AB133-SSA1,608,86 3. Is functionally eligible at the intermediate level and is determined by an
7agency under s. 46.90 (2) or specified in s. 55.05 (1t) to be in need of protective services
8under s. 55.05 or protective placement under s. 55.06.
AB133-SSA1,608,99 4. Is functionally eligible under sub. (1) (a) 2.
AB133-SSA1,608,1010 5. Is eligible under sub. (1m).
AB133-SSA1,608,1211 (b) An entitled individual who is enrolled in a care management organization
12may not be involuntarily disenrolled except as follows:
AB133-SSA1,608,1313 1. For cause, subject to the requirements of s. 46.284 (4) (a).
AB133-SSA1,608,1814 2. If the contract between the care management organization and the
15department is canceled or not renewed. If this circumstance occurs, the department
16shall assure that enrollees continue to receive needed services through another care
17management organization or through the medical assistance fee-for-service system
18or any of the programs specified under sub. (1) (a) 2. a. to d.
AB133-SSA1,608,2019 3. The department or its designee determines that the person no longer meets
20eligibility criteria under sub. (1).
AB133-SSA1,609,221 (c) Within each county and for each client group, par. (a) shall first apply on the
22effective date of a contract under which a care management organization accepts a
23per person per month payment to provide services under the family care benefit to
24eligible persons in that client group in the county. Within 24 months after this date,
25the department shall assure that sufficient capacity exists within one or more care

1management organizations to provide the family care benefit to all entitled persons
2in that client group in the county.
AB133-SSA1,609,53 (d) The department shall determine the date, which shall not be later than July
41, 2000, on which par. (a) shall first apply to persons who are not eligible for medical
5assistance under ch. 49.
AB133-SSA1,609,8 6(4) Divestment; rules. The department shall promulgate rules relating to
7prohibitions on divestment of assets of persons who receive the family care benefit,
8that are substantially similar to applicable provisions under s. 49.453.
AB133-SSA1,609,11 9(5) Treatment of trust amounts; rules. The department shall promulgate
10rules relating to treatment of trust amounts of persons who receive the family care
11benefit, that are substantially similar to applicable provisions under s. 49.454.
AB133-SSA1,609,16 12(6) Protection of income and resources of couple for maintenance of
13community spouse; rules.
The department shall promulgate rules relating to
14protection of income and resources of couples for the maintenance of the spouse in
15the community with regard to persons who receive the family care benefit, that are
16substantially similar to applicable provisions under s. 49.455.
AB133-SSA1,609,21 17(7) Recovery of family care benefit payments; rules. The department shall
18promulgate rules relating to the recovery from persons who receive the family care
19benefit, including by liens and from estates, of correctly and incorrectly paid family
20care benefits, that are substantially similar to applicable provisions under ss. 49.496
21and 49.497.
AB133-SSA1, s. 1079 22Section 1079. 46.287 of the statutes is created to read:
AB133-SSA1,609,24 2346.287 Hearings. (1) Definition. In this section, "client" means a person
24applying for eligibility for the family care benefit, an eligible person or an enrollee.
AB133-SSA1,610,6
1(2) Hearing. (a) 1. Except as provided in subd. 2., a client may contest any of
2the following applicable matters by filing, within 45 days of the failure of a resource
3center or care management organization to act on the contested matter within the
4time frames specified by rule by the department or within 45 days after receipt of
5notice of a decision in a contested matter, a written request for a hearing under s.
6227.44 to the division of hearings and appeals created under s. 15.103 (1):
AB133-SSA1,610,77 a. Denial of eligibility under s. 46.286 (1) or (1m).
AB133-SSA1,610,88 b. Determination of cost sharing under s. 46.286 (2).
AB133-SSA1,610,99 c. Denial of entitlement under s. 46.286 (3).
AB133-SSA1,610,1110 d. Failure to provide timely services and support items that are included in the
11plan of care.
AB133-SSA1,610,1212 e. Reduction of services or support items under the family care benefit.
AB133-SSA1,610,1613 f. Development of a plan of care that is unacceptable because the plan of care
14requires the enrollee to live in a place that is unacceptable to the enrollee or the plan
15of care provides care, treatment or support items that are insufficient to meet the
16enrollee's needs, are unnecessarily restrictive or are unwanted by the enrollee.
AB133-SSA1,610,1717 g. Termination of the family care benefit.
AB133-SSA1,610,1818 h. Imposition of ineligibility for the family care benefit under s. 46.286 (4).
AB133-SSA1,610,2019 i. Denial of eligibility or reduction of the amounts of the family care benefit
20under s. 46.286 (5).
AB133-SSA1,610,2221 j. Determinations similar to those specified under s. 49.455 (8) (a), made under
22s. 46.286 (6).
AB133-SSA1,610,2323 k. Recovery of family care benefit payments under s. 46.286 (7).
AB133-SSA1,611,3
12. An applicant for or recipient of medical assistance is not entitled to a hearing
2concerning the identical dispute or matter under both this section and 42 CFR
3431.200
to 431.246.
AB133-SSA1,611,104 (b) An enrollee may contest a decision, omission or action of a care management
5organization other than those specified in par. (a), or may contest the choice of service
6provider. In these instances, the enrollee shall first send a written request for review
7by the unit of the department that monitors care management organization
8contracts. This unit shall review and attempt to resolve the dispute. If the dispute
9is not resolved to the satisfaction of the enrollee, he or she may request a hearing
10under the procedures specified in par. (a) 1. (intro.).
AB133-SSA1,611,1411 (c) Information regarding the availability of advocacy services and notice of
12adverse actions taken and appeal rights shall be provided to a client by the resource
13center or care management organization in a form and manner that is prescribed by
14the department by rule.
AB133-SSA1, s. 1080 15Section 1080. 46.288 of the statutes is created to read:
AB133-SSA1,611,17 1646.288 Rule-making. The department shall promulgate as rules all of the
17following:
AB133-SSA1,611,20 18(1) Standards for performance by resource centers and for certification of care
19management organizations, including requirements for maintaining quality
20assurance and quality improvement.
AB133-SSA1,612,2 21(2) Criteria and procedures for determining functional eligibility under s.
2246.286 (1) (a), financial eligibility under s. 46.286 (1) (b), cost sharing under s. 46.286
23(2) (a) and entitlement under s. 46.286 (3). The rules for determining functional
24eligibility under s. 46.286 (1) (a) 1. a. shall be substantially similar to eligibility
25criteria for receipt of the long-term support community options program under s.

146.27. Rules under this subsection shall include definitions of the following terms
2applicable to s. 46.286:
AB133-SSA1,612,33 (a) "Primary disabling condition".
AB133-SSA1,612,44 (b) "Mental illness".
AB133-SSA1,612,55 (c) "Substance abuse".
AB133-SSA1,612,66 (d) "Long-term or irreversible".
AB133-SSA1,612,77 (e) "Requires ongoing care, assistance or supervision".
AB133-SSA1,612,98 (f) "Condition that is expected to last at least 90 days or result in death within
9one year".
AB133-SSA1,612,1010 (g) "At risk of losing independence or functional capacity".
AB133-SSA1,612,1111 (h) "Gross monthly income".
AB133-SSA1,612,1212 (i) "Deductions and allowances".
AB133-SSA1,612,1313 (j) "Countable assets".
AB133-SSA1,612,16 14(3) Procedures and standards for procedures for s. 46.287 (2), including time
15frames for action by a resource center or a care management organization on a
16contested matter.
AB133-SSA1, s. 1081 17Section 1081. 46.289 of the statutes is created to read:
AB133-SSA1,612,24 1846.289 Transition. In order to facilitate the transition to the long-term care
19system specified in ss. 46.2805 to 46.2895, within the limits of applicable federal
20statutes and regulations and if the secretary of health and family services finds it
21necessary, he or she may grant a county limited waivers to or exemptions from ss.
2246.27 (3) (e) (intro.), 1. and 2. and (f), (5) (d) and (e), (6) (a) 1., 2. and 3. and (b) (intro.),
231. and 2., (6r) (c), (7) (b), (cj) and (cm) and (11) (c) 5m. (intro.) and 6. and 46.277 (3)
24(a), (4) (a) and (5) (d) 1m., 1n. and 2. and rules promulgated under those provisions.
AB133-SSA1, s. 1082 25Section 1082. 46.2895 of the statutes is created to read:
AB133-SSA1,613,6
146.2895 Family care district. (1) Creation. (a) After considering
2recommendations of the local long-term care council under s. 46.282 (3) (a) 1., a
3county board of supervisors may create a special purpose district that is termed a
4"family care district", that is a local unit of government, that is separate and distinct
5from, and independent of, the state and the county, and that has the powers and
6duties specified in this section, if the county board does all of the following:
AB133-SSA1,613,77 1. Adopts an enabling resolution that does all of the following:
AB133-SSA1,613,88 a. Declares the need for establishing the family care district.
AB133-SSA1,613,119 b. Specifies the family care district's primary purpose, which shall be to
10operate, under contract with the department, either a resource center under s.
1146.283 or a care management organization under s. 46.284, but not both.
AB133-SSA1,613,1312 2. Files copies of the enabling resolution with the secretary of administration,
13the secretary of health and family services and the secretary of revenue.
AB133-SSA1,613,1714 (b) The county boards of supervisors of 2 or more counties may together create
15a family care district with the attributes specified in par. (a) (intro.) on a multicounty
16basis within the counties if the county boards of supervisors comply with the
17requirements of par. (a) 1. and 2.
AB133-SSA1,613,20 18(2) Jurisdiction. A family care district's jurisdiction is the geographical area
19of the county or counties of the county board or boards of supervisors who created the
20family care district.
AB133-SSA1,613,25 21(3) Family care district board. (a) 1. The county board of supervisors of a
22county or, in a county with a county administrator or county executive, the county
23administrator or county executive shall appoint the members of the family care
24district board, which is the governing board of a family care district under sub. (1)
25(a).
AB133-SSA1,614,5
12. The county boards of supervisors of 2 or more counties shall appoint the
2members of the family care district board, which is the governing board of the family
3care district under sub. (1) (b). Each county board shall appoint members in the same
4proportion that the county's population represents to the total population of all of the
5counties that constitute the jurisdiction of the family care district.
AB133-SSA1,614,106 (b) 1. The family care district board appointed under par. (a) 1. shall consist of
715 persons who are residents of the area of jurisdiction of the family care district.
8At least one-fourth of the members shall be representative of the client group or
9groups whom it is the family care district's primary purpose to serve or those clients'
10family members, guardians or other advocates.
AB133-SSA1,614,1611 2. The family care district board appointed under par. (a) 2. shall consist of an
12odd number of members that is at least 15 but not more than 21 persons, all of whom
13are residents of the area of jurisdiction of the family care district. At least one-fourth
14of the members shall be representative of the client group or groups whom it is the
15family care district's primary purpose to serve or those clients' family members,
16guardians or other advocates.
AB133-SSA1,614,2217 3. Membership of the family care district board under subd. 1. or 2. shall reflect
18the ethnic and economic diversity of the area of jurisdiction of the family care district.
19Up to one-fourth of the members of the board may be elected or appointed officials
20or employes of the county or counties that created the family care district. No
21member of the board may have a private financial interest in or profit directly or
22indirectly from any contract or other business of the family care district.
AB133-SSA1,615,323 (c) The members of the family care district board appointed under par. (a) shall
24serve 3-year terms. No member may serve more than 2 consecutive terms. Of the
25members first appointed, 5 shall be appointed for 3 years; 5 shall be appointed for

14 years; and 5 or, in the case of a board appointed under par. (b) 2., the remainder,
2shall be appointed for 5 years. A member shall serve until his or her successor is
3appointed, unless removed for cause under s. 17.13.
AB133-SSA1,615,104 (d) As soon as possible after the appointment of the initial members of the
5family care district board, the board shall organize for the transaction of business
6and elect a chairperson and other necessary officers. Each chairperson shall be
7elected by the board from time to time for the term of that chairperson's office as a
8member of the board or for the term of 3 years, whichever is shorter, and shall be
9eligible for reelection. A majority of the board shall constitute a quorum. The board
10may act based on the affirmative vote of a majority of a quorum.
AB133-SSA1,615,14 11(4) Powers. Subject to sub. (1) (a) 1. b., a family care district has all the powers
12necessary or convenient to carry out the purposes and provisions of ss. 46.2805 to
1346.2895. In addition to all these powers, a family care district may do all of the
14following:
AB133-SSA1,615,1515 (a) Adopt and alter, at pleasure, an official seal.
AB133-SSA1,615,1916 (b) Adopt bylaws and policies and procedures for the regulation of its affairs
17and the conduct of its business. The bylaws, policies and procedures shall be
18consistent with ss. 46.2085 to 46.2895 and, if the family care district contracts with
19the department under par. (d), with the terms of that contract.
AB133-SSA1,615,2020 (c) Sue and be sued.
AB133-SSA1,615,2421 (d) Negotiate and enter into leases or contracts, including a contract with the
22department to operate either a resource center or a portion of its functions under s.
2346.283 or a care management organization under s. 46.284, but not both a resource
24center or its functions and a care management organization.
AB133-SSA1,616,3
1(e) Provide services related to services available under the family care benefit,
2to older persons and persons with disabilities, in addition to the services funded
3under the contract with the department that is specified under par. (d).
AB133-SSA1,616,54 (f) Acquire, construct, equip, maintain, improve or manage a resource center
5under s. 46.283 or a care management organization under s. 46.284, but not both.
AB133-SSA1,616,106 (g) Subject to sub. (8), employ any agent, employe or special adviser that the
7family care district finds necessary, fix and regulate his or her compensation and
8provide, either directly or subject to an agreement under s. 66.30 as a participant in
9a benefit plan of another governmental entity, any employe benefits, including an
10employe pension plan.
AB133-SSA1,616,1211 (h) Mortgage, pledge or otherwise encumber the family care district's property
12or funds.
AB133-SSA1,616,1413 (i) Buy, sell or lease property, including real estate, and maintain or dispose of
14the property.
AB133-SSA1,616,1615 (j) Invest any funds not required for immediate disbursement in any of the
16following:
AB133-SSA1,616,1817 1. An interest-bearing escrow account with a financial institution, as defined
18in s. 69.30 (1) (b).
AB133-SSA1,616,2019 2. Time deposits in any financial institution, as defined in s. 69.30 (1) (b), if the
20time deposits mature in not more than 2 years.
AB133-SSA1,616,2321 3. Bonds or securities issued or guaranteed as to principal and interest by the
22federal government or by a commission, board or other instrumentality of the federal
23government.
AB133-SSA1,617,3
1(k) Create a risk reserve or other special reserve as the family care district
2board desires or as the department requires under the contract with the department
3that is specified under par. (d).
AB133-SSA1,617,74 (L) Accept aid, including loans, to accomplish the purpose of the family care
5district from any local, state or federal governmental agency or accept gifts, loans,
6grants or bequests from individuals or entities, if the conditions under which the aid,
7loan, gift, grant or bequest is furnished are not in conflict with this section.
AB133-SSA1,617,98 (m) Make and execute other instruments necessary or convenient to exercise
9the powers of the family care district.
AB133-SSA1,617,11 10(5) Limitation on powers. A family care district may not issue bonds or levy
11a tax or assessment.
AB133-SSA1,617,12 12(6) Duties. The family care district board shall do all of the following:
AB133-SSA1,617,1313 (a) Appoint a director, who shall hold office at the pleasure of the board.
AB133-SSA1,617,1514 (b) Subject to sub. (8), develop and implement a personnel structure and other
15employment policies for employes of the family care district.
AB133-SSA1,617,1716 (c) Assure compliance with the terms of any contract with the department
17under sub. (4) (d).
AB133-SSA1,617,1918 (d) Establish a fiscal operating year and annually adopt a budget for the family
19care district.
AB133-SSA1,617,2020 (e) Contract for any legal services required for the family care district.
AB133-SSA1,617,2521 (f) Subject to sub. (8), procure liability insurance covering its officers, employes
22and agents, insurance against any loss in connection with its property and other
23assets and other necessary insurance; establish and administer a plan of
24self-insurance; or, subject to an agreement under s. 66.30, participate in a
25governmental plan of insurance or self-insurance.
AB133-SSA1,618,2
1(7) Director; duties. The director appointed under sub. (6) (a) shall do all of
2the following:
AB133-SSA1,618,53 (a) Manage the property and business of the family care district and manage
4the employes of the district, subject to the general control of the family care district
5board.
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