SB21,721,73 49.345 (1) Liability and the collection and enforcement of such liability for the
4care, maintenance, services, and supplies specified in this section are governed
5exclusively by this section, except in cases of child support ordered by a court under
6s. 48.355 (2) (b) 4., 48.357 (5m) (a), or 48.363 (2), 938.183 (4), 938.355 (2) (b) 4.,
7938.357 (5m) (a), or 938.363 (2)
or ch. 767.
SB21,1779 8Section 1779. 49.345 (2) of the statutes is amended to read:
SB21,722,49 49.345 (2) Except as provided in sub. (14) (b) and (c), any person, including but
10not limited to
a person placed under s. 48.345 (3) or , 48.357 (1) or (2m), 938.183,
11938.34 (3) or (4d), or 938.357 (1), (2m), (4), or (5) (e),
receiving care, maintenance,
12services, and supplies provided by any institution in this state, in which the state is
13chargeable with all or part of the person's care, maintenance, services, and supplies,
14and the person's property and estate, including the homestead, and the spouse of the
15person, and the spouse's property and estate, including the homestead, and, in the
16case of a minor child, the parents of the person, and their property and estates,
17including their homestead, and, in the case of a foreign child described in s. 48.839
18(1) who became dependent on public funds for his or her primary support before an
19order granting his or her adoption, the resident of this state appointed guardian of
20the child by a foreign court who brought the child into this state for the purpose of
21adoption, and his or her property and estate, including his or her homestead, shall
22be liable for the cost of the care, maintenance, services, and supplies in accordance
23with the fee schedule established by the department under s. 49.32 (1). If a spouse,
24widow, or minor, or an incapacitated person may be lawfully dependent upon the
25property for his or her support, the court shall release all or such part of the property

1and estate from the charges that may be necessary to provide for the person. The
2department shall make every reasonable effort to notify the liable persons as soon
3as possible after the beginning of the maintenance, but the notice or the receipt
4thereof of the notice is not a condition of liability.
SB21,1780 5Section 1780. 49.345 (8) (g) of the statutes is amended to read:
SB21,722,86 49.345 (8) (g) Pay quarterly from the appropriation under s. 20.437 (1) (gg) the
7collection moneys due county departments under ss. 46.215, 46.22, and 46.23.
8Payments shall be made as soon after the close of each quarter as is practicable.
SB21,1781 9Section 1781. 49.345 (14) (b) of the statutes is amended to read:
SB21,722,1710 49.345 (14) (b) Except as provided in par. (c), and subject to par. (cm), liability
11of a parent specified in sub. (2) or s. 49.32 (1) for the care and maintenance of the
12parent's minor child who has been placed by a court order under s. 48.355 or, 48.357,
13938.183, 938.355, or 938.357
in a residential, nonmedical facility such as a group
14home, foster home, subsidized guardianship home, or residential care center for
15children and youth shall be determined by the court by using the percentage
16standard established by the department under s. 49.22 (9) and by applying the
17percentage standard in the manner established by the department under par. (g).
SB21,1782 18Section 1782. 49.345 (14) (e) 1. of the statutes is amended to read:
SB21,723,219 49.345 (14) (e) 1. An order issued under s. 48.355 (2) (b) 4., 48.357 (5m) (a), or
2048.363 (2) for support determined under this subsection constitutes an assignment
21of all commissions, earnings, salaries, wages, pension benefits, income continuation
22insurance benefits under s. 40.62, duty disability benefits under s. 40.65,
benefits
23under ch. 102 or 108, and other money due or to be due in the future to the county
24department under s. 46.22 or 46.23 in the county where the order was entered or to
25the department, depending upon the placement of the child as specified by rules

1promulgated under subd. 5. The assignment shall be for an amount sufficient to
2ensure payment under the order.
SB21,1783 3Section 1783 . 49.345 (14) (e) 1. of the statutes, as affected by 2015 Wisconsin
4Act .... (this act), is amended to read:
SB21,723,145 49.345 (14) (e) 1. An order issued under s. 48.355 (2) (b) 4., 48.357 (5m) (a), or
648.363 (2), 938.183 (4), 938.355 (2) (b) 4., 938.357 (5m) (a), or 938.363 (2) for support
7determined under this subsection constitutes an assignment of all commissions,
8earnings, salaries, wages, pension benefits, income continuation insurance benefits
9under s. 40.62, duty disability benefits under s. 40.65, benefits under ch. 102 or 108,
10and other money due or to be due in the future to the county department under s.
1146.215, 46.22, or 46.23 in the county where the order was entered or to the
12department, depending upon the placement of the child as specified by rules
13promulgated under subd. 5. The assignment shall be for an amount sufficient to
14ensure payment under the order.
SB21,1784 15Section 1784. 49.345 (14) (g) of the statutes is amended to read:
SB21,723,2216 49.345 (14) (g) For purposes of determining child support under par. (b), the
17department shall promulgate rules related to the application of the standard
18established by the department under s. 49.22 (9) to a child support obligation for the
19care and maintenance of a child who is placed by a court order under s. 48.355 or,
2048.357, 938.183, 938.355, or 938.357 in a residential, nonmedical facility. The rules
21shall take into account the needs of any person, including dependent children other
22than the child, whom either parent is legally obligated to support.
SB21,1785 23Section 1785. 49.345 (16) of the statutes is amended to read:
SB21,724,724 49.345 (16) The department shall delegate to county departments under ss.
2546.215, 46.22, and 46.23 or the local providers of care and services meeting the

1standards established by the department under s. 49.34 the responsibilities vested
2in the department under this section for collection of fees for services other than
3those provided at state facilities, if the county departments or providers meet the
4conditions that the department determines are appropriate. The department may
5delegate to county departments under ss. 46.215, 46.22, and 46.23 the
6responsibilities vested in the department under this section for collection of fees for
7services provided at the state facilities if the necessary conditions are met.
SB21,1786 8Section 1786. 49.35 (1) (a) of the statutes is amended to read:
SB21,724,169 49.35 (1) (a) The department shall supervise the administration of programs
10under this subchapter and ch. 48 and of community-based juvenile
11delinquency-related programs under ch. 938
. The department shall submit to the
12federal authorities state plans for the administration of programs under this
13subchapter and ch. 48 and of community-based juvenile delinquency-related
14programs under ch. 938
in such form and containing such information as the federal
15authorities require, and shall comply with all requirements prescribed to ensure
16their correctness.
SB21,1787 17Section 1787. 49.35 (1) (b) of the statutes is amended to read:
SB21,725,218 49.35 (1) (b) All records of the department and all county records relating to
19programs under this subchapter and ch. 48, community-based juvenile
20delinquency-related programs under ch. 938,
and aid under s. 49.18, 1971 stats., s.
2149.20, 1971 stats., and s. 49.61, 1971 stats., as affected by chapter 90, laws of 1973,
22shall be open to inspection at all reasonable hours by authorized representatives of
23the federal government. Notwithstanding ss. 48.396 (2) and 938.396 (2), all county
24records relating to the administration of the services and public assistance specified

1in this paragraph shall be open to inspection at all reasonable hours by authorized
2representatives of the department.
SB21,1788 3Section 1788. 49.35 (2) of the statutes is amended to read:
SB21,725,74 49.35 (2) The county administration of all laws relating to programs under this
5subchapter and ch. 48 and to community-based juvenile delinquency-related
6programs under ch. 938
shall be vested in the officers and agencies designated in the
7statutes.
SB21,1789 8Section 1789. 49.36 (3) (a) of the statutes is amended to read:
SB21,725,119 49.36 (3) (a) Except as provided in par. (f) and subject to sub. (3m), a person
10ordered to register under s. 767.55 (2) (am) shall participate in a work experience
11program if services are available.
SB21,1790 12Section 1790. 49.36 (3m) of the statutes is created to read:
SB21,725,1513 49.36 (3m) A person is not eligible to participate in a program under this
14section unless the person satisfies all of the requirements related to substance abuse
15screening, testing, and treatment under s. 49.162 that apply to the individual.
SB21,1791 16Section 1791. 49.43 (9m) of the statutes is created to read:
SB21,725,2017 49.43 (9m) "Primary care shortage area" means an area that is in a primary
18care health professional shortage area as determined by the federal department of
19health and human services under 42 CFR part 5, appendix A, excluding a state or
20federal prison.
SB21,1792 21Section 1792. 49.45 (6m) (br) 1. of the statutes is amended to read:
SB21,726,522 49.45 (6m) (br) 1. Notwithstanding s. 20.410 (3) (cd), 20.435 or (7) (b) or 20.437
23(1) (cj) or (2) (dz), the department shall reduce allocations of funds to counties in the
24amount of the disallowance from the appropriation account under s. 20.435 (7) (b),
25or the department shall direct the department of children and families to reduce

1allocations of funds to counties or Wisconsin Works agencies in the amount of the
2disallowance from the appropriation account under s. 20.437 (1) (cj) or (2) (dz) or
3direct the department of corrections to reduce allocations of funds to counties in the
4amount of the disallowance from the appropriation account under s. 20.410 (3) (cd)
,
5in accordance with s. 16.544 to the extent applicable.
SB21,1793 6Section 1793. 49.45 (6v) of the statutes, as affected by 2015 Wisconsin Act ....
7(this act), is repealed.
SB21,1794 8Section 1794. 49.45 (6v) (c) of the statutes is amended to read:
SB21,726,199 49.45 (6v) (c) If the report specified in par. (b) indicates that utilization of beds
10by recipients of medical assistance in facilities is less than estimates for that
11utilization reflected in the intentions of the joint committee on finance, legislature
12and governor, as expressed by them in the budget determinations, the department
13shall include a proposal to transfer moneys from the appropriation under s. 20.435
14(4) (b) to the appropriation under s. 20.435 (7) (4) (bd) for the purpose of increasing
15funding for the community options program under s. 46.27. The amount proposed
16for transfer may not reduce the balance in the appropriation account under s. 20.435
17(4) (b) below an amount necessary to ensure that that appropriation account will end
18the current fiscal year or the current fiscal biennium with a positive balance. The
19secretary shall transfer the amount identified under the proposal.
SB21,1795 20Section 1795. 49.45 (8r) of the statutes is amended to read:
SB21,727,221 49.45 (8r) Payment for certain obstetric and gynecological care. The rate
22of payment for obstetric and gynecological care provided in primary care shortage
23areas, as defined in s. 36.60 (1) (cm), or provided to recipients of medical assistance
24who reside in primary care shortage areas, that is equal to 125% of the rates paid
25under this section to primary care physicians in primary care shortage areas, shall

1be paid to all certified primary care providers who provide obstetric or gynecological
2care to those recipients.
SB21,1796 3Section 1796. 49.45 (23) (c) of the statutes is repealed.
SB21,1797 4Section 1797. 49.45 (23) (g) of the statutes is created to read:
SB21,727,85 49.45 (23) (g) 1. The department shall submit to the secretary of the federal
6department of health and human services an amendment to the waiver requested
7under par. (a) that authorizes the department to do all of the following with respect
8to the childless adults demonstration project under this subsection:
SB21,727,99 a. Impose monthly premiums as determined by the department.
SB21,727,1110 b. Impose higher premiums for enrollees who engage in behaviors that increase
11their health risks, as determined by the department.
SB21,727,1212 c. Require a health risk assessment for all enrollees.
SB21,727,1513 d. Limit an enrollee's eligibility under the demonstration project to no more
14than 48 months. The department shall specify the eligibility formula in the waiver
15amendment.
SB21,727,1816 e. Require, as a condition of eligibility, that an applicant or enrollee submit to
17a drug screening assessment and, if indicated, a drug test, as specified by the
18department in the waiver amendment.
SB21,727,2319 2. If the secretary of the federal department of health and human services
20approves the amendment to the waiver under par. (a), in whole or in part, the
21department shall implement the changes to the demonstration project under this
22subsection specified in subd. 1. a. to e. that are approved by the secretary, consistent
23with the approval.
SB21,1798 24Section 1798. 49.45 (24k) of the statutes is created to read:
SB21,728,6
149.45 (24k) Dental reimbursement pilot project. (a) Subject to approval of
2the federal department of health and human services under par. (b), the department,
3as a pilot project, shall distribute moneys in each fiscal year to increase the
4reimbursement rate under Medical Assistance for pediatric dental care and adult
5emergency dental services, as defined by the department, that are provided in
6Brown, Polk, and Racine counties.
SB21,728,127 (b) The department shall request any waiver from and submit any
8amendments to the state Medical Assistance plan to the federal department of health
9and human services necessary for the reimbursement rate increase pilot project
10under par. (a). If any necessary waiver request or state plan amendment request is
11approved, the department shall implement par. (a) beginning on the effective date
12of the waiver or plan amendment.
SB21,1799 13Section 1799. 49.45 (30x) of the statutes is created to read:
SB21,728,1814 49.45 (30x) Licensed midwife services. (a) Provider reimbursement.
15Beginning January 1, 2016, services under s. 49.46 (2) (b) 12t. provided to an
16individual are reimbursable under the Medical Assistance program if an
17amendment to the state medical assistance plan approved by the federal department
18of health and human services permits reimbursement under s. 49.46 (2) (b) 12t.
SB21,728,2319 (b) Plan amendment. The department shall submit to the federal department
20of health and human services an amendment to the state medical assistance plan to
21permit the application of par. (a). The department may not pay reimbursement
22under par. (a) unless the amendment to the state plan allowing reimbursement
23under s. 49.46 (2) (b) 12t. is approved and in effect.
SB21,1800 24Section 1800. 49.45 (39) (bm) of the statutes is created to read:
SB21,729,4
149.45 (39) (bm) Excess state share. Any portion of the state share under this
2subsection in excess of $42,200,000 in fiscal year 2015-16 and in excess of
3$41,700,000 in fiscal year 2016-17 and each fiscal year thereafter shall be deposited
4in the Medical Assistance trust fund.
SB21,1801 5Section 1801. 49.45 (39m) of the statutes is created to read:
SB21,729,156 49.45 (39m) State plan amendment for pharmacist reimbursement. The
7department shall submit to the federal department of health and human services an
8amendment to the state Medical Assistance plan to permit Medical Assistance
9reimbursement to pharmacists who meet the training requirements specified by the
10department to administer vaccines, as determined by the department, to a person 6
11to 18 years of age. The department shall provide Medical Assistance reimbursement
12under this subsection if the federal department of health and human services
13approves the amendment to the state Medical Assistance plan. A pharmacist or
14pharmacy shall enroll in the federal Vaccines for Children Program under 42 USC
151396s
to be eligible for Medical Assistance reimbursement under this subsection.
SB21,1802 16Section 1802. 49.45 (41) (b) of the statutes is amended to read:
SB21,730,217 49.45 (41) (b) If a county elects to become certified as a provider of mental
18health crisis intervention services, the county may provide mental health crisis
19intervention services under this subsection in the county to medical assistance
20recipients through the medical assistance program. A county that elects to provide
21the services shall pay the amount of the allowable charges for the services under the
22medical assistance program that is not provided by the federal government. From
23the appropriation account under s. 20.435 (5) (bL), the
The department shall
24reimburse the county under this subsection only for the amount of the allowable

1charges for those services under the medical assistance program that is provided by
2the federal government.
SB21,1803 3Section 1803. 49.452 of the statutes is created to read:
SB21,730,8 449.452 Counting promissory notes as assets for certain Medical
5Assistance programs.
(1) In this section, "promissory note" means a written,
6unconditional agreement, given in return for goods, money loaned, or services
7rendered, under which one party promises to pay another party a specified sum of
8money at a specified time or on demand.
SB21,730,11 9(2) If an individual's assets are counted when determining or redetermining
10the individual's financial eligibility for Medical Assistance, the department shall
11include a promissory note as a countable asset if all of the following apply:
SB21,730,1412 (a) The individual applying for or receiving benefits under Medical Assistance
13or his or her spouse provided the goods, money loaned, or services rendered for the
14promissory note.
SB21,730,1615 (b) The promissory note was entered into or purchased on or after the effective
16date of this paragraph .... [LRB inserts date].
SB21,730,1817 (c) The promissory note is negotiable, assignable, and enforceable and does not
18contain any terms making it unmarketable.
SB21,730,24 19(3) A promissory note is presumed to be negotiable and its asset value is the
20outstanding principal balance at the time the individual applies for Medical
21Assistance or at the time the individual's eligibility for Medical Assistance is
22redetermined, unless the individual shows by credible evidence from a
23knowledgeable source that the note is nonnegotiable or has a different current
24market value, which will then be considered the asset value.
SB21,1804 25Section 1804. 49.453 (4c) (am) of the statutes is created to read:
SB21,731,4
149.453 (4c) (am) Notwithstanding par. (a), for purposes of sub. (2), the purchase
2of or entering into a promissory note by an individual or his or her spouse on or after
3the effective date of this paragraph .... [LRB inserts date], is a transfer of assets for
4less than fair market value unless all of the following apply:
SB21,731,55 1. The promissory note satisfies the requirements under par. (a) 1. to 3.
SB21,731,76 2. The promissory note is negotiable, assignable, and enforceable and does not
7contain any terms making it unmarketable.
SB21,1805 8Section 1805. 49.453 (4c) (b) of the statutes is renumbered 49.453 (4c) (b) 1.
9and amended to read:
SB21,731,1410 49.453 (4c) (b) 1. The value of a promissory note, purchased before the effective
11date of this subdivision .... [LRB inserts date], a
loan, or a mortgage that does not
12satisfy the requirements under par. (a) 1. to 3. is the outstanding balance due on the
13date that the individual applies for medical assistance for nursing facility services
14or other long-term care services described in sub. (2).
SB21,1806 15Section 1806. 49.453 (4c) (b) 2. of the statutes is created to read:
SB21,731,2216 49.453 (4c) (b) 2. The value of a promissory note purchased or entered into on
17or after the effective date of this subdivision .... [LRB inserts date], that does not
18satisfy the requirements under par. (am) 1. and 2. is the outstanding balance due on
19the date that the individual applies for Medical Assistance for nursing facility
20services or other long-term care services described in sub. (2) or on the date that the
21individual's eligibility for Medical Assistance for nursing facility services or other
22long-term care services described in sub. (2) is redetermined.
SB21,1807 23Section 1807. 49.46 (2) (b) 12t. of the statutes is created to read:
SB21,732,3
149.46 (2) (b) 12t. Subject to the limitations under s. 49.45 (30x), licensed
2midwife services provided by a certified professional midwife licensed under s.
3440.982.
SB21,1808 4Section 1808. 49.46 (2) (b) 14m. of the statutes is created to read:
SB21,732,75 49.46 (2) (b) 14m. Subject to par. (bt), substance abuse treatment services
6provided by a medically monitored treatment service or a transitional residential
7treatment service.
SB21,1809 8Section 1809. 49.46 (2) (bt) of the statutes is created to read:
SB21,732,139 49.46 (2) (bt) 1. For the purposes of par. (b) 14m., a "medically monitored
10treatment service" is a 24-hour, community-based service providing observation,
11monitoring, and treatment by a multidisciplinary team under supervision of a
12physician, with a minimum of 12 hours of counseling provided per week for each
13patient.
SB21,732,1714 2. For the purposes of par. (b) 14m., a "transitional residential treatment
15service" is a clinically supervised, peer-supported, therapeutic environment with
16clinical involvement providing substance abuse treatment in the form of counseling
17for 3 to 11 hours provided per week for each patient.
SB21,732,2118 3. If approval by the federal department of health and human services of a state
19plan amendment or waiver request is necessary for federal reimbursement of the
20services under par. (b) 14m., the department is not required to pay for services
21described in par. (b) 14m. if the department does not receive the necessary approval.
SB21,1810 22Section 1810. 49.471 (8) (d) 1. a. of the statutes is amended to read:
SB21,732,2423 49.471 (8) (d) 1. a. A pregnant woman, except as provided in pars. par. (cr) 1.
24c. and (fm) 4.
SB21,1811 25Section 1811. 49.471 (8) (f) of the statutes is repealed.
SB21,1812
1Section 1812. 49.471 (8) (fm) of the statutes is repealed.
SB21,1813 2Section 1813. 49.471 (8) (g) of the statutes is repealed.
SB21,1814 3Section 1814. 49.472 (5) of the statutes is amended to read:
SB21,733,74 49.472 (5) Community options participants. From the appropriation under s.
520.435 (7) (4) (bd), the department may pay all or a portion of the monthly premium
6calculated under sub. (4) (a) for an individual who is a participant in the community
7options program under s. 46.27 (11).
SB21,1815 8Section 1815. 49.475 (1) (e) 2. of the statutes is amended to read:
SB21,733,109 49.475 (1) (e) 2. An enrollee of the family care program, as defined in s. 46.2805
10(4m)
.
SB21,1816 11Section 1816. 49.496 (1) (bk) 2. of the statutes is repealed.
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