SB40-CSA1,565,1614
(h) Annually report to the department regarding significant achievements and
15problems relating to the provision of long-term care services in the committee's
16region.
SB40-CSA1, s. 978
17Section
978. 46.283 (1) (a) 2. of the statutes is amended to read:
SB40-CSA1,565,1918
46.283
(1) (a) 2. Whether to create a
family long-term care district to apply to
19the department for a contract to operate a resource center.
SB40-CSA1, s. 980
21Section
980. 46.283 (2) (b) of the statutes is renumbered 46.283 (2), and 46.283
22(2) (intro.) and (b), as renumbered, are amended to read:
SB40-CSA1,566,523
46.283
(2) (intro.)
After June 30, 2001, the The department may
, if the
24applicable review conditions under s. 46.281 (1) (e) 2. are satisfied, contract to
25operate a resource center with counties,
family long-term care districts, or the
1governing body of a tribe or band or the Great Lakes Inter-Tribal Council, Inc., under
2a joint application of any of these, or with a private nonprofit organization if the
3department determines that the organization has no significant connection to an
4entity that operates a care management organization and if any of the following
5applies:
SB40-CSA1,566,76
(b) A county agency or a
family long-term care district applies for a contract
7but fails to meet the standards specified in sub. (3).
SB40-CSA1,566,1311
46.283
(3) (k) A determination of eligibility for state supplemental payments
12under s. 49.77, medical assistance under s. 49.46, 49.468
or, 49.47
, or 49.471, or the
13federal food stamp program under
7 USC 2011 to
2029.
SB40-CSA1,566,2215
46.283
(4) (e)
Within 6 months after the family care benefit is available to all
16eligible persons in the area of the resource center, provide Provide information about
17the services of the resource center, including the services specified in sub. (3) (d),
18about assessments under s. 46.284 (4) (b) and care plans under s. 46.284 (4) (c) and
19about the family care benefit to all older persons and persons with a physical
20disability who are residents of nursing homes, community-based residential
21facilities, adult family homes and residential care apartment complexes in the area
22of the resource center.
SB40-CSA1,567,224
46.283
(4) (f)
Provide Perform a functional
screening and
a financial
screen to 25and cost-sharing screening for any resident, as specified in par. (e), who requests a
1screen screening and assist any resident who is eligible and chooses to enroll in a care
2management organization to do so.
SB40-CSA1,567,174
46.283
(4) (g)
Provide Perform a functional
screening and
a financial
screen to 5and cost-sharing screening for any person seeking admission to a nursing home,
6community-based residential facility, residential care apartment complex
, or adult
7family home if the secretary has certified that the resource center is available to the
8person and the facility and the person is determined by the resource center to have
9a condition that is expected to last at least 90 days that would require care,
10assistance
, or supervision. A resource center may not require a financial
screen and
11cost-sharing screening for a person seeking admission or about to be admitted on a
12private pay basis who waives the requirement for a financial
screen and cost-sharing
13screening under this paragraph, unless the person is expected to become eligible for
14medical assistance within 6 months. A resource center need not
provide perform a
15functional
screen for screening for a person seeking admission or about to be
16admitted
who has received a screen for
whom a functional
eligibility under s. 46.286
17(1) (a) screening was performed within the previous 6 months.
SB40-CSA1,567,2119
46.283
(4) (j) Target any outreach, education, and prevention services it
20provides and any service development efforts it conducts on the basis of findings
21made by the governing board of the resource center under sub. (6) (b) 2. and 3.
SB40-CSA1,567,2523
46.283
(6) Governing board. (a) 1. A resource center shall have a governing
24board that reflects the ethnic and economic diversity of the geographic area served
25by the resource center.
SB40-CSA1,568,7
12. At least one-fourth of the members of the governing board shall
be older
2persons or persons with physical or developmental disabilities individuals who
3belong to a client group served by the resource center or their family members,
4guardians
, or other advocates.
The proportion of these board members who belong
5to each client group, or their family members, guardians, or advocates, shall be the
6same, respectively, as the proportion of individuals in this state who receive services
7under s. 46.2805 to 46.2895 and belong to each client group.
SB40-CSA1, s. 990
8Section
990. 46.283 (6) (a) 3. of the statutes is created to read:
SB40-CSA1,568,159
46.283
(6) (a) 3. An individual who has a financial interest in, or serves on the
10governing board of, a care management organization or an organization that
11administers a program described under s. 46.2805 (1) (a) or (b) or a managed care
12program under s. 49.45 for individuals who are eligible to receive supplemental
13security income under
42 USC 1381 to
1383c, which serves any geographic area also
14served by a resource center, and the individual's family members, may not serve as
15members of the governing board of the resource center.
SB40-CSA1,568,1817
46.283
(6) (b) The governing board of a resource center shall do all of the
18following:
SB40-CSA1,568,2119
1. Determine the structure, policies, and procedures of, and oversee the
20operations of, the resource center. The operations of a resource center that is
21operated by a county are subject to the county's ordinances and budget.
SB40-CSA1,569,222
2. Annually gather information from consumers and providers of long-term
23care services and other interested persons concerning the adequacy of long-term
24care services offered in the area served by the resource center. The board shall
1provide well-advertised opportunities for persons to participate in the board's
2information gathering activities conducted under this subdivision.
SB40-CSA1,569,43
4. Report findings made under subds. 2. and 3. to the applicable regional
4long-term care advisory committee.
SB40-CSA1,569,75
5. Recommend strategies for building local capacity to serve older persons and
6persons with physical or developmental disabilities, as appropriate, to local elected
7officials, the regional long-term care advisory committee, or the department.
SB40-CSA1,569,98
7. Appoint members to the regional long-term care advisory committee, as
9provided under s. 46.2825 (1).
SB40-CSA1, s. 992
10Section
992. 46.284 (1) (a) (intro.) of the statutes is amended to read:
SB40-CSA1,569,1411
46.284
(1) (a) (intro.)
After considering recommendations of the local
12long-term care council under s. 46.282 (3) (a) 1., a A county board of supervisors and,
13in a county with a county executive or a county administrator, the county executive
14or county administrator, may decide all of the following:
SB40-CSA1, s. 993
15Section
993. 46.284 (1) (a) 2. of the statutes is amended to read:
SB40-CSA1,569,1716
46.284
(1) (a) 2. Whether to create a
family long-term care district to apply to
17the department for a contract to operate a care management organization.
SB40-CSA1, s. 994
18Section
994. 46.284 (2) (b) (intro.) of the statutes is repealed.
SB40-CSA1, s. 997
21Section
997. 46.284 (2) (b) 3. of the statutes is renumbered 46.284 (2) (bm) and
22amended to read:
SB40-CSA1,570,823
46.284
(2) (bm)
After December 31, 2003, the The department may contract
24with counties,
family long-term care districts, the governing body of a tribe or band
25or the Great Lakes inter-tribal council, inc., or under a joint application of any of
1these, or with a private organization that has no significant connection to an entity
2that operates a resource center. Proposals for contracts under this subdivision shall
3be solicited under a competitive sealed proposal process under s. 16.75 (2m) and
,
4after consulting with the local long-term care council for the county or counties, the
5department shall evaluate the proposals primarily as to the quality of care that is
6proposed to be provided, certify those applicants that meet the requirements
7specified in sub. (3) (a), select certified applicants for contract and contract with the
8selected applicants.
SB40-CSA1,570,2210
46.284
(2) (c) The department shall require, as a term of any contract with a
11care management organization under this section, that the care management
12organization contract for the provision of services that are covered under the family
13care benefit with any community-based residential facility under s. 50.01 (1g),
14residential care apartment complex under s. 50.01 (1d), nursing home under s. 50.01
15(3), intermediate care facility for the mentally retarded under s. 50.14 (1) (b),
16community rehabilitation program, home health agency under s. 50.49 (1) (a),
17provider of day services, or provider of personal care, as defined in s. 50.01 (4o), that
18agrees to accept the reimbursement rate that the care management organization
19pays under contract to similar providers for the same service and that satisfies any
20applicable quality of care, utilization, or other criteria that the care management
21organization requires of other providers with which it contracts to provide the same
22service.
SB40-CSA1,571,524
46.284
(3) (a) If an entity meets the requirements under par. (b) and applicable
25rules of the department and submits to the department an application for initial
1certification or certification renewal, the department shall certify that the entity
2meets the requirements for a care management organization.
An application shall
3include comments about the applicant and recommendations about the application
4that are provided by the appropriate local long-term care council, as specified under
5s. 46.282 (3) (a) 3.
SB40-CSA1,571,137
46.284
(5) (a) From the appropriation accounts under s. 20.435 (4) (b), (g), (gp),
8(im), (o), and (w) and (7) (b)
and, (bd)
, and (g), the department shall provide funding
9on a capitated payment basis for the provision of services under this section.
10Notwithstanding s. 46.036 (3) and (5m), a care management organization that is
11under contract with the department may expend the funds, consistent with this
12section, including providing payment, on a capitated basis, to providers of services
13under the family care benefit.
SB40-CSA1,571,2215
46.284
(6) Governing board. A care management organization shall have a
16governing board that reflects the ethnic and economic diversity of the geographic
17area served by the care management organization. At least one-fourth of the
18members of the governing board shall be
older persons or persons with physical or
19developmental disabilities or their family members, guardians or other advocates
20who are representative of the
client group or groups whom the care management
21organization's enrollee organization is contracted to serve or those clients' family
22members, guardians, or other advocates.
SB40-CSA1, s. 1001
23Section
1001. 46.285 (1) of the statutes is renumbered 46.285, and 46.285
24(intro.), (1) and (2), as renumbered, are amended to read:
SB40-CSA1,572,6
146.285 Operation of resource center and care management
2organization. (intro.) In order to meet federal requirements and assure federal
3financial participation in funding of the family care benefit, a county, a tribe or band,
4a
family long-term care district or an organization, including a private, nonprofit
5corporation, may not directly operate both a resource center and a care management
6organization, except as follows:
SB40-CSA1,572,10
7(1) For an entity with which the department has contracted under s. 46.281 (1)
8(e) 1.,
2005 stats., provision of the services specified under s. 46.283 (3) (b), (e), (f) and
9(g) shall be structurally separate from the provision of services of the care
10management organization by January 1, 2001.
SB40-CSA1,572,14
11(2) The department may approve separation of the functions of a resource
12center from those of a care management organization by a means other than
those
13specified in sub. (2) creating a long-term care district under s. 46.2895 to serve either
14as a resource center or as a care management organization.
SB40-CSA1, s. 1003
16Section
1003. 46.286 (1) (intro.) of the statutes is amended to read:
SB40-CSA1,572,2117
46.286
(1) Eligibility. (intro.) A person is eligible for, but not necessarily
18entitled to, the family care benefit if the person is at least 18 years of age; has a
19physical disability, as defined in s. 15.197 (4) (a) 2.,
or a developmental disability, as
20defined in s. 51.01 (5) (a), or
degenerative brain disorder, as defined in s. 55.01 (1v) 21is a frail elder; and meets all of the following criteria:
SB40-CSA1,572,2423
46.286
(1) (a) 1. The person's
functional capacity level of care need is
at either
24of the following
levels:
SB40-CSA1,573,3
1a. The
comprehensive nursing home level, if the person has a long-term or
2irreversible condition, expected to last at least 90 days or result in death within one
3year of the date of application, and requires ongoing care, assistance or supervision.
SB40-CSA1,573,74
b. The
intermediate non-nursing home level, if the person has a condition that
5is expected to last at least 90 days or result in death within 12 months after the date
6of application, and is at risk of losing his or her independence or functional capacity
7unless he or she receives assistance from others.
SB40-CSA1, s. 1005
8Section
1005. 46.286 (1) (b) (intro.) of the statutes is amended to read:
SB40-CSA1,573,109
46.286
(1) (b)
Financial eligibility. (intro.) A person is financially eligible if
10all any of the following apply:
SB40-CSA1, s. 1006
11Section
1006. 46.286 (1) (b) 1. (intro.) of the statutes is repealed.
SB40-CSA1, s. 1007
12Section
1007. 46.286 (1) (b) 1. a. of the statutes is renumbered 46.286 (1) (b)
133. and amended to read:
SB40-CSA1,573,1914
46.286
(1) (b) 3. The person
was receiving the family care benefit on the
15effective date of this subdivision .... [revisor inserts date], the person would qualify
16for medical assistance except for financial or disability criteria, and the projected cost
17of the person's care plan, as calculated by the department or its designee, exceeds the
18person's gross monthly income, plus one-twelfth of his or her countable assets, less
19deductions and allowances permitted by rule by the department.
SB40-CSA1, s. 1008
20Section
1008. 46.286 (1) (b) 1. b. and 2. of the statutes are consolidated,
21renumbered 46.286 (1) (b) 1m. and amended to read:
SB40-CSA1,573,2522
46.286
(1) (b) 1m. The person is eligible under ch. 49 for medical assistance
.
232. If subd. 1. b. applies, the person accepts medical assistance
and, unless he or she
24is exempt from
the acceptance under rules promulgated by the department
, accepts
25medical assistance.
SB40-CSA1, s. 1009
1Section
1009. 46.286 (3) (a) (intro.) of the statutes is amended to read:
SB40-CSA1,574,42
46.286
(3) (a) (intro.) Subject to
pars. par. (c)
and (d), a person is entitled to and
3may receive the family care benefit through enrollment in a care management
4organization if
he or she all of the following apply:
SB40-CSA1,574,5
51m. The person is at least 18 years of age
,.
SB40-CSA1,574,8
62m. The person has a physical disability, as defined in s. 15.197 (4) (a) 2., a
7developmental disability, as defined in s. 51.01 (5) (a), or
degenerative brain disorder,
8as defined in s. 55.01 (1v), is a frail elder.
SB40-CSA1,574,10
94m. The person is financially eligible
, under sub. (1) (b) 1m., and fulfills any
10applicable cost-sharing requirements
and meets any of the following criteria:.
SB40-CSA1,574,1515
46.286
(3) (a) 3m. The person is functionally eligible under sub. (1) (a).
SB40-CSA1, s. 1017
19Section
1017. 46.286 (3m) of the statutes is repealed and recreated to read:
SB40-CSA1,574,2120
46.286
(3m) Information about enrollees. The department shall obtain and
21share information about family care enrollees as provided in s. 49.475.
SB40-CSA1, s. 1018
22Section
1018. 46.288 (2) (intro.) of the statutes is amended to read:
SB40-CSA1,575,423
46.288
(2) (intro.) Criteria and procedures for determining functional
24eligibility under s. 46.286 (1) (a), financial eligibility under s. 46.286 (1) (b),
and cost
25sharing under s. 46.286 (2) (a)
and entitlement under s. 46.286 (3). The rules for
1determining functional eligibility under s. 46.286 (1) (a) 1. a. shall be substantially
2similar to eligibility criteria for receipt of the long-term support community options
3program under s. 46.27. Rules under this subsection shall include definitions of the
4following terms applicable to s. 46.286:
SB40-CSA1, s. 1019
5Section
1019. 46.289 (title) of the statutes is renumbered 46.2803 (title).
SB40-CSA1,575,8
846.2895 (title)
Family Long-term care district.
SB40-CSA1, s. 1022
9Section
1022. 46.2895 (1) (a) (intro.) of the statutes is amended to read:
SB40-CSA1,575,1610
46.2895
(1) (a) (intro.) A county
board of supervisors, a tribe or band, or any
11combination of counties or tribes or bands, may create a special purpose district that
12is termed a
"family "long-term care district", that is a local unit of government, that
13is separate and distinct from, and independent of, the state and the county
or tribe
14or band that created it, and that has the powers and duties specified in this section,
15if
the each county
board or tribe or band that participates in creating the district does
16all of the following: