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.
SB210, s. 1
1Section
1. 20.435 (7) (co) of the statutes is amended to read:
SB210,4,52
20.435
(7) (co)
Integrated service programs for children with severe disabilities
3Initiatives for coordinated services. The amounts in the schedule to fund county
4integrated service programs for children with severe disabilities and tribal
5initiatives 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.
SB210, s. 2
6Section
2. 38.14 (12) of the statutes is amended to read:
SB210,4,137
38.14
(12) Integrated service programs for children with severe disabilities
8Initiatives to provide coordinated services. If the county board of supervisors
9establishes an
integrated service program for children with severe disabilities 10initiative to provide coordinated services under s. 59.53 (7), the district board may
11participate in
an integrated service program for children with severe disabilities
12under s. 59.53 (7) the initiative and may enter into written interagency agreements
13or contracts under the
program initiative.
Note: Modifies the powers of technical college district boards.
SB210, s. 3
14Section
3. 46.215 (1) (q) of the statutes is amended to read:
SB210,5,5
146.215
(1) (q) If the county board of supervisors establishes an
integrated
2service program for children with severe disabilities initiative to provide coordinated
3services under s. 59.53 (7), to participate in and administer
an integrated service
4program for children with severe disabilities under s. 59.53 (7)
the initiative,
5including entering into any written interagency agreements or contracts.
Note: Modifies the duties of the county department of social services in Milwaukee
County.
SB210, s. 4
6Section
4. 46.22 (1) (b) 1. i. of the statutes is amended to read:
SB210,5,117
46.22
(1) (b) 1. i. If the county board of supervisors establishes an
integrated
8service program for children with severe disabilities initiative to provide coordinated
9services under s. 59.53 (7), to participate in and administer
an integrated service
10program for children with severe disabilities under s. 59.53 (7)
the initiative,
11including 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.
SB210, s. 5
12Section
5
. 46.56 (title) of the statutes is amended to read:
SB210,5,14
1346.56 (title)
Integrated service programs Initiatives to provide
14coordinated services for children with severe disabilities and families.
SB210, s. 6
15Section
6. 46.56 (1) (a) of the statutes is amended to read:
SB210,5,1816
46.56
(1) (a) "Administering agency" means a
county department designated
17by
the a county board of supervisors
or by a tribe to administer
the program an
18initiative.
Note: Modifies the current definition of "administering agency" to include tribes.
SB210, s. 7
19Section
7. 46.56 (1) (ar) of the statutes is created to read:
SB210,5,2020
46.56
(1) (ar) "Advocacy" means all of the following:
SB210,6,4
11. Actively supporting a child who is involved in 2 or more systems of care and
2his or her family under an initiative to enable their receipt of the full benefits of the
3initiative by ensuring that the coordinated services team approach to providing
4services and principles are followed.
SB210,6,75
2. Helping families of a child who is involved in 2 or more systems of care gain
6access to and a voice in the decision making that establishes the child's and family's
7plan of care.
SB210,6,108
3. Fostering strong working relationships among families, systems of care, and
9providers, with the goal of improving the lives of children who are involved in 2 or
10more systems of care and their families.
Note: Creates a definition of "advocacy".
SB210, s. 8
11Section
8. 46.56 (1) (b) of the statutes is amended to read:
SB210,6,1412
46.56
(1) (b) "Agency" means a
public, tribal, or private
nonprofit organization
13that provides
treatment services for children with severe disabilities and their
14families 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.
SB210, s. 9
15Section
9. 46.56 (1) (bm) of the statutes is created to read:
SB210,6,1616
46.56
(1) (bm) "Child" means an individual under the age of 18.
Note: Creates a definition of "child".
SB210, s. 10
17Section
10. 46.56 (1) (c) of the statutes is renumbered 46.56 (1) (om), and 46.56
18(1) (om) (intro.), 3. and 4., as renumbered, are amended to read:
SB210,7,219
46.56
(1) (om) (intro.) "
Child with severe disabilities Severe disability" means
20an individual who has not attained 18 years of age and whose a mental, physical,
21sensory, behavioral, emotional
, or developmental
disabilities disability, including
1severe emotional disturbance, or
whose
a combination of
multiple these disabilities
,
2that meets all of the following conditions:
SB210,7,53
3. Causes substantial limitations in
the a child's ability to function in
the his
4or her family,
the school
, or
the community and with
the child's his or her ability to
5cope with the ordinary demands of life.
SB210,7,76
4. Causes
the a child to need services
or other resources from 2 or more
service 7systems
of care.
Note: Modifies the current definition of "child with severe disabilities" to instead
define "severe disability".
SB210, s. 11
8Section
11. 46.56 (1) (de), (dm) and (ds) of the statutes are created to read:
SB210,7,109
46.56
(1) (de) "Family" means a child's primary caregiver or caregivers and the
10child's siblings.
SB210,7,1311
(dm) "Family resources" means housing, environment, institutions, sources of
12income, services, education, a child's extended family and community relationships,
13and other resources families need to raise their children.
SB210,7,1614
(ds) "Initiative" means a system that is based on the strengths of children and
15their families for providing coordinated services to children who are involved in 2 or
16more systems of care and their families.
Note: Creates definitions of "family", "family resources", and "initiative".
SB210, s. 12
17Section
12. 46.56 (1) (e) of the statutes is amended to read:
SB210,8,218
46.56
(1) (e) "Intake" means the process by which
the a service coordination
19agency
or individuals designated by the coordinating committee under sub. (3) 20initially
screens screen a child
with severe disabilities who is involved in 2 or more
21systems of care and
the child's his or her family to
see if a complete assessment is
22needed determine eligibility for an initiative and the process by which the service
1coordination agency determines the need for a comprehensive clinical mental health
2assessment.
Note: Modifies the definition of "intake".
SB210, s. 13
3Section
13
. 46.56 (1) (f) of the statutes is renumbered 46.56 (1) (ce) and
4amended to read:
SB210,8,85
46.56
(1) (ce) "
Integrated Coordinated services" means treatment, education,
6care
and support, services
, and other resources provided, in a coordinated manner,
7for a child
with severe disabilities who is involved in 2 or more systems of care and
8his or her family.
SB210, s. 14
9Section
14
. 46.56 (1) (g) of the statutes is renumbered 46.56 (1) (cm) and
10amended to read:
SB210,8,1411
46.56
(1) (cm) "
Integrated service plan Coordinated services plan of care"
12means
the a plan
for treatment, education and support services under sub. (8) (h) for
13an eligible a child
with severe disabilities who is involved in 2 or more systems of care 14and
the child's his or her family
under sub. (8) (h).
Note: Sections 13 and 14 modify the current definitions of "integrated services"
and "integrated service plan" to instead define "coordinated services" and "coordinated
services plan of care" and modify those definitions.
SB210, s. 15
15Section
15
. 46.56 (1) (h) of the statutes is amended to read:
SB210,8,2016
46.56
(1) (h) "Interagency agreement" means a written document of
17understanding among service providers
and other partner agencies that are
18represented on a coordinating committee under sub. (3) that identifies mutual
19responsibilities for implementing
integrated coordinated services for children
with
20severe disabilities who are involved in 2 or more systems of care and their families.
Note: Modifies the definition of "interagency agreement".
SB210, s. 16
1Section
16. 46.56 (1) (i) (intro.) and 4. of the statutes are consolidated,
2renumbered 46.56 (1) (cs) and amended to read:
SB210,9,103
46.56
(1) (cs) "
Interdisciplinary team Coordinated services team" means a
4group of
professionals, assembled by the service coordinator, from various service
5systems who meet all of the following criteria: 4. Are providing treatment, education
6or support services to the child with severe disabilities or the child's family, if the
7child or the child's family is receiving any treatment, education or support services 8individuals, including family members, service providers, and informal resource
9persons, who work together to respond to service needs of a child who is involved in
102 or more systems of care and his or her family.