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.
46.2805(11)
(11) "Tribe or band" means a federally recognized American Indian tribe or band.
46.2805 History
History: 1999 a. 9,
185.
46.281
46.281
Powers and duties of the department and the secretary; long-term care. 46.281(1)
(1)
Duties of the department. The department shall do all of the following:
46.281(1)(a)
(a) Provide training to members of the council on long-term care who are aged 65 or older or who have physical or developmental disabilities or their family members, guardians or other advocates, to enable these members to participate in the council's duties.
Effective date note
NOTE: Par. (a) is repealed eff. 7-1-01, or the day after publication of the 2001-03 biennial budget act, whichever is later, by
1999 Wis. Act 9.
46.281(1)(b)
(b) Provide information to the council on long-term care, including copies of reports submitted to the department by local long-term care councils, and seek recommendations of the council.
Effective date note
NOTE: Par. (b) is repealed eff. 7-1-01, or the day after publication of the 2001-03 biennial budget act, whichever is later, by
1999 Wis. Act 9.
46.281(1)(c)
(c) Request from the secretary of the federal department of health and human services any waivers of federal medicaid laws necessary to permit the use of federal moneys to provide the family care benefit to recipients of medical assistance. The department shall implement any waiver that is approved and that is consistent with
ss. 46.2805 to
46.2895. Regardless of whether a waiver is approved, the department may implement operation of resource centers, care management organizations and the family care benefit.
46.281(1)(d)1.
1. Establish, in geographic areas in which resides no more than 29% of the population that is eligible for the family care benefit, a pilot project under which the department may contract with a county, a family care district, a tribe or band or the Great Lakes inter-tribal council, inc., or with any 2 or more of these entities under a joint application, to operate a resource center.
46.281(1)(d)2.
2. In geographic areas in which resides no more than 29% of the population that is eligible for the family care benefit, contract with counties or tribes or bands under a pilot project to demonstrate the ability of counties or tribes or bands to manage all long-term care programs and administer the family care benefit as care management organizations.
46.281(1)(e)
(e) After June 30, 2001, if the local long-term care council for the applicable area has developed the initial plan under
s. 46.282 (3) (a) 1., contract with entities specified under
par. (d) and, only if specifically authorized by the legislature and if the legislature appropriates necessary funding, contract as so authorized with one or more entities in addition to those specified in
par. (d) certified as meeting requirements under
s. 46.284 (3) for services of the entity as a care management organization and one or more entities for services specified under
s. 46.283 (3) and
(4).
46.281(1)(f)
(f) Prescribe and implement a per person monthly rate structure for costs of the family care benefit.
46.281(1)(g)
(g) In order to maintain continuous quality assurance and quality improvement for resource centers and care management organizations, do all of the following:
46.281(1)(g)1.
1. Prescribe by rule and by contract and enforce performance standards for operation of resource centers and care management organizations.
46.281(1)(g)2.
2. Use performance expectations that are related to outcomes for persons in contracting with care management organizations and resource centers.
46.281(1)(g)4.
4. Require that quality assurance and quality improvement efforts be included throughout the long-term care system specified in
ss. 46.2805 to
46.2895.
46.281(1)(g)5.
5. Ensure that reviews of the quality of management and service delivery of resource centers and care management organizations are conducted by external organizations and make information about specific review results available to the public.
46.281(1)(h)
(h) Require by contract that resource centers and care management organizations establish procedures under which an individual who applies for or receives the family care benefit may register a complaint or grievance and procedures for resolving complaints and grievances.
46.281(1)(i)
(i) Prescribe criteria to assign priority equitably on any necessary waiting lists for persons who are eligible for the family care benefit but who do not meet the criteria under
s. 46.286 (3).
46.281(2)
(2) Powers of the department. The department may develop risk-sharing arrangements in contracts with care management organizations, in accordance with applicable state laws and federal statutes and regulations.
46.281(3)
(3) Duty of the secretary. The secretary shall certify to each county, hospital, nursing home, community-based residential facility, adult family home and residential care apartment complex the date on which a resource center that serves the area of the county, hospital, nursing home, community-based residential facility, adult family home or residential care apartment complex is first available to provide a functional and financial screen. To facilitate phase-in of services of resource centers, the secretary may certify that the resource center is available for specified groups of eligible individuals or for specified facilities in the county.
46.281 History
History: 1999 a. 9.
46.282
46.282
Councils on long-term care. 46.282(1)
(1)
Council on long-term care. The council on long-term care appointed under
s. 15.197 (5) shall do all of the following:
46.282(1)(a)
(a) Assist the department in developing broad policy issues related to long-term care services.
46.282(1)(b)
(b) Assist the department in developing, implementing, coordinating and guiding long-term care services and systems, including by reviewing and making nonbinding recommendations to the department on all of the following:
46.282(1)(b)1.
1. The department's standard contract provisions for resource centers and care management organizations.
46.282(1)(b)2.
2. The family care benefit, including the per person rate structure for the benefit.
46.282(1)(b)5.
5. Programs other than those under pars (c) and (d) that provide home and community-based services.
46.282(1)(b)6.
6. The provision of medical assistance services under a fee-for-service system.
46.282(1)(c)
(c) Monitor patterns of complaints, grievances and appeals related to long-term care in order to identify issues of statewide importance.
46.282(1)(d)
(d) Monitor the numbers of persons on waiting lists.
46.282(1)(e)
(e) Review patterns of utilization of various types of services by care management organizations.
46.282(1)(f)
(f) Monitor the pattern of care management organization enrollments and disenrollments throughout the state.
46.282(1)(g)
(g) Report annually to the legislature under
s. 13.172 (2) and to the governor on the status, significant achievements and problems of resource centers, care management organizations and the family care benefit, including all of the following:
46.282(1)(g)2.
2. Costs of long-term care provided under the family care benefit.
46.282(1)(g)3.
3. The number and service areas of resource centers and care management organizations.
46.282(1)(g)5.
5. Results of reviews of quality of services provided by resource centers and care management organizations.
Effective date note
NOTE: Sub. (1) is repealed eff. 7-1-01, or the day after publication of the 2001-03 biennial budget act, whichever is later, by
1999 Wis. Act 9.
46.282(2)
(2) Local long-term care councils; appointment; membership; terms; compensation and training; officers. 46.282(2)(a)(a) Appointment by a county. In a county that participates in a pilot project under
s. 46.281 (1) (d) and before a county participates in the program under
ss. 46.2805 to
46.2895, the following shall be done:
