2. Persons from the service area representing the county department under s. 13
46.23, 51.42, or 51.437 and the county department under s. 46.215 or 46.22, school 14
districts, and local health departments, as defined in s. 250.01 (4). At least one of the 15
committee members selected under this subdivision shall be a person providing 16
community social services to children with disabilities who are eligible for the 17
3. Persons in the service area who provide social or educational services to 19
children who have disabilities other than the providers specified in subd. 2.
(b) Cooperate with the committee appointed under par. (a) to prepare a 21
program plan. The program plan shall include all of the following:
1. A description of the proposed program.
2. The estimated number of families that will be assessed and served.
3. A list of specific groups, if any, that will be given priority for available 25
4. A description of the outreach procedures that will be used to ensure that the 2
program will be made available to children with physical, emotional, and mental 3
5. The procedures that will be used to determine family needs.
6. A description of the methods that will be used for the development and 6
monitoring of service plans and for coordinating the provision of services and goods 7
to participating families.
7. A description of the methods that will be used to promote the creation of 9
informal support and advocacy systems for families.
8. A description of the method that will be used to monitor the children's 11
community options program.
(c) Submit the proposed program plan to the county board of supervisors in each 13
county in the service area for review. After approval by the county board of 14
supervisors in each county in which families are eligible to participate in the 15
program, the county department shall submit the proposed program plan to the 16
(d) Administer the program or contract with a human service agency in the 18
service area to administer the program within the limits of state and federal funds 19
under subs. (13) and (14).
(e) In conjunction with the county department under s. 46.215 or 46.22, if any, 21
in the service area and with the administering agency, if it is not the county 22
department under s. 46.23, 51.42, or 51.437, coordinate the administration of the 23
program with the administration of other publicly funded programs that serve 24
children who have disabilities.
(f) Submit all information and reports required by the department.
1(5) Powers and duties of a private nonprofit agency.
A private nonprofit 2
agency with which the department contracts for service under sub. (14) (b) 3. shall 3
have the powers and duties under this section of a county department designated to 4
administer the program.
5(6) Duties of administering agencies.
Each administering agency shall:
(a) Cooperate in the development of the program plan under sub. (4) (b).
(b) Provide information about the program and other programs for children 8
who have disabilities to families in the service area.
(c) Implement the program in accordance with the program plan.
(d) Designate one of its employees as the coordinator for each participating 11
12(7) County department duties.
The county department selected to administer 13
the children's community options program shall:
(a) Organize assessment activities specified in par. (f) and sub. (8). The county 15
department shall utilize persons for each assessment who can determine the needs 16
of the child being assessed and who know the availability within the county of 17
services. The county department shall coordinate the involvement of 18
representatives from the county departments under ss. 46.215, 46.22, 51.42 and 19
51.437, and health service providers in the assessment activities specified in sub. (8), 20
as well as the child being assessed and members of the child's family or the child's 21
(b) Within the limits of state and federal funds allocated under sub. (13), 23
arrange service contracts under s. 46.036 and ensure the provision of necessary 24
long-term community support services for each child who meets the criteria for 25
services under the children's community options program.
(c) Within the limits of state and federal funds allocated under sub. (13), 2
provide for ongoing care management services in accordance with the requirements 3
established under sub. (10) (b) 1., periodic case plan review and follow-up services 4
for any child receiving community support services under the children's community 5
(d) Determine, under sub. (9), the fee, if any, for all families or guardians of 7
children who meet the criteria to receive services and are applying for or receiving 8
children's community support services that are funded under sub. (13) or (14).
(e) In the instances in which a child who is provided community support 10
services under this section for which the child or his or her parent or guardian 11
receives direct funding, serve directly as a fiscal agent or contract with a fiscal 12
intermediary to serve as a fiscal agent for that child for the purposes of performing 13
the responsibilities and protecting the interests of the individual under the 14
unemployment insurance law. The county department may elect to act as a fiscal 15
agent or contract with a fiscal intermediary to serve as a fiscal agent for a child who 16
is provided long-term community support services under s. 46.275, 46.277, 46.278, 17
46.2785, 46.495, 51.42, or 51.437. The fiscal agent under this paragraph is 18
responsible for remitting any federal unemployment compensation taxes or state 19
unemployment insurance contributions owed by the child, including any interest 20
and penalties which are owed by the child; for serving as the representative of the 21
child in any investigation, meeting, hearing or appeal involving ch. 108 or the federal 22
unemployment tax act (26 USC 3301
) in which the child is a party; and for 23
receiving, reviewing, completing and returning all forms, reports and other 24
documents required under ch. 108 or the federal unemployment tax act on behalf of 25
the child. A child may make an informed, knowing and voluntary election to waive
the right to a fiscal agent. The waiver may be as to all or any portion of the fiscal 2
agent's responsibilities. The waiver may be rescinded in whole or in part at any time.
(f) Develop assessments and care plans according to uniform criteria 4
established by the department for children in all long-term care programs.
Within the limits of state and federal funds allocated under 6
sub. (13) and within the limits of fees collected, an assessment shall be conducted for 7
any child with a disability who is seeking services in the program.
8(9) Financial eligibility and fees.
(a) The department shall create a sliding 9
scale formula for a fee chargeable for conduct of an assessment under sub. (8), for 10
development of a case plan, and for children's long-term community support services 11
that is based on the child's ability to pay, unless prohibited from payment under the 12
federal Medicaid law.
(b) The county department selected to administer the program shall require all 14
children or their parents or guardians applying for children's long-term community 15
support services at the time of application and all children receiving the services that 16
are funded under sub. (13) or (14) annually to provide the following information:
1. A declaration of income, on a form prescribed by the department.
2. A declaration of costs paid annually for care and services related to the 19
special needs or disability of the child for whom the application is made or services 20
(c) From the information obtained under par. (b), the county department shall 22
determine the amount of the fee for receipt of children's long-term community 23
support services under this section. The county department shall require payment 24
by the child or parent or guardian of the child of 100 percent of the amount calculated 25
under this paragraph.
(d) The county department shall used funds received under par (c) to pay for 2
long-term community support services for children who are eligible for services 3
under the children's community options program.
4(10) Services; care management requirements.
(a) 1. Within the limits of state 5
and federal funds allocated under sub. (13) and within the limits of fees collected, the 6
department shall reimburse, if applicable, and the county department or private 7
nonprofit agency shall provide long-term community support services to eligible 8
children who have a disability.
2. The department may not reimburse and the county department or private 10
nonprofit agency may not pay for room and board for children under the children's 11
community options program.
(b) The department, after consulting with representatives of counties, 13
hospitals, and individuals who receive services under the children's community 14
options program under this section, shall do all of the following:
1. Establish minimum requirements for the provision of care management 16
services, as defined by the department, including standards for care, times for 17
performance of duties, and size of case loads.
2. Specify a reasonable schedule for phasing in the requirements established 19
under subd. 1.
3. Provide technical consultation and assistance to the administrator of the 21
program with respect to the requirements established under subd. 1.
(c) The department need not promulgate as rules under ch. 227 the 23
requirements under par. (b) 1. or the schedule under par. (b) 2.
24(11) Fiscal responsibility.
Except as provided in s. 51.40, and within the 25
limitations under sub. (13) (a) 2., the fiscal responsibility of a county for an
assessment, unless the assessment is performed by an entity under a contract as 2
specified under s. 46.284 (2), case plan, or services provided to a child under this 3
section is as follows:
(a) For a child seeking admission to or about to be admitted to an institutional 5
setting, the county in which the child has residence is the county of fiscal 6
(b) For a child residing in an institutional setting, except a state-operated 8
long-term care facility, the county in which the institution is located is the county 9
of fiscal responsibility.
(c) For a child living in an institutional setting, except a state-operated 11
long-term care facility, whose legal residence is established in another county, the 12
county in which the legal residence is established is the county of fiscal responsibility.
(d) For a child residing in a state-operated long-term care facility, or for a 14
person protectively placed under ch. 55, the county in which the child has residence 15
before he or she enters the state-operated long-term care facility or is protectively 16
placed is the county of fiscal responsibility.
17(12) Reimbursement disallowances.
The department may disallow 18
reimbursement under this section for services provided to children who do not meet 19
the eligibility requirements for the children's community options program or any 20
other eligibility requirements established by the department.
(a) Subject to pars. (b) and (h), from the appropriation under 22
s. 20.435 (4) (bd), the department shall allocate funds to each county or private 23
nonprofit agency with which the department contracts for all of the following 24
1. To pay assessment and case plan costs not otherwise paid by fee or under s. 2
49.45 or 49.78 (2). The department shall reimburse multicounty consortia for the 3
cost of assessing children eligible for medical assistance under s. 49.46, 49.468, 4
49.47, or 49.471 (4) (a) as part of the administrative services of medical assistance, 5
payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this 6
subdivision to pay the cost of long-term community support services and for a risk 7
reserve under par. (f).
2. To pay the cost of providing long-term community support services described 9
under sub. (7) (b) not otherwise paid under s. 49.45 to children eligible for medical 10
assistance under s. 49.46, 49.47, or 49.471 (4) (a). The county department 11
administering the program may spend funds received under this paragraph only in 12
accordance with the case plan and service contract created for each child receiving 13
long-term community support services. Counties may use unspent funds allocated 14
under this subdivision from the appropriation under s. 20.435 (4) (bd) for a risk 15
reserve under par. (f).
(b) 1. Receipt of funds under this section is subject to s. 46.495 (2).
2. The department may not release funds under this subsection before 18
approving the county's community options plan.
3. No county may use funds received under par. (a) 2. to pay for long-term 20
community support services provided to any child who resides in a nursing home, 21
unless the department waives this restriction on use of funds and the services are 22
provided in accordance with a discharge plan.
4. No county may use funds received under this section to purchase land or 24
(c) The department may release funds to counties acting jointly, if the counties 2
sign a contract approved by the secretary that explains the plans for joint 3
(d) If the department determines that a county demonstrates a pattern of 5
failure to serve clients whose cost of care significantly exceeds the average cost of care 6
for children's long-term community support services provided under this section, the 7
department may require that county to reserve a portion of funds allocated under 8
this subsection for provision of service to those clients.
(e) The department shall, at the request of a county, carry forward up to 5 10
percent of the amount allocated under this subsection to the county for a calendar 11
year if up to 5 percent of the amount so allocated has not been spent or encumbered 12
by the county by December 31 of that year, for use by the county in the following 13
calendar year, except that the amount carried forward shall be reduced by the 14
amount of funds that the county has notified the department that the county wishes 15
to place in a risk reserve under par. (f). The department may transfer funds within 16
s. 20.435 (4) (bd) to accomplish this purpose. An allocation under this paragraph does 17
not affect a county's base allocation under this subsection and shall lapse to the 18
general fund unless expended within the calendar year to which the funds are 19
carried forward. A county may not expend funds carried forward under this 20
paragraph for administrative or staff costs, except administrative or staff costs that 21
are associated with implementation of the waiver under sub. (14) and approved by 22
(f) 1. Notwithstanding s. 46.036 (3) and (5m), a county may place in a risk 24
reserve funds that are allocated under par. (a) or sub. (14) (b) 1. and are not expended 25
or encumbered for services under this subsection or sub. (14). The county shall notify
the department of this decision and of the amount to be placed in the risk reserve. 2
The county shall maintain the risk reserve in an interest-bearing escrow account 3
with a financial institution, as defined in s. 69.30 (1) (b), if the department has 4
approved the terms of the escrow. All interest from the principal shall be reinvested 5
in the escrow account.
2. The annual amount of a county's expenditure for a risk reserve, as specified 7
in subd. 1., may not exceed 10 percent of the county's most recent allocation under 8
par. (a) and sub. (14) (b) 1. or $750,000, whichever is less. The total amount of the 9
risk reserve, including interest, may not exceed 15 percent of the county's most recent 10
allocation under this subsection.
3. A county may expend funds maintained in a risk reserve, as specified in subd. 12
1., for any of the following purposes:
a. To defray costs of children's long-term community support services under 14
b. If approved by the department, for administrative or staff costs under this 16
4. A county that maintains a risk reserve, as specified in subd. 1., shall 18
annually, on a form prescribed by the department, submit to the department a record 19
of the status of the risk reserve, including revenues and disbursements.
(g) The department may carry forward to the next state fiscal year funds 21
allocated under this subsection and not encumbered by counties by December 31 or 22
carried forward under par. (e). The department may transfer moneys within s. 23
20.435 (4) (bd) to accomplish this purpose. An allocation under this paragraph shall 24
not affect a county's base allocation for the program. The department may allocate 25
these transferred moneys during the next fiscal year to counties for the improvement
or expansion of long-term community support services for clients whose cost of care 2
significantly exceeds the average cost of care provided under this section, including 3
any of the following:
1. Specialized training for providers of services under this section.
2. Start-up costs for developing needed services.
3. Home modifications.
4. Purchase of medical equipment or other specially adapted equipment.
(h) Funds allocated under this subsection may not be used to replace any other 9
state and federal funds or any county funds that are currently being provided under 10
any program to a family whose child is receiving services through the children's 11
community options program.
12(14) Medical assistance waiver.
(a) The department may request a waiver 13
from the federal department of health and human services authorizing the 14
department to provide as part of the Medical Assistance program services for persons 15
who are eligible for children's long-term support community options program 16
services under sub. (7) (b).
(b) 1. Medical assistance reimbursement for services a county or a private 18
nonprofit agency, or with which the department contracts provides under this 19
subsection shall be made from the appropriations under s. 20.435 (4) (bd) and (o) and 20
(7) (b). Payments made under sub. (13) (a) may be used as the state share for 21
purposes of Medical Assistance reimbursement.
3. The department may contract for services under this subsection with a 23
county or a private nonprofit agency.
4. No county or private nonprofit agency may use funds received under this 25
subsection to provide residential services in a group home, as defined in s. 48.02 (7),
that has more than 5 beds, unless the department approves the provision of services 2
in a group home that has 6 to 8 beds.
(c) If a county department or private nonprofit agency providing services under 4
this subsection is certified under s. 49.45 (37) (a), the waiver under s. 49.45 (37), if 5
in effect, applies to plans of care for children receiving services under this subsection.
6(15) Right to hearing.
A child who is denied eligibility for services or whose 7
services are reduced or terminated under this section may request a hearing from the 8
department under s. 227.44, except that lack of adequate funding may not serve as 9
the basis for a request under this subsection.
46.277 (5g) (b) of the statutes is renumbered 46.277 (5g) (b) 11
(intro.) and amended to read:
(b) (intro.) This section does not apply to the delicensure of a bed 13
of an institution for mental diseases of an individual who is aged 21 to 64, who has 14
a primary diagnosis of mental illness and who otherwise meets any of
the following 15
requirements of s. 46.266 (1) (a), (b) or (c).:
46.277 (5g) (b) 1. and 2. of the statutes are created to read:
(b) 1. A person who resided in the facility on the date of the finding 18
that a skilled nursing facility or intermediate care facility that provides care to 19
Medical Assistance recipients to be an institution for mental diseases whose care in 20
the facility is disallowed for federal financial participation under Medical 21
2. A person who is aged 21 to 64, who has a primary diagnosis of mental illness, 23
who would meet the level of care requirements for Medical Assistance 24
reimbursement in a skilled nursing facility or intermediate care facility but for a
finding that the facility is an institution for mental diseases, and for whom services 2
would be provided in place of a person specified in subd. 1. who discontinues services.
46.28 (1) (a) of the statutes is amended to read:
(a) "Authority" means the Forward
Wisconsin Housing and Economic 5
Development Authority created under ch. 234 235
46.28 (3) of the statutes is amended to read:
The department may authorize the authority to issue revenue bonds 8
under s. 234.61 235.61
to finance any residential facility it approves under sub. (2).
46.28 (4) of the statutes is amended to read:
The department may charge sponsors for administrative costs and 11
expenses it incurs in exercising its powers and duties under this section and under 12
s. 234.61 235.61
46.2803 (1) of the statutes is amended to read:
In order to facilitate the transition to the long-term care system
15specified in ss. family care program as defined in s.
46.2805 to 46.2895 (4m)
, within 16
the limits of applicable federal statutes and regulations and if the secretary of health 17
services finds it necessary, he or she may grant a county limited waivers to or 18
exemptions from ss. 46.27 (3) (e) (intro.), 1. and 2. and (f), (5) (d) and (e), (6) (a) 1., 2. 19
and 3. and (b) (intro.), 1. and 2., (6r) (c), (7) (b), (cj) and (cm) and (11) (c) 5m. (intro.) 20
and 6. and 46.277 (3) (a), (4) (a) and (5) (d) 1m., 1n. and 2. and rules promulgated 21
under those provisions.