SB21: Bill Text

SB21,1575 Section 1575. 46.283 (2) (a) of the statutes is repealed.

SB21,1576 Section 1576. 46.283 (2) (b) of the statutes is repealed.

SB21,1577 Section 1577. 46.283 (3) (title) of the statutes is repealed and recreated to read: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

SB21,663,25 46.283 (3) (m) Provide information Information about the services of the resource center or other entity, including the services specified in sub. (3) (d), about assessments under s. 46.284 (4) (b) and care plans under s. 46.284 (4) (c), and about the family care benefit and the self-directed services option to all older persons and adults with a physical or developmental disability who are residents of nursing homes, community-based residential facilities, adult family homes, and residential care apartment complexes in the area of the resource center or other entity when the benefit under s. 46.286 first becomes available in the county where the nursing home, community-based residential facility, adult family home, or residential care apartment complex is located.

SB21,1583 Section 1583. 46.283 (4) (f) of the statutes is renumbered 46.283 (3) (n) and amended to read:

SB21,664,6 46.283 (3) (n) Perform Performance of a functional screening and a financial and cost-sharing screening for any resident, as specified in par. (e) (m), who requests a screening and assist any resident who is eligible and chooses to enroll in a care management organization or the self-directed services option to do so.

SB21,1584 Section 1584. 46.283 (4) (g) of the statutes is renumbered 46.283 (3) (o) and amended to read:

SB21,664,22 46.283 (3) (o) Perform Performance of a functional screening and a financial and cost-sharing screening for any person seeking admission to a nursing home, community-based residential facility, residential care apartment complex, or adult family home, if the secretary has certified that the resource center or other entity is available to the person and the facility and the person is determined by the resource center or other entity to have a condition that is expected to last at least 90 days that would require care, assistance, or supervision. A resource center or other entity may not require a financial and cost-sharing screening for a person seeking admission or about to be admitted on a private pay basis who waives the requirement for a financial and cost-sharing screening under this paragraph, unless the person is expected to become eligible for medical assistance within 6 months. A resource center or other entity need not perform a functional screening for a person seeking admission or about to be admitted for whom a functional screening was performed within the previous 6 months.

SB21,1585 Section 1585. 46.283 (4) (j) of the statutes is repealed.

SB21,1586 Section 1586. 46.283 (5) of the statutes is amended to read:

SB21,665,5 46.283 (5) Funding. From the appropriation accounts under s. 20.435 (4) (b), (bd), (bm), (gm), (pa), and (w) and (7) (b), (bd), and (md), the department may contract with organizations that meet standards under sub. (3) for performance of the duties under sub. (4) (3) and shall distribute funds for services provided by resource centers and other entities.

SB21,1587 Section 1587. 46.283 (6) of the statutes is repealed.

SB21,1588 Section 1588. 46.283 (7) (intro.) of the statutes is amended to read:

SB21,665,12 46.283 (7) (intro.) No record, as defined in s. 19.32 (2), of a resource center or other contracted entity under sub. (2) that contains personally identifiable information, as defined in s. 19.62 (5), concerning an individual who receives services from the resource center may be disclosed by the resource center without the individual's informed consent, except as follows:

SB21,1589 Section 1589. 46.283 (7) (a) of the statutes is amended to read:

SB21,665,17 46.283 (7) (a) A resource center or other contracted entity under sub. (2) may provide information as required to comply with s. 16.009 (2) (p) or 49.45 (4) or as necessary for the department to administer the family care program under ss. 46.2805 to 46.2895.

SB21,1590 Section 1590. 46.283 (7) (b) of the statutes is amended to read:

SB21,666,2 46.283 (7) (b) Notwithstanding ss. 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a resource center or other contracted entity under sub. (2) acting under this section may exchange confidential information about a client, as defined in s. 46.287 (1), without the informed consent of the client, under s. 46.21 (2m) (c), 46.215 (1m), 46.22 (1) (dm), 46.23 (3) (e), 46.284 (7), 46.2895 (10), 51.42 (3) (e) or 51.437 (4r) (b) in the county operating area of the resource center or other entity, if necessary to enable the resource center or other entity to perform its duties or to coordinate the delivery of services to the client.

SB21,1591 Section 1591 . 46.283 (7) (b) of the statutes, as affected by 2015 Wisconsin Act .... (this act), is amended to read:

SB21,666,13 46.283 (7) (b) Notwithstanding ss. 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a resource center or other contracted entity under sub. (2) acting under this section may exchange confidential information about a client, as defined in s. 46.287 (1), without the informed consent of the client, under s. 46.21 (2m) (c), 46.215 (1m), 46.22 (1) (dm), 46.23 (3) (e), 46.284 (7), 46.2895 (10), 51.42 (3) (e) or 51.437 (4r) (b) in the operating area of the resource center or other entity, if necessary to enable the resource center or other entity to perform its duties or to coordinate the delivery of services to the client.

SB21,1592 Section 1592. 46.284 (1) (a) (intro.) and 1. of the statutes are consolidated, renumbered 46.284 (1) (a) and amended to read:

SB21,666,21 46.284 (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. or 2. to apply to the department for a contract to operate a care management organization and, if so, which to authorize and what client group to serve.

SB21,1593 Section 1593. 46.284 (1) (a) 2. of the statutes is repealed.

SB21,1594 Section 1594. 46.284 (2) (a) of the statutes is amended to read:

SB21,667,3 46.284 (2) (a) The department may contract for operation of a care management organization only with an entity that is certified by the department as meeting the requirements under sub. (3). No entity may operate as a care management organization under the requirements of this section unless so certified and under contract with the department.

SB21,1595 Section 1595. 46.284 (2) (bm) of the statutes is amended to read:

SB21,667,16 46.284 (2) (bm) The department may contract with counties, long-term care districts, the governing body of a tribe or band or the Great Lakes inter-tribal council, inc., or under a joint application of any of these, or with a private organization that has no significant connection to an entity that operates a resource center. Proposals for contracts under this subdivision shall be solicited under a competitive sealed proposal process under s. 16.75 (2m) and the department shall evaluate the proposals primarily as to the quality of care that is proposed to be provided, certify those The department may contract with any applicants that meet it certifies as meeting the requirements specified in sub. (3) (a), select certified applicants for contract and contract with the selected applicants. The department is not required to solicit proposals for contracts to be a care management organization under a competitive sealed proposal process.

SB21,1596 Section 1596 . 46.284 (2) (bm) of the statutes, as affected by 2015 Wisconsin Act .... (this act), is amended to read:

SB21,668,2 46.284 (2) (bm) The department may contract with counties, long-term care districts, the governing body of a tribe or band or the Great Lakes inter-tribal council, inc., or under a joint application of any of these, or with a private organization that has no significant connection to an entity that operates a resource center. The department may contract with any applicants that it certifies as meeting the requirements specified in sub. (3) (a). The department is not required to solicit proposals for contracts to be a care management organization under a competitive sealed proposal process.

SB21,1597 Section 1597. 46.284 (2) (c) of the statutes is repealed.

SB21,1598 Section 1598. 46.284 (2) (d) of the statutes is repealed.

SB21,1599 Section 1599. 46.284 (3) (b) 10. of the statutes is amended to read:

SB21,668,8 46.284 (3) (b) 10. Coverage statewide or for a geographic area specified by the department if the department grants the applicant an exception to statewide coverage.

SB21,1600 Section 1600. 46.284 (3) (b) 11. of the statutes is amended to read:

SB21,668,12 46.284 (3) (b) 11. The ability to develop strong linkages with systems and services that are not directly within the scope of the applicant's responsibility but that are important to the target group that it proposes to serve, including.

SB21,668,15 11m. If the department chooses to make primary and acute health care services part of the family care benefit, the ability to provide or provide access to primary and acute health care services under s. 49.46 (2) as determined by the department.

SB21,1601 Section 1601. 46.284 (3m) of the statutes is repealed.

SB21,1602 Section 1602. 46.284 (4) (e) of the statutes is amended to read:

SB21,669,4 46.284 (4) (e) Provide, within guidelines established by the department, a mechanism self-directed services option by which an enrollee may arrange for, manage, and monitor his or her family care benefit directly or with the assistance of another person chosen by the enrollee. The care management organization shall provide each enrollee with a form on which the enrollee shall indicate whether he or she has been offered the self-directed services option under this paragraph and whether he or she has accepted or declined the self-directed services option. If the enrollee accepts the option, the care management organization shall monitor the enrollee's use of a fixed budget for purchase of services or support items from any qualified provider, monitor the health and safety of the enrollee, and provide assistance in management of the enrollee's budget and services at a level tailored to the enrollee's need and desire for the assistance.

SB21,1603 Section 1603. 46.284 (5) (a) of the statutes is amended to read:

SB21,669,12 46.284 (5) (a) From the appropriation accounts under s. 20.435 (4) (b), (bd), (g), (gm), (h), (im), (o), and (w) and (7) (b), (bd), and (g), the department shall provide funding on a capitated payment basis for the provision of services under this section. Notwithstanding s. 46.036 (3) and (5m), a care management organization that is under contract with the department may expend the funds, consistent with this section, including providing payment, on a capitated basis, to providers of services under the family care benefit.

SB21,1604 Section 1604. 46.284 (5) (d) 4. of the statutes is amended to read:

SB21,669,24 46.284 (5) (d) 4. The requirement that a care management organization place funds in a risk reserve and maintain the risk reserve in an interest-bearing escrow account with a financial institution, as defined in s. 69.30 (1) (b) , or invest funds as specified in s. 46.2895 (4) (j) 2. or 3. Moneys in the risk reserve or invested as specified in this subdivision may be expended only for the provision of services under this section. If a care management organization ceases participation under this section, the funds in the risk reserve or invested as specified in this subdivision, minus any contribution of moneys other than those specified in par. (c), shall be returned to the department. The department shall expend the moneys for the payment of outstanding debts to providers of family care benefit services and for the continuation of family care benefit services to enrollees.

SB21,1605 Section 1605. 46.284 (6) of the statutes is amended to read:

SB21,670,6 46.284 (6) Governing board. A care management organization shall have a governing board that reflects the ethnic and economic diversity of the geographic area served by the care management organization. At least one-fourth of the members of the governing board shall be representative of the client group or groups whom the care management organization is contracted to serve or those clients' enrollees or the enrollees' family members, guardians, or other advocates.

SB21,1606 Section 1606. 46.284 (7) (a) of the statutes is amended to read:

SB21,670,10 46.284 (7) (a) A care management organization may provide information as required to comply with s. 16.009 (2) (p) or 49.45 (4) or as necessary for the department to administer the family care program under ss. 46.2805 to 46.2895.

SB21,1607 Section 1607. 46.284 (7) (b) of the statutes is amended to read:

SB21,670,19 46.284 (7) (b) Notwithstanding ss. 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a care management organization acting under this section may exchange confidential information about a client, as defined in s. 46.287 (1), without the informed consent of the client, under s. 46.21 (2m) (c), 46.215 (1m), 46.22 (1) (dm), 46.23 (3) (e), 46.283 (7), 46.2895 (10), 51.42 (3) (e) or 51.437 (4r) (b) in the county of the care management organization, if necessary to enable the care management organization to perform its duties or to coordinate the delivery of services to the client.

SB21,1608 Section 1608. 46.285 (intro.) and (1) of the statutes are consolidated, renumbered 46.285 and amended to read:

SB21,671,5 46.285 Operation of resource center and care management organization. In order to meet federal requirements and assure federal financial participation in funding of the family care benefit, a county, a tribe or band, a long-term care district or an organization, including a private, nonprofit corporation, may not directly operate both a resource center and a care management organization, except as follows: (1) For that for an entity with which the department has contracted under s. 46.281 (1) (e) 1., 2005 stats., provision of the services specified under s. 46.283 (3) (b), (e), (f) and (g) shall be structurally separate from the provision of services of the care management organization by January 1, 2001.

SB21,1609 Section 1609. 46.285 (2) of the statutes is repealed.

SB21,1610 Section 1610. 46.286 (3g) of the statutes is created to read:

SB21,671,11 46.286 (3g) Transferring care management organizations. An enrollee may transfer his or her enrollment to a different care management organization but only during an open enrollment period specified by the department, unless the enrollee meets an exception specified by the department.

SB21,1611 Section 1611. 46.287 (2) (c) of the statutes is amended to read:

SB21,671,16 46.287 (2) (c) Information regarding the availability of advocacy services and notice of adverse actions taken and appeal rights shall be provided to a client by the resource center or other contracted entity under s. 46.283 (2) or care management organization in a form and manner that is prescribed by the department by rule.

SB21,1612 Section 1612. 46.2895 of the statutes, as affected by 2015 Wisconsin Act .... (this act), is repealed.

SB21,1613 Section 1613. 46.2895 (1) (a) (intro.) of the statutes is amended to read:

SB21,672,2 46.2895 (1) (a) (intro.) A Except as provided in par. (f), a county, a tribe or band, or any combination of counties or tribes or bands, may create a special purpose district that is termed a "long-term care district", that is a local unit of government, that is separate and distinct from, and independent of, the state and the county or tribe or band that created it, and that has the powers and duties specified in this section, if each county or tribe or band that participates in creating the district does all of the following:

SB21,1614 Section 1614. 46.2895 (1) (a) 1. b. of the statutes is amended to read:

SB21,672,8 46.2895 (1) (a) 1. b. Specifies the long-term care district's primary purpose, which shall be to operate, under contract with the department, a resource center under s. 46.283, a care management organization under s. 46.284, or a program described under s. 46.2805 (1) (a) or (b) of all-inclusive care for the elderly or the Family Care Partnership Program.

SB21,1615 Section 1615. 46.2895 (1) (c) of the statutes is amended to read:

SB21,672,13 46.2895 (1) (c) A long-term care district may not operate a care management organization under s. 46.284 or, a program described under s. 46.2805 (1) (a) or (b) of all-inclusive care for the elderly, or the Family Care Partnership Program if the district operates a resource center under s. 46.283.

SB21,1616 Section 1616. 46.2895 (1) (f) of the statutes is created to read:

SB21,672,16 46.2895 (1) (f) No county, tribe, band, or combination of counties, tribes, or bands, may create a long-term care district after June 30, 2015.

SB21,1617 Section 1617. 46.2895 (4) (intro.) of the statutes is amended to read:

SB21,672,21 46.2895 (4) Powers. (intro.) Subject to sub. subs. (1) (c) and (12m), a long-term care district has all the powers necessary or convenient to carry out the purposes and provisions of the family care program ss. 46.2805 to 46.2895. In addition to all these powers, a long-term care district may do all of the following:

SB21,1618 Section 1618. 46.2895 (4) (dm) of the statutes is amended to read:

SB21,673,2 46.2895 (4) (dm) Subject to sub. (1) (c), enter into a contract with the department to operate a the program described under s. 46.2805 (1) (a) or (b) of all-inclusive care for the elderly or the Family Care Partnership Program and provide services related to the contracted services.

SB21,1619 Section 1619. 46.2895 (8) (a) (intro.) of the statutes is amended to read:

SB21,673,5 46.2895 (8) (a) (intro.) A Subject to sub. (12m), a long-term care district board that is created at least in part by a county shall do all of the following:

SB21,1620 Section 1620. 46.2895 (12m) of the statutes is created to read:

SB21,673,9 46.2895 (12m) Required dissolution. A long-term care district that exists on June 30, 2015, shall dissolve under the procedures in sub. (13) before June 30, 2017, or before a date established by the department, whichever is later.

SB21,1621 Section 1621. 46.2896 of the statutes is created to read:

SB21,673,11 46.2896 Counting promissory notes as assets. (1) In this section:

SB21,673,15 (a) "Long-term care program" means the long-term care program under s. 46.27, 46.275, 46.277, 46.278, or 46.2785; the family care program providing the benefit under s. 46.286; the Family Care Partnership program; or the long-term care program defined in s. 46.2899 (1), 2013 stats.

SB21,673,19 (b) "Promissory note" means a written, unconditional agreement, given in return for goods, money loaned, or services rendered, under which one party promises to pay another party a specified sum of money at a specified time or on demand.

SB21,673,22 (2) When determining or redetermining an individual's financial eligibility for a long-term care program, the department shall include a promissory note as a countable asset if all of the following apply:

SB21,673,25 (a) The individual applying for or receiving benefits under the long-term care program or his or her spouse provided the goods, money loaned, or services rendered for the promissory note.