46.278 (2) (a) The department may request one or more waivers from the secretary of the federal department of health and human services, under 42 USC 1396n (c), authorizing the department to serve medical assistance recipients, who meet the level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded persons with mental retardation or in a brain injury rehabilitation facility, in their communities by providing home or community-based services as part of medical assistance. If the department requests a waiver, it shall include all assurances required under 42 USC 1396n (c) (2) in its request.
153,5 Section 5. 46.278 (4) (a) of the statutes is amended to read:
46.278 (4) (a) Sections 46.27 (3) (b) and 46.275 (3) (a) and (c) to (e) apply to county participation in a program, except that services provided in the program shall substitute for care provided a person in an intermediate care facility for the mentally retarded persons with mental retardation or in a brain injury rehabilitation facility who meets the intermediate care facility for the mentally retarded persons with mental retardation or brain injury rehabilitation facility level of care requirements for medical assistance reimbursement to that facility rather than for care provided at a state center for the developmentally disabled.
153,6 Section 6. 46.278 (5) (a) of the statutes is amended to read:
46.278 (5) (a) Any medical assistance recipient who meets the level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded persons with mental retardation or in a brain injury rehabilitation facility and is ineligible for service under s. 46.275 or 46.277 is eligible to participate in a program, except that persons eligible for the brain injury waiver program must meet the definition of brain injury under s. 51.01 (2g), and except that the number of participants may not exceed the number approved under the waiver received under sub. (3). Such a recipient may apply, or any person may apply on behalf of such a recipient, for participation in a program. Section 46.275 (4) (b) applies to participation in a program.
153,7 Section 7. 46.278 (6) (e) 1. a. of the statutes is amended to read:
46.278 (6) (e) 1. a. An intermediate care facility for the mentally retarded persons with mental retardation that closes under s. 50.03 (14).
153,8 Section 8. 46.278 (6) (e) 1. b. of the statutes is amended to read:
46.278 (6) (e) 1. b. An intermediate care facility for the mentally retarded persons with mental retardation or a distinct part thereof that has a plan of closure approved by the department and that intends to close within 12 months.
153,9 Section 9. 46.278 (6) (e) 1. c. of the statutes is amended to read:
46.278 (6) (e) 1. c. An intermediate care facility for the mentally retarded persons with mental retardation that has a plan of closure or significant reduction in capacity approved by the department and that intends to close or significantly reduce its capacity within 60 months.
153,10 Section 10. 46.279 (1) (b) of the statutes is amended to read:
46.279 (1) (b) "Intermediate facility" means has the meaning given for an intermediate care facility for the mentally retarded, as defined in under 42 USC 1396d (d), other than a center for the developmentally disabled, as defined in s. 51.01 (3).
153,11 Section 11 . 48.685 (8) of the statutes, as affected by 2007 Wisconsin Act 20, is amended to read:
48.685 (8) The department, the department of health services, a county department, a child welfare agency, or a school board may charge a fee for obtaining the information required under sub. (2) (am) or (3) (a) or for providing information to an entity to enable the entity to comply with sub. (2) (b) 1. or (3) (b). The fee may not exceed the reasonable cost of obtaining the information. No fee may be charged to a nurse's assistant nurse aide, as defined in s. 146.40 (1) (d), for obtaining or maintaining information if to do so would be inconsistent with federal law.
153,12 Section 12. 49.45 (6m) (am) 1. bm. of the statutes is amended to read:
49.45 (6m) (am) 1. bm. Nonbillable services of a registered nurse, licensed practical nurse, and nurse's assistant nurse aide.
153,13 Section 13. 49.45 (8) (a) 1. of the statutes is repealed.
153,14 Section 14. 49.45 (8) (a) 2m. of the statutes is created to read:
49.45 (8) (a) 2m. "Nurse aide" has the meaning given in s. 146.40 (1) (d).
153,15 Section 15. 49.45 (8) (a) 4. of the statutes, as affected by 2007 Wisconsin Act 20, is repealed and recreated to read:
49.45 (8) (a) 4. "Patient care visit" means a personal contact with a patient in a patient's home that is made by a registered nurse, licensed practical nurse, nurse aide, physical therapist, occupational therapist, or speech-language pathologist who is on the staff of or under contract or arrangement with a home health agency, or by a registered nurse or licensed practical nurse practicing independently, to provide a service that is covered under s. 49.46, 49.47, or 49.471. "Patient care visit" does not include time spent by a nurse, therapist, or nurse aide on case management, care coordination, travel, record keeping, or supervision that is related to the patient care visit.
153,16 Section 16. 49.45 (30m) (a) 2. of the statutes is amended to read:
49.45 (30m) (a) 2. Services in an intermediate care facility for the mentally retarded persons with mental retardation, as defined in s. 46.278 (1m) (am), other than a state center for the developmentally disabled.
153,17 Section 17. 49.45 (42) (b) of the statutes is amended to read:
49.45 (42) (b) The individual is not eligible to receive home health aide services under medicare, as defined in sub. (3) (L) 1. b.
153,18 Section 18. 49.498 (1) (h) of the statutes is amended to read:
49.498 (1) (h) "Nurse's assistant Nurse aide" has the meaning given for "nurse aide" under 42 USC 1396r (b) (5) (F).
153,19 Section 19. 49.498 (2) (e) 1. of the statutes is repealed.
153,20 Section 20. 49.498 (2) (e) 2. of the statutes is amended to read:
49.498 (2) (e) 2. A nursing facility may not use the individual as a nurse's assistant nurse aide unless the nursing facility has inquired of the department concerning information about the individual in the registry under s. 146.40 (4g).
153,21 Section 21. 49.498 (2) (e) 3. of the statutes is amended to read:
49.498 (2) (e) 3. A nursing facility shall provide the regular performance review and regular in-service education that assures that individuals used as nurse's assistants nurse aides are competent to perform services as nurse's assistants nurse aides, including training for individuals to provide nursing and nursing-related services to nursing facility residents with cognitive impairments.
153,22 Section 22. 50.01 (2) of the statutes is amended to read:
50.01 (2) "Nurse's assistant Nurse aide" means a person who performs routine patient care duties delegated by a registered nurse or licensed practical nurse who supervises the person, for the direct health care of a patient or resident. "Nurse's assistant Nurse aide" does not mean a feeding assistant, as defined in s. 146.40 (1) (aw); a person who is licensed, permitted, certified, or registered under ch. 441, 448, 449, 450, 451, 455, 459, or 460; or a person whose duties primarily involve skills that are different than those taught in instructional programs for nurse's assistants nurse aides.
153,23 Section 23. 50.04 (2) (c) 2. b. of the statutes is amended to read:
50.04 (2) (c) 2. b. A shortage of nurses or nurse's assistants nurse aides available for employment by the nursing home exists.
153,24 Section 24. 50.04 (2) (d) (intro.) of the statutes is amended to read:
50.04 (2) (d) (intro.) Each nursing home, other than nursing homes that primarily serve the developmentally disabled, shall provide at least the following hours of service by registered nurses, licensed practical nurses, or nurse's assistants nurse aides and may not use hours of service by a feeding assistant, as defined in s. 146.40 (1) (aw), in fulfilling these requirements:
153,25 Section 25. 50.04 (2r) of the statutes is amended to read:
50.04 (2r) Admissions requiring approval. Except in an emergency, a nursing home that is not certified as a provider of medical assistance or that is an intermediate care facility for the mentally retarded persons with mental retardation, as defined in s. 46.278 (1m) (am), or an institution for mental diseases, as defined under 42 CFR 435.1009, may not admit as a resident an individual who has a developmental disability, as defined in s. 51.01 (5), or who is both under age 65 and has mental illness, as defined in s. 51.01 (13), unless the county department under s. 46.23, 51.42 or 51.437 of the individual's county of residence has recommended the admission.
153,26 Section 26. 50.065 (8) of the statutes is amended to read:
50.065 (8) The department may charge a fee for obtaining the information required under sub. (2) (am) or (3) (a) or for providing information to an entity to enable the entity to comply with sub. (2) (b) or (3) (b). No fee may be charged to a nurse's assistant nurse aide, as defined in s. 146.40 (1) (d), for obtaining or maintaining the information if to do so would be inconsistent with federal law.
153,27 Section 27. 50.095 (3) (b) of the statutes is amended to read:
50.095 (3) (b) The staff replacement rates for full-time and part-time nursing staff, nurse's assistants nurse aides, and administrators for the previous year for the nursing home and for all similar nursing homes in the same geographical area, as determined by the department.
153,28 Section 28. 50.097 of the statutes is amended to read:
50.097 Registry. Any person may receive, upon specific written request to the department, requested information that is contained in the registry of nurse's assistants and home health aides individuals under s. 146.40 (4g) (a) or that is contained in the registry of hospice aides under s. 146.40 (4g) (a) 1.
153,29 Section 29. 50.14 (1) (a) of the statutes is amended to read:
50.14 (1) (a) Notwithstanding s. 50.01 (1m), "facility" means a nursing home or an intermediate care facility for the mentally retarded persons with mental retardation that is not located outside the state.
153,30 Section 30. 50.14 (1) (b) of the statutes is amended to read:
50.14 (1) (b) "Intermediate care facility for the mentally retarded persons with mental retardation" has the meaning given for "intermediate care facility for the mentally retarded" under 42 USC 1396d (c) and (d).
153,31 Section 31. 50.14 (2) (bm) of the statutes, as created by 2007 Wisconsin Act 20, is amended to read:
50.14 (2) (bm) For intermediate care facilities for the mentally retarded persons with mental retardation, an amount calculated by multiplying the projected annual gross revenues of all intermediate care facilities for the mentally retarded persons with mental retardation in this state by 0.055, dividing the product by the number of licensed beds of intermediate care facilities for persons with mental retardation in this state and dividing the quotient by 12.
153,32 Section 32. 51.06 (8) (a) 1. of the statutes is amended to read:
51.06 (8) (a) 1. "Intermediate care facility for the mentally retarded persons with mental retardation" has the meaning given in for "intermediate care facility for the mentally retarded" under 42 USC 1396d (d).
153,33 Section 33. 51.06 (8) (b) (intro.) of the statutes is amended to read:
51.06 (8) (b) (intro.) Annually by October 1, the department shall submit to the joint committee on finance and to the appropriate standing committees of the legislature under s. 13.172 (3) a report that includes information collected from the previous fiscal year on the relocation or diversion of individuals who are Medical Assistance eligibles or recipients from nursing homes, intermediate care facilities for the mentally retarded persons with mental retardation, and centers for the developmentally disabled. The report shall include all of the following information:
153,34 Section 34. 51.06 (8) (b) 4. of the statutes is amended to read:
51.06 (8) (b) 4. An accounting of the costs and savings under the Medical Assistance program of relocations and diversions and the resulting reduction in capacity for services of nursing homes, intermediate care facilities for the mentally retarded persons with mental retardation, and centers for the developmentally disabled. The accounting shall include the per individual savings as well as the collective savings of relocations and diversions.
153,35 Section 35. 51.06 (8) (b) 7. of the statutes is amended to read:
51.06 (8) (b) 7. Staff turnover rates for nursing homes, intermediate care facilities for the mentally retarded persons with mental retardation, and centers for the developmentally disabled in communities in which an individual relocated or diverted from a nursing home, intermediate care facility for the mentally retarded persons with mental retardation, or center for the developmentally disabled currently resides.
153,36 Section 36. 51.62 (4) of the statutes is amended to read:
51.62 (4) Departmental duties. The department shall provide the protection and advocacy agency with copies of annual surveys and plans of correction for intermediate care facilities for the mentally retarded persons with mental retardation on or before the first day of the 2nd month commencing after completion of the survey or plan.
153,37 Section 37. 146.40 (title) of the statutes is amended to read:
146.40 (title) Instructional programs for nurse's nurse aides; reporting client abuse.
153,38 Section 38. 146.40 (1) (aw) of the statutes is created to read:
146.40 (1) (aw) "Feeding assistant" means an individual who has completed a state-approved training and testing program, as specified by the department by rule, to perform one nursing-related duty, as defined by the department by rule.
153,39 Section 39. 146.40 (1) (bm) of the statutes is repealed.
153,40 Section 40. 146.40 (1) (bo) of the statutes is amended to read:
146.40 (1) (bo) "Hospice" means a hospice that is licensed under subch. IV of ch. 50 and that is certified as a provider of services under 42 USC 1395 to 1395ccc.
153,41 Section 41. 146.40 (1) (bp) of the statutes is repealed.
153,42 Section 42. 146.40 (1) (bt) of the statutes is amended to read:
146.40 (1) (bt) "Intermediate care facility for the mentally retarded persons with mental retardation" has the meaning given for "intermediate care facility for the mentally retarded" under 42 USC 1396d (c) and (d).
153,43 Section 43. 146.40 (1) (d) of the statutes is amended to read:
146.40 (1) (d) "Nurse's assistant Nurse aide" means an individual who performs routine patient care duties delegated by a registered nurse or licensed practical nurse who supervises the individual, for the direct health care of a patient or resident. "Nurse's assistant Nurse aide" does not mean a feeding assistant, an individual who is licensed, permitted, certified, or registered under ch. 441, 448, 449, 450, 451, 455, 459, or 460, or an individual whose duties primarily involve skills that are different than those taught in instructional and competency evaluation programs for nurse's assistants certified nurse aides approved under sub. (3) or evaluated by competency evaluation programs for nurse's assistants nurse aides approved under sub. (3m).
153,44 Section 44. 146.40 (2) (intro.) of the statutes is amended to read:
146.40 (2) (intro.) A hospital, nursing home or, intermediate care facility for the mentally retarded persons with mental retardation, home health agency, or hospice may not employ or contract for the services of an individual as a nurse's assistant, a home health agency may not employ or contract for the services of an individual as a home health aide and a hospice may not employ or contract for the services of an individual as a hospice nurse aide, regardless of the title under which the individual is employed or contracted for, unless one of the following is true:
153,45 Section 45. 146.40 (2) (a) of the statutes is amended to read:
146.40 (2) (a) For hospitals, nursing homes, home health agencies or hospices, whether or not certified providers of medical assistance, except as provided in par. (g), and intermediate care facilities for the mentally retarded that are certified providers of medical assistance, the The individual has successfully completed instruction in an instructional and competency evaluation program for nurse's assistants, home health aides or hospice nurse aides that is certified by the department approved under sub. (3) and has successfully completed a competency evaluation program that is approved under sub. (3m).
153,46 Section 46. 146.40 (2) (am) of the statutes is repealed.
153,47 Section 47. 146.40 (2) (b) of the statutes is repealed.
153,48 Section 48. 146.40 (2) (bm) of the statutes is repealed.
153,49 Section 49. 146.40 (2) (c) of the statutes is renumbered 146.40 (2) (c) (intro.) and amended to read:
146.40 (2) (c) (intro.) For hospitals, nursing homes, home health agencies or hospices, whether or not certified providers of medical assistance, and intermediate care facilities for the mentally retarded persons with mental retardation that are certified providers of medical assistance, the individual is enrolled in an instructional program for nurse aides that is approved under sub. (3) and is employed or under contract as a nurse's assistant, home health aide or hospice aide fewer than 120 calendar days by the hospital, nursing home, home health agency, hospice or intermediate care facility for the mentally retarded. All of the following applies to an individual specified under this paragraph:
153,50 Section 50. 146.40 (2) (c) 1. of the statutes is created to read:
146.40 (2) (c) 1. He or she may perform only services for which he or she has received training and has been found proficient by an instructor under the instructional program.
153,51 Section 51. 146.40 (2) (c) 2. of the statutes is created to read:
146.40 (2) (c) 2. The hospital, nursing home, home health agency, hospice, or intermediate care facility for persons with mental retardation may not include the individual in meeting or complying with a requirement for nursing care staff and functions, including a minimum nursing staff requirement.
153,52 Section 52. 146.40 (2) (d) of the statutes is amended to read:
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