SB504: Bill Text

LRB-4801/1

DAK/GMM/PJK:cjs&kg:jf

1999 - 2000 LEGISLATURE

1999 Senate BILL 504

March 23, 2000 - Introduced by Law Revision Committee. Referred to Committee on Human Services and Aging.

SB504,2,15 An Act to repeal 46.036 (5m) (b) 3., 46.70 (3) and 46.717; to renumber 48.357 (5m) and 938.357 (5m); to renumber and amend 48.30 (6), 48.31 (7), 48.363 (1), 938.30 (6), 938.31 (7) and 938.363 (1); to consolidate, renumber and amend 46.70 (1) and (2); to amend 20.435 (3) (o), 20.435 (7) (o), 46.036 (5m) (b) 1., 46.036 (5m) (b) 2., 46.10 (1), 46.10 (14) (e) 1., 48.363 (1m), 48.363 (2), 48.57 (3m) (am) 5., 48.57 (3n) (am) 5., 49.45 (3) (e) 4., 50.035 (3) (a), 50.04 (6) (c), 50.04 (6) (d), 50.04 (6) (e), 50.053, 252.17 (3) (b), 252.17 (4) (a), 301.12 (1), 301.12 (14) (e) 1., 767.02 (1) (m), 767.30 (1), 767.305, 767.32 (1) (a), 767.32 (2r), 780.01 (5), 938.363 (1m) and 938.363 (2); and to create 48.30 (6) (c), 48.31 (7) (c), 48.355 (2) (b) 4m., 48.357 (5m) (b), 48.363 (1) (d), 48.75 (1g) (a) 5., 50.02 (2) (ag), 252.17 (4) (d), 252.17 (6) (c), 938.30 (6) (c), 938.31 (7) (c), 938.355 (2) (b) 4m., 938.357 (5m) (b) and 938.363 (1) (d) of the statutes; relating to: increasing the family income that an individual may have to be eligible for the medical leave premium subsidy program; changing the term "informal conference" to "case conference" for resolution of appeals of alleged violations by certain facilities; additional medical assistance payments to a hospital that qualifies as a disproportionate share hospital; the amounts of revenues in excess of allowable costs that may be retained by nonprofit providers of rate-based services under contracts with the department of health and family services or with certain county departments; requiring the presence of a manager or his or her agent at certain times in specifically classified community-based residential facilities; funding for fiscal year 1993-94 for pilot alcohol and other drug abuse treatment program for hearing-impaired individuals; funding for social services and mental hygiene services for American Indians; the provision of financial information by a parent of a child who is placed in substitute care; the licensing of foster homes; the conditions that must be met for a person to receive kinship care or long-term kinship care payments; and granting rule-making authority (suggested as remedial legislation by the department of health and family services).

Analysis by the Legislative Reference Bureau

Under current law, the department of health and family services (DHFS) pays the premiums for coverage under a group health plan for an individual who has HIV infection and who is on unpaid medical leave from his or her employment because of an illness or medical condition related to HIV infection. The individual must have coverage under the group health plan through his or her employment and the individual's family income may not exceed 200% of the federal poverty line. This bill changes the level of family income that an individual who is eligible for the program may have to 300% of the federal poverty line. If the individual's family income exceeds 200% of the federal poverty line, DHFS will pay only a portion of the individual's premium for the group health plan. DHFS must, by rule, establish a schedule for the amount of the premium that the individual must pay, taking into consideration both income and family size.

Currently, DHFS may hold informal conferences, prior to contested case hearings, to resolve issues related to alleged violations of licensure and other statutory requirements by nursing homes, community-based residential facilities, adult family homes and residential care apartment complexes. DHFS also is authorized to revoke a nursing home's license by issuing a conditional license, if DHFS finds that certain violations continue to exist in the nursing home. A nursing home may request an informal conference prior to issuance of the conditional license. This bill changes the term "informal conference" to "case conference".

Under current state law, DHFS may reimburse hospitals prospectively or retrospectively for providing services to recipients of medical assistance. For hospitals that DHFS reimburses retrospectively, total reimbursement during a hospital's fiscal year may not exceed the lower of the hospital's charges for the services or the actual and reasonable allowable costs to the hospital of providing the services. Under current federal law, a hospital that serves a high proportion of medical assistance recipients or low-income persons may qualify for increased medical assistance reimbursement as a "disproportionate share" hospital. This bill provides for increased medical assistance reimbursement for hospitals that are paid retrospectively under the medical assistance program and that qualify under federal requirements as "disproportionate share" hospitals.

Under current law, DHFS and county departments of social services, human services, developmental disabilities services and community programs contract with nonprofit agencies to provide rate-based services (services that are reimbursed through a prospectively set rate). The nonprofit service providers are authorized to retain limited amounts of revenues in excess of allowable costs that are incurred in the contract period. Amounts of revenue in excess of the limits must be returned to the purchaser upon request. The limits are specified under a two-part test. The first test caps the amount that is authorized to be retained at 5% of the contract amount. The second test caps accumulated reserves for all years at 10% of the amount of all current contracts for the rate-based service; if a provider has been able to retain excess revenue at this amount for four consecutive contract periods, the provider must apply 50% of that accumulated amount to reducing its unit rate of service per client for that rate-based service in the next contract period. Special provisions apply for excess revenues authorized to be retained in 1995. This bill changes the basis for calculating limits on amounts of revenues in excess of allowable costs that may be retained by nonprofit providers of rate-based services under contract with DHFS and county departments. Under the bill, the first limit is changed to cap the amount that a provider may retain at 5% of the revenue received under the contract, rather than 5% of the contract amount. The second limit is changed to cap an accumulated amount that a provider may retain at 10% of the revenue received under all current contracts for that rate-based service, rather than 10% of the amount of all current contracts. In addition, the bill eliminates the special provisions for excess revenues authorized to be retained in 1995.

Under current law, a community-based residential facility is defined to be a place where five or more adults reside who are unrelated to the operator or administrator and who do not require care above intermediate level nursing care. The residents may receive care, treatment or services above the level of room and board but that include no more than three hours of nursing care per week per resident. DHFS licenses and otherwise regulates community-based residential facilities. As part of that regulation, unless waived by DHFS, managers of "Class C" community-based residential facilities, or their agents, must be in the facility at any time that residents are. Managers of "Class A" or "Class B" community-based residential facilities must be in the facility from 7 p.m. to 7 a.m., when residents are in the facility, and must be available to residents from 7 a.m. to 7 p.m. The statutes refer to specified Wisconsin Administrative Code (rules) provisions for the definitions of "Class A", "Class B" and "Class C" community-based residential facilities; however, the rules specify designations only for "Class A" and "Class C" community-based residential facilities. This bill eliminates reference to "Class B" community-based residential facilities in provisions that require the manager's or his or her agent's presence in the facility. The bill requires that DHFS define "Class A" and "Class C" community-based residential facilities by rule.

Under current law, DHFS receives federal block grant funding for substance abuse treatment and community mental health programs. DHFS was directed to distribute $50,000 of that money to fund start-up costs for a pilot alcohol and other drug abuse treatment program for hearing-impaired individuals in fiscal year 1993-94. This bill eliminates the provision relating to the distribution of funding for those start-up costs for fiscal year 1993-94.

Under current law, DHFS provides funding to federally recognized tribal governing bodies to facilitate the delivery of social services and mental hygiene services by county departments of social services, county departments of community programs and county departments of developmental disabilities services. Current law includes ceilings for this funding for fiscal years 1991-92 and 1992-93. The provisions relating to this funding also condition its disbursement on DHFS approval of an application submitted by the tribal governing body and on the tribal governing body complying with certain accounting and reporting requirements. Current law, however, also permits DHFS to consolidate these funds with other funding appropriated for tribes for health and social services, without directly imposing such conditions on its disbursement. Finally, DHFS funds this program exclusively through general purpose revenues, while current law indicates that DHFS may use certain money from federal grants to fund it. This bill eliminates references to funding for this program which were applicable only to fiscal years 1991-92 and 1992-93. It also eliminates procedural requirements relating to the funding while maintaining DHFS' authority to consolidate and distribute it with other tribal health and social service funding. Finally, it eliminates cross-references between provisions relating to this program and certain appropriations provisions relating to federal grants.

Under current law, if it appears to the court assigned to exercise jurisdiction under the children's code and juvenile justice code (juvenile court) that the juvenile court's disposition of the case of a child or juvenile who is alleged to be in need of protection or services or of a juvenile who is alleged to be delinquent may include placement of the child or juvenile outside of his or her home, the juvenile court must order the parent of the child or juvenile to provide a statement of income, assets, debts and living expenses to the juvenile court or to the county department of human services or social services (county department), DHFS, the department of corrections (DOC) or the child welfare agency (collectively "agency") designated to provide a dispositional report to the juvenile court. Similarly, if a proposed change in placement of a child or juvenile who is subject to a dispositional order would change the placement of the child or juvenile from a placement in his or her home to a placement outside of his or her home or if a proposed revision of a dispositional order would change the amount of child support to be paid by a parent, the juvenile court must order the parent of the child or juvenile to provide such a statement to the juvenile court or to the person or agency that is primarily responsible for implementing the dispositional order. This bill provides that, if the juvenile court orders the parent of a child or juvenile to provide a statement of income, assets, debts and living expenses to the juvenile court, or orders the parent to provide such a statement to the agency designated to provide a dispositional report to the juvenile court or to the agency that is primarily responsible for implementing the juvenile court's dispositional order and that agency is not the county department or, in the case of a child in need of protection or services in Milwaukee County, DHFS, the juvenile court must also order the parent to provide such a statement to the county department or, in the case of a child in need of protection or services in Milwaukee County, DHFS. The county department or DHFS must use the information provided in the statement to determine whether DHFS or DOC may claim federal foster care and adoption assistance reimbursement under Title IV-E of the federal Social Security Act for the cost of providing care for the child.

