AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
health and human services
Other health and human services
Under current law, DHFS administers the Family Care program to provide long-term care services to people who are at least 18 years of age, have a physical or developmental disability or a degenerative brain disorder, and satisfy financial eligibility criteria. Under Family Care, DHFS contracts with care management organizations to provide a flexible long-term care benefit called the family care benefit for a capitated payment rate, and contracts with resource centers to provide information and referral services pertaining to long-term care and to assess financial and functional eligibility for the family care benefit, among other services. DHFS may contract with a county, an American Indian tribe or band, the Great Lakes Inter-Tribal Council, a family care district, or a private entity to operate either a care management organization or a resource center, but not both. A family care district is a special purpose district created by one or more counties that is independent of the county and that may operate either a care management organization or a resource center.
Also under current law, in several counties organizations administer the Wisconsin Partnership Program or the Program for All-Inclusive Care for the Elderly (PACE), capitated payment rate programs to provide both acute health and long-term care services to elderly people or people with physical disabilities who are eligible for nursing home care.
This bill renames a family care district a long-term care district and provides for American Indian tribes or bands acting alone or in conjunction with other tribes or bands or counties to create a long-term care district. The bill allows a long-term care district to operate the Wisconsin Partnership Program or PACE, as long as the district does not also operate a resource center. The bill also does the following: modifies provisions governing membership of long-term care district boards; modifies compensation and benefit provisions relevant to former county employees who are hired by a long-term care district; specifies that counties are not responsible for providing or paying for any services that a long-term care district is required by statute or contract to provide or pay for; and provides for a county or American Indian tribe or band to withdraw or be removed from a long-term care district. Finally, the bill modifies provisions governing membership of a governing board of a care management organization.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SECTION 1. 13.94 (4) (a) 1. of the statutes is amended to read:
13.94 (4) (a) 1. Every state department, board, examining board, affiliated credentialing board, commission, independent agency, council or office in the executive branch of state government; all bodies created by the legislature in the legislative or judicial branch of state government; any public body corporate and politic created by the legislature including specifically the Fox River Navigational System Authority and the Wisconsin Aerospace Authority, a professional baseball park district, a local professional football stadium district, a local cultural arts district and a family long-term care district under s. 46.2895; every Wisconsin works agency under subch. III of ch. 49; every provider of medical assistance under subch. IV of ch. 49; technical college district boards; development zones designated under s. 560.71; every county department under s. 51.42 or 51.437; every nonprofit corporation or cooperative or unincorporated cooperative association to which moneys are specifically appropriated by state law; and every corporation, institution, association or other organization which receives more than 50% of its annual budget from appropriations made by state law, including subgrantee or subcontractor recipients of such funds.
SECTION 2. 13.94 (4) (b) of the statutes is amended to read:
13.94 (4) (b) In performing audits of family long-term care districts under s. 46.2895, Wisconsin works agencies under subch. III of ch. 49, providers of medical assistance under subch. IV of ch. 49, corporations, institutions, associations, or other organizations, and their subgrantees or subcontractors, the legislative audit bureau shall audit only the records and operations of such providers and organizations which pertain to the receipt, disbursement or other handling of appropriations made by state law.
SECTION 3. 17.13 (intro.) of the statutes is amended to read:
17.13 Removal of village, town, town sanitary district, school district, and technical college and family care district officers. (intro.) Officers of towns, town sanitary districts, villages, school districts, and technical college districts and family care districts may be removed as follows:
SECTION 4. 17.13 (4) of the statutes is repealed.
SECTION 5. 17.15 (5) of the statutes is amended to read:
17.15 (5) FAMILY LONG-TERM CARE DISTRICT. Any member of a family long-term care district governing board appointed under s. 46.2895 (3) (a) 2. may be removed by the appointing authority for cause.
SECTION 6. 17.27 (3m) of the statutes is amended to read:
17.27 (3m) FAMILY LONG-TERM CARE DISTRICT BOARD. If a vacancy occurs in the position of any appointed member of a family long-term care district board, the appointing authority shall appoint to serve for the residue of the unexpired term a person who meets the applicable requirements under s. 46.2895 (3) (b).
SECTION 7. 19.32 (1) of the statutes is amended to read:
19.32 (1) "Authority" means any of the following having custody of a record: a state or local office, elected official, agency, board, commission, committee, council, department or public body corporate and politic created by constitution, law, ordinance, rule or order; a governmental or quasi-governmental corporation except for the Bradley center sports and entertainment corporation; a local exposition district under subch. II of ch. 229; a family long-term care district under s. 46.2895; any court of law; the assembly or senate; a nonprofit corporation which receives more than 50% of its funds from a county or a municipality, as defined in s. 59.001 (3), and which provides services related to public health or safety to the county or municipality; a nonprofit corporation operating the Olympic ice training center under s. 42.11 (3); or a formally constituted subunit of any of the foregoing.
SECTION 8. 19.82 (1) of the statutes is amended to read:
19.82 (1) "Governmental body" means a state or local agency, board, commission, committee, council, department or public body corporate and politic created by constitution, statute, ordinance, rule or order; a governmental or quasi-governmental corporation except for the Bradley center sports and entertainment corporation; a local exposition district under subch. II of ch. 229; a family long-term care district under s. 46.2895; a nonprofit corporation operating the Olympic ice training center under s. 42.11 (3); or a formally constituted subunit of any of the foregoing, but excludes any such body or committee or subunit of such body which is formed for or meeting for the purpose of collective bargaining under subch. I, IV or, V, or VI of ch. 111.
****NOTE: This is reconciled s. 19.82 (1). This SECTION has been affected by drafts with the following LRB numbers: 1524 and 1352.
SECTION 9. 20.927 (1m) of the statutes is amended to read:
20.927 (1m) Except as provided under subs. (2) and (3), no funds of this state or of any county, city, village, town or family long-term care district under s. 46.2895 or of any subdivision or agency of this state or of any county, city, village or town and no federal funds passing through the state treasury shall be authorized for or paid to a physician or surgeon or a hospital, clinic or other medical facility for the performance of an abortion.
SECTION 10. 20.9275 (1) (b) of the statutes is amended to read:
20.9275 (1) (b) "Local governmental unit" means a city, village, town, county or family long-term care district under s. 46.2895 or an agency or subdivision of a city, village, town, or county.
SECTION 11. 25.50 (1) (d) of the statutes is amended to read:
25.50 (1) (d) "Local government" means any county, town, village, city, power district, sewerage district, drainage district, town sanitary district, public inland lake protection and rehabilitation district, local professional baseball park district created under subch. III of ch. 229, family long-term care district under s. 46.2895, local professional football stadium district created under subch. IV of ch. 229, local cultural arts district created under subch. V of ch. 229, public library system, school district or technical college district in this state, any commission, committee, board or officer of any governmental subdivision of this state, any court of this state, other than the court of appeals or the supreme court, or any authority created under s. 114.61, 149.41, 231.02, 233.02 or 234.02.
****NOTE: This is reconciled s. 25.50 (1) (d). This SECTION has been affected by drafts with the following LRB numbers: 1524 and 1006.
SECTION 12. 40.02 (28) of the statutes is amended to read:
40.02 (28) "Employer" means the state, including each state agency, any county, city, village, town, school district, other governmental unit or instrumentality of 2 or more units of government now existing or hereafter created within the state, any federated public library system established under s. 43.19 whose territory lies within a single county with a population of 500,000 or more, a local exposition district created under subch. II of ch. 229 and a family long-term care district created under s. 46.2895, except as provided under ss. 40.51 (7) and 40.61 (3) and subch. X. "Employer" does not include a local cultural arts district created under subch. V of ch. 229. Each employer shall be a separate legal jurisdiction for OASDHI purposes.
SECTION 13. 40.02 (28) of the statutes, as affected by 1999 Wisconsin Act 65, is amended to read:
40.02 (28) "Employer" means the state, including each state agency, any county, city, village, town, school district, other governmental unit or instrumentality of 2 or more units of government now existing or hereafter created within the state, any federated public library system established under s. 43.19 whose territory lies within a single county with a population of 500,000 or more, a local exposition district created under subch. II of ch. 229 and a family long-term care district created under s. 46.2895, except as provided under ss. 40.51 (7) and 40.61 (3). "Employer" does not include a local cultural arts district created under subch. V of ch. 229. Each employer shall be a separate legal jurisdiction for OASDHI purposes.
SECTION 14. 40.02 (36) of the statutes is amended to read:
40.02 (36) "Governing body" means the legislature or the head of each state agency with respect to employees of that agency for the state, the common council in cities, the village board in villages, the town board in towns, the county board in counties, the school board in school districts, or the board, commission or other governing body having the final authority for any other unit of government, for any agency or instrumentality of 2 or more units of government, for any federated public library system established under s. 43.19 whose territory lies within a single county with a population of 500,000 or more, for a local exposition district created under subch. II of ch. 229 or for a family long-term care district created under s. 46.2895, but does not include a local cultural arts district created under subch. V of ch. 229.
SECTION 15. 46.21 (2m) (c) of the statutes is amended to read:
46.21 (2m) (c) Exchange of information. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7) and 253.07 (3) (c), a subunit of a county department of human services or tribal agency acting under this subsection may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of human services or tribal agency, with a resource center, a care management organization, or a family long-term care district, with an elder-adult-at-risk agency, an adult-at-risk agency, or any agency to which referral for investigation is made under s. 46.90 (5) (a) 1. or 55.043 (1r) (a) 1g., or with a person providing services to the client under a purchase of services contract with the county department of human services or tribal agency or with a resource center, a care management organization, or a family long-term care district, if necessary to enable an employee or service provider to perform his or her duties, or to enable the county department of human services or tribal agency to coordinate the delivery of services to the client. An agency that releases information under this paragraph shall document that a request for information was received and what information was provided.
SECTION 16. 46.215 (1m) of the statutes is amended to read:
46.215 (1m) EXCHANGE OF INFORMATION; LONG-TERM CARE. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a subunit of a county department of social services or tribal agency acting under this section may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of social services or tribal agency, with a resource center, a care management organization, or a family long-term care district, with an elder-adult-at-risk agency, an adult-at-risk agency, or any agency to which referral for investigation is made under s. 46.90 (5) (a) 1. or 55.043 (1r) (a) 1g., or with a person providing services to the client under a purchase of services contract with the county department of social services or tribal agency or with a resource center, a care management organization, or a family long-term care district, if necessary to enable an employee or service provider to perform his or her duties, or to enable the county department of social services or tribal agency to coordinate the delivery of services to the client. An agency that releases information under this subsection shall document that a request for information was received and what information was provided.
SECTION 17. 46.22 (1) (dm) of the statutes is amended to read:
46.22 (1) (dm) Exchange of information; long-term care. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a subunit of a county department of social services or tribal agency acting under this subsection may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of social services or tribal agency, with a resource center, a care management organization, or a family long-term care district, with an elder-adult-at-risk agency, an adult-at-risk agency, or any agency to which referral for investigation is made under s. 46.90 (5) (a) 1. or 55.043 (1r) (a) 1g., or with a person providing services to the client under a purchase of services contract with the county department of social services or tribal agency or with a resource center, a care management organization, or a family long-term care district, if necessary to enable an employee or service provider to perform his or her duties, or to enable the county department of social services or tribal agency to coordinate the delivery of services to the client. An agency that releases information under this paragraph shall document that a request for information was received and what information was provided.
SECTION 18. 46.23 (3) (e) of the statutes is amended to read:
46.23 (3) (e) Exchange of information; long-term care. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a subunit of a county department of human services or tribal agency acting under this section may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of human services or tribal agency, with a resource center, a care management organization, or a family long-term care district, with an elder-adult-at-risk agency, an adult-at-risk agency, or any agency to which referral for investigation is made under s. 46.90 (5) (a) 1. or 55.043 (1r) (a) 1g., or with a person providing services to the client under a purchase of services contract with the county department of human services or tribal agency or with a resource center, a care management organization, or a family long-term care district, if necessary to enable an employee or service provider to perform his or her duties, or to enable the county department of human services or tribal agency to coordinate the delivery of services to the client. An agency that releases information under this paragraph shall document that a request for information was received and what information was provided.
SECTION 19. 46.27 (7) (fr) 3. c. of the statutes is amended to read:
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.
SECTION 20. 46.2805 (5) of the statutes is renumbered 46.2805 (7r) and amended to read:
46.2805 (7r) "Family Long-term care district" means a special purpose district created under s. 46.2895 (1).
SECTION 21. 46.2805 (6) of the statutes is renumbered 46.2805 (7u) and amended to read:
46.2805 (7u) "Family Long-term care district board" means the governing board of a family long-term care district.
SECTION 22. 46.283 (1) (a) 2. of the statutes is amended to read:
46.283 (1) (a) 2. Whether to create a family long-term care district to apply to the department for a contract to operate a resource center.
SECTION 23. 46.284 (1) (a) 2. of the statutes is amended to read:
46.284 (1) (a) 2. Whether to create a family long-term care district to apply to the department for a contract to operate a care management organization.
SECTION 24. 46.284 (6) of the statutes is amended to read:
46.284 (6) GOVERNING BOARD. A care management organization shall have a governing board that reflects the ethnic and economic diversity of the geographic area served by the care management organization. At least one-fourth of the members of the governing board shall be older persons or persons with physical or developmental disabilities or their family members, guardians or other advocates who are representative of the client group or groups whom the care management organization's enrollee organization is contracted to serve or those clients' family members, guardians, or other advocates.
SECTION 25. 46.285 (1) of the statutes is renumbered 46.285, and 46.285 (intro.), (1) and (2), as renumbered, are amended to read:
46.285 (intro.) In order to meet federal requirements and assure federal financial participation in funding of the family care benefit, a county, a tribe or band, a family long-term care district or an organization, including a private, nonprofit corporation, may not directly operate both a resource center and a care management organization, except as follows:
(1) For an entity with which the department has contracted under s. 46.281 (1) (e) 1., 2005 stats., 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.
****NOTE: This is reconciled s. 46.285 (1) (a). This SECTION has been affected by drafts with the following LRB numbers: 0330 and 1524.
(2) The department may approve separation of the functions of a resource center from those of a care management organization by a means other than those specified in sub. (2) creating a long-term care district under s. 46.2895 to serve either as a resource center or a care management organization.
SECTION 26. 46.285 (2) of the statutes is repealed.
SECTION 27. 46.2895 (title) of the statutes is amended to read:
46.2895 (title) Family Long-term care district.
SECTION 28. 46.2895 (1) (a) (intro.) of the statutes is amended to read:
46.2895 (1) CREATION. (a) (intro.) A county board of supervisors, a tribe or band, or any combination of counties or tribes or bands, may create a special purpose district that is termed a "family long-term care district", that is a local unit of government, that is separate and distinct from, and independent of, the state and the county or tribe or band that created it, and that has the powers and duties specified in this section, if the each county board or tribe or band that participates in creating the district does all of the following:
SECTION 29. 46.2895 (1) (a) 1. a. of the statutes is amended to read:
46.2895 (1) (a) 1. a. Declares the need for establishing the family long-term care district.
SECTION 30. 46.2895 (1) (a) 1. b. of the statutes is amended to read:
46.2895 (1) (a) 1. b. Specifies the family long-term care district's primary purpose, which shall be to operate, under contract with the department, either a resource center under s. 46.283 or, a care management organization under s. 46.284, but not both, or a program described under s. 46.2805 (1) (a) or (b).
SECTION 31. 46.2895 (1) (a) 1. c. of the statutes is created to read:
46.2895 (1) (a) 1. c. Specifies the number of individuals who shall be appointed as members of the long-term care district board, the length of their terms, and, if the long-term care district is created by more than one county or tribe or band, how many members shall be appointed by each county or tribe or band.
SECTION 32. 46.2895 (1) (b) of the statutes is repealed.
SECTION 33. 46.2895 (1) (c) of the statutes is created to read:
46.2895 (1) (c) A long-term care district may not operate a care management organization under s. 46.284 or a program described under s. 46.2805 (1) (a) or (b) if the district operates a resource center under s. 46.283.
SECTION 34. 46.2895 (1) (d) of the statutes is created to read:
46.2895 (1) (d) A county or tribe or band may create more than one long-term care district.
SECTION 35. 46.2895 (1) (e) of the statutes is created to read:
46.2895 (1) (e) A long-term care district may change its primary purpose specified under par. (a) 1. b. if all the counties or tribes or bands that created the district and that have not withdrawn or been removed from the district under sub. (14), adopt a resolution approving the change in primary purpose and if the change in purpose does not violate par. (c) or any provision of a contract between the department and the district.
SECTION 36. 46.2895 (2) of the statutes is amended to read:
46.2895 (2) JURISDICTION. A family long-term care district's jurisdiction is the geographical area of the county or counties of the county board or boards of supervisors who that created the family long-term care district and the geographic area of the reservation of, or lands held in trust for, any tribe or band that created the long-term care district.
SECTION 37. 46.2895 (3) (title) of the statutes is amended to read:
46.2895 (3) (title) FAMILY LONG-TERM CARE DISTRICT BOARD.
SECTION 38. 46.2895 (3) (a) 1. of the statutes is renumbered 46.2895 (3) (a) and amended to read:
46.2895 (3) (a) The county board of supervisors of a county or, in a county with a county administrator or county executive, the county administrator or county executive shall appoint the members of the family long-term care district board, which is the governing board of a family care district under sub. (1) (a) members whom the county is allotted, by resolutions adopted under sub. (1) (a) 1. c., to appoint.
SECTION 39. 46.2895 (3) (a) 2. of the statutes is repealed.
SECTION 40. 46.2895 (3) (b) 1. of the statutes is amended to read:
46.2895 (3) (b) 1. The family care district board appointed under par. (a) 1. shall consist of 15 persons who are residents of the area of jurisdiction of the family care district. At least one-fourth of the members of a long-term care district board shall be representative of the client group or groups whom it is the family long-term care district's primary purpose to serve or those clients' family members, guardians, or other advocates.
SECTION 41. 46.2895 (3) (b) 2. of the statutes is repealed.
SECTION 42. 46.2895 (3) (b) 3. of the statutes is amended to read:
46.2895 (3) (b) 3. Membership of the family a long-term care district board under subd. 1. or 2. shall reflect the ethnic and economic diversity of in the area of jurisdiction of the family long-term care district. Up to one-fourth of the members of the board may be elected or appointed officials or employees of the county or counties that created the family care district.
