2. Under current law, DHSS is permitted to distribute supplemental payments to nursing homes to cover the costs of caring for emotionally disturbed residents. This bill eliminates supplemental payments for emotionally disturbed residents effective July 1, 1997.
3. This bill requires DHSS to use interest and investment income of a nursing home and affiliated entities, to the extent required under the state's approved medical assistance plan, to offset allowable interest expenses in determining the nursing home's reimbursement rate. It also requires, as a condition of receiving reimbursement under the medical assistance program, that nursing homes provide information to DHSS, upon request, that DHSS considers necessary to determine allowable interest expenses of the nursing home and of affiliated entities.
4. Under current law, the "capital" component of a nursing home's reimbursement rate is based on the replacement value of a nursing home facility, as determined by a commercial estimator who is paid and contracted for by DHSS. This provision is changed to require the nursing home to pay for a commercial estimator contracted for by DHSS.
5. This bill permits an increase in total payments to nursing home facilities for state fiscal year 1995-96 of no more than 4.25% over that paid for services in state fiscal year 1994-95 and for state fiscal year 1996-97 of no more than 5% over that paid for services in state fiscal year 1995-96.
Under current law, DHSS may reimburse the 3 state centers for the developmentally disabled for the cost of services provided by the centers. This reimbursement is made from state revenues under the medical assistance program and from federal matching funds. The reimbursement is reduced by a specified amount following each placement made under the community reintegration program that involves a relocation from one of the state centers. Under current law, the specified reduction amount for the central Wisconsin center for the developmentally disabled is $55.77 per day; the amount for the northern Wisconsin center for the developmentally disabled is $49.06 per day; and the amount from the southern Wisconsin center for the developmentally disabled is $48.37 per day. This bill changes these amounts, beginning in fiscal year 1995-96, to $232, $225 and $173, respectively.
This bill permits DHSS to impose certain requirements on certain providers of medical assistance services relating to the amount that the provider may claim from DHSS as reimbursement for medical assistance services. DHSS may impose these requirements with respect to all medical assistance services except certain hospital services, skilled nursing facility and intermediate care facility services, and home and community-based services. The bill allows DHSS to require that the providers of these services charge DHSS the lesser of the provider's "best price" for the service or the provider's actual cost for the service, unless a different price is determined by a contract. The bill defines "best price" for a service to mean the lowest price that a provider has accepted or agreed to accept as payment, from any 3rd-party payer, including self-insured plans, the medicare program and insurers, for a like service provided to a customer during the same month that the service is provided. If DHSS requires that a provider charge a particular price for a service, DHSS may not reimburse the provider for more than that amount.
This bill provides that medical assistance reimbursement for home health and private-duty nursing services provided to a medical assistance recipient in a month may not exceed the average monthly cost of nursing home care, as determined by DHSS. The monthly limit does not apply to a medical assistance recipient under the age of 22, to a ventilator-dependent individual or to any other individual if DHSS determines that the cost of providing that individual with nursing home care would exceed the cost of providing the individual with the home health and private-duty nursing services.
This bill provides up to $4,500,000 in federal medical assistance moneys in each fiscal year as a match to costs of a county department of social services or human services that exceed medical assistance reimbursement for home health services, medical day treatment services, mental health services and alcohol and other drug abuse services. Under the bill, county departments that have operating deficits resulting from these costs may apply to DHSS for federal matching funds. DHSS must develop a method, using criteria specified in the bill, to distribute the federal moneys to individual county departments of social services or human services.
Under current law, DHSS must annually submit to the joint committee on finance (JCF) a report on nursing home bed use by medical assistance recipients for the immediate prior 2 fiscal years. If the report indicates a decrease in the number of beds used in the most recent fiscal year from the previous fiscal year, DHSS must calculate the difference in costs between the 2 fiscal years for the provision of the care. The DHSS report to JCF must include a proposal to transfer an amount equal to the difference from the appropriation for medical assistance to the appropriation for the community options program. If within 14 working days after submission of the report JFC does not schedule a meeting to review the action, the secretary of health and social services must transfer the funds.
This bill eliminates the requirements that DHSS annually submit a report to JCF concerning medical assistance-funded bed utilization in nursing homes; that, if the bed utilization has decreased, DHSS calculate a figure that is the difference in costs for the provision of this care; and that, if JCF fails to schedule a meeting to review the issue, funds be transferred from the medical assistance program to the community options program.
This bill requires DHSS to conduct a study of the feasibility of contracting out the operation of the medical assistance program. DHSS is required to report its findings to the governor and to the appropriate standing committees of the legislature before July 1, 1996.
Under current law, DHSS distributes certain supplemental funding under the medical assistance program to county hospitals and county mental health complexes, as determined by DHSS, for inpatient hospital services that are not in excess of the hospitals' customary charges for the services, subject to certain limitations under federal law. This bill allows DHSS to distribute this supplemental funding to county hospitals and county mental health complexes for all hospital services, not just inpatient services.
Other public assistance
Under current law, the state makes payments to certain individuals who meet the resource limitations and the nonfinancial eligibility requirements of the federal SSI program, including needy persons or couples residing in this state who receive benefits under the federal SSI program or whose income, after deducting income excludable under the federal SSI program, is less than the combined benefit level available under the federal SSI program and the state supplement. This bill changes these eligibility criteria. First, the bill eliminates eligibility for the state supplement for those needy persons and couples whose income, after deducting income excludable under the federal SSI program, is less than the combined benefit level available under the federal SSI program and the state supplement. Second, the bill allows DHSS to make certain needy persons or couples residing in this state who receive benefits under the federal SSI program ineligible for the state supplement if DHSS and the secretary of administration approve the change in eligibility and the change is not disapproved by the JCF or the governor. This procedure for changing eligibility criteria is virtually identical to the procedure under current law that allows DHSS to adjust state supplement benefit levels.
Current law allows DHSS the option of administering the state supplement directly or under a contract with the federal government. However, the appropriation from which state supplement administrative expenses are paid authorizes expenditures only for the payment of fees charged by the federal government for administration of the state supplement. This bill allows moneys to be expended from the appropriation to administer the state supplement, either directly or under a contract with the federal government.
Under current law, DHSS supplements the provision of supplemental foods, nutrition education and other services to individuals who meet the eligibility criteria under the federal special supplemental food program for women, infants and children (WIC). This bill eliminates the state supplement to the WIC program.
Under current law, DHSS may distribute funds to nonprofit organizations for certain food stamp outreach projects. The projects must inform individuals with low incomes about the availability, eligibility requirements, application procedures and benefits of the food stamp program and must meet federal requirements to allow federal reimbursement of 50% of the project costs. This bill repeals the provisions that allow DHSS to distribute funds for these outreach projects.
Under current law, if a recipient of certain types of public assistance dies and the recipient's estate is insufficient to pay the cemetery, funeral and burial expenses, the county or the applicable tribal governing body, or other organization responsible for the burial of the recipient, is required to pay certain cemetery, funeral and burial expenses. In particular, the county or tribal governing body or organization is required to pay all of the deceased recipient's cemetery expenses and the lesser of $1,000 or the amount of funeral and burial expenses that are not paid by the deceased recipient's estate or by other persons. Current law also requires DHSS to reimburse the county or tribal governing body or organization for all cemetery expenses that it pays and for those funeral and burial expenses that it is required to pay under the provision. If DHSS approves the reimbursement due to unusual circumstances, DHSS may reimburse a county or applicable tribal governing body or organization for funeral and burial expenses that it pays for the deceased, even if these expenses exceed the amount that the county or tribal governing body or organization is required to pay under the provision.
Under this bill, the county or tribal governing body or organization is required to pay the lesser of $1,000 or the amount of cemetery expenses that are not paid by the estate of the deceased and other persons. For funeral and burial expenses, the county or tribal governing body or organization is required to pay the lesser of the amount of funeral and burial expenses that are not paid by the deceased recipient's estate and other persons or the following: 1) if the total funeral and burial expenses are $1,000 or less, the amount of these expenses; 2) if the total funeral and burial expenses are more than $1,000 but not more than $2,000, 50% of the total funeral and burial expenses; and 3) if the total funeral and burial expenses are more than $2,000, $0. DHSS is required to reimburse a county or applicable tribal governing body for any cemetery, funeral or burial expenses that it is required to pay under these provisions and, if DHSS approves the reimbursement due to unusual circumstances, for any additional expenses.
Under current law, counties and tribal governing bodies are authorized to recover overpayments under the food stamp, AFDC and medical assistance programs; they are also authorized to retain a percentage of the amount recovered. Current law also authorizes DHSS to certify certain overpayments under these programs to the department of revenue (DOR) for offset against any tax refunds due the recipient of the overpayment. This bill allows DHSS to charge counties and tribal governing bodies for the administrative costs that are incurred by DOR and that are related to certification of these amounts. Recovered administrative costs may be used by DHSS for reducing error and fraud in the food stamp, AFDC and medical assistance programs.
Under current law, overpayments under the food stamp, AFDC and medical assistance programs are often recovered under a recovery plan. This bill authorizes a county or tribal governing body to assess persons who fail to comply with the terms of a recovery plan a fee in an amount not to exceed 10% of the amount remaining to be recovered at the time of the noncompliance. The fee may not be assessed more than once with respect to the same overpayment and may be assessed only if a person is no longer eligible for the type of benefits, such as food stamps, AFDC or medical assistance, that were overpaid. The fee may be retained by the county or the tribal governing body.
Under current law, DHSS may contract with a county to administer a work experience and job training program for noncustodial parents who fail to pay child support or to meet their children's needs for support as a result of unemployment or underemployment. This program is commonly referred to as the "children-first program". A judge may order, in certain child support actions, a noncustodial parent to participate in the children-first program if the noncustodial parent lives in the county in which the court action occurs and that county has a children-first program. This bill permits a judge to order a noncustodial parent to participate in a children-first program regardless of whether the noncustodial parent resides in the county in which the court action occurs. However, if the parent resides in a county other than the county in which the court action occurs, the judge may order the parent to participate in a children-first program only if the parent's county of residence has a children-first program and that county agrees to enroll the parent in that program.
Under current law, DHSS, a county or an elected tribal governing body that provides certain types of public assistance as the result of an injury, sickness or death that results in a possible recovery of an indemnity from a 3rd party, including an insurer, may require an assignment of the right to the indemnity from the public assistance recipient. Under this bill, this assignment is automatic upon the application for public assistance.
Current law provides for subrogation of certain claims against a 3rd party by a public assistance recipient, if the public assistance is provided as a result of the occurrence of an injury, sickness or death that creates a claim or cause of action against the 3rd party. This bill establishes certain notice requirements for claims assigned or subrogated under these provisions. The notice requirements generally apply to the attorney retained to represent the public assistance recipient, or his or her estate, in asserting the claim. If no attorney is retained, the notice requirements apply to the public assistance recipient or his or her guardian or, if the recipient is deceased, to the personal representative of the recipient's estate. A person who is subject to the notice requirements is required to provide notice by certified mail to DHSS as soon as practicable after the filing of the action asserting the claim; the intervention in, or consolidation of, the action; or the settlement of all or part of the claim.
Current law provides that the provision of medical benefits under the general relief program or the RNIP program or under medical assistance constitutes an assignment to DHSS, or to a county providing medical assistance or benefits, to the extent of the medical benefits or assistance provided and for benefits to which the recipient would be entitled under any policy of health and disability insurance. A similar provision assigns rights under uninsured health plans, for example, self-insured employer health plans, although this provision covers only medical assistance. Separate provisions also prohibit the imposition of requirements on DHSS, as an assignee, that are different from those imposed on any other agent or assignee of a person covered under the health and disability insurance policy or under the uninsured health plan.
This bill makes several changes to these provisions. The bill amends the provision covering assignments by uninsured health plans to cover medical benefits under the general relief and RNIP programs, or, after January 1, 1996, the emergency medical relief program, as well as medical assistance. Under current law, only the provision regarding assignment of rights under health and disability policies applies to counties providing medical assistance or benefits, as well as to DHSS. Under this bill, all of the provisions require assignment not only to DHSS, but also to counties providing medical assistance or benefits and to health maintenance organizations with which DHSS has contracted to provide medical assistance or benefits.
This bill requires DHSS to seek a waiver from the secretary of the federal department of agriculture to apply certain special eligibility criteria to migrant workers and their dependents in determining eligibility for benefits under the food stamp program. The bill uses the definition of migrant worker that is used for the waiver that the bill requires DHSS to request for migrant workers under the medical assistance program. If the waiver is granted and in effect, DHSS must determine food stamp eligibility for a migrant worker and his or her dependents using an income-averaging method, if the migrant worker and his or her dependents are not eligible for food stamps using prospective budgeting.
Under current law, DHSS has an appropriation for employment and training programs, which include the JOBS program and the food stamp employment and training project. Under this appropriation, funds that are not encumbered by December 31 of each year lapse to the general fund on the next January 1 unless transferred to the next calendar year by JCF.
This bill allows DHSS to carry forward for a county funds that are committed to the county under a performance-based contract for a specific calendar year and that are earned by the county in that year to the following calendar year, if the carry-forward is approved by the secretary of administration, without approval of JCF. The funds carried forward do not affect a county's base allocation.
The low-income energy assistance program (LIEAP) is a federal block grant program designed to support energy costs incurred by low-income households. Current law requires that $2,400,000 of LIEAP block grant funds be allocated to the payment of crisis assistance benefits to meet weather-related or fuel supply shortage emergencies. This bill eliminates this requirement and allows DHSS or, after July 1, 1996, DOA to determine the amount of the allocation.
Health
Under current law, with certain exceptions, the 3-member cost containment commission is responsible for reviewing and approving the following proposed projects:
A capital expenditure in excess of $1,000,000 made by or on behalf of a hospital.
The implementation of new services to a hospital that exceed $500,000 in a 12-month period.
An expenditure in excess of $500,000 made by or on behalf of a hospital, independent practitioner, limited liability company, partnership, unincorporated medical group or service corporation for clinical medical equipment.
The purchase or acquisition of a hospital.
The construction or operation of an ambulatory surgery center or a home health agency.
Current law sets forth criteria that the commission must use in its review of an application for project approval. These criteria focus on the economic efficiency of and need for the proposed projects. The first priority of the commission in applying the criteria must be cost containment.
The cost containment council represents economic, provider, scientific and consumer viewpoints. It advises the commission, reviews proposed commission rules and periodically reports on the performance of the commission and its operations.
This bill eliminates the cost containment commission, the cost containment council and the capital expenditure review program.
Under current law, DHSS must investigate the concept of regulating a new category of health care providers known as rural medical centers.
This bill eliminates that requirement and establishes rural medical centers as a category of health care providers that, beginning on January 1, 1997, must be licensed, inspected and otherwise regulated by DHSS. Under the bill, a facility may be regulated as a rural medical center if it is located in a county, city, town or village that has a population of less than 15,000 and in an area that the federal bureau of the census has not defined as an urbanized area, and if it provides 2 or more health care services. "Health care services" means those provided by a hospital, nursing home, hospice, rural health clinic or ambulatory surgery center; or home health services, outpatient physical therapy services, end-stage renal disease services or other services that are specified by DHSS by rule.
The bill establishes licensing procedures and requires that DHSS promulgate rules that establish standards for operation of rural medical centers, minimum requirements for license issuance, licensure fee amounts, and procedures and criteria for waiver of or variance from standards and requirements. The bill authorizes DHSS to conduct unannounced inspections of rural medical centers and requires a rural medical center to provide access to any patient health care records necessary to fulfill the purpose of any DHSS inspections or investigations. The bill prohibits an unlicensed entity from using the phrase "rural medical center" to describe itself, prohibits intentional interference with any investigation by DHSS of alleged violations, prohibits certain intentional retaliation or discrimination against employes or patients and prohibits intentional destruction or modification of original inspection reports.
Under current law, DHSS allocates $50,000 in each fiscal year as a grant for the provision of direct health care services to migrant workers and their families. A migrant worker is any person who temporarily leaves a principal place of residence outside of this state and comes to this state for not more than 10 months in a year to accept seasonal employment related to unmanufactured agricultural or horticultural commodities. This bill eliminates the migrant health care program.
Under current law, DHSS is authorized to conduct plan reviews of all capital construction and remodeling for nursing homes and hospitals, to ensure compliance with certain federal life safety code requirements for nursing homes and with certain physical plant requirements. At the same time, DILHR must examine plans of public buildings (which include hospitals and nursing homes) for compliance with building code requirements. Both DHSS and DILHR charge fees for these plan reviews.
Beginning on October 1, 1995, this bill exempts hospitals and nursing homes from DILHR's review for compliance with building code requirements. Instead, the bill requires DHSS to conduct plan reviews of hospitals and nursing homes for compliance with both the building code requirements and with the physical plant and life safety code requirements. The bill requires DHSS to promulgate rules that establish fees for the reviews that are less than the sum of the amounts collected by both DHSS and DILHR. However, until DHSS promulgates these rules or until June 30, 1996, whichever is earlier, the bill permits DHSS to collect fees that are equal to the amounts collected by both DHSS and DILHR.
Under current law, a community-based residential facility (C-BRF) is annually licensed by DHSS and annually pays a fee, plus a per resident fee, based on the C-BRF's licensed capacity. Certain adult family homes are annually licensed by county departments of social services, human services, community programs or developmental disabilities services or by DHSS.
Beginning on January 1, 1996, this bill changes the licensure period for a C-BRF and for a licensed adult family home to 2 years, increases biennial license fees for C-BRFs and establishes license fees for licensed adult family homes.
Under current law, DHSS may order certain sanctions against a C-BRF that violates specific statutes or rules and, if the C-BRF fails to comply with such an order, may directly assess forfeitures (civil monetary penalties). Under this bill, if DHSS provides notice and explanations of sanctions or penalties, DHSS may, without issuing an order, assess forfeitures against a C-BRF that violates statutes or rules.
Under current law, DHSS must award grants to local health departments to fund specified activities related to lead poisoning or lead exposure, including educational programs, screening, care coordination and follow-up services such as lead inspection. Certain grants are awarded under criteria that ensure that funding is provided for areas, including Milwaukee, with significant incidence of lead poisoning or lead exposure. This bill eliminates these grants under the program.
Under current law, DHSS provides funds to the Marquette University School of Dentistry to provide dental services at clinics in the city of Milwaukee. This bill provides that the school of dentistry must also use the funds to provide dental services at correctional centers in Milwaukee County.
Under current law, DHSS is authorized to award grants to provide mammography services to women who are 40 years or older. The women must live in any of 12 rural counties that are specified in rules promulgated by DHSS as having the highest incidence of late-stage breast cancer in this state.
This bill expands the purpose of grants for mammography services to include breast cancer screening services and makes these services available statewide to women who are 40 years of age or older.
Under current law, DHSS must carry out a statewide immunization program to eliminate mumps, measles, German measles, diptheria, whooping cough, poliomyelitis and any other diseases that DHSS has specified by rule and to protect against tetanus. Annually by July 1 until July 1, 1994, DHSS must submit a report for distribution to the standing committees of the legislature on the success of the statewide immunization program. This bill extends the reporting requirement until July 1, 1996.
Under current law, DHSS is required to distribute not more than $375,600 in fiscal year 1993-94 and not more than $491,500 in fiscal year 1994-95 to reimburse or supplement the reimbursement of the cost of certain drugs for certain individuals who are infected with the human immunodeficiency virus (HIV). This bill removes this statutory allocation. This allows DHSS to determine the amount that will be used for drug reimbursement for HIV-infected individuals, subject to the availability of funds in the pertinent appropriation.
Children
Under current law, DHSS investigates and licenses child welfare agencies, group homes, shelter care facilities (nonsecure places of temporary care and physical custody for children) and day care centers. Currently, DHSS, a county department and, if licensed to do so by DHSS, a child welfare agency investigate and license foster homes and treatment foster homes. This bill requires that, as part of the prelicensing investigation of a child welfare agency, group home, shelter care facility or day care center, DHSS, with the assistance of DOJ, conduct a background investigation of the applicant for the license. If the applicant is applying for a license to operate a day care center for 4 to 8 children, DHSS must also conduct a background investigation of the employes and prospective employes of the day care center. The bill also requires a shelter care facility, child welfare agency, group home or day care center that cares for 9 or more children to conduct a background investigation of all employes and prospective employes as a condition of initial licensure or license renewal. Under the bill, if the person being investigated is a nonresident, or at any time within the preceding 5 years has been a nonresident, or if the person conducting the investigation has a reasonable basis for further investigation of the person, the person conducting the investigation must require the person to be photographed and fingerprinted and DOJ may submit the fingerprints to the federal bureau of investigation for the purpose of verifying the identity of the person fingerprinted and obtaining his or her arrest and conviction record. DHSS may not issue a license to or renew the license of, and a shelter care facility, child welfare agency, group home or day care center may not employ, any person who has been convicted of a felony drug violation, who has had imposed on him or her an increased penalty for habitual criminality, for certain domestic abuse offenses, for use of a dangerous weapon, for committing a violent crime in a school zone, for use of a bulletproof garment, for concealing his or her identity or for a hate crime or, subject to certain exceptions, who has been convicted of a crime against life and bodily security, a crime against sexual morality or a crime against children. DHSS may order a child welfare agency, group home, shelter care facility or day care center that employs a person who has been so convicted or so punished to terminate the employment of that person immediately on receipt of the order. The bill also requires DHSS, a county department or a child welfare agency to conduct the same background investigation of an applicant for a foster home or a treatment foster home license and any adult resident of the home and to deny licensure to any applicant who has been so convicted or so punished.
Under current law, no person may establish a shelter care facility without first obtaining a license from DHSS. Current law does not specify a licensure period or a license fee for shelter care facilities. This bill establishes a 2-year licensure period for shelter care facilities and a biennial fee of $180, plus $24 per child, based on licensed capacity.
Under current law, a child welfare agency that provides care and maintenance for children must pay a biennial license fee of $75, plus $10 per child, based on licensed capacity. This bill raises that fee to $180, plus $24 per child, based on licensed capacity.
Under current law, a child welfare agency that places children in foster homes or group homes must pay a biennial license fee of $200. This bill raises that fee to $220.
Under current law, a group home must pay a biennial license fee of $75, plus $10 per child, based on licensed capacity. This bill raises that fee to $180, plus $24 per child, based on licensed capacity.
Under current law, a day care center that provides care and supervision for 9 or more children must pay a biennial license fee of $25, plus $5 per child, based on licensed capacity. This bill raises the per child fee to $10 per child.
Under current law, DHSS may order certain sanctions against a child welfare agency, shelter care facility, group home or day care center (licensee) that violates a provision of licensure or a rule promulgated by DHSS. If the licensee fails to comply with such an order, DHSS may, after providing notice and an explanation of the penalties and appeal process, directly assess forfeitures (civil monetary penalties) of not less than $10 or more than $50 for each day of violation. This bill increases that maximum daily forfeiture amount to $1,000. The bill also permits DHSS, after providing notice and an explanation of the penalties and appeal process, to assess a forfeiture against a licensee that violates a provision of licensure or a rule, without first ordering a sanction against the licensee.
Under current law, a person whose birth parent's rights have been terminated, or who has been adopted, in this state may request DHSS to provide the person, after the person reaches 18 years of age, with medical or genetic information filed with DHSS by the person's birth parents, with a copy of the person's original birth certificate and with the identity and location of the person's birth parents. If the person's birth parent has not filed the medical or genetic information with DHSS or has not filed an affidavit authorizing DHSS to disclose the person's original birth certificate or the identity and location of the birth parent, DHSS must conduct a search for the birth parent to obtain the medical or genetic information or to inform the birth parent that he or she may file an affidavit authorizing that disclosure. This process is called the adoption search program. This bill permits DHSS to contract with a county department or a licensed child welfare agency to administer the adoption search program.
Under current law, DHSS provides adoption services for children with special needs. This bill requires DHSS to develop a plan by July 1, 1997, for contracting out the adoption services currently provided by DHSS for children with special needs.
Under current law, DHSS administers various child care grant programs. Current law specifies certain procedures and eligibility criteria that DHSS must follow in awarding grants under those programs. This bill simplifies those procedures and criteria by eliminating certain requirements specified in current law.
Under current law, DHSS distributes state revenues, as community aids, and federal child care grant moneys to counties for child care services for parents who are gainfully employed and who need child care services (low-income child care); for parents who are at-risk of becoming eligible for AFDC (at-risk child care); and for parents who need child care services to prevent or remedy child abuse or neglect, to alleviate stress in the family or to preserve the family unit (respite child care). This bill requires DHSS to recover overpayments made for low-income, at-risk and respite child care. The bill requires DHSS to promulgate rules regarding the recovery of those child care overpayments.
Currently, if the at-risk child care funds distributed to a county are insufficient to meet the needs of all eligible parents, the county must distribute those funds to the following persons according to the following order of priority: 1) to parents who are working and who have been recipients of AFDC within the last 12 months (transitional child care); 2) to parents who are working and who have been recipients of AFDC, but not within the last 12 months (post-transitional child care); and 3) to participants in the new hope project (a program to assist low-income people in finding jobs). This bill eliminates the order of priority for at-risk child care funds.
Under current law, unspent or unencumbered child care funds that DHSS carries forward from one calendar year to the next may be used to provide child care in counties with unmet needs, to provide child care start-up and expansion grants and to provide training for child care providers. This bill eliminates the use of those funds for child care start-up and expansion grants and permits DHSS to use those funds to provide child care for certain recipients of AFDC and for former recipients of AFDC and to automate state child care licensing.
Current law appropriates a sum sufficient to provide state aid for certain county-administered public assistance programs, including AFDC, and for the cost of foster care and treatment foster care provided by certain nonlegally responsible relatives under state-administered or county-administered programs. Currently, this aid for the cost of this foster care by nonlegally responsible relatives is provided by reimbursing counties for their costs of providing this foster care. As a result, counties need not use community aids foster care funds for foster care provided by nonlegally responsible relatives under state-administered or county-administered programs. This bill limits the amount that may be paid from the sum sufficient appropriation to a county for foster care provided by nonlegally responsible relatives to the amount that the county received for these reimbursements in 1994.
Under current law, the child abuse and neglect prevention board awards general purpose revenues (GPR), program revenues (PR) received by the board as contributions, gifts, grants and bequests and segregated revenues (SEG) received by the children's trust fund as contributions, gifts, grants and bequests, to nonprofit organizations and public agencies to provide parenting education services and culturally competent outreach services to the parents of newborn infants (right from the start program). This bill eliminates GPR funding for this program and provides instead for PR funding from duplicate birth certificate fees for the program. The bill also increases the fee for a copy of a birth certificate from $10 to $15 and increases the amount of that fee that is credited to the board from $5 to $7.50.
Under current law, DHSS awards grants to counties that have high numbers of substantiated cases of child abuse and neglect to provide 24-hour crisis and respite care for abused and neglected children (children-in-crisis program). This bill eliminates this program.
Under current law, DHSS must allocate $250,000 in each fiscal year to enter into a contract with an organization to provide services in Milwaukee County to divert youths from gang activities. In addition, current law requires DHSS to allocate $300,000 in each fiscal year to that organization for alcohol and other drug abuse (AODA) education and treatment services for participants in the organization's youth diversion program. This bill eliminates the allocation to that organization for AODA education and treatment.
Mental illness and developmental disabilities
Under current law, a law enforcement officer or a juvenile court intake worker may take a person into custody, in a process known as emergency detention, if the officer or worker has cause to believe that the person is mentally ill, drug dependent or developmentally disabled and if the person evidences certain dangerousness. The law enforcement officer must transport the person to a mental health treatment facility, where the treatment director must, within 24 hours, determine if the person must be detained and, if the person consents, treated. If the person is detained, he or she must be released within 72 hours, excluding holidays and weekends, or a petition for commitment must be filed against the person. Individuals who act in accordance with the authorization provided by these laws are not liable in civil court for actions taken in good faith.
This bill authorizes a treatment director of a mental health treatment facility or his or her designee to evaluate and diagnose, as well as treat, an individual who so consents and who has been transported to the facility under emergency detention or who has voluntarily entered the facility. The immunity in civil court that is provided to individuals who act in accordance with the laws under emergency detention is, by the bill, extended to the evaluation and diagnosis of persons under emergency detention or who voluntarily enter mental health treatment facilities. The bill also specifically extends immunity to the making of a determination that an individual has or does not have mental illness or is or is not dangerous. Lastly, the bill extends immunity to a director of a treatment facility, or his or her designee, who under a court order evaluates, diagnoses or treats an individual who is confined in a jail.
This bill requires DHSS to investigate the feasibility of and analyze the potential savings and efficiencies of contracting with a private vendor to operate the state centers for the developmentally disabled and selling the state centers for the developmentally disabled to such a private vendor. By June 30, 1996, DHSS must report the findings resulting from its investigation and analysis to the appropriate standing committees of the legislature and to the governor.
Under this bill, beginning on January 1, 1996, a county must annually establish, from the sum of the county's annual allocation of moneys under the community integration program for persons relocated or meeting reimbursable levels of care (commonly known as "CIP II") and under the community options program, a maximum amount of not more than 25% for expenditure for services to persons residing in C-BRFs. The county must deny eligibility to these persons if they are initially applying for CIP II or community options program services and if the funding for their care would exceed the 25% maximum, unless DHSS, under criteria promulgated as rules, grants an exception based on the person's hardship that would result if the requirement is enforced. If a county's services, under CIP II or the community options program, to persons residing in community-based residential facilities exceed the 25% maximum as of January 1, 1996, the county may seek a waiver of the requirement from DHSS. DHSS must provide technical assistance to counties to explore alternative methods of providing services. DHSS also must submit, by October 1, 1995, rules establishing criteria for hardship exceptions, as proposed, and the proposed standards for granting variances to counties to DOA for review and approval.
Under this bill, community options program services that are funded solely from state general purpose revenues may not be used to provide services in a C-BRF with more than 8 beds unless DHSS approves. DHSS is authorized to approve the provision if the C-BRF is composed of independent apartments for certain disabled or elderly residents or if the C-BRF meets standards that, under the bill, DHSS must establish by January 1, 1996. DHSS must submit the proposed standards to DOA for approval by October 1, 1995.
This bill requires DHSS to develop, by January 1, 1996, a model contract for purchase of long-term community support services under the community options program for persons who reside in C-BRFs. Under the bill, county departments of social services, human services, community programs or developmental disabilities services, agencies of county and tribal governments that are directed by county or tribal commissions on aging and private nonprofit agencies that contract with providers for these services must use the model contract.
Under current law, long-term support services under the community options program are funded from state revenues; under a waiver of federal medicaid laws, home and community-based services under the community options program are funded from a combination of state revenues and federal medicaid funds. The latter funding is commonly known as "COP waiver" funding. If a person who is eligible for community options program services and for medical assistance refuses the offer of community options program services that are funded under the "COP waiver", the person may not receive community options program services that are funded solely from state revenues, except for services funded during a 90-day period in which an application for "COP waiver" funding is processed. A person who is denied services on this basis may not request a hearing to review the denial.
This bill expands the limitation on use of solely state-funded community options program services by denying these services to persons who are eligible for and are offered and yet refuse home and community-based services under the community integration programs for persons who are relocated from certain institutions or who meet certain level-of-care requirements.
Current federal medicaid law prohibits federal funding, under this state's medical assistance program, of mentally ill persons aged 21 to 64 who receive services in a facility that the federal health care financing administration finds is an institution for mental diseases (IMD). Currently, 2 programs under DHSS fund, from state revenues, services for persons who reside in or who are relocated into communities from facilities that are found to be IMDs.
This bill expands eligibility for a program that funds services for persons who reside in or who are relocated from IMDs. The bill permits funding, at a rate that is 90% of the medical assistance reimbursement rate for the IMD in fiscal year 1987-88, for community-based care for persons who are at least 65 and are relocated from an IMD, if the IMD closes a bed for the relocation.
This bill eliminates an appropriation to DHSS to provide community mental health protection and advocacy services.
This bill eliminates a program under which DHSS must award a grant to a private nonprofit organization to collect and disseminate information on Alzheimer's disease, to coordinate public awareness activities related to the disease and to provide training, technical assistance and training material to certain entities that provide services to persons with the disease.
This bill revises the program of mental health services for severely emotionally disturbed children. The bill authorizes DHSS to transfer funds, for use as inpatient and community mental health services for severely emotionally disturbed children, from the medical assistance appropriation for distribution to applying counties that meet certain requirements. In order to receive the funding, a county must be the recipient of a federal grant for comprehensive community mental health services for children with serious emotional disturbances; be the recipient of any other grant for services for severely emotionally disturbed children; or meet requirements for participating in the integrated services programs for children with severe disabilities and meet certain other requirements. The bill requires that a county that is applying for the funds submit a proposed plan for children who are served under the program to be enrolled in a limited services health organization at the time that the program terminates. Funding that is used under this revised program that is not encumbered by a recipient county by the June 30 that is 24 months after the fiscal year in which the funds were distributed lapses to the medical assistance appropriation.
The bill also permits moneys received as payments in restitution of property that is damaged at the Mendota or Winnebago mental health institutes or at the state centers for the developmentally disabled and money that is received from the sale of surplus property at the mental health institutes or state centers for the developmentally disabled to be used for replacement of the damaged property.
Other health and social services
