SB21,1531
1Section 1531. 46.27 (7g) (e) of the statutes is amended to read:
SB21,640,52 46.27 (7g) (e) From the appropriation under s. 20.435 (7) (4) (im), the
3department shall pay the amount of the payments under par. (d) and shall spend the
4remainder of the funds recovered under this subsection for long-term community
5support services funded under sub. (7) (b).
SB21,1532 6Section 1532. 46.27 (11) (c) 3. of the statutes is amended to read:
SB21,640,107 46.27 (11) (c) 3. Medical assistance reimbursement for services a county, a
8private nonprofit agency or an aging unit with which the department contracts
9provides under this subsection shall be made from the appropriations under s. 20.435
10(4) (bd) and (o) and (7) (b) and (bd).
SB21,1533 11Section 1533. 46.27 (13) of the statutes is created to read:
SB21,640,1512 46.27 (13) Program termination. Notwithstanding subs. (5), (6), (6g), (6u), (7),
13(7m), (8), and (11), after the date the family care benefit, as defined in s. 46.2805 (4),
14is available to eligible residents of a county, the department may discontinue the
15program under this section in that county.
SB21,1534 16Section 1534. 46.271 (1) (a) (intro.) of the statutes is amended to read:
SB21,640,2217 46.271 (1) (a) (intro.) From the appropriation under s. 20.435 (7) (4) (bd), the
18department shall award $100,000 in each fiscal year to applying county departments
19under s. 46.215, 46.22, 46.23, 51.42 or 51.437 or to an aging unit under the conditions
20specified in par. (c) to establish pilot projects for home and community-based
21long-term support services. Funds awarded to the pilot projects shall be used to do
22any of the following:
SB21,1535 23Section 1535. 46.272 of the statutes is created to read:
SB21,640,25 2446.272 Children's community options program. (1) Definitions. In this
25section:
SB21,641,2
1(a) "Child" means a person under 22 years of age who is not receiving services
2in or on a waiting list for an adult long-term care program.
SB21,641,83 (b) "Disability" means a severe physical, developmental, or emotional
4impairment which is diagnosed medically, behaviorally, or psychologically, which is
5characterized by the need for individually planned and coordinated care, treatment,
6vocational rehabilitation, or other services and which has resulted or is likely to
7result in substantial limitation on the ability to function in at least 2 of the following
8areas, equivalent to nursing home or institution for mental disease level of care:
SB21,641,99 1. Self-care.
SB21,641,1010 2. Receptive and expressive language.
SB21,641,1111 3. Learning.
SB21,641,1212 4. Mobility.
SB21,641,1313 5. Self-direction.
SB21,641,1414 (c) "Hospital" has the meaning provided in s. 50.33 (2).
SB21,641,1715 (d) "Institutional setting" means a nursing home, as defined in s. 50.01 (3), a
16state-operated long-term care facility, or any other residential facility that provides
17long-term care to children outside of a home.
SB21,641,2018 (e) "Residence" means the voluntary concurrence of physical presence with
19intent to remain in a place of fixed habitation. Physical presence shall be prima facie
20evidence of intent to remain.
SB21,641,2321 (f) "State-operated long-term care facility" means a state center for the
22developmentally disabled and a Wisconsin veterans home operated by the
23department of veterans affairs under s. 45.50.
SB21,642,3
1(g) "Voluntary" means according to an individual's free choice, if competent, or
2by choice of his or her parent or guardian, if the individual is adjudicated
3incompetent or is a minor.
SB21,642,5 4(2) Departmental duties. The department shall do all of the following to
5establish a children's community options program:
SB21,642,76 (a) Review and approve or disapprove the selection of a county department to
7administer the children's community options program.
SB21,642,158 (b) In consultation with representatives of counties, hospitals, and other
9institutional settings and with recipients of children's community support services,
10develop guidelines for implementing the program and criteria for reviewing
11community options plans from counties participating in the program under this
12section. The guidelines and criteria shall address cost-effectiveness, scope,
13feasibility and impact on the quality and appropriateness of health services and
14social services and shall provide counties with maximum flexibility to develop
15programs that address local needs.
SB21,642,1716 (c) Review and approve or disapprove the community options plan of each
17county participating in the children's community options program.
SB21,642,2018 (d) Require that a county, by use of a form provided by the department or other
19appropriate procedure, ensure that persons receiving services under this section
20meet the eligibility requirements for the children's community options program.
SB21,642,2221 (e) Periodically monitor the implementation of the children's community
22options program.
SB21,642,2523 (f) Review and approve or disapprove the terms of risk reserve escrow accounts
24created under sub. (13) (f) and approve or disapprove disbursements for
25administrative or staff costs from the risk reserve escrow accounts.
SB21,643,2
1(4) Duties of participating county departments. Each participating county
2department shall do all of the following:
SB21,643,63 (a) Appoint members to an advisory committee or appoint an existing
4committee in the service area as the children's community options advisory
5committee to assist in developing the program plan and to monitor the program. The
6committee shall include, but need not be limited to, the following members:
SB21,643,117 1. Parents of children with disabilities including, if possible, parents from
8families that participate in the children's community options program. To the
9maximum extent possible, the parents shall be representative of the various
10disability, racial, and ethnic groups in the service area. The members specified under
11this subdivision shall constitute a majority of the membership of the committee.
SB21,643,1712 2. Persons from the service area representing the county department under s.
1346.23, 51.42, or 51.437 and the county department under s. 46.215 or 46.22, school
14districts, and local health departments, as defined in s. 250.01 (4). At least one of the
15committee members selected under this subdivision shall be a person providing
16community social services to children with disabilities who are eligible for the
17program.
SB21,643,1918 3. Persons in the service area who provide social or educational services to
19children who have disabilities other than the providers specified in subd. 2.
SB21,643,2120 (b) Cooperate with the committee appointed under par. (a) to prepare a
21program plan. The program plan shall include all of the following:
SB21,643,2222 1. A description of the proposed program.
SB21,643,2323 2. The estimated number of families that will be assessed and served.
SB21,643,2524 3. A list of specific groups, if any, that will be given priority for available
25funding.
SB21,644,3
14. A description of the outreach procedures that will be used to ensure that the
2program will be made available to children with physical, emotional, and mental
3impairments.
SB21,644,44 5. The procedures that will be used to determine family needs.
SB21,644,75 6. A description of the methods that will be used for the development and
6monitoring of service plans and for coordinating the provision of services and goods
7to participating families.
SB21,644,98 7. A description of the methods that will be used to promote the creation of
9informal support and advocacy systems for families.
SB21,644,1110 8. A description of the method that will be used to monitor the children's
11community options program.
SB21,644,1612 (c) Submit the proposed program plan to the county board of supervisors in each
13county in the service area for review. After approval by the county board of
14supervisors in each county in which families are eligible to participate in the
15program, the county department shall submit the proposed program plan to the
16department.
SB21,644,1917 (d) Administer the program or contract with a human service agency in the
18service area to administer the program within the limits of state and federal funds
19under subs. (13) and (14).
SB21,644,2420 (e) In conjunction with the county department under s. 46.215 or 46.22, if any,
21in the service area and with the administering agency, if it is not the county
22department under s. 46.23, 51.42, or 51.437, coordinate the administration of the
23program with the administration of other publicly funded programs that serve
24children who have disabilities.
SB21,644,2525 (f) Submit all information and reports required by the department.
SB21,645,4
1(5) Powers and duties of a private nonprofit agency. A private nonprofit
2agency with which the department contracts for service under sub. (14) (b) 3. shall
3have the powers and duties under this section of a county department designated to
4administer the program.
SB21,645,5 5(6) Duties of administering agencies. Each administering agency shall:
SB21,645,66 (a) Cooperate in the development of the program plan under sub. (4) (b).
SB21,645,87 (b) Provide information about the program and other programs for children
8who have disabilities to families in the service area.
SB21,645,99 (c) Implement the program in accordance with the program plan.
SB21,645,1110 (d) Designate one of its employees as the coordinator for each participating
11family.
SB21,645,13 12(7) County department duties. The county department selected to administer
13the children's community options program shall:
SB21,645,2114 (a) Organize assessment activities specified in par. (f) and sub. (8). The county
15department shall utilize persons for each assessment who can determine the needs
16of the child being assessed and who know the availability within the county of
17services. The county department shall coordinate the involvement of
18representatives from the county departments under ss. 46.215, 46.22, 51.42 and
1951.437, and health service providers in the assessment activities specified in sub. (8),
20as well as the child being assessed and members of the child's family or the child's
21guardian.
SB21,645,2522 (b) Within the limits of state and federal funds allocated under sub. (13),
23arrange service contracts under s. 46.036 and ensure the provision of necessary
24long-term community support services for each child who meets the criteria for
25services under the children's community options program.
SB21,646,5
1(c) Within the limits of state and federal funds allocated under sub. (13),
2provide for ongoing care management services in accordance with the requirements
3established under sub. (10) (b) 1., periodic case plan review and follow-up services
4for any child receiving community support services under the children's community
5options program.
SB21,646,86 (d) Determine, under sub. (9), the fee, if any, for all families or guardians of
7children who meet the criteria to receive services and are applying for or receiving
8children's community support services that are funded under sub. (13) or (14).
SB21,647,29 (e) In the instances in which a child who is provided community support
10services under this section for which the child or his or her parent or guardian
11receives direct funding, serve directly as a fiscal agent or contract with a fiscal
12intermediary to serve as a fiscal agent for that child for the purposes of performing
13the responsibilities and protecting the interests of the individual under the
14unemployment insurance law. The county department may elect to act as a fiscal
15agent or contract with a fiscal intermediary to serve as a fiscal agent for a child who
16is provided long-term community support services under s. 46.275, 46.277, 46.278,
1746.2785, 46.495, 51.42, or 51.437. The fiscal agent under this paragraph is
18responsible for remitting any federal unemployment compensation taxes or state
19unemployment insurance contributions owed by the child, including any interest
20and penalties which are owed by the child; for serving as the representative of the
21child in any investigation, meeting, hearing or appeal involving ch. 108 or the federal
22unemployment tax act (26 USC 3301 to 3311) in which the child is a party; and for
23receiving, reviewing, completing and returning all forms, reports and other
24documents required under ch. 108 or the federal unemployment tax act on behalf of
25the child. A child may make an informed, knowing and voluntary election to waive

1the right to a fiscal agent. The waiver may be as to all or any portion of the fiscal
2agent's responsibilities. The waiver may be rescinded in whole or in part at any time.
SB21,647,43 (f) Develop assessments and care plans according to uniform criteria
4established by the department for children in all long-term care programs.
SB21,647,7 5(8) Assessments. Within the limits of state and federal funds allocated under
6sub. (13) and within the limits of fees collected, an assessment shall be conducted for
7any child with a disability who is seeking services in the program.
SB21,647,12 8(9) Financial eligibility and fees. (a) The department shall create a sliding
9scale formula for a fee chargeable for conduct of an assessment under sub. (8), for
10development of a case plan, and for children's long-term community support services
11that is based on the child's ability to pay, unless prohibited from payment under the
12federal Medicaid law.
SB21,647,1613 (b) The county department selected to administer the program shall require all
14children or their parents or guardians applying for children's long-term community
15support services at the time of application and all children receiving the services that
16are funded under sub. (13) or (14) annually to provide the following information:
SB21,647,1717 1. A declaration of income, on a form prescribed by the department.
SB21,647,2018 2. A declaration of costs paid annually for care and services related to the
19special needs or disability of the child for whom the application is made or services
20are provided.
SB21,647,2521 (c) From the information obtained under par. (b), the county department shall
22determine the amount of the fee for receipt of children's long-term community
23support services under this section. The county department shall require payment
24by the child or parent or guardian of the child of 100 percent of the amount calculated
25under this paragraph.
SB21,648,3
1(d) The county department shall used funds received under par (c) to pay for
2long-term community support services for children who are eligible for services
3under the children's community options program.
SB21,648,8 4(10) Services; care management requirements. (a) 1. Within the limits of state
5and federal funds allocated under sub. (13) and within the limits of fees collected, the
6department shall reimburse, if applicable, and the county department or private
7nonprofit agency shall provide long-term community support services to eligible
8children who have a disability.
SB21,648,119 2. The department may not reimburse and the county department or private
10nonprofit agency may not pay for room and board for children under the children's
11community options program.
SB21,648,1412 (b) The department, after consulting with representatives of counties,
13hospitals, and individuals who receive services under the children's community
14options program under this section, shall do all of the following:
SB21,648,1715 1. Establish minimum requirements for the provision of care management
16services, as defined by the department, including standards for care, times for
17performance of duties, and size of case loads.
SB21,648,1918 2. Specify a reasonable schedule for phasing in the requirements established
19under subd. 1.
SB21,648,2120 3. Provide technical consultation and assistance to the administrator of the
21program with respect to the requirements established under subd. 1.
SB21,648,2322 (c) The department need not promulgate as rules under ch. 227 the
23requirements under par. (b) 1. or the schedule under par. (b) 2.
SB21,649,3 24(11) Fiscal responsibility. Except as provided in s. 51.40, and within the
25limitations under sub. (13) (a) 2., the fiscal responsibility of a county for an

1assessment, unless the assessment is performed by an entity under a contract as
2specified under s. 46.284 (2), case plan, or services provided to a child under this
3section is as follows:
SB21,649,64 (a) For a child seeking admission to or about to be admitted to an institutional
5setting, the county in which the child has residence is the county of fiscal
6responsibility.
SB21,649,97 (b) For a child residing in an institutional setting, except a state-operated
8long-term care facility, the county in which the institution is located is the county
9of fiscal responsibility.
SB21,649,1210 (c) For a child living in an institutional setting, except a state-operated
11long-term care facility, whose legal residence is established in another county, the
12county in which the legal residence is established is the county of fiscal responsibility.
SB21,649,1613 (d) For a child residing in a state-operated long-term care facility, or for a
14person protectively placed under ch. 55, the county in which the child has residence
15before he or she enters the state-operated long-term care facility or is protectively
16placed is the county of fiscal responsibility.
SB21,649,20 17(12) Reimbursement disallowances. The department may disallow
18reimbursement under this section for services provided to children who do not meet
19the eligibility requirements for the children's community options program or any
20other eligibility requirements established by the department.
SB21,649,24 21(13) Funding. (a) Subject to pars. (b) and (h), from the appropriation under
22s. 20.435 (4) (bd), the department shall allocate funds to each county or private
23nonprofit agency with which the department contracts for all of the following
24purposes:
SB21,650,7
11. To pay assessment and case plan costs not otherwise paid by fee or under s.
249.45 or 49.78 (2). The department shall reimburse multicounty consortia for the
3cost of assessing children eligible for medical assistance under s. 49.46, 49.468,
449.47, or 49.471 (4) (a) as part of the administrative services of medical assistance,
5payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this
6subdivision to pay the cost of long-term community support services and for a risk
7reserve under par. (f).
SB21,650,158 2. To pay the cost of providing long-term community support services described
9under sub. (7) (b) not otherwise paid under s. 49.45 to children eligible for medical
10assistance under s. 49.46, 49.47, or 49.471 (4) (a). The county department
11administering the program may spend funds received under this paragraph only in
12accordance with the case plan and service contract created for each child receiving
13long-term community support services. Counties may use unspent funds allocated
14under this subdivision from the appropriation under s. 20.435 (4) (bd) for a risk
15reserve under par. (f).
SB21,650,1616 (b) 1. Receipt of funds under this section is subject to s. 46.495 (2).
SB21,650,1817 2. The department may not release funds under this subsection before
18approving the county's community options plan.
SB21,650,2219 3. No county may use funds received under par. (a) 2. to pay for long-term
20community support services provided to any child who resides in a nursing home,
21unless the department waives this restriction on use of funds and the services are
22provided in accordance with a discharge plan.
SB21,650,2423 4. No county may use funds received under this section to purchase land or
24construct buildings.
SB21,651,3
1(c) The department may release funds to counties acting jointly, if the counties
2sign a contract approved by the secretary that explains the plans for joint
3sponsorship.
SB21,651,84 (d) If the department determines that a county demonstrates a pattern of
5failure to serve clients whose cost of care significantly exceeds the average cost of care
6for children's long-term community support services provided under this section, the
7department may require that county to reserve a portion of funds allocated under
8this subsection for provision of service to those clients.
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