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 a. of the statutes is repealed.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.
d. If approved by the department, for administrative or staff costs under this section.
4. A county that maintains a risk reserve, as specified in subd. 1., shall annually, on a form prescribed by the department, submit to the department a record of the status of the risk reserve, including revenues and disbursements.
SECTION 1048. 46.27 (7) (g) (intro.) of the statutes is amended to read:
46.27 (7) (g) (intro.) The department may carry forward to the next state fiscal year up to $500,000 of funds allocated under this subsection and not encumbered by counties by December 31 or carried forward under par. (fm). The department may transfer moneys within s. 20.435 (7) (bd) to accomplish this purpose. An allocation under this paragraph shall not affect a county's base allocation for the program. The department may allocate these transferred moneys during the next fiscal year to counties for planning and implementation of resource centers under s. 46.283 or care management organizations under s. 46.284 and for the improvement or expansion of long-term community support services for clients whose cost of care significantly exceeds the average cost of care provided under this section, including any of the following:
SECTION 1049. 46.27 (7g) (c) 3. (intro.) of the statutes is amended to read:
46.27 (7g) (c) 3. (intro.) The court shall reduce the amount of a claim under subd. 1. by up to $3,000 the amount specified in s. 861.33 (2) if necessary to allow the client's heirs or the beneficiaries of the client's will to retain the following personal property:
SECTION 1050. 46.27 (7g) (c) 3. c. of the statutes is amended to read:
46.27 (7g) (c) 3. c. Other tangible personal property not used in trade, agriculture or other business, not to exceed $1,000 in value the amount specified in s. 861.33 (1) (a) 4.
SECTION 1051. 46.27 (7g) (c) 5. of the statutes is renumbered 46.27 (7g) (c) 5. a. and amended to read:
46.27 (7g) (c) 5. a. If the department's claim is not allowable because of subd. 4. and the estate includes an interest in a home, the court exercising probate jurisdiction shall, in the final judgment or summary findings and order, assign the interest in the home subject to a lien in favor of the department for the amount described in subd. 1. The personal representative or petitioner for summary settlement or summary assignment of the estate shall record the final judgment as provided in s. 863.29, 867.01 (3) (h) or 867.02 (2) (h).
SECTION 1052. 46.27 (7g) (c) 5. b. of the statutes is created to read:
46.27 (7g) (c) 5. b. If the department's claim is not allowable because of subd. 4., the estate includes an interest in a home and the personal representative closes the estate by sworn statement under s. 865.16, the personal representative shall stipulate in the statement that the home is assigned subject to a lien in favor of the department for the amount described in subd. 1. The personal representative shall record the statement in the same manner as described in s. 863.29, as if the statement were a final judgment.
SECTION 1053. 46.27 (7g) (h) of the statutes is created to read:
46.27 (7g) (h) The department may contract with or employ an attorney to probate estates to recover under this subsection the costs of care.
SECTION 1054. 46.27 (9) (a) of the statutes is amended to read:
46.27 (9) (a) The department may select up to 5 counties that volunteer to participate in a pilot project under which they will receive certain funds allocated for long-term care. The department shall allocate a level of funds to these counties equal to the amount that would otherwise be paid under s. 20.435 (5) (4) (b) to nursing homes for providing care because of increased utilization of nursing home services, as estimated by the department. In estimating these levels, the department shall exclude any increased utilization of services provided by state centers for the developmentally disabled. The department shall calculate these amounts on a calendar year basis under sub. (10).
SECTION 1055. 46.27 (9) (c) of the statutes is amended to read:
46.27 (9) (c) All long-term community support services provided under this pilot project in lieu of nursing home care shall be consistent with those services described in the participating county's community options plan under sub. (4) (c) 1. and provided under sub. (5) (b). Unless the department has contracted under s. 46.271 (2m) 46.281 (1) (d) with an entity other than the county department, each county participating in the pilot project shall assess persons under sub. (6).
SECTION 1056. 46.27 (10) (a) 1. of the statutes is amended to read:
46.27 (10) (a) 1. The department shall determine for each county participating in the pilot project under sub. (9) a funding level of state medical assistance expenditures to be received by the county. This level shall equal the amount that the department determines would otherwise be paid under s. 20.435 (5) (4) (b) because of increased utilization of nursing home services, as estimated by the department.
SECTION 1057. 46.27 (11) (c) 3. of the statutes is amended to read:
46.27 (11) (c) 3. Medical assistance reimbursement for services a county, a private nonprofit agency or an aging unit with which the department contracts provides under this subsection shall be made from the appropriations under s. 20.435 (5) (4) (o) and (7) (b) and (bd).
SECTION 1058. 46.27 (11) (c) 4. of the statutes is amended to read:
46.27 (11) (c) 4. The department may, from the appropriation under s. 20.435 (5) (4) (o), provide reimbursement for services provided under this subsection by counties that are in excess of the current average annual per person rate, as established by the department, and are less than or equal to the average amount approved in the waiver received under par. (am).
SECTION 1059. 46.27 (11) (c) 5n. a. of the statutes is amended to read:
46.27 (11) (c) 5n. 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 1060. 46.271 (2m) of the statutes is repealed.
SECTION 1061. 46.275 (5) (a) of the statutes is amended to read:
46.275 (5) (a) Medical assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriations under s. 20.435 (5) (4) (b) and (o). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, medical assistance reimbursement is also available for services provided jointly by these counties.
