46.27(10)(a)2.
2. The department shall transfer or credit to the participating county the amount calculated under
subd. 1. for 1984 or for the first 6 months of 1985, depending on the date the county begins participating in the pilot project. The county shall use these funds to provide long-term care to medical assistance recipients covered by its community options plan, either in the form of nursing home care financed under
par. (b) or in the form of long-term community support services. The county may use extra funds available under this paragraph after it provides this long-term care for other long-term community support services under its community options plan.
46.27(10)(b)
(b) Each county participating in the pilot project is liable for the entire nonfederal share of medical assistance costs related to increased utilization of nursing homes that are located in the county.
46.27(10)(c)
(c) The department's method of determining each county's base level of funding, the transfer or credit of funds and the department's specification of county financial liability under the pilot project are subject to the approval of the joint committee on finance.
46.27(11)(a)(a) In this subsection, "physically disabled" means having a condition that affects one's physical functioning by limiting mobility or the ability to see or hear, that is the result of injury, disease or congenital deficiency and that significantly interferes with or limits at least one major life activity and the performance of one's major personal or social roles.
46.27(11)(am)
(am) The department shall request a waiver from the secretary of the federal department of health and human services, under
42 USC 1396n (c), authorizing the department to provide as part of the medical assistance program home and community-based services for persons who are eligible for long-term support community options program services under
sub. (5) (b).
46.27(11)(b)
(b) The department shall include all assurances required under
42 USC 1396n (c) in the implementation of the waiver.
46.27(11)(c)
(c) The following conditions apply under the waiver:
46.27(11)(c)1.
1. At the end of the 3-year period during which the waiver remains in effect the department may request a 3-year extension of the waiver.
46.27(11)(c)2.
2. The department shall annually submit to the secretary of the federal department of health and human services information showing the effect of the program on the type and amount of medical assistance provided and on the health and welfare of program participants.
46.27(11)(c)3.
3. Medical assistance reimbursement for services a county, a private nonprofit agency or an aging unit with which the department contracts provides under this subsection shall be made from the appropriations under
s. 20.435 (4) (o) and
(7) (b) and
(bd).
46.27(11)(c)4.
4. The department may, from the appropriation under
s. 20.435 (4) (o), provide reimbursement for services provided under this subsection by counties that are in excess of the current average annual per person rate, as established by the department, and are less than or equal to the average amount approved in the waiver received under
par. (am).
46.27(11)(c)5.
5. The department may contract for services under this subsection with a county, a private nonprofit agency or, if a county board of supervisors by resolution so requests the department, an aging unit.
46.27(11)(c)5m.
5m. No county may use funds received under this subsection to provide services to a person who does not live in his or her own home or apartment unless, subject to the limitations under
subds. 6.,
7. and
8., one of the following applies:
46.27(11)(c)5m.a.
a. The services are provided to the person in a community-based residential facility that entirely consists of independent apartments, each of which has an individual lockable independent entrance and exit and individual separate kitchen, bathroom, sleeping and living areas.
46.27(11)(c)5m.b.
b. The person suffers from Alzheimer's disease or related dementia and the services are provided to the person in a community-based residential facility that has a dementia care program.
46.27(11)(c)5n.
5n. A county may also use funds received under this subsection, subject to the limitations under
subds. 6.,
7. and
8., to provide services to a person who does not live in his or her own home or apartment if the services are provided to the person in a community-based residential facility and the county department or aging unit has determined that all of the following conditions have been met:
46.27(11)(c)5n.a.
a. An assessment under
sub. (6) has been completed for the person prior to the person's admission to the community-based residential facility, whether or not the person is a private pay admittee at the time of admission. The county may waive this condition in accordance with guidelines established by the department. If the county waives this condition, the county must meet with the person or the person's guardian to discuss the cost-effectiveness of various service options.
46.27(11)(c)5n.b.
b. The county department or aging unit documents that the option of in-home services has been discussed with the person, thoroughly evaluated and found to be infeasible, as determined by the county department or aging unit in accordance with rules promulgated by the department of health and family services.
46.27(11)(c)5n.c.
c. The county department or aging unit determines that the community-based residential facility is the person's preferred place of residence or is the setting preferred by the person's guardian.
46.27(11)(c)5n.d.
d. The county department or aging unit determines that the community-based residential facility provides a quality environment and quality care services.
46.27(11)(c)5n.e.
e. The county department or aging unit determines that placement in the community-based residential facility is cost-effective compared to other options, including home care and nursing home care.
46.27(11)(c)5p.a.a. Subject to the approval of the department, a county may establish and implement more restrictive conditions than those imposed under
subd. 5m. on the use of funds received under
sub. (7) (b) for the provision of services to a person in a community-based residential facility. A county that establishes more restrictive conditions under this
subd. 5p. a. shall include the conditions in its community options plan under
sub. (3) (cm).
46.27(11)(c)5p.b.
b. If the department determines that a county has engaged in a pattern of inappropriate use of funds received under
sub. (7) (b), the department may revoke its approval of the county's conditions established under
subd. 5p. a., if any, and may prohibit the county from using funds received under
sub. (7) (b) to provide services under
subd. 5n.