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,

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1as defined in s. 46.278 (1m) (am), including a state center for the developmentally
2disabled.

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.

SB548,4,1917 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).

SB548,5,421 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

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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.

SB548,5,136 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.

SB548,5,2415 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.

SB548,6,2

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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).

SB548,6,64 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.

SB548,6,118 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.

SB548,6,1613 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.

SB548,7,32 49.45 (6m) (am) 1. bm. Nonbillable services of a registered nurse, licensed
3practical nurse, and nurse's assistant nurse aide.

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.

SB548,7,2119 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.

SB548,7,2423 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.

SB548,8,2

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149.498 (1) (h) "Nurse's assistant Nurse aide" has the meaning given for "nurse
2aide" under 42 USC 1396r (b) (5) (F).

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).

SB548,8,139 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.

SB548,8,2215 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.

SB548,8,2524 50.04 (2) (c) 2. b. A shortage of nurses or nurse's assistants nurse aides
25available for employment by the nursing home exists.

SB548,9,62 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:

SB548,9,168 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.

SB548,9,2218 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.

SB548,9,2524 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

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1nursing home and for all similar nursing homes in the same geographical area, as
2determined by the department.

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.

SB548,10,119 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.

SB548,10,1513 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.

SB548,11,3

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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).

SB548,11,115 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:

SB548,11,1813 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.

SB548,11,2520 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.

SB548,12,62 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.

SB548,12,9 8146.40 (title) Instructional programs for nurse's nurse aides; reporting
9client abuse.

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.

SB548,12,1716 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.

SB548,12,2220 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).

SB548,13,824 146.40 (1) (d) "Nurse's assistant Nurse aide" means an individual who
25performs routine patient care duties delegated by a registered nurse or licensed

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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).

SB548,13,1610 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:

SB548,13,2518 146.40 (2) (a) For hospitals, nursing homes, home health agencies or hospices,
19whether or not certified providers of medical assistance, except as provided in par.
20(g), and intermediate care facilities for the mentally retarded that are certified
21providers of medical assistance, the The individual has successfully completed
22instruction in an instructional and competency evaluation program for nurse's
23assistants, home health aides or hospice nurse aides that is certified by the
24department approved under sub. (3) and has successfully completed a competency
25evaluation program that is approved under sub. (3m).