SECTION 2235. 46.27 (11m) of the statutes is created to read:
46.27 (11m) LIMITATION. The department may not allocate funds to a county to provide long-term community support services that substitute for the benefit under s. 49.46 (2) (a) 4. a. or (b) 6. a. for persons who meet the condition specified under sub. (6r) (b) 1. but who are eligible for medical assistance only under s. 49.47.
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.
SECTION 2237. 46.275 (2) (intro.) of the statutes is amended to read:
46.275 (2) DEPARTMENTAL POWERS AND DUTIES. (intro.) The department may request a waiver from the secretary of the U.S. federal department of health and human services, under 42 USC 1396n (c), authorizing the department to integrate medical assistance recipients who reside in state centers for the developmentally disabled into their communities by providing home and community-based services as part of the medical assistance program, except as provided in sub. (5g). If the department requests this waiver, it shall include all assurances required under 42 USC 1396n (c) (2) in its request. If the department receives this waiver, at the end of the 3-year period during which the waiver remains in effect the department may request an additional 3-year extension of the waiver. If the department receives this waiver, it shall:
SECTION 2238. 46.275 (4) (a) of the statutes is amended to read:
46.275 (4) (a) Any Except as provided in sub. (5g), any medical assistance recipient living in a state center for the developmentally disabled is eligible to participate in the program. Such a recipient may apply, or any person may apply on behalf of such a recipient, for participation in the program.
SECTION 2239. 46.275 (5) (a) of the statutes is amended to read:
46.275 (5) (a) Medical Except as provided in sub. (5g), medical assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriations under s. 20.435 (1) (b) and (o). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, medical assistance reimbursement is also available for services provided jointly by these counties.
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.
SECTION 2241. 46.275 (5d) of the statutes is created to read:
46.275 (5d) WAIVER AMENDMENT. (a) The department shall request from the secretary of the federal department of health and human services an amendment to the waiver specified in sub. (2) to allow the department to receive federal financial participation to continue to provide, notwithstanding sub. (5g), home and community-based services that substitute for the benefit under s. 49.46 (2) (a) 4. a. or (b) 6. a. to an individual who is eligible for medical assistance only under s. 49.47; who was receiving the services, provided as a medical assistance benefit, on January 1, 1996; and who has continued to receive those services or the services, provided as a medical assistance benefit, that are described in s. 46.27 (11m), 46.277 (5g) (c) or 46.278 (6m) or specified in s. 49.46 (2) (a) 4. c. or (b) 6. a. since that date.
(b) If the waiver amendment under par. (a) is granted and remains in effect, the department shall provide the services described in par. (a) to individuals covered by the waiver amendment, notwithstanding sub. (5g).
****NOTE: This is reconciled s. 46.275 (5d). This section has been affected by a draft with the following LRB #: 0444/1.
SECTION 2242. 46.275 (5g) of the statutes is created to read:
46.275 (5g) LIMITATION. The department may not provide under this section home and community-based services that substitute for the benefit under s. 49.46 (2) (a) 4. a. or (b) 6. a. for persons who are eligible for medical assistance only under s. 49.47.
SECTION 2243. 46.277 (1) of the statutes is amended to read:
46.277 (1) LEGISLATIVE INTENT. The intent of the program under this section, except as provided in sub. (5g) (c), is to provide home or community-based care to serve in a noninstitutional community setting a person who meets eligibility requirements under 42 USC 1396n (c) and is relocated from an institution other than a state center for the developmentally disabled or meets the level of care requirements for medical assistance reimbursement in a skilled nursing facility or an intermediate care facility, except that the number of persons who receive home or community-based care under this section is not intended to exceed the number of nursing home beds that are delicensed as part of a plan submitted by the facility and approved by the department. The intent of the program is also that counties use all existing services for providing care under this section, including those services currently provided by counties.
****NOTE: This is reconciled s. 46.277 (1). This section has been affected by a draft with the following LRB #: 0444/1.
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.
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).
SECTION 2246. 46.277 (2) (intro.) of the statutes is amended to read:
46.277 (2) DEPARTMENTAL POWERS AND DUTIES. (intro.) The department may request a waiver 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 a skilled nursing facility or an intermediate care facility, in their communities by providing home or community-based services as part of medical assistance, except as provided in sub. (5g) (c). The number of persons for whom the waiver is requested may not exceed the number of nursing home beds that are delicensed as part of a plan submitted by the facility and approved by the department. If the department requests a waiver, it shall include all assurances required under 42 USC 1396n (c) (2) in its request. If the department receives this waiver, it may request one or more 3-year extensions of the waiver under 42 USC 1396n (c) and shall perform the following duties:
****NOTE: This is reconciled s. 46.277 (2) (intro.). This section has been affected by a draft with the following LRB #: 0444/1.
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.
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.
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.
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.
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.
SECTION 2252. 46.277 (4) (a) of the statutes, as affected by 1995 Wisconsin Act .... (this act), 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 and except as provided in sub. (5g) (c). 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.
****NOTE: This is reconciled s. 46.277 (4) (a). This section has been affected by a draft with the following LRB #: 0444/1.
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.
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.
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 an assisted living facility, as defined in s. 50.01 (1d). Funding of the services may not exceed 85% of the statewide rate for reimbursement under s. 49.45 (6m), as determined by the department under s. 49.45 (6m) (L).
SECTION 2256. 46.277 (5d) of the statutes is created to read:
46.277 (5d) WAIVER AMENDMENT. (a) The department shall request from the secretary of the federal department of health and human services an amendment to the waiver specified in sub. (2) to allow the department to receive federal financial participation to continue to provide, notwithstanding sub. (5g) (c), home or community-based services that substitute for the benefit under s. 49.46 (2) (a) 4. a. or (b) 6. a. to an individual who is eligible for medical assistance only under s. 49.47; who was receiving the services, provided as a medical assistance benefit, on January 1, 1996; and who has continued to receive those services or the services, provided as a medical assistance benefit, that are described in s. 46.27 (11m), 46.275 (5g) or 46.278 (6m) or specified in s. 49.46 (2) (a) 4. c. or (b) 6. a. since that date.
(b) If the waiver amendment under par. (a) is granted and remains in effect, the department shall provide the services described in par. (a) to individuals covered by the waiver amendment, notwithstanding sub. (5g) (c).
****NOTE: This is reconciled s. 46.277 (5d). This section has been affected by a draft with the following LRB #: 0444/1.
SECTION 2257. 46.277 (5g) (title) of the statutes is amended to read:
46.277 (5g) (title) LIMITATION LIMITATIONS ON SERVICE.
SECTION 2258. 46.277 (5g) of the statutes is renumbered 46.277 (5g) (a).
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).
SECTION 2260. 46.277 (5g) (c) of the statutes is created to read:
46.277 (5g) (c) The department may not provide under this section home or community-based services that substitute for the benefit under s. 49.46 (2) (a) 4. a. or (b) 6. a. for persons who are eligible for medical assistance only under s. 49.47.
****NOTE: This is reconciled s. 46.277 (5g) (c). This section has been affected by a draft with the following LRB #: 0444/1.
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.
SECTION 2262. 46.278 (1) of the statutes is amended to read:
46.278 (1) LEGISLATIVE INTENT. The intent of the program under this section, except as provided in sub. (6m), is to provide home or community-based care to serve in a noninstitutional community setting a person who meets eligibility requirements under 42 USC 1396n (c) and who is diagnosed as developmentally disabled under the definition specified in s. 51.01 (5) and relocated from an institution other than a state center for the developmentally disabled or who meets the intermediate care facility for the mentally retarded level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded and is ineligible for services under s. 46.275 or 46.277. The intent of the program is also that counties use all existing services for providing care under this section, including those services currently provided by counties.
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.
SECTION 2264. 46.278 (2) (a) of the statutes is amended to read:
46.278 (2) (a) The department may request a waiver 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, in their communities by providing home or community-based services as part of medical assistance, except as provided in sub. (6m). If the department requests a waiver, it shall include all assurances required under 42 USC 1396n (c) (2) in its request.
SECTION 2265. 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 and is ineligible for service under s. 46.275 or 46.277 is eligible to participate in the program, except that the number of participants may not exceed the number approved under the waiver received under sub. (3) and except that sub. (6m) applies. 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.
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.
SECTION 2267. 46.278 (6d) of the statutes is created to read:
46.278 (6d) WAIVER AMENDMENT. (a) The department shall request from the secretary of the federal department of health and human services an amendment to the waiver specified in sub. (2) to allow the department to receive federal financial participation to continue to provide, notwithstanding sub. (6m), home or community-based services that substitute for the benefit under s. 49.46 (2) (a) 4. a. or (b) 6. a. to an individual who is eligible for medical assistance only under s. 49.47; who was receiving the services, provided as a medical assistance benefit, on January 1, 1996; and who has continued to receive those services or the services, provided as a medical assistance benefit, that are described in s. 46.27 (11m), 46.275 (5g) or 46.277 (5g) (c) or specified in s. 49.46 (2) (a) 4. c. or (b) 6. a. since that date.
(b) If the waiver amendment under par. (a) is granted and remains in effect, the department shall provide the services described in par. (a) to individuals covered by the waiver amendment, notwithstanding sub. (6m).
****NOTE: This is reconciled s. 46.278 (6d). This section has been affected by a draft with the following LRB #: 0444/1.
SECTION 2268. 46.278 (6m) of the statutes is created to read:
46.278 (6m) LIMITATION. The department may not provide under this section home or community-based services that substitute for the benefit under s. 49.46 (2) (a) 4. a. or (b) 6. a. for persons who are eligible for medical assistance only under s. 49.47.
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:
SECTION 2270. 46.293 (title) of the statutes is created to read:
46.293 (title) Specialized programs for the blind and visually impaired.
SECTION 2271. 46.295 (title) of the statutes is created to read:
46.295 (title) Interpreters for the hearing-impaired.
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.
SECTION 2273. 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) (6) (mc) and (7) (md) and the state supplement under s. 20.435 (4) (cr) (7) (cr) as provided in this subsection.
SECTION 2274. 46.30 (4) (cm) of the statutes is renumbered 46.30 (4) (cm) 1. and amended to read:
46.30 (4) (cm) 1. The department shall allocate distribute all of the funds under s. 20.435 (4) (cr) (7) (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.
SECTION 2275. 46.30 (4) (cm) 2. of the statutes is created to read:
46.30 (4) (cm) 2. The department may contract with the department of industry, labor and human relations to distribute the funds under this paragraph.
SECTION 2276. 46.30 (4) (d) of the statutes is amended to read:
46.30 (4) (d) Before January 1 of each year the department or, if par. (cm) 2. applies, the department of industry, labor and human relations shall contract with each agency and organization being funded, specifying the amount of money the organization will receive and the activities to be carried out by the organization.
SECTION 2277. 46.31 of the statutes is repealed.
****NOTE: This is reconciled s. 46.31. This section has been affected by drafts with the following LRB numbers: -1601/1 and -2153/1.
SECTION 2278. 46.32 of the statutes is repealed.
SECTION 2279. 46.40 (1) (title) of the statutes is amended to read:
