AB296: Bill Text

2009 Assembly BILL 296

June 2, 2009 - Introduced by Joint Legislative Council. Referred to Committee on Children and Families.

AB296,2,11 An Act to repeal 46.56 (1) (i) 1. to 3., 46.56 (1) (k), 46.56 (3) (d) 2. (intro.), 46.56 (8) (L), 46.56 (8) (p) and (q), 46.56 (14) (c) 2., 46.56 (14) (c) 8. and 46.56 (15) (e); to renumber 46.56 (3) (d) 1. (intro.); to renumber and amend 46.56 (1) (c), 46.56 (1) (f), 46.56 (1) (g), 46.56 (1) (o), 46.56 (3) (d) 1. a. to d., 46.56 (3) (d) 2. a. and b., 46.56 (6) (a) 3., 46.56 (6) (a) 4., 48.02 (9s) and 938.02 (9s); to consolidate, renumber and amend 46.56 (1) (i) (intro.) and 4.; to amend 20.435 (7) (co), 38.14 (12), 46.215 (1) (q), 46.22 (1) (b) 1. i., 46.56 (title), 46.56 (1) (a), 46.56 (1) (b), 46.56 (1) (e), 46.56 (1) (h), 46.56 (1) (L), 46.56 (1) (m), 46.56 (1) (n), 46.56 (1) (p), 46.56 (2), 46.56 (3) (a), 46.56 (3) (b) 1., 2., 4., 5. and 7., 46.56 (4) (a) to (e), 46.56 (5) (a), (b) and (d) to (i), 46.56 (6) (title), (a) (intro.), 1. and 2., 46.56 (6) (b), 46.56 (6) (c), 46.56 (7), 46.56 (8) (title), 46.56 (8) (a) to (g) and (h) (intro.), 2., 3., 4., 5. and 6., 46.56 (8) (i) to (k), 46.56 (8) (m) to (o), 46.56 (8) (r) and (s), 46.56 (9), 46.56 (10) to (13), 46.56 (14) (a), 46.56 (14) (b) (intro.), 46.56 (14) (b) 1. and 3., 46.56 (14) (c) (intro.) and 1., 46.56 (14) (c) 3. to 5., 46.56 (14) (c) 6. and 7., 46.56 (14) (d), 46.56 (15) (a) and (b) (intro.), 46.56 (15) (b) 2. to 4., 46.56 (15) (c) and (d), 46.56 (15) (f), 48.33 (1) (c), 48.345 (6m), 49.45 (25) (bm) 2., 51.42 (3) (ar) 14., 51.437 (4m) (m), 51.437 (4r) (a) 3., 115.817 (5) (c), 116.03 (13m), 120.12 (19), 938.33 (1) (c) and 938.34 (6m); to repeal and recreate 59.53 (7); and to create 46.56 (1) (ar), 46.56 (1) (bm), 46.56 (1) (de), (dm) and (ds), 46.56 (1) (nm), 46.56 (1) (op), 46.56 (1) (q), 46.56 (3) (a) 8., 46.56 (3) (b) 8. to 16., 46.56 (3) (d) 3., 46.56 (3) (d) 8. to 12., 46.56 (3) (d) 15., 46.56 (3) (e), 46.56 (5) (j) and (k), 46.56 (6) (cr), 46.56 (6) (d), 46.56 (8) (cm), 46.56 (8) (h) 7. and 8., 46.56 (14) (c) 9., 46.56 (15) (b) 1r. and 46.56 (15) (b) 5. of the statutes; relating to: children and their families who are involved in two or more systems of care and making an appropriation.

Analysis by the Legislative Reference Bureau

This bill is explained in the Notes provided by the Joint Legislative Council in the bill.

For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

Prefatory note: This bill is prepared for the Joint Legislative Council's Special Committee on Strengthening Wisconsin Families.

Under current law, s. 46.56, stats., governs the integrated services programs (ISP) for children with severe disabilities. A "child with severe disabilities" is defined as follows:

An individual who has not attained 18 years of age and whose mental, physical, sensory, behavioral, emotional or developmental disabilities, or whose combination of multiple disabilities meets all of the following conditions:

1. Is severe in degree.

2. Has persisted for at least one year or is expected to persist for at least one year.

3. Causes substantial limitations in the child's ability to function in the family, the school or the community and with the child's ability to cope with the ordinary demands of life.

4. Causes the child to need services from 2 or more service systems.

The ISP began in 1989. As of September 2008, 18 counties operated ISPs. The statute requires a county that operates an ISP to establish a coordinating committee comprised of representatives from multiple systems of care. The coordinating committee must prepare interagency agreements that participating organizations in the ISP agree to follow in creating and operating the ISP. The interagency agreement's components are also outlined by statute. The ISP must have one or more service coordination agencies. The service coordination agency must identify a service coordinator for each child with severe disabilities who participates in the program. Referrals into the ISP may come from many different types of public agencies or organizations, or from the child or the child's family. A treatment team is developed which includes representatives of all service providers working with the family, as well as the family members and the child.

In 2002, the department of health and family services developed a request for proposals for counties to develop coordinated services team (CST) initiatives. The CST model is based on the ISP model of integrated services for children and families with multiple needs. As of October 1, 2008, 33 counties and 2 tribes operate CST initiatives. This bill makes several changes to s. 46.56. Specifically, the bill does the following:

• Expands the ISP's coverage to children who are involved in 2 or more systems of care, as well as their families, and changes the name of the program to the CST initiative.

• To reflect the expansion of the program's focus, changes the terms "integrated services", "integrated service plan", and "interdisciplinary team" to "coordinated services", "coordinated services plan of care", and "coordinated services team", respectively.

• Includes tribes as entities that may administer the CST initiative.

• Provides funding to begin to phase in the remaining counties and tribes that do not currently operate either an ISP or a CST initiative, to enable these counties and tribes to establish the CST initiative.

• Amends the definition of CST to emphasize the process by which the child's family, service providers, and informal resource persons work together to respond to the needs of the child and family, rather than by describing the characteristics of the individuals on the team.

• Expands the required and optional representatives that serve on the coordinating committee in a county or tribe. The coordinating committee is the entity that:

— Prepares interagency agreements for the creation and operation of a CST initiative.

— Assesses how the CST initiative relates to other service coordination programs operating at the county, tribal, or local level.

— Assists the administering agency in developing the application for CST funding.

— Reviews determinations by the service coordination agency regarding program eligibility, appropriate family resources, and funding of services.

• Expands the duties of the coordinating committee to include:

— Establishing operational policies and procedures.

— Ensuring quality, including adherence to core values as adopted by the state advisory committee.

— Developing a plan for orientation of new coordinating committee members and CST members to the CST process.

— Identifying and addressing gaps in services.

— Ensuring client and partner agency satisfaction.

• Creates the role of initiative coordinator, and defines the initiative coordinator's duties, which are to:

— Bring together parents and staff from agencies and organizations to comprise the coordinating committee, and support their activities.

— Work with the coordinating committee to maintain and support agency participation as established in the interagency agreement.

— Work with the coordinating committee and service coordination agency to receive and review referrals.

— Work with the coordinating committee and service coordination agency to assure service coordination for all groups working with the child and the child's family.

— Guide the development of CSTs working with the child and the child's family to ensure compliance with the basic principles of the CST initiative's core values.

— Review plans of care.

— Assist the coordinating committee and family teams in establishing consistent measures for initiative development, implementation, evaluation, and monitoring of the project and outcomes.

— Facilitate public education and awareness of issues and programming for families and children.

— Ensure ongoing support and training related to the CST process to families, service coordinators, and providers.

— Provide support to service providers in developing strategies to enhance existing programs, to increase resources, and to establish new resources.

— Ensure that local and state agencies submit data and reports in an accurate and timely manner.

• Increases the annual appropriation to the department of health services to provide grants to counties for CST initiatives by $1,466,000 in general purpose revenue.

AB296, s. 1 Section 1. 20.435 (7) (co) of the statutes is amended to read:

AB296,4,5 20.435 (7) (co) Integrated service programs for children with severe disabilities Initiatives for coordinated services. The amounts in the schedule to fund county integrated service programs for children with severe disabilities and tribal initiatives under s. 46.56 to provide coordinated services.

Note: Modifies the integrated service program appropriation to provide funding for coordinated services for both county and tribal initiatives.

AB296, s. 2 Section 2. 38.14 (12) of the statutes is amended to read:

AB296,4,13 38.14 (12) Integrated service programs for children with severe disabilities Initiatives to provide coordinated services. If the county board of supervisors establishes an integrated service program for children with severe disabilities initiative to provide coordinated services under s. 59.53 (7), the district board may participate in an integrated service program for children with severe disabilities under s. 59.53 (7) the initiative and may enter into written interagency agreements or contracts under the program initiative.

Note: Modifies the powers of technical college district boards.

AB296, s. 3 Section 3. 46.215 (1) (q) of the statutes is amended to read:

AB296,5,5 46.215 (1) (q) If the county board of supervisors establishes an integrated service program for children with severe disabilities initiative to provide coordinated services under s. 59.53 (7), to participate in and administer an integrated service program for children with severe disabilities under s. 59.53 (7) the initiative, including entering into any written interagency agreements or contracts.

Note: Modifies the duties of the county department of social services in Milwaukee County.

AB296, s. 4 Section 4. 46.22 (1) (b) 1. i. of the statutes is amended to read:

AB296,5,11 46.22 (1) (b) 1. i. If the county board of supervisors establishes an integrated service program for children with severe disabilities initiative to provide coordinated services under s. 59.53 (7), to participate in and administer an integrated service program for children with severe disabilities under s. 59.53 (7) the initiative, including entering into any written interagency agreements or contracts.

Note: Modifies the duties of the county department of social services in counties other than Milwaukee County.

AB296, s. 5 Section 5 . 46.56 (title) of the statutes is amended to read:

AB296,5,14 46.56 (title) Integrated service programs Initiatives to provide coordinated services for children with severe disabilities and families.

AB296, s. 6 Section 6. 46.56 (1) (a) of the statutes is amended to read:

AB296,5,18 46.56 (1) (a) "Administering agency" means a county department designated by the a county board of supervisors or by a tribe to administer the program an initiative.

Note: Modifies the current definition of "administering agency" to include tribes.

AB296, s. 7 Section 7. 46.56 (1) (ar) of the statutes is created to read:

AB296,5,20 46.56 (1) (ar) "Advocacy" means all of the following:

AB296,6,4 1. Actively supporting a child who is involved in 2 or more systems of care and his or her family under an initiative to enable their receipt of the full benefits of the initiative by ensuring that the coordinated services team approach to providing services and principles are followed.

AB296,6,7 2. Helping families of a child who is involved in 2 or more systems of care gain access to and a voice in the decision making that establishes the child's and family's plan of care.

AB296,6,10 3. Fostering strong working relationships among families, systems of care, and providers, with the goal of improving the lives of children who are involved in 2 or more systems of care and their families.

Note: Creates a definition of "advocacy".

AB296, s. 8 Section 8. 46.56 (1) (b) of the statutes is amended to read:

AB296,6,14 46.56 (1) (b) "Agency" means a public, tribal, or private nonprofit organization that provides treatment services for children with severe disabilities and their families services and other resources for children and families.

Note: Modifies the definition of "agency" to include public and tribal organizations and to broaden the description of services and resources provided.

AB296, s. 9 Section 9. 46.56 (1) (bm) of the statutes is created to read:

AB296,6,16 46.56 (1) (bm) "Child" means an individual under the age of 18.

Note: Creates a definition of "child".

AB296, s. 10 Section 10. 46.56 (1) (c) of the statutes is renumbered 46.56 (1) (om), and 46.56 (1) (om) (intro.), 3. and 4., as renumbered, are amended to read:

AB296,7,2 46.56 (1) (om) (intro.) "Child with severe disabilities Severe disability" means an individual who has not attained 18 years of age and whose a mental, physical, sensory, behavioral, emotional, or developmental disabilities disability, including severe emotional disturbance, or whose a combination of multiple these disabilities, that meets all of the following conditions:

AB296,7,5 3. Causes substantial limitations in the a child's ability to function in the his or her family, the school, or the community and with the child's his or her ability to cope with the ordinary demands of life.

AB296,7,7 4. Causes the a child to need services or other resources from 2 or more service systems of care.

Note: Modifies the current definition of "child with severe disabilities" to instead define "severe disability".

AB296, s. 11 Section 11. 46.56 (1) (de), (dm) and (ds) of the statutes are created to read:

AB296,7,10 46.56 (1) (de) "Family" means a child's primary caregiver or caregivers and the child's siblings.

AB296,7,13 (dm) "Family resources" means housing, environment, institutions, sources of income, services, education, a child's extended family and community relationships, and other resources families need to raise their children.

AB296,7,16 (ds) "Initiative" means a system that is based on the strengths of children and their families for providing coordinated services to children who are involved in 2 or more systems of care and their families.

Note: Creates definitions of "family", "family resources", and "initiative".

AB296, s. 12 Section 12. 46.56 (1) (e) of the statutes is amended to read: