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LRB-4597/1
TJD&SWB:amn
2015 - 2016 LEGISLATURE
February 1, 2016 - Introduced by Senators Marklein, Cowles, Lasee, Lassa,
Petrowski, Roth, Vukmir and Olsen, cosponsored by Representatives Krug,
Novak, Bernier, Edming, Knodl, Mursau, A. Ott, Petryk, Quinn, Rohrkaste,
Tauchen, Tittl, Tranel, VanderMeer and Knudson. Referred to Committee
on Health and Human Services.
SB687,1,5 1An Act to renumber and amend 46.2895 (2); to amend 46.2895 (3) (b) 5. and
246.2895 (13); and to create 46.284 (2) (br), 46.284 (4m), 46.2895 (2) (b), 46.2895
3(2) (c), 46.2895 (3) (e), 46.2895 (4) (o), 46.2895 (4) (p), 46.2895 (4) (q), 46.2895
4(4) (r), 46.2895 (4r) and 46.2895 (6) (cm) of the statutes; relating to: long-term
5care districts and care management organizations.
Analysis by the Legislative Reference Bureau
This bill allows the Department of Health Services to contract with a county or
long-term care district to operate a care management organization outside the
geographic area of that county or long-term care district and specifies a different
disposition of property and assets upon dissolution of a long-term care district. The
bill also allows a long-term care district or a governmental entity that has a contract
to operate a care management organization to create a nonstock, nonprofit
corporation or a service insurance corporation and to assign certain contracts,
permits, and certifications to the corporation with approval of DHS and the Office
of the Commissioner of Insurance.
Currently, a care management organization, under a contract with DHS,
enrolls individuals in the Family Care program and administers the Family Care
benefit, which provides financial assistance for long-term care to a frail elder or a
person with a physical or developmental disability. DHS may contract with a county,
a long-term care district, a governing body of a tribe or band or the Great Lakes
Inter-Tribal Council, a joint association of those entities, or a private organization

to be a care management organization. A county, tribe or band, or a combination of
counties or tribes or bands may create a long-term care district, which is a special
purpose district that is a local unit of government. Currently, the jurisdiction of a
long-term care district is the geographic area of the county or counties that created
the district or the geographic area of the reservation of, or land held in trust for, any
tribe or band that created the district. This bill allows DHS to contract with a county
or long-term care district to operate a care management organization outside the
geographic area of that county or long-term care district. The bill specifies that DHS
may award contracts to one or more certified entities to operate a care management
organization within a county or geographic area. If DHS awards a contract to a
long-term care district to operate a care management organization outside the
geographic area of the counties that created the long-term care district, the bill
allows any county that is newly served by that care management organization to join
the existing long-term care district under certain circumstances at the discretion of
the long-term care district's board. The bill also specifies that upon dissolution of
a long-term care district the property and the assets of the corporation transfer to
DHS instead of the entity that created the long-term care district.
The bill also allows a long-term care district or a governmental entity that has
a contract to operate a care management organization to create a nonstock, nonprofit
corporation or a service insurance corporation. Before creating the corporation that
provides the Family Care benefit, the long-term care district or governmental entity
must submit the proposed articles of incorporation to DHS for review and approval.
With approval of DHS and OCI, the long-term care district or governmental entity
may then assign to the corporation the district's assets and liabilities, a contract with
DHS to operate a care management organization, a permit issued by OCI to operate
as a care management organization, or a care management organization
certification by DHS. DHS must then notify enrollees of the transfer of the contract
to the corporation and inform enrollees of their rights and responsibilities in
accordance with any federal requirements.
The 2015-17 budget act specifies that the Family Care program will be
expanded statewide and requires DHS to request a waiver to make certain changes
to the long-term care program, including the creation of integrated health agencies.
DHS must include in its waiver request provisions to allow a long-term care district
to operate an integrated health agency, including operating an integrated health
agency outside its geographic area.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB687,1 1Section 1. 46.284 (2) (br) of the statutes is created to read:
SB687,3,3
146.284 (2) (br) 1. The department may contract with a county or long-term care
2district to operate a care management organization outside the geographic area of
3that county or long-term care district.
SB687,3,64 2. The department may award contracts under this paragraph to one or more
5entities certified under sub. (3) to operate a care management organization within
6a county or geographic area.
SB687,2 7Section 2. 46.284 (4m) of the statutes is created to read:
SB687,3,108 46.284 (4m) Creating corporation. (a) In this subsection, "governmental
9entity" means a political subdivision, as defined in s. 16.99 (3d), or a subunit of a
10political subdivision.
SB687,3,1211 (b) A governmental entity that has a contract under sub. (2) may do all of the
12following:
SB687,3,2213 1. Create a nonstock, nonprofit corporation under ch. 181 or a service insurance
14corporation under ch. 613. Before creating a nonstock, nonprofit corporation or a
15service insurance corporation that will provide services under the family care
16benefit, the governmental entity shall submit to the department the proposed
17articles of incorporation for review and approval. If the department does not
18disapprove the articles of incorporation within 30 days of the date of submission to
19the department, the articles of incorporation are considered approved. If the
20department disapproves the articles of incorporation, the department shall provide
21specific reasons for the disapproval and recommendations regarding how the articles
22may be amended to cure the defect.
SB687,3,2423 2. With approval of the department and office of the commissioner of insurance,
24assign any of the following to a corporation created under subd. 1.:
SB687,4,4
1a. The governmental entity's assets and liabilities relating to providing the
2family care benefit, including operating capital funds, risk reserve funds, solvency
3funds, or other special reserve funds required by the department or the office of the
4commissioner of insurance.
SB687,4,55 b. A contract with the department as described in sub. (2).
SB687,4,66 c. A permit issued by the office of the commissioner of insurance under ch. 648.
SB687,4,77 d. A certification by the department under sub. (3).
SB687,4,128 (c) Upon approval of the department and the commissioner of insurance under
9par. (b) 2., the department shall notify enrollees of the care management
10organization regarding the transfer of the contract to the corporation created under
11par. (b) 1. and shall inform enrollees of their rights and responsibilities in accordance
12with any requirements of the federal department of health and human services.
SB687,3 13Section 3. 46.2895 (2) of the statutes is renumbered 46.2895 (2) (a) and
14amended to read:
SB687,4,1815 46.2895 (2) (a) A Except as provided in par. (b) or (c), a long-term care district's
16jurisdiction is the geographical area of the county or counties that created the
17long-term care district and the geographic area of the reservation of, or lands held
18in trust for, any tribe or band that created the long-term care district.
SB687,4 19Section 4. 46.2895 (2) (b) of the statutes is created to read:
SB687,4,2320 46.2895 (2) (b) A long-term care district may apply to the department for a
21contract to operate a care management organization under s. 46.284 in an area
22outside the geographic boundary of the county or counties that created the long-term
23care district.
SB687,5 24Section 5. 46.2895 (2) (c) of the statutes is created to read:
SB687,5,10
146.2895 (2) (c) If the department awards a contract to a long-term care district
2to operate a care management organization outside the geographic area of the
3counties that created the long-term care district, any county that is newly served by
4the care management organization and is outside the geographic area of the counties
5that created the long-term care district may join the existing long-term care district
6at the discretion of the long-term care district's board, provided the newly served
7county adopts a resolution that authorizes the county to join the long-term care
8district. A county served by a care management organization operated by a
9long-term care district to which the county does not belong shall cooperate with and
10may not impede the operation of the care management organization.
SB687,6 11Section 6. 46.2895 (3) (b) 5. of the statutes is amended to read:
SB687,5,1412 46.2895 (3) (b) 5. Only individuals who reside within the jurisdiction of area
13served by
a long-term care district may serve as members of the long-term care
14district board.
SB687,7 15Section 7. 46.2895 (3) (e) of the statutes is created to read:
SB687,5,2316 46.2895 (3) (e) Notwithstanding sub. (1) (a) 1. c., if a long-term care district is
17awarded a contract with the department to operate a care management organization
18outside the geographic area of the county or counties that created the long-term care
19district, the long-term care district board may add members to the long-term care
20district board to represent the counties or areas newly served by the long-term care
21district. The long-term care district board shall file notice of the change of the
22long-term care district board's composition with the secretary of administration, the
23secretary of health services, and the secretary of revenue.
SB687,8 24Section 8. 46.2895 (4) (o) of the statutes is created to read:
SB687,6,3
146.2895 (4) (o) If awarded a contract by the department as described in sub. (2)
2(b) or (c), operate a care management organization outside the geographic boundary
3of the long-term care district.
SB687,9 4Section 9. 46.2895 (4) (p) of the statutes is created to read:
SB687,6,85 46.2895 (4) (p) If awarded a contract by the department to operate a care
6management organization outside its geographic boundaries as described in sub. (2)
7(b) or (c), determine whether to add new counties, tribes, or bands into the long-term
8care district.
SB687,10 9Section 10 . 46.2895 (4) (q) of the statutes is created to read:
SB687,6,2010 46.2895 (4) (q) Notwithstanding subs. (1) to (3), create a nonstock, nonprofit
11corporation under ch. 181 or a service insurance corporation under ch. 613 that may
12succeed the long-term care district and survive the district's dissolution under sub.
13(13). Before creating a nonstock, nonprofit corporation or a service insurance
14corporation that will provide services under the family care benefit, the long-term
15care district shall submit to the department the proposed articles of incorporation for
16review and approval. If the department does not disapprove the articles of
17incorporation within 30 days of the date of submission to the department, the articles
18of incorporation are considered approved. If the department disapproves the articles
19of incorporation, the department shall provide specific reasons for the disapproval
20and recommendations regarding how the articles may be amended to cure the defect.
SB687,11 21Section 11. 46.2895 (4) (r) of the statutes is created to read:
SB687,6,2322 46.2895 (4) (r) With approval of the department and office of the commissioner
23of insurance, assign the following to a corporation created under par. (q):
SB687,7,3
11. The long-term care district's assets and liabilities, including operating
2capital funds, risk reserve funds, solvency funds, or other special reserve funds
3required by the department or the office of the commissioner of insurance.
SB687,7,44 2. A contract with the department as described in sub. (2) (b) or (c).
SB687,7,55 3. A permit issued by the office of the commissioner of insurance under ch. 648.
SB687,7,66 4. A certification by the department under s. 46.284 (3).
SB687,12 7Section 12. 46.2895 (4r) of the statutes is created to read:
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