AB150-engrossed,796,74 46.27 (12) (c) A sliding scale formula for a fee chargeable for conduct of an
5assessment under sub. (6) (a) or for development of a case plan under sub. (6) (b) that
6is based on the person's ability to pay, unless prohibited from payment under 42 USC
71396 to 1396v or under regulations under 42 USC 1396 to 1396v.

AB150-engrossed,796,109 46.275 (1m) (a) "Medical assistance" means aid provided under ss. 49.43 to
1049.47 subch. IV of ch. 49, except s. 49.468.

AB150-engrossed,796,1612 46.275 (5) (b) 2. Reduce federal, state or county matching expenditures for
13long-term community support services provided to any person as part of this
14program from funds allocated under s. 46.495 (1) (d), 46.80 (5), 46.85 (3m) (b) 1. and
152., 49.52 (1) (d) or 51.423, as indicated in the county's budget or by actual
16expenditures.

AB150-engrossed,796,1918 46.277 (1m) (a) "Medical assistance" means aid provided under ss. 49.43 to
1949.47 subch. IV of ch. 49, except s. 49.468.

AB150-engrossed,796,2321 46.277 (1m) (b) "Program" means the community integration program for
22facilities certified as medical assistance providers, for which a waiver has been
23received under sub. (2).

AB150-engrossed,797,6

146.277 (2) (e) Review and approve or disapprove waiver requests under sub.
2(3) (c), review and approve or disapprove requests for exceptions under sub. (5) (d)
33. and provide technical assistance to a county that reaches or exceeds the annual
4allocation limit specified in sub. (3) (c) in order to explore alternative methods of
5providing long-term community support services for persons who are in group living
6arrangements in that county.

AB150-engrossed,797,168 46.277 (3) (a) Sections 46.27 (3) (b) and 46.275 (3) (a) and (c) to (e) apply to
9county participation in this program, except that services provided in the program
10shall substitute for care provided a person in a skilled nursing facility or
11intermediate care facility who meets the level of care requirements for medical
12assistance reimbursement to that facility rather than for care provided at a state
13center for the developmentally disabled. The number of persons who receive services
14provided by the program under this paragraph may not exceed the number of
15nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as
16part of a plan submitted by the facility and approved by the department.

AB150-engrossed,797,2318 46.277 (3) (b) 2. Each county department participating in the program shall
19provide home or community-based care to persons eligible under this section, except
20that the number of persons who receive home or community-based care under this
21section may not exceed the number of nursing home beds, other than beds specified
22in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and
23approved by the department.

AB150-engrossed,798,10

146.277 (3) (c) Beginning on January 1, 1996, from the annual allocation to the
2county for the provision of long-term community support services under sub. (5),
3annually establish a maximum total amount, not to exceed 25% of the annual
4allocation, that may be encumbered in a calendar year for services for eligible
5individuals in community-based residential facilities. If the total amount that is
6encumbered for services for individuals in community-based residential facilities
7who are receiving services under sub. (5) on January 1, 1996, exceeds 25% of the
8county's annual allocation, a county may request a waiver of the requirement under
9this paragraph from the department. The department need not promulgate as rules
10under ch. 227 the standards for granting a waiver request under this paragraph.

AB150-engrossed,798,1912 46.277 (4) (a) Any medical assistance recipient who meets the level of care
13requirements for medical assistance reimbursement in a skilled nursing facility or
14intermediate care facility is eligible to participate in the program, except that the
15number of participants may not exceed the number of nursing home beds , other than
16beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the
17facility and approved by the department. Such a recipient may apply, or any person
18may apply on behalf of such a recipient, for participation in the program. Section
1946.275 (4) (b) applies to participation in the program.

AB150-engrossed,799,321 46.277 (4) (b) To the extent authorized under 42 USC 1396n, if a person
22discontinues participation in the program, a medical assistance recipient may
23participate in the program in place of the participant who discontinues if that
24recipient meets the level of care requirements for medical assistance reimbursement
25in a skilled nursing facility or intermediate care facility, except that the number of

1participants may not exceed the number of nursing home beds , other than beds
2specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility
3and approved by the department.

AB150-engrossed,799,115 46.277 (5) (d) 3. If subd. 2. a. or b. applies, no county may use funds received
6under this section to pay for services provided to a person who resides or intends to
7reside in a community-based residential facility and who is initially applying for the
8services, if the projected cost of services for the person, plus the cost of services for
9existing participants, would cause the county to exceed the limitation under sub. (3)
10(c). The department may grant an exception to the requirement under this
11subdivision, under the conditions specified by rule, to avoid hardship to the person.

AB150-engrossed,799,1813 46.277 (5) (e) A county may use funds received under this subsection to provide
14supportive, personal or nursing services, as defined in rules promulgated under s.
1549.45 (2) (a) 23., to a person who resides in a certified assisted living facility, as
16defined in s. 50.01 (1d). Funding of the services may not exceed 85% of the statewide
17medical assistance daily cost of nursing home care, as determined by the
18department.