AB133-ASA1,568,5
146.27 (6g) Fiscal responsibility. (intro.) Except as provided in s. 51.40, and
2within the limitations under sub. (7) (b), the fiscal responsibility of a county for an
3assessment, unless the assessment is performed by an entity under s. 46.271 (2m)
446.281 (1) (d), case plan or services provided to a person under this section is as
5follows:
AB133-ASA1, s. 1041m 6Section 1041m. 46.27 (6r) (f) of the statutes is created to read:
AB133-ASA1,568,127 46.27 (6r) (f) A person who has attained the age of 18 but has not attained the
8age of 65 unless that person is engaged in gainful employment or participating in a
9program that is certified by the department to provide health and employment
10services that are aimed at helping the individual achieve employment goals. The
11department may waive this paragraph for any individual for whom its application
12would cause undue hardship.
AB133-ASA1, s. 1042 13Section 1042. 46.27 (6u) (c) 2. of the statutes is amended to read:
AB133-ASA1,568,2114 46.27 (6u) (c) 2. For a person who is determined to be financially eligible under
15subd. 1. calculate, by use of the uniform fee system under s. 46.03 (18), the amount
16of cost sharing required for receipt of long-term community support services
17provided under sub. (5) (b). The county department or aging unit shall require
18payment by the person of 100% of the amount calculated under this subdivision,
19unless the person is a recipient of medical assistance under s. 49.472. If the person
20is a recipient of medical assistance under s. 49.472, the county department or aging
21unit may not require any payment from the person under this subdivision
.
AB133-ASA1, s. 1043 22Section 1043. 46.27 (7) (am) of the statutes is amended to read:
AB133-ASA1,569,623 46.27 (7) (am) From the appropriation under s. 20.435 (7) (bd), the department
24shall allocate funds to each county or private nonprofit agency with which the
25department contracts to pay assessment and case plan costs under sub. (6) not

1otherwise paid by fee or under s. 49.33 (2) or 49.45. The department shall reimburse
2counties for the cost of assessing persons eligible for medical assistance under s.
349.46, 49.468 or 49.47 as part of the administrative services of medical assistance,
4payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this
5paragraph to pay the cost of long-term community support services and for a risk
6reserve under par. (fr)
.
AB133-ASA1, s. 1044 7Section 1044. 46.27 (7) (b) of the statutes is amended to read:
AB133-ASA1,569,218 46.27 (7) (b) 1m. From the appropriations under s. 20.435 (7) (bd) and (im), the
9department shall allocate funds to each county to pay the cost of providing long-term
10community support services under sub. (5) (b) not otherwise paid under s. 49.45 to
11persons eligible for medical assistance under s. 49.46 or 49.47 or to persons whom
12the county department or aging unit administering the program finds likely to
13become medically indigent within 6 months by spending excess income or assets for
14medical or remedial care. The average per person reimbursement under this
15paragraph may not exceed the state share of the average per person payment rate
16the department expects under s. 49.45 (6m). The county department or aging unit
17administering the program may spend funds received under this paragraph only in
18accordance with the case plan and service contract created for each person receiving
19long-term community support services. Counties may use unspent funds allocated
20under this paragraph from the appropriation under s. 20.435 (7) (bd) for a risk
21reserve under par. (fr).
AB133-ASA1, s. 1045 22Section 1045. 46.27 (7) (cj) 3. a. of the statutes is amended to read:
AB133-ASA1,570,423 46.27 (7) (cj) 3. a. An assessment under sub. (6) has been completed for the
24person prior to the person's admission to the community-based residential facility,
25whether or not the person is a private pay admittee at the time of admission. The

1county may waive this condition in accordance with guidelines established by the
2department. If the county waives this condition, the county must meet with the
3person or the person's guardian to discuss the cost-effectiveness of various service
4options.
AB133-ASA1, s. 1046 5Section 1046. 46.27 (7) (fm) of the statutes is amended to read:
AB133-ASA1,570,186 46.27 (7) (fm) The department shall, at the request of a county, carry forward
7up to 10% of the amount allocated under this subsection to the county for a calendar
8year if up to 10% of the amount so allocated has not been spent or encumbered by the
9county by December 31 of that year, for use by the county in the following calendar
10year, except that the amount carried forward shall be reduced by the amount of funds
11that the county has notified the department that the county wishes to place in a risk
12reserve under par. (fr)
. The department may transfer funds within s. 20.435 (7) (bd)
13to accomplish this purpose. An allocation under this paragraph does not affect a
14county's base allocation under this subsection and shall lapse to the general fund
15unless expended within the calendar year to which the funds are carried forward.
16A county may not expend funds carried forward under this paragraph for
17administrative or staff costs, except administrative or staff costs that are associated
18with implementation of the waiver under sub. (11) and approved by the department.
AB133-ASA1, s. 1047 19Section 1047. 46.27 (7) (fr) of the statutes is created to read:
AB133-ASA1,571,220 46.27 (7) (fr) 1. Notwithstanding s. 46.036 (3) and (5m), a county may place in
21a risk reserve funds that are allocated under par. (am) or (b) or sub. (11) (c) 3. and
22are not expended or encumbered for services under this subsection or sub. (11). The
23county shall notify the department of this decision and of the amount to be placed in
24the risk reserve. The county shall maintain the risk reserve in an interest-bearing
25escrow account with a financial institution, as defined in s. 69.30 (1) (b), if the

1department has approved the terms of the escrow. All interest from the principal
2shall be reinvested in the escrow account.
AB133-ASA1,571,73 2. The annual amount of a county's expenditure for a risk reserve, as specified
4in subd. 1., may not exceed 10% of the county's most recent allocation under pars.
5(am) and (b) and sub. (11) (c) 3. or $750,000, whichever is less. The total amount of
6the risk reserve, including interest, may not exceed 15% of the county's most recent
7allocation under this subsection.
AB133-ASA1,571,98 3. A county may expend funds maintained in a risk reserve, as specified in subd.
91., for any of the following purposes:
AB133-ASA1,571,1010 a. To defray costs of long-term community support services under this section.
AB133-ASA1,571,1211 b. To meet requirements under any contract that the county has with the
12department to operate a care management organization under s. 46.284.
AB133-ASA1,571,1413 c. If approved by a resolution of the county board of supervisors, to transfer
14funds to a family care district.
AB133-ASA1,571,1615 d. If approved by the department, for administrative or staff costs under this
16section.
AB133-ASA1,571,1917 4. A county that maintains a risk reserve, as specified in subd. 1., shall
18annually, on a form prescribed by the department, submit to the department a record
19of the status of the risk reserve, including revenues and disbursements.
AB133-ASA1, s. 1048 20Section 1048. 46.27 (7) (g) (intro.) of the statutes is amended to read:
AB133-ASA1,572,621 46.27 (7) (g) (intro.) The department may carry forward to the next state fiscal
22year up to $500,000 of funds allocated under this subsection and not encumbered by
23counties by December 31 or carried forward under par. (fm). The department may
24transfer moneys within s. 20.435 (7) (bd) to accomplish this purpose. An allocation
25under this paragraph shall not affect a county's base allocation for the program. The

1department may allocate these transferred moneys during the next fiscal year to
2counties for planning and implementation of resource centers under s. 46.283 or care
3management organizations under s. 46.284 and
for the improvement or expansion
4of long-term community support services for clients whose cost of care significantly
5exceeds the average cost of care provided under this section, including any of the
6following:
AB133-ASA1, s. 1049 7Section 1049. 46.27 (7g) (c) 3. (intro.) of the statutes is amended to read:
AB133-ASA1,572,118 46.27 (7g) (c) 3. (intro.) The court shall reduce the amount of a claim under
9subd. 1. by up to $3,000 the amount specified in s. 861.33 (2) if necessary to allow the
10client's heirs or the beneficiaries of the client's will to retain the following personal
11property:
AB133-ASA1, s. 1050 12Section 1050. 46.27 (7g) (c) 3. c. of the statutes is amended to read:
AB133-ASA1,572,1513 46.27 (7g) (c) 3. c. Other tangible personal property not used in trade,
14agriculture or other business, not to exceed $1,000 in value the amount specified in
15s. 861.33 (1) (a) 4
.
AB133-ASA1, s. 1051 16Section 1051. 46.27 (7g) (c) 5. of the statutes is renumbered 46.27 (7g) (c) 5.
17a. and amended to read:
AB133-ASA1,572,2418 46.27 (7g) (c) 5. a. If the department's claim is not allowable because of subd.
194. and the estate includes an interest in a home, the court exercising probate
20jurisdiction shall, in the final judgment or summary findings and order, assign the
21interest in the home subject to a lien in favor of the department for the amount
22described in subd. 1. The personal representative or petitioner for summary
23settlement or summary assignment of the estate
shall record the final judgment as
24provided in s. 863.29, 867.01 (3) (h) or 867.02 (2) (h).
AB133-ASA1, s. 1052 25Section 1052. 46.27 (7g) (c) 5. b. of the statutes is created to read:
AB133-ASA1,573,7
146.27 (7g) (c) 5. b. If the department's claim is not allowable because of subd.
24., the estate includes an interest in a home and the personal representative closes
3the estate by sworn statement under s. 865.16, the personal representative shall
4stipulate in the statement that the home is assigned subject to a lien in favor of the
5department for the amount described in subd. 1. The personal representative shall
6record the statement in the same manner as described in s. 863.29, as if the
7statement were a final judgment.
AB133-ASA1, s. 1053 8Section 1053. 46.27 (7g) (h) of the statutes is created to read:
AB133-ASA1,573,109 46.27 (7g) (h) The department may contract with or employ an attorney to
10probate estates to recover under this subsection the costs of care.
AB133-ASA1, s. 1054 11Section 1054. 46.27 (9) (a) of the statutes is amended to read:
AB133-ASA1,573,2012 46.27 (9) (a) The department may select up to 5 counties that volunteer to
13participate in a pilot project under which they will receive certain funds allocated for
14long-term care. The department shall allocate a level of funds to these counties
15equal to the amount that would otherwise be paid under s. 20.435 (5) (4) (b) to nursing
16homes for providing care because of increased utilization of nursing home services,
17as estimated by the department. In estimating these levels, the department shall
18exclude any increased utilization of services provided by state centers for the
19developmentally disabled. The department shall calculate these amounts on a
20calendar year basis under sub. (10).
AB133-ASA1, s. 1055 21Section 1055. 46.27 (9) (c) of the statutes is amended to read:
AB133-ASA1,574,222 46.27 (9) (c) All long-term community support services provided under this
23pilot project in lieu of nursing home care shall be consistent with those services
24described in the participating county's community options plan under sub. (4) (c) 1.
25and provided under sub. (5) (b). Unless the department has contracted under s.

146.271 (2m) 46.281 (1) (d) with an entity other than the county department, each
2county participating in the pilot project shall assess persons under sub. (6).
AB133-ASA1, s. 1056 3Section 1056. 46.27 (10) (a) 1. of the statutes is amended to read:
AB133-ASA1,574,84 46.27 (10) (a) 1. The department shall determine for each county participating
5in the pilot project under sub. (9) a funding level of state medical assistance
6expenditures to be received by the county. This level shall equal the amount that the
7department determines would otherwise be paid under s. 20.435 (5) (4) (b) because
8of increased utilization of nursing home services, as estimated by the department.
AB133-ASA1, s. 1057 9Section 1057. 46.27 (11) (c) 3. of the statutes is amended to read:
AB133-ASA1,574,1310 46.27 (11) (c) 3. Medical assistance reimbursement for services a county, a
11private nonprofit agency or an aging unit with which the department contracts
12provides under this subsection shall be made from the appropriations under s. 20.435
13(5) (4) (o) and (7) (b) and (bd).
AB133-ASA1, s. 1058 14Section 1058. 46.27 (11) (c) 4. of the statutes is amended to read:
AB133-ASA1,574,1915 46.27 (11) (c) 4. The department may, from the appropriation under s. 20.435
16(5) (4) (o), provide reimbursement for services provided under this subsection by
17counties that are in excess of the current average annual per person rate, as
18established by the department, and are less than or equal to the average amount
19approved in the waiver received under par. (am).
AB133-ASA1, s. 1059 20Section 1059. 46.27 (11) (c) 5n. a. of the statutes is amended to read:
AB133-ASA1,575,221 46.27 (11) (c) 5n. a. An assessment under sub. (6) has been completed for the
22person prior to the person's admission to the community-based residential facility,
23whether or not the person is a private pay admittee at the time of admission. The
24county may waive this condition in accordance with guidelines established by the
25department. If the county waives this condition, the county must meet with the

1person or the person's guardian to discuss the cost-effectiveness of various service
2options.
AB133-ASA1, s. 1060 3Section 1060. 46.271 (2m) of the statutes is repealed.
AB133-ASA1, s. 1061 4Section 1061. 46.275 (5) (a) of the statutes is amended to read:
AB133-ASA1,575,105 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 (5) (4) (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.
AB133-ASA1, s. 1062 11Section 1062. 46.275 (5) (c) of the statutes is amended to read:
AB133-ASA1,575,1812 46.275 (5) (c) The total allocation under s. 20.435 (5) (4) (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.
AB133-ASA1, s. 1063 19Section 1063. 46.275 (5) (d) of the statutes is amended to read:
AB133-ASA1,575,2420 46.275 (5) (d) The department may, from the appropriation under s. 20.435 (5)
21(4) (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).
AB133-ASA1, s. 1064 25Section 1064. 46.277 (5) (d) 1n. a. of the statutes is amended to read:
AB133-ASA1,576,7
146.277 (5) (d) 1n. a. An assessment under s. 46.27 (6) has been completed for
2the person prior to the person's admission to the community-based residential
3facility, whether or not the person is a private pay admittee at the time of admission.
4The county may waive this condition in accordance with guidelines established by
5the department. If the county waives this condition, the county must meet with the
6person or the person's guardian to discuss the cost-effectiveness of various service
7options.
AB133-ASA1, s. 1065 8Section 1065. 46.278 (6) (d) of the statutes is amended to read:
AB133-ASA1,576,149 46.278 (6) (d) If a county makes available nonfederal funds equal to the state
10share of service costs under the waiver received under sub. (3), the department may,
11from the appropriation under s. 20.435 (5) (4) (o), provide reimbursement for services
12that the county provides under this section to persons who are in addition to those
13who may be served under this section with funds from the appropriation under s.
1420.435 (5) (4) (b).
AB133-ASA1, s. 1066 15Section 1066. 46.278 (6) (e) of the statutes is renumbered 46.278 (6) (e) 1.
16(intro.) and amended to read:
AB133-ASA1,576,1917 46.278 (6) (e) 1. (intro.) The department may provide enhanced reimbursement
18for services under the program for an individual who was relocated to the community
19by a county department from an one of the following:
AB133-ASA1,576,21 20a. An intermediate care facility for the mentally retarded that closes under s.
2150.03 (14).
AB133-ASA1,576,23 222. a. The enhanced reimbursement rate under this paragraph subd. 1. a. and
23b.
shall be determined under a formula that is developed by the department.
AB133-ASA1, s. 1067 24Section 1067. 46.278 (6) (e) 1. b. of the statutes is created to read:
AB133-ASA1,577,3
146.278 (6) (e) 1. b. An intermediate care facility for the mentally retarded or
2a distinct part thereof that has a plan of closure approved by the department and that
3intends to close within 12 months.
AB133-ASA1, s. 1067b 4Section 1067b. 46.278 (6) (e) 1. c. of the statutes is created to read:
AB133-ASA1,577,75 46.278 (6) (e) 1. c. An intermediate care facility for the mentally retarded that
6has a plan of closure or significant reduction in capacity approved by the department
7and that intends to close or significantly reduce its capacity within 60 months.
AB133-ASA1, s. 1067c 8Section 1067c. 46.278 (6) (e) 2. b. of the statutes is created to read:
AB133-ASA1,577,109 46.278 (6) (e) 2. b. The enhanced reimbursement rate under subd. 1. c. shall
10be 90% of the enhanced reimbursement rate under this subd. 2. a.
AB133-ASA1, s. 1068 11Section 1068. 46.2805 of the statutes is created to read:
AB133-ASA1,577,12 1246.2805 Definitions; long-term care. In ss. 46.2805 to 46.2895:
AB133-ASA1,577,17 13(1) "Care management organization" means an entity that is certified as
14meeting the requirements for a care management organization under s. 46.284 (3)
15and that has a contract under s. 46.284 (2). "Care management organization" does
16not mean an entity that contracts with the department to operate one of the
17following:
AB133-ASA1,577,1918 (a) A program of all-inclusive care for persons aged 65 or older authorized
19under 42 USC 1395 to 1395ggg.
AB133-ASA1,577,2120 (b) A demonstration program known as the Wisconsin partnership program
21under a federal waiver authorized under 42 USC 1315.
AB133-ASA1,577,23 22(2) "Eligible person" means a person who meets all eligibility criteria under s.
2346.286 (1) or (1m).
AB133-ASA1,577,25 24(3) "Enrollee" means a person who is enrolled in a care management
25organization.
AB133-ASA1,578,2
1(4). "Family care benefit" means financial assistance for long-term care and
2support items for an enrollee.
AB133-ASA1,578,4 3(5) "Family care district" means a special purpose district created under s.
446.2895 (1).
AB133-ASA1,578,6 5(6) "Family care district board" means the governing board of a family care
6district.
AB133-ASA1,578,9 7(7) "Functional and financial screen" means a screen prescribed by the
8department that is used to determine functional eligibility under s. 46.286 (1) (a) and
9financial eligibility under s. 46.286 (1) (b).
AB133-ASA1,578,11 10(7m) "Local long-term care council" means a local long-term care council that
11is appointed under s. 46.282 (2) (a).
AB133-ASA1,578,12 12(8) "Nonprofit organization" has the meaning given in s. 108.02 (19).
AB133-ASA1,578,13 13(9) "Older person" means a person who is aged at least 65.
AB133-ASA1,578,16 14(10) "Resource center" means an entity that meets the standards for operation
15under s. 46.283 (3) or, if under contract to provide a portion of the services specified
16under s. 46.283 (3), meets the standards for operation with respect to those services.
AB133-ASA1,578,18 17(11) "Tribe or band" means a federally recognized American Indian tribe or
18band.
AB133-ASA1, s. 1069 19Section 1069. 46.281 of the statutes is created to read:
AB133-ASA1,578,22 2046.281 Powers and duties of the department and the secretary;
21long-term care.
(1) Duties of the department. The department shall do all of the
22following:
AB133-ASA1,579,223 (a) Provide training to members of the council on long-term care who are aged
2465 or older or who have physical or developmental disabilities or their family

1members, guardians or other advocates, to enable these members to participate in
2the council's duties.
AB133-ASA1,579,53 (b) Provide information to the council on long-term care, including copies of
4reports submitted to the department by local long-term care councils, and seek
5recommendations of the council.
AB133-ASA1,579,126 (c) Request from the secretary of the federal department of health and human
7services any waivers of federal medicaid laws necessary to permit the use of federal
8moneys to provide the family care benefit to recipients of medical assistance. The
9department shall implement any waiver that is approved and that is consistent with
10ss. 46.2805 to 46.2895. Regardless of whether a waiver is approved, the department
11may implement operation of resource centers, care management organizations and
12the family care benefit.
AB133-ASA1,579,1313 (d) Before July 1, 2001:
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