Amendment ASA1-AB75

AB75-ASA1, s. 862 Section 862. 46.284 (3m) of the statutes is created to read:

AB75-ASA1,461,4 46.284 (3m) Permit required. A care management organization that is described under s. 600.01 (1) (b) 10. a., to which s. 600.01 (1) (b) 10. b. does not apply and that is certified under sub. (3) shall apply for a permit with the office of the commissioner of insurance under ch. 648.

AB75-ASA1, s. 863 Section 863. 46.284 (4) (m) of the statutes is created to read:

AB75-ASA1,461,9 46.284 (4) (m) Compensate providers, as defined in s. 46.2898 (1) (e), in accordance with any agreement under subch. V of ch. 111 relating to a provider hired directly by an enrollee and make any payroll deductions authorized by those agreements.

AB75-ASA1, s. 864 Section 864. 46.286 (1) (a) (intro.) and 1. (intro.) of the statutes are consolidated, renumbered 46.286 (1) (a) (intro.) and amended to read:

AB75-ASA1,461,15 46.286 (1) (a) Functional eligibility. (intro.) A person is functionally eligible if any of the following applies the person's level of care need, as determined by the department or its designee: 1. (intro.) The person's level of care need, is either of the following:

AB75-ASA1, s. 865 Section 865. 46.286 (1) (a) 1. a. of the statutes is renumbered 46.286 (1) (a) 1m.

AB75-ASA1, s. 866 Section 866. 46.286 (1) (a) 1. b. of the statutes is renumbered 46.286 (1) (a) 2m.

AB75-ASA1, s. 867 Section 867. 46.286 (1) (a) 2. (intro.) of the statutes is repealed.

AB75-ASA1, s. 868 Section 868. 46.286 (1) (a) 2. a. of the statutes is renumbered 46.286 (3) (b) 2. a.

AB75-ASA1, s. 869 Section 869. 46.286 (1) (a) 2. b. of the statutes is renumbered 46.286 (3) (b) 2. b.

AB75-ASA1, s. 870 Section 870. 46.286 (1) (a) 2. c. of the statutes is renumbered 46.286 (3) (b) 2. c.

AB75-ASA1, s. 871 Section 871. 46.286 (1) (a) 2. d. of the statutes is renumbered 46.286 (3) (b) 2. d.

AB75-ASA1, s. 872 Section 872. 46.286 (1) (a) 2. e. of the statutes is renumbered 46.286 (3) (b) 2. e.

AB75-ASA1, s. 872k Section 872k. 46.286 (1) (b) (intro.) (except 46.286 (1) (b) (title)) of the statutes is renumbered 46.286 (1) (b) 2m. (intro.).

AB75-ASA1, s. 873 Section 873. 46.286 (1) (b) 1c. of the statutes is created to read:

AB75-ASA1,462,9 46.286 (1) (b) 1c. In this paragraph, "medical assistance" does not include coverage of the benefits under s. 49.471 (11).

AB75-ASA1, s. 874 Section 874. 46.286 (1) (b) 1m. of the statutes is renumbered 46.286 (1) (b) 2m. a.

AB75-ASA1, s. 875 Section 875. 46.286 (1) (b) 3. of the statutes is renumbered 46.286 (1) (b) 2m. b.

AB75-ASA1, s. 877 Section 877. 46.286 (3) (a) 4m. of the statutes is amended to read:

AB75-ASA1,462,16 46.286 (3) (a) 4m. The person is financially eligible under sub. (1) (b) 1m. 2m. a., and fulfills any applicable cost-sharing requirements.

AB75-ASA1, s. 878 Section 878. 46.286 (3) (b) 2. of the statutes is renumbered 46.286 (3) (b) 2. (intro.) and amended to read:

AB75-ASA1,462,24 46.286 (3) (b) 2. (intro.) If the contract between the care management organization and the department is canceled or not renewed. If this circumstance occurs, the department shall assure that enrollees continue to receive needed services through another care management organization or through the medical assistance fee-for-service system or any of the following programs specified under sub. (1) (a) 2. a. to d.:

AB75-ASA1, s. 879 Section 879. 46.286 (3) (c) of the statutes is amended to read:

AB75-ASA1,463,7 46.286 (3) (c) Within each county and for each client group, par. (a) shall first apply on the effective date of a contract under which a care management organization accepts a per person per month payment to provide services under the family care benefit to eligible persons in that client group in the county. Within 24 36 months after this date, the department shall assure that sufficient capacity exists within one or more care management organizations to provide the family care benefit to all entitled persons in that client group in the county.

AB75-ASA1, s. 880 Section 880. 46.288 (2) (intro.) of the statutes is amended to read:

AB75-ASA1,463,14 46.288 (2) (intro.) Criteria and procedures for determining functional eligibility under s. 46.286 (1) (a), financial eligibility under s. 46.286 (1) (b), and cost sharing under s. 46.286 (2) (a). The rules for determining functional eligibility under s. 46.286 (1) (a) 1. a. 1m. shall be substantially similar to eligibility criteria for receipt of the long-term support community options program under s. 46.27. Rules under this subsection shall include definitions of the following terms applicable to s. 46.286:

AB75-ASA1, s. 881 Section 881. 46.288 (2) (a) of the statutes is repealed.

AB75-ASA1, s. 882 Section 882. 46.288 (2) (b) of the statutes is repealed.

AB75-ASA1, s. 883 Section 883. 46.288 (2) (c) of the statutes is repealed.

AB75-ASA1, s. 884 Section 884. 46.2898 of the statutes is created to read:

AB75-ASA1,463,19 46.2898 Quality home care. (1) Definitions. In this section:

AB75-ASA1,463,20 (a) "Authority" means the Wisconsin Quality Home Care Authority.

AB75-ASA1,463,21 (b) "Care management organization" has the meaning given in s. 46.2805 (1).

AB75-ASA1,463,23 (cm) "Consumer" means an adult who receives home care services and who meets all of the following criteria:

AB75-ASA1,463,24 1. Is a resident of any of the following:

AB75-ASA1,463,25 a. A county that has acted under sub. (2) (a).

AB75-ASA1,463,26 b. A county in which the Family Care Program under s. 46.286 is available.

AB75-ASA1,464,3 c. A county in which the Program of All-Inclusive Care for the Elderly under 42 USC 1396u-4 is available.

AB75-ASA1,464,6 d. A county in which the self-directed services option program under 42 USC 1396n (c) is available or in which a program operated under an amendment to the state medical assistance plan under 42 USC 1396n (j) is available.

AB75-ASA1,464,8 2. Self-directs all or part of his or her home care services and is an employer listed on the provider's income tax forms.

AB75-ASA1,464,9 3. Is eligible to receive a home care benefit under one of the following:

AB75-ASA1,464,10 a. The Family Care Program under s. 46.286.

AB75-ASA1,464,11 b. The Program of All-Inclusive Care for the Elderly, under 42 USC 1396u-4.

AB75-ASA1,464,14 c. A program operated under a waiver from the secretary of the federal department of health and human services under 42 USC 1396n (c) or 42 USC 1396n (b) and (c) or the self-directed services option operated under 42 USC 1396n (c).

AB75-ASA1,464,16 d. A program operated under an amendment to the state medical assistance plan under 42 USC 1396n (j).

AB75-ASA1,464,21 (dm) "Home care" means supportive home care, personal care, and other nonprofessional services of a type that may be covered under a medical assistance waiver under 42 USC 1396n (c) and that are provided to individuals to assist them in meeting their daily living needs, ensuring adequate functioning in their homes, and permitting safe access to their communities.

AB75-ASA1,464,23 (e) "Provider" means an individual who is hired by a consumer to provide home care to the consumer but does not include any of the following:

AB75-ASA1,464,25 1. A person, while he or she is providing services in the capacity of an employee of any of the following entities:

AB75-ASA1,464,26 a. A home health agency licensed under s. 50.49.

AB75-ASA1,465,2 b. A personal care provider agency.

AB75-ASA1,465,3 c. A company or agency providing supportive home care.

AB75-ASA1,465,4 d. An independent living center, as defined in s. 46.96 (1) (ah).

AB75-ASA1,465,6 e. A county agency or department under s. 46.215, 46.22, 46.23, 51.42, or 51.437.

AB75-ASA1,465,8 2. A health care provider, as defined in s. 146.997 (1) (d), acting in his or her professional capacity.

AB75-ASA1,465,17 (f) "Qualified provider" means a provider who meets the qualifications for payment through the Family Care Program under s. 46.286, the Program for All-Inclusive Care for the Elderly operated under 42 USC 1396u-4, an amendment to the state medical assistance plan under 42 USC 1396n (j), or a medical assistance waiver program operated under a waiver from the secretary of the U.S. department of health and human services under 42 USC 1396n (c) or 42 USC 1396n (b) and (c) and any qualification criteria established in the rules promulgated under sub. (7) and who the authority determines is eligible for placement on the registry maintained by the authority under s. 52.20 (1).

AB75-ASA1,465,21 (2) County participation. (a) A county board of supervisors may require a county department under 46.215, 46.22, 46.23, 51.42, or 51.437 to follow procedures under this section and to pay providers in accordance with agreements under subch. V of ch. 111.

AB75-ASA1,465,23 (b) If a county acts under par. (a), it shall notify the department and the authority of its action.

AB75-ASA1,466,3 (c) A county that acts under par. (a) shall compensate providers in accordance with any agreement under subch. V of ch. 111 and make any payroll deductions authorized by such agreements.

AB75-ASA1,466,8 (4) Duties of home care payors. Care management organizations, the state, and counties, as described under sub. (1) (cm) 1. a. to d., that pay for the provision of home care services to consumers shall provide to the authority the name, address, telephone number, date of hire, and date of termination of any provider hired by an individual receiving home care services.

AB75-ASA1,466,9 (5) Duties of consumers. A consumer shall do all of the following:

AB75-ASA1,466,12 (a) Inform the authority of the name, address, telephone number, date of hire, and date of termination of any provider hired by the consumer to provide home care services.

AB75-ASA1,466,15 (b) Compensate providers in accordance with any collective bargaining agreement that applies to home care providers under subch. V of ch. 111 and make any payroll deductions authorized by the agreement.

AB75-ASA1,466,18 (6) Providers. (a) A qualified provider providing home care services under this section shall be subject to the collective bargaining agreement that applies to home care providers under subch. V of ch. 111.

AB75-ASA1,466,20 (b) A qualified provider may choose to be placed on the registry maintained by the authority under s. 52.20 (1).

AB75-ASA1,466,24 (7) Department rule-making. The department may promulgate rules defining terms, specifying which services constitute home care, establishing the qualification criteria that apply under sub. (1) (d), and establishing procedures for implementation of this section.

AB75-ASA1, s. 885 Section 885. 46.29 (1) (intro.) of the statutes is amended to read:

AB75-ASA1,467,4 46.29 (1) (intro.) From the appropriation account under s. 20.435 (6) (7) (a), the department shall allocate distribute at least $16,100 in each fiscal year for operation of the council on physical disabilities. The council on physical disabilities shall do all of the following:

AB75-ASA1, s. 888 Section 888. 46.295 (1) of the statutes is amended to read:

AB75-ASA1,467,9 46.295 (1) The department may, on the request of any hearing-impaired person, city, village, town, or county or private agency, provide funds from the appropriation accounts under s. 20.435 (6) (7) (d) and (hs) and (7) (d) to reimburse interpreters for hearing-impaired persons for the provision of interpreter services.

AB75-ASA1, s. 889 Section 889. 46.40 (2m) (a) of the statutes is amended to read:

AB75-ASA1,467,14 46.40 (2m) (a) Prevention and treatment of substance abuse. For prevention and treatment of substance abuse under 42 USC 300x-21 to 300x-35, the department shall distribute not more than $13,975,500 in fiscal year 2009-10 and $9,735,700 in each fiscal year thereafter.

AB75-ASA1, s. 892 Section 892. 46.48 (1) of the statutes is amended to read:

AB75-ASA1,467,18 46.48 (1) General. From the appropriation accounts under s. 20.435 (5) (bc) and (7) (bc), the department shall distribute award grants for community programs as provided in this section.

AB75-ASA1, s. 893 Section 893. 46.48 (9) of the statutes is repealed.

AB75-ASA1, s. 894 Section 894. 46.48 (9m) of the statutes is created to read:

AB75-ASA1,467,24 46.48 (9m) Quality home care. The department shall award a grant to the Wisconsin Quality Home Care Authority for the purpose of providing services to recipients and providers of home care under s. 46.2898 and ch. 52 and may award grants to counties to facilitate transition to procedures established under s. 46.2898.

AB75-ASA1, s. 895 Section 895. 46.48 (11m) of the statutes is repealed.

AB75-ASA1, s. 896 Section 896. 46.48 (30) (a) of the statutes is amended to read:

AB75-ASA1,468,10 46.48 (30) (a) From the appropriation account under s. 20.435 (7) (bc), the department shall distribute grants on a competitive basis to county departments of social services and to private nonprofit organizations, as defined in s. 103.21 (2), for the provision of alcohol and other drug abuse treatment services in counties with a population of 500,000 or more. Grants distributed under this subsection may be used only to provide treatment for alcohol and other drug abuse to individuals who are eligible for federal temporary assistance for needy families under 42 USC 601 et. seq. and who have a family income of not more than 200% of the poverty line, as defined in s. 49.001 (5).

AB75-ASA1, s. 897 Section 897. 46.485 (2g) (intro.) of the statutes, as affected by 2009 Wisconsin Act 2, is amended to read:

AB75-ASA1,468,18 46.485 (2g) (intro.) From the appropriation account under s. 20.435 (4) (b), the department may in each fiscal year transfer funds to the appropriation account under s. 20.435 (7) (kb) (5) (kc) for distribution under this section and from the appropriation account under s. 20.435 (7) (mb) the department may not distribute more than $1,330,500 in each fiscal year to applying counties in this state that meet all of the following requirements, as determined by the department:

AB75-ASA1, s. 898 Section 898. 46.485 (3r) of the statutes is amended to read:

AB75-ASA1,468,25 46.485 (3r) Funds from the appropriation account under s. 20.435 (7) (kb) (5) (kc) that the department does not distribute to a county before 24 months after June 30 of the fiscal year in which the department allocated the funds to the county under sub. (2g) lapse to the appropriation account under s. 20.435 (4) (b). A county may at any time expend funds that the department distributes to the county, consistent with the requirements under sub. (3m).

AB75-ASA1, s. 899 Section 899. 46.495 (1) (am) of the statutes is amended to read:

AB75-ASA1,469,6 46.495 (1) (am) The department shall reimburse each county from the appropriations under s. 20.435 (7) (b) and (o) for social services as approved by the department under ss. 46.215 (1), (2) (c) 1., and (3) and 46.22 (1) (b) 1. d. and (e) 3. a. except that no reimbursement may be made for the administration of or aid granted under s. 49.02, 2009 stats.

AB75-ASA1, s. 900 Section 900. 46.56 (8) (L) of the statutes is amended to read:

AB75-ASA1,469,14 46.56 (8) (L) In providing integrated services under this section, the service coordination agency and the designated service providers shall include in the integrated service plan all individuals who are active in the care of the child with severe disabilities, including members of the child's family, foster parents, treatment foster parents and other individuals who by close and continued association with the child have come to occupy significant roles in the care and treatment of the child with severe disabilities.