes is repealed.
AB56-SA2,474b 11Section 474b. 46.286 (3) (b) 2. a. of the statutes is repealed.
AB56-SA2,475b 12Section 475b. 46.287 (2) (a) 1. (intro.) of the statutes is amended to read:
AB56-SA2,18,1813 46.287 (2) (a) 1. (intro.) Except as provided in subd. 2., a client may contest any
14of the following applicable matters by filing, within 45 days of the failure of a resource
15center or care management organization county to act on the contested matter
16within the time frames specified by rule by the department or within 45 days after
17receipt of notice of a decision in a contested matter, a written request for a hearing
18under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1):
AB56-SA2,476b 19Section 476b. 46.287 (2) (a) 1. d. of the statutes is renumbered 46.287 (2) (a)
201m. b.
AB56-SA2,477b 21Section 477b. 46.287 (2) (a) 1. e. of the statutes is repealed.
AB56-SA2,478b 22Section 478b. 46.287 (2) (a) 1. f. of the statutes is repealed.
AB56-SA2,479b 23Section 479b. 46.287 (2) (a) 1m. of the statutes is created to read:
AB56-SA2,19,524 46.287 (2) (a) 1m. Except as provided in subd. 2., a client may contest any of
25the following adverse benefit determinations by filing, within 90 days of the failure

1of a care management organization to act on a contested adverse benefit
2determination within the time frames specified by rule by the department or within
390 days after receipt of notice of a decision upholding the adverse benefit
4determination, a written request for a hearing under s. 227.44 to the division of
5hearings and appeals created under s. 15.103 (1):
AB56-SA2,19,96 a. Denial of functional eligibility under s. 46.286 (1) as a result of the care
7management organization's administration of the long-term care functional screen,
8including a change from a nursing home level of care to a non-nursing home level
9of care.
AB56-SA2,19,1210 c. Denial or limited authorization of a requested service, including
11determinations based on type or level of service, requirements or medical necessity,
12appropriateness, setting, or effectiveness of a covered benefit.
AB56-SA2,19,1513 d. Reduction, suspension, or termination of a previously authorized service,
14unless the service was only authorized for a limited amount or duration and that
15amount or duration has been completed.
AB56-SA2,19,1616 e. Denial, in whole or in part, of payment for a service.
AB56-SA2,19,1917 f. The failure of a care management organization to act within the time frames
18provided in 42 CFR 438.408 (b) (1) and (2) regarding the standard resolution of
19grievances and appeals.
AB56-SA2,19,2220 g. Denial of an enrollee's request to dispute financial liability, including
21copayments, premiums, deductibles, coinsurance, other cost sharing, and other
22member financial liabilities.
AB56-SA2,19,2523 h. Denial of an enrollee, who is a resident of a rural area with only one care
24management organization, to obtain services outside the care management
25organization's network of contracted providers.
AB56-SA2,20,6
1i. Development of a plan of care that is unacceptable to the enrollee because the
2plan of care requires the enrollee to live in a place that is unacceptable to the enrollee;
3the plan of care does not provide sufficient care, treatment, or support to meet the
4enrollee's needs and support the enrollee's identified outcomes; or the plan of care
5requires the enrollee to accept care, treatment, or support that is unnecessarily
6restrictive or unwanted by the enrollee.
AB56-SA2,20,77 j. Involuntary disenrollment from the care management organization.
AB56-SA2,480b 8Section 480b. 46.287 (2) (b) of the statutes is amended to read:
AB56-SA2,20,179 46.287 (2) (b) An enrollee may contest a decision, omission or action of a care
10management organization other than those specified in par. (a), or may contest the
11choice of service provider. In these instances, the enrollee shall first send a written
12request for review by the unit of the department that monitors care management
13organization contracts. This unit shall review and attempt to resolve the dispute.
141m. by filing a grievance with the care management organization. If the dispute
15grievance is not resolved to the satisfaction of the enrollee, he or she may request
16a hearing under the procedures specified in par. (a) 1. (intro.) that the department
17review the decision of the care management organization
.
AB56-SA2,481b 18Section 481b. 46.288 (2) (intro.) of the statutes is renumbered 46.288 (2) and
19amended to read:
AB56-SA2,20,2520 46.288 (2) Criteria and procedures for determining functional eligibility under
21s. 46.286 (1) (a), financial eligibility under s. 46.286 (1) (b), and cost sharing under
22s. 46.286 (2) (a). The rules for determining functional eligibility under s. 46.286 (1)
23(a) 1m. shall be substantially similar to eligibility criteria for receipt of the long-term
24support community options program under s. 46.27. Rules under this subsection
25shall include definitions of the following terms applicable to s. 46.286:
AB56-SA2,482b
1Section 482b. 46.288 (2) (d) to (j) of the statutes are repealed.
AB56-SA2,483b 2Section 483b. 46.2896 (1) (a) of the statutes is amended to read:
AB56-SA2,21,63 46.2896 (1) (a) “Long-term care program" means the long-term care program
4under s. 46.27, 46.275, 46.277, 46.278, or 46.2785; the family care program providing
5the benefit under s. 46.286; the Family Care Partnership program; or the long-term
6care program defined in s. 46.2899 (1).”.
AB56-SA2,21,7 767. Page 304, line 10: delete lines 10 to 18 and substitute:
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