Under current law, DCF is required to allocate to counties community youth
and family aids (youth aids) funding. Youth aids funding comes from various state
and federal moneys and is used to pay for state-provided juvenile correctional
services and local delinquency-related and juvenile justice services. The bill updates
the allocation of youth aids funding that is available to counties for the 2021-23 fiscal
biennium.
Under current law, some of the youth aids funding is allocated to reimburse
counties that are purchasing community supervision services from DOC for
juveniles, and some of the funding is allocated for alcohol and other drug abuse
treatment programs. The bill eliminates these earmarks and instead provides that
DCF may use youth aids funding to reimburse counties for the costs associated with
the care and maintenance of juveniles who are adjudged delinquent and who are
placed in certain secured juvenile facilities under the supervision of a county or the
state.
Youth aids; administration
Current law allocates some youth aids for the purchase of juvenile correctional
services, emergencies, provision of community supervision services for juveniles,
and for alcohol and other drug abuse treatment programs. Also under current law,
DCF may award funding to counties for early intervention services for first offenders
under the Community Intervention Program (CIP).
The bill replaces CIP with the Youth Justice System Improvements Program.
Under the bill, DCF may use funding for the Youth Justice System Improvements
Program to support diversion programs, to address emergencies related to youth
aids, or to fund other activities required of DCF under youth aids.
Under current law, youth aids funding is allocated to counties on a calendar
year basis. Youth aids funds that are not spent in the calendar year can be carried
forward three ways: 1) DCF may carry forward 5 percent of a county's allocation for
that county for use in the subsequent calendar year; 2) DCF may carry forward
$500,000 or 10 percent of its unspent youth aids funds, whichever is larger, for use
in the subsequent two calendar years; and 3) DCF may carry forward any unspent
emergency funds for use in the subsequent two calendar years.
The bill changes the way that unspent youth aids are reallocated. Under the
bill, DCF may still carry forward 5 percent of a county's allocation for that county to
use in the next calendar year. However, instead of carrying forward $500,000 or 10
percent of its unspent youth aids funds, whichever is larger, for use in the next two
calendar years, under the bill, DCF may transfer 10 percent of unspent youth aids
funds to the Youth Justice System Improvements Program.
Child abuse and neglect prevention program; home visitation
Under current law, DCF provides funding to counties, cities, private agencies,
and Indian tribes to provide home visitation program services to individuals who are
determined, through a risk assessment, to be at risk of poor birth outcomes or of
abusing or neglecting his or her child. The bill requires DCF to allocate an additional
$500,000 per year to the Nurse Family Partnership home visitation program in
Milwaukee county, beginning in fiscal year 2021-22.
Recruitment for adoptive placements
The bill requires DCF to provide $300,000 annually to the Wendy's Wonderful
Kids program at the Children's Hospital of Wisconsin, which provides support in
finding adoptive placements for children with special needs in foster care. The bill
specifies that the funding is to recruit adoptive placements for children in Milwaukee
County.
Grants to support foster parents and children
2017 Wisconsin Act 260 established a one-year pilot program for DCF to
distribute grants to counties, nonprofit organizations, and tribes for the purpose of
supporting foster parents and providing normalcy for children in out-of-home care.
The bill makes the grant program permanent and specifies that grants under the
program may be distributed for the purpose of sibling reconnection.
Five-county pilot program for representation of parents in CHIPS
proceedings.
Under current law, a parent is generally not entitled to representation by a
public defender in a proceeding under the Children's Code in which a child is alleged
to be in need of protection or services. However, a pilot program that began in 2018
requires the state public defender to assign counsel to any nonpetitioning parent in
these cases in the counties of Brown, Outagamie, Racine, Kenosha, and Winnebago.
This five-county pilot program is set to expire on June 30, 2021. The bill extends the
expiration date of the pilot program to June 30, 2023.
Congregate care facility staff training
The bill specifies that DCF is authorized to provide training to staff or
contractors of a congregate care facility or a child welfare agency.
Grants for youth services
The bill consolidates certain DCF youth services programs into a new youth
services grant program. Under current law, the following DCF programs provide
youth services: grants for services for homeless and runaway youth, treatment and
services for children who are the victims of sex trafficking, grants for children's
community programs, and the Brighter Futures Initiative. Under the bill, these
programs are consolidated into the youth services grant program, under which DCF
must distribute grants to public agencies, nonprofit corporations, and Indian tribes
to provide programs that accomplish one or more of the following purposes:
1. Increasing youth access to housing.
2. Increasing youth self-sufficiency through employment, education, and
training.
3. Increasing youth social and emotional health by promoting healthy and
stable adult connections, social engagement, and connection with necessary
services.
4. Preventing sex trafficking of children and youth.
5. Providing treatment and services for documented and suspected victims of
child and youth sex trafficking.
6. Preventing and reducing the incidence of youth violence and other
delinquent behavior.
7. Preventing and reducing the incidence of youth alcohol and other drug use
and abuse.
8. Preventing and reducing the incidence of child abuse and neglect.
9. Preventing and reducing the incidence of teen pregnancy.
Under current law, DCF must allocate in each fiscal year specific amounts of
money, including federal moneys received under the Temporary Assistance for
Needy Families (TANF) block grant program, for various public assistance
programs, including $500,000 for the Brighter Futures Initiative for programs to
provide evidence-based programs and practices for substance abuse prevention to
at-risk youth and their families. Under the bill, this amount is allocated instead to
the grants for youth services.
Under current law, DHS transfers amounts to DCF for the Brighter Futures
Initiative. Under the bill, DHS transfers those amounts to DCF for the grants for
youth services. The bill maintains a requirement, currently under the Brighter
Futures Initiative, that DCF distribute $55,000 in each fiscal year to Diverse and
Resilient, Inc., to provide youth services, as part of the new youth services grant
program.
Safety promotion and placement prevention services
The bill creates new authority for DCF to provide funding for services or to
provide direct evidence-based services or support to agencies for the provision of
evidence-based services aimed at preventing the removal of children from the home
under the Children's Code and the Juvenile Justice Code.
The bill also creates a new GPR appropriation for DCF to provide services that
allow a child to remain at home in lieu of an out-of-home placement.
Children and family services
Under current law, DCF must distribute not more than $80,125,200 in fiscal
year 2019-20 and $101,145,500 in fiscal year 2020-21 to counties for children and
family services. The bill increases the maximum amount DCF must distribute to
counties for these services to $106,389,600 in fiscal year 2021-22 and $111,868,900
in fiscal year 2022-23.
Diversity, equity, and inclusion grants
The bill requires DCF to award grants to public, private, or nonprofit entities
that promote diversity and advance equity and inclusion.
Health
Requiring hospitals to allow designation of a caregiver
The bill requires hospitals to provide a patient or, if applicable, a patient's legal
guardian with an opportunity to designate a caregiver who will receive, before the
patient is discharged from the hospital, instruction regarding assistance with the
patient's care after discharge.
Under the bill, a hospital must, no later than 24 hours following a patient's
admission to a hospital and before the patient is discharged or transferred, provide
at least one opportunity for a patient or, if applicable, a patient's legal guardian to
designate at least one caregiver. If a patient is unconscious or otherwise
incapacitated when admitted, the hospital shall provide an opportunity for caregiver
designation within 24 hours after the patient regains consciousness or capacity. If
a patient or legal guardian designates a caregiver, a hospital must promptly record
the name and contact information of the caregiver. If a patient or legal guardian
declines to designate a caregiver, the hospital must also promptly document that
information. Patients are not required to designate a caregiver under the bill and,
further, the designation of a caregiver does not obligate any individual to provide
aftercare for the patient. A patient may elect to change the designated caregiver at
any time, and the hospital must record the change within 24 hours.
The bill requires that if a patient designates a caregiver, the hospital must
promptly request written consent to release medical information to the patient's
caregiver. If the patient or the patient's legal guardian declines to provide consent,
the hospital is relieved of its notification and consultation obligations.
Under current law, patient medical records are kept confidential except in
certain limited circumstances, including if a patient or a person authorized by the
patient gives consent to the disclosure. Even without agreement, a health care
provider may provide to the patient's immediate family, another relative, a close
personal friend of the patient, or an individual identified by the patient, that portion
of information from the health care record directly relevant to that individual's
involvement in the patient's care. The bill adds designated caregivers to the list of
individuals permitted access to information directly relevant to that individual's
involvement in the patient's care.
Pediatric inpatient supplement
The bill establishes in statute reference to supplemental funding totaling
$2,000,000 to be distributed by DHS to certain acute care hospitals located in
Wisconsin that have a total of more than 12,000 inpatient days in the hospital's acute
care pediatric units and intensive care pediatric units, not including neonatal
intensive care units. In addition, under the bill, DHS may distribute additional
funding of $7,500,000 in each state fiscal year to hospitals that are free-standing
pediatric teaching hospitals located in Wisconsin that have a Medicaid inpatient
utilization rate greater than 45 percent if DHS has expanded eligibility for the
Medical Assistance program under the federal Patient Protection and Affordable
Care Act.
Tailored caregiver assessment and referral (TCARE) pilot program
The bill requires DHS to conduct, during fiscal year 2021-22, a one-year
Tailored Caregiver Assessment and Referral pilot program as described in the
September 2020 report of the Governor's Task Force on Caregiving. Tailored
Caregiver Assessment and Referral, commonly referred to as TCARE or a family
caregiver survey, is an evidence-based care management protocol designed to
support family members who are providing care to adults of any age with chronic or
acute health conditions. TCARE includes both a pre-screening tool and a full
assessment that seeks information from the family or informal caregiver in order to
assess their health and well-being, stress levels, challenges, skills needed to perform
care, their informal support system, and strengths that enable them to provide care.
Title V and Title X family planning funding
Current law requires DHS to apply for federal Title X grant funds and to
distribute any funds received to public entities for family planning and related
preventive health services. The bill eliminates that requirement.
Under current law, DHS must allocate women's health funds, which are federal
Title V funds and women's health block grant funds, to develop and maintain an
integrated system of community health services and maximize coordination of
family planning services. Current law excludes from the definition of “family
planning” the performance, promotion, encouragement, or counseling in favor of, or
referral either directly or through an intermediary for, voluntary termination of
pregnancy but includes in the definition of “family planning” the provision of
nondirective information explaining prenatal care and delivery or infant care, foster
care, or adoption. DHS must distribute women's health funds only to public entities.
Currently, those public entities may provide some or all of the funds to other public
entities or private entities as long as the recipients of the funds do not provide
abortion services, make referrals for abortion services, or have an affiliate that
provides abortion services or makes referrals for abortion services. The bill retains
the authorization for the public entity that receives funds from DHS to provide some
or all of the funds to other public or private entities but eliminates the restriction on
which public or private entities may receive those funds. The bill also includes in the
definition of “family planning” the provision of nondirective information explaining
pregnancy termination.
Grants to free and charitable clinics
Under current law, DHS is required to award grants each fiscal year to several
classes of community health centers. A community health center is a health care
entity that provides primary health care, health education, and social services to
low-income individuals. The 2019 biennial budget act,
2019 Wisconsin Act 9,
required DHS to annually award $500,000 in grants to free and charitable clinics
from the same community health services appropriation. The bill continues the
grant for free and charitable clinics and directs DHS to annually award $2,500,000
in grants to free and charitable clinics. The bill defines “free and charitable clinics”
as health care organizations that use a volunteer and staff model to provide health
services to uninsured, underinsured, underserved, economically and socially
disadvantaged, and vulnerable populations and that meet criteria specified in the
bill.
Black women's health and infant and maternal mortality
The bill instructs DHS to annually award $1,750,000 in grants to
community-serving organizations that are led by Black women that improve Black
women's health in Dane, Milwaukee, Rock, and Kenosha Counties. Further, the bill
directs DHS to annually award $1,750,000 in grants to organizations that work to
reduce racial disparities related to infant and maternal mortality. Additionally, the
bill instructs DHS to award a grant totaling $500,000 in fiscal year 2021-22 and
another grant totaling $500,000 in fiscal year 2022-23 to an entity to coordinate
efforts between the state, public and private sector organizations, and community
organizations to support a statewide strategy to advance Black women's health.
Alzheimer's family and caregiver support
Under current law, DHS distributes funds for certain community aids,
including for the Alzheimer's family and caregiver support program. The bill
increases the community aid funding available for the Alzheimer's family and
caregiver support program from not more than $2,558,900 each fiscal year to not
more than $3,058,900 each fiscal year, and broadens financial eligibility for the
program by increasing the maximum joint income an individual and the individual's
spouse may earn per year and remain financially eligible from $48,000 to $55,000.
Health equity grants
The bill directs DHS to award grants to community organizations to implement
community health worker care models. The bill also directs DHS to award grants
to community organizations and local or tribal health departments to hire health
equity strategists and to implement health equity action plans.
Lead screening and outreach grants
Under current law, DHS must award grants related to lead poisoning and lead
exposure prevention. The bill increases the amount of money granted to fund lead
screening and outreach activities at community-based human service agencies that
provide primary health care, health education, and social services to low-income
individuals in first class cities from $125,000 each fiscal year to $175,000. Currently,
the only first class city is Milwaukee.
Wisconsin drug repository program
Under current law, DHS is required to maintain a drug repository program
under which persons may donate certain drugs or supplies that may be used by other
individuals identified by the department by rule. The bill allows DHS to partner
with out-of-state drug repository programs. The bill also allows out-of-state
persons to donate to the drug repository program in Wisconsin, and persons in
Wisconsin to donate to participating drug repository programs in other states.
Further, the bill directs DHS to study and implement a centralized physical drug
repository program.
Surgical quality improvement grant
The bill allows, but does not require, DHS to award a onetime grant up to a total
amount of $335,000 in fiscal year 2021-22 to support surgical quality improvement
activities. The bill allows DHS to transfer moneys appropriated for this grant from
fiscal year 2021-22 to fiscal year 2022-23.
Spinal cord injury research grants and symposia
The bill requires DHS to establish a program to award grants to persons in this
state for research into spinal cord injuries. The grants must support research into
new and innovative treatments and rehabilitative efforts for the functional
improvement of people with spinal cord injuries. Research topics may include
pharmaceutical, medical device, brain stimulus, and rehabilitative approaches and
techniques. DHS must make annual reports to the legislature about the grants. The
bill also allows DHS to hold symposia every two years for grant recipients to present
their research findings. The bill biennially appropriates general purpose revenues
not exceeding $3,000,000 for the grants and symposia.
The bill also requires DHS to appoint a Spinal Cord Injury Council with one
member representing the University of Wisconsin School of Medicine and Public
Health, one member representing the Medical College of Wisconsin, and the
following members: 1) a person with a spinal cord injury; 2) a family member of a
person with a spinal cord injury; 3) a veteran with a spinal cord injury; 4) a physician
specializing in the treatment of spinal cord injuries; 5) a neurosurgery researcher;
and 6) a researcher employed by the Veterans Health Administration of the U.S.
Department of Veterans Affairs. If DHS is unable to appoint any of the foregoing
members, the bill allows DHS to appoint, in lieu of that member, a member
representing the general public. Members of the council have two-year terms. The
bill requires the council to develop criteria for DHS to evaluate and award grants,
review and make recommendations on grant applications, and perform other duties
specified by DHS. Council members must make written disclosures of financial
interests in organizations that the council recommends for grants.
Public health campaign to prevent tobacco and vapor product use
The bill allows DHS to develop and carry out a public health campaign aimed
at the prevention of initiation of tobacco and vapor product use. The bill also allows
DHS to distribute grants to local and regional organizations working on youth
vaping and providing cessation services.
Direct support professional training pilot program
The bill directs DHS to develop and implement a pilot program in the 2021-23
biennium to provide person-centered direct support professional training to achieve
consistent standards of health care practice. The bill instructs DHS to collaborate
with DWD, TCS, and health care providers in developing and implementing the pilot
program. Further, the bill directs DHS to develop a career plan that describes the
steps that lead to potential certification as a nurse aide.
Behavioral health and developmental disabilities
Guardianship training requirements
The bill establishes mandatory initial training requirements for certain
guardians. Under current law, a guardian of the person is a person appointed by a
court to act to secure any necessary care or services for the ward that are in the ward's
best interests, and a guardian of the estate is a person appointed by a court to provide
a ward with the greatest amount of independence and self-determination with
respect to property management. Currently, there are no training requirements for
guardians of the person or guardians of the estate.
Under the bill, guardians of the person must complete training on all of the
following topics: 1) the duties and responsibilities of a guardian of the person under
the law and limits of the guardian of the person's decision-making authority; 2)
alternatives to guardianship, included supported decision-making and powers of
attorney; 3) rights retained by the ward; 4) best practices for a guardian to solicit and
understand the wishes and preferences of a ward, to involve a ward in
decision-making, and to take a ward's wishes and preferences into account in
decisions made by the guardian; 5) restoration of a ward's rights and the process for
removal of guardianship; 6) future planning and identification of a potential standby
or successor guardian; and 7) resources and technical support for guardians. The bill
also requires that guardians of the estate complete training on the duties and
responsibilities of a guardian of the estate under the law, limits of a guardian of the
estate's decision-making authority, and inventory and accounting requirements.
The bill provides limited exemptions for guardians of minors and children and
certain corporate and volunteer guardians.
Under the bill, a proposed guardian of the person or a proposed guardian of the
estate must submit, as part of the guardianship case, a sworn and notarized
statement to the court that the proposed guardian has completed the training
requirements.
The bill requires DHS to award a grant to administer and conduct the required
guardian training. DHS must require, in the request for proposal, that the grantee
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. In addition, the grantee selected to develop
training 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.
Early intervention services for children with lead in their blood
Under current law, DHS implements a statewide program, referred to as the
Birth to 3 program, that provides early intervention services for children aged three
and under who are developmentally delayed or are diagnosed as having a condition
that is likely to result in significantly delayed development. The bill ensures that
children with a concentration of lead in their blood of at least 5 micrograms per 100
milliliters of blood are eligible for services under the Birth to 3 program.
Crisis response system
The bill requires DHS to award grants to entities to provide a continuum of
mental health crisis services, including crisis urgent care and observation centers,
crisis stabilization and inpatient psychiatric beds, and crisis stabilization facilities.
DHS must also award up to five grants for services at facilities providing crisis
stabilization services. The bill also allows DHS to create a certification for crisis
urgent care and observation centers and establish criteria for that certification by
rule. If DHS creates the certification, then no one may operate a crisis urgent care
and observation center without a certification.
Bed tracking system
Currently, DHS is required to award a grant to the entity that collects data on
hospitals for the purpose of developing and operating a system to show the
availability of inpatient psychiatric beds. To receive the grant, the entity must use
a secure website to allow reporting of and access to information on the availability
and location of psychiatric beds by hospitals and inpatient units. The bill expands
the system to include reporting of availability of peer run respite and crisis
stabilization beds by facilities, centers, and programs and expands access to the
system to county departments and any other entity that is involved in identifying
placement options. The bill also increases the amount of the grant awarded in each
fiscal year.
Crisis program enhancement grants
The bill expands the crisis program enhancement grant program to include
grants to establish and enhance law enforcement and behavioral health emergency
response collaboration services and grants to Milwaukee County to enhance mobile
crisis teams. Under current law, the program requires DHS to award grants to
counties or regions of counties to establish or enhance crisis programs to serve
individuals having crises in rural areas. The bill instructs DHS to annually award
at least $1,250,000 to establish and enhance law enforcement and behavioral health
services emergency response collaboration programs, and at least $850,000 to
Milwaukee County to enhance mobile crisis teams.
The bill requires any entity, including a county or region, that receives a grant
to establish and enhance law enforcement and behavioral health services emergency
response collaboration programs to contribute at least 25 percent of the grant
amount awarded for the purpose that the grant money is received.
County crisis call center support
Under current law, DHS awards several grants during each fiscal biennium to
certain entities for various programs involving mental health and crisis
intervention. The bill directs DHS to annually award grants to support mental
health professionals to provide supervision and consultation to individuals who
support crisis call center services. The bill specifies that each county or multicounty
program that receives supervision and consultation services from a mental health
professional awarded a grant under this program shall contribute at least 10 percent
of the costs of the services that the mental health professional incurs for the purpose
that the grant is received.
Trauma response teams
