Amendment SSA1-SB59

SB59-SSA1,302,15 c. Denial or limited authorization of a requested service, including determinations based on type or level of service, requirements or medical necessity, appropriateness, setting, or effectiveness of a covered benefit.

SB59-SSA1,302,18 d. Reduction, suspension, or termination of a previously authorized service, unless the service was only authorized for a limited amount or duration and that amount or duration has been completed.

SB59-SSA1,302,19 e. Denial, in whole or in part, of payment for a service.

SB59-SSA1,302,22 f. The failure of a care management organization to act within the time frames provided in 42 CFR 438.408 (b) (1) and (2) regarding the standard resolution of grievances and appeals.

SB59-SSA1,302,25 g. Denial of an enrollee's request to dispute financial liability, including copayments, premiums, deductibles, coinsurance, other cost sharing, and other member financial liabilities.

SB59-SSA1,303,3 h. Denial of an enrollee, who is a resident of a rural area with only one care management organization, to obtain services outside the care management organization's network of contracted providers.

SB59-SSA1,303,9 i. Development of a plan of care that is unacceptable to the enrollee because the plan of care requires the enrollee to live in a place that is unacceptable to the enrollee; the plan of care does not provide sufficient care, treatment, or support to meet the enrollee's needs and support the enrollee's identified outcomes; or the plan of care requires the enrollee to accept care, treatment, or support that is unnecessarily restrictive or unwanted by the enrollee.

SB59-SSA1,303,10 j. Involuntary disenrollment from the care management organization.

SB59-SSA1,480 Section 480 . 46.287 (2) (b) of the statutes is amended to read:

SB59-SSA1,303,20 46.287 (2) (b) An enrollee may contest a decision, omission or action of a care management organization other than those specified in par. (a), or may contest the choice of service provider. In these instances, the enrollee shall first send a written request for review by the unit of the department that monitors care management organization contracts. This unit shall review and attempt to resolve the dispute. 1m. by filing a grievance with the care management organization. If the dispute grievance is not resolved to the satisfaction of the enrollee, he or she may request a hearing under the procedures specified in par. (a) 1. (intro.) that the department review the decision of the care management organization.

SB59-SSA1,481 Section 481 . 46.288 (2) (intro.) of the statutes is renumbered 46.288 (2) and amended to read:

SB59-SSA1,304,3 46.288 (2) Criteria and procedures for determining functional eligibility under s. 46.286 (1) (a), financial eligibility under s. 46.286 (1) (b), and cost sharing under s. 46.286 (2) (a). The rules for determining functional eligibility under s. 46.286 (1) (a) 1m. shall be substantially similar to eligibility criteria for receipt of the long-term support community options program under s. 46.27. Rules under this subsection shall include definitions of the following terms applicable to s. 46.286:

SB59-SSA1,482 Section 482 . 46.288 (2) (d) to (j) of the statutes are repealed.

SB59-SSA1,483 Section 483 . 46.2896 (1) (a) of the statutes is amended to read:

SB59-SSA1,304,9 46.2896 (1) (a) “Long-term care program" means the long-term care program under s. 46.27, 46.275, 46.277, 46.278, or 46.2785; the family care program providing the benefit under s. 46.286; the Family Care Partnership program; or the long-term care program defined in s. 46.2899 (1).

SB59-SSA1,484 Section 484 . 46.536 of the statutes is amended to read:

SB59-SSA1,304,18 46.536 Mobile crisis team Crisis program enhancement grants. From the appropriation under s. 20.435 (5) (cf), the department shall award grants in the total amount of $250,000 in each fiscal biennium to counties or regions comprised of multiple counties to establish certified or enhance crisis programs that create mental health mobile crisis teams to serve individuals having mental health crises in rural areas. The department shall award a grant under this section in an amount equal to one-half the amount of money the county or region provides to establish certified or enhance crisis programs that create mobile crisis teams.

SB59-SSA1,485 Section 485 . 46.82 (3) (a) 13. of the statutes is repealed.

SB59-SSA1,488 Section 488 . 47.07 of the statutes is created to read:

SB59-SSA1,304,23 47.07 Project SEARCH. (1) The department shall allocate for each fiscal year at least $250,000 from the appropriation under s. 20.445 (1) (b) for contracts entered into under this section.

SB59-SSA1,305,3 (2) The department may enter into contracts to provide services to persons with disabilities under the Project SEARCH program operated by the Cincinnati Children's Hospital or its successor organization.

SB59-SSA1,491 Section 491 . 48.02 (14m) of the statutes is created to read:

SB59-SSA1,305,7 48.02 (14m) “Qualifying residential family-based treatment facility” means a certified residential family-based alcohol or drug abuse treatment facility that meets all of the following criteria:

SB59-SSA1,305,10 (a) The treatment facility provides, as part of the treatment for substance abuse, parenting skills training, parent education, and individual and family counseling.

SB59-SSA1,305,16 (b) The substance abuse treatment, parenting skills training, parent education, and individual and family counseling is provided under an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma and in accordance with recognized principles of a trauma-informed approach and trauma-specific interventions to address the consequences of trauma and facilitate healing.

SB59-SSA1,492 Section 492 . 48.13 of the statutes is amended to read:

SB59-SSA1,305,21 48.13 Jurisdiction over children alleged to be in need of protection or services. Except as provided in s. 48.028 (3), the court has exclusive original jurisdiction over a child alleged to be in need of protection or services which can be ordered by the court, and if one of the following applies:

SB59-SSA1,305,22 (1) Who The child is without a parent or guardian;.

SB59-SSA1,305,23 (2) Who The child has been abandoned;.

SB59-SSA1,305,25 (2m) Whose The child's parent has relinquished custody of the child under s. 48.195 (1);.

SB59-SSA1,306,2 (3) Who The child has been the victim of abuse, as defined in s. 48.02 (1) (a) or (b) to (g), including injury that is self-inflicted or inflicted by another;.

SB59-SSA1,306,6 (3m) Who The child is at substantial risk of becoming the victim of abuse, as defined in s. 48.02 (1) (a) or (b) to (g), including injury that is self-inflicted or inflicted by another, based on reliable and credible information that another child in the home has been the victim of such abuse;.

SB59-SSA1,306,9 (4) Whose The child's parent or guardian signs the petition requesting jurisdiction under this subsection and is unable or needs assistance to care for or provide necessary special treatment or care for the child;.

SB59-SSA1,306,12 (4m) Whose The child's guardian is unable or needs assistance to care for or provide necessary special treatment or care for the child, but is unwilling or unable to sign the petition requesting jurisdiction under this subsection ;.

SB59-SSA1,306,13 (5) Who The child has been placed for care or adoption in violation of law; .

SB59-SSA1,306,15 (8) Who The child is receiving inadequate care during the period of time a parent is missing, incarcerated, hospitalized or institutionalized ;.

SB59-SSA1,306,19 (9) Who The child is at least age 12, signs the petition requesting jurisdiction under this subsection and is in need of special treatment or care which the parent, guardian or legal custodian is unwilling, neglecting, unable or needs assistance to provide;.

SB59-SSA1,306,23 (10) Whose The child's parent, guardian or legal custodian neglects, refuses or is unable for reasons other than poverty to provide necessary care, food, clothing, medical or dental care or shelter so as to seriously endanger the physical health of the child;.

SB59-SSA1,307,6 (10m) Whose The child's parent, guardian or legal custodian is at substantial risk of neglecting, refusing or being unable for reasons other than poverty to provide necessary care, food, clothing, medical or dental care or shelter so as to endanger seriously the physical health of the child, based on reliable and credible information that the child's parent, guardian or legal custodian has neglected, refused or been unable for reasons other than poverty to provide necessary care, food, clothing, medical or dental care or shelter so as to endanger seriously the physical health of another child in the home;.

SB59-SSA1,307,10 (11) Who The child is suffering emotional damage for which the parent, guardian or legal custodian has neglected, refused or been unable and is neglecting, refusing or unable, for reasons other than poverty, to obtain necessary treatment or to take necessary steps to ameliorate the symptoms; .

SB59-SSA1,307,13 (11m) Who The child is suffering from an alcohol and other drug abuse impairment, exhibited to a severe degree, for which the parent, guardian or legal custodian is neglecting, refusing or unable to provide treatment ; or.

SB59-SSA1,307,15 (13) Who The child has not been immunized as required by s. 252.04 and not exempted under s. 252.04 (3).

SB59-SSA1,493 Section 493 . 48.13 (14) of the statutes is created to read:

SB59-SSA1,307,22 48.13 (14) The child's parent is residing in a qualifying residential family-based treatment facility or will be residing at such a facility at the time of a child's placement with the parent in the facility, signs the petition requesting jurisdiction under this subsection, and, with the department's consent, requests that the child reside with him or her at the qualifying residential family-based treatment facility.

SB59-SSA1,494 Section 494 . 48.207 (1) (L) of the statutes is created to read:

SB59-SSA1,308,2 48.207 (1) (L) With a parent in a qualifying residential family-based treatment facility if the child's permanency plan includes a recommendation for such a placement under s. 48.38 (4) (em) before the placement is made and the parent consents to the placement.

SB59-SSA1,495 Section 495 . 48.345 (3) (c) of the statutes is amended to read:

SB59-SSA1,308,6 48.345 (3) (c) A foster home licensed under s. 48.62, a group home licensed under s. 48.625, a foster home, group home, or similar facility regulated in another state, or in the home of a guardian under s. 48.977 (2).

SB59-SSA1,496 Section 496 . 48.345 (3) (cm) of the statutes is amended to read:

SB59-SSA1,308,11 48.345 (3) (cm) A group home described in s. 48.625 (1m) or a similar facility regulated in another state, if the child is at least 12 years of age, is a custodial parent, as defined in s. 49.141 (1) (b), or an expectant mother, is receiving inadequate care, and is in need of a safe and structured living arrangement.

SB59-SSA1,497 Section 497 . 48.345 (3) (d) of the statutes is amended to read:

SB59-SSA1,308,15 48.345 (3) (d) A residential treatment care center for children and youth operated by a child welfare agency licensed under s. 48.60, or a similar facility regulated in another state.

SB59-SSA1,498 Section 498 . 48.345 (3) (e) of the statutes is created to read:

SB59-SSA1,308,20 48.345 (3) (e) With a parent in a qualifying residential family-based treatment facility, or a similar facility regulated in another state, if the child's permanency plan includes a recommendation for such a placement under s. 48.38 (4) (em) before the placement is made.

SB59-SSA1,499 Section 499 . 48.38 (2) (intro.) of the statutes is amended to read:

SB59-SSA1,309,6 48.38 (2) Permanency plan required. (intro.) Except as provided in sub. (3), for each child living in a foster home, group home, residential care center for children and youth, juvenile detention facility, shelter care facility, qualifying residential family-based treatment facility with a parent, or supervised independent living arrangement, the agency that placed the child or arranged the placement or the agency assigned primary responsibility for providing services to the child under s. 48.355 (2) (b) 6g. shall prepare a written permanency plan, if any of the following conditions exists, and, for each child living in the home of a guardian or a relative other than a parent, that agency shall prepare a written permanency plan, if any of the conditions specified in pars. (a) to (e) exists:

SB59-SSA1,500 Section 500 . 48.38 (2) (d) of the statutes is amended to read:

SB59-SSA1,309,10 48.38 (2) (d) The child was placed under a voluntary agreement between the agency and the child's parent under s. 48.63 (1) (a) or (bm) or (5) (b) or under a voluntary transition-to-independent-living agreement under s. 48.366 (3).

SB59-SSA1,501 Section 501 . 48.38 (4) (em) of the statutes is created to read:

SB59-SSA1,309,13 48.38 (4) (em) A recommendation regarding placement with a parent in a qualifying residential family-based treatment facility.

SB59-SSA1,507 Section 507 . 48.48 (17) (a) 3. of the statutes is amended to read:

SB59-SSA1,310,4 48.48 (17) (a) 3. Provide appropriate protection and services for children and the expectant mothers of unborn children in its care, including providing services for those children and their families and for those expectant mothers in their own homes, placing the those children in licensed foster homes or group homes in this state or similar facilities regulated in another state within a reasonable proximity to the agency with legal custody, placing the those children in the homes of guardians under s. 48.977 (2), placing those children in a qualifying residential family-based treatment facility with a parent or in similar facilities regulated in another state, or contracting for services for those children by licensed child welfare agencies in this state or a similar child welfare agency regulated in another state, except that the department may not purchase the educational component of private day treatment programs unless the department, the school board, as defined in s. 115.001 (7), and the state superintendent of public instruction all determine that an appropriate public education program is not available. Disputes between the department and the school district shall be resolved by the state superintendent of public instruction.

SB59-SSA1,508 Section 508 . 48.48 (17) (c) 4. of the statutes is amended to read:

SB59-SSA1,310,9 48.48 (17) (c) 4. Is living in a foster home, group home, or residential care center for children and youth, qualifying residential family-based treatment facility, or a similar facility regulated in another state or in a supervised independent living arrangement.

SB59-SSA1,509 Section 509 . 48.481 (3) of the statutes is repealed.

SB59-SSA1,511 Section 511 . 48.487 (1m) of the statutes is amended to read:

SB59-SSA1,310,17 48.487 (1m) Tribal family services grants. From the appropriation account under s. 20.437 (1) (bd) (js), the department may distribute tribal family services grants to the elected governing bodies of the Indian tribes in this state. An elected governing body that receives a grant under this subsection may expend the grant moneys received for any of the purposes specified in subs. (2), (3) (b), (4m) (b), (5) (b), (6), and (7) as determined by that body.

