SB495: Bill Text

LRB-4349/2

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1997 - 1998 LEGISLATURE

1997 Senate BILL 495

March 10, 1998 - Introduced by Law Revision Committee. Referred to Committee on Health, Human Services, Aging, Corrections, Veterans and Military Affairs.

SB495,2,20 An Act to repeal 46.56 (14) (a) 2., 46.974, 49.45 (41) (a) 2., 50.096 (title), 69.05 (6) and 115.28 (16); to renumber 50.095; to renumber and amend 50.096 (1), 50.096 (2) and 50.096 (3); to consolidate, renumber and amend 46.56 (14) (a) (intro.) and 1. and 49.45 (41) (a) (intro.) and 1.; to amend 46.56 (14) (c) (intro.), 46.56 (15) (c), 48.46 (1), 48.981 (3) (c) 4., 49.45 (41) (b), 50.03 (2m) (a), 50.03 (4) (e), 50.035 (6), 50.04 (2v), 50.04 (3) (d), 50.09 (4), 50.095 (title), 50.14 (3), 69.18 (1) (e) 1. (intro.), 146.82 (1), 251.04 (8), 251.06 (1) (a) 1., 255.04 (3) (intro.) and 806.07 (1) (intro.); and to create 46.275 (5) (b) 7., 46.277 (5) (f), 48.46 (3), 146.82 (2) (a) 18., 251.06 (1) (a) 3. and 806.07 (3) of the statutes; relating to: mental health crisis intervention services; requirements for a Level I local health officer; coordination by a local board of health of activities of a sanitarian; fetal death reports; access by a coroner, deputy coroner, medical examiner or medical examiner's assistant to patient health care records; confidentiality restrictions on cancer reports; service contracts under community integration programs; eliminating outdated requirements for bed assessments for nursing homes and intermediate care facilities for the mentally retarded; designation by a nursing home of a person to accept service of notice or mail; required information for licenses for nursing homes and community-based residential facilities; eliminating a date for posting notice about the long-term care ombudsman program; eliminating dates for determinations that nursing homes are institutions for mental diseases; resident rights and responsibilities for residents of nursing homes and community-based residential facilities; eliminating dates for requesting and providing information about nursing homes; evaluations of integrated services projects; matching funds requirements for participants in integrated services projects; eliminating a requirement for a plan and report on school-community alcohol and drug abuse prevention and other services; eliminating a requirement that a person investigating a report of suspected or threatened emotional abuse of a child determine that the person responsible for the emotional damage is neglecting, refusing or unable for reasons other than poverty to remedy the harm; and prohibiting an adoptive parent from moving for relief from an order granting adoption or petitioning for a rehearing of such an order (suggested as remedial legislation by the department of health and family services).

Analysis by the Legislative Reference Bureau

Currently, mental health crisis intervention services are provided as a benefit under the medical assistance program by a county, city, village or town that elects to provide the services, becomes certified as a provider of the services and pays the allowable charges for the services that are not paid by the federal government. This bill eliminates the authority for a city, village or town to provide mental health crisis intervention services under the medical assistance program.

Under current law, local health departments are required to provide a minimum level of services (Level I) and may provide higher levels of service (Levels II or III). Local health officers must meet minimum requirements for each level of service provided by the local health department. For Level I, a local health officer must have at least a bachelor's degree from an accredited nursing program, although the local health officer need not meet this requirement if the county has a human services department that employs at least one person who does meet the requirement. The bill allows the local health officer of a Level I local health department to meet requirements for a Level II or III local health officer, if the local health department has more than one full-time employe, including a full-time public health nurse.

Currently, a local board of health may be governed by a county board of supervisors, by the governing body of each city or village (in Milwaukee County), or by the governing body of a village or town (in Racine County). In addition, city-county local health departments and multiple-county local health departments, if established, are governed by their relevant governing bodies. A local board of health must coordinate the activities of any sanitarian who is employed by a county's board of supervisors. The bill changes this requirement to require the local board of health to coordinate the activities of a sanitarian who is employed by the governing body of the jurisdiction that the local board of health serves.

Currently, when a spontaneous fetal death occurs, a hospital or a funeral director must file a fetal death report with the county register of deeds office or, in certain approved cities, the office of the city registrar. These offices must transmit the fetal death reports to the state registrar within 5 days and without making any copies. The bill requires that a fetal death report be filed directly with the state registrar, rather than with the county register of deeds or the city registrar.

Current law requires that all health care records be kept confidential and be released only with the informed consent of the patient or a person authorized by the patient. There are numerous exceptions to this requirement. The bill allows a coroner, deputy coroner, medical examiner or medical examiner's assistant access to the health care record of a person who has died, in order to complete a death certificate or investigate the death. The bill also authorizes the patient's health care provider to release unrequested information by contacting the office of the coroner or medical examiner.

Currently, every hospital, physician and federally certified laboratory must report to the department of health and family services (DHFS) information concerning persons who are diagnosed as having cancer or a precancerous condition. The identity of the diagnosed person and the person submitting the report may not be disclosed by DHFS except to a central tumor registry in another state or to the national tumor registry. The bill changes the cancer reporting requirement to apply confidentiality restrictions to the physician, rather than the person, submitting the report.

Currently, community options program funds may be used for services in a community-based residential facility (C-BRF) only if the service contract used is a model contract that has been developed by DHFS. The bill applies this same requirement to the community integration programs for residents of state centers for the developmentally disabled, for developmentally disabled persons and for persons who are relocated from nursing homes or who meet certain standards of care.

Currently, DHFS imposes assessments of $32 per calendar month per occupied, licensed bed of a nursing home and $100 per calendar month per occupied, licensed bed of an intermediate care facility for the mentally retarded. By October 31, 1992, each of these facilities was required to submit to DHFS the occupied licensed bed count and the amount due under the assessment from July 1 to September 30, 1992. Thereafter, each facility must submit its bed count and payment for the month preceding the month of submittal. This bill eliminates references to requirements for 1992.

Currently, each nursing home and C-BRF licensee or applicant for licensure must file with DHFS the name and address of a person who is authorized to accept service of notice or other matters sent by DHFS by registered or certified mail. This bill requires that the person authorized by a nursing home to accept service and registered or certified mail be located at the nursing home.

Licenses for nursing homes and C-BRFs currently must state the maximum bed capacity of the nursing home or C-BRF. The bill changes that requirement to instead require that nursing home and C-BRF licenses state the number of beds of the nursing home or C-BRF that are licensed by DHFS.

Under current law, beginning on January 1, 1992, each nursing home and C-BRF must post in a conspicuous location a notice about the long-term care ombudsman program. The bill eliminates the date by which nursing homes and C-BRFs must post notices about the long-term care ombudsman program.

Under current law, DHFS was required, before July 1, 1988, to conduct surveys to determine whether any licensed nursing home was an institution for mental diseases (and thus ineligible for federal medical assistance reimbursement). Beginning July 1, 1988, DHFS is required to make these determinations during biennial inspections of nursing homes. The bill eliminates the requirement that DHFS make determinations before July 1, 1988, as to whether a nursing home is an institution for mental diseases and eliminates the beginning date for these determinations to be made during biennial inspections of nursing homes.

Currently, each nursing home or C-BRF must make available a copy of resident rights and responsibilities to each resident and resident's guardian at or before admission, to each person who was a resident of the C-BRF or nursing home on December 12, 1975, and to staff members. The bill eliminates the date requirement for provision of copies of resident rights and responsibilities to residents of nursing homes and C-BRFs. The bill also requires that the copies be made available to a resident's legal representative, rather than a resident's guardian.

Under current law, beginning in 1988, DHFS has authority to request from nursing homes information about staffing ratios, staff replacement rates and violations of statutes or rules in the previous year. Beginning July 1, 1988, and annually thereafter, DHFS must provide nursing homes with a report about this information; nursing homes must make the report available to anyone who requests it. The bill eliminates references to dates and makes minor technical changes.

Under current law, participants in integrated services projects (also known as "Children Come First" projects), for care for children with severe disabilities and their families, must provide matching funds equal to 20% of the proposed funding. The bill changes the matching fund requirement to be 20% of the proposed total program budget.

Currently, a DHFS advisory committee supporting development of integrated services projects was required, by August 9, 1991, to submit an evaluation report. DHFS also was required to evaluate the projects by January 1, 1992, and to submit a report to various entities. The bill eliminates the requirement that the DHFS advisory committee submit a report evaluating integrated services projects. The bill also eliminates required submittal of the evaluation report and the date by which DHFS must evaluate the projects.

Currently, DHFS and the department of public instruction must prepare a plan about school-community alcohol and drug abuse prevention, intervention, treatment and rehabilitation services and must biennially submit a report to the legislature on plan implementation. The bill eliminates these requirements.

Under current law, a county department of human services or social services (county department) or, in a county having a population of 500,000 or more (Milwaukee County), DHFS or a licensed child welfare agency under contract with DHFS must determine, within 60 days after receiving a report of suspected or threatened child abuse, whether abuse, including emotional abuse, has occurred. Current law requires a county department or, in Milwaukee County, DHFS or a licensed child welfare agency under contract with DHFS, in making a determination that emotional damage has occurred, to give due regard to the culture of the subjects and to establish that the person alleged to be responsible for the emotional damage is neglecting, refusing or unable for reasons other than poverty to remedy the harm. Current law, however, defines emotional "abuse" as emotional damage for which the child's parent, guardian or legal custodian has neglected, refused or been unable for reasons other than poverty to obtain the necessary treatment or to take steps to ameliorate the symptoms.

This bill eliminates the requirement that a county department or, in Milwaukee County, DHFS or a licensed child welfare agency under contract with DHFS, in making a determination that emotional damage has occurred, establish that the person alleged to be responsible for the emotional damage is neglecting, refusing or unable for reasons other than poverty to remedy the harm.

Under current law, a court may relieve a party from a judgment or order for various reasons such as mistake, inadvertence, surprise, excusable neglect, newly discovered evidence, fraud of an adverse party or any other reason justifying relief from the operation of the judgment. Also under current law, the parent of a child whose status is adjudicated by the court assigned to exercise jurisdiction under the children's code (juvenile court) may at any time within one year after the entering of the juvenile court's order petition the juvenile court for a rehearing on the grounds that new evidence has been discovered affecting the advisability of the juvenile court's original adjudication.

This bill prohibits an adoptive parent from moving for relief from an order granting adoption of a child and from petitioning the juvenile court for a rehearing of such an order. Under the bill, the exclusive remedies for an adoptive parent who wishes to end his or her parental relationship with his or her adoptive child are a petition for termination of parental rights and an appeal to the court of appeals.

For further information, see the Notes provided by the law revision committee of the joint legislative council.

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:

Law revision committee prefatory note: This bill is a remedial legislation proposal, requested by the department of health and family services and introduced by the law revision committee under s. 13.83 (1) (c) 4., stats. After careful consideration of the various provisions of the bill, the law revision committee has determined that this bill makes minor substantive changes in the statutes, and that these changes are desirable as a matter of public policy.

SB495, s. 1 Section 1 . 46.275 (5) (b) 7. of the statutes is created to read:

SB495,6,5 46.275 (5) (b) 7. Provide services in any community-based residential facility unless the county or department uses as a service contract the approved model contract developed under s. 46.27 (2) (j) or a contract that includes all of the provisions of the approved model contract.

SB495, s. 2 Section 2 . 46.277 (5) (f) of the statutes is created to read:

SB495,6,11 46.277 (5) (f) No county or private nonprofit agency may use funds received under this subsection to provide services in any community-based residential facility unless the county or agency uses as a service contract the approved model contract developed under s. 46.27 (2) (j) or a contract that includes all of the provisions of the approved model contract.

Note: The amendments in Sections 1 and 2 require the use of the approved model contract under s. 46.27 (2) (j), or a similar contract, when providing services in any community-based residential facility (CBRF) under the community integration program (CIP) I-A or I-B. According to the Department of Health and Family Services (DHFS), the use of this model contract is currently required for persons receiving services in a CBRF under the community options program (COP). Because funds from both COP and CIP I-A and I-B may be used to fund care in a particular CBRF, it would eliminate confusion to have only one contract format in use for providers to review and sign.

SB495, s. 3 Section 3 . 46.56 (14) (a) (intro.) and 1. of the statutes, as affected by 1997 Wisconsin Act 3, are consolidated, renumbered 46.56 (14) (a) and amended to read:

SB495,7,17 46.56 (14) (a) In order to support the development of a comprehensive system of coordinated care for children with severe disabilities and their families, the department shall establish a statewide advisory committee with representatives of county departments, the department of public instruction, educational agencies, professionals experienced in the provision of services to children with severe disabilities, families with children with severe disabilities, advocates for such families and their children, the subunit of the department of workforce development that administers vocational rehabilitation, the technical college system, health care providers, courts assigned to exercise jurisdiction under chs. 48 and 938, child welfare officials, and other appropriate persons as selected by the department. The department may use an existing committee for this purpose if it has representatives from the listed groups and is willing to perform the required functions. This committee shall do all of the following: Monitor monitor the development of programs throughout the state and support communication and mutual assistance among operating programs as well as those that are being developed.

SB495, s. 4 Section 4. 46.56 (14) (a) 2. of the statutes is repealed.

SB495, s. 5 Section 5. 46.56 (14) (c) (intro.) of the statutes is amended to read:

SB495,8,4 46.56 (14) (c) (intro.) The department shall evaluate the programs funded under this section. The report of this evaluation shall be submitted to the chief clerk of each house of the legislature for distribution to the appropriate standing committees on children, in the manner provided in s. 13.172 (3), and shall be broadly disseminated to county departments and school districts. The evaluation shall be completed by January 1, 1992 and all All organizations participating in the program shall cooperate with the evaluation. The evaluation shall include information about all of the following:

SB495, s. 6 Section 6 . 46.56 (15) (c) of the statutes is amended to read:

SB495,8,11 46.56 (15) (c) In order to obtain funds under this section, matching funds equal to 20% of the proposed total program budget, including the requested funding, shall be provided by the participating county departments and school districts. All of the participating county departments and school districts shall participate in providing the match, which may be cash or in-kind. The department shall determine what may be used as in-kind match.

Note: The amendments in Sections 3 to 6 eliminate outdated provisions regarding specific evaluation due dates of programs for children with severe emotional disturbances and also eliminate outdated provisions regarding dissemination of these evaluations. Further, these amendments modify the matching fund requirement for these projects from 20% of the requested funding to 20% of the proposed total program budget. According to the DHFS, this change to the matching funds requirement would codify current practice.

SB495, s. 7 Section 7. 46.974 of the statutes, as affected by 1997 Wisconsin Act 27, is repealed.

Note: This provision deletes a requirement that the DHFS prepare, in cooperation with the department of public instruction, a joint alcohol and drug abuse prevention plan. According to the DHFS, the elimination of this requirement will allow the State Council on Alcohol and Other Drug Abuse to determine how interdepartmental collaboration and reporting will occur.

SB495, s. 8 Section 8 . 48.46 (1) of the statutes is amended to read:

SB495,9,2 48.46 (1) Except as provided in sub. subs. (2) and (3), the parent, guardian or legal custodian of the child or the child whose status is adjudicated by the court may at any time within one year after the entering of the court's order petition the court for a rehearing on the ground that new evidence has been discovered affecting the advisability of the court's original adjudication. Upon a showing that such evidence does exist, the court shall order a new hearing.