AB150: Bill Text

AB150,1078,18 49.45 (25) (bg) An independent living center, as defined in s. 46.96 (1) (a), that is a certified case management provider may elect to provide case management services to one or more of the categories of medical assistance beneficiaries specified under par. (am). The amount of allowable charges for the services under the medical assistance program that is not provided by the federal government shall be paid from nonfederal, public funds received by the independent living center from a county, city, village or town or from funds distributed under the appropriation under s. 20.435 (5) (bm) or as a grant under s. 46.96.

AB150, s. 2998 Section 2998. 49.45 (25) (bm) (intro.) of the statutes is amended to read:

AB150,1078,22 49.45 (25) (bm) (intro.) Case management services under this subsection may not be provided to a person under the category of severely emotionally disturbed child par. (am) 7. unless any of the following is true:

AB150, s. 2999 Section 2999. 49.45 (34) of the statutes is amended to read:

AB150,1079,3 49.45 (34) Medical assistance manual. The department shall prepare a medical assistance manual that is clear, comprehensive and consistent with ss. 49.43 to 49.47 this subchapter and 42 USC 1396a to 1396u and shall, no later than July 1, 1992, provide the manual to counties for use by county employes who administer the medical assistance program.

AB150, s. 3000 Section 3000. 49.45 (39) of the statutes is created to read:

AB150,1079,5 49.45 (39) School medical services. (a) Definitions. In this subsection:

AB150,1079,9 1. "School" means a public school described under s. 115.01 (1) or a charter school, as defined in s. 115.001 (1). It includes school-operated early childhood programs for developmentally delayed and disabled 4-year-old and 5-year-old children.

AB150,1079,12 2. "School medical services" means health care services that are provided in a school to children who are eligible for medical assistance and that are appropriate to a school setting, under rules promulgated by the department.

AB150,1079,22 (b) Payment for school medical services. If a school district elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district for the federal share of allowable charges for the school medical services that it provides and for allowable administrative costs. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. All other expenses for the school medical services shall be paid for by the school district with funds received from state or local taxes. The school district shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.

AB150,1079,25 (c) Certification and reporting requirements. The department shall promulgate rules establishing specific certification and reporting requirements with respect to school medical services under this subsection.

AB150, s. 3001 Section 3001. 49.45 (40) of the statutes is created to read:

AB150,1080,4 49.45 (40) Periodic record matches. The department shall cooperate with the department of industry, labor and human relations in matching records of medical assistance recipients under s. 49.32 (7).

AB150, s. 3002 Section 3002. 49.45 (41) of the statutes is created to read:

AB150,1080,16 49.45 (41) Mental health crisis intervention services. A county, city, village or town may elect to make mental health crisis intervention services under this subsection available in the county, city, village or town to medical assistance recipients through the medical assistance program. A county, city, village or town that elects to make the services available shall reimburse the provider of the mental health crisis intervention services for the amount of the allowable charges for those services under the medical assistance program that is not provided by the federal government. The department shall reimburse the provider of mental health crisis intervention services under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

AB150, s. 3003 Section 3003. 49.455 (4) (c) of the statutes is repealed and recreated to read:

AB150,1080,23 49.455 (4) (c) 1. For all years other than 1996 and 1997, the minimum monthly maintenance needs allowance equals $1,500 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved. For 1996 and 1997, the minimum monthly maintenance needs allowance equals the lesser of the amount determined under subd. 2., or the sum of the following:

AB150,1080,24 a. One-twelfth of 200% of the poverty line for a family of 2 persons.

AB150,1080,25 b. Any excess shelter allowance under par. (d).

AB150,1081,4 2. The minimum monthly maintenance needs allowance in a year may not exceed $1,500 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.

AB150,1081,7 3. In making the calculation under subd. 1. a., when the poverty line is revised the department shall use the revised amount starting on the first day of the 2nd calendar quarter beginning after the date of publication of the revision.

AB150, s. 3004 Section 3004. 49.455 (4) (d) of the statutes is created to read:

AB150,1081,10 49.455 (4) (d) The excess shelter allowance equals the amount by which 30% of the amount determined under par. (c) 1. a. is exceeded by the sum of the following:

AB150,1081,13 1. The community spouse's expenses for rent or mortgage principal and interest, taxes and insurance for his or her principal residence and, if the community spouse lives in a condominium or cooperative, any required maintenance charge.

AB150,1081,18 2. The standard utility allowance established under 7 USC 2014 (e), except that if the community spouse lives in a condominium or cooperative for which the maintenance charge includes utility expenses, the standard utility allowance under 7 USC 2014 (e) is reduced by the amount of the utility expenses included in the maintenance charge.

AB150, s. 3005 Section 3005. 49.455 (6) (b) 1. of the statutes is amended to read:

AB150,1081,25 49.455 (6) (b) 1. In 1989, $60,000; in a calendar year after 1989, 1996 and 1997, $12,000 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved. In all other years, $60,000 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.

AB150, s. 3006 Section 3006. 49.455 (6) (b) 2. of the statutes is created to read:

AB150,1082,2 49.455 (6) (b) 2. The lesser of the following:

AB150,1082,3 a. The spousal share computed under sub. (5) (a) 1.

AB150,1082,6 b. In any year, $60,000 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.

AB150, s. 3007 Section 3007. 49.46 (1) (a) 4. of the statutes is amended to read:

AB150,1082,9 49.46 (1) (a) 4. Any person receiving benefits under s. 49.177 49.77 or federal Title XVI.

AB150, s. 3008 Section 3008. 49.46 (1) (a) 15. of the statutes is created to read:

AB150,1082,13 49.46 (1) (a) 15. Any individual who is infected with tuberculosis and meets the income and resource eligibility requirements for the federal supplemental security program under 42 USC 1381 to 1383d.

AB150, s. 3009 Section 3009. 49.46 (1) (d) 4. of the statutes is amended to read:

AB150,1082,16 49.46 (1) (d) 4. A child who meets the conditions under 42 USC 1396a (e) 3. (3) shall be considered a recipient of benefits under s. 49.177 49.77 or federal Title XVI.

AB150, s. 3010 Section 3010. 49.46 (1) (e) of the statutes is amended to read:

AB150,1082,23 49.46 (1) (e) If an application under s. 49.47 (3) shows that the person has income and resources within the limitations of s. 49.19, federal Title XVI or s. 49.177 49.77, or that the person is an essential person, an accommodated person or a patient in a public medical institution, the person shall be granted the benefits enumerated under sub. (2) whether or not the person requests or receives a grant of any of such aids.

AB150, s. 3011 Section 3011. 49.46 (2) (a) 2. of the statutes is amended to read:

AB150,1083,4 49.46 (2) (a) 2. Early and periodic screening and diagnosis, including case management services, of persons under 21 years of age and all medical treatment and dentists' services specified in par. (b) 1. found necessary by this screening and diagnosis.

AB150, s. 3012 Section 3012. 49.46 (2) (a) 4. d. of the statutes is amended to read:

AB150,1083,8 49.46 (2) (a) 4. d. Home health services, subject to the limitations under s. 49.45 (8) and (8e), or nursing services, if a home health agency is unavailable, nursing services, subject to the limitation under s. 49.45 (8e).

AB150, s. 3013 Section 3013. 49.46 (2) (a) 4. g. of the statutes is renumbered 49.46 (2) (a) 4m. and amended to read:

AB150,1083,11 49.46 (2) (a) 4m. Nurse midwifery Nurse-midwifery services.

AB150, s. 3014 Section 3014. 49.46 (2) (b) 1. a. of the statutes is repealed.

AB150, s. 3015 Section 3015. 49.46 (2) (b) 1. b. of the statutes is repealed.

AB150, s. 3016 Section 3016. 49.46 (2) (b) 1. c. of the statutes is repealed.

AB150, s. 3017 Section 3017. 49.46 (2) (b) 1. d. of the statutes is repealed.

AB150, s. 3018 Section 3018. 49.46 (2) (b) 1. e. of the statutes is repealed.

AB150, s. 3019 Section 3019. 49.46 (2) (b) 1. f. of the statutes is repealed.

AB150, s. 3020 Section 3020. 49.46 (2) (b) 6. j. of the statutes is repealed.

AB150, s. 3021 Section 3021. 49.46 (2) (b) 6. k. of the statutes is amended to read:

AB150,1083,22 49.46 (2) (b) 6. k. Alcohol and other drug abuse day treatment services. This subd. 6. k. does not apply after June 30, 1995, or the day after publication of the 1995-97 biennial budget act, whichever is later.

AB150, s. 3022 Section 3022. 49.46 (2) (b) 14. of the statutes is created to read:

AB150,1083,24 49.46 (2) (b) 14. School medical services under s. 49.45 (39).

AB150, s. 3023 Section 3023. 49.46 (2) (b) 15. of the statutes is created to read:

AB150,1084,1 49.46 (2) (b) 15. Mental health crisis intervention services under s. 49.45 (41).

AB150, s. 3024 Section 3024. 49.46 (2) (bm) of the statutes is created to read:

AB150,1084,5 49.46 (2) (bm) Benefits for an individual who is eligible for medical assistance only under sub. (1) (a) 15. are limited to those services related to tuberculosis that are described in 42 USC 1396a (z) (2).

AB150, s. 3025 Section 3025. 49.46 (2) (d) of the statutes is amended to read:

AB150,1084,12 49.46 (2) (d) Benefits authorized under this subsection may not include payment for that part of any service payable through 3rd party liability or any federal, state, county, municipal or private benefit system to which the beneficiary is entitled. "Benefit system" does not include any public assistance program such as, but not limited to, Hill-Burton benefits under 42 USC 291c (e), in effect on April 30, 1980, or general emergency medical relief.

AB150, s. 3026 Section 3026. 49.47 (4) (av) of the statutes is created to read:

AB150,1084,20 49.47 (4) (av) 1. In this paragraph, "migrant worker" means any person who temporarily leaves a principal place of residence outside of this state and comes to this state for not more than 10 months in a year to accept seasonal employment in the planting, cultivating, raising, harvesting, handling, drying, packing, packaging, processing, freezing, grading or storing of any agricultural or horticultural commodity in its unmanufactured state. "Migrant worker" does not include any of the following:

AB150,1084,24 a. A person who is employed only by a state resident if the resident or the resident's spouse is related to the person as the child, parent, grandchild, grandparent, brother, sister, aunt, uncle, niece, nephew, or the spouse of any such relative.

AB150,1085,3 b. A student who is enrolled or, during the past 6 months has been enrolled, in any school, college or university unless the student is a member of a family or household which contains a migrant worker.

AB150,1085,5 c. Any other person qualifying for an exemption under rules promulgated by the department.

AB150,1085,11 2. The department shall request a waiver from the secretary of the federal department of health and human services to allow the application of subd. 3. The waiver shall also seek a waiver from those federal quality control standards under the medical assistance program that the department determines to be necessary in order to make the application of subd. 3. feasible. Subdivision 3. applies only while the waiver under this subdivision is in effect.

AB150,1085,13 3. In determining the eligibility for a migrant worker and his or her dependents for medical assistance under this section, the department shall do all of the following:

AB150,1085,21 a. Grant the migrant worker and his or her dependents eligibility for medical assistance in this state, if the migrant worker and his or her dependents have a valid medical assistance identification card issued in another state and the migrant worker completes a Wisconsin medical assistance application provided by the department. Eligibility under this subd. 3. a. continues for the period specified on the identification card issued in the other state. The department shall notify the other state that the migrant worker and his or her dependents are eligible for medical assistance in Wisconsin.

AB150,1085,25 b. Determine medical assistance eligibility using an income-averaging method described in the waiver under subd. 2., if the migrant worker and his or her dependents do not meet the income limitations under par. (c) using prospective budgeting.

AB150, s. 3027 Section 3027 . 49.47 (4) (c) 1. of the statutes is amended to read:

AB150,1086,12 49.47 (4) (c) 1. Except as provided in par. (am) and as limited by subd. subds. 3. and 4., eligibility exists if income does not exceed 133 1/3% of the maximum aid to families with dependent children payment under s. 49.19 (11) for the applicant's family size or the combined benefit amount available under supplemental security income under 42 USC 1381 to 1383c and state supplemental aid under s. 49.177 whichever is higher. In this subdivision "income" includes earned or unearned income that would be included in determining eligibility for the individual or family under s. 49.177 or 49.19, or for the aged, blind or disabled under 42 USC 1381 to 1385. "Income" does not include earned or unearned income which would be excluded in determining eligibility for the individual or family under s. 49.177 or 49.19, or for the aged, blind or disabled individual under 42 USC 1381 to 1385.

AB150, s. 3028 Section 3028 . 49.47 (4) (c) 1. of the statutes, as affected by 1995 Wisconsin Act .... (this act), is amended to read:

AB150,1086,25 49.47 (4) (c) 1. Except as provided in par. (am) and subds. 3. and 4., eligibility exists if income does not exceed 133 1/3% of the maximum aid to families with dependent children payment under s. 49.19 (11) for the applicant's family size or the combined benefit amount available under supplemental security income under 42 USC 1381 to 1383c and state supplemental aid under s. 49.177 49.77 whichever is higher. In this subdivision "income" includes earned or unearned income that would be included in determining eligibility for the individual or family under s. 49.177 or 49.19 or 49.77, or for the aged, blind or disabled under 42 USC 1381 to 1385. "Income" does not include earned or unearned income which would be excluded in determining eligibility for the individual or family under s. 49.177 or 49.19 or 49.77, or for the aged, blind or disabled individual under 42 USC 1381 to 1385.

****Note: This is reconciled s. 49.47 (4) (c) 1. This Section has been affected by drafts with the following LRB numbers: -2153/1 and -2406/2.

AB150, s. 3029 Section 3029. 49.47 (4) (c) 3. of the statutes is repealed and recreated to read:

AB150,1087,4 49.47 (4) (c) 3. Notwithstanding the income limitations under sub. (4) (c) 1., an individual is eligible for medical assistance under this section if all of the following requirements are met:

AB150,1087,5 a. The individual is an individual described under par. (a) 3. or 4.

AB150,1087,8 b. The individual is eligible for medical assistance equal in amount, duration and scope to the medical assistance made available to individuals described in 42 USC 1396a (a) (10) (A).

AB150,1087,11 c. The income of the individual, as determined under 42 USC 1382a without regard to 42 USC 1382a (b), does not exceed 225% of the supplemental security income benefit rate established under 42 USC 1382 (b) (1).

AB150, s. 3030 Section 3030. 49.47 (4) (c) 4. of the statutes is created to read:

AB150,1087,22 49.47 (4) (c) 4. The department shall request a waiver from the secretary of the federal department of health and human services to allow the department to receive federal financial participation to provide, after January 1, 1996, medical assistance benefits under this section, notwithstanding subd. 1. or 3., to persons who received skilled nursing care services or intermediate care services as a resident of a facility, as defined under s. 49.45 (6m) (a) 3., on January 1, 1996, as a medical assistance benefit and who would qualify for medical assistance benefits under this section if the percentage in subd. 3. c. were 300% instead of 225%. If the waiver under this subdivision is granted and in effect, persons covered by the waiver are eligible for medical assistance under this section.

AB150, s. 3031 Section 3031. 49.47 (6) (a) 1. of the statutes is amended to read:

AB150,1088,3 49.47 (6) (a) 1. Except as provided in subds. 6. to 7., all beneficiaries, for all services under s. 49.46 (2) (a) and (b) other than services under s. 49.46 (2) (a) 4. c. and (b) 6. a.

AB150, s. 3032 Section 3032. 49.47 (6) (am) of the statutes is created to read:

AB150,1088,10 49.47 (6) (am) 1. The department shall request a waiver from the secretary of the federal department of health and human services to allow the department to receive federal financial participation to continue to provide, notwithstanding par. (a) 1., skilled nursing care services or intermediate care facility services as a medical assistance benefit under this section to an individual who meets all of the following conditions:

AB150,1088,11 a. The individual is eligible for medical assistance benefits under this section.

AB150,1088,14 b. The individual was receiving skilled nursing care services or intermediate care facility services as a resident of a facility, as defined under s. 49.45 (6m) (a) 3., on January 1, 1996.