AB100-engrossed,718,1210 46.27 (7) (cj) No county may use funds received under par. (b) to provide
11services to a person who does not live in his or her own home or apartment unless,
12subject to the limitations under par. (cm), one of the following applies:
AB100-engrossed,718,1613 1. The services are provided to the person in a community-based residential
14facility that entirely consists of independent apartments, each of which has an
15individual lockable independent entrance and exit and individual separate kitchen,
16bathroom, sleeping and living areas.
AB100-engrossed,718,1917 2. The person suffers from Alzheimer's disease or related dementia and the
18services are provided to the person in a community-based residential facility that
19has a dementia care program.
AB100-engrossed,718,2220 3. The services are provided to the person in a community-based residential
21facility and the county department or aging unit has determined that all of the
22following conditions have been met:
AB100-engrossed,718,2523 a. An assessment under sub. (6) has been completed for the person prior to the
24person's admission to the community-based residential facility, whether or not the
25person is a private pay admittee at the time of admission.
AB100-engrossed,719,4
1b. The county department or aging unit documents that the option of in-home
2services has been discussed with the person, thoroughly evaluated and found to be
3infeasible, as determined by the county department or aging unit in accordance with
4rules promulgated by the department of health and family services.
AB100-engrossed,719,75 c. The county department or aging unit determines that the community-based
6residential facility is the person's preferred place of residence or is the setting
7preferred by the person's guardian.
AB100-engrossed,719,98 d. The county department or aging unit determines that the community-based
9residential facility provides a quality environment and quality care services.
AB100-engrossed,719,1210 e. The county department or aging unit determines that placement in the
11community-based residential facility is cost-effective compared to other options,
12including home care and nursing home care.
AB100-engrossed,719,1413 5. The services are provided to the person in an adult family home, as defined
14in s. 50.01 (1).
AB100-engrossed, s. 1459mf 15Section 1459mf. 46.27 (7) (ck) of the statutes is created to read:
AB100-engrossed,719,2116 46.27 (7) (ck) 1. Subject to the approval of the department, a county may
17establish and implement more restrictive conditions than those imposed under par.
18(cj) on the use of funds received under par. (b) for the provision of services to a person
19in a community-based residential facility. A county that establishes more restrictive
20conditions under this subdivision shall include the conditions in its community
21options plan under sub. (3) (cm).
AB100-engrossed,720,222 2. If the department determines that a county has engaged in a pattern of
23inappropriate use of funds received under par. (b), the department may revoke its
24approval of the county's conditions established under subd. 1., if any, and may

1prohibit the county from using funds received under par. (b) to provide services under
2par. (cj) 3.
AB100-engrossed, s. 1460m 3Section 1460m. 46.27 (9) (a) of the statutes is amended to read:
AB100-engrossed,720,124 46.27 (9) (a) The department may select up to 5 counties that volunteer to
5participate in a pilot project under which they will receive certain funds allocated for
6long-term care. The department shall allocate a level of funds to these counties
7equal to the amount that would otherwise be paid under s. 20.435 (1) (5) (b) to nursing
8homes for providing care because of increased utilization of nursing home services,
9as estimated by the department. In estimating these levels, the department shall
10exclude any increased utilization of services provided by state centers any center for
11the developmentally disabled. The department shall calculate these amounts on a
12calendar year basis under sub. (10).
AB100-engrossed, s. 1461 13Section 1461. 46.27 (9) (c) of the statutes is amended to read:
AB100-engrossed,720,1914 46.27 (9) (c) All long-term community support services provided under this
15pilot project in lieu of nursing home care shall be consistent with those services
16described in the participating county's community options plan under sub. (4) (c) and
17provided under sub. (5) (b). Each Unless the department has contracted under s.
1846.271 (2m) with an entity other than the county department, each
county
19participating in the pilot project shall assess persons under sub. (6).
AB100-engrossed, s. 1462 20Section 1462. 46.27 (10) (a) 1. of the statutes is amended to read:
AB100-engrossed,720,2521 46.27 (10) (a) 1. The department shall determine for each county participating
22in the pilot project under sub. (9) a funding level of state medical assistance
23expenditures to be received by the county. This level shall equal the amount that the
24department determines would otherwise be paid under s. 20.435 (1) (5) (b) because
25of increased utilization of nursing home services, as estimated by the department.
AB100-engrossed, s. 1463
1Section 1463. 46.27 (11) (c) 3. of the statutes is amended to read:
AB100-engrossed,721,52 46.27 (11) (c) 3. Medical assistance reimbursement for services a county, a
3private nonprofit agency or an aging unit with which the department contracts
4provides under this subsection shall be made from the appropriations under s. 20.435
5(1) (5) (o) and (7) (b) and (bd).
AB100-engrossed, s. 1464 6Section 1464. 46.27 (11) (c) 4. of the statutes is amended to read:
AB100-engrossed,721,117 46.27 (11) (c) 4. The department may, from the appropriation under s. 20.435
8(1) (5) (o), provide reimbursement for services provided under this subsection by
9counties that are in excess of the current average annual per person rate, as
10established by the department, and are less than or equal to the average amount
11approved in the waiver received under par. (am).
AB100-engrossed, s. 1464g 12Section 1464g. 46.27 (11) (c) 5m. of the statutes is created to read:
AB100-engrossed,721,1613 46.27 (11) (c) 5m. No county may use funds received under this subsection to
14provide services to a person who does not live in his or her own home or apartment
15unless, subject to the limitations under subds. 6., 7. and 8., one of the following
16applies:
AB100-engrossed,721,2017 a. The services are provided to the person in a community-based residential
18facility that entirely consists of independent apartments, each of which has an
19individual lockable independent entrance and exit and individual separate kitchen,
20bathroom, sleeping and living areas.
AB100-engrossed,721,2321 b. The person suffers from Alzheimer's disease or related dementia and the
22services are provided to the person in a community-based residential facility that
23has a dementia care program.
AB100-engrossed,721,2524 c. The services are provided to the person in a residential care apartment
25complex, as defined in s. 50.01 (1d).
AB100-engrossed,722,2
1d. The services are provided to the individual in an adult family home, as
2defined in s. 50.01 (1).
AB100-engrossed,722,33 e. Subdivision 5n. applies.
AB100-engrossed, s. 1464h 4Section 1464h. 46.27 (11) (c) 5n. of the statutes is created to read:
AB100-engrossed,722,95 46.27 (11) (c) 5n. A county may also use funds received under this subsection,
6subject to the limitations under subds. 6., 7. and 8., to provide services to a person
7who does not live in his or her own home or apartment if the services are provided
8to the person in a community-based residential facility and the county department
9or aging unit has determined that all of the following conditions have been met:
AB100-engrossed,722,1210 a. An assessment under sub. (6) has been completed for the person prior to the
11person's admission to the community-based residential facility, whether or not the
12person is a private pay admittee at the time of admission.
AB100-engrossed,722,1613 b. The county department or aging unit documents that the option of in-home
14services has been discussed with the person, thoroughly evaluated and found to be
15infeasible, as determined by the county department or aging unit in accordance with
16rules promulgated by the department of health and family services.
AB100-engrossed,722,1917 c. The county department or aging unit determines that the community-based
18residential facility is the person's preferred place of residence or is the setting
19preferred by the person's guardian.
AB100-engrossed,722,2120 d. The county department or aging unit determines that the community-based
21residential facility provides a quality environment and quality care services.
AB100-engrossed,722,2422 e. The county department or aging unit determines that placement in the
23community-based residential facility is cost-effective compared to other options,
24including home care and nursing home care.
AB100-engrossed, s. 1464j 25Section 1464j. 46.27 (11) (c) 5p. of the statutes is created to read:
AB100-engrossed,723,6
146.27 (11) (c) 5p. a. Subject to the approval of the department, a county may
2establish and implement more restrictive conditions than those imposed under subd.
35m. on the use of funds received under sub. (7) (b) for the provision of services to a
4person in a community-based residential facility. A county that establishes more
5restrictive conditions under this subd. 5p. a. shall include the conditions in its
6community options plan under sub. (3) (cm).
AB100-engrossed,723,117 b. If the department determines that a county has engaged in a pattern of
8inappropriate use of funds received under sub. (7) (b), the department may revoke
9its approval of the county's conditions established under subd. 5p. a., if any, and may
10prohibit the county from using funds received under sub. (7) (b) to provide services
11under subd. 5n.
AB100-engrossed, s. 1465 12Section 1465. 46.271 (1) of the statutes is renumbered 46.271 (1) (a), and
1346.271 (1) (a) (intro.), as renumbered, is amended to read:
AB100-engrossed,723,1914 46.271 (1) (a) (intro.) From the appropriation under s. 20.435 (7) (bd), the
15department shall award $100,000 in each fiscal year to applying county departments
16under s. 46.215, 46.22, 46.23, 51.42 or 51.437 or to an aging unit under the conditions
17specified in sub. (3) par. (c) to establish pilot projects for home and community-based
18long-term support services. Funds awarded to the pilot projects shall be used to do
19any of the following:
AB100-engrossed, s. 1466 20Section 1466. 46.271 (2) of the statutes is renumbered 46.271 (1) (b), and
2146.271 (1) (b) 1. and 2., as renumbered, are amended to read:
AB100-engrossed,723,2322 46.271 (1) (b) 1. Solicit applications from county departments or aging units
23for the pilot projects under sub. (1) par. (a).
AB100-engrossed,724,224 2. Require that an applying county department or aging unit under par. (a)
25subd. 1. submit as part of the application specific plans for improving the

1coordination between hospitals and providers of home and community-based
2long-term support services.
AB100-engrossed, s. 1467 3Section 1467. 46.271 (2m) of the statutes is created to read:
AB100-engrossed,724,64 46.271 (2m) (a) The department may establish, in geographic areas
5determined by the department, a pilot project under which the department may
6contract with a private or public entity to do all of the following:
AB100-engrossed,724,97 1. Serve as a clearinghouse of information for individuals who are interested
8in home or community-based long-term support services or institutional long-term
9care services.
AB100-engrossed,724,1710 2. Perform assessments using the assessment method established by the
11department to determine an individual's functional abilities, disabilities, personal
12preferences and need for home or community-based long-term support services or
13institutional long-term care services. Each assessment shall include an
14investigation of long-term community support services that could serve as
15alternatives to institutional care in a nursing home or community-based residential
16facility. The assessment shall include an explanation of the potential community
17alternatives to the person being assessed and the person's family or guardian.
AB100-engrossed,724,1918 3. Collect information specified by the department on the individuals served
19by the entity and provide that information to the department.
AB100-engrossed,724,2420 (am) Residents of the geographic areas where a pilot project under this
21subsection is established shall receive an assessment by the entity contracted with
22under par. (a) (intro.) prior to entry into a nursing home or community-based
23residential facility or participation in the long-term support community options
24program under s. 46.27.
AB100-engrossed,725,3
1(ap) The department may require that the results of a client's assessment
2under par. (a) 2. be submitted at the time that a provider submits a request for prior
3authorization for medical assistance services.
AB100-engrossed,725,74 (b) From the amounts carried forward under 1997 Wisconsin Act .... (this act),
5section 9123 (2), the department shall distribute funds to the entities with which the
6department contracts under par. (a) (intro.) for the performance of the functions
7specified under par. (a) 1. to 3.
AB100-engrossed,725,88 (c) Paragraphs (a) 2., (am) and (ap) do not apply to any of the following:
AB100-engrossed,725,109 1. Emergency admissions, as determined by a physician, but shall be applied
10within 10 days after the admission.
AB100-engrossed,725,1411 2. A private pay patient seeking admission to or about to be admitted to a
12nursing home or community-based residential facility who is informed about the
13program but waives the assessment, unless the patient will be eligible for medical
14assistance within 6 months after the assessment.
AB100-engrossed,725,1715 3. Persons seeking admission to or about to be admitted to the Wisconsin
16Veteran's Home at King who are informed about the pilot project but waive the
17assessment.
AB100-engrossed,725,1918 4. Any person who is readmitted to a nursing home or community-based
19residential facility from a hospital within 6 months after being assessed.
AB100-engrossed,725,2120 5. Current residents of a nursing home or community-based residential facility
21who are eligible for an assessment but who waive the assessment.
AB100-engrossed,725,2322 6. A person who enters a nursing home or community-based residential facility
23for recuperative care.
AB100-engrossed,725,2524 7. A person who enters a nursing home or community-based residential facility
25for respite care.
AB100-engrossed,726,4
18. A person who is admitted to a nursing home or community-based residential
2facility from another nursing home or community-based residential facility, unless
3the person requests an assessment and funds distributed for assessments under par.
4(b) are available to the entity.
AB100-engrossed, s. 1468 5Section 1468. 46.271 (3) of the statutes is renumbered 46.271 (1) (c) and
6amended to read:
AB100-engrossed,726,97 46.271 (1) (c) The department may contract with an aging unit, as defined in
8s. 46.27 (1) (a), for administration of services under sub. (1) par. (a) if, by resolution,
9the county board of supervisors of that county so requests the department.
AB100-engrossed, s. 1468d 10Section 1468d. 46.275 (title) of the statutes is amended to read:
AB100-engrossed,726,12 1146.275 (title) Community integration program for state center
12residents
of state centers.
AB100-engrossed, s. 1468g 13Section 1468g. 46.275 (1) of the statutes is amended to read:
AB100-engrossed,726,1914 46.275 (1) Legislative intent. The intent of the program under this section is
15to relocate persons from the residents of any state centers center for the
16developmentally disabled into appropriate community settings with the assistance
17of home and community-based services and with continuity of care. The intent of
18the program is also to minimize its impact on state employes through redeployment
19of employes into vacant positions.
AB100-engrossed, s. 1468m 20Section 1468m. 46.275 (1m) (b) of the statutes is amended to read:
AB100-engrossed,726,2321 46.275 (1m) (b) "Program" means the community integration program for
22residents of any state centers center for the developmentally disabled, for which a
23waiver has been received under sub. (2).
AB100-engrossed, s. 1468p 24Section 1468p. 46.275 (2) (intro.) of the statutes is amended to read:
AB100-engrossed,727,11
146.275 (2) Departmental powers and duties. (intro.) The department may
2request a waiver from the secretary of the U.S. department of health and human
3services, under 42 USC 1396n (c), authorizing the department to integrate medical
4assistance recipients who reside in state centers
residents of any state center for the
5developmentally disabled who receive medical assistance into their communities by
6providing home and community-based services as part of the medical assistance
7program. If the department requests this waiver, it shall include all assurances
8required under 42 USC 1396n (c) (2) in its request. If the department receives this
9waiver, at the end of the 3-year period during which the waiver remains in effect the
10department may request an additional 3-year extension of the waiver. If the
11department receives this waiver, it shall:
AB100-engrossed, s. 1468r 12Section 1468r. 46.275 (2) (b) of the statutes is amended to read:
AB100-engrossed,727,1513 46.275 (2) (b) Evaluate the effect of the program on medical assistance costs
14and on the program's ability to provide community care alternatives to institutional
15care in a state centers center for the developmentally disabled.
AB100-engrossed, s. 1469 16Section 1469. 46.275 (5) (a) of the statutes is amended to read:
AB100-engrossed,727,2217 46.275 (5) (a) Medical assistance reimbursement for services a county, or the
18department under sub. (3r), provides under this program is available from the
19appropriations under s. 20.435 (1) (5) (b) and (o). If 2 or more counties jointly contract
20to provide services under this program and the department approves the contract,
21medical assistance reimbursement is also available for services provided jointly by
22these counties.
AB100-engrossed, s. 1470 23Section 1470. 46.275 (5) (c) of the statutes is amended to read:
AB100-engrossed,728,524 46.275 (5) (c) The total allocation under s. 20.435 (1) (5) (b) and (o) to counties
25and to the department under sub. (3r) for services provided under this section may

1not exceed the amount approved by the federal department of health and human
2services. A county may use funds received under this section only to provide services
3to persons who meet the requirements under sub. (4) and may not use unexpended
4funds received under this section to serve other developmentally disabled persons
5residing in the county.
AB100-engrossed, s. 1471 6Section 1471. 46.275 (5) (d) of the statutes is amended to read:
AB100-engrossed,728,117 46.275 (5) (d) The department may, from the appropriation under s. 20.435 (1)
8(5) (o), provide reimbursement for services provided under this section by counties
9that are in excess of the current average annual per person rate, as established by
10the department, and are less than the average amount approved in the waiver
11received under sub. (2).
AB100-engrossed, s. 1471m 12Section 1471m. 46.277 (3) (c) of the statutes is amended to read:
AB100-engrossed,728,2213 46.277 (3) (c) Beginning on January 1, 1996, from the annual allocation to the
14county for the provision of long-term community support services under sub. (5),
15annually establish a maximum total amount, not to exceed 25% of the annual
16allocation,
that may be encumbered in a calendar year for services for eligible
17individuals in community-based residential facilities. If the total amount that is
18encumbered for services for individuals in community-based residential facilities
19who are receiving services under sub. (5) on January 1, 1996, exceeds 25% of the
20county's annual allocation, a county may request a waiver of the requirement under
21this paragraph from the department. The department need not promulgate as rules
22under ch. 227 the standards for granting a waiver request under this paragraph.
AB100-engrossed, s. 1471p 23Section 1471p. 46.277 (5) (d) 1m. of the statutes is created to read:
AB100-engrossed,729,224 46.277 (5) (d) 1m. No county may use funds received under this section to
25provide services to a person who does not live in his or her own home or apartment

1unless, subject to the limitations under subds. 2. and 3. and par. (e), one of the
2following applies:
AB100-engrossed,729,63 a. The services are provided to the person in a community-based residential
4facility that entirely consists of independent apartments, each of which has an
5individual lockable independent entrance and exit and individual separate kitchen,
6bathroom, sleeping and living areas.
AB100-engrossed,729,97 b. The person suffers from Alzheimer's disease or related dementia and the
8services are provided to the person in a community-based residential facility that
9has a dementia care program.
AB100-engrossed,729,1110 c. The services are provided to the person in a residential care apartment
11complex, as defined in s. 50.01 (1d).
AB100-engrossed,729,1312 d. The services are provided to the individual in an adult family home, as
13defined in s. 50.01 (1).
AB100-engrossed,729,1414 e. Subdivision 1n. applies.
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