AB150-engrossed,997,1111
49.45
(39) School medical services. (a)
Definitions. In this subsection:
AB150-engrossed,997,1512
1. "School" means a public school described under s. 115.01 (1) or a charter
13school, as defined in s. 115.001 (1). It includes school-operated early childhood
14programs for developmentally delayed and disabled 4-year-old and 5-year-old
15children.
AB150-engrossed,997,1816
2. "School medical services" means health care services that are provided in a
17school to children who are eligible for medical assistance and that are appropriate
18to a school setting, under rules promulgated by the department.
AB150-engrossed,998,319
(b)
Payment for school medical services. If a school district elects to provide
20school medical services and meets all requirements under par. (c), the department
21shall reimburse the school district for the federal share of allowable charges for the
22school medical services that it provides and for allowable administrative costs. The
23department shall promulgate rules establishing a methodology for making
24reimbursements under this paragraph. All other expenses for the school medical
25services shall be paid for by the school district with funds received from state or local
1taxes. The school district shall comply with all requirements of the federal
2department of health and human services for receiving federal financial
3participation.
AB150-engrossed,998,64
(c)
Certification and reporting requirements. The department shall promulgate
5rules establishing specific certification and reporting requirements with respect to
6school medical services under this subsection.
AB150-engrossed,998,108
49.45
(40) Periodic record matches. The department shall cooperate with the
9department of industry, labor and human relations in matching records of medical
10assistance recipients under s. 49.32 (7).
AB150-engrossed,998,1212
49.45
(41) Mental health crisis intervention services. (a) In this subsection:
AB150-engrossed,998,1613
1. "Mental health crisis intervention services" means services that are provided
14by a mental health crisis intervention program operated by, or under contract with,
15a county or municipality, if the county or municipality is certified as a medical
16assistance provider.
AB150-engrossed,998,1717
2. "Municipality" means a city, village or town.
AB150-engrossed,999,218
(b) If a county or municipality elects to become certified as a provider of mental
19health crisis intervention services, the county or municipality may provide mental
20health crisis intervention services under this subsection in the county or
21municipality to medical assistance recipients through the medical assistance
22program. A county or municipality that elects to provide the services shall pay the
23amount of the allowable charges for the services under the medical assistance
24program that is not provided by the federal government. The department shall
25reimburse the county or municipality under this subsection only for the amount of
1the allowable charges for those services under the medical assistance program that
2is provided by the federal government.
AB150-engrossed,999,64
49.45
(42) Personal care services. Personal care services under s. 49.46 (2)
5(b) 6. j. provided to an individual are reimbursable under medical assistance only if
6all of the following conditions are met:
AB150-engrossed,999,97
(a) The provider of the personal care services receives prior authorization from
8the department for all personal care services that are provided to the individual in
9excess of 50 hours in a calendar year.
AB150-engrossed,999,1110
(b) The individual is not eligible to receive home health aide services under
11medicare, as defined in sub. (3) (L) 1. b.
AB150-engrossed,999,1813
49.45
(43) Case management services for high-cost recipients. The
14department may establish a program to provide case management services for
15medical assistance recipients with high-cost chronic health conditions or high-cost
16catastrophic health conditions. If the department establishes a program to provide
17these case management services, the department shall provide reimbursement for
18providers of these case management services under the medical assistance program.
AB150-engrossed,999,2220
49.455
(4) (c) 1. For any year, the minimum monthly maintenance needs
21allowance equals the lesser of the amount determined under subd. 2., or the sum of
22the following:
AB150-engrossed,999,2323
a. One-twelfth of 200% of the poverty line for a family of 2 persons.
AB150-engrossed,999,2424
b. Any excess shelter allowance under par. (d).
AB150-engrossed,1000,4
12. The minimum monthly maintenance needs allowance in a year may not
2exceed $1,500 increased by the same percentage as the percentage increase in the
3consumer price index between September 1988 and September of the year before the
4year involved.
AB150-engrossed,1000,75
3. In making the calculation under subd. 1. a., when the poverty line is revised
6the department shall use the revised amount starting on the first day of the 2nd
7calendar quarter beginning after the date of publication of the revision.
AB150-engrossed,1000,109
49.455
(4) (d) The excess shelter allowance equals the amount by which 30%
10of the amount determined under par. (c) 1. a. is exceeded by the sum of the following:
AB150-engrossed,1000,1311
1. The community spouse's expenses for rent or mortgage principal and
12interest, taxes and insurance for his or her principal residence and, if the community
13spouse lives in a condominium or cooperative, any required maintenance charge.
AB150-engrossed,1000,18142. The standard utility allowance established under
7 USC 2014 (e), except that
15if the community spouse lives in a condominium or cooperative for which the
16maintenance charge includes utility expenses, the standard utility allowance under
177 USC 2014 (e) is reduced by the amount of the utility expenses included in the
18maintenance charge.
AB150-engrossed,1000,2320
49.455
(6) (b) 1. In
1989, $60,000; in a calendar year after 1989, $60,000 any
21year, $12,000 increased by the same percentage as the percentage increase in the
22consumer price index between September 1988 and September of the year before the
23calendar year involved.
AB150-engrossed,1000,2525
49.455
(6) (b) 1m. $50,000.
AB150-engrossed,1001,22
49.455
(6) (b) 2. The lesser of the following:
AB150-engrossed,1001,33
a. The spousal share computed under sub. (5) (a) 1.
AB150-engrossed,1001,64
b. In any year, $60,000 increased by the same percentage as the percentage
5increase in the consumer price index between September 1988 and September of the
6year before the year involved.
AB150-engrossed,1001,98
49.46
(1) (a) 4. Any person receiving benefits under s.
49.177 49.77 or federal
9Title XVI.
AB150-engrossed,1001,1311
49.46
(1) (a) 15. Any individual who is infected with tuberculosis and meets the
12income and resource eligibility requirements for the federal supplemental security
13program under
42 USC 1381 to
1383d.
AB150-engrossed,1001,1615
49.46
(1) (d) 4. A child who meets the conditions under
42 USC 1396a (e)
3. (3) 16shall be considered a recipient of benefits under s.
49.177 49.77 or federal Title XVI.
AB150-engrossed,1001,2318
49.46
(1) (e) If an application under s. 49.47 (3) shows that the person has
19income and resources within the limitations of s. 49.19, federal Title XVI or s.
49.177 2049.77, or that the person is an essential person, an accommodated person or a patient
21in a public medical institution, the person shall be granted the benefits enumerated
22under sub. (2) whether or not the person requests or receives a grant of any of such
23aids.
AB150-engrossed,1002,4
149.46
(2) (a) 2. Early and periodic screening and diagnosis, including case
2management services, of persons under 21 years of age and all medical treatment
3and dentists' services
specified in par. (b) 1. found necessary by this screening and
4diagnosis.
AB150-engrossed,1002,86
49.46
(2) (a) 4. d. Home health services
, subject to the limitations under s. 49.45
7(8), (8e) and (8f), or
nursing services, if a home health agency is unavailable
, nursing
8services, subject to the limitations under s. 49.45 (8e) and (8f).
AB150-engrossed, s. 3013
9Section
3013. 49.46 (2) (a) 4. g. of the statutes is renumbered 49.46 (2) (a) 4m.
10and amended to read:
AB150-engrossed,1002,1111
49.46
(2) (a) 4m.
Nurse midwifery
Nurse-midwifery services.
AB150-engrossed,1002,1615
49.46
(2) (b) 6. j. Personal care services
, subject to the limitations under s. 49.45
16(8e), (8f) and (42).
AB150-engrossed,1002,2018
49.46
(2) (b) 6. k. Alcohol and other drug abuse day treatment services.
This
19subd. 6. k. does not apply after June 30, 1995, or the day after publication of the
201995-97 biennial budget act, whichever is later.
AB150-engrossed,1002,2222
49.46
(2) (b) 14. School medical services under s. 49.45 (39).
AB150-engrossed,1002,2424
49.46
(2) (b) 15. Mental health crisis intervention services under s. 49.45 (41).
AB150-engrossed,1003,3
149.46
(2) (b) 16. Case management services for recipients with high-cost
2chronic health conditions or high-cost catastrophic health conditions, if the
3department operates a program under s. 49.45 (43).
AB150-engrossed,1003,75
49.46
(2) (bm) Benefits for an individual who is eligible for medical assistance
6only under sub. (1) (a) 15. are limited to those services related to tuberculosis that
7are described in
42 USC 1396a (z) (2).
AB150-engrossed,1003,149
49.46
(2) (d) Benefits authorized under this subsection may not include
10payment for that part of any service payable through 3rd party liability or any
11federal, state, county, municipal or private benefit system to which the beneficiary
12is entitled. "Benefit system" does not include any public assistance program such as,
13but not limited to, Hill-Burton benefits under
42 USC 291c (e), in effect on April 30,
141980, or
general relief
funded by a relief block grant.
AB150-engrossed,1003,2216
49.47
(4) (av) 1. In this paragraph, "migrant worker" means any person who
17temporarily leaves a principal place of residence outside of this state and comes to
18this state for not more than 10 months in a year to accept seasonal employment in
19the planting, cultivating, raising, harvesting, handling, drying, packing, packaging,
20processing, freezing, grading or storing of any agricultural or horticultural
21commodity in its unmanufactured state. "Migrant worker" does not include any of
22the following:
AB150-engrossed,1004,223
a. A person who is employed only by a state resident if the resident or the
24resident's spouse is related to the person as the child, parent, grandchild,
1grandparent, brother, sister, aunt, uncle, niece, nephew, or the spouse of any such
2relative.
AB150-engrossed,1004,53
b. A student who is enrolled or, during the past 6 months has been enrolled, in
4any school, college or university unless the student is a member of a family or
5household which contains a migrant worker.
AB150-engrossed,1004,76
c. Any other person qualifying for an exemption under rules promulgated by
7the department.
AB150-engrossed,1004,138
2. The department shall request a waiver from the secretary of the federal
9department of health and human services to allow the application of subd. 3. The
10waiver shall also seek a waiver from those federal quality control standards under
11the medical assistance program that the department determines to be necessary in
12order to make the application of subd. 3. feasible. Subdivision 3. applies only while
13the waiver under this subdivision is in effect.
AB150-engrossed,1004,1514
3. In determining the eligibility for a migrant worker and his or her dependents
15for medical assistance under this section, the department shall do all of the following:
AB150-engrossed,1004,2316
a. Grant the migrant worker and his or her dependents eligibility for medical
17assistance in this state, if the migrant worker and his or her dependents have a valid
18medical assistance identification card issued in another state and the migrant
19worker completes a Wisconsin medical assistance application provided by the
20department. Eligibility under this subd. 3. a. continues for the period specified on
21the identification card issued in the other state. The department shall notify the
22other state that the migrant worker and his or her dependents are eligible for
23medical assistance in Wisconsin.
AB150-engrossed,1005,224
b. Determine medical assistance eligibility using an income-averaging method
25described in the waiver under subd. 2., if the migrant worker and his or her
1dependents do not meet the income limitations under par. (c) using prospective
2budgeting.
AB150-engrossed,1005,154
49.47
(4) (c) 1. Except as provided in par. (am) and as limited by subd. 3.,
5eligibility exists if income does not exceed 133 1/3% of the maximum aid to families
6with dependent children payment under s. 49.19 (11) for the applicant's family size
7or the combined benefit amount available under supplemental security income
8under
42 USC 1381 to
1383c and state supplemental aid under s.
49.177 49.77 9whichever is higher. In this subdivision "income" includes earned or unearned
10income that would be included in determining eligibility for the individual or family
11under s.
49.177 or 49.19
or 49.77, or for the aged, blind or disabled under
42 USC 1381 12to
1385. "Income" does not include earned or unearned income which would be
13excluded in determining eligibility for the individual or family under s.
49.177 or 1449.19
or 49.77, or for the aged, blind or disabled individual under
42 USC 1381 to
151385.
AB150-engrossed, s. 3040
21Section
3040. 49.48 (3) (a) of the statutes is renumbered 49.68 (3) (a) and
22amended to read:
AB150-engrossed,1006,223
49.68
(3) (a) Any permanent resident of this state who suffers from chronic
24renal disease may be accepted into the dialysis treatment phase of the renal disease
1control program if the resident meets standards set by rule under sub. (2) and s.
249.487 49.687.