46.278(6)(e)1.b.
b. An intermediate care facility for persons with an intellectual disability or a distinct part thereof that has a plan of closure approved by the department and that intends to close within 12 months.
46.278(6)(e)1.c.
c. An intermediate care facility for persons with an intellectual disability that has a plan of closure or significant reduction in capacity approved by the department and that intends to close or significantly reduce its capacity within 60 months.
46.278(6)(e)2.a.a. The enhanced reimbursement rate under subd.
1. a. and
b. shall be determined under a formula that is developed by the department.
46.278(6)(e)2.b.
b. The enhanced reimbursement rate under subd.
1. c. shall be 90 percent of the enhanced reimbursement rate under subd.
2. a. 46.278(7)
(7) Report. By July 1 of each year, the department shall submit to the joint committee on finance and to the chief clerk of each house of the legislature, for distribution to the appropriate standing committees under s.
13.172 (3), a report describing the cost and quality of services used under the program and the extent to which existing services have been used under the program in the preceding calendar year.
46.278(8)
(8) Effective period. Except as provided under sub.
(2), this section takes effect on the date approved by the secretary of the federal department of health and human services as the beginning date of the period of waiver received under sub.
(3). This section remains in effect for 3 years following that date and, if the secretary of the federal department of health and human services approves a waiver extension, shall continue an additional 3 years.
46.2785
46.2785
Community Opportunities and Recovery Program. 46.2785(1)(c)
(c) “Waiver program" means the Community Opportunities and Recovery Program for which a waiver has been requested under sub.
(2) and granted under
42 USC 1396n (c).
46.2785(2)
(2) Waiver request. The department may request a waiver from the secretary of the U.S. department of health and human services, under
42 USC 1396n (c), authorizing the department to serve in their communities medical assistance recipients who meet eligibility requirements specified in sub.
(4) by providing them home or community-based services as part of the Medical Assistance program. If the department requests the waiver, it shall include all the assurances required under
42 USC 1396n (c) (2) in the request. If the department receives the waiver, it may request an extension of the waiver under
42 USC 1396n (c).
46.2785(3)
(3) Contract for administration. If doing so is consistent with the waiver received by the department as specified in sub.
(2), the department may contract with a county or a private agency to administer the waiver program. A private agency with which the department contracts shall have the powers and duties of a county under this section.
46.2785(4)
(4) Eligibility. Any medical assistance recipient who has a serious mental illness and meets the level of care requirements under s.
49.45 (6m) (i) for reimbursement of nursing home care under the Medical Assistance program is eligible to participate in the waiver program.
46.2785(5)(a)
(a) Medical assistance reimbursement for services a county or private agency contracts for or provides under the waiver program shall be made from the appropriation accounts under s.
20.435 (4) (b),
(gm), and
(o).
46.2785(5)(b)
(b) The department may, from the appropriation account under s.
20.435 (4) (o), reimburse a county for providing, or contracting to provide, services that cost more than the average annual per person rate established by the department, but less than the average amount approved by the federal government for the waiver program.
46.2785 History
History: 2005 a. 25;
2011 a. 32.
46.279
46.279
Restrictions on placements and admissions to intermediate and nursing facilities. 46.279(1)(b)
(b) “Intermediate facility" has the meaning given for an intermediate care facility for the mentally retarded under
42 USC 1396d (d), other than a center for the developmentally disabled, as defined in s.
51.01 (3).
46.279(1)(bm)
(bm) “Most integrated setting" means a setting that enables an individual to interact with persons without developmental disabilities to the fullest extent possible.
46.279(2)
(2) Placements and admissions to intermediate facilities. Except as provided in sub.
(5), no person may protectively place or continue protective placement of an individual with a developmental disability in an intermediate facility and no intermediate facility may admit or continue service for such an individual unless, before the protective placement, continued placement following review under s.
55.18, or admission and after having considered a plan developed under sub.
(4), a court under s.
55.12 or
55.18 (1) (ar) finds that protective placement in the intermediate facility is the most integrated setting that is appropriate to the needs of the individual or that the county of residence of the individual would not reasonably be able to provide community-based care in accordance with the plan within the limits of available state and federal funds and county funds required to be appropriated to match state funds, taking into account information presented by all affected parties. An intermediate facility to which an individual who has a developmental disability applies for admission shall, within 5 days after receiving the application, notify the county department that is participating in the program under s.
46.278 of the county of residence of the individual who is seeking admission concerning the application.
46.279(3)
(3) Placements and admissions to nursing facilities. Except as provided in sub.
(5), if the department or an entity determines from a screening under s.
49.45 (6c) (b) that an individual requires active treatment for developmental disability, no individual may be protectively placed in a nursing facility or have protective placement in a nursing facility continued following review under s.
55.18, and no nursing facility may admit or continue service for the individual, unless the department or entity that conducts the screening determines that the individual's need for care cannot fully be met in an intermediate facility or under a plan under sub.
(4) or that the county of residence of the individual would not reasonably be able to provide community-based care in accordance with the plan within the limits of available state and federal funds and county funds required to be appropriated to match state funds.
46.279(4)
(4) Plan for home or community-based care. Except as provided in a contract specified in sub.
(4m), a county department that participates in the program under s.
46.278 shall develop a plan for providing home or community-based care in a noninstitutional community setting to an individual who is a resident of that county, under any of the following circumstances: