SB378: Bill Text

LRB-4361/2

GMM&TAY:kmg&kaf:ijs

1997 - 1998 LEGISLATURE

1997 Senate BILL 378

December 17, 1997 - Introduced by Joint Legislative Council. Referred to Committee on Health, Human Services, Aging, Corrections, Veterans and Military Affairs.

SB378,2,2 An Act to amend 20.433 (1) (q), 25.67 (2), 48.981 (8) (a) and (d) 1., 48.982 (6) (d), 49.45 (25) (b) and 49.45 (25) (c); to repeal and recreate 25.67 (2) (a) 1. and (b), 46.515 (1) (b) 1. c., 48.981 (8) (a) and (d) 1. and 49.45 (25) (b); and to create 20.435 (3) (de), 20.435 (3) (df), 46.515, 48.982 (2e) and 49.45 (25) (bc) of the statutes; relating to: creating a child abuse and neglect prevention program, medical assistance for certain case management services, authorizing the child abuse and neglect prevention board to form a nonstock, nonprofit corporation, early childhood family education center grants awarded by the child abuse and neglect prevention board, training programs and training requirements for staff of county departments or licensed child welfare agencies under contract with county departments whose responsibilities include investigation or treatment of child abuse and neglect, granting rule-making authority and making appropriations.

Analysis by the Legislative Reference Bureau

This bill is explained in the Notes provided by the joint legislative council in the bill.

For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

Prefatory note: This bill was prepared for the joint legislative council's special committee on prevention of child abuse and neglect ("special committee").

Child abuse and neglect prevention program

The bill establishes a child abuse and neglect prevention program for counties and federally recognized American Indian tribes and bands in Wisconsin ("Indian tribes") which has the following features:

1. The department of health and family services (DHFS) is responsible for administering the program, awarding prevention grants to counties and Indian tribes under the program and reimbursing medical assistance (MA) certified case management providers for certain case management services provided under the program.

2. DHFS must provide application procedures for the program according to DHFS's competitive application procedures. Counties and Indian tribes are permitted to submit joint applications.

3. The program is to be phased in and DHFS is to 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 2001-2003 state fiscal biennium, counties and Indian tribes that have not been selected previously may also be selected. An urban county is defined in the bill as any county which is located in a federal metropolitan statistical area or a primary metropolitan statistical area. A rural county is defined as any county which is not an urban county.

4. A new appropriation to DHFS is created from which DHFS is to award the prevention grants. Prevention grants are to be used for the following purposes:

a. To establish or maintain the flexible fund described in item 7. b. (1), below, from which payments may be made for appropriate, authorized expenses of a family that is part of the home visitation program described in item 7. a., below, or a family in Milwaukee County that is receiving home visitation services as part of the program that provides prenatal and postpartum care coordination services and care coordination services for children who have not attained 7 years of age.

b. To establish or maintain the flexible fund described in item 7. b. (2), below, from which payments may be made for appropriate, authorized expenses for a target population, which is defined in the bill as a "case", as described in item 8., below.

c. To reimburse a case management provider for the amount of allowable charges that is not reimbursed by the federal government (the nonfederal portion), that is, approximately 40%, for MA case management services provided to a MA beneficiary who is part of the target population that is defined in the bill as a "case".

d. To pay up to $1,500 per grant year for expenses incurred in connection with attending training activities that are related to the program created by the bill.

The minimum amount of a prevention grant under the bill is $10,000. DHFS must determine the remaining amount of a prevention grant awarded to a county or Indian tribe based on the MA-eligible population of the county or Indian tribe in proportion to the MA-eligible population of other counties or Indian tribes to which prevention grants are awarded.

5. The general purpose revenue (GPR) appropriation for MA is increased to enable DHFS to reimburse providers for the nonfederal portion for MA case management services that are provided to members of families who are part of the home visitation program created in the bill. Milwaukee County is not eligible for the reimbursement for the nonfederal portion of MA for the case management services provided as part of the home visitation program.

DHFS is also required to expend certain amounts from the federal program revenue appropriation for MA to reimburse providers for the amount of the allowable charges that is reimbursed by the federal government for case management services which are provided to: (a) members of families who are part of the home visitation program created in the bill; and (b) persons who are defined in the bill as "cases" for whom a county or Indian tribe uses prevention grant funds to reimburse a case management provider for the nonfederal portion of allowable charges for case management services.

6. If there are more applicant counties and Indian tribes that meet the minimum criteria for selection (as discussed in item 7., below) than can be selected in a particular state fiscal biennium, DHFS must make the selection based on a method to be established by DHFS for ranking applicants based on the quality of their grant applications. In ranking the applications submitted by urban counties in the 1997-99 state fiscal biennium, DHFS must give favorable consideration to a county that has indicated a willingness to participate in the evaluation described in item 9., below.

7. A county or Indian tribe must meet certain criteria as set forth in the bill for selection to participate in the program. DHFS is authorized to establish criteria in addition to the criteria set forth in the bill. The following criteria are set forth in the bill:

a. Home visitation programs. The home visitation programs in the selected counties and Indian tribes must have the following characteristics:

(1) The programs must select first-time parents who are eligible for MA to undergo a risk assessment for child abuse and neglect. The assessment must be initiated, if possible, during the prenatal period or as soon after the birth of the child as possible.

(2) The risk assessment tool to measure the parent's risk of perpetrating child abuse and neglect must be developed by DHFS, by rule.

(3) Persons who are assessed to be at risk for perpetrating child abuse and neglect must be offered the opportunity to participate in the home visitation program. Participation in the program is voluntary on the part of an individual who is selected to undergo the risk assessment.

Further, persons who are not first-time parents or who are not eligible for MA may request the risk assessment and may be allowed to participate in the home visitation program. Funding for reimbursement of the nonfederal portion of MA for case management services for those participants, however, is not provided under the bill nor are those participants eligible for flexible fund payments as described in item b., below.

(4) Services may be provided until the identified child in the family reaches 3 years of age (or 5 years of age when risk factors for child abuse and neglect continue to be present in the family).

(5) The county or Indian tribe must include certain information in the grant application, including 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.

b. Flexible funds. The county or Indian tribe must have established, or must demonstrate that, if it is selected, it has plans to establish, 2 flexible funds from which appropriate, authorized payments may be made as follows:

(1) A flexible fund from which payments totaling not more than $500 (or a greater amount when adjusted for inflation) per calendar year may be made for appropriate expenses of each family participating 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 or neglect and who are offered and accept home visitation program services), or under s. 49.45 (44), stats., (that is, those 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). Payments 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 flexible fund.

(2) A flexible fund from which payments totaling not more than $500 (or a greater amount when adjusted for inflation) may be made for appropriate expenses of each "case" as described in item 8., below. Payments must be authorized by an individual whom the county or Indian tribe has designated to authorize such payments.

c. Case management benefit. The county or Indian tribe must have elected, or state that, if selected, it will elect, to make the MA case management benefit available to MA beneficiaries described in s. 49.45 (25) (am) 9., stats., that 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]". This election is necessary in order for the county or Indian tribe to make MA case management benefits available to individuals who are defined in the bill as "cases", as described in item 8., below. The county or Indian tribe is responsible for reimbursing the case management provider for the nonfederal portion of the allowable charges for those MA case management services provided to "cases". In contrast, as noted in item 5., above, DHFS must reimburse the case management provider for the nonfederal portion of the allowable charges for MA case management services provided to those persons participating in the home visitation program created by the bill.

d. Wraparound process. The county or Indian tribe must demonstrate in the grant application how payments that will be made from the flexible fund for "cases" and how MA case management services provided to the target population defined as "cases" will promote the provision of services for these "cases" using a wraparound process to provide services in a flexible, comprehensive and individualized manner in order to reduce court-ordered services.

e. Anticipated allocation. The county or Indian tribe must explain in the grant application how the applicant anticipates that grant moneys will be allocated between the 2 flexible funds described in item b. (1) and (2), above, and the reimbursement of the nonfederal portion of MA case management services provided to "cases", as described in item c., above.

8. The target population, defined as a "case" in the bill, for whom one of the flexible funds and the MA targeted case management services apply (although the latter benefit applies only with respect to persons in the target population who are MA beneficiaries) is a family or person who meets all of the following criteria:

a. The family or person is any of the following: (1) a family or person who has been the subject of a child abuse and neglect report under s. 48.981, stats., and with respect to whom the individual making the investigation or the intake worker assigned to the family or person has determined that all of the conditions in item b., below, exist; (2) an Indian child who has been the subject of a child abuse and neglect report about which an Indian tribe that has been awarded a prevention grant has received notice, including but not limited to notice provided to a tribal agent under s. 48.981 (3) (bm), stats., and with respect to whom an individual designated by the Indian tribe has determined that all of the conditions in item b., below, exist; or (3) a family that includes a person who has contacted a county department of human services or county department of social services (county department) or an Indian tribe requesting assistance to prevent abuse or neglect of a child in the person's family and with respect to which the individual responding to the request determines that all of the conditions in item b., below, exist.

b. The family or person has been determined to meet all of the following conditions: (1) there is a substantial risk of future abuse or neglect of a child in the family if assistance is not provided; (2) the child and child's parent or the person primarily responsible for the child's care are willing to cooperate with an informal plan of support and services; and (3) it does not appear that a petition alleging that a child in the family is in need of protection or services (CHIPS) will be filed in juvenile court and, if an Indian child is involved, it also does not appear that there will be a similar proceeding in tribal court relating to abuse or neglect of the Indian child.

9. DHFS is required to designate 2 of the urban counties selected for the home visitation program in the 1997-99 state fiscal biennium to participate in an evaluation of the home visitation program. DHFS must select the evaluator for the program and apply for private funding for the evaluation. If DHFS is unable to obtain private funding for the evaluation, it must submit a request to the joint committee on finance for consideration of funding under the procedures set forth in ss. 13.10 and 13.101, stats. Persons who have been assessed to be at risk of perpetrating child abuse and neglect will be randomly assigned to control and treatment groups. Control group members will not receive home visitation program services, while treatment group members will receive those services. The bill sets forth criteria that must be measured in the evaluation for both the control and treatment groups.

The bill also requires the counties and Indian tribes which are awarded prevention grants but which are not participating in the evaluation to collect data on the same criteria which will be evaluated for the 2 urban counties and to submit the data to DHFS.

10. If the federal bureau of health care financing disallows reimbursement for case management services provided to MA-eligible participants in the treatment group, DHFS must apply for private funding to replace this disallowed funding in order to operate the home visitation program in these urban counties during the 2-year period in which the evaluation is being conducted.

11. A new appropriation to DHFS is created from which DHFS is to provide technical assistance and training to the counties and Indian tribes that are awarded prevention grants. Additional positions are not created at DHFS. Thus, it is anticipated that DHFS will contract with others to provide most of this technical assistance and training, 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).

Nonprofit fund-raising corporation

Under current law, the child abuse and neglect prevention board (the board) is authorized to solicit and accept contributions, grants, gifts and bequests (contributions) for the children's trust fund (CTF) or for other purposes. [s. 48.982 (2) (d), stats.] Under current law, moneys received for the CTF as a contribution under s. 48.982 (2) (d), stats., may be deposited in the appropriation account under s. 20.433 (1) (q) or (r), stats., as described below. [s. 48.982 (2) (d), stats.]

Moneys accepted by the board for the CTF are to be used, in accordance with the donor's wishes, to do any of the following: