Under current law, the compensation paid to a retailer who sells lottery tickets
is 5.5% of the retail price of the lottery tickets. In addition, under current law, the
compensation paid to a retailer who sells scratch-off or instant games is 6.25% of the
retail price of scratch-off or instant games. This bill authorizes the department of
revenue to establish, by rule, a program to provide for additional compensation to be
paid to retailers who meet certain performance goals. Under this program, the total
compensation provided to retailers who meet the performance goals may not exceed
1.0% of gross lottery revenues.
Under current law, the department of health and family services may award
grants to individuals or organizations in the private sector to conduct compulsive
gambling awareness campaigns. These grants are funded from the lottery fund,
from revenues generated by pari-mutuel wagering and from moneys paid to the
state under Indian gaming compacts. This bill provides that the grants must be
funded entirely from moneys paid to the state under Indian gaming compacts.
health and human services
Long-term care; family care
Current law
Currently, home and community-based long-term care is provided to persons
who are elderly, physically or developmentally disabled, chronically mentally ill or
chemically dependent as a benefit under one or more programs administered by the
department of health and family services (DHFS). These programs are funded by
federal, state or, in some instances, county moneys, and each program has
individualized eligibility criteria and benefit restrictions. For elderly and disabled
persons, these programs include medical assistance (MA), the long-term support
community options program (COP), three community integration programs (CIPs)
and community aids. MA is a comprehensive jointly funded federal-state health
program for persons with low income and few assets. COP provides assessments of
functionality and home and community-based care to, among others, elderly and
disabled persons as an alternative to institutionalized care; one part of COP is
funded by state moneys and the other part is funded under a joint federal-state
program under a waiver of federal medicaid laws. Under other joint federal-state
programs under waivers of federal medicaid laws, CIPs provide home and
community-based services and continuity of care for persons relocated from
institutions, including state centers for the developmentally disabled, and persons
who meet requirements for MA reimbursement in nursing homes.
Currently, under a pilot project, DHFS contracts with a public or private entity
to serve as a clearinghouse of information for individuals who are interested in home
or community-based long-term support services or institutional long-term care
services and to perform assessments to determine an individual's functional
abilities, disabilities, personal preferences and need for home or community-based
services or institutional services. Under a second pilot project, DHFS may contract
with counties or federally recognized American Indian tribes or bands to
demonstrate the ability of counties or tribes or bands to manage all long-term care
programs under a long-term care management organization.
Currently, nursing homes are prohibited from admitting patients until a
physician has completed a plan of care and the patient has been assessed under COP
or the long-term care pilot project or has waived the assessment.
Creation of family care benefit, resource centers and care management
organizations
This bill establishes a program of financial assistance for long-term care and
support items, called a family care benefit, for persons who are eligible and are
enrolled in a care management organization, an entity whose attributes are
established in this bill. The family care benefit is funded by general purpose revenue
appropriated for MA, COP and community aids. DHFS must request from the
federal secretary of health and human services any waivers of federal medicaid laws
necessary to permit the use of federal moneys to provide the family care benefit to
recipients of MA; however, regardless of whether a waiver is approved, DHFS may
implement the family care benefit. Persons are eligible for, but not necessarily
entitled to, the family care benefit if they are at least 18 years of age, do not have a
primary disabling condition of mental illness, substance abuse or developmental
disability and meet certain functional and financial eligibility criteria. A person is
entitled to the family care benefit and may enroll in a care management organization
if he or she is financially eligible, meets cost-sharing requirements and meets any
of several functional eligibility requirements or if he or she has a primary disabling
condition of developmental disability and was a resident of a county or member of a
tribe or band that operated a care management organization under a pilot project.
Divestment prohibitions, prohibitions on treatment of certain trusts, provisions on
protection of income and resources of a couple for maintenance of a spouse in the
community, and estate recovery provisions, all of which correspond to similar
prohibitions and provisions under MA, apply to enrollees. A client may contest
denial of eligibility, the determination of cost sharing, denial of entitlement, failure
to provide timely services and support items in the plan of care, reduction of services
or support items, development of an unacceptable plan of care and termination of the
family care benefit, by filing a written request for a hearing within 45 days after
receipt of notice of the contested matter.
The bill establishes requirements for a resource center, which, among other
things, must provide information and referral services, determine functional and
financial eligibility for the family care benefit, assist persons to enroll in a care
management organization and determine eligibility for certain other benefits,
including MA. Within six months after the family care benefit is available to all
eligible persons in the area of the resource center, the resource center must provide
information about its services to all older persons and persons with physical
disabilities who reside in nursing homes, community-based residential facilities,
adult family homes and residential care apartment complexes in the area of the
resource center. A resource center must have a governing board that reflects the
ethnic and economic diversity of the geographic area served by the resource center,
and at least one-fourth of the governing board's members must be older persons or
persons with physical or developmental disabilities or family members, guardians
or other advocates of such persons.
The bill establishes requirements for a care management organization, which
must accept the enrollment of persons who are entitled to the family care benefit, as
well as the enrollment of persons who are eligible for the family care benefit and for
whom funding is available. Under a contract with DHFS, the care management
organization must, among other things, conduct a comprehensive assessment for
each enrollee, develop a comprehensive care plan for the enrollee and provide or
contract for the provision of necessary services. DHFS may, by contract, require
solvency protections for a care management organization. A care management
organization must have a governing board that is subject to requirements that are
similar to those for the governing board of a resource center. The bill specifically
exempts a care management organization from requirements for licensure as a home
health agency.
Under the bill, DHFS must prescribe and implement a per person monthly rate
structure for costs of the family care benefit. DHFS also must prescribe and enforce
performance standards for the operation of resource centers and care management
organizations, conduct ongoing evaluations of the system implementing the family
care benefit and ensure that independent organizations conduct reviews of the
quality of management and service delivery of resource centers and care
management organizations.
Family care district
This bill authorizes county boards of supervisors to create, on a single county
or multicounty basis, family care districts. Under the bill, a family care district is
a separate local unit of government, the primary purpose of which is to operate a
resource center or a care management organization, but not both. The jurisdiction
of the family care district is the county or counties of the county board or boards of
supervisors who created the district. The family care district's board is appointed by
the county board or boards of supervisors and must consist of 15 persons for a single
county and, for a multicounty family care district, an additional member for each
county in excess of two. Board members must be residents of the family care district's
jurisdiction and must satisfy certain additional requirements.
The bill grants to a family care district various local government powers,
including the power to adopt and alter an official seal; adopt bylaws and policies and
procedures to regulate its affairs; sue and be sued; negotiate and enter into leases
and contracts; employ agents, employes or special advisers; and buy, sell or lease
property. However, a family care district may not issue bonds or levy a tax or
assessment. Under the bill, a family care district must appoint a director, who must
manage the family care district's property, business and employes. The family care
district must also develop and implement a personnel structure and other
employment policies. With respect to the hiring of employes who formerly were
county employes to perform the same or substantially similar functions that they
previously performed, the family care district must perform certain tasks to ensure
that the employes' compensation, benefits, seniority and status in class under county
employment are not diminished. If the county has established its own retirement
system the county must include family care district employes in participation and
applicable benefits.
Numerous laws that apply to special purpose districts and local units of
government apply to the family care district, including, among others:
1. The members of the family care district governing board and the director of
the family care district are subject to the code of ethics for local government officials.
2. The family care district is exempt from the sales and use taxes.
3. The family care district is subject to public employe occupational safety and
health laws.
4. The family care district is governed by unemployment compensation laws.
5. The family care district may participate in the local governmental property
insurance fund.
6. The family care district is governed by municipal administrative procedures
concerning constitutionally protected rights.
7. Persons attempting to sue the family care district are subject to limitations
on actions that may be brought against it and limitations as to the filing of the notice
of the injury and recoverable damages.
The bill also provides that a family care district:
1. Must adhere to the open records laws, except in certain circumstances.
2. Must adhere to the open meetings laws.
3. Is subject to auditing by the legislative audit bureau and review of its
performance by the joint legislative audit committee.
4. Is an employer for all purposes of the municipal employment relations laws;
as such, employes of the district may organize and seek to establish all terms of
wages, hours and conditions of employment through collective bargaining.
5. Is subject to prohibitions on public funding for abortions and for
abortion-related activities.
6. May participate in the local government pooled-investment fund.
7. Is exempt from local property tax and income tax.
8. Is subject to laws regulating buildings and safety.
9. Is governed by state minimum wage and hour and family and medical leave
laws and is subject to worker's compensation laws.
10. May participate in programs of state retirement, health and long-term care
benefits, disability benefits and survivor benefits, deferred compensation plans,
employe-funded reimbursement accounts and health insurance premium credits
and be included as a coverage group under social security.
11. Is an employer for the purposes of coverage for group and individual health
benefits and for small employer health insurance.
12. Is a municipality for the purposes of laws relating to the publication of legal
notices.
Under the bill, obligations and debts of a family care district are not the
obligations or debts of the county that created the family care district. A family care
district may be dissolved by joint action of the family care district board and the
county board or boards of supervisors that created the district, subject to
performance of its contractual obligations and approval by the secretary of health
and family services. If the family care district was created by more than one county,
the county boards of supervisors that created the district must agree on the
apportioning of the district's property before dissolution may occur.
Expansion of pilot projects
This bill authorizes DHFS to continue contracting with counties or American
Indian tribes or bands under the current pilot projects until July 1, 2001. After that
date, DHFS may contract with one or more entities certified as meeting
requirements for a resource center and for services of an entity as a care management
organization. During the first 24 months in which a county has a contract with
DHFS under which the county accepts a per person per month payment for each
enrollee in the county's care management organization, the authority of DHFS to
contract with another organization to operate a care maintenance organization in
that county is restricted.
Under the bill, a county, an American Indian tribe or band, a family care district
or an organization may not directly operate both a resource center and a care
management organization. If a county board of supervisors and the county executive
or county administrator apply to DHFS for a contract to operate a resource center,
the county board may create a family care district to apply to DHFS for a contract
to operate a care management organization; if the county board and the county
executive or administrator apply for a contract to operate a care management
organization, the county board may create a family care district to apply to DHFS
for a contract to operate a resource center. If the governing body of an American
Indian tribe or band elects to apply for a contract to operate a resource center, the
tribe or band members may form a separate corporation to apply for a contract to
operate a care management organization; if the governing body elects to apply for a
contract to operate a care management organization, the tribe or band members may
form a separate corporation to apply for a contract to operate a resource center. A
county or family care district may apply jointly with a tribe or band or tribal or band
corporation for a contract to operate a care management organization or resource
center.
The bill authorizes a county department of social services, human services,
developmental disabilities services or community programs or an aging unit
authorized by the applicable county board of supervisors to apply to DHFS to operate
a resource center or a care management organization. The bill also authorizes the
secretary of health and family services, in order to facilitate the transition to the
family care benefit system, to grant a county limited waivers to certain COP and CIP
statutes and rules promulgated under those statutes.
Requirements of care facilities
This bill requires the secretary of health and family services to certify to each
county, nursing home, community-based residential facility, adult family home and
residential care apartment complex the date on which a resource center that serves
the area of the county, home, facility or complex is first available to provide a
functional and financial screen to specific groups of eligible individuals or for
specified facilities. Each affected nursing home, community-based residential
facility, adult family home and residential care apartment complex must inform
prospective residents of the facility about the services of the resource center, the
family care benefit and the availability of a functional and financial screen to
determine eligibility. Also, these facilities and hospitals must refer to the resource
center any person who seeks admission and who is aged at least 65 years or has a
physical disability, unless the person has received a screen for functional eligibility
within the previous six months, is entering the facility only for respite care or is an
enrollee of a care management organization. Failure to comply with these
requirements subjects the facility to an administrative forfeiture. Current
prohibitions on the admittance to nursing homes of persons without a COP or other
assessment do not apply to persons for whom the secretary of health and family
services has certified that a resource center is available.
Council on long-term care and board on aging and long-term care
This bill creates in DHFS a 15-member council on long-term care that
terminates on July 1, 2001. The council must assist DHFS in developing policy
related to long-term care issues. The council also must review and make
recommendations to DHFS concerning the DHFS standard contract provisions for
resource centers and care management organizations, the family care benefit and
other matters, and must monitor patterns of complaints, persons on waiting lists and
patterns of enrollments and disenrollments.
The bill makes several changes to the membership of the board on aging and
long-term care and requires the board to contract with organizations to provide
advocacy services, including negotiation, mediation and assistance in
administrative hearings or judicial proceedings, to potential or actual recipients of
the family care benefit or their families or guardians.
Other long-term care
Under current law, a county may not use COP or CIP funds to provide services
to an individual who resides in a community-based residential facility unless the
individual receives, before admission, an assessment of his or her functional
abilities, disabilities and need for medical and social long-term community support
services.
Current law also requires a community-based residential facility, prior to
admitting a person, to prepare a statement of financial condition for a person who
intends to pay for residence in the facility from private funds. The statement of
financial condition must estimate a date, if any, by which the person's assets and
other private funding would be depleted if he or she were to reside continuously in
the community-based residential facility. If that date is less than 24 months after
the date of the statement of financial condition, the community-based residential
facility must provide the statement to the county department of social services.
This bill allows a county, in accordance with guidelines established by DHFS,
to waive the requirement to conduct a functional assessment prior to a person's
admission to a community-based residential facility. However, if a person applies
for admission to a community-based residential facility on or after the date that this
bill becomes law and his or her statement of financial condition indicates that, if the
individual were to reside in the community-based residential facility, his or her
assets and other private funds would be depleted within 12 months, the
community-based residential facility must refer him or her to the county
department of social services to determine whether an assessment should be
conducted.
Currently, revenues received by DHFS from skilled nursing facility violation
forfeiture assessment surcharges and interest pay for certain costs that are
associated with the violations, such as resident relocation to another facility and
reimbursement for misappropriated property. This bill permits DHFS to use a
portion of the penalty assessment surcharge and interest revenues for innovative
projects that aim to protect health and property of residents of skilled nursing
facilities.
Public assistance
Under current law, a county department of human services or social services
(county department) or, in Milwaukee County, DHFS must make payments of $215
per month to a relative of a child who is providing care and maintenance for the child
if certain conditions are met (kinship care and long-term kinship care). Under this
bill, a county department or DHFS may, but is not required to, make those payments
if certain conditions are met. The bill also provides that, notwithstanding fulfillment
of the conditions of eligibility for the receipt of those payments, a relative who is
providing kinship care or long-term kinship care for a child is not entitled to receive
those payments.
Under current law, a parent who receives federal supplemental security income
(SSI), or a state supplemental payment, receives a monthly supplemental payment
of $100 for each dependent child with whom the parent lives, if certain conditions are
met. This bill increases that monthly supplemental payment to $150 per dependent
child.
Current federal law permits states to establish a demonstration project under
which certain low-income individuals may establish savings accounts, referred to as
individual development accounts. The funds deposited into an individual
development account may be used for certain expenses associated with
postsecondary education, first home purchases, business capital expenses or medical
expenses, to meet necessary living expenses following loss of employment or to make
payments necessary to prevent the eviction of the individual from his or her
residence or the foreclosure on the mortgage for the principal residence of the
individual. An individual may only deposit earned income into the account. For
every dollar that the individual deposits into the account, the administering state or
local agency or American Indian tribal governing body, or a qualified nonprofit
agency, must deposit at least 50 cents and not more than four dollars into that
account. The federal government makes a grant to the matching contributor that
equals the lesser of the aggregate amount of funds committed as matching
contributions from nonfederal funds or $1,000,000.
This bill allows the department of workforce development (DWD) to establish
an individual development account demonstration project in this state in accordance
with the federal law.
Under current law, DWD is required to recover benefit overpayments made
under the aid to families with dependent children (AFDC) program and under the
Wisconsin works (W-2) program (this state's welfare reform initiative which
emphasizes work for benefits).
This bill permits DWD to recover overpaid AFDC or W-2 benefit amounts from
former benefit recipients by issuing a warrant directed to the clerk of circuit court.
The warrant is considered a perfected lien upon the person's right, title and interest
in all real and personal property. DWD may then file an execution commanding the
sheriff of any county in which property of the person is found to collect and sell
sufficient property to pay the amount stated in the warrant.
The bill also allows DWD to collect the overpaid AFDC or W-2 benefits by levy
upon any property of the person to whom the benefits were paid. Under the bill, such
a person who refuses to surrender the property is subject to enforcement
proceedings. A third party who fails to surrender property that is subject to a levy
is liable for up to 25% of the amount the debt. The bill sets forth the process for
serving the levy and releasing the levy. The bill also exempts certain wages, the first
$1,000 in a bank account and certain other property from a levy.
Under current law, DWD must allocate certain moneys for various public
assistance programs. This bill eliminates the requirement that moneys be allocated
for some of the programs and adds the following new programs to the list of those for
which moneys must be allocated:
1. A program to fund efforts to provide an emotionally and intellectually
stimulating environment for certain low-income children under the age of five.
2. A literacy program targeted at certain low-income individuals.
3. A competitive grant program to fund programs that improve social, academic
and employment skills of certain low-income youth.
4. A program to assist low-income workers to maintain their jobs and to
improve their basic skills.
5. A program to match retirees with youth to provide the youth with workforce
mentoring.
6. A program to encourage the positive involvement of fathers in their
children's lives.
7. A grant program under which DWD may award up to $1,000,000 to counties
and private entities to provide community-based alcohol and other drug abuse
treatment that is targeted to certain low-income individuals.
The bill also permits DWD to transfer funds received under the federal
temporary assistance for needy families block grant program to other agencies for
various programs.
Under current law, a county department of social or human services must
certify eligibility for and issue food coupons to needy households, except that a
Wisconsin works (W-2) agency is required, to the extent permitted under federal law
or waiver, to certify eligibility for and issue food coupons to eligible participants in
the W-2 program.
This bill requires a W-2 agency, to the extent permitted under federal law or
waiver, also to certify eligibility for and issue food coupons to: 1) persons who may
be required to participate in the food stamp employment and training program; and
2) other persons who are under the age of 61 and who are not disabled.
Under current law, certain federal economic support programs require that a
state maintain or increase its average annual expenditures for those programs. This
is commonly referred to as a maintenance-of-effort requirement.
This bill allows DWD to expend moneys from its economic support programs
appropriation for services to identify funds that may be used for the
maintenance-of-effort requirement.
Currently, under the learnfare program, a child between the ages of 6 and 17
who is the dependent child of a recipient of benefits under the W-2 program must
meet a school attendance requirement to avoid the imposition of certain sanctions.
Currently, DWD may expend moneys for a study of the school attendance
requirement under the learnfare program for children who are 6 to 12 years of age.
This bill eliminates that expenditure authority.
Under current law, if a recipient of certain public assistance benefits dies and
the estate of the deceased recipient is insufficient to pay for the funeral, burial and
cemetery expenses, the county or applicable American Indian tribal governing body
or the organization responsible for burial of the recipient must pay the cemetery
expenses that are not paid by the deceased recipient's estate (but not more than
$1,000) and must pay the funeral and burial expenses that are not paid by the
deceased recipient's estate (but not more than $1,000).
Under this bill, a county, tribal governing body or organization responsible for
burying the recipient is not required to make a payment for funeral, burial or
cemetery expenses if the request for the payment is made more than 12 months after
the recipient died.