7. The department may enforce a lien under subd. 5. by foreclosure in the same manner as a mortgage on real property.
(d) The department may require the county department or aging unit selected to administer the program in each county to gather and provide the department with information needed to recover payment of long-term community support services under this subsection. The department shall pay to the county department or aging unit an amount equal to 5% of the recovery collected by the department relating to a beneficiary for whom the county department or aging unit made the last determination of eligibility for funding under sub. (7). A county department or aging unit may use funds received under this paragraph only to pay costs incurred under this paragraph and shall remit the remainder, if any, to the department for deposit in the appropriation account under s. 20.435 (7) (im). The department may withhold payments under this paragraph for failure to comply with the department's requirements under this paragraph. The department shall treat payments made under this paragraph as costs of administration of the program.
(e) From the appropriation under s. 20.435 (7) (im), the department shall pay the amount of the payments under par. (d) and shall spend the remainder of the funds recovered under this subsection for long-term community support services funded under sub. (7) (b) 1m.
(f) 1. The department may recover amounts under this subsection for the provision of long-term community support services paid on and after January 1, 1996.
2. The department may file a claim under par. (c) only with respect to a client who dies after February 15, 1996.
(g) The department shall promulgate rules establishing standards for determining whether the application of this subsection would work an undue hardship in individual cases. If the department determines that the application of this subsection would work an undue hardship in a particular case, the department shall waive application of this subsection in that case.
27,2231r
Section 2231r. 46.27 (11) (c) 3m. of the statutes is created to read:
46.27 (11) (c) 3m. Reimbursement under this paragraph for long-term community support services provided to a person
in a month may not exceed the average monthly cost of nursing home care, as determined by the department, except that this limitation does not apply to any of the following:
a. A person under the age of 22.
b. A ventilator-dependent person.
c. A person not specified under subd. 3m. a. or b., if the department determines that the cost of providing the person with nursing home care would exceed the cost of providing the person with care in the community. In making this determination, the department shall consider the
actual nursing home costs of that person and the extent to which costs under the medical assistance program for nursing home care would actually exceed the cost of providing the person with care in the community.
d. Any individual, if the department determines that nursing home care is not available for that individual.
e. Any individual, if the department determines that public funding is not available for the institutional care of that individual.
27,2232
Section 2232
. 46.27 (11) (c) 7. of the statutes is created to read:
46.27 (11) (c) 7. A county may use funds received under this subsection to provide supportive, personal or nursing services, as defined in rules promulgated under s. 49.45 (2) (a) 23., to a person who resides in a certified assisted living facility, as defined in s. 50.01 (1d). Funding of the services may not exceed 85% of the statewide medical assistance daily cost of nursing home care, as determined by the department.
27,2233
Section 2233
. 46.27 (11) (c) 8. of the statutes is created to read:
46.27 (11) (c) 8. No county, private nonprofit agency or aging unit may use funds received under this subsection to provide services in any community-based residential facility unless the county, agency or aging unit uses as a service contract the approved model contract developed under sub. (2) (j) or a contract that includes all of the provisions of the approved model contract.
27,2234m
Section 2234m. 46.27 (11g) of the statutes is created to read:
46.27 (11g) Report. Beginning January 1, 1997, and every January 1 thereafter, the department shall submit a report to the joint committee on finance and to the appropriate standing committees under s. 13.172 (3), summarizing the data collected for the state and for individual counties under the program in the calendar year ending immediately before the preceding calendar year.
27,2235g
Section 2235g. 46.27 (12) (c) of the statutes is created to read:
46.27 (12) (c) A sliding scale formula for a fee chargeable for conduct of an assessment under sub. (6) (a) or for development of a case plan under sub. (6) (b) that is based on the person's ability to pay, unless prohibited from payment under 42 USC 1396 to 1396v or under regulations under 42 USC 1396 to 1396v.
27,2236
Section 2236
. 46.275 (1m) (a) of the statutes is amended to read:
46.275 (1m) (a) “Medical assistance" means aid provided under ss. 49.43 to 49.47 subch. IV of ch. 49, except s. 49.468.
27,2240
Section 2240
. 46.275 (5) (b) 2. of the statutes is amended to read:
46.275 (5) (b) 2. Reduce federal, state or county matching expenditures for long-term community support services provided to any person as part of this program from funds allocated under s. 46.495 (1) (d), 46.80 (5), 46.85 (3m) (b) 1. and 2., 49.52 (1) (d) or 51.423, as indicated in the county's budget or by actual expenditures.
27,2244
Section 2244
. 46.277 (1m) (a) of the statutes is amended to read:
46.277 (1m) (a) “Medical assistance" means aid provided under ss. 49.43 to 49.47 subch. IV of ch. 49, except s. 49.468.
27,2245
Section 2245
. 46.277 (1m) (b) of the statutes is amended to read:
46.277 (1m) (b) “Program" means the community integration program for facilities certified as medical assistance providers, for which a waiver has been received under sub. (2).
27,2247
Section 2247
. 46.277 (2) (e) of the statutes is created to read:
46.277 (2) (e) Review and approve or disapprove waiver requests under sub. (3) (c), review and approve or disapprove requests for exceptions under sub. (5) (d) 3. and provide technical assistance to a county that reaches or exceeds the annual allocation limit specified in sub. (3) (c) in order to explore alternative methods of providing long-term community support services for persons who are in group living arrangements in that county.
27,2248
Section 2248
. 46.277 (3) (a) of the statutes is amended to read:
46.277 (3) (a) Sections 46.27 (3) (b) and 46.275 (3) (a) and (c) to (e) apply to county participation in this program, except that services provided in the program shall substitute for care provided a person in a skilled nursing facility or intermediate care facility who meets the level of care requirements for medical assistance reimbursement to that facility rather than for care provided at a state center for the developmentally disabled. The number of persons who receive services provided by the program under this paragraph may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and approved by the department.
27,2249
Section 2249
. 46.277 (3) (b) 2. of the statutes is amended to read:
46.277 (3) (b) 2. Each county department participating in the program shall provide home or community-based care to persons eligible under this section, except that the number of persons who receive home or community-based care under this section may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and approved by the department.
27,2250
Section 2250
. 46.277 (3) (c) of the statutes is created to read:
46.277 (3) (c) Beginning on January 1, 1996, from the annual allocation to the county for the provision of long-term community support services under sub. (5), annually establish a maximum total amount, not to exceed 25% of the annual allocation, that may be encumbered in a calendar year for services for eligible individuals in community-based residential facilities. If the total amount that is encumbered for services for individuals in community-based residential facilities who are receiving services under sub. (5) on January 1, 1996, exceeds 25% of the county's annual allocation, a county may request a waiver of the requirement under this paragraph from the department. The department need not promulgate as rules under ch. 227 the standards for granting a waiver request under this paragraph.
27,2251
Section 2251
. 46.277 (4) (a) of the statutes is amended to read:
46.277 (4) (a) Any medical assistance recipient who meets the level of care requirements for medical assistance reimbursement in a skilled nursing facility or intermediate care facility is eligible to participate in the program, except that the number of participants may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and approved by the department. Such a recipient may apply, or any person may apply on behalf of such a recipient, for participation in the program. Section 46.275 (4) (b) applies to participation in the program.
27,2253
Section 2253
. 46.277 (4) (b) of the statutes is amended to read:
46.277 (4) (b) To the extent authorized under 42 USC 1396n, if a person discontinues participation in the program, a medical assistance recipient may participate in the program in place of the participant who discontinues if that recipient meets the level of care requirements for medical assistance reimbursement in a skilled nursing facility or intermediate care facility, except that the number of participants may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and approved by the department.
27,2254
Section 2254
. 46.277 (5) (d) 3. of the statutes is created to read:
46.277 (5) (d) 3. If subd. 2. a. or b. applies, no county may use funds received under this section to pay for services provided to a person who resides or intends to reside in a community-based residential facility and who is initially applying for the services, if the projected cost of services for the person, plus the cost of services for existing participants, would cause the county to exceed the limitation under sub. (3) (c). The department may grant an exception to the requirement under this subdivision, under the conditions specified by rule, to avoid hardship to the person.
27,2255
Section 2255
. 46.277 (5) (e) of the statutes is created to read:
46.277 (5) (e) A county may use funds received under this subsection to provide supportive, personal or nursing services, as defined in rules promulgated under s. 49.45 (2) (a) 23., to a person who resides in a certified assisted living facility, as defined in s. 50.01 (1d). Funding of the services may not exceed 85% of the statewide medical assistance daily cost of nursing home care, as determined by the department.
27,2257
Section 2257
. 46.277 (5g) (title) of the statutes is amended to read:
46.277 (5g) (title) Limitation Limitations on service.
27,2258
Section 2258
. 46.277 (5g) of the statutes is renumbered 46.277 (5g) (a).
27,2259
Section 2259
. 46.277 (5g) (b) of the statutes is created to read:
46.277 (5g) (b) This section does not apply to the delicensure of a bed of an institution for mental diseases of an individual who is aged 21 to 64, who has a primary diagnosis of mental illness and who otherwise meets the requirements of s. 46.266 (1) (a), (b) or (c).
27,2261
Section 2261
. 46.277 (5r) of the statutes is created to read:
46.277 (5r) Rule making. The department shall promulgate rules that specify conditions of hardship under which the department may grant an exception to the requirement of sub. (5) (d) 3.
27,2263
Section 2263
. 46.278 (1m) (b) of the statutes is amended to read:
46.278 (1m) (b) “Medical assistance" means aid provided under ss. 49.43 to 49.47 subch. IV of ch. 49, except s. 49.468.
27,2266
Section 2266
. 46.278 (6) (e) of the statutes is created to read:
46.278 (6) (e) The department may provide enhanced reimbursement for services under the program for an individual who was relocated to the community by a county department from an intermediate care facility for the mentally retarded that closes under s. 50.03 (14). The enhanced reimbursement rate under this paragraph shall be determined under a formula that is developed by the department.
27,2269
Section 2269
. 46.29 (1) (intro.) of the statutes is amended to read:
46.29 (1) (intro.) From the appropriation under s. 20.435 (6) (d), the department shall allocate up to $12,000 $10,000 in each fiscal year for operation of the council on physical disabilities. The council on physical disabilities shall do all of the following:
27,2270
Section 2270
. 46.293 (title) of the statutes is created to read:
46.293 (title) Specialized programs for the blind and visually impaired.
27,2271
Section 2271
. 46.295 (title) of the statutes is created to read:
46.295 (title) Interpreters for the hearing-impaired.
27,2272
Section 2272
. 46.30 (3) (a) 1. of the statutes is amended to read:
46.30 (3) (a) 1. Administer funds received from the department under sub. (4) and funds from other sources provided to support a community action program.
27,2276c
Section 2276c. 46.30 (4) (a) of the statutes is amended to read:
46.30 (4) (a) The department shall allocate distribute the federal community services block grant funds received under 42 USC 9903 and deposited in the appropriations under s. 20.435 (4) (mc) and (md) and the state supplement under s. 20.435 (4) (cr) as provided in this subsection (6) (mc) and (7) (md).
27,2276d
Section 2276d. 46.30 (4) (cm) of the statutes is renumbered 49.32 (11) and amended to read:
49.32 (11) (title) Community action agencies. The department shall allocate distribute all of the funds under s. 20.435 (4) 20.445 (3) (cr) to community action agencies and organizations, including any of the 11 federally recognized tribal governing bodies in this state and limited-purpose agencies, in proportion to the share of funds actually allocated to these entities under 42 USC 1315 and from other federal and private foundation sources that provide funds for job creation and development for individuals with low incomes.
27,2276e
Section 2276e. 46.30 (4) (d) of the statutes is amended to read:
46.30 (4) (d) Before January 1 of each year the department shall contract with each agency and organization being funded, specifying the amount of money the organization will receive under this section and the activities to be carried out by the organization.
27,2277b
Section 2277b. 46.31 of the statutes, as affected by 1995 Wisconsin Act .... (this act), is renumbered 49.37, and 49.37 (1) (intro.) and (3), as renumbered, are amended to read:
49.37 (1) (intro.) From the appropriation under s. 20.435 (4) 20.445 (3) (dk), the department shall allocate funds to new hope project, inc., for a demonstration project that will be conducted in 2 areas in the city of Milwaukee, if all of the following conditions are satisfied:
(3) The contract under sub. (1) (g) shall require an interim evaluation to be submitted to the department no later than January 1, 1993. New hope project, inc., may not use funds appropriated under s. 20.435 (4) 20.445 (3) (dk) to fund the evaluation under sub. (1) (g).
27,2277d
Section 2277d. 46.31 (4) of the statutes is amended to read:
46.31 (4) This section does not apply after June 30, 1995 1997.
27,2278
Section 2278
. 46.32 of the statutes is repealed.
27,2280
Section 2280
. 46.40 (1) of the statutes is renumbered 46.40 (1) (a) and amended to read:
46.40 (1) (a) Within the limits of available federal funds and of the appropriations under s. 20.435 (7) (b) and (o), the department shall distribute funds for community social, mental health, developmental disabilities and alcohol and other drug abuse services and for services under ss. 46.51, 46.87, 46.98 (2m), (3) and (4g), 46.985 and 51.421 to county departments under ss. 46.215, 46.22, 46.23, 51.42 and 51.437, to county aging units and to private nonprofit organizations as authorized under s. 46.98 (2) (a), as provided in subs. (2) to (12) (8).
27,2281m
Section 2281m. 46.40 (2) of the statutes is amended to read:
46.40 (2) Basic county allocation. For social services under s. 49.52 (1) (d) and services under s. 51.423 (2), the department shall distribute not more than $121,552,100 for the last 6 months of 1993, not more than $246,743,400 for 1994 and not more than $127,281,500 for the first 6 months of 1995 $292,368,400 for fiscal year 1995-96 and $292,109,500 for fiscal year 1996-97.
27,2281s
Section 2281s. 46.40 (2) of the statutes, as affected by 1995 Wisconsin Act .... (this act), is amended to read:
46.40 (2) Basic county allocation. For social services under s. 49.52 (1) (d) 46.495 (1) (d) and services under s. 51.423 (2), the department shall distribute not more than $292,368,400 for fiscal year 1995-96 and $292,109,500 for fiscal year 1996-97.
27,2282
Section 2282
. 46.40 (2m) of the statutes is created to read:
46.40 (2m) Federal block grant allocations. (a) Prevention and treatment of substance abuse. For prevention and treatment of substance abuse under 42 USC 300x-21 to 300x-35, the department shall distribute not more than $11,087,200 in fiscal year 1995-96 and not more than $11,285,200 in fiscal year 1996-97.
(b) Community mental health services. For community mental health services under 42 USC 300x to 300x-9, the department shall distribute not more than $2,513,400 in fiscal year 1995-96 and not more than $2,513,400 in fiscal year 1996-97.
27,2283
Section 2283
. 46.40 (3) (a) of the statutes is repealed.
27,2284
Section 2284
. 46.40 (3) (b) 1. of the statutes is repealed.
27,2285
Section 2285
. 46.40 (3) (b) 2. of the statutes is repealed.
27,2286
Section 2286
. 46.40 (3) (b) 3. of the statutes, as created by 1993 Wisconsin Act 446, is renumbered 46.40 (1) (b) and amended to read:
