SB44-SSA1,524,228 49.45 (6c) (b) Preadmission screening. Except as provided in par. (e), beginning
9on August 9, 1989,
every individual who applies for admission to a facility or to an
10institution for mental diseases shall be screened to determine if the individual has
11developmental disability or mental illness. Beginning on August 9, 1989, the The
12department or an entity to which the department has delegated authority shall
13screen every individual who has been identified as having a developmental disability
14or mental illness to determine if the individual needs facility care. If the individual
15is determined to need facility care, the department or an entity to which the
16department has delegated authority shall also assess the individual to determine if
17he or she requires active treatment for developmental disability or active treatment
18for mental illness. If the department or entity determines that the individual
19requires active treatment for developmental disability, the department or entity
20shall determine whether the level of care required by the individual that is provided
21by a facility could be provided safely in an intermediate facility or under a plan that
22is developed under s. 46.279 (4).
SB44-SSA1, s. 1323 23Section 1323. 49.45 (6c) (c) (intro.) of the statutes is amended to read:
SB44-SSA1,525,424 49.45 (6c) (c) Resident review. (intro.) Except as provided in par. (e), the
25department or an entity to which the department has delegated authority shall

1review every resident of a facility or institution for mental diseases who has a
2developmental disability or mental illness and who has experienced a significant
3change in his or her physical or mental condition to determine if any all of the
4following applies:
SB44-SSA1, s. 1324 5Section 1324. 49.45 (6c) (c) 1. of the statutes is amended to read:
SB44-SSA1,525,66 49.45 (6c) (c) 1. The Whether the resident needs facility care.
SB44-SSA1, s. 1325 7Section 1325. 49.45 (6c) (c) 2. of the statutes is amended to read:
SB44-SSA1,525,98 49.45 (6c) (c) 2. The Whether the resident requires active treatment for
9developmental disability or active treatment for mental illness.
SB44-SSA1, s. 1326 10Section 1326. 49.45 (6c) (c) 3. of the statutes is created to read:
SB44-SSA1,525,1511 49.45 (6c) (c) 3. If the department or entity determines under subd. 1. that the
12resident needs facility care and under subd. 2. that the resident requires active
13treatment for developmental disability, whether the level of care required by the
14resident that is provided by a facility could be provided safely in an intermediate
15facility or under a plan that is developed under s. 46.279 (4).
SB44-SSA1, s. 1327 16Section 1327. 49.45 (6m) (a) 4. of the statutes is repealed.
SB44-SSA1, s. 1328 17Section 1328. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:
SB44-SSA1,525,2418 49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this
19subsection made under s. 20.435 (4) (b), (gp), (pa), (o), (w), or (wm) shall, except as
20provided in pars. (bg), (bm), and (br), be determined according to a prospective
21payment system updated annually by the department. The payment system shall
22implement standards that are necessary and proper for providing patient care and
23that meet quality and safety standards established under subch. II of ch. 50 and ch.
24150. The payment system shall reflect all of the following:
SB44-SSA1, s. 1329 25Section 1329. 49.45 (6m) (ag) 2. of the statutes is amended to read:
SB44-SSA1,526,4
149.45 (6m) (ag) 2. Standards Except as provided in subd. 3r., standards
2established by the department that shall be based upon allowable costs incurred by
3facilities in the state as available from information submitted under par. (c) 3. and
4compiled by the department.
SB44-SSA1, s. 1330 5Section 1330. 49.45 (6m) (ag) 3m. of the statutes is amended to read:
SB44-SSA1,526,106 49.45 (6m) (ag) 3m. For each state fiscal year 1999-2000, rates that shall be
7set by the department based on information from cost reports for the 1998 most
8recently completed
fiscal year of the facility and for state fiscal year 2000-01, rates
9that shall be set by the department based on information from cost reports for the

101999 fiscal year of the facility.
SB44-SSA1, s. 1331 11Section 1331 . 49.45 (6m) (ag) 3m. of the statutes, as affected by 2003
12Wisconsin Act .... (this act), is amended to read:
SB44-SSA1,526,1513 49.45 (6m) (ag) 3m. For each state fiscal year, rates that shall be set by the
14department based on information from cost reports for costs specified under par. (am)
151. bm., 4., 5m., and 6.
for the most recently completed fiscal year of the facility.
SB44-SSA1, s. 1332 16Section 1332. 49.45 (6m) (ag) 3r. of the statutes is created to read:
SB44-SSA1,526,1817 49.45 (6m) (ag) 3r. Flat-rate payment, as determined by the department, for
18costs specified under par. (am) 1. a. and 2.
SB44-SSA1, s. 1333 19Section 1333. 49.45 (6m) (ag) 3r. of the statutes, as created by 2003 Wisconsin
20Act .... (this act), is amended to read:
SB44-SSA1,526,2221 49.45 (6m) (ag) 3r. Flat-rate payment, as determined by the department, for
22all costs specified under par. (am) 1. a. and 2.
SB44-SSA1, s. 1333d 23Section 1333d. 49.45 (6m) (ag) 8. of the statutes is created to read:
SB44-SSA1,527,3
149.45 (6m) (ag) 8. Maintenance of the identical proportion of payment for direct
2care costs, as specified in par. (am) 1., to total payment for all costs specified in par.
3(am) as that made in state fiscal year 2002-03.
SB44-SSA1, s. 1334 4Section 1334. 49.45 (6m) (am) 1. a. of the statutes is amended to read:
SB44-SSA1,527,95 49.45 (6m) (am) 1. a. Personal comfort supplies; medical supplies;
6over-the-counter drugs; and nonbillable services of a ward clerk, activity person,
7recreation person, social worker, volunteer coordinator, teacher for residents aged 22
8and older, vocational counselor for residents aged 22 and older, religious person,
9therapy aide, therapy assistant, and counselor on resident living
.
SB44-SSA1, s. 1335 10Section 1335. 49.45 (6m) (am) 1. b. of the statutes is repealed.
SB44-SSA1, s. 1336 11Section 1336. 49.45 (6m) (am) 1. bm. of the statutes is created to read:
SB44-SSA1,527,1312 49.45 (6m) (am) 1. bm. Nonbillable services of a registered nurse, licensed
13practical nurse and nurse's assistant.
SB44-SSA1, s. 1337 14Section 1337. 49.45 (6m) (am) 1. d. of the statutes is repealed.
SB44-SSA1, s. 1338 15Section 1338. 49.45 (6m) (am) 1. e. of the statutes is repealed.
SB44-SSA1, s. 1339 16Section 1339. 49.45 (6m) (am) 3. (intro.) of the statutes is renumbered 49.45
17(6m) (am) 2. c. and amended to read:
SB44-SSA1,527,2018 49.45 (6m) (am) 2. c. Allowable fuel and utility costs, including the facility
19expenses that the department determines are allowable for the provision of:
20electrical service, water and sewer services, and heat.
SB44-SSA1, s. 1340 21Section 1340. 49.45 (6m) (am) 3. a. of the statutes is repealed.
SB44-SSA1, s. 1341 22Section 1341. 49.45 (6m) (am) 3. b. of the statutes is repealed.
SB44-SSA1, s. 1342 23Section 1342. 49.45 (6m) (am) 3. c. of the statutes is repealed.
SB44-SSA1, s. 1343 24Section 1343. 49.45 (6m) (am) 4. of the statutes is amended to read:
SB44-SSA1,528,2
149.45 (6m) (am) 4. Net property Property tax or allowable municipal service
2costs incurred paid by the owner of the facility for the facility.
SB44-SSA1, s. 1344 3Section 1344. 49.45 (6m) (am) 5. of the statutes is renumbered 49.45 (6m) (am)
42. d.
SB44-SSA1, s. 1346d 5Section 1346d. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:
SB44-SSA1,528,166 49.45 (6m) (ar) 1. a. The department shall establish standards for payment of
7allowable direct care costs under par. (am) 1. bm., for facilities that do not primarily
8serve the developmentally disabled, that take into account direct care costs for a
9sample of all of those facilities in this state and separate standards for payment of
10allowable direct care costs, for facilities that primarily serve the developmentally
11disabled, that take into account direct care costs for a sample of all of those facilities
12in this state. The standards shall be adjusted by the department for regional labor
13cost variations. For facilities in Douglas, Pierce, and St. Croix counties, the
14department shall perform the adjustment by use of the wage index that is used by
15the federal department of health and human services for hospital reimbursement
16under 42 USC 1395 to 1395ggg.
SB44-SSA1, s. 1347 17Section 1347. 49.45 (6m) (ar) 2. (intro.) and 2. a. of the statutes are
18consolidated, renumbered 49.45 (6m) (ar) 2. and amended to read:
SB44-SSA1,528,2119 49.45 (6m) (ar) 2. For support service costs: 2. a. The, the department shall
20establish one or more standards for the payment of support service costs that take
21into account support service costs for a sample of all facilities within the state.
SB44-SSA1, s. 1348 22Section 1348. 49.45 (6m) (ar) 2. b. of the statutes is repealed.
SB44-SSA1, s. 1349 23Section 1349. 49.45 (6m) (ar) 2. d. of the statutes is repealed.
SB44-SSA1, s. 1350 24Section 1350. 49.45 (6m) (ar) 3. of the statutes is repealed.
SB44-SSA1, s. 1351 25Section 1351. 49.45 (6m) (ar) 5. of the statutes is repealed.
SB44-SSA1, s. 1352
1Section 1352. 49.45 (6m) (av) 1. of the statutes is renumbered 49.45 (6m) (av)
2and amended to read:
SB44-SSA1,529,73 49.45 (6m) (av) The department shall calculate a payment rate for a facility by
4applying the criteria set forth under pars. (ag) 1. to 5. and 7., (am) 1. to 5. bm., 4., 5m.
5and 6.,
and (ar) 1. to 5., 4., and 6. to information from cost reports submitted by the
6facility, as affected by any adjustment for ancillary services and materials under par.
7(b)
.
SB44-SSA1, s. 1353 8Section 1353. 49.45 (6m) (av) 2. of the statutes is repealed.
SB44-SSA1, s. 1354 9Section 1354. 49.45 (6m) (av) 3. of the statutes is repealed.
SB44-SSA1, s. 1355 10Section 1355. 49.45 (6m) (av) 4. of the statutes is repealed.
SB44-SSA1, s. 1356 11Section 1356. 49.45 (6m) (av) 5. of the statutes is repealed.
SB44-SSA1, s. 1357 12Section 1357. 49.45 (6m) (av) 5m. of the statutes is repealed.
SB44-SSA1, s. 1358 13Section 1358. 49.45 (6m) (av) 6. of the statutes is repealed.
SB44-SSA1, s. 1359 14Section 1359. 49.45 (6m) (bc) of the statutes is repealed.
SB44-SSA1, s. 1360 15Section 1360. 49.45 (6t) of the statutes, as affected by 2001 Wisconsin Act 16,
16is renumbered 49.45 (6t) (a), and 49.45 (6t) (a) 2. (intro.), 3. and 4., as renumbered,
17are amended to read:
SB44-SSA1,529,2218 49.45 (6t) (a) 2. (intro.) Based on the amount estimated to be available under
19par. (a) subd. 1., develop a method, which need not be promulgated as rules under
20ch. 227, to distribute this allocation to the individual county departments under s.
2146.215, 46.22, 46.23 or 51.42 or to local health departments that have incurred
22operating deficits that shall include all of the following:
SB44-SSA1,529,2423 3. Except as provided in par. (d) subd. 4., distribute the allocation under the
24distribution method that is developed.
SB44-SSA1,530,5
14. If the federal department of health and human services approves for state
2expenditure in a fiscal year amounts under s. 20.435 (4) (o) that result in a lesser
3allocation amount than that allocated under this subsection or disallows use of the
4allocation of federal medicaid funds under par. (c) subd. 3., reduce allocations under
5this subsection and distribute on a prorated basis, as determined by the department.
SB44-SSA1, s. 1361 6Section 1361. 49.45 (6t) (b) of the statutes is created to read:
SB44-SSA1,530,87 49.45 (6t) (b) If 2003 Wisconsin Act .... (this act), section 9124 (8) (a) applies,
8this subsection does not apply.
SB44-SSA1, s. 1362 9Section 1362. 49.45 (6tt) of the statutes is created to read:
SB44-SSA1,530,1410 49.45 (6tt) Distributions to county departments and local health
11departments.
From the appropriation under s. 20.435 (4) (w), the department may
12in each fiscal year distribute moneys to county departments under s. 46.215, 46.22,
1346.23, or 51.42 or to local health departments, as defined in s. 250.01 (4), under a plan
14developed by the department.
SB44-SSA1, s. 1363 15Section 1363. 49.45 (6u) (am) (intro.) of the statutes is amended to read:
SB44-SSA1,531,216 49.45 (6u) (am) (intro.) Notwithstanding sub. (6m), in state fiscal years in
17which less than $1 in federal financial participation relating to facilities is received
18under 42 CFR 433.51,
from the appropriations under s. 20.435 (4) (o), (w), and (wm),
19for reduction of operating deficits, as defined under the methodology used by the
20department in December, 2000, incurred by a facility that is established under s.
2149.70 (1) or that is owned and operated by a city, village, or town, and as payment
22to care management organizations,
the department may not distribute to these
23facilities and to care management organizations more than $37,100,000 in each
24fiscal year, as determined by the department. The total amount that a county
25certifies under this subsection may not exceed 100% of otherwise-unreimbursed

1care. In distributing funds under this subsection, the department shall perform all
2of the following:
SB44-SSA1, s. 1364 3Section 1364. 49.45 (6u) (bm) of the statutes is repealed.
SB44-SSA1, s. 1365 4Section 1365. 49.45 (6v) (b) of the statutes is amended to read:
SB44-SSA1,531,105 49.45 (6v) (b) The department shall, each year, submit to the joint committee
6on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that
7provides information on the utilization of beds by recipients of medical assistance in
8facilities and a discussion and detailed projection of the likely balances,
9expenditures, encumbrances and carry over of currently appropriated amounts in
10the appropriation accounts under s. 20.435 (4) (b), (gp), and (o).
SB44-SSA1, s. 1366 11Section 1366. 49.45 (6x) (a) of the statutes is amended to read:
SB44-SSA1,531,1712 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriations
13appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall
14distribute not more than $4,748,000 in each fiscal year, to provide funds to an
15essential access city hospital, except that the department may not allocate funds to
16an essential access city hospital to the extent that the allocation would exceed any
17limitation under 42 USC 1396b (i) (3).
SB44-SSA1, s. 1367 18Section 1367. 49.45 (6y) (a) of the statutes is amended to read:
SB44-SSA1,532,319 49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriations
20appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall
21distribute funding in each fiscal year to provide supplemental payment to hospitals
22that enter into a contract under s. 49.02 (2) to provide health care services funded
23by a relief block grant, as determined by the department, for hospital services that
24are not in excess of the hospitals' customary charges for the services, as limited under
2542 USC 1396b (i) (3). If no relief block grant is awarded under this chapter or if the

1allocation of funds to such hospitals would exceed any limitation under 42 USC
21396b
(i) (3), the department may distribute funds to hospitals that have not entered
3into a contract under s. 49.02 (2).
SB44-SSA1, s. 1368 4Section 1368. 49.45 (6y) (am) of the statutes is amended to read:
SB44-SSA1,532,125 49.45 (6y) (am) Notwithstanding sub. (3) (e), from the appropriations
6appropriation accounts under s. 20.435 (4) (b), (h), (gp), (o), and (w), the department
7shall distribute funding in each fiscal year to provide supplemental payments to
8hospitals that enter into contracts under s. 49.02 (2) with a county having a
9population of 500,000 or more to provide health care services funded by a relief block
10grant, as determined by the department, for hospital services that are not in excess
11of the hospitals' customary charges for the services, as limited under 42 USC 1396b
12(i) (3).
SB44-SSA1, s. 1369 13Section 1369. 49.45 (6z) (a) (intro.) of the statutes is amended to read:
SB44-SSA1,532,2414 49.45 (6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriations
15appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall
16distribute funding in each fiscal year to supplement payment for services to hospitals
17that enter into a contract under s. 49.02 (2) to provide health care services funded
18by a relief block grant under this chapter, if the department determines that the
19hospitals serve a disproportionate number of low-income patients with special
20needs. If no medical relief block grant under this chapter is awarded or if the
21allocation of funds to such hospitals would exceed any limitation under 42 USC
221396b
(i) (3), the department may distribute funds to hospitals that have not entered
23into a contract under s. 49.02 (2). The department may not distribute funds under
24this subsection to the extent that the distribution would do any of the following:
SB44-SSA1, s. 1372 25Section 1372. 49.45 (8) (b) of the statutes is amended to read:
SB44-SSA1,533,5
149.45 (8) (b) Reimbursement under s. 20.435 (4) (b), (gp), (o), and (w) for home
2health services provided by a certified home health agency or independent nurse
3shall be made at the home health agency's or nurse's usual and customary fee per
4patient care visit, subject to a maximum allowable fee per patient care visit that is
5established under par. (c).
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