SB377: Bill Text

SB377, s. 25 Section 25. 51.06 (8) (b) 4. of the statutes is amended to read:

SB377,9,14 51.06 (8) (b) 4. An accounting of the costs and savings under the Medical Assistance program of relocations and diversions and the resulting reduction in capacity for services of nursing homes, intermediate care facilities for persons with mental retardation an intellectual disability, and centers for the developmentally disabled. The accounting shall include the per individual savings as well as the collective savings of relocations and diversions.

SB377, s. 26 Section 26. 51.06 (8) (b) 7. of the statutes is amended to read:

SB377,9,21 51.06 (8) (b) 7. Staff turnover rates for nursing homes, intermediate care facilities for persons with mental retardation an intellectual disability, and centers for the developmentally disabled in communities in which an individual relocated or diverted from a nursing home, intermediate care facility for persons with mental retardation an intellectual disability, or center for the developmentally disabled currently resides.

SB377, s. 27 Section 27. 51.42 (6m) (intro.) of the statutes is amended to read:

SB377,9,25 51.42 (6m) County community programs director in certain counties with a county executive or county administrator. (intro.) In any county with a county executive or county administrator in which the county board of supervisors has established a single-county department of community programs, the county executive or county administrator shall appoint and supervise the county community programs director. In any county with a population of 500,000 or more, the county executive or county administrator shall appoint the director of the county department of human services under s. 46.21 as the county community programs director. The appointment of a county community programs director under this subsection shall be on the basis of recognized and demonstrated interest in and knowledge of the problems of mental health, mental retardation intellectual disability, alcoholism and drug addiction, 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 of a county community programs director under this subsection 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 community programs director, subject only to the supervision of the county executive or county administrator, shall:

SB377, s. 28 Section 28. 51.437 (4g) (c) of the statutes is amended to read:

SB377,10,22 51.437 (4g) (c) In a county with a population of 500,000 or more, the county board of supervisors shall integrate day care programs for mentally retarded persons with an intellectual disability and those programs for persons with other developmental disabilities into the county developmental disabilities program.

SB377, s. 29 Section 29. 51.62 (4) of the statutes is amended to read:

SB377,11,3 51.62 (4) Departmental duties. The department shall provide the protection and advocacy agency with copies of annual surveys and plans of correction for intermediate care facilities for persons with mental retardation an intellectual disability on or before the first day of the 2nd month commencing after completion of the survey or plan.

SB377, s. 30 Section 30. 54.01 (8) of the statutes is amended to read:

SB377,11,13 54.01 (8) "Developmental disability" means a disability attributable to mental retardation intellectual disability, cerebral palsy, epilepsy, autism, or another neurological condition closely related to mental retardation an intellectual disability or requiring treatment similar to that required for individuals with mental retardation an intellectual disability, which has continued or can be expected to continue indefinitely, substantially impairs an individual from adequately providing for his or her own care or custody, and constitutes a substantial handicap to the afflicted individual. The term does not include dementia that is primarily caused by degenerative brain disorder.

SB377, s. 31 Section 31. 55.01 (2) of the statutes is amended to read:

SB377,11,23 55.01 (2) "Developmental disability" means a disability attributable to mental retardation intellectual disability, cerebral palsy, epilepsy, autism or another neurological condition closely related to mental retardation an intellectual disability or requiring treatment similar to that required for individuals with mental retardation an intellectual disability, which has continued or can be expected to continue indefinitely, substantially impairs an individual from adequately providing for his or her own care or custody, and constitutes a substantial handicap to the afflicted individual. The term does not include dementia that is primarily caused by degenerative brain disorder.

SB377, s. 32 Section 32. 58.05 (title) of the statutes is amended to read:

SB377,12,2 58.05 (title) Private institutions for persons who are mentally ill or retarded have an intellectual disability.

SB377, s. 33 Section 33. 58.05 (1) of the statutes is amended to read:

SB377,12,11 58.05 (1) The articles of organization of any corporation organized under the laws of this state for the establishment and maintenance of any hospital or other institution for the care, treatment or relief of persons who are mentally ill or retarded have an intellectual disability may contain provisions authorizing it to receive general, special, permanent or temporary endowments and to secure the repayment of the same in accordance with the terms and conditions upon which they may be made by a mortgage upon its real or personal property, or both, or otherwise, in the manner in such articles provided.

SB377, s. 34 Section 34. 146.40 (1) (bt) of the statutes is amended to read:

SB377,12,15 146.40 (1) (bt) "Intermediate care facility for persons with mental retardation an intellectual disability" has the meaning given for "intermediate care facility for the mentally retarded" under 42 USC 1396d (d).

SB377, s. 35 Section 35. 146.40 (2) (intro.) of the statutes is amended to read:

SB377,12,21 146.40 (2) (intro.) A hospital, nursing home, intermediate care facility for persons with mental retardation an intellectual disability, home health agency, or hospice may not employ or contract for the services of an individual as a nurse aide, regardless of the title under which the individual is employed or contracted for, unless one of the following is true:

SB377, s. 36 Section 36. 146.40 (2) (c) (intro.) of the statutes is amended to read:

SB377,13,7 146.40 (2) (c) (intro.) For hospitals, nursing homes, home health agencies or hospices, whether or not certified providers of medical assistance, and intermediate care facilities persons with mental retardation an intellectual disability that are certified providers of medical assistance, the individual is enrolled in an instructional program for nurse aides that is approved under sub. (3) and is employed or under contract as a nurse's assistant, home health aide or hospice aide fewer than 120 calendar days by the hospital, nursing home, home health agency, hospice or intermediate care facility for the mentally retarded persons with an intellectual disability. All of the following applies to an individual specified under this paragraph:

SB377, s. 37 Section 37. 146.40 (2) (c) 2. of the statutes is amended to read:

SB377,13,13 146.40 (2) (c) 2. The hospital, nursing home, home health agency, hospice, or intermediate care facility for persons with mental retardation an intellectual disability may not include the individual in meeting or complying with a requirement for nursing care staff and functions, including a minimum nursing staff requirement.

SB377, s. 38 Section 38. 146.40 (2) (d) of the statutes is amended to read:

SB377,13,21 146.40 (2) (d) For hospitals, nursing homes, home health agencies, or hospices, whether or not certified providers of medical assistance, and intermediate care facilities for persons with mental retardation an intellectual disability that are certified providers of medical assistance, the individual has successfully completed an instructional program and a competency evaluation program for nurse aides that is certified in another state that meets criteria for acceptance in this state as specified by the department by rule.

SB377, s. 39 Section 39. 146.40 (2) (e) of the statutes is amended to read:

SB377,14,5 146.40 (2) (e) For hospitals, home health agencies, or hospices, whether or not certified providers of medical assistance, nursing homes that are not certified providers of medical assistance and intermediate care facilities for persons with mental retardation an intellectual disability that are certified providers of medical assistance, the individual is a student nurse who has successfully completed a basic nursing course from a school that is on the accredited list of schools specified under s. 441.01 (4) or who successfully completes a competency evaluation program for nurse aides that is approved by the department under sub. (3m).

SB377, s. 40 Section 40. 146.40 (2) (g) of the statutes is amended to read:

SB377,14,14 146.40 (2) (g) For hospitals, nursing homes, home health agencies, or hospices, whether or not certified providers of medical assistance, and intermediate care facilities for persons with mental retardation an intellectual disability that are certified providers of medical assistance, the individual, if he or she has performed no nursing-related service for monetary compensation for 24 consecutive months after having satisfied the requirement under par. (a), again successfully completes a competency evaluation program for nurse aides that is approved by the department under sub. (3m).

SB377, s. 41 Section 41. 146.40 (2m) of the statutes is amended to read:

SB377,14,22 146.40 (2m) A nursing home or intermediate care facility for persons with mental retardation an intellectual disability, whether or not the nursing home or intermediate care facility is a certified provider of medical assistance, may not employ or contract for the services of an individual as a feeding assistant, regardless of the title under which the individual is employed or contracted for, unless the individual has successfully completed a state-approved training and testing program, as specified by the department by rule.

SB377, s. 42 Section 42. Subchapter VIII (title) of chapter 150 [precedes 150.96] of the statutes is amended to read:

SB377,14,25 CHAPTER 150

SB377,15,1 SUBCHAPTER VIII

SB377,15,4 MENTAL RETARDATION FACILITIES for the intellectually disabled AND COMMUNITY MENTAL HEALTH CENTERS CONSTRUCTION

SB377, s. 43 Section 43. 150.96 (2) of the statutes is amended to read:

SB377,15,13 150.96 (2) "Facility for the mentally retarded individuals with an intellectual disability" means a facility specially designed for the diagnosis, treatment, education, training or custodial care of the mentally retarded individuals with an intellectual disability; including facilities for training specialists and sheltered workshops for the mentally retarded individuals with an intellectual disability, but only if such workshops are part of facilities which provide or will provide comprehensive services for the mentally retarded individuals with an intellectual disability.

SB377, s. 44 Section 44. 150.96 (4) of the statutes is amended to read:

SB377,15,21 150.96 (4) "Nonprofit facility for the mentally retarded individuals with an intellectual disability", and "nonprofit community mental health center" mean, respectively, a facility for the mentally retarded individuals with an intellectual disability, and a community mental health center which is owned and operated by one or more nonprofit corporations or associations no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual.

SB377, s. 45 Section 45. 150.963 (title) of the statutes is amended to read:

SB377,15,24 150.963 (title) Construction of mental retardation facilities for the intellectually disabled and community mental health centers.

SB377, s. 46 Section 46. 150.963 (2) (a) of the statutes is amended to read:

SB377,16,4 150.963 (2) (a) Making inventories of existing facilities, surveying the need for construction for facilities for the mentally retarded individuals with an intellectual disability and community mental health centers, and developing programs of construction.

SB377, s. 47 Section 47. 150.963 (2) (b) of the statutes is amended to read:

SB377,16,9 150.963 (2) (b) Developing and administering a state plan for the construction of public and other nonprofit facilities for the mentally retarded individuals with an intellectual disability, and a state plan for the construction of public and other nonprofit community mental health centers.

SB377, s. 48 Section 48. 150.965 of the statutes is amended to read:

SB377,16,20 150.965 Construction programs. The department is directed to develop construction programs for facilities for the mentally retarded individuals with an intellectual disability and community mental health centers for the mentally ill, which shall be based respectively on statewide inventories of existing facilities for the mentally retarded individuals with an intellectual disability and the mentally ill and surveys of need, and which shall provide in accordance with regulations prescribed under the federal act, for facilities which will provide adequate services for the mentally retarded individuals with an intellectual disability and adequate community mental health services for the people residing in this state and for furnishing needed services to persons unable to pay therefor.

SB377, s. 49 Section 49. 150.97 of the statutes is amended to read:

SB377,17,2 150.97 Standards for maintenance and operation. The department shall by regulation prescribe, and shall be authorized to enforce, standards for the maintenance and operation of facilities for the mentally retarded individuals with an intellectual disability, and community mental health centers which receive federal aid for construction under the state plans.

SB377, s. 50 Section 50. 150.975 of the statutes is amended to read:

SB377,17,9 150.975 Applications. Applications for mental retardation facility for individuals with an intellectual disability or community mental health center construction projects for which federal funds are requested shall be submitted to the department by the state, a political subdivision thereof or by a public or other nonprofit agency. Each application for a construction project shall conform to federal and state requirements.

SB377, s. 51 Section 51. 150.983 of the statutes is amended to read:

SB377,17,20 150.983 Mental retardation facilities Facilities for individuals with an intellectual disability and community mental health centers construction funds. The department may receive federal funds in behalf of, and transmit them to, applicants. In the general fund there is hereby established, separate and apart from all public moneys of this state, a mental retardation an intellectual disability facilities construction fund and a community mental health centers construction fund. Money received from the federal government for a construction project under this subchapter approved by the secretary shall be deposited to the credit of the appropriate fund and shall be used solely for payments to applicants for work performed, or purchases made, in carrying out the approved project.

SB377, s. 52 Section 52. 155.20 (2) (a) 2. of the statutes is amended to read:

SB377,17,23 155.20 (2) (a) 2. An intermediate care facility for persons with mental retardation an intellectual disability, as defined in s. 46.278 (1m) (am).

SB377, s. 53 Section 53. 155.30 (3) of the statutes is amended to read:

SB377,18,13 155.30 (3) The department shall prepare and provide copies of a power of attorney for health care instrument and accompanying information for distribution in quantities to health care professionals, hospitals, nursing homes, multipurpose senior centers, county clerks, and local bar associations and individually to private persons. The department shall include, in information accompanying the copy of the instrument, at least the statutory definitions of terms used in the instrument, statutory restrictions on who may be witnesses to a valid instrument, a statement explaining that valid witnesses acting in good faith are statutorily immune from civil or criminal liability and a statement explaining that an instrument may, but need not, be filed with the register in probate of the principal's county of residence. The department may charge a reasonable fee for the cost of preparation and distribution. The power of attorney for health care instrument distributed by the department shall include the notice specified in sub. (1) and shall be in the following form:

SB377,18,14 POWER OF ATTORNEY FOR HEALTH CARE

SB377,18,15 Document made this.... day of.... (month),.... (year).

SB377,18,17 CREATION OF POWER OF ATTORNEY FOR HEALTH CARE

SB377,18,25 I,.... (print name, address and date of birth), being of sound mind, intend by this document to create a power of attorney for health care. My executing this power of attorney for health care is voluntary. Despite the creation of this power of attorney for health care, I expect to be fully informed about and allowed to participate in any health care decision for me, to the extent that I am able. For the purposes of this document, "health care decision" means an informed decision to accept, maintain, discontinue or refuse any care, treatment, service or procedure to maintain, diagnose or treat my physical or mental condition.

SB377,19,2 In addition, I may, by this document, specify my wishes with respect to making an anatomical gift upon my death.

SB377,19,3 DESIGNATION OF HEALTH CARE AGENT

SB377,19,18 If I am no longer able to make health care decisions for myself, due to my incapacity, I hereby designate.... (print name, address and telephone number) to be my health care agent for the purpose of making health care decisions on my behalf. If he or she is ever unable or unwilling to do so, I hereby designate.... (print name, address and telephone number) to be my alternate health care agent for the purpose of making health care decisions on my behalf. Neither my health care agent nor my alternate health care agent whom I have designated is my health care provider, an employee of my health care provider, an employee of a health care facility in which I am a patient or a spouse of any of those persons, unless he or she is also my relative. For purposes of this document, "incapacity" exists if 2 physicians or a physician and a psychologist who have personally examined me sign a statement that specifically expresses their opinion that I have a condition that means that I am unable to receive and evaluate information effectively or to communicate decisions to such an extent that I lack the capacity to manage my health care decisions. A copy of that statement must be attached to this document.

SB377,19,19 GENERAL STATEMENT OF AUTHORITY GRANTED

SB377,20,2 Unless I have specified otherwise in this document, if I ever have incapacity I instruct my health care provider to obtain the health care decision of my health care agent, if I need treatment, for all of my health care and treatment. I have discussed my desires thoroughly with my health care agent and believe that he or she understands my philosophy regarding the health care decisions I would make if I were able. I desire that my wishes be carried out through the authority given to my health care agent under this document.

SB377,20,11 If I am unable, due to my incapacity, to make a health care decision, my health care agent is instructed to make the health care decision for me, but my health care agent should try to discuss with me any specific proposed health care if I am able to communicate in any manner, including by blinking my eyes. If this communication cannot be made, my health care agent shall base his or her decision on any health care choices that I have expressed prior to the time of the decision. If I have not expressed a health care choice about the health care in question and communication cannot be made, my health care agent shall base his or her health care decision on what he or she believes to be in my best interest.

SB377,20,12 LIMITATIONS ON MENTAL HEALTH TREATMENT

SB377,20,18 My health care agent may not admit or commit me on an inpatient basis to an institution for mental diseases, an intermediate care facility for persons with mental retardation an intellectual disability, a state treatment facility or a treatment facility. My health care agent may not consent to experimental mental health research or psychosurgery, electroconvulsive treatment or drastic mental health treatment procedures for me.

SB377,20,20 ADMISSION TO NURSING HOMES OR COMMUNITY-BASED RESIDENTIAL FACILITIES

SB377,20,22 My health care agent may admit me to a nursing home or community-based residential facility for short-term stays for recuperative care or respite care.

SB377,20,25 If I have checked "Yes" to the following, my health care agent may admit me for a purpose other than recuperative care or respite care, but if I have checked "No" to the following, my health care agent may not so admit me:

SB377,21,1 1. A nursing home — Yes.... No....

SB377,21,2 2. A community-based residential facility — Yes.... No....

SB377,21,4 If I have not checked either "Yes" or "No" immediately above, my health care agent may admit me only for short-term stays for recuperative care or respite care.

SB377,21,5 PROVISION OF A FEEDING TUBE

SB377,21,10 If I have checked "Yes" to the following, my health care agent may have a feeding tube withheld or withdrawn from me, unless my physician has advised that, in his or her professional judgment, this will cause me pain or will reduce my comfort. If I have checked "No" to the following, my health care agent may not have a feeding tube withheld or withdrawn from me.

SB377,21,13 My health care agent may not have orally ingested nutrition or hydration withheld or withdrawn from me unless provision of the nutrition or hydration is medically contraindicated.

SB377,21,14 Withhold or withdraw a feeding tube — Yes.... No....

SB377,21,16 If I have not checked either "Yes" or "No" immediately above, my health care agent may not have a feeding tube withdrawn from me.

SB377,21,18 HEALTH CARE DECISIONS FOR PREGNANT WOMEN

SB377,21,22 If I have checked "Yes" to the following, my health care agent may make health care decisions for me even if my agent knows I am pregnant. If I have checked "No" to the following, my health care agent may not make health care decisions for me if my health care agent knows I am pregnant.

SB377,21,23 Health care decision if I am pregnant — Yes.... No....

SB377,22,3 If I have not checked either "Yes" or "No" immediately above, my health care agent may not make health care decisions for me if my health care agent knows I am pregnant.

SB377,22,5 STATEMENT OF DESIRES, SPECIAL PROVISIONS OR LIMITATIONS

SB377,22,9 In exercising authority under this document, my health care agent shall act consistently with my following stated desires, if any, and is subject to any special provisions or limitations that I specify. The following are specific desires, provisions or limitations that I wish to state (add more items if needed):