Wisconsin Legislature: LRB-2079/1

49.85 (3) (a) 1. Inform the person that the department of health and family services intends to certify to the department of revenue an amount that the department of health and family services has determined to be due under s. 49.45 (2) (a) 10. or 49.497, for setoff from any state tax refund that may be due the person.

SECTION 1487. 49.855 (7) of the statutes is repealed.

SECTION 1488. 49.857 (1) (d) 3. of the statutes is amended to read:

49.857 (1) (d) 3. A license issued under s. 48.66 (1) (a) or (b).

SECTION 1489. 49.89 (2) of the statutes is amended to read:

49.89 (2) SUBROGATION. The department of health and family services, the department of workforce development, a county or an elected tribal governing body that provides any public assistance under this chapter or under s. 253.05 as a result of the occurrence of an injury, sickness or death that creates a claim or cause of action, whether in tort or contract, on the part of a public assistance recipient or beneficiary or the estate of a recipient or beneficiary against a 3rd party, including an insurer, is subrogated to the rights of the recipient, beneficiary or estate and may make a claim or maintain an action or intervene in a claim or action by the recipient, beneficiary or estate against the 3rd party. Subrogation under this subsection because of the provision of medical assistance under subch. IV constitutes a lien, equal to the amount of the medical assistance provided as a result of the injury, sickness or death that gave rise to the claim. The lien is on any lump sum payment resulting from a judgment or settlement that may be due the obligor. A lien under this subsection continues until it is released and discharged by the department of health and family services.

SECTION 1490. 49.89 (3m) (bm) of the statutes is created to read:

49.89 (3m) (bm) A person against whom a claim that is subrogated under sub. (2) or assigned under sub. (3) is made, or that person's attorney or insurer, shall provide notice under par. (c), if that person, attorney or insurer knows, or could reasonably determine, that the claimant is a recipient or former recipient of medical assistance under subch. IV, or is the estate of a former recipient of medical assistance under subch. IV.

SECTION 1491. 49.89 (7) (c) of the statutes is amended to read:

49.89 (7) (c) The incentive payment shall be an amount equal to 15% of the amount recovered because of benefits paid under s. 49.19, 49.20, s. 49.20, 1997 stats., and 49.30 or 253.05. The incentive payment shall be taken from the state share of the sum recovered, except that the incentive payment for an amount recovered because of benefits paid under s. 49.19 shall be considered an administrative cost under s. 49.19 for the purpose of claiming federal funding.

SECTION 1492. 50.01 (6h) of the statutes is created to read:

50.01 (6h) "Secretary" means the secretary of health and family services.

SECTION 1493. 50.02 (2) (d) of the statutes is created to read:

50.02 (2) (d) The department shall promulgate rules that prescribe the time periods and the methods of providing information specified in ss. 50.033 (2r) and (2s), 50.034 (5m) and (5n), 50.035 (4m) and (4n) and 50.04 (2g) (a) and (2h) (a).

SECTION 1494. 50.03 (13) (a) of the statutes is amended to read:

50.03 (13) (a) New license. Whenever ownership of a facility is transferred from the person or persons named in the license to any other person or persons, the transferee must obtain a new license. The license may be a probationary license. Penalties under sub. (1) shall apply to violations of this subsection. The transferee shall notify the department of the transfer, file an application under sub. (3) (b) and apply for a new license at least 30 days prior to final transfer. Retention of any interest required to be disclosed under sub. (3) (b) after transfer by any person who held such an interest prior to transfer may constitute grounds for denial of a license where violations of this subchapter for which notice had been given to the transferor are outstanding and uncorrected, if the department determines that effective control over operation of the facility has not been transferred. If the transferor was a provider under s. 49.43 (10), the transferee and transferor shall comply with s. 49.45 (21).

SECTION 1495. 50.033 (2) of the statutes is amended to read:

50.033 (2) REGULATION. Standards for operation of licensed adult family homes and procedures for application for licensure, monitoring, inspection, revocation and appeal of revocation under this section shall be under rules promulgated by the department under s. 50.02 (2) (am) 2. An adult family home licensure is valid until revoked under this section. Licensure is not transferable. The biennial licensure fee for a licensed adult family home is $75 $142.50. The fee is payable to the county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437, if the county department licenses the adult family home under sub. (1m) (b), and is payable to the department, on a schedule determined by the department if the department licenses the adult family home under sub. (1m) (b).

