SB40-SSA1, s. 913
24Section
913. 46.27 (6u) (d) (intro.) of the statutes is amended to read:
SB40-SSA1,529,6
146.27
(6u) (d) (intro.) In determining financial eligibility under par. (c) 1. and
2in calculating the amount under par. (c) 2., the county department or aging unit shall
3include as the assets for any person, except those persons who are eligible for medical
4assistance under s. 49.46, 49.468
or, 49.47
, or 49.471 (4) (a), any portion of assets that
5the person or the person's spouse has, after August 12, 1993, transferred to another
6as specified in par. (b), unless one of the following conditions applies:
SB40-SSA1,529,168
46.27
(7) (am) From the appropriation under s. 20.435 (7) (bd), the department
9shall allocate funds to each county or private nonprofit agency with which the
10department contracts to pay assessment and case plan costs under sub. (6) not
11otherwise paid by fee or under s. 49.45 or 49.78 (2). The department shall reimburse
12counties for the cost of assessing persons eligible for medical assistance under s.
1349.46, 49.468,
or 49.47
, or 49.471 (4) (a) as part of the administrative services of
14medical assistance, payable under s. 49.45 (3) (a). Counties may use unspent funds
15allocated under this paragraph to pay the cost of long-term community support
16services and for a risk reserve under par. (fr).
SB40-SSA1,530,618
46.27
(7) (b) From the appropriations under s. 20.435 (7) (bd) and (im), the
19department shall allocate funds to each county to pay the cost of providing long-term
20community support services under sub. (5) (b) not otherwise paid under s. 49.45 to
21persons eligible for medical assistance under s. 49.46
or
, 49.47
, or 49.471 (4) (a) or
22to persons whom the county department or aging unit administering the program
23finds likely to become medically indigent within 6 months by spending excess income
24or assets for medical or remedial care. The average per person reimbursement under
25this paragraph may not exceed the state share of the average per person payment
1rate the department expects under s. 49.45 (6m). The county department or aging
2unit administering the program may spend funds received under this paragraph
3only in accordance with the case plan and service contract created for each person
4receiving long-term community support services. Counties may use unspent funds
5allocated under this paragraph from the appropriation under s. 20.435 (7) (bd) for a
6risk reserve under par. (fr).
SB40-SSA1, s. 917
8Section
917. 46.27 (7) (fr) 3. c. of the statutes is amended to read:
SB40-SSA1,530,109
46.27
(7) (fr) 3. c. If approved by a resolution of the county board of supervisors,
10to transfer funds to a
family long-term care district.
SB40-SSA1,530,2012
46.27
(9) (a) The department may select up to 5 counties that volunteer to
13participate in a pilot project under which they will receive certain funds allocated for
14long-term care. The department shall allocate a level of funds to these counties
15equal to the amount that would otherwise be paid under s. 20.435 (4) (b),
(gp), or (w),
16or (xd) to nursing homes for providing care because of increased utilization of nursing
17home services, as estimated by the department. In estimating these levels, the
18department shall exclude any increased utilization of services provided by state
19centers for the developmentally disabled. The department shall calculate these
20amounts on a calendar year basis under sub. (10).
SB40-SSA1,531,222
46.27
(9) (c) All long-term community support services provided under this
23pilot project in lieu of nursing home care shall be consistent with those services
24described in the participating county's community options plan under sub. (4) (c) 1.
25and provided under sub. (5) (b). Unless the department has contracted under s.
146.281 (1) (e) 1. 46.284 (2) with an entity other than the county department, each
2county participating in the pilot project shall assess persons under sub. (6).
SB40-SSA1, s. 920
3Section
920. 46.27 (10) (a) 1. of the statutes is amended to read:
SB40-SSA1,531,94
46.27
(10) (a) 1. The department shall determine for each county participating
5in the pilot project under sub. (9) a funding level of state medical assistance
6expenditures to be received by the county. This level shall equal the amount that the
7department determines would otherwise be paid under s. 20.435 (4) (b),
(gp), or (w)
, 8or (xd), or because of increased utilization of nursing home services, as estimated by
9the department.
SB40-SSA1,531,1312
46.275
(1m) (a) "Medical assistance" means aid provided under subch. IV of ch.
1349, except
s. ss. 49.468
and 49.471.
SB40-SSA1,531,2015
46.275
(5) (a) Medical Assistance reimbursement for services a county, or the
16department under sub. (3r), provides under this program is available from the
17appropriation accounts under s. 20.435 (4) (b),
(gp), (o),
and (w)
, and (xd). If 2 or more
18counties jointly contract to provide services under this program and the department
19approves the contract, Medical Assistance reimbursement is also available for
20services provided jointly by these counties.
SB40-SSA1,532,322
46.275
(5) (c) The total allocation under s. 20.435 (4) (b),
(gp), (o),
and (w)
, and
23(xd) to counties and to the department under sub. (3r) for services provided under
24this section may not exceed the amount approved by the federal department of health
25and human services. A county may use funds received under this section only to
1provide services to persons who meet the requirements under sub. (4) and may not
2use unexpended funds received under this section to serve other developmentally
3disabled persons residing in the county.
SB40-SSA1,532,65
46.277
(1m) (a) "Medical assistance" means aid provided under subch. IV of ch.
649, except
s. ss. 49.468
and 49.471.
SB40-SSA1,532,128
46.277
(3) (d) The county department or aging unit that administers the
9program under this section shall, within the time period specified by the department,
10offer counseling, that is specified by the department, concerning public and private
11benefit programs to prospective residents of community-based residential facilities
12who are referred to the county department or aging unit under s. 50.035 (4n).
SB40-SSA1,532,1615
46.278
(1m) (b) "Medical assistance" means aid provided under subch. IV of ch.
1649, except
s. ss. 49.468
and 49.471.
SB40-SSA1,532,2318
46.278
(6) (d) If a county makes available nonfederal funds equal to the state
19share of service costs under a waiver received under sub. (3), the department may,
20from the appropriation under s. 20.435 (4) (o), provide reimbursement for services
21that the county provides under this section to persons who are in addition to those
22who may be served under this section with funds from the appropriation
account
23under s. 20.435 (4) (b)
or, (w)
, or (xd).
SB40-SSA1,533,3
146.2785
(5) (a) Medical assistance reimbursement for services a county or
2private agency contracts for or provides under the waiver program shall be made
3from the appropriation accounts under s. 20.435 (4) (b)
and
, (o)
, and (xd).
SB40-SSA1,533,65
46.28
(1) (f) "Victim of domestic abuse" means an individual who has
6encountered domestic abuse, as defined in s.
46.95
49.165 (1) (a).
SB40-SSA1,533,148
46.2803
(2) Notwithstanding s. 46.27 (7), a county in which a care management
9organization is operating pursuant to a contract under s. 46.284 (2) or a county in
10which a program described under s. 46.2805 (1) (a) or (b) is administered may use
11funds appropriated under 20.435 (7) (bd) and allocated to the county under s. 46.27
12(7) to provide community mental health or substance abuse services and supports for
13persons with mental illness or persons in need of services or supports for substance
14abuse and to provide services under the Family Support Program under s. 46.985.
SB40-SSA1,533,17
1646.2804 (title)
Managed care programs for Client management of
17managed care long-term care services
benefit.
SB40-SSA1, s. 938
20Section
938. 46.2805 (5) of the statutes is renumbered 46.2805 (7r) and
21amended to read:
SB40-SSA1,533,2322
46.2805
(7r) "
Family Long-term care district" means a special purpose district
23created under s. 46.2895 (1).
SB40-SSA1, s. 939
24Section
939. 46.2805 (6) of the statutes is renumbered 46.2805 (7u) and
25amended to read:
SB40-SSA1,534,2
146.2805
(7u) "
Family
Long-term care district board" means the governing
2board of a
family long-term care district.
SB40-SSA1,534,64
46.2805
(6m) "Family member" means a spouse or an individual related by
5blood, marriage, or adoption within the 3rd degree of kinship as computed under s.
6990.001 (16).
SB40-SSA1,534,108
46.2805
(6r) "Financial and cost-sharing screening" means a screening to
9determine financial eligibility under s. 46.286 (1) (b) and cost-sharing under s.
1046.286 (2) using a uniform tool prescribed by the department.
SB40-SSA1,534,1512
46.2805
(6v) "Frail elder" means an individual who is 65 years of age or older
13and has a physical disability or irreversible dementia that restricts the individual's
14ability to perform normal daily tasks or that threatens the capacity of the individual
15to live independently.
SB40-SSA1,534,2017
46.2805
(7) "Functional
and financial screen screening" means a
screen 18prescribed by the department that is used screening to determine functional
19eligibility under s. 46.286 (1) (a)
and financial eligibility under s. 46.286 (1) (b) using
20a uniform tool prescribed by the department.
SB40-SSA1,534,24
2346.281 (title)
Powers and duties of the department and the, secretary
,
24and counties; long-term care.
SB40-SSA1, s. 945
1Section
945. 46.281 (1) (intro.) of the statutes is renumbered 46.281 (1n)
2(intro.), and 46.281 (1n) (title), as renumbered, is amended to read:
SB40-SSA1,535,33
46.281
(1n) (title)
Duties
Other duties of the department.
SB40-SSA1, s. 946
4Section
946. 46.281 (1) (c) of the statutes is renumbered 46.281 (1d) and
5amended to read:
SB40-SSA1,535,136
46.281
(1d) Waiver request. Request The department shall request from the
7secretary of the federal department of health and human services any waivers of
8federal medicaid laws necessary to permit the use of federal moneys to provide the
9family care benefit to recipients of medical assistance. The department shall
10implement any waiver that is approved and that is consistent with ss. 46.2805 to
1146.2895. Regardless of whether a waiver is approved, the department may
12implement operation of resource centers, care management organizations
, and the
13family care benefit.
SB40-SSA1, s. 947m
14Section 947m. 46.281 (1) (d) of the statutes is renumbered 46.281 (1g) (b) and
15amended to read:
SB40-SSA1,536,2316
46.281
(1g) (b)
In geographic areas in which, in the aggregate, resides no more
17than 29 percent of the state population that is eligible for the family care benefit,
18contract with a county, a family care district, a tribe or band, the Great Lakes
19Inter-Tribal Council, Inc., or with 2 or more of these entities to manage all long-term
20care programs and administer the family care benefit as care management
21organizations. If the department proposes to contract with
these entities to
22administer
care management organizations the family care benefit in geographic
23areas in which, in the aggregate, resides more than 29 percent
but less than 50
24percent of the state population that is eligible for the family care benefit, the
25department shall first notify the joint committee on finance in writing of the
1proposed contract. The notification shall include the contract proposal; and an
2estimate of the fiscal impact of the proposed addition that demonstrates that the
3addition will be cost neutral, including startup, transitional, and ongoing
4operational costs and any proposed county contribution.
The notification shall also
5include, for each county affected by the proposal, documentation that the county
6consents to administration of the family care benefit in the county, the amount of the
7county's payment or reduction in community aids under s. 46.281 (4), and a proposal
8by the county for using any savings in county expenditures on long-term care that
9result from administration of the family care benefit in the county. If the
10cochairpersons of the committee do not notify the department within 14 working
11days after the date of the department's notification that the committee has scheduled
12a meeting for the purpose of reviewing the proposed contract, the department may
13enter into the proposed contract. If within 14
working days after the date of the
14department's notification the cochairpersons of the committee notify the department
15that the committee has scheduled a meeting for the purpose of reviewing the
16proposed contract, the department may enter into the proposed contract only
upon
17approval of if the committee
. The department may contract with these entities to
18administer care management organizations in geographic areas in which, in the
19aggregate, resides 50 percent or more of the state population that is eligible for the
20family care benefit only if specifically authorized by the legislature and if the
21legislature appropriates necessary funding approves the proposed contract or if the
22committee fails to act on the proposed contract within 59 working days after the date
23of the department's notification.
SB40-SSA1, s. 949
25Section
949. 46.281 (1) (f) of the statutes is renumbered 46.281 (1n) (a).
SB40-SSA1, s. 950
1Section
950. 46.281 (1) (g) of the statutes is renumbered 46.281 (1n) (b).
SB40-SSA1, s. 951
2Section
951. 46.281 (1) (h) of the statutes is renumbered 46.281 (1n) (c).
SB40-SSA1,537,65
46.281
(1g) (title)
Contracting for resource centers and care management
6organizations.
SB40-SSA1,537,128
46.281
(1g) (a) Subject to par. (b), the department may contract with entities
9as provided under s. 46.283 (2) to provide the services under s. 46.283 (3) and (4) as
10resource centers in any geographic area in the state, and may contract with entities
11as provided under s. 46.284 (2) to administer the family care benefit as care
12management organizations in any geographic area in the state.
SB40-SSA1,537,1614
46.281
(1n) (d) 1. Establish regions for long-term care advisory committees
15under s. 46.2825, periodically review the boundaries of the regions, and, as
16appropriate, revise the boundaries.
SB40-SSA1,537,2117
2. Specify the number of members that each governing board of a resource
18center shall appoint to a regional long-term care advisory committee. The total
19number of committee members shall not exceed 25, and the department shall allot
20committee membership equally among the governing boards of resource centers
21operating within the boundaries of the regional long-term care advisory committee.
SB40-SSA1,537,2322
3. Provide information and staff assistance to assist regional long-term care
23advisory committees in performing the duties under s. 46.2825 (2).
SB40-SSA1,538,11
146.281
(1n) (e) Contract with a person to provide the advocacy services
2described under s. 16.009 (2) (p) 1. to 5. to actual or potential recipients of the family
3care benefit who are under age 60 or to their families or guardians. The department
4may not contract under this paragraph with a county or with a person who has a
5contract with the department to provide services under s. 46.283 (3) and (4) as a
6resource center or to administer the family care benefit as a care management
7organization. The contract under this paragraph shall include as a goal that the
8provider of advocacy services provide one advocate for every 2,500 individuals under
9age 60 who receive the family care benefit. The department shall allocate $190,000
10for the contract under this paragraph in fiscal year 2007-08 and $525,000 in each
11subsequent fiscal year.
SB40-SSA1, s. 955
12Section
955. 46.281 (2) (title) of the statutes is amended to read:
SB40-SSA1,538,1313
46.281
(2) (title)
Powers
Other powers of the department.
SB40-SSA1,538,2315
46.281
(3) Duty of the secretary. The secretary shall certify to each county,
16hospital, nursing home, community-based residential facility, adult family home
17and residential care apartment complex the date on which a resource center that
18serves the area of the county, hospital, nursing home, community-based residential
19facility, adult family home or residential care apartment complex is first available
20to
provide a perform functional
screenings and financial
screen and cost-sharing
21screenings. To facilitate phase-in of services of resource centers, the secretary may
22certify that the resource center is available for specified groups of eligible individuals
23or for specified facilities in the county.
SB40-SSA1,539,5
146.281
(4) County contribution. (a) In this subsection, "base amount" means
2the amount that a county expended in calendar year 2006, as determined by the
3department, to provide long-term care services to individuals who would have been
4eligible for the family care benefit in calendar year 2006 if the family care benefit had
5been available to residents of the county.
SB40-SSA1,539,96
(b) Except as provided in par. (c), each county in which the department has a
7contract with an entity to administer the family care benefit shall in each year of the
8contract either pay the department the following amount or agree to reduce the
9community aids distribution to the county under s. 46.40 (2) by the following amount:
SB40-SSA1,539,1210
1. If the base amount for the county is less than or equal to 22 percent of the
11calendar year 2006 community aids distribution to the county under s. 46.40 (2), the
12base amount.
SB40-SSA1,539,1513
2. If the base amount for the county is greater than 22 percent of the calendar
14year 2006 community aids distribution to the county under s. 46.40 (2), the following
15amounts in the following years:
SB40-SSA1,539,1716
a. For the first year that the department contracts for administration of the
17family care benefit in the county, the base amount for the county.
SB40-SSA1,539,2218
b. For the 2nd, 3rd, and 4th years that the department contracts for
19administration of the family care benefit in the county, the amount from the previous
20year minus 25 percent of the difference between the base amount for the county and
2122 percent of the calendar year 2006 community aids distribution to the county under
22s. 46.40 (2).
SB40-SSA1,539,2523
c. For the 5th year and each subsequent year that the department contracts for
24administration of the family care benefit in the county, 22 percent of the calendar
25year 2006 community aids distribution to the county under s. 46.40 (2).