SB565: Bill Text

SB565,22,13 46.18 (15) Joint operation of health-related service. If the county board of supervisors, or the Milwaukee County mental health board, as applicable, so authorizes, the trustees of the county hospital may, together with a private or public organization or affiliation, organize, establish and participate in the governance and operation of an entity to operate, wholly or in part, any health-related service, may participate in the financing of the entity and may provide administrative and financial services or resources for its operation on terms prescribed by the county board of supervisors or the Milwaukee County mental health board, as applicable.

SB565,25 Section 25. 46.19 (4) of the statutes is amended to read:

SB565,22,20 46.19 (4) The salaries of the superintendent, visiting physician and all necessary additional officers and employees shall be fixed by the county board. In Milwaukee County, the salaries of any superintendent of a mental health institution and the salaries of any visiting physician and necessary additional officers and employees whose duties are related to mental health shall be fixed by the county executive.

SB565,26 Section 26. 46.21 (2) (a), (j), (k), (m) and (q), (2m) (a) and (b) 1. (intro.), (3), (3g), (3r), (4), (4m) (a) and (b) and (6) of the statutes are amended to read:

SB565,23,11 46.21 (2) (a) Shall adopt policies for the management, operation, maintenance and improvement of the county hospital; the detention center; the probation section of the children's court center; the provision and maintenance of the physical facilities for the children's court and its intake section under the supervision and operation of the judges assigned to exercise jurisdiction under chs. 48 and 938 and as provided in s. 938.06 (1); the mental health complex; the county department of human services; the central service departments; and all buildings and land used in connection with any institution under this section except a mental health institution. The powers and duties of the county board of supervisors are policy forming only, and not administrative or executive. The county board of supervisors may not form policies regarding mental health or mental health institutions, programs, or services. The Milwaukee County mental health board shall adopt the policies under this paragraph regarding mental health and mental health institutions, programs, and services.

SB565,23,23 (j) May exercise approval or disapproval power over contracts and purchases of the director that are for $50,000 or more, except that the county board of supervisors may not exercise approval or disapproval power over any personal service contract or over any contract or purchase of the director that relates to community living arrangements, adult family homes, or foster homes and that was entered into pursuant to a contract under s. 46.031 (2g) or 301.031 (2g), regardless of whether the contract mentions the provider, except as provided in par. (m). The county board of supervisors may not exercise approval or disapproval power over any contract relating to mental health or mental health institutions, programs, or services. This paragraph does not preclude the county board of supervisors from creating a central purchasing department for all county purchases that are not related to mental health.

SB565,24,7 (k) Shall make sufficient appropriation annually for the support, maintenance, salaries, repairs and improvements to the county department of human services and the institutions, except for mental health institutions. The appropriations shall be used subject to the order of the director or administrator and as the policies adopted by the county board of supervisors provide. The director or administrator may not incur any expense or contract for new buildings, additions to present buildings or the purchase of land until the county board of supervisors, or the Milwaukee County mental health board, as applicable, has appropriated or provided for the money to defray such expense.

SB565,25,5 (m) May establish and maintain in connection with such county hospital, an emergency unit or department for the treatment, subject to such rules as may be prescribed by the county board of supervisors, of persons in the county who may meet with accidents or be suddenly afflicted with illness not contagious; provided that medical care and treatment shall only be furnished in such unit or department until such time as the patient may be safely removed to another hospital or to his or her place of abode, or regularly admitted to the county hospital. The county board of supervisors may also contract with any private hospital or nonprofit hospital within the county for the use of its facilities and for medical service to be furnished by a licensed physician or physicians to patients who require emergency medical treatment or first aid as a result of any accident, injury or sudden affliction of illness occurring within the county, except that reasonable compensation may only be authorized until the patient is regularly admitted as an inpatient or safely removed to another hospital or to his place of abode. In this paragraph, "hospital" includes, without limitation due to enumeration, public health centers, medical facilities and general, tuberculosis, mental, chronic disease and other types of hospitals and related facilities, such as laboratories, outpatient departments, nurses' home and training facilities, and central service facilities operated in connection with hospitals. In this paragraph, "hospital" does not include any hospital furnishing primarily domiciliary care. In this paragraph "nonprofit hospital" means any hospital owned and operated by a corporation or association, no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual.

SB565,25,15 (q) May, together with a private or public organization or affiliation, organize, establish and participate in the governance and operation of an entity to operate, wholly or in part, any health-related service except a mental health-related service, may participate in the financing of the entity and may provide administrative and financial services or resources for its operation on terms prescribed by the county board of supervisors. The Milwaukee County mental health board may, together with a private or public organization or affiliation, organize, establish, and participate in the governance and operation of an entity to operate, wholly or in part, any mental health-related service, may participate in the financing of the entity, and may provide administrative and financial services or resources for its operation.

SB565,25,23 (2m) (a) Creation. The management, operation, maintenance and improvement of human services in a county with a population of 500,000 750,000 or more is vested in a county department of human services under the jurisdiction, as to policy, of the county board of supervisors or, as to mental health policy, the Milwaukee County mental health board. The county department of human services shall consist of the director appointed under sub. (1m), any division administrator appointed under sub. (4) or s. 51.41 (8), and necessary personnel appointed by the director or appointed by a division administrator and approved by the director.

SB565,26,2 (b) 1. (intro.) The county board of supervisors or, in matters related to mental health, the Milwaukee County mental health board may transfer the powers and duties of any human services program under the control of the county and shall transfer all of the following to the county department of human services:

SB565,26,10 (3) Powers and duties of the director. All of the administrative and executive powers and duties of managing, operating, maintaining and improving the county department of human services and other institutions and departments that the county board of supervisors or, in matters of mental health, the Milwaukee County mental health board may place under the jurisdiction of the director are vested in the director, subject to the policies and in accordance with the principles adopted by the county board of supervisors or, in matters of mental health, the Milwaukee County health board.

SB565,26,18 (3g) Powers and duties of the administrator. All of the administrative and executive powers and duties of managing, operating, maintaining and improving the county hospital and other institutions and departments that the county board of supervisors or, in matters of mental health, the Milwaukee County mental health board may place under the jurisdiction of the administrator are vested in the administrator, subject to the policies and in accordance with the principles adopted by the county board of supervisors or, in matters of mental health, the Milwaukee County mental health board.

SB565,26,25 (3r) Other powers and duties. The county board of supervisors or, in matters of mental health, the Milwaukee County mental health board may place under the jurisdiction of county entities not specified under this section the administrative and executive powers and duties of managing, operating, maintaining and improving institutions and departments or other responsibilities that are specified in sub. (2), including functions related to the central service departments and buildings and land used in connection with any institution under sub. (2).

SB565,27,4 (4) Management personnel. The Except as provided in s. 51.41 (8), the director may appoint personnel to manage the county department of human services and the administrator may appoint personnel to manage the county hospital, in accordance with ordinances of the county board of supervisors.

SB565,27,12 (4m) (a) The county hospitals and county sanatoriums of a county with a population of 500,000 750,000 or more shall be devoted to hospital service and the treatment of patients upon such terms and conditions as the county board of supervisors or, in matters of mental health, the Milwaukee County mental health board establishes. The hospitals and sanatoriums may be utilized for instruction of medical students, physicians and nurses and for scientific and clinical research that will promote the welfare of the patients and assist the application of science to the alleviation of human suffering.

SB565,27,16 (b) Professional staff responsible for the care of patients under this subsection may submit bills for professional services under policies adopted by the county board of supervisors or under mental health policies adopted by the Milwaukee County mental health board.

SB565,28,2 (6) Reports; expenditures. The director and the administrator shall submit annually to the county board of supervisors, or to the Milwaukee County mental health board in matters of mental health, reports, including itemized statements of receipts and disbursements, at the times and in the manner that the county board of supervisors or Milwaukee County mental health board specifies and as are required to comply with applicable federal statutes and regulations and state statutes and rules. Disbursements shall be made in the manner that the county board of supervisors or Milwaukee County mental health board, as applicable, adopts, consistent with sound accounting and auditing procedure and with applicable federal statutes and regulations, state statutes and rules and requirements of the county auditor and county department of administration.

SB565,27 Section 27. 46.56 (1) (a) of the statutes is amended to read:

SB565,28,6 46.56 (1) (a) "Administering agency" means a department designated by a county board of supervisors, by the Milwaukee County mental health board in Milwaukee County, or by a tribe to administer an initiative.

SB565,28 Section 28. 46.56 (2) (a) of the statutes, as affected by 2013 Wisconsin Act 20, is amended to read:

SB565,28,15 46.56 (2) (a) Except as provided in par. (b), if a county board of supervisors or the Milwaukee County mental health board establishes an initiative under s. 59.53 (7) or if a tribe establishes an initiative, the county board, Milwaukee County mental health board, or tribe shall appoint a coordinating committee and designate an administering agency. The initiative may be funded by the county or tribe or the county board of supervisors, Milwaukee County mental health board, or tribe may apply for funding by the state in accordance with sub. (15).

SB565,29 Section 29. 46.56 (2) (b) of the statutes, as created by 2013 Wisconsin Act 20, is amended to read:

SB565,29,4 46.56 (2) (b) A county may enter into an agreement with one or more other counties or tribes to establish an initiative and a tribe may enter into an agreement with one or more counties or tribes to establish an initiative. The parties to the agreement shall designate in the agreement a single lead administrative county or lead administrative tribe. The county board of the lead administrative county, the Milwaukee County mental health board, if Milwaukee County is the lead administrative county, or the lead administrative tribe shall appoint a coordinating committee and designate an administering agency. The initiative may be funded by the participating entities, or the county board of supervisors of the lead administrative county, the Milwaukee County mental health board, if Milwaukee County is the lead administrative county, or the lead administrative tribe may apply for funding by the state in accordance with sub. (15).

SB565,30 Section 30. 46.56 (3) (b) 11. of the statutes is amended to read:

SB565,29,8 46.56 (3) (b) 11. Representatives of the county board or, in Milwaukee County, the Milwaukee County mental health board or, for an initiative established by a tribe, representatives of the elected governing body of the tribe.

SB565,31 Section 31. 46.56 (4) (d) of the statutes, as affected by 2013 Wisconsin Act 20, is amended to read:

SB565,29,13 46.56 (4) (d) If the county board of supervisors, Milwaukee County mental health board, or tribe or a multi-entity initiative decides to seek state funding under sub. (15), develop the application in cooperation with the coordinating committee.

SB565,32 Section 32. 46.56 (15) (b) (intro.) of the statutes, as affected by 2013 Wisconsin Act 20, is amended to read:

SB565,29,20 46.56 (15) (b) (intro.) In order to apply for funds under this subsection, the county board of supervisors, Milwaukee County mental health board, or tribe or, for a multi-entity initiative, the county board of the lead administrative county, the Milwaukee County mental health board, if Milwaukee County is the lead administrative county, or the lead administrative tribe shall do all of the following:

SB565,33 Section 33. 51.08 of the statutes is amended to read:

SB565,30,7 51.08 Milwaukee County Mental Health Complex. Any county having a population of 500,000 or more may, pursuant to s. 46.17, establish and maintain a county mental health complex. The county mental health complex shall be a hospital devoted to the detention and care of drug addicts, alcoholics, chronic patients and mentally ill persons whose mental illness is acute. Such hospital shall be governed pursuant to s. 46.21. Treatment of alcoholics at the county mental health complex is subject to approval by the department under s. 51.45 (8). The county mental health complex established pursuant to this section is subject to rules promulgated by the department concerning hospital standards. The county board may not sell the county mental health complex under this section without approval of the Milwaukee County mental health board.

SB565,34 Section 34. 51.20 (18) (a) of the statutes is amended to read:

SB565,30,12 51.20 (18) (a) Unless previously fixed by the county board of supervisors or the Milwaukee County mental health board in the county in which the examination is held, the examiners shall receive a fee as fixed by the court for participation in commitment proceedings, and reasonable reimbursement for travel expenses.

SB565,35 Section 35. 51.41 of the statutes is created to read:

SB565,30,15 51.41 Milwaukee County mental health; Milwaukee County mental health board.

SB565,30,17 (1) Duties of the board. The Milwaukee County mental health board shall do all of the following:

SB565,30,19 (a) Oversee the provision of mental health programs and services in Milwaukee County.

SB565,30,21 (b) Allocate moneys for mental health functions, programs, and services in Milwaukee County within the budget amount set in sub. (3) (a).

SB565,30,22 (c) Make the final determination on mental health policy in Milwaukee County.

SB565,30,24 (d) Replace the Milwaukee County board of supervisors in all mental health functions that are typically performed by a county board of supervisors.

SB565,31,2 (e) Facilitate delivery of mental health services in an efficient and effective manner by making a commitment to all of the following:

SB565,31,4 1. Community-based, person-centered, recovery-oriented, mental health systems.

SB565,31,5 2. Maximizing comprehensive community-based services.

SB565,31,7 3. Prioritizing access to community-based services and reducing reliance on institutional and inpatient care.

SB565,31,10 4. Protecting the personal liberty of individuals experiencing mental illness so that they may be treated in the least restrictive environment to the greatest extent possible.

SB565,31,12 5. Providing early intervention to minimize the length and depth of psychotic and other mental health episodes.

SB565,31,14 6. Diverting people experiencing mental illness from the corrections system when appropriate.

SB565,31,15 7. Maximizing use of mobile crisis units and crisis intervention training.

SB565,31,17 (f) Attempt to achieve costs savings in the provision of mental health programs and services in Milwaukee County.

SB565,31,22 (2) Powers of the board. The Milwaukee County mental health board may request information from the Milwaukee Mental Health Complex, a county department under s. 46.21 or 51.42 or any other Milwaukee County governmental unit that possesses mental health information in order to fulfill its duties of overseeing mental health functions, programs, and services in Milwaukee County.

SB565,32,4 (3) Milwaukee County mental health budget. (a) 1. The Milwaukee County board of supervisors shall incorporate into the budget for Milwaukee County for a fiscal year a total amount of funding for mental health functions, services, and programs that is equal to the sum of any amount held in the mental health reserve fund as described under par. (c) for the fiscal year previous to the fiscal year for which the budget is being determined and the base budget amount of $177,425,000, adjusted as provided in subds. 2. to 4.

SB565,32,8 2. The base budget amount under subd. 1. shall be decreased by an amount equal to any amount held in the mental health reserve fund as described under par. (c) for the fiscal year previous to the fiscal year for which the budget is being determined.

SB565,32,13 3. If there are no moneys in the mental health reserve fund, the Milwaukee County mental health board makes a request to the Milwaukee County executive for a mental health budget increase, and the Milwaukee County executive approves the mental health budget increase, the base budget amount under subd. 1., together with any increase under subd. 4., shall be increased to reflect one of the following:

SB565,32,17 a. Unless subd. 3. b. applies, the percentage change in the consumer price index for all urban consumers, U.S. city average, as determined by the U.S. department of labor, during the calendar year preceding the fiscal year for which the budget is being determined.

SB565,32,21 b. If the percentage change described in subd. 3. a. is positive and if there was a smaller positive percentage change in the property tax levy for Milwaukee County between the 2 calendar years preceding the fiscal year for which the budget is being determined, that smaller positive percentage change.

SB565,33,4 4. If the Milwaukee County mental health board transfers to itself jurisdiction of a function, service, or program under sub. (4) (b) that it did not have jurisdiction over on the effective date of this subdivision .... [LRB inserts date], the base budget amount under subd. 1. shall be increased by an amount equal to the amount expended by Milwaukee County on that function, service, or program in the fiscal year before the fiscal year in which the function, program, or service is transferred. An increase under this subdivision applies for every fiscal year the Milwaukee County mental health board has jurisdiction over that function, service, or program.

SB565,33,8 (b) The Milwaukee County board of supervisors may not in any fiscal year provide funding for and the Milwaukee County executive may not in any fiscal year approve funding for mental health functions, services, and programs that is less than or more than the total amount specified under par. (a) for that fiscal year.

SB565,33,13 (c) The treasurer of Milwaukee County shall hold any unexpended moneys in a fiscal year that had been appropriated for use for mental health functions, programs, and services in a mental health reserve fund. The moneys in the mental health reserve fund may be expended in any fiscal year only for mental health functions, programs, and services in Milwaukee County.

SB565,33,22 (4) Jurisdiction of Milwaukee County board. (a) The Milwaukee County board of supervisors has no jurisdiction over any mental health policy, functions, programs, or services. The Milwaukee County board of supervisors may not create new mental health functions, programs, or services that are under the jurisdiction of the board of supervisors. Any dispute between the Milwaukee County board of supervisors and the Milwaukee County mental health board over whether a function, program, or service is a mental health function, program, or service under the jurisdiction of the Milwaukee County mental health board shall be resolved by the secretary of health services.

SB565,34,3 (b) The Milwaukee County mental health board may transfer jurisdiction over a Milwaukee County function, service, or program to itself that pertains to mental health or is highly integrated with mental health services and that is not under its jurisdiction by statute or by agreement with the Milwaukee County board of supervisors, by an affirmative vote of 8 of the voting Milwaukee County mental health board members if the secretary of health services approves the transfer.

SB565,34,6 (5) Payment of board expenditures. (a) The Milwaukee County board of supervisors and the department shall enter an agreement for the payment of expenses of the Milwaukee County mental health board.

SB565,34,10 (b) The Milwaukee County board of supervisors shall arrange for the payment of expenses from the total budget amount under sub. (3) (a) according to the agreement under par. (a). All payments shall be credited to the appropriation account under s. 20.435 (5) (kf).

SB565,34,14 (6) County department requirements. (a) A county department under s. 46.21 or 51.42 in Milwaukee County may not impede the Milwaukee County mental health board in performing its duties under this section or exercising its powers under this section.

SB565,34,17 (b) A county department under s. 46.21 or 51.42 in Milwaukee County shall respond to any requests for information from the Milwaukee County mental health board.

SB565,34,25 (7) Reports; studies. (a) By March 1, 2015, and annually by March 1 thereafter, the Milwaukee County mental health board shall submit to the Milwaukee County executive, the Milwaukee County board of supervisors, and the department a report including a description of the funding allocations for Milwaukee County's mental health functions, services, and programs and a description of any improvements and efficiencies in those mental health functions, programs, and services. The department shall provide access to the report under this subsection to the public including posting the report on the department's Internet site.

SB565,35,8 (b) The Milwaukee County mental health board shall arrange for a study to be conducted on alternate funding sources for mental health services and programs including fee-for-service models, managed care models that integrate mental health services into the contracts with an increased offset through basic county allocation reduction, and other funding models. By March 1, 2016, the Milwaukee County mental health board shall submit to the Milwaukee County board of supervisors, the Milwaukee County executive, and the department a report of the results of the study.

SB565,35,18 (8) Administrator. (a) The Milwaukee County executive shall nominate an individual to be the administrator of any division of the department under s. 46.21 that administers behavioral health for Milwaukee County. The nominated individual may be hired as the administrator only upon approval of the Milwaukee County mental health board. If the county executive does not nominate an individual by June 1, 2015, the Milwaukee County mental health board may hire an individual to be the administrator. Upon a vacancy in the position of administrator, if the county executive does not nominate an individual within 12 months of the date the position becomes vacant, the Milwaukee County mental health board may hire an individual to be the administrator.

SB565,35,22 (b) The Milwaukee County executive shall determine the salary and benefits and the job duties of the administrator. The county executive may not assign the administrator any duties that are not related to mental health functions, programs, and services in Milwaukee County.

SB565,35,24 (c) 1. The administrator under this subsection may be removed by the Milwaukee County mental health board by a vote of 8 members of that board.

SB565,36,5 2. The Milwaukee County executive may recommend removal of the administrator under this subsection to the Milwaukee County mental health board. If the county executive recommends removal under this subdivision, the Milwaukee County mental health board may remove the administrator upon a vote of 6 members of that board.

SB565,36,8 (d) The Milwaukee County board of supervisors may not hire, remove, or discipline; set the salary or benefits of, or assign or remove any job duties of the administrator under this subsection.

SB565,36,12 (9) Mental health contracts. Any contract related to mental health with a value of at least $100,000, to which Milwaukee County is a party may take effect only if the Milwaukee County mental health board does not vote to reject the contract within 14 days after the contract is signed or countersigned by the county executive.

SB565,36 Section 36. 51.42 (1) (b) of the statutes is amended to read:

SB565,37,20 51.42 (1) (b) County liability. The county board of supervisors except in Milwaukee County, has the primary responsibility for the well-being, treatment and care of the mentally ill, developmentally disabled, alcoholic and other drug dependent citizens residing within its county and for ensuring that those individuals in need of such emergency services found within its county receive immediate emergency services. In Milwaukee County, the Milwaukee County mental health board has the primary responsibility for the well-being, treatment and care of the mentally ill, alcoholic, and other drug dependent citizens residing within Milwaukee County and for ensuring that those individuals in need of such emergency services found within Milwaukee County receive immediate emergency services. The county board of supervisors of Milwaukee County has the primary responsibility for the well-being, treatment, and care of the developmentally disabled citizens residing within Milwaukee County, except where the responsibility is delegated explicitly under this section to the Milwaukee County mental health board, and for ensuring that developmentally disabled individuals in need of such emergency services found within Milwaukee County receive immediate emergency services. This primary responsibility is limited to the programs, services and resources that the county board of supervisors, or, as applicable, the Milwaukee County mental health board, is reasonably able to provide within the limits of available state and federal funds and of county funds required to be appropriated to match state funds. County liability for care and services purchased through or provided by a county department of community programs established under this section shall be based upon the client's county of residence except for emergency services for which liability shall be placed with the county in which the individual is found. For the purpose of establishing county liability, "emergency services" includes those services provided under the authority of s. 55.05 (4), 2003 stats., or s. 55.06 (11) (a), 2003 stats., or s. 51.15, 51.45 (11) (a) or (b) or (12), 55.13, or 55.135 for not more than 72 hours. Nothing in this paragraph prevents recovery of liability under s. 46.10 or any other statute creating liability upon the individual receiving a service or any other designated responsible party, or prevents reimbursement by the department of health services for the actual cost of all care and services from the appropriation under s. 20.435 (7) (da), as provided in s. 51.22 (3).

SB565,37 Section 37. 51.42 (3) (a) of the statutes is amended to read:

SB565,38,6 51.42 (3) (a) Creation. Except as provided under s. 46.23 (3) (b), the county board of supervisors of any county except Milwaukee County, the Milwaukee County mental health board, or the county boards of supervisors of 2 or more counties, shall establish a county department of community programs on a single-county or multicounty basis to administer a community mental health, developmental disabilities, alcoholism and drug abuse program, make appropriations to operate the program and authorize the county department of community programs to apply for grants-in-aid under s. 51.423. The county department of community programs shall consist of a county community programs board, a county community programs director and necessary personnel.

SB565,38 Section 38. 51.42 (3) (ar) 8. of the statutes is amended to read:

SB565,38,17 51.42 (3) (ar) 8. By September 30, submit for inclusion as part of the proposed county budget to the Milwaukee County mental health board in Milwaukee County, to the county executive or county administrator, or, in those counties without a county executive or county administrator, directly to the county board of supervisors in a county with a single-county department of community programs or the county boards of supervisors in counties with a multicounty department of community programs a proposed budget for the succeeding calendar year covering services, including active treatment community mental health center services, based on the plan required under subd. 5. The final budget shall be submitted to the department of health services.

SB565,39 Section 39. 51.42 (3) (ar) 14. of the statutes is amended to read:

SB565,38,22 51.42 (3) (ar) 14. If the county board of supervisors or, as applicable, the Milwaukee County mental health board establishes an initiative to provide coordinated services under s. 59.53 (7), participate in and may administer the initiative, including entering into any written interagency agreements or contracts.

SB565,40 Section 40. 51.42 (3) (b) of the statutes is amended to read:

SB565,39,5 51.42 (3) (b) Other powers and duties. The county board of supervisors of any county with a single-county department of community programs, the Milwaukee County mental health board, and the county boards of supervisors of counties with a multicounty department of community programs may designate the county department of community programs as the administrator of any other county health care program or institution, but the operation of such program or institution is not reimbursable under s. 51.423.

SB565,41 Section 41. 51.42 (4) (a) 2. (intro.) of the statutes is amended to read:

SB565,39,15 51.42 (4) (a) 2. (intro.) In any county with a county executive or county administrator and which has established a single-county department of community programs, the county executive or county administrator shall appoint, subject to confirmation by the Milwaukee County mental health board in Milwaukee County or the county board of supervisors, the county community programs board, which shall be only a policy-making body determining the broad outlines and principles governing the administration of programs under this section. A member of a county community programs board appointed under this subdivision may be removed by the county executive or county administrator under the following circumstances:

SB565,42 Section 42. 51.42 (6m) (intro.) of the statutes is amended to read:

SB565,40,12 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 or the Milwaukee County mental health board 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 500,000 750,000 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, 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, except in Milwaukee County, 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:

SB565,43 Section 43. 51.42 (6m) (c) of the statutes is amended to read:

SB565,40,21 51.42 (6m) (c) Determine, subject to the approval of the county board of supervisors or the Milwaukee County mental health board, as applicable, and with the advice of the county community programs board, whether services are to be provided directly by the county department of community programs or contracted for with other providers and make such contracts. The county board of supervisors, except in Milwaukee County, or the Milwaukee County mental health board in Milwaukee County may elect to require the approval of any such contract by the county board of supervisors or the Milwaukee County mental health board.