SB44: Bill Text

SB44, s. 1103 Section 1103. 46.22 (1) (b) 4m. d. of the statutes is amended to read:

SB44,529,23 46.22 (1) (b) 4m. d. To provide information on the income eligibility for weatherization of a recipient of low-income energy assistance to an entity with which the department of administration contracts for provision of weatherization under s. 16.39 16.26.

SB44, s. 1104 Section 1104. 46.22 (1) (b) 4m. e. of the statutes is amended to read:

SB44,530,3 46.22 (1) (b) 4m. e. To receive a request, determine a correct payment amount, if any, and provide payment, if any, for emergency assistance under s. 16.385 16.27 (8).

SB44, s. 1105 Section 1105. 46.22 (1) (d) of the statutes is amended to read:

SB44,530,11 46.22 (1) (d) Merit system; records. The county department of social services is subject to s. 49.33 49.78 (4) to (7). The county department of social services and all county officers and employees performing any duties in connection with the administration of aid to families with dependent children shall observe all rules promulgated by the department of workforce development under s. 49.33 49.78 (4) and shall keep records and furnish reports as the department of workforce development requires in relation to their performance of such duties.

SB44, s. 1106 Section 1106. 46.22 (2) (b) of the statutes is amended to read:

SB44,530,17 46.22 (2) (b) Appoint the county social services director under sub. (3) subject to s. 49.33 49.78 (4) to (7) and the rules promulgated thereunder and subject to the approval of the county board of supervisors in a county with a single-county department of social services or the county boards of supervisors in counties with a multicounty department of social services.

SB44, s. 1107 Section 1107. 46.22 (3m) (a) of the statutes is amended to read:

SB44,531,2 46.22 (3m) (a) In any county with a county executive or a county administrator which that has established a single-county department of social services, the county executive or county administrator, subject to s. 49.33 49.78 (4) to (7) and the rules promulgated thereunder, shall appoint and supervise the county social services director. The appointment is subject to the confirmation of the county board of supervisors unless the county board of supervisors, by ordinance, elects to waive confirmation or unless the appointment is made under a civil service system competitive examination procedure established under s. 59.52 (8) or ch. 63.

SB44, s. 1108 Section 1108. 46.27 (7) (am) of the statutes is amended to read:

SB44,531,12 46.27 (7) (am) From the appropriation under s. 20.435 (7) (bd), the department shall allocate funds to each county or private nonprofit agency with which the department contracts to pay assessment and case plan costs under sub. (6) not otherwise paid by fee or under s. 49.33 (2) or 49.45 or 49.78 (2). The department shall reimburse counties for the cost of assessing persons eligible for medical assistance under s. 49.46, 49.468, or 49.47 as part of the administrative services of medical assistance, payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this paragraph to pay the cost of long-term community support services and for a risk reserve under par. (fr).

SB44, s. 1109 Section 1109. 46.27 (7) (fm) of the statutes is amended to read:

SB44,532,2 46.27 (7) (fm) The department shall, at the request of a county, carry forward up to 10% 5% of the amount allocated under this subsection to the county for a calendar year if up to 10% 5% of the amount so allocated has not been spent or encumbered by the county by December 31 of that year, for use by the county in the following calendar year, except that the amount carried forward shall be reduced by the amount of funds that the county has notified the department that the county wishes to place in a risk reserve under par. (fr). The department may transfer funds within s. 20.435 (7) (bd) to accomplish this purpose. An allocation under this paragraph does not affect a county's base allocation under this subsection and shall lapse to the general fund unless expended within the calendar year to which the funds are carried forward. A county may not expend funds carried forward under this paragraph for administrative or staff costs, except administrative or staff costs that are associated with implementation of the waiver under sub. (11) and approved by the department.

SB44, s. 1110 Section 1110. 46.27 (7g) (h) of the statutes is amended to read:

SB44,532,5 46.27 (7g) (h) The department may contract with or employ retain an attorney to probate estates to recover under this subsection the costs of care.

SB44, s. 1111 Section 1111. 46.27 (9) (a) of the statutes is amended to read:

SB44,532,15 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 (4) (b), (gp), (r), or (w) 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).

SB44, s. 1112 Section 1112. 46.27 (10) (a) 1. of the statutes is amended to read:

SB44,532,22 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 (4) (b), (gp), (r), or (w) because of increased utilization of nursing home services, as estimated by the department.

SB44, s. 1113 Section 1113. 46.275 (5) (a) of the statutes is amended to read:

SB44,533,5 46.275 (5) (a) Medical assistance Assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriations appropriation accounts under s. 20.435 (4) (b), (gp), (hm), (o), (r), and (w). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, medical assistance Medical Assistance reimbursement is also available for services provided jointly by these counties.

SB44, s. 1114 Section 1114. 46.275 (5) (c) of the statutes is amended to read:

SB44,533,13 46.275 (5) (c) The total allocation under s. 20.435 (4) (b), (gp), (hm), (o), (r), and (w) 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.

SB44, s. 1115 Section 1115. 46.275 (5) (e) of the statutes is created to read:

SB44,533,18 46.275 (5) (e) From the appropriation under s. 20.435 (2) (gL), the department may provide moneys to a county to pay for one-time costs associated with the relocation under this section of an individual from a state center for the developmentally disabled.

SB44, s. 1116 Section 1116. 46.277 (1m) (ak) of the statutes is created to read:

SB44,533,22 46.277 (1m) (ak) "Nursing home" means a nursing home, as defined in s. 50.01 (3), that is certified as a provider of medical assistance, other than an intermediate care facility for the mentally retarded, as defined in s. 46.278 (1m) (am).

SB44, s. 1117 Section 1117. 46.277 (2) (b) of the statutes is amended to read:

SB44,534,3 46.277 (2) (b) Fund Except as provided in subs. (3r) and (5) (bm), fund home or community-based services provided by any county that meet the requirements of this section.

SB44, s. 1118 Section 1118. 46.277 (3) (c) of the statutes is amended to read:

SB44,534,10 46.277 (3) (c) Beginning on January 1, 1996, from the annual allocation to the county for the provision of long-term community support services under sub. (5), except as provided in subs. (3r) and (5) (bm), a county department participating in the program shall annually establish a maximum total amount that may be encumbered in a calendar year for services for eligible individuals in community-based residential facilities.

SB44, s. 1119 Section 1119. 46.277 (3r) of the statutes is created to read:

SB44,534,21 46.277 (3r) Relocation of nursing home residents. (a) In a county that is participating in the program, for each nursing home resident who has applied for participation and has been found eligible under sub. (4), but is not participating in the program and who indicates that he or she prefers to receive services in the community, rather than in the nursing home, the participating county department shall initiate a needs and costs-based assessment before the resident has resided in the nursing home for 90 continuous days or before the cost of the resident's nursing home care has been paid under Medical Assistance for 30 days, whichever is longer. The county department shall complete the needs and costs-based assessment within 90 days after initiating it.

SB44,534,23 (b) After completion of the needs and costs-based assessment, the county department shall contact the department regarding available funding.

SB44,535,5 (c) If the department determines that costs for home or community-based services for the nursing home resident, as determined under the needs and costs-based assessment, are equal to or less than the amount specified under sub. (5) (bm) 1., the county department shall offer and, if accepted, provide home or community-based services under this section to the nursing home resident, if the cost of the resident's nursing home care has been paid under Medical Assistance for at least 30 days.

SB44,535,13 (d) If the department determines that costs for home or community-based services for the nursing home resident, as determined under the needs and costs-based assessment, exceed the amount specified under sub. (5) (bm) 1., the department may ascertain whether additional funding, as specified under sub. (5) (bm) 2., is available. If additional funding is available and if the cost of the resident's nursing home care has been paid under Medical Assistance for at least 30 days, the county department shall offer and, if accepted, provide home or community-based services under this section to the nursing home resident.

SB44, s. 1120 Section 1120. 46.277 (5) (am) of the statutes is created to read:

SB44,535,17 46.277 (5) (am) From the appropriation under s. 20.435 (4) (w), the department may provide reimbursement to a county for administrative activities by the county to relocate a nursing home resident under sub. (3r).

SB44, s. 1121 Section 1121. 46.277 (5) (b) of the statutes is amended to read:

SB44,535,21 46.277 (5) (b) Total Except as provided in subs. (3r) and (5) (bm), funding to counties under the program may not exceed the amount approved in the waiver received under sub. (2).

SB44, s. 1122 Section 1122. 46.277 (5) (bm) of the statutes is created to read:

SB44,536,6 46.277 (5) (bm) 1. Funding to a county for an individual who is relocated from a nursing home under sub. (3r) shall be no more than the per-person, per-day payment rate at the individual's level-of-care requirement for the nursing home under s. 49.45 (6m), indexed annually by the percentage of any annual nursing home average rate increase under s. 49.45 (6m), minus the amount that is obtained by subtracting the average annual costs for allowable charges under s. 49.46 (2) (a) and (b) payable on behalf of individuals in nursing homes from the average annual costs per medical assistance recipient for the allowable charges payable on behalf of individuals who are relocated into communities from nursing homes.

SB44,536,12 2. Notwithstanding the limitation on payment to a county under subd. 1., funding to a county for an individual who is relocated from a nursing home under sub. (3r) may include, in addition to the amount specified in subd. 1., an amount not to exceed the sum obtained by subtracting the total of all payments made for home or community-based services for nursing home residents relocated under sub. (3r) (c) from the amount available under subd. 1.

SB44,536,18 3. If a county department fails to complete a needs and costs-based assessment and offer home or community-based services under this section to a nursing home resident within the time period specified in sub. (3r) (a), the county shall pay the nonfederal share of Medical Assistance for his or her nursing home care unless the nursing home resident refused participation or the needs and costs-based assessment determined that participation was not feasible.

SB44,536,20 4. Funding to a county is available under subd. 1. or 2. only during the period in which a relocated individual continues to receive home or community-based care.

SB44, s. 1123 Section 1123. 46.277 (5) (g) of the statutes is created to read:

SB44,537,2 46.277 (5) (g) The department may provide enhanced reimbursement for services provided under this section to an individual who is relocated to the community from a nursing home by a county department on or after the effective date of this paragraph .... [revisor inserts date], if the nursing home bed that was used by the individual is delicensed upon relocation of the individual. The department shall develop and utilize a formula to determine the enhanced reimbursement rate.

SB44, s. 1124 Section 1124. 46.278 (1m) (bg) of the statutes is created to read:

SB44,537,6 46.278 (1m) (bg) "Nursing home" means a nursing home, as defined in s. 50.01 (3), that is certified as a provider of medical assistance, other than an intermediate care facility for the mentally retarded.

SB44, s. 1125 Section 1125. 46.278 (3) (b) of the statutes is amended to read:

SB44,537,10 46.278 (3) (b) Fund Except as provided in subs. (4g) and (6) (bm), fund home or community-based services provided by any county that meet the requirements of this section.

SB44, s. 1126 Section 1126. 46.278 (4g) of the statutes is created to read:

SB44,537,21 46.278 (4g) Relocation of nursing home residents. (a) In a county that is participating in the program, for each nursing home resident who has applied for participation and has been found eligible under sub. (5), but is not participating in the program and who indicates that he or she prefers to receive services in the community, rather than in the nursing home, the participating county department shall initiate a needs and costs-based assessment before the resident has resided in the nursing home for 90 continuous days or before the cost of the resident's nursing home care has been paid under Medical Assistance for 30 days, whichever is longer. The county department shall complete the needs and costs-based assessment within 90 days after initiating the assessment.

SB44,537,23 (b) After completion of the needs and costs-based assessment, the county department shall contact the department regarding available funding.

SB44,538,5 (c) If the department determines that costs for home or community-based services for the nursing home resident, as determined under the needs and costs-based assessment, are equal to or less than the amount specified under sub. (6) (bm) 1., the county department shall offer and, if accepted, provide home or community-based services under this section to the nursing home resident, if the cost of the resident's nursing home care has been paid under Medical Assistance for at least 30 days.

SB44,538,13 (d) If the department determines that costs for home or community-based services for the nursing home resident, as determined under the needs and costs-based assessment, exceed the amount specified under sub. (6) (bm) 1., the department may ascertain whether additional funding, as specified under sub. (6) (bm) 2., is available. If additional funding is available and if the cost of the resident's nursing home care has been paid under Medical Assistance for at least 30 days, the county department shall offer and, if accepted, provide home or community-based services under this section to the nursing home resident.

SB44, s. 1127 Section 1127. 46.278 (6) (am) of the statutes is created to read:

SB44,538,17 46.278 (6) (am) From the appropriation under s. 20.435 (4) (w), the department may provide reimbursement to a county for administrative activities by the county to relocate a nursing home resident under sub. (4g).

SB44, s. 1128 Section 1128. 46.278 (6) (b) of the statutes is amended to read:

SB44,538,21 46.278 (6) (b) Total Except as provided in subs. (4g) and (6) (bm), total funding to counties for relocating each person under a program may not exceed the amount approved in the waiver received under sub. (3).

SB44, s. 1129 Section 1129. 46.278 (6) (bm) of the statutes is created to read:

SB44,539,6 46.278 (6) (bm) 1. Funding to a county for an individual who is relocated from a nursing home under sub. (4g) shall be no more than the per-person, per-day payment rate at the individual's level-of-care requirement for the nursing home under s. 49.45 (6m), indexed annually by the percentage of any annual nursing home average rate increase under s. 49.45 (6m), minus the amount that is obtained by subtracting the average annual costs for allowable charges under s. 49.46 (2) (a) and (b) payable on behalf of individuals in nursing homes from the average annual costs for the allowable charges payable on behalf of individuals who are relocated into communities from nursing homes.

SB44,539,12 2. Notwithstanding the limitation on payment to a county under subd. 1., funding to a county for an individual who is relocated from a nursing home under sub. (4g) may include, in addition to the amount specified in subd. 1., an amount not to exceed the sum obtained by subtracting the total of all payments made for home or community-based services for nursing home residents relocated under sub. (4g) (c) from the amount available under subd. 1.

SB44,539,18 3. If a county department fails to complete a needs and costs-based assessment and offer home or community-based services under this section to a nursing home resident within the time period specified in sub. (4g) (a), the county shall pay the nonfederal share of Medical Assistance for his or her nursing home care unless the nursing home resident refused participation or the needs and costs-based assessment determined that participation was not feasible.

SB44,539,20 4. Funding to a county is available under subd. 1. or 2. only during the period in which a relocated individual continues to receive home or community-based care.

SB44, s. 1130 Section 1130. 46.278 (6) (d) of the statutes is amended to read:

SB44,540,2 46.278 (6) (d) If a county makes available nonfederal funds equal to the state share of service costs under a waiver received under sub. (3), the department may, from the appropriation under s. 20.435 (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 (4) (b), (r), or (w).

SB44, s. 1131 Section 1131. 46.278 (6) (f) of the statutes is repealed.

SB44, s. 1132 Section 1132. 46.279 of the statutes is created to read:

SB44,540,6 46.279 Restrictions on placements and admissions to intermediate and nursing facilities. (1) Definitions. In this section:

SB44,540,7 (a) "Developmental disability" has the meaning given in s. 51.01 (5) (a).

SB44,540,10 (b) "Intermediate facility" means an intermediate care facility for the mentally retarded, as defined in 42 USC 1396d (d), other than a center for the developmentally disabled, as defined in s. 51.01 (3).

SB44,540,11 (c) "Nursing facility" has the meaning given under 42 USC 1369r (a).

SB44,540,21 (2) Placements and admissions to intermediate facilities. Except as provided in sub. (5), no person may place an individual with a developmental disability in an intermediate facility and no intermediate facility may admit such an individual unless, before the placement or admission, a court under s. 55.06 (9) (a) or (10) (a) 2. finds that placement under a plan that was developed under sub. (4) is not in the individual's best interests. An intermediate facility to which an individual who has a developmental disability applies for admission shall, within 5 days after receiving the application, notify the county department that is participating in the program under s. 46.278 of the county of residence of the individual who is seeking admission concerning the application.

SB44,541,2 (3) Placements and admissions to nursing facilities. Except as provided in sub. (5), if the department or an entity determines from a screening under s. 49.45 (6c) (b) that an individual requires active treatment for developmental disability, no individual may be placed in a nursing facility, and no nursing facility may admit the individual, unless it is determined from the screening that the individual's need for care cannot fully be met in an intermediate facility or under a plan under sub. (4).

SB44,541,6 (4) Plan for home or community-based care. A county department that participates in the program under s. 46.278 shall develop a plan for providing home or community-based care to an individual in a noninstitutional community setting under any of the following circumstances:

SB44,541,9 (a) Within 90 days after any determination made under s. 49.45 (6c) (c) 3. that the level of care required by a resident that is provided by a facility could be provided in an intermediate facility or under a plan under this subsection.

SB44,541,11 (b) Within 90 days after receiving written notice under sub. (2) of an application.

SB44,541,13 (c) Within 90 days after a proposal is made under s. 55.06 (9) (a) to place the individual in an intermediate facility or a nursing facility.

SB44,541,15 (d) Within 90 days after receiving written notice under s. 55.06 (10) (a) 2. of the placement of the individual in a nursing facility or an intermediate facility.

SB44,541,17 (e) Within 60 days after extension of a temporary placement order by the court under s. 55.06 (11) (c).

SB44,541,19 (5) Exceptions. Subsections (2) and (3) do not apply to an emergency placement under s. 55.06 (11) (a) or to a temporary placement under s. 55.06 (11) (c) or (12).

SB44, s. 1133 Section 1133. 46.2805 (2) of the statutes is amended to read: