46.21 Institutions and department of human services in populous counties. (1) DEFINITIONS. In this section: (a) “Administrator” means the administrator of the county hospital who is appointed under sub. (1m) (am). (am) “County board of supervisors” means the county board of supervisors in a county with a population of 750,000 or more. (b) “County department of human services” means the county department of human services that is created under sub. (2m) (a). (c) “Director” means the director of the county department of human services who is appointed under sub. (1m) (a). (d) “Human services” means the total range of services to people, including mental illness treatment, developmental disabilities services, physical disabilities services, income maintenance, youth probation, extended supervision and parole services, alcohol and drug abuse services, services to children, youth and families, family counseling, early intervention services for children from birth to the age of 3, and manpower services. “Human services” does not include child welfare services administered by the department of children and families under s. 48.48 (17). (1m) DIRECTOR AND ADMINISTRATOR; APPOINTMENTS. (a) The county executive shall appoint under ss. 63.01 to 63.17 a director of the county department of human services. The appointment shall be made on the basis of recognized and demonstrated public interest in and knowledge of the problems of human services, and with due regard to training, experience, executive and administrative ability and efficiency, and general qualifications and fitness for performing the duties of the office. The director shall file an official oath and bond in the amount determined by the county board of supervisors. The county board of supervisors may create a position of deputy director of the county department of human services. The director shall be appointed by the county executive in the unclassified civil service and is subject to confirmation by the county board of supervisors under s. 59.17 (2) (bm). (am) The county executive shall appoint under ss. 63.01 to 63.17 an administrator of the county hospital. The appointment shall be made on the basis of recognized and demonstrated public interest in and knowledge of the problems of delivery of medical care and treatment, and with due regard to training, experience, executive and administrative ability and efficiency, and general qualifications and fitness for performing the duties of the office. The administrator shall file an official oath and bond in the amount determined by the county board of supervisors. The county board of supervisors may create positions to assist the administrator. The administrator shall be appointed by the county executive in the unclassified civil service and the appointment is subject to confirmation by the county board of supervisors under s. 59.17 (2) (bm). (b) Provisions shall be made in the organization of the office of the director and in the office of the administrator for the devolution of the director’s or administrator’s authority in the case of his or her temporary absence, illness or other disability to act. (2) POWERS AND DUTIES OF THE COUNTY BOARD OF SUPERVISORS. The county board of supervisors:
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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(a) Shall adopt policies for the management, operation, maintenance and improvement of the county hospital; the detention center; the probation section of the children’s court center; the provision and maintenance of the physical facilities for the children’s court and its intake section under the supervision and operation of the judges assigned to exercise jurisdiction under chs. 48 and 938 and as provided in s. 938.06 (1); the county department of human services; the central service departments; and all buildings and land used in connection with any institution under this section except a mental health institution. The powers and duties of the county board of supervisors are policy forming only, and not administrative or executive. The county board of supervisors may not form policies regarding mental health or mental health institutions, programs, or services. The Milwaukee County mental health board shall adopt the policies under this paragraph regarding mental health and mental health institutions, programs, and services. (b) May make such arrangements with the University of Wisconsin-Madison Medical School or the Medical College of Wisconsin, or any other duly accredited medical colleges and medical societies for teaching and research in such institutions as in its judgment will best promote the purpose of hospitals and sanatoriums under sub. (4m). (e) May pay a reasonable fee and the actual travel expense of persons called into consultation by the county board of supervisors as to matters within the field of human services or health care delivery. (i) May designate an amount as and appropriate funds for a work allowance to inmates at its institutions. The county board of supervisors shall prescribe the amount of such work allowance after the director determines reasonable hours and health and other conditions, as shall be observed in connection with the employment. Such employment is not within the provisions of ss. 63.01 to 63.17 nor is it subject to ch. 102. Work allowances or wages paid to inmates shall not be included as costs in arriving at the per capita rate for state aids or charges to other counties and the state for care of inmates. (j) May exercise approval or disapproval power over contracts and purchases of the director that are for $50,000 or more, except that the county board of supervisors may not exercise approval or disapproval power over any personal service contract or over any contract or purchase of the director that relates to community living arrangements, adult family homes, or foster homes and that was entered into pursuant to a contract under s. 46.031 (2g) or 49.325 (2g), regardless of whether the contract mentions the provider, except as provided in par. (m). The county board of supervisors may not exercise approval or disapproval power over any contract relating to mental health or mental health institutions, programs, or services. This paragraph does not preclude the county board of supervisors from creating a central purchasing department for all county purchases that are not related to mental health. (k) Shall make sufficient appropriation annually for the support, maintenance, salaries, repairs and improvements to the county department of human services and the institutions, except for mental health institutions. The appropriations shall be used subject to the order of the director or administrator and as the policies adopted by the county board of supervisors provide. The director or administrator may not incur any expense or contract for new buildings, additions to present buildings or the purchase of land until the county board of supervisors, or the Milwaukee County mental health board, as applicable, has appropriated or provided for the money to defray such expense. (L) May establish and maintain a public health and medical dispensary and conduct same as may be proper and necessary for
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the preservation of the public health and the prevention of disease in the county. (m) May establish and maintain in connection with such county hospital, an emergency unit or department for the treatment, subject to such rules as may be prescribed by the county board of supervisors, of persons in the county who may meet with accidents or be suddenly afflicted with illness not contagious; provided that medical care and treatment shall only be furnished in such unit or department until such time as the patient may be safely removed to another hospital or to his or her place of abode, or regularly admitted to the county hospital. The county board of supervisors may also contract with any private hospital or nonprofit hospital within the county for the use of its facilities and for medical service to be furnished by a licensed physician or physicians to patients who require emergency medical treatment or first aid as a result of any accident, injury or sudden affliction of illness occurring within the county, except that reasonable compensation may only be authorized until the patient is regularly admitted as an inpatient or safely removed to another hospital or to his place of abode. In this paragraph, “hospital” includes, without limitation due to enumeration, public health centers, medical facilities and general, tuberculosis, chronic disease and other types of hospitals and related facilities, such as laboratories, outpatient departments, nurses’ home and training facilities, and central service facilities operated in connection with hospitals. In this paragraph, “hospital” does not include any hospital furnishing primarily domiciliary care. In this paragraph “nonprofit hospital” means any hospital owned and operated by a corporation or association, no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual. (n) May establish and maintain, in connection with the institutions and departments under the control of the county board of supervisors, a training school for nurses, to purchase and take over all property, to assume all obligations and to conduct any training school now operated in connection with those institutions or departments. (nm) May, together with a nonstock corporation organized under ch. 181 that is a nonprofit corporation, as defined in s. 181.0103 (17), and that is organized solely for the purpose of operating duly accredited educational programs offering baccalaureate and associate degrees in nursing and allied health fields, maintain and fund the programs. (o) May establish and maintain in connection with or separate from the county hospital a unit or department for the treatment, subject to the adopted policies of the county board of supervisors, of persons in the county who may be afflicted with contagious diseases. (p) May, on such terms as it prescribes, make its land, buildings, facilities and supportive services available to organizations for the construction and operation of medical, hospital and health-related activities at the site of the institutions under this section. (q) May, together with a private or public organization or affiliation, organize, establish and participate in the governance and operation of an entity to operate, wholly or in part, any health-related service except a mental health-related service, may participate in the financing of the entity and may provide administrative and financial services or resources for its operation on terms prescribed by the county board of supervisors. The Milwaukee County mental health board may, together with a private or public organization or affiliation, organize, establish, and participate in the governance and operation of an entity to operate, wholly or in part, any mental health-related service, may participate in the financing of the entity, and may provide administrative and financial services or resources for its operation.
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(2m) COUNTY DEPARTMENT OF HUMAN SERVICES. (a) Creation. The management, operation, maintenance and improvement of human services in a county with a population of 750,000 or more is vested in a county department of human services under the jurisdiction, as to policy, of the county board of supervisors or, as to mental health policy, the Milwaukee County mental health board. The county department of human services shall consist of the director appointed under sub. (1m), any division administrator appointed under sub. (4) or s. 51.41 (9), and necessary personnel appointed by the director or appointed by a division administrator and approved by the director. (am) Multicounty department. A county board of supervisors may establish with one or more other counties a county department of human services on a multicounty basis. A multicounty department of human services established under this paragraph shall meet the requirements for a county department of human services under this section. (b) Powers and duties. 1. The county board of supervisors or, in matters related to mental health, the Milwaukee County mental health board may transfer the powers and duties of any human services program under the control of the county and shall transfer all of the following to the county department of human services: a. The powers and duties of the county departments under ss. 46.215, 51.42 and 51.437. c. The management, operation, maintenance and improvement of the county mental health complex under s. 51.08. 2. a. Any reference in any law to a county department under s. 46.215, 51.42 or 51.437 applies to the county department of human services under sub. (2m) in its administration of the powers and duties of the county department to which the reference is made. b. Any reference in any law to a county director appointed under s. 51.42 (6m) (intro.) or 51.437 (10m) (intro.) applies to the director appointed under sub. (1m) (a) in his or her administration of the powers and duties of the county director to which the reference is made. c. Any reference in any law to the county board appointed under s. 51.42 (4) (a) 2. or 51.437 (7) (a) 2. is limited, with respect to the county department of human services under this subsection, to the powers and duties of the county board to which the reference is made. (c) Exchange of information. Notwithstanding ss. 46.2895 (9), 48.78 (2) (a), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), and 253.07 (3) (c), a subunit of a county department of human services or tribal agency acting under this subsection may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of human services or tribal agency, with a resource center, a care management organization, or a long-term care district, with an elder-adult-at-risk agency, an adult-at-risk agency, or any agency to which referral for investigation is made under s. 46.90 (5) (a) 1. or 55.043 (1r) (a) 1g., or with a person providing services to the client under a purchase of services contract with the county department of human services or tribal agency or with a resource center, a care management organization, or a long-term care district, if necessary to enable an employee or service provider to perform his or her duties, or to enable the county department of human services or tribal agency to coordinate the delivery of services to the client. An agency that releases information under this paragraph shall document that a request for information was received and what information was provided. (d) Limitation. The powers and duties of the county depart-
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ment of human services under s. 46.23 do not apply to this section. (3) POWERS AND DUTIES OF THE DIRECTOR. All of the administrative and executive powers and duties of managing, operating, maintaining and improving the county department of human services and other institutions and departments that the county board of supervisors or, in matters of mental health, the Milwaukee County mental health board may place under the jurisdiction of the director are vested in the director, subject to the policies and in accordance with the principles adopted by the county board of supervisors or, in matters of mental health, the Milwaukee County health board. (3g) POWERS AND DUTIES OF THE ADMINISTRATOR. All of the administrative and executive powers and duties of managing, operating, maintaining and improving the county hospital and other institutions and departments that the county board of supervisors or, in matters of mental health, the Milwaukee County mental health board may place under the jurisdiction of the administrator are vested in the administrator, subject to the policies and in accordance with the principles adopted by the county board of supervisors or, in matters of mental health, the Milwaukee County mental health board. (3r) OTHER POWERS AND DUTIES. The county board of supervisors or, in matters of mental health, the Milwaukee County mental health board may place under the jurisdiction of county entities not specified under this section the administrative and executive powers and duties of managing, operating, maintaining and improving institutions and departments or other responsibilities that are specified in sub. (2), including functions related to the central service departments and buildings and land used in connection with any institution under sub. (2). (4) MANAGEMENT PERSONNEL. Except as provided in s. 51.41 (9), the director may appoint personnel to manage the county department of human services and the administrator may appoint personnel to manage the county hospital, in accordance with ordinances of the county board of supervisors. (4m) HOSPITALS AND SANATORIUMS. (a) The county hospitals and county sanatoriums of a county with a population of 750,000 or more shall be devoted to hospital service and the treatment of patients upon such terms and conditions as the county board of supervisors or, in matters of mental health, the Milwaukee County mental health board establishes. The hospitals and sanatoriums may be utilized for instruction of medical students, physicians and nurses and for scientific and clinical research that will promote the welfare of the patients and assist the application of science to the alleviation of human suffering. (b) Professional staff responsible for the care of patients under this subsection may submit bills for professional services under policies adopted by the county board of supervisors or under mental health policies adopted by the Milwaukee County mental health board. (5) ADMISSION OF INMATES FOR PAY. (a) Any resident of this state, not indigent, may be received into an infirmary to be treated, cared for, and maintained upon such terms and conditions and at such rate of pay as may be established by the county board of supervisors; but indigent and destitute persons shall have preference in admission to and care in such institution. (b) Sections 46.10, 49.08, 49.345, 49.90, and 301.12 govern the support and maintenance of persons in any of the institutions specified in sub. (2) (a). (6) REPORTS; EXPENDITURES. The director and the administrator shall submit annually to the county board of supervisors, or to the Milwaukee County mental health board in matters of mental health, reports, including itemized statements of receipts and disbursements, at the times and in the manner that the county
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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board of supervisors or Milwaukee County mental health board specifies and as are required to comply with applicable federal statutes and regulations and state statutes and rules. Disbursements shall be made in the manner that the county board of supervisors or Milwaukee County mental health board, as applicable, adopts, consistent with sound accounting and auditing procedure and with applicable federal statutes and regulations, state statutes and rules and requirements of the county auditor and county department of administration. (7) APPLICABILITY. Except as provided in s. 59.79 (10), this section does not apply, with respect to the county hospital under s. 49.71 (2), if the county board of supervisors acts under s. 59.79 (10). History: 1973 c. 136, 153, 262; 1975 c. 224; 1975 c. 413 s. 18; 1977 c. 271, 272, 449; 1979 c. 34; 1981 c. 217, 329, 391; 1983 a. 27, 239, 368, 524; 1985 a. 29 s. 3202 (23); 1985 a. 120, 176, 332; 1987 a. 399; 1989 a. 31, 112, 319; 1991 a. 274; 1993 a. 27, 186, 213, 446; 1995 a. 27, 77, 201; 1997 a. 27, 79, 164, 237, 283; 1999 a. 9; 2005 a. 264, 388, 443; 2007 a. 20, 45; 2009 a. 28, 180; 2011 a. 32; 2013 a. 20, 203; 2017 a. 207 s. 5; 2019 a. 8, 9.
46.215 County department of social services in populous counties. (1) CREATION; POWERS AND DUTIES. Except as provided in ss. 49.155 (3g), 49.78 (1r), 49.825, and 49.826, in a county with a population of 750,000 or more the administration of welfare services, other than child welfare services administered by the department of children and families under s. 48.48 (17), is vested in a county department of social services under the jurisdiction of the county board of supervisors under s. 46.21 (2m) (b) 1. a. Any reference in any law to a county department of social services under this section applies to a county department under s. 46.21 (2m) in its administration under s. 46.21 (2m) of the powers and duties of the county department of social services. Except as provided in ss. 49.155 (3g), 49.78 (1r), 49.825, and 49.826, the county department of social services shall have the following functions, duties, and powers, and such other welfare functions as may be delegated to it: (a) To make investigations relating to relief or welfare administration and admissions to state, county and other institutions upon request of court, superintendent, district attorney, veterans’ service commission or any other county official. (b) To furnish services to families or persons other than the granting of financial or material aid where such services may prevent such families or persons from becoming public charges or restore them to a condition of self-support. (c) To make certification or referral of eligibles for state or federal works or other assistance programs, eligibility for which is based on need, when designated to perform such certification or referral services. (d) To make investigations that relate to services under subchs. IV and V of ch. 49 upon request by the department of health services and to make investigations that relate to programs under ch. 48 and subch. III of ch. 49 or to community-based juvenile delinquency-related services upon request by the department of children and families. (e) To maintain administrative and reporting relationships with all pertinent state departments. (g) To administer aid to families with dependent children under s. 49.19. (h) To administer juvenile welfare services under s. 938.57; and, if contracted to do so by the department, to accept custody and guardianship of children upon the order of a competent court, to place children for adoption and to make recommendations relating to the adoption of children under s. 48.85. (i) To make such investigations as are provided for in s. 48.88 (2) (a) and (c), if contracted to do so by the department and if the court having jurisdiction so directs. (j) To make payments in such manner as the department of
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children and families may determine for training of recipients, former recipients, and potential recipients of aid in programs established under s. 49.193, 1997 stats., and s. 49.26 (1). (k) Certify eligibility for and issue food coupons to needy households in conformity with the federal food stamp act of 1964 as amended, and, in addition, the county department of social services may certify eligibility for and distribute surplus commodities and food stuffs. (L) Within the limits of available state and federal funds and of county funds appropriated to match state funds, to provide social services for persons eligible for or receiving benefits under the supplementary security income program under federal Title XVI, the supplemental payments program under s. 49.77 or aid to families with dependent children under s. 49.19. (n) To collect and transmit information to the department of administration so that a federal energy assistance payment may be made to an eligible household; to collect and transmit information to the department of administration so that weatherization services may be made available to an eligible household; to receive applications from individuals seeking low-income energy assistance under s. 16.27 (4) or weatherization services under s. 16.26; to provide information on the income eligibility for weatherization of a recipient of low-income energy assistance to an entity with which the department of administration contracts for provision of weatherization under s. 16.26; and to receive a request, determine a correct payment amount, if any, and provide payment, if any, for emergency assistance under s. 16.27 (8). (p) To administer the child care program under s. 49.155, if the department of children and families contracts with the county department of social services to do so. (q) If the county board of supervisors establishes an initiative to provide coordinated services under s. 59.53 (7), to participate in and administer the initiative, including entering into any written interagency agreements or contracts. (r) If authorized under s. 46.283 (1) (a) 1., to apply to the department of health services to operate a resource center under s. 46.283 and, if the department contracts with the county under s. 46.283 (2), to operate the resource center. (s) If authorized under s. 46.284 (1) (a) 1., to apply to the department of health services to operate a care management organization under s. 46.284 and, if the department contracts with the county under s. 46.284 (2), to operate the care management organization and, if appropriate, place funds in a risk reserve. (t) At the discretion of the county board of supervisors, to combine with one or more other counties to establish a county department of social services on a multicounty basis. A multicounty department of social services established under this paragraph shall meet the requirements for a county department of social services under this section. (1m) EXCHANGE OF INFORMATION; LONG-TERM CARE. Notwithstanding ss. 46.2895 (9), 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 subunit of a county department of social services or tribal agency acting under this section may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of social services or tribal agency, with a resource center, a care management organization, or a long-term care district, with an elder-adult-at-risk agency, an adult-at-risk agency, or any agency to which referral for investigation is made under s. 46.90 (5) (a) 1. or 55.043 (1r) (a) 1g., or with a person providing services to the client under a purchase of services contract with the county department of social services or tribal agency or with a resource center, a care management organization, or a longterm care district, if necessary to enable an employee or service
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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provider to perform his or her duties, or to enable the county department of social services or tribal agency to coordinate the delivery of services to the client. An agency that releases information under this subsection shall document that a request for information was received and what information was provided. (1p) EXCHANGE OF INFORMATION; STATEWIDE AUTOMATED CHILD WELFARE INFORMATION SYSTEM. Notwithstanding ss. 46.2895 (9), 48.396 (1) and (2) (a), 48.78 (2) (a), 48.981 (7), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 252.15, 253.07 (3) (c), 938.396 (1) (a) and (2), and 938.78 (2) (a), a county department under this section may enter the content of any record kept or information received by that county department into the statewide automated child welfare information system established under s. 48.47 (7g). (2) PURCHASE OF CARE AND SERVICES. (a) 1. In order to ensure the availability of a full range of care and services, the county department of social services may contract, either directly or through the department of health services, with public or voluntary agencies or others to purchase, in full or in part, care and services, except as provided under subch. III of ch. 49 and s. 301.08 (2) and except for community-based juvenile delinquency-related services, that the county department of social services is authorized by any statute to furnish in any manner. That care and those services may be purchased from the department of health services if the department of health services has staff to furnish that care and those services. If the county department of social services has adequate staff, it may sell that care and those services directly to another county or state agency. 2. In order to ensure the availability of a full range of care and services, the county department of social services may contract, either directly or through the department of children and families, with public or voluntary agencies, or others to purchase, in full or in part, care and services under ch. 48 and subch. III of ch. 49 and community-based juvenile delinquency-related services that the county department of social services is authorized to furnish. That care and those services may be purchased from the department of children and families if the department of children and families has staff to furnish that care and those services. If the county department of social services has adequate staff, it may sell that care and those services directly to another county or state agency. 3. In order to ensure the availability of a full range of care and services, the county department of social services may contract, either directly or through the department of corrections, with public or voluntary agencies or others to purchase, in full or in part, juvenile delinquency-related care and services which the county department of social services is authorized by any statute to furnish in any manner. Such services may be purchased from the department of corrections if the department of corrections has staff to furnish the services. If the county department of social services has adequate staff, it may sell the care and services directly to another county or state agency. (b) A county department of social services may purchase development and training services from the department of health services, from the department of children and families, from the department of corrections or from other county agencies when the services are available. A county department of social services may sell the development and staff training services to another county or state agency if the county department has adequate staff to provide the services. (c) 1. A county department of social services shall develop, under the requirements of s. 46.036, plans and contracts for the purchase of care and services, except for care and services under subch. III of ch. 49 or s. 301.08 (2) and community-based juvenile delinquency-related services. The department of health services may review the contracts and approve them if they are con-
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sistent with s. 46.036 and if state or federal funds are available for those purposes. The joint committee on finance may require the department of health services to submit the contracts to the committee for review and approval. The department of health services may not make any payments to a county for programs included in a contract under review by the committee. The department of health services shall reimburse each county for the contracts from the appropriations under s. 20.435 (7) (b) and (o), as appropriate, under s. 46.495. 2. A county department of social services shall develop, under the requirements of s. 49.34, plans and contracts for the purchase of care and services under ch. 48 and subch. III of ch. 49 and of community-based juvenile delinquency-related services. The department of children and families may review the contracts and approve them if they are consistent with s. 49.34 and if state or federal funds are available for those purposes. The joint committee on finance may require the department of children and families to submit the contracts to the committee for review and approval. The department of children and families may not make any payments to a county for programs included in a contract under review by the committee. 3. A county department of social services shall develop, under the requirements of s. 301.08 (2), plans and contracts for the purchase of juvenile correctional services. The department of corrections may review the contracts and approve them if they are consistent with s. 301.08 (2) and if state or federal funds are available for such purposes. The joint committee on finance may require the department of corrections to submit the contracts to the committee for review and approval. The department of children and families may not make any payments under s. 48.526 to a county for programs included in a contract under review by the committee. The department of children and families shall reimburse each county for the contracts from the appropriations under s. 20.437 (1) (cj), (o), and (q) as appropriate. (3) PROGRAM BUDGETS. The county department of social services shall submit a final budget for authorized services to the department of health services under s. 46.031 (1) and to the department of children and families under s. 49.325 (1). History: 1971 c. 218; 1973 c. 90, 147, 333, 336; 1975 c. 39, 307, 421; 1977 c. 29, 271, 418; 1979 c. 34; 1981 c. 20 ss. 867m to 870, 2202 (20) (j); 1981 c. 81, 329; 1983 a. 27 ss. 1080, 2202 (20); 1983 a. 190 s. 7; 1983 a. 193; 1985 a. 29, 120; 1985 a. 176 ss. 322 to 332; Stats. 1985 s. 46.215; 1987 a. 27; 1987 a. 403 s. 256; 1989 a. 31, 107, 336, 359; 1991 a. 39, 274; 1993 a. 16; 1995 a. 27 ss. 2063 to 2076, 9126 (19), 9130 (4); 1995 a. 64, 77, 201, 225, 289, 352, 404, 417; 1997 a. 3, 27, 35, 252; 1999 a. 9; 2001 a. 16; 2003 a. 33; 2005 a. 25, 264, 388, 406; 2007 a. 20 ss. 848 to 856, 9121 (6) (a); 2007 a. 45, 96; 2009 a. 15, 28, 180, 334; 2011 a. 32; 2013 a. 20; 2015 a. 55; 2019 a. 8, 9; 2023 a. 19. Counties have authority to provide the funding of services under s. 49.51 (3) (c) [now sub. (2) (c)] on their own but are not required to do so when reimbursement is unavailable. 63 Atty. Gen. 584.
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County social services. (1) COUNTY DEPARTMENT OF SOCIAL SERVICES. (a) Creation. Except as provided under s. 46.23 (3) (b), the county board of supervisors of any county with a population of less than 750,000, or the county boards of 2 or more counties, shall establish a county department of social services on a single-county or multicounty basis. The county department of social services shall consist of a county social services board, a county social services director and necessary personnel. (am) Funding for multicounties. State social services funding under s. 20.435 (7) (b) is not available to counties which establish a multicounty department of social services until the counties have drafted a contractual agreement, approved by the secretary, setting forth the plans for direct sponsorship and have drafted a budget under par. (b) 1. d. (b) Powers and duties. 1. The county department of social services shall have the following functions, duties and powers in accordance with the rules promulgated by the department of
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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SOCIAL SERVICES
health services and subject to the supervision of the department of health services: a. To maintain administrative and reporting relationships with all pertinent state departments. b. To make investigations that relate to welfare services, except for welfare services provided under ch. 48 and subch. III of ch. 49, community-based juvenile delinquency-related services, and juvenile correctional services, upon request by the department of health services. c. Within the limits of available state and federal funds and of county funds appropriated to match state funds, to provide social services for persons eligible for or receiving supplemental security aids under Title XVI of the social security act, eligible for or receiving state supplemental payments under s. 49.77 or eligible for or receiving aid to families with dependent children under s. 49.19. d. To submit a final budget in accordance with s. 46.031 (1) for services authorized in this section, except for the administration of and cost of aid granted under ss. 49.19 and 49.45 to 49.471. g. To make certification or referral of eligibles for state or federal assistance programs under subch. V of ch. 49, eligibility for which is based on need. i. If the county board of supervisors establishes an initiative to provide coordinated services under s. 59.53 (7), to participate in and administer the initiative, including entering into any written interagency agreements or contracts. j. If authorized under s. 46.283 (1) (a) 1., to apply to the department of health services to operate a resource center under s. 46.283 and, if the department contracts with the county under s. 46.283 (2), to operate the resource center. k. If authorized under s. 46.284 (1) (a) 1., to apply to the department of health services to operate a care management organization under s. 46.284 and, if the department contracts with the county under s. 46.284 (2), to operate the care management organization and, if appropriate, place funds in a risk reserve. 2. A county department of social services shall have the following functions, duties, and powers in accordance with the rules promulgated by the department of children and families and subject to the supervision of the department of children and families: a. To administer community-based juvenile delinquency-related services under s. 48.526. b. To maintain administrative and reporting relationships with all pertinent state departments. c. To make investigations as provided under ch. 48 and subch. III of ch. 49 and investigations relating to communitybased juvenile delinquency-related services upon request by the department of children and families. d. To certify eligibility for and issue food coupons to needy households in conformity with 7 USC 2011 to 2036, subject to s. 49.78. e. To make payments in such manner as the department of children and families may determine for training of recipients, former recipients and potential recipients of aid in programs established under s. 49.193, 1997 stats., and s. 49.26 (1). f. To submit a final budget in accordance with s. 49.325 (1) for services authorized in this subdivision. fm. To administer the child care program under s. 49.155, if the department of children and families contracts with the county department of social services to do so. g. To make certification or referral of eligibles for state or federal works or other assistance programs under ch. 48 and subch. III of ch. 49, eligibility for which is based on need. 3. A county department of social services shall have the fol-
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lowing functions, duties, and powers in accordance with the rules promulgated and standards established by the department of health services and subject to the supervision of the department of children and families: a. To maintain administrative and reporting relationships with all pertinent state departments. b. To make investigations which relate to programs under s. 49.046, 1993 stats., upon request by the department of health services. d. To submit a final budget to the department of children and families in accordance with s. 49.325 for services authorized in this subdivision. 4m. A county department of social services shall have the following functions, duties and powers in accordance with the rules promulgated by the department of administration and subject to the supervision of the department of administration: a. To collect and transmit information to the department of administration so that a federal energy assistance payment may be made to an eligible household. b. To collect and transmit information to the department of administration so that weatherization services may be made available to an eligible household. c. To receive applications from individuals seeking low-income energy assistance under s. 16.27 (4) or weatherization services under s. 16.26. d. To provide information on the income eligibility for weatherization of a recipient of low-income energy assistance to an entity with which the department of administration contracts for provision of weatherization under s. 16.26. e. To receive a request, determine a correct payment amount, if any, and provide payment, if any, for emergency assistance under s. 16.27 (8). 5m. A county department of social services shall have the following functions, duties and powers in accordance with the rules promulgated by the department of corrections and subject to the supervision of the department of corrections: a. To purchase juvenile correctional services under s. 301.26. b. To maintain administrative and reporting relationships with all pertinent state departments. (c) Other powers and duties. The county board of supervisors in a county with a single-county department of social services and the county boards of supervisors in counties with a multicounty department of social services may provide that the county department of social services shall, in addition to exercising the mandatory functions, duties and powers under par. (b), have any or all of the following functions, duties and powers and such other welfare functions as may be delegated to it by the county board of supervisors in a county with a single-county department of social services and the county boards of supervisors in counties with a multicounty department of social services: 1. Make investigations in cooperation with the court, institution superintendent, district attorney and other agencies and officials operating in the welfare field regarding admissions to and release or conditional release from the following institutions: a. ‘County institutions.’ Any county infirmary, home, asylum or hospital for mental diseases, tuberculosis or otherwise. b. ‘State institutions.’ The Mendota Mental Health Institute, the Winnebago Mental Health Institute, centers for the developmentally disabled, and Type 1 juvenile correctional facilities, as defined in s. 938.02 (19). c. ‘Other institution.’ University of Wisconsin Hospitals and Clinics and secured residential care centers for children and youth, as defined in s. 938.02 (15g). 2. Subdivision 1. does not authorize the county department
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of social services to make investigations regarding admission to or release from state prisons under s. 302.01, county houses of correction, jails, detention homes or reforestation camps. 4. Make investigations which are provided for under s. 48.88 (2) (a) and (c), if the court having jurisdiction so directs. 5. Perform the duties and functions prescribed in ss. 48.08 and 938.08 when requested to do so by the judge assigned to exercise jurisdiction under chs. 48 and 938. 6. To furnish services to families or persons other than the granting of financial or material aid where such services may prevent such families or persons from becoming public charges or restore them to a condition of self-support. 7. To certify eligibility for and distribute surplus commodities and foodstuffs. 8. To administer child welfare services including services to juveniles who are delinquent and to children who have an intellectual disability or are dependent, neglected or nonmarital, and to other children who are in need of such services. In administering child welfare services the county department of social services shall be governed by the following: a. The county department of social services may avail itself of the cooperation of any individual or private agency or organization interested in the social welfare of children in the county with a single-county department of social services or in the counties with a multicounty department of social services. b. The county department of social services shall administer and expend such amounts as may be necessary out of any moneys which may be appropriated for child welfare purposes by the county board of supervisors in a county with a single-county department of social services or by the county boards of supervisors in counties with a multicounty department of social services or donated by individuals or private organizations. c. Upon the request of the judge assigned to exercise jurisdiction under chs. 48 and 938, the county department of social services shall investigate the home environment and other factors in the life of any child brought to the attention of the court for alleged dependency or neglect, or any juvenile brought to the attention of the court for alleged delinquency, and to assume guidance and supervision of any juvenile placed on probation by that court. d. Upon the request of the department of corrections and under its direction, the county department of social services shall assume the oversight of any juvenile under parole from or otherwise subject to the supervision of any state institution. e. The county department of social services shall have the powers and duties specified in ss. 48.57 and 938.57. f. The county department of social services shall implement the statewide automated child welfare information system established under s. 48.47 (7g). 9. The authority given to the county department of social services under subd. 8. to function as an authorized child welfare agency shall not be interpreted as excluding agencies licensed under s. 48.60 from also exercising such functions. (d) Merit system; records. The county department of social services is subject to s. 49.78 (4) to (7). The county department of social services and all county officers and employees performing any duties in connection with the administration of aid to families with dependent children shall observe all rules promulgated by the department of children and families under s. 49.78 (4) and shall keep records and furnish reports as the department of children and families requires in relation to their performance of such duties. (dm) Exchange of information; long-term care. Notwithstanding ss. 46.2895 (9), 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
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938.78 (2) (a), a subunit of a county department of social services or tribal agency acting under this subsection may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of social services or tribal agency, with a resource center, a care management organization, or a long-term care district, with an elder-adult-at-risk agency, an adult-at-risk agency, or any agency to which referral for investigation is made under s. 46.90 (5) (a) 1. or 55.043 (1r) (a) 1g., or with a person providing services to the client under a purchase of services contract with the county department of social services or tribal agency or with a resource center, a care management organization, or a long-term care district, if necessary to enable an employee or service provider to perform his or her duties, or to enable the county department of social services or tribal agency to coordinate the delivery of services to the client. An agency that releases information under this paragraph shall document that a request for information was received and what information was provided. (dp) Exchange of information; statewide automated child welfare information system. Notwithstanding ss. 46.2895 (9), 48.396 (1) and (2) (a), 48.78 (2) (a), 48.981 (7), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 252.15, 253.07 (3) (c), 938.396 (1) (a) and (2), and 938.78 (2) (a), a county department under this section may enter the content of any record kept or information received by that county department into the statewide automated child welfare information system established under s. 48.47 (7g). (e) Purchase of care and services. 1. In order to ensure the availability of a full range of care and services, a county department of social services may contract, either directly or through the department of health services, the department of children and families, or the department of corrections, with public or voluntary agencies or others to purchase, in full or in part, care and services which the county department of social services is authorized by any statute to furnish in any manner. The services may be purchased from the department of health services, the department of children and families, or the department of corrections if the department of health services, the department of children and families, or the department of corrections has staff to furnish the services. The county department of social services, if it has adequate staff, may sell the care and services directly to another county or state agency. 2. A county department of social services may purchase development and training services from the department of health services, the department of children and families, or the department of corrections or from other county agencies if the services are available or sell the development and staff training services to another county or state agency if the county department of social services has adequate staff to provide the services. 3. a. A county department of social services shall develop, under the requirements of s. 46.036, plans and contracts for the purchase of care and services, except for care and services provided under ch. 48, subch. III of ch. 49, and s. 301.08 (2) and community-based juvenile delinquency-related services. The department of health services may review the contracts and approve them if they are consistent with s. 46.036 and to the extent that state or federal funds are available for those purposes. The joint committee on finance may require the department of health services to submit the contracts to the committee for review and approval. The department of health services may not make any payments to a county for programs included in the contract that is under review by the committee. The department of health services shall reimburse each county for the contracts from the appropriations under s. 20.435 (7) (b) and (o) according to s. 46.495. b. A county department of social services shall develop, under the requirements of s. 49.34, plans and contracts for the pur-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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SOCIAL SERVICES
chase of care and services under ch. 48 and subch. III of ch. 49 and of community-based juvenile delinquency-related services. The department of children and families may review the contracts and approve them if they are consistent with s. 49.34 and to the extent that state or federal funds are available for such purposes. The joint committee on finance may require the department of children and families to submit the contracts to the committee for review and approval. The department of children and families may not make any payments to a county for programs included in the contract that is under review by the committee. c. A county department of social services shall develop, under the requirements of s. 301.08 (2), plans and contracts for the purchase of juvenile correctional services. The department of corrections may review the contracts and approve them if they are consistent with s. 301.08 (2) and to the extent that state or federal funds are available for those purposes. The joint committee on finance may require the department of corrections to submit the contracts to the committee for review and approval. The department of children and families may not make any payments under s. 48.526 to a county for programs included in the contract that is under review by the committee. The department of children and families shall reimburse each county for the contracts from the appropriations under s. 20.437 (1) (cj), (o), and (q) as appropriate. (1m) COUNTY SOCIAL SERVICES BOARD. (a) Composition. 1. In any single-county department of social services, the county social services board shall consist of 3, 5 or 7 residents of the county, as determined by the county board of supervisors. 2. In any multicounty department of social services, the county social services board shall be composed of 11 members plus 3 additional members for each county in a multicounty department of social services in excess of 2. (b) Appointment, election. The members of the county social services board shall be elected or appointed either from members of the county board of supervisors or from the county at large, or both, on the basis of knowledge and interest in public welfare as follows: 1. In a single-county department of social services in a county without a county executive or county administrator, the county board of supervisors shall elect, or the chairperson of the county board of supervisors under rules of the county board of supervisors shall appoint, the county social services board. 2. In any county with a county executive or county administrator which has established a single-county department of social services, the county executive or county administrator shall appoint, subject to confirmation by the county board of supervisors, the county social services board, which shall be only a policymaking body determining the broad outlines and principles governing the administration of programs under this section. 3. The county boards of supervisors of the counties in a multicounty department of social services shall make appointments in a manner acceptable to the counties in a multicounty department of social services, but each of the counties in a multicounty department of social services may appoint to the county social services board not more than 3 members from its county board of supervisors. (c) Compensation; terms; removal. The members of the county social services board shall receive compensation and hold office for a term as fixed by the county board of supervisors in a county with a single-county department or by the county boards of supervisors in counties with a multicounty department, except as follows: 1. A member of the county social services board appointed under par. (b) 2. may be removed at pleasure by the county executive or county administrator.
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2. The term of office of any member of the county social services board appointed under par. (b) 3. shall be 3 years, but of the members first appointed, at least one-third shall be appointed for one year; at least one-third for 2 years; and the remainder for 3 years. Vacancies shall be filled for the residue of the unexpired term in the manner that original appointments are made. Any county social services board member may be removed from office by a two-thirds vote of the appointing authority, on due notice in writing. (2) POWERS AND DUTIES OF COUNTY SOCIAL SERVICES BOARD IN CERTAIN COUNTIES. A county social services board elected or appointed under sub. (1m) (b) 1. and 3. shall: (a) At the first meeting of the county social services board, elect from their number, a chairperson, a secretary and other officers as deemed necessary. Vacancies in these offices shall be filled for the unexpired terms. The chairperson presides at all meetings when present, and countersigns all actions taken by the county social services board. In case of the absence of the chairperson for any meeting the members present shall choose a temporary chairperson. (b) Appoint the county social services director under sub. (3) subject to s. 49.78 (4) to (7) and the rules promulgated thereunder and subject to the approval of the county board of supervisors in a county with a single-county department of social services or the county boards of supervisors in counties with a multicounty department of social services. (c) Supervise the working of the county department of social services and shall be a policy-making body determining the broad outlines and principles governing the administration of the functions, duties and powers assigned to the county department of social services under sub. (1) (b) and (c). (d) As it determines necessary, appoint committees consisting of residents of the county, which shall advise the county social services board on any matters for which they are created. Members of such committees shall serve without compensation. (e) Consult with the county social services director appointed under par. (b) concerning the preparation of the annual budget, the annual report of the operation of the county department of social services and the appointment of necessary personnel. (f) Recommend program priorities, identify unmet service needs and prepare short-term and long-term plans and budgets for meeting such priorities and needs. (g) Determine, subject to the approval of the county board of supervisors in a county with a single-county department of social services or the county boards of supervisors in counties with a multicounty department of social services and with the advice of the county social services director appointed under par. (b), whether services are to be provided directly by the county department of social services or contracted for with other providers and make such contracts. The county board of supervisors in a county with a single-county department of social services or the county boards of supervisors in counties with a multicounty department of social services may elect to require the approval of any such contract by the county board of supervisors in a county with a single-county department of social services or the county boards of supervisors in counties with a multicounty department of social services. (h) Develop county social services board operating procedures. (i) Comply with state requirements. (j) Assist in arranging cooperative working agreements with persons providing health, education, vocational or welfare services related to services provided under this section. (k) Establish priorities in addition to those mandated by the department.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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(L) Evaluate services delivery. (m) Cooperate to the extent feasible with the school board, health planning agencies, law enforcement agencies, and other human service agencies, committees and planning bodies in the geographic area served by the county department of social services. (n) Assume the powers and duties of the county department of social services under sub. (1) (b) to (e). (2g) POWERS AND DUTIES OF COUNTY SOCIAL SERVICES BOARD IN CERTAIN COUNTIES WITH A COUNTY EXECUTIVE OR COUNTY ADMINISTRATOR. A county social services board ap-
pointed under sub. (1m) (b) 2. shall: (a) At the first meeting of the county social services board, elect from their number, a chairperson, a secretary and other officers as deemed necessary. Vacancies in these offices shall be filled for the unexpired terms. The chairperson presides at all meetings when present, and countersigns all actions taken by the county social services board. In case of the absence of the chairperson for any meeting the members present shall choose a temporary chairperson. (b) Appoint committees consisting of residents of the county to advise the county social services board as it deems necessary. Members of such committees shall serve without compensation. (c) Recommend program priorities, identify unmet service needs and prepare short-term and long-term plans and budgets for meeting such priorities and needs. (d) Prepare, with the assistance of the county social services director under sub. (3m) (b) 5., all of the following: 1. A proposed budget for submission to the county executive or county administrator. 2. A final budget for submission to the department of health services in accordance with s. 46.031 (1) for authorized services, except services under ch. 48, subch. III of ch. 49, or s. 301.08 (2) and authorized community-based juvenile delinquency-related services. 3. A final budget for submission to the department of children and families in accordance with s. 49.325 for authorized services under ch. 48 and subch. III of ch. 49 and authorized community-based juvenile delinquency-related services. (e) Advise the county social services director under sub. (3m) (b) 3. regarding purchasing and providing services and the selection of purchase of service vendors, and make recommendations to the county executive or county administrator regarding modifications in such purchasing, providing and selection. (f) Develop county social services board operating procedures. (g) Comply with state requirements. (h) Assist in arranging cooperative working agreements with persons providing health, education, vocational or welfare services related to services provided under this section. (3) COUNTY SOCIAL SERVICES DIRECTOR IN CERTAIN COUNTIES. A county social services director appointed under sub. (2) (b) shall: (a) Serve as the executive and administrative officer of the county department of social services. (b) In consultation and agreement with the county social services board under sub. (2), prepare and submit to the county board of supervisors an annual budget of all funds necessary for the county department of social services, and prepare annually a full report of the operations and administration of the county department of social services. The county board of supervisors shall review and approve, reject or revise by majority vote the annual budget of the county department of social services. (c) Recommend to the county social services board under sub.
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(2) the appointment of employees necessary to administer the functions of the county department of social services. (d) Make recommendations to the county board of supervisors in a county with a single-county department of social services or the county boards of supervisors in counties with a multicounty department of social services who shall fix the salary of such employees. (f) Comply with state requirements. (g) Cooperate to the extent feasible with the school board, health planning agencies, law enforcement agencies, and other human service agencies, committees and planning bodies in the geographic area served by the county department of social services. (3m) COUNTY SOCIAL SERVICES DIRECTOR IN CERTAIN COUNTIES WITH A COUNTY EXECUTIVE OR COUNTY ADMINISTRATOR. (a) In any county with a county executive or a county ad-
ministrator that has established a single-county department of social services, the county executive or county administrator, subject to s. 49.78 (4) to (7) and the rules promulgated thereunder, shall appoint and supervise the county social services director. The appointment is subject to the confirmation of the county board of supervisors unless the county board of supervisors, by ordinance, elects to waive confirmation or unless the appointment is made under a civil service system competitive examination procedure established under s. 59.52 (8) or ch. 63. (b) A county social services director appointed under par. (a) shall: 1. Supervise and administer any program established by the county department of social services. 1m. Supervise the operations and administration of the county department of social services. 2. Determine administrative and program procedures. 3. Determine, subject to the approval of the county board of supervisors and with the advice of the county social services board under sub. (2g) (e), whether services are to be provided directly by the county department of social services or contracted for with other providers and make such contracts. The county board of supervisors may elect to require the approval of any such contract by the county board of supervisors. 5. Assist the county social services board in the preparation of the budgets required under sub. (2g) (d). 6. Make recommendations to the county executive or county administrator regarding modifications to the proposed budget prepared by the county social services board under sub. (2g) (d). 7. Evaluate service delivery. 9. Establish salaries and personnel policies of the county department of social services subject to approval of the county executive or county administrator and county board of supervisors. 10. Perform other functions necessary to manage, operate, maintain and improve programs. 11. Comply with state requirements. 12. Establish priorities in addition to those mandated by the department of health services, by the department of children and families, or by the department of corrections. 13. Determine the number and location of outstations when appropriate to meet service demands. 15. Prepare annually a full report of the operations and administration of the county department of social services. 16. Cooperate to the extent feasible with the school board, health planning agencies, law enforcement agencies, and other human service agencies, committees and planning bodies in the geographic area served by the county department of social services.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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SOCIAL SERVICES
17. In consultation with the county social services board under sub. (2g), prepare: a. Intermediate-range plans and budget. b. Such other reports as are required by the secretary of health services, the secretary of children and families, the secretary of corrections, and the county board of supervisors. (4) CONSTRUCTION. (a) Any reference in any law to a county department of social services under this section applies to a county department under s. 46.23 in its administration of the powers and duties of the county department of social services under s. 46.23 (3) (b). (b) 1. Any reference in any law to a county social services director appointed under sub. (2) (b) applies to the director of a county department appointed under s. 46.23 (5) (f) in his or her administration of the powers and duties of that county social services director. 2. Any reference in any law to a county social services director appointed under sub. (3m) (a) applies to the director of a county department appointed under s. 46.23 (6m) (intro.) in his or her administration of the powers and duties of that county social services director. (c) 1. Any reference in any law to a county social services board appointed under sub. (1m) (b) 1. and 3. applies to the board of a county department appointed under s. 46.23 (4) (b) 1. in its administration of the powers and duties of that county social services board. 2. Any reference in any law to a county social services board appointed under sub. (1m) (b) 2. applies to the board of a county department appointed under s. 46.23 (4) (b) 2. in its administration of the powers and duties of that county social services board. History: 1971 c. 164, 218; 1973 c. 90 ss. 226, 560 (3); 1973 c. 147, 333; 1975 c. 39; 1975 c. 189 s. 99 (1), (2); 1975 c. 224 ss. 52p, 146m; 1975 c. 307, 422; 1975 c. 430 s. 78; 1977 c. 29 ss. 560, 1656 (18); 1977 c. 83 s. 26; 1977 c. 418, 449; 1979 c. 34, 221; 1981 c. 20 ss. 759 to 763m, 2202 (20) (j); 1981 c. 329; 1981 c. 390 s. 252; 1983 a. 27 s. 2202 (20); 1983 a. 190 s. 7; 1983 a. 192, 193, 447; 1985 a. 29, 120; 1985 a. 176 ss. 28, 30, 59 to 105; 1985 a. 332; 1987 a. 5, 27; 1989 a. 31, 107, 336, 359; 1991 a. 39, 274; 1993 a. 16; 1995 a. 27 ss. 2077 to 2111, 9126 (19), 9130 (4); 1995 a. 64, 77, 201, 289, 352, 404, 417; 1997 a. 3, 27, 35, 252; 1999 a. 9, 83; 2001 a. 16, 103; 2003 a. 33; 2005 a. 25, 264, 344, 388, 406; 2007 a. 20 ss. 857 to 877, 9121 (6) (a); 2007 a. 45, 96; 2009 a. 28, 180, 334; 2011 a. 32, 126; 2015 a. 55; 2017 a. 150, 185; 2017 a. 207 s. 5; 2019 a. 8, 9; 2023 a. 19. Members of a social services board in a county with a county executive or a county administrator may be granted access to child abuse and neglect files under s. 48.981 if access is necessary for the performance of their statutory duties. 79 Atty. Gen. 212.
46.225 Indigency determinations. If applicable under s. 977.07 (1), a county department under s. 46.21, 46.22 or 46.23 shall make indigency determinations. History: 1979 c. 356; 1985 a. 176.
46.23 County department of human services. (1) INTENT. The intent of this section is to enable and encourage counties to develop and make available to all citizens of this state a comprehensive range of human services in an integrated and efficient manner; to utilize and expand existing governmental, voluntary and private community resources for the provision of services to prevent or ameliorate social, mental and physical disabilities; to provide for the integration of administration of those services and facilities organized under this section through the establishment of a unified administrative structure and of a unified policy-making body; and to authorize state consultative services, reviews and establishments of standards and grants-in-aid for such programs of services and facilities. (2) DEFINITIONS. Except as otherwise provided, in this section: (a) “Human services” means the total range of services to people including, but not limited to, health care, mental illness treatment, developmental disabilities services, income mainte-
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nance, probation, extended supervision and parole services, alcohol and drug abuse services, services to children, youth and aging, family counseling, special education services, and manpower services. (b) “Program” means community services and facilities for the prevention and amelioration of social, mental and physical disabilities. (3) COUNTY DEPARTMENT OF HUMAN SERVICES. (a) Creation. Upon approval by the secretary of health services, by the secretary of corrections, and by the secretary of children and families of a feasibility study and a program implementation plan, the county board of supervisors of any county with a population of less than 750,000, or the county boards of supervisors of 2 or more counties, may establish by resolution a county department of human services on a single-county or multicounty basis to provide the services required under this section. The county department of human services shall consist of the county human services board, the county human services director and necessary personnel. (am) Delivery of services plan. 1. The county department of human services shall prepare a local plan for the delivery of human services which includes an inventory of all existing resources, identifies needed new resources and services and contains a plan for meeting the health, mental health and social needs of individuals and families. The plan shall be based on an annual need survey of the prevalence and incidence of the various disabilities within the geographic boundaries of the county department of human services. The plan shall also include the establishment of long-range goals and intermediate-range plans, detailing priorities and estimated costs and providing for coordination of local services and continuity of care. 2. Prior to adoption of the plan by the county department of human services under subd. 1., it shall hold a public hearing on the plan. As far as practicable, the county department of human services shall annually publish or otherwise circulate notice of its proposed plan and afford interested persons opportunity to submit data or views orally or in writing. 3. The county board of supervisors in a county with a singlecounty department of human services and the county boards of supervisors in counties with a multicounty department of human services shall review and approve the overall plan, program and budgets proposed by the county department of human services. 4. No funds may be allocated to any multicounty department of human services until the counties have drawn up a detailed contractual agreement, approved by the secretary of health services, by the secretary of corrections, and by the secretary of children and families, setting forth the plan for joint sponsorship. (b) Transfer of other county powers and duties. 1. If a county department of human services is established under par. (a), the county board of supervisors in a county with a single-county department of human services or the county boards of supervisors in counties with a multicounty department of human services shall transfer the powers and duties of the county departments under ss. 46.22 and 51.42 to the county department of human services. The county board of supervisors in a county with a singlecounty department of human services and the county boards of supervisors in counties with a multicounty department of human services may transfer the powers and duties of the following to the county department of human services established under par. (a): a. A county unit created by the county board of supervisors exercising its authority under s. 59.03 (1). am. A county department under s. 51.437. b. A local board of health for a local health department, as defined in s. 250.01 (4) (a) 1. or 2. or (c).
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bm. A local health officer for a local health department, as defined in s. 250.01 (4) (a) 1. or 2. or (c) c. A local health department, as defined in s. 250.01 (4) (a) 1. or 2. or (c). d. Any other human services program under county control. 2. a. Except as provided in s. 46.21 (2m) (b) 2. a., any reference in any law to a county department under s. 46.22, 51.42 or 51.437 applies to the county department of human services under this section in its administration of the powers and duties of the county department to which the reference is made. b. Any reference in any law to a county director appointed under s. 46.22 (2) (b), 51.42 (5) (a) 4. or 51.437 (9) (a) applies to the county human services director appointed under sub. (5) (f) in his or her administration of the powers and duties of the county director to which the reference is made. Except as provided in s. 46.21 (2m) (b) 2. b., any reference in any law to a county director appointed under s. 46.22 (3m) (a), 51.42 (6m) (intro.) or 51.437 (10m) (intro.) applies to the county human services director appointed under sub. (6m) (intro.) in his or her administration of the powers and duties of the county director to which the reference is made. c. Any reference to a county board appointed under s. 46.22 (1m) (b) 1., 51.42 (4) (a) 1. or 51.437 (7) (a) 1. applies to the county human services board appointed under sub. (4) (b) 1. in its administration of the powers and duties of the county board to which the reference is made. Except as provided in s. 46.21 (2m) (b) 2. c., any reference in any law to the county board appointed under s. 46.22 (1m) (b) 2., 51.42 (4) (a) 2. or 51.437 (7) (a) 2. applies to the county human services board appointed under sub. (4) (b) 2. in its administration of the powers and duties of the county board to which the reference is made. d. The powers and duties of the county department of human services under s. 46.21 (2m) do not apply to this section. (d) Employee protections. All persons employed by a county or by the state, whose functions are assumed by a county department of human services shall continue as employees of the county department of human services without loss in seniority, status or benefits, subject to the merit or civil service system. (e) Exchange of information; long-term care. Notwithstanding ss. 46.2895 (9), 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 subunit of a county department of human services or tribal agency acting under this section may exchange confidential information about a client, without the informed consent of the client, with any other subunit of the same county department of human services or tribal agency, with a resource center, a care management organization, or a long-term care district, with an elder-adult-at-risk agency, an adult-at-risk agency, or any agency to which referral for investigation is made under s. 46.90 (5) (a) 1. or 55.043 (1r) (a) 1g., or with a person providing services to the client under a purchase of services contract with the county department of human services or tribal agency or with a resource center, a care management organization, or a long-term care district, if necessary to enable an employee or service provider to perform his or her duties, or to enable the county department of human services or tribal agency to coordinate the delivery of services to the client. An agency that releases information under this paragraph shall document that a request for information was received and what information was provided. (ed) Exchange of information; statewide automated child welfare information system. Notwithstanding ss. 46.2895 (9), 48.396 (1) and (2) (a), 48.78 (2) (a), 48.981 (7), 49.45 (4), 49.83, 51.30, 51.45 (14) (a), 55.22 (3), 146.82, 252.11 (7), 252.15, 253.07 (3) (c), 938.396 (1) (a) and (2), and 938.78 (2) (a), a county department under this section may enter the content of
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any record kept or information received by that county department into the statewide automated child welfare information system established under s. 48.47 (7g). (4) COUNTY HUMAN SERVICES BOARD. (a) Composition. 1. In any single-county or multicounty department of human services, the county human services board shall be composed of not less than 7 nor more than 15 persons of recognized ability and demonstrated interest in human services. Not less than one-third nor more than two-thirds of the county human services board members may be members of the county board of supervisors. At least one member appointed to a county human services board shall be an individual who receives or has received human services or shall be a family member of such an individual. The remainder of the county human services board members shall be consumers of services or citizens-at-large. No public or private provider of services may be appointed to the county human services board. 2. In a multicounty department of human services, the county human services board shall be constituted so that the representation shall be as equal as possible among the participating counties. (b) Appointment. 1. Except as provided under subd. 2., the county board of supervisors in a county which has established a single-county department of human services or the county boards of supervisors in counties which have established a multicounty department of human services shall, before qualification under this section, appoint a governing and policy-making board to be known as the county human services board. 2. In any county with a county executive or county administrator and which has established a single-county department of human services, the county executive or county administrator shall appoint, subject to confirmation by the county board of supervisors, the county human services board, which shall be only a policy-making body determining the broad outlines and principles governing the administration of programs under this section. A member of a county human services board appointed under this subdivision may be removed by the county executive or county administrator on due notice in writing. (c) Terms. Members of a county human services board shall serve for terms of 3 years, so arranged that as nearly as practicable, the terms of one-third of the members shall expire each year. Vacancies shall be filled in the same manner as the original appointments. A county human services board member appointed under par. (b) 1. may be removed from office for the following reasons: 1. By a two-thirds vote of each county board of supervisors participating in the appointment, on due notice in writing. 2. If the member when appointed was a member of the county board of supervisors and was not reelected to that office, on due notice in writing. (5) POWERS AND DUTIES OF COUNTY HUMAN SERVICES BOARD IN CERTAIN COUNTIES. A county human services board appointed under sub. (4) (b) 1.: (a) 1. Shall determine administrative and program policies, except as provided under ch. 48 and subch. III of ch. 49 and except for policies relating to community-based juvenile delinquency-related services or to the purchase of juvenile correctional services, within limits established by the department of health services. Policy decisions, except as provided under ch. 48 and subch. III of ch. 49 and except for policy decisions relating to community-based juvenile delinquency-related services or to the purchase of juvenile correctional services, that are not reserved by statute for the department of health services may be delegated by the secretary to the county human services board. 2. Shall determine administrative and program policies un-
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der ch. 48 and subch. III of ch. 49 and administrative and program policies relating to community-based juvenile delinquency-related services within limits established by the department of children and families. Policy decisions under ch. 48 and subch. III of ch. 49 and policy decisions relating to community-based juvenile delinquency-related services that are not reserved by statute for the department of children and families may be delegated by the secretary of children and families to the county human services board. 3. Shall determine administrative programs and policies relating to the purchase of juvenile correctional services within limits established by the department of corrections. Policy decisions relating to the purchase of juvenile correctional services that are not reserved by statute for the department of corrections may be delegated by the secretary of corrections to the county human services board. (b) Shall establish priorities in addition to those mandated by the department of health services, the department of corrections, or the department of children and families. (c) 1. Shall determine whether state mandated services, except for services under ch. 48 and subch. III of ch. 49, community-based juvenile delinquency-related services, and juvenile correctional services, are provided by, purchased from, or contracted for with local providers, and monitor the performance of those contracts. Purchase of services contracts shall be subject to the conditions specified in s. 46.036. 2. Shall determine whether state mandated services under ch. 48 and subch. III of ch. 49 and state-mandated community-based juvenile delinquency-related services are provided by, purchased from, or contracted for with local providers, and monitor the performance of those contracts. Purchase of services contracts shall be subject to the conditions specified in s. 49.34. 3. Shall monitor the performance of contracts for the purchase of juvenile correctional services. (d) Shall determine, subject to the approval of the county board of supervisors in a county with a single-county department of human services or the county boards of supervisors in counties with a multicounty department of human services and with the advice of the county human services director appointed under par. (f), whether services are to be provided directly by the county department of human services or contracted for with other providers and make such contracts. The county board of supervisors in a county with a single-county department of human services or the county boards of supervisors in counties with a multicounty department of human services may elect to require the approval of any such contract by the county board of supervisors in a county with a single-county department of human services or the county boards of supervisors in counties with a multicounty department of human services. (e) Shall represent human service agencies, professionals and consumers of services in negotiations with the state and federal governments. (f) Shall appoint a county human services director on the basis of recognized and demonstrated interest in and knowledge of human services problems, with due regard to training, experience, executive and administrative ability and general qualification and fitness for the performance of the duties of the county human services director. The appointment is subject to the personnel policies and procedures established by each county board of supervisors which participated in the appointment of the county human services board. (g) Shall appoint advisory committees for the purpose of receiving community, professional or technical information concerning particular policy considerations.
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(h) Shall determine the number and location of outstations when appropriate to meet service demands. (i) May recommend the removal of the county human services director to each county board of supervisors which participated in the appointment of the county human services board, and each such county board of supervisors may remove the county human services director by a two-thirds vote of each such county, on due notice in writing. (j) Shall develop county human services board operating procedures. (k) Shall oversee the operation of one or more service delivery programs. (L) Shall evaluate services delivery. (m) May perform such other general functions necessary to administer the program. (n) 1. Shall submit a final budget in accordance with s. 46.031 (1) for authorized services, except for services under ch. 48 and subch. III of ch. 49, community-based juvenile delinquency-related services, and juvenile correctional services. Notwithstanding the categorization of or limits specified for funds allocated under s. 46.495 or 51.423 (2), with the approval of the department of health services the county human services board may expend those funds consistent with any service provided under s. 46.495 or 51.42. 2. Shall submit a final budget in accordance with s. 49.325 (1) for authorized services under ch. 48 and subch. III of ch. 49 and for authorized community-based juvenile delinquency-related services. Notwithstanding the categorization of or limits specified for funds allocated under s. 48.569, with the approval of the department of children and families the county human services board may expend those funds consistent with any service provided under s. 48.569. (o) Shall cooperate to the extent feasible with the school board, health planning agencies, law enforcement agencies, and other human service agencies, committees and planning bodies in the geographic area served by the county human services board. (p) Shall comply with state requirements. (5m) POWERS AND DUTIES OF COUNTY HUMAN SERVICES BOARD IN CERTAIN COUNTIES WITH A COUNTY EXECUTIVE OR COUNTY ADMINISTRATOR. A county human services board ap-
pointed under sub. (4) (b) 2. shall: (a) Appoint committees consisting of residents of the county to advise the county human services board as it deems necessary. (b) Recommend program priorities and policies, identify unmet service needs and prepare short-term and long-term plans and budgets for meeting such priorities and needs. (c) Prepare, with the assistance of the county human services director under sub. (6m) (e), a proposed budget for submission to the county executive or county administrator; a final budget for submission to the department of health services in accordance with s. 46.031 (1) for authorized services, except services under ch. 48 and subch. III of ch. 49, community-based juvenile delinquency-related services, and juvenile correctional services; and a final budget for submission to the department of children and families in accordance with s. 49.325 for authorized services under ch. 48 and subch. III of ch. 49 and for authorized communitybased juvenile delinquency-related services. (d) Advise the county human services director under sub. (6m) regarding purchasing and providing services and the selection of purchase of service vendors, and make recommendations to the county executive or county administrator regarding modifications in such purchasing, providing and selection. (e) Develop county human services board operating procedures.
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(f) Comply with state requirements. (g) Assist in arranging cooperative working agreements with persons providing health, education, vocational or welfare services related to services provided under this section. (6) POWERS AND DUTIES OF COUNTY HUMAN SERVICES DIRECTOR IN CERTAIN COUNTIES. (a) A county human services director appointed under sub. (5) (f) shall have all of the administrative and executive powers and duties of managing, operating, maintaining, and improving the services and programs of the county department of human services. Those powers and duties are subject to the rules promulgated by the department of health services for programs, except that, with respect to services or programs under ch. 48 and subch. III of ch. 49 and community-based juvenile delinquency-related services or programs, those powers and duties are subject to the rules promulgated by the department of children and families and, with respect to the purchase of juvenile correctional services or programs, those powers and duties are subject to the rules promulgated by the department of corrections. In consultation with the county human services board under sub. (5) and subject to its approval, the county human services director shall prepare all of the following: 1. An annual comprehensive plan and budget of all funds necessary for the program and services authorized by this section in which priorities and objectives for the year are established as well as any modifications of long-range objectives. 2. Intermediate-range plans and budget. 3. Such other reports as are required by the secretary of health services, by the secretary of corrections, or by the secretary of children and families and the county board of supervisors in a county with a single-county department of human services or the county boards of supervisors in counties with a multicounty department of human services. (c) A county human services director under this subsection shall make recommendations to the county human services board under sub. (5) for: 1. Personnel and salaries of employees. 2. Changes in the organization and management of the program. 3. Changes in program services. (e) A county human services director under this subsection shall comply with state requirements. (6m) COUNTY HUMAN SERVICES DIRECTOR IN CERTAIN COUNTIES WITH A COUNTY EXECUTIVE OR COUNTY ADMINISTRATOR. In any county with a county executive or county administra-
tor in which the county board of supervisors has established a single-county department of human services, the county executive or county administrator shall appoint a county human services director on the basis of recognized and demonstrated interest in and knowledge of human services problems, with due regard to training, experience, executive and administrative ability and general qualification and fitness for the performance of the duties of the director. The appointment is subject to confirmation by the county board of supervisors unless the county board of supervisors, by ordinance, elects to waive confirmation or unless the appointment is made under a civil service system competitive examination procedure established under s. 59.52 (8) or ch. 63. The county human services director, subject only to the supervision of the county executive or county administrator, shall: (a) Supervise and administer any program for which supervision and administration is authorized under this section. (b) Determine administrative and program procedures and administrative policies. (c) Determine, subject to the approval of the county board of supervisors and with the advice of the county human services
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board under sub. (5m), whether services are to be provided directly by the county department of human services or contracted for with other providers and make such contracts. The county board of supervisors may elect to require the approval of any such contract by the county board of supervisors. (e) Assist the county human services board under sub. (5m) (c) in the preparation of the budgets required under sub. (5m) (c). (f) Make recommendations to the county executive or county administrator regarding modifications to the proposed budget prepared by the county human services board under sub. (5m) (c). (g) Evaluate service delivery. (j) Perform other functions necessary to manage, operate, maintain and improve programs. (k) Comply with state requirements. (L) Represent human service agencies, professionals and consumers of services in negotiations with the state and federal governments. (m) Determine the number and location of outstations when appropriate to meet service demands. History: 1975 c. 39, 224; 1977 c. 29; 1981 c. 20, 93, 291; 1981 c. 329 s. 31; 1983 a. 27 ss. 962, 2202 (20); 1985 a. 29 ss. 844m to 860, 3200 (56) (a); 1985 a. 120, 176, 332; 1987 a. 186; 1987 a. 403 s. 256; 1989 a. 56, 359; 1991 a. 274; 1993 a. 16, 27, 83, 445, 491; 1995 a. 27 ss. 2112 to 2127, 9126 (19), 9130 (4); 1995 a. 64, 201, 352, 417; 1997 a. 3, 164, 268, 283; 1999 a. 9; 2005 a. 264, 388, 406; 2007 a. 20 ss. 878 to 891, 9121 (6) (a); 2007 a. 45, 96; 2009 a. 28, 180; 2011 a. 32; 2015 a. 55; 2017 a. 150; 2017 a. 207 s. 5; 2019 a. 8, 9. There is no unconditional guarantee of continued employment under sub. (3) (d); employment is continued during a reorganization unless civil service rules provide otherwise. Dane County v. McCartney, 166 Wis. 2d 956, 480 N.W.2d 830 (Ct. App. 1992). Boards and directors may view client information without written and informed consent for any purpose related to their powers and duties. 69 Atty. Gen. 273. Officers, employees, and directors of public or private entities that furnish “human services” to a county may not be appointed to the board under sub. (4) (a); this provision does not extend to family members of “human services” providers. 80 Atty. Gen. 30. Because there is no explicit statutory authority for county human services departments to accept gifts, the statutory scheme contemplates that gifts, grants, and donations to a county human services department created under this section may be accepted only by the county board of supervisors. OAG 1-08.
46.234 Recovery residences; registration. (1) DEFINITION. In this section, “recovery residence” means a home-like, residential environment that promotes healthy recovery from a substance use disorder and supports persons recovering from a substance use disorder through the use of peer recovery support. (2) REGISTRATION. The department shall establish and maintain a registry of approved recovery residences. Subject to sub. (3), the department shall approve a recovery residence for inclusion in the registry if the recovery residence requests registration from the department and agrees to do or does all of the following: (a) Operate with integrity, uphold residents’ rights, create a culture of empowerment where residents engage in governance and leadership, and develop abilities to apply the social model form of recovery that focuses on learning from the experiences of peers who are also in recovery. (b) Provide a home-like, safe, and healthy environment. (c) Facilitate active recovery and recovery community engagement, model positive social behaviors and relationship enhancement skills, and cultivate residents’ senses of belonging and responsibility toward community. (d) Maintain an environment in the residence free from alcohol and illicit drugs. (e) Have courtesy rules for residents and be responsive to concerns of neighbors to the residence. (f) Display in the residence the code of ethics, grievance procedure, and grievance contact information. (3) ACCEPTANCE OF MEDICATION-ASSISTED TREATMENT. Beginning on April 1, 2022, the department may not include a re-
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covery residence in the registry if the recovery residence excludes any resident solely on the basis that the resident is participating in medication-assisted treatment. (4) REGISTRATION REQUIRED FOR REFERRALS OR FUNDING. A recovery residence is not required to register with the department unless the recovery residence seeks referrals under sub. (5) or state or federal funds passing through the state treasury. (5) REFERRALS. Upon request for referrals to recovery residences, the department shall provide a list of recovery residences that are included on the registry under sub. (2). The department may limit the list of registered recovery residences provided under this subsection based on the geographical and other preferences specified by the person requesting referrals. (6) USE OF REGISTERED DESIGNATION. A recovery residence may not use the designation of or hold itself out as “registered” or “state approved” unless the recovery residence is included in the registry under sub. (2). (7) INFORMATION REQUIRED. The recovery residence shall provide at the time of its request for registration for the purpose of inclusion on the registry all of the following information: (a) The name of any organization that has certified the recovery residence. (b) The name of any organization under which the recovery residence operates. (c) The address of the recovery residence. (d) The number of residents allowed to reside at the recovery residence. (8) REVOCATION OF REGISTRATION. The department shall revoke the registration of a recovery residence if the recovery residence ceases to meet the criteria under sub. (2). History: 2019 a. 120.
46.238 Infants and unborn children whose mothers abuse controlled substances, controlled substance analogs, or alcohol. If an agency, as defined in s. 48.981 (1) (ag), receives a report under s. 146.0255 (2) or 146.0257 (2) and that agency is a county department under s. 46.22 or 46.23 or a licensed child welfare agency under contract with that county department, the agency shall offer to provide appropriate services and treatment to the infant and the infant’s mother or to the unborn child, as defined in s. 48.02 (19), and the expectant mother of the unborn child or the agency shall make arrangements for the provision of appropriate services and treatment. If an agency receives a report under s. 146.0255 (2) or 146.0257 (2) and that agency is the department or a licensed child welfare agency under contract with the department, the agency shall refer the report to the county department under s. 51.42 or 51.437 and that county department shall offer to provide, or make arrangements for the provision of, those services and that treatment. History: 1989 a. 122; 1993 a. 16; 1995 a. 386, 448; 1997 a. 27, 292; 2009 a. 79; 2013 a. 260.
46.245 Information for certain pregnant women. Upon request, a county department under s. 46.215, 46.22 or 46.23 shall distribute the materials described under s. 253.10 (3) (d), as prepared and distributed by the department. A physician who intends to perform or induce an abortion or another qualified physician, as defined in s. 253.10 (2) (g), who reasonably believes that he or she might have a patient for whom the information under s. 253.10 (3) (d) is required to be given, shall request a reasonably adequate number of the materials from the county department under this section or from the department under s. 253.10 (3) (d). An individual may request a reasonably adequate number of the materials. History: 1985 a. 56, 176; 1993 a. 27; 1995 a. 309; 1997 a. 27.
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46.248 Reach Out and Read Wisconsin grants. From the appropriation under s. 20.435 (1) (dx), the department shall distribute moneys to Reach Out and Read, Inc., for the early literacy program known as Reach Out and Read Wisconsin. History: 2021 a. 58.
46.269 Determining financial eligibility for long-term care programs. To the extent approved by the federal government, the department or its designee shall exclude any assets accumulated in a person’s independence account, as defined in s. 49.472 (1) (c), and any income or assets from retirement benefits earned or accumulated from income or employer contributions while employed and receiving medical assistance under s. 49.472 in determining financial eligibility and cost-sharing requirements, if any, for a long-term care program under s. 46.275 or 46.277, for the family care program that provides the benefit defined in s. 46.2805 (4), for the Family Care Partnership program, or for the self-directed services option, as defined in s. 46.2897 (1). History: 2017 a. 59; 2019 a. 9.
46.271 Long-term support pilot projects. (1) (a) From the appropriation under s. 20.435 (4) (bd), the department shall award $100,000 in each fiscal year to applying county departments under s. 46.215, 46.22, 46.23, 51.42 or 51.437 or to an aging unit under the conditions specified in par. (c) to establish pilot projects for home and community-based long-term support services. Funds awarded to the pilot projects shall be used to do any of the following: 1. Provide administration for projects that serve individuals who are discharged from hospitals and meet one of the eligibility requirements under [s. 46.27 (6r) (b) 1. to 4.]. NOTE: The cross-reference in brackets does not exist. 2019 Wis. Act 9 repealed s. 46.27.
2. Promote the development of a system of home and community-based long-term support services that is easily accessible to individuals who are eligible for and potentially need these services. (b) The department shall do all of the following: 1. Solicit applications from county departments or aging units for the pilot projects under par. (a). 2. Require that an applying county department or aging unit under subd. 1. submit as part of the application specific plans for improving the coordination between hospitals and providers of home and community-based long-term support services. (c) The department may contract with an aging unit, as defined in s. 46.82 (1) (a), for administration of services under par. (a) if, by resolution, the county board of supervisors of that county so requests the department. History: 1989 a. 31, 336; 1991 a. 39, 235; 1993 a. 16; 1997 a. 27; 1999 a. 9; 2015 a. 55; 2019 a. 9.
46.272 Children’s community options program. (1) DEFINITIONS. In this section: (a) “Child” means a person under 22 years of age who is not eligible to receive services in or on a waiting list for an adult longterm care program. (b) “Disability” means a severe physical, developmental, or emotional impairment which is diagnosed medically, behaviorally, or psychologically, which is characterized by the need for individually planned and coordinated care, treatment, vocational rehabilitation, or other services and which has resulted or is likely to result in substantial limitation on the ability to function in at least 2 of the following areas, equivalent to nursing home, hospital, or institution for mental disease level of care: 1. Self-care. 2. Receptive and expressive language.
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3. Learning. 4. Mobility. 5. Self-direction. (c) “Hospital” has the meaning provided in s. 50.33 (2). (d) “Institutional setting” means a nursing home, as defined in s. 50.01 (3), a state-operated long-term care facility, or any other residential facility that provides long-term care to children outside of a home. (e) “Residence” means the voluntary concurrence of physical presence with intent to remain in a place of fixed habitation. Physical presence shall be prima facie evidence of intent to remain. (f) “State-operated long-term care facility” means a state center for the developmentally disabled and a Wisconsin veterans home operated by the department of veterans affairs under s. 45.50. (g) “Voluntary” means according to an individual’s free choice, if competent, or by choice of his or her parent or guardian, if the individual is adjudicated incompetent or is a minor. (2) DEPARTMENTAL DUTIES. The department shall do all of the following to establish a children’s community options program: (a) Review and approve or disapprove the selection of a county department to administer the children’s community options program. (b) In consultation with representatives of counties; programs that provide community-based services to children or families, other publicly funded programs, and the social services, mental health, and developmental disabilities programs under ss. 46.495, 51.42, and 51.437; the independent living center program under s. 46.96; and the Medical Assistance program under subch. IV of ch. 49; and with recipients of children’s community support services, develop guidelines for implementing the program and criteria for reviewing community options plans from counties participating in the program under this section. The guidelines and criteria shall address cost-effectiveness, scope, feasibility and impact on the quality and appropriateness of health services and social services and shall provide counties with maximum flexibility to develop programs that address local needs. (c) Review and approve or disapprove the community options plan of each county participating in the children’s community options program. (d) Require that a county, by use of a form provided by the department or other appropriate procedure, ensure that persons receiving services under this section meet the eligibility requirements for the children’s community options program. (e) Periodically monitor the implementation of the children’s community options program. (f) Review and approve or disapprove the terms of risk reserve escrow accounts created under sub. (13) (f) and approve or disapprove disbursements for administrative or staff costs from the risk reserve escrow accounts. (4) DUTIES OF PARTICIPATING COUNTY DEPARTMENTS. Each participating county department shall do all of the following: (a) Appoint members to an advisory committee or appoint an existing committee in the service area as the children’s community options advisory committee to assist in developing the program plan and to monitor the program. The committee shall include, but need not be limited to, the following members: 1. Parents of children with disabilities including, if possible, parents from families that participate in the children’s community options program. To the maximum extent possible, the parents shall be representative of the various disability, racial, and ethnic groups in the service area. The members specified under this
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subdivision shall constitute a majority of the membership of the committee. 2. Persons from the service area representing the county department under s. 46.23, 51.42, or 51.437 and the county department under s. 46.215 or 46.22, school districts, and local health departments, as defined in s. 250.01 (4). At least one of the committee members selected under this subdivision shall be a person providing community social services to children with disabilities who are eligible for the program. 3. Persons in the service area who provide social or educational services to children who have disabilities other than the providers specified in subd. 2. (b) Cooperate with the committee appointed under par. (a) to prepare a program plan. The program plan shall include all of the following: 1. A description of the proposed program operations. 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 funding. 4. A description of the outreach procedures that will be used to ensure that the program will be made available to children with physical, emotional, and developmental disabilities. 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 monitoring of service plans and for coordinating the provision of services and goods to participating families. 7. A description of the methods that will be used to promote the creation of informal support and advocacy systems for families. 8. A description of the method that will be used to monitor the children’s community options program. (c) Submit the proposed program plan to the department upon approval by the children’s community options program advisory committee. (d) Administer the program or contract with a human service agency in the service area to administer the program within the limits of state and federal funds under subs. (13) and (14). (e) In conjunction with the county department under s. 46.215 or 46.22, if any, in the service area and with the administering agency, if it is not the county department under s. 46.23, 51.42, or 51.437, coordinate the administration of the program with the administration of other publicly funded programs that serve children who have disabilities. (f) Submit all information and reports required by the department. (5) POWERS AND DUTIES OF A PRIVATE NONPROFIT AGENCY. The department may contract with a private nonprofit agency for services under this section. The agency shall have the powers and duties under this section of a county department designated to administer the program. (6) DUTIES OF COUNTIES OR AGENCIES. Each county or each agency under contract under sub. (5) 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 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 family.
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(7) COUNTY DEPARTMENT DUTIES. The county department selected to administer the children’s community options program shall: (a) Organize assessment activities specified in par. (f) and sub. (8). The county department shall utilize persons for each assessment who can determine the needs of the child being assessed and who know the availability within the county of services. The county department shall coordinate the involvement of representatives from the county departments under ss. 46.215, 46.22, 51.42 and 51.437, and health service providers in the assessment activities specified in sub. (8), as well as the child being assessed and members of the child’s family or the child’s guardian. (b) Within the limits of state and federal funds allocated under sub. (13), arrange service contracts under s. 46.036 and ensure the provision of necessary long-term community support services for each child who meets the criteria for services under the children’s community options program. (c) Within the limits of state and federal funds allocated under sub. (13), provide for ongoing care management services in accordance with the requirements established under sub. (10) (b) 1., periodic case plan review and follow-up services for any child receiving community support services under the children’s community options program. (d) Determine, under sub. (9), the fee, if any, for all families or guardians of children who meet the criteria to receive services and are applying for or receiving 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 services under this section for which the child or his or her parent or guardian receives direct funding, serve directly as a fiscal agent or contract with a fiscal intermediary to serve as a fiscal agent for that child for the purposes of performing the responsibilities and protecting the interests of the individual under the unemployment insurance law. The county department may elect to act as a fiscal agent or contract with a fiscal intermediary to serve as a fiscal agent for a child who is provided long-term community support services under s. 46.275, 46.277, 46.278, 46.2785, 46.495, 51.42, or 51.437. The fiscal agent under this paragraph is responsible for remitting any federal unemployment compensation taxes or state unemployment insurance contributions owed by the child, including any interest and penalties which are owed by the child; for serving as the representative of the child in any investigation, meeting, hearing, or appeal involving ch. 108 or the federal unemployment tax act (26 USC 3301 to 3311) in which the child is a party; and for receiving, reviewing, completing, and returning all forms, reports, and other documents required under ch. 108 or the federal unemployment tax act on behalf of 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 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 established by the department for children in all longterm care programs. (8) ASSESSMENTS. Within the limits of state and federal funds allocated under sub. (13) and within the limits of fees collected, an assessment shall be conducted for any child with a disability who is seeking services in the program. (9) FINANCIAL ELIGIBILITY AND FEES. (a) The department shall create a sliding scale formula for a fee chargeable for conduct of an assessment under sub. (8), for development of a case plan, and for children’s long-term community support services
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that is based on the child’s ability to pay, unless prohibited from payment under the federal Medicaid law. (b) The county department selected to administer the program shall require all children or their parents or guardians applying for children’s long-term community support services at the time of application and all children receiving the services that 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 special needs or disability of the child for whom the application is made or services are provided. (c) From the information obtained under par. (b), the county department shall determine the amount of the fee for receipt of children’s long-term community support services under this section. The county department shall require payment by the child or parent or guardian of the child of 100 percent of the amount calculated under this paragraph. (d) The county department shall use funds received under par. (c) to pay for long-term community support services for children who are eligible for services under the children’s community options program. (10) SERVICES; CARE MANAGEMENT REQUIREMENTS. (a) 1. Within the limits of state and federal funds allocated under sub. (13) and within the limits of fees collected, the department shall reimburse, if applicable, and the county department or private nonprofit agency shall provide long-term community support services to eligible children who have a disability. 2. The department may not reimburse and the county department or private nonprofit agency may not pay for room and board for children under the children’s community options program. (b) The department, after consulting with representatives of counties, hospitals, and individuals who receive services under the children’s community options program under this section, shall do all of the following: 1. Establish minimum requirements for the provision of care management services, as defined by the department, including standards for care, times for performance of duties, and size of case loads. 2. Specify a reasonable schedule for phasing in the requirements established under subd. 1. 3. Provide technical consultation and assistance to the administrator of the program with respect to the requirements established under subd. 1. (c) The department need not promulgate as rules under ch. 227 the requirements under par. (b) 1. or the schedule under par. (b) 2. (11) FISCAL RESPONSIBILITY. Except as provided in s. 51.40, and within the 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 specified under s. 46.284 (2), case plan, or services provided to a child under this section is as follows: (a) For a child seeking admission to or about to be admitted to an institutional setting, the county in which the child has residence is the county of fiscal responsibility. (b) For a child residing in an institutional setting, except a state-operated long-term care facility, the county in which the institution is located is the county of fiscal responsibility. (c) For a child living in an institutional setting, except a stateoperated long-term care facility, whose legal residence is established in another county, the county in which the legal residence is established is the county of fiscal responsibility.
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(d) For a child residing in a state-operated long-term care facility, or for a person protectively placed under ch. 55, the county in which the child has residence before he or she enters the stateoperated long-term care facility or is protectively placed is the county of fiscal responsibility. (12) REIMBURSEMENT DISALLOWANCES. The department may disallow reimbursement under this section for services provided to children who do not meet the eligibility requirements for the children’s community options program or any other eligibility requirements established by the department. (13) FUNDING. (a) Subject to pars. (b) and (h), from the appropriation under s. 20.435 (4) (bd), the department shall allocate funds to each county or private nonprofit agency with which the department contracts for all of the following purposes: 1. To pay assessment and case plan costs not otherwise paid by fee or under s. 49.45 or 49.78 (2). The department shall reimburse multicounty consortia for the cost of assessing children eligible for medical assistance under s. 49.46, 49.468, 49.47, or 49.471 (4) (a) as part of the administrative services of medical assistance, payable under s. 49.45 (3) (a). Counties may use unspent funds allocated under this subdivision to pay the cost of long-term community support services and for a risk reserve under par. (f). 2. To pay the cost of providing long-term community support services described under sub. (7) (b) not otherwise paid under s. 49.45 to children eligible for medical assistance under s. 49.46, 49.47, or 49.471 (4) (a). The county department administering the program may spend funds received under this paragraph only in accordance with the case plan and service contract created for each child receiving long-term community support services. Counties may use unspent funds allocated under this subdivision from the appropriation under s. 20.435 (4) (bd) for a risk 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 approving the county’s community options plan. 3. No county may use funds received under par. (a) 2. to pay for long-term community support services provided to any child who resides in a nursing home, unless the department waives this restriction on use of funds and the services are provided in accordance with a discharge plan. 4. No county may use funds received under this section to purchase land or construct buildings. (c) The department may release funds to counties acting jointly, if the counties sign a contract approved by the secretary that explains the plans for joint sponsorship. (d) If the department determines that a county demonstrates a pattern of failure to serve clients whose cost of care significantly exceeds the average cost of care for children’s long-term community support services provided under this section, the department may require that county to reserve a portion of funds allocated under this subsection for provision of service to those clients. (e) The department shall, at the request of a county, carry forward up to 5 percent of the amount allocated under this subsection to the county for a calendar year if up to 5 percent of the amount so allocated has not been spent or encumbered by the county by December 31 of that year, for use by the county in the following calendar year, except that the amount carried forward shall be reduced by the amount of funds that the county has notified the department that the county wishes to place in a risk reserve under par. (f). The department may transfer funds within s. 20.435 (4) (bd) to accomplish this purpose. An allocation under this paragraph does not affect a county’s base allocation under
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this subsection and shall lapse to the general fund unless expended within the calendar year to which the funds are carried forward. A county may not expend funds carried forward under this paragraph for administrative or staff costs, except administrative or staff costs that are associated with implementation of the waiver under sub. (14) and approved by the department. (f) 1. Notwithstanding s. 46.036 (3) and (5m), a county may place in a risk reserve funds that are allocated under par. (a) or sub. (14) (b) 1. and are not expended 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. The county shall maintain the risk reserve in an interest-bearing escrow account with a financial institution, as defined in s. 69.30 (1) (b), if the department has approved the terms of the escrow. All interest from the principal shall be reinvested in the escrow account. 2. The annual amount of a county’s expenditure for a risk reserve, as specified in subd. 1., may not exceed 10 percent of the county’s most recent allocation under par. (a) and sub. (14) (b) 1. or $750,000, whichever is less. The total amount of the risk reserve, including interest, may not exceed 15 percent of the county’s most recent allocation under this subsection. 3. A county may expend funds maintained in a risk reserve, as specified in subd. 1., for any of the following purposes: a. To defray costs of children’s long-term community support services under this section. b. If approved by the department, for administrative or staff costs under this section. 4. A county that maintains a risk reserve, as specified in subd. 1., shall annually, on a form prescribed by the department, submit to the department a record of the status of the risk reserve, including revenues and disbursements. (g) The department may carry forward to the next state fiscal year funds allocated under this subsection and not encumbered by counties by December 31 or carried forward under par. (e). The department may transfer moneys within s. 20.435 (4) (bd) to accomplish this purpose. An allocation under this paragraph shall not affect a county’s base allocation for the program. The department may allocate 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 significantly exceeds the average cost of care provided under this section, including 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 state and federal funds or any county funds that are currently being provided under any program to a family whose child is receiving services through the children’s community options program. (14) MEDICAL ASSISTANCE WAIVER. (a) The department may request a waiver from the federal department of health and human services authorizing the department to provide as part of the Medical Assistance program services for persons who are eligible for children’s long-term support community options program services under sub. (7) (b). (b) 1. Medical assistance reimbursement for services a county or a private nonprofit agency with which the department contracts provides under this subsection shall be made from the appropriations under s. 20.435 (4) (bd) and (o) and (7) (b). Pay-
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ments made under sub. (13) (a) may be used as the state share for purposes of Medical Assistance reimbursement. 3. The department may contract for services under this subsection with a county or a private nonprofit agency. 4. No county or private nonprofit agency may use funds received under this 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 in a group home that has 6 to 8 beds. (c) If a county department or private nonprofit agency providing services under this subsection is certified under s. 49.45 (37) (a), the waiver under s. 49.45 (37), if in effect, applies to plans of care for children receiving services under this subsection. (15) RIGHT TO HEARING. A child who is denied eligibility for services or whose services are reduced or terminated under this section may request a hearing from the department under s. 227.44, except that lack of adequate funding may not serve as the basis for a request under this subsection. History: 2015 a. 55; 2017 a. 365 s. 111; 2017 a. 366.
46.275 Community integration program for residents of state centers. (1) LEGISLATIVE INTENT. The intent of the program under this section is to relocate persons from the state centers for the developmentally disabled into appropriate community settings with the assistance of home and communitybased services and with continuity of care. The intent of the program is also to minimize its impact on state employees through redeployment of employees into vacant positions. (1m) DEFINITIONS. In this section: (a) “Medical assistance” means aid provided under subch. IV of ch. 49, except ss. 49.468 and 49.471. (b) “Program” means the community integration program for residents of state centers for the developmentally disabled, for which a waiver has been received under sub. (2). (2) DEPARTMENTAL POWERS AND DUTIES. The department may request a waiver from the secretary of the U.S. department of health and human services, under 42 USC 1396n (c), authorizing the department to integrate medical assistance recipients who reside in state centers for the developmentally disabled into their communities by providing home and community-based services as part of the medical assistance program. If the department requests this waiver, it shall include all assurances required under 42 USC 1396n (c) (2) in its request. If the department receives this waiver, at the end of the 3-year period during which the waiver remains in effect the department may request an additional 3-year extension of the waiver. If the department receives this waiver, it shall: (a) Annually submit to the secretary of the U.S. department of health and human services information showing the effect of the program on medical assistance costs and on the health and welfare of program participants. (b) Evaluate the effect of the program on medical assistance costs and on the program’s ability to provide community care alternatives to institutional care in state centers for the developmentally disabled. (c) Fund home or community-based services provided by any county or by the department that meet the requirements of this section. (d) Unless s. 49.45 (37) applies, review and approve or disapprove each plan of care developed under sub. (3) (c) 2. (e) Submit to the governor and to the chief clerk of each house of the legislature, for distribution to appropriate legislative standing committees under s. 13.172 (3), annual progress reports on the program plus any other information requested. (3) COUNTY PARTICIPATION. (a) Any county may participate
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in the program, if it meets the conditions specified in this subsection and the requirements established by the department, including requirements concerning the qualifications and levels of staff for home or community-based service providers. (b) The board of supervisors of any county that participates in the program shall designate one of the following county departments to administer the program, subject to departmental review and approval: 2. A county department under s. 51.42 to which the powers and duties of a county department under s. 51.437 have been transferred under s. 51.437 (4g) (b). 3. A county department under s. 46.23. 4. A county department under s. 51.437. (c) Any county participating in the program shall inform the persons eligible for program services under sub. (4) that home and community-based services are available, at their choosing, in place of institutional care. Services provided under this section shall meet the following conditions: 1. The services substitute for care provided at a state center for the developmentally disabled. 2. The services are provided to each recipient under a written plan of care designed for that recipient and, unless s. 49.45 (37) applies, approved by the department. (d) Any county participating in the program shall provide case management services, including the responsibility for locating, coordinating and monitoring all services and informal supports needed by eligible persons and their families. (3g) DUTIES OF THE DEPARTMENT. The department shall provide fair and equitable arrangements to protect the interests of all state employees affected by the program, including arrangements designed to preserve employee rights and benefits. (3r) RELOCATION BY THE DEPARTMENT. (a) The department may, without county participation under sub. (3) or county reimbursement under sub. (5) (a), relocate a person eligible for program services under sub. (4) from a state center for the developmentally disabled into a community setting in any of the following situations: 1. The person’s county of residence when the person entered the state center for the developmentally disabled cannot be determined with reasonable certainty. 2. The person’s county of residence when the person entered the state center for the developmentally disabled is not participating, under sub. (3), in the program. 3. The person will be relocated into the home of the person’s parent or guardian and will be receiving state monitoring of the relocation and services provided by a public or private school or a tribal school, as defined in s. 115.001 (15m). (b) If the department relocates a person under this subsection, it shall comply with the requirements imposed on counties under sub. (3) (c) and (d). (c) Prior to relocating a person under this subsection, the department shall ensure delivery of any necessary education, habilitation, vocational, medical and therapy services through contracting with community-based service providers. If any service is not available, the department may provide it directly. (4) ELIGIBILITY OF RECIPIENTS. (a) Any medical assistance recipient living in a state center for the developmentally disabled is eligible to participate in the program. Such a recipient may apply, or any person may apply on behalf of such a recipient, for participation in the program. (b) The department in conjunction with the county shall review any application for participation in the program as to eligibility and the appropriateness of planned services. The county department administering the program for the county in which
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the medical assistance recipient resides shall review any application for participation in the program as to eligibility, except applications for relocation under sub. (3r). No person may participate in the program unless all of the following occur: 1. Consent for participation is given either by the person’s parent, guardian or legal custodian, if the person is under age 18, or by the person or the person’s guardian, if the person is age 18 or over, except that this subdivision does not limit the authority of the circuit court to enter, change, revise or extend a dispositional order under subch. VI of ch. 48 or subch. VI of ch. 938 or to order a protective placement or protective services under s. 55.12. 2. The county, or the department under sub. (3r), agrees to provide services to the person. 3. The department determines that available home or community-based services are appropriate for that person. (c) 1. Except as provided in subd. 2., if a resident of a state center for the developmentally disabled is relocated in order to receive home or community-based services under the program, the center may not accept a patient to fill the bed left vacant by the person leaving. 2. If a person who has been relocated from a state center for the developmentally disabled under this program seeks to return to the center within 365 days after relocating because the person or the county department administering the program, or the department under sub. (3r), finds that the services available are inappropriate, the center shall accept the person as a patient to fill the bed that the person vacated. After this 365-day period, the person may only be readmitted into a bed not left vacant because of relocation under this section. (f) To the extent provided in 42 USC 1396n, if a person who has been relocated from a state center for the developmentally disabled under this program discontinues participating in the program for any reason other than institutional placement, the department may reallocate on a case-by-case basis the funding within the relocating county to another medical assistance recipient who is developmentally disabled and who, but for this program, would require the level of care provided in a state center for the developmentally disabled. (4m) WORKER’S COMPENSATION COVERAGE. An individual who is performing services for a person receiving long-term care benefits under this section on a self-directed basis 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. (5) FUNDING. (a) Medical Assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriation accounts under s. 20.435 (4) (b), (gm), (o), and (w). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, Medical Assistance reimbursement is also available for services provided jointly by these counties. (b) No county, or the department under sub. (3r), may use funds received under this section to do any of the following: 1. Purchase land or construct buildings. 2. Reduce federal, state or county matching expenditures for long-term community support services provided to any person as part of this program from funds allocated under s. 46.495 (1) (d), 46.80 (5), 46.85 (3m) (b) 1. and 2. or 51.423, as indicated in the county’s budget or by actual expenditures. 3. Provide room and board, except for respite care. 4. Provide services, except respite care that is approved by the department, within a skilled nursing facility, intermediate care facility or intermediate care facility for persons with an intel-
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lectual disability, as defined in s. 46.278 (1m) (am), including a state center for the developmentally disabled. 5. Provide residential services in any community-based residential facility, as defined in s. 50.01 (1g), or group home, as defined in s. 48.02 (7) that has more than 8 beds. 6. Provide services to a recipient that are not specified in the recipient’s written plan of care. 7. Provide services in any community-based residential facility unless the county or department uses as a service contract the approved model contract developed under s. 46.27 (2) (j), 2017 stats., or a contract that includes all of the provisions of the approved model contract. (c) The total allocation under s. 20.435 (4) (b), (gm), (o), and (w) to counties and to the department under sub. (3r) for services provided under this section may not exceed the amount approved by the federal department of health and human services. A county may use funds received under this section only to provide services to persons who meet the requirements under sub. (4) and may not use unexpended funds received under this section to serve other developmentally disabled persons residing in the county. (d) The department may, from the appropriation under s. 20.435 (4) (o), provide reimbursement for services provided under this section by counties that are in excess of the current average annual per person rate, as established by the department, and are less than the average amount approved in the waiver received under sub. (2). (e) From the appropriation under s. 20.435 (2) (gL), the department may provide moneys to a county to pay for one-time costs associated with the relocation under this section of an individual from a state center for the developmentally disabled. (5m) REPORT. By March 1 of each year, the department shall submit a report to the joint committee on finance and to the chief clerk of each house of the legislature, for distribution to the appropriate standing committees under s. 13.172 (3), describing the program’s impact during the preceding calendar year on state employees, including the department’s efforts to redeploy employees into vacant positions and the number of employees laid off. (6) EFFECTIVE PERIOD. This section takes effect on the date approved by the secretary of the U.S. department of health and human services as the beginning date of the period of waiver received under sub. (2). This section remains in effect for 3 years following that date and, if the secretary of the U.S. department of health and human services approves a waiver extension, shall continue an additional 3 years. History: 1983 a. 27; 1985 a. 29 ss. 896b to 896L, 3202 (23); 1985 a. 120, 176; 1987 a. 27; 1987 a. 161 s. 13m; 1987 a. 186; 1989 a. 31; 1993 a. 16; 1995 a. 27, 77; 1997 a. 27, 114; 1999 a. 9; 2001 a. 16; 2003 a. 33, 318; 2005 a. 25, 264; 2007 a. 20, 153; 2009 a. 2, 302; 2011 a. 32, 126; 2015 a. 180; 2019 a. 9; 2021 a. 232, 239. The circuit court that protectively placed an incompetent person in a center for the developmentally disabled, and not the person’s parent or guardian, has the ultimate authority under state and federal law to determine whether the person should remain institutionalized or receive home or community based services. OAG 3-97.
46.277 Community integration program for persons relocated or meeting reimbursable levels of care. (1) LEGISLATIVE INTENT. The intent of the program under this section is to provide home or community-based care to serve in a noninstitutional community setting a person who meets eligibility requirements under 42 USC 1396n (c) and is relocated from an institution other than a state center for the developmentally disabled or meets the level of care requirements for medical assistance reimbursement in a skilled nursing facility or an intermediate care facility, except that the number of persons who receive home or community-based care under this section is not intended to exceed the number of nursing home beds that are delicensed as part of a plan submitted by the facility and approved by the department. The intent of the program is also that counties use all
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existing services for providing care under this section, including those services currently provided by counties. (1m) DEFINITIONS. In this section: (a) “Medical assistance” means aid provided under subch. IV of ch. 49, except ss. 49.468 and 49.471. (ag) “Delicensed” means deducted from the number of beds stated on a facility’s license, as specified under s. 50.03 (4) (e). (am) “Plan submitted by the facility” means an individual relocation plan under s. 50.03 (14). (at) “Private nonprofit agency” means a nonprofit corporation, as defined in s. 181.0103 (17), that provides a program of all-inclusive care for the elderly under 42 USC 1395eee or 1396u4. (b) “Program” means the community integration program for which a waiver has been received under sub. (2). (2) DEPARTMENTAL POWERS AND DUTIES. The department may request a waiver from the secretary of the federal department of health and human services, under 42 USC 1396n (c), authorizing the department to serve medical assistance recipients, who meet the level of care requirements for medical assistance reimbursement in a skilled nursing facility or an intermediate care facility, in their communities by providing home or communitybased services as part of medical assistance. The number of persons for whom the waiver is requested may not exceed the number of nursing home beds that are delicensed as part of a plan submitted by the facility and approved by the department. If the department requests a waiver, it shall include all assurances required under 42 USC 1396n (c) (2) in its request. If the department receives this waiver, it may request one or more 3-year extensions of the waiver under 42 USC 1396n (c) and shall perform the following duties: (a) Evaluate the effect of the program on medical assistance costs and on the program’s ability to provide community care alternatives to institutional care in facilities certified as medical assistance providers. (b) Fund home or community-based services provided by any county that meet the requirements of this section. (c) To the maximum extent possible, authorize the provision of services under this section to serve persons, except those institutionalized in a state center for the developmentally disabled, in noninstitutional settings and coordinate application of the review criterion under s. 150.39 (5) with the services provided under this section. (d) Unless s. 49.45 (37) applies, review and approve or disapprove each plan of care developed by the county department under sub. (3). (e) Review and approve or disapprove waiver requests under sub. (3) (c), review and approve or disapprove requests for exceptions under sub. (5) (d) 3. and provide technical assistance to a county that reaches or exceeds the annual allocation limit specified in sub. (3) (c) in order to explore alternative methods of providing long-term community support services for persons who are in group living arrangements in that county. (3) COUNTY PARTICIPATION. (a) Section 46.275 (3) (a), (c), and (d) applies to county participation in this program, except that services provided in the program shall substitute for care provided a person in a skilled nursing facility or intermediate care facility who meets the level of care requirements for medical assistance reimbursement to that facility rather than for care provided at a state center for the developmentally disabled. The number of persons who receive services provided by the program under this paragraph may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as
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part of a plan submitted by the facility and approved by the department. (b) 1. If the provision of services under this section results in a decrease in the statewide nursing home bed limit under s. 150.31 (3), the facility affected by the decrease shall submit a plan for delicensing all or part of the facility that is approved by the department. 2. Each county department participating in the program shall provide home or community-based care to persons eligible under this section, except that the number of persons who receive home or community-based care under this section may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and approved by the department. (c) Beginning on January 1, 1996, from the annual allocation to the county for the provision of long-term community support services under sub. (5), annually establish a maximum total amount that may be encumbered in a calendar year for services for eligible individuals in community-based residential facilities. (d) The county department or aging unit that administers the program under this section shall, within the time period specified by the department, offer counseling, that is specified by the department, concerning public and private benefit programs to prospective residents of community-based residential facilities who are referred to the county department or aging unit under s. 50.035 (4n). (3m) PARTICIPATION BY A PRIVATE NONPROFIT AGENCY. A private nonprofit agency with which the department contracts for service under sub. (5) (c) shall have the powers and duties under this section of a county department, as specified in sub. (3) (a). (3r) WORKER’S COMPENSATION COVERAGE. An individual who is performing services for a person receiving long-term care benefits under this section on a self-directed basis 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. (4) ELIGIBILITY OF RESIDENTS. (a) Any medical assistance recipient who meets the level of care requirements for medical assistance reimbursement in a skilled nursing facility or intermediate care facility is eligible to participate in the program, except that the number of participants may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and approved by the department. Such a recipient may apply, or any person may apply on behalf of such a recipient, for participation in the program. Section 46.275 (4) (b) applies to participation in the program. (b) To the extent authorized under 42 USC 1396n, if a person discontinues participation in the program, a medical assistance recipient may participate in the program in place of the participant who discontinues if that recipient meets the level of care requirements for medical assistance reimbursement in a skilled nursing facility or intermediate care facility, except that the number of participants may not exceed the number of nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted by the facility and approved by the department. (5) FUNDING. (a) The provisions of s. 46.275 (5) (a), (b) 1. to 4. and 6. and (d) apply to funding received by counties under the program. (b) Total funding to counties under the program may not exceed the amount approved in the waiver received under sub. (2). (c) The department may contract for services under this section with a private nonprofit agency. Paragraphs (a) and (b) apply
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to funding received by a private nonprofit agency under this subsection. (d) 1. In this paragraph, “physically disabled” means having a condition that affects one’s physical functioning by limiting mobility or the ability to see or hear, that is the result of injury, disease or congenital deficiency and that significantly interferes with or limits at least one major life activity and the performance of one’s major personal or social roles. 1m. No county may use funds received under this section to provide services to a person who does not live in his or her own home or apartment unless, subject to the limitations under subds. 2., 3., and 4. and par. (e), one of the following applies: a. The services are provided to the person in a communitybased residential facility that entirely consists of independent apartments, each of which has an individual lockable independent entrance and exit and individual separate kitchen, bathroom, sleeping and living areas. b. The person suffers from Alzheimer’s disease or related dementia and the services are provided to the person in a community-based residential facility that has a dementia care program. c. The services are provided to the person in a residential care apartment complex, as defined in s. 50.01 (6d). d. The services are provided to the individual in an adult family home, as defined in s. 50.01 (1). e. Subdivision 1n. applies. 1n. A county may also use funds received under this section, subject to the limitations under subds. 2., 3., and 4. and par. (e), to provide services to a person who does not live in his or her own home or apartment if the services are provided to the person in a community-based residential facility and the county department or aging unit has determined that all of the following conditions have been met: b. The county department or aging unit documents that the option of in-home services has been discussed with the person, thoroughly evaluated and found to be infeasible, as determined by the county department or aging unit in accordance with rules promulgated by the department of health services. c. The county department or aging unit determines that the community-based residential facility is the person’s preferred place of residence or is the setting preferred by the person’s guardian. d. The county department or aging unit determines that the community-based residential facility provides a quality environment and quality care services. e. The county department or aging unit determines that placement in the community-based residential facility is cost-effective compared to other options, including home care and nursing home care. 1p. a. Subject to the approval of the department, a county may establish and implement more restrictive conditions than those imposed under subd. 1m. on the use of funds received under this section for the provision of services to a person in a community-based residential facility. A county that establishes more restrictive conditions under this subd. 1p. a. shall include the conditions in its plan under sub. (3) (a). b. If the department determines that a county has engaged in a pattern of inappropriate use of funds received under this section, the department may revoke its approval of the county’s conditions established under subd. 1p. a., if any, and may prohibit the county from using funds received under this section to provide services under subd. 1n. 2. No county may use funds received under this section to provide residential services in any community-based residential facility, as defined in s. 50.01 (1g), unless the department ap-
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proves the provision of services in a community-based residential facility that entirely consists of independent apartments, each of which has an individual lockable entrance and exit and individual separate kitchen, bathroom, sleeping and living areas, to individuals who are eligible under this section and are physically disabled or are at least 65 years of age. 3. If subd. 2. applies, no county may use funds received under this section to pay for services provided to a person who resides or intends to reside in a community-based residential facility and who is initially applying for the services, if the projected cost of services for the person, plus the cost of services for existing participants, would cause the county to exceed the limitation under sub. (3) (c). The department may grant an exception to the requirement under this subdivision, under the conditions specified by rule, to avoid hardship to the person. 4. No county may use funds received under this section 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 in a group home that has 6 to 8 beds. (e) A county may use funds received under this subsection to provide supportive, personal or nursing services, as defined in rules promulgated under s. 49.45 (2) (a) 23., to a person who resides in a certified residential care apartment complex, as defined in s. 50.01 (6d). Funding of the services may not exceed 85 percent of the statewide medical assistance daily cost of nursing home care, as determined by the department. (f) No county or private nonprofit agency may use funds received under this subsection to provide services in any community-based residential facility unless the county or agency uses as a service contract the approved model contract developed under s. 46.27 (2) (j), 2017 stats., or a contract that includes all of the provisions of the approved model contract. (g) 1. The department may provide enhanced reimbursement for services provided under this section to an individual who, on or after July 27, 2005, is relocated to the community from a nursing home by a county department or to an individual who meets the level of care requirements for Medical Assistance reimbursement in a skilled nursing facility or an intermediate care facility and is diverted from imminent entry into a nursing home. The number of individuals served under this paragraph may not exceed the number of nursing home beds that are delicensed as part of plans submitted by nursing homes and approved by the department. 2. The department shall develop and utilize a formula to determine the enhanced reimbursement rate for services provided under subd. 1. The department shall also develop and utilize criteria for determining imminent entry into a nursing home under subd. 1. that shall include an imminent loss of current living arrangements and an imminent risk of a long-term nursing home stay. The department need not promulgate as rules under ch. 227 the criteria required to be developed and utilized under this subdivision. (5g) LIMITATIONS ON SERVICE. (a) The number of persons served under this section may not exceed the number of nursing home beds that are delicensed as part of a plan submitted by the facility and approved by the department. (b) This section does not apply to the delicensure of a bed of an institution for mental diseases of an individual who is aged 21 to 64, who has a primary diagnosis of mental illness and who otherwise meets any of the following requirements: 1. A person who resided in the facility on the date of the finding that a skilled nursing facility or intermediate care facility that provides care to Medical Assistance recipients is an institu-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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tion for mental diseases whose care in the facility is disallowed for federal financial participation under Medical Assistance. 2. A person who is aged 21 to 64, who has a primary diagnosis of mental illness, who would meet the level of care requirements for Medical Assistance 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 would be provided in place of a person specified in subd. 1. who discontinues services. (5m) REPORT. By October 1 of each year, the department shall submit a report to the joint committee on finance and to the chief clerk of each house of the legislature, for distribution to the appropriate standing committees under s. 13.172 (3), describing the cost and quality of services used under the program and the extent to which existing services have been used under the program in the preceding calendar year. (5r) RULE MAKING. The department shall promulgate rules that specify conditions of hardship under which the department may grant an exception to the requirement of sub. (5) (d) 3. (6) EFFECTIVE PERIOD. The effective date provisions of s. 46.275 (6) apply to this section. History: 1983 a. 27; 1985 a. 29 ss. 896nc to 896u, 3202 (23); 1985 a. 176; 1987 a. 27, 186, 399; 1989 a. 31; 1991 a. 39; 1993 a. 16; 1995 a. 27; 1997 a. 13, 27, 114; 1999 a. 9; 2001 a. 16; 2003 a. 33; 2005 a. 25, 355; 2007 a. 20 ss. 926 to 928, 9121 (6) (a); 2009 a. 277; 2013 a. 165 s. 114; 2015 a. 55, 180; 2017 a. 366; 2019 a. 9; 2021 a. 232, 239. Cross-reference: See also ch. DHS 73, Wis. adm. code.
46.278 Community integration program and brain injury waiver program for persons with developmental disabilities. (1) LEGISLATIVE INTENT. The intent of the programs under this section is to provide home or community-based care to serve in a noninstitutional community setting a person who meets eligibility requirements under 42 USC 1396n (c) and who is diagnosed as developmentally disabled under the definition specified in s. 51.01 (5) and relocated from an institution other than a state center for the developmentally disabled or who meets the intermediate care facility for persons with an intellectual disability or brain injury rehabilitation facility level of care requirements for medical assistance reimbursement in an intermediate care facility for persons with an intellectual disability or a brain injury rehabilitation facility and is ineligible for services under s. 46.275 or 46.277. The intent of the program is also that counties use all existing services for providing care under this section, including those services currently provided by counties. (1m) DEFINITIONS. In this section: (a) “Brain injury rehabilitation facility” means a nursing facility or hospital designated as a facility for brain injury rehabilitation by the department under the approved state medicaid plan. (ag) “Family consortium” means a group composed of relatives, or of relatives and the guardian, of an individual with developmental disability who together provide services for the individual in a home that is an extension of a relative’s or the guardian’s home. (am) “Intermediate care facility for persons with an intellectual disability” has the meaning given for “intermediate care facility for the mentally retarded” under 42 USC 1396d (d). (b) “Medical assistance” means aid provided under subch. IV of ch. 49, except ss. 49.468 and 49.471. (c) “Program” means the community integration program or the brain injury waiver program, for facilities certified as medical assistance providers, for which a waiver has been received under sub. (3). (2) DEPARTMENTAL POWERS AND DUTIES. (a) The department may request one or more waivers from the secretary of the federal department of health and human services, under 42 USC
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1396n (c), authorizing the department to serve medical assistance recipients, who meet the level of care requirements for medical assistance reimbursement in an intermediate care facility for persons with an intellectual disability or in a brain injury rehabilitation facility, in their communities by providing home or community-based services as part of medical assistance. If the department requests a waiver, it shall include all assurances required under 42 USC 1396n (c) (2) in its request. (b) Section 49.45 (37) applies to this subsection. (3) WAIVER; EXTENSION; DUTIES. If the department receives a waiver requested under sub. (2) (a), it may request a 3-year extension of the waiver under 42 USC 1396n (c) and shall perform the following duties: (a) Evaluate the effect of each program on medical assistance costs and on the program’s ability to provide community care alternatives to institutional care in facilities certified as medical assistance providers. (b) Fund home or community-based services provided by any county that meet the requirements of this section. (c) To the maximum extent possible, authorize the provision of services under this section to serve persons, except those institutionalized in a state center for the developmentally disabled, in noninstitutional settings and coordinate application of the review criterion under s. 150.39 (5) with the services provided under this section. (4) COUNTY PARTICIPATION. (a) Section 46.275 (3) (a), (c), and (d) applies to county participation in a program, except that services provided in the program shall substitute for care provided a person in an intermediate care facility for persons with an intellectual disability or in a brain injury rehabilitation facility who meets the intermediate care facility for persons with an intellectual disability or brain injury rehabilitation facility level of care requirements for medical assistance reimbursement to that facility rather than for care provided at a state center for the developmentally disabled. (b) 1. If the provision of services under this section results in a decrease in the statewide nursing home bed limit under s. 150.31 (3), the facility affected by the decrease shall submit a plan for delicensing all or part of the facility that is approved by the department. 2. Each county department participating in a program shall provide home or community-based care to persons eligible under this section, except that the number of persons who receive home or community-based care under this section may not exceed the number that are approved under an applicable waiver received under sub. (3). (5) ELIGIBILITY OF RESIDENTS. (a) Any medical assistance recipient who meets the level of care requirements for medical assistance reimbursement in an intermediate care facility for persons with an intellectual disability or in a brain injury rehabilitation facility and is ineligible for service under s. 46.275 or 46.277 is eligible to participate in a program, except that persons eligible for the brain injury waiver program must meet the definition of brain injury under s. 51.01 (2g), and except that the number of participants may not exceed the number approved under the waiver received under sub. (3). Such a recipient may apply, or any person may apply on behalf of such a recipient, for participation in a program. Section 46.275 (4) (b) applies to participation in a program. (am) One individual who is eligible under par. (a) may, beginning January 1, 1992, participate in the program through services provided by a family consortium that is formed before January 1, 1991, and is approved by the department. (b) To the extent authorized under 42 USC 1396n, if a person discontinues participation in a program, a medical assistance re-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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cipient may participate in a program in place of the participant who discontinues if that recipient meets the requirements under par. (a). (6) FUNDING. (a) The provisions of s. 46.275 (5) (a), (b) and (d) apply to funding received by counties under the programs. (b) Total funding to counties for relocating each person under a program may not exceed the amount approved in the waiver received under sub. (3). (c) Funding may be provided under a program for services of a family consortium. (d) If a county makes available nonfederal funds equal to the state share of service costs under a waiver received under sub. (3), the department may, from the appropriation under s. 20.435 (4) (o), provide reimbursement for services that the county provides under this section to persons who are in addition to those who may be served under this section with funds from the appropriation accounts under s. 20.435 (4) (b), (gm), or (w). (e) 1. The department may provide enhanced reimbursement for services under the community integration program for an individual who was relocated to the community by a county department from one of the following: a. An intermediate care facility for persons with an intellectual disability that closes under s. 50.03 (14). b. An intermediate care facility for persons with an intellectual disability or a distinct part thereof that has a plan of closure approved by the department and that intends to close within 12 months. c. An intermediate care facility for persons with an intellectual disability that has a plan of closure or significant reduction in capacity approved by the department and that intends to close or significantly reduce its capacity within 60 months. 2. a. The enhanced reimbursement rate under subd. 1. a. and b. shall be determined under a formula that is developed by the department. b. The enhanced reimbursement rate under subd. 1. c. shall be 90 percent of the enhanced reimbursement rate under subd. 2. a. (7) REPORT. By July 1 of each year, the department shall submit to the joint committee on finance and to the chief clerk of each house of the legislature, for distribution to the appropriate standing committees under s. 13.172 (3), a report describing the cost and quality of services used under the program and the extent to which existing services have been used under the program in the preceding calendar year. (8) EFFECTIVE PERIOD. Except as provided under sub. (2), this section takes effect on the date approved by the secretary of the federal department of health and human services as the beginning date of the period of waiver received under sub. (3). This section remains in effect for 3 years following that date and, if the secretary of the federal department of health and human services approves a waiver extension, shall continue an additional 3 years. History: 1987 a. 27, 186; 1989 a. 31; 1991 a. 269; 1993 a. 16; 1995 a. 27; 1997 a. 27; 1999 a. 9; 2001 a. 16; 2003 a. 33; 2007 a. 153; 2011 a. 32, 126; 2013 a. 173 s. 33; 2019 a. 9; 2021 a. 239.
46.2785 Community Opportunities and Recovery Program. (1) DEFINITIONS. In this section: (a) “Nursing facility” has the meaning given in 42 USC 1396r (a). (b) “Serious mental illness” has the meaning given in 42 CFR 483.102 (b) (1). (c) “Waiver program” means the Community Opportunities and Recovery Program for which a waiver has been requested under sub. (2) and granted under 42 USC 1396n (c). (2) WAIVER REQUEST. The department may request a waiver
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from the secretary of the U.S. department of health and human services, under 42 USC 1396n (c), authorizing the department to serve in their communities medical assistance recipients who meet eligibility requirements specified in sub. (4) by providing them home or community-based services as part of the Medical Assistance program. If the department requests the waiver, it shall include all the assurances required under 42 USC 1396n (c) (2) in the request. If the department receives the waiver, it may request an extension of the waiver under 42 USC 1396n (c). (3) CONTRACT FOR ADMINISTRATION. If doing so is consistent with the waiver received by the department as specified in sub. (2), the department may contract with a county or a private agency to administer the waiver program. A private agency with which the department contracts shall have the powers and duties of a county under this section. (4) ELIGIBILITY. Any medical assistance recipient who has a serious mental illness and meets the level of care requirements under s. 49.45 (6m) (i) for reimbursement of nursing home care under the Medical Assistance program is eligible to participate in the waiver program. (5) FUNDING. (a) Medical assistance reimbursement for services a county or private agency contracts for or provides under the waiver program shall be made from the appropriation accounts under s. 20.435 (4) (b), (gm), and (o). (b) The department may, from the appropriation account under s. 20.435 (4) (o), reimburse a county for providing, or contracting to provide, services that cost more than the average annual per person rate established by the department, but less than the average amount approved by the federal government for the waiver program. History: 2005 a. 25; 2011 a. 32.
46.279 Restrictions on placements and admissions to intermediate and nursing facilities. (1) DEFINITIONS. In this section: (a) “Developmental disability” has the meaning given in s. 51.01 (5) (a). (b) “Intermediate facility” has the meaning given for an intermediate care facility for the mentally retarded under 42 USC 1396d (d), other than a center for the developmentally disabled, as defined in s. 51.01 (3). (bm) “Most integrated setting” means a setting that enables an individual to interact with persons without developmental disabilities to the fullest extent possible. (c) “Nursing facility” has the meaning given under 42 USC 1396r (a). (2) PLACEMENTS AND ADMISSIONS TO INTERMEDIATE FACILITIES. Except as provided in sub. (5), no person may protectively place or continue protective placement of an individual with a developmental disability in an intermediate facility and no intermediate facility may admit or continue service for such an individual unless, before the protective placement, continued placement following review under s. 55.18, or admission and after having considered a plan developed under sub. (4), a court under s. 55.12 or 55.18 (1) (ar) finds that protective placement in the intermediate facility is the most integrated setting that is appropriate to the needs of the individual or that the county of residence of the individual would not reasonably be able to provide community-based care in accordance with the plan within the limits of available state and federal funds and county funds required to be appropriated to match state funds, taking into account information presented by all affected parties. An intermediate facility to which an individual who has a developmental disability applies for admission shall, within 5 days after receiving the application, notify the county department that is participating in the program under
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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s. 46.278 of the county of residence of the individual who is seeking admission concerning the application. (3) PLACEMENTS AND ADMISSIONS TO NURSING FACILITIES. Except as provided in sub. (5), if the department or an entity determines from a screening under s. 49.45 (6c) (b) that an individual requires active treatment for developmental disability, no individual may be protectively placed in a nursing facility or have protective placement in a nursing facility continued following review under s. 55.18, and no nursing facility may admit or continue service for the individual, unless the department or entity that conducts the screening determines that the individual’s need for care cannot fully be met in an intermediate facility or under a plan under sub. (4) or that the county of residence of the individual would not reasonably be able to provide community-based care in accordance with the plan within the limits of available state and federal funds and county funds required to be appropriated to match state funds. (4) PLAN FOR HOME OR COMMUNITY-BASED CARE. Except as provided in a contract specified in sub. (4m), a county department that participates in the program under s. 46.278 shall develop a plan for providing home or community-based care in a noninstitutional community setting to an individual who is a resident of that county, under any of the following circumstances: (a) Within 120 days after any determination made under s. 49.45 (6c) (c) 3. that the level of care required by a resident that is provided by a facility could be provided in an intermediate facility or under a plan under this subsection. (b) Within 120 days after receiving written notice under sub. (2) of an application. (c) Within 120 days after a proposal is made under s. 55.12 (6) to provide protective placement to the individual in an intermediate facility or a nursing facility. (d) Within 120 days after receiving written notice under s. 55.18 (1) (ar) of the protective placement of the individual in a nursing facility or an intermediate facility. (e) Within 90 days after extension of a temporary protective placement order by the court under s. 55.135 (5). (4m) CONTRACT FOR PLAN DEVELOPMENT. The department shall contract with a public or private agency to develop a plan under sub. (4), and the county department is not required to develop such a plan, for an individual, as specified in the contract, to whom all of the following apply: (a) The individual resides in a county with a population of less than 100,000 in which are located at least 2 intermediate facilities that have licenses issued to private nonprofit organizations that are exempt from federal income tax under section 501 (a) of the Internal Revenue Code. (b) Placement for the individual is in, or proposed to be in, an intermediate facility specified under par. (a) that has agreed to reduce its licensed bed capacity to an extent and according to a schedule acceptable to the facility and the department. (4n) CONTRACT FOR PLAN PAYMENT. The department and the county specified in sub. (4m) (a) shall negotiate a contract under which the department shall provide payment, from the appropriation account under s. 20.435 (4) (b), to implement a plan to provide care in a noninstitutional community setting to an individual who has established residence in the county in order to be admitted to an intermediate facility in the county. The contract may provide for the negotiation of a memorandum of understanding between the parties that identifies the relative functions and duties of the department and the county in implementing plans under sub. (4) for residents of intermediate facilities in the county. (5) EXCEPTIONS. Subsections (2) and (3) do not apply to entrance to a facility under s. 49.45 (6c) (e) 1., to an emergency pro-
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tective placement under s. 55.135, or to a temporary protective placement under s. 55.135 (5) or 55.055 (5). History: 2003 a. 33; 2005 a. 25, 47, 253, 264; 2007 a. 139, 153.
46.28 Revenue bonding for residential facilities. (1) In this section: (a) “Authority” means the Wisconsin Housing and Economic Development Authority created under ch. 234. (am) “Child with long-term care needs” means any of the following: 1. A juvenile adjudged delinquent for whom a case disposition is made under s. 938.34. 2. A child found to be in need of protection or services for whom an order is made under s. 48.345 or a juvenile found to be in need of protection or services for whom an order is made under s. 938.345. 3. A child placed under s. 48.63. 4. A child who is eligible under 42 USC 1396a (e) (3). (b) “Chronically disabled” means any person who is alcoholic, developmentally disabled, drug dependent, or mentally ill, as defined in s. 51.01 (1h), (5), (8b), and (13), or any person who is physically disabled. (c) “Elderly” means a person 60 years of age or older. (cg) “Eligible individual” means an individual who is elderly or chronically disabled, a child with long-term care needs, a homeless individual or a victim of domestic abuse. (cr) “Homeless individual” has the meaning given in 42 USC 11302 (a). (d) “Residential facility” means a living unit for eligible individuals that is developed by a sponsor and that is not physically connected to a nursing home or hospital except by common service units for laundry, kitchen or utility purposes and that may include buildings and grounds for activities related to residence, including congregate meal sites, socialization, physical rehabilitation facilities and child care facilities. (e) “Sponsor” means any of the following: 1. A nonprofit participating health institution, as defined in s. 231.01 (6). 2. A tribal council or housing authority or any nonprofit entity created by a tribal council. 3. The department. 4. Any county department under s. 46.21, 46.22, 46.23, 51.42 or 51.437. 5. A county commission on aging appointed under s. 46.82 (4) (a). 6. Any housing authority created under s. 59.53 (22), 66.1201, 66.1213 or 66.1335. 7. Any housing corporation, limited-profit or nonprofit entity. 8. Any other entity meeting criteria established by the authority and organized to provide housing for persons and families of low and moderate income. 9. An entity that is operated for profit and that is engaged in providing medical care or residential care or services, including all of the following: a. A hospital, as defined in s. 50.33 (2). b. A nursing home, as defined in s. 50.01 (3). c. A community-based residential facility, as defined in s. 50.01 (1g). d. A residential care apartment complex, as defined in s. 50.01 (6d). (f) “Victim of domestic abuse” means an individual who has encountered domestic abuse, as defined in s. 49.165 (1) (a).
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(2) The department may approve any residential facility for financing by the authority if it determines that the residential facility will help meet the housing needs of an eligible individual, based on factors that include: (a) The geographic location of the residential facility. (b) The population served by the residential facility. (c) The services offered by the residential facility. (3) The department may authorize the authority to issue revenue bonds under s. 234.61 to finance any residential facility it approves under sub. (2). (4) The department may charge sponsors for administrative costs and expenses it incurs in exercising its powers and duties under this section and under s. 234.61. History: 1981 c. 298; 1983 a. 27 ss. 996g to 996r, 2202 (20); 1983 a. 81 s. 11; 1983 a. 83 s. 20; 1983 a. 189 s. 329 (9); 1985 a. 29, 176; 1985 a. 265 s. 4; 1985 a. 332; 1991 a. 39, 235, 269; 1995 a. 77, 201; 1997 a. 27, 35, 320; 1999 a. 150 s. 672; 2001 a. 104; 2007 a. 20; 2013 a. 165 s. 114; 2017 a. 34; 2023 a. 229.
46.2804 Client management of managed care longterm care benefit. Under a managed care program for provision of long-term care services, the care manager shall provide, within guidelines established by the department, a mechanism by which an enrollee, beneficiary, or recipient of the program may arrange for, manage, and monitor his or her benefit directly or with the assistance of another person chosen by the enrollee, beneficiary, or recipient. The care manager shall provide each enrollee, beneficiary, or recipient with a form on which the enrollee, beneficiary, or recipient shall indicate whether he or she has been offered the option under this subsection and whether he or she has accepted or declined the option. If the enrollee, beneficiary, or recipient accepts the option, the care manager shall monitor the use by the enrollee, beneficiary, or recipient of a fixed budget for purchase of services or support items from any qualified provider, monitor the health and safety of the enrollee, beneficiary, or recipient, and provide assistance in management of the budget and services of the enrollee, beneficiary, or recipient at a level tailored to the need and desire of the enrollee, beneficiary, or recipient for the assistance. History: 2005 a. 386; 2007 a. 20.
46.2805 Definitions; long-term care. In ss. 46.2805 to 46.2895: (1) “Care management organization” means an entity that is certified as meeting the requirements for a care management organization under s. 46.284 (3) and that has a contract under s. 46.284 (2). “Care management organization” does not mean an entity that contracts with the department to operate one of the following: (a) A program of all-inclusive care for the elderly under 42 USC 1395eee or 1396u-4. (b) A demonstration program known as the Family Care Partnership program under a federal waiver authorized under 42 USC 1396n. (2) “Eligible person” means a person who meets all eligibility criteria under s. 46.286 (1). (3) “Enrollee” means a person who is enrolled in a care management organization. (4) “Family care benefit” means financial assistance for longterm care and support items for an enrollee. (6m) “Family member” means a spouse or an individual related by blood, marriage, or adoption within the 3rd degree of kinship as computed under s. 990.001 (16). (6r) “Financial and cost-sharing screening” means a screening to determine financial eligibility under s. 46.286 (1) (b) or the self-directed services option and cost-sharing under s. 46.286 (2) using a uniform tool prescribed by the department.
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(6v) “Frail elder” means an individual who is 65 years of age or older and has a physical disability or irreversible dementia that restricts the individual’s ability to perform normal daily tasks or that threatens the capacity of the individual to live independently. (7) “Functional screening” means a screening to determine functional eligibility under s. 46.286 (1) (a) or the self-directed services option using a uniform tool prescribed by the department. (7r) “Long-term care district” means a special purpose district created under s. 46.2895 (1). (7u) “Long-term care district board” means the governing board of a long-term care district. (8) “Nonprofit organization” has the meaning given in s. 108.02 (19). (9) “Older person” means a person who is at least 65 years of age. (10) “Resource center” means an entity that meets the standards for operation under s. 46.283 (3) or, if under contract to provide a portion of the services specified under s. 46.283 (3), meets the standards for operation with respect to those services. (10m) “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. (11) “Tribe or band” means a federally recognized American Indian tribe or band. History: 1999 a. 9, 185; 2003 a. 33; 2007 a. 20, 141; 2009 a. 247; 2019 a. 9.
46.281 Powers and duties of the department, secretary, and counties; long-term care. (1d) WAIVER REQUEST. The department shall request from the secretary of the federal department of health and human services any waivers of federal medicaid laws necessary to permit the use of federal moneys to provide the family care benefit and the self-directed services option to recipients of medical assistance. The department shall implement any waiver that is approved and that is consistent with ss. 46.2805 to 46.2895. Regardless of whether a waiver is approved, the department may implement operation of resource centers, care management organizations, and the family care benefit. (1g) CONTRACTING FOR RESOURCE CENTERS AND CARE MANAGEMENT ORGANIZATIONS. (a) Subject to par. (b), the department may contract with entities as provided under s. 46.283 (2) to provide the services under s. 46.283 (3) and (4) as resource centers in any geographic area in the state, and may contract with entities as provided under s. 46.284 (2) to administer the family care benefit as care management organizations in any geographic area in the state. (b) If the department proposes to contract with entities to administer the family care benefit in geographic areas in which, in the aggregate, resides more than 29 percent of the state population that is eligible for the family care benefit, the department shall first submit to the joint committee on finance in writing the proposed contract for the approval of the committee. The submission shall include the contract proposal; and an estimate of the fiscal impact of the proposed addition that demonstrates that the addition will be cost neutral, including startup, transitional, and ongoing operational costs and any proposed county contribution. The submission shall also include, for each county affected by the proposal, documentation that the county consents to administration of the family care benefit in the county, the amount of the county’s payment or reduction in community aids under s. 46.281 (4), and a proposal by the county for using any savings in county expenditures on long-term care that result from adminis-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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tration of the family care benefit in the county. The department may enter into the proposed contract only if the committee approves the proposed contract. The procedures under s. 13.10 do not apply to this paragraph. (1k) WORKER’S COMPENSATION COVERAGE. An individual who is performing services for a person receiving the Family Care benefit, or benefits under Family Care Partnership, on a self-directed basis 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. (1n) OTHER DUTIES OF THE DEPARTMENT. The department shall do all of the following: (a) Prescribe and implement a per person monthly rate structure for costs of the family care benefit. (b) In order to maintain continuous quality assurance and quality improvement for resource centers and care management organizations, do all of the following: 1. Prescribe by rule and by contract and enforce performance standards for operation of resource centers and care management organizations. 2. Use performance expectations that are related to outcomes for persons in contracting with care management organizations and resource centers. 3. Conduct ongoing evaluations of managed care programs for provision of long-term care services that are funded by medical assistance, as defined in s. 46.278 (1m) (b), as to client access to services, the availability of client choice of living and service options, quality of care, and cost-effectiveness. In evaluating the availability of client choice, the department shall evaluate the opportunity for a client to arrange for, manage, and monitor his or her family care benefit directly or with assistance, as specified in s. 46.284 (4) (e). 4. Require that quality assurance and quality improvement efforts be included throughout the long-term care system specified in ss. 46.2805 to 46.2895. 5. Ensure that reviews of the quality of management and service delivery of resource centers and care management organizations are conducted by external organizations and make information about specific review results available to the public. (c) Require by contract that resource centers and care management organizations establish procedures under which an individual who applies for or receives the family care benefit may register a complaint or grievance and procedures for resolving complaints and grievances. (e) Contract with a person to provide the advocacy services described under s. 16.009 (2) (p) 1. to 5. to actual or potential recipients of the family care benefit who are under age 60 or to their families or guardians. The department may not contract under this paragraph with a county or with a person who has a contract with the department to provide services under s. 46.283 (3) and (4) as a resource center or to administer the family care benefit as a care management organization. The contract under this paragraph shall include as a goal that the provider of advocacy services provide one advocate for every 2,500 individuals under age 60 who receive the family care benefit or who participates in the self-directed services option. (f) From the appropriation under s. 20.435 (7) (b), provide $75,000 annually to Grant County to provide, with respect to issues concerning family care benefits, liaison services between the county and a managed care organization and advocacy services on behalf of the county. (2) OTHER POWERS OF THE DEPARTMENT. The department
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may develop risk-sharing arrangements in contracts with care management organizations, in accordance with applicable state laws and federal statutes and regulations. (4) COUNTY CONTRIBUTION. (a) In this subsection, “base amount” means the amount that a county expended in calendar year 2006, as determined by the department, to provide long-term care services to individuals who would have been eligible for the family care benefit in calendar year 2006 if the family care benefit had been available to residents of the county. (b) Except as provided in par. (c), each county in which the department has a contract with an entity to administer the family care benefit shall in each year of the contract either pay the department the following amount or agree to reduce the community aids distribution to the county under s. 46.40 (2) by the following amount: 1. If the base amount for the county is less than or equal to 22 percent of the calendar year 2006 community aids distribution to the county under s. 46.40 (2), the base amount. 2. If the base amount for the county is greater than 22 percent of the calendar year 2006 community aids distribution to the county under s. 46.40 (2), the following amounts in the following years: a. For the first year that the department contracts for administration of the family care benefit in the county, the base amount for the county. b. For the 2nd, 3rd, and 4th years that the department contracts for administration of the family care benefit in the county, the amount from the previous year minus 25 percent of the difference between the base amount for the county and 22 percent of the calendar year 2006 community aids distribution to the county under s. 46.40 (2). c. For the 5th year and each subsequent year that the department contracts for administration of the family care benefit in the county, 22 percent of the calendar year 2006 community aids distribution to the county under s. 46.40 (2). (c) Each county in which the department has a contract with an entity to administer the family care benefit, and in which the department had such a contract before January 1, 2006, shall annually either pay the department or agree to reduce the community aids distribution to the county under s. 46.40 (2) by the amount that the county paid the department, or by which the county’s community aids distribution was reduced, in calendar year 2006 to fund the program under ss. 46.2805 to 46.2895. (d) The department shall deposit payments made by counties under this subsection in the appropriation account under s. 20.435 (4) (h). History: 1999 a. 9; 2001 a. 103; 2005 a. 25, 386; 2007 a. 20; 2009 a. 28, 247; 2011 a. 32, 127; 2015 a. 55, 180; 2019 a. 9; 2021 a. 232.
46.283 Resource centers. (1) APPLICATION FOR CONTRACT. (a) A county board of supervisors and, in a county with a county executive or a county administrator, the county executive or county administrator, may decide all of the following: 1. Whether to authorize one or more county departments under s. 46.21, 46.215, 46.22 or 46.23 or an aging unit under s. 46.82 (1) (a) 1., 2., or 3. to apply to the department for a contract to operate a resource center and, if so, which to authorize and what client group to serve. 2. Whether to create a long-term care district to apply to the department for a contract to operate a resource center. (b) The governing body of a tribe or band or of the Great Lakes Inter-Tribal Council, Inc., may decide whether to authorize a tribal agency to apply to the department for a contract to operate a resource center for tribal members and, if so, which client group to serve.
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(c) A county board of supervisors may decide to apply to the department for a contract to operate a multicounty resource center in conjunction with the county board or boards of one or more other counties or a county-tribal resource center in conjunction with the governing body of a tribe or band or the Great Lakes Inter-Tribal Council, Inc. (d) The governing body of a tribe or band may decide to apply to the department for a contract to operate a resource center in conjunction with the governing body or governing bodies of one or more other tribes or bands or the Great Lakes Inter-Tribal Council, Inc., or with a county board of supervisors. (2) EXCLUSIVE CONTRACT. The department may contract to operate a resource center with counties, long-term care districts, or the governing body of a tribe or band or the Great Lakes InterTribal Council, Inc., under a joint application of any of these, or with a private nonprofit organization if the department determines that the organization has no significant connection to an entity that operates a care management organization and if any of the following applies: (a) A county board of supervisors declines in writing to apply for a contract to operate a resource center. (b) A county agency or a long-term care district applies for a contract but fails to meet the standards specified in sub. (3). (3) STANDARDS FOR OPERATION. The department shall assure that at least all of the following are available to a person who contacts a resource center for service: (a) Information and referral services and other assistance at hours that are convenient for the public. (b) A determination of functional eligibility for the family care benefit. (c) Within the limits of available funding, prevention and intervention services. (d) Counseling concerning public and private benefits programs. (e) A determination of financial eligibility and of the maximum amount of cost sharing required for a person who is seeking long-term care services, under standards prescribed by the department. (f) Assistance to a person with respect to the person’s choice of whether or not to enroll in the self-directed services option, as defined in s. 46.2899 (1), a care management organization for the family care benefit or the Family Care Partnership program, or the program of all-inclusive care for the elderly and, if so, which available long-term care program or care management organization would best meet his or her needs. (g) Assistance in enrolling in a care management organization for persons who choose to enroll. (j) Transitional services to families whose children with physical or developmental disabilities are preparing to enter the adult service system. (k) A determination of eligibility for state supplemental payments under s. 49.77, medical assistance under s. 49.46, 49.468, 49.47, or 49.471, or the federal food stamp program under 7 USC 2011 to 2029. (4) DUTIES. A resource center shall do all of the following: (a) Provide services within the entire geographic area prescribed for the resource center by the department. (b) Submit to the department all reports and data required or requested by the department. (c) Implement internal quality improvement and quality assurance processes that meet standards prescribed by the department. (d) Cooperate with any review by an external advocacy organization.
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(f) Perform a functional screening and a financial and costsharing screening for any resident who requests a screening and assist any resident who is eligible and chooses to enroll in a care management organization or the self-directed services option to do so. (g) Perform a functional screening and a financial and costsharing screening for any person seeking admission to a nursing home, community-based residential facility, residential care apartment complex, or adult family home, if the secretary has certified that the resource center is available to the person and the facility and the person is determined by the resource center to have a condition that is expected to last at least 90 days that would require care, assistance, or supervision. A resource center may not require a financial and cost-sharing screening for a person seeking admission or about to be admitted on a private pay basis who waives the requirement for a financial and cost-sharing screening under this paragraph, unless the person is expected to become eligible for medical assistance within 6 months. A resource center need not perform a functional screening for a person seeking admission or about to be admitted for whom a functional screening was performed within the previous 6 months. (h) Provide access to services under s. 46.90 and ch. 55 to a person who is eligible for the services, through cooperation with the elder-adult-at-risk agency or the adult-at-risk agency that provides the services. (i) Assure that emergency calls to the resource center are responded to promptly, 24 hours per day. (j) Target any outreach, education, and prevention services it provides and any service development efforts it conducts on the basis of findings made by the governing board of the resource center under sub. (6) (b) 2. and 3. (5) FUNDING. From the appropriation accounts under s. 20.435 (1) (n), (4) (b), (bd), (bm), (gm), (pa), and (w), and (7) (b) and (md), the department may contract with organizations that meet standards under sub. (3) for performance of the duties under sub. (4) and shall distribute funds for services provided by resource centers. (6) GOVERNING BOARD. (a) 1. A resource center shall have a governing board that reflects the ethnic and economic diversity of the geographic area served by the resource center. 2. At least one-fourth of the members of the governing board shall be individuals who belong to a client group served by the resource center or their family members, guardians, or other advocates. The proportion of these board members who belong to each client group, or their family members, guardians, or advocates, shall be the same, respectively, as the proportion of individuals in this state who receive services under s. 46.2805 to 46.2895 and belong to each client group. 3. An individual who has a financial interest in, or serves on the governing board of, a care management organization or an organization that administers a program described under s. 46.2805 (1) (a) or (b) or a managed care program under s. 49.45 for individuals who are eligible to receive supplemental security income under 42 USC 1381 to 1383c, which serves any geographic area also served by a resource center, and the individual’s family members, may not serve as members of the governing board of the resource center. (b) The governing board of a resource center shall do all of the following: 1. Determine the structure, policies, and procedures of, and oversee the operations of, the resource center. The operations of a resource center that is operated by a county are subject to the county’s ordinances and budget. 2. Annually gather information from consumers and providers of long-term care services and other interested persons
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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concerning the adequacy of long-term care services offered in the area served by the resource center. The board shall provide welladvertised opportunities for persons to participate in the board’s information gathering activities conducted under this subdivision. 3. Identify any gaps in services, living arrangements, and community resources needed by individuals belonging to the client groups served by the resource center, especially those with long-term care needs. 5. Recommend strategies for building local capacity to serve older persons and persons with physical or developmental disabilities, as appropriate, to local elected officials or the department. 6. Identify potential new sources of community resources and funding for needed services for individuals belonging to the client groups served by the resource center. 8. Annually review interagency agreements between the resource center and care management organizations that provide services in the area served by the resource center and make recommendations, as appropriate, on the interaction between the resource center and the care management organizations to assure coordination between or among them and to assure access to and timeliness in provision of services by the resource center and the care management organizations. 9. Review the number and types of grievances and appeals related to the resource center to determine if a need exists for system changes and recommend system or other changes if appropriate. (7) CONFIDENTIALITY; EXCHANGE OF INFORMATION. No record, as defined in s. 19.32 (2), of a resource center that contains personally identifiable information, as defined in s. 19.62 (5), concerning an individual who receives services from the resource center may be disclosed by the resource center without the individual’s informed consent, except as follows: (a) A resource center may provide information as required to comply with s. 16.009 (2) (p) or 49.45 (4) or as necessary for the department to administer the program under ss. 46.2805 to 46.2895. (b) Notwithstanding 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 resource center 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), 46.284 (7), 46.2895 (10), 51.42 (3) (e) or 51.437 (4r) (b) in the county of the resource center, if necessary to enable the resource center to perform its duties or to coordinate the delivery of services to the client. History: 1999 a. 9; 2001 a. 16, 103; 2003 a. 33; 2005 a. 25, 254, 264, 386, 388; 2007 a. 20 ss. 969, 971 to 973, 976, 978 to 991; 2009 a. 2, 28, 180, 247, 249; 2011 a. 32; 2015 a. 55; 2017 a. 59; 2019 a. 9; 2023 a. 259. Neither this section nor the resource center’s contract with the Department of Health Services established that the owner of a residential care facility had a protected property interest in the resource center listing the facility in the resource center’s directory that would be sufficient to support a due process claim under the 14th amendment to the U.S. Constitution. First, this section provides for the creation and operation of resource centers. It does not confer any property rights to individuals. Second, the contract between the resource center and the department did not include the owner as a party or grant the owner a property interest. Makhsous v. Daye, 980 F.3d 1181 (2020).
46.284
Care management organizations. (1) APPLICATION FOR CONTRACT. (a) A county board of supervisors and, in a county with a county executive or a county administrator, the county executive or county administrator, may decide all of the following: 1. Whether to authorize one or more county departments under s. 46.21, 46.215, 46.22 or 46.23 or an aging unit under s. 46.82 (1) (a) 1. or 2. to apply to the department for a contract to
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operate a care management organization and, if so, which to authorize and what client group to serve. 2. Whether to create a long-term care district to apply to the department for a contract to operate a care management organization. (b) The governing body of a tribe or band or of the Great Lakes Inter-Tribal Council, Inc., may decide whether to authorize a tribal agency to apply to the department for a contract to operate a care management organization for tribal members and, if so, which client group to serve. (c) Under the requirements of par. (a), a county board of supervisors may decide to apply to the department for a contract to operate a multicounty care management organization in conjunction with the county board or boards of one or more other counties or a county-tribal care management organization in conjunction with the governing body of a tribe or band or the Great Lakes Inter-Tribal Council, Inc. (d) Under the requirements of par. (b), the governing body of a tribe or band may decide to apply to the department for a contract to operate a care management organization in conjunction with the governing body or governing bodies of one or more other tribes or bands or the Great Lakes Inter-Tribal Council, Inc., or with a county board of supervisors. (2) CONTRACTS. (a) The department may contract for operation of a care management organization only with an entity that is certified as meeting the requirements under sub. (3). No entity may operate as a care management organization under the requirements of this section unless so certified and under contract with the department. (bm) The department may contract with counties, long-term care districts, the governing body of a tribe or band or the Great Lakes inter-tribal council, inc., or under a joint application of any of these, or with a private organization that has no significant connection to an entity that operates a resource center. Proposals for contracts under this subdivision shall be solicited under a competitive sealed proposal process under s. 16.75 (2m) and the department shall evaluate the proposals primarily as to the quality of care that is proposed to be provided, certify those applicants that meet the requirements specified in sub. (3) (a), select certified applicants for contract and contract with the selected applicants. (br) 1. The department may contract with a county or longterm care district to operate a care management organization outside the geographic area of that county or long-term care district. 2. The department may award contracts under this paragraph to one or more entities certified under sub. (3) to operate a care management organization within a county or geographic area. (c) The department shall require, as a term of any contract with a care management organization under this section, that the care management organization contract for the provision of services that are covered under the family care benefit with any community-based residential facility under s. 50.01 (1g), residential care apartment complex under s. 50.01 (6d), nursing home under s. 50.01 (3), intermediate care facility for persons with an intellectual disability under s. 50.14 (1) (b), community rehabilitation program, home health agency under s. 50.49 (1) (a), provider of day services, or provider of personal care, as defined in s. 50.01 (4o), that agrees to accept the reimbursement rate that the care management organization pays under contract to similar providers for the same service and that satisfies any applicable quality of care, utilization, or other criteria that the care management organization requires of other providers with which it contracts to provide the same service. (d) As a term of a contract with a care management organization under this section, the department shall prohibit a care man-
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agement organization from including a provision that requires a provider to return any funding for residential services, prevocational services, or supported employment services that exceeds the cost of those services to the care management organization in a contract for services covered by the family care benefit. (3) CERTIFICATION; REQUIREMENTS. (a) If an entity meets the requirements under par. (b) and applicable rules of the department and submits to the department an application for initial certification or certification renewal, the department shall certify that the entity meets the requirements for a care management organization. (b) To be certified as a care management organization, an applicant shall demonstrate or ensure all of the following: 1. Adequate availability of providers with the expertise and ability to provide services that are responsive to the disabilities or conditions of all of the applicant’s proposed enrollees and sufficient representation of programmatic philosophies and cultural orientations to accommodate a variety of enrollee preferences and needs. 2. Adequate availability of providers that can meet the preferences and needs of its proposed service recipients for services at various times, including evenings, weekends and, when applicable, on a 24-hour basis. 3. Adequate availability of providers that are able and willing to perform all of the tasks that are likely to be identified in proposed enrollees’ service and care plans. 4. Adequate availability of residential and day services that are geographically accessible to proposed enrollees’ homes, families or friends. 5. Adequate supported living arrangements of the types and sizes that meet proposed enrollees’ preference and needs. 6. Expertise in determining and meeting the needs of every target population that the applicant proposes to serve and connections to the appropriate service providers. 7. Thorough knowledge of local long-term care and other community resources. 8. The ability to manage and deliver, either directly or through subcontracts or partnerships with other organizations, the full range of benefits to be included in the monthly payment amount. 9. Thorough knowledge of methods for maximizing informal caregivers and community resources and integrating them into a service or care plan. 10. Coverage for a geographic area specified by the department. 11. The ability to develop strong linkages with systems and services that are not directly within the scope of the applicant’s responsibility but that are important to the target group that it proposes to serve, including primary and acute health care services. 12. Adequate and competent staffing by qualified personnel to perform all of the functions that the applicant proposes to undertake. (3m) PERMIT REQUIRED. A care management organization that is described under s. 600.01 (1) (b) 10. a., to which s. 600.01 (1) (b) 10. b. does not apply and that is certified under sub. (3) shall apply for a permit with the office of the commissioner of insurance under ch. 648. (4) DUTIES. A care management organization shall, in addition to meeting all contract requirements, do all of the following: (a) Accept requested enrollment of any person who is entitled to the family care benefit and of any person who is eligible for the family care benefit and for whom funding is available. No care management organization may disenroll any enrollee, except un-
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der circumstances specified by the department by contract. No care management organization may encourage any enrollee to disenroll in order to obtain long-term care services under the medical assistance fee-for-service system. No involuntary disenrollment is effective unless the department has reviewed and approved it. (b) Conduct a comprehensive assessment for each enrollee, including an in-person interview with the enrollee, using a standard format developed by the department. (c) With the enrollee and the enrollee’s family or guardian, if appropriate, develop a comprehensive care plan that reflects the enrollee’s values and preferences. (d) Provide or contract for the provision of necessary services and monitor the provided or contracted services. (e) Provide, within guidelines established by the department, a mechanism by which an enrollee may arrange for, manage, and monitor his or her family care benefit directly or with the assistance of another person chosen by the enrollee. The care management organization shall provide each enrollee with a form on which the enrollee shall indicate whether he or she has been offered the option under this paragraph and whether he or she has accepted or declined the option. If the enrollee accepts the option, the care management organization shall monitor the enrollee’s use of a fixed budget for purchase of services or support items from any qualified provider, monitor the health and safety of the enrollee, and provide assistance in management of the enrollee’s budget and services at a level tailored to the enrollee’s need and desire for the assistance. (f) Provide, on a fee-for-service basis, case management services to persons who are functionally eligible but not financially eligible for the family care benefit. (g) Meet all performance standards required by the federal government or promulgated by the department by rule. (h) Submit to the department reports and data required or requested by the department. (i) Implement internal quality improvement and assurance processes that meet standards prescribed by the department by rule. (j) Cooperate with external quality assurance reviews. (k) Meet departmental requirements for protection of solvency. (L) Annually submit to the department an independent financial audit that meets federal requirements. (4m) CREATING CORPORATION. (a) In this subsection, “governmental entity” means a political subdivision, as defined in s. 16.99 (3d), or a subunit of a political subdivision. (b) A governmental entity that has a contract under sub. (2) may do all of the following: 1. Create a nonstock, nonprofit corporation under ch. 181 or a service insurance corporation under ch. 613. Before creating a nonstock, nonprofit corporation or a service insurance corporation that will provide services under the family care benefit, the governmental entity 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. 2. With approval of the department and office of the commissioner of insurance, assign any of the following to a corporation created under subd. 1.: a. The governmental entity’s assets and liabilities relating to
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providing the family care benefit, 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. b. A contract with the department as described in sub. (2). c. A permit issued by the office of the commissioner of insurance under ch. 648. d. A certification by the department under sub. (3). (c) Upon approval of the department and the commissioner of insurance under par. (b) 2., the department shall notify enrollees of the care management organization regarding the transfer of the contract to the corporation created under par. (b) 1. and shall inform enrollees of their rights and responsibilities in accordance with any requirements of the federal department of health and human services. (5) FUNDING AND RISK-SHARING. (a) From the appropriation accounts under s. 20.435 (4) (b), (bd), (g), (gm), (h), (im), (o), and (w) and (7) (b), the department shall provide funding on a capitated payment basis for the provision of services under this section. Notwithstanding s. 46.036 (3) and (5m), a care management organization that is under contract with the department may expend the funds, consistent with this section, including providing payment, on a capitated basis, to providers of services under the family care benefit. (b) If the expenditures by a care management organization under par. (a) exceed payments received from the department under par. (a), as determined by the department by contract, the department may share the loss with the care management organization, within the limits prescribed under the contract with the department. (c) If the payments received from the department under par. (a) exceed the expenditures by a care management organization under par. (a), as determined by the department by contract, the care management organization may retain a portion of the excess payments, within the limits prescribed under the contract with the department, and shall return the remainder to the department. (d) The department may, by contract, impose solvency protections that the department determines are reasonable and necessary to retain federal financial participation. These protections may include all of the following: 1. The requirement that a care management organization segregate a risk reserve from other funds of the care management organization or the authorizing body for the care management organization. 2. The requirement that interest accruing to the risk reserve remain in the escrow account for the risk reserve. 3. Limitations on the distribution of funds from the risk reserve. 4. The requirement that a care management organization place funds in a risk reserve and maintain the risk reserve in an interest-bearing escrow account with a financial institution, as defined in s. 69.30 (1) (b), or invest funds as specified in s. 46.2895 (4) (j) 2. or 3. Moneys in the risk reserve or invested as specified in this subdivision may be expended only for the provision of services under this section. If a care management organization ceases participation under this section, the funds in the risk reserve or invested as specified in this subdivision, minus any contribution of moneys other than those specified in par. (c), shall be returned to the department. The department shall expend the moneys for the payment of outstanding debts to providers of family care benefit services and for the continuation of family care benefit services to enrollees. (e) 1. Subject to subd. 2., a care management organization may enter into contracts with providers of family care benefit services and may limit profits of the providers under the contracts.
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2. The department shall review the contracts in subd. 1., including rates for the provision of service, to ensure that the contract terms protect services access by enrollees and financial viability of the care management organization, and may require contract revision. (6) GOVERNING BOARD. A care management organization shall have a governing board that reflects the ethnic and economic diversity of the geographic area served by the care management organization. At least one-fourth of the members of the governing board shall be representative of the client group or groups whom the care management organization is contracted to serve or those clients’ family members, guardians, or other advocates. (7) CONFIDENTIALITY; EXCHANGE OF INFORMATION. No record, as defined in s. 19.32 (2), of a care management organization that contains personally identifiable information, as defined in s. 19.62 (5), concerning an individual who receives services from the care management organization may be disclosed by the care management organization without the individual’s informed consent, except as follows: (a) A care management organization may provide information as required to comply with s. 16.009 (2) (p) or 49.45 (4) or as necessary for the department to administer the program under ss. 46.2805 to 46.2895. (b) Notwithstanding 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 care management organization 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), 46.2895 (10), 51.42 (3) (e) or 51.437 (4r) (b) in the county of the care management organization, if necessary to enable the care management organization to perform its duties or to coordinate the delivery of services to the client. History: 1999 a. 9; 2001 a. 16, 103; 2003 a. 33; 2005 a. 264, 386; 2007 a. 20; 2009 a. 2, 28; 2011 a. 10, 32, 126; 2013 a. 165 s. 114; 2015 a. 55, 215. A long-term care district is governed by s. 46.2895 (2) and is limited to the counties that are members of the district. Before a district may provide care management organization services 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 315.
46.285 Operation of resource center and care management organization. In order to meet federal requirements and assure federal financial participation in funding of the family care benefit, a county, a tribe or band, a long-term care district or an organization, including a private, nonprofit corporation, may not directly operate both a resource center and a care management organization. History: 1999 a. 9; 2005 a. 386; 2007 a. 20; 2019 a. 9.
46.286 Family care benefit. (1) ELIGIBILITY. A person is eligible for, but not necessarily entitled to, the family care benefit if the person is at least 18 years of age; has a physical disability, as defined in s. 15.197 (4) (a) 2., or a developmental disability, as defined in s. 51.01 (5) (a), or is a frail elder; and meets all of the following criteria: (a) Functional eligibility. A person is functionally eligible if the person’s level of care need, as determined by the department or its designee, is either of the following: 1m. The nursing home level, if the person has a long-term or irreversible condition, expected to last at least 90 days or result in death within one year of the date of application, and requires ongoing care, assistance or supervision. 2m. The non-nursing home level, if the person has a condition that is expected to last at least 90 days or result in death within 12 months after the date of application, and is at risk of
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losing his or her independence or functional capacity unless he or she receives assistance from others. (b) Financial eligibility. 1c. In this paragraph, “medical assistance” does not include coverage of the benefits under s. 49.471 (11). 2m. A person is financially eligible if any of the following apply: a. The person is eligible under ch. 49 for medical assistance and, unless he or she is exempt from acceptance under rules promulgated by the department, accepts medical assistance. b. The person was receiving the family care benefit on October 27, 2007, the person would qualify for medical assistance except for financial or disability criteria, and the projected cost of the person’s care plan, as calculated by the department or its designee, exceeds the person’s gross monthly income, plus onetwelfth of his or her countable assets, less deductions and allowances permitted by rule by the department. (2) COST SHARING. (a) A person who is determined to be financially eligible under sub. (1) (b) shall contribute to the cost of his or her care an amount that is calculated by the department or its designee after subtracting from the person’s gross income, plus one-twelfth of countable assets, the deductions and allowances permitted by the department by rule. (b) Funds received under par. (a) shall be used by a care management organization to pay for services under the family care benefit. (c) A person who is required to contribute to the cost of his or her care but who fails to make the required contributions is ineligible for the family care benefit unless he or she is exempt from the requirement under rules promulgated by the department. (3) ENTITLEMENT. (a) Subject to par. (c), a person is entitled to and may receive the family care benefit through enrollment in a care management organization if all of the following apply: 1m. The person is at least 18 years of age. 2m. The person has a physical disability, as defined in s. 15.197 (4) (a) 2., a developmental disability, as defined in s. 51.01 (5) (a), or is a frail elder. 3m. The person is functionally eligible under sub. (1) (a). 4m. The person is financially eligible under sub. (1) (b) 2m. a., and fulfills any applicable cost-sharing requirements. (b) An entitled individual who is enrolled in a care management organization may not be involuntarily disenrolled except as follows: 1. For cause, subject to the requirements of s. 46.284 (4) (a). 2. If the contract between the care management organization and the department is canceled or not renewed. If this circumstance occurs, the department shall assure that enrollees continue to receive needed services through another care management organization or through the medical assistance fee-for-service system or any of the following programs: b. Home and community-based waiver programs under 42 USC 1396n (c), including a community integration program under s. 46.275, 46.277, or 46.278 and the Community Opportunities and Recovery Program under s. 46.2785. c. The Alzheimer’s family caregiver support program under s. 46.87. d. Community aids under s. 46.40, if documented by the county under a method prescribed by the department. e. County funding, if documented by the county under a method prescribed by the department. 3. The department or its designee determines that the person no longer meets eligibility criteria under sub. (1). (c) Within each county and for each client group, par. (a) shall
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first apply on the effective date of a contract under which a care management organization accepts a per person per month payment to provide services under the family care benefit to eligible persons in that client group in the county. Within 36 months after this date, the department shall assure that sufficient capacity exists within one or more care management organizations to provide the family care benefit to all entitled persons in that client group in the county. (3m) INFORMATION ABOUT ENROLLEES. The department shall obtain and share information about family care enrollees as provided in s. 49.475. (4) DIVESTMENT; RULES. The department shall promulgate rules relating to prohibitions on divestment of assets of persons who receive the family care benefit, that are substantially similar to applicable provisions under s. 49.453. (5) TREATMENT OF TRUST AMOUNTS; RULES. The department shall promulgate rules relating to treatment of trust amounts of persons who receive the family care benefit, that are substantially similar to applicable provisions under s. 49.454. (6) PROTECTION OF INCOME AND RESOURCES OF COUPLE FOR MAINTENANCE OF COMMUNITY SPOUSE; RULES. The department shall promulgate rules relating to protection of income and resources of couples for the maintenance of the spouse in the community with regard to persons who receive the family care benefit, that are substantially similar to applicable provisions under s. 49.455. (7) RECOVERY OF FAMILY CARE BENEFIT PAYMENTS. The department shall apply to the recovery from persons who receive the family care benefit, including by liens and affidavits and from estates, of correctly paid family care benefits, the applicable provisions under ss. 49.496 and 49.849. History: 1999 a. 9, 185; 2001 a. 16, 109; 2003 a. 33; 2005 a. 25, 264, 388; 2007 a. 20; 2009 a. 28; 2013 a. 20, 92; 2019 a. 9. Cross-reference: See also ch. DHS 10, Wis. adm. code.
46.287 Hearings. (1) DEFINITION. In this section, “client” means a person applying for eligibility for the family care benefit, an eligible person or an enrollee. (2) HEARING. (a) 1. Except as provided in subd. 2., a client may contest any of the following applicable matters by filing, within 45 days of the failure of a resource center or county to act on the contested matter within the time frames specified by rule by the department or within 45 days after receipt of notice of a decision in a contested matter, a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1): a. Denial of eligibility under s. 46.286 (1). b. Determination of cost sharing under s. 46.286 (2). c. Denial of entitlement under s. 46.286 (3). g. Termination of the family care benefit. h. Imposition of ineligibility for the family care benefit under s. 46.286 (4). i. Denial of eligibility or reduction of the amounts of the family care benefit under s. 46.286 (5). j. Determinations similar to those specified under s. 49.455 (8) (a), made under s. 46.286 (6). k. Recovery of family care benefit payments. 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):
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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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. b. Failure to provide timely services and support items that are included in the plan of care. 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. 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. e. Denial, in whole or in part, of payment for a service. 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. g. Denial of an enrollee’s request to dispute financial liability, including copayments, premiums, deductibles, coinsurance, other cost sharing, and other member financial liabilities. 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. 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. j. Involuntary disenrollment from the care management organization. 2. An applicant for or recipient of medical assistance is not entitled to a hearing concerning the identical dispute or matter under both this section and 42 CFR 431.200 to 431.246. (b) An enrollee may contest a decision, omission or action of a care management organization other than those specified in par. (a) 1m. by filing a grievance with the care management organization. If the grievance is not resolved to the satisfaction of the enrollee, he or she may request that the department review the decision of the care management organization. (c) Information regarding the availability of advocacy services and notice of adverse actions taken and appeal rights shall be provided to a client by the resource center or care management organization in a form and manner that is prescribed by the department by rule. History: 1999 a. 9; 2003 a. 33; 2013 a. 20; 2019 a. 9.
46.288 Rule-making. The department shall promulgate as rules all of the following: (1) Standards for performance by resource centers and for certification of care management organizations, including requirements for maintaining quality assurance and quality improvement. (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). (3) Procedures and standards for procedures for s. 46.287 (2), including time frames for action by a resource center or a care management organization on a contested matter. History: 1999 a. 9; 2007 a. 20; 2009 a. 28; 2019 a. 9.
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46.2895 Long-term care district. (1) CREATION. (a) A county, a tribe or band, or any combination of counties or tribes or bands, may create a special purpose district that is termed a “long-term care district”, that is a local unit of government, that is separate and distinct from, and independent of, the state and the county or tribe or band that created it, and that has the powers and duties specified in this section, if each county or tribe or band that participates in creating the district does all of the following: 1. Adopts an enabling resolution that does all of the following: a. Declares the need for establishing the long-term care district. b. Specifies the long-term care district’s primary purpose, which shall be to operate, under contract with the department, a resource center under s. 46.283, a care management organization under s. 46.284, or a program described under s. 46.2805 (1) (a) or (b). c. Specifies the number of individuals who shall be appointed as members of the long-term care district board, the length of their terms, and, if the long-term care district is created by more than one county or tribe or band, how many members shall be appointed by each county or tribe or band. 2. Files copies of the enabling resolution with the secretary of administration, the secretary of health services and the secretary of revenue. (c) A long-term care district may not operate a care management organization under s. 46.284 or a program described under s. 46.2805 (1) (a) or (b) if the district operates a resource center under s. 46.283. (d) A county or tribe or band may create more than one longterm care district. (e) A long-term care district may change its primary purpose specified under par. (a) 1. b. if all the counties or tribes or bands that created the district and that have not withdrawn or been removed from the district under sub. (14), adopt a resolution approving the change in primary purpose and if the change in purpose does not violate par. (c) or any provision of a contract between the department and the district. (2) JURISDICTION. (a) Except as provided in par. (b) or (c), a long-term care district’s jurisdiction is the geographical area of the county or counties that created the long-term care district and the geographic area of the reservation of, or lands held in trust for, any tribe or band that created the long-term care district. (b) A long-term care district may apply to the department for a contract to operate a care management organization under s. 46.284 in an area outside the geographic boundary of the county or counties that created the long-term care district. (c) If the department awards a contract to a long-term care district to operate a care management organization outside the geographic area of the counties that created the long-term care district, any county that is newly served by the care management organization and is outside the geographic area of the counties that created the long-term care district may join the existing long-term care district at the discretion of the long-term care district’s board, provided the newly served county adopts a resolution that authorizes the county to join the long-term care district. A county served by a care management organization operated by a long-term care district to which the county does not belong shall cooperate with and may not impede the operation of the care management organization. (3) LONG-TERM CARE DISTRICT BOARD. (a) The county board of supervisors of a county or, in a county with a county administrator or county executive, the county administrator or county executive shall appoint the long-term care district board
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members whom the county is allotted, by resolutions adopted under sub. (1) (a) 1. c., to appoint. (b) 1. At least one-fourth of the members of a long-term care district board shall be representative of the client group or groups whom it is the long-term care district’s primary purpose to serve or those clients’ family members, guardians, or other advocates. 3. Membership of a long-term care district board shall reflect the ethnic and economic diversity in the jurisdiction of the longterm care district. 4. No member of a long-term care district board may have a private financial interest in or profit directly or indirectly from any contract or other business of the long-term care district. 5. Only individuals who reside within the area served by a long-term care district may serve as members of the long-term care district board. (d) As soon as possible after the appointment of the initial members of the long-term care district board, the board shall organize for the transaction of business and elect a chairperson and other necessary officers. Each chairperson shall be elected by the board from time to time for the term of that chairperson’s office as a member of the board or for the term of 3 years, whichever is shorter, and shall be eligible for reelection. A majority of the board shall constitute a quorum. Unless specified otherwise in a bylaw adopted by the board, the board may act based on the affirmative vote of a majority of a quorum. (e) Notwithstanding sub. (1) (a) 1. c., if a long-term care district is awarded a contract with the department to operate a care management organization outside the geographic area of the county or counties that created the long-term care district, the long-term care district board may add members to the long-term care district board to represent the counties or areas newly served by the long-term care district. The long-term care district board shall file notice of the change of the long-term care district board’s composition with the secretary of administration, the secretary of health services, and the secretary of revenue. (4) POWERS. Subject to sub. (1) (c), a long-term care district has all the powers necessary or convenient to carry out the purposes and provisions of ss. 46.2805 to 46.2895. In addition to all these powers, a long-term care district may do all of the following: (a) Adopt and alter, at pleasure, an official seal. (b) Adopt bylaws and policies and procedures for the regulation of its affairs and the conduct of its business. The bylaws, policies and procedures shall be consistent with ss. 46.2805 to 46.2895 and, if the long-term care district contracts with the department under par. (d) or (dm), with the terms of that contract. (c) Sue and be sued. (d) Negotiate and enter into leases or contracts, including a contract with the department to operate either a resource center or a portion of its functions under s. 46.283 or a care management organization under s. 46.284, but not both a resource center or its functions and a care management organization. (dm) Subject to sub. (1) (c), enter into a contract with the department to operate a program described under s. 46.2805 (1) (a) or (b) and provide services related to the contracted services. (e) Provide services related to services available under the family care benefit, to older persons and persons with disabilities, in addition to the services funded under the contract with the department that is specified under par. (d). (f) Acquire, construct, equip, maintain, improve or manage a resource center under s. 46.283 or a care management organization under s. 46.284, but not both. (g) Subject to sub. (8), employ any agent, employee, or special adviser that the long-term care district finds necessary, fix and
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regulate his or her compensation and provide, either directly or subject to an agreement under s. 66.0301 as a participant in a benefit plan of another governmental entity, any employee benefits, including an employee pension plan. (h) Mortgage, pledge or otherwise encumber the long-term care district’s property or funds. (i) Buy, sell or lease property, including real estate, and maintain or dispose of the property. (j) Invest any funds not required for immediate disbursement in any of the following: 1. An interest-bearing escrow account with a financial institution, as defined in s. 69.30 (1) (b). 2. Time deposits in any financial institution, as defined in s. 69.30 (1) (b), if the time deposits mature in not more than 2 years. 3. Bonds or securities issued or guaranteed as to principal and interest by the federal government or by a commission, board or other instrumentality of the federal government. (k) Create a risk reserve or other special reserve as the longterm care district board desires or as the department requires under the contract with the department that is specified under par. (d). (L) Accept aid, including loans, to accomplish the purpose of the long-term care district from any local, state or federal governmental agency or accept gifts, loans, grants or bequests from individuals or entities, if the conditions under which the aid, loan, gift, grant or bequest is furnished are not in conflict with this section. (m) Make and execute other instruments necessary or convenient to exercise the powers of the long-term care district. (n) In accordance with state law, operate a health maintenance organization. (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. (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. (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. (r) With approval of the department and office of the commissioner of insurance, assign the following to a corporation created under par. (q): 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. 2. A contract with the department as described in sub. (2) (b) or (c). 3. A permit issued by the office of the commissioner of insurance under ch. 648.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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4. A certification by the department under s. 46.284 (3). (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. (5) LIMITATION ON POWERS. A long-term care district may not issue bonds or levy a tax or assessment. (6) DUTIES. The long-term care district board shall do all of the following: (a) Appoint a director, who shall hold office at the pleasure of the board. (b) Subject to sub. (8), develop and implement a personnel structure and other employment policies for employees of the long-term care district. (c) Assure compliance with the terms of any contract with the department under sub. (4) (d) or (dm). (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. (d) Establish a fiscal operating year and annually adopt a budget for the long-term care district. (e) Contract for any legal services required for the long-term care district. (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. (7) DIRECTOR; DUTIES. The director appointed under sub. (6) (a) shall do all of the following: (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. (b) Comply with the bylaws and direct enforcement of all policies and procedures adopted by the long-term care district board. (c) Perform duties in addition to those specified in pars. (a) and (b) as are prescribed by the long-term care district board. (8) EMPLOYMENT AND EMPLOYEE BENEFITS OF CERTAIN EMPLOYEES. (a) A long-term care district board that is created at least in part by a county shall do all of the following: 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. 3. If the long-term care district offers employment to any in-
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dividual 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. 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. (b) The county board of supervisors of each county that creates a long-term care district shall do all of the following: 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. 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. (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. (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). (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. (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. (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. (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 dis-
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trict 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. (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. 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. 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 Counting promissory notes as assets. (1) In this section: (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). (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. (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: (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. (b) The promissory note was entered into or purchased on or after July 14, 2015. (c) The promissory note is negotiable, assignable, and enforceable and does not contain any terms making it unmarketable. (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. History: 2015 a. 55; 2019 a. 9.
46.2897 Self-directed services option. (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
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(c) in which an enrolled individual selects his or her own services and service providers. (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). (3) WORKER’S COMPENSATION COVERAGE. An individual who is performing services for a person participating in the selfdirected 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. History: 2009 a. 28; 2015 a. 180; 2021 a. 232.
46.2898 Employment of individuals with disabilities; long-term care programs. (1) DEFINITIONS. In this section: (a) “Board” means the board for people with developmental disabilities. (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. (c) “Family care” means the program that provided the family care benefit, as defined in s. 46.2805 (4). (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. (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. (f) “Self-directed services option” has the meaning given in s. 46.2899 (1). (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: (a) Develop a model of coaching businesses in the hiring and employment of individuals with disabilities that engages businesses directly. (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. (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. (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. (e) Include travel costs in costs available for any reimbursement, including grants awarded for meeting criteria under sub. (4) (b). (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. (4) COACHING RECIPIENTS; GRANTS. (a) The board shall re-
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quest proposals from any of the following to participate in a coaching program for the hiring of qualified employees: 1. Public schools. 2. Care management organizations that administer family care or the Family Care Partnership Program. 3. Consultant agencies that assist enrollees of the self-directed services option. 4. Employment services providers for the state’s long-term care programs. 5. Private businesses. (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: 1. Annually, the entity submits a report to the board containing all of the following: a. The number of individuals with disabilities hired by the entity that provides supported employment through a businessbased internal support model. 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. 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. 2. The entity demonstrates an increase in the number of businesses hiring and employing individuals with disabilities and providing internal support for those individuals. 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. 4. The entity meets other outcome measures as determined by the board. History: 2017 a. 323; 2021 a. 238 ss. 9, 45.
46.2899 Services for the developmentally disabled who receive post-secondary education. (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). (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 postsecondary 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. (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. (4) SERVICES AND BENEFITS. The department shall provide
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the same services under the waiver program described in sub. (2) as it provides under the self-directed services option. The department shall determine the funding amount for a waiver program participant under this section. History: 2013 a. 20.
46.29 Council on physical disabilities. (1) From the appropriation account under s. 20.435 (1) (a), the department shall distribute at least $16,100 in each fiscal year for operation of the council on physical disabilities. The council on physical disabilities shall do all of the following: (a) Develop, approve and continue modification of a state plan, for services to physically disabled persons, that encompasses services from the entities specified under sub. (3). (b) Request reports or other information from the entities specified under sub. (3) concerning programs, funding, clients or services as they relate to physically disabled persons. (c) Advise the secretary of the department and make recommendations, including recommendations for legislation, to the entities specified under sub. (3) concerning funding, programs, policies and operations of those entities and other matters with respect to physically disabled persons. (d) Encourage public understanding of the needs of and issues concerning physically disabled persons. (e) Consider all questions and matters concerning physically disabled persons arising within the council or brought to the council for review. (em) Approve educational material relating to the parking privileges of physically disabled persons for placement on vehicles as provided in s. 346.94 (4). The council may delegate to a member of the council or an officer or employee of a state agency the authority granted under this paragraph. (fm) By April 15, 1996, and biennially thereafter, submit a report to the legislature under s. 13.172 (2) concerning the time limitations imposed by any ordinances enacted under s. 346.50 (3m) on spaces reserved for use by a motor vehicle used by a physically disabled person, including any recommended changes to s. 346.50 (3m) and copies of any reports submitted from cities as required by s. 346.50 (3m) (b) 5. (g) Meet at least 4 times annually. (2) The council on physical disabilities may do all of the following: (a) Report to the public concerning needs of physically disabled persons and issues that affect those persons. (b) Promote programs related to the prevention of physical disability. (c) Form committees for consideration of policies or programs for physically disabled persons. (3) All of the following shall maintain liaison with and periodically report to the council on physical disabilities concerning progress in achieving objectives in the state plan developed under sub. (1) (a): (a) The state superintendent of public instruction. (b) The secretary of transportation. (c) The secretary of workforce development. (d) The administrator of the division of personnel management in the department of administration. (e) The secretary of safety and professional services. (f) The commissioner of insurance. (g) The president of the University of Wisconsin System. (h) The president of the technical college system board. (i) The executive director of the board on aging and long-term care. History: 1989 a. 202; 1991 a. 39; 1993 a. 256, 399; 1995 a. 27 ss. 9116 (5), 9130
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(4), 9145 (1); 1995 a. 131; 1997 a. 3, 27; 1999 a. 9; 2001 a. 16; 2003 a. 33 ss. 1142, 9160; 2007 a. 20, 96; 2009 a. 28; 2011 a. 32; 2015 a. 55; 2017 a. 59.
46.293 Specialized programs for the blind and visually impaired. The department shall provide rehabilitation teaching services for persons who are blind or visually impaired including elderly persons and young persons and their parents or guardians, regardless of their eligibility for vocational rehabilitation services. These services may include assessments of each client’s service needs, development of an individual service plan, instruction in braille, training in orientation and movement in the person’s home or neighborhood, counseling and guidance to increase the blind or visually impaired person’s independence, instruction in the use of low-vision aids, personal and home management training and instruction in leisure activities. In conjunction with the provision of these services the department shall: (1) Work with blind and visually impaired persons, in a setting appropriate to each individual, to form rehabilitation plans for independent living to enable them to increase their selfreliance. (2) Assist blind and visually impaired persons in physical orientation and personal adjustment. History: 1995 a. 27 ss. 2270, 2413; Stats. 1995 s. 46.293.
46.295 Interpreters for the hearing-impaired. (1) The department may, on the request of any hearing-impaired person, city, village, town, or county or private agency, provide funds from the appropriation accounts under s. 20.435 (1) (da) and (hs) to reimburse interpreters for hearing-impaired persons for the provision of interpreter services. (2) The department shall grant priority to requests to pay fees charged by interpreters for the following, in the following order: (a) Emergencies. (b) Medical, mental health, alcohol and drug abuse, psychiatric and psychological services. (c) Legal services and civil court proceedings. (d) Matters concerning law enforcement personnel. (e) Matters concerning any federal, state, county or municipal agency. (3) The department shall maintain lists of qualified interpreters under s. 885.37 (5) (b). (4) The department may use as an interpreter for hearing-impaired persons only the following: (a) An interpreter for hearing-impaired persons who is certified by the national registry of interpreters for the deaf. (b) If an interpreter under par. (a) is unavailable, an interpreter for hearing-impaired persons whose qualifications have been determined appropriate by the department. (5) The department may bill any public or private agency at the rates established by the department for interpreter services for hearing-impaired persons commensurate with the certification or qualification level of the interpreter providing services if the department determines that the agency is required under state or federal law to provide interpreter services to a hearing-impaired person or if the agency agrees to pay for the services. (6) The department shall promulgate rules to implement this section. History: 1995 a. 27 ss. 2271, 2417; Stats. 1995 s. 46.295; 2003 a. 33; 2009 a. 28; 2015 a. 55; 2017 a. 59. Cross-reference: See also ch. DHS 77, Wis. adm. code.
46.297 Telecommunication aid for the hearing impaired. (1) ASSISTANCE. From the appropriation under s. 20.435 (1) (da), the department shall, subject to the availability of funds, provide assistance to hearing-impaired persons to secure telecommunication devices capable of serving their needs. Ex-
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cept in extraordinary circumstances, the department shall purchase or provide funds for the purchase of telecommunication devices. (2) ELIGIBILITY. A person is eligible to receive assistance under sub. (1) if all of the following conditions are met: (a) The person is certified as deaf or severely hearing impaired by a physician, an audiologist who is licensed under subch. II of ch. 459 or who holds a compact privilege under subch. III of ch. 459, or the department. (b) The adjusted gross income of the person’s family is equal to or less than 200 percent of the poverty line established under 42 USC 9902 (2). (3) HEARING RIGHTS. Any person aggrieved by a decision of the department under this section has a right to a contested case hearing under ch. 227. (4) DEPARTMENTAL DUTIES. The department shall: (a) Promulgate rules necessary for the administration of this section. (b) Establish application procedures and determine eligibility. History: 1983 a. 427; Stats. 1983 s. 46.90; 1983 a. 538 s. 51; Stats. 1983 s. 46.92; 1987 a. 27; 1987 a. 257 s. 2; 1989 a. 173 s. 3; Stats. 1989 s. 47.20; 1989 a. 316; 1995 a. 27 s. 2421; Stats. 1995 s. 46.297; 2017 a. 59; 2023 a. 56. Cross-reference: See also chs. DHS 77 and 78, Wis. adm. code.
46.298 Vehicle sticker for the hearing impaired. Upon the request of a person who is certified as hearing impaired by the department, by a physician, by a hearing instrument specialist licensed under subch. I of ch. 459, or by an audiologist who is licensed under subch. II of ch. 459 or who holds a compact privilege under subch. III of ch. 459, the department shall issue to the person a decal or sticker for display on a motor vehicle owned or frequently operated by the person to apprise law enforcement officers of the fact that the vehicle is owned or operated by a hearing-impaired person. No charge shall be made for issuance of the decal or sticker. The department shall specify the design of the decal or sticker. The department shall designate the location on the vehicle at which the decal or sticker shall be affixed by its own adhesive. History: 1987 a. 257; 1989 a. 31; 1989 a. 173 s. 4; Stats. 1989 s. 47.25; 1989 a. 316; 1995 a. 27 s. 2422; Stats. s. 46.298; 2023 a. 56.
46.33 Employee counseling referral programs. The department may provide technical assistance to municipalities, counties, school districts and private employers for referral programs for employee counseling. The department may charge fees to cover the costs of these services. History: 1989 a. 31.
46.34 Emission standards for hazardous air contaminants. The department may assist the department of natural resources in the development of emission standards for hazardous air contaminants under s. 285.27 (2) (b). History: 1993 a. 16; 1995 a. 227.
46.37 Certain water and sewerage service in Winnebago County. The department, as a member of the tri-institutional Winnebago Mental Health Institute, Winnebago County Asylum, and Sunny View Sanatorium sewer agreement in Winnebago County, is authorized to furnish and charge for water and sewerage services to business and dwelling units located in the privately owned area lying west of the Winnebago Mental Health Institute and bounded on the west by the railroad properties and on the north, east, and south by the grounds of the Winnebago Mental Health Institute, together with any dwelling or other units located on the railroad-owned and state-owned property adjacent to this area. History: 1973 c. 90 s. 560 (3); 2001 a. 103.
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46.40 Community aids funding. (1) DISTRIBUTION LIMITS. (a) Within the limits of available federal funds and of the appropriations under s. 20.435 (7) (b) and (o), the department shall distribute funds for community social, mental health, developmental disabilities, and alcohol and other drug abuse services and for services under ss. 46.87 and 51.421 to county departments under ss. 46.215, 46.22, 46.23, 51.42, and 51.437 and to county aging units, as provided in subs. (2), (2m), (8), and (9). (d) If the department of health services receives any federal moneys under 42 USC 1396 to 1396v in reimbursement of the cost of preventing out-of-home placements of children, the department of health services shall transfer those moneys to the department of children and families, and the department of children and families shall use those moneys as the first source of moneys used to meet the amount of the allocation under s. 48.563 (2) that is budgeted from federal funds. (2) BASIC COUNTY ALLOCATION. Subject to sub. (9), for social services under s. 46.495 (1) (d) and services under s. 51.423 (2), the department shall distribute not more than $176,068,400 in each fiscal year. (2m) FEDERAL BLOCK GRANT ALLOCATIONS. (a) Prevention and treatment of substance abuse. For prevention and treatment of substance abuse under 42 USC 300x-21 to 300x-35, the department shall distribute not more than $13,975,500 in fiscal year 2009-10 and $9,735,700 in each fiscal year thereafter. (b) Community mental health services. For community mental health services under 42 USC 300x to 300x-9, the department shall distribute $2,513,400 in each fiscal year. (7m) STATE COMMUNITY MENTAL HEALTH ALLOCATION. For community mental health services, the department shall distribute not less than $24,348,700 in each fiscal year. (8) ALZHEIMER’S FAMILY AND CAREGIVER SUPPORT ALLOCATION. Subject to sub. (9), the department cannot distribute more than $3,058,900 in each fiscal year for services to persons with Alzheimer’s disease and their caregivers under s. 46.87. (9) TRANSFER OR ADJUSTMENT OF COMMUNITY AIDS ALLOCATIONS. (ag) Adjustment for family care. If a care management organization under s. 46.284 is available in a county and the county has under s. 46.281 (4) agreed to a reduction in its distribution under sub. (2), the department shall use the amount established under s. 46.281 (4) to fund the services of care management organizations under s. 46.284 (4). (ar) Transfer to family care program and adult protective services allocation. If a care management organization under s. 46.284 is available in a county, the department may, of the amount allocated under sub. (8), dispose of the lesser of up to 60 percent or the amount remaining after subtracting an amount necessary to maintain funding for recipients under sub. (8) who, on September 1, 2001, are ineligible for the family care benefit under s. 46.286, to that county, as follows: 1. By transferring a portion of that amount, as determined by the department, to the family care program to fund the services of resource centers under s. 46.283 (5) and the services of care management organizations under s. 46.284 (4). 2. By transferring a portion of that amount, as determined by the department, to the county’s adult protective services allocation under par. (b). (b) Adult protective services allocation. For adult protective services, the department shall distribute the amounts transferred under par. (ar) 2. in each fiscal year. (c) Adjustment for medical assistance buy-in program. If a former recipient of services funded under the allocation under sub. (2) is a participant in the medical assistance buy-in program under s. 49.472, the department may decrease that allocation by
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the amount that the department estimates it will incur in providing services to that participant under s. 49.472. (d) Payment adjustments for certain Medical Assistance services. The department may decrease a county’s allocation under sub. (2) by the amount of any payment adjustments under s. 49.45 (52) (a) made for that county from the appropriation account under s. 20.435 (7) (b) for services described under s. 49.45 (52) (a) 1. The total amount of the decrease for a county under this paragraph during any fiscal year may not exceed that part of the county’s allocation under sub. (2) that derives from the appropriation account under s. 20.435 (7) (b) for that fiscal year. (e) County income maintenance administration. Beginning in calendar year 2012, the department shall decrease the allocation under sub. (2) for a county with a population of 750,000 or more from the appropriation under s. 20.435 (7) (b) by $2,700,000. (14m) COUNTY COMMUNITY AIDS BUDGETS. Before December 1 of each year, each county department under ss. 46.215, 46.22, 46.23, 51.42 and 51.437 and each tribal governing body shall submit to the department a proposed budget for the expenditure of funds allocated under this section or carried forward under s. 46.45 (3). The proposed budget shall be submitted on a form developed by the department and approved by the department of administration. History: 1987 a. 27, 399, 405; 1989 a. 31, 122, 336; 1991 a. 6, 39, 189, 269, 275, 315; 1993 a. 16, 437, 446; 1995 a. 27, 275, 303, 404; 1997 a. 27, 35, 237, 292; 1999 a. 9, 185; 2001 a. 16; 2003 a. 33, 318; 2005 a. 25 ss. 879, 2501, 2510; 2007 a. 20 ss. 1096 to 1104g, 9121 (6) (a); 2009 a. 28, 180; 2011 a. 32; 2015 a. 55, 273; 2021 a. 58; 2023 a. 19.
46.45 Carry-over of community aids funds. Funds allocated by the department under ss. 46.495 (1) (d), 46.87 (3) (c) 4. and (4) and 51.423 (2) but not spent or encumbered by counties, governing bodies of federally recognized American Indian tribes or private nonprofit organizations by December 31 of each year and funds recovered under ss. 46.495 (2) (b) and 51.423 (15) and deposited in the appropriation under s. 20.435 (7) (b) lapse to the general fund on the succeeding January 1 unless carried forward to the next calendar year under s. 20.435 (7) (b) or as follows: (3) (a) Except as provided in par. (b), at the request of a county, tribal governing body, or private nonprofit organization, the department shall carry forward up to 3 percent of the total amount allocated to the county, tribal governing body, or nonprofit organization for a calendar year. All funds carried forward for a tribal governing body or nonprofit organization and all funds allocated under s. 46.40 (2m) carried forward for a county shall be used for the purpose for which the funds were originally allocated. Other funds carried forward under this paragraph may be used for any purpose under s. 20.435 (7) (b), except that a county may not use any funds carried forward under this paragraph for administrative or staff costs. An allocation of carriedforward funding under this paragraph does not affect a county’s base allocations under s. 46.40 (2), (2m), (8), and (9). (b) The department may not carry forward funds allocated to a private nonprofit organization for a calendar year for use in the next calendar year unless the organization continues to be eligible to receive an allocation under s. 46.87 (4) in the next calendar year. (6) The department may carry forward 10 percent of any funds specified in sub. (3) that are not carried forward under sub. (3) for emergencies, for justifiable unit services costs above planned levels, and for increased costs due to population shifts. An allocation of carried-forward funding under this paragraph does not affect a county’s base allocations under s. 46.40 (2), (2m), (8), and (9). History: 1987 a. 27, 399, 405; 1989 a. 31, 122, 336; 1991 a. 39, 269; 1993 a. 16; 1995 a. 27, 404; 1997 a. 27; 1999 a. 9; 2001 a. 16; 2003 a. 33, 320; 2007 a. 20; 2015 a. 55.
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46.47 Grants for nonnarcotic drug treatment in county jails. (1) From the appropriation account under s. 20.435 (5) (bd), the department shall award grants to provide nonnarcotic drug treatment as provided in sub. (2) to a county or federally recognized American Indian tribe or band that meets all of the following criteria: (a) The county or tribe has a county or tribal jail. (b) The county or tribe has an established drug court, as defined in s. 165.955 (1). (c) The county or tribe provides care coordination for inmates exiting county or tribal jail. (d) The county or tribe has identified how it will use care coordination to ensure that all program participants are enrolled in Medical Assistance under subch. IV of ch. 49 and will continue to receive treatment after an inmate leaves county or tribal jail custody. (2) Grant funds awarded under sub. (1) may be used only to provide nonnarcotic, non-addictive, injectable medically assisted treatment to inmates of county or tribal jails who voluntarily receive the treatment within the 5 days immediately preceding release from jail into the community. (3) The department shall provide application procedures for awarding grants to counties or tribes under sub. (1) in accordance with the department’s request-for-proposal procedures. History: 2017 a. 261; 2021 a. 238 s. 45.
46.48 Grants for community programs. (1) GENERAL. From the appropriation accounts under s. 20.435 (1) (b), (5) (bc), and (7) (bc), the department shall award grants for community programs as provided in this section. (4) TREATMENT ALTERNATIVE PROGRAM. For grants under s. 46.65, the department shall award not more than $261,300 in each fiscal year as grants to applicants that have previously received grants under s. 46.65. (5) ALCOHOL AND OTHER DRUG ABUSE RESIDENTIAL TREATMENT. For funding of at least 8 beds at a community-based residential facility in which English and Spanish are spoken, to provide treatment for alcohol and other drug abuse to residents of a 1st class city, the department may distribute not more than $248,200 for each fiscal year as a grant to the New Beginning residential treatment program in the city of Milwaukee. (8) PRISONER REINTEGRATION PROGRAM. (a) In this subsection, “prisoner” has the meaning given in s. 301.01 (2). (b) The department shall award $125,000 in each fiscal year as a grant to an organization or a group of organizations to provide a pilot program in Milwaukee County for prisoner reintegration. (c) The department shall provide application procedures and selection criteria for awarding the grant under par. (b) in accordance with that department’s request-for-proposal procedures. (d) The program under par. (b) shall provide at least all of the following: 1. The use of liaisons to meet with prospective program participants to provide information about the program and to assist program participants, prior to their release on extended supervision or parole, in planning for and obtaining the housing, employment, education and treatment that they will need upon release. 2. The use of mentors to assist participants in their reintegration into the community. (13) SUPPORTED EMPLOYMENT OPPORTUNITIES. The department shall distribute at least $60,000 in each fiscal year for programs to provide supported employment opportunities for severely disabled persons. (14) EPILEPSY SERVICES GRANTS. The department shall dis-
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tribute not more than $150,000 in each fiscal year for grants under s. 46.57 for services to persons with epilepsy. (18) OUTREACH SERVICES. The department shall distribute $84,000 in each fiscal year as grants to community organizations in southeastern and south central Wisconsin to provide outreach services relating to health, mental health, housing, assisted living, domestic violence, and other services. (26) COMMUNITY IMPROVEMENT JOB TRAINING. The department shall award $250,000 in each fiscal year, beginning in fiscal year 1994-95, as a grant to a community organization to conduct a community improvement job training program which shall do all of the following: (a) Provide job training, counseling and education for persons 16 to 23 years of age who reside in neighborhoods that have gang problems. (b) Provide projects to rebuild and strengthen neighborhoods that have gang problems. (c) Assist program participants who want to start their own small businesses by referring those participants to sources of grants, loans, venture capital and other funding and by assisting those participants with the funding application process. (d) Encourage former gang members to participate in the program. (29) ARC COMMUNITY SERVICES, INC. The department shall distribute $175,000 in each fiscal year to ARC Community Services, Inc., for a program to provide substance abuse day treatment services for pregnant and postpartum women and their infants. (30) SUBSTANCE ABUSE TREATMENT GRANTS. (a) From the appropriation account under s. 20.435 (5) (bc), the department shall distribute grants on a competitive basis to county departments of social services and to private nonprofit organizations, as defined in s. 103.21 (2), for the provision of alcohol and other drug abuse treatment services in counties with a population of 750,000 or more. Grants distributed under this subsection may be used only to provide treatment for alcohol and other drug abuse to individuals who are eligible for federal temporary assistance for needy families under 42 USC 601 et. seq. and who have a family income of not more than 200 percent of the poverty line, as defined in s. 49.001 (5). (b) Notwithstanding par. (a), the department may distribute grants under par. (a) only to the extent that the distribution meets the maintenance-of-effort requirement under the federal temporary assistance for needy families program under 42 USC 601 et. seq. (31) PEER RUN RESPITE CENTERS. The department may distribute not more than $1,200,000 in each fiscal year, beginning in fiscal year 2014-15, to regional peer run respite centers for individuals with mental health and substance abuse concerns. (32) PEER-RUN RESPITE CENTER CONTRACTS. The department shall contract with a peer-run organization to establish peerrun respite centers for individuals experiencing mental health conditions or substance abuse. Notwithstanding sub. (1), the department may make payments to an organization that establishes peer-run respite centers that provide services to veterans from the appropriation under s. 20.435 (5) (kp). History: 1989 a. 31 ss. 1085, 1090, 1092 to 1094, 1099; 1989 a. 122, 336, 359; 1991 a. 39, 269; 1993 a. 16, 98, 446; 1995 a. 27 ss. 2301m to 2304, 2600, 2601; 1997 a. 27, 283; 1999 a. 9; 2001 a. 16; 2003 a. 33; 2005 a. 25; 2007 a. 20; 2009 a. 28; 2011 a. 10; 2013 a. 20, 129; 2017 a. 59; 2017 a. 207 s. 5.
46.482 Coordination of care in substance use overdose. (1) In this section: (a) “Overdose treatment provider” means an entity, including an emergency department of a hospital, that offers treatment or
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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other services to individuals in response to or following a substance use overdose. (b) “Peer recovery coach” means an individual described under s. 49.45 (30j) (a) 2. who has completed the training requirements specified under s. 49.45 (30j) (b) 4. (2) The department shall establish and maintain a program to facilitate overdose treatment providers to do all of the following: (a) Use peer recovery coaches to encourage individuals to seek treatment for a substance use disorder following an overdose. (b) Provide access to medications to reverse overdose, as appropriate. (c) Coordinate and continue care and treatment of individuals after an overdose, including through referrals to treatment services, to peer support, to community organizations that support recovery, to education, training, and employment services, to housing services, and to child welfare agencies. An overdose treatment provider may coordinate and continue care and treatment under this paragraph by establishing an integrated model of care for patients who have experienced an overdose that may include assessment, follow-up services, and transportation to and from treatment. (d) Provide education to patients and families on preventing and reversing an overdose. (e) Provide follow-up services for patients after overdose to ensure continued recovery and connection to support services. (f) Collect and evaluate data on the outcomes of patients receiving peer recovery coach services and coordination and continuation of care services under this section. (3) The department may establish policies and procedures to provide guidance on any of the following: (a) The provision of medications that reverse an overdose and any other medications or biological products used to treat a substance use disorder. (b) Continuation of, or referral to, evidence-based treatment services for patients with a substance use disorder who have experienced an overdose, for the purpose of supporting long-term treatment and preventing relapse or future overdoses. (4) The department shall seek any funding available from the federal government, including grant funding under 42 USC 290dd-4, to establish and maintain the program under sub. (2) or establish the policies and procedures under sub. (3). The department may satisfy the requirement under sub. (2) by encouraging or facilitating or providing funding to programs operated by nongovernmental overdose treatment providers. History: 2019 a. 122; 2021 a. 240 s. 30.
46.485 Mental health services for severely emotionally disturbed children. (1) In this section: (a) “Inpatient facility” has the meaning given in s. 51.01 (10). (b) “Limited service health organization” has the meaning given in s. 609.01 (3). (c) “Serious emotional disturbance” has the meaning given in 42 USC 290ff-4 (d) (4). (d) “Severely emotionally disturbed child” has the meaning given in s. 49.45 (25) (a). (2g) From the appropriation account under s. 20.435 (4) (b), the department may in each fiscal year transfer funds to the appropriation account under s. 20.435 (5) (kc) for distribution under this section and from the appropriation account under s. 20.435 (7) (mb) the department may not distribute more than $1,330,500 in each fiscal year to applying counties in this state that meet all of the following requirements, as determined by the department:
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(a) Any of the following applies to the county: 1. The county receives a grant under 42 USC 290ff to 290ff4 for community mental health services for children with serious emotional disturbances. 2. The county receives any grant for services to severely emotionally disturbed children. 3. The county is in compliance with the requirements of s. 46.56, except that the county need not receive funding under s. 46.56 (15). (b) Any of the following applies to the county: 1. The county submits to the department a plan that specifies the proposed use of funds to implement the program under this section, including, at the time of termination of funding under this section, enrollment of children served under the program in a limited service health organization that covers both inpatient and outpatient expenses. 2. The county provides service coordination, as defined in s. 46.56 (1) (L), on behalf of a child with a serious emotional disturbance and the child’s family in the county. (3g) The amount that the department may transfer under sub. (2g) for counties may not exceed the estimated state share of payments under s. 49.45, 49.46, 49.47, or 49.471 for mental health care and treatment that is provided in inpatient facilities for children with severe emotional disturbances. (3m) Funds that are distributed under sub. (2g) may be used for all of the following: (a) Mental health care and treatment, other than care and treatment under s. 51.35 (3), in an inpatient facility for children with severe emotional disturbances. (b) Community mental health services for children with severe emotional disturbances. (3r) Funds from the appropriation account under s. 20.435 (5) (kc) that the department does not distribute to a county before 24 months after June 30 of the fiscal year in which the department allocated the funds to the county under sub. (2g) lapse to the appropriation account under s. 20.435 (4) (b). A county may at any time expend funds that the department distributes to the county, consistent with the requirements under sub. (3m). (4) The county receiving funds under sub. (2g) is not liable for payment for any care and treatment of the type authorized to be paid under sub. (3m) that is above the amount transferred under sub. (2g) (intro.). History: 1989 a. 336; 1991 a. 39, 269; 1993 a. 16, 437; 1995 a. 27; 1997 a. 27; 1999 a. 9; 2003 a. 33; 2007 a. 20; 2009 a. 2, 28.
46.49 Allocation of federal funds for community aids. (1) If the department receives unanticipated federal community mental health services block grant funds under 42 USC 300x to 300x-9 or federal prevention and treatment of substance abuse block grant funds under 42 USC 300x-21 to 300x-35 and if the department proposes to allocate the unanticipated funds so that an allocation limit in s. 46.40 is exceeded, the department shall submit a plan for the proposed allocation to the secretary of administration. If the secretary of administration approves the plan, he or she shall submit it to the joint committee on finance. If the cochairpersons of the committee do not notify the secretary of administration that the committee has scheduled a meeting for the purpose of reviewing the plan within 14 working days after the date of his or her submittal, the department may implement the plan, notwithstanding any allocation limits under s. 46.40. If within 14 working days after the date of the submittal by the secretary of administration the cochairpersons of the committee notify him or her that the committee has scheduled a meeting for the purpose of reviewing the plan, the department may implement
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the plan, notwithstanding s. 46.40, only with the approval of the committee. (2) If the department receives unanticipated federal social services block grant funds under 42 USC 1397 to 1397e, the department shall deposit the moneys in the appropriation under s. 20.435 (7) (o), unless the funds are for a specified purpose that is not included in s. 20.435 (7) (o), in which case the department shall deposit the moneys in the appropriation under s. 20.435 (7) (md) or (me), as appropriate. History: 1989 a. 31; 1991 a. 269, 275, 315; 1993 a. 16, 437, 446; 1995 a. 27, 404; 1997 a. 27; 2007 a. 20.
46.495 Distribution of community aids funds to counties. (1) (am) The department shall reimburse each county from the appropriations under s. 20.435 (7) (b) and (o) for social services as approved by the department under ss. 46.215 (1), (2) (c) 1., and (3) and 46.22 (1) (b) 1. d. and (e) 3. a. except that no reimbursement may be made for the administration of or aid granted under s. 49.02, 2009 stats. (d) From the appropriations under s. 20.435 (7) (b) and (o), the department shall distribute the funding for social services to county departments under ss. 46.215, 46.22, and 46.23 as provided under s. 46.40. County matching funds are required for the distributions under s. 46.40 (2), (8), and (9) (b). Each county’s required match for the distribution under s. 46.40 (2) shall be specified in a schedule established annually by the department. Each county’s required match for the distribution under s. 46.40 (8) for a year equals 9.89 percent of the total of the county’s distributions under s. 46.40 (8) for that year for which matching funds are required plus the amount the county was required by s. 46.26 (2) (c), 1985 stats., to spend for juvenile delinquency-related services from its distribution for 1987. Each county’s required match for the distribution under s. 46.40 (9) (b) for a year equals 9.89 percent of that county’s amounts described in s. 46.40 (9) (ar) (intro.) for that year. Matching funds may be from county tax levies, federal and state revenue sharing funds, or private donations to the county that meet the requirements specified in s. 51.423 (5). Private donations may not exceed 25 percent of the total county match. If the county match is less than the amount required to generate the full amount of state and federal funds distributed for this period, the decrease in the amount of state and federal funds equals the difference between the required and the actual amount of county matching funds. (dc) The department shall prorate the amount allocated to any county department under s. 46.215 or 46.22 under par. (d) to reflect actual federal funds available. (f) 1. If any state matching funds allocated under par. (d) to match county funds are not claimed, the funds shall be redistributed for the purposes the department designates. 2. The county allocation to match aid increases shall be included in the contract under s. 46.031 (2g) and approved by January 1 of the year for which funds are allocated, in order to generate state aid matching funds. All funds allocated under par. (d) shall be included in the contract under s. 46.031 (2g) and approved. (2) (a) The county treasurer and each director of a county department under s. 46.215, 46.22 or 46.23 shall monthly certify under oath to the department in such manner as the department prescribes the claim of the county for state reimbursement under this section and if the department approves such claim it shall certify to the department of administration for reimbursement to the county for amounts due under this subsection and payment claimed to be made to the counties monthly. The department may make advance payments prior to the beginning of each month equal to one-twelfth of the contracted amount. (b) To facilitate prompt reimbursement the certificate of the
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department may be based on the certified statements of the county officers filed under par. (a). Funds recovered from audit adjustments from a prior fiscal year may be included in subsequent certifications only to pay counties owed funds as a result of any audit adjustment. By September 30 of each year the department shall submit a report to the appropriate standing committees under s. 13.172 (3) on funds recovered and paid out during the previous calendar year as a result of audit adjustments. History: 1995 a. 27 ss. 3129, 3132, 3135 to 3139; 1995 a. 289, 404; 1997 a. 3, 27, 252; 1999 a. 9; 2001 a. 16; 2003 a. 318; 2005 a. 25 ss. 883, 884, 2502, 2510; 2007 a. 20; 2009 a. 28.
46.50 State mental health authority. In order to promote coordination and efficient development of mental health services by the state and by municipalities in the state, the department is declared to be the state mental health authority of Wisconsin and as such is authorized to receive federal grants in aid and to cooperate with the federal government in promoting the extension of such services. 46.52 Systems change grants. From the appropriation under s. 20.435 (5) (md), the department shall distribute funds to each grant recipient under this section so as to permit initial phasing in of recovery-oriented system changes, prevention and early intervention strategies, and consumer and family involvement for individuals with mental illness. At least 10 percent of the funds distributed shall be for children with mental illness. History: 1995 a. 27, 216; 1997 a. 27; 2001 a. 16; 2005 a. 25; 2013 a. 20.
46.53 Mental health treatment provider training. From the appropriation under s. 20.435 (5) (md), the department may not distribute more than $182,000 in each fiscal year to provide training for mental health treatment professionals on new mental health treatment approaches in working with special populations, including seriously mentally ill individuals and children with serious emotional disturbances, and on the use of new mental health treatment medications. History: 1995 a. 27; 1997 a. 27; 2013 a. 20.
46.533 Suicide and crisis lifeline; grants. (1) In this section, “national crisis hotline” means the telephone or text access number “988,” or its successor, that is maintained under the federally administered program under 42 USC 290bb-36c. (2) The department shall award grants to organizations that provide crisis intervention services and crisis care coordination to individuals who contact the national crisis hotline from anywhere within this state. History: 2025 a. 15.
46.535 Crisis intervention training grants. From the appropriation under s. 20.435 (5) (cd), the department shall award grants in the total amount of $1,000,000 in each fiscal biennium for mental health crisis intervention team training for law enforcement agencies, as described in s. 165.77 (1) (c), and correctional officers, as defined in s. 102.475 (8) (a). History: 2013 a. 126; 2021 a. 58.
46.536 Crisis program enhancement grants. (1) 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 or enhance crisis programs to serve individuals having crises in rural areas or counties, municipalities, or regions comprised of multiple counties or municipalities to establish and enhance law enforcement and behavioral health services emergency response collaboration programs. Grant recipients under this section shall match at least 25 percent of the grant amount awarded for the purpose that the grant is received. The depart-
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ment may not award any single grant in an amount greater than $100,000. (2) By June 30 of each odd-numbered year, the department shall collect information from counties, municipalities, and regions comprised of multiple counties and municipalities receiving a grant under sub. (1) and submit a report to the appropriate standing committees of the legislature under s. 13.172 (3) on all of the following topics: (a) The uses that the grants were directed towards. (b) Outcomes generated as a result of enhancing relationships between law enforcement and crisis response services. (c) Any other accountability measures determined relevant by the department. History: 2013 a. 132; 2019 a. 9; 2021 a. 184.
46.537 Sharing minors’ safety plans. (1) DEFINITIONS. In this section: (a) “Facilitator” means an individual who assists in the creation of a safety plan. (b) “Safety plan” means an individual’s written document, created in advance of a crisis, that provides guidance on how to help the individual when the individual experiences a behavioral or developmental health challenge or crisis. (c) “Safety plan partner” means a person who is part of a network formed under sub. (4) (a). (2) SAFETY PLAN CONTENTS AND REQUIREMENTS. (a) A minor who is at risk of an encounter with law enforcement or other emergency service providers during a behavioral or developmental health challenge or crisis may create a safety plan, with a facilitator, that includes any of the following information about the minor: 1. The minor’s name. 2. The minor’s address or addresses. 3. What it looks like when the minor feels unsafe or needs assistance. 4. De-escalation strategies that work for the minor. 5. Contact information for the minor’s parent or guardian. 6. Contact information for the minor’s health care providers, as defined under s. 146.81 (1) (a) to (hp). 7. Contact information for individuals who can provide emotional support to the minor in times of crisis. 8. What the minor would like law enforcement officers or emergency medical responders to know. 9. Other information that is important to the minor. (b) A minor and a facilitator who create a safety plan under par. (a) shall sign the safety plan. (c) A safety plan created under par. (a) expires one year after the date the safety plan is signed. (3) SAFETY PLAN SHARING; RELEASE OF INFORMATION. (a) A minor’s safety plan may be shared with a safety plan partner through the portal under sub. (5) only if the minor has signed a release of information stating that the minor agrees and understands all of the following: 1. The safety plan will be used only to ensure the safety and well-being of the minor by the safety plan partners. 2. The safety plan may be revoked at any time other than during a crisis. 3. The safety plan will be shared in the portal under sub. (5) and may be accessed by all safety plan partners. 4. Additional safety plan partners may join the network under sub. (4) (a) and the safety plan may be shared with those additional safety plan partners. 5. During a crisis, the safety plan may be accessed by a dif-
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ferent network formed under sub. (4) (a) that uses the portal under sub. (5). 6. The release of information will be attached to the minor’s safety plan until the safety plan expires or is revoked. (b) A facilitator shall ensure the minor understands the release of information under par. (a). (c) A release of information under par. (a) shall identify all current safety plan partners at the time the release of information is signed by the minor. (d) A release of information signed by a minor under par. (a) shall be attached to the minor’s safety plan until the safety plan expires or is revoked. (e) A safety plan partner may access a safety plan only to ensure the safety and well-being of the minor during a crisis, to review or update a safety plan, or at the minor’s request. (f) A safety plan partner shall maintain confidentiality of a safety plan and may disclose a safety plan to a person who is not in the safety plan partner’s network under sub. (4) (a) only if the person is one of the following: 1. The minor’s parent, guardian, legal custodian, Indian custodian, as defined in s. 48.02 (8p), or legal representative. 2. During a crisis, another safety plan network formed under sub. (4) (a) that uses the portal under sub. (5). 3. A bona fide researcher using de-identified information. (4) SAFETY PLAN NETWORK. (a) Two or more persons, including any of the following, may form a network for the purpose of sharing safety plans of minors who are at risk of an encounter with law enforcement or other emergency service providers during a behavioral or developmental health challenge or crisis: 1. A system of care, as defined in s. 46.56 (1) (or). 2. A physical or mental health care provider. 3. A county department of human services. 4. A county department of social services. 5. A school. 6. A school district. 7. A law enforcement agency, as defined in s. 165.77 (1) (b). 8. A fire department, as defined in s. 66.0314 (1) (c). 9. An emergency medical services provider, as defined in s. 256.215 (1) (d). 10. A tribal agency. 11. The division of the department of children and families that is responsible for administering child welfare services in Milwaukee County. 12. A public safety answering point, as defined in s. 256.35 (1) (gm). 13. A center designated to respond to statewide or regional contacts with the universal telephone number for the national suicide prevention and mental health crisis hotline system maintained under 42 USC 290bb-36c. (b) When a network is formed under par. (a), the safety plan partners shall enter into a formalized agreement that addresses the expectations for the safety plan partners, such as the safety plan partners’ obligations, training requirements, and roles in the network. (5) SAFETY PLAN SHARING PORTAL. The department shall develop and maintain, or make payments to a nonprofit corporation that supports the state’s electronic health information exchange under ss. 153.80 to 153.82 to develop and maintain, a portal that is available throughout the state to facilitate sharing of safety plans among safety plan partners. The portal developed under this subsection shall include all of the following: (a) The ability to fill out a safety plan online and download the safety plan for the purpose of obtaining a handwritten or electronic signature on the safety plan.
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(b) The standard safety plan template developed by the department under sub. (6). (c) Simplified views for law enforcement officers for quick access to safety plan information. (d) The capacity to support several thousand users in the system with role-based access for roles such as facilitators, law enforcement officers, and 911 dispatchers. (e) The potential for future integrations or single sign-on with other systems, including electronic health records systems and 911 dispatch systems. (f) Scalable storage capacity to support unlimited numbers of safety plans as discrete data and as printable documents. (g) Cloud-hosted, technical infrastructure certified by the Underlying Health Information Trust Alliance, or its successor, and technical audit-logging capabilities that meet the requirements of the federal Health Insurance Portability and Accountability Act of 1996. (h) Flexibility to allow a network formed under sub. (4) (a) to share a safety plan with another network formed under sub. (4) (a) or keep access to the safety plan restricted to within that network. (i) Notifications to a minor and facilitator when the minor’s safety plan is about to expire, if a safety plan is accessed, and any other activity that occurs related to a safety plan. (j) Safety plan audit data and use logging with reporting capabilities. (6) STANDARD SAFETY PLAN TEMPLATE. The department shall develop a standard safety plan template to be used under this section. History: 2025 a. 10.
46.54 Consumer and family self-help and peer-support programs. From the appropriation under s. 20.435 (5) (md), the department shall distribute $874,000 in each fiscal year to increase support for mental health family support projects, employment projects operated by consumers of mental health services, mental health crisis intervention and drop-in projects, and public mental health information activities. History: 1995 a. 27, 216; 1997 a. 27; 2001 a. 16; 2007 a. 20; 2013 a. 20.
46.545 Individual placement and support. (1) (a) The department shall create all of the following regional centers for individual placement and support for employment of individuals experiencing mental illness. 1. A northwestern Wisconsin region. 2. A south-central Wisconsin region. 3. A region consisting of a consortium of counties in northeastern Wisconsin. 4. A region consisting of a consortium of counties in central Wisconsin. 5. A region consisting of a consortium of counties in southeastern Wisconsin. (b) The department shall ensure that each county in the state is served by one of the regional centers created under par. (a). (c) The department may contract with existing organizations or consortiums to create any regional center. (2) The department shall ensure that each regional center created under sub. (1) (a) has access to the services of all of the following: (a) An individual placement and support trainer or mentor, who is responsible for the duties required of a trainer or mentor by an evidence-based individual placement and support model of supported employment. (b) An individual placement and support supervisor who is responsible for the duties required of a supervisor by an evi-
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dence-based individual placement and support model of supported employment. (3) (a) The department shall award grants to county or tribal unit programs or employment sites implementing individual placement and support services or regional centers for any of the following activities: 1. Implementing individual placement and support programs. 2. Offsetting costs until a program is capable of billing the Medical Assistance program for any services covered under the Medical Assistance program. 3. Becoming a provider of vocational rehabilitation services through the department of workforce development. (b) An applicant for a grant under this subsection shall, in the grant application, identify future sources of possible funding to support the individual placement and support services program. (4) The department and regional centers shall provide or arrange for work incentive benefits counseling for individuals who are not receiving vocational rehabilitation services from the department of workforce development. (5) The department shall seek any approval from the federal department of health and human services that is necessary to obtain federal Medicaid matching funds, if available, for reimbursement of individual placement and support services. History: 2013 a. 131.
46.548 Regional tertiary care center. (1) DEFINITION. In this section, “eligible hospital” means a hospital that meets all of the following criteria: (a) The hospital is located in Waukesha County. (b) The hospital is certified under s. 50.35. (c) The hospital has 300 or more licensed acute care beds. (d) The hospital is privately owned and operated as a nonprofit. (e) The hospital is a regional tertiary care center. (f) The hospital provides specialized services in at least 3 of the following areas: 1. Cardiology. 2. Oncology. 3. Orthopedic surgery. 4. Obstetrics with neonatal intensive care. 5. Behavioral health. (2) STATE SUPPLEMENTAL PAYMENT. Beginning in fiscal year 2025-26 and annually thereafter, the department shall, from the appropriation under s. 20.435 (1) (be), make a payment in the amount appropriated under s. 20.435 (1) (be) for the fiscal year in which the payment is made to each eligible hospital under this section. (3) USE OF FUNDS. A hospital receiving a payment under this section may use the funds for any of the following expenses: (a) Staffing and equipment for specialty services with high regional demand. (b) Capital upgrades that expand access to intensive or specialty care. (c) Support for complex patient discharge planning and community care coordination. (d) Programs that improve outcomes for patients with dementia, chronic disease, or behavioral health conditions. (4) REPORTING REQUIREMENTS. Each hospital receiving a payment under this section shall submit an annual report to the department that includes a summary of how funds were used. History: 2025 a. 15.
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Grants for services to persons in treatment. (1)
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The department shall award grants to county departments under s. 46.23 or 51.42 for the purpose of providing services to persons who are receiving alcohol and other drug abuse treatment, including child care services for the children of the persons. (2) A county department under s. 46.23 or 51.42 may apply to the department for a grant under sub. (1). The department shall select applicants to receive grants under sub. (1) based on criteria developed by the department. (3) A county department under s. 46.23 or 51.42 which receives a grant under sub. (1) shall give priority for the services to a family whose income is below 150 percent of the poverty line, under 42 USC 9902 (2), or to a family with only one parent living in the home. (3m) Within the limits of available funding under s. 20.435 (5) (mb), the department shall award grants under this section in a total amount for all grants of not more than $250,000 in each fiscal year. History: 1987 a. 339; 1989 a. 31; 1991 a. 39; 1993 a. 16; 2013 a. 20.
46.56 Initiatives to provide coordinated services for children and families. (1) DEFINITIONS. In this section: (a) “Administering agency” means a department designated by a county board of supervisors, by the Milwaukee County mental health board in Milwaukee County, or by a tribe to administer an initiative. (ar) “Advocacy” means all of the following: 1. Actively supporting a child who is involved in 2 or more systems of care and his or her family under an initiative to enable their receipt of the full benefits of the initiative by ensuring that the coordinated services team approach to providing services and principles are followed. 2. Helping families of a child who is involved in 2 or more systems of care gain access to and a voice in the decision making that establishes the child’s and family’s plan of care. 3. Fostering strong working relationships among families, systems of care, and providers, with the goal of improving the lives of children who are involved in 2 or more systems of care and their families. (b) “Agency” means a public, tribal, or private organization that provides services and other resources for children and families. (bm) “Child” means an individual under the age of 18. (ce) “Coordinated services” means treatment, education, care, services, and other resources provided, in a coordinated manner, for a child who is involved in 2 or more systems of care and his or her family. (cm) “Coordinated services plan of care” means a plan under sub. (8) (h) for a child who is involved in 2 or more systems of care and his or her family. (cs) “Coordinated services team” means a group of individuals, including family members, service providers, and informal resource persons, who work together to respond to service needs of a child who is involved in 2 or more systems of care and his or her family. (d) “County department” means a county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437, unless the context requires otherwise. (de) “Family” means a child’s primary caregiver or caregivers and the child’s siblings. (dm) “Family resources” means housing, environment, institutions, sources of income, services, education, a child’s extended family and community relationships, and other resources families need to raise their children. (ds) “Initiative” means a system that is based on the strengths
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of children and their families for providing coordinated services to children who are involved in 2 or more systems of care and their families. (e) “Intake” means the process by which a service coordination agency or individuals designated by the coordinating committee under sub. (3) initially screen a child who is involved in 2 or more systems of care and his or her family to determine eligibility for an initiative and the process by which the service coordination agency determines the need for a comprehensive clinical mental health assessment. (h) “Interagency agreement” means a written document of understanding among service providers and other partner agencies that are represented on a coordinating committee under sub. (3) that identifies mutual responsibilities for implementing coordinated services for children who are involved in 2 or more systems of care and their families. (hm) “Multi-entity initiative” means an initiative including more than one county or tribe that is established under sub. (2) (b). (j) “Parent” means a parent who has legal custody, as defined in s. 767.001 (2), of a child, or a guardian or legal custodian of a child, as defined in s. 48.02 (8) and (11). (L) “Service coordination” means the coordination of multiple service providers and family resources that are serving a particular child who is involved in 2 or more systems of care and his or her family. The term includes coordination of the assessment process, development of a coordinated services plan of care based on the strengths and needs identified in the assessment, advocacy, monitoring of the progress of the child or his or her family, facilitation of periodic reviews of the coordinated services plan of care, and coordination and maintenance of clear lines of communication among all family resources providers, the child, and his or her family. (m) “Service coordination agency” means a county department, tribe, agency, school district, cooperative educational service agency, or county children with disabilities education board designated in an interagency agreement by a coordinating committee under sub. (3) to provide intake and service coordination for one or more target groups of children who are involved in 2 or more systems of care and their families. (n) “Service coordinator” means an individual who is qualified by specialized training and experience with children who are involved in 2 or more systems of care and their families and who is appointed by the service coordination agency to provide service coordination for eligible children and their families. (nm) “Service provider” means a professional from a system of care who meets one or more of the following criteria: 1. Is skilled in providing treatment services, education, and other family resources for children who are involved in 2 or more systems of care and their families. 2. Conducts comprehensive evaluations of the needs of children who are involved in 2 or more systems of care and their families for family resources. 3. Possesses skills appropriate for and knowledge of the specific types of needs or dysfunctions presented by a child who is involved in 2 or more systems of care and is undergoing an assessment. 4. Is currently providing treatment, education, or other family resources for a child who is involved in 2 or more systems of care, a family of such a child, or both. (om) “Severe disability” means a mental, physical, sensory, behavioral, emotional, or developmental disability, including severe emotional disturbance, or a combination of these disabilities, that meets all of the following conditions:
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1. Is severe in degree. 2. Has persisted for at least one year or is expected to persist for at least one year. 3. Causes substantial limitations in a child’s ability to function in his or her family, school, or community and with his or her ability to cope with the ordinary demands of life. 4. Causes a child to need services or other resources from 2 or more systems of care. (op) “Severely emotionally disturbed child” has the meaning given in s. 49.45 (25) (a). (or) “System of care” means a public or private organization that provides specialized services for children with mental, physical, sensory, behavioral, emotional, or developmental disabilities or that provides child welfare, juvenile justice, educational, economic support, alcohol or other drug abuse, or health care services for children. (p) “Treatment services” means the individualized social, emotional, behavioral and medical services designed to bring about habilitation, rehabilitation and appropriate developmental growth of a child. (q) “Tribe” means a federally recognized American Indian tribe or band in this state. (2) COORDINATING COMMITTEE; ADMINISTERING AGENCY; INITIATIVE FUNDING. (a) Except as provided in par. (b), if a county board of supervisors or the Milwaukee County mental health board establishes an initiative under s. 59.53 (7) or if a tribe establishes an initiative, the county board, Milwaukee County mental health board, or tribe shall appoint a coordinating committee and designate an administering agency. The initiative may be funded by the county or tribe or the county board of supervisors, Milwaukee County mental health board, or tribe may apply for funding by the state in accordance with sub. (15). (b) A county may enter into an agreement with one or more other counties or tribes to establish an initiative and a tribe may enter into an agreement with one or more counties or tribes to establish an initiative. The parties to the agreement shall designate in the agreement a single lead administrative county or lead administrative tribe. The county board of the lead administrative county, the Milwaukee County mental health board, if Milwaukee County is the lead administrative county, or the lead administrative tribe shall appoint a coordinating committee and designate an administering agency. The initiative may be funded by the participating entities, or the county board of supervisors of the lead administrative county, the Milwaukee County mental health board, if Milwaukee County is the lead administrative county, or the lead administrative tribe may apply for funding by the state in accordance with sub. (15). (3) COORDINATING COMMITTEE. (a) The coordinating committee shall include representatives from all of the following: 1. The county department responsible for child welfare and protection services or, for an initiative established by a tribe, the tribal agency responsible for child welfare and protection services. 2. The county department responsible for mental health and alcohol and drug abuse services for children and families or, for an initiative established by a tribe, the tribal agency responsible for these services. 3. The county department responsible for providing services for children who have developmental disability or, for an initiative established by a tribe, the tribal agency responsible for providing these services. 5. The juvenile court administrator or another representative appointed by the judge responsible for cases heard under chs. 48
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and 938 or, for an initiative established by a tribe, a representative of the tribal court. 6. The largest school district in the county and any cooperative educational service agency, if it provides special education in the county, or any county children with disabilities education board in the county, and any other school district in the county that is willing to participate in the initiative, at the discretion of the administering agency. For an initiative established by a tribe, the coordinating committee shall include a representative of the school district serving the majority of pupils who reside on the reservation of the tribe or on trust lands held for the tribe and any cooperative educational service agency providing special education services to these pupils. 7. At least 2 parents, or the number that equals 25 percent of the coordinating committee’s membership, whichever is greater, of children who are involved in 2 or more systems of care. 8. The agency responsible for economic support programs. (b) The coordinating committee may include any of the following: 1. Representatives of the vocational rehabilitation office that provides services to the county or, for an initiative established by a tribe, that provides services to the tribe. 2. Representatives of a technical college district that is located in the county or, for an initiative established by a tribe, that serves members of the tribe. 3. Physicians specializing in care for children. 4. Representatives of health maintenance organizations that are operating in the county or, for an initiative established by a tribe, are serving members of the tribe. 5. Representatives of law enforcement agencies that are located in the county or, for an initiative established by a tribe, are representatives of a tribal law enforcement agency. 6. Representatives of the county health department established under s. 251.02 (1) or city-county health department established under s. 251.02 (1m). 7. Representatives of agencies that are located in the county or, for an initiative established by a tribe, are serving members of the tribe. 8. Local elected officials. 9. Representatives of a vocational and technical school. 10. Local business representatives. 11. Representatives of the county board or, in Milwaukee County, the Milwaukee County mental health board or, for an initiative established by a tribe, representatives of the elected governing body of the tribe. 12. Representatives of the regional offices of the department. 13. Representatives of the local faith-based community. 14. Representatives of probation and parole agencies. 15. Representatives of economic support agencies and the Wisconsin Works agency under subch. III of ch. 49, if a different agency. 16. Representatives of vocational rehabilitation programs. (bm) 1. The coordinating committee of a multi-entity initiative shall include representatives described under par. (a) 1. to 7. who are from any county or tribe included in the multi-entity initiative, except that, of the representatives described under par. (a) 1. to 7., the committee shall include at least one representative from each county or tribe included in the initiative. 2. For purposes of a coordinating committee appointed for a multi-entity initiative, a representative under par. (b) 1., 2., 4., 5., 6., 7., and 11. may be from any county or tribe included in the multi-entity initiative. (c) An existing committee within the county may serve as the
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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coordinating committee if it has the membership required under par. (a) and agrees to undertake the responsibilities in par. (d). (d) The coordinating committee shall: 3. Oversee the development and implementation of the initiative. 4. Prepare one or more interagency agreements in accordance with sub. (5) that all participatory organizations in the initiative agree to follow in creating and operating an initiative. 5. Assess how the initiative relates to other service coordination programs operating at the county, tribal, or local level and take steps to work with the other service coordination programs and to avoid duplication of activities, services, and resources. 6. If a county or tribe or a multi-entity initiative applies for funding under sub. (15), assist the administering agency in developing the application required under sub. (15) (b). 7. Review determinations by the service coordination agency regarding eligibility for assessment, appropriate family resources, or funding of services, at the request of any applicant, recipient, parent of a child who is involved in 2 or more systems of care, or participating county department or tribal agency, school district, cooperative educational service agency, or county children with disabilities education board. The coordinating committee shall adopt written procedures for conducting reviews. 8. Establish operational policies and procedures, such as referral and screening procedures, a conflict management policy, and a flexible funding policy, and ensure that the policies and procedures are monitored and adhered to. 9. Ensure quality, including adherence to core values as adopted by the state advisory committee established under sub. (14) (a). 10. Develop a plan for orientation of new coordinating committee members and coordinated services team members to the coordinated services team approach to providing services to a child and his or her family. 11. Identify and address gaps in services for children and families who are enrolled in the initiative. 12. Ensure client and partner agency satisfaction through performance of a client and partner agency satisfaction survey. 13. Plan for sustainability of the system change started by the initiative beginning in the first year of any funding received for the initiative and thereafter by acting as a consortium to pursue additional funding for the initiative through grants from the state or federal government or private foundations; maintaining formal collaborative agency relationships; including families in the process by emphasizing rights and advocacy; addressing funding and issues related to providing matching funds required under sub. (15) (c); and recommending a plan for realized savings from substitute care budgets to be reinvested in community-based care. 14. Establish target groups of children who are involved in 2 or more systems of care and their families to be served by the initiative. For a county or tribe or a multi-entity initiative that applies for funding under sub. (15), severely emotionally disturbed children are required to be a priority target group. 15. Distribute information about the availability and operation of the initiative to the general public and to public or private service providers who might seek to make referrals to the initiative. (e) The coordinating committee may direct the initiative coordinator or another person to do any of the following: 1. Maintain data of enrollments in the initiative and results of screening. 2. Establish and report monitoring and evaluation results. 3. Monitor, or ensure proper monitoring by the appropriate entity of, targeted case management and in-home services pro-
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vided under the Medical Assistance Program, under subch. IV of ch. 49, including record-keeping and billing processes. 4. Assist in developing and maintaining additional funding sources, including collaborative efforts with system partners. 5. Assist in the development and implementation of advocacy for families. (f) This subsection does not apply with respect to multi-entity initiatives to the extent that the department has adopted requirements under sub. (14) (e) that conflict with those contained in this subsection. (4) ROLE OF ADMINISTERING AGENCY. Except when otherwise provided in requirements established by the department under sub. (14) (e) that apply with respect to multi-entity initiatives, the administering agency designated under sub. (2) shall do all of the following: (a) Assist the coordinating committee in overseeing the development and implementation of the initiative and designate the staff needed for the initiative. (b) Assist the coordinating committee in drafting and executing interagency agreements and any other policies and procedures necessary for the start-up and operation of the initiative. (c) Assist the coordinating committee in distributing information about the availability and operation of the initiative to the general public and to public or private service providers who might seek to make referrals to the initiative. (d) If the county board of supervisors, Milwaukee County mental health board, or tribe or a multi-entity initiative decides to seek state funding under sub. (15), develop the application in cooperation with the coordinating committee. (e) Undertake such other activities in compliance with other statutes, rules, department guidelines, interagency agreements, and the directions of the coordinating committee as are necessary to ensure the effective and efficient operation of the initiative. (5) INTERAGENCY AGREEMENT. Except when otherwise provided in requirements established by the department under sub. (14) (e) that apply with respect to multi-entity initiatives, an interagency agreement shall include all of the following: (a) The identity of every county department, tribal agency, agency, school district, cooperative educational service agency, county children with disabilities education board, technical college district, or other organization that will participate in the initiative. (b) The identification of services and resources that the participating organizations will commit to the initiative or will seek to obtain, including joint funding of services and resources and funding for the qualified staff needed to support the initiative, such as by cash or contribution of in-kind services and resources as determined by the department under sub. (15) (c). This identification shall specify the roles and responsibilities of the coordinated services team and the coordinating committee. (c) The designation of service coordination agencies. (d) The identification of any group of children who will be targeted for services and resources through the initiative. (e) The procedures for outreach, referral, intake, assessment, case planning, and service coordination that the initiative will use. (f) The specific criteria, based on sub. (7), that will be used for deciding whether a child and his or her family are eligible for services and resources through the initiative. (g) The procedures to be followed to obtain any required authorizations for sharing of confidential information among organizations providing treatment, services, education, and other resources to a child and his or her family. (h) The procedures that will be used for managing conflicts
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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among service providers or coordinated services team members or between a child or his or her family and service providers. (i) The methods that will be used to measure initiative effectiveness, including satisfaction of a child and his or her family, and for revising the operation of the initiative in light of evaluation results. (j) The mission and core values of the initiative. (k) Expectations for organizations represented on the coordinating committee under sub. (3), including provision of the funding match required under sub. (15) (c). (6) ROLES OF SERVICE COORDINATION AGENCY, SERVICE COORDINATOR, INITIATIVE COORDINATOR, AND COORDINATED SERVICES TEAM. (a) One or more service coordination agencies may participate under the initiative. The organizations and the target groups that are to be served shall be identified in the interagency agreement under sub. (5). All of the following applies to a service coordination agency: 1. The service coordination agency shall be selected based on its experience in providing services and resources. 2. The service coordination agency shall do all of the following: a. Identify a specific individual to act as service coordinator for each child who is enrolled in the initiative and his or her family to facilitate the implementation of the coordinated services plan of care. b. Provide or arrange for intake, assessment, development of the plan of care, and service coordination under sub. (8). c. Act as a source for information about other services and resources for children who are involved in 2 or more systems of care and their families who are not eligible for the initiative, if the coordinating committee determines that the service coordination agency can provide the information without interfering with the primary purpose of the initiative. (b) The service coordinator shall have the functions specified in sub. (8) (f) to (h), (n), and (r). (c) The coordinated services team has the functions specified under sub. (8) (f), (h), and (i). (cr) 1. Except as provided in subd. 2., every county and tribe that operates any initiative shall develop written policies and procedures specifying the selection process for the initiative coordinator. 2. For a multi-entity initiative, the lead administrative county or the lead administrative tribe shall develop the written policies and procedures under subd. 1. specifying the selection process for the initiative coordinator. (d) The primary responsibility of the initiative coordinator is to promote collaborative relationships between systems of care. The initiative coordinator shall do all of the following: 1. Bring together parents and relevant staff from various agencies and organizations to comprise the coordinating committee under sub. (3) (a) and (b), and support their activities, in order to ensure compliance with established policies and procedures specified in sub. (3) (d). 2. Work with the coordinating committee to maintain and support agency participation as established in the interagency agreement. 3. Work with the coordinating committee and service coordination agency to receive and review referrals. 4. Work with the coordinating committee and service coordination agency to assure provision of service coordination services for all groups of people working with the child and his or her family. 5. Guide the development of the coordinated service team
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working with the child and his or her family in order to ensure compliance with basic principles of the initiative core values. 6. Review plans of care, including crisis response plans, for consistency with the coordinated services team approach to providing services to a child and his or her family and core values. 7. Assist the coordinating committee and coordinated services teams in establishing consistent measures for the development, implementation, evaluation, and monitoring of the initiative and its outcomes. 8. Facilitate public education and awareness of issues and programs for children who are involved in 2 or more systems of care and their families. 9. Ensure provision of ongoing support and training that is related to the coordinated services team process for families, service coordinators, and providers and ensure orientation for coordinated services team members. 10. Support service providers in developing strategies to enhance existing programs, to increase resources, and to establish new resources relevant to project goals and objectives. 11. Ensure that local and state agencies submit data and reports in an accurate and timely manner. 12. If directed to do so by the coordinating committee, perform any of the duties set forth in sub. (3) (e). (e) This subsection does not apply with respect to multi-entity initiatives to the extent that the department has adopted requirements under sub. (14) (e) that conflict with those contained in this subsection. (7) ELIGIBILITY OF CHILDREN AND FAMILIES. Except when otherwise provided in requirements established by the department under sub. (14) (e) that apply with respect to multi-entity initiatives, children who are involved in 2 or more systems of care and their families shall be eligible for the initiative, except that the coordinating committee may establish specific additional criteria for eligibility for services and may establish certain target groups of children who are involved in 2 or more systems of care to receive services. If target groups are established, only children falling within the target groups may be enrolled in the initiative. Any eligibility criteria shall meet all of the following conditions: (a) Be based on a community assessment that identifies areas of greatest need for coordinated services. (b) Give priority to children who are at risk of placement outside the home or who are in an institution and are not receiving coordinated services based in the community and other resources, or who would be able to return to community placement or their homes from an institutional placement if the services and other resources were provided. (c) Not exclude a child or his or her family from services or other resources because of lack of ability to pay. (8) REFERRAL, INTAKE, ASSESSMENT, PLAN OF CARE DEVELOPMENT, AND SERVICE COORDINATION. (a) Referrals to the initiative may come from county departments, tribal agencies, agencies, school districts, cooperative educational service agencies, county children with disabilities education boards, technical college districts, courts assigned to exercise jurisdiction under chs. 48 and 938, tribal courts, or any other organization, or a child who is involved in 2 or more systems of care or his or her family may contact the administering agency or service coordination agency to request services and resources. (b) Upon referral, staff from the service coordination agency or individuals designated by the coordinating committee shall screen the referral to determine if the child and his or her family appear to meet the eligibility criteria and any target group requirements established by the coordinating committee. If the child and his or her family appear to be eligible, the staff shall as-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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sist the entity that made the referral under par. (a), and the parent or parents, in gathering information necessary to prepare an application for the initiative. (c) Consent for release of information relating to a child shall be obtained from the child’s parent, or the child, if appropriate or required by federal statute or regulation or state statute or rule, or by order of a court with appropriate jurisdiction. (cm) Consent for participation of a child and his or her family in the initiative and in the initiative evaluation shall be obtained from the child’s parent or, if appropriate, the child. (d) The service coordination agency or individuals designated by the coordinating committee shall review the completed application with the family, and, in light of the eligibility criteria in the interagency agreement and sub. (7), determine whether the child and his or her family are eligible for and appropriate for enrollment in the initiative. The service coordination agency or the individuals designated by the coordinating committee shall approve or disapprove each application within 30 days after the date on which the application was completed. (e) If the child who is involved in 2 or more systems of care and his or her family are found to be ineligible, or if it is determined that enrollment in the initiative is not the best method of meeting the needs of the child and his or her family, staff from the service coordination agency or individuals designated by the coordinating committee shall assist the child and family in identifying and accessing needed services or resources from appropriate providers. (f) If the child and his or her family are found to be eligible for and are enrolled in the initiative, the agency shall assign a service coordinator who shall assemble a coordinated services team to assess the strengths and needs of the child and his or her family’s need for treatment, education, care, and support. The service coordinator shall coordinate the operations of the coordinated services team. (g) The service coordinator shall assemble the results of all prior relevant assessments and evaluations documenting the strengths and needs of a child enrolled in the initiative and his or her family, including educational, medical, vocational, and psychosocial evaluations. (h) The coordinated services team, the family of the child enrolled in the initiative, and the service coordinator shall, based on a review of a summary of existing assessments of strengths and needs that have been assembled and any additional evaluations and plans that the team, the coordinator, or the family finds to be necessary, prepare a strength-based, gender-competent and culturally competent, family-centered, coordinated services plan of care within 60 days after the date on which the application was approved. The coordinated services plan of care shall include all of the following: 1. The child’s present level of functioning expressed in objective terms that will permit ongoing evaluation of the child’s progress. 2. The short-term and long-term goals to address the needs of the child and his or her family. 3. The services and resources needed by the child and his or her family, including the identity of each individual and organization that will be responsible for providing the services and other resources. The coordinated services plan of care shall place emphasis on services and resources that are available through community and informal sources. 4. Criteria for measuring the effectiveness and appropriateness of the coordinated services plan of care so that it can be modified as needed to better meet the child’s and the child’s family’s needs. A coordinated services plan of care shall be oriented
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so as to produce meaningful outcomes and to provide services in the least restrictive setting possible. 5. Identification of any administrative or judicial procedures under ch. 48, 51, 55, 115, 118, or 938 that may be necessary in order to fully implement the coordinated services plan of care and the identity of the individual or organization that will be responsible for initiating those procedures, if any are required. 6. Identification of available sources of funding to support the services and other resources needed for the child and his or her family and an allocation of funding responsibility among organizations if more than one organization is responsible for the child’s and his or her family’s treatment, education and support services. 7. Clear statements articulating the specific needs of the child and family that are to be addressed. Needs may not be stated solely in terms of the need for services but may be described in a strength-based manner with a response that is readily achievable. 8. Plans for responding to possible crisis situations that may occur with the child and his or her family. (i) If additional evaluations are needed, the coordinated services team shall arrange for them or assist the child’s family in obtaining them. (j) The proposed coordinated services plan of care shall be submitted to any service providers who are included in the proposed plan of care. (k) Upon written approval of the coordinated services plan of care by the proposed service providers, the child’s family, and the coordinated services team, the plan of care shall be implemented by the service coordination agency and the individuals and organizations designated to provide services and other resources under the plan of care. (m) Each organization or service provider designated to provide services and other resources under the coordinated services plan of care shall identify a specific individual who shall serve as the ongoing contact person to ensure continuity and communication while services are being provided to the child and his or her family under the plan of care. (n) The service coordinator shall advocate for the child and his or her family and ensure that they are provided the opportunity to participate in assessment, planning, and ongoing review of services to the fullest extent possible. (o) Services and other resources under this section shall be provided in the community, preferably in the child’s home or home community, in the least restrictive and least intrusive setting and manner that meets the best interests of the child. (r) On a regular basis, and at least every 3 months, the service coordinator shall assemble the coordinated services team, the family of the child, the child if appropriate, and any counsel, guardian ad litem, or other person advocating for the interests of the child or his or her family to review the plan of care and progress toward the goals of the plan of care, establish new goals, request the inclusion of new participating organizations or individuals, or otherwise modify the coordinated services plan of care to better meet the needs of the child and his or her family. Decisions to amend the coordinated services plan of care must be approved by the service coordinator, the coordinated services team, the family and, if the plan of care is being provided under a court order, the court. (s) Coordination of services by a coordinated services team may be ended by the agreement of all participants on the coordinated services team that the goals of treatment and support have been met or are being met; by withdrawal of the family of the child; by the service coordination agency upon a recommendation from the service coordinator and the coordinated services
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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team; by the family’s refusal to participate in the process; if the child and his or her family no longer meet the eligibility criteria for the coordinated services team; or by court order, if services are being provided under court order. (t) This subsection does not apply with respect to multi-entity initiatives to the extent that the department has adopted requirements under sub. (14) (e) that conflict with those contained in this subsection. (9) IMMEDIATE CARE. Individual county departments, tribal agencies, other agencies, and other service providers shall provide immediate services and other resources as necessary and appropriate to children who are involved in 2 or more systems of care and their families who have been referred for an evaluation of eligibility for and appropriateness of enrollment in the initiative while assessment and planning take place. This subsection does not apply with respect to multi-entity initiatives to the extent that the department has adopted requirements under sub. (14) (e) that conflict with those contained in this subsection. (11) CONFLICT MANAGEMENT. The department, administering agency, service coordination agencies, and service coordinators shall establish and use informal means for conflict management, including consultation, mediation, and independent assessment, whenever possible. A formal conflict management policy shall be established in writing by the coordinating committee for use by families, providers, and other individuals involved in the initiative. This subsection does not apply with respect to multientity initiatives to the extent that the department has adopted requirements under sub. (14) (e) that conflict with those contained in this subsection. (12) ADMINISTRATIVE APPEALS. Decisions by the service coordination agency regarding eligibility, enrollment, denial, termination, reduction, or appropriateness of services and decisions by the individuals designated by the coordinating committee regarding eligibility, enrollment, or denial may be appealed to the coordinating committee by a child who is a service applicant or recipient or by the parent or guardian or guardian ad litem of the applicant or recipient. Decisions of the coordinating committee may be appealed to the department under ch. 227. This subsection does not apply with respect to multi-entity initiatives to the extent that the department has adopted requirements under sub. (14) (e) that conflict with those contained in this subsection. (13) REVIEW OF ACTIONS BY INDIVIDUAL AGENCIES. Nothing in this section shall limit, modify, or expand the rights, remedies, or procedures established in federal statutes or regulations or state statutes or rules for individuals or families receiving services provided by individual organizations that are participating in the coordinated services plan of care. This subsection does not apply with respect to multi-entity initiatives to the extent that the department has adopted requirements under sub. (14) (e) that conflict with those contained in this subsection. (14) DUTIES OF DEPARTMENT. (a) In order to support the development of a comprehensive service system of coordinated care for children who are involved in 2 or more systems of care and their families, the department shall establish a state advisory committee with representatives of county departments and tribal governing bodies, the department of public instruction, educational agencies, the department of children and families, the department of corrections, the juvenile correctional system, professionals experienced in the provision of services to children who are involved in 2 or more systems of care and their families, advocates for such families and their children, the subunit of the department of workforce development that administers vocational rehabilitation, a representative of the local workforce development board established under 29 USC 2832, a representative of the philanthropy community, the technical college system, health
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care providers, courts assigned to exercise jurisdiction under chs. 48 and 938, child welfare officials, and other appropriate persons as selected by the department. The department may use an existing committee for this purpose if it has representatives from the listed groups and is willing to perform the required functions. This committee shall establish principles and core values for administering initiatives, monitor the development of initiatives throughout the state, and support communication and mutual assistance among operating initiatives as well as those that are being developed. (b) The department shall provide, either directly or through purchase of services, the following support services to the counties and tribes that elect to participate in the initiative and to multi-entity initiatives: 1. Consultation in the areas of developing and maintaining individual initiatives and finding appropriate resources. 2. Mediation to assist in the management of conflict among service providers or funding organizations or between service recipients and organizations. 3. Assessment resources for cases where no local evaluation resource is available or sufficient to enable development of an effective coordinated services plan of care. These resources may be provided directly through state-operated programs or by referral to private service providers. (c) The department shall evaluate the initiatives funded under this section. All organizations participating in the initiatives shall cooperate with the evaluation. The evaluation shall include information about all of the following: 1. The number of days that children enrolled in the initiative spent in out-of-home placement compared to other children who are involved in 2 or more systems of care and are not enrolled in the initiative and the costs associated with these placements. 3. A comparison between any changes in problem behaviors of enrollees before and after enrollment in the initiative. 4. A comparison between school attendance and performance of enrollees before and after enrollment in the initiative. 5. A comparison between recidivism rates of enrollees who have a history of delinquency. 6. Parent and child satisfaction with the initiative. 7. Types of services provided to children and their families through the initiative and the cost of these services. 9. A systems change and sustainability plan under sub. (3) (d) 13. (d) Notwithstanding eligibility requirements for enrollment in the initiative, if the state is funding the initiative in a particular county or for a tribe or is funding a multi-entity initiative under sub. (15), the department may permit the county, tribe, or multientity initiative to serve under this section any individual who has a severe disability and who has not attained 22 years of age, and his or her family, if the individual’s mental, physical, sensory, behavioral, emotional, or developmental disability or whose combination of multiple disabilities meets the requirements specified in sub. (1) (om) 1. to 4. (e) The department may establish additional requirements to apply with respect to multi-entity initiatives, including requirements that conflict with any requirements in subs. (3) to (13). (15) FUNDING. (a) From the appropriation account under s. 20.435 (5) (co), the department shall make available funds to implement initiatives under this section. (b) In order to apply for funds under this subsection, the county board of supervisors, Milwaukee County mental health board, or tribe or, for a multi-entity initiative, the county board of the lead administrative county, the Milwaukee County mental health board, if Milwaukee County is the lead administrative
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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county, or the lead administrative tribe shall do all of the following: 1. Establish a coordinating committee and designate an administering agency under sub. (2). 1r. Demonstrate that the coordinating services team approach to providing services to children who are involved in 2 or more systems of care and families will be followed, and principles and core values, as outlined by the advisory committee established by the department, will be adhered to. 2. Establish the priority target group to be served by the initiative as severely emotionally disturbed children. 3. Submit a plan to the department for implementation of the initiative in accordance with the requirements of this section. 4. Submit a description of the existing services and other resources in the county or tribe or in the area or areas served by a multi-entity initiative for children who are involved in 2 or more systems of care, an assessment of any gaps in services, and a plan for using the funds received under this subsection or funds from other sources to develop or expand the initiative. 5. Agree to comply with this section. (c) In order for a county or tribe or a multi-entity initiative to obtain funds under this subsection, all of the participating agencies and organizations shall provide matching funds that, in total, equal 20 percent of the requested funding. The match may be cash or in-kind. The department shall determine what may be used as in-kind match. (d) In order to apply for funding, a county or tribe or a multientity initiative shall have a coordinating committee that meets the requirements under sub. (3) (a) and (b) and, if applicable, sub. (3) (bm) that will carry out the responsibilities under sub. (3) (d). (f) Funds allocated under this subsection may not be used to replace any other state and federal funds or any county funds that are being used to fund services for children who are involved in 2 or more systems of care. History: 1989 a. 31; 1993 a. 27, 399, 446; 1995 a. 27 ss. 2317, 2318, 9130 (4), 9145 (1); 1995 a. 77, 201; 1997 a. 3, 27, 114, 164; 2001 a. 16; 2009 a. 28, 334; 2011 a. 260; 2013 a. 20, 203; 2015 a. 55.
46.57 Grants for services to persons with epilepsy. (1) DEFINITIONS. In this section: (a) “Agency” means a private nonprofit organization or a county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437 which provides or proposes to provide direct services or indirect services to or on behalf of persons with epilepsy, their families or both. (b) “Direct services” means services provided to a person with epilepsy or a member of the family of a person with epilepsy and includes counseling, referral to other services, case management, daily living skills training, providing information, parent helper services, employment services and support group services. (c) “Indirect services” means services provided to a person working with or on behalf of a person with epilepsy and includes service provider training, community education, prevention programs and advocacy. (2) PURPOSE; ALLOCATION. (a) As provided under s. 46.48 (14), the department shall distribute funds to agencies to provide direct services or indirect services to or on behalf of persons with epilepsy or their families or both. (b) The department may not allocate more than $50,000 per year to any agency for the program under this section. (3) CRITERIA FOR AWARDING GRANTS. In reviewing applications for grants, the department shall consider the following: (a) The need for direct services and indirect services to per-
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sons with epilepsy and their families in the area in which the applicant provides services or proposes to provide services. (b) Ways to ensure that both urban and rural areas receive services under the grant program. (4) REPORTING. After each year that an agency operates a program funded under this section the agency shall provide the following information to the department: (a) The estimated number of persons with epilepsy that reside within the area served by the agency. (b) The number of persons with epilepsy and other persons and organizations who received services within the area served by the agency. History: 1987 a. 399; 1989 a. 31; 1991 a. 39; 1993 a. 16.
46.65 Treatment alternative program. (1) The department shall implement a treatment alternative program. The department shall make grants to provide alcohol or other drug abuse services, as a treatment alternative in lieu of imprisonment, for eligible persons in need of those services. The department shall make grants so that the treatment alternative program serves a variety of geographic locations. (2) The department shall promulgate rules to implement the treatment alternative program. The rules shall include all of the following: (a) Organizational and administrative requirements for independent program units. (b) Procedures for communicating and reaching agreements with representatives of the criminal justice system and treatment providers. (c) Eligibility criteria for participants who obtain services under the program. (d) Procedures for early identification of eligible participants. (e) Assessment, referral, treatment and monitoring procedures. (f) Policies and procedures for staff training. (g) A data collection system to be used for program management and evaluation. (h) A requirement that 75 percent of any recipient’s grant must be used to provide treatment services to clients in the program. History: 1987 a. 339; 1989 a. 122. Cross-reference: See also ch. DHS 66, Wis. adm. code.
46.68 Trauma care hospital supplement grants. From the appropriation under s. 20.435 (1) (bf), the department shall award grants to support hospitals that satisfy the criteria established by the American College of Surgeons for classification as a Level I adult trauma center. History: 2025 a. 15.
46.70 Delivery of services to American Indians. To facilitate the delivery of accessible, available and culturally appropriate social services and mental hygiene services to American Indians by county departments under s. 46.215, 46.22, 51.42 or 51.437, the department may fund federally recognized tribal governing bodies in this state from the appropriation account under s. 20.435 (5) (kL). History: 1981 c. 20; 1983 a. 27; 1985 a. 29, 176; 1989 a. 31; 1991 a. 39; 1999 a. 9, 103; 2009 a. 28.
46.71 American Indian drug abuse prevention, treatment and education. (1) From the appropriation account under s. 20.435 (5) (km), the department shall, for the development of new drug abuse prevention, treatment and education programs that are culturally specific with respect to American Indians or to supplement like existing programs, allocate a total of not more
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than $500,000 in each fiscal year to all the elected governing bodies of federally recognized American Indian tribes or bands that submit to the department plans, approved by the department, that do all of the following: (a) Demonstrate the need for the proposed funding. (b) Outline the manner in which the funds will be used. (2) The amount of funds allocated by the department under sub. (1) may not exceed the amounts appropriated under the appropriation account under s. 20.435 (5) (km). History: 1989 a. 122, 336; 1991 a. 39; 1993 a. 16.; 1995 a. 27; 1999 a. 9; 2009 a. 28, 276.
46.75 Food distribution grants. (1) DEFINITIONS. In this section: (a) “Agency” means a public agency or private nonprofit organization. (b) “Food distribution program” means a program that provides food directly to needy individuals or a program that collects and distributes food to persons who provide the food directly to needy individuals. (2) PURPOSE; AMOUNT. (a) From the appropriation under s. 20.435 (1) (dn), the department shall award grants to agencies to operate food distribution programs that qualify for participation in the emergency food assistance program under 7 USC ch. 102. (b) The department may not award more than $20,000 to any agency for the program under this section. (3) CRITERIA FOR AWARDING GRANTS. In evaluating applications for grants, the department shall give priority to food distribution programs that do the following: (a) Serve areas that are not served or are underserved by food distribution services. (b) Operate a program that routinely provides prepared meals to homeless persons. (c) Provide information to individuals with low incomes concerning other services available to those individuals. (e) Use simple methods to determine eligibility. (f) Appear likely to continue operation after using the grant under this section. History: 2009 a. 28 s. 1218; Stats. 2009 s. 46.75.
46.77 Food distribution administration. From the appropriation under s. 20.435 (1) (dn), the department shall allocate funds to eligible recipient agencies, as defined in 7 USC 7501 (3), for the storage, transportation, and distribution of commodities provided under 7 USC ch. 102. History: 2009 a. 28 s. 1219; Stats. 2009 s. 46.77.
46.80 Aging. (1) The department’s primary responsibility to elderly persons is to assure that all elderly and disabled persons have available and accessible a continuum of care or a wide range of community and supportive services so that they may remain in their homes and neighborhoods for as long as it is possible. The department shall be the mechanism by which governmental and nongovernmental agencies may coordinate their policies, plans and activities with regard to the aging. To this end it shall: (a) Conduct a continuous review of the scope and degree of coordination of all state programs and activities on the aging and make recommendations to the appropriate agencies regarding the expansion, coordination, consolidation and reorganization of particular activities as a means of developing a more effective and efficient total program for the aging. (b) Examine the need for future activities, programs, services and facilities for the aging on the state, local and voluntary levels. (c) Encourage, promote and aid in the establishment of programs and services for the aging within subordinate units of gov-
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ernment and nongovernmental groups, and assist organizations and committees in the development of programs in such manner as the division deems appropriate. (d) Gather and disseminate information about programs, services, activities and facilities for the aging. (e) Conduct a continuous program to stimulate public awareness and understanding of the needs and potentials of the aging. (f) Provide consultant service to assist in the development of local housing for the aged. (2) The several state agencies shall cooperate with the department in making available to it such available data as will facilitate the work of the department. The department shall make available to the several state agencies such information as it secures which will facilitate the effective operation of their programs for the aging. (2m) The department: (a) In accordance with the requirements of 42 USC 3025, 3026 and 3027, shall do all of the following: 1. Divide the state into distinct planning and service areas and designate a public or private nonprofit agency or organization as the area agency on aging for each planning and service area. 2. Develop formulas for distribution within the state of funds received under 42 USC 3001 to 3030. The department need not promulgate as rules under ch. 227 the formulas developed under this subdivision. 3. Receive area plans prepared and developed by area agencies on aging designated under subd. 1. 4. Contract with each area agency on aging that is designated under subd. 1. to do all of the following: a. Distribute, according to the formulas developed by the department, state or federal funds to a county, to the elected governing body of a federally recognized American Indian tribe or band or to a private, nonprofit organization for the purposes that are established in an area plan that is specified in subd. 3. b. Monitor programs of services for individuals who are at least 60 years of age that are provided under an area plan by a county or the elected governing body of a federally recognized American Indian tribe or band. c. Provide technical assistance and training. 5. Ensure that each area agency on aging meets the requirements that are specified for an area agency on aging under 42 USC 3025 and 3026. 6. Establish and operate, either directly or by contract or other arrangement with a public agency or private, nonprofit organization, other than an agency or organization that licenses or certifies long-term care services or is an association of providers of long-term care services, a long-term care ombudsman program. (b) May operate the foster grandparent project specified under 42 USC 5011 (a). If the department operates that project, the department shall distribute funds from the appropriation under s. 20.435 (1) (dh) to supplement any federal foster grandparent project funds received under 42 USC 5011 (a). (c) May operate the older American community service employment program under 42 USC 3056. (3) The department may accept, on behalf of the state, and use gifts and grants for the purposes of this section. It shall use, to the fullest extent legally possible, all available grants from federal, state and other public or private sources to fund community home care services or programs which offer alternatives to institutionalization and which provide comprehensive services at the community level. The state plan for the older Americans act shall detail objectives designed to accomplish this purpose.
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(4) The secretary shall appoint such technical staff as is necessary to carry out the functions of this program. (5) (a) From the appropriation under s. 20.435 (1) (dh), the department shall provide a state supplement to the federal congregate nutrition projects under 42 USC 3030e, in effect on April 30, 1980, which will promote expansion of projects throughout the state and, from the appropriation under s. 20.435 (1) (kn), the department shall provide a state supplement to the federal congregate nutrition projects of $450,000 for home-delivered meals and $50,000 for congregate meals. Except as provided in par. (b), the department shall allocate these funds based on the formulas developed by the department under sub. (2m) (a) 2. A county that receives federal funds for congregate nutrition projects on or after July 1, 1977, may not receive under this paragraph an amount that is less than the 1976-77 allocation as a result of the program expansion. This paragraph does not require that federal limitations on the use of federal congregate nutrition funds for home delivered meals apply to the state supplement. (b) The department may use up to 10 percent of the funds provided under par. (a) to reduce county losses, if any, as a result of changes in census data or revisions in the formula for distribution under sub. (2m) (a) 2. History: 1971 c. 164; 1975 c. 39, 200; 1977 c. 29; 1979 c. 34 ss. 828g to 829, 2102 (20) (a); 1979 c. 221; 1981 c. 20; 1983 a. 27 s. 2202 (20); 1985 a. 332; 1987 a. 27; 1989 a. 31; 1991 a. 235; 1993 a. 16; 1997 a. 27; 1999 a. 52; 2017 a. 59.
46.81 Benefit specialist program. (1) In this section: (a) “Aging unit” means an aging unit director and necessary personnel, directed by a county commission on aging and organized as one of the following: 1. An agency of county government with the primary purpose of administering programs of services for older individuals of the county. 2. A unit, within a county department under s. 46.215, 46.22 or 46.23, with the primary purpose of administering programs of services for older individuals of the county. 3. A private corporation that is organized under ch. 181 and that is a nonprofit corporation, as defined in s. 181.0103 (17). (b) “Area agency on aging” means the agency designated under 42 USC 3025 (a) (2) (A). (c) “Older individual” means an individual who is 60 years of age or older. (2) From the appropriation account under s. 20.435 (1) (dh), the department shall allocate $2,298,400 in each fiscal year to aging units to provide benefit specialist services for older individuals. The department shall ensure that each aging unit receives funds and shall take into account the proportion of the state’s population of low-income older individuals who reside in a county. (3) An aging unit shall use the funds allocated under sub. (2) and federal funds designated for the purpose to provide benefit specialist services to older individuals. Aging units may also use other funds to provide benefit specialist services. (4) Benefit specialists shall offer information, advice and assistance to older individuals related to individual eligibility for, and problems with, public benefits and services and to health care financing, insurance, housing and other financial and consumer concerns. Benefit specialists shall refer older individuals in need of legal representation to the private bar or other available legal resources. (5) From the appropriation under s. 20.435 (1) (dh) the department shall allocate $182,500 in each fiscal year to area agencies on aging. Each area agency on aging shall use the funds for
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training, supervision and legal back-up services for benefit specialists within its area. History: 1987 a. 27, 399; 1989 a. 31; 1991 a. 39, 235, 269, 315; 1993 a. 16; 1995 a. 27; 1997 a. 41, 79; 1999 a. 9; 2005 a. 25; 2017 a. 59.
46.82 Aging unit. (1) DEFINITIONS. In this section: (a) “Aging unit” means an aging unit director and necessary personnel, directed by a county or tribal commission on aging and organized as one of the following: 1. An agency of county or tribal government with the primary purpose of administering programs of services for older individuals of the county or tribe. 2. A unit, within a county department under s. 46.215, 46.22 or 46.23, with the primary purpose of administering programs of services for older individuals of the county. 3. A private corporation that is organized under ch. 181 and that is a nonprofit corporation, as defined in s. 181.0103 (17). (b) “Area agency on aging” means an agency designated as specified in 42 USC 3025 (a) (2) (A). (c) “Older individual” means an individual who is 60 years of age or older. (2) AGING UNIT; CREATION. A county board of supervisors of a county, the county boards of supervisors of 2 or more contiguous counties or an elected tribal governing body of a federally recognized American Indian tribe or band in this state may choose to administer, at the county or tribal level, programs for older individuals that are funded under 42 USC 3001 to 3057n, 42 USC 5001 and 42 USC 5011 (b). If this is done, the county board or boards of supervisors or tribal governing body shall establish by resolution a county or tribal aging unit to provide the services required under this section. If a county board of supervisors or a tribal governing body chooses, or the county boards of supervisors of 2 or more contiguous counties choose, not to administer the programs for older individuals, the department shall direct the area agency on aging that serves the relevant area to contract with a private, nonprofit corporation to provide for the county, tribe or counties the services required under this section. (3) AGING UNIT; POWERS AND DUTIES. In accordance with state statutes, rules promulgated by the department and relevant provisions of 42 USC 3001 to 3057n and as directed by the county or tribal commission on aging, an aging unit: (a) Duties. Shall do all of the following: 1. Work to ensure that all older individuals, regardless of income, have access to information, services and opportunities available through the county or tribal aging unit and have the opportunity to contribute to the cost of services and that the services and resources of the county or tribal aging unit are designed to reach those in greatest social and economic need. 2. Plan for, receive and administer federal, state and county, city, town or village funds allocated under the state and area plan on aging to the county or tribal aging unit and any gifts, grants or payments received by the county or tribal aging unit, for the purposes for which allocated or made. 3. Provide a visible and accessible point of contact for individuals to obtain accurate and comprehensive information about public and private resources available in the community which can meet the needs of older individuals. 4. As specified under s. 46.81, provide older individuals with services of benefit specialists or appropriate referrals for assistance. 5. Organize and administer congregate programs, which shall include a nutrition program and may include one or more senior centers or adult day care or respite care programs, that enable older individuals and their families to secure a variety of services, including nutrition, daytime care, educational or volunteer
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opportunities, job skills preparation and information on health promotion, consumer affairs and civic participation. 6. Work to secure a countywide or tribal transportation system that makes community programs and opportunities accessible to, and meets the basic needs of, older individuals. 7. Work to ensure that programs and services for older individuals are available to homebound, disabled and non-English speaking persons, and to racial, ethnic and religious minorities. 8. Identify and publicize gaps in services needed by older individuals and provide leadership in developing services and programs, including recruitment and training of volunteers, that address those needs. 9. Work cooperatively with other organizations to enable their services to function effectively for older individuals. 10. Actively incorporate and promote the participation of older individuals in the preparation of a county or tribal comprehensive plan for aging resources that identifies needs, goals, activities and county or tribal resources for older individuals. 11. Provide information to the public about the aging experience and about resources for and within the aging population. 12. Assist in representing needs, views and concerns of older individuals in local decision making and assist older individuals in expressing their views to elected officials and providers of services. 14. If the department is so requested by the county board of supervisors, administer the pilot projects for home and community-based long-term support services under s. 46.271. 15. If designated under s. 46.90 (2), administer the elder abuse reporting system under s. 46.90. 16. If designated under s. 46.87 (3) (c) or (d), administer the Alzheimer’s disease family and caregiver support program under s. 46.87. 17. If designated by the county or in accordance with a contract with the department, operate the specialized transportation assistance program for a county under s. 85.21. 18. Advocate on behalf of older individuals to assist in enabling them to meet their basic needs. 19. If an aging unit under sub. (1) (a) 1. or 2. and if authorized under s. 46.283 (1) (a) 1., apply to the department to operate a resource center under s. 46.283 and, if the department contracts with the county under s. 46.283 (2), operate the resource center. 20. If an aging unit under sub. (1) (a) 1. or 2. and if authorized under s. 46.284 (1) (a) 1., apply to the department to operate a care management organization under s. 46.284 and, if the department contracts with the county under s. 46.284 (2), operate the care management organization and, if appropriate, place funds in a risk reserve. (b) Powers. May perform any other general functions necessary to administer services for older individuals. (4) COMMISSION ON AGING. (a) Appointment. 1. Except as provided under subd. 2., the county board of supervisors in a county that has established a single-county aging unit, the county boards of supervisors in counties that have established a multicounty aging unit or the elected tribal governing body of a federally recognized American Indian tribe or band that has established a tribal aging unit shall, before qualification under this section, appoint a governing and policy-making body to be known as the commission on aging. 2. In any county that has a county executive or county administrator and that has established a single-county aging unit, the county executive or county administrator shall appoint, subject to confirmation by the county board of supervisors, the commission on aging. A member of a commission on aging appointed under
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this subdivision may be removed at pleasure by the county executive or county administrator. (b) Composition. A commission on aging, appointed under par. (a) shall be one of the following: 1. For an aging unit that is described in sub. (1) (a) 1. or 2., organized as a committee of the county board of supervisors, composed of supervisors and, beginning January 1, 1993, advised by an advisory committee, appointed by the county board. Older individuals shall constitute at least 50 percent of the membership of the advisory committee and individuals who are elected to any office may not constitute 50 percent or more of the membership of the advisory committee. 2. For an aging unit that is described in sub. (1) (a) 1. or 2., composed of individuals of recognized ability and demonstrated interest in services for older individuals. Older individuals shall constitute at least 50 percent of the membership of this commission and individuals who are elected to any office may not constitute 50 percent or more of the membership of this commission. 3. For an aging unit that is described in sub. (1) (a) 3., the board of directors of the private, nonprofit corporation. Older individuals shall constitute at least 50 percent of the membership of this commission and individuals who are elected to any office may not constitute 50 percent or more of the membership of this commission. (c) Terms. Members of a county or tribal commission on aging shall serve for terms of 3 years, so arranged that, as nearly as practicable, the terms of one-third of the members shall expire each year, and no member may serve more than 2 consecutive 3year terms. Vacancies shall be filled in the same manner as the original appointments. A tribal commission on aging member appointed under par. (a) 1. may be removed from office for cause by a two-thirds vote of each tribal governing body participating in the appointment, on due notice in writing and hearing of the charges against the member. A county commission on aging member appointed under par. (a) 1. may be removed from office by a two-thirds vote of each county board of supervisors participating in the appointment, on due notice in writing. (d) Powers and duties. A county or tribal commission on aging appointed under sub. (4) (a) shall, in addition to any other powers or duties established by state law, plan and develop administrative and program policies, in accordance with state law and within limits established by the department of health services, if any, for programs in the county or for the tribe or band that are funded by the federal or state government for administration by the aging unit. Policy decisions not reserved by statute for the department of health services may be delegated by the secretary to the county or tribal commission on aging. The county or tribal commission on aging shall direct the aging unit with respect to the powers and duties of the aging unit under sub. (3). (5) AGING UNIT DIRECTOR; APPOINTMENT. A full-time aging unit director shall be appointed on the basis of recognized and demonstrated interest in and knowledge of problems of older individuals, with due regard to training, experience, executive and administrative ability and general qualification and fitness for the performance of his or her duties, by one of the following: (a) 1. For an aging unit that is described in sub. (1) (a) 1., except as provided in subd. 2., a county or tribal commission on aging shall make the appointment, subject to the approval of and to the personnel policies and procedures established by each county board of supervisors or the tribal governing body that participated in the appointment of the county or tribal commission on aging. 2. In any county that has a county executive or county administrator and that has established a single-county aging unit, the county executive or county administrator shall make the appoint-
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ment, subject to the approval of and to the personnel policies and procedures established by each county board of supervisors that participated in the appointment of the county commission on aging. (b) For an aging unit that is described in sub. (1) (a) 2., the director of the county department under s. 46.215, 46.22 or 46.23 of which the aging unit is a part shall make the appointment, subject to the personnel policies and procedures established by the county board of supervisors. (c) For an aging unit that is described in sub. (1) (a) 3., the commission on aging under sub. (4) (b) 3. shall make the appointment, subject to ch. 181. History: 1991 a. 235; 1993 a. 213; 1995 a. 27 ss. 2332, 9126 (19); 1997 a. 79; 1999 a. 9; 2007 a. 20 s. 9121 (6) (a); 2015 a. 273; 2017 a. 150; 2019 a. 9.
46.85 Programs for older individuals. (1) The department may establish and operate a Senior Companion Program modeled after the federal Senior Companion Program under 42 USC 5011 (b), in effect on April 30, 1980. If operated, the program shall engage the services of low-income persons aged 60 or over to provide supportive person-to-person assistance in health, education, recreation, welfare and related fields to persons aged 60 or over with special needs who reside in their own homes, and it may engage other persons aged 60 or older, regardless of income, as volunteers in similar activities. The department may also establish and operate a Retired Senior Volunteer Program modeled after the federal Retired Senior Volunteer Program under 42 USC 5001, in effect on April 30, 1980, to provide voluntary services in a community. If operated, the program shall engage persons aged 55 or older as volunteers. (2) If the department establishes a program under this section, it shall promulgate rules for the operation of the program. Such rules shall include: (a) A definition of “low income” which shall at least equal the guidelines of the federal ACTION program. (b) A requirement that program units provide accident and liability insurance coverage during working hours for all program participants, including volunteers. (c) A requirement that program units receiving federal funds establish advisory councils empowered according to, but not limited by, applicable federal guidelines. Council members may be reimbursed for transportation and other expenses incurred in service to the program. (3m) (a) From the appropriation under s. 20.435 (1) (dh), the department shall provide a state supplement to federally funded Senior Companion Program and Retired Senior Volunteer Program units that were in operation on December 1, 1988, and administered by qualified public and non-profit private agencies. (b) From the appropriation under s. 20.435 (1) (dh), the department shall allocate funds, based on the percentage of the state’s population of low-income persons over age 60 who reside in each county or are members of an American Indian tribe, and distribute the funds to counties and federally recognized tribal governing bodies to supplement any of the following: 1. Federally and nonfederally funded senior companion and retired senior volunteer programs. 2. Federal projects providing supportive services under 42 USC 3030d, congregate nutrition services under 42 USC 3030e, home-delivered meals under 42 USC 3030f and 3030g, in-home services for frail older individuals under 42 USC 3030h, 3030i, 3030j and 3030k and preventive health services under 42 USC 3030m, 3030n and 3030o. (4) Low income older persons employed in a senior companion program shall be paid a stipend which compensates them for no more than 20 hours per week at an hourly rate not to exceed
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the federal minimum wage, and in addition shall receive reimbursement for the cost of one meal per working day. (5) All persons engaged in a program under this section, whether for compensation or as volunteers, are eligible for: (a) Transportation assistance, not to exceed mileage payments for 20 miles per day. (b) Accident and liability insurance coverage during working hours. History: 1977 c. 418; 1979 c. 34, 221; 1981 c. 20; 1983 a. 27 s. 2202 (20); 1987 a. 27; 1989 a. 31; 1993 a. 16; 2003 a. 33; 2017 a. 59.
46.856 Alzheimer’s disease; training and information grants. (1) In this section: (a) “Private nonprofit organization” has the meaning given in s. 108.02 (19). (b) “Public agency” means a county, city, village, town or school district or an agency of this state or of a county, city, village, town or school district. (2) From the appropriation under s. 20.435 (1) (bg), the department shall award a grant to at least one public agency or private nonprofit organization to do all of the following: (a) Provide training and technical assistance to the staff of county departments under ss. 46.215, 46.22 and 46.23, to the staff of administering agencies designated under s. 46.87 (3) (c) or (d) and to other providers of services to persons with Alzheimer’s disease, as defined in s. 46.87 (1) (a). (b) Determine the need for and create appropriate services to persons with Alzheimer’s disease in coordination with local agencies and service providers. (c) Collect and disseminate information on Alzheimer’s disease, coordinate public awareness activities related to the disease and advise the department on public policy issues concerning the disease. History: 1995 a. 464; 1999 a. 9; 2015 a. 273; 2017 a. 59.
46.86 Treatment programs. (1) From the appropriation under s. 20.435 (5) (md) the department may award not more than $125,500 in each fiscal year as grants to counties and private nonprofit entities for treatment for pregnant women and mothers with alcohol and other drug abuse treatment needs; mothers who have alcohol and other drug abuse treatment needs and dependent children up to the age of 5 years; and the dependent children up to the age of 5 years of those mothers. The grants shall be awarded in accordance with the department’s request-for-proposal procedures. The grants shall be used to establish community-based programs, residential family-centered treatment programs or home-based treatment programs. The program under a grant must include alcohol and other drug abuse treatment services, parent education, support services for the children of the women who are enrolled in the program, vocational assistance and housing assistance. Any program funded under this subsection must also provide follow-up aftercare services to each woman and her children for at least 2 years after the date on which a woman has left the program. (2m) (a) In this subsection, “long-term treatment” means treatment that is, in the majority of instances, not less than 5 months nor more than 12 months in duration. (b) From the appropriation under s. 20.435 (5) (md), the department shall distribute not more than $79,500 in each fiscal year for residential long-term treatment for alcohol and other drug abuse, including treatment with respect to family relationships, antisocial behavior and employability, in a treatment facility, as defined in s. 51.01 (19), in a 1st class city. (3m) From the appropriation under s. 20.435 (5) (md), the department may not distribute more than $900,000 in each fiscal
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year to fund a multidisciplinary prevention and treatment team in Milwaukee County for cocaine-abusing women and their children. The multidisciplinary prevention and treatment team must coordinate its activities with other prevention and treatment programs in Milwaukee County for cocaine-abusing women and their children. Residents from other counties may be served by the multidisciplinary prevention and treatment team. The department may carry forward funds distributed under this subsection, but not encumbered by December 31, for distribution for the purpose under this subsection in the following calendar year. (5) From the appropriation under s. 20.435 (5) (md), the department may not distribute more than $235,000 in each fiscal year as a grant to ARC Community Services, Inc., for women and children in Dane County, to provide funding for staff of the center and transportation and meal expenses for chemically dependent women who receive services from the center. (6) (a) From the appropriation account under s. 20.435 (5) (md), the department may award up to $1,330,800 in each fiscal year, and from the appropriation account under s. 20.435 (5) (gb), the department may award not more than $319,500 in each fiscal year, as grants to counties and private entities to provide community-based alcohol and other drug abuse treatment programs that do all of the following: 1. Meet special needs of women with problems resulting from alcohol or other drug abuse. 2. Emphasize parent education, vocational and housing assistance and coordination with other community programs and with treatment under intensive care. (b) The department shall do all of the following with respect to the grants under par. (a): 1. Award the grants in accordance with the department’s request-for-proposal procedures. 2. Ensure that the grants are distributed in both urban and rural communities. 3. Evaluate the programs under the grants by use of clientoutcome measurements that the department develops. History: 1989 a. 122; 1991 a. 39; 1993 a. 16 ss. 998, 1001, 1005, 1012, 1061 to 1066; 1995 a. 27; 1997 a. 27; 1999 a. 9, 32; 2001 a. 16; 2009 a. 28; 2013 a. 20.
46.87 Alzheimer’s family and caregiver support program. (1) In this section: (a) “Alzheimer’s disease” means a degenerative disease of the central nervous system characterized especially by premature senile mental deterioration, and also includes any other irreversible deterioration of intellectual faculties with concomitant emotional disturbance resulting from organic brain disorder. (b) “Caregiver” means any person other than a paid provider who provides care for a person with Alzheimer’s disease. (c) “Tribe or band” has the meaning given in s. 46.2805 (11). (2) From the appropriations under s. 20.435 (7) (b) and (o), the department shall allocate funds to agencies designated under sub. (3) (c) or (d), to be used for the administration and implementation of an Alzheimer’s family and caregiver support program for persons with Alzheimer’s disease and their caregivers. The department shall allocate at least $1,000,000 in each fiscal year toward respite care. (3) (a) A county board or tribe or band may apply to initially participate in the program created under this section by submitting to the department a one-time letter of intent to participate which includes a description of the program and services related to Alzheimer’s disease which the county board or tribe or band intends to provide. (b) The department shall select counties and tribes or bands to participate in the program on the basis of criteria promulgated by rule.
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(c) The county board for each county selected to participate shall designate one of the following as the administering agency for the program: 1. The county department under s. 46.215 or 46.22. 2. The county department under s. 51.42 or 51.437. 3. The county department under s. 46.23. 4. An aging unit, as defined in s. 46.82 (1) (a). 5. The local health department, if any, established under s. 251.02. (d) A tribe or band selected to participate in the program shall designate an administering agency for the program. (4) If a county board or tribe or band does not submit an application under sub. (3) (a) by January 1, 1986, the department shall make that allocation of the county or tribe or band available to a private nonprofit organization, as defined under s. 108.02 (19), to administer the program created under this section and shall select the organization according to criteria promulgated by rule. An organization selected as the administering agency under this subsection shall continue to be eligible to receive the allocation of the county or tribe or band unless the county board or tribe or band subsequently submits to the department a letter of intent to participate and receives approval of its proposed program. (5) The administering agency in each county or tribe or band may use the funds allocated to it to do any of the following: (a) Provide or contract for the provision of services and goods or make payments for services to households that meet all of the following conditions: 1. At least one member of the household must be a person who has been diagnosed by a physician as having Alzheimer’s disease. 2. Either the person with Alzheimer’s disease or the person’s caregiver resides in the county or is a member of the tribe or band to which the household applies for participation in the program. 3. Persons in the household are ineligible for the family care benefit under s. 46.286 in a county in which a care management organization under s. 46.284 operates. (b) Provide or contract for the provision of services and goods or make payments for services to a person with Alzheimer’s disease living in a residential facility in the county or in a residential facility associated with the tribe or band who is ineligible for the family care benefit under s. 46.286 in a county in which a care management organization under s. 46.284 operates. (bm) Maintain a contract in effect on June 30, 1987, with a service provider under funds allocated under sub. (2). (c) Contract with service providers to develop new programs or expand services, under this section, as defined by the department by rule. (e) Provide outreach or other activities designed to develop public awareness of Alzheimer’s disease. (6) (a) For the purpose of distributing funds allocated under this section to households or individuals participating in the program, the administering agency shall determine all of the following: 1. The services and goods needed by the household to enable it to maintain the person with Alzheimer’s disease as a member of the household, or the services or goods needed by a person with Alzheimer’s disease living in a residential facility, and the cost of each service or good that is needed. 2. The ability of the household or of the person to pay for the services and goods identified under subd. 1., using as the basis for the determination the uniform fee schedule established by the department under s. 46.03 (18). (b) 1. An administering agency may pay to or expend on be-
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half of a participating household or individual person the cost of any goods and services identified under par. (a) 1., less any amount paid under subd. 2., except that the amount paid or expended may not exceed $4,000 in any calendar year for each person with Alzheimer’s disease in the household or for an individual person living in a residential facility. 2. An administering agency: a. Shall require that the household or person with Alzheimer’s disease pay, if able as determined under par. (a) 2., for services and goods provided under sub. (5) (a), (b) and (bm) unless the contract is determined to be a contract under sub. (5) (c). b. May require that the household or person with Alzheimer’s disease pay, if able as determined under par. (a) 2., for services and goods provided under sub. (5) (c). (7) The county board or tribe or band shall notify the department if any of the following occurs: (a) The administering agency in the county or tribe or band is replaced by another. (b) The county board or tribe or band intends to terminate participation in the program. (c) The program and services of the county or tribe or band related to Alzheimer’s disease contain a substantial difference, as defined by rule, from the description of the program and services of the county or tribe or band contained in the letter of intent most recently submitted by the county board or tribe or band to the department under sub. (3) (a). (8) The department shall collect and analyze information about persons with Alzheimer’s disease who are served under this section and about caregivers. History: 1985 a. 29, 176; 1987 a. 27, 255, 403; 1989 a. 31, 336; 1991 a. 235; 1993 a. 27; 1997 a. 27; 2001 a. 16; 2015 a. 273; 2025 a. 21. Cross-reference: See also ch. DHS 68, Wis. adm. code.
46.90 Elder abuse reporting system. (1) DEFINITIONS. In this section: (a) “Abuse” means any of the following: 1. Physical abuse. 2. Emotional abuse. 3. Sexual abuse. 4. Treatment without consent. 5. Unreasonable confinement or restraint. (ag) “Aging unit” has the meaning given under s. 46.82 (1) (a). (aj) “Bodily harm” means physical pain or injury, illness, or any impairment of physical condition. (an) “Caregiver” means a person who has assumed responsibility for all or a portion of an individual’s care voluntarily, by contract, or by agreement, including a person acting or claiming to act as a legal guardian. (ar) “Case management” means an assessment of need for direct services, development of a direct service plan and coordination and monitoring of the provision of direct services. (bm) “Direct services” includes temporary shelter, relocation assistance, housing, respite care, emergency funds for food and clothing and legal assistance. (br) “Elder adult at risk” means any person age 60 or older who has experienced, is currently experiencing, or is at risk of experiencing abuse, neglect, self-neglect, or financial exploitation. (bt) “Elder-adult-at-risk agency” means the agency designated by the county board of supervisors under sub. (2) to receive, respond to, and investigate reports of abuse, neglect, self-neglect, and financial exploitation under sub. (4). (cm) “Emotional abuse” means language or behavior that serves no legitimate purpose and is intended to be intimidating,
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humiliating, threatening, frightening, or otherwise harassing, and that does or reasonably could intimidate, humiliate, threaten, frighten, or otherwise harass the individual to whom the conduct or language is directed. (ed) “Financial exploitation” means any of the following: 1. Obtaining an individual’s money or property by deceiving or enticing the individual, or by forcing, compelling, or coercing the individual to give, sell at less than fair market value, or in other ways convey money or property against his or her will without his or her informed consent. 2. Theft, as prohibited in s. 943.20. 3. The substantial failure or neglect of a fiscal agent to fulfill his or her responsibilities. 4. Unauthorized use of an individual’s personal identifying information or documents, as prohibited in s. 943.201. 5. Unauthorized use of an entity’s identifying information or documents, as prohibited in s. 943.203. 6. Forgery, as prohibited in s. 943.38. 7. Financial transaction card crimes, as prohibited in s. 943.41. (eg) “Fiscal agent” includes any of the following: 1. A guardian of the estate appointed under s. 54.10. 2. A conservator appointed under s. 54.76. 3. An agent under a power of attorney under ch. 244. 4. A representative payee under 20 CFR 416.635. 5. A conservatorship under the U.S. department of veterans affairs. (er) “Investigative agency” means a law enforcement or a city, town, village, county, or state governmental agency or unit with functions relating to protecting health, welfare, safety, or property, including an agency concerned with animal protection, public health, building code enforcement, consumer protection, or insurance or financial institution regulation. (f) “Neglect” means the failure of a caregiver, as evidenced by an act, omission, or course of conduct, to endeavor to secure or maintain adequate care, services, or supervision for an individual, including food, clothing, shelter, or physical or mental health care, and creating significant risk or danger to the individual’s physical or mental health. “Neglect” does not include a decision that is made to not seek medical care for an individual, if that decision is consistent with the individual’s previously executed declaration or do-not-resuscitate order under ch. 154, a power of attorney for health care under ch. 155, or as otherwise authorized by law. (fg) “Physical abuse” means the intentional or reckless infliction of bodily harm. (g) “Self-neglect” means a significant danger to an individual’s physical or mental health because the individual is responsible for his or her own care but fails to obtain adequate care, including food, shelter, clothing, or medical or dental care. (gd) “Sexual abuse” means a violation of s. 940.225 (1), (2), (3), or (3m). (gf) “State governmental agency” has the meaning given for “agency” in s. 16.417 (1) (a). (gr) “State official” means any law enforcement officer employed by the state or an employee of one of the following: 1. The department of health services. 2. The department of justice. 3. The department of safety and professional services. 4. The board on aging and long-term care. 5. A state governmental agency other than those specified in subds. 1. to 4. with functions relating to protecting health and safety.
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(h) “Treatment without consent” means the administration of medication to an individual who has not provided informed consent, or the performance of psychosurgery, electroconvulsive therapy, or experimental research on an individual who has not provided informed consent, with the knowledge that no lawful authority exists for the administration or performance. (i) “Unreasonable confinement or restraint” includes the intentional and unreasonable confinement of an individual in a locked room, involuntary separation of an individual from his or her living area, use on an individual of physical restraining devices, or the provision of unnecessary or excessive medication to an individual, but does not include the use of these methods or devices in entities regulated by the department if the methods or devices are employed in conformance with state and federal standards governing confinement and restraint. (2) ELDER-ADULT-AT-RISK AGENCY DESIGNATION. Each county board shall designate an agency in the county as the elderadult-at-risk agency for the purposes of this section. (3) ELDER-ADULT-AT-RISK AGENCY DUTIES. (a) Each elderadult-at-risk agency shall develop a policy for notifying other investigative agencies, including law enforcement officials in appropriate cases, and shall establish an elder abuse reporting system to carry out the purposes of this section. Each elder-adult-atrisk agency shall enter into a memorandum of understanding regarding the operation of the system with the county department under s. 46.215 or 46.22 and with any private or public agency, including a county department under s. 51.42 or 51.437, within the county that is participating in the elder abuse reporting system. The memorandum of understanding shall, at a minimum, identify the agencies that are responsible for the investigation of reports of abuse, financial exploitation, neglect, or self-neglect of elder adults at risk and for the provision of specific direct services. (b) Each elder-adult-at-risk agency shall receive reports of abuse, financial exploitation, neglect, or self-neglect of elder adults at risk. (c) Each elder-adult-at-risk agency shall publicize the existence of an elder abuse reporting system in the county and shall provide a publicized telephone number that can be used by persons wishing to report suspected cases of abuse, financial exploitation, neglect, or self-neglect of elder adults at risk. Each elder-adult-at-risk agency shall also provide a telephone number that can be used to make reports after the elder-adult-at-risk agency’s regular business hours. (4) REPORTING. (ab) The following persons shall file reports as specified in par. (ad): 1. An employee of any entity that is licensed, certified, or approved by or registered with the department. 3. A health care provider, as defined in s. 155.01 (7). 4. A social worker, professional counselor, or marriage and family therapist certified under subch. I of ch. 457 or a professional counselor who is exercising the privilege to practice, as defined in s. 457.50 (2) (s), in this state. (ad) Except as provided in par. (ae), a person specified in par. (ab) who has seen an elder adult at risk in the course of the person’s professional duties shall file a report with the county department, the elder-adult-at-risk agency, a state or local law enforcement agency, the department, or the board on aging and long-term care if the elder adult at risk has requested the person to make the report, or if the person has reasonable cause to believe that any of the following situations exist: 1. The elder adult at risk is at imminent risk of serious bodily harm, death, sexual assault, or significant property loss and is unable to make an informed judgment about whether to report the risk.
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2. An elder adult at risk other than the subject of the report is at risk of serious bodily harm, death, sexual assault, or significant property loss inflicted by a suspected perpetrator. (ae) A person specified in par. (ab) to whom any of the following applies is not required to file a report as provided in par. (ad): 1. If the person believes that filing a report would not be in the best interest of the elder adult at risk. If the person so believes, the person shall document the reasons for this belief in the case file that the person maintains on the elder adult at risk. 2. If a health care provider provides treatment by spiritual means through prayer for healing in lieu of medical care in accordance with his or her religious tradition and his or her communications with patients are required by his or her religious denomination to be held confidential. (ar) Any person, including an attorney or a person working under the supervision of an attorney, may report to the county department, the elder-adult-at-risk agency, a state or local law enforcement agency, the department, or the board on aging and long-term care that he or she believes that abuse, financial exploitation, neglect, or self-neglect of an elder adult at risk has occurred if the person is aware of facts or circumstances that would lead a reasonable person to believe or suspect that abuse, financial exploitation, neglect, or self-neglect of an elder adult at risk has occurred. The person shall indicate the facts and circumstances of the situation as part of the report. (b) 1. a. No person may discharge or otherwise retaliate or discriminate against any person for reporting in good faith under this subsection. b. No person may discharge or otherwise retaliate or discriminate against any individual on whose behalf another person has reported in good faith under this subsection. cm. Any discharge of a person or act of retaliation or discrimination that is taken against a person who makes a report under this subsection, within 120 days after the report is made, establishes a rebuttable presumption that the discharge or act is made in response to the report. This presumption may be rebutted by a preponderance of evidence that the discharge or act was not made in response to the report. 2. b. Any employee who is discharged or otherwise discriminated against may file a complaint with the department of workforce development under s. 106.54 (5). c. Any person not described in subd. 2. b. who is retaliated or discriminated against in violation of subd. 1. a. or b. may commence an action in circuit court for damages incurred as a result of the violation. (c) No person may be held civilly or criminally liable or be found guilty of unprofessional conduct for reporting in good faith under this subsection and within the scope of his or her authority, or for filing a report with an agency not listed in par. (ad) (intro.) or (ar) if the person had a good faith belief that the report was filed correctly with one of the listed agencies. (d) If a report under par. (ad) or (ar) is made to a state official, the state official shall refer the report to the appropriate elderadult-at-risk agency. The requirement under this paragraph does not apply to an employee of the board on aging and long-term care who determines that his or her referral would be in violation of 42 USC 3058g (d). (e) Any person making a report under this subsection is presumed to have reported in good faith. (5) RESPONSE AND INVESTIGATION. (a) 1. Except as otherwise provided, upon receiving a report of alleged abuse, financial exploitation, neglect, or self-neglect of an elder adult at risk, the elder-adult-at-risk agency shall either respond to the report including, if necessary, by conducting an investigation, or refer the
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report to another agency for investigation. Upon receiving a report of alleged abuse, financial exploitation, neglect, or self-neglect of a client, as defined in s. 50.065 (1) (b), of an entity, as defined in s. 50.065 (1) (c), if the person suspected of perpetrating the alleged abuse, financial exploitation, or neglect is a caregiver or a nonclient resident of the entity, the elder-adult-at-risk agency shall refer the report within 24 hours after the report is received to the department for investigation. The department shall coordinate its investigatory efforts with other investigative agencies or authorities as appropriate. An elder-adult-at-risk agency’s response to or another investigative agency’s investigation of a report of alleged abuse, financial exploitation, neglect, or self-neglect that is not referred to the department shall be commenced within 24 hours after a report is received, excluding Saturdays, Sundays and legal holidays. 2. If an agent or employee of an elder-adult-at-risk agency required to respond under this subsection is the subject of a report, or if the elder-adult-at-risk agency or an agency under contract with the county department determines that the relationship between the elder-adult-at-risk agency and the agency under contract with the county department would not allow for an unbiased response, the elder-adult-at-risk agency shall, after taking any action necessary to protect the elder adult at risk, notify the department. Upon receipt of the notice, the department or a county department under s. 46.215, 46.22, 51.42, or 51.437 designated by the department shall conduct an independent investigation. The powers and duties of a county department making an independent investigation are those given to an elder-adult-at-risk agency under pars. (b) to (f) and sub. (6). (b) The elder-adult-at-risk agency’s response or another investigative agency’s investigation shall include at least one of the following: 1. A visit to the residence of the elder adult at risk. 2. Observation of the elder adult at risk, with or without consent of his or her guardian or agent under an activated power of attorney for health care, if any. 3. An interview with the elder adult at risk, in private to the extent practicable, and with or without the consent of his or her guardian or agent under an activated power of attorney for health care, if any. 4. An interview with the guardian or agent under an activated power of attorney for health care, if any, and with any caregiver of the elder adult at risk. 5. A review of the treatment and patient health care records of the elder adult at risk. 6. A review of any financial records of the elder adult at risk that are maintained by a financial institution, as defined in s. 705.01 (3); by an entity, as defined in s. 50.065; by any caregiver of the elder adult at risk; or by a member of the immediate family of the elder adult at risk or caregiver. The records shall be released without informed consent in either of the following circumstances: a. To an elder-adult-at-risk agency or other investigative agency under this section. The financial record holder may release financial record information by initiating contact with the elder-adult-at-risk agency or other investigative agency without first receiving a request for release of the information from the elder-adult-at-risk agency or other investigative agency. b. Under a lawful order of a court of record. (br) The elder-adult-at-risk agency or other investigative agency may transport the elder adult at risk for performance of a medical examination by a physician if any of the following applies: 1. The elder adult at risk or his or her guardian or agent under
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an activated power of attorney for health care, if any, consents to the examination. 2. The elder adult at risk is incapable of consenting to the examination and one of the following applies: a. The elder adult at risk has no guardian or agent under an activated power of attorney for health care. b. The elder adult at risk has a guardian or an agent under an activated power of attorney for health care, but that guardian or agent is the person suspected of abusing, neglecting, or financially exploiting the elder adult at risk. c. The examination is authorized by order of a court. (c) The elder-adult-at-risk agency may request a sheriff or police officer to accompany the elder-adult-at-risk agency investigator or worker during visits to the residence of the elder adult at risk or request other assistance as needed. If the request is made, a sheriff or police officer shall accompany the elder-adult-at-risk agency investigator or worker to the residence of the elder adult at risk and shall provide other assistance as requested or necessary. (d) If a person interferes with the response or investigation under this subsection or interferes with the delivery of protective services under ch. 55 to the elder adult at risk, the elder-adult-atrisk agency investigator or worker may apply for an order under s. 813.123 prohibiting the interference. (f) If the elder-adult-at-risk agency worker or investigator or other agency investigator has reason to believe that substantial physical harm, irreparable injury, or death may occur to an elder adult at risk, the worker or investigator shall request immediate assistance in either initiating a protective services action under ch. 55 or contact law enforcement or another public agency, as appropriate. (h) No person may be held civilly or criminally liable or be found guilty of unprofessional conduct for responding to a report or for participating in or conducting an investigation under this subsection, including the taking of photographs or the conducting of a medical examination, if the response or investigation was performed in good faith and within the scope of his or her authority. (5m) OFFER OF SERVICES AND REFERRAL OF CASES. (a) Upon responding to a report, the elder-adult-at-risk agency or the investigative agency shall determine whether the elder adult at risk or any other individual involved in the alleged abuse, financial exploitation, neglect, or self-neglect is in need of services under this chapter or ch. 47, 49, 51, 54, or 55. From the appropriation under s. 20.435 (1) (dh), the department shall allocate to selected counties not less than $25,000 in each fiscal year, and within the limits of these funds and of available state and federal funds and of county funds appropriated to match the state and federal funds, the elder-adult-at-risk agency shall provide the necessary direct services to the elder adult at risk or other individual or arrange for the provision of the direct services with other agencies or individuals. Those direct services provided shall be rendered under the least restrictive conditions necessary to achieve their objective. (b) If the elder-adult-at-risk agency is not the aging unit, the elder-adult-at-risk agency in each county shall consult with and accept advice from the aging unit with respect to the distribution of the funds for direct services that are allocated under par. (a). (br) If, after responding to a report, the elder-adult-at-risk agency has reason to believe that the elder adult at risk has been the subject of abuse, financial exploitation, neglect, or self-neglect, the elder-adult-at-risk agency may do any of the following: 1. Request immediate assistance in initiating a protective services action under ch. 55 or contact an investigative agency, as appropriate. 2. Take appropriate emergency action, including emergency
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protective placement under s. 55.135, if the elder-adult-at-risk agency determines that the emergency action is in the best interests of the elder adult at risk and the emergency action is the least restrictive appropriate intervention. 3. Refer the case to law enforcement officials, as specified in sub. (3) (a), for further investigation or to the district attorney, if the elder-adult-at-risk agency has reason to believe that a crime has been committed. 4. Refer the case to the licensing, permitting, registration, or certification authorities of the department or to other regulatory bodies if the residence, facility, or program for the elder adult at risk is or should be licensed, permitted, registered, or certified or is otherwise regulated. 5. Refer the case to the department of safety and professional services if the financial exploitation, neglect, self-neglect, or abuse involves an individual who is required to hold a credential, as defined in s. 440.01 (2) (a), under chs. 440 to 460. 5g. Refer the case to the department of financial institutions if the financial exploitation, neglect, self-neglect, or abuse involves an individual who is required to be registered under s. 202.13 or 202.14. 6. Bring a petition for a guardianship and protective services or protective placement under ch. 55 or a review of an existing guardianship if necessary to prevent financial exploitation, neglect, self-neglect, or abuse and if the elder adult at risk would otherwise be at risk of serious harm because of an inability to arrange for necessary food, clothing, shelter, or services. (c) An elder adult at risk may refuse to accept services unless a guardian authorizes the services. The elder-adult-at-risk agency or other provider agency shall notify the elder adult at risk of this right to refuse before providing services. (6) RECORDS; CONFIDENTIALITY. (ac) In this subsection: 1. “Departmental report form” includes documentation of an elder-adult-at-risk agency’s response to or investigation of a report made under sub. (5) and is the information required to be submitted to the department. 2. “Record” includes any document relating to the response, investigation, assessment, and disposition of a report made under this section. (am) The elder-adult-at-risk agency shall prepare a departmental report form of its response under sub. (5) to a report of suspected abuse, financial exploitation, neglect, or self-neglect. If the elder-adult-at-risk agency refers the report to an investigative agency, the investigative agency shall advise the elder-adultat-risk agency in writing of its response to the report. The elderadult-at-risk agency shall maintain records of suspected abuse, financial exploitation, neglect, or self-neglect. (b) Departmental report forms are confidential and may not be released by the elder-adult-at-risk agency or other investigative agency, except under the following circumstances: 1. To the elder adult at risk, any person named in a departmental report form who is suspected of abusing, neglecting, or financially exploiting an elder adult at risk, and the suspect’s attorney. These persons may inspect the departmental report form, except that information identifying the person who initially reported the suspected abuse, financial exploitation, neglect, or self-neglect, or any other person whose safety might be endangered through disclosure, may not be released. 2. To the agency or other entity from which assistance is requested under sub. (5) (f). Information obtained under this subdivision shall remain confidential. 3. To an individual, organization, or agency designated by the department or as required by law for the purposes of management audits or program monitoring and evaluation. Information
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obtained under this subdivision shall remain confidential and may not be used in any way that discloses the names of or other identifying information about the individuals involved. 4. For purposes of research, if the research project has been approved by the department or the elder-adult-at-risk agency and the researcher has provided assurances that the information will be used only for the purposes for which it was provided to the researcher, the information will not be released to a person not connected with the study under consideration, and the final product of the research will not reveal information that may serve to identify the individuals involved. The information shall remain confidential. In approving the use of information under this subdivision, the department shall impose any additional safeguards needed to prevent unwarranted disclosure of information. 5. Under a lawful order of a court of record. 6. To any agency or individual that provides direct services under sub. (5m), including an attending physician for purposes of diagnosis and treatment, and within the department to coordinate treatment for mental illness, developmental disabilities, alcoholism, or drug abuse of individuals committed to or under the supervision of the department. Information obtained under this subdivision shall remain confidential. 7. To the guardian of the elder adult at risk or the guardian of any person named in a report who is suspected of abusing, neglecting, or financially exploiting an elder adult at risk. These persons may inspect the departmental report form, except that information identifying the person who initially reported the suspected abuse, financial exploitation, neglect, or self-neglect, or any other person whose safety might be endangered through disclosure, may not be released. 8. To law enforcement officials in accordance with the policy developed under sub. (3) (a). 9. To a federal agency, state governmental agency, agency of any other state, or local governmental unit in this state or any other state that has a need for a departmental report form in order to carry out its responsibility to protect elder adults at risk from abuse, financial exploitation, neglect, or self-neglect. 10. To the reporter who made a report in his or her professional capacity, regarding action to be taken to protect or provide services to the alleged victim of abuse, financial exploitation, neglect, or self-neglect. (bd) If a person requesting a departmental report form is not one of the persons or entities specified in par. (b), the elder-adultat-risk agency may release information indicating only whether or not a report was received and whether or not statutory responsibility was fulfilled. (br) Notwithstanding par. (b) 1. to 10., an elder-adult-at-risk agency or an investigative agency may not release departmental report forms under this section if any of the following applies: 1. The elder-adult-at-risk agency determines that the release would be contrary to the best interests of the elder adult at risk who is the subject of the departmental report form or of another person residing with the subject of the departmental report form, or the release is likely to cause mental, emotional, or physical harm to the subject of the departmental report form or to any other individual. 2. The district attorney determines that disclosure of the information would jeopardize any ongoing or future criminal investigation or prosecution or would jeopardize a defendant’s right to a fair trial. 3. The elder-adult-at-risk agency determines that disclosure would jeopardize ongoing or future civil investigations or proceedings or would jeopardize the fairness of such a legal proceeding. (bt) Subject to pars. (b), (bd), (br), (bv), and (bw), records un-
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der this subsection are confidential and may not be released by the elder-adult-at-risk agency or other investigative agency, except under the following circumstances, upon request: 1. To the elder adult at risk who is the alleged victim named in the record. 2. To the legal guardian, conservator, or other legal representative of the elder adult at risk who is the alleged victim named in the record, if the legal guardian, conservator, or other legal representative of the alleged victim is not the alleged perpetrator of the abuse, financial exploitation, or neglect. 3. To law enforcement officials and agencies in accordance with the policy developed under sub. (3) (a) or with investigations conducted under sub. (5), or a district attorney, for purposes of investigation or prosecution. 4. To the department, under s. 51.03 (2), or for death investigations under s. 50.04 (2t) or 50.035 (5); or to a sheriff, police department, or district attorney for death investigations under s. 51.64 (2) (a). 5. To an employee of a county department under s. 51.42 or 51.437 that is providing services either to the elder adult at risk who is the alleged victim named in the record or to the alleged perpetrator of abuse, to determine whether the alleged victim should be transferred to a less restrictive or more appropriate treatment modality or facility. 6. To a court, tribal court, or state governmental agency for a proceeding relating to the licensure or regulation of an individual or entity regulated or licensed by the state governmental agency, that was an alleged perpetrator of abuse, financial exploitation, or neglect. 7. To the department, for management, audit, program monitoring, evaluation, billing, or collection purposes. 8. To the attorney or guardian ad litem for the elder adult at risk who is the alleged victim named in the record, to assist in preparing for any proceeding under ch. 48, 51, 54, 55, 813, 971, or 975 pertaining to the alleged victim. 9. To a coroner, medical examiner, pathologist, or other physician investigating the cause of death of an elder adult at risk that is unexplained or unusual or is associated with unexplained or suspicious circumstances. 10. To staff members of the protection and advocacy agency designated under s. 51.62 and the board on aging and long-term care under s. 16.009. 11. To an agency, including a probation or parole agency, that is legally responsible for the supervision of an alleged perpetrator of abuse, neglect, or financial exploitation of an elder adult at risk. 12. To a grand jury, if it determines that access to specified records is necessary for the conduct of its official business. 13. Under a lawful order of a court of record. (bv) The identity of a person making a report of alleged abuse, neglect, self-neglect, or financial exploitation shall be deleted from any record prior to its release under par. (bt) or from any departmental report form prior to its release under par. (b). The identity of any reporter may only be released with the written consent of the reporter or under a lawful order of a court of record. (bw) A person to whom a departmental report form or a record is disclosed under this subsection may not further disclose it, except to the persons and for the purposes specified in this subsection. (by) A custodian of records or departmental report forms incurs no civil or criminal liability under this subsection and may not be found guilty of unprofessional conduct for the release or nonrelease of records or departmental report forms in accordance
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with this subsection while acting in good faith and within the scope of his or her authority. (d) Any person who requests or obtains confidential information under this subsection under false pretenses may be fined not more than $500 or imprisoned not more than one year in the county jail or both. (e) Any employee who violates this subsection may be subject to discharge or suspension without pay. (7) EXCEPTION. Nothing in this section may be construed to mean that a person is abused, financially exploited, neglected or in need of direct or protective services solely because he or she consistently relies upon treatment by spiritual means through prayer for healing in lieu of medical care in accordance with his or her religious tradition. (8) DEPARTMENT DUTIES. (a) The department shall develop a plan to assist elder-adult-at-risk agencies in determining appropriate responses to reports of abuse, financial exploitation, neglect, or self-neglect. (b) The department shall prepare and distribute sample departmental report forms for use by elder-adult-at-risk agencies. (c) The department shall collect statistical information from each county pertaining to each reported case of abuse, financial exploitation, neglect, or self-neglect. The department may require elder-adult-at-risk agency workers or investigators to submit departmental report forms to the department that summarize the information being reported. These departmental report forms may not name or otherwise identify individuals. The department shall use this information to review the effectiveness of this section, to plan program changes, and to formulate reports. (d) The department shall develop and disseminate information on elder-adult-at-risk abuse and the elder abuse reporting system under this section. The department shall also develop informational materials to be used by elder-adult-at-risk agencies regarding abuse of elder adults at risk and regarding the elder abuse reporting system. The department shall solicit contributions of labor, materials, and expertise from private sources to assist in developing the informational materials. (9) PENALTIES. (a) Any person, including the state or any political subdivision of the state, violating sub. (6) is liable to any person damaged as a result of the violation for such damages as may be proved, together with exemplary damages of not less than $100 nor more than $500 for each violation and the costs and reasonable actual attorney fees that are incurred by the person damaged. (b) In any action brought under par. (a) in which the court determines that the violator acted in a manner that was knowing and willful, the violator shall be liable for such damages as may be proved together with exemplary damages of not less than $500 nor more than $1,000 for each violation, together with costs and reasonable actual attorney fees as may be incurred. It is not a prerequisite to an action under par. (a) that the plaintiff suffer or be threatened with actual damages. (c) An individual may bring an action to enjoin any violation of sub. (6) or to compel compliance with sub. (6), and may in the same action seek damages as provided in this subsection. The individual may recover costs and reasonable actual attorney fees incurred in the action, if he or she prevails. (d) Any person who violates sub. (4) (b) 1. may be fined not more than $10,000 or imprisoned for not more than 6 months or both. (e) Whoever intentionally violates sub. (4) (ad) by failure to report as required may be fined not more than $500 or imprisoned not more than 6 months or both. History: 1983 a. 398, 1985 a. 176; 1989 a. 31; 1991 a. 39, 235; 1993 a. 27; 1995 a. 27 ss. 2334, 9130 (4); 1995 a. 225; 1997 a. 3, 131; 1999 a. 82; 2003 a. 33; 2005 a.
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264, 388; 2007 a. 20 s. 9121 (6) (a); 2007 a. 45; 2009 a. 319; 2011 a. 32; 2013 a. 20; 2017 a. 59; 2021 a. 122; 2023 a. 55. Failure of a defamation plaintiff to assert any facts to support a finding of bad faith on the part of a person who reported possible material abuse resulted in a concession that the reporter was acting in good faith at the time the reporter made the elder abuse report, and thus the reporter’s statements were entitled to protection or privilege under sub. (4) (c). A ruling finding good faith did not resolve a counterclaim under sub. (4) (b) 2. c. that the lawsuit was retaliatory. Attorney fees are not recoverable as damages resulting from the statutory tort of retaliation. Schaul v. Kordell, 2009 WI App 135, 321 Wis. 2d 105, 773 N.W.2d 454, 08-2571. Abuse and Neglect in Long-term Care Facilities: The Civil Justice System’s Response. Studinski. Wis. Law. Aug. 2004. Preventing Abuse and Neglect in Health Care Settings: The Regulatory Agency’s Responsibility. Dawson. Wis. Law. Aug. 2004. Seeking Justice in Death’s Waiting Room: Barriers to Effectively Prosecuting Crime in Long-term Care Facilities. Hanrahan. Wis. Law. Aug. 2004. A Response: Issues Affecting Long-term Care. Purtell. Wis. Law. Oct. 2004. Adult Protective Services: On the Front Line Against Elder Abuse. Page. Wis. Law. June 2020.
46.94 Referral system for community-based services. From the appropriation under s. 20.435 (1) (fe), the department shall provide grants to a nonprofit organization to operate a statewide Internet site and telephone-based system to provide information on and referrals to community-based services, advocacy in accessing services, connection to crisis intervention, and follow-up contact. As a condition of receiving a grant under this section, the nonprofit organization shall agree to allocate moneys for promoting and marketing the system to make the public aware of its existence and purposes. History: 2017 a. 250.
46.96 Independent living center grants; independent living services. (1) In this section: (ad) “Cross-disability basis” has the meaning given under 29 USC 796f-4 (b) (2). (ah) “Independent living center” means a community-based, nonresidential private nonprofit agency that vests power and authority in individuals with disabilities, that is designed and operated within a local community by individuals with disabilities and that provides an array of independent living services, including independent living core services, on a cross-disability basis. (am) “Independent living core services” has the meaning given in 29 USC 705 (17). (ap) “Independent living services” has the meaning given under 29 USC 705 (18). (at) “Individual with a disability” has the meaning given under 29 USC 705 (20). (b) “Severely disabled individual” means any individual with a severe physical or mental impairment whose ability to function independently in his or her family or community or whose ability to obtain, maintain or advance in employment is substantially limited and for whom the delivery of independent living services will improve either his or her ability to function independently in his or her family or community or his or her ability to engage in employment. (2) The department shall make grants from the appropriations under s. 20.435 (1) (cx) and (kc) and (7) (na) to independent living centers for nonresidential services to severely disabled individuals. (2d) The department shall make grants from the appropriations under s. 20.435 (1) (cx) and (7) (na) for the purposes for which the federal moneys are received, including for independent living services. (3m) (a) By July 1, 1994, an independent living center that receives funds under sub. (2) shall comply with all of the following requirements: 1. The independent living center shall have a board of directors that is the principal governing body of the independent living center.
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2. Severely disabled individuals shall be substantially involved in policy direction and management of the independent living center and shall be employed by the independent living center. 3. The independent living center shall offer severely disabled individuals a combination of independent living services that includes, as appropriate, those services that assist severely disabled individuals to increase personal self-determination and to minimize unnecessary dependence upon others. (am) Notwithstanding par. (a), all of the following apply: 1. Any independent living center that first receives funding under this section after June 21, 1996, shall comply with requirements that are specified under 29 USC 796f-4. 2. Any independent living center that is receiving funding under this section on June 21, 1996, shall comply with requirements under 29 USC 796f-4 by July 1, 1998. (b) The department shall periodically review independent living centers and identify instances of noncompliance with the requirements of par. (a), if any. If the department identifies an instance of noncompliance, the department shall direct the noncomplying independent living center to comply within a reasonable period of time, which may not be less than 60 days after the date of the directive. History: 1983 a. 27; 1985 a. 29 ss. 903, 903m, 3202 (23); 1985 a. 120; 1989 a. 31; 1993 a. 16; 1995 a. 27, 398; 2009 a. 28; 2013 a. 20; 2015 a. 55; 2017 a. 59; 2021 a. 248.
46.972 Primary health for homeless individuals. (1) In this subsection, “primary health services” has the meaning given in 42 USC 254c (b) (1). (2) From the appropriation account under s. 20.435 (1) (ce), the department shall award up to $125,000 in each fiscal year as grants to applying public or nonprofit private entities for the costs of providing primary health services and any other services that may be funded by the program under 42 USC 256 to homeless individuals. Entities that receive funds awarded by the department under this paragraph shall provide the primary health services as required under 42 USC 256 (f). The department may award to an applying entity up to 100 percent of the amount of matching funds required under 42 USC 256 (e). History: 1989. a. 31; 1991 a. 39, 189; 1993 a. 16; 1997 a. 27; 2001 a. 16; 2005 a. 25; 2009 a. 28.
46.973 Drug dependence program. (1) In this section: (a) “Drug” means a controlled substance, as defined in s. 961.01 (4), or a controlled substance analog, as defined in s. 961.01 (4m). (b) “Drug abuse” means the use of a drug in such a manner as to endanger the public health, safety or welfare. (c) “Drug dependence” means a condition arising from the periodic or continuous use of a drug which may result in psychic or physical dependence which would affect or potentially affect the public health, safety or welfare. (2) A drug dependence and drug abuse program is established in the department. The secretary may develop and carry out programs concerned with education about and prevention of drug dependence and drug abuse, and programs concerned with treatment and rehabilitation of drug dependent persons and persons who abuse drugs. The secretary shall appoint a drug dependence program coordinator to handle liaison with other departments and agencies, including the state council on alcohol and other drug abuse. These programs may include, but are not limited to: (a) Education regarding use of drugs and the prevention of drug dependence and drug abuse.
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(b) Diagnosis, treatment and rehabilitation of patients who are drug dependent persons or persons who abuse drugs. (c) Development of standards and provision of consultation for local drug dependence and drug abuse programs. (d) Evaluation of programs conducted pursuant to the authority of this subsection as to their effectiveness and relationship to the public health, safety and welfare and the development of improved techniques for the prevention and treatment of drug dependence and drug abuse. (e) Promotion and establishment of cooperative relationship with public and private agencies which have a responsibility for the prevention and treatment of drug dependence and drug abuse. (2m) Within the availability of funding, the department shall establish a program that includes, but is not limited to all of the following: (a) Collection and analysis of data on drug abuse treatment from all approved public and private treatment facilities as defined in s. 51.45 (2) (b) and (c) which shall include, but not be limited to, all of the following information: 1. The total number of persons who received treatment for drug abuse statewide. 2. The type and amount of treatment that persons receive from alcohol and other drug abuse provider facilities. 3. The primary drug of abuse, the primary means of administration of drugs and the diagnosis of clients. 4. The number of persons on waiting lists for alcohol and other drug abuse provider facilities. 5. The total costs of drug abuse treatment statewide. 6. The sources and amounts of federal, state, local, insurance and private financing of alcohol and other drug abuse treatment programs. 7. The amount of funds retained by counties under s. 59.25 (3) (j). (b) Collection of data which indicates the extent of illicit drug use, the prevalence of drug abuse and which illicit drugs are available and being abused. Data shall be collected from law enforcement agencies, courts, criminal justice agencies, emergency medical treatment providers, other medical care facilities and agencies designated by the department. (c) A report summarizing the data collected under pars. (a) and (b) which shall be written annually and submitted to the state council on alcohol and other drug abuse by June 30 of every year and which shall include all of the following: 1. The nature and extent of this state’s drug abuse problems. 2. The use and abuse of each controlled substance or controlled substance analog specified in ch. 961. 3. The changes in the use and abuse of drugs noted by the facilities specified in par. (a) (intro.) including those changes resulting from initiatives of the state council on alcohol and other drug abuse or other state agencies. (3) The department may accept, receive, administer, and expend any money, material, or other gifts or grants of any description for purposes related to those set forth in this section. Moneys and grants received under this section shall be deposited with the secretary of administration and shall be credited to the department under s. 20.435 (2) (i) and expended by the department or the state council on alcohol and other drug abuse for the purposes specified. History: 1971 c. 219; 1975 c. 370; 1979 c. 221; 1983 a. 189; 1987 a. 339; 1993 a. 27 s. 248; Stats. 1993 s. 46.973; 1995 a. 201, 448; 2003 a. 33.
46.975 Grant and funding program; services related to alcohol and other drug abuse. (1) DEFINITION. In this section, “organization” means a nonprofit corporation or a public
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agency that proposes to provide services for individuals with alcohol or other drug abuse problems. (2) DISTRIBUTION OF FUNDS. The department shall allocate funds for programs as follows: (a) The department shall make grants to applying communitybased organizations to provide in-home and community-based alcohol and other drug abuse intervention, treatment or family support services directed at low-income Hispanics and Black Americans in urban areas and make funds available to any of the federally recognized tribal governing bodies in this state to increase the capacity of reservations to provide outpatient, intervention, treatment or family support services for alcohol and other drug abusers. (b) The department shall make a grant to an applying organization to implement an alcohol and other drug abuse treatment program which meets the special needs of women with alcohol or other drug abuse problems. (c) The department shall make grants to applying organizations for the purpose of organizing community initiatives to combat alcohol and other drug abuse in youth. History: 1987 a. 339.
46.977 Guardianship grants. (1) DEFINITION. In this section, “guardian” has the meaning given in s. 54.01 (10). (2) GRANT APPLICATIONS AND AWARDS. (ag) In this subsection, “organization” means a private, nonprofit agency or a county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437. (am) From the appropriation under s. 20.435 (1) (cg), the department may under this section, based on the criteria under par. (c), award grants to applying organizations for the purpose of training and assisting guardians for individuals found incompetent under ch. 54. No grant may be paid unless the awardee provides matching funds equal to 10 percent of the amount of the award. (b) Organizations awarded grants under par. (am) shall do all of the following: 2. Provide training and technical assistance on guardianship issues. 4. Provide technical assistance to recruited guardians in performing their duties. (c) In reviewing applications for grants under par. (am), the department shall consider the extent to which the proposed program will effectively train and assist guardians for individuals found incompetent under ch. 54. (3) GRANT FOR INITIAL TRAINING. (a) The department shall award a grant to develop, administer, and conduct the guardian training required under s. 54.26. (b) The department shall require the grantee to have expertise in state guardianship law, experience with technical assistance and support to guardians and wards, and knowledge of common challenges and questions encountered by guardians and wards. (c) The grantee selected to develop training that meets the requirements under s. 54.26 (1) shall develop plain language, webbased online training modules using adult-learning design principles that can be accessed for free by training topic and in formats that maximize accessibility, with printed versions available for free upon request. History: 1987 a. 368; 1989 a. 31; 1995 a. 27, 464; 2005 a. 25, 387; 2017 a. 59; 2021 a. 97.
46.986 Respite care program. (1) DEFINITIONS. In this section: (a) “Abuse” means the willful infliction on a person of physical pain or injury or unreasonable confinement.
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(b) “Caregiver” means an individual who lives in the home of a person with special needs and provides care or supervision for that person. (c) “County department” means a county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437. (d) “Neglect” means an act, omission or course of conduct that, because of the failure to provide adequate food, shelter, clothing, medical care or dental care, creates a significant danger to the physical and mental health of a person. (e) “Provider” means an individual or agency that a caregiver selects, with input to the selection by the person with special needs, if competent, to provide respite care to the person with special needs. (f) “Respite care” means care that is provided to a person with special needs, or a person at risk of abuse or neglect, in order to provide temporary relief to the caregiver of that person or when the caregiver is unable to provide care. (g) “Special need” means a person’s need resulting from an emotional, behavioral, cognitive, physical or personal condition that necessitates receipt of care or supervision in order to meet the person’s basic needs or to prevent harm from occurring to him or her. (h) “Tribe or band” means the governing body of a federally recognized American Indian tribe or band in this state. (2) PROGRAM. (a) From the appropriation account under s. 20.435 (1) (br), the department shall contract for the administration of life-span respite care projects with an organization to which all of the following apply: 1. The organization is a private, nonprofit organization, as defined in s. 108.02 (19), that is capable of operating on a statewide basis and has expertise in respite care issues. 2. At least 51 percent of the members of the organization’s governing board are consumers of respite care or caregivers. 3. The membership of the organization’s governing board includes providers and elected officials and represents the diverse geographical areas and cultural groups of the state. (b) The organization with which the department contracts under par. (a) shall do all of the following: 1. After consulting with the department, county departments, tribes or bands, providers and caregivers, prescribe criteria for the distribution of grants to conduct life-span respite care projects. The criteria shall include the requirement that grant funds be equally distributed among 5 administrative regions of the state, as prescribed by the department. 2. Solicit applications from and, using the criteria under subd. 1., award in each state fiscal biennium up to one grant in each of the 5 administrative regions prescribed by the department to any of the following to conduct a life-span respite care project: a. A county department. b. A tribe or band. c. A community-based private, nonprofit entity. d. A community-based private entity that is operated for profit. 3. Require that the grantee contribute matching funds to the operation of the life-span respite care project in the following amounts: a. Ten percent of the amount of the grant awarded by the organization, as direct services, which shall be used by the grantee to fund payments from caregivers to providers. b. Fifteen percent of the amount of the grant awarded by the organization, as in-kind services. 4. Oversee grants awarded under subd. 2., and monitor, pro-
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vide technical assistance to and evaluate the life-span respite care projects. 5. Develop best practice guidelines and a training curriculum that may be used by life-span respite care projects that are funded under this section and that may be used, if appropriate, by any other respite care providers in the state. 6. Promote the exchange of information and coordination among the state, local governments, life-span respite care projects, entities serving persons with special needs, families of persons with special needs and persons in favor of the promotion of respite care services, to encourage the efficient provision of respite care services. 7. Act as a statewide clearinghouse of information about respite care and existing respite care programs and resources and operate a library of materials that may be lent to persons or organizations upon request. 8. Conduct analyses of respite care policies and proposals, and identify and promote resolution of respite care policy concerns at legislative, state and local levels. (3) GRANTS NOT TO SUPPLANT OTHER MONEYS. Moneys awarded as grants under sub. (2) (b) may not be used to supplant moneys otherwise available and, prior to receipt of the grant, dedicated by the grantee to respite care. (4) LIFE-SPAN RESPITE CARE PROJECT REQUIREMENTS. Lifespan respite care projects for which a grant is awarded under sub. (2) (b) 2. shall do all of the following: (a) Operate in a culturally competent manner and be sensitive to the unique needs and strengths of a person with special needs and his or her family or caregiver. (b) Identify, coordinate and develop resources for respite care that are built, to the extent possible, on existing community support services. (c) Recruit and screen providers. (d) Identify training resources and organize training programs for providers that address different populations in need of respite care. (e) Facilitate access by caregivers and families of persons with special needs to an array of respite care service options for which the person with special needs is eligible, that are responsive to caregiver and family needs and that are available before families and primary caregivers reach a crisis situation. (f) Assist caregivers and families of persons with special needs to identify and coordinate funds and resources available for respite care for which the person with special needs is eligible, and authorize and provide a variety of funds and resources to make available additional respite care services for persons with special needs, under eligibility criteria established by the project. (5) ADVISORY COMMITTEES. Each grantee of moneys to conduct a life-span respite care project under sub. (2) shall create an advisory committee that shall advise the project on how the project may best serve persons with special needs and their caregivers. Consumers of respite care services and caregivers shall comprise at least 51 percent of the advisory committee membership and shall be representative of the diversity of persons who receive services under the project. Other members shall include providers, representatives of local service agencies and members of the community. (6) EVALUATION. By June 1, 2004, the department and the organization with which the department contracts under sub. (2) (a) shall together evaluate the life-span respite care projects that are conducted under this section. If, following the evaluation, the department and the organization together determine that it is feasible to integrate the life-span respite care projects with any integrated, organized system of long-term care services that is oper-
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ated by the department, the department shall, by July 1, 2004, provide to the department of administration statutory language that is proposed for inclusion in the 2005-07 biennial budget bill to effect the integration. History: 1999 a. 9; 2001 a. 16, 103; 2017 a. 59.
46.99 Medical assistance waiver for Birth to 3 participants. (1) In this section, “medical assistance” means the program under subch. IV of ch. 49. (2) The department shall request from the secretary of the U.S. department of health and human services a waiver under 42 USC 1396n (c) that authorizes the provision of home or community-based services under medical assistance to children who are eligible for medical assistance and receive early intervention services under s. 51.44. (3) If the waiver requested under sub. (2) is granted, counties shall provide to the department the nonfederal share of costs for medical assistance services provided under the waiver. Counties may use moneys appropriated under s. 20.435 (7) (bt) and distributed to counties under s. 51.44 (3) (a) to provide the nonfederal share of medical assistance costs. (3m) If the waiver requested under sub. (2) is granted, counties shall provide to the department the nonfederal share of the cost incurred by an entity to administer the waiver program under this section. (4) From the appropriation account under s. 20.435 (4) (o), the department may distribute to counties that provide services under this section the amount of federal moneys received by the state as the federal share of medical assistance for those services, minus the amount transferred to the appropriation account under s. 20.435 (4) (im) for the department’s costs of administering this section. Counties shall use moneys distributed under this section to provide services under this section or s. 51.44. History: 2009 a. 28; 2011 a. 32; 2015 a. 55.
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46.995 Disabled children’s long-term support program; local funding. (1) A county shall provide to the department the nonfederal share of the cost incurred by an entity to administer services provided without state funding under the disabled children’s long-term support program for a child enrolled in the program after December 31, 2010. (2) A county shall provide to the department the nonfederal share of the cost of services provided without state funding under the disabled children’s long-term support program. (2g) (a) The department may require a county to maintain a specified level of contribution for the disabled children’s longterm support program. The department shall determine the amount of contribution that a county is required to maintain based on the historical county expenditures for the disabled children’s long-term support program. (b) Beginning in the 2017-19 fiscal biennium and thereafter, counties shall cooperate with the department to determine an equitable funding methodology and county contribution mechanism for contribution for the disabled children’s long-term support program under par. (a) and to ensure that county contributions determined by the department are expended for the disabled children’s long-term support program in the counties. (2r) The department may contract with a county or a group of counties to deliver disabled children’s long-term support program services. (3) An individual who is performing services for a person receiving long-term care benefits under any children’s long-term support waiver program on a self-directed basis 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. History: 2011 a. 32; 2015 a. 180; 2017 a. 59; 2021 a. 232.
May 22, 2026, are designated by NOTES. (Published 5-22-26)