AB150,1052,23 19(2) Assessment of needs. Before developing and submitting a proposed budget
20for services directly provided or purchased under this subchapter to the county
21executive or county administrator or the county board, the county departments listed
22in sub. (1) shall assess needs and inventory resources and services, using an open
23public participation process.

AB150,1053,13 24(2g) Contract. (a) The department shall annually submit to the county board
25of supervisors in a county with a single-county department or the county boards of

---

1supervisors in counties with a multicounty department a proposed written contract
2containing the allocation of funds for services directly provided or purchased under
3this subchapter and such administrative requirements as necessary. The contract
4as approved may contain conditions of participation consistent with federal and state
5law. The contract may also include provisions necessary to ensure uniform cost
6accounting of services. Any changes to the proposed contract shall be mutually
7agreed upon. The county board of supervisors in a county with a single-county
8department or the county boards of supervisors in counties with a multicounty
9department shall approve the contract before January 1 of the year in which it takes
10effect unless the department grants an extension. The county board of supervisors
11in a county with a single-county department or the county boards of supervisors in
12counties with a multicounty department may designate an agent to approve addenda
13to any contract after the contract has been approved.

AB150,1053,1614 (b) The department may not approve contracts for amounts in excess of
15available revenues. Actual expenditure of county funds shall be reported in
16compliance with procedures developed by the department.

AB150,1053,1917 (c) The joint committee on finance may require the department to submit
18contracts between county departments under ss. 46.215, 46.22 and 46.23 and
19providers of services under this subchapter to the committee for review and approval.

AB150,1053,23 20(2r) Withholding funds. (a) The department, after reasonable notice, may
21withhold a portion of the appropriation allocated to a county department under s.
2246.215, 46.22 or 46.23 if the department determines that that portion of the allocated
23appropriation is any of the following:

AB150,1054,3

---

11. For services under this subchapter which duplicate or are inconsistent with
2services being provided or purchased by the department or other county
3departments receiving grants-in-aid or reimbursement from the department.

AB150,1054,84 2. Inconsistent with state or federal statutes, rules or regulations, in which case
5the department may also arrange for provision of services under this subchapter by
6an alternate agency. The department may not arrange for provision of services by
7an alternate agency unless the joint committee on finance or a review body
8designated by the committee reviews and approves the department's determination.

AB150,1054,109 5. Inconsistent with the provisions of the county department's contract under
10sub. (2g).

AB150,1054,2311 (b) If the department withholds a portion of the allocable appropriation under
12par. (a), the county department under s. 46.215, 46.22 or 46.23 that is affected by the
13action of the department may submit to the county board of supervisors in a county
14with a single-county department or to its designated agent or the county boards of
15supervisors in counties with a multicounty department or their designated agents
16a plan to rectify the deficiency found by the department. The county board of
17supervisors or its designated agent in a county with a single-county department or
18the county boards of supervisors in counties with a multicounty department or their
19designated agents may approve or amend the plan and may submit for departmental
20approval the plan as adopted. If a multicounty department is administering a
21program, the plan may not be submitted unless each county board of supervisors
22which participated in the establishment of the multicounty department, or its
23designated agent, adopts it.

AB150,1055,19 24(3) Open public participation process. (a) Citizen advisory committee. Except
25as provided in par. (b), the county board of supervisors of each county or the county

---

1boards of supervisors of 2 or more counties jointly shall establish a citizen advisory
2committee to the county departments under ss. 46.215, 46.22 and 46.23. The citizen
3advisory committee shall advise in the formulation of the budget under sub. (1).
4Membership on the committee shall be determined by the county board of
5supervisors in a county with a single-county committee or by the county boards of
6supervisors in counties with a multicounty committee and shall include
7representatives of those persons receiving services, providers of services and
8citizens. A majority of the members of the committee shall be citizens and consumers
9of services. At least one member of the committee shall be chosen from the governing
10or administrative board of the community action agency serving the county or
11counties under s. 46.30, if any. The committee's membership may not consist of more
12than 25% county supervisors, nor of more than 20% services providers. The
13chairperson of the committee shall be appointed by the county board of supervisors
14establishing it. In the case of a multicounty committee, the chairperson shall be
15nominated by the committee and approved by the county boards of supervisors
16establishing it. The county board of supervisors in a county with a single-county
17committee or the county boards of supervisors in counties with a multicounty
18committee may designate an agent to determine the membership of the committee
19and to appoint the committee chairperson or approve the nominee.

AB150,1055,2520 (b) Alternate process. The county board of supervisors or the boards of 2 or more
21counties acting jointly may submit a report to the department on the open public
22participation process used under sub. (2). The county board of supervisors may
23designate an agent, or the boards of 2 or more counties acting jointly may designate
24an agent, to submit the report. If the department approves the report, establishment
25of a citizen advisory committee under par. (a) is not required.

AB150,1056,5

---

1(c) Yearly report. The county board of supervisors or its designated agent, or
2the boards of 2 or more counties acting jointly or their designated agent, shall submit
3to the department a list of members of the citizen advisory committee under par. (a)
4or a report on the open public participation process under par. (b) on or before July
51 annually.

AB150,1056,77 49.33 (1) Definitions. (intro.) In this section:

AB150,1056,99 49.33 (3) (title) Rules.

AB150,1056,1411 49.33 (9) Reimbursement for income maintenance benefits. The department
12shall reimburse each county from the appropriations under s. 20.445 (3) (d) and (p)
13for 100% of the cost of aid to families with dependent children granted under s. 49.19
14and for funeral expenses paid for recipients of aid under s. 49.30.

AB150,1056,2416 49.33 (10) County certification. (a) The county treasurer and each director
17of a county department under s. 46.215, 46.22 or 46.23 shall certify monthly under
18oath to the department in such manner as the department prescribes the claim of the
19county for state reimbursement under subs. (8) and (9) and if the department
20approves such claim it shall certify to the department of administration for
21reimbursement to the county for amounts due under these subsections and payment
22claimed to be made to the counties monthly. The department may make advance
23payments prior to the beginning of each month equal to one-twelfth of the contracted
24amount.

AB150,1057,7

---

1(b) To facilitate prompt reimbursement the certificate of the department may
2be based on the certified statements of the county officers filed under par. (a). Funds
3recovered from audit adjustments from a prior fiscal year may be included in
4subsequent certifications only to pay counties owed funds as a result of any audit
5adjustment. By September 30 annually, the department shall submit a report to the
6appropriate standing committees under s. 13.172 (3) on funds recovered and paid out
7during the previous calendar year as a result of audit adjustments.

AB150,1057,16 949.34 Purchase of care and services. (1) All services under this subchapter
10purchased by the department or by a county department under s. 46.215, 46.22 or
1146.23 shall be authorized and contracted for under the standards established under
12this section. The department may require the county departments to submit the
13contracts to the department for review and approval. For purchases of $10,000 or
14less the requirement for a written contract may be waived by the department. When
15the department directly contracts for services, it shall follow the procedures in this
16section in addition to meeting purchasing requirements established in s. 16.75.

AB150,1057,22 17(2) All services purchased under this subchapter shall meet standards
18established by the department and other requirements specified by the purchaser in
19the contract. Based on these standards the department shall establish standards for
20cost accounting and management information systems that shall monitor the
21utilization of the services, and document the specific services in meeting the service
22plan for the client and the objective of the service.

AB150,1058,2 23(3) (a) Purchase of service contracts shall be written in accordance with rules
24promulgated and procedures established by the department. Contracts for client
25services shall show the total dollar amount to be purchased and for each service the

---

1number of clients to be served, number of client service units, the unit rate per client
2service and the total dollar amount for each service.

AB150,1058,73 (b) Payments under a contract may be made on the basis of actual allowable
4costs or on the basis of a unit rate per client service multiplied by the actual client
5units furnished each month. The contract may be renegotiated when units vary from
6the contracted number. The purchaser shall determine actual marginal costs for
7each service unit less than or in addition to the contracted number.

AB150,1058,98 (c) For proprietary agencies, contracts may include a percentage add-on for
9profit according to rules promulgated by the department.

AB150,1058,1510 (d) Reimbursement to an agency may be based on total costs agreed to by the
11parties regardless of the actual number of service units to be furnished, when the
12agency is entering into a contract for a new or expanded service that the purchaser
13recognizes will require a start-up period not to exceed 180 days. This
14reimbursement applies only if identified client needs necessitate the establishment
15of a new service or expansion of an existing service.

AB150,1058,1916 (e) If the purchaser finds it necessary to terminate a contract prior to the
17contract expiration date for reasons other than nonperformance by the provider, the
18actual cost incurred by the provider may be reimbursed in an amount determined by
19mutual agreement of the parties.

AB150,1058,2420 (f) Advance payments of up to one-twelfth of an annual contract may be
21allowed under the contract. If the advance payment exceeds $10,000, the provider
22shall supply a surety bond in an amount equal to the amount of the advance payment
23applied for. No surety bond is required if the provider is a state agency. The cost of
24the surety bond shall be allowable as an expense.

AB150,1059,2

---

1(4) For purposes of this section and as a condition of reimbursement, each
2provider under contract shall:

AB150,1059,53 (a) Except as provided in this subsection, maintain a uniform double entry
4accounting system and a management information system which are compatible
5with cost accounting and control systems prescribed by the department.

AB150,1059,76 (b) Cooperate with the department and purchaser in establishing costs for
7reimbursement purposes.

AB150,1059,118 (c) Unless waived by the department, biennially, or annually if required under
9federal law, provide the purchaser with a certified financial and compliance audit
10report if the care and services purchased exceed $25,000. The audit shall follow
11standards that the department prescribes.

AB150,1059,1312 (d) Transfer a client from one category of care or service to another only with
13the approval of the purchaser.

AB150,1059,1714 (e) Charge a uniform schedule of fees as specified under s. 49.32 (1) unless
15waived by the purchaser with the approval of the department. Whenever providers
16recover funds attributed to the client, such funds shall offset the amount paid under
17the contract.

AB150,1059,20 18(5) Except as provided in sub. (5m), the purchaser shall recover from provider
19agencies money paid in excess of the conditions of the contract from subsequent
20payments made to the provider.

AB150,1059,21 21(5m) (a) In this subsection:

AB150,1059,2422 1. "Provider" means a nonprofit, nonstock corporation organized under ch. 181
23that contracts under this section to provide client services on the basis of a unit rate
24per client service.

AB150,1060,5

---

12. "Rate-based service" means a service or a group of services, as determined
2by the department, that is reimbursed through a prospectively set rate and that is
3distinguishable from other services or groups of services by the purpose for which
4funds are provided for that service or group of services and by the source of funding
5for that service or group of services.

AB150,1060,136 (b) 1. Subject to subds. 2. and 3., if revenue under a contract for the provision
7of a rate-based service exceeds allowable costs incurred in the contract period, the
8provider may retain from the surplus generated by that rate-based service up to 5%
9of the contract amount. A provider that retains a surplus under this subdivision
10shall use that retained surplus to cover a deficit between revenue and allowable costs
11incurred in any preceding or future contract period for the same rate-based service
12that generated the surplus or to address the programmatic needs of clients served
13by the same rate-based service that generated the surplus.

AB150,1060,2514 2. Subject to subd. 3., a provider may accumulate funds from more than one
15contract period under this paragraph, except that, if at the end of a contract period
16the amount accumulated from all contract periods for a rate-based service exceeds
1710% of the amount of all current contracts for that rate-based service, the provider
18shall, at the request of a purchaser, return to that purchaser the purchaser's
19proportional share of that excess and use any of that excess that is not returned to
20a purchaser to reduce the provider's unit rate per client for that rate-based service
21in the next contract period. If a provider has held for 4 consecutive contract periods
22an accumulated reserve for a rate-based service that is equal to or exceeds 10% of
23the amount of all current contracts for that rate-based service, the provider shall
24apply 50% of that accumulated amount to reducing its unit rate per client for that
25rate-based service in the next contract period.

AB150,1061,6

---

13. If on December 31, 1995, the amount accumulated by a provider from all
2contract periods ending on or before that date for all rate-based services provided by
3the provider exceeds 10% of the provider's total contract amount for all rate-based
4services provided by the provider in 1995, the provider shall, at the request of a
5purchaser, return to that purchaser the purchaser's proportional share of that
6excess.

AB150,1061,147 (f) All providers that are subject to this subsection shall comply with any
8financial reporting and auditing requirements that the department may prescribe.
9Those requirements shall include a requirement that a provider provide to any
10purchaser and the department any information that the department needs to claim
11federal reimbursement for the cost of any services purchased from the provider and
12a requirement that a provider provide audit reports to any purchaser and the
13department according to standards specified in the provider's contract and any other
14standards that the department may prescribe.

AB150,1061,16 15(6) Contracts may be renegotiated by the purchaser under conditions specified
16in the contract.

AB150,1061,18 17(7) The service provider under this section may appeal decisions of the
18purchaser in accordance with terms and conditions of the contract and ch. 68 or 227.

AB150,1061,25 2049.35 Public assistance; supervisory functions of department. (1) (a)
21The department shall supervise the administration of programs under this
22subchapter. The department shall submit to the federal authorities state plans for
23the administration of programs under this subchapter in such form and containing
24such information as the federal authorities require, and shall comply with all
25requirements prescribed to ensure their correctness.

AB150,1062,8

---

1(b) All records of the department and all county records relating to programs
2under this subchapter and aid under s. 49.18, 1971 stats., s. 49.20, 1971 stats., and
3s. 49.61, 1971 stats., as affected by chapter 90, laws of 1973, shall be open to
4inspection at all reasonable hours by authorized representatives of the federal
5government. Notwithstanding s. 48.396 (2), all county records relating to the
6administration of the services and public assistance specified in this paragraph shall
7be open to inspection at all reasonable hours by authorized representatives of the
8department.

AB150,1062,199 (bm) All records of the department relating to aid provided under s. 49.19 are
10open to inspection at reasonable hours by members of the legislature who require the
11information contained in the records in pursuit of a specific state legislative purpose.
12All records of any county relating to aid provided under s. 49.19 are open to inspection
13at reasonable hours by members of the board of supervisors of the county or the
14governing body of a city, village or town located in the county who require the
15information contained in the records in pursuit of a specific county or municipal
16legislative purpose. The right to records access provided by this paragraph does not
17apply if access is prohibited by federal law or regulation or if this state is required
18to prohibit such access as a condition precedent to participation in a federal program
19in which this state participates.

AB150,1063,320 (c) The department may at any time audit all county records relating to the
21administration of the services and public assistance specified in this section and may
22at any time conduct administrative reviews of county departments under ss. 46.215,
2346.22 and 46.23. If the department conducts such an audit or administrative review
24in a county, the department shall furnish a copy of the audit or administrative review
25report to the chairperson of the county board of supervisors and the county clerk in

---

1a county with a single-county department or to the county boards of supervisors and
2the county clerks in counties with a multicounty department, and to the director of
3the county department under s. 46.215, 46.22 or 46.23.

AB150,1063,5 4(2) The county administration of all laws relating to programs under this
5subchapter shall be vested in the officers and agencies designated in the statutes.

AB150,1063,11 749.41 Assistance grants exempt from levy. All grants of aid to families with
8dependent children, payments made for social services, cash benefits paid by
9counties under s. 59.07 (154), and benefits under ss. 49.032, 49.046 and s. 49.177 or
10federal Title XVI, are exempt from every tax, and from execution, garnishment,
11attachment and every other process and shall be inalienable.

AB150,1063,18 1449.96 Assistance grants exempt from levy. All grants of aid to families with
15dependent children, payments made for social services, cash benefits paid by
16counties under s. 59.07 (154), and benefits under s. 49.177 49.77 or federal Title XVI,
17are exempt from every tax, and from execution, garnishment, attachment and every
18other process and shall be inalienable.

AB150,1064,77 49.43 (3e) "Department" means the department of health and social services.

AB150,1064,129 49.43 (10) "Provider" means a person, corporation, limited liability company,
10partnership, unincorporated business or professional association and any agent or
11employe thereof who provides medical assistance under ss. 49.45 to 49.47, 49.49 and
1249.495.

AB150,1064,1414 49.43 (10s) "Secretary" means the secretary of health and social services.

AB150,1064,1816 49.45 (2) (a) 15. Routinely provide notification to persons eligible for medical
17assistance under ss. 49.46 to 49.47, or such persons' guardians, of the department's
18access to provider records.

AB150,1065,221 49.45 (2) (a) 23. Promulgate rules that define "supportive services", "personal
22services" and "nursing services" provided in an assisted living facility, as defined

---

1under s. 50.02 (1d), for purposes of reimbursement under ss. 46.27 (11) (c) 7. and
246.277 (5) (e).

AB150,1065,74 49.45 (2) (b) 4. Audit claims filed by any provider of medical assistance, and as
5part of that audit, request of any such provider, and review, medical records of
6individuals who have received benefits under the medical assistance program, or
7under s. 49.046.

AB150,1065,139 49.45 (3) (a) Reimbursement shall be made to each county department under
10ss. 46.215, 46.22 and 46.23 for the administrative services performed in the medical
11assistance program on the basis of s. 49.52 49.33 (8). For purposes of reimbursement
12under this paragraph, assessments completed under s. 46.27 (6) (a) are
13administrative services performed in the medical assistance program.

AB150,1065,1915 49.45 (3) (cm) 1. In this paragraph, "best price" means, with respect to any
16service, the lowest price that a provider has accepted or agreed to accept as payment
17from any 3rd-party payer, including medicare, a self-insured plan and an insurer,
18as defined under s. 600.03 (27), for a like service provided to a customer during the
19same month that the service is provided.

AB150,1065,2320 2. Except as provided in subd. 4., the department may require, as a condition
21of reimbursement, that providers of services charge the department the lesser of the
22following when claiming reimbursement for medical assistance services, unless a
23different price is set by contract:

AB150,1065,2424 a. The provider's best price for the service.

AB150,1065,2525 b. The provider's actual cost for the service.

AB150,1066,2

---

13. When a provider is required to charge the department a price under subd.
22., the department may not reimburse the provider for more than that amount.

AB150,1066,43 4. This paragraph does not apply to services under s. 49.46 (2) (a) 4. a., b., or
4c., (b) 6. e. or 8.

AB150,1066,96 49.45 (5) Appeal. Any person whose application for medical assistance is
7denied or is not acted upon promptly or who believes that the payments made in the
8person's behalf have not been properly determined may file an appeal with the
9department pursuant to s. 49.50 (8) 49.21 (1).