Amendment AA37-ASA1-AB100

AB100-ASA1-AA37,10,3 25.775 Health care quality improvement fund. There is created a separate nonlapsible trust fund designated as the health care quality improvement fund, consisting of all of the following:

AB100-ASA1-AA37,10,5 (1) All moneys transferred to the fund from the general fund under 2005 Wisconsin Act .... (this act), section 9221 (5f).

AB100-ASA1-AA37,10,6 (2) In each fiscal year, $250,000 of the assessments paid under s. 153.60.

AB100-ASA1-AA37,10,7 (3) Repayment of any loans made under s. 153.076 (2).".

AB100-ASA1-AA37,10,8 28. Page 439, line 21: after that line insert:

AB100-ASA1-AA37,10,9 " Section 857h. 46.27 (9) (a) of the statutes is amended to read:

AB100-ASA1-AA37,10,18 46.27 (9) (a) The department may select up to 5 counties that volunteer to participate in a pilot project under which they will receive certain funds allocated for long-term care. The department shall allocate a level of funds to these counties equal to the amount that would otherwise be paid under s. 20.435 (4) (b), (gp), (r), (rg), or (w) to nursing homes for providing care because of increased utilization of nursing home services, as estimated by the department. In estimating these levels, the department shall exclude any increased utilization of services provided by state centers for the developmentally disabled. The department shall calculate these amounts on a calendar year basis under sub. (10).

AB100-ASA1-AA37, s. 857i Section 857i. 46.27 (9) (a) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,11,5 46.27 (9) (a) The department may select up to 5 counties that volunteer to participate in a pilot project under which they will receive certain funds allocated for long-term care. The department shall allocate a level of funds to these counties equal to the amount that would otherwise be paid under s. 20.435 (4) (b), (gp), (r), (rg), or (w) to nursing homes for providing care because of increased utilization of nursing home services, as estimated by the department. In estimating these levels, the department shall exclude any increased utilization of services provided by state centers for the developmentally disabled. The department shall calculate these amounts on a calendar year basis under sub. (10).

AB100-ASA1-AA37, s. 857m Section 857m. 46.27 (10) (a) 1. of the statutes is amended to read:

AB100-ASA1-AA37,11,12 46.27 (10) (a) 1. The department shall determine for each county participating in the pilot project under sub. (9) a funding level of state medical assistance expenditures to be received by the county. This level shall equal the amount that the department determines would otherwise be paid under s. 20.435 (4) (b), (gp), (r), (rg), or (w) because of increased utilization of nursing home services, as estimated by the department.

AB100-ASA1-AA37, s. 857n Section 857n. 46.27 (10) (a) 1. of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,11,20 46.27 (10) (a) 1. The department shall determine for each county participating in the pilot project under sub. (9) a funding level of state medical assistance expenditures to be received by the county. This level shall equal the amount that the department determines would otherwise be paid under s. 20.435 (4) (b), (gp), (r), (rg), or (w) because of increased utilization of nursing home services, as estimated by the department.".

AB100-ASA1-AA37,11,21 29. Page 439, line 22: after that line insert:

AB100-ASA1-AA37,11,22 " Section 862x. 46.275 (5) (a) of the statutes is amended to read:

AB100-ASA1-AA37,12,4 46.275 (5) (a) Medical Assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), (r), (rg), and (w). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, Medical Assistance reimbursement is also available for services provided jointly by these counties.

AB100-ASA1-AA37,12,6 " Section 862y. 46.275 (5) (a) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,12,12 46.275 (5) (a) Medical Assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), (r), (rg), and (w). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, Medical Assistance reimbursement is also available for services provided jointly by these counties.".

AB100-ASA1-AA37,12,13 30. Page 440, line 2: after that line insert:

AB100-ASA1-AA37,12,14 " Section 865p. 46.275 (5) (c) of the statutes is amended to read:

AB100-ASA1-AA37,12,21 46.275 (5) (c) The total allocation under s. 20.435 (4) (b), (gp), (o), (r), (rg), and (w) to counties and to the department under sub. (3r) for services provided under this section may not exceed the amount approved by the federal department of health and human services. A county may use funds received under this section only to provide services to persons who meet the requirements under sub. (4) and may not use unexpended funds received under this section to serve other developmentally disabled persons residing in the county.

AB100-ASA1-AA37, s. 865q Section 865q. 46.275 (5) (c) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,13,7 46.275 (5) (c) The total allocation under s. 20.435 (4) (b), (gp), (o), (r), (rg), and (w) to counties and to the department under sub. (3r) for services provided under this section may not exceed the amount approved by the federal department of health and human services. A county may use funds received under this section only to provide services to persons who meet the requirements under sub. (4) and may not use unexpended funds received under this section to serve other developmentally disabled persons residing in the county.".

AB100-ASA1-AA37,13,8 31. Page 440, line 8: delete "who has resided in a nursing".

AB100-ASA1-AA37,13,9 32. Page 440, line 9: delete "home for at least 100 consecutive days".

AB100-ASA1-AA37,13,10 33. Page 440, line 16: after that line insert:

AB100-ASA1-AA37,13,11 " Section 870g. 46.278 (6) (d) of the statutes is amended to read:

AB100-ASA1-AA37,13,17 46.278 (6) (d) If a county makes available nonfederal funds equal to the state share of service costs under a waiver received under sub. (3), the department may, from the appropriation under s. 20.435 (4) (o), provide reimbursement for services that the county provides under this section to persons who are in addition to those who may be served under this section with funds from the appropriation under s. 20.435 (4) (b), (r), (rg), or (w).

AB100-ASA1-AA37, s. 870h Section 870h. 46.278 (6) (d) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,14,2 46.278 (6) (d) If a county makes available nonfederal funds equal to the state share of service costs under a waiver received under sub. (3), the department may, from the appropriation under s. 20.435 (4) (o), provide reimbursement for services that the county provides under this section to persons who are in addition to those who may be served under this section with funds from the appropriation under s. 20.435 (4) (b), (r), (rg), or (w).".

AB100-ASA1-AA37,14,3 34. Page 444, line 18: after that line insert:

AB100-ASA1-AA37,14,4 " Section 873s. 46.283 (5) of the statutes is amended to read:

AB100-ASA1-AA37,14,9 46.283 (5) Funding. From the appropriation accounts under s. 20.435 (4) (b), (bm), (gp), (pa), (r), (rg), and (w) and (7) (b), (bd), and (md), the department may contract with organizations that meet standards under sub. (3) for performance of the duties under sub. (4) and shall distribute funds for services provided by resource centers.

AB100-ASA1-AA37, s. 873t Section 873t. 46.283 (5) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,14,16 46.283 (5) Funding. From the appropriation accounts under s. 20.435 (4) (b), (bm), (gp), (pa), (r), (rg), and (w) and (7) (b), (bd), and (md), the department may contract with organizations that meet standards under sub. (3) for performance of the duties under sub. (4) and shall distribute funds for services provided by resource centers.

AB100-ASA1-AA37, s. 873u Section 873u. 46.284 (5) (a) of the statutes is amended to read:

AB100-ASA1-AA37,14,24 46.284 (5) (a) From the appropriation accounts under s. 20.435 (4) (b), (g), (gp), (im), (o), (r), (rg), and (w) and (7) (b) and (bd), the department shall provide funding on a capitated payment basis for the provision of services under this section. Notwithstanding s. 46.036 (3) and (5m), a care management organization that is under contract with the department may expend the funds, consistent with this section, including providing payment, on a capitated basis, to providers of services under the family care benefit.

AB100-ASA1-AA37, s. 873v Section 873v. 46.284 (5) (a) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,15,9 46.284 (5) (a) From the appropriation accounts under s. 20.435 (4) (b), (g), (gp), (im), (o), (r), (rg), and (w) and (7) (b) and (bd), the department shall provide funding on a capitated payment basis for the provision of services under this section. Notwithstanding s. 46.036 (3) and (5m), a care management organization that is under contract with the department may expend the funds, consistent with this section, including providing payment, on a capitated basis, to providers of services under the family care benefit.".

AB100-ASA1-AA37,15,10 35. Page 447, line 22: after that line insert:

AB100-ASA1-AA37,15,11 " Section 887g. 46.515 (1) (i) of the statutes is repealed.

AB100-ASA1-AA37, s. 888g Section 888g. 46.515 (1) (j) of the statutes is repealed.".

AB100-ASA1-AA37,15,13 36. Page 448, line 16: after that line insert:

AB100-ASA1-AA37,15,15 " Section 890g. 46.515 (2) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,16,8 46.515 (2) Funds provided. If a county or Indian tribe applies and is selected by the department under sub. (5) to participate in the program under this section, the department shall award, from the appropriation under s. 20.435 (5) (ab), a grant annually to be used only for the purposes specified in sub. (4) (a) and (am). The minimum amount of a grant is $10,000. The department shall determine the amount of a grant awarded to a county, other than a county with a population of 500,000 or more, or Indian tribe in excess of the minimum amount based on the number of births that are funded by medical assistance under subch. IV of ch. 49 in that county or the reservation of that Indian tribe in proportion to the number of births that are funded by medical assistance under subch. IV of ch. 49 in all of the counties and the reservations of all of the Indian tribes to which grants are awarded under this section. The department shall determine the amount of a grant awarded to a county with a population of 500,000 or more in excess of the minimum amount based on 60% of the number of births that are funded by medical assistance under subch. IV of ch. 49 in that county in proportion to the number of births that are funded by medical assistance under subch. IV of ch. 49 in all of the counties and the reservations of all of the Indian tribes to which grants are awarded under this section.

AB100-ASA1-AA37, s. 891g Section 891g. 46.515 (3) (title) of the statutes is repealed.

AB100-ASA1-AA37, s. 892g Section 892g. 46.515 (3) (a) of the statutes is repealed.

AB100-ASA1-AA37, s. 893g Section 893g. 46.515 (3) (b) of the statutes is renumbered 46.515 (3) and amended to read:

AB100-ASA1-AA37,16,17 46.515 (3) Joint application permitted. Two or more counties and Indian tribes may submit a joint application to the department. Each county or Indian tribe in a joint application shall be counted as a separate county or Indian tribe for the purpose of limiting the number of counties and Indian tribes selected in each state fiscal biennium.

AB100-ASA1-AA37, s. 894g Section 894g. 46.516 of the statutes is created to read:

AB100-ASA1-AA37,16,20 46.516 Universal home visitation services. (1) Definitions. In this section:

AB100-ASA1-AA37,16,22 (a) "County department" means a county department of human services or social services under s. 46.215, 46.22, or 46.23.

AB100-ASA1-AA37,16,24 (b) "Indian tribe" means a federally recognized American Indian tribe or band in this state.

AB100-ASA1-AA37,16,25 (c) "Local health department" has the meaning given in s. 250.01 (4).

AB100-ASA1-AA37,17,4 (d) "Local partnership" means any combination of 2 or more county departments, local health departments, Indian tribes, and private nonprofit agencies that have agreed to implement jointly a program of universal home visitation services under this section.

AB100-ASA1-AA37,17,6 (e) "Organization" means a county department, local health department, Indian tribe, private nonprofit agency, or local partnership.

AB100-ASA1-AA37,17,8 (f) "Private nonprofit agency" means a nonstock corporation organized under ch. 181 that is a nonprofit corporation, as defined in s. 181.0103 (17).

AB100-ASA1-AA37,17,20 (2) Awarding of grants. From the appropriation account under s. 20.435 (5) (ab), the department shall award grants to applying organizations for the provision of the home visitation services specified in sub. (3) (a). The department shall determine the amount of a grant awarded to an organization based on the number of first-time births in the community served by the organization. The department shall provide competitive application procedures for selecting organizations to receive grants under this subsection and shall establish a method for ranking applicants based on the quality of their applications. The department shall require a grant recipient to provide matching funds or in-kind contributions as determined by the department and shall ensure that a grant recipient does not use any grant moneys awarded to supplant any other moneys used by the grant recipient at the time of the awarding of the grant to provide home visitation services.

AB100-ASA1-AA37,18,7 (3) Purposes of grants. (a) Universal home visitation services. An organization that receives a grant under sub. (2) shall use the grant moneys awarded to provide a one-time visit to all first-time parents in the community served by the organization for the purposes of providing those parents with basic information regarding infant health and nutrition, the care, safety, and development of infants, and emergency services for infants; identifying the needs of those parents; and providing those parents with referrals to programs, services, and other resources that may meet those needs. An organization may visit a first-time parent only if the parent or, if the parent is a child, his or her parent, guardian, or legal custodian consents to the visit. No person who is required or permitted to report suspected or threatened abuse or neglect under s. 48.981 (2) may make or threaten to make such a report based on a refusal of a person to receive a home visit under this paragraph.

AB100-ASA1-AA37,18,13 (b) Start-up costs and capacity building. In the first year in which a grant under sub. (2) is awarded to an organization, the organization may use a portion of the grant to pay for start-up costs and capacity building related to the provision of home visitation services by the organization. The department shall determine the maximum amount of a grant that an organization may use to pay for those start-up costs and that capacity building.

AB100-ASA1-AA37,18,22 (4) Confidentiality. (a) Nondisclosure of information; exceptions. No person may use or disclose any information concerning an individual who is offered home visitation services under sub. (3) (a), including an individual who declines to receive those services, or concerning an individual who is provided with a referral under sub. (3) (a), including an individual who declines the referral, unless disclosure of the information is required or permitted under s. 48.981 (2), the use or disclosure of the information is connected to the administration of the program under this section, or the individual has given his or her written informed consent to the use or disclosure of the information.

AB100-ASA1-AA37,19,2 (b) Explanation of confidentiality requirements. An organization that receives a grant under sub. (2) shall provide or shall designate an individual or entity to provide an explanation of the confidentiality requirements under par. (a) to each individual who is offered home visitation services under sub. (3) (a) by the organization.

AB100-ASA1-AA37,19,12 (5) Notification of parent prior to making abuse or neglect report. If a person who is providing home visitation services under sub. (3) (a) determines that he or she is required or permitted to make a report under s. 48.981 (2) about a child in a family to which the person is providing those services, the person shall, prior to making the report under s. 48.981 (2), make a reasonable effort to notify the child's parent that a report under s. 48.981 (2) will be made and to encourage the parent to contact a county department under s. 46.22 or 46.23 or, in a county having a population of 500,000 or more, the department to request assistance. The notification requirements under this subsection do not affect the reporting requirements under s. 48.981 (2).

AB100-ASA1-AA37,19,16 (6) Informational materials. Any informational materials about the home visitation services provided under sub. (3) (a) that are distributed to a person who is offered or who is receiving those services shall state the sources of funding for the services.".

AB100-ASA1-AA37,19,17 37. Page 495, line 5: after that line insert:

AB100-ASA1-AA37,19,18 " Section 1120r. 49.45 (2) (a) 17. of the statutes is amended to read:

AB100-ASA1-AA37,19,23 49.45 (2) (a) 17. Notify the governor, the joint committee on legislative organization, the joint committee on finance, and appropriate standing committees, as determined by the presiding officer of each house, if the appropriation accounts under s. 20.435 (4) (b) and, (gp), (r), and (rg) are insufficient to provide the state share of medical assistance.

AB100-ASA1-AA37, s. 1120s Section 1120s. 49.45 (2) (a) 17. of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,20,7 49.45 (2) (a) 17. Notify the governor, the joint committee on legislative organization, the joint committee on finance and appropriate standing committees, as determined by the presiding officer of each house, if the appropriation accounts under s. 20.435 (4) (b), (gp), and (r), and (rg) are insufficient to provide the state share of medical assistance.".

AB100-ASA1-AA37,20,8 38. Page 495, line 11: after that line insert:

AB100-ASA1-AA37,20,9 " Section 1124p. 49.45 (5m) (am) of the statutes is amended to read:

AB100-ASA1-AA37,20,17 49.45 (5m) (am) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w) (rm), the department shall distribute not more than $2,256,000 in each fiscal year, to provide supplemental funds to rural hospitals that, as determined by the department, have high utilization of inpatient services by patients whose care is provided from governmental sources, and to provide supplemental funds to critical access hospitals, except that the department may not distribute funds to a rural hospital or to a critical access hospital to the extent that the distribution would exceed any limitation under 42 USC 1396b (i) (3).".

AB100-ASA1-AA37,20,18 39. Page 495, line 16: after that line insert:

AB100-ASA1-AA37,20,19 " Section 1125x. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:

AB100-ASA1-AA37,21,2 49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this subsection made under s. 20.435 (4) (b), (gp), (pa), (o), (r), (rg), (w), or (wm) shall, except as provided in pars. (bg), (bm), and (br), be determined according to a prospective payment system updated annually by the department. The payment system shall implement standards that are necessary and proper for providing patient care and that meet quality and safety standards established under subch. II of ch. 50 and ch. 150. The payment system shall reflect all of the following:

AB100-ASA1-AA37, s. 1125y Section 1125y. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:

AB100-ASA1-AA37,21,10 49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this subsection made under s. 20.435 (4) (b), (gp), (pa), (o), (r), (rg), (w), or (wm) shall, except as provided in pars. (bg), (bm), and (br), be determined according to a prospective payment system updated annually by the department. The payment system shall implement standards that are necessary and proper for providing patient care and that meet quality and safety standards established under subch. II of ch. 50 and ch. 150. The payment system shall reflect all of the following:".

AB100-ASA1-AA37,21,11 40. Page 496, line 14: after that line insert:

AB100-ASA1-AA37,21,13 " Section 1133g. 49.45 (6L) (b) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1-AA37,21,19 49.45 (6L) (b) The department shall, each year, submit to the joint committee on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that provides information on the utilization of beds by recipients of medical assistance in facilities and a discussion and detailed projection of the likely balances, expenditures, encumbrances and carry over of currently appropriated amounts in the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (r), and (rg).

AB100-ASA1-AA37, s. 1133gd Section 1133gd. 49.45 (6ur) of the statutes is created to read:

AB100-ASA1-AA37,22,3 49.45 (6ur) Physician order entry record system; incentive payments. From the appropriation accounts under s. 20.435 (4) (b) and (o), the department shall annually make an incentive payment to each hospital that establishes, by January 1, 2009, and thereafter continues to maintain a physician order entry record system for provided medical services that, at a minimum, include pharmacy, laboratory, ultrasonography, and radiology services. The incentive payment shall equal 1% of the Medical Assistance reimbursement to the hospital for the previous fiscal year.

AB100-ASA1-AA37, s. 1133j Section 1133j. 49.45 (6v) of the statutes, as affected by 2005 Wisconsin Act .... (this act), is renumbered 49.45 (6L).".

AB100-ASA1-AA37, s. 1133k Section 1133k. 49.45 (6v) (b) of the statutes is amended to read:

AB100-ASA1-AA37,22,12 49.45 (6v) (b) The department shall, each year, submit to the joint committee on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that provides information on the utilization of beds by recipients of medical assistance in facilities and a discussion and detailed projection of the likely balances, expenditures, encumbrances, and carry over of currently appropriated amounts in the appropriation accounts under s. 20.435 (4) (b), (gp), and (o), (r), and (rg).".

AB100-ASA1-AA37,22,13 41. Page 496, line 17: delete lines 17 to 23 and substitute:

AB100-ASA1-AA37,22,14 " Section 1135dm. 49.45 (6x) (a) of the statutes is amended to read:

AB100-ASA1-AA37,22,20 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w) (rm), the department shall distribute not more than $4,748,000 $6,248,000 in each fiscal year, to provide funds to an essential access city hospital hospitals, except that the department may not allocate funds to an essential access city hospital to the extent that the allocation would exceed any limitation under 42 USC 1396b (i) (3).".

AB100-ASA1-AA37,22,21 42. Page 497, line 9: after that line insert: