Chapter 46

46.2895(4)(o) (o) If awarded a contract by the department as described in sub. (2) (b) or (c), operate a care management organization outside the geographic boundary of the long-term care district.

46.2895(4)(p) (p) If awarded a contract by the department to operate a care management organization outside its geographic boundaries as described in sub. (2) (b) or (c), determine whether to add new counties, tribes, or bands into the long-term care district.

46.2895(4)(q) (q) Notwithstanding subs. (1) to (3), create a nonstock, nonprofit corporation under ch. 181 or a service insurance corporation under ch. 613 that may succeed the long-term care district and survive the district’s dissolution under sub. (13). Before creating a nonstock, nonprofit corporation or a service insurance corporation that will provide services under the family care benefit, the long-term care district shall submit to the department the proposed articles of incorporation for review and approval. If the department does not disapprove the articles of incorporation within 30 days of the date of submission to the department, the articles of incorporation are considered approved. If the department disapproves the articles of incorporation, the department shall provide specific reasons for the disapproval and recommendations regarding how the articles may be amended to cure the defect.

46.2895(4)(r) (r) With approval of the department and office of the commissioner of insurance, assign the following to a corporation created under par. (q):

46.2895(4)(r)1. 1. The long-term care district’s assets and liabilities, including operating capital funds, risk reserve funds, solvency funds, or other special reserve funds required by the department or the office of the commissioner of insurance.

46.2895(4)(r)2. 2. A contract with the department as described in sub. (2) (b) or (c).

46.2895(4)(r)3. 3. A permit issued by the office of the commissioner of insurance under ch. 648.

46.2895(4)(r)4. 4. A certification by the department under s. 46.284 (3).

46.2895(4r) (4r) Transfer of enrollees. Upon approval of the department and the commissioner of insurance under sub. (4) (r), the department shall notify enrollees of the care management organization operated by the long-term care district regarding the transfer of the contract to the corporation created under sub. (4) (q) and shall inform enrollees of their rights and responsibilities in accordance with any requirements of the federal department of health and human services.

46.2895(5) (5) Limitation on powers. A long-term care district may not issue bonds or levy a tax or assessment.

46.2895(6) (6) Duties. The long-term care district board shall do all of the following:

46.2895(6)(a) (a) Appoint a director, who shall hold office at the pleasure of the board.

46.2895(6)(b) (b) Subject to sub. (8), develop and implement a personnel structure and other employment policies for employees of the long-term care district.

46.2895(6)(c) (c) Assure compliance with the terms of any contract with the department under sub. (4) (d) or (dm).

46.2895(6)(cm) (cm) Determine whether to authorize the long-term care district director to apply to the department for a contract to operate a care management organization outside the geographic boundary of the long-term care district.

46.2895(6)(d) (d) Establish a fiscal operating year and annually adopt a budget for the long-term care district.

46.2895(6)(e) (e) Contract for any legal services required for the long-term care district.

46.2895(6)(f) (f) Subject to sub. (8), procure liability insurance covering its officers, employees, and agents, insurance against any loss in connection with its property and other assets and other necessary insurance; establish and administer a plan of self-insurance; or, subject to an agreement under s. 66.0301, participate in a governmental plan of insurance or self-insurance.

46.2895(7) (7) Director; duties. The director appointed under sub. (6) (a) shall do all of the following:

46.2895(7)(a) (a) Manage the property and business of the long-term care district and manage the employees of the district, subject to the general control of the long-term care district board.

46.2895(7)(b) (b) Comply with the bylaws and direct enforcement of all policies and procedures adopted by the long-term care district board.

46.2895(7)(c) (c) Perform duties in addition to those specified in pars. (a) and (b) as are prescribed by the long-term care district board.

46.2895(8) (8) Employment and employee benefits of certain employees.

46.2895(8)(a) (a) A long-term care district board that is created at least in part by a county shall do all of the following:

46.2895(8)(a)1. 1. If the long-term care district offers employment to any individual who was previously employed by a county, which participated in creating the district and at the time of the offer had not withdrawn or been removed from the district under sub. (14), and who while employed by the county performed duties relating to the same or a substantially similar function for which the individual is offered employment by the district and whose wages were established in a collective bargaining agreement with the county under subch. IV of ch. 111 that is in effect on the date that the individual commences employment with the district, with respect to that individual, abide by the terms of the collective bargaining agreement concerning the individual’s wages until the time of the expiration of that collective bargaining agreement or adoption of a collective bargaining agreement with the district under subch. IV of ch. 111 covering the individual as an employee of the district, whichever occurs first.

46.2895(8)(a)3. 3. If the long-term care district offers employment to any individual who was previously employed by a county, which participated in creating the district and at the time of the offer had not withdrawn or been removed from the district under sub. (14), and who while employed by the county performed duties relating to the same or a substantially similar function for which the individual is offered employment by the district, with respect to that individual, recognize all years of service with the county for any benefit provided or program operated by the district for which an employee’s years of service may affect the provision of the benefit or the operation of the program.

46.2895(8)(a)4. 4. If the county has not established its own retirement system for county employees, adopt a resolution that the long-term care district be included within the provisions of the Wisconsin retirement system under s. 40.21 (1). In this resolution, the long-term care district shall agree to recognize 100 percent of the prior creditable service of its employees earned by the employees while employed by the district.

46.2895(8)(b) (b) The county board of supervisors of each county that creates a long-term care district shall do all of the following:

46.2895(8)(b)1. 1. If the county has established its own retirement system for county employees, provide that long-term care district employees are eligible to participate in the county retirement system.

46.2895(8)(b)2m. 2m. If the long-term care district employs any individual who was previously employed by the county, provide the individual health care coverage that is similar to the health care coverage that the county provided the individual when he or she was employed by the county.

46.2895(8)(c) (c) A long-term care district and any county that created the district and has not withdrawn from or been removed from the district under sub. (14) may enter into an agreement allocating the costs of providing benefits described under this section between the district and the county.

46.2895(9) (9) Confidentiality of records. No record, as defined in s. 19.32 (2), of a long-term care district that contains personally identifiable information, as defined in s. 19.62 (5), concerning an individual who receives services from the long-term care district may be disclosed by the long-term care district without the individual’s informed consent, except as required to comply with s. 16.009 (2) (p) or 49.45 (4).

46.2895(10) (10) Exchange of information. Notwithstanding sub. (9) and ss. 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 253.07 (3) (c) and 938.78 (2) (a), a long-term care district acting under this section may exchange confidential information about a client, as defined in s. 46.287 (1), without the informed consent of the client, under s. 46.21 (2m) (c), 46.215 (1m), 46.22 (1) (dm), 46.23 (3) (e), 46.283 (7), 46.284 (7), 51.42 (3) (e) or 51.437 (4r) (b) in the jurisdiction of the long-term care district, if necessary to enable the long-term care district to perform its duties or to coordinate the delivery of services to the client.

46.2895(11) (11) Obligations, debts, and responsibilities not those of county. The obligations and debts of a long-term care district are not the obligations or debts of any county that created the district. If a long-term care district is obligated by statute or contract to provide or pay for services or benefits, no county is responsible for providing or paying for those services or benefits.

46.2895(12) (12) Assistance to long-term care district. From moneys in a county treasury that are not appropriated to some other purpose, the county board of supervisors may appropriate moneys to a long-term care district that the county participated in creating as a gift or may lend moneys to the long-term care district.

46.2895(13) (13) Dissolution. Subject to the performance of the contractual obligations of a long-term care district and if first approved by the secretary of the department, the long-term care district may be dissolved by the joint action of the long-term care district board and each county or tribe or band that created the long-term care district and has not withdrawn or been removed from the district under sub. (14). If a long-term care district that is created by one county or tribe or band is dissolved, the property and assets of the district shall be transferred to the department. If a long-term care district is created by more than one county or tribe or band, all of the counties or tribes or bands that created the district and that have not withdrawn or been removed from the district under sub. (14) shall transfer the property and assets of the district to the department. If the long-term care district operates a care management organization under s. 46.284, disposition of any remaining funds in the risk reserve under s. 46.284 (5) (d) shall be made under the terms of the district’s contract with the department.

46.2895(14) (14) Withdrawal or removal of a county or tribe or band. Subject to approval from the department, a long-term care district may establish conditions for a county or tribe or band that participated with one or more counties or tribes or bands in creating the district to withdraw from the district or for the district to remove the county or tribe or band from the district.

46.2895 History History: 1999 a. 9, 185; 2001 a. 30; 2005 a. 25, 264; 2007 a. 20 ss. 1021 to 1073, 9121 (6) (a); 2009 a. 180; 2011 a. 10; 2015 a. 55, 215.

46.2895 Annotation A long-term care district is governed by sub. (2) and is limited to the counties that are members of the district. Before a district may provide care management organization services under s. 46.284 to a county beyond its jurisdiction, that county must become a member of the district. New counties joining a district, like the original creating members, are entitled to representation on the district’s governing board. OAG 3-15.

46.2896 46.2896 Counting promissory notes as assets.

46.2896(1) (1) In this section:

46.2896(1)(a) (a) “Long-term care program” means the long-term care program under s. 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).

46.2896(1)(b) (b) “Promissory note” means a written, unconditional agreement, given in return for goods, money loaned, or services rendered, under which one party promises to pay another party a specified sum of money at a specified time or on demand.

46.2896(2) (2) When determining or redetermining an individual’s financial eligibility for a long-term care program, the department shall include a promissory note as a countable asset if all of the following apply:

46.2896(2)(a) (a) The individual applying for or receiving benefits under the long-term care program or his or her spouse provided the goods, money loaned, or services rendered for the promissory note.

46.2896(2)(b) (b) The promissory note was entered into or purchased on or after July 14, 2015.

46.2896(2)(c) (c) The promissory note is negotiable, assignable, and enforceable and does not contain any terms making it unmarketable.

46.2896(3) (3) A promissory note is presumed to be negotiable and its asset value is the outstanding principal balance at the time the individual applies for the long-term care program or at the time the individual’s eligibility for the long-term care program is redetermined, unless the individual shows by credible evidence from a knowledgeable source that the note is nonnegotiable or has a different current market value, which will then be considered the asset value.

46.2896 History History: 2015 a. 55; 2019 a. 9.

46.2897 46.2897 Self-directed services option.

46.2897(1) (1) Definition. In this section, “self-directed services option” means the program that is operated under a waiver from the secretary of the federal department of health and human services under 42 USC 1396n (c) in which an enrolled individual selects his or her own services and service providers.

46.2897(2) (2) Advocacy services. The department shall allow a participant in the self-directed services option that is operated under a waiver from the secretary of the federal department of health and human services under 42 USC 1396n (c) to access the advocacy services contracted for by the department under s. 46.281 (1n) (e).

46.2897(3) (3) Worker’s compensation coverage. An individual who is performing services for a person participating in the self-directed services option and who does not otherwise have worker’s compensation coverage for those services is considered, for purposes of worker’s compensation coverage, to be an employee of the entity that is providing financial management services for that person.

46.2897 History History: 2009 a. 28; 2015 a. 180; 2021 a. 232.

46.2898 46.2898 Employment of individuals with disabilities; long-term care programs.

46.2898(1) (1) Definitions. In this section:

46.2898(1)(a) (a) “Board” means the board for people with developmental disabilities.

46.2898(1)(b) (b) “Coaching” means providing specific, targeted supports to a business, school district, or vocational agency that demonstrates how coworkers can provide internal support to a coworker with a disability, eliminating the need for a job coach or other individual from outside of the employer.

46.2898(1)(c) (c) “Family care” means the program that provided the family care benefit, as defined in s. 46.2805 (4).

46.2898(1)(d) (d) “Internal support” means primary employment support for an individual with a disability provided by an employer or employees of the employer and not by a job coach or other individual from outside the employer.

46.2898(1)(e) (e) “Qualified employee” means an individual with a disability that is an enrollee of family care, the Family Care Partnership Program, or the self-directed services option.

46.2898(1)(f) (f) “Self-directed services option” has the meaning given in s. 46.2899 (1).

46.2898(2) (2) Coaching program established. The board shall develop a program to provide coaching for the hiring of individuals with disabilities and shall do all of the following:

46.2898(2)(a) (a) Develop a model of coaching businesses in the hiring and employment of individuals with disabilities that engages businesses directly.

46.2898(2)(b) (b) Expand awareness and competence across the private sector in hiring individuals with significant disabilities who are enrollees of family care, the Family Care Partnership Program, or the self-directed services option.

46.2898(2)(c) (c) Collaborate with individuals and businesses that hire and provide internal support for individuals with disabilities to develop tools and training programs for use in other businesses.

46.2898(2)(d) (d) Coordinate with the department of public instruction to explore the use of business-supported employment of individuals with disabilities in the school-age population.

46.2898(2)(e) (e) Include travel costs in costs available for any reimbursement, including grants awarded for meeting criteria under sub. (4) (b).

46.2898(3) (3) Coaching; board duties. The board shall provide the coaching described under sub. (2) to private and nonprofit businesses and to schools, care management organizations that administer family care or the Family Care Partnership Program, consultant agencies that assist enrollees of the self-directed services option, and other employment services providers for the state’s long-term care programs.

46.2898(4) (4) Coaching recipients; grants.

46.2898(4)(a) (a) The board shall request proposals from any of the following to participate in a coaching program for the hiring of qualified employees:

46.2898(4)(a)1. 1. Public schools.

46.2898(4)(a)2. 2. Care management organizations that administer family care or the Family Care Partnership Program.

46.2898(4)(a)3. 3. Consultant agencies that assist enrollees of the self-directed services option.

46.2898(4)(a)4. 4. Employment services providers for the state’s long-term care programs.

46.2898(4)(a)5. 5. Private businesses.

46.2898(4)(b) (b) From the appropriation under s. 20.438 (1) (a), the board shall provide coaching and award grants to entities described under par. (a) that meet all of the following criteria:

46.2898(4)(b)1. 1. Annually, the entity submits a report to the board containing all of the following:

46.2898(4)(b)1.a. a. The number of individuals with disabilities hired by the entity that provides supported employment through a business-based internal support model.

46.2898(4)(b)1.b. b. The wages and hours worked of employees with disabilities hired by the entity that provides supported employment through a business-based internal support model.

46.2898(4)(b)1.c. c. The number of businesses receiving coaching from the entity that hire and employ individuals with disabilities and that provide internal support for those individuals.

46.2898(4)(b)2. 2. The entity demonstrates an increase in the number of businesses hiring and employing individuals with disabilities and providing internal support for those individuals.

46.2898(4)(b)3. 3. The entity demonstrates a reduction in public spending on employment supports for individuals with disabilities by a minimum of 25 percent compared to previous costs or cost estimates. The entity shall provide information on this reduction and a description of the impact of the program under this section in the annual report under subd. 1.

46.2898(4)(b)4. 4. The entity meets other outcome measures as determined by the board.

46.2898 History History: 2017 a. 323; 2021 a. 238 ss. 9, 45.

46.2899 46.2899 Services for the developmentally disabled who receive post-secondary education.

46.2899(1) (1) Definition. In this section, “self-directed services option” means a program known as Include, Respect, I Self-direct or IRIS operated by the department under a waiver from the secretary of the federal department of health and human services under 42 USC 1396n (c).

46.2899(2) (2) Waiver program. The department shall request a waiver from the federal centers for medicare and medicaid services in order to receive the federal medical assistance percentage for home-based and community-based services provided to individuals who are developmentally disabled and who received post-secondary education on the grounds of institutions. If the waiver is approved the department shall operate a waiver program to provide those services to no more than 100 individuals per month per year.

46.2899(3) (3) Eligibility. The department shall consider as eligible for the waiver program described under sub. (2) only individuals who are receiving post-secondary education in a setting that is distinguishable from the institution. The department shall set the financial eligibility requirements and functional eligibility requirements for the waiver program described under sub. (2) the same as the financial eligibility requirements and functional eligibility requirements for the self-directed services option except for the requirement to be an individual who is developmentally disabled and who is receiving post-secondary education on the grounds of a institution.