46.278
46.278
Community integration program for persons with mental retardation. 46.278(1)
(1)
Legislative intent. The intent of the program under this section is to provide home or community-based care to serve in a noninstitutional community setting a person who meets eligibility requirements under
42 USC 1396n (c) and who is diagnosed as developmentally disabled under the definition specified in
s. 51.01 (5) and relocated from an institution other than a state center for the developmentally disabled or who meets the intermediate care facility for the mentally retarded level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded and is ineligible for services under
s. 46.275 or
46.277. The intent of the program is also that counties use all existing services for providing care under this section, including those services currently provided by counties.
46.278(1m)(ag)
(ag) "Family consortium" means a group composed of relatives, or of relatives and the guardian, of an individual with developmental disability who together provide services for the individual in a home that is an extension of a relative's or the guardian's home.
46.278(1m)(c)
(c) "Program" means the community integration program for facilities certified as medical assistance providers, for which a waiver has been received under
sub. (3).
46.278(2)
(2) Departmental powers and duties. 46.278(2)(a)(a) The department may request a waiver from the secretary of the federal department of health and human services, under
42 USC 1396n (c), authorizing the department to serve medical assistance recipients, who meet the level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded, in their communities by providing home or community-based services as part of medical assistance. If the department requests a waiver, it shall include all assurances required under
42 USC 1396n (c) (2) in its request.
46.278(3)
(3) Waiver; extension; duties. If the department receives a waiver requested under
sub. (2) (a), it may request a 3-year extension of the waiver under
42 USC 1396n (c) and shall perform the following duties:
46.278(3)(a)
(a) Evaluate the effect of the program on medical assistance costs and on the program's ability to provide community care alternatives to institutional care in facilities certified as medical assistance providers.
46.278(3)(b)
(b) Fund home or community-based services provided by any county that meet the requirements of this section.
46.278(3)(c)
(c) To the maximum extent possible, authorize the provision of services under this section to serve persons, except those institutionalized in a state center for the developmentally disabled, in noninstitutional settings and coordinate application of the review criterion under
s. 150.39 (5) with the services provided under this section.
46.278(4)(a)(a) Sections 46.27 (3) (b) and
46.275 (3) (a) and
(c) to
(e) apply to county participation in this program, except that services provided in the program shall substitute for care provided a person in an intermediate care facility for the mentally retarded who meets the intermediate care facility for the mentally retarded level of care requirements for medical assistance reimbursement to that facility rather than for care provided at a state center for the developmentally disabled.
46.278(4)(b)1.1. If the provision of services under this section results in a decrease in the statewide nursing home bed limit under
s. 150.31 (3), the facility affected by the decrease shall submit a plan for delicensing all or part of the facility that is approved by the department.
46.278(4)(b)2.
2. Each county department participating in the program shall provide home or community-based care to persons eligible under this section, except that the number of persons who receive home or community-based care under this section may not exceed the number that are approved under the waiver received under
sub. (3).
46.278(5)(a)(a) Any medical assistance recipient who meets the level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded and is ineligible for service under
s. 46.275 or
46.277 is eligible to participate in the program, except that the number of participants may not exceed the number approved under the waiver received under
sub. (3). Such a recipient may apply, or any person may apply on behalf of such a recipient, for participation in the program.
Section 46.275 (4) (b) applies to participation in the program.
46.278(5)(am)
(am) One individual who is eligible under
par. (a) may, beginning January 1, 1992, participate in the program through services provided by a family consortium that is formed before January 1, 1991, and is approved by the department.
46.278(5)(b)
(b) To the extent authorized under
42 USC 1396n, if a person discontinues participation in the program, a medical assistance recipient may participate in the program in place of the participant who discontinues if that recipient meets the intermediate care facility for the mentally retarded level of care requirements for medical assistance reimbursement in an intermediate care facility for the mentally retarded, except that the number of participants concurrently served may not exceed the number approved under the waiver received under
sub. (3).
46.278(6)(b)
(b) Total funding to counties for relocating each person under the program may not exceed the amount approved in the waiver received under
sub. (3).
46.278(6)(c)
(c) Funding may be provided under the program for services of a family consortium.
46.278(6)(d)
(d) If a county makes available nonfederal funds equal to the state share of service costs under the 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).
46.278(6)(e)1.1. The department may provide enhanced reimbursement for services under the program for an individual who was relocated to the community by a county department from one of the following:
46.278(6)(e)1.b.
b. An intermediate care facility for the mentally retarded or a distinct part thereof that has a plan of closure approved by the department and that intends to close within 12 months.
46.278(6)(e)1.c.
c. An intermediate care facility for the mentally retarded that has a plan of closure or significant reduction in capacity approved by the department and that intends to close or significantly reduce its capacity within 60 months.
46.278(6)(e)2.a.a. The enhanced reimbursement rate under
subd. 1. a. and
b. shall be determined under a formula that is developed by the department.
46.278(6)(e)2.b.
b. The enhanced reimbursement rate under
subd. 1. c. shall be 90% of the enhanced reimbursement rate under this
subd. 2. a.
46.278(6)(f)
(f) If a county owns the institution or intermediate care facility for the mentally retarded from which an individual is relocated to the community under this section, in order to receive funding under the program, the county shall submit a plan for delicensing a bed of the institution or intermediate care facility for the mentally retarded that is approved by the department.
46.278(7)
(7) Report. By July 1 of each year, the department shall submit to the joint committee on finance and to the chief clerk of each house of the legislature, for distribution to the appropriate standing committees under
s. 13.172 (3), a report describing the cost and quality of services used under the program and the extent to which existing services have been used under the program in the preceding calendar year.
46.278(8)
(8) Effective period. Except as provided under
sub. (2), this section takes effect on the date approved by the secretary of the federal department of health and human services as the beginning date of the period of waiver received under
sub. (3). This section remains in effect for 3 years following that date and, if the secretary of the federal department of health and human services approves a waiver extension, shall continue an additional 3 years.
46.28
46.28
Revenue bonding for residential facilities. 46.28(1)(a)
(a) "Authority" means the Wisconsin housing and economic development authority created under
ch. 234.
46.28(1)(am)
(am) "Child with long-term care needs" means any of the following:
46.28(1)(am)1.
1. A juvenile adjudged delinquent for whom a case disposition is made under
s. 938.34.
46.28(1)(am)2.
2. A child found to be in need of protection or services for whom an order is made under
s. 48.345 or a juvenile found to be in need of protection or services for whom an order is made under
s. 938.345.
46.28(1)(b)
(b) "Chronically disabled" means any person who is alcoholic, developmentally disabled, drug dependent or mentally ill, as defined in
s. 51.01 (1),
(5),
(8) and
(13), or any person who is physically disabled.
46.28(1)(c)
(c) "Elderly" means a person 60 years of age or older.
46.28(1)(cg)
(cg) "Eligible individual" means an individual who is elderly or chronically disabled, a child with long-term care needs, a homeless individual or a victim of domestic abuse.
46.28(1)(d)
(d) "Residential facility" means a living unit for eligible individuals that is developed by a sponsor and that is not physically connected to a nursing home or hospital except by common service units for laundry, kitchen or utility purposes and that may include buildings and grounds for activities related to residence, including congregate meal sites, socialization, physical rehabilitation facilities and child care facilities.
46.28(1)(e)2.
2. A tribal council or housing authority or any nonprofit entity created by a tribal council.
46.28(1)(e)7.
7. Any housing corporation, limited-profit or nonprofit entity.
46.28(1)(e)8.
8. Any other entity meeting criteria established by the authority and organized to provide housing for persons and families of low and moderate income.
46.28(1)(e)9.
9. An entity that is operated for profit and that is engaged in providing medical care or residential care or services, including all of the following:
46.28(1)(f)
(f) "Victim of domestic abuse" means an individual who has encountered domestic abuse, as defined in
s. 46.95 (1) (a).
46.28(2)
(2) The department may approve any residential facility for financing by the authority if it determines that the residential facility will help meet the housing needs of an eligible individual, based on factors that include:
46.28(2)(a)
(a) The geographic location of the residential facility.
46.28(2)(b)
(b) The population served by the residential facility.
46.28(2)(c)
(c) The services offered by the residential facility.
46.28(3)
(3) The department may authorize the authority to issue revenue bonds under
s. 234.61 to finance any residential facility it approves under
sub. (2).
46.28(4)
(4) The department may charge sponsors for administrative costs and expenses it incurs in exercising its powers and duties under this section and under
s. 234.61.
46.2805(1)
(1) "Care management organization" means an entity that is certified as meeting the requirements for a care management organization under
s. 46.284 (3) and that has a contract under
s. 46.284 (2). "Care management organization" does not mean an entity that contracts with the department to operate one of the following:
46.2805(1)(b)
(b) A demonstration program known as the Wisconsin partnership program under a federal waiver authorized under
42 USC 1315.
46.2805(3)
(3) "Enrollee" means a person who is enrolled in a care management organization.
46.2805(4)
(4) "Family care benefit" means financial assistance for long-term care and support items for an enrollee.
46.2805(6)
(6) "Family care district board" means the governing board of a family care district.
46.2805(7)
(7) "Functional and financial screen" means a screen prescribed by the department that is used to determine functional eligibility under
s. 46.286 (1) (a) and financial eligibility under
s. 46.286 (1) (b).
46.2805(7m)
(7m) "Local long-term care council" means a local long-term care council that is appointed under
s. 46.282 (2) (a).
46.2805(9)
(9) "Older person" means a person who is at least 65 years of age.
46.2805(10)
(10) "Resource center" means an entity that meets the standards for operation under
s. 46.283 (3) or, if under contract to provide a portion of the services specified under
s. 46.283 (3), meets the standards for operation with respect to those services.
