The bill requires DHS to select, using a competitive grant selection process, partnership groups to be designated as participating sites for a complex patient pilot program and then award grants to the partnership groups selected. The bill provides that a partnership group is one or more hospitals in partnership with one or more post-acute facilities. The bill provides that DHS must solicit feedback regarding the pilot program from representatives of healthcare system organizations, long-term care provider organizations, long-term care operator organizations, patient advocate groups, insurers, and any other organization determined to be relevant by the secretary of health services. Under the bill, DHS must require each partnership group that applies to be designated as a site for the pilot program to address certain issues in its application, including: 1) the number of complex patient care beds that will be set aside in a post-acute facility or through implementation of another innovative model of patient care in a post-acute facility to which participating hospitals agree; 2) defined goals and measurable outcomes of the partnership both during and after the pilot program; 3) the types of complex patients for whom care will be provided; 4) an operating budget for the proposed site; and 5) the participant group’s expertise to successfully implement the proposal.

The bill requires DHS to reserve 10 percent of the pilot program funding for reconciliation to help address unanticipated costs. Under the bill, DHS must also develop a methodology to evaluate the pilot program and contract with an independent organization to complete the evaluation. Under the bill, DHS may pay the organization’s fee from the funding appropriated for the pilot program. Under the bill, DHS must give additional weight to partnership groups that would ensure geographic diversity.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

SB1027,,4 The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB1027,1 Section 1. 50.06 (1) of the statutes is renumbered 50.06 (1) (intro.) and amended to read:

SB1027,,6 50.06 (1) (intro.) In this section, “incapacitated”:

SB1027,,7 (a) “Incapacitated” means unable to receive and evaluate information effectively or to communicate decisions to such an extent that the individual lacks the capacity to manage his or her health care decisions, including decisions about his or her post-hospital care.

SB1027,2 Section 2. 50.06 (1) (b) of the statutes is created to read:

SB1027,,9 50.06 (1) (b) “Patient’s representative” means the individual described under sub. (3) who may consent to an admission of an incapacitated individual under sub. (2).

SB1027,3 Section 3. 50.06 (2) (b) of the statutes is amended to read:

SB1027,,11 50.06 (2) (b) The individual for whom admission is sought is not diagnosed as developmentally disabled or as having a mental illness, as defined in s. 51.01 (13) (a), at the time of the proposed admission.

SB1027,4 Section 4. 50.06 (2) (c) of the statutes is amended to read:

SB1027,,13 50.06 (2) (c) A Unless the incapacitated individual is admitted to a facility under sub. (8), a petition for guardianship for the individual under s. 54.34 and a petition under s. 55.075 for protective placement of the individual are filed prior to the proposed admission.

SB1027,5 Section 5. 50.06 (5) (a) (intro.) of the statutes is amended to read:

SB1027,,15 50.06 (5) (a) (intro.) Except as otherwise provided in par. pars. (am) and (b), an individual who consents to an admission under this section a patient’s representative may, for the incapacitated individual, make health care decisions to the same extent as a guardian of the person may and authorize expenditures related to health care to the same extent as a guardian of the estate may, until the earliest of the following:

SB1027,6 Section 6. 50.06 (5) (am) of the statutes is created to read:

SB1027,,17 50.06 (5) (am) Except as otherwise provided in par. (b), a patient’s representative may, for the incapacitated individual, make health care decisions to the same extent as a guardian of the person may and authorize expenditures related to health care to the same extent as a guardian of the estate may if the patient’s representative consents to admission for the incapacitated individual in the manner provided in sub. (8). The authority of a patient’s representative to make health care decisions or authorize expenditures under this paragraph ends if a court appoints a guardian to make such decisions for the incapacitated individual.

SB1027,7 Section 7. 50.06 (5) (b) of the statutes is amended to read:

SB1027,,19 50.06 (5) (b) An individual who consents to an admission under this section A patient’s representative may not authorize expenditures related to health care if the incapacitated individual has an agent under a durable power of attorney, as defined in s. 244.02 (3), who may authorize expenditures related to health care.

SB1027,8 Section 8. 50.06 (6) of the statutes is amended to read:

SB1027,,21 50.06 (6) If Unless the incapacitated individual was admitted to a facility under sub. (8), if the incapacitated individual is in the facility after 60 days after admission and a guardian has not been appointed, the authority of the person who consented to the admission patient’s representative to make decisions and, if sub. (5) (a) applies, to authorize expenditures is extended for 30 days for the purpose of allowing the facility to initiate discharge planning for the incapacitated individual.

SB1027,9 Section 9. 50.06 (7) of the statutes is amended to read:

SB1027,,23 50.06 (7) An individual who consents to an admission under this section A patient’s representative may request a functional screening and a financial and cost-sharing screening to determine eligibility for the family care benefit under s. 46.286 (1). If admission is sought on behalf of the incapacitated individual or if the incapacitated individual is about to be admitted on a private pay basis, the individual who consents to the admission patient’s representative may waive the requirement for a financial and cost-sharing screening under s. 46.283 (4) (g), unless the incapacitated individual is expected to become eligible for medical assistance within 6 months.

SB1027,10 Section 10. 50.06 (8) of the statutes is created to read:

SB1027,,25 50.06 (8) (a) A patient’s representative may consent to an admission of an incapacitated individual under sub. (2) without a petition for guardianship or protective placement of the incapacitated individual being filed if all of the following apply:

SB1027,,26 1. The patient’s representative acknowledges in writing that he or she agrees to make health care decisions on the incapacitated individual’s behalf under this subsection and provides the acknowledgment to the discharging hospital and the accepting facility.

SB1027,,27 2. The patient’s representative promptly notifies all of the incapacitated individual’s family members that can be readily contacted that the patient’s representative may make decisions or authorize expenditures under sub. (5) (am).

SB1027,,28 3. The patient’s representative provides a written statement to the discharging hospital and the accepting facility that states all of the following: