2001 Wisconsin Act 16

16,1495m Section 1495m. 46.22 (1g) of the statutes is repealed.

16,1502L Section 1502L. 46.27 (3) (f) of the statutes is amended to read:

46.27 (3) (f) Beginning on January 1, 1996, from the annual allocation to the county for the provision of long-term community support services under subs. (7) (b) and (11), annually establish a maximum total amount that may be encumbered in a calendar year for services for eligible individuals in community-based residential facilities, unless the department waives the requirement under sub (2) (i) or approves a request for an exception under sub. (6r) (c).

16,1502n Section 1502n. 46.27 (7) (cm) 1. (intro.) of the statutes is amended to read:

46.27 (7) (cm) 1. (intro.) Except as provided sub. (7b), beginning Beginning on January 1, 1996, no county, private nonprofit agency or aging unit may use funds received under par. (b) to provide services in any community-based residential facility that has more than 8 20 beds, unless one of the following applies:

16,1502p Section 1502p. 46.27 (7) (cm) 1. c. of the statutes is amended to read:

46.27 (7) (cm) 1. c. The department approves the provision of services in a community-based residential facility that is initially licensed after July 29, 1995, that is licensed for more than 20 or fewer beds and that meets standards established under subd. 2.

16,1502r Section 1502r. 46.27 (7b) of the statutes is repealed.

16,1503 Section 1503. 46.27 (9) (a) of the statutes is amended to read:

46.27 (9) (a) The department may select up to 5 counties that volunteer to participate in a pilot project under which they will receive certain funds allocated for long-term care. The department shall allocate a level of funds to these counties equal to the amount that would otherwise be paid under s. 20.435 (4) (b) or (w) to nursing homes for providing care because of increased utilization of nursing home services, as estimated by the department. In estimating these levels, the department shall exclude any increased utilization of services provided by state centers for the developmentally disabled. The department shall calculate these amounts on a calendar year basis under sub. (10).

16,1504 Section 1504. 46.27 (10) (a) 1. of the statutes is amended to read:

46.27 (10) (a) 1. The department shall determine for each county participating in the pilot project under sub. (9) a funding level of state medical assistance expenditures to be received by the county. This level shall equal the amount that the department determines would otherwise be paid under s. 20.435 (4) (b) or (w) because of increased utilization of nursing home services, as estimated by the department.

16,1504r Section 1504r. 46.27 (11) (c) 5p. of the statutes is repealed.

16,1505b Section 1505b. 46.27 (11) (c) 6. (intro.) and a. of the statutes are consolidated, renumbered 46.27 (11) (c) 6. a. and amended to read:

46.27 (11) (c) 6. a. No county, private nonprofit agency or aging unit may use funds received under this subsection to provide residential services in any community-based residential facility, as defined in s. 50.01 (1g), or a group home, as defined in s. 48.02 (7), that has more than 4 5 beds, unless one of the following applies: a. The the department approves the provision of services in a community-based residential facility or group home that has 5 6 to 8 beds.

16,1505d Section 1505d. 46.27 (11) (c) 6. b. of the statutes is repealed and recreated to read:

46.27 (11) (c) 6. b. No county, private nonprofit agency, or aging unit may use funds received under this subsection to provide residential services in a community-based residential facility, as defined in s. 50.01 (1g), that has more than 20 beds, unless the requirements of sub. (7) (cm) 1. a., b., or c. are met.

16,1506 Section 1506. 46.275 (5) (a) of the statutes is amended to read:

46.275 (5) (a) Medical assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriations under s. 20.435 (4) (b) and, (o), and (w). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, medical assistance reimbursement is also available for services provided jointly by these counties.

16,1507 Section 1507. 46.275 (5) (c) of the statutes is amended to read:

46.275 (5) (c) The total allocation under s. 20.435 (4) (b) and, (o), and (w) to counties and to the department under sub. (3r) for services provided under this section may not exceed the amount approved by the federal department of health and human services. A county may use funds received under this section only to provide services to persons who meet the requirements under sub. (4) and may not use unexpended funds received under this section to serve other developmentally disabled persons residing in the county.

16,1507s Section 1507s. 46.277 (5) (d) 1m. (intro.) of the statutes is amended to read:

46.277 (5) (d) 1m. (intro.) No county may use funds received under this section to provide services to a person who does not live in his or her own home or apartment unless, subject to the limitations under subds. 2. and , 3., and 4. and par. (e), one of the following applies:

16,1507t Section 1507t. 46.277 (5) (d) 1n. (intro.) of the statutes is amended to read:

46.277 (5) (d) 1n. (intro.) A county may also use funds received under this section, subject to the limitations under subds. 2. and, 3., and 4. and par. (e), to provide services to a person who does not live in his or her own home or apartment if the services are provided to the person in a community-based residential facility and the county department or aging unit has determined that all of the following conditions have been met:

16,1507u Section 1507u. 46.277 (5) (d) 2. (intro.) of the statutes is amended to read:

46.277 (5) (d) 2. (intro.) 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), or group home, as defined in s. 48.02 (7), that has more than 4 beds, unless one of the following applies:

16,1508b Section 1508b. 46.277 (5) (d) 2. a. of the statutes is repealed and recreated to read:

46.277 (5) (d) 2. a. The requirements of s. 46.27 (7) (cm) 1. a. or c. are met.

16,1508d Section 1508d. 46.277 (5) (d) 4. of the statutes is created to read:

46.277 (5) (d) 4. No county may use funds received under this section to provide residential services in a group home, as defined in s. 48.02 (7), that has more than 5 beds, unless the department approves the provision of services in a group home that has 6 to 8 beds.

16,1508rg Section 1508rg. 46.278 (title) and (1) of the statutes are amended to read:

46.278 (title) Community integration program and brain injury waiver program for persons with mental retardation developmental disabilities.

(1) Legislative intent. The intent of the program programs under this section is to provide home or community-based care to serve in a noninstitutional community setting a person who meets eligibility requirements under 42 USC 1396n (c) and who is diagnosed as developmentally disabled under the definition specified in s. 51.01 (5) and relocated from an institution other than a state center for the developmentally disabled or who meets the intermediate care facility for the mentally retarded or a brain injury rehabilitation facility level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded or brain injury rehabilitation facility and is ineligible for services under s. 46.275 or 46.277. The intent of the program is also that counties use all existing services for providing care under this section, including those services currently provided by counties.

16,1508rh Section 1508rh. 46.278 (1m) (a) of the statutes is created to read:

46.278 (1m) (a) "Brain injury rehabilitation facility" means a nursing facility or hospital designated as a facility for brain injury rehabilitation by the department under the approved state medicaid plan.

16,1508ri Section 1508ri. 46.278 (1m) (c) of the statutes is amended to read:

46.278 (1m) (c) "Program" means the community integration program or the brain injury waiver program, for facilities certified as medical assistance providers, for which a waiver has been received under sub. (3).

16,1508rj Section 1508rj. 46.278 (2) (a) of the statutes is amended to read:

46.278 (2) (a) The department may request a waiver one or more waivers from the secretary of the federal department of health and human services, under 42 USC 1396n (c), authorizing the department to serve medical assistance recipients, who meet the level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded or in a brain injury rehabilitation facility, in their communities by providing home or community-based services as part of medical assistance. If the department requests a waiver, it shall include all assurances required under 42 USC 1396n (c) (2) in its request.

16,1508rk Section 1508rk. 46.278 (3) (a) of the statutes is amended to read:

46.278 (3) (a) Evaluate the effect of the each program on medical assistance costs and on the program's ability to provide community care alternatives to institutional care in facilities certified as medical assistance providers.

16,1508rL Section 1508rL. 46.278 (4) (a) of the statutes is amended to read:

46.278 (4) (a) Sections 46.27 (3) (b) and 46.275 (3) (a) and (c) to (e) apply to county participation in this a program, except that services provided in the program shall substitute for care provided a person in an intermediate care facility for the mentally retarded or brain injury rehabilitation facility who meets the intermediate care facility for the mentally retarded 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.

16,1508rm Section 1508rm. 46.278 (4) (b) 2. of the statutes is amended to read:

46.278 (4) (b) 2. Each county department participating in the a program shall provide home or community-based care to persons eligible under this section, except that the number of persons who receive home or community-based care under this section may not exceed the number that are approved under the an applicable waiver received under sub. (3).

16,1508rn Section 1508rn. 46.278 (5) (a) and (b) of the statutes are amended to read:

46.278 (5) (a) Any medical assistance recipient who meets the level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded or in a brain injury rehabilitation facility and is ineligible for service under s. 46.275 or 46.277 is eligible to participate in the a program, except that persons eligible for the brain injury waiver program must meet the definition of brain injury under s. 51.01 (2g), and except that the number of participants may not exceed the number approved under the waiver received under sub. (3). Such a recipient may apply, or any person may apply on behalf of such a recipient, for participation in the a program. Section 46.275 (4) (b) applies to participation in the a program.

(b) To the extent authorized under 42 USC 1396n, if a person discontinues participation in the a program, a medical assistance recipient may participate in the a program in place of the participant who discontinues if that recipient meets the intermediate care facility for the mentally retarded level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded except that the number of participants concurrently served may not exceed the number approved under the waiver received under sub. (3) requirements under par. (a).

16,1508rp Section 1508rp. 46.278 (6) (a), (b) and (c) of the statutes are amended to read:

46.278 (6) (a) The provisions of s. 46.275 (5) (a), (b) and (d) apply to funding received by counties under the program programs.

(b) Total funding to counties for relocating each person under the a program may not exceed the amount approved in the waiver received under sub. (3).

(c) Funding may be provided under the a program for services of a family consortium.

16,1509 Section 1509. 46.278 (6) (d) of the statutes is amended to read:

46.278 (6) (d) If a county makes available nonfederal funds equal to the state share of service costs under the a waiver received under sub. (3), the department may, from the appropriation under s. 20.435 (4) (o), provide reimbursement for services that the county provides under this section to persons who are in addition to those who may be served under this section with funds from the appropriation under s. 20.435 (4) (b) or (w).

16,1509g Section 1509g. 46.278 (6) (e) 1. of the statutes is amended to read:

46.278 (6) (e) 1. The department may provide enhanced reimbursement for services under the community integration program for an individual who was relocated to the community by a county department from one of the following:

16,1509h Section 1509h. 46.278 (6) (f) of the statutes is amended to read:

46.278 (6) (f) If a county owns the institution or intermediate care facility for the mentally retarded from which an individual is relocated to the community under this section, in order to receive funding under the community integration program, the county shall submit a plan for delicensing a bed of the institution or intermediate care facility for the mentally retarded that is approved by the department.

16,1520d Section 1520d. 46.282 (3) (a) 2. a. of the statutes is amended to read:

46.282 (3) (a) 2. a. In the years 2000 and 2001 Before July 1, 2003, under criteria that the department prescribes, after consulting with the council on long-term care, evaluate the performance of the care management organization or organizations in the area of the local long-term care council and determine whether additional care management organizations are needed in the area and, if so, recommend this to the department.

16,1520e Section 1520e. 46.282 (3) (a) 2. b. of the statutes is amended to read:

46.282 (3) (a) 2. b. In the year 2002 and thereafter After June 30, 2003, under criteria that the department prescribes, evaluate the performance of the care management organization or organizations in the area of the local long-term care council and determine whether additional care management organizations are needed in the area and, if so recommend this to the department.

16,1520w Section 1520w. 46.282 (3) (a) 15. of the statutes is amended to read:

46.282 (3) (a) 15. Annually report to the department and, before July 1, 2001 2003, to the council on long-term care council concerning significant achievements and problems in the local long-term care system.

16,1528 Section 1528. 46.283 (5) of the statutes is amended to read:

46.283 (5) Funding. From the appropriation accounts under s. 20.435 (4) (b), (bm) and, (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) and shall distribute funds for services provided by resource centers.

16,1532 Section 1532. 46.284 (5) (a) of the statutes is amended to read:

46.284 (5) (a) From the appropriation accounts under s. 20.435 (4) (b), (g) and, (im), (o) , and (w) and (7) (b) and (bd), 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.

16,1534 Section 1534. 46.286 (1) (a) 2. (intro.) of the statutes is amended to read:

46.286 (1) (a) 2. (intro.) The person has a condition that is expected to last at least 90 days or result in death within 12 months after the date of application but that does not meet the level specified under subd. 1. a. or b.; the person first applies for eligibility for the family care benefit within 36 months after the date on which the family care benefit is initially available in the person's county residence; and, on the date that the family care benefit became available in the person's county of residence, the person was a resident in a nursing home or had been receiving for at least 60 days, under a written plan of care, long-term care services, as specified by the department, that were funded under any of the following:

16,1535 Section 1535. 46.286 (1m) of the statutes is amended to read:

46.286 (1m) Eligibility exception. A person whose primary disabling condition is developmental disability is eligible for the family care benefit if the person is a resident of a county or is a member of a tribe or band that has operated, before July 1, 2001 2003, a care management organization under s. 46.281 (1) (d), is at least 18 years of age and meets all other eligibility criteria under this subsection sub. (1) (a) and (b).

16,1536 Section 1536. 46.286 (3) (a) (intro.) of the statutes is amended to read:

46.286 (3) (a) (intro.) Subject to pars. (c) and (d), a person is entitled to and may receive the family care benefit through enrollment in a care management organization if, except as provided in subd. 5., he or she meets the requirements of sub. (1) (intro.) is at least 18 years of age, has a physical disability, as defined in s. 15.197 (4) (a) 2., or infirmities of aging, as defined in s. 55.01 (3), is financially eligible, fulfills any applicable cost-sharing requirements and meets any of the following criteria:

16,1537 Section 1537. 46.286 (3) (a) 6. of the statutes is created to read:

46.286 (3) (a) 6. Is functionally eligible at the intermediate level and meets all of the following criteria:

a. On the date on which the family care benefit is initially available in the person's county of residence, is a resident in a nursing home or has been receiving for at least 60 days, under a written plan of care, long-term care services, as specified by the department, which are funded as specified under sub. (1) (a) 2. a., b., c., d., or e.

b. Enrolls within 36 months after the date on which the family care benefit is initially available in the person's county of residence.

16,1538 Section 1538. 46.286 (3) (d) of the statutes is amended to read:

46.286 (3) (d) The department shall determine the date, which shall not be later than July 1, 2000 January 1, 2004, on which par. (a) shall first apply to persons who are not eligible for medical assistance under ch. 49. Before the date determined by the department, persons who are not eligible for medical assistance may receive the family care benefit within the limits of state funds appropriated for this purpose and available federal funds.

16,1553b Section 1553b. 46.29 (1) (f) of the statutes is repealed.

16,1553t Section 1553t. 46.40 (1) (a) of the statutes is amended to read:

46.40 (1) (a) Within the limits of available federal funds and of the appropriations under s. 20.435 (3) (o) and (7) (b), (kw) and (o), the department shall distribute funds for community social, mental health, developmental disabilities, and alcohol and other drug abuse services and for services under ss. 46.51, 46.87, 46.985, and 51.421 to county departments under ss. 46.215, 46.22, 46.23, 51.42, and 51.437 and to county aging units, as provided in subs. (2), (2m), and (7) to (9).

16,1554d Section 1554d. 46.40 (2) of the statutes is amended to read:

46.40 (2) Basic county allocation. Subject to sub. (9), for social services under s. 46.495 (1) (d) and services under s. 51.423 (2), the department shall distribute not more than $284,978,800 $244,745,200 for fiscal year 1999-2000 2001-02 and $285,511,800 $244,703,400 for fiscal year 2000-01 2002-03.

16,1555 Section 1555. 46.40 (2m) (a) of the statutes is amended to read:

46.40 (2m) (a) Prevention and treatment of substance abuse. For prevention and treatment of substance abuse under 42 USC 300x-21 to 300x-35, the department shall distribute not more than $11,318,700 $9,735,700 in each fiscal year.

16,1555w Section 1555w. 46.40 (7) of the statutes is amended to read: