SB21-SSA1,481,1412 (b) The department, after consulting with representatives of counties,
13hospitals, and individuals who receive services under the children's community
14options program under this section, shall do all of the following:
SB21-SSA1,481,1715 1. Establish minimum requirements for the provision of care management
16services, as defined by the department, including standards for care, times for
17performance of duties, and size of case loads.
SB21-SSA1,481,1918 2. Specify a reasonable schedule for phasing in the requirements established
19under subd. 1.
SB21-SSA1,481,2120 3. Provide technical consultation and assistance to the administrator of the
21program with respect to the requirements established under subd. 1.
SB21-SSA1,481,2322 (c) The department need not promulgate as rules under ch. 227 the
23requirements under par. (b) 1. or the schedule under par. (b) 2.
SB21-SSA1,482,3 24(11) Fiscal responsibility. Except as provided in s. 51.40, and within the
25limitations under sub. (13) (a) 2., the fiscal responsibility of a county for an

1assessment, unless the assessment is performed by an entity under a contract as
2specified under s. 46.284 (2), case plan, or services provided to a child under this
3section is as follows:
SB21-SSA1,482,64 (a) For a child seeking admission to or about to be admitted to an institutional
5setting, the county in which the child has residence is the county of fiscal
6responsibility.
SB21-SSA1,482,97 (b) For a child residing in an institutional setting, except a state-operated
8long-term care facility, the county in which the institution is located is the county
9of fiscal responsibility.
SB21-SSA1,482,1210 (c) For a child living in an institutional setting, except a state-operated
11long-term care facility, whose legal residence is established in another county, the
12county in which the legal residence is established is the county of fiscal responsibility.
SB21-SSA1,482,1613 (d) For a child residing in a state-operated long-term care facility, or for a
14person protectively placed under ch. 55, the county in which the child has residence
15before he or she enters the state-operated long-term care facility or is protectively
16placed is the county of fiscal responsibility.
SB21-SSA1,482,20 17(12) Reimbursement disallowances. The department may disallow
18reimbursement under this section for services provided to children who do not meet
19the eligibility requirements for the children's community options program or any
20other eligibility requirements established by the department.
SB21-SSA1,482,24 21(13) Funding. (a) Subject to pars. (b) and (h), from the appropriation under
22s. 20.435 (4) (bd), the department shall allocate funds to each county or private
23nonprofit agency with which the department contracts for all of the following
24purposes:
SB21-SSA1,483,7
11. To pay assessment and case plan costs not otherwise paid by fee or under s.
249.45 or 49.78 (2). The department shall reimburse multicounty consortia for the
3cost of assessing children eligible for medical assistance under s. 49.46, 49.468,
449.47, or 49.471 (4) (a) as part of the administrative services of medical assistance,
5payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this
6subdivision to pay the cost of long-term community support services and for a risk
7reserve under par. (f).
SB21-SSA1,483,158 2. To pay the cost of providing long-term community support services described
9under sub. (7) (b) not otherwise paid under s. 49.45 to children eligible for medical
10assistance under s. 49.46, 49.47, or 49.471 (4) (a). The county department
11administering the program may spend funds received under this paragraph only in
12accordance with the case plan and service contract created for each child receiving
13long-term community support services. Counties may use unspent funds allocated
14under this subdivision from the appropriation under s. 20.435 (4) (bd) for a risk
15reserve under par. (f).
SB21-SSA1,483,1616 (b) 1. Receipt of funds under this section is subject to s. 46.495 (2).
SB21-SSA1,483,1817 2. The department may not release funds under this subsection before
18approving the county's community options plan.
SB21-SSA1,483,2219 3. No county may use funds received under par. (a) 2. to pay for long-term
20community support services provided to any child who resides in a nursing home,
21unless the department waives this restriction on use of funds and the services are
22provided in accordance with a discharge plan.
SB21-SSA1,483,2423 4. No county may use funds received under this section to purchase land or
24construct buildings.
SB21-SSA1,484,3
1(c) The department may release funds to counties acting jointly, if the counties
2sign a contract approved by the secretary that explains the plans for joint
3sponsorship.
SB21-SSA1,484,84 (d) If the department determines that a county demonstrates a pattern of
5failure to serve clients whose cost of care significantly exceeds the average cost of care
6for children's long-term community support services provided under this section, the
7department may require that county to reserve a portion of funds allocated under
8this subsection for provision of service to those clients.
SB21-SSA1,484,229 (e) The department shall, at the request of a county, carry forward up to 5
10percent of the amount allocated under this subsection to the county for a calendar
11year if up to 5 percent of the amount so allocated has not been spent or encumbered
12by the county by December 31 of that year, for use by the county in the following
13calendar year, except that the amount carried forward shall be reduced by the
14amount of funds that the county has notified the department that the county wishes
15to place in a risk reserve under par. (f). The department may transfer funds within
16s. 20.435 (4) (bd) to accomplish this purpose. An allocation under this paragraph does
17not affect a county's base allocation under this subsection and shall lapse to the
18general fund unless expended within the calendar year to which the funds are
19carried forward. A county may not expend funds carried forward under this
20paragraph for administrative or staff costs, except administrative or staff costs that
21are associated with implementation of the waiver under sub. (14) and approved by
22the department.
SB21-SSA1,485,523 (f) 1. Notwithstanding s. 46.036 (3) and (5m), a county may place in a risk
24reserve funds that are allocated under par. (a) or sub. (14) (b) 1. and are not expended
25or encumbered for services under this subsection or sub. (14). The county shall notify

1the department of this decision and of the amount to be placed in the risk reserve.
2The county shall maintain the risk reserve in an interest-bearing escrow account
3with a financial institution, as defined in s. 69.30 (1) (b), if the department has
4approved the terms of the escrow. All interest from the principal shall be reinvested
5in the escrow account.
SB21-SSA1,485,106 2. The annual amount of a county's expenditure for a risk reserve, as specified
7in subd. 1., may not exceed 10 percent of the county's most recent allocation under
8par. (a) and sub. (14) (b) 1. or $750,000, whichever is less. The total amount of the
9risk reserve, including interest, may not exceed 15 percent of the county's most recent
10allocation under this subsection.
SB21-SSA1,485,1211 3. A county may expend funds maintained in a risk reserve, as specified in subd.
121., for any of the following purposes:
SB21-SSA1,485,1413 a. To defray costs of children's long-term community support services under
14this section.
SB21-SSA1,485,1615 b. If approved by the department, for administrative or staff costs under this
16section.
SB21-SSA1,485,1917 4. A county that maintains a risk reserve, as specified in subd. 1., shall
18annually, on a form prescribed by the department, submit to the department a record
19of the status of the risk reserve, including revenues and disbursements.
SB21-SSA1,486,320 (g) The department may carry forward to the next state fiscal year funds
21allocated under this subsection and not encumbered by counties by December 31 or
22carried forward under par. (e). The department may transfer moneys within s.
2320.435 (4) (bd) to accomplish this purpose. An allocation under this paragraph shall
24not affect a county's base allocation for the program. The department may allocate
25these transferred moneys during the next fiscal year to counties for the improvement

1or expansion of long-term community support services for clients whose cost of care
2significantly exceeds the average cost of care provided under this section, including
3any of the following:
SB21-SSA1,486,44 1. Specialized training for providers of services under this section.
SB21-SSA1,486,55 2. Start-up costs for developing needed services.
SB21-SSA1,486,66 3. Home modifications.
SB21-SSA1,486,77 4. Purchase of medical equipment or other specially adapted equipment.
SB21-SSA1,486,118 (h) Funds allocated under this subsection may not be used to replace any other
9state and federal funds or any county funds that are currently being provided under
10any program to a family whose child is receiving services through the children's
11community options program.
SB21-SSA1,486,16 12(14) Medical assistance waiver. (a) The department may request a waiver
13from the federal department of health and human services authorizing the
14department to provide as part of the Medical Assistance program services for persons
15who are eligible for children's long-term support community options program
16services under sub. (7) (b).
SB21-SSA1,486,2117 (b) 1. Medical assistance reimbursement for services a county or a private
18nonprofit agency, or with which the department contracts provides under this
19subsection shall be made from the appropriations under s. 20.435 (4) (bd) and (o) and
20(7) (b). Payments made under sub. (13) (a) may be used as the state share for
21purposes of Medical Assistance reimbursement.
SB21-SSA1,486,2322 3. The department may contract for services under this subsection with a
23county or a private nonprofit agency.
SB21-SSA1,487,224 4. No county or private nonprofit agency may use funds received under this
25subsection to provide residential services in a group home, as defined in s. 48.02 (7),

1that has more than 5 beds, unless the department approves the provision of services
2in a group home that has 6 to 8 beds.
SB21-SSA1,487,53 (c) If a county department or private nonprofit agency providing services under
4this subsection is certified under s. 49.45 (37) (a), the waiver under s. 49.45 (37), if
5in effect, applies to plans of care for children receiving services under this subsection.
SB21-SSA1,487,9 6(15) Right to hearing. A child who is denied eligibility for services or whose
7services are reduced or terminated under this section may request a hearing from the
8department under s. 227.44, except that lack of adequate funding may not serve as
9the basis for a request under this subsection.
SB21-SSA1,1536 10Section 1536. 46.277 (5g) (b) of the statutes is renumbered 46.277 (5g) (b)
11(intro.) and amended to read:
SB21-SSA1,487,1512 46.277 (5g) (b) (intro.) This section does not apply to the delicensure of a bed
13of an institution for mental diseases of an individual who is aged 21 to 64, who has
14a primary diagnosis of mental illness and who otherwise meets any of the following
15requirements of s. 46.266 (1) (a), (b) or (c).:
SB21-SSA1,1537 16Section 1537. 46.277 (5g) (b) 1. and 2. of the statutes are created to read:
SB21-SSA1,487,2117 46.277 (5g) (b) 1. A person who resided in the facility on the date of the finding
18that a skilled nursing facility or intermediate care facility that provides care to
19Medical Assistance recipients to be an institution for mental diseases whose care in
20the facility is disallowed for federal financial participation under Medical
21Assistance.
SB21-SSA1,488,222 2. A person who is aged 21 to 64, who has a primary diagnosis of mental illness,
23who would meet the level of care requirements for Medical Assistance
24reimbursement in a skilled nursing facility or intermediate care facility but for a

1finding that the facility is an institution for mental diseases, and for whom services
2would be provided in place of a person specified in subd. 1. who discontinues services.
SB21-SSA1,1542 3Section 1542. 46.2803 (2) of the statutes is amended to read:
SB21-SSA1,488,114 46.2803 (2) Notwithstanding s. 46.27 (7), a county in which a care management
5organization is operating pursuant to a contract under s. 46.284 (2) or a county in
6which a program described under s. 46.2805 (1) (a) or (b) is administered may use
7funds appropriated under s. 20.435 (7) (4) (bd) and allocated to the county under s.
846.27 (7) to provide community mental health or substance abuse services and
9supports for persons with mental illness or persons in need of services or supports
10for substance abuse and to provide services under the Family Support Program
11under s. 46.985.
SB21-SSA1,1543 12Section 1543 . 46.2803 (2) of the statutes, as affected by 2015 Wisconsin Act
13.... (this act), is amended to read:
SB21-SSA1,488,2014 46.2803 (2) Notwithstanding s. 46.27 (7), a county in which a care management
15organization is operating pursuant to a contract under s. 46.284 (2) or a county in
16which a program described under s. 46.2805 (1) (a) or (b) is administered may use
17funds appropriated under s. 20.435 (4) (bd) and allocated to the county under s. 46.27
18(7) to provide community mental health or substance abuse services and supports for
19persons with mental illness or persons in need of services or supports for substance
20abuse and to provide services under the Family Support Program under s. 46.985.
SB21-SSA1,1568 21Section 1568. 46.281 (4) (d) of the statutes is amended to read:
SB21-SSA1,488,2322 46.281 (4) (d) The department shall deposit payments made by counties under
23this subsection in the appropriation account under s. 20.435 (7) (g) (4) (h).
SB21-SSA1,1569b 24Section 1569b. 46.2825 (2) (i) of the statutes is created to read:
SB21-SSA1,489,2
146.2825 (2) (i) Review and assess the self-directed services option, as defined
2in s. 46.2899 (1).
SB21-SSA1,1586 3Section 1586. 46.283 (5) of the statutes is amended to read:
SB21-SSA1,489,74 46.283 (5) Funding. From the appropriation accounts under s. 20.435 (4) (b),
5(bd), (bm), (gm), (pa), and (w) and (7) (b), (bd), and (md), the department may contract
6with organizations that meet standards under sub. (3) for performance of the duties
7under sub. (4) and shall distribute funds for services provided by resource centers.
SB21-SSA1,1603 8Section 1603. 46.284 (5) (a) of the statutes is amended to read:
SB21-SSA1,489,159 46.284 (5) (a) From the appropriation accounts under s. 20.435 (4) (b), (bd), (g),
10(gm), (h), (im), (o), and (w) and (7) (b), (bd), and (g), the department shall provide
11funding on a capitated payment basis for the provision of services under this section.
12Notwithstanding s. 46.036 (3) and (5m), a care management organization that is
13under contract with the department may expend the funds, consistent with this
14section, including providing payment, on a capitated basis, to providers of services
15under the family care benefit.
SB21-SSA1,1618c 16Section 1618c. 46.2895 (4) (n) of the statutes is created to read:
SB21-SSA1,489,1817 46.2895 (4) (n) In accordance with state law, operate a health maintenance
18organization.
SB21-SSA1,1621 19Section 1621. 46.2896 of the statutes is created to read:
SB21-SSA1,489,20 2046.2896 Counting promissory notes as assets. (1) In this section:
SB21-SSA1,489,2421 (a) "Long-term care program" means the long-term care program under s.
2246.27, 46.275, 46.277, 46.278, or 46.2785; the family care program providing the
23benefit under s. 46.286; the Family Care Partnership program; or the long-term care
24program defined in s. 46.2899 (1).
SB21-SSA1,490,4
1(b) "Promissory note" means a written, unconditional agreement, given in
2return for goods, money loaned, or services rendered, under which one party
3promises to pay another party a specified sum of money at a specified time or on
4demand.
SB21-SSA1,490,7 5(2) When determining or redetermining an individual's financial eligibility for
6a long-term care program, the department shall include a promissory note as a
7countable asset if all of the following apply:
SB21-SSA1,490,108 (a) The individual applying for or receiving benefits under the long-term care
9program or his or her spouse provided the goods, money loaned, or services rendered
10for the promissory note.
SB21-SSA1,490,1211 (b) The promissory note was entered into or purchased on or after the effective
12date of this paragraph .... [LRB inserts date].
SB21-SSA1,490,1413 (c) The promissory note is negotiable, assignable, and enforceable and does not
14contain any terms making it unmarketable.
SB21-SSA1,490,20 15(3) A promissory note is presumed to be negotiable and its asset value is the
16outstanding principal balance at the time the individual applies for the long-term
17care program or at the time the individual's eligibility for the long-term care
18program is redetermined, unless the individual shows by credible evidence from a
19knowledgeable source that the note is nonnegotiable or has a different current
20market value, which will then be considered the asset value.
SB21-SSA1,1626 21Section 1626. 46.29 (1) (intro.) of the statutes is amended to read:
SB21-SSA1,490,2522 46.29 (1) (intro.) From the appropriation account under s. 20.435 (7) (4) (a), the
23department shall distribute at least $16,100 in each fiscal year for operation of the
24council on physical disabilities. The council on physical disabilities shall do all of the
25following:
SB21-SSA1,1627
1Section 1627. 46.29 (3) (d) of the statutes is amended to read:
SB21-SSA1,491,32 46.29 (3) (d) The director of the office administrator of the division of state
3employment relations
personnel management in the department of administration.
SB21-SSA1,1630 4Section 1630. 46.295 (1) of the statutes is amended to read:
SB21-SSA1,491,85 46.295 (1) The department may, on the request of any hearing-impaired
6person, city, village, town, or county or private agency, provide funds from the
7appropriation accounts under s. 20.435 (4) (hs) and (7) (d) and (hs) to reimburse
8interpreters for hearing-impaired persons for the provision of interpreter services.
SB21-SSA1,1631 9Section 1631. 46.40 (1) (a) of the statutes is amended to read:
SB21-SSA1,491,1510 46.40 (1) (a) Within the limits of available federal funds and of the
11appropriations under s. 20.435 (7) (b) and (o), the department shall distribute funds
12for community social, mental health, developmental disabilities, and alcohol and
13other drug abuse services and for services under ss. 46.87, 46.985, and 51.421 to
14county departments under ss. 46.215, 46.22, 46.23, 51.42, and 51.437 and to county
15aging units, as provided in subs. (2), (2m), (8), and (7) to (9).
SB21-SSA1,1632 16Section 1632. 46.40 (7) of the statutes is repealed.
SB21-SSA1,1633 17Section 1633. 46.40 (7m) of the statutes is created to read:
SB21-SSA1,491,2018 46.40 (7m) State community mental health allocation. For community
19mental health services, the department shall distribute not less than $24,348,700 in
20each fiscal year.
SB21-SSA1,1634 21Section 1634. 46.40 (14m) of the statutes is amended to read:
SB21-SSA1,492,222 46.40 (14m) County community aids budgets. Before December 1 of each year,
23each county department under ss. 46.215, 46.22, 46.23, 51.42 and 51.437 and each
24tribal governing body shall submit to the department a proposed budget for the
25expenditure of funds allocated under this section or carried forward under s. 46.45

1(3) (a). The proposed budget shall be submitted on a form developed by the
2department and approved by the department of administration.
SB21-SSA1,1635 3Section 1635. 46.45 (3) (a) of the statutes is amended to read:
SB21-SSA1,492,164 46.45 (3) (a) Except as provided in par. (b), at the request of a county, tribal
5governing body, or private nonprofit organization, the department shall carry
6forward up to 3% of the total amount allocated to the county, tribal governing body,
7or nonprofit organization for a calendar year, not including the amount allocated to
8the county under s. 46.40 (7), which amount may be carried forward as provided in
9par. (c)
. All funds carried forward for a tribal governing body or nonprofit
10organization and all funds allocated under s. 46.40 (2m) carried forward for a county
11shall be used for the purpose for which the funds were originally allocated. Other
12funds carried forward under this paragraph may be used for any purpose under s.
1320.435 (7) (b), except that a county may not use any funds carried forward under this
14paragraph for administrative or staff costs. An allocation of carried-forward funding
15under this paragraph does not affect a county's base allocations under s. 46.40 (2),
16(2m), (8), and (9).
SB21-SSA1,1636 17Section 1636. 46.45 (3) (c) of the statutes is repealed.
SB21-SSA1,1637 18Section 1637. 46.45 (6) (a) of the statutes is renumbered 46.45 (6) and
19amended to read:
SB21-SSA1,492,2420 46.45 (6) The department may carry forward 10% of any funds specified in sub.
21(3) (a) that are not carried forward under sub. (3) (a) for emergencies, for justifiable
22unit services costs above planned levels, and for increased costs due to population
23shifts. An allocation of carried-forward funding under this paragraph does not affect
24a county's base allocations under s. 46.40 (2), (2m), (8), and (9).
SB21-SSA1,1638 25Section 1638. 46.45 (6) (b) of the statutes is repealed.
SB21-SSA1,1639
1Section 1639. 46.56 (3) (a) 4. of the statutes is repealed.
SB21-SSA1,1640 2Section 1640. 46.56 (10) of the statutes is repealed.
SB21-SSA1,1644w 3Section 1644w. 46.96 (title) of the statutes is amended to read:
Loading...
Loading...