SB45: Bill Text

SB45, s. 1047 Section 1047. 46.27 (7) (fr) of the statutes is created to read:

SB45,593,5 46.27 (7) (fr) 1. Notwithstanding s. 46.036 (3) and (5m), a county may place in a risk reserve funds that are allocated under par. (am) or (b) or sub. (11) (c) 3. and are not expended or encumbered for services under this subsection or sub. (11). The county shall notify the department of this decision and of the amount to be placed in the risk reserve. The county shall maintain the risk reserve in an interest-bearing escrow account with a financial institution, as defined in s. 69.30 (1) (b), if the department has approved the terms of the escrow. All interest from the principal shall be reinvested in the escrow account.

SB45,593,10 2. The annual amount of a county's expenditure for a risk reserve, as specified in subd. 1., may not exceed 10% of the county's most recent allocation under pars. (am) and (b) and sub. (11) (c) 3. or $750,000, whichever is less. The total amount of the risk reserve, including interest, may not exceed 15% of the county's most recent allocation under this subsection.

SB45,593,12 3. A county may expend funds maintained in a risk reserve, as specified in subd. 1., for any of the following purposes:

SB45,593,13 a. To defray costs of long-term community support services under this section.

SB45,593,15 b. To meet requirements under any contract that the county has with the department to operate a care management organization under s. 46.284.

SB45,593,17 c. If approved by a resolution of the county board of supervisors, to transfer funds to a family care district.

SB45,593,19 d. If approved by the department, for administrative or staff costs under this section.

SB45,593,22 4. A county that maintains a risk reserve, as specified in subd. 1., shall annually, on a form prescribed by the department, submit to the department a record of the status of the risk reserve, including revenues and disbursements.

SB45, s. 1048 Section 1048. 46.27 (7) (g) (intro.) of the statutes is amended to read:

SB45,594,9 46.27 (7) (g) (intro.) The department may carry forward to the next state fiscal year up to $500,000 of funds allocated under this subsection and not encumbered by counties by December 31 or carried forward under par. (fm). The department may transfer moneys within s. 20.435 (7) (bd) to accomplish this purpose. An allocation under this paragraph shall not affect a county's base allocation for the program. The department may allocate these transferred moneys during the next fiscal year to counties for planning and implementation of resource centers under s. 46.283 or care management organizations under s. 46.284 and for the improvement or expansion of long-term community support services for clients whose cost of care significantly exceeds the average cost of care provided under this section, including any of the following:

SB45, s. 1049 Section 1049. 46.27 (7g) (c) 3. (intro.) of the statutes is amended to read:

SB45,594,14 46.27 (7g) (c) 3. (intro.) The court shall reduce the amount of a claim under subd. 1. by up to $3,000 the amount specified in s. 861.33 (2) if necessary to allow the client's heirs or the beneficiaries of the client's will to retain the following personal property:

SB45, s. 1050 Section 1050. 46.27 (7g) (c) 3. c. of the statutes is amended to read:

SB45,594,18 46.27 (7g) (c) 3. c. Other tangible personal property not used in trade, agriculture or other business, not to exceed $1,000 in value the amount specified in s. 861.33 (1) (a) 4.

SB45, s. 1051 Section 1051. 46.27 (7g) (c) 5. of the statutes is renumbered 46.27 (7g) (c) 5. a. and amended to read:

SB45,595,2 46.27 (7g) (c) 5. a. If the department's claim is not allowable because of subd. 4. and the estate includes an interest in a home, the court exercising probate jurisdiction shall, in the final judgment or summary findings and order, assign the interest in the home subject to a lien in favor of the department for the amount described in subd. 1. The personal representative or petitioner for summary settlement or summary assignment of the estate shall record the final judgment as provided in s. 863.29, 867.01 (3) (h) or 867.02 (2) (h).

SB45, s. 1052 Section 1052. 46.27 (7g) (c) 5. b. of the statutes is created to read:

SB45,595,10 46.27 (7g) (c) 5. b. If the department's claim is not allowable because of subd. 4., the estate includes an interest in a home and the personal representative closes the estate by sworn statement under s. 865.16, the personal representative shall stipulate in the statement that the home is assigned subject to a lien in favor of the department for the amount described in subd. 1. The personal representative shall record the statement in the same manner as described in s. 863.29, as if the statement were a final judgment.

SB45, s. 1053 Section 1053. 46.27 (7g) (h) of the statutes is created to read:

SB45,595,13 46.27 (7g) (h) The department may contract with or employ an attorney to probate estates to recover under this subsection the costs of care.

SB45, s. 1054 Section 1054. 46.27 (9) (a) of the statutes is amended to read:

SB45,595,23 46.27 (9) (a) The department may select up to 5 counties that volunteer to participate in a pilot project under which they will receive certain funds allocated for long-term care. The department shall allocate a level of funds to these counties equal to the amount that would otherwise be paid under s. 20.435 (5) (4) (b) to nursing homes for providing care because of increased utilization of nursing home services, as estimated by the department. In estimating these levels, the department shall exclude any increased utilization of services provided by state centers for the developmentally disabled. The department shall calculate these amounts on a calendar year basis under sub. (10).

SB45, s. 1055 Section 1055. 46.27 (9) (c) of the statutes is amended to read:

SB45,596,6 46.27 (9) (c) All long-term community support services provided under this pilot project in lieu of nursing home care shall be consistent with those services described in the participating county's community options plan under sub. (4) (c) 1. and provided under sub. (5) (b). Unless the department has contracted under s. 46.271 (2m) 46.281 (1) (d) with an entity other than the county department, each county participating in the pilot project shall assess persons under sub. (6).

SB45, s. 1056 Section 1056. 46.27 (10) (a) 1. of the statutes is amended to read:

SB45,596,12 46.27 (10) (a) 1. The department shall determine for each county participating in the pilot project under sub. (9) a funding level of state medical assistance expenditures to be received by the county. This level shall equal the amount that the department determines would otherwise be paid under s. 20.435 (5) (4) (b) because of increased utilization of nursing home services, as estimated by the department.

SB45, s. 1057 Section 1057. 46.27 (11) (c) 3. of the statutes is amended to read:

SB45,596,17 46.27 (11) (c) 3. Medical assistance reimbursement for services a county, a private nonprofit agency or an aging unit with which the department contracts provides under this subsection shall be made from the appropriations under s. 20.435 (5) (4) (o) and (7) (b) and (bd).

SB45, s. 1058 Section 1058. 46.27 (11) (c) 4. of the statutes is amended to read:

SB45,596,23 46.27 (11) (c) 4. The department may, from the appropriation under s. 20.435 (5) (4) (o), provide reimbursement for services provided under this subsection by counties that are in excess of the current average annual per person rate, as established by the department, and are less than or equal to the average amount approved in the waiver received under par. (am).

SB45, s. 1059 Section 1059. 46.27 (11) (c) 5n. a. of the statutes is amended to read:

SB45,597,7 46.27 (11) (c) 5n. a. An assessment under sub. (6) has been completed for the person prior to the person's admission to the community-based residential facility, whether or not the person is a private pay admittee at the time of admission. The county may waive this condition in accordance with guidelines established by the department. If the county waives this condition, the county must meet with the person or the person's guardian to discuss the cost-effectiveness of various service options.

SB45, s. 1060 Section 1060. 46.271 (2m) of the statutes is repealed.

SB45, s. 1061 Section 1061. 46.275 (5) (a) of the statutes is amended to read:

SB45,597,15 46.275 (5) (a) Medical assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriations under s. 20.435 (5) (4) (b) and (o). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, medical assistance reimbursement is also available for services provided jointly by these counties.

SB45, s. 1062 Section 1062. 46.275 (5) (c) of the statutes is amended to read:

SB45,597,23 46.275 (5) (c) The total allocation under s. 20.435 (5) (4) (b) and (o) to counties and to the department under sub. (3r) for services provided under this section may not exceed the amount approved by the federal department of health and human services. A county may use funds received under this section only to provide services to persons who meet the requirements under sub. (4) and may not use unexpended funds received under this section to serve other developmentally disabled persons residing in the county.

SB45, s. 1063 Section 1063. 46.275 (5) (d) of the statutes is amended to read:

SB45,598,5 46.275 (5) (d) The department may, from the appropriation under s. 20.435 (5) (4) (o), provide reimbursement for services provided under this section by counties that are in excess of the current average annual per person rate, as established by the department, and are less than the average amount approved in the waiver received under sub. (2).

SB45, s. 1064 Section 1064. 46.277 (5) (d) 1n. a. of the statutes is amended to read:

SB45,598,13 46.277 (5) (d) 1n. a. An assessment under s. 46.27 (6) has been completed for the person prior to the person's admission to the community-based residential facility, whether or not the person is a private pay admittee at the time of admission. The county may waive this condition in accordance with guidelines established by the department. If the county waives this condition, the county must meet with the person or the person's guardian to discuss the cost-effectiveness of various service options.

SB45, s. 1065 Section 1065. 46.278 (6) (d) of the statutes is amended to read:

SB45,598,20 46.278 (6) (d) If a county makes available nonfederal funds equal to the state share of service costs under the waiver received under sub. (3), the department may, from the appropriation under s. 20.435 (5) (4) (o), provide reimbursement for services that the county provides under this section to persons who are in addition to those who may be served under this section with funds from the appropriation under s. 20.435 (5) (4) (b).

SB45, s. 1066 Section 1066. 46.278 (6) (e) of the statutes is renumbered 46.278 (6) (e) 1. (intro.) and amended to read:

SB45,598,25 46.278 (6) (e) 1. (intro.) The department may provide enhanced reimbursement for services under the program for an individual who was relocated to the community by a county department from an one of the following:

SB45,599,2 a. An intermediate care facility for the mentally retarded that closes under s. 50.03 (14).

SB45,599,4 2. The enhanced reimbursement rate under this paragraph shall be determined under a formula that is developed by the department.

SB45, s. 1067 Section 1067. 46.278 (6) (e) 1. b. of the statutes is created to read:

SB45,599,8 46.278 (6) (e) 1. b. An intermediate care facility for the mentally retarded or a distinct part thereof that has a plan of closure approved by the department and that intends to close within 12 months.

SB45, s. 1068 Section 1068. 46.2805 of the statutes is created to read:

SB45,599,10 46.2805 Definitions; long-term care. In ss. 46.2805 to 46.2895:

SB45,599,15 (1) "Care management organization" means an entity that is certified as meeting the requirements for a care management organization under s. 46.284 (3) and that has a contract under s. 46.284 (2). "Care management organization" does not mean an entity that contracts with the department to operate one of the following:

SB45,599,17 (a) A program of all-inclusive care for persons aged 65 or older authorized under 42 USC 1395 to 1395ggg.

SB45,599,19 (b) A demonstration program known as the Wisconsin partnership program under a federal waiver authorized under 42 USC 1315.

SB45,599,21 (2) "Eligible person" means a person who meets all eligibility criteria under s. 46.286 (1) or (1m).

SB45,599,23 (3) "Enrollee" means a person who is enrolled in a care management organization.

SB45,599,25 (4). "Family care benefit" means financial assistance for long-term care and support items for an enrollee.

SB45,600,2 (5) "Family care district" means a special purpose district created under s. 46.2895 (1).

SB45,600,4 (6) "Family care district board" means the governing board of a family care district.

SB45,600,7 (7) "Functional and financial screen" means a screen prescribed by the department that is used to determine functional eligibility under s. 46.286 (1) (a) and financial eligibility under s. 46.286 (1) (b).

SB45,600,8 (8) "Nonprofit organization" has the meaning given in s. 108.02 (19).

SB45,600,9 (9) "Older person" means a person who is aged at least 65.

SB45,600,12 (10) "Resource center" means an entity that meets the standards for operation under s. 46.283 (3) or, if under contract to provide a portion of the services specified under s. 46.283 (3), meets the standards for operation with respect to those services.

SB45,600,14 (11) "Tribe or band" means a federally recognized American Indian tribe or band.

SB45, s. 1069 Section 1069. 46.281 of the statutes is created to read:

SB45,600,18 46.281 Powers and duties of the department and the secretary; long-term care. (1) Duties of the department. The department shall do all of the following:

SB45,600,22 (a) Provide training to members of the council on long-term care who are aged 65 or older or who have physical or developmental disabilities or their family members, guardians or other advocates, to enable these members to participate in the council's duties.

SB45,600,24 (b) Provide information to the council on long-term care and seek recommendations of the council.

SB45,601,7 (c) Request from the secretary of the federal department of health and human services any waivers of federal medicaid laws necessary to permit the use of federal moneys to provide the family care benefit to recipients of medical assistance. The department shall implement any waiver that is approved and that is consistent with ss. 46.2805 to 46.2895. Regardless of whether a waiver is approved, the department may implement operation of resource centers, care management organizations and the family care benefit.

SB45,601,8 (d) Before July 1, 2001:

SB45,601,12 1. Establish, in geographic areas determined by the department, a pilot project under which the department may contract with a county, a family care district, a tribe or band or the Great Lakes inter-tribal council, inc., or with any 2 or more of these entities under a joint application, to operate a resource center.

SB45,601,15 2. Contract with counties or tribes or bands under a pilot project to demonstrate the ability of counties or tribes or bands to manage all long-term care programs and administer the family care benefit as care management organizations.

SB45,601,19 (e) After June 30, 2001, contract with one or more entities certified as meeting requirements under s. 46.284 (3) for services of the entity as a care management organization and one or more entities for services specified under s. 46.283 (3) and (4).

SB45,601,21 (f) Prescribe and implement a per person monthly rate structure for costs of the family care benefit.

SB45,601,24 (g) In order to maintain continuous quality assurance and quality improvement for resource centers and care management organizations, do all of the following:

SB45,602,2 1. Prescribe by rule and by contract and enforce performance standards for operation of resource centers and care management organizations.

SB45,602,4 2. Use performance expectations that are related to outcomes for persons in contracting with care management organizations and resource centers.

SB45,602,6 3. Conduct ongoing evaluations of the long-term care system specified in ss. 46.2805 to 46.2895.

SB45,602,8 4. Require that quality assurance and quality improvement efforts be included throughout the long-term care system specified in ss. 46.2805 to 46.2895.

SB45,602,12 5. Ensure that reviews of the quality of management and service delivery of resource centers and care management organizations are conducted by external organizations and make information about specific review results available to the public.

SB45,602,16 (h) Require by contract that resource centers and care management organizations establish procedures under which an individual who applies for or receives the family care benefit may register a complaint or grievance and procedures for resolving complaints and grievances.

SB45,602,19 (i) Prescribe criteria to assign priority equitably on any necessary waiting lists for persons who are eligible for the family care benefit but who do not meet the criteria under s. 46.286 (3).

SB45,602,22 (2) Powers of the department. The department may develop risk-sharing arrangements in contracts with care management organizations, in accordance with applicable state laws and federal statutes and regulations.

SB45,603,5 (3) Duty of the secretary. The secretary shall certify to each county, nursing home, community-based residential facility, adult family home and residential care apartment complex the date on which a resource center that serves the area of the county, nursing home, community-based residential facility, adult family home or residential care apartment complex is first available to provide a functional and financial screen. To facilitate phase-in of services of resource centers, the secretary may certify that the resource center is available for specified groups of eligible individuals or for specified facilities in the county.

SB45, s. 1070 Section 1070. 46.281 (1) (a) of the statutes, as created by 1999 Wisconsin Act .... (this act), is repealed.

SB45, s. 1071 Section 1071. 46.281 (1) (b) of the statutes, as created by 1999 Wisconsin Act .... (this act), is repealed.

SB45, s. 1072 Section 1072. 46.282 of the statutes is created to read:

SB45,603,12 46.282 Council on long-term care. The council on long-term care appointed under s. 15.197 (5) shall do all of the following: