46.18 (1) TRUSTEES. Every county home, infirmary, hospital, tuberculosis hospital or sanatorium, or similar institution, shall, subject to regulations approved by the county board, be managed by a board of trustees, electors of the county, chosen by ballot by the county board. At its annual meeting, the county board shall appoint an uneven number of trustees, from 3 to 9 at the option of the board, for staggered 3-year terms ending the first Monday in January. Any vacancy shall be filled for the unexpired term by the county board; but the chairperson of the county board may appoint a trustee to fill the vacancy until the county board acts.
SECTION 1006. 46.20 (1) of the statutes is amended to read:
46.20 (1) Any 2 or more counties may jointly, by majority vote of all the members of each county board, provide for a county home, infirmary, hospital, tuberculosis hospital or sanatorium, or similar institution, or juvenile detention home, which shall be established, maintained and operated pursuant to all the statutes relating to the establishment, maintenance and operation of similar institutions, respectively, by any single county whose population is less than 250,000, except as otherwise provided in this section; and in all respects, except as herein specified, each such institution shall be the county institution of each of the counties so joining.
SECTION 1007. 46.20 (3) of the statutes is amended to read:
46.20 (3) Upon approval of the site, plans and specifications, as provided in s. 252.073 as to tuberculosis sanatoriums and ss. 46.17 and 301.37, as to other institutions, the joint committee shall report to the several county boards the estimated cost of the site and buildings, and the amount thereof chargeable to each county on the basis set forth in sub. (6) (a), appending to each report a copy of the plans and specifications and all matter relating to the site and buildings. If the report is approved by each county board, the joint committee shall purchase the site and cause the buildings to be erected in accordance with the plans and specifications.
SECTION 1008. 46.20 (8) of the statutes is repealed.
SECTION 1009. 46.20 (10) of the statutes is repealed.
SECTION 1010. 46.21 (2m) (c) of the statutes is amended to read:
46.21 (2m) (c) Exchange of information. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.06 (17) (c), 146.82, 252.11 (7) and 253.07 (3) (c), any subunit of the county department of human services acting under this subsection may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of human services, with a resource center, care management organization or family care district, or with any person providing services to the client under a purchase of services contract with the county department of human services or with a resource center, care management organization or family care district, if necessary to enable an employe or service provider to perform his or her duties, or to enable the county department of human services to coordinate the delivery of services to the client.
SECTION 1011. 46.215 (1) (j) of the statutes is amended to read:
46.215 (1) (j) To make payments in such manner as the department of workforce development may determine for training of recipients, former recipients and potential recipients of aid in programs established under ss. s. 49.193, 1997 stats., and s. 49.26 (1).
SECTION 1012. 46.215 (1) (r) of the statutes is created to read:
46.215 (1) (r) If authorized under s. 46.283 (1) (a) 1., to apply to the department of health and family services to operate a resource center under s. 46.283 and, if the department contracts with the county under s. 46.283 (2), to operate the resource center.
SECTION 1013. 46.215 (1) (s) of the statutes is created to read:
46.215 (1) (s) If authorized under s. 46.284 (1) (a) 1., to apply to the department of health and family services to operate a care management organization under s. 46.284 and, if the department contracts with the county under s. 46.284 (2), to operate the care management organization and, if appropriate, place funds in a risk reserve.
SECTION 1014. 46.215 (1g) of the statutes is renumbered 46.215 (1g) (intro.) and amended to read:
46.215 (1g) ADMINISTRATION OF FOOD STAMPS FOR PARTICIPANTS IN BY A WISCONSIN WORKS AGENCY. (intro.) The Wisconsin works agency, as defined in s. 49.001 (9), shall, to the extent permitted by federal law, certify eligibility for and distribute, if determined eligible, issue food coupons under s. 49.143 (2) (e) to eligible participants to all of the following:
(a) Participants in the Wisconsin works program under subch. III of ch. 49.
SECTION 1015. 46.215 (1g) (b) of the statutes is created to read:
46.215 (1g) (b) Persons who may be required to participate in the food stamp employment and training program under s. 49.124 (1m), if the department of workforce development has contracted with the Wisconsin works agency to administer the food stamp employment and training program under s. 49.124 (1m).
SECTION 1016. 46.215 (1g) (c) of the statutes is created to read:
46.215 (1g) (c) Other persons who are under the age of 61 and who are not disabled, as defined by the department.
SECTION 1017. 46.215 (1m) of the statutes is amended to read:
46.215 (1m) EXCHANGE OF INFORMATION. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.06 (17) (c), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), any subunit of the county department of social services acting under this section may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of social services, with a resource center, care management organization or family care district, or with any person providing services to the client under a purchase of services contract with the county department of social services or with a resource center, care management organization or family care district, if necessary to enable an employe or service provider to perform his or her duties, or to enable the county department of social services to coordinate the delivery of services to the client.
SECTION 1018. 46.215 (2) (c) 1. of the statutes is amended to read:
46.215 (2) (c) 1. A county department of social services shall develop, under the requirements of s. 46.036, plans and contracts for care and services to be purchased, except for care and services under subch. III of ch. 49 or s. 301.08 (2). The department of health and family services may review the contracts and approve them if they are consistent with s. 46.036 and if state or federal funds are available for such purposes. The joint committee on finance may require the department of health and family services to submit the contracts to the committee for review and approval. The department of health and family services may not make any payments to a county for programs included in a contract under review by the committee. The department of health and family services shall reimburse each county for the contracts from the appropriations under s. 20.435 (3) (o) and (7) (b), (kw), (kz) and (o), as appropriate, under s. 46.495.
SECTION 1019. 46.22 (1) (b) 1. j. of the statutes is created to read:
46.22 (1) (b) 1. j. If authorized under s. 46.283 (1) (a) 1., to apply to the department of health and family services to operate a resource center under s. 46.283 and, if the department contracts with the county under s. 46.283 (2), to operate the resource center.
SECTION 1020. 46.22 (1) (b) 1. k. of the statutes is created to read:
46.22 (1) (b) 1. k. If authorized under s. 46.284 (1) (a) 1., to apply to the department of health and family services to operate a care management organization under s. 46.284 and, if the department contracts with the county under s. 46.284 (2), to operate the care management organization and, if appropriate, place funds in a risk reserve.
SECTION 1021. 46.22 (1) (b) 2. a. of the statutes is repealed.
SECTION 1022. 46.22 (1) (b) 2. e. of the statutes is amended to read:
46.22 (1) (b) 2. e. To make payments in such manner as the department of workforce development may determine for training of recipients, former recipients and potential recipients of aid in programs established under ss. 49.193, 1997 stats., and 49.26 (1).
SECTION 1023. 46.22 (1) (c) 8. f. of the statutes is created to read:
46.22 (1) (c) 8. f. Before July 1, 2006, the county department of social services shall implement the statewide automated child welfare information system established by the department under s. 46.03 (7) (g).
SECTION 1024. 46.22 (1) (dm) of the statutes is amended to read:
46.22 (1) (dm) Exchange of information. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.06 (17) (c), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), any subunit of the county department of social services acting under this subsection may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of social services, with a resource center, care management organization or family care district, or with any person providing services to the client under a purchase of services contract with the county department of social services or with a resource center, care management organization or family care district, if necessary to enable an employe or service provider to perform his or her duties, or to enable the county department of social services to coordinate the delivery of services to the client.
SECTION 1025. 46.22 (1) (e) 3. a. of the statutes is amended to read:
46.22 (1) (e) 3. a. A county department of social services shall develop, under the requirements of s. 46.036, plans and contracts for care and services, except under subch. III of ch. 49 and s. 301.08 (2), to be purchased. The department of health and family services may review the contracts and approve them if they are consistent with s. 46.036 and to the extent that state or federal funds are available for such purposes. The joint committee on finance may require the department of health and family services to submit the contracts to the committee for review and approval. The department of health and family services may not make any payments to a county for programs included in the contract that is under review by the committee. The department of health and family services shall reimburse each county for the contracts from the appropriations under s. 20.435 (3) (o) and (7) (b), (kw), (kz) and (o) according to s. 46.495.
SECTION 1026. 46.22 (1g) of the statutes is renumbered 46.22 (1g) (intro.) and amended to read:
46.22 (1g) ADMINISTRATION OF FOOD STAMPS FOR PARTICIPANTS IN BY A WISCONSIN WORKS AGENCY. (intro.) The Wisconsin works agency, as defined in s. 49.001 (9), shall, to the extent permitted by federal law, certify eligibility for and distribute, if determined eligible, issue food coupons under s. 49.143 (2) (e) to eligible participants to all of the following:
(a) Participants in the Wisconsin works program under subch. III of ch. 49.
SECTION 1027. 46.22 (1g) (b) of the statutes is created to read:
46.22 (1g) (b) Persons who may be required to participate in the food stamp employment and training program under s. 49.124 (1m), if the department of workforce development has contracted with the Wisconsin works agency to administer the food stamp employment and training program under s. 49.124 (1m).
SECTION 1028. 46.22 (1g) (c) of the statutes is created to read:
46.22 (1g) (c) Other persons who are under the age of 61 and who are not disabled, as defined by the department.
SECTION 1029. 46.23 (3) (e) of the statutes is amended to read:
46.23 (3) (e) Exchange of information. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.06 (17) (c), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), any subunit of a county department of human services acting under this section may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of human services, with a resource center, care management organization or family care district, or with any person providing services to the client under a purchase of services contract with the county department of human services or with a resource center, care management organization or family care district, if necessary to enable an employe or service provider to perform his or her duties, or to enable the county department of human services to coordinate the delivery of services to the client.
SECTION 1030. 46.266 (1) (d) of the statutes is created to read:
46.266 (1) (d) A person in the facility who has been determined under s. 49.45 (6c) (b) to require active treatment for mental illness.
SECTION 1031. 46.27 (1) (bm) of the statutes is amended to read:
46.27 (1) (bm) "Private nonprofit agency" means a nonprofit corporation, as defined in s. 181.0103 (17), which provides comprehensive health care services to elderly persons a program of all-inclusive care for persons aged 65 or older authorized under 42 USC 1395 to 1395ggg and which participates in the On Lok replication initiative.
SECTION 1032. 46.27 (2) (k) of the statutes is created to read:
46.27 (2) (k) Review and approve or disapprove the terms of risk reserve escrow accounts created under sub. (7) (fr) and approve or disapprove disbursements for administrative or staff costs from the risk reserve escrow accounts.
SECTION 1033. 46.27 (4) (c) (intro.) of the statutes is amended to read:
46.27 (4) (c) (intro.) The planning committee shall develop do all of the following:
1. Develop a community options plan for participation in the program. The plan shall include:
SECTION 1034. 46.27 (4) (c) 1. to 7. of the statutes are renumbered 46.27 (4) (c) 1. a. to g.
SECTION 1035. 46.27 (4) (c) 2. of the statutes is created to read:
46.27 (4) (c) 2. Advise the county board of supervisors and, if applicable, the county administrator or county executive on whether to apply to the department for a contract to operate a resource center or a care management organization and whether to create a family care district to apply to the department for such a contract.
SECTION 1036. 46.27 (4) (c) 3. of the statutes is created to read:
46.27 (4) (c) 3. Review initial plans and existing provider networks of any care management organization in the area to assist the care management organization in developing a network of service providers that includes a sufficient number of accessible, convenient and desirable services.
SECTION 1037. 46.27 (4) (c) 4. of the statutes is created to read:
46.27 (4) (c) 4. Advise care management organizations about whether to offer optional acute and primary health care services and, if so, how these benefits should be offered.
SECTION 1038. 46.27 (4) (c) 8. of the statutes is renumbered 46.27 (4) (c) 1. h. and amended to read:
46.27 (4) (c) 1. h. If a pilot project under s. 46.271 (2m) 46.281 (1) (d) is established in the county, a description of how the activities of the pilot project relate to and are coordinated with the county's proposed program.
SECTION 1039. 46.27 (5) (am) of the statutes is amended to read:
46.27 (5) (am) Organize assessment activities specified in sub. (6). The county department or aging unit shall utilize persons for each assessment who can determine the needs of the person being assessed and who know the availability within the county of services alternative to placement in a nursing home. If any hospital patient is referred to a nursing home for admission, these persons shall work with the hospital discharge planner in performing the activities specified in sub. (6). The county department or aging unit shall coordinate the involvement of representatives from the county departments under ss. 46.215, 46.22, 51.42 and 51.437, health service providers and the county commission on aging in the assessment activities specified in sub. (6), as well as the person being assessed and members of the person's family or the person's guardian. This paragraph does not apply to a county department or aging unit in a county where a pilot project under s. 46.271 (2m) 46.281 (1) (d) is established.
SECTION 1040. 46.27 (6) (a) 3. of the statutes is amended to read:
46.27 (6) (a) 3. In each participating county, except in counties where a pilot project under s. 46.271 (2m) 46.281 (1) (d) is established, assessments shall be conducted for those persons and in accordance with the procedures described in the county's community options plan. The county may elect to establish assessment priorities for persons in target groups identified by the county in its plan regarding gradual implementation. If a person who is already admitted to a nursing home requests an assessment and if funds allocated for assessments under sub. (7) (am) are available, the county shall conduct the assessment.
SECTION 1041. 46.27 (6g) (intro.) of the statutes is amended to read:
46.27 (6g) FISCAL RESPONSIBILITY. (intro.) Except as provided in s. 51.40, and within the limitations under sub. (7) (b), the fiscal responsibility of a county for an assessment, unless the assessment is performed by an entity under s. 46.271 (2m) 46.281 (1) (d), case plan or services provided to a person under this section is as follows:
SECTION 1042. 46.27 (6u) (c) 2. of the statutes is amended to read:
46.27 (6u) (c) 2. For a person who is determined to be financially eligible under subd. 1. calculate, by use of the uniform fee system under s. 46.03 (18), the amount of cost sharing required for receipt of long-term community support services provided under sub. (5) (b). The county department or aging unit shall require payment by the person of 100% of the amount calculated under this subdivision, unless the person pays the premiums established under s. 49.472 (4) (a). If the person pays those premiums, the county department or aging unit may not require any payment from the person under this subdivision.
SECTION 1043. 46.27 (7) (am) of the statutes is amended to read:
46.27 (7) (am) From the appropriation under s. 20.435 (7) (bd), the department shall allocate funds to each county or private nonprofit agency with which the department contracts to pay assessment and case plan costs under sub. (6) not otherwise paid by fee or under s. 49.33 (2) or 49.45. The department shall reimburse counties for the cost of assessing persons eligible for medical assistance under s. 49.46, 49.468 or 49.47 as part of the administrative services of medical assistance, payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this paragraph to pay the cost of long-term community support services and for a risk reserve under par. (fr).
SECTION 1044. 46.27 (7) (b) of the statutes is amended to read:
46.27 (7) (b) 1m. From the appropriations under s. 20.435 (7) (bd) and (im), the department shall allocate funds to each county to pay the cost of providing long-term community support services under sub. (5) (b) not otherwise paid under s. 49.45 to persons eligible for medical assistance under s. 49.46 or 49.47 or to persons whom the county department or aging unit administering the program finds likely to become medically indigent within 6 months by spending excess income or assets for medical or remedial care. The average per person reimbursement under this paragraph may not exceed the state share of the average per person payment rate the department expects under s. 49.45 (6m). The county department or aging unit administering the program may spend funds received under this paragraph only in accordance with the case plan and service contract created for each person receiving long-term community support services. Counties may use unspent funds allocated under this paragraph from the appropriation under s. 20.435 (7) (bd) for a risk reserve under par. (fr).
SECTION 1045. 46.27 (7) (cj) 3. a. of the statutes is amended to read:
46.27 (7) (cj) 3. a. An assessment under sub. (6) has been completed for the person prior to the person's admission to the community-based residential facility, whether or not the person is a private pay admittee at the time of admission. The county may waive this condition in accordance with guidelines established by the department. If the county waives this condition, the county must meet with the person or the person's guardian to discuss the cost-effectiveness of various service options.
SECTION 1046. 46.27 (7) (fm) of the statutes is amended to read:
46.27 (7) (fm) The department shall, at the request of a county, carry forward up to 10% of the amount allocated under this subsection to the county for a calendar year if up to 10% of the amount so allocated has not been spent or encumbered by the county by December 31 of that year, for use by the county in the following calendar year, except that the amount carried forward shall be reduced by the amount of funds that the county has notified the department that the county wishes to place in a risk reserve under par. (fr). The department may transfer funds within s. 20.435 (7) (bd) to accomplish this purpose. An allocation under this paragraph does not affect a county's base allocation under this subsection and shall lapse to the general fund unless expended within the calendar year to which the funds are carried forward. A county may not expend funds carried forward under this paragraph for administrative or staff costs, except administrative or staff costs that are associated with implementation of the waiver under sub. (11) and approved by the department.
SECTION 1047. 46.27 (7) (fr) of the statutes is created to read:
46.27 (7) (fr) 1. Notwithstanding s. 46.036 (3) and (5m), a county may place in a risk reserve funds that are allocated under par. (am) or (b) or sub. (11) (c) 3. and are not expended or encumbered for services under this subsection or sub. (11). The county shall notify the department of this decision and of the amount to be placed in the risk reserve. The county shall maintain the risk reserve in an interest-bearing escrow account with a financial institution, as defined in s. 69.30 (1) (b), if the department has approved the terms of the escrow. All interest from the principal shall be reinvested in the escrow account.
2. The annual amount of a county's expenditure for a risk reserve, as specified in subd. 1., may not exceed 10% of the county's most recent allocation under pars. (am) and (b) and sub. (11) (c) 3. or $750,000, whichever is less. The total amount of the risk reserve, including interest, may not exceed 15% of the county's most recent allocation under this subsection.
3. A county may expend funds maintained in a risk reserve, as specified in subd. 1., for any of the following purposes:
a. To defray costs of long-term community support services under this section.
b. To meet requirements under any contract that the county has with the department to operate a care management organization under s. 46.284.
c. If approved by a resolution of the county board of supervisors, to transfer funds to a family care district.
