AB100-engrossed,901,199
49.32
(9) (a) Each county department under s. 46.215, 46.22 or 46.23
10administering aid to families with dependent children shall maintain a monthly
11report at its office showing the names of all persons receiving
such aid
to families
12with dependent children together with the amount paid during the preceding month.
13Each Wisconsin works agency administering Wisconsin works under ss. 49.141 to
1449.161 shall maintain a monthly report at its office showing the names
and addresses 15of all persons receiving benefits under s. 49.148 together with the amount paid
16during the preceding month. Nothing in this paragraph shall be construed to
17authorize or require the disclosure in the report of any information (names, amounts
18of aid or otherwise) pertaining to adoptions, or aid furnished for the care of children
19in foster homes or treatment foster homes under s.
42.261 46.261 or 49.19 (10).
AB100-engrossed,902,2021
49.32
(9) (b) The report under par. (a) shall be open to public inspection at all
22times during regular office hours and may be destroyed after the next succeeding
23report becomes available. Any person except any public officer, seeking permission
24to inspect such report shall be required to prove his or her identity and to sign a
25statement setting forth his or her address and the reasons for making the request
1and indicating that he or she understands the provisions of par. (c) with respect to
2the use of the information obtained. The use of a fictitious name is a violation of this
3section.
or Wisconsin works agency Within 7 days after the record is inspected, or
4on the next regularly scheduled communication with that person, whichever is
5sooner, the
county department
or Wisconsin works agency shall notify each person
6whose name and amount of aid was inspected that the record was inspected and of
7the name and address of the person making such inspection. County departments
8under ss. 46.215
and, 46.22
and 46.23 administering aid to families with dependent
9children
and Wisconsin works agencies administering Wisconsin works under ss.
1049.141 to 49.161 may withhold the right to inspect the name of and amount paid to
11recipients from private individuals who are not inspecting this information for
12purposes related to public, educational, organizational, governmental or research
13purposes until the person whose record is to be inspected is notified by the county
14department
or Wisconsin works agency, but in no case may the
county department
15or Wisconsin works agency withhold this information for more than 5 working days.
16The county department or Wisconsin works agency shall keep a record of such
17requests. The record shall indicate the name, address, employer and telephone
18number of the person making the request. If the person refuses to provide his or her
19name, address, employer and telephone number, the request to inspect this
20information may be denied.
AB100-engrossed,903,222
49.32
(10) (a) (intro.) Each county department under s. 46.215
or, 46.22
or 46.23 23may release the current address of a recipient of
food stamps or of aid under s. 49.19,
24and each Wisconsin works agency may release the current address of a participant
25in Wisconsin works under ss. 49.141 to 49.161
or, if administering the food stamp
1program, of a food stamp recipient, to a law enforcement officer if the officer meets
2all of the following conditions:
AB100-engrossed,903,54
49.32
(10) (a) 1. The officer provides, in writing, the name
and social security
5number of the recipient
or participant.
AB100-engrossed,903,107
49.32
(10) (a) 2. a. That the recipient
or participant is a fugitive felon under
42
8USC 602 608 (a) (9)
, is violating a condition of probation or parole imposed under
9state or federal law or has information that is necessary for the officer to conduct the
10official duties of the officer.
AB100-engrossed,903,1312
49.32
(10) (a) 2. b. That the location or apprehension of the
felon recipient or
13participant under subd. 2. a. is within the official duties of the officer.
AB100-engrossed,903,2315
49.33
(2) Contracts. County departments under ss. 46.215, 46.22 and 46.23
16shall annually enter into a contract with the department detailing the reasonable
17cost of administering the income maintenance programs and the food stamp program
18under
7 USC 2011 to
2029 when so appointed by the department. Contracts created
19under this section control the distribution of payments under s. 20.445 (3)
(de) (dz),
20(md) and (nL) in accordance with the reimbursement method established under sub.
21(8). The department may reduce its payment to any county under s. 20.445 (3)
(de) 22(dz), (md) and (nL) if federal reimbursement is withheld due to audits, quality control
23samples or program reviews.
AB100-engrossed,904,7
149.33
(8) (a) The department shall reimburse each county for reasonable costs
2of income maintenance relating to the administration of the programs under this
3subchapter and subch. IV according to a formula based on workload within the limits
4of available state and federal funds under s. 20.445 (3)
(de), (dz)
, (md) and (nL) by
5contract under s. 49.33 (2). The amount of reimbursement calculated under this
6paragraph and par. (b) is in addition to any reimbursement provided to a county for
7fraud and error reduction under s. 49.197 (1m) and (4).
AB100-engrossed,904,129
49.33
(9) Reimbursement for income maintenance benefits. The department
10shall reimburse each county from the appropriations under s. 20.445 (3)
(d) (dz) and
11(p) (md) for 100% of the cost of aid to families with dependent children granted under
12s. 49.19 and for funeral expenses paid for recipients of aid under s. 49.30.
AB100-engrossed,904,2114
49.36
(2) The department may contract with any county to administer a work
15experience and job training program for parents who are not custodial parents and
16who fail to pay child support or to meet their children's needs for support as a result
17of unemployment or underemployment. The program may provide the kinds of work
18experience and job training services available from the program under s. 49.193 or
1949.147 (3) or (4). The program may also include job search and job orientation
20activities. The department shall fund the program from the appropriation under s.
2120.445 (3)
(df) (dz).
AB100-engrossed,905,223
49.37
(1) (intro.)
From the appropriation under s. 20.445 (3) (dk), the The 24department shall allocate funds to new hope project, inc.,
as provided in s. 49.175 (1)
1(s), for a demonstration project that will be conducted in 2 areas in the city of
2Milwaukee, if all of the following conditions are satisfied:
AB100-engrossed,905,74
49.37
(3) The contract under sub. (1) (g) shall require an interim evaluation to
5be submitted to the department no later than January 1, 1993. New hope project,
6inc., may not use funds appropriated under s. 20.445 (3)
(dk) (dz) to fund the
7evaluation under sub. (1) (g).
AB100-engrossed,905,99
49.37
(4) This section does not apply after June 30,
1997 1999.
AB100-engrossed,905,1611
49.45
(2) (a) 3. Determine the eligibility of persons for medical assistance,
12rehabilitative and social services under ss. 49.46, 49.468 and 49.47 and rules and
13policies adopted by the department and may designate this function to the county
14department under s. 46.215
or, 46.22
or 46.23 or , to the extent permitted by federal
15law or a waiver from federal secretary of health and human services, to a Wisconsin
16works agency.
AB100-engrossed,905,2018
49.45
(2) (a) 5. Cooperate with the division for learning support, equity and
19advocacy in the department of
education public instruction to carry out the
20provisions of Title XIX.
AB100-engrossed,905,2522
49.45
(2) (a) 17. Notify the governor, the joint committee on legislative
23organization, the joint committee on finance and appropriate standing committees,
24as determined by the presiding officer of each house, if the appropriation under s.
2520.435
(1) (5) (b) is insufficient to provide the state share of medical assistance.
AB100-engrossed,906,32
49.45
(3) (ag) Reimbursement shall be made to each entity contracted with
3under s. 46.271 (2m) for assessments completed under s. 46.271 (2m) (a) 2.
AB100-engrossed,906,116
49.45
(5) (a) Any person whose application for medical assistance is denied or
7is not acted upon promptly or who believes that the payments made in the person's
8behalf have not been properly determined
or that his or her eligibility has not been
9properly determined may file an appeal with the department pursuant to
s. 49.21 (1) 10par. (b). Review is unavailable if the decision or failure to act arose more than 45 days
11before submission of the petition for a hearing.
AB100-engrossed,907,213
49.45
(5) (b) 1. Upon receipt of a timely petition under par. (a) the department
14shall give the applicant or recipient reasonable notice and opportunity for a fair
15hearing. The department may make such additional investigation as it considers
16necessary. Notice of the hearing shall be given to the applicant or recipient and to
17the county clerk or, if a Wisconsin works agency is responsible for making the medical
18assistance determination, the Wisconsin works agency. The county or the Wisconsin
19works agency
may be represented at such hearing. The department shall render its
20decision as soon as possible after the hearing and shall send a certified copy of its
21decision to the applicant or recipient, the county clerk and to the county officer or the
22Wisconsin works agency charged with administration of the medical assistance
23program. The decision of the department shall have the same effect as an order of
24the county officer or the Wisconsin works agency charged with the administration
25of the medical assistance program. The decision shall be final, but may be revoked
1or modified as altered conditions may require. The department shall deny a petition
2for a hearing or shall refuse to grant relief if:
AB100-engrossed,907,33
a. The petitioner withdraws the petition in writing.
AB100-engrossed,907,64
b. The sole issue in the petition concerns an automatic payment adjustment or
5change that affects an entire class of recipients and is the result of a change in state
6or federal law.
AB100-engrossed,907,97
c. The petitioner abandons the petition. Abandonment occurs if the petitioner
8fails to appear in person or by representative at a scheduled hearing without good
9cause, as determined by the department.
AB100-engrossed,907,1810
2. If a recipient requests a hearing within the timely notice period specified in
1142 CFR 431.231 (c), medical assistance coverage shall not be suspended, reduced or
12discontinued until a decision is rendered after the hearing but medical assistance
13payments made pending the hearing decision may be recovered by the department
14if the contested decision or failure to act is upheld. The department shall promptly
15notify the county department or, if a Wisconsin works agency is responsible for
16making the medical assistance determination, the Wisconsin works agency of the
17county in which the recipient resides that the recipient has requested a hearing.
18Medical assistance coverage shall be suspended, reduced or discontinued if:
AB100-engrossed,907,2019
a. The recipient is contesting a state or federal law or a change in state or
20federal law and not the determination of the payment made on the recipient's behalf.
AB100-engrossed,907,2321
b. The recipient is notified of a change in his or her medical assistance coverage
22while the hearing decision is pending but the recipient fails to request a hearing on
23the change.
AB100-engrossed,907,2524
3. The recipient shall be promptly informed in writing if medical assistance is
25to be suspended, reduced or terminated pending the hearing decision.
AB100-engrossed,908,82
49.45
(5m) (a) Notwithstanding sub. (3) (e), from the appropriations under s.
320.435
(1) (5) (b) and (o) the department shall distribute not more than $2,256,000
4in each fiscal year, to provide supplemental funds to rural hospitals that, as
5determined by the department, have high utilization of inpatient services by
6patients whose care is provided from governmental sources, except that the
7department may not distribute funds to a rural hospital to the extent that the
8distribution would exceed any limitation under
42 USC 1396b (i) (3).
AB100-engrossed,908,1510
49.45
(6b) (title)
Centers Center for the developmentally disabled. (intro.)
11From the appropriation under s. 20.435 (2) (gk), the department may reimburse the
12cost of services provided by
the centers a center for the developmentally disabled.
13Reimbursement to
the centers a center for the developmentally disabled shall be
14reduced following each placement made under s. 46.275 which involves a relocation
15from a center for the developmentally disabled, as follows:
AB100-engrossed,908,1917
49.45
(6b) (a) Beginning in fiscal year
1995-96 1997-98, for relocations from
18the central Wisconsin a center for the developmentally disabled, by $205 per day
, if
19that center is located in Dane County.
AB100-engrossed,908,2321
49.45
(6b) (b) Beginning in fiscal year
1995-96 1997-98, for relocations from
22the northern Wisconsin a center for the developmentally disabled, by
$199 $174 per
23day
, if that center is located in Chippewa County.
AB100-engrossed,909,3
149.45
(6b) (c) Beginning in fiscal year
1995-96 1997-98, for relocations from
2the southern Wisconsin a center for the developmentally disabled, by
$149 $174 per
3day
, if that center is located in Racine County.
AB100-engrossed,909,105
49.45
(6c) (c)
Resident review. (intro.) Except as provided in par. (e),
by April
61, 1990, and at least annually thereafter, the department or an entity to which the
7department has delegated authority shall review every resident of a facility or
8institution for mental diseases who has a developmental disability or mental illness
9and who has experienced a significant change in his or her physical or mental
10condition to determine if any of the following applies:
AB100-engrossed,909,1412
49.45
(6m) (a) 3. "Facility" means a nursing home
as defined under s. 50.01 (3) 13or a community-based residential facility that is licensed under s. 50.03 and that is
14certified by the department as a provider of medical assistance.
AB100-engrossed,909,1616
49.45
(6m) (a) 5. "Nursing home" has the meaning given under s. 50.01 (3).
AB100-engrossed,910,518
49.45
(6m) (ag) (intro.) Payment for care provided in a facility under this
19subsection made under s. 20.435 (1)
(b), (o) or (p)
or (5) (b) or (o) shall, except as
20provided in pars. (bg), (bm) and (br), be determined according to a prospective
21payment system updated annually by the department. The payment system shall
22implement standards
which are reasonable and adequate to meet the costs which
23must be incurred by efficiently and economically operated facilities in order to
24provide care in conformity with this section, with federal regulations authorized
25under 42 USC 1396a (a) (13) (A), 1396a (a) (30), 1396b (i) (3), 1396L and 1396r (e)
1and with quality and safety standards established under subch. II of ch. 50 and ch.
2150. In administering this payment system, the department shall allow costs it
3determines that are necessary and proper for providing patient care
and that meet
4quality and safety standards established under subch. II of ch. 50 and ch. 150. The
5payment system shall reflect all of the following:
AB100-engrossed,910,107
49.45
(6m) (ag) 2. Standards established by the department
for costs of
8economically and efficiently operated facilities that shall be based upon allowable
9costs incurred by facilities in the state as available from information submitted
10under par. (c) 3. and compiled by the department.
AB100-engrossed,910,1612
49.45
(6m) (ag) 3m. For state fiscal year
1995-96 1997-98, rates that shall be
13set by the department based on information from cost reports for the
1994 1996 fiscal
14year of the facility and for state fiscal year
1996-97
1998-99, rates that shall be set
15by the department based on information from cost reports for the
1995 1997 fiscal
16year of the facility.
AB100-engrossed,911,1018
49.45
(6m) (ag) 8. Calculation of total payments and supplementary payments
19to facilities that permits an
aggregate increase in funds allocated under s. 20.435
(1) 20(5) (b) and (o) for nursing home care provided medical assistance recipients
,
21including an increase resulting in adjustment of facility base rates and percentage
22increases over facility base rates, over that paid for services provided in state fiscal
23year
1994-95 1996-97 of no more than
4.25% 5.4% or $45,908,500, whichever is less, 24during state fiscal year
1995-96 and 1997-98; and calculation of total payments and
25supplementary payments to facilities that permits an aggregate increase in funds
1allocated under s. 20.435 (5) (b) and (o) for nursing home care provided medical
2assistance recipients, including a percentage increase over facility base rates, over
3that paid for services provided in state fiscal year
1995-96 1997-98 of no more than
43.5%
or $30,145,200, whichever is less, during state fiscal year
1996-97, excluding 51998-99. Calculation of total payments and supplementary payments under this
6subdivision excludes increases in total payments attributable to increases in
7recipient utilization of facility care, payments for the provision of active treatment
8to facility residents with developmental disability or chronic mental illness and
9payments for preadmission screening of facility applicants and annual reviews of
10facility residents required under
42 USC 1396r (e).
AB100-engrossed,911,1612
49.45
(6m) (ap) If the bed occupancy of a nursing home is below the minimum
13patient day occupancy standards that are established by the department under par.
14(ar) (intro.), the department may approve a request by the nursing home to delicense
15any of the nursing home's licensed beds. If the department approves the nursing
16home's request, all of the following apply:
AB100-engrossed,911,1817
1. The department shall delicense the number of beds in accordance with the
18nursing home's request.
AB100-engrossed,911,2119
2. The department may not include the number of beds of the nursing home
20that the department delicenses under this paragraph in determining the costs per
21patient day under the minimum patient day occupancy standards under par. (ar).
AB100-engrossed,911,2322
3. The nursing home may not use or sell a bed that is delicensed under this
23paragraph.
AB100-engrossed,912,624
4. a. Every 12 months following the delicensure of a bed under this paragraph,
25for which a nursing home has not resumed licensure under subd. 5., the department
1shall reduce the licensed bed capacity of the nursing home by 10% of all of the nursing
2home's beds that remain delicensed under this paragraph or by 25% of one bed,
3whichever is greater. The department shall reduce the statewide maximum number
4of licensed nursing home beds under s. 150.31 (1) (intro.) by the number or portion
5of a number of beds by which the nursing home's licensed bed capacity is reduced
6under this subdivision.
AB100-engrossed,912,107
b. Subdivision 4. a. does not apply with respect to the delicensure of beds
8between July 1, 1997, and October 1, 1997, during the period of any contract entered
9into by a nursing home prior to January 1, 1997, if the contract requires the nursing
10home to maintain its current licensed bed capacity.
AB100-engrossed,912,1811
5. A nursing home retains the right to resume licensure of a bed of the nursing
12home that was delicensed under this paragraph unless the licensed bed capacity of
13the nursing home has been reduced by that bed under subd. 4. The nursing home
14may not resume licensure of a fraction of a bed. The nursing home may resume
15licensure 18 months after the nursing home notifies the department in writing that
16the nursing home intends to resume the licensure. If a nursing home resumes
17licensure of a bed under this subdivision, subd. 2. does not apply with respect to that
18bed.
AB100-engrossed,912,2419
6. If subd. 4. b. applies and the nursing home later resumes licensure of a bed
20that was delicensed between the effective date of this subdivision .... [revisor inserts
21date], and the date that is 60 days after the effective date of this subdivision ....
22[revisor inserts date], the department shall calculate the costs per patient day using
23the methodology specified in the state plan that is in place at the time that the
24delicensed beds are resumed.
AB100-engrossed,913,12
149.45
(6m) (ar) 1. a. The department shall establish standards for payment of
2allowable direct care costs
, for facilities that do not primarily serve the
3developmentally disabled, that are
at least 110% of not less than the median for
4direct care costs for
a sample of all of those facilities
that do not primarily serve the
5developmentally disabled in this state and separate standards for payment of
6allowable direct care costs
, for facilities that primarily serve the developmentally
7disabled, that are
at least 110% of not less than the median for direct care costs for
8a sample of all of those facilities
primarily serving the developmentally disabled in
9this state. The standards shall be adjusted by the department for regional labor cost
10variations.
The department may decrease the percentage established for the
11standards only if amounts available under par. (ag) (intro.) are insufficient to provide
12total payment under par. (am), less capital costs under subd. 6.
AB100-engrossed,913,2415
49.45
(6m) (br) 1. Notwithstanding s. 20.410 (3) (cd), 20.435
(1) (5) (bt) or (bu)
16or (7) (b) or 20.445 (3)
(de) (dz), the department shall reduce allocations of funds to
17counties in the amount of the disallowance from the
appropriations appropriation
18account under s.
20.410 (3) (cd) or 20.435
(1) (5) (bt) or (bu) or (7) (b), or the
19department shall direct the department of workforce development to reduce
20allocations of funds to counties or Wisconsin works agencies in the amount of the
21disallowance from the appropriation
account under s. 20.445 (3)
(de) or (dz)
or direct
22the department of corrections to reduce allocations of funds to counties in the amount
23of the disallowance from the appropriation account under s. 20.410 (3) (cd), in
24accordance with s. 16.544 to the extent applicable.
AB100-engrossed,914,122
49.45
(6t) County department and local health department operating
3deficit reduction. (intro.) From the appropriation under s. 20.435
(1) (5) (o), for
4reduction of operating deficits, as defined under criteria developed by the
5department, incurred by a county department under s. 46.215, 46.22, 46.23 or 51.42
6or by a local health department, as defined in s. 250.01 (4), for services provided
7under s. 49.46 (2) (a) 4. d. and (b) 6. f., j., k. and L., 9. and 15., for case management
8services under s. 49.46 (2) (b) 12. and for mental health day treatment services for
9minors provided under the authorization under
42 USC 1396d (r) (5), the department
10shall allocate up to $4,500,000 in each fiscal year to these county departments, or
11local health departments as determined by the department, and shall perform all of
12the following:
AB100-engrossed,914,1814
49.45
(6t) (d) If the federal department of health and human services approves
15for state expenditure in a fiscal year amounts under s. 20.435
(1) (5) (o) that result
16in a lesser allocation amount than that allocated under this subsection or disallows
17use of the allocation of federal medicaid funds under par. (c), reduce allocations under
18this subsection and distribute on a prorated basis, as determined by the department.
AB100-engrossed,915,920
49.45
(6u) (title)
Facility operating deficit reduction Supplemental
21payments to certain facilities. (intro.)
Except as provided in par. (g) 22Notwithstanding sub. (6m), from the appropriation under s. 20.435
(1) (5) (o), for
23reduction of operating deficits, as defined under criteria developed by the
24department, incurred by a facility, as defined under sub. (6m) (a)
2. 3., that is
25established under s. 49.70 (1) or that is owned and operated by a city, village or town,
1the department
shall may not distribute to these facilities
not more than
$18,600,000 2$38,600,000 in each fiscal year, as determined by the department,
and except that
3the department shall also distribute for this same purpose from the appropriation
4under s. 20.435 (5) (o) any additional federal medical assistance moneys that were
5not anticipated before enactment of the biennial budget act or other legislation
6affecting s. 20.435 (5) (o) and that were not used to fund nursing home rate increases
7under sub. (6m) (ag) 8. The total amount that a county certifies under this subsection
8may not exceed 100% of otherwise-unreimbursed care. In distributing funds under
9this subsection, the department shall perform all of the following: