SB44, s. 1108
3Section
1108. 46.27 (7) (am) of the statutes is amended to read:
SB44,531,124
46.27
(7) (am) From the appropriation under s. 20.435 (7) (bd), the department
5shall allocate funds to each county or private nonprofit agency with which the
6department contracts to pay assessment and case plan costs under sub. (6) not
7otherwise paid by fee or under s.
49.33 (2) or 49.45
or 49.78 (2). The department shall
8reimburse counties for the cost of assessing persons eligible for medical assistance
9under s. 49.46, 49.468
, or 49.47 as part of the administrative services of medical
10assistance, payable under s. 49.45 (3) (a). Counties may use unspent funds allocated
11under this paragraph to pay the cost of long-term community support services and
12for a risk reserve under par. (fr).
SB44, s. 1109
13Section
1109. 46.27 (7) (fm) of the statutes is amended to read:
SB44,532,214
46.27
(7) (fm) The department shall, at the request of a county, carry forward
15up to
10% 5% of the amount allocated under this subsection to the county for a
16calendar year if up to
10% 5% of the amount so allocated has not been spent or
17encumbered by the county by December 31 of that year, for use by the county in the
18following calendar year, except that the amount carried forward shall be reduced by
19the amount of funds that the county has notified the department that the county
20wishes to place in a risk reserve under par. (fr). The department may transfer funds
21within s. 20.435 (7) (bd) to accomplish this purpose. An allocation under this
22paragraph does not affect a county's base allocation under this subsection and shall
23lapse to the general fund unless expended within the calendar year to which the
24funds are carried forward. A county may not expend funds carried forward under
25this paragraph for administrative or staff costs, except administrative or staff costs
1that are associated with implementation of the waiver under sub. (11) and approved
2by the department.
SB44, s. 1110
3Section
1110. 46.27 (7g) (h) of the statutes is amended to read:
SB44,532,54
46.27
(7g) (h) The department may
contract with or employ retain an attorney
5to probate estates to recover under this subsection the costs of care.
SB44, s. 1111
6Section
1111. 46.27 (9) (a) of the statutes is amended to read:
SB44,532,157
46.27
(9) (a) The department may select up to 5 counties that volunteer to
8participate in a pilot project under which they will receive certain funds allocated for
9long-term care. The department shall allocate a level of funds to these counties
10equal to the amount that would otherwise be paid under s. 20.435 (4) (b)
, (gp), (r), or
11(w) to nursing homes for providing care because of increased utilization of nursing
12home services, as estimated by the department. In estimating these levels, the
13department shall exclude any increased utilization of services provided by state
14centers for the developmentally disabled. The department shall calculate these
15amounts on a calendar year basis under sub. (10).
SB44, s. 1112
16Section
1112. 46.27 (10) (a) 1. of the statutes is amended to read:
SB44,532,2217
46.27
(10) (a) 1. The department shall determine for each county participating
18in the pilot project under sub. (9) a funding level of state medical assistance
19expenditures to be received by the county. This level shall equal the amount that the
20department determines would otherwise be paid under s. 20.435 (4) (b)
, (gp), (r), or
21(w) because of increased utilization of nursing home services, as estimated by the
22department.
SB44, s. 1113
23Section
1113. 46.275 (5) (a) of the statutes is amended to read:
SB44,533,524
46.275
(5) (a) Medical
assistance
Assistance reimbursement for services a
25county, or the department under sub. (3r), provides under this program is available
1from the
appropriations appropriation accounts under s. 20.435 (4) (b),
(gp), (hm), (o),
2(r), and (w). If 2 or more counties jointly contract to provide services under this
3program and the department approves the contract,
medical assistance Medical
4Assistance reimbursement is also available for services provided jointly by these
5counties.
SB44, s. 1114
6Section
1114. 46.275 (5) (c) of the statutes is amended to read:
SB44,533,137
46.275
(5) (c) The total allocation under s. 20.435 (4) (b),
(gp), (hm), (o),
(r), and
8(w) to counties and to the department under sub. (3r) for services provided under this
9section may not exceed the amount approved by the federal department of health and
10human services. A county may use funds received under this section only to provide
11services to persons who meet the requirements under sub. (4) and may not use
12unexpended funds received under this section to serve other developmentally
13disabled persons residing in the county.
SB44, s. 1115
14Section
1115. 46.275 (5) (e) of the statutes is created to read:
SB44,533,1815
46.275
(5) (e) From the appropriation under s. 20.435 (2) (gL), the department
16may provide moneys to a county to pay for one-time costs associated with the
17relocation under this section of an individual from a state center for the
18developmentally disabled.
SB44, s. 1116
19Section
1116. 46.277 (1m) (ak) of the statutes is created to read:
SB44,533,2220
46.277
(1m) (ak) "Nursing home" means a nursing home, as defined in s. 50.01
21(3), that is certified as a provider of medical assistance, other than an intermediate
22care facility for the mentally retarded, as defined in s. 46.278 (1m) (am).
SB44, s. 1117
23Section
1117. 46.277 (2) (b) of the statutes is amended to read:
SB44,534,3
146.277
(2) (b)
Fund Except as provided in subs. (3r) and (5) (bm), fund home
2or community-based services provided by any county that meet the requirements of
3this section.
SB44, s. 1118
4Section
1118. 46.277 (3) (c) of the statutes is amended to read:
SB44,534,105
46.277
(3) (c) Beginning on January 1, 1996, from the annual allocation to the
6county for the provision of long-term community support services under sub. (5),
7except as provided in subs. (3r) and (5) (bm), a county department participating in
8the program shall annually establish a maximum total amount that may be
9encumbered in a calendar year for services for eligible individuals in
10community-based residential facilities.
SB44, s. 1119
11Section
1119. 46.277 (3r) of the statutes is created to read:
SB44,534,2112
46.277
(3r) Relocation of nursing home residents. (a) In a county that is
13participating in the program, for each nursing home resident who has applied for
14participation and has been found eligible under sub. (4), but is not participating in
15the program and who indicates that he or she prefers to receive services in the
16community, rather than in the nursing home, the participating county department
17shall initiate a needs and costs-based assessment before the resident has resided in
18the nursing home for 90 continuous days or before the cost of the resident's nursing
19home care has been paid under Medical Assistance for 30 days, whichever is longer.
20The county department shall complete the needs and costs-based assessment within
2190 days after initiating it.
SB44,534,2322
(b) After completion of the needs and costs-based assessment, the county
23department shall contact the department regarding available funding.
SB44,535,524
(c) If the department determines that costs for home or community-based
25services for the nursing home resident, as determined under the needs and
1costs-based assessment, are equal to or less than the amount specified under sub.
2(5) (bm) 1., the county department shall offer and, if accepted, provide home or
3community-based services under this section to the nursing home resident, if the
4cost of the resident's nursing home care has been paid under Medical Assistance for
5at least 30 days.
SB44,535,136
(d) If the department determines that costs for home or community-based
7services for the nursing home resident, as determined under the needs and
8costs-based assessment, exceed the amount specified under sub. (5) (bm) 1., the
9department may ascertain whether additional funding, as specified under sub. (5)
10(bm) 2., is available. If additional funding is available and if the cost of the resident's
11nursing home care has been paid under Medical Assistance for at least 30 days, the
12county department shall offer and, if accepted, provide home or community-based
13services under this section to the nursing home resident.
SB44, s. 1120
14Section
1120. 46.277 (5) (am) of the statutes is created to read:
SB44,535,1715
46.277
(5) (am) From the appropriation under s. 20.435 (4) (w), the department
16may provide reimbursement to a county for administrative activities by the county
17to relocate a nursing home resident under sub. (3r).
SB44, s. 1121
18Section
1121. 46.277 (5) (b) of the statutes is amended to read:
SB44,535,2119
46.277
(5) (b)
Total Except as provided in subs. (3r) and (5) (bm), funding to
20counties under the program may not exceed the amount approved in the waiver
21received under sub. (2).
SB44, s. 1122
22Section
1122. 46.277 (5) (bm) of the statutes is created to read:
SB44,536,623
46.277
(5) (bm) 1. Funding to a county for an individual who is relocated from
24a nursing home under sub. (3r) shall be no more than the per-person, per-day
25payment rate at the individual's level-of-care requirement for the nursing home
1under s. 49.45 (6m), indexed annually by the percentage of any annual nursing home
2average rate increase under s. 49.45 (6m), minus the amount that is obtained by
3subtracting the average annual costs for allowable charges under s. 49.46 (2) (a) and
4(b) payable on behalf of individuals in nursing homes from the average annual costs
5per medical assistance recipient for the allowable charges payable on behalf of
6individuals who are relocated into communities from nursing homes.
SB44,536,127
2. Notwithstanding the limitation on payment to a county under subd. 1.,
8funding to a county for an individual who is relocated from a nursing home under
9sub. (3r) may include, in addition to the amount specified in subd. 1., an amount not
10to exceed the sum obtained by subtracting the total of all payments made for home
11or community-based services for nursing home residents relocated under sub. (3r)
12(c) from the amount available under subd. 1.
SB44,536,1813
3. If a county department fails to complete a needs and costs-based assessment
14and offer home or community-based services under this section to a nursing home
15resident within the time period specified in sub. (3r) (a), the county shall pay the
16nonfederal share of Medical Assistance for his or her nursing home care unless the
17nursing home resident refused participation or the needs and costs-based
18assessment determined that participation was not feasible.
SB44,536,2019
4. Funding to a county is available under subd. 1. or 2. only during the period
20in which a relocated individual continues to receive home or community-based care.
SB44, s. 1123
21Section
1123. 46.277 (5) (g) of the statutes is created to read:
SB44,537,222
46.277
(5) (g) The department may provide enhanced reimbursement for
23services provided under this section to an individual who is relocated to the
24community from a nursing home by a county department on or after the effective date
25of this paragraph .... [revisor inserts date], if the nursing home bed that was used by
1the individual is delicensed upon relocation of the individual. The department shall
2develop and utilize a formula to determine the enhanced reimbursement rate.
SB44, s. 1124
3Section
1124. 46.278 (1m) (bg) of the statutes is created to read:
SB44,537,64
46.278
(1m) (bg) "Nursing home" means a nursing home, as defined in s. 50.01
5(3), that is certified as a provider of medical assistance, other than an intermediate
6care facility for the mentally retarded.
SB44, s. 1125
7Section
1125. 46.278 (3) (b) of the statutes is amended to read:
SB44,537,108
46.278
(3) (b)
Fund Except as provided in subs. (4g) and (6) (bm), fund home
9or community-based services provided by any county that meet the requirements of
10this section.
SB44, s. 1126
11Section
1126. 46.278 (4g) of the statutes is created to read:
SB44,537,2112
46.278
(4g) Relocation of nursing home residents. (a) In a county that is
13participating in the program, for each nursing home resident who has applied for
14participation and has been found eligible under sub. (5), but is not participating in
15the program and who indicates that he or she prefers to receive services in the
16community, rather than in the nursing home, the participating county department
17shall initiate a needs and costs-based assessment before the resident has resided in
18the nursing home for 90 continuous days or before the cost of the resident's nursing
19home care has been paid under Medical Assistance for 30 days, whichever is longer.
20The county department shall complete the needs and costs-based assessment within
2190 days after initiating the assessment.
SB44,537,2322
(b) After completion of the needs and costs-based assessment, the county
23department shall contact the department regarding available funding.
SB44,538,524
(c) If the department determines that costs for home or community-based
25services for the nursing home resident, as determined under the needs and
1costs-based assessment, are equal to or less than the amount specified under sub.
2(6) (bm) 1., the county department shall offer and, if accepted, provide home or
3community-based services under this section to the nursing home resident, if the
4cost of the resident's nursing home care has been paid under Medical Assistance for
5at least 30 days.
SB44,538,136
(d) If the department determines that costs for home or community-based
7services for the nursing home resident, as determined under the needs and
8costs-based assessment, exceed the amount specified under sub. (6) (bm) 1., the
9department may ascertain whether additional funding, as specified under sub. (6)
10(bm) 2., is available. If additional funding is available and if the cost of the resident's
11nursing home care has been paid under Medical Assistance for at least 30 days, the
12county department shall offer and, if accepted, provide home or community-based
13services under this section to the nursing home resident.
SB44, s. 1127
14Section
1127. 46.278 (6) (am) of the statutes is created to read:
SB44,538,1715
46.278
(6) (am) From the appropriation under s. 20.435 (4) (w), the department
16may provide reimbursement to a county for administrative activities by the county
17to relocate a nursing home resident under sub. (4g).
SB44, s. 1128
18Section
1128. 46.278 (6) (b) of the statutes is amended to read:
SB44,538,2119
46.278
(6) (b)
Total Except as provided in subs. (4g) and (6) (bm), total funding
20to counties for relocating each person under a program may not exceed the amount
21approved in the waiver received under sub. (3).
SB44, s. 1129
22Section
1129. 46.278 (6) (bm) of the statutes is created to read:
SB44,539,623
46.278
(6) (bm) 1. Funding to a county for an individual who is relocated from
24a nursing home under sub. (4g) shall be no more than the per-person, per-day
25payment rate at the individual's level-of-care requirement for the nursing home
1under s. 49.45 (6m), indexed annually by the percentage of any annual nursing home
2average rate increase under s. 49.45 (6m), minus the amount that is obtained by
3subtracting the average annual costs for allowable charges under s. 49.46 (2) (a) and
4(b) payable on behalf of individuals in nursing homes from the average annual costs
5for the allowable charges payable on behalf of individuals who are relocated into
6communities from nursing homes.
SB44,539,127
2. Notwithstanding the limitation on payment to a county under subd. 1.,
8funding to a county for an individual who is relocated from a nursing home under
9sub. (4g) may include, in addition to the amount specified in subd. 1., an amount not
10to exceed the sum obtained by subtracting the total of all payments made for home
11or community-based services for nursing home residents relocated under sub. (4g)
12(c) from the amount available under subd. 1.
SB44,539,1813
3. If a county department fails to complete a needs and costs-based assessment
14and offer home or community-based services under this section to a nursing home
15resident within the time period specified in sub. (4g) (a), the county shall pay the
16nonfederal share of Medical Assistance for his or her nursing home care unless the
17nursing home resident refused participation or the needs and costs-based
18assessment determined that participation was not feasible.
SB44,539,2019
4. Funding to a county is available under subd. 1. or 2. only during the period
20in which a relocated individual continues to receive home or community-based care.
SB44, s. 1130
21Section
1130. 46.278 (6) (d) of the statutes is amended to read:
SB44,540,222
46.278
(6) (d) If a county makes available nonfederal funds equal to the state
23share of service costs under a waiver received under sub. (3), the department may,
24from the appropriation under s. 20.435 (4) (o), provide reimbursement for services
25that the county provides under this section to persons who are in addition to those
1who may be served under this section with funds from the appropriation under s.
220.435 (4) (b)
, (r), or (w).
SB44, s. 1131
3Section
1131. 46.278 (6) (f) of the statutes is repealed.
SB44, s. 1132
4Section
1132. 46.279 of the statutes is created to read:
SB44,540,6
546.279 Restrictions on placements and admissions to intermediate
6and nursing facilities. (1) Definitions. In this section:
SB44,540,77
(a) "Developmental disability" has the meaning given in s. 51.01 (5) (a).
SB44,540,108
(b) "Intermediate facility" means an intermediate care facility for the mentally
9retarded, as defined in
42 USC 1396d (d), other than a center for the developmentally
10disabled, as defined in s. 51.01 (3).
SB44,540,1111
(c) "Nursing facility" has the meaning given under
42 USC 1369r (a).
SB44,540,21
12(2) Placements and admissions to intermediate facilities. Except as provided
13in sub. (5), no person may place an individual with a developmental disability in an
14intermediate facility and no intermediate facility may admit such an individual
15unless, before the placement or admission, a court under s. 55.06 (9) (a) or (10) (a)
162. finds that placement under a plan that was developed under sub. (4) is not in the
17individual's best interests. An intermediate facility to which an individual who has
18a developmental disability applies for admission shall, within 5 days after receiving
19the application, notify the county department that is participating in the program
20under s. 46.278 of the county of residence of the individual who is seeking admission
21concerning the application.
SB44,541,2
22(3) Placements and admissions to nursing facilities. Except as provided in
23sub. (5), if the department or an entity determines from a screening under s. 49.45
24(6c) (b) that an individual requires active treatment for developmental disability, no
25individual may be placed in a nursing facility, and no nursing facility may admit the
1individual, unless it is determined from the screening that the individual's need for
2care cannot fully be met in an intermediate facility or under a plan under sub. (4).
SB44,541,6
3(4) Plan for home or community-based care. A county department that
4participates in the program under s. 46.278 shall develop a plan for providing home
5or community-based care to an individual in a noninstitutional community setting
6under any of the following circumstances:
SB44,541,97
(a) Within 90 days after any determination made under s. 49.45 (6c) (c) 3. that
8the level of care required by a resident that is provided by a facility could be provided
9in an intermediate facility or under a plan under this subsection.
SB44,541,1110
(b) Within 90 days after receiving written notice under sub. (2) of an
11application.
SB44,541,1312
(c) Within 90 days after a proposal is made under s. 55.06 (9) (a) to place the
13individual in an intermediate facility or a nursing facility.
SB44,541,1514
(d) Within 90 days after receiving written notice under s. 55.06 (10) (a) 2. of the
15placement of the individual in a nursing facility or an intermediate facility.
SB44,541,1716
(e) Within 60 days after extension of a temporary placement order by the court
17under s. 55.06 (11) (c).
SB44,541,19
18(5) Exceptions. Subsections (2) and (3) do not apply to an emergency placement
19under s. 55.06 (11) (a) or to a temporary placement under s. 55.06 (11) (c) or (12).
SB44, s. 1133
20Section
1133. 46.2805 (2) of the statutes is amended to read:
SB44,541,2221
46.2805
(2) "Eligible person" means a person who meets all eligibility criteria
22under s. 46.286 (1)
or (1m).
SB44, s. 1134
23Section
1134. 46.283 (5) of the statutes is amended to read:
SB44,542,224
46.283
(5) Funding. From the appropriation accounts under s. 20.435 (4) (b),
25(bm),
(gp), (pa),
(r), and (w) and (7) (b), (bd), and (md), the department may contract
1with organizations that meet standards under sub. (3) for performance of the duties
2under sub. (4) and shall distribute funds for services provided by resource centers.
SB44, s. 1135
3Section
1135. 46.284 (5) (a) of the statutes is amended to read:
SB44,542,104
46.284
(5) (a) From the appropriation accounts under s. 20.435 (4) (b), (g),
(gp), 5(im), (o),
(r), and (w) and (7) (b) and (bd), the department shall provide funding on a
6capitated payment basis for the provision of services under this section.
7Notwithstanding s. 46.036 (3) and (5m), a care management organization that is
8under contract with the department may expend the funds, consistent with this
9section, including providing payment, on a capitated basis, to providers of services
10under the family care benefit.
SB44, s. 1136
11Section
1136. 46.286 (1) (intro.) of the statutes is amended to read:
SB44,542,1612
46.286
(1) Eligibility. (intro.)
Except as provided in sub. (1m), a A person is
13eligible for, but not necessarily entitled to, the family care benefit if the person is at
14least 18 years of age; has a physical disability, as defined in s. 15.197 (4) (a) 2.,
a
15developmental disability, as defined in s. 51.01 (5) (a), or infirmities of aging, as
16defined in s. 55.01 (3); and meets all of the following criteria:
SB44, s. 1137
17Section
1137. 46.286 (1m) of the statutes is repealed.