For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
Law Revision Committee prefatory note: This bill is a remedial legislation
proposal, requested by the Department of Health and Family Services and introduced by
the Law Revision Committee under s. 13.83 (1) (c) 4., stats. After careful consideration
of the various provisions of the bill, the Law Revision Committee has determined that this
bill makes minor substantive changes in the statutes, and that these changes are
desirable as a matter of public policy.
SB548, s. 1
1Section
1. 46.275 (5) (b) 4. of the statutes is amended to read:
SB548,4,22
46.275
(5) (b) 4. Provide services, except respite care that is approved by the
3department, within a skilled nursing facility, intermediate care facility or
4intermediate care facility for
the mentally retarded
persons with mental retardation,
1as defined in s. 46.278 (1m) (am), including a state center for the developmentally
2disabled.
SB548, s. 2
3Section
2. 46.278 (1) of the statutes is amended to read:
SB548,4,154
46.278
(1) The intent of the programs under this section is to provide home or
5community-based care to serve in a noninstitutional community setting a person
6who meets eligibility requirements under
42 USC 1396n (c) and who is diagnosed as
7developmentally disabled under the definition specified in s. 51.01 (5) and relocated
8from an institution other than a state center for the developmentally disabled or who
9meets the intermediate care facility for
the mentally retarded persons with mental
10retardation or
a brain injury rehabilitation facility level of care requirements for
11medical assistance reimbursement in an intermediate care facility for
the mentally
12retarded persons with mental retardation or
a brain injury rehabilitation facility and
13is ineligible for services under s. 46.275 or 46.277. The intent of the program is also
14that counties use all existing services for providing care under this section, including
15those services currently provided by counties.
SB548, s. 3
16Section
3. 46.278 (1m) (am) of the statutes is amended to read:
SB548,4,1917
46.278
(1m) (am) "Intermediate care facility for
the mentally retarded persons
18with mental retardation" has the meaning
given for "intermediate care facility for
19the mentally retarded" under
42 USC 1396d (c) and (d).
SB548, s. 4
20Section
4. 46.278 (2) (a) of the statutes is amended to read:
SB548,5,421
46.278
(2) (a) The department may request one or more waivers from the
22secretary of the federal department of health and human services, under
42 USC
231396n (c), authorizing the department to serve medical assistance recipients, who
24meet the level of care requirements for medical assistance reimbursement in an
25intermediate care facility for
the mentally retarded
persons with mental retardation
1or in a brain injury rehabilitation facility, in their communities by providing home
2or community-based services as part of medical assistance. If the department
3requests a waiver, it shall include all assurances required under
42 USC 1396n (c)
4(2) in its request.
SB548, s. 5
5Section
5. 46.278 (4) (a) of the statutes is amended to read:
SB548,5,136
46.278
(4) (a) Sections 46.27 (3) (b) and 46.275 (3) (a) and (c) to (e) apply to
7county participation in a program, except that services provided in the program shall
8substitute for care provided a person in an intermediate care facility for
the mentally
9retarded persons with mental retardation or
in a brain injury rehabilitation facility
10who meets the intermediate care facility for
the mentally retarded persons with
11mental retardation or brain injury rehabilitation facility level of care requirements
12for medical assistance reimbursement to that facility rather than for care provided
13at a state center for the developmentally disabled.
SB548, s. 6
14Section
6. 46.278 (5) (a) of the statutes is amended to read:
SB548,5,2415
46.278
(5) (a) Any medical assistance recipient who meets the level of care
16requirements for medical assistance reimbursement in an intermediate care facility
17for
the mentally retarded persons with mental retardation or in a brain injury
18rehabilitation facility and is ineligible for service under s. 46.275 or 46.277 is eligible
19to participate in a program, except that persons eligible for the brain injury waiver
20program must meet the definition of brain injury under s. 51.01 (2g), and except that
21the number of participants may not exceed the number approved under the waiver
22received under sub. (3). Such a recipient may apply, or any person may apply on
23behalf of such a recipient, for participation in a program. Section 46.275 (4) (b)
24applies to participation in a program.
SB548, s. 7
25Section
7. 46.278 (6) (e) 1. a. of the statutes is amended to read:
SB548,6,2
146.278
(6) (e) 1. a. An intermediate care facility for
the mentally retarded 2persons with mental retardation that closes under s. 50.03 (14).
SB548, s. 8
3Section
8. 46.278 (6) (e) 1. b. of the statutes is amended to read:
SB548,6,64
46.278
(6) (e) 1. b. An intermediate care facility for
the mentally retarded 5persons with mental retardation or a distinct part thereof that has a plan of closure
6approved by the department and that intends to close within 12 months.
SB548, s. 9
7Section
9. 46.278 (6) (e) 1. c. of the statutes is amended to read:
SB548,6,118
46.278
(6) (e) 1. c. An intermediate care facility for
the mentally retarded 9persons with mental retardation that has a plan of closure or significant reduction
10in capacity approved by the department and that intends to close or significantly
11reduce its capacity within 60 months.
SB548, s. 10
12Section
10. 46.279 (1) (b) of the statutes is amended to read:
SB548,6,1613
46.279
(1) (b) "Intermediate facility"
means has the meaning given for an
14intermediate care facility for the mentally retarded
, as defined in under 42 USC
151396d (d), other than a center for the developmentally disabled, as defined in s. 51.01
16(3).
SB548,6,2519
48.685
(8) The department, the department of health services, a county
20department, a child welfare agency, or a school board may charge a fee for obtaining
21the information required under sub. (2) (am) or (3) (a) or for providing information
22to an entity to enable the entity to comply with sub. (2) (b) 1. or (3) (b). The fee may
23not exceed the reasonable cost of obtaining the information. No fee may be charged
24to a
nurse's assistant nurse aide, as defined in s. 146.40 (1) (d), for obtaining or
25maintaining information if to do so would be inconsistent with federal law.
SB548, s. 12
1Section
12. 49.45 (6m) (am) 1. bm. of the statutes is amended to read:
SB548,7,32
49.45
(6m) (am) 1. bm. Nonbillable services of a registered nurse, licensed
3practical nurse
, and
nurse's assistant nurse aide.
SB548, s. 13
4Section
13. 49.45 (8) (a) 1. of the statutes is repealed.
SB548, s. 14
5Section
14. 49.45 (8) (a) 2m. of the statutes is created to read:
SB548,7,66
49.45
(8) (a) 2m. "Nurse aide" has the meaning given in s. 146.40 (1) (d).
SB548,7,179
49.45
(8) (a) 4. "Patient care visit" means a personal contact with a patient in
10a patient's home that is made by a registered nurse, licensed practical nurse, nurse
11aide, physical therapist, occupational therapist, or speech-language pathologist who
12is on the staff of or under contract or arrangement with a home health agency, or by
13a registered nurse or licensed practical nurse practicing independently, to provide a
14service that is covered under s. 49.46, 49.47, or 49.471. "Patient care visit" does not
15include time spent by a nurse, therapist, or nurse aide on case management, care
16coordination, travel, record keeping, or supervision that is related to the patient care
17visit.
SB548, s. 16
18Section
16. 49.45 (30m) (a) 2. of the statutes is amended to read:
SB548,7,2119
49.45
(30m) (a) 2. Services in an intermediate care facility for
the mentally
20retarded persons with mental retardation, as defined in s. 46.278 (1m) (am), other
21than a state center for the developmentally disabled.
SB548, s. 17
22Section
17. 49.45 (42) (b) of the statutes is amended to read:
SB548,7,2423
49.45
(42) (b) The individual is not eligible to receive home health
aide services
24under medicare, as defined in sub. (3) (L) 1. b.
SB548, s. 18
25Section
18. 49.498 (1) (h) of the statutes is amended to read:
SB548,8,2
149.498
(1) (h) "
Nurse's assistant Nurse aide" has the meaning given
for "nurse
2aide" under
42 USC 1396r (b) (5) (F).
SB548, s. 19
3Section
19. 49.498 (2) (e) 1. of the statutes is repealed.
SB548, s. 20
4Section
20. 49.498 (2) (e) 2. of the statutes is amended to read:
SB548,8,75
49.498
(2) (e) 2. A nursing facility may not use the individual as a
nurse's
6assistant nurse aide unless the nursing facility has inquired of the department
7concerning information about the individual in the registry under s. 146.40 (4g).
SB548, s. 21
8Section
21. 49.498 (2) (e) 3. of the statutes is amended to read:
SB548,8,139
49.498
(2) (e) 3. A nursing facility shall provide the regular performance review
10and regular in-service education that assures that individuals used as
nurse's
11assistants nurse aides are competent to perform services as
nurse's assistants nurse
12aides, including training for individuals to provide nursing and nursing-related
13services to nursing facility residents with cognitive impairments.
SB548, s. 22
14Section
22. 50.01 (2) of the statutes is amended to read:
SB548,8,2215
50.01
(2) "
Nurse's assistant
Nurse aide" means a person who performs routine
16patient care duties delegated by a registered nurse or licensed practical nurse who
17supervises the person, for the direct health care of a patient or resident. "
Nurse's
18assistant Nurse aide" does not mean a
feeding assistant, as defined in s. 146.40 (1)
19(aw); a person who is licensed, permitted, certified, or registered under ch. 441, 448,
20449, 450, 451, 455, 459, or 460
; or a person whose duties primarily involve skills that
21are different than those taught in instructional programs for
nurse's assistants 22nurse aides.
SB548, s. 23
23Section
23. 50.04 (2) (c) 2. b. of the statutes is amended to read:
SB548,8,2524
50.04
(2) (c) 2. b. A shortage of nurses or
nurse's assistants nurse aides 25available for employment by the nursing home exists.
SB548, s. 24
1Section
24. 50.04 (2) (d) (intro.) of the statutes is amended to read:
SB548,9,62
50.04
(2) (d) (intro.) Each nursing home, other than nursing homes that
3primarily serve the developmentally disabled, shall provide at least the following
4hours of service by registered nurses, licensed practical nurses
, or
nurse's assistants
5nurse aides and may not use hours of service by a feeding assistant, as defined in s.
6146.40 (1) (aw), in fulfilling these requirements:
SB548, s. 25
7Section
25. 50.04 (2r) of the statutes is amended to read:
SB548,9,168
50.04
(2r) Admissions requiring approval. Except in an emergency, a nursing
9home that is not certified as a provider of medical assistance or that is an
10intermediate care facility for
the mentally retarded
persons with mental retardation,
11as defined in s. 46.278 (1m) (am), or an institution for mental diseases, as defined
12under
42 CFR 435.1009, may not admit as a resident an individual who has a
13developmental disability, as defined in s. 51.01 (5), or who is both under age 65 and
14has mental illness, as defined in s. 51.01 (13), unless the county department under
15s. 46.23, 51.42 or 51.437 of the individual's county of residence has recommended the
16admission.
SB548, s. 26
17Section
26. 50.065 (8) of the statutes is amended to read:
SB548,9,2218
50.065
(8) The department may charge a fee for obtaining the information
19required under sub. (2) (am) or (3) (a) or for providing information to an entity to
20enable the entity to comply with sub. (2) (b) or (3) (b). No fee may be charged to a
21nurse's assistant nurse aide, as defined in s. 146.40 (1) (d), for obtaining or
22maintaining the information if to do so would be inconsistent with federal law.
SB548, s. 27
23Section
27. 50.095 (3) (b) of the statutes is amended to read:
SB548,9,2524
50.095
(3) (b) The staff replacement rates for full-time and part-time nursing
25staff,
nurse's assistants nurse aides, and administrators for the previous year for the
1nursing home and for all similar nursing homes in the same geographical area, as
2determined by the department.
SB548, s. 28
3Section
28. 50.097 of the statutes is amended to read:
SB548,10,7
450.097 Registry. Any person may receive, upon specific written request to the
5department, requested information that is contained in the registry of
nurse's
6assistants and home health aides individuals under s. 146.40 (4g) (a)
or that is
7contained in the registry of hospice aides under s. 146.40 (4g) (a) 1.
SB548, s. 29
8Section
29. 50.14 (1) (a) of the statutes is amended to read:
SB548,10,119
50.14
(1) (a) Notwithstanding s. 50.01 (1m), "facility" means a nursing home
10or an intermediate care facility for
the mentally retarded persons with mental
11retardation that is not located outside the state.
SB548, s. 30
12Section
30. 50.14 (1) (b) of the statutes is amended to read:
SB548,10,1513
50.14
(1) (b) "Intermediate care facility for
the mentally retarded persons with
14mental retardation" has the meaning given
for "intermediate care facility for the
15mentally retarded" under
42 USC 1396d (c) and (d).
SB548,10,2318
50.14
(2) (bm) For intermediate care facilities for
the mentally retarded 19persons with mental retardation, an amount calculated by multiplying the projected
20annual gross revenues of all intermediate care facilities for
the mentally retarded 21persons with mental retardation in this state by 0.055, dividing the product by the
22number of licensed beds of intermediate care facilities
for persons with mental
23retardation in this state and dividing the quotient by 12.
SB548, s. 32
24Section
32. 51.06 (8) (a) 1. of the statutes is amended to read:
SB548,11,3
151.06
(8) (a) 1. "Intermediate care facility for
the mentally retarded persons
2with mental retardation" has the meaning given
in
for "intermediate care facility for
3the mentally retarded" under 42 USC 1396d (d).
SB548, s. 33
4Section
33. 51.06 (8) (b) (intro.) of the statutes is amended to read:
SB548,11,115
51.06
(8) (b) (intro.) Annually by October 1, the department shall submit to the
6joint committee on finance and to the appropriate standing committees of the
7legislature under s. 13.172 (3) a report that includes information collected from the
8previous fiscal year on the relocation or diversion of individuals who are Medical
9Assistance eligibles or recipients from nursing homes, intermediate care facilities for
10the mentally retarded persons with mental retardation, and centers for the
11developmentally disabled. The report shall include all of the following information:
SB548, s. 34
12Section
34. 51.06 (8) (b) 4. of the statutes is amended to read:
SB548,11,1813
51.06
(8) (b) 4. An accounting of the costs and savings under the Medical
14Assistance program of relocations and diversions and the resulting reduction in
15capacity for services of nursing homes, intermediate care facilities for
the mentally
16retarded persons with mental retardation, and centers for the developmentally
17disabled. The accounting shall include the per individual savings as well as the
18collective savings of relocations and diversions.
SB548, s. 35
19Section
35. 51.06 (8) (b) 7. of the statutes is amended to read:
SB548,11,2520
51.06
(8) (b) 7. Staff turnover rates for nursing homes, intermediate care
21facilities for
the mentally retarded persons with mental retardation, and centers for
22the developmentally disabled in communities in which an individual relocated or
23diverted from a nursing home, intermediate care facility for
the mentally retarded 24persons with mental retardation, or center for the developmentally disabled
25currently resides.
SB548, s. 36
1Section
36. 51.62 (4) of the statutes is amended to read:
SB548,12,62
51.62
(4) Departmental duties. The department shall provide the protection
3and advocacy agency with copies of annual surveys and plans of correction for
4intermediate care facilities for
the mentally retarded
persons with mental
5retardation on or before the first day of the 2nd month commencing after completion
6of the survey or plan.
SB548, s. 37
7Section
37. 146.40 (title) of the statutes is amended to read:
SB548,12,9
8146.40 (title)
Instructional programs for
nurse's nurse aides; reporting
9client abuse.
SB548, s. 38
10Section
38. 146.40 (1) (aw) of the statutes is created to read:
SB548,12,1311
146.40
(1) (aw) "Feeding assistant" means an individual who has completed a
12state-approved training and testing program, as specified by the department by
13rule, to perform one nursing-related duty, as defined by the department by rule.
SB548, s. 39
14Section
39. 146.40 (1) (bm) of the statutes is repealed.
SB548, s. 40
15Section
40. 146.40 (1) (bo) of the statutes is amended to read:
SB548,12,1716
146.40
(1) (bo) "Hospice" means a hospice that is licensed under subch. IV of
17ch. 50
and that is certified as a provider of services under 42 USC 1395 to 1395ccc.
SB548, s. 41
18Section
41. 146.40 (1) (bp) of the statutes is repealed.
SB548, s. 42
19Section
42. 146.40 (1) (bt) of the statutes is amended to read:
SB548,12,2220
146.40
(1) (bt) "Intermediate care facility for
the mentally retarded persons
21with mental retardation" has the meaning
given for "intermediate care facility for
22the mentally retarded" under
42 USC 1396d (c) and (d).
SB548, s. 43
23Section
43. 146.40 (1) (d) of the statutes is amended to read:
SB548,13,824
146.40
(1) (d) "
Nurse's assistant
Nurse aide" means an individual who
25performs routine patient care duties delegated by a registered nurse or licensed
1practical nurse who supervises the individual, for the direct health care of a patient
2or resident. "
Nurse's assistant Nurse aide" does not mean
a feeding assistant, an
3individual who is licensed, permitted, certified, or registered under ch. 441, 448, 449,
4450, 451, 455, 459, or 460
, or an individual whose duties primarily involve skills that
5are different than those taught in instructional
and competency evaluation 6programs for
nurse's assistants certified nurse aides approved under sub. (3) or
7evaluated by competency evaluation programs for
nurse's assistants nurse aides 8approved under sub. (3m).
SB548, s. 44
9Section
44. 146.40 (2) (intro.) of the statutes is amended to read:
SB548,13,1610
146.40
(2) (intro.) A hospital, nursing home
or, intermediate care facility for
the
11mentally retarded persons with mental retardation, home health agency, or hospice 12may not employ or contract for the services of an individual as a
nurse's assistant,
13a home health agency may not employ or contract for the services of an individual
14as a home health aide and a hospice may not employ or contract for the services of
15an individual as a hospice nurse aide, regardless of the title under which the
16individual is employed
or contracted for, unless one of the following is true: