Amendment AA3-SB70

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SB70-AA3,206,1 “ Section 258. 20.940 of the statutes is repealed.

SB70-AA3,259 Section 259. 49.45 (2t) of the statutes is repealed.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

SB70-AA3,209,21 4. Recruitment of other clinicians into the program as participating clinicians when possible.

SB70-AA3,209,22 (g) Report to the department any information requested by the department.

SB70-AA3,210,6 (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-AA3,210,10 (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-AA3,210,13 (a) Second opinion diagnostic and medication management evaluations and community resource referrals conducted by either a psychiatrist or allied health professionals.

SB70-AA3,210,16 (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-AA3,210,17 (c) Data evaluation and assessment of the program.”.

SB70-AA3,210,18 245. Page 374, line 11: after that line insert:

SB70-AA3,210,19 “ Section 268. 46.48 (35) of the statutes is created to read:

SB70-AA3,210,22 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-AA3,269 Section 269. 49.46 (2) (b) 14c. of the statutes is created to read:

SB70-AA3,211,2 49.46 (2) (b) 14c. Subject to par. (bv), services by a psychiatric residential treatment facility.

SB70-AA3,270 Section 270. 49.46 (2) (bv) of the statutes is created to read:

SB70-AA3,211,11 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-AA3,271 Section 271. 51.044 of the statutes is created to read:

SB70-AA3,211,18 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-AA3,211,22 (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-AA3,211,24 (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-AA3,211,25 (3) Rules. The department may promulgate rules to implement this section.

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

SB70-AA3,212,14 (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-AA3,212,15 246. Page 374, line 11: after that line insert:

SB70-AA3,212,16 “ Section 272. 46.48 (22) of the statutes is created to read:

SB70-AA3,212,20 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-AA3,212,21 247. Page 374, line 11: after that line insert:

SB70-AA3,212,22 “ Section 9119. Nonstatutory provisions; Health Services.

SB70-AA3,212,23 (4u) Complex patient pilot program.

SB70-AA3,212,24 (a) In this subsection, “department” means the department of health services.

SB70-AA3,213,5 (b) The department shall form an advisory group to assist with development and implementation of a complex patient pilot program. The secretary of health services, or his or her designee, shall be the chair of the advisory group. Members of the advisory group under this paragraph shall have clinical, financial, or administrative expertise in government programs, acute care, or post-acute care.

SB70-AA3,213,8 (c) The department shall use its request-for-proposal procedure to select partnership groups to be designated as participating sites for the complex patient pilot program under this subsection.

SB70-AA3,213,14 (d) The advisory group formed under this subsection shall develop a request for proposal for the complex patient pilot program that includes eligibility requirements. For purposes of the pilot program under this subsection, only partnerships of hospitals and post-acute facilities are eligible to submit proposals. An eligible partnership shall include at least one hospital and at least one post-acute facility, but may include more than one hospital or post-acute facility.

SB70-AA3,213,17 (e) Each partnership group that applies to the department to be designated as a site for the complex patient pilot program shall specifically address all of the following issues:

SB70-AA3,213,18 1. The number of beds that would be set aside in the post-acute facility.

SB70-AA3,213,20 2. The goals of the partnership during the pilot program and after the pilot program.

SB70-AA3,213,21 3. The types of complex patients for whom care would be provided.

SB70-AA3,213,23 4. Expertise to successfully implement the proposal, including a discussion of at least all of the following issues:

SB70-AA3,213,24 a. Experience of the partners working together.

SB70-AA3,213,25 b. Plan for staffing the unit.

SB70-AA3,214,1 c. Ability to electronically exchange health information.

SB70-AA3,214,2 d. Clinical expertise.

SB70-AA3,214,3 e. Hospital and post-acute facility survey history over the past 3 years.

SB70-AA3,214,4 f. Acute care partner readmissions history over the past 3 years.

SB70-AA3,214,5 g. Discharge planning and patient intake resources.

SB70-AA3,214,10 h. Stability of finances to support the proposal, including matching funds that could be dedicated to the pilot program under this subsection. No applicant is required to provide matching funds or a contribution, but the advisory group and the department of health services may take into consideration the availability of matching funds or a contribution in evaluating an application.

SB70-AA3,214,12 5. The per diem rate requested to adequately compensate the hospital or hospitals and the post-acute facility or facilities.

SB70-AA3,214,13 6. A post-acute bed reserve rate.

SB70-AA3,214,15 7. Anticipated impediments to successful implementation and how the applicant partnership group intends to overcome the anticipated impediments.

SB70-AA3,214,16 (f) The advisory group formed under this subsection shall do all of the following:

SB70-AA3,214,20 1. Determine and recommend to the department an amount of the funding budgeted for the complex patient pilot program under s. 20.435 (7) (d) to be reserved for reconciliation to ensure that participants in the pilot program are held harmless from unanticipated financial loss.

SB70-AA3,215,2 2. Develop a methodology to evaluate the complex patient pilot program, including a recommendation on whether the department should contract with an independent organization to evaluate the complex patient pilot program. The department may contract with an independent organization to complete the evaluation described under this subdivision and, if the department does so, the department may pay the fee of the organization selected from the appropriation under s. 20.435 (7) (d).

SB70-AA3,215,5 3. Make recommendations to the secretary of health services regarding which partnership groups should receive designation as a participating site for the complex patient pilot program.

SB70-AA3,215,9 (g) 1. No later than 90 days after the effective date of this subdivision, the advisory group shall complete development of the request for proposal for partnership groups to be designated as participating sites in the complex patient pilot program and provide its recommendations to the secretary of health services.