49.45 (39) School medical services. (a) Definitions. In this subsection:
1. “School" means a public school described under s. 115.01 (1) or a charter school, as defined in s. 115.001 (1). It includes school-operated early childhood programs for developmentally delayed and disabled 4-year-old and 5-year-old children.
2. “School medical services" means health care services that are provided in a school to children who are eligible for medical assistance that are appropriate to a school setting, as provided in the amendment to the state medical assistance plan under par. (am).
(am) Plan amendment. No later than September 30, 1995, the department shall submit to the federal department of health and human services an amendment to the state medical assistance plan to permit the application of pars. (b) to (c). If the amendment to the state plan is approved,
the department shall implement an administrative system to permit school districts and cooperative educational service agencies
to claim reimbursement under pars. (b) to (c). If the amendment to the state plan is approved and in effect, the department shall implement an administrative system to permit reimbursement under pars. (b) to (c). Paragraphs (b) to (c) do not apply unless the amendment to the state plan is approved and in effect
and the department determines that the an administrative system to permit reimbursement under pars. (b) to (c) has been implemented.
(b) Payment for school medical services. If a school district or a cooperative educational service agency elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district or the cooperative educational service agency for 60% of the federal share of allowable charges for the school medical services that it provides and for allowable administrative costs. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. All other expenses for the school medical services shall be paid for by the school district or the cooperative educational service agency with funds received from state or local taxes. The school district or the cooperative educational service agency shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.
(c) Certification and reporting requirements. The department shall promulgate rules establishing specific certification and reporting requirements with respect to school medical services under this subsection.
27,3001
Section 3001
. 49.45 (40) of the statutes is created to read:
49.45 (40) Periodic record matches. The department shall cooperate with the department of industry, labor and human relations in matching records of medical assistance recipients under s. 49.32 (7).
27,3002b
Section 3002b. 49.45 (41) of the statutes is created to read:
49.45 (41) Mental health crisis intervention services. (a) In this subsection:
1. “Mental health crisis intervention services" means services that are provided by a mental health crisis intervention program operated by, or under contract with, a county or municipality, if the county or municipality is certified as a medical assistance provider.
2. “Municipality" means a city, village or town.
(b) If a county or municipality elects to become certified as a provider of mental health crisis intervention services, the county or municipality may provide mental health crisis intervention services under this subsection in the county or municipality to medical assistance recipients through the medical assistance program. A county or municipality that elects to provide the services shall pay the amount of the allowable charges for the services under the medical assistance program that is not provided by the federal government. The department shall reimburse the county or municipality under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.
27,3002m
Section 3002m. 49.45 (42) of the statutes is created to read:
49.45 (42) Personal care services. Personal care services under s. 49.46 (2) (b) 6. j. provided to an individual are reimbursable under medical assistance only if all of the following conditions are met:
(a) The provider of the personal care services receives prior authorization from the department for all personal care services that are provided to the individual in excess of 50 hours in a calendar year.
(b) The individual is not eligible to receive home health aide services under medicare, as defined in sub. (3) (L) 1. b.
27,3002r
Section 3002r. 49.45 (43) of the statutes is created to read:
49.45 (43) Case management services for high-cost recipients. The department may establish a program to provide case management services for medical assistance recipients with high-cost chronic health conditions or high-cost catastrophic health conditions. If the department establishes a program to provide these case management services, the department shall provide reimbursement for providers of these case management services under the medical assistance program.
27,3003
Section 3003
. 49.455 (4) (c) of the statutes is repealed and recreated to read:
49.455 (4) (c) 1. For any year, the minimum monthly maintenance needs allowance equals the lesser of the amount determined under subd. 2., or the sum of the following:
a. One-twelfth of 200% of the poverty line for a family of 2 persons.
b. Any excess shelter allowance under par. (d).
2. The minimum monthly maintenance needs allowance in a year may not exceed $1,500 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.
3. In making the calculation under subd. 1. a., when the poverty line is revised the department shall use the revised amount starting on the first day of the 2nd calendar quarter beginning after the date of publication of the revision.
27,3004
Section 3004
. 49.455 (4) (d) of the statutes is created to read:
49.455 (4) (d) The excess shelter allowance equals the amount by which 30% of the amount determined under par. (c) 1. a. is exceeded by the sum of the following:
1. The community spouse's expenses for rent or mortgage principal and interest, taxes and insurance for his or her principal residence and, if the community spouse lives in a condominium or cooperative, any required maintenance charge.
2. The standard utility allowance established under 7 USC 2014 (e), except that if the community spouse lives in a condominium or cooperative for which the maintenance charge includes utility expenses, the standard utility allowance under 7 USC 2014 (e) is reduced by the amount of the utility expenses included in the maintenance charge.
27,3005b
Section 3005b. 49.455 (6) (b) 1. of the statutes is amended to read:
49.455 (6) (b) 1. In 1989, $60,000; in a calendar year after 1989, $60,000 any year, $12,000 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the calendar year involved.
27,3005d
Section 3005d. 49.455 (6) (b) 1m. of the statutes is created to read:
49.455 (6) (b) 1m. $50,000.
27,3006
Section 3006
. 49.455 (6) (b) 2. of the statutes is created to read:
49.455 (6) (b) 2. The lesser of the following:
a. The spousal share computed under sub. (5) (a) 1.
b. In any year, $60,000 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.
27,3007
Section 3007
. 49.46 (1) (a) 4. of the statutes is amended to read:
49.46 (1) (a) 4. Any person receiving benefits under s. 49.177 49.77 or federal Title XVI.
27,3008
Section 3008
. 49.46 (1) (a) 15. of the statutes is created to read:
49.46 (1) (a) 15. Any individual who is infected with tuberculosis and meets the income and resource eligibility requirements for the federal supplemental security program under 42 USC 1381 to 1383d.
27,3009
Section 3009
. 49.46 (1) (d) 4. of the statutes is amended to read:
49.46 (1) (d) 4. A child who meets the conditions under 42 USC 1396a (e) 3. (3) shall be considered a recipient of benefits under s. 49.177 49.77 or federal Title XVI.
27,3010
Section 3010
. 49.46 (1) (e) of the statutes is amended to read:
49.46 (1) (e) If an application under s. 49.47 (3) shows that the person has income and resources within the limitations of s. 49.19, federal Title XVI or s. 49.177 49.77, or that the person is an essential person, an accommodated person or a patient in a public medical institution, the person shall be granted the benefits enumerated under sub. (2) whether or not the person requests or receives a grant of any of such aids.
27,3011
Section 3011
. 49.46 (2) (a) 2. of the statutes is amended to read:
49.46 (2) (a) 2. Early and periodic screening and diagnosis, including case management services, of persons under 21 years of age and all medical treatment and dentists' services specified in par. (b) 1. found necessary by this screening and diagnosis.
27,3012
Section 3012
. 49.46 (2) (a) 4. d. of the statutes is amended to read:
49.46 (2) (a) 4. d. Home health services, subject to the limitations under s. 49.45 (8), (8e) and (8f), or nursing services, if a home health agency is unavailable
, nursing services, subject to the limitations under s. 49.45 (8e) and (8f).
27,3013
Section 3013
. 49.46 (2) (a) 4. g. of the statutes is renumbered 49.46 (2) (a) 4m. and amended to read:
49.46 (2) (a) 4m. Nurse midwifery
Nurse-midwifery services.
27,3019b
Section 3019b. 49.46 (2) (b) 1. h. of the statutes is repealed.
27,3019c
Section 3019c. 49.46 (2) (b) 1. i. of the statutes is repealed.
27,3020m
Section 3020m. 49.46 (2) (b) 6. j. of the statutes is amended to read:
49.46 (2) (b) 6. j. Personal care services, subject to the limitations under s. 49.45 (8e), (8f) and (42).
27,3021
Section 3021
. 49.46 (2) (b) 6. k. of the statutes is amended to read:
49.46 (2) (b) 6. k. Alcohol and other drug abuse day treatment services. This subd. 6. k. does not apply after June 30, 1995, or the day after publication of the 1995-97 biennial budget act, whichever is later.
27,3022
Section 3022
. 49.46 (2) (b) 14. of the statutes is created to read:
49.46 (2) (b) 14. School medical services under s. 49.45 (39).
27,3023
Section 3023
. 49.46 (2) (b) 15. of the statutes is created to read:
49.46 (2) (b) 15. Mental health crisis intervention services under s. 49.45 (41).
27,3023m
Section 3023m. 49.46 (2) (b) 16. of the statutes is created to read:
49.46 (2) (b) 16. Case management services for recipients with high-cost chronic health conditions or high-cost catastrophic health conditions, if the department operates a program under s. 49.45 (43).
27,3024
Section 3024
. 49.46 (2) (bm) of the statutes is created to read:
49.46 (2) (bm) Benefits for an individual who is eligible for medical assistance only under sub. (1) (a) 15. are limited to those services related to tuberculosis that are described in 42 USC 1396a (z) (2).
27,3025
Section 3025
. 49.46 (2) (d) of the statutes is amended to read:
49.46 (2) (d) Benefits authorized under this subsection may not include payment for that part of any service payable through 3rd party liability or any federal, state, county, municipal or private benefit system to which the beneficiary is entitled. “Benefit system" does not include any public assistance program such as, but not limited to, Hill-Burton benefits under 42 USC 291c (e), in effect on April 30, 1980, or general relief funded by a relief block grant.
27,3026
Section 3026
. 49.47 (4) (av) of the statutes is created to read:
49.47 (4) (av) 1. In this paragraph, “migrant worker" means any person who temporarily leaves a principal place of residence outside of this state and comes to this state for not more than 10 months in a year to accept seasonal employment in the planting, cultivating, raising, harvesting, handling, drying, packing, packaging, processing, freezing, grading or storing of any agricultural or horticultural commodity in its unmanufactured state. “Migrant worker" does not include any of the following:
a. A person who is employed only by a state resident if the resident or the resident's spouse is related to the person as the child, parent, grandchild, grandparent, brother, sister, aunt, uncle, niece, nephew, or the spouse of any such relative.
b. A student who is enrolled or, during the past 6 months has been enrolled, in any school, college or university unless the student is a member of a family or household which contains a migrant worker.
c. Any other person qualifying for an exemption under rules promulgated by the department.
2. The department shall request a waiver from the secretary of the federal department of health and human services to allow the application of subd. 3. The waiver shall also seek a waiver from those federal quality control standards under the medical assistance program that the department determines to be necessary in order to make the application of subd. 3. feasible. Subdivision 3. applies only while the waiver under this subdivision is in effect.
3. In determining the eligibility for a migrant worker and his or her dependents for medical assistance under this section, the department shall do all of the following:
a. Grant the migrant worker and his or her dependents eligibility for medical assistance in this state, if the migrant worker and his or her dependents have a valid medical assistance identification card issued in another state and the migrant worker completes a Wisconsin medical assistance application provided by the department. Eligibility under this subd. 3. a. continues for the period specified on the identification card issued in the other state. The department shall notify the other state that the migrant worker and his or her dependents are eligible for medical assistance in Wisconsin.
b. Determine medical assistance eligibility using an income-averaging method described in the waiver under subd. 2., if the migrant worker and his or her dependents do not meet the income limitations under par. (c) using prospective budgeting.
27,3028
Section 3028. 49.47 (4) (c) 1. of the statutes is amended to read:
49.47 (4) (c) 1. Except as provided in par. (am) and as limited by subd. 3., eligibility exists if income does not exceed 133 1/3% of the maximum aid to families with dependent children payment under s. 49.19 (11) for the applicant's family size or the combined benefit amount available under supplemental security income under 42 USC 1381 to 1383c and state supplemental aid under s. 49.177 49.77 whichever is higher. In this subdivision “income" includes earned or unearned income that would be included in determining eligibility for the individual or family under s. 49.177 or 49.19 or 49.77, or for the aged, blind or disabled under 42 USC 1381 to 1385. “Income" does not include earned or unearned income which would be excluded in determining eligibility for the individual or family under s. 49.177 or 49.19
or 49.77, or for the aged, blind or disabled individual under 42 USC 1381 to 1385.
27,3035
Section 3035
. 49.48 (title) of the statutes is renumbered 49.68 (title).
27,3036
Section 3036
. 49.48 (1) of the statutes is renumbered 49.68 (1).
27,3037
Section 3037
. 49.48 (1m) of the statutes is renumbered 49.68 (1m).
27,3038
Section 3038
. 49.48 (2) of the statutes is renumbered 49.68 (2).
27,3039
Section 3039
. 49.48 (3) (title) of the statutes is renumbered 49.68 (3) (title).
27,3040
Section 3040
. 49.48 (3) (a) of the statutes is renumbered 49.68 (3) (a) and amended to read:
49.68 (3) (a) Any permanent resident of this state who suffers from chronic renal disease may be accepted into the dialysis treatment phase of the renal disease control program if the resident meets standards set by rule under sub. (2) and s. 49.487 49.687.
27,3041
Section 3041
. 49.48 (3) (b) of the statutes is renumbered 49.68 (3) (b).
27,3042
Section 3042
. 49.48 (3) (c) of the statutes is renumbered 49.68 (3) (c).
27,3043
Section 3043
. 49.48 (3) (d) of the statutes is renumbered 49.68 (3) (d).
27,3044
Section
3044. 49.48 (3) (e) of the statutes is renumbered 49.68 (3) (e).