SECTION 1496. 50.033 (2r) of the statutes is created to read:

50.033 (2r) PROVISION OF INFORMATION REQUIRED. Subject to sub. (2t), an adult family home shall, within the time period after inquiry by a prospective resident that is prescribed by the department by rule, inform the prospective resident of the services of a resource center under s. 46.283, the family care benefit under s. 46.286 and the availability of a functional and financial screen to determine the prospective resident's eligibility for the family care benefit under s. 46.286 (1).

SECTION 1497. 50.033 (2s) of the statutes is created to read:

50.033 (2s) REQUIRED REFERRAL. Subject to sub. (2t), an adult family home shall, within the time period prescribed by the department by rule, refer to a resource center under s. 46.283 a person who is seeking admission, who is at least 65 years of age or has a physical disability and whose disability or condition is expected to last at least 90 days, unless any of the following applies:

(a) The person has received a screen for functional eligibility under s. 46.286 (1) (a) within the previous 6 months.

(b) The person is entering the adult family home only for respite care.

SECTION 1498. 50.033 (2t) of the statutes is created to read:

50.033 (2t) APPLICABILITY. Subsections (2r) and (2s) apply only if the secretary has certified under s. 46.281 (3) that a resource center is available for the adult family home and for specified groups of eligible individuals that include those persons seeking admission to or the residents of the adult family home.

SECTION 1499. 50.034 (5m) of the statutes is created to read:

50.034 (5m) PROVISION OF INFORMATION REQUIRED. Subject to sub. (5p), a residential care apartment complex shall, within the time period after inquiry by a prospective resident that is prescribed by the department by rule, inform the prospective resident of the services of a resource center under s. 46.283, the family care benefit under s. 46.286 and the availability of a functional and financial screen to determine the prospective resident's eligibility for the family care benefit under s. 46.286 (1).

SECTION 1500. 50.034 (5n) of the statutes is created to read:

50.034 (5n) REQUIRED REFERRAL. Subject to sub. (5p), a residential care apartment complex shall, within the time period prescribed by the department by rule, refer to a resource center under s. 46.283 a person who is seeking admission, who is at least 65 years of age or has a physical disability and whose disability or condition is expected to last at least 90 days, unless any of the following applies:

(a) The person has received a screen for functional eligibility under s. 46.286 (1) (a) within the previous 6 months.

(b) The person is entering the residential care apartment complex only for respite care.

SECTION 1501. 50.034 (5p) of the statutes is created to read:

50.034 (5p) APPLICABILITY. Subsections (5m) and (5n) apply only if the secretary has certified under s. 46.281 (3) that a resource center is available for the residential care apartment complex and for specified groups of eligible individuals that include those person seeking admission to or the residents of the residential care apartment complex.

SECTION 1502. 50.034 (8) of the statutes is created to read:

50.034 (8) FORFEITURES. (a) Whoever violates sub. (5m) or (5n) or rules promulgated under sub. (5m) or (5n) may be required to forfeit not more than $500 for each violation.

(b) The department may directly assess forfeitures provided for under par. (a). If the department determines that a forfeiture should be assessed for a particular violation, it shall send a notice of assessment to the residential care apartment complex. The notice shall specify the amount of the forfeiture assessed, the violation and the statute or rule alleged to have been violated, and shall inform the residential care apartment complex of the right to a hearing under par. (c).

(c) A residential care apartment complex may contest an assessment of a forfeiture by sending, within 10 days after receipt of notice under par. (b), a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1). The administrator of the division may designate a hearing examiner to preside over the case and recommend a decision to the administrator under s. 227.46. The decision of the administrator of the division shall be the final administrative decision. The division shall commence the hearing within 30 days after receipt of the request for a hearing and shall issue a final decision within 15 days after the close of the hearing. Proceedings before the division are governed by ch. 227. In any petition for judicial review of a decision by the division, the party, other than the petitioner, who was in the proceeding before the division shall be the named respondent.

(d) All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested under par. (c), within 10 days after receipt of the final decision after exhaustion of administrative review, unless the final decision is appealed and the order is stayed by court order. The department shall remit all forfeitures paid to the state treasurer for deposit in the school fund.

