Amendment SA4-SSA2-SB70

SB70-SSA2-SA4,119,1 164. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,119,2 “ Section 120. 49.45 (3) (e) 11. of the statutes is amended to read:

SB70-SSA2-SA4,119,14 49.45 (3) (e) 11. The department shall use a portion of the moneys collected under s. 50.38 (2) (a) to pay for services provided by eligible hospitals, as defined in s. 50.38 (1), other than critical access hospitals, under the Medical Assistance Program under this subchapter, including services reimbursed on a fee-for-service basis and services provided under a managed care system. For state fiscal year 2008-09, total payments required under this subdivision, including both the federal and state share of Medical Assistance, shall equal the amount collected under s. 50.38 (2) (a) for fiscal year 2008-09 divided by 57.75 percent. For each state fiscal year after state fiscal year 2008-09, total payments required under this subdivision, including both the federal and state share of Medical Assistance, shall equal the amount collected under s. 50.38 (2) (a) for the fiscal year divided by 61.68 44.21 percent.”.

SB70-SSA2-SA4,119,15 165. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,119,16 “ Section 121. 49.45 (3) (e) 12. of the statutes is amended to read:

SB70-SSA2-SA4,119,24 49.45 (3) (e) 12. The department shall use a portion of the moneys collected under s. 50.38 (2) (b) to pay for services provided by critical access hospitals under the Medical Assistance Program under this subchapter, including services reimbursed on a fee-for-service basis and services provided under a managed care system. For each state fiscal year, total payments required under this subdivision, including both the federal and state share of Medical Assistance, shall equal the amount collected under s. 50.38 (2) (b) for the fiscal year divided by 61.68 44.21 percent.”.

SB70-SSA2-SA4,120,1 166. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,120,2 “ Section 122. 49.45 (6xm) of the statutes is created to read:

SB70-SSA2-SA4,120,6 49.45 (6xm) Pediatric inpatient supplement. (a) From the appropriations under s. 20.435 (4) (b), (o), and (w), the department shall, using a method determined by the department, distribute a total sum of $2,000,000 in each state fiscal year to hospitals that meet all of the following criteria:

SB70-SSA2-SA4,120,7 1. The hospital is an acute care hospital located in this state.

SB70-SSA2-SA4,120,12 2. During the hospital's fiscal year, the inpatient days in the hospital's acute care pediatric units and intensive care pediatric units totaled more than 12,000 days, not including neonatal intensive care units. For purposes of this subdivision, the hospital's fiscal year is the hospital's fiscal year that ended in the 2nd calendar year preceding the beginning of the state fiscal year.

SB70-SSA2-SA4,120,17 (b) Notwithstanding par. (a), from the appropriations under s. 20.435 (4) (b), (o), and (w), the department may, using a method determined by the department, distribute an additional total sum of $10,000,000 in each state fiscal year to hospitals that are freestanding pediatric teaching hospitals located in Wisconsin that have a percentage calculated under s. 49.45 (3m) (b) 1. a. greater than 45 percent.”.

SB70-SSA2-SA4,120,18 167. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,120,19 “ Section 123. 49.45 (30p) of the statutes is created to read:

SB70-SSA2-SA4,120,20 49.45 (30p) Detoxification and stabilization services. (a) In this subsection:

SB70-SSA2-SA4,121,9 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.

SB70-SSA2-SA4,121,12 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.

SB70-SSA2-SA4,121,15 3. “Detoxification and stabilization services” means adult residential integrated behavioral health stabilization service, residential withdrawal management service, or residential intoxication monitoring service.

SB70-SSA2-SA4,121,24 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 healthcare. “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.

SB70-SSA2-SA4,122,13 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.

SB70-SSA2-SA4,122,18 (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.

SB70-SSA2-SA4,123,2 (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 par. 49.46 (2) (b) 14r. If the federal department disapproves the request, the department may not provide the reimbursement described in this subsection.

SB70-SSA2-SA4,124 Section 124. 49.46 (2) (b) 14r. of the statutes is created to read:

SB70-SSA2-SA4,123,5 49.46 (2) (b) 14r. Detoxification and stabilization services as specified under s. 49.45 (30p).”.

SB70-SSA2-SA4,123,6 168. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,123,7 “ Section 125. 49.45 (7m) of the statutes is created to read:

SB70-SSA2-SA4,123,15 49.45 (7m) Pay-for-performance; health information exchange. The department shall develop and implement for non-hospital providers in the Medical Assistance program, including physicians, clinics, health departments, home health agencies, and post-acute care facilities, a payment system based on performance to incentivize participation in health information data sharing to facilitate better patient care, reduced costs, and easier access to patient information. The department shall establish performance metrics for the payment system under this subsection that satisfy all of the following:

SB70-SSA2-SA4,123,17 (a) The metric shall include participation by providers in a health information exchange at a minimum level of patient record access.

SB70-SSA2-SA4,123,19 (b) The payment under the payment system shall increase as the participation level in the health information exchange increases.

SB70-SSA2-SA4,123,20 (c) The payment system shall begin in the 2024 rate year.

SB70-SSA2-SA4,123,22 (d) For purposes of the payment system, the department shall seek any available federal moneys.”.

SB70-SSA2-SA4,123,23 169. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,124,2 “ Section 126. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table - See PDF for table

SB70-SSA2-SA4,127 Section 127. 20.435 (1) (ex) of the statutes is created to read:

SB70-SSA2-SA4,124,6 20.435 (1) (ex) Maternal and infant mortality prevention and response. The amounts in the schedule for the prevention of and response to maternal and infant mortality under s. 253.143.

SB70-SSA2-SA4,128 Section 128. 253.143 of the statutes is created to read:

SB70-SSA2-SA4,124,10 253.143 Maternal and infant mortality prevention and response. From the appropriation under s. 20.435 (1) (ex), the department shall do all of the following:

SB70-SSA2-SA4,124,12 (1) Annually award grants to community organizations whose goal is the prevention of maternal and infant mortality.

SB70-SSA2-SA4,124,16 (2) Annually 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.

SB70-SSA2-SA4,124,18 (3) Provide funding and technical assistance to community-based organizations aimed at preventing infant morality.

SB70-SSA2-SA4,125,2 (4) Provide funding for grief and bereavement programming for those impacted by infant loss.

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

SB70-SSA2-SA4,125,8 (1) Maternal and infant mortality prevention and response. The authorized FTE positions for the department of health services are increased by 2.0 FTE positions, to be funded from the appropriation under s. 20.435 (1) (ex), for the purpose of administering the maternal and infant mortality prevention and response program.”.

SB70-SSA2-SA4,125,9 170. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,125,10 “ Section 9119. Nonstatutory provisions; Health Services.

SB70-SSA2-SA4,125,24 (1) Low-value care analysis grant. From the appropriation under s. 20.435 (1) (b), in the 2023-24 and 2024-25 fiscal years, the department of health services shall award a grant in an amount not to exceed $900,000 in each fiscal year to an organization for the purpose of conducting a data analysis of claims under the medical assistance program administered by the department of health services and claims under health care coverage plans offered by the state under s. 40.51 (6) to identify low-value care. The recipient of the grant under this subsection shall report the organization's findings, including any recommendations for providing effective and efficient care, to the department of health services and the department of employee trust funds. The department of health services and the department of employee trust funds shall distribute the findings reported under this subsection to health care providers that provide services covered by the medical assistance program or a health care coverage plan and to health maintenance organizations and insurance companies that provide health insurance to state employees.”.

SB70-SSA2-SA4,126,1 171. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,126,2 “ Section 129. 46.48 (36) of the statutes is created to read:

SB70-SSA2-SA4,126,9 46.48 (36) Amyotrophic lateral sclerosis. From the appropriation under s. 20.435 (1) (b), the department shall award $250,000 in each fiscal year as a grant to an organization that supports and provides services to individuals with amyotrophic lateral sclerosis for the purposes of assisting individuals diagnosed with amyotrophic lateral sclerosis and their families with the costs of respite care and costs associated with amyotrophic lateral sclerosis that are not covered by insurance.”.

SB70-SSA2-SA4,126,10 172. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,126,11 “ Section 130. 49.79 (9) (f) of the statutes is repealed.”.

SB70-SSA2-SA4,126,12 173. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,126,14 “ Section 131. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table

SB70-SSA2-SA4,132 Section 132. 20.435 (5) (ch) of the statutes is created to read:

SB70-SSA2-SA4,126,17 20.435 (5) (ch) Suicide and crisis lifeline grants. The amounts in the schedule for grants under s. 46.533.

SB70-SSA2-SA4,133 Section 133. 46.533 of the statutes is created to read:

SB70-SSA2-SA4,127,3 46.533 Suicide and crisis lifeline; grants. (1) In this section, “national crisis hotline” means the telephone or text access number “988,” or its successor, that is maintained under the federally administered program under 42 USC 290bb-36c.

SB70-SSA2-SA4,127,7 (2) From the appropriation under s. 20.435 (5) (ch), the department shall award grants to organizations that provide crisis intervention services and crisis care coordination to individuals who contact the national crisis hotline from anywhere within this state.”.

SB70-SSA2-SA4,127,8 174. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,127,9 “ Section 134. 46.482 (1) (a) of the statutes is renumbered 46.482 (1) (bm).

SB70-SSA2-SA4,135 Section 135. 46.482 (1) (am) of the statutes is created to read:

SB70-SSA2-SA4,127,13 46.482 (1) (am) “Certified peer specialist” means an individual described under s. 49.45 (30j) (a) 1m. who has met the certification requirements established by the department.

SB70-SSA2-SA4,136 Section 136. 46.482 (1) (b) of the statutes is renumbered 46.482 (1) (c) and amended to read:

SB70-SSA2-SA4,127,18 46.482 (1) (c) “Peer recovery coach” means an individual described under s. 49.45 (30j) (a) 2. 3. who has completed the training requirements specified under s. 49.45 (30j) (b) 4.

SB70-SSA2-SA4,137 Section 137. 46.482 (2) (a) of the statutes is amended to read:

SB70-SSA2-SA4,127,22 46.482 (2) (a) Use peer recovery coaches and certified peer specialists to encourage individuals to seek treatment for a substance use disorder following an overdose.

SB70-SSA2-SA4,138 Section 138. 46.482 (2) (f) of the statutes is amended to read:

SB70-SSA2-SA4,128,3 46.482 (2) (f) Collect and evaluate data on the outcomes of patients receiving peer recovery coach or certified peer specialist services and coordination and continuation of care services under this section.

SB70-SSA2-SA4,139 Section 139. 49.45 (30j) (title) of the statutes is amended to read:

SB70-SSA2-SA4,128,6 49.45 (30j) (title) Reimbursement for peer recovery coach and certified peer specialist services.

SB70-SSA2-SA4,140 Section 140. 49.45 (30j) (a) 1. and 2. of the statutes are renumbered 49.45 (30j) (a) 2m. and 3.

SB70-SSA2-SA4,141 Section 141. 49.45 (30j) (a) 1m. of the statutes is created to read:

SB70-SSA2-SA4,128,13 49.45 (30j) (a) 1m. “Certified peer specialist” means an individual who has experience in the mental health and substance use services system, who is trained to provide support to others, and who has received peer specialist or parent peer specialist certification under the rules established by the department.

SB70-SSA2-SA4,142 Section 142. 49.45 (30j) (bm) of the statutes is created to read:

SB70-SSA2-SA4,128,17 49.45 (30j) (bm) The department shall reimburse under the Medical Assistance program under this subchapter any service provided by a certified peer specialist if the service satisfies all of the following conditions:

SB70-SSA2-SA4,128,19 1. The recipient of the service provided by a certified peer specialist is in treatment for or recovery from a mental illness or a substance use disorder.

SB70-SSA2-SA4,128,21 2. The certified peer specialist provides the service under the supervision of a competent mental health professional.

SB70-SSA2-SA4,128,24 3. The certified peer specialist provides the service in coordination with the Medical Assistance recipient's individual treatment plan and in accordance with the recipient's individual treatment goals.

SB70-SSA2-SA4,129,3 4. The certified peer specialist providing the service has completed training requirements, as established by the department by rule, after consulting with members of the recovery community.

SB70-SSA2-SA4,143 Section 143. 49.45 (30j) (c) of the statutes is amended to read:

SB70-SSA2-SA4,129,7 49.45 (30j) (c) The department shall certify under Medical Assistance peer recovery coaches and certified peer specialists to provide services in accordance with this subsection.

SB70-SSA2-SA4,144 Section 144. 49.46 (2) (b) 14p. of the statutes is amended to read:

SB70-SSA2-SA4,129,10 49.46 (2) (b) 14p. Subject to s. 49.45 (30j), services provided by a peer recovery coach or a certified peer specialist.

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

SB70-SSA2-SA4,129,21 (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-SSA2-SA4,129,22 175. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,129,23 “ Section 145. 20.435 (4) (bm) of the statutes is amended to read:

SB70-SSA2-SA4,130,18 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 s. 46.73, 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).

SB70-SSA2-SA4,146 Section 146. 20.435 (4) (pa) of the statutes is amended to read: