Amendment AA2-ASA2-AB68

2021 - 2022 LEGISLATURE

ASSEMBLY AMENDMENT 2, TO ASSEMBLY SUBSTITUTE AMENDMENT 2, TO ASSEMBLY BILL 68

June 29, 2021 - Offered by Representatives Subeck, Anderson, Andraca, Baldeh, Billings, Bowen, Brostoff, Cabrera, Conley, Considine, Doyle, Drake, Emerson, Goyke, Haywood, Hebl, Hesselbein, Hintz, Hong, McGuire, B. Meyers, Milroy, Moore Omokunde, L. Myers, Neubauer, Ohnstad, Ortiz-Velez, Pope, Riemer, S. Rodriguez, Shankland, Shelton, Sinicki, Snodgrass, Spreitzer, Stubbs, Vining and Vruwink.

AB68-ASA2-AA2,1,1 At the locations indicated, amend the substitute amendment as follows:

AB68-ASA2-AA2,1,2 1. Page 8, line 9: after that line insert:

AB68-ASA2-AA2,1,3 “ Section 9g. 15.07 (3) (bm) 7. of the statutes is created to read:

AB68-ASA2-AA2,1,5 15.07 (3) (bm) 7. The prescription drug affordability review board shall meet at least 4 times each year.

AB68-ASA2-AA2,9m Section 9m. 15.197 (20) of the statutes is created to read:

AB68-ASA2-AA2,1,9 15.197 (20) Spinal cord injury council. (a) There is created in the department of health services a spinal cord injury council that, except as provided in par. (b), consists of the following members appointed by the department for 2-year terms:

AB68-ASA2-AA2,1,11 1. One member representing the University of Wisconsin School of Medicine and Public Health.

AB68-ASA2-AA2,1,12 2. One member representing the Medical College of Wisconsin.

AB68-ASA2-AA2,2,1 3. One member who has a spinal cord injury.

AB68-ASA2-AA2,2,2 4. One member who is a family member of a person with a spinal cord injury.

AB68-ASA2-AA2,2,3 5. One member who is a veteran who has a spinal cord injury.

AB68-ASA2-AA2,2,5 6. One member who is a physician specializing in the treatment of spinal cord injuries.

AB68-ASA2-AA2,2,6 7. One member who is a researcher in the field of neurosurgery.

AB68-ASA2-AA2,2,8 8. One member who is a researcher employed by the veterans health administration of the U.S. department of veterans affairs.

AB68-ASA2-AA2,2,11 (b) If the department of health services is unable to appoint a member specified in par. (a) 1. to 8., the department of health services may appoint a member representing the general public in lieu of the member so specified.”.

AB68-ASA2-AA2,2,12 2. Page 8, line 14: after that line insert:

AB68-ASA2-AA2,2,13 “ Section 10m. 15.735 of the statutes is created to read:

AB68-ASA2-AA2,2,16 15.735 Same; attached board. (1) There is created a prescription drug affordability review board attached to the office of the commissioner of insurance under s. 15.03. The board shall consist of the following members:

AB68-ASA2-AA2,2,17 (a) The commissioner of insurance or his or her designee.

AB68-ASA2-AA2,2,21 (b) Two members appointed for 4-year terms who represent the pharmaceutical drug industry, including pharmaceutical drug manufacturers and wholesalers. At least one of the members appointed under this paragraph shall be a licensed pharmacist.

AB68-ASA2-AA2,2,23 (c) Two members appointed for 4-year terms who represent the health insurance industry, including insurers and pharmacy benefit managers.

AB68-ASA2-AA2,3,3 (d) Two members appointed for 4-year terms who represent the health care industry, including hospitals, physicians, pharmacies, and pharmacists. At least one of the members appointed under this paragraph shall be a licensed practitioner.

AB68-ASA2-AA2,3,5 (e) Two members appointed for 4-year terms who represent the interests of the public.

AB68-ASA2-AA2,3,8 (2) A member appointed under sub. (1) may not be an employee of, a board member of, or a consultant to a drug manufacturer or trade association for drug manufacturers.

AB68-ASA2-AA2,3,13 (3) Any conflict of interest, including any financial or personal association, that has the potential to bias or has the appearance of biasing an individual's decision in matters related to the board or the conduct of the board's activities shall be considered and disclosed when appointing that individual to the board under sub. (1).”.

AB68-ASA2-AA2,3,14 3. Page 36, line 18: after that line insert: - See PDF for table

AB68-ASA2-AA2,3,17 4. Page 36, line 19: increase the dollar amount for fiscal year 2022-23 by $3,000,000 for the purpose of developing and implementing a state-based health insurance exchange as described in this act.

AB68-ASA2-AA2,3,20 5. Page 36, line 19: increase the dollar amount for fiscal year 2022-23 by $900,000 for an analysis and actuarial study for the development of a public option health insurance plan.

AB68-ASA2-AA2,4,5 6. Page 36, line 19: increase the dollar amount for fiscal year 2021-22 by $1,701,000 to provide $500,000 in onetime implementation costs for establishing an office of prescription drug affordability in the office of the commissioner of insurance and $1,201,000 to authorize 16.0 PR positions within the office of prescription drug affordability, including 5.0 insurance examiners, 4.0 policy initiatives advisors, 2.0 attorneys, 1.0 insurance program manager, 2.0 insurance administrators, and 2.0 operations program associates and increase the dollar amount for fiscal year 2022-23 by $1,533,900 for the purpose of funding these authorized positions.

AB68-ASA2-AA2,4,11 7. Page 134, line 4: increase the dollar amount for fiscal year 2021-22 by $1,564,300 and increase the dollar amount for fiscal year 2022-23 by $2,044,100 for the purpose of increasing the authorized FTE positions for the department of health services by 23.0 GPR positions, including 17.0 permanent positions and 6.0 4-year project positions, beginning in fiscal year 2021-22, for the bureau of communicable diseases to prevent and respond to future outbreaks of communicable disease.

AB68-ASA2-AA2,4,16 8. Page 134, line 4: increase the dollar amount for fiscal year 2021-22 by $189,300 and increase the dollar amount for fiscal year 2022-23 by $246,000 for the purpose of increasing the authorized FTE positions for the department of health services by 3.0 GPR positions, beginning in fiscal year 2021-22, to create a field team in the bureau of communicable diseases dedicated to harm reduction.

AB68-ASA2-AA2,4,23 9. Page 134, line 4: increase the dollar amount for fiscal year 2021-22 by $162,400 and increase the dollar amount for fiscal year 2022-23 by $213,500 for the purpose of increasing the authorized FTE positions for the department of health services by 2.0 GPR positions, beginning in fiscal year 2021-22, to create a data analysis team in the office of health informatics consisting of a senior statistician and a modeler, dedicated to analyzing health metrics and creating predictive models to inform public health responses.

AB68-ASA2-AA2,5,6 10. Page 134, line 4: increase the dollar amount for fiscal year 2021-22 by $116,600 and increase the dollar amount for fiscal year 2022-23 by $153,100 for the purpose of converting 2.0 FED positions in the department of health services to 2.0 GPR positions, beginning in fiscal year 2021-22, to support 1.0 state trauma coordinator and 1.0 trauma program associate with state funds rather than funds received under the federal hospital preparedness program.

AB68-ASA2-AA2,5,11 11. Page 134, line 4: increase the dollar amount for fiscal year 2021-22 by $100,000 and increase the dollar amount for fiscal year 2022-23 by $100,000 for the purpose of contracting for the services of one full-time web developer in the division of public health to translate the Internet pages of the department of health services into multiple languages.

AB68-ASA2-AA2,5,16 12. Page 134, line 4: increase the dollar amount for fiscal year 2021-22 by $66,200 and increase the dollar amount for fiscal year 2022-23 by $88,200 for the purpose of increasing the authorized FTE positions for the department of health services by 1.0 GPR position, beginning in fiscal year 2021-22, to create an interdepartmental team to promote health in all policies.

AB68-ASA2-AA2,5,21 13. Page 134, line 4: increase the dollar amount for fiscal year 2022-23 by $87,600 for the purpose of increasing the authorized FTE positions for the department of health services by 1.0 GPR position, beginning in fiscal year 2022-23, to oversee a self-reported compliance program for ambulance medical equipment and operational requirements and conduct inspections as necessary.

AB68-ASA2-AA2,5,24 14. Page 134, line 8: increase the dollar amount for fiscal year 2021-22 by $655,000 and increase the dollar amount for fiscal year 2022-23 by $655,000 for grants to support health information exchange activities.

AB68-ASA2-AA2,6,6 15. Page 134, line 8: increase the dollar amount for fiscal year 2021-22 by $500,000 and increase the dollar amount for fiscal year 2022-23 by $500,000 for the purpose of awarding a grant in each fiscal year to an entity to connect and convene efforts among state agencies, public and private sector organizations, and community organizations to support a statewide public health strategy to advance Black women's health.

AB68-ASA2-AA2,6,7 16. Page 135, line 2: after that line insert: - See PDF for table

AB68-ASA2-AA2,6,11 17. Page 135, line 6: increase the dollar amount for fiscal year 2021-22 by $5,000,000 and increase the dollar amount for fiscal year 2022-23 by $5,000,000 for the purpose of grants to local public health departments to prevent and control communicable diseases.

AB68-ASA2-AA2,6,15 18. Page 135, line 7: increase the dollar amount for fiscal year 2021-22 by $125,000 and increase the dollar amount for fiscal year 2022-23 by $125,000 for the purpose of awarding a grant to an organization to train and assist guardians for individuals found to be incompetent under ch. 54.

AB68-ASA2-AA2,6,19 19. Page 135, line 13: increase the dollar amount for fiscal year 2021-22 by $3,500,000 and increase the dollar amount for fiscal year 2022-23 by $3,500,000 for the purpose of Black women's health grants under s. 250.20 (7) and for infant and maternal mortality grants under s. 250.20 (8).

AB68-ASA2-AA2,6,22 20. Page 135, line 17: increase the dollar amount for fiscal year 2021-22 by $321,800 and increase the dollar amount for fiscal year 2022-23 by $321,800 for the purpose of increasing funding for the hearing aid assistance program.

AB68-ASA2-AA2,7,5 21. Page 136, line 9: increase the dollar amount for fiscal year 2021-22 by $961,800 and increase the dollar amount for fiscal year 2022-23 by $1,054,800 for the purpose of increasing the authorized FTE positions for the department of health services by 1.0 GPR position, beginning in fiscal year 2021-22, to resume the Window Plus lead exposure prevention program.

AB68-ASA2-AA2,7,8 22. Page 136, line 21: increase the dollar amount for fiscal year 2021-22 by $1,000,000 and increase the dollar amount for fiscal year 2022-23 by $1,000,000 for grants for federally qualified health centers.

AB68-ASA2-AA2,7,11 23. Page 136, line 21: increase the dollar amount for fiscal year 2021-22 by $1,000,000 and increase the dollar amount for fiscal year 2022-23 by $1,000,000 for free and charitable clinic grants.

AB68-ASA2-AA2,7,14 24. Page 137, line 4: increase the dollar amount for fiscal year 2021-22 by $2,000,000 for the purpose of a public health campaign aimed at preventing initiation of tobacco and vapor product use as provided under s. 255.15 (3) (d).

AB68-ASA2-AA2,7,18 25. Page 139, line 2: increase the dollar amount for fiscal year 2021-22 by $5,827,600 and increase the dollar amount for fiscal year 2022-23 by $5,827,600 for the purpose of paying anticipated overtime costs at care and treatment residential facilities owned by the department of health services.

AB68-ASA2-AA2,7,24 26. Page 139, line 2: increase the dollar amount for fiscal year 2021-22 by $3,028,200 and increase the dollar amount for fiscal year 2022-23 by $3,028,200 for the purpose of increasing the authorized FTE positions for the department of health services by 36.5 GPR positions, beginning in fiscal year 2021-22, to staff a 14-bed unit for adult forensic patients in the building at the Mendota Mental Health Institute that houses the Mendota Juvenile Treatment Center.

AB68-ASA2-AA2,8,5 27. Page 139, line 8: increase the dollar amount for fiscal year 2021-22 by $2,273,800 and increase the dollar amount for fiscal year 2022-23 by $2,273,800 for the purpose of contracting for treatment delivered under an assertive community treatment model for individuals with serious mental illness that are involved in the criminal justice system.

AB68-ASA2-AA2,8,7 28. Page 139, line 12: increase the dollar amount for fiscal year 2021-22 by $20,000 for the behavioral health bed tracking system grant.

AB68-ASA2-AA2,8,11 29. Page 139, line 22: increase the dollar amount for fiscal year 2021-22 by $3,351,800 and increase the dollar amount for fiscal year 2022-23 by $3,351,800 for the purpose of paying anticipated overtime costs at care and treatment residential facilities owned by the department of health services.

AB68-ASA2-AA2,8,15 30. Page 140, line 19: decrease the dollar amount for fiscal year 2021-22 by $849,788,000 and decrease the dollar amount for fiscal year 2022-23 by $841,925,400 as a result of the expansion of eligibility for the Medical Assistance program.

AB68-ASA2-AA2,8,18 31. Page 140, line 19: decrease the dollar amount for fiscal year 2021-22 by $1,390,700 and decrease the dollar amount for fiscal year 2022-23 by $2,026,500 for the purpose of decreasing the nursing home reimbursement.

AB68-ASA2-AA2,8,21 32. Page 140, line 19: decrease the dollar amount for fiscal year 2021-22 by $5,000,000 and decrease the dollar amount for fiscal year 2022-23 by $5,000,000 for the purpose of decreasing direct care workforce funding.

AB68-ASA2-AA2,9,3 33. Page 140, line 19: decrease the dollar amount for fiscal year 2021-22 by $2,844,100 and decrease the dollar amount for fiscal year 2022-23 by $5,000,000 for the purpose of decreasing personal care reimbursement.

AB68-ASA2-AA2,9,6 34. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $1,145,100 and increase the dollar amount for fiscal year 2022-23 by $2,290,200 to increase Medical Assistance reimbursement rates for emergency physician services.

AB68-ASA2-AA2,9,10 35. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $1,293,300 and increase the dollar amount for fiscal year 2022-23 by $2,586,700 for the purpose of providing an additional increase to the Medical Assistance reimbursement rates for medication-assisted treatment services.

AB68-ASA2-AA2,9,14 36. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $36,696,100 and increase the dollar amount for fiscal year 2022-23 by $39,581,700 for the purpose of increasing the total hospital access payments under the Medical Assistance program.

AB68-ASA2-AA2,9,18 37. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $547,500 and increase the dollar amount for fiscal year 2022-23 by $590,700 for the purpose of increasing critical access hospital access payments under the Medical Assistance program.

AB68-ASA2-AA2,9,22 38. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $883,800 and increase the dollar amount for fiscal year 2022-23 by $5,302,500 for a 20 percent increase to reimbursement rates for outpatient mental health and substance abuse services on each of January 1, 2022, and January 1, 2023.

AB68-ASA2-AA2,10,3 39. Page 140, line 19: increase the dollar amount for fiscal year 2022-23 by $534,200 for the purpose of increasing by 20 percent the reimbursement rates for child and adolescent day treatment services on January 1, 2023.

AB68-ASA2-AA2,10,7 40. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $500,000 and increase the dollar amount for fiscal year 2022-23 by $7,260,000 for the purpose of extending Medical Assistance benefits for postpartum women as described in this act.

AB68-ASA2-AA2,10,12 41. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $1,950,200 and increase the dollar amount for fiscal year 2022-23 by $2,103,100 for the purpose of supplemental payments to hospitals that are freestanding pediatric teaching hospitals located in Wisconsin for which 45 percent or more of their total inpatient days are for Medical Assistance recipients.

AB68-ASA2-AA2,10,16 42. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $3,274,600 and increase the dollar amount for fiscal year 2022-23 by $3,274,600 for the purpose of providing coverage for room and board costs of Medical Assistance enrollees receiving residential treatment for substance use disorders.

AB68-ASA2-AA2,10,19 43. Page 140, line 19: increase the dollar amount for fiscal year 2022-23 by $803,200 for the purpose of expanding access to Medical Assistance psychosocial services through the use of non-county providers.

AB68-ASA2-AA2,10,23 44. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $500,000 and increase the dollar amount for fiscal year 2022-23 by $10,014,000 for the purpose of providing a new Medical Assistance benefit, subject to federal approval, for nonmedical services that contribute to determinants of health.

AB68-ASA2-AA2,11,3 45. Page 140, line 19: increase the dollar amount for fiscal year 2022-23 by $5,701,600 for the purpose of funding coverage of community health worker services under the Medical Assistance program.

AB68-ASA2-AA2,11,6 46. Page 140, line 19: increase the dollar amount for fiscal year 2022-23 by $406,700 for the purpose of providing coverage of doula services under the Medical Assistance program.

AB68-ASA2-AA2,11,11 47. Page 140, line 19: decrease the dollar amount for fiscal year 2021-22 by $1,393,300 and decrease the dollar amount for fiscal year 2022-23 by $2,786,600 for the purpose of increasing reimbursement rates for dental providers that meet quality of care standards, as established by the department of health services, and meet other criteria established under s. 49.45 (24L).

AB68-ASA2-AA2,11,16 48. Page 140, line 19: increase the dollar amount for fiscal year 2021-22 by $3,080,900 and increase the dollar amount for fiscal year 2022-23 by $6,161,700 for the purpose of increasing reimbursement rates for behavioral health treatment services related to autism under the Medical Assistance program by 25 percent, effective January 1, 2022.

AB68-ASA2-AA2,11,20 49. Page 140, line 19: increase the dollar amount for fiscal year 2022-23 by $1,281,900 for the purpose of providing reimbursement under the Medical Assistance program, subject to federal approval, for acupuncture services provided by a certified acupuncturist.

AB68-ASA2-AA2,11,21 50. Page 141, line 2: after that line insert: - See PDF for table

AB68-ASA2-AA2,12,4 51. Page 141, line 7: increase the dollar amount for fiscal year 2021-22 by $5,025,300 and increase the dollar amount for fiscal year 2022-23 by $5,983,000 for the purpose of increasing funding for contractual services and systems costs for the administration of the Medical Assistance and FoodShare programs.

AB68-ASA2-AA2,12,8 52. Page 141, line 8: increase the dollar amount for fiscal year 2021-22 by $1,445,300 and increase the dollar amount for fiscal year 2022-23 by $2,117,000 for the purpose of funding projected workload increases for income maintenance consortia and tribal income maintenance agencies in the 2021-23 biennium.

AB68-ASA2-AA2,12,10 53. Page 141, line 10: increase the dollar amount for fiscal year 2022-23 by $4,027,400 for the FoodShare employment and training program.

AB68-ASA2-AA2,12,14 54. Page 141, line 15: increase the dollar amount for fiscal year 2021-22 by $187,500 and increase the dollar amount for fiscal year 2022-23 by $612,500 for the FoodShare healthy eating incentives and benefit and card processing equipment for farmers markets and direct-marketing farmers as described in this act.

AB68-ASA2-AA2,12,17 55. Page 144, line 16: decrease the dollar amount for fiscal year 2021-22 by $36,696,100 and decrease the dollar amount for fiscal year 2022-23 by $39,581,700 for the purpose of hospital access payments.

AB68-ASA2-AA2,12,20 56. Page 144, line 16: decrease the dollar amount for fiscal year 2021-22 by $547,500 and decrease the dollar amount for fiscal year 2022-23 by $590,700 for the purpose of critical access hospital payments.