46.23(6)(a)(a) A county human services director appointed under
sub. (5) (f) shall have all of the administrative and executive powers and duties of managing, operating, maintaining, and improving the programs of the county department of human services, subject to the rules promulgated by the department of health services for programs, except services or programs under
ch. 48 and
subch. III of ch. 49 and juvenile delinquency-related services or programs, subject to the rules promulgated by the department of children and families for services or programs under
ch. 48 and
subch. III of ch. 49, and subject to the rules promulgated by the department of corrections for juvenile delinquency-related services or programs. In consultation with the county human services board under
sub. (5) and subject to its approval, the county human services director shall prepare:
46.23(6)(a)1.
1. An annual comprehensive plan and budget of all funds necessary for the program and services authorized by this section in which priorities and objectives for the year are established as well as any modifications of long-range objectives.
46.23(6)(a)3.
3. Such other reports as are required by the secretary of health services, by the secretary of corrections, or by the secretary of children and families and the county board of supervisors in a county with a single-county department of human services or the county boards of supervisors in counties with a multicounty department of human services.
46.23(6)(c)
(c) A county human services director under this subsection shall make recommendations to the county human services board under
sub. (5) for:
46.23(6)(c)2.
2. Changes in the organization and management of the program.
46.23(6)(e)
(e) A county human services director under this subsection shall comply with state requirements.
46.23(6m)
(6m) County human services director in certain counties with a county executive or county administrator. In any county with a county executive or county administrator in which the county board of supervisors has established a single-county department of human services, the county executive or county administrator shall appoint a county human services director on the basis of recognized and demonstrated interest in and knowledge of human services problems, with due regard to training, experience, executive and administrative ability and general qualification and fitness for the performance of the duties of the director. The appointment is subject to confirmation by the county board of supervisors unless the county board of supervisors, by ordinance, elects to waive confirmation or unless the appointment is made under a civil service system competitive examination procedure established under
s. 59.52 (8) or
ch. 63. The county human services director, subject only to the supervision of the county executive or county administrator, shall:
46.23(6m)(a)
(a) Supervise and administer any program for which supervision and administration is authorized under this section.
46.23(6m)(b)
(b) Determine administrative and program procedures and administrative policies.
46.23(6m)(c)
(c) Determine, subject to the approval of the county board of supervisors and with the advice of the county human services board under
sub. (5m), whether services are to be provided directly by the county department of human services or contracted for with other providers and make such contracts. The county board of supervisors may elect to require the approval of any such contract by the county board of supervisors.
46.23(6m)(f)
(f) Make recommendations to the county executive or county administrator regarding modifications to the proposed budget prepared by the county human services board under
sub. (5m) (c).
46.23(6m)(j)
(j) Perform other functions necessary to manage, operate, maintain and improve programs.
46.23(6m)(L)
(L) Represent human service agencies, professionals and consumers of services in negotiations with the state and federal governments.
46.23(6m)(m)
(m) Determine the number and location of outstations when appropriate to meet service demands.
46.23 History
History: 1975 c. 39,
224;
1977 c. 29;
1981 c. 20,
93,
291;
1981 c. 329 s.
31;
1983 a. 27 ss.
962,
2202 (20);
1985 a. 29 ss.
844m to
860,
3200 (56) (a);
1985 a. 120,
176,
332;
1987 a. 186;
1987 a. 403 s.
256;
1989 a. 56,
359;
1991 a. 274;
1993 a. 16,
27,
83,
445,
491;
1995 a. 27 ss.
2112 to
2127,
9126 (19),
9130 (4);
1995 a. 64,
201,
352,
417;
1997 a. 3,
164,
268,
283;
1999 a. 9;
2005 a. 264,
388,
406;
2007 a. 20 ss.
878 to
891,
9121 (6) (a);
2007 a. 45,
96; s. 13.92 (2) (i).
46.23 Annotation
There is no unconditional guarantee of continued employment under sub. (3) (d); employment is continued during a reorganization unless civil service rules provide otherwise. Dane County v. McCartney,
166 Wis. 2d 956,
480 N.W.2d 830 (Ct. App. 1992).
46.23 Annotation
Boards and directors may view client information without written and informed consent for any purpose related to their powers and duties. 69 Atty. Gen. 273.
46.23 Annotation
Officers, employees, and directors of public or private entities that furnish "human services" to a county may not be appointed to the board under sub. (4) (a); this provision does not extend to family members of "human services" providers.
80 Atty. Gen. 30.
46.23 Annotation
Because there is no explicit statutory authority for county human services departments to accept gifts, the statutory scheme contemplates that gifts, grants, and donations to a county human services department created under this section may be accepted only by the county board of supervisors.
OAG 1-08.
46.238
46.238
Infants and unborn children whose mothers abuse controlled substances or controlled substance analogs. If a county department under
s. 46.22 or
46.23 or, in a county having a population of 500,000 or more, a county department under
s. 51.42 or
51.437 receives a report under
s. 146.0255 (2), the county department shall offer to provide appropriate services and treatment to the child and the child's mother or to the unborn child, as defined in
s. 48.02 (19), and the expectant mother of the unborn child or the county department shall make arrangements for the provision of appropriate services or treatment.
46.245
46.245
Information for certain pregnant women. Upon request, a county department under
s. 46.215,
46.22 or
46.23 shall distribute the materials described under
s. 253.10 (3) (d), as prepared and distributed by the department. A physician who intends to perform or induce an abortion or another qualified physician, as defined in
s. 253.10 (2) (g), who reasonably believes that he or she might have a patient for whom the information under
s. 253.10 (3) (d) is required to be given, shall request a reasonably adequate number of the materials from the county department under this section or from the department under
s. 253.10 (3) (d). An individual may request a reasonably adequate number of the materials.
46.266
46.266
Treatment funds for mentally ill persons. 46.266(1)(1) Notwithstanding
s. 49.45 (6m) (ag) and except as provided in
sub. (3), if before July 1, 1989, the federal health care financing administration or the department found a skilled nursing facility or intermediate care facility in this state that provides care to medical assistance recipients for which the facility receives reimbursement under
s. 49.45 (6m) to be an institution for mental diseases, the department shall allocate funds from the appropriation under
s. 20.435 (7) (be) for distribution under this section to a county department under
s. 51.42 for the care, in the community or in a facility found to be an institution for mental diseases, of the following persons:
46.266(1)(a)
(a) A person who resided in the facility on the date of the finding whose care in the facility is disallowed for federal financial participation.
46.266(1)(b)
(b) A person who is aged 21 to 64, who has a primary diagnosis of mental illness, who would meet the level of care requirements for medical assistance reimbursement in a skilled nursing facility or intermediate care facility but for a finding that the facility is an institution for mental diseases, and for whom services would be provided in place of a person specified in
par. (a) who discontinues services.
46.266(1)(c)
(c) A person who is provided services in the community under this subsection, who was relocated from a nursing home found to be an institution for mental diseases and who reenters, within 6 months following his or her first receipt of services under this subsection, a nursing home that was, before July 1, 1989, found to be an institution for mental diseases.
46.266(1)(d)
(d) A person in the facility who has been determined under
s. 49.45 (6c) (b) to require active treatment for mental illness.
46.266(2)
(2) Funds distributed under
sub. (1) shall be all of the following:
46.266(2)(a)
(a) The amount of $10,914,700 in each fiscal year, subject to all of the following conditions:
46.266(2)(a)1.
1. Funding for treatment in an institution for mental diseases may not exceed 90% of the daily medical assistance reimbursement rate under
s. 49.45 (6m) of the facility.
46.266(2)(a)2.
2. Funding for community care, for persons who were relocated by a county department to the community from an institution for mental diseases before January 1, 1993, may not exceed 60% of the daily medical assistance reimbursement rate under
s. 49.45 (6m) of the facility.
46.266(2)(a)3.
3. Funding for community care, for persons who were relocated by a county department to the community from an institution for mental diseases after December 31, 1992, may not exceed 90% of the daily medical assistance reimbursement rate under
s. 49.45 (6m) of the facility, if the facility closes a bed under
sub. (8) (a).
46.266(2)(a)4.
4. Funding for community care, for persons who were relocated by a county department to the community from an institution for mental diseases after December 31, 1992, may not exceed 60% of the daily medical assistance reimbursement rate under
s. 49.45 (6m) of the facility, if the requirement to close a bed under
sub. (8) (a) is waived by the department under
sub. (8) (b) or if
sub. (9) applies.
46.266(2)(a)5.
5. Funding for services in the community is not authorized under
s. 46.277 for the person or for a person receiving care under
s. 46.40 and for whom care under
s. 46.277 might be substituted.
46.266(2)(a)6.
6. If funding for treatment in institutions for mental diseases and for community care under this section is insufficient to reimburse all eligible costs, the department shall prorate the funds.
46.266(2)(a)7.
7. Funding under this paragraph shall be reduced by the amount of any funds provided as reimbursement to a skilled nursing facility or intermediate care facility under this paragraph after the date of a finding, if any, by the federal health care financing administration that the facility is no longer an institution for mental diseases and is eligible for reimbursement under
s. 49.45 (6m).
46.266(2)(a)8.
8. Funding under this paragraph requires compliance by an institution for mental diseases with the requirements under
s. 49.45 (6c).
46.266(2)(b)
(b) Funds, calculated according to a method specified by the department, equivalent to the state share of the average daily medical assistance payment for noninstitutional medical services for residents of skilled nursing facilities or intermediate care facilities found to be institutions for mental diseases whose care has been disallowed for federal financial participation.
46.266(3)
(3) The total number of beds in skilled nursing facilities or intermediate care facilities that are funded at any one time under
subs. (1) and
(2) may not exceed the number of beds available for the persons specified in
sub. (1) (a), minus the number of beds reduced under
sub. (8) (a), plus the number of beds added for persons who are specified under
sub. (1) (c) and
(d). The department may redistribute funds for a vacant bed from one county to another county that is seeking to effect the placement of a person in an institution for mental diseases.
46.266(4)
(4) The county department under
s. 51.42 to which funding shall be provided under
sub. (1) is one of the following:
46.266(4)(a)
(a) The county department in the county of residence of the person whose care in the facility has been disallowed for federal financial participation.
46.266(4)(b)
(b) If the department is unable to determine the county of residence under
par. (a), the county department of the county in which is located the facility where the person resided on the date of the finding by the federal health care financing administration or the department.
46.266(5)
(5) The board under
s. 51.42 (5) or, in a county with a county administrator or a county executive, the director under
s. 51.42 (6m) shall use funds provided under this section to contribute to the cost of the person's continued care in an institution for mental diseases or in the community.
46.266(6)
(6) No skilled nursing facility or intermediate care facility that has residents who are 21 to 64 years of age and have primary diagnoses of mental illness may receive funds under this section unless the skilled nursing facility or intermediate care facility has received distinct part or separate licensure under
s. 50.03 (1m).
46.266(7)
(7) The department is not required to decrease the statewide nursing home bed limit under
s. 150.31 to account for institution for mental diseases beds closed under this section and, notwithstanding
subch. II of ch. 150, may redistribute the institution for mental diseases beds made available by the provision of services under this section if the department promulgates rules establishing a method by which the beds will be redistributed.
46.266(8)(a)(a) Except as provided in
sub. (9), if a county department seeks to relocate a person from an institution for mental diseases to the community using funds provided under
sub. (1), the county department shall first obtain approval of the institution for mental diseases to terminate use of the bed occupied by the individual as part of a plan submitted by the institution for mental diseases and approved by the department.
46.266(8)(b)
(b) The department may waive the requirement under
par. (a) for relocations that are part of a plan submitted by the institution for mental diseases and approved by the department that the department expects will result in all of the following:
46.266(8)(b)1.
1. A finding by the federal health care financing administration that the nursing home is no longer an institution for mental diseases.
46.266(8)(b)2.
2. Licensure of the institution for mental diseases as a nursing home under
s. 50.03.
46.266(8)(b)3.
3. Certification by the department of the institution for mental diseases as a provider of medical assistance.
46.266(9)
(9) If approved by the department, an institution for mental diseases may, instead of closing a bed, agree to receive a permanent limitation on payment as a facility under
s. 49.45 (6m) for each person relocated under this section. The department shall promulgate rules to administer this subsection.
46.268
46.268
Relocation services for individuals with mental illness. 46.268(1)(1) Notwithstanding
s. 49.45 (6m) (ag), from the appropriation under
s. 20.435 (7) (be), the department shall distribute not more than $830,000 in each fiscal year in order to provide funding of community services for an eligible individual, if all of the following apply:
46.268(1)(b)
(b) Provision of services is not authorized under
s. 46.277 for the individual or for an individual receiving care under
s. 46.40 and for whom care under
s. 46.277 might be substituted.
46.268(1)(c)1.1. The amount of funds for an individual who was relocated by a county department to the community from a facility before January 1, 1993, does not exceed 60% of the daily medical assistance reimbursement rate of the facility under
s. 49.45 (6m).
46.268(1)(c)2.
2. The amount of funds for an individual who was relocated by a county department to the community from a facility after December 31, 1992, does not exceed 90% of the daily medical assistance reimbursement rate of the facility under
s. 49.45 (6m).
46.268(2)
(2) If an individual who is provided services under
sub. (1) discontinues service receipt, an individual may receive services in his or her place if that individual has mental illness, as defined in
s. 49.45 (6c) (a) 7., is otherwise eligible for medical assistance and is determined under
s. 49.45 (6c) (d) 1. to be in need of active treatment but not to require facility care.
46.268(3)
(3) County matching funds are required for allocations under
sub. (1). A county's required match equals 9.89% of the cost of community service.
46.27
46.27
Long-term support community options program. 46.27(1)(1)
Definitions. In this section:
46.27(1)(a)
(a) "Aging unit" means an aging unit director and necessary personnel, directed by a county commission on aging and organized as one of the following:
46.27(1)(a)1.
1. An agency of county government with the primary purpose of administering programs of services for older individuals of the county.
46.27(1)(a)2.
2. A unit, within a county department under
s. 46.215,
46.22 or
46.23, with the primary purpose of administering programs of services for older individuals of the county.
46.27(1)(ai)
(ai) "Community-based residential facility" means a facility that meets the definition in
s. 50.01 (1g) and that is licensed under
s. 50.03 (1).
46.27(1)(b)
(b) "Nursing home" means a facility that meets the definition in
s. 50.01 (3) and that is licensed under
s. 50.03 (1) and includes a state center for the developmentally disabled and a Wisconsin veterans home operated by the department of veterans affairs under
s. 45.50.
46.27(1)(c)
(c) "Program" means the long-term support community options program.
46.27(1)(d)
(d) "Residence" means the voluntary concurrence of physical presence with intent to remain in a place of fixed habitation. Physical presence shall be prima facie evidence of intent to remain.
