40.04 (2) (a) An administrative account shall be maintained within the fund from which administrative costs of the department shall be paid, except charges for services performed by the investment board, costs of medical and vocational evaluations used in determinations of eligibility for benefits under ss. 40.61, 40.63 and 40.65 and costs of contracting for insurance data collection and analysis services under s. 40.03 (6) (j).
9,407
Section 407
. 40.04 (2) (e) of the statutes is repealed.
9,427
Section 427
. 45.03 (15) of the statutes is amended to read:
45.03 (15) Deferral of payments and interest on loans. When a veteran or a member of the veteran's family makes application for deferment of payment of monthly installments and waiver of interest charges on veterans loans made under this chapter, showing that the ability of the veteran to make payment is materially and adversely affected by reason of military service, the department may, with the approval of the board, defer payment of monthly installments and waive interest charges on veterans loans made under this chapter for the duration of any period of service in the armed forces of the United States during a national emergency or in time of war or under P.L. 87-117 and 6 months from date of discharge or separation and the time for payment may be extended for the same period. However, when funds estimated to be received in the veterans mortgage loan repayment fund to pay debt service on public debt contracted under s. 20.866 (2) (zn) and (zo) are less than the funds estimated to be required for the payment of the debt service, the board may grant deferral of payments and interest on loans provided under s. 45.37 only when so required by federal law.
9,428
Section 428
. 45.03 (16) (c) 2. (intro.) of the statutes is amended to read:
45.03 (16) (c) 2. (intro.) The department shall declare immediately due and payable any loan made after July 29, 1979, under a program administered by the department under s. 45.40 or subch. III, if it finds that the loan was granted to an ineligible person due to any of the following circumstances:
9,429
Section 429
. 45.03 (16) (c) 3. (intro.) of the statutes is amended to read:
45.03 (16) (c) 3. (intro.) Loan application forms processed by the department for programs administered under s. 45.40 or subch. III shall do all of the following:
9,430
Section 430
. 45.03 (16) (c) 4. of the statutes is amended to read:
45.03 (16) (c) 4. The department shall incorporate the payment acceleration requirements of subd. 2. in all loan documents for programs administered by the department under s. 45.40 or subch. III.
9,431
Section 431
. Subchapter III of chapter 45 [precedes 45.30] of the statutes is repealed.
9,432
Section 432
. 45.42 (4) of the statutes is amended to read:
45.42 (4) The department may execute necessary instruments, collect interest and principal, compromise indebtedness, sue and be sued, post bonds, and write off indebtedness that it considers uncollectible. If a loan under this section is secured by a real estate mortgage, the department may exercise the rights of owners and mortgagees generally and the rights and powers set forth in s. 45.32, 2017 stats. The department shall pay all interest and principal repaid on the loan into the veterans trust fund.
9,433
Section 433
. 45.42 (8) (a) of the statutes is repealed.
9,434
Section 434
. 45.42 (8) (b) of the statutes is renumbered 45.42 (8).
9,435
Section 435
. 45.48 of the statutes is created to read:
45.48 Veterans outreach and recovery program. (1) To be funded from the appropriation under s. 20.485 (2) (qs), the department shall administer a program to provide outreach, mental health services, and support to individuals who reside in this state, who may have a mental health condition or substance use disorder, and who meet one of the following conditions:
(a) Are serving in the national guard of any state or a reserve component of the U.S. armed forces.
(b) Served on active duty in the U.S. armed forces, forces incorporated as part of the U.S. armed forces, a reserve component of the U.S. armed forces, or the national guard of any state and were discharged under conditions other than dishonorable.
(2) The eligibility requirements under s. 45.02 do not apply to an individual receiving services under sub. (1).
(3) The department may provide payments to facilitate the provision of services under sub. (1).
9,436
Section 436
. 45.57 of the statutes is amended to read:
45.57 Veterans homes; transfer of funding. The department may transfer all or part of the unencumbered balance of any of the appropriations under s. 20.485 (1) (g), (gd), (gk), or (i) to the veterans trust fund or to the veterans mortgage loan repayment fund. The department shall notify the joint committee on finance in writing of any balance transferred under this section.
9,440
Section 440
. 46.057 (2) of the statutes is amended to read:
46.057 (2) From the appropriation account under s. 20.410 (3) (ba), the department of corrections shall transfer to the appropriation account under s. 20.435 (2) (kx) $1,365,500 in each fiscal year and, from the appropriation account under s. 20.410 (3) (hm), the department of corrections shall transfer to the appropriation account under s. 20.435 (2) (kx) $2,869,200 $3,224,100 in fiscal year 2017-18 2019-20 and $2,932,600 $5,429,000 in fiscal year 2018-19 2020-21, for services for juveniles placed at the Mendota juvenile treatment center. The department of health services may charge the department of corrections not more than the actual cost of providing those services.
9,441
Section 441
. 46.10 (16) of the statutes is amended to read:
46.10 (16) The department shall delegate to county departments under ss. 51.42 and 51.437 or the local providers of care and services meeting the standards established by the department under s. 46.036, the responsibilities vested in the department under this section for collection of patient fees for services other than those provided at state facilities, those provided to children that are reimbursed under a waiver under s. 46.27 (11), 46.275, 46.278, or 46.2785, or those provided under the disabled children's long-term support program if the county departments or providers meet the conditions that the department determines are appropriate. The department may delegate to county departments under ss. 51.42 and 51.437 the responsibilities vested in the department under this section for collection of patient fees for services provided at the state facilities if the necessary conditions are met.
9,442
Section 442
. 46.21 (2m) (b) 1. a. of the statutes is amended to read:
46.21 (2m) (b) 1. a. The powers and duties of the county departments under ss. 46.215, 51.42 and 51.437, including the administration of the long-term support community options program under s. 46.27, if the county department under s. 46.215 is designated as the administering agency under s. 46.27 (3) (b) 1.
9,443
Section 443
. 46.21 (2m) (b) 1. b. of the statutes is repealed.
9,444
Section 444
. 46.215 (1) (m) of the statutes is repealed.
9,445
Section 445
. 46.22 (1) (b) 1. e. of the statutes is repealed.
9,446
Section 446
. 46.23 (3) (bm) of the statutes is repealed.
9,447
Section 447
. 46.269 of the statutes is amended to read:
46.269 Determining financial eligibility for long-term care programs. To the extent approved by the federal government, the department or its designee shall exclude any assets accumulated in a person's independence account, as defined in s. 49.472 (1) (c), and any income or assets from retirement benefits earned or accumulated from income or employer contributions while employed and receiving state-funded benefits under s. 46.27 or medical assistance under s. 49.472 in determining financial eligibility and cost-sharing requirements, if any, for a long-term care program under s. 46.27, 46.275, or 46.277, for the family care program that provides the benefit defined in s. 46.2805 (4), for the Family Care Partnership program, or for the self-directed services option, as defined in s. 46.2897 (1).
9,448
Section 448
. 46.27 of the statutes is repealed.
9,449
Section 449
. 46.271 (1) (c) of the statutes is amended to read:
46.271 (1) (c) The department may contract with an aging unit, as defined in s. 46.27 46.82 (1) (a), for administration of services under par. (a) if, by resolution, the county board of supervisors of that county so requests the department.
9,450
Section 450
. 46.275 (3) (e) of the statutes is repealed.
9,451
Section 451
. 46.275 (5) (b) 7. of the statutes is amended to read:
46.275 (5) (b) 7. Provide services in any community-based residential facility unless the county or department uses as a service contract the approved model contract developed under s. 46.27 (2) (j), 2017 stats., or a contract that includes all of the provisions of the approved model contract.
9,452
Section 452
. 46.277 (1m) (at) of the statutes is amended to read:
46.277 (1m) (at) “Private nonprofit agency"
has the meaning specified in s. 46.27 (1) (bm) means a nonprofit corporation, as defined in s. 181.0103 (17), that provides a program of all-inclusive care for the elderly under 42 USC 1395eee or 1396u-4.
9,453
Section 453
. 46.277 (3) (a) of the statutes is amended to read:
46.277 (3) (a) Sections 46.27 (3) (b) and Section 46.275 (3) (a) and (c) to (e) apply applies to county participation in this program, except that services provided in the program shall substitute for care provided a person in a skilled nursing facility or intermediate care facility who meets the level of care requirements for medical assistance reimbursement to that facility rather than for care provided at a state center for the developmentally disabled. The number of persons who receive services provided by the program under this paragraph may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and approved by the department.
9,454
Section 454
. 46.277 (5) (d) 2. (intro.) and b. of the statutes are consolidated, renumbered 46.277 (5) (d) 2. and amended to read:
46.277 (5) (d) 2. No county may use funds received under this section to provide residential services in any community-based residential facility, as defined in s. 50.01 (1g), unless one of the following applies: b. The the department approves the provision of services in a community-based residential facility that entirely consists of independent apartments, each of which has an individual lockable entrance and exit and individual separate kitchen, bathroom, sleeping and living areas, to individuals who are eligible under this section and are physically disabled or are at least 65 years of age.
9,455
Section 455
. 46.277 (5) (d) 2. a. of the statutes is repealed.
9,456
Section 456
. 46.277 (5) (d) 3. of the statutes is amended to read:
46.277 (5) (d) 3. If subd. 2. a. or b. applies, no county may use funds received under this section to pay for services provided to a person who resides or intends to reside in a community-based residential facility and who is initially applying for the services, if the projected cost of services for the person, plus the cost of services for existing participants, would cause the county to exceed the limitation under sub. (3) (c). The department may grant an exception to the requirement under this subdivision, under the conditions specified by rule, to avoid hardship to the person.
9,457
Section 457
. 46.277 (5) (f) of the statutes is amended to read:
46.277 (5) (f) No county or private nonprofit agency may use funds received under this subsection to provide services in any community-based residential facility unless the county or agency uses as a service contract the approved model contract developed under s. 46.27 (2) (j), 2017 stats., or a contract that includes all of the provisions of the approved model contract.
9,458
Section 458
. 46.278 (4) (a) of the statutes is amended to read:
46.278 (4) (a) Sections 46.27 (3) (b) and Section 46.275 (3) (a) and (c) to (e) apply applies to county participation in a program, except that services provided in the program shall substitute for care provided a person in an intermediate care facility for persons with an intellectual disability or in a brain injury rehabilitation facility who meets the intermediate care facility for persons with an intellectual disability or brain injury rehabilitation facility level of care requirements for medical assistance reimbursement to that facility rather than for care provided at a state center for the developmentally disabled.
9,459
Section 459
. 46.2803 of the statutes is repealed.
9,460
Section 460
. 46.2805 (1) (b) of the statutes is amended to read:
46.2805 (1) (b) A demonstration program known as the Wisconsin partnership Family Care Partnership program under a federal waiver authorized under 42 USC 1315 1396n.
9,461
Section 461
. 46.281 (1d) of the statutes is amended to read:
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 and the self-directed services option 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. Regardless of whether a waiver is approved, the department may implement operation of resource centers, care management organizations, and the family care benefit.
9,462
Section 462
. 46.281 (1n) (d) of the statutes is repealed.
9,463
Section 463
. 46.281 (3) of the statutes is repealed.
9,464
Section 464
. 46.2825 of the statutes is repealed.
9,465
Section 465
. 46.283 (3) (f) of the statutes is amended to read:
46.283 (3) (f) Assistance to a person who is eligible for the family care benefit with respect to the person's choice of whether or not to enroll in the self-directed services option, as defined in s. 46.2899 (1), a care management organization for the family care benefit or the Family Care Partnership program, or the program of all-inclusive care for the elderly and, if so, which available long-term care program or care management organization would best meet his or her needs.
9,466
Section 466
. 46.283 (4) (e) of the statutes is repealed.
9,467
Section 467
. 46.283 (4) (f) of the statutes is amended to read:
46.283 (4) (f) Perform a functional screening and a financial and cost-sharing screening for any resident, as specified in par. (e), 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.
9,468
Section 468
. 46.283 (6) (b) 7. of the statutes is repealed.
9,469
Section
469. 46.283 (6) (b) 9. of the statutes is amended to read:
46.283 (6) (b) 9. Review the number and types of grievances and appeals concerning the long-term care system in the area served by related to the resource center, to determine if a need exists for system changes, and recommend system or other changes if appropriate.
9,470
Section 470
. 46.283 (6) (b) 10. of the statutes is repealed.
9,471
Section 471
. 46.285 (intro.) of the statutes is renumbered 46.285 and amended to read:
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:.
9,472
Section 472
. 46.285 (1) of the statutes is repealed.
9,473
Section 473
. 46.285 (2) of the statutes is repealed.
9,474
Section 474
. 46.286 (3) (b) 2. a. of the statutes is repealed.
9,475
Section 475
. 46.287 (2) (a) 1. (intro.) of the statutes is amended to read:
46.287 (2) (a) 1. (intro.) Except as provided in subd. 2., a client may contest any of the following applicable matters by filing, within 45 days of the failure of a resource center or care management organization
county to act on the contested matter within the time frames specified by rule by the department or within 45 days after receipt of notice of a decision in a contested matter, a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1):
9,476
Section 476
. 46.287 (2) (a) 1. d. of the statutes is renumbered 46.287 (2) (a) 1m. b.
9,477
Section 477
. 46.287 (2) (a) 1. e. of the statutes is repealed.
9,478
Section 478
. 46.287 (2) (a) 1. f. of the statutes is repealed.
9,479
Section 479
. 46.287 (2) (a) 1m. of the statutes is created to read:
46.287 (2) (a) 1m. Except as provided in subd. 2., a client may contest any of the following adverse benefit determinations by filing, within 90 days of the failure of a care management organization to act on a contested adverse benefit determination within the time frames specified by rule by the department or within 90 days after receipt of notice of a decision upholding the adverse benefit determination, a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1):
a. Denial of functional eligibility under s. 46.286 (1) as a result of the care management organization's administration of the long-term care functional screen, including a change from a nursing home level of care to a non-nursing home level of care.
c. Denial or limited authorization of a requested service, including determinations based on type or level of service, requirements or medical necessity, appropriateness, setting, or effectiveness of a covered benefit.
d. Reduction, suspension, or termination of a previously authorized service, unless the service was only authorized for a limited amount or duration and that amount or duration has been completed.
e. Denial, in whole or in part, of payment for a service.
f. The failure of a care management organization to act within the time frames provided in 42 CFR 438.408 (b) (1) and (2) regarding the standard resolution of grievances and appeals.
g. Denial of an enrollee's request to dispute financial liability, including copayments, premiums, deductibles, coinsurance, other cost sharing, and other member financial liabilities.