SB59-SSA1,512 Section 512 . 48.526 (7) (intro.) of the statutes is amended to read:

SB59-SSA1,310,23 48.526 (7) Allocations of funds. (intro.) Within the limits of the availability of the appropriations under s. 20.437 (1) (cj) and (o), the department shall allocate funds for community youth and family aids for the period beginning on July 1, 2015 2019, and ending on June 30, 2017 2021, as provided in this subsection to county departments under ss. 46.215, 46.22, and 46.23 as follows:

SB59-SSA1,513m Section 513m. 48.526 (7) (a) of the statutes is amended to read:

SB59-SSA1,311,4 48.526 (7) (a) For community youth and family aids under this section, amounts not to exceed $45,572,100 $45,383,600 for the last 6 months of 2015, $91,150,200 2019, $90,767,200 for 2016 2020, and $45,578,100 $45,383,600 for the first 6 months of 2017 2021.

SB59-SSA1,514 Section 514 . 48.526 (7) (b) (intro.) of the statutes is amended to read:

SB59-SSA1,311,9 48.526 (7) (b) (intro.) Of the amounts specified in par. (a), the department shall allocate $2,000,000 for the last 6 months of 2015 2019, $4,000,000 for 2016 2020, and $2,000,000 for the first 6 months of 2017 2021 to counties based on each of the following factors weighted equally:

SB59-SSA1,515 Section 515 . 48.526 (7) (bm) of the statutes is amended to read:

SB59-SSA1,311,16 48.526 (7) (bm) Of the amounts specified in par. (a), the department shall allocate $6,250,000 for the last 6 months of 2015 2019, $12,500,000 for 2016 2020, and $6,250,000 for the first 6 months of 2017 2021 to counties based on each county's proportion of the number of juveniles statewide who are placed in a juvenile correctional facility or a secured residential care center for children and youth during the most recent 3-year period for which that information is available.

SB59-SSA1,516 Section 516 . 48.526 (7) (c) of the statutes is amended to read:

SB59-SSA1,311,25 48.526 (7) (c) Of the amounts specified in par. (a), the department shall allocate $1,053,200 for the last 6 months of 2015 2019, $2,106,500 for 2016 2020, and $1,053,300 for the first 6 months of 2017 2021 to counties based on each of the factors specified in par. (b) 1. to 3. weighted equally, except that no county may receive an allocation under this paragraph that is less than 93 percent nor more than 115 percent of the amount that the county would have received under this paragraph if the allocation had been distributed only on the basis of the factor specified in par. (b) 3.

SB59-SSA1,517 Section 517. 48.526 (7) (e) of the statutes is amended to read:

SB59-SSA1,312,6 48.526 (7) (e) For emergencies related to community youth and family aids under this section, amounts not to exceed $125,000 for the last 6 months of 2015 2019, $250,000 for 2016 2020, and $125,000 for the first 6 months of 2017 2021. A county is eligible for payments under this paragraph only if it has a population of not more than 45,000.

SB59-SSA1,518 Section 518 . 48.526 (7) (h) of the statutes is amended to read:

SB59-SSA1,312,18 48.526 (7) (h) For counties that are purchasing community supervision services under s. 938.533 (2), $1,062,400 in the last 6 months of 2017 2019, $2,124,800 in 2018 2020, and $1,062,400 in the first 6 months of 2019 2021 for the provision of community supervision services for juveniles from that county. In distributing funds to counties under this paragraph, the department shall distribute to each county the full amount of the charges for the services purchased by that county, except that if the amounts available under this paragraph are insufficient to distribute that full amount, the department shall distribute those available amounts to each county that purchases community supervision services based on the ratio that the charges to that county for those services bear to the total charges to all counties that purchase those services.

SB59-SSA1,519 Section 519 . 48.526 (8) of the statutes is amended to read:

SB59-SSA1,312,23 48.526 (8) Alcohol and other drug abuse treatment. From the amount of the allocations specified in sub. (7) (a), the department shall allocate $666,700 in the last 6 months of 2015 2019, $1,333,400 in 2016 2020, and $666,700 in the first 6 months of 2017 2021 for alcohol and other drug abuse treatment programs.

SB59-SSA1,522 Section 522 . 48.53 of the statutes is repealed.

SB59-SSA1,522m Section 522m. 48.561 (3) (a) of the statutes is amended to read:

SB59-SSA1,313,4 48.561 (3) (a) A county having a population of 750,000 or more shall contribute the greater of $58,893,500 or the amount in the schedule for the appropriation under s. 20.437 (1) (cx) in each state fiscal year for the provision of child welfare services in that county by the department. That contribution shall be made as follows:

SB59-SSA1,313,6 1. Through a reduction of $37,209,200 from the amounts distributed to that county under ss. 46.40 (2) and 48.563 (2) in each state fiscal year.

SB59-SSA1,313,8 2. Through a reduction of $1,583,000 from the amount distributed to that county under s. 46.40 (2m) (a) in each state fiscal year.

SB59-SSA1,313,11 3. Through a deduction of $20,101,300 the remainder of the payment after the county's contribution under subds. 1. and 2. from any state payment due that county under s. 79.035, 79.04, or 79.08 as provided in par. (b).