AB75-ASA1,596,2
1949.25 Incentive payments for identifying children with health
20insurance. From the appropriation under s. 20.437 (2) (e), the department may
21provide incentive payments to county child support agencies under s. 59.53 (5) for
22identifying children who are receiving medical assistance benefits and who have
23health insurance coverage or access to health insurance coverage. The department
24of children and families may disclose to the department of health services
25information that it possesses or obtains that would assist in identifying children with
1medical assistance coverage who have health insurance coverage or access to health
2insurance coverage.
AB75-ASA1,596,145
49.32
(6) Welfare reform studies. The department shall request proposals
6from persons in this state for studies of the effectiveness of various program changes,
7referred to as welfare reform, to the aid to families with dependent children program,
8including the requirement that certain recipients of aid to families with dependent
9children with children under age 6 participate in training programs,
the learnfare
10school attendance requirement under s. 49.26 (1) (g) and the modification of the
11earned income disregard under s. 49.19 (5) (am). The studies shall evaluate the
12effectiveness of the various efforts, including their cost-effectiveness, in helping
13individuals gain independence through the securing of jobs and providing financial
14incentives and in identifying barriers to independence.
AB75-ASA1,597,216
49.32
(9) (a) Each county department under s. 46.215, 46.22, or 46.23
17administering aid to families with dependent children shall maintain a monthly
18report at its office showing the names of all persons receiving aid to families with
19dependent children together with the amount paid during the preceding month.
20Each Wisconsin Works agency administering Wisconsin Works under ss. 49.141 to
2149.161 shall maintain a monthly report at its office showing the names of all persons
22receiving benefits under s. 49.148 together with the amount paid during the
23preceding month. Nothing in this paragraph shall be construed to authorize or
24require the disclosure in the report of any information (names, amounts of aid or
1otherwise) pertaining to adoptions, or aid furnished for the care of children in foster
2homes
or treatment foster homes under s. 48.645 or 49.19 (10).
AB75-ASA1,598,94
49.32
(10m) (a) A county department, relief agency under s. 49.01 (3m)
, 2009
5stats., or Wisconsin
works Works agency shall, upon request, and after providing the
6notice to the recipient required by this paragraph, release the current address of a
7recipient of relief under s. 49.01 (3),
2009 stats., aid to families with dependent
8children
, or benefits under s. 49.148 to a person, the person's attorney
, or an employee
9or agent of that attorney, if the person is a party to a legal action or proceeding in
10which the recipient is a party or a witness, unless the person is a respondent in an
11action commenced by the recipient under s. 813.12, 813.122, 813.123, 813.125
, or
12813.127. If the person is a respondent in an action commenced by the recipient under
13s. 813.12, 813.122, 813.123, 813.125
, or 813.127, the county department, relief
14agency
, or Wisconsin
works Works agency may not release the current address of the
15recipient. No county department, relief agency
, or Wisconsin
works Works agency
16may release an address under this paragraph until 21 days after the address has
17been requested. A person requesting an address under this paragraph shall be
18required to prove his or her identity and his or her participation as a party in a legal
19action or proceeding in which the recipient is a party or a witness by presenting a
20copy of the pleading or a copy of the subpoena for the witness. The person shall also
21be required to sign a statement setting forth his or her name, address
, and the
22reasons for making the request and indicating that he or she understands the
23provisions of par. (b) with respect to the use of the information obtained. The
24statement shall be made on a form prescribed by the department and shall be sworn
25and notarized. Within 7 days after an address has been requested under this
1paragraph, the county department, relief agency
, or Wisconsin
works Works agency
2shall mail to each recipient whose address has been requested a notification of that
3fact on a form prescribed by the department. The form shall also include the date
4on which the address was requested, the name and address of the person who
5requested the disclosure of the address, the reason that the address was requested
, 6and a statement that the address will be released to the person who requested the
7address no sooner than 21 days after the date on which the request for the address
8was made. County departments, relief agencies
, and Wisconsin
works Works 9agencies shall keep a record of each request for an address under this paragraph.
AB75-ASA1,598,2011
49.34
(1) All services under this subchapter and ch. 48 purchased by the
12department or by a county department under s. 46.215, 46.22, or 46.23 shall be
13authorized and contracted for under the standards established under this section.
14The department may require the county departments to submit the contracts to the
15department for review and approval. For purchases of $10,000 or less the
16requirement for a written contract may be waived by the department. No contract
17is required for care provided by foster homes
or treatment foster homes that are
18required to be licensed under s. 48.62. When the department directly contracts for
19services, it shall follow the procedures in this section in addition to meeting
20purchasing requirements established in s. 16.75.
AB75-ASA1,598,23
2249.343 (title)
Rates for residential care centers and, group homes, and
23child welfare agencies.
AB75-ASA1, s. 1275
24Section
1275. 49.343 (1) of the statutes is renumbered 49.343 (1g) and
25amended to read:
AB75-ASA1,599,9
149.343
(1g) Establishment of rates. Subject to sub. (1m), each residential care
2center for children and youth
, as defined in s. 48.02 (15d), and each group home
, as
3defined in s. 48.02 (7), that is incorporated under ch. 180, 181, 185, or 193 shall
4establish a per client rate for its services and
each child welfare agency shall
5establish a per client administrative rate for the administrative portion of its
6treatment foster care services. A residential care center for children and youth and
7a group home shall charge all purchasers the same rate
for the same services and a
8child welfare agency shall charge all purchasers the same administrative rate for the
9same treatment foster care services.
AB75-ASA1,599,1111
49.343
(1d) Definitions. In this section:
AB75-ASA1,599,1512
(a) "Administrative rate" means the difference between the rate charged by a
13child welfare agency to a purchaser of treatment foster care services and the rate
14paid by the child welfare agency to a treatment foster parent for the care and
15maintenance of a child.
AB75-ASA1,599,1716
(b) "Child welfare agency" means a child welfare agency that is authorized
17under s. 48.61 (7) to license treatment foster homes.
AB75-ASA1,599,1818
(c) "Group home" has the meaning given in s. 48.02 (7).
AB75-ASA1,599,2019
(d) "Residential care center for children and youth" has the meaning given in
20s. 48.02 (15d).
AB75-ASA1, s. 1276g
21Section 1276g. 49.343 (1d) (a) of the statutes, as created by 2009 Wisconsin
22Act .... (this act), is amended to read:
AB75-ASA1,600,223
49.343
(1d) (a) "Administrative rate" means the difference between the rate
24charged by a child welfare agency to a purchaser of
treatment foster care services and
1the rate paid by the child welfare agency to a
treatment foster parent for the care and
2maintenance of a child.
AB75-ASA1, s. 1276j
3Section 1276j. 49.343 (1d) (b) of the statutes, as created by 2009 Wisconsin Act
4.... (this act), is amended to read:
AB75-ASA1,600,65
49.343
(1d) (b) "Child welfare agency" means a child welfare agency that is
6authorized under s. 48.61 (7) to license
treatment foster homes.
AB75-ASA1, s. 1276m
7Section 1276m. 49.343 (1g) of the statutes, as affected by 2009 Wisconsin Act
8.... (this act), section 1275, is amended to read:
AB75-ASA1,600,179
49.343
(1g) Establishment of rates. Subject to sub. (1m), each residential care
10center for children and youth and each group home shall establish a per client rate
11for its services and each child welfare agency shall establish a per client
12administrative rate for the administrative portion of its
treatment foster care
13services. A residential care center for children and youth and a group home shall
14charge all purchasers the same rate for the same services and a child welfare agency
15shall charge all purchasers the same administrative rate for the same
treatment 16foster care services.
The department shall determine the levels of care created under
17the rules promulgated under s. 48.62 (8) to which this section applies.
AB75-ASA1, s. 1277
18Section
1277. 49.343 (1g) of the statutes, as affected by 2009 Wisconsin Act
19.... (this act), sections 1275 and 1276m, is repealed and recreated to read:
AB75-ASA1,601,620
49.343
(1g) Establishment of rates. For services provided beginning on
21January 1, 2011, the department shall establish the per client rate that a residential
22care center for children and youth or a group home may charge for its services, and
23the per client administrative rate that a child welfare agency may charge for the
24administrative portion of its foster care services, as provided in this section. In
25establishing rates for a placement specified in s. 938.357 (4) (c) 1. or 2., the
1department shall consult with the department of corrections. A residential care
2center for children and youth and a group home shall charge all purchasers the same
3rate for the same services and a child welfare agency shall charge all purchasers the
4same administrative rate for the same foster care services. The department shall
5determine the levels of care created under the rules promulgated under s. 48.62 (8)
6to which this section applies.
AB75-ASA1,602,38
49.343
(1m) Negotiation of rates. Notwithstanding sub.
(1) (1g), the
9department, a county department under s. 46.215, 46.22, 46.23, 51.42, or 51.437, a
10group of those county departments, or the department and one or more of those
11county departments, and a residential care center for children and youth or group
12home
, as described in sub. (1), may negotiate a per client rate for the services of that
13residential care center for children and youth or group home,
and the department,
14a county department under s. 46.215, 46.22, 46.23, 51.42, or 51.437, a group of those
15county departments, or the department and one or more of those county
16departments, and a child welfare agency may negotiate a per client administrative
17rate for the administrative portion of the treatment foster care services of that child
18welfare agency, if the department, that county department, the county departments
19in that group of county departments, or the department and one or more of those
20county departments, agree to place 75% or more of the residents of that residential
21care center for children and youth or group home
or of the treatment foster homes
22operated by that child welfare agency during the period for which that rate is
23effective. A residential care center for children and youth or group home that
24negotiates a per client rate under this subsection shall charge
that rate to all
25purchasers of its services
the same rate for the same services and a child welfare
1agency that negotiates a per client administrative rate under this subsection shall
2charge all purchasers of its treatment foster care services the same administrative
3rate for the same treatment foster care services.
AB75-ASA1, s. 1278g
4Section 1278g. 49.343 (1m) of the statutes, as affected by 2009 Wisconsin Act
5.... (this act), section 1278, is amended to read:
AB75-ASA1,602,256
49.343
(1m) Negotiation of rates. Notwithstanding sub. (1g), the
7department, a county department under s. 46.215, 46.22, 46.23, 51.42, or 51.437, a
8group of those county departments, or the department and one or more of those
9county departments, and a residential care center for children and youth or group
10home may negotiate a per client rate for the services of that residential care center
11for children and youth or group home, and the department, a county department
12under s. 46.215, 46.22, 46.23, 51.42, or 51.437, a group of those county departments,
13or the department and one or more of those county departments, and a child welfare
14agency may negotiate a per client administrative rate for the administrative portion
15of the
treatment foster care services of that child welfare agency, if the department,
16that county department, the county departments in that group of county
17departments, or the department and one or more of those county departments, agree
18to place 75% or more of the residents of that residential care center for children and
19youth or group home or of the
treatment foster homes operated by that child welfare
20agency during the period for which that rate is effective. A residential care center
21for children and youth or group home that negotiates a per client rate under this
22subsection shall charge all purchasers of its services the same rate for the same
23services and a child welfare agency that negotiates a per client administrative rate
24under this subsection shall charge all purchasers of its
treatment foster care services
25the same administrative rate for the same
treatment foster care services.
AB75-ASA1, s. 1279
1Section
1279. 49.343 (1m) of the statutes, as affected by 2009 Wisconsin Act
2.... (this act), sections 1278 and 1278g, is repealed.
AB75-ASA1,603,44
49.343
(2) (title)
Determination of rates.
AB75-ASA1, s. 1281
5Section
1281. 49.343 (2) of the statutes is renumbered 49.343 (2) (a) and
6amended to read:
AB75-ASA1,603,187
49.343
(2) (a)
A By October 1, 2010, and annually after that, a residential care
8center for children and youth or a group home
, as described in sub. (1) or (1m), shall
9submit to the department the
rate it charges and any change in that rate before a
10charge is made to any purchaser per client rate that it proposes to charge for services
11provided in the next year and a child welfare agency shall submit to the department
12the proposed per client administrative rate that it proposes to charge for foster care
13services provided in the next year. The department shall provide forms and
14instructions for the submission of
rates and changes in proposed rates under this
15subsection paragraph and a residential care center for children and youth
or a , group
16home
, or child welfare agency that is required to submit a
rate or a change in a 17proposed rate under this
subsection
paragraph shall submit that
rate or change in
18a proposed rate using those forms and instructions.
AB75-ASA1, s. 1282
19Section
1282. 49.343 (2) (a) of the statutes, as affected by 2009 Wisconsin Act
20.... (this act), is repealed and recreated to read:
AB75-ASA1,604,421
49.343
(2) (a) By October 1 annually, a residential care center for children and
22youth or a group home shall submit to the department the per client rate that it
23proposes to charge for services provided in the next year and a child welfare agency
24shall submit to the department the proposed per client administrative rate that it
25proposes to charge for foster care services provided in the next year. The department
1shall provide forms and instructions for the submission of proposed rates under this
2paragraph and a residential care center for children and youth, group home, or child
3welfare agency that is required to submit a proposed rate under this paragraph shall
4submit that proposed rate using those forms and instructions.
AB75-ASA1,604,136
49.343
(2) (b) The department shall review a proposed rate submitted under
7par. (a) and audit the residential care center for children and youth, group home, or
8child welfare agency submitting the proposed rate to determine whether the
9proposed rate is appropriate to the level of services to be provided, the qualifications
10of the residential care center for children and youth, group home, or child welfare
11agency to provide those services, and the reasonable and necessary costs of providing
12those services. In reviewing a proposed rate, the department shall consider all of the
13following factors:
AB75-ASA1,604,1614
1. Changes in the consumer price index for all urban consumers, U.S. city
15average, as determined by the U.S. department of labor, for the 12 months ending
16on June 30 of the year in which the proposed rate is submitted.
AB75-ASA1,604,1917
2. Changes in the allowable costs of the residential care center for children and
18youth, group home, or child welfare agency based on current actual cost data or
19documented projections of costs.
AB75-ASA1,604,2120
3. Changes in program utilization that affect the per client rate or per client
21administrative rate.
AB75-ASA1,604,2222
4. Changes in the department's expectations relating to service delivery.
AB75-ASA1,604,2523
5. Changes in service delivery proposed by the residential care center for
24children and youth, group home, or child welfare agency and agreed to by the
25department.
AB75-ASA1,605,2
16. The loss of any source of revenue that had been used to pay expenses,
2resulting in a lower per client rate or per client administrative rate for services.
AB75-ASA1,605,53
7. Changes in any state or federal laws, rules, or regulations that result in any
4change in the cost of providing services, including any changes in the minimum
5wage, as defined in s. 49.141 (1) (g).
AB75-ASA1,605,66
8. Competitive factors.
AB75-ASA1,605,87
9. The availability of funding to pay for the services to be provided under the
8proposed rate.
AB75-ASA1,605,109
10. Any other factor relevant to the setting of a rate that the department may
10determine by rule promulgated under sub. (4).
AB75-ASA1,605,2212
49.343
(2) (c) If the department determines under par. (b) that a proposed rate
13submitted under par. (a) is appropriate, the department shall approve the proposed
14rate. If the department does not approve a proposed rate, the department shall
15negotiate with the residential care center for children and youth, group home, or
16child welfare agency to determine an agreed to rate. If after negotiations a rate is
17not agreed to, the department and residential care center for children and youth,
18group home, or child welfare agency shall engage in mediation under the rate
19resolution procedure promulgated by rule under sub. (4) to arrive at an agreed to
20rate. If after mediation a rate is not agreed to, the residential care center for children
21and youth, group home, or child welfare agency may not provide the service for which
22the rate was proposed.
AB75-ASA1,606,3
149.343
(3) Audit. The department may require an audit of any residential care
2center for children and youth
or, group home,
as described in sub. (1) or (1m), or child
3welfare agency for the purpose of collecting federal funds.
AB75-ASA1,606,65
49.343
(4) Rules. The department shall promulgate rules to implement this
6section. Those rules shall include rules providing for all of the following:
AB75-ASA1,606,107
(a) Standards for determining whether a proposed rate is appropriate to the
8level of services to be provided, the qualifications of a residential care center for
9children and youth, group home, or child welfare agency to provide those services,
10and the reasonable and necessary costs of providing those services.
AB75-ASA1,606,1111
(b) Factors for the department to consider in reviewing a proposed rate.
AB75-ASA1,606,1412
(c) Procedures for reviewing proposed rates, including rate resolution
13procedures for mediating an agreed to rate when negotiations fail to produce an
14agreed to rate.
AB75-ASA1,607,216
49.345
(14) (a) Except as provided in pars. (b) and (c), liability of a person
17specified in sub. (2) or s. 49.32 (1) for care and maintenance of persons under 18 years
18of age in residential, nonmedical facilities such as group homes, foster homes,
19treatment foster homes, subsidized guardianship homes, and residential care
20centers for children and youth is determined in accordance with the cost-based fee
21established under s. 49.32 (1). The department shall bill the liable person up to any
22amount of liability not paid by an insurer under s. 632.89 (2) or (2m) or by other
233rd-party benefits, subject to rules that include formulas governing ability to pay
24established by the department under s. 49.32 (1). Any liability of the person not
1payable by any other person terminates when the person reaches age 18, unless the
2liable person has prevented payment by any act or omission.
AB75-ASA1,607,114
49.345
(14) (b) Except as provided in par. (c), and subject to par. (cm), liability
5of a parent specified in sub. (2) or s. 49.32 (1) for the care and maintenance of the
6parent's minor child who has been placed by a court order under s. 48.355 or 48.357
7in a residential, nonmedical facility such as a group home, foster home,
treatment
8foster home, subsidized guardianship home, or residential care center for children
9and youth shall be determined by the court by using the percentage standard
10established by the department under s. 49.22 (9) and by applying the percentage
11standard in the manner established by the department under par. (g).
AB75-ASA1,608,513
49.45
(3) (e) 7. The daily reimbursement or payment rate to a hospital for
14services provided to medical assistance recipients awaiting admission to a skilled
15nursing home, intermediate care facility, community-based residential facility,
16group home, foster home,
treatment foster home or other custodial living
17arrangement may not exceed the maximum reimbursement or payment rate based
18on the average adjusted state skilled nursing facility rate, created under sub. (6m).
19This limited reimbursement or payment rate to a hospital commences on the date the
20department, through its own data or information provided by hospitals, determines
21that continued hospitalization is no longer medically necessary or appropriate
22during a period
where when the recipient awaits placement in an alternate custodial
23living arrangement. The department may contract with a peer review organization,
24established under
42 USC 1320c to
1320c-10, to determine that continued
25hospitalization of a recipient is no longer necessary and that admission to an
1alternate custodial living arrangement is more appropriate for the continued care of
2the recipient. In addition, the department may contract with a peer review
3organization to determine the medical necessity or appropriateness of physician
4services or other services provided during the period when a hospital patient awaits
5placement in an alternate custodial living arrangement.
AB75-ASA1,608,137
49.45
(3) (e) 10r. All facilities listed in a certificate of approval issued to a
8free-standing pediatric teaching hospital under s. 50.35 are a hospital for purposes
9of reimbursement under this section. Notwithstanding this subdivision, the
10department shall use physician clinic reimbursement rates to reimburse the
11facilities under this section for types of services for which, before July 1, 2009, the
12department reimbursed the facilities using physician clinic reimbursement rates, as
13determined by the department.
AB75-ASA1,609,215
49.45
(6b) Centers for the developmentally disabled. From the
16appropriation under s. 20.435 (2) (gk), the department may reimburse the cost of
17services provided by the centers for the developmentally disabled.
Reimbursement
18to the centers for the developmentally disabled shall be reduced following each
19placement made under s. 46.275 that involves a relocation from a center for the
20developmentally disabled, by $225 per day, beginning in fiscal year 2002-03, and by
21$325 per day, beginning in fiscal year 2004 Beginning in fiscal year 2009-10,
22following each placement made under s. 46.275 that involves a relocation from a
23center for the developmentally disabled, the department shall reduce the
24reimbursement to the center by an amount, as determined by the department for
1each placement, that is equal to the nonfederal share of the costs for the placement
2under s. 46.275.
AB75-ASA1,609,124
49.45
(6m) (br) 1. Notwithstanding s. 20.410 (3) (cd), 20.435
(4) (bt) or (7) (b)
5or 20.437 (2) (dz), the department shall reduce allocations of funds to counties in the
6amount of the disallowance from the appropriation account under s. 20.435
(4) (bt)
7or (7) (b), or the department shall direct the department of children and families to
8reduce allocations of funds to counties or Wisconsin Works agencies in the amount
9of the disallowance from the appropriation account under s. 20.437 (2) (dz) or direct
10the department of corrections to reduce allocations of funds to counties in the amount
11of the disallowance from the appropriation account under s. 20.410 (3) (cd), in
12accordance with s. 16.544 to the extent applicable.
AB75-ASA1,609,2215
49.45
(6u) (b) Notwithstanding the limitation on the amount of disbursements
16under par. (am) (intro.), from the appropriation under s. 20.435 (4) (wm), the
17department shall, using the criteria specified in par. (am) 1. to 7., disburse any
18federal medical assistance funds that are received by the state as
matching funds to 19federal financial participation for operating deficits incurred by a facility that is
20operated by a county, city, village, or town and that are in excess of the amount of
21match federal financial participation anticipated and budgeted as revenue in the
22biennial budget act for the fiscal year in which the funds are received.
AB75-ASA1,610,137
49.45
(8r) Payment for certain obstetric and gynecological care. The rate
8of payment for obstetric and gynecological care provided in primary care shortage
9areas, as defined in s.
560.183 36.60 (1) (cm), or provided to recipients of medical
10assistance who reside in primary care shortage areas, that is equal to 125% of the
11rates paid under this section to primary care physicians in primary care shortage
12areas, shall be paid to all certified primary care providers who provide obstetric or
13gynecological care to those recipients.
AB75-ASA1, s. 1297
14Section
1297. 49.45 (18) (am) of the statutes is renumbered 49.45 (18) (am)
151. and amended to read:
AB75-ASA1,610,1916
49.45
(18) (am) 1.
No Except as provided in subd. 2., no person is liable under
17this subsection for services provided through prepayment contracts.
This paragraph
18does not apply to a person who is eligible for the benefits under s. 49.46 (2) (a) and
19(b) under s. 49.471.
AB75-ASA1,610,2421
49.45
(18) (am) 2. A person who is eligible for the benefits under s. 49.46 (2) (a)
22and (b) under s. 49.471 is liable under this subsection for services provided through
23a prepayment contract in the amounts and according to the procedures specified by
24the department.
AB75-ASA1,611,4
149.45
(18) (b) 2. Any service provided to a person who is less than 18 years old.
2This subdivision does not apply if the person's family income exceeds 100 percent of
3the poverty line and he or she is eligible for the benefits under s. 49.46 (2) (a) and (b)
4under s. 49.471.
AB75-ASA1,611,136
49.45
(23) (b) If the waiver is granted and in effect, the department may
7promulgate rules defining the health care benefit plan, including more specific
8eligibility requirements and cost-sharing requirements.
Cost sharing may include
9an annual enrollment fee, which may not exceed $75 per year. Notwithstanding s.
10227.24 (3), the plan details under this subsection may be promulgated as an
11emergency rule under s. 227.24 without a finding of emergency. If the waiver is
12granted and in effect, the demonstration project under this subsection shall begin on
13January 1, 2009, or on the effective date of the waiver, whichever is later.