AB100-ASA1,664,2
15. The services are provided to the person in an adult family home, as defined
2in s. 50.01 (1).
AB100-ASA1, s. 1459mf 3Section 1459mf. 46.27 (7) (ck) of the statutes is created to read:
AB100-ASA1,664,94 46.27 (7) (ck) 1. Subject to the approval of the department, a county may
5establish and implement more restrictive conditions than those imposed under par.
6(cj) on the use of funds received under par. (b) for the provision of services to a person
7in a community-based residential facility. A county that establishes more restrictive
8conditions under this paragraph shall include the conditions in its community
9options plan under sub. (3) (cm).
AB100-ASA1,664,1410 2. If the department determines that a county has engaged in a pattern of
11inappropriate use of funds received under par. (b), the department may revoke its
12approval of the county's conditions established under subd. 1., if any, and may
13prohibit the county from using funds received under par. (b) to provide services under
14par. (cj) 3.
AB100-ASA1, s. 1460m 15Section 1460m. 46.27 (9) (a) of the statutes is amended to read:
AB100-ASA1,664,2416 46.27 (9) (a) The department may select up to 5 counties that volunteer to
17participate in a pilot project under which they will receive certain funds allocated for
18long-term care. The department shall allocate a level of funds to these counties
19equal to the amount that would otherwise be paid under s. 20.435 (1) (5) (b) to nursing
20homes for providing care because of increased utilization of nursing home services,
21as estimated by the department. In estimating these levels, the department shall
22exclude any increased utilization of services provided by state centers any center for
23the developmentally disabled. The department shall calculate these amounts on a
24calendar year basis under sub. (10).
AB100-ASA1, s. 1134 25Section 1134. 46.27 (9) (c) of the statutes is amended to read:
AB100-ASA1,665,6
146.27 (9) (c) All long-term community support services provided under this
2pilot project in lieu of nursing home care shall be consistent with those services
3described in the participating county's community options plan under sub. (4) (c) and
4provided under sub. (5) (b). Each Unless the department has contracted under s.
546.271 (2m) with an entity other than the county department, each
county
6participating in the pilot project shall assess persons under sub. (6).
AB100-ASA1, s. 1135 7Section 1135. 46.27 (10) (a) 1. of the statutes is amended to read:
AB100-ASA1,665,128 46.27 (10) (a) 1. The department shall determine for each county participating
9in the pilot project under sub. (9) a funding level of state medical assistance
10expenditures to be received by the county. This level shall equal the amount that the
11department determines would otherwise be paid under s. 20.435 (1) (5) (b) because
12of increased utilization of nursing home services, as estimated by the department.
AB100-ASA1, s. 1136 13Section 1136. 46.27 (11) (c) 3. of the statutes is amended to read:
AB100-ASA1,665,1714 46.27 (11) (c) 3. Medical assistance reimbursement for services a county, a
15private nonprofit agency or an aging unit with which the department contracts
16provides under this subsection shall be made from the appropriations under s. 20.435
17(1) (5) (o) and (7) (b) and (bd).
AB100-ASA1, s. 1137 18Section 1137. 46.27 (11) (c) 4. of the statutes is amended to read:
AB100-ASA1,665,2319 46.27 (11) (c) 4. The department may, from the appropriation under s. 20.435
20(1) (5) (o), provide reimbursement for services provided under this subsection by
21counties that are in excess of the current average annual per person rate, as
22established by the department, and are less than or equal to the average amount
23approved in the waiver received under par. (am).
AB100-ASA1, s. 1464g 24Section 1464g. 46.27 (11) (c) 5m. of the statutes is created to read:
AB100-ASA1,666,4
146.27 (11) (c) 5m. No county may use funds received under this subsection to
2provide services to a person who does not live in his or her own home or apartment
3unless, subject to the limitations under subds. 6., 7. and 8., one of the following
4applies:
AB100-ASA1,666,85 a. The services are provided to the person in a community-based residential
6facility that entirely consists of independent apartments, each of which has an
7individual lockable independent entrance and exit and individual separate kitchen,
8bathroom, sleeping and living areas.
AB100-ASA1,666,119 b. The person suffers from Alzheimer's disease or related dementia and the
10services are provided to the person in a community-based residential facility that
11has a dementia care program.
AB100-ASA1,666,1312 c. The services are provided to the person in a residential care apartment
13complex, as defined in s. 50.01 (1d).
AB100-ASA1,666,1514 d. The services are provided to the individual in an adult family home, as
15defined in s. 50.01 (1).
AB100-ASA1,666,1616 e. Subdivision 5n. applies.
AB100-ASA1, s. 1464h 17Section 1464h. 46.27 (11) (c) 5n. of the statutes is created to read:
AB100-ASA1,666,2218 46.27 (11) (c) 5n. A county may also use funds received under this subsection,
19subject to the limitations under subds. 6., 7. and 8., to provide services to a person
20who does not live in his or her own home or apartment if the services are provided
21to the person in a community-based residential facility and the county department
22or aging unit has determined that all of the following conditions have been met:
AB100-ASA1,666,2523 a. An assessment under sub. (6) has been completed for the person prior to the
24person's admission to the community-based residential facility, whether or not the
25person is a private pay admittee at the time of admission.
AB100-ASA1,667,4
1b. The county department or aging unit documents that the option of in-home
2services has been discussed with the person, thoroughly evaluated and found to be
3infeasible, as determined by the county department or aging unit in accordance with
4rules promulgated by the department of health and family services.
AB100-ASA1,667,75 c. The county department or aging unit determines that the community-based
6residential facility is the person's preferred place of residence or is the setting
7preferred by the person's guardian.
AB100-ASA1,667,98 d. The county department or aging unit determines that the community-based
9residential facility provides a quality environment and quality care services.
AB100-ASA1,667,1210 e. The county department or aging unit determines that placement in the
11community-based residential facility is cost-effective compared to other options,
12including home care and nursing home care.
AB100-ASA1, s. 1464j 13Section 1464j. 46.27 (11) (c) 5p. of the statutes is created to read:
AB100-ASA1,667,1914 46.27 (11) (c) 5p. a. Subject to the approval of the department, a county may
15establish and implement more restrictive conditions than those imposed under subd.
165m. on the use of funds received under par. (b) for the provision of services to a person
17in a community-based residential facility. A county that establishes more restrictive
18conditions under this paragraph shall include the conditions in its community
19options plan under sub. (3) (cm).
AB100-ASA1,667,2420 b. If the department determines that a county has engaged in a pattern of
21inappropriate use of funds received under par. (b), the department may revoke its
22approval of the county's conditions established under subd. 1. a., if any, and may
23prohibit the county from using funds received under par. (b) to provide services under
24subd. 5n.
AB100-ASA1, s. 1138
1Section 1138. 46.271 (1) of the statutes is renumbered 46.271 (1) (a), and
246.271 (1) (a) (intro.), as renumbered, is amended to read:
AB100-ASA1,668,83 46.271 (1) (a) (intro.) From the appropriation under s. 20.435 (7) (bd), the
4department shall award $100,000 in each fiscal year to applying county departments
5under s. 46.215, 46.22, 46.23, 51.42 or 51.437 or to an aging unit under the conditions
6specified in sub. (3) par. (c) to establish pilot projects for home and community-based
7long-term support services. Funds awarded to the pilot projects shall be used to do
8any of the following:
AB100-ASA1, s. 1139 9Section 1139. 46.271 (2) of the statutes is renumbered 46.271 (1) (b), and
1046.271 (1) (b) 1. and 2., as renumbered, are amended to read:
AB100-ASA1,668,1211 46.271 (1) (b) 1. Solicit applications from county departments or aging units
12for the pilot projects under sub. (1) par. (a).
AB100-ASA1,668,1613 2. Require that an applying county department or aging unit under par. (a)
14subd. 1. submit as part of the application specific plans for improving the
15coordination between hospitals and providers of home and community-based
16long-term support services.
AB100-ASA1, s. 1140 17Section 1140. 46.271 (2m) of the statutes is created to read:
AB100-ASA1,668,2018 46.271 (2m) (a) The department may establish, in geographic areas
19determined by the department, a pilot project under which the department may
20contract with a private or public entity to do all of the following:
AB100-ASA1,668,2321 1. Serve as a clearinghouse of information for individuals who are interested
22in home or community-based long-term support services or institutional long-term
23care services.
AB100-ASA1,669,624 2. Perform assessments using the assessment method established by the
25department to determine an individual's functional abilities, disabilities, personal

1preferences and need for home or community-based long-term support services or
2institutional long-term care services. Each assessment shall include an
3investigation of long-term community support services that could serve as
4alternatives to institutional care in a nursing home or community-based residential
5facility. The assessment shall include an explanation of the potential community
6alternatives to the person being assessed and the person's family or guardian.
AB100-ASA1,669,87 3. Collect information specified by the department on the individuals served
8by the entity and provide that information to the department.
AB100-ASA1,669,139 (am) Residents of the geographic areas where a pilot project under this
10subsection is established shall receive an assessment by the entity contracted with
11under par. (a) (intro.) prior to entry into a nursing home or community-based
12residential facility or participation in the long-term support community options
13program under s. 46.27.
AB100-ASA1,669,1614 (ap) The department may require that the results of a client's assessment
15under par. (a) 2. be submitted at the time that a provider submits a request for prior
16authorization for medical assistance services.
AB100-ASA1,669,2017 (b) From the amounts carried forward under 1997 Wisconsin Act .... (this act),
18section 9123 (2), the department shall distribute funds to the entities with which the
19department contracts under par. (a) (intro.) for the performance of the functions
20specified under par. (a) 1. to 3.
AB100-ASA1,669,2121 (c) Paragraphs (a) 2., (am) and (ap) do not apply to any of the following:
AB100-ASA1,669,2322 1. Emergency admissions, as determined by a physician, but shall be applied
23within 10 days after the admission.
AB100-ASA1,670,224 2. A private pay patient seeking admission to or about to be admitted to a
25nursing home or community-based residential facility who is informed about the

1program but waives the assessment, unless the patient will be eligible for medical
2assistance within 6 months after the assessment.
AB100-ASA1,670,53 3. Persons seeking admission to or about to be admitted to the Wisconsin
4Veteran's Home at King who are informed about the pilot project but waive the
5assessment.
AB100-ASA1,670,76 4. Any person who is readmitted to a nursing home or community-based
7residential facility from a hospital within 6 months after being assessed.
AB100-ASA1,670,98 5. Current residents of a nursing home or community-based residential facility
9who are eligible for an assessment but who waive the assessment.
AB100-ASA1,670,1110 6. A person who enters a nursing home or community-based residential facility
11for recuperative care.
AB100-ASA1,670,1312 7. A person who enters a nursing home or community-based residential facility
13for respite care.
AB100-ASA1,670,1714 8. A person who is admitted to a nursing home or community-based residential
15facility from another nursing home or community-based residential facility, unless
16the person requests an assessment and funds distributed for assessments under par.
17(b) are available to the entity.
AB100-ASA1, s. 1141 18Section 1141. 46.271 (3) of the statutes is renumbered 46.271 (1) (c) and
19amended to read:
AB100-ASA1,670,2220 46.271 (1) (c) The department may contract with an aging unit, as defined in
21s. 46.27 (1) (a), for administration of services under sub. (1) par. (a) if, by resolution,
22the county board of supervisors of that county so requests the department.
AB100-ASA1, s. 1468d 23Section 1468d. 46.275 (title) of the statutes is amended to read:
AB100-ASA1,670,25 2446.275 (title) Community integration program for state center
25residents
of state centers.
AB100-ASA1, s. 1468g
1Section 1468g. 46.275 (1) of the statutes is amended to read:
AB100-ASA1,671,72 46.275 (1) Legislative intent. The intent of the program under this section is
3to relocate persons from the residents of any state centers center for the
4developmentally disabled into appropriate community settings with the assistance
5of home and community-based services and with continuity of care. The intent of
6the program is also to minimize its impact on state employes through redeployment
7of employes into vacant positions.
AB100-ASA1, s. 1468m 8Section 1468m. 46.275 (1m) (b) of the statutes is amended to read:
AB100-ASA1,671,119 46.275 (1m) (b) "Program" means the community integration program for
10residents of any state centers center for the developmentally disabled, for which a
11waiver has been received under sub. (2).
AB100-ASA1, s. 1468p 12Section 1468p. 46.275 (2) (intro.) of the statutes is amended to read:
AB100-ASA1,671,2313 46.275 (2) Departmental powers and duties. (intro.) The department may
14request a waiver from the secretary of the U.S. department of health and human
15services, under 42 USC 1396n (c), authorizing the department to integrate medical
16assistance recipients who reside in state centers
residents of any state center for the
17developmentally disabled who receive medical assistance into their communities by
18providing home and community-based services as part of the medical assistance
19program. If the department requests this waiver, it shall include all assurances
20required under 42 USC 1396n (c) (2) in its request. If the department receives this
21waiver, at the end of the 3-year period during which the waiver remains in effect the
22department may request an additional 3-year extension of the waiver. If the
23department receives this waiver, it shall:
AB100-ASA1, s. 1468r 24Section 1468r. 46.275 (2) (b) of the statutes is amended to read:
AB100-ASA1,672,3
146.275 (2) (b) Evaluate the effect of the program on medical assistance costs
2and on the program's ability to provide community care alternatives to institutional
3care in a state centers center for the developmentally disabled.
AB100-ASA1, s. 1142 4Section 1142. 46.275 (5) (a) of the statutes is amended to read:
AB100-ASA1,672,105 46.275 (5) (a) Medical assistance reimbursement for services a county, or the
6department under sub. (3r), provides under this program is available from the
7appropriations under s. 20.435 (1) (5) (b) and (o). If 2 or more counties jointly contract
8to provide services under this program and the department approves the contract,
9medical assistance reimbursement is also available for services provided jointly by
10these counties.
AB100-ASA1, s. 1143 11Section 1143. 46.275 (5) (c) of the statutes is amended to read:
AB100-ASA1,672,1812 46.275 (5) (c) The total allocation under s. 20.435 (1) (5) (b) and (o) to counties
13and to the department under sub. (3r) for services provided under this section may
14not exceed the amount approved by the federal department of health and human
15services. A county may use funds received under this section only to provide services
16to persons who meet the requirements under sub. (4) and may not use unexpended
17funds received under this section to serve other developmentally disabled persons
18residing in the county.
AB100-ASA1, s. 1144 19Section 1144. 46.275 (5) (d) of the statutes is amended to read:
AB100-ASA1,672,2420 46.275 (5) (d) The department may, from the appropriation under s. 20.435 (1)
21(5) (o), provide reimbursement for services provided under this section by counties
22that are in excess of the current average annual per person rate, as established by
23the department, and are less than the average amount approved in the waiver
24received under sub. (2).
AB100-ASA1, s. 1471m 25Section 1471m. 46.277 (3) (c) of the statutes is amended to read:
AB100-ASA1,673,10
146.277 (3) (c) Beginning on January 1, 1996, from the annual allocation to the
2county for the provision of long-term community support services under sub. (5),
3annually establish a maximum total amount, not to exceed 25% of the annual
4allocation,
that may be encumbered in a calendar year for services for eligible
5individuals in community-based residential facilities. If the total amount that is
6encumbered for services for individuals in community-based residential facilities
7who are receiving services under sub. (5) on January 1, 1996, exceeds 25% of the
8county's annual allocation, a county may request a waiver of the requirement under
9this paragraph from the department. The department need not promulgate as rules
10under ch. 227 the standards for granting a waiver request under this paragraph.
AB100-ASA1, s. 1471p 11Section 1471p. 46.277 (5) (d) 1m. of the statutes is created to read:
AB100-ASA1,673,1512 46.277 (5) (d) 1m. No county may use funds received under this section to
13provide services to a person who does not live in his or her own home or apartment
14unless, subject to the limitations under subds. 2. and 3. and par. (e), one of the
15following applies:
AB100-ASA1,673,1916 a. The services are provided to the person in a community-based residential
17facility that entirely consists of independent apartments, each of which has an
18individual lockable independent entrance and exit and individual separate kitchen,
19bathroom, sleeping and living areas.
AB100-ASA1,673,2220 b. The person suffers from Alzheimer's disease or related dementia and the
21services are provided to the person in a community-based residential facility that
22has a dementia care program.
AB100-ASA1,673,2423 c. The services are provided to the person in a residential care apartment
24complex, as defined in s. 50.01 (1d).
AB100-ASA1,674,2
1d. The services are provided to the individual in an adult family home, as
2defined in s. 50.01 (1).
AB100-ASA1,674,33 e. Subdivision 1n. applies.
AB100-ASA1, s. 1471q 4Section 1471q. 46.277 (5) (d) 1n. of the statutes is created to read:
AB100-ASA1,674,105 46.277 (5) (d) 1n. A county may also use funds received under this section,
6subject to the limitations under subds. 2. and 3. and par. (e), to provide services to
7a person who does not live in his or her own home or apartment if the services are
8provided to the person in a community-based residential facility and the county
9department or aging unit has determined that all of the following conditions have
10been met:
AB100-ASA1,674,1311 a. An assessment under s. 46.27 (6) has been completed for the person prior
12to the person's admission to the community-based residential facility, whether or not
13the person is a private pay admittee at the time of admission.
AB100-ASA1,674,1714 b. The county department or aging unit documents that the option of in-home
15services has been discussed with the person, thoroughly evaluated and found to be
16infeasible, as determined by the county department or aging unit in accordance with
17rules promulgated by the department of health and family services.
AB100-ASA1,674,2018 c. The county department or aging unit determines that the community-based
19residential facility is the person's preferred place of residence or is the setting
20preferred by the person's guardian.
AB100-ASA1,674,2221 d. The county department or aging unit determines that the community-based
22residential facility provides a quality environment and quality care services.
AB100-ASA1,674,2523 e. The county department or aging unit determines that placement in the
24community-based residential facility is cost-effective compared to other options,
25including home care and nursing home care.
AB100-ASA1, s. 1471qi
1Section 1471qi. 46.277 (5) (d) 1p. of the statutes is created to read:
AB100-ASA1,675,72 46.277 (5) (d) 1p. a. Subject to the approval of the department, a county may
3establish and implement more restrictive conditions than those imposed under subd.
41m. on the use of funds received under this section for the provision of services to a
5person in a community-based residential facility. A county that establishes more
6restrictive conditions under this paragraph shall include the conditions in its plan
7under sub. (3) (a).
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