Wisconsin Legislature: 203,40

(6) Payment of board expenditures. (a) The Milwaukee County board of supervisors and the department shall enter an agreement for the payment of expenses of the Milwaukee County mental health board and for the performance of the audit and the completion of the report under 2013 Wisconsin Act .... (this act), section 53 (4).

(b) The Milwaukee County board of supervisors shall arrange for the payment of expenses from the mental health budget, as defined in sub. (4) (a) 2., according to the agreement under par. (a). All payments shall be credited to the appropriation account under s. 20.435 (5) (kf).

(7) County department requirements. (a) A county department under s. 46.21 or 51.42 in Milwaukee County may not impede the Milwaukee County mental health board in performing its duties under this section or exercising its powers under this section.

(b) A county department under s. 46.21 or 51.42 in Milwaukee County shall respond to any requests for information from the Milwaukee County mental health board.

(8) Reports; studies. (a) By March 1, 2015, and annually by March 1 thereafter, the Milwaukee County mental health board shall submit to the Milwaukee County executive, the Milwaukee County board of supervisors, and the department a report including a description of the funding allocations for Milwaukee County's mental health functions, services, and programs and a description of any improvements and efficiencies in those mental health functions, programs, and services. The department shall provide access to the report under this subsection to the public including posting the report on the department's Internet site.

(b) The Milwaukee County mental health board shall arrange for a study to be conducted on alternate funding sources for mental health services and programs including fee-for-service models, managed care models that integrate mental health services into the contracts with an increased offset through basic county allocation reduction, and other funding models. By March 1, 2016, the Milwaukee County mental health board shall submit to the Milwaukee County board of supervisors, the Milwaukee County executive, and the department a report of the results of the study.

(9) Administrator. (a) The Milwaukee County executive shall nominate an individual to be the administrator of any division or branch of the department under s. 46.21 that administers behavioral health for Milwaukee County. The nominated individual may be hired as the administrator only upon approval of the Milwaukee County mental health board. If the county executive does not nominate an individual by June 1, 2015, the Milwaukee County mental health board may hire an individual to be the administrator. Upon a vacancy in the position of administrator, if the county executive does not nominate an individual within 12 months of the date the position becomes vacant, the Milwaukee County mental health board may hire an individual to be the administrator.

(b) The Milwaukee County executive shall determine the salary and benefits and the job duties of the administrator. The county executive may not assign the administrator any duties that are not related to mental health functions, programs, and services in Milwaukee County.

(c) 1. The administrator under this subsection may be removed by the Milwaukee County mental health board by a vote of 8 members of that board.

2. The Milwaukee County executive may recommend removal of the administrator under this subsection to the Milwaukee County mental health board. If the county executive recommends removal under this subdivision, the Milwaukee County mental health board may remove the administrator upon a vote of 6 members of that board.

(d) The Milwaukee County board of supervisors may not hire, remove, or discipline; set the salary or benefits of, or assign or remove any job duties of the administrator under this subsection.

(10) Mental health contracts. Any contract related to mental health with a value of at least $100,000, to which Milwaukee County is a party may take effect only if the Milwaukee County mental health board votes to approve, or does not vote to reject, the contract within 28 days after the contract is signed or countersigned by the county executive.

(11) Transition liaison position. (a) The Milwaukee County executive shall nominate an individual who has knowledge of the services provided by and the mental health systems of Milwaukee County to be a transition liaison to assist the Milwaukee County mental health board in the transition of oversight functions and to ensure there is no interruption of mental health services. The transition liaison shall be assigned or hired to that position only upon approval of the Milwaukee County mental health board. The transition liaison shall be assigned to or employed in that position for no longer than 12 months, except that the county executive may grant extensions to the term of that position.

(b) 1. The Milwaukee County executive shall determine the salary and benefits and the job duties of the transition liaison assigned or hired under par. (a).

2. The Milwaukee County executive may remove the transition liaison assigned or hired under par. (a). If the Milwaukee County executive removes the transition liaison assigned or hired under par. (a) before the 12 months following the date of the assignment or hiring of the initial transition liaison have expired, the Milwaukee County executive shall nominate another transition liaison to serve for at least the remainder of the 12 months following the date of the assignment or hiring of the initial transition liaison.

(c) The Milwaukee County board of supervisors may not hire, remove, or discipline; set the salary or benefits of; or assign or remove any job duties of the transition liaison assigned or hired under this subsection.

203,35m Section 35m. 51.41 (3) and (5) (a) and (b) of the statutes, as created by 2013 Wisconsin Act .... (this act), are amended to read:

51.41 (3) Public hearing; meetings. The Milwaukee County mental health board shall meet 6 times each year and may meet at other times on the call of the chairperson or a majority of the board's members. Annually, the Milwaukee County mental health board shall hold a public hearing in Milwaukee County as one of its required meetings.

(5) (a) The Milwaukee County board of supervisors has no jurisdiction over any mental health policy, functions, programs, or services. The Milwaukee County board of supervisors may not create new mental health functions, programs, or services that are under the jurisdiction of the board of supervisors. Any dispute between the Milwaukee County board of supervisors and the Milwaukee County mental health board over whether a function, program, or service is a mental health function, program, or service under the jurisdiction of the Milwaukee County mental health board shall be resolved by the secretary of health services.

(b) The Milwaukee County mental health board may transfer jurisdiction over a Milwaukee County function, service, or program to itself that pertains to mental health or is highly integrated with mental health services and that is not under its jurisdiction by statute or by agreement with the Milwaukee County board of supervisors, by an affirmative vote of 8 of the voting a majority of the Milwaukee County mental health board and a majority of the Milwaukee County board of supervisors.

203,35p Section 35p. 51.41 (6) of the statutes, as created by 2013 Wisconsin Act .... (this act), is repealed.

203,36 Section 36. 51.42 (1) (b) of the statutes is amended to read:

51.42 (1) (b) County liability. The county board of supervisors except in Milwaukee County, has the primary responsibility for the well-being, treatment and care of the mentally ill, developmentally disabled, alcoholic and other drug dependent citizens residing within its county and for ensuring that those individuals in need of such emergency services found within its county receive immediate emergency services. In Milwaukee County, the Milwaukee County mental health board has the primary responsibility for the well-being, treatment and care of the mentally ill, alcoholic, and other drug dependent citizens residing within Milwaukee County and for ensuring that those individuals in need of such emergency services found within Milwaukee County receive immediate emergency services. The county board of supervisors of Milwaukee County has the primary responsibility for the well-being, treatment, and care of the developmentally disabled citizens residing within Milwaukee County, except where the responsibility is delegated explicitly under this section to the Milwaukee County mental health board, and for ensuring that developmentally disabled individuals in need of such emergency services found within Milwaukee County receive immediate emergency services. This primary responsibility is limited to the programs, services and resources that the county board of supervisors, or, as applicable, the Milwaukee County mental health board, is reasonably able to provide within the limits of available state and federal funds and of county funds required to be appropriated to match state funds. County liability for care and services purchased through or provided by a county department of community programs established under this section shall be based upon the client's county of residence except for emergency services for which liability shall be placed with the county in which the individual is found. For the purpose of establishing county liability, "emergency services" includes those services provided under the authority of s. 55.05 (4), 2003 stats., or s. 55.06 (11) (a), 2003 stats., or s. 51.15, 51.45 (11) (a) or (b) or (12), 55.13, or 55.135 for not more than 72 hours. Nothing in this paragraph prevents recovery of liability under s. 46.10 or any other statute creating liability upon the individual receiving a service or any other designated responsible party, or prevents reimbursement by the department of health services for the actual cost of all care and services from the appropriation under s. 20.435 (7) (da), as provided in s. 51.22 (3).

203,37 Section 37. 51.42 (3) (a) of the statutes is amended to read:

51.42 (3) (a) Creation. Except as provided under s. 46.23 (3) (b), the county board of supervisors of any county except Milwaukee County, the Milwaukee County mental health board, or the county boards of supervisors of 2 or more counties, shall establish a county department of community programs on a single-county or multicounty basis to administer a community mental health, developmental disabilities, alcoholism and drug abuse program, make appropriations to operate the program and authorize the county department of community programs to apply for grants-in-aid under s. 51.423. The county department of community programs shall consist of a county community programs board, a county community programs director and necessary personnel.

203,38 Section 38. 51.42 (3) (ar) 8. of the statutes is amended to read:

51.42 (3) (ar) 8. By September 30, submit for inclusion as part of the proposed county budget to the Milwaukee County mental health board in Milwaukee County, to the county executive or county administrator, or, in those counties without a county executive or county administrator, directly to the county board of supervisors in a county with a single-county department of community programs or the county boards of supervisors in counties with a multicounty department of community programs a proposed budget for the succeeding calendar year covering services, including active treatment community mental health center services, based on the plan required under subd. 5. The final budget shall be submitted to the department of health services.

203,39 Section 39. 51.42 (3) (ar) 14. of the statutes is amended to read:

51.42 (3) (ar) 14. If the county board of supervisors or, as applicable, the Milwaukee County mental health board establishes an initiative to provide coordinated services under s. 59.53 (7), participate in and may administer the initiative, including entering into any written interagency agreements or contracts.

203,40 Section 40. 51.42 (3) (b) of the statutes is amended to read:

51.42 (3) (b) Other powers and duties. The county board of supervisors of any county with a single-county department of community programs, the Milwaukee County mental health board, and the county boards of supervisors of counties with a multicounty department of community programs may designate the county department of community programs as the administrator of any other county health care program or institution, but the operation of such program or institution is not reimbursable under s. 51.423.

203,41 Section 41. 51.42 (4) (a) 2. (intro.) of the statutes is amended to read:

51.42 (4) (a) 2. (intro.) In any county with a county executive or county administrator and which has established a single-county department of community programs, the county executive or county administrator shall appoint, subject to confirmation by the Milwaukee County mental health board in Milwaukee County or the county board of supervisors, the county community programs board, which shall be only a policy-making body determining the broad outlines and principles governing the administration of programs under this section. A member of a county community programs board appointed under this subdivision may be removed by the county executive or county administrator under the following circumstances:

203,42 Section 42. 51.42 (6m) (intro.) of the statutes is amended to read:

51.42 (6m) County community programs director in certain counties with a county executive or county administrator. (intro.) In any county with a county executive or county administrator in which the county board of supervisors or the Milwaukee County mental health board has established a single-county department of community programs, the county executive or county administrator shall appoint and supervise the county community programs director. In any county with a population of 500,000 750,000 or more, the county executive or county administrator shall appoint the director of the county department of human services under s. 46.21 as the county community programs director. The appointment of a county community programs director under this subsection shall be on the basis of recognized and demonstrated interest in and knowledge of the problems of mental health, intellectual disability, alcoholism and drug addiction, with due regard to training, experience, executive and administrative ability, and general qualification and fitness for the performance of the duties of the director. The appointment of a county community programs director under this subsection is subject to confirmation by the county board of supervisors, except in Milwaukee County, unless the county board of supervisors, by ordinance, elects to waive confirmation or unless the appointment is made under a civil service system competitive examination procedure established under s. 59.52 (8) or ch. 63. The county community programs director, subject only to the supervision of the county executive or county administrator, shall:

203,43 Section 43. 51.42 (6m) (c) of the statutes is amended to read:

51.42 (6m) (c) Determine, subject to the approval of the county board of supervisors or the Milwaukee County mental health board, as applicable, and with the advice of the county community programs board, whether services are to be provided directly by the county department of community programs or contracted for with other providers and make such contracts. The county board of supervisors, except in Milwaukee County, or the Milwaukee County mental health board in Milwaukee County may elect to require the approval of any such contract by the county board of supervisors or the Milwaukee County mental health board.

203,44 Section 44. 51.42 (6m) (i) of the statutes is amended to read:

51.42 (6m) (i) Establish salaries and personnel policies of the programs of the county department of community programs subject to approval of the county executive or county administrator and county board of supervisors, except in Milwaukee County, or the Milwaukee County mental health board in Milwaukee County unless the county board of supervisors or the Milwaukee County mental health board elects not to review the salaries and personnel policies.

203,45 Section 45. 51.42 (6m) (m) 3. of the statutes is amended to read:

51.42 (6m) (m) 3. Such other reports as are required by the secretary and the county board of supervisors or, as applicable, the Milwaukee County mental health board.

203,46 Section 46. 51.423 (11) of the statutes is amended to read:

51.423 (11) Each county department under s. 51.42 or 51.437, or both, shall apply all funds it receives under subs. (1) to (7) to provide the services required under ss. 51.42, 51.437 and 51.45 (2) (g) to meet the needs for service quality and accessibility of the persons in its jurisdiction, except that the county department may pay for inpatient treatment only with funds designated by the department for inpatient treatment. The county department may expand programs and services with county funds not used to match state funds under this section subject to the approval of the county board of supervisors in a county with a single-county department, except in Milwaukee County, the Milwaukee County mental health board in Milwaukee County, or the county boards of supervisors in counties with multicounty departments and with other local or private funds subject to the approval of the department and the county board of supervisors in a county with a single-county department under s. 51.42 or 51.437, the Milwaukee County mental health board with a department under s. 51.42, or the county boards of supervisors in counties with a multicounty department under s. 51.42 or 51.437. The county board of supervisors in a county with a single-county department under s. 51.42 or 51.437, the Milwaukee County mental health board with a department under s. 51.42, or the county boards of supervisors in counties with a multicounty department under s. 51.42 or 51.437 may delegate the authority to expand programs and services to the county department under s. 51.42 or 51.437. The county department under s. 51.42 or 51.437 shall report to the department all county funds allocated to the county department under s. 51.42 or 51.437 and the use of such funds. Moneys collected under s. 46.10 shall be applied to cover the costs of primary services, exceptional and specialized services or to reimburse supplemental appropriations funded by counties. County departments under ss. 51.42 and 51.437 shall include collections made on and after October 1, 1978, by the department that are subject to s. 46.10 (8m) (a) 3. and 4. and are distributed to county departments under ss. 51.42 and 51.437 from the appropriation account under s. 20.435 (5) (gg), as revenues on their grant-in-aid expenditure reports to the department.

203,47 Section 47. 51.44 (4) of the statutes is amended to read:

51.44 (4) Each county board of supervisors, except in Milwaukee County, and the Milwaukee County mental health board in Milwaukee County shall designate the appropriate county department under s. 46.21, 46.23 or 51.437, the local health department of the county or another entity as the local lead agency to provide early intervention services under the funding specified in sub. (3).

203,48 Section 48. 51.61 (1) (e) of the statutes is amended to read:

51.61 (1) (e) Except in the case of a patient who is admitted or transferred under s. 51.35 (3) or 51.37 or under ch. 971 or 975, have the right to the least restrictive conditions necessary to achieve the purposes of admission, commitment or protective placement, under programs, services and resources that the county board of supervisors or the Milwaukee County mental health board, as applicable, is reasonably able to provide within the limits of available state and federal funds and of county funds required to be appropriated to match state funds.

203,49 Section 49. 51.61 (1) (f) of the statutes is amended to read:

51.61 (1) (f) Have a right to receive prompt and adequate treatment, rehabilitation and educational services appropriate for his or her condition, under programs, services and resources that the county board of supervisors or the Milwaukee County mental health board, as applicable, is reasonably able to provide within the limits of available state and federal funds and of county funds required to be appropriated to match state funds.

203,50 Section 50. 55.001 of the statutes is amended to read:

55.001 Declaration of policy. The legislature recognizes that many citizens of the state, because of serious and persistent mental illness, degenerative brain disorder, developmental disabilities, or other like incapacities, are in need of protective services or protective placement. Except as provided in s. 49.45 (30m) (a), the protective services or protective placement should, to the maximum degree of feasibility under programs, services and resources that the county board of supervisors or the Milwaukee County mental health board, as applicable, is reasonably able to provide within the limits of available state and federal funds and of county funds required to be appropriated to match state funds, allow the individual the same rights as other citizens, and at the same time protect the individual from financial exploitation, abuse, neglect, and self-neglect. This chapter is designed to establish those protective services and protective placements, to assure their availability to all individuals when in need of them, and to place the least possible restriction on personal liberty and exercise of constitutional rights consistent with due process and protection from abuse, financial exploitation, neglect, and self-neglect.

203,51 Section 51. 59.53 (7) of the statutes is amended to read:

59.53 (7) Initiative to provide coordinated services. The Except in Milwaukee County, the board may establish an initiative to provide coordinated services under s. 46.56.

203,52 Section 52. 59.53 (25) of the statutes is created to read:

59.53 (25) Milwaukee County mental health. The Milwaukee County board has no jurisdiction and may not take any actions, including under ss. 59.52 (6) and (31), 66.0301, and 66.0607 (2), related to mental health functions, programs, and services.

203,53 Section 53 . Nonstatutory provisions.

(1) Initial terms of the Milwaukee County mental health board. Notwithstanding the length of terms for the members of the Milwaukee County mental health board specified in sections 15.07 (1) (cm) and 15.195 (9) of the statutes the initial members, other than the members approved under section 15.195 (9) (b) 10. and 11. of the statutes, as created by this act, shall be appointed for the following terms:

(a) Three members, as designated by the governor, specified under section 15.195 (9) (b) of the statutes, as created by this act, for terms that expire on May 1, 2016.

(b) Three members, as designated by the governor, specified under section 15.195 (9) (b) of the statutes, as created by this act, for terms that expire on May 1, 2017.

(c) Three members, as designated by the governor, specified under section 15.195 (9) (b) of the statutes, as created by this act, for terms that expire on May 1, 2018.

(d) The members specified under section 15.195 (9) (c) of the statutes, as created by this act, for terms that expire on May 1, 2017.

(2) Provisional appointments to the Milwaukee County mental health board.

(a) Notwithstanding section 15.07 (1) (b) 24. of the statutes, as created by this act, within 60 days after the effective date of this act, the governor shall provisionally appoint initial members of the Milwaukee County mental health board under section 15.195 (9) of the statutes, as created by this act. Those provisional appointments remain in force until withdrawn by the governor or acted upon by the senate, and if confirmed by the senate shall continue for the remainder of the unexpired term, if any, of the member and until a successor is chosen and qualifies. A provisional appointee under this paragraph may exercise all the powers and duties of the office to which the person is appointed during the time in which the appointee qualifies.

(b) A provisional appointment made under paragraph (a) that is withdrawn by the governor lapses and such withdrawal creates a vacancy for provisional appointment of a replacement initial member of the Milwaukee County mental health board. Any provisional appointment made under paragraph (a ) that is rejected by the senate lapses and such rejection creates a vacancy for nomination and appointment under section 15.07 (1) (b) 24. of the statutes, as created by this act, of a replacement initial board member.

(2d) County-based Milwaukee County mental health board; transfer of board member appointments. Notwithstanding section 51.41 (1d) of the statutes, as created by this act, on January 1, 2015, the Milwaukee County executive shall appoint the individuals who are appointed to the state-based Milwaukee County mental health board under section 15.195 (9) of the statutes, as created by this act, as of December 31, 2014, to the county-based Milwaukee County mental health board as created in section 51.41 (1d) of the statutes, as created by this act, to serve the remainder of their terms as specified under subsection (1). Beginning January 1, 2015, the Milwaukee County executive shall make appointments to the Milwaukee County mental health board in accordance with section 51.41 (1d) of the statutes, as created by this act, to fill board vacancies and to fill positions when the term of a board member expires.

(3) Jurisdiction of the Milwaukee County mental health board. The mental health functions, programs, and services over which the Milwaukee County mental health board has jurisdiction upon appointment of the Milwaukee County mental health board are those functions, programs, and services that Milwaukee County included in its 2014 budget under the behavioral health division unit 6300 and under the behavioral health community services branch of unit 8700.

(4) Audit and report by department of health services.

(a) The department of health services shall perform or arrange for an operational and programmatic audit of the behavioral health division of the Milwaukee County department of health and human services, the psychiatric hospital of the Milwaukee County mental health complex, and the related behavioral health programs. The audit shall include recommendations for the state assuming oversight responsibility for emergency detention services and the psychiatric hospital of the Milwaukee County Mental Health Complex, developing a plan for closing the Milwaukee County Mental Health Complex, and developing a plan for state oversight of a regional facility for the delivery of institutional, inpatient, crisis services, and behavioral health services using similar state-operated regional facilities as a model. In addition, the audit shall provide details and specifications on how, after the transitioning of the county-run institutional model to a state-based regionalized model, the state-based Milwaukee County mental health board will transition to a county-based board, the positions on the Milwaukee County mental health board will transition to a community-based focus, the funding for inpatient services and community-based services will continue, and mental health services will be delivered in a manner that reflects all of the following principles:

1. Community-based, person-centered, recovery-oriented mental health systems.

2. Maximizing comprehensive community-based services.

3. Prioritizing access to community-based services and reducing reliance on institutional and inpatient care.

4. Protecting the personal liberty of individuals experiencing mental illness so that they may be treated in the least restrictive environment to the greatest extent possible.

5. Providing early intervention to minimize the length and depth of psychotic and other mental health episodes.

6. Diverting people experiencing mental illness from the corrections system when appropriate.

7. Maximizing use of mobile crisis units and crisis intervention training.

(b) The department of health services may enter into a contract for the performance of the audit under paragraph (a). By December 1, 2014, the department of health services or the person with whom the department of health services has entered into a contract for the audit under paragraph (a) shall submit a report of the findings of the audit under paragraph (a), including recommendations for inpatient mental health treatment in Milwaukee County, to the secretary of health services. The secretary of health services shall submit a copy of the report to the Milwaukee County mental health board, the Milwaukee County board of supervisors, the Milwaukee County executive, and the legislature under section 13.172 (2) of the statutes.

(c) The Milwaukee County mental health board, the behavioral health division and the community services branch of the Milwaukee County department of health and human services, and any other Milwaukee County governmental unit that has information necessary for the performance of the audit under paragraph (a ) shall cooperate with the department of health services or the contractor of the department of health services for the performance of the audit.

203,54m Section 54m.0 Effective dates. This act takes effect on the day after publication, except as follows:

(1) Transition to county-based Milwaukee County mental health board. The treatment of sections 15.07 (1) (cm) (by Section 3d), 19.42 (7w) (e), 46.011 (1s), and 51.41 (1d), (3) (by Section 35m), and (5) (a) and (b) (by Section 35m) of the statutes and the repeal of sections 15.07 (1) (b) 24. and (3) (bm) 7., 15.195 (9), 17.07 (3r), 20.435 (5) (kf), and 51.41 (6) of the statutes take effect on January 1, 2015.