Amendment SSA1-SB21

SB21-SSA1,1507 Section 1507. 46.23 (5) (a) 1. of the statutes is amended to read:

SB21-SSA1,466,4 46.23 (5) (a) 1. Shall determine administrative and program policies, except as provided under ch. 48 and subch. III of ch. 49 and except for policies relating to community-based juvenile delinquency-related policies, services or to the purchase of juvenile correctional services, within limits established by the department of health services. Policy decisions, except as provided under ch. 48 and subch. III of ch. 49 and except for policy decisions relating to community-based juvenile delinquency-related policies, services or to the purchase of juvenile correctional services, that are not reserved by statute for the department of health services may be delegated by the secretary to the county human services board.

SB21-SSA1,1508 Section 1508. 46.23 (5) (a) 2. of the statutes is amended to read:

SB21-SSA1,466,13 46.23 (5) (a) 2. Shall determine administrative and program policies under ch. 48 and subch. III of ch. 49 and administrative and program policies relating to community-based juvenile delinquency-related services within limits established by the department of children and families. Policy decisions under ch. 48 and subch. III of ch. 49 and policy decisions relating to community-based juvenile delinquency-related services that are not reserved by statute for the department of children and families may be delegated by the secretary of children and families to the county human services board.

SB21-SSA1,1509 Section 1509. 46.23 (5) (a) 3. of the statutes is amended to read:

SB21-SSA1,466,21 46.23 (5) (a) 3. Shall determine juvenile delinquency-related administrative programs and policies relating to the purchase of juvenile correctional services within limits established by the department of corrections. Juvenile delinquency-related policy Policy decisions relating to the purchase of juvenile correctional services that are not reserved by statute for the department of corrections may be delegated by the secretary of corrections to the county human services board.

SB21-SSA1,1510 Section 1510. 46.23 (5) (c) 1. of the statutes is amended to read:

SB21-SSA1,467,3 46.23 (5) (c) 1. Shall determine whether state mandated services, except for services under ch. 48 and subch. III of ch. 49, community-based juvenile delinquency-related services, and juvenile delinquency-related correctional services, are provided or by, purchased from, or contracted for with local providers, and monitor the performance of such those contracts. Purchase of services contracts shall be subject to the conditions specified in s. 46.036.

SB21-SSA1,1511 Section 1511. 46.23 (5) (c) 2. of the statutes is amended to read:

SB21-SSA1,467,9 46.23 (5) (c) 2. Shall determine whether state mandated services under ch. 48 and subch. III of ch. 49 and state-mandated community-based juvenile delinquency-related services are provided or by, purchased from, or contracted for with local providers, and monitor the performance of such those contracts. Purchase of services contracts shall be subject to the conditions specified in s. 49.34.

SB21-SSA1,1512d Section 1512d. 46.23 (5) (c) 3. of the statutes is amended to read:

SB21-SSA1,467,15 46.23 (5) (c) 3. Shall determine whether state mandated juvenile delinquency-related services are provided or purchased or contracted for with local providers, and monitor the performance of such contracts. Purchase of service contracts for the purchase of juvenile correctional services. Contracts for the purchase of those services shall be subject to the conditions specified in s. 301.031.

SB21-SSA1,1513 Section 1513. 46.23 (5) (n) 1. of the statutes is amended to read:

SB21-SSA1,467,23 46.23 (5) (n) 1. Shall submit a final budget in accordance with s. 46.031 (1) for authorized services, except for services under ch. 48 and subch. III of ch. 49, community-based juvenile delinquency-related services, and juvenile delinquency-related correctional services. Notwithstanding the categorization of or limits specified for funds allocated under s. 46.495 or 51.423 (2), with the approval of the department of health services the county human services board may expend these those funds consistent with any service provided under s. 46.495 or 51.42.

SB21-SSA1,1514 Section 1514. 46.23 (5) (n) 2. of the statutes is amended to read:

SB21-SSA1,468,6 46.23 (5) (n) 2. Shall submit a final budget in accordance with s. 49.325 (1) for authorized services under ch. 48 and subch. III of ch. 49 and for authorized community-based juvenile delinquency-related services. Notwithstanding the categorization of or limits specified for funds allocated under s. 48.569, with the approval of the department of children and families the county human services board may expend these those funds consistent with any service provided under s. 48.569.

SB21-SSA1,1515 Section 1515. 46.23 (5) (n) 3. of the statutes is amended to read:

SB21-SSA1,468,9 46.23 (5) (n) 3. Shall submit a final budget in accordance with s. 301.031 (1) for the purchase of authorized juvenile delinquency-related correctional services.

SB21-SSA1,1516 Section 1516. 46.23 (5m) (c) of the statutes is amended to read:

SB21-SSA1,468,21 46.23 (5m) (c) Prepare, with the assistance of the county human services director under sub. (6m) (e), a proposed budget for submission to the county executive or county administrator,; a final budget for submission to the department of health services in accordance with s. 46.031 (1) for authorized services, except services under ch. 48 and subch. III of ch. 49 and, community-based juvenile delinquency-related services, and juvenile correctional services; a final budget for submission to the department of children and families in accordance with s. 49.325 for authorized services under ch. 48 and subch. III of ch. 49, and for authorized community-based juvenile delinquency-related services; and a final budget for submission to the department of corrections in accordance with s. 301.031 for the purchase of authorized juvenile delinquency-related correctional services.

SB21-SSA1,1517 Section 1517. 46.23 (6) (a) (intro.) of the statutes is amended to read:

SB21-SSA1,469,11 46.23 (6) (a) (intro.) A county human services director appointed under sub. (5) (f) shall have all of the administrative and executive powers and duties of managing, operating, maintaining, and improving the services and programs of the county department of human services,. Those powers and duties are subject to the rules promulgated by the department of health services for programs, except that, with respect to services or programs under ch. 48 and subch. III of ch. 49 and community-based juvenile delinquency-related services or programs, those powers and duties are subject to the rules promulgated by the department of children and families for services or programs under ch. 48 and subch. III of ch. 49, and, with respect to the purchase of juvenile correctional services or programs, those powers and duties are subject to the rules promulgated by the department of corrections for juvenile delinquency-related services or programs. In consultation with the county human services board under sub. (5) and subject to its approval, the county human services director shall prepare all of the following:

SB21-SSA1,1518 Section 1518. 46.266 of the statutes is repealed.

SB21-SSA1,1519 Section 1519. 46.268 of the statutes is repealed.

SB21-SSA1,1523 Section 1523. 46.27 (6r) (b) 1m. of the statutes is renumbered 46.27 (6r) (b) 1m. (intro.) and amended to read:

SB21-SSA1,469,18 46.27 (6r) (b) 1m. (intro.) The person meets the requirements under s. 46.266 (1) (a), (b) or (c) any of the following for receipt of care in an institution for mental diseases.:

SB21-SSA1,1524 Section 1524. 46.27 (6r) (b) 1m. a. and b. of the statutes are created to read:

SB21-SSA1,469,24 46.27 (6r) (b) 1m. a. A person who resided in the facility on the date of the finding that a skilled nursing facility or intermediate care facility that provides care to Medical Assistance recipients to be an institution for mental diseases whose care in the facility is disallowed for federal financial participation under Medical Assistance.

SB21-SSA1,470,6 b. A person who is aged 21 to 64, who has a primary diagnosis of mental illness, who would meet the level of care requirements for Medical Assistance reimbursement in a skilled nursing facility or intermediate care facility but for a finding that the facility is an institution for mental diseases, and for whom services would be provided in place of a person specified in subd. 1m. a. who discontinues services.

SB21-SSA1,1525 Section 1525. 46.27 (7) (am) of the statutes is amended to read:

SB21-SSA1,470,16 46.27 (7) (am) From the appropriation under s. 20.435 (7) (4) (bd), the department shall allocate funds to each county or private nonprofit agency with which the department contracts to pay assessment and case plan costs under sub. (6) not otherwise paid by fee or under s. 49.45 or 49.78 (2). The department shall reimburse multicounty consortia for the cost of assessing persons eligible for medical assistance under s. 49.46, 49.468, 49.47, or 49.471 (4) (a) as part of the administrative services of medical assistance, payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this paragraph to pay the cost of long-term community support services and for a risk reserve under par. (fr).

SB21-SSA1,1526 Section 1526. 46.27 (7) (b) of the statutes is amended to read:

SB21-SSA1,471,6 46.27 (7) (b) From the appropriations under s. 20.435 (7) (4) (bd) and (im), the department shall allocate funds to each county to pay the cost of providing long-term community support services under sub. (5) (b) not otherwise paid under s. 49.45 to persons eligible for medical assistance under s. 49.46, 49.47, or 49.471 (4) (a) or to persons whom the county department or aging unit administering the program finds likely to become medically indigent within 6 months by spending excess income or assets for medical or remedial care. The average per person reimbursement under this paragraph may not exceed the state share of the average per person payment rate the department expects under s. 49.45 (6m). The county department or aging unit administering the program may spend funds received under this paragraph only in accordance with the case plan and service contract created for each person receiving long-term community support services. Counties may use unspent funds allocated under this paragraph from the appropriation under s. 20.435 (7) (4) (bd) for a risk reserve under par. (fr).

SB21-SSA1,1527 Section 1527. 46.27 (7) (fm) of the statutes is amended to read:

SB21-SSA1,471,20 46.27 (7) (fm) The department shall, at the request of a county, carry forward up to 5% of the amount allocated under this subsection to the county for a calendar year if up to 5% of the amount so allocated has not been spent or encumbered by the county by December 31 of that year, for use by the county in the following calendar year, except that the amount carried forward shall be reduced by the amount of funds that the county has notified the department that the county wishes to place in a risk reserve under par. (fr). The department may transfer funds within s. 20.435 (7) (4) (bd) to accomplish this purpose. An allocation under this paragraph does not affect a county's base allocation under this subsection and shall lapse to the general fund unless expended within the calendar year to which the funds are carried forward. A county may not expend funds carried forward under this paragraph for administrative or staff costs, except administrative or staff costs that are associated with implementation of the waiver under sub. (11) and approved by the department.

SB21-SSA1,1529 Section 1529. 46.27 (7) (g) (intro.) of the statutes is amended to read:

SB21-SSA1,472,7 46.27 (7) (g) (intro.) The department may carry forward to the next state fiscal year funds allocated under this subsection and not encumbered by counties by December 31 or carried forward under par. (fm). The department may transfer moneys within s. 20.435 (7) (4) (bd) to accomplish this purpose. An allocation under this paragraph shall not affect a county's base allocation for the program. The department may allocate these transferred moneys during the next fiscal year to counties for planning and implementation of resource centers under s. 46.283 or care management organizations under s. 46.284 and for the improvement or expansion of long-term community support services for clients whose cost of care significantly exceeds the average cost of care provided under this section, including any of the following:

SB21-SSA1,1530 Section 1530. 46.27 (7g) (d) of the statutes is amended to read:

SB21-SSA1,472,21 46.27 (7g) (d) The department may require the county department or aging unit selected to administer the program in each county to gather and provide the department with information needed to recover payment of long-term community support services under this subsection. The department shall pay to the county department or aging unit an amount equal to 5% of the recovery collected by the department relating to a beneficiary for whom the county department or aging unit made the last determination of eligibility for funding under sub. (7). A county department or aging unit may use funds received under this paragraph only to pay costs incurred under this paragraph and shall remit the remainder, if any, to the department for deposit in the appropriation account under s. 20.435 (7) (4) (im). The department may withhold payments under this paragraph for failure to comply with the department's requirements under this paragraph. The department shall treat payments made under this paragraph as costs of administration of the program.

