50.52 (2) (intro.) The department shall issue a provisional license, or a regular
initial license or a license renewal as a rural medical center to an applicant if all of the following are first done:
27,2075c
Section 2075c. 50.52 (2) (a) of the statutes is amended to read:
50.52 (2) (a) The applicant pays the appropriate license fee, as established under s. 50.51 (2) (c). Fees collected under this paragraph shall be credited to the appropriation under s. 20.435 (1) (gm) (6) (jm) for licensing and inspection activities.
27,2076
Section 2076
. 50.52 (4) of the statutes is amended to read:
50.52 (4) Unless sooner revoked or suspended, a A regular initial license or a license renewal issued to a rural medical center is valid for 24 months from the date of issuance and a until it is suspended or revoked. A provisional license issued to a rural medical center is valid for 6 months from the date of issuance.
27,2077
Section 2077
. 50.535 of the statutes is created to read:
50.535 Reporting. Every 24 months, on a schedule determined by the department, a licensed rural medical center shall submit a biennial report in the form and containing the information that the department requires, including payment of the fee required under s. 50.51 (2) (c). If a complete annual report is not timely filed, the department shall issue a warning to the licensee. The department may revoke the license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.
27,2078
Section 2078
. 50.56 (1) (intro.) of the statutes is amended to read:
50.56 (1) (intro.) Any of the following facilities or entities is not required to obtain licensure or a certificate of approval under the following statutes or to pay initial or renewal license fees under the following statutes if all of the services of the facility or entity are provided as a part of a rural medical center that holds a current, valid license under this subchapter:
27,2079
Section 2079
. 50.57 of the statutes is created to read:
50.57 Fees permitted for a workshop or seminar. If the department develops and provides a workshop or seminar relating to the provision of services by rural medical centers under this subchapter, the department may establish a fee for each workshop or seminar and impose the fee on registrants for the workshop or seminar. A fee so established and imposed shall be in an amount sufficient to reimburse the department for the costs directly associated with developing and providing the workshop or seminar.
27,2080
Section 2080
. 50.92 (2) of the statutes is amended to read:
50.92 (2) The department shall issue an initial license or a renewal of a license if the department finds that the applicant is fit and qualified and that the hospice meets the requirements of this subchapter and the rules promulgated under this subchapter.
27,2081
Section 2081
. 50.92 (4) (a) of the statutes is amended to read:
50.92 (4) (a) In lieu of inspecting or investigating a hospice under sub. (3) prior to issuance of an initial a license, the department may accept evidence that a hospice applying for licensure under s. 50.93 has been inspected under and is currently certified as meeting the conditions for medicare participation under 42 USC 1395 to 1395ccc. In lieu of inspecting or investigating a hospice under sub. (3) prior to issuance of a license renewal, the department shall accept evidence that a hospice applying for licensure under s. 50.93 has been inspected under and is currently certified as meeting the conditions for medicare participation under 42 USC 1395 to 1395ccc. The department shall inspect or investigate under sub. (3) prior to issuance of an initial license or a renewal of a license If a hospice that fails to meet the conditions for medicare participation under 42 USC 1395 to 1395ccc, the department shall inspect or investigate the hospice under sub. (3) before initially issuing a license for the hospice.
27,2082
Section 2082
. 50.92 (4) (b) of the statutes is amended to read:
50.92 (4) (b) In lieu of inspecting or investigating a hospice under sub. (3) prior to issuance of an initial license or a renewal of a license, the department may accept evidence that a hospice applying for licensure under s. 50.93 has been inspected under and is currently in compliance with the hospice requirements of the joint commission for the accreditation of health organizations. A hospice shall provide the department with a copy of the report by the joint commission for the accreditation of health organizations of each periodic review the association conducts of the hospice.
27,2083
Section 2083
. 50.92 (5) of the statutes is amended to read:
50.92 (5) The past record of violations of applicable laws or regulations of the United States or of state statutes or rules of this or any other state, in the operation of any health-related organization, by an operator, managing employe or direct or indirect owner of a hospice or of an interest of a hospice is relevant to the issue of the fitness of an applicant for receipt of an initial license or the renewal of a license. The department or the department's designated representative shall inspect and investigate as necessary to determine the conditions existing in each case under this subsection and shall prepare and maintain a written report concerning the investigation and inspection.
27,2084
Section 2084
. 50.93 (1) (intro.) of the statutes is amended to read:
50.93 (1) Application. (intro.) The application for an initial license, for renewal of a license or for a provisional license shall:
27,2085
Section 2085
. 50.93 (1) (c) of the statutes is amended to read:
50.93 (1) (c) Include licensing fee payment, unless the licensing fee is waived by the department on a case-by-case basis under criteria for determining financial hardship established in rules promulgated by the department. An initial licensing fee is $300, except that, for a hospice that is a nonprofit corporation and that is served entirely by uncompensated volunteers or employs persons in not more than 1.5 positions at 40 hours of employment per week, the initial licensing fee is $25. The renewal annual fee thereafter is an amount equal to 0.15% of the net annual income of the hospice, based on the most recent annual report of the hospice under par. (d)
sub. (3m), or, if that amount is less than $200, the renewal fee is $200, whichever is greater, and if that the amount equal to 0.15% of the net annual income of the hospice is greater than $1,000, the renewal fee is $1,000, except that for a hospice that is a nonprofit corporation and that is served entirely by uncompensated volunteers or employs persons in not more than 1.5 positions at 40 hours of employment per week the renewal annual fee is $10. The amount of the provisional licensing fee shall be established under s. 50.95 (2). The initial licensing fee for
an initial license a hospice, including the initial licensing fee for a hospice that is a nonprofit corporation and that is served entirely by uncompensated volunteers or employs persons in not more than 1.5 positions at 40 hours of employment per week, issued after September 1 shall may be prorated according to the number of full months remaining in the license period.
27,2086
Section 2086
. 50.93 (1) (d) of the statutes is repealed.
27,2087
Section 2087
. 50.93 (2) (title) of the statutes is amended to read:
50.93 (2) (title) Issuance of
initial license or license renewal.
27,2088
Section 2088
. 50.93 (2) (a) of the statutes is amended to read:
50.93 (2) (a) Unless sooner revoked or suspended, an initial A hospice license or renewal of a license issued to a hospice is valid for 12 months from the date of issuance until suspended or revoked.
27,2089
Section 2089
. 50.93 (2) (b) of the statutes is repealed.
27,2090
Section 2090
. 50.93 (2) (d) of the statutes is amended to read:
50.93 (2) (d) Any initial license
or renewal of a license shall state any additional information or granted under special limitations prescribed by the department shall state the limitations.
27,2092
Section 2092
. 50.93 (3m) of the statutes is created to read:
50.93 (3m) Reporting. Every 12 months, on a schedule determined by the department, a licensed hospice shall submit an annual report in the form and containing the information that the department requires, including payment of the fee required under sub. (1) (c), evidence of current certification as meeting the conditions for medicare participation under 42 USC 1395 to 1395ccc and evidence of current compliance with the hospice requirements of the joint commission for the accreditation of health organizations. If a complete annual report is not timely filed, the department shall issue a warning to the licensee. The department may revoke the license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.
27,2093
Section 2093
. 50.93 (4) (title) of the statutes is amended to read:
50.93 (4) (title) Suspension
, nonrenewal and revocation.
27,2094
Section 2094
. 50.93 (4) (a) of the statutes is amended to read:
50.93 (4) (a) The department, after notice to the applicant or licensee, may suspend, or revoke or refuse to renew a license in any case in which the department finds that there has been a substantial failure to comply with the requirements of this subchapter or the rules promulgated under this subchapter. No state or federal funds passing through the state treasury may be paid to a hospice not having a valid license issued under this section.
27,2095
Section 2095
. 50.93 (4) (b) of the statutes is amended to read:
50.93 (4) (b) Notice under this subsection shall include a clear and concise statement of the violations on which the nonrenewal or revocation is based, the statute or rule violated and notice of the opportunity for an evidentiary hearing under par. (c).
27,2096
Section 2096
. 50.93 (4) (c) of the statutes is amended to read:
50.93 (4) (c) If a hospice desires to contest the
nonrenewal or revocation of a license, the hospice shall, within 10 days after receipt of notice under par. (b), notify the department in writing of its request for a hearing under s. 227.44.
27,2097
Section 2097
. 50.93 (4) (d) 2. of the statutes is repealed.
27,2098
Section 2098
. 50.93 (4) (d) 3. of the statutes is amended to read:
50.93 (4) (d) 3. The department may extend the effective date of license revocation or expiration in any case in order to permit orderly removal and relocation of individuals served by the hospice.
27,2100
Section 2100
. 50.95 (5) of the statutes is amended to read:
50.95 (5) Criteria for determining that the applicant for initial licensure or license renewal is fit and qualified.
27,2101
Section 2101
. 50.981 of the statutes is created to read:
50.981 Fees permitted for a workshop or seminar. If the department develops and provides a workshop or seminar relating to the provision of services by hospices under this subchapter, the department may establish a fee for each workshop or seminar and impose the fee on registrants for the workshop or seminar. A fee so established and imposed shall be in an amount sufficient to reimburse the department for the costs directly associated with developing and providing the workshop or seminar.
27,2106b
Section 2106b. 51.05 (3g) of the statutes is amended to read:
51.05 (3g) Beginning October 1, 1994, the The department shall annually increase rates charged for the various types of services provided by the mental health institutes by amounts that equal an average of at least a 10% total increase in rates reduce by $500,000 the amount by which accumulated expenses of providing care to patients of the mental health institutes exceed the accumulated revenues from providing that care, until the accumulated revenues of the mental health institutes are in balance with the accumulated expenses of the mental health institutes.
27,2107
Section 2107
. 51.05 (3m) of the statutes is amended to read:
51.05 (3m) Notwithstanding s. 20.903 (1), the department shall implement a plan that is approved by the department of administration to assure that, before July 1, 1999, there are sufficient revenues, as projected by the department of health and family services, to cover anticipated expenditures by that date under the appropriation under s. 20.435 (2) (gk) for the purpose of reimbursing the provision of care to patients of the Mendota mental health institute or the Winnebago mental health institute and to ensure that the department complies with sub. (3g). The department of health and family services shall make reports to the department of administration every 3 months, beginning on October 1, 1993, and ending on July 1, 1999, concerning the implementation of this plan. The department of health and family services shall make reports to the joint committee on finance by December 31 of each year that identify the change, during the preceding fiscal year, in the amount by which the accumulated expenses of providing care to patients of the mental health institutes exceed the accumulated revenues from providing that care; describe the actions taken by the department during the preceding fiscal year to reduce that amount; and describe the actions that the department is taking during the current year to reduce that amount.
27,2108
Section 2108
. 51.05 (5) of the statutes is amended to read:
51.05 (5) School activities. If an individual over the age of 2 and under the age of 22 and eligible for schooling under ss. 115.76 (2) and 115.85 is committed, admitted or transferred to or is a resident of the Mendota mental health institute or Winnebago mental health institute, the individual shall attend a school program operated by the applicable mental health institute or a school outside the applicable mental health institute which is approved by the department of education public instruction. A school program operated by the Mendota mental health institute or Winnebago mental health institute shall be under the supervision of the department of education public instruction and shall meet standards prescribed by that agency.
27,2110
Section 2110
. 51.06 (2) of the statutes is amended to read:
51.06 (2) School activities. If an individual over the age of 2 years and under the age of 22 years and eligible for schooling under ss. 115.76 (2) and 115.85 is admitted to, is placed in or is a resident of a center, the individual shall attend a school program operated by the center or a school outside the center which is approved by the department of education public instruction. A school program operated by the center shall be under the supervision of the department of education public instruction and shall meet standards prescribed by that agency.
27,2111
Section 2111
. 51.07 (3) of the statutes is amended to read:
51.07 (3) The department may provide outpatient services only to patients contracted for with county departments under ss. 51.42 and 51.437 in accordance with s. 46.03 (18), except for those patients whom the department finds to be nonresidents of this state and those patients specified in sub. (4) (a). The full and actual cost less applicable collections of such services contracted for with county departments under s. 51.42 or 51.437 shall be charged to the respective county department under s. 51.42 or 51.437. The state shall provide the services required for patient care only if no such outpatient services are funded by the department in the county or group of counties served by the respective county department under s. 51.42 or 51.437.
27,2112
Section 2112
. 51.07 (4) of the statutes is created to read:
51.07 (4) (a) The department may provide outpatient services at the Winnebago Mental Health Institute to a patient who is a pupil of a school district that contracts with the department for the provision of those services. The department shall charge the full and actual cost of those services contracted for to the school district in which the patient is enrolled.
(b) If the Winnebago Mental Health Institute has provided a pupil of a school district with the services contracted for under par. (a), the department shall regularly bill the school district for the services provided and, subject to the provisions of the contract, the school district shall pay the amount due within 60 days after the billing date.
(c) The department shall credit any revenues received under this subsection to the appropriation account under s. 20.435 (2) (gk).
27,2112p
Section 2112p. 51.13 (4) (g) (intro.) of the statutes is amended to read:
51.13 (4) (g) (intro.) If the court finds that the minor is in need of psychiatric services, or services for developmental disability, alcoholism or drug abuse in an inpatient facility, and that the inpatient facility to which the minor is admitted offers therapy or treatment which
that is appropriate for the minor's needs and which
that is the least restrictive therapy or treatment consistent with the minor's needs and, in the case of a minor aged 14 or older, the application is voluntary on the part of the minor, it the court shall permit voluntary admission. If the court finds that the therapy or treatment in the inpatient facility to which the minor is admitted is not appropriate or is not the least restrictive therapy or treatment consistent with the minor's needs, the court may order placement in or transfer to another more appropriate or less restrictive inpatient facility, except that the court may not permit or order placement in or transfer to the northern or southern centers for the developmentally disabled of a minor unless the department gives approval for the placement or transfer and if the order of the court is approved by all of the following if applicable:
27,2112vm
Section 2112vm. 51.14 (4) (a) of the statutes is amended to read:
51.14 (4) (a) Within 21 days after the issuance of the order by the mental health review officer under sub. (3) or if the requirements of sub. (3) (f) are satisfied, the minor or his or her parent or guardian may petition a court assigned to exercise jurisdiction under ch. chs. 48 and 938 in the county of residence of the minor's parent or guardian for a review of the refusal of either the minor or his or her parent or guardian to provide the informed consent for outpatient mental health treatment required under s. 51.61 (6).
27,2126
Section 2126
. 51.42 (3) (bm) of the statutes is amended to read:
51.42 (3) (bm) Educational services. A county department of community programs may not furnish services and programs provided by the department of education public instruction and local educational agencies.
27,2127
Section 2127
. 51.42 (7) (a) 5. of the statutes is amended to read:
51.42 (7) (a) 5. Ensure that county departments of community programs that elect to provide special education programs to children aged 3 years and under comply with requirements established by the department of education public instruction.
27,2131
Section 2131
. 51.423 (1) of the statutes is amended to read:
51.423 (1) The department shall fund, within the limits of the department's allocation for mental health services under s. 20.435 (3) (o) and (7) (b), (kw) and (o) and subject to this section, services for mental illness, developmental disability, alcoholism and drug abuse to meet standards of service quality and accessibility. The department's primary responsibility is to guarantee that county departments established under either s. 51.42 or 51.437 receive a reasonably uniform minimum level of funding and its secondary responsibility is to fund programs which meet exceptional community needs or provide specialized or innovative services. Moneys appropriated under s. 20.435 (7) (b) and earmarked by the department for mental health services under s. 20.435 (7) (o) shall be allocated by the department to county departments under s. 51.42 or 51.437 in the manner set forth in this section.
27,2132
Section 2132
. 51.423 (2) of the statutes is amended to read:
51.423 (2) From the appropriations under s. 20.435 (3) (o) and (7) (b), (kw) and (o), the department shall distribute the funding for services provided or purchased by county departments under s. 46.23, 51.42 or 51.437 to such county departments as provided under s. 46.40. County matching funds are required for the distributions under s. 46.40 (2). Each county's required match for a year equals 9.89% of the total of the county's distributions for that year for which matching funds are required plus the amount the county was required by s. 46.26 (2) (c), 1985 stats., to spend for juvenile delinquency-related services from its distribution for 1987. Matching funds may be from county tax levies, federal and state revenue sharing funds or private donations to the counties that meet the requirements specified in sub. (5). Private donations may not exceed 25% of the total county match. If the county match is less than the amount required to generate the full amount of state and federal funds distributed for this period, the decrease in the amount of state and federal funds equals the difference between the required and the actual amount of county matching funds.
27,2133
Section 2133
. 51.437 (4r) (a) 1. of the statutes is amended to read:
51.437 (4r) (a) 1. May not furnish services and programs provided by the department of education
public instruction and local educational agencies.
27,2134
Section 2134
. 51.437 (4rm) (a) of the statutes is amended to read:
51.437 (4rm) (a) A county department of developmental disabilities services shall authorize all care of any patient in a state, local or private facility under a contractual agreement between the county department of developmental disabilities services and the facility, unless the county department of developmental disabilities services governs the facility. The need for inpatient care shall be determined by the program director or designee in consultation with and upon the recommendation of a licensed physician trained in psychiatry and employed by the county department of developmental disabilities services or its contract agency prior to the admission of a patient to the facility except in the case of emergency services. In cases of emergency, a facility under contract with any county department of developmental disabilities services shall charge the county department of developmental disabilities services having jurisdiction in the county where the individual receiving care is found. The county department of developmental disabilities services shall reimburse the facility, except as provided under par. (c), for the actual cost of all authorized care and services less applicable collections under s. 46.036, unless the department of health and family services determines that a charge is administratively infeasible, or unless the department of health and family services, after individual review, determines that the charge is not attributable to the cost of basic care and services. The exclusionary provisions of s. 46.03 (18) do not apply to direct and indirect costs which are attributable to care and treatment of the client. County departments of developmental disabilities services may not reimburse any state institution or receive credit for collections for care received therein by nonresidents of this state, interstate compact clients, transfers under s. 51.35 (3) (a), commitments under s. 975.01, 1977 stats., or s. 975.02, 1977 stats., or s. 971.14, 971.17 or 975.06, admissions under s. 975.17, 1977 stats., or children placed in the guardianship of the department of health and family services under s. 48.427 or 48.43 or under the supervision of the department of corrections under s. 938.183 (2) or 938.355.
27,2135
Section 2135
. 51.437 (4rm) (c) 1. of the statutes is amended to read:
51.437 (4rm) (c) 1. Regularly bill the county department of developmental disabilities services for services provided prior to January 1, 1982 as specified in par. (c) 2. a. and 2m. If collections for care received by the department of health and family services prior to January 1, 1982, exceed current billings, the difference shall be remitted to the county department of developmental disabilities services through the appropriation under s. 20.435 (2) (gk). If billings for the quarter ending December 31, 1981, exceed collections for care received by the department of health and family services during the quarter ending December 31, 1981, collections for care provided prior to January 1, 1982, shall be remitted to the county department of developmental disabilities services through the appropriation under s. 20.435 (2) (gk), up to the level of the net amount billed the county department of developmental disabilities services for the quarter ending December 31, 1981. Under this section, collections on or after January 1, 1976, from medical assistance shall be the approved amounts listed by the patient on remittance advices from the medical assistance carrier, not including adjustments due to retroactive rate approval and less any refunds to the medical assistance program. For care provided on and after January 1, 1978, the department of health and family services shall adjust collections from medical assistance to compensate for differences between specific rate scales for care charged to the county department of developmental disabilities services and the average daily medical assistance reimbursement rate. Payment shall be due from the county department of developmental disabilities services within 60 days of the billing date subject to provisions of the contract. If any payment has not been received within 60 days, the department of health and family services shall deduct all or part of the amount due from any payment due from the department of health and family services to the county department of developmental disabilities services.
27,2136
Section 2136
. 51.437 (4rm) (c) 2. b. of the statutes is amended to read:
51.437 (4rm) (c) 2. b. Bill the county department of developmental disabilities services for services provided on or after January 1, 1982, at 10% of the rate paid by medical assistance, excluding any retroactive rate adjustment December 31, 1997, at $48 per day,
if the guardian or parent of the person served does not object to placement of the person in the community and if an independent professional review established under 42 USC 1396a (a) (31) designates the person served as appropriate for community care, including persons who have been admitted for more than 180 consecutive days and for whom the cost of care in the community would be less than $184 per day. The department of health and family services shall use money it receives from the county department of developmental disabilities services to offset the state's share of medical assistance. Payment is due from the county department of developmental disabilities services within 60 days of the billing date, subject to provisions of the contract. If the department of health and family services does not receive any payment within 60 days, it shall deduct all or part of the amount due from any payment the department of health and family services is required to make to the county department of developmental disabilities services. The department of health and family services shall first use collections received under s. 46.10 as a result of care at a center for the developmentally disabled to reduce the costs paid by medical assistance, and shall remit the remainder to the county department of developmental disabilities services up to the portion billed. The department of health and family services shall use the appropriation under s. 20.435 (2) (gk) to remit collection credits and other appropriate refunds to county departments of developmental disabilities services.
27,2137
Section 2137
. 51.437 (4rm) (c) 2m. of the statutes is amended to read:
51.437 (4rm) (c) 2m. Bill the county department of developmental disabilities services for services provided under s. 51.06 (1) (d) to individuals who are eligible for medical assistance that are not provided by the federal government, using the procedure established under subd. 1.
27,2138
Section 2138
. 51.437 (14) (g) of the statutes is amended to read:
51.437 (14) (g) Ensure that any county department of developmental disabilities services which elects to provide special education programs to children aged 3 years and under complies with requirements established by the department of education public instruction.
27,2139
Section 2139
. 51.44 (3) (a) of the statutes is amended to read:
51.44 (3) (a) From the appropriations under s. 20.435 (3) (7) (bt) and (nL) the department shall allocate and distribute funds to counties to provide or contract for the provision of early intervention services to individuals eligible to receive the early intervention services.
27,2141
Section 2141
. 51.45 (4) (d) of the statutes is amended to read:
