Amendment AA8-ASA2-AB50

AB50-ASA2-AA8,201,16 “Section 351. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated:

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AB50-ASA2-AA8,352 Section 352. 20.165 (1) (e) of the statutes is created to read:

AB50-ASA2-AA8,201,19 20.165 (1) (e) Statewide clinician wellness program. The amounts in the schedule for the statewide clinician wellness program under s. 440.03 (18).

AB50-ASA2-AA8,353 Section 353. 440.03 (18) of the statutes is created to read:

AB50-ASA2-AA8,202,2 440.03 (18) The department may provide a statewide clinician wellness program to provide support to healthcare workers in this state in maintaining their physical and mental health and ensuring long-term vitality and effectiveness for their patients and their profession. The department shall ensure that the program is coordinated with the procedure under sub. (1c).”.

AB50-ASA2-AA8,202,3 78. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,202,4 “Section 354. 609.823 of the statutes is created to read:

AB50-ASA2-AA8,202,7 609.823 Coverage without prior authorization for inpatient mental health services. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.891.

AB50-ASA2-AA8,355 Section 355. 632.891 of the statutes is created to read:

AB50-ASA2-AA8,202,13 632.891 Coverage without prior authorization for inpatient mental health services. A disability insurance policy, as defined in s. 632.895 (1) (a), or self-insured health plan, as defined in s. 632.745 (24), that covers inpatient mental health services may not require prior authorization for the provision or coverage of those services.

AB50-ASA2-AA8,9323 Section 9323. Initial applicability; Insurance.

AB50-ASA2-AA8,202,15 (1) Inpatient mental health prior authorization.

AB50-ASA2-AA8,202,19 (a) For policies and plans containing provisions inconsistent with ss. 609.823 and 632.891, the treatment of ss. 609.823 and 632.891 first applies to policy or plan years beginning on January 1 of the year following the year in which this paragraph takes effect, except as provided in par. (b).

AB50-ASA2-AA8,203,2 (b) For policies and plans that are affected by a collective bargaining agreement containing provisions inconsistent with ss. 609.823 and 632.891, the treatment of ss. 609.823 and 632.891 first applies to policy or plan years beginning on the effective date of this subsection or on the day on which the collective bargaining agreement is newly established, extended, modified, or renewed, whichever is later.

AB50-ASA2-AA8,9423 Section 9423. Effective dates; Insurance.

AB50-ASA2-AA8,203,6 (1) Inpatient mental health prior authorization. The treatment of ss. 609.823 and 632.891 and Section 9323 (1) of this act takes effect on the first day of the 4th month beginning after publication.”.

AB50-ASA2-AA8,203,7 79. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,203,8 “Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA8,203,9 (1) Behavioral health licensure and oversight staff.

AB50-ASA2-AA8,203,18 (a) In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (6) (jm), the dollar amount for fiscal year 2025-26 is increased by $145,000 to increase the authorized FTE positions in the department of health services by 1.89 PR positions to support the certification, licensure, and oversight of behavioral health, and alcohol and other drug abuse treatment programs.. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (6) (jm), the dollar amount for fiscal year 2026-27 is increased by $193,400 for the positions authorized under this paragraph.

AB50-ASA2-AA8,204,3 (b) In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (6) (m), the dollar amount for fiscal year 2025-26 is increased by $85,200 to increase the authorized FTE positions in the department of health services by 1.11 FED positions to support the certification, licensure, and oversight of behavioral health, and alcohol and other drug abuse treatment programs.. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (6) (m), the dollar amount for fiscal year 2026-27 is increased by $113,600 for the positions authorized under this paragraph.

AB50-ASA2-AA8,204,6 (c) The positions authorized under pars. (a) and (b) shall be 2.0 surveyor positions and 1.0 license permit program associate position to provide administrative support to facilitate processing of the increased survey capacity.”.

AB50-ASA2-AA8,204,7 80. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,204,8 “Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA8,204,9 (1) Quality assurance services.

AB50-ASA2-AA8,204,17 (a) In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (6) (jm), the dollar amount for fiscal year 2025-26 is increased by $481,700 to increase the authorized FTE positions for the department by 8.0 PR positions to address a backlog of surveys conducted by the bureau of assisted living. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (6) (jm), the dollar amount for fiscal year 2026-27 is increased by $642,200 to provide funding for the positions authorized under this paragraph.

AB50-ASA2-AA8,205,2 (b) In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (6) (n), the dollar amount for fiscal year 2025-26 is increased by $160,500 to increase the authorized FTE positions for the department by 3.0 FED positions to address a backlog of surveys conducted by the bureau of assisted living. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (6) (n), the dollar amount for fiscal year 2026-27 is increased by $214,100 to provide funding for the positions authorized under this paragraph.”.

AB50-ASA2-AA8,205,3 81. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,205,4 “Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA8,205,14 (1) Cardiac arrest registry to enhance survival. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (1) (a), the dollar amount for fiscal year 2025-26 is increased by $25,000 to fund automatic data uploading privileges in the Cardiac Arrest Registry to Enhance Survival (CARES) digital registry of out-of-hospital cardiac arrests. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (1) (a), the dollar amount for fiscal year 2026-27 is increased by $25,000 to fund automatic data uploading privileges in the Cardiac Arrest Registry to Enhance Survival (CARES) digital registry of out-of-hospital cardiac arrests.”.

AB50-ASA2-AA8,205,15 82. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,205,16 “Section 9119. Nonstatutory provisions; Health Services.

AB50-ASA2-AA8,206,2 (1) Senior care reestimate. For fiscal year 2025-26, to reflect a reestimate of benefit costs under the senior care program, the GPR funding for senior care shall be decreased by $4,402,700; the FED funding for senior care shall be increased by $1,357,800; and the PR funding for senior care shall be decreased by $32,679,200. For fiscal year 2026-27, to reflect a reestimate of benefit costs under the senior care program, the GPR funding for senior care shall be decreased by $1,646,400; the FED funding for senior care shall be increased by $1,288,400; and the PR funding for senior care shall be decreased by $29,613,000.”.

AB50-ASA2-AA8,206,3 83. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,206,4 “Section 356. 46.995 (4) of the statutes is created to read:

AB50-ASA2-AA8,206,8 46.995 (4) The department shall ensure that any child who is eligible and who applies for the disabled children’s long-term support program that is operating under a waiver of federal law receives services under the disabled children’s long‑term support program that is operating under a waiver of federal law.”.

AB50-ASA2-AA8,206,9 84. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,206,10 “Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA8,206,18 (1) Community aids basic county allocations. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (7) (b), the dollar amount for fiscal year 2025-26 is increased by $1,698,200 to increase basic county allocations under the community aids program.. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (7) (b), the dollar amount for fiscal year 2026-27 is increased by $5,162,600 to increase basic county allocations under the community aids program.”.

AB50-ASA2-AA8,206,19 85. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,206,20 “Section 357. 20.435 (4) (bm) of the statutes is amended to read:

AB50-ASA2-AA8,207,15 20.435 (4) (bm) Medical Assistance, food stamps, and Badger Care administration; contract costs, insurer reports, and resource centers. Biennially, the amounts in the schedule to provide a portion of the state share of administrative contract costs for the Medical Assistance program under subch. IV of ch. 49 and the Badger Care health care program under s. 49.665 and to provide the state share of administrative costs for the food stamp program under s. 49.79, other than payments under s. 49.78 (8), to develop and implement a registry of recipient immunizations, to reimburse 3rd parties for their costs under s. 49.475, for costs associated with outreach activities, for state administration of state supplemental grants to supplemental security income recipients under s. 49.77, for grants under ss. 46.73 and 46.74, and for services of resource centers under s. 46.283. No state positions may be funded in the department of health services from this appropriation, except positions for the performance of duties under a contract in effect before January 1, 1987, related to the administration of the Medical Assistance program between the subunit of the department primarily responsible for administering the Medical Assistance program and another subunit of the department. Total administrative funding authorized for the program under s. 49.665 may not exceed 10 percent of the amounts budgeted under pars. (p) and (x).

AB50-ASA2-AA8,358 Section 358. 20.435 (4) (pa) of the statutes is amended to read:

AB50-ASA2-AA8,207,23 20.435 (4) (pa) Federal aid; Medical Assistance and food stamp contracts administration. All federal moneys received for the federal share of the cost of contracting for payment and services administration and reporting, other than moneys received under pars. (nn) and (np), to reimburse 3rd parties for their costs under s. 49.475, for administrative contract costs for the food stamp program under s. 49.79, for grants under ss. 46.73 and 46.74, and for services of resource centers under s. 46.283.

AB50-ASA2-AA8,359 Section 359. 46.73 of the statutes is created to read:

AB50-ASA2-AA8,208,4 46.73 Community dental health coordinators. From the appropriations under s. 20.435 (4) (bm) and (pa), the department shall award grants to support community dental health coordinators in rural regions of the state.

AB50-ASA2-AA8,360 Section 360. 46.74 of the statutes is created to read:

AB50-ASA2-AA8,208,8 46.74 Grants for mobile dental clinics. The department shall award grants to community health centers, as defined in s. 250.15 (1) (a), to procure and operate mobile dental clinics.”.

AB50-ASA2-AA8,208,9 86. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,208,10 “Section 361. 49.45 (30) (a) of the statutes is repealed.

AB50-ASA2-AA8,362 Section 362. 49.45 (30) (b) of the statutes is renumbered 49.45 (30) and amended to read:

AB50-ASA2-AA8,208,18 49.45 (30) Services provided by community support programs. The department shall reimburse a provider of county that provides services under s. 49.46 (2) (b) 6. L. only for the amount of the allowable charges for those services under the Medical Assistance program that is provided by the federal government and for the amount of the allowable charges for those services under the Medical Assistance program that is not provided by the federal government.

AB50-ASA2-AA8,363 Section 363. 49.45 (52) (a) 1. of the statutes is amended to read:

AB50-ASA2-AA8,209,9 49.45 (52) (a) 1. If the department provides the notice under par. (c) selecting the payment procedure in this paragraph, the department may, from the appropriation account under s. 20.435 (7) (b), make Medical Assistance payment adjustments to county departments under s. 46.215, 46.22, 46.23, 51.42, or 51.437 or to local health departments, as defined in s. 250.01 (4), as appropriate, for covered services under s. 49.46 (2) (a) 2. and 4. d. and f. and (b) 6. b., c., f., fm., g., j., k., L., Lm., and m., 9., 12., 12m., 13., 15., and 16., except for services specified under s. 49.46 (2) (b) 6. b. and c. provided to children participating in the early intervention program under s. 51.44. Payment adjustments under this paragraph shall include the state share of the payments. The total of any payment adjustments under this paragraph and Medical Assistance payments made from appropriation accounts under s. 20.435 (4) (b), (gm), (o), and (w), may not exceed applicable limitations on payments under 42 USC 1396a (a) (30) (A).

AB50-ASA2-AA8,364 Section 364. 49.45 (52) (b) 1. of the statutes is amended to read:

AB50-ASA2-AA8,209,16 49.45 (52) (b) 1. Annually, a county department under s. 46.215, 46.22, 46.23, 51.42, or 51.437 shall submit a certified cost report that meets the requirements of the federal department of health and human services for covered services under s. 49.46 (2) (a) 2. and 4. d. and f. and (b) 6. b., c., f., fm., g., j., k., L., Lm., and m., 9., 12., 12m., 13., 15., and 16., except for services specified under s. 49.46 (2) (b) 6. b. and c. provided to children participating in the early intervention program under s. 51.44.

AB50-ASA2-AA8,9219 Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA8,210,2 (1) Community support program; state payment of nonfederal share. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (4) (a), the dollar amount for fiscal year 2025-26 is increased by $19,616,200 for Medical Assistance services provided under the community support program. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (4) (a), the dollar amount for fiscal year 2026-27 is increased by $21,467,000 for Medical Assistance services provided under the community support program.”.

AB50-ASA2-AA8,210,3 87. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,210,4 “Section 365. 46.48 (27) of the statutes is created to read:

AB50-ASA2-AA8,210,11 46.48 (27) Community-based withdrawal management centers. From the appropriation under s. 20.435 (5) (bc), the department shall distribute not more than $500,000 in each fiscal year for grants to community-based withdrawal centers, including those certified as an adult residential integrated behavioral health stabilization service, residential intoxication monitoring service, or residential withdrawal management service, as those terms are defined under s. 49.45 (30p) (a) 1., 4., and 5.

AB50-ASA2-AA8,366 Section 366. 49.45 (30p) of the statutes is created to read:

AB50-ASA2-AA8,210,14 49.45 (30p) Detoxification and stabilization services. (a) In this subsection:

AB50-ASA2-AA8,211,4 1. “Adult residential integrated behavioral health stabilization service” means a residential behavioral health treatment service, delivered under the oversight of a medical director, that provides withdrawal management and intoxication monitoring, as well as integrated behavioral health stabilization services, and includes nursing care on site for medical monitoring available on a 24- hour basis. “Adult residential integrated behavioral health stabilization service” may include the provision of services including screening, assessment, intake, evaluation and diagnosis, medical care, observation and monitoring, physical examination, determination of medical stability, medication management, nursing services, case management, drug testing, counseling, individual therapy, group therapy, family therapy, psychoeducation, peer support services, recovery coaching, recovery support services, and crisis intervention services, to ameliorate acute behavioral health symptoms and stabilize functioning.

AB50-ASA2-AA8,211,7 2. “Community-based withdrawal management” means a medically managed withdrawal management service delivered on an outpatient basis by a physician or other service personnel acting under the supervision of a physician.

AB50-ASA2-AA8,211,10 3. “Detoxification and stabilization services” means adult residential integrated behavioral health stabilization service, residential withdrawal management service, or residential intoxication monitoring service.

AB50-ASA2-AA8,211,19 4. “Residential intoxication monitoring service” means a residential service that provides 24-hour observation to monitor the safe resolution of alcohol or sedative intoxication and to monitor for the development of alcohol withdrawal for intoxicated patients who are not in need of emergency medical or behavioral health care. “Residential intoxication monitoring service” may include the provision of services including screening, assessment, intake, evaluation and diagnosis, observation and monitoring, case management, drug testing, counseling, individual therapy, group therapy, family therapy, psychoeducation, peer support services, recovery coaching, and recovery support services.

AB50-ASA2-AA8,212,9 5. “Residential withdrawal management service” means a residential substance use treatment service that provides withdrawal management and intoxication monitoring, and includes medically managed 24-hour on-site nursing care, under the supervision of a physician. “Residential withdrawal management service” may include the provision of services, including screening, assessment, intake, evaluation and diagnosis, medical care, observation and monitoring, physical examination, medication management, nursing services, case management, drug testing, counseling, individual therapy, group therapy, family therapy, psychoeducation, peer support services, recovery coaching, and recovery support services, to ameliorate symptoms of acute intoxication and withdrawal and to stabilize functioning. “Residential withdrawal management service” may also include community-based withdrawal management and intoxication monitoring services.

AB50-ASA2-AA8,212,14 (b) Subject to par. (c), the department shall provide reimbursement for detoxification and stabilization services under the Medical Assistance program under s. 49.46 (2) (b) 14r. The department shall certify providers under the Medical Assistance program to provide detoxification and stabilization services in accordance with this subsection.

AB50-ASA2-AA8,212,22 (c) 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 detoxification and stabilization services as described in this subsection. If the federal department approves the request or if no federal approval is necessary, the department shall provide the reimbursement under s. 49.46 (2) (b) 14r. If the federal department disapproves the request, the department may not provide the reimbursement described in this subsection.

AB50-ASA2-AA8,367 Section 367. 49.46 (2) (b) 14r. of the statutes is created to read:

AB50-ASA2-AA8,213,2 49.46 (2) (b) 14r. Detoxification and stabilization services as specified under s. 49.45 (30p).”

AB50-ASA2-AA8,213,3 88. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,213,4 “Section 9119. Nonstatutory provisions; Health Services.

AB50-ASA2-AA8,213,5 (1) Complex patient pilot program.

AB50-ASA2-AA8,213,6 (a) In this subsection:

AB50-ASA2-AA8,213,7 1. “Department” means the department of health services.

AB50-ASA2-AA8,213,9 2. “Partnership group” means one or more hospitals in partnership with one or more post-acute facilities.

AB50-ASA2-AA8,213,13 (b) The department shall use a competitive grant selection process to select partnership groups to be designated as participating sites for a complex patient pilot program under this subsection and, from the appropriation under s. 20.435 (7) (d), award grants to the groups selected.

AB50-ASA2-AA8,213,18 (c) The department shall solicit feedback regarding the complex patient pilot program from representatives of healthcare system organizations, long-term care provider organizations, long-term care operator organizations, patient advocate groups, insurers, and any other organization determined to be relevant by the secretary of health services.

AB50-ASA2-AA8,213,21 (d) The department shall require that each partnership group that applies to the department to be designated as a site for the complex patient pilot program shall address all of the following issues in its application:

AB50-ASA2-AA8,214,2 1. The number of complex patient care beds that will be set aside in a post- acute facility or through implementation of an innovative model of patient care in a post-acute facility to which participating hospitals agree, such as dedicated staffing for dementia or a behavioral health unit.

AB50-ASA2-AA8,214,4 2. Defined goals and measurable outcomes of the partnership group during the pilot program and after the pilot program.

AB50-ASA2-AA8,214,8 3. The types of complex patients for whom care will be provided, which may include patients needing total care for multiple conditions or comorbidities such as cardiac and respiratory diseases, obesity, mental health, substance use, or dementia.

AB50-ASA2-AA8,214,11 4. An operating budget for the proposed site that details how fiscal responsibility will be shared among members of the partnership group and includes all of the following:

AB50-ASA2-AA8,214,13 a. Estimated patient revenues from other sources, including the Medical Assistance program under subch. IV of ch. 49, and estimated total costs.

AB50-ASA2-AA8,214,14 b. A margin to account for reserved beds.

AB50-ASA2-AA8,214,16 5. The partnership group’s expertise to successfully implement the proposal, which may include a discussion of the following issues: