46.281 (1) (e) 1. If Subject to the requirements of par. (d), if the local long-term care council for the applicable area has developed the initial plan under s. 46.282 (3) (a) 1., contract with entities specified under par. (d) and may, only if specifically authorized by the legislature and if the legislature appropriates necessary funding, contract as so authorized with one or more entities in addition to those specified in par. (d) certified as meeting requirements under s. 46.284 (3) for services of the entity as a care management organization.
46.281 (1) (e) 2. Contract with entities specified under par. (d) and may contract with other entities for the provision of services under s. 46.283 (3) and (4), except that after July 27, 2005, the department shall notify the joint committee on finance in writing of any proposed contract with an entity that did not have a contract to provide services under s. 46.283 (3) and (4) before July 27, 2005. If the cochairpersons of the committee do not notify the department within 14 working days after the date of the department's notification that the committee has scheduled a meeting for the purpose of reviewing the proposed contract, the department may enter into the proposed contract. If within 14 working days after the date of the department's notification the cochairpersons of the committee notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposed contract, the department may enter into the proposed contract only upon approval of the committee.
46.281 (1) (g) 3. of the statutes is amended to read:
46.281 (1) (g) 3. Conduct ongoing evaluations of the long-term care system specified in ss. 46.2805 to 46.2895 managed care programs for provision of long-term care services that are funded by medical assistance, as defined in s. 46.278 (1m) (b), as to client access to services, the availability of client choice of living and service options, quality of care, and cost-effectiveness. In evaluating the availability of client choice, the department shall evaluate the opportunity for a client to arrange for, manage, and monitor his or her family care benefit directly or with assistance, as specified in s. 46.284 (4) (e).
46.282 (2) (a) (intro.) of the statutes is amended to read:
46.282 (2) (a) Appointment by a county. (intro.) In a county that participates in a pilot project in which the department has a contract under s. 46.281 (1) (d)
(e) and before a county participates in the program under ss. 46.2805 to 46.2895, the following shall be done:
46.283 (2) (b) (intro.) After June 30, 2001, the department shall contract with the entities specified under s. 46.281 (1) (d) 1. and may, if the applicable review conditions under s. 48.281 (1) (e) 2. s. 46.281 (1) (e) 2. are satisfied, in addition to contracting with these entities, contract to operate a resource center with counties, family care districts, or the governing body of a tribe or band or the Great Lakes Inter-Tribal Council, Inc., under a joint application of any of these, or with a private nonprofit organization if the department determines that the organization has no significant connection to an entity that operates a care management organization and if any of the following applies:
46.284 (4) (e) of the statutes is amended to read:
46.284 (4) (e) Provide, within guidelines established by the department, a mechanism by which an enrollee may arrange for, manage, and monitor his or her family care benefit directly or with the assistance of another person chosen by the enrollee. The care management organization shall provide each enrollee with a form on which the enrollee shall indicate whether he or she has been offered the option under this paragraph and whether he or she has accepted or declined the option. If the enrollee accepts the option, the care management organization shall monitor the enrollee's use of a fixed budget for purchase of services or support items from any qualified provider, monitor the health and safety of the enrollee, and provide assistance in management of the enrollee's budget and services at a level tailored to the enrollee's need and desire for the assistance.
46.285 (1) (a) of the statutes is amended to read:
46.285 (1) (a) For a pilot project established an entity with which the department has contracted under s. 46.281 (1) (d) 2. (e) 1., provision of the services specified under s. 46.283 (3) (b), (e), (f) and (g) shall be structurally separate from the provision of services of the care management organization by January 1, 2001.
49.45 (3) (ag) of the statutes is amended to read:
49.45 (3) (ag) Reimbursement shall be made to each entity contracted with under s. 46.281 (1) (d) (e) for functional screens performed under s. 46.281 (1) (d)
by the entity.
51.06 (8) of the statutes is created to read:
51.06 (8) Relocations; report. (a) In this subsection:
1. "Intermediate care facility for the mentally retarded" has the meaning given in 42 USC 1396d
2. "Medical Assistance" has the meaning given in s. 49.43 (8).
3. "Nursing home" has the meaning given in s. 50.01 (3).
(b) Annually by October 1, the department shall submit to the joint committee on finance and to the appropriate standing committees of the legislature under s. 13.172 (3) a report that includes information collected from the previous fiscal year on the relocation or diversion of individuals who are Medical Assistance eligibles or recipients from nursing homes, intermediate care facilities for the mentally retarded, and centers for the developmentally disabled. The report shall include all of the following information:
1. The impact of the relocations and diversions on the health and safety of the individuals relocated or diverted.
2. The extent of involvement of guardians or family members of the individuals in efforts to relocate or divert the individuals.
3. The nature and duration of relocations or diversions that specifies the locations of relocated or diverted individuals every year after home or community placement occurs, so as to keep track of the individuals on an ongoing basis.
4. An accounting of the costs and savings under the Medical Assistance program of relocations and diversions and the resulting reduction in capacity for services of nursing homes, intermediate care facilities for the mentally retarded, and centers for the developmentally disabled. The accounting shall include the per individual savings as well as the collective savings of relocations and diversions.
5. The costs under the Medical Assistance program of administration, housing, and other services, including nursing, personal care, and physical therapy services, that are associated with the relocations and diversions.
6. The extent of Medical Assistance provided to relocated or diverted individuals that is in addition to Medical Assistance provided to the individuals under s. 46.27 (11), 46.275, 46.277, or 46.278, as a family care benefit under ss. 46.2805 to 46.2895, or under any other home-based or community-based program for which the department has received a waiver under 42 USC 2396n
7. Staff turnover rates for nursing homes, intermediate care facilities for the mentally retarded, and centers for the developmentally disabled in communities in which an individual relocated or diverted from a nursing home, intermediate care facility for the mentally retarded, or center for the developmentally disabled currently resides.
(1) Increased payments for nursing homes providing Family Care benefit services.
(a) In this subsection:
1. "Care management organization" has the meaning given in section 46.2805 (1) of the statutes.
2. "Facility" has the meaning given in section 49.45 (6m) (a) 3. of the statutes.
3. "Family Care benefit" has the meaning given in section 46.2805 (4) of the statutes.
4. "Medical Assistance" has the meaning given in section 46.278 (1m) (b) of the statutes.
(b) Care management organizations shall provide increased funding for reimbursement for care provided by facilities for recipients of Medical Assistance as a Family Care benefit, in amounts that proportionately reflect all of the following:
1. For fiscal year 2005-06, the nursing home reimbursement supplement authorized under 2005 Wisconsin Act 211
, Section 1 (4d)
2. For fiscal year 2006-07, the nursing home reimbursement rate increase authorized under 2005 Wisconsin Act 211
, Section 1 (4c)