SB21-SSA1,1531 Section 1531. 46.27 (7g) (e) of the statutes is amended to read:

SB21-SSA1,473,2 46.27 (7g) (e) From the appropriation under s. 20.435 (7) (4) (im), the department shall pay the amount of the payments under par. (d) and shall spend the remainder of the funds recovered under this subsection for long-term community support services funded under sub. (7) (b).

SB21-SSA1,1532 Section 1532. 46.27 (11) (c) 3. of the statutes is amended to read:

SB21-SSA1,473,7 46.27 (11) (c) 3. Medical assistance reimbursement for services a county, a private nonprofit agency or an aging unit with which the department contracts provides under this subsection shall be made from the appropriations under s. 20.435 (4) (bd) and (o) and (7) (b) and (bd).

SB21-SSA1,1533 Section 1533. 46.27 (13) of the statutes is created to read:

SB21-SSA1,473,12 46.27 (13) Program termination. Notwithstanding subs. (5), (6), (6g), (6u), (7), (7m), (8), and (11), after the date the family care benefit, as defined in s. 46.2805 (4), is available to eligible residents of a county, the department may discontinue the program under this section in that county.

SB21-SSA1,1534 Section 1534. 46.271 (1) (a) (intro.) of the statutes is amended to read:

SB21-SSA1,473,19 46.271 (1) (a) (intro.) From the appropriation under s. 20.435 (7) (4) (bd), the department shall award $100,000 in each fiscal year to applying county departments under s. 46.215, 46.22, 46.23, 51.42 or 51.437 or to an aging unit under the conditions specified in par. (c) to establish pilot projects for home and community-based long-term support services. Funds awarded to the pilot projects shall be used to do any of the following:

SB21-SSA1,1535 Section 1535. 46.272 of the statutes is created to read:

SB21-SSA1,473,22 46.272 Children's community options program. (1) Definitions. In this section:

SB21-SSA1,473,24 (a) "Child" means a person under 22 years of age who is not eligible to receive services in or be on a waiting list for an adult long-term care program.

SB21-SSA1,474,7 (b) "Disability" means a severe physical, developmental, or emotional impairment which is diagnosed medically, behaviorally, or psychologically, which is characterized by the need for individually planned and coordinated care, treatment, vocational rehabilitation, or other services and which has resulted or is likely to result in substantial limitation on the ability to function in at least 2 of the following areas, equivalent to nursing home, hospital, or institution for mental disease level of care:

SB21-SSA1,474,8 1. Self-care.

SB21-SSA1,474,9 2. Receptive and expressive language.

SB21-SSA1,474,10 3. Learning.

SB21-SSA1,474,11 4. Mobility.

SB21-SSA1,474,12 5. Self-direction.

SB21-SSA1,474,13 (c) "Hospital" has the meaning provided in s. 50.33 (2).

SB21-SSA1,474,16 (d) "Institutional setting" means a nursing home, as defined in s. 50.01 (3), a state-operated long-term care facility, or any other residential facility that provides long-term care to children outside of a home.

SB21-SSA1,474,19 (e) "Residence" means the voluntary concurrence of physical presence with intent to remain in a place of fixed habitation. Physical presence shall be prima facie evidence of intent to remain.

SB21-SSA1,474,22 (f) "State-operated long-term care facility" means a state center for the developmentally disabled and a Wisconsin veterans home operated by the department of veterans affairs under s. 45.50.

SB21-SSA1,474,25 (g) "Voluntary" means according to an individual's free choice, if competent, or by choice of his or her parent or guardian, if the individual is adjudicated incompetent or is a minor.

SB21-SSA1,475,2 (2) Departmental duties. The department shall do all of the following to establish a children's community options program:

SB21-SSA1,475,4 (a) Review and approve or disapprove the selection of a county department to administer the children's community options program.

SB21-SSA1,475,15 (b) In consultation with representatives of counties; programs that provide community-based services to children or families, other publicly funded programs, and the social services, mental health, and developmental disabilities programs under ss. 46.495, 51.42, and 51.437; the independent living center program under s. 46.96; and the Medical Assistance program under subch. IV of ch. 49; and with recipients of children's community support services, develop guidelines for implementing the program and criteria for reviewing community options plans from counties participating in the program under this section. The guidelines and criteria shall address cost-effectiveness, scope, feasibility and impact on the quality and appropriateness of health services and social services and shall provide counties with maximum flexibility to develop programs that address local needs.

SB21-SSA1,475,17 (c) Review and approve or disapprove the community options plan of each county participating in the children's community options program.

SB21-SSA1,475,20 (d) Require that a county, by use of a form provided by the department or other appropriate procedure, ensure that persons receiving services under this section meet the eligibility requirements for the children's community options program.

SB21-SSA1,475,22 (e) Periodically monitor the implementation of the children's community options program.

SB21-SSA1,475,25 (f) Review and approve or disapprove the terms of risk reserve escrow accounts created under sub. (13) (f) and approve or disapprove disbursements for administrative or staff costs from the risk reserve escrow accounts.

SB21-SSA1,476,2 (4) Duties of participating county departments. Each participating county department shall do all of the following:

SB21-SSA1,476,6 (a) Appoint members to an advisory committee or appoint an existing committee in the service area as the children's community options advisory committee to assist in developing the program plan and to monitor the program. The committee shall include, but need not be limited to, the following members:

SB21-SSA1,476,11 1. Parents of children with disabilities including, if possible, parents from families that participate in the children's community options program. To the maximum extent possible, the parents shall be representative of the various disability, racial, and ethnic groups in the service area. The members specified under this subdivision shall constitute a majority of the membership of the committee.

SB21-SSA1,476,17 2. Persons from the service area representing the county department under s. 46.23, 51.42, or 51.437 and the county department under s. 46.215 or 46.22, school districts, and local health departments, as defined in s. 250.01 (4). At least one of the committee members selected under this subdivision shall be a person providing community social services to children with disabilities who are eligible for the program.

SB21-SSA1,476,19 3. Persons in the service area who provide social or educational services to children who have disabilities other than the providers specified in subd. 2.

SB21-SSA1,476,21 (b) Cooperate with the committee appointed under par. (a) to prepare a program plan. The program plan shall include all of the following:

SB21-SSA1,476,22 1. A description of the proposed program operations.

SB21-SSA1,476,23 2. The estimated number of families that will be assessed and served.

SB21-SSA1,476,25 3. A list of specific groups, if any, that will be given priority for available funding.

SB21-SSA1,477,3 4. A description of the outreach procedures that will be used to ensure that the program will be made available to children with physical, emotional, and developmental disabilities.

SB21-SSA1,477,4 5. The procedures that will be used to determine family needs.

SB21-SSA1,477,7 6. A description of the methods that will be used for the development and monitoring of service plans and for coordinating the provision of services and goods to participating families.

SB21-SSA1,477,9 7. A description of the methods that will be used to promote the creation of informal support and advocacy systems for families.

SB21-SSA1,477,11 8. A description of the method that will be used to monitor the children's community options program.

SB21-SSA1,477,13 (c) Submit the proposed program plan to the department upon approval by the children's community options program advisory committee.

SB21-SSA1,477,16 (d) Administer the program or contract with a human service agency in the service area to administer the program within the limits of state and federal funds under subs. (13) and (14).

SB21-SSA1,477,21 (e) In conjunction with the county department under s. 46.215 or 46.22, if any, in the service area and with the administering agency, if it is not the county department under s. 46.23, 51.42, or 51.437, coordinate the administration of the program with the administration of other publicly funded programs that serve children who have disabilities.

SB21-SSA1,477,22 (f) Submit all information and reports required by the department.

SB21-SSA1,478,2 (5) Powers and duties of a private nonprofit agency. The department may contract with a private nonprofit agency for services under this section. The agency shall have the powers and duties under this section of a county department designated to administer the program.

SB21-SSA1,478,4 (6) Duties of counties or agencies. Each county or each agency under contract under sub. (5) shall:

SB21-SSA1,478,5 (a) Cooperate in the development of the program plan under sub. (4) (b).