Amendment AA3-SB70

SB70-AA3,231,11 254. Page 374, line 11: after that line insert:

SB70-AA3,231,12 “ Section 245m. 46.48 (34) of the statutes is created to read:

SB70-AA3,231,15 46.48 (34) Stimulant prevention and treatment response programs. The department may distribute not more than $1,644,000 in each fiscal year to support stimulant use prevention and treatment programs and services.”.

SB70-AA3,231,16 255. Page 374, line 11: after that line insert:

SB70-AA3,231,17 “ Section 296. 20.435 (1) (b) of the statutes is amended to read:

SB70-AA3,232,5 20.435 (1) (b) General aids and local assistance. The amounts in the schedule for aids and local assistance relating to public health services , for grants for the suicide prevention program under s. 255.20 (4), and for grants for community programs under s. 46.48. Notwithstanding ss. 20.001 (3) (a) and 20.002 (1), the department may transfer funds between fiscal years under this paragraph. Except as otherwise provided in this paragraph, all funds allocated but not encumbered by December 31 of each year lapse to the general fund on the next January 1 unless carried forward to the next calendar year by the joint committee on finance.

SB70-AA3,297 Section 297. 255.20 (4) of the statutes is created to read:

SB70-AA3,232,11 255.20 (4) (a) Implement a suicide prevention program that creates public awareness for issues relating to suicide prevention, builds community networks, and conducts training programs on suicide prevention for law enforcement personnel, health care providers, school employees, and other persons who have contact with persons at risk of suicide.

SB70-AA3,232,13 (b) As part of the suicide prevention program under this subsection, the department shall do all of the following:

SB70-AA3,232,14 1. Coordinate suicide prevention activities with other state agencies.

SB70-AA3,232,16 2. Provide educational activities to the general public relating to suicide prevention.

SB70-AA3,232,19 3. Provide training to persons who routinely interact with persons at risk of suicide, including training on recognizing persons at risk of suicide and referring those persons for appropriate treatment or support services.

SB70-AA3,232,21 4. Develop and carry out public awareness and media campaigns in each county targeting groups of persons who are at risk of suicide.

SB70-AA3,232,22 5. Enhance crisis services relating to suicide prevention.

SB70-AA3,232,25 6. Link persons trained in the assessment of and intervention in suicide with schools, public community centers, nursing homes, and other facilities serving persons most at risk of suicide.

SB70-AA3,233,2 7. Coordinate the establishment of local advisory groups in each county to support the efforts of the suicide prevention program under this subsection.

SB70-AA3,233,7 8. Work with groups advocating suicide prevention, community coalitions, managers of existing crisis hotlines that are nationally accredited or certified, and staff members of mental health agencies in this state to identify and address the barriers that interfere with providing services to groups of persons who are at risk of suicide.

SB70-AA3,233,11 9. Develop and maintain a website with links to appropriate resource documents, suicide hotlines that are nationally accredited or certified, credentialed professional personnel, state and local mental health agencies, and appropriate national organizations.

SB70-AA3,233,14 10. Review current research on data collection for factors related to suicide and develop recommendations for improved systems of surveillance for suicide and uniform collection of data related to suicide.

SB70-AA3,233,16 11. Develop and submit proposals for funding from federal government agencies and nongovernmental organizations.

SB70-AA3,233,17 12. Administer grant programs involving suicide prevention.

SB70-AA3,233,20 (c) 1. The department shall award grants to organizations or coalitions of organizations, which may include a city, village, town, county, or federally recognized American Indian tribe or band in this state for any of the following purposes:

SB70-AA3,233,22 a. To train staff at a firearm retailer or firearm range on how to recognize a person that may be considering suicide.

SB70-AA3,233,24 b. To provide suicide prevention materials for distribution at a firearm retailer or firearm range.

SB70-AA3,233,25 c. To provide voluntary, temporary firearm storage.

SB70-AA3,234,3 2. The department may not award a grant under subd. 1. unless the recipient contributes matching funds or in-kind services having a value equal to at least 20 percent of the grant.

SB70-AA3,234,11 3. The department may not award a grant to a recipient under subd. 1. for an amount that exceeds $5,000. The department may not award a grant under subd. 1. having a duration of more than one year and may not automatically renew a grant awarded under subd. 1. This subdivision shall not be construed to prevent an organization or coalition of organizations from reapplying for a grant in consecutive years. In awarding grants under subd. 1., the department shall give preference to organizations or coalitions of organizations that have not previously received a grant under this paragraph.

SB70-AA3,234,14 (d) From the appropriation under s. 20.435 (1) (b), the department may distribute up to $500,000 in grants each fiscal year for grants under this subsection, up to $75,000 of which may be distributed each fiscal year for grants under par. (c).”.

SB70-AA3,234,15 256. Page 374, line 11: after that line insert:

SB70-AA3,234,16 “ Section 298. 254.11 (5m) of the statutes is repealed.

SB70-AA3,299 Section 299. 254.11 (9) of the statutes is amended to read:

SB70-AA3,234,19 254.11 (9) “Lead poisoning or lead exposure" means a level of lead in the blood of 5 3.5 or more micrograms per 100 milliliters of blood.

SB70-AA3,300 Section 300. 254.166 (1) of the statutes is amended to read:

SB70-AA3,235,19 254.166 (1) The department may shall, after being notified that an occupant of a dwelling or premises who is under 6 years of age has blood lead poisoning or lead exposure, present official credentials to the owner or occupant of the dwelling or premises, or to a representative of the owner, and request admission to conduct a lead investigation of the dwelling or premises. If the department is notified that an occupant of a dwelling or premises who is a child under 6 years of age has an elevated blood lead level blood lead poisoning or lead exposure, the department shall conduct a lead investigation of the dwelling or premises or ensure that a lead investigation of the dwelling or premises is conducted. The lead investigation shall be conducted during business hours, unless the owner or occupant of the dwelling or premises consents to an investigation during nonbusiness hours or unless the department determines that the dwelling or premises presents an imminent lead hazard. The department shall use reasonable efforts to provide prior notice of the lead investigation to the owner of the dwelling or premises. The department may remove samples or objects necessary for laboratory analysis to determine the presence of a lead hazard in the dwelling or premises. The department shall prepare and file written reports of all lead investigations conducted under this section and shall make the contents of these reports available for inspection by the public, except for medical information, which may be disclosed only to the extent that patient health care records may be disclosed under ss. 146.82 to 146.835. If the owner or occupant refuses admission, the department may seek a warrant to investigate the dwelling or premises. The warrant shall advise the owner or occupant of the scope of the lead investigation.”.

SB70-AA3,235,20 257. Page 374, line 11: after that line insert:

SB70-AA3,235,22 “ Section 301. 49.45 (41) (a) of the statutes is renumbered 49.45 (41) (a) (intro.) and amended to read:

SB70-AA3,236,3 49.45 (41) (a) (intro.) In this subsection, “crisis intervention services" means crisis intervention services for the treatment of mental illness, intellectual disability, substance abuse, and dementia that are provided by a any of the following:

SB70-AA3,236,5 2. A crisis intervention program operated by, or under contract with, a county, if the county is certified as a medical assistance provider.

SB70-AA3,302 Section 302. 49.45 (41) (a) 1. of the statutes is created to read:

SB70-AA3,236,8 49.45 (41) (a) 1. A crisis urgent care and observation facility certified under s. 51.036.

SB70-AA3,303 Section 303. 49.45 (41) (b) of the statutes is amended to read:

SB70-AA3,236,18 49.45 (41) (b) If a county elects to become certified as a provider of crisis intervention services under par. (a) 2., the county may provide crisis intervention services under this subsection in the county to medical assistance recipients through the medical assistance program. A county that elects to provide the services shall pay the amount of the allowable charges for the services under the medical assistance program that is not provided by the federal government. The department shall reimburse the county under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

SB70-AA3,304 Section 304. 49.45 (41) (c) (intro.) of the statutes is amended to read:

SB70-AA3,236,23 49.45 (41) (c) (intro.) Notwithstanding par. (b), if a county elects, pursuant to par. (a) 2., to deliver crisis intervention services under the Medical Assistance program on a regional basis according to criteria established by the department, all of the following apply:

SB70-AA3,305 Section 305. 49.45 (41) (d) of the statutes is created to read:

SB70-AA3,237,7 49.45 (41) (d) The department shall request any necessary federal approval required to provide reimbursement to crisis urgent care and observation facilities certified under s. 51.036 for crisis intervention services under this subsection. If federal approval is granted or no federal approval is required, the department shall provide reimbursement under s. 49.46 (2) (b) 15. If federal approval is necessary but is not granted, the department may not provide reimbursement for crisis intervention services provided by crisis urgent care and observation facilities.

SB70-AA3,306 Section 306. 51.036 of the statutes is created to read:

SB70-AA3,237,10 51.036 Crisis urgent care and observation facilities. (1) Definitions. In this section:

SB70-AA3,237,15 (a) “Crisis” means a situation caused by an individual's apparent mental or substance use disorder that results in a high level of stress or anxiety for the individual, persons providing care for the individual, or the public and that is not resolved by the available coping methods of the individual or by the efforts of those providing ordinary care or support for the individual.

SB70-AA3,237,19 (b) “Crisis urgent care and observation facility” means a treatment facility that admits an individual to prevent, de-escalate, or treat the individual's mental health or substance use disorder and includes the necessary structure and staff to support the individual's needs relating to the mental health or substance use disorder.

SB70-AA3,238,4 (2) Certification required; exemption. (a) The department shall establish a certification process for crisis urgent care and observation facilities and may establish criteria by rule for the certification of crisis urgent care and observation facilities. The department may limit the number of certifications it grants to operate crisis urgent care and observation facilities. No person may operate a crisis urgent care and observation facility without a certification under this section. The department shall establish by rule a process for crisis urgent care and observation facilities to apply to the department for certification of the facility for the receipt of funds for services provided as a benefit to a recipient under the Medical Assistance program.

SB70-AA3,238,9 (b) A crisis urgent care and observation facility certified under this section is not subject to facility regulation under ch. 50, unless otherwise required due to the facility's licensure or certification for other services or purposes. A crisis urgent care and observation facility is not a hospital under s. 50.32 and nothing in this paragraph limits services a hospital may provide under s. 50.32.

SB70-AA3,238,11 (c) A crisis urgent care and observation facility certified under this section shall do all of the following:

SB70-AA3,238,15 1. Accept referrals for crisis services for both youths and adults, including involuntary patients under emergency detention, voluntary patients, walk-ins, and individuals brought by law enforcement, emergency medical responders, and other emergency medical services practitioners.

SB70-AA3,238,17 2. Abstain from having a requirement for medical clearance before admission assessment.

SB70-AA3,238,19 3. Provide assessments for physical health, substance use disorder, and mental health.

SB70-AA3,238,20 4. Provide screens for suicide and violence risk.

SB70-AA3,238,21 5. Provide medication management and therapeutic counseling.

SB70-AA3,238,22 6. Provide coordination of services for basic needs.

SB70-AA3,239,2 7. Have adequate staffing 24 hours a day, 7 days a week, with a multidisciplinary team including, as needed, psychiatrists or psychiatric nurse practitioners, nurses, licensed clinicians capable of completing assessments and providing necessary treatment, peers with lived experience, and other appropriate staff.

SB70-AA3,239,6 8. Allow for voluntary and involuntary treatment of individuals in crisis as a means to avoid unnecessary placement of those individuals in hospital inpatient beds and allow for an effective conversion to voluntary stabilization when warranted in the same setting.

SB70-AA3,239,11 (3) Admission. (a) A crisis urgent care and observation facility certified under this section may accept individuals for voluntary stabilization, observation and treatment, including for assessments for mental health or substance use disorder, screening for suicide and violence risk, and medication management and therapeutic counseling.

SB70-AA3,239,18 (b) A crisis urgent care and observation facility certified under this section may accept individuals for emergency detention under s. 51.15 if the facility agrees to accept the individual. A county crisis assessment under s. 51.15 (2) (c) is required prior to acceptance of an individual for purposes of emergency detention at a crisis urgent care and observation facility certified under this section. Medical clearance is not required before admission, but the facility shall provide necessary medical services on site.

SB70-AA3,239,21 (4) Grants. From the appropriation under s. 20.435 (5) (ck), the department shall award grants to individuals and entities to develop and support crisis urgent care and observation facilities under this section.

SB70-AA3,240,6 (5) Rules. The department may promulgate rules to implement this section, including requirements for admitting and holding individuals for purposes of emergency detention. The department may promulgate the rules under this section as emergency rules under s. 227.24. Notwithstanding s. 227.24 (1) (c) and (2), a rule promulgated under this subsection may remain in effect for not more than 24 months. Notwithstanding s. 227.24 (1) (a) and (3), the department is not required to provide evidence that promulgating a rule under this subsection as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subsection.”.

SB70-AA3,240,7 258. Page 374, line 11: after that line insert:

SB70-AA3,240,8 “ Section 307. 20.437 (1) (dd) of the statutes is amended to read:

SB70-AA3,240,20 20.437 (1) (dd) State out-of-home care, adoption services, and subsidized guardianships. The amounts in the schedule for foster care, institutional child care, and subsidized adoptions under ss. 48.48 (12) and 48.52, for the cost of care for children under s. 49.19 (10) (d), for the cost of placements of children 18 years of age or over in residential care centers for children and youth under voluntary agreements under s. 48.366 (3) or under orders that terminate as provided in s. 48.355 (4) (b) 4., 48.357 (6) (a) 4., or 48.365 (5) (b) 4., for the cost of the foster care monitoring system, for the cost of reimbursing counties and Indian tribes for subsidized guardianship payments under s. 48.623 (3) (a), for the cost of services to children with special needs who are under the guardianship of the department to prepare those children for adoption, and for the cost of postadoption services to children with special needs.

SB70-AA3,308 Section 308. 20.437 (1) (pd) of the statutes is amended to read:

SB70-AA3,241,10 20.437 (1) (pd) Federal aid; state out-of-home care, adoption services, and subsidized guardianships. All federal moneys received for meeting the costs of providing foster care, institutional child care, and subsidized adoptions under ss. 48.48 (12) and 48.52, the cost of care for children under s. 49.19 (10) (d), the cost of placements of children 18 years of age or over in residential care centers for children and youth under voluntary agreements under s. 48.366 (3) or under orders that terminate as provided in s. 48.355 (4) (b) 4., 48.357 (6) (a) 4., or 48.365 (5) (b) 4., the cost of reimbursing counties and Indian tribes for subsidized guardianship payments under s. 48.623 (3) (a), the cost of services to children with special needs who are under the guardianship of the department to prepare those children for adoption, and the cost of postadoption services to children with special needs. Disbursements for foster care under s. 49.32 (2) and for the purposes described under s. 48.627 may be made from this appropriation.

SB70-AA3,309 Section 309. 48.48 (8r) of the statutes is amended to read:

SB70-AA3,241,15 48.48 (8r) To reimburse county departments and Indian tribes, from the appropriations under s. 20.437 (1) (dd) and (pd), for subsidized guardianship payments made under s. 48.623 (1) or (6), including guardianships of Indian children ordered by tribal courts.

SB70-AA3,310 Section 310. 48.623 (1) (intro.) of the statutes is amended to read:

SB70-AA3,242,5 48.623 (1) Eligibility. (intro.) A county department or, as provided in sub. (3) (a), an Indian tribe or the department shall provide monthly subsidized guardianship payments in the amount specified in sub. (3) (b) to a guardian of a child under s. 48.977 (2) or under a substantially similar tribal law if the county department, Indian tribe, or department determines that the conditions specified in pars. (a) to (d) have been met. A county department or, as provided in sub. (3) (a), a tribe or the department shall also provide those payments for the care of a sibling of such a child, regardless of whether the sibling meets the conditions specified in par. (a), if the county department, Indian tribe, or department and the guardian agree on the appropriateness of placing the sibling in the home of the guardian. A guardian of a child under s. 48.977 (2) or under a substantially similar tribal law is eligible for monthly subsidized guardianship payments under this subsection if the county department, Indian tribe, or the department, whichever will be providing those payments, determines that all of the following apply:

SB70-AA3,311 Section 311. 48.623 (1) (b) 3. of the statutes is amended to read:

SB70-AA3,242,13 48.623 (1) (b) 3. The guardian is licensed as the child's foster parent and the guardian and all adults residing in the guardian's home meet the requirements specified in s. 48.685 or, for a guardianship of a child ordered by a tribal court in which the background investigation is conducted by the Indian tribe, all adults residing in the guardian's home meet either the requirements specified in s. 48.685 or the background check requirements for foster parent licensing under 42 USC 671 (a) (20).

SB70-AA3,312 Section 312. 48.623 (1) (c) of the statutes is amended to read:

SB70-AA3,242,20 48.623 (1) (c) An order under s. 48.345, 48.357, 48.363, 48.365, 938.345, 938.357, 938.363, or 938.365 or a tribal court under a substantially similar tribal law placing the child, or continuing the placement of the child, outside of the child's home has been terminated, or any proceeding in which the child has been adjudged to be in need of protection or services specified in s. 48.977 (2) (a) has been dismissed, as provided in s. 48.977 (3r) (a).

SB70-AA3,313 Section 313. 48.623 (2) (intro.) of the statutes is amended to read:

SB70-AA3,243,12 48.623 (2) Subsidized guardianship agreement. (intro.) Before a county department, an Indian tribe, or the department may approve the provision of subsidized guardianship payments under sub. (1) to a proposed guardian, the county department, Indian tribe, or department shall negotiate and enter into a written, binding subsidized guardianship agreement with the proposed guardian and provide the proposed guardian with a copy of the agreement. A subsidized guardianship agreement or an amended subsidized guardianship agreement may also name a prospective successor guardian of the child to assume the duty and authority of guardianship on the death or incapacity of the guardian. A successor guardian is eligible for monthly subsidized guardianship payments under this section only if the successor guardian is named as a prospective successor guardian of the child in a subsidized guardianship agreement or amended subsidized guardianship agreement that was entered into before the death or incapacity of the guardian, the conditions specified in sub. (6) (bm) are met, and the court appoints the successor guardian to assume the duty and authority of guardianship as provided in s. 48.977 (5m). A subsidized guardianship agreement shall specify all of the following:

SB70-AA3,314 Section 314. 48.623 (2) (c) of the statutes is amended to read:

SB70-AA3,243,16 48.623 (2) (c) That the county department, Indian tribe, or department will pay the total cost of the nonrecurring expenses that are associated with obtaining guardianship of the child, not to exceed $2,000.

SB70-AA3,315 Section 315. 48.623 (3) (a) of the statutes is amended to read:

SB70-AA3,244,8 48.623 (3) (a) Except as provided in this paragraph, the county department shall provide the monthly payments under sub. (1) or (6). An Indian tribe that has entered into an agreement with the department under sub. (8) shall provide the monthly payments under sub. (1) or (6) for guardianships of children ordered by the tribal court, or a county department may provide the monthly payments under sub. (1) or (6) for guardianships of children ordered by the tribal court if the county department has entered into an agreement with the governing body of an Indian tribe to provide those payments. The county department or Indian tribe shall provide those payments from moneys received under s. 48.48 (8r). The department shall reimburse county departments and Indian tribes for the cost of subsidized guardianship payments, including payments made by county departments for guardianships of Indian children ordered by tribal courts, from the appropriations under s. 20.437 (1) (dd) and (pd). In a county having a population of 750,000 or more or in the circumstances specified in s. 48.43 (7) (a) or 48.485 (1), the department shall provide the monthly payments under sub. (1) or (6). The department shall provide those payments from the appropriations under s. 20.437 (1) (cx) and (mx).

SB70-AA3,316 Section 316. 48.623 (3) (b) of the statutes is amended to read:

SB70-AA3,244,18 48.623 (3) (b) The county department or, as provided in par. (a), an Indian tribe or the department shall determine the initial amount of a monthly payment under sub. (1) or (6) for the care of a child based on the circumstances of the guardian and the needs of the child. That amount may not exceed the amount received under s. 48.62 (4) or a substantially similar tribal law by the guardian of the child for the month immediately preceding the month in which the guardianship order was granted. A guardian or an interim caretaker who receives a monthly payment under sub. (1) or (6) for the care of a child is not eligible to receive a payment under s. 48.57 (3m) or (3n) or 48.62 (4) for the care of that child.

SB70-AA3,317 Section 317. 48.623 (3) (c) 1. of the statutes is amended to read:

SB70-AA3,245,10 48.623 (3) (c) 1. If a person who is receiving monthly subsidized guardianship payments under an agreement under sub. (2) believes that there has been a substantial change in circumstances, as defined by the department by rule promulgated under sub. (7) (a), he or she may request that the agreement be amended to increase the amount of those payments. If a request is received under this subdivision, the county department, Indian tribe, or department shall determine whether there has been a substantial change in circumstances and whether there has been a substantiated report of abuse or neglect of the child by the person receiving those payments. If there has been a substantial change in circumstances and if there has been no substantiated report of abuse or neglect of the child by that person, the county department, Indian tribe, or department shall offer to increase the amount of those payments based on criteria established by the department by rule promulgated under sub. (7) (b). If an increased monthly subsidized guardianship payment is agreed to by the person receiving those payments, the county department, Indian tribe, or department shall amend the agreement in writing to specify the increased amount of those payments.

SB70-AA3,318 Section 318. 48.623 (3) (c) 2. of the statutes is amended to read: