51.40(2)(b)2.
2. `Individuals in nursing homes.' The following are presumptions regarding the county of residence of an individual in a nursing home that may be overcome by substantial evidence that clearly establishes other county residence:
51.40(2)(b)2.ag.
ag. An individual in a nursing home who was admitted under
s. 50.04 (2r) to the nursing home after December 1, 2006, is a resident of the county that approved the admission under
s. 50.04 (2r).
51.40(2)(b)2.bg.
bg. An individual residing in a nursing home on December 1, 2006, is a resident of the county in which the individual is physically present unless another county accepts the individual as a resident.
51.40(2)(b)2.cg.
cg. If the individual had an established residence in another county prior to entering the nursing home; the individual or the individual's guardian, if any, indicates an intent that the individual will return to that county when the purpose of entering the nursing home has been accomplished or when needed care and services can be obtained in that county; and the individual, when capable of indicating intent, or a guardian for the individual, has made no clearly documented expression to a court or county department of an intent to establish residence elsewhere since leaving that county, the individual is a resident of that county.
51.40(2)(b)2.dg.
dg. If the individual is incapable of indicating intent as determined by the county department, has no guardian, ordinarily resides in another county, and is expected to return to that county within one year, the individual is a resident of that county.
51.40(2)(b)2.eg.
eg. If another county has accepted responsibility for or provided services to the individual prior to December 1, 2006, the individual is a resident of that county.
51.40(2)(b)2.fg.
fg. If the individual is incapable of indicating intent; the individual was living in another county outside of a nursing home or state facility on December 1, 2006, or under circumstances that established residence in that county after December 1, 2006; and that county was the last county in which the individual had residence while living outside of a nursing home or state facility, the individual is a resident of that county.
51.40(2)(b)2.g.
g. If
subd. 2. ag. to
fg. does not apply, an individual who is incapable of indicating intent and is residing in a facility is a resident of the county in which the individual resided before admittance to the facility.
51.40(2)(f)
(f)
Guardian's authority to declare county of residence. A guardian may declare any of the following, under any of the following conditions:
51.40(2)(f)1.
1. The ward is a resident of the guardian's county of residence, if
pars. (a) and
(b) do not apply, if the guardian's ward is in a facility and is incapable of indicating intent, and if the guardian is a resident of the county in which the facility is located or states in writing that the ward is expected to return to the guardian's county of residence when the purpose of entering the facility has been accomplished or when needed care and services can be obtained in the guardian's county of residence.
51.40(2)(f)2.
2. The ward is a resident of the county in which the ward is physically present, if
pars. (a) and
(b) do not apply and if all of the following apply:
51.40(2)(f)2.b.
b. There is no current order under
ch. 55 in effect with respect to the ward, and the ward is not under an involuntary commitment order to the department of corrections or to a county other than the county in which the ward is physically present.
51.40(2)(f)2.d.
d. The guardian states in writing that it is the ward's intent to remain in the county for the foreseeable future.
51.40(2)(f)3.
3. The ward is a resident of the county specified by the guardian, regardless if a previous determination of county of residence has been made, notwithstanding
pars. (a) and
(b) for good cause shown, if, in the ward's best interest, the guardian files with the probate court having jurisdiction of the guardianship and protective placement a written statement declaring the ward's domiciliary intent, subject to court approval, and if notice and opportunity to be heard are provided to all affected counties and parties. Notice under this subdivision shall be sent to the corporation counsel of each affected county by certified mail.
51.40(2)(g)
(g)
Determination of county of responsibility. 51.40(2)(g)1.1. An individual, an interested person on behalf of the individual, or any county may request that the department make a determination of the county of responsibility of the individual. Any motion for change of venue pending before the court of jurisdiction may be stayed until the determination under this paragraph is final. Within 10 days after receiving the request, the department shall provide written notice to the individual; to the individual's guardian, guardian ad litem, and counsel, if any; to the individual's immediate family, if they can be located; and to all potentially responsible counties that a determination of county of responsibility shall be made and that written information and comments may be submitted within 30 days after the date on which the notice is sent.
51.40(2)(g)2.
2. The department shall review information submitted under
subd. 1. and make such investigation as it deems proper. Within 30 days after the end of the period for submitting information, the department shall make a decision as to residence, and send a copy of the decision to the individual and to all involved counties. The decision may be appealed under
s. 227.44 by the individual or the county determined to be responsible.
51.40(2)(g)3.
3. Pending a determination under
subd. 2., a county department which has been providing services to the individual shall continue to provide services if necessary to meet the individual's needs. If no county department is currently providing services, the county in which the client is physically present shall provide necessary services pending the determination.
51.40(2)(g)4.
4. A determination under
subd. 2. may provide for a period of transitional services to assure continuity of services by specifying a date until which the county department which has been providing services shall continue to do so.
51.40(2)(g)5.
5. The decision of the department under
subd. 2. is binding on the individual and on any county which received notice of the proceeding. Except as provided in the determination, the county determined to be the county of responsibility shall act as the county of responsibility immediately after receiving notice of the determination, and during the pendency of any appeal of the determination that is brought under
ch. 227.
51.40(2)(g)6.
6. The county that is determined to be the county of responsibility shall reimburse any other county for all care, treatment, and services provided by the other county to the individual under
ch. 46,
51, or
55. Full reimbursement by the county that is determined to be the county of responsibility shall be made within 120 days after the date of the department's determination of the county of responsibility or within 120 days after the date of the outcome of any appeal of the department's determination that is brought under
ch. 227, or by a date or under a schedule of 2 or more payments that is agreed to by both counties.
51.40 Annotation
The residence of an adult who was protectively placed as a minor is discussed. Waukesha County v. B.D.
163 Wis. 2d 779,
472 N.W.2d 563 (Ct. App. 1991).
51.40 Annotation
A community-based residential facility is neither a nursing home nor a state facility. Sub. (2) is limited to individuals living in nursing homes or state facilities. Juneau County v. Sauk County,
217 Wis. 2d 705,
580 N.W.2d 694 (Ct. App. 1998),
97-1365.
51.42
51.42
Community mental health, developmental disabilities, alcoholism and drug abuse services. 51.42(1)(a)(a)
Purpose and intent. All of the following are the purposes and intent of this section:
51.42(1)(a)1.
1. To enable and encourage counties to develop a comprehensive range of services offering continuity of care.
51.42(1)(a)2.
2. To utilize and expand existing governmental, voluntary and private community resources for provision of services to prevent or ameliorate mental disabilities, including but not limited to mental illness, developmental disabilities, alcoholism and drug abuse.
51.42(1)(a)3.
3. To provide for the integration of administration of those services and facilities organized under this section through the establishment of a county department of community programs.
51.42(1)(a)4.
4. To authorize state consultative services, reviews and establishment of standards and grants-in-aid for such program of services and facilities.
51.42(1)(b)
(b)
County liability. The county board of supervisors has the primary responsibility for the well-being, treatment and care of the mentally ill, developmentally disabled, alcoholic and other drug dependent citizens residing within its county and for ensuring that those individuals in need of such emergency services found within its county receive immediate emergency services. This primary responsibility is limited to the programs, services and resources that the county board of supervisors is reasonably able to provide within the limits of available state and federal funds and of county funds required to be appropriated to match state funds. County liability for care and services purchased through or provided by a county department of community programs established under this section shall be based upon the client's county of residence except for emergency services for which liability shall be placed with the county in which the individual is found. For the purpose of establishing county liability, "emergency services" includes those services provided under the authority of s.
55.05 (4), 2003 stats., or s.
55.06 (11) (a), 2003 stats., or
s. 51.15,
51.45 (11) (a) or
(b) or
(12),
55.13, or
55.135 for not more than 72 hours. Nothing in this paragraph prevents recovery of liability under
s. 46.10 or any other statute creating liability upon the individual receiving a service or any other designated responsible party, or prevents reimbursement by the department of health services for the actual cost of all care and services from the appropriation under
s. 20.435 (7) (da), as provided in
s. 51.22 (3).
51.42(2)
(2) Definition. In this section, "program" means community services and facilities for the prevention or amelioration of mental disabilities, including but not limited to mental illness, developmental disabilities, alcoholism and drug abuse.
51.42(3)
(3) County department of community programs. 51.42(3)(a)(a)
Creation. Except as provided under
s. 46.23 (3) (b), the county board of supervisors of any county, or the county boards of supervisors of 2 or more contiguous counties, shall establish a county department of community programs on a single-county or multicounty basis to administer a community mental health, developmental disabilities, alcoholism and drug abuse program, make appropriations to operate the program and authorize the county department of community programs to apply for grants-in-aid under
s. 51.423. The county department of community programs shall consist of a county community programs board, a county community programs director and necessary personnel.
51.42(3)(ar)
(ar)
Duties. A county department of community programs shall do all of the following:
51.42(3)(ar)1.
1. Enter into contracts to render services to or secure services from other agencies or resources including out-of-state agencies or resources. Notwithstanding
ss. 59.42 (1) and
(2) (b) and
978.05, any multicounty department of community programs may contract for professional legal services that are necessary to carry out the duties of the multicounty department of community programs if the corporation counsel of each county of the multicounty department of community programs has notified the multicounty department of community programs that he or she is unable to provide those services in a timely manner.
51.42(3)(ar)2.
2. Enter into contracts for the use of any facility as an approved public treatment facility under
s. 51.45 for the treatment of alcoholics if the county department of community programs deems it to be an effective and economical course to follow.
51.42(3)(ar)3.
3. Plan for and establish a community developmental disabilities program to deliver the services required under
s. 51.437 if, under
s. 51.437 (4g) (b), the county board of supervisors in a county with a single-county department of community programs or the county boards of supervisors in counties with a multicounty department of community programs transfer the powers and duties of the county department under
s. 51.437 to the county department of community programs. The county board of supervisors in a county with a single-county department of community programs and the county boards of supervisors in counties with a multicounty department of community programs may designate the county department of community programs to which these powers and duties have been transferred as the administrative agency of the long-term support community options program under
s. 46.27 (3) (b) 1. and
5. and the community integration programs under
ss. 46.275,
46.277 and
46.278.
51.42(3)(ar)4.
4. Within the limits of available state and federal funds and of county funds required to be appropriated to match state funds, provide for the program needs of persons suffering from mental disabilities, including mental illness, developmental disabilities, alcoholism or drug abuse, by offering the following services:
51.42(3)(ar)4.a.
a. Collaborative and cooperative services with public health and other groups for programs of prevention.
51.42(3)(ar)4.c.
c. Inpatient and outpatient care and treatment, residential facilities, partial hospitalization, emergency care and supportive transitional services.
51.42(3)(ar)4.d.
d. Related research and staff in-service training, including periodic training on emergency detention procedures under
s. 51.15, emergency protective services under
s. 55.13, and emergency protective placement procedures under
s. 55.135, for persons within the jurisdiction of the county department of community programs who are authorized to take individuals into custody under
ss. 51.15 and
55.135. In developing in-service training on emergency detention and emergency protective placement procedures, the county department of community programs shall consult the county department of developmental disabilities services under
s. 51.437 in counties where these departments are separate.
51.42(3)(ar)4.e.
e. Continuous planning, development and evaluation of programs and services for all population groups.
51.42(3)(ar)4m.
4m. If state, federal and county funding for alcohol and other drug abuse treatment services provided under
subd. 4. are insufficient to meet the needs of all eligible individuals, ensure that first priority for services is given to pregnant women who suffer from alcoholism or alcohol abuse or are drug dependent.
51.42(3)(ar)5.
5. Prepare a local plan which includes an inventory of all existing resources, identifies needed new resources and services and contains a plan for meeting the needs of the mentally ill, developmentally disabled, alcoholic, drug abusers and those with other psychiatric disabilities for citizens residing within the jurisdiction of the county department of community programs and for persons in need of emergency services found within the jurisdiction of the county department of community programs. The plan shall also include the establishment of long-range goals and intermediate-range plans, detailing priorities and estimated costs and providing for coordination of local services and continuity of care. The plan shall state how the needs of homeless persons and adults with serious and persistent mental illness, children with serious emotional disturbances and minorities will be met by the county department of community programs. The county department of community programs shall submit the plan to the department for review under
sub. (7) (a) 9. and
s. 51.02 (1) (f) in accordance with the schedule and deadlines established under
sub. (7) (a) 9.
51.42(3)(ar)6.
6. Under the supervision of the county community programs director, using qualified personnel with training or experience, or both, in mental health, developmental disabilities, or in alcoholism and drug abuse, be responsible for the planning and implementation of programs relating to mental health, developmental disabilities, alcoholism or drug abuse. A single coordinator may be responsible for alcoholism, drug abuse, mental health and developmental disabilities programs.
51.42(3)(ar)8.
8. By September 30, submit for inclusion as part of the proposed county budget to the county executive or county administrator or, in those counties without a county executive or county administrator, directly to the county board of supervisors in a county with a single-county department of community programs or the county boards of supervisors in counties with a multicounty department of community programs a proposed budget for the succeeding calendar year covering services, including active treatment community mental health center services, based on the plan required under
subd. 5. The final budget shall be submitted to the department of health services.
51.42(3)(ar)9.
9. Develop the cost of all services which it purchases based on the standards and requirements of
s. 46.036.
51.42(3)(ar)11.
11. Annually report to the department of health services regarding the use of any contract entered into under
s. 51.87.
51.42(3)(ar)13.
13. Except in an emergency, review and approve or disapprove all admissions to nursing homes of mentally ill persons under age 65 who are residents of the county.
51.42(3)(ar)14.
14. If the county board of supervisors establishes an integrated service program for children with severe disabilities under
s. 59.53 (7), participate in and may administer an integrated service program for children with severe disabilities under
s. 59.53 (7), including entering into any written interagency agreements or contracts.
51.42(3)(ar)15.
15. Submit to the department in a timely fashion, as specified by the department, any reports necessary to comply with the requirements under
42 USC 300x-52.
51.42(3)(ar)17.
17. If authorized under
s. 46.283 (1) (a) 1., apply to the department of health services to operate a resource center under
s. 46.283 and, if the department contracts with the county under
s. 46.283 (2), operate the resource center.
51.42(3)(ar)18.
18. If authorized under
s. 46.284 (1) (a) 1., apply to the department of health services to operate a care management organization under
s. 46.284 and, if the department contracts with the county under
s. 46.284 (2), operate the care management organization and, if appropriate, place funds in a risk reserve.
51.42(3)(as)1.1. A county department of community programs shall authorize all care of any patient in a state, local, or private facility under a contractual agreement between the county department of community programs and the facility, unless the county department of community programs governs the facility. The need for inpatient care shall be determined by the program director or designee in consultation with and upon the recommendation of a licensed physician trained in psychiatry and employed by the county department of community programs or its contract agency. In cases of emergency, a facility under contract with any county department of community programs shall charge the county department of community programs having jurisdiction in the county where the patient is found. The county department of community programs shall reimburse the facility for the actual cost of all authorized care and services less applicable collections under
s. 46.036, unless the department of health services determines that a charge is administratively infeasible, or unless the department of health services, after individual review, determines that the charge is not attributable to the cost of basic care and services. Except as provided in
subd. 1m., a county department of community programs may not reimburse any state institution or receive credit for collections for care received in a state institution by nonresidents of this state, interstate compact clients, transfers under
s. 51.35 (3), transfers from Wisconsin state prisons under
s. 51.37 (5) (a), commitments under s.
975.01, 1977 stats., or s.
975.02, 1977 stats., or
s. 971.14,
971.17 or
975.06 or admissions under s.
975.17, 1977 stats., or children placed in the guardianship of the department of children and families under
s. 48.427 or
48.43 or under the supervision of the department of corrections under
s. 938.183 or
938.355. The exclusionary provisions of
s. 46.03 (18) do not apply to direct and indirect costs that are attributable to care and treatment of the client.
51.42(3)(as)1m.
1m. A county department of community programs shall reimburse a mental health institute at the institute's daily rate for custody of any person who is ordered by a court located in that county to be examined at the mental health institute under
s. 971.14 (2) for all days that the person remains in custody at the mental health institute, beginning 48 hours, not including Saturdays, Sundays, and legal holidays, after the sheriff and county department receive notice under
s. 971.14 (2) (d) that the examination has been completed.
51.42(3)(as)2.
2. If a mental health institute has provided a county department of community programs with service, the department of health services shall regularly bill the county department of community programs, except as provided under
subd. 2m. If collections for care exceed current billings, the difference shall be remitted to the county department of community programs through the appropriation under
s. 20.435 (2) (gk). For care provided on and after February 1, 1979, the department of health services shall adjust collections from medical assistance to compensate for differences between specific rate scales for care charged to the county department of community programs and the average daily medical assistance reimbursement rate. Payment shall be due from the county department of community programs within 60 days of the billing date subject to provisions of the contract. If any payment has not been received within 60 days, the department of health services shall deduct all or part of the amount from any payment due from the department of health services to the county department of community programs.
51.42(3)(as)2m.
2m. The department of health services may bill the county department of community programs under
subd. 2. for inpatient services provided on or after October 1, 1987, by a mental health institute for individuals under 21 years of age or for individuals under 22 years of age who are receiving the services immediately prior to reaching age 21, only if the person lacks full means of payment, including payment from medical assistance and other sources.
51.42(3)(as)3.
3. Care, services and supplies provided after December 31, 1973, to any person who, on December 31, 1973, was in or under the supervision of a mental health institute, or was receiving mental health services in a facility authorized by
s. 51.08 or
51.09, but was not admitted to a mental health institute by the department of health services, shall be charged to the county department of community programs which was responsible for such care and services at the place where the patient resided when admitted to the institution. The department of health services may bill county departments of community programs for care provided at the mental health institutes at rates which the department of health services sets on a flexible basis, except that this flexible rate structure shall cover the cost of operations of the mental health institutes.
51.42(3)(aw)1.1. Within the limits of state and county appropriations and maximum available funding from other sources, a county department of community programs may provide for the program needs of persons suffering from mental disabilities, including but not limited to mental illness, developmental disability, alcoholism or drug abuse, by offering the following services:
51.42(3)(aw)1.a.
a. Precare, aftercare and rehabilitation and habilitation services.
51.42(3)(aw)1.d.
d. Provide treatment and services that are specified in a conditional release plan approved by a court for a person who is a county resident and is conditionally released under s.
971.17 (3) or
(4) or that are specified in a supervised release plan approved by a court under s.
980.06 (2) (c), 1997 stats., s.
980.08 (5), 2003 stats., or
s. 980.08 (4) (g). If the county department provides treatment and services under this subdivision, the department of health services shall, from the appropriation under
s. 20.435 (2) (bj), pay the county department for the costs of the treatment and services.
51.42(3)(aw)2.
2. A county department of community programs may allocate services among service recipients to reflect the availability of limited resources.
51.42(3)(aw)3.
3. A county department of community programs may own, lease or manage real property for the purposes of operating a treatment facility.
51.42(3)(b)
(b)
Other powers and duties. The county board of supervisors of any county with a single-county department of community programs and the county boards of supervisors of counties with a multicounty department of community programs may designate the county department of community programs as the administrator of any other county health care program or institution, but the operation of such program or institution is not reimbursable under
s. 51.423.
51.42(3)(bm)
(bm)
Educational services. A county department of community programs may not furnish services and programs provided by the department of public instruction and local educational agencies.
51.42(3)(c)
(c)
Multicounty contract. No grant-in-aid may be made under
s. 51.423 to any multicounty department of community programs until the counties which established the multicounty department of community programs have drawn up a detailed contractual agreement, approved by the secretary, setting forth the plans for joint sponsorship.
51.42(3)(e)
(e)
Exchange of information. Notwithstanding
ss. 46.2895 (9),
48.78 (2) (a),
49.45 (4),
49.83,
51.30,
51.45 (14) (a),
55.22 (3),
146.82,
252.11 (7),
253.07 (3) (c) and
938.78 (2) (a), any subunit of a county department of community programs or tribal agency acting under this section may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of community programs or tribal agency, with a resource center, a care management organization, or a family [long-term] care district, or with any person providing services to the client under a purchase of services contract with the county department of community programs or tribal agency or with a resource center, care management organization, or family [long-term] care district, if necessary to enable an employee or service provider to perform his or her duties, or to enable the county department of community programs or tribal agency to coordinate the delivery of services to the client. Any agency releasing information under this paragraph shall document that a request was received and what information was provided.
51.42 Note
NOTE: The correct term is shown in brackets. Corrective legislation pending.
51.42(4)
(4) County community programs board. 51.42(4)(a)1.1. Except as provided under
subd. 2., the county board of supervisors of every county with a single-county department of community programs or the county boards of supervisors in counties with a multicounty department of community programs shall, before qualification under this section, appoint a governing and policy-making board to be known as the county community programs board. A county community programs board appointed under this subdivision shall govern the single-county or multicounty department of community programs and shall assume all of the powers and duties of the county department of community programs under
sub. (3) (ar) to
(bm). A member of a county community programs board appointed under this subdivision may be removed from office under the following circumstances:
51.42(4)(a)1.a.
a. For cause, by a two-thirds vote of each county board of supervisors participating in the appointment, on due notice in writing and hearing of the charges against the member.
51.42(4)(a)1.b.
b. If the member when appointed was a member of the county board of supervisors and the member is not reelected to that office, on due notice in writing.
51.42(4)(a)2.
2. In any county with a county executive or county administrator and which has established a single-county department of community programs, the county executive or county administrator shall appoint, subject to confirmation by the county board of supervisors, the county community programs board, which shall be only a policy-making body determining the broad outlines and principles governing the administration of programs under this section. A member of a county community programs board appointed under this subdivision may be removed by the county executive or county administrator under the following circumstances:
51.42(4)(a)2.b.
b. If the member when appointed was a member of the county board of supervisors and the member is not reelected to that office.
51.42(4)(b)1.1. In a single-county department of community programs the county community programs board shall be composed of not less than 9 nor more than 15 persons of recognized ability and demonstrated interest in the problems of the mentally ill, developmentally disabled, alcoholic or drug dependent persons and shall have representation from the interest group of the mentally ill, the interest group of the developmentally disabled, the interest group of the alcoholic and the interest group of the drug dependent. At least one member appointed to a county community programs board shall be an individual who receives or has received services for mental illness, developmental disability, alcoholism or drug dependency or shall be a family member of such an individual. No more than 5 members may be appointed from the county board of supervisors.
51.42(4)(b)2.
2. In a multicounty department of community programs, the county community programs board shall be composed of 11 members with 3 additional members for each county in a multicounty department of community programs in excess of 2. Appointments shall be made by the county boards of supervisors of the counties in a multicounty department of community programs in a manner acceptable to the counties in the multicounty department of community programs and shall have representation from the interest group of the mentally ill, the interest group of the developmentally disabled, the interest group of the alcoholic and the interest group of the drug dependent. At least one member appointed to a county community programs board shall be an individual who receives or has received services for mental illness, developmental disability, alcoholism or drug dependency or shall be a family member of such an individual. Each of the counties in the multicounty department of community programs may appoint to the county community programs board not more than 3 members from its county board of supervisors.
