SB44-SSA1, s. 1296e 11Section 1296e. 49.24 (2) (c) of the statutes is created to read:
SB44-SSA1,517,1812 49.24 (2) (c) The department may retain 50% of the amount of federal child
13support incentive payments awarded to the state for federal fiscal year 2002 that
14exceeds $12,340,000, and may retain 70% of the amount of federal child support
15incentive payments awarded to the state for each federal fiscal year after federal
16fiscal year 2002 that exceeds $12,340,000, to be used to pay the costs of the
17department's activities under ss. 49.22 and 49.227 and costs related to receiving and
18disbursing support and support-related payments.
SB44-SSA1, s. 1296g 19Section 1296g. 49.24 (2) (d) of the statutes is created to read:
SB44-SSA1,517,2320 49.24 (2) (d) If the amount of federal child support incentive payments awarded
21to the state for a federal fiscal year is less than $12,340,000, the total of payments
22distributed to counties under par. (b) and sub. (1) for that federal fiscal year may not
23exceed $12,340,000.
SB44-SSA1, s. 1298 24Section 1298. 49.24 (3) of the statutes is amended to read:
SB44-SSA1,518,3
149.24 (3) A county that receives any state child support incentive payment
2under sub. (1) or any federal child support incentive payment under sub. (2) may use
3the funds only to pay costs under its child support program under s. 49.22.
SB44-SSA1, s. 1302 4Section 1302. 49.30 of the statutes is renumbered 49.785, and 49.785 (2), as
5renumbered, is amended to read:
SB44-SSA1,518,156 49.785 (2) From the appropriations under s. 20.445 (3) (dz) and (md)
7appropriation under s. 20.435 (4) (bn), the department shall reimburse a county or
8applicable tribal governing body or organization for any amount that the county or
9applicable tribal governing body or organization is required to pay under sub. (1).
10From the appropriations under s. 20.445 (3) (dz) and (md) appropriation under s.
1120.435 (4) (bn)
, the department shall reimburse a county or applicable tribal
12governing body or organization for cemetery expenses or for funeral and burial
13expenses for persons described under sub. (1) that the county or applicable tribal
14governing body or organization is not required to pay under subs. (1) and (1m) only
15if the department approves the reimbursement due to unusual circumstances.
SB44-SSA1, s. 1303 16Section 1303. 49.32 (2) (d) of the statutes is repealed.
SB44-SSA1, s. 1308 17Section 1308. 49.33 of the statutes is renumbered 49.78, and 49.78 (1) (b), (2),
18(4), (7), (8) (a) and (10), as renumbered, are amended to read:
SB44-SSA1,518,2219 49.78 (1) (b) "Income maintenance program" means the medical assistance
20Medical Assistance program under subch. IV of ch. 49, the badger care Badger Care
21health care program under s. 49.665, or the food stamp program under 7 USC 2011
22to 2036, or the cemetery, funeral, and burial expenses program under s. 49.785.
SB44-SSA1,519,2 23(2) Contracts. Annually, the department of health and family services shall
24contract with county departments under ss. 46.215, 46.22, and 46.23, and may
25contract with tribal governing bodies, to reimburse the county departments and

1tribal governing bodies for the reasonable cost of administering income maintenance
2programs.
SB44-SSA1,519,9 3(4) Rules; merit system. The department of workforce development shall
4promulgate rules for the efficient administration of aid to families with dependent
5children in agreement with the requirement for federal aid, including the
6establishment and maintenance of personnel standards on a merit basis. The
7provisions of this section relating to personnel standards on a merit basis supersede
8any inconsistent provisions of any law relating to county personnel. This subsection
9shall not be construed to invalidate the provisions of s. 46.22 (1) (d).
SB44-SSA1,519,14 10(7) County personnel systems. Pursuant to rules promulgated under sub. (4),
11the department of workforce development where requested by the county shall
12delegate to that county, without restriction because of enumeration, any or all of the
13department's department of workforce development's authority under sub. (4) to
14establish and maintain personnel standards including salary levels.
SB44-SSA1,519,24 15(8) (a) From the appropriation accounts under s. 20.435 (4) (bn) and (nn) and
16subject to par. (b), the department of health and family services shall reimburse each
17county and tribal governing body that contracts with the department under sub. (2)
18for reasonable costs of administering the income maintenance programs. The
19amount of each reimbursement paid under this paragraph shall be calculated using
20a formula based on workload within the limits of available state and federal funds
21under s. 20.435 (4) (bn) and (nn) by contract under s. 49.33 sub. (2). The amount of
22reimbursement calculated under this paragraph and par. (b) is in addition to any
23reimbursement provided to a county or tribal governing body for fraud and error
24reduction under s. 49.197 (1m) and (4).
SB44-SSA1,520,12
1(10) County certification. (a) Each county treasurer and director of a county
2department under s. 46.215, 46.22, or 46.23 and each tribal governing body shall
3certify monthly under oath to the department of health and family services in such
4manner as the department of health and family services prescribes the claim of the
5county for state reimbursement under sub. (8) (a). The department of health and
6family services
shall review each claim of reimbursement and, if the department of
7health and family services
approves the claim, the department of health and family
8services
shall certify to the department of administration for reimbursement to the
9county for amounts due under sub. (8) (a) and payment claimed to be made to the
10counties monthly. The department of health and family services may make advance
11payments prior to the beginning of each month equal to one-twelfth of the contracted
12amount.
SB44-SSA1,520,2113 (b) To facilitate prompt reimbursement the certificate of the department of
14health and family services
may be based on the certified statements of the county
15officers or tribal governing body executives filed under par. (a). Funds recovered
16from audit adjustments from a prior fiscal year may be included in subsequent
17certifications only to pay counties owed funds as a result of any audit adjustment.
18By September 30 annually, the department of health and family services shall
19submit a report to the appropriate standing committees under s. 13.172 (3) on funds
20recovered and paid out during the previous calendar year as a result of audit
21adjustments.
SB44-SSA1, s. 1310 22Section 1310. 49.45 (2) (a) 3. of the statutes is amended to read:
SB44-SSA1,521,223 49.45 (2) (a) 3. Determine the eligibility of persons for medical assistance,
24rehabilitative, and social services under ss. 49.46, 49.468, and 49.47 and rules and
25policies adopted by the department and shall may, under a contract under s. 49.33

149.78 (2), designate delegate all, or any portion, of this function to the county
2department under s. 46.215, 46.22, or 46.23 or a tribal governing body.
SB44-SSA1, s. 1311 3Section 1311. 49.45 (2) (a) 17. of the statutes is amended to read:
SB44-SSA1,521,84 49.45 (2) (a) 17. Notify the governor, the joint committee on legislative
5organization, the joint committee on finance and appropriate standing committees,
6as determined by the presiding officer of each house, if the appropriation accounts
7under s. 20.435 (4) (b) is and (gp) are insufficient to provide the state share of medical
8assistance.
SB44-SSA1, s. 1312n 9Section 1312n. 49.45 (2) (a) 26. of the statutes is created to read:
SB44-SSA1,521,1310 49.45 (2) (a) 26. For recipients of Medical Assistance who are eligible for the
11Supplemental Security Income Program under 42 USC 1382 to 1383f, who are not
12eligible under s. 49.468, who are not minors, and who are required to be enrolled in
13managed care plans, annually do all of the following:
SB44-SSA1,521,1814 a. Consult with advocacy groups and managed care organizations in
15determining the types of services required by the recipients, particularly those with
16problems related to mental illness or alcohol or other drug abuse; and in determining
17the capitation rates for managed care plan contracts, so as to ensure that the services
18required are available to the recipients.
SB44-SSA1,521,2119 b. Submit the proposed contracts for managed care plans for the recipients to
20the appropriate standing committees of the legislature for review before offering the
21contracts to managed care organizations for bidding.
SB44-SSA1, s. 1313 22Section 1313. 49.45 (3) (a) of the statutes is amended to read:
SB44-SSA1,522,323 49.45 (3) (a) Reimbursement shall be made to each county department under
24ss. 46.215, 46.22, and 46.23 for the any administrative services performed in the
25medical assistance Medical Assistance program on the basis of s. 49.33 49.78 (8). For

1purposes of reimbursement under this paragraph, assessments completed under s.
246.27 (6) (a) are administrative services performed in the medical assistance Medical
3Assistance
program.
SB44-SSA1, s. 1314 4Section 1314. 49.45 (3) (am) of the statutes is repealed.
SB44-SSA1, s. 1315 5Section 1315. 49.45 (5) (b) 1. (intro.) of the statutes is amended to read:
SB44-SSA1,522,226 49.45 (5) (b) 1. (intro.) Upon receipt of a timely petition under par. (a) the
7department shall give the applicant or recipient reasonable notice and opportunity
8for a fair hearing. The department may make such additional investigation as it
9considers necessary. Notice of the hearing shall be given to the applicant or recipient
10and to the county clerk or, if a Wisconsin works agency , if a county department under
11s. 46.215, 46.22, or 46.23
is responsible for making the medical assistance
12determination, the Wisconsin works agency to the county clerk of the county. The
13county or the Wisconsin works agency may be represented at such hearing. The
14department shall render its decision as soon as possible after the hearing and shall
15send a certified copy of its decision to the applicant or recipient, to the county clerk,
16and to the any county officer or the Wisconsin works agency charged with
17administration of the medical assistance Medical Assistance program. The decision
18of the department shall have the same effect as an order of the a county officer or the
19Wisconsin works agency charged with the administration of the medical assistance
20Medical Assistance program. The decision shall be final, but may be revoked or
21modified as altered conditions may require. The department shall deny a petition
22for a hearing or shall refuse to grant relief if:
SB44-SSA1, s. 1316 23Section 1316. 49.45 (5) (b) 2. (intro.) of the statutes is amended to read:
SB44-SSA1,523,924 49.45 (5) (b) 2. (intro.) If a recipient requests a hearing within the timely notice
25period specified in 42 CFR 431.231 (c), medical assistance coverage shall not be

1suspended, reduced, or discontinued until a decision is rendered after the hearing
2but medical assistance payments made pending the hearing decision may be
3recovered by the department if the contested decision or failure to act is upheld. The
4department shall promptly notify the county department or, if a Wisconsin works
5agency
If a county department is responsible for making the medical assistance
6determination, the Wisconsin works agency department shall notify the county
7department
of the county in which the recipient resides that the recipient has
8requested a hearing. Medical assistance coverage shall be suspended, reduced, or
9discontinued if:
SB44-SSA1, s. 1318 10Section 1318. 49.45 (5m) (am) of the statutes is amended to read:
SB44-SSA1,523,1911 49.45 (5m) (am) Notwithstanding sub. (3) (e), from the appropriations
12appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall
13distribute not more than $2,256,000 in each fiscal year, to provide supplemental
14funds to rural hospitals that, as determined by the department, have high utilization
15of inpatient services by patients whose care is provided from governmental sources,
16and to provide supplemental funds to critical access hospitals, except that the
17department may not distribute funds to a rural hospital or to a critical access hospital
18to the extent that the distribution would exceed any limitation under 42 USC 1396b
19(i) (3).
SB44-SSA1, s. 1320 20Section 1320. 49.45 (6b) of the statutes is amended to read:
SB44-SSA1,524,321 49.45 (6b) Centers for the developmentally disabled. From the
22appropriation under s. 20.435 (2) (gk), the department may reimburse the cost of
23services provided by the centers for the developmentally disabled. Reimbursement
24to the centers for the developmentally disabled shall be reduced following each
25placement made under s. 46.275 that involves a relocation from a center for the

1developmentally disabled, by $200 per day, beginning in fiscal year 2001-02, and by
2$225 per day, beginning in fiscal year 2002-03, and by $325 per day, beginning in
3fiscal year 2004-05
.
SB44-SSA1, s. 1321 4Section 1321. 49.45 (6c) (a) 6m. of the statutes is created to read:
SB44-SSA1,524,65 49.45 (6c) (a) 6m. "Intermediate facility" has the meaning given in s. 46.279
6(1) (a).
SB44-SSA1, s. 1322 7Section 1322. 49.45 (6c) (b) of the statutes is amended to read:
SB44-SSA1,524,228 49.45 (6c) (b) Preadmission screening. Except as provided in par. (e), beginning
9on August 9, 1989,
every individual who applies for admission to a facility or to an
10institution for mental diseases shall be screened to determine if the individual has
11developmental disability or mental illness. Beginning on August 9, 1989, the The
12department or an entity to which the department has delegated authority shall
13screen every individual who has been identified as having a developmental disability
14or mental illness to determine if the individual needs facility care. If the individual
15is determined to need facility care, the department or an entity to which the
16department has delegated authority shall also assess the individual to determine if
17he or she requires active treatment for developmental disability or active treatment
18for mental illness. If the department or entity determines that the individual
19requires active treatment for developmental disability, the department or entity
20shall determine whether the level of care required by the individual that is provided
21by a facility could be provided safely in an intermediate facility or under a plan that
22is developed under s. 46.279 (4).
SB44-SSA1, s. 1323 23Section 1323. 49.45 (6c) (c) (intro.) of the statutes is amended to read:
SB44-SSA1,525,424 49.45 (6c) (c) Resident review. (intro.) Except as provided in par. (e), the
25department or an entity to which the department has delegated authority shall

1review every resident of a facility or institution for mental diseases who has a
2developmental disability or mental illness and who has experienced a significant
3change in his or her physical or mental condition to determine if any all of the
4following applies:
SB44-SSA1, s. 1324 5Section 1324. 49.45 (6c) (c) 1. of the statutes is amended to read:
SB44-SSA1,525,66 49.45 (6c) (c) 1. The Whether the resident needs facility care.
SB44-SSA1, s. 1325 7Section 1325. 49.45 (6c) (c) 2. of the statutes is amended to read:
SB44-SSA1,525,98 49.45 (6c) (c) 2. The Whether the resident requires active treatment for
9developmental disability or active treatment for mental illness.
SB44-SSA1, s. 1326 10Section 1326. 49.45 (6c) (c) 3. of the statutes is created to read:
SB44-SSA1,525,1511 49.45 (6c) (c) 3. If the department or entity determines under subd. 1. that the
12resident needs facility care and under subd. 2. that the resident requires active
13treatment for developmental disability, whether the level of care required by the
14resident that is provided by a facility could be provided safely in an intermediate
15facility or under a plan that is developed under s. 46.279 (4).
SB44-SSA1, s. 1327 16Section 1327. 49.45 (6m) (a) 4. of the statutes is repealed.
SB44-SSA1, s. 1328 17Section 1328. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:
SB44-SSA1,525,2418 49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this
19subsection made under s. 20.435 (4) (b), (gp), (pa), (o), (w), or (wm) shall, except as
20provided in pars. (bg), (bm), and (br), be determined according to a prospective
21payment system updated annually by the department. The payment system shall
22implement standards that are necessary and proper for providing patient care and
23that meet quality and safety standards established under subch. II of ch. 50 and ch.
24150. The payment system shall reflect all of the following:
SB44-SSA1, s. 1329 25Section 1329. 49.45 (6m) (ag) 2. of the statutes is amended to read:
SB44-SSA1,526,4
149.45 (6m) (ag) 2. Standards Except as provided in subd. 3r., standards
2established by the department that shall be based upon allowable costs incurred by
3facilities in the state as available from information submitted under par. (c) 3. and
4compiled by the department.
SB44-SSA1, s. 1330 5Section 1330. 49.45 (6m) (ag) 3m. of the statutes is amended to read:
SB44-SSA1,526,106 49.45 (6m) (ag) 3m. For each state fiscal year 1999-2000, rates that shall be
7set by the department based on information from cost reports for the 1998 most
8recently completed
fiscal year of the facility and for state fiscal year 2000-01, rates
9that shall be set by the department based on information from cost reports for the

101999 fiscal year of the facility.
SB44-SSA1, s. 1331 11Section 1331 . 49.45 (6m) (ag) 3m. of the statutes, as affected by 2003
12Wisconsin Act .... (this act), is amended to read:
SB44-SSA1,526,1513 49.45 (6m) (ag) 3m. For each state fiscal year, rates that shall be set by the
14department based on information from cost reports for costs specified under par. (am)
151. bm., 4., 5m., and 6.
for the most recently completed fiscal year of the facility.
SB44-SSA1, s. 1332 16Section 1332. 49.45 (6m) (ag) 3r. of the statutes is created to read:
SB44-SSA1,526,1817 49.45 (6m) (ag) 3r. Flat-rate payment, as determined by the department, for
18costs specified under par. (am) 1. a. and 2.
SB44-SSA1, s. 1333 19Section 1333. 49.45 (6m) (ag) 3r. of the statutes, as created by 2003 Wisconsin
20Act .... (this act), is amended to read:
SB44-SSA1,526,2221 49.45 (6m) (ag) 3r. Flat-rate payment, as determined by the department, for
22all costs specified under par. (am) 1. a. and 2.
SB44-SSA1, s. 1333d 23Section 1333d. 49.45 (6m) (ag) 8. of the statutes is created to read:
SB44-SSA1,527,3
149.45 (6m) (ag) 8. Maintenance of the identical proportion of payment for direct
2care costs, as specified in par. (am) 1., to total payment for all costs specified in par.
3(am) as that made in state fiscal year 2002-03.
SB44-SSA1, s. 1334 4Section 1334. 49.45 (6m) (am) 1. a. of the statutes is amended to read:
SB44-SSA1,527,95 49.45 (6m) (am) 1. a. Personal comfort supplies; medical supplies;
6over-the-counter drugs; and nonbillable services of a ward clerk, activity person,
7recreation person, social worker, volunteer coordinator, teacher for residents aged 22
8and older, vocational counselor for residents aged 22 and older, religious person,
9therapy aide, therapy assistant, and counselor on resident living
.
SB44-SSA1, s. 1335 10Section 1335. 49.45 (6m) (am) 1. b. of the statutes is repealed.
SB44-SSA1, s. 1336 11Section 1336. 49.45 (6m) (am) 1. bm. of the statutes is created to read:
SB44-SSA1,527,1312 49.45 (6m) (am) 1. bm. Nonbillable services of a registered nurse, licensed
13practical nurse and nurse's assistant.
SB44-SSA1, s. 1337 14Section 1337. 49.45 (6m) (am) 1. d. of the statutes is repealed.
SB44-SSA1, s. 1338 15Section 1338. 49.45 (6m) (am) 1. e. of the statutes is repealed.
SB44-SSA1, s. 1339 16Section 1339. 49.45 (6m) (am) 3. (intro.) of the statutes is renumbered 49.45
17(6m) (am) 2. c. and amended to read:
SB44-SSA1,527,2018 49.45 (6m) (am) 2. c. Allowable fuel and utility costs, including the facility
19expenses that the department determines are allowable for the provision of:
20electrical service, water and sewer services, and heat.
SB44-SSA1, s. 1340 21Section 1340. 49.45 (6m) (am) 3. a. of the statutes is repealed.
SB44-SSA1, s. 1341 22Section 1341. 49.45 (6m) (am) 3. b. of the statutes is repealed.
SB44-SSA1, s. 1342 23Section 1342. 49.45 (6m) (am) 3. c. of the statutes is repealed.
SB44-SSA1, s. 1343 24Section 1343. 49.45 (6m) (am) 4. of the statutes is amended to read:
SB44-SSA1,528,2
149.45 (6m) (am) 4. Net property Property tax or allowable municipal service
2costs incurred paid by the owner of the facility for the facility.
SB44-SSA1, s. 1344 3Section 1344. 49.45 (6m) (am) 5. of the statutes is renumbered 49.45 (6m) (am)
42. d.
SB44-SSA1, s. 1346d 5Section 1346d. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:
SB44-SSA1,528,166 49.45 (6m) (ar) 1. a. The department shall establish standards for payment of
7allowable direct care costs under par. (am) 1. bm., for facilities that do not primarily
8serve the developmentally disabled, that take into account direct care costs for a
9sample of all of those facilities in this state and separate standards for payment of
10allowable direct care costs, for facilities that primarily serve the developmentally
11disabled, that take into account direct care costs for a sample of all of those facilities
12in this state. The standards shall be adjusted by the department for regional labor
13cost variations. For facilities in Douglas, Pierce, and St. Croix counties, the
14department shall perform the adjustment by use of the wage index that is used by
15the federal department of health and human services for hospital reimbursement
16under 42 USC 1395 to 1395ggg.
SB44-SSA1, s. 1347 17Section 1347. 49.45 (6m) (ar) 2. (intro.) and 2. a. of the statutes are
18consolidated, renumbered 49.45 (6m) (ar) 2. and amended to read:
SB44-SSA1,528,2119 49.45 (6m) (ar) 2. For support service costs: 2. a. The, the department shall
20establish one or more standards for the payment of support service costs that take
21into account support service costs for a sample of all facilities within the state.
SB44-SSA1, s. 1348 22Section 1348. 49.45 (6m) (ar) 2. b. of the statutes is repealed.
SB44-SSA1, s. 1349 23Section 1349. 49.45 (6m) (ar) 2. d. of the statutes is repealed.
SB44-SSA1, s. 1350 24Section 1350. 49.45 (6m) (ar) 3. of the statutes is repealed.
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