SB45,593,106
2. The annual amount of a county's expenditure for a risk reserve, as specified
7in subd. 1., may not exceed 10% of the county's most recent allocation under pars.
8(am) and (b) and sub. (11) (c) 3. or $750,000, whichever is less. The total amount of
9the risk reserve, including interest, may not exceed 15% of the county's most recent
10allocation under this subsection.
SB45,593,1211
3. A county may expend funds maintained in a risk reserve, as specified in subd.
121., for any of the following purposes:
SB45,593,1313
a. To defray costs of long-term community support services under this section.
SB45,593,1514
b. To meet requirements under any contract that the county has with the
15department to operate a care management organization under s. 46.284.
SB45,593,1716
c. If approved by a resolution of the county board of supervisors, to transfer
17funds to a family care district.
SB45,593,1918
d. If approved by the department, for administrative or staff costs under this
19section.
SB45,593,2220
4. A county that maintains a risk reserve, as specified in subd. 1., shall
21annually, on a form prescribed by the department, submit to the department a record
22of the status of the risk reserve, including revenues and disbursements.
SB45, s. 1048
23Section
1048. 46.27 (7) (g) (intro.) of the statutes is amended to read:
SB45,594,924
46.27
(7) (g) (intro.) The department may carry forward to the next state fiscal
25year
up to $500,000 of funds allocated under this subsection and not encumbered by
1counties by December 31 or carried forward under par. (fm). The department may
2transfer moneys within s. 20.435 (7) (bd) to accomplish this purpose. An allocation
3under this paragraph shall not affect a county's base allocation for the program. The
4department may allocate these transferred moneys during the next fiscal year to
5counties
for planning and implementation of resource centers under s. 46.283 or care
6management organizations under s. 46.284 and for the improvement or expansion
7of long-term community support services for clients whose cost of care significantly
8exceeds the average cost of care provided under this section, including any of the
9following:
SB45, s. 1049
10Section
1049. 46.27 (7g) (c) 3. (intro.) of the statutes is amended to read:
SB45,594,1411
46.27
(7g) (c) 3. (intro.) The court shall reduce the amount of a claim under
12subd. 1. by up to
$3,000 the amount specified in s. 861.33 (2) if necessary to allow the
13client's heirs or the beneficiaries of the client's will to retain the following personal
14property:
SB45, s. 1050
15Section
1050. 46.27 (7g) (c) 3. c. of the statutes is amended to read:
SB45,594,1816
46.27
(7g) (c) 3. c. Other tangible personal property not used in trade,
17agriculture or other business, not to exceed
$1,000 in value
the amount specified in
18s. 861.33 (1) (a) 4.
SB45, s. 1051
19Section
1051. 46.27 (7g) (c) 5. of the statutes is renumbered 46.27 (7g) (c) 5.
20a. and amended to read:
SB45,595,221
46.27
(7g) (c) 5. a. If the department's claim is not allowable because of subd.
224. and the estate includes an interest in a home, the court exercising probate
23jurisdiction shall, in the final judgment
or summary findings and order, assign the
24interest in the home subject to a lien in favor of the department for the amount
25described in subd. 1. The personal representative
or petitioner for summary
1settlement or summary assignment of the estate shall record the final judgment as
2provided in s. 863.29
, 867.01 (3) (h) or 867.02 (2) (h).
SB45, s. 1052
3Section
1052. 46.27 (7g) (c) 5. b. of the statutes is created to read:
SB45,595,104
46.27
(7g) (c) 5. b. If the department's claim is not allowable because of subd.
54., the estate includes an interest in a home and the personal representative closes
6the estate by sworn statement under s. 865.16, the personal representative shall
7stipulate in the statement that the home is assigned subject to a lien in favor of the
8department for the amount described in subd. 1. The personal representative shall
9record the statement in the same manner as described in s. 863.29, as if the
10statement were a final judgment.
SB45, s. 1053
11Section
1053. 46.27 (7g) (h) of the statutes is created to read:
SB45,595,1312
46.27
(7g) (h) The department may contract with or employ an attorney to
13probate estates to recover under this subsection the costs of care.
SB45, s. 1054
14Section
1054. 46.27 (9) (a) of the statutes is amended to read:
SB45,595,2315
46.27
(9) (a) The department may select up to 5 counties that volunteer to
16participate in a pilot project under which they will receive certain funds allocated for
17long-term care. The department shall allocate a level of funds to these counties
18equal to the amount that would otherwise be paid under s. 20.435
(5) (4) (b) to nursing
19homes for providing care because of increased utilization of nursing home services,
20as estimated by the department. In estimating these levels, the department shall
21exclude any increased utilization of services provided by state centers for the
22developmentally disabled. The department shall calculate these amounts on a
23calendar year basis under sub. (10).
SB45, s. 1055
24Section
1055. 46.27 (9) (c) of the statutes is amended to read:
SB45,596,6
146.27
(9) (c) All long-term community support services provided under this
2pilot project in lieu of nursing home care shall be consistent with those services
3described in the participating county's community options plan under sub. (4) (c)
1. 4and provided under sub. (5) (b). Unless the department has contracted under s.
546.271 (2m) 46.281 (1) (d) with an entity other than the county department, each
6county participating in the pilot project shall assess persons under sub. (6).
SB45, s. 1056
7Section
1056. 46.27 (10) (a) 1. of the statutes is amended to read:
SB45,596,128
46.27
(10) (a) 1. The department shall determine for each county participating
9in the pilot project under sub. (9) a funding level of state medical assistance
10expenditures to be received by the county. This level shall equal the amount that the
11department determines would otherwise be paid under s. 20.435
(5) (4) (b) because
12of increased utilization of nursing home services, as estimated by the department.
SB45, s. 1057
13Section
1057. 46.27 (11) (c) 3. of the statutes is amended to read:
SB45,596,1714
46.27
(11) (c) 3. Medical assistance reimbursement for services a county, a
15private nonprofit agency or an aging unit with which the department contracts
16provides under this subsection shall be made from the appropriations under s. 20.435
17(5) (4) (o) and (7) (b) and (bd).
SB45, s. 1058
18Section
1058. 46.27 (11) (c) 4. of the statutes is amended to read:
SB45,596,2319
46.27
(11) (c) 4. The department may, from the appropriation under s. 20.435
20(5) (4) (o), provide reimbursement for services provided under this subsection by
21counties that are in excess of the current average annual per person rate, as
22established by the department, and are less than or equal to the average amount
23approved in the waiver received under par. (am).
SB45, s. 1059
24Section
1059. 46.27 (11) (c) 5n. a. of the statutes is amended to read:
SB45,597,7
146.27
(11) (c) 5n. a. An assessment under sub. (6) has been completed for the
2person prior to the person's admission to the community-based residential facility,
3whether or not the person is a private pay admittee at the time of admission.
The
4county may waive this condition in accordance with guidelines established by the
5department. 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.
SB45, s. 1060
8Section
1060. 46.271 (2m) of the statutes is repealed.
SB45, s. 1061
9Section
1061. 46.275 (5) (a) of the statutes is amended to read:
SB45,597,1510
46.275
(5) (a) Medical assistance reimbursement for services a county, or the
11department under sub. (3r), provides under this program is available from the
12appropriations under s. 20.435
(5) (4) (b) and (o). If 2 or more counties jointly contract
13to provide services under this program and the department approves the contract,
14medical assistance reimbursement is also available for services provided jointly by
15these counties.
SB45, s. 1062
16Section
1062. 46.275 (5) (c) of the statutes is amended to read:
SB45,597,2317
46.275
(5) (c) The total allocation under s. 20.435
(5) (4) (b) and (o) to counties
18and to the department under sub. (3r) for services provided under this section may
19not exceed the amount approved by the federal department of health and human
20services. A county may use funds received under this section only to provide services
21to persons who meet the requirements under sub. (4) and may not use unexpended
22funds received under this section to serve other developmentally disabled persons
23residing in the county.
SB45, s. 1063
24Section
1063. 46.275 (5) (d) of the statutes is amended to read:
SB45,598,5
146.275
(5) (d) The department may, from the appropriation under s. 20.435
(5) 2(4) (o), provide reimbursement for services provided under this section by counties
3that are in excess of the current average annual per person rate, as established by
4the department, and are less than the average amount approved in the waiver
5received under sub. (2).
SB45, s. 1064
6Section
1064. 46.277 (5) (d) 1n. a. of the statutes is amended to read:
SB45,598,137
46.277
(5) (d) 1n. a. An assessment under s. 46.27 (6) has been completed for
8the person prior to the person's admission to the community-based residential
9facility, whether or not the person is a private pay admittee at the time of admission.
10The county may waive this condition in accordance with guidelines established by
11the department. If the county waives this condition, the county must meet with the
12person or the person's guardian to discuss the cost-effectiveness of various service
13options.
SB45, s. 1065
14Section
1065. 46.278 (6) (d) of the statutes is amended to read:
SB45,598,2015
46.278
(6) (d) If a county makes available nonfederal funds equal to the state
16share of service costs under the waiver received under sub. (3), the department may,
17from the appropriation under s. 20.435
(5) (4) (o), provide reimbursement for services
18that the county provides under this section to persons who are in addition to those
19who may be served under this section with funds from the appropriation under s.
2020.435
(5) (4) (b).
SB45, s. 1066
21Section
1066. 46.278 (6) (e) of the statutes is renumbered 46.278 (6) (e) 1.
22(intro.) and amended to read:
SB45,598,2523
46.278
(6) (e) 1. (intro.) The department may provide enhanced reimbursement
24for services under the program for an individual who was relocated to the community
25by a county department from
an one of the following:
SB45,599,2
1a. An intermediate care facility for the mentally retarded that closes under s.
250.03 (14).
SB45,599,4
32. The enhanced reimbursement rate under this paragraph shall be
4determined under a formula that is developed by the department.
SB45, s. 1067
5Section
1067. 46.278 (6) (e) 1. b. of the statutes is created to read:
SB45,599,86
46.278
(6) (e) 1. b. An intermediate care facility for the mentally retarded or
7a distinct part thereof that has a plan of closure approved by the department and that
8intends to close within 12 months.
SB45, s. 1068
9Section
1068. 46.2805 of the statutes is created to read:
SB45,599,10
1046.2805 Definitions; long-term care. In ss. 46.2805 to 46.2895:
SB45,599,15
11(1) "Care management organization" means an entity that is certified as
12meeting the requirements for a care management organization under s. 46.284 (3)
13and that has a contract under s. 46.284 (2). "Care management organization" does
14not mean an entity that contracts with the department to operate one of the
15following:
SB45,599,1716
(a) A program of all-inclusive care for persons aged 65 or older authorized
17under
42 USC 1395 to
1395ggg.
SB45,599,1918
(b) A demonstration program known as the Wisconsin partnership program
19under a federal waiver authorized under
42 USC 1315.
SB45,599,21
20(2) "Eligible person" means a person who meets all eligibility criteria under s.
2146.286 (1) or (1m).
SB45,599,23
22(3) "Enrollee" means a person who is enrolled in a care management
23organization.
SB45,599,25
24(4). "Family care benefit" means financial assistance for long-term care and
25support items for an enrollee.
SB45,600,2
1(5) "Family care district" means a special purpose district created under s.
246.2895 (1).
SB45,600,4
3(6) "Family care district board" means the governing board of a family care
4district.
SB45,600,7
5(7) "Functional and financial screen" means a screen prescribed by the
6department that is used to determine functional eligibility under s. 46.286 (1) (a) and
7financial eligibility under s. 46.286 (1) (b).
SB45,600,8
8(8) "Nonprofit organization" has the meaning given in s. 108.02 (19).
SB45,600,9
9(9) "Older person" means a person who is aged at least 65.
SB45,600,12
10(10) "Resource center" means an entity that meets the standards for operation
11under s. 46.283 (3) or, if under contract to provide a portion of the services specified
12under s. 46.283 (3), meets the standards for operation with respect to those services.
SB45,600,14
13(11) "Tribe or band" means a federally recognized American Indian tribe or
14band.
SB45, s. 1069
15Section
1069. 46.281 of the statutes is created to read:
SB45,600,18
1646.281 Powers and duties of the department and the secretary;
17long-term care. (1) Duties of the department. The department shall do all of the
18following:
SB45,600,2219
(a) Provide training to members of the council on long-term care who are aged
2065 or older or who have physical or developmental disabilities or their family
21members, guardians or other advocates, to enable these members to participate in
22the council's duties.
SB45,600,2423
(b) Provide information to the council on long-term care and seek
24recommendations of the council.
SB45,601,7
1(c) Request from the secretary of the federal department of health and human
2services any waivers of federal medicaid laws necessary to permit the use of federal
3moneys to provide the family care benefit to recipients of medical assistance. The
4department shall implement any waiver that is approved and that is consistent with
5ss. 46.2805 to 46.2895. Regardless of whether a waiver is approved, the department
6may implement operation of resource centers, care management organizations and
7the family care benefit.
SB45,601,88
(d) Before July 1, 2001:
SB45,601,129
1. Establish, in geographic areas determined by the department, a pilot project
10under which the department may contract with a county, a family care district, a
11tribe or band or the Great Lakes inter-tribal council, inc., or with any 2 or more of
12these entities under a joint application, to operate a resource center.
SB45,601,1513
2. Contract with counties or tribes or bands under a pilot project to demonstrate
14the ability of counties or tribes or bands to manage all long-term care programs and
15administer the family care benefit as care management organizations.
SB45,601,1916
(e) After June 30, 2001, contract with one or more entities certified as meeting
17requirements under s. 46.284 (3) for services of the entity as a care management
18organization and one or more entities for services specified under s. 46.283 (3) and
19(4).
SB45,601,2120
(f) Prescribe and implement a per person monthly rate structure for costs of the
21family care benefit.
SB45,601,2422
(g) In order to maintain continuous quality assurance and quality
23improvement for resource centers and care management organizations, do all of the
24following:
SB45,602,2
11. Prescribe by rule and by contract and enforce performance standards for
2operation of resource centers and care management organizations.
SB45,602,43
2. Use performance expectations that are related to outcomes for persons in
4contracting with care management organizations and resource centers.
SB45,602,65
3. Conduct ongoing evaluations of the long-term care system specified in ss.
646.2805 to 46.2895.
SB45,602,87
4. Require that quality assurance and quality improvement efforts be included
8throughout the long-term care system specified in ss. 46.2805 to 46.2895.
SB45,602,129
5. Ensure that reviews of the quality of management and service delivery of
10resource centers and care management organizations are conducted by external
11organizations and make information about specific review results available to the
12public.
SB45,602,1613
(h) Require by contract that resource centers and care management
14organizations establish procedures under which an individual who applies for or
15receives the family care benefit may register a complaint or grievance and
16procedures for resolving complaints and grievances.
SB45,602,1917
(i) Prescribe criteria to assign priority equitably on any necessary waiting lists
18for persons who are eligible for the family care benefit but who do not meet the
19criteria under s. 46.286 (3).
SB45,602,22
20(2) Powers of the department. The department may develop risk-sharing
21arrangements in contracts with care management organizations, in accordance with
22applicable state laws and federal statutes and regulations.
SB45,603,5
23(3) Duty of the secretary. The secretary shall certify to each county, nursing
24home, community-based residential facility, adult family home and residential care
25apartment complex the date on which a resource center that serves the area of the
1county, nursing home, community-based residential facility, adult family home or
2residential care apartment complex is first available to provide a functional and
3financial screen. To facilitate phase-in of services of resource centers, the secretary
4may certify that the resource center is available for specified groups of eligible
5individuals or for specified facilities in the county.
SB45, s. 1070
6Section
1070. 46.281 (1) (a) of the statutes, as created by 1999 Wisconsin Act
7.... (this act), is repealed.
SB45, s. 1071
8Section
1071. 46.281 (1) (b) of the statutes, as created by 1999 Wisconsin Act
9.... (this act), is repealed.
SB45, s. 1072
10Section
1072. 46.282 of the statutes is created to read:
SB45,603,12
1146.282 Council on long-term care. The council on long-term care appointed
12under s. 15.197 (5) shall do all of the following:
SB45,603,14
13(1) Assist the department in developing broad policy issues related to
14long-term care services.
SB45,603,17
15(2) Assist the department in developing, implementing, coordinating and
16guiding long-term care services and systems, including by reviewing and making
17nonbinding recommendations to the department on all of the following: