1999 - 2000 LEGISLATURE
March 15, 2000 - Introduced by Representatives Hundertmark, Suder, La Fave,
Ainsworth, Jeskewitz, Ladwig, Montgomery, Brandemuehl, Musser, F.
Lasee, Balow, Leibham, Steinbrink, Johnsrud, Meyer, Meyerhofer, Schooff,
Rhoades, Plouff, Stone, Plale, Powers, Porter, Waukau, Boyle, Handrick,
J. Lehman, Spillner and Kelso, cosponsored by Senators Grobschmidt,
Erpenbach and Huelsman. Referred to Committee on Health.
AB880,1,7
1An Act to repeal 46.27 (7b);
to consolidate, renumber and amend 46.27 (11)
2(c) 6. (intro.) and a.;
to amend 46.27 (3) (f), 46.27 (7) (cm) 1. (intro.), 46.27 (7)
3(cm) 1. c., 46.27 (11) (c) 6. b., 46.277 (5) (d) 1m. (intro.), 46.277 (5) (d) 1n. (intro.)
4and 46.277 (5) (d) 2. (intro.);
to repeal and recreate 46.277 (5) (d) 2. a.; and
5to create 46.277 (5) (d) 4. of the statutes;
relating to: the use of community
6options program funds and community integration program funds to provide
7services in community-based residential facilities.
Analysis by the Legislative Reference Bureau
Currently, home and community-based long-term care is provided to persons
who are elderly, physically or developmentally disabled, chronically mentally ill or
chemically dependent as a benefit under the long-term support community options
program (COP). COP provides assessments of functionality and home and
community-based care as an alternative to institutionalized care; one part of COP
(commonly referred to as "COP-Regular") is funded by state general purpose
revenues and the other part (commonly referred to as "COP-Waiver") is funded by
the joint federal-state program of medical assistance, under a waiver of federal
medicaid laws. Also under a waiver of federal medicaid laws, a community
integration program (commonly referred to as "CIP II") provides home and
community-based services and continuity of care for persons who meet medical
assistance eligibility requirements and are relocated from certain institutions or
meet requirements for medical assistance reimbursement in nursing homes.
Numerous restrictions exist on the use of COP-Regular, COP-Waiver or CIP II funds
to provide eligible individuals with services in community-based residential
facilities (C-BRFs). Among these restrictions is the requirement that a county
annually establish a maximum total amount, from the county's annual allocation,
that may be encumbered in a calendar year for COP services to eligible individuals
in C-BRFs, unless the department of health and family services (DHFS) grants a
hardship exception for an individual or waives the requirement. Other provisions
restrict the licensed capacity of a C-BRF in which an individual may reside and
receive COP services. Under COP-Regular, a county, non-profit agency or aging
unit may not use funds to provide services in a C-BRF that has more than eight beds,
unless DHFS approves service provision in a C-BRF that was licensed on July 29,
1995, or is licensed for 20 or fewer beds and meets certain standards; or unless the
C-BRF entirely consists of independent apartments and the residents are aged or
physically disabled and eligible for COP-Regular. Under COP-Waiver, a county,
nonprofit agency or aging unit may not use funds to provide services in a C-BRF that
has more than four beds, unless DHFS approves service provision in a C-BRF that
entirely consists of independent apartments with residents who are aged or
physically disabled and eligible for COP-Waiver; or in a C-BRF that has five to eight
beds. Subject to DHFS approval, a county may establish more restrictive conditions
than these on the provision of services to a person in a C-BRF. CIP II restrictions
with respect to C-BRFs are similar to those under COP-Waive.
Under
1999 Wisconsin Act 9 (the biennial budget act), DHFS must establish a
pilot project in Chippewa County under which that county, in determining the cost
effectiveness of a placement for COP-Regular services in a C-BRF, must consider all
state and federal funds needed for all options considered. Further, in that county,
the county, a private nonprofit agency or an aging unit may use COP-Regular funds
to provide services in any C-BRF that has 20 or fewer beds, but must meet certain
restrictions for provision of services in a C-BRF with more than 20 beds.
This bill eliminates the eight-bed restriction under COP-Regular and the
four-bed restriction under COP-Waiver and CIP II for provision of services in a
C-BRF and limits service provision to 20-bed C-BRFs, unless otherwise approved
by DHFS under current standards. Lastly, the bill eliminates the COP-Regular pilot
project in Chippewa County.
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:
AB880, s. 1
1Section
1. 46.27 (3) (f) of the statutes is amended to read:
AB880,3,6
146.27
(3) (f) Beginning on January 1, 1996, from the annual allocation to the
2county for the provision of long-term community support services under subs. (7) (b)
3and (11), annually establish a maximum total amount that may be encumbered in
4a calendar year for services for eligible individuals in community-based residential
5facilities
, unless the department waives the requirement under sub (2) (i) or
6approves a request for an exception under sub. (6r) (c).
AB880,3,129
46.27
(7) (cm) 1. (intro.)
Except as provided sub. (7b), beginning Beginning on
10January 1, 1996, no county, private nonprofit agency or aging unit may use funds
11received under par. (b) to provide services in any community-based residential
12facility that has more than
8 20 beds, unless one of the following applies:
AB880, s. 3
13Section
3. 46.27 (7) (cm) 1. c. of the statutes is amended to read:
AB880,3,1714
46.27
(7) (cm) 1. c. The department approves the provision of services in a
15community-based residential facility that is initially licensed after July 29, 1995,
16that is licensed for
more than 20
or fewer beds and that meets standards established
17under subd. 2.
AB880, s. 5
20Section
5. 46.27 (11) (c) 6. (intro.) and a. of the statutes are consolidated,
21renumbered 46.27 (11) (c) 6. a. and amended to read:
AB880,4,222
46.27
(11) (c) 6. a. No county, private nonprofit agency or aging unit may use
23funds received under this subsection to provide residential services in
any
24community-based residential facility, as defined in s. 50.01 (1g), or a group home, as
25defined in s. 48.02 (7), that has more than
4 5 beds, unless
one of the following
1applies: a. The the department approves the provision of services in a
2community-based residential facility or group home that has
5 6 to 8 beds.
AB880, s. 6
3Section
6. 46.27 (11) (c) 6. b. of the statutes is amended to read:
AB880,4,124
46.27
(11) (c) 6. b.
The No county, private nonprofit agency or aging unit may
5use funds received under this subsection to provide residential services in a
6community-based residential facility, as defined in s. 50.01 (1g), that has more than
720 beds, unless the department approves the provision of services in a
8community-based residential facility that entirely consists of independent
9apartments, each of which has an individual lockable entrance and exit and
10individual separate kitchen, bathroom, sleeping and living areas, to individuals who
11are eligible under this subsection and are physically disabled or are at least 65 years
12of age.
AB880, s. 7
13Section
7. 46.277 (5) (d) 1m. (intro.) of the statutes is amended to read:
AB880,4,1714
46.277
(5) (d) 1m. (intro.) No county may use funds received under this section
15to provide services to a person who does not live in his or her own home or apartment
16unless, subject to the limitations under subds. 2.
and
, 3.
and 4. and par. (e), one of
17the following applies:
AB880, s. 8
18Section
8. 46.277 (5) (d) 1n. (intro.) of the statutes is amended to read:
AB880,4,2419
46.277
(5) (d) 1n. (intro.) A county may also use funds received under this
20section, subject to the limitations under subds. 2.
and
, 3.
and 4. and par. (e), to provide
21services to a person who does not live in his or her own home or apartment if the
22services are provided to the person in a community-based residential facility and the
23county department or aging unit has determined that all of the following conditions
24have been met:
AB880, s. 9
25Section
9. 46.277 (5) (d) 2. (intro.) of the statutes is amended to read:
AB880,5,4
146.277
(5) (d) 2. (intro.) No county may use funds received under this section
2to provide residential services in any community-based residential facility, as
3defined in s. 50.01 (1g),
or group home, as defined in s. 48.02 (7), that has more than
44 beds, unless one of the following applies:
AB880, s. 10
5Section
10. 46.277 (5) (d) 2. a. of the statutes is repealed and recreated to read:
AB880,5,66
46.277
(5) (d) 2. a. The requirements of s. 46.27 (7) (cm) 1. a. or c. are met.
AB880, s. 11
7Section
11. 46.277 (5) (d) 4. of the statutes is created to read:
AB880,5,118
46.277
(5) (d) 4. No county may use funds received under this section to provide
9residential services in a group home, as defined in s. 48.02 (7), that has more than
105 beds, unless the department approves the provision of services in a group home that
11has 6 to 8 beds.