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:
AB133-ASA1,585,33
a. Providers of long-term care services.
AB133-ASA1,585,54
b. Persons residing in the county with recognized ability and demonstrated
5interest in long-term care.
AB133-ASA1,585,96
c. Either up to 4 members of the county boards of supervisors or other elected
7officials or, for a council that serves an area of more than 4 contiguous counties, up
8to one member of the county board of supervisors of the contiguous counties or up to
9one other elected official in each contiguous county area.
AB133-ASA1,585,2010
3. A local long-term care council that is appointed by a tribe or band or by the
11Great Lakes inter-tribal council, inc., shall consist of 21 members, at least 11 of
12whom are older persons or persons with physical or developmental disabilities or
13their family members or other representatives. The age or disability represented by
14these 11 members shall correspond to the proportion of numbers of persons, as
15determined by the department, receiving long-term care in this state who are aged
1665 or older or have a physical or developmental disability. The total remaining 10
17members shall consist of providers of long-term care services, persons residing in the
18county with recognized ability and demonstrated interest in long-term care and up
19to 3 members of the governing board of the tribe or band or the Great Lakes
20inter-tribal council, inc., that appoints the local long-term care council.
AB133-ASA1,585,2421
4. Vacancies in membership in a local long-term care council shall be filled for
22the residue of the unexpired term in the manner that the original appointments are
23made. A local long-term care council member may be removed from office for the
24following reasons:
AB133-ASA1,586,3
1a. For cause, by a two-thirds vote of each county board of supervisors or
2governing body of a tribe or band participating in the appointment, on due notice in
3writing and hearing of the charges against the member.
AB133-ASA1,586,64
b. If the member, when appointed, was a member of the county board of
5supervisors or was another elected official and was not reelected to that office, on due
6notice in writing.
AB133-ASA1,586,147
(c)
Terms. The members of the local long-term care council appointed under
8par. (a) shall serve 3-year terms. No member may serve more than 2 consecutive
9terms. Of the members first appointed under par. (b) 1., 6 shall be appointed for 3
10years; 6 shall be appointed for 4 years; and 5 shall be appointed for 5 years. Of the
11members first appointed under par. (b) 2., 8 shall be appointed for 3 years; 8 shall be
12appointed for 4 years; and 7 shall be appointed for 5 years. Of the members appointed
13under par. (b) 3., one-third shall be appointed for 3 years; one-third shall be
14appointed for 4 years; and one-third shall be appointed for 5 years.
AB133-ASA1,586,2215
(d)
Compensation and training. Members of the local long-term care council
16who are older persons, persons with physical or developmental disabilities or the
17family members or other representatives of these persons shall receive compensation
18from the applicable county for reasonable expenses associated with membership
19participation. The county board of supervisors or, in the case of a member appointed
20by the governing body of a tribe or band or by the Great Lakes inter-tribal council,
21inc., the tribe or band or the Great Lakes inter-tribal council, inc., shall provide
22training to these members to enable them to participate effectively.
AB133-ASA1,587,323
(e)
Officers. At the first meeting of a local long-term care council, members
24shall elect from their number a chairperson, a secretary and other officers as
25necessary. Vacancies in these offices shall be filled for the unexpired terms. The
1chairperson shall preside at all meetings when present and countersign all actions
2taken by the local long-term care council. In case of the absence of the chairperson
3for any meeting, the members present shall choose a temporary chairperson.
AB133-ASA1,587,5
4(3) Local long-term care councils; powers and duties. (a) A local long-term
5care council shall do all of the following within the council's area:
AB133-ASA1,587,126
1. Develop the initial plan for the structure of the county, multicounty or tribal
7resource center and care management organization or organizations, including
8formulating recommendations to the county board or boards of supervisors and, in
9a county with a county executive or a county administrator, to the county executive
10or county administrator, to the governing body of the tribe or band or of the Great
11Lakes inter-tribal council, inc., if applicable, and to the department on all of the
12following:
AB133-ASA1,587,1613
a. Whether or not the county, counties, tribe or band or Great Lakes inter-tribal
14council, inc., should exercise its right to apply under s. 46.283 (1) for a contract to
15operate a resource center or to apply under s. 46.284 (1) for a contract to operate a
16care management organization and how the operation should proceed.
AB133-ASA1,587,1817
b. Whether the county should create a family care district to operate a resource
18center or under a care management organization.
AB133-ASA1,587,2219
c. Whether local organizations other than the county should serve as
20alternatives or in addition to county-operated entities to operate a resource center
21or a care management organization and, if so, which organizations should be
22considered.