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 improvement program.
Under the bill, DCF may use funding for the youth justice system improvement
program to support diversion programs, to address emergencies related to youth
aids, and 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 carried forward. 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 appropriation for the youth justice system improvement program.
Children and family services
Under current law, DCF must distribute not more than $101,154,200 in fiscal
year 2021-22 and $101,162,800 in fiscal year 2022-23 to counties for children and
family services. The bill updates those amounts to $101,564,700 in fiscal year
2023-24 and $101,961,600 in fiscal year 2024-25.
Intensive family preservation services
The bill creates new authority for DCF to provide intensive family preservation
services or to provide funding for a county department, a nonprofit or for-profit
corporation, a tribe, or a child welfare agency to provide intensive family
preservation services. The bill defines “intensive family preservation services” to
mean evidence-informed services or support aimed at preventing the removal of
children from the home under the Children's Code or the Juvenile Justice Code,
promoting the safety of children in the home, or serving children who are placed in
out-of-home care or who are involved in the juvenile justice system.
The bill also creates a new GPR appropriation for DCF to provide intensive
family preservation services.
Group care referral clearinghouse
The bill creates new authority for DCF to create, maintain, and require the use
of a group care referral clearinghouse, and to promulgate administrative rules
necessary to accomplish this.
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 CHIPS proceeding. However, a pilot program
that began in 2018 requires the state public defender to assign counsel to any
nonpetitioning parent in these cases in Brown, Outagamie, Racine, Kenosha, and
Winnebago Counties. This five-county pilot program is set to expire on June 30,
2023. The bill extends the expiration date of the pilot program to June 30, 2025.
Tribal family services grants and funding for out-of-home-care placements
by tribal courts
Current law uses Indian gaming receipts to fund tribal family service grants
and unexpected or unusually high-cost out-of-home-care placements of Indian
children by tribal courts. The bill appropriates GPR moneys for those purposes as
well.
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.
Sibling connections scholarships
The bill requires DCF to provide scholarships to adopted children and their
biological siblings who do not reside in the same household to attend programs
together in order to build sibling connections.
Child care partnership grant program
The bill authorizes DCF to establish a grant program to award funding to
businesses that provide or wish to provide child care services for their employees.
The bill allows such a grant to be used to reserve child care placements for local
business employees, pay child care tuition, and other costs related to child care.
Under the bill, a grant recipient must provide at least 25 percent matching funds.
The bill allows DCF to promulgate administrative rules to administer the grant
program, including to determine eligibility for a grant.
Emergency services
Ambulance assessment and certified public expenditures program
The bill creates an appropriation to make payments from the ambulance
service provider trust fund to eligible ambulance service providers as specified under
2021 Wisconsin Act 228. Act 228 implemented an ambulance service provider
assessment on private ambulance service providers for supplemental
reimbursements under the MA program and a supplemental reimbursement under
the MA program to public ambulance service providers through certified public
expenditures. Generally, under the MA program, the state provides its share of the
funding for benefits and the federal government then contributes its designated
share of funding, also known as federal financial participation. Act 228 imposes on
each private ambulance service provider a fee for the privilege of doing business in
this state and establishes an ambulance service provider trust fund for the fees
collected.
The bill also requires DHS to transfer moneys annually from the ambulance
service provider trust fund to cover the administrative costs associated with
administering the ambulance assessment and making supplemental
reimbursements to ambulance providers.
Certification of emergency medical responders
Under current law, no individual may act as an emergency medical responder
unless he or she is certified by DHS as an emergency medical responder. To be
eligible for certification as an emergency medical responder, current law requires an
individual to be at least 18 years of age, to be capable of performing the actions
required of an emergency medical responder, and to have completed an emergency
medical responder course that meets or exceeds the guidelines issued by the federal
National Highway Traffic Safety Administration. The bill requires DHS to certify
individuals as emergency medical responders who complete a certified training
program for emergency medical responders or pass the National Registry of
Emergency Medical Technicians (NREMT) examination for emergency medical
responders without requiring any further examination. However, the bill provides
that any relevant education, training, instruction, or other experience that an
applicant obtained in connection with any military service satisfies the completion
of a certified training program if the applicant demonstrates that the education,
training, instruction, or other experience obtained is substantially equivalent to the
certified course. The bill allows DHS, in consultation with the Emergency Medical
Services Board, to promulgate administrative rules to establish educational
standards for training programs for emergency medical responders and minimum
examination standards for training programs for emergency medical responders.
Further, the bill prohibits emergency medical responders from replacing emergency
medical technicians as members of an ambulance crew unless the emergency
medical responder has passed the NREMT examination for emergency medical
responders.
Epinephrine for ambulances
The bill requires that DHS reimburse ambulance service providers for a set of
two epinephrine auto-injectors or a set of two draw-up epinephrine kits for each
ambulance operating in this state. Under the bill, an ambulance service provider
means an ambulance service provider that is a public agency, volunteer fire
department, or nonprofit corporation. The bill also requires that, on an ongoing
basis, DHS must, upon request, reimburse ambulance service providers for
replacement sets of epinephrine auto-injectors or draw-up epinephrine kits. DHS
may only reimburse ambulance service providers for epinephrine if each ambulance
for which the ambulance service provider is reimbursed is staffed with an emergency
medical services provider who is qualified to administer the epinephrine.
Emergency medical services flex grant
During the 2021-23 fiscal biennium, DHS administered a grant program,
known as the Emergency Medical Services Flex grant program, under which DHS
awarded grants to emergency medical services providers for reasonable operating
expenses related to providing emergency medical services. The EMS Flex grants
were funded with moneys provided under the federal American Rescue Plan Act of
2021.
The bill allows DHS to award grants to emergency medical services providers
for the same purposes as DHS awarded grants under the EMS Flex grant program.
The bill provides GPR funding for this purpose as a continuing appropriation, which
means that any unencumbered balance at the end of a fiscal year does not lapse to
the general fund. In other words, DHS may continue to expend moneys appropriated
for grants to emergency medical services providers until the appropriation is fully
depleted.
Ambulance inspection
Under current law, prior to issuing a registration for an ambulance, DOT must
inspect the ambulance to determine whether it meets requirements for
specifications, medical equipment, supplies, and sanitation.
The bill provides that DHS, rather than DOT, must inspect an ambulance to
determine whether it meets requirements for medical equipment and prohibits DOT
from issuing a registration for an ambulance until DHS has conducted the
inspection. The bill authorizes DHS to promulgate administrative rules to establish
these medical equipment requirements for ambulances.
Health
Complex patient pilot program
The bill requires DHS to form an advisory group to assist with development and
implementation of a complex patient pilot program. Under the bill, the secretary of
health services shall serve as chair of the advisory group, and members must have
clinical, financial, or administrative expertise in government programs, acute care,
or post-acute care. The bill requires the advisory group to develop a request for
proposal from partnership groups that would be designated as participating sites for
the pilot program. Under the bill, only partnership groups that include at least one
hospital and at least one post-acute facility are eligible to participate, but
partnership groups could include more than one hospital or post-acute facility. The
bill requires applicant partnership groups to address certain issues in the
application, including 1) the number of beds that would be set aside in the post-acute
facility; 2) the goals of the partnership during the pilot program and after the pilot
program; 3) the types of complex patients for whom care would be provided; 4)
expertise to successfully implement the proposal; 5) the per diem rate requested to
adequately compensate the hospital or hospitals and the post-acute facility or
facilities; 6) a post-acute bed reserve rate; and 7) anticipated impediments to
successful implementation and how the applicant partnership group intends to
overcome the anticipated impediments.
Under the bill, the advisory group must also determine and recommend to DHS
an amount of the funding budgeted for the pilot program to be reserved for
reconciliation to ensure that participants are held harmless from unanticipated
financial loss. The bill also requires the advisory group to develop a methodology to
evaluate the complex patient pilot program and make recommendations to the
secretary of health services regarding which partnership groups should receive
designation as participating sites for the pilot program. The bill allows DHS to
contract with an independent organization to evaluate the complex patient pilot
program. The advisory group or any independent organization hired to complete the
evaluation of the pilot program must complete and submit to the secretary of health
services an evaluation of the pilot program, including a written report and
recommendations, no later than June 30, 2025.
Funding for opioid antagonists
The bill directs DHS to annually award up to $2,000,000 to entities for the
purchase of opioid antagonists.
Health care provider innovation grants
Under current law, DHS is required to award grants for certain community
programs. The bill allows DHS to distribute up to $15,000,000 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.
Defining lead poisoning or lead exposure
The bill modifies the definition of lead poisoning or lead exposure from a level
of lead in the blood of five or more micrograms per 100 milliliters of blood to 3.5 or
more micrograms per 100 milliliters of blood. The bill also changes the
circumstances under which DHS is required to conduct, or ensure there is conducted,
a lead investigation of a dwelling or premises. Under current law, DHS is required
to conduct, or ensure there is conducted, a lead investigation of a dwelling or
premises when DHS is notified that an occupant of the dwelling or premises who is
under the age of six has an elevated blood lead level, which current law defines as
a level of lead in the blood that is either 1) 20 or more micrograms per 100 milliliters
of blood, as confirmed by one venous blood test; or 2) 15 or more micrograms per 100
milliliters of blood, as confirmed by two venous blood tests that are performed at least
90 days apart. Under the bill, DHS is required to conduct, or ensure there is
conducted, a lead investigation of a dwelling or premises when DHS is notified that
an occupant of the dwelling or premises who is under the age of six has lead poisoning
or lead exposure. The bill also requires that when DHS receives such a notification,
DHS must present official credentials to the owner or occupant of the dwelling or
premises or a representative of the owner and request admission to conduct a lead
investigation of the dwelling or premises. As under current law, if an owner or
occupant refuses to grant admission, DHS may seek a warrant to investigate the
dwelling or premises.
Maternal and infant mortality prevention and response
The bill requires the DHS to do all of the following for the prevention of and
response to maternal and infant mortality, including 1) award grants to community
organizations with the aim of preventing maternal and infant mortality, 2) award
grants to support the expansion of fetal and infant mortality review and maternal
mortality review teams statewide and expand technical assistance and support for
existing fetal and infant mortality review and child death review teams, 3) provide
funding and technical assistance to community-based organizations aimed at
preventing infant morality, and 4) provide funding for grief and bereavement
programming for those impacted by infant loss.
Funding for infant testing programs
Under current law, DHS and the Wisconsin State Laboratory of Hygiene
operate a newborn screening program under which newborn babies are tested for
certain blood disorders, in addition to hearing loss and critical congenital heart
disease. Current law appropriates funding for the program from fees charged for
various costs associated with the program. The bill creates an additional GPR
appropriation to provide funding for the program and various costs associated with
the program.
Personal protective equipment stockpile
The bill provides funding to DHS to establish and maintain a state stockpile of
personal protective equipment.
Grants for tribal long-term care system development
The bill requires DHS to annually allocate up to $5,500,000 to federally
recognized American Indian tribes and bands located in this state for capital
improvements to tribal facilities serving tribal members with long-term care needs
and for improvements and repairs to homes of tribal members with long-term care
needs to enable tribal members to receive long-term care services at home.
Funding for free and charitable clinics
The bill increases from $1,500,000 to $2,000,000 the amount DHS is required
to award in grants to free and charitable clinics each fiscal year.
Grants to free-standing pediatric teaching hospitals
The bill directs DHS to award grants to free-standing pediatric teaching
hospitals to fund programming related to parenting, educational needs of and
supports for chronically ill children, and case management for children with asthma.
The bill specifies that only free-standing pediatric teaching hospitals for which at
least 45 percent of total inpatient days are provided to MA recipients are eligible for
the grant.
Low-value care analysis grant
In each of the 2023-24 and 2024-25 fiscal years, the bill requires DHS to award
a grant of up to $900,000 to an organization for the purpose of conducting a data
analysis of claims under the MA program and under health insurance plans offered
to state employees to identify low-value care. The grant recipient must report its
findings, including any recommendations for providing effective and efficient care,
to DHS and ETF, who must then distribute the grant recipient's findings to certain
health care providers, health care maintenance organizations, and insurance
companies.
Amyotrophic lateral sclerosis grant
The bill requires DHS to annually award $250,000 to an organization that
supports and provides services to individuals with amyotrophic lateral sclerosis
(ALS) to assist individuals with ALS and their families with respite care costs and
costs associated with ALS that are not covered by insurance.
Alzheimer's family and caregiver support
Under current law, DHS distributes funds for certain community aids,
including 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
$3,308,900 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 $60,000.
Healthy aging grant program
The bill requires DHS to award in each fiscal year a grant of $600,000 to an
entity that conducts programs in healthy aging.
Behavioral health and developmental disabilities
Crisis urgent care and observation facilities
The bill requires DHS to award grants to individuals and entities to develop and
support crisis urgent care and observation facilities. The bill also requires DHS to
create a certification process for crisis urgent care and observation facilities. DHS
may limit the number of certifications it grants to operate these facilities, and no
person may operate a crisis urgent care and observation facility without a
certification from DHS. The bill requires DHS to request any necessary federal
approval to add services provided by a crisis urgent care and observation facility as
a type of crisis intervention service reimbursable under the MA program. Under the
bill, if federal approval is either unnecessary or is necessary and is granted, DHS
may provide reimbursement for these services. The bill also requires DHS to include
a process for crisis urgent care and observation facilities to apply for certification of
the facility for the reimbursement of services provided under the MA program.
Mental health consultation program
The bill combines the child psychiatry consultation program with additional
services into a new mental health consultation program. Currently, the child
psychiatry consultation program assists participating clinicians in providing care to
children with mental health care needs and provides referral support and additional
services. The 2019-21 biennial budget act requires DHS to convene interested
persons, including the Medical College of Wisconsin, to develop a plan and standards
for a comprehensive mental health consultation program incorporating various
psychiatry specialties, including addiction medicine; a perinatal psychiatry
consultation program; and the child psychiatry consultation program. This
requirement from the 2019-21 biennial budget act is eliminated in the bill along with
the separate child psychiatry consultation program. The addiction medicine
consultation program currently assists participating clinicians in providing care to
patients with substance use addiction and provides referral support and additional
services, and the bill retains the addiction medicine consultation program as a
separate program.
The bill requires an organization to administer a mental health consultation
program (MHCP) that incorporates a comprehensive set of mental health
consultation services and may include perinatal, child, adult, geriatric, pain,
veteran, and general mental health consultation services. Under the bill, the
organization that currently administers the child psychiatry consultation program
must administer the MHCP during the 2023-24 fiscal year, but DHS may contract
with another organization in subsequent fiscal years. The contracting organization
may contract with any other entity to perform any operations and satisfy any
requirements of the MHCP. The contracting organization must do all of the
following: 1) ensure that mental health providers providing services through the
MHCP have the appropriate credentials as described in the bill, 2) maintain
infrastructure to provide services statewide on every weekday, provide consultation
services as promptly as practicable, 3) report to DHS any information DHS requires,
4) conduct surveys of participating clinicians as described in the bill, and 5) provide
certain specified services. Those specified services are the following: 1) support for
clinicians participating in the MHCP to assist in the management of mental health
problems; 2) triage-level assessments to determine the most appropriate response;
3) diagnostics and therapeutic feedback when medically appropriate; and 4)
recruitment of other practices to a provider's services. The MHCP must be able to
provide consultation services by telephone and email but may also provide services
by other means. In addition to the services required in the bill, which are eligible for
funding by DHS, the contracting organization may provide any of the services
specified in the bill that are eligible for funding by DHS.
Repeal of school-based mental health consultation pilot program
The bill repeals a school-based mental health consultation pilot program
created by
2019 Wisconsin Act 117. Under the current law pilot program, DHS is
required to administer a school-based mental health consultation pilot program in
Outagamie County to assist participating school-based providers in providing
enhanced care to student with mental health care needs, to provide referral support
for those students, and to provide additional services. Under current law, DHS must
conduct annual surveys of the participating school-based providers who use the
consultation pilot program and was required to submit a report on the program to
the appropriate standing committees of the legislature by August 1, 2022.
Grants for peer recovery centers
The bill allows DHS to distribute not more than $260,000 in each fiscal year to
regional recovery centers for individuals experiencing mental health and substance
abuse issues.
Psychiatric residential treatment facilities
The bill establishes a DHS certification process for psychiatric residential
treatment facilities. The bill defines a psychiatric residential treatment facility as
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. Psychiatric residential
treatment facilities must be certified by DHS to operate.
The bill also provides that services through a psychiatric residential treatment
facility are reimbursable under the MA program. The bill requires DHS to submit
to the federal government any request for federal approval necessary to provide the
reimbursement for services by a psychiatric residential treatment facility under the
MA program.
Under current law, DHS is required to award grants for certain community
programs. The bill allows DHS to distribute up to $1,790,000 each fiscal year to
support psychiatric residential treatment facilities.
COVID-19 health care workforce pilot project
The bill requires DHS to distribute $621,000 in fiscal year 2024-25 to support
a pilot project in Dane County relating to the impact of the COVID-19 pandemic on
the health care workforce.
Suicide prevention program
The bill requires DHS to implement a suicide prevention program, coordinate
suicide prevention activities with other state agencies, administer grant programs
involving suicide prevention, and perform various other functions specified in the
bill to promote efforts to prevent suicide. The bill also specifically requires DHS to
award grants to organizations or coalitions of organizations, including cities,
villages, towns, counties, and federally recognized American Indian tribes or bands
in this state, for 1) training staff at a firearm retailer or firearm range on how to
recognize a person that may be considering suicide; 2) providing suicide prevention
materials for distribution at a firearm retailer or firearm range; or 3) providing
voluntary, temporary firearm storage. A grant recipient must contribute matching
funds or in-kind services having a value equal to at least 20 percent of the grant
amount. The bill specifies that DHS may award up to $500,000 in grants for the
suicide prevention program each fiscal year, including up to $75,000 per fiscal year
for the grants related to preventing suicide by firearm.
988 Suicide and Crisis Lifeline grants
The bill requires DHS to awards grants to organizations that provide crisis
intervention services and crisis care coordination to individuals who contact the
national 988 Suicide and Crisis Lifeline from anywhere within this state. Currently,
DHS partners with Wisconsin Lifeline to provide statewide 988 crisis hotline
services.
Stimulant prevention and treatment response programs
Under current law, DHS awards grants for certain community programs. The
bill allows DHS to distribute up to $1,644,000 in each fiscal year to support stimulant
use prevention and treatment programs and services.
Grants for youth crisis stabilization facilities
The bill requires DHS to award grants to organizations to develop and support
youth crisis stabilization facilities. Under current law, a youth crisis stabilization
facility is a treatment facility with a maximum of eight beds that admits minors to
prevent or de-escalate a mental health crisis and avoid admission to a more
restrictive setting. Youth crisis stabilization facilities must be certified by DHS to
operate.
