AB150, s. 2213 4Section 2213. 46.27 (2) (i) of the statutes is created to read:
AB150,868,105 46.27 (2) (i) Review and approve or disapprove waiver requests under sub. (3)
6(f), review and approve or disapprove requests for exceptions under sub. (6r) (c) and
7provide technical assistance to a county that reaches or exceeds the annual allocation
8limit specified in sub. (3) (f) in order to explore alternative methods of providing
9long-term community support services for persons who are in group living
10arrangements in that county.
AB150, s. 2214 11Section 2214. 46.27 (2) (j) of the statutes is created to read:
AB150,868,1412 46.27 (2) (j) By January 1, 1996, develop a model contract for use by counties
13for purchase of long-term community support services for persons who reside in
14community-based residential facilities.
AB150,868,15 15Section 2215 . 46.27 (3) (e) 1. of the statutes is amended to read:
AB150,868,2116 46.27 (3) (e) 1. For a county with an annual allocation for provision of long-term
17community support services under sub. (7) (b) 1m. that exceeds $185,000, the
18department shall, unless the department finds that an emergency or unusual
19circumstance exists, designate a portion of the county's allocation for increased
20service in each calendar year that the county fails to meet the requirement, to one
21or more of the groups specified under sub. (4) (a) 1. a. to e.
AB150, s. 2216 22Section 2216. 46.27 (3) (e) 2. of the statutes is amended to read:
AB150,869,223 46.27 (3) (e) 2. For a county with an annual allocation for provision of long-term
24community support services under sub. (7) (b) 1m. that is $185,000 or less, the
25department may designate a portion of the county's allocation for increased service

1in each calendar year that the county fails to meet the requirement, to one or more
2of the groups specified under sub. (4) (a) 1. a. to e.
AB150, s. 2217 3Section 2217. 46.27 (3) (f) of the statutes is created to read:
AB150,869,134 46.27 (3) (f) Beginning on January 1, 1996, from the annual allocation to the
5county for the provision of long-term community support services under subs. (7) (b)
6and (11), annually establish a maximum total amount, not to exceed 25% of the
7annual allocation, that may be encumbered in a calendar year for services for eligible
8individuals in community-based residential facilities. If the total amount that is
9encumbered for services for individuals in community-based residential facilities
10who are receiving services under sub. (7) (b) on January 1, 1996, exceeds 25% of the
11county's annual allocation, a county may request a waiver of the requirement under
12this paragraph from the department. The department need not promulgate as rules
13under ch. 227 the standards for granting a waiver request under this paragraph.
AB150, s. 2218 14Section 2218. 46.27 (4) (c) 4. of the statutes is amended to read:
AB150,869,1815 46.27 (4) (c) 4. A description of the method to be used to coordinate the use of
16funds received under this program with the use of other funds allocated to the county
17under ss. 46.495 (1) (d), 46.80 (5), and 46.85 (3m) (b) 1. and 2. and 49.52 (1) (d) and
18to county departments under s. 51.423.
AB150, s. 2219 19Section 2219. 46.27 (5) (b) of the statutes is amended to read:
AB150,870,220 46.27 (5) (b) Within the limits of state and federal funds allocated under sub.
21(7), arrange service contracts under s. 46.036 and ensure the provision of necessary
22long-term community support services for each person who meets the criteria
23specified in sub. (6) (b). No county department or aging unit may use funds allocated
24under sub. (7) (b) to provide services in any community-based residential facility
25unless the county department or aging unit uses as a service contract the model

1contract developed under sub. (2) (j) or a contract that includes all of the provisions
2of the model contract.
AB150, s. 2220 3Section 2220. 46.27 (5) (i) of the statutes is amended to read:
AB150,870,234 46.27 (5) (i) In the instances in which an individual who is provided long-term
5community support services under par. (b) for which the individual receives direct
6funding, serve directly as a fiscal agent or contract with a fiscal intermediary to serve
7as a fiscal agent for that individual for the purposes of performing the responsibilities
8and protecting the interests of the individual under the unemployment
9compensation law. The county department or aging unit may elect to act as a fiscal
10agent or contract with a fiscal intermediary to serve as a fiscal agent for an individual
11who is provided long-term support services under s. 46.275, 46.277, 46.278, 49.52,
1246.495, 51.42 or 51.437. The fiscal agent under this paragraph is responsible for
13remitting any federal unemployment compensation taxes or state unemployment
14compensation contributions owed by the individual, including any interest and
15penalties which are owed by the individual; for serving as the representative of the
16individual in any investigation, meeting, hearing or appeal involving ch. 108 or the
17federal unemployment tax act (26 USC 3301 to 3311) in which the individual is a
18party; and for receiving, reviewing, completing and returning all forms, reports and
19other documents required under ch. 108 or the federal unemployment tax act on
20behalf of the individual. An individual may make an informed, knowing and
21voluntary election to waive the right to a fiscal agent. The waiver may be as to all
22or any portion of the fiscal agent's responsibilities. The waiver may be rescinded in
23whole or in part at any time.
AB150, s. 2221 24Section 2221. 46.27 (6r) (a) of the statutes is amended to read:
AB150,871,9
146.27 (6r) (a) A person who is initially eligible for services under sub. (7) (b),
2for whom home and community-based services are available under sub. (11) or s.
346.275, 46.277 or 46.278
that require less total expenditure of state funds than do
4comparable services under sub. (7) (b) and who is eligible for and offered the home
5and community-based services under sub. (11) or s. 46.275, 46.277 or 46.278, but who
6declines the offer, except that a county may use funds received under sub. (7) (b) to
7pay for long-term community support services for the person for a period of up to 90
8days during which an application for services under sub. (11) or s. 46.275, 46.277 or
946.278
for the person is processed.
AB150, s. 2222 10Section 2222. 46.27 (6r) (c) of the statutes is created to read:
AB150,871,1611 46.27 (6r) (c) A person who resides or intends to reside in a community-based
12residential facility and who is initially applying for long-term community support
13services, if the projected cost of services for the person, plus the cost of services for
14existing participants, would cause the county to exceed the limitation under sub. (3)
15(f), unless the department grants an exception to the requirement under this
16paragraph, under the conditions specified by rule, to avoid hardship to the person.
AB150, s. 2223 17Section 2223. 46.27 (6r) (d) of the statutes is created to read:
AB150,871,1818 46.27 (6r) (d) A person as specified in sub. (11m).
****Note: This is reconciled s. 46.27 (6r) (d). This section has been affected by a draft with the
following LRB #: 0450/3.
AB150, s. 2224 19Section 2224. 46.27 (7) (am) of the statutes is amended to read:
AB150,872,420 46.27 (7) (am) From the appropriation under s. 20.435 (7) (bd), the department
21shall allocate funds to each county or private nonprofit agency with which the
22department contracts to pay assessment and case plan costs under sub. (6) not
23otherwise paid under s. 46.032 49.33 (2) or 49.45. The department shall reimburse

1counties for the cost of assessing persons eligible for medical assistance under s.
249.46, 49.468 or 49.47 as part of the administrative services of medical assistance,
3payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this
4paragraph to pay the cost of long-term community support services.
AB150, s. 2225 5Section 2225. 46.27 (7) (b) of the statutes, as affected by 1995 Wisconsin Act
6.... (this act), is amended to read:
AB150,872,187 46.27 (7) (b) From Except as specified in sub. (11m), from the appropriation
8under s. 20.435 (7) (bd), the department shall allocate funds to each county to pay
9the cost of providing long-term community support services under sub. (5) (b) not
10otherwise paid under s. 49.45 to persons eligible for medical assistance under s. 49.46
11or 49.47 or to persons whom the county department or aging unit administering the
12program finds likely to become medically indigent within 6 months by spending
13excess income or assets for medical or remedial care. The average per person
14reimbursement under this paragraph may not exceed the state share of the average
15per person payment rate the department expects under s. 49.45 (6m). The county
16department or aging unit administering the program may spend funds received
17under this paragraph only in accordance with the case plan and service contract
18created for each person receiving long-term community support services.
****Note: This is reconciled s. 46.27 (7) (b). This section has been affected by a draft with the
following LRB #: 0448/2.
AB150, s. 2226 19Section 2226. 46.27 (7) (b) 1m. of the statutes is renumbered 46.27 (7) (b).
AB150, s. 2227 20Section 2227. 46.27 (7) (b) 2. of the statutes is renumbered 46.27 (7) (cg) and
21amended to read:
AB150,873,222 46.27 (7) (cg) No county may use funds received under this paragraph par. (b)
23to pay for long-term community support services provided any person who resides

1in a nursing home, unless the department waives this restriction on use of funds and
2the services are provided in accordance with a discharge plan.
AB150, s. 2228 3Section 2228. 46.27 (7) (c) 2. of the statutes is amended to read:
AB150,873,54 46.27 (7) (c) 2. Receipt of funds under this section is subject to s. 49.52 (2) 46.495
5(2)
.
AB150, s. 2229 6Section 2229. 46.27 (7) (cm) of the statutes is created to read:
AB150,873,107 46.27 (7) (cm) 1. Beginning on January 1, 1996, no county, private nonprofit
8agency or aging unit may use funds received under par. (b) to provide services in any
9community-based residential facility, as defined in s. 50.01 (1g), that has more than
108 beds, unless one of the following applies:
AB150,873,1211 a. The department approves the provision of services in a community-based
12residential facility that meets standards established under subd. 2.
AB150,873,1713 b. The department approves the provision of services in a community-based
14residential facility that entirely consists of independent apartments, each of which
15has an individual lockable entrance and exit and individual separate kitchen,
16bathroom, sleeping and living areas, to individuals who are provided services under
17sub. (5) (b) and are physically disabled or are at least 65 years of age.
AB150,873,2118 2. By January 1, 1996, the department shall establish standards for approvals
19made under subd. 1. a., including whether the proposed use of funds for residents at
20the community-based residential facility in question adequately provides for all of
21the following:
AB150,873,2222 a. Sufficient responsiveness to individual resident needs.
AB150,873,2323 b. Maintenance of approved levels of quality of care.
AB150,873,2424 c. Cost effectiveness, in comparison with other feasible funding uses.
AB150,874,2
1d. Sufficient consideration of care for facility residents with dementia or related
2conditions.
AB150,874,43 3. The department need not promulgate as rules under ch. 227 the standards
4required to be established under subd. 2.
AB150,874,75 4. This paragraph does not apply to individuals who are receiving services
6under this section that are funded under par. (b) and who are residing in
7community-based residential facilities with more than 8 beds on January 1, 1996.
AB150, s. 2230 8Section 2230. 46.27 (7m) of the statutes is amended to read:
AB150,874,139 46.27 (7m) Right to hearing. A person who is denied eligibility for services or
10whose services are reduced or terminated under this section may request a hearing
11from the department under s. 227.44, except that lack of adequate funding or a denial
12under sub. (6r) (a) or (d) may not serve as the basis for a request under this
13subsection.
AB150, s. 2231 14Section 2231. 46.27 (11) (am) of the statutes is amended to read:
AB150,874,2015 46.27 (11) (am) The department shall request a waiver from the secretary of
16the federal department of health and human services, under 42 USC 1396n (c),
17authorizing the department to provide as part of the medical assistance program,
18except as specified in sub. (11m),
home and community-based services for persons
19who are eligible for long-term support community options program services under
20sub. (5) (b).
AB150, s. 2232 21Section 2232. 46.27 (11) (c) 7. of the statutes is created to read:
AB150,875,222 46.27 (11) (c) 7. A county may use funds received under this subsection to
23provide supportive, personal or nursing services, as defined in rules promulgated
24under s. 49.45 (2) (a) 23., to a person who resides in an assisted living facility, as
25defined in s. 50.01 (1d). Funding of the services may not exceed 85% of the statewide

1rate for reimbursement under s. 49.45 (6m), as determined by the department under
2s. 49.45 (6m) (L).
AB150, s. 2233 3Section 2233. 46.27 (11) (c) 8. of the statutes is created to read:
AB150,875,84 46.27 (11) (c) 8. No county, private nonprofit agency or aging unit may use funds
5received under this subsection to provide services in any community-based
6residential facility unless the county, agency or aging unit uses as a service contract
7the model contract developed under sub. (2) (j) or a contract that includes all of the
8provisions of the model contract.
****Note: This is reconciled s. 46.27 (11) (c) 8. This Section has been affected by a draft with
the following LRB number: -0453/2.
AB150, s. 2234 9Section 2234. 46.27 (11) (cm) of the statutes is created to read:
AB150,875,1910 46.27 (11) (cm) 1. The department shall request from the secretary of the
11federal department of health and human services an amendment to the waiver
12specified in par. (am) to allow the department to receive federal financial
13participation to continue to provide, notwithstanding sub. (11m), long-term
14community support services that substitute for the benefit under s. 49.46 (2) (a) 4.
15a. or (b) 6. a. to an individual who is eligible for medical assistance only under s. 49.47;
16who was receiving the services, provided as a medical assistance benefit, on January
171, 1996; and who has continued to receive those services or the services, provided as
18a medical assistance benefit, that are described in s. 46.275 (5g), 46.277 (5g) (c) or
1946.278 (6m) or specified in s. 49.46 (2) (a) 4. c. or (b) 6. a. since that date.
AB150,875,2220 2. If the waiver amendment under subd. 1. is granted and remains in effect, the
21department shall provide the services described in subd. 1. to individuals covered by
22the waiver amendment, notwithstanding sub. (11m).
****Note: This is reconciled s. 46.27 (11) (cm) 1. This section has been affected by a draft with
the following LRB #: 0444/1.
AB150, s. 2235
1Section 2235. 46.27 (11m) of the statutes is created to read:
AB150,876,52 46.27 (11m) Limitation. The department may not allocate funds to a county
3to provide long-term community support services that substitute for the benefit
4under s. 49.46 (2) (a) 4. a. or (b) 6. a. for persons who meet the condition specified
5under sub. (6r) (b) 1. but who are eligible for medical assistance only under s. 49.47.
AB150, s. 2236 6Section 2236. 46.275 (1m) (a) of the statutes is amended to read:
AB150,876,87 46.275 (1m) (a) "Medical assistance" means aid provided under ss. 49.43 to
849.47
subch. IV of ch. 49, except s. 49.468.
AB150, s. 2237 9Section 2237. 46.275 (2) (intro.) of the statutes is amended to read:
AB150,876,2010 46.275 (2) Departmental powers and duties. (intro.) The department may
11request a waiver from the secretary of the U.S. federal department of health and
12human services, under 42 USC 1396n (c), authorizing the department to integrate
13medical assistance recipients who reside in state centers for the developmentally
14disabled into their communities by providing home and community-based services
15as part of the medical assistance program, except as provided in sub. (5g). If the
16department requests this waiver, it shall include all assurances required under 42
17USC 1396n
(c) (2) in its request. If the department receives this waiver, at the end
18of the 3-year period during which the waiver remains in effect the department may
19request an additional 3-year extension of the waiver. If the department receives this
20waiver, it shall:
AB150, s. 2238 21Section 2238. 46.275 (4) (a) of the statutes is amended to read:
AB150,876,2522 46.275 (4) (a) Any Except as provided in sub. (5g), any medical assistance
23recipient living in a state center for the developmentally disabled is eligible to
24participate in the program. Such a recipient may apply, or any person may apply on
25behalf of such a recipient, for participation in the program.
AB150, s. 2239
1Section 2239. 46.275 (5) (a) of the statutes is amended to read:
AB150,877,72 46.275 (5) (a) Medical Except as provided in sub. (5g), medical assistance
3reimbursement for services a county, or the department under sub. (3r), provides
4under this program is available from the appropriations under s. 20.435 (1) (b) and
5(o). If 2 or more counties jointly contract to provide services under this program and
6the department approves the contract, medical assistance reimbursement is also
7available for services provided jointly by these counties.
AB150, s. 2240 8Section 2240. 46.275 (5) (b) 2. of the statutes is amended to read:
AB150,877,139 46.275 (5) (b) 2. Reduce federal, state or county matching expenditures for
10long-term community support services provided to any person as part of this
11program from funds allocated under s. 46.495 (1) (d), 46.80 (5), 46.85 (3m) (b) 1. and
122., 49.52 (1) (d) or 51.423, as indicated in the county's budget or by actual
13expenditures.
AB150, s. 2241 14Section 2241. 46.275 (5d) of the statutes is created to read:
AB150,877,2415 46.275 (5d) Waiver amendment. (a) The department shall request from the
16secretary of the federal department of health and human services an amendment to
17the waiver specified in sub. (2) to allow the department to receive federal financial
18participation to continue to provide, notwithstanding sub. (5g), home and
19community-based services that substitute for the benefit under s. 49.46 (2) (a) 4. a.
20or (b) 6. a. to an individual who is eligible for medical assistance only under s. 49.47;
21who was receiving the services, provided as a medical assistance benefit, on January
221, 1996; and who has continued to receive those services or the services, provided as
23a medical assistance benefit, that are described in s. 46.27 (11m), 46.277 (5g) (c) or
2446.278 (6m) or specified in s. 49.46 (2) (a) 4. c. or (b) 6. a. since that date.
AB150,878,3
1(b) If the waiver amendment under par. (a) is granted and remains in effect,
2the department shall provide the services described in par. (a) to individuals covered
3by 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.
AB150, s. 2242 4Section 2242. 46.275 (5g) of the statutes is created to read:
AB150,878,85 46.275 (5g) Limitation. The department may not provide under this section
6home and community-based services that substitute for the benefit under s. 49.46
7(2) (a) 4. a. or (b) 6. a. for persons who are eligible for medical assistance only under
8s. 49.47.
AB150, s. 2243 9Section 2243. 46.277 (1) of the statutes is amended to read:
AB150,878,2110 46.277 (1) Legislative intent. The intent of the program under this section,
11except as provided in sub. (5g) (c),
is to provide home or community-based care to
12serve in a noninstitutional community setting a person who meets eligibility
13requirements under 42 USC 1396n (c) and is relocated from an institution other than
14a state center for the developmentally disabled or meets the level of care
15requirements for medical assistance reimbursement in a skilled nursing facility or
16an intermediate care facility, except that the number of persons who receive home
17or community-based care under this section is not intended to exceed the number
18of nursing home beds that are delicensed as part of a plan submitted by the facility
19and approved by the department. The intent of the program is also that counties use
20all existing services for providing care under this section, including those services
21currently 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.
AB150, s. 2244 22Section 2244. 46.277 (1m) (a) of the statutes is amended to read:
AB150,879,2
146.277 (1m) (a) "Medical assistance" means aid provided under ss. 49.43 to
249.47
subch. IV of ch. 49, except s. 49.468.
AB150, s. 2245 3Section 2245. 46.277 (1m) (b) of the statutes is amended to read:
AB150,879,64 46.277 (1m) (b) "Program" means the community integration program for
5facilities certified as medical assistance providers, for which a waiver has been
6received under sub. (2).
AB150, s. 2246 7Section 2246. 46.277 (2) (intro.) of the statutes is amended to read:
AB150,879,208 46.277 (2) Departmental powers and duties. (intro.) The department may
9request a waiver from the secretary of the federal department of health and human
10services, under 42 USC 1396n (c), authorizing the department to serve medical
11assistance recipients, who meet the level of care requirements for medical assistance
12reimbursement in a skilled nursing facility or an intermediate care facility, in their
13communities by providing home or community-based services as part of medical
14assistance, except as provided in sub. (5g) (c). The number of persons for whom the
15waiver is requested may not exceed the number of nursing home beds that are
16delicensed as part of a plan submitted by the facility and approved by the
17department. If the department requests a waiver, it shall include all assurances
18required under 42 USC 1396n (c) (2) in its request. If the department receives this
19waiver, it may request one or more 3-year extensions of the waiver under 42 USC
201396n
(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.
AB150, s. 2247 21Section 2247. 46.277 (2) (e) of the statutes is created to read:
AB150,880,422 46.277 (2) (e) Review and approve or disapprove waiver requests under sub.
23(3) (c), review and approve or disapprove requests for exceptions under sub. (5) (d)

13. and provide technical assistance to a county that reaches or exceeds the annual
2allocation limit specified in sub. (3) (c) in order to explore alternative methods of
3providing long-term community support services for persons who are in group living
4arrangements in that county.
AB150, s. 2248 5Section 2248. 46.277 (3) (a) of the statutes is amended to read:
AB150,880,146 46.277 (3) (a) Sections 46.27 (3) (b) and 46.275 (3) (a) and (c) to (e) apply to
7county participation in this program, except that services provided in the program
8shall substitute for care provided a person in a skilled nursing facility or
9intermediate care facility who meets the level of care requirements for medical
10assistance reimbursement to that facility rather than for care provided at a state
11center for the developmentally disabled. The number of persons who receive services
12provided by the program under this paragraph may not exceed the number of
13nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as
14part of a plan submitted by the facility and approved by the department.
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