AB1110-ASA2, s. 6 10Section 6. 46.2804 of the statutes is created to read:
AB1110-ASA2,5,2111 46.2804 Managed care programs for long-term care services. (1) If the
12department intends to expand its use of capitation payments under managed care
13programs for provision of long-term care services over the number of capitated
14payments made on behalf of individuals enrolled in these managed care programs
15under 2005 Wisconsin Act 25, the department shall first notify the joint committee
16on finance in writing of the proposed expansion. Unless the proposed expansion is
17a part of a biennial budget bill, the joint committee on finance shall, within 14
18working days after the date of the department's notification, schedule a meeting
19under s. 13.10 to approve, modify, or disapprove the proposed expansion. The
20department may make the expansion only as approved or modified by the joint
21committee on finance.
AB1110-ASA2,6,11 22(2) Under a managed care program for provision of long-term care services, the
23care manager shall provide, within guidelines established by the department, a
24mechanism by which an enrollee, beneficiary, or recipient of the program may
25arrange for, manage, and monitor his or her benefit directly or with the assistance

1of another person chosen by the enrollee, beneficiary, or recipient. The care manager
2shall provide each enrollee, beneficiary, or recipient with a form on which the
3enrollee, beneficiary, or recipient shall indicate whether he or she has been offered
4the option under this subsection and whether he or she has accepted or declined the
5option. If the enrollee, beneficiary, or recipient accepts the option, the care manager
6shall monitor the use by the enrollee, beneficiary, or recipient of a fixed budget for
7purchase of services or support items from any qualified provider, monitor the health
8and safety of the enrollee, beneficiary, or recipient, and provide assistance in
9management of the budget and services of the enrollee, beneficiary, or recipient at
10a level tailored to the need and desire of the enrollee, beneficiary, or recipient for the
11assistance.
AB1110-ASA2, s. 7 12Section 7. 46.281 (1) (d) (intro.) of the statutes is repealed.
AB1110-ASA2, s. 8 13Section 8. 46.281 (1) (d) 1. of the statutes is repealed.
AB1110-ASA2, s. 9 14Section 9. 46.281 (1) (d) 2. of the statutes is renumbered 46.281 (1) (d) and
15amended to read:
AB1110-ASA2,7,1616 46.281 (1) (d) In geographic areas in which, in the aggregate, resides no more
17than 29% 29 percent of the state population that is eligible for the family care benefit,
18contract with counties or tribes or bands under a pilot project to demonstrate the
19ability of counties or tribes or bands
a county, a family care district, a tribe or band,
20the Great Lakes Inter-Tribal Council, Inc., or with 2 or more of these entities
to
21manage all long-term care programs and administer the family care benefit as care
22management organizations. If the department proposes to contract with these
23entities to administer care management organizations in geographic areas in which,
24in the aggregate, resides more than 29 percent but less than 50 percent of the state
25population that is eligible for the family care benefit, the department shall first

1notify the joint committee on finance in writing of the proposed contract. The
2notification shall include the contract proposal; and an estimate of the fiscal impact
3of the proposed addition that demonstrates that the addition will be cost neutral,
4including startup, transitional, and ongoing operational costs and any proposed
5county contribution. If the cochairpersons of the committee do not notify the
6department within 14 working days after the date of the department's notification
7that the committee has scheduled a meeting for the purpose of reviewing the
8proposed contract, the department may enter into the proposed contract. If within
914 days after the date of the department's notification the cochairpersons of the
10committee notify the department that the committee has scheduled a meeting for the
11purpose of reviewing the proposed contract, the department may enter into the
12proposed contract only upon approval of the committee. The department may
13contract with these entities to administer care management organizations in
14geographic areas in which, in the aggregate, resides 50 percent or more of the state
15population that is eligible for the family care benefit only if specifically authorized
16by the legislature and if the legislature appropriates necessary funding.
AB1110-ASA2, s. 10 17Section 10. 46.281 (1) (e) (intro.) of the statutes, as affected by 2005 Wisconsin
18Act 25
, is repealed.
AB1110-ASA2, s. 11 19Section 11. 46.281 (1) (e) 1. of the statutes, as affected by 2005 Wisconsin Act
2025
, is amended to read:
AB1110-ASA2,8,221 46.281 (1) (e) 1. If Subject to the requirements of par. (d), if the local long-term
22care council for the applicable area has developed the initial plan under s. 46.282 (3)
23(a) 1., contract with entities specified under par. (d) and may, only if specifically
24authorized by the legislature and if the legislature appropriates necessary funding,
25contract as so authorized with one or more entities in addition to those specified in

1par. (d) certified as meeting requirements under s. 46.284 (3) for services of the entity
2as a care management organization.
AB1110-ASA2, s. 12 3Section 12. 46.281 (1) (e) 2. of the statutes, as created by 2005 Wisconsin Act
425
, is amended to read:
AB1110-ASA2,8,175 46.281 (1) (e) 2. Contract with entities specified under par. (d) and may contract
6with
other entities for the provision of services under s. 46.283 (3) and (4), except that
7after July 27, 2005, the department shall notify the joint committee on finance in
8writing of any proposed contract with an entity that did not have a contract to provide
9services under s. 46.283 (3) and (4) before July 27, 2005. If the cochairpersons of the
10committee do not notify the department within 14 working days after the date of the
11department's notification that the committee has scheduled a meeting for the
12purpose of reviewing the proposed contract, the department may enter into the
13proposed contract. If within 14 working days after the date of the department's
14notification the cochairpersons of the committee notify the department that the
15committee has scheduled a meeting for the purpose of reviewing the proposed
16contract, the department may enter into the proposed contract only upon approval
17of the committee.
AB1110-ASA2, s. 13 18Section 13. 46.281 (1) (g) 3. of the statutes is amended to read:
AB1110-ASA2,9,219 46.281 (1) (g) 3. Conduct ongoing evaluations of the long-term care system
20specified in ss. 46.2805 to 46.2895
managed care programs for provision of long-term
21care services that are funded by medical assistance, as defined in s. 46.278 (1m) (b),
22as to client access to services, the availability of client choice of living and service
23options, quality of care, and cost-effectiveness. In evaluating the availability of
24client choice, the department shall evaluate the opportunity for a client to arrange

1for, manage, and monitor his or her family care benefit directly or with assistance,
2as specified in s. 46.284 (4) (e)
.
AB1110-ASA2, s. 14 3Section 14. 46.282 (2) (a) (intro.) of the statutes is amended to read:
AB1110-ASA2,9,74 46.282 (2) (a) Appointment by a county. (intro.) In a county that participates
5in a pilot project
in which the department has a contract under s. 46.281 (1) (d) (e)
6and before a county participates in the program under ss. 46.2805 to 46.2895, the
7following shall be done:
AB1110-ASA2, s. 15 8Section 15. 46.283 (2) (b) (intro.) of the statutes, as affected by 2005 Wisconsin
9Act 25
, is amended to read:
AB1110-ASA2,9,1810 46.283 (2) (b) (intro.) After June 30, 2001, the department shall contract with
11the entities specified under s. 46.281 (1) (d) 1. and
may, if the applicable review
12conditions under s. 48.281 (1) (e) 2. s. 46.281 (1) (e) 2. are satisfied, in addition to
13contracting with these entities,
contract to operate a resource center with counties,
14family care districts, or the governing body of a tribe or band or the Great Lakes
15Inter-Tribal Council, Inc., under a joint application of any of these, or with a private
16nonprofit organization if the department determines that the organization has no
17significant connection to an entity that operates a care management organization
18and if any of the following applies:
AB1110-ASA2, s. 16 19Section 16. 46.284 (4) (e) of the statutes is amended to read:
AB1110-ASA2,9,2520 46.284 (4) (e) Provide, within guidelines established by the department, a
21mechanism by which an enrollee may arrange for, manage, and monitor his or her
22family care benefit directly or with the assistance of another person chosen by the
23enrollee. The care management organization shall provide each enrollee with a form
24on which the enrollee shall indicate whether he or she has been offered the option
25under this paragraph and whether he or she has accepted or declined the option. If

1the enrollee accepts the option, the care management organization shall
monitor the
2enrollee's use of a fixed budget for purchase of services or support items from any
3qualified provider, monitor the health and safety of the enrollee, and provide
4assistance in management of the enrollee's budget and services at a level tailored to
5the enrollee's need and desire for the assistance.
AB1110-ASA2, s. 17 6Section 17. 46.285 (1) (a) of the statutes is amended to read:
AB1110-ASA2,10,107 46.285 (1) (a) For a pilot project established an entity with which the
8department has contracted
under s. 46.281 (1) (d) 2. (e) 1., provision of the services
9specified under s. 46.283 (3) (b), (e), (f) and (g) shall be structurally separate from the
10provision of services of the care management organization by January 1, 2001.
AB1110-ASA2, s. 18 11Section 18. 49.45 (3) (ag) of the statutes is amended to read:
AB1110-ASA2,10,1412 49.45 (3) (ag) Reimbursement shall be made to each entity contracted with
13under s. 46.281 (1) (d) (e) for functional screens performed under s. 46.281 (1) (d) by
14the entity
.
AB1110-ASA2, s. 19 15Section 19. Nonstatutory provisions.
AB1110-ASA2,10,1716 (1) Increased payments for nursing homes providing Family Care benefit
17services.
AB1110-ASA2,10,1818 (a) In this subsection:
AB1110-ASA2,10,20 191. "Care management organization" has the meaning given in section 46.2805
20(1) of the statutes.
AB1110-ASA2,10,21 212. "Facility" has the meaning given in section 49.45 (6m) (a) 3. of the statutes.
AB1110-ASA2,10,23 223. "Family Care benefit" has the meaning given in section 46.2805 (4) of the
23statutes.
AB1110-ASA2,10,25 244. "Medical Assistance" has the meaning given in section 46.278 (1m) (b) of the
25statutes.
AB1110-ASA2,11,3
1(b) Care management organizations shall provide increased funding for
2reimbursement for care provided by facilities for recipients of Medical Assistance as
3a Family Care benefit, in amounts that proportionately reflect all of the following:
AB1110-ASA2,11,5 41. For fiscal year 2005-06, the nursing home reimbursement supplement
5authorized under 2005 Wisconsin Act 211, Section 1 (4d).
AB1110-ASA2,11,7 62. For fiscal year 2006-07, the nursing home reimbursement rate increase
7authorized under 2005 Wisconsin Act 211, Section 1 (4c).
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