(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. 49.455 (4) (c) of the statutes is repealed and recreated to read: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).
27,3044b
Section 3044b. 49.482 of the statutes is created to read:
49.482 Recovery from estates.
(1) In this section:
(a) “Client" means a person who receives or received aid under s. 49.48, 49.483 or 49.485.
(b) “Disabled" has the meaning given in s. 49.468 (1) (a) 1.
(c) “Home" means property in which a person has an ownership interest consisting of the person's dwelling and the land used and operated in connection with the dwelling.
(2) (a) Except as provided in par. (d), the department shall file a claim against the estate of a client or against the estate of the surviving spouse of a client for the amount of aid under s. 49.48, 49.483 or 49.485 paid to or on behalf of the client.
(b) The affidavit of a person designated by the secretary to administer this subsection is evidence of the amount of the claim.
(c) The court shall reduce the amount of a claim under par. (a) by up to $3,000 if necessary to allow the client's heirs or the beneficiaries of the client's will to retain the following personal property:
1. The decedent's wearing apparel and jewelry held for personal use.
2. Household furniture, furnishings and appliances.
3. Other tangible personal property not used in trade, agriculture or other business, not to exceed $1,000 in value.
(d) A claim under par. (a) is not allowable if the decedent has a surviving child who is under age 21 or disabled or a surviving spouse.
(e) If the department's claim is not allowable because of par. (d) and the estate includes an interest in a home, the court exercising probate jurisdiction shall, in the final judgment, assign the interest in the home subject to a lien in favor of the department for the amount described in par. (a). The personal representative shall record the final judgment as provided in s. 863.29.
(f) The department may not enforce the lien under par. (e) as long as any of the following survive the decedent:
1. A spouse.
2. A child who is under age 21 or disabled.
