Amendment SSA1-SB55

SB55-SSA1, s. 1731m Section 1731m. 49.33 (1) (c) of the statutes is repealed.

SB55-SSA1, s. 1731t Section 1731t. 49.33 (1) (cr) of the statutes is created to read:

SB55-SSA1,616,2 49.33 (1) (cr) "Tribal governing body" means an elected governing body of a federally recognized American Indian tribe.

SB55-SSA1, s. 1732b Section 1732b. 49.33 (2) of the statutes is repealed and recreated to read:

SB55-SSA1,616,9 49.33 (2) Contracts. (a) Annually, the department and the department of health and family services shall, jointly, contract with county departments under ss. 46.215, 46.22, and 46.23, and may, jointly, contract with tribal governing bodies, to reimburse the county departments and tribal governing bodies for the reasonable cost of administering the medical assistance program under subch. IV and the badger care health care program under s. 49.665.

SB55-SSA1,616,15 (b) Annually, the department shall contract with county departments under ss. 46.215, 46.22, and 46.23, and may, jointly, contract with tribal governing bodies, to reimburse the county departments and tribal governing bodies for the reasonable cost of administering income maintenance programs, other than the medical assistance program under subch. IV and the badger care health care program under s. 49.665.

SB55-SSA1, s. 1732c Section 1732c. 49.33 (2) of the statutes, as affected by 2001 Wisconsin Act .... (this act), is repealed and recreated to read:

SB55-SSA1,616,21 49.33 (2) Contracts. Annually, the department of health and family services shall contract with county departments under ss. 46.215, 46.22, and 46.23 to reimburse the county departments for the reasonable cost of administering income maintenance programs.

SB55-SSA1, s. 1737 Section 1737. 49.33 (8) (a) of the statutes is amended to read:

SB55-SSA1,617,13 49.33 (8) (a) The From the appropriation accounts under ss. 20.445 (3) (dz), (kx), (md), and (nL) and subject to par. (b), the department shall reimburse each county and tribal governing body that contracts with the department and the department of health and family services under sub. (2) (a) for reasonable costs of income maintenance relating to the administration of the programs under this subchapter and subch. IV according to administering the medical assistance program under subch. IV and the badger care health care program under s. 49.665 and that contracts with the department under sub. (2) (b) for the reasonable costs of administering income maintenance programs other than the medical assistance program under subch. IV and the badger care health care program under s. 49.665. The amount of each reimbursement paid under this paragraph shall be calculated using a formula based on workload within the limits of available state and federal funds under s. 20.445 (3) (dz), (kx), (md), and (nL) by contract under s. 49.33 (2). The amount of reimbursement calculated under this paragraph and par. (b) is in addition to any reimbursement provided to a county or tribal governing body for fraud and error reduction under s. 49.197 (1m) and (4).

SB55-SSA1, s. 1737c Section 1737c. 49.33 (8) (a) of the statutes, as affected by 2001 Wisconsin Act .... (this act), is amended to read:

SB55-SSA1,618,5 49.33 (8) (a) From the appropriation accounts under ss. 20.445 (3) (dz), (kx), (md), and (nL) s. 20.435 (4) (bn) and (nn) and subject to par. (b), the department of health and family services shall reimburse each county and tribal governing body that contracts with the department and the department of health and family services under sub. (2) (a) for reasonable costs of administering the medical assistance program under subch. IV and the badger care health care program under s. 49.665 and that contracts with the department under sub. (2) (b) for the reasonable costs of administering income maintenance programs other than the medical assistance program under subch. IV and the badger care health care program under s. 49.665. The amount of each reimbursement paid under this paragraph shall be calculated using a formula based on workload within the limits of available state and federal funds under s. 20.445 (3) (dz), (kx), (md), and (nL) 20.435 (4) (bn) and (nn) by contract under s. 49.33 (2). The amount of reimbursement calculated under this paragraph and par. (b) is in addition to any reimbursement provided to a county or tribal governing body for fraud and error reduction under s. 49.197 (1m) and (4).

SB55-SSA1, s. 1738 Section 1738. 49.33 (8) (b) of the statutes is amended to read:

SB55-SSA1,618,11 49.33 (8) (b) The department may adjust the amounts determined under par. (a) for workload changes and computer network activities performed by counties a county or tribal governing body and may reduce the amount of any reimbursement if federal reimbursement is withheld due to audits, quality control samples, or program reviews.

SB55-SSA1, s. 1739 Section 1739. 49.33 (9) of the statutes is repealed.

SB55-SSA1, s. 1740 Section 1740. 49.33 (10) (a) of the statutes is amended to read:

SB55-SSA1,618,23 49.33 (10) (a) The Each county treasurer and each director of a county department under s. 46.215, 46.22, or 46.23 and each tribal governing body shall certify monthly under oath to the department in such manner as the department prescribes the claim of the county for state reimbursement under subs. sub. (8) and (9) and (a). The department shall review each claim of reimbursement and, if the department approves such the claim it, the department shall certify to the department of administration for reimbursement to the county for amounts due under these subsections sub. (8) (a) and payment claimed to be made to the counties monthly. The department may make advance payments prior to the beginning of each month equal to one-twelfth of the contracted amount.

SB55-SSA1, s. 1740am Section 1740am. 49.33 (10) (a) of the statutes, as affected by 2001 Wisconsin Act .... (this act), is amended to read:

SB55-SSA1,619,12 49.33 (10) (a) Each county treasurer and director of a county department under s. 46.215, 46.22, or 46.23 and each tribal governing body shall certify monthly under oath to the department of health and family services in such manner as the department of health and family services prescribes the claim of the county for state reimbursement under sub. (8) (a). The department of health and family services shall review each claim of reimbursement and, if the department of health and family services approves the claim, the department of health and family services shall certify to the department of administration for reimbursement to the county for amounts due under sub. (8) (a) and payment claimed to be made to the counties monthly. The department of health and family services may make advance payments prior to the beginning of each month equal to one-twelfth of the contracted amount.

SB55-SSA1, s. 1740bg Section 1740bg. 49.33 (10) (b) of the statutes is amended to read:

SB55-SSA1,619,21 49.33 (10) (b) To facilitate prompt reimbursement the certificate of the department may be based on the certified statements of the county officers or tribal governing body executives filed under par. (a). Funds recovered from audit adjustments from a prior fiscal year may be included in subsequent certifications only to pay counties owed funds as a result of any audit adjustment. By September 30 annually, the department shall submit a report to the appropriate standing committees under s. 13.172 (3) on funds recovered and paid out during the previous calendar year as a result of audit adjustments.

SB55-SSA1, s. 1740bq Section 1740bq. 49.33 (10) (b) of the statutes, as affected by 2001 Wisconsin Act .... (this act), is amended to read:

SB55-SSA1,620,7 49.33 (10) (b) To facilitate prompt reimbursement the certificate of the department of health and family services may be based on the certified statements of the county officers or tribal governing body executives filed under par. (a). Funds recovered from audit adjustments from a prior fiscal year may be included in subsequent certifications only to pay counties owed funds as a result of any audit adjustment. By September 30 annually, the department of health and family services shall submit a report to the appropriate standing committees under s. 13.172 (3) on funds recovered and paid out during the previous calendar year as a result of audit adjustments.

SB55-SSA1, s. 1741 Section 1741. 49.36 (1) of the statutes is renumbered 49.36 (1) (intro.) and amended to read:

SB55-SSA1,620,10 49.36 (1) (intro.) In this section, "custodial:

SB55-SSA1,620,12 (a) "Custodial parent" means a parent who lives with his or her child for substantial periods of time.

SB55-SSA1, s. 1742 Section 1742. 49.36 (1) (b) of the statutes is created to read:

SB55-SSA1,620,15 49.36 (1) (b) "Tribal governing body" means an elected tribal governing body of a federally recognized American Indian tribe or band.

SB55-SSA1, s. 1743 Section 1743. 49.36 (2) of the statutes is amended to read:

SB55-SSA1,620,24 49.36 (2) The department may contract with any county , tribal governing body, or Wisconsin works agency to administer a work experience and job training program for parents who are not custodial parents and who fail to pay child support or to meet their children's needs for support as a result of unemployment or underemployment. The program may provide the kinds of work experience and job training services available from the program under s. 49.193, 1997 stats., or s. 49.147 (3) or (4). The program may also include job search and job orientation activities. The department shall fund the program from the appropriation under s. 20.445 (3) (dz).

SB55-SSA1, s. 1744 Section 1744. 49.36 (4) of the statutes is amended to read:

SB55-SSA1,621,4 49.36 (4) When a person completes 16 weeks of participation in a program under this section, the county, tribal governing body, or Wisconsin works agency operating the program shall inform the clerk of courts, by affidavit, of that completion.

SB55-SSA1, s. 1745 Section 1745. 49.36 (5) of the statutes is amended to read:

SB55-SSA1,621,9 49.36 (5) A person participating in work experience as part of the program under this section is considered an employee of the county, tribal governing body, or Wisconsin works agency administering the program under this section for purposes of worker's compensation benefits only.

SB55-SSA1, s. 1746 Section 1746. 49.36 (6) of the statutes is amended to read:

SB55-SSA1,621,14 49.36 (6) A county, tribal governing body, or Wisconsin works agency administering the program under this section shall reimburse a person for reasonable transportation costs incurred because of participation in a program under this section up to a maximum of $25 per month.

SB55-SSA1, s. 1747 Section 1747. 49.36 (7) of the statutes is amended to read:

SB55-SSA1,621,21 49.36 (7) The department shall pay a county, tribal governing body, or Wisconsin works agency not more than $400 for each person who participates in the program under this section in the region in which the county, tribal governing body, or Wisconsin works agency administers the program under this section. The county, tribal governing body, or Wisconsin works agency shall pay any additional costs of the program.

SB55-SSA1, s. 1748 Section 1748. 49.43 (8) of the statutes is amended to read:

SB55-SSA1,621,25 49.43 (8) "Medical assistance" means any services or items under ss. 49.45 to 49.472 49.473, except s. 49.472 (6), and under ss. 49.49 to 49.497, or any payment or reimbursement made for such services or items.

SB55-SSA1, s. 1749 Section 1749. 49.45 (2) (a) 3. of the statutes is amended to read:

SB55-SSA1,622,7 49.45 (2) (a) 3. Determine the eligibility of persons for medical assistance, rehabilitative, and social services under ss. 49.46, 49.468, and 49.47 and rules and policies adopted by the department and may shall, under a contract under s. 49.33 (2) (a), designate this function to the county department under s. 46.215, 46.22, or 46.23 or, to the extent permitted by federal law or a waiver from federal secretary of health and human services to a Wisconsin works agency a tribal governing body.

SB55-SSA1, s. 1750 Section 1750. 49.45 (2) (a) 3m. of the statutes is created to read:

SB55-SSA1,622,12 49.45 (2) (a) 3m. If the department does not contract with the department of workforce development under s. 49.197 (5), establish a program to investigate suspected fraudulent activity on the part of recipients of medical assistance and establish a program to reduce errors in the payments of medical assistance.

SB55-SSA1, s. 1765 Section 1765. 49.45 (5m) (am) of the statutes is amended to read:

SB55-SSA1,622,21 49.45 (5m) (am) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (4) (b) and, (o), and (w), the department shall distribute not more than $2,256,000 in each fiscal year, to provide supplemental funds to rural hospitals that, as determined by the department, have high utilization of inpatient services by patients whose care is provided from governmental sources, and to provide supplemental funds to critical access hospitals, except that the department may not distribute funds to a rural hospital or to a critical access hospital to the extent that the distribution would exceed any limitation under 42 USC 1396b (i) (3).

SB55-SSA1, s. 1766 Section 1766. 49.45 (5r) of the statutes is repealed.

SB55-SSA1, s. 1767 Section 1767. 49.45 (6b) of the statutes is amended to read:

SB55-SSA1,623,5 49.45 (6b) Centers for the developmentally disabled. From the appropriation under s. 20.435 (2) (gk), the department may reimburse the cost of services provided by the centers for the developmentally disabled. Reimbursement to the centers for the developmentally disabled shall be reduced following each placement made under s. 46.275 that involves a relocation from a center for the developmentally disabled, by $184 $200 per day, beginning in fiscal year 1999-2000 2001-02, and by $190 $225 per day, beginning in fiscal year 2000-01 2002-03.

SB55-SSA1, s. 1768 Section 1768. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:

SB55-SSA1,623,13 49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this subsection made under s. 20.435 (4) (b), (pa) or, (o), or (w) shall, except as provided in pars. (bg), (bm), and (br), be determined according to a prospective payment system updated annually by the department. The payment system shall implement standards that are necessary and proper for providing patient care and that meet quality and safety standards established under subch. II of ch. 50 and ch. 150. The payment system shall reflect all of the following:

SB55-SSA1, s. 1769 Section 1769. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:

SB55-SSA1,623,21 49.45 (6m) (ar) 1. a. The department shall establish standards for payment of allowable direct care costs, for facilities that do not primarily serve the developmentally disabled, that take into account direct care costs for a sample of all of those facilities in this state and separate standards for payment of allowable direct care costs, for facilities that primarily serve the developmentally disabled, that take into account direct care costs for a sample of all of those facilities in this state. The standards shall be adjusted by the department for regional labor cost variations.

SB55-SSA1, s. 1771 Section 1771. 49.45 (6t) (intro.) of the statutes is amended to read:

SB55-SSA1,624,8 49.45 (6t) County department and local health department operating deficit reduction. (intro.) From the appropriation under s. 20.435 (4) (o), for reduction of operating deficits, as defined under criteria developed by the department, incurred by a county department under s. 46.215, 46.22, 46.23, or 51.42 or by a local health department, as defined in s. 250.01 (4), for services provided under s. 49.46 (2) (a) 4. d. and (b) 6. f., fm., j., k. and, L., and Lm., 9. and, 15., and 18., for case management services under s. 49.46 (2) (b) 12. and for mental health day treatment services for minors provided under the authorization under 42 USC 1396d (r) (5), the department shall allocate up to $4,500,000 moneys in each fiscal year to these county departments, or local health departments as determined by the department, and shall perform all of the following:

SB55-SSA1, s. 1772 Section 1772. 49.45 (6t) (intro.) of the statutes, as affected by 2001 Wisconsin Act .... (this act), is repealed and recreated to read:

SB55-SSA1,624,21 49.45 (6t) County department and local health department operating deficit reduction. (intro.) From the appropriation under s. 20.435 (4) (o), for reduction of operating deficits, as defined under criteria developed by the department, incurred by a county department under s. 46.215, 46.22, 46.23, or 51.42 or by a local health department, as defined in s. 250.01 (4), for services provided under s. 49.46 (2) (a) 4. d. and (b) 6. f., fm., j., k., L., and Lm., 9., and 15., for case management services under s. 49.46 (2) (b) 12. and for mental health day treatment services for minors provided under the authorization under 42 USC 1396d (r) (5), the department shall allocate moneys in each fiscal year to these county departments, or local health departments as determined by the department, and shall perform all of the following:

SB55-SSA1, s. 1773 Section 1773. 49.45 (6t) (a) of the statutes is amended to read:

SB55-SSA1,625,5 49.45 (6t) (a) For the reduction of operating deficits incurred by the county departments or local health departments, estimate the availability of federal medicaid funds that may be matched to county, city, town, or village funds that are expended for costs in excess of reimbursement for services provided under s. 49.46 (2) (a) 4. d. and (b) 6. f., fm., j., k. and, L., and Lm., 9. and , 15., and 18., for case management services under s. 49.46 (2) (b) 12. and for mental health day treatment services for minor minors provided under the authorization under 42 USC 1396d (r) (5).

SB55-SSA1, s. 1774 Section 1774. 49.45 (6t) (a) of the statutes, as affected by 2001 Wisconsin Act .... (this act), is repealed and recreated to read:

SB55-SSA1,625,14 49.45 (6t) (a) For the reduction of operating deficits incurred by the county departments or local health departments, estimate the availability of federal medicaid funds that may be matched to county, city, town, or village funds that are expended for costs in excess of reimbursement for services provided under s. 49.46 (2) (a) 4. d. and (b) 6. f., fm., j., k., L., and Lm., 9., and 15., for case management services under s. 49.46 (2) (b) 12. and for mental health day treatment services for minors provided under the authorization under 42 USC 1396d (r) (5).

SB55-SSA1, s. 1775 Section 1775. 49.45 (6u) of the statutes, as affected by 2001 Wisconsin Act .... (this act), is renumbered 49.45 (6u) (am), and 49.45 (6u) (am) (intro.) and 2. (intro.) and b., 3., 4., 5. and 6., as renumbered, are amended to read:

SB55-SSA1,626,3 49.45 (6u) (am) (intro.) Notwithstanding sub. (6m), in state fiscal years in which less than $115,200,000 in federal financial participation relating to facilities is received under 42 CFR 433.51, from the appropriation appropriations under s. 20.435 (4) (o) and (w), for reduction of operating deficits, as defined under criteria developed the methodology used by the department in December, 2000, incurred by a facility that is established under s. 49.70 (1) or that is owned and operated by a city, village, or town, the department may not distribute to these facilities more than $40,100,000 $37,100,000 in each fiscal year, as determined by the department. The total amount that a county certifies under this subsection may not exceed 100% of otherwise-unreimbursed care. In distributing funds under this subsection, the department shall perform all of the following:

SB55-SSA1,626,6 2. (intro.) Based on the amount estimated available under par. (a) subd. 1., develop a method to distribute this allocation to the individual facilities that have incurred operating deficits that shall include:

SB55-SSA1,626,10 b. Agreement by the county in which is located the facility established under s. 49.70 (1) and agreement by the city, village, or town that owns and operates the facility that the applicable county, city, village, or town shall provide funds to match federal medical assistance matching funds under this subsection paragraph.

SB55-SSA1,626,12 3. Distribute the allocation under the distribution method that is developed, unless a county has failed to comply with par. (b) 2m subd. 2. bm.

SB55-SSA1,626,17 4. If the federal department of health and human services approves for state expenditure in a fiscal year amounts under s. 20.435 (4) (o) and (w) that result in a lesser allocation amount than that allocated under this subsection paragraph, allocate not more than the lesser amount so approved by the federal department of health and human services.

SB55-SSA1,626,22 5. If the federal department of health and human services approves for state expenditure in a fiscal year amounts under s. 20.435 (4) (o) and (w) that result in a lesser allocation amount than that allocated under this subsection paragraph, submit a revision of the method developed under par. (b) subd. 2. for approval by the joint committee on finance in that state fiscal year.

SB55-SSA1,626,25 6. If the federal department of health and human services disallows use of the allocation of matching federal medical assistance funds distributed under par. (c) subd. 3., apply the requirements under sub. (6m) (br).

SB55-SSA1, s. 1776 Section 1776. 49.45 (6u) (intro.) of the statutes is amended to read:

SB55-SSA1,627,14 49.45 (6u) Supplemental payments to certain facilities. (intro.) Notwithstanding sub. (6m), from the appropriation under s. 20.435 (4) (o), for reduction of operating deficits, as defined under criteria developed by the department, incurred by a facility, as defined under sub. (6m) (a) 3., that is established under s. 49.70 (1) or that is owned and operated by a city, village or town, the department may not distribute to these facilities more than $38,600,000 $40,100,000 in each fiscal year, as determined by the department, except that the department shall also distribute for this same purpose from the appropriation under s. 20.435 (4) (o) any additional federal medical assistance moneys that were not anticipated before enactment of the biennial budget act or other legislation affecting s. 20.435 (4) (o). The total amount that a county certifies under this subsection may not exceed 100% of otherwise-unreimbursed care. In distributing funds under this subsection, the department shall perform all of the following:

SB55-SSA1, s. 1777 Section 1777. 49.45 (6u) (ag) of the statutes is created to read:

SB55-SSA1,627,17 49.45 (6u) (ag) In this subsection, "facility" has the meaning given in sub. (6m) (a) 3.

SB55-SSA1, s. 1778 Section 1778. 49.45 (6u) (bm) of the statutes is created to read:

SB55-SSA1,628,2 49.45 (6u) (bm) In state fiscal years in which $115,200,000 or more in federal financial participation relating to facilities is received under 42 CFR 433.51, from the appropriations under s. 20.435 (4) (o) and (w), for reduction of operating deficits, as defined under criteria developed by the department, incurred by a facility that is established under s. 49.70 (1) or that is owned and operated by a city, village, or town, the department may not distribute to these facilities more than $77,100,000 in each fiscal year, as determined by the department under a methodology as specified in the state plan for services under 42 USC 1396.

SB55-SSA1, s. 1779 Section 1779. 49.45 (6x) (a) of the statutes is amended to read:

SB55-SSA1,628,9 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (4) (b) and, (o), and (w), the department shall distribute not more than $4,748,000 in each fiscal year, to provide funds to an essential access city hospital, except that the department may not allocate funds to an essential access city hospital to the extent that the allocation would exceed any limitation under 42 USC 1396b (i) (3).

SB55-SSA1, s. 1780 Section 1780. 49.45 (6y) (a) of the statutes is amended to read:

SB55-SSA1,628,20 49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (4) (b) and, (o), and (w), the department shall distribute funding in each fiscal year to provide supplemental payment to hospitals that enter into a contract under s. 49.02 (2) to provide health care services funded by a relief block grant, as determined by the department, for hospital services that are not in excess of the hospitals' customary charges for the services, as limited under 42 USC 1396b (i) (3). If no relief block grant is awarded under this chapter or if the allocation of funds to such hospitals would exceed any limitation under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that have not entered into a contract under s. 49.02 (2).

SB55-SSA1, s. 1781 Section 1781. 49.45 (6y) (am) of the statutes is amended to read:

SB55-SSA1,629,3 49.45 (6y) (am) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (4) (b), (h) and, (o), and (w), the department shall distribute funding in each fiscal year to provide supplemental payments to hospitals that enter into contracts under s. 49.02 (2) with a county having a population of 500,000 or more to provide health care services funded by a relief block grant, as determined by the department, for hospital services that are not in excess of the hospitals' customary charges for the services, as limited under 42 USC 1396b (i) (3).

SB55-SSA1, s. 1782 Section 1782. 49.45 (6z) (a) (intro.) of the statutes is amended to read:

SB55-SSA1,629,15 49.45 (6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (4) (b) and, (o), and (w), the department shall distribute funding in each fiscal year to supplement payment for services to hospitals that enter into a contract under s. 49.02 (2) to provide health care services funded by a relief block grant under this chapter, if the department determines that the hospitals serve a disproportionate number of low-income patients with special needs. If no medical relief block grant under this chapter is awarded or if the allocation of funds to such hospitals would exceed any limitation under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that have not entered into a contract under s. 49.02 (2). The department may not distribute funds under this subsection to the extent that the distribution would do any of the following:

SB55-SSA1, s. 1783 Section 1783. 49.45 (8) (b) of the statutes is amended to read:

SB55-SSA1,629,21 49.45 (8) (b) Reimbursement under s. 20.435 (4) (b) and, (o), and (w) for home health services provided by a certified home health agency or independent nurse shall be made at the home health agency's or nurse's usual and customary fee per patient care visit, subject to a maximum allowable fee per patient care visit that is established under par. (c).

SB55-SSA1, s. 1787m Section 1787m. 49.45 (22) of the statutes is amended to read:

SB55-SSA1,630,2 49.45 (22) (a) If the department contracts with health maintenance organizations for the provision of medical assistance it shall give special consideration to health maintenance organizations that provide or that contract to provide comprehensive, specialized health care services to pregnant teenagers.

SB55-SSA1,630,11 (b) If the department contracts with health maintenance organizations for the provision of medical assistance, the department shall determine which medical assistance recipients who have attained the age of 2 but have not attained the age of 6 and who are at risk for lead poisoning have not received lead screening from those health maintenance organizations. The department shall report annually to the appropriate standing committees of the legislature under s. 13.172 (3) on the percentage of medical assistance recipients under the age of 2 who received a lead screening test in that year provided by a health maintenance organization compared with the percentage that the department set as a goal for that year.

SB55-SSA1, s. 1787mg Section 1787mg. 49.45 (22) (c) of the statutes is created to read: