Amendment AA2-ASA2-AB68

AB68-ASA2-AA2,20,7 40.51 (8m) Every health care coverage plan offered by the group insurance board under sub. (7) shall comply with ss. 631.95, 632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.862, 632.867, 632.871, 632.885, 632.89, and 632.895 (11) to (17).

AB68-ASA2-AA2,180h Section 180h. 40.51 (8m) of the statutes, as affected by 2021 Wisconsin Act .... (this act), section 180g, is amended to read:

AB68-ASA2-AA2,20,13 40.51 (8m) Every health care coverage plan offered by the group insurance board under sub. (7) shall comply with ss. 631.95, 632.728, 632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.862, 632.867, 632.871, 632.885, 632.89, and 632.895 (11) (8) and (10) to (17).”.

AB68-ASA2-AA2,20,14 82. Page 281, line 16: delete “$2,808,900" and substitute “ $3,058,900".

AB68-ASA2-AA2,20,15 83. Page 281, line 17: after that line insert:

AB68-ASA2-AA2,20,16 “ Section 190d. 46.48 (3m) of the statutes is created to read:

AB68-ASA2-AA2,20,21 46.48 (3m) Deaf, hard of hearing, and deaf-blind behavioral health treatment center. The department may distribute not more than $1,936,000 in each fiscal year, beginning in fiscal year 2022-23, to a statewide provider of behavioral health treatment services for individuals who are deaf, hard of hearing, or deaf-blind.

AB68-ASA2-AA2,190f Section 190f. 46.48 (6) of the statutes is created to read:

AB68-ASA2-AA2,21,2 46.48 (6) Trauma response teams. The department shall annually award a grant equal to $450,000 for the Milwaukee trauma response team. Notwithstanding sub. (1), grants awarded under this subsection shall be from the appropriation under s. 20.435 (5) (bc).

AB68-ASA2-AA2,190f Section 190f. 46.48 (7) of the statutes is created to read:

AB68-ASA2-AA2,21,8 46.48 (7) Medication-assisted treatment grants. The department shall award up to $500,000 in fiscal year 2021-22 and up to $1,000,000 annually thereafter to develop or support entities that offer medication-assisted treatment. Notwithstanding sub. (1), grants awarded under this subsection shall be from the appropriation under s. 20.435 (5) (bc).

AB68-ASA2-AA2,190h Section 190h. 46.48 (9) of the statutes is created to read:

AB68-ASA2-AA2,21,14 46.48 (9) Substance use harm reduction grant. The department may annually award up to $250,000 to organizations with comprehensive harm reduction strategies for the development or support of substance use harm reduction programs, as determined by the department. Notwithstanding sub. (1), grants awarded under this subsection shall be from the appropriation under s. 20.435 (5) (bc).”.

AB68-ASA2-AA2,21,15 84. Page 281, line 23: after that line insert:

AB68-ASA2-AA2,21,17 “ Section 191c. 46.536 of the statutes is renumbered 46.536 (intro.) and amended to read:

AB68-ASA2-AA2,21,20 46.536 Crisis program enhancement grants. (intro.) From the appropriation under s. 20.435 (5) (cf), the department shall award all of the following grants:

AB68-ASA2-AA2,22,2 (1) A 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. The department shall award a grant under this section subsection in an amount equal to one-half the amount of money the county or region provides to establish or enhance crisis programs.

AB68-ASA2-AA2,191e Section 191e. 46.536 (2) of the statutes is created to read:

AB68-ASA2-AA2,22,7 46.536 (2) At least $1,250,000 in each fiscal year to establish and enhance law enforcement and behavioral health services emergency response collaboration programs. Grant recipients under this subsection shall match at least 25 percent of the grant amount awarded for the purpose that the grant is received.

AB68-ASA2-AA2,191g Section 191g. 46.536 (3) of the statutes is created to read:

AB68-ASA2-AA2,22,10 46.536 (3) At least $850,000 in each fiscal year to a county with a population of more than 750,000 to enhance mobile crisis teams.

AB68-ASA2-AA2,191j Section 191j. 46.537 of the statutes is created to read:

AB68-ASA2-AA2,22,18 46.537 County crisis call center support grants. From the appropriation under s. 20.435 (5) (cj), the department shall award grants to support mental health professionals to provide supervision and consultation to individuals who support crisis call center services. Each county or multicounty program that receives supervision and consultation services from a grant recipient described under this section shall contribute at least 10 percent of the costs of the services that the grant recipient incurs for the purpose that the grant is received.

AB68-ASA2-AA2,191k Section 191k. 46.87 (5m) of the statutes is amended to read:

AB68-ASA2-AA2,23,2 46.87 (5m) A person is financially eligible for the program under this section if the joint income of the person with Alzheimer's disease and that person's spouse, if any, is $48,000 $55,000 per year or less, unless the department sets a higher limitation on income eligibility by rule. In determining joint income for purposes of this subsection, the administering agency shall subtract any expenses attributable to the Alzheimer's-related needs of the person with Alzheimer's disease or of the person's caregiver.

AB68-ASA2-AA2,191m Section 191m. 46.977 (1) (intro.) and (a) of the statutes are consolidated, renumbered 46.977 (1) and amended to read:

AB68-ASA2-AA2,23,6 46.977 (1) Definitions Definition. In this section : (a) “Guardian", “guardian” has the meaning given in s. 54.01 (10).

AB68-ASA2-AA2,191p Section 191p. 46.977 (1) (b) of the statutes is renumbered 46.977 (2) (ag) and amended to read:

AB68-ASA2-AA2,23,11 46.977 (2) (ag) “Organization" 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.

AB68-ASA2-AA2,191r Section 191r. 46.977 (2) (a) of the statutes is renumbered 46.977 (2) (am) and amended to read:

AB68-ASA2-AA2,23,18 46.977 (2) (am) From the appropriation under s. 20.435 (1) (cg), the department may under this section subsection, 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.

AB68-ASA2-AA2,191s Section 191s. 46.977 (2) (b) (intro.) of the statutes is amended to read:

AB68-ASA2-AA2,23,21 46.977 (2) (b) (intro.) Organizations awarded grants under par. (a) (am) shall do all of the following:

AB68-ASA2-AA2,191u Section 191u. 46.977 (2) (c) of the statutes is amended to read:

AB68-ASA2-AA2,23,25 46.977 (2) (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.

AB68-ASA2-AA2,191w Section 191w. 46.977 (3) of the statutes is created to read:

AB68-ASA2-AA2,24,3 46.977 (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.

AB68-ASA2-AA2,24,7 (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.

AB68-ASA2-AA2,24,12 (c) The grantee selected to develop training that meets the requirements under s. 54.26 (1) shall develop plain-language, web-based 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.

AB68-ASA2-AA2,191y Section 191y. 46.995 (4) of the statutes is created to read:

AB68-ASA2-AA2,24,17 46.995 (4) The department shall ensure that any child who is eligible and who applies for the disabled children's long-term support program that is operating under a waiver of federal law receives services under the disabled children's long-term support program that is operating under a waiver of federal law.”.

AB68-ASA2-AA2,24,18 85. Page 290, line 22: after that line insert:

AB68-ASA2-AA2,24,19 “ Section 226g. 49.45 (2p) of the statutes is repealed.

AB68-ASA2-AA2,226m Section 226m. 49.45 (3) (e) 11. of the statutes is amended to read:

AB68-ASA2-AA2,25,11 49.45 (3) (e) 11. The department shall use a portion of the moneys collected under s. 50.38 (2) (a) to pay for services provided by eligible hospitals, as defined in s. 50.38 (1), other than critical access hospitals, under the Medical Assistance Program under this subchapter, including services reimbursed on a fee-for-service basis and services provided under a managed care system. For state fiscal year 2008-09, total payments required under this subdivision, including both the federal and state share of Medical Assistance, shall equal the amount collected under s. 50.38 (2) (a) for fiscal year 2008-09 divided by 57.75 percent. For each state fiscal year after state fiscal year 2008-09, total payments required under this subdivision, including both the federal and state share of Medical Assistance, shall equal the amount collected under s. 50.38 (2) (a) for the fiscal year divided by 61.68 percent, except that if the department has expanded eligibility under section 2001 (a) (1) (C) of the Patient Protection and Affordable Care Act, P.L. 111-148, for the Medical Assistance program under this subchapter, the amount collected for the fiscal year shall be divided by 53.69 percent.

AB68-ASA2-AA2,226r Section 226r. 49.45 (3) (e) 12. of the statutes is amended to read:

AB68-ASA2-AA2,25,23 49.45 (3) (e) 12. The department shall use a portion of the moneys collected under s. 50.38 (2) (b) to pay for services provided by critical access hospitals under the Medical Assistance Program under this subchapter, including services reimbursed on a fee-for-service basis and services provided under a managed care system. For each state fiscal year, total payments required under this subdivision, including both the federal and state share of Medical Assistance, shall equal the amount collected under s. 50.38 (2) (b) for the fiscal year divided by 61.68 percent, except that if the department has expanded eligibility under section 2001 (a) (1) (C) of the Patient Protection and Affordable Care Act, P.L. 111-148, for the Medical Assistance program under this subchapter, the amount collected for the fiscal year shall be divided by 53.69 percent.”.

AB68-ASA2-AA2,25,24 86. Page 291, line 7: delete lines 7 to 10 and substitute:

AB68-ASA2-AA2,26,4 “49.45 (3m) (b) 3. a. No single hospital receives more than $4,600,000 $7,950,000, except that in the 2021-23 fiscal biennium the department may increase proportionately the maximum a single hospital may receive if the state is eligible for an enhanced federal medical assistance percentage under federal law.” .

AB68-ASA2-AA2,26,6 87. Page 291, line 11: delete the material beginning with that line and ending with page 292, line 12, and substitute:

AB68-ASA2-AA2,26,7 “ Section 229. 49.45 (5g) of the statutes is created to read:

AB68-ASA2-AA2,26,17 49.45 (5g) Payments to tribes. (a) Tribal care coordination agreements. A tribal health care provider's care coordination agreement with a nontribal health care provider shall meet federal requirements, including that a service provided by the nontribal health care provider be at the request of the tribal health care provider on behalf of a tribal member who remains in the tribal health care provider's care according to the care coordination agreement; that both the tribal health care provider and nontribal health care provider are providers, as defined in s. 49.43 (10); that an established relationship exists between the tribal health care provider and the tribal member; and that the care be provided pursuant to a written care coordination agreement.

AB68-ASA2-AA2,27,3 (b) Amount and distribution of payments. 1. From the appropriation account under s. 20.435 (4) (b), the department shall make payments to eligible governing bodies of federally recognized American Indian tribes or bands or tribal health care providers in an amount and manner determined by the department. The department shall determine payment amounts on the basis of the difference between the state share of medical assistance payments paid for services rendered to tribal members for whom a care coordination agreement with nontribal health care providers is in place and the state share of medical assistance payments that would have been paid for those services absent a care coordination agreement with nontribal partners.

AB68-ASA2-AA2,27,6 2. The department shall withhold from the payments under subd. 1. the state share of administrative costs associated with carrying out this subsection, not to exceed 10 percent of the amounts calculated in subd. 1.

AB68-ASA2-AA2,27,9 3. Federally recognized American Indian tribes or bands may use funds paid under this subsection for health-related purposes. The department shall consult biennially with tribes to determine the timing and distribution of payments.”.

AB68-ASA2-AA2,27,10 88. Page 292, line 12: after that line insert:

AB68-ASA2-AA2,27,11 “ Section 229c. 49.45 (6xm) of the statutes is created to read:

AB68-ASA2-AA2,27,15 49.45 (6xm) Pediatric inpatient supplement. (a) From the appropriations under s. 20.435 (4) (b), (o), and (w), the department shall, using a method determined by the department, distribute a total sum of $2,000,000 each state fiscal year to hospitals that meet all of the following criteria:

AB68-ASA2-AA2,27,16 1. The hospital is an acute care hospital located in this state.

AB68-ASA2-AA2,27,21 2. During the hospital's fiscal year, the inpatient days in the hospital's acute care pediatric units and intensive care pediatric units totaled more than 12,000 days, not including neonatal intensive care units. For purposes of this subsection, the hospital's fiscal year is the hospital's fiscal year that ended in the 2nd calendar year preceding the beginning of the state fiscal year.

AB68-ASA2-AA2,28,5 (b) Notwithstanding par. (a), from the appropriations under s. 20.435 (4) (b), (o), and (w), if the department has expanded eligibility under section 2001 (a) (1) (C) of the Patient Protection and Affordable Care Act, P.L. 111-148, for the Medical Assistance program under this subchapter, then the department may, using a method determined by the department, distribute an additional total sum of $7,500,000 in each state fiscal year to hospitals that are free-standing pediatric teaching hospitals located in Wisconsin that have a percentage calculated under s. 49.45 (3m) (b) 1. a. greater than 45 percent.

AB68-ASA2-AA2,229d Section 229d. 49.45 (23) of the statutes is repealed.

AB68-ASA2-AA2,229f Section 229f. 49.45 (23b) (title) of the statutes is amended to read:

AB68-ASA2-AA2,28,9 49.45 (23b) (title) Childless adults demonstration project reform waiver implementation required.

AB68-ASA2-AA2,229g Section 229g. 49.45 (23b) (b) of the statutes is amended to read:

AB68-ASA2-AA2,28,14 49.45 (23b) (b) Beginning as soon as practicable after October 31, 2018, and ending no sooner than December 31, 2023, the department shall do all of the following with regard to the childless adults demonstration project under sub. (23) s. 49.471 (4) (a) 8.:

AB68-ASA2-AA2,28,20 1. Require in each month persons, except exempt individuals, who are eligible to receive Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. and who are at least 19 years of age but have not attained the age of 50 to participate in, document, and report 80 hours per calendar month of community engagement activities. The department, after finding good cause, may grant a temporary exemption from the requirement under this subdivision upon request of a Medical Assistance recipient.

AB68-ASA2-AA2,28,23 2. Require persons with incomes of at least 50 percent of the poverty line to pay premiums in accordance with par. (c) as a condition of eligibility for Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.

AB68-ASA2-AA2,28,25 3. Require as a condition of eligibility for Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. completion of a health risk assessment.

AB68-ASA2-AA2,29,3 4. Charge recipients of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. an $8 copayment for nonemergency use of the emergency department in accordance with 42 USC 1396o-1 (e) (1) and 42 CFR 447.54.

AB68-ASA2-AA2,29,8 5. Disenroll from Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. for 6 months any individual who does not pay a required premium under subd. 2. and any individual who is required under subd. 1. to participate in a community engagement activity but who does not participate for 48 aggregate months in the community engagement activity.

AB68-ASA2-AA2,229h Section 229h. 49.45 (23b) (c) of the statutes is amended to read:

AB68-ASA2-AA2,29,15 49.45 (23b) (c) 1. Persons who are eligible for the demonstration project under sub. (23) s. 49.471 (4) (a) 8. and who have monthly household income that exceeds 50 percent of the poverty line shall pay a monthly premium amount of $8 per household. A person who is eligible to receive an item or service furnished by an Indian health care provider is exempt from the premium requirement under this subdivision.

AB68-ASA2-AA2,29,21 2. The department may disenroll under par. (b) 5. a person for nonpayment of a required monthly premium only at annual eligibility redetermination after providing notice and reasonable opportunity for the person to pay. If a person who is disenrolled for nonpayment of premiums pays all owed premiums or becomes exempt from payment of premiums, he or she may reenroll in Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.

AB68-ASA2-AA2,29,25 3. The department shall reduce the amount of the required household premium by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. who does not engage in certain behaviors that increase health risks or who attests to actively managing certain unhealthy behaviors.

AB68-ASA2-AA2,229j Section 229j. 49.45 (23b) (e) of the statutes is amended to read:

AB68-ASA2-AA2,30,6 49.45 (23b) (e) Before December 31, 2023, the demonstration project requirements under this subsection may not be withdrawn and the department may not request from the federal government withdrawal, suspension, or termination of the demonstration project requirements under this subsection unless legislation has been enacted specifically allowing for the withdrawal, suspension, or termination.

AB68-ASA2-AA2,229m Section 229m. 49.45 (24L) of the statutes is created to read:

AB68-ASA2-AA2,30,11 49.45 (24L) Critical access reimbursement payments to dental providers. (a) Based on the criteria in pars. (b) and (c), the department shall increase reimbursements to dental providers that meet quality of care standards, as established by the department.

AB68-ASA2-AA2,30,13 (b) In order to be eligible for enhanced reimbursement under this subsection, the provider must meet one of the following qualifications:

AB68-ASA2-AA2,30,16 1. For a nonprofit or public provider, 50 percent or more of the individuals served by the provider are individuals who are without dental insurance or are enrolled in the Medical Assistance program.

AB68-ASA2-AA2,30,18 2. For a for-profit provider, 5 percent or more of the individuals served by the provider are enrolled in the Medical Assistance program.

AB68-ASA2-AA2,31,4 (c) For dental services rendered on or after January 1, 2022, by a qualified nonprofit or public dental provider, the department shall increase reimbursement by 50 percent above the reimbursement rate that would otherwise be paid to that provider. For dental services rendered on or after January 1, 2022, by a qualified for-profit dental provider, the department shall increase reimbursement by 30 percent above the reimbursement rate that would otherwise be paid to that provider. For dental providers rendering services to individuals in managed care under the Medical Assistance program, for services rendered on or after January 1, 2022, the department shall increase reimbursement to pay an additional amount on the basis of the rate that would have been paid to the dental provider had the individual not been enrolled in managed care.

AB68-ASA2-AA2,31,7 (d) If a provider has more than one service location, the thresholds described under par. (b) apply to each location, and the department will determine the payment for each separate service location.

AB68-ASA2-AA2,31,9 (e) Any provider that receives reimbursement through the pilot project under sub. (24k) is not eligible for reimbursement under this subsection.

AB68-ASA2-AA2,229p Section 229p. 49.45 (25r) of the statutes is created to read:

AB68-ASA2-AA2,31,11 49.45 (25r) Community health worker services. (a) In this subsection:

AB68-ASA2-AA2,31,13 1. “Community health services” means services provided by a community health worker.

AB68-ASA2-AA2,31,21 2. “Community health worker” means a front-line public health worker who is a trusted member of or has a close understanding of the community served, enabling the worker to serve as a liaison, link, or intermediary between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery, and who builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy.