49.001(9)
(9) "Wisconsin works agency" means a person under contract under
s. 49.143 to administer Wisconsin works under
ss. 49.141 to
49.161. If no contract is awarded under
s. 49.143, "Wisconsin works agency" means the department of industry, labor and job development.
49.001 History
History: 1995 a. 27 ss.
2639,
2644,
2654 to
2666,
3083;
1995 a. 289.
RELIEF BLOCK GRANTS
49.002
49.002
Legislative declaration. It is the declared legislative policy that a county receiving a relief block grant is the payer of last resort in all cases, except those cases involving crime victim awards under
s. 949.06, where a benefit is covered by relief funded by a relief block grant in a county and where a dispute may arise over payment for costs associated with providing health care services to recipients of relief funded by a relief block grant.
49.002 Annotation
Administrative rule under which applicants for general relief benefits were, in effect, deemed unwilling to work if they had lost 2 jobs without justification within past 12 months created impermissible, irrebuttable presumption that otherwise eligible applicants were presently unwilling to comply with this section. Garcia v. Silverman, 393 F Supp. 590.
49.01
49.01
Definitions. As used in this subchapter:
49.01(1g)
(1g) "American Indian" means a person who is recognized by an elected tribal governing body in this state as a member of a federally recognized Wisconsin tribe or band of Indians.
49.01(1m)
(1m) "Department" means the department of health and family services.
49.01(2)
(2) "Dependent person" means an individual who is eligible for relief under
s. 49.015.
49.01(2g)
(2g) "Health care services" means such emergency and nonemergency medical, surgical, dental, hospital, nursing and optometric services as are reasonable and necessary under the circumstances, as determined by the county or tribal governing body. "Health care services" does not include services described under
s. 51.42 (3) (ar) 4.
49.01(3)
(3) "Relief" means assistance that is provided to a dependent person and funded by a relief block grant.
49.01(3m)
(3m) "Relief agency" means the following if a county or tribal governing body operates a relief program funded by a relief block grant:
49.01(3m)(a)
(a) A county department under
s. 46.215,
46.22 or
46.23 or an agency under contract with a county department to administer relief.
49.01(3m)(b)
(b) A tribal governing body or an agency under contract with the governing body to administer relief.
49.01(8j)
(8j) "Secretary" means the secretary of health and family services.
49.01(8L)
(8L) "Tax-free land" means land in this state within the boundaries of a federally recognized reservation or within the bureau of Indian affairs service area for the Winnebago tribe, which is not subject to assessment or levy of a real property tax either as a general tax or as a payment in lieu of taxes.
49.01(8p)
(8p) "Tribal governing body" means an elected tribal governing body of a federally recognized American Indian tribe.
49.01 Cross-reference
Cross-reference: See s.
46.011 for definitions applicable to chs.
46 to
51,
55 and
58.
49.01 Annotation
A man who quits a job for personal reasons may not be denied welfare if he is otherwise "dependent". Section 49.002 establishes a condition for continued eligibility, not a bar to initial eligibility. State ex rel. Arteaga v. Silverman, 56 W (2d) 110, 201 NW (2d) 538.
49.01 Annotation
AFDC recipient may qualify as "dependent". State ex rel. Tiner v. Milwaukee County, 81 W (2d) 277, 260 NW (2d) 393.
49.01 Annotation
"Dependent person" defined. St. Michael Hosp. v. County of Milwaukee, 98 W (2d) 1, 295 NW (2d) 189 (Ct. App. 1980).
49.01 Annotation
Indigent veteran's right to apply for veteran's emergency relief grant did not disqualify veteran as "dependent". Luther Hospital v. Eau Claire County, 115 W (2d) 100, 339 NW (2d) 798 (Ct. App. 1983).
49.01 Annotation
A county's discretion as to times and amounts for relief payments under s. 49.01 (5m) does not preempt the mandate under s. 49.02 (1m) requiring written standards of need to determine the amount necessary to secure adequate housing. The county must provide housing whether in the form of money or actual shelter which is adequate for health and decency. Clark v. Milwaukee County, 188 W (2d) 171, 524 NW (2d) 382 (1994).
49.01 Annotation
"Relief" is not broad enough to include attorneys' fees incurred by eligible dependent person to prosecute or defend divorce action. 61 Atty. Gen. 330.
49.01 Annotation
See note to Art. I, s. 1, citing Lavine v. Milne, 424 US 577.
49.01 Annotation
Constitutional law: residency requirements. 53 MLR 439.
49.015
49.015
Relief eligibility. 49.015(1)(1)
General eligibility requirements. Except as provided in
subs. (1m) to
(2m), an individual is eligible for relief if the individual meets all of the following conditions:
49.015(1)(a)
(a) Except as provided in
sub. (3) (a), the individual resides in a county, or on tax-free land, in which the county or tribal governing body operates a program funded by a relief block grant.
49.015(1)(am)
(am) The individual authorizes any program or resource for which he or she is determined to be eligible to reimburse the relief agency for health care services provided to the individual if the program or resource permits reimbursement for the services provided.
49.015(1)(c)
(c) The individual qualifies under written criteria of dependency under
s. 49.02 (1) (b) established by the relief agency in that county or on that tax-free land.
49.015(1m)(a)(a) In this subsection, "close relative" means the person's parent, grandparent, brother, sister, spouse or child.
49.015(1m)(b)
(b) No individual is eligible for relief unless the individual has resided in this state for at least 60 consecutive days before applying for relief. This requirement does not apply if the individual resides in this state and meets any of the following conditions:
49.015(1m)(b)2.
2. The individual has, in the past, resided in this state for at least 365 consecutive days.
49.015(1m)(b)3.
3. The individual came to this state to join a close relative who has resided in this state for at least 180 days before the arrival of the individual.
49.015(1m)(b)4.
4. The individual came to this state to accept a bona fide offer of employment and the individual was eligible to accept the employment.
49.015(2)
(2) Recipients of other aid. Except as provided in
sub. (3), an individual is not eligible for relief for a month in which the individual has received aid to families with dependent children under
s. 49.19 or supplemental security income under
42 USC 1381 to
1383c or has participated in a Wisconsin works employment position under
s. 49.147 (3) to
(5) or in which aid to families with dependent children, supplemental security income benefits or a Wisconsin works employment position is immediately available to the individual.
49.015(2m)
(2m) Ineligibility due to medical assistance divestment. Any person found ineligible for medical assistance because of the divestment provisions under
s. 49.453 is ineligible for relief funded by a relief block grant for the same period during which ineligibility exists under
s. 49.453.
49.015(3)
(3) Waiver of certain eligibility requirements. 49.015(3)(a)(a) A relief agency may waive the requirement under
sub. (1) (a) for an individual receiving health care services from a trauma center that meets the criteria established by the American College of Surgeons for classification as a Level I trauma center. If the county waives the requirement under
sub. (1) (a) for an individual, the county may seek reimbursement from the individual's county of residence if that county operates a program funded by a relief block grant.
49.015(3)(b)
(b) A relief agency may waive the requirement under
sub. (2) or
(2m) in case of unusual misfortune or hardship. Each waiver shall be reported to the department. The department may make a determination as to the appropriateness of the waiver under rules promulgated by the department under
s. 49.02 (7m) (d).
49.015 Annotation
Sixty day waiting period under (1) (b) does not unconstitutionally penalize an individual's right to travel. Jones v. Milwaukee County, 168 W (2d) 892, 485 NW (2d) 21 (1992).
49.02
49.02
Relief block grant administration. 49.02(1)
(1)
Eligibility for relief block grants. A county or tribal governing body is eligible to receive a relief block grant if all of the following conditions are met:
49.02(1)(a)
(a) The county board or tribal governing body adopts a resolution applying for a relief block grant.
49.02(1)(b)
(b) The county or tribal governing body establishes written criteria to be used to determine dependency and reviews these written criteria at least annually.
49.02(1)(c)
(c) The county or tribal governing body submits to the department a plan for the provision of services to be funded by the relief block grant. The plan shall include all of the following:
49.02(1)(c)1.
1. How the county or tribal governing body will determine eligibility and how these eligibility determinations may be appealed. The procedures for determining eligibility and for notice, fair hearing and review shall be consistent with rules promulgated by the department under
sub. (7m).
49.02(1)(c)2.
2. How the county or tribal governing body will determine which health care services are needed by a dependent person.
49.02(1)(c)3.
3. The cost containment mechanisms that will be used, including what limitations will be placed on the inappropriate use of emergency room care and what limitations will be placed on payments to providers contracted for under
sub. (2).
49.02(1)(c)4.
4. In the case of a county submitting a plan for a relief block grant under
s. 49.027, whether the county will provide services other than health care services and, if such services are offered, how the county will determine what services will be provided to a dependent person.
49.02(1)(d)
(d) The department has approved the plan under
par. (c). The department shall approve or disapprove the plan within a reasonable period of time after the plan is submitted.
49.02(1e)
(1e) Relief agencies. If a county or tribal governing agency is eligible to receive a relief block grant, the county or tribal governing body shall establish or designate a relief agency to administer relief under this section.
49.02(2)
(2) Contracting with private health care providers. A relief agency may use a relief block grant to provide health care services directly or, if the conditions in this subsection are met, by contracting with private health care providers, or by a combination of contracting with private health care providers and providing services directly. A relief agency may contract with a private health care provider to provide health care services under this subsection only if all of the following conditions are met:
49.02(2)(a)
(a) The relief agency enters into a contract with the private health care provider to provide specified health care services.
49.02(2)(b)
(b) The contract between the relief agency and the private health care provider provides that all records of the health care provider relating to the administration and provision of the health care services shall be open to inspection at all reasonable hours by authorized representatives of the county and the department.
49.02(2)(c)
(c) The contract between the relief agency and the private health care provider provides that any payments under
s. 49.45 (6y) and
(6z) made to the health care provider shall be used to offset the liability of the relief agency for the costs of the health care services provided under the contract.
49.02(2)(d)
(d) The contract limits payment for services under the contract to the amount payable by medical assistance for care for which a medical assistance rate exists.
49.02(2)(e)
(e) The contract does not provide for payment for hospitalization or care provided as uncompensated services required under
42 USC 291c.
49.02(2)(f)
(f) The contract prohibits the health care provider from holding an individual recipient of health care services funded under this section liable for the difference between the costs of the health care services and the amount paid to the health care provider by the county for the services.
49.02(5)
(5) Liability for health care services. 49.02(5)(b)(b) A relief agency is not liable for health care services provided to a dependent person if the hospital provides the health care services to the person as uncompensated services required under
42 USC 291c.
49.02(5)(bm)
(bm) A relief agency shall limit its liability for health care services funded by a relief block grant to the amount payable by medical assistance under
subch. IV for care for which a medical assistance rate exists.
49.02(6g)
(6g) Liability of recipients. No individual who receives health care services funded by a relief block grant may be liable for the difference between the costs of the services charged by the health care provider and the amount paid by the relief agency.
49.02(7)
(7) Notification requirement. Whenever the department or a relief agency has reason to believe that a person receiving relief is engaging in conduct or behavior prohibited in
ch. 944 or
ss. 940.225,
948.02,
948.025 or
948.06 to
948.11 the department or relief agency shall promptly notify the law enforcement officials of the county thereof, including facts relating to such person's alleged misconduct or illegal behavior.
49.02(7m)
(7m) Rules. The department shall promulgate rules regarding use of relief block grants. The rules shall include all of the following:
49.02(7m)(a)
(a) Procedures that relief agencies shall follow in making eligibility determinations.
49.02(7m)(b)
(b) Procedures for appealing eligibility determinations under
s. 49.015. These procedures shall provide for notice, fair hearing and review.
49.02(7m)(c)
(c) Procedures that relief agencies shall follow to obtain relief block grants under
sub. (1).
49.02(11)
(11) Department of transportation records. A relief agency may use vehicle registration information from the department of transportation in determining eligibility for relief.
49.02 Annotation
A county is liable under (5) for emergency services given a person who would be eligible for general relief even though that person refuses to apply therefor. Mercy Medical Center v. Winnebago County, 58 W (2d) 260, 206 NW (2d) 198.
49.02 Annotation
Prerequisites for municipal liability under (5) discussed. Clintonville Community Hosp. v. Clintonville, 87 W (2d) 635, 275 NW (2d) 655 (1979).
49.02 Annotation
Hospital has no duty to undertake credit investigation of apparently dependent patient prior to rendering medical services; county should investigate after receiving notice under (5). Trinity Memorial Hosp. v. Milwaukee, 98 W (2d) 220, 295 NW (2d) 814 (Ct. App. 1980).
49.02 Annotation
County's income guidelines under sub. (9) upheld; there is no requirement that the county consider the applicant's level of need. Hiller v. Adams County, 166 W (2d) 1038, 480 NW (2d) 563 (Ct. App. 1992).
49.02 Annotation
Sub. (5) (c) does not require the notice of emergency treatment to be signed by physician or require the form relating to a patient's residence to be notarized and does not deny coverage to an otherwise eligible person due to a provider's inability to submit a statement concerning the probable duration of treatment. Koller v. Pierce County DHSS, 187 W (2d) 1, 522 NW (2d) 240 (Ct. App. 1994).
49.02 Annotation
A county's discretion as to times and amounts for relief payments under s. 49.01 (5m) does not preempt the mandate under s. 49.02 (1m) requiring written standards of need to determine the amount necessary to secure adequate housing. The county must provide housing whether in the form of money or actual shelter which is adequate for health and decency. Clark v. Milwaukee County, 188 W (2d) 171, 524 NW (2d) 382 (1994).
49.02 Annotation
Counties may not require relief recipient to surrender auto title and plates as condition of receipt of assistance. 61 Atty. Gen. 313.
49.02 Annotation
Liability for cost of providing medical care to indigent person under arrest discussed. 67 Atty. Gen. 245.
49.02 Annotation
Section 53.38, 1987 stats., [now 302.38] is exclusively applicable in providing relief from medical and hospital care costs incurred by indigent prisoner while receiving emergency medical treatment in hospital. 69 Atty. Gen. 230.
49.02 Annotation
Rights and obligations of hospitals, counties and individual patients under Hill-Burton Act discussed. 70 Atty. Gen. 24.
49.02 Annotation
Welfare applicants are entitled to a statement of reasons and administrative hearing after their application for general welfare relief is denied. Alexander v. Silverman, 356 F Supp. 1179.