(e) The attorney general may bring an action in the name of the state to collect any forfeiture imposed under this section if the forfeiture has not been paid following the exhaustion of all administrative and judicial reviews. The only issue to be contested in any such action shall be whether the forfeiture has been paid.

SECTION 1503. 50.035 (4m) of the statutes is created to read:

50.035 (4m) PROVISION OF INFORMATION REQUIRED. Subject to sub. (4p), a community-based residential facility shall, within the time period after inquiry by a prospective resident that is prescribed by the department by rule, inform the prospective resident of the services of a resource center under s. 46.283, the family care benefit under s. 46.286 and the availability of a functional and financial screen to determine the prospective resident's eligibility for the family care benefit under s. 46.286 (1).

SECTION 1504. 50.035 (4n) of the statutes is created to read:

50.035 (4n) REQUIRED REFERRAL. Subject to sub. (4p), a community-based residential facility shall, within the time period prescribed by the department by rule, refer to a resource center under s. 46.283 a person who is seeking admission, who is at least 65 years of age or has a physical disability and whose disability or condition is expected to last at least 90 days, unless any of the following applies:

(a) The person has received a screen for functional eligibility under s. 46.286 (1) (a) within the previous 6 months.

(b) The person is entering the community-based residential facility only for respite care.

SECTION 1505. 50.035 (4p) of the statutes is created to read:

50.035 (4p) APPLICABILITY. Subsections (4m) and (4n) apply only if the secretary has certified under s. 46.281 (3) that a resource center is available for the community-based residential facility and for specified groups of eligible individuals that include those persons seeking admission to or the residents of the community-based residential facility.

SECTION 1506. 50.035 (7) (c) of the statutes is amended to read:

50.035 (7) (c) If the date estimated under par. (a) 2. is less than 24 months after the date of the individual's statement of financial condition, the community-based residential facility shall provide the statement to the county department under s. 46.215 or 46.22 and shall refer the potential resident to the county department to determine whether an assessment under s. 46.27 (6) should be conducted.

SECTION 1507. 50.035 (8) of the statutes is repealed.

SECTION 1508. 50.035 (11) of the statutes is created to read:

50.035 (11) FORFEITURES. (a) Whoever violates sub. (4m) or (4n) or rules promulgated under sub. (4m) or (4n) may be required to forfeit not more than $500 for each violation.

(b) The department may directly assess forfeitures provided for under par. (a). If the department determines that a forfeiture should be assessed for a particular violation, it shall send a notice of assessment to the community-based residential facility. The notice shall specify the amount of the forfeiture assessed, the violation and the statute or rule alleged to have been violated, and shall inform the licensee of the right to a hearing under par. (c).

(c) A community-based residential facility may contest an assessment of a forfeiture by sending, within 10 days after receipt of notice under par. (b), a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1). The administrator of the division may designate a hearing examiner to preside over the case and recommend a decision to the administrator under s. 227.46. The decision of the administrator of the division shall be the final administrative decision. The division shall commence the hearing within 30 days after receipt of the request for a hearing and shall issue a final decision within 15 days after the close of the hearing. Proceedings before the division are governed by ch. 227. In any petition for judicial review of a decision by the division, the party, other than the petitioner, who was in the proceeding before the division shall be the named respondent.

SECTION 1509. 50.037 (2) (a) of the statutes is amended to read:

50.037 (2) (a) The biennial fee for a community-based residential facility is $170 $323, plus a biennial fee of $22 $41.80 per resident, based on the number of residents that the facility is licensed to serve.

SECTION 1510. 50.04 (2g) of the statutes is created to read:

50.04 (2g) PROVISION OF INFORMATION REQUIRED. (a) Subject to sub. (2i), a nursing home shall, within the time period after inquiry by a prospective resident that is prescribed by the department by rule, inform the prospective resident of the services of a resource center under s. 46.283, the family care benefit under s. 46.286 and the availability of a functional and financial screen to determine the prospective resident's eligibility for the family care benefit under s. 46.286 (1).

(b) Failure to comply with this subsection is a class "C" violation under sub. (4) (b) 3.

SECTION 1511. 50.04 (2h) of the statutes is created to read:

50.04 (2h) REQUIRED REFERRAL. (a) Subject to sub. (2i), a nursing home shall, within the time period prescribed by the department by rule, refer to a resource center under s. 46.283 a person who is seeking admission, who is at least 65 years of age or has developmental disability or physical disability and whose disability or condition is expected to last at least 90 days, unless any of the following applies:

1. The person has received a screen for functional eligibility under s. 46.286 (1) (a) within the previous 6 months.

2. The person is seeking admission to the nursing home only for respite care.

3. The person is an enrollee of a care management organization.

(b) Failure to comply with this subsection is a class "C" violation under sub. (4) (b) 3.

SECTION 1512. 50.04 (2i) of the statutes is created to read:

50.04 (2i) APPLICABILITY. Subsections (2g) and (2h) apply only if the secretary has certified under s. 46.281 (3) that a resource center is available for the nursing home and for specified groups of eligible individuals that include those persons seeking admission to or the residents of the nursing home.

SECTION 1513. 50.04 (2m) of the statutes is renumbered 50.04 (2m) (a) and amended to read:

50.04 (2m) (a) No Except as provided in par. (b), no nursing home may admit any patient until a physician has completed a plan of care for the patient and the patient is assessed or the patient is exempt from or waives assessment under s. 46.27 (6) (a) or 46.271 (2m) (a) 2. Failure to comply with this subsection is a class "C" violation under sub. (4) (b) 3.

SECTION 1514. 50.04 (2m) (b) of the statutes is created to read:

50.04 (2m) (b) Paragraph (a) does not apply to those residents for whom the secretary has certified under s. 46.281 (3) that a resource center is available.

SECTION 1515. 50.06 (7) of the statutes is amended to read:

50.06 (7) (a) An individual who consents to an admission under this section may request that an assessment be conducted for the incapacitated individual under the long-term support community options program under s. 46.27 (6) or, if the secretary has certified under s. 46.281 (3) that a resource center is available for the individual, a functional and financial screen to determine eligibility for the family care benefit under s. 46.286 (1).

SECTION 1516. 50.065 (2) (a) (intro.) of the statutes is amended to read:

50.065 (2) (a) (intro.) Notwithstanding s. 111.335, and except as provided in sub. (5), if the department knows or should know any of the following, the department may not license, certify, issue a certificate of approval to or register a person to operate an entity or continue the license, certification, certificate of approval or registration of a person to operate an entity if the department knows or should have known any of the following:

SECTION 1517. 50.065 (2) (ag) (intro.) of the statutes is amended to read:

50.065 (2) (ag) (intro.) Notwithstanding s. 111.335, and except as provided in sub. (5), if an entity knows or should know any of the following, the entity may not hire or contract with a person who will be under the entity's control, as defined by the department by rule, and who is expected to have access to its clients, or provide to clients of the entity direct care that is more intensive than negligible care in quantity or quality or in amount of time required to provide the care; or the entity may not permit to reside at the entity a person who is not a client and who is expected to have access to a client, if the entity knows or should have known any of the following:

SECTION 1518. 50.065 (2) (ag) (intro.) of the statutes, as affected by 1997 Wisconsin Act 27, section 2059f, and 1999 Wisconsin Act .... (this act), is repealed and recreated to read:

50.065 (2) (ag) (intro.) Notwithstanding s. 111.335, and except as provided in sub. (5), if an entity knows or should have known any of the following, the entity may not employ or contract with a person who will be under the entity's control, as defined by the department by rule, and who provides to clients of the entity, or is expected to provide to them, direct care that is more intensive than negligible care in quantity or quality or in the amount of time required to provide the care; or the entity may not permit to reside at the entity a person who is not a client and who has, or is expected to have, access to a client:

SECTION 1519. 50.065 (2) (b) 1. (intro.) of the statutes is amended to read:

50.065 (2) (b) 1. (intro.) Subject to subds. 1. e. and 2. and par. (bd), every entity shall obtain all of the following with respect to a person specified under par. (ag) (intro.) who is an employe or contractor or a prospective employe or contractor of the entity:

SECTION 1520. 50.065 (2) (b) 2. of the statutes is repealed.

SECTION 1521. 50.065 (6) (am) 1. of the statutes is amended to read: