LRB-2557/2
TJD:med:ph
2011 - 2012 LEGISLATURE
January 9, 2012 - Introduced by Representatives Severson, Bernier, Berceau,
Bies, E. Coggs, Endsley, Hintz, Jacque, Kaufert, Kerkman, Knodl, Kooyenga,
Litjens, Mason, Nygren, Pasch, Petryk, Radcliffe, Rivard, Sinicki,
Spanbauer, Strachota, C. Taylor, Thiesfeldt, Tranel
and Zepnick,
cosponsored by Senators Galloway, Harsdorf, Erpenbach, Hansen, Holperin,
King, C. Larson, Moulton, Risser, Taylor, Vinehout, Lassa
and Olsen.
Referred to Committee on Health.
AB471,2,2 1An Act to amend 46.22 (1) (c) 8. (intro.), 46.275 (5) (b) 4., 46.278 (1), 46.278 (1m)
2(am), 46.278 (2) (a), 46.278 (4) (a), 46.278 (5) (a), 46.278 (6) (e) 1. a., 46.278 (6)
3(e) 1. b., 46.278 (6) (e) 1. c., 46.284 (2) (c), 49.43 (7) (b) 1., 49.45 (6m) (ar) 1. c.,
449.45 (6m) (bg), 49.45 (30m) (a) 2., 50.04 (2r), 50.04 (4) (dm), 50.14 (1) (a), 50.14
5(1) (b), 50.14 (2) (bm), 50.14 (2m), 51.01 (5) (a), 51.06 (8) (a) 1., 51.06 (8) (b)
6(intro.), 51.06 (8) (b) 4., 51.06 (8) (b) 7., 51.42 (6m) (intro.), 51.437 (4g) (c), 51.62
7(4), 54.01 (8), 55.01 (2), 58.05 (title), 58.05 (1), 146.40 (1) (bt), 146.40 (2) (intro.),
8146.40 (2) (c) (intro.), 146.40 (2) (c) 2., 146.40 (2) (d), 146.40 (2) (e), 146.40 (2)
9(g), 146.40 (2m), subchapter VIII (title) of chapter 150 [precedes 150.96], 150.96
10(2), 150.96 (4), 150.963 (title), 150.963 (2) (a), 150.963 (2) (b), 150.965, 150.97,

1150.975, 150.983, 155.20 (2) (a) 2., 155.30 (3) and 632.88 (1) (a) of the statutes;
2relating to: changing terminology for those with an intellectual disability.
Analysis by the Legislative Reference Bureau
This bill substitutes the phrase "intellectual disability" for "mental
retardation" and "mentally retarded" in the statutes.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB471, s. 1 3Section 1. 46.22 (1) (c) 8. (intro.) of the statutes is amended to read:
AB471,2,84 46.22 (1) (c) 8. (intro.) To administer child welfare services including services
5to juveniles who are delinquent and to children who are mentally retarded, have an
6intellectual disability or are
dependent, neglected or nonmarital, and to other
7children who are in need of such services. In administering child welfare services the
8county department of social services shall be governed by the following:
AB471, s. 2 9Section 2. 46.275 (5) (b) 4. of the statutes is amended to read:
AB471,2,1410 46.275 (5) (b) 4. Provide services, except respite care that is approved by the
11department, within a skilled nursing facility, intermediate care facility or
12intermediate care facility for persons with mental retardation an intellectual
13disability
, as defined in s. 46.278 (1m) (am), including a state center for the
14developmentally disabled.
AB471, s. 3 15Section 3. 46.278 (1) of the statutes is amended to read:
AB471,3,816 46.278 (1) Legislative intent. The intent of the programs under this section
17is to provide home or community-based care to serve in a noninstitutional
18community setting a person who meets eligibility requirements under 42 USC 1396n
19(c) and who is diagnosed as developmentally disabled under the definition specified
20in s. 51.01 (5) and relocated from an institution other than a state center for the

1developmentally disabled or who meets the intermediate care facility for persons
2with mental retardation an intellectual disability or brain injury rehabilitation
3facility level of care requirements for medical assistance reimbursement in an
4intermediate care facility for persons with mental retardation an intellectual
5disability
or a brain injury rehabilitation facility and is ineligible for services under
6s. 46.275 or 46.277. The intent of the program is also that counties use all existing
7services for providing care under this section, including those services currently
8provided by counties.
AB471, s. 4 9Section 4. 46.278 (1m) (am) of the statutes is amended to read:
AB471,3,1210 46.278 (1m) (am) "Intermediate care facility for persons with mental
11retardation
an intellectual disability" has the meaning given for "intermediate care
12facility for the mentally retarded" under 42 USC 1396d (d).
AB471, s. 5 13Section 5. 46.278 (2) (a) of the statutes is amended to read:
AB471,3,2214 46.278 (2) (a) The department may request one or more waivers from the
15secretary of the federal department of health and human services, under 42 USC
161396n
(c), authorizing the department to serve medical assistance recipients, who
17meet the level of care requirements for medical assistance reimbursement in an
18intermediate care facility for persons with mental retardation an intellectual
19disability
or in a brain injury rehabilitation facility, in their communities by
20providing home or community-based services as part of medical assistance. If the
21department requests a waiver, it shall include all assurances required under 42 USC
221396n
(c) (2) in its request.
AB471, s. 6 23Section 6. 46.278 (4) (a) of the statutes is amended to read:
AB471,4,624 46.278 (4) (a) Sections 46.27 (3) (b) and 46.275 (3) (a) and (c) to (e) apply to
25county participation in a program, except that services provided in the program shall

1substitute for care provided a person in an intermediate care facility for persons with
2mental retardation
an intellectual disability or in a brain injury rehabilitation
3facility who meets the intermediate care facility for persons with mental retardation
4an intellectual disability or brain injury rehabilitation facility level of care
5requirements for medical assistance reimbursement to that facility rather than for
6care provided at a state center for the developmentally disabled.
AB471, s. 7 7Section 7. 46.278 (5) (a) of the statutes is amended to read:
AB471,4,178 46.278 (5) (a) Any medical assistance recipient who meets the level of care
9requirements for medical assistance reimbursement in an intermediate care facility
10for persons with mental retardation an intellectual disability or in a brain injury
11rehabilitation facility and is ineligible for service under s. 46.275 or 46.277 is eligible
12to participate in a program, except that persons eligible for the brain injury waiver
13program must meet the definition of brain injury under s. 51.01 (2g), and except that
14the number of participants may not exceed the number approved under the waiver
15received under sub. (3). Such a recipient may apply, or any person may apply on
16behalf of such a recipient, for participation in a program. Section 46.275 (4) (b)
17applies to participation in a program.
AB471, s. 8 18Section 8. 46.278 (6) (e) 1. a. of the statutes is amended to read:
AB471,4,2019 46.278 (6) (e) 1. a. An intermediate care facility for persons with mental
20retardation
an intellectual disability that closes under s. 50.03 (14).
AB471, s. 9 21Section 9. 46.278 (6) (e) 1. b. of the statutes is amended to read:
AB471,4,2422 46.278 (6) (e) 1. b. An intermediate care facility for persons with mental
23retardation
an intellectual disability or a distinct part thereof that has a plan of
24closure approved by the department and that intends to close within 12 months.
AB471, s. 10 25Section 10. 46.278 (6) (e) 1. c. of the statutes is amended to read:
AB471,5,4
146.278 (6) (e) 1. c. An intermediate care facility for persons with mental
2retardation
an intellectual disability that has a plan of closure or significant
3reduction in capacity approved by the department and that intends to close or
4significantly reduce its capacity within 60 months.
AB471, s. 11 5Section 11. 46.284 (2) (c) of the statutes is amended to read:
AB471,5,186 46.284 (2) (c) The department shall require, as a term of any contract with a
7care management organization under this section, that the care management
8organization contract for the provision of services that are covered under the family
9care benefit with any community-based residential facility under s. 50.01 (1g),
10residential care apartment complex under s. 50.01 (1d), nursing home under s. 50.01
11(3), intermediate care facility for the mentally retarded persons with an intellectual
12disability
under s. 50.14 (1) (b), community rehabilitation program, home health
13agency under s. 50.49 (1) (a), provider of day services, or provider of personal care,
14as defined in s. 50.01 (4o), that agrees to accept the reimbursement rate that the care
15management organization pays under contract to similar providers for the same
16service and that satisfies any applicable quality of care, utilization, or other criteria
17that the care management organization requires of other providers with which it
18contracts to provide the same service.
AB471, s. 12 19Section 12. 49.43 (7) (b) 1. of the statutes is amended to read:
AB471,5,2420 49.43 (7) (b) 1. Licensed or approved under state law for the mentally retarded
21individuals with an intellectual disability or persons with related conditions, the
22primary purpose of which is to provide health or rehabilitative services for mentally
23retarded
individuals with an intellectual disability according to rules promulgated
24by the department; and
AB471, s. 13 25Section 13. 49.45 (6m) (ar) 1. c. of the statutes is amended to read:
AB471,6,6
149.45 (6m) (ar) 1. c. If a facility has an approved program for provision of service
2to mentally retarded residents who have an intellectual disability, residents
3dependent upon ventilators, or residents requiring supplemental skilled care due to
4complex medical conditions, a supplement to the direct care component of the facility
5rate under subd. 1. b. may be made to that facility according to a method developed
6by the department.
AB471, s. 14 7Section 14. 49.45 (6m) (bg) of the statutes is amended to read:
AB471,6,138 49.45 (6m) (bg) The department shall determine payment levels for the
9provision of skilled, intermediate, limited, personal or residential care or care for the
10mentally retarded individuals with an intellectual disability in the state centers for
11the developmentally disabled and in a Wisconsin veterans home operated by the
12department of veterans affairs under s. 45.50 separately from the payment
13principles, applicable costs and methods established under this subsection.
AB471, s. 15 14Section 15. 49.45 (30m) (a) 2. of the statutes is amended to read:
AB471,6,1715 49.45 (30m) (a) 2. Services in an intermediate care facility for persons with
16mental retardation an intellectual disability, as defined in s. 46.278 (1m) (am), other
17than a state center for the developmentally disabled.
AB471, s. 16 18Section 16. 50.04 (2r) of the statutes is amended to read:
AB471,7,219 50.04 (2r) Admissions requiring approval. Except in an emergency, a nursing
20home that is not certified as a provider of medical assistance or that is an
21intermediate care facility for persons with mental retardation an intellectual
22disability
, as defined in s. 46.278 (1m) (am), or an institution for mental diseases, as
23defined under 42 CFR 435.1009, may not admit as a resident an individual who has
24a developmental disability, as defined in s. 51.01 (5), or who is both under age 65 and
25has mental illness, as defined in s. 51.01 (13), unless the county department under

1s. 46.23, 51.42 or 51.437 of the individual's county of residence has recommended the
2admission.
AB471, s. 17 3Section 17. 50.04 (4) (dm) of the statutes is amended to read:
AB471,7,114 50.04 (4) (dm) Inspection fee. If the department takes enforcement action
5against a nursing home, including an intermediate care facility for the mentally
6retarded
persons with an intellectual disability, as defined in 42 USC 1396d (d) s.
750.14 (1) (b)
, for a violation of this subchapter or rules promulgated under it or for
8a violation of a requirement under 42 USC 1396r, and the department subsequently
9conducts an on-site inspection of the nursing home to review the nursing home's
10action to correct the violation, the department may, unless the nursing home is
11operated by the state, impose a $200 inspection fee on the nursing home.
AB471, s. 18 12Section 18. 50.14 (1) (a) of the statutes is amended to read:
AB471,7,1513 50.14 (1) (a) Notwithstanding s. 50.01 (1m), "facility" means a nursing home
14or an intermediate care facility for persons with mental retardation an intellectual
15disability
that is not located outside the state.
AB471, s. 19 16Section 19. 50.14 (1) (b) of the statutes is amended to read:
AB471,7,1917 50.14 (1) (b) "Intermediate care facility for persons with mental retardation an
18intellectual disability
" has the meaning given for "intermediate care facility for the
19mentally retarded" under 42 USC 1396d (d).
AB471, s. 20 20Section 20. 50.14 (2) (bm) of the statutes is amended to read:
AB471,8,221 50.14 (2) (bm) For intermediate care facilities for persons with mental
22retardation
an intellectual disability, an amount calculated by multiplying the
23projected annual gross revenues of all intermediate care facilities for persons with
24mental retardation an intellectual disability in this state by 0.055, dividing the
25product by the number of licensed beds of intermediate care facilities for persons

1with mental retardation an intellectual disability in this state and dividing the
2quotient by 12.
AB471, s. 21 3Section 21. 50.14 (2m) of the statutes is amended to read:
AB471,8,104 50.14 (2m) Prior to each state fiscal year, the department shall calculate the
5amount of the assessment under sub. (2) (bm) that shall apply during the fiscal year.
6The department may reduce the assessment amount during a state fiscal year to
7avoid collecting for the fiscal year an amount in bed assessment receipts under sub.
8(2) (bm) that exceeds 5.5 percent of the aggregate gross revenues for intermediate
9care facilities for the mentally retarded persons with an intellectual disability for the
10fiscal year.
AB471, s. 22 11Section 22. 51.01 (5) (a) of the statutes is amended to read:
AB471,8,1912 51.01 (5) (a) "Developmental disability" means a disability attributable to
13brain injury, cerebral palsy, epilepsy, autism, Prader-Willi syndrome, mental
14retardation
intellectual disability, or another neurological condition closely related
15to mental retardation an intellectual disability or requiring treatment similar to that
16required for individuals with mental retardation an intellectual disability, which has
17continued or can be expected to continue indefinitely and constitutes a substantial
18handicap to the afflicted individual. "Developmental disability" does not include
19dementia that is primarily caused by degenerative brain disorder.
AB471, s. 23 20Section 23. 51.06 (8) (a) 1. of the statutes is amended to read:
AB471,8,2321 51.06 (8) (a) 1. "Intermediate care facility for persons with mental retardation
22an intellectual disability" has the meaning given for "intermediate care facility for
23the mentally retarded" under 42 USC 1396d (d).
AB471, s. 24 24Section 24. 51.06 (8) (b) (intro.) of the statutes is amended to read:
AB471,9,7
151.06 (8) (b) (intro.) Annually by October 1, the department shall submit to the
2joint committee on finance and to the appropriate standing committees of the
3legislature under s. 13.172 (3) a report that includes information collected from the
4previous fiscal year on the relocation or diversion of individuals who are Medical
5Assistance eligibles or recipients from nursing homes, intermediate care facilities for
6persons with mental retardation an intellectual disability, and centers for the
7developmentally disabled. The report shall include all of the following information:
AB471, s. 25 8Section 25. 51.06 (8) (b) 4. of the statutes is amended to read:
AB471,9,149 51.06 (8) (b) 4. An accounting of the costs and savings under the Medical
10Assistance program of relocations and diversions and the resulting reduction in
11capacity for services of nursing homes, intermediate care facilities for persons with
12mental retardation an intellectual disability, and centers for the developmentally
13disabled. The accounting shall include the per individual savings as well as the
14collective savings of relocations and diversions.
AB471, s. 26 15Section 26. 51.06 (8) (b) 7. of the statutes is amended to read:
AB471,9,2116 51.06 (8) (b) 7. Staff turnover rates for nursing homes, intermediate care
17facilities for persons with mental retardation an intellectual disability, and centers
18for the developmentally disabled in communities in which an individual relocated or
19diverted from a nursing home, intermediate care facility for persons with mental
20retardation
an intellectual disability, or center for the developmentally disabled
21currently resides.
AB471, s. 27 22Section 27. 51.42 (6m) (intro.) of the statutes is amended to read:
AB471,9,2523 51.42 (6m) County community programs director in certain counties with a
24county executive or county administrator.
(intro.) In any county with a county
25executive or county administrator in which the county board of supervisors has

1established a single-county department of community programs, the county
2executive or county administrator shall appoint and supervise the county
3community programs director. In any county with a population of 500,000 or more,
4the county executive or county administrator shall appoint the director of the county
5department of human services under s. 46.21 as the county community programs
6director. The appointment of a county community programs director under this
7subsection shall be on the basis of recognized and demonstrated interest in and
8knowledge of the problems of mental health, mental retardation intellectual
9disability
, alcoholism and drug addiction, with due regard to training, experience,
10executive and administrative ability, and general qualification and fitness for the
11performance of the duties of the director. The appointment of a county community
12programs director under this subsection is subject to confirmation by the county
13board of supervisors unless the county board of supervisors, by ordinance, elects to
14waive confirmation or unless the appointment is made under a civil service system
15competitive examination procedure established under s. 59.52 (8) or ch. 63. The
16county community programs director, subject only to the supervision of the county
17executive or county administrator, shall:
AB471, s. 28 18Section 28. 51.437 (4g) (c) of the statutes is amended to read:
AB471,10,2219 51.437 (4g) (c) In a county with a population of 500,000 or more, the county
20board of supervisors shall integrate day care programs for mentally retarded persons
21with an intellectual disability and those programs for persons with other
22developmental disabilities into the county developmental disabilities program.
AB471, s. 29 23Section 29. 51.62 (4) of the statutes is amended to read:
AB471,11,324 51.62 (4) Departmental duties. The department shall provide the protection
25and advocacy agency with copies of annual surveys and plans of correction for

1intermediate care facilities for persons with mental retardation an intellectual
2disability
on or before the first day of the 2nd month commencing after completion
3of the survey or plan.
AB471, s. 30 4Section 30. 54.01 (8) of the statutes is amended to read:
AB471,11,135 54.01 (8) "Developmental disability" means a disability attributable to mental
6retardation
intellectual disability, cerebral palsy, epilepsy, autism, or another
7neurological condition closely related to mental retardation an intellectual disability
8or requiring treatment similar to that required for individuals with mental
9retardation
an intellectual disability, which has continued or can be expected to
10continue indefinitely, substantially impairs an individual from adequately providing
11for his or her own care or custody, and constitutes a substantial handicap to the
12afflicted individual. The term does not include dementia that is primarily caused by
13degenerative brain disorder.
AB471, s. 31 14Section 31. 55.01 (2) of the statutes is amended to read:
AB471,11,2315 55.01 (2) "Developmental disability" means a disability attributable to mental
16retardation
intellectual disability, cerebral palsy, epilepsy, autism or another
17neurological condition closely related to mental retardation an intellectual disability
18or requiring treatment similar to that required for individuals with mental
19retardation
an intellectual disability, which has continued or can be expected to
20continue indefinitely, substantially impairs an individual from adequately providing
21for his or her own care or custody, and constitutes a substantial handicap to the
22afflicted individual. The term does not include dementia that is primarily caused by
23degenerative brain disorder.
AB471, s. 32 24Section 32. 58.05 (title) of the statutes is amended to read:
AB471,12,2
158.05 (title) Private institutions for persons who are mentally ill or
2retarded have an intellectual disability.
AB471, s. 33 3Section 33. 58.05 (1) of the statutes is amended to read:
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