Amendment AA3-SB70

SB70-AA3,198,17 (1) Rules regarding training of certified peer specialists. The department of health services may promulgate the rules required under s. 49.45 (30j) (bm) 4. as emergency rules under s. 227.24. 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 January 1, 2025, or the date the permanent rules take effect, whichever is sooner.”.

SB70-AA3,198,18 232. Page 374, line 11: after that line insert:

SB70-AA3,198,19 “ Section 242. 46.854 of the statutes is created to read:

SB70-AA3,198,22 46.854 Healthy aging grant program. From the appropriation under s. 20.435 (1) (b), the department shall award in each fiscal year a grant of $600,000 to an entity that conducts programs in healthy aging.”.

SB70-AA3,198,23 233. Page 374, line 11: after that line insert:

SB70-AA3,198,24 “ Section 243. 20.145 (1) (g) 5. of the statutes is created to read:

SB70-AA3,199,4 20.145 (1) (g) 5. All moneys received from the regulation of pharmacy benefit managers, pharmacy benefit management brokers, pharmacy benefit management consultants, pharmacy services administration organizations, and pharmaceutical representatives.”.

SB70-AA3,199,5 234. Page 374, line 11: after that line insert:

SB70-AA3,199,6 “ Section 244. 256.158 of the statutes is created to read:

SB70-AA3,199,7 256.158 Epinephrine for ambulances. (1) In this section:

SB70-AA3,199,9 (a) “Ambulance service provider” means an ambulance service provider that is a public agency, volunteer fire department, or nonprofit corporation.

SB70-AA3,199,11 (b) “Draw-up epinephrine” means epinephrine that is administered intramuscularly using a needle and syringe and drawn up from a vial or ampule.

SB70-AA3,199,13 (c) “Draw-up epinephrine kit” means a single-use vial or ampule of draw-up epinephrine and a syringe for administration to a patient.

SB70-AA3,199,15 (d) “Epinephrine auto-injector" means a device for the automatic injection of epinephrine into the human body.

SB70-AA3,200,2 (2) From the appropriation under s. 20.435 (1) (b), the department shall reimburse ambulance service providers for a set of 2 epinephrine auto-injectors or a set of 2 draw-up epinephrine kits for each ambulance operating in the state. On an ongoing basis, the department shall, upon request from an ambulance service provider, reimburse the ambulance service provider for a replacement set of 2 epinephrine auto-injectors or a set of 2 draw-up epinephrine kits. The department shall allow the ambulance service provider to choose between epinephrine auto-injectors and draw-up epinephrine kits. The department may not reimburse an ambulance service provider for epinephrine unless each ambulance for which the ambulance service provider is reimbursed is staffed with an emergency medical services practitioner who is qualified to administer the provided epinephrine.”.

SB70-AA3,200,3 235. Page 374, line 11: after that line insert:

SB70-AA3,200,4 “ Section 245. 253.19 of the statutes is created to read:

SB70-AA3,200,12 253.19 Grants to free-standing pediatric teaching hospitals. From the appropriation under s. 20.435 (1) (b), the department shall 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. A free-standing pediatric teaching hospital is eligible for a grant under this section only if the percentage of Medical Assistance recipient inpatient days at the free-standing pediatric teaching hospital calculated under s. 49.45 (3m) (b) 1. a. is greater than 45 percent.”.

SB70-AA3,200,13 236. Page 374, line 11: after that line insert:

SB70-AA3,200,14 “ Section 9119. Nonstatutory provisions; Health Services.

SB70-AA3,200,22 (1w) Electrocardiogram screening pilot program. The department of health services shall develop a pilot program to provide electrocardiogram screenings for participants in middle school and high school athletics programs in Milwaukee and Waukesha Counties. From the appropriation under s. 20.435 (1) (b), in fiscal year 2024-25, the department shall award $4,172,000 in grants to local health departments, as defined under s. 250.01 (4), to implement the pilot program under this subsection. Participation in the pilot program by participants in middle school and high school athletics programs shall be optional.”.

SB70-AA3,200,23 237. Page 374, line 11: after that line insert:

SB70-AA3,200,24 “ Section 246. 51.44 (5) (bm) of the statutes is created to read:

SB70-AA3,201,3 51.44 (5) (bm) Ensure that any child with a level of lead in his or her blood that is 3.5 or more micrograms per 100 milliliters of blood, as confirmed by one venous blood test, is eligible for services under the program under this section.

SB70-AA3,9119 Section 9119. Nonstatutory provisions; Health Services.

SB70-AA3,201,7 (1u) Early intervention services. The department of health services may develop a methodology to allocate moneys under s. 20.435 (7) (bt) across county programs.”.

SB70-AA3,201,8 238. Page 374, line 11: after that line insert:

SB70-AA3,201,9 “ Section 247. 46.995 (4) of the statutes is created to read:

SB70-AA3,201,13 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.”.

SB70-AA3,201,14 239. Page 374, line 11: after that line insert:

SB70-AA3,201,15 “ Section 248. 49.45 (30t) of the statutes is created to read:

SB70-AA3,201,16 49.45 (30t) Doula services. (a) In this subsection:

SB70-AA3,201,18 1. “Certified doula” means an individual who has received certification from a doula certifying organization recognized by the department.

SB70-AA3,201,21 2. “Doula services” means childbirth education and support services, including emotional and physical support provided during pregnancy, labor, birth, and the postpartum period.

SB70-AA3,202,3 (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-AA3,249 Section 249. 49.46 (2) (b) 12p. of the statutes is created to read:

SB70-AA3,202,6 49.46 (2) (b) 12p. Doula services provided by a certified doula, as specified under s. 49.45 (30t).”.

SB70-AA3,202,7 240. Page 374, line 11: after that line insert:

SB70-AA3,202,8 “ Section 250. 49.45 (39) (b) 1. of the statutes is amended to read:

SB70-AA3,203,17 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-AA3,251 Section 251. 49.45 (39) (b) 2. of the statutes is amended to read:

SB70-AA3,204,3 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-AA3,204,4 241. Page 374, line 11: after that line insert:

SB70-AA3,204,5 “ Section 252. 49.46 (2) (b) 24. of the statutes is created to read:

SB70-AA3,204,7 49.46 (2) (b) 24. Subject to par. (by), nonmedical services that contribute to the determinants of health.

SB70-AA3,253 Section 253. 49.46 (2) (by) of the statutes is created to read:

SB70-AA3,204,15 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-AA3,204,16 242. Page 374, line 11: after that line insert:

SB70-AA3,204,17 “ Section 254. 20.435 (4) (jw) of the statutes is amended to read:

SB70-AA3,205,2 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-AA3,255 Section 255. 20.435 (4) (xm) of the statutes is created to read:

SB70-AA3,205,8 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-AA3,256 Section 256. 49.45 (3) (em) of the statutes is amended to read:

SB70-AA3,205,17 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-AA3,257 Section 257. 256.23 (6) of the statutes is created to read:

SB70-AA3,205,23 256.23 (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-AA3,205,24 243. Page 374, line 11: after that line insert:

SB70-AA3,206,1 “ Section 258. 20.940 of the statutes is repealed.

SB70-AA3,259 Section 259. 49.45 (2t) of the statutes is repealed.

SB70-AA3,260 Section 260. 256.23 (5) of the statutes is amended to read:

SB70-AA3,206,9 256.23 (5) In accordance with s. 20.940, the The department shall submit to the federal department of health and human services a request for any state plan amendment, waiver or other approval that is required to implement this section and s. 49.45 (3) (em). If federal approval is required, the department may not implement the collection of the fee under sub. (2) until it receives approval from the federal government to obtain federal matching funds.

SB70-AA3,261 Section 261. 601.83 (1) (a) of the statutes is amended to read:

SB70-AA3,206,23 601.83 (1) (a) The commissioner shall administer a state-based reinsurance program known as the healthcare stability plan in accordance with the specific terms and conditions approved by the federal department of health and human services dated July 29, 2018. Before December 31, 2023, the commissioner may not request from the federal department of health and human services a modification, suspension, withdrawal, or termination of the waiver under 42 USC 18052 under which the healthcare stability plan under this subchapter operates unless legislation has been enacted specifically directing the modification, suspension, withdrawal, or termination. Before December 31, 2023, the commissioner may request renewal, without substantive change, of the waiver under 42 USC 18052 under which the health care stability plan operates in accordance with s. 20.940 (4) unless legislation has been enacted that is contrary to such a renewal request. The commissioner shall comply with applicable timing in and requirements of s. 20.940.

SB70-AA3,9119 Section 9119. Nonstatutory provisions; Health Services.

SB70-AA3,207,4 (1v) Childless adults demonstration project reform waiver. The department of health services may submit a request to the federal department of health and human services to modify or withdraw the waiver granted under s. 49.45 (23) (g), 2021 stats.”.

SB70-AA3,207,5 244. Page 374, line 11: after that line insert:

SB70-AA3,207,6 “ Section 262. 20.435 (5) (bw) of the statutes is amended to read:

SB70-AA3,207,11 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-AA3,263 Section 263. 20.435 (5) (bx) of the statutes is created to read:

SB70-AA3,207,15 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-AA3,264 Section 264. 20.435 (5) (ct) of the statutes is repealed.

SB70-AA3,265 Section 265. 51.441 of the statutes is repealed.

SB70-AA3,266 Section 266. 51.442 of the statutes is repealed.

SB70-AA3,267 Section 267. 51.443 of the statutes is created to read:

SB70-AA3,207,20 51.443 Mental health consultation program. (1) In this section:

SB70-AA3,207,23 (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-AA3,208,2 (b) “Program” means the mental health consultation program under this section.

SB70-AA3,208,10 (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-AA3,208,16 (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-AA3,208,18 (4) As a condition of providing services through the program, the contracting organization under sub. (2) shall do all of the following:

SB70-AA3,209,2 (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-AA3,209,4 (b) Maintain the infrastructure necessary to provide the program's services statewide.

SB70-AA3,209,6 (c) Operate the program on weekdays during normal business hours of 8 a.m. to 5 p.m.

SB70-AA3,209,8 (d) Provide consultation services under the program as promptly as is practicable.

SB70-AA3,209,12 (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-AA3,209,13 (f) Provide all of the following services through the program:

SB70-AA3,209,15 1. Support for participating clinicians to assist in the management of mental health concerns.

SB70-AA3,209,18 2. Triage-level assessments to determine the most appropriate response to each request, including appropriate referrals to any community providers and health systems.

SB70-AA3,209,19 3. When medically appropriate, diagnostics and therapeutic feedback.