Amendment ASA1-SB40

SB40-ASA1, s. 738 Section 738. 46.27 (4) (c) 8. of the statutes is amended to read:

SB40-ASA1,527,9 46.27 (4) (c) 8. If a contract with an entity under s. 46.281 (1) (e) 1. 46.284 (2) is established in the county, a description of how the activities of the entity relate to and are coordinated with the county's proposed program.

SB40-ASA1, s. 739 Section 739. 46.27 (5) (am) of the statutes is amended to read:

SB40-ASA1,527,23 46.27 (5) (am) Organize assessment activities specified in sub. (6). The county department or aging unit shall utilize persons for each assessment who can determine the needs of the person being assessed and who know the availability within the county of services alternative to placement in a nursing home. If any hospital patient is referred to a nursing home for admission, these persons shall work with the hospital discharge planner in performing the activities specified in sub. (6). The county department or aging unit shall coordinate the involvement of representatives from the county departments under ss. 46.215, 46.22, 51.42 and 51.437, health service providers and the county commission on aging in the assessment activities specified in sub. (6), as well as the person being assessed and members of the person's family or the person's guardian. This paragraph does not apply to a county department or aging unit in a county in which the department has contracted with an entity under s. 46.281 (1) (e) 1 46.284 (2).

SB40-ASA1, s. 740 Section 740. 46.27 (5) (j) of the statutes is created to read:

SB40-ASA1,528,4 46.27 (5) (j) Within the time period specified by the department, offer counseling, that is specified by the department, concerning public and private benefit programs to prospective residents of community-based residential facilities who are referred to the county department or aging unit under s. 50.035 (4n).

SB40-ASA1, s. 741 Section 741. 46.27 (6) (a) 3. of the statutes is amended to read:

SB40-ASA1,528,14 46.27 (6) (a) 3. In each participating county, except in counties in which the department has contracted with an entity under s. 46.281 (1) (e) 1. 46.284 (2), assessments shall be conducted for those persons and in accordance with the procedures described in the county's community options plan. The county may elect to establish assessment priorities for persons in target groups identified by the county in its plan regarding gradual implementation. If a person who is already admitted to a nursing home requests an assessment and if funds allocated for assessments under sub. (7) (am) are available, the county shall conduct the assessment.

SB40-ASA1, s. 742 Section 742. 46.27 (6g) (intro.) of the statutes is amended to read:

SB40-ASA1,528,20 46.27 (6g) Fiscal responsibility. (intro.) Except as provided in s. 51.40, and within the limitations under sub. (7) (b), the fiscal responsibility of a county for an assessment, unless the assessment is performed by an entity under a contract as specified under s. 46.281 (1) (e) 1. 46.284 (2), case plan, or services provided to a person under this section is as follows:

SB40-ASA1, s. 743 Section 743. 46.27 (6u) (c) 1. a. of the statutes is amended to read:

SB40-ASA1,528,23 46.27 (6u) (c) 1. a. Eligible for medical assistance under s. 49.46, 49.468 or, 49.47, or 49.471 (4) (a).

SB40-ASA1, s. 744 Section 744. 46.27 (6u) (d) (intro.) of the statutes is amended to read:

SB40-ASA1,529,6 46.27 (6u) (d) (intro.) In determining financial eligibility under par. (c) 1. and in calculating the amount under par. (c) 2., the county department or aging unit shall include as the assets for any person, except those persons who are eligible for medical assistance under s. 49.46, 49.468 or, 49.47, or 49.471 (4) (a), any portion of assets that the person or the person's spouse has, after August 12, 1993, transferred to another as specified in par. (b), unless one of the following conditions applies:

SB40-ASA1, s. 745 Section 745. 46.27 (7) (am) of the statutes is amended to read:

SB40-ASA1,529,16 46.27 (7) (am) From the appropriation under s. 20.435 (7) (bd), the department shall allocate funds to each county or private nonprofit agency with which the department contracts to pay assessment and case plan costs under sub. (6) not otherwise paid by fee or under s. 49.45 or 49.78 (2). The department shall reimburse counties for the cost of assessing persons eligible for medical assistance under s. 49.46, 49.468, or 49.47, or 49.471 (4) (a) as part of the administrative services of medical assistance, payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this paragraph to pay the cost of long-term community support services and for a risk reserve under par. (fr).

SB40-ASA1, s. 746 Section 746. 46.27 (7) (b) of the statutes is amended to read:

SB40-ASA1,530,6 46.27 (7) (b) From the appropriations under s. 20.435 (7) (bd) and (im), the department shall allocate funds to each county to pay the cost of providing long-term community support services under sub. (5) (b) not otherwise paid under s. 49.45 to persons eligible for medical assistance under s. 49.46 or , 49.47, or 49.471 (4) (a) or to persons whom the county department or aging unit administering the program finds likely to become medically indigent within 6 months by spending excess income or assets for medical or remedial care. The average per person reimbursement under this paragraph may not exceed the state share of the average per person payment rate the department expects under s. 49.45 (6m). The county department or aging unit administering the program may spend funds received under this paragraph only in accordance with the case plan and service contract created for each person receiving long-term community support services. Counties may use unspent funds allocated under this paragraph from the appropriation under s. 20.435 (7) (bd) for a risk reserve under par. (fr).

SB40-ASA1, s. 747 Section 747. 46.27 (7) (cj) 3. a. of the statutes is repealed.

SB40-ASA1, s. 748 Section 748. 46.27 (7) (fr) 3. c. of the statutes is amended to read:

SB40-ASA1,530,10 46.27 (7) (fr) 3. c. If approved by a resolution of the county board of supervisors, to transfer funds to a family long-term care district.

SB40-ASA1, s. 749 Section 749. 46.27 (9) (a) of the statutes is amended to read:

SB40-ASA1,530,20 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), or (w), or (xd) 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).

SB40-ASA1, s. 750 Section 750. 46.27 (9) (c) of the statutes is amended to read:

SB40-ASA1,531,2 46.27 (9) (c) All long-term community support services provided under this pilot project in lieu of nursing home care shall be consistent with those services described in the participating county's community options plan under sub. (4) (c) 1. and provided under sub. (5) (b). Unless the department has contracted under s. 46.281 (1) (e) 1. 46.284 (2) with an entity other than the county department, each county participating in the pilot project shall assess persons under sub. (6).

SB40-ASA1, s. 751 Section 751. 46.27 (10) (a) 1. of the statutes is amended to read:

SB40-ASA1,531,9 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), or (w), or (xd), or because of increased utilization of nursing home services, as estimated by the department.

SB40-ASA1, s. 752 Section 752. 46.27 (11) (c) 5n. a. of the statutes is repealed.

SB40-ASA1, s. 753 Section 753. 46.275 (1m) (a) of the statutes is amended to read:

SB40-ASA1,531,13 46.275 (1m) (a) "Medical assistance" means aid provided under subch. IV of ch. 49, except s. ss. 49.468 and 49.471.

SB40-ASA1, s. 754 Section 754. 46.275 (5) (a) of the statutes is amended to read:

SB40-ASA1,531,20 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), and (w), and (xd). 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.

SB40-ASA1, s. 755 Section 755. 46.275 (5) (c) of the statutes is amended to read:

SB40-ASA1,532,3 46.275 (5) (c) The total allocation under s. 20.435 (4) (b), (gp), (o), and (w), and (xd) 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.

SB40-ASA1, s. 756 Section 756. 46.277 (1m) (a) of the statutes is amended to read:

SB40-ASA1,532,6 46.277 (1m) (a) "Medical assistance" means aid provided under subch. IV of ch. 49, except s. ss. 49.468 and 49.471.

SB40-ASA1, s. 757 Section 757. 46.277 (3) (d) of the statutes is created to read:

SB40-ASA1,532,12 46.277 (3) (d) The county department or aging unit that administers the program under this section shall, within the time period specified by the department, offer counseling, that is specified by the department, concerning public and private benefit programs to prospective residents of community-based residential facilities who are referred to the county department or aging unit under s. 50.035 (4n).

SB40-ASA1, s. 758 Section 758. 46.277 (5) (d) 1n. a. of the statutes is repealed.

SB40-ASA1, s. 759 Section 759. 46.278 (1m) (b) of the statutes is amended to read:

SB40-ASA1,532,16 46.278 (1m) (b) "Medical assistance" means aid provided under subch. IV of ch. 49, except s. ss. 49.468 and 49.471.

SB40-ASA1, s. 760 Section 760. 46.278 (6) (d) of the statutes is amended to read:

SB40-ASA1,532,23 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 account under s. 20.435 (4) (b) or, (w), or (xd).

SB40-ASA1, s. 761 Section 761. 46.2785 (5) (a) of the statutes is amended to read:

SB40-ASA1,533,3 46.2785 (5) (a) Medical assistance reimbursement for services a county or private agency contracts for or provides under the waiver program shall be made from the appropriation accounts under s. 20.435 (4) (b) and , (o), and (xd).

SB40-ASA1, s. 762 Section 762. 46.28 (1) (f) of the statutes is amended to read:

SB40-ASA1,533,6 46.28 (1) (f) "Victim of domestic abuse" means an individual who has encountered domestic abuse, as defined in s. 46.95 49.165 (1) (a).

SB40-ASA1, s. 763 Section 763. 46.2803 (2) of the statutes is created to read:

SB40-ASA1,533,14 46.2803 (2) Notwithstanding s. 46.27 (7), a county in which a care management organization is operating pursuant to a contract under s. 46.284 (2) or a county in which a program described under s. 46.2805 (1) (a) or (b) is administered may use funds appropriated under 20.435 (7) (bd) and allocated to the county under s. 46.27 (7) to provide community mental health or substance abuse services and supports for persons with mental illness or persons in need of services or supports for substance abuse and to provide services under the Family Support Program under s. 46.985.

SB40-ASA1, s. 764 Section 764. 46.2804 (title) of the statutes is amended to read:

SB40-ASA1,533,17 46.2804 (title) Managed care programs for Client management of managed care long-term care services benefit.

SB40-ASA1, s. 765 Section 765. 46.2804 (1) of the statutes is repealed.

SB40-ASA1, s. 766 Section 766. 46.2804 (2) of the statutes is renumbered 46.2804.

SB40-ASA1, s. 767 Section 767. 46.2805 (5) of the statutes is renumbered 46.2805 (7r) and amended to read:

SB40-ASA1,533,23 46.2805 (7r) "Family Long-term care district" means a special purpose district created under s. 46.2895 (1).

SB40-ASA1, s. 768 Section 768. 46.2805 (6) of the statutes is renumbered 46.2805 (7u) and amended to read:

SB40-ASA1,534,2 46.2805 (7u) "Family Long-term care district board" means the governing board of a family long-term care district.

SB40-ASA1, s. 769 Section 769. 46.2805 (6m) of the statutes is created to read:

SB40-ASA1,534,6 46.2805 (6m) "Family member" means a spouse or an individual related by blood, marriage, or adoption within the 3rd degree of kinship as computed under s. 990.001 (16).

SB40-ASA1, s. 770 Section 770. 46.2805 (6r) of the statutes is created to read:

SB40-ASA1,534,10 46.2805 (6r) "Financial and cost-sharing screening" means a screening to determine financial eligibility under s. 46.286 (1) (b) and cost-sharing under s. 46.286 (2) using a uniform tool prescribed by the department.

SB40-ASA1, s. 771 Section 771. 46.2805 (6v) of the statutes is created to read:

SB40-ASA1,534,15 46.2805 (6v) "Frail elder" means an individual who is 65 years of age or older and has a physical disability or irreversible dementia that restricts the individual's ability to perform normal daily tasks or that threatens the capacity of the individual to live independently.

SB40-ASA1, s. 772 Section 772. 46.2805 (7) of the statutes is amended to read:

SB40-ASA1,534,20 46.2805 (7) "Functional and financial screen screening" means a screen prescribed by the department that is used screening to determine functional eligibility under s. 46.286 (1) (a) and financial eligibility under s. 46.286 (1) (b) using a uniform tool prescribed by the department.

SB40-ASA1, s. 773 Section 773. 46.2805 (7m) of the statutes is repealed.

SB40-ASA1, s. 944r Section 944r. 46.281 (title) of the statutes is amended to read:

SB40-ASA1,534,24 46.281 (title) Powers and duties of the department and the, secretary , and counties; long-term care.

SB40-ASA1, s. 774 Section 774. 46.281 (1) (intro.) of the statutes is renumbered 46.281 (1n) (intro.), and 46.281 (1n) (title), as renumbered, is amended to read:

SB40-ASA1,535,3 46.281 (1n) (title) Duties Other duties of the department.

SB40-ASA1, s. 775 Section 775. 46.281 (1) (c) of the statutes is renumbered 46.281 (1d) and amended to read:

SB40-ASA1,535,13 46.281 (1d) Waiver request. Request The department shall request from the secretary of the federal department 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 medical assistance. The department shall implement any waiver that is approved and that is consistent with ss. 46.2805 to 46.2895. Regardless of whether a waiver is approved, the department may implement operation of resource centers, care management organizations , and the family care benefit.

SB40-ASA1, s. 947m Section 947m. 46.281 (1) (d) of the statutes is renumbered 46.281 (1g) (b) and amended to read:

SB40-ASA1,536,23 46.281 (1g) (b) In geographic areas in which, in the aggregate, resides no more than 29 percent of the state population that is eligible for the family care benefit, contract with a county, a family care district, a tribe or band, the Great Lakes Inter-Tribal Council, Inc., or with 2 or more of these entities to manage all long-term care programs and administer the family care benefit as care management organizations. If the department proposes to contract with these entities to administer care management organizations the family care benefit in geographic areas in which, in the aggregate, resides more than 29 percent but less than 50 percent of the state population that is eligible for the family care benefit, the department shall first notify the joint committee on finance in writing of the proposed contract. The notification shall include the contract proposal; and an estimate of the fiscal impact of the proposed addition that demonstrates that the addition will be cost neutral, including startup, transitional, and ongoing operational costs and any proposed county contribution. The notification shall also include, for each county affected by the proposal, documentation that the county consents to administration of the family care benefit in the county, the amount of the county's payment or reduction in community aids under s. 46.281 (4), and a proposal by the county for using any savings in county expenditures on long-term care that result from administration of the family care benefit in the county. 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 if the committee. The department may contract with these entities to administer care management organizations in geographic areas in which, in the aggregate, resides 50 percent or more of the state population that is eligible for the family care benefit only if specifically authorized by the legislature and if the legislature appropriates necessary funding approves the proposed contract or if the committee fails to act on the proposed contract within 59 working days after the date of the department's notification.

SB40-ASA1, s. 776 Section 776. 46.281 (1) (e) of the statutes is repealed.

SB40-ASA1, s. 777 Section 777. 46.281 (1) (f) of the statutes is renumbered 46.281 (1n) (a).

SB40-ASA1, s. 778 Section 778. 46.281 (1) (g) of the statutes is renumbered 46.281 (1n) (b).

SB40-ASA1, s. 779 Section 779. 46.281 (1) (h) of the statutes is renumbered 46.281 (1n) (c).

SB40-ASA1, s. 780 Section 780. 46.281 (1) (i) of the statutes is repealed.

SB40-ASA1, s. 952m Section 952m. 46.281 (1g) (title) of the statutes is created to read:

SB40-ASA1,537,6 46.281 (1g) (title) Contracting for resource centers and care management organizations.

SB40-ASA1, s. 781 Section 781. 46.281 (1g) (a) of the statutes is created to read:

SB40-ASA1,537,12 46.281 (1g) (a) Subject to par. (b), the department may contract with entities as provided under s. 46.283 (2) to provide the services under s. 46.283 (3) and (4) as resource centers in any geographic area in the state, and may contract with entities as provided under s. 46.284 (2) to administer the family care benefit as care management organizations in any geographic area in the state.

SB40-ASA1, s. 782 Section 782. 46.281 (1n) (d) of the statutes is created to read:

SB40-ASA1,537,16 46.281 (1n) (d) 1. Establish regions for long-term care advisory committees under s. 46.2825, periodically review the boundaries of the regions, and, as appropriate, revise the boundaries.

SB40-ASA1,537,21 2. Specify the number of members that each governing board of a resource center shall appoint to a regional long-term care advisory committee. The total number of committee members shall not exceed 25, and the department shall allot committee membership equally among the governing boards of resource centers operating within the boundaries of the regional long-term care advisory committee.

SB40-ASA1,537,23 3. Provide information and staff assistance to assist regional long-term care advisory committees in performing the duties under s. 46.2825 (2).

SB40-ASA1, s. 954m Section 954m. 46.281 (1n) (e) of the statutes is created to read:

SB40-ASA1,538,11 46.281 (1n) (e) Contract with a person to provide the advocacy services described under s. 16.009 (2) (p) 1. to 5. to actual or potential recipients of the family care benefit who are under age 60 or to their families or guardians. The department may not contract under this paragraph with a county or with a person who has a contract with the department to provide services under s. 46.283 (3) and (4) as a resource center or to administer the family care benefit as a care management organization. The contract under this paragraph shall include as a goal that the provider of advocacy services provide one advocate for every 2,500 individuals under age 60 who receive the family care benefit. The department shall allocate $190,000 for the contract under this paragraph in fiscal year 2007-08 and $525,000 in each subsequent fiscal year.