Under current law, the county department of human services or social services or, in a county having a population of 500,000 or more, DHFS (public licensing agency) ordinarily may license a foster home only if the foster home is located in the county of the public licensing agency. A public licensing agency may, however, license a foster home located in another county if certain exceptions apply. This bill permits a public licensing agency to license a foster home located in another county on the request of the public licensing agency of the county in which the prospective foster home is located.

Under current law, certain relatives of a child who provide care and maintenance for the child are eligible for payments in the amount of $215 per month if certain conditions are met (kinship care relatives and long-term kinship care relatives). Those conditions include the condition that the kinship care relative or long-term kinship care relative cooperate with the county department of human services or social services (county department) or, in a county having a population of 500,000 or more, DHFS in the application process, including applying for other forms of assistance for which the kinship care relative or long-term kinship care relative may be eligible. This bill changes that condition to require the kinship care relative or long-term kinship care relative to cooperate with the county department or DHFS, including applying for other forms of assistance for which the child may be eligible.

For further information, see the Note 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.

This bill makes a number of minor substantive and remedial changes in statutes within the purview of the department of health and family services (DHFS). It includes:

1. Changing the eligibility level of family income for the medical leave premium subsidy program from 200% to 300% of the federal poverty line and permitting the DHFS by rule, to establish a schedule of the amount of the premium subsidy if the individual's family income exceeds 200% of the federal poverty line.

2. Changing references to the term "informal conference" to "case conference" for appeals of alleged violations by nursing homes, community-based residential facilities, adult family homes and residential care apartment complexes.

3. Providing for increased Medical Assistance reimbursement for hospitals that are paid retrospectively under the Medical Assistance program and that qualify under federal requirements as "disproportionate share" hospitals which serve a high proportion of Medical Assistance recipients or low-income persons.

4. Changing the basis for calculating limits on the amounts of revenues that may be retained by nonprofit providers of rate-based services under contract with the DHFS and county agencies.

5. Eliminating references to Class B community-based residential facilities in provisions that require the manager or his or her agent to be present in the facility and requires that DHFS define "Class A" and "Class C" community-based residential facilities by rule.

6. Repealing a provision relating to the distribution of alcohol and drug abuse treatment program funds in fiscal year 1993-94.

7. Eliminating references to funding for social services and mental hygiene services for American Indian tribes that were applicable only for fiscal years 1991-92 and 1993-94, eliminating procedural requirements relating to the funding and eliminating cross-references between provisions relating to that program and appropriation provisions relating to federal grants.

8. Providing that where a juvenile court has ordered the parent of a child or juvenile to provide a statement of income, assets, debts and living expenses to the court or orders a parent to provide such a statement to an agency that will provide a dispositional report to a juvenile court or that is responsible for implementing the dispositional order, the court must order the parent to provide such a statement to a county department of social services or the DHFS. The DHFS or agency must use the information in the statement to determine whether the DHFS or the department of corrections may claim reimbursement under certain programs for the costs of providing care to the child.

9. Permitting a public licensing agency to license a foster home located in another county upon the request of another licensing agency of the county in which the prospective foster home is located.

10. Changing kinship care laws to require the kinship care relative or long-term kinship care relative to cooperate with the county agency or DHFS, including applying for other forms of assistance for which a child in kinship care may be eligible.

SB504, s. 1 Section 1. 20.435 (3) (o) of the statutes is amended to read:

SB504,7,6 20.435 (3) (o) Community aids; prevention activities. All federal moneys received under 42 USC 300x-21 to 300x-35 in amounts pursuant to allocation plans developed by the department of health and family services for the provision or purchase of services authorized under sub. (7) (b) and s. 46.70 for distribution under s. 46.40 (2m) (a) for prevention related activities.

SB504, s. 2 Section 2. 20.435 (7) (o) of the statutes is amended to read:

SB504,7,18 20.435 (7) (o) Federal aid; community aids. All federal moneys received in amounts pursuant to allocation plans developed by the department for the provision or purchase of services authorized under par. (b) and s. 46.70; all federal moneys received as child welfare funds under 42 USC 620 to 626 as limited under s. 48.985; all moneys transferred under 1997 Wisconsin Act 237, section 9222 (3), from the appropriation account under par. (md); and all unanticipated federal social services block grant funds received under 42 USC 1397 to 1397e, in accordance with s. 46.49 (2), for distribution under s. 46.40. Disbursements from this appropriation may be made directly to counties for social and mental hygiene services under s. 46.03 (20) (b) or 46.031 or directly to counties in accordance with federal requirements for the disbursal of federal funds.

SB504, s. 3 Section 3. 46.036 (5m) (b) 1. of the statutes is amended to read:

SB504,8,5 46.036 (5m) (b) 1. Subject to subds. 2. and 3. subd. 2., if revenue under a contract for the provision of a rate-based service exceeds allowable costs incurred in the contract period, the provider may retain from the surplus generated by that rate-based service up to 5% of the revenue received under the contract amount. A provider that retains a surplus under this subdivision shall use that retained surplus to cover a deficit between revenue and allowable costs incurred in any preceding or future contract period for the same rate-based service that generated the surplus or to address the programmatic needs of clients served by the same rate-based service that generated the surplus.

SB504, s. 4 Section 4. 46.036 (5m) (b) 2. of the statutes is amended to read:

SB504,8,19 46.036 (5m) (b) 2. Subject to subd. 3., a A provider may accumulate funds from more than one contract period under this paragraph, except that, if at the end of a contract period the amount accumulated from all contract periods for a rate-based service exceeds 10% of the amount of revenue received under all current contracts for that rate-based service, the provider shall, at the request of a purchaser, return to that purchaser the purchaser's proportional share of that excess and use any of that excess that is not returned to a purchaser to reduce the provider's unit rate per client for that rate-based service in the next contract period. If a provider has held for 4 consecutive contract periods an accumulated reserve for a rate-based service that is equal to or exceeds 10% of the amount of revenue received under all current contracts for that rate-based service, the provider shall apply 50% of that accumulated amount to reducing its unit rate per client for that rate-based service in the next contract period.

SB504, s. 5 Section 5. 46.036 (5m) (b) 3. of the statutes is repealed.

SB504, s. 6 Section 6. 46.10 (1) of the statutes is amended to read:

SB504,8,25 46.10 (1) Liability and the collection and enforcement of such liability for the care, maintenance, services and supplies specified in this section is governed exclusively by this section, except in cases of child support ordered by a court under s. 48.355 (2) (b) 4., 48.357 (5m) (a) or 48.363 (2) or ch. 767.

SB504, s. 7 Section 7. 46.10 (14) (e) 1. of the statutes is amended to read:

SB504,9,9 46.10 (14) (e) 1. An order issued under s. 48.355 (2) (b) 4., 48.357 (5m) (a) or 48.363 (2) for support determined under this subsection constitutes an assignment of all commissions, earnings, salaries, wages, pension benefits, benefits under ch. 102 or 108 and other money due or to be due in the future to the county department under s. 46.22 or 46.23 in the county where the order was entered or to the department, depending upon the placement of the child as specified by rules promulgated under subd. 5. The assignment shall be for an amount sufficient to ensure payment under the order.

SB504, s. 8 Section 8. 46.70 (1) and (2) of the statutes, as affected by 1999 Wisconsin Act 9, are consolidated, renumbered 46.70 and amended to read:

SB504,9,25 46.70 Delivery of services to American Indians. To facilitate the delivery of accessible, available and culturally appropriate social services and mental hygiene services to American Indians by county departments under s. 46.215, 46.22, 51.42 or 51.437, the department may fund federally recognized tribal governing bodies. (2) From the appropriations in this state from the appropriation under s. 20.435 (7) (kL) and (o), the department may make available to any of the 11 federally recognized tribal governing bodies in this state funds for the purposes stated in sub. (1). Beginning July 1, 1991, and ending September 30, 1991, the department may award to each tribal governing body up to $6,800. Beginning October 1, 1991, and ending September 30, 1992, the department may award to each tribal governing body up to $27,200. Beginning October 1, 1992, and ending June 30, 1993, the department may award to each tribal governing body up to $20,400. Receipt of funds is contingent upon department approval of an application submitted by a tribal governing body. The department may partially approve any application and provide only part of the funds requested. Each application shall contain a plan for expenditure of funds, consistent with the purposes stated in sub. (1).

SB504, s. 9 Section 9. 46.70 (3) of the statutes is repealed.

SB504, s. 10 Section 10. 46.717 of the statutes is repealed.