SB21,1565
1Section
1565. 46.281 (1n) (e) of the statutes is amended to read:
SB21,660,112
46.281
(1n) (e) Contract with a person to provide the advocacy services
3described under s. 16.009 (2) (p) 1. to 5. to actual or potential recipients of the family
4care benefit who are under age 60 or to their families or guardians. The department
5may not contract under this paragraph with a county or with a person who has a
6contract with the department to provide services under s. 46.283 (3)
and (4) as a
7resource center
or other entity or to administer the family care benefit as a care
8management organization. The contract under this paragraph shall include as a
9goal that the provider of advocacy services provide one advocate for every 2,500
10individuals under age 60 who receive the family care benefit or who participates in
11the self-directed services option.
SB21,1566
12Section
1566. 46.281 (3) of the statutes is amended to read:
SB21,660,2213
46.281
(3) Duty of the secretary. The secretary shall certify to each county,
14hospital, nursing home, community-based residential facility, adult family home,
15and residential care apartment complex the date on which a resource center
or other
16entity under contract under s. 46.283 (2) that serves the area of the county, hospital,
17nursing home, community-based residential facility, adult family home, or
18residential care apartment complex is first available to perform functional
19screenings and financial and cost-sharing screenings. To facilitate phase-in of
20services
of resource centers, the secretary may certify that the resource center
or
21other entity is available for specified groups of eligible individuals or for specified
22facilities in the county.
SB21,1567
23Section
1567. 46.281 (4) (c) of the statutes is amended to read:
SB21,661,524
46.281
(4) (c) Each county in which the department has a contract with an
25entity to administer the family care benefit, and in which the department had such
1a contract before January 1, 2006, shall annually either pay the department or agree
2to reduce the community aids distribution to the county under s. 46.40 (2) by the
3amount that the county paid the department, or by which the county's community
4aids distribution was reduced, in calendar year 2006 to fund the
family care program
5under ss. 46.2805 to 46.2895.
SB21,1568
6Section
1568. 46.281 (4) (d) of the statutes is amended to read:
SB21,661,87
46.281
(4) (d) The department shall deposit payments made by counties under
8this subsection in the appropriation account under s. 20.435
(7) (g) (4) (h).
SB21,1569
9Section
1569. 46.2825 of the statutes is repealed.
SB21,1570
10Section
1570. 46.283 (title) of the statutes is amended to read:
SB21,661,11
1146.283 (title)
Resource centers; resource functions.
SB21,1571
12Section
1571. 46.283 (1) (a) (intro.) and 1. of the statutes are consolidated,
13renumbered 46.283 (1) (a) and amended to read:
SB21,661,1914
46.283
(1) (a) A county board of supervisors and, in a county with a county
15executive or a county administrator, the county executive or county administrator,
16may decide
all of the following: 1. Whether whether to authorize one or more county
17departments under s. 46.21, 46.215, 46.22 or 46.23 or an aging unit under s. 46.82
18(1) (a) 1., 2., or 3. to apply to the department for a contract to operate a resource center
19and, if so, which to authorize and what client group to serve.
SB21,1572
20Section
1572. 46.283 (1) (a) 2. of the statutes is repealed.
SB21,1573
21Section
1573. 46.283 (2) (intro.) of the statutes is renumbered 46.283 (2) and
22amended to read:
SB21,662,623
46.283
(2) Exclusive
Resource center contract; contract for certain
24functions. The department may contract to operate a resource center with counties,
25long-term care districts, or the governing body of a tribe or band or the Great Lakes
1Inter-Tribal Council, Inc., under a joint application of any of these, or with a private
2entity or nonprofit organization if the department determines that the organization
3has no significant connection to an entity that operates a care management
4organization
and if any of the following applies:. The department may contract with
5an entity other than a resource center to perform certain functions of a resource
6center.
SB21,1574
7Section
1574
. 46.283 (2) of the statutes, as affected by 2015 Wisconsin Act ....
8(this act), is amended to read:
SB21,662,169
46.283
(2) Resource center contract; contract for certain functions. The
10department may contract to operate a resource center with counties
, long-term care
11districts, or the governing body of a tribe or band or the Great Lakes Inter-Tribal
12Council, Inc., under a joint application of any of these, or with a private entity or
13nonprofit organization if the department determines that the organization has no
14significant connection to an entity that operates a care management organization.
15The department may contract with an entity other than a resource center to perform
16certain functions of a resource center.
SB21,1575
17Section
1575. 46.283 (2) (a) of the statutes is repealed.
SB21,1576
18Section
1576. 46.283 (2) (b) of the statutes is repealed.
SB21,1577
19Section
1577. 46.283 (3) (title) of the statutes is repealed and recreated to
20read:
SB21,662,2121
46.283
(3) (title)
Resource function duties.
SB21,1578
22Section
1578. 46.283 (3) (intro.) of the statutes is amended to read:
SB21,663,223
46.283
(3) (intro.) The department
shall assure that at least all may in a
24contract with a resource center or other entity specify that the resource center or
1other entity provide any of the following
are available to a person who contacts a
2resource center for service services or functions:
SB21,1579
3Section
1579. 46.283 (3) (e) of the statutes is amended to read:
SB21,663,64
46.283
(3) (e) A determination of financial eligibility and of the maximum
5amount of cost sharing required for a person who is seeking long-term care services
6or the family care benefit, under standards prescribed by the department.
SB21,1580
7Section
1580. 46.283 (4) (title) of the statutes is amended to read:
SB21,663,88
46.283
(4) (title)
Duties; resource centers.
SB21,1581
9Section
1581. 46.283 (4) (a) of the statutes is renumbered 46.283 (3) (L) and
10amended to read:
SB21,663,1311
46.283
(3) (L)
Provide Provision of services
statewide or within the entire
12geographic area prescribed for the resource center
or other entity by the department
13as specified in the contract.
SB21,1582
14Section
1582. 46.283 (4) (e) of the statutes is renumbered 46.283 (3) (m) and
15amended to read:
SB21,663,2516
46.283
(3) (m)
Provide information
Information about the services of the
17resource center
or other entity, including the services specified in sub. (3) (d), about
18assessments under s. 46.284 (4) (b) and care plans under s. 46.284 (4) (c), and about
19the family care benefit and the self-directed services option to all older persons and
20adults with a physical or developmental disability who are residents of nursing
21homes, community-based residential facilities, adult family homes, and residential
22care apartment complexes in the area of the resource center
or other entity when the
23benefit under s. 46.286 first becomes available in the county where the nursing home,
24community-based residential facility, adult family home, or residential care
25apartment complex is located.
SB21,1583
1Section
1583. 46.283 (4) (f) of the statutes is renumbered 46.283 (3) (n) and
2amended to read:
SB21,664,63
46.283
(3) (n)
Perform Performance of a functional screening and a financial
4and cost-sharing screening for any resident, as specified in par.
(e) (m), who requests
5a screening and assist any resident who is eligible and chooses to enroll in a care
6management organization
or the self-directed services option to do so.
SB21,1584
7Section
1584. 46.283 (4) (g) of the statutes is renumbered 46.283 (3) (o) and
8amended to read:
SB21,664,229
46.283
(3) (o)
Perform Performance of a functional screening and a financial
10and cost-sharing screening for any person seeking admission to a nursing home,
11community-based residential facility, residential care apartment complex, or adult
12family home, if the secretary has certified that the resource center
or other entity is
13available to the person and the facility and the person is determined by the resource
14center
or other entity to have a condition that is expected to last at least 90 days that
15would require care, assistance, or supervision. A resource center
or other entity may
16not require a financial and cost-sharing screening for a person seeking admission
17or about to be admitted on a private pay basis who waives the requirement for a
18financial and cost-sharing screening under this paragraph, unless the person is
19expected to become eligible for medical assistance within 6 months. A resource
20center
or other entity need not perform a functional screening for a person seeking
21admission or about to be admitted for whom a functional screening was performed
22within the previous 6 months.
SB21,1585
23Section
1585. 46.283 (4) (j) of the statutes is repealed.
SB21,1586
24Section
1586. 46.283 (5) of the statutes is amended to read:
SB21,665,5
146.283
(5) Funding. From the appropriation accounts under s. 20.435 (4) (b),
2(bd), (bm), (gm), (pa), and (w) and (7) (b)
, (bd), and (md), the department may contract
3with organizations
that meet standards under sub. (3) for performance of the duties
4under sub.
(4) (3) and shall distribute funds for services provided by resource centers
5and other entities.
SB21,1587
6Section
1587. 46.283 (6) of the statutes is repealed.
SB21,1588
7Section
1588. 46.283 (7) (intro.) of the statutes is amended to read:
SB21,665,128
46.283
(7) (intro.) No record, as defined in s. 19.32 (2), of a resource center
or
9other contracted entity under sub. (2) that contains personally identifiable
10information, as defined in s. 19.62 (5), concerning an individual who receives services
11from the resource center may be disclosed by the resource center without the
12individual's informed consent, except as follows:
SB21,1589
13Section
1589. 46.283 (7) (a) of the statutes is amended to read:
SB21,665,1714
46.283
(7) (a) A resource center
or other contracted entity under sub. (2) may
15provide information as required to comply with s. 16.009 (2) (p) or 49.45 (4) or as
16necessary for the department to administer the
family care program
under ss.
1746.2805 to 46.2895.
SB21,1590
18Section
1590. 46.283 (7) (b) of the statutes is amended to read:
SB21,666,219
46.283
(7) (b) Notwithstanding ss. 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45
20(14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a resource center
21or other contracted entity under sub. (2) acting under this section may exchange
22confidential information about a client, as defined in s. 46.287 (1), without the
23informed consent of the client, under s. 46.21 (2m) (c), 46.215 (1m), 46.22 (1) (dm),
2446.23 (3) (e), 46.284 (7), 46.2895 (10), 51.42 (3) (e) or 51.437 (4r) (b) in the
county 25operating area of the resource center
or other entity, if necessary to enable the
1resource center
or other entity to perform its duties or to coordinate the delivery of
2services to the client.
SB21,1591
3Section
1591
. 46.283 (7) (b) of the statutes, as affected by 2015 Wisconsin Act
4.... (this act), is amended to read:
SB21,666,135
46.283
(7) (b) Notwithstanding ss. 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45
6(14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a resource center
7or other contracted entity under sub. (2) acting under this section may exchange
8confidential information about a client, as defined in s. 46.287 (1), without the
9informed consent of the client, under s. 46.21 (2m) (c), 46.215 (1m), 46.22 (1) (dm),
1046.23 (3) (e), 46.284 (7),
46.2895 (10), 51.42 (3) (e) or 51.437 (4r) (b) in the operating
11area of the resource center or other entity, if necessary to enable the resource center
12or other entity to perform its duties or to coordinate the delivery of services to the
13client.
SB21,1592
14Section
1592. 46.284 (1) (a) (intro.) and 1. of the statutes are consolidated,
15renumbered 46.284 (1) (a) and amended to read:
SB21,666,2116
46.284
(1) (a) A county board of supervisors and, in a county with a county
17executive or a county administrator, the county executive or county administrator,
18may decide
all of the following: 1. Whether whether to authorize one or more county
19departments under s. 46.21, 46.215, 46.22 or 46.23 or an aging unit under s. 46.82
20(1) (a) 1. or 2. to apply to the department for a contract to operate a care management
21organization and, if so, which to authorize and what client group to serve.
SB21,1593
22Section
1593. 46.284 (1) (a) 2. of the statutes is repealed.
SB21,1594
23Section
1594. 46.284 (2) (a) of the statutes is amended to read:
SB21,667,324
46.284
(2) (a) The department may contract for operation of a care
25management organization only with an entity that is certified
by the department as
1meeting the requirements under sub. (3). No entity may operate as a care
2management organization under the requirements of this section unless so certified
3and under contract with the department.
SB21,1595
4Section
1595. 46.284 (2) (bm) of the statutes is amended to read:
SB21,667,165
46.284
(2) (bm) The department may contract with counties, long-term care
6districts, the governing body of a tribe or band or the Great Lakes inter-tribal
7council, inc., or under a joint application of any of these, or with a private
8organization that has no significant connection to an entity that operates a resource
9center.
Proposals for contracts under this subdivision shall be solicited under a
10competitive sealed proposal process under s. 16.75 (2m) and the department shall
11evaluate the proposals primarily as to the quality of care that is proposed to be
12provided, certify those The department may contract with any applicants that
meet 13it certifies as meeting the requirements specified in sub. (3) (a)
, select certified
14applicants for contract and contract with the selected applicants. The department
15is not required to solicit proposals for contracts to be a care management
16organization under a competitive sealed proposal process.
SB21,1596
17Section
1596
. 46.284 (2) (bm) of the statutes, as affected by 2015 Wisconsin
18Act .... (this act), is amended to read:
SB21,668,219
46.284
(2) (bm) The department may contract with counties,
long-term care
20districts, the governing body of a tribe or band or the Great Lakes inter-tribal
21council, inc., or under a joint application of any of these, or with a private
22organization that has no significant connection to an entity that operates a resource
23center. The department may contract with any applicants that it certifies as meeting
24the requirements specified in sub. (3) (a). The department is not required to solicit
1proposals for contracts to be a care management organization under a competitive
2sealed proposal process.
SB21,1597
3Section
1597. 46.284 (2) (c) of the statutes is repealed.
SB21,1598
4Section
1598. 46.284 (2) (d) of the statutes is repealed.
SB21,1599
5Section
1599. 46.284 (3) (b) 10. of the statutes is amended to read:
SB21,668,86
46.284
(3) (b) 10. Coverage
statewide or for a geographic area specified by the
7department
if the department grants the applicant an exception to statewide
8coverage.
SB21,1600
9Section
1600. 46.284 (3) (b) 11. of the statutes is amended to read:
SB21,668,1210
46.284
(3) (b) 11. The ability to develop strong linkages with systems and
11services that are not directly within the scope of the applicant's responsibility but
12that are important to the target group that it proposes to serve
, including.
SB21,668,15
1311m. If the department chooses to make primary and acute health care services
14part of the family care benefit, the ability to provide or provide access to primary and
15acute health care services under s. 49.46 (2) as determined by the department.
SB21,1601
16Section
1601. 46.284 (3m) of the statutes is repealed.
SB21,1602
17Section
1602. 46.284 (4) (e) of the statutes is amended to read:
SB21,669,418
46.284
(4) (e) Provide, within guidelines established by the department, a
19mechanism self-directed services option by which an enrollee may arrange for,
20manage, and monitor his or her family care benefit directly or with the assistance of
21another person chosen by the enrollee. The care management organization shall
22provide each enrollee with a form on which the enrollee shall indicate whether he or
23she has been offered the
self-directed services option under this paragraph and
24whether he or she has accepted or declined the
self-directed services option. If the
25enrollee accepts the option, the care management organization shall monitor the
1enrollee's use of a fixed budget for purchase of services or support items from any
2qualified provider, monitor the health and safety of the enrollee, and provide
3assistance in management of the enrollee's budget and services at a level tailored to
4the enrollee's need and desire for the assistance.
SB21,1603
5Section
1603. 46.284 (5) (a) of the statutes is amended to read:
SB21,669,126
46.284
(5) (a) From the appropriation accounts under s. 20.435 (4) (b),
(bd), (g),
7(gm),
(h), (im), (o), and (w) and (7) (b),
(bd), and (g), the department shall provide
8funding on a capitated payment basis for the provision of services under this section.
9Notwithstanding s. 46.036 (3) and (5m), a care management organization that is
10under contract with the department may expend the funds, consistent with this
11section, including providing payment, on a capitated basis, to providers of services
12under the family care benefit.
SB21,1604
13Section
1604. 46.284 (5) (d) 4. of the statutes is amended to read:
SB21,669,2414
46.284
(5) (d) 4. The requirement that a care management organization place
15funds in a risk reserve and maintain the risk reserve in an interest-bearing escrow
16account with a financial institution, as defined in s. 69.30 (1) (b)
, or invest funds as
17specified in s. 46.2895 (4) (j) 2. or 3. Moneys in the risk reserve or invested as specified
18in this subdivision may be expended only for the provision of services under this
19section. If a care management organization ceases participation under this section,
20the funds in the risk reserve or invested as specified in this subdivision, minus any
21contribution of moneys other than those specified in par. (c), shall be returned to the
22department. The department shall expend the moneys for the payment of
23outstanding debts to providers of family care benefit services and for the
24continuation of family care benefit services to enrollees.
SB21,1605
25Section
1605. 46.284 (6) of the statutes is amended to read:
SB21,670,6
146.284
(6) Governing board. A care management organization shall have a
2governing board that reflects the ethnic and economic diversity of the geographic
3area served by the care management organization. At least one-fourth of the
4members of the governing board shall be representative of the
client group or groups
5whom the care management organization is contracted to serve or those clients' 6enrollees or the enrollees' family members, guardians, or other advocates.
SB21,1606
7Section
1606. 46.284 (7) (a) of the statutes is amended to read:
SB21,670,108
46.284
(7) (a) A care management organization may provide information as
9required to comply with s. 16.009 (2) (p) or 49.45 (4) or as necessary for the
10department to administer the
family care program
under ss. 46.2805 to 46.2895.
SB21,1607
11Section
1607. 46.284 (7) (b) of the statutes is amended to read:
SB21,670,1912
46.284
(7) (b) Notwithstanding ss. 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45
13(14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a care
14management organization acting under this section may exchange confidential
15information about a client, as defined in s. 46.287 (1), without the informed consent
16of the client, under s. 46.21 (2m) (c), 46.215 (1m), 46.22 (1) (dm), 46.23 (3) (e), 46.283
17(7),
46.2895 (10), 51.42 (3) (e) or 51.437 (4r) (b) in the county of the care management
18organization, if necessary to enable the care management organization to perform
19its duties or to coordinate the delivery of services to the client.
SB21,1608
20Section
1608. 46.285 (intro.) and (1) of the statutes are consolidated,
21renumbered 46.285 and amended to read:
SB21,671,5
2246.285 Operation of resource center and care management
23organization. In order to meet federal requirements and assure federal financial
24participation in funding of the family care benefit, a county, a tribe or band,
a
25long-term care district or an organization, including a private, nonprofit
1corporation, may not directly operate both a resource center and a care management
2organization, except
as follows: (1) For that for an entity with which the department
3has contracted under s. 46.281 (1) (e) 1., 2005 stats., provision of the services
4specified under s. 46.283 (3) (b), (e), (f) and (g) shall be structurally separate from the
5provision of services of the care management organization by January 1, 2001.
SB21,1609
6Section
1609. 46.285 (2) of the statutes is repealed.
SB21,1610
7Section
1610. 46.286 (3g) of the statutes is created to read:
SB21,671,118
46.286
(3g) Transferring care management organizations. An enrollee may
9transfer his or her enrollment to a different care management organization but only
10during an open enrollment period specified by the department, unless the enrollee
11meets an exception specified by the department.
SB21,1611
12Section
1611. 46.287 (2) (c) of the statutes is amended to read:
SB21,671,1613
46.287
(2) (c) Information regarding the availability of advocacy services and
14notice of adverse actions taken and appeal rights shall be provided to a client by the
15resource center
or other contracted entity under s. 46.283 (2) or care management
16organization in a form and manner that is prescribed by the department by rule.
SB21,1612
17Section
1612. 46.2895 of the statutes, as affected by 2015 Wisconsin Act ....
18(this act), is repealed.
SB21,1613
19Section
1613. 46.2895 (1) (a) (intro.) of the statutes is amended to read:
SB21,672,220
46.2895
(1) (a) (intro.)
A Except as provided in par. (f), a county, a tribe or band,
21or any combination of counties or tribes or bands, may create a special purpose
22district that is termed a "long-term care district", that is a local unit of government,
23that is separate and distinct from, and independent of, the state and the county or
24tribe or band that created it, and that has the powers and duties specified in this
1section, if each county or tribe or band that participates in creating the district does
2all of the following:
SB21,1614
3Section
1614. 46.2895 (1) (a) 1. b. of the statutes is amended to read:
SB21,672,84
46.2895
(1) (a) 1. b. Specifies the long-term care district's primary purpose,
5which shall be to operate, under contract with the department, a resource center
6under s. 46.283, a care management organization under s. 46.284, or a program
7described under s. 46.2805 (1) (a) or (b) of all-inclusive care for the elderly or the
8Family Care Partnership Program.