49.32 Note
NOTE: The above-cited cases relate to uniform fee schedules for services provided by predecessor agencies to the department of children and families under s. 46.03 (18).
49.325
49.325
County department budgets and contracts. 49.325(1)(a)(a) Each county department under
s. 46.215,
46.22, or
46.23 shall submit its final budget for services directly provided or purchased under this subchapter or
ch. 48 to the department by December 31 annually.
49.325(2)
(2) Assessment of needs. Before developing and submitting a proposed budget for services directly provided or purchased under this subchapter or
ch. 48 to the county executive or county administrator or the county board, the county departments listed in
sub. (1) shall assess needs and inventory resources and services, using an open public participation process.
49.325(2g)(a)(a) The department shall annually submit to the county board of supervisors in a county with a single-county department or the county boards of supervisors in counties with a multicounty department a proposed written contract containing the allocation of funds for services directly provided or purchased under this subchapter or
ch. 48 and such administrative requirements as necessary. The contract as approved may contain conditions of participation consistent with federal and state law. The contract may also include provisions necessary to ensure uniform cost accounting of services. Any changes to the proposed contract shall be mutually agreed upon. The county board of supervisors in a county with a single-county department or the county boards of supervisors in counties with a multicounty department shall approve the contract before January 1 of the year in which it takes effect unless the department grants an extension. The county board of supervisors in a county with a single-county department or the county boards of supervisors in counties with a multicounty department may designate an agent to approve addenda to any contract after the contract has been approved.
49.325(2g)(b)
(b) The department may not approve contracts for amounts in excess of available revenues. Actual expenditure of county funds shall be reported in compliance with procedures developed by the department.
49.325(2g)(c)
(c) The joint committee on finance may require the department to submit contracts between county departments under
ss. 46.215,
46.22, and
46.23 and providers of services under this subchapter or
ch. 48 to the committee for review and approval.
49.325(2r)(a)(a) The department, after reasonable notice, may withhold a portion of the appropriation allocated to a county department under
s. 46.215,
46.22 or
46.23 if the department determines that that portion of the allocated appropriation is any of the following:
49.325(2r)(a)1.
1. For services under this subchapter or
ch. 48 that duplicate or are inconsistent with services being provided or purchased by the department or other county departments receiving grants-in-aid or reimbursement from the department.
49.325(2r)(a)2.
2. Inconsistent with state or federal statutes, rules, or regulations, in which case the department may also arrange for provision of services under this subchapter or
ch. 48 by an alternate agency. The department may not arrange for provision of services by an alternate agency unless the joint committee on finance or a review body designated by the committee reviews and approves the department's determination.
49.325(2r)(a)5.
5. Inconsistent with the provisions of the county department's contract under
sub. (2g).
49.325(2r)(b)
(b) If the department withholds a portion of the allocable appropriation under
par. (a), the county department under
s. 46.215,
46.22 or
46.23 that is affected by the action of the department may submit to the county board of supervisors in a county with a single-county department or to its designated agent or the county boards of supervisors in counties with a multicounty department or their designated agents a plan to rectify the deficiency found by the department. The county board of supervisors or its designated agent in a county with a single-county department or the county boards of supervisors in counties with a multicounty department or their designated agents may approve or amend the plan and may submit for departmental approval the plan as adopted. If a multicounty department is administering a program, the plan may not be submitted unless each county board of supervisors which participated in the establishment of the multicounty department, or its designated agent, adopts it.
49.325(3)
(3) Open public participation process. 49.325(3)(a)(a)
Citizen advisory committee. Except as provided in
par. (b), the county board of supervisors of each county or the county boards of supervisors of 2 or more counties jointly shall establish a citizen advisory committee to the county departments under
ss. 46.215,
46.22 and
46.23. The citizen advisory committee shall advise in the formulation of the budget under
sub. (1). Membership on the committee shall be determined by the county board of supervisors in a county with a single-county committee or by the county boards of supervisors in counties with a multicounty committee and shall include representatives of those persons receiving services, providers of services and citizens. A majority of the members of the committee shall be citizens and consumers of services. At least one member of the committee shall be chosen from the governing or administrative board of the community action agency serving the county or counties under
s. 49.265, if any. The committee's membership may not consist of more than 25% county supervisors, nor of more than 20% services providers. The chairperson of the committee shall be appointed by the county board of supervisors establishing it. In the case of a multicounty committee, the chairperson shall be nominated by the committee and approved by the county boards of supervisors establishing it. The county board of supervisors in a county with a single-county committee or the county boards of supervisors in counties with a multicounty committee may designate an agent to determine the membership of the committee and to appoint the committee chairperson or approve the nominee.
49.325(3)(b)
(b)
Alternate process. The county board of supervisors or the boards of 2 or more counties acting jointly may submit a report to the department on the open public participation process used under
sub. (2). The county board of supervisors may designate an agent, or the boards of 2 or more counties acting jointly may designate an agent, to submit the report. If the department approves the report, establishment of a citizen advisory committee under
par. (a) is not required.
49.325(3)(c)
(c)
Yearly report. The county board of supervisors or its designated agent, or the boards of 2 or more counties acting jointly or their designated agent, shall submit to the department a list of members of the citizen advisory committee under
par. (a) or a report on the open public participation process under
par. (b) on or before July 1 annually.
49.325 History
History: 1995 a. 27;
2007 a. 20.
49.34
49.34
Purchase of care and services. 49.34(1)
(1) All services under this subchapter and
ch. 48 purchased by the department or by a county department under
s. 46.215,
46.22, or
46.23 shall be authorized and contracted for under the standards established under this section. The department may require the county departments to submit the contracts to the department for review and approval. For purchases of $10,000 or less the requirement for a written contract may be waived by the department. No contract is required for care provided by foster homes that are required to be licensed under
s. 48.62. When the department directly contracts for services, it shall follow the procedures in this section in addition to meeting purchasing requirements established in
s. 16.75.
49.34(2)
(2) All services purchased under this subchapter and
ch. 48 shall meet standards established by the department and other requirements specified by the purchaser in the contract. Based on these standards the department shall establish standards for cost accounting and management information systems that shall monitor the utilization of the services, and document the specific services in meeting the service plan for the client and the objective of the service.
49.34(3)(a)(a) Purchase of service contracts shall be written in accordance with rules promulgated and procedures established by the department. Contracts for client services shall show the total dollar amount to be purchased and for each service the number of clients to be served, number of client service units, the unit rate per client service and the total dollar amount for each service.
49.34(3)(b)
(b) Payments under a contract may be made on the basis of actual allowable costs or on the basis of a unit rate per client service multiplied by the actual client units furnished each month. The contract may be renegotiated when units vary from the contracted number. The purchaser shall determine actual marginal costs for each service unit less than or in addition to the contracted number.
49.34(3)(c)
(c) For proprietary agencies, contracts may include a percentage add-on for profit according to rules promulgated by the department.
49.34(3)(d)
(d) Reimbursement to an agency may be based on total costs agreed to by the parties regardless of the actual number of service units to be furnished, when the agency is entering into a contract for a new or expanded service that the purchaser recognizes will require a start-up period not to exceed 180 days. This reimbursement applies only if identified client needs necessitate the establishment of a new service or expansion of an existing service.
49.34(3)(e)
(e) If the purchaser finds it necessary to terminate a contract prior to the contract expiration date for reasons other than nonperformance by the provider, the actual cost incurred by the provider may be reimbursed in an amount determined by mutual agreement of the parties.
49.34(3)(f)
(f) Advance payments of up to one-twelfth of an annual contract may be allowed under the contract. If the advance payment exceeds $10,000, the provider shall supply a surety bond in an amount equal to the amount of the advance payment applied for. No surety bond is required if the provider is a state agency. The cost of the surety bond shall be allowable as an expense.
49.34(4)
(4) For purposes of this section and as a condition of reimbursement, each provider under contract shall:
49.34(4)(a)
(a) Except as provided in this subsection, maintain a uniform double entry accounting system and a management information system which are compatible with cost accounting and control systems prescribed by the department. The department shall establish a simplified double-entry bookkeeping system for use by family-operated group homes. Each purchaser shall determine whether a family-operated group home from which it purchases services shall use the double-entry accounting system or the simplified system and shall include this determination in the purchase of service contract. In this paragraph, "family-operated group home" means a group home licensed under
s. 48.66 (1) (a) for which the licensee is one or more individuals who operate not more than one group home.
49.34(4)(b)
(b) Cooperate with the department and purchaser in establishing costs for reimbursement purposes.
49.34(4)(c)
(c) Unless waived by the department, biennially, or annually if required under federal law, provide the purchaser with a certified financial and compliance audit report if the care and services purchased exceed $25,000. The audit shall follow standards that the department prescribes. A purchaser may waive the requirements of this paragraph for any family-operated group home, as defined in
par. (a), from which it purchases services.
49.34(4)(d)
(d) Transfer a client from one category of care or service to another only with the approval of the purchaser.
49.34(4)(e)
(e) Charge a uniform schedule of fees as specified under
s. 49.32 (1) unless waived by the purchaser with the approval of the department. Whenever providers recover funds attributed to the client, such funds shall offset the amount paid under the contract.
49.34(5)
(5) Except as provided in
sub. (5m), the purchaser shall recover from provider agencies money paid in excess of the conditions of the contract from subsequent payments made to the provider.
49.34(5m)(a)1.
1. "Provider" means a nonstock corporation organized under
ch. 181 that is a nonprofit corporation, as defined in
s. 181.0103 (17), and that contracts under this section to provide client services on the basis of a unit rate per client service or a county department under
s. 46.215,
46.22,
46.23,
51.42, or
51.437 that contracts under this section to provide client services on the basis of a unit rate per client service.
49.34(5m)(a)2.
2. "Rate-based service" means a service or a group of services, as determined by the department, that is reimbursed through a prospectively set rate and that is distinguishable from other services or groups of services by the purpose for which funds are provided for that service or group of services and by the source of funding for that service or group of services.
49.34(5m)(b)1.1. Subject to
subds. 2. and
3. and
par. (em), if revenue under a contract for the provision of a rate-based service exceeds allowable costs incurred in the contract period, the provider may retain from the surplus generated by that rate-based service up to 5% of the contract amount. A provider that retains a surplus under this subdivision shall use that retained surplus to cover a deficit between revenue and allowable costs incurred in any preceding or future contract period for the same rate-based service that generated the surplus or to address the programmatic needs of clients served by the same rate-based service that generated the surplus. This subdivision does not apply to a child welfare agency that is authorized under
s. 48.61 (7) to license foster homes, a group home, as defined in
s. 48.02 (7), or a residential care center for children and youth, as defined in
s. 48.02 (15d).
49.34(5m)(b)2.
2. Subject to
subd. 3. and
par. (em), a provider may accumulate funds from more than one contract period under this paragraph, except that, if at the end of a contract period the amount accumulated from all contract periods for a rate-based service exceeds 10% of the amount of all current contracts for that rate-based service, the provider shall, at the request of a purchaser, return to that purchaser the purchaser's proportional share of that excess and use any of that excess that is not returned to a purchaser to reduce the provider's unit rate per client for that rate-based service in the next contract period. If a provider has held for 4 consecutive contract periods an accumulated reserve for a rate-based service that is equal to or exceeds 10% of the amount of all current contracts for that rate-based service, the provider shall apply 50% of that accumulated amount to reducing its unit rate per client for that rate-based service in the next contract period. The department may grant an exception to this subdivision upon request of a provider that is a child welfare agency that is authorized under
s. 48.61 (7) to license foster homes, a group home, as defined in
s. 48.02 (7), or a residential care center for children and youth, as defined in
s. 48.02 (15d).
49.34(5m)(b)3.
3. If on December 31, 1995, the amount accumulated by a provider from all contract periods ending on or before that date for all rate-based services provided by the provider exceeds 10% of the provider's total contract amount for all rate-based services provided by the provider in 1995, the provider shall, at the request of a purchaser, return to that purchaser the purchaser's proportional share of that excess.
49.34(5m)(em)
(em) Notwithstanding
par. (b) 1. and
2., a county department under
s. 46.215,
51.42, or
51.437 providing client services in a county having a population of 500,000 or more or a nonstock, nonprofit corporation providing client services in such a county may not retain a surplus generated by a rate-based service or accumulate funds from more than one contract period for a rate-based service from revenues that are used to meet the maintenance-of-effort requirement under the federal temporary assistance for needy families program under
42 USC 601 to
619.
49.34(5m)(f)
(f) All providers that are subject to this subsection shall comply with any financial reporting and auditing requirements that the department may prescribe. Those requirements shall include a requirement that a provider provide to any purchaser and the department any information that the department needs to claim federal reimbursement for the cost of any services purchased from the provider and a requirement that a provider provide audit reports to any purchaser and the department according to standards specified in the provider's contract and any other standards that the department may prescribe.
49.34(6)
(6) Contracts may be renegotiated by the purchaser under conditions specified in the contract.
49.34(7)
(7) The service provider under this section may appeal decisions of the purchaser in accordance with terms and conditions of the contract and
ch. 68 or
227.
49.343
49.343
Rates for residential care centers, group homes, and child welfare agencies. 49.343(1d)(a)
(a) "Administrative rate" means the difference between the rate charged by a child welfare agency to a purchaser of foster care services and the rate paid by the child welfare agency to a foster parent for the care and maintenance of a child.
49.343(1d)(b)
(b) "Child welfare agency" means a child welfare agency that is authorized under
s. 48.61 (7) to license foster homes.
49.343(1d)(cg)
(cg) "Performance-based contracting system" means a system of paying a provider for services based on the achievement of specified measurable outcomes.
49.343(1d)(cr)
(cr) "Provider" means a residential care center for children and youth, a group home, or a child welfare agency.
49.343(1g)
(1g) Establishment of rates. For services provided beginning on January 1, 2011, the department shall establish the per client rate that a residential care center for children and youth or a group home may charge for its services, and the per client administrative rate that a child welfare agency may charge for the administrative portion of its foster care services, as provided in this section. In establishing rates for a placement specified in
s. 938.357 (4) (c) 1. or
2., the department shall consult with the department of corrections. A residential care center for children and youth and a group home shall charge all purchasers the same rate for the same services and a child welfare agency shall charge all purchasers the same administrative rate for the same foster care services. The department shall determine the levels of care created under the rules promulgated under
s. 48.62 (8) to which this section applies.
49.343(2)(a)(a) By October 1, annually, a residential care center for children and youth or a group home shall submit to the department the per client rate that it proposes to charge for services provided in the next year and a child welfare agency shall submit to the department the proposed per client administrative rate that it proposes to charge for foster care services provided in the next year. The department shall provide forms and instructions for the submission of proposed rates under this paragraph and a residential care center for children and youth, group home, or child welfare agency that is required to submit a proposed rate under this paragraph shall submit that proposed rate using those forms and instructions.
49.343(2)(b)
(b) The department shall review a proposed rate submitted under
par. (a) and audit the provider submitting the proposed rate to determine whether the proposed rate is appropriate to the level of services to be provided, the qualifications of the provider to provide those services, and the reasonable and necessary costs of providing those services. In reviewing a proposed rate, the department shall consider all of the following factors:
49.343(2)(b)1.
1. Changes in the consumer price index for all urban consumers, U.S. city average, as determined by the U.S. department of labor, for the 12 months ending on June 30 of the year in which the proposed rate is submitted.
49.343(2)(b)1m.
1m. Changes in the consumer price index for all urban consumers, U.S. city average, for the medical care group, as determined by the U.S. department of labor, for the 12 months ending on June 30 of the year in which the proposed rate is submitted.
49.343(2)(b)2.
2. Changes in the allowable costs of the residential care center for children and youth, group home, or child welfare agency based on current actual cost data or documented projections of costs.
49.343(2)(b)3.
3. Changes in program utilization that affect the per client rate or per client administrative rate.
49.343(2)(b)4.
4. Changes in the department's expectations relating to service delivery.
49.343(2)(b)5.
5. Changes in service delivery proposed by the provider and agreed to by the department.
49.343(2)(b)6.
6. The loss of any source of revenue that had been used to pay expenses, resulting in a lower per client rate or per client administrative rate for services.
49.343(2)(b)6m.
6m. Whether the agency is accredited by a national accrediting body that has developed child welfare standards.
49.343(2)(b)7.
7. Changes in any state or federal laws, rules, or regulations that result in any change in the cost of providing services, including any changes in the minimum wage, as defined in
s. 49.141 (1) (g).
49.343(2)(b)9.
9. The availability of funding to pay for the services to be provided under the proposed rate.
49.343(2)(b)10.
10. Any other factor relevant to the setting of a rate that the department may determine by rule promulgated under
sub. (4).
49.343(2)(c)
(c) If the department determines under
par. (b) that a proposed rate submitted under
par. (a) is appropriate, the department shall approve the proposed rate. If the department does not approve a proposed rate, the department shall negotiate with the provider to determine an agreed to rate. If after negotiations a rate is not agreed to, the department and the provider shall engage in mediation under the rate resolution procedure promulgated by rule under
sub. (4) to arrive at an agreed to rate. If after mediation a rate is not agreed to, the department shall order a rate for the service after considering the factors under
par. (b). A provider may appeal the rate set by the department as a contested case under
ch. 227 by filing with the department a request for a hearing within 30 days after the date of the order.
49.343(3)
(3) Audit. The department may require an audit of any provider for the purpose of collecting federal funds.
49.343(4)
(4) Rules. The department shall promulgate rules to implement this section. Those rules shall include rules providing for all of the following:
49.343(4)(a)
(a) Standards for determining whether a proposed rate is appropriate to the level of services to be provided, the qualifications of a provider to provide those services, and the reasonable and necessary costs of providing those services.
49.343(4)(b)
(b) Factors for the department to consider in reviewing a proposed rate.
49.343(4)(c)
(c) Procedures for reviewing proposed rates, including procedures for ordering a rate when negotiations and mediation fail to produce an agreed to rate.
49.343(5)
(5) Advisory committee. The secretary shall create an advisory committee under
s. 15.04 (1) (c) consisting of representatives of purchasers; county departments; the department, in a county having a population of 500,000 or more; tribes; consumers; and a statewide association of private, incorporated family and children's social service agencies representing all groups of providers that are affected by the rate regulation process. The committee shall advise the department on all of the following:
49.343(5)(b)
(b) The implementation of rate regulation for providers as authorized under this section.
49.343(5)(c)
(c) The identification of the measurements specified in
sub. (6) (a) and the development of the payment levels specified in
sub. (6) (a).
49.343(6)
(6) Performance-based contracting system. 49.343(6)(a)(a) For purposes of implementing a performance-based contracting system, the department, in cooperation with the advisory committee created under
sub. (5), shall do all of the following:
49.343(6)(a)1.
1. Identify measurements by which to evaluate the performance of providers in meeting both the goals for the children placed in their care and the goals for the out-of-home care system in this state and adjust, as needed, those measurements.
49.343(6)(a)2.
2. Develop payment levels that correspond to the achievement of the measurements identified under
subd. 1. based on the assessed level of care of a child.
