SB21: Bill Text

SB21,653,21 (b) 1. Medical assistance reimbursement for services a county or a private nonprofit agency, or with which the department contracts provides under this subsection shall be made from the appropriations under s. 20.435 (4) (bd) and (o) and (7) (b). Payments made under sub. (13) (a) may be used as the state share for purposes of Medical Assistance reimbursement.

SB21,653,23 3. The department may contract for services under this subsection with a county or a private nonprofit agency.

SB21,654,2 4. No county or private nonprofit agency may use funds received under this subsection to provide residential services in a group home, as defined in s. 48.02 (7), that has more than 5 beds, unless the department approves the provision of services in a group home that has 6 to 8 beds.

SB21,654,5 (c) If a county department or private nonprofit agency providing services under this subsection is certified under s. 49.45 (37) (a), the waiver under s. 49.45 (37), if in effect, applies to plans of care for children receiving services under this subsection.

SB21,654,9 (15) Right to hearing. A child who is denied eligibility for services or whose services are reduced or terminated under this section may request a hearing from the department under s. 227.44, except that lack of adequate funding may not serve as the basis for a request under this subsection.

SB21,1536 Section 1536. 46.277 (5g) (b) of the statutes is renumbered 46.277 (5g) (b) (intro.) and amended to read:

SB21,654,15 46.277 (5g) (b) (intro.) This section does not apply to the delicensure of a bed of an institution for mental diseases of an individual who is aged 21 to 64, who has a primary diagnosis of mental illness and who otherwise meets any of the following requirements of s. 46.266 (1) (a), (b) or (c).:

SB21,1537 Section 1537. 46.277 (5g) (b) 1. and 2. of the statutes are created to read:

SB21,654,21 46.277 (5g) (b) 1. A person who resided in the facility on the date of the finding that a skilled nursing facility or intermediate care facility that provides care to Medical Assistance recipients to be an institution for mental diseases whose care in the facility is disallowed for federal financial participation under Medical Assistance.

SB21,655,2 2. A person who is aged 21 to 64, who has a primary diagnosis of mental illness, who would meet the level of care requirements for Medical Assistance reimbursement in a skilled nursing facility or intermediate care facility but for a finding that the facility is an institution for mental diseases, and for whom services would be provided in place of a person specified in subd. 1. who discontinues services.

SB21,1538 Section 1538. 46.28 (1) (a) of the statutes is amended to read:

SB21,655,5 46.28 (1) (a) "Authority" means the Forward Wisconsin Housing and Economic Development Authority created under ch. 234 235.

SB21,1539 Section 1539. 46.28 (3) of the statutes is amended to read:

SB21,655,8 46.28 (3) The department may authorize the authority to issue revenue bonds under s. 234.61 235.61 to finance any residential facility it approves under sub. (2).

SB21,1540 Section 1540. 46.28 (4) of the statutes is amended to read:

SB21,655,12 46.28 (4) The department may charge sponsors for administrative costs and expenses it incurs in exercising its powers and duties under this section and under s. 234.61 235.61.

SB21,1541 Section 1541. 46.2803 (1) of the statutes is amended to read:

SB21,655,21 46.2803 (1) In order to facilitate the transition to the long-term care system specified in ss. family care program as defined in s. 46.2805 to 46.2895 (4m), within the limits of applicable federal statutes and regulations and if the secretary of health services finds it necessary, he or she may grant a county limited waivers to or exemptions from ss. 46.27 (3) (e) (intro.), 1. and 2. and (f), (5) (d) and (e), (6) (a) 1., 2. and 3. and (b) (intro.), 1. and 2., (6r) (c), (7) (b), (cj) and (cm) and (11) (c) 5m. (intro.) and 6. and 46.277 (3) (a), (4) (a) and (5) (d) 1m., 1n. and 2. and rules promulgated under those provisions.

SB21,1542 Section 1542. 46.2803 (2) of the statutes is amended to read:

SB21,656,5 46.2803 (2) Notwithstanding s. 46.27 (7), a county in which a care management organization is operating pursuant to a contract under s. 46.284 (2) or a county in which a program described under s. 46.2805 (1) (a) (4k) or (b) (9m) is administered may use funds appropriated under s. 20.435 (7) (4) (bd) and allocated to the county under s. 46.27 (7) to provide community mental health or substance abuse services and supports for persons with mental illness or persons in need of services or supports for substance abuse and to provide services under the Family Support Program under s. 46.985.

SB21,1543 Section 1543 . 46.2803 (2) of the statutes, as affected by 2015 Wisconsin Act .... (this act), is amended to read:

SB21,656,14 46.2803 (2) Notwithstanding s. 46.27 (7), a county in which a care management organization is operating pursuant to a contract under s. 46.284 (2) or a county in which a program described under s. 46.2805 (4k) or (9m) is administered may use funds appropriated under s. 20.435 (4) (bd) and allocated to the county under s. 46.27 (7) to provide community mental health or substance abuse services and supports for persons with mental illness or persons in need of services or supports for substance abuse and to provide services under the Family Support Program under s. 46.985.

SB21,1544 Section 1544. 46.2804 of the statutes is repealed.

SB21,1545 Section 1545. 46.2805 (intro.) of the statutes is amended to read:

SB21,656,18 46.2805 Definitions; long-term care. (intro.) In ss. 46.2805 to 46.2895 46.288:

SB21,1546 Section 1546. 46.2805 (1) (intro.) of the statutes is amended to read:

SB21,656,21 46.2805 (1) (intro.) "Care management organization" means all of the following:

SB21,657,2 (cm) Before January 1, 2017, or the date specified in 2015 Wisconsin Act .... (this act), section 9118 (9), whichever is later, an entity that is certified as meeting the requirements for a care management organization under s. 46.284 (3) and that has a contract under s. 46.284 (2). "Care management organization" does not mean an entity that contracts with the department to operate one of the following:

SB21,1547 Section 1547. 46.2805 (1) (a) of the statutes is repealed.

SB21,1548 Section 1548. 46.2805 (1) (b) of the statutes is repealed.

SB21,1549 Section 1549. 46.2805 (1) (dm) of the statutes is created to read:

SB21,657,10 46.2805 (1) (dm) Beginning on January 1, 2017, or the date specified in 2015 Wisconsin Act .... (this act), section 9118 (9 ), whichever is later, an insurer that is licensed and in compliance with the applicable provisions of chs. 600 to 646, that is certified as meeting the requirements for a care management organization under s. 46.284 (3), and that has a contract under s. 46.284 (2).

SB21,1550 Section 1550. 46.2805 (4) of the statutes is amended to read:

SB21,657,15 46.2805 (4) "Family care benefit" means financial assistance for long-term care and support items for an enrollee and any financial assistance, as specified by the department, for primary and acute health care services under s. 49.46 (2) for an enrollee.

SB21,1551 Section 1551. 46.2805 (4k) of the statutes is created to read:

SB21,657,19 46.2805 (4k) "Family Care Partnership Program" means an integrated health and long-term care program operated under an amendment to the state Medical Assistance plan under 42 USC 1396u-2 and a waiver under 42 USC 1396n (c).

SB21,1552 Section 1552. 46.2805 (4m) of the statutes is created to read:

SB21,657,22 46.2805 (4m) "Family care program" means the program under s. 46.2805 to 46.2895 that provides the family care benefit.

SB21,1553 Section 1553. 46.2805 (4m) of the statutes, as created by 2015 Wisconsin Act .... (this act), is amended to read:

SB21,658,2 46.2805 (4m) "Family care program" means the program under s. 46.2805 to 46.2895 46.288 that provides the family care benefit.

SB21,1554 Section 1554. 46.2805 (7r) of the statutes is repealed.

SB21,1555 Section 1555. 46.2805 (7u) of the statutes is repealed.

SB21,1556 Section 1556. 46.2805 (9m) of the statutes is created to read:

SB21,658,8 46.2805 (9m) "Program of all-inclusive care for the elderly" means an integrated health and long-term care program operated under 42 USC 1395eee or 1396u-4.

SB21,1557 Section 1557. 46.2805 (10) of the statutes is amended to read:

SB21,658,13 46.2805 (10) "Resource center" means an entity that meets the standards for operation under s. 46.283 (3) or, if under contract to provide a portion of the services specified under s. 46.283 (3), meets the standards for operation with respect to those services, and fulfills the duties under s. 46.283 (4).

SB21,1558 Section 1558. 46.2805 (10m) of the statutes is amended to read:

SB21,658,18 46.2805 (10m) "Self-directed services option" means the option in the family care program that is operated under a waiver from the secretary of the federal department of health and human services under 42 USC 1396n (c) in which an enrolled individual selects his or her own services and service providers.

SB21,1559 Section 1559. 46.281 (1d) of the statutes is amended to read:

SB21,659,2 46.281 (1d) Waiver request. The department shall request from the secretary of the federal department of health and human services any waivers of federal medicaid laws necessary to permit the use of federal moneys to provide the family care benefit to recipients of medical assistance. The department shall implement any waiver that is approved and that is consistent with ss. 46.2805 to 46.2895 46.288. Regardless of whether a waiver is approved, the department may implement operation of resource centers, care management organizations, and the family care benefit.

SB21,1560 Section 1560. 46.281 (1g) (a) of the statutes is renumbered 46.281 (1g) and amended to read:

SB21,659,10 46.281 (1g) Contracting for resource centers and care management organizations. Subject to par. (b), the The department may contract with entities or resource centers as provided under s. 46.283 (2) to provide any of the services under s. 46.283 (3) and (4) as resource centers in any geographic area in the state, and may contract with entities as provided under s. 46.284 (2) to administer the family care benefit as care management organizations in any geographic area in the state.

SB21,1561 Section 1561. 46.281 (1g) (b) of the statutes is repealed.

SB21,1562 Section 1562. 46.281 (1n) (b) 3. of the statutes is amended to read:

SB21,659,20 46.281 (1n) (b) 3. Conduct ongoing evaluations of managed care programs for provision of long-term care services that are funded by medical assistance, as defined in s. 46.278 (1m) (b), as to client access to services, the availability of client choice of living and service options, quality of care, and cost-effectiveness. In evaluating the availability of client choice, the department shall evaluate the opportunity for a client to arrange for, manage, and monitor his or her family care benefit directly or with assistance, self-directed services option as specified in s. 46.284 (4) (e).

SB21,1563 Section 1563. 46.281 (1n) (b) 4. of the statutes is amended to read:

SB21,659,24 46.281 (1n) (b) 4. Require that quality assurance and quality improvement efforts be included throughout the long-term care system specified in ss. 46.2805 to 46.2895 family care program.

SB21,1564 Section 1564. 46.281 (1n) (d) of the statutes is repealed.

SB21,1565 Section 1565. 46.281 (1n) (e) of the statutes is amended to read:

SB21,660,11 46.281 (1n) (e) Contract with a person to provide the advocacy services described under s. 16.009 (2) (p) 1. to 5. to actual or potential recipients of the family care benefit who are under age 60 or to their families or guardians. The department may not contract under this paragraph with a county or with a person who has a contract with the department to provide services under s. 46.283 (3) and (4) as a resource center or other entity or to administer the family care benefit as a care management organization. The contract under this paragraph shall include as a goal that the provider of advocacy services provide one advocate for every 2,500 individuals under age 60 who receive the family care benefit or who participates in the self-directed services option.

SB21,1566 Section 1566. 46.281 (3) of the statutes is amended to read:

SB21,660,22 46.281 (3) Duty of the secretary. The secretary shall certify to each county, hospital, nursing home, community-based residential facility, adult family home, and residential care apartment complex the date on which a resource center or other entity under contract under s. 46.283 (2) that serves the area of the county, hospital, nursing home, community-based residential facility, adult family home, or residential care apartment complex is first available to perform functional screenings and financial and cost-sharing screenings. To facilitate phase-in of services of resource centers, the secretary may certify that the resource center or other entity is available for specified groups of eligible individuals or for specified facilities in the county.

SB21,1567 Section 1567. 46.281 (4) (c) of the statutes is amended to read:

SB21,661,5 46.281 (4) (c) Each county in which the department has a contract with an entity to administer the family care benefit, and in which the department had such a contract before January 1, 2006, shall annually either pay the department or agree to reduce the community aids distribution to the county under s. 46.40 (2) by the amount that the county paid the department, or by which the county's community aids distribution was reduced, in calendar year 2006 to fund the family care program under ss. 46.2805 to 46.2895.

SB21,1568 Section 1568. 46.281 (4) (d) of the statutes is amended to read:

SB21,661,8 46.281 (4) (d) The department shall deposit payments made by counties under this subsection in the appropriation account under s. 20.435 (7) (g) (4) (h).

SB21,1569 Section 1569. 46.2825 of the statutes is repealed.

SB21,1570 Section 1570. 46.283 (title) of the statutes is amended to read:

SB21,661,11 46.283 (title) Resource centers; resource functions.

SB21,1571 Section 1571. 46.283 (1) (a) (intro.) and 1. of the statutes are consolidated, renumbered 46.283 (1) (a) and amended to read:

SB21,661,19 46.283 (1) (a) A county board of supervisors and, in a county with a county executive or a county administrator, the county executive or county administrator, may decide all of the following: 1. Whether whether to authorize one or more county departments under s. 46.21, 46.215, 46.22 or 46.23 or an aging unit under s. 46.82 (1) (a) 1., 2., or 3. to apply to the department for a contract to operate a resource center and, if so, which to authorize and what client group to serve.

SB21,1572 Section 1572. 46.283 (1) (a) 2. of the statutes is repealed.

SB21,1573 Section 1573. 46.283 (2) (intro.) of the statutes is renumbered 46.283 (2) and amended to read:

SB21,662,6 46.283 (2) Exclusive Resource center contract; contract for certain functions. The department may contract to operate a resource center with counties, long-term care districts, or the governing body of a tribe or band or the Great Lakes Inter-Tribal Council, Inc., under a joint application of any of these, or with a private entity or nonprofit organization if the department determines that the organization has no significant connection to an entity that operates a care management organization and if any of the following applies:. The department may contract with an entity other than a resource center to perform certain functions of a resource center.

SB21,1574 Section 1574 . 46.283 (2) of the statutes, as affected by 2015 Wisconsin Act .... (this act), is amended to read:

SB21,662,16 46.283 (2) Resource center contract; contract for certain functions. The department may contract to operate a resource center with counties , long-term care districts, or the governing body of a tribe or band or the Great Lakes Inter-Tribal Council, Inc., under a joint application of any of these, or with a private entity or nonprofit organization if the department determines that the organization has no significant connection to an entity that operates a care management organization. The department may contract with an entity other than a resource center to perform certain functions of a resource center.

SB21,1575 Section 1575. 46.283 (2) (a) of the statutes is repealed.

SB21,1576 Section 1576. 46.283 (2) (b) of the statutes is repealed.

SB21,1577 Section 1577. 46.283 (3) (title) of the statutes is repealed and recreated to read:

SB21,662,21 46.283 (3) (title) Resource function duties.

SB21,1578 Section 1578. 46.283 (3) (intro.) of the statutes is amended to read:

SB21,663,2 46.283 (3) (intro.) The department shall assure that at least all may in a contract with a resource center or other entity specify that the resource center or other entity provide any of the following are available to a person who contacts a resource center for service services or functions:

SB21,1579 Section 1579. 46.283 (3) (e) of the statutes is amended to read:

SB21,663,6 46.283 (3) (e) A determination of financial eligibility and of the maximum amount of cost sharing required for a person who is seeking long-term care services or the family care benefit, under standards prescribed by the department.

SB21,1580 Section 1580. 46.283 (4) (title) of the statutes is amended to read:

SB21,663,8 46.283 (4) (title) Duties; resource centers.

SB21,1581 Section 1581. 46.283 (4) (a) of the statutes is renumbered 46.283 (3) (L) and amended to read:

SB21,663,13 46.283 (3) (L) Provide Provision of services statewide or within the entire geographic area prescribed for the resource center or other entity by the department as specified in the contract.

SB21,1582 Section 1582. 46.283 (4) (e) of the statutes is renumbered 46.283 (3) (m) and amended to read: