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
This bill changes the name of DHSS, on July 1, 1996, to the department of
health and family services.
Under current law, the division of vocational rehabilitation, a subunit of DHSS,
administers the vocational rehabilitation laws. Under these laws, DHSS assists
eligible handicapped persons to become capable of competing in the labor market,
practicing a profession, raising a family and making a home or participating in
sheltered employment or other gainful work. Among other requirements under
current law, DHSS must assess and evaluate services appropriate to each individual,
develop an individualized written rehabilitation program with each handicapped
person and develop and supervise services that are part of any handicapped person's
vocational rehabilitation program. DHSS must also provide medical or other
evaluations at no cost to the applicant to determine the applicant's eligibility for
vocational rehabilitation services. DHSS must also provide rehabilitation teaching
services for persons who are blind or visually impaired regardless of their eligibility
for vocational rehabilitation services. Finally, under current law, DHSS may provide
interpreters for the hearing impaired and must, subject to availability of funds,
provide assistance to hearing-impaired persons to secure telecommunication
devices. DHSS must provide, free of charge, at the request of an eligible hearing
impaired person, a vehicle sticker that apprises law enforcement officers of the fact
that the operator or owner of the vehicle is hearing impaired.
This bill transfers the division of vocational rehabilitation from DHSS to
DILHR on July 1, 1996. Under this bill, DILHR is responsible for administering the
vocational rehabilitation laws for handicapped persons except that DHSS retains
responsibility for administering nonvocational services for the hearing and visually
impaired.
This bill authorizes DHSS to regulate a type of facility, known as an assisted
living facility, beginning on July 1, 1996. Under the bill, an assisted living facility
is defined as a place in which at least 5 adults reside, that consists entirely of
independent apartments and that provides not more than 28 hours per week of
supportive, personal and nursing services to a resident of the facility. The bill
requires that an assisted living facility be certified by DHSS as a provider of medical
assistance in order to operate and requires DHSS to promulgate rules, approved by
DOA, that establish standards for the certification.
Under current law, DHSS allocates $52,400 in each state fiscal year to contract
with an organization to provide services to Hispanic workers who have been injured
in industrial accidents. The services provided include group support and self-help
activities, counseling, advocacy on behalf of injured workers for appropriate services,
interpreter services, outreach and assistance in maximizing utilization of certain
public programs. This bill eliminates this funding.
Under current law, generally only after a man has been adjudicated to be the
father of a nonmarital child in a paternity action may the man be ordered to pay child
support for the child. However, if the man has signed and filed with the state
registrar a statement acknowledging paternity, a judge or family court commissioner
may order the man to pay child support in any action affecting the family, such as
an action for support. Within one year after signing a statement acknowledging
paternity or one year after attaining age 18, whichever is later, a person who signed
the statement may request that the judge or family court commissioner order blood
tests. If the results of the blood tests exclude the man as the father of the child, the
court must dismiss any action for support, or vacate any order for support, with
respect to the man.
This bill provides that, if the results of the blood tests exclude the man, the court
must also notify the state registrar, who must prepare a new birth certificate for the
child, omitting the man's name. If no action for support has been filed, a person who
has signed a statement acknowledging paternity may request that the county child
support agency arrange for blood tests. If the results exclude the man, the child
support agency must notify the state registrar. The bill also provides that a
nonjudicial determination of paternity that has the same effect as a judgment of
paternity becomes effective when a statement acknowledging paternity has been on
file with the state registrar for one year or one year after the man who signed the
statement attains age 18, whichever is later. Such a determination may be reopened
under the same circumstances as a judgment of paternity.
This bill prohibits a C-BRF from initially admitting a potential resident who
intends to pay for residency from private funds unless the C-BRF first obtains
financial information from the potential resident at the time that he or she applies
for admission. The potential resident must waive to specified persons his or her right
to confidentiality of the information provided. From this information, the C-BRF
must prepare a statement of financial condition of the potential resident and provide
the statement to him or her. The statement must estimate a date, if any, by which
the person's assets and other funding sources would be depleted, must indicate that,
at the time of depletion, public funding may not be available in order to remain in
the C-BRF and must specify options available to the individual at that time. If the
estimated date of depletion of the individual's funds is less than 24 months after the
date of the financial statement, the C-BRF must forward the statement to the county
department of social services.
Under current law, DHSS, as part of the home-based enterprise program, is
required to provide services, vocational rehabilitation, craft instruction and a
supervised business initiatives program to severely handicapped persons who are
eligible for vocational rehabilitation services. DHSS is permitted to own, lease,
manage, supervise or operate businesses for the benefit of severely handicapped
persons, including home-based craft work, also known as the homecraft program.
Currently, the homecraft program is funded, in part, by a federal grant. Those
persons ineligible to participate under the federal grant may participate in a portion
of the program funded by state revenue.
This bill eliminates the homecraft portion of the home-based enterprise
program funded by state revenue.
Under current law, community aids funds are distributed in accordance with
certain statutory allocations. There is a basic county allocation from which DHSS
allocates money to the counties for social services in general. There are also a
number of specific categorical allocations for specific types of social services. Current
law has categorical allocations for services to children and families; supportive home
care services; child care services; community support programs; community-based
programs for the developmentally disabled; family support programs; Alzheimer's
family and caregiver support services; emergency services; and alcohol, drug abuse
and mental health services. This bill restructures community aids allocations into
a single general community aids allocation and 3 specific categorical allocations —
one for prevention and treatment of substance abuse, one for community mental
health services and one for child care services — and allocates funding for each of the
categories.
Under current law, community aids funds that are not spent or encumbered by
December 31 of each year lapse to the general fund. However, current law contains
a number of provisions allowing counties, tribal governing bodies and nonprofit
organizations to carry over certain community aids funds to the next year. Under one
of these provisions, DHSS is permitted to carry forward up to 3% of the total amount
of community aids funds, other than certain child care funds, that are allocated for
use by the county, tribal governing body or nonprofit organization. These funds may
be used in the following calendar year, subject to certain limitations. One of these
limitations prevents DHSS from carrying forward more than 25% of the amount
allocated to the county, tribal governing body or nonprofit organization under certain
community aids categorical allocations. This bill repeals this 25% rule. Under
current law, if DHSS determines that a county department will be unable to expend
certain funds for at-risk child care, low-income child care and respite child care by
December 31 each year, DHSS may authorize that county department to expend part
of these funds for the start-up, improvement or expansion of child care services or
facilities, to the extent permitted by federal law. This bill repeals this provision.
Under current law, counties are required to provide matching funds for
community aids funds distributed from certain allocations. Each county's yearly
required match equals 9.89% of the total of the county's distributions for that year
for which matching funds are required. These matching funds may come from county
tax levies, federal and state revenue sharing funds or, subject to certain limitations,
private donations. This bill eliminates these county matching requirements.
The bill also makes certain changes relating to the administration of the
community aids program. The bill requires county departments of health or social
services, county departments of community programs, county departments of
developmental disabilities services and tribal governing bodies to submit to DHSS,
before October 1 of each year beginning in 1995, a proposed budget for the
expenditure of community aids funds. The proposed budget must be submitted on
a form developed by DHSS and approved by DOA. In addition, the bill requires
DHSS to develop performance standards for all services funded through community
aids. These performance standards are to be developed after consultation with DOA
and with county departments and are required to be implemented no later than July
1, 1996.
Under current law, the payee or payer under a judgment or order providing for
child or family support may file a petition, motion or order to show cause with the
court to have the amount of support revised. The court or family court commissioner
may not revise the amount of support unless the person requesting the change can
show a substantial change in circumstances since the last order or revision. If the
court or family court commissioner revises child or family support, it must be done
by using a percentage standard. The revised amount may deviate from the amount
that would result from use of the percentage standard if, on the basis of various
factors, the court or family court commissioner determines that use of the percentage
standard would be unfair to the child or to either of the parties.
This bill provides that a payee under a judgment or order for child or family
support may file an affidavit with the court for a revision of the support, unless the
current judgment or order is based on the percentage standard and is expressed as
a percentage of income or unless less than 33 months have elapsed since the entry
of the current judgment or order. The affidavit must include: facts supporting a
reasonable basis for a substantial change in circumstances; the proposed amount of
support, which must be determined by using the percentage standard; the number
of children to be supported under the revised judgment or order; and the payer's
current income or earning capacity, if the proposed amount of support is expressed
as a fixed sum or as a combination of a percentage and a fixed sum in the alternative.
The payee must serve the affidavit on the payer, or send it by registered or certified
mail to the payer's last-known address. Upon proof of service on the payer, the court
must send notice to the payer that informs the payer that the court or family court
commissioner may revise the support amount as requested in the affidavit unless the
payer requests a hearing within 30 days.
If the payer does not timely request a hearing, the court or family court
commissioner may revise the support amount as requested in the affidavit if the
affidavit complies with all of the requirements under the statute and demonstrates
to the satisfaction of the court or family court commissioner that the revision in
support is determined in a manner consistent with the statute under current law
that provides for revision of support. If the support is revised, the court must send
the revised order to the payer along with notice that an assignment is in effect for
the new amount of support. If the payer does timely request a hearing, the court or
family court commissioner must hold a hearing and determine, in accordance with
the statute in current law that provides for revision of support, whether the support
should be revised.
Under current law, DHSS must provide agencies of county and tribal
governments that are directed by county or tribal commissions on aging with funds
to provide older individuals with the services of benefit specialists or appropriate
referrals for assistance. Benefit specialists offer information, advice and assistance
that are related to eligibility for and problems with public benefits and services,
health care financing, insurance, housing and other financial and consumer
concerns and refer individuals who are in need of legal representation to legal
resources.
This bill removes the requirement that tribal governments provide benefit
specialist services and the funding for this purpose and requires, instead, that only
counties both receive funding for these services and provide these services to all older
individuals living within the county.
Currently, county departments of social services must submit to DHSS their
plans and contracts for care and services that the county departments will purchase.
DHSS, in turn, must review the contracts and approve them if they are consistent
with DHSS rules and procedures and if state and federal funds are available for their
purposes.
This bill authorizes, rather than requires, DHSS to require county departments
of social services, human services, community programs and developmental
disabilities services to submit contracts for the purchase of care and services to
DHSS for review and approval.
Current law provides a procedure for the involuntary commitment for
treatment of sexually violent persons. A sexually violent person who is committed
for treatment may be placed in an institution for care or may be placed on supervised
release in the community. DHSS is responsible for the costs of evaluating, treating
and caring for sexually violent persons who are committed for treatment. This bill
clarifies that if a sexually violent person is placed on supervised release, DHSS is
responsible for paying for treatment and care provided to the sexually violent person
while he or she is in the community.
Under current law, if a child's birth occurs in or en route to a hospital and if the
child's parents are unmarried, the hospital administrator or certain other persons
must provide the child's mother with a voluntary paternity acknowledgment form
and with a pamphlet that has information about birth certificates.
This bill requires that trained, designated hospital staff provide oral
information to the child's available unmarried parents about the voluntary paternity
acknowledgment form and about the legal significance and benefits of establishing
paternity.
Under current law, a general purpose revenue appropriation to DHSS funds
payments to counties for establishing paternity. Another general purpose revenue
appropriation to DHSS funds assistance to certain counties in establishing paternity
and obtaining child support and payments to Milwaukee County for an additional
family court commissioner. A program revenue appropriation to DHSS that consists
of child support moneys collected for children receiving AFDC funds, among other
things, state incentive payments to counties that meet certain efficiency criteria for
paternity establishment and child support collection. Another program revenue
appropriation to DHSS from the same funding source, (AFDC child support
collections), funds grants to counties for programs to revise child support orders.
This bill provides one single program revenue appropriation to DHSS for
payments to counties for all activities related to child support establishment and
collection, funded entirely from AFDC child support collections.
This bill eliminates a program in DHSS to conduct a statewide elder abuse
awareness campaign.
This bill directs DHSS to conduct a study, and submit its conclusions and
recommendations to DOA and JCF by December 1, 1995, on limiting licenses issued
by the state for failure to pay child or family support. DHSS must address such
issues as: what licenses are amenable to limitation; what types of limitations are
feasible; how to implement such a program; the cost of administering such a
program; and the estimated increase in support collections from such a program.
Insurance
Under current law, the commissioner of insurance may by rule prescribe
educational prerequisites and set continuing education standards for insurance
intermediaries (generally, insurance agents). The commissioner may also suspend
the license of an intermediary who fails to produce evidence of compliance with any
continuing education standards set by the commissioner.
This bill authorizes the commissioner to approve organizations that may offer
prelicensing or continuing education courses or programs, for an initial fee not
exceeding $500 and an annual renewal fee not exceeding $100, and to approve the
courses that an approved organization may offer, for a fee not exceeding $25 per
credit hour. The bill also provides that if an intermediary whose license is suspended
for failure to produce evidence of compliance with continuing education standards
produces such evidence within 60 days after the license is suspended, the license is
reinstated, effective on the date of the suspension. If the intermediary does not
produce evidence of compliance within 60 days, however, the license is revoked and
the intermediary must satisfy all original licensing requirements to be relicensed.
Under current law, every business corporation, including a nonprofit
corporation, and every limited partnership must maintain in this state a registered
agent for service of process. Current law does not require insurers to maintain a
registered agent for service of process. Service is made on the commissioner of
insurance or, if a legal proceeding is brought by the state, on the secretary of state.
The commissioner or secretary of state must send a copy of the process by certified
mail to the person served at the person's last-known principal place of business,
residence or post-office address. The fee for service on the commissioner is $5.
This bill requires every insurer to maintain in this state a registered agent for
service of process, whose name and address must be filed with the commissioner. If
an insurer fails to maintain an agent or if the agent cannot be found, substituted
service may be made on the commissioner, or on the secretary of state if the action
is brought by the state. If substituted service is made, the commissioner or the
secretary of state must follow the same procedure as before for mailing the process.
The bill, however, increases the fee for service on the commissioner to $10.
Under current law, the commissioner of insurance collects fees for various
services provided by the office of the commissioner of insurance (OCI). The fees are
used to pay for the general operating costs of OCI. This bill increases the fees for
insurers, rate service organizations and motor clubs for: filing documents required
by law as a prerequisite to operating in this state; issuing a certificate of authority;
annually continuing a certificate of authority; and filing an annual statement. The
bill also creates a fee for certifying copies of a number of types of documents, such as
certificates of authority and annual statements.
Under current law, hospitals must use a uniform accounting system developed
by the office of health care information (OHCI) in OCI and specified in rules
promulgated by the commissioner of insurance. This bill eliminates that
requirement.
Under current law, the activities of OHCI are funded by assessments paid by
hospitals in proportion to gross private-pay patient revenues during the most
recently concluded fiscal year. One of the responsibilities of OHCI is to collect health
care information from health care providers other than hospitals and ambulatory
surgery centers to analyze and disseminate in language that can be understood by
lay persons. General operations of OCI are funded by fees paid by insurers for
various services provided by OCI, such as issuing certificates of authority, filing
annual statements and listing insurance agents.