AB56: Bill Text

AB56,478 Section 478. 46.287 (2) (a) 1. f. of the statutes is repealed.

AB56,479 Section 479. 46.287 (2) (a) 1m. of the statutes is created to read:

AB56,475,3 46.287 (2) (a) 1m. Except as provided in subd. 2., a client may contest any of the following adverse benefit determinations by filing, within 90 days of the failure of a care management organization to act on a contested adverse benefit determination within the time frames specified by rule by the department or within 90 days after receipt of notice of a decision upholding the adverse benefit determination, a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1):

AB56,475,7 a. Denial of functional eligibility under s. 46.286 (1) as a result of the care management organization's administration of the long-term care functional screen, including a change from a nursing home level of care to a non-nursing home level of care.

AB56,475,10 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.

AB56,475,13 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.

AB56,475,14 e. Denial, in whole or in part, of payment for a service.

AB56,475,17 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.

AB56,475,20 g. Denial of an enrollee's request to dispute financial liability, including copayments, premiums, deductibles, coinsurance, other cost sharing, and other member financial liabilities.

AB56,475,23 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.

AB56,476,4 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.

AB56,476,5 j. Involuntary disenrollment from the care management organization.

AB56,480 Section 480. 46.287 (2) (b) of the statutes is amended to read:

AB56,476,15 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.

AB56,481 Section 481. 46.288 (2) (intro.) of the statutes is renumbered 46.288 (2) and amended to read:

AB56,476,23 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:

AB56,482 Section 482. 46.288 (2) (d) to (j) of the statutes are repealed.

AB56,483 Section 483. 46.2896 (1) (a) of the statutes is amended to read:

AB56,477,4 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).

AB56,484 Section 484. 46.536 of the statutes is amended to read:

AB56,477,13 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.

AB56,485 Section 485. 46.82 (3) (a) 13. of the statutes is repealed.

AB56,486 Section 486. 46.854 of the statutes is created to read:

AB56,477,18 46.854 Healthy aging grant program. From the appropriation under s. 20.435 (1) (bk), the department shall award in each fiscal year a grant of $250,000 to an entity that conducts programs in healthy aging.

AB56,487 Section 487. 46.995 (4) of the statutes is created to read:

AB56,477,23 46.995 (4) The department shall ensure that any child who is eligible and who applies for the disabled children's long-term support program that is operating under a waiver of federal law receives services under the disabled children's long-term support program that is operating under a waiver of federal law.

AB56,488 Section 488. 47.07 of the statutes is created to read:

AB56,478,3 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.

AB56,478,6 (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.

AB56,489 Section 489 . 48.02 (1d) of the statutes is amended to read:

AB56,478,11 48.02 (1d) “Adult" means a person who is 18 years of age or older, except that for purposes of investigating or prosecuting a person who is alleged to have violated any state or federal criminal law or any civil law or municipal ordinance, “ adult" means a person who has attained 17 years of age.

AB56,490 Section 490 . 48.02 (2) of the statutes is amended to read:

AB56,478,17 48.02 (2) “Child," when used without further qualification, means a person who is less than 18 years of age, except that for purposes of investigating or prosecuting a person who is alleged to have violated a state or federal criminal law or any civil law or municipal ordinance, “child" does not include a person who has attained 17 years of age.

AB56,491 Section 491. 48.02 (14m) of the statutes is created to read:

AB56,478,21 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:

AB56,478,24 (a) The treatment facility provides, as part of the treatment for substance abuse, parenting skills training, parent education, and individual and family counseling.

AB56,479,6 (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.

AB56,492 Section 492. 48.13 of the statutes is amended to read:

AB56,479,11 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:

AB56,479,12 (1) Who The child is without a parent or guardian;.

AB56,479,13 (2) Who The child has been abandoned;.

AB56,479,15 (2m) Whose The child's parent has relinquished custody of the child under s. 48.195 (1);.

AB56,479,17 (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;.

AB56,479,21 (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;.

AB56,479,24 (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;.

AB56,480,3 (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 ;.

AB56,480,4 (5) Who The child has been placed for care or adoption in violation of law ;.

AB56,480,6 (8) Who The child is receiving inadequate care during the period of time a parent is missing, incarcerated, hospitalized or institutionalized ;.

AB56,480,10 (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;.

AB56,480,14 (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;.

AB56,480,22 (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;.

AB56,481,2 (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; .

AB56,481,5 (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.

AB56,481,7 (13) Who The child has not been immunized as required by s. 252.04 and not exempted under s. 252.04 (3).

AB56,493 Section 493. 48.13 (14) of the statutes is created to read:

AB56,481,12 48.13 (14) The child's parent is residing in a qualifying residential family-based treatment 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.

AB56,494 Section 494. 48.207 (1) (L) of the statutes is created to read:

AB56,481,17 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.

AB56,495 Section 495 . 48.345 (3) (c) of the statutes is amended to read:

AB56,481,21 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).

AB56,496 Section 496 . 48.345 (3) (cm) of the statutes is amended to read:

AB56,482,2 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.

AB56,497 Section 497 . 48.345 (3) (d) of the statutes is amended to read:

AB56,482,6 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.

AB56,498 Section 498. 48.345 (3) (e) of the statutes is created to read:

AB56,482,11 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.

AB56,499 Section 499. 48.38 (2) (intro.) of the statutes is amended to read:

AB56,482,22 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:

AB56,500 Section 500. 48.38 (2) (d) of the statutes is amended to read:

AB56,483,3 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).

AB56,501 Section 501. 48.38 (4) (em) of the statutes is created to read:

AB56,483,6 48.38 (4) (em) A recommendation regarding placement with a parent in a qualifying residential family-based treatment facility.

AB56,502 Section 502 . Subchapter IX (title) of chapter 48 [precedes 48.44] of the statutes is amended to read:

AB56,483,9 CHAPTER 48

AB56,483,12 SUBCHAPTER IX JURISDICTION OVER PERSON 17 OR OLDER adults

AB56,503 Section 503 . 48.44 of the statutes is amended to read:

AB56,483,17 48.44 Jurisdiction over persons 17 or older adults. The court has jurisdiction over persons 17 years of age or older adults as provided under ss. 48.133, 48.355 (4), 48.357 (6), 48.365 (5), and 48.45 and as otherwise specifically provided in this chapter.

AB56,504 Section 504 . 48.45 (1) (a) of the statutes is amended to read:

AB56,484,2 48.45 (1) (a) If in the hearing of a case of a child alleged to be in a condition described in s. 48.13 it appears that any person 17 years of age or older adult has been guilty of contributing to, encouraging, or tending to cause by any act or omission, such that condition of the child, the judge may make orders with respect to the conduct of such that person in his or her relationship to the child, including orders determining the ability of the person to provide for the maintenance or care of the child and directing when, how, and from where funds for the maintenance or care shall be paid.

AB56,505 Section 505 . 48.45 (1) (am) of the statutes is amended to read:

AB56,484,10 48.45 (1) (am) If in the hearing of a case of an unborn child and the unborn child's expectant mother alleged to be in a condition described in s. 48.133 it appears that any person 17 years of age or over adult has been guilty of contributing to, encouraging, or tending to cause by any act or omission, such that condition of the unborn child and expectant mother, the judge may make orders with respect to the conduct of such that person in his or her relationship to the unborn child and expectant mother.

AB56,506 Section 506 . 48.45 (3) of the statutes is amended to read:

AB56,484,16 48.45 (3) If it appears at a court hearing that any person 17 years of age or older adult has violated s. 948.40, the judge shall refer the record to the district attorney for criminal proceedings as may be warranted in the district attorney's judgment. This subsection does not prevent prosecution of violations of s. 948.40 without the prior reference by the judge to the district attorney, as in other criminal cases.

AB56,507 Section 507 . 48.48 (17) (a) 3. of the statutes is amended to read:

AB56,485,7 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 a similar facility 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 a similar facility 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.

AB56,508 Section 508. 48.48 (17) (c) 4. of the statutes is amended to read:

AB56,485,12 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.

AB56,509 Section 509. 48.481 (3) of the statutes is repealed.

AB56,510 Section 510. 48.481 (4) of the statutes is created to read: