AB100-engrossed,927,134
49.46
(1) (a) 11.
Any If a waiver under s. 49.665 is granted and in effect, any 5child not described under subd. 1.
who was born after September 30, 1983, who has
6attained the age of 6 but has not attained the age of 19 and whose family income does
7not exceed 100% of the poverty line for a family the size of the child's family.
This
8subdivision does not apply beginning on the first day of the 6th month beginning
9after the date stated in the notice under s. 49.141 (2) (d) If a waiver under s. 49.665
10is not granted or in effect, any child not described in subd. 1. who was born after
11September 30,1983, who has attained the age of 6 but has not attained the age of 19
12and whose family income does not exceed 100% of the poverty line for a family the
13size of the child's family.
AB100-engrossed,927,1815
49.46
(1) (a) 12. Any child not described under subd. 1. who is under 19 years
16of age and who meets the resource and income limits under s. 49.19 (4).
This
17subdivision does not apply beginning on the first day of the 6th month beginning
18after the date stated in the notice under s. 49.141 (2) (d).
AB100-engrossed,927,2320
49.46
(1) (a) 13. Any child who is under one year of age, whose mother was
21determined to be eligible under subd. 9. and who lives with his or her mother.
This
22subdivision does not apply beginning on the first day of the 6th month beginning
23after the date stated in the notice under s. 49.141 (2) (d).
AB100-engrossed,928,5
149.46
(1) (c) (intro.) Except as provided under
pars. par. (co)
and (cs), a family
2that becomes ineligible for aid to families with dependent children under s. 49.19
3because of increased income from employment or increased hours of employment or
4because of the expiration of the time during which the disregards under s. 49.19 (5)
5(a) 4. or 4m. or (am) apply shall receive medical assistance for:
AB100-engrossed,928,178
49.46
(1) (cg)
Except as provided in par. (cs), medical Medical assistance shall
9be provided to a dependent child, a relative with whom the child is living or the
10spouse of the relative, if the spouse meets the requirements of s. 49.19 (1) (c) 2. a. or
11b., for 4 calendar months beginning with the month in which the child, relative or
12spouse is ineligible for aid to families with dependent children because of the
13collection or increased collection of maintenance or support, if the child, relative or
14spouse received aid to families with dependent children in 3 or more of the 6 months
15immediately preceding the month in which that ineligibility begins.
This paragraph
16does not apply beginning on the first day of the 6th month beginning after the date
17stated in the notice under s. 49.141 (2) (d).
AB100-engrossed,929,219
49.46
(1) (co) 1. Except as provided under subd. 2.
and par. (cs), medical
20assistance shall be provided to a family for 12 consecutive calendar months following
21the month in which the family becomes ineligible for aid to families with dependent
22children because of increased income from employment, because the family no longer
23receives the earned income disregard under s. 49.19 (5) (a) 4. or 4m. or (am) due to
24the expiration of the time limit during which the disregards are applied or because
1of the application of the monthly employment time eligibility limitation under
45
2CFR 233.100 (a) (1) (i).
AB100-engrossed,929,137
49.46
(1) (d) 1. Children who are placed in licensed foster homes or licensed
8treatment foster homes by the department and who would be eligible for payment
9of aid to families with dependent children in foster homes or treatment foster homes
10except that their placement is not made by a county department under s. 46.215,
1146.22 or 46.23 will be considered as recipients of aid to families with dependent
12children.
This subdivision does not apply beginning on the first day of the 6th month
13beginning after the date stated in the notice under s. 49.141 (2) (d).
AB100-engrossed,929,1917
49.46
(2) (a) 4. d. Home health services, subject to the
limitations limitation 18under s. 49.45 (8)
and (8e), or, if a home health agency is unavailable, nursing
19services
, subject to the limitations under s. 49.45 (8e).
AB100-engrossed,929,2221
49.46
(2) (a) 4. f.
Family planning services Services and supplies
for family
22planning, as defined in s. 253.07 (1) (a).
AB100-engrossed,930,224
49.46
(2) (b) 6. fm. Subject to the limitations under s. 49.45 (45), mental health
25services and alcohol and other drug abuse services, including services provided by
1a psychiatrist, to an individual who is 21 years of age or older in the individual's home
2or in the community.
AB100-engrossed,930,54
49.46
(2) (b) 6. j. Personal care services, subject to the
limitations limitation 5under s. 49.45
(8e) and (42).
AB100-engrossed,930,97
49.46
(2) (b) 6. Lm. Subject to the limitations under s. 49.45 (30e), psychosocial
8services, including case management services, provided by the staff of a
9community-based psychosocial service program.
AB100-engrossed,930,1411
49.46
(2) (be) Benefits for an individual eligible under sub. (1) (a) 9. are limited
12to those services under par. (a) or (b) that are related to pregnancy, including
13postpartum
services and family planning services,
as defined in s. 253.07 (1) (b), or
14related to other conditions which may complicate pregnancy.
AB100-engrossed,930,2017
49.47
(1) Purpose. Medical assistance as set forth herein shall be provided to
18persons over 65,
if eligible under this section, all disabled children under 18
, if
19eligible under this section, and persons who are blind or disabled
, if eligible under
20this section.
AB100-engrossed,930,2522
49.47
(4) (a) (intro.)
Except as provided in par. (ag), any Any individual who
23meets the limitations on income and resources under pars. (b) and (c) and who
24complies with par. (cm) shall be eligible for medical assistance under this section if
25such individual is:
AB100-engrossed,931,94
49.47
(4) (c) 2. Whenever an applicant has excess income under subd. 1. or par.
5(am), no certification may be issued until the excess income above the applicable
6limits has been obligated or expended for medical care or for any other type of
7remedial care recognized under state law or for personal health insurance premiums
8or both.
No individual is eligible for medical assistance under this subdivision in a
9month in which the individual is eligible for health care coverage under s. 49.153.
AB100-engrossed,931,1411
49.47
(6) (a) 7. Beneficiaries eligible under sub. (4) (a) 2. or (am) 1., for services
12under s. 49.46 (2) (a) and (b) that are related to pregnancy, including postpartum
13services and family planning services,
as defined in s. 253.07 (1) (b), or related to
14other conditions which may complicate pregnancy.
AB100-engrossed,931,2116
49.496
(5) Use of funds. From the appropriation under s. 20.435
(1) (5) (im),
17the department shall pay the amount of the payments under sub. (4) that is not paid
18from federal funds, shall pay to the federal government the amount of the funds
19recovered under this section equal to the amount of federal funds used to pay the
20benefits recovered under this section and shall spend the remainder of the funds
21recovered under this section for medical assistance benefits under this subchapter
AB100-engrossed,932,223
49.496
(7) Instalment payments. If a recovery under sub. (3) does not work an
24undue hardship on the heirs of the estate, and if the heirs wish to satisfy the recovery
1claim without selling a nonliquid asset that is subject to recovery, the department
2may establish a reasonable payment schedule subject to reasonable interest.
AB100-engrossed,932,94
49.498
(3) (b) 1. Inform each resident, orally and in writing at the time of
5admission to the nursing facility, of the resident's legal rights during the stay at the
6nursing facility, including a description of the protection of personal funds under sub.
7(8) and a statement that a resident may file a complaint with the department under
8s. 146.40 (4r) (a) concerning
neglect, abuse or misappropriation of property
or neglect
9or abuse of a resident.
AB100-engrossed,932,1811
49.498
(16) (g) All forfeitures, penalty assessments and interest, if any, shall
12be paid to the department within 10 days of receipt of notice of assessment or, if the
13forfeiture, penalty assessment and interest, if any, are contested under par. (f),
14within 10 days of receipt of the final decision after exhaustion of administrative
15review, unless the final decision is appealed and the order is stayed by court order
16under sub. (19) (b). The department shall remit all forfeitures paid to the state
17treasurer for deposit in the school fund. The department shall deposit all penalty
18assessments and interest in the appropriation under s. 20.435
(1) (6) (g).
AB100-engrossed,932,24
2049.499 Nursing facility resident protection. (intro.) From the
21appropriation under s. 20.435
(1) (6) (g), the department shall contribute to the
22payment of all of the following, as needed by a resident in a nursing facility, as defined
23in s. 49.498 (1) (i), that is in violation of s. 49.498 or of a rule promulgated under s.
2449.498:
AB100-engrossed,933,1
149.665 Badger care. (1) Definitions. In this section:
AB100-engrossed,933,22
(a) "Custodial parent" has the meaning given in s. 49.141 (1) (b).
AB100-engrossed,933,33
(b) "Dependent child" has the meaning given in s. 49.141 (c).
AB100-engrossed,933,74
(c) "Employer-subsidized health care coverage" means family coverage under
5a group health insurance plan offered by an employer for which the employer pays
6at least 75% of the cost, excluding any deductibles or copayments that may be
7required under the plan.
AB100-engrossed,933,88
(d) "Family" means a custodial parent and his or her dependent children.
AB100-engrossed,933,19
9(2) Waiver. The department of health and family services shall request a
10waiver from the secretary of the federal department of health and human services
11to permit the department of health and family services to implement, beginning not
12later than July 1, 1998, or the effective date of the waiver, whichever is later, a health
13care program under this section. If a waiver that is consistent with all of the
14provisions of this section is granted and in effect, the department of health and family
15services shall implement the program under this section. The department of health
16and family services may not implement the program under this section unless a
17waiver that is consistent with all of the provisions of this section is granted and in
18effect. The department of health and family services shall promulgate all rules
19required under this section no later than 60 days after the receipt of the waiver.
AB100-engrossed,934,4
20(3) Administration. The department shall administer a program to provide the
21health services and benefits described in s. 49.46 (2) to families that meet the
22eligibility requirements specified in sub. (4). The department shall promulgate rules
23setting forth the application procedures and appeal and grievance procedures. The
24department may promulgate rules limiting access to the program under this section
25to defined enrollment periods. The department may also promulgate rules
1establishing a method by which the department may purchase family coverage
2offered by the employer of a member of an eligible family under circumstances in
3which the department determines that purchasing that coverage would not be more
4costly than providing the coverage under this section.
AB100-engrossed,934,6
5(4) Eligibility. (a) A family is eligible for health care coverage under this
6section if the family meets all of the following requirements:
AB100-engrossed,934,107
1. The family's income does not exceed 185% of the poverty line, except that a
8family that is already receiving health care coverage under this section may have an
9income that does not exceed 200% of the poverty line. The department shall establish
10by rule the criteria to be used to determine income.
AB100-engrossed,934,1211
2. The family does not have access to employer-subsidized health care
12coverage.
AB100-engrossed,934,1613
3. The family has not had access to employer-subsidized health care coverage
14within the time period established by the department by rule, but not to exceed 18
15months, immediately preceding application for health care coverage under this
16section. The department may establish exceptions to this subdivision by rule.
AB100-engrossed,934,1917
4. The family meets all other requirements established by the department by
18rule. In establishing other eligibility criteria, the department may not include any
19health condition requirements.
AB100-engrossed,934,2120
(b) Notwithstanding fulfillment of the eligibility requirements under this
21subsection, a family is not entitled to health care coverage under this section.
AB100-engrossed,934,2322
(c) No family may be denied health care coverage under this section solely
23because of a health condition of any family member.
AB100-engrossed,935,13
24(5) Liability for cost. (a) Except as provided in par. (b), a family that receives
25health care coverage under this section shall pay a percentage of the cost of that
1coverage in accordance with a schedule established by the department by rule. If the
2schedule established by the department requires a family to contribute more than
33.5% of the family's income towards the cost of the health care coverage provided
4under this section, the department shall submit the schedule to the joint committee
5on finance for review and approval of the schedule. If the cochairpersons of the joint
6committee on finance do not notify the department within 14 working days after the
7date of the department's submittal of the schedule that the committee has scheduled
8a meeting to review the schedule, the department may implement the schedule. If,
9within 14 days after the date of the department's submittal of the schedule, the
10cochairpersons of the committee notify the department that the committee has
11scheduled a meeting to review the schedule, the department may not require a family
12to contribute more than 3.5% of the family's income unless the joint committee on
13finance approves the schedule.
AB100-engrossed,935,1614
(b) The department may not require a family with an income below 133% of the
15poverty line to contribute to the cost of health care coverage provided under this
16section.
AB100-engrossed,935,1917
(c) The department may establish by rule requirements for wage withholding
18as a means of collecting the family's share of the cost of the health care coverage
19under this section.
AB100-engrossed,935,24
20(6) Annual report. Not later than October 1 of each year, the department shall
21submit a report to the legislature under s. 13.172 (2) that summarizes enrollment in
22and cost of the health care program under this section and any other information that
23the department determines is pertinent information regarding the program under
24this section.
AB100-engrossed,936,2
149.683
(2) Approved costs for medical care under sub. (1) shall be paid from the
2appropriation under s. 20.435
(1) (5) (e).
AB100-engrossed,936,74
49.686
(2) Reimbursement. From the appropriation under s. 20.435
(1) (5) (am),
5the department may reimburse or supplement the reimbursement of the cost of AZT,
6the drug pentamidine and any drug approved for reimbursement under sub. (4) (c)
7for an individual who is eligible under sub. (3).
AB100-engrossed,936,169
49.687
(2) The department shall develop and implement a sliding scale of
10patient liability for kidney disease aid under s. 49.68, cystic fibrosis aid under s.
1149.683 and hemophilia treatment under s. 49.685, based on the patient's ability to
12pay for treatment. To ensure that the needs for treatment of patients with lower
13incomes receive priority within the availability of funds under s. 20.435
(1) (5) (e),
14the department shall revise the sliding scale for patient liability by January 1, 1994,
15and shall, every 3 years thereafter by January 1, review and, if necessary, revise the
16sliding scale.
AB100-engrossed,936,19
1849.775 Payments for the support of children of supplemental security
19income recipients. (1) Definitions. In this section:
AB100-engrossed,936,2020
(a) "Custodial parent" has the meaning given in s. 49.141 (1) (b).
AB100-engrossed,936,2121
(b) "Dependent child" has the meaning given in s. 49.141 (1) (c).
AB100-engrossed,936,25
22(2) Supplemental payments. Subject to sub. (3), from the appropriations under
23s. 20.435 (7) (ed) and (ky), the department shall make a monthly payment of $77 to
24a custodial parent for the support of each dependent child of the custodial parent if
25all of the following conditions are met:
AB100-engrossed,937,2
1(a) The custodial parent is a recipient of supplemental security income under
242 USC 1381 to
1383c or of state supplemental payments under s. 49.77, or both.
AB100-engrossed,937,53
(b) If the dependent child has 2 custodial parents, each custodial parent
4receives supplemental security income under
42 USC 1381 to
1383c or state
5supplemental payments under s. 49.77, or both.
AB100-engrossed,937,116
(bm) The custodial parent assigns to the state any right of the custodial parent
7or of the dependent child to support from any other person. No amount of support
8that begins to accrue after the individual ceases to receive payments under this
9section may be considered assigned to the state. Any money received by the
10department of workforce development under an assignment to the state under this
11paragraph shall be paid to the custodial parent.
AB100-engrossed,937,1512
(c) The dependent child of the custodian parent meets the eligibility criteria
13under the aid to families with dependent children program under s. 49.19 (1) to (19)
14or would meet the eligibility criteria under s. 49.19 but for the application of s. 49.19
15(20).
AB100-engrossed,937,1716
(d) The dependent child does not receive supplemental security income under
1742 USC 1381 to
1383d.