46.23(6)(c)2.
2. Changes in the organization and management of the program.
46.23(6)(e)
(e) A county human services director under this subsection shall comply with state requirements.
46.23(6m)
(6m) County human services director in certain counties with a county executive or county administrator. In any county with a county executive or county administrator in which the county board of supervisors has established a single-county department of human services, the county executive or county administrator shall appoint a county human services director on the basis of recognized and demonstrated interest in and knowledge of human services problems, with due regard to training, experience, executive and administrative ability and general qualification and fitness for the performance of the duties of the director. The appointment is subject to confirmation by the county board of supervisors unless the county board of supervisors, by ordinance, elects to waive confirmation or unless the appointment is made under a civil service system competitive examination procedure established under
s. 59.52 (8) or
ch. 63. The county human services director, subject only to the supervision of the county executive or county administrator, shall:
46.23(6m)(a)
(a) Supervise and administer any program for which supervision and administration is authorized under this section.
46.23(6m)(b)
(b) Determine administrative and program procedures and administrative policies.
46.23(6m)(c)
(c) Determine, subject to the approval of the county board of supervisors and with the advice of the county human services board under
sub. (5m), whether services are to be provided directly by the county department of human services or contracted for with other providers and make such contracts. The county board of supervisors may elect to require the approval of any such contract by the county board of supervisors.
46.23(6m)(f)
(f) Make recommendations to the county executive or county administrator regarding modifications to the proposed budget prepared by the county human services board under
sub. (5m) (c).
46.23(6m)(j)
(j) Perform other functions necessary to manage, operate, maintain and improve programs.
46.23(6m)(L)
(L) Represent human service agencies, professionals and consumers of services in negotiations with the state and federal governments.
46.23(6m)(m)
(m) Determine the number and location of outstations when appropriate to meet service demands.
46.23 History
History: 1975 c. 39,
224;
1977 c. 29;
1981 c. 20,
93,
291;
1981 c. 329 s.
31;
1983 a. 27 ss.
962,
2202 (20);
1985 a. 29 ss.
844m to
860,
3200 (56) (a);
1985 a. 120,
176,
332;
1987 a. 186;
1987 a. 403 s.
256;
1989 a. 56,
359;
1991 a. 274;
1993 a. 16,
27,
83,
445,
491;
1995 a. 27 ss.
2112 to
2127,
9126 (19),
9130 (4);
1995 a. 64,
201,
352,
417;
1997 a. 3,
164,
268,
283;
1999 a. 9;
2005 a. 264,
388,
406;
2007 a. 20 ss.
878 to
891,
9121 (6) (a);
2007 a. 45,
96;
2009 a. 28,
180;
2011 a. 32;
2015 a. 55.
46.23 Annotation
There is no unconditional guarantee of continued employment under sub. (3) (d); employment is continued during a reorganization unless civil service rules provide otherwise. Dane County v. McCartney,
166 Wis. 2d 956,
480 N.W.2d 830 (Ct. App. 1992).
46.23 Annotation
Boards and directors may view client information without written and informed consent for any purpose related to their powers and duties. 69 Atty. Gen. 273.
46.23 Annotation
Officers, employees, and directors of public or private entities that furnish “human services" to a county may not be appointed to the board under sub. (4) (a); this provision does not extend to family members of “human services" providers.
80 Atty. Gen. 30.
46.23 Annotation
Because there is no explicit statutory authority for county human services departments to accept gifts, the statutory scheme contemplates that gifts, grants, and donations to a county human services department created under this section may be accepted only by the county board of supervisors.
OAG 1-08.
46.238
46.238
Infants and unborn children whose mothers abuse controlled substances, controlled substance analogs, or alcohol. If an agency, as defined in
s. 48.981 (1) (ag), receives a report under
s. 146.0255 (2) or
146.0257 (2) and that agency is a county department under
s. 46.22 or
46.23 or a licensed child welfare agency under contract with that county department, the agency shall offer to provide appropriate services and treatment to the infant and the infant's mother or to the unborn child, as defined in
s. 48.02 (19), and the expectant mother of the unborn child or the agency shall make arrangements for the provision of appropriate services and treatment. If an agency receives a report under
s. 146.0255 (2) or
146.0257 (2) and that agency is the department or a licensed child welfare agency under contract with the department, the agency shall refer the report to the county department under
s. 51.42 or
51.437 and that county department shall offer to provide, or make arrangements for the provision of, those services and that treatment.
46.245
46.245
Information for certain pregnant women. Upon request, a county department under
s. 46.215,
46.22 or
46.23 shall distribute the materials described under
s. 253.10 (3) (d), as prepared and distributed by the department. A physician who intends to perform or induce an abortion or another qualified physician, as defined in
s. 253.10 (2) (g), who reasonably believes that he or she might have a patient for whom the information under
s. 253.10 (3) (d) is required to be given, shall request a reasonably adequate number of the materials from the county department under this section or from the department under
s. 253.10 (3) (d). An individual may request a reasonably adequate number of the materials.
46.27
46.27
Long-term support community options program. 46.27(1)(1)
Definitions. In this section:
46.27(1)(a)
(a) “Aging unit" means an aging unit director and necessary personnel, directed by a county commission on aging and organized as one of the following:
46.27(1)(a)1.
1. An agency of county government with the primary purpose of administering programs of services for older individuals of the county.
46.27(1)(a)2.
2. A unit, within a county department under
s. 46.215,
46.22 or
46.23, with the primary purpose of administering programs of services for older individuals of the county.
46.27(1)(ai)
(ai) “Community-based residential facility" means a facility that meets the definition in
s. 50.01 (1g) and that is licensed under
s. 50.03 (1).
46.27(1)(b)
(b) “Nursing home" means a facility that meets the definition in
s. 50.01 (3) and that is licensed under
s. 50.03 (1) and includes a state center for the developmentally disabled and a Wisconsin veterans home operated by the department of veterans affairs under
s. 45.50.
46.27(1)(c)
(c) “Program" means the long-term support community options program.
46.27(1)(d)
(d) “Residence" means the voluntary concurrence of physical presence with intent to remain in a place of fixed habitation. Physical presence shall be prima facie evidence of intent to remain.
46.27(1)(dr)
(dr) “State-operated long-term care facility" means a state center for the developmentally disabled and a Wisconsin veterans home operated by the department of veterans affairs under
s. 45.50.
46.27(1)(e)
(e) “Voluntary" means according to an individual's free choice, if competent, or by choice of his or her guardian, if the individual is adjudicated incompetent.
46.27(2)
(2) Departmental duties. The department shall:
46.27(2)(c)
(c) Review and approve or disapprove the selection of a county department or aging unit under
sub. (3) (b) to administer the program.
46.27(2)(d)
(d) In consultation with representatives of counties, hospitals and nursing homes and with recipients of long-term community support services, develop guidelines for implementing the program and criteria for reviewing community options plans from counties participating in the program. The guidelines and criteria shall address cost-effectiveness, scope, feasibility and impact on the quality and appropriateness of health services and social services and shall provide counties with maximum flexibility to develop programs that address local needs.
46.27(2)(e)
(e) Review and approve or disapprove the community options plan of each county participating in the program.
46.27(2)(f)
(f) Evaluate the cost-effectiveness of the program, the ability of the program to provide alternatives to institutional care of persons and the reasons why any county department or aging unit administering the program finds that a community arrangement is not feasible under
sub. (6) (d).
46.27(2)(g)1.
1. Require that a county, by use of a form provided by the department or other appropriate procedure, ensure that persons receiving services under this section meet the eligibility requirements for the program.
46.27(2)(g)2.
2. Periodically monitor the implementation of the program.
46.27(2)(h)
(h) Promulgate all of the following as rules:
46.27(2)(h)1.
1. Adoption of a long-term community support service fee schedule as part of the uniform fee schedule under
s. 46.03 (18) that is substantially similar to the fee calculation schedule existing on January 1, 1985, that was developed as a part of the guidelines required under
par. (d).
46.27(2)(h)2.
2. Conditions of hardship under which the department may grant an exception to the requirement of
sub. (6r) (c).
46.27(2)(i)
(i) Review and approve or disapprove waiver requests under
sub. (3) (f), review and approve or disapprove requests for exceptions under
sub. (6r) (c) and provide technical assistance to a county that reaches or exceeds the annual allocation limit specified in
sub. (3) (f) in order to explore alternative methods of providing long-term community support services for persons who are in group living arrangements in that county.
46.27(2)(j)
(j) By January 1, 1997, develop a model contract for use by counties for purchase of long-term community support services for persons who reside in community-based residential facilities. The governor and the joint committee on finance shall approve the model contract before it is implemented.
46.27(2)(k)
(k) Review and approve or disapprove the terms of risk reserve escrow accounts created under
sub. (7) (fr) and approve or disapprove disbursements for administrative or staff costs from the risk reserve escrow accounts.
46.27(2m)
(2m) Reimbursement disallowances. The department may disallow reimbursement under this section for services provided to persons who do not meet the eligibility requirements.
46.27(3)
(3) Duties of participating counties. The county board of supervisors of any county participating in the program shall:
46.27(3)(a)
(a) Create an interagency long-term support planning committee, with the composition and the duties specified under
sub. (4).
46.27(3)(b)
(b) Designate one of the following, subject to departmental review and approval, to administer the program:
46.27(3)(b)5.
5. The departments under
subds. 1. and
2. jointly, if the county long-term support planning committee develops no more than one annual community options plan under
sub. (4).
46.27(3)(c)
(c) Develop procedures and phases for gradual implementation of this section in accordance with guidelines and criteria the department develops under
sub. (2) (d).
46.27(3)(cm)
(cm) Review and approve, disapprove or amend a community options plan to participate in the program, prior to submitting the plan to the department.
46.27(3)(d)
(d) Ensure that the program uses existing county resources and personnel to the greatest extent practicable and enhances the effectiveness of discharge planning from hospitals.
46.27(3)(e)
(e) Except as provided in
sub. (3g), after implementing the program for 12 months and within the limits of state and federal funds allocated under
sub. (7), provide noninstitutional community alternatives for a significant number of persons in each of the groups listed in
sub. (4) (a) 1. and eligible under
sub. (6). The department shall determine what constitutes a “significant number of persons" for each participating county, based on county size and on the statewide proportion of persons from each group receiving medical assistance in a nursing home, and, beginning on January 1, 1994, shall annually adjust each determination to reflect changes in the state population of eligible persons and to reflect purposes for which increased funds, if any, are appropriated by the legislature for the program. If a county fails to meet the “significant number of persons" requirement under this paragraph, all of the following apply:
46.27(3)(e)1.
1. For a county with an annual allocation for provision of long-term community support services under
sub. (7) (b) that exceeds $185,000, the department shall, unless the department finds that an emergency or unusual circumstance exists, designate a portion of the county's allocation for increased service in each calendar year that the county fails to meet the requirement, to one or more of the groups specified under
sub. (4) (a) 1. a. to
e.
46.27(3)(e)2.
2. For a county with an annual allocation for provision of long-term community support services under
sub. (7) (b) that is $185,000 or less, the department may designate a portion of the county's allocation for increased service in each calendar year that the county fails to meet the requirement, to one or more of the groups specified under
sub. (4) (a) 1. a. to
e.
46.27(3)(f)
(f) Beginning on January 1, 1996, from the annual allocation to the county for the provision of long-term community support services under
subs. (7) (b) and
(11), annually establish a maximum total amount that may be encumbered in a calendar year for services for eligible individuals in community-based residential facilities, unless the department waives the requirement under
sub. (2) (i) or approves a request for an exception under
sub. (6r) (c).
46.27(3)(h)
(h) Identify the service needs of persons with Alzheimer's disease and of their caregivers.
46.27(3g)
(3g) Waiver of requirements. The department may waive requirements under
sub. (3) (e) for a county if the county is able to demonstrate one of the following:
46.27(3g)(a)
(a) That the county has disproportionately lengthy waiting lists for services under
sub. (7) or under
sub. (11) for one or more of the groups listed in
sub. (4) (a) 1.
46.27(3g)(b)
(b) That demographic or other data indicate that the county's population is significantly at variance with the statewide proportion of persons from each group listed in
sub. (4) (a) 1. receiving medical assistance in a nursing home.
46.27(3m)
(3m) Powers and duties of a private nonprofit agency. A private nonprofit agency with which the department contracts for service under
sub. (11) (c) 5. shall have the powers and duties under this section of a county department designated under
sub. (3) (b) to administer the program.
46.27(4)(a)(a) The county board of supervisors shall select the county long-term support planning committee, which shall include at a minimum the following members:
46.27(4)(a)1.
1. At least 5 persons receiving long-term community support services, each of whom represents one of the following groups:
