AB665: Bill Text

2. For selected counties (except for Milwaukee County) and Indian tribes, DHFS must reimburse providers of case management services provided through the MA program for MA-eligible participants in the home visitation program component of the program under s. 46.515 (4) (b) 1., stats.

AB665,13,3 (3) Number of counties and Indian tribes selected. (a) Number selected. The following number of counties and Indian tribes may be selected by the department to participate in the program under this section:

AB665,13,5 1. In the 1997-99 state fiscal biennium, no more than 6 rural counties, 3 urban counties and one Indian tribe may be selected.

AB665,13,8 2. In the 1999-2001 state fiscal biennium, no more than 14 rural counties, 6 urban counties and 3 Indian tribes may be selected, in addition to those selected in the previous state fiscal biennium.

AB665,13,11 3. In the 2001-03 state fiscal biennium, counties and Indian tribes that have not been selected previously may be selected, in addition to those selected in previous state fiscal biennia.

AB665,13,16 (b) Joint application permitted. Two or more counties and Indian tribes may submit a joint application to the department. Each county or Indian tribe in a joint application shall be counted as a separate county or Indian tribe for the purpose of limiting the number of counties and Indian tribes selected in each state fiscal biennium.

Note: Provides that:

1. DHFS may select counties and Indian tribes according to the following schedule: (a) in the 1997-99 state fiscal biennium, no more than 6 rural counties, 3 urban counties and one Indian tribe may be selected; (b) in the 1999-2001 state fiscal biennium, no more than 14 additional rural counties, 6 additional urban counties and 3 additional Indian tribes may be selected; and (c) in the 2001-03 state fiscal biennium, counties and Indian tribes that have not been selected previously may be selected.

2. Counties and Indian tribes may submit joint applications.

AB665,14,2 (4) Purpose. (a) Grants. The grants awarded under this section shall be used for all of the following purposes:

AB665,14,3 1. To establish or maintain the fund under sub. (6) (b) 1.

AB665,14,4 2. To establish or maintain the fund under sub. (6) (b) 2.

AB665,14,9 3. To reimburse a case management provider under s. 49.45 (25) (b) for the amount of the allowable charges under the medical assistance program that is not provided by the federal government for case management services provided to a medical assistance beneficiary described under s. 49.45 (25) (am) 9. if that medical assistance beneficiary is a case or is a member of a family that is a case.

AB665,14,12 4. To pay expenses incurred in connection with attending training activities related to the program under this section. No more than $1,500 of the grant amount may be used for this purpose in the 12 months following receipt of a grant.

AB665,15,8 (b) Reimbursement for certain case management services. 1. As provided in s. 49.45 (25) (bc), the department shall reimburse providers for case management services provided for persons who are selected for and agree to participate in a home visitation program described in this subdivision. A county, other than a county with a population of 500,000 or more, or an Indian tribe that is selected to participate in the program under this section shall select persons who are first-time parents and who are eligible for medical assistance under subch. IV of ch. 49 to undergo an assessment through use of a risk assessment instrument to determine whether the parent presents risk factors for perpetrating child abuse or neglect. Persons who are selected shall be assessed during the prenatal period, if possible, or as close to the time of the child's birth as possible. The risk assessment instrument shall be developed by the department by rule and shall be based on risk assessment instruments developed by the department for similar programs which are in operation. A person who is assessed to be at risk of abusing or neglecting his or her child shall be offered home visitation program services unless the person is assigned to a control group under sub. (7) (a). Home visitation program services may be provided to a family with a child identified as being at risk of child abuse or neglect until the identified child reaches 3 years of age. If risk factors for child abuse or neglect with respect to the identified child continue to be present when the child reaches 3 years of age, home visitation program services may be provided until the identified child reaches 5 years of age.

AB665,15,16 2. The counties and Indian tribes that are selected to participate in the program under this section may permit a person who is not a first-time parent or who is not eligible for medical assistance under subch. IV of ch. 49 to undergo the risk assessment and to participate in the home visitation program if that person presents risk factors for perpetrating child abuse or neglect. No payments from the fund under sub. (6) (b) 1. may be made to a person described in this subdivision. Reimbursement may not be provided by the department under s. 49.45 (25) (bc) for a person described in this subdivision.

Note: 1. Specifies that grant funds must be used for all of the following purposes:

a. To establish or maintain the flexible fund which is used for families participating in the home visitation program under s. 46.515 (4) (b) 1., stats., as created by the bill, or families in Milwaukee County receiving home visitation services under s. 49.45 (44), stats.

b. To establish or maintain the flexible fund which is used for "cases", as defined in s. 46.515 (1) (b), stats., as created by the bill.

c. To reimburse a case management provider for the nonfederal portion for case management services provided to a MA beneficiary who is part of a "case" as defined in s. 46.515 (1) (b), stats., as created by the bill.

d. To pay expenses incurred in connection with attending training activities related to the prevention program described in s. 46.515, stats., as created by the bill. No more than $1,500 of the grant amount, however, may be used for this purpose in any grant year.

2. Specifies that DHFS must reimburse providers for MA case management services provided to persons who are selected for risk assessment, who undergo the assessment and who agree to receive home visitation program services. Other than in Milwaukee County, persons who are first-time parents and who are eligible for MA must be selected to receive an assessment to determine whether they present risk factors for causing child abuse or neglect. The assessment must be done during the prenatal period or as soon after the child's birth as possible. Those persons who are determined to be at risk must be offered home visitation program services. Services may be provided to a family with a child identified as being at risk of child abuse or neglect until the child reaches 3 years or age, unless risk factors continue to be present, in which case services may continue until the child reaches 5 years of age.

3. Specifies that other persons who are not selected for risk assessment but who wish to undergo a risk assessment may be permitted to do so and may be offered home visitation program services if risk factors are present. Reimbursement of the nonfederal portion for MA case management services for those persons, however, may not be provided by DHFS. In addition, no payments from the flexible fund for the home visitation program may be made to those persons.

AB665,16,9 (5) Selection of counties and Indian tribes. The department shall provide competitive application procedures for selecting counties and Indian tribes for participation in the program under this section. The department shall establish a method for ranking applicants for selection based on the quality of their applications. In ranking the applications submitted by urban counties in the 1997-99 state fiscal biennium, the department shall give favorable consideration to a county that has indicated under sub. (6) (a) 7. that it is willing to participate in the evaluation under sub. (7). The application procedures provided shall be clear and understandable to the applicants.

Note: Requires DHFS to do all of the following:

1. Provide application procedures for selecting counties and Indian tribes using DHFS's competitive application procedures.

2. Establish a method for ranking counties and Indian tribes for selection as grant recipients based on the quality of their grant applications. Favorable consideration must be given to urban counties that are willing to participate in the evaluation.

3. Provide application procedures which are clear and understandable to the applicants.

AB665,16,12 (6) Criteria for awarding grants. In addition to any other criteria developed by the department, a county or Indian tribe shall meet all of the following criteria in order to be selected for participation in the program under this section:

AB665,16,15 (a) Home visitation program criteria. The part of an application submitted by a county, other than a county with a population of 500,000 or more, or an Indian tribe which relates to home visitation programs shall include all of the following:

AB665,17,4 1. Information on how the applicant's home visitation program is comprehensive and incorporates practice standards that have been developed for home visitation programs by entities concerned with the prevention of child abuse and neglect.

AB665,17,9 2. Documentation that the application of the county or Indian tribe was developed through collaboration among public and private organizations that provide services to children, especially children who are at risk of child abuse or neglect, or that are otherwise interested in child welfare and a description of how that collaboration effort will support a comprehensive home visitation program.

AB665,17,13 3. An identification of existing child abuse and neglect prevention services that are available to residents of the county or reservation of the Indian tribe and a description of how those services and any additional needed services will support a comprehensive home visitation program.

AB665,17,17 4. An explanation of how the home visitation program will build on existing child abuse and neglect prevention programs, including programs that provide support to families, and how the home visitation program will coordinate with those programs.

AB665,17,19 5. An identification of ways to maximize the use of volunteers and other community resources in support of the home visitation program.

AB665,17,23 6. An identification of how the home visitation program is comprehensive and incorporates the practice standards for home visitation programs referred to in subd. 1., including how services will vary in intensity levels depending on the needs and strengths of the participating family.

AB665,17,25 7. An indication of the applicant's willingness to participate in the evaluation under sub. (7).

Note: For other than Milwaukee County, provides that the part of the application relating to home visitation programs must include all of the following:

1. Information on how the applicant's home visitation program is comprehensive and incorporates practice standards that have been developed for home visitation programs by entities concerned with the prevention of child abuse and neglect.

2. Documentation that the application was developed through a collaborative process, including both public and private entities.

3. An identification of existing child abuse and neglect prevention services that are available to residents of the county or reservation of the Indian tribe and a description of how those services and any additional needed services will support a comprehensive home visitation program.

4. An explanation of how the home visitation program will build on existing child abuse and neglect prevention programs, including programs that provide support to families, and how the home visitation program will coordinate with those programs.

5. An identification of ways to maximize the use of volunteers and other community resources in support of the home visitation program.

6. An identification of how the home visitation program is comprehensive and incorporates the practice standards for home visitation programs referred to in item 1., above, including how services will vary in intensity levels depending on the needs and strengths of the participating family.

7. An indication of the applicant's willingness to participate in the evaluation under s. 46.515 (7), stats., as created by the bill.

AB665,18,8 (b) Flexible funds. 1. `Flexible fund for home visitation programs.' The applicant demonstrates in the application that the applicant has established, or has plans to establish, if selected, a fund from which payments totaling not more than $500 per calendar year may be made for appropriate expenses of each family that is participating in the home visitation program under sub. (4) (b) 1. or that is receiving home visitation services under s. 49.45 (44). The payments shall be authorized by an individual designated by the applicant. The applicant shall provide an equal cash match for payments made under this subdivision.

Note: Provides that a county or Indian tribe must demonstrate that it has established, or has plans to establish, if selected, a flexible fund from which payments of up to $500 per calendar year may be made for each family that is involved in the home visitation program under s. 46.515 (4) (b) 1. stats., as created by the bill, (that is, those first-time, MA-eligible parents who are selected for risk assessment, who undergo the assessment, who are found to be at risk of perpetrating child abuse and neglect and who are offered and accept home visitation program services) or that is receiving home visitation services under s. 49.45 (44), stats., (that is, individuals in Milwaukee County who are receiving prenatal and postpartum care coordination services and care coordination services for children who have not attained 7 years of age). The payments may be made for appropriate expenses of the family and must be authorized by an individual whom the county or Indian tribe has designated to authorize such payments. The county or Indian tribe must provide an equal cash match for payments made from this fund. Thus, for example, if payment of an expense of $626 were authorized, $313 would be paid from grant moneys included in the flexible fund and the remaining $313 would be paid with other moneys raised by the county or Indian tribe.

AB665,19,10 2. `Flexible fund for cases.' The applicant demonstrates in the grant application that the applicant has established, or has plans to establish, if selected, a fund from which payments totaling not more than $500 for each case may be made for appropriate expenses related to the case. The payments shall be authorized by an individual designated by the applicant. The applicant shall demonstrate in the grant application that it has established, or has plans to establish, if selected, procedures to encourage, when appropriate, a person to whom or on whose behalf payments are made under this subdivision to make a contribution to the fund described in this subdivision up to the amount of payments made to or on behalf of the person when the person's financial situation permits such a contribution.

Note: Does the following:

1. Provides that a county or Indian tribe must demonstrate that it has established, or has plans to establish, if selected, a flexible fund from which payments of up to $500 may be made for each "case", as defined in s. 46.515 (1) (b), stats., as created by the bill. The payments may be made for appropriate expenses related to the "case" and must be authorized by an individual whom the county or Indian tribe has designated to authorize such payments.

2. Provides that the county or Indian tribe must demonstrate that it has established, or has plans to establish, if selected, procedures to encourage, when appropriate, a person to whom or on whose behalf payments are made from the flexible fund for "cases" to make a contribution to this flexible fund up to the amount of payments made to or on behalf of the person when the person's financial situation permits such a contribution.

AB665,20,7 3. `Inflationary adjustment.' The department shall review biennially the maximum payment amounts specified in subds. 1. and 2. and shall adjust those amounts to reflect increases in expenditures due to inflation. Adjustments shall be in increments of $20. The department shall publish notice of an adjustment in a maximum payment amount in the Wisconsin administrative register and shall send a notice about the adjustment to all counties and Indian tribes. Notwithstanding subd. 1., the maximum payment amount from the fund established under subd. 1. for a family that is participating in the home visitation program under sub. (4) (b) 1. or that is receiving home visitation services under s. 49.45 (44) shall be the greater of $500 or the last amount published in the Wisconsin Administrative Register as the maximum payment amount under subd. 1. Notwithstanding subd. 2., the maximum payment amount from the fund established under subd. 2. for expenses of a case shall be the greater of $500 or the last amount published in the Wisconsin Administrative Register as the maximum payment amount under subd. 2.

Note: Provides a mechanism to adjust for inflation the $500 maximum payment amounts from the flexible funds.

AB665,20,12 4. `Nonentitlement.' No individual is entitled to any payment from a fund established under subd. 1. or 2. Nothing in this section shall be construed as requiring a county or Indian tribe to make a determination described in sub. (1) (b) 2. A determination described in sub. (1) (b) 2. may not be construed to be a determination described in s. 48.981 (3) (c) 4.

Note: Does the following:

1. Specifies that an individual is not entitled to a payment from the flexible fund established to assist families in a home visitation program or from the flexible fund established to assist "cases".

2. Specifies that neither a county nor an Indian tribe is required to make a determination described in s. 46.515 (1) (b) 2., stats., as created by the bill, to determine whether a family or person is a "case". Such a determination is made only at the option of the county or Indian tribe.

3. Specifies that a determination described in s. 46.515 (1) (b) 2., stats., as created by the bill, is not a determination under s. 48.981 (3) (c) 4., stats., that a report of abuse or neglect or threatened abuse or neglect has been substantiated or unsubstantiated.

AB665,20,16 (c) Case management benefit. The applicant states in the grant application that it has elected, or, if selected, that it will elect, under s. 49.45 (25) (b), to make the case management benefit under s. 49.45 (25) available to the category of beneficiaries under s. 49.45 (25) (am) 9.

Note: Specifies that, in order to be eligible for a prevention grant, a county or Indian tribe must have elected, or stated that, if selected, it will elect, to make the MA case management benefit available to the category of beneficiaries under s. 49.45 (25) (am) 9., stats., that is, to an MA beneficiary who is "a member of a family that has a child who is at risk of serious physical, mental or emotional dysfunction, as defined by [DHFS]".

AB665,21,7 (d) Wraparound process. The applicant demonstrates in the grant application that payments that will be made from the fund established under sub. (4) (b) 2. and case management services provided to a medical assistance beneficiary under s. 49.45 (25) (am) 9. who is a case or who is a member of a family that is a case will promote the provision of services for the case using a wraparound process to provide services in a flexible, comprehensive and individualized manner in order to reduce court-ordered services.

Note: Requires a county or Indian tribe to demonstrate in the grant application how payments that will be made from the flexible fund for families or persons who are defined as a "case" under s. 46.515 (1) (b), stats., as created by the bill, and how case management services provided to an MA beneficiary who is defined as a "case" or who is a member of a family that is defined as a "case" will promote the provision of services for those "cases" using a wraparound process to provide services in a flexible, comprehensive and individualized manner in order to reduce court-ordered services.

AB665,21,10 (e) Anticipated allocation. The applicant explains in the grant application how the applicant anticipates allocating moneys awarded under the grant among the purposes described in sub. (4) (a) 1. to 3.

Note: Requires a county or Indian tribe to explain in the grant application how the applicant anticipates that moneys awarded under the grant will be allocated among the following purposes: (1) the flexible fund for persons in home visitation programs; (2) the flexible fund for "cases"; and (3) paying the nonfederal share of MA case management for "cases".

AB665,22,3 (7) Home visitation program evaluation. (a) The department shall designate 2 of the urban counties selected for the program in the 1997-99 state fiscal biennium to participate in an evaluation of the home visitation program. The department shall select the evaluator for the home visitation program and shall apply for funding from private organizations for the evaluation. The evaluation shall randomly assign persons who have been assessed as described under sub. (4) (b) 1. and determined to be at risk of perpetrating child abuse or neglect to control and treatment groups. Persons in the control group may not receive services under sub. (4) (b) 1. or payment from the fund under sub. (6) (b) 1. The evaluator shall measure all of the following criteria for a 2-year period in families in both the control and treatment groups:

AB665,22,4 1. The number of substantiated reports of child abuse and neglect.

AB665,22,5 2. The number of emergency room visits for injuries to children.

AB665,22,6 3. The number of out-of-home placements of children.

AB665,22,7 4. Immunization rates of children.

AB665,22,8 5. The number of services provided under s. 49.46 (2) (a) 2. to children.

AB665,22,10 6. Any other items that the department determines to be appropriate for evaluation.

AB665,22,13 (b) The department shall require the evaluation to determine the number of families in the treatment group who remained in the home visitation program for the time recommended in the family's case plan.

AB665,22,16 (c) The department shall determine the most appropriate way to evaluate the following criteria and shall require those criteria to be evaluated in both the control and treatment groups:

AB665,22,17 1. Strengthened family functioning.

AB665,22,18 2. Enhanced child development.

AB665,22,19 3. Positive parenting practices.

AB665,22,23 (d) All counties and Indian tribes selected for participation in the 1997-99 state fiscal biennium but not selected for the evaluation shall also gather data on the criteria specified in pars. (a) to (c) for persons participating in the home visitation program under sub. (4) (b) 1. and shall submit the data to the department.

AB665,23,5 (e) If the federal health care financing administration disallows reimbursement for case management services provided to medical assistance-eligible participants in the treatment groups specified in par. (a), the department shall apply for funding from private organizations to provide for the disallowed reimbursement of the federal share of medical assistance for case management services provided as part of the home visitation program in the 2 urban counties for the 2-year period during which the evaluation is being conducted.

Note: Outlines the program evaluation to be performed in 2 of the urban counties initially selected for the program in the 1997-99 state fiscal biennium. Two urban counties will be selected to conduct the evaluation, which will be an experimental design which randomly assigns individuals eligible for program participation into control and treatment groups. Persons in the control group may not receive the case management services under s. 46.515 (4) (b) 1., stats., as created by the bill, or payments from the flexible fund under s. 46.515 (6) (b) 1., stats., as created by the bill. Specifies the criteria which will be measured for these control and treatment groups. Further specifies that the counties and Indian tribes which receive prevention grants but which are not selected for the evaluation must also collect data on those criteria for persons participating in the home visitation program under s. 46.515 (4) (b) 1., stats., as created by the bill, and must submit the data to DHFS.

AB665,23,8 (8) Technical assistance and training. The department shall provide technical assistance and training to counties and Indian tribes that are selected to participate in the program under this section.

Note: Provides that DHFS must provide technical assistance and training to counties and Indian tribes that are selected to participate in the prevention program. As set forth in attachment 1 to Legislative Council staff Child Abuse and Neglect memo no. 20, Summary of Recommendations Relating to Providing Technical Assistance and Training (April 24, 1997), DHFS, the University of Wisconsin cooperative extension service and others have developed a training and technical assistance plan which the special committee understands will be used to provide technical assistance and training to grantees.

AB665, s. 8 Section 8. 46.515 (1) (b) 1. c. of the statutes, as created by 1997 Wisconsin Act .... (this act), is repealed and recreated to read:

AB665,24,3 46.515 (1) (b) 1. c. A family that includes a person who has contacted a county department, as defined in s. 48.02 (2g), or an Indian tribe that has been awarded a grant under this section or, in a county having a population of 500,000 or more that has been awarded a grant under this section, the department or a licensed child welfare agency under contract with the department requesting assistance to prevent abuse or neglect of a child in the person's family and with respect to which an individual responding to the request has determined that all of the conditions in subd. 2. exist.

Note: The 1997 budget act, 1997 Wisconsin Act 27, transfers the duty and authority to provide child welfare services in Milwaukee County from the Milwaukee County department of social services to DHFS, effective January 1, 1998. The budget act also permits DHFS to contract with a licensed child welfare agency to provide those services. This bill reconciles this provision of this bill with that transfer of duty and authority by the budget act.

AB665, s. 9 Section 9. 48.981 (8) (a) and (d) 1. of the statutes are amended to read:

AB665,24,18 48.981 (8) (a) The department and county departments to the extent feasible shall conduct continuing education and training programs for staff of the department, county departments and tribal social services departments, persons and officials required to report, the general public and others as appropriate. The programs shall be designed to encourage reporting of child abuse and neglect, to encourage self-reporting and voluntary acceptance of services and to improve communication, cooperation and coordination in the identification, prevention and treatment of child abuse and neglect. Programs provided for staff of county departments and licensed child welfare agencies under contract with county departments whose responsibilities include the investigation or treatment of child abuse and neglect shall also be designed to provide information on means of recognizing and appropriately responding to domestic abuse, as defined in s. 46.95 (1) (a). The department and county departments shall develop public information programs about child abuse and neglect.

Note: Requires that continuing education and training programs that are provided for staff of county departments and licensed child welfare agencies under contract with county departments whose responsibilities include the investigation or treatment of child abuse and neglect also be designed to provide information on means of appropriately responding to and recognizing domestic abuse, as defined in s. 46.95 (1) (a), stats. See the Prefatory note for an explanation of that definition.

AB665,25,8 (d) 1. Each county department or licensed child welfare agency under contract with a county department staff member and supervisor whose responsibilities include investigation or treatment of child abuse and neglect shall successfully complete training in child abuse and neglect protective services approved by the department. The training shall include information on means of recognizing and appropriately responding to domestic abuse, as defined in s. 46.95 (1) (a). The department shall monitor compliance with this subdivision according to rules promulgated by the department.

Note: Requires that the training required of each staff member and supervisor of a county department or licensed child welfare agency under contract with a county department whose responsibilities include investigation or treatment of child abuse and neglect include information on means of recognizing and appropriately responding to domestic abuse, as defined in s. 46.95 (1) (a), stats. See the Prefatory note for an explanation of that definition.