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 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.
49.015
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
States may deny benefits to those who fail to prove they did not quit job in order to obtain benefits. Lavine v. Milne,
424 U.S. 577 (1976).
49.015 Annotation
Constitutional law: residency requirements. 53 MLR 439.
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)(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 Cross-reference
Cross Reference: See also chs.
DHS 250 and
251, Wis. adm. code.
49.025
49.025
Relief block grants to counties with a population of 500,000 or more; medical relief. 49.025(1)
(1)
Applicability. This section applies only to a county having a population of 500,000 or more.
49.025(2)(a)(a) If a county is eligible to receive a relief block grant in a year, the department shall pay to the county, in accordance with
s. 49.031, from the appropriation under
s. 20.435 (4) (bt), an amount for that year determined as follows:
49.025(2)(a)1.
1. The department shall determine the lesser of the following:
49.025(2)(a)1.a.
a. For 1996, $17,600,000, and for each year thereafter, $16,600,000.
49.025(2)(a)1.b.
b. For any year, 45% of the total amount expended by the county in that year as relief for health care services provided to dependent persons, including the amount transferred to the appropriation account under
s. 20.435 (4) (h) in that year and the amount estimated to be received from the federal government as a match to the funds expended from the appropriation account under
s. 20.435 (4) (h).
49.025(2)(a)2.
2. The department shall subtract from the amount determined under
subd. 1. amounts paid to hospitals in that county under
s. 49.45 (6y) and
(6z) in that year and amounts paid on behalf of individuals in that county under the demonstration project under
s. 49.45 (23) in that year. If the amount determined under this subdivision is less than zero, the amount of the relief block grant is $0.
49.025(2)(b)
(b) In calculating the total amount expended by the county under
par. (a), the department may exclude any amount expended as a result of a waiver determined to be inappropriate under rules promulgated by the department under
s. 49.02 (7m) (d).
49.025(3)
(3) Use of relief block grant funds. A county may use moneys received as a relief block grant only for the purpose of providing health care services to dependent persons.
49.027
49.027
Relief block grants to counties having a population of less than 500,000; medical and nonmedical relief. 49.027(1)(1) A
pplicability. This section applies only to a county having a population of less than 500,000.
49.027(2)(a)(a) If a county is eligible to receive a relief block grant in a year, the department shall pay to the county, in accordance with
s. 49.031 and subject to
par. (c), from the appropriation under
s. 20.435 (4) (bt), an amount for that year determined as follows:
49.027(2)(a)2.
2. The department shall calculate the sum of the following:
49.027(2)(a)2.a.
a. For any year, 50% of the total costs incurred by the county for health care services provided to dependent persons as relief in that year.
49.027(2)(a)2.b.
b. For any year, 40% of the total costs incurred by the county for cash benefits, and for services other than health care services, provided to dependent persons as relief in that year.
49.027(2)(a)4.
4. From the amount determined under
subd. 2., the department shall subtract amounts paid to hospitals in that county under
s. 49.45 (6y) and
(6z) for that calendar year.
49.027(2)(b)
(b) In calculating the total costs incurred by the county under
par. (a) 2., the department may exclude any amount expended as relief by the county in that year as a result of a waiver determined by the department to be inappropriate under rules promulgated by the department under
s. 49.02 (7m) (d).
49.027(2)(c)
(c) If sufficient funds are not available to pay all of the relief block grants calculated under
par. (a), the department shall prorate the available funds among the eligible counties in proportion to the amounts calculated under
par. (a).
49.027(3)
(3) Use of relief block grant funds. A county may use moneys received as a relief block grant to provide services only as follows:
49.027(3)(a)
(a) To provide health care services to dependent persons.
49.027(3)(b)
(b) If the county provides health care services to dependent persons, to provide cash benefits, or services other than health care services, to dependent persons.
49.027(4)
(4) Work component. If a county provides cash benefits, or services other than health care services, as relief, the county may include a work component as part of its relief program funded under this section. If a county includes a work component under this subsection, the county may require a dependent person to participate in the work component as a condition for receiving cash benefits, or services other than health care services.
49.029
49.029
Block grants to tribal governing bodies; medical relief. 49.029(1)(1) A
pplicability. This section applies only to tribal governing bodies.
49.029(2)
(2) Amount and distribution of relief block grant. From the appropriation under
s. 20.435 (4) (kb), the department shall distribute a relief block grant to each eligible tribal governing body in an amount and in a manner determined in accordance with rules promulgated by the department. The department shall promulgate the rules after consulting with all tribal governing bodies eligible for a relief block grant. In promulgating rules under this section, the department shall consider each tribe's economic circumstances and need for health care services.
49.029(3)
(3) Use of relief block grant funds. A tribal governing body may use moneys received as a relief block grant only for the purpose of providing health care services to dependent persons. Notwithstanding
s. 49.01 (2g), health care services may include treatment services for alcohol and other drug abuse and mental health services.
