49.162 (3) (am) 5. Host sites for employing individuals or placing work crews under this section must be businesses that are operated for profit, except that in the case of a natural disaster for which the governor has declared a state of emergency under s. 323.10, the department shall give a preference to any work crew placement or host site involved in natural disaster recovery.
32,1386 Section 1386. 49.165 (2) (c) (intro.) of the statutes is amended to read:
49.165 (2) (c) (intro.) No grant may be made to an organization which provides or will provide shelter facilities unless the department of commerce safety and professional services determines that the physical plant of the facility will not be dangerous to the health or safety of the residents when the facility is in operation. No grant may be given to an organization which provides or will provide shelter facilities or private home shelter care unless the organization ensures that the following services will be provided either by that organization or by another organization, person or agency:
32,1388 Section 1388. 49.175 (1) (intro.) of the statutes, as affected by 2009 Wisconsin Act 28, section 1227, is amended to read:
49.175 (1) Allocation of funds. (intro.) Except as provided in sub. (2), within the limits of the appropriations under s. 20.437 (2) (a), (cm), (dz), (k), (kx), (L), (mc), (md), (me), (mf), and (s), the department shall allocate the following amounts for the following purposes:
32,1389 Section 1389. 49.175 (1) (a) of the statutes is amended to read:
49.175 (1) (a) Wisconsin Works benefits. For Wisconsin Works benefits, $49,139,400 $74,650,100 in fiscal year 2009-10 2011-12 and $51,229,600 $72,131,500 in fiscal year 2010-11 2012-13.
32,1390 Section 1390. 49.175 (1) (b) of the statutes is amended to read:
49.175 (1) (b) Wisconsin Works administration. For administration of Wisconsin Works performed under contracts under s. 49.143, $8,247,000 $10,107,200 in fiscal year 2009-10 2011-12 and $8,247,000 $10,107,200 in fiscal year 2010-11 2012-13.
32,1391 Section 1391. 49.175 (1) (f) of the statutes is amended to read:
49.175 (1) (f) Wisconsin Works ancillary services. For program services under Wisconsin Works provided under contracts under s. 49.143, $38,471,500 $47,229,300 in fiscal year 2009-10 2011-12 and $35,471,500 $47,229,300 in fiscal year 2010-11 2012-13.
32,1392 Section 1392. 49.175 (1) (g) of the statutes is amended to read:
49.175 (1) (g) State administration of public assistance programs and costs of overpayment collections. For state administration of public assistance programs and costs associated with the collection of public assistance overpayments, $16,985,900 in fiscal year 2009-10 and $17,091,700 $12,918,900 in each fiscal year 2010-11.
32,1393 Section 1393. 49.175 (1) (i) of the statutes is amended to read:
49.175 (1) (i) Emergency assistance. For emergency assistance under s. 49.138, $6,500,000 and for transfer to the department of administration for low-income energy or weatherization assistance programs, $6,200,000 in fiscal year 2009-10 2011-12 and $6,000,000 in fiscal year 2010-11 2012-13.
32,1393L Section 1393L. 49.175 (1) (L) of the statutes is created to read:
49.175 (1) (L) Transitional jobs demonstration project. For the transitional jobs demonstration project under s. 49.162, $12,000,000 in fiscal year 2011-12.
32,1394 Section 1394. 49.175 (1) (p) of the statutes is amended to read:
49.175 (1) (p) Direct child care services. For direct child care services under s. 49.155, $384,987,600 $301,631,000 in fiscal year 2009-10 2011-12 and $402,496,800 $298,523,500 in fiscal year 2010-11 2012-13.
32,1395 Section 1395. 49.175 (1) (q) of the statutes is amended to read:
49.175 (1) (q) Child care state administration and child care licensing activities. For administration of child care programs under s. 49.155 and the allocation under s. 49.155 (1g) (c) for child care licensing activities, $8,534,700 $19,702,100 in fiscal year 2009-10 2011-12 and $8,889,700 $19,783,800 in fiscal year 2010-11 2012-13.
32,1396 Section 1396. 49.175 (1) (qm) of the statutes is amended to read:
49.175 (1) (qm) Quality care for quality kids. For the child care quality improvement activities specified in s. 49.155 (1g), $5,384,600 $13,486,700 in fiscal year 2009-10 2011-12 and $5,384,600 $13,169,400 in fiscal year 2010-11 2012-13.
32,1397 Section 1397. 49.175 (1) (r) of the statutes is amended to read:
49.175 (1) (r) Children of recipients of supplemental security income. For payments made under s. 49.775 for the support of the dependent children of recipients of supplemental security income, $29,899,800 in fiscal year 2009-10 and $29,933,200 $31,232,200 in each fiscal year thereafter.
32,1398 Section 1398. 49.175 (1) (s) of the statutes is amended to read:
49.175 (1) (s) Kinship care, long-term kinship care, and foster care assistance. For the kinship care and long-term kinship care programs under s. 48.57 (3m), (3n), and (3p) and for foster care for relatives under s. 48.62, $24,435,000 in fiscal year 2009-10 and $24,435,000 $21,375,800 in each fiscal year 2010-11.
32,1399 Section 1399. 49.175 (1) (v) of the statutes is created to read:
49.175 (1) (v) Program improvement plan. For services provided under the child welfare program improvement plan developed under 45 CFR 1355.35, $680,400 in fiscal year 2011-12 and $1,360,800 in each fiscal year thereafter.
32,1400 Section 1400. 49.175 (1) (zh) of the statutes, as affected by 2011 Wisconsin Act 13, is amended to read:
49.175 (1) (zh) Earned income tax credit supplement. For the transfer of moneys from the appropriation account under s. 20.437 (2) (md) to the appropriation account under s. 20.835 (2) (kf) for the earned income tax credit, $6,664,200 in fiscal year 2009-10 and $43,664,200 in each fiscal year 2010-11.
32,1402m Section 1402m. 49.197 (1m) of the statutes is amended to read:
49.197 (1m) Fraud investigation. From the appropriations under s. 20.437 (2) (dz), (kx), (L), (mc), (md), (me), and (nL), the department shall establish a program to investigate suspected fraudulent activity on the part of recipients of aid to families with dependent children under s. 49.19, on the part of participants in the Wisconsin Works program under ss. 49.141 to 49.161, and, if the department of health services contracts with the department under sub. (5), on the part of recipients of medical assistance under subch. IV, food stamp benefits under the food stamp program under 7 USC 2011 to 2036, supplemental security income payments under s. 49.77, payments for the support of children of supplemental security income recipients under s. 49.775, and health care benefits under the Badger Care health care program under s. 49.665. The department's activities under this subsection may include, but are not limited to, comparisons of information provided to the department by an applicant and information provided by the applicant to other federal, state, and local agencies, development of an advisory welfare investigation prosecution standard, and provision of funds to county departments under ss. 46.215, 46.22, and 46.23 or multicounty consortia, as defined in s. 49.78 (1) (br), and to Wisconsin Works agencies to encourage activities to detect fraud. The department shall cooperate with district attorneys regarding fraud prosecutions.
32,1405g Section 1405g. 49.197 (2) of the statutes is repealed and recreated to read:
49.197 (2) Incentive program for local fraud detection. (a) In this subsection:
1. "County department" means a county department under s. 46.22 or 46.23.
2. "Subsidy program" means the child care subsidy program under s. 49.155.
3. "Tribal governing body" means an elected governing body of a federally recognized American Indian tribe.
(b) 1. Subject to subd. 2., the department shall by rule establish an incentive program that, using moneys from the allocation under s. 49.175 (1) (p), rewards county departments, Wisconsin Works agencies, and tribal governing bodies that administer the subsidy program for identifying fraud in the subsidy program. The rules shall specify that a county department, Wisconsin Works agency, or tribal governing body shall receive, for identifying fraudulent activity under the subsidy program on the part of a child care provider, an amount equal to the average monthly subsidy payment per child during the prior fiscal year, multiplied by the number of children participating in the subsidy program for whom the provider provides care, multiplied by 1.5 months. A county department, Wisconsin Works agency, or tribal governing body may use payments received under this subsection for any purpose for which moneys under the Temporary Assistance for Needy Families block grant program may be used under federal law.
2. No later than January 1, 2012, the department shall submit its plan for the incentive program to the cochairpersons of the joint committee on finance for review by the committee. If the cochairpersons of the committee do not notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposed plan within 14 working days after the date of the department's submittal, the department shall promulgate the rules for the incentive program in accordance with its proposed plan. If, within 14 working days after the date of the department's submittal, the cochairpersons of the committee notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposed plan, the department may not promulgate the rules for the incentive program unless the committee approves the proposed plan. If the committee modifies and approves the proposed plan, the department may promulgate the rules for the incentive program only as modified by the committee.
32,1408m Section 1408m. 49.197 (4) of the statutes is amended to read:
49.197 (4) County and tribal error reduction. If the department of health services contracts with the department under sub. (5), the department shall provide funds from the appropriation under s. 20.437 (2) (kx) to counties, multicounty consortia, as defined in s. 49.78 (1) (br), and governing bodies of federally recognized American Indian tribes administering Medical Assistance under subch. IV, the food stamp program under 7 USC 2011 to 2036, the supplemental security income payments program under s. 49.77, the program providing payments for the support of children of supplemental security income recipients under s. 49.775, and the Badger Care health care program under s. 49.665 to offset administrative costs of reducing payment errors in those programs.
32,1415 Section 1415. 49.265 (4) (a) of the statutes is amended to read:
49.265 (4) (a) The department shall distribute the federal community services block grant funds received under 42 USC 9903 and deposited in credited to the appropriations appropriation account under s. 20.437 (1) (mc) and (md) (2) (mg).
32,1420m Section 1420m. 49.43 (2r) of the statutes is created to read:
49.43 (2r) "County," "county department," and "county department under s. 46.215, 46.22, or 46.23" includes a multicounty consortium in accordance with a contract under s. 49.78 (2).
32,1422m Section 1422m. 49.43 (8m) of the statutes is created to read:
49.43 (8m) "Multicounty consortium" has the meaning given in s. 49.78 (1) (br).
32,1423k Section 1423k. 49.45 (2m) of the statutes, as created by 2011 Wisconsin Act 10, is repealed and recreated to read:
49.45 (2m) Authorization for modifications to programs; study. (a) In this subsection, "Medical Assistance program" includes any program operated under this subchapter, demonstration program operated under 42 USC 1315, and program operated under a waiver of federal law relating to medical assistance that is granted by the federal department of health and human services.
(b) The department shall study potential changes to the Medical Assistance state plan and to waivers of federal law relating to medical assistance obtained from the federal department of health and human services for all of the following purposes:
1. Increasing the cost effectiveness and efficiency of care and the care delivery system for Medical Assistance programs.
2. Limiting switching from private health insurance to Medical Assistance programs.
3. Ensuring the long-term viability and sustainability of Medical Assistance programs.
4. Advancing the accuracy and reliability of eligibility for Medical Assistance programs and claims determinations and payments.
5. Improving the health status of individuals who receive benefits under a Medical Assistance program.
6. Aligning Medical Assistance program benefit recipient and service provider incentives with health care outcomes.
7. Supporting responsibility and choice of medical assistance recipients.
(c) Subject to par. (d), if the department determines, as a result of the study under par. (b), that revision of existing statutes or rules would be necessary to advance a purpose described in par. (b) 1. to 7., the department may propose a policy that makes any of the following changes related to Medical Assistance programs:
1. Requires cost sharing from program benefit recipients up to the maximum allowed by federal law or a waiver of federal law.
2. Authorizes providers to deny care or services if a program benefit recipient is unable to share costs, to the extent allowed by federal law or waiver.
3. Modifies existing benefits or establishes various benefit packages and offers different packages to different groups of recipients.
4. Revises provider reimbursement models for particular services.
5. Mandates that program benefit recipients enroll in managed care.
6. Restricts or eliminates presumptive eligibility.
7. To the extent permitted by federal law, imposes restrictions on providing benefits to individuals who are not citizens of the United States.
8. Sets standards for establishing and verifying eligibility requirements.
9. Develops standards and methodologies to assure accurate eligibility determinations and redetermines continuing eligibility.
10. Reduces income levels for purposes of determining eligibility to the extent allowed by federal law or waiver and subject to the limitations under par. (e) 2.
(d) Before implementing a policy proposed under par. (c) that conflicts with a statute, and before submitting any amendment or waiver request under par. (e) that is necessary to implement any such policy, the department shall submit to the joint committee on finance the proposed amendment or waiver request and estimates of the projected cost savings associated with that amendment or waiver request. If the cochairpersons of the committee do not notify the department within 14 working days after the date of the department's submittal that the committee has scheduled a meeting for the purpose of reviewing the proposed amendment or waiver request, the proposed amendment or waiver request may be submitted to the federal department of health and human services. If, within 14 working days after the date of the department's submittal, the cochairpersons of the committee notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposed amendment or waiver request, the proposed amendment or waiver requested may be submitted only on approval of the committee.
(e) 1. Subject to par. (d), the department shall submit an amendment to the state Medical Assistance plan or request a waiver of federal laws related to medical assistance, if necessary, to the extent necessary to implement any policy created under par. (c). If the federal department of health and human services does not allow the amendment or does not grant the waiver, the department may not implement the policy.
2. The department shall request a waiver from the secretary of the federal department of health and human services to permit the department to have in effect eligibility standards, methodologies, and procedures under the state Medical Assistance plan or waivers of federal laws related to medical assistance that are more restrictive than those in place on March 23, 2010. If the waiver request does not receive federal approval before December 31, 2011, the department shall reduce income levels on July 1, 2012, for the purposes of determining eligibility to 133 percent of the federal poverty line for adults who are not pregnant and not disabled, to the extent permitted under 42 USC 1396a (gg), if the department follows the procedures under 42 USC 1396a (gg) (3).
(f) Within 90 days after the effective date of this paragraph .... [LRB inserts date], and every 90 days thereafter, the department shall submit to the joint committee on finance a report that contains all of the following information:
1. An updated description of any Medical Assistance program changes implemented by the department, including any amendments to the Medical Assistance state plan.
2. An updated estimate of the projected savings associated with any changes described under subd. 1.
3. An updated projection of the total Medical Assistance program benefit expenditures during the fiscal biennium and an analysis of how these projected expenditures compare to the funding provided in the 2011-13 biennial budget act.
32,1423m Section 1423m. 49.45 (2m) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is repealed.
32,1424p Section 1424p. 49.45 (3) (n) of the statutes, as created by 2011 Wisconsin Act 10, is repealed and recreated to read:
49.45 (3) (n) This subsection does not apply if the department creates a policy under sub. (2m) (c) 4., to the extent that the policy conflicts with this subsection.
32,1424q Section 1424q. 49.45 (3) (n) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is repealed.
32,1427 Section 1427. 49.45 (5m) (am) of the statutes is amended to read:
49.45 (5m) (am) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gm), (o), (w) and (xc), the department shall distribute not more than $5,000,000 in each fiscal year, to provide supplemental funds to rural hospitals that, as determined by the department, have high utilization of inpatient services by patients whose care is provided from governmental sources, except that the department may not distribute funds to a rural hospital to the extent that the distribution would exceed any limitation under 42 USC 1396b (i) (3).
32,1428 Section 1428. 49.45 (6m) (a) 6. of the statutes is amended to read:
49.45 (6m) (a) 6. "Resource Utilization Groupings III" means a comparative resource utilization grouping that classifies each facility resident based on information obtained from performing, for the resident, a minimum data set assessment developed by the federal Centers for Medicare and Medicaid Services.
32,1429 Section 1429. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:
49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this subsection made under s. 20.435 (4) (b), (gm), (o), (pa), or (w) shall, except as provided in pars. (bg), (bm), and (br), be determined according to a prospective payment system updated annually by the department. The payment system shall implement standards that are necessary and proper for providing patient care and that meet quality and safety standards established under subch. II of ch. 50 and ch. 150. The payment system shall reflect all of the following:
32,1430 Section 1430. 49.45 (6m) (ag) 3p. a. of the statutes is amended to read:
49.45 (6m) (ag) 3p. a. The system shall may incorporate acuity measurements under the most recent Resource Utilization Groupings III methodology to determine factors for case-mix adjustment.
32,1430c Section 1430c. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:
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