AB50-ASA2-AA8,210,141349.45 (30p) Detoxification and stabilization services. (a) In this 14subsection: AB50-ASA2-AA8,211,4151. “Adult residential integrated behavioral health stabilization service” 16means a residential behavioral health treatment service, delivered under the 17oversight of a medical director, that provides withdrawal management and 18intoxication monitoring, as well as integrated behavioral health stabilization 19services, and includes nursing care on site for medical monitoring available on a 24-20hour basis. “Adult residential integrated behavioral health stabilization service” 21may include the provision of services including screening, assessment, intake, 22evaluation and diagnosis, medical care, observation and monitoring, physical 23examination, determination of medical stability, medication management, nursing
1services, case management, drug testing, counseling, individual therapy, group 2therapy, family therapy, psychoeducation, peer support services, recovery coaching, 3recovery support services, and crisis intervention services, to ameliorate acute 4behavioral health symptoms and stabilize functioning. AB50-ASA2-AA8,211,752. “Community-based withdrawal management” means a medically managed 6withdrawal management service delivered on an outpatient basis by a physician or 7other service personnel acting under the supervision of a physician. AB50-ASA2-AA8,211,1083. “Detoxification and stabilization services” means adult residential 9integrated behavioral health stabilization service, residential withdrawal 10management service, or residential intoxication monitoring service. AB50-ASA2-AA8,211,19114. “Residential intoxication monitoring service” means a residential service 12that provides 24-hour observation to monitor the safe resolution of alcohol or 13sedative intoxication and to monitor for the development of alcohol withdrawal for 14intoxicated patients who are not in need of emergency medical or behavioral health 15care. “Residential intoxication monitoring service” may include the provision of 16services including screening, assessment, intake, evaluation and diagnosis, 17observation and monitoring, case management, drug testing, counseling, individual 18therapy, group therapy, family therapy, psychoeducation, peer support services, 19recovery coaching, and recovery support services. AB50-ASA2-AA8,212,9205. “Residential withdrawal management service” means a residential 21substance use treatment service that provides withdrawal management and 22intoxication monitoring, and includes medically managed 24-hour on-site nursing 23care, under the supervision of a physician. “Residential withdrawal management
1service” may include the provision of services, including screening, assessment, 2intake, evaluation and diagnosis, medical care, observation and monitoring, 3physical examination, medication management, nursing services, case 4management, drug testing, counseling, individual therapy, group therapy, family 5therapy, psychoeducation, peer support services, recovery coaching, and recovery 6support services, to ameliorate symptoms of acute intoxication and withdrawal and 7to stabilize functioning. “Residential withdrawal management service” may also 8include community-based withdrawal management and intoxication monitoring 9services. AB50-ASA2-AA8,212,1410(b) Subject to par. (c), the department shall provide reimbursement for 11detoxification and stabilization services under the Medical Assistance program 12under s. 49.46 (2) (b) 14r. The department shall certify providers under the Medical 13Assistance program to provide detoxification and stabilization services in 14accordance with this subsection. AB50-ASA2-AA8,212,2215(c) The department shall submit to the federal department of health and 16human services any request for a state plan amendment, waiver, or other federal 17approval necessary to provide reimbursement for detoxification and stabilization 18services as described in this subsection. If the federal department approves the 19request or if no federal approval is necessary, the department shall provide the 20reimbursement under s. 49.46 (2) (b) 14r. If the federal department disapproves the 21request, the department may not provide the reimbursement described in this 22subsection. AB50-ASA2-AA8,36723Section 367. 49.46 (2) (b) 14r. of the statutes is created to read: AB50-ASA2-AA8,213,2
149.46 (2) (b) 14r. Detoxification and stabilization services as specified under s. 249.45 (30p).” AB50-ASA2-AA8,213,55(1) Complex patient pilot program. AB50-ASA2-AA8,213,66(a) In this subsection: AB50-ASA2-AA8,213,771. “Department” means the department of health services. AB50-ASA2-AA8,213,982. “Partnership group” means one or more hospitals in partnership with one 9or more post-acute facilities. AB50-ASA2-AA8,213,1310(b) The department shall use a competitive grant selection process to select 11partnership groups to be designated as participating sites for a complex patient 12pilot program under this subsection and, from the appropriation under s. 20.435 (7) 13(d), award grants to the groups selected. AB50-ASA2-AA8,213,1814(c) The department shall solicit feedback regarding the complex patient pilot 15program from representatives of healthcare system organizations, long-term care 16provider organizations, long-term care operator organizations, patient advocate 17groups, insurers, and any other organization determined to be relevant by the 18secretary of health services. AB50-ASA2-AA8,213,2119(d) The department shall require that each partnership group that applies to 20the department to be designated as a site for the complex patient pilot program 21shall address all of the following issues in its application: AB50-ASA2-AA8,214,2221. The number of complex patient care beds that will be set aside in a post-23acute facility or through implementation of an innovative model of patient care in a
1post-acute facility to which participating hospitals agree, such as dedicated staffing 2for dementia or a behavioral health unit. AB50-ASA2-AA8,214,432. Defined goals and measurable outcomes of the partnership group during 4the pilot program and after the pilot program. AB50-ASA2-AA8,214,853. The types of complex patients for whom care will be provided, which may 6include patients needing total care for multiple conditions or comorbidities such as 7cardiac and respiratory diseases, obesity, mental health, substance use, or 8dementia. AB50-ASA2-AA8,214,1194. An operating budget for the proposed site that details how fiscal 10responsibility will be shared among members of the partnership group and includes 11all of the following: AB50-ASA2-AA8,214,1312a. Estimated patient revenues from other sources, including the Medical 13Assistance program under subch. IV of ch. 49, and estimated total costs. AB50-ASA2-AA8,214,1414b. A margin to account for reserved beds. AB50-ASA2-AA8,214,16155. The partnership group’s expertise to successfully implement the proposal, 16which may include a discussion of the following issues: AB50-ASA2-AA8,214,1817a. Documented experience of the partners working together to serve complex 18patients. AB50-ASA2-AA8,214,2119b. The implementation timeline and the plan for post-acute facilities to accept 20admissions and transfer patients within 72 hours of a request submitted by a 21hospital. AB50-ASA2-AA8,215,222c. The plan for an interdisciplinary team that will staff the unit in the post-23acute facility, including the availability of staff with appropriate expertise that
1includes physicians, nurses, advance practice health professionals, pharmacists, 2physical therapists, occupational therapists, and social workers. AB50-ASA2-AA8,215,33d. Ability to electronically exchange health information. AB50-ASA2-AA8,215,54e. Resources to conduct patient intake and discharge planning from the post-5acute facility, including case managers and social workers. AB50-ASA2-AA8,215,86f. Ability to conduct monthly case management reviews with the 7interdisciplinary team for every complex care patient that cover care plan progress 8and any readmissions to an acute care hospital. AB50-ASA2-AA8,215,99g. Ability to conduct monthly quality assurance reviews. AB50-ASA2-AA8,215,1010h. Ability of the treatment model to be replicated by other healthcare systems. AB50-ASA2-AA8,215,1211i. Plans to document decreases in lengths of stay for complex patients in 12hospitals and avoided hospital days. AB50-ASA2-AA8,215,1713j. Documentation of stable finances among partnership group members to 14support the proposal, including matching funds that could be dedicated to the pilot 15program under this subsection. No applicant may be required to provide matching 16funds or a contribution, but the department may take into consideration the 17availability of matching funds or a contribution in evaluating an application. AB50-ASA2-AA8,215,1918k. Description of anticipated impediments to successful implementation and 19how the partnership group intends to overcome the anticipated impediments. AB50-ASA2-AA8,215,2120(e) In implementing this subsection, the department shall do all of the 21following: AB50-ASA2-AA8,216,2221. Develop a methodology to evaluate the complex patient pilot program and 23contract with an independent organization to complete the evaluation. The
1department may pay the fee of the organization selected from the appropriation 2under s. 20.435 (7) (d). AB50-ASA2-AA8,216,432. Give additional weight to partnership groups that would ensure geographic 4diversity. AB50-ASA2-AA8,216,75(f) Upon completion of the evaluation required under par. (e) 1., the 6independent organization contracted by the department to complete the evaluation 7shall provide the evaluation to the department. AB50-ASA2-AA8,216,149(1) Complex patient pilot program. In the schedule under s. 20.005 (3) for 10the appropriation to the department of health services under s. 20.435 (7) (d), the 11dollar amount for fiscal year 2025-26 is increased by $15,000,000 to fund, on a one-12time basis, a complex patient pilot program to help facilitate the transfer of complex 13patients from acute care settings, such as hospitals, to post-acute care facilities, in 14the 2025-27 biennium.”. AB50-ASA2-AA8,216,211720.435 (5) (bw) Child psychiatry and addiction medicine consultation 18programs Mental health consultation program. Biennially, the amounts in the 19schedule for operating the child psychiatry consultation program under s. 51.442 20and the addiction medicine consultation program under s. 51.448 mental health 21consultation program under s. 51.443. AB50-ASA2-AA8,217,22320.435 (5) (bx) Addiction medicine consultation program. Biennially, the
1amounts in the schedule for operating the addiction medicine consultation program 2under s. 51.448. AB50-ASA2-AA8,217,7751.443 Mental health consultation program. (1) In this section: AB50-ASA2-AA8,217,108(a) “Participating clinicians” includes physicians, nurse practitioners, 9physician assistants, and medically appropriate members of the care teams of 10physicians, nurse practitioners, and physician assistants. AB50-ASA2-AA8,217,1211(b) “Program” means the mental health consultation program under this 12section. AB50-ASA2-AA8,217,2113(2) During fiscal year 2025-26, the department shall contract with the 14organization that provided consultation services through the child psychiatry 15consultation program under s. 51.442, 2023 stats., as of January 1, 2025, to 16administer the mental health consultation program described under this section. 17Beginning in fiscal year 2026-27, the department shall contract with the 18organization that provided consultation services through the child psychiatry 19consultation program under s. 51.442, 2023 stats., as of January 1, 2025, or another 20organization to administer the mental health consultation program under this 21section. AB50-ASA2-AA8,218,422(3) The contracting organization under sub. (2) shall administer a mental 23health consultation program that incorporates a comprehensive set of mental
1health consultation services, which may include perinatal, child, adult, geriatric, 2pain, veteran, and general mental health consultation services, and may contract 3with any other entity to perform any operations and satisfy any requirements under 4this section for the program. AB50-ASA2-AA8,218,65(4) As a condition of providing services through the program, the contracting 6organization under sub. (2) shall do all of the following: AB50-ASA2-AA8,218,147(a) Ensure that all mental health care providers who are providing services 8through the program have the applicable credential from this state; if a psychiatric 9professional, that the provider is eligible for certification or is certified by the 10American Board of Psychiatry and Neurology for adult psychiatry, child and 11adolescent psychiatry, or both; and if a psychologist, that the provider is registered 12in a professional organization, including the American Psychological Association, 13National Register of Health Service Psychologists, Association for Psychological 14Science, or the National Alliance of Professional Psychology Providers. AB50-ASA2-AA8,218,1615(b) Maintain the infrastructure necessary to provide the program’s services 16statewide. AB50-ASA2-AA8,218,1817(c) Operate the program on weekdays during normal business hours of 8 a.m. 18to 5 p.m. AB50-ASA2-AA8,218,2019(d) Provide consultation services under the program as promptly as is 20practicable. AB50-ASA2-AA8,219,221(e) Have the capability to provide consultation services by, at a minimum, 22telephone and email. Consultation through the program may be provided by
1teleconference, video conference, voice over Internet protocol, email, pager, in-2person conference, or any other telecommunication or electronic means. AB50-ASA2-AA8,219,33(f) Provide all of the following services through the program: AB50-ASA2-AA8,219,541. Support for participating clinicians to assist in the management of mental 5health concerns. AB50-ASA2-AA8,219,862. Triage-level assessments to determine the most appropriate response to 7each request, including appropriate referrals to any community providers and 8health systems. AB50-ASA2-AA8,219,993. When medically appropriate, diagnostics and therapeutic feedback. AB50-ASA2-AA8,219,11104. Recruitment of other clinicians into the program as participating clinicians 11when possible. AB50-ASA2-AA8,219,1212(g) Report to the department any information requested by the department. AB50-ASA2-AA8,219,2213(h) Conduct annual surveys of participating clinicians who use the program to 14assess the quality of care provided, self-perceived levels of confidence in providing 15mental health services, and satisfaction with the consultations and other services 16provided through the program. Immediately after participating clinicians begin 17using the program and again 6 to 12 months later, the contracting organization 18under sub. (2) may conduct assessments of participating clinicians to assess the 19barriers to and benefits of participation in the program to make future 20improvements and to determine the participating clinicians’ treatment abilities, 21confidence, and awareness of relevant resources before and after beginning to use 22the program. AB50-ASA2-AA8,220,323(5) Services provided under sub. (4) (b) to (h) are eligible for funding from the
1department. The contracting organization under sub. (2) also may provide any of 2the following services under the program that are eligible for funding from the 3department: AB50-ASA2-AA8,220,64(a) Second opinion diagnostic and medication management evaluations and 5community resource referrals conducted by either a psychiatrist or allied health 6professionals. AB50-ASA2-AA8,220,97(b) In-person or web-based educational seminars and refresher courses on a 8medically appropriate topic within mental or behavioral health care provided to any 9participating clinician who uses the program. AB50-ASA2-AA8,220,1010(c) Data evaluation and assessment of the program. AB50-ASA2-AA8,220,1712(1) Comprehensive mental health consultation program. In the 13schedule under s. 20.005 (3) for the appropriation to the department of health 14services under s. 20.435 (5) (bw), the dollar amount for fiscal year 2025-26 is 15increased by $2,000,000 and the dollar amount for fiscal year 2026-27 is increased 16by $2,000,000 to support a comprehensive mental health consultation program 17under s. 51.443.”. AB50-ASA2-AA8,221,520(1) Contracted community services. In the schedule under s. 20.005 (3) for 21the appropriation to the department of health services under s. 20.435 (2) (bj), the 22dollar amount for fiscal year 2025-26 is increased by $3,742,500 to fund contracts 23for community-based mental health services for the treatment and monitoring for
1forensic and sexually violent persons programs. In the schedule under s. 20.005 (3) 2for the appropriation to the department of health services under s. 20.435 (2) (bj), 3the dollar amount for fiscal year 2026-27 is increased by $6,305,000 to fund 4contracts for community-based mental health services for the treatment and 5monitoring for forensic and sexually violent persons programs.”. AB50-ASA2-AA8,221,88(1) Coverage of continuous glucose monitoring devices. AB50-ASA2-AA8,221,139(a) In the schedule under s. 20.005 (3) for the appropriation to the department 10of health services under s. 20.435 (4) (b), the dollar amount for fiscal year 2026-27 is 11increased by $4,647,100 to support the cost of providing coverage for continuous 12glucose monitoring devices and insulin pumps for diabetic care as a pharmacy 13benefit. AB50-ASA2-AA8,221,1814(b) In the schedule under s. 20.005 (3) for the appropriation to the department 15of health services under s. 20.435 (4) (j), the dollar amount for fiscal year 2026-27 is 16increased by $9,600,000 to support the cost of providing coverage for continuous 17glucose monitoring devices and insulin pumps for diabetic care as a pharmacy 18benefit.”. AB50-ASA2-AA8,221,212149.45 (30t) Doula services. (a) In this subsection: AB50-ASA2-AA8,221,23221. “Certified doula” means an individual who has received certification from 23a doula certifying organization recognized by the department.
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