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-ASA1,575,105
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-ASA1,575,1812
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-ASA1,575,2420
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-ASA1,576,7
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-ASA1,576,149
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-ASA1,577,3
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-ASA1,577,75
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-ASA1,577,109
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-ASA1,577,12
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-ASA1,578,22
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:
AB133-ASA1,579,1814
1. Establish, in geographic areas in which resides no more than 29% of the
15population that is eligible for the family care benefit, a pilot project under which the
16department may contract with a county, a family care district, a tribe or band or the
17Great Lakes inter-tribal council, inc., or with any 2 or more of these entities under
18a joint application, to operate a resource center.
AB133-ASA1,579,2319
2. In geographic areas in which resides no more than 29% of the population that
20is eligible for the family care benefit, contract with counties or tribes or bands under
21a pilot project to demonstrate the ability of counties or tribes or bands to manage all
22long-term care programs and administer the family care benefit as care
23management organizations.
AB133-ASA1,580,624
(e) After June 30, 2001, if the local long-term care council for the applicable
25area has developed the initial plan under s. 46.282 (3) (a) 1., contract with entities
1specified under par. (d) and, only if specifically authorized by the legislature and if
2the legislature appropriates necessary funding, contract as so authorized with one
3or more entities in addition to those specified in par. (d) certified as meeting
4requirements under s. 46.284 (3) for services of the entity as a care management
5organization and one or more entities for services specified under s. 46.283 (3) and
6(4).
AB133-ASA1,580,87
(f) Prescribe and implement a per person monthly rate structure for costs of the
8family care benefit.
AB133-ASA1,580,119
(g) In order to maintain continuous quality assurance and quality
10improvement for resource centers and care management organizations, do all of the
11following:
AB133-ASA1,580,1312
1. Prescribe by rule and by contract and enforce performance standards for
13operation of resource centers and care management organizations.
AB133-ASA1,580,1514
2. Use performance expectations that are related to outcomes for persons in
15contracting with care management organizations and resource centers.
AB133-ASA1,580,1716
3. Conduct ongoing evaluations of the long-term care system specified in ss.
1746.2805 to 46.2895.
AB133-ASA1,580,1918
4. Require that quality assurance and quality improvement efforts be included
19throughout the long-term care system specified in ss. 46.2805 to 46.2895.
AB133-ASA1,580,2320
5. Ensure that reviews of the quality of management and service delivery of
21resource centers and care management organizations are conducted by external
22organizations and make information about specific review results available to the
23public.
AB133-ASA1,581,224
(h) Require by contract that resource centers and care management
25organizations establish procedures under which an individual who applies for or
1receives the family care benefit may register a complaint or grievance and
2procedures for resolving complaints and grievances.
AB133-ASA1,581,53
(i) Prescribe criteria to assign priority equitably on any necessary waiting lists
4for persons who are eligible for the family care benefit but who do not meet the
5criteria under s. 46.286 (3).
AB133-ASA1,581,8
6(2) Powers of the department. The department may develop risk-sharing
7arrangements in contracts with care management organizations, in accordance with
8applicable state laws and federal statutes and regulations.
AB133-ASA1,581,16
9(3) Duty of the secretary. The secretary shall certify to each county, hospital,
10nursing home, community-based residential facility, adult family home and
11residential care apartment complex the date on which a resource center that serves
12the area of the county, hospital, nursing home, community-based residential facility,
13adult family home or residential care apartment complex is first available to provide
14a functional and financial screen. To facilitate phase-in of services of resource
15centers, the secretary may certify that the resource center is available for specified
16groups of eligible individuals or for specified facilities in the county.
AB133-ASA1, s. 1070
17Section
1070. 46.281 (1) (a) of the statutes, as created by 1999 Wisconsin Act
18.... (this act), is repealed.
AB133-ASA1, s. 1071
19Section
1071. 46.281 (1) (b) of the statutes, as created by 1999 Wisconsin Act
20.... (this act), is repealed.
AB133-ASA1,581,23
2246.282 Councils on long-term care. (1) Council on long-term care. The
23council on long-term care appointed under s. 15.197 (5) shall do all of the following:
AB133-ASA1,581,2524
(a) Assist the department in developing broad policy issues related to
25long-term care services.
AB133-ASA1,582,3
1(b) Assist the department in developing, implementing, coordinating and
2guiding long-term care services and systems, including by reviewing and making
3nonbinding recommendations to the department on all of the following:
AB133-ASA1,582,54
1. The department's standard contract provisions for resource centers and care
5management organizations.
AB133-ASA1,582,76
2. The family care benefit, including the per person rate structure for the
7benefit.
AB133-ASA1,582,88
3. The long-term support community options program under s. 46.27.
AB133-ASA1,582,99
4. The community integration programs under ss. 46.275, 46.277 and 46.278.
AB133-ASA1,582,1110
5. Programs other than those under pars (c) and (d) that provide home and
11community-based services.
AB133-ASA1,582,1212
6. The provision of medical assistance services under a fee-for-service system.
AB133-ASA1,582,1413
(c) Monitor patterns of complaints, grievances and appeals related to
14long-term care in order to identify issues of statewide importance.
AB133-ASA1,582,1515
(d) Monitor the numbers of persons on waiting lists.
AB133-ASA1,582,1716
(e) Review patterns of utilization of various types of services by care
17management organizations.
AB133-ASA1,582,1918
(f) Monitor the pattern of care management organization enrollments and
19disenrollments throughout the state.
AB133-ASA1,582,2220
(g) Report annually to the legislature under s. 13.172 (2) and to the governor
21on the status, significant achievements and problems of resource centers, care
22management organizations and the family care benefit, including all of the following:
AB133-ASA1,582,2323
1. Numbers of persons served.
AB133-ASA1,582,2424
2. Costs of long-term care provided under the family care benefit.
AB133-ASA1,583,2
13. The number and service areas of resource centers and care management
2organizations.
AB133-ASA1,583,33
4. Waiting list information.
AB133-ASA1,583,54
5. Results of reviews of quality of services provided by resource centers and care
5management organizations.
AB133-ASA1,583,9
6(2) Local long-term care councils; appointment; membership; terms;
7compensation and training; officers. (a)
Appointment by a county. In a county that
8participates in a pilot project under s. 46.281 (1) (d) and before a county participates
9in the program under ss. 46.2805 to 46.2895, the following shall be done:
AB133-ASA1,583,1210
1. The county board of supervisors of the county shall appoint a local long-term
11care council or the county boards of supervisors of 2 or more contiguous counties shall
12appoint a local long-term care council, except as follows:
AB133-ASA1,583,1613
a. In a county with a county executive or a county administrator, the county
14executive or county administrator shall appoint the local long-term care council,
15other than as provided in subd. 1. b., subject to confirmation by the county board of
16supervisors.
AB133-ASA1,583,1917
b. If the lands of any tribe or band are located in the county or contiguous
18counties to be served by a local long-term care council, each tribe or band with these
19lands shall appoint at least one member of the local long-term care council.
AB133-ASA1,584,320
2. A county board of supervisors or, in a county with a county executive or a
21county administrator, the county executive or county administrator shall appoint
22members of the local long-term care council who are required to be older persons or
23persons with physical or developmental disabilities or their immediate family
24members or other representatives from nominations that are submitted to the
25county board of supervisors or the county executive or county administrator by older
1persons or persons with physical or developmental disabilities or their immediate
2family members or other representatives and by local organizations that represent
3older persons or persons with physical or developmental disabilities.
AB133-ASA1,584,84
(am)
Appointment by a tribe or band or council. If a tribe or band or the Great
5Lakes inter-tribal council, inc., intends to apply for a contract to operate a resource
6center or for certification as a care management organization, the tribe or band or
7the council shall, as a condition of the application or the certification appoint a local
8long-term care council.
AB133-ASA1,584,189
(b)
Membership. 1. A local long-term care council that serves a single-county
10area shall consist of 17 members, at least 9 of whom are older persons or persons with
11physical or developmental disabilities or their immediate family members or other
12representatives. The age or disability represented by these 9 members shall
13correspond to the proportion of numbers of persons, as determined by the
14department, receiving long-term care in this state who are aged 65 or older or have
15a physical or developmental disability. The total remaining 8 members shall consist
16of providers of long-term care services, persons residing in the county with
17recognized ability and demonstrated interest in long-term care and up to 3 members
18of the county board of supervisors or other elected officials.
AB133-ASA1,585,219
2. A local long-term care council that serves an area of 2 or more contiguous
20counties shall consist of 23 members, at least 12 of whom are older persons or persons
21with physical or developmental disabilities or their immediate family members or
22other representatives. The age or disability represented by these 12 members shall
23correspond to the proportion of numbers of persons, as determined by the
24department, receiving long-term care in this state who are aged 65 or older or have
1a physical or developmental disability. The total remaining 11 members shall consist
2of all of the following: