Amendment SA4-SSA2-SB70

SB70-SSA2-SA4,158,2 (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-SSA2-SA4,158,4 (c) A crisis urgent care and observation facility certified under this section shall do all of the following:

SB70-SSA2-SA4,158,8 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-SSA2-SA4,158,10 2. Abstain from having a requirement for medical clearance before admission assessment.

SB70-SSA2-SA4,158,12 3. Provide assessments for physical health, substance use disorder, and mental health.

SB70-SSA2-SA4,158,13 4. Provide screens for suicide and violence risk.

SB70-SSA2-SA4,158,14 5. Provide medication management and therapeutic counseling.

SB70-SSA2-SA4,158,15 6. Provide coordination of services for basic needs.

SB70-SSA2-SA4,158,20 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-SSA2-SA4,158,24 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-SSA2-SA4,159,5 (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-SSA2-SA4,159,12 (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-SSA2-SA4,159,15 (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-SSA2-SA4,159,25 (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-SSA2-SA4,160,1 189. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,160,2 “ Section 184. 46.48 (35) of the statutes is created to read:

SB70-SSA2-SA4,160,5 46.48 (35) Psychiatric residential treatment facilities. The department may distribute not more than $1,790,000 in each fiscal year to support psychiatric residential treatment facilities.

SB70-SSA2-SA4,185 Section 185. 49.46 (2) (b) 14c. of the statutes is created to read:

SB70-SSA2-SA4,160,8 49.46 (2) (b) 14c. Subject to par. (bv), services by a psychiatric residential treatment facility.

SB70-SSA2-SA4,186 Section 186. 49.46 (2) (bv) of the statutes is created to read:

SB70-SSA2-SA4,160,17 49.46 (2) (bv) The department shall submit to the federal department of health and human services any request for a state plan amendment, waiver, or other federal approval necessary to provide reimbursement for services by a psychiatric residential treatment facility. If the federal department of health and human services approves the request or if no federal approval is necessary, the department shall provide reimbursement under par. (b) 14c. If the federal department of health and human services disapproves the request, the department may not provide reimbursement for services under par. (b) 14c.

SB70-SSA2-SA4,187 Section 187. 51.044 of the statutes is created to read:

SB70-SSA2-SA4,160,24 51.044 Psychiatric residential treatment facilities. (1) Definition. In this section, “psychiatric residential treatment facility” is a non-hospital facility that provides inpatient comprehensive mental health treatment services to individuals under the age of 21 who, due to mental illness, substance use, or severe emotional disturbance, need treatment that can most effectively be provided in a residential treatment facility.

SB70-SSA2-SA4,161,4 (2) Certification required; exemption. (a) No person may operate a psychiatric residential treatment facility without a certification from the department. The department may limit the number of certifications it grants to operate a psychiatric residential treatment facility.

SB70-SSA2-SA4,161,6 (b) A psychiatric residential treatment facility that has a certification from the department under this section is not subject to facility regulation under ch. 48.

SB70-SSA2-SA4,161,7 (3) Rules. The department may promulgate rules to implement this section.

SB70-SSA2-SA4,9119 Section 9119. Nonstatutory provisions; Health Services.

SB70-SSA2-SA4,161,21 (1) Emergency rules on psychiatric residential treatment facilities. The department of health services may promulgate emergency rules under s. 227.24 implementing certification of psychiatric residential treatment facilities under s. 51.044, including development of a new provider type and a reimbursement model for psychiatric residential treatment facilities under the Medical Assistance program under subch. IV of ch. 49. Notwithstanding s. 227.24 (1) (a) and (3), the department of health services 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. Notwithstanding s. 227.24 (1) (c) and (2), emergency rules promulgated under this subsection remain in effect until July 1, 2025, or the date on which permanent rules take effect, whichever is sooner.”.

SB70-SSA2-SA4,161,22 190. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,161,23 “ Section 188. 20.435 (5) (bw) of the statutes is amended to read:

SB70-SSA2-SA4,162,5 20.435 (5) (bw) Child psychiatry and addiction medicine consultation programs Mental health consultation program. Biennially, the amounts in the schedule for operating the child psychiatry consultation program under s. 51.442 and the addiction medicine consultation program under s. 51.448 mental health consultation program under s. 51.443.

SB70-SSA2-SA4,189 Section 189. 20.435 (5) (bx) of the statutes is created to read:

SB70-SSA2-SA4,162,9 20.435 (5) (bx) Addiction medicine consultation program. Biennially, the amounts in the schedule for operating the addiction medicine consultation program under s. 51.448.

SB70-SSA2-SA4,190 Section 190. 20.435 (5) (ct) of the statutes is repealed.

SB70-SSA2-SA4,191 Section 191. 51.441 of the statutes is repealed.

SB70-SSA2-SA4,192 Section 192. 51.442 of the statutes is repealed.

SB70-SSA2-SA4,193 Section 193. 51.443 of the statutes is created to read:

SB70-SSA2-SA4,162,14 51.443 Mental health consultation program. (1) In this section:

SB70-SSA2-SA4,162,17 (a) “Participating clinicians” includes physicians, nurse practitioners, physician assistants, and medically appropriate members of the care teams of physicians, nurse practitioners, and physician assistants.

SB70-SSA2-SA4,162,19 (b) “Program” means the mental health consultation program under this section.

SB70-SSA2-SA4,163,2 (2) During the fiscal year 2023-24, the department shall contract with the organization that provided consultation services through the child psychiatry consultation program under s. 51.442, 2021 stats., as of January 1, 2023, to administer the mental health consultation program described under this section. In subsequent fiscal years, the department shall contract with the organization that provided consultation services through the child psychiatry consultation program under s. 51.442, 2021 stats., as of January 1, 2023, or another organization to administer the mental health consultation program under this section.

SB70-SSA2-SA4,163,8 (3) The contracting organization under sub. (2) shall administer a mental health consultation program that incorporates a comprehensive set of mental health consultation services, which may include perinatal, child, adult, geriatric, pain, veteran, and general mental health consultation services, and may contract with any other entity to perform any operations and satisfy any requirements under this section for the program.

SB70-SSA2-SA4,163,10 (4) As a condition of providing services through the program, the contracting organization under sub. (2) shall do all of the following:

SB70-SSA2-SA4,163,18 (a) Ensure that all mental health care providers who are providing services through the program have the applicable credential from this state; if a psychiatric professional, that the provider is eligible for certification or is certified by the American Board of Psychiatry and Neurology for adult psychiatry, child and adolescent psychiatry, or both; and if a psychologist, that the provider is registered in a professional organization, including the American Psychological Association, National Register of Health Service Psychologists, Association for Psychological Science, or the National Alliance of Professional Psychology Providers.

SB70-SSA2-SA4,163,20 (b) Maintain the infrastructure necessary to provide the program's services statewide.

SB70-SSA2-SA4,163,22 (c) Operate the program on weekdays during normal business hours of 8 a.m. to 5 p.m.

SB70-SSA2-SA4,163,24 (d) Provide consultation services under the program as promptly as is practicable.

SB70-SSA2-SA4,164,4 (e) Have the capability to provide consultation services by, at a minimum, telephone and email. Consultation through the program may be provided by teleconference, video conference, voice over Internet protocol, email, pager, in-person conference, or any other telecommunication or electronic means.

SB70-SSA2-SA4,164,5 (f) Provide all of the following services through the program:

SB70-SSA2-SA4,164,7 1. Support for participating clinicians to assist in the management of mental health concerns.

SB70-SSA2-SA4,164,10 2. Triage-level assessments to determine the most appropriate response to each request, including appropriate referrals to any community providers and health systems.

SB70-SSA2-SA4,164,11 3. When medically appropriate, diagnostics and therapeutic feedback.

SB70-SSA2-SA4,164,13 4. Recruitment of other clinicians into the program as participating clinicians when possible.

SB70-SSA2-SA4,164,14 (g) Report to the department any information requested by the department.

SB70-SSA2-SA4,164,23 (h) Conduct annual surveys of participating clinicians who use the program to assess the quality of care provided, self-perceived levels of confidence in providing mental health services, and satisfaction with the consultations and other services provided through the program. Immediately after participating clinicians begin using the program and again 6 to 12 months later, the contracting organization under sub. (2) may conduct assessments of participating clinicians to assess the barriers to and benefits of participation in the program to make future improvements and to determine the participating clinicians' treatment abilities, confidence, and awareness of relevant resources before and after beginning to use the program.

SB70-SSA2-SA4,165,2 (5) Services provided under sub. (4) (b) to (h) are eligible for funding from the department. The contracting organization under sub. (2) also may provide any of the following services under the program that are eligible for funding from the department:

SB70-SSA2-SA4,165,5 (a) Second opinion diagnostic and medication management evaluations and community resource referrals conducted by either a psychiatrist or allied health professionals.

SB70-SSA2-SA4,165,8 (b) In-person or web-based educational seminars and refresher courses on a medically appropriate topic within mental or behavioral health care provided to any participating clinician who uses the program.

SB70-SSA2-SA4,165,9 (c) Data evaluation and assessment of the program.”.

SB70-SSA2-SA4,165,10 191. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,165,11 “ Section 194. 46.48 (22) of the statutes is created to read:

SB70-SSA2-SA4,165,15 46.48 (22) Health care provider innovation grants. The department may distribute not more than $14,550,000 in each fiscal year as grants to health care providers and long-term care providers to implement best practices and innovative solutions to increase worker recruitment and retention.”.

SB70-SSA2-SA4,165,16 192. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,165,17 “ Section 195. 20.435 (4) (jw) of the statutes is amended to read:

SB70-SSA2-SA4,166,2 20.435 (4) (jw) BadgerCare Plus and hospital assessment. All moneys received from payment of enrollment fees under the program under s. 49.45 (23), all moneys transferred under s. 50.38 (9), all moneys transferred under s. 256.23 (6), all moneys transferred from the appropriation account under par. (jz), and 10 percent of all moneys received from penalty assessments under s. 49.471 (9) (c), for administration of the program under s. 49.45 (23), to provide a portion of the state share of administrative costs for the BadgerCare Plus Medical Assistance program under s. 49.471, and for administration of the hospital assessment under s. 50.38, and for administration of the ambulance service provider fee under s. 256.23.

SB70-SSA2-SA4,196 Section 196. 20.435 (4) (xm) of the statutes is created to read:

SB70-SSA2-SA4,166,8 20.435 (4) (xm) Ambulance service provider trust fund; ambulance payments. From the ambulance service provider trust fund, all moneys received from the assessment under s. 256.23, except amounts transferred to the appropriation under s. 20.435 (4) (jw) as specified in s. 256.23 (6), to make payments to eligible ambulance service providers as specified under s. 49.45 (3) (em).

SB70-SSA2-SA4,197 Section 197. 49.45 (3) (em) of the statutes is amended to read:

SB70-SSA2-SA4,166,17 49.45 (3) (em) The department shall expend moneys collected under s. 256.23 (2), less amounts transferred under s. 256.23 (6), to supplement reimbursement for eligible ambulance service providers, as defined in s. 256.23 (1) (a), for services provided under the Medical Assistance program under this subchapter, including services reimbursed on a fee-for-service basis and provided under managed care, by eligible ambulance service providers. Health plans shall be indemnified and held harmless for any errors made by the department or its agents in calculation of any supplemental reimbursement made under this paragraph.

SB70-SSA2-SA4,198 Section 198. 256.23 (6) of the statutes is created to read:

SB70-SSA2-SA4,166,23 256.23 (6) In each fiscal year, the secretary of administration shall transfer from the ambulance service provider trust fund under s. 25.776 to the appropriation under s. 20.435 (4) (jw) an amount equal to the annual costs of administering the ambulance assessment as specified under this section and making supplemental reimbursements to ambulance service providers under s. 49.45 (3) (em).”.

SB70-SSA2-SA4,166,24 193. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,167,1 “ Section 199. 49.46 (2) (b) 24. of the statutes is created to read:

SB70-SSA2-SA4,167,3 49.46 (2) (b) 24. Subject to par. (by), nonmedical services that contribute to the determinants of health.

SB70-SSA2-SA4,200 Section 200. 49.46 (2) (by) of the statutes is created to read:

SB70-SSA2-SA4,167,11 49.46 (2) (by) The department shall determine those services under par. (b) 24. that contribute to the determinants of health. The department shall seek any necessary state plan amendment or request any waiver of federal Medicaid law to implement this paragraph. The department is not required to provide the services under this paragraph as a benefit under the Medical Assistance program if the federal department of health and human services does not provide federal financial participation for the services under this paragraph.”.

SB70-SSA2-SA4,167,12 194. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,167,13 “ Section 201. 49.45 (39) (b) 1. of the statutes is amended to read:

SB70-SSA2-SA4,168,22 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a cooperative educational service agency elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district or the cooperative educational service agency for 60 100 percent of the federal share of allowable charges for the school medical services that it provides and, as specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the department of public instruction for 60 100 percent of the federal share of allowable charges for the school medical services that the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing provides and, as specified in subd. 2., for allowable administrative costs. A school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired, or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, claims for common carrier transportation costs as a school medical service unless the department receives notice from the federal health care financing administration that, under a change in federal policy, the claims are not allowed. If the department receives the notice, a school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired, or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, unreimbursed claims for common carrier transportation costs incurred before the date of the change in federal policy. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. All other expenses for the school medical services provided by a school district or a cooperative educational service agency shall be paid for by the school district or the cooperative educational service agency with funds received from state or local taxes. The school district, the Wisconsin Center for the Blind and Visually Impaired, the Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the cooperative educational service agency shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.

SB70-SSA2-SA4,202 Section 202. 49.45 (39) (b) 2. of the statutes is amended to read:

SB70-SSA2-SA4,169,8 49.45 (39) (b) 2. `Payment for school medical services administrative costs.' The department shall reimburse a school district or a cooperative educational service agency specified under subd. 1. and shall reimburse the department of public instruction on behalf of the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing for 90 100 percent of the federal share of allowable administrative costs, using time studies, beginning in fiscal year 1999-2000. A school district or a cooperative educational service agency may submit, and the department of health services shall allow, claims for administrative costs incurred during the period that is up to 24 months before the date of the claim, if allowable under federal law.”.

SB70-SSA2-SA4,169,9 195. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,169,10 “ Section 203. 49.45 (30t) of the statutes is created to read:

SB70-SSA2-SA4,169,11 49.45 (30t) Doula services. (a) In this subsection:

SB70-SSA2-SA4,169,13 1. “Certified doula” means an individual who has received certification from a doula certifying organization recognized by the department.

SB70-SSA2-SA4,169,16 2. “Doula services” means childbirth education and support services, including emotional and physical support provided during pregnancy, labor, birth, and the postpartum period.

SB70-SSA2-SA4,169,22 (b) The department shall request from the secretary of the federal department of health and human services any required waiver or any required amendment to the state plan for Medical Assistance to allow reimbursement for doula services provided by a certified doula. If the waiver or state plan amendment is granted, the department shall reimburse a certified doula under s. 49.46 (2) (b) 12p. for the allowable charges for doula services provided to Medical Assistance recipients.

SB70-SSA2-SA4,204 Section 204. 49.46 (2) (b) 12p. of the statutes is created to read:

SB70-SSA2-SA4,170,2 49.46 (2) (b) 12p. Doula services provided by a certified doula, as specified under s. 49.45 (30t).”.