1997 Wisconsin Act 27

49.27 (11) (i) Provide transitional child care services under sub. (6), and shelter payments under sub. (7) and transitional medical assistance coverage under sub. (8).

27,1893 Section 1893. 49.30 (2) of the statutes is amended to read:

49.30 (2) The state From the appropriation under s. 20.445 (3) (dz), the department shall reimburse a county or applicable tribal governing body or organization for any amount that the county or applicable tribal governing body or organization is required to pay under sub. (1). The state From the appropriation under s. 20.445 (3) (dz), the department shall reimburse a county or applicable tribal governing body or organization for cemetery expenses or for funeral and burial expenses for persons described under sub. (1) that the county or applicable tribal governing body or organization is not required to pay under subs. (1) and (1m) only if the department approves the reimbursement due to unusual circumstances.

27,1894 Section 1894 . 49.32 (8) of the statutes is amended to read:

49.32 (8) Periodic earnings check by department. The department shall make a periodic check of the amounts earned by recipients of aid to families with dependent children under s. 49.19 and by participants under Wisconsin works under ss. 49.141 to 49.161 through a check of the amounts credited to the recipient's social security number. The department shall make an investigation into any discrepancy between the amounts credited to a social security number and amounts reported as income on the declaration application and take appropriate action under s. 49.95 when warranted. The department shall use the state wage reporting system under 1985 Wisconsin Act 17, section 65 (1), when the system is implemented, to make periodic earnings checks.

27,1895 Section 1895 . 49.32 (9) (a) of the statutes is amended to read:

49.32 (9) (a) Each county department under s. 46.215, 46.22 or 46.23 administering aid to families with dependent children shall maintain a monthly report at its office showing the names of all persons receiving such aid to families with dependent children together with the amount paid during the preceding month. Each Wisconsin works agency administering Wisconsin works under ss. 49.141 to 49.161 shall maintain a monthly report at its office showing the names and addresses of all persons receiving benefits under s. 49.148 together with the amount paid during the preceding month. Nothing in this paragraph shall be construed to authorize or require the disclosure in the report of any information (names, amounts of aid or otherwise) pertaining to adoptions, or aid furnished for the care of children in foster homes or treatment foster homes under s. 42.261 46.261 or 49.19 (10).

27,1896 Section 1896 . 49.32 (9) (b) of the statutes is amended to read:

49.32 (9) (b) The report under par. (a) shall be open to public inspection at all times during regular office hours and may be destroyed after the next succeeding report becomes available. Any person except any public officer, seeking permission to inspect such report shall be required to prove his or her identity and to sign a statement setting forth his or her address and the reasons for making the request and indicating that he or she understands the provisions of par. (c) with respect to the use of the information obtained. The use of a fictitious name is a violation of this section. or Wisconsin works agency Within 7 days after the record is inspected, or on the next regularly scheduled communication with that person, whichever is sooner, the county department or Wisconsin works agency shall notify each person whose name and amount of aid was inspected that the record was inspected and of the name and address of the person making such inspection. County departments under ss. 46.215 and , 46.22 and 46.23 administering aid to families with dependent children and Wisconsin works agencies administering Wisconsin works under ss. 49.141 to 49.161 may withhold the right to inspect the name of and amount paid to recipients from private individuals who are not inspecting this information for purposes related to public, educational, organizational, governmental or research purposes until the person whose record is to be inspected is notified by the county department or Wisconsin works agency, but in no case may the county department or Wisconsin works agency withhold this information for more than 5 working days. The county department or Wisconsin works agency shall keep a record of such requests. The record shall indicate the name, address, employer and telephone number of the person making the request. If the person refuses to provide his or her name, address, employer and telephone number, the request to inspect this information may be denied.

27,1897 Section 1897 . 49.32 (10) (a) (intro.) of the statutes is amended to read:

49.32 (10) (a) (intro.) Each county department under s. 46.215 or, 46.22 or 46.23 may release the current address of a recipient of food stamps or of aid under s. 49.19, and each Wisconsin works agency may release the current address of a participant in Wisconsin works under ss. 49.141 to 49.161 or, if administering the food stamp program, of a food stamp recipient, to a law enforcement officer if the officer meets all of the following conditions:

27,1898 Section 1898 . 49.32 (10) (a) 1. of the statutes is amended to read:

49.32 (10) (a) 1. The officer provides, in writing, the name and social security number of the recipient or participant.

27,1899 Section 1899 . 49.32 (10) (a) 2. a. of the statutes is amended to read:

49.32 (10) (a) 2. a. That the recipient or participant is a fugitive felon under 42 USC 602 608 (a) (9), is violating a condition of probation or parole imposed under state or federal law or has information that is necessary for the officer to conduct the official duties of the officer.

27,1900 Section 1900 . 49.32 (10) (a) 2. b. of the statutes is amended to read:

49.32 (10) (a) 2. b. That the location or apprehension of the felon recipient or participant under subd. 2. a. is within the official duties of the officer.

27,1901 Section 1901 . 49.33 (2) of the statutes is amended to read:

49.33 (2) Contracts. County departments under ss. 46.215, 46.22 and 46.23 shall annually enter into a contract with the department detailing the reasonable cost of administering the income maintenance programs and the food stamp program under 7 USC 2011 to 2029 when so appointed by the department. Contracts created under this section control the distribution of payments under s. 20.445 (3) (de) (dz), (md) and (nL) in accordance with the reimbursement method established under sub. (8). The department may reduce its payment to any county under s. 20.445 (3) (de) (dz), (md) and (nL) if federal reimbursement is withheld due to audits, quality control samples or program reviews.

27,1902 Section 1902 . 49.33 (8) (a) of the statutes is amended to read:

49.33 (8) (a) The department shall reimburse each county for reasonable costs of income maintenance relating to the administration of the programs under this subchapter and subch. IV according to a formula based on workload within the limits of available state and federal funds under s. 20.445 (3) (de), (dz), (md) and (nL) by contract under s. 49.33 (2). The amount of reimbursement calculated under this paragraph and par. (b) is in addition to any reimbursement provided to a county for fraud and error reduction under s. 49.197 (1m) and (4).

27,1903 Section 1903 . 49.33 (9) of the statutes is amended to read:

49.33 (9) Reimbursement for income maintenance benefits. The department shall reimburse each county from the appropriations under s. 20.445 (3) (d) (dz) and (p) (md) for 100% of the cost of aid to families with dependent children granted under s. 49.19 and for funeral expenses paid for recipients of aid under s. 49.30.

27,1904 Section 1904 . 49.36 (2) of the statutes is amended to read:

49.36 (2) The department may contract with any county to administer a work experience and job training program for parents who are not custodial parents and who fail to pay child support or to meet their children's needs for support as a result of unemployment or underemployment. The program may provide the kinds of work experience and job training services available from the program under s. 49.193 or 49.147 (3) or (4). The program may also include job search and job orientation activities. The department shall fund the program from the appropriation under s. 20.445 (3) (df) (dz).

27,1904k Section 1904k. 49.37 (1) (intro.) of the statutes is amended to read:

49.37 (1) (intro.)  From the appropriation under s. 20.445 (3) (dk), the The department shall allocate funds to new hope project, inc., as provided in s. 49.175 (1) (s), for a demonstration project that will be conducted in 2 areas in the city of Milwaukee, if all of the following conditions are satisfied:

27,1904L Section 1904L. 49.37 (3) of the statutes is amended to read:

49.37 (3) The contract under sub. (1) (g) shall require an interim evaluation to be submitted to the department no later than January 1, 1993. New hope project, inc., may not use funds appropriated under s. 20.445 (3) (dk) (dz) to fund the evaluation under sub. (1) (g).

27,1904m Section 1904m. 49.37 (4) of the statutes is amended to read:

49.37 (4) This section does not apply after June 30, 1997 1999.

27,1905 Section 1905 . 49.45 (2) (a) 3. of the statutes is amended to read:

49.45 (2) (a) 3. Determine the eligibility of persons for medical assistance, rehabilitative and social services under ss. 49.46, 49.468 and 49.47 and rules and policies adopted by the department and may designate this function to the county department under s. 46.215 or, 46.22 or 46.23 or , to the extent permitted by federal law or a waiver from federal secretary of health and human services, to a Wisconsin works agency.

27,1906 Section 1906 . 49.45 (2) (a) 5. of the statutes is amended to read:

49.45 (2) (a) 5. Cooperate with the division for learning support, equity and advocacy in the department of education public instruction to carry out the provisions of Title XIX.

27,1909 Section 1909 . 49.45 (2) (a) 17. of the statutes is amended to read:

49.45 (2) (a) 17. Notify the governor, the joint committee on legislative organization, the joint committee on finance and appropriate standing committees, as determined by the presiding officer of each house, if the appropriation under s. 20.435 (1) (5) (b) is insufficient to provide the state share of medical assistance.

27,1910 Section 1910 . 49.45 (3) (ag) of the statutes is created to read:

49.45 (3) (ag) Reimbursement shall be made to each entity contracted with under s. 46.271 (2m) for assessments completed under s. 46.271 (2m) (a) 2.

27,1911 Section 1911 . 49.45 (5) of the statutes is renumbered 49.45 (5) (a) and amended to read:

49.45 (5) (a) Any person whose application for medical assistance is denied or is not acted upon promptly or who believes that the payments made in the person's behalf have not been properly determined or that his or her eligibility has not been properly determined may file an appeal with the department pursuant to s. 49.21 (1) par. (b). Review is unavailable if the decision or failure to act arose more than 45 days before submission of the petition for a hearing.

27,1912 Section 1912 . 49.45 (5) (b) of the statutes is created to read:

49.45 (5) (b) 1. Upon receipt of a timely petition under par. (a) the department shall give the applicant or recipient reasonable notice and opportunity for a fair hearing. The department may make such additional investigation as it considers necessary. Notice of the hearing shall be given to the applicant or recipient and to the county clerk or, if a Wisconsin works agency is responsible for making the medical assistance determination, the Wisconsin works agency. The county or the Wisconsin works agency may be represented at such hearing. The department shall render its decision as soon as possible after the hearing and shall send a certified copy of its decision to the applicant or recipient, the county clerk and to the county officer or the Wisconsin works agency charged with administration of the medical assistance program. The decision of the department shall have the same effect as an order of the county officer or the Wisconsin works agency charged with the administration of the medical assistance program. The decision shall be final, but may be revoked or modified as altered conditions may require. The department shall deny a petition for a hearing or shall refuse to grant relief if:

a. The petitioner withdraws the petition in writing.

b. The sole issue in the petition concerns an automatic payment adjustment or change that affects an entire class of recipients and is the result of a change in state or federal law.

c. The petitioner abandons the petition. Abandonment occurs if the petitioner fails to appear in person or by representative at a scheduled hearing without good cause, as determined by the department.

2. If a recipient requests a hearing within the timely notice period specified in 42 CFR 431.231 (c), medical assistance coverage shall not be suspended, reduced or discontinued until a decision is rendered after the hearing but medical assistance payments made pending the hearing decision may be recovered by the department if the contested decision or failure to act is upheld. The department shall promptly notify the county department or, if a Wisconsin works agency is responsible for making the medical assistance determination, the Wisconsin works agency of the county in which the recipient resides that the recipient has requested a hearing. Medical assistance coverage shall be suspended, reduced or discontinued if:

a. The recipient is contesting a state or federal law or a change in state or federal law and not the determination of the payment made on the recipient's behalf.

b. The recipient is notified of a change in his or her medical assistance coverage while the hearing decision is pending but the recipient fails to request a hearing on the change.

3. The recipient shall be promptly informed in writing if medical assistance is to be suspended, reduced or terminated pending the hearing decision.

27,1913 Section 1913 . 49.45 (5m) (a) of the statutes is amended to read:

49.45 (5m) (a) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (1) (5) (b) and (o) the department shall distribute not more than $2,256,000 in each fiscal year, to provide supplemental funds to rural hospitals that, as determined by the department, have high utilization of inpatient services by patients whose care is provided from governmental sources, except that the department may not distribute funds to a rural hospital to the extent that the distribution would exceed any limitation under 42 USC 1396b (i) (3).

27,1914m Section 1914m. 49.45 (6b) (b) of the statutes is amended to read:

49.45 (6b) (b) Beginning in fiscal year 1995-96 1997-98, for relocations from the northern Wisconsin center for the developmentally disabled, by $199 $174 per day.

27,1915m Section 1915m. 49.45 (6b) (c) of the statutes is amended to read:

49.45 (6b) (c) Beginning in fiscal year 1995-96 1997-98, for relocations from the southern Wisconsin center for the developmentally disabled, by $149 $174 per day.

27,1916 Section 1916 . 49.45 (6c) (c) (intro.) of the statutes is amended to read:

49.45 (6c) (c) Resident review. (intro.) Except as provided in par. (e), by April 1, 1990, and at least annually thereafter, the department or an entity to which the department has delegated authority shall review every resident of a facility or institution for mental diseases who has a developmental disability or mental illness and who has experienced a significant change in his or her physical or mental condition to determine if any of the following applies:

27,1917 Section 1917 . 49.45 (6m) (a) 3. of the statutes is amended to read:

49.45 (6m) (a) 3. “Facility" means a nursing home as defined under s. 50.01 (3) or a community-based residential facility that is licensed under s. 50.03 and that is certified by the department as a provider of medical assistance.

27,1918 Section 1918 . 49.45 (6m) (a) 5. of the statutes is created to read:

49.45 (6m) (a) 5. “Nursing home" has the meaning given under s. 50.01 (3).

27,1919 Section 1919 . 49.45 (6m) (ag) (intro.) of the statutes is amended to read:

49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this subsection made under s. 20.435 (1) (b), (o) or (p) or (5) (b) or (o) shall, except as provided in pars. (bg), (bm) and (br), be determined according to a prospective payment system updated annually by the department. The payment system shall implement standards which are reasonable and adequate to meet the costs which must be incurred by efficiently and economically operated facilities in order to provide care in conformity with this section, with federal regulations authorized under 42 USC 1396a (a) (13) (A), 1396a (a) (30), 1396b (i) (3), 1396L and 1396r (e) and with quality and safety standards established under subch. II of ch. 50 and ch. 150. In administering this payment system, the department shall allow costs it determines that are necessary and proper for providing patient care and that meet quality and safety standards established under subch. II of ch. 50 and ch. 150. The payment system shall reflect all of the following:

27,1919g Section 1919g. 49.45 (6m) (ag) 2. of the statutes is amended to read:

49.45 (6m) (ag) 2. Standards established by the department for costs of economically and efficiently operated facilities that shall be based upon allowable costs incurred by facilities in the state as available from information submitted under par. (c) 3. and compiled by the department.

27,1920 Section 1920 . 49.45 (6m) (ag) 3m. of the statutes is amended to read:

49.45 (6m) (ag) 3m. For state fiscal year 1995-96 1997-98, rates that shall be set by the department based on information from cost reports for the 1994 1996 fiscal year of the facility and for state fiscal year 1996-97 1998-99, rates that shall be set by the department based on information from cost reports for the 1995 1997 fiscal year of the facility.

27,1921 Section 1921 . 49.45 (6m) (ag) 8. of the statutes is amended to read:

49.45 (6m) (ag) 8. Calculation of total payments and supplementary payments to facilities that permits an aggregate increase in funds allocated under s. 20.435 (1) (5) (b) and (o) for nursing home care provided medical assistance recipients, including an increase resulting in adjustment of facility base rates and percentage increases over facility base rates, over that paid for services provided in state fiscal year 1994-95 1996‐97 of no more than 4.25% 5 .4% or $45,908,500, whichever is less, during state fiscal year 1995-96 and 1997‐98; and calculation of total payments and supplementary payments to facilities that permits an aggregate increase in funds allocated under s. 20.435 (5) (b) and (o) for nursing home care provided medical assistance recipients, including a percentage increase over facility base rates, over that paid for services provided in state fiscal year 1995-96 1997‐ 98 of no more than 3.5% or $30,145,200, whichever is less, during state fiscal year 1996-97, excluding 1998‐99. Calculation of total payments and supplementary payments under this subdivision excludes increases in total payments attributable to increases in recipient utilization of facility care, payments for the provision of active treatment to facility residents with developmental disability or chronic mental illness and payments for preadmission screening of facility applicants and annual reviews of facility residents required under 42 USC 1396r (e).

27,1922 Section 1922 . 49.45 (6m) (ap) of the statutes is created to read:

49.45 (6m) (ap) If the bed occupancy of a nursing home is below the minimum patient day occupancy standards that are established by the department under par. (ar) (intro.), the department may approve a request by the nursing home to delicense any of the nursing home's licensed beds. If the department approves the nursing home's request, all of the following apply:

1. The department shall delicense the number of beds in accordance with the nursing home's request.

2. The department may not include the number of beds of the nursing home that the department delicenses under this paragraph in determining the costs per patient day under the minimum patient day occupancy standards under par. (ar).

3. The nursing home may not use or sell a bed that is delicensed under this paragraph.

4. a. Every 12 months following the delicensure of a bed under this paragraph, for which a nursing home has not resumed licensure under subd. 5., the department shall reduce the licensed bed capacity of the nursing home by 10% of all of the nursing home's beds that remain delicensed under this paragraph or by 25% of one bed, whichever is greater. The department shall reduce the statewide maximum number of licensed nursing home beds under s. 150.31 (1) (intro.) by the number or portion of a number of beds by which the nursing home's licensed bed capacity is reduced under this subdivision.

b. Subdivision 4. a. does not apply with respect to the delicensure of beds between the effective date of this subd. 4. b. .... [revisor inserts date], and the date that is 60 days after the effective date of this subd. 4. b. .... [revisor inserts date], during the period of any contract entered into by a nursing home prior to January 1, 1997, if the contract requires the nursing home to maintain its current licensed bed capacity.

5. A nursing home retains the right to resume licensure of a bed of the nursing home that was delicensed under this paragraph unless the licensed bed capacity of the nursing home has been reduced by that bed under subd. 4. The nursing home may not resume licensure of a fraction of a bed. The nursing home may resume licensure 18 months after the nursing home notifies the department in writing that the nursing home intends to resume the licensure. If a nursing home resumes licensure of a bed under this subdivision, subd. 2. does not apply with respect to that bed.

6. If subd. 4. b. applies and the nursing home later resumes licensure of a bed that was delicensed between the effective date of this subdivision .... [revisor inserts date], and the date that is 60 days after the effective date of this subdivision .... [revisor inserts date], the department shall calculate the costs per patient day using the methodology specified in the state plan that is in place at the time that the delicensed beds are resumed.

27,1923 Section 1923 . 49.45 (6m) (ar) 1. a. of the statutes is amended to read:

49.45 (6m) (ar) 1. a. The department shall establish standards for payment of allowable direct care costs, for facilities that do not primarily serve the developmentally disabled, that are at least 110% of not less than the median for direct care costs for a sample of all of those facilities that do not primarily serve the developmentally disabled in this state and separate standards for payment of allowable direct care costs, for facilities that primarily serve the developmentally disabled, that are at least 110% of not less than the median for direct care costs for a sample of all of those facilities primarily serving the developmentally disabled in this state. The standards shall be adjusted by the department for regional labor cost variations. The department may decrease the percentage established for the standards only if amounts available under par. (ag) (intro.) are insufficient to provide total payment under par. (am), less capital costs under subd. 6.

27,1924 Section 1924 . 49.45 (6m) (br) 1. of the statutes, as affected by 1997 Wisconsin Act 3, is amended to read:

49.45 (6m) (br) 1. Notwithstanding s. 20.410 (3) (cd), 20.435 (1) (5) (bt) or (bu) or (7) (b) or 20.445 (3) (de) (dz), the department shall reduce allocations of funds to counties in the amount of the disallowance from the appropriations appropriation account under s. 20.410 (3) (cd) or 20.435 (1) (5) (bt) or (bu) or (7) (b), or the department shall direct the department of workforce development to reduce allocations of funds to counties or Wisconsin works agencies in the amount of the disallowance from the appropriation account under s. 20.445 (3) (de) or (dz) or direct the department of corrections to reduce allocations of funds to counties in the amount of the disallowance from the appropriation account under s. 20.410 (3) (cd), in accordance with s. 16.544 to the extent applicable.

27,1925 Section 1925 . 49.45 (6s) of the statutes is repealed.

27,1926 Section 1926 . 49.45 (6t) (intro.) of the statutes is amended to read:

49.45 (6t) County department and local health department operating deficit reduction. (intro.) From the appropriation under s. 20.435 (1) (5) (o), for reduction of operating deficits, as defined under criteria developed by the department, incurred by a county department under s. 46.215, 46.22, 46.23 or 51.42 or by a local health department, as defined in s. 250.01 (4), for services provided under s. 49.46 (2) (a) 4. d. and (b) 6. f., j., k. and L., 9. and 15., for case management services under s. 49.46 (2) (b) 12. and for mental health day treatment services for minors provided under the authorization under 42 USC 1396d (r) (5), the department shall allocate up to $4,500,000 in each fiscal year to these county departments, or local health departments as determined by the department, and shall perform all of the following:

27,1927 Section 1927 . 49.45 (6t) (d) of the statutes is amended to read:

49.45 (6t) (d) If the federal department of health and human services approves for state expenditure in a fiscal year amounts under s. 20.435 (1) (5) (o) that result in a lesser allocation amount than that allocated under this subsection or disallows use of the allocation of federal medicaid funds under par. (c), reduce allocations under this subsection and distribute on a prorated basis, as determined by the department.

27,1928 Section 1928 . 49.45 (6u) (intro.) of the statutes is amended to